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Weight management methods include multiple surgeries to shrink the stomach and keep you from being hungry

Weight management is popular nowadays, and there are many methods. Dr. Wong Kin-hung, Honorary Clinical Associate Professor of the Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, pointed out that weight can generally be managed through diet and exercise, followed by medication. When medications and diet are not effective, other auxiliary methods may be needed, including surgery and non-surgery.

Huang Jianhong pointed out that there are surgical and non-surgical methods to help patients with diseases caused by obesity manage their weight.

Who needs weight management? Huang Jianhong said that the simplest indicator is the BMI body mass index, which is weight (kg) / height (meter) 2. “Theoretically, the normal BMI level for Asians is 23, and if it exceeds 28.5, it is defined as obesity. Although BMI is just a number , but if obesity has caused internal medical diseases in the body, such as high blood pressure, sleep apnea, fatty liver, etc., weight management needs to be seriously considered.” When drugs and diet are not effective, you can consider the following three commonly used aids method.

The first step in weight management is improving your eating habits.

Water balloon placed in the stomach: 10% to 14% weight loss

Huang Jianhong said that this is a non-surgical treatment. “It mainly uses a gastroscope to put the capsule into the patient’s stomach through the esophagus. Some patients can swallow the capsule on their own. Then about 500 ml of water is injected into the capsule to expand it into a water balloon. The water balloon is then left in In the stomach, on the one hand, it makes the stomach itself feel full for a long time. On the other hand, when a certain amount of food is eaten, the water ball will move and block the gastric outlet like a valve, so that the patient can no longer eat too much, thereby controlling the food intake to achieve reduction. Serious effects. Of course, at the same time, guidance and assistance from a nutritionist is also needed to adjust a suitable diet.”

The water balloon is always a foreign object and is not permanent. It needs to be removed in about 4 months to a year. Generally, it can reduce 10% to 14% of the body weight. Patients need to improve their overall lifestyle habits such as diet and exercise during the period when the water balloon is placed, and maintain it after the water balloon is removed, in order to achieve sustained weight loss. “There are also cases where water balloons are removed and then supplemented with weight loss drugs. In addition, water balloons can also be used as auxiliary treatment before surgery. It is easier to achieve the desired effect by losing part of the weight first and then performing ‘gastric reduction surgery.'” Huang Jianhong said.

Gastric reduction surgery: reduce body weight by 20% to 30%

Gastric reduction surgery is a permanent treatment. “Simply put, it involves endoscopic resection of the “greater curvature” of the stomach, changing its shape from a bag to a tube-like shape. There is no place for food storage, leaving only a passage for food. , the purpose is to reduce the capacity of the stomach. Secondly, the greater curvature of the stomach itself secretes hunger hormone (ghrelin). This hormone is greatly reduced after resection, and it is not easy to feel hungry even if the food intake is small. Many patients only eat food every day after surgery You won’t feel hungry even if you eat 800 to 1,000 calories, and you won’t be looking for something to eat everywhere, so the weight loss effect is more significant, and you can generally reduce your weight by 20% to 30%.”

Gastric reduction surgery is permanent. Some patients are more likely to suffer from acid reflux after surgery. Generally speaking, as long as they gradually develop new living habits and cooperate with eating speed and weight, acid reflux will be alleviated. Although the surgery itself is minimally invasive, it also requires general anesthesia and carries certain risks. Not every patient may accept it. Therefore, there is another surgery that falls somewhere between water balloon and gastric shrinkage: endoscopic gastric suturing.

Endoscopic gastric suturing: still secretes hunger hormone

Huang Jianhong pointed out that endoscopic gastric suturing is also a permanent method. “The method is to extend the endoscope into the stomach and tie up the greater curvature of the stomach, thereby narrowing the gastric capacity. The advantage is that there is no need to remove the greater curvature of the stomach. , there are no wounds, it is a choice between surgery and non-surgery, and it requires general anesthesia. Also, because the greater curvature of the stomach is still there, that is, ghrelin is still secreted, so the patient’s feeling of hunger will be stronger, depending on the patient’s condition. choose.”

2024-02-15 20:29:52

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Seek medical attention early if you have severe cough and thick phlegm due to sequelae of pneumonia.

Recently, due to the attack of the new coronavirus and the flu, many people have a few coughs. If the condition is not properly treated, it is more likely to develop into pneumonia. In severe cases, it can lead to long-term lung damage, reduced lung function and other sequelae. Therefore, if you have cough symptoms, especially if you cough up thick, yellow-green or bloody sputum, you must seek medical advice as soon as possible.

Respiratory system specialist Dr. Tan Zijun said that pneumonia refers to the infection and inflammation of lung tissue, which can affect a single lobe or both lungs. “The most common cause is bacterial infection, such as pneumococcus, Legionella and Mycobacterium tuberculosis. Secondly, it is viral infection. Others can also cause pneumonia due to fungal, parasitic infection, or inhalation of harmful substances.”

Tan Zijun said that children, the elderly and patients with chronic diseases are at greater risk of contracting pneumonia.

or chest pain accompanied by fever

Having an upper respiratory tract infection does not necessarily lead to pneumonia, but it can increase your risk. As for how patients can tell whether their lungs are infected, Tan Zijun said, “Upper respiratory tract infections are often accompanied by nasal congestion, sore throat and cough, and the cough may be dry or have a small amount of phlegm. Pneumonia coughs usually contain phlegm and are more common. It is sticky and may be accompanied by symptoms such as fever, chest pain and difficulty breathing. Please note that cough alone may not be able to accurately distinguish, and if you have any suspicion, you should seek medical advice as soon as possible.”

If fibrosis occurs in the lungs, it will reduce lung capacity and affect lung function.

Lung function or impairment

Pneumonia can cause a variety of complications, which are more likely to occur in the elderly, patients with chronic diseases or those with compromised immune function, such as pneumonitis, sepsis and respiratory failure, which can lead to serious consequences and even death. Tan Zijun continued, “Even if they can recover from pneumonia, some patients still have to face sequelae.”
‧Pulmonary fibrosis: Lung tissue becomes fibrotic due to infection and inflammation, that is, connective tissue hyperplasia, leading to impaired lung function.
‧Lung abscess and empyema: A mass of pus forms in the lung tissue. Empyema is a condition in which pus accumulates around the lung membrane.
‧Bronchiectasis: Bronchiectasis makes the respiratory tract susceptible to infection and inflammation.

Recoverable with appropriate treatment

Pneumonia treatment depends on the cause of the pneumonia. Doctors will also use tools such as the Pneumonia Severity Index and CURB-65 scoring system to assess the patient’s risk and formulate a personalized treatment plan. Tan Zijun explained, “Bacterial pneumonia is usually treated with antibiotics, while viral pneumonia is mainly treated with supportive symptoms. Adequate rest, adequate fluid intake, antipyretic drugs, and symptom-relieving drugs may be used to relieve symptoms. In severe cases, will require hospitalization. Most healthy people can recover with appropriate treatment, but recovery time varies depending on the severity of the condition and the individual’s health. During treatment, it is very important to follow your doctor’s instructions and complete the entire course of treatment. important.”

good personal hygiene

To prevent pneumonia, you can get pneumococcal vaccine and influenza vaccine to reduce the risk of infection, especially the elderly, young children, long-term smokers or people with chronic diseases. In addition, although it is a cliché, maintaining good personal hygiene, washing hands frequently, avoiding contact with sick people, maintaining social distance, and regularly cleaning and disinfecting frequently touched surfaces can all help prevent infection. Maintaining a balanced diet, adequate sleep, moderate exercise and stress reduction can enhance personal immunity.

2024-01-18 20:28:41

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Health Decoding｜Serotype B meningococcal cases increase. Doctors urge vaccination before traveling to study abroad to increase protection

Neisseria meningitidis can cause brain damage, and severe cases are more likely to die within 24 hours. However, Hong Kong people are not sufficiently aware of this disease. Some family medicine specialists pointed out that the mainland’s infant vaccine program has already eliminated meningitis. The diplococcal vaccine is included as one of the required vaccines. Schools in foreign places, such as the United States, the United Kingdom, and Australia, will require students to receive the meningococcal vaccine before entering school, and encourage students to travel or allow their children to study abroad. Parents pay attention.

Meningitis refers to an inflammatory reaction caused by microbial infection or other causes in the meninges surrounding the brain and spinal cord, and Neisseria meningitidis is one of the common bacterial meningitis. Zhu Weixing, a specialist in family medicine, said that 10 to 35% of adults are long-term carriers of Neisseria meningitidis. They can spread it through droplets produced by coughing or sneezing, or through direct contact with respiratory secretions of patients, and their immunity is relatively low. Children, teenagers, elderly people aged 65 or above, and people with weakened immune systems congenitally or due to disease are more susceptible to infection.

May cause brain damage and mental decline

“The initial symptoms of meningococcal infection are similar to those of a cold, such as high fever, severe headache, stiff neck, vomiting, photophobia, ecchymosis on the skin, rash, etc. The condition can worsen within a few hours, and in severe cases Death may occur within 24 hours, and patients may also develop serious symptoms, such as brain damage, mental retardation, mental retardation, deafness, and electrolyte imbalance, which must not be ignored.”

Dr. Zhu Weixing said that Neisseria meningitidis, also known as meningococcal meningitis (meningococcal meningitis for short) in the Mainland, has long been included in the infant vaccine program as one of the required preventive vaccines. However, studies in recent years have shown that it is not included in the list. The serotypes of Neisseria meningitidis included in the original vaccine have begun to increase. Whether in the Mainland or Hong Kong, serotype B has accounted for the majority of cases in recent years.

According to data, the most common meningococcal infection cases in the Mainland belong to serotype B, which has increased sharply from about 22% of cases before 2015 to 52% after 2015. In addition, after the COVID-19 epidemic, the global epidemiology of many bacteria and viruses has changed. Meningococci are rampant in different regions, and type B is particularly common, including the United Kingdom and Australia.

Serotype B can cause serious complications

“The biological structure of meningococci of serotype B is quite special, so it has not been able to be combined with other serotypes of meningococci into the same vaccine for prevention. However, the most worrying thing is that meningococci of serotype B are The seriousness of cocci is higher. Once infected, there is a greater chance of serious complications. Even if it is not life-threatening, there is still a chance of disability, because the bacteria will stretch to the periphery along with the meningeal nerves, and inflammation will occur throughout the area, causing The meninges become thick and swollen, and may produce a lot of pus. Even with antibiotic treatment, if the meninges are injured, such as hardening or stenosis, they will compress the nerves and even cause cerebral edema. It can also cause Other complications, such as inflammation of the heart muscle.”

Dr. Zhu Weixing emphasizes that prevention is better than cure: “No matter how many cases of meningococcal infection there are and how high the risk of infection is, once complications occur after infection, the impact on the person concerned will be 100%, especially if this disease has It may cause many sequelae, especially for children, which may greatly reduce their intelligence, mobility, and even self-care ability.” Parents are called on to vaccinate their children with the meningococcal preventive vaccine targeting the correct serotype as early as possible to enhance protection.

Zhu Weixing, a specialist in family medicine, said that once infected with meningococci, patients may have many sequelae, and early prevention is recommended.

2024-01-15 23:30:00

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