Drinking coffee is a power medicine against Non-Alcoholic Fatty Liver Disease (NAFLD). NAFLD is a frequent disorder due to overweight and diabetes, that may lead to severe complications like liver cirrhosis and cancer. The consequences of Fatty liver diseases represent the first cause of liver transplantation. The best prevention and treatments of NAFLD are diet and exercise. But analysis of several international studies including over 2 million patients shows that drinking two or more cups of coffee per day reduces the risks of developing liver fibrosis, cirrhosis and cancer. The risk of cirrhosis is reduced by 47%. Reference: Dr Manal F Abdelmalek communication at Gastroenterology Updates, IBD, Liver Disease Conference, Feb. 2021

Everyone knows that lifestyle measures such as adjusting food patterns and increasing physical activities help to prevent or ameliorate diabetes type 2. However, what is not generally known is that sitting too much can worsen health conditions such as diabetes type 2. Research has shown that there is a new important modifiable lifestyle factor and that is “the time spent sitting”. Prolonged sitting time is associated with high blood sugar levels. Standing up or walk every 15 minute for about 3 minutes is enough to control the blood sugar throughout the day. The reason for this is that even small exercise make the body’s muscles work allowing sugar in the blood to enter cells and fuel the body. At the same time blood sugar levels reduce. Standing or walking during work, taking calls, during meetings or watching TV thus appears to be a very good idea. This of course next to the advices given by your doctor or other health care professionals. Reference: Paing AC et al Prev.Med.Reports 2018;12:94-100 and The Conversation May 11, 2021.

Vaccination changes the genes. this is untrue, the genes remain unchanged. The (RNA) vaccines do not enter the cells and thus also do not reach/affect DNA which is in the cell nucleus. The genes are made up of DNA. Vaccine development was too quick to be safe. Untrue, the development was quicker than usual because several steps usually performed after each other have now been done simultaneously. Also administrative procedures have been accelerated. However, every step, every procedure has been followed, so safety and efficacy are ensured. Vaccine side-effects. There are side-effects, but they are usually mild and consist of flue-like symptoms such as muscle and joint-pain, tiredness and unwellbeing, headache. They usually last a few days and are not dangerous. Actually it is a sign that the immune system is active and that is exactly the effect which is wanted. Also slight pain at the site of injection can occur and this is also short-lasting. There are more serious side-effects, but they are very rare. Infertility. This is absolutely no side-effect of the vaccines. However, there is limited research that Covid 19 itself may have a negative effect on fertility in men. Risk of allergy. The risk is limited […]

Internists are experts in diagnosing, treating and caring for adult patients. They often serve as medical consultants to physicians in other specialties. In some countries internists may specialize in general primary care of adults (for instance in Switzerland); they can also take additional training and “subspecialize” in such areas as endocrinology, hematology/oncology, immunology. Cardiology, pulmonology, gastroenterology and reumatology ususally are independent subspecialties. What is internal medicine? (European definition): The specialty of internal medicine covers a wide range of conditions affecting the internal organs of the body. Although some diseases specifically affect individual organs, the majority of common diseases may affect many internal organs of the body. The internist must then be trained to recognise and manage a broad range of diseases and, with the aging population, many patients with chronic and multiple disorders.

Although everyone knows that cycling is good for overall health, this has now scientifically been proven for persons with diabetes. In a longitudinal European study in 10 countries, the benefits of cycling in a large cohort of persons with diabetes (110,944 person years; 7459 persons) have been reported. Cycling for between 1 to 5 hours per week was associated with at least 24 % lower all-cause and CVD (cardiovascular disease) mortality when compared with non-cyclists, independent of other physical activities and possible confounders. Usually 4 – 5 hours of exercise per week is the recommended time to improve health. Taking up cycling for a 5-year period was associated with at least 35 % lower risk of all-cause and CVD mortality. These relations are stronger than the earlier reported beneficial effects of walking, probably because cycling is more intensive than walking. Cycling should be encouraged as an activity for persons with diabetes to reduce the risk of premature death.

A prospective cohort study from the US was performed in  2110 young adults of 38 to 50 years, wearing an accelerometer. Patients were followed during a mean of 10,8 years. Daily steps were classified as low (< 7000 steps/d), moderate (7000 – 9999 steps/d) and high ( > 10000 steps/d) and stepping intensity as peak 30-minute-stepping rate and time spent at 100 steps/min or more. Outcome prameter was all-cause mortality. During the follow-up period 72 patients (3.4 %) died. There was significantly lower risk of mortality in the moderate and high step groups. This lower risk was about equal in Black and White participants and also in women. There was, however, no association of step intensity with mortality.

A pooled cohort study was done in 20.065 English (9.254) and Chinese (10.811) aged people with a mean age of 64.6 years (UK) and 57.8 years (China) and a median follow-up of respectively 8 and 4 years. The proportion of females and males was approximately equal. During 100.000 person-years of follow-up global cognitive sccores in individuals with 4 hours or less and 10 hours or more of sleep per night declined faster than in the reference group (7 hours per night). The sleep duration per night was self-reported according to face-to-face interviews. An inverted U-shaped association between sleep duration and global cognitive decline was also observed. It is concluded that cognitive function should be monitored in individuals with insufficient (≤ 4 hours per night) or excessive ( ≥ 10 hours per night) sleep duration. Future studies should examine the mechanism of the association between sleep duration and cognitive decline.

Unwanted loss of appetite after major abdominal surgery is a common problem and has significance for the prognosis of the patient. The cause lies in a reduced gastric reservoir, combined with a decrease in the formation of ghrelin ( an appetite promoting hormone ) in the stomach and decreased secretion of satiety hormones in the small bowel. German investigators conducted a systemic review into this problem. They concluded that research into the problem is limited and heterogeneous. The studies analyzed include 20.506 patients. The only treatment with a high burden of proof was chewing chewing gum, measured on the basis of the time until the first feeling of hunger. Next to that diet guidance, watching cooking shows and “rikkunshito” (a traditional Japanese herbal remedy) could stimulate appetite. Administration of sophisticated drugs such as ghrelin intravenously and 5-HT-agonists respectively showed various results or were investigated only once. Appetite stimulants such as cannabinoids and corticosteroids have not been investigated in surgical patients. Unfortunately, it was not mentioned by the authors whether peppermint or a more sweet flavour of the gum had a better effect.