Stress management for hipertensi

 Various definitions of stress that can be understood. That stress itself according to (Kaplan, 2006 in Hawari 2012), is a condition or the body's response to any pressures and demands generated by it changes in the environment, whether from favorable conditions or not pleasant. Stress is a reality of everyday life that cannot be avoid by all people, stress or emotional tension can affect the cardiovascular system (Marliani, 2007). 

Unbelievable stress as a psychological factor that can increase blood pressure

The etiology of stress itself is a factor causing deep trauma development of post-traumatic stress disorder in developmental disorders post traumatic stress. But not everyone experiences stress disorder post-traumatic after a traumatic event. Sources of stress quoted by (Sarwono, 1988 in Syam, 2014) distinguishes the sources of stress, namely within the individual, family, community and society.

The sources of stress in a person can sometimes come from

in a person. For example, through pain (Budi Keliat, 2002).

The level of stress that arises in a person through an assessment of multifacial forces that fight when someone experiences conflict. Furthermore, the sources of stress in the family; stress here can sourced from interactions among family members such as; dispute in family matters of finances, feelings of mutual indifference.

Furthermore, the sources of stress in the community and environment;

Enter the stress approaches according to several authors.

(Sytherland & Cooper, 1990) stress among others can be conceptualized from various points/views including: Stress as a stimulus, ie

The first approach focuses on the environment and describe stress as a stimulus. Hippocrates believed that The health characteristics of these diseases are coordinated by the environment external (Sutherland & Cooper, 1990). Furthermore, stress as a response,

What is meant in this approach focuses on a person's reaction to the stressor as a response (or the stress of a variable depending) the response referred to here is the response that contains two components, namely psychological and physiological components. Then stress

as the individual's interaction with the individual's environment will provide

different stress reactions to the same stressor for example we can

Observe the behavior of people in traffic. People trapped in the past

Continuous traffic will look at the clock while there is also a quiet one

just. In fact, it is not uncommon to still be able to enjoy music (Budi Keliat, 2002).

The stress response can be divided into two, namely the components

psychology as well as physiology.

Signs and symptoms each person has a different response

to stress experienced, so the symptoms are also different.

As expressed by (Munajat, 2000 in Syam 2014), namely;

physical symptoms which include rapid breathing, dry lips, clammy hands, feeling

hot and hot, tense muscles, diarrhea or constipation, tired easily,

Symptoms and food for diabetes

The symptoms of diabetes mellitus may include:

1. Frequent thirst.

2. Persistent hunger.

3. Increased urination, particularly during the night.

4. Unexplained weight loss.

5. Loss of muscle mass.

6. Frequent fatigue.

7. Blurred vision.

8. Slow-healing wounds.

9. Recurrent infections, such as those affecting the gums, skin, vagina, or urinary tract.

Individuals with diabetes can still include sweet foods in their diet, but it should be done with specific guidelines, such as:

1. Consume sweet treats infrequently and in small portions.

2. Offset sweet food intake with other nutritional elements like vegetables, nuts, and lean proteins such as fish.

3. Opt for fiber-rich foods, such as soybeans, which are not only high in protein but also fiber, promoting prolonged feelings of fullness.

4. Reduce the consumption of high-carbohydrate sources like white rice, refined pasta, white bread, potatoes, and corn.

5. Examine nutrition labels on food packaging to determine the sugar and carbohydrate content.

Living alone with a blood cancer

Living alone with a blood cancer. Living as an independent person is important for many young people, but it may be very challenging to keep the spirits up and continue to be positive, if you are living alone with a blood cancer. You may be someone who normally appreciates your independence; however being unwell may make you feel lonely and isolated.

The possibility of having to sacrifice your current living situation on top of the diagnosis of a blood cancer is all very overwhelming.  There are aspects of living with a blood cancer that can make it difficult to manage everyday life, such as grocery shopping and cleaning.

Some young adults may feel comfortable with temporarily moving home with family or whanau whilst they undergo treatment for their blood cancer. For many young adults this is simply not an option, and for those individuals there is support available to help them through this time and remain living independently.

Ask to speak to your social worker who will be able to help you to remain as independent as possible.

If you are living alone it is important that you:

•  • Put together a list of emergency contacts in case you do unexpectedly become unwell. 
•  • Let friends, family, whanau and neighbours know about what could happen so if you call them in an emergency, they will know what to do and who to call. Your doctors and nurses will also give you a list of 24 hour emergency contact numbers to use in such circumstances.

It is okay to accept help. Family and friends who care about you may want to help in any way they can, and it is sometimes difficult to accept this help when you have previously lived so independently.  Some family, whanau and friends may find it difficult to talk openly about your blood cancer, but would be happy to help in more practical ways, such as doing your shopping or helping with your house cleaning and transporting you to doctors’ appointments.

Accepting support offered may make living alone easier, and therefore enable you to retain your independence. Although you may want to stay independent for as long as possible, remember that it is okay to ask for help when you need it. Being independent is about finding the right balance between acknowledging when you need support and looking after yourself.

Breast cancer molecular alteration

Molecular alterations The most frequently mutated and/or amplified genes in the tumour cells are TP53 (41% of tumours), PIK3CA (30%), MYC (20%), PTEN (16%), CCND1 (16%), ERBB2 (13%), FGFR1 (11%) and GATA3 (10%), as reported in a series of early breast cancers. These genes encode cell-cycle modulators that are either repressed (for example, p53) or activated (for example, cyclin D1), sustaining proliferation and/or inhibiting apoptosis, inhibiting oncogenic pathways that are activated (MYC, HER2 and FGFR1) or inhibiting elements that are no longer repressed (PTEN).

The majority of the mutations affecting 100 putative breast cancer drivers are extremely rare, therefore, most breast cancers are caused by multiple, low-penetrant mutations that act cumulatively. Luminal A tumours have a high prevalence of PIK3CA mutations (49%), whereas a high prevalence of TP53 mutations is a hallmark of basal-like tumours (84%).

For TNBC, different molecular drivers under- line its subtypes. At the metastatic stage, specific predictive alterations, such as PIK3CA mutations, can be easily detected non-invasively in the plasma in circulat- ing tumour DNA rather than on tumour biopsy; never- theless, depending on the technology used, the level of sensitivity may vary. 

Epigenetic alterations are involved in breast carcinogenesis and progression. In breast cancer, genes can be either globally hypomethylated (leading to gene activation, upregulation of oncogenes and chromosomal instability) or, less frequently, focally (locus-specific) hypermethylated (leading to gene repression and genetic instability due to the silencing of DNA repair genes).

Other epigenetic mechanisms involve histone tail modifications by DNA methylation, inducing chromatin structure changes to silence gene expression and nucleosomal remodelling. These changes are reversible, enzyme-mediated and potentially targetable. For example, in luminal-like breast cancer cell lines, inhibition of histone deacetylase with specific inhibitors such as vorinostat or chidamide can reverse resistance to endocrine therapy via inhibition of the resistance pathway driven by epidermal growth factor receptor signalling.

Recently, a phase III trial in metastatic luminal breast cancer showed the superiority of a treatment combining chidamide with endocrine therapy (namely, the aromatase inhibitor exemestane) to exemestane alone.

Immune crosstalk in breast cancer

Immune crosstalk in breast cancer. The immune reaction to breast cancer is initiated by the neoantigens expressed by tumour cells, encoded by altered genes and presented by antigen-presenting cells (APCs) on major histocompatibility complex class I (MHC I) or MHC II molecules. Neoantigen presentation results in activation of CD8+ (cytotoxic) and CD4+ (helper) T cells. CD8+ T cells are the main effector cell of the anti-tumour immune response; their activation (principally through the T cell receptor (TCR)) results in release of the cytolytic molecules perforin and granzyme B, which directly induce tumour cell lysis.

The anti-tumour action of CD8+ T cells is amplified by cytokines secreted from CD4+ T cells, namely IFNγ, IL-2 and tumour necrosis factor (TNF). Activated CD8+ T cells also upregulate expression of Fas ligand (FasL) and TNF-related apoptosis-inducing ligand (TRAIL; also known as TNFSF10) on their membrane, which induce apoptotic pathways to kill tumour cells.

Cancer cells elicit an innate immune response, comprising natural killer (NK) and NK T cells that are capable of direct tumour cell killing. Malignant cells can suppress the immune response by expressing immune checkpoint regulators (for example, cytotoxic T lymphocyte-associated protein 4 (CTLA-4) and programmed cell death 1 ligand 1 (PD-L1)), which are upregulated by effector T cells as a consequence of chronic exposure to tumour antigens (T cell exhaustion).

The reduced anti-tumour immune response by upregulated immune checkpoint molecules establishes a pro-tumour microenvironment, which is further enriched by recruitment of immunosuppressive cells, T regulatory (Treg) cells and myeloid-derived stromal cells (MDSCs). Treg cells, which inhibit activation of CD4+ and CD8+ T cells, are induced by tumour-associated macrophages (TAMs) and by tumour-secreted and cancer-associated fibroblast (CAF)-secreted factors, such as transforming growth factor-β (TGFβ).

 In addition, TAMs and Treg cells inhibit APCs via IL-10 secretion, inducing a tolerogenic state of APCs. MDSCs are recruited to the tumour bed by tumour-secreted factors, inhibit trafficking of T cells to the tumour bed and inhibit effector T cell activation by upregulating 2,3-indoleamine- dioxygenase (IDO) and arginase expression, enzymes involved in the T cell nutrient depletion.

The secretome of the pro-tumour microenvironment, containing factors that stimulate angiogenesis and invasion (such as vascular-endothelial growth factor (VEGF) and matrix metalloproteinases (MMPs)) also contribute to tumour immune escape and propagation. CCL22, CC-chemokine ligand 22; CXCL16, CXC-chemokine ligand 16; NOS, nitric oxide synthase; PD-1, programmed cell death 1; RANKL, receptor activator of nuclear factor-κB (RANK) ligand; TH1 cell, type 1 T helper cell. Adapted from ref. 75, CC-BY-4.0 https://creativecommons.org/licenses/by/4.0/

Causes and symptoms of cholesterol

Causes of Cholesterol

 If the cholesterol level in the blood exceeds the normal level, then this condition is known as hypercholesterolemia or high cholesterol. High cholesterol conditions can increase the risk of serious diseases. Cholesterol itself is a waxy fat compound which is mostly produced in the liver and some of it is obtained from food. Generally, heart attack and stroke are diseases that lurk with high cholesterol, which is caused by excessive cholesterol deposition in blood vessels. 

 Based on a report from WHO in 2011, about 35 percent of Indonesia's population is estimated to have cholesterol levels higher than the normal limit for health. This shows that one third of Indonesia's population is at high risk of arterial disease.

Eating foods with high cholesterol content or lack of exercise can also cause excess cholesterol, however, heredity can also be a trigger for cholesterol.

Cholesterol Symptoms

When there is deposition on artery walls due to excessive cholesterol levels, obstruction to blood flow to the heart, brain and other parts of the body can occur. High cholesterol increases a person's risk of narrowing the arteries or atherosclerosis, blood clots in certain parts of the body, minor strokes, strokes, and heart attacks.

Pain in the front of the chest or in the arms (angina) when a person is under stress or is doing strenuous physical activity can also be caused by high cholesterol. High cholesterol also increases a person's risk for coronary heart disease.

If you don't change your diet and don't stop smoking, people with high cholesterol will have an increased risk of having a stroke or heart disease. In cigarettes, a chemical called acrolein is found. This substance can stop the activity of good cholesterol or HDL to transport fat deposits to the liver. As a result, there can be narrowing of the arteries or atherosclerosis.

Effect of alcohol on liver health

Effect of Alcohol on Liver Health Alcohol has a significant impact on liver health. The liver has a fairly important role in the body, which regulates the metabolism of sugar, detoxifies the body, and helps relieve infection.

Also Read: Why Alcohol Reduces Chances of Pregnancy

If there is damage, the liver or liver can regenerate itself. Even so, an unhealthy lifestyle such as consuming alcoholic beverages interferes with this regeneration ability. If not treated immediately, the liver will suffer serious damage. One of the liver diseases caused by alcohol consumption is alcoholic fatty liver.

When it enters the body, alcohol travels to the bloodstream to the liver so as not to cause serious harm to other organs in the body. When digesting this alcohol, some of the liver cells are damaged and die. If you constantly consume alcohol, the liver can no longer do its job, in this case, it is digesting fat. As a result, fat will accumulate and there will be fatty liver.

The study, uploaded in the US National Library of Medicine, National Institutes of Health, states that the maximum limit of alcohol consumption associated with fatty liver disease in men is more than 80 grams and 40 grams for women per day.

If this habit is not stopped, the stage of fatty liver disease will increase to alcoholic hepatitis and cirrhosis as the most acute stage of alcohol-induced liver dysfunction.

Symptoms that arise in the body affected by fatty liver include swelling in the legs and abdomen, drastic weight loss, yellowing of the eyes and skin, chills fever, and vomiting of blood. In the chronic stage, the person experiences a coma and leads to death. This is why you are not allowed to consume excessive amounts of alcohol.