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[ { "content": "how smoking tobacco affects the brain\n\nRisks of tobacco: Tobacco is a plant. Its leaves are smoked, chewed, or sniffed for a variety of effects. - Tobacco contains the chemical nicotine, which is an addictive substance. - Tobacco smoke contains more than 7000 chemicals, 69 of which are known to cause cancer. - Tobacco that is not burned is called smokeless tobacco. Including nicotine, there are 29 chemicals in smokeless tobacco that are known to cause cancer. HEALTH RISKS OF SMOKING OR USING SMOKELESS TOBACCO Knowing the serious health risks of using tobacco may help motivate you to quit. Using tobacco over a long time can increase your risk of many health problems. Heart and blood vessel problems: - Blood clots and weakness in the walls of blood vessels in the brain, which can lead to stroke - Blood clots in the legs, which may travel to the lungs - Coronary artery disease, including angina and heart attacks - Temporarily increased blood pressure after smoking - Poor blood supply to the legs - Problems with erections because of decreased blood flow into the penis Other health risks or problems: - Cancer (more likely in the lung, mouth, larynx, nose and sinuses, throat, esophagus, stomach, bladder, kidney, pancreas, cervix, colon, and rectum) - Poor wound healing after surgery - Lung problems, such as COPD or asthma that is harder to control - Problems during pregnancy, such as babies born at a low birth weight, early labor, losing your baby, and cleft lip - Decreased ability to taste and smell - Harm to sperm, which may lead to infertility - Loss of sight due to an increased risk of macular degeneration - Tooth and gum diseases - Wrinkling of the skin Smokers who switch to smokeless tobacco instead of quitting tobacco still have health risks: - Increased risk of mouth or nasal cancer - Gum problems, tooth wear, and cavities - Worsening high blood pressure and angina HEALTH RISKS OF SECONDHAND SMOKE Those who are often around the smoke of others (secondhand smoke) have a higher risk of: - Heart attack and heart disease - Lung cancer - Sudden and severe reactions, including of the eye, nose, throat, and lower respiratory tract Infants and children who are often exposed to secondhand smoke are at risk of: - Asthma flares (children with asthma who live with a smoker are much more likely to visit the emergency room) - Infections of the mouth, throat, sinuses, ears, and lungs - Lung damage (poor lung function) - Sudden infant death syndrome (SIDS) Like any addiction, quitting tobacco is difficult, especially if you are doing it alone. - Seek support from family members, friends, and coworkers. - Talk to your health care provider about nicotine replacement therapy and smoking cessation medicines. - Join a smoking cessation program and you will have a much better chance of success. Such programs are offered by hospitals, health departments, community centers, and work sites. Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Internal review and update on 09/01/2016 by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.", "role": "user" }, { "content": "The risks of using tobacco include heart and blood vessel problems, cancer, lung problems, problems during pregnancy, decreased ability to taste and smell, tooth and gum disease, and wrinkling of skin.", "role": "assistant" } ]

[ { "content": "Hello, I have a scoliosis problem plz help me I want its treatment I can send my x.ray also\n\nScoliosis in Children and Adolescents (How is it treated?): Your doctor may recommend the following treatments: - Observation. If the curve is mild and you are still growing, your doctor will re-examine you every few months. - Bracing. If the curve is moderate and you are still growing, your doctor may recommend a brace to keep the curve from getting worse. Braces are selected for the specific curve problem and fitted to each patient. Braces must be worn every day for the full number of hours prescribed by the doctor. - Surgery. If you are still growing and have a severe curve that is getting worse, your doctor may suggest surgery. This often involves fusing together two or more bones in the spine. The doctor may also put in a metal rod or other device to help keep the spine straight after surgery. You should seek the advice of at least two experts, and ask about the benefits and risks of the surgery. The following treatments have not been shown to keep curves from getting worse in scoliosis: - Chiropractic treatment. - Electrical stimulation. - Nutritional supplements. Your doctor may recommend the following treatments: - Observation. If the curve is mild and you are still growing, your doctor will re-examine you every few months. - Bracing. If the curve is moderate and you are still growing, your doctor may recommend a brace to keep the curve from getting worse. Braces are selected for the specific curve problem and fitted to each patient. Braces must be worn every day for the full number of hours prescribed by the doctor. - Surgery. If you are still growing and have a severe curve that is getting worse, your doctor may suggest surgery. This often involves fusing together two or more bones in the spine. The doctor may also put in a metal rod or other device to help keep the spine straight after surgery. You should seek the advice of at least two experts, and ask about the benefits and risks of the surgery. The following treatments have not been shown to keep curves from getting worse in scoliosis: - Chiropractic treatment. - Electrical stimulation. - Nutritional supplements. Your doctor may recommend the following treatments: - Observation. If the curve is mild and you are still growing, your doctor will re-examine you every few months. - Bracing. If the curve is moderate and you are still growing, your doctor may recommend a brace to keep the curve from getting worse. Braces are selected for the specific curve problem and fitted to each patient. Braces must be worn every day for the full number of hours prescribed by the doctor. - Surgery. If you are still growing and have a severe curve that is getting worse, your doctor may suggest surgery. This often involves fusing together two or more bones in the spine. The doctor may also put in a metal rod or other device to help keep the spine straight after surgery. You should seek the advice of at least two experts, and ask about the benefits and risks of the surgery. The following treatments have not been shown to keep curves from getting worse in scoliosis: - Chiropractic treatment. - Electrical stimulation. - Nutritional supplements.", "role": "user" }, { "content": "If you are still growing and have mild scoliosis, your doctor will observe and examine you every few months. If the curve is moderate, your doctor may recommend a brace that must be worn every day for the full number of hours prescribed by the doctor. For a severe curve, your doctor may suggest surgery, which involves fusing vertebrae together or getting a metal rod to keep the spine straight. Ask at least two doctors about risks and benefits of surgery.Chiropractic treatments, electrical stimulation, and nutritional supplements did not help with scoliosis.", "role": "assistant" } ]

[ { "content": "Vitelliform Macular Dystrophy Would like to obtain more info on possible treatments.\n\n Adult-onset vitelliform macular dystrophy AVMD Macular dystrophy, vitelliform, adult-onset Vitelliform macular dystrophy, adult-onset AVMD Macular dystrophy, vitelliform, adult-onset Vitelliform macular dystrophy, adult-onset Foveomacular dystrophy, adult-onset AOFMD Foveomacular dystrophy, adult-onset, with choroidal neovascularization Adult-onset foveomacular vitelliform dystrophy See More Summary Adult-onset vitelliform macular dystrophy (AVMD) is an eye disorder that can cause progressive vision loss. AVMD affects an area of the retina called the macula, which is responsible for sharp central vision. The condition causes a fatty yellow pigment to accumulate in cells underlying the macula, eventually damaging the cells. [1] AVMD usually begins after age 40. Some people remain without symptoms throughout their life. Other people with AVMD may slowly develop blurred and/or distorted vision, that can progress to central vision loss over time. [1] [2] In the past, AVMD was believed to be mainly a genetic disorder caused by mutations in the PRPH2, BEST1, IMPG1, and IMPG2 genes ; however, recent studies focused on genetic testing suggest that the genetic cause for most cases of AVMD has not been found. [2] [3] Sometimes AVMD clearly runs in families in an autosomal dominant manner, but the inheritance is suspected to be more complicated in the majority of cases. [1] [2] Symptoms Signs and symptoms of adult-onset vitelliform macular dystrophy typically begin during mid-adulthood, in the fourth or fifth decade of life. At the time of diagnosis, mild blurring or mildly distorted vision may be present. In most cases, the cells underlying the macula become more damaged over time, which can cause slowly progressive vision loss. The condition is usually affects both eyes. [2] [3] It usually does not affect peripheral vision or the ability to see at night. [1] Studies have revealed much variability in the signs, symptoms and progression of this condition. Some people with AVMD do not have any visual symptoms throughout their life. Others may experience ongoing visual loss, but for most people the vision loss is not severe. In general, the long-term outlook ( prognosis ) is usually good, but loss of central visual function is possible. [2] [3] This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom. Showing of Medical Terms Other Names Learn More: HPO ID 80%-99% of people have these symptoms Vitelliform-like macular lesions 0007677 30%-79% of people have these symptoms Abnormality of color vision Abnormal color vision 0000551 Choroideremia 0001139 Iris hypopigmentation Light eye color 0007730 Visual field defect Partial loss of field of vision 0001123 5%-29% of people have these symptoms Retinal nonattachment 0007899 1%-4% of people have these symptoms Choroidal neovascularization 0011506 Percent of people who have these symptoms is not available through HPO Autosomal dominant inheritance 0000006 Drusen 0011510 Macular atrophy 0007401 Macular dystrophy 0007754 Metamorphopsia 0012508 Photophobia Extreme sensitivity of the eyes to light Light hypersensitivity 0000613 Reduced visual acuity Decreased clarity of vision 0007663 Showing of Cause Historically, adult-onset vitelliform macular dystrophy (AVMD) was defined as a genetic disorder; however, recent studies have concluded that only a minority of cases have an identified genetic cause, suggesting that there might be other underlying causes of environmental origin, genetic origin, or a mix of genetics and environment (multifactorial). More studies are needed to better define other underlying causes that might be present, whether of genetic or environmental origin. [2] [3] Currently known genetic causes include mutations in the PRPH2, BEST1, IMPG1, and IMPG2 genes . It is additionally suspected that AVMD might be associated with a single-nucleotide polymorphism (variant DNA sequence ) in the HTRA1 gene. Single- nucleotide polymorphisms in the HTRA1 gene are additionally associated with age-related macular degeneration. [2] [3] Inheritance The majority of cases with an identified family history or genetic cause are inherited in an autosomal dominant mutation ) in one copy of the responsible gene in each cell . In some cases, an affected person inherits the mutation from an affected parent. Other cases may result from a new ( de novo ) mutation in the gene. These cases occur in people with no history of the disorder in their family. When caused by a known mutation inherited in an autosomal dominant manner, a person with adult-onset macular dystrophy (AVMD) has a 50% chance with each pregnancy of passing along the altered gene to his or her child. The inheritance pattern of AVMD can be confusing as not all individuals with AVMD have a family history and not all individuals who inherit a causative gene mutation develop symptoms. [1] Diagnosis Making a diagnosis for a genetic or rare disease can often be challenging. Healthcare professionals typically look at a person's medical history, symptoms, physical exam, and laboratory test results in order to make a diagnosis. The following resources provide information relating to diagnosis and testing for this condition. If you have questions about getting a diagnosis, you should contact a healthcare professional. Testing Resources Orphanet lists international laboratories offering diagnostic testing for this condition. Treatment There is no cure or known treatment to stop the progression of adult-onset vitelliform macular dystrophy. [2] Management usually includes a comprehensive eye examination once or twice a year to monitor progression of the disease and for complications such as choroidal neovascularization ( CNV ). [4] CNV is sometimes associated with adult-onset vitelliform macular dystrophy because macular degeneration can damage the retinal layers. When this happens, the vascular layer of the eye between the sclera and the retina known as the choroid may produce new blood vessels (neovascularization) which grow up through the damaged layers and leak or bleed into the retina. This can cause vision loss on its own. If CNV does develop, anti-VEGF therapy such as Ranibizumab or Bevacizumab can control and even reverse the CNV. However anti-VEGF therapy does not stop or reverse the vision loss caused by adult-onset vitelliform macular dystrophy, only the extra vision loss that is due to also developing CNV. [2] Although vision loss is usually slow, when vision is impaired significantly, people with adult-onset vitelliform macular dystrophy may be referred for low vision testing and rehabilitation. Low vision rehabilitation can help maintain and optimize reading ability and improve overall quality of life. [4] [5] Find a Specialist If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments. If you can't find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care. You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists. Healthcare Resources To find a medical professional who specializes in genetics, you can ask your doctor for a referral or you can search for one yourself. Online directories are provided by the American College of Medical Genetics and the National Society of Genetic Counselors. If you need additional help, contact a GARD Information Specialist. You can also learn more about genetic consultations from Genetics Home Reference. Related Diseases Related diseases are conditions that have similar signs and symptoms. A health care provider may consider these conditions in the table below when making a diagnosis. Please note that the table may not include all the possible conditions related to this disease. Conditions with similar signs and symptoms from Orphanet The differential diagnosis of AOFVD includes Best vitelliform macular dystrophy, Stargardt disease, central areolar choroidal dystrophy, central serous retinopathy (CSR), pigmented epithelial detachment (PED), basal laminar drusen, acute exudative polymorphous vitelliform maculopathy (AEPVM) (see these terms) and occult CNV secondary to AMD. Visit the Orphanet disease page for more information. ", "role": "user" }, { "content": "There is no known treatment to stop the progression of adult-onset vitelliform macular dystrophy. Management of the disease includes a comprehensive eye exam once or twice a year, in order to monitor the progression of the disease and check for complications.", "role": "assistant" } ]

[ { "content": "Iron Overdose Um...i took 25 iron pills...what do i do...this was last night\n\n Iron overdose Ferrous sulfate overdose Ferrous gluconate overdose Ferrous fumarate overdose Summary Iron is a mineral found in many over-the-counter supplements. Iron overdose occurs when someone takes more than the normal or recommended amount of this mineral. This can be by accident or on purpose. Iron overdose is especially dangerous for children. A severe overdose can happen if a child eats adult multivitamins, such as prenatal vitamins. If the child eats too many pediatric multivitamins, the effect is usually minor. This article is for information only. DO NOT use it to treat or manage an actual overdose. If you or someone you are with has an overdose, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. Poisonous Ingredient Iron can be harmful in large amounts. Where Found Iron is an ingredient in many mineral and vitamin supplements. Iron supplements are also sold by themselves. Types include: Ferrous sulfate (Feosol, Slow Fe) Ferrous gluconate (Fergon) Ferrous fumarate (Femiron, Feostat) Other products may also contain iron. Symptoms Below are symptoms of an iron overdose in different parts of the body. AIRWAYS AND LUNGS Buildup of fluids in the lungs STOMACH AND INTESTINES Black, and possibly bloody stools Diarrhea Liver damage Metallic taste in mouth Nausea Vomiting blood HEART AND BLOOD Dehydration Low blood pressure Fast and weak pulse Shock NERVOUS SYSTEM Chills Coma (decreased level of consciousness and lack of responsiveness, may occur within 1/2 hour to 1 hour after overdose) Convulsions Dizziness Drowsiness Fever Headache Lack of desire to do anything SKIN Bluish-colored lips and fingernails Flushing Loss of color from the skin (pallor) Note: Symptoms may go away in a few hours, then return again after 1 day or later. Before Calling Emergency Have this information ready: Person's age, weight, and condition Name of the product (ingredients and strength, if known) Time it was swallowed Amount swallowed If the medicine was prescribed for the person Poison Control Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions. This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week. What to Expect at the Emergency Room Take the container to the hospital with you, if possible. The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated. Tests that may done include: Blood and urine tests, including tests to check iron levels ECG (electrocardiogram, or heart tracing) X-ray to detect and track iron tablets through the stomach and intestines Treatment may include: Fluids through a vein (by IV) Medicine to help remove iron from the body and treat symptoms Endoscopy -- camera and tube placed down the throat to view the esophagus and the stomach and to remove pills or stop internal bleeding Whole bowel irrigation with a special solution to quickly flush the iron through the stomach and intestines (taken by mouth or through a tube through the nose into the stomach) Breathing support, including tube through the mouth into the lungs and connected to a breathing machine (ventilator) Outlook (Prognosis) There is a good chance of recovery if the person's symptoms are gone 48 hours after the iron overdose. But, severe liver damage can occur 2 to 5 days after the overdose. Some people have died up to a week after an iron overdose. The more quickly the person receives treatment, the better the chance for survival. Iron overdose can be very severe in children. Children may sometimes eat large amounts of iron pills because they look like candy. Many manufacturers have changed their pills so they no longer look like candy. Review Date 10/8/2017 Updated by: Jacob L. Heller, MD, MHA, Emergency Medicine, Emeritus, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "If you or someone you are with overdoses, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.", "role": "assistant" } ]

[ { "content": "what are the uses of vitamin e capsules\n\n Ataxia with vitamin E deficiency ataxia with isolated vitamin E deficiency AVED familial isolated vitamin E deficiency FIVE Friedreich ataxia phenotype with selective vitamin E deficiency Friedreich-like ataxia Description Ataxia with vitamin E deficiency is a disorder that impairs the body's ability to use vitamin E obtained from the diet. Vitamin E is an antioxidant, which means that it protects cells in the body from the damaging effects of unstable molecules called free radicals. A shortage (deficiency) of vitamin E can lead to neurological problems, such as difficulty coordinating movements (ataxia) and speech (dysarthria), loss of reflexes in the legs (lower limb areflexia), and a loss of sensation in the extremities (peripheral neuropathy). Some people with this condition have developed an eye disorder called retinitis pigmentosa that causes vision loss. Most people who have ataxia with vitamin E deficiency start to experience problems with movement between the ages of 5 and 15 years. The movement problems tend to worsen with age. Frequency Ataxia with vitamin E deficiency is a rare condition; however, its prevalence is unknown. Causes Mutations in the TTPA gene cause ataxia with vitamin E deficiency. The TTPA gene provides instructions for making the alpha-tocopherol transfer protein (alphaTTP), which is found in the liver and brain. This protein controls distribution of vitamin E obtained from the diet (also called alpha-tocopherol) to cells and tissues throughout the body. Vitamin E helps cells prevent damage that might be done by free radicals. TTPA gene mutations impair the activity of the alphaTTP protein, resulting in an inability to retain and use dietary vitamin E. As a result, vitamin E levels in the blood are greatly reduced and free radicals accumulate within cells. Nerve cells (neurons) in the brain and spinal cord (central nervous system) are particularly vulnerable to the damaging effects of free radicals and these cells die off when they are deprived of vitamin E. Nerve cell damage can lead to problems with movement and other features of ataxia with vitamin E deficiency. Inheritance Pattern This condition is inherited in an autosomal recessive pattern, which means both copies of the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition. Sources for This Page Bromley D, Anderson PC, Daggett V. Structural consequences of mutations to the alpha-tocopherol transfer protein associated with the neurodegenerative disease ataxia with vitamin E deficiency. Biochemistry. 2013 Jun 18;52(24):4264-73. doi: 10.1021/bi4001084. Epub 2013 Jun 10. ", "role": "user" }, { "content": "Vitamin E is an antioxidant, which means that it protects cells in the body from the damaging effects of unstable molecules called free radicals. A shortage (deficiency) of vitamin E can lead to neurological problems, such as difficulty coordinating movements (ataxia) and speech (dysarthria), loss of reflexes in the legs (lower limb areflexia), and a loss of sensation in the extremities (peripheral neuropathy).", "role": "assistant" } ]

[ { "content": "CURE FOR PNEUMONIA Dear DR, please i have a friend that has the above illness..I want to find out...since i want to marry her...is it an infectious illness,,and can it be totally cured. And how can i help her to get this cured..Please i really need your reply urgently\n\n Pneumonia Overview Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing. A variety of organisms, including bacteria, viruses and fungi, can cause pneumonia. Pneumonia can range in seriousness from mild to life-threatening. It is most serious for infants and young children, people older than age 65, and people with health problems or weakened immune systems. Symptoms The signs and symptoms of pneumonia vary from mild to severe, depending on factors such as the type of germ causing the infection, and your age and overall health. Mild signs and symptoms often are similar to those of a cold or flu, but they last longer. Signs and symptoms of pneumonia may include: - Chest pain when you breathe or cough - Confusion or changes in mental awareness (in adults age 65 and older) - Cough, which may produce phlegm - Fatigue - Fever, sweating and shaking chills - Lower than normal body temperature (in adults older than age 65 and people with weak immune systems) - Nausea, vomiting or diarrhea - Shortness of breath Newborns and infants may not show any sign of the infection. Or they may vomit, have a fever and cough, appear restless or tired and without energy, or have difficulty breathing and eating. See your doctor if you have difficulty breathing, chest pain, persistent fever of 102 F (39 C) or higher, or persistent cough, especially if you're coughing up pus. It's especially important that people in these high-risk groups see a doctor: - Adults older than age 65 - Children younger than age 2 with signs and symptoms - People with an underlying health condition or weakened immune system - People receiving chemotherapy or taking medication that suppresses the immune system For some older adults and people with heart failure or chronic lung problems, pneumonia can quickly become a life-threatening condition. Causes Many germs can cause pneumonia. The most common are bacteria and viruses in the air we breathe. Your body usually prevents these germs from infecting your lungs. But sometimes these germs can overpower your immune system, even if your health is generally good. Pneumonia is classified according to the types of germs that cause it and where you got the infection. Community-acquired pneumonia is the most common type of pneumonia. It occurs outside of hospitals or other health care facilities. It may be caused by: - Bacteria. The most common cause of bacterial pneumonia in the U.S. is Streptococcus pneumoniae. This type of pneumonia can occur on its own or after you've had a cold or the flu. It may affect one part (lobe) of the lung, a condition called lobar pneumonia. - Bacteria-like organisms. Mycoplasma pneumoniae also can cause pneumonia. It typically produces milder symptoms than do other types of pneumonia. Walking pneumonia is an informal name given to this type of pneumonia, which typically isn't severe enough to require bed rest. - Fungi. This type of pneumonia is most common in people with chronic health problems or weakened immune systems, and in people who have inhaled large doses of the organisms. The fungi that cause it can be found in soil or bird droppings and vary depending upon geographic location. - Viruses. Some of the viruses that cause colds and the flu can cause pneumonia. Viruses are the most common cause of pneumonia in children younger than 5 years. Viral pneumonia is usually mild. But in some cases it can become very serious. Some people catch pneumonia during a hospital stay for another illness. Hospital-acquired pneumonia can be serious because the bacteria causing it may be more resistant to antibiotics and because the people who get it are already sick. People who are on breathing machines (ventilators), often used in intensive care units, are at higher risk of this type of pneumonia. Health care-acquired pneumonia is a bacterial infection that occurs in people who live in long-term care facilities or who receive care in outpatient clinics, including kidney dialysis centers. Like hospital-acquired pneumonia, health care-acquired pneumonia can be caused by bacteria that are more resistant to antibiotics. Aspiration pneumonia occurs when you inhale food, drink, vomit or saliva into your lungs. Aspiration is more likely if something disturbs your normal gag reflex, such as a brain injury or swallowing problem, or excessive use of alcohol or drugs. Risk factors Pneumonia can affect anyone. But the two age groups at highest risk are: - Children who are 2 years old or younger - People who are age 65 or older Other risk factors include: - Being hospitalized. You're at greater risk of pneumonia if you're in a hospital intensive care unit, especially if you're on a machine that helps you breathe (a ventilator). - Chronic disease. You're more likely to get pneumonia if you have asthma, chronic obstructive pulmonary disease (COPD) or heart disease. - Smoking. Smoking damages your body's natural defenses against the bacteria and viruses that cause pneumonia. - Weakened or suppressed immune system. People who have HIV/AIDS, who've had an organ transplant, or who receive chemotherapy or long-term steroids are at risk. Complications Even with treatment, some people with pneumonia, especially those in high-risk groups, may experience complications, including: - Bacteria in the bloodstream (bacteremia). Bacteria that enter the bloodstream from your lungs can spread the infection to other organs, potentially causing organ failure. - Difficulty breathing. If your pneumonia is severe or you have chronic underlying lung diseases, you may have trouble breathing in enough oxygen. You may need to be hospitalized and use a breathing machine (ventilator) while your lung heals. - Fluid accumulation around the lungs (pleural effusion). Pneumonia may cause fluid to build up in the thin space between layers of tissue that line the lungs and chest cavity (pleura). If the fluid becomes infected, you may need to have it drained through a chest tube or removed with surgery. - Lung abscess. An abscess occurs if pus forms in a cavity in the lung. An abscess is usually treated with antibiotics. Sometimes, surgery or drainage with a long needle or tube placed into the abscess is needed to remove the pus. Diagnosis Your doctor will start by asking about your medical history and doing a physical exam, including listening to your lungs with a stethoscope to check for abnormal bubbling or crackling sounds that suggest pneumonia. If pneumonia is suspected, your doctor may recommend the following tests: - Blood tests. Blood tests are used to confirm an infection and to try to identify the type of organism causing the infection. However, precise identification isn't always possible. - Chest X-ray. This helps your doctor diagnose pneumonia and determine the extent and location of the infection. However, it can't tell your doctor what kind of germ is causing the pneumonia. - Pulse oximetry. This measures the oxygen level in your blood. Pneumonia can prevent your lungs from moving enough oxygen into your bloodstream. - Sputum test. A sample of fluid from your lungs (sputum) is taken after a deep cough and analyzed to help pinpoint the cause of the infection. Your doctor might order additional tests if you're older than age 65, are in the hospital, or have serious symptoms or health conditions. These may include: - CT scan. If your pneumonia isn't clearing as quickly as expected, your doctor may recommend a chest CT scan to obtain a more detailed image of your lungs. - Pleural fluid culture. A fluid sample is taken by putting a needle between your ribs from the pleural area and analyzed to help determine the type of infection. Treatment Treatment for pneumonia involves curing the infection and preventing complications. People who have community-acquired pneumonia usually can be treated at home with medication. Although most symptoms ease in a few days or weeks, the feeling of tiredness can persist for a month or more. Specific treatments depend on the type and severity of your pneumonia, your age and your overall health. The options include: - Antibiotics. These medicines are used to treat bacterial pneumonia. It may take time to identify the type of bacteria causing your pneumonia and to choose the best antibiotic to treat it. If your symptoms don't improve, your doctor may recommend a different antibiotic. - Cough medicine. This medicine may be used to calm your cough so that you can rest. Because coughing helps loosen and move fluid from your lungs, it's a good idea not to eliminate your cough completely. In addition, you should know that very few studies have looked at whether over-the-counter cough medicines lessen coughing caused by pneumonia. If you want to try a cough suppressant, use the lowest dose that helps you rest. - Fever reducers/pain relievers. You may take these as needed for fever and discomfort. These include drugs such as aspirin, ibuprofen (Advil, Motrin IB, others) and acetaminophen (Tylenol, others). Hospitalization You may need to be hospitalized if: - You are older than age 65 - You are confused about time, people or places - Your kidney function has declined - Your systolic blood pressure is below 90 millimeters of mercury (mm Hg) or your diastolic blood pressure is 60 mm Hg or below - Your breathing is rapid (30 breaths or more a minute) - You need breathing assistance - Your temperature is below normal - Your heart rate is below 50 or above 100 You may be admitted to the intensive care unit if you need to be placed on a breathing machine (ventilator) or if your symptoms are severe. Children may be hospitalized if: - They are younger than age 2 months - They are lethargic or excessively sleepy - They have trouble breathing - They have low blood oxygen levels - They appear dehydrated Lifestyle and home remedies These tips can help you recover more quickly and decrease your risk of complications: - Get plenty of rest. Don't go back to school or work until after your temperature returns to normal and you stop coughing up mucus. Even when you start to feel better, be careful not to overdo it. Because pneumonia can recur, it's better not to jump back into your routine until you are fully recovered. Ask your doctor if you're not sure. - Stay hydrated. Drink plenty of fluids, especially water, to help loosen mucus in your lungs. - Take your medicine as prescribed. Take the entire course of any medications your doctor prescribed for you. If you stop taking medication too soon, your lungs may continue to harbor bacteria that can multiply and cause your pneumonia to recur. ", "role": "user" }, { "content": "Treatment for pneumonia involves curing the infection and preventing complications. ... Specific treatments depend on the type and severity of your pneumonia, your age and your overall health. The options include: - Antibiotics. These medicines are used to treat bacterial pneumonia. It may take time to identify the type of bacteria causing your pneumonia and to choose the best antibiotic to treat it. If your symptoms don't improve, your doctor may recommend a different antibiotic. - Cough medicine. This medicine may be used to calm your cough so that you can rest. Because coughing helps loosen and move fluid from your lungs, it's a good idea not to eliminate your cough completely. In addition, you should know that very few studies have looked at whether over-the-counter cough medicines lessen coughing caused by pneumonia. If you want to try a cough suppressant, use the lowest dose that helps you rest. - Fever reducers/pain relievers. You may take these as needed for fever and discomfort.", "role": "assistant" } ]

[ { "content": "Psoriasis for past 7-8 years I had psoriasis on my scalp for nearly 10 years. Please give suggestions and medications.\n\nPsoriasis (Support Groups): Some people may benefit from a psoriasis support group. The National Psoriasis Foundation is a good resource: www.psoriasis.org.", "role": "user" }, { "content": "Some people may benefit from a psoriasis support group. The National Psoriasis Foundation is a good resource: www.psoriasis.org.", "role": "assistant" } ]

[ { "content": "how is epilepsy diagnosed\n\n Epilepsy - overview Seizure disorder Epileptic - epilepsy Summary Epilepsy is a brain disorder in which a person has repeated seizures over time. Seizures are episodes of uncontrolled and abnormal firing of brain cells that may cause changes in attention or behavior. Causes Epilepsy occurs when changes in the brain cause it to be too excitable or irritable. As a result, the brain sends out abnormal signals. This leads to repeated, unpredictable seizures. (A single seizure that does not happen again is not epilepsy.) Epilepsy may be due to a medical condition or injury that affects the brain. Or, the cause may be unknown (idiopathic). Common causes of epilepsy include: Stroke or transient ischemic attack (TIA) Dementia, such as Alzheimer disease Traumatic brain injury Infections, including brain abscess, meningitis, encephalitis, and HIV/AIDS Brain problems that are present at birth (congenital brain defect) Brain injury that occurs during or near birth Metabolism disorders present at birth (such as phenylketonuria) Brain tumor Abnormal blood vessels in the brain Other illness that damages or destroys brain tissue Seizure disorders that run in families (hereditary epilepsy) Epileptic seizures usually begin between ages 5 and 20. There is also a higher chance of seizures in adults older than 60. But epileptic seizures can happen at any age. There may be a family history of seizures or epilepsy. Symptoms Symptoms vary from person to person. Some people may have simple staring spells. Others have violent shaking and loss of alertness. The type of seizure depends on the part of the brain that is affected. Most of the time, the seizure is similar to the one before it. Some people with epilepsy have a strange sensation before each seizure. Sensations may be tingling, smelling an odor that is not actually there, or emotional changes. This is called an aura. Your doctor can tell you more about the specific type of seizure you may have: Absence (petit mal) seizure (staring spells) Generalized tonic-clonic (grand mal) seizure (involves the entire body, including aura, rigid muscles, and loss of alertness) Partial (focal) seizure (can involve any of the symptoms described above, depending on where in the brain the seizure starts) Exams and Tests The doctor will perform a physical exam. This will include a detailed look at the brain and nervous system. An EEG (electroencephalogram) will be done to check the electrical activity in the brain. People with epilepsy often have abnormal electrical activity seen on this test. In some cases, the test shows the area in the brain where the seizures start. The brain may appear normal after a seizure or between seizures. To diagnose epilepsy or plan for epilepsy surgery, you may need to: Wear an EEG recorder for days or weeks as you go about your everyday life. Stay in a special hospital where brain activity can be recorded while video cameras capture what happens to you during the seizure. This is called video EEG. Tests that may be done include: Blood chemistry Blood sugar Complete blood count (CBC) Kidney function tests Liver function tests Lumbar puncture (spinal tap) Tests for infectious diseases Head CT or MRI scan is often done to find the cause and location of the problem in the brain. Treatment Treatment for epilepsy includes taking medicines, lifestyle changes, and sometimes surgery. If epilepsy is due to a tumor, abnormal blood vessels, or bleeding in the brain, surgery to treat these disorders may make the seizures stop. Medicines to prevent seizures, called anticonvulsants (or antiepileptic drugs), may reduce the number of future seizures: These drugs are taken by mouth. Which type you are prescribed depends on the type of seizures you have. Your dosage may need to be changed from time to time. You may need regular blood tests to check for side effects. Always take your medicine on time and as directed. Missing a dose can cause you to have a seizure. DO NOT stop taking or change medicines on your own. Talk to your doctor first. Many epilepsy medicines cause birth defects. Women who plan to become pregnant should tell their doctor in advance in order to adjust medicines. Many epilepsy drugs may affect the health of your bones. Talk to your doctor about whether you need vitamins and other supplements. Epilepsy that does not get better after 2 or 3 anti-seizure drugs have been tried is called \"medically refractory epilepsy.\" In this case, the doctor may recommend surgery to: Remove the abnormal brain cells causing the seizures. Place a vagal nerve stimulator (VNS). This device is similar to a heart pacemaker. It can help reduce the number of seizures. Some children are placed on a special diet to help prevent seizures. The most popular one is the ketogenic diet. A diet low in carbohydrates, such as the Atkins diet, may also be helpful in some adults. Be sure to discuss these options with your doctor before trying them. Lifestyle or medical changes can increase the risk for a seizure in adults and children with epilepsy. Talk with your doctor about: New prescribed drugs, vitamins, or supplements Emotional stress Illness, especially infection Lack of sleep Pregnancy Skipping doses of epilepsy medicines Use of alcohol or other recreational drugs Other considerations: People with epilepsy should wear medical alert jewelry so that prompt treatment can be obtained if a seizure occurs. People with poorly controlled epilepsy should not drive. Check your state's law about which people with a history of seizures are allowed to drive. DO NOT use machinery or do activities that can cause loss of awareness, such as climbing to high places, biking, and swimming alone. Support Groups The stress of having epilepsy or being a caretaker of someone with epilepsy can often be helped by joining a support group. In these groups, members share common experiences and problems. Outlook (Prognosis) Some people with epilepsy may be able to reduce or even stop their anti-seizure medicines after having no seizures for several years. Certain types of childhood epilepsy go away or improve with age, usually in the late teens or 20s. For many people, epilepsy is a lifelong condition. In these cases, anti-seizure drugs need to be continued. There is a very low risk for sudden death with epilepsy. Possible Complications Complications may include: Difficulty learning Breathing in food or saliva into the lungs during a seizure, which can cause aspiration pneumonia Injury from falls, bumps, self-inflicted bites, driving or operating machinery during a seizure Permanent brain damage (stroke or other damage) Side effects of medicines When to Contact a Medical Professional Call your local emergency number (such as 911) if: This is the first time a person has a seizure A seizure occurs in someone who is not wearing a medical ID bracelet (which has instructions explaining what to do) In the case of someone who has had seizures before, call 911 for any of these emergency situations: This is a longer seizure than the person normally has, or an unusual number of seizures for the person Repeated seizures over a few minutes Repeated seizures in which consciousness or normal behavior is not regained between them (status epilepticus) Call your doctor if any new symptoms occur: Loss of hair Nausea or vomiting Rash Side effects of medicines, such as drowsiness, restlessness, confusion, sedation Tremors or abnormal movements, or problems with coordination Prevention There is no known way to prevent epilepsy. Proper diet and sleep, and staying away from alcohol and illegal drugs may decrease the likelihood of triggering seizures in people with epilepsy. Reduce the risk for head injury by wearing a helmet during risky activities. This can lessen the likelihood of a brain injury that leads to seizures and epilepsy. Review Date 2/27/2018 Updated by: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Epilepsy - overview (Exams and Tests): The doctor will perform a physical exam. This will include a detailed look at the brain and nervous system. An EEG (electroencephalogram) will be done to check the electrical activity in the brain. People with epilepsy often have abnormal electrical activity seen on this test. In some cases, the test shows the area in the brain where the seizures start. To diagnose epilepsy or plan for epilepsy surgery, you may need to: - Wear an EEG recorder for days or weeks as you go about your everyday life. - Stay in a special hospital where brain activity can be recorded while video cameras capture what happens to you during the seizure. This is called video EEG. Tests that may be done include: - Blood chemistry - Blood sugar - Complete blood count (CBC) - Kidney function tests - Liver function tests - Lumbar puncture (spinal tap) - Tests for infectious diseases Head CT or MRI scan is often done to find the cause and location of the problem in the brain.", "role": "assistant" } ]

[ { "content": "how to prevent atherosclerosis\n\n Atherosclerosis What Is... Español Atherosclerosis is a disease in which plaque builds up inside your arteries. Arteries are blood vessels that carry oxygen-rich blood to your heart and other parts of your body. Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque hardens and narrows your arteries. This limits the flow of oxygen-rich blood to your organs and other parts of your body. Atherosclerosis can lead to serious problems, including heart attack, stroke, or even death. Atherosclerosis Atherosclerosis-Related Diseases Atherosclerosis can affect any artery in the body, including arteries in the heart, brain, arms, legs, pelvis, and kidneys. As a result, different diseases may develop based on which arteries are affected. Coronary Heart Disease Coronary heart disease (CHD), also called coronary artery disease, occurs when plaque builds up in the coronary arteries. These arteries supply oxygen-rich blood to your heart. Plaque narrows the coronary arteries and reduces blood flow to your heart muscle. Plaque buildup also makes it more likely that blood clots will form in your arteries. Blood clots can partially or completely block blood flow. If blood flow to your heart muscle is reduced or blocked, you may have angina (chest pain or discomfort) or a heart attack. Plaque also can form in the heart's smallest arteries. This disease is called coronary microvascular disease (MVD). In coronary MVD, plaque doesn't cause blockages in the arteries as it does in CHD. Carotid Artery Disease Carotid (ka-ROT-id) artery disease occurs if plaque builds up in the arteries on each side of your neck (the carotid arteries). These arteries supply oxygen-rich blood to your brain. If blood flow to your brain is reduced or blocked, you may have a stroke. Peripheral Artery Disease Peripheral artery disease (P.A.D.) occurs if plaque builds up in the major arteries that supply oxygen-rich blood to your legs, arms, and pelvis. If blood flow to these parts of your body is reduced or blocked, you may have numbness, pain, and, sometimes, dangerous infections. Chronic Kidney Disease Chronic kidney disease can occur if plaque builds up in the renal arteries. These arteries supply oxygen-rich blood to your kidneys. Over time, chronic kidney disease causes a slow loss of kidney function. The main function of the kidneys is to remove waste and extra water from the body. Overview The cause of atherosclerosis isn't known. However, certain traits, conditions, or habits may raise your risk for the disease. These conditions are known as risk factors. You can control some risk factors, such as lack of physical activity, smoking, and an unhealthy diet. Others you can't control, such as age and a family history of heart disease. Some people who have atherosclerosis have no signs or symptoms. They may not be diagnosed until after a heart attack or stroke. The main treatment for atherosclerosis is lifestyle changes. You also may need medicines and medical procedures. These treatments, along with ongoing medical care, can help you live a healthier life. Outlook Improved treatments have reduced the number of deaths from atherosclerosis-related diseases. These treatments also have improved the quality of life for people who have these diseases. However, atherosclerosis remains a common health problem. You may be able to prevent or delay atherosclerosis and the diseases it can cause. Making lifestyle changes and getting ongoing care can help you avoid the problems of atherosclerosis and live a long, healthy life. OTHER NAMES Arteriosclerosis Hardening of the arteries CAUSES The exact cause of atherosclerosis isn't known. However, studies show that atherosclerosis is a slow, complex disease that may start in childhood. It develops faster as you age. Atherosclerosis may start when certain factors damage the inner layers of the arteries. These factors include: Smoking High amounts of certain fats and cholesterol in the blood High blood pressure High amounts of sugar in the blood due to insulin resistance or diabetes Plaque may begin to build up where the arteries are damaged. Over time, plaque hardens and narrows the arteries. Eventually, an area of plaque can rupture (break open). When this happens, blood cell fragments called platelets (PLATE-lets) stick to the site of the injury. They may clump together to form blood clots. Clots narrow the arteries even more, limiting the flow of oxygen-rich blood to your body. Depending on which arteries are affected, blood clots can worsen angina (chest pain) or cause a heart attack or stroke. Researchers continue to look for the causes of atherosclerosis. They hope to find answers to questions such as: Why and how do the arteries become damaged? How does plaque develop and change over time? Why does plaque rupture and lead to blood clots? WHO IS AT RISK The exact cause of atherosclerosis isn't known. However, certain traits, conditions, or habits may raise your risk for the disease. These conditions are known as risk factors. The more risk factors you have, the more likely it is that you'll develop atherosclerosis. You can control most risk factors and help prevent or delay atherosclerosis. Other risk factors can't be controlled. Major Risk Factors Unhealthy blood cholesterol levels. This includes high LDL cholesterol (sometimes called \"bad\" cholesterol) and low HDL cholesterol (sometimes called \"good\" cholesterol). High blood pressure. Blood pressure is considered high if it stays at or above 140/90 mmHg over time. If you have diabetes or chronic kidney disease, high blood pressure is defined as 130/80 mmHg or higher. (The mmHg is millimeters of mercury—the units used to measure blood pressure.) Smoking. Smoking can damage and tighten blood vessels, raise cholesterol levels, and raise blood pressure. Smoking also doesn't allow enough oxygen to reach the body's tissues. Insulin resistance. This condition occurs if the body can't use its insulin properly. Insulin is a hormone that helps move blood sugar into cells where it's used as an energy source. Insulin resistance may lead to diabetes. Diabetes. With this disease, the body's blood sugar level is too high because the body doesn't make enough insulin or doesn't use its insulin properly. Overweight or obesity. The terms \"overweight\" and \"obesity\" refer to body weight that's greater than what is considered healthy for a certain height. Lack of physical activity. A lack of physical activity can worsen other risk factors for atherosclerosis, such as unhealthy blood cholesterol levels, high blood pressure, diabetes, and overweight and obesity. Unhealthy diet. An unhealthy diet can raise your risk for atherosclerosis. Foods that are high in saturated and trans fats, cholesterol, sodium (salt), and sugar can worsen other atherosclerosis risk factors. Older age. As you get older, your risk for atherosclerosis increases. Genetic or lifestyle factors cause plaque to build up in your arteries as you age. By the time you're middle-aged or older, enough plaque has built up to cause signs or symptoms. In men, the risk increases after age 45. In women, the risk increases after age 55. Family history of early heart disease. Your risk for atherosclerosis increases if your father or a brother was diagnosed with heart disease before 55 years of age, or if your mother or a sister was diagnosed with heart disease before 65 years of age. Although age and a family history of early heart disease are risk factors, it doesn't mean that you'll develop atherosclerosis if you have one or both. Controlling other risk factors often can lessen genetic influences and prevent atherosclerosis, even in older adults. Studies show that an increasing number of children and youth are at risk for atherosclerosis. This is due to a number of causes, including rising childhood obesity rates. Emerging Risk Factors Scientists continue to study other possible risk factors for atherosclerosis. High levels of a protein called C-reactive protein (CRP) in the blood may raise the risk for atherosclerosis and heart attack. High levels of CRP are a sign of inflammation in the body. Inflammation is the body's response to injury or infection. Damage to the arteries' inner walls seems to trigger inflammation and help plaque grow. People who have low CRP levels may develop atherosclerosis at a slower rate than people who have high CRP levels. Research is under way to find out whether reducing inflammation and lowering CRP levels also can reduce the risk for atherosclerosis. High levels of triglycerides (tri-GLIH-seh-rides) in the blood also may raise the risk for atherosclerosis, especially in women. Triglycerides are a type of fat. Studies are under way to find out whether genetics may play a role in atherosclerosis risk. Other Factors That Affect Atherosclerosis Other factors also may raise your risk for atherosclerosis, such as: Sleep apnea. Sleep apnea is a disorder that causes one or more pauses in breathing or shallow breaths while you sleep. Untreated sleep apnea can raise your risk for high blood pressure, diabetes, and even a heart attack or stroke. Stress. Research shows that the most commonly reported \"trigger\" for a heart attack is an emotionally upsetting event, especially one involving anger. Alcohol. Heavy drinking can damage the heart muscle and worsen other risk factors for atherosclerosis. Men should have no more than two drinks containing alcohol a day. Women should have no more than one drink containing alcohol a day. SIGNS & SYMPTOMS Atherosclerosis usually doesn't cause signs and symptoms until it severely narrows or totally blocks an artery. Many people don't know they have the disease until they have a medical emergency, such as a heart attack or stroke. Some people may have signs and symptoms of the disease. Signs and symptoms will depend on which arteries are affected. Coronary Arteries The coronary arteries supply oxygen-rich blood to your heart. If plaque narrows or blocks these arteries (a disease called coronary heart disease, or CHD), a common symptom is angina. Angina is chest pain or discomfort that occurs when your heart muscle doesn't get enough oxygen-rich blood. Angina may feel like pressure or squeezing in your chest. You also may feel it in your shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion. The pain tends to get worse with activity and go away with rest. Emotional stress also can trigger the pain. Other symptoms of CHD are shortness of breath and arrhythmias (ah-RITH-me-ahs). Arrhythmias are problems with the rate or rhythm of the heartbeat. Plaque also can form in the heart's smallest arteries. This disease is called coronary microvascular disease (MVD). Symptoms of coronary MVD include angina, shortness of breath, sleep problems, fatigue (tiredness), and lack of energy. Carotid Arteries The carotid arteries supply oxygen-rich blood to your brain. If plaque narrows or blocks these arteries (a disease called carotid artery disease), you may have symptoms of a stroke. These symptoms may include: Sudden weakness Paralysis (an inability to move) or numbness of the face, arms, or legs, especially on one side of the body Confusion Trouble speaking or understanding speech Trouble seeing in one or both eyes Problems breathing Dizziness, trouble walking, loss of balance or coordination, and unexplained falls Loss of consciousness Sudden and severe headache Peripheral Arteries Plaque also can build up in the major arteries that supply oxygen-rich blood to the legs, arms, and pelvis (a disease called peripheral artery disease). If these major arteries are narrowed or blocked, you may have numbness, pain, and, sometimes, dangerous infections. Renal Arteries The renal arteries supply oxygen-rich blood to your kidneys. If plaque builds up in these arteries, you may develop chronic kidney disease. Over time, chronic kidney disease causes a slow loss of kidney function. Early kidney disease often has no signs or symptoms. As the disease gets worse it can cause tiredness, changes in how you urinate (more often or less often), loss of appetite, nausea (feeling sick to the stomach), swelling in the hands or feet, itchiness or numbness, and trouble concentrating. DIAGNOSIS Your doctor will diagnose atherosclerosis based on your medical and family histories, a physical exam, and test results. Specialists Involved If you have atherosclerosis, a primary care doctor, such as an internist or family practitioner, may handle your care. Your doctor may recommend other health care specialists if you need expert care, such as: A cardiologist. This is a doctor who specializes in diagnosing and treating heart diseases and conditions. You may go to a cardiologist if you have peripheral artery disease (P.A.D.) or coronary microvascular disease (MVD). A vascular specialist. This is a doctor who specializes in diagnosing and treating blood vessel problems. You may go to a vascular specialist if you have P.A.D. A neurologist. This is a doctor who specializes in diagnosing and treating nervous system disorders. You may see a neurologist if you've had a stroke due to carotid artery disease. A nephrologist. This is a doctor who specializes in diagnosing and treating kidney diseases and conditions. You may go to a nephrologist if you have chronic kidney disease. Physical Exam During the physical exam, your doctor may listen to your arteries for an abnormal whooshing sound called a bruit (broo-E). Your doctor can hear a bruit when placing a stethoscope over an affected artery. A bruit may indicate poor blood flow due to plaque buildup. Your doctor also may check to see whether any of your pulses (for example, in the leg or foot) are weak or absent. A weak or absent pulse can be a sign of a blocked artery. Diagnostic Tests Your doctor may recommend one or more tests to diagnose atherosclerosis. These tests also can help your doctor learn the extent of your disease and plan the best treatment. Blood Tests Blood tests check the levels of certain fats, cholesterol, sugar, and proteins in your blood. Abnormal levels may be a sign that you're at risk for atherosclerosis. EKG (Electrocardiogram) An EKG is a simple, painless test that detects and records the heart's electrical activity. The test shows how fast the heart is beating and its rhythm (steady or irregular). An EKG also records the strength and timing of electrical signals as they pass through the heart. An EKG can show signs of heart damage caused by CHD. The test also can show signs of a previous or current heart attack. Chest X Ray A chest x ray takes pictures of the organs and structures inside your chest, such as your heart, lungs, and blood vessels. A chest x ray can reveal signs of heart failure. Ankle/Brachial Index This test compares the blood pressure in your ankle with the blood pressure in your arm to see how well your blood is flowing. This test can help diagnose P.A.D. Echocardiography Echocardiography (echo) uses sound waves to create a moving picture of your heart. The test provides information about the size and shape of your heart and how well your heart chambers and valves are working. Echo also can identify areas of poor blood flow to the heart, areas of heart muscle that aren't contracting normally, and previous injury to the heart muscle caused by poor blood flow. Computed Tomography Scan A computed tomography (CT) scan creates computer-generated pictures of the heart, brain, or other areas of the body. The test can show hardening and narrowing of large arteries. A cardiac CT scan also can show whether calcium has built up in the walls of the coronary (heart) arteries. This may be an early sign of CHD. Stress Testing During stress testing, you exercise to make your heart work hard and beat fast while heart tests are done. If you can't exercise, you may be given medicine to make your heart work hard and beat fast. When your heart is working hard, it needs more blood and oxygen. Plaque-narrowed arteries can't supply enough oxygen-rich blood to meet your heart's needs. A stress test can show possible signs and symptoms of CHD, such as: Abnormal changes in your heart rate or blood pressure Shortness of breath or chest pain Abnormal changes in your heart rhythm or your heart's electrical activity As part of some stress tests, pictures are taken of your heart while you exercise and while you rest. These imaging stress tests can show how well blood is flowing in various parts of your heart. They also can show how well your heart pumps blood when it beats. Angiography Angiography (an-jee-OG-ra-fee) is a test that uses dye and special x rays to show the inside of your arteries. This test can show whether plaque is blocking your arteries and how severe the blockage is. A thin, flexible tube called a catheter is put into a blood vessel in your arm, groin (upper thigh), or neck. Dye that can be seen on an x-ray picture is injected through the catheter into the arteries. By looking at the x-ray picture, your doctor can see the flow of blood through your arteries. Other Tests Other tests are being studied to see whether they can give a better view of plaque buildup in the arteries. Examples of these tests include magnetic resonance imaging (MRI) and positron emission tomography (PET). TREATMENTS Treatments for atherosclerosis may include heart-healthy lifestyle changes, medicines, and medical procedures or surgery. The goals of treatment include: Lowering the risk of blood clots forming Preventing atherosclerosis-related diseases Reducing risk factors in an effort to slow or stop the buildup of plaque Relieving symptoms Widening or bypassing plaque-clogged arteries Heart-Healthy Lifestyle Changes Your doctor may recommend heart-healthy lifestyle changes if you have atherosclerosis. Heart-healthy lifestyle changes include heart-healthy eating, maintaining a healthy weight, managing stress, physical activity and quitting smoking. Heart-Healthy Eating Your doctor may recommend heart-healthy eating, which should include: Fat-free or low-fat dairy products, such as skim milk Fish high in omega-3 fatty acids, such as salmon, tuna, and trout, about twice a week Fruits, such as apples, bananas, oranges, pears, and prunes Legumes, such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans Vegetables, such as broccoli, cabbage, and carrots Whole grains, such as oatmeal, brown rice, and corn tortillas When following a heart-healthy diet, you should avoid eating: A lot of red meat Palm and coconut oils Sugary foods and beverages Two nutrients in your diet make blood cholesterol levels rise: Saturated fat—found mostly in foods that come from animals Trans fat (trans fatty acids)—found in foods made with hydrogenated oils and fats, such as stick margarine; baked goods, such as cookies, cakes, and pies; crackers; frostings; and coffee creamers. Some trans fats also occur naturally in animal fats and meats. Saturated fat raises your blood cholesterol more than anything else in your diet. When you follow a heart-healthy eating plan, only 5 percent to 6 percent of your daily calories should come from saturated fat. Food labels list the amounts of saturated fat. To help you stay on track, here are some examples: 1,200 calories a day 8 grams of saturated fat a day 1,500 calories a day 10 grams of saturated fat a day 1,800 calories a day 12 grams of saturated fat a day 2,000 calories a day 13 grams of saturated fat a day 2,500 calories a day 17 grams of saturated fat a day Not all fats are bad. Monounsaturated and polyunsaturated fats actually help lower blood cholesterol levels. Some sources of monounsaturated and polyunsaturated fats are: Avocados Corn, sunflower, and soybean oils Nuts and seeds, such as walnuts Olive, canola, peanut, safflower, and sesame oils Peanut butter Salmon and trout Tofu Sodium You should try to limit the amount of sodium that you eat. This means choosing and preparing foods that are lower in salt and sodium. Try to use low-sodium and “no added salt” foods and seasonings at the table or while cooking. Food labels tell you what you need to know about choosing foods that are lower in sodium. Try to eat no more than 2,300 milligrams of sodium a day. If you have high blood pressure, you may need to restrict your sodium intake even more. Dietary Approaches to Stop Hypertension Your doctor may recommend the Dietary Approaches to Stop Hypertension (DASH) eating plan if you have high blood pressure. The DASH eating plan focuses on fruits, vegetables, whole grains, and other foods that are heart healthy and low in fat, cholesterol, and sodium and salt. The DASH eating plan is a good heart-healthy eating plan, even for those who don’t have high blood pressure. Read more about DASH. Alcohol Try to limit alcohol intake. Too much alcohol will raise your blood pressure and triglyceride levels, a type of fat found in the blood. Alcohol also adds extra calories, which may cause weight gain. Men should have no more than two drinks containing alcohol a day. Women should have no more than one drink containing alcohol a day. One drink is: 12 ounces of beer 5 ounces of wine 1½ ounces of liquor Maintaining a Healthy Weight Maintaining a healthy weight is important for overall health and can lower your risk for coronary heart disease. Aim for a Healthy Weight by following a heart-healthy eating plan and keeping physically active. Knowing your body mass index (BMI) helps you find out if you’re a healthy weight in relation to your height and gives an estimate of your total body fat. To figure out your BMI, check out the National Heart, Lung, and Blood Institute’s online BMI calculator or talk to your doctor. A BMI: Below 18.5 is a sign that you are underweight. Between 18.5 and 24.9 is in the normal range. Between 25.0 and 29.9 is considered overweight. A BMI of 30.0 or higher is considered obese. A general goal to aim for is a BMI of less than 25. Your doctor or health care provider can help you set an appropriate BMI goal. Measuring waist circumference helps screen for possible health risks. If most of your fat is around your waist rather than at your hips, you’re at a higher risk for heart disease and type 2 diabetes. This risk may be high with a waist size that is greater than 35 inches for women or greater than 40 inches for men. To learn how to measure your waist, visit Assessing Your Weight and Health Risk. For more information about losing weight or maintaining your weight, visit Aim for a Healthy Weight. If you’re overweight or obese, try to lose weight. A loss of just 3 percent to 5 percent of your current weight can lower your triglycerides, blood glucose, and the risk of developing type 2 diabetes. Greater amounts of weight loss can improve blood pressure readings, lower LDL cholesterol, and increase HDL cholesterol. Managing Stress Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health. Consider healthy stress-reducing activities, such as: A stress management program Meditation Physical activity Relaxation therapy Talking things out with friends or family Physical Activity Regular physical activity can lower many atherosclerosis risk factors, including LDL or “bad” cholesterol, high blood pressure, and excess weight. Physical activity also can lower your risk for diabetes and raise your HDL or “good” cholesterol, which helps prevent atherosclerosis. Everyone should try to participate in moderate-intensity aerobic exercise at least 2 hours and 30 minutes per week or vigorous aerobic exercise for 1 hour and 15 minutes per week. Aerobic exercise, such as brisk walking, is any exercise in which your heart beats faster and you use more oxygen than usual. The more active you are, the more you will benefit. Participate in aerobic exercise for at least 10 minutes at a time spread throughout the week. Talk with your doctor before you start a new exercise plan. Ask your doctor how much and what kinds of physical activity are safe for you. Read more about physical activity at: Physical Activity and Your Heart U.S. Department of Health and Human Services, 2008 Physical Activity Guidelines for Americans Quitting Smoking If you smoke or use tobacco, quit. Smoking can damage and tighten blood vessels and raise your risk for atherosclerosis. Talk with your doctor about programs and products that can help you quit. Also, try to avoid secondhand smoke. If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking. For more information about how to quit smoking, visit Smoking and Your Heart. Medicines Sometimes lifestyle changes alone aren’t enough to control your cholesterol levels. For example, you also may need statin medications to control or lower your cholesterol. By lowering your blood cholesterol level, you can decrease your chance of having a heart attack or stroke. Doctors usually prescribe statins for people who have: Coronary heart disease, peripheral artery disease, or had a prior stroke Diabetes High LDL cholesterol levels Doctors may discuss beginning statin treatment with people who have an elevated risk for developing heart disease or having a stroke. Your doctor also may prescribe other medications to: Lower your blood pressure Lower your blood sugar levels Prevent blood clots, which can lead to heart attack and stroke Prevent inflammation Take all medicines regularly, as your doctor prescribes. Don’t change the amount of your medicine or skip a dose unless your doctor tells you to. You should still follow a heart healthy lifestyle, even if you take medicines to treat your atherosclerosis. Medical Procedures and Surgery If you have severe atherosclerosis, your doctor may recommend a medical procedure or surgery. Percutaneous coronary intervention (PCI), also known as coronary angioplasty, is a procedure that’s used to open blocked or narrowed coronary (heart) arteries. PCI can improve blood flow to the heart and relieve chest pain. Sometimes a small mesh tube called a stent is placed in the artery to keep it open after the procedure. Coronary artery bypass grafting (CABG) is a type of surgery. In CABG, arteries or veins from other areas in your body are used to bypass or go around your narrowed coronary arteries. CABG can improve blood flow to your heart, relieve chest pain, and possibly prevent a heart attack. Bypass grafting also can be used for leg arteries. For this surgery, a healthy blood vessel is used to bypass a narrowed or blocked artery in one of the legs. The healthy blood vessel redirects blood around the blocked artery, improving blood flow to the leg. Carotid endarterectomy is a type of surgery to remove plaque buildup from the carotid arteries in the neck. This procedure restores blood flow to the brain, which can help prevent a stroke. PREVENTION Taking action to control your risk factors can help prevent or delay atherosclerosis and its related diseases. Your risk for atherosclerosis increases with the number of risk factors you have. One step you can take is to adopt a healthy lifestyle, which can include: Heart-Healthy Eating. Adopt heart-healthy eating habits, which include eating different fruits and vegetables (including beans and peas), whole grains, lean meats, poultry without skin, seafood, and fat-free or low-fat milk and dairy products. A heart-healthy diet is low in sodium, added sugar, solid fats, and refined grains. Following a heart-healthy diet is an important part of a healthy lifestyle. Physical Activity. Be as physically active as you can. Physical activity can improve your fitness level and your health. Ask your doctor what types and amounts of activity are safe for you. Read more about Physical Activity and Your Heart. Quit Smoking. If you smoke, quit. Smoking can damage and tighten blood vessels and raise your risk for atherosclerosis. Talk with your doctor about programs and products that can help you quit. Also, try to avoid secondhand smoke. Read more about Smoking and Your Heart. Weight Control. If you’re overweight or obese, work with your doctor to create a reasonable weight-loss plan. Controlling your weight helps you control risk factors for atherosclerosis. Other steps that can prevent or delay atherosclerosis include knowing your family history of atherosclerosis. If you or someone in your family has an atherosclerosis-related disease, be sure to tell your doctor. If lifestyle changes aren’t enough, your doctor may prescribe medicines to control your atherosclerosis risk factors. Take all of your medicines as your doctor advises. LIVING WITH Improved treatments have reduced the number of deaths from atherosclerosis-related diseases. These treatments also have improved the quality of life for people who have these diseases. Adopting a healthy lifestyle may help you prevent or delay atherosclerosis and the problems it can cause. This, along with ongoing medical care, can help you avoid the problems of atherosclerosis and live a long, healthy life. Researchers continue to look for ways to improve the health of people who have atherosclerosis or may develop it. Ongoing Care If you have atherosclerosis, work closely with your doctor and other health care providers to avoid serious problems, such as heart attack and stroke. Follow your treatment plan and take all of your medicines as your doctor prescribes. Your doctor will let you know how often you should schedule office visits or blood tests. Be sure to let your doctor know if you have new or worsening symptoms. Emotional Issues and Support Having an atherosclerosis-related disease may cause fear, anxiety, depression, and stress. Talk about how you feel with your doctor. Talking to a professional counselor also can help. If you're very depressed, your doctor may recommend medicines or other treatments that can improve your quality of life. Community resources are available to help you learn more about atherosclerosis. Contact your local public health departments, hospitals, and local chapters of national health organizations to learn more about available resources in your area. Talk about your lifestyle changes with your family and friends—whoever can provide support or needs to understand why you're changing your habits. Family and friends may be able to help you make lifestyle changes. For example, they can help you plan healthier meals. Because atherosclerosis tends to run in families, your lifestyle changes may help many of your family members too. ", "role": "user" }, { "content": "You can control most risk factors and help prevent or delay atherosclerosis. Major risk factors include unhealthy blood cholesterol levels, high LDL cholesterol, low HDL cholesterol, an unhealthy diet, or a family history of heart disease.", "role": "assistant" } ]

[ { "content": "Diabetes Type 2 I test before going to bed and the reading is 94 but when I test again in the morning, the reading is 165. How can I lower it? I eat dinner around 8PM and nothing until the next morning.\n\nType 2 diabetes - what to ask your doctor (Questions): Ask your provider to check the nerves, skin, and pulses in your feet. Also ask these questions: - How often should I check my feet? What should I do when I check them? What problems should I call my provider about? - Who should trim my toenails? Is it OK if I trim them? - How should I take care of my feet every day? What type of shoes and socks should I wear? - Should I see a foot doctor (podiatrist)? Ask your provider about getting exercise: - Before I start, do I need to have my heart checked? My eyes? My feet? - What type of exercise program should I do? What type of activities should I avoid? - When should I check my blood sugar when I exercise? What should I bring with me when I exercise? Should I eat before or during exercise? Do I need to adjust my medicines when I exercise? When should I next have an eye doctor check my eyes? What eye problems should I call my doctor about? Ask your provider about meeting with a dietitian. Questions for the dietitian may include: - What foods increase my blood sugar the most? - What foods can help me with my weight loss goals? Ask your provider about your diabetes medicines: - When should I take them? - What should I do if I miss a dose? - Are there any side effects? How often should I check my blood sugar level at home? Should I do it at different times of the day? What is too low? What is too high? What should I do if my blood sugar is too low or too high? Should I get a medical alert bracelet or necklace? Should I have glucagon at home? Ask your provider about symptoms that you are having if they have not been discussed. Tell your provider about blurred vision, skin changes, depression, reactions at injection sites, sexual dysfunction, tooth pain, muscle pain, or nausea. Ask your provider about other tests you may need, such as cholesterol, A1C, and a urine test to check for kidney problems. Ask your provider about vaccinations you should have like the flu shot, hepatitis B, or pneumonia vaccines. How should I take care of my diabetes when I travel? Ask your provider how you should take care of your diabetes when you are sick: - What should I eat or drink? - How should I take my diabetes medicines? - How often should I check my blood sugar? - When should I call the provider?", "role": "user" }, { "content": "Ask your provider about symptoms that you are having if they have not been discussed. Your provider will set the target range for your blood sugar, clarify what type of exercise you need and if you need to see a dietitian for discussing healthy eating and weight loss or maintenance goals. Your provider will tell you how often and when you need to check your blood sugar levels, and what to do if they are out of range.", "role": "assistant" } ]

[ { "content": "When and how do you know when you have congenital night blindness?\n\n Autosomal recessive congenital stationary night blindness autosomal recessive complete congenital stationary night blindness autosomal recessive incomplete congenital stationary night blindness Description Autosomal recessive congenital stationary night blindness is a disorder of the retina, which is the specialized tissue at the back of the eye that detects light and color. People with this condition typically have difficulty seeing and distinguishing objects in low light (night blindness). For example, they may not be able to identify road signs at night or see stars in the night sky. They also often have other vision problems, including loss of sharpness (reduced acuity), nearsightedness (myopia), involuntary movements of the eyes (nystagmus), and eyes that do not look in the same direction (strabismus). The vision problems associated with this condition are congenital, which means they are present from birth. They tend to remain stable (stationary) over time. Frequency Autosomal recessive congenital stationary night blindness is likely a rare disease; however, its prevalence is unknown. Causes Mutations in several genes can cause autosomal recessive congenital stationary night blindness. Each of these genes provide instructions for making proteins that are found in the retina. These proteins are involved in sending (transmitting) visual signals from cells called rods, which are specialized for vision in low light, to cells called bipolar cells, which relay the signals to other retinal cells. This signaling is an essential step in the transmission of visual information from the eyes to the brain. Mutations in two genes, GRM6 and TRPM1, cause most cases of this condition. These genes provide instructions for making proteins that are necessary for bipolar cells to receive and relay signals. Mutations in other genes involved in the same bipolar cell signaling pathway are likely responsible for a small percentage of cases of autosomal recessive congenital stationary night blindness. Gene mutations that cause autosomal recessive congenital stationary night blindness disrupt the transmission of visual signals between rod cells and bipolar cells or interfere with the bipolar cells' ability to pass on these signals. As a result, visual information received by rod cells cannot be effectively transmitted to the brain, leading to difficulty seeing in low light. The cause of the other vision problems associated with this condition is unclear. It has been suggested that the mechanisms that underlie night blindness can interfere with other visual systems, causing myopia, reduced visual acuity, and other impairments. Some people with autosomal recessive congenital stationary night blindness have no identified mutation in any of the known genes. The cause of the disorder in these individuals is unknown. Inheritance Pattern This condition is inherited in an autosomal recessive pattern, which means both copies of the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition. Sources for This Page Audo I, Bujakowska K, Orhan E, Poloschek CM, Defoort-Dhellemmes S, Drumare I, Kohl S, Luu TD, Lecompte O, Zrenner E, Lancelot ME, Antonio A, Germain A, Michiels C, Audier C, Letexier M, Saraiva JP, Leroy BP, Munier FL, Mohand-Said S, Lorenz B, Friedburg C, Preising M, Kellner U, Renner AB, Moskova-Doumanova V, Berger W, Wissinger B, Hamel CP, Schorderet DF, De Baere E, Sharon D, Banin E, Jacobson SG, Bonneau D, Zanlonghi X, Le Meur G, Casteels I, Koenekoop R, Long VW, Meire F, Prescott K, de Ravel T, Simmons I, Nguyen H, Dollfus H, Poch O, Leveillard T, Nguyen-Ba-Charvet K, Sahel JA, Bhattacharya SS, Zeitz C. Whole-exome sequencing identifies mutations in GPR179 leading to autosomal-recessive complete congenital stationary night blindness. Am J Hum Genet. 2012 Feb 10;90(2):321-30. doi: 10.1016/j.ajhg.2011.12.007. Erratum in: Am J Hum Genet. 2012 Jul 13;91(1):209. ", "role": "user" }, { "content": "Gene mutations that cause autosomal recessive congenital stationary night blindness disrupt the transmission of visual signals between rod cells and bipolar cells or interfere with the bipolar cells' ability to pass on these signals. As a result, visual information received by rod cells cannot be effectively transmitted to the brain, leading to difficulty seeing in low light. The cause of the other vision problems associated with this condition is unclear. It has been suggested that the mechanisms that underlie night blindness can interfere with other visual systems, causing myopia, reduced visual acuity, and other impairments. Some people with autosomal recessive congenital stationary night blindness have no identified mutation in any of the known genes. The cause of the disorder in these individuals is unknown.", "role": "assistant" } ]

[ { "content": "how is a heart attack treated\n\n Heart attack Myocardial infarction MI Acute MI ST - elevation myocardial infarction Non-ST - elevation myocardial infarction NSTEMI CAD - heart attack Coronary artery disease - heart attack Summary Most heart attacks are caused by a blood clot that blocks one of the coronary arteries. The coronary arteries bring blood and oxygen to the heart. If the blood flow is blocked, the heart is starved of oxygen and heart cells die. The medical term for this is myocardial infarction. Causes A substance called plaque can build up in the walls of your coronary arteries. This plaque is made up of cholesterol and other cells. A heart attack may occur when: A tear in the plaque occurs. This triggers blood platelets and other substances to form a blood clot at the site that blocks most or all of the oxygen-carrying blood from flowing to a part of the heart muscle. This is the most common cause of heart attack. A slow buildup of plaque may narrow one of the coronary arteries so that it is almost blocked. In either case, there is not enough blood flow to the heart muscle and heart muscle dies. The cause of heart attack is not always known. Heart attack may occur: When you are resting or asleep After a sudden increase in physical activity When you are active outside in cold weather After sudden, severe emotional or physical stress, including an illness Many risk factors may lead to the development of plaque buildup and a heart attack. Symptoms A heart attack is a medical emergency. If you have symptoms of a heart attack, call 911 or your local emergency number right away. DO NOT try to drive yourself to the hospital. DO NOT WAIT. You are at greatest risk of sudden death in the early hours of a heart attack. Chest pain is the most common symptom of a heart attack. You may feel the pain in only one part of your body OR Pain may move from your chest to your arms, shoulder, neck, teeth, jaw, belly area, or back The pain can be severe or mild. It can feel like: A tight band around the chest Bad indigestion Something heavy sitting on your chest Squeezing or heavy pressure The pain most often lasts longer than 20 minutes. Rest and a medicine to relax the blood vessels (called nitroglycerin) may not completely relieve the pain of a heart attack. Symptoms may also go away and come back. Other symptoms of a heart attack can include: Anxiety Cough Fainting Lightheadedness, dizziness Nausea and vomiting Palpitations (feeling like your heart is beating too fast or irregularly) Shortness of breath Sweating, which may be very heavy Some people (the older adults, people with diabetes, and women) may have little or no chest pain. Or, they may have unusual symptoms such as shortness of breath, fatigue, and weakness. A \"silent heart attack\" is a heart attack with no symptoms. Exams and Tests A health care provider will perform a physical exam and listen to your chest using a stethoscope. The provider may hear abnormal sounds in your lungs (called crackles), a heart murmur, or other abnormal sounds. You may have a fast or uneven pulse. Your blood pressure may be normal, high, or low. You will have an electrocardiogram (ECG) to look for heart damage. Most of the time, certain changes on the ECG indicate you are having a heart attack. Sometimes these changes are not present, even though other tests indicate you have had a heart attack. This can be called non-ST elevation myocardial infarction (NSTEMI). A blood test can show if you have heart tissue damage. This test can confirm that you are having a heart attack. You will likely have this test 3 times over the first 6 to 12 hours. Coronary angiography may be done right away or when you are more stable. This test uses a special dye and x-rays to see how blood flows through your heart. It can help your doctor decide which treatments you need next. Other tests to look at your heart that may be done while you are in the hospital: Echocardiography with or with stress testing Exercise stress test Nuclear stress test Heart CT scan or heart MRI Treatment IMMEDIATE TREATMENT You will be hooked up to a heart monitor, so the health care team can see how regularly your heart is beating. You will receive oxygen so that your heart doesn't have to work as hard. An intravenous line (IV) will be placed into one of your veins. Medicines and fluids pass through this IV. You may get nitroglycerin and morphine to help reduce chest pain. You may receive aspirin, unless it would not be safe for you. In that case, you will be given another medicine that prevents blood clots. Dangerous abnormal heartbeats (arrhythmias) may be treated with medicine or electric shocks. EMERGENCY PROCEDURES Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart. Angioplasty is often the first choice of treatment. It should be done within 90 minutes after you get to the hospital, and usually no later than 12 hours after a heart attack. A stent is a small, metal mesh tube that opens up (expands) inside a coronary artery. A stent is usually placed after or during angioplasty. It helps prevent the artery from closing up again. You may be given drugs to break up the clot. This is called thrombolytic therapy. It is best if these drugs are given soon after the onset of symptoms, usually no later than 12 hours after it and ideally within 30 minutes of arriving to the hospital. Some people may also have heart bypass surgery to open narrowed or blocked blood vessels that supply blood to the heart. This procedure is also called coronary artery bypass grafting and/or open heart surgery. TREATMENT AFTER A HEART ATTACK After several days, you will be discharged from the hospital. You will likely need to take medicines, some for the rest of your life. Always talk to your provider before stopping or changing how you take any medicines. Stopping certain medicines can be deadly. While under the care of your health care team, you will learn: How to take medicines to treat your heart problem and prevent more heart attacks How to eat a heart-healthy diet How to be active and exercise safely What to do when you have chest pain How to stop smoking Strong emotions are common after a heart attack. You may feel sad You may feel anxious and worry about being careful about everything you do All of these feelings are normal. They go away for most people after 2 or 3 weeks. You may also feel tired when you leave the hospital to go home. Most people who have had a heart attack take part in a cardiac rehabilitation program. Support Groups Many people benefit from taking part in support groups for people with heart disease. Outlook (Prognosis) After a heart attack, you have a higher chance of having another heart attack. How well you do after a heart attack depends on several factors such as: The amount of damage to your heart muscle and heart valves Where that damage is located Your medical care after the heart attack If your heart can no longer pump blood out to your body as well as it used to, you may develop heart failure. Abnormal heart rhythms can occur, and they can be life threatening. Most people can slowly go back to normal activities after a heart attack. This includes sexual activity. Talk to your provider about how much activity is good for you. Review Date 6/18/2018 Updated by: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Heart attack (Treatment): IMMEDIATE TREATMENT - You will be hooked up to a heart monitor, so the health care team can see how regularly your heart is beating. - You will receive oxygen so that your heart doesn't have to work as hard. - An intravenous line (IV) will be placed into one of your veins. Medicines and fluids pass through this IV. - You may get nitroglycerin and morphine to help reduce chest pain. - You may receive aspirin, unless it would not be safe for you. In that case, you will be given another medicine that prevents blood clots. EMERGENCY PROCEDURES Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart. - Angioplasty is often the first choice of treatment.", "role": "assistant" } ]

[ { "content": "Can you mail me patient information about Glaucoma, I was recently diagnosed and want to learn all I can about the disease.\n\n Glaucoma Open-angle glaucoma Chronic glaucoma Chronic open-angle glaucoma Primary open-angle glaucoma Closed-angle glaucoma Narrow-angle glaucoma Angle-closure glaucoma Acute glaucoma Secondary glaucoma Congenital glaucoma Vision loss - glaucoma Summary Glaucoma is a group of eye conditions that can damage the optic nerve. This nerve sends the images you see to your brain. Most often, optic nerve damage is caused by increased pressure in the eye. This is called intraocular pressure. Watch this video about: Glaucoma </div> </div> Causes Glaucoma is the second most common cause of blindness in the United States. There are four major types of glaucoma: Open-angle glaucoma Angle-closure glaucoma, also called closed-angle glaucoma Congenital glaucoma Secondary glaucoma The front part of the eye is filled with a clear fluid called aqueous humor. This fluid is made in an area behind the colored part of the eye (iris). It leaves the eye through channels where the iris and cornea meet. This area is called the anterior chamber angle, or the angle. The cornea is the clear covering on the front of the eye that covers the iris, pupil, and angle. Anything that slows or blocks the flow of this fluid will cause pressure to build up in the eye. In open-angle glaucoma, the increase in pressure is often small and slow. In closed-angle glaucoma, the increase is often high and sudden. Either type can damage the optic nerve. <strong>Open-angle glaucoma</strong> is the most common type of glaucoma. The cause is unknown. The increase in eye pressure happens slowly over time. You cannot feel it. The increased pressure pushes on the optic nerve. Damage to the optic nerve causes blind spots in your vision. Open-angle glaucoma tends to run in families. Your risk is higher if you have a parent or grandparent with open-angle glaucoma. People of African descent are also at higher risk for this disease. <strong>Closed-angle glaucoma</strong> occurs when the fluid is suddenly blocked and cannot flow out of the eye. This causes a quick, severe rise in eye pressure. Dilating eye drops and certain medicines may trigger an acute glaucoma attack. Closed-angle glaucoma is an emergency. If you have had acute glaucoma in one eye, you are at risk for it in the second eye. Your health care provider is likely to treat your second eye to prevent a first attack in that eye. <strong>Secondary glaucoma</strong> occurs due to a known cause. Both open- and closed-angle glaucoma can be secondary when caused by something known. Causes include: Drugs such as corticosteroids Eye diseases such as uveitis (an infection of the middle layer of the eye) Diseases such as diabetes Eye injury <strong>Congenital glaucoma</strong> occurs in babies. It often runs in families. It is present at birth. It is caused when the eye does not develop normally. Symptoms OPEN-ANGLE GLAUCOMA Most people have no symptoms. Once you are aware of vision loss, the damage is already severe. Slow loss of side (peripheral) vision (also called tunnel vision). Advanced glaucoma can lead to blindness. ANGLE-CLOSURE GLAUCOMA Symptoms may come and go at first, or steadily become worse. You may notice: Sudden, severe pain in one eye Decreased or cloudy vision, often called \"steamy\" vision Nausea and vomiting Rainbow-like halos around lights Red eye Eye feels swollen CONGENITAL GLAUCOMA Symptoms are most often noticed when the child is a few months old. Cloudiness of the front of the eye Enlargement of one eye or both eyes Red eye Sensitivity to light Tearing SECONDARY GLAUCOMA Symptoms are most often related to the underlying problem causing the glaucoma. Depending on the cause, symptoms may either be like open-angle glaucoma or angle-closure glaucoma. Exams and Tests The only way to diagnose glaucoma is by having a complete eye exam. You will be given a test to check your eye pressure. This is called tonometry. In most cases, you will be given eye drops to widen (dilate) your pupil. When your pupil is dilated, your eye doctor will look at the inside of your eye and the optic nerve. Eye pressure is different at different times of the day. Eye pressure can even be normal in some people with glaucoma. So you will need other tests to confirm glaucoma. They may include: Using a special lens to look at the angle of the eye (gonioscopy). Photographs or laser scanning images of the inside of your eye (optic nerve imaging). Laser scanning images of the angle of the eye. Checking your retina -- The retina is the light-sensitive tissue at the back of your eye. Checking how your pupil responds to light (pupillary reflex response). 3-D view of your eye (slit lamp examination). Testing the clearness of your vision (visual acuity). Testing your field of vision (visual field measurement). Treatment The goal of treatment is to reduce your eye pressure. Treatment depends on the type of glaucoma that you have. OPEN-ANGLE GLAUCOMA If you have open-angle glaucoma, you will probably be given eye drops. You may need more than one type. Most people can be treated with eye drops. Most of the eye drops used today have fewer side effects than those used in the past. You also may be given pills to lower pressure in the eye. If drops alone do not work, you may need other treatment: Laser treatment uses a painless laser to open the channels where fluid flows out. If drops and laser treatment do not work, you may need surgery. The doctor will open a new channel so fluid can escape. This will help lower your pressure. Recently, new implants have been developed that can help treat glaucoma in people having cataract surgery. ACUTE ANGLE GLAUCOMA An acute angle-closure attack is a medical emergency. You can become blind in a few days if you are not treated. You may be given drops, pills, and medicine given through a vein (by IV) to lower your eye pressure. Some people also need an emergency operation, called an iridotomy. The doctor uses a laser to open a new channel in the iris. Sometimes this is done with surgery. The new channel relieves the attack and will prevent another attack. To help prevent an attack in the other eye, the procedure will often be performed on the other eye. This may be done even if it has never had an attack. CONGENITAL GLAUCOMA Congenital glaucoma is almost always treated with surgery. This is done using general anesthesia. This means the child is asleep and feels no pain. SECONDARY GLAUCOMA If you have secondary glaucoma, treating the cause may help your symptoms go away. Other treatments also may be needed. Outlook (Prognosis) Open-angle glaucoma cannot be cured. You can manage it and keep your sight by following your provider's directions. Closed-angle glaucoma is a medical emergency. You need treatment right away to save your vision. Babies with congenital glaucoma usually do well when surgery is done early. How you do with secondary glaucoma depends on what is causing the condition. When to Contact a Medical Professional If you have severe eye pain or a sudden loss of vision, get immediate medical help. These may be signs of closed-angle glaucoma. Prevention You cannot prevent open-angle glaucoma. Most people have no symptoms. But you can help prevent vision loss. A complete eye exam can help find open-angle glaucoma early, when it is easier to treat. All adults should have a complete eye exam by the age of 40. If you are at risk for glaucoma, you should have a complete eye exam sooner than age 40. You should have regular eye exams as recommended by your provider. If you are at risk for closed-angle glaucoma, your provider may recommend treatment before you have an attack to help prevent eye damage and vision loss. Review Date 2/19/2018 Updated by: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Open-angle glaucoma occurs due to slow increase in eye pressure over time, and is the most common type of glaucoma. Its cause is unknown, but it tends to run in the families. Most people cannot feel open-angle glaucoma. Closed-angle glaucoma occurs due to a quick, severe rise in eye pressure. Dilating eye drops and certain medicines may trigger an acute glaucoma attack. Secondary glaucoma occurs due to a known cause. Both open- and closed-angle glaucoma can be secondary when caused by something known. Causes include: drugs such as corticosteroids, eye diseases such as uveitis, diabetes, eye injury.", "role": "assistant" } ]

[ { "content": "If oleandor was ingested by touching the plant stems inner part and then directly eating without washing hands, how long would u exspect symptoms would start? And how severe would you say symptoms may get.\n\n Oleander poisoning Rosebay poisoning Yellow oleander poisoning Thevetia peruviana poisoning Summary Oleander poisoning occurs when someone eats the flowers or chews the leaves or stems of the oleander plant (<em>Nerium oleander</em>), or its relative, the yellow oleander (<em>Cascabela thevetia</em>). This article is for information only. DO NOT use it to treat or manage an actual poison exposure. If you or someone you are with has an exposure, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. Poisonous Ingredient Poisonous ingredients include: Digitoxigenin Neriin Oleandrin Oleondroside <strong>Note:</strong> This list may not include all poisonous ingredients. Where Found The poisonous substances are found in all parts of the oleander plant: Flowers Leaves Stems Twigs Symptoms Oleander poisoning can affect many parts of the body. HEART AND BLOOD Irregular or slow heartbeat Low blood pressure Weakness EYES, EARS, NOSE, MOUTH, AND THROAT Blurred vision Vision disturbances, including halos STOMACH AND INTESTINES Diarrhea Loss of appetite Nausea and vomiting Stomach pain NERVOUS SYSTEM Confusion Death Depression Disorientation Dizziness Drowsiness Fainting Headache Lethargy SKIN Hives Rash <strong>Note:</strong> Depression, loss of appetite, and halos are most often seen in chronic overdose cases. Home Care Seek immediate medical help. DO NOT make a person throw up unless told to do so by poison control or a health care provider. Before Calling Emergency Get the following information: Person's age, weight, and condition Name and part of the plant swallowed, if known Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This hotline number will let you talk to experts in poisoning. They will give you further instructions. This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does not need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week. What to Expect at the Emergency Room The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. The person may receive: Activated charcoal Blood and urine tests Breathing support Chest x-ray ECG (electrocardiogram, or heart tracing) Fluids through a vein (IV) Medicines to treat symptoms including an antidote to reverse the effects of the poison Tube through the mouth into the stomach to wash out the stomach (gastric lavage) Outlook (Prognosis) How well you do depends on the amount of poison swallowed and how quickly treatment is received. The faster you get medical help, the better the chance for recovery. Symptoms last for 1 to 3 days and may require a hospital stay. Death is unlikely. DO NOT touch or eat any plant with which you are not familiar. Wash your hands after working in the garden or walking in the woods. Review Date 10/16/2017 Updated by: Jesse Borke, MD, FACEP, FAAEM, Attending Physician at FDR Medical Services/Millard Fillmore Suburban Hospital, Buffalo, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Oleander poisoning can cause irregular or slow heartbeat, low blood pressure, weakness, blurred vision, vision disturbances, including halos, diarrhea, loss of appetite, nausea and vomiting, stomach pain, confusion, disorientation, dizziness, drowsiness, fainting, headache, lethargy, hives, and rash. Depression, loss of appetite, and halos are most often seen in chronic overdose cases.", "role": "assistant" } ]

[ { "content": "How bad can endometriosis get?\n\n Endometriosis Pelvic pain - endometriosis Endometrioma Summary Endometriosis occurs when cells from the lining of your womb (uterus) grow in other areas of your body. This can cause pain, heavy bleeding, bleeding between periods, and problems getting pregnant (infertility). Causes Every month, a woman's ovaries produce hormones that tell the cells lining the uterus to swell and get thicker. Your uterus sheds these cells along with blood and tissue through your vagina when you have your period. Endometriosis occurs when these cells grow outside the uterus in other parts of your body. This tissue may attach on your: Ovaries Bowel Rectum Bladder Lining of your pelvic area It can grow in other areas of the body, too. These growths stay in your body, and like the cells in the lining of your uterus, these growths react to the hormones from your ovaries. They grow and bleed when you get your period. Over time, the growths may add more tissue and blood. The buildup of blood and tissue in your body leads to pain and other symptoms. No one knows what causes endometriosis. One idea is that when you get your period, the cells may travel backwards through the fallopian tubes into the pelvis. Once there, the cells attach and grow. However, this backward period flow occurs in many women. Researchers think that the immune system plays a role in causing endometriosis in women the condition. Endometriosis is common. Sometimes, it may run in families. Endometriosis probably starts when a woman begins having periods. However, it usually is not diagnosed until ages 25 to 35. You are more likely to develop endometriosis if you: Have a mother or sister with endometriosis Started your period at a young age Never had children Have frequent periods, or they last 7 or more days Have a closed hymen, which blocks the flow of menstrual blood during the period Symptoms Pain is the main symptom of endometriosis. You may have: Painful periods. Pain in your lower belly before and during your period. Cramps for a week or 2 before and during your period. Cramps may be steady and range from dull to severe. Pain during or following sexual intercourse. Pain with bowel movements. Pelvic or low back pain that may occur at any time. You may not have any symptoms. Some women with a lot of tissue in their pelvis have no pain at all, while some women with milder disease have severe pain. Exams and Tests Your health care provider will perform a physical exam, including a pelvic exam. You may have one of these tests to help diagnose the disease: Transvaginal ultrasound Pelvic laparoscopy Treatment Learning how to manage your symptoms can make it easier to live with endometriosis. What type of treatment you have depends on: Your age Severity of your symptoms Severity of the disease Whether you want children in the future There are different treatment options. PAIN RELIEVERS If you have mild symptoms, you may be able to manage cramping and pain with: Exercise and relaxation techniques. Over-the-counter pain relievers -- These include ibuprofen (Advil), naproxen (Aleve), and acetaminophen (Tylenol). Prescription painkillers, if needed, for more severe pain. Regular exams every 6 to 12 months so your doctor can assess the disease. HORMONE THERAPY These medicines can stop endometriosis from getting worse. They may be given as pills, nasal spray, or shots. Only women who are not trying get pregnant should have this therapy. Hormone therapy will prevent you from getting pregnant. Once you stop therapy, you can get pregnant again. Birth control pills<strong> --</strong> With this therapy, you take the hormone pills (not the inactive or placebo pills) for 6 to 9 months continuously. Taking these pills relieves most symptoms. However, it does not treat any damage that has already occurred. Progesterone pills or injections <strong>--</strong> This treatment helps shrink growths. Side effects may include weight gain and depression. <strong> </strong> Gonadotropin-agonist medicines <strong>-- </strong>These medicines stop your ovaries from producing the hormone estrogen. This causes a menopause-like state. Side effects include hot flashes, vaginal dryness, and mood changes. Treatment is often limited to 6 months because it can weaken your bones. Your provider may give you small doses of hormone to relieve symptoms during this treatment. This is known as 'add-back' therapy. It may also help protect against bone loss, while not triggering growth of the endometriosis. SURGERY Your provider may recommend surgery if you have severe pain that does not get better with other treatments. Laparoscopy helps diagnose the disease and can also remove growths and scar tissue. Because only a small cut is made in your belly, you will heal faster than other types of surgery. Laparotomy involves making a large incision (cut) in your belly to remove growths and scar tissue. This is major surgery, so healing takes longer. Laparoscopy or laparotomy may be a good option if you want to become pregnant, because they treat the disease and leave your organs in place. Hysterectomy is surgery to remove your uterus, fallopian tubes, and ovaries. If your ovaries are not removed, symptoms may return. You would only have this surgery if you have severe symptoms and do not want to have children in the future. Outlook (Prognosis) Hormone therapy and laparoscopy can't cure endometriosis. However, in some women, these treatments may help relieve symptoms for years. Removal of the uterus, fallopian tubes, and both ovaries (a hysterectomy) gives you the best chance for a cure. Once you enter menopause, endometriosis is unlikely to cause problems. Possible Complications Endometriosis can lead to problems getting pregnant. However, most women with mild symptoms can still get pregnant. Laparoscopy to remove growths and scar tissue may help improve your chances of becoming pregnant. If it does not, you may want to consider fertility treatments. Other complications of endometriosis include: Long-term pelvic pain that interferes with social and work activities Large cysts in the pelvis that may break open (rupture) In rare cases, endometriosis tissue may block the intestines or urinary tract. Very rarely, cancer may develop in the areas of tissue growth after menopause. When to Contact a Medical Professional Call your provider if: You have symptoms of endometriosis Back pain or other symptoms reoccurring after endometriosis is treated You may want to get screened for endometriosis if: Your mother or sister has the disease You are unable to become pregnant after trying for 1 year Prevention Birth control pills may help to prevent or slow down the development of the endometriosis. Birth control pills used as treatment for endometriosis work best when taken continuously and not stopped to allow a menstrual period. They may be used for young women in late adolescence or early 20s with painful periods that may be due to endometriosis. Review Date 2/13/2018 Updated by: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Endometriosis occurs when cells from the lining of the womb (uterus) grow in other areas of the body. This can cause pain, heavy bleeding, bleeding between periods, and problems getting pregnant (infertility).", "role": "assistant" } ]

[ { "content": "how to prevent atherosclerosis\n\nAtherosclerosis (PREVENTION): Taking action to control your risk factors can help prevent or delay atherosclerosis and its related diseases. Your risk for atherosclerosis increases with the number of risk factors you have. One step you can take is to adopt a healthy lifestyle, which can include: Heart-Healthy Eating. Adopt heart-healthy eating habits, which include eating different fruits and vegetables (including beans and peas), whole grains, lean meats, poultry without skin, seafood, and fat-free or low-fat milk and dairy products. A heart-healthy diet is low in sodium, added sugar, solid fats, and refined grains. Following a heart-healthy diet is an important part of a healthy lifestyle. Physical Activity. Be as physically active as you can. Physical activity can improve your fitness level and your health. Ask your doctor what types and amounts of activity are safe for you. Read more about Physical Activity and Your Heart. Quit Smoking. If you smoke, quit. Smoking can damage and tighten blood vessels and raise your risk for atherosclerosis. Talk with your doctor about programs and products that can help you quit. Also, try to avoid secondhand smoke. Read more about Smoking and Your Heart. Weight Control. If you’re overweight or obese, work with your doctor to create a reasonable weight-loss plan. Controlling your weight helps you control risk factors for atherosclerosis. Other steps that can prevent or delay atherosclerosis include knowing your family history of atherosclerosis. If you or someone in your family has an atherosclerosis-related disease, be sure to tell your doctor. If lifestyle changes aren’t enough, your doctor may prescribe medicines to control your atherosclerosis risk factors. Take all of your medicines as your doctor advises.  ", "role": "user" }, { "content": "Taking action to control your risk factors can help prevent or delay atherosclerosis and its related diseases. You can adopt heart-healthy eating habits, be as physically active as you can, avoid smoking, or work with your doctor to create a reasonable weight-loss plan.", "role": "assistant" } ]

[ { "content": "prevention of preeclampsia I know that the jury is out on the exact causes of preeclampsia, but I am looking for some of the ways that the chances of acquiring it can be minimized.\n\n Preeclampsia Overview Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of damage to another organ system, most often the liver and kidneys. Preeclampsia usually begins after 20 weeks of pregnancy in women whose blood pressure had been normal. Even a slight rise in blood pressure may be a sign of preeclampsia. Left untreated, preeclampsia can lead to serious - even fatal - complications for both you and your baby. If you have preeclampsia, the only cure is delivery of your baby. If you're diagnosed with preeclampsia too early in your pregnancy to deliver your baby, you and your doctor face a challenging task. Your baby needs more time to mature, but you need to avoid putting yourself or your baby at risk of serious complications. Symptoms Preeclampsia sometimes develops without any symptoms. High blood pressure may develop slowly, or it may have a sudden onset. Monitoring your blood pressure is an important part of prenatal care because the first sign of preeclampsia is commonly a rise in blood pressure. Blood pressure that exceeds 140/90 millimeters of mercury (mm Hg) or greater - documented on two occasions, at least four hours apart - is abnormal. Other signs and symptoms of preeclampsia may include: - Excess protein in your urine (proteinuria) or additional signs of kidney problems - Severe headaches - Changes in vision, including temporary loss of vision, blurred vision or light sensitivity - Upper abdominal pain, usually under your ribs on the right side - Nausea or vomiting - Decreased urine output - Decreased levels of platelets in your blood (thrombocytopenia) - Impaired liver function - Shortness of breath, caused by fluid in your lungs Sudden weight gain and swelling (edema) - particularly in your face and hands - may occur with preeclampsia. But these also occur in many normal pregnancies, so they're not considered reliable signs of preeclampsia. Make sure you attend your prenatal visits so that your care provider can monitor your blood pressure. Contact your doctor immediately or go to an emergency room if you have severe headaches, blurred vision or other visual disturbance, severe pain in your abdomen, or severe shortness of breath. Because headaches, nausea, and aches and pains are common pregnancy complaints, it's difficult to know when new symptoms are simply part of being pregnant and when they may indicate a serious problem - especially if it's your first pregnancy. If you're concerned about your symptoms, contact your doctor. Causes The exact cause of preeclampsia involves several factors. Experts believe it begins in the placenta - the organ that nourishes the fetus throughout pregnancy. Early in pregnancy, new blood vessels develop and evolve to efficiently send blood to the placenta. In women with preeclampsia, these blood vessels don't seem to develop or function properly. They're narrower than normal blood vessels and react differently to hormonal signaling, which limits the amount of blood that can flow through them. Causes of this abnormal development may include: - Insufficient blood flow to the uterus - Damage to the blood vessels - A problem with the immune system - Certain genes Preeclampsia is classified as one of four high blood pressure disorders that can occur during pregnancy. The other three are: - Gestational hypertension. Women with gestational hypertension have high blood pressure but no excess protein in their urine or other signs of organ damage. Some women with gestational hypertension eventually develop preeclampsia. - Chronic hypertension. Chronic hypertension is high blood pressure that was present before pregnancy or that occurs before 20 weeks of pregnancy. But because high blood pressure usually doesn't have symptoms, it may be hard to determine when it began. - Chronic hypertension with superimposed preeclampsia. This condition occurs in women who have been diagnosed with chronic high blood pressure before pregnancy, but then develop worsening high blood pressure and protein in the urine or other health complications during pregnancy. Risk factors Preeclampsia develops only as a complication of pregnancy. Risk factors include: - History of preeclampsia. A personal or family history of preeclampsia significantly raises your risk of preeclampsia. - Chronic hypertension. If you already have chronic hypertension, you have a higher risk of developing preeclampsia. - First pregnancy. The risk of developing preeclampsia is highest during your first pregnancy. - New paternity. Each pregnancy with a new partner increases the risk of preeclampsia more than does a second or third pregnancy with the same partner. - Age. The risk of preeclampsia is higher for very young pregnant women as well as pregnant women older than 40. - Obesity. The risk of preeclampsia is higher if you're obese. - Multiple pregnancy. Preeclampsia is more common in women who are carrying twins, triplets or other multiples. - Interval between pregnancies. Having babies less than two years or more than 10 years apart leads to a higher risk of preeclampsia. - History of certain conditions. Having certain conditions before you become pregnant - such as chronic high blood pressure, migraines, type 1 or type 2 diabetes, kidney disease, a tendency to develop blood clots, or lupus - increases your risk of preeclampsia. - In vitro fertilization. Your risk of preeclampsia is increased if your baby was conceived with in vitro fertilization. Complications The more severe your preeclampsia and the earlier it occurs in your pregnancy, the greater the risks for you and your baby. Preeclampsia may require induced labor and delivery. Delivery by cesarean delivery (C-section) may be necessary if there are clinical or obstetric conditions that require a speedy delivery. Your obstetric provider will assist you in deciding what type of delivery is correct for your condition. Complications of preeclampsia may include: - Fetal growth restriction. Preeclampsia affects the arteries carrying blood to the placenta. If the placenta doesn't get enough blood, your baby may receive inadequate blood and oxygen and fewer nutrients. This can lead to slow growth known as fetal growth restriction, low birth weight or preterm birth. - Preterm birth. If you have preeclampsia with severe features, you may need to be delivered early, to save the life of you and your baby. Prematurity can lead to breathing and other problems for your baby. Your health care provider will help you understand when is the ideal time for your delivery. - Placental abruption. Preeclampsia increases your risk of placental abruption, a condition in which the placenta separates from the inner wall of your uterus before delivery. Severe abruption can cause heavy bleeding, which can be life-threatening for both you and your baby. - HELLP syndrome. HELLP - which stands for hemolysis (the destruction of red blood cells), elevated liver enzymes and low platelet count - syndrome is a more severe form of preeclampsia, and can rapidly become life-threatening for both you and your baby. Symptoms of HELLP syndrome include nausea and vomiting, headache, and upper right abdominal pain. HELLP syndrome is particularly dangerous because it represents damage to several organ systems. On occasion, it may develop suddenly, even before high blood pressure is detected or it may develop without any symptoms at all. - Eclampsia. When preeclampsia isn't controlled, eclampsia - which is essentially preeclampsia plus seizures - can develop. It is very difficult to predict which patients will have preeclampsia that is severe enough to result in eclampsia. Often, there are no symptoms or warning signs to predict eclampsia. Because eclampsia can have serious consequences for both mom and baby, delivery becomes necessary, regardless of how far along the pregnancy is. - Other organ damage. Preeclampsia may result in kidney, liver, lung, heart, or eyes, and may cause a stroke or other brain injury. The amount of injury to other organs depends on the severity of preeclampsia. - Cardiovascular disease. Having preeclampsia may increase your risk of future heart and blood vessel (cardiovascular) disease. The risk is even greater if you've had preeclampsia more than once or you've had a preterm delivery. To minimize this risk, after delivery try to maintain your ideal weight, eat a variety of fruits and vegetables, exercise regularly, and don't smoke. Diagnosis To diagnose preeclampsia, you have to have high blood pressure and one or more of the following complications after the 20th week of pregnancy: - Protein in your urine (proteinuria) - A low platelet count - Impaired liver function - Signs of kidney trouble other than protein in the urine - Fluid in the lungs (pulmonary edema) - New-onset headaches or visual disturbances Previously, preeclampsia was only diagnosed if high blood pressure and protein in the urine were present. However, experts now know that it's possible to have preeclampsia, yet never have protein in the urine. A blood pressure reading in excess of 140/90 mm Hg is abnormal in pregnancy. However, a single high blood pressure reading doesn't mean you have preeclampsia. If you have one reading in the abnormal range - or a reading that's substantially higher than your usual blood pressure - your doctor will closely observe your numbers. Having a second abnormal blood pressure reading four hours after the first may confirm your doctor's suspicion of preeclampsia. Your doctor may have you come in for additional blood pressure readings and blood and urine tests. Tests that may be needed If your doctor suspects preeclampsia, you may need certain tests, including: - Blood tests. Your doctor will order liver function tests, kidney function tests and also measure your platelets - the cells that help blood clot. - Urine analysis. Your doctor will ask you to collect your urine for 24 hours, for measurement of the amount of protein in your urine. A single urine sample that measures the ratio of protein to creatinine - a chemical that's always present in the urine - also may be used to make the diagnosis. - Fetal ultrasound. Your doctor may also recommend close monitoring of your baby's growth, typically through ultrasound. The images of your baby created during the ultrasound exam allow your doctor to estimate fetal weight and the amount of fluid in the uterus (amniotic fluid). - Nonstress test or biophysical profile. A nonstress test is a simple procedure that checks how your baby's heart rate reacts when your baby moves. A biophysical profile uses an ultrasound to measure your baby's breathing, muscle tone, movement and the volume of amniotic fluid in your uterus. Treatment The only cure for preeclampsia is delivery. You're at increased risk of seizures, placental abruption, stroke and possibly severe bleeding until your blood pressure decreases. Of course, if it's too early in your pregnancy, delivery may not be the best thing for your baby. If you're diagnosed with preeclampsia, your doctor will let you know how often you'll need to come in for prenatal visits - likely more frequently than what's typically recommended for pregnancy. You'll also need more frequent blood tests, ultrasounds and nonstress tests than would be expected in an uncomplicated pregnancy. Medications Possible treatment for preeclampsia may include: - Medications to lower blood pressure. These medications, called antihypertensives, are used to lower your blood pressure if it's dangerously high. Blood pressure in the 140/90 millimeters of mercury (mm Hg) range generally isn't treated. Although there are many different types of antihypertensive medications, a number of them aren't safe to use during pregnancy. Discuss with your doctor whether you need to use an antihypertensive medicine in your situation to control your blood pressure. - Corticosteroids. If you have severe preeclampsia or HELLP syndrome, corticosteroid medications can temporarily improve liver and platelet function to help prolong your pregnancy. Corticosteroids can also help your baby's lungs become more mature in as little as 48 hours - an important step in preparing a premature baby for life outside the womb. - Anticonvulsant medications. If your preeclampsia is severe, your doctor may prescribe an anticonvulsant medication, such as magnesium sulfate, to prevent a first seizure. Bed rest Bed rest used to be routinely recommended for women with preeclampsia. But research hasn't shown a benefit from this practice, and it can increase your risk of blood clots, as well as impact your economic and social lives. For most women, bed rest is no longer recommended. Hospitalization Severe preeclampsia may require that you be hospitalized. In the hospital, your doctor may perform regular nonstress tests or biophysical profiles to monitor your baby's well-being and measure the volume of amniotic fluid. A lack of amniotic fluid is a sign of poor blood supply to the baby. Delivery If you're diagnosed with preeclampsia near the end of your pregnancy, your doctor may recommend inducing labor right away. The readiness of your cervix - whether it's beginning to open (dilate), thin (efface) and soften (ripen) - also may be a factor in determining whether or when labor will be induced. In severe cases, it may not be possible to consider your baby's gestational age or the readiness of your cervix. If it's not possible to wait, your doctor may induce labor or schedule a C-section right away. During delivery, you may be given magnesium sulfate intravenously to prevent seizures. If you need pain-relieving medication after your delivery, ask your doctor what you should take. NSAIDs, such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), can increase your blood pressure. ", "role": "user" }, { "content": "Experts believe preeclampsia begins in the placenta. Early in pregnancy, new blood vessels develop to send blood to the placenta. In women with preeclampsia, these blood vessels don't to develop or function properly: they are narrower than normal and react differently to hormones. Causes of this abnormal development include: insufficient blood flow to the uterus, damage to the blood vessels, problems with the immune system, or certain genes.", "role": "assistant" } ]

[ { "content": "Is it necessary to go to the dr. when getting a skull fracture?\n\nWhat to do for Skull fracture?: If you think someone has a skull fracture: - Check the airways, breathing, and circulation. If necessary, begin rescue breathing and CPR. - Avoid moving the person (unless absolutely necessary) until medical help arrives. Have someone to call 911 (or the local emergency number) for medical assistance. - If the person must be moved, take care to stabilize the head and neck. Place your hands on both sides of the head and under the shoulders. Do not allow the head to bend forward or backward, or to twist or turn. - Carefully check the site of injury, but do not probe in or around the site with a foreign object. It can be hard to know if the skull is fractured or depressed (dented in) at the site of injury. - If there is bleeding, apply firm pressure with a clean cloth over a broad area to control blood loss. - If blood soaks through, do not remove the original cloth. Instead, apply more cloths on top, and continue to apply pressure. - If the person is vomiting, stabilize the head and neck, and carefully turn the victim to the side to prevent choking on vomit. - If the person is conscious and experiencing any of the previously listed symptoms, transport to the nearest emergency medical facility (even if the patient does not think medical help is needed).", "role": "user" }, { "content": "If you think someone has a skull fracture: - Check the airways, breathing, and circulation. If necessary, begin rescue breathing and CPR. - Avoid moving the person (unless absolutely necessary) until medical help arrives. Have someone to call 911 (or the local emergency number) for medical assistance.", "role": "assistant" } ]

[ { "content": "Polycystic ovarian syndrome Is it possible for parents to pass this on in the genes to their children - is there any other way this can be acquired?\n\n Polycystic ovarian syndrome PCOS Summary Polycystic ovarian syndrome (PCOS) is a health problem that can affect a woman's menstrual cycle, ability to have children, hormones , heart, blood vessels, and appearance. Women with this condition typically have high levels of hormones called androgens, missed or irregular periods, and many small cysts in their ovaries. The cause of PCOS is unknown, but probably involves a combination of genetic and environmental factors . Treatment for PCOS may involve birth control pills and medications for diabetes and infertility. Medicines called anti-androgens are also used to speed the growth of hair and clear acne. [1] [2] Symptoms This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom. Showing of Medical Terms Other Names Learn More: HPO ID Percent of people who have these symptoms is not available through HPO Abnormality of metabolism/homeostasis Laboratory abnormality Metabolism abnormality 0001939 Amenorrhea Abnormal absence of menstruation 0000141 Autosomal dominant inheritance 0000006 Enlarged polycystic ovaries 0008675 Hirsutism Excessive hairiness 0001007 Obesity Having too much body fat 0001513 Oligomenorrhea 0000876 Showing of Find a Specialist If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments. If you can't find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care. You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists. Healthcare Resources To find a medical professional who specializes in genetics, you can ask your doctor for a referral or you can search for one yourself. Online directories are provided by the American College of Medical Genetics and the National Society of Genetic Counselors. If you need additional help, contact a GARD Information Specialist. You can also learn more about genetic consultations from Genetics Home Reference. ", "role": "user" }, { "content": "The cause of PCOS is unknown, but probably involves a combination of genetic and environmental factors", "role": "assistant" } ]

[ { "content": "how is a heart attack treated\n\nHeart attack (Treatment): IMMEDIATE TREATMENT - You will be hooked up to a heart monitor, so the health care team can see how regularly your heart is beating. - You will receive oxygen so that your heart doesn't have to work as hard. - An intravenous line (IV) will be placed into one of your veins. Medicines and fluids pass through this IV. - You may get nitroglycerin and morphine to help reduce chest pain. - You may receive aspirin, unless it would not be safe for you. In that case, you will be given another medicine that prevents blood clots. - Dangerous abnormal heartbeats (arrhythmias) may be treated with medicine or electric shocks. EMERGENCY PROCEDURES Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart. - Angioplasty is often the first choice of treatment. It should be done within 90 minutes after you get to the hospital, and usually no later than 12 hours after a heart attack. - A stent is a small, metal mesh tube that opens up (expands) inside a coronary artery. A stent is usually placed after or during angioplasty. It helps prevent the artery from closing up again. You may be given drugs to break up the clot. This is called thrombolytic therapy. It is best if these drugs are given soon after the onset of symptoms, usually no later than 12 hours after it and ideally within 30 minutes of arriving to the hospital. Some people may also have heart bypass surgery to open narrowed or blocked blood vessels that supply blood to the heart. This procedure is also called coronary artery bypass grafting and/or open heart surgery. TREATMENT AFTER A HEART ATTACK After several days, you will be discharged from the hospital. You will likely need to take medicines, some for the rest of your life. Always talk to your provider before stopping or changing how you take any medicines. Stopping certain medicines can be deadly. While under the care of your health care team, you will learn: - How to take medicines to treat your heart problem and prevent more heart attacks - How to eat a heart-healthy diet - How to be active and exercise safely - What to do when you have chest pain - How to stop smoking Strong emotions are common after a heart attack. - You may feel sad - You may feel anxious and worry about being careful about everything you do All of these feelings are normal. They go away for most people after 2 or 3 weeks. You may also feel tired when you leave the hospital to go home. Most people who have had a heart attack take part in a cardiac rehabilitation program.", "role": "user" }, { "content": "Treatment of heart attacks depends on the immediacy of the attack. If you have just experienced a heart attack and have been taken to a hospital, you will be hooked up to a heart monitor so your health care team the check to see how regularly your heart is beating. You will receive oxygen, so your heart doesn't have to work as hard. You may get medicines through an IV to help reduce chest pain. You may be provided aspirin or another medicine to prevent blood clots. If it is an emergency and your blood vessels are not capable of delivering blood to the heart, angioplasty is a surgical procedure that is often the first choice of treatment. This is when narrowed or blocked blood vessels are opened to allow them to flow again.", "role": "assistant" } ]

[ { "content": "Anal Fissure I may have a couple anal fissures and looking to speak with someone to get some information and support.\n\n Anal fissure Overview An anal fissure is a small tear in the thin, moist tissue (mucosa) that lines the anus. An anal fissure may occur when you pass hard or large stools during a bowel movement. Anal fissures typically cause pain and bleeding with bowel movements. You also may experience spasms in the ring of muscle at the end of your anus (anal sphincter). Anal fissures are very common in young infants but can affect people of any age. Most anal fissures get better with simple treatments, such as increased fiber intake or sitz baths. Some people with anal fissures may need medication or, occasionally, surgery. Symptoms Signs and symptoms of an anal fissure include: - Pain, sometimes severe, during bowel movements - Pain after bowel movements that can last up to several hours - Bright red blood on the stool or toilet paper after a bowel movement - Itching or irritation around the anus - A visible crack in the skin around the anus - A small lump or skin tag on the skin near the anal fissure When to see a doctor See your doctor if you have pain during bowel movements or notice blood on stools or toilet paper after a bowel movement. Causes Common causes of anal fissure include: - Passing large or hard stools - Constipation and straining during bowel movements - Chronic diarrhea - Inflammation of the anorectal area, caused by Crohn's disease or another inflammatory bowel disease - Childbirth Less common causes of anal fissures include: - Anal cancer - HIV - Tuberculosis - Syphilis - Herpes Risk factors Factors that may increase your risk of developing an anal fissure include: - Infancy. Many infants experience an anal fissure during their first year of life; experts aren't sure why. - Aging. Older adults may develop an anal fissure partly due to slowed circulation, resulting in decreased blood flow to the rectal area. - Constipation. Straining during bowel movements and passing hard stools increase the risk of tearing. - Childbirth. Anal fissures are more common in women after they give birth. - Crohn's disease. This inflammatory bowel disease causes chronic inflammation of the intestinal tract, which may make the lining of the anal canal more vulnerable to tearing. - Anal intercourse. Complications Complications of anal fissure can include: - Failure to heal. An anal fissure that fails to heal within six weeks is considered chronic and may need further treatment. - Recurrence. Once you've experienced an anal fissure, you are prone to having another one. - A tear that extends to surrounding muscles. An anal fissure may extend into the ring of muscle that holds your anus closed (internal anal sphincter), making it more difficult for your anal fissure to heal. An unhealed fissure can trigger a cycle of discomfort that may require medications or surgery to reduce the pain and to repair or remove the fissure. Diagnosis If possible, your doctor will perform a digital rectal exam, which involves inserting a gloved finger into your anal canal, or use a short, lighted tube (anoscope) to inspect your anal canal. However, if this is too painful for you, your doctor may be able to diagnose an anal fissure only by observation. An acute anal fissure looks like a fresh tear, somewhat like a paper cut. A chronic anal fissure likely has the tear, as well as two separate lumps or tags of skin, one internal (sentinel pile) and one external (hypertrophied papilla). The fissure's location offers clues about its cause. A fissure that occurs on the side of the anal opening, rather than the back or front, is more likely to be a sign of another disorder, such as Crohn's disease. Your doctor may recommend further testing if he or she thinks you have an underlying condition: - Flexible sigmoidoscopy. Your doctor will insert a thin, flexible tube with a tiny video into the bottom portion of your colon. This test may be done if you're younger than 50 and have no risk factors for intestinal diseases or colon cancer. - Colonoscopy. Your doctor will insert a flexible tube into your rectum to inspect the entire colon. This test may be done if you are older than age 50 or you have risk factors for colon cancer, signs of other conditions, or other symptoms such as abdominal pain or diarrhea. Treatment Anal fissures often heal within a few weeks if you take steps to keep your stool soft, such as increasing your intake of fiber and fluids. Soaking in warm water for 10 to 20 minutes several times a day, especially after bowel movements, can help relax the sphincter and promote healing. If your symptoms persist, you'll likely need further treatment. Nonsurgical treatments Your doctor may recommend: - Externally applied nitroglycerin (Rectiv), to help increase blood flow to the fissure and promote healing and to help relax the anal sphincter. Nitroglycerin is generally considered the medical treatment of choice when other conservative measures fail. Side effects may include headache, which can be severe. - Topical anesthetic creams such as lidocaine hydrochloride (Xylocaine) may be helpful for pain relief. - Botulinum toxin type A (Botox) injection, to paralyze the anal sphincter muscle and relax spasms. - Blood pressure medications, such as oral nifedipine (Procardia) or diltiazem (Cardizem) can help relax the anal sphincter. These medications may be taken by mouth or applied externally and may be used when nitroglycerin is not effective or causes significant side effects. Surgery If you have a chronic anal fissure that is resistant to other treatments, or if your symptoms are severe, your doctor may recommend surgery. Doctors usually perform a procedure called lateral internal sphincterotomy (LIS), which involves cutting a small portion of the anal sphincter muscle to reduce spasm and pain, and promote healing. Studies have found that for chronic fissure, surgery is much more effective than any medical treatment. However, surgery has a small risk of causing incontinence. Lifestyle and home remedies Several lifestyle changes may help relieve discomfort and promote healing of an anal fissure, as well as prevent recurrences: - Add fiber to your diet. Eating about 25 to 30 grams of fiber a day can help keep stools soft and improve fissure healing. Fiber-rich foods include fruits, vegetables, nuts and whole grains. You also can take a fiber supplement. Adding fiber may cause gas and bloating, so increase your intake gradually. - Drink adequate fluids. Fluids help prevent constipation. - Exercise regularly. Engage in 30 minutes or more of moderate physical activity, such as walking, most days of the week. Exercise promotes regular bowel movements and increases blood flow to all parts of your body, which may promote healing of an anal fissure. - Avoid straining during bowel movements. Straining creates pressure, which can open a healing tear or cause a new tear. If your infant has an anal fissure, be sure to change diapers frequently, wash the area gently and discuss the problem with your child's doctor. ", "role": "user" }, { "content": "Anal fissures may fail to heal, recur after healing and cause other complications, such as tears extending into the anal sphincter muscles. Fissures that fail to heal within six week may require medications to relieve symptoms or surgery to repair the leasions.", "role": "assistant" } ]

[ { "content": "I am 23yr boy,i have knock knees i want treatment. Please help me.\n\nKnock knees (Possible Complications): Complications may include: - Difficulty walking (very rare) - Self-esteem changes related to cosmetic appearance of knock knees - If left untreated, knock knees can lead to early arthritis of the knee", "role": "user" }, { "content": "Rare complications of knock knees include difficulty walking and self-esteem changes related to appearance of the knees. Untreated knock knees can lead to early arthritis of the knee.", "role": "assistant" } ]

[ { "content": "can i take keflex to cure staph?\n\n Staph infections Overview Staph infections are caused by staphylococcus bacteria, types of germs commonly found on the skin or in the nose of even healthy individuals. Most of the time, these bacteria cause no problems or result in relatively minor skin infections. But staph infections can turn deadly if the bacteria invade deeper into your body, entering your bloodstream, joints, bones, lungs or heart. A growing number of otherwise healthy people are developing life-threatening staph infections. Treatment usually involves antibiotics and drainage of the infected area. However, some staph infections no longer respond to common antibiotics. Symptoms Staph infections can range from minor skin problems to endocarditis, a life-threatening infection of the inner lining of your heart (endocardium). As a result, signs and symptoms of staph infections vary widely, depending on the location and severity of the infection. Skin infections caused by staph bacteria include: - Boils. The most common type of staph infection is the boil, a pocket of pus that develops in a hair follicle or oil gland. The skin over the infected area usually becomes red and swollen. If a boil breaks open, it will probably drain pus. Boils occur most often under the arms or around the groin or buttocks. - Impetigo. This contagious, often painful rash can be caused by staph bacteria. Impetigo usually features large blisters that may ooze fluid and develop a honey-colored crust. - Cellulitis. Cellulitis - an infection of the deeper layers of skin - causes skin redness and swelling on the surface of your skin. Sores (ulcers) or areas of oozing discharge may develop, too. - Staphylococcal scalded skin syndrome. Toxins produced as a result of a staph infection may lead to staphylococcal scalded skin syndrome. Affecting mostly babies and children, this condition features fever, a rash and sometimes blisters. When the blisters break, the top layer of skin comes off - leaving a red, raw surface that looks like a burn. Staph bacteria are one of the most common causes of food poisoning. Symptoms come on quickly, usually within hours of eating a contaminated food. Symptoms usually disappear quickly, too, often lasting just half a day. A staph infection in food usually doesn't cause a fever. Signs and symptoms you can expect with this type of staph infection include: - Nausea and vomiting - Diarrhea - Dehydration - Low blood pressure Also known as blood poisoning, septicemia occurs when staph bacteria enter a person's bloodstream. A fever and low blood pressure are signs of septicemia. The bacteria can travel to locations deep within your body, to produce infections affecting: - Internal organs, such as your brain, heart or lungs - Bones and muscles - Surgically implanted devices, such as artificial joints or cardiac pacemakers This life-threatening condition results from toxins produced by some strains of staph bacteria and has been linked to certain types of tampons, skin wounds and surgery. It usually develops suddenly with: - A high fever - Nausea and vomiting - A rash on your palms and soles that resembles sunburn - Confusion - Muscle aches - Diarrhea - Abdominal pain Septic arthritis is often caused by a staph infection. The bacteria often target the knees, shoulders, hips, and fingers or toes. Signs and symptoms may include: - Joint swelling - Severe pain in the affected joint - Fever Go to the doctor if you or your child has: - An area of red, irritated or painful skin - Pus-filled blisters - Fever You may also want to consult your doctor if: - Skin infections are being passed from one family member to another - Two or more family members have skin infections at the same time Causes Many people carry staph bacteria and never develop staph infections. However, if you develop a staph infection, there's a good chance that it's from bacteria you've been carrying around for some time. These bacteria can also be transmitted from person to person. Because staph bacteria are so hardy, they can live on inanimate objects such as pillowcases or towels long enough to transfer to the next person who touches them. Staph bacteria are able to survive: - Drying - Extremes of temperature - Stomach acid - High levels of salt Risk factors A variety of factors - including the status of your immune system to the types of sports you play - can increase your risk of developing staph infections. Certain disorders or the medications used to treat them can make you more susceptible to staph infections. People who may be more likely to get a staph infection include those with: - Diabetes who use insulin - HIV/AIDS - Kidney failure requiring dialysis - Weakened immune systems - either from a disease or medications that suppress the immune system - Cancer, especially those who are undergoing chemotherapy or radiation - Skin damage from conditions such as eczema, insect bites or minor trauma that opens the skin - Respiratory illness, such as cystic fibrosis or emphysema Despite vigorous attempts to eradicate them, staph bacteria remain present in hospitals, where they attack the most vulnerable, including people with: - Weakened immune systems - Burns - Surgical wounds Staph bacteria can travel along the medical tubing that connects the outside world with your internal organs. Examples include: - Dialysis tubing - Urinary catheters - Feeding tubes - Breathing tubes - Intravascular catheters Staph bacteria can spread easily through cuts, abrasions and skin-to-skin contact. Staph infections may also spread in the locker room through shared razors, towels, uniforms or equipment. Food handlers who don't properly wash their hands can transfer staph from their skin to the food they're preparing. Foods that are contaminated with staph look and taste normal. Complications If staph bacteria invade your bloodstream, you may develop a type of infection that affects your entire body. Called sepsis, this infection can lead to septic shock - a life-threatening episode with extremely low blood pressure. Diagnosis To diagnose a staph infection, your doctor will: - Perform a physical exam. During the exam, your doctor will closely examine any skin lesions you may have. - Collect a sample for testing. Most often, doctors diagnose staph infections by checking a tissue sample or nasal secretions for signs of the bacteria. Treatment Treatment of a staph infection may include: - Antibiotics. Your doctor may perform tests to identify of the staph bacteria behind your infection, and to help choose the antibiotic that will work best. Antibiotics commonly prescribed to treat staph infections include certain cephalosporins, nafcillin or related antibiotics, sulfa drugs, or vancomycin. Vancomycin increasingly is required to treat serious staph infections because so many strains of staph bacteria have become resistant to other traditional medicines. But vancomycin and some other antibiotics have to be given intravenously. If you're given an oral antibiotic, be sure to take it as directed, and to finish all of the medication prescribed by your doctor. Ask your doctor what signs and symptoms you should watch for that might indicate your infection is worsening. - Wound drainage. If you have a skin infection, your doctor will likely make an incision into the sore to drain fluid that has collected there. - Device removal. If your infection involves a device or prosthetic, prompt removal of the device is needed. For some devices, removal might require surgery. Antibiotic resistance Staph bacteria are very adaptable, and many varieties have become resistant to one or more antibiotics. For example, only about 10 percent of today's staph infections can be cured with penicillin. The emergence of antibiotic-resistant strains of staph bacteria - often described as methicillin-resistant Staphylococcus aureus (MRSA) strains - has led to the use of IV antibiotics, such as vancomycin, with the potential for more side effects, such as vancomycin. ", "role": "user" }, { "content": "Treatment of a staph infection may include: - Antibiotics. Your doctor may perform tests to identify of the staph bacteria behind your infection, and to help choose the antibiotic that will work best. Antibiotics commonly prescribed to treat staph infections include certain cephalosporins, nafcillin or related antibiotics, sulfa drugs, or vancomycin. But vancomycin and some other antibiotics have to be given intravenously.", "role": "assistant" } ]

[ { "content": "We have 14 siblings in our family , at least 10 of us has had a frozen shoulder. We are wondering why? should we be concerned?\n\nWhat are the complications of Frozen shoulder?: Complications may include: - Stiffness and pain continue even with therapy - The arm can break if the shoulder is moved forcefully during surgery", "role": "user" }, { "content": "What are the complications of Frozen shoulder?: Complications may include: - Stiffness and pain continue even with therapy - The arm can break if the shoulder is moved forcefully during surgery", "role": "assistant" } ]

[ { "content": "how is klineflyers syndrome screened\n\nKlinefelter syndrome: Klinefelter syndrome (KS) is a condition that occurs in males when they have an extra X chromosome . Some males with KS have no obvious signs or symptoms while others may have varying degrees of cognitive, social, behavioral, and learning difficulties. Adults with Klinefelter syndrome may also experience primary hypogonadism (decreased testosterone production), small testes , enlarged breast tissue ( gynecomastia ), tall stature, and/or infertility. KS is not inherited , but usually occurs as a random event during the formation of reproductive cells (eggs and sperm). Treatment is based on the signs and symptoms present in each person. [1] [2] [3] The signs and symptoms of Klinefelter syndrome (KS) vary among affected people. Some men with KS have no symptoms of the condition or are only mildy affected. In these cases, they may not even know that they are affected by KS. When present, symptoms may include: [1] [2] [3] Small, firm testicles Delayed or incomplete puberty Breast growth ( gynecomastia ) Reduced facial and body hair Infertility Tall height Abnormal body proportions (long legs, short trunk, shoulder equal to hip size) Learning disablity Speech delay Whether or not a male with KS has visible symptoms depends on many factors, including how much testosterone his body makes, if he is mosaic (with both XY and XXY cells ), and his age when the condition is diagnosed and treated. [1] Klinefelter syndrome usually occurs as a random event during the formation of reproductive cells (eggs and sperm). An error in cell division called nondisjunction results in a reproductive cell with an abnormal number of chromosomes . For example, an egg or sperm cell may gain one or more extra copies of the X chromosome as a result of nondisjunction. If one of these atypical reproductive cells contributes to the genetic makeup of a child, the child will have one or more extra X chromosomes in each of the body's cells. [2] Most often, Klinefelter syndrome is caused by a single extra copy of the X chromosome, resulting in a total of 47 chromosomes per cell. Males normally have one X chromosome and one Y chromosome in each cell (46, XY), while females have two X chromosomes (46, XX). People with Klinefelter syndrome usually have two X chromosomes and one Y chromosome (47, XXY). Some people with Klinefelter syndrome have the extra X chromosome in only some of their cells; these people are said to have mosaic Klinefelter syndrome. [2] It is estimated that about half of the time, the cell division error occurs during development of the sperm, while the remainder are due to errors in egg development. Women who have pregnancies after age 35 have a slightly increased chance of having offspring with this syndrome. [4] The features of Klinefelter syndrome are due to the extra copies of genes on the extra X chromosome, which can alter male sexual development. [3] Klinefelter syndrome  is not inherited , but usually occurs as a random event during the formation of reproductive cells (eggs and sperm). An error in cell division called nondisjunction can result in reproductive cells with an abnormal number of chromosomes . For example, an egg or sperm cell may gain one or more extra copies of the X chromosome as a result of nondisjunction. If one of these reproductive cells contributes to the genetic makeup of a child, the child will have one or several extra X chromosomes in each of the body's cells. [2] A diagnosis of Klinefelter syndrome is often suspected based on the presence of characteristic signs and symptoms. Additional testing can then be ordered to confirm the diagnosis. This generally includes a chromosomal analysis (called a karyotype ). [3] [5]  It is also possible to diagnosis Klinefelter syndrome before birth through chorionic villous sampling or amniocentesis . [5] Because symptoms of Klinefelter syndrome (KS) can sometimes be very mild, many people are never diagnosed or treated. When a diagnosis is made, treatment is based on the signs and symptoms present in each person. This may include: [1] [3] [6] Educational interventions - As children, many people with Klinefelter syndrome qualify for special services to help them in school. Teachers can also help by using certain methods in the classroom, such as breaking bigger tasks into small steps. Therapeutic options - A variety of therapists, such as physical, speech, occupational, behavioral, mental health, and family therapists can often help reduce or eliminate some of the symptoms of Klinefelter syndrome such as poor muscle tone; speech and language problems; or low self-confidence. Medical management - About half of people with KS have low testosterone levels, which may be raised by taking supplemental testosterone. Having a more normal testosterone level can help affected people develop bigger muscles, a deeper voice, and facial and body hair. Many healthcare providers recommend testosterone therapy when a boy reaches puberty. However, not all males with KS benefit from testosterone therapy. Some affected people may opt to have breast removal or reduction surgery. The Eunice Kennedy Shriver National Institute of Child Health and Human Development's Web site offers more specific information on the treatment and management of Klinefelter syndrome. Please click on the link to access this resource. Babies with the 47, XXY form of Klinefelter differ little from healthy children. The results of one study on non- mosaic XXY infants younger than 2 years indicated that most XXY babies had normal external genitalia and facial features with height and weight in the normal range. Genetic testing had been performed due to a delay in walking and/or speech. Early detection of Klinefelter syndrome is shown to be important to monitor potential developmental problems. [6] Boys with the 47, XXY karyotype may struggle through adolescence with academics, various frustrations, and, in a few instances, serious emotional or behavioral difficulties. However, most move toward full independence from their families as they enter adulthood. Some have completed graduate education and have a normal level of functioning.  Lifespan is not affected by Klinefelter syndrome. [6] It is estimated that 1 in every 500 to 1,000 newborn males has an extra X chromosome, making Klinefelter syndrome one of the most common chromosomal disorders seen among newborns. Variants of Klinefelter syndrome (such as 48,XXXY, 49,XXXXY) are much rarer, occurring in 1 in 50,000 to 1 in 85,000 or fewer newborns. [1] [7] It is suspected that Klinefelter syndrome is underdiagnosed because mild cases may not be identified. In addition, the features of this condition vary and can overlap significantly with those of other conditions. [7] The following diseases are related to Klinefelter syndrome. If you have a question about any of these diseases, you can contact GARD. 47, XXY", "role": "user" }, { "content": "Once the characteristic signs and symptoms of Klinefelter syndrome have been observed, testing can be ordered to confirm the diagnosis. The includes a chromosomal analysis, called a karyotype, which shows the arrangement of your chromosomes. It is also possible to diagnose Kinefelter syndrome before birth through chorionic villous sampling or amniocentesis.", "role": "assistant" } ]

[ { "content": "how is epilepsy diagnosed\n\nEpilepsy - children (Exams and Tests): The provider will: - Ask about your child's medical and family history in detail - Ask about the seizure episode - Do a physical exam of your child, including a detailed look at the brain and nervous system The provider will order an EEG (electroencephalogram) to check the electrical activity in the brain. This test often shows any abnormal electrical activity in the brain. In some cases, the test shows the area in the brain where the seizures start. The brain may appear normal after a seizure or between seizures. To diagnose epilepsy or plan for epilepsy surgery, your child may need to: - Wear an EEG recorder for few days during day-to-day activities - Stay in the hospital where brain activity can be watched on video cameras (video EEG) The provider also may order other tests, including: - Blood chemistry - Blood sugar - Complete blood count (CBC) - Kidney function tests - Liver function tests - Lumbar puncture (spinal tap) - Tests for infectious diseases Head CT or MRI scan are often done to find the cause and location of the problem in the brain. Much less often, PET scan of the brain is needed to help plan surgery.", "role": "user" }, { "content": "Epilepsy - children (Exams and Tests): The provider will: - Ask about your child's medical and family history in detail - Ask about the seizure episode - Do a physical exam of your child, including a detailed look at the brain and nervous system The provider will order an EEG (electroencephalogram) to check the electrical activity in the brain. This test often shows any abnormal electrical activity in the brain. In some cases, the test shows the area in the brain where the seizures start. To diagnose epilepsy or plan for epilepsy surgery, your child may need to: - Wear an EEG recorder for few days during day-to-day activities - Stay in the hospital where brain activity can be watched on video cameras (video EEG) The provider also may order other tests, including: - Blood chemistry - Blood sugar - Complete blood count (CBC) - Kidney function tests - Liver function tests - Lumbar puncture (spinal tap) - Tests for infectious diseases Head CT or MRI scan are often done to find the cause and location of the problem in the brain.", "role": "assistant" } ]

[ { "content": "could tetanus be a cause of death?\n\nTetanus: Tetanus is a serious bacterial disease that affects your nervous system, leading to painful muscle contractions, particularly of your jaw and neck muscles. Tetanus can interfere with your ability to breathe and can threaten your life. Tetanus is commonly known as \"lockjaw.\" Thanks to the tetanus vaccine, cases of tetanus are rare in the United States and other parts of the developed world. However, the disease remains a threat to those who aren't up to date on their vaccinations, and is more common in developing countries. There's no cure for tetanus. Treatment focuses on managing complications until the effects of the tetanus toxin resolve. Signs and symptoms of tetanus appear anytime from a few days to several weeks after tetanus bacteria enter your body through a wound. The average incubation period is seven to 10 days. Common signs and symptoms of tetanus include: - Spasms and stiffness in your jaw muscles (trismus) - Stiffness of your neck muscles - Difficulty swallowing - Stiffness of your abdominal muscles - Painful body spasms lasting for several minutes, typically triggered by minor occurrences, such as a draft, loud noise, physical touch or light Possible other signs and symptoms include: - Fever - Sweating - Elevated blood pressure - Rapid heart rate See your doctor for a tetanus booster shot if you have a deep or dirty wound and you haven't had a booster shot in five years. If you aren't sure of when your last booster was, get a booster. Or see your doctor about a tetanus booster for any wound - especially if it might have been contaminated with dirt, animal feces or manure - if you haven't had a booster shot within the past 10 years or aren't sure of when you were last vaccinated. Spores of the bacteria that cause tetanus, Clostridium tetani, are found in soil, dust and animal feces. When they enter a deep flesh wound, spores grow into bacteria that can produce a powerful toxin, tetanospasmin, which impairs the nerves that control your muscles (motor neurons). The toxin can cause muscle stiffness and spasms - the major signs of tetanus. Nearly all cases of tetanus occur in people who have never been vaccinated or adults who haven't kept up with their 10-year booster shots. You can't catch tetanus from a person who has it. The following increase your likelihood of getting tetanus: - Failure to get vaccinated or to keep up to date with booster shots against tetanus - An injury that lets tetanus spores into the wound - A foreign body, such as a nail or splinter Tetanus cases have developed from the following: - Puncture wounds - including from splinters, body piercings, tattoos, injection drugs - Gunshot wounds - Compound fractures - Burns - Surgical wounds - Injection drug use - Animal or insect bites - Infected foot ulcers - Dental infections - Infected umbilical stumps in newborns born of inadequately immunized mothers Once tetanus toxin has bonded to your nerve endings it is impossible to remove. Complete recovery from a tetanus infection requires new nerve endings to grow, which can take up to several months. Complications of tetanus infection may include: - Broken bones. The severity of spasms may cause the spine and other bones to break. - Blockage of a lung artery (pulmonary embolism). A blood clot that has traveled from elsewhere in your body can block the main artery of the lung or one of its branches. - Death. Severe tetanus-induced (tetanic) muscle spasms can interfere with or stop your breathing. Respiratory failure is the most common cause of death. Lack of oxygen may also induce cardiac arrest and death. Pneumonia is another cause of death. Doctors diagnose tetanus based on a physical exam, medical and immunization history, and the signs and symptoms of muscle spasms, stiffness and pain. Laboratory tests generally aren't helpful for diagnosing tetanus. Since there's no cure for tetanus, treatment consists of wound care, medications to ease symptoms and supportive care. Wound care Cleaning the wound is essential to preventing growth of tetanus spores. This involves removing dirt, foreign objects and dead tissue from the wound. Medications - Antitoxin. Your doctor may give you a tetanus antitoxin, such as tetanus immune globulin. However, the antitoxin can neutralize only toxin that hasn't yet bonded to nerve tissue. - Antibiotics. Your doctor may also give you antibiotics, either orally or by injection, to fight tetanus bacteria. - Vaccine. All people with tetanus should receive the tetanus vaccine as soon as they're diagnosed with the condition. - Sedatives. Doctors generally use powerful sedatives to control muscle spasms. - Other drugs. Other medications, such as magnesium sulfate and certain beta blockers, might be used to regulate involuntary muscle activity, such as your heartbeat and breathing. Morphine might be used for this purpose as well as sedation. Supportive therapies Severe tetanus infection often requires a long stay in an intensive care setting. Since sedatives can inhibit breathing, you might temporarily need a ventilator. Puncture wounds or other deep cuts, animal bites, or particularly dirty wounds put you at increased risk of tetanus infection. Get medical attention if the wound is deep and dirty, and particularly if you're unsure of when you were last vaccinated. Leave unclean wounds open to avoid trapping bacteria in the wound with a bandage. Your doctor may need to clean the wound, prescribe an antibiotic and give you a booster shot of the tetanus toxoid vaccine. If you've previously been immunized, your body should quickly make the needed antibodies to protect you against tetanus. If you have a minor wound, these steps will help prevent tetanus: - Control bleeding. Apply direct pressure to control bleeding. - Keep the wound clean. After the bleeding stops, rinse the wound thoroughly with clean running water. Clean the area around the wound with soap and a washcloth. If something is embedded in a wound, see your doctor. - Use an antibiotic. After you clean the wound, apply a thin layer of an antibiotic cream or ointment, such as the multi-ingredient antibiotics Neosporin and Polysporin. These antibiotics won't make the wound heal faster, but they can discourage bacterial growth and infection. Certain ingredients in some ointments can cause a mild rash in some people. If a rash appears, stop using the ointment. - Cover the wound. Exposure to the air might speed healing, but bandages can keep the wound clean and keep harmful bacteria out. Blisters that are draining are vulnerable. Keep them covered until a scab forms. - Change the dressing. Apply a new dressing at least once a day or whenever the dressing becomes wet or dirty to help prevent infection. If you're allergic to the adhesive used in most bandages, switch to adhesive-free dressings or sterile gauze and paper tape.", "role": "user" }, { "content": "Complications of tetanus infection may include death due to respiratory failure, cardiac arrest or pneumonia.", "role": "assistant" } ]

[ { "content": "symptoms of dehydration When a person is very dehydrated do they sometimes get a tight pain in their chest (right below the breasts) right before they faint/pass out?\n\nDehydration: Dehydration occurs when your body does not have as much water and fluids as it should. Dehydration can be mild, moderate, or severe, based on how much of your body's fluid is lost or not replaced. Severe dehydration is a life-threatening emergency. You can become dehydrated if you lose too much fluid, do not drink enough water or fluids, or both. Your body may lose a lot of fluid from: - Sweating too much, for example, from exercising in hot weather - Fever - Vomiting or diarrhea - Urinating too much (uncontrolled diabetes or some medications, like diuretics, can cause you to urinate a lot) You might not drink enough fluids because: - You do not feel like eating or drinking because you are sick - You are nauseated - You have a sore throat or mouth sores Older adults and people with certain diseases, such as diabetes, are also at higher risk for dehydration. Signs of mild to moderate dehydration: - Thirst - Dry or sticky mouth - Not urinating much - Darker yellow urine - Dry, cool skin - Headache - Muscle cramps Signs of severe dehydration: - Not urinating, or very dark yellow or amber-colored urine - Dry, shriveled skin - Irritability or confusion - Dizziness or light-headedness - Rapid heartbeat - Rapid breathing - Sunken eyes - Listlessness - Shock (not enough blood flow through the body) - Unconsciousness or delirium Your health care provider will look for these signs of dehydration: - Low blood pressure - Blood pressure that drops when you stand up after lying down - White finger tips that do not return to a pink color after your doctor presses the fingertip - Skin that is not as elastic as normal. When the provider pinches it into a fold, it may slowly sag back into place. Normally, skin springs back right away. - Rapid heart rate Your doctor may do lab tests: - Blood tests to check kidney function - Urine tests to see what may be causing dehydration - Other tests to see what may be causing dehydration (blood sugar test for diabetes) To treat dehydration: - Try sipping water or sucking on ice cubes. - Try drinking water or sports drinks that contain electrolytes. - Do not take salt tablets. They can cause serious complications. - Ask your provider what you should eat if you have diarrhea. For more severe dehydration or heat emergency, you may need to stay in a hospital and receive fluid through a vein (IV). The provider will also treat the cause of the dehydration. Dehydration caused by a stomach virus should get better on its own after a few days. If you notice signs of dehydration and treat it quickly, you should recover completely. Untreated severe dehydration may cause: - Death - Permanent brain damage - Seizures You should call 911 if: - The person loses consciousness at any time. - There is any other change in the person's alertness (for example, confusion or seizures). - The person has a fever over 102°F (38.8°C). - You notice symptoms of heatstroke (such as rapid pulse or rapid breathing). - The person's condition does not improve or gets worse despite treatment. To prevent dehydration: - Drink plenty of fluids every day, even when you are well. Drink more when the weather is hot or you are exercising. - If anyone in your family is ill, pay attention to how much they are able to drink. Pay close attention to children and older adults. - Anyone with a fever, vomiting, or diarrhea should drink plenty of fluids. DO NOT wait for signs of dehydration. - If you think you or someone in your family may become dehydrated, call your provider. Do this before the person becomes dehydrated. Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.", "role": "user" }, { "content": "Moderate dehydration causes dry mouth, thirst, headache, muscle cramps, and reduced urination and darker urine. As dehydration becomes severe, urination might stop, you might experience irritability, confusion, dizziness, rapid heartbeat, rapid breathing, lack of energy, shock, and unconsciousness or delirium.", "role": "assistant" } ]

[ { "content": "what are the causes of pulmonary hypertension\n\nPulmonary hypertension (Causes): Your heart has two upper chambers (atria) and two lower chambers (ventricles). Each time blood passes through your heart, the lower right chamber (right ventricle) pumps blood to your lungs through a large blood vessel (pulmonary artery). In your lungs, the blood releases carbon dioxide and picks up oxygen. The oxygen-rich blood then flows through blood vessels in your lungs (pulmonary arteries, capillaries and veins) to the left side of your heart. Ordinarily, the blood flows easily through the vessels in your lungs, so blood pressure is usually much lower in your lungs. With pulmonary hypertension, the rise in blood pressure is caused by changes in the cells that line your pulmonary arteries. These changes can cause the walls of the arteries to become stiff and thick, and extra tissue may form. The blood vessels may also become inflamed and tight. These changes in the pulmonary arteries can reduce or block blood flow through the blood vessels. This makes it harder for blood to flow, raising the blood pressure in the pulmonary arteries. Pulmonary hypertension is classified into five groups, depending on the cause. Group 1: Pulmonary arterial hypertension - Cause unknown, known as idiopathic pulmonary arterial hypertension - A specific gene mutation that can cause pulmonary hypertension to develop in families, also called heritable pulmonary arterial hypertension - Certain drugs - such as certain prescription diet drugs or illegal drugs such as methamphetamines - or certain toxins - Heart abnormalities present at birth (congenital heart disease) - Other conditions, such as connective tissue disorders (scleroderma, lupus, others), HIV infection or chronic liver disease (cirrhosis) Group 2: Pulmonary hypertension caused by left-sided heart disease - Left-sided valvular heart disease, such as mitral valve or aortic valve disease - Failure of the lower left heart chamber (left ventricle) Group 3: Pulmonary hypertension caused by lung disease - Chronic obstructive pulmonary disease, such as emphysema - Lung disease such as pulmonary fibrosis, a condition that causes scarring in the tissue between the lungs' air sacs (interstitium) - Sleep apnea and other sleep disorders - Long-term exposure to high altitudes in people who may be at higher risk of pulmonary hypertension Group 4: Pulmonary hypertension caused by chronic blood clots - Chronic blood clots in the lungs (pulmonary emboli) Group 5: Pulmonary hypertension associated with other conditions that have unclear reasons why the pulmonary hypertension occurs - Blood disorders - Disorders that affect several organs in the body, such as sarcoidosis - Metabolic disorders, such as glycogen storage disease - Tumors pressing against pulmonary arteries Eisenmenger syndrome and pulmonary hypertension Eisenmenger syndrome, a type of congenital heart disease, causes pulmonary hypertension. It's most commonly caused by a large hole in your heart between the two lower heart chambers (ventricles), called a ventricular septal defect. This hole in your heart causes blood to circulate abnormally in your heart. Oxygen-carrying blood (red blood) mixes with oxygen-poor blood (blue blood). The blood then returns to your lungs instead of going to the rest of your body, increasing the pressure in the pulmonary arteries and causing pulmonary hypertension.", "role": "user" }, { "content": "Each time blood passes through your heart, the lower right chamber (right ventricle) pumps blood to your lungs through a large blood vessel (pulmonary artery). In your lungs, the blood releases carbon dioxide and picks up oxygen. The oxygen-rich blood then flows through blood vessels in your lungs (pulmonary arteries, capillaries and veins) to the left side of your heart. Ordinarily, the blood flows easily through the vessels in your lungs, so blood pressure is usually much lower in your lungs. With pulmonary hypertension, the rise in blood pressure is caused by changes in the cells that line your pulmonary arteries. These changes can cause the walls of the arteries to become stiff and thick, and extra tissue may form.This makes it harder for blood to flow, raising the blood pressure in the pulmonary arteries.", "role": "assistant" } ]

[ { "content": "If oleandor was ingested by touching the plant stems inner part and then directly eating without washing hands, how long would u exspect symptoms would start? And how severe would you say symptoms may get.\n\nOleander poisoning (Outlook (Prognosis)): How well you do depends on the amount of poison swallowed and how quickly treatment is received. The faster you get medical help, the better the chance for recovery. Symptoms last for 1 to 3 days and may require a hospital stay. Death is unlikely. DO NOT touch or eat any plant with which you are not familiar. Wash your hands after working in the garden or walking in the woods.", "role": "user" }, { "content": "The faster you get medical help, the better the chance for recovery. Symptoms last for 1 to 3 days and may require a hospital stay. Death is unlikely.", "role": "assistant" } ]

[ { "content": "how smoking tobacco affects the brain\n\n Nicotine and tobacco Withdrawal from nicotine Smoking - nicotine addiction and withdrawal Smokeless tobacco - nicotine addiction Cigar smoking Pipe smoking Smokeless snuff Tobacco use Chewing tobacco Nicotine addiction and tobacco Summary The nicotine in tobacco can be addictive like alcohol, cocaine, and morphine. Causes Tobacco is a plant grown for its leaves, which are smoked, chewed, or sniffed. Tobacco contains a chemical called nicotine. Nicotine is an addictive substance. Millions of people in the United States have been able to quit smoking. Although the number of cigarette smokers in the United States has dropped in recent years, the number of smokeless tobacco users has steadily increased. Smokeless tobacco products are either placed in the mouth, cheek, or lip and sucked or chewed on, or placed in the nasal passage. The nicotine in these products is absorbed at the same rate as smoking tobacco, and addiction is still very strong. Both smoking and smokeless tobacco use carry many health risks. Symptoms Nicotine use can have many different effects on the body. It can: Decrease the appetite -- Fear of weight gain makes some people unwilling to stop smoking. Boost mood, give people a sense of well-being, and possibly even relieve minor depression. Increase activity in the intestines. Create more saliva and phlegm. Increase the heart rate by around 10 to 20 beats per minute. Increase blood pressure by 5 to 10 mm Hg. Possibly cause sweating, nausea, and diarrhea. Stimulate memory and alertness -- People who use tobacco often depend on it to help them accomplish certain tasks and perform well. Symptoms of nicotine withdrawal appear within 2 to 3 hours after you last use tobacco. People who smoked the longest or smoked a greater number of cigarettes each day are more likely to have withdrawal symptoms. For those who are quitting, symptoms peak about 2 to 3 days later. Common symptoms include: Intense craving for nicotine Anxiety Depression Drowsiness or trouble sleeping Bad dreams and nightmares Feeling tense, restless, or frustrated Headaches Increased appetite and weight gain Problems concentrating You may notice some or all of these symptoms when switching from regular to low-nicotine cigarettes or reducing the number of cigarettes you smoke. Treatment It is hard to stop smoking or using smokeless tobacco, but anyone can do it. There are many ways to quit smoking. There are also resources to help you quit. Family members, friends, and co-workers may be supportive. Quitting tobacco is hard if you are trying to do it alone. To be successful, you must really want to quit. Most people who have quit smoking were unsuccessful at least once in the past. Try not to view past attempts as failures. See them as learning experiences. Most smokers find it hard to break all the habits they have created around smoking. A smoking cessation program may improve your chance for success. These programs are offered by hospitals, health departments, community centers, work sites, and national organizations. Nicotine replacement therapy may also be helpful. It involves the use of products that provide low doses of nicotine, but none of the toxins found in smoke. Nicotine replacement comes in the form of: Gum Inhalers Throat lozenges Nasal spray Skin patches You can buy many types of nicotine replacement without a prescription. Your health care provider can also prescribe other types of medicines to help you quit. Varenicline (Chantix) and bupropion (Zyban, Wellbutrin) are prescription medications that affect the nicotine receptors in the brain. The goal of these therapies is to relieve cravings for nicotine and ease your withdrawal symptoms. Health experts warn that e-cigarettes are not a replacement therapy for cigarette smoking. It is not known exactly how much nicotine is in e-cigarette cartridges, because information on labels is often wrong. Support Groups Your provider can refer you to stop smoking programs. These are offered by hospitals, health departments, community centers, work sites, and national organizations. Outlook (Prognosis) People who are trying to quit smoking often become discouraged when they do not succeed at first. Research shows that the more times you try, the more likely you are to succeed. If you start smoking again after you have tried to quit, do not give up. Look at what worked or did not work, think of new ways to quit smoking, and try again. Possible Complications There are many more reasons to quit using tobacco. Knowing the serious health risks from tobacco may help motivate you to quit. Tobacco and related chemicals can increase your risk of serious health problems such as cancer, lung disease, and heart attack. When to Contact a Medical Professional See your provider if you wish to stop smoking, or have already done so and are having withdrawal symptoms. Your provider can help recommend treatments. Review Date 2/12/2018 Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Nicotine has many different effects on the body. It can decrease appetite, create more saliva and phlegm, boost mood, increase intestinal activity, increase blood pressure and heart rate, and stimulate memory and alertness. Nicotine withdrawal symptoms appear within 2 to 3 hours after your last use of tobacco.", "role": "assistant" } ]

[ { "content": "williams sydrome conditon. i need to send me more information about Williams Syndrome and some tips how to educate people with this disorder.I hope having news from you soon!!thank you\n\nWilliams Syndrome (Treatment): There is no cure for Williams syndrome, nor is there a standard course of treatment. Because WS is an uncommon and complex disorder, multidisciplinary clinics have been established at several centers in the United States. Treatments are based on an individual’s particular symptoms. People with WS require regular cardiovascular monitoring for potential medical problems, such as symptomatic narrowing of the blood vessels, high blood pressure, and heart failure.", "role": "user" }, { "content": "There is currently no cure or standard course of treatment for Williams syndrome. Because it is an uncommon and complex disorder, several multidisciplinary clinics have been established around the United States. Treatments are based on an individuals symptoms. People with Wiliams syndrome require regular cardiovascular monitoring for potential medical problems, such as symptomatic narrowing of the blood vessels, high blood pressure, and heart failure.", "role": "assistant" } ]

[ { "content": "how to loose weight\n\n Very Low-calorie Diets How is obesity treated? Obesity is treated using one or more of these strategies:a diet low in calories increased physical activity behavior therapy prescription medications weight-loss surgery What is a VLCD? A VLCD is a special diet that provides up to 800 calories per day. VLCDs use commercial formulas, usually liquid shakes, soups, or bars, which replace all your regular meals. These formulas are not the same as the meal replacements you can find at grocerystores or pharmacies, which are meant to replace one or two meals a day.Depending on a number of factors, healthy adults need different amounts of calories to meet their daily energy needs. A standard amount is about 2,000 calories. VLCDs provide far fewer calories than most people need to maintain a healthy weight. This type of diet is used to promote quick weight loss, often as a way to jump-start an obesity treatment program.VLCD formulas are designed to provide all of the nutrients you need while helping you lose weight quickly. However, this type of diet should only be used for a short time—usually about 12 weeks.The Low-calorie Diet (LCD)An LCD limits calories, but not as much as a VLCD. A typical LCD may provide1,000–1,200 calories/day for a woman 1,200–1,600 calories/day for a manThe number of calories may be adjusted based on your age, weight, and how active you are. An LCD usually consists of regular foods, but could also include meal replacements. As a result, you may find this type of diet much easier to follow than a VLCD. In the long term, LCDs have been found to lead to the same amount of weight loss as VLCDs. Should I use a VLCD to lose weight? Most people who need to lose weight should not use a VLCD. For many of them, a low-calorie diet (LCD) may work better (see The Low-calorie Diet (LCD)).VLCDs may be used to promote rapid weight loss among adults who have obesity. Health care providers must review risks and benefits on a case-by-case basis.In general, VLCDs are not appropriate for children. In a few cases, they may be used with some adolescents who are being treated for obesity.Not much is known about the use of VLCDs to promote weight loss among older adults. Some people over age 50 may have medical issues that may not make them good candidates for this type of diet. What are the health benefits of a VLCD? A VLCD may allow you to lose about 3 to 5 pounds per week. This may lead to an average total weight loss of 44 pounds over 12 weeks. Such a weight loss can rapidly improve medical conditions linked to obesity, including diabetes, high blood pressure, and high cholesterol.The rapid weight loss experienced by most people on a VLCD can be very motivating. Patients who participate in a VLCD program that also includes lifestyle changes may lose about 15 to 25 percent of their initial weight during the first 3 to 6 months. They may maintain a 5 percent weight loss after 4 years if they adopt a healthy eating plan and physical activity habits. What are the health risks of a VLCD? Doctors must monitor all VLCD patients regularly—ideally every 2 weeks in the initial period of rapid weight loss—to be sure patients are not experiencing serious side effects.Many patients on a VLCD for 4 to 16 weeks report minor side effects such as fatigue, constipation, nausea, or diarrhea. These conditions usually improve within a few weeks and rarely prevent patients from completing the program.The most common serious side effect is gallstones. Gallstones, which often develop in people who are obese, especially women, may be even more commonly developed during rapid weight loss. Some medicines can prevent gallstones from forming during rapid weight loss. Your health care provider can determine if these medicines are appropriate for you. For more information, see the WIN fact sheet on dieting and gallstones, listed under Additional Links. Will I regain the weight? Although the long-term results of VLCDs vary widely, weight regain is common. To prevent weight regain, the VLCD should always be combined with other ways to lose weight and with an active follow-up program.For most people who have obesity, the condition is long term and requires a lifetime of attention even after formal methods to treat the obesity end. You may need to commit to permanent changes of healthier eating, regular physical activity, and an improved outlook about food. Very Low-calorie Diets The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.What are clinical trials, and are they right for you?Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.What clinical trials are open?Clinical trials that are currently open and are recruiting can be viewed at www.ClinicalTrials.gov. ", "role": "user" }, { "content": "Very Low-calorie Diets (Should I use a VLCD to lose weight?) Most people who need to lose weight should not use a VLCD. For many of them, a low-calorie diet (LCD) may work better (see The Low-calorie Diet (LCD)).VLCDs may be used to promote rapid weight loss among adults who have obesity. Health care providers must review risks and benefits on a case-by-case basis. In general, VLCDs are not appropriate for children. In a few cases, they may be used with some adolescents who are being treated for obesity.Not much is known about the use of VLCDs to promote weight loss among older adults. Some people over age 50 may have medical issues that may not make them good candidates for this type of diet.", "role": "assistant" } ]

[ { "content": "how to treat a heart attack\n\nHeart attack (Lifestyle and home remedies): Your lifestyle affects your heart health. The following steps can help you not only prevent but also recover from a heart attack: - Avoid smoke. The most important thing you can do to improve your heart's health is to not smoke. Also, avoid being around secondhand smoke. If you need to quit, ask your doctor for help. - Control your blood pressure and cholesterol levels. If one or both of these is high, your doctor can prescribe changes to your diet and medications. Ask your doctor how often you need to have your blood pressure and cholesterol levels monitored. - Get regular medical checkups. Some of the major risk factors for heart attack - high blood cholesterol, high blood pressure and diabetes - cause no symptoms early on. Your doctor can perform tests to check for these conditions and help you manage them, if necessary. - Exercise regularly. Regular exercise helps improve heart muscle function after a heart attack and helps prevent a heart attack by helping you to control your weight, diabetes, cholesterol and blood pressure. Exercise needn't be vigorous. Walking 30 minutes a day, five days a week can improve your health. - Maintain a healthy weight. Excess weight strains your heart and can contribute to high cholesterol, high blood pressure and diabetes. - Eat a heart-healthy diet. Saturated fat, trans fats and cholesterol in your diet can narrow arteries to your heart, and too much salt can raise blood pressure. Eat a heart-healthy diet that includes lean proteins, such as fish and beans, plenty of fruits and vegetables and whole grains. - Manage diabetes. High blood sugar is damaging to your heart. Regular exercise, eating well and losing weight all help to keep blood sugar levels at more-desirable levels. Many people also need medication to manage their diabetes. - Control stress. Reduce stress in your day-to-day activities. Rethink workaholic habits and find healthy ways to minimize or deal with stressful events in your life. - If you drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and men older than age 65, and up to two drinks a day for men age 65 and younger.", "role": "user" }, { "content": "Heart health can be improved by your lifestyle choices. The following are a few ways that you can lower the risk of heart attack and potentially help you recover from one: Avoid smoking and secondhand smoke. Control your blood pressure and cholesterol levels. Get regular medical checkups. Eat a heart-healthy diet. Control stress.", "role": "assistant" } ]

[ { "content": "what are the causes of childhood obesity\n\n Overweight and Obesity What Are... Español The terms \"overweight\" and \"obesity\" refer to body weight that’s greater than what is considered healthy for a certain height. The most useful measure of overweight and obesity is body mass index (BMI). BMI is calculated from your height and weight. For more information about BMI, go to \"How Are Overweight and Obesity Diagnosed?\" Overview Millions of Americans and people worldwide are overweight or obese. Being overweight or obese puts you at risk for many health problems. The more body fat that you have and the more you weigh, the more likely you are to develop: Coronary heart disease High blood pressure Type 2 diabetes Gallstones Breathing problems Certain cancers Your weight is the result of many factors. These factors include environment, family history and genetics, metabolism (the way your body changes food and oxygen into energy), behavior or habits, and more. You can't change some factors, such as family history. However, you can change other factors, such as your lifestyle habits. For example, follow a healthy eating plan and keep your calorie needs in mind. Be physically active and try to limit the amount of time that you're inactive. Weight-loss medicines and surgery also are options for some people if lifestyle changes aren't enough. Outlook Reaching and staying at a healthy weight is a long-term challenge for people who are overweight or obese. But it also is a chance to lower your risk for other serious health problems. With the right treatment and motivation, it's possible to lose weight and lower your long-term disease risk. Causes Lack of Energy Balance A lack of energy balance most often causes overweight and obesity. Energy balance means that your energy IN equals your energy OUT. Energy IN is the amount of energy or calories you get from food and drinks. Energy OUT is the amount of energy your body uses for things like breathing, digesting, and being physically active. To maintain a healthy weight, your energy IN and OUT don't have to balance exactly every day. It's the balance over time that helps you maintain a healthy weight. The same amount of energy IN and energy OUT over time = weight stays the same More energy IN than energy OUT over time = weight gain More energy OUT than energy IN over time = weight loss Overweight and obesity happen over time when you take in more calories than you use. Other Causes An Inactive Lifestyle Many Americans aren't very physically active. One reason for this is that many people spend hours in front of TVs and computers doing work, schoolwork, and leisure activities. In fact, more than 2 hours a day of regular TV viewing time has been linked to overweight and obesity. Other reasons for not being active include: relying on cars instead of walking, fewer physical demands at work or at home because of modern technology and conveniences, and lack of physical education classes in schools. People who are inactive are more likely to gain weight because they don't burn the calories that they take in from food and drinks. An inactive lifestyle also raises your risk for coronary heart disease, high blood pressure, diabetes, colon cancer, and other health problems. Environment Our environment doesn't support healthy lifestyle habits; in fact, it encourages obesity. Some reasons include: Lack of neighborhood sidewalks and safe places for recreation. Not having area parks, trails, sidewalks, and affordable gyms makes it hard for people to be physically active. Work schedules. People often say that they don't have time to be physically active because of long work hours and time spent commuting. Oversized food portions. Americans are exposed to huge food portions in restaurants, fast food places, gas stations, movie theaters, supermarkets, and even at home. Some of these meals and snacks can feed two or more people. Eating large portions means too much energy IN. Over time, this will cause weight gain if it isn't balanced with physical activity. Lack of access to healthy foods. Some people don't live in neighborhoods that have supermarkets that sell healthy foods, such as fresh fruits and vegetables. Or, for some people, these healthy foods are too costly. Food advertising. Americans are surrounded by ads from food companies. Often children are the targets of advertising for high-calorie, high-fat snacks and sugary drinks. The goal of these ads is to sway people to buy these high-calorie foods, and often they do. Genes and Family History Studies of identical twins who have been raised apart show that genes have a strong influence on a person's weight. Overweight and obesity tend to run in families. Your chances of being overweight are greater if one or both of your parents are overweight or obese. Your genes also may affect the amount of fat you store in your body and where on your body you carry the extra fat. Because families also share food and physical activity habits, a link exists between genes and the environment. Children adopt the habits of their parents. A child who has overweight parents who eat high-calorie foods and are inactive will likely become overweight too. However, if the family adopts healthy food and physical activity habits, the child's chance of being overweight or obese is reduced. Health Conditions Some hormone problems may cause overweight and obesity, such as underactive thyroid (hypothyroidism), Cushing's syndrome, and polycystic ovarian syndrome (PCOS). Underactive thyroid is a condition in which the thyroid gland doesn't make enough thyroid hormone. Lack of thyroid hormone will slow down your metabolism and cause weight gain. You'll also feel tired and weak. Cushing's syndrome is a condition in which the body's adrenal glands make too much of the hormone cortisol. Cushing's syndrome also can develop if a person takes high doses of certain medicines, such as prednisone, for long periods. People who have Cushing's syndrome gain weight, have upper-body obesity, a rounded face, fat around the neck, and thin arms and legs. PCOS is a condition that affects about 5–10 percent of women of childbearing age. Women who have PCOS often are obese, have excess hair growth, and have reproductive problems and other health issues. These problems are caused by high levels of hormones called androgens. Medicines Certain medicines may cause you to gain weight. These medicines include some corticosteroids, antidepressants, and seizure medicines. These medicines can slow the rate at which your body burns calories, increase your appetite, or cause your body to hold on to extra water. All of these factors can lead to weight gain. Emotional Factors Some people eat more than usual when they're bored, angry, or stressed. Over time, overeating will lead to weight gain and may cause overweight or obesity. Smoking Some people gain weight when they stop smoking. One reason is that food often tastes and smells better after quitting smoking. Another reason is because nicotine raises the rate at which your body burns calories, so you burn fewer calories when you stop smoking. However, smoking is a serious health risk, and quitting is more important than possible weight gain. Age As you get older, you tend to lose muscle, especially if you're less active. Muscle loss can slow down the rate at which your body burns calories. If you don't reduce your calorie intake as you get older, you may gain weight. Midlife weight gain in women is mainly due to aging and lifestyle, but menopause also plays a role. Many women gain about 5 pounds during menopause and have more fat around the waist than they did before. Pregnancy During pregnancy, women gain weight to support their babies’ growth and development. After giving birth, some women find it hard to lose the weight. This may lead to overweight or obesity, especially after a few pregnancies. Lack of Sleep Research shows that lack of sleep increases the risk of obesity. For example, one study of teenagers showed that with each hour of sleep lost, the odds of becoming obese went up. Lack of sleep increases the risk of obesity in other age groups as well. People who sleep fewer hours also seem to prefer eating foods that are higher in calories and carbohydrates, which can lead to overeating, weight gain, and obesity. Sleep helps maintain a healthy balance of the hormones that make you feel hungry (ghrelin) or full (leptin). When you don't get enough sleep, your level of ghrelin goes up and your level of leptin goes down. This makes you feel hungrier than when you're well-rested. Sleep also affects how your body reacts to insulin, the hormone that controls your blood glucose (sugar) level. Lack of sleep results in a higher than normal blood sugar level, which may increase your risk for diabetes. For more information, go to the Health Topics Sleep Deprivation and Deficiency article. Risks Being overweight or obese isn't a cosmetic problem. These conditions greatly raise your risk for other health problems. Overweight and Obesity-Related Health Problems in Adults Coronary Heart Disease As your body mass index rises, so does your risk for coronary heart disease (CHD). CHD is a condition in which a waxy substance called plaque (plak) builds up inside the coronary arteries. These arteries supply oxygen-rich blood to your heart. Plaque can narrow or block the coronary arteries and reduce blood flow to the heart muscle. This can cause angina (an-JI-nuh or AN-juh-nuh) or a heart attack. (Angina is chest pain or discomfort.) Obesity also can lead to heart failure. This is a serious condition in which your heart can't pump enough blood to meet your body's needs. High Blood Pressure Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps blood. If this pressure rises and stays high over time, it can damage the body in many ways. Your chances of having high blood pressure are greater if you're overweight or obese. Stroke Being overweight or obese can lead to a buildup of plaque in your arteries. Eventually, an area of plaque can rupture, causing a blood clot to form. If the clot is close to your brain, it can block the flow of blood and oxygen to your brain and cause a stroke. The risk of having a stroke rises as BMI increases. Type 2 Diabetes Diabetes is a disease in which the body's blood glucose, or blood sugar, level is too high. Normally, the body breaks down food into glucose and then carries it to cells throughout the body. The cells use a hormone called insulin to turn the glucose into energy. In type 2 diabetes, the body's cells don't use insulin properly. At first, the body reacts by making more insulin. Over time, however, the body can't make enough insulin to control its blood sugar level. Diabetes is a leading cause of early death, CHD, stroke, kidney disease, and blindness. Most people who have type 2 diabetes are overweight. Abnormal Blood Fats If you're overweight or obese, you're at increased risk of having abnormal levels of blood fats. These include high levels of triglycerides and LDL (\"bad\") cholesterol and low levels of HDL (\"good\") cholesterol. Abnormal levels of these blood fats are a risk factor for CHD. For more information about triglycerides and LDL and HDL cholesterol, go to the Health Topics High Blood Cholesterol article. Metabolic Syndrome Metabolic syndrome is the name for a group of risk factors that raises your risk for heart disease and other health problems, such as diabetes and stroke. You can develop any one of these risk factors by itself, but they tend to occur together. A diagnosis of metabolic syndrome is made if you have at least three of the following risk factors: A large waistline. This is called abdominal obesity or \"having an apple shape.\" Having extra fat in the waist area is a greater risk factor for CHD than having extra fat in other parts of the body, such as on the hips. A higher than normal triglyceride level (or you're on medicine to treat high triglycerides). A lower than normal HDL cholesterol level (or you're on medicine to treat low HDL cholesterol). Higher than normal blood pressure (or you're on medicine to treat high blood pressure). Higher than normal fasting blood sugar (or you're on medicine to treat diabetes). Cancer Being overweight or obese raises your risk for colon, breast, endometrial, and gallbladder cancers. Osteoarthritis Osteoarthritis is a common joint problem of the knees, hips, and lower back. The condition occurs if the tissue that protects the joints wears away. Extra weight can put more pressure and wear on joints, causing pain. Sleep Apnea Sleep apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep. A person who has sleep apnea may have more fat stored around the neck. This can narrow the airway, making it hard to breathe. Obesity Hypoventilation Syndrome Obesity hypoventilation syndrome (OHS) is a breathing disorder that affects some obese people. In OHS, poor breathing results in too much carbon dioxide (hypoventilation) and too little oxygen in the blood (hypoxemia). OHS can lead to serious health problems and may even cause death. Reproductive Problems Obesity can cause menstrual issues and infertility in women. Gallstones Gallstones are hard pieces of stone-like material that form in the gallbladder. They're mostly made of cholesterol. Gallstones can cause stomach or back pain. People who are overweight or obese are at increased risk of having gallstones. Also, being overweight may result in an enlarged gallbladder that doesn't work well. Overweight and Obesity-Related Health Problems in Children and Teens Overweight and obesity also increase the health risks for children and teens. Type 2 diabetes once was rare in American children, but an increasing number of children are developing the disease. Also, overweight children are more likely to become overweight or obese as adults, with the same disease risks. Who Is at Risk Overweight and obesity affect Americans of all ages, sexes, and racial/ethnic groups. This serious health problem has been growing over the last 30 years. Adults According to the National Health and Nutrition Examination Survey (NHANES) 2009–2010, almost 70 percent of Americans are overweight or obese. The survey also shows differences in overweight and obesity among racial/ethnic groups. In women, overweight and obesity are highest among non-Hispanic Black women (about 82 percent), compared with about 76 percent for Hispanic women and 64 percent for non-Hispanic White women. In men, overweight and obesity are highest among Hispanic men (about 82 percent), compared with about 74 percent for non-Hispanic White men and about 70 percent for non-Hispanic Black men. Children and Teens Children also have become heavier. In the past 30 years, obesity has tripled among school-aged children and teens. According to NHANES 2009–2010, about 1 in 6 American children ages 2–19 are obese. The survey also suggests that overweight and obesity are having a greater effect on minority groups, including Blacks and Hispanics. Signs & Symptoms Weight gain usually happens over time. Most people know when they've gained weight. Some of the signs of overweight or obesity include: Clothes feeling tight and needing a larger size. The scale showing that you've gained weight. Having extra fat around the waist. A higher than normal body mass index and waist circumference. (For more information, go to \"How Are Overweight and Obesity Diagnosed?\") Diagnosis The most common way to find out whether you're overweight or obese is to figure out your body mass index (BMI). BMI is an estimate of body fat, and it's a good gauge of your risk for diseases that occur with more body fat. BMI is calculated from your height and weight. You can use the chart below or the National Heart, Lung, and Blood Institute's (NHLBI's) online BMI calculator to figure out your BMI. Or, you health care provider can measure your BMI. Body Mass Index for Adults Use this table to learn your BMI. First, find your height on the far left column. Next, move across the row to find your weight. Weight is measured with underwear but no shoes. Once you've found your weight, move to the very top of that column. This number is your BMI. This table offers a sample of BMI measurements. If you don't see your height and/or weight listed on this table, go the NHLBI's complete Body Mass Index Table. What Does Body Mass Index Mean? Although BMI can be used for most men and women, it does have some limits. It may overestimate body fat in athletes and others who have a muscular build. BMI also may underestimate body fat in older people and others who have lost muscle. Body Mass Index for Children and Teens Overweight are obesity are defined differently for children and teens than for adults. Children are still growing, and boys and girls mature at different rates. BMIs for children and teens compare their heights and weights against growth charts that take age and sex into account. This is called BMI-for-age percentile. A child or teen's BMI-for-age percentile shows how his or her BMI compares with other boys and girls of the same age. For more information about BMI-for-age and growth charts for children, go to the Centers for Disease Control and Prevention's BMI-for-age calculator. What Does the BMI-for-Age Percentile Mean? Waist Circumference Health care professionals also may take your waist measurement. This helps screen for the possible health risks related to overweight and obesity in adults. If you have abdominal obesity and most of your fat is around your waist rather than at your hips, you're at increased risk for coronary heart disease and type 2 diabetes. The risk goes up with a waist size that's greater than 35 inches for women or greater than 40 inches for men. You also can measure your waist size. To do so correctly, stand and place a tape measure around your middle, just above your hipbones. Measure your waist just after you breathe out. Specialists Involved A primary care doctor (or pediatrician for children and teens) will assess your BMI, waist measurement, and overall health risk. If you're overweight or obese, or if you have a large waist size, your doctor should explain the health risks and find out whether you're interested and willing to lose weight. If you are, you and your doctor can work together to create a treatment plan. The plan may include weight-loss goals and treatment options that are realistic for you. Your doctor may send you to other health care specialists if you need expert care. These specialists may include: An endocrinologist if you need to be treated for type 2 diabetes or a hormone problem, such as an underactive thyroid. A registered dietitian or nutritionist to work with you on ways to change your eating habits. An exercise physiologist or trainer to figure out your level of fitness and show you how to do physical activities suitable for you. A bariatric surgeon if weight-loss surgery is an option for you. A psychiatrist, psychologist, or clinical social worker to help treat depression or stress. Treatments Successful weight-loss treatments include setting goals and making lifestyle changes, such as eating fewer calories and being physically active. Medicines and weight-loss surgery also are options for some people if lifestyle changes aren't enough. Set Realistic Goals Setting realistic weight-loss goals is an important first step to losing weight. For Adults Try to lose 5 to 10 percent of your current weight over 6 months. This will lower your risk for coronary heart disease (CHD) and other conditions. The best way to lose weight is slowly. A weight loss of 1 to 2 pounds a week is do-able, safe, and will help you keep off the weight. It also will give you the time to make new, healthy lifestyle changes. If you've lost 10 percent of your body weight, have kept it off for 6 months, and are still overweight or obese, you may want to consider further weight loss. For Children and Teens If your child is overweight or at risk for overweight or obesity, the goal is to maintain his or her current weight and to focus on eating healthy and being physically active. This should be part of a family effort to make lifestyle changes. If your child is overweight or obese and has a health condition related to overweight or obesity, your doctor may refer you to a pediatric obesity treatment center. Lifestyle Changes Lifestyle changes can help you and your family achieve long-term weight-loss success. Example of lifestyle changes include: Focusing on balancing energy IN (calories from food and drinks) with energy OUT (physical activity) Following a healthy eating plan Learning how to adopt healthy lifestyle habits Over time, these changes will become part of your everyday life. Calories Cutting back on calories (energy IN) will help you lose weight. To lose 1 to 2 pounds a week, adults should cut back their calorie intake by 500 to 1,000 calories a day. In general, having 1,000 to 1,200 calories a day will help most women lose weight safely. In general, having 1,200 to 1,600 calories a day will help most men lose weight safely. This calorie range also is suitable for women who weigh 165 pounds or more or who exercise routinely. These calorie levels are a guide and may need to be adjusted. If you eat 1,600 calories a day but don't lose weight, then you may want to cut back to 1,200 calories. If you're hungry on either diet, then you may want to add 100 to 200 calories a day. Very low-calorie diets with fewer than 800 calories a day shouldn't be used unless your doctor is monitoring you. For overweight children and teens, it's important to slow the rate of weight gain. However, reduced-calorie diets aren't advised unless you talk with a health care provider. Healthy Eating Plan A healthy eating plan gives your body the nutrients it needs every day. It has enough calories for good health, but not so many that you gain weight. A healthy eating plan is low in saturated fat, trans fat, cholesterol, sodium (salt), and added sugar. Following a healthy eating plan will lower your risk for heart disease and other conditions. Healthy foods include: Fat-free and low-fat dairy products, such as low-fat yogurt, cheese, and milk. Protein foods, such as lean meat, fish, poultry without skin, beans, and peas. Whole-grain foods, such as whole-wheat bread, oatmeal, and brown rice. Other grain foods include pasta, cereal, bagels, bread, tortillas, couscous, and crackers. Fruits, which can be fresh, canned, frozen, or dried. Vegetables, which can be fresh, canned (without salt), frozen, or dried. Canola and olive oils, and soft margarines made from these oils, are heart healthy. However, you should use them in small amounts because they're high in calories. You also can include unsalted nuts, like walnuts and almonds, in your diet as long as you limit the amount you eat (nuts also are high in calories). The National Heart, Lung, and Blood Institute's \"Aim for a Healthy Weight\" patient booklet provides more information about following a healthy eating plan. Foods to limit. Foods that are high in saturated and trans fats and cholesterol raise blood cholesterol levels and also might be high in calories. Fats and cholesterol raise your risk for heart disease, so they should be limited. Saturated fat is found mainly in: Fatty cuts of meat, such as ground beef, sausage, and processed meats (for example, bologna, hot dogs, and deli meats) Poultry with the skin High-fat dairy products like whole-milk cheeses, whole milk, cream, butter, and ice cream Lard, coconut, and palm oils, which are found in many processed foods Trans fat is found mainly in: Foods with partially hydrogenated oils, such as many hard margarines and shortening Baked products and snack foods, such as crackers, cookies, doughnuts, and breads Foods fried in hydrogenated shortening, such as french fries and chicken Cholesterol mainly is found in: Egg yolks Organ meats, such as liver Shrimp Whole milk or whole-milk products, such as butter, cream, and cheese Limiting foods and drinks with added sugars, like high-fructose corn syrup, is important. Added sugars will give you extra calories without nutrients like vitamins and minerals. Added sugars are found in many desserts, canned fruit packed in syrup, fruit drinks, and nondiet drinks. Check the list of ingredients on food packages for added sugars like high-fructose corn syrup. Drinks that contain alcohol also will add calories, so it's a good idea to limit your alcohol intake. Portion size. A portion is the amount of food that you choose to eat for a meal or snack. It's different from a serving, which is a measured amount of food and is noted on the Nutrition Facts label on food packages. Anyone who has eaten out lately is likely to notice how big the portions are. In fact, over the past 40 years, portion sizes have grown significantly. These growing portion sizes have changed what we think of as a normal portion. Cutting back on portion size is a good way to eat fewer calories and balance your energy IN. Food weight. Studies have shown that we all tend to eat a constant \"weight\" of food. Ounce for ounce, our food intake is fairly consistent. Knowing this, you can lose weight if you eat foods that are lower in calories and fat for a given amount of food. For example, replacing a full-fat food product that weighs 2 ounces with a low-fat product that weighs the same helps you cut back on calories. Another helpful practice is to eat foods that contain a lot of water, such as vegetables, fruits, and soups. Physical Activity Being physically active and eating fewer calories will help you lose weight and keep weight off over time. Physical activity also will benefit you in other ways. It will: Lower your risk for heart disease, heart attack, diabetes, and cancers (such as breast, uterine, and colon cancers) Strengthen your heart and help your lungs work better Strengthen your muscles and keep your joints in good condition Slow bone loss Give you more energy Help you relax and better cope with stress Allow you to fall asleep more quickly and sleep more soundly Give you an enjoyable way to share time with friends and family The four main types of physical activity are aerobic, muscle-strengthening, bone strengthening, and stretching. You can do physical activity with light, moderate, or vigorous intensity. The level of intensity depends on how hard you have to work to do the activity. People vary in the amount of physical activity they need to control their weight. Many people can maintain their weight by doing 150 to 300 minutes (2 hours and 30 minutes to 5 hours) of moderate-intensity activity per week, such as brisk walking. People who want to lose a large amount of weight (more than 5 percent of their body weight) may need to do more than 300 minutes of moderate-intensity activity per week. This also may be true for people who want to keep off weight that they've lost. You don't have to do the activity all at once. You can break it up into short periods of at least 10 minutes each. If you have a heart problem or chronic disease, such as heart disease, diabetes, or high blood pressure, talk with your doctor about what types of physical activity are safe for you. You also should talk with your doctor about safe physical activities if you have symptoms such as chest pain or dizziness. Children should get at least 60 minutes or more of physical activity every day. Most physical activity should be moderate-intensity aerobic activity. Activity should vary and be a good fit for the child's age and physical development. Many people lead inactive lives and might not be motivated to do more physical activity. When starting a physical activity program, some people may need help and supervision to avoid injury. If you're obese, or if you haven't been active in the past, start physical activity slowly and build up the intensity a little at a time. When starting out, one way to be active is to do more everyday activities, such as taking the stairs instead of the elevator and doing household chores and yard work. The next step is to start walking, biking, or swimming at a slow pace, and then build up the amount of time you exercise or the intensity level of the activity. To lose weight and gain better health, it's important to get moderate-intensity physical activity. Choose activities that you enjoy and that fit into your daily life. A daily, brisk walk is an easy way to be more active and improve your health. Use a pedometer to count your daily steps and keep track of how much you're walking. Try to increase the number of steps you take each day. Other examples of moderate-intensity physical activity include dancing, gardening, and water aerobics. For greater health benefits, try to step up your level of activity or the length of time you're active. For example, start walking for 10 to 15 minutes three times a week, and then build up to brisk walking for 60 minutes, 5 days a week. For more information about physical activity, go to the Department of Health and Human Services \"2008 Physical Activity Guidelines for Americans\" and the Health Topics Physical Activity and Your Heart article. Behavioral Changes Changing your behaviors or habits related to food and physical activity is important for losing weight. The first step is to understand which habits lead you to overeat or have an inactive lifestyle. The next step is to change these habits. Below are some simple tips to help you adopt healthier habits. Change your surroundings. You might be more likely to overeat when watching TV, when treats are available at work, or when you're with a certain friend. You also might find it hard to motivate yourself to be physically active. However, you can change these habits. Instead of watching TV, dance to music in your living room or go for a walk. Leave the office break room right after you get a cup of coffee. Bring a change of clothes to work. Head straight to an exercise class on the way home from work. Put a note on your calendar to remind yourself to take a walk or go to your exercise class. Keep a record. A record of your food intake and the amount of physical activity that you do each day will help inspire you. You also can keep track of your weight. For example, when the record shows that you've been meeting your physical activity goals, you'll want to keep it up. A record also is an easy way to track how you're doing, especially if you're working with a registered dietitian or nutritionist. Seek support. Ask for help or encouragement from your friends, family, and health care provider. You can get support in person, through e-mail, or by talking on the phone. You also can join a support group. Reward success. Reward your success for meeting your weight-loss goals or other achievements with something you would like to do, not with food. Choose rewards that you'll enjoy, such as a movie, music CD, an afternoon off from work, a massage, or personal time. Weight-Loss Medicines Weight-loss medicines approved by the Food and Drug Administration (FDA) might be an option for some people. If you're not successful at losing 1 pound a week after 6 months of using lifestyle changes, medicines may help. You should only use medicines as part of a program that includes diet, physical activity, and behavioral changes. Weight-loss medicines might be suitable for adults who are obese (a BMI of 30 or greater). People who have BMIs of 27 or greater, and who are at risk for heart disease and other health conditions, also may benefit from weight-loss medicines. Sibutramine (Meridia®) As of October 2010, the weight-loss medicine sibutramine (Meridia®) was taken off the market in the United States. Research showed that the medicine may raise the risk of heart attack and stroke. Orlistat (Xenical® and Alli®) Orlistat (Xenical®) causes a weight loss between 5 and 10 pounds, although some people lose more weight. Most of the weight loss occurs within the first 6 months of taking the medicine. People taking Xenical need regular checkups with their doctors, especially during the first year of taking the medicine. During checkups, your doctor will check your weight, blood pressure, and pulse and may recommend other tests. He or she also will talk with you about any medicine side effects and answer your questions. The FDA also has approved Alli®, an over-the-counter (OTC) weight-loss aid for adults. Alli is the lower dose form of orlistat. Alli is meant to be used along with a reduced-calorie, low-fat diet and physical activity. In studies, most people taking Alli lost 5 to 10 pounds over 6 months. Both Xenical and Alli reduce the absorption of fats, fat calories, and vitamins A, D, E, and K to promote weight loss. Both medicines also can cause mild side effects, such as oily and loose stools. Although rare, some reports of liver disease have occurred with the use of orlistat. More research is needed to find out whether the medicine plays a role in causing liver disease. Talk with your doctor if you’re considering using Xenical or Alli to lose weight. He or she can discuss the risks and benefits with you. You also should talk with your doctor before starting orlistat if you’re taking blood-thinning medicines or being treated for diabetes or thyroid disease. Also, ask your doctor whether you should take a multivitamin due to the possible loss of some vitamins. Lorcaserin Hydrochloride (Belviq®) and Qsymia™ In July 2012, the FDA approved two new medicines for chronic (ongoing) weight management. Lorcaserin hydrochloride (Belviq®) and Qsymia™ are approved for adults who have a BMI of 30 or greater. (Qsymia is a combination of two FDA-approved medicines: phentermine and topiramate.) These medicines also are approved for adults with a BMI of 27 or greater who have at least one weight-related condition, such as high blood pressure, type 2 diabetes, or high blood cholesterol. Both medicines are meant to be used along with a reduced-calorie diet and physical activity. Other Medicines Some prescription medicines are used for weight loss, but aren't FDA-approved for treating obesity. They include: Medicines to treat depression. Some medicines for depression cause an initial weight loss and then a regain of weight while taking the medicine. Medicines to treat seizures. Two medicines used for seizures, topiramate and zonisamide, have been shown to cause weight loss. These medicines are being studied to see whether they will be useful in treating obesity. Medicines to treat diabetes. Metformin may cause small amounts of weight loss in people who have obesity and diabetes. It's not known how this medicine causes weight loss, but it has been shown to reduce hunger and food intake. Over-the-Counter Products Some OTC products claim to promote weight loss. The FDA doesn't regulate these products because they're considered dietary supplements, not medicines. However, many of these products have serious side effects and generally aren't recommended. Some of these OTC products include: Ephedra (also called ma huang). Ephedra comes from plants and has been sold as a dietary supplement. The active ingredient in the plant is called ephedrine. Ephedra can cause short-term weight loss, but it also has serious side effects. It causes high blood pressure and stresses the heart. In 2004, the FDA banned the sale of dietary supplements containing ephedra in the United States. Chromium. This is a mineral that's sold as a dietary supplement to reduce body fat. While studies haven't found any weight-loss benefit from chromium, there are few serious side effects from taking it. Diuretics and herbal laxatives. These products cause you to lose water weight, not fat. They also can lower your body's potassium levels, which may cause heart and muscle problems. Hoodia. Hoodia is a cactus that's native to Africa. It's sold in pill form as an appetite suppressant. However, no firm evidence shows that hoodia works. No large-scale research has been done on humans to show whether hoodia is effective or safe. Weight-Loss Surgery Weight-loss surgery might be an option for people who have extreme obesity (BMI of 40 or more) when other treatments have failed. Weight-loss surgery also is an option for people who have a BMI of 35 or more and life-threatening conditions, such as: Severe sleep apnea (a condition in which you have one or more pauses in breathing or shallow breaths while you sleep) Obesity-related cardiomyopathy (KAR-de-o-mi-OP-ah-thee; diseases of the heart muscle) Severe type 2 diabetes Types of Weight-Loss Surgery Two common weight-loss surgeries include banded gastroplasty and Roux-en-Y gastric bypass. For gastroplasty, a band or staples are used to create a small pouch at the top of your stomach. This surgery limits the amount of food and liquids the stomach can hold. For gastric bypass, a small stomach pouch is created with a bypass around part of the small intestine where most of the calories you eat are absorbed. This surgery limits food intake and reduces the calories your body absorbs. Weight-loss surgery can improve your health and weight. However, the surgery can be risky, depending on your overall health. Gastroplasty has few long-term side effects, but you must limit your food intake dramatically. Gastric bypass has more side effects. They include nausea (feeling sick to your stomach), bloating, diarrhea, and faintness. These side effects are all part of a condition called dumping syndrome. After gastric bypass, you may need multivitamins and minerals to prevent nutrient deficiencies. Lifelong medical followup is needed after both surgeries. Your doctor also may recommend a program both before and after surgery to help you with diet, physical activity, and coping skills. If you think you would benefit from weight-loss surgery, talk with your doctor. Ask whether you're a candidate for the surgery and discuss the risks, benefits, and what to expect. Weight-Loss Maintenance Maintaining your weight loss over time can be a challenge. For adults, weight loss is a success if you lose at least 10 percent of your initial weight and you don't regain more than 6 or 7 pounds in 2 years. You also must keep a lower waist circumference (at least 2 inches lower than your waist circumference before you lost weight). After 6 months of keeping off the weight, you can think about losing more if: You've already lost 5 to 10 percent of your body weight You're still overweight or obese The key to losing more weight or maintaining your weight loss is to continue with lifestyle changes. Adopt these changes as a new way of life. If you want to lose more weight, you may need to eat fewer calories and increase your activity level. For example, if you eat 1,600 calories a day but don't lose weight, you may want to cut back to 1,200 calories. It's also important to make physical activity part of your normal daily routine. Prevention Following a healthy lifestyle can help you prevent overweight and obesity. Many lifestyle habits begin during childhood. Thus, parents and families should encourage their children to make healthy choices, such as following a healthy diet and being physically active. Make following a healthy lifestyle a family goal. For example: Follow a healthy eating plan. Make healthy food choices, keep your calorie needs and your family's calorie needs in mind, and focus on the balance of energy IN and energy OUT. Focus on portion size. Watch the portion sizes in fast food and other restaurants. The portions served often are enough for two or three people. Children's portion sizes should be smaller than those for adults. Cutting back on portion size will help you balance energy IN and energy OUT. Be active. Make personal and family time active. Find activities that everyone will enjoy. For example, go for a brisk walk, bike or rollerblade, or train together for a walk or run. Reduce screen time. Limit the use of TVs, computers, DVDs, and videogames because they limit time for physical activity. Health experts recommend 2 hours or less a day of screen time that's not work- or homework-related. Keep track of your weight, body mass index, and waist circumference. Also, keep track of your children's growth. Led by the National Heart, Lung, and Blood Institute, four Institutes from the National Institutes of Health have come together to promote We Can!®—Ways to Enhance Children's Activity & Nutrition. We Can! is a national education program designed for parents and caregivers to help children 8 to 13 years old maintain a healthy weight. The evidence-based program offers parents and families tips and fun activities to encourage healthy eating, increase physical activity, and reduce time spent being inactive. Currently, more than 140 community groups around the country are participating in We Can! programs for parents and youth. These community groups include hospitals, health departments, clinics, faith-based organizations, YMCAs, schools, and more. ____________ ®We Can! is a registered trademark of the U.S. Department of Health and Human Services. ", "role": "user" }, { "content": "There are many risk factors for overweight and obesity. Some risk factors can be changed, such as unhealthy lifestyle habits and environments. Other risk factors, such as age, family history and genetics, race and ethnicity, and sex, cannot be changed.", "role": "assistant" } ]

[ { "content": "more information in relation to Ellis van creveld syndrome Specifically in later life can they have children has it ever been reported any researchcarried out and just as much information as possible to help my understanding of what I have Many thanks\n\n Ellis-van Creveld syndrome Chondroectodermal dysplasia EVC Summary Ellis-van Creveld syndrome is a rare genetic disorder that affects bone growth. Causes Ellis-van Creveld is passed down through families (inherited). It is caused by defects in 1 of 2 Ellis-van Creveld syndrome genes (<em>EVC</em> and <em>EVC2</em>). These genes are positioned next to each other on the same chromosome. The severity of the disease varies from person to person. The highest rate of the condition is seen among the Old Order Amish population of Lancaster County, Pennsylvania. It is fairly rare in the general population. Symptoms Symptoms may include: Cleft lip or palate Epispadias or undescended testicle (cryptorchidism) Extra fingers (polydactyly) Limited range of motion Nail problems, including missing or deformed nails Short arms and legs, especially forearm and lower leg Short height, between 3.5 to 5 feet (1 to 1.5 meters) tall Sparse, absent, or fine textured hair Tooth abnormalities, such as peg teeth, widely-spaced teeth Teeth present at birth (natal teeth) Delayed or missing teeth Exams and Tests Signs of this condition include: Growth hormone deficiency Heart defects, such as a hole in the heart (atrial septal defect), occur in about half of all cases Tests include: Chest x-ray Echocardiogram Genetic testing may be performed for mutations in one of the two EVC genes Skeletal x-ray Ultrasound Urinalysis Treatment Treatment depends on which body system is affected and the severity of the problem. The condition itself is not treatable, but many of the complications can be treated. Support Groups Many communities have EVC support groups. Ask your health care provider or local hospital if there is one in your area. Outlook (Prognosis) Many babies with this condition die in early infancy. Most often this is due to a small chest or heart defect. Stillbirth is common. The outcome depends on which body system is involved and to what extent that body system is involved. Like many genetic conditions involving bones or the physical structure, intelligence is normal. Possible Complications Complications may include: Bone abnormalities Breathing difficulty Congenital heart disease (CHD) especially atrial septal defect (ASD) Kidney disease When to Contact a Medical Professional Call your provider if your child has symptoms of this syndrome. If you have a family history of EVC syndrome and your child has any symptoms, visit your provider. Genetic counseling can help families understand the condition and how to care for the person. Prevention Genetic counseling is recommended for prospective parents from a high-risk group, or who have a family history of EVC syndrome. Review Date 8/6/2017 Updated by: Anna C. Edens Hurst, MD, MS, Assistant Professor in Medical Genetics, The University of Alabama at Birmingham, Birmingham, AL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Ellis-van Creveld syndrome (Treatment): Treatment depends on which body system is affected and the severity of the problem. The condition itself is not treatable, but many of the complications can be treated.", "role": "assistant" } ]

[ { "content": "Is optic atrophy ginetic and what cause it?\n\n Optic nerve atrophy Optic atrophy Optic neuropathy Summary Optic nerve atrophy is damage to the optic nerve. The optic nerve carries images of what the eye sees to the brain. Causes There are many causes of optic atrophy. The most common is poor blood flow. This is called ischemic optic neuropathy. The problem most often affects older adults. The optic nerve can also be damaged by shock, toxins, radiation, and trauma. Eye diseases, such as glaucoma, can also cause a form of optic nerve atrophy. The condition can also be caused by diseases of the brain and central nervous system. These may include: Brain tumor Cranial arteritis (sometimes called temporal arteritis) Multiple sclerosis Stroke There are also rare forms of hereditary optic nerve atrophy that affect children and young adults. Symptoms Optic nerve atrophy causes vision to dim and reduces the field of vision. The ability to see fine detail will also be lost. Colors will seem faded. Over time, the pupil will be less able to react to light, and eventually, its ability to react to light may be lost. Exams and Tests The health care provider will do a complete eye exam to look for the condition. The exam will include tests of: Color vision Pupil light reflex Tonometry Visual acuity You may also need a complete physical exam and other tests. Treatment Damage from optic nerve atrophy cannot be reversed. The underlying disease must be found and treated. Otherwise, vision loss will continue. Rarely, conditions that lead to optic atrophy may be treatable. Outlook (Prognosis) Vision lost to optic nerve atrophy cannot be recovered. It is very important to protect the other eye. When to Contact a Medical Professional People with this condition need to be checked regularly by an eye doctor with experience in nerve-related conditions. Tell your doctor right away about any change in vision. Prevention Many causes of optic nerve atrophy cannot be prevented. Prevention steps include: Older adults should have their provider carefully manage their blood pressure. Use standard safety precautions to prevent injuries to the face. Most facial injuries are the result of car accidents. Wearing seat belts may help prevent these injuries. Schedule a routine annual eye exam to check for glaucoma. Never drink home-brewed alcohol and forms of alcohol that are not intended for drinking. Methanol, which is found in home-brewed alcohol, can cause optic nerve atrophy in both eyes. Review Date 8/20/2016 Updated by: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Many causes of optic nerve atrophy cannot be prevented. Prevention steps include: - Older adults should have their provider carefully manage their blood pressure. - Use standard safety precautions to prevent injuries to the face. - Schedule a routine annual eye exam to check for glaucoma. - Methanol, which is found in home-brewed alcohol, can cause optic nerve atrophy in both eyes.", "role": "assistant" } ]

[ { "content": "prostate cancer using seeds aimed at maligmem tumors is this a safe decision\n\n Prostate Cancer Overview The prostate gland makes fluid that forms part of semen. The prostate lies just below the bladder in front of the rectum. It surrounds the urethra (the tube that carries urine and semen through the penis and out of the body). Prostate cancer is the most common cancer in men in the United States, after skin cancer. It is the second leading cause of death from cancer in men. Prostate cancer occurs more often in African-American men than in white men. African-American men with prostate cancer are more likely to die from the disease than white men with prostate cancer. Almost all prostate cancers are adenocarcinomas (cancers that begin in cells that make and release mucus and other fluids). Prostate cancer often has no early symptoms. Advanced prostate cancer can cause men to urinate more often or have a weaker flow of urine, but these symptoms can also be caused by benign prostate conditions. Prostate cancer usually grows very slowly. Most men with prostate cancer are older than 65 years and do not die from the disease. Finding and treating prostate cancer before symptoms occur may not improve health or help you live longer. Talk to your doctor about your risk of prostate cancer and whether you need screening tests. General Information About Prostate Cancer Key Points - Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the prostate. - Signs of prostate cancer include a weak flow of urine or frequent urination. - Tests that examine the prostate and blood are used to detect (find) and diagnose prostate cancer. - Certain factors affect prognosis (chance of recovery) and treatment options. Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the prostate. The prostate is a gland in the male reproductive system. It lies just below the bladder (the organ that collects and empties urine) and in front of the rectum (the lower part of the intestine). It is about the size of a walnut and surrounds part of the urethra (the tube that empties urine from the bladder). The prostate gland makes fluid that is part of the semen. Enlarge Anatomy of the male reproductive and urinary systems, showing the prostate, testicles, bladder, and other organs. Prostate cancer is most common in older men. In the U.S., about 1 out of 5 men will be diagnosed with prostate cancer. Signs of prostate cancer include a weak flow of urine or frequent urination. These and other signs and symptoms may be caused by prostate cancer or by other conditions. Check with your doctor if you have any of the following: - Weak or interrupted (\"stop-and-go\") flow of urine. - Sudden urge to urinate. - Frequent urination (especially at night). - Trouble starting the flow of urine. - Trouble emptying the bladder completely. - Pain or burning while urinating. - Blood in the urine or semen. - A pain in the back, hips, or pelvis that doesn't go away. - Shortness of breath, feeling very tired, fast heartbeat, dizziness, or pale skin caused by anemia. Other conditions may cause the same symptoms. As men age, the prostate may get bigger and block the urethra or bladder. This may cause trouble urinating or sexual problems. The condition is called benign prostatic hyperplasia (BPH), and although it is not cancer, surgery may be needed. The symptoms of benign prostatic hyperplasia or of other problems in the prostate may be like symptoms of prostate cancer. Enlarge Normal prostate and benign prostatic hyperplasia (BPH). A normal prostate does not block the flow of urine from the bladder. An enlarged prostate presses on the bladder and urethra and blocks the flow of urine. Tests that examine the prostate and blood are used to detect (find) and diagnose prostate cancer. The following tests and procedures may be used: - Physical exam and history : An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments will also be taken. - Digital rectal exam (DRE): An exam of the rectum. The doctor or nurse inserts a lubricated, gloved finger into the rectum and feels the prostate through the rectal wall for lumps or abnormal areas. Enlarge Digital rectal exam (DRE). The doctor inserts a gloved, lubricated finger into the rectum and feels the prostate to check for anything abnormal. - Prostate-specific antigen (PSA) test : A test that measures the level of PSA in the blood. PSA is a substance made by the prostate that may be found in an increased amount in the blood of men who have prostate cancer. PSA levels may also be high in men who have an infection or inflammation of the prostate or BPH (an enlarged, but noncancerous, prostate). - Transrectal ultrasound : A procedure in which a probe that is about the size of a finger is inserted into the rectum to check the prostate. The probe is used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. Transrectal ultrasound may be used during a biopsy procedure. Enlarge Transrectal ultrasound. An ultrasound probe is inserted into the rectum to check the prostate. The probe bounces sound waves off body tissues to make echoes that form a sonogram (computer picture) of the prostate. - Transrectal magnetic resonance imaging (MRI): A procedure that uses a strong magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. A probe that gives off radio waves is inserted into the rectum near the prostate. This helps the MRI machine make clearer pictures of the prostate and nearby tissue. A transrectal MRI is done to find out if the cancer has spread outside the prostate into nearby tissues. This procedure is also called nuclear magnetic resonance imaging (NMRI). - Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist. The pathologist will check the tissue sample to see if there are cancer cells and find out the Gleason score. The Gleason score ranges from 2-10 and describes how likely it is that a tumor will spread. The lower the number, the less likely the tumor is to spread. A transrectal biopsy is used to diagnose prostate cancer. A transrectal biopsy is the removal of tissue from the prostate by inserting a thin needle through the rectum and into the prostate. This procedure is usually done using transrectal ultrasound to help guide where samples of tissue are taken from. A pathologist views the tissue under a microscope to look for cancer cells. Enlarge Transrectal biopsy. An ultrasound probe is inserted into the rectum to show where the tumor is. Then a needle is inserted through the rectum into the prostate to remove tissue from the prostate. Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery) and treatment options depend on the following: - The stage of the cancer (level of PSA, Gleason score, grade of the tumor, how much of the prostate is affected by the cancer, and whether the cancer has spread to other places in the body). - The patient's age. - Whether the cancer has just been diagnosed or has recurred (come back). Treatment options also may depend on the following: - Whether the patient has other health problems. - The expected side effects of treatment. - Past treatment for prostate cancer. - The wishes of the patient. Most men diagnosed with prostate cancer do not die of it. Stages of Prostate Cancer Key Points - After prostate cancer has been diagnosed, tests are done to find out if cancer cells have spread within the prostate or to other parts of the body. - There are three ways that cancer spreads in the body. - Cancer may spread from where it began to other parts of the body. - The following stages are used for prostate cancer: - Stage I - Stage II - Stage III - Stage IV After prostate cancer has been diagnosed, tests are done to find out if cancer cells have spread within the prostate or to other parts of the body. The process used to find out if cancer has spread within the prostate or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The results of the tests used to diagnose prostate cancer are often also used to stage the disease. (See the General Information section.) In prostate cancer, staging tests may not be done unless the patient has symptoms or signs that the cancer has spread, such as bone pain, a high PSA level, or a high Gleason score. The following tests and procedures also may be used in the staging process: - Bone scan : A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones with cancer and is detected by a scanner. Enlarge Bone scan. A small amount of radioactive material is injected into the patient's bloodstream and collects in abnormal cells in the bones. As the patient lies on a table that slides under the scanner, the radioactive material is detected and images are made on a computer screen or film. - MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI). - CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. - Pelvic lymphadenectomy : A surgical procedure to remove the lymph nodes in the pelvis. A pathologist views the tissue under a microscope to look for cancer cells. - Seminal vesicle biopsy : The removal of fluid from the seminal vesicles (glands that make semen) using a needle. A pathologist views the fluid under a microscope to look for cancer cells. - ProstaScint scan : A procedure to check for cancer that has spread from the prostate to other parts of the body, such as the lymph nodes. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material attaches to prostate cancer cells and is detected by a scanner. The radioactive material shows up as a bright spot on the picture in areas where there are a lot of prostate cancer cells. The stage of the cancer is based on the results of the staging and diagnostic tests, including the prostate-specific antigen (PSA) test and the Gleason score. The tissue samples removed during the biopsy are used to find out the Gleason score. The Gleason score ranges from 2-10 and describes how different the cancer cells look from normal cells and how likely it is that the tumor will spread. The lower the number, the less likely the tumor is to spread. There are three ways that cancer spreads in the body. Cancer can spread through tissue, the lymph system, and the blood: - Tissue. The cancer spreads from where it began by growing into nearby areas. - Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body. - Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body. Cancer may spread from where it began to other parts of the body. When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood. - Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body. - Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body. The metastatic tumor is the same type of cancer as the primary tumor. For example, if prostate cancer spreads to the bone, the cancer cells in the bone are actually prostate cancer cells. The disease is metastatic prostate cancer, not bone cancer. Denosumab, a monoclonal antibody, may be used to prevent bone metastases. The following stages are used for prostate cancer: Enlarge As prostate cancer progresses from Stage I to Stage IV, the cancer cells grow within the prostate, through the outer layer of the prostate into nearby tissue, and then to lymph nodes or other parts of the body. Stage I In stage I, cancer is found in the prostate only. The cancer: - is found by needle biopsy (done for a high PSA level) or in a small amount of tissue during surgery for other reasons (such as benign prostatic hyperplasia). The PSA level is lower than 10 and the Gleason score is 6 or lower; or - is found in one-half or less of one lobe of the prostate. The PSA level is lower than 10 and the Gleason score is 6 or lower; or - cannot be felt during a digital rectal exam and cannot be seen in imaging tests. Cancer is found in one-half or less of one lobe of the prostate. The PSA level and the Gleason score are not known. Stage II In stage II, cancer is more advanced than in stage I, but has not spread outside the prostate. Stage II is divided into stages IIA and IIB. In stage IIA, cancer: - is found by needle biopsy (done for a high PSA level) or in a small amount of tissue during surgery for other reasons (such as benign prostatic hyperplasia). The PSA level is lower than 20 and the Gleason score is 7; or - is found by needle biopsy (done for a high PSA level) or in a small amount of tissue during surgery for other reasons (such as benign prostatic hyperplasia). The PSA level is at least 10 but lower than 20 and the Gleason score is 6 or lower; or - is found in one-half or less of one lobe of the prostate. The PSA level is at least 10 but lower than 20 and the Gleason score is 6 or lower; or - is found in one-half or less of one lobe of the prostate. The PSA level is lower than 20 and the Gleason score is 7; or - is found in more than one-half of one lobe of the prostate. In stage IIB, cancer: - is found in opposite sides of the prostate. The PSA can be any level and the Gleason score can range from 2 to 10; or - cannot be felt during a digital rectal exam and cannot be seen in imaging tests. The PSA level is 20 or higher and the Gleason score can range from 2 to 10; or - cannot be felt during a digital rectal exam and cannot be seen in imaging tests. The PSA can be any level and the Gleason score is 8 or higher. Stage III In stage III, cancer has spread beyond the outer layer of the prostate and may have spread to the seminal vesicles. The PSA can be any level and the Gleason score can range from 2 to 10. Stage IV In stage IV, the PSA can be any level and the Gleason score can range from 2 to 10. Also, cancer: - has spread beyond the seminal vesicles to nearby tissue or organs, such as the rectum, bladder, or pelvic wall; or - may have spread to the seminal vesicles or to nearby tissue or organs, such as the rectum, bladder, or pelvic wall. Cancer has spread to nearby lymph nodes; or - has spread to distant parts of the body, which may include lymph nodes or bones. Prostate cancer often spreads to the bones. Stage I In stage I, cancer is found in the prostate only. The cancer: - is found by needle biopsy (done for a high PSA level) or in a small amount of tissue during surgery for other reasons (such as benign prostatic hyperplasia). The PSA level is lower than 10 and the Gleason score is 6 or lower; or - is found in one-half or less of one lobe of the prostate. The PSA level is lower than 10 and the Gleason score is 6 or lower; or - cannot be felt during a digital rectal exam and cannot be seen in imaging tests. Cancer is found in one-half or less of one lobe of the prostate. The PSA level and the Gleason score are not known. Stage II In stage II, cancer is more advanced than in stage I, but has not spread outside the prostate. Stage II is divided into stages IIA and IIB. In stage IIA, cancer: - is found by needle biopsy (done for a high PSA level) or in a small amount of tissue during surgery for other reasons (such as benign prostatic hyperplasia). The PSA level is lower than 20 and the Gleason score is 7; or - is found by needle biopsy (done for a high PSA level) or in a small amount of tissue during surgery for other reasons (such as benign prostatic hyperplasia). The PSA level is at least 10 but lower than 20 and the Gleason score is 6 or lower; or - is found in one-half or less of one lobe of the prostate. The PSA level is at least 10 but lower than 20 and the Gleason score is 6 or lower; or - is found in one-half or less of one lobe of the prostate. The PSA level is lower than 20 and the Gleason score is 7; or - is found in more than one-half of one lobe of the prostate. In stage IIB, cancer: - is found in opposite sides of the prostate. The PSA can be any level and the Gleason score can range from 2 to 10; or - cannot be felt during a digital rectal exam and cannot be seen in imaging tests. The PSA level is 20 or higher and the Gleason score can range from 2 to 10; or - cannot be felt during a digital rectal exam and cannot be seen in imaging tests. The PSA can be any level and the Gleason score is 8 or higher. Stage III In stage III, cancer has spread beyond the outer layer of the prostate and may have spread to the seminal vesicles. The PSA can be any level and the Gleason score can range from 2 to 10. Stage IV In stage IV, the PSA can be any level and the Gleason score can range from 2 to 10. Also, cancer: - has spread beyond the seminal vesicles to nearby tissue or organs, such as the rectum, bladder, or pelvic wall; or - may have spread to the seminal vesicles or to nearby tissue or organs, such as the rectum, bladder, or pelvic wall. Cancer has spread to nearby lymph nodes; or - has spread to distant parts of the body, which may include lymph nodes or bones. Prostate cancer often spreads to the bones. Recurrent Prostate Cancer Treatment Option Overview Key Points - There are different types of treatment for patients with prostate cancer. - Seven types of standard treatment are used: - Watchful waiting or active surveillance - Surgery - Radiation therapy and radiopharmaceutical therapy - Hormone therapy - Chemotherapy - Biologic therapy - Bisphosphonate therapy - There are treatments for bone pain caused by bone metastases or hormone therapy. - New types of treatment are being tested in clinical trials. - Cryosurgery - High-intensity-focused ultrasound therapy - Proton beam radiation therapy - Patients may want to think about taking part in a clinical trial. - Patients can enter clinical trials before, during, or after starting their cancer treatment. - Follow-up tests may be needed. There are different types of treatment for patients with prostate cancer. Different types of treatment are available for patients with prostate cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment. Seven types of standard treatment are used: Watchful waiting or active surveillance Watchful waiting and active surveillance are treatments used for older men who do not have signs or symptoms or have other medical conditions and for men whose prostate cancer is found during a screening test. Watchful waiting is closely monitoring a patient's condition without giving any treatment until signs or symptoms appear or change. Treatment is given to relieve symptoms and improve quality of life. Active surveillance is closely following a patient's condition without giving any treatment unless there are changes in test results. It is used to find early signs that the condition is getting worse. In active surveillance, patients are given certain exams and tests, including digital rectal exam, PSA test, transrectal ultrasound, and transrectal needle biopsy, to check if the cancer is growing. When the cancer begins to grow, treatment is given to cure the cancer. Other terms that are used to describe not giving treatment to cure prostate cancer right after diagnosis are observation, watch and wait, and expectant management. Surgery Patients in good health whose tumor is in the prostate gland only may be treated with surgery to remove the tumor. The following types of surgery are used: - Radical prostatectomy: A surgical procedure to remove the prostate, surrounding tissue, and seminal vesicles. There are two types of radical prostatectomy: - Retropubic prostatectomy: A surgical procedure to remove the prostate through an incision (cut) in the abdominal wall. Removal of nearby lymph nodes may be done at the same time. - Perineal prostatectomy: A surgical procedure to remove the prostate through an incision (cut) made in the perineum (area between the scrotum and anus). Nearby lymph nodes may also be removed through a separate incision in the abdomen. Enlarge Two types of radical prostatectomy. In a retropubic prostatectomy, the prostate is removed through an incision in the wall of the abdomen. In a perineal prostatectomy, the prostate is removed through an incision in the area between the scrotum and the anus. - Pelvic lymphadenectomy: A surgical procedure to remove the lymph nodes in the pelvis. A pathologist views the tissue under a microscope to look for cancer cells. If the lymph nodes contain cancer, the doctor will not remove the prostate and may recommend other treatment. - Transurethral resection of the prostate (TURP): A surgical procedure to remove tissue from the prostate using a resectoscope (a thin, lighted tube with a cutting tool) inserted through the urethra. This procedure is done to treat benign prostatic hypertrophy and it is sometimes done to relieve symptoms caused by a tumor before other cancer treatment is given. TURP may also be done in men whose tumor is in the prostate only and who cannot have a radical prostatectomy. Enlarge Transurethral resection of the prostate (TURP). Tissue is removed from the prostate using a resectoscope (a thin, lighted tube with a cutting tool at the end) inserted through the urethra. Prostate tissue that is blocking the urethra is cut away and removed through the resectoscope. In some cases, nerve-sparing surgery can be done. This type of surgery may save the nerves that control erection. However, men with large tumors or tumors that are very close to the nerves may not be able to have this surgery. Possible problems after prostate cancer surgery include the following: - Impotence. - Leakage of urine from the bladder or stool from the rectum. - Shortening of the penis (1 to 2 centimeters). The exact reason for this is not known. - Inguinal hernia (bulging of fat or part of the small intestine through weak muscles into the groin). Inguinal hernia may occur more often in men treated with radical prostatectomy than in men who have some other types of prostate surgery, radiation therapy, or prostate biopsy alone. It is most likely to occur within the first 2 years after radical prostatectomy. Radiation therapy and radiopharmaceutical therapy Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are different types of radiation therapy: - External radiation therapy uses a machine outside the body to send radiation toward the cancer. Conformal radiation is a type of external radiation therapy that uses a computer to make a 3-dimensional (3-D) picture of the tumor and shapes the radiation beams to fit the tumor. This allows a high dose of radiation to reach the tumor and causes less damage to nearby healthy tissue. Hypofractionated radiation therapy may be given because it has a more convenient treatment schedule. Hypofractionated radiation therapy is radiation treatment in which a larger than usual total dose of radiation is given once a day over a shorter period of time (fewer days) compared to standard radiation therapy. Hypofractionated radiation therapy may have worse side effects than standard radiation therapy, depending on the schedules used. - Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. In early-stage prostate cancer, the radioactive seeds are placed in the prostate using needles that are inserted through the skin between the scrotum and rectum. The placement of the radioactive seeds in the prostate is guided by images from transrectal ultrasound or computed tomography (CT). The needles are removed after the radioactive seeds are placed in the prostate. - Radiopharmaceutical therapy uses a radioactive substance to treat cancer. Radiopharmaceutical therapy includes the following: - Alpha emitter radiation therapy uses a radioactive substance to treat prostate cancer that has spread to the bone. A radioactive substance called radium-223 is injected into a vein and travels through the bloodstream. The radium-223 collects in areas of bone with cancer and kills the cancer cells. The way the radiation therapy is given depends on the type and stage of the cancer being treated. External radiation therapy, internal radiation therapy, and radiopharmaceutical therapy are used to treat prostate cancer. Men treated with radiation therapy for prostate cancer have an increased risk of having bladder and/or gastrointestinal cancer. Radiation therapy can cause impotence and urinary problems that may get worse with age. Hormone therapy Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances made by glands in the body and circulated in the bloodstream. In prostate cancer, male sex hormones can cause prostate cancer to grow. Drugs, surgery, or other hormones are used to reduce the amount of male hormones or block them from working. Hormone therapy for prostate cancer may include the following: - Abiraterone acetate can prevent prostate cancer cells from making androgens. It is used in men with advanced prostate cancer that has not gotten better with other hormone therapy. - Orchiectomy is a surgical procedure to remove one or both testicles, the main source of male hormones, such as testosterone, to decrease the amount of hormone being made. - Estrogens (hormones that promote female sex characteristics) can prevent the testicles from making testosterone. However, estrogens are seldom used today in the treatment of prostate cancer because of the risk of serious side effects. - Luteinizing hormone-releasing hormone agonists can stop the testicles from making testosterone. Examples are leuprolide, goserelin, and buserelin. - Antiandrogens can block the action of androgens (hormones that promote male sex characteristics), such as testosterone. Examples are flutamide, bicalutamide, enzalutamide, and nilutamide. - Drugs that can prevent the adrenal glands from making androgens include ketoconazole and aminoglutethimide. Hot flashes, impaired sexual function, loss of desire for sex, and weakened bones may occur in men treated with hormone therapy. Other side effects include diarrhea, nausea, and itching. See Drugs Approved for Prostate Cancer for more information. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated. See Drugs Approved for Prostate Cancer for more information. Biologic therapy Biologic therapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. Sipuleucel-T is a type of biologic therapy used to treat prostate cancer that has metastasized (spread to other parts of the body). See Drugs Approved for Prostate Cancer for more information. Bisphosphonate therapy Bisphosphonate drugs, such as clodronate or zoledronate, reduce bone disease when cancer has spread to the bone. Men who are treated with antiandrogen therapy or orchiectomy are at an increased risk of bone loss. In these men, bisphosphonate drugs lessen the risk of bone fracture (breaks). The use of bisphosphonate drugs to prevent or slow the growth of bone metastases is being studied in clinical trials. Watchful waiting or active surveillance Watchful waiting and active surveillance are treatments used for older men who do not have signs or symptoms or have other medical conditions and for men whose prostate cancer is found during a screening test. Watchful waiting is closely monitoring a patient's condition without giving any treatment until signs or symptoms appear or change. Treatment is given to relieve symptoms and improve quality of life. Active surveillance is closely following a patient's condition without giving any treatment unless there are changes in test results. It is used to find early signs that the condition is getting worse. In active surveillance, patients are given certain exams and tests, including digital rectal exam, PSA test, transrectal ultrasound, and transrectal needle biopsy, to check if the cancer is growing. When the cancer begins to grow, treatment is given to cure the cancer. Other terms that are used to describe not giving treatment to cure prostate cancer right after diagnosis are observation, watch and wait, and expectant management. Surgery Patients in good health whose tumor is in the prostate gland only may be treated with surgery to remove the tumor. The following types of surgery are used: - Radical prostatectomy: A surgical procedure to remove the prostate, surrounding tissue, and seminal vesicles. There are two types of radical prostatectomy: - Retropubic prostatectomy: A surgical procedure to remove the prostate through an incision (cut) in the abdominal wall. Removal of nearby lymph nodes may be done at the same time. - Perineal prostatectomy: A surgical procedure to remove the prostate through an incision (cut) made in the perineum (area between the scrotum and anus). Nearby lymph nodes may also be removed through a separate incision in the abdomen. Enlarge Two types of radical prostatectomy. In a retropubic prostatectomy, the prostate is removed through an incision in the wall of the abdomen. In a perineal prostatectomy, the prostate is removed through an incision in the area between the scrotum and the anus. - Pelvic lymphadenectomy: A surgical procedure to remove the lymph nodes in the pelvis. A pathologist views the tissue under a microscope to look for cancer cells. If the lymph nodes contain cancer, the doctor will not remove the prostate and may recommend other treatment. - Transurethral resection of the prostate (TURP): A surgical procedure to remove tissue from the prostate using a resectoscope (a thin, lighted tube with a cutting tool) inserted through the urethra. This procedure is done to treat benign prostatic hypertrophy and it is sometimes done to relieve symptoms caused by a tumor before other cancer treatment is given. TURP may also be done in men whose tumor is in the prostate only and who cannot have a radical prostatectomy. Enlarge Transurethral resection of the prostate (TURP). Tissue is removed from the prostate using a resectoscope (a thin, lighted tube with a cutting tool at the end) inserted through the urethra. Prostate tissue that is blocking the urethra is cut away and removed through the resectoscope. In some cases, nerve-sparing surgery can be done. This type of surgery may save the nerves that control erection. However, men with large tumors or tumors that are very close to the nerves may not be able to have this surgery. Possible problems after prostate cancer surgery include the following: - Impotence. - Leakage of urine from the bladder or stool from the rectum. - Shortening of the penis (1 to 2 centimeters). The exact reason for this is not known. - Inguinal hernia (bulging of fat or part of the small intestine through weak muscles into the groin). Inguinal hernia may occur more often in men treated with radical prostatectomy than in men who have some other types of prostate surgery, radiation therapy, or prostate biopsy alone. It is most likely to occur within the first 2 years after radical prostatectomy. Radiation therapy and radiopharmaceutical therapy Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are different types of radiation therapy: - External radiation therapy uses a machine outside the body to send radiation toward the cancer. Conformal radiation is a type of external radiation therapy that uses a computer to make a 3-dimensional (3-D) picture of the tumor and shapes the radiation beams to fit the tumor. This allows a high dose of radiation to reach the tumor and causes less damage to nearby healthy tissue. Hypofractionated radiation therapy may be given because it has a more convenient treatment schedule. Hypofractionated radiation therapy is radiation treatment in which a larger than usual total dose of radiation is given once a day over a shorter period of time (fewer days) compared to standard radiation therapy. Hypofractionated radiation therapy may have worse side effects than standard radiation therapy, depending on the schedules used. - Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. In early-stage prostate cancer, the radioactive seeds are placed in the prostate using needles that are inserted through the skin between the scrotum and rectum. The placement of the radioactive seeds in the prostate is guided by images from transrectal ultrasound or computed tomography (CT). The needles are removed after the radioactive seeds are placed in the prostate. - Radiopharmaceutical therapy uses a radioactive substance to treat cancer. Radiopharmaceutical therapy includes the following: - Alpha emitter radiation therapy uses a radioactive substance to treat prostate cancer that has spread to the bone. A radioactive substance called radium-223 is injected into a vein and travels through the bloodstream. The radium-223 collects in areas of bone with cancer and kills the cancer cells. The way the radiation therapy is given depends on the type and stage of the cancer being treated. External radiation therapy, internal radiation therapy, and radiopharmaceutical therapy are used to treat prostate cancer. Men treated with radiation therapy for prostate cancer have an increased risk of having bladder and/or gastrointestinal cancer. Radiation therapy can cause impotence and urinary problems that may get worse with age. Hormone therapy Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances made by glands in the body and circulated in the bloodstream. In prostate cancer, male sex hormones can cause prostate cancer to grow. Drugs, surgery, or other hormones are used to reduce the amount of male hormones or block them from working. Hormone therapy for prostate cancer may include the following: - Abiraterone acetate can prevent prostate cancer cells from making androgens. It is used in men with advanced prostate cancer that has not gotten better with other hormone therapy. - Orchiectomy is a surgical procedure to remove one or both testicles, the main source of male hormones, such as testosterone, to decrease the amount of hormone being made. - Estrogens (hormones that promote female sex characteristics) can prevent the testicles from making testosterone. However, estrogens are seldom used today in the treatment of prostate cancer because of the risk of serious side effects. - Luteinizing hormone-releasing hormone agonists can stop the testicles from making testosterone. Examples are leuprolide, goserelin, and buserelin. - Antiandrogens can block the action of androgens (hormones that promote male sex characteristics), such as testosterone. Examples are flutamide, bicalutamide, enzalutamide, and nilutamide. - Drugs that can prevent the adrenal glands from making androgens include ketoconazole and aminoglutethimide. Hot flashes, impaired sexual function, loss of desire for sex, and weakened bones may occur in men treated with hormone therapy. Other side effects include diarrhea, nausea, and itching. See Drugs Approved for Prostate Cancer for more information. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated. See Drugs Approved for Prostate Cancer for more information. Biologic therapy Biologic therapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. Sipuleucel-T is a type of biologic therapy used to treat prostate cancer that has metastasized (spread to other parts of the body). See Drugs Approved for Prostate Cancer for more information. Bisphosphonate therapy Bisphosphonate drugs, such as clodronate or zoledronate, reduce bone disease when cancer has spread to the bone. Men who are treated with antiandrogen therapy or orchiectomy are at an increased risk of bone loss. In these men, bisphosphonate drugs lessen the risk of bone fracture (breaks). The use of bisphosphonate drugs to prevent or slow the growth of bone metastases is being studied in clinical trials. There are treatments for bone pain caused by bone metastases or hormone therapy. Prostate cancer that has spread to the bone and certain types of hormone therapy can weaken bones and lead to bone pain. Treatments for bone pain include the following: - Pain medicine. - External radiation therapy. - Strontium-89 (a radioisotope). - Targeted therapy with a monoclonal antibody, such as denosumab. - Bisphosphonate therapy. - Corticosteroids. See the PDQ summary on Pain for more information. New types of treatment are being tested in clinical trials. This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI website. Cryosurgery Cryosurgery is a treatment that uses an instrument to freeze and destroy prostate cancer cells. Ultrasound is used to find the area that will be treated. This type of treatment is also called cryotherapy. Cryosurgery can cause impotence and leakage of urine from the bladder or stool from the rectum. High-intensity-focused ultrasound therapy High-intensity-focused ultrasound therapy is a treatment that uses ultrasound (high-energy sound waves) to destroy cancer cells. To treat prostate cancer, an endorectal probe is used to make the sound waves. Proton beam radiation therapy Proton beam radiation therapy is a type of high-energy, external radiation therapy that targets tumors with streams of protons (small, positively charged particles). This type of radiation therapy is being studied in the treatment of prostate cancer. Cryosurgery Cryosurgery is a treatment that uses an instrument to freeze and destroy prostate cancer cells. Ultrasound is used to find the area that will be treated. This type of treatment is also called cryotherapy. Cryosurgery can cause impotence and leakage of urine from the bladder or stool from the rectum. High-intensity-focused ultrasound therapy High-intensity-focused ultrasound therapy is a treatment that uses ultrasound (high-energy sound waves) to destroy cancer cells. To treat prostate cancer, an endorectal probe is used to make the sound waves. Proton beam radiation therapy Proton beam radiation therapy is a type of high-energy, external radiation therapy that targets tumors with streams of protons (small, positively charged particles). This type of radiation therapy is being studied in the treatment of prostate cancer. Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI's clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website. Follow-up tests may be needed. Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups. Treatment Options by Stage Stage I Prostate Cancer Standard treatment of stage I prostate cancer may include the following: - Watchful waiting. - Active surveillance. If the cancer begins to grow, hormone therapy may be given. - Radical prostatectomy, usually with pelvic lymphadenectomy. Radiation therapy may be given after surgery. - External radiation therapy. Hormone therapy may be given after radiation therapy. - Internal radiation therapy with radioactive seeds. - A clinical trial of high-intensity-focused ultrasound therapy. - A clinical trial of cryosurgery. Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available. Stage II Prostate Cancer Standard treatment of stage II prostate cancer may include the following: - Watchful waiting. - Active surveillance. If the cancer begins to grow, hormone therapy may be given. - Radical prostatectomy, usually with pelvic lymphadenectomy. Radiation therapy may be given after surgery. - External radiation therapy. Hormone therapy may be given after radiation therapy. - Internal radiation therapy with radioactive seeds. - A clinical trial of cryosurgery. - A clinical trial of high-intensity-focused ultrasound therapy. - A clinical trial of proton beam radiation therapy. - Clinical trials of new types of treatment, such as hormone therapy followed by radical prostatectomy. Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available. Stage III Prostate Cancer Standard treatment of stage III prostate cancer may include the following: - External radiation therapy. Hormone therapy may be given after radiation therapy. - Hormone therapy. Radiation therapy may be given after hormone therapy. - Radical prostatectomy. Radiation therapy may be given after surgery. - Watchful waiting. - Active surveillance. If the cancer begins to grow, hormone therapy may be given. Treatment to control cancer that is in the prostate and lessen urinary symptoms may include the following: - External radiation therapy. - Internal radiation therapy with radioactive seeds. - Hormone therapy. - Transurethral resection of the prostate (TURP). - A clinical trial of new types of radiation therapy. - A clinical trial of cryosurgery. Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available. Stage IV Prostate Cancer Standard treatment of stage IV prostate cancer may include the following: - Hormone therapy. - Hormone therapy combined with chemotherapy. - Bisphosphonate therapy. - External radiation therapy. Hormone therapy may be given after radiation therapy. - Alpha emitter radiation therapy. - Watchful waiting. - Active surveillance. If the cancer begins to grow, hormone therapy may be given. - A clinical trial of radical prostatectomy with orchiectomy. Treatment to control cancer that is in the prostate and lessen urinary symptoms may include the following: - Transurethral resection of the prostate (TURP). - Radiation therapy. Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available. Treatment Options for Recurrent Prostate Cancer ", "role": "user" }, { "content": "Seven types of standard treatment are used: - Watchful waiting or active surveillance - Surgery - Radiation therapy and radiopharmaceutical therapy - Hormone therapy - Chemotherapy - Biologic therapy - Bisphosphonate therapy - New types of treatment are being tested in clinical trials. - Cryosurgery - High-intensity-focused ultrasound therapy - Proton beam radiation therapy - Treatment to control cancer that is in the prostate and lessen urinary symptoms may include the following: - External radiation therapy. - Internal radiation therapy with radioactive seeds. - Hormone therapy. - Transurethral resection of the prostate (TURP). -", "role": "assistant" } ]

[ { "content": "I have a fractured nose i need it fixed. its been broke for 3 years now\n\nNose fracture: A nose fracture is a break in the bone or cartilage over the bridge, or in the sidewall or septum (structure that divides the nostrils) of the nose. A fractured nose is the most common fracture of the face. It most often occurs after an injury and often occurs with other fractures of the face. Nose injuries and neck injuries are often seen together. A blow that is forceful enough to injure the nose may be hard enough to injure the neck. Serious nose injuries cause problems that need a health care provider's attention right away. For example, damage to the cartilage can cause a collection of blood to form inside the nose. If this blood is not drained right away, it can cause an abscess or a permanent deformity that blocks the nose. It may lead to tissue death and cause the nose to collapse. For minor nose injuries, the provider may want to see the person within the first week after the injury to see if the nose has moved out of its normal shape. Sometimes, surgery may be needed to correct a nose or septum that has been bent out of shape by an injury. Symptoms may include: - Blood coming from the nose - Bruising around the eyes - Difficulty breathing through the nose - Misshapen appearance (may not be obvious until the swelling goes down) - Pain - Swelling The bruised appearance most often disappears after 2 weeks. If a nose injury happens: - Try to stay calm. - Breathe through your mouth and lean forward in a sitting position to keep blood from going down the back of your throat. - Squeeze the nostrils closed and hold pressure to stop the bleeding. - Apply cold compresses to your nose to reduce swelling. If possible, hold the compress so that there isn't too much pressure on the nose. - To help relieve pain, try acetaminophen (Tylenol). - DO NOT try to straighten a broken nose - DO NOT move the person if there is reason to suspect a head or neck injury Get medical help right away if: - Bleeding will not stop - Clear fluid keeps draining from the nose - You suspect a blood clot in the septum - You suspect a neck or head injury - The nose looks deformed or out of its usual shape - The person is having difficulty breathing Wear protective headgear while playing contact sports, or riding bicycles, skateboards, roller skates, or rollerblades. Use seat belts and appropriate car seats when driving. Updated by: Josef Shargorodsky, MD, MPH, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.", "role": "user" }, { "content": "Sometimes, surgery may be needed to correct a nose or septum that has been bent out of shape by an injury.", "role": "assistant" } ]

[ { "content": "Would appreciate any good info on Lewy Body Dementia, we need to get people aware of this dreadful disease, all they talk about is alzheimers. Thank you\n\nLewy body dementia (Risk factors): A few factors seem to increase the risk of developing Lewy body dementia, including: - Being older than 60 - Being male - Having a family member with Lewy body dementia or Parkinson's disease Research has indicated that depression is also associated with Lewy body dementia.", "role": "user" }, { "content": "Individuals are at risk for Lewy body dementia if they are older than 60, male, a history of depression, or have a family member with Lewy body dementia or Parkinson's disease.", "role": "assistant" } ]

[ { "content": "what are some common symptoms of bulimia\n\nBulimia: Bulimia is an eating disorder in which a person has regular episodes of eating a very large amount of food (bingeing) during which the person feels a loss of control over eating. The person then uses different ways, such as vomiting or laxatives (purging), to prevent weight gain. Many people with bulimia also have anorexia nervosa. Many more women than men have bulimia. The disorder is most common in teenage girls and young women. The person usually knows that her eating pattern is abnormal. She may feel fear or guilt with the binge-purge episodes. The exact cause of bulimia is unknown. Genetic, psychological, family, society, or cultural factors may play a role. Bulimia is likely due to more than one factor. With bulimia, eating binges may occur as often as several times a day for many months. The person often eats large amounts of high-calorie foods, usually in secret. During these episodes, the person feels a lack of control over the eating. Binges lead to self-disgust, which causes purging to prevent weight gain. Purging may include: - Forcing oneself to vomit - Excessive exercise - Using laxatives, enemas, or diuretics (water pills) Purging often brings a sense of relief. People with bulimia are often at a normal weight, but they may see themselves as being overweight. Because the person's weight is often normal, other people may not notice this eating disorder. Symptoms that other people can see include: - Spending a lot of time exercising - Suddenly eating large amounts of food or buying large amounts of food that disappear right away - Regularly going to the bathroom right after meals - Throwing away packages of laxatives, diet pills, emetics (drugs that cause vomiting), or diuretics A dental exam may show cavities or gum infections (such as gingivitis). The enamel of the teeth may be worn away or pitted because of too much exposure to the acid in vomit. A physical exam may also show: - Broken blood vessels in the eyes (from the strain of vomiting) - Dry mouth - Pouch-like look to the cheeks - Rashes and pimples - Small cuts and calluses across the tops of the finger joints from forcing oneself to vomit Blood tests may show an electrolyte imbalance (such as low potassium level) or dehydration. People with bulimia rarely have to go to the hospital, unless they: - Have anorexia - Have major depression - Need medicines to help them stop purging Most often, a stepped approach is used to treat bulimia. Treatment depends on how severe the bulimia is, and the person's response to treatments: - Support groups may be helpful for mild bulimia without other health problems. - Counseling, such as talk therapy and nutritional therapy are the first treatments for bulimia that does not respond to support groups. - Medicines that also treat depression, known as selective serotonin-reuptake inhibitors (SSRIs) are often used for bulimia. Combining talk therapy with SSRIs may help, if talk therapy alone does not work. People may drop out of programs if they have unrealistic hopes of being \"cured\" by therapy alone. Before a program begins, people should know that: - Different therapies will likely be needed to manage this disorder. - It is common for bulimia to return (relapse), and this is no cause for despair. - The process is painful, and the person and their family will need to work hard. The stress of illness can be eased by joining a support group. Sharing with others who have common experiences and problems can help you not feel alone. Bulimia is a long-term illness. Many people will still have some symptoms, even with treatment. People with fewer medical complications of bulimia and those willing and able to take part in therapy have a better chance of recovery. Bulimia can be dangerous. It may lead to serious health problems over time. For example, vomiting over and over can cause: - Stomach acid in the esophagus (the tube that moves food from the mouth to the stomach). This can lead to permanent damage of this area. - Tears in the esophagus - Dental cavities - Swelling of the throat Vomiting and overuse of enemas or laxatives can lead to: - Your body not having as much water and fluid as it should - Low level of potassium in the blood, which may lead to dangerous heart rhythm problems - Hard stools or constipation - Hemorrhoids - Damage of the pancreas Call for an appointment with your health care provider if you or your child has symptoms of an eating disorder. Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.", "role": "user" }, { "content": "For people with bulimia, eating binges may occur as often as several times a day for many months. he person often eats large amounts of high-calorie foods, usually in secret. During these episodes, the person feels a lack of control over the eating. Binges lead to self-disgust, which causes purging to prevent weight gain. Purging may include using laxatives, enemas, or diuretics. People with bulimia are often at a normal weight, but they may see themselves as being overweight. Because the person's weight is often normal, other people may not notice this eating disorder. Symptoms that other people can see include spending a large amount of time exercising, suddenly eating large amounts of food, regularly going to the bathroom after meals, or throwing away packages of laxatives, diet pills, emetics (drugs that cause vomiting), or diuretics.", "role": "assistant" } ]

[ { "content": "what are some common symptoms of bulimia\n\n Bulimia Bulimia nervosa Binge-purge behavior Eating disorder - bulimia Summary Bulimia is an eating disorder in which a person has regular episodes of eating a very large amount of food (bingeing) during which the person feels a loss of control over eating. The person then uses different ways, such as vomiting or laxatives (purging), to prevent weight gain. Many people with bulimia also have anorexia. Causes Many more women than men have bulimia. The disorder is most common in teenage girls and young women. The person usually knows that her eating pattern is abnormal. She may feel fear or guilt with the binge-purge episodes. The exact cause of bulimia is unknown. Genetic, psychological, family, society, or cultural factors may play a role. Bulimia is likely due to more than one factor. Symptoms With bulimia, eating binges may occur as often as several times a day for many months. The person often eats large amounts of high-calorie foods, usually in secret. During these episodes, the person feels a lack of control over the eating. Binges lead to self-disgust, which causes purging to prevent weight gain. Purging may include: Forcing oneself to vomit Excessive exercise Using laxatives, enemas, or diuretics (water pills) Purging often brings a sense of relief. People with bulimia are often at a normal weight, but they may see themselves as being overweight. Because the person's weight is often normal, other people may not notice this eating disorder. Symptoms that other people can see include: Spending a lot of time exercising Suddenly eating large amounts of food or buying large amounts of food that disappear right away Regularly going to the bathroom right after meals Throwing away packages of laxatives, diet pills, emetics (drugs that cause vomiting), or diuretics Exams and Tests A dental exam may show cavities or gum infections (such as gingivitis). The enamel of the teeth may be worn away or pitted because of too much exposure to the acid in vomit. A physical exam may also show: Broken blood vessels in the eyes (from the strain of vomiting) Dry mouth Pouch-like look to the cheeks Rashes and pimples Small cuts and calluses across the tops of the finger joints from forcing oneself to vomit Blood tests may show an electrolyte imbalance (such as low potassium level) or dehydration. Treatment People with bulimia rarely have to go to the hospital, unless they: Have anorexia Have major depression Need medicines to help them stop purging Most often, a stepped approach is used to treat bulimia. Treatment depends on how severe the bulimia is, and the person's response to treatments: Support groups may be helpful for mild bulimia without other health problems. Counseling, such as talk therapy and nutritional therapy are the first treatments for bulimia that does not respond to support groups. Medicines that also treat depression, known as selective serotonin-reuptake inhibitors (SSRIs) are often used for bulimia. Combining talk therapy with SSRIs may help, if talk therapy alone does not work. People may drop out of programs if they have unrealistic hopes of being \"cured\" by therapy alone. Before a program begins, people should know that: Different therapies will likely be needed to manage this disorder. It is common for bulimia to return (relapse), and this is no cause for despair. The process is painful, and the person and their family will need to work hard. Support Groups The stress of illness can be eased by joining a support group. Sharing with others who have common experiences and problems can help you not feel alone. Outlook (Prognosis) Bulimia is a long-term illness. Many people will still have some symptoms, even with treatment. People with fewer medical complications of bulimia and those willing and able to take part in therapy have a better chance of recovery. Possible Complications Bulimia can be dangerous. It may lead to serious health problems over time. For example, vomiting over and over can cause: Stomach acid in the esophagus (the tube that moves food from the mouth to the stomach). This can lead to permanent damage of this area. Tears in the esophagus. Dental cavities. Swelling of the throat. Vomiting and overuse of enemas or laxatives can lead to: Your body not having as much water and fluid as it should Low level of potassium in the blood, which may lead to dangerous heart rhythm problems Hard stools or constipation Hemorrhoids Damage of the pancreas When to Contact a Medical Professional Call for an appointment with your health care provider if you or your child has symptoms of an eating disorder. Review Date 3/26/2018 Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "With bulimia, eating binges may occur as often as several times a day for many months. The person often eats large amounts of high-calorie foods, usually in secret. During these episodes, the person feels a lack of control over the eating. Binges lead to self-disgust, which causes purging to prevent weight gain. Purging may include: - Forcing oneself to vomit - Excessive exercise - Using laxatives, enemas, or diuretics (water pills) Purging often brings a sense of relief. People with bulimia are often at a normal weight, but they may see themselves as being overweight. Because the person's weight is often normal, other people may not notice this eating disorder. Symptoms that other people can see include: - Spending a lot of time exercising - Suddenly eating large amounts of food or buying large amounts of food that disappear right away - Regularly going to the bathroom right after meals - Throwing away packages of laxatives, diet pills, emetics (drugs that cause vomiting), or diuretics", "role": "assistant" } ]

[ { "content": "how to manage prostate cancer\n\n Prostate cancer treatment Summary Treatment for your prostate cancer is chosen after a thorough evaluation. Your health care provider will discuss the benefits and risks of each treatment. Sometimes your provider may recommend one treatment for you because of your type of cancer and risk factors. Other times, there may be two or more treatments that could be good for you. Factors you and your provider must think about include: Your age and other medical problems you may have Side effects that occur with each type of treatment How much the prostate cancer has spread Your Gleason score, which tells how likely it is that cancer has already spread Your prostate-specific antigen (PSA) test result Ask your provider to explain these things following about your treatment choices: Which choices offer the best chance of curing your cancer or controlling its spread? How likely is it that you will have different side effects, and how they will affect your life? Radical Prostatectomy (Prostate Removal) Radical prostatectomy is a surgery to remove the prostate and some of the surrounding tissue. It is an option when the cancer has not spread beyond the prostate gland. Healthy men who will likely live 10 or more years after being diagnosed with prostate cancer often have this procedure. Be aware that it is not always possible to know for certain, before surgery, if the cancer has spread beyond the prostate gland. Possible problems after surgery include difficulty controlling urine and erection problems. Also, some men need further treatments after this surgery. Radiation Therapy Radiation therapy works best for treating prostate cancer that has not spread outside of the prostate. It may also be used after surgery if there is a risk that cancer cells are still present. Radiation is sometimes used for pain relief when cancer has spread to the bone. External beam radiation therapy uses high-powered x-rays pointed at the prostate gland: Before treatment, the radiation therapist uses a special pen to mark the part of the body that is to be treated. Radiation is delivered to the prostate gland using a machine similar to a regular x-ray machine. The treatment itself is usually painless. Treatment is done in a radiation oncology center that is usually connected to a hospital. Treatment is usually done 5 days a week for 6 to 8 weeks. Side effects may include: Appetite loss Diarrhea Erection problems Fatigue Rectal burning or injury Skin reactions Urinary incontinence, the feeling of needing to urinate urgently, or blood in the urine There are reports of secondary cancers arising from the radiation as well. Proton therapy is another kind of radiation therapy used to treat prostate cancer. Proton beams target the tumor precisely, so there is less damage to the surrounding tissue. This therapy is not widely accepted or used. Prostate Brachytherapy Brachytherapy is often used for small prostate cancers that are found early and are slow-growing. Brachytherapy may be combined with external beam radiation therapy for more advanced cancers. Brachytherapy involves placing radioactive seeds inside the prostate gland. A surgeon inserts small needles through the skin beneath your scrotum to inject the seeds. The seeds are so small that you do not feel them. The seeds are left in place permanently. Side effects may include: Pain, swelling, or bruising in the penis or scrotum Red-brown urine or semen Impotence Incontinence Urinary retention Diarrhea Hormonal Therapy Testosterone is the main male hormone. Prostate tumors need testosterone to grow. Hormonal therapy is treatment that decreases the effect of testosterone on prostate cancer. Hormone therapy is mainly used for cancer that has spread beyond the prostate. The treatment can help relieve symptoms and prevent further growth and spread of cancer. But it does not cure the cancer. The main type of hormone therapy is called a luteinizing hormone-releasing hormones (LH-RH) agonist: The medicine blocks the testicles from making testosterone. The drugs must be given by injection, usually every 3 to 6 months. Possible side effects include nausea and vomiting, hot flashes, anemia, fatigue, thinning bones (osteoporosis), reduced sexual desire, decreased muscle mass, weight gain, and impotence. The other type of hormone medicine is called an androgen-blocking drug: It is often given along with LH-RH drugs to block the effect of testosterone produced by the adrenal glands, which make a small amount of testosterone. Possible side effects include erection problems, reduced sexual desire, liver problems, diarrhea, and enlarged breasts. Much of the body's testosterone is made by the testes. As a result, surgery to remove the testes (called orchiectomy) can also be used as a hormonal treatment. Chemotherapy Chemotherapy and immunotherapy (medicine that helps the body's immune system fight the cancer) may be used to treat prostate cancer that no longer responds to hormone treatment. Usually a single drug or a combination of drugs is recommended. Cryotherapy Cryotherapy uses very cold temperatures to freeze and kill prostate cancer cells. The goal of cryosurgery is to destroy the entire prostate gland and possibly surrounding tissue. Cryosurgery is generally not used as a first treatment for prostate cancer. Review Date 10/10/2017 Updated by: Jennifer Sobol, DO, Urologist with the Michigan Institute of Urology, West Bloomfield, MI. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Hormonal therapy is a treatment for prostate cancer. Because prostate tumors need testosterone to grow, hormonal therapy can decrease the effect of testosterone on prostate cancer. It does not cure the cancer, but it can relieve symptoms and prevent further growth and spread of the cancer.", "role": "assistant" } ]

[ { "content": "how do you diagnose anxiety\n\n Anxiety Overview Experiencing occasional anxiety is a normal part of life. However, people with anxiety disorders frequently have intense, excessive and persistent worry and fear about everyday situations. Often, anxiety disorders involve repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). These feelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. You may avoid places or situations to prevent these feelings. Symptoms may start during childhood or the teen years and continue into adulthood. Examples of anxiety disorders include generalized anxiety disorder, social anxiety disorder (social phobia), specific phobias and separation anxiety disorder. You can have more than one anxiety disorder. Sometimes anxiety results from a medical condition that needs treatment. Whatever form of anxiety you have, treatment can help. Anxiety care at Mayo Clinic Symptoms Common anxiety signs and symptoms include: - Feeling nervous, restless or tense - Having a sense of impending danger, panic or doom - Having an increased heart rate - Breathing rapidly (hyperventilation) - Sweating - Trembling - Feeling weak or tired - Trouble concentrating or thinking about anything other than the present worry - Having trouble sleeping - Experiencing gastrointestinal (GI) problems - Having difficulty controlling worry - Having the urge to avoid things that trigger anxiety Several types of anxiety disorders exist: - Agoraphobia (ag-uh-ruh-FOE-be-uh) is a type of anxiety disorder in which you fear and often avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed. - Anxiety disorder due to a medical condition includes symptoms of intense anxiety or panic that are directly caused by a physical health problem. - Generalized anxiety disorder includes persistent and excessive anxiety and worry about activities or events - even ordinary, routine issues. The worry is out of proportion to the actual circumstance, is difficult to control and affects how you feel physically. It often occurs along with other anxiety disorders or depression. - Panic disorder involves repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). You may have feelings of impending doom, shortness of breath, chest pain, or a rapid, fluttering or pounding heart (heart palpitations). These panic attacks may lead to worrying about them happening again or avoiding situations in which they've occurred. - Selective mutism is a consistent failure of children to speak in certain situations, such as school, even when they can speak in other situations, such as at home with close family members. This can interfere with school, work and social functioning. - Separation anxiety disorder is a childhood disorder characterized by anxiety that's excessive for the child's developmental level and related to separation from parents or others who have parental roles. - Social anxiety disorder (social phobia) involves high levels of anxiety, fear and avoidance of social situations due to feelings of embarrassment, self-consciousness and concern about being judged or viewed negatively by others. - Specific phobias are characterized by major anxiety when you're exposed to a specific object or situation and a desire to avoid it. Phobias provoke panic attacks in some people. - Substance-induced anxiety disorder is characterized by symptoms of intense anxiety or panic that are a direct result of abusing drugs, taking medications, being exposed to a toxic substance or withdrawal from drugs. - Other specified anxiety disorder and unspecified anxiety disorder are terms for anxiety or phobias that don't meet the exact criteria for any other anxiety disorders but are significant enough to be distressing and disruptive. When to see a doctor See your doctor if: - You feel like you're worrying too much and it's interfering with your work, relationships or other parts of your life - Your fear, worry or anxiety is upsetting to you and difficult to control - You feel depressed, have trouble with alcohol or drug use, or have other mental health concerns along with anxiety - You think your anxiety could be linked to a physical health problem - You have suicidal thoughts or behaviors - if this is the case, seek emergency treatment immediately Your worries may not go away on their own, and they may get worse over time if you don't seek help. See your doctor or a mental health provider before your anxiety gets worse. It's easier to treat if you get help early. Causes The causes of anxiety disorders aren't fully understood. Life experiences such as traumatic events appear to trigger anxiety disorders in people who are already prone to anxiety. Inherited traits also can be a factor. Medical causes For some people, anxiety may be linked to an underlying health issue. In some cases, anxiety signs and symptoms are the first indicators of a medical illness. If your doctor suspects your anxiety may have a medical cause, he or she may order tests to look for signs of a problem. Examples of medical problems that can be linked to anxiety include: - Heart disease - Diabetes - Thyroid problems, such as hyperthyroidism - Respiratory disorders, such as chronic obstructive pulmonary disease (COPD) and asthma - Drug abuse or withdrawal - Withdrawal from alcohol, anti-anxiety medications (benzodiazepines) or other medications - Chronic pain or irritable bowel syndrome - Rare tumors that produce certain \"fight-or-flight\" hormones Sometimes anxiety can be a side effect of certain medications. It's possible that your anxiety may be due to an underlying medical condition if: - You don't have any blood relatives (such as a parent or sibling) with an anxiety disorder - You didn't have an anxiety disorder as a child - You don't avoid certain things or situations because of anxiety - You have a sudden occurrence of anxiety that seems unrelated to life events and you didn't have a previous history of anxiety Risk factors These factors may increase your risk of developing an anxiety disorder: - Trauma. Children who endured abuse or trauma or witnessed traumatic events are at higher risk of developing an anxiety disorder at some point in life. Adults who experience a traumatic event also can develop anxiety disorders. - Stress due to an illness. Having a health condition or serious illness can cause significant worry about issues such as your treatment and your future. - Stress buildup. A big event or a buildup of smaller stressful life situations may trigger excessive anxiety - for example, a death in the family, work stress or ongoing worry about finances. - Personality. People with certain personality types are more prone to anxiety disorders than others are. - Other mental health disorders. People with other mental health disorders, such as depression, often also have an anxiety disorder. - Having blood relatives with an anxiety disorder. Anxiety disorders can run in families. - Drugs or alcohol. Drug or alcohol use or abuse or withdrawal can cause or worsen anxiety. Complications Having an anxiety disorder does more than make you worry. It can also lead to, or worsen, other mental and physical conditions, such as: - Depression (which often occurs with an anxiety disorder) or other mental health disorders - Substance abuse - Trouble sleeping (insomnia) - Digestive or bowel problems - Headaches and chronic pain - Social isolation - Problems functioning at school or work - Poor quality of life - Suicide Diagnosis You may start by seeing your primary care doctor to find out if your anxiety could be related to your physical health. Your doctor can check for signs of an underlying medical condition that may need treatment. However, you may need to see a mental health specialist if you have severe anxiety. A psychiatrist is a medical doctor who specializes in diagnosing and treating mental health conditions. A psychologist and certain other mental health professionals can diagnose anxiety and provide counseling (psychotherapy). To help diagnose an anxiety disorder and rule out other conditions, your provider may: - Give you a psychological evaluation. This involves describing your thoughts, feelings and behavior to help pinpoint a diagnosis and check for related complications. Anxiety disorders often occur along with other mental health problems - such as depression or substance abuse - which can make diagnosis more challenging. - Compare your symptoms to the criteria in the DSM-5. Many doctors use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to diagnose an anxiety disorder. Treatment The two main treatments for anxiety disorders are psychotherapy and medications. You may benefit most from a combination of the two. It may take some trial and error to discover which treatments work best for you. Psychotherapy Also known as talk therapy or psychological counseling, psychotherapy involves working with a therapist to reduce your anxiety symptoms. It can be an effective treatment for anxiety. Cognitive behavioral therapy (CBT) is the most effective form of psychotherapy for anxiety disorders. Generally a short-term treatment, CBT focuses on teaching you specific skills to improve your symptoms and gradually return to the activities you've avoided because of anxiety. CBT includes exposure therapy, in which you gradually encounter the object or situation that triggers your anxiety so you build confidence that you can manage the situation and anxiety symptoms. Medications Several types of medications are used to help relieve symptoms, depending on the type of anxiety disorder you have and whether you also have other mental or physical health issues. For example: - Certain antidepressants are also used to treat anxiety disorders. - An anti-anxiety medication called buspirone may be prescribed. - In limited circumstances, your doctor may prescribe a certain type of sedative called a benzodiazepine for short-term relief of anxiety symptoms. Talk with your doctor about benefits, risks and possible side effects of medications. Lifestyle and home remedies While most people with anxiety disorders need psychotherapy or medications to get anxiety under control, lifestyle changes also can make a difference. Here's what you can do: - Keep physically active. Develop a routine so that you're physically active most days of the week. Exercise is a powerful stress reducer. It may improve your mood and help you stay healthy. Start out slowly and gradually increase the amount and intensity of your activities. - Avoid alcohol and recreational drugs. These substances can cause or worsen anxiety. If you can't quit on your own, see your doctor or find a support group to help you. - Quit smoking and cut back or quit drinking caffeinated beverages. Both nicotine and caffeine can worsen anxiety. - Use stress management and relaxation techniques. Visualization techniques, meditation and yoga are examples of relaxation techniques that can ease anxiety. - Make sleep a priority. Do what you can to make sure you're getting enough sleep to feel rested. If you aren't sleeping well, see your doctor. - Eat healthy. Healthy eating - such as focusing on vegetables, fruits, whole grains and fish - may be linked to reduced anxiety, but more research is needed. Alternative medicine Several herbal remedies have been studied as a treatment for anxiety, but more research is needed to understand the risks and benefits. Herbal and dietary supplements aren't monitored by the FDA the same way medications are. You can't always be certain of what you're getting and whether it's safe. Some of these supplements can interfere with prescription medications or cause dangerous interactions. Before taking herbal remedies or dietary supplements, talk to your doctor to make sure they're safe for you and won't interact with any medications you take. ", "role": "user" }, { "content": "Talk to your primary care doctor to find out if your anxiety could be related to your physical health. However, if you have severe anxiety, you may need to see a mental health specialist such as a psychiatrist, psychologist, or other mental health professional. To help diagnose an anxiety disorder, your provider may give you a psychological evaluation. This includes describing your thoughts, feelings and behavior to help pinpoint a diagnosis and check for related complications. Many doctors use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to diagnose an anxiety disorder.", "role": "assistant" } ]

[ { "content": "how do you catch hepatitis c\n\n Hepatitis C HCV Summary Your liver is the largest organ inside your body. It helps your body digest food, store energy, and remove poisons. Hepatitis is an inflammation of the liver. One type, hepatitis C, is caused by the hepatitis C virus (HCV). It usually spreads through contact with infected blood. It can also spread through sex with an infected person and from mother to baby during childbirth. Most people who are infected with hepatitis C don't have any symptoms for years. If you do get symptoms, you may feel as if you have the flu. You may also have jaundice, a yellowing of skin and eyes, dark-colored urine, and pale bowel movements. A blood test can tell if you have it. Usually, hepatitis C does not get better by itself. The infection can last a lifetime and may lead to scarring of the liver or liver cancer. Medicines sometimes help, but side effects can be a problem. Serious cases may need a liver transplant. There is no vaccine for HCV. NIH: National Institute of Diabetes and Digestive and Kidney Diseases ", "role": "user" }, { "content": "Hepatitis C can be spread through contact with blood already infected by the virus. It can be spread through sex sex with an affected individual, or from the mother to her child during birth.", "role": "assistant" } ]

[ { "content": "how is asthma diagnosed\n\nAsthma (Diagnosis): Physical exam To rule out other possible conditions - such as a respiratory infection or chronic obstructive pulmonary disease (COPD) - your doctor will do a physical exam and ask you questions about your signs and symptoms and about any other health problems. Tests to measure lung function You may also be given lung (pulmonary) function tests to determine how much air moves in and out as you breathe. These tests may include: - Spirometry. This test estimates the narrowing of your bronchial tubes by checking how much air you can exhale after a deep breath and how fast you can breathe out. - Peak flow. A peak flow meter is a simple device that measures how hard you can breathe out. Lower than usual peak flow readings are a sign your lungs may not be working as well and that your asthma may be getting worse. Your doctor will give you instructions on how to track and deal with low peak flow readings. Lung function tests often are done before and after taking a medication called a bronchodilator (brong-koh-DIE-lay-tur), such as albuterol, to open your airways. If your lung function improves with use of a bronchodilator, it's likely you have asthma. Additional tests Other tests to diagnose asthma include: - Methacholine challenge. Methacholine is a known asthma trigger that, when inhaled, will cause mild constriction of your airways. If you react to the methacholine, you likely have asthma. This test may be used even if your initial lung function test is normal. - Nitric oxide test. This test, though not widely available, measures the amount of the gas, nitric oxide, that you have in your breath. When your airways are inflamed - a sign of asthma - you may have higher than normal nitric oxide levels. - Imaging tests. A chest X-ray and high-resolution computerized tomography (CT) scan of your lungs and nose cavities (sinuses) can identify any structural abnormalities or diseases (such as infection) that can cause or aggravate breathing problems. - Allergy testing. This can be performed by a skin test or blood test. Allergy tests can identify allergy to pets, dust, mold and pollen. If important allergy triggers are identified, this can lead to a recommendation for allergen immunotherapy. - Sputum eosinophils. This test looks for certain white blood cells (eosinophils) in the mixture of saliva and mucus (sputum) you discharge during coughing. Eosinophils are present when symptoms develop and become visible when stained with a rose-colored dye (eosin). - Provocative testing for exercise and cold-induced asthma. In these tests, your doctor measures your airway obstruction before and after you perform vigorous physical activity or take several breaths of cold air. How asthma is classified To classify your asthma severity, your doctor considers your answers to questions about symptoms (such as how often you have asthma attacks and how bad they are), along with the results of your physical exam and diagnostic tests. Determining your asthma severity helps your doctor choose the best treatment. Asthma severity often changes over time, requiring treatment adjustments. Asthma is classified into four general categories:", "role": "user" }, { "content": "Asthma (Diagnosis): Physical exam To rule out other possible conditions - such as a respiratory infection or chronic obstructive pulmonary disease (COPD) - your doctor will do a physical exam and ask you questions about your signs and symptoms and about any other health problems. You may also be given lung (pulmonary) function tests to determine how much air moves in and out as you breathe. These tests may include: Spirometry. This test estimates the narrowing of your bronchial tubes by checking how much air you can exhale after a deep breath and how fast you can breathe out. Peak flow. A peak flow meter is a simple device that measures how hard you can breathe out. Lower than usual peak flow readings are a sign your lungs may not be working as well and that your asthma may be getting worse. A chest X-ray and high-resolution computerized tomography (CT) scan of your lungs and nose cavities (sinuses) can identify any structural abnormalities or diseases (such as infection) that can cause or aggravate breathing problems. Allergy tests can identify allergy to pets, dust, mold and pollen.", "role": "assistant" } ]

[ { "content": "more information in relation to Ellis van creveld syndrome Specifically in later life can they have children has it ever been reported any researchcarried out and just as much information as possible to help my understanding of what I have Many thanks\n\n EVC gene DWF-1 Ellis van Creveld protein Ellis van Creveld syndrome Ellis van Creveld syndrome protein EVC1 EVC_HUMAN EVCL Normal Function The EVC gene provides instructions for making a protein whose function is unclear. However, it appears to be important for normal growth and development, particularly the development of bones and teeth. The EVC protein is found in primary cilia, which are microscopic, finger-like projections that stick out from the surface of cells and are involved in signaling pathways that transmit information between cells. In particular, the EVC protein is thought to help regulate a signaling pathway known as Sonic Hedgehog, which plays roles in cell growth, cell specialization, and the normal shaping (patterning) of many parts of the body. EVC and another gene, EVC2, are located very close together on chromosome 4. Researchers believe that the two genes may have related functions and that their activity may be coordinated. Health Conditions Related to Genetic Changes More than 25 mutations in the EVC gene have been reported to cause Ellis-van Creveld syndrome, an inherited disorder characterized by dwarfism, abnormal nails and teeth, and heart defects. The mutations that cause this condition occur in both copies of the EVC gene in each cell. These genetic changes disrupt the normal function of the EVC protein or lead to the production of an abnormally small, nonfunctional version of the protein. Although it is unclear how the loss of this protein's function underlies the signs and symptoms of Ellis-van Creveld syndrome, researchers believe that it may prevent normal Sonic Hedgehog signaling in the developing embryo. Problems with this signaling pathway may ultimately lead to the abnormal bone growth and heart defects seen with this condition. Chromosomal Location Cytogenetic Location: 4p16.2, which is the short (p) arm of chromosome 4 at position 16.2 Molecular Location: base pairs 5,711,197 to 5,829,043 on chromosome 4 (Homo sapiens Annotation Release 109, GRCh38.p12) (NCBI) </div> Credit: Genome Decoration Page/NCBI Sources for This Page Blair HJ, Tompson S, Liu YN, Campbell J, MacArthur K, Ponting CP, Ruiz-Perez VL, Goodship JA. Evc2 is a positive modulator of Hedgehog signalling that interacts with Evc at the cilia membrane and is also found in the nucleus. BMC Biol. 2011 Feb 28;9:14. doi: 10.1186/1741-7007-9-14. ", "role": "user" }, { "content": "Ellis-van Creveld syndrome is an inherited disorder characterized by dwarfism, abnormal nails and teeth, and heart defects.", "role": "assistant" } ]

[ { "content": "how is epilepsy diagnosed\n\nEpilepsy (Diagnosis): To diagnose your condition, your doctor will review your symptoms and medical history. Your doctor may order several tests to diagnose epilepsy and determine the cause of seizures. Your evaluation may include: - A neurological exam. Your doctor may test your behavior, motor abilities, mental function and other areas to diagnose your condition and determine the type of epilepsy you may have. - Blood tests. Your doctor may take a blood sample to check for signs of infections, genetic conditions or other conditions that may be associated with seizures. Your doctor may also suggest tests to detect brain abnormalities, such as: - Electroencephalogram (EEG). This is the most common test used to diagnose epilepsy. In this test, doctors attach electrodes to your scalp with a paste-like substance. The electrodes record the electrical activity of your brain. If you have epilepsy, it's common to have changes in your normal pattern of brain waves, even when you're not having a seizure. Your doctor may monitor you on video while conducting an EEG while you're awake or asleep, to record any seizures you experience. Recording the seizures may help the doctor determine what kind of seizures you're having or rule out other conditions. Your doctor may give you instructions to do something that will cause seizures, such as getting little sleep prior to the test. - High-density EEG. In a variation of an EEG test, your doctor may recommend high-density EEG, which spaces electrodes more closely than conventional EEG - about a half a centimeter apart. High-density EEG may help your doctor more precisely determine which areas of your brain are affected by seizures. - Computerized tomography (CT) scan. A CT scan uses X-rays to obtain cross-sectional images of your brain. CT scans can reveal abnormalities in your brain that might be causing your seizures, such as tumors, bleeding and cysts. - Magnetic resonance imaging (MRI). An MRI uses powerful magnets and radio waves to create a detailed view of your brain. Your doctor may be able to detect lesions or abnormalities in your brain that could be causing your seizures. - Functional MRI (fMRI). A functional MRI measures the changes in blood flow that occur when specific parts of your brain are working. Doctors may use an fMRI before surgery to identify the exact locations of critical functions, such as speech and movement, so that surgeons can avoid injuring those places while operating. - Positron emission tomography (PET). PET scans use a small amount of low-dose radioactive material that's injected into a vein to help visualize active areas of the brain and detect abnormalities. - Single-photon emission computerized tomography (SPECT). This type of test is used primarily if you've had an MRI and EEG that didn't pinpoint the location in your brain where the seizures are originating. A SPECT test uses a small amount of low-dose radioactive material that's injected into a vein to create a detailed, 3-D map of the blood flow activity in your brain during seizures. Doctors also may conduct a form of a SPECT test called subtraction ictal SPECT coregistered to MRI (SISCOM), which may provide even more-detailed results. - Neuropsychological tests. In these tests, doctors assess your thinking, memory and speech skills. The test results help doctors determine which areas of your brain are affected. Along with your test results, your doctor may use a combination of analysis techniques to help pinpoint where in the brain seizures start: - Statistical parametric mapping (SPM). SPM is a method of comparing areas of the brain that have increased metabolism during seizures to normal brains, which can give doctors an idea of where seizures begin. - Curry analysis. Curry analysis is a technique that takes EEG data and projects it onto an MRI of the brain to show doctors where seizures are occurring. - Magnetoencephalography (MEG). MEG measures the magnetic fields produced by brain activity to identify potential areas of seizure onset. Accurate diagnosis of your seizure type and where seizures begin gives you the best chance for finding an effective treatment.", "role": "user" }, { "content": "To diagnose your condition, your doctor will review your symptoms and medical history. Your doctor may order several tests to diagnose epilepsy and determine the cause of seizures. Your evaluation may include: - A neurological exam. Your doctor may test your behavior, motor abilities, mental function and other areas to diagnose your condition and determine the type of epilepsy you may have. - Blood tests. Your doctor may take a blood sample to check for signs of infections, genetic conditions or other conditions that may be associated with seizures. Your doctor may also suggest tests to detect brain abnormalities, such as: - Electroencephalogram (EEG). This is the most common test used to diagnose epilepsy. Computerized tomography (CT) scan. A CT scan uses X-rays to obtain cross-sectional images of your brain. CT scans can reveal abnormalities in your brain that might be causing your seizures, such as tumors, bleeding and cysts. - Magnetic resonance imaging (MRI). An MRI uses powerful magnets and radio waves to create a detailed view of your brain. Accurate diagnosis of your seizure type and where seizures begin gives you the best chance for finding an effective treatment.", "role": "assistant" } ]

[ { "content": "Subcutaneous retrocalcaneal bursitis Haglund's deformity of the calcaneum. I have this problem. Can you please help to overcome this?\n\nBursitis of the heel (Treatment): Your provider may recommend that you do the following: - Avoid activities that cause pain. - Put ice on the heel several times a day. - Take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. - Try using over-the-counter or custom heel wedges in your shoe to help decrease stress on the heel. - Try ultrasound treatment during physical therapy to reduce inflammation. Have physical therapy to improve flexibility and strength around the ankle. The focus will be on stretching your Achilles tendon. This can help the bursitis improve and prevent it from coming back. If these treatments DO NOT work, your provider may inject a small amount of steroid medicine into the bursa. After the injection, you should avoid overstretching the tendon because it can break open (rupture). If the condition is connected to Achilles tendinitis, you may need to wear a cast on the ankle for several weeks. Very rarely, surgery may be needed to remove the inflamed bursa.", "role": "user" }, { "content": "Your provider may recommend that you avoid activities that cause pain. Put ice on the heel several times a day. Take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. Try using over-the-counter or custom heel wedges in your shoe to help decrease stress on the heel. Try ultrasound treatment during physical therapy to reduce inflammation. Have physical therapy to improve flexibility and strength around the ankle. The focus will be on stretching your Achilles tendon. This can help the bursitis improve and prevent it from coming back. If these treatments do not work, your provider may inject steroid medicine into the bursa. If the condition is connected to Achilles tendinitis, you may need to wear a cast on the ankle for several weeks. Very rarely, surgery may be needed to remove the inflamed bursa. This condition most often gets better in several weeks with the proper treatment. To prevent the problem, maintain proper form when exercising and good flexibility and strength around the ankle. Wear shoes with enough arch support to decrease the amount of stress on the tendon and inflammation in the bursa.", "role": "assistant" } ]

[ { "content": "adrenoleukodystrophy A child I have been asked to work with has been diagnosed with this condition.I am so far unable to find info pertaining to this illness. Can you help??\n\n Adrenoleukodystrophy X-linked Adrenoleukodystrophy Adrenomyeloneuropathy Childhood cerebral adrenoleukodystrophy ALD Schilder-Addison Complex Summary Adrenoleukodystrophy describes several closely related disorders that disrupt the breakdown of certain fats. These disorders are passed down (inherited) in families. Causes Adrenoleukodystrophy is usually passed down from parent to child as an X-linked genetic trait. It affects mostly males. Some women who are carriers can have milder forms of the disease. It affects about 1 in 20,000 people from all races. The condition results in the buildup of very-long-chain fatty acids in the nervous system, adrenal gland, and testes. This disrupts normal activity in these parts of the body. There are three major categories of disease: Childhood cerebral form -- appears in mid-childhood (at ages 4 to 8) Adrenomyelopathy -- occurs in men in their 20s or later in life Impaired adrenal gland function (called Addison disease or Addison-like phenotype) -- adrenal gland does not produce enough steroid hormones Symptoms Childhood cerebral type symptoms include: Changes in muscle tone, especially muscle spasms and uncontrolled movements Crossed eyes Handwriting that gets worse Difficulty at school Difficulty understanding what people are saying Hearing loss Hyperactivity Worsening nervous system damage, including coma, decreased fine motor control, and paralysis Seizures Swallowing difficulties Visual impairment or blindness Adrenomyelopathy symptoms include: Difficulty controlling urination Possible worsening muscle weakness or leg stiffness Problems with thinking speed and visual memory Adrenal gland failure (Addison type) symptoms include: Coma Decreased appetite Increased skin color Loss of weight and muscle mass (wasting) Muscle weakness Vomiting Exams and Tests Tests for this condition include: Blood levels of very long chain fatty acids and hormones that are produced by the adrenal gland Chromosome study to look for changes (mutations) in the <em>ABCD1</em> gene MRI of the head Skin biopsy Treatment Adrenal dysfunction may be treated with steroids (such as cortisol) if the adrenal gland is not producing enough hormones. A specific treatment for X-linked adrenoleukodystrophy is not available. A bone marrow transplant can cure a people of the condition. Supportive care and careful monitoring of impaired adrenal gland function may help in improving comfort and quality of life. Support Groups The following resources can provide more information on adrenoleukodystrophy: National Organization for Rare Disease Disorders -- rarediseases.org/rare-diseases/adrenoleukodystrophy NIH/NLM Genetics Home Reference -- ghr.nlm.nih.gov/condition/x-linked-adrenoleukodystrophy Outlook (Prognosis) The childhood form of X-linked adrenoleukodystrophy is a progressive disease. It leads to a long-term coma (vegetative state) about 2 years after nervous system symptoms develop. The child can live in this condition for as long as 10 years until death occurs. The other forms of this disease are milder. Possible Complications These complications can occur: Adrenal crisis Vegetative state When to Contact a Medical Professional Call your health care provider if: Your child develops symptoms of X-linked adrenoleukodystrophy Your child has X-linked adrenoleukodystrophy and is getting worse Prevention Genetic counseling is recommended for couples with a family history of X-linked adrenoleukodystrophy. Mothers of affected sons have an 85% chance of being a carrier for this condition. Prenatal diagnosis of X-linked adrenoleukodystrophy is also available. It is done by testing cells from chorionic villus sampling or amniocentesis. These tests look for either a known genetic change in the family or for very long chain fatty acid levels. Review Date 10/26/2017 Updated by: Anna C. Edens Hurst, MD, MS, Assistant Professor in Medical Genetics, The University of Alabama at Birmingham, Birmingham, AL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Adrenoleukodystrophy describes several closely related disorders that disrupt the breakdown of certain fats. These disorders are passed down (inherited) in families.", "role": "assistant" } ]

[ { "content": "varicella shingles How can I determine whether or not I've had chicken pox. If there is a test for it, what are the results of the tests I need to know that will tell me whether or not I have had chicken pox? I want to know this to determine if I should have shingles vaccine (Zostavax) Thank you.\n\nChickenpox (Exams and Tests): Your health care provider can most often diagnose chickenpox by looking at the rash and asking questions about the person's medical history. Small blisters on the scalp confirm the diagnosis in most cases. Lab tests can help confirm the diagnosis, if needed.", "role": "user" }, { "content": "Your health care provider can most often diagnose chickenpox by looking at the rash and asking questions about the person's medical history.. Lab tests can help confirm the diagnosis.", "role": "assistant" } ]

[ { "content": "CURE FOR PNEUMONIA Dear DR, please i have a friend that has the above illness..I want to find out...since i want to marry her...is it an infectious illness,,and can it be totally cured. And how can i help her to get this cured..Please i really need your reply urgently\n\nAtypical pneumonia (Treatment): To feel better, you can take these self-care measures at home: - Control your fever with aspirin, NSAIDs (such as ibuprofen or naproxen), or acetaminophen. DO NOT give aspirin to children because it may cause a dangerous illness called Reye syndrome. - DO NOT take cough medicines without first talking to your provider. Cough medicines may make it harder for your body to cough up the extra sputum. - Drink plenty of fluids to help loosen secretions and bring up phlegm. - Get a lot of rest. Have someone else do household chores. Antibiotics are used to treat atypical pneumonia. - You may be able to take antibiotics by mouth at home. - If your condition is severe, you will likely be admitted to a hospital. There, you will be given antibiotics through a vein (intravenously), as well as oxygen. - Antibiotics might be used for 2 weeks or more. - Finish all the antibiotics you've been prescribed, even if you feel better. If you stop the medicine too soon, the pneumonia can return and may be harder to treat.", "role": "user" }, { "content": "Control your fever with aspirin, NSAIDs (such as ibuprofen or naproxen), or acetaminophen. ... Drink plenty of fluids to help loosen secretions and bring up phlegm. - Get a lot of rest. Have someone else do household chores. Antibiotics might be used for 2 weeks or more. - Finish all the antibiotics you've been prescribed, even if you feel better. If you stop the medicine too soon, the pneumonia can return and may be harder to treat.", "role": "assistant" } ]

[ { "content": "how common is fragile x syndrome\n\n Fragile X Syndrome Fragile X syndrome or Fragile X Martin-Bell syndrome Overview The genetic disorder Fragile X syndrome, which results from mutations in a gene on the X chromosome, is the most commonly inherited form of developmental and intellectual disability. The NICHD supports and conducts research on the diagnosis, treatment, management, prevention, and inheritance of Fragile X and its associated conditions, Fragile X-Associated Primary Ovarian Insufficiency (FXPOI) and Fragile X-Associated Tremor/Ataxia Syndrome (FXTAS). All three conditions result from changes in the same gene on the X chromosome. Condition Information What is Fragile X syndrome? Fragile X syndrome is a genetic disorder that affects a person’s development, especially that person’s behavior and ability to learn. In addition, Fragile X can affect: - Communication skills - Physical appearance - Sensitivity to noise, light, or other sensory information Fragile X syndrome is the most common form of inherited intellectual and developmental disability (IDD) People with Fragile X syndrome may not have noticeable symptoms, or they can have more serious symptoms that range from learning disabilities to cognitive and behavior problems. How is FMR1 mutation related? » How is the FMR1 mutation related to Fragile X-associated disorders? Fragile X syndrome and its associated conditions are caused by changes (mutations) in the FMR1 gene found on the X chromosome. This mutation affects how the body makes the Fragile X Mental Retardation Protein, or FMRP. The mutation causes the body to make only a little bit or none of the protein, which can cause the symptoms of Fragile X. In a gene, the information for making a protein has two parts: the introduction, and the instructions for making the protein itself. Researchers call the introduction the promoter because of how it helps to start the process of building the protein. The promoter part of the FMR1 gene includes many repeats—repeated instances of a specific DNA sequence called the CGG sequence. A normal FMR1 gene has between 6 and 40 repeats in the promoter; the average is 30 repeats. People with between 55 and 200 repeats have a premutation of the gene. The premutation may cause the gene to not work properly, but it does not cause intellectual and developmental disability (IDD). The premutation is linked to the disorders FXPOI and FXTAS. However, not all people with the premutation show symptoms of FXPOI or FXTAS. People with 200 or more repeats in the promoter part of the gene have a full mutation, meaning the gene might not work at all. People with a full mutation often have Fragile X syndrome. The number of repeats, also called the “size of the mutation,” affects the type of symptoms and how serious the symptoms of Fragile X syndrome will be. Inheriting Fragile X Syndrome Fragile X syndrome is inherited, which means it is passed down from parents to children. Anyone with the FMR1 gene mutation can pass it to their children. However, a person who inherits the gene mutation may not develop Fragile X syndrome. Males will pass it down to all of their daughters and not their sons. Females have a 50/50 chance to pass it along to both their sons and daughters. In some cases, an FMR1 premutation can change to a full mutation when it is passed from parent to child. Read more about how FMR1 changes as it is passed from parent to child. « Condition Information What causes it? » What causes it? Fragile X results from a change or mutation in the Fragile X Mental Retardation 1 (FMR1) gene, which is found on the X chromosome. The gene normally makes a protein called Fragile X Mental Retardation Protein, or FMRP. This protein is important for creating and maintaining connections between cells in the brain and nervous system. The mutation causes the body to make only a little bit or none of the protein, which often causes the symptoms of Fragile X. Not everyone with the mutated FMR1 gene has symptoms of Fragile X syndrome, because the body may still be able to make FMRP. A few things affect how much FMRP the body can make: - The size of the mutation. Some people have a smaller mutation (a lower number of repeats) in their FMR1 gene, while others have big mutations (a large number of repeats) in the gene. If the mutation is small, the body may be able to make some of the protein. Having the protein available makes the symptoms milder. - The number of cells that have the mutation. Because not every cell in the body is exactly the same, some cells might have the FMR1 mutation while others do not. This situation is called mosaicism (pronounced moh-ZAY-uh-siz-uhm). If the mutation is in most of the body’s cells, the person will probably have symptoms of Fragile X syndrome. If the mutation is in only some of the cells, the person might not have any symptoms at all or only mild symptoms. - Being female. Females have two X chromosomes (XX), while males have only one. In females, if the FMR1 gene on one X chromosome has the mutation, the FMR1 gene on the other X chromosome might not have the mutation. Even if one of the female’s genes has a very large mutation, the body can usually make at least some FMRP, leading to milder symptoms. « How is FMR1 mutation related? How many people are affected? » How many people are affected? About 1 in 4,000 males and 1 in 8,000 females have Fragile X syndrome. How many people have the Fragile X premutation? Although Fragile X syndrome is relatively rare, premutations in the FMR1 gene are relatively common: A recent study of 6,747 people found that 1 in 151 women and 1 in 468 men had the premutation. People with the premutation might not have any symptoms of Fragile X. However, the premutation can sometimes expand in the next generation, which can cause Fragile X syndrome. « What causes it? What are common symptoms » What are common symptoms? People with Fragile X do not all have the same signs and symptoms, but they do have some things in common. Symptoms are often milder in females than in males. - Intelligence and learning. Many people with Fragile X have problems with intellectual functioning. - These problems can range from the mild, such as learning disorders or problems with mathematics, to the severe, such as an intellectual or developmental disability. - The syndrome may affect the ability to think, reason, and learn. - Because many people with Fragile X also have attention disorders, hyperactivity, anxiety, and language-processing problems, a person with Fragile X may have more capabilities than his or her IQ (intelligence quotient) score suggests. - Physical. Most infants and younger children with Fragile X don’t have any specific physical features of this syndrome. When these children start to go through puberty, however, many will begin to develop certain features that are typical of those with Fragile X. - These features include a narrow face, large head, large ears, flexible joints, flat feet, and a prominent forehead. - These physical signs become more obvious with age. - Behavioral, social, and emotional. Most children with Fragile X have some behavioral challenges. - They may be afraid or anxious in new situations. - They may have trouble making eye contact with other people. - Boys, especially, may have trouble paying attention or be aggressive. - Girls may be shy around new people. They may also have attention disorders and problems with hyperactivity. - Speech and language. Most boys with Fragile X have some problems with speech and language. - They may have trouble speaking clearly, may stutter, or may leave out parts of words. They may also have problems understanding other people’s social cues, such as tone of voice or specific types of body language. - Girls usually do not have severe problems with speech or language. - Some children with Fragile X begin talking later than typically developing children. Most will talk eventually, but a few might stay nonverbal throughout their lives. - Sensory. Many children with Fragile X are bothered by certain sensations, such as bright light, loud noises, or the way certain clothing feels on their bodies. - These sensory issues might cause them to act out or display behavior problems. « How many people are affected? How is it diagnosed? » How is it diagnosed? Health care providers often use a blood sample to diagnose Fragile X. The health care provider will take a sample of blood and will send it to a laboratory, which will determine what form of the FMR1 gene is present. Prenatal Testing (During Pregnancy) Pregnant women who have an FMR1 premutation or full mutation may pass that mutated gene on to their children. A prenatal test allows health care providers to detect the mutated gene in the developing fetus. This important information helps families and providers to prepare for Fragile X syndrome and to intervene as early as possible. Possible types of prenatal tests include: - Amniocentesis (pronounced am-nee-oh-sen-TEE-sis). A health care provider takes a sample of amniotic (pronounced am-nee-OT-ik) fluid, which is then tested for the FMR1 mutation. - Chorionic villus (pronounced KOHR-ee-on-ik VILL-uhs) sampling. A health care provider takes a sample of cells from the placenta, which is then tested for the FMR1 mutation. Because prenatal testing involves some risk to the mother and fetus, if you or a family member is considering prenatal testing for Fragile X, discuss all the risks and benefits with your health care provider. Prenatal testing is not very common, and many parents do not know they carry the mutation. Therefore, parents usually start to notice symptoms in their children when they are infants or toddlers. The average age at diagnosis is 36 months for boys and 42 months for girls. Diagnosis of Children Many parents first notice symptoms of delayed development in their infants or toddlers. These symptoms may include delays in speech and language skills, social and emotional difficulties, and being sensitive to certain sensations. Children may also be delayed in or have problems with motor skills such as learning to walk. A health care provider can perform developmental screening to determine the nature of delays in a child. If a health care provider suspects the child has Fragile X syndrome, he/she can refer parents to a clinical geneticist, who can perform a genetic test for Fragile X syndrome. « What are common symptoms? What are the treatments? » ​​ What are the treatments? There is no single treatment for Fragile X syndrome, but there are treatments that help minimize the symptoms of the condition. Individuals with Fragile X who receive appropriate education, therapy services, and medications have the best chance of using all of their individual capabilities and skills. Even those with an intellectual or developmental disability can learn to master many self-help skills. Early intervention is important. Because a young child’s brain is still forming, early intervention gives children the best start possible and the greatest chance of developing a full range of skills. The sooner a child with Fragile X syndrome gets treatment, the more opportunity there is for learning. « How is it diagnosed? Educational treatments » Other FAQs Are there specific disorders or conditions associated with Fragile X syndrome? How is Fragile X syndrome inherited? How does the FMR1 gene change as it is passed from parent to child? Are there specific disorders or conditions associated with Fragile X syndrome? Among the other conditions associated with Fragile X syndrome are the following: - Autism spectrum disorder. From 30% to 50% of people with Fragile X also meet the criteria for autism spectrum disorder. - Mitral valve prolapse. In mitral valve prolapse (pronounced MY-truhl valv PROH-laps), a heart condition, the valve that separates the upper and lower left chambers of the heart does not work properly. This condition is usually not life-threatening, but in severe cases, surgery might be required to correct the problem. - Seizures. Between 6% and 20% of children with Fragile X syndrome have seizures. Seizures associated with the syndrome are more common in boys than in girls. [top] How is Fragile X syndrome inherited? The gene for Fragile X is carried on the X chromosome. Because both males (XY) and females (XX) have at least one X chromosome, both can pass on the mutated gene to their children. - A father with the altered gene for Fragile X on his X chromosome will pass that gene on only to his daughters. To his sons he will pass on a Y chromosome, which doesn’t transmit Fragile X syndrome. Therefore, a father with the altered gene on his X chromosome and a mother with normal X chromosomes would have daughters with the altered gene for Fragile X, while none of their sons would have the mutated gene. - A father can pass on the premutation form of the FMR1 gene to his daughters but not the full mutation. Even if the father himself has a full mutation of this gene, it appears that sperm can carry only the premutation. Scientists don’t understand how or why fathers can pass on only the milder form of Fragile X to their daughters. This remains an area of focused research. - Mothers pass on only X chromosomes to their children, so if a mother has the altered gene for Fragile X, she can pass that gene to either her sons or her daughters. If a mother has the mutated gene on one X chromosome and has one normal X chromosome, and the father has no mutations, all the children have a 50-50 chance of inheriting the mutated gene. - These 50-50 odds apply for each child the parents have. Having one child with the FMR1 mutation does not increase or decrease the chances of having another child with the mutated FMR1 gene. This is also true for the severity of the symptoms. Having one child with mild symptoms does not mean that the other children will have severe symptoms, and having a child with severe symptoms does not mean that the other children will have mild symptoms. [top] How does the FMR1 gene change as it is passed from parent to child? The repeats in the promoter part of the FMR1 gene are unstable, and sometimes the number of repeats increases from one generation to the next. A premutation gene is less stable than a full mutation gene. So as it passes from parent to child, a premutation gene might expand to become a full mutation gene. The chances of expansion depend on the number of repeats in the promoter of the premutation gene: Normal FMR1 genes that have 5 to 44 CGG repeats in the promoter are considered normal. When these genes are passed from parent to child, the number of repeats does not increase or decrease. Intermediate FMR1 genes with 45 to 54 CGG repeats in the promoter are considered intermediate, or borderline. An intermediate gene may expand from one generation to the next, depending on which parent has the gene. Mother to Child About 14% of the time, when a mother passes an intermediate gene to her child, the CGG repeats increase to a number seen with premutations. Research shows that an intermediate gene will not become a full mutation gene in one generation, and so a mother with an intermediate gene will not have a child with a full mutation. Father to Child When intermediate genes are transmitted from father to child, they are generally stable and do not increase to premutations. Premutations Premutation (55 to 199 CGG repeats) FMR1 genes can expand to a full mutation from one generation to the next. The risk of expansion depends on which parent has the gene and the number of repeats in that gene. Mother to Child An FMR1 gene from the mother with 100 CGG repeats is very likely to expand to a full mutation when passed to the child. An FMR1 gene from the mother with 70 to 79 CGG repeats has about a 30% chance of expanding to a full mutation in one generation. Father to Child Premutations passed from father to child have almost no chance of expanding to full mutations. [top] « What are the Treatments? ", "role": "user" }, { "content": "Fragile X syndrome occurs in about 1 in 4,000 males and 1 in 8,000 females. Although Fragile X syndrome is relatively rare, people may have a premutation in the gene responsible for the syndrome without showing symptoms of the syndrome. The premutations of the FMR1 gene are relatively common: A recent study of 6,747 people found that 1 in 151 women and 1 in 468 men had the premutation.", "role": "assistant" } ]

[ { "content": "Is it necessary to go to the dr. when getting a skull fracture?\n\nSkull fracture (When to Contact a Medical Professional): Get medical help right away if: - There are problems with breathing or circulation. - Direct pressure does not stop bleeding from the nose, ears, or wound. - There is drainage of clear fluid from the nose or ears. - There is facial swelling, bleeding, or bruising. - There is an object protruding from the skull. - The person is unconscious, is experiencing convulsions, has multiple injuries, appears to be in any distress, or cannot think clearly.", "role": "user" }, { "content": "Get medical help right away if: - There are problems with breathing or circulation. - Direct pressure does not stop bleeding from the nose, ears, or wound. - There is drainage of clear fluid from the nose or ears. - There is facial swelling, bleeding, or bruising. - There is an object protruding from the skull. - The person is unconscious, is experiencing convulsions, has multiple injuries, appears to be in any distress, or cannot think clearly.", "role": "assistant" } ]

[ { "content": "Hello, I have a scoliosis problem plz help me I want its treatment I can send my x.ray also\n\n Scoliosis Spinal curvature Infantile scoliosis Juvenile scoliosis Summary Scoliosis is an abnormal curving of the spine. Your spine is your backbone. It runs straight down your back. Everyone's spine naturally curves a bit. But people with scoliosis have a spine that curves too much. The spine might look like the letter C or S. Causes Most of the time, the cause of scoliosis is unknown. This is called idiopathic scoliosis. It is the most common type. It is grouped by age. In children age 3 and younger, it is called infantile scoliosis. In children age 4 through 10, it is called juvenile scoliosis. In children age 11 through 18, it is called adolescent scoliosis. Scoliosis most often affects girls. Some people are more likely to have curving of the spine. Curving generally gets worse during a growth spurt. Other types of scoliosis are: Congenital scoliosis: This type of scoliosis is present at birth. It occurs when the baby's ribs or spine bones do not form properly. Neuromuscular scoliosis: This type is caused by a nervous system problem that affects the muscles. Problems can include cerebral palsy, muscular dystrophy, spina bifida, and polio. Symptoms Most often, there are no symptoms. If there are symptoms, they may include: Backache or low-back pain that goes down the legs Weakness or tired feeling in the spine after sitting or standing for a long time Uneven hips or shoulders (one shoulder may be higher than the other) Spine curves more to one side Exams and Tests The health care provider will perform a physical exam. You will be asked to bend forward. This makes your spine easier to see. It may be hard to see changes in the early stages of scoliosis. The exam may show: One shoulder is higher than the other The pelvis is tilted X-rays of the spine are done. X-rays are important because the actual curving of the spine may be worse than what your doctor can see during an exam. Other tests may include: Spinal curve measurement (scoliometer screening) MRI of the spine CT scan of the spine to look at the bony changes Treatment Treatment depends on many things: The cause of scoliosis Where the curve is in your spine How big the curve is If your body is still growing Most people with idiopathic scoliosis do not need treatment. But you should still be checked by a doctor about every 6 months. If you are still growing, your doctor might recommend a back brace. A back brace prevents further curving. There are many different types of braces. What kind you get depends on the size and location of your curve. Your provider will pick the best one for you and show you how to use it. Back braces can be adjusted as you grow. Back braces work best in people over age 10. Braces do not work for those with congenital or neuromuscular scoliosis. You may need surgery if the spine curve is severe or getting worse very quickly. Surgery involves correcting the curve as much as possible: Surgery is done with a cut through the back, belly area, or beneath the ribs. The spine bones are held in place with 1 or 2 metal rods. The rods are held down with hooks and screws until the bone heals together. After surgery, you may need to wear a brace for a while to keep the spine still. Scoliosis treatment may also include: Emotional support: Some children, especially teens, may be self-conscious when using a back brace. Physical therapy and other specialists to help explain the treatments and make sure the brace fits correctly. Support Groups Seek support and more information from organizations that specialize in scoliosis. Outlook (Prognosis) How well a person with scoliosis does depends on the type, cause, and severity of the curve. The more severe the curving, the more likely it will get worse after the child stops growing. People with mild scoliosis do well with braces. They usually do not have long-term problems. Back pain may be more likely when the person gets older. Outlook for those with neuromuscular or congenital scoliosis varies. They may have another serious disorder, such as cerebral palsy or muscular dystrophy, so their goals are much different. Often, the goal of surgery is simply to allow a child to be able to sit upright in a wheelchair. Congenital scoliosis is difficult to treat and usually requires many surgeries. Possible Complications Complications of scoliosis can include: Breathing problems (in severe scoliosis) Low back pain Lower self-esteem Persistent pain if there is wear and tear of the spine bones Spinal infection after surgery Spine or nerve damage from an uncorrected curve or spinal surgery Leakage of spinal fluid When to Contact a Medical Professional Call your provider if you suspect your child may have scoliosis. Prevention Routine scoliosis screening is now done in middle schools. Such screening has helped detect early scoliosis in many children. Review Date 9/7/2017 Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "How well a person with scoliosis does depends on the type, cause, and severity of the curve. The more severe the curving, the more likely it will get worse after the child stops growing. People with mild scoliosis do well with braces. Back pain may be more likely when the person gets older.", "role": "assistant" } ]

[ { "content": "how to loose weight\n\nOverweight, obesity, and weight loss (What is the best way for me to lose weight?): The best way to lose weight is to use more calories than you take in. You can do this by following a healthy eating plan and being more active. Before you start a weight-loss program, talk to your doctor. Safe weight-loss programs that work well:", "role": "user" }, { "content": "The best way to lose weight is to use more calories than you take in. You can do this by following a healthy eating plan and being more active. Before you start a weight-loss program, talk to your doctor.", "role": "assistant" } ]

[ { "content": "what are the causes of headaches\n\nWhat causes Headaches - danger signs?: Problems with blood vessels and bleeding in the brain cancause as a headache. These include: - Abnormal connection between the arteries and veins in the brain that usually forms before birth. This problem is called an arteriovenous malformation, or AVM. - Blood flow to part of the brain stops. This is called a stroke. - Weakening of the wall of a blood vessel that can break open and bleed into the brain. This is known as a brain aneurysm. - Bleeding in the area between the brain and the thin tissue that covers the brain. This iscalled a subarachnoid hemorrhage Other causes of headaches that should be checked by a doctor right awayinclude: - Blood pressure that is very high - Brain tumor - Buildup of fluid inside the skull that leads to brain swelling (hydrocephalus) - Buildup of pressure inside the skull that appears to be, but is not a tumor (pseudomotor cerebri) - Carbon monoxide poisoning - Infection in the brain or the tissue that surrounds the brain, as well as a brain abscess - Swollen, inflamed arterythat supplies blood to part of the head, temple, and neck area (temporal arteritis)", "role": "user" }, { "content": "Some headaches can be dangerous, if they are related to problems with blood vessels and bleeding in the brain. These types of headaches may be caused by abnormal connection between the arteries and veins in the brain that usually forms before birth. Other possible causes include a stroke, a brain aneurysm, high blood pressure, or carbon monoxide poisoning.", "role": "assistant" } ]

[ { "content": "Causes of Peripheral Neuropathy What information does the National Library of Medicine have that states causes of peripheral neuropathy?\n\nPeripheral neuropathy (Overview): Peripheral neuropathy, a result of damage to your peripheral nerves, often causes weakness, numbness and pain, usually in your hands and feet. It can also affect other areas of your body. Your peripheral nervous system sends information from your brain and spinal cord (central nervous system) to the rest of your body. Peripheral neuropathy can result from traumatic injuries, infections, metabolic problems, inherited causes and exposure to toxins. One of the most common causes is diabetes mellitus. People with peripheral neuropathy generally describe the pain as stabbing, burning or tingling. In many cases, symptoms improve, especially if caused by a treatable condition. Medications can reduce the pain of peripheral neuropathy. Peripheral neuropathy care at Mayo Clinic", "role": "user" }, { "content": "Peripheral neuropathy can result from traumatic injuries, infections, metabolic problems, inherited causes and exposure to toxins. One of the most common causes is diabetes mellitus.", "role": "assistant" } ]

[ { "content": "Rubella My grandson (4 yrs old) has contracted Rubella. I know for sure he has had at least one of the vaccines. They are living in Mexico right now. Should we be worried?\n\n Rubella Overview Rubella, also called German measles or three-day measles, is a contagious viral infection best known by its distinctive red rash. Rubella is not the same as measles (rubeola), though the two illnesses do share some characteristics, including the red rash. However, rubella is caused by a different virus than measles, and is neither as infectious nor usually as severe as measles. The measles-mumps-rubella (MMR) vaccine, usually given to children in the United States twice before they reach school age, is highly effective in preventing rubella. Because of widespread use of the vaccine, the Centers for Disease Control and Prevention (CDC) has declared rubella eliminated in the United States, but cautions parents to make sure their children are vaccinated to prevent its reemergence. Symptoms The signs and symptoms of rubella are often so mild they're difficult to notice, especially in children. If signs and symptoms do occur, they generally appear between two and three weeks after exposure to the virus. They typically last about two to three days and may include: - Mild fever of 102 F (38.9 C) or lower - Headache - Stuffy or runny nose - Inflamed, red eyes - Enlarged, tender lymph nodes at the base of the skull, the back of the neck and behind the ears - A fine, pink rash that begins on the face and quickly spreads to the trunk and then the arms and legs, before disappearing in the same sequence - Aching joints, especially in young women When to see a doctor Contact your doctor if you think you or your child may have been exposed to rubella or if you have the signs or symptoms listed above. If you're contemplating getting pregnant, check your vaccination record to make sure you've received your MMR inoculations. If a pregnant woman contracts rubella, especially during her first trimester, the virus can cause death or serious birth defects in her developing fetus. Rubella during pregnancy is the most common cause of congenital deafness. It's best for women to be protected against rubella before pregnancy. If you're pregnant, you'll likely undergo a routine screening for immunity to rubella. But if you've never received the vaccine and think you might have been exposed to rubella, contact your doctor immediately. A blood test might confirm that you're already immune. Causes The cause of rubella is a virus that's passed from person to person. It can spread when an infected person coughs or sneezes, or it can spread by direct contact with an infected person's respiratory secretions, such as mucus. It can also be transmitted from a pregnant woman to her unborn child via the bloodstream. A person with rubella is contagious from 10 days before the onset of the rash until about one or two weeks after the rash disappears. An infected person can spread the illness before the person realizes he or she has it. Rubella is rare in the United States because most children receive a vaccination against the infection at an early age. However, cases of rubella do occur, mostly in unvaccinated foreign-born adults. The disease is still common in many parts of the world. The prevalence of rubella in other countries is something to consider before going abroad, especially if you're pregnant. Complications Rubella is a mild infection. Once you've had the disease, you're usually permanently immune. Some women with rubella experience arthritis in the fingers, wrists and knees, which generally lasts for about one month. In rare cases, rubella can cause an ear infection (otitis media) or inflammation of the brain (encephalitis). However, if you're pregnant when you contract rubella, the consequences for your unborn child may be severe. Up to 90 percent of infants born to mothers who had rubella during the first 12 weeks of pregnancy develop congenital rubella syndrome. This syndrome can cause one or more problems, including: - Growth retardation - Cataracts - Deafness - Congenital heart defects - Defects in other organs - Mental retardation The highest risk to the fetus is during the first trimester, but exposure later in pregnancy also is dangerous. Diagnosis The rubella rash can look like many other viral rashes. So doctors usually confirm rubella with the help of laboratory tests. You may have a virus culture or a blood test, which can detect the presence of different types of rubella antibodies in your blood. These antibodies indicate whether you've had a recent or past infection or a rubella vaccine. Treatment No treatment will shorten the course of rubella infection, and symptoms are so mild that treatment usually isn't necessary. However, doctors often recommend isolation from others - especially pregnant women - during the infectious period. If you contract rubella while you're pregnant, discuss the risks to your baby with your doctor. If you wish to continue your pregnancy, you may be given antibodies called hyperimmune globulin that can fight off the infection. This can reduce your symptoms, but doesn't eliminate the possibility of your baby developing congenital rubella syndrome. Support of an infant born with congenital rubella syndrome varies depending on the extent of the infant's problems. Children with multiple complications may require early treatment from a team of specialists. Lifestyle and home remedies In rare instances when a child or adult is infected with rubella, simple self-care measures are required: - Rest in bed as necessary. - Take acetaminophen (Tylenol, others) to relieve discomfort from fever and aches. - Tell friends, family and co-workers - especially pregnant women - about your diagnosis if they may have been exposed to the disease. - Avoid people who have conditions that cause deficient or suppressed immune systems. - Tell your child's school or child care provider that your child has rubella. ", "role": "user" }, { "content": "The measles-mumps-rubella (MMR) vaccine, usually given to children in the United States twice before they reach school age, is highly effective in preventing rubella. Rubella is a mild infection. Once you've had the disease, you're usually permanently immune. In rare cases, rubella can cause an ear infection (otitis media) or inflammation of the brain (encephalitis). No treatment will shorten the course of rubella infection, and symptoms are so mild that treatment usually isn't necessary. However, doctors often recommend isolation from others - especially pregnant women - during the infectious period. In rare instances when a child or adult is infected with rubella, simple self-care measures are required: - Rest in bed as necessary. - Take acetaminophen (Tylenol, others) to relieve discomfort from fever and aches. - Tell your child's school or child care provider that your child has rubella.", "role": "assistant" } ]

[ { "content": "Psoriasis for past 7-8 years I had psoriasis on my scalp for nearly 10 years. Please give suggestions and medications.\n\n Psoriasis Plaque psoriasis Psoriasis vulgaris Guttate psoriasis Pustular psoriasis Summary Psoriasis is a skin condition that causes skin redness and irritation. Most people with psoriasis have thick, red, well-defined patches of skin with flaky, silver-white scales. These patches are called plaques. Causes Psoriasis is very common. Anyone can develop it, but it most often begins between ages 15 and 35, or as people get older. Psoriasis isn't contagious. This means it doesn't spread to other people. Psoriasis seems to be passed down through families. Normal skin cells grow deep in the skin and rise to the surface about once a month. When you have psoriasis, this process takes place in days rather than in 3 to 4 weeks. This results in dead skin cells building up on the skin's surface, forming the collections of scales. The following may trigger an attack of psoriasis or make it harder to treat: Infections from bacteria or viruses, including strep throat and upper respiratory infections Dry air or dry skin Injury to the skin, including cuts, burns, insect bites, and other skin rashes Some medicines, including antimalaria drugs, beta-blockers, and lithium Stress Too little sunlight Too much sunlight (sunburn) Psoriasis may be worse in people who have a weak immune system, including people with HIV/AIDS. Some people with psoriasis also have arthritis (psoriatic arthritis). In addition, people with psoriasis have an increased risk of fatty liver disease and cardiovascular disorders, such as heart disease and stroke. Symptoms Psoriasis can appear suddenly or slowly. Many times, it goes away and then comes back. The main symptom of the condition is irritated, red, flaky plaques of skin. Plaques are most often seen on the elbows, knees, and middle of the body. But they can appear anywhere, including on the scalp, palms, soles of the feet, and genitalia. The skin may be: Itchy Dry and covered with silver, flaky skin (scales) Pink-red in color Raised and thick Other symptoms may include: Joint or tendon pain or aching Nail changes, including thick nails, yellow-brown nails, dents in the nail, and a lifting of the nail from the skin underneath Severe dandruff on the scalp There are five main types of psoriasis: Erythrodermic -- The skin redness is very intense and covers a large area. Guttate -- Small, pink-red spots appear on the skin. This form is often linked to strep infections, especially in children. Inverse -- Skin redness and irritation occur in the armpits, groin, and in between overlapping skin rather than the more common areas of the elbows and knees. Plaque -- Thick, red patches of skin are covered by flaky, silver-white scales. This is the most common type of psoriasis. Pustular -- Yellow pus-filled blisters (pustules) are surrounded by red, irritated skin. Exams and Tests Your health care provider can usually diagnose this condition by looking at your skin. Sometimes, a skin biopsy is done to rule out other possible conditions. If you have joint pain, your provider may order imaging studies. Treatment The goal of treatment is to control your symptoms and prevent infection. Three treatment options are available: Skin lotions, ointments, creams, and shampoos -- These are called topical treatments. Pills or injections that affect the body's immune response, not just the skin -- These are called systemic, or body-wide, treatments. Phototherapy, which uses ultraviolet light to treat psoriasis. TREATMENTS USED ON THE SKIN (TOPICAL) Most of the time, psoriasis is treated with medicines that are placed directly on the skin or scalp. These may include: Cortisone creams and ointments Other anti-inflammatory creams and ointments Creams or ointments that contain coal tar or anthralin Creams to remove the scaling (usually salicylic acid or lactic acid) Dandruff shampoos (over-the-counter or prescription) Moisturizers Prescription medicines containing vitamin D or vitamin A (retinoids) SYSTEMIC (BODY-WIDE) TREATMENTS If you have very severe psoriasis, your provider will likely recommend medicines that suppress the immune system's faulty response. These medicines include methotrexate or cyclosporine. Retinoids, such as acetretin, can also be used. Newer drugs, called biologics, are used when other treatments do not work. Biologics approved for the treatment of psoriasis include: Adalimumab (Humira) Abatacept (Orencia) Apremilast (Otezla) Brodalumab (Siliq) Certolizumab pegol (Cimzia) Etanercept (Enbrel) Infliximab (Remicade) Ixekizumab (Taltz) Golimumab (Simponi) Guselkumab (Tremfya) Ustekinumab (Stelara) Secukinumab (Cosentyx) PHOTOTHERAPY Some people may choose to have phototherapy, which is safe and can be very effective: This is treatment in which your skin is carefully exposed to ultraviolet light. It may be given alone or after you take a drug that makes the skin sensitive to light. Phototherapy for psoriasis can be given as ultraviolet A (UVA) or ultraviolet B (UVB) light. OTHER TREATMENTS If you have an infection, your provider will prescribe antibiotics. HOME CARE Following these tips at home may help: Taking a daily bath or shower -- Try not to scrub too hard, because this can irritate the skin and trigger an attack. Oatmeal baths may be soothing and may help to loosen scales. You can use over-the-counter oatmeal bath products. Or, you can mix 1 cup (240 mL) of oatmeal into a tub (bath) of warm water. Keeping your skin clean and moist, and avoiding your specific psoriasis triggers may help reduce the number of flare-ups. Sunlight may help your symptoms go away. Be careful not to get sunburned. Relaxation and anti-stress techniques -- The link between stress and flares of psoriasis is not well understood. Support Groups Some people may benefit from a psoriasis support group. The National Psoriasis Foundation is a good resource: www.psoriasis.org. Outlook (Prognosis) Psoriasis can be a lifelong condition that can be usually controlled with treatment. It may go away for a long time and then return. With proper treatment, it will not affect your overall health. But be aware that there is a strong link between psoriasis and other health problems, such as heart disease. When to Contact a Medical Professional Call your provider if you have symptoms of psoriasis or if your skin irritation continues despite treatment. Tell your provider if you have joint pain or fever with your psoriasis attacks. If you have symptoms of arthritis, talk to your dermatologist or rheumatologist. Go to the emergency room or call the local emergency number (such as 911) if you have a severe outbreak that covers all or most of your body. Prevention There is no known way to prevent psoriasis. Keeping the skin clean and moist and avoiding your psoriasis triggers may help reduce the number of flare-ups. Providers recommend daily baths or showers for people with psoriasis. Avoid scrubbing too hard, because this can irritate the skin and trigger an attack. Review Date 2/27/2018 Updated by: David L. Swanson, MD, Vice Chair of Medical Dermatology, Associate Professor of Dermatology, Mayo Medical School, Scottsdale, AZ. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Keeping the skin clean and moist and avoiding your psoriasis triggers may help reduce the number of flare-ups. Providers recommend daily baths or showers for people with psoriasis. Avoid scrubbing too hard, because this can irritate the skin and trigger an attack.", "role": "assistant" } ]

[ { "content": "how is epilepsy diagnosed\n\n Autosomal dominant nocturnal frontal lobe epilepsy ADNFLE Epilepsy, nocturnal frontal lobe, 1 ENFL1 Summary Autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) is an uncommon, inherited form of epilepsy. People with ADNFLE have seizures that usually occur at night during sleep. Some people with ADNFLE also have seizures during the day. These seizures can last from a few seconds to a few minutes, and can vary from causing simple arousal from sleep, to dramatic muscle spasms and movements. The onset of ADNFLE ranges from infancy to adulthood, but most cases begin in childhood. Episodes tend to become milder and less frequent with age. [1] [2] It is diagnosed based on symptoms and the results of tests such as an EEG . ADNFLE is inherited in an autosomal dominant manner and may be caused by a mutation in any of several genes . In most cases however, the genetic cause is not found. Seizures can usually be controlled with anti-seizure medications. [2] Symptoms The main symptom in people with autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) is seizures that generally occur at night. Seizures may begin anywhere from early childhood to adulthood, but most often begin in childhood. [3] [4] Seizures may last from a few seconds to a few minutes. [1] The frequency of seizures varies from several per year to several per night. [3] Seizures may become less frequent or more mild as a person gets older. [1] Some people with ADNFLE occasionally have seizures while they are awake. [4] When a person with ADNFLE is having a seizure, they may experience a variety of movement-related symptoms ranging from mild to severe. Examples include: [1] [3] [4] Short bursts of random, repetitive movements of the limbs, trunk, or head, lasting 2 to 4 seconds. Brief, sudden arousal (waking), sometimes with repetitive movements, making sounds, crying, or feelings of fear. Major attacks lasting 20 to 30 seconds, characterized by extreme stiffening of muscles, or movements such as pelvic thrusting, pedaling, twisting and writhing, or fast, forceful motions of the limbs. Recurring episodes of exertion during the night may lead to sleepiness during the day. [4] Most people with ADNFLE have normal intellect (thinking abilities), but in some cases, intellect is reduced. Some people with ADNFLE also have psychiatric disorders or behavior problems, but it is unclear if these are directly related to ADNFLE. [1] [3] This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom. Showing of Medical Terms Other Names Learn More: HPO ID 5%-29% of people have these symptoms Intellectual disability Mental deficiency Mental retardation Mental retardation, nonspecific Mental-retardation 0001249 Percent of people who have these symptoms is not available through HPO Autosomal dominant inheritance 0000006 Childhood onset Symptoms begin in childhood 0011463 Focal-onset seizure 0007359 Incomplete penetrance 0003829 Showing of Diagnosis A diagnosis of autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) is made based on signs and symptoms. In addition to the doctor taking a detailed medical and family history from the person with symptoms, obtaining information from others who see episodes occur is very helpful. In some cases, video- EEG monitoring during sleep is needed. The features that suggest a diagnosis of ADNFLE include: Clusters of seizures that occur mainly during sleep. A normal neurologic exam and normal findings on brain imaging tests. A normal EEG recorded during a seizure (ictal EEG), or one that is obscured by movement of the cables or electrodes. An EEG recorded between seizures (interictal EEG) that shows few or no instances of patterns seen in people with epilepsy. The presence of the same disorder in other family members, with evidence of autosomal dominant If ADNFLE is suspected, genetic testing may be ordered. However, genetic testing can confirm the diagnosis in only 20% of people with a family history of ADNFLE, and in fewer than 5% of people with no family history. [2] Testing Resources The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional. Find a Specialist If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments. If you can't find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care. You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists. Healthcare Resources To find a medical professional who specializes in genetics, you can ask your doctor for a referral or you can search for one yourself. Online directories are provided by the American College of Medical Genetics and the National Society of Genetic Counselors. If you need additional help, contact a GARD Information Specialist. You can also learn more about genetic consultations from Genetics Home Reference. Related Diseases Related diseases are conditions that have similar signs and symptoms. A health care provider may consider these conditions in the table below when making a diagnosis. Please note that the table may not include all the possible conditions related to this disease. Conditions with similar signs and symptoms from Orphanet Differential diagnoses include sporadic NFLE, paroxysmal dyskinesia, familial focal epilepsy with variable foci (see these terms), restless legs syndrome, periodic limb movement disorders (PLMS), REM sleep behavior disorders (RBD), nocturnal panic attacks, non-REM parasomnias, obstructive sleep apnea syndrome, and arousal disorders. Visit the Orphanet disease page for more information. ", "role": "user" }, { "content": "If you think you may be having seizures, or have other symptoms of epilepsy, you should talk to a neurologist. Having a patient's medical history is essential for diagnosing epilepsy, as well as having people who have witnessed the affected person's seizures. EEG monitoring can be helpful as well.", "role": "assistant" } ]

[ { "content": "Anal Fissure I may have a couple anal fissures and looking to speak with someone to get some information and support.\n\n Anal fissure Overview An anal fissure is a small tear in the thin, moist tissue (mucosa) that lines the anus. An anal fissure may occur when you pass hard or large stools during a bowel movement. Anal fissures typically cause pain and bleeding with bowel movements. You also may experience spasms in the ring of muscle at the end of your anus (anal sphincter). Anal fissures are very common in young infants but can affect people of any age. Most anal fissures get better with simple treatments, such as increased fiber intake or sitz baths. Some people with anal fissures may need medication or, occasionally, surgery. Symptoms Signs and symptoms of an anal fissure include: - Pain, sometimes severe, during bowel movements - Pain after bowel movements that can last up to several hours - Bright red blood on the stool or toilet paper after a bowel movement - Itching or irritation around the anus - A visible crack in the skin around the anus - A small lump or skin tag on the skin near the anal fissure When to see a doctor See your doctor if you have pain during bowel movements or notice blood on stools or toilet paper after a bowel movement. Causes Common causes of anal fissure include: - Passing large or hard stools - Constipation and straining during bowel movements - Chronic diarrhea - Inflammation of the anorectal area, caused by Crohn's disease or another inflammatory bowel disease - Childbirth Less common causes of anal fissures include: - Anal cancer - HIV - Tuberculosis - Syphilis - Herpes Risk factors Factors that may increase your risk of developing an anal fissure include: - Infancy. Many infants experience an anal fissure during their first year of life; experts aren't sure why. - Aging. Older adults may develop an anal fissure partly due to slowed circulation, resulting in decreased blood flow to the rectal area. - Constipation. Straining during bowel movements and passing hard stools increase the risk of tearing. - Childbirth. Anal fissures are more common in women after they give birth. - Crohn's disease. This inflammatory bowel disease causes chronic inflammation of the intestinal tract, which may make the lining of the anal canal more vulnerable to tearing. - Anal intercourse. Complications Complications of anal fissure can include: - Failure to heal. An anal fissure that fails to heal within six weeks is considered chronic and may need further treatment. - Recurrence. Once you've experienced an anal fissure, you are prone to having another one. - A tear that extends to surrounding muscles. An anal fissure may extend into the ring of muscle that holds your anus closed (internal anal sphincter), making it more difficult for your anal fissure to heal. An unhealed fissure can trigger a cycle of discomfort that may require medications or surgery to reduce the pain and to repair or remove the fissure. Diagnosis If possible, your doctor will perform a digital rectal exam, which involves inserting a gloved finger into your anal canal, or use a short, lighted tube (anoscope) to inspect your anal canal. However, if this is too painful for you, your doctor may be able to diagnose an anal fissure only by observation. An acute anal fissure looks like a fresh tear, somewhat like a paper cut. A chronic anal fissure likely has the tear, as well as two separate lumps or tags of skin, one internal (sentinel pile) and one external (hypertrophied papilla). The fissure's location offers clues about its cause. A fissure that occurs on the side of the anal opening, rather than the back or front, is more likely to be a sign of another disorder, such as Crohn's disease. Your doctor may recommend further testing if he or she thinks you have an underlying condition: - Flexible sigmoidoscopy. Your doctor will insert a thin, flexible tube with a tiny video into the bottom portion of your colon. This test may be done if you're younger than 50 and have no risk factors for intestinal diseases or colon cancer. - Colonoscopy. Your doctor will insert a flexible tube into your rectum to inspect the entire colon. This test may be done if you are older than age 50 or you have risk factors for colon cancer, signs of other conditions, or other symptoms such as abdominal pain or diarrhea. Treatment Anal fissures often heal within a few weeks if you take steps to keep your stool soft, such as increasing your intake of fiber and fluids. Soaking in warm water for 10 to 20 minutes several times a day, especially after bowel movements, can help relax the sphincter and promote healing. If your symptoms persist, you'll likely need further treatment. Nonsurgical treatments Your doctor may recommend: - Externally applied nitroglycerin (Rectiv), to help increase blood flow to the fissure and promote healing and to help relax the anal sphincter. Nitroglycerin is generally considered the medical treatment of choice when other conservative measures fail. Side effects may include headache, which can be severe. - Topical anesthetic creams such as lidocaine hydrochloride (Xylocaine) may be helpful for pain relief. - Botulinum toxin type A (Botox) injection, to paralyze the anal sphincter muscle and relax spasms. - Blood pressure medications, such as oral nifedipine (Procardia) or diltiazem (Cardizem) can help relax the anal sphincter. These medications may be taken by mouth or applied externally and may be used when nitroglycerin is not effective or causes significant side effects. Surgery If you have a chronic anal fissure that is resistant to other treatments, or if your symptoms are severe, your doctor may recommend surgery. Doctors usually perform a procedure called lateral internal sphincterotomy (LIS), which involves cutting a small portion of the anal sphincter muscle to reduce spasm and pain, and promote healing. Studies have found that for chronic fissure, surgery is much more effective than any medical treatment. However, surgery has a small risk of causing incontinence. Lifestyle and home remedies Several lifestyle changes may help relieve discomfort and promote healing of an anal fissure, as well as prevent recurrences: - Add fiber to your diet. Eating about 25 to 30 grams of fiber a day can help keep stools soft and improve fissure healing. Fiber-rich foods include fruits, vegetables, nuts and whole grains. You also can take a fiber supplement. Adding fiber may cause gas and bloating, so increase your intake gradually. - Drink adequate fluids. Fluids help prevent constipation. - Exercise regularly. Engage in 30 minutes or more of moderate physical activity, such as walking, most days of the week. Exercise promotes regular bowel movements and increases blood flow to all parts of your body, which may promote healing of an anal fissure. - Avoid straining during bowel movements. Straining creates pressure, which can open a healing tear or cause a new tear. If your infant has an anal fissure, be sure to change diapers frequently, wash the area gently and discuss the problem with your child's doctor. ", "role": "user" }, { "content": "Anal fissures, small tears in the tissues that line the anus, could be caused by hard stools, chronic diarrhea and inflammation of the anorectal area, and some less common problems. Factors that increase the risk of developing an anal feature include: decreased blood flow to the rectal area due to aging; straining during bowel movements, e.g., due to constipation; chronic inflammation of the intestinal tract; and anal intercourse. Anal fissures are likely to heal within weeks if you keep your stool soft, e.g., by increasing fiber and fluids in your diet, and relax the sphincter by soaking in warm water for 10-20 minutes after bowel movements. If the fissures persist, your doctor may recommend medications to relax the sphincter, such as nitroglycerin applied externally (Rectiv), Botulinum toxin type A (Botox) injection, or oral blood pressure medications, such as nifedipine (Procardia) or diltiazem (Cardizem) . Topical anesthetics, e.g., lidocaine hydrochloride (Xylocaine) may relieve pain. For chronic fissures, surgery might be more effective. The procedure called lateral internal sphincterotomy (LIS) involves cutting a small portion of the anal sphincter muscle to reduce spasm and pain, and promote healing.", "role": "assistant" } ]

[ { "content": "how much ibuprofen is too much\n\nIbuprofen dosing for children: Taking ibuprofen can help children feel better when they have colds or minor injuries. As with all drugs, it is important to give children the correct dose. Ibuprofen is safe when taken as directed. But taking too much of this medicine can be harmful. Ibuprofen is a type of nonsteroidal anti-inflammatory drug (NSAID). It can help: - Reduce aches, pain, sore throat, or fever in children with a cold or the flu - Relieve headaches or toothaches - Reduce pain and swelling from an injury or broken bone Ibuprofen can be taken as liquid or chewable tablets. To give the correct dose, you need to know your child's weight. You also need to know how much ibuprofen is in a tablet, teaspoon (tsp), 1.25 milliliters (mL), or 5 mL of the product you are using. You can read the label to find out. - For chewable tablets, the label will tell you how many milligrams (mg) are found in each tablet, for example 50 mg per tablet. - For liquids, the label will tell you how many mg are found in 1 tsp, in 1.25 mL, or in 5mL. For example, the label may read 100 mg/1 tsp, 50 mg/1.25 mL, or 100 mg/5 mL. For syrups, you need some type of dosing syringe. It may come with the medicine, or you can ask your pharmacist. Make sure to clean it out after every usage. If your child weighs 12 to 17 pounds (lbs) or 5.4 to 7.7 kilograms (kg): - For infant drops that say 50mg/1.25 mL on the label, give a 1.25 mL dose. - For liquid that says 100 mg/1 teaspoon (tsp) on the label, give a ½ tsp dose. - For liquid that says 100 mg/5 mL on the label, give a 2.5 mL dose. If your child weighs 18 to 23 lbs or 8 to 10 kg: - For infant drops that say 50mg/1.25 mL on the label, give a 1.875 mL dose. - For liquid that says 100 mg/1 tsp on the label, give a ¾ tsp dose. - For liquid that says 100 mg/5 mL on the label, give a 4 mL dose. If your child weighs 24 to 35 lbs or 10.5 to 15.5 kg: - For infant drops that say 50mg/1.25 mL on the label, give a 2.5 mL dose. - For liquid that says 100 mg/1 tsp on the label, give a 1 tsp dose. - For liquid that says 100 mg/5 mL on the label, give a 5 mL dose. - For chewable tablets that say 50 mg tablets on the label, give 2 tablets. If your child weighs 36 to 47 lbs or 16 to 21 kg: - For infant drops that say 50mg/1.25 mL on the label, give a 3.75 mL dose. - For liquid that says 100 mg/1 tsp on the label, give a 1½ tsp dose. - For liquid that says 100 mg/5 mL on the label, give a 7.5 mL dose. - For chewable tablets that say 50 mg tablets on the label, give 3 tablets. If your child weighs 48 to 59 lbs or 21.5 to 26.5 kg: - For infant drops that say 50mg/1.25 mL on the label, give a 5 mL dose. - For liquid that says 100 mg/1 tsp on the label, give a 2 tsp dose. - For liquid that says 100 mg/5 mL on the label, give a 10 mL dose. - For chewable tablets that say 50 mg tablets on the label, give 4 tablets. - For junior-strength tablets that say 100 mg tablets on the label, give 2 tablets. If your child weighs 60 to 71 lbs or 27 to 32 kg: - For liquid that says 100 mg/1 tsp on the label, give a 2½ tsp dose. - For liquid that says 100 mg/5 mL on the label, give a 12.5 mL dose. - For chewable tablets that say 50 mg tablets on the label, give 5 tablets. - For junior-strength tablets that say 100 mg tablets on the label, give 2½ tablets. If your child weighs 72 to 95 lbs or 32.5 to 43 kg: - For liquid that says 100 mg/1 tsp on the label, give a 3 tsp dose. - For liquid that says 100 mg/5 mL on the label, give a 15 mL dose. - For chewable tablets that say 50 mg tablets on the label, give 6 tablets. - For junior-strength tablets that say 100 mg tablets on the label, give 3 tablets. If your child weighs 96 lbs or 43.5 kg or more: - For liquid that says 100 mg/1 tsp on the label, give a 4 tsp dose. - For liquid that says 100 mg/5 mL on the label, give a 20 mL dose. - For chewable tablets that say 50 mg tablets on the label, give 8 tablets. - For junior-strength tablets that say 100 mg tablets on the label, give 4 tablets. Try giving your child the medicine with food to avoid stomach upset. If you are not sure how much to give your child, call your health care provider. DO NOT give ibuprofen to children under 6 months of age, unless directed by your provider. You should also check with your provider before giving ibuprofen to children under 2 years old or less than 12 pounds or 5.5 kilograms. Make sure you don't give your child more than one medicine with ibuprofen. For example, ibuprofen can be found in many allergy and cold remedies. Read the label before giving any medicine to children. You should not give medicine with more than one active ingredient to children under age 6. There are important child medicine safety tips to follow. - Carefully read all of the instructions on the label before giving your child medicine. - Make sure you know the strength of the medicine in the bottle you purchased. - Use the syringe, dropper, or dosing cup that comes with your child's liquid medicine. You can also get one at your local pharmacy. - Make sure you are using the right unit of measurement when filling medicine. You may have the option of milliliters (mL) or teaspoon (tsp) dosing. - If you are not sure what medicine to give your child, call your provider. Children with certain medical conditions or taking certain medicines should not take ibuprofen. Check with your provider. Be sure to post the number for the poison control center by your home phone. If you think your child has taken too much medicine, call the poison control center at 1-800-222-1222. It is open 24 hours a day. Signs of poisoning include nausea, vomiting, fatigue, and abdominal pain. Go to the nearest emergency room. Your child may need: - Activated charcoal. Charcoal stops the body from absorbing the medicine. It has to be given within an hour. It does not work for every medicine. - To be admitted to the hospital to be monitored. - Blood tests to see what the medicine is doing. - To have his or her heart rate, breathing rate, and blood pressure monitored. Call your provider if: - You are not sure what dose of medicine to give your infant or child. - You are having trouble getting your child to take medicine. - Your child's symptoms do not go away when you would expect. - Your child is an infant and has signs of illness, such as fever. Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.", "role": "user" }, { "content": "Ibuprofen can help children with colds or minor injuries feel better. It is important to give your child the correct dose, as taking too much can be harmful. To give the direct dose, you need to know your child's weight and the amount of ibuprofen in the product you are using. This information can be found on the label. If you are not sure about how big of a dose to give your child, contact your health care provider. Do not give ibuprofen to a child under 6 months of age unless you have talked to your provider first.", "role": "assistant" } ]

[ { "content": "I have a fractured nose i need it fixed. its been broke for 3 years now\n\n Nose fracture Fracture of the nose Broken nose Nasal fracture Nasal bone fracture Nasal septal fracture Summary A nose fracture is a break in the bone or cartilage over the bridge, or in the sidewall or septum (structure that divides the nostrils) of the nose. Considerations A fractured nose is the most common fracture of the face. It most often occurs after an injury and often occurs with other fractures of the face. Nose injuries and neck injuries are often seen together. A blow that is forceful enough to injure the nose may be hard enough to injure the neck. Serious nose injuries cause problems that need a health care provider's attention right away. For example, damage to the cartilage can cause a collection of blood to form inside the nose. If this blood is not drained right away, it can cause an abscess or a permanent deformity that blocks the nose. It may lead to tissue death and cause the nose to collapse. For minor nose injuries, the provider may want to see the person within the first week after the injury to see if the nose has moved out of its normal shape. Sometimes, surgery may be needed to correct a nose or septum that has been bent out of shape by an injury. Symptoms Symptoms may include: Blood coming from the nose Bruising around the eyes Difficulty breathing through the nose Misshapen appearance (may not be obvious until the swelling goes down) Pain Swelling The bruised appearance most often disappears after 2 weeks. First Aid If a nose injury happens: Try to stay calm. Breathe through your mouth and lean forward in a sitting position to keep blood from going down the back of your throat. Squeeze the nostrils closed and hold pressure to stop the bleeding. Apply cold compresses to your nose to reduce swelling. If possible, hold the compress so that there isn't too much pressure on the nose. To help relieve pain, try acetaminophen (Tylenol). DO NOT DO NOT try to straighten a broken nose DO NOT move the person if there is reason to suspect a head or neck injury When to Contact a Medical Professional Get medical help right away if: Bleeding will not stop Clear fluid keeps draining from the nose You suspect a blood clot in the septum You suspect a neck or head injury The nose looks deformed or out of its usual shape The person is having difficulty breathing Prevention Wear protective headgear while playing contact sports, or riding bicycles, skateboards, roller skates, or rollerblades. Use seat belts and appropriate car seats when driving. Review Date 8/17/2016 Updated by: Josef Shargorodsky, MD, MPH, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Sometimes, surgery may be needed to correct a nose or septum that has been bent out of shape by an injury.", "role": "assistant" } ]

[ { "content": "symptoms of dehydration When a person is very dehydrated do they sometimes get a tight pain in their chest (right below the breasts) right before they faint/pass out?\n\n Dehydration Overview Dehydration occurs when you use or lose more fluid than you take in, and your body doesn't have enough water and other fluids to carry out its normal functions. If you don't replace lost fluids, you will get dehydrated. Anyone may become dehydrated, but the condition is especially dangerous for young children and older adults. The most common cause of dehydration in young children is severe diarrhea and vomiting. Older adults naturally have a lower volume of water in their bodies, and may have conditions or take medications that increase the risk of dehydration. This means that even minor illnesses, such as infections affecting the lungs or bladder, can result in dehydration in older adults. Dehydration also can occur in any age group if you don't drink enough water during hot weather - especially if you are exercising vigorously. You can usually reverse mild to moderate dehydration by drinking more fluids, but severe dehydration needs immediate medical treatment. Symptoms Thirst isn't always a reliable early indicator of the body's need for water. Many people, particularly older adults, don't feel thirsty until they're already dehydrated. That's why it's important to increase water intake during hot weather or when you're ill. The signs and symptoms of dehydration also may differ by age. - Dry mouth and tongue - No tears when crying - No wet diapers for three hours - Sunken eyes, cheeks - Sunken soft spot on top of skull - Listlessness or irritability - Extreme thirst - Less frequent urination - Dark-colored urine - Fatigue - Dizziness - Confusion Call your family doctor if you or a loved one: - Has had diarrhea for 24 hours or more - Is irritable or disoriented and much sleepier or less active than usual - Can't keep down fluids - Has bloody or black stool Causes Sometimes dehydration occurs for simple reasons: You don't drink enough because you're sick or busy, or because you lack access to safe drinking water when you're traveling, hiking or camping. Other dehydration causes include: - Diarrhea, vomiting. Severe, acute diarrhea - that is, diarrhea that comes on suddenly and violently - can cause a tremendous loss of water and electrolytes in a short amount of time. If you have vomiting along with diarrhea, you lose even more fluids and minerals. - Fever. In general, the higher your fever, the more dehydrated you may become. The problem worsens if you have a fever in addition to diarrhea and vomiting. - Excessive sweating. You lose water when you sweat. If you do vigorous activity and don't replace fluids as you go along, you can become dehydrated. Hot, humid weather increases the amount you sweat and the amount of fluid you lose. - Increased urination. This may be due to undiagnosed or uncontrolled diabetes. Certain medications, such as diuretics and some blood pressure medications, also can lead to dehydration, generally because they cause you to urinate more. Risk factors Anyone can become dehydrated, but certain people are at greater risk: - Infants and children. The most likely group to experience severe diarrhea and vomiting, infants and children are especially vulnerable to dehydration. Having a higher surface area to volume area, they also lose a higher proportion of their fluids from a high fever or burns. Young children often can't tell you that they're thirsty, nor can they get a drink for themselves. - Older adults. As you age, your body's fluid reserve becomes smaller, your ability to conserve water is reduced and your thirst sense becomes less acute. These problems are compounded by chronic illnesses such as diabetes and dementia, and by the use of certain medications. Older adults also may have mobility problems that limit their ability to obtain water for themselves. - People with chronic illnesses. Having uncontrolled or untreated diabetes puts you at high risk of dehydration. Kidney disease also increases your risk, as do medications that increase urination. Even having a cold or sore throat makes you more susceptible to dehydration because you're less likely to feel like eating or drinking when you're sick. - People who work or exercise outside. When it's hot and humid, your risk of dehydration and heat illness increases. That's because when the air is humid, sweat can't evaporate and cool you as quickly as it normally does, and this can lead to an increased body temperature and the need for more fluids. Complications Dehydration can lead to serious complications, including: - Heat injury. If you don't drink enough fluids when you're exercising vigorously and perspiring heavily, you may end up with a heat injury, ranging in severity from mild heat cramps to heat exhaustion or potentially life-threatening heatstroke. - Urinary and kidney problems. Prolonged or repeated bouts of dehydration can cause urinary tract infections, kidney stones and even kidney failure. - Seizures. Electrolytes - such as potassium and sodium - help carry electrical signals from cell to cell. If your electrolytes are out of balance, the normal electrical messages can become mixed up, which can lead to involuntary muscle contractions and sometimes to a loss of consciousness. - Low blood volume shock (hypovolemic shock). This is one of the most serious, and sometimes life-threatening, complications of dehydration. It occurs when low blood volume causes a drop in blood pressure and a drop in the amount of oxygen in your body. Diagnosis Your doctor can often diagnose dehydration on the basis of physical signs and symptoms. If you're dehydrated, you're also likely to have low blood pressure, especially when moving from a lying to a standing position, a faster than normal heart rate and reduced blood flow to your extremities. To help confirm the diagnosis and pinpoint the degree of dehydration, you may have other tests, such as: - Blood tests. Blood samples may be used to check for a number of factors, such as the levels of your electrolytes - especially sodium and potassium - and how well your kidneys are working. - Urinalysis. Tests done on your urine can help show whether you're dehydrated and to what degree. They also can check for signs of a bladder infection. Treatment The only effective treatment for dehydration is to replace lost fluids and lost electrolytes. The best approach to dehydration treatment depends on age, the severity of dehydration and its cause. For infants and children who have become dehydrated from diarrhea, vomiting or fever, use an over-the-counter oral rehydration solution. These solutions contain water and salts in specific proportions to replenish both fluids and electrolytes. Start with about a teaspoon (5 milliliters) every one to five minutes and increase as tolerated. It may be easier to use a syringe for very young children. Older children can be given diluted sports drinks. Use 1 part sports drink to 1 part water. Most adults with mild to moderate dehydration from diarrhea, vomiting or fever can improve their condition by drinking more water or other liquids. Diarrhea may be worsened by full-strength fruit juice and soft drinks. If you work or exercise outdoors during hot or humid weather, cool water is your best bet. Sports drinks containing electrolytes and a carbohydrate solution also may be helpful. Children and adults who are severely dehydrated should be treated by emergency personnel arriving in an ambulance or in a hospital emergency room. Salts and fluids delivered through a vein (intravenously) are absorbed quickly and speed recovery. ", "role": "user" }, { "content": "Dehydration causes dry mouth, thirst, reduced urination, dark urine, irritability, lack of energy, fatigue, confusion, and dizziness.", "role": "assistant" } ]

[ { "content": "Anal Fissure I may have a couple anal fissures and looking to speak with someone to get some information and support.\n\n Anal fissure Overview An anal fissure is a small tear in the thin, moist tissue (mucosa) that lines the anus. An anal fissure may occur when you pass hard or large stools during a bowel movement. Anal fissures typically cause pain and bleeding with bowel movements. You also may experience spasms in the ring of muscle at the end of your anus (anal sphincter). Anal fissures are very common in young infants but can affect people of any age. Most anal fissures get better with simple treatments, such as increased fiber intake or sitz baths. Some people with anal fissures may need medication or, occasionally, surgery. Symptoms Signs and symptoms of an anal fissure include: - Pain, sometimes severe, during bowel movements - Pain after bowel movements that can last up to several hours - Bright red blood on the stool or toilet paper after a bowel movement - Itching or irritation around the anus - A visible crack in the skin around the anus - A small lump or skin tag on the skin near the anal fissure When to see a doctor See your doctor if you have pain during bowel movements or notice blood on stools or toilet paper after a bowel movement. Causes Common causes of anal fissure include: - Passing large or hard stools - Constipation and straining during bowel movements - Chronic diarrhea - Inflammation of the anorectal area, caused by Crohn's disease or another inflammatory bowel disease - Childbirth Less common causes of anal fissures include: - Anal cancer - HIV - Tuberculosis - Syphilis - Herpes Risk factors Factors that may increase your risk of developing an anal fissure include: - Infancy. Many infants experience an anal fissure during their first year of life; experts aren't sure why. - Aging. Older adults may develop an anal fissure partly due to slowed circulation, resulting in decreased blood flow to the rectal area. - Constipation. Straining during bowel movements and passing hard stools increase the risk of tearing. - Childbirth. Anal fissures are more common in women after they give birth. - Crohn's disease. This inflammatory bowel disease causes chronic inflammation of the intestinal tract, which may make the lining of the anal canal more vulnerable to tearing. - Anal intercourse. Complications Complications of anal fissure can include: - Failure to heal. An anal fissure that fails to heal within six weeks is considered chronic and may need further treatment. - Recurrence. Once you've experienced an anal fissure, you are prone to having another one. - A tear that extends to surrounding muscles. An anal fissure may extend into the ring of muscle that holds your anus closed (internal anal sphincter), making it more difficult for your anal fissure to heal. An unhealed fissure can trigger a cycle of discomfort that may require medications or surgery to reduce the pain and to repair or remove the fissure. Diagnosis If possible, your doctor will perform a digital rectal exam, which involves inserting a gloved finger into your anal canal, or use a short, lighted tube (anoscope) to inspect your anal canal. However, if this is too painful for you, your doctor may be able to diagnose an anal fissure only by observation. An acute anal fissure looks like a fresh tear, somewhat like a paper cut. A chronic anal fissure likely has the tear, as well as two separate lumps or tags of skin, one internal (sentinel pile) and one external (hypertrophied papilla). The fissure's location offers clues about its cause. A fissure that occurs on the side of the anal opening, rather than the back or front, is more likely to be a sign of another disorder, such as Crohn's disease. Your doctor may recommend further testing if he or she thinks you have an underlying condition: - Flexible sigmoidoscopy. Your doctor will insert a thin, flexible tube with a tiny video into the bottom portion of your colon. This test may be done if you're younger than 50 and have no risk factors for intestinal diseases or colon cancer. - Colonoscopy. Your doctor will insert a flexible tube into your rectum to inspect the entire colon. This test may be done if you are older than age 50 or you have risk factors for colon cancer, signs of other conditions, or other symptoms such as abdominal pain or diarrhea. Treatment Anal fissures often heal within a few weeks if you take steps to keep your stool soft, such as increasing your intake of fiber and fluids. Soaking in warm water for 10 to 20 minutes several times a day, especially after bowel movements, can help relax the sphincter and promote healing. If your symptoms persist, you'll likely need further treatment. Nonsurgical treatments Your doctor may recommend: - Externally applied nitroglycerin (Rectiv), to help increase blood flow to the fissure and promote healing and to help relax the anal sphincter. Nitroglycerin is generally considered the medical treatment of choice when other conservative measures fail. Side effects may include headache, which can be severe. - Topical anesthetic creams such as lidocaine hydrochloride (Xylocaine) may be helpful for pain relief. - Botulinum toxin type A (Botox) injection, to paralyze the anal sphincter muscle and relax spasms. - Blood pressure medications, such as oral nifedipine (Procardia) or diltiazem (Cardizem) can help relax the anal sphincter. These medications may be taken by mouth or applied externally and may be used when nitroglycerin is not effective or causes significant side effects. Surgery If you have a chronic anal fissure that is resistant to other treatments, or if your symptoms are severe, your doctor may recommend surgery. Doctors usually perform a procedure called lateral internal sphincterotomy (LIS), which involves cutting a small portion of the anal sphincter muscle to reduce spasm and pain, and promote healing. Studies have found that for chronic fissure, surgery is much more effective than any medical treatment. However, surgery has a small risk of causing incontinence. Lifestyle and home remedies Several lifestyle changes may help relieve discomfort and promote healing of an anal fissure, as well as prevent recurrences: - Add fiber to your diet. Eating about 25 to 30 grams of fiber a day can help keep stools soft and improve fissure healing. Fiber-rich foods include fruits, vegetables, nuts and whole grains. You also can take a fiber supplement. Adding fiber may cause gas and bloating, so increase your intake gradually. - Drink adequate fluids. Fluids help prevent constipation. - Exercise regularly. Engage in 30 minutes or more of moderate physical activity, such as walking, most days of the week. Exercise promotes regular bowel movements and increases blood flow to all parts of your body, which may promote healing of an anal fissure. - Avoid straining during bowel movements. Straining creates pressure, which can open a healing tear or cause a new tear. If your infant has an anal fissure, be sure to change diapers frequently, wash the area gently and discuss the problem with your child's doctor. ", "role": "user" }, { "content": "Common causes of anal fissure include: hard stools, constipation, chronic diarrhea, and inflammation of the anorectal area. Less common causes of anal fissures include: anal cancer, HIV, tuberculosis, syphilis, and herpes", "role": "assistant" } ]

[ { "content": "how to prevent conjunctivitis\n\n Vernal conjunctivitis Summary Vernal conjunctivitis is long-term (chronic) swelling (inflammation) of the outer lining of the eyes. It is due to an allergic reaction. Causes Vernal conjunctivitis often occurs in people with a strong family history of allergies. These may include allergic rhinitis, asthma, and eczema. It is most common in young males, and most often occurs during the spring and summer. Symptoms Symptoms include: Burning eyes. Discomfort in bright light (photophobia). Itching eyes. The area around the cornea where the white of the eye and the cornea meet (limbus) may become rough and swollen. The inside of the eyelids (most often the upper ones) may become rough and covered with bumps and a white mucus. Watering eyes. Exams and Tests The health care provider will perform an eye exam. Treatment Avoid rubbing the eyes because this can irritate them more. Cold compresses (a clean cloth soaked in cold water and then placed over the closed eyes) may be soothing. Lubricating drops may also help soothe the eye. If home-care measures do not help, you may need to be treated by your provider. Treatment may include: Antihistamine or anti-inflammatory drops that are placed into the eye Eye drops that prevent a type of white blood cell called mast cells from releasing histamine (may help prevent future attacks) Mild steroids that are applied directly to the surface of the eye (for severe reactions) Recent research suggests that a mild form of cyclosporine, which is an anti-cancer drug, may be helpful for acute episodes. It may also help prevent recurrences. Outlook (Prognosis) The condition continues over time (is chronic). It gets worse during certain seasons of the year, most often in the spring and summer. Treatment may provide relief. Possible Complications Complications may include: Continuing discomfort Reduced vision Scarring of cornea When to Contact a Medical Professional Call your provider if your symptoms continue or get worse. Prevention Using air conditioning or moving to a cooler climate may help prevent the problem from getting worse in the future. Review Date 3/6/2018 Updated by: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "How to prevent Vernal conjunctivitis?: Using air conditioning or moving to a cooler climate may help prevent the problem from getting worse in the future.", "role": "assistant" } ]

[ { "content": "how do you get a prolapse bladder\n\nPelvic organ prolapse: Pelvic organ prolapse happens when the muscles and tissues supporting the pelvic organs (the uterus, bladder, or rectum) become weak or loose. This allows one or more of the pelvic organs to drop or press into or out of the vagina. Many women are embarrassed to talk to their doctor about their symptoms or think that their symptoms are normal. But pelvic organ prolapse is treatable. The pelvic muscles and tissues support the pelvic organs like a hammock. The pelvic organs include the bladder, uterus and cervix, vagina, and rectum, which is part of the bowel. A prolapse happens when the pelvis muscles and tissues can no longer support these organs because the muscles and tissues are weak or damaged. This causes one or more pelvic organs to drop or press into or out of the vagina. Pelvic organ prolapse is a type of pelvic floor disorder. The most common pelvic floor disorders are: The different types of pelvic organ prolapse depend on the pelvic organ affected. The most common types include: Although it is rare, pelvic organ prolapse can also happen after a hysterectomy. Any part of the vaginal wall may drop, causing a bulge into or out of the vagina. Pelvic floor disorders (urinary incontinence, fecal incontinence, and pelvic organ prolapse) affect one in five women in the United States.1 Pelvic organ prolapse is less common than urinary or fecal incontinence but affects almost 3% of U.S. women.1 Pelvic organ prolapse happens more often in older women and in white and Hispanic women than in younger women or women of other racial and ethnic groups.2,3 Some women develop more than one pelvic floor disorder, such as pelvic organ prolapse with urinary incontinence. The pressure from prolapse can cause a bulge in the vagina that can sometimes be felt or seen. Women with pelvic organ prolapse may feel uncomfortable pressure during physical activity or sex. Other symptoms of pelvic organ prolapse include: Some women say that their symptoms are worse at certain times of the day, during physical activity, or after standing for a long time. Talk to your doctor or nurse about your symptoms. Pelvic organ prolapse happens when the muscles or connective tissues of the pelvis do not work as they should. The most common risk factors are: Your doctor will talk to you about your symptoms and do a pelvic exam. You may be asked to strain or cough during the exam so your doctor can see whether these actions cause prolapse or urine leakage. Your doctor may also do other tests to see whether you can completely empty your bladder when you go to the bathroom. Treatment for pelvic organ prolapse depends on the type of prolapse you have, your symptoms, your age, other health problems, and whether you are sexually active. Your treatment may include one or more of the following: Researchers are studying ways to prevent pelvic organ prolapse. The following steps may reduce your risk of getting a pelvic floor problem: For more information about pelvic organ prolapse, call the OWH Helpline at 1-800-994-9662 or contact the following organizations:", "role": "user" }, { "content": "Pelvic organ prolapse: Pelvic organ prolapse happens when the muscles and tissues supporting the pelvic organs (the uterus, bladder, or rectum) become weak or loose.", "role": "assistant" } ]

[ { "content": "I am a current Gastroparesis fighter with a GJ feeding tube. I am also one of the admins for a GP support group and an advocacy group. I have become a volunteer advocater. I would appreciate any info you can share about Gastroparesis, Feeding tubes, and even TPN. Thanks\n\n Gastroparesis Definition and Facts Gastroparesis, also called delayed gastric emptying, is a disorder that slows or stops the movement of food from your stomach to your small intestine, even though there is no blockage in the stomach or intestines. What is gastroparesis? Gastroparesis, also called delayed gastric emptying, is a disorder that slows or stops the movement of food from your stomach to your small intestine. Normally, after you swallow food, the muscles in the wall of your stomach grind the food into smaller pieces and push them into your small intestine to continue digestion. When you have gastroparesis, your stomach muscles work poorly or not at all, and your stomach takes too long to empty its contents. Gastroparesis can delay digestion, which can lead to various symptoms and complications. How common is gastroparesis? Gastroparesis is not common. Out of 100,000 people, about 10 men and about 40 women have gastroparesis1. However, symptoms that are similar to those of gastroparesis occur in about 1 out of 4 adults in the United States2, 3. Who is more likely to get gastroparesis? You are more likely to get gastroparesis if youhave diabetes had surgery on your esophagus, stomach, or small intestine, which may injure the vagus nerve . The vagus nerve controls the muscles of the stomach and small intestine. had certain cancer treatments, such as radiation therapy on your chest or stomach area What other health problems do people with gastroparesis have? People with gastroparesis may have other health problems, such asdiabetes scleroderma hypothyroidism nervous system disorders, such as migraine, Parkinson's disease, and multiple sclerosis gastroesophageal reflux disease (GERD) eating disorders amyloidosis What are the complications of gastroparesis? Complications of gastroparesis may includedehydration due to repeated vomiting malnutrition due to poor absorption of nutrients blood glucose, also called blood sugar, levels that are harder to control, which can worsen diabetes low calorie intake bezoars losing weight without trying lower quality of life Definition & Facts Symptoms and Causes The symptoms of gastroparesis may include feeling full shortly after starting a meal, feeling full long after eating a meal, nausea, and vomiting. Diabetes is the most common known cause of gastroparesis. What are the symptoms of gastroparesis? The symptoms of gastroparesis may includefeeling full soon after starting a meal feeling full long after eating a meal nausea vomiting too much bloating too much belching pain in your upper abdomen heartburn poor appetiteCertain medicines may delay gastric emptying or affect motility, resulting in symptoms that are similar to those of gastroparesis. If you have been diagnosed with gastroparesis, these medicines may make your symptoms worse. Medicines that may delay gastric emptying or make symptoms worse include the following:narcotic pain medicines, such as codeine , hydrocodone , morphine , oxycodone , and tapentadol some antidepressants , such as amitriptyline , nortriptyline , and venlafaxine some anticholinergics -medicines that block certain nerve signals some medicines used to treat overactive bladder pramlintideThese medicines do not cause gastroparesis. When should I seek a doctor’s help? You should seek a doctor's help right away if you have any of the following signs or symptoms:severe pain or cramping in your abdomen blood glucose levels that are too high or too low red blood in your vomit, or vomit that looks like coffee grounds sudden, sharp stomach pain that doesn't go away vomiting for more than an hour feeling extremely weak or fainting difficulty breathing feverYou should seek a doctor's help if you have any signs or symptoms of dehydration, which may includeextreme thirst and dry mouth urinating less than usual feeling tired dark-colored urine decreased skin turgor, meaning that when your skin is pinched and released, the skin does not flatten back to normal right away sunken eyes or cheeks light-headedness or faintingYou should seek a doctor's help if you have any signs or symptoms of malnutrition, which may includefeeling tired or weak all the time losing weight without trying feeling dizzy loss of appetite abnormal paleness of the skin Symptoms & Causes In most cases, doctors aren't able to find the underlying cause of gastroparesis, even with medical tests. Gastroparesis without a known cause is called idiopathic gastroparesis.Diabetes is the most common known underlying cause of gastroparesis. Diabetes can damage nerves, such as the vagus nerve and nerves and special cells, called pacemaker cells, in the wall of the stomach. The vagus nerve controls the muscles of the stomach and small intestine. If the vagus nerve is damaged or stops working, the muscles of the stomach and small intestine do not work normally. The movement of food through the digestive tract is then slowed or stopped. Similarly, if nerves or pacemaker cells in the wall of the stomach are damaged or do not work normally, the stomach does not empty.In addition to diabetes, other known causes of gastroparesis includeinjury to the vagus nerve due to surgery on your esophagus, stomach, or small intestine hypothyroidism certain autoimmune diseases, such as scleroderma certain nervous system disorders, such as Parkinson's disease and multiple sclerosis viral infections of your stomach Diagnosis Doctors diagnose gastroparesis based on your medical history, a physical exam, symptoms, and medical tests, such as tests to measure stomach emptying. Your doctor may use medical tests to look for gastroparesis complications. How do doctors diagnose gastroparesis? Doctors diagnose gastroparesis based on your medical history, a physical exam, your symptoms, and medical tests. Your doctor may also perform medical tests to look for signs of gastroparesis complications and to rule out other health problems that may be causing your symptoms.Your doctor will ask about your medical history. He or she will ask for details about your current symptoms and medicines, and current and past health problems such as diabetes, scleroderma, nervous system disorders, and hypothyroidism.Your doctor may also ask aboutthe types of medicines you are taking. Be sure to tell your doctor about all prescription medicines, over-the-counter medicines, and dietary supplements you are taking. whether you've had surgery on your esophagus, stomach, or small intestine whether you've had radiation therapy on your chest or stomach areaDuring a physical exam, your doctor willcheck your blood pressure, temperature, and heart rate check for signs of dehydration and malnutrition check your abdomen for unusual sounds, tenderness, or pain Diagnosis Doctors use lab tests, upper gastrointestinal (GI) endoscopy, imaging tests, and tests to measure how fast your stomach is emptying its contents to diagnose gastroparesis.Your doctor may use the following lab tests:Blood tests can show signs of dehydration, malnutrition, inflammation, and infection. Blood tests can also show whether your blood glucose levels are too high or too low. Urine tests can show signs of diabetes, dehydration, infection, and kidney problems.Your doctor may perform an upper GI endoscopy to look for problems in your upper digestive tract that may be causing your symptoms.Imaging tests can show problems, such as stomach blockage or intestinal obstruction, that may be causing your symptoms. Your doctor may perform the following imaging tests:upper GI series ultrasound of your abdomenYour doctor may perform one of more of the following tests to see how fast your stomach is emptying its contents.Gastric emptying scan, also called gastric emptying scintigraphy. For this test, you eat a bland meal-such as eggs or an egg substitute-that contains a small amount of radioactive material. A camera outside your body scans your abdomen to show where the radioactive material is located. By tracking the radioactive material, a health care professional can measure how fast your stomach empties after the meal. The scan usually takes about 4 hours. Gastric emptying breath test. For this test, you eat a meal that contains a substance that is absorbed in your intestines and eventually passed into your breath. After you eat the meal, a health care professional collects samples of your breath over a period of a few hours-usually about 4 hours. The test can show how fast your stomach empties after the meal by measuring the amount of the substance in your breath. Wireless motility capsule, also called a SmartPill. The SmartPill is a small electronic device that you swallow. The capsule moves through your entire digestive tract and sends information to a recorder hung around your neck or clipped to your belt. A health care professional uses the information to find out how fast or slow your stomach empties, and how fast liquid and food move through your small intestine and large intestine. The capsule will pass naturally out of your body with a bowel movement. Treatment How doctors treat gastroparesis depends on the cause, how bad your symptoms and complications are, and how well you respond to different treatments. If diabetes is causing your gastroparesis, your doctor will help you control your blood glucose levels. How do doctors treat gastroparesis? How doctors treat gastroparesis depends on the cause, how severe your symptoms and complications are, and how well you respond to different treatments. Sometimes, treating the cause may stop gastroparesis. If diabetes is causing your gastroparesis, your health care professional will work with you to help control your blood glucose levels. When the cause of your gastroparesis is not known, your doctor will provide treatments to help relieve your symptoms and treat complications.Changing your eating habits can help control gastroparesis and make sure you get the right amount of nutrients, calories, and liquids. Getting the right amount of nutrients, calories, and liquids can also treat the disorder's two main complications: malnutrition and dehydration.Your doctor may recommend that youeat foods low in fat and fiber eat five or six small, nutritious meals a day instead of two or three large meals chew your food thoroughly eat soft, well-cooked foods avoid carbonated, or fizzy, beverages avoid alcohol drink plenty of water or liquids that contain glucose and electrolytes, such as low-fat broths or clear soups naturally sweetened, low-fiber fruit and vegetable juices sports drinks oral rehydration solutions do some gentle physical activity after a meal, such as taking a walk avoid lying down for 2 hours after a meal take a multivitamin each dayIf your symptoms are moderate to severe, your doctor may recommend drinking only liquids or eating well-cooked solid foods that have been processed into very small pieces or paste in a blender.If you have gastroparesis and diabetes, you will need to control your blood glucose levels, especially hyperglycemia. Hyperglycemia may further delay the emptying of food from your stomach. Your doctor will work with you to make sure your blood glucose levels are not too high or too low and don't keep going up or down. Your doctor may recommendtaking insulin more often, or changing the type of insulin you take taking insulin after, instead of before, meals checking your blood glucose levels often after you eat, and taking insulin when you need itYour doctor will give you specific instructions for taking insulin based on your needs and the severity of your gastroparesis.Your doctor may prescribe medicines that help the muscles in the wall of your stomach work better. He or she may also prescribe medicines to control nausea and vomiting and reduce pain.Your doctor may prescribe one or more of the following medicines:Metoclopramide. This medicine increases the tightening, or contraction, of the muscles in the wall of your stomach and may improve gastric emptying. Metoclopramide may also help relieve nausea and vomiting. Domperidone. This medicine also increases the contraction of the muscles in the wall of your stomach and may improve gastric emptying. However, this medicine is available for use only under a special program administered by the U.S. Food and Drug Administration. Erythromycin. This medicine also increases stomach muscle contraction and may improve gastric emptying. Antiemetics. Antiemetics are medicines that help relieve nausea and vomiting. Prescription antiemetics include ondansetron , prochlorperazine , and promethazine. Over-the-counter antiemetics include bismuth subsalicylate and diphenhydramine . Antiemetics do not improve gastric emptying. Antidepressants. Certain antidepressants, such as mirtazapine, may help relieve nausea and vomiting. These medicines may not improve gastric emptying. Pain medicines. Pain medicines that are not narcotic pain medicines may reduce pain in your abdomen due to gastroparesis.In some cases, your doctor may recommend oral or nasal tube feeding to make sure you're getting the right amount of nutrients and calories. A health care professional will put a tube either into your mouth or nose, through your esophagus and stomach, to your small intestine. Oral and nasal tube feeding bypass your stomach and deliver a special liquid food directly into your small intestine.If you aren't getting enough nutrients and calories from other treatments, your doctor may recommend jejunostomy tube feeding. Jejunostomy feedings are a longer term method of feeding, compared to oral or nasal tube feeding.Jejunostomy tube feeding is a way to feed you through a tube placed into part of your small intestine called the jejunum. To place the tube into the jejunum, a doctor creates an opening, called a jejunostomy, in your abdominal wall that goes into your jejunum. The feeding tube bypasses your stomach and delivers a liquid food directly into your jejunum.Your doctor may recommend parenteral, or intravenous (IV), nutrition if your gastroparesis is so severe that other treatments are not helping. Parenteral nutrition delivers liquid nutrients directly into your bloodstream. Parenteral nutrition may be short term, until you can eat again. Parenteral nutrition may also be used until a tube can be placed for oral, nasal, or jejunostomy tube feeding. In some cases, parental nutrition may be long term.Your doctor may recommend a venting gastrostomy to relieve pressure inside your stomach. A doctor creates an opening, called a gastrostomy, in your abdominal wall and into your stomach. The doctor then places a tube through the gastrostomy into your stomach. Stomach contents can then flow out of the tube and relieve pressure inside your stomach.Gastric electrical stimulation (GES) uses a small, battery-powered device to send mild electrical pulses to the nerves and muscles in the lower stomach. A surgeon puts the device under the skin in your lower abdomen and attaches wires from the device to the muscles in the wall of your stomach. GES can help decrease long-term nausea and vomiting.GES is used to treat people with gastroparesis due to diabetes or unknown causes only, and only in people whose symptoms can't be controlled with medicines. Treatment Gastroparesis without a known cause, called idiopathic gastroparesis, cannot be prevented.If you have diabetes, you can prevent or delay nerve damage that can cause gastroparesis by keeping your blood glucose levels within the target range that your doctor thinks is best for you. Meal planning, physical activity, and medicines, if needed, can help you keep your blood glucose levels within your target range. Eating, Diet, and Nutrition What you eat can help relieve gastroparesis symptoms. What you eat can also help make sure you get the right amount of nutrients, calories, and liquids if you are malnourished or dehydrated due to gastroparesis. How can my diet help prevent or relieve gastroparesis? What you eat can help prevent or relieve your gastroparesis symptoms. If you have diabetes, following a healthy meal plan can help you manage your blood glucose levels. What you eat can also help make sure you get the right amount of nutrients, calories, and liquids if you are malnourished or dehydrated from gastroparesis. What should I eat and drink if I have gastroparesis? If you have gastroparesis, your doctor may recommend that you eat or drinkfoods and beverages that are low in fat foods and beverages that are low in fiber five or six small, nutritious meals a day instead of two or three large meals soft, well-cooked foodsIf you are unable to eat solid foods, your doctor may recommend that you drinkliquid nutrition meals solid foods pureed in a blenderYour doctor may also recommend that you drink plenty of water or liquids that contain glucose and electrolytes, such aslow-fat broths and clear soups low-fiber fruit and vegetable juices sports drinks oral rehydration solutionsIf your symptoms are moderate to severe, your doctor may recommend drinking only liquids or eating well-cooked solid foods that have been processed into very small pieces or paste in a blender. Eating, Diet, & Nutrition If you have gastroparesis, you should avoidfoods and beverages that are high in fat foods and beverages that are high in fiber foods that can't be chewed easily carbonated, or fizzy, beverages alcoholYour doctor may refer you to a dietitian to help you plan healthy meals that are easy for you to digest and give you the right amount of nutrients, calories, and liquids. ", "role": "user" }, { "content": "Gastroparesis, also called delayed gastric emptying, is a disorder that slows or stops the movement of food from the stomach to the small intestine. ... For reasons that are still unclear, gastroparesis is more commonly found in women than in men. The most common symptoms of gastroparesis are nausea, a feeling of fullness after eating only a small amount of food, and vomiting undigested food?sometimes several hours after a meal. Other symptoms of gastroparesis includegastroesophageal reflux (GER), Most people diagnosed with gastroparesis have idiopathic gastroparesis, which means a health care provider cannot identify the cause, even with medical tests. Diabetes is the most common known cause of gastroparesis. ... Gastroparesis is diagnosed through a physical exam, medical history, blood tests, tests to rule out blockage or structural problems in the gastrointestinal (GI) tract, and gastric emptying tests. ... Treatment of gastroparesis may include medications, botulinum toxin, gastric electrical stimulation, jejunostomy, and parenteral nutrition.For people with gastroparesis and diabetes, a health care provider will likely adjust the person?s insulin regimen. ... a health care provider may recommend surgically placing a feeding tube through the abdominal wall directly into a part of the small intestine called the jejunum. The surgical procedure is known as a jejunostomy.", "role": "assistant" } ]

[ { "content": "what are some of the treatments available to males with klinefelter's\n\nWhat are the treatments for Klinefelter syndrome?: Testosterone therapy may be prescribed. This can help: - Grow body hair - Improve appearance of muscles - Improve concentration - Improve mood and self esteem - Increase energy and sex drive - Increase strength Most men with this syndrome are not able to get a woman pregnant. But, an infertility specialist may be able to help. Seeing a doctor called an endocrinologist may also be helpful.", "role": "user" }, { "content": "Testosterone therapy may be prescribed for individuals with Klinefelter syndrome. This can help increase body hair, sex drive, concentration, mood and self-esteem, and strength. Men with this syndrome may be infertile, but should talk to an infertility specialist.", "role": "assistant" } ]

[ { "content": "how to prevent atherosclerosis\n\n Atherosclerosis What Is... Español Atherosclerosis is a disease in which plaque builds up inside your arteries. Arteries are blood vessels that carry oxygen-rich blood to your heart and other parts of your body. Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque hardens and narrows your arteries. This limits the flow of oxygen-rich blood to your organs and other parts of your body. Atherosclerosis can lead to serious problems, including heart attack, stroke, or even death. Atherosclerosis Atherosclerosis-Related Diseases Atherosclerosis can affect any artery in the body, including arteries in the heart, brain, arms, legs, pelvis, and kidneys. As a result, different diseases may develop based on which arteries are affected. Coronary Heart Disease Coronary heart disease (CHD), also called coronary artery disease, occurs when plaque builds up in the coronary arteries. These arteries supply oxygen-rich blood to your heart. Plaque narrows the coronary arteries and reduces blood flow to your heart muscle. Plaque buildup also makes it more likely that blood clots will form in your arteries. Blood clots can partially or completely block blood flow. If blood flow to your heart muscle is reduced or blocked, you may have angina (chest pain or discomfort) or a heart attack. Plaque also can form in the heart's smallest arteries. This disease is called coronary microvascular disease (MVD). In coronary MVD, plaque doesn't cause blockages in the arteries as it does in CHD. Carotid Artery Disease Carotid (ka-ROT-id) artery disease occurs if plaque builds up in the arteries on each side of your neck (the carotid arteries). These arteries supply oxygen-rich blood to your brain. If blood flow to your brain is reduced or blocked, you may have a stroke. Peripheral Artery Disease Peripheral artery disease (P.A.D.) occurs if plaque builds up in the major arteries that supply oxygen-rich blood to your legs, arms, and pelvis. If blood flow to these parts of your body is reduced or blocked, you may have numbness, pain, and, sometimes, dangerous infections. Chronic Kidney Disease Chronic kidney disease can occur if plaque builds up in the renal arteries. These arteries supply oxygen-rich blood to your kidneys. Over time, chronic kidney disease causes a slow loss of kidney function. The main function of the kidneys is to remove waste and extra water from the body. Overview The cause of atherosclerosis isn't known. However, certain traits, conditions, or habits may raise your risk for the disease. These conditions are known as risk factors. You can control some risk factors, such as lack of physical activity, smoking, and an unhealthy diet. Others you can't control, such as age and a family history of heart disease. Some people who have atherosclerosis have no signs or symptoms. They may not be diagnosed until after a heart attack or stroke. The main treatment for atherosclerosis is lifestyle changes. You also may need medicines and medical procedures. These treatments, along with ongoing medical care, can help you live a healthier life. Outlook Improved treatments have reduced the number of deaths from atherosclerosis-related diseases. These treatments also have improved the quality of life for people who have these diseases. However, atherosclerosis remains a common health problem. You may be able to prevent or delay atherosclerosis and the diseases it can cause. Making lifestyle changes and getting ongoing care can help you avoid the problems of atherosclerosis and live a long, healthy life. OTHER NAMES Arteriosclerosis Hardening of the arteries CAUSES The exact cause of atherosclerosis isn't known. However, studies show that atherosclerosis is a slow, complex disease that may start in childhood. It develops faster as you age. Atherosclerosis may start when certain factors damage the inner layers of the arteries. These factors include: Smoking High amounts of certain fats and cholesterol in the blood High blood pressure High amounts of sugar in the blood due to insulin resistance or diabetes Plaque may begin to build up where the arteries are damaged. Over time, plaque hardens and narrows the arteries. Eventually, an area of plaque can rupture (break open). When this happens, blood cell fragments called platelets (PLATE-lets) stick to the site of the injury. They may clump together to form blood clots. Clots narrow the arteries even more, limiting the flow of oxygen-rich blood to your body. Depending on which arteries are affected, blood clots can worsen angina (chest pain) or cause a heart attack or stroke. Researchers continue to look for the causes of atherosclerosis. They hope to find answers to questions such as: Why and how do the arteries become damaged? How does plaque develop and change over time? Why does plaque rupture and lead to blood clots? WHO IS AT RISK The exact cause of atherosclerosis isn't known. However, certain traits, conditions, or habits may raise your risk for the disease. These conditions are known as risk factors. The more risk factors you have, the more likely it is that you'll develop atherosclerosis. You can control most risk factors and help prevent or delay atherosclerosis. Other risk factors can't be controlled. Major Risk Factors Unhealthy blood cholesterol levels. This includes high LDL cholesterol (sometimes called \"bad\" cholesterol) and low HDL cholesterol (sometimes called \"good\" cholesterol). High blood pressure. Blood pressure is considered high if it stays at or above 140/90 mmHg over time. If you have diabetes or chronic kidney disease, high blood pressure is defined as 130/80 mmHg or higher. (The mmHg is millimeters of mercury—the units used to measure blood pressure.) Smoking. Smoking can damage and tighten blood vessels, raise cholesterol levels, and raise blood pressure. Smoking also doesn't allow enough oxygen to reach the body's tissues. Insulin resistance. This condition occurs if the body can't use its insulin properly. Insulin is a hormone that helps move blood sugar into cells where it's used as an energy source. Insulin resistance may lead to diabetes. Diabetes. With this disease, the body's blood sugar level is too high because the body doesn't make enough insulin or doesn't use its insulin properly. Overweight or obesity. The terms \"overweight\" and \"obesity\" refer to body weight that's greater than what is considered healthy for a certain height. Lack of physical activity. A lack of physical activity can worsen other risk factors for atherosclerosis, such as unhealthy blood cholesterol levels, high blood pressure, diabetes, and overweight and obesity. Unhealthy diet. An unhealthy diet can raise your risk for atherosclerosis. Foods that are high in saturated and trans fats, cholesterol, sodium (salt), and sugar can worsen other atherosclerosis risk factors. Older age. As you get older, your risk for atherosclerosis increases. Genetic or lifestyle factors cause plaque to build up in your arteries as you age. By the time you're middle-aged or older, enough plaque has built up to cause signs or symptoms. In men, the risk increases after age 45. In women, the risk increases after age 55. Family history of early heart disease. Your risk for atherosclerosis increases if your father or a brother was diagnosed with heart disease before 55 years of age, or if your mother or a sister was diagnosed with heart disease before 65 years of age. Although age and a family history of early heart disease are risk factors, it doesn't mean that you'll develop atherosclerosis if you have one or both. Controlling other risk factors often can lessen genetic influences and prevent atherosclerosis, even in older adults. Studies show that an increasing number of children and youth are at risk for atherosclerosis. This is due to a number of causes, including rising childhood obesity rates. Emerging Risk Factors Scientists continue to study other possible risk factors for atherosclerosis. High levels of a protein called C-reactive protein (CRP) in the blood may raise the risk for atherosclerosis and heart attack. High levels of CRP are a sign of inflammation in the body. Inflammation is the body's response to injury or infection. Damage to the arteries' inner walls seems to trigger inflammation and help plaque grow. People who have low CRP levels may develop atherosclerosis at a slower rate than people who have high CRP levels. Research is under way to find out whether reducing inflammation and lowering CRP levels also can reduce the risk for atherosclerosis. High levels of triglycerides (tri-GLIH-seh-rides) in the blood also may raise the risk for atherosclerosis, especially in women. Triglycerides are a type of fat. Studies are under way to find out whether genetics may play a role in atherosclerosis risk. Other Factors That Affect Atherosclerosis Other factors also may raise your risk for atherosclerosis, such as: Sleep apnea. Sleep apnea is a disorder that causes one or more pauses in breathing or shallow breaths while you sleep. Untreated sleep apnea can raise your risk for high blood pressure, diabetes, and even a heart attack or stroke. Stress. Research shows that the most commonly reported \"trigger\" for a heart attack is an emotionally upsetting event, especially one involving anger. Alcohol. Heavy drinking can damage the heart muscle and worsen other risk factors for atherosclerosis. Men should have no more than two drinks containing alcohol a day. Women should have no more than one drink containing alcohol a day. SIGNS & SYMPTOMS Atherosclerosis usually doesn't cause signs and symptoms until it severely narrows or totally blocks an artery. Many people don't know they have the disease until they have a medical emergency, such as a heart attack or stroke. Some people may have signs and symptoms of the disease. Signs and symptoms will depend on which arteries are affected. Coronary Arteries The coronary arteries supply oxygen-rich blood to your heart. If plaque narrows or blocks these arteries (a disease called coronary heart disease, or CHD), a common symptom is angina. Angina is chest pain or discomfort that occurs when your heart muscle doesn't get enough oxygen-rich blood. Angina may feel like pressure or squeezing in your chest. You also may feel it in your shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion. The pain tends to get worse with activity and go away with rest. Emotional stress also can trigger the pain. Other symptoms of CHD are shortness of breath and arrhythmias (ah-RITH-me-ahs). Arrhythmias are problems with the rate or rhythm of the heartbeat. Plaque also can form in the heart's smallest arteries. This disease is called coronary microvascular disease (MVD). Symptoms of coronary MVD include angina, shortness of breath, sleep problems, fatigue (tiredness), and lack of energy. Carotid Arteries The carotid arteries supply oxygen-rich blood to your brain. If plaque narrows or blocks these arteries (a disease called carotid artery disease), you may have symptoms of a stroke. These symptoms may include: Sudden weakness Paralysis (an inability to move) or numbness of the face, arms, or legs, especially on one side of the body Confusion Trouble speaking or understanding speech Trouble seeing in one or both eyes Problems breathing Dizziness, trouble walking, loss of balance or coordination, and unexplained falls Loss of consciousness Sudden and severe headache Peripheral Arteries Plaque also can build up in the major arteries that supply oxygen-rich blood to the legs, arms, and pelvis (a disease called peripheral artery disease). If these major arteries are narrowed or blocked, you may have numbness, pain, and, sometimes, dangerous infections. Renal Arteries The renal arteries supply oxygen-rich blood to your kidneys. If plaque builds up in these arteries, you may develop chronic kidney disease. Over time, chronic kidney disease causes a slow loss of kidney function. Early kidney disease often has no signs or symptoms. As the disease gets worse it can cause tiredness, changes in how you urinate (more often or less often), loss of appetite, nausea (feeling sick to the stomach), swelling in the hands or feet, itchiness or numbness, and trouble concentrating. DIAGNOSIS Your doctor will diagnose atherosclerosis based on your medical and family histories, a physical exam, and test results. Specialists Involved If you have atherosclerosis, a primary care doctor, such as an internist or family practitioner, may handle your care. Your doctor may recommend other health care specialists if you need expert care, such as: A cardiologist. This is a doctor who specializes in diagnosing and treating heart diseases and conditions. You may go to a cardiologist if you have peripheral artery disease (P.A.D.) or coronary microvascular disease (MVD). A vascular specialist. This is a doctor who specializes in diagnosing and treating blood vessel problems. You may go to a vascular specialist if you have P.A.D. A neurologist. This is a doctor who specializes in diagnosing and treating nervous system disorders. You may see a neurologist if you've had a stroke due to carotid artery disease. A nephrologist. This is a doctor who specializes in diagnosing and treating kidney diseases and conditions. You may go to a nephrologist if you have chronic kidney disease. Physical Exam During the physical exam, your doctor may listen to your arteries for an abnormal whooshing sound called a bruit (broo-E). Your doctor can hear a bruit when placing a stethoscope over an affected artery. A bruit may indicate poor blood flow due to plaque buildup. Your doctor also may check to see whether any of your pulses (for example, in the leg or foot) are weak or absent. A weak or absent pulse can be a sign of a blocked artery. Diagnostic Tests Your doctor may recommend one or more tests to diagnose atherosclerosis. These tests also can help your doctor learn the extent of your disease and plan the best treatment. Blood Tests Blood tests check the levels of certain fats, cholesterol, sugar, and proteins in your blood. Abnormal levels may be a sign that you're at risk for atherosclerosis. EKG (Electrocardiogram) An EKG is a simple, painless test that detects and records the heart's electrical activity. The test shows how fast the heart is beating and its rhythm (steady or irregular). An EKG also records the strength and timing of electrical signals as they pass through the heart. An EKG can show signs of heart damage caused by CHD. The test also can show signs of a previous or current heart attack. Chest X Ray A chest x ray takes pictures of the organs and structures inside your chest, such as your heart, lungs, and blood vessels. A chest x ray can reveal signs of heart failure. Ankle/Brachial Index This test compares the blood pressure in your ankle with the blood pressure in your arm to see how well your blood is flowing. This test can help diagnose P.A.D. Echocardiography Echocardiography (echo) uses sound waves to create a moving picture of your heart. The test provides information about the size and shape of your heart and how well your heart chambers and valves are working. Echo also can identify areas of poor blood flow to the heart, areas of heart muscle that aren't contracting normally, and previous injury to the heart muscle caused by poor blood flow. Computed Tomography Scan A computed tomography (CT) scan creates computer-generated pictures of the heart, brain, or other areas of the body. The test can show hardening and narrowing of large arteries. A cardiac CT scan also can show whether calcium has built up in the walls of the coronary (heart) arteries. This may be an early sign of CHD. Stress Testing During stress testing, you exercise to make your heart work hard and beat fast while heart tests are done. If you can't exercise, you may be given medicine to make your heart work hard and beat fast. When your heart is working hard, it needs more blood and oxygen. Plaque-narrowed arteries can't supply enough oxygen-rich blood to meet your heart's needs. A stress test can show possible signs and symptoms of CHD, such as: Abnormal changes in your heart rate or blood pressure Shortness of breath or chest pain Abnormal changes in your heart rhythm or your heart's electrical activity As part of some stress tests, pictures are taken of your heart while you exercise and while you rest. These imaging stress tests can show how well blood is flowing in various parts of your heart. They also can show how well your heart pumps blood when it beats. Angiography Angiography (an-jee-OG-ra-fee) is a test that uses dye and special x rays to show the inside of your arteries. This test can show whether plaque is blocking your arteries and how severe the blockage is. A thin, flexible tube called a catheter is put into a blood vessel in your arm, groin (upper thigh), or neck. Dye that can be seen on an x-ray picture is injected through the catheter into the arteries. By looking at the x-ray picture, your doctor can see the flow of blood through your arteries. Other Tests Other tests are being studied to see whether they can give a better view of plaque buildup in the arteries. Examples of these tests include magnetic resonance imaging (MRI) and positron emission tomography (PET). TREATMENTS Treatments for atherosclerosis may include heart-healthy lifestyle changes, medicines, and medical procedures or surgery. The goals of treatment include: Lowering the risk of blood clots forming Preventing atherosclerosis-related diseases Reducing risk factors in an effort to slow or stop the buildup of plaque Relieving symptoms Widening or bypassing plaque-clogged arteries Heart-Healthy Lifestyle Changes Your doctor may recommend heart-healthy lifestyle changes if you have atherosclerosis. Heart-healthy lifestyle changes include heart-healthy eating, maintaining a healthy weight, managing stress, physical activity and quitting smoking. Heart-Healthy Eating Your doctor may recommend heart-healthy eating, which should include: Fat-free or low-fat dairy products, such as skim milk Fish high in omega-3 fatty acids, such as salmon, tuna, and trout, about twice a week Fruits, such as apples, bananas, oranges, pears, and prunes Legumes, such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans Vegetables, such as broccoli, cabbage, and carrots Whole grains, such as oatmeal, brown rice, and corn tortillas When following a heart-healthy diet, you should avoid eating: A lot of red meat Palm and coconut oils Sugary foods and beverages Two nutrients in your diet make blood cholesterol levels rise: Saturated fat—found mostly in foods that come from animals Trans fat (trans fatty acids)—found in foods made with hydrogenated oils and fats, such as stick margarine; baked goods, such as cookies, cakes, and pies; crackers; frostings; and coffee creamers. Some trans fats also occur naturally in animal fats and meats. Saturated fat raises your blood cholesterol more than anything else in your diet. When you follow a heart-healthy eating plan, only 5 percent to 6 percent of your daily calories should come from saturated fat. Food labels list the amounts of saturated fat. To help you stay on track, here are some examples: 1,200 calories a day 8 grams of saturated fat a day 1,500 calories a day 10 grams of saturated fat a day 1,800 calories a day 12 grams of saturated fat a day 2,000 calories a day 13 grams of saturated fat a day 2,500 calories a day 17 grams of saturated fat a day Not all fats are bad. Monounsaturated and polyunsaturated fats actually help lower blood cholesterol levels. Some sources of monounsaturated and polyunsaturated fats are: Avocados Corn, sunflower, and soybean oils Nuts and seeds, such as walnuts Olive, canola, peanut, safflower, and sesame oils Peanut butter Salmon and trout Tofu Sodium You should try to limit the amount of sodium that you eat. This means choosing and preparing foods that are lower in salt and sodium. Try to use low-sodium and “no added salt” foods and seasonings at the table or while cooking. Food labels tell you what you need to know about choosing foods that are lower in sodium. Try to eat no more than 2,300 milligrams of sodium a day. If you have high blood pressure, you may need to restrict your sodium intake even more. Dietary Approaches to Stop Hypertension Your doctor may recommend the Dietary Approaches to Stop Hypertension (DASH) eating plan if you have high blood pressure. The DASH eating plan focuses on fruits, vegetables, whole grains, and other foods that are heart healthy and low in fat, cholesterol, and sodium and salt. The DASH eating plan is a good heart-healthy eating plan, even for those who don’t have high blood pressure. Read more about DASH. Alcohol Try to limit alcohol intake. Too much alcohol will raise your blood pressure and triglyceride levels, a type of fat found in the blood. Alcohol also adds extra calories, which may cause weight gain. Men should have no more than two drinks containing alcohol a day. Women should have no more than one drink containing alcohol a day. One drink is: 12 ounces of beer 5 ounces of wine 1½ ounces of liquor Maintaining a Healthy Weight Maintaining a healthy weight is important for overall health and can lower your risk for coronary heart disease. Aim for a Healthy Weight by following a heart-healthy eating plan and keeping physically active. Knowing your body mass index (BMI) helps you find out if you’re a healthy weight in relation to your height and gives an estimate of your total body fat. To figure out your BMI, check out the National Heart, Lung, and Blood Institute’s online BMI calculator or talk to your doctor. A BMI: Below 18.5 is a sign that you are underweight. Between 18.5 and 24.9 is in the normal range. Between 25.0 and 29.9 is considered overweight. A BMI of 30.0 or higher is considered obese. A general goal to aim for is a BMI of less than 25. Your doctor or health care provider can help you set an appropriate BMI goal. Measuring waist circumference helps screen for possible health risks. If most of your fat is around your waist rather than at your hips, you’re at a higher risk for heart disease and type 2 diabetes. This risk may be high with a waist size that is greater than 35 inches for women or greater than 40 inches for men. To learn how to measure your waist, visit Assessing Your Weight and Health Risk. For more information about losing weight or maintaining your weight, visit Aim for a Healthy Weight. If you’re overweight or obese, try to lose weight. A loss of just 3 percent to 5 percent of your current weight can lower your triglycerides, blood glucose, and the risk of developing type 2 diabetes. Greater amounts of weight loss can improve blood pressure readings, lower LDL cholesterol, and increase HDL cholesterol. Managing Stress Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health. Consider healthy stress-reducing activities, such as: A stress management program Meditation Physical activity Relaxation therapy Talking things out with friends or family Physical Activity Regular physical activity can lower many atherosclerosis risk factors, including LDL or “bad” cholesterol, high blood pressure, and excess weight. Physical activity also can lower your risk for diabetes and raise your HDL or “good” cholesterol, which helps prevent atherosclerosis. Everyone should try to participate in moderate-intensity aerobic exercise at least 2 hours and 30 minutes per week or vigorous aerobic exercise for 1 hour and 15 minutes per week. Aerobic exercise, such as brisk walking, is any exercise in which your heart beats faster and you use more oxygen than usual. The more active you are, the more you will benefit. Participate in aerobic exercise for at least 10 minutes at a time spread throughout the week. Talk with your doctor before you start a new exercise plan. Ask your doctor how much and what kinds of physical activity are safe for you. Read more about physical activity at: Physical Activity and Your Heart U.S. Department of Health and Human Services, 2008 Physical Activity Guidelines for Americans Quitting Smoking If you smoke or use tobacco, quit. Smoking can damage and tighten blood vessels and raise your risk for atherosclerosis. Talk with your doctor about programs and products that can help you quit. Also, try to avoid secondhand smoke. If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking. For more information about how to quit smoking, visit Smoking and Your Heart. Medicines Sometimes lifestyle changes alone aren’t enough to control your cholesterol levels. For example, you also may need statin medications to control or lower your cholesterol. By lowering your blood cholesterol level, you can decrease your chance of having a heart attack or stroke. Doctors usually prescribe statins for people who have: Coronary heart disease, peripheral artery disease, or had a prior stroke Diabetes High LDL cholesterol levels Doctors may discuss beginning statin treatment with people who have an elevated risk for developing heart disease or having a stroke. Your doctor also may prescribe other medications to: Lower your blood pressure Lower your blood sugar levels Prevent blood clots, which can lead to heart attack and stroke Prevent inflammation Take all medicines regularly, as your doctor prescribes. Don’t change the amount of your medicine or skip a dose unless your doctor tells you to. You should still follow a heart healthy lifestyle, even if you take medicines to treat your atherosclerosis. Medical Procedures and Surgery If you have severe atherosclerosis, your doctor may recommend a medical procedure or surgery. Percutaneous coronary intervention (PCI), also known as coronary angioplasty, is a procedure that’s used to open blocked or narrowed coronary (heart) arteries. PCI can improve blood flow to the heart and relieve chest pain. Sometimes a small mesh tube called a stent is placed in the artery to keep it open after the procedure. Coronary artery bypass grafting (CABG) is a type of surgery. In CABG, arteries or veins from other areas in your body are used to bypass or go around your narrowed coronary arteries. CABG can improve blood flow to your heart, relieve chest pain, and possibly prevent a heart attack. Bypass grafting also can be used for leg arteries. For this surgery, a healthy blood vessel is used to bypass a narrowed or blocked artery in one of the legs. The healthy blood vessel redirects blood around the blocked artery, improving blood flow to the leg. Carotid endarterectomy is a type of surgery to remove plaque buildup from the carotid arteries in the neck. This procedure restores blood flow to the brain, which can help prevent a stroke. PREVENTION Taking action to control your risk factors can help prevent or delay atherosclerosis and its related diseases. Your risk for atherosclerosis increases with the number of risk factors you have. One step you can take is to adopt a healthy lifestyle, which can include: Heart-Healthy Eating. Adopt heart-healthy eating habits, which include eating different fruits and vegetables (including beans and peas), whole grains, lean meats, poultry without skin, seafood, and fat-free or low-fat milk and dairy products. A heart-healthy diet is low in sodium, added sugar, solid fats, and refined grains. Following a heart-healthy diet is an important part of a healthy lifestyle. Physical Activity. Be as physically active as you can. Physical activity can improve your fitness level and your health. Ask your doctor what types and amounts of activity are safe for you. Read more about Physical Activity and Your Heart. Quit Smoking. If you smoke, quit. Smoking can damage and tighten blood vessels and raise your risk for atherosclerosis. Talk with your doctor about programs and products that can help you quit. Also, try to avoid secondhand smoke. Read more about Smoking and Your Heart. Weight Control. If you’re overweight or obese, work with your doctor to create a reasonable weight-loss plan. Controlling your weight helps you control risk factors for atherosclerosis. Other steps that can prevent or delay atherosclerosis include knowing your family history of atherosclerosis. If you or someone in your family has an atherosclerosis-related disease, be sure to tell your doctor. If lifestyle changes aren’t enough, your doctor may prescribe medicines to control your atherosclerosis risk factors. Take all of your medicines as your doctor advises. LIVING WITH Improved treatments have reduced the number of deaths from atherosclerosis-related diseases. These treatments also have improved the quality of life for people who have these diseases. Adopting a healthy lifestyle may help you prevent or delay atherosclerosis and the problems it can cause. This, along with ongoing medical care, can help you avoid the problems of atherosclerosis and live a long, healthy life. Researchers continue to look for ways to improve the health of people who have atherosclerosis or may develop it. Ongoing Care If you have atherosclerosis, work closely with your doctor and other health care providers to avoid serious problems, such as heart attack and stroke. Follow your treatment plan and take all of your medicines as your doctor prescribes. Your doctor will let you know how often you should schedule office visits or blood tests. Be sure to let your doctor know if you have new or worsening symptoms. Emotional Issues and Support Having an atherosclerosis-related disease may cause fear, anxiety, depression, and stress. Talk about how you feel with your doctor. Talking to a professional counselor also can help. If you're very depressed, your doctor may recommend medicines or other treatments that can improve your quality of life. Community resources are available to help you learn more about atherosclerosis. Contact your local public health departments, hospitals, and local chapters of national health organizations to learn more about available resources in your area. Talk about your lifestyle changes with your family and friends—whoever can provide support or needs to understand why you're changing your habits. Family and friends may be able to help you make lifestyle changes. For example, they can help you plan healthier meals. Because atherosclerosis tends to run in families, your lifestyle changes may help many of your family members too. ", "role": "user" }, { "content": "You can control most risk factors and help prevent or delay atherosclerosis. Other risk factors can't be controlled. Major Risk Factors Unhealthy blood cholesterol levels. This includes high LDL cholesterol (sometimes called \"bad\" cholesterol) and low HDL cholesterol (sometimes called \"good\" cholesterol). Smoking can damage and tighten blood vessels, raise cholesterol levels, and raise blood pressure. An unhealthy diet can raise your risk for atherosclerosis. Your risk for atherosclerosis increases if your father or a brother was diagnosed with heart disease before 55 years of age, or if your mother or a sister was diagnosed with heart disease before 65 years of age.", "role": "assistant" } ]

[ { "content": "how to prevent atherosclerosis\n\nAtherosclerosis (TREATMENTS): Treatments for atherosclerosis may include heart-healthy lifestyle changes, medicines, and medical procedures or surgery. The goals of treatment include: Lowering the risk of blood clots forming Preventing atherosclerosis-related diseases Reducing risk factors in an effort to slow or stop the buildup of plaque Relieving symptoms Widening or bypassing plaque-clogged arteries Heart-Healthy Lifestyle Changes Your doctor may recommend heart-healthy lifestyle changes if you have atherosclerosis. Heart-healthy lifestyle changes include heart-healthy eating, aiming for a healthy weight, managing stress, physical activity and quitting smoking. Medicines Sometimes lifestyle changes alone aren’t enough to control your cholesterol levels. For example, you also may need statin medications to control or lower your cholesterol. By lowering your blood cholesterol level, you can decrease your chance of having a heart attack or stroke. Doctors usually prescribe statins for people who have: Coronary heart disease, peripheral artery disease, or had a prior stroke Diabetes High LDL cholesterol levels Doctors may discuss beginning statin treatment with people who have an elevated risk for developing heart disease or having a stroke. Your doctor also may prescribe other medications to: Lower your blood pressure Lower your blood sugar levels Prevent blood clots, which can lead to heart attack and stroke Prevent inflammation Take all medicines regularly, as your doctor prescribes. Don’t change the amount of your medicine or skip a dose unless your doctor tells you to. You should still follow a heart healthy lifestyle, even if you take medicines to treat your atherosclerosis. Medical Procedures and Surgery If you have severe atherosclerosis, your doctor may recommend a medical procedure or surgery. Percutaneous coronary intervention (PCI), also known as coronary angioplasty, is a procedure that’s used to open blocked or narrowed coronary (heart) arteries. PCI can improve blood flow to the heart and relieve chest pain. Sometimes a small mesh tube called a stent is placed in the artery to keep it open after the procedure. Coronary artery bypass grafting (CABG) is a type of surgery. In CABG, arteries or veins from other areas in your body are used to bypass or go around your narrowed coronary arteries. CABG can improve blood flow to your heart, relieve chest pain, and possibly prevent a heart attack. Bypass grafting also can be used for leg arteries. For this surgery, a healthy blood vessel is used to bypass a narrowed or blocked artery in one of the legs. The healthy blood vessel redirects blood around the blocked artery, improving blood flow to the leg. Carotid endarterectomy is a type of surgery to remove plaque buildup from the carotid arteries in the neck. This procedure restores blood flow to the brain, which can help prevent a stroke.", "role": "user" }, { "content": "Treatments for atherosclerosis may include heart-healthy lifestyle changes, medicines, and medical procedures or surgery. The goals of treatment are to lower your risk of blood clots, preventing atherosclerosis-related diseases, reducing risk factors for plaque buildup, and widening or bypassing plaque-clogged arteries.", "role": "assistant" } ]

[ { "content": "prevention of preeclampsia I know that the jury is out on the exact causes of preeclampsia, but I am looking for some of the ways that the chances of acquiring it can be minimized.\n\nPreeclampsia (Prevention): There is no known way to prevent preeclampsia. It is important for all pregnant women to start prenatal care early and continue it through the pregnancy.", "role": "user" }, { "content": "There is no known way to prevent preeclampsia. It is important for all pregnant women to start prenatal care early and continue it through the pregnancy.", "role": "assistant" } ]

[ { "content": "what are pancreatic enzymes?\n\n Pancreatic Islet Transplantation What are pancreatic islets? Pancreatic islets, also called islets of Langerhans, are tiny clusters of cells scattered throughout the pancreas. The pancreas is an organ about the size of a hand located behind the lower part of the stomach.Pancreatic islets contain several types of cells, including beta cells, that produce the hormone insulin. The pancreas also makes enzymes that help the body digest and use food.Pancreatic islets contain several types of cells, including beta cells, that produce the hormone insulin.Pancreatic islets contain several types of cells, including beta cells, that produce the hormone insulin.Pancreatic islets contain several types of cells, including beta cells, that produce the hormone insulin.When the level of blood glucose, also called blood sugar, rises after a meal, the pancreas responds by releasing insulin into the bloodstream. Insulin helps cells throughout the body absorb glucose from the bloodstream and use it for energy.Diabetes develops when the pancreas does not make enough insulin, the body's cells do not use insulin effectively, or both. As a result, glucose builds up in the blood instead of being absorbed by cells in the body.In type 1 diabetes, the beta cells of the pancreas no longer make insulin because the body's immune system has attacked and destroyed them. The immune system protects people from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances. A person who has type 1 diabetes must take insulin daily to live. Type 2 diabetes usually begins with a condition called insulin resistance, in which the body has trouble using insulin effectively. Over time, insulin production declines as well, so many people with type 2 diabetes eventually need to take insulin. What is pancreatic islet transplantation? The two types of pancreatic islet transplantation areallo-transplantation auto-transplantationallo-transplantationauto-transplantationPancreatic islet allo-transplantation is a procedure in which islets from the pancreas of a deceased organ donor are purified, processed, and transferred into another person. Pancreatic islet allo-transplantation is currently labeled an experimental procedure until the transplantation technology is considered successful enough to be labeled therapeutic. For more information, see the section \"What are the obstacles to pancreatic islet allo-transplantation?\"Pancreatic islet allo-transplantation\"What are the obstacles to pancreatic islet allo-transplantation?\"For each pancreatic islet allo-transplant infusion, researchers use specialized enzymes to remove islets from the pancreas of a single, deceased donor. The islets are purified and counted in a lab. Transplant patients typically receive two infusions with an average of 400,000 to 500,000 islets per infusion. Once implanted, the beta cells in these islets begin to make and release insulin.Pancreatic islet allo-transplantation is performed in certain patients with type 1 diabetes whose blood glucose levels are difficult to control. The goals of the transplant are to help these patients achieve normal blood glucose levels with or without daily injections of insulin and to reduce or eliminate hypoglycemia unawareness—a dangerous condition in which a person with diabetes cannot feel the symptoms of hypoglycemia, or low blood glucose. When a person feels the symptoms of hypoglycemia, steps can be taken to bring blood glucose levels back to normal.Pancreatic islet allo-transplants are only performed at hospitals that have received permission from the U.S. Food and Drug Administration (FDA) for clinical research on islet transplantation. The transplants are often performed by a radiologist—a doctor who specializes in medical imaging. The radiologist uses x rays and ultrasound to guide the placement of a thin, flexible tube called a catheter through a small incision in the upper abdomen—the area between the chest and hips—and into the portal vein of the liver. The portal vein is the major vein that supplies blood to the liver. The islets are then infused, or pushed, slowly into the liver through the catheter. Usually, the patient receives a local anesthetic and a sedative. In some cases, a surgeon performs the transplant using general anesthesia.Patients often need two or more transplants to get enough functioning islets to stop or reduce their need for insulin injections.Pancreatic islet allo-transplantation (above). In islet auto-transplantation, the islets are extracted from the patient's own pancreas.Pancreatic islet allo-transplantation (above). In islet auto-transplantation, the islets are extracted from the patient's own pancreas.Pancreatic islet allo-transplantation (above). In islet auto-transplantation, the islets are extracted from the patient's own pancreas.Pancreatic islet auto-transplantation is performed following total pancreatectomy—the surgical removal of the whole pancreas—in patients with severe and chronic, or long lasting, pancreatitis that cannot be managed by other treatments. This procedure is not considered experimental. Patients with type 1 diabetes cannot receive pancreatic islet auto-transplantation. The procedure is performed in a hospital, and the patient receives general anesthesia. The surgeon first removes the pancreas and then extracts and purifies islets from the pancreas. Within hours, the islets are infused through a catheter into the patient's liver. The goal is to give the body enough healthy islets to make insulin.Pancreatic islet auto-transplantation What happens after pancreatic islet transplantation? Pancreatic islets begin to release insulin soon after transplantation. However, full islet function and new blood vessel growth from the new islets take time. Transplant recipients usually take insulin injections until the islets are fully functional. They may also receive various medications before and after transplantation to promote successful implantation and long-term functioning of the islets. However, the autoimmune response that destroyed transplant recipients' own islets in the first place can happen again and attack the transplanted islets. Although the liver has been the traditional site for infusing the donor islets, researchers are investigating alternative sites, such as muscle tissue or another organ. What are the benefits and risks of pancreatic islet allo-transplantation? The benefits of pancreatic islet allo-transplantation include improved blood glucose control, reducing or eliminating the need for insulin injections to control diabetes, and preventing hypoglycemia. An alternative to islet transplantation is whole organ pancreas transplantation that is performed most often with kidney transplantation. The advantages of whole organ pancreas transplantation are less dependence on insulin and longer duration of organ function. The main disadvantage is that a whole organ transplant is a major surgery that involves a greater risk of complications and even death.Pancreatic islet allo-transplantation can also help reverse hypoglycemia unawareness. Research has shown that even partial islet function after a transplant can eliminate hypoglycemia unawareness.Improved blood glucose control from a successful allo-transplant may also slow or prevent the progression of diabetes problems, such as heart disease, kidney disease, and nerve or eye damage. Research to evaluate this possibility is ongoing.The risks of pancreatic islet allo-transplantation include the risks associated with the transplant procedure—particularly bleeding and blood clots. The transplanted islets may not function well or may stop functioning entirely. Other risks are the side effects from the immunosuppressive medications that transplant recipients must take to stop the immune system from rejecting the transplanted islets. When a patient has received a kidney transplant and is already taking immunosuppressive medications, the only additional risks are the islet infusion and the side effects from the immunosuppressive medications given at the time of allo-transplantation. Immunosuppressive medications are not needed in the case of an auto-transplant because the infused cells come from the patient's own body. Read more in the section \"What is the role of immunosuppressive medications?\"\"What is the role of immunosuppressive medications?\"Collaborative Islet Transplant Registry Data In its 2010 annual report,1 the Collaborative Islet Transplant Registry presented data on 571 patients who received pancreatic islet allo-transplants between 1999 and 2009. Although most procedures were pancreatic islet allo-transplants alone, 90 procedures were done in conjunction with a kidney transplant. The majority of the islet transplant patients received one or two infusions of islets; at the end of the decade, the average number of islets received per infusion was 463,000. According to the report, about 60 percent of transplant recipients achieved insulin independence—defined as being able to stop insulin injections for at least 14 days—during the year following transplantation. By the end of the second year, 50 percent of recipients were able to stop taking insulin for at least 14 days. However, long-term insulin independence is difficult to maintain, and eventually most recipients needed to start taking insulin again. The report identified factors linked to better outcomes for recipients, including age—35 years or older lower pre-transplant triglyceride, or blood fat, levels lower pre-transplant insulin use The report noted that even partial function of the transplanted islets can improve blood glucose control and reduce the amount of insulin needed after loss of insulin independence. Collaborative Islet Transplant Registry Data In its 2010 annual report,1 the Collaborative Islet Transplant Registry presented data on 571 patients who received pancreatic islet allo-transplants between 1999 and 2009. Although most procedures were pancreatic islet allo-transplants alone, 90 procedures were done in conjunction with a kidney transplant. The majority of the islet transplant patients received one or two infusions of islets; at the end of the decade, the average number of islets received per infusion was 463,000.11According to the report, about 60 percent of transplant recipients achieved insulin independence—defined as being able to stop insulin injections for at least 14 days—during the year following transplantation.By the end of the second year, 50 percent of recipients were able to stop taking insulin for at least 14 days. However, long-term insulin independence is difficult to maintain, and eventually most recipients needed to start taking insulin again.The report identified factors linked to better outcomes for recipients, includingage—35 years or older lower pre-transplant triglyceride, or blood fat, levels lower pre-transplant insulin useage—35 years or olderlower pre-transplant triglyceride, or blood fat, levelslower pre-transplant insulin useThe report noted that even partial function of the transplanted islets can improve blood glucose control and reduce the amount of insulin needed after loss of insulin independence.1Collaborative Islet Transplant Registry seventh annual report. Collaborative Islet Transplant Registry website. https://web.emmes.com/study/isl//reports/01062012_7thAnnualReport.pdf (PDF, 8.2 MB) Updated December 30, 2011. Accessed July 23, 2013.1https://web.emmes.com/study/isl//reports/01062012_7thAnnualReport.pdf What is the role of immunosuppressive medications? Immunosuppressive medications are needed to prevent rejection—a common problem with any transplant.Scientists have made many advances in islet transplantation in recent years. In 2000, islet transplantation researchers at the University of Alberta in Edmonton, Canada, reported their findings in the New England Journal of Medicine. Their transplant protocol, known as the Edmonton protocol, has since been adapted by transplant centers around the world and continues to be refined.New England Journal of MedicineThe Edmonton protocol introduced the use of a new combination of immunosuppressive medications, also called anti-rejection medications, including daclizumab (Zenapax), sirolimus (Rapamune), and tacrolimus (Prograf). Researchers continue to develop and study modifications to the Edmonton protocol, including improved medication regimens that promote successful transplants. Medication regimens vary from one transplant center to another. Examples of other immunosuppressive medications used in islet transplantation include antithymocyte globulin (Thymoglobulin), alemtuzumab (Campath), basiliximab (Simulect), belatacept (Nulojix), etanercept (Enbrel), everolimus (Zortress), and mycophenolate mofetil (CellCept, Myfortic). Researchers are also evaluating nonimmunosuppresive medications, such as exenatide (Byetta) and sitagliptin (Januvia).Immunosuppressive medications have significant side effects, and their long-term effects are still not fully known. Immediate side effects may include mouth sores and gastrointestinal problems, such as upset stomach and diarrhea. Patients may also haveincreased blood cholesterol, or blood fat, levels high blood pressure anemia, a condition in which red blood cells are fewer or smaller than normal, which prevents the body's cells from getting enough oxygen fatigue decreased white blood cell counts decreased kidney function increased susceptibility to bacterial and viral infectionsincreased blood cholesterol, or blood fat, levelshigh blood pressureanemia, a condition in which red blood cells are fewer or smaller than normal, which prevents the body's cells from getting enough oxygenfatiguedecreased white blood cell countsdecreased kidney functionincreased susceptibility to bacterial and viral infectionsTaking immunosuppressive medications also increases the risk of developing certain tumors and cancers.Scientists are seeking ways to achieve immune tolerance of the transplanted islets, in which the patient's immune system no longer recognizes the islets as foreign. Immune tolerance would allow patients to maintain transplanted islets without long-term use of immunosuppressive medications. For example, one approach is to transplant islets encapsulated with a special coating, which may help to prevent rejection. What are the obstacles to pancreatic islet allo-transplantation? The shortage of islets from donors is a significant obstacle to widespread use of pancreatic islet allo-transplantation. According to the Organ Procurement and Transplantation Network, in 2011 there were about 8,000 deceased organ donors available in the United States.2 However, only 1,562 pancreases were recovered from donors in 2011.2 Also, many donated pancreases are not suitable for extracting islets for transplants because they do not meet the selection criteria, and islets are often damaged or destroyed during processing. Therefore, only a small number of islet transplants can be performed each year.2222Researchers are pursuing various approaches to solve this shortage of islets, such as transplanting islets from a single, donated pancreas, using only a portion of the pancreas from a living donor, or using islets from pigs. Researchers have transplanted pig islets into other animals, including monkeys, by encapsulating the islets with a special coating or by using medications to prevent rejection. Another approach is creating islets from other types of cells, such as stem cells. New technologies could then be employed to grow islets in the lab.Financial barriers also prevent the widespread use of islet allo-transplantation. Until the transplantation technology is considered successful enough to be labeled therapeutic rather than experimental, the costs of islet allo-transplants must be covered by research funds. Health insurance companies and Medicare generally do not cover experimental procedures. Federal law also does not allow health care providers or hospitals to charge patients or health insurance companies for research procedures. Some patient advocates and islet researchers feel that islet allo-transplantation is close to having a therapeutic label. The National Institutes of Health (NIH) currently supports studies that are working toward obtaining FDA licensure to reclassify islet allo-transplantation as therapeutic. In other countries, such as Canada and Scandinavia, islet allo-transplantation is no longer considered experimental and is an accepted therapy in certain patients.2National data. Organ Procurement and Transplantation Network website. https://optn.transplant.hrsa.gov/data/. Accessed July 23, 2013.2https://optn.transplant.hrsa.gov/data/ Eating, Diet, and Nutrition A person who receives a pancreatic islet transplant should follow a meal plan worked out with a health care provider and dietitian. Immunosuppressive medications taken after the transplant can cause changes in a person's body, such as weight gain. A healthy diet after the transplant is important to control weight gain, blood pressure, blood cholesterol, and blood glucose levels. Points to Remember Pancreatic islets, also called islets of Langerhans, are tiny clusters of cells scattered throughout the pancreas. Pancreatic islets contain several types of cells, including beta cells, that produce the hormone insulin. Insulin helps cells throughout the body absorb glucose from the bloodstream and use it for energy. Pancreatic islet allo-transplantation is a procedure in which islets from the pancreas of a deceased organ donor are purified, processed, and transferred into another person. Pancreatic islet allo-transplantation is performed in certain patients with type 1 diabetes whose blood glucose levels are difficult to control. The goals of the transplant are to help these patients achieve normal blood glucose levels with or without daily injections of insulin and to reduce or eliminate hypoglycemia unawareness. Pancreatic islet auto-transplantation is performed following total pancreatectomy in patients with severe and chronic pancreatitis that cannot be managed by other treatments. This procedure is not considered experimental. Patients with type 1 diabetes cannot receive pancreatic islet auto-transplantation. The shortage of islets from donors is a significant obstacle to widespread use of pancreatic islet allo-transplantation. Financial barriers also prevent the widespread use of islet allo-transplantation. Until the transplantation technology is considered successful enough to be labeled therapeutic rather than experimental, the costs of islet allo-transplants must be covered by research funds.Pancreatic islets, also called islets of Langerhans, are tiny clusters of cells scattered throughout the pancreas. Pancreatic islets contain several types of cells, including beta cells, that produce the hormone insulin. Insulin helps cells throughout the body absorb glucose from the bloodstream and use it for energy.Pancreatic islet allo-transplantation is a procedure in which islets from the pancreas of a deceased organ donor are purified, processed, and transferred into another person.Pancreatic islet allo-transplantation is performed in certain patients with type 1 diabetes whose blood glucose levels are difficult to control. The goals of the transplant are to help these patients achieve normal blood glucose levels with or without daily injections of insulin and to reduce or eliminate hypoglycemia unawareness.Pancreatic islet auto-transplantation is performed following total pancreatectomy in patients with severe and chronic pancreatitis that cannot be managed by other treatments. This procedure is not considered experimental. Patients with type 1 diabetes cannot receive pancreatic islet auto-transplantation.The shortage of islets from donors is a significant obstacle to widespread use of pancreatic islet allo-transplantation. Financial barriers also prevent the widespread use of islet allo-transplantation. Until the transplantation technology is considered successful enough to be labeled therapeutic rather than experimental, the costs of islet allo-transplants must be covered by research funds. Pancreatic Islet Transplantation The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.What are clinical trials, and are they right for you? Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.What are clinical trials, and are they right for you?Find out if clinical trials are right for youWhat clinical trials are open? Clinical trials that are currently open and are recruiting can be viewed at www.ClinicalTrials.gov.What clinical trials are open?www.ClinicalTrials.govWhat are pancreatic islets? Pancreatic islets, also called islets of Langerhans, are tiny clusters of cells scattered throughout the pancreas. The pancreas is an organ about the size of a hand located behind the lower part of the stomach. Pancreatic islets contain several types of cells, including beta cells, that produce the hormone insulin. The pancreas also makes enzymes that help the body digest and use food. Pancreatic islets contain several types of cells, including beta cells, that produce the hormone insulin. When the level of blood glucose, also called blood sugar, rises after a meal, the pancreas responds by releasing insulin into the bloodstream. Insulin helps cells throughout the body absorb glucose from the bloodstream and use it for energy. Diabetes develops when the pancreas does not make enough insulin, the body's cells do not use insulin effectively, or both. As a result, glucose builds up in the blood instead of being absorbed by cells in the body. In type 1 diabetes, the beta cells of the pancreas no longer make insulin because the body's immune system has attacked and destroyed them. The immune system protects people from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances. A person who has type 1 diabetes must take insulin daily to live. Type 2 diabetes usually begins with a condition called insulin resistance, in which the body has trouble using insulin effectively. Over time, insulin production declines as well, so many people with type 2 diabetes eventually need to take insulin. What is pancreatic islet transplantation? The two types of pancreatic islet transplantation are allo-transplantation auto-transplantation Pancreatic islet allo-transplantation is a procedure in which islets from the pancreas of a deceased organ donor are purified, processed, and transferred into another person. Pancreatic islet allo-transplantation is currently labeled an experimental procedure until the transplantation technology is considered successful enough to be labeled therapeutic. For more information, see the section \"What are the obstacles to pancreatic islet allo-transplantation?\" For each pancreatic islet allo-transplant infusion, researchers use specialized enzymes to remove islets from the pancreas of a single, deceased donor. The islets are purified and counted in a lab. Transplant patients typically receive two infusions with an average of 400,000 to 500,000 islets per infusion. Once implanted, the beta cells in these islets begin to make and release insulin. Pancreatic islet allo-transplantation is performed in certain patients with type 1 diabetes whose blood glucose levels are difficult to control. The goals of the transplant are to help these patients achieve normal blood glucose levels with or without daily injections of insulin and to reduce or eliminate hypoglycemia unawareness—a dangerous condition in which a person with diabetes cannot feel the symptoms of hypoglycemia, or low blood glucose. When a person feels the symptoms of hypoglycemia, steps can be taken to bring blood glucose levels back to normal. Pancreatic islet allo-transplants are only performed at hospitals that have received permission from the U.S. Food and Drug Administration (FDA) for clinical research on islet transplantation. The transplants are often performed by a radiologist—a doctor who specializes in medical imaging. The radiologist uses x rays and ultrasound to guide the placement of a thin, flexible tube called a catheter through a small incision in the upper abdomen—the area between the chest and hips—and into the portal vein of the liver. The portal vein is the major vein that supplies blood to the liver. The islets are then infused, or pushed, slowly into the liver through the catheter. Usually, the patient receives a local anesthetic and a sedative. In some cases, a surgeon performs the transplant using general anesthesia. Patients often need two or more transplants to get enough functioning islets to stop or reduce their need for insulin injections. Pancreatic islet allo-transplantation (above). In islet auto-transplantation, the islets are extracted from the patient's own pancreas. Pancreatic islet auto-transplantation is performed following total pancreatectomy—the surgical removal of the whole pancreas—in patients with severe and chronic, or long lasting, pancreatitis that cannot be managed by other treatments. This procedure is not considered experimental. Patients with type 1 diabetes cannot receive pancreatic islet auto-transplantation. The procedure is performed in a hospital, and the patient receives general anesthesia. The surgeon first removes the pancreas and then extracts and purifies islets from the pancreas. Within hours, the islets are infused through a catheter into the patient's liver. The goal is to give the body enough healthy islets to make insulin. What happens after pancreatic islet transplantation? Pancreatic islets begin to release insulin soon after transplantation. However, full islet function and new blood vessel growth from the new islets take time. Transplant recipients usually take insulin injections until the islets are fully functional. They may also receive various medications before and after transplantation to promote successful implantation and long-term functioning of the islets. However, the autoimmune response that destroyed transplant recipients' own islets in the first place can happen again and attack the transplanted islets. Although the liver has been the traditional site for infusing the donor islets, researchers are investigating alternative sites, such as muscle tissue or another organ. What are the benefits and risks of pancreatic islet allo-transplantation? The benefits of pancreatic islet allo-transplantation include improved blood glucose control, reducing or eliminating the need for insulin injections to control diabetes, and preventing hypoglycemia. An alternative to islet transplantation is whole organ pancreas transplantation that is performed most often with kidney transplantation. The advantages of whole organ pancreas transplantation are less dependence on insulin and longer duration of organ function. The main disadvantage is that a whole organ transplant is a major surgery that involves a greater risk of complications and even death. Pancreatic islet allo-transplantation can also help reverse hypoglycemia unawareness. Research has shown that even partial islet function after a transplant can eliminate hypoglycemia unawareness. Improved blood glucose control from a successful allo-transplant may also slow or prevent the progression of diabetes problems, such as heart disease, kidney disease, and nerve or eye damage. Research to evaluate this possibility is ongoing. The risks of pancreatic islet allo-transplantation include the risks associated with the transplant procedure—particularly bleeding and blood clots. The transplanted islets may not function well or may stop functioning entirely. Other risks are the side effects from the immunosuppressive medications that transplant recipients must take to stop the immune system from rejecting the transplanted islets. When a patient has received a kidney transplant and is already taking immunosuppressive medications, the only additional risks are the islet infusion and the side effects from the immunosuppressive medications given at the time of allo-transplantation. Immunosuppressive medications are not needed in the case of an auto-transplant because the infused cells come from the patient's own body. Read more in the section \"What is the role of immunosuppressive medications?\" Collaborative Islet Transplant Registry Data In its 2010 annual report,1 the Collaborative Islet Transplant Registry presented data on 571 patients who received pancreatic islet allo-transplants between 1999 and 2009. Although most procedures were pancreatic islet allo-transplants alone, 90 procedures were done in conjunction with a kidney transplant. The majority of the islet transplant patients received one or two infusions of islets; at the end of the decade, the average number of islets received per infusion was 463,000. According to the report, about 60 percent of transplant recipients achieved insulin independence—defined as being able to stop insulin injections for at least 14 days—during the year following transplantation. By the end of the second year, 50 percent of recipients were able to stop taking insulin for at least 14 days. However, long-term insulin independence is difficult to maintain, and eventually most recipients needed to start taking insulin again. The report identified factors linked to better outcomes for recipients, including age—35 years or older lower pre-transplant triglyceride, or blood fat, levels lower pre-transplant insulin use The report noted that even partial function of the transplanted islets can improve blood glucose control and reduce the amount of insulin needed after loss of insulin independence. 1Collaborative Islet Transplant Registry seventh annual report. Collaborative Islet Transplant Registry website. https://web.emmes.com/study/isl//reports/01062012_7thAnnualReport.pdf (PDF, 8.2 MB) Updated December 30, 2011. Accessed July 23, 2013. What is the role of immunosuppressive medications? Immunosuppressive medications are needed to prevent rejection—a common problem with any transplant. Scientists have made many advances in islet transplantation in recent years. In 2000, islet transplantation researchers at the University of Alberta in Edmonton, Canada, reported their findings in the New England Journal of Medicine. Their transplant protocol, known as the Edmonton protocol, has since been adapted by transplant centers around the world and continues to be refined. The Edmonton protocol introduced the use of a new combination of immunosuppressive medications, also called anti-rejection medications, including daclizumab (Zenapax), sirolimus (Rapamune), and tacrolimus (Prograf). Researchers continue to develop and study modifications to the Edmonton protocol, including improved medication regimens that promote successful transplants. Medication regimens vary from one transplant center to another. Examples of other immunosuppressive medications used in islet transplantation include antithymocyte globulin (Thymoglobulin), alemtuzumab (Campath), basiliximab (Simulect), belatacept (Nulojix), etanercept (Enbrel), everolimus (Zortress), and mycophenolate mofetil (CellCept, Myfortic). Researchers are also evaluating nonimmunosuppresive medications, such as exenatide (Byetta) and sitagliptin (Januvia). Immunosuppressive medications have significant side effects, and their long-term effects are still not fully known. Immediate side effects may include mouth sores and gastrointestinal problems, such as upset stomach and diarrhea. Patients may also have increased blood cholesterol, or blood fat, levels high blood pressure anemia, a condition in which red blood cells are fewer or smaller than normal, which prevents the body's cells from getting enough oxygen fatigue decreased white blood cell counts decreased kidney function increased susceptibility to bacterial and viral infections Taking immunosuppressive medications also increases the risk of developing certain tumors and cancers. Scientists are seeking ways to achieve immune tolerance of the transplanted islets, in which the patient's immune system no longer recognizes the islets as foreign. Immune tolerance would allow patients to maintain transplanted islets without long-term use of immunosuppressive medications. For example, one approach is to transplant islets encapsulated with a special coating, which may help to prevent rejection. What are the obstacles to pancreatic islet allo-transplantation? The shortage of islets from donors is a significant obstacle to widespread use of pancreatic islet allo-transplantation. According to the Organ Procurement and Transplantation Network, in 2011 there were about 8,000 deceased organ donors available in the United States.2 However, only 1,562 pancreases were recovered from donors in 2011.2 Also, many donated pancreases are not suitable for extracting islets for transplants because they do not meet the selection criteria, and islets are often damaged or destroyed during processing. Therefore, only a small number of islet transplants can be performed each year. Researchers are pursuing various approaches to solve this shortage of islets, such as transplanting islets from a single, donated pancreas, using only a portion of the pancreas from a living donor, or using islets from pigs. Researchers have transplanted pig islets into other animals, including monkeys, by encapsulating the islets with a special coating or by using medications to prevent rejection. Another approach is creating islets from other types of cells, such as stem cells. New technologies could then be employed to grow islets in the lab. Financial barriers also prevent the widespread use of islet allo-transplantation. Until the transplantation technology is considered successful enough to be labeled therapeutic rather than experimental, the costs of islet allo-transplants must be covered by research funds. Health insurance companies and Medicare generally do not cover experimental procedures. Federal law also does not allow health care providers or hospitals to charge patients or health insurance companies for research procedures. Some patient advocates and islet researchers feel that islet allo-transplantation is close to having a therapeutic label. The National Institutes of Health (NIH) currently supports studies that are working toward obtaining FDA licensure to reclassify islet allo-transplantation as therapeutic. In other countries, such as Canada and Scandinavia, islet allo-transplantation is no longer considered experimental and is an accepted therapy in certain patients. 2National data. Organ Procurement and Transplantation Network website. https://optn.transplant.hrsa.gov/data/. Accessed July 23, 2013. Eating, Diet, and Nutrition A person who receives a pancreatic islet transplant should follow a meal plan worked out with a health care provider and dietitian. Immunosuppressive medications taken after the transplant can cause changes in a person's body, such as weight gain. A healthy diet after the transplant is important to control weight gain, blood pressure, blood cholesterol, and blood glucose levels. Points to Remember Pancreatic islets, also called islets of Langerhans, are tiny clusters of cells scattered throughout the pancreas. Pancreatic islets contain several types of cells, including beta cells, that produce the hormone insulin. Insulin helps cells throughout the body absorb glucose from the bloodstream and use it for energy. Pancreatic islet allo-transplantation is a procedure in which islets from the pancreas of a deceased organ donor are purified, processed, and transferred into another person. Pancreatic islet allo-transplantation is performed in certain patients with type 1 diabetes whose blood glucose levels are difficult to control. The goals of the transplant are to help these patients achieve normal blood glucose levels with or without daily injections of insulin and to reduce or eliminate hypoglycemia unawareness. Pancreatic islet auto-transplantation is performed following total pancreatectomy in patients with severe and chronic pancreatitis that cannot be managed by other treatments. This procedure is not considered experimental. Patients with type 1 diabetes cannot receive pancreatic islet auto-transplantation. The shortage of islets from donors is a significant obstacle to widespread use of pancreatic islet allo-transplantation. Financial barriers also prevent the widespread use of islet allo-transplantation. Until the transplantation technology is considered successful enough to be labeled therapeutic rather than experimental, the costs of islet allo-transplants must be covered by research funds. Clinical Trials The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions. What are clinical trials, and are they right for you? Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you. What clinical trials are open? Clinical trials that are currently open and are recruiting can be viewed at www.ClinicalTrials.gov. ", "role": "user" }, { "content": "The pancreas also makes enzymes that help the body digest and use food.", "role": "assistant" } ]

[ { "content": "what are the risk factors of type ii diabetes\n\nWho is at risk for Diabetes??: Diabetes is a serious, life-long disease. It can lead to problems such as heart disease, stroke, vision loss, kidney disease, and nerve damage. More than 8 million people in the United States have type 2 diabetes and dont know it. Many people dont find out they have diabetes until they are faced with problems such as blurry vision or heart trouble. Certain factors can increase your risk for diabetes, and its important to know what they are. Type 1 Diabetes Type 1 diabetes is an autoimmune disease. In an autoimmune reaction, antibodies, or immune cells, attach to the bodys own healthy tissues by mistake, signaling the body to attack them. At present, scientists do not know exactly what causes the body's immune system to attack the cells, but many believe that both genetic factors and environmental factors, such as viruses, are involved. Studies are now underway to identify these factors and prevent type 1 diabetes in people at risk. Learn more about the causes of type 1 diabetes. Type 2 Diabetes Type 2 diabetes -- the most common form -- is linked closely to overweight and obesity, high blood pressure, and abnormal cholesterol levels. Many people with type 2 diabetes are overweight. Being overweight can keep your body from using insulin properly. Genes also play an important role in a person's risk for type 2 diabetes. Having certain genes or combinations of genes may increase or decrease a persons risk for developing the disease. Here are the risk factors for type 2 diabetes. - being over 45 years of age - being overweight or obese - having a first-degree relative -- a parent, brother, or sister -- with diabetes - being African American, American Indian or Alaska Native, Asian American or Pacific Islander, or Hispanic American/Latino. (Watch the video to learn more about native Americans and diabetes risk. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) being over 45 years of age being overweight or obese having a first-degree relative -- a parent, brother, or sister -- with diabetes being African American, American Indian or Alaska Native, Asian American or Pacific Islander, or Hispanic American/Latino. (Watch the video to learn more about native Americans and diabetes risk. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) - having gestational diabetes, or giving birth to at least one baby weighing more than 9 pounds - having blood pressure of 140/90 or higher, or having been told that you have high blood pressure. - having abnormal cholesterol levels -- an HDL cholesterol level of 35 or lower, or a triglyceride level of 250 or higher - being inactive or exercising fewer than three times a week. - having polycystic ovary syndrome, also called PCOS (women only) - on previous testing, having prediabetes (an A1C level of 5.7 to 6.4 percent), impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) - history of cardiovascular disease (disease affecting the heart and blood vessels). having gestational diabetes, or giving birth to at least one baby weighing more than 9 pounds having blood pressure of 140/90 or higher, or having been told that you have high blood pressure. having abnormal cholesterol levels -- an HDL cholesterol level of 35 or lower, or a triglyceride level of 250 or higher being inactive or exercising fewer than three times a week. having polycystic ovary syndrome, also called PCOS (women only) on previous testing, having prediabetes (an A1C level of 5.7 to 6.4 percent), impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) history of cardiovascular disease (disease affecting the heart and blood vessels). Learn more about the causes of type 2 diabetes. Prediabetes and Type 2 Diabetes Before people develop type 2 diabetes, they usually have prediabetes -- a condition in which blood glucose levels are higher than normal, but not high enough for a diagnosis of diabetes. People with prediabetes are more likely to develop diabetes within 10 years and also are more likely to have a heart attack or stroke. Prediabetes is increasingly common in the U.S. adult population. In 2012, about 86 million people in the U.S. had pre-diabetes, and 51% of those 65 or older had prediabetes. Learn more about prediabetes. Gestational Diabetes Some women develop diabetes during the late stages of pregnancy. This is called gestational diabetes. Although this form of diabetes usually goes away after the baby is born, a woman who has had it has a lifelong risk for developing diabetes, mostly type 2.", "role": "user" }, { "content": "Certain factors can increase your risk for diabetes, and its important to know what they are. Type 1 Diabetes Type 1 diabetes is an autoimmune disease. In an autoimmune reaction, antibodies, or immune cells, attach to the bodys own healthy tissues by mistake, signaling the body to attack them. At present, scientists do not know exactly what causes the body's immune system to attack the cells, but many believe that both genetic factors and environmental factors, such as viruses, are involved. Studies are now underway to identify these factors and prevent type 1 diabetes in people at risk. Learn more about the causes of type 1 diabetes. Type 2 Diabetes Type 2 diabetes -- the most common form -- is linked closely to overweight and obesity, high blood pressure, and abnormal cholesterol levels. Many people with type 2 diabetes are overweight. Being overweight can keep your body from using insulin properly. Genes also play an important role in a person's risk for type 2 diabetes. Having certain genes or combinations of genes may increase or decrease a persons risk for developing the disease. Here are the risk factors for type 2 diabetes. - being over 45 years of age - being overweight or obese - having a first-degree relative -- a parent, brother, or sister -- with diabetes - being African American, American Indian or Alaska Native, Asian American or Pacific Islander, or Hispanic American/Latino. - having gestational diabetes, or giving birth to at least one baby weighing more than 9 pounds - having blood pressure of 140/90 or higher, or having been told that you have high blood pressure. - having abnormal cholesterol levels --", "role": "assistant" } ]

[ { "content": "how is generalized anxiety disorder diagnosed\n\nGeneralized anxiety disorder (Exams and Tests): There is no test that can make a diagnosis of GAD. The diagnosis is based on your answers to questions about the symptoms of GAD. Your health care provider will ask about these symptoms. You will also be asked about other aspects of your mental and physical health. A physical exam or lab tests may be done to rule out other conditions that cause similar symptoms.", "role": "user" }, { "content": "There is no test that can make a diagnosis of GAD. The diagnosis is based on your answers to questions about the symptoms of GAD. Your health care provider will ask about these symptoms. You will also be asked about other aspects of your mental and physical health. A physical exam or lab tests may be done to rule out other conditions that cause similar symptoms.", "role": "assistant" } ]

[ { "content": "how do you test for cholesterol level in your body\n\n High cholesterol Overview Cholesterol is a waxy substance that's found in the fats (lipids) in your blood. While your body needs cholesterol to continue building healthy cells, having high cholesterol can increase your risk of heart disease. When you have high cholesterol, you may develop fatty deposits in your blood vessels. Eventually, these deposits make it difficult for enough blood to flow through your arteries. Your heart may not get as much oxygen-rich blood as it needs, which increases the risk of a heart attack. Decreased blood flow to your brain can cause a stroke. High cholesterol can be inherited, but it's often the result of unhealthy lifestyle choices, and thus preventable and treatable. A healthy diet, regular exercise and sometimes medication can go a long way toward reducing high cholesterol. Symptoms High cholesterol has no symptoms. A blood test is the only way to detect high cholesterol. When to see a doctor Ask your doctor if you should have a cholesterol test. Recommendations for the age of first screening vary. Retesting is usually performed every five years. If your test results aren't within desirable ranges, your doctor may recommend more frequent measurements. Your doctor may also suggest you have more frequent tests if you have a family history of high cholesterol, heart disease or other risk factors, such as smoking, diabetes or high blood pressure. Causes Cholesterol is carried through your blood, attached to proteins. This combination of proteins and cholesterol is called a lipoprotein. You may have heard of different types of cholesterol, based on what type of cholesterol the lipoprotein carries. They are: - Low-density lipoprotein (LDL). LDL, or \"bad,\" cholesterol transports cholesterol particles throughout your body. LDL cholesterol builds up in the walls of your arteries, making them hard and narrow. - High-density lipoprotein (HDL). HDL, or \"good,\" cholesterol picks up excess cholesterol and takes it back to your liver. Factors within your control - such as inactivity, obesity and an unhealthy diet - contribute to high LDL cholesterol and low HDL cholesterol. Factors beyond your control may play a role, too. For example, your genetic makeup may keep cells from removing LDL cholesterol from your blood efficiently or cause your liver to produce too much cholesterol. Risk factors Factors that may increase your risk of high cholesterol include: - Poor diet. Eating saturated fat, found in animal products, and trans fats, found in some commercially baked cookies and crackers, can raise your cholesterol level. Foods that are high in cholesterol, such as red meat and full-fat dairy products, will also increase your total cholesterol. - Obesity. Having a body mass index (BMI) of 30 or greater puts you at risk of high cholesterol. - Large waist circumference. Your risk increases if you are a man with a waist circumference of at least 40 inches (102 centimeters) or a woman with a waist circumference of at least 35 inches (89 centimeters). - Lack of exercise. Exercise helps boost your body's HDL, or \"good,\" cholesterol while increasing the size of the particles that make up your LDL, or \"bad,\" cholesterol, which makes it less harmful. - Smoking. Cigarette smoking damages the walls of your blood vessels, making them likely to accumulate fatty deposits. Smoking may also lower your level of HDL, or \"good,\" cholesterol. - Diabetes. High blood sugar contributes to higher LDL cholesterol and lower HDL cholesterol. High blood sugar also damages the lining of your arteries. Complications High cholesterol can cause atherosclerosis, a dangerous accumulation of cholesterol and other deposits on the walls of your arteries. These deposits (plaques) can reduce blood flow through your arteries, which can cause complications, such as: - Chest pain. If the arteries that supply your heart with blood (coronary arteries) are affected, you may have chest pain (angina) and other symptoms of coronary artery disease. - Heart attack. If plaques tear or rupture, a blood clot may form at the plaque-rupture site - blocking the flow of blood or breaking free and plugging an artery downstream. If blood flow to part of your heart stops, you'll have a heart attack. - Stroke. Similar to a heart attack, if blood flow to part of your brain is blocked by a blood clot, a stroke occurs. Diagnosis A blood test to check cholesterol levels - called a lipid panel or lipid profile - typically reports: - Total cholesterol - LDL cholesterol - HDL cholesterol - Triglycerides - a type of fat in the blood For the most accurate measurements, don't eat or drink anything (other than water) for nine to 12 hours before the blood sample is taken. Interpreting the numbers In the United States, cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood. In Canada and many European countries, cholesterol levels are measured in millimoles per liter (mmol/L). To interpret your test results, use these general guidelines. Children and cholesterol testing For most children, the National Heart, Lung, and Blood Institute recommends one cholesterol screening test between the ages of 9 and 11, and another cholesterol screening test between the ages of 17 and 21. Cholesterol testing is usually avoided between the ages of 12 and 16 because false-negative results are more likely within this age group. If your child has a family history of early-onset heart disease or a personal history of obesity or diabetes, your doctor may recommend earlier or more frequent cholesterol testing. Treatment Lifestyle changes such as exercising and eating a healthy diet are the first line of defense against high cholesterol. But, if you've made these important lifestyle changes and your cholesterol levels remain high, your doctor may recommend medication. The specific choice of medication or combination of medications depends on various factors, including your individual risk factors, your age, your current health and possible side effects. Common choices include: - Statins. Statins block a substance your liver needs to make cholesterol. This causes your liver to remove cholesterol from your blood. Statins may also help your body reabsorb cholesterol from built-up deposits on your artery walls, potentially reversing coronary artery disease. Choices include atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Altoprev), pitavastatin (Livalo), pravastatin (Pravachol), rosuvastatin (Crestor) and simvastatin (Zocor). - Bile-acid-binding resins. Your liver uses cholesterol to make bile acids, a substance needed for digestion. The medications cholestyramine (Prevalite), colesevelam (Welchol) and colestipol (Colestid) lower cholesterol indirectly by binding to bile acids. This prompts your liver to use excess cholesterol to make more bile acids, which reduces the level of cholesterol in your blood. - Cholesterol absorption inhibitors. Your small intestine absorbs the cholesterol from your diet and releases it into your bloodstream. The drug ezetimibe (Zetia) helps reduce blood cholesterol by limiting the absorption of dietary cholesterol. Ezetimibe can be used in combination with a statin drug. - Injectable medications. A new class of drugs can help the liver absorb more LDL cholesterol - which lowers the amount of cholesterol circulating in your blood. Alirocumab (Praluent) and evolocumab (Repatha) may be used for people who have a genetic condition that causes very high levels of LDL or in people with a history of coronary disease who have intolerance to statins or other cholesterol medications. Medications for high triglycerides If you also have high triglycerides, your doctor may prescribe: - Fibrates. The medications fenofibrate (TriCor, Fenoglide, others) and gemfibrozil (Lopid) decrease triglycerides by reducing your liver's production of very-low-density lipoprotein (VLDL) cholesterol and by speeding up the removal of triglycerides from your blood. VLDL cholesterol contains mostly triglycerides. - Niacin. Niacin decreases triglycerides by limiting your liver's ability to produce LDL and VLDL cholesterol. But niacin doesn't provide any additional benefit than using statins alone. Niacin has also been linked to liver damage and stroke, so most doctors now recommend it only for people who can't take statins. - Omega-3 fatty acid supplements. Omega-3 fatty acid supplements can help lower your triglycerides. They are available by prescription or over-the-counter. If you choose to take over-the-counter supplements, get your doctor's OK first. Omega-3 fatty acid supplements could affect other medications you're taking. Tolerance varies Tolerance of medications varies from person to person. The common side effects are muscle pains, stomach pain, constipation, nausea and diarrhea. If you decide to take cholesterol medication, your doctor may recommend liver function tests to monitor the medication's effect on your liver. Children and cholesterol treatment Diet and exercise are the best initial treatment for children age 2 and older who have high cholesterol or who are obese. Children age 10 and older might be prescribed cholesterol-lowering drugs, such as statins, if they have extremely high cholesterol levels. Lifestyle and home remedies Lifestyle changes are essential to improve your cholesterol level. To bring your numbers down, lose excess weight, eat healthy foods and increase your physical activity. If you smoke, quit. Eat heart-healthy foods What you eat has a direct impact on your cholesterol level. - Choose healthier fats. Saturated fat and trans fat raise your total cholesterol and LDL cholesterol. The most common sources of saturated fat in the diet are red meat, processed meats and dairy products that are not fat-free. Monounsaturated fat - found in olive and canola oils - is a healthier option. Avocados, almonds, pecans and walnuts are other sources of healthy fat. - Avoid trans fats. Trans fats, which are often found in margarines and commercially baked cookies, crackers and snack cakes, are particularly bad for your cholesterol levels. Not only do trans fats increase your total LDL (\"bad\") cholesterol, but they also lower your HDL (\"good\") cholesterol. Foods listing \"partially hydrogenated oils\" in the ingredients contain trans fats. - Limit your dietary cholesterol. The most concentrated sources of cholesterol include organ meats, egg yolks and whole milk products. Use lean cuts of meat and skim milk instead. Limit the intake of eggs to no more than 7 a week. - Select whole grains. Various nutrients found in whole grains promote heart health. Choose whole-grain breads, whole-wheat pasta, whole-wheat flour and brown rice. Oatmeal and oat bran are other good choices. - Stock up on fruits and vegetables. Fruits and vegetables are rich in dietary fiber, which can help lower cholesterol. Snack on seasonal fruits. Experiment with vegetable-based casseroles, soups and stir-fries. - Eat heart-healthy fish. Some types of fish - such as cod, tuna and halibut - have less total fat, saturated fat and cholesterol than do meat and poultry. Salmon, mackerel and herring are rich in omega-3 fatty acids, which help promote heart health. - Drink alcohol only in moderation. Moderate use of alcohol may increase your levels of HDL cholesterol - but the benefits aren't strong enough to recommend alcohol for anyone who doesn't drink already. If you choose to drink, do so in moderation. This means no more than one drink a day for women and one to two drinks a day for men. Lose extra pounds Excess weight contributes to high cholesterol. Losing even 5 to 10 pounds can help lower total cholesterol levels. Start by taking an honest look at your eating habits and daily routine. Consider your challenges to weight loss - and ways to overcome them. Set long-term, sustainable goals. Exercise regularly Regular exercise can help improve your cholesterol levels. With your doctor's OK, work up to 30 to 60 minutes of exercise a day. Take a brisk daily walk. Ride your bike. Swim laps. To maintain your motivation, keep it fun. Find an exercise buddy or join an exercise group. And you don't need to get all 30 to 60 minutes in one exercise session. If you can squeeze in three to six 10-minute intervals of exercise, you'll still get some benefits. If you are not doing any exercise at all right now, try even 15 minutes of exercise a day several days of the week. Some exercise is much better than no exercise. Don't smoke If you smoke, stop. Cigarette smoking increases your risk of heart disease because it damages your blood vessels and speeds up the accumulation of plaque within arteries. Alternative medicine Few natural products have been proven to reduce cholesterol, but some might be helpful. With your doctor's OK, consider these cholesterol-lowering supplements and products: - Barley - Beta-sitosterol (found in oral supplements and some margarines, such as Promise Activ) - Blond psyllium (found in seed husk and products such as Metamucil) - Oat bran (found in oatmeal and whole oats) - Sitostanol (found in oral supplements and some margarines, such as Benecol) Some red yeast rice products contain monacolin K, which is chemically identical to the prescription drug lovastatin. The FDA has prohibited the sale of these products, since there's no way to determine the quantity or quality of the active ingredient. If you choose to take cholesterol-lowering supplements, remember the importance of a healthy lifestyle. If your doctor prescribes medication to reduce your cholesterol, take it as directed. Make sure your doctor knows which supplements you're taking as well. ", "role": "user" }, { "content": "A blood test to check cholesterol levels - called a lipid panel or lipid profile - typically reports: - Total cholesterol - LDL cholesterol - HDL cholesterol - Triglycerides - a type of fat in the blood For the most accurate measurements, don't eat or drink anything (other than water) for nine to 12 hours before the blood sample is taken.", "role": "assistant" } ]

[ { "content": "what is the cause of the coffin lowry syndrome?\n\n Coffin-Lowry syndrome CLS Mental retardation with osteocartilaginous abnormalities Description Coffin-Lowry syndrome is a condition that affects many parts of the body. The signs and symptoms are usually more severe in males than in females, although the features of this disorder range from very mild to severe in affected women. Males with Coffin-Lowry syndrome typically have severe to profound intellectual disability and delayed development. Affected women may be cognitively normal, or they may have intellectual disability ranging from mild to profound. Beginning in childhood or adolescence, some people with this condition experience brief episodes of collapse when excited or startled by a loud noise. These attacks are called stimulus-induced drop episodes (SIDEs). Most affected males and some affected females have distinctive facial features including a prominent forehead, widely spaced and downward-slanting eyes, a short nose with a wide tip, and a wide mouth with full lips. These features become more pronounced with age. Soft hands with short, tapered fingers are also characteristic of Coffin-Lowry syndrome. Additional features of this condition include short stature, an unusually small head (microcephaly), progressive abnormal curvature of the spine (kyphoscoliosis), and other skeletal abnormalities. Frequency The incidence of this condition is uncertain, but researchers estimate that the disorder affects 1 in 40,000 to 50,000 people. Causes Mutations in the RPS6KA3 gene cause Coffin-Lowry syndrome. This gene provides instructions for making a protein that is involved in signaling within cells. Researchers believe that this protein helps control the activity of other genes and plays an important role in the brain. The protein is involved in cell signaling pathways that are required for learning, the formation of long-term memories, and the survival of nerve cells. Gene mutations result in the production of little or no RPS6KA3 protein, but it is unclear how a lack of this protein causes the signs and symptoms of Coffin-Lowry syndrome. Some people with the features of Coffin-Lowry syndrome do not have identified mutations in the RPS6KA3 gene. In these cases, the cause of the condition is unknown. Inheritance Pattern This condition is inherited in an X-linked dominant pattern. A condition is considered X-linked if the mutated gene that causes the disorder is located on the X chromosome, one of the two sex chromosomes. The inheritance is dominant if one copy of the altered gene in each cell is sufficient to cause the condition. In most cases, males (who have one X chromosome in each cell) experience more severe signs and symptoms of the disorder than females (who have two X chromosomes in each cell). A characteristic of X-linked inheritance is that fathers cannot pass X-linked traits to their sons. Between 70 percent and 80 percent of people with Coffin-Lowry syndrome have no history of the condition in their families. These cases are caused by new mutations in the RPS6KA3 gene. The remaining 20 percent to 30 percent of affected individuals have other family members with Coffin-Lowry syndrome. Sources for This Page Hanauer A, Young ID. Coffin-Lowry syndrome: clinical and molecular features. J Med Genet. 2002 Oct;39(10):705-13. Review. ", "role": "user" }, { "content": "Mutations in the RPS6KA3 gene cause Coffin-Lowry syndrome. This gene provides instructions for making a protein that is involved in signaling within cells. Gene mutations result in the production of little or no RPS6KA3 protein, but it is unclear how a lack of this protein causes the signs and symptoms of Coffin-Lowry syndrome. Some people with the features of Coffin-Lowry syndrome do not have identified mutations in the RPS6KA3 gene. In these cases, the cause of the condition is unknown.", "role": "assistant" } ]

[ { "content": "how is edward's syndrome diagnosed\n\nTrisomy 18: Trisomy 18 is a genetic disorder in which a person has a third copy of material from chromosome 18, instead of the usual 2 copies. Trisomy 18 occurs in 1 in 6,000 live births. It is 3 times more common in girls than boys. The syndrome occurs when there is extra material from chromosome 18. The extra material affects normal development. Symptoms may include: - Clenched hands - Crossed legs - Feet with a rounded bottom (rocker-bottom feet) - Low birth weight - Low-set ears - Mental delay - Poorly developed fingernails - Small head (microcephaly) - Small jaw (micrognathia) - Undescended testicle - Unusual shaped chest (pectus carinatum) An exam during pregnancy may show an unusually large uterus and extra amniotic fluid. There may be an unusually small placenta when the baby is born. A physical exam of the infant may show unusual fingerprint patterns. X-rays may show a short breast bone. Chromosome studies will show trisomy 18. The chromosome abnormality may be present in every cell or present in only a certain percentage of the cells (called mosaicism). Studies may also show part of the chromosome in some cells. Rarely, part of the chromosome 18 becomes attached to another chromosome. This is called translocation. Other signs include: - Hole, split, or cleft in the iris of the eye (coloboma) - Separation between the left and right side of the abdominal muscle (diastasis recti) - Umbilical hernia or inguinal hernia There are often signs of congenital heart disease, such as: - Atrial septal defect (ASD) - Patent ductus arteriosus (PDA) - Ventricular septal defect (VSD) Tests may also show kidney problems, including: - Horseshoe kidney - Hydronephrosis - Polycystic kidney There are no specific treatments for trisomy 18. Which treatments are used depend on the person's individual condition. Support groups include: - Support Organization for Trisomy 18, 13 and Related Disorders (SOFT): trisomy.org - Trisomy 18 Foundation: www.trisomy18.org - Hope for Trisomy 13 and 18: www.hopefortrisomy13and18.org Half of infants with this condition do not survive beyond the first week of life. Nine out of 10 children will die by 1 year of age. Some children have survived to the teenage years, but with serious medical and developmental problems. Complications depend on the specific defects and symptoms. Genetic counseling can help families understand the condition, the risks of inheriting it, and how to care for the person. Tests can be done during pregnancy to find out if the child has this syndrome. Genetic testing is recommended for parents who have a child with this syndrome and who want to have more children. Updated by: Chad Haldeman-Englert, MD, FACMG, Fullerton Genetics Center, Asheville, NC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.", "role": "user" }, { "content": "To diagnose Edwards syndrome, also known as Trisomy 18, exams of the pregnant mother and the infant can be done. An exam during pregnancy may show an abnormally large uterus and extra amniotic fluid. A small placenta when the baby is born is another sign of the disorder. Other physical signs include unusual fingerprint patterns of the infant, a short breast bone, a cleft in the iris of the eye, separation of the left and right side of the abdominal muscle, or signs of congenital heart disease. To concretely diagnose the disorder, chromosome studies should be performed, which will show the chromosome abnormality.", "role": "assistant" } ]

[ { "content": "Please let me know where I can get literature on Cardiac amyloidosis. My uncle died yesterday from this disorder. Since this is such a rare disorder, and to honor his memory, I would like to distribute literature at his funeral service.\n\n Cardiac amyloidosis Amyloidosis - cardiac Primary cardiac amyloidosis - AL type Secondary cardiac amyloidosis - AA type Stiff heart syndrome Senile amyloidosis Summary Cardiac amyloidosis is a disorder caused by deposits of an abnormal protein (amyloid) in the heart tissue. These deposits make it hard for the heart to work properly. Causes Amyloidosis is a group of diseases in which clumps of proteins called amyloids build up in body tissues. Over time, these proteins replace normal tissue, leading to failure of the involved organ. There are many forms of amyloidosis. Cardiac amyloidosis (\"stiff heart syndrome\") occurs when amyloid deposits take the place of normal heart muscle. It is the most typical type of restrictive cardiomyopathy. Cardiac amyloidosis may affect the way electrical signals move through the heart (conduction system). This can lead to abnormal heartbeats (arrhythmias) and faulty heart signals (heart block). The condition can be inherited. This is called familial cardiac amyloidosis. It can also develop as the result of another disease such as a type of bone and blood cancer, or as the result of another medical problem causing inflammation. Cardiac amyloidosis is more common in men than in women. The disease is rare in people under age 40. Symptoms Some people may have no symptoms. When present, symptoms may include: Excessive urination at night Fatigue, reduced exercise ability Palpitations (sensation of feeling heartbeat) Shortness of breath with activity Swelling of the abdomen, legs, ankles, or other part of the body Trouble breathing while lying down Exams and Tests The signs of cardiac amyloidosis can be related to a number of different conditions. This can make the problem hard to diagnose. Signs may include: Abnormal sounds in the lung (lung crackles) or a heart murmur Blood pressure that is low or drops when you stand up Enlarged neck veins Swollen liver The following tests may be done: Chest or abdomen CT scan (considered the \"gold standard\" to help diagnose this condition) Coronary angiography Electrocardiogram (ECG) Echocardiogram Magnetic resonance imaging (MRI) Nuclear heart scans (MUGA, RNV) Positron emission tomography (PET) An ECG may show problems with the heartbeat or heart signals. It may also show low signals (called \"low voltage\"). A cardiac biopsy is used to confirm the diagnosis. A biopsy of another area, such as the abdomen, kidney, or bone marrow, is often done as well. Treatment Your health care provider may tell you to make changes to your diet, including limiting salt and fluids. You may need to take water pills (diuretics) to help your body get rid of excess fluid. The provider may tell you to weigh yourself every day. A weight gain of 3 or more pounds (1 kilogram or more) over 1 to 2 days can mean there is too much fluid in the body. Medicines including digoxin, calcium-channel blockers, and beta-blockers may be used in people with atrial fibrillation. However, the drugs must be used with caution, and the dosage must be carefully monitored. People with cardiac amyloidosis may be extra sensitive to side effects of these drugs. Other treatments may include: Chemotherapy Implantable cardioverter-defibrillator (AICD) Pacemaker, if there are problems with heart signals Prednisone, an anti-inflammatory medicine A heart transplant may be considered for people with some types of amyloidosis who have very poor heart function. People with hereditary amyloidosis may need a liver transplant. Outlook (Prognosis) In the past, cardiac amyloidosis was thought to be an untreatable and rapidly fatal disease. However, the field is changing rapidly. Different types of amyloidosis can affect the heart in different ways. Some types are more severe than others. Many people can now expect to survive and experience a good quality of life for several years after diagnosis. Possible Complications Complications may include: Atrial fibrillation or ventricular arrhythmias Congestive heart failure Fluid buildup in the abdomen (ascites) Increased sensitivity to digoxin Low blood pressure and dizziness from excessive urination (due to medicine) Sick sinus syndrome Symptomatic cardiac conduction system disease (arrhythmias related to abnormal conduction of impulses through the heart muscle) When to Contact a Medical Professional Call your provider if you have this disorder and develop new symptoms such as: Dizziness when you change position Excessive weight (fluid) gain Excessive weight loss Fainting spells Severe breathing problems Review Date 5/16/2018 Updated by: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Cardiac amyloidosis is a disorder caused by deposits of an abnormal protein (amyloid) in the heart tissue. These deposits make it hard for the heart to work properly.", "role": "assistant" } ]

[ { "content": "williams sydrome conditon. i need to send me more information about Williams Syndrome and some tips how to educate people with this disorder.I hope having news from you soon!!thank you\n\n Williams syndrome Williams-Beuren syndrome Summary Williams syndrome is a rare disorder that can lead to problems with development. Causes Williams syndrome is caused by not having a copy of several genes. It may be passed down in families. Parents may not have any family history of the condition. However, people with Williams syndrome have a 50% chance of passing the disorder on to each of their children. It often occurs randomly. One of the 25 missing genes is the gene that produces elastin, a protein that allows blood vessels and other tissues in the body to stretch. It is likely that missing a copy of this gene results in the narrowing of blood vessels, stretchy skin, and flexible joints seen in this condition. Symptoms Symptoms of Williams syndrome are: Delayed speech that may later turn into strong speaking ability and strong learning by hearing Developmental delay Easily distracted, attention deficit hyperactivity disorder (ADHD) Feeding problems including colic, reflux, and vomiting Inward bend of the small finger Learning disorders Mild to moderate intellectual disability Personality traits including being very friendly, trusting strangers, fearing loud sounds or physical contact, and being interested in music Short, compared to the rest of the person's family Sunken chest The face and mouth of someone with Williams syndrome may show: A flattened nasal bridge with small upturned nose Long ridges in the skin that run from the nose to the upper lip Prominent lips with an open mouth Skin that covers the inner corner of the eye Partially missing teeth, defective tooth enamel, or small, widely spaced teeth Exams and Tests Signs include: Narrowing of some blood vessels Farsightedness High blood calcium level that may cause seizures and rigid muscles High blood pressure Slack joints that may change to stiffness as the person gets older Unusual star-like pattern in iris of the eye Tests for Williams syndrome include: Blood pressure check Blood test for a missing piece of chromosome 7 (FISH test) Echocardiography combined with Doppler ultrasound Kidney ultrasound Treatment There is no cure for Williams syndrome. Avoid taking extra calcium and vitamin D. Treat high blood calcium, if it occurs. Blood vessel narrowing can be a major health problem. It is treated based on how severe it is. Physical therapy is helpful to people with joint stiffness. Developmental and speech therapy can also help. For example, having strong verbal skills can help make up for other weaknesses. Other treatments are based on the person's symptoms. It can help to have treatment coordinated by a geneticist who is experienced with Williams syndrome. Support Groups A support group can be helpful for emotional support and for giving and receiving practical advice. The following organization provides additional information about Williams syndrome: Williams Syndrome Association -- williams-syndrome.org Outlook (Prognosis) About 75% of people with Williams syndrome have some intellectual disability. Most people will not live as long as normal due to the various medical issues and other possible complications. Most people require full-time caregivers and often live in supervised group homes. Possible Complications Complications may include: Calcium deposits in the kidney and other kidney problems Death (in rare cases from anesthesia) Heart failure due to narrowed blood vessels Pain in the abdomen When to Contact a Medical Professional Many of the symptoms and signs of Williams syndrome may not be obvious at birth. Call your health care provider if your child has features similar to those of Williams syndrome. Seek genetic counseling if you have a family history of Williams syndrome. Prevention There is no known way to prevent the genetic problem that causes Williams syndrome. Prenatal testing is available for couples with a family history of Williams syndrome who wish to conceive. Review Date 10/26/2017 Updated by: Anna C. Edens Hurst, MD, MS, Assistant Professor in Medical Genetics, The University of Alabama at Birmingham, Birmingham, AL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Williams syndrome (Prevention): There is no known way to prevent the genetic problem that causes Williams syndrome. Prenatal testing is available for couples with a family history of Williams syndrome who wish to conceive.", "role": "assistant" } ]

[ { "content": "what are the causes of childhood obesity\n\nOverweight and Obesity (Risk Factors): There are many risk factors for overweight and obesity. Some risk factors can be changed, such as unhealthy lifestyle habits and environments. Other risk factors, such as age, family history and genetics, race and ethnicity, and sex, cannot be changed. Heathy lifestyle changes can decrease your risk for developing overweight and obesity. Unhealthy lifestyle habits Lack of physical activity, unhealthy eating patterns, not enough sleep, and high amounts of stress can increase your risk for overweight and obesity. Lack of physical activity Lack of physical activity due to high amounts of TV, computer, videogame or other screen usage has been associated with a high body mass index. Healthy lifestyle changes, such as being physically active and reducing screen time, can help you aim for a healthy weight. Unhealthy eating behaviors Some unhealthy eating behaviors can increase your risk for overweight and obesity. Eating more calories than you use. The amount of calories you need will vary based on your sex, age, and physical activity level. Find out your daily calorie needs or goals with the Body Weight Planner. Eating too much saturated and trans fats Eating foods high in added sugars Visit Heart-healthy eating for more information about healthy eating patterns. Not enough sleep Many studies have seen a high BMI in people who do not get enough sleep. Some studies have seen a relationship between sleep and the way our bodies use nutrients for energy and how lack of sleep can affect hormones that control hunger urges. Visit our Sleep Deprivation and Deficiency Health Topic for more information about lack of sleep. High amounts of stress Acute stress and chronic stress affect the brain and trigger the production of hormones, such as cortisol, that control our energy balances and hunger urges. Acute stress can trigger hormone changes that make you not want to eat. If the stress becomes chronic, hormone changes can make you eat more and store more fat. Age Childhood obesity remains a serious problem in the United States, and some populations are more at risk for childhood obesity than others. The risk of unhealthy weight gain increases as you age. Adults who have a healthy BMI often start to gain weight in young adulthood and continue to gain weight until 60 to 65 years old, when they tend to start losing weight. Unhealthy environments Many environmental factors can increase your risk for overweight and obesity:   social factors such as having a low socioeconomic status or an unhealthy social or unsafe environment in the neighborhood  built environment factors such as easy access to unhealthy fast foods, limited access to recreational facilities or parks, and few safe or easy ways to walk in your neighborhood exposure to chemicals known as obesogens that can change hormones and increase fatty tissue in our bodies Family history and genetics Genetic studies have found that overweight and obesity can run in families, so it is possible that our genes or DNA can cause these conditions. Research studies have found that certain DNA elements are associated with obesity. Read more Did you know obesity can change your DNA and the DNA you pass on to your children? Learn more about these DNA changes. Eating too much or eating too little during your pregnancy can change your baby’s DNA and can affect how your child stores and uses fat later in life. Also, studies have shown that obese fathers have DNA changes in their sperm that can be passed on to their children. Race or ethnicity Overweight and obesity is highly prevalent in some racial and ethnic minority groups. Rates of obesity in American adults are highest in blacks, followed by Hispanics, then whites. This is true for men or women. While Asian men and women have the lowest rates of unhealthy BMIs, they may have high amounts of unhealthy fat in the abdomen. Samoans may be at risk for overweight and obesity because they may carry a DNA variant that is associated with increased BMI but not with common obesity-related complications. Sex In the United States, obesity is more common in black or Hispanic women than in black or Hispanic men. A person’s sex may also affect the way the body stores fat. For example, women tend to store less unhealthy fat in the abdomen than men do. Overweight and obesity is also common in women with polycystic ovary syndrome (PCOS). This is an endocrine condition that causes large ovaries and prevents proper ovulation, which can reduce fertility.    ", "role": "user" }, { "content": "There are many risk factors for overweight and obesity. Some risk factors can be changed, such as unhealthy lifestyle habits and environments. Other risk factors, such as age, family history and genetics, race and ethnicity, and sex, cannot be changed.", "role": "assistant" } ]

[ { "content": "how is epidural harmful\n\nEpidural block - pregnancy (Is an Epidural Safe?): Many studies have shown that an epidural is a safe way to manage pain during childbirth. While rare, there are some risks. Your blood pressure may drop for a short while. This might cause the baby's heart rate to slow down. - To avoid this, you will receive fluids through an intravenous (IV) line to help keep your blood pressure stable. - If your blood pressure shows a drop, you may need to lie on your side to keep the blood moving throughout your body. - Your provider may also give you medicine to raise your blood pressure. An epidural block may change or alter labor and delivery. - If you are very numb from the block, you may have a harder time bearing down to push your baby through the birth canal. - Contractions may lessen or slow down for a little while, but labor will still move along as it should. In some cases, it may even go faster. If your labor slows down, your doctor can give you medicine to speed up your contractions. It is best to wait until you are in active labor to have the epidural placed. Other rare side effects are: - You may get a headache after your epidural but this is rare. - Medicine could enter your spinal fluid. For a short while, it could make you feel dizzy, or you might have a hard time breathing. You could also have a seizure. This is also rare.", "role": "user" }, { "content": "Many studies have shown that an epidural is a safe way to manage pain during childbirth. While rare, there are some risks. Your blood pressure may drop for a short while. This might cause the baby's heart rate to slow down. - To avoid this, you will receive fluids through an intravenous (IV) line to help keep your blood pressure stable. An epidural block may change or alter labor and delivery. - If you are very numb from the block, you may have a harder time bearing down to push your baby through the birth canal. - Contractions may lessen or slow down for a little while, but labor will still move along as it should. Other rare side effects are: - You may get a headache after your epidural but this is rare. - Medicine could enter your spinal fluid. For a short while, it could make you feel dizzy, or you might have a hard time breathing. You could also have a seizure. This is also rare.", "role": "assistant" } ]

[ { "content": "what are the causes of pulmonary hypertension\n\nPulmonary hypertension (Causes): The right side of the heart pumps blood through the lungs, where it picks up oxygen. Blood returns to the left side of the heart, where it is pumped to the rest of the body. When the small arteries (blood vessels) of the lungs become narrowed, they cannot carry as much blood. When this happens, pressure builds up. This is called pulmonary hypertension. The heart needs to work harder to force the blood through the vessels against this pressure. Over time, this causes the right side of the heart to become larger. This condition is called right-sided heart failure, or cor pulmonale. Pulmonary hypertension may be caused by: - Autoimmune diseases that damage the lungs, such as scleroderma and rheumatoid arthritis - Birth defects of the heart - Blood clots in the lung (pulmonary embolism) - Heart failure - Heart valve disease - HIV infection - Low oxygen levels in the blood for a long time (chronic) - Lung disease, such as COPD or pulmonary fibrosis - Medicines (for example, certain diet drugs) - Obstructive sleep apnea In rare cases, the cause of pulmonary hypertension is unknown. In this case, the condition is called idiopathic pulmonary arterial hypertension (IPAH). Idiopathic means the cause of a disease is not known. IPAH affects more women than men. If pulmonary hypertension is caused by a known medicine or medical condition, it is called secondary pulmonary hypertension.", "role": "user" }, { "content": "The right side of the heart pumps blood through the lungs, where it picks up oxygen. Blood returns to the left side of the heart, where it is pumped to the rest of the body. When the small arteries (blood vessels) of the lungs become narrowed, they cannot carry as much blood. When this happens, pressure builds up. This is called pulmonary hypertension.", "role": "assistant" } ]

[ { "content": "Rubella My grandson (4 yrs old) has contracted Rubella. I know for sure he has had at least one of the vaccines. They are living in Mexico right now. Should we be worried?\n\n Rubella Overview Rubella, also called German measles or three-day measles, is a contagious viral infection best known by its distinctive red rash. Rubella is not the same as measles (rubeola), though the two illnesses do share some characteristics, including the red rash. However, rubella is caused by a different virus than measles, and is neither as infectious nor usually as severe as measles. The measles-mumps-rubella (MMR) vaccine, usually given to children in the United States twice before they reach school age, is highly effective in preventing rubella. Because of widespread use of the vaccine, the Centers for Disease Control and Prevention (CDC) has declared rubella eliminated in the United States, but cautions parents to make sure their children are vaccinated to prevent its reemergence. Symptoms The signs and symptoms of rubella are often so mild they're difficult to notice, especially in children. If signs and symptoms do occur, they generally appear between two and three weeks after exposure to the virus. They typically last about two to three days and may include: - Mild fever of 102 F (38.9 C) or lower - Headache - Stuffy or runny nose - Inflamed, red eyes - Enlarged, tender lymph nodes at the base of the skull, the back of the neck and behind the ears - A fine, pink rash that begins on the face and quickly spreads to the trunk and then the arms and legs, before disappearing in the same sequence - Aching joints, especially in young women When to see a doctor Contact your doctor if you think you or your child may have been exposed to rubella or if you have the signs or symptoms listed above. If you're contemplating getting pregnant, check your vaccination record to make sure you've received your MMR inoculations. If a pregnant woman contracts rubella, especially during her first trimester, the virus can cause death or serious birth defects in her developing fetus. Rubella during pregnancy is the most common cause of congenital deafness. It's best for women to be protected against rubella before pregnancy. If you're pregnant, you'll likely undergo a routine screening for immunity to rubella. But if you've never received the vaccine and think you might have been exposed to rubella, contact your doctor immediately. A blood test might confirm that you're already immune. Causes The cause of rubella is a virus that's passed from person to person. It can spread when an infected person coughs or sneezes, or it can spread by direct contact with an infected person's respiratory secretions, such as mucus. It can also be transmitted from a pregnant woman to her unborn child via the bloodstream. A person with rubella is contagious from 10 days before the onset of the rash until about one or two weeks after the rash disappears. An infected person can spread the illness before the person realizes he or she has it. Rubella is rare in the United States because most children receive a vaccination against the infection at an early age. However, cases of rubella do occur, mostly in unvaccinated foreign-born adults. The disease is still common in many parts of the world. The prevalence of rubella in other countries is something to consider before going abroad, especially if you're pregnant. Complications Rubella is a mild infection. Once you've had the disease, you're usually permanently immune. Some women with rubella experience arthritis in the fingers, wrists and knees, which generally lasts for about one month. In rare cases, rubella can cause an ear infection (otitis media) or inflammation of the brain (encephalitis). However, if you're pregnant when you contract rubella, the consequences for your unborn child may be severe. Up to 90 percent of infants born to mothers who had rubella during the first 12 weeks of pregnancy develop congenital rubella syndrome. This syndrome can cause one or more problems, including: - Growth retardation - Cataracts - Deafness - Congenital heart defects - Defects in other organs - Mental retardation The highest risk to the fetus is during the first trimester, but exposure later in pregnancy also is dangerous. Diagnosis The rubella rash can look like many other viral rashes. So doctors usually confirm rubella with the help of laboratory tests. You may have a virus culture or a blood test, which can detect the presence of different types of rubella antibodies in your blood. These antibodies indicate whether you've had a recent or past infection or a rubella vaccine. Treatment No treatment will shorten the course of rubella infection, and symptoms are so mild that treatment usually isn't necessary. However, doctors often recommend isolation from others - especially pregnant women - during the infectious period. If you contract rubella while you're pregnant, discuss the risks to your baby with your doctor. If you wish to continue your pregnancy, you may be given antibodies called hyperimmune globulin that can fight off the infection. This can reduce your symptoms, but doesn't eliminate the possibility of your baby developing congenital rubella syndrome. Support of an infant born with congenital rubella syndrome varies depending on the extent of the infant's problems. Children with multiple complications may require early treatment from a team of specialists. Lifestyle and home remedies In rare instances when a child or adult is infected with rubella, simple self-care measures are required: - Rest in bed as necessary. - Take acetaminophen (Tylenol, others) to relieve discomfort from fever and aches. - Tell friends, family and co-workers - especially pregnant women - about your diagnosis if they may have been exposed to the disease. - Avoid people who have conditions that cause deficient or suppressed immune systems. - Tell your child's school or child care provider that your child has rubella. ", "role": "user" }, { "content": "Rubella is a mild infection. Once you've had the disease, you're usually permanently immune. . In rare cases, rubella can cause an ear infection (otitis media) or inflammation of the brain (encephalitis).", "role": "assistant" } ]

[ { "content": "how do you check for lupus?\n\nLupus: Lupus is a systemic autoimmune disease that occurs when your body's immune system attacks your own tissues and organs. Inflammation caused by lupus can affect many different body systems - including your joints, skin, kidneys, blood cells, brain, heart and lungs. Lupus can be difficult to diagnose because its signs and symptoms often mimic those of other ailments. The most distinctive sign of lupus - a facial rash that resembles the wings of a butterfly unfolding across both cheeks - occurs in many but not all cases of lupus. Some people are born with a tendency toward developing lupus, which may be triggered by infections, certain drugs or even sunlight. While there's no cure for lupus, treatments can help control symptoms. No two cases of lupus are exactly alike. Signs and symptoms may come on suddenly or develop slowly, may be mild or severe, and may be temporary or permanent. Most people with lupus have mild disease characterized by episodes - called flares - when signs and symptoms get worse for a while, then improve or even disappear completely for a time. The signs and symptoms of lupus that you experience will depend on which body systems are affected by the disease. The most common signs and symptoms include: - Fatigue - Fever - Joint pain, stiffness and swelling - Butterfly-shaped rash on the face that covers the cheeks and bridge of the nose or rashes elsewhere on the body - Skin lesions that appear or worsen with sun exposure (photosensitivity) - Fingers and toes that turn white or blue when exposed to cold or during stressful periods (Raynaud's phenomenon) - Shortness of breath - Chest pain - Dry eyes - Headaches, confusion and memory loss When to see a doctor See your doctor if you develop an unexplained rash, ongoing fever, persistent aching or fatigue. Lupus occurs when your immune system attacks healthy tissue in your body (autoimmune disease). It's likely that lupus results from a combination of your genetics and your environment. It appears that people with an inherited predisposition for lupus may develop the disease when they come into contact with something in the environment that can trigger lupus. The cause of lupus in most cases, however, is unknown. Some potential triggers include: - Sunlight. Exposure to the sun may bring on lupus skin lesions or trigger an internal response in susceptible people. - Infections. Having an infection can initiate lupus or cause a relapse in some people. - Medications. Lupus can be triggered by certain types of blood pressure medications, anti-seizure medications and antibiotics. People who have drug-induced lupus usually get better when they stop taking the medication. Rarely, symptoms may persist even after the drug is stopped. Factors that may increase your risk of lupus include: - Your sex. Lupus is more common in women. - Age. Although lupus affects people of all ages, it's most often diagnosed between the ages of 15 and 45. - Race. Lupus is more common in African-Americans, Hispanics and Asian-Americans. Diagnosing lupus is difficult because signs and symptoms vary considerably from person to person. Signs and symptoms of lupus may vary over time and overlap with those of many other disorders. No one test can diagnose lupus. The combination of blood and urine tests, signs and symptoms, and physical examination findings leads to the diagnosis. Laboratory tests Blood and urine tests may include: - Complete blood count. This test measures the number of red blood cells, white blood cells and platelets as well as the amount of hemoglobin, a protein in red blood cells. Results may indicate you have anemia, which commonly occurs in lupus. A low white blood cell or platelet count may occur in lupus as well. - Erythrocyte sedimentation rate. This blood test determines the rate at which red blood cells settle to the bottom of a tube in an hour. A faster than normal rate may indicate a systemic disease, such as lupus. The sedimentation rate isn't specific for any one disease. It may be elevated if you have lupus, an infection, another inflammatory condition or cancer. - Kidney and liver assessment. Blood tests can assess how well your kidneys and liver are functioning. Lupus can affect these organs. - Urinalysis. An examination of a sample of your urine may show an increased protein level or red blood cells in the urine, which may occur if lupus has affected your kidneys. - Antinuclear antibody (ANA) test. A positive test for the presence of these antibodies - produced by your immune system - indicates a stimulated immune system. While most people with lupus have a positive ANA test, most people with a positive ANA do not have lupus. If you test positive for ANA, your doctor may advise more-specific antibody testing. Imaging tests If your doctor suspects that lupus is affecting your lungs or heart, he or she may suggest: - Chest X-ray. An image of your chest may reveal abnormal shadows that suggest fluid or inflammation in your lungs. - Echocardiogram. This test uses sound waves to produce real-time images of your beating heart. It can check for problems with your valves and other portions of your heart. Biopsy Lupus can harm your kidneys in many different ways, and treatments can vary, depending on the type of damage that occurs. In some cases, it's necessary to test a small sample of kidney tissue to determine what the best treatment might be. The sample can be obtained with a needle or through a small incision. Skin biopsy is sometimes performed to confirm a diagnosis of lupus affecting the skin. Treatment for lupus depends on your signs and symptoms. Determining whether your signs and symptoms should be treated and what medications to use requires a careful discussion of the benefits and risks with your doctor. As your signs and symptoms flare and subside, you and your doctor may find that you'll need to change medications or dosages. The medications most commonly used to control lupus include: - Nonsteroidal anti-inflammatory drugs (NSAIDs). Over-the-counter NSAIDs, such as naproxen sodium (Aleve) and ibuprofen (Advil, Motrin IB, others), may be used to treat pain, swelling and fever associated with lupus. Stronger NSAIDs are available by prescription. Side effects of NSAIDs include stomach bleeding, kidney problems and an increased risk of heart problems. - Antimalarial drugs. Medications commonly used to treat malaria, such as hydroxychloroquine (Plaquenil), affect the immune system and can help decrease the risk of lupus flares. Side effects can include stomach upset and, very rarely, damage to the retina of the eye. Regular eye exams are recommended when taking these medications. - Corticosteroids. Prednisone and other types of corticosteroids can counter the inflammation of lupus. High doses of steroids such as methylprednisolone (A-Methapred, Medrol) are often used to control serious disease that involves the kidneys and brain. Side effects include weight gain, easy bruising, thinning bones (osteoporosis), high blood pressure, diabetes and increased risk of infection. The risk of side effects increases with higher doses and longer term therapy. - Immunosuppressants. Drugs that suppress the immune system may be helpful in serious cases of lupus. Examples include azathioprine (Imuran, Azasan), mycophenolate mofetil (CellCept) and methotrexate (Trexall). Potential side effects may include an increased risk of infection, liver damage, decreased fertility and an increased risk of cancer. - Biologics. A different type of medication, belimumab (Benlysta) administered intravenously, also reduces lupus symptoms in some people. Side effects include nausea, diarrhea and infections. Rarely, worsening of depression can occur. - Rituximab (Rituxan) can be beneficial in cases of resistant lupus. Side effects include allergic reaction to the intravenous infusion and infections. Take steps to care for your body if you have lupus. Simple measures can help you prevent lupus flares and, should they occur, better cope with the signs and symptoms you experience. Try to: - See your doctor regularly. Having regular checkups instead of only seeing your doctor when your symptoms worsen may help your doctor prevent flare-ups, and can be useful in addressing routine health concerns, such as stress, diet and exercise that can be helpful in preventing lupus complications. - Be sun smart. Because ultraviolet light can trigger a flare, wear protective clothing - such as a hat, long-sleeved shirt and long pants - and use sunscreens with a sun protection factor (SPF) of at least 55 every time you go outside. - Get regular exercise. Exercise can help keep your bones strong, reduce your risk of heart attack and promote general well-being. - Don't smoke. Smoking increases your risk of cardiovascular disease and can worsen the effects of lupus on your heart and blood vessels. - Eat a healthy diet. A healthy diet emphasizes fruits, vegetables and whole grains. Sometimes you may have dietary restrictions, especially if you have high blood pressure, kidney damage or gastrointestinal problems. - Ask your doctor if you need vitamin D and calcium supplements. There is some evidence to suggest that people with lupus may benefit from supplemental vitamin D. A 1,200- to 1,500-milligram calcium supplement taken daily may help keep your bones healthy. Sometimes people with lupus seek alternative or complementary medicine. However, there aren't any alternative therapies that have been shown to alter the course of lupus, although some may help ease symptoms of the disease. Discuss these treatments with your doctor before initiating them on your own. He or she can help you weigh the benefits and risks and tell you if the treatments will interfere adversely with your current lupus medications. Complementary and alternative treatments for lupus include: - Dehydroepiandrosterone (DHEA). Supplements containing this hormone may help fatigue and muscle pain. It may lead to acne in women. - Fish oil. Fish oil supplements contain omega-3 fatty acids that may be beneficial for people with lupus. Preliminary studies have found some promise, though more study is needed. Side effects of fish oil supplements can include nausea, belching and a fishy taste in the mouth. - Acupuncture. This therapy uses tiny needles inserted just under the skin. It may help ease the muscle pain associated with lupus.", "role": "user" }, { "content": "There is no one test that can diagnose lupus. However, doctos can use a combination of tools to make a diagnosis. These include blood and urine tests, physical examinations, imaging tests, skin biopsy, and other observations of signs and symptoms. For example, an examination of a sample of your urine may show increased protein or red blood cell levels, which may have occurred if lupus has affected your kidneys. A chest X-ray may be used to check for fluid or inflammation in your lungs, which can occur if lupus has affected your lungs.", "role": "assistant" } ]

[ { "content": "what is the disorder achondroplasia\n\n Achondroplasia Summary Achondroplasia is a disorder of bone growth that causes the most common type of dwarfism. Causes Achondroplasia is one of a group of disorders called chondrodystrophies, or osteochondrodysplasias. Achondroplasia may be inherited as an autosomal dominant trait, which means that if a child gets the defective gene from one parent, the child will have the disorder. If one parent has achondroplasia, the infant has a 50% chance of inheriting the disorder. If both parents have the condition, the infant's chances of being affected increase to 75%. However, most cases appear as spontaneous mutations. This means that two parents without achondroplasia may give birth to a baby with the condition. Symptoms The typical appearance of achondroplastic dwarfism can be seen at birth. Symptoms may include: Abnormal hand appearance with persistent space between the long and ring fingers Bowed legs Decreased muscle tone Disproportionately large head-to-body size difference Prominent forehead (frontal bossing) Shortened arms and legs (especially the upper arm and thigh) Short stature (significantly below the average height for a person of the same age and sex) Narrowing of the spinal column (spinal stenosis) Spine curvatures called kyphosis and lordosis Exams and Tests During pregnancy, a prenatal ultrasound may show excessive amniotic fluid surrounding the unborn infant. Examination of the infant after birth shows increased front-to-back head size. There may be signs of hydrocephalus (\"water on the brain\"). X-rays of the long bones can reveal achondroplasia in the newborn. Treatment There is no specific treatment for achondroplasia. Related abnormalities, including spinal stenosis and spinal cord compression, should be treated when they cause problems. Outlook (Prognosis) People with achondroplasia seldom reach 5 feet (1.5 meters) in height. Intelligence is in the normal range. Infants who receive the abnormal gene from both parents do not often live beyond a few months. Possible Complications Health problems that may develop include: Breathing problems from a small upper airway and from pressure on the area of the brain that controls breathing Lung problems from a small ribcage When to Contact a Medical Professional If there is a family history of achondroplasia and you plan to have children, you may find it helpful to speak to your health care provider. Prevention Genetic counseling may be helpful for prospective parents when one or both have achondroplasia. However, because achondroplasia most often develops spontaneously, prevention is not always possible. Review Date 10/18/2017 Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Achondroplasia is a disorder of bone growth that causes the most common type of dwarfism. Achondroplasia may be inherited as an autosomal dominant trait, which means that if a child gets the defective gene from 1 parent, the child will have the disorder. The typical appearance of achondroplastic dwarfism can be seen at birth. Symptoms may include: - Abnormal hand appearance with persistent space between the long and ring fingers - Bowed legs - Decreased muscle tone - Disproportionately large head-to-body size difference - Prominent forehead (frontal bossing) - Shortened arms and legs (especially the upper arm and thigh) - Short stature (significantly below the average height for a person of the same age and sex) - Narrowing of the spinal column spinal stenosis - Spine curvatures called kyphosis and lordosis ... Genetic counseling may be helpful for prospective parents when 1 or both have achondroplasia. However, because achondroplasia most often develops spontaneously, prevention is not always possible.", "role": "assistant" } ]

[ { "content": "what test do you do for rheumatoid \"arthritis?\"\n\n Rheumatoid arthritis Overview Rheumatoid arthritis is a chronic inflammatory disorder that can affect more than just your joints. In some people, the condition also can damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels. An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body's tissues. Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity. The inflammation associated with rheumatoid arthritis is what can damage other parts of the body as well. While new types of medications have improved treatment options dramatically, severe rheumatoid arthritis can still cause physical disabilities. Symptoms Signs and symptoms of rheumatoid arthritis may include: - Tender, warm, swollen joints - Joint stiffness that is usually worse in the mornings and after inactivity - Fatigue, fever and weight loss Early rheumatoid arthritis tends to affect your smaller joints first - particularly the joints that attach your fingers to your hands and your toes to your feet. As the disease progresses, symptoms often spread to the wrists, knees, ankles, elbows, hips and shoulders. In most cases, symptoms occur in the same joints on both sides of your body. About 40 percent of the people who have rheumatoid arthritis also experience signs and symptoms that don't involve the joints. Rheumatoid arthritis can affect many nonjoint structures, including: - Skin - Eyes - Lungs - Heart - Kidneys - Salivary glands - Nerve tissue - Bone marrow - Blood vessels Rheumatoid arthritis signs and symptoms may vary in severity and may even come and go. Periods of increased disease activity, called flares, alternate with periods of relative remission - when the swelling and pain fade or disappear. Over time, rheumatoid arthritis can cause joints to deform and shift out of place. Make an appointment with your doctor if you have persistent discomfort and swelling in your joints. Causes Rheumatoid arthritis occurs when your immune system attacks the synovium - the lining of the membranes that surround your joints. The resulting inflammation thickens the synovium, which can eventually destroy the cartilage and bone within the joint. The tendons and ligaments that hold the joint together weaken and stretch. Gradually, the joint loses its shape and alignment. Doctors don't know what starts this process, although a genetic component appears likely. While your genes don't actually cause rheumatoid arthritis, they can make you more susceptible to environmental factors - such as infection with certain viruses and bacteria - that may trigger the disease. Risk factors Factors that may increase your risk of rheumatoid arthritis include: - Your sex. Women are more likely than men to develop rheumatoid arthritis. - Age. Rheumatoid arthritis can occur at any age, but it most commonly begins between the ages of 40 and 60. - Family history. If a member of your family has rheumatoid arthritis, you may have an increased risk of the disease. - Smoking. Cigarette smoking increases your risk of developing rheumatoid arthritis, particularly if you have a genetic predisposition for developing the disease. Smoking also appears to be associated with greater disease severity. - Environmental exposures. Although uncertain and poorly understood, some exposures such as asbestos or silica may increase the risk for developing rheumatoid arthritis. Emergency workers exposed to dust from the collapse of the World Trade Center are at higher risk of autoimmune diseases such as rheumatoid arthritis. - Obesity. People who are overweight or obese appear to be at somewhat higher risk of developing rheumatoid arthritis, especially in women diagnosed with the disease when they were 55 or younger. Diagnosis Rheumatoid arthritis can be difficult to diagnose in its early stages because the early signs and symptoms mimic those of many other diseases. There is no one blood test or physical finding to confirm the diagnosis. During the physical exam, your doctor will check your joints for swelling, redness and warmth. He or she may also check your reflexes and muscle strength. Blood tests People with rheumatoid arthritis often have an elevated erythrocyte sedimentation rate (ESR, or sed rate) or C-reactive protein (CRP), which may indicate the presence of an inflammatory process in the body. Other common blood tests look for rheumatoid factor and anti-cyclic citrullinated peptide (anti-CCP) antibodies. Imaging tests Your doctor may recommend X-rays to help track the progression of rheumatoid arthritis in your joints over time. MRI and ultrasound tests can help your doctor judge the severity of the disease in your body. Treatment There is no cure for rheumatoid arthritis. But recent discoveries indicate that remission of symptoms is more likely when treatment begins early with strong medications known as disease-modifying antirheumatic drugs (DMARDs). Medications The types of medications recommended by your doctor will depend on the severity of your symptoms and how long you've had rheumatoid arthritis. - NSAIDs. Nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain and reduce inflammation. Over-the-counter NSAIDs include ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve). Stronger NSAIDs are available by prescription. Side effects may include ringing in your ears, stomach irritation, heart problems, and liver and kidney damage. - Steroids. Corticosteroid medications, such as prednisone, reduce inflammation and pain and slow joint damage. Side effects may include thinning of bones, weight gain and diabetes. Doctors often prescribe a corticosteroid to relieve acute symptoms, with the goal of gradually tapering off the medication. - Disease-modifying antirheumatic drugs (DMARDs). These drugs can slow the progression of rheumatoid arthritis and save the joints and other tissues from permanent damage. Common DMARDs include methotrexate (Trexall, Otrexup, Rasuvo), leflunomide (Arava), hydroxychloroquine (Plaquenil) and sulfasalazine (Azulfidine). Side effects vary but may include liver damage, bone marrow suppression and severe lung infections. - Biologic agents. Also known as biologic response modifiers, this newer class of DMARDs includes abatacept (Orencia), adalimumab (Humira), anakinra (Kineret), certolizumab (Cimzia), etanercept (Enbrel), golimumab (Simponi), infliximab (Remicade), rituximab (Rituxan), tocilizumab (Actemra) and tofacitinib (Xeljanz). These drugs can target parts of the immune system that trigger inflammation that causes joint and tissue damage. These types of drugs also increase the risk of infections. Biologic DMARDs are usually most effective when paired with a nonbiologic DMARD, such as methotrexate. Therapy Your doctor may send you to a physical or occupational therapist who can teach you exercises to help keep your joints flexible. The therapist may also suggest new ways to do daily tasks, which will be easier on your joints. For example, if your fingers are sore, you may want to pick up an object using your forearms. Assistive devices can make it easier to avoid stressing your painful joints. For instance, a kitchen knife equipped with a saw handle helps protect your finger and wrist joints. Certain tools, such as buttonhooks, can make it easier to get dressed. Catalogs and medical supply stores are good places to look for ideas. Surgery If medications fail to prevent or slow joint damage, you and your doctor may consider surgery to repair damaged joints. Surgery may help restore your ability to use your joint. It can also reduce pain and correct deformities. Rheumatoid arthritis surgery may involve one or more of the following procedures: - Synovectomy. Surgery to remove the inflamed synovium (lining of the joint). Synovectomy can be performed on knees, elbows, wrists, fingers and hips. - Tendon repair. Inflammation and joint damage may cause tendons around your joint to loosen or rupture. Your surgeon may be able to repair the tendons around your joint. - Joint fusion. Surgically fusing a joint may be recommended to stabilize or realign a joint and for pain relief when a joint replacement isn't an option. - Total joint replacement. During joint replacement surgery, your surgeon removes the damaged parts of your joint and inserts a prosthesis made of metal and plastic. Surgery carries a risk of bleeding, infection and pain. Discuss the benefits and risks with your doctor. Lifestyle and home remedies You can take steps to care for your body if you have rheumatoid arthritis. These self-care measures, when used along with your rheumatoid arthritis medications, can help you manage your signs and symptoms: - Exercise regularly. Gentle exercise can help strengthen the muscles around your joints, and it can help fight fatigue you might feel. Check with your doctor before you start exercising. If you're just getting started, begin by taking a walk. Try swimming or gentle water aerobics. Avoid exercising tender, injured or severely inflamed joints. - Apply heat or cold. Heat can help ease your pain and relax tense, painful muscles. Cold may dull the sensation of pain. Cold also has a numbing effect and decreases muscle spasms. - Relax. Find ways to cope with pain by reducing stress in your life. Techniques such as guided imagery, distraction and muscle relaxation can all be used to control pain. Alternative medicine Some common complementary and alternative treatments that have shown promise for rheumatoid arthritis include: - Fish oil. Some preliminary studies have found that fish oil supplements may reduce rheumatoid arthritis pain and stiffness. Side effects can include nausea, belching and a fishy taste in the mouth. Fish oil can interfere with medications, so check with your doctor first. - Plant oils. The seeds of evening primrose, borage and black currant contain a type of fatty acid that may help with rheumatoid arthritis pain and morning stiffness. Side effects may include nausea, diarrhea and gas. Some plant oils can cause liver damage or interfere with medications, so check with your doctor first. - Tai chi. This movement therapy involves gentle exercises and stretches combined with deep breathing. Many people use tai chi to relieve stress in their lives. Small studies have found that tai chi may reduce rheumatoid arthritis pain. When led by a knowledgeable instructor, tai chi is safe. But don't do any moves that cause pain. ", "role": "user" }, { "content": "Rheumatoid arthritis can be difficult to diagnose in its early stages because the symptoms can be the same as in other kinds of joint disease. There is no one blood test or physical finding to confirm the diagnosis. To diagnose rheumatoid arthritis, doctors use medical history, a physical exam, x-rays and other imaging tests, such as MRI and ultrasound tests, and lab tests. During physical exams doctors may check your reflexes and muscle strength. Blood tests often show elevated erythrocyte sedimentation rate (ESR, or sed rate) or C-reactive protein (CRP), which may indicate the presence of an inflammatory process in the body. Other common blood tests look for rheumatoid factor and anti-cyclic citrullinated peptide (anti-CCP) antibodies.", "role": "assistant" } ]

[ { "content": "how to prevent atherosclerosis\n\n Atherosclerosis What Is... Español Atherosclerosis is a disease in which plaque builds up inside your arteries. Arteries are blood vessels that carry oxygen-rich blood to your heart and other parts of your body. Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque hardens and narrows your arteries. This limits the flow of oxygen-rich blood to your organs and other parts of your body. Atherosclerosis can lead to serious problems, including heart attack, stroke, or even death. Atherosclerosis Atherosclerosis-Related Diseases Atherosclerosis can affect any artery in the body, including arteries in the heart, brain, arms, legs, pelvis, and kidneys. As a result, different diseases may develop based on which arteries are affected. Coronary Heart Disease Coronary heart disease (CHD), also called coronary artery disease, occurs when plaque builds up in the coronary arteries. These arteries supply oxygen-rich blood to your heart. Plaque narrows the coronary arteries and reduces blood flow to your heart muscle. Plaque buildup also makes it more likely that blood clots will form in your arteries. Blood clots can partially or completely block blood flow. If blood flow to your heart muscle is reduced or blocked, you may have angina (chest pain or discomfort) or a heart attack. Plaque also can form in the heart's smallest arteries. This disease is called coronary microvascular disease (MVD). In coronary MVD, plaque doesn't cause blockages in the arteries as it does in CHD. Carotid Artery Disease Carotid (ka-ROT-id) artery disease occurs if plaque builds up in the arteries on each side of your neck (the carotid arteries). These arteries supply oxygen-rich blood to your brain. If blood flow to your brain is reduced or blocked, you may have a stroke. Peripheral Artery Disease Peripheral artery disease (P.A.D.) occurs if plaque builds up in the major arteries that supply oxygen-rich blood to your legs, arms, and pelvis. If blood flow to these parts of your body is reduced or blocked, you may have numbness, pain, and, sometimes, dangerous infections. Chronic Kidney Disease Chronic kidney disease can occur if plaque builds up in the renal arteries. These arteries supply oxygen-rich blood to your kidneys. Over time, chronic kidney disease causes a slow loss of kidney function. The main function of the kidneys is to remove waste and extra water from the body. Overview The cause of atherosclerosis isn't known. However, certain traits, conditions, or habits may raise your risk for the disease. These conditions are known as risk factors. You can control some risk factors, such as lack of physical activity, smoking, and an unhealthy diet. Others you can't control, such as age and a family history of heart disease. Some people who have atherosclerosis have no signs or symptoms. They may not be diagnosed until after a heart attack or stroke. The main treatment for atherosclerosis is lifestyle changes. You also may need medicines and medical procedures. These treatments, along with ongoing medical care, can help you live a healthier life. Outlook Improved treatments have reduced the number of deaths from atherosclerosis-related diseases. These treatments also have improved the quality of life for people who have these diseases. However, atherosclerosis remains a common health problem. You may be able to prevent or delay atherosclerosis and the diseases it can cause. Making lifestyle changes and getting ongoing care can help you avoid the problems of atherosclerosis and live a long, healthy life. OTHER NAMES Arteriosclerosis Hardening of the arteries CAUSES The exact cause of atherosclerosis isn't known. However, studies show that atherosclerosis is a slow, complex disease that may start in childhood. It develops faster as you age. Atherosclerosis may start when certain factors damage the inner layers of the arteries. These factors include: Smoking High amounts of certain fats and cholesterol in the blood High blood pressure High amounts of sugar in the blood due to insulin resistance or diabetes Plaque may begin to build up where the arteries are damaged. Over time, plaque hardens and narrows the arteries. Eventually, an area of plaque can rupture (break open). When this happens, blood cell fragments called platelets (PLATE-lets) stick to the site of the injury. They may clump together to form blood clots. Clots narrow the arteries even more, limiting the flow of oxygen-rich blood to your body. Depending on which arteries are affected, blood clots can worsen angina (chest pain) or cause a heart attack or stroke. Researchers continue to look for the causes of atherosclerosis. They hope to find answers to questions such as: Why and how do the arteries become damaged? How does plaque develop and change over time? Why does plaque rupture and lead to blood clots? WHO IS AT RISK The exact cause of atherosclerosis isn't known. However, certain traits, conditions, or habits may raise your risk for the disease. These conditions are known as risk factors. The more risk factors you have, the more likely it is that you'll develop atherosclerosis. You can control most risk factors and help prevent or delay atherosclerosis. Other risk factors can't be controlled. Major Risk Factors Unhealthy blood cholesterol levels. This includes high LDL cholesterol (sometimes called \"bad\" cholesterol) and low HDL cholesterol (sometimes called \"good\" cholesterol). High blood pressure. Blood pressure is considered high if it stays at or above 140/90 mmHg over time. If you have diabetes or chronic kidney disease, high blood pressure is defined as 130/80 mmHg or higher. (The mmHg is millimeters of mercury—the units used to measure blood pressure.) Smoking. Smoking can damage and tighten blood vessels, raise cholesterol levels, and raise blood pressure. Smoking also doesn't allow enough oxygen to reach the body's tissues. Insulin resistance. This condition occurs if the body can't use its insulin properly. Insulin is a hormone that helps move blood sugar into cells where it's used as an energy source. Insulin resistance may lead to diabetes. Diabetes. With this disease, the body's blood sugar level is too high because the body doesn't make enough insulin or doesn't use its insulin properly. Overweight or obesity. The terms \"overweight\" and \"obesity\" refer to body weight that's greater than what is considered healthy for a certain height. Lack of physical activity. A lack of physical activity can worsen other risk factors for atherosclerosis, such as unhealthy blood cholesterol levels, high blood pressure, diabetes, and overweight and obesity. Unhealthy diet. An unhealthy diet can raise your risk for atherosclerosis. Foods that are high in saturated and trans fats, cholesterol, sodium (salt), and sugar can worsen other atherosclerosis risk factors. Older age. As you get older, your risk for atherosclerosis increases. Genetic or lifestyle factors cause plaque to build up in your arteries as you age. By the time you're middle-aged or older, enough plaque has built up to cause signs or symptoms. In men, the risk increases after age 45. In women, the risk increases after age 55. Family history of early heart disease. Your risk for atherosclerosis increases if your father or a brother was diagnosed with heart disease before 55 years of age, or if your mother or a sister was diagnosed with heart disease before 65 years of age. Although age and a family history of early heart disease are risk factors, it doesn't mean that you'll develop atherosclerosis if you have one or both. Controlling other risk factors often can lessen genetic influences and prevent atherosclerosis, even in older adults. Studies show that an increasing number of children and youth are at risk for atherosclerosis. This is due to a number of causes, including rising childhood obesity rates. Emerging Risk Factors Scientists continue to study other possible risk factors for atherosclerosis. High levels of a protein called C-reactive protein (CRP) in the blood may raise the risk for atherosclerosis and heart attack. High levels of CRP are a sign of inflammation in the body. Inflammation is the body's response to injury or infection. Damage to the arteries' inner walls seems to trigger inflammation and help plaque grow. People who have low CRP levels may develop atherosclerosis at a slower rate than people who have high CRP levels. Research is under way to find out whether reducing inflammation and lowering CRP levels also can reduce the risk for atherosclerosis. High levels of triglycerides (tri-GLIH-seh-rides) in the blood also may raise the risk for atherosclerosis, especially in women. Triglycerides are a type of fat. Studies are under way to find out whether genetics may play a role in atherosclerosis risk. Other Factors That Affect Atherosclerosis Other factors also may raise your risk for atherosclerosis, such as: Sleep apnea. Sleep apnea is a disorder that causes one or more pauses in breathing or shallow breaths while you sleep. Untreated sleep apnea can raise your risk for high blood pressure, diabetes, and even a heart attack or stroke. Stress. Research shows that the most commonly reported \"trigger\" for a heart attack is an emotionally upsetting event, especially one involving anger. Alcohol. Heavy drinking can damage the heart muscle and worsen other risk factors for atherosclerosis. Men should have no more than two drinks containing alcohol a day. Women should have no more than one drink containing alcohol a day. SIGNS & SYMPTOMS Atherosclerosis usually doesn't cause signs and symptoms until it severely narrows or totally blocks an artery. Many people don't know they have the disease until they have a medical emergency, such as a heart attack or stroke. Some people may have signs and symptoms of the disease. Signs and symptoms will depend on which arteries are affected. Coronary Arteries The coronary arteries supply oxygen-rich blood to your heart. If plaque narrows or blocks these arteries (a disease called coronary heart disease, or CHD), a common symptom is angina. Angina is chest pain or discomfort that occurs when your heart muscle doesn't get enough oxygen-rich blood. Angina may feel like pressure or squeezing in your chest. You also may feel it in your shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion. The pain tends to get worse with activity and go away with rest. Emotional stress also can trigger the pain. Other symptoms of CHD are shortness of breath and arrhythmias (ah-RITH-me-ahs). Arrhythmias are problems with the rate or rhythm of the heartbeat. Plaque also can form in the heart's smallest arteries. This disease is called coronary microvascular disease (MVD). Symptoms of coronary MVD include angina, shortness of breath, sleep problems, fatigue (tiredness), and lack of energy. Carotid Arteries The carotid arteries supply oxygen-rich blood to your brain. If plaque narrows or blocks these arteries (a disease called carotid artery disease), you may have symptoms of a stroke. These symptoms may include: Sudden weakness Paralysis (an inability to move) or numbness of the face, arms, or legs, especially on one side of the body Confusion Trouble speaking or understanding speech Trouble seeing in one or both eyes Problems breathing Dizziness, trouble walking, loss of balance or coordination, and unexplained falls Loss of consciousness Sudden and severe headache Peripheral Arteries Plaque also can build up in the major arteries that supply oxygen-rich blood to the legs, arms, and pelvis (a disease called peripheral artery disease). If these major arteries are narrowed or blocked, you may have numbness, pain, and, sometimes, dangerous infections. Renal Arteries The renal arteries supply oxygen-rich blood to your kidneys. If plaque builds up in these arteries, you may develop chronic kidney disease. Over time, chronic kidney disease causes a slow loss of kidney function. Early kidney disease often has no signs or symptoms. As the disease gets worse it can cause tiredness, changes in how you urinate (more often or less often), loss of appetite, nausea (feeling sick to the stomach), swelling in the hands or feet, itchiness or numbness, and trouble concentrating. DIAGNOSIS Your doctor will diagnose atherosclerosis based on your medical and family histories, a physical exam, and test results. Specialists Involved If you have atherosclerosis, a primary care doctor, such as an internist or family practitioner, may handle your care. Your doctor may recommend other health care specialists if you need expert care, such as: A cardiologist. This is a doctor who specializes in diagnosing and treating heart diseases and conditions. You may go to a cardiologist if you have peripheral artery disease (P.A.D.) or coronary microvascular disease (MVD). A vascular specialist. This is a doctor who specializes in diagnosing and treating blood vessel problems. You may go to a vascular specialist if you have P.A.D. A neurologist. This is a doctor who specializes in diagnosing and treating nervous system disorders. You may see a neurologist if you've had a stroke due to carotid artery disease. A nephrologist. This is a doctor who specializes in diagnosing and treating kidney diseases and conditions. You may go to a nephrologist if you have chronic kidney disease. Physical Exam During the physical exam, your doctor may listen to your arteries for an abnormal whooshing sound called a bruit (broo-E). Your doctor can hear a bruit when placing a stethoscope over an affected artery. A bruit may indicate poor blood flow due to plaque buildup. Your doctor also may check to see whether any of your pulses (for example, in the leg or foot) are weak or absent. A weak or absent pulse can be a sign of a blocked artery. Diagnostic Tests Your doctor may recommend one or more tests to diagnose atherosclerosis. These tests also can help your doctor learn the extent of your disease and plan the best treatment. Blood Tests Blood tests check the levels of certain fats, cholesterol, sugar, and proteins in your blood. Abnormal levels may be a sign that you're at risk for atherosclerosis. EKG (Electrocardiogram) An EKG is a simple, painless test that detects and records the heart's electrical activity. The test shows how fast the heart is beating and its rhythm (steady or irregular). An EKG also records the strength and timing of electrical signals as they pass through the heart. An EKG can show signs of heart damage caused by CHD. The test also can show signs of a previous or current heart attack. Chest X Ray A chest x ray takes pictures of the organs and structures inside your chest, such as your heart, lungs, and blood vessels. A chest x ray can reveal signs of heart failure. Ankle/Brachial Index This test compares the blood pressure in your ankle with the blood pressure in your arm to see how well your blood is flowing. This test can help diagnose P.A.D. Echocardiography Echocardiography (echo) uses sound waves to create a moving picture of your heart. The test provides information about the size and shape of your heart and how well your heart chambers and valves are working. Echo also can identify areas of poor blood flow to the heart, areas of heart muscle that aren't contracting normally, and previous injury to the heart muscle caused by poor blood flow. Computed Tomography Scan A computed tomography (CT) scan creates computer-generated pictures of the heart, brain, or other areas of the body. The test can show hardening and narrowing of large arteries. A cardiac CT scan also can show whether calcium has built up in the walls of the coronary (heart) arteries. This may be an early sign of CHD. Stress Testing During stress testing, you exercise to make your heart work hard and beat fast while heart tests are done. If you can't exercise, you may be given medicine to make your heart work hard and beat fast. When your heart is working hard, it needs more blood and oxygen. Plaque-narrowed arteries can't supply enough oxygen-rich blood to meet your heart's needs. A stress test can show possible signs and symptoms of CHD, such as: Abnormal changes in your heart rate or blood pressure Shortness of breath or chest pain Abnormal changes in your heart rhythm or your heart's electrical activity As part of some stress tests, pictures are taken of your heart while you exercise and while you rest. These imaging stress tests can show how well blood is flowing in various parts of your heart. They also can show how well your heart pumps blood when it beats. Angiography Angiography (an-jee-OG-ra-fee) is a test that uses dye and special x rays to show the inside of your arteries. This test can show whether plaque is blocking your arteries and how severe the blockage is. A thin, flexible tube called a catheter is put into a blood vessel in your arm, groin (upper thigh), or neck. Dye that can be seen on an x-ray picture is injected through the catheter into the arteries. By looking at the x-ray picture, your doctor can see the flow of blood through your arteries. Other Tests Other tests are being studied to see whether they can give a better view of plaque buildup in the arteries. Examples of these tests include magnetic resonance imaging (MRI) and positron emission tomography (PET). TREATMENTS Treatments for atherosclerosis may include heart-healthy lifestyle changes, medicines, and medical procedures or surgery. The goals of treatment include: Lowering the risk of blood clots forming Preventing atherosclerosis-related diseases Reducing risk factors in an effort to slow or stop the buildup of plaque Relieving symptoms Widening or bypassing plaque-clogged arteries Heart-Healthy Lifestyle Changes Your doctor may recommend heart-healthy lifestyle changes if you have atherosclerosis. Heart-healthy lifestyle changes include heart-healthy eating, maintaining a healthy weight, managing stress, physical activity and quitting smoking. Heart-Healthy Eating Your doctor may recommend heart-healthy eating, which should include: Fat-free or low-fat dairy products, such as skim milk Fish high in omega-3 fatty acids, such as salmon, tuna, and trout, about twice a week Fruits, such as apples, bananas, oranges, pears, and prunes Legumes, such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans Vegetables, such as broccoli, cabbage, and carrots Whole grains, such as oatmeal, brown rice, and corn tortillas When following a heart-healthy diet, you should avoid eating: A lot of red meat Palm and coconut oils Sugary foods and beverages Two nutrients in your diet make blood cholesterol levels rise: Saturated fat—found mostly in foods that come from animals Trans fat (trans fatty acids)—found in foods made with hydrogenated oils and fats, such as stick margarine; baked goods, such as cookies, cakes, and pies; crackers; frostings; and coffee creamers. Some trans fats also occur naturally in animal fats and meats. Saturated fat raises your blood cholesterol more than anything else in your diet. When you follow a heart-healthy eating plan, only 5 percent to 6 percent of your daily calories should come from saturated fat. Food labels list the amounts of saturated fat. To help you stay on track, here are some examples: 1,200 calories a day 8 grams of saturated fat a day 1,500 calories a day 10 grams of saturated fat a day 1,800 calories a day 12 grams of saturated fat a day 2,000 calories a day 13 grams of saturated fat a day 2,500 calories a day 17 grams of saturated fat a day Not all fats are bad. Monounsaturated and polyunsaturated fats actually help lower blood cholesterol levels. Some sources of monounsaturated and polyunsaturated fats are: Avocados Corn, sunflower, and soybean oils Nuts and seeds, such as walnuts Olive, canola, peanut, safflower, and sesame oils Peanut butter Salmon and trout Tofu Sodium You should try to limit the amount of sodium that you eat. This means choosing and preparing foods that are lower in salt and sodium. Try to use low-sodium and “no added salt” foods and seasonings at the table or while cooking. Food labels tell you what you need to know about choosing foods that are lower in sodium. Try to eat no more than 2,300 milligrams of sodium a day. If you have high blood pressure, you may need to restrict your sodium intake even more. Dietary Approaches to Stop Hypertension Your doctor may recommend the Dietary Approaches to Stop Hypertension (DASH) eating plan if you have high blood pressure. The DASH eating plan focuses on fruits, vegetables, whole grains, and other foods that are heart healthy and low in fat, cholesterol, and sodium and salt. The DASH eating plan is a good heart-healthy eating plan, even for those who don’t have high blood pressure. Read more about DASH. Alcohol Try to limit alcohol intake. Too much alcohol will raise your blood pressure and triglyceride levels, a type of fat found in the blood. Alcohol also adds extra calories, which may cause weight gain. Men should have no more than two drinks containing alcohol a day. Women should have no more than one drink containing alcohol a day. One drink is: 12 ounces of beer 5 ounces of wine 1½ ounces of liquor Maintaining a Healthy Weight Maintaining a healthy weight is important for overall health and can lower your risk for coronary heart disease. Aim for a Healthy Weight by following a heart-healthy eating plan and keeping physically active. Knowing your body mass index (BMI) helps you find out if you’re a healthy weight in relation to your height and gives an estimate of your total body fat. To figure out your BMI, check out the National Heart, Lung, and Blood Institute’s online BMI calculator or talk to your doctor. A BMI: Below 18.5 is a sign that you are underweight. Between 18.5 and 24.9 is in the normal range. Between 25.0 and 29.9 is considered overweight. A BMI of 30.0 or higher is considered obese. A general goal to aim for is a BMI of less than 25. Your doctor or health care provider can help you set an appropriate BMI goal. Measuring waist circumference helps screen for possible health risks. If most of your fat is around your waist rather than at your hips, you’re at a higher risk for heart disease and type 2 diabetes. This risk may be high with a waist size that is greater than 35 inches for women or greater than 40 inches for men. To learn how to measure your waist, visit Assessing Your Weight and Health Risk. For more information about losing weight or maintaining your weight, visit Aim for a Healthy Weight. If you’re overweight or obese, try to lose weight. A loss of just 3 percent to 5 percent of your current weight can lower your triglycerides, blood glucose, and the risk of developing type 2 diabetes. Greater amounts of weight loss can improve blood pressure readings, lower LDL cholesterol, and increase HDL cholesterol. Managing Stress Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health. Consider healthy stress-reducing activities, such as: A stress management program Meditation Physical activity Relaxation therapy Talking things out with friends or family Physical Activity Regular physical activity can lower many atherosclerosis risk factors, including LDL or “bad” cholesterol, high blood pressure, and excess weight. Physical activity also can lower your risk for diabetes and raise your HDL or “good” cholesterol, which helps prevent atherosclerosis. Everyone should try to participate in moderate-intensity aerobic exercise at least 2 hours and 30 minutes per week or vigorous aerobic exercise for 1 hour and 15 minutes per week. Aerobic exercise, such as brisk walking, is any exercise in which your heart beats faster and you use more oxygen than usual. The more active you are, the more you will benefit. Participate in aerobic exercise for at least 10 minutes at a time spread throughout the week. Talk with your doctor before you start a new exercise plan. Ask your doctor how much and what kinds of physical activity are safe for you. Read more about physical activity at: Physical Activity and Your Heart U.S. Department of Health and Human Services, 2008 Physical Activity Guidelines for Americans Quitting Smoking If you smoke or use tobacco, quit. Smoking can damage and tighten blood vessels and raise your risk for atherosclerosis. Talk with your doctor about programs and products that can help you quit. Also, try to avoid secondhand smoke. If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking. For more information about how to quit smoking, visit Smoking and Your Heart. Medicines Sometimes lifestyle changes alone aren’t enough to control your cholesterol levels. For example, you also may need statin medications to control or lower your cholesterol. By lowering your blood cholesterol level, you can decrease your chance of having a heart attack or stroke. Doctors usually prescribe statins for people who have: Coronary heart disease, peripheral artery disease, or had a prior stroke Diabetes High LDL cholesterol levels Doctors may discuss beginning statin treatment with people who have an elevated risk for developing heart disease or having a stroke. Your doctor also may prescribe other medications to: Lower your blood pressure Lower your blood sugar levels Prevent blood clots, which can lead to heart attack and stroke Prevent inflammation Take all medicines regularly, as your doctor prescribes. Don’t change the amount of your medicine or skip a dose unless your doctor tells you to. You should still follow a heart healthy lifestyle, even if you take medicines to treat your atherosclerosis. Medical Procedures and Surgery If you have severe atherosclerosis, your doctor may recommend a medical procedure or surgery. Percutaneous coronary intervention (PCI), also known as coronary angioplasty, is a procedure that’s used to open blocked or narrowed coronary (heart) arteries. PCI can improve blood flow to the heart and relieve chest pain. Sometimes a small mesh tube called a stent is placed in the artery to keep it open after the procedure. Coronary artery bypass grafting (CABG) is a type of surgery. In CABG, arteries or veins from other areas in your body are used to bypass or go around your narrowed coronary arteries. CABG can improve blood flow to your heart, relieve chest pain, and possibly prevent a heart attack. Bypass grafting also can be used for leg arteries. For this surgery, a healthy blood vessel is used to bypass a narrowed or blocked artery in one of the legs. The healthy blood vessel redirects blood around the blocked artery, improving blood flow to the leg. Carotid endarterectomy is a type of surgery to remove plaque buildup from the carotid arteries in the neck. This procedure restores blood flow to the brain, which can help prevent a stroke. PREVENTION Taking action to control your risk factors can help prevent or delay atherosclerosis and its related diseases. Your risk for atherosclerosis increases with the number of risk factors you have. One step you can take is to adopt a healthy lifestyle, which can include: Heart-Healthy Eating. Adopt heart-healthy eating habits, which include eating different fruits and vegetables (including beans and peas), whole grains, lean meats, poultry without skin, seafood, and fat-free or low-fat milk and dairy products. A heart-healthy diet is low in sodium, added sugar, solid fats, and refined grains. Following a heart-healthy diet is an important part of a healthy lifestyle. Physical Activity. Be as physically active as you can. Physical activity can improve your fitness level and your health. Ask your doctor what types and amounts of activity are safe for you. Read more about Physical Activity and Your Heart. Quit Smoking. If you smoke, quit. Smoking can damage and tighten blood vessels and raise your risk for atherosclerosis. Talk with your doctor about programs and products that can help you quit. Also, try to avoid secondhand smoke. Read more about Smoking and Your Heart. Weight Control. If you’re overweight or obese, work with your doctor to create a reasonable weight-loss plan. Controlling your weight helps you control risk factors for atherosclerosis. Other steps that can prevent or delay atherosclerosis include knowing your family history of atherosclerosis. If you or someone in your family has an atherosclerosis-related disease, be sure to tell your doctor. If lifestyle changes aren’t enough, your doctor may prescribe medicines to control your atherosclerosis risk factors. Take all of your medicines as your doctor advises. LIVING WITH Improved treatments have reduced the number of deaths from atherosclerosis-related diseases. These treatments also have improved the quality of life for people who have these diseases. Adopting a healthy lifestyle may help you prevent or delay atherosclerosis and the problems it can cause. This, along with ongoing medical care, can help you avoid the problems of atherosclerosis and live a long, healthy life. Researchers continue to look for ways to improve the health of people who have atherosclerosis or may develop it. Ongoing Care If you have atherosclerosis, work closely with your doctor and other health care providers to avoid serious problems, such as heart attack and stroke. Follow your treatment plan and take all of your medicines as your doctor prescribes. Your doctor will let you know how often you should schedule office visits or blood tests. Be sure to let your doctor know if you have new or worsening symptoms. Emotional Issues and Support Having an atherosclerosis-related disease may cause fear, anxiety, depression, and stress. Talk about how you feel with your doctor. Talking to a professional counselor also can help. If you're very depressed, your doctor may recommend medicines or other treatments that can improve your quality of life. Community resources are available to help you learn more about atherosclerosis. Contact your local public health departments, hospitals, and local chapters of national health organizations to learn more about available resources in your area. Talk about your lifestyle changes with your family and friends—whoever can provide support or needs to understand why you're changing your habits. Family and friends may be able to help you make lifestyle changes. For example, they can help you plan healthier meals. Because atherosclerosis tends to run in families, your lifestyle changes may help many of your family members too. ", "role": "user" }, { "content": "Treatments for atherosclerosis may include heart-healthy lifestyle changes, medicines, and medical procedures or surgery. The goals of treatment are to lower your risk of blood clots, preventing atherosclerosis-related diseases, reducing risk factors for plaque buildup, and widening or bypassing plaque-clogged arteries.", "role": "assistant" } ]

[ { "content": "what is copd\n\nCOPD: Español   Also known as chronic obstructive pulmonary disease; chronic bronchitis; or emphysema. COPD, or chronic obstructive pulmonary disease, is a progressive disease that makes it hard to breathe. Progressive means the disease gets worse over time. COPD can cause coughing that produces large amounts of a slimy substance called mucus, wheezing, shortness of breath, chest tightness, and other symptoms. Cigarette smoking is the leading cause of COPD. Most people who have COPD smoke or used to smoke. However, up to 25 percent of people with COPD never smoked. Long-term exposure to other lung irritants—such as air pollution, chemical fumes, or dusts—also may contribute to COPD. A rare genetic condition called alpha-1 antitrypsin (AAT) deficiency can also cause the disease. Overview To understand COPD, it helps to understand how the lungs work. The air that you breathe goes down your windpipe into tubes in your lungs called bronchial tubes or airways. Within the lungs, your bronchial tubes branch many times into thousands of smaller, thinner tubes called bronchioles. These tubes end in bunches of tiny round air sacs called alveoli. Small blood vessels called capillaries run along the walls of the air sacs. When air reaches the air sacs, oxygen passes through the air sac walls into the blood in the capillaries. At the same time, a waste product, called carbon dioxide (CO2) gas, moves from the capillaries into the air sacs. This process, called gas exchange, brings in oxygen for the body to use for vital functions and removes the CO2. The airways and air sacs are elastic or stretchy. When you breathe in, each air sac fills up with air, like a small balloon. When you breathe out, the air sacs deflate and the air goes out. In COPD, less air flows in and out of the airways because of one or more of the following: The airways and air sacs lose their elastic quality. The walls between many of the air sacs are destroyed. The walls of the airways become thick and inflamed. The airways make more mucus than usual and can become clogged. Normal Lungs and Lungs With COPD In the United States, the term COPD includes two main conditions—emphysema and chronic bronchitis. In emphysema, the walls between many of the air sacs are damaged. As a result, the air sacs lose their shape and become floppy. This damage also can destroy the walls of the air sacs, leading to fewer and larger air sacs instead of many tiny ones. If this happens, the amount of gas exchange in the lungs is reduced. In chronic bronchitis, the lining of the airways stays constantly irritated and inflamed, and this causes the lining to swell. Lots of thick mucus forms in the airways, making it hard to breathe. Most people who have COPD have both emphysema and chronic bronchitis, but the severity of each condition varies from person to person. Thus, the general term COPD is more accurate. Outlook COPD is a major cause of disability, and it is the third leading cause of death in the United States. Currently, 16 million people are diagnosed with COPD. Many more people may have the disease and not even know it. COPD develops slowly. Symptoms often worsen over time and can limit your ability to do routine activities. Severe COPD may prevent you from doing even basic activities like walking, cooking, or taking care of yourself. Most of the time, COPD is diagnosed in middle-aged or older adults. The disease is not contagious, meaning it cannot be passed from person to person. COPD has no cure yet, and doctors do not know how to reverse the damage to the lungs. However, treatments and lifestyle changes can help you feel better, stay more active, and slow the progress of the disease.", "role": "user" }, { "content": "COPD, or chronic obstructive pulmonary disease, is a progressive disease that makes it hard to breathe. COPD can cause coughing that produces large amounts of mucus, wheezing, shortness of breath, chest tightness, and other symptoms. Cigarette smoking is the leading cause of COPD. COPD develops slowly, and most of the time, COPD is diagnosed in middle-aged or older adults. . Severe COPD may prevent you from doing even basic activities like walking, cooking, or taking care of yourself. The disease is not contagious. COPD has no cure yet, and the damage to the lungs is not reversible, but treatments and lifestyle changes can help you feel better, stay more active, and slow the progress of the disease.", "role": "assistant" } ]

[ { "content": "what is the cause of the coffin lowry syndrome?\n\nCoffin-Lowry syndrome (Genetic Changes): Mutations in the RPS6KA3 gene cause Coffin-Lowry syndrome. This gene provides instructions for making a protein that is involved in signaling within cells. Researchers believe that this protein helps control the activity of other genes and plays an important role in the brain. The protein is involved in cell signaling pathways that are required for learning, the formation of long-term memories, and the survival of nerve cells. Gene mutations result in the production of little or no RPS6KA3 protein, but it is unclear how a lack of this protein causes the signs and symptoms of Coffin-Lowry syndrome. Some people with the features of Coffin-Lowry syndrome do not have identified mutations in the RPS6KA3 gene. In these cases, the cause of the condition is unknown.", "role": "user" }, { "content": "Mutations in the RPS6KA3 gene cause Coffin-Lowry syndrome. This gene provides instructions for making a protein that is involved in signaling within cells. Gene mutations result in the production of little or no RPS6KA3 protein, but it is unclear how a lack of this protein causes the signs and symptoms of Coffin-Lowry syndrome. Some people with the features of Coffin-Lowry syndrome do not have identified mutations in the RPS6KA3 gene. In these cases, the cause of the condition is unknown.", "role": "assistant" } ]

[ { "content": "My father is suffering from IBS and is loosing weight day by day.sometimes he even faints due to weakness.He cannot digest food .please help us and suggest us upon this problem.\n\n Irritable bowel syndrome - aftercare IBS Mucus colitis IBS-D IBS-C Summary Irritable bowel syndrome (IBS) is a disorder that leads to abdominal pain and bowel changes. Your health care provider will talk about things you can do at home to manage your condition. What to Expect at Home Irritable bowel syndrome (IBS) may be a lifelong condition. You may be suffering from cramping and loose stools, diarrhea, constipation, or some combination of these symptoms. For some people, IBS symptoms may interfere with work, travel, and attending social events. But taking medicines and making lifestyle changes can help you manage your symptoms. Diet Changes in your diet may be helpful. However, IBS varies from person to person. So the same changes may not work for everyone. Keep track of your symptoms and the foods you are eating. This will help you look for a pattern of foods that may make your symptoms worse. Avoid foods that cause symptoms. These may include fatty or fried foods, dairy products, caffeine, sodas, alcohol, chocolate, and grains such as wheat, rye, and barley. Eat 4 to 5 smaller meals a day, rather than 3 larger ones. Increase the fiber in your diet to relieve symptoms of constipation. Fiber is found in whole grain breads and cereals, beans, fruits, and vegetables. Since fiber may cause gas, it is best to add these foods to your diet slowly. Medicines No one drug will work for everyone. Medicines your provider may have you try include: Antispasmodic medicines that you take before eating to control colon muscle spasms and abdominal cramping Antidiarrheal medicines such as loperamide Laxatives, such as lubiprostone, bisacodyl , and other ones bought without a prescription Antidepressants to help relieve pain or discomfort Rifaximin, an antibiotic that is not absorbed from your intestines It is very important to follow your provider's instructions when using medicines for IBS. Taking different medicines or not taking medicines the way you have been advised can lead to more problems. Stress Stress may cause your intestines to be more sensitive and contract more. Many things can cause stress, including: Not being able to do activities because of your pain Changes or problems at work or at home A busy schedule Spending too much time alone Having other medical problems A first step toward reducing your stress is to figure out what makes you feel stressed. Look at the things in your life that cause you the most worry. Keep a diary of the experiences and thoughts that seem to be related to your anxiety and see if you can make changes to these situations. Reach out to other people. Find someone you trust (such as a friend, family member, neighbor, or clergy member) who will listen to you. Often, just talking to someone helps relieve anxiety and stress. When to Call the Doctor Call your provider if: You develop a fever You have gastrointestinal bleeding You have bad pain that does not go away You lose over 5 to 10 pounds (2 to 4.5 kilograms) when you are not trying to lose weight Review Date 4/24/2017 Updated by: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Changes in your diet may be helpful. However, IBS varies from person to person. So the same changes may not work for everyone. - Keep track of your symptoms and the foods you are eating. This will help you look for a pattern of foods that may make your symptoms worse. - Avoid foods that cause symptoms. These may include fatty or fried foods, dairy products, caffeine, sodas, alcohol, chocolate, and grains such as wheat, rye, and barley. - Eat 4 to 5 smaller meals a day, rather than 3 larger ones. Medicines your provider may have you try include: - Antispasmodic medicines that you take before eating to control colon muscle spasms and abdominal cramping - Antidiarrheal medicines such as loperamide - Antidepressants to help relieve pain or discomfort - Rifaximin, an antibiotic that is not absorbed from your intestines It is very important to follow your provider's instructions when using medicines for IBS.", "role": "assistant" } ]

[ { "content": "how do you test for cholesterol level in your body\n\nHow to diagnose High blood cholesterol levels?: A cholesterol test is done to diagnose a lipid disorder. Some guidelines recommend having your first screening cholesterol test at age 20. Everyone should have their first screening test by age 35 in men, and age 45 in women. (Note: Different experts recommend different starting ages.) It is important to work with your health care provider to set your cholesterol goals. Newer guidelines steer doctors away from targeting specific levels of cholesterol. Instead, it recommends different medicines and doses depending on a person's history and risk factor profile. General targets are: - LDL: 70 to 130 mg/dL (lower numbers are better) - HDL: more than 50 mg/dL (high numbers are better) - Total cholesterol: less than 200 mg/dL (lower numbers are better) - Triglycerides: 10 to 150 mg/dL (lower numbers are better) If your cholesterol results are abnormal, you may also have other tests such as: - Blood sugar (glucose) test to look for diabetes - Kidney function tests - Thyroid function tests to look for an underactive thyroid gland", "role": "user" }, { "content": "How to diagnose High blood cholesterol levels?: A cholesterol test is done to diagnose a lipid disorder. Some guidelines recommend having your first screening cholesterol test at age 20. Everyone should have their first screening test by age 35 in men, and age 45 in women. (Note: Different experts recommend different starting ages.)", "role": "assistant" } ]

[ { "content": "adrenoleukodystrophy A child I have been asked to work with has been diagnosed with this condition.I am so far unable to find info pertaining to this illness. Can you help??\n\nWhat is Adrenoleukodystrophy?: X-linked Adrenoleukodystrophy (ALD) is one of a group of genetic disorders called the leukodystrophies that cause damage to the myelin sheath, an insulating membrane that surrounds nerve cells in the brain. Women have two X chromosomes and are the carriers of the disease, but since men only have one X chromosome and lack the protective effect of the extra X chromosome, they are more severely affected. People with X-ALD accumulate high levels of saturated, very long chain fatty acids (VLCFA) in the brain and adrenal cortex. The loss of myelin and the progressive dysfunction of the adrenal gland are the primary characteristics of X-ALD. While nearly all patients with X-ALD suffer from adrenal insufficiency, also known as Addison's disease, the neurological symptoms can begin either in childhood or in adulthood. The childhood cerebral form is the most severe, with onset between ages 4 and 10. The most common symptoms are usually behavioral changes such as abnormal withdrawal or aggression, poor memory, and poor school performance. Other symptoms include visual loss, learning disabilities, seizures, poorly articulated speech, difficulty swallowing, deafness, disturbances of gait and coordination, fatigue, intermittent vomiting, increased skin pigmentation, and progressive dementia. The milder adult-onset form is also known as adrenomyeloneuropathy (AMN), which typically begins between ages 21 and 35. Symptoms may include progressive stiffness, weakness or paralysis of the lower limbs, and ataxia. Although adult-onset ALD progresses more slowly than the classic childhood form, it can also result in deterioration of brain function. Almost half the women who are carriers of X-ALS will develop a milder form of AMN but almost never will develop symptoms seen in boys the X-ALD. X-ALD should not be confused with neonatal adrenoleukodsystrophy, which is a disease of newborns and young infants and belongs to the group of peroxisomal biogenesis disorders.", "role": "user" }, { "content": "X-linked Adrenoleukodystrophy (ALD) is one of a group of genetic disorders called the leukodystrophies that cause damage to the myelin sheath, an insulating membrane that surrounds nerve cells in the brain. Women have two X chromosomes and are the carriers of the disease, but since men only have one X chromosome and lack the protective effect of the extra X chromosome, they are more severely affected. People with X-ALD accumulate high levels of saturated, very long chain fatty acids (VLCFA) in the brain and adrenal cortex. The loss of myelin and the progressive dysfunction of the adrenal gland are the primary characteristics of X-ALD. While nearly all patients with X-ALD suffer from adrenal insufficiency, also known as Addison's disease, the neurological symptoms can begin either in childhood or in adulthood. The childhood cerebral form is the most severe, with onset between ages 4 and 10. The most common symptoms are usually behavioral changes such as abnormal withdrawal or aggression, poor memory, and poor school performance.Other symptoms include visual loss, learning disabilities, seizures, poorly articulated speech, difficulty swallowing, deafness, disturbances of gait and coordination, fatigue, intermittent vomiting, increased skin pigmentation, and progressive dementia. The milder adult-onset form is also known as adrenomyeloneuropathy (AMN), which typically begins between ages 21 and 35. Symptoms may include progressive stiffness, weakness or paralysis of the lower limbs, and ataxia. Although adult-onset ALD progresses more slowly than the classic childhood form, it can also result in deterioration of brain function. Almost half the women who are carriers of X-ALS will develop a milder form of AMN but almost never will develop symptoms seen in boys the X-ALD.", "role": "assistant" } ]

[ { "content": "I have been battling Anal fissure for close to two years now and it has refused to heal all these while. Please what do you suggest i do? Thanks\n\n Anal fissure Fissure in ano Anorectal fissure Anal ulcer Summary An anal fissure is a small split or tear in the thin moist tissue (mucosa) lining the lower rectum (anus). Causes Anal fissures are very common in infants, but they may occur at any age. In adults, fissures may be caused by passing large, hard stools, or having diarrhea for a long time. Other factors may include: Decreased blood flow to the area Too much tension in the sphincter muscles that control the anus The condition affects males and females equally. Anal fissures are also common in women after childbirth and in people with Crohn disease. Symptoms An anal fissure can be seen as a crack in the anal skin when the area is stretched slightly. The fissure is almost always in the middle. Anal fissures may cause painful bowel movements and bleeding. There may be blood on the outside of the stool or on the toilet paper (or baby wipes) after a bowel movement. Symptoms may begin suddenly or develop slowly over time. Exams and Tests The health care provider will perform a rectal exam and look at the anal tissue. Other medical tests that may be done include: Anoscopy -- examination of the anus, anal canal, and lower rectum Sigmoidoscopy -- examination of the lower part of large intestine Biopsy -- removal of rectal tissue for examination Colonoscopy -- examination of the colon Treatment Most fissures heal on their own and do not need treatment. To prevent or treat anal fissures in infants, be sure to change diapers often and clean the area gently. CHILDREN AND ADULTS Worrying about pain during a bowel movement may cause a person to avoid them. But not having bowel movements will only cause the stools to become even harder, which can make the anal fissure worse. Prevent hard stools and constipation by: Making dietary changes -- eating more fiber or bulk, such as fruits, vegetables, and grains Drinking more fluids Using stool softeners Ask your provider about the following ointments or creams to help soothe the affected skin: Numbing cream, if pain interferes with normal bowel movements Petroleum jelly Zinc oxide, 1% hydrocortisone cream, Preparation H, and other products A sitz bath is a warm water bath used for healing or cleansing. Sit in the bath 2 to 3 times a day. The water should cover only the hips and buttocks. If the anal fissures do not go away with home care methods, treatment may involve: Botox injections into the muscle in the anus (anal sphincter) Minor surgery to relax the anal muscle Prescription creams such as nitrates or calcium channel blockers, applied over the fissure to help relax the muscles Outlook (Prognosis) Anal fissures often heal quickly without any more problems. People who develop fissures once are more likely to have them in the future. Review Date 6/11/2018 Updated by: Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Prevent hard stools and constipation by: - Making dietary changes -- eating more fiber or bulk, such as fruits, vegetables, and grains - Drinking more fluids - Using stool softeners Ask your provider about the following ointments or creams to help soothe the affected skin: - Numbing cream, if pain interferes with normal bowel movements - Petroleum jelly - Zinc oxide, 1% hydrocortisone cream, Preparation H, and other products A sitz bath is a warm water bath used for healing or cleansing. Sit in the bath 2 to 3 times a day. The water should cover only the hips and buttocks. If the anal fissures do not go away with home care methods, treatment may involve: - Botox injections into the muscle in the anus (anal sphincter) - Minor surgery to relax the anal muscle - Prescription creams such as nitrates or calcium channel blockers, applied over the fissure to help relax the muscles", "role": "assistant" } ]

[ { "content": "how to prevent lung cancer\n\nLung cancer - small cell (Prevention): If you smoke, now is the time to quit. If you are having trouble quitting, talk with your provider. There are many methods to help you quit, from support groups to prescription medicines. Also try to avoid secondhand smoke. If you smoke or used to smoke, talk with your provider about getting screened for lung cancer. To get screened, you need to have a CT scan of the chest.", "role": "user" }, { "content": "If you smoke, now is the time to quit. If you are having difficulty quitting, talk to your health care provider. There are many methods to help you quit. Try to avoid secondhand smoke as well. If you smoke or have smoked in the past, talk with your provider about getting screened for lung cancer.", "role": "assistant" } ]

[ { "content": "I am suffering from Kartagener's syndrome and wanted information from you or from Dr. . for this syndrome. (About fertility) and if possible other symptoms. Thank you.\n\nKartagener syndrome (Inheritance): Kartagener syndrome is inherited in an autosomal recessive manner. [4] This means that to be affected, a person must have a mutation in both copies of the responsible gene in each cell . The parents of an affected person usually each carry one mutated copy of the gene and are referred to as carriers . Carriers typically do not show signs or symptoms of the condition. When two carriers of an autosomal recessive condition have children, each child has a 25% (1 in 4) risk to have the condition, a 50% (1 in 2) risk to be a carrier like each of the parents, and a 25% chance to not have the condition and not be a carrier.", "role": "user" }, { "content": "Kartagener syndrome is inherited in an autosomal recessive manner. [4] This means that to be affected, a person must have a mutation in both copies of the responsible gene in each cell . The parents of an affected person usually each carry one mutated copy of the gene and are referred to as carriers . Carriers typically do not show signs or symptoms of the condition. When two carriers of an autosomal recessive condition have children, each child has a 25% (1 in 4) risk to have the condition, a 50% (1 in 2) risk to be a carrier like each of the parents, and a 25% chance to not have the condition and not be a carrier.", "role": "assistant" } ]

[ { "content": "Anal Fissure I may have a couple anal fissures and looking to speak with someone to get some information and support.\n\nAnal fissure (Complications): Complications of anal fissure can include: - Failure to heal. An anal fissure that fails to heal within six weeks is considered chronic and may need further treatment. - Recurrence. Once you've experienced an anal fissure, you are prone to having another one. - A tear that extends to surrounding muscles. An anal fissure may extend into the ring of muscle that holds your anus closed (internal anal sphincter), making it more difficult for your anal fissure to heal. An unhealed fissure can trigger a cycle of discomfort that may require medications or surgery to reduce the pain and to repair or remove the fissure.", "role": "user" }, { "content": "Anal fissures may fail to heal, recur after healing and cause other complications, such as tears extending into the anal sphincter muscles. Fissures that fail to heal within six week may require medications to relieve symptoms or surgery to repair the leasions.", "role": "assistant" } ]

[ { "content": "My father is suffering from IBS and is loosing weight day by day.sometimes he even faints due to weakness.He cannot digest food .please help us and suggest us upon this problem.\n\n Irritable bowel syndrome - aftercare IBS Mucus colitis IBS-D IBS-C Summary Irritable bowel syndrome (IBS) is a disorder that leads to abdominal pain and bowel changes. Your health care provider will talk about things you can do at home to manage your condition. What to Expect at Home Irritable bowel syndrome (IBS) may be a lifelong condition. You may be suffering from cramping and loose stools, diarrhea, constipation, or some combination of these symptoms. For some people, IBS symptoms may interfere with work, travel, and attending social events. But taking medicines and making lifestyle changes can help you manage your symptoms. Diet Changes in your diet may be helpful. However, IBS varies from person to person. So the same changes may not work for everyone. Keep track of your symptoms and the foods you are eating. This will help you look for a pattern of foods that may make your symptoms worse. Avoid foods that cause symptoms. These may include fatty or fried foods, dairy products, caffeine, sodas, alcohol, chocolate, and grains such as wheat, rye, and barley. Eat 4 to 5 smaller meals a day, rather than 3 larger ones. Increase the fiber in your diet to relieve symptoms of constipation. Fiber is found in whole grain breads and cereals, beans, fruits, and vegetables. Since fiber may cause gas, it is best to add these foods to your diet slowly. Medicines No one drug will work for everyone. Medicines your provider may have you try include: Antispasmodic medicines that you take before eating to control colon muscle spasms and abdominal cramping Antidiarrheal medicines such as loperamide Laxatives, such as lubiprostone, bisacodyl , and other ones bought without a prescription Antidepressants to help relieve pain or discomfort Rifaximin, an antibiotic that is not absorbed from your intestines It is very important to follow your provider's instructions when using medicines for IBS. Taking different medicines or not taking medicines the way you have been advised can lead to more problems. Stress Stress may cause your intestines to be more sensitive and contract more. Many things can cause stress, including: Not being able to do activities because of your pain Changes or problems at work or at home A busy schedule Spending too much time alone Having other medical problems A first step toward reducing your stress is to figure out what makes you feel stressed. Look at the things in your life that cause you the most worry. Keep a diary of the experiences and thoughts that seem to be related to your anxiety and see if you can make changes to these situations. Reach out to other people. Find someone you trust (such as a friend, family member, neighbor, or clergy member) who will listen to you. Often, just talking to someone helps relieve anxiety and stress. When to Call the Doctor Call your provider if: You develop a fever You have gastrointestinal bleeding You have bad pain that does not go away You lose over 5 to 10 pounds (2 to 4.5 kilograms) when you are not trying to lose weight Review Date 4/24/2017 Updated by: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Look for foods that make the symptoms worse and change your diet to avoid such foods. These may include fatty or fried foods, dairy products, caffeine, sodas, alcohol, chocolate, and grains such as wheat, rye, and barley. Eat 4 or five smaller meals a day and follow your doctor's instructions to take medicines.", "role": "assistant" } ]

[ { "content": "adrenoleukodystrophy A child I have been asked to work with has been diagnosed with this condition.I am so far unable to find info pertaining to this illness. Can you help??\n\nX-linked adrenoleukodystrophy (Summary): X-linked adrenoleukodystrophy (X-ALD) is an inherited  condition that occurs mostly in males.  The condition mainly affects the nervous system and the adrenal glands (small glands located on top of each kidney). People with this disorder often have progressive destruction of the fatty covering ( myelin ) that insulates nerves in the brain and spinal cord. They may also have a shortage of certain hormones caused by damage to the outer layer of the adrenal glands (adrenal cortex), called adrenocortical insufficiency.  X-ALD is caused by mutations in the  gene . These gene mutations cause a shortage (deficiency) of a protein  called adrenoleukodystrophy protein (ALDP).  A deficiency of this protein leads to an abnormally high level of fat molecules called very long-chain fatty acids (VLCFA) to build up in the body.  High levels of VLCFA may be toxic to the adrenal cortex and myelin.   There are several forms of X-ALD including: a childhood cerebral form, an adrenomyeloneuropathy (AMN) type, and an adrenal insufficiency-only type. Another form of ALD is occasionally seen in women who are carriers of the condition [1] A specific treatment for X-ALD is not currently available, but eating a diet low in VLCFA and taking special oils can lower the blood levels of VLCFA.  Bone marrow transplantation (BMT) may be an option for boys and adolescents in early stages who have evidence of brain involvement on MRI . [2]  Adrenocortical insufficiency is treated with cortisone replacement.", "role": "user" }, { "content": "X-linked adrenoleukodystrophy (X-ALD) is an inherited condition that occurs mostly in males, and affects the nervous system and the adrenal glands located on top of each kidney. Treatments for X-ALD are not currently available. ,Eating a diet low in very long-chain fatty acids (VLCFA) and taking special oils can lower the blood levels of VLCFA, which might reduce damage to the adrenal cortex and myelin. Bone marrow transplantation (BMT) may be an option for boys and adolescents in early stages who have evidence of brain involvement on MRI . Adrenocortical insufficiency is treated with cortisone replacement.", "role": "assistant" } ]