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[ { "content": "how to prevent lung cancer\n\n Lung cancer - small cell Cancer - lung - small cell Small cell lung cancer SCLC Summary Small cell lung cancer (SCLC) is a fast-growing type of lung cancer. It spreads much more quickly than non-small cell lung cancer. There are two types of SCLC: Small cell carcinoma (oat cell cancer) Combined small cell carcinoma Most SCLCs are of the oat cell type. Causes About 15% of all lung cancer cases are SCLC. Small cell lung cancer is slightly more common in men than women. Almost all cases of SCLC are due to cigarette smoking. SCLC is very rare in people who have never smoked. SCLC is the most aggressive form of lung cancer. It usually starts in the breathing tubes (bronchi) in the center of the chest. Although the cancer cells are small, they grow very quickly and create large tumors. These tumors often spread rapidly (metastasize) to other parts of the body, including the brain, liver, and bone. Symptoms Symptoms of SCLC include: Bloody sputum (phlegm) Chest pain Cough Loss of appetite Shortness of breath Weight loss Wheezing Other symptoms that may occur with this disease, especially in the late stages, include: Facial swelling Fever Hoarseness or changing voice Swallowing difficulty Weakness Exams and Tests The health care provider will perform a physical exam and ask about your medical history. You will be asked whether you smoke, and if so, how much and for how long. When listening to your chest with a stethoscope, the provider may hear fluid around the lungs or areas where the lung has partially collapsed. Each of these findings may suggest cancer. SCLC has usually spread to other parts of your body by the time it is diagnosed. Tests that may be performed include: Bone scan Chest x-ray Complete blood count (CBC) CT scan Liver function tests MRI scan Positron emission tomography (PET) scan Sputum test (to look for cancer cells) Thoracentesis (removal of fluid from the chest cavity around the lungs) In most cases, a piece of tissue is removed from your lungs or other areas to be examined under a microscope. This is called a biopsy. There are several ways to do a biopsy: Bronchoscopy combined with biopsy CT scan-directed needle biopsy Endoscopic esophageal or bronchial ultrasound with biopsy Mediastinoscopy with biopsy Open lung biopsy Pleural biopsy Video-assisted thoracoscopy Usually, if a biopsy shows cancer, more imaging tests are done to find out the stage of the cancer. Stage means how big the tumor is and how far it has spread. SCLC is classified as either: Limited: cancer is only in the chest and can be treated with radiation therapy. Extensive: cancer has spread outside the area that can be covered by radiation. Treatment Because SCLC spreads quickly throughout the body, treatment will include cancer-killing drugs (chemotherapy), which are usually given through a vein (by IV). Treatment with chemotherapy and radiation may be done for people with SCLC that has spread throughout the body (most cases). In this case, the treatment only helps relieve symptoms and prolongs life, but does not cure the disease. Radiation therapy can be used with chemotherapy if surgery is not possible. Radiation therapy uses powerful x-rays or other forms of radiation to kill cancer cells. Radiation may be used to: Treat the cancer, along with chemotherapy, if surgery is not possible. Help relieve symptoms caused by the cancer, such as breathing problems and swelling. Help relieve cancer pain when the cancer has spread to the bones. Often, SCLC may have already spread to the brain. This can occur even when there are no symptoms or other signs of cancer in the brain. As a result, some people with smaller cancers, or who had a good response in their first round of chemotherapy may receive radiation therapy to the brain. This therapy is done to prevent spread of the cancer to the brain. Surgery helps very few people with SCLC because the disease has often spread by the time it is diagnosed. Surgery may be done when there is only one tumor that has not spread. If surgery is done, chemotherapy or radiation therapy is still needed. Support Groups You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone. Outlook (Prognosis) How well you do depends on how much the lung cancer has spread. SCLC is very deadly. Not many people with this type of cancer are still alive 5 years after diagnosis. Treatment can often prolong life for 6 to 12 months, even when the cancer has spread. In rare cases, if SCLC is diagnosed early, treatment may result in a long-term cure. When to Contact a Medical Professional Call your provider if you have symptoms of lung cancer, particularly if you smoke. 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. Review Date 8/14/2017 Updated by: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. 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. Editorial update 04/12/2018. ", "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": "My daughter has menkes syndrome and would like to know how to go about. Thx\n\nWhat is Menkes syndrome?: In Menkes syndrome, cells in the body can absorb copper, but they are unable to release it. It is one of several conditions called an \"inborn error of metabolism.\"", "role": "user" }, { "content": "In Menkes syndrome, cells in the body can absorb copper, but they are unable to release it.", "role": "assistant" } ]
[ { "content": "Causes of Peripheral Neuropathy What information does the National Library of Medicine have that states causes of peripheral neuropathy?\n\n Peripheral 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 Symptoms Every nerve in your peripheral system has a specific function, so symptoms depend on the type of nerves affected. Nerves are classified into: - Sensory nerves that receive sensation, such as temperature, pain, vibration or touch, from the skin - Motor nerves that control muscle movement - Autonomic nerves that control functions such as blood pressure, heart rate, digestion and bladder Signs and symptoms of peripheral neuropathy might include: - Gradual onset of numbness, prickling or tingling in your feet or hands, which can spread upward into your legs and arms - Sharp, jabbing, throbbing, freezing or burning pain - Extreme sensitivity to touch - Lack of coordination and falling - Muscle weakness or paralysis if motor nerves are affected If autonomic nerves are affected, signs and symptoms might include: - Heat intolerance and altered sweating - Bowel, bladder or digestive problems - Changes in blood pressure, causing dizziness or lightheadedness Peripheral neuropathy can affect one nerve (mononeuropathy), two or more nerves in different areas (multiple mononeuropathy) or many nerves (polyneuropathy). Carpal tunnel syndrome is an example of mononeuropathy. Most people with peripheral neuropathy have polyneuropathy. Seek medical care right away if you notice unusual tingling, weakness or pain in your hands or feet. Early diagnosis and treatment offer the best chance for controlling your symptoms and preventing further damage to your peripheral nerves. Causes Not a single disease, peripheral neuropathy is nerve damage caused by a number of conditions. Causes of neuropathies include: - Alcoholism. Poor dietary choices made by people with alcoholism can lead to vitamin deficiencies. - Autoimmune diseases. These include Sjogren's syndrome, lupus, rheumatoid arthritis, Guillain-Barre syndrome, chronic inflammatory demyelinating polyneuropathy and necrotizing vasculitis. - Diabetes. More than half the people with diabetes develop some type of neuropathy. - Exposure to poisons. Toxic substances include heavy metals or chemicals. - Medications. Certain medications, especially those used to treat cancer (chemotherapy), can cause peripheral neuropathy. - Infections. These include certain viral or bacterial infections, including Lyme disease, shingles, Epstein-Barr virus, hepatitis C, leprosy, diphtheria and HIV. - Inherited disorders. Disorders such as Charcot-Marie-Tooth disease are hereditary types of neuropathy. - Trauma or pressure on the nerve. Traumas, such as from motor vehicle accidents, falls or sports injuries, can sever or damage peripheral nerves. Nerve pressure can result from having a cast or using crutches or repeating a motion such as typing many times. - Tumors. Growths, cancerous (malignant) and noncancerous (benign), can develop on the nerves or press nerves. Also, polyneuropathy can arise as a result of some cancers related to the body's immune response. These are a form of paraneoplastic syndrome. - Vitamin deficiencies. B vitamins - including B-1, B-6 and B-12 - vitamin E and niacin are crucial to nerve health. - Bone marrow disorders. These include abnormal protein in the blood (monoclonal gammopathies), a form of bone cancer (osteosclerotic myeloma), lymphoma and amyloidosis. - Other diseases. These include kidney disease, liver disease, connective tissue disorders and an underactive thyroid (hypothyroidism). In a number of cases, no cause can be identified (idiopathic). Risk factors Peripheral neuropathy risk factors include: - Diabetes mellitus, especially if your sugar levels are poorly controlled - Alcohol abuse - Vitamin deficiencies, particularly B vitamins - Infections, such as Lyme disease, shingles, Epstein-Barr virus, hepatitis C and HIV - Autoimmune diseases, such as rheumatoid arthritis and lupus, in which your immune system attacks your own tissues - Kidney, liver or thyroid disorders - Exposure to toxins - Repetitive motion, such as those performed for certain jobs - Family history of neuropathy Complications Complications of peripheral neuropathy can include: - Burns and skin trauma. You might not feel temperature changes or pain on parts of your body that are numb. - Infection. Your feet and other areas lacking sensation can become injured without your knowing. Check these areas regularly and treat minor injuries before they become infected, especially if you have diabetes mellitus. - Falls. Weakness and loss of sensation may be associated with lack of balance and falling. Diagnosis Peripheral neuropathy has many potential causes. Besides a physical exam, which may include blood tests, diagnosis usually requires: - A full medical history. Your doctor will review your medical history, including your symptoms, your lifestyle, exposure to toxins, drinking habits and a family history of nervous system (neurological) diseases. - Neurological examination. Your doctor might check your tendon reflexes, your muscle strength and tone, your ability to feel certain sensations, and your posture and coordination. Your doctor may order tests, including: - Blood tests. These can detect vitamin deficiencies, diabetes, abnormal immune function and other indications of conditions that can cause peripheral neuropathy. - Imaging tests. CT or MRI scans can look for herniated disks, tumors or other abnormalities. - Nerve function tests. Electromyography records electrical activity in your muscles to detect nerve damage. A probe sends electrical signals to a nerve, and an electrode placed along the nerve's pathway records the nerve's response to the signals (nerve conduction studies). - Other nerve function tests. These might include an autonomic reflex screen that records how the autonomic nerve fibers work, a sweat test, and sensory tests that record how you feel touch, vibration, cooling and heat. - Nerve biopsy. This involves removing a small portion of a nerve, usually a sensory nerve, to look for abnormalities. - Skin biopsy. Your doctor removes a small portion of skin to look for a reduction in nerve endings. Treatment Treatment goals are to manage the condition causing your neuropathy and to relieve symptoms. If your lab tests indicate no underlying condition, your doctor might recommend watchful waiting to see if your neuropathy improves. Medications Besides medications used to treat conditions associated with peripheral neuropathy, medications used to relieve peripheral neuropathy signs and symptoms include: - Pain relievers. Over-the-counter pain medications, such as nonsteroidal anti-inflammatory drugs, can relieve mild symptoms. For more-severe symptoms, your doctor might prescribe painkillers. Medications containing opioids, such as tramadol (Conzip, Ultram) or oxycodone (Oxycontin, Roxicodone, others), can lead to dependence and addiction, so these drugs generally are prescribed only when other treatments fail. - Anti-seizure medications. Medications such as gabapentin (Gralise, Neurontin) and pregabalin (Lyrica), developed to treat epilepsy, may relieve nerve pain. Side effects can include drowsiness and dizziness. - Topical treatments. Capsaicin cream, which contains a substance found in hot peppers, can cause modest improvements in peripheral neuropathy symptoms. You might have skin burning and irritation where you apply the cream, but this usually lessens over time. Some people, however, can't tolerate it. Lidocaine patches are another treatment you apply to your skin that might offer pain relief. Side effects can include drowsiness, dizziness and numbness at the site of the patch. - Antidepressants. Certain tricyclic antidepressants, such as amitriptyline, doxepin and nortriptyline (Pamelor), have been found to help relieve pain by interfering with chemical processes in your brain and spinal cord that cause you to feel pain. The serotonin and norepinephrine reuptake inhibitor duloxetine (Cymbalta) and the extended-release antidepressant venlafaxine (Effexor XR) also might ease the pain of peripheral neuropathy caused by diabetes. Side effects may include dry mouth, nausea, drowsiness, dizziness, decreased appetite and constipation. Therapies Various therapies and procedures might help ease the signs and symptoms of peripheral neuropathy. - Transcutaneous electrical nerve stimulation (TENS). Electrodes placed on the skin deliver a gentle electric current at varying frequencies. TENS should be applied for 30 minutes daily for about a month. - Plasma exchange and intravenous immune globulin. These procedures, which help suppress immune system activity, might benefit people with certain inflammatory conditions. Plasma exchange involves removing your blood, then removing antibodies and other proteins from the blood and returning the blood to your body. In immune globulin therapy, you receive high levels of proteins that work as antibodies (immunoglobulins). - Physical therapy. If you have muscle weakness, physical therapy can help improve your movements. You may also need hand or foot braces, a cane, a walker, or a wheelchair. - Surgery. If you have neuropathies caused by pressure on nerves, such as pressure from tumors, you might need surgery to reduce the pressure. Lifestyle and home remedies To help you manage peripheral neuropathy: - Take care of your feet, especially if you have diabetes. Check daily for blisters, cuts or calluses. Wear soft, loose cotton socks and padded shoes. You can use a semicircular hoop, which is available in medical supply stores, to keep bedcovers off hot or sensitive feet. - Exercise. Regular exercise, such as walking three times a week, can reduce neuropathy pain, improve muscle strength and help control blood sugar levels. Gentle routines such as yoga and tai chi might also help. - Quit smoking. Cigarette smoking can affect circulation, increasing the risk of foot problems and other neuropathy complications. - Eat healthy meals. Good nutrition is especially important to ensure that you get essential vitamins and minerals. Include fruits, vegetables, whole grains and lean protein in your diet. - Avoid excessive alcohol. Alcohol can worsen peripheral neuropathy. - Monitor your blood glucose levels. If you have diabetes, this will help keep your blood glucose under control and might help improve your neuropathy. Alternative medicine Some people with peripheral neuropathy try complementary treatments for relief. Although researchers haven't studied these techniques as thoroughly as they have most medications, the following therapies have shown some promise: - Acupuncture. Inserting thin needles into various points on your body might reduce peripheral neuropathy symptoms. You might need multiple sessions before you notice improvement. Acupuncture is generally considered safe when performed by a certified practitioner using sterile needles. - Alpha-lipoic acid. This has been used as a treatment for peripheral neuropathy in Europe for years. Discuss using alpha-lipoic acid with your doctor because it can affect blood sugar levels. Other side effects can include stomach upset and skin rash. - Herbs. Certain herbs, such as evening primrose oil, might help reduce neuropathy pain in people with diabetes. Some herbs interact with medications, so discuss herbs you're considering with your doctor. - Amino acids. Amino acids, such as acetyl-L-carnitine, might benefit people who have undergone chemotherapy and people with diabetes. Side effects might include nausea and vomiting. ", "role": "user" }, { "content": "Causes of peripheral neuropathy include: trauma, infections, metabolic problems, and exposure to toxins. One of the most common causes of peripheral neuropathy is diabetes mellitus. It can also be inherited.", "role": "assistant" } ]
[ { "content": "why can you not take grapefruit with felodipine\n\n Felodipine Why is this medication prescribed? Felodipine is used to treat high blood pressure. Felodipine is in a class of medications called calcium channel blockers. It works by relaxing the blood vessels so your heart does not have to pump as hard. High blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation. How should this medicine be used? Felodipine comes as an extended release tablet to take by mouth. It is usually taken once a day. To help you remember to take felodipine, take it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take felodipine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Swallow the tablets whole; do not split, chew, or crush them. Felodipine controls high blood pressure but does not cure it. Continue to take felodipine even if you feel well. Do not stop taking felodipine without talking to your doctor. Other uses for this medicine This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. What special precautions should I follow? <h3>Before taking felodipine,</h3> /h3> tell your doctor and pharmacist if you are allergic to felodipine, any other medications, or any ingredients in felodipine tablets. Ask your pharmacist for a list of the ingredients. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: antiseizure medicines such as carbamazepine (Carbatrol, Equetro, Tegretol), phenytoin (Dilantin, Phenytek), and phenobarbital; cimetidine (Tagamet); erythromycin (E.E.S., Eryc, Ery-tab); itraconazole (Sporanox); ketoconazole (Nizoral); ranitidine (Zantac); and tacrolimus (Astagraf SL, Prograf). tell your doctor if you have or have ever had heart, liver, or kidney disease. tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking felodipine, call your doctor. if you are having surgery, including dental surgery, tell your doctor or dentist that you take felodipine. What special dietary instructions should I follow? Talk to your doctor about drinking grapefruit juice or eating grapefruit while taking felodipine. Talk to your doctor before using salt substitutes containing potassium. If your doctor prescribes a low-salt or low-sodium diet, follow these directions carefully. What should I do if I forget a dose? Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. What side effects can this medication cause? <h3>Felodipine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: </h3> /h3> headache flushing dizziness or lightheadedness weakness fast heartbeat heartburn constipation enlargement of gum tissue around teeth <h3>Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment: </h3> /h3> swelling of the face, eyes, lips, tongue, arms, or legs difficulty breathing or swallowing fainting rash If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088). What should I know about storage and disposal of this medication? Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location - one that is up and away and out of their sight and reach. http://www.upandaway.org Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program. In case of emergency/overdose In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911. What other information should I know? Keep all appointments with your doctor and the laboratory. Your blood pressure should be checked regularly to determine your response to felodipine. Good dental hygiene decreases the chance and severity of gum swelling. Brush your teeth regularly and schedule dental cleanings every 6 months. Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. Brand names Plendil Brand names of combination products Lexxel (containing Enalapril, Felodipine) ", "role": "user" }, { "content": "Talk to your doctor about drinking grapefruit juice or eating grapefruit while taking felodipine.", "role": "assistant" } ]
[ { "content": "what does kidney disease look like\n\n Diabetic Kidney Disease What is diabetic kidney disease? Diabetic kidney disease is a type of kidney disease caused by diabetes.Diabetes is the leading cause of kidney disease. About 1 out of 4 adults with diabetes has kidney disease.1The main job of the kidneys is to filter wastes and extra water out of your blood to make urine. Your kidneys also help control blood pressure and make hormones that your body needs to stay healthy.Your kidneys are located in the middle of your back, just below your rib cage.When your kidneys are damaged, they can’t filter blood like they should, which can cause wastes to build up in your body. Kidney damage can also cause other health problems.Kidney damage caused by diabetes usually occurs slowly, over many years. You can take steps to protect your kidneys and to prevent or delay kidney damage.Watch a video about Diabetes and Kidney Disease.What are other names for diabetic kidney disease?Diabetic kidney disease is also called DKD, chronic kidney disease, CKD, kidney disease of diabetes, or diabetic nephropathy. How does diabetes cause kidney disease? High blood glucose, also called blood sugar, can damage the blood vessels in your kidneys. When the blood vessels are damaged, they don’t work as well. Many people with diabetes also develop high blood pressure, which can also damage your kidneys. Learn more about high blood pressure and kidney disease. What increases my chances of developing diabetic kidney disease? Having diabetes for a longer time increases the chances that you will have kidney damage. If you have diabetes, you are more likely to develop kidney disease if yourblood glucose is too high blood pressure is too highAfrican Americans, American Indians, and Hispanics/Latinos develop diabetes, kidney disease, and kidney failure at a higher rate than Caucasians.You are also more likely to develop kidney disease if you have diabetes andsmoke don’t follow your diabetes eating plan eat foods high in salt are not active are overweight have heart disease have a family history of kidney failureIf you have diabetes, you are more likely to develop kidney disease if you have high blood pressure. How can I tell if I have diabetic kidney disease? Most people with diabetic kidney disease do not have symptoms. The only way to know if you have diabetic kidney disease is to get your kidneys checked.Health care professionals use blood and urine tests to check for diabetic kidney disease. Your health care professional will check your urine for albumin and will also do a blood test to see how well your kidneys are filtering your blood.You should get tested every year for kidney disease if youhave type 2 diabetes have had type 1 diabetes for more than 5 yearsHealth care professionals use blood and urine tests to check for kidney disease. How can I keep my kidneys healthy if I have diabetes? The best way to slow or prevent diabetes-related kidney disease is to try to reach your blood glucose and blood pressure goals. Healthy lifestyle habits and taking your medicines as prescribed can help you achieve these goals and improve your health overall.Reach your blood glucose goalsYour health care professional will test your A1C. The A1C is a blood test that shows your average blood glucose level over the past 3 months. This is different from the blood glucose checks that you may do yourself. The higher your A1C number, the higher your blood glucose levels have been during the past 3 months.The A1C goal for many people with diabetes is below 7 percent. Ask your health care team what your goal should be. Reaching your goal numbers will help you protect your kidneys.To reach your A1C goal, your health care professional may ask you to check your blood glucose levels. Work with your health care team to use the results to guide decisions about food, physical activity, and medicines. Ask your health care team how often you should check your blood glucose level.Protect your kidneys by keeping your blood glucose under control.Control your blood pressureBlood pressure is the force of your blood against the wall of your blood vessels. High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease.Your health care team will also work with you to help you set and reach your blood pressure goal. The blood pressure goal for most people with diabetes is below 140/90 mm Hg. Ask your health care team what your goal should be.Protect your kidneys by keeping your blood pressure under control.Medicines that lower blood pressure can also help slow kidney damage. Two types of blood pressure medicines, ACE inhibitors and ARBs, play a special role in protecting your kidneys. Each has been found to slow kidney damage in people with diabetes who have high blood pressure and DKD. The names of these medicines end in –pril or –sartan. ACE inhibitors and ARBs are not safe for women who are pregnant.Develop or maintain healthy lifestyle habitsHealthy lifestyle habits can help you reach your blood glucose and blood pressure goals. Following the steps below will also help you keep your kidneys healthy:Stop smoking. Work with a dietitian to develop a diabetes meal plan and limit salt and sodium. Make physical activity part of your routine. Stay at or get to a healthy weight. Get enough sleep. Aim for 7 to 8 hours of sleep each night.Learn more about these tips to manage diabetes.Take medicines as prescribedMedicines may be an important part of your treatment plan. Your health care professional will prescribe medicine based on your specific needs. Medicine can help you meet your blood glucose and blood pressure goals. You may need to take more than one kind of medicine to control your blood pressure.Talk to your health care professional or pharmacist about all of the medicines you take, including over-the-counter medicines. How can I cope with the stress of managing my diabetes? Managing diabetes isn’t always easy. Feeling stressed, sad, or angry is common when you are living with diabetes. You may know what to do to stay healthy but may have trouble sticking with your plan over time. Long-term stress can raise your blood glucose and blood pressure, but you can learn ways to lower your stress. Try deep breathing, gardening, taking a walk, doing yoga, meditating, doing a hobby, or listening to your favorite music. Learn more about healthy ways to cope with stress. Does diabetic kidney disease get worse over time? Kidney damage from diabetes can get worse over time. However, you can take steps to keep your kidneys healthy and help slow kidney damage to prevent or delay kidney failure. Kidney failure means that your kidneys have lost most of their ability to function—less than 15 percent of normal kidney function. However, most people with diabetes and kidney disease don’t end up with kidney failure.If your kidneys become damaged as a result of diabetes, learn how to manage kidney disease. Diabetic Kidney Disease [1] Afkarian M, Zelnick LR, Hall YN, et.al. Clinical manifestations of kidney disease among US adults with diabetes. Journal of the American Medical Association. 2016;316(6):602–610. ", "role": "user" }, { "content": "Most people with diabetic kidney disease do not have symptoms. The only way to know if you have diabetic kidney disease is to get your kidneys checked.Health care professionals use blood and urine tests to check for diabetic kidney disease. Your health care professional will check your urine for albumin and will also do a blood test to see how well your kidneys are filtering your blood.", "role": "assistant" } ]
[ { "content": "what blood tests confirm celiac disease\n\nCeliac Disease (What tests do doctors use to diagnose celiac disease?): A health care professional may take a blood sample from you and send the sample to a lab to test for antibodies common in celiac disease. If blood test results are negative and your doctor still suspects celiac disease, he or she may order more blood tests.If a biopsy and other blood tests do not clearly confirm celiac disease, your doctor may order genetic blood tests to check for certain gene changes, or variants.4 You are very unlikely to have celiac disease if these gene variants are not present. Having these variants alone is not enough to diagnose celiac disease because they also are common in people without the disease. In fact, most people with these genes will never get celiac disease.If blood tests suggest you have celiac disease, your doctor will perform a biopsy to be sure. During a biopsy, the doctor takes a small piece of tissue from your small intestine during a procedure called an upper GI endoscopy.If a doctor suspects you have dermatitis herpetiformis, he or she will perform a skin biopsy. For a skin biopsy, the doctor removes tiny pieces of skin tissue to examine with a microscope.A doctor examines the skin tissue and checks the tissue for antibodies common in celiac disease. If the skin tissue has the antibodies, a doctor will perform blood tests to confirm celiac disease. If the skin biopsy and blood tests both suggest celiac disease, you may not need an intestinal biopsy.", "role": "user" }, { "content": "A health care professional may take a blood sample from you and send the sample to a lab to test for antibodies common in celiac disease. If blood test results are negative and your doctor still suspects celiac disease, he or she may order more blood tests.If a biopsy and other blood tests do not clearly confirm celiac disease, your doctor may order genetic blood tests to check for certain gene changes, or variants.", "role": "assistant" } ]
[ { "content": "what the treatment for bronchitis\n\n Industrial bronchitis Occupational bronchitis Summary Industrial bronchitis is swelling (inflammation) of the large airways of the lungs that occurs in some people who work around certain dusts, fumes, smoke, or other substances. Causes Exposure to dusts, fumes, strong acids, and other chemicals in the air causes this type of bronchitis. Smoking may also contribute. You may be at risk if you are exposed to dusts that contain: Asbestos Coal Cotton Flax Latex Metals Silica Talc Toluene diisocyanate Western red cedar Symptoms Symptoms may include any of the following: Cough that brings up mucus (sputum) Shortness of breath Wheezing Exams and Tests The health care provider will listen to your lungs using a stethoscope. Wheezing sounds or crackles may be heard. Tests that may be ordered include: Chest CT scan Chest x-ray Pulmonary function tests (to measure breathing and how well the lungs are functioning) Treatment The goal of treatment is to reduce the irritation. Getting more air into the workplace or wearing masks to filter out the offending dust particles may help. Some people may need to be taken out of the workplace. Some cases of industrial bronchitis go away without treatment. Other times, a person may need inhaled anti-inflammatory medicines. If you are at risk or have experienced this problem and you smoke, stop smoking. Helpful measures include: Breathing humidified air Increasing fluid intake Resting Outlook (Prognosis) The outcome may be good as long as you can stop being exposed to the irritant. Chronic disability from industrial bronchitis is rare. Possible Complications Continued exposure to irritating gases, fumes, or other substances can lead to permanent lung damage. When to Contact a Medical Professional Call your provider if you are regularly exposed to dusts, fumes, strong acids, or other chemicals that can affect the lungs and you develop symptoms of bronchitis. Prevention Control dust in industrial settings by wearing face masks and protective clothing, and by treating textiles. Stop smoking if you are at risk. Get early screening by a doctor if you are exposed to chemicals that can cause this condition. If you think a chemical you work with is affecting your breathing, ask your employer for a copy of the Material Safety Data Sheet. Bring it with you to your provider. Review Date 11/14/2016 Updated by: Denis Hadjiliadis, MD, MHS, Paul F. Harron Jr. Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. 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 bronchitis occurs due to working around certain dusts, fumes, smoke, or other substances, the goal of treatment is to reduce the irritation by getting more air into the workplace or wearing masks. Some cases of such industrial bronchitis go away without treatment. Other, may need inhaled anti-inflammatory medicines. Helpful measures include: stopping smoking, breathing humidified air, increasing fluid intake, and resting.", "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\nGlaucoma (Symptoms): The signs and symptoms of glaucoma vary depending on the type and stage of your condition. For example: Open-angle glaucoma - Patchy blind spots in your side (peripheral) or central vision, frequently in both eyes - Tunnel vision in the advanced stages Acute angle-closure glaucoma - Severe headache - Eye pain - Nausea and vomiting - Blurred vision - Halos around lights - Eye redness If left untreated, glaucoma will eventually cause blindness. Even with treatment, about 15 percent of people with glaucoma become blind in at least one eye within 20 years. When to see a doctor Seek immediate medical care Promptly go to an emergency room or an eye doctor's (ophthalmologist's) office if you experience some of the symptoms of acute angle-closure glaucoma, such as severe headache, eye pain and blurred vision. Schedule eye exams Open-angle glaucoma gives few warning signs until permanent damage has already occurred. Regular eye exams are the key to detecting glaucoma early enough to successfully slow or prevent vision loss. The American Academy of Ophthalmology recommends glaucoma screening: - Every four years beginning at age 40 if you don't have any glaucoma risk factors - Every two years if you're at high risk or over 65", "role": "user" }, { "content": "Different types and stages of glaucoma have different symptoms. Open-angle glaucoma starts with patchy blind spots in peripheral or central vision, frequently in both eyes. In the advanced stages, the symptoms include tunnel vision. Open-angle glaucoma might have no symptoms until permanent damage has already occurred. Symptoms of acute angle-closure glaucoma include: severe headache, eye pain, nausea and vomiting, blurred vision, halos around lights, eye redness. Promptly go to an eye doctor if you experience some of the symptoms of acute angle-closure glaucoma, such as severe headache, eye pain and blurred vision. If left untreated, glaucoma will eventually cause blindness. Even with treatment, about 15 percent of people with glaucoma become blind in at least one eye within 20 years. Regular eye exams are the key to detecting glaucoma early enough to successfully slow or prevent vision loss.", "role": "assistant" } ]
[ { "content": "what is copd\n\n COPD What is COPD? Chronic obstructive pulmonary disease, or COPD, is a progressive lung disease in which the airways of the lungs become damaged, making it hard to breathe. You may also have heard COPD called other names, like emphysema or chronic bronchitis. In people who have COPD, the airways that carry air in and out of the lungs are partially blocked, making it difficult to get air in and out. COPD is a major cause of death and illness throughout the world. It kills more than 120,000 Americans each year. That's one death every 4 minutes. How COPD Affects Airways The \"airways\" are the tubes that carry air in and out of the lungs through the nose and mouth. The airways of the lungs branch out like an upside-down tree. At the end of each branch are many small, balloon-like air sacs. In healthy people, the airways and air sacs are elastic (stretchy). When you breathe in, each air sac fills up with air, like a small balloon, and when you breathe out, the balloon deflates and the air goes out. In people with COPD, the airways and air sacs lose their shape and become floppy. Less air gets in and less air goes out of the airways because - The airways and air sacs lose their elasticity like an old rubber band. - The walls between many of the air sacs are destroyed. - The walls of the airways become thick and inflamed or swollen. - Cells in the airways make more mucus or sputum than usual, which tends to clog the airways. The airways and air sacs lose their elasticity like an old rubber band. The walls between many of the air sacs are destroyed. The walls of the airways become thick and inflamed or swollen. Cells in the airways make more mucus or sputum than usual, which tends to clog the airways. COPD Develops Slowly, Has No Cure When COPD is severe, shortness of breath and other symptoms of COPD can get in the way of even the most basic tasks, such as doing light housework, taking a walk, even washing and dressing. COPD develops slowly, and it may be many years before you notice symptoms like feeling short of breath. Most of the time, COPD is diagnosed in middle-aged or older people. There is no cure for COPD. The damage to your airways and lungs cannot be reversed, but there are things you can do to control the disabling effects of the disease. COPD is not contagious. You cannot catch it from someone else. Causes Smoking Most cases of COPD develop over time, from breathing in fumes and other things that irritate the lungs. Some of the things that put you at risk for COPD include smoking, environmental exposure, and genetic factors. Cigarette smoking is the most common cause of COPD in the United States (either current or former smokers). Pipe, cigar, and other types of tobacco smoking can also cause COPD, especially if the smoke is inhaled. Environmental Exposure COPD can also occur in people who have had long-term exposure to things that can irritate your lungs, like chemical fumes, or dust from the environment or workplace. Heavy or long-term exposure to secondhand smoke or other air pollutants may also contribute to COPD even if you have never smoked or had long-term exposure to harmful pollutants. Secondhand smoke is smoke in the air from other people smoking. Genetic Factors In a small number of people, COPD is caused by a genetic condition known as alpha-1 antitrypsin, or AAT, deficiency. People who have this condition have low levels of alpha-1 antitrypsin (AAT)—a protein made in the liver. Having a low level of the AAT protein can lead to lung damage and COPD if you're exposed to smoke or other lung irritants. If you have this condition and smoke, COPD can worsen very quickly. While very few people know if they have AAT deficiency, it is estimated that about 1 in every 1,600 people to about 1 in every 5,000 people have it. People with AAT deficiency can get COPD even if they have never smoked or had long-term exposure to harmful pollutants. Asthma Although uncommon, some people who have asthma can develop COPD. Asthma is a chronic (long-term) lung disease that inflames and narrows the airways. Treatment usually can reverse the inflammation and narrowing. However, if not, COPD can develop. Preventing Complications If you have COPD, you can take these steps to prevent complications and control the disabling effects of the disease. - Quit smoking. - Avoid exposure to pollutants and lung irritants. - Take precautions against the flu. - Talk to your doctor about the flu and pneumonia vaccines. - See your doctor on a regular basis. - Follow your treatments for COPD exactly as your doctor prescribes. Quit smoking. Avoid exposure to pollutants and lung irritants. Take precautions against the flu. Talk to your doctor about the flu and pneumonia vaccines. See your doctor on a regular basis. Follow your treatments for COPD exactly as your doctor prescribes. Quit Smoking If you smoke, the most important thing you can do to prevent more lung damage is to stop smoking. Quitting can help prevent complications and slow the progress of the disease. It is also important to stay away from people who smoke and places where you know there will be smokers. To help you quit, there are many online resources and several new aids available from your doctor or health care provider. The National Cancer Institute (NCI) has information on smoking cessation. Visit SmokeFree.gov , or check out NCI's Clear Horizons, a quit smoking guide for people 50+. You can also visit The American Lung Association, or call 1-800-QUIT NOW (1-800-784-8669). Avoid Exposure to Pollutants and Lung Irritants Try to stay away from other things that could irritate your lungs, like dust and strong fumes. Stay indoors when the outside air quality is poor. You should also stay away from places where there might be cigarette smoke. Take Precautions Against the Flu The flu (influenza) can cause serious problems for people who have COPD. Do your best to avoid crowds during flu season. In addition to avoiding people with the flu, remembering to wash and sanitize your hands can be one of the best ways to guard against getting sick. Talk to Your Doctor About the Flu (influenza) and Pneumonia Vaccines Talk with your doctor about getting a yearly flu shot and whether and when you should get the pneumonia vaccine. Flu shots can reduce your risk of getting the flu, and the pneumonia vaccine lowers your risk for pneumococcal pneumonia (NU-mo-KOK-al nu-MO-ne-ah) and its complications. Both of these illnesses are major health risks for people who have COPD. See Your Doctor Regularly See your doctor or health care provider regularly even if you are feeling fine. Make a list of your breathing symptoms and think about any activities that you can no longer do because of shortness of breath. Be sure to bring a list of all the medicines you are taking to each office visit. Follow Your Treatments Follow your treatments for COPD exactly as your doctor prescribes. They can help you breathe easier, stay more active, and avoid or manage severe symptoms. Symptoms and Diagnosis Common Symptoms The most common symptoms of COPD are - a cough that does not go away - coughing up lots of sputum (mucus). a cough that does not go away coughing up lots of sputum (mucus). These symptoms often start years before the flow of air in and out of the lungs is reduced. Not everyone who has a cough and sputum goes on to develop COPD. Other common symptoms of COPD include - shortness of breath while doing activities you used to be able to do - wheezing (a whistling sound when you breathe) - tightness in the chest. shortness of breath while doing activities you used to be able to do wheezing (a whistling sound when you breathe) tightness in the chest. Getting a Diagnosis Your doctor will diagnose COPD based on your signs and symptoms, your medical and family histories, and test results. If your doctor thinks you may have COPD, he or she will examine you, listen to your lungs, and ask you questions about your medical history, and what lung irritants you may have been around for long periods of time. The Spirometry Test To confirm a diagnosis of COPD, your doctor will use a breathing test called spirometry. The test is easy and painless and shows how much air you can breathe out and measures how fast you can breathe it out. In a spirometry test, you breathe hard into a large hose connected to a machine called a spirometer. When you breathe out, the spirometer measures how much air your lungs can hold and how fast you can blow air out of your lungs. Spirometry can detect COPD before symptoms develop. Your doctor also might use the test results to find out how severe your COPD is and to help set your treatment goals. The test results also may help find out whether another condition, such as asthma or heart failure, is causing your symptoms. Determining COPD Severity Based on this test, your doctor can determine if you have COPD and how severe it is. There are four levels of severity for COPD: - people at risk for COPD - people with mild COPD - people with moderate COPD - people with severe COPD. people at risk for COPD people with mild COPD people with moderate COPD people with severe COPD. People at risk for developing COPD have a normal breathing test and mild symptoms such as chronic cough and sputum (mucus) production. People with mild COPD have mild breathing limitation. Symptoms may include a chronic cough and sputum (mucus) production. At this stage, you may not be aware that airflow in your lungs is reduced. People with moderate COPD have a breathing test that shows worsening airflow blockages. Symptoms may be worse than with mild COPD and you may experience shortness of breath while working hard, walking fast, or doing brisk activity. At this stage, you would seek medical attention. People with severe COPD have a breathing test that shows severe limitation of the airflow. People with severe COPD will be short of breath after just a little activity. In very severe COPD, complications like respiratory failure or signs of heart failure may develop. At this stage, quality of life is impaired and worsening symptoms may be life-threatening. Other Tests Other tests are used to rule out other causes of the symptoms. - Bronchodilator reversibility testing uses the spirometer and medications called bronchodilators to assess whether breathing problems may be caused by asthma. Bronchodilator reversibility testing uses the spirometer and medications called bronchodilators to assess whether breathing problems may be caused by asthma. - A chest X-ray or a chest CT scan may also be ordered by your doctor. These tests create pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. The pictures can show signs of COPD. They also may show whether another condition, such as heart failure, is causing your symptoms. A chest X-ray or a chest CT scan may also be ordered by your doctor. These tests create pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. The pictures can show signs of COPD. They also may show whether another condition, such as heart failure, is causing your symptoms. - An arterial blood gas test is another test that is used. This blood test shows the oxygen level in the blood to see how severe your COPD is and whether you need oxygen therapy. An arterial blood gas test is another test that is used. This blood test shows the oxygen level in the blood to see how severe your COPD is and whether you need oxygen therapy. Treating COPD Although there is no cure for COPD, treatments and lifestyle changes can help manage symptoms. Quit Smoking Quitting smoking is the most important step you can take to treat COPD. Talk with your doctor about programs and products that can help you quit. Many hospitals, workplaces, and community groups offer classes to help people quit smoking. Ask your family members and friends to support you in your efforts to quit. Also, try to avoid secondhand smoke and places with dust, fumes, or other toxic substances that you may inhale. (Secondhand smoke is smoke in the air from other people smoking.) The National Cancer Institute has information on smoking cessation. Visit SmokeFree.gov and check out Clear Horizons, a quit smoking guide for adults 50+. You can also visit the website of the American Lung Association at www.lung.org, or call 1-800-QUIT NOW (1-800-784-8669). Other Lifestyle Changes If you have COPD, you may have trouble eating enough because of your symptoms, such as shortness of breath and fatigue. (This issue is more common with severe disease.) As a result, you may not get all of the calories and nutrients you need, which can worsen your symptoms and raise your risk for infections. Talk with your doctor about following an eating plan that will meet your nutritional needs. Your doctor may suggest eating smaller, more frequent meals; resting before eating; and taking vitamins or nutritional supplements. Also, talk with your doctor about what types of activity are safe for you. You may find it hard to be active with your symptoms. However, physical activity can strengthen the muscles that help you breathe and improve your overall wellness. Treatment Goals The goals of COPD treatment are to - relieve symptoms with no or minimal side effects of treatment - slow the progress of the disease - improve the ability to stay active and exercise - prevent and treat any complications from the disease - improve health overall. relieve symptoms with no or minimal side effects of treatment slow the progress of the disease improve the ability to stay active and exercise prevent and treat any complications from the disease improve health overall. Treatment for COPD can be different for each person and is based on whether symptoms are mild, moderate, or severe. Treatments include medication, pulmonary or lung rehabilitation, oxygen treatment, and surgery. There are also treatments to manage complications or a sudden onset of symptoms. COPD Medications - Bronchodilators are medications that work by relaxing the muscles around your airways. This helps open your airways and makes breathing easier. Depending on the severity of your COPD, your doctor may prescribe short-acting or long-acting bronchodilators. Short-acting bronchodilators last about 4–6 hours and should be used only when needed. Long-acting bronchodilators last about 12 hours or more and are used every day. Most bronchodilators are inhaled directly into the lungs with the use of an inhaler. This device allows the medicine to go straight to your lungs. Not all inhalers are used the same way. Ask your health care team to show you the correct way to use your inhaler. People with mild COPD may use inhalers only when needed. Those with moderate or severe COPD may need more regular bronchodilator treatment. Bronchodilators are medications that work by relaxing the muscles around your airways. This helps open your airways and makes breathing easier. Depending on the severity of your COPD, your doctor may prescribe short-acting or long-acting bronchodilators. Short-acting bronchodilators last about 4–6 hours and should be used only when needed. Long-acting bronchodilators last about 12 hours or more and are used every day. Most bronchodilators are inhaled directly into the lungs with the use of an inhaler. This device allows the medicine to go straight to your lungs. Not all inhalers are used the same way. Ask your health care team to show you the correct way to use your inhaler. People with mild COPD may use inhalers only when needed. Those with moderate or severe COPD may need more regular bronchodilator treatment. - Inhaled steroids are used for some people with moderate or severe COPD. They work to reduce the inflammation or swelling in the airways. Your doctor may ask you to try inhaled steroids for a trial period of 6 weeks to 3 months to see whether the medicine helps relieve your breathing problems. Inhaled steroids are used for some people with moderate or severe COPD. They work to reduce the inflammation or swelling in the airways. Your doctor may ask you to try inhaled steroids for a trial period of 6 weeks to 3 months to see whether the medicine helps relieve your breathing problems. Vaccines Doctors recommend that people with COPD get an annual flu shot to avoid any breathing complications from the flu and a pneumococcal vaccine to prevent pneumonia. - Flu Shot. The flu (influenza) can cause serious problems for people who have COPD. Flu shots can reduce your risk of getting the flu. Talk with your doctor about getting a yearly flu shot. Flu Shot. The flu (influenza) can cause serious problems for people who have COPD. Flu shots can reduce your risk of getting the flu. Talk with your doctor about getting a yearly flu shot. - Pneumococcal Vaccine.This vaccine lowers your risk for pneumococcal pneumonia (NU-mo-KOK-al nu-MO-ne-ah) and its complications. People who have COPD are at higher risk for pneumonia than people who don't have COPD. Talk with your doctor about whether you should get this vaccine. Pneumococcal Vaccine.This vaccine lowers your risk for pneumococcal pneumonia (NU-mo-KOK-al nu-MO-ne-ah) and its complications. People who have COPD are at higher risk for pneumonia than people who don't have COPD. Talk with your doctor about whether you should get this vaccine. Pulmonary Rehabilitation In addition to medications, doctors may recommend pulmonary or lung rehabilitation (rehab) to help people with COPD stay active. Pulmonary rehabilitation may include exercise training, nutritional counseling, and education about managing the disease. The program's goal is to help you stay active and carry out your daily activities. A program of pulmonary rehabilitation would be managed by doctors, nurses, respiratory therapists, exercise specialists, and dietitians, and would be customized for each patient. Oxygen Therapy For people with severe COPD and low levels of oxygen in the blood, doctors may recommend oxygen therapy to help with shortness of breath. For this treatment, you're given oxygen through nasal prongs or a mask. You may need extra oxygen all the time or only at certain times. For some people who have severe COPD, using extra oxygen for most of the day can help them - do tasks or activities, while having fewer symptoms - protect their hearts and other organs from damage - sleep more during the night and improve alertness during the day - live longer. do tasks or activities, while having fewer symptoms protect their hearts and other organs from damage sleep more during the night and improve alertness during the day live longer. Surgery For some people with severe COPD, surgery may be recommended. Surgery is usually a last resort for patients who have severe symptoms that have not improved from taking medicines. Surgeries for people who have COPD that's mainly related to emphysema include bullectomy (bul-EK-toe-me) and lung volume reduction surgery (LVRS). A lung transplant might be an option for people who have very severe COPD. - Bullectomy. When the walls of the air sacs are destroyed, larger air spaces called bullae (BUL-e) form. These air spaces can become so large that they interfere with breathing. In a bullectomy, doctors remove one or more very large bullae from the lungs. Bullectomy. When the walls of the air sacs are destroyed, larger air spaces called bullae (BUL-e) form. These air spaces can become so large that they interfere with breathing. In a bullectomy, doctors remove one or more very large bullae from the lungs. - Lung Volume Reduction Surgery. In LVRS, surgeons remove damaged tissue from the lungs. This helps the lungs work better. In carefully selected patients, LVRS can improve breathing and quality of life. Lung Volume Reduction Surgery. In LVRS, surgeons remove damaged tissue from the lungs. This helps the lungs work better. In carefully selected patients, LVRS can improve breathing and quality of life. - Lung Transplant. During a lung transplant, your damaged lung is removed and replaced with a healthy lung from a deceased donor. A lung transplant can improve your lung function and quality of life. However, lung transplants have many risks, such as infections. The surgery can cause death if the body rejects the transplanted lung. If you have very severe COPD, talk with your doctor about whether a lung transplant is an option. Ask your doctor about the benefits and risks of this type of surgery. Lung Transplant. During a lung transplant, your damaged lung is removed and replaced with a healthy lung from a deceased donor. A lung transplant can improve your lung function and quality of life. However, lung transplants have many risks, such as infections. The surgery can cause death if the body rejects the transplanted lung. If you have very severe COPD, talk with your doctor about whether a lung transplant is an option. Ask your doctor about the benefits and risks of this type of surgery. If COPD Suddenly Gets Worse People with COPD usually have symptoms that worsen slowly over time. However, they can have symptoms that suddenly get worse. Call your doctor right away if your symptoms worsen suddenly. A cold, the flu, or a lung infection may cause your symptoms to quickly worsen. When this happens, you have a much harder time catching your breath. You should call your doctor right away if you have sudden chest tightness, more coughing, a change in your sputum (mucus), or fever. Your doctor will look at things that may be causing these sudden symptoms. Your doctor might recommend antibiotics to fight the infection, or bronchodilators or inhaled steroids to help you breathe. Some severe symptoms may require treatment in a hospital. Frequently Asked Questions What is COPD? Chronic obstructive pulmonary disease, or COPD, is a progressive lung disease in which the airways of the lungs become damaged, making it harder to breathe. With COPD, airways become blocked, making it harder to get air in and out. Can COPD cause someone to die? COPD is a disease that slowly worsens over time, especially if you continue to smoke. If you have COPD, you are more likely to have lung infections, which can be fatal. If the lungs are severely damaged, the heart may be affected. A person with COPD dies when the lungs and heart are unable to function and get oxygen to the body's organs and tissues, or when a complication, such as a severe infection, occurs. Treatment for COPD may help prevent complications, prolong life, and improve a person's quality of life. What causes COPD? Cigarette smoking is the most common cause of COPD. Most people with COPD are smokers or have been smokers in the past. Breathing in other fumes and dusts over long periods of time can also lead to COPD. Pipe, cigar, and other types of tobacco smoking can cause COPD, especially if the smoke is inhaled. Exposure to secondhand smoke can play a role in causing COPD. Most people with COPD are at least 40 years old or around middle age when symptoms start. What are the symptoms of COPD? The most common symptoms of COPD are a cough that does not go away and coughing up a lot of sputum (mucus). These symptoms may occur years before lung damage has reduced the flow of air in and out of the lungs. Other symptoms of COPD include shortness of breath, especially with exercise; wheezing (a whistling sound when you breathe); and tightness in the chest. How is COPD diagnosed? To confirm a COPD diagnosis, a doctor will use a breathing test called spirometry. The test is easy and painless. It shows how well the lungs are working. The spirometer measures how much air the lungs can hold and how fast air is blown out of the lungs. Other tests, such as bronchodilator reversibility testing, a chest X-ray, and arterial blood gas test, may be ordered. What are the treatments for COPD? Treatment for COPD can be different for each person and is based on whether symptoms are mild, moderate or severe. Treatments include medication, pulmonary or lung rehabilitation, oxygen treatment, and surgery. There are also treatments to manage complications or a sudden onset of symptoms. If I am diagnosed with COPD, can I exercise? If you have not been exercising regularly, you should get the advice of your doctor before starting. The symptoms of COPD are different for each person. People with mild COPD may not have much difficulty walking or exercising. As the symptoms of COPD get worse over time, a person may have more difficulty with walking and exercising. You should talk to your doctor about exercising and whether you would benefit from a pulmonary or lung rehabilitation program. If my doctor sends me for pulmonary rehabilitation, what type of people will I be working with and what do they do? The pulmonary rehabilitation team is a group of health care professionals who work together with the patient and his/her own doctor to develop and monitor rehabilitation programs for patients with chronic lung diseases. Each member brings to the team expertise from his or her own area of specialty. Each team may have a different makeup and combination of staff depending on what is needed and who is available. Teams can include a doctor, a nurse, a respiratory therapist, a physical therapist, an occupational therapist, an exercise therapist, a sociologist, a social worker, and a dietitian. - A doctor with a special interest in working with patients with lung problems usually leads the team. - A nurse with special training in lung problems can help evaluate patients, develop the treatment plan, and make sure the program works for the patient and that the goals of the program are being met. - A respiratory therapist may help teach breathing techniques and proper use of equipment such as nebulizers and oxygen. - A physical therapist may help with physical training to improve strength, flexibility, and ability to exercise. - An occupational therapist can teach easier ways of doing everyday activities such as dressing, bathing, running errands, and doing chores. - An exercise therapist is someone with special training to help people with their physical activity and exercise. - A psychologist, social worker, or other therapist may help with the emotional adjustments to living with chronic lung disease. - A dietitian can work with persons with chronic lung diseases to make sure they are getting enough nutrition in their diets. A doctor with a special interest in working with patients with lung problems usually leads the team. A nurse with special training in lung problems can help evaluate patients, develop the treatment plan, and make sure the program works for the patient and that the goals of the program are being met. A respiratory therapist may help teach breathing techniques and proper use of equipment such as nebulizers and oxygen. A physical therapist may help with physical training to improve strength, flexibility, and ability to exercise. An occupational therapist can teach easier ways of doing everyday activities such as dressing, bathing, running errands, and doing chores. An exercise therapist is someone with special training to help people with their physical activity and exercise. A psychologist, social worker, or other therapist may help with the emotional adjustments to living with chronic lung disease. A dietitian can work with persons with chronic lung diseases to make sure they are getting enough nutrition in their diets. How can I prevent my COPD from getting worse? If you smoke, the most important thing you can do to prevent more lung damage is to stop smoking. It is also important to stay away from people who smoke and places where you know there will be smokers. Avoid exposure to pollutants like dust, fumes, and poor air quality, and take precautions to prevent flu and pneumonia. Following your doctor's instructions with medications and rehabilitative treatment can help alleviate COPD symptoms and control the disabling effects of the disease. What medications are used to treat COPD? Bronchodilators and inhaled steroids are two medications used to treat COPD. Bronchodilators work by relaxing the muscles around the airways, opening them and making it easier to breathe. People with mild COPD take bronchodilators using an inhaler only when needed. Those with moderate or severe COPD may need more regular treatment. Inhaled steroids also are used for people with moderate or severe COPD in order to reduce swelling in the airways. When is oxygen therapy used for COPD? For people with severe COPD and low levels of oxygen in the blood, doctors may recommend oxygen therapy to help with shortness of breath. Using extra oxygen more than 15 hours per day can help you perform tasks or activities with less shortness of breath, protect the heart and other organs from damage, help you sleep more, improve your alertness during the day, and help you live longer. When is surgery recommended for people with COPD? For some people with severe COPD, surgery may be recommended. Surgery is usually done for patients who have severe symptoms, have not gotten improvement from medications, and have a hard time breathing most of the time. There are two types of surgery that are considered in the case of severe COPD; a bullectomy, which removes a large air sac that may compress a good lung, or lung volume reduction surgery. A lung transplant may be done for some people with very severe COPD. What should I do if my COPD symptoms suddenly get worse? Call your doctor right away if your symptoms worsen suddenly. People with COPD may have symptoms that suddenly get worse. When this happens, you have a much harder time catching your breath. Symptoms that worsen suddenly can include sudden chest tightness, more coughing, a change in your sputum (mucus), or fever. Your doctor will look at things that may be causing these sudden symptoms. Sometimes the symptoms are caused by a lung infection. Where else can I find information on COPD? More information on COPD is available at: What is COPD? and at the Learn More, Breathe Better Campaign® For information on quitting smoking, visit http://www.surgeongeneral.gov/tobacco/ or Smokefree.gov. For information on the H1N1 flu and COPD, go to The Centers for Disease Control and Prevention. ", "role": "user" }, { "content": "COPD, Chronic obstructive pulmonary disease, is a progressive lung disease in which the airways of the lungs become damaged and blocked, making it harder to breathe.", "role": "assistant" } ]
[ { "content": "how to prevent schizophrenia\n\n Schizophrenia Psychosis - schizophrenia Psychotic disorders - schizophrenia Summary Schizophrenia is a mental disorder that makes it hard to tell the difference between what is real and not real. It also makes it hard to think clearly, have normal emotional responses, and act normally in social situations. Causes Schizophrenia is a complex illness. Mental health experts are not sure what causes it. Genes may play a role. Schizophrenia occurs in just as many men as women. It usually begins in the teen or young adult years, but it may begin later in life. In women, it tends to begin later and is a milder condition. Schizophrenia in children usually begins after age 5. Childhood schizophrenia is rare and can be hard to tell apart from other developmental problems, such as autism spectrum disorder. Symptoms Symptoms usually develop slowly over months or years. The person may have many symptoms, or only a few. People with schizophrenia may have trouble keeping friends and working. They may also have problems with anxiety, depression, and suicidal thoughts or behaviors. Early symptoms may include: Irritable or tense feelings Trouble concentrating Trouble sleeping As the illness continues, the person may have problems with thinking, emotions, and behavior, including: Hearing or seeing things that are not there (hallucinations) Isolation Reduced emotions in tone of voice or expression of face Problems with understanding and making decisions Problems paying attention and following through with activities Strongly held beliefs that are not real (delusions) Talking in a way that does not make sense Thoughts that \"jump\" between different topics (loose associations) Exams and Tests There are no medical tests to diagnose schizophrenia. A psychiatrist should examine the person and make the diagnosis. The diagnosis is made based on an interview of the person and family members. The psychiatrist will ask about the following: How long symptoms have lasted How the person's ability to function has changed What the person's developmental background was like About the person's genetic and family history How well medicines have worked Whether the person has problems with substance abuse Other medical conditions the person has Brain scans (such as CT or MRI) and blood tests may help rule out other conditions that have similar symptoms. Treatment During an episode of schizophrenia, the person may need to stay in the hospital for safety reasons. MEDICINES Antipsychotic drugs are the most effective treatment for schizophrenia. They change the balance of chemicals in the brain and can help control symptoms. These drugs can cause side effects, but many side effects can be managed. Side effects should not prevent the person from getting treated for this serious condition. Common side effects from antipsychotics may include: Dizziness Feelings of restlessness or jitteriness Sleepiness (sedation) Slowed movements Tremor Weight gain Long-term use of antipsychotics may increase the risk of a movement disorder called tardive dyskinesia. This condition causes repeated movements that the person cannot control. Call the health care provider right away if you think you or your family member may have this condition due to the medicine. When schizophrenia does not improve with antipsychotics, other medicines may be tried. Schizophrenia is a life-long illness. Most people with this condition need to stay on antipsychotics for life. SUPPORT PROGRAMS AND THERAPIES Support therapy may be helpful for many people with schizophrenia. Behavioral techniques, such as social skills training, can help the person function better in social and work situations. Job training and relationship-building classes are also important. Family members and caregivers are very important during treatment. Therapy can teach important skills, such as: Coping with symptoms that continue, even while taking medicines Following a healthy lifestyle, including getting enough sleep and staying away from recreational drugs Taking medicines correctly and managing side effects Watching for the return of symptoms, and knowing what to do when they return Getting the right support services Outlook (Prognosis) Outlook is hard to predict. Most of the time, symptoms improve with medicines. But many people may have trouble functioning. They are at risk of repeated episodes, especially during the early stages of the illness. People with schizophrenia may need housing, job training, and other community support programs. Those with the most severe forms of this disorder may not be able to live alone. They may need to live in group homes or other long-term, structured residences. Symptoms are very likely to return when medicine is stopped. Possible Complications Having schizophrenia increases the risk of: Developing a problem with alcohol or drugs. Using these substances increases the chances that symptoms will return. Physical illness. This is due to an inactive lifestyle and side effects of medicines. Suicide. When to Contact a Medical Professional Call your provider if you (or a family member): Hear voices telling you to hurt yourself or others Have the urge to hurt yourself or others Feel scared or overwhelmed See things that are not really there Feel that you cannot leave the house Feel that you are not able to care for yourself Prevention Schizophrenia cannot be prevented. Symptoms may be prevented by taking medicine exactly as the doctor instructed. Symptoms are likely to return if medicine is stopped. Changing or stopping medicines should only be done by the doctor who prescribed them. Review Date 8/14/2017 Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Internal review and update on 11/06/2018 by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Schizophrenia cannot be prevented. Symptoms may be prevented by taking medicine exactly as the doctor instructed. Symptoms are likely to return if medicine is stopped. Changing or stopping medicines should only be done by the doctor who prescribed them.", "role": "assistant" } ]
[ { "content": "how smoking tobacco affects the rest of the body\n\nSmoking and surgery: Quitting smoking and other tobacco products before surgery can improve your recovery and outcome after surgery. Most people who successfully quit smoking have tried and failed many times. DO NOT give up. Learning from your past tries can help you succeed. Tar, nicotine, and other chemicals from smoking can increase your risk of many health problems. These include heart and blood vessel problems, such as: - Blood clots and aneurysms in the brain, which can lead to strokes - Coronary artery disease, including chest pain (angina) and heart attacks - High blood pressure - Poor blood supply to the legs - Problems with erections Smoking also increases your risk for different types of cancer, including cancer of the: - Lungs - Mouth - Larynx - Esophagus - Bladder - Kidneys - Pancreas - Cervix Smoking also leads to lung problems, such as emphysema and chronic bronchitis, and makes asthma harder to control. Some smokers switch to smokeless tobacco instead of quitting tobacco completely. But using smokeless tobacco still carries health risks, such as: - Developing mouth or nasal cancer - Gum problems, tooth wear, and cavities - Worsening high blood pressure and chest pain Smokers who have surgery have a higher chance than nonsmokers of blood clots forming in their legs. These clots may travel to and damage the lungs. Smoking decreases the amount of oxygen that reaches the cells in your surgical wound. As a result, your wound may heal more slowly and is more likely to become infected. All smokers carry an increased risk for heart and lung problems. Even when your surgery goes smoothly, smoking causes your body, heart, and lungs to work harder than if you did not smoke. Most doctors will tell you to stop using cigarettes and tobacco at least 4 weeks before your surgery. Stretching the time between quitting smoking and your surgery out to at least 10 weeks can decrease your risk of problems even more. Like any addiction, quitting tobacco is difficult. There are many ways to quit smoking and many resources to help you, such as: - Family members, friends, and coworkers may be supportive or encouraging. - Talk to your doctor about medicines, such as nicotine replacement and prescription medicines. - If you join smoking cessation programs, you have a much better chance of success. Such programs are offered by hospitals, health departments, community centers, and work sites. Using nicotine gum around the time of surgery is not encouraged. The nicotine will still interfere with the healing of your surgical wound and have the same effect on your general health as using cigarettes and tobacco. 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, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.", "role": "user" }, { "content": "Tar, nicotine, and other chemicals from smoking can increase your risk of many health problems. These include heart and blood vessel problems, such as: - Blood clots and aneurysms in the brain, which can lead to strokes - Coronary artery disease, including chest pain (angina) and heart attacks - High blood pressure - Poor blood supply to the legs - Problems with erections Smoking also increases your risk for different types of cancer, including cancer of the: - Lungs - Mouth - Larynx - Esophagus - Bladder - Kidneys - Pancreas - Cervix Smoking also leads to lung problems, such as emphysema and chronic bronchitis, and makes asthma harder to control.", "role": "assistant" } ]
[ { "content": "how to prevent diabetes\n\n Diabetes Overview Diabetes is a disease in which blood sugar (glucose) levels in your body are too high. Diabetes can cause serious health problems, including heart attack or stroke, blindness, problems during pregnancy, and kidney failure. More than 13 million women have diabetes, or about one in 10 women ages 20 and older.1 What is diabetes? Diabetes is a disease caused by high levels of blood sugar (glucose) in your body. This can happen when your body does not make insulin or does not use insulin correctly. Insulin is a hormone made in the pancreas, an organ near your stomach. Insulin helps the glucose from food get into your body's cells for energy. If your body does not make enough insulin, or your body does not use the insulin correctly, the glucose stays and builds up in your blood. Over time, this extra glucose can lead to prediabetes or diabetes. Diabetes puts you at risk for other serious and life-threatening health problems, such as heart disease, stroke, blindness, and kidney damage. What are the different types of diabetes? The three main types of diabetes are: Am I at risk for diabetes? A risk factor is something that puts you at a higher risk for a disease compared with an average person. Risk factors for type 1 diabetes in women and girls include: Risk factors for type 2 diabetes in women and girls include:4 If you have any of these risk factors, talk to your doctor about ways to lower your risk for diabetes. You can also take the Diabetes Risk Test and talk about the results with your doctor. Who gets diabetes? Type 1 diabetes usually develops in childhood, but it can happen at any age. It is more common in whites than in other racial or ethnic groups. About 5% of adults with diabetes have type 1 diabetes.1 Genes you inherit from your parents play an important role in the development of type 1 diabetes. However, where you live may also affect your risk. Type 1 diabetes develops more often in winter and in people who live in colder climates. Type 2 diabetes is more common in adults, especially in people who are overweight and have a family history of diabetes. About 95% of adults with diabetes have type 2 diabetes.1 Type 2 diabetes is becoming more common in children and teens as more of them become overweight and obese.5 Do women of color need to worry about diabetes? Yes. Certain racial and ethnic groups have a higher risk for type 2 diabetes. These groups include: How does diabetes affect women differently than men? Diabetes affects women and men in almost equal numbers. However, diabetes affects women differently than men. Compared with men with diabetes, women with diabetes have:9 Does diabetes raise my risk for other health problems? Yes. The longer you have type 2 diabetes, the higher your risk for developing serious medical problems from diabetes. Also, if you smoke and have diabetes, you are even more likely to develop serious medical problems from diabetes, compared with people who have diabetes and do not smoke.11 The extra glucose in the blood that leads to diabetes can damage your nerves and blood vessels. Nerve damage from diabetes can lead to pain or a permanent loss of feeling in your hands, feet, and other parts of your body.12 Blood vessel damage from diabetes can also lead to: Women with diabetes are also at higher risk for: What causes diabetes? Researchers do not know the exact causes of type 1 and type 2 diabetes. Researchers do know that inheriting certain genes from your family can raise your risk for developing diabetes. Obesity is also a major risk factor for type 2 diabetes. Smoking can also cause type 2 diabetes. And the more you smoke the higher your risk for type 2 diabetes and other serious health problems if you already have diabetes.13 Weight loss can help control type 2 diabetes so that you are healthier. Quitting smoking can also help you control your blood sugar levels. Being a healthy weight and not smoking can help all women be healthier. But, obesity and smoking do not always cause diabetes. Some women who are overweight or obese or smoke never develop diabetes. Also, women who are a normal weight or only slightly overweight can develop diabetes if they have other risk factors, such as a family history of diabetes. What are the signs and symptoms of diabetes? Type 1 diabetes symptoms are usually more severe and may develop suddenly. Type 2 diabetes may not cause any signs or symptoms at first. Symptoms can develop slowly over time. You may not notice them right away. Common signs and symptoms of type 1 and type 2 diabetes include: Do I need to be tested for diabetes? Maybe. You should be tested for diabetes if you are between 40 and 70 years old and are overweight or obese. Your doctor may recommend testing earlier than age 40 if you also have other risk factors for diabetes. Also, talk to your doctor about diabetes testing if you have signs or symptoms of diabetes. Your doctor will use a blood test to see if you have diabetes. If the testing shows that your blood sugar levels are high, you can begin making healthy changes to your eating habits and getting more physical activity to help prevent diabetes. What is prediabetes? Prediabetes means your blood sugar (glucose) level is higher than normal, but it is lower than the diabetes range. It also means you are at higher risk of getting type 2 diabetes and heart disease. As many as 27 million American women have prediabetes.14 If you have prediabetes, you can make healthy changes, such as doing some type of physical activity on most days, to lower your risk of getting diabetes and return to normal blood sugar levels. Losing 7% of your body weight (or 14 pounds if you weigh 200 pounds) can lower your risk for type 2 diabetes by more than half. If you have prediabetes, get your blood glucose checked every year by a doctor or nurse.15 How is diabetes treated? Diabetes treatment includes managing your blood sugar levels to control your symptoms. You can help control your blood sugar levels by eating healthy and getting regular physical activity. With type 1 diabetes, you also will need to take insulin through shots or an insulin pump. Insulin cannot be taken as a pill. Type 2 diabetes treatment also may include taking medicine to control your blood sugar. Over time, people with type 2 diabetes make less and less of their own insulin. This may mean that you will need to increase your medicines or start taking insulin shots to keep your diabetes in control. Learn more about controlling diabetes at the National Diabetes Education Program website. Is there anything I can do to prevent type 1 diabetes? Researchers do not know how to prevent type 1 diabetes. Researchers are still looking for ways to prevent type 1 diabetes in women and girls by studying their close relatives who have diabetes. Is there anything I can do to prevent type 2 diabetes? Yes. Many studies, including the large Diabetes Prevention Program study, have proven that you can prevent diabetes by losing weight. Weight loss through healthy eating and more physical activity improves the way your body uses insulin and glucose. Learn how to eat healthier and get more physical activity. Is it safe for women with diabetes to get pregnant? Yes. If you have type 1 or type 2 diabetes, you can have a healthy pregnancy. If you have diabetes and you want to have a baby, you need to plan ahead, before you get pregnant. Talk to your doctor before you get pregnant. He or she can talk to you about steps you can take to keep your baby healthy. This may include a diabetes education program to help you better understand your diabetes and how to control it during pregnancy. Did we answer your question about diabetes? For more information about diabetes, call the OWH Helpline at 1-800-994-9662 or contact the following organizations: Sources ", "role": "user" }, { "content": "Diabetes (Is there anything I can do to prevent type 1 diabetes?): Researchers do not know how to prevent type 1 diabetes. Researchers are still looking for ways to prevent type 1 diabetes in women and girls by studying their close relatives who have diabetes.", "role": "assistant" } ]
[ { "content": "how to deal with anxiety\n\n Generalized anxiety disorder - self-care GAD - self-care Anxiety - self-care Anxiety disorder - self-care Summary Generalized anxiety disorder (GAD) is a mental condition in which you're frequently worried or anxious about many things. Even when there is no clear cause, you're still not able to control your anxiety. The right treatment can often improve GAD. You and your health care provider should make a treatment plan that could include talk therapy (psychotherapy), taking medicine, or both. Taking Medicine Your provider may prescribe one or more medicines, including: An antidepressant, which can help with anxiety and depression. This kind of medicine may take weeks to start working. It is a safe medium- to long-term treatment for GAD. A benzodiazepine, which acts faster than an antidepressant to control anxiety. But it can become less effective over time. Your provider may prescribe a benzodiazepine to help your anxiety while you wait for the antidepressant to work. Also, benzodiazepines may become habit forming over time. When taking medicine for GAD: Keep your provider informed about your symptoms. If a medicine isn't controlling symptoms, its dosage may need to be changed, or you may need to try a new medicine instead. DO NOT change the dosage or stop taking the medicine without talking to your provider. Take medicine at set times. For example, take it every day at breakfast. Check with your provider about the best time to take your medicine. Ask your provider about side effects and what to do if they occur. Therapy Talk therapy takes place with a trained therapist and in a safe place. It helps you learn ways of managing and reducing your anxiety. Some forms of talk therapy can help you understand what causes your anxiety. This allows you to gain better control over it. Many types of talk therapy may be helpful for GAD. One common and effective talk therapy is cognitive-behavioral therapy (CBT). CBT can help you understand the relationship between your thoughts, your behaviors, and your symptoms. Often CBT involves a set number of visits. During CBT you can learn how to: Understand and gain control of distorted views of stressors, such as other people's behavior or life events. Recognize and replace panic-causing thoughts to help you feel more in control. Manage stress and relax when symptoms occur. Avoid thinking that minor problems will develop into terrible ones. Your provider can discuss talk therapy options with you. Then you can decide together if it is right for you. Other Ways to Manage Your Anxiety Taking medicine and going to talk therapy can get you started on the road to feeling better. It can also help you take care of your body and relationships. To help improve your condition: Get enough sleep. Eat healthy foods. Keep a regular daily schedule. Get out of the house every day. Exercise every day. Even a little bit of exercise, such as a 15-minute walk, can help. Stay away from alcohol and street drugs. Talk with family or friends when you feel nervous or frightened. Find out about different types of group activities you can join. When to Call the Doctor Call your provider if you: Find it hard to control your anxiety Do not sleep well Feel sad or feel like you want to hurt yourself Have physical symptoms from your anxiety Review Date 5/12/2017 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": "Generalized anxiety disorder - self-care (Therapy): Talk therapy takes place with a trained therapist and in a safe place. It helps you learn ways of managing and reducing your anxiety. Some forms of talk therapy can help you understand what causes your anxiety. This allows you to gain better control over it. Many types of talk therapy may be helpful for GAD. One common and effective talk therapy is cognitive-behavioral therapy (CBT). CBT can help you understand the relationship between your thoughts, your behaviors, and your symptoms. Often CBT involves a set number of visits. During CBT you can learn how to: - Understand and gain control of distorted views of stressors, such as other people's behavior or life events. - Recognize and replace panic-causing thoughts to help you feel more in control. - Manage stress and relax when symptoms occur. - Avoid thinking that minor problems will develop into terrible ones. Your provider can discuss talk therapy options with you.", "role": "assistant" } ]
[ { "content": "how do i prevent myself from having dementia\n\nDementia (WHAT IS VASCULAR DEMENTIA?): Vascular dementia, considered the second most common form of dementia after Alzheimer's disease, and vascular cognitive impairment (VCI) result from injuries to the vessels supplying blood to the brain, often after a stroke or series of strokes. Vascular dementia and VCI arise as a result of risk factors that similarly increase the risk for cerebrovascular disease (such as stroke), including atrial fibrillation, hypertension (high blood pressure), diabetes, and high cholesterol. The symptoms of vascular dementia can be similar to those of Alzheimer's, and both conditions can occur at the same time. Symptoms of vascular dementia can begin suddenly and worsen or improve during one's lifetime.This type of dementia is often managed with drugs to prevent strokes. The aim is to reduce the risk of additional brain damage. Some studies suggest that drugs that improve memory in Alzheimer's disease might benefit people with early vascular dementia. Interventions that address risk factors may be incorporated into the management of vascular dementia.Some types of vascular dementia include:Multi-infarct dementia. This type of dementia occurs when a person has had many small strokes that damage brain cells. One side of the body may be disproportionally affected, and multi-infarct dementia may impair language or other functions, depending on the region of the brain that is affected. When the strokes occur on both sides of the brain, dementia is more likely than when stroke occurs on one side of the brain. In some cases, a single stroke can damage the brain enough to cause dementia. This so-called single-infarct dementia is more common when stroke affects the left side of the brain-where speech centers are located-and/or when it involves the hippocampus, the part of the brain that is vital for memory.Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). This inherited form of cardiovascular disease results in a thickening of the walls of small- and medium-sized blood vessels, eventually stemming the flow of blood to the brain. It is associated with mutations of a gene called Notch3. CADASIL is associated with multi-infarct dementia, stroke, migraine with aura (migraine preceded by visual symptoms), and mood disorders. The first symptoms can appear in people between ages 20 and 40. Many people with CADASIL are undiagnosed. People with first-degree relatives who have CADASIL can be tested for genetic mutations to the Notch3 gene to determine their own risk of developing CADASIL.Subcortical vascular dementia, also called Binswanger's disease. This rare form of dementia involves extensive damage to the small blood vessels and nerve fibers that make up white matter, the \"network\" part of the brain believed to be critical for relaying messages between regions. The symptoms of Binswanger's are related to the disruption of subcortical neural circuits involving short-term memory, organization, mood, attention, decision making, and appropriate behavior. A characteristic feature of this disease is psychomotor slowness, such as an increase in the time it takes for a person to think of a letter and then write it on a piece of paper.For more information about vascular dementia and VCI, see NIA's list of resources.", "role": "user" }, { "content": "Symptoms of vascular dementia can begin suddenly and worsen or improve over one's lifetime. For this type of dementia, drugs that prevent strokes can be prescribed. These do not prevent the progression of the dementia, but do reduce the risk of brain damage caused by strokes.", "role": "assistant" } ]
[ { "content": "how is epilepsy diagnosed\n\nEpilepsy: Epilepsy is a central nervous system (neurological) disorder in which brain activity becomes abnormal, causing seizures or periods of unusual behavior, sensations, and sometimes loss of awareness. Anyone can develop epilepsy. Epilepsy affects both males and females of all races, ethnic backgrounds and ages. Seizure symptoms can vary widely. Some people with epilepsy simply stare blankly for a few seconds during a seizure, while others repeatedly twitch their arms or legs. Having a single seizure doesn't mean you have epilepsy. At least two unprovoked seizures are generally required for an epilepsy diagnosis. Treatment with medications or sometimes surgery can control seizures for the majority of people with epilepsy. Some people require lifelong treatment to control seizures, but for others, the seizures eventually go away. Some children with epilepsy may outgrow the condition with age. Epilepsy care at Mayo Clinic Because epilepsy is caused by abnormal activity in the brain, seizures can affect any process your brain coordinates. Seizure signs and symptoms may include: - Temporary confusion - A staring spell - Uncontrollable jerking movements of the arms and legs - Loss of consciousness or awareness - Psychic symptoms such as fear, anxiety or deja vu Symptoms vary depending on the type of seizure. In most cases, a person with epilepsy will tend to have the same type of seizure each time, so the symptoms will be similar from episode to episode. Doctors generally classify seizures as either focal or generalized, based on how the abnormal brain activity begins. Focal seizures When seizures appear to result from abnormal activity in just one area of your brain, they're called focal (partial) seizures. These seizures fall into two categories: - Focal seizures without loss of consciousness. Once called simple partial seizures, these seizures don't cause a loss of consciousness. They may alter emotions or change the way things look, smell, feel, taste or sound. They may also result in involuntary jerking of a body part, such as an arm or leg, and spontaneous sensory symptoms such as tingling, dizziness and flashing lights. - Focal seizures with impaired awareness. Once called complex partial seizures, these seizures involve a change or loss of consciousness or awareness. During a complex partial seizure, you may stare into space and not respond normally to your environment or perform repetitive movements, such as hand rubbing, chewing, swallowing or walking in circles. Symptoms of focal seizures may be confused with other neurological disorders, such as migraine, narcolepsy or mental illness. A thorough examination and testing are needed to distinguish epilepsy from other disorders. Generalized seizures Seizures that appear to involve all areas of the brain are called generalized seizures. Six types of generalized seizures exist. - Absence seizures. Absence seizures, previously known as petit mal seizures, often occur in children and are characterized by staring into space or subtle body movements such as eye blinking or lip smacking. These seizures may occur in clusters and cause a brief loss of awareness. - Tonic seizures. Tonic seizures cause stiffening of your muscles. These seizures usually affect muscles in your back, arms and legs and may cause you to fall to the ground. - Atonic seizures. Atonic seizures, also known as drop seizures, cause a loss of muscle control, which may cause you to suddenly collapse or fall down. - Clonic seizures. Clonic seizures are associated with repeated or rhythmic, jerking muscle movements. These seizures usually affect the neck, face and arms. - Myoclonic seizures. Myoclonic seizures usually appear as sudden brief jerks or twitches of your arms and legs. - Tonic-clonic seizures. Tonic-clonic seizures, previously known as grand mal seizures, are the most dramatic type of epileptic seizure and can cause an abrupt loss of consciousness, body stiffening and shaking, and sometimes loss of bladder control or biting your tongue. When to see a doctor Seek immediate medical help if any of the following occurs: - The seizure lasts more than five minutes. - Breathing or consciousness doesn't return after the seizure stops. - A second seizure follows immediately. - You have a high fever. - You're experiencing heat exhaustion. - You're pregnant. - You have diabetes. - You've injured yourself during the seizure. If you experience a seizure for the first time, seek medical advice. Epilepsy has no identifiable cause in about half the people with the condition. In the other half, the condition may be traced to various factors, including: - Genetic influence. Some types of epilepsy, which are categorized by the type of seizure you experience or the part of the brain that is affected, run in families. In these cases, it's likely that there's a genetic influence. Researchers have linked some types of epilepsy to specific genes, but for most people, genes are only part of the cause of epilepsy. Certain genes may make a person more sensitive to environmental conditions that trigger seizures. - Head trauma. Head trauma as a result of a car accident or other traumatic injury can cause epilepsy. - Brain conditions. Brain conditions that cause damage to the brain, such as brain tumors or strokes, can cause epilepsy. Stroke is a leading cause of epilepsy in adults older than age 35. - Infectious diseases. Infectious diseases, such as meningitis, AIDS and viral encephalitis, can cause epilepsy. - Prenatal injury. Before birth, babies are sensitive to brain damage that could be caused by several factors, such as an infection in the mother, poor nutrition or oxygen deficiencies. This brain damage can result in epilepsy or cerebral palsy. - Developmental disorders. Epilepsy can sometimes be associated with developmental disorders, such as autism and neurofibromatosis. Certain factors may increase your risk of epilepsy: - Age. The onset of epilepsy is most common in children and older adults, but the condition can occur at any age. - Family history. If you have a family history of epilepsy, you may be at an increased risk of developing a seizure disorder. - Head injuries. Head injuries are responsible for some cases of epilepsy. You can reduce your risk by wearing a seat belt while riding in a car and by wearing a helmet while bicycling, skiing, riding a motorcycle or engaging in other activities with a high risk of head injury. - Stroke and other vascular diseases. Stroke and other blood vessel (vascular) diseases can lead to brain damage that may trigger epilepsy. You can take a number of steps to reduce your risk of these diseases, including limiting your intake of alcohol and avoiding cigarettes, eating a healthy diet, and exercising regularly. - Dementia. Dementia can increase the risk of epilepsy in older adults. - Brain infections. Infections such as meningitis, which causes inflammation in your brain or spinal cord, can increase your risk. - Seizures in childhood. High fevers in childhood can sometimes be associated with seizures. Children who have seizures due to high fevers generally won't develop epilepsy. The risk of epilepsy increases if a child has a long seizure, another nervous system condition or a family history of epilepsy. 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. Doctors generally begin by treating epilepsy with medication. If medications don't treat the condition, doctors may propose surgery or another type of treatment. Medication Most people with epilepsy can become seizure-free by taking one anti-seizure medication, which is also called anti-epileptic medication. Others may be able to decrease the frequency and intensity of their seizures by taking a combination of medications. Many children with epilepsy who aren't experiencing epilepsy symptoms can eventually discontinue medications and live a seizure-free life. Many adults can discontinue medications after two or more years without seizures. Your doctor will advise you about the appropriate time to stop taking medications. Finding the right medication and dosage can be complex. Your doctor will consider your condition, frequency of seizures, your age and other factors when choosing which medication to prescribe. Your doctor will also review any other medications you may be taking, to ensure the anti-epileptic medications won't interact with them. Your doctor likely will first prescribe a single medication at a relatively low dosage and may increase the dosage gradually until your seizures are well-controlled. Anti-seizure medications may have some side effects. Mild side effects include: - Fatigue - Dizziness - Weight gain - Loss of bone density - Skin rashes - Loss of coordination - Speech problems - Memory and thinking problems More-severe but rare side effects include: - Depression - Suicidal thoughts and behaviors - Severe rash - Inflammation of certain organs, such as your liver To achieve the best seizure control possible with medication, follow these steps: - Take medications exactly as prescribed. - Always call your doctor before switching to a generic version of your medication or taking other prescription medications, over-the-counter drugs or herbal remedies. - Never stop taking your medication without talking to your doctor. - Notify your doctor immediately if you notice new or increased feelings of depression, suicidal thoughts, or unusual changes in your mood or behaviors. - Tell your doctor if you have migraines. Doctors may prescribe one of the anti-epileptic medications that can prevent your migraines and treat epilepsy. At least half the people newly diagnosed with epilepsy will become seizure-free with their first medication. If anti-epileptic medications don't provide satisfactory results, your doctor may suggest surgery or other therapies. You'll have regular follow-up appointments with your doctor to evaluate your condition and medications. Surgery When medications fail to provide adequate control over seizures, surgery may be an option. With epilepsy surgery, a surgeon removes the area of your brain that's causing seizures. Doctors usually perform surgery when tests show that: - Your seizures originate in a small, well-defined area of your brain - The area in your brain to be operated on doesn't interfere with vital functions such as speech, language, motor function, vision or hearing Although many people continue to need some medication to help prevent seizures after successful surgery, you may be able to take fewer drugs and reduce your dosages. In a small number of cases, surgery for epilepsy can cause complications such as permanently altering your thinking (cognitive) abilities. Talk to your surgeon about his or her experience, success rates, and complication rates with the procedure you're considering. Therapies Apart from medications and surgery, these potential therapies offer an alternative for treating epilepsy: - Vagus nerve stimulation. In vagus nerve stimulation, doctors implant a device called a vagus nerve stimulator underneath the skin of your chest, similar to a heart pacemaker. Wires from the stimulator are connected to the vagus nerve in your neck. The battery-powered device sends bursts of electrical energy through the vagus nerve and to your brain. It's not clear how this inhibits seizures, but the device can usually reduce seizures by 20 to 40 percent. Most people still need to take anti-epileptic medication, although some people may be able to lower their medication dose. You may experience side effects from vagus nerve stimulation, such as throat pain, hoarse voice, shortness of breath or coughing. - Ketogenic diet. Some children with epilepsy have been able to reduce their seizures by following a strict diet that's high in fats and low in carbohydrates. In this diet, called a ketogenic diet, the body breaks down fats instead of carbohydrates for energy. After a few years, some children may be able to stop the ketogenic diet - under close supervision of their doctors - and remain seizure-free. Consult a doctor if you or your child is considering a ketogenic diet. It's important to make sure that your child doesn't become malnourished when following the diet. Side effects of a ketogenic diet may include dehydration, constipation, slowed growth because of nutritional deficiencies and a buildup of uric acid in the blood, which can cause kidney stones. These side effects are uncommon if the diet is properly and medically supervised. Following a ketogenic diet can be a challenge. Low-glycemic index and modified Atkins diets offer less restrictive alternatives that may still provide some benefit for seizure control. Potential future treatments Researchers are studying many potential new treatments for epilepsy, including: - Deep brain stimulation. In deep brain stimulation, surgeons implant electrodes into a specific part of your brain, typically your thalamus. The electrodes are connected to a generator implanted in your chest or the skull that sends electrical pulses to your brain and may reduce your seizures. - Responsive neurostimulation. Implantable, pacemaker-like devices that help prevent seizures are also under investigation. These responsive stimulation or closed loop devices analyze brain activity patterns to detect seizures before they happen and deliver an electrical charge or drug to stop the seizure. - Continuous stimulation of the seizure onset zone (subthreshold stimulation). Subthreshold stimulation - continuous stimulation to an area of your brain below a level that's physically noticeable - appears to improve seizure outcomes and quality of life for some people with seizures. This treatment approach may work in people who have seizures that start in an area of the brain that can't be removed because it would affect speech and motor functions (eloquent area). Or it might benefit people whose seizure characteristics mean their chances of successful treatment with responsive neurostimulation are low. - Minimally invasive surgery. New minimally invasive surgical techniques, such as MRI-guided laser ablation, show promise at reducing seizures with fewer risks than traditional open brain surgery for epilepsy. - Stereotactic laser ablation or radiosurgery. For some types of epilepsy, stereotactic laser ablation or stereotactic radiosurgery may provide effective treatment for people in which an open procedure may be too risky. In these procedures, doctors direct radiation at the specific area in the brain causing seizures, to destroy that tissue in an effort to better control the seizures. - External nerve stimulation device. Similar to vagus nerve stimulation, this device would stimulate specific nerves to reduce frequency of seizures. But unlike vagus nerve stimulation, this device would be worn externally so that no surgery to implant the device is needed. Understanding your condition can help you take better control of it: - Take your medication correctly. Don't adjust your dosage before talking to your doctor. If you feel your medication should be changed, discuss it with your doctor. - Get enough sleep. Lack of sleep can trigger seizures. Be sure to get adequate rest every night. - Wear a medical alert bracelet. This will help emergency personnel know how to treat you correctly. - Exercise. Exercising may help keep you physically healthy and reduce depression. Make sure to drink enough water, and rest if you get tired during exercise. In addition, make healthy life choices, such as managing stress, limiting alcoholic beverages and avoiding cigarettes.", "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": "what are the causes of pulmonary hypertension\n\nPulmonary Hypertension (Causes): Pulmonary hypertension (PH) begins with inflammation and changes in the cells that line your pulmonary arteries. Other factors also can affect the pulmonary arteries and cause PH. For example, the condition may develop if: The walls of the arteries tighten. The walls of the arteries are stiff at birth or become stiff from an overgrowth of cells. Blood clots form in the arteries. These changes make it hard for your heart to push blood through your pulmonary arteries and into your lungs. Thus, the pressure in the arteries rises, causing PH. Many factors can contribute to the process that leads to the different types of PH. Group 1 pulmonary arterial hypertension (PAH) may have no known cause, or the condition may be inherited. (\"Inherited\" means the condition is passed from parents to children through genes.) Some diseases and conditions also can cause group 1 PAH. Examples include HIV infection, congenital heart disease, and sickle cell disease. Also, the use of street drugs (such as cocaine) and certain diet medicines can lead to PAH. Many diseases and conditions can cause groups 2 through 5 PH (often called secondary PH), including: Mitral valve disease Lung diseases, such as COPD (chronic obstructive pulmonary disease) Sleep apnea Sarcoidosis For more information about the types of PH and the diseases, conditions, and factors that can cause them, go to \"Types of Pulmonary Hypertension.\"", "role": "user" }, { "content": "Pulmonary hypertension (PH) begins with inflammation and changes in the cells that line your pulmonary arteries. It can also be caused by the tightening of the walls of the arteries, or if they are stiff at birth or from overgrown cells. These changes make it difficult for your heart to pump blood through your pulmonary arteries and into your lungs. This causes the blood pressure in the pulmonary arteries to rise.", "role": "assistant" } ]
[ { "content": "milroy disease hello , my daughter has lymph edema her both legs and left hand is swelling , this problem started when she was of 3 months now she is 16 months , her swelling is growing day by day , im clue less what to do and what kind of treatment i should do plz help and suggest us\n\nMilroy disease: Milroy disease is a condition that affects the normal function of the lymphatic system. The lymphatic system produces and transports fluids and immune cells throughout the body. Impaired transport with accumulation of lymph fluid can cause swelling (lymphedema). Individuals with Milroy disease typically have lymphedema in their lower legs and feet at birth or develop it in infancy. The lymphedema typically occurs on both sides of the body and may worsen over time. Milroy disease is associated with other features in addition to lymphedema. Males with Milroy disease are sometimes born with an accumulation of fluid in the scrotum (hydrocele). Males and females may have upslanting toenails, deep creases in the toes, wart-like growths (papillomas), and prominent leg veins. Some individuals develop non-contagious skin infections called cellulitis that can damage the thin tubes that carry lymph fluid (lymphatic vessels). Episodes of cellulitis can cause further swelling in the lower limbs. Milroy disease is a rare disorder; its incidence is unknown. Mutations in the FLT4 gene cause some cases of Milroy disease. The FLT4 gene provides instructions for producing a protein called vascular endothelial growth factor receptor 3 (VEGFR-3), which regulates the development and maintenance of the lymphatic system. Mutations in the FLT4 gene interfere with the growth, movement, and survival of cells that line the lymphatic vessels (lymphatic endothelial cells). These mutations lead to the development of small or absent lymphatic vessels. If lymph fluid is not properly transported, it builds up in the body's tissues and causes lymphedema. It is not known how mutations in the FLT4 gene lead to the other features of this disorder. Many individuals with Milroy disease do not have a mutation in the FLT4 gene. In these individuals, the cause of the disorder is unknown. Milroy disease is inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to cause the disorder. In many cases, an affected person inherits the mutation from one affected parent. Other cases may result from new mutations in the FLT4 gene. These cases occur in people with no history of the disorder in their family. About 10 percent to 15 percent of people with a mutation in the FLT4 gene do not develop the features of Milroy disease. Brice G, Child AH, Evans A, Bell R, Mansour S, Burnand K, Sarfarazi M, Jeffery S, Mortimer P. Milroy disease and the VEGFR-3 mutation phenotype. J Med Genet. 2005 Feb;42(2):98-102. Review.", "role": "user" }, { "content": "Milroy disease is a condition that affects the normal function of the lymphatic system. The lymphatic system produces and transports fluids and immune cells throughout the body. Impaired transport with accumulation of lymph fluid can cause swelling (lymphedema). Individuals with Milroy disease typically have lymphedema in their lower legs and feet at birth or develop it in infancy. The lymphedema typically occurs on both sides of the body and may worsen over time. Milroy disease is associated with other features in addition to lymphedema. Males and females may have upslanting toenails, deep creases in the toes, wart-like growths (papillomas), and prominent leg veins. Some individuals develop non-contagious skin infections called cellulitis that can damage the thin tubes that carry lymph fluid (lymphatic vessels). Episodes of cellulitis can cause further swelling in the lower limbs.", "role": "assistant" } ]
[ { "content": "how is epidural harmful\n\n Epidural block - pregnancy Delivery - epidural Labor - epidural Summary An epidural block is a numbing medicine given by injection (shot) in the back. It numbs or causes a loss of feeling in the lower half your body. This lessens the pain of contractions during childbirth. An epidural block may also be used to reduce pain during surgery on the lower extremities. This article focuses on epidural blocks during childbirth. How is the Epidural Given? The block or shot is given into an area over your lower back or spine. You may be asked to lie on your side, or you may sit up. Either way, you will be asked to pull your stomach inward and hunch your back outward. Your health care provider will wash the area of your back and inject a little medicine to numb the spot where the epidural needle is placed: The provider inserts a needle into your lower back. The needle is placed into a small space outside your spinal cord. A small soft tube (catheter) is placed into your back, next to your spine. The needle is removed. The numbing medicine is given through the tube for as long as it is needed. In most cases, you will receive a low dose because it is safer for you and baby. Once the medicine takes effect (10 to 20 minutes), you should feel better. You may still feel some back or rectal pressure during contractions. You may shiver after an epidural, but this is common. Many women shiver during labor even without an epidural. 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. What Types of Epidurals are There? There are 2 types: \"Walking\" epidural block. This type of epidural will lessen your pain, but you will still be able to move your legs. Most women are not really able to walk around, but they can move their legs. Combined spinal epidural block. This combines both a spinal and epidural block. It provides pain relief much faster. The combined block is used when women are in very active labor and want relief right away. Review Date 4/19/2018 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": "Many studies have shown that epidural is a safe way to manage pain during childbirth. However, there are some rare risks. Your blood pressure may drop, and if this occurs, you will receive fluids through an intravenous line to help keep your blood pressure stable. The epidural may change your labor and delivery. For example, if you are very numb from the block, you may have a harder time bearing down to push your baby through the birth canal. Your contractions may slow down for a little while, but your labor will still continue as it should. Other rare side effects include a headache with the epidural, dizziness, or, also rarely, a seizure.", "role": "assistant" } ]
[ { "content": "about thalassemia treatment sir,my friend is suffering from thalassemia ,in that majorly red blood anemia,white blood anemia and the blood is comming out from mouth when she got cough .her condition is very severe .in her body the red ,white blood cells are abscent .so that blood transfusion is doing for every 16-20days.then in the recent days the blood also comming out from mouth please tell me where can i get the treatment for this disease .we can travel around the world for treatment please reply me as soon as possible. thank you sir.\n\nThalassemia (Treatment): Treatment for thalassemia depends on which type you have and how severe it is. Treatments for mild thalassemia Signs and symptoms are usually mild with thalassemia minor and little, if any, treatment is needed. Occasionally, you may need a blood transfusion, particularly after surgery, after having a baby or to help manage thalassemia complications. People with severe beta-thalassemia will need blood transfusions. And because this treatment can cause iron overload, they will also need treatment to remove excess iron. An oral medication called deferasirox (Exjade, Jadenu) can help remove the excess iron. Treatments for moderate to severe thalassemia Treatments for moderate to severe thalassemia may include: - Frequent blood transfusions. More-severe forms of thalassemia often require frequent blood transfusions, possibly every few weeks. Over time, blood transfusions cause a buildup of iron in your blood, which can damage your heart, liver and other organs. To help your body get rid of the extra iron, you may need to take medications that rid your body of extra iron. - Stem cell transplant. Also called a bone marrow transplant, a stem cell transplant may be an option in select cases, including children born with severe thalassemia. It can eliminate the need for lifelong blood transfusions and drugs to control iron overload. During this procedure, you receive infusions of stem cells from a compatible donor, usually a sibling.", "role": "user" }, { "content": "People with severe beta-thalassemia need frequent blood transfusions, which can cause iron overload, Excess iron could be removed using oral medication called deferasirox (Exjade, Jadenu.) In some cases, stem cell transplant (bone marrow transplant) can eliminate the need for lifelong blood transfusions and drugs to control iron overload. During this procedure, patients receive infusions of stem cells from a compatible donor, usually a sibling.", "role": "assistant" } ]
[ { "content": "what are the causes of headaches\n\n Rebound headaches Overview Rebound headaches (medication-overuse headaches) are caused by regular, long-term use of medication to treat headaches, such as migraine. Pain relievers offer relief for occasional headaches. But if you take them more than a couple of days a week, they may trigger rebound headaches. It appears that any medication taken for pain relief can cause rebound headaches, but only if you already have a headache disorder. Pain relievers taken regularly for another condition, such as arthritis, have not been shown to cause rebound headaches in people who never had a headache disorder. Rebound headaches usually stop when you stop taking the pain medication. It's tough in the short term, but your doctor can help you beat rebound headaches for long-term relief. Symptoms Signs and symptoms of rebound headaches may differ according to the type of original headache being treated and the medication used. Rebound headaches tend to: - Occur every day or nearly every day, often waking you in the early morning - Improve with pain relief medication but then return as your medication wears off Other signs and symptoms may include: - Nausea - Listlessness - Restlessness and difficulty concentrating - Memory problems - Irritability When to see a doctor Occasional headaches are common. But it's important to take your headaches seriously. Some types of headaches can be life-threatening. Seek immediate medical care if your headache: - Is sudden and severe - Accompanies a fever, stiff neck, rash, confusion, seizure, double vision, weakness, numbness or difficulty speaking - Follows a head injury - Gets worse despite rest and pain medication - Is a new type in someone older than 50 - Wakes you from sleep Consult your doctor if: - You usually have two or more headaches a week - You take a pain reliever for your headaches more than twice a week - You need more than the recommended dose of over-the-counter pain remedies to relieve your headaches - Your headache pattern changes - Your headaches are getting worse Causes Rebound headaches can develop if you frequently use headache medication. Although the risk of developing medication-overuse headache varies depending on the medication, any acute headache medication has the potential to lead to rebound headaches, including: - Simple pain relievers. Common pain relievers such as aspirin and acetaminophen (Tylenol, others) may contribute to rebound headaches - especially if you exceed the recommended daily dosages. Pain relievers such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) have a low risk of contributing to medication-overuse headaches. - Combination pain relievers. Over-the-counter (OTC) pain relievers that combine caffeine, aspirin and acetaminophen (Excedrin, others) are common culprits. This group also includes prescription medications such as Fiorinal, which contains the sedative butalbital. Butalbital-containing compounds have an especially high risk of causing rebound headaches, so it's best not to take them to treat headaches. If you do take this type of drug, limit its use to no more than four days a month. - Migraine medications. Various migraine medications have been linked with rebound headaches, including triptans (Imitrex, Zomig, others) and certain ergots - such as ergotamine (Ergomar, others). These medications have a moderate risk of causing medication-overuse headaches. The ergot dihydroergotamine (D.H.E. 45) appears to have a lower potential for leading to this problem. - Opiates. Painkillers derived from opium or from synthetic opium compounds include combinations of codeine and acetaminophen (Tylenol with Codeine No. 3 and No. 4, others). These medications have a high risk of causing rebound headaches. Daily doses of caffeine - from your morning coffee, your afternoon soda, and pain relievers and other products containing this mild stimulant - may fuel rebound headaches, as well. Read product labels to make sure you're not wiring your system with more caffeine than you realize. Risk factors Risk factors for developing rebound headaches include: - History of chronic headaches. A history of migraines, tension-type headaches or other chronic headaches puts you at risk. - Frequent use of headache medications. Your risk increases if you use combination analgesics, ergotamine or triptans 10 or more days a month or simple analgesics more than 15 days a month - especially if this regular use continues for three or more months. Diagnosis The diagnosis of rebound headache usually is based on a history of chronic headache and frequent use of medication. Testing usually isn't necessary. Treatment To break the cycle of rebound headaches, you'll need to restrict your pain medication. Depending on the drug you're taking, your doctor may recommend stopping the medication right away or gradually reducing the dose. Breaking the cycle When you stop your medication, expect your headaches to get worse before they get better. Drug dependency may be a risk factor for drugs that result in rebound headaches, and you may have withdrawal symptoms such as nervousness, restlessness, nausea, vomiting, insomnia or constipation. These symptoms generally last from two to 10 days, but they can persist for several weeks. Your doctor may prescribe various treatments to help alleviate headache pain and the side effects associated with drug withdrawal. This is known as bridge or transitional therapy, and treatments may include nonsteroidal anti-inflammatory drugs, corticosteroids or dihydroergotamine, an ergot often given through a vein (intravenously). Hospitalization Sometimes it's best to be in a controlled environment when you stop taking pain medication. A short hospital stay may be recommended if you: - Aren't able to stop using pain medication on your own - Have other conditions, such as depression or anxiety - Are taking high doses of drugs that contain opiates or the sedative butalbital - Are abusing substances such as tranquilizers, opioids or barbiturates - Have limited or no family support Preventive medications After you've broken the rebound-headache cycle, continue to work with your doctor to avoid relapsing and to find a safer way to manage your headaches. During or after withdrawal, your doctor may prescribe any of the following daily preventive medications: - A tricyclic antidepressant such as amitriptyline or nortriptyline (Pamelor) - An anticonvulsant such as divalproex (Depakote), topiramate (Topamax, Qudexy XR, Trokendi XR) or gabapentin (Gralise, Neurontin) - A beta blocker such as propranolol (Inderal, Innopran XL) - A calcium channel blocker, such as verapamil (Calan, Verelan, others) These medications can help control your pain without risking rebound headaches. If you're careful, you may be able to take a medication specifically meant for pain during future headache attacks. Be sure to take medications exactly as prescribed. Cognitive behavioral therapy (CBT) During this talk therapy, you learn ways to cope with your headaches. In CBT, you also work on healthy lifestyle habits and keeping a headache diary. Alternative medicine For many people, complementary or alternative therapies offer relief from headache pain. However, not all complementary or alternative therapies have been studied as headache treatments, and others need further research. - Acupuncture. This ancient technique uses fine needles to promote the release of natural painkillers and other chemicals in the central nervous system. There is some evidence that it can help control headaches and other conditions that cause chronic pain. - Biofeedback. Biofeedback teaches you to control certain body responses that help reduce pain. During a session, you're connected to devices that monitor and give you feedback on body functions, such as muscle tension, heart rate and blood pressure. You then learn how to reduce muscle tension and slow your heart rate and breathing to help you relax, which may help you cope with pain. - Herbs, vitamins and minerals. Some dietary supplements - including magnesium, feverfew and butterbur - seem to help prevent or treat some types of headaches, but there's little scientific support for these claims. If you're considering using supplements, check with your doctor. Some supplements may interfere with other drugs you take or have other harmful effects. Discuss the risks and benefits of complementary therapy with your doctor. ", "role": "user" }, { "content": "Rebound headaches are caused by regular, long-term use of medication to treat headaches, such a pain relievers. If you take them more than a couple of days a week, they may cause rebound headaches. Rebound headaches usually stop when you stop taking the pain medication.", "role": "assistant" } ]
[ { "content": "how to manage prostate cancer\n\nProstate Cancer (Treatment Option Overview): - 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.", "role": "user" }, { "content": "There are different types of treatment for patients with prostate cancer. These include surgery, radiation therapy, hormone therapy, chemotherapy, biologic therapy, and bisphosphonate therapy. New types of treatments are tested in clinical trials, which you may want to think about taking part in.", "role": "assistant" } ]
[ { "content": "treatment options versus migraine types Migraine seems to be a spectrum of conditions rather than only one easily diagnosed affliction. Many innovative migraine treatments are now in use, but it seems that each treatment only addresses a narrow set of conditions; for example, my daughter has tried many different treatment options (QEEG, HEG, TMS, topamax, ...) without success. Has any research been done to characterize which treatment types are effective against which migraine types?\n\n Migraine Definition The pain of a migraine headache is often described as an intense pulsing or throbbing pain in one area of the head. However, it is much more; the International Headache Society diagnoses a migraine by its pain and number of attacks (at least 5, lasting 4-72 hours if untreated), and additional symptoms including nausea and/or vomiting, or sensitivity to both light and sound. Migraine is three times more common in women than in men and affects more than 10 percent of people worldwide. Roughly one-third of affected individuals can predict the onset of a migraine because it is preceded by an \"aura,\" visual disturbances that appear as flashing lights, zig-zag lines or a temporary loss of vision. People with migraine tend to have recurring attacks triggered by a number of different factors, including stress, anxiety, hormonal changes, bright or flashing lights, lack of food or sleep, and dietary substances. Migraine in some women may relate to changes in hormones and hormonal levels during their menstrual cycle. For many years, scientists believed that migraines were linked to the dilation and constriction of blood vessels in the head. Investigators now believe that migraine has a genetic cause. Treatment There is no absolute cure for migraine since its pathophysiology has yet to be fully understood. There are two ways to approach the treatment of migraine headache with drugs: prevent the attacks, or relieve the symptoms during the attacks. Prevention involves the use of medications and behavioral changes. Drugs originally developed for epilepsy, depression, or high blood pressure to prevent future attacks have been shown to be extremely effective in treating migraine. Botulinum toxin A has been shown to be effective in prevention of chronic migraine. Behaviorally, stress management strategies, such as exercise, relaxation techniques, biofeedback mechanisms, and other therapies designed to limit daily discomfort, may reduce the number and severity of migraine attacks. Making a log of personal triggers of migraine can also provide useful information for trigger-avoiding lifestyle changes, including dietary considerations, eating regularly scheduled meals with adequate hydration, stopping certain medications, and establishing a consistent sleep schedule. Hormone therapy may help some women whose migraines seem to be linked to their menstrual cycle. A weight loss program is recommended for obese individuals with migraine. Relief of symptoms, or acute treatments, during attacks consists of sumatriptan, ergotamine drugs, and analgesics such as ibuprofen and aspirin. The sooner these treatments are administered, the more effective they are. Prognosis Responsive prevention and treatment of migraine is incredibly important. Evidence shows an increased sensitivity after each successive attack, eventually leading to chronic daily migraine in some individuals With proper combination of drugs for prevention and treatment of migraine attacks most individuals can overcome much of the discomfort from this debilitating disorder. Women whose migraine attacks occur in association with their menstrual cycle are likely to have fewer attacks and milder symptoms after menopause. ", "role": "user" }, { "content": "While there is no cure to migraine, there are two approaches to prevention: prevent the attacks, or relieve the symptoms during the attacks. For prevention, drugs, such as those used for epilepsy, have shown to be effective. Botulinum toxin A has been shown to be effective in prevention of chronic migraine. Behavioral approaches such as exercise, a consistent sleep schedule and stress management techniques may reduce the number and severity of attacks. For relief of symptoms, sumatriptan, ergotamines, and analgesics such as ibuprofen and aspirin may help, especially if administered soon after onset of the symptoms.", "role": "assistant" } ]
[ { "content": "what treatment do you use to cure chickenpox\n\nChickenpox (Treatment): In otherwise healthy children, chickenpox typically requires no medical treatment. Your doctor may prescribe an antihistamine to relieve itching. But for the most part, the disease is allowed to run its course. If you're at high risk of complications For people who have a high risk of complications from chickenpox, doctors sometimes prescribe medications to shorten the duration of the infection and to help reduce the risk of complications. If you or your child falls into a high-risk group, your doctor may suggest an antiviral drug such as acyclovir (Zovirax) or another drug called immune globulin intravenous (Privigen). These medications may lessen the severity of the disease when given within 24 hours after the rash first appears. Other antiviral drugs, such as valacyclovir (Valtrex) and famciclovir (Famvir), also may lessen the severity of the disease, but may not be approved or appropriate for all cases. In some instances, your doctor may recommend getting the chickenpox vaccine after exposure to the virus. This can prevent the disease or lessen its severity. Don't give anyone with chickenpox - child or adult - any medicine containing aspirin because this combination has been associated with a condition called Reye's syndrome. Treating complications If complications do develop, your doctor will determine the appropriate treatment. Treatment for skin infections and pneumonia may be with antibiotics. Treatment for encephalitis is usually with antiviral drugs. Hospitalization may be necessary.", "role": "user" }, { "content": "In otherwise healthy children, chickenpox typically requires no medical treatment. Your doctor may prescribe an antihistamine to relieve itching. If you or your child falls into a high-risk group, your doctor may suggest an antiviral drug such as acyclovir (Zovirax) or another drug called immune globulin intravenous (Privigen). These medications may lessen the severity of the disease when given within 24 hours after the rash first appears. Other antiviral drugs, such as valacyclovir (Valtrex) and famciclovir (Famvir), also may lessen the severity of the disease, but may not be approved or appropriate for all cases. Don't give anyone with chickenpox - child or adult - any medicine containing aspirin because this combination has been associated with a condition called Reye's syndrome.", "role": "assistant" } ]
[ { "content": "what the treatment for bronchitis\n\n Acute bronchitis Summary Acute bronchitis is swelling and inflamed tissue in the main passages that carry air to the lungs. This swelling narrows the airways, which makes it harder to breathe. Other symptoms of bronchitis are a cough and coughing up mucus. Acute means the symptoms have been present only for a short time. Causes When acute bronchitis occurs, it almost always comes after having a cold or flu-like illness. The bronchitis infection is caused by a virus. At first, it affects your nose, sinuses, and throat. Then it spreads to the airways that lead to your lungs. Sometimes, bacteria also infect your airways. This is more common in people with COPD. Chronic bronchitis is a long-term condition. To be diagnosed with chronic bronchitis, you must have a cough with mucus on most days for at least 3 months. Symptoms Some symptoms of acute bronchitis are: Chest discomfort Cough that produces mucus -- the mucus may be clear or yellow-green Fatigue Fever -- usually low-grade Shortness of breath that gets worse with activity Wheezing, in people with asthma Even after acute bronchitis has cleared, you may have a dry, nagging cough that lasts for 1 to 4 weeks. Sometimes it can be hard to know if you have pneumonia or bronchitis. If you have pneumonia, you are more likely to have a high fever and chills, feel sicker, or be more short of breath. Exams and Tests Your health care provider will listen to the breathing sounds in your lungs with a stethoscope. Your breathing may sound abnormal or rough. Tests may include: Chest x-ray, if your provider suspects pneumonia Pulse oximetry, a painless test that helps determine the amount of oxygen in your blood by using a device placed on the end of your finger Treatment Most people DO NOT need antibiotics for acute bronchitis caused by a virus. The infection will almost always go away on its own within 1 week. Doing these things may help you feel better: Drink plenty of fluids. If you have asthma or another chronic lung condition, use your inhaler. Get plenty of rest. Take aspirin or acetaminophen if you have a fever. DO NOT give aspirin to children. Breathe moist air by using a humidifier or steaming up the bathroom. Certain medicines that you can buy without a prescription can help break up or loosen mucus. Look for the word \"guaifenesin\" on the label. Ask the pharmacist for help finding it. If your symptoms do not improve or if you are wheezing, your provider may prescribe an inhaler to open your airways. If your provider thinks you also have bacteria in your airways, they may prescribe antibiotics. This medicine will only get rid of bacteria, not viruses. Your provider may also prescribe corticosteroid medicine to reduce swelling in your lungs. If you have the flu and it is caught in the first 48 hours after getting sick, your provider might also prescribe antiviral medicine. Other tips include: DO NOT smoke. Avoid secondhand smoke and air pollution. Wash your hands (and your children's hands) often to avoid spreading viruses and other germs. Outlook (Prognosis) Except for the cough, symptoms usually go away in 7 to 10 days if you do not have a lung disorder. When to Contact a Medical Professional Call your provider if you: Have a cough on most days, or have a cough that keeps returning Are coughing up blood Have a high fever or shaking chills Have a low-grade fever for 3 or more days Have thick, yellow-green mucus, especially if it has a bad smell Feel short of breath or have chest pain Have a chronic illness, like heart or lung disease Review Date 2/18/2018 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": "Most cases of acute bronchitis get better without treatment, usually within a week. Cases of bronchitis that are caused by viral infections do not need antibiotics. If doctors suspect that the infection is bacterial, they may prescribe an antibiotic. Sometimes, corticosteroid medicine is also needed to reduce inflammation in the lungs. Doctors may also recommend cough medicine containing guaifenesin. The following steps may help: drinking plenty of fluids; getting rest; taking aspirin or acetaminophen case of a fever; using a humidifier or steam in the bathroom; quitting smoking and avoiding secondhand smoke and air pollution; wash hands often to avoid spreading viruses and other germs.", "role": "assistant" } ]
[ { "content": "typhoid fever Hi, My name is from X i have suffering from typhoid please give me solution i have one question i had got treatment from one year but i am not well now give me solution?\n\n Typhoid fever Enteric fever Summary Typhoid fever is an infection that causes diarrhea and a rash. It is most commonly caused due to a bacteria called <em>Salmonella typhi</em> (<em>S typhi</em>). Causes <em>S typhi</em> is spread through contaminated food, drink, or water. If you eat or drink something that is contaminated with the bacteria, the bacteria enter your body. They travel into your intestines, and then into your blood. In the blood, they travel to your lymph nodes, gallbladder, liver, spleen, and other parts of the body. Some people become carriers of <em>S typhi</em> and continue to release the bacteria in their stools for years, spreading the disease. Typhoid fever is common in developing countries. Most cases in the United States are brought in from other countries where typhoid fever is common. Symptoms Early symptoms include fever, general ill-feeling, and abdominal pain. High fever (103F, or 39.5C) or higher and severe diarrhea occur as the disease gets worse. Some people develop a rash called \"rose spots,\" which are small red spots on the abdomen and chest. Other symptoms that occur include: Bloody stools Chills Agitation, confusion, delirium, seeing or hearing things that are not there (hallucinations) Difficulty paying attention (attention deficit) Nosebleeds Severe fatigue Slow, sluggish, weak feeling Exams and Tests The health care provider will perform a physical exam and ask about the symptoms. A complete blood count (CBC) will show a high number of white blood cells. A blood culture during the first week of the fever can show <em>S typhi</em> bacteria. Other tests that can help diagnose this condition include: ELISA blood test to look for antibodies to the <em>S typhi</em> bacteria Fluorescent antibody study to look for substances that are specific to <em>S typhi</em> bacteria Platelet count (platelet count may be low) Stool culture Treatment Fluids and electrolytes may be given by IV (into a vein) or you may be asked to drink water with electrolyte packets. Antibiotics are given to kill the bacteria. There are increasing rates of antibiotic resistance throughout the world, so your provider will check current recommendations before choosing an antibiotic. Outlook (Prognosis) Symptoms usually improve in 2 to 4 weeks with treatment. The outcome is likely to be good with early treatment, but becomes poor if complications develop. Symptoms may return if the treatment has not completely cured the infection. Possible Complications Health problems that may develop include: Intestinal hemorrhage (severe GI bleeding) Intestinal perforation Kidney failure Peritonitis When to Contact a Medical Professional Contact your provider if you have any of the following: You know you have been exposed to someone who has typhoid fever You have been in an area where there are people who have typhoid fever and you develop symptoms of typhoid fever You have had typhoid fever and the symptoms return You develop severe abdominal pain, decreased urine output, or other new symptoms Prevention A vaccine is recommended for travel outside of the United States to places where there is typhoid fever. The Centers for Disease Control and Prevention website has information about where typhoid fever is common -- www.cdc.gov/typhoid-fever/index.html. Ask your provider if you should bring electrolyte packets in case you get sick. When traveling, drink only boiled or bottled water and eat well-cooked food. Wash you hands thoroughly before eating. Water treatment, waste disposal, and protecting the food supply from contamination are important public health measures. Carriers of typhoid must not be allowed to work as food handlers. Review Date 5/18/2017 Updated by: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "To prevent Typhoid fever while traveling outside of the US, a vaccine is recommend. While traveling, drink only boiled or bottled water, and eat well-cooked food. Ask you r provider if you should bring electrolyte packets in case you get sick.", "role": "assistant" } ]
[ { "content": "what is the cause of congenital heart defects\n\n Congenital heart defects in children Overview If your child has a congenital heart defect, it means that your child was born with a problem in the structure of his or her heart. Some congenital heart defects in children are simple and don't need treatment. Other congenital heart defects in children are more complex and may require several surgeries performed over a period of several years. Learning about your child's congenital heart defect can help you understand the condition and know what you can expect in the coming months and years. Congenital heart defect care at Mayo Clinic Symptoms Serious congenital heart defects usually become evident soon after birth or during the first few months of life. Signs and symptoms could include: - Pale gray or blue skin color (cyanosis) - Rapid breathing - Swelling in the legs, abdomen or areas around the eyes - Shortness of breath during feedings, leading to poor weight gain Less serious congenital heart defects may not be diagnosed until later in childhood, because your child may not have any noticeable signs of a problem. If signs and symptoms are evident in older children, they may include: - Easily becoming short of breath during exercise or activity - Easily tiring during exercise or activity - Fainting during exercise or activity - Swelling in the hands, ankles or feet Serious congenital heart defects are often diagnosed before or soon after your child is born. If you notice that your baby has any of the signs or symptoms above, call your child's doctor. If your child has any of the signs or symptoms of less serious heart defects as he or she grows, call your child's doctor. Your child's doctor can let you know if your child's symptoms are due to a heart defect or another medical condition. Causes The heart is divided into four hollow chambers, two on the right and two on the left. To pump blood throughout the body, the heart uses its left and right sides for different tasks. The right side of the heart moves blood to the lungs through vessels called pulmonary arteries. In the lungs, blood picks up oxygen then returns to the heart's left side through the pulmonary veins. The left side of the heart then pumps the blood through the aorta and out to the rest of the body. During the first six weeks of pregnancy, the heart begins taking shape and starts beating. The major blood vessels that run to and from the heart also begin to form during this critical time during gestation. It's at this point in your baby's development that heart defects may begin to develop. Researchers aren't sure exactly what causes most of these defects, but they think genetics, certain medical conditions, some medications and environmental factors, such as smoking, may play a role. There are many different types of congenital heart defects, falling mainly into these categories: - Holes in the heart. Holes can form in the walls between heart chambers or between major blood vessels leaving the heart. In certain situations, these holes allow oxygen-poor blood to mix with oxygen-rich blood, resulting in less oxygen being carried to your child's body. Depending on the size of the hole, this lack of sufficient oxygen can cause your child's skin or fingernails to appear blue or possibly lead to congestive heart failure. A ventricular septal defect is a hole in the wall between the right and left chambers on the lower half of the heart (ventricles). An atrial septal defect occurs when there's a hole between the upper heart chambers (atria). Patent ductus arteriosus (PAY-tunt DUK-tus ahr-teer-e-O-sus) is a connection between the pulmonary artery (containing deoxygenated blood) and the aorta (containing oxygenated blood). A complete atrioventricular canal defect is a condition that causes a hole in the center of the heart. - Obstructed blood flow. When blood vessels or heart valves are narrow because of a heart defect, the heart must work harder to pump blood through them. Eventually, this leads to enlarging of the heart and thickening of the heart muscle. Examples of this type of defect are pulmonary stenosis or aortic stenosis (stuh-NO-sis). - Abnormal blood vessels. Several congenital heart defects happen when blood vessels going to and from the heart don't form correctly, or they're not positioned the way they're supposed to be. A defect called transposition of the great arteries occurs when the pulmonary artery and the aorta are on the wrong sides of the heart. A condition called coarctation of the aorta happens when the main blood vessel supplying blood to the body is too narrow. Total anomalous pulmonary venous connection is a defect that occurs when blood vessels from the lungs attach to wrong area of the heart. - Heart valve abnormalities. If the heart valves can't open and close correctly, blood can't flow smoothly. One example of this type of defect is called Ebstein's anomaly. In Ebstein's anomaly, the tricuspid valve - which is located between the right atrium and the right ventricle - is malformed and often leaks. Another example is pulmonary atresia, in which the pulmonary valve is missing, causing abnormal blood flow to the lungs. - An underdeveloped heart. Sometimes, a major portion of the heart fails to develop properly. For example, in hypoplastic left heart syndrome, the left side of the heart hasn't developed enough to effectively pump enough blood to the body. - A combination of defects. Some infants are born with several heart defects. Tetralogy of Fallot (teh-TRAL-uh-jee of fuh-LOW) is a combination of four defects: a hole in the wall between the heart's ventricles, a narrowed passage between the right ventricle and pulmonary artery, a shift in the connection of the aorta to the heart, and thickened muscle in the right ventricle. Risk factors Most congenital heart defects result from problems early in your child's heart development, the cause of which is unknown. However, certain environmental and genetic risk factors may play a role. They include: - Rubella (German measles). Having rubella during pregnancy can cause problems in your baby's heart development. Your doctor can test you for immunity to this viral disease before pregnancy and vaccinate you against it if you aren't immune. - Diabetes. You can reduce the risk of congenital heart defects by carefully controlling your diabetes before attempting to conceive and during pregnancy. Gestational diabetes generally doesn't increase your baby's risk of developing a heart defect. - Medications. Certain medications taken during pregnancy may cause birth defects, including congenital heart defects. Give your doctor a complete list of medications you take before attempting to become pregnant. Medications known to increase the risk of congenital heart defects include thalidomide (Thalomid), angiotensin-converting enzyme (ACE) inhibitors, statins, the acne medication isotretinoin (Absorica, Amnesteem, Claravis) and lithium. - Drinking alcohol during pregnancy. Avoid alcohol during pregnancy because it increases the risk of congenital heart defects. - Smoking. Smoking during pregnancy increases the likelihood of a congenital heart defect in the baby. - Heredity. Congenital heart defects sometimes run in families and may be associated with a genetic syndrome. Many children with Down syndrome - which is caused by an extra 21st chromosome (trisomy 21) - have heart defects. A missing piece (deletion) of genetic material on chromosome 22 also causes heart defects. Genetic testing can detect such disorders during fetal development. If you already have a child with a congenital heart defect, a genetic counselor can estimate the odds that your next child will have one. Complications Some potential complications that can occur with a congenital heart defect include: - Congestive heart failure. This serious complication may develop in babies who have a significant heart defect. Signs of congestive heart failure include rapid breathing, often with gasping breaths, and poor weight gain. - Slower growth and development. Children with more-serious congenital heart defects often develop and grow more slowly than do children who don't have heart defects. They may be smaller than other children of the same age and, if the nervous system has been affected, may learn to walk and talk later than other children. - Heart rhythm problems. Heart rhythm problems (arrhythmias) can be caused by a congenital heart defect or from scarring that forms after surgery to correct a congenital heart defect. - Cyanosis. If your child's heart defect causes oxygen-poor blood to mix with oxygen-rich blood in his or her heart, your child may develop a grayish-blue skin color, a condition called cyanosis. - Stroke. Although uncommon, some children with congenital heart defects are at increased risk of stroke due to blood clots traveling through a hole in the heart and on to the brain. - Emotional issues. Some children with congenital heart defects may feel insecure or develop emotional problems because of their size, activity restrictions or learning difficulties. Talk to your child's doctor if you're concerned about your child's moods. - A need for lifelong follow-up. Children who have heart defects should be mindful of their heart problems their entire lives, as their defect could lead to an increased risk of heart tissue infection (endocarditis), heart failure or heart valve problems. Most children with congenital heart defects will need to be seen regularly by a cardiologist throughout life. Diagnosis Your child's doctor may initially suspect a problem because he or she hears a heart murmur during a routine exam. A heart murmur is a sound that occurs when blood flows through the heart or blood vessels fast enough to make a sound that a doctor can hear with a stethoscope. Most heart murmurs are innocent, meaning that there is no heart defect and the murmur isn't dangerous to your child's health. Some murmurs, however, may mean blood is flowing through your child's heart abnormally because he or she has a heart defect. Tests to diagnose a congenital heart defect If it's possible your child has a heart defect, your doctor or your child's doctor may order several tests to see if your child has a heart problem. In addition to a regular physical exam, these could include: - Fetal echocardiogram. This test allows your doctor to see if your child has a heart defect before he or she is born, allowing your doctor to better plan treatment. In this test, your doctor performs an ultrasound. The sound waves from the ultrasound are used to create a picture of your baby's heart. - Echocardiogram. Your child's doctor may use a regular echocardiogram to diagnose a congenital heart defect after your child has been born. In this noninvasive test, your child's doctor performs an ultrasound to produce images of the heart. An echocardiogram allows the doctor to see your child's heart in motion and to identify abnormalities in the heart muscle and valves. - Electrocardiogram. This noninvasive test records the electrical activity of your child's heart and can help diagnose heart defects or rhythm problems. Electrodes connected to a computer and printer are placed on your baby's chest and show waves that indicate how your child's heart is beating. - Chest X-ray. Your child may have a chest X-ray to see if the heart is enlarged, or if the lungs have extra blood or other fluid in them. These could be signs of heart failure. - Pulse oximetry. This test measures how much oxygen is in your child's blood. A sensor is placed over the end of your child's finger to record the amount of oxygen in your child's blood. Too little oxygen could suggest your child has a heart problem. - Cardiac catheterization. In this test, a thin, flexible tube (catheter) is inserted into a blood vessel at your baby's groin and guided through it into the heart. Catheterization is sometimes necessary because it may give your child's doctor a much more detailed view of your child's heart defect than an echocardiogram. In addition, some treatment procedures can be done during cardiac catheterization. - Cardiovascular magnetic resonance imaging (MRI). This type of imaging is becoming increasingly used to diagnose and evaluate congenital heart defects in adolescents and adults. Newer MRI technology provides faster imaging and higher resolution than other methods, such as echocardiography. Treatment A congenital heart defect may have no long-term effect on your child's health - in some instances, such defects can safely go untreated. Certain defects, such as small holes, may even correct themselves as your child ages. Some heart defects, however, are serious and require treatment soon after they're found. Depending on the type of heart defect your child has, doctors treat congenital heart defects with: - Procedures using catheterization. Some children and adults now have their congenital heart defects repaired using catheterization techniques, which allow the repair to be done without surgically opening the chest and heart. Catheter procedures can often be used to fix holes or areas of narrowing. In procedures that can be done using catheterization, the doctor inserts a thin tube (catheter) into a leg vein and guides it to the heart with the help of X-ray images. Once the catheter is positioned at the site of the defect, tiny tools are threaded through the catheter to the heart to repair the defect. - Open-heart surgery. Depending on your child's condition, he or she may need surgery to repair the defect. Many congenital heart defects are corrected using open-heart surgery. In open-heart surgery, the chest has to be opened. In some cases, minimally invasive heart surgery may be an option. This type of surgery involves making small incisions between the ribs and inserting instruments through them to repair the defect. - Heart transplant. If a serious heart defect can't be repaired, a heart transplant may be an option. - Medications. Some mild congenital heart defects, especially those found later in childhood or adulthood, can be treated with medications that help the heart work more efficiently. Drugs known as angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs) and beta blockers and medications that cause fluid loss (diuretics) can help ease stress on the heart by lowering blood pressure, heart rate and the amount of fluid in the chest. Certain medications can also be prescribed to help irregular heartbeats (arrhythmias). Sometimes, a combination of treatments is necessary. In addition, some catheter or surgical procedures have to be done in steps, over a period of years. Others may need to be repeated as a child grows. Long-term treatment Some children with congenital heart defects require multiple procedures and surgeries throughout life. Although the outcomes for children with heart defects have improved dramatically, most people, except those with very simple defects, will require ongoing care, even after corrective surgery. - Lifelong monitoring and treatment. Even if your child has surgery to treat a heart defect, your child's condition will need to be monitored for the rest of his or her life. Initially, your child with a congenital heart defect will be monitored and have regular follow-up appointments with a pediatric cardiologist. As your child grows older, his or her care will transition to an adult congenital cardiologist, who can monitor his or her condition over time. A congenital heart defect can affect your child's adult life, as it can contribute to other health problems. Adults who have congenital heart defects may need other treatments for their condition. As your child ages, it's important to remind him or her of the heart condition that was corrected and the need for ongoing, lifelong care by doctors experienced in evaluating and treating congenital heart disease. Encourage your child to keep his or her doctor informed about the heart defect and the procedures performed to treat the problem. - Exercise restrictions. Parents of children with congenital heart defects may worry about the risks of rough play and activity even after treatment. Although some children may need to limit the amount or type of exercise, many can participate in normal or near-normal activity. Your child's doctor can tell you which activities are safe for your child. If some activities do pose distinct dangers, encourage your child to participate in other activities instead of focusing on what he or she can't do. Although every child is different, most children with congenital heart defects grow up to lead healthy, productive lives. - Infection prevention. Depending on the type of congenital heart defect your child had, and the surgery used to correct it, your child may need to take extra steps to prevent infection. Sometimes, a congenital heart defect can increase the risk of infections - either in the lining of the heart or heart valves (infective endocarditis). Because of this risk, your child may need to take antibiotics to prevent infection before additional surgeries or dental procedures. Children who are most likely to have a higher risk of infection include those whose defect was repaired with a prosthetic material or device, such as an artificial heart valve. Ask your child's cardiologist if preventive antibiotics are necessary for your child. ", "role": "user" }, { "content": "Causes of congenital heart defects are unknown. The risk factors for these problems that occur early in the baby's heart development include: having rubella during pregnancy; uncontrolled diabetes; taking medications known to increase the risk of congenital heart defects, such as thalidomide (Thalomid), angiotensin-converting enzyme (ACE) inhibitors, statins, the acne medication isotretinoin (Absorica, Amnesteem, Claravis) and lithium. Other factors are smoking, drinking alcohol during pregnancy, and genetic syndromes, such as Down syndrome. A genetic counselor can estimate the odds that a child will have a genetic disorder.", "role": "assistant" } ]
[ { "content": "how smoking tobacco affects the brain\n\n Smoking and surgery Surgery - quitting smoking Surgery - quitting tobacco Wound healing - smoking Summary Quitting smoking and other tobacco products before surgery can improve your recovery and outcome after surgery. Most people who successfully quit smoking have tried and failed many times. DO NOT give up. Learning from your past tries can help you succeed. There Are Many Reasons to Quit Smoking Tar, nicotine, and other chemicals from smoking can increase your risk of many health problems. These include heart and blood vessel problems, such as: Blood clots and aneurysms in the brain, which can lead to strokes Coronary artery disease, including chest pain (angina) and heart attacks High blood pressure Poor blood supply to the legs Problems with erections Smoking also increases your risk for different types of cancer, including cancer of the: Lungs Mouth Larynx Esophagus Bladder Kidneys Pancreas Cervix Smoking also leads to lung problems, such as emphysema and chronic bronchitis, and makes asthma harder to control. Some smokers switch to smokeless tobacco instead of quitting tobacco completely. But using smokeless tobacco still carries health risks, such as: Developing mouth or nasal cancer Gum problems, tooth wear, and cavities Worsening high blood pressure and chest pain How Smoking Affects Surgery Smokers who have surgery have a higher chance than nonsmokers of blood clots forming in their legs. These clots may travel to and damage the lungs. Smoking decreases the amount of oxygen that reaches the cells in your surgical wound. As a result, your wound may heal more slowly and is more likely to become infected. All smokers carry an increased risk for heart and lung problems. Even when your surgery goes smoothly, smoking causes your body, heart, and lungs to work harder than if you did not smoke. Making the Decision to Quit Most doctors will tell you to stop using cigarettes and tobacco at least 4 weeks before your surgery. Stretching the time between quitting smoking and your surgery out to at least 10 weeks can decrease your risk of problems even more. Like any addiction, quitting tobacco is difficult. There are many ways to quit smoking and many resources to help you, such as: Family members, friends, and coworkers may be supportive or encouraging. Talk to your doctor about medicines, such as nicotine replacement and prescription medicines. If you join smoking cessation programs, you have a much better chance of success. Such programs are offered by hospitals, health departments, community centers, and work sites. Using nicotine gum around the time of surgery is not encouraged. The nicotine will still interfere with the healing of your surgical wound and have the same effect on your general health as using cigarettes and tobacco. Review Date 9/17/2016 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, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Tar, nicotine, and other chemicals from smoking can increase your risk of many health problems. These include heart and blood vessel problems, increased risk for different types of cancer, and lung problems.", "role": "assistant" } ]
[ { "content": "Research assignment Hi, I am a grade 12 student who is doing a research assignment on neurological disorders. Do you believe that there will ever be a bonafide cure for Multiple Sclerosis? If so, what kind of time frame would put on this cure?\n\n Multiple Sclerosis What is Multiple Sclerosis? An unpredictable disease of the central nervous system, multiple sclerosis (MS) can range from relatively benign to somewhat disabling to devastating, as communication between the brain and other parts of the body is disrupted. Many investigators believe MS to be an autoimmune disease -- one in which the body, through its immune system, launches a defensive attack against its own tissues. In the case of MS, it is the nerve-insulating myelin that comes under assault. Such assaults may be linked to an unknown environmental trigger, perhaps a virus. Most people experience their first symptoms of MS between the ages of 20 and 40; the initial symptom of MS is often blurred or double vision, red-green color distortion, or even blindness in one eye. Most MS patients experience muscle weakness in their extremities and difficulty with coordination and balance. These symptoms may be severe enough to impair walking or even standing. In the worst cases, MS can produce partial or complete paralysis. Most people with MS also exhibit paresthesias, transitory abnormal sensory feelings such as numbness, prickling, or \"pins and needles\" sensations. Some may also experience pain. Speech impediments, tremors, and dizziness are other frequent complaints. Occasionally, people with MS have hearing loss. Approximately half of all people with MS experience cognitive impairments such as difficulties with concentration, attention, memory, and poor judgment, but such symptoms are usually mild and are frequently overlooked. Depression is another common feature of MS. Is there any treatment? There is as yet no cure for MS. Many patients do well with no therapy at all, especially since many medications have serious side effects and some carry significant risks. However, three forms of beta interferon (Avonex, Betaseron, and Rebif) have now been approved by the Food and Drug Administration for treatment of relapsing-remitting MS. Beta interferon has been shown to reduce the number of exacerbations and may slow the progression of physical disability. When attacks do occur, they tend to be shorter and less severe. The FDA also has approved a synthetic form of myelin basic protein, called copolymer I (Copaxone), for the treatment of relapsing-remitting MS. Copolymer I has few side effects, and studies indicate that the agent can reduce the relapse rate by almost one third. Other FDA approved drugs to treat relapsing forms of MS in adults include teriflunomide and dimethyl fumarate. An immunosuppressant treatment, Novantrone (mitoxantrone), is approved by the FDA for the treatment of advanced or chronic MS. The FDA has also approved dalfampridine (Ampyra) to improve walking in individuals with MS. One monoclonal antibody, natalizumab (Tysabri), was shown in clinical trials to significantly reduce the frequency of attacks in people with relapsing forms of MS and was approved for marketing by the U.S. Food and Drug Administration (FDA) in 2004. However, in 2005 the drug’s manufacturer voluntarily suspended marketing of the drug after several reports of significant adverse events. In 2006, the FDA again approved sale of the drug for MS but under strict treatment guidelines involving infusion centers where patients can be monitored by specially trained physicians. While steroids do not affect the course of MS over time, they can reduce the duration and severity of attacks in some patients. Spasticity, which can occur either as a sustained stiffness caused by increased muscle tone or as spasms that come and go, is usually treated with muscle relaxants and tranquilizers such as baclofen, tizanidine, diazepam, clonazepam, and dantrolene. Physical therapy and exercise can help preserve remaining function, and patients may find that various aids -- such as foot braces, canes, and walkers -- can help them remain independent and mobile. Avoiding excessive activity and avoiding heat are probably the most important measures patients can take to counter physiological fatigue. If psychological symptoms of fatigue such as depression or apathy are evident, antidepressant medications may help. Other drugs that may reduce fatigue in some, but not all, patients include amantadine (Symmetrel), pemoline (Cylert), and the still-experimental drug aminopyridine. Although improvement of optic symptoms usually occurs even without treatment, a short course of treatment with intravenous methylprednisolone (Solu-Medrol) followed by treatment with oral steroids is sometimes used. What is the prognosis? A physician may diagnose MS in some patients soon after the onset of the illness. In others, however, doctors may not be able to readily identify the cause of the symptoms, leading to years of uncertainty and multiple diagnoses punctuated by baffling symptoms that mysteriously wax and wane. The vast majority of patients are mildly affected, but in the worst cases, MS can render a person unable to write, speak, or walk. MS is a disease with a natural tendency to remit spontaneously, for which there is no universally effective treatment. What research is being done? The National Institute of Neurological Disorders and Stroke (NINDS) and other institutes of the National Institutes of Health (NIH) conduct research in laboratories at the NIH and also support additional research through grants to major medical institutions across the country. Scientists continue their extensive efforts to create new and better therapies for MS. One of the most promising MS research areas involves naturally occurring antiviral proteins known as interferons. Beta interferon has been shown to reduce the number of exacerbations and may slow the progression of physical disability. When attacks do occur, they tend to be shorter and less severe. In addition, there are a number of treatments under investigation that may curtail attacks or improve function. Over a dozen clinical trials testing potential therapies are underway, and additional new treatments are being devised and tested in animal models. In 2001, the National Academies/Institute of Medicine, a Federal technical and scientific advisory agency, prepared a strategic review of MS research. To read or download the National Academies/Institute of Medicine report, go to: \"Multiple Sclerosis: Current Status and Strategies for the Future.\" ", "role": "user" }, { "content": "Scientists continue researching treatments for MS. Over a dozen clinical trials are underway, and additional new treatments are tested in animal models.One of the most promising MS research areas involves naturally occurring antiviral proteins known as interferons. Beta interferon has been shown to reduce the number of exacerbations and may slow the progression of physical disability.", "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": "Causes of gastroparesis, or delayed gastric emptying, are unknown in most people. The most common known cause is diabetes. The symptoms of gastrparesis, a disorder that mostly affects women, are nausea, gastroesophageal reflux, a feeling of fullness after eating only a small amount of food, and vomiting undigested food, sometimes several hours after a meal. Your doctor will diagnose gastroparesis through a physical examination, medical history, blood tests, tests to rule out blockage or structural problems in the gastrointestinal tract, and gastric emptying tests. Treatment of gastroparesis may include medications, botulinum toxin, gastric electrical stimulation, jejunostomy (surgery to place a feeding tube through the abdominal wall directly into a part of the small intestine called the jejunum), and parenteral nutrition.", "role": "assistant" } ]
[ { "content": "what test do you do for rheumatoid \"arthritis?\"\n\nHow to diagnose Rheumatoid Arthritis?: Rheumatoid arthritis can be difficult to diagnose in its early stages because the full range of symptoms develops over time, and only a few symptoms may be present in the early stages. As part of the diagnosis, your doctor will look for symptoms such as swelling, warmth, pain, and limitations in joint motion throughout your body. Your doctor may ask you questions about the intensity of your pain symptoms, how often they occur, and what makes the pain better or worse.", "role": "user" }, { "content": "Rheumatoid arthritis can be difficult to diagnose in its early stages because the full range of symptoms develops over time, and only a few symptoms may be present in the early stages. As part of the diagnosis, your doctor will look for symptoms such as swelling, warmth, pain, and limitations in joint motion throughout your body.", "role": "assistant" } ]
[ { "content": "what the treatment for bronchitis\n\nIndustrial bronchitis: Industrial bronchitis is swelling (inflammation) of the large airways of the lungs that occurs in some people who work around certain dusts, fumes, smoke, or other substances. Exposure to dusts, fumes, strong acids, and other chemicals in the air causes this type of bronchitis. Smoking may also contribute. You may be at risk if you are exposed to dusts that contain: - Asbestos - Coal - Cotton - Flax - Latex - Metals - Silica - Talc - Toluene diisocyanate - Western red cedar Symptoms may include any of the following: - Cough that brings up mucus (sputum) - Shortness of breath - Wheezing The health care provider will listen to your lungs using a stethoscope. Wheezing sounds or crackles may be heard. Tests that may be ordered include: - Chest CT scan - Chest x-ray - Pulmonary function tests (to measure breathing and how well the lungs are functioning) The goal of treatment is to reduce the irritation. Getting more air into the workplace or wearing masks to filter out the offending dust particles may help. Some people may need to be taken out of the workplace. Some cases of industrial bronchitis go away without treatment. Other times, a person may need inhaled anti-inflammatory medicines. If you are at risk or have experienced this problem and you smoke, stop smoking. Helpful measures include: - Breathing humidified air - Increasing fluid intake - Resting The outcome may be good as long as you can stop being exposed to the irritant. Chronic disability from industrial bronchitis is rare. Continued exposure to irritating gases, fumes, or other substances can lead to permanent lung damage. Call your provider if you are regularly exposed to dusts, fumes, strong acids, or other chemicals that can affect the lungs and you develop symptoms of bronchitis. Control dust in industrial settings by wearing face masks and protective clothing, and by treating textiles. Stop smoking if you are at risk. Get early screening by a doctor if you are exposed to chemicals that can cause this condition. If you think a chemical you work with is affecting your breathing, ask your employer for a copy of the Material Safety Data Sheet. Bring it with you to your provider. Updated by: Denis Hadjiliadis, MD, MHS, Paul F. Harron Jr. Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. 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 bronchitis occurs due to working around certain dusts, fumes, smoke, or other substances, the goal of treatment is to reduce the irritation by getting more air into the workplace or wearing masks. Some cases of such industrial bronchitis go away without treatment. Other, may need inhaled anti-inflammatory medicines. Helpful measures include: stopping smoking, breathing humidified air, increasing fluid intake, resting, and stopping being exposed to the irritant.", "role": "assistant" } ]
[ { "content": "what are the causes of headaches\n\n Sinus headaches Overview Sinus headaches are headaches that may feel like an infection in the sinuses (sinusitis). You may feel pressure around your eyes, cheeks and forehead. Perhaps your head throbs. However, many people who assume they have headaches from sinusitis, including many who have received such a diagnosis, actually have migraines or tension headaches. Symptoms Signs and symptoms of sinus headaches - regardless of cause - may include: - Pain, pressure and fullness in your cheeks, brow or forehead - Worsening pain if you bend forward or lie down - Stuffy nose - Fatigue - Achy feeling in your upper teeth Sinusitis or migraine? Migraines and headaches from sinusitis are easy to confuse because the signs and symptoms of the two types of headaches often overlap. Both sinusitis and migraine headache pain often gets worse when you bend forward. Migraine can also be accompanied by various nasal signs and symptoms - including congestion, facial pressure and a clear, watery nasal discharge. In fact, studies have shown that approximately 90 percent of people who see a doctor for sinus headaches are found to have migraines instead. Sinusitis, however, usually isn't associated with nausea or vomiting or aggravated by noise or bright light - all common features of migraines. Sinusitis usually occurs after a viral upper respiratory infection or cold and includes thick, discolored nasal mucus, decreased sense of smell, and pain in one cheek or upper teeth. When to see a doctor Consult your doctor if: - Your headache symptoms occur more than 15 days a month or require frequent over-the-counter pain medicine - You have a severe headache, and over-the-counter pain medicine doesn't help - You miss school or work because of frequent headaches or the headaches interfere with your daily life Causes Sinus headaches are usually associated with migraines or other forms of headaches. Sinus headaches are associated with pain and pressure in the face and sinuses and can cause nasal symptoms. Most of these headaches are not caused by sinus infections and should not be treated with antibiotics. Risk factors Sinus headaches can affect anyone but may be more likely if you have: - A previous history of migraines or headaches - A family history of migraines or headaches - Hormonal changes associated with headaches Diagnosis The cause of headaches can be difficult to determine. The doctor will question you about your headaches and do a physical exam. Your doctor may perform imaging tests to help determine the cause of your headache, including: - CT scan. CT scans use a computer to create cross-sectional images of your brain and head (including your sinuses) by combining images from an X-ray unit that rotates around your body. - Magnetic resonance imaging (MRI). With MRIs, a magnetic field and radio waves are used to create cross-sectional images of the structures within your brain. Treatment Most people who assume they have sinusitis actually have migraines or tension-type headaches. Migraines and chronic or recurrent headaches may be treated with prescription medication that is either taken every day to reduce or prevent headaches or taken at the onset of a headache to prevent it from getting worse. To treat these types of headaches, your doctor may recommend: - Over-the-counter pain relievers. Migraines and other types of headaches may be treated with over-the-counter medications, such as acetaminophen (Tylenol, others), naproxen sodium (Aleve) and ibuprofen (Advil, Motrin IB). - Triptans. Many people with migraine attacks use triptans to relieve pain. Triptans work by promoting constriction of blood vessels and blocking pain pathways in the brain. Medications include sumatriptan (Imitrex), rizatriptan (Maxalt), almotriptan (Axert), naratriptan (Amerge), zolmitriptan (Zomig), frovatriptan (Frova) and eletriptan (Relpax). Some triptans are available as nasal sprays and injections, in addition to tablets. A single-tablet combination of sumatriptan and naproxen sodium (Treximet) has proved to be more effective in relieving migraine symptoms than either medication on its own. - Ergots. Ergotamine and caffeine combination drugs (Migergot, Cafergot) are less effective than triptans. Ergots seem most effective in those whose pain lasts for more than 72 hours. Ergotamine may cause worsened nausea and vomiting related to your migraines and other side effects, and it may also lead to medication-overuse headaches. Dihydroergotamine (D.H.E. 45, Migranal) is an ergot derivative that is more effective and has fewer side effects than ergotamine. It's available as a nasal spray and in injection form. This medication may cause fewer side effects than ergotamine and is less likely to lead to medication-overuse headaches. - Anti-nausea medications. Because migraines are often accompanied by nausea, with or without vomiting, medication for nausea is appropriate and is usually combined with other medications. Frequently prescribed medications are chlorpromazine, metoclopramide (Reglan) or prochlorperazine (Compro). - Glucocorticoids (dexamethasone). A glucocorticoid may be used in conjunction with other medications to improve pain relief. Because of the risk of steroid toxicity, glucocorticoids shouldn't be used frequently. ", "role": "user" }, { "content": "Sinus headaches are usually associated with migraines or other types of headaches. Sinus headaches are caused by pain and pressure in the face and sinuses. These are not caused by sinus infections and should not be treated with antibiotics.", "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 IBS IBD - irritable bowel Spastic colon Irritable colon Mucous colitis Spastic colitis Abdominal pain - IBS Diarrhea - IBS Constipation - IBS Summary Irritable bowel syndrome (IBS) is a disorder that leads to abdominal pain and bowel changes. IBS is not the same as inflammatory bowel disease (IBD). Causes The reasons why IBS develops are not clear. It can occur after a bacterial infection or a parasitic infection (giardiasis) of the intestines. This is called postinfectious IBS. There may also be other triggers, including stress. The intestine is connected to the brain using hormone and nerve signals that go back and forth between the bowel and the brain. These signals affect bowel function and symptoms. The nerves can become more active during stress. This can cause the intestines to be more sensitive and contract more. IBS can occur at any age. Often, it begins in the teen years or early adulthood. It is twice as common in women as in men. It is less likely to begin in older people above 50 years of age. About 10% to 15% of people in the United States have symptoms of IBS. It is the most common intestinal problem that causes people to be referred to a bowel specialist (gastroenterologist). Symptoms IBS symptoms vary from person to person, and range from mild to severe. Most people have mild symptoms. You are said to have IBS when symptoms are present for at least 3 days a month for a period of 3 months or more. The main symptoms include: Abdominal pain Gas Fullness Bloating Change in bowel habits. Can have either diarrhea (IBS-D), or constipation (IBS-C). Pain and other symptoms will often be reduced or go away after a bowel movement. Symptoms may flare up when there is a change in the frequency of your bowel movements. People with IBS may go back and forth between having constipation and diarrhea or have or mostly have one or the other. If you have IBS with diarrhea, you will have frequent, loose, watery stools. You may have an urgent need to have a bowel movement, which may be hard to control. If you have IBS with constipation, you will have a hard time passing stool, as well as fewer bowel movements. You may need to strain with a bowel movement and have cramps. Often, only a small amount or no stool at all will pass. The symptoms may get worse for a few weeks or a month, and then decrease for a while. In other cases, symptoms are present most of the time. You may also lose your appetite if you have IBS. However, blood in stools and unintentional weight loss are not a part of IBS. Exams and Tests There is no test to diagnose IBS. Most of the time, your health care provider can diagnose IBS based on your symptoms. Eating a lactose-free diet for 2 weeks may help the provider identify lactase deficiency (or lactose intolerance). The following tests may be done to rule out other problems: Blood tests to see if you have celiac disease or a low blood count (anemia) Stool cultures to check for an infection Your provider may recommend a colonoscopy. During this test, a flexible tube is inserted through the anus to examine the colon. You may need this test if: Symptoms began later in life (over age 50) You have symptoms such as weight loss or bloody stools You have abnormal blood tests (such as a low blood count) Other disorders that can cause similar symptoms include: Celiac disease Colon cancer (cancer rarely causes typical IBS symptoms, unless symptoms such as weight loss, blood in the stools, or abnormal blood tests are also present) Crohn disease or ulcerative colitis Treatment The goal of treatment is to relieve symptoms. In some cases of IBS, lifestyle changes can help. For example, regular exercise and improved sleep habits may reduce anxiety and help relieve bowel symptoms. Dietary changes can be helpful. However, no specific diet can be recommended for IBS because the condition differs from one person to another. The following changes may help: Avoiding foods and drinks that stimulate the intestines (such as caffeine, tea, or colas) Eating smaller meals Increasing fiber in the diet (this may improve constipation or diarrhea, but make bloating worse) Talk with your provider before taking over-the-counter medicines. No one medicine works for everyone. Some that your provider may suggest include: Anticholinergic medicines (dicyclomine, propantheline, belladonna, and hyoscyamine) taken about a half-hour before eating to control intestinal muscle spasms Bisacodyl to treat constipation Loperamide to treat diarrhea Low doses of tricyclic antidepressants to help relieve intestinal pain Lubiprostone for constipation symptoms Rifaximin, an antibiotic Psychological therapy or medicines for anxiety or depression may help with the problem. Outlook (Prognosis) IBS may be a life-long condition. For some people, symptoms are disabling and interfere with work, travel, and social activities. Symptoms often get better with treatment. IBS does not cause permanent harm to the intestines. Also, it does not lead to a serious disease, such as cancer. When to Contact a Medical Professional Call your provider if you have symptoms of IBS or if you notice changes in your bowel habits that do not go away. Review Date 4/3/2017 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": "The goal of treatment is to relieve symptoms. In some cases of IBS, lifestyle changes can help. For example, regular exercise and improved sleep habits may reduce anxiety and help relieve bowel symptoms. Dietary changes can be helpful. However, no specific diet can be recommended for IBS because the condition differs from one person to another. The following changes may help: - Avoiding foods and drinks that stimulate the intestines (such as caffeine, tea, or colas) - Eating smaller meals - Increasing fiber in the diet (this may improve constipation or diarrhea, but make bloating worse) Talk with your provider before taking over-the-counter medicines. No one medicine works for everyone. Some that your provider may suggest include: - Anticholinergic medicines (dicyclomine, propantheline, belladonna, and hyoscyamine) taken about a half-hour before eating to control intestinal muscle spasms - Bisacodyl to treat constipation - Loperamide to treat diarrhea - Low doses of tricyclic antidepressants to help relieve intestinal pain - Lubiprostone for constipation symptoms - Rifaximin, an antibiotic Psychological therapy or medicines for anxiety or depression may help with the problem. IBS may be a life-long condition. For some people, symptoms are disabling and interfere with work, travel, and social activities. Symptoms often get better with treatment. IBS does not cause permanent harm to the intestines. Also, it does not lead to a serious disease, such as cancer. Call your provider if you have symptoms of IBS or if you notice changes in your bowel habits that do not go away.", "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\n Kartagener syndrome Dextrocardia bronchiectasis and sinusitis Siewert syndrome Immotile cilia syndrome, Kartagener type Dextrocardia bronchiectasis and sinusitis Siewert syndrome Immotile cilia syndrome, Kartagener type Primary ciliary dyskinesia, Kartagener type Dextrocardia-bronchiectasis-sinusitis syndrome Primary ciliary dyskinesia and situs inversus See More Summary Kartagener syndrome is a type of p that is also characterized by situs inversus totalis (mirror-image reversal of internal organs ). The signs and symptoms vary but may include neonatal respiratory distress; frequent lung, sinus and middle ear infections beginning in early childhood; and infertility. [1] [2] [3] It can be cause by changes ( mutations ) in many different genes that are inherited in an autosomal recessive manner. Although scientists have identified many of the genes associated with Kartagener syndrome, the genetic cause of some cases is unknown. [4] [2] There is no cure for Kartagener syndrome. Treatment varies based on the signs and symptoms present in each person but may include airway clearance therapy and antibiotics . [1] [2] [3] Symptoms Kartagener syndrome is characterized by p and situs inversus totalis. In people affected by situs inversus totalis, the internal organs including the heart, liver, spleen and intestine are on the opposite side of the body. Although the internal organs are abnormally placed, this condition typically does not cause any health problems. [1] [2] The signs and symptoms of primary ciliary dyskinesia vary, but may include: [1] [2] [3] Neonatal respiratory distress Frequent respiratory infections that can lead to severe lung damage Chronic nasal congestion Frequent sinus infections Recurrent middle ear infections, particularly in early childhood Hearing loss Hydrocephalus Infertility Cause Kartagener syndrome can be caused by changes ( mutations ) in many different genes . These genes encode proteins that are important to the structure and function of cilia. Cilia are tiny, hair-like structures that are found on the surface of cells in various parts of the body such as the lining of the airway, the reproductive system, and other organs . The coordinated movement of cilia in wave-like motions is important to the normal functioning of certain organs and tissues throughout the body and ensures the proper placement of organs in the developing embryo. Mutations in these genes cause the cilia to be either immotile (unable to move) or dysmotile (they move incorrectly), which leads to the many signs and symptoms of Kartagener syndrome. [1] [4] [3] Scientists have identified several different genes that are associated with Kartagener syndrome; however, the genetic cause is unknown in some cases. [1] [4] [3] 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. Diagnosis Kartagener syndrome is typically suspected based on the presence of characteristic signs and symptoms. A diagnosis can be confirmed by examining a small sample of tissue ( biopsy ) from an area of the body known to have cilia such as the sinus cavities or the airway. Abnormalities in the structure of cilia, as seen in people affected by Kartagener syndrome, can be observed under a special microscope (called an electron microscope). If the disease-causing change ( mutation ) is known, genetic testing can also be used to confirm the diagnosis. [1] [2] [3] 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. Treatment There is currently no cure for Kartagener syndrome . Treatment varies based on the signs and symptoms present in each person. Airway clearance therapy, similar to that used in cystic fibrosis, can loosen thick, sticky mucus so it can be cleared away. Antibiotics may be prescribed to treat respiratory, sinus, and middle ear infections and may be given on a long-term basis in people with chronic or frequent infections. Surgery to insert ear tubes may be recommended in children with chronic ear infections that are resistant to antibiotics. In people with severe lung disease, lung transplantation may be an option. [1] [2] [3] For more information on the treatment and management of Kartagener syndrome, please click here. Prognosis The long-term outlook for people with Kartagener syndrome varies widely and largely depends on timely diagnosis and treatment. Chronic childhood infections can be very debilitating. However, with appropriate treatment, the progression of lung disease can be slowed and other complications such as hearing loss can be avoided. [3] [2] [5] ", "role": "user" }, { "content": "Kartagener syndrome is a type of p that is also characterized by situs inversus totalis (mirror-image reversal of internal organs ). The signs and symptoms vary but may include neonatal respiratory distress; frequent lung, sinus and middle ear infections beginning in early childhood; and infertility. In people affected by situs inversus totalis, the internal organs including the heart, liver, spleen and intestine are on the opposite side of the body. Although the internal organs are abnormally placed, this condition typically does not cause any health problems. Kartagener syndrome can be caused by changes ( mutations ) in many different genes . These genes encode proteins that are important to the structure and function of cilia. Cilia are tiny, hair-like structures that are found on the surface of cells in various parts of the body such as the lining of the airway, the reproductive system, and other organs . Mutations in these genes cause the cilia to be either immotile (unable to move) or dysmotile (they move incorrectly), which leads to the many signs and symptoms of Kartagener syndrome. Scientists have identified several different genes that are associated with Kartagener syndrome; however, the genetic cause is unknown in some cases. Kartagener syndrome is inherited in an autosomal recessive manner. 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. Kartagener syndrome is typically suspected based on the presence of characteristic signs and symptoms. A diagnosis can be confirmed by examining a small sample of tissue ( biopsy ) from an area of the body known to have cilia such as the sinus cavities or the airway. Abnormalities in the structure of cilia, as seen in people affected by Kartagener syndrome, can be observed under a special microscope (called an electron microscope). If the disease-causing change ( mutation ) is known, genetic testing can also be used to confirm the diagnosis.l. There is currently no cure for Kartagener syndrome . Treatment varies based on the signs and symptoms present in each person. Airway clearance therapy, similar to that used in cystic fibrosis, can loosen thick, sticky mucus so it can be cleared away. Antibiotics may be prescribed to treat respiratory, sinus, and middle ear infections and may be given on a long-term basis in people with chronic or frequent infections. In people with severe lung disease, lung transplantation may be an option. The long-term outlook for people with Kartagener syndrome varies widely and largely depends on timely diagnosis and treatment. Chronic childhood infections can be very debilitating. However, with appropriate treatment, the progression of lung disease can be slowed and other complications such as hearing loss can be avoided.", "role": "assistant" } ]
[ { "content": "how is asthma diagnosed\n\n Asthma attack Overview During an asthma attack, also called an asthma exacerbation, your airways become swollen and inflamed. The muscles around the airways contract and the airways also produce extra mucus, causing your breathing (bronchial) tubes to narrow. During an attack, you may cough, wheeze and have trouble breathing. An asthma attack may be minor, with symptoms that get better with prompt home treatment, or it may be more serious. A severe asthma attack that doesn't improve with home treatment can become a life-threatening emergency. The key to stopping an asthma attack is recognizing and treating an asthma flare-up early. Follow the treatment plan you worked out with your doctor ahead of time. Your treatment plan should include what to do when your asthma starts getting worse, and how to deal with an asthma attack in progress. Symptoms Asthma attack signs and symptoms include: - Severe shortness of breath, chest tightness or pain, and coughing or wheezing - Low peak expiratory flow (PEF) readings, if you use a peak flow meter - Symptoms that fail to respond to use of a quick-acting (rescue) inhaler Signs and symptoms of an asthma attack vary from person to person. Work with your doctor to identify your particular signs and symptoms of worsening asthma - and what to do when they occur. If your asthma symptoms keep getting worse even after you take medication as your doctor directed, you may need emergency room care. Your doctor can help you learn to recognize an asthma emergency so that you'll know when to get help. If your asthma flares up, immediately follow the treatment steps you and your doctor worked out ahead of time in your written asthma plan. If your symptoms and peak expiratory flow (PEF) readings improve, home treatment may be all that's needed. If your symptoms don't improve with home treatment, you may need to seek emergency care. When your asthma symptoms flare up, follow your written asthma plan's instructions for using your quick-acting (rescue) inhaler. PEF readings ranging from 50 to 79 percent of your personal best are a sign you need to use the quick-acting (rescue) medications prescribed by your doctor. Asthma can change over time, so you'll need periodic adjustments to your treatment plan to keep daily symptoms under control. If your asthma isn't well-controlled, it increases your risk of future asthma attacks. Lingering lung inflammation means your asthma could flare up at any time. Go to all scheduled doctor's appointments. If you have regular asthma flare-ups, low peak flow readings or other signs your asthma isn't well-controlled, make an appointment to see your doctor. Seek medical attention right away if you have signs or symptoms of a serious asthma attack, which include: - Severe breathlessness or wheezing, especially at night or in the early morning - The inability to speak more than short phrases due to shortness of breath - Having to strain your chest muscles to breathe - Low peak flow readings when you use a peak flow meter - No improvement after using a quick-acting (rescue) inhaler Causes An overly sensitive immune system makes your airways (bronchial tubes) become inflamed and swollen when you're exposed to certain triggers. Asthma triggers vary from person to person. Common asthma attack triggers include: - Pollen, pets, mold and dust mites - Upper respiratory infections - Tobacco smoke - Inhaling cold, dry air - Gastroesophageal reflux disease (GERD) - Stress For many people, asthma symptoms get worse with a respiratory infection such as a cold. Some people have asthma flare-ups caused by something in their work environment. Sometimes, asthma attacks occur with no apparent cause. Risk factors Anyone who has asthma is at risk of an asthma attack. You may be at increased risk of a serious asthma attack if: - You've had a severe asthma attack in the past - You've previously been admitted to the hospital or had to go to the emergency room for asthma - You've previously required intubation for an asthma attack - You use more than two quick-acting (rescue) inhalers a month - Your asthma attacks tend to sneak up on you before you notice symptoms have worsened - You have other chronic health conditions, such as sinusitis or nasal polyps, or cardiovascular or chronic lung disease Complications Asthma attacks can be serious. - Asthma attacks can interrupt everyday activities such as sleep, school, work and exercise, causing a significant impact on your quality of life - and can disrupt the lives of those around you. - Serious asthma attacks mean you're likely to need trips to the emergency room, which can be stressful and costly. - A very severe asthma attack can lead to respiratory arrest and death. Diagnosis For adults and children over 5 years old, lung (pulmonary) function tests are used to check how well the lungs are working. Poor lung function is a sign that your asthma isn't well-controlled. In some cases, lung function tests are also used in asthma emergencies to help check the severity of an asthma attack or how well treatment is working. Lung function tests include: - Peak flow. Your doctor may take a peak flow reading when you come in for a scheduled visit or for emergency treatment during an asthma attack. This test measures how quickly you can breathe out. You also may use a peak flow meter at home to monitor your lung function. The results of this test are known as peak expiratory flow (PEF). A peak flow test is done by blowing into a mouthpiece as hard and as fast as you can with a single breath (expiration). - Spirometry. During spirometry, you take deep breaths and forcefully exhale into a hose connected to a machine called a spirometer. A common spirometry measurement is forced expiratory volume, which measures how much air you can breathe out in one second. The results of this test are known as forced expiratory volume (FEV). Spirometry can also measure how much air your lungs can hold and the rate at which you can inhale and exhale. - Nitric oxide measurement. A newer diagnostic test, this exam measures the amount of nitric oxide gas you have in your breath when you exhale. High nitric oxide readings indicate inflammation of the bronchial tubes. Exhaled nitric oxide can be measured by having a patient exhale directly into an analyzer. Exhaled air may be captured in a nitric-oxide-impervious container for measurement later. - Pulse oximetry. This test is used during a severe asthma attack. It measures the amount of oxygen in your blood. It's measured through your fingernail and only takes seconds. Treatment If you and your doctor have worked out an asthma plan, follow its directions at the first sign of an asthma attack. This generally means taking two to six puffs of a quick-acting (rescue) inhaler to get airway-expanding medication, such as albuterol (ProAir HFA, Proventil HFA, Ventolin HFA, others), deep into your lungs. Small children and those who have trouble with inhalers can use a nebulizer. After 20 minutes, you can repeat the treatment one time if necessary. For an asthma attack with severe symptoms, such as difficulty speaking because you're so short of breath, start with the same initial step of using quick-acting medication - but instead of waiting for the drug to work, get to a doctor's office or urgent care immediately. Same-day medical care is also warranted if you continue to wheeze and feel at all breathless after initial treatment. Your doctor may recommend that you continue to use quick-acting medication every three to four hours for a day or two after the attack. You might also need to take oral corticosteroid medication for a short time. Emergency treatment If you go to the emergency room for an asthma attack in progress, you'll need medications to get your asthma under immediate control. These can include: - Short-acting beta agonists, such as albuterol (ProAir HFA, Proventil HFA, Ventolin HFA, others). These are the same medications as those in your quick-acting (rescue) inhaler. You may need to use a machine called a nebulizer, which turns the medication into a mist that can be inhaled deep into your lungs. - Oral corticosteroids. Taken in pill form, these medications help reduce lung inflammation and get your asthma symptoms under control. Corticosteroids can also be given intravenously, typically to patients who are vomiting or under respiratory failure. - Ipratropium (Atrovent). Ipratropium is sometimes used as a bronchodilator to treat a severe asthma attack, especially if albuterol is not fully effective. - Intubation, mechanical ventilation and oxygen. If your asthma attack is life-threatening, your doctor may put a breathing tube down your throat into your upper airway. Using a machine that pumps oxygen into your lungs will help you breathe while your doctor gives you medications to bring your asthma under control. After your asthma symptoms improve, your doctor may want you to stay in the emergency room for a few hours or longer to make sure you don't have another asthma attack. When your doctor feels your asthma is sufficiently under control, you'll be able to go home. Your doctor will give you instructions on what to do if you have another asthma attack. If your asthma symptoms don't improve after emergency treatment, your doctor may admit you to the hospital and give you medications every hour or every few hours. If you're having severe asthma symptoms, you may need to breathe oxygen through a mask. In some cases, a severe, persistent asthma attack requires a stay in the intensive care unit (ICU). Lifestyle and home remedies All asthma attacks require treatment with a quick-acting (rescue) inhaler such as albuterol. One of the key steps in preventing an asthma attack is to avoid your triggers. - If your asthma attacks seem to be set off by outside triggers, your doctor can help you learn how to minimize your exposure to them. Allergy tests can help identify any allergic triggers. - Washing your hands frequently can help reduce your risk of catching a cold virus. - If your asthma flares up when you exercise in the cold, it may help to cover your face with a mask or scarf until you get warmed up. ", "role": "user" }, { "content": "For adults and children over 5 years old, lung (pulmonary) function tests are used to check how well the lungs are working. Poor lung function is a sign that your asthma isn't well-controlled. In some cases, lung function tests are also used in asthma emergencies to help check the severity of an asthma attack or how well treatment is working. Lung function tests include: - Peak flow. Your doctor may take a peak flow reading when you come in for a scheduled visit or for emergency treatment during an asthma attack. This test measures how quickly you can breathe out. Spirometry. During spirometry, you take deep breaths and forcefully exhale into a hose connected to a machine called a spirometer. A common spirometry measurement is forced expiratory volume, which measures how much air you can breathe out in one second. Nitric oxide measurement. A newer diagnostic test, this exam measures the amount of nitric oxide gas you have in your breath when you exhale. High nitric oxide readings indicate inflammation of the bronchial tubes. Pulse oximetry. This test is used during a severe asthma attack. It measures the amount of oxygen in your blood.", "role": "assistant" } ]
[ { "content": "Colon cancer cure seen on tv. My father has colon cancer and said he saw a commercial on tv about a cure for colon cancer. He cannot remember any details about it. I was wondering if you know anything about something like this. Please let me know. Thank you,\n\nColon cancer: Colon cancer is cancer of the large intestine (colon), which is the final part of your digestive tract. Most cases of colon cancer begin as small, noncancerous (benign) clumps of cells called adenomatous polyps. Over time some of these polyps can become colon cancers. Polyps may be small and produce few, if any, symptoms. For this reason, doctors recommend regular screening tests to help prevent colon cancer by identifying and removing polyps before they turn into cancer. Signs and symptoms of colon cancer include: - A change in your bowel habits, including diarrhea or constipation or a change in the consistency of your stool, that lasts longer than four weeks - Rectal bleeding or blood in your stool - Persistent abdominal discomfort, such as cramps, gas or pain - A feeling that your bowel doesn't empty completely - Weakness or fatigue - Unexplained weight loss Many people with colon cancer experience no symptoms in the early stages of the disease. When symptoms appear, they'll likely vary, depending on the cancer's size and location in your large intestine. When to see a doctor If you notice any symptoms of colon cancer, such as blood in your stool or an ongoing change in bowel habits, do not hesitate to make an appointment with your doctor. Talk to your doctor about when you should begin screening for colon cancer. Guidelines generally recommend that colon cancer screenings begin at age 50. Your doctor may recommend more frequent or earlier screening if you have other risk factors, such as a family history of the disease. In most cases, it's not clear what causes colon cancer. Doctors know that colon cancer occurs when healthy cells in the colon develop errors in their genetic blueprint, the DNA. Healthy cells grow and divide in an orderly way to keep your body functioning normally. But when a cell's DNA is damaged and becomes cancerous, cells continue to divide - even when new cells aren't needed. As the cells accumulate, they form a tumor. With time, the cancer cells can grow to invade and destroy normal tissue nearby. And cancerous cells can travel to other parts of the body to form deposits there (metastasis). Inherited gene mutations that increase the risk of colon cancer Inherited gene mutations that increase the risk of colon cancer can be passed through families, but these inherited genes are linked to only a small percentage of colon cancers. Inherited gene mutations don't make cancer inevitable, but they can increase an individual's risk of cancer significantly. The most common forms of inherited colon cancer syndromes are: - Hereditary nonpolyposis colorectal cancer (HNPCC). HNPCC, also called Lynch syndrome, increases the risk of colon cancer and other cancers. People with HNPCC tend to develop colon cancer before age 50. - Familial adenomatous polyposis (FAP). FAP is a rare disorder that causes you to develop thousands of polyps in the lining of your colon and rectum. People with untreated FAP have a greatly increased risk of developing colon cancer before age 40. FAP, HNPCC and other, rarer inherited colon cancer syndromes can be detected through genetic testing. If you're concerned about your family's history of colon cancer, talk to your doctor about whether your family history suggests you have a risk of these conditions. Association between diet and increased colon cancer risk Studies of large groups of people have shown an association between a typical Western diet and an increased risk of colon cancer. A typical Western diet is high in fat and low in fiber. When people move from areas where the typical diet is low in fat and high in fiber to areas where the typical Western diet is most common, the risk of colon cancer in these people increases significantly. It's not clear why this occurs, but researchers are studying whether a high-fat, low-fiber diet affects the microbes that live in the colon or causes underlying inflammation that may contribute to cancer risk. This is an area of active investigation and research is ongoing. Factors that may increase your risk of colon cancer include: - Older age. The great majority of people diagnosed with colon cancer are older than 50. Colon cancer can occur in younger people, but it occurs much less frequently. - African-American race. African-Americans have a greater risk of colon cancer than do people of other races. - A personal history of colorectal cancer or polyps. If you've already had colon cancer or adenomatous polyps, you have a greater risk of colon cancer in the future. - Inflammatory intestinal conditions. Chronic inflammatory diseases of the colon, such as ulcerative colitis and Crohn's disease, can increase your risk of colon cancer. - Inherited syndromes that increase colon cancer risk. Genetic syndromes passed through generations of your family can increase your risk of colon cancer. These syndromes include familial adenomatous polyposis and hereditary nonpolyposis colorectal cancer, which is also known as Lynch syndrome. - Family history of colon cancer. You're more likely to develop colon cancer if you have a parent, sibling or child with the disease. If more than one family member has colon cancer or rectal cancer, your risk is even greater. - Low-fiber, high-fat diet. Colon cancer and rectal cancer may be associated with a diet low in fiber and high in fat and calories. Research in this area has had mixed results. Some studies have found an increased risk of colon cancer in people who eat diets high in red meat and processed meat. - A sedentary lifestyle. If you're inactive, you're more likely to develop colon cancer. Getting regular physical activity may reduce your risk of colon cancer. - Diabetes. People with diabetes and insulin resistance have an increased risk of colon cancer. - Obesity. People who are obese have an increased risk of colon cancer and an increased risk of dying of colon cancer when compared with people considered normal weight. - Smoking. People who smoke may have an increased risk of colon cancer. - Alcohol. Heavy use of alcohol increases your risk of colon cancer. - Radiation therapy for cancer. Radiation therapy directed at the abdomen to treat previous cancers increases the risk of colon and rectal cancer. Screening for colon cancer Doctors recommend certain screening tests for healthy people with no signs or symptoms in order to look for early colon cancer. Finding colon cancer at its earliest stage provides the greatest chance for a cure. Screening has been shown to reduce your risk of dying of colon cancer. People with an average risk of colon cancer can consider screening beginning at age 50. But people with an increased risk, such as those with a family history of colon cancer, should consider screening sooner. African-Americans and American Indians may consider beginning colon cancer screening at age 45. Several screening options exist - each with its own benefits and drawbacks. Talk about your options with your doctor, and together you can decide which tests are appropriate for you. If a colonoscopy is used for screening, polyps can be removed during the procedure before they turn into cancer. Diagnosing colon cancer If your signs and symptoms indicate that you could have colon cancer, your doctor may recommend one or more tests and procedures, including: - Using a scope to examine the inside of your colon. Colonoscopy uses a long, flexible and slender tube attached to a video camera and monitor to view your entire colon and rectum. If any suspicious areas are found, your doctor can pass surgical tools through the tube to take tissue samples (biopsies) for analysis and remove polyps. - Blood tests. No blood test can tell you if you have colon cancer. But your doctor may test your blood for clues about your overall health, such as kidney and liver function tests. Your doctor may also test your blood for a chemical sometimes produced by colon cancers (carcinoembryonic antigen or CEA). Tracked over time, the level of CEA in your blood may help your doctor understand your prognosis and whether your cancer is responding to treatment. Staging colon cancer Once you've been diagnosed with colon cancer, your doctor will order tests to determine the extent (stage) of your cancer. Staging helps determine what treatments are most appropriate for you. Staging tests may include imaging procedures such as abdominal, pelvic and chest CT scans. In many cases, the stage of your cancer may not be determined until after colon cancer surgery. The stages of colon cancer are: - Stage I. The cancer has grown through the superficial lining (mucosa) of the colon or rectum but hasn't spread beyond the colon wall or rectum. - Stage II. The cancer has grown into or through the wall of the colon or rectum but hasn't spread to nearby lymph nodes. - Stage III. The cancer has invaded nearby lymph nodes but isn't affecting other parts of your body yet. - Stage IV. The cancer has spread to distant sites, such as other organs - for instance, to your liver or lung. The type of treatment your doctor recommends will depend largely on the stage of your cancer. The three primary treatment options are surgery, chemotherapy and radiation. Surgery for early-stage colon cancer If your colon cancer is very small, your doctor may recommend a minimally invasive approach to surgery, such as: - Removing polyps during a colonoscopy. If your cancer is small, localized and completely contained within a polyp and in a very early stage, your doctor may be able to remove it completely during a colonoscopy. - Endoscopic mucosal resection. Removing larger polyps may require also taking a small amount of the lining of the colon or rectum in a procedure called an endoscopic mucosal resection. - Minimally invasive surgery. Polyps that can't be removed during a colonoscopy may be removed using laparoscopic surgery. In this procedure, your surgeon performs the operation through several small incisions in your abdominal wall, inserting instruments with attached cameras that display your colon on a video monitor. The surgeon may also take samples from lymph nodes in the area where the cancer is located. Surgery for invasive colon cancer If the cancer has grown into or through your colon, your surgeon may recommend: - Partial colectomy. During this procedure, the surgeon removes the part of your colon that contains the cancer, along with a margin of normal tissue on either side of the cancer. Your surgeon is often able to reconnect the healthy portions of your colon or rectum. This procedure can commonly be done by a minimally invasive approach (laparoscopy). - Surgery to create a way for waste to leave your body. When it's not possible to reconnect the healthy portions of your colon or rectum, you may need an ostomy. This involves creating an opening in the wall of your abdomen from a portion of the remaining bowel for the elimination of stool into a bag that fits securely over the opening. Sometimes the ostomy is only temporary, allowing your colon or rectum time to heal after surgery. In some cases, however, the colostomy may be permanent. - Lymph node removal. Nearby lymph nodes are usually also removed during colon cancer surgery and tested for cancer. Surgery for advanced cancer If your cancer is very advanced or your overall health very poor, your surgeon may recommend an operation to relieve a blockage of your colon or other conditions in order to improve your symptoms. This surgery isn't done to cure cancer, but instead to relieve signs and symptoms, such as bleeding and pain. In specific cases where the cancer has spread only to the liver but your overall health is otherwise good, your doctor may recommend surgery to remove the cancerous lesion from your liver. Chemotherapy may be used before or after this type of surgery. This approach provides a chance to be free of cancer over the long term. Chemotherapy Chemotherapy uses drugs to destroy cancer cells. Chemotherapy for colon cancer is usually given after surgery if the cancer has spread to lymph nodes. In this way, chemotherapy may help reduce the risk of cancer recurrence and death from cancer. Sometimes chemotherapy may be used before surgery as well, with the goal of shrinking the cancer before an operation. Chemotherapy before surgery is more common in rectal cancer than in colon cancer. Chemotherapy can also be given to relieve symptoms of colon cancer that has spread to other areas of the body. Radiation therapy Radiation therapy uses powerful energy sources, such as X-rays, to kill cancer cells, to shrink large tumors before an operation so that they can be removed more easily, or to relieve symptoms of colon cancer and rectal cancer. Radiation therapy either alone or combined with chemotherapy is one of the standard treatment options for the initial management of rectal cancer followed by surgery. Targeted drug therapy Drugs that target specific malfunctions that allow cancer cells to grow are available to people with advanced colon cancer, including: - Bevacizumab (Avastin) - Cetuximab (Erbitux) - Panitumumab (Vectibix) - Ramucirumab (Cyramza) - Regorafenib (Stivarga) - Ziv-aflibercept (Zaltrap) Targeted drugs can be given along with chemotherapy or alone. Targeted drugs are typically reserved for people with advanced colon cancer. Some people are helped by targeted drugs, while others are not. Researchers have recently made progress in determining who is most likely to benefit from specific targeted drugs. Until more is known, doctors carefully weigh the possible benefit of targeted drugs against the risk of side effects and the cost when deciding whether to use these treatments. Immunotherapy Some patients with advanced colon cancer have a chance to benefit from immunotherapy with antibodies such as pembrolizumab (Keytruda) and nivolumab (Opdivo). Whether a colon cancer has the chance to respond to these immunotherapies can be determined by a specific test of the tumor tissue. Supportive (palliative) care Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care. When palliative care is used along with all of the other appropriate treatments, people with cancer may feel better and live longer. Palliative care is provided by a team of doctors, nurses and other specially trained professionals. Palliative care teams aim to improve the quality of life for people with cancer and their families. This form of care is offered alongside curative or other treatments you may be receiving.", "role": "user" }, { "content": "Your doctor will choose treatments depending on the stage of your cancer. Traditional treatments include surgery, chemotherapy and radiation. .Small early-stage localized cancers may be removed completely during a colonoscopy or laparoscopic surgery. If the cancer has grown into or through your colon, your surgeon may remove the part of your colon that contains the cancer, along with a margin of normal tissue on either side of the cancer. Chemotherapy, rugs that destroy cancer cells, may be used before or after surgery to reduce the risk of cancer recurrence. Radiation therapy uses powerful energy sources, such as X-rays, to kill cancer cells, to shrink large tumors before an operation so that they can be removed more easily, or to relieve symptoms of colon cancer and rectal cancer. Drugs that target specific malfunctions that allow cancer cells to grow are available to people with advanced colon cancer, including: - Bevacizumab (Avastin) - Cetuximab (Erbitux) - Panitumumab (Vectibix) - Ramucirumab (Cyramza) - Regorafenib (Stivarga) - Ziv-aflibercept (Zaltrap) Targeted drugs can be given along with chemotherapy or alone. Targeted drugs are typically reserved for people with advanced colon cancer. Some patients with advanced colon cancer have a chance to benefit from immunotherapy with antibodies such as pembrolizumab (Keytruda) and nivolumab (Opdivo). Whether a colon cancer has the chance to respond to these immunotherapies can be determined by a specific test of the tumor tissue.", "role": "assistant" } ]
[ { "content": "how smoking tobacco affects the rest of the body\n\n Benefits of quitting tobacco Secondhand smoke Cigarette smoking - quitting Tobacco cessation Smoking and smokeless tobacco - quitting Why you should quit smoking Summary If you smoke, you should quit. But quitting can be hard. Most people who have quit smoking have tried at least once, without success, in the past. View any past attempts to quit as a learning experience, not a failure. There are many reasons to quit using tobacco. Long-term use of tobacco can increase your risk of many serious health problems. THE BENEFITS OF QUITTING You may enjoy the following when you quit smoking. Your breath, clothes, and hair will smell better. Your sense of smell will return. Food will taste better. Your fingers and fingernails will slowly appear less yellow. Your stained teeth may slowly become whiter. Your children will be healthier and will be less likely to start smoking. It will be easier and cheaper to find an apartment or hotel room. You may have an easier time getting a job. Friends may be more willing to be in your car or home. It may be easier to find a date. Many people do not smoke and do not like to be around people who smoke. You will save money. If you smoke a pack a day, you spend about $2,000 a year on cigarettes. HEALTH BENEFITS Some health benefits begin almost immediately. Every week, month, and year without tobacco further improves your health. Within 20 minutes of quitting: Your blood pressure and pulse rate drop to normal and the temperature of your hands and feet increases to normal. Within 8 hours of quitting: Your blood carbon monoxide levels drop and your blood oxygen levels increase to normal levels. Within 24 hours of quitting: Your risk of a sudden heart attack goes down. Within 48 hours of quitting: Your nerve endings begin to regrow. Your senses of smell and taste begin to return to normal. Within 2 weeks to 3 months of quitting: Your circulation improves. Walking becomes easier. Your lungs work better. Wounds heal more quickly. Within 1 to 9 months of quitting: You have more energy. Smoking-related symptoms, such as coughing, nasal congestion, fatigue, and shortness of breath improve. You will have fewer illnesses, colds, and asthma attacks. You will gradually no longer be short of breath with everyday activities. Within 1 year of quitting: Your risk of coronary heart disease is half that of someone still using tobacco. Within 5 years of quitting: Your risk of mouth, throat, esophagus, and bladder cancers are reduced by half. Within 10 years of quitting: Your risk of dying from lung cancer is about one half that of a person who still smokes. Other health benefits of quitting smoking include: Lower chance of blood clots in the legs, which may travel to the lungs Lower risk of erectile dysfunction Fewer problems during pregnancy, such as babies born at low birth weight, premature labor, miscarriage, and cleft lip Lower risk of infertility due to damaged sperm Healthier teeth, gums, and skin Infants and children who you live with will have: Asthma that is easier to control Fewer visits to the emergency room Fewer colds, ear infections, and pneumonia Reduced risk of sudden infant death syndrome (SIDS) MAKING THE DECISION Like any addiction, quitting tobacco is difficult, especially if you do it alone. There are a lot of ways to quit smoking and many resources to help you. Talk to your health care provider about nicotine replacement therapy and smoking cessation medicines. If you join smoking cessation programs, you have a much better chance of success. Such programs are offered by hospitals, health departments, community centers, and work sites. Review Date 11/20/2017 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": "Long-term use of tobacco can increase your risk of many serious health problems. The health benefits of quitting include decrease in blood pressure and pulse, improved circulation, improved nasal congestion, less fatigue, fewer illnesses, and decreased risk of many types of cancer.", "role": "assistant" } ]
[ { "content": "I have a list of questions about Tay sachs disease and clubfoot 1. what is TSD/Clubfoot, and how does it effect a baby 2. what causes both? can it be prevented, treated, or cured 3. How common is TSD? how common is Clubfoot 4. How can your "agency" help a women/couple who are concerned about this congenital condition, and is there a cost? If you can answer these few questions I would be thankful, please get back as soon as you can.\n\nTay-Sachs Disease: Tay-Sachs disease is a inherited metabolic disease caused by the harmful buildup of lipids (fatty materials such as oils and acids) in various cells and tissues in the body. It is part of a group of genetic disorders called the GM2 gangliosidoses. Tay-Sachs and its variant form are caused by a deficiency in the enzyme hexosaminidase A. Affected children appear to develop normally until about age 6 months. Then, symptoms begin and include progressive loss of mental ability, dementia, blindness, increased startle reflex to noise, progressive loss of hearing leading to deafness, and difficulty with swallowing. Seizures may begin in the child's second year. Persons with Tay-Sachs also have \"cherry-red\" spots in their eyes. A much rarer form of the disorder, called late-onset Tay-Sachs disease, occurs in individuals in their twenties and early thirties and is characterized by an unsteady gait and progressive neurological deterioration. The incidence of Tay-Sachs has been particularly high among people of Eastern European and Askhenazi Jewish descent., as well as in certain French Canadians and Louisiana Cajuns. Affected individuals and carriers of Tay-Sachs disease can be identified by a blood test that measures hexosaminidase A activity. Both parents must carry the mutated gene in order to have an affected child. In these instances, there is a 25 percent chance with each pregnancy that the child will be affected with Tay-Sachs disease. Prenatal diagnosis is available if desired. A very severe form of Tay-Sachs disease is know as Sandhoff disease, which is not limited to any ethnic group. Presently there is no specific treatment for Tay-Sachs disease. Anticonvulsant medicine may initially control seizures. Other supportive treatment includes proper nutrition and hydration and techniques to keep the airway open. Children may eventually need a feeding tube. Even with the best of care, children with Tay-Sachs disease usually die by age 4, from recurring infection.", "role": "user" }, { "content": "Tay-Sachs disease is a inherited metabolic disease caused by the harmful buildup of lipids (fatty materials such as oils and acids) in various cells and tissues in the body. Affected children appear to develop normally until about age 6 months. Then, symptoms begin and include progressive loss of mental ability, dementia, blindness, increased startle reflex to noise, progressive loss of hearing leading to deafness, and difficulty with swallowing. Seizures may begin in the child's second year. Persons with Tay-Sachs also have \"cherry-red\" spots in their eyes. Affected individuals and carriers of Tay-Sachs disease can be identified by a blood test that measures hexosaminidase A activity. Both parents must carry the mutated gene in order to have an affected child. Presently there is no specific treatment for Tay-Sachs disease. Anticonvulsant medicine may initially control seizures. Other supportive treatment includes proper nutrition and hydration and techniques to keep the airway open. Children may eventually need a feeding tube. Even with the best of care, children with Tay-Sachs disease usually die by age 4, from recurring infection.", "role": "assistant" } ]
[ { "content": "what are the causes of headaches\n\n Sex headaches Overview Sex headaches are brought on by sexual activity - especially an orgasm. You may notice a dull ache in your head and neck that builds up as sexual excitement increases. Or, more commonly, you may experience a sudden, severe headache just before or during orgasm. Most sex headaches are nothing to worry about. But some can be a sign of something serious, such as problems with the blood vessels that feed your brain. Symptoms There are two types of sex headaches: - A dull ache in the head and neck that intensifies as sexual excitement increases - A sudden, severe, throbbing headache that occurs just before or at the moment of orgasm In some people, both types of headaches are combined. Most sex headaches last at least several minutes. Others may linger for hours or even two to three days. Many people who have sex headaches will experience them in clusters over a few months, and then they may go for a year or more without having any sex headaches. Up to half of all people with sex headaches experience them over the course of about six months. Some people may only have one attack during their lives. When to see a doctor Sex headaches aren't usually a cause for concern. But consult your doctor right away if you experience a headache during sexual activity - especially if it begins abruptly or it's your first headache of this type. Causes Any type of sexual activity that leads to orgasm can trigger sex headaches. Abrupt-onset and slow-to-build sex headaches can be primary headache disorders not associated with any underlying condition. Sex headaches that come on suddenly are more likely to be associated with: - A widening or bubble in the wall of an artery inside your head (intracranial aneurysm) - An abnormal connection between arteries and veins in the brain (arteriovenous malformation) that bleeds into the spinal fluid-filled space in and around the brain - Bleeding into the wall of an artery leading to the brain (dissection) - Stroke - Coronary artery disease - Use of some medications, such as birth control pills - Inflammation from certain infections Sex headaches associated with loss of consciousness, vomiting, stiff neck, other neurological symptoms and severe pain lasting more than 24 hours are more likely to be due to an underlying cause. Risk factors Sex headaches can affect anyone. But risk factors for these headaches include: - Being male. Men are more prone to having sex headaches. - History of migraines. Being prone to migraines increases your risk of sex headaches. Diagnosis Brain imaging Your doctor will likely recommend brain imaging. - Magnetic resonance imaging (MRI). An MRI of the brain can help detect any underlying causes for your headache. During the MRI exam, a magnetic field and radio waves are used to create cross-sectional images of the structures within your brain. - Computerized tomography (CT). In some cases, especially if your headache occurred less than 48 to 72 hours beforehand, a CT scan of your brain may be done. CT uses an X-ray unit that rotates around your body and a computer to create cross-sectional images of your brain and head. - Magnetic resonance angiography (MRA) and computerized tomography (CT) angiography. These tests visualize the blood vessels leading to and inside your brain and neck. Angiograms Your doctor may also order a cerebral angiogram, a test that can show the neck and brain arteries. This procedure involves threading a thin, flexible tube through a blood vessel, usually starting in the groin, to an artery in your neck. Contrast material is injected into the tube to allow an X-ray machine to create an image of the arteries in your neck and brain. Spinal tap Sometimes a spinal tap (lumbar puncture) is needed as well - especially if the headache started abruptly and very recently and brain imaging is normal. With this procedure, the doctor removes a small amount of the fluid that surrounds your brain and spinal cord. The fluid sample can show if there's bleeding or infection. Treatment In some cases, your first sex headache may also be your only one. Some sex headaches improve rapidly, so the pain is gone before any pain reliever can work. Preventive medications If you have a history of sex headaches and there's no underlying cause, your doctor may recommend that you take preventive medications regularly. These may include: - Daily medications. Beta blockers, for example, propranolol (Inderal, Innopran XL) or metoprolol (Lopressor, Toprol-XL) - which are used to treat high blood pressure, coronary artery disease and migraines - may be taken daily to prevent sex headaches. They're recommended only if you have frequent or prolonged attacks. - Occasional medications. Indomethacin (Indocin, Tivorbex), an anti-inflammatory, or one of the triptans, a class of anti-migraine medications, can be taken an hour before sex to prevent headaches. ", "role": "user" }, { "content": "Sex headaches are headaches caused by any type of sexual activity. They may be associated with the following: a widening or bubble in the wall of an artery inside your head (intracranial aneurysm); an abnormal connection between arteries and veins in the brain (arteriovenous malformation) that bleeds into the spinal fluid-filled space in and around the brain; bleeding into the wall of an artery leading to the brain (dissection); stroke; coronary artery disease; or use of some medications, such as birth control pills.", "role": "assistant" } ]
[ { "content": "I have a fractured nose i need it fixed. its been broke for 3 years now\n\n Broken nose Overview A broken nose, also called a nasal fracture, is a break or crack in a bone in your nose - often the bone over the bridge of your nose. Common causes of a broken nose include contact sports, physical fights, falls and motor vehicle accidents that result in facial trauma. A broken nose can cause pain, along with swelling and bruising around your nose and under your eyes. Your nose may look crooked, and you may have trouble breathing. Treatment for a broken nose may include procedures that realign your nose. Surgery usually isn't necessary for a broken nose. Symptoms Signs and symptoms of a broken nose: - Pain or tenderness, especially when touching your nose - Swelling of your nose and surrounding areas - Bleeding from your nose - Bruising around your nose or eyes - Crooked or misshapen nose - Difficulty breathing through your nose - Discharge of mucus from your nose - Feeling that one or both of your nasal passages are blocked When to see a doctor Seek emergency medical attention if you experience a nose injury accompanied by: - A head or neck injury, which may be marked by severe headache, neck pain, vomiting or loss of consciousness - Difficulty breathing - Bleeding you can't stop - A noticeable change in the shape of your nose that isn't related to swelling, such as a crooked or twisted appearance - Clear, watery fluid draining from your nose Causes Common causes of a broken nose include: - Injury from contact sports, such as football or hockey - Physical altercations - Motor vehicle accidents - Falls A broken nose can even be caused by walking into a fixed object, such as a door or wall, or by rough, wrestling-type play. Risk factors Any activity that increases your risk of a facial injury increases your risk of a broken nose. Such activities may include: - Playing contact sports, such as football and hockey, especially without a helmet that has a face mask - Engaging in a physical fight - Riding a bicycle - Lifting weights, especially if you don't use a spotter - Riding in a motor vehicle, especially without a seat belt Complications Complications or injuries related to a broken nose may include: - Deviated septum. A nose fracture may cause a deviated septum, a condition that occurs when the thin wall dividing the two sides of your nose (nasal septum) is displaced, narrowing your nasal passage. Medications, such as decongestants and antihistamines, can help you manage a deviated septum, but surgery is required to correct the condition. - Collection of blood. Sometimes, pools of clotted blood form in a broken nose, creating a condition called a septal hematoma. A septal hematoma can block one or both nostrils. Septal hematoma requires prompt surgical drainage to prevent cartilage damage. - Cartilage fracture. If your fracture is due to a forceful blow, such as from an automobile accident, you also may experience a cartilage fracture. If your injury is severe enough to warrant surgical treatment, the surgeon should address both your bone and cartilage injuries. - Neck injury. Likewise, nose fractures resulting from high-velocity injuries - like those experienced in motor vehicle accidents - may be accompanied by injuries to your neck. If a blow is strong enough to break your nose, it may also be strong enough to damage the bones in your neck. If you suspect a neck injury, see your doctor immediately. Diagnosis Your doctor may press gently on the outside of your nose and its surrounding areas. He or she may look inside your nasal passage to check for obstruction and further signs of broken bones. Your doctor may use anesthetics - either a nasal spray or local injections - to make you more comfortable during the exam. X-rays and other imaging studies are usually unnecessary. However, your doctor may recommend a computerized tomography (CT) scan if the severity of your injuries makes a thorough physical exam impossible or if your doctor suspects you may have other injuries. Treatment If you have a minor fracture that hasn't caused your nose to become crooked or otherwise misshapen, you may not need professional medical treatment. Your doctor may recommend simple self-care measures, such as using ice on the area and taking over-the-counter pain medications. Fixing displacements and breaks Your doctor may be able to realign your nose manually, or you may need surgery. Manual realignment If the break has displaced the bones and cartilage in your nose, your doctor may be able to manually realign them. This needs to be done within 14 days from when the fracture occurred, preferably sooner. During this procedure, your doctor: - Administers medication by injection or nasal spray to ease discomfort - Opens your nostrils with a nasal speculum - Uses special instruments to help realign your broken bones and cartilage Your doctor will also splint your nose using packing in your nose and a dressing on the outside. Sometimes, an internal splint is also necessary for a short time. The packing usually needs to stay in for a week. You'll also be given a prescription for antibiotics to prevent infection with the bacteria that may normally reside in your nose. Surgery Severe breaks, multiple breaks or breaks that have gone untreated for more than 14 days may not be candidates for manual realignment. In these cases, surgery to realign the bones and reshape your nose may be necessary. If the break has damaged your nasal septum, causing obstruction or difficulty breathing, reconstructive surgery may be recommended. Surgery is typically performed on an outpatient basis. Lifestyle and home remedies If you think you may have broken your nose, take these steps to reduce pain and swelling before seeing your doctor: - Act quickly. When the break first occurs, breathe through your mouth and lean forward to reduce the amount of blood that drains into your throat. - Use ice. Apply ice packs or cold compresses immediately after the injury, and then at least four times a day for the first 24 to 48 hours to reduce swelling. Keep the ice or cold compress on for 10 to 15 minutes at a time. Wrap the ice in a washcloth to prevent frostbite. Try not to apply too much pressure, which can cause additional pain or damage to your nose. - Relieve pain. Take over-the-counter pain relievers, such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve, others), as necessary. - Keep your head up. Elevate your head - especially when sleeping - so as not to worsen swelling and throbbing. - Limit your activities. For the first two weeks after treatment, don't play any sports. Avoid contact sports for at least six weeks after your injury. ", "role": "user" }, { "content": "If you have a minor fracture that hasn't caused your nose to become crooked or otherwise misshapen, you may not need professional medical treatment. If your injury is severe enough to warrant surgical treatment, the surgeon should address both your bone and cartilage injuries.", "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": "Atherosclerosis (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. 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. 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. Quit Smoking. If you smoke, quit. If you?re overweight or obese, work with your doctor to create a reasonable weight-loss plan.", "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": "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.", "role": "assistant" } ]
[ { "content": "how is hemophilia treated\n\n Hemophilia A Factor VIII deficiency Classic hemophilia Bleeding disorder - hemophilia A Summary Hemophilia A is a hereditary bleeding disorder caused by a lack of blood clotting factor VIII. Without enough factor VIII, the blood cannot clot properly to control bleeding. Causes When you bleed, a series of reactions take place in the body that helps blood clots form. This process is called the coagulation cascade. It involves special proteins called coagulation, or clotting, factors. You may have a higher chance of excess bleeding if one or more of these factors are missing or are not functioning like they should. Factor VIII (eight) is one such coagulation factor. Hemophilia A is the result of the body not making enough factor VIII. Hemophilia A is caused by an inherited X-linked recessive trait, with the defective gene located on the X chromosome. Females have two copies of the X chromosome. So if the factor VIII gene on one chromosome does not work, the gene on the other chromosome can do the job of making enough factor VIII. Males have only one X chromosome. If the factor VIII gene is missing on a boy's X chromosome, he will have hemophilia A. For this reason, most people with hemophilia A are male. If a woman has a defective factor VIII gene, she is considered a carrier. This means the defective gene can be passed down to her children. Boys born to such women have a 50% chance of having hemophilia A. Their daughters have a 50% chance of being a carrier. All female children of men with hemophilia carry the defective gene. Risk factors for hemophilia A include: Family history of bleeding Being male Symptoms Severity of symptoms vary. Prolonged bleeding is the main symptom. It is often first seen when an infant is circumcised. Other bleeding problems usually show up when the infant starts crawling and walking. Mild cases may go unnoticed until later in life. Symptoms may first occur after surgery or injury. Internal bleeding may occur anywhere. Symptoms can include: Bleeding into joints with associated pain and swelling Blood in the urine or stool Bruising Gastrointestinal tract and urinary tract bleeding Nosebleeds Prolonged bleeding from cuts, tooth extraction, and surgery Bleeding that starts without cause Exams and Tests If you are the first person in the family to have a suspected bleeding disorder, your health care provider will order a series of tests called a coagulation study. Once the specific defect has been identified, other people in your family will need tests to diagnose the disorder. Tests to diagnose hemophilia A include: Prothrombin time Bleeding time Fibrinogen level Partial thromboplastin time (PTT) Serum factor VIII activity Treatment Treatment includes replacing the missing clotting factor. You will receive factor VIII concentrates. How much you get depends on: Severity of bleeding Site of bleeding Your weight and height Mild hemophilia may be treated with desmopressin (DDAVP). This medicine helps the body release factor VIII that is stored within the lining of blood vessels. To prevent a bleeding crisis, people with hemophilia and their families can be taught to give factor VIII concentrates at home at the first signs of bleeding. People with severe forms of the disease may need regular preventive treatment. DDAVP or factor VIII concentrate may also be needed before having dental extractions or surgery. You should get the hepatitis B vaccine. People with hemophilia are more likely to get hepatitis B because they may receive blood products. Some people with hemophilia A develop antibodies to factor VIII. These antibodies are called inhibitors. The inhibitors attack factor VIII so that it no longer works. In such cases, a man-made clotting factor called VIIa can be given. Support Groups You can ease the stress of illness by joining a hemophilia support group. Sharing with others who have common experiences and problems can help you not feel alone. Outlook (Prognosis) With treatment, most people with hemophilia A are able to lead a fairly normal life. If you have hemophilia A, you should have regular checkups with a hematologist. Possible Complications Complications may include: Long-term joint problems, which may require a joint replacement Bleeding in the brain (intracerebral hemorrhage) Blood clots due to treatment When to Contact a Medical Professional Call your provider if: Symptoms of a bleeding disorder develops A family member has been diagnosed with hemophilia A You have hemophilia A and you plan to have children; genetic counseling is available Prevention Genetic counseling may be recommended. Testing can identify women and girls who carry the hemophilia gene. Identify women and girls who carry the hemophilia gene. Testing can be done during pregnancy on a baby in the mother's womb. Review Date 1/19/2018 Updated by: Richard LoCicero, MD, private practice specializing in hematology and medical oncology, Longstreet Cancer Center, Gainesville, GA. 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": "Treatment of hemophilia A involves replacing the missing clotting factor A. For some people, the clotting factor can be given at the first sign of a bleeding crisis. For people with more severe hemophilia, preventative treatments should be given. Mild hemophilia may be treated with desmopressin (DDAVP). This medicine helps the body release factor VIII that is stored within the lining of blood vessels.", "role": "assistant" } ]
[ { "content": "how is epidural harmful\n\n Spinal and epidural anesthesia Intraspinal anesthesia Subarachnoid anesthesia Epidural Peridural anesthesia Summary Spinal and epidural anesthesia are medicines that numb parts of your body to block pain. They are given through shots in or around the spine. Description The doctor who gives you epidural or spinal anesthesia is called an anesthesiologist. First, the area of your back where the needle is inserted is cleaned with a special solution. The area may also be numbed with a local anesthetic. You'll likely receive fluids through an intravenous line (IV) in a vein. You may receive medicine through the IV to help you relax or sleep lightly. For an epidural: The doctor injects medicine just outside of the sac of fluid around your spinal cord. This is called the epidural space. The medicine numbs, or blocks feeling in a certain part of your body so that you cannot feel pain. The medicine begins to take effect in about 10 to 20 minutes. It works well for longer procedures. Women often have an epidural during childbirth. A small tube (catheter) is often left in place. You can receive more medicine through the catheter to help control your pain during or after your procedure. For a spinal: The doctor injects medicine into the fluid in your spinal cord. This is usually done only once, so you will not need to have a catheter placed. The medicine begins to take effect right away. It works well for shorter and simpler procedures. Your pulse, blood pressure and oxygen level in your blood are checked during the procedure. After the procedure, you will have a bandage where the needle was inserted. Why the Procedure is Performed Spinal and epidural anesthesia have fewer side effects and risks than general anesthesia (asleep and pain-free). People usually recover their senses much faster. Sometimes, they have to wait for the anesthetic to wear off so they can walk. Spinal anesthesia is often used for genital, urinary tract, or lower body procedures. Epidural anesthesia is often used during labor and delivery, and surgery in the pelvis and legs. Epidural and spinal anesthesia are often used when: The procedure or labor is too painful without any pain medicine. The procedure is in the belly, legs, or feet. Your body can remain in a comfortable position during your procedure. You want fewer systemic side effects and a shorter recovery than you would have from general anesthesia. Risks Spinal and epidural anesthesia are generally safe. Ask your doctor about these possible complications: Allergic reaction to the anesthesia used Bleeding around the spinal column (hematoma) Difficulty urinating Drop in blood pressure Infection in your spine (meningitis or abscess) Nerve damage Seizures (this is rare) Severe headache Before the Procedure Tell your health care provider: If you are or could be pregnant What medicines you are taking, including medicines, supplements, or herbs you bought without a prescription During the days before the procedure: Tell your doctor about any allergies or health conditions you have, what medicines you are taking, and what anesthesia or sedation you have had before. If your procedure is planned, you may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), warfarin (Coumadin), and any other blood thinners. Ask your doctor which medicines you should still take on the day of your procedure. Arrange for a responsible adult to drive you to and from the hospital or clinic. If you smoke, try to stop. Ask your provider for help quitting. On the day of the procedure: Follow instructions on when to stop eating and drinking. Do not drink alcohol the night before and the day of your procedure. Take the medicines your doctor told you to take with a small sip of water. Follow instructions on when to arrive at the hospital. Be sure to arrive on time. After the Procedure After an epidural, the catheter in your back is removed. You lie in bed until you have feeling in your legs and can walk. You may feel sick to your stomach and be dizzy. You may be tired. After spinal anesthesia, you lie flat in bed for a few hours. This is to keep you from getting a headache. You may feel sick to your stomach and be dizzy. You may be tired. Outlook (Prognosis) Most people feel no pain during spinal and epidural anesthesia and recover fully. Review Date 5/1/2017 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": "Spinal and epidural anesthesia are generally safe. You can talk to your doctor about any associated risks. These may include an allergic reaction to the anesthesia, bleeding around the spinal column, trouble urinating, a drop in blood pressure, infection in the spine, or, very rarely, seizure. Make sure to tell your health provider what medicines you are currently taking, any allergies you may have, and any previous anesthesia you have had before.", "role": "assistant" } ]
[ { "content": "what is the cause of congenital heart defects\n\nCongenital heart defects in children (Risk factors): Most congenital heart defects result from problems early in your child's heart development, the cause of which is unknown. However, certain environmental and genetic risk factors may play a role. They include: - Rubella (German measles). Having rubella during pregnancy can cause problems in your baby's heart development. Your doctor can test you for immunity to this viral disease before pregnancy and vaccinate you against it if you aren't immune. - Diabetes. You can reduce the risk of congenital heart defects by carefully controlling your diabetes before attempting to conceive and during pregnancy. Gestational diabetes generally doesn't increase your baby's risk of developing a heart defect. - Medications. Certain medications taken during pregnancy may cause birth defects, including congenital heart defects. Give your doctor a complete list of medications you take before attempting to become pregnant. Medications known to increase the risk of congenital heart defects include thalidomide (Thalomid), angiotensin-converting enzyme (ACE) inhibitors, statins, the acne medication isotretinoin (Absorica, Amnesteem, Claravis) and lithium. - Drinking alcohol during pregnancy. Avoid alcohol during pregnancy because it increases the risk of congenital heart defects. - Smoking. Smoking during pregnancy increases the likelihood of a congenital heart defect in the baby. - Heredity. Congenital heart defects sometimes run in families and may be associated with a genetic syndrome. Many children with Down syndrome - which is caused by an extra 21st chromosome (trisomy 21) - have heart defects. A missing piece (deletion) of genetic material on chromosome 22 also causes heart defects. Genetic testing can detect such disorders during fetal development. If you already have a child with a congenital heart defect, a genetic counselor can estimate the odds that your next child will have one.", "role": "user" }, { "content": "Causes of congenital heart defects are unknown. The risk factors for these problems that occur early in the baby's heart development include: having rubella during pregnancy; uncontrolled diabetes; taking medications known to increase the risk of congenital heart defects, such as thalidomide (Thalomid), angiotensin-converting enzyme (ACE) inhibitors, statins, the acne medication isotretinoin (Absorica, Amnesteem, Claravis) and lithium. Other factors are smoking, drinking alcohol during pregnancy, and genetic syndromes, such as Down syndrome. A genetic counselor can estimate the odds that a child will have a genetic disorder.", "role": "assistant" } ]
[ { "content": "what is epilepsy\n\nEpilepsy - children: Epilepsy is a brain disorder in which a person has repeated seizures over time. A seizure is a sudden change in the electrical and chemical activity in the brain. 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. Common causes of epilepsy include: - Traumatic brain injury - Damage or scarring after infections of the brain - Birth defects that involve the brain - Brain injury that occurs during or near birth - Metabolic disorders present at birth (such as phenylketonuria) - Benign brain tumor, often very small - Abnormal blood vessels in the brain - Stroke - Other illnesses that damage or destroy brain tissue Epileptic seizures usually start between ages 5 and 20. But they can happen at any age. There may be a family history of seizures or epilepsy. A febrile seizure is a convulsion in a child triggered by a fever. Most of the time, a febrile seizure is not a sign that the child has epilepsy. Symptoms vary from child to child. Some children may simply stare. Others may shake violently and lose alertness. The movements or symptoms of a seizure may depend on the part of the brain that is affected. Your child's health care provider can tell you more about the specific type of seizure your child 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 Most of the time, the seizure is similar to the one before it. Some children have a strange sensation before a seizure. Sensations may be tingling, smelling an odor that is not actually there, feeling fear or anxiety for no reason or having a sense of déjà vu (feeling that something has happened before). This is called an aura. 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. Treatment for epilepsy includes: - Medicines - Lifestyle changes - Surgery If your child's epilepsy is due to a tumor, abnormal blood vessels, or bleeding in the brain, surgery may be needed. Medicines to prevent seizures are called anticonvulsants or antiepileptic drugs. These may reduce the number of future seizures. - These medicines are taken by mouth. The type of medicine prescribed depends on the type of seizure your child has. - The dosage may need to be changed from time to time. The provider may order regular blood tests to check for side effects. - Always make sure your child takes the medicine on time and as directed. Missing a dose can cause your child to have a seizure. Do NOT stop or change medicines on your own. Talk to the provider first. Many epilepsy drugs may affect your child's bone health. Talk to your child's provider about whether your child needs vitamins and other supplements. Epilepsy that is not well controlled after trying a number of antiseizure drugs 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, also may be helpful. Be sure to discuss these options with your child's provider before trying them. Epilepsy is often a lifelong or chronic illness. Important management issues include: - Taking medicines - Staying safe, such as never swimming alone, fall-proofing your home and so on - Managing stress and sleep - Avoiding alcohol and drug abuse - Keeping up in school - Managing other illnesses Managing these lifestyle or medical issues at home can be a challenge. The stress of being a caretaker of a child with epilepsy can often be helped by joining a support group. In these groups, members share common experiences and problems. Most children with epilepsy live a normal life. Certain types of childhood epilepsy go away or improve with age, usually in the late teens or 20s. If your child does not have seizures for a few years, the provider may stop medicines. For many children, epilepsy is a lifelong condition. In these cases, the medicines need to be continued. Children who have developmental disorders that also cause epilepsy may face challenges throughout their life. Knowing more about the condition will help you take better care of your child's epilepsy. Complications may include: - Difficulty learning - Breathing in food or saliva into the lungs during a seizure, which can cause aspiration pneumonia - Irregular heartbeat - Injury from falls, bumps, or self-caused bites during a seizure - Permanent brain damage (stroke or other damage) - Side effects of medicines Call your local emergency number (such as 911) if: - This is the first time your child has a seizure - A seizure occurs in a child who is not wearing a medical ID bracelet (which has instructions explaining what to do) If your child has had seizures before, call 911 for any of these emergency situations: - The seizure is longer than the child normally has or the child has an unusual number of seizures - The child has repeated seizures over a few minutes - The child has repeated seizures in which consciousness or normal behavior is not regained between them (status epilepticus) - The child gets injured during the seizure - The child has difficulty breathing Call the provider if your child has new symptoms: - Nausea or vomiting - Rash - Side effects of medicines, such as drowsiness, restlessness, or confusion - Tremors or abnormal movements, or problems with coordination Contact the provider even if your child is normal after the seizure has stopped. There is no known way to prevent epilepsy. Proper diet and sleep may decrease the chances of seizures in children with epilepsy. Reduce the risk of head injury during risky activities. This can decrease the likelihood of a brain injury that leads to seizures and epilepsy. 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, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.", "role": "user" }, { "content": "Epilepsy is a brain disorder in which a person has repeated seizures over time that are caused by a sudden change in the electrical and chemical activity in the brain. The movements or symptoms of a seizure may depend on the part of the brain that is affected. Epilepsy is often a lifelong illness that requires taking medicines and taking precautions to stay safe, such as never swimming alone, fall-proofing your home and so on. People with epilepsy need to manage stress and sleep, avoiding alcohol and drug abuse, keeping up in school, and manage other illnesses. Some types of childhood epilepsy go away or improve with age, usually in the late teens or 20s. If the child does not have seizures for a few years, the doctor may stop medicines. For many children, epilepsy is a lifelong condition. In these cases, the medicines need to be continued. There is no known way to prevent epilepsy. Proper diet and sleep may decrease the chances of seizures in children with epilepsy. To decrease the likelihood of a brain injury that leads to seizures and epilepsy, reduce the risk of head injury during risky activities.", "role": "assistant" } ]
[ { "content": "how do you administer lanreotide\n\nHow should Lanreotide Injection be used and what is the dosage?: Lanreotide comes as a long-acting solution (liquid) to be injected subcutaneously (under the skin) into the upper outer area of your buttock by a doctor or nurse. Lanreotide long-acting injection is usually injected once every 4 weeks. Ask your doctor or pharmacist to explain any part you do not understand. Your doctor will probably adjust your dose or the length of time between doses depending on your lab results. Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.", "role": "user" }, { "content": "Lanreotide may be administered under the skin (subcutaneously), into the upper area of the buttock. A nurse or doctor will be able to do this for you.", "role": "assistant" } ]
[ { "content": "how do you diagnose anxiety\n\n Generalized anxiety disorder GAD Anxiety disorder Summary Generalized anxiety disorder (GAD) is a mental disorder in which a person is often worried or anxious about many things and finds it hard to control this anxiety. Causes The cause of GAD is unknown. Genes may play a role. Stress may also contribute to the development of GAD. GAD is a common condition. Anyone can develop this disorder, even children. GAD occurs more often in women than in men. Symptoms The main symptom is frequent worry or tension for at least 6 months, even when there is little or no clear cause. Worries seem to float from one problem to another. Problems may involve family, other relationships, work, school, money, and health. Even when aware that worries or fears are stronger than appropriate for the situation, a person with GAD still has difficulty controlling them. Other symptoms of GAD include: Problems concentrating Fatigue Irritability Problems falling or staying asleep, or sleep that is restless and unsatisfying Restlessness when awake The person may also have other physical symptoms. These can include muscle tension, upset stomach, sweating, or difficulty breathing. 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. Treatment The goal of treatment is to help you feel better and function well in daily life. Talk therapy or medicine alone can be helpful. Sometimes, a combination of these may work best. TALK THERAPY Many types of talk therapy may be helpful for GAD. One common and effective talk therapy is cognitive-behavioral therapy (CBT). CBT can help you understand the relationship between your thoughts, behaviors, and symptoms. Often CBT involves a set number of visits. During CBT you can learn how to: Understand and gain control of distorted views of stressors, such as other people's behavior or life events. Recognize and replace panic-causing thoughts to help you feel more in control. Manage stress and relax when symptoms occur. Avoid thinking that minor problems will develop into terrible ones. Other types of talk therapy may also be helpful in managing symptoms of an anxiety disorder. MEDICINES Certain medicines, usually used to treat depression, may be very helpful for this disorder. They work by preventing your symptoms or making them less severe. You must take these medicines every day. DO NOT stop taking them without talking with your provider. Medicines called sedatives or hypnotics may also be prescribed. These medicines should only be taken under a doctor's direction. Your doctor will prescribe a limited amount of these drugs. They should not to be used everyday. They may be used when symptoms become very severe or when you are about to be exposed to something that always brings on your symptoms. If you are prescribed a sedative, do not drink alcohol while on this medicine. SELF-CARE Other than taking medicine and going to therapy, you can help yourself get better by: Reducing caffeine Not using street drugs or large amounts of alcohol Exercising, getting enough rest, and eating healthy foods Support Groups You can ease the stress of having GAD by joining a support group. Sharing with others who have common experiences and problems can help you not feel alone. Support groups are usually not a good substitute for talk therapy or taking medicine, but can be a helpful addition. Resources for more information include: Anxiety and Depression Association of America -- adaa.org National Institute of Mental Health -- www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml Outlook (Prognosis) How well a person does depends on how severe the condition is. In some cases, GAD is long-term and is difficult to treat. Most people, though, get better with medicine and/or talk therapy. Possible Complications Depression and substance abuse may occur with an anxiety disorder. When to Contact a Medical Professional Call your provider if you frequently worry or feel anxious, especially if it interferes with your daily activities. 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": "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": "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": "Glaucoma can damage the optic nerve due to increased pressure in the eye. Adults may have open-angle glaucoma, angle-closure glaucoma, also called closed-angle glaucoma or secondary glaucoma. 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. 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. Most people cannot feel open-angle glaucoma. People may experience blind spots and slow loss of side (peripheral) vision (also called tunnel vision). Symptoms of closed-angle glaucoma may come and go at first, or steadily become worse. You may notice: sudden, severe pain in one eye decreased or cloudy vision, nausea and vomiting, rainbow-like halos around lights, red eye, feeling that an eye is swollen. The only way to diagnose glaucoma is by having a complete eye exam. You will be given a test to check your eye pressure (tonometry.) Eye pressure can 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), optic nerve imaging, checking your visual acuity, field of vision, retina and how your pupil responds to light (pupillary reflex response), 3-D view of your eye (slit lamp examination). The goal of treatment is to reduce your eye pressure. Treatment depends on the type of glaucoma that you have. If you have open-angle glaucoma, you will probably be given eye drops. You also may be given pills to lower pressure in the eye. If drops alone do not work, you may need laser treatment that uses a painless laser to open the channels for fluid to flow 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. An acute angle-closure attack is a medical emergency. If you have had acute glaucoma in one eye, your doctor is likely to treat your second eye to prevent an attack in that eye.You can become blind in a few days if you are not treated. You may be given drops, pills, and IV medicine to lower your eye pressure. Some people also need an emergency operation, called an iridotomy. If you have secondary glaucoma, treating the cause may help your symptoms go away. Other treatments also may be needed. Open-angle glaucoma cannot be cured. You can manage it and keep your sight by following your provider's directions. You cannot prevent open-angle glaucoma, 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. 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.", "role": "assistant" } ]
[ { "content": "diarrhea i had bad diarrhea over the weekend and though how my mother used paregoric, went to the drug store to get some, he said they dont sell it any more HELP\n\nDiarrhea (Treatment): Most cases of diarrhea clear on their own within a couple of days without treatment. If you've tried lifestyle changes and home remedies for diarrhea without success, your doctor might recommend medications or other treatments. Antibiotics Antibiotics might help treat diarrhea caused by bacteria or parasites. If a virus is causing your diarrhea, antibiotics won't help. Treatment to replace fluids Your doctor likely will advise you to replace the fluids and salts. For most adults, that means drinking water, juice or broth. If drinking liquids upsets your stomach or causes diarrhea, your doctor might recommend getting fluids through a vein in your arm (intravenously). Water is a good way to replace fluids, but it doesn't contain the salts and electrolytes - minerals such as sodium and potassium - you need to maintain the electric currents that keep your heart beating. You can help maintain your electrolyte levels by drinking fruit juices for potassium or eating soups for sodium. Certain fruit juices, such as apple juice, might make diarrhea worse. For children, ask your doctor about using an oral rehydration solution, such as Pedialyte, to prevent dehydration or replace lost fluids. Adjusting medications you're taking If your doctor determines that an antibiotic caused your diarrhea, your doctor might lower your dose or switch to another medication. Treating underlying conditions If your diarrhea is caused by a more serious condition, such as inflammatory bowel disease, your doctor will work to control that condition. You might be referred to a specialist, such as a gastroenterologist, who can help devise a treatment plan for you.", "role": "user" }, { "content": "Most cases of diarrhea do not require treatment. If diet changes and home remedies do not help within a couple of days, your doctor might give you antibiotics to treat diarrhea caused by bacteria or parasites. If a virus is causing your diarrhea, antibiotics won't help. Your doctor might recommend drinking water or broth to replace fluids and electrolytes.", "role": "assistant" } ]
[ { "content": "Cushing, fybromyaglia, Chronic fatigue my main concern is no treatment and the musclar distrophy effecting my heart, legs feet, shoulders, arms, etc.\n\nFibromyalgia (Treatment): In general, treatments for fibromyalgia include both medication and self-care. The emphasis is on minimizing symptoms and improving general health. No one treatment works for all symptoms. Medications Medications can help reduce the pain of fibromyalgia and improve sleep. Common choices include: - Pain relievers. Over-the-counter pain relievers such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve, others) may be helpful. Your doctor might suggest a prescription pain reliever such as tramadol (Ultram). Narcotics are not advised, because they can lead to dependence and may even worsen the pain over time. - Antidepressants. Duloxetine (Cymbalta) and milnacipran (Savella) may help ease the pain and fatigue associated with fibromyalgia. Your doctor may prescribe amitriptyline or the muscle relaxant cyclobenzaprine to help promote sleep. - Anti-seizure drugs. Medications designed to treat epilepsy are often useful in reducing certain types of pain. Gabapentin (Neurontin) is sometimes helpful in reducing fibromyalgia symptoms, while pregabalin (Lyrica) was the first drug approved by the Food and Drug Administration to treat fibromyalgia. Therapy A variety of different therapies can help reduce the effect that fibromyalgia has on your body and your life. Examples include: - Physical therapy. A physical therapist can teach you exercises that will improve your strength, flexibility and stamina. Water-based exercises might be particularly helpful. - Occupational therapy. An occupational therapist can help you make adjustments to your work area or the way you perform certain tasks that will cause less stress on your body. - Counseling. Talking with a counselor can help strengthen your belief in your abilities and teach you strategies for dealing with stressful situations.", "role": "user" }, { "content": "Treatments for fibromyalgia include medications and self-care to minimize symptoms and improve general health. Medications can help reduce the pain of fibromyalgia and improve sleep. Common choices are over-the-counter pain relievers such as acetaminophen or ibuprofen. Your doctor might suggest a prescription pain reliever or anti-seizure drugs to reduce pain, antidepressants that may help with the pain and fatigue, muscle relaxants to help with sleep. Different therapies can help reduce the effect that fibromyalgia has on your body and your life. A physical therapist can teach you exercises that will improve your strength, flexibility and stamina. An occupational therapist can help you make adjustments to your work area or the way you perform certain tasks that will cause less stress on your body. Talking with a counselor can help strengthen your belief in your abilities and teach you strategies for dealing with stressful situations.", "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": "To diagnose epilepsy in children, your medical provider will ask about your family and child's medical history, as well as any seizure episodes. The provider will order an electroencephalogram (EEG) to check the electrical activity in the brain. This may show the area in the brain where the seizures start. Your child may need to wear an EEG recorder over the course of a few days, or stay in a hospital where brain activity can be monitored on video EEG. Other tests your provider might order include include blood tests, kidney or liver function tests, or potentially CT or MRI scans.", "role": "assistant" } ]
[ { "content": "I am 23yr boy,i have knock knees i want treatment. Please help me.\n\nKnock knees: Knock knees are condition in which the knees touch, but the ankles do not touch. The legs turn inward. Infants start out with bowlegs because of their folded position while in their mother's womb. The legs begin to straighten once the child starts to walk (at about 12 to 18 months). By age 3, the child becomes knock-kneed. When the child stands, the knees touch but the ankles are apart. By puberty, the legs straighten out and most children can stand with the knees and ankles touching (without forcing the position). Knock knees can also develop as a result of a medical problem or disease, such as: - Injury of the shinbone (only one leg will be knock-kneed) - Osteomyelitis (bone infection) - Overweight or obesity - Rickets (a disease caused by a lack of vitamin D) A health care provider will examine your child. Tests will be done if there are signs that knock knees are not a part of normal development. Knock knees are not treated in most cases. If the problem continues after age 7, the child may use a night brace. This brace is attached to a shoe. Surgery may be considered for knock knees that are severe and continue beyond late childhood. Children normally outgrow knock knees without treatment, unless it is caused by a disease. If surgery is needed, the results are most often good. 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 Call your provider if you think your child has knock knees. There is no known prevention for normal knock knees. 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": "If the problem continues after age 7, the child may use a night brace. This brace is attached to a shoe. Surgery may be considered for knock knees that are severe and continue beyond late childhood. Children normally outgrow knock knees without treatment, unless it is caused by a disease. If surgery is needed, the results are most often good. 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": "assistant" } ]
[ { "content": "about thalassemia treatment sir,my friend is suffering from thalassemia ,in that majorly red blood anemia,white blood anemia and the blood is comming out from mouth when she got cough .her condition is very severe .in her body the red ,white blood cells are abscent .so that blood transfusion is doing for every 16-20days.then in the recent days the blood also comming out from mouth please tell me where can i get the treatment for this disease .we can travel around the world for treatment please reply me as soon as possible. thank you sir.\n\n Thalassemia Overview Thalassemia (thal-uh-SEE-me-uh) is an inherited blood disorder characterized by less hemoglobin and fewer red blood cells in your body than normal. Hemoglobin is the substance in your red blood cells that allows them to carry oxygen. The low hemoglobin and fewer red blood cells of thalassemia may cause anemia, leaving you fatigued. If you have mild thalassemia, you may not need treatment. But if you have a more severe form of the disorder, you may need regular blood transfusions. You can also take steps on your own to cope with fatigue, such as choosing a healthy diet and exercising regularly. Symptoms Thalassemia signs and symptoms may include: - Fatigue - Weakness - Pale or yellowish skin - Facial bone deformities - Slow growth - Abdominal swelling - Dark urine Several types of thalassemia exist, including alpha-thalassemia, thalassemia intermedia and Cooley anemia. The signs and symptoms you experience depend on the type and severity of your condition. Some babies show signs and symptoms of thalassemia at birth, while others may develop them during the first two years of life. Some people who have only one affected hemoglobin gene don't experience any thalassemia symptoms. Make an appointment with your child's doctor for an evaluation if he or she has any signs or symptoms that worry you. Causes Thalassemia is caused by mutations in the DNA of cells that make hemoglobin - the substance in your red blood cells that carries oxygen throughout your body. The mutations associated with thalassemia are passed from parents to children. Thalassemia disrupts the normal production of hemoglobin and healthy red blood cells. This causes anemia. With anemia, your blood doesn't have enough red blood cells to carry oxygen to your tissues - leaving you fatigued. The type of thalassemia you have depends on the number of gene mutations you inherit from your parents and which part of the hemoglobin molecule is affected by the mutations. The more mutated genes, the more severe your thalassemia. Hemoglobin molecules are made of alpha and beta parts that can be affected by mutations. Four genes are involved in making the alpha hemoglobin chain. You get two from each of your parents. If you inherit: - 1 mutated gene, you'll have no signs or symptoms of thalassemia. But you are a carrier of the disease and can pass it on to your children. - 2 mutated genes, your thalassemia signs and symptoms will be mild. This condition may be called alpha-thalassemia trait. - 3 mutated genes, your signs and symptoms will be moderate to severe. - 4 mutated genes. This type is rare. Affected fetuses have severe anemia and usually are stillborn. Babies born with this condition often die shortly after birth or require lifelong transfusion therapy. In rare cases, a child born with this condition may be treated with transfusions and a stem cell transplant, which is also called a bone marrow transplant. Two genes are involved in making the beta hemoglobin chain. You get one from each of your parents. If you inherit: - 1 mutated gene, you'll have mild signs and symptoms. This condition is called thalassemia minor or beta-thalassemia. - 2 mutated genes, your signs and symptoms will be moderate to severe. This condition is called thalassemia major, or Cooley anemia. Babies born with two defective beta hemoglobin genes usually are healthy at birth but develop signs and symptoms within the first two years of life. A milder form, called thalassemia intermedia, also may occur with two mutated genes. Risk factors Factors that increase your risk of thalassemia include: - Family history of thalassemia. Thalassemia is passed from parents to children through mutated hemoglobin genes. If you have a family history of thalassemia, you may have an increased risk of the condition. - Certain ancestry. Thalassemia occurs most often in African-Americans and in people of Mediterranean and Southeast Asian ancestry. Complications Possible complications of thalassemia include: - Iron overload. People with thalassemia can get too much iron in their bodies, either from the disease or from frequent blood transfusions. Too much iron can result in damage to your heart, liver and endocrine system. This system includes hormone-producing glands that regulate processes throughout your body. - Infection. People with thalassemia have an increased risk of infection. This is especially true if you've had your spleen removed. In cases of severe thalassemia, the following complications can occur: - Bone deformities. Thalassemia can make your bone marrow expand, which causes your bones to widen. This can result in abnormal bone structure, especially in your face and skull. Bone marrow expansion also makes bones thin and brittle, increasing the chance of broken bones. - Enlarged spleen (splenomegaly). The spleen helps your body fight infection and filter unwanted material, such as old or damaged blood cells. Thalassemia is often accompanied by the destruction of a large number of red blood cells. This causes your spleen to enlarge and work harder than normal. Splenomegaly can make anemia worse, and it can reduce the life of transfused red blood cells. If your spleen grows too big, your doctor may suggest surgery to remove it (splenectomy). - Slowed growth rates. Anemia can cause a child's growth to slow. And thalassemia may cause a delay in puberty. - Heart problems. Heart problems - such as congestive heart failure and abnormal heart rhythms (arrhythmias) - may be associated with severe thalassemia. Diagnosis Most children with moderate to severe thalassemia show signs and symptoms within their first two years of life. If your doctor suspects your child has thalassemia, he or she may confirm a diagnosis using blood tests. If your child has thalassemia, blood tests may reveal: - A low level of red blood cells - Smaller than expected red blood cells - Pale red blood cells - Red blood cells that are varied in size and shape - Red blood cells with uneven hemoglobin distribution, which gives the cells a bull's-eye appearance under the microscope Blood tests may also be used to: - Measure the amount of iron in your child's blood - Evaluate his or her hemoglobin - Perform DNA analysis to diagnose thalassemia or to determine if a person is carrying mutated hemoglobin genes Prenatal testing Testing can be done before a baby is born to find out if he or she has thalassemia and determine how severe it may be. Tests used to diagnose thalassemia in fetuses include: - Chorionic villus sampling. This test is usually done around the 11th week of pregnancy and involves removing a tiny piece of the placenta for evaluation. - Amniocentesis. This test is usually done around the 16th week of pregnancy and involves taking a sample of the fluid that surrounds the fetus. Assisted reproductive technology A form of assisted reproductive technology that combines preimplantation genetic diagnosis with in vitro fertilization may help parents who have thalassemia or who are carriers of a defective hemoglobin gene give birth to healthy babies. The procedure involves retrieving mature eggs and fertilizing them with sperm in a dish in a laboratory. The embryos are tested for the defective genes, and only those without genetic defects are implanted into the uterus. Treatment Treatment for thalassemia depends on which type you have and how severe it is. Treatments for mild thalassemia Signs and symptoms are usually mild with thalassemia minor and little, if any, treatment is needed. Occasionally, you may need a blood transfusion, particularly after surgery, after having a baby or to help manage thalassemia complications. People with severe beta-thalassemia will need blood transfusions. And because this treatment can cause iron overload, they will also need treatment to remove excess iron. An oral medication called deferasirox (Exjade, Jadenu) can help remove the excess iron. Treatments for moderate to severe thalassemia Treatments for moderate to severe thalassemia may include: - Frequent blood transfusions. More-severe forms of thalassemia often require frequent blood transfusions, possibly every few weeks. Over time, blood transfusions cause a buildup of iron in your blood, which can damage your heart, liver and other organs. To help your body get rid of the extra iron, you may need to take medications that rid your body of extra iron. - Stem cell transplant. Also called a bone marrow transplant, a stem cell transplant may be an option in select cases, including children born with severe thalassemia. It can eliminate the need for lifelong blood transfusions and drugs to control iron overload. During this procedure, you receive infusions of stem cells from a compatible donor, usually a sibling. Lifestyle and home remedies You can help manage your thalassemia by following your treatment plan and adopting healthy-living habits. The following tips will help: - Avoid excess iron. Unless your doctor recommends it, don't take vitamins or other supplements that contain iron. - Eat a healthy diet. Eating a balanced diet that contains plenty of nutritious foods can help you feel better and boost your energy. Your doctor also may recommend you take a folic acid supplement to help your body make new red blood cells. Also, to keep your bones healthy, make sure your diet contains adequate calcium and vitamin D. Ask your doctor what the right amounts are for you and whether you need to take a supplement. - Avoid infections. Protect yourself from infections with frequent hand-washing and by avoiding sick people. This is especially important if you've had to have your spleen removed. You'll also need an annual flu shot, as well as the meningitis, pneumococcal and hepatitis B vaccines to prevent infections. If you develop a fever or other signs and symptoms of an infection, see your doctor for treatment. ", "role": "user" }, { "content": "More-severe forms of thalassemia often require frequent blood transfusions, possibly every few weeks. Over time, blood transfusions cause a buildup of iron in your blood, which can damage your heart, liver and other organs. To help your body get rid of the extra iron, you may need to take medications that rid your body of extra iron. - Stem cell transplant. Also called a bone marrow transplant, a stem cell transplant may be an option in select cases, including children born with severe thalassemia. It can eliminate the need for lifelong blood transfusions and drugs to control iron overload. During this procedure, you receive infusions of stem cells from a compatible donor, usually a sibling", "role": "assistant" } ]
[ { "content": "what blood tests confirm celiac disease\n\nCeliac disease: Celiac disease (gluten-sensitive enteropathy), sometimes called sprue or coeliac, is an immune reaction to eating gluten, a protein found in wheat, barley and rye. If you have celiac disease, eating gluten triggers an immune response in your small intestine. Over time, this reaction damages your small intestine's lining and prevents absorption of some nutrients (malabsorption). The intestinal damage often causes diarrhea, fatigue, weight loss, bloating and anemia, and can lead to serious complications. In children, malabsorption can affect growth and development, in addition to the symptoms seen in adults. There's no cure for celiac disease - but for most people, following a strict gluten-free diet can help manage symptoms and promote intestinal healing. The signs and symptoms of celiac disease can vary greatly and are different in children and adults. The most common signs for adults are diarrhea, fatigue and weight loss. Adults may also experience bloating and gas, abdominal pain, nausea, constipation, and vomiting. However, more than half of adults with celiac disease have signs and symptoms that are not related to the digestive system, including: - Anemia, usually resulting from iron deficiency - Loss of bone density (osteoporosis) or softening of bone (osteomalacia) - Itchy, blistery skin rash (dermatitis herpetiformis) - Damage to dental enamel - Mouth ulcers - Headaches and fatigue - Nervous system injury, including numbness and tingling in the feet and hands, possible problems with balance, and cognitive impairment - Joint pain - Reduced functioning of the spleen (hyposplenism) - Acid reflux and heartburn In children under 2 years old, typical signs and symptoms of celiac disease include: - Vomiting - Chronic diarrhea - Swollen belly - Failure to thrive - Poor appetite - Muscle wasting Older children may experience: - Diarrhea - Constipation - Weight loss - Irritability - Short stature - Delayed puberty - Neurological symptoms, including attention-deficit/hyperactivity disorder (ADHD), learning disabilities, headaches, lack of muscle coordination and seizures Dermatitis herpetiformis is an itchy, blistering skin disease that stems from intestinal gluten intolerance. The rash usually occurs on the elbows, knees, torso, scalp and buttocks. Dermatitis herpetiformis is often associated with changes to the lining of the small intestine identical to those of celiac disease, but the disease may not produce noticeable digestive symptoms. Doctors treat dermatitis herpetiformis with a gluten-free diet or medication, or both, to control the rash. Consult your doctor if you have diarrhea or digestive discomfort that lasts for more than two weeks. Consult your child's doctor if your child is pale, irritable or failing to grow or has a potbelly and foul-smelling, bulky stools. Be sure to consult your doctor before trying a gluten-free diet. If you stop or even reduce the amount of gluten you eat before you're tested for celiac disease, you may change the test results. Celiac disease tends to run in families. If someone in your family has the condition, ask your doctor if you should be tested. Also ask your doctor about testing if you or someone in your family has a risk factor for celiac disease, such as type 1 diabetes. Celiac disease occurs from an interaction between genes, eating foods with gluten and other environmental factors, but the precise cause isn't known. Infant feeding practices, gastrointestinal infections and gut bacteria might contribute to developing celiac disease. Sometimes celiac disease is triggered - or becomes active for the first time - after surgery, pregnancy, childbirth, viral infection or severe emotional stress. When the body's immune system overreacts to gluten in food, the reaction damages the tiny, hair-like projections (villi) that line the small intestine. Villi absorb vitamins, minerals and other nutrients from the food you eat. If your villi are damaged, you can't get enough nutrients, no matter how much you eat. Some gene variations appear to increase the risk of developing the disease. But having those gene variants doesn't mean you'll get celiac disease, which suggests that additional factors must be involved. The rate of celiac disease in Western countries is estimated at about 1 percent of the population. Celiac disease is most common in Caucasians; however, it is now being diagnosed among many ethnic groups and is being found globally. Celiac disease can affect anyone. However, it tends to be more common in people who have: - A family member with celiac disease or dermatitis herpetiformis - Type 1 diabetes - Down syndrome or Turner syndrome - Autoimmune thyroid disease - Microscopic colitis (lymphocytic or collagenous colitis) - Addison's disease - Rheumatoid arthritis Researchers estimate that only 20 percent of people with celiac disease may receive a diagnosis. Doctors may order two blood tests to help diagnose celiac disease. - Serology testing looks for antibodies in your blood. Elevated levels of certain antibody proteins indicate an immune reaction to gluten. - Genetic testing for human leukocyte antigens (HLA-DQ2 and HLA-DQ8) can be used to rule out celiac disease. If the results of these tests indicate celiac disease, your doctor may order an endoscopy to view your small intestine and to take a small tissue sample (biopsy) to analyze for damage to the villi. It's important to be tested for celiac disease before trying a gluten-free diet. Eliminating gluten from your diet may change the results of blood tests so that they appear to be normal. A strict, lifelong gluten-free diet is the only way to manage celiac disease. In addition to wheat, foods that contain gluten include: - Barley - Bulgur - Durum - Farina - Graham flour - Malt - Rye - Semolina - Spelt (a form of wheat) - Triticale Your doctor may refer you to a dietitian, who can help you plan a healthy gluten-free diet. Once you remove gluten from your diet, inflammation in your small intestine generally begins to lessen - usually within several weeks, though you may start to feel better in just a few days. Complete healing and regrowth of the villi may take several months to several years. Healing in the small intestine tends to occur more quickly in children than adults. If you accidentally eat a product that contains gluten, you may experience abdominal pain and diarrhea. Some people experience no signs or symptoms after eating gluten, but this doesn't mean it's not harmful to them. Even trace amounts of gluten in your diet can be damaging, whether or not they cause signs or symptoms. Hidden gluten can be present in foods, medications and nonfood products, including: - Modified food starch, preservatives and food stabilizers - Prescription and over-the-counter medications - Vitamin and mineral supplements - Herbal and nutritional supplements - Lipstick products - Toothpaste and mouthwash - Envelope and stamp glue - Play-Doh Vitamin and mineral supplements If your nutritional deficiencies are severe, your doctor or dietitian may recommend taking vitamin and mineral supplements. You may need to supplement your levels of: - Calcium - Folate - Iron - Vitamin B-12 - Vitamin D - Vitamin K - Zinc Vitamins and supplements are usually taken in pill form. If your digestive tract has trouble absorbing vitamins, your doctor may give them by injection. You need to be sure that the vitamins and supplements are gluten-free. Follow-up care If you have celiac disease, you will need medical follow-up to make sure your symptoms have responded to a gluten-free diet. Doctors will also want to be sure you are getting the support you need to maintain the diet for life. They will use blood tests to monitor your response. The results of these tests, which are primarily designed as a way to detect celiac disease, usually become negative once you have been gluten-free for six to 12 months. If test results remain positive, then your doctor may try to find the reason, the most common being unintentional exposure to gluten in your diet. However, these tests are not perfect, and even if the results become negative, it is possible that you could still be exposed to a significant amount of gluten and continue to have symptoms and damage to your intestines. If you continue to have symptoms, or your symptoms recur, you may need a follow-up endoscopy with biopsies to ensure that healing has occurred. Adults typically have a greater need for follow-up testing, although children may require it, too. Some doctors recommend a routine re-biopsy if you are diagnosed in adulthood, as healing is often quite slow and uncertain. It also can be helpful to follow up with an expert dietitian for assistance in adapting to, and maintaining, a healthy, nutritious, gluten-free diet. Medications to control intestinal inflammation If your small intestine is severely damaged, your doctor may recommend steroids to control inflammation. Steroids can ease severe signs and symptoms of celiac disease while the intestine heals. Dermatitis herpetiformis If you have this itchy, blistering skin rash that sometimes accompanies celiac disease, your doctor may recommend a skin medication (dapsone) along with the gluten-free diet. Refractory celiac disease If you have refractory celiac disease, you may continue to have severe symptoms, or your symptoms may lessen but then relapse. In either case, your small intestine does not heal. When this happens, you likely will require evaluation in a specialized center. Refractory celiac disease can be quite serious and there is currently no proven treatment. People with refractory celiac disease should be treated by experts. There may be several causes for this condition. Doctors will often use steroid therapy - either a topical budesonide or systemic steroids such as prednisone. Sometimes, they will use the same medications used to treat other conditions. Potential future treatments While the only proven therapy for celiac disease is a gluten-free diet, it is not perfect. People with celiac disease may often be accidentally exposed to gluten, possibly causing severe symptoms. Several treatments are in development for celiac disease. Some try to neutralize or bind to gluten. Others address the barrier of the intestine, blocking the leakiness that gluten can trigger. Still others target the body's immune system. Researchers have also been trying to genetically modify wheat, but have not yet been successful. None of these treatments is likely to be approved within the next two to three years. However, given the number of different approaches, there is a good chance that there will be additional treatments available for celiac disease in the future. If you've been diagnosed with celiac disease, you'll need to avoid all foods that contain gluten. Ask your doctor for a referral to a dietitian, who can help you plan a healthy gluten-free diet. It's important to get enough vitamins, nutrients, fiber and calcium in your diet. Here's an overview of foods that contain gluten and gluten-free foods that are safe to eat. Avoid food and drinks containing: - Barley - Bulgur - Durum - Farina - Graham flour - Malt - Rye - Semolina - Spelt (a form of wheat) - Triticale - Wheat Packaged foods should be avoided unless they're labeled as gluten-free or have no gluten-containing ingredients. In addition to cereals, pastas and baked goods - such as breads, cakes, pies and cookies - other packaged foods that may contain gluten include: - Beer - Candies - Gravies - Imitation meats or seafood - Processed luncheon meats - Salad dressings and sauces, including soy sauce - Self-basting poultry - Soups Certain grains, such as oats, can be contaminated with wheat during growing and processing. Pure oats are not harmful for most people with celiac disease. In the United States, doctors generally recommend avoiding oats unless they have been specifically labeled gluten-free. Outside of the United States, different labeling laws for oats apply. Occasionally, even pure oats can be a problem for people with celiac disease. Many basic foods are allowed in a gluten-free diet, including: - Fresh meats, fish and poultry that aren't breaded, batter-coated or marinated - Fruits - Most dairy products - Potatoes - Vegetables - Wine and distilled liquors, ciders and spirits Grains and starches allowed in a gluten-free diet include: - Amaranth - Arrowroot - Buckwheat - Corn - Cornmeal - Gluten-free flours (rice, soy, corn, potato, bean) - Pure corn tortillas - Quinoa - Rice - Tapioca Carob is a potential substitute for gluten, but more research is needed about its effect on people with celiac disease. Fortunately for bread and pasta lovers with celiac disease, an increasing number of gluten-free products are available. If you can't find any at your local bakery or grocery store, check online. There are gluten-free substitutes for many gluten-containing foods. However, be aware that processed gluten-free foods may contain excessive fat and calories. There are no proven treatments that assist with celiac disease. Enzyme therapies that claim to digest gluten may be available in health food stores or other outlets, but there is no scientific evidence that they are effective in treating celiac disease.", "role": "user" }, { "content": "There are two blood tests your doctor may order to help diagnose celiac disease. Serology testing looks for antibodies in your blood, which can indicate an immune reaction to gluten. Genetic testing for human leukocyte antigens (HLA-DQ2 and HLA-DQ8) can be used to rule out celiac disease. If the results of these tests indicate celiac disease, your doctor may order an endoscopy to view your small intestine and to take a small tissue sample (biopsy) to analyze for damage to the villi.", "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 (Alternative medicine): Studies indicate that the following treatments for scoliosis are ineffective: - Chiropractic manipulation - Electrical stimulation of muscles - Dietary supplements", "role": "user" }, { "content": "Studies indicate that the following treatments for scoliosis are ineffective: - Chiropractic manipulation - Electrical stimulation of muscles - Dietary supplements", "role": "assistant" } ]
[ { "content": "how to prevent diabetes\n\n Diabetes Diabetes - type 1 Diabetes - type 2 Diabetes - gestational Type 1 diabetes Type 2 diabetes Gestational diabetes Diabetes mellitus Summary Diabetes is a long-term (chronic) disease in which the body cannot regulate the amount of sugar in the blood. Causes Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both. To understand diabetes, it is important to first understand the normal process by which food is broken down and used by the body for energy. Several things happen when food is digested and absorbed: A sugar called glucose enters the bloodstream. Glucose is a source of fuel for the body. An organ called the pancreas makes insulin. The role of insulin is to move glucose from the bloodstream into muscle, fat, and other cells, where it can be stored or used as fuel. People with diabetes have high blood sugar because their body cannot move sugar from the blood into muscle and fat cells to be burned or stored for energy, and/or because their liver makes too much glucose and releases it into the blood. This is because either: Their pancreas does not make enough insulin Their cells do not respond to insulin normally Both of the above There are two major types of diabetes. The causes and risk factors are different for each type: Type 1 diabetes is less common. It can occur at any age, but it is most often diagnosed in children, teens, or young adults. In this disease, the body makes little or no insulin. This is because the pancreas cells that make insulin stop working. Daily injections of insulin are needed. The exact cause of the failure to make enough insulin is unknown. Type 2 diabetes is more common. It most often occurs in adulthood, but because of high obesity rates, children and teens are now being diagnosed with this disease. Some people with type 2 diabetes do not know they have it. With type 2 diabetes, the body is resistant to insulin and doesn't use insulin as well as it should. Not all people with type 2 diabetes are overweight or obese. There are other causes of diabetes, and some people cannot be classified as type 1 or type 2. Gestational diabetes is high blood sugar that develops at any time during pregnancy in a woman who does not have diabetes. If your parent, brother, or sister has diabetes, you may be more likely to develop the disease. Symptoms A high blood sugar level can cause several symptoms, including: Blurry vision Excess thirst Fatigue Frequent urination Hunger Weight loss Because type 2 diabetes develops slowly, some people with high blood sugar have no symptoms. Symptoms of type 1 diabetes develop over a short period. People may be very sick by the time they are diagnosed. After many years, diabetes can lead to other serious problems. These problems are known as diabetes complications, and include: Eye problems, including trouble seeing (especially at night), light sensitivity, and blindness Sores and infections of the leg or foot, which if untreated, can lead to amputation of the leg or foot Damage to nerves in the body, causing pain, tingling, a loss of feeling, problems digesting food, and erectile dysfunction Kidney problems, which can lead to kidney failure Weakened immune system, which can lead to more frequent infections Increased chance of having a heart attack or stroke Exams and Tests A urine analysis may show high blood sugar. But a urine test alone does not diagnose diabetes. Your health care provider may suspect that you have diabetes if your blood sugar level is higher than 200 mg/dL (11.1 mmol/L). To confirm the diagnosis, one or more of the following tests must be done. Blood tests: Fasting blood glucose level. Diabetes is diagnosed if the fasting glucose level is higher than 126 mg/dL (7.0 mmol/L) on two different tests. Levels between 100 and 126 mg/dL (5.5 and 7.0 mmol/L) are called impaired fasting glucose or prediabetes. These levels are risk factors for type 2 diabetes. Hemoglobin A1c (A1C) test. Normal is less than 5.7%; prediabetes is 5.7% to 6.4%; and diabetes is 6.5% or higher. Oral glucose tolerance test. Diabetes is diagnosed if the glucose level is higher than 200 mg/dL (11.1 mmol/L) 2 hours after drinking a sugar drink (this test is used more often for type 2 diabetes). Screening for type 2 diabetes in people who have no symptoms is recommended for: Overweight children who have other risk factors for diabetes, starting at age 10 and repeated every 3 years. Overweight adults (BMI of 25 or higher) who have other risk factors such as having high blood pressure, or having a mother, father, sister or brother with diabetes. Adults over age 45, repeated every 3 years. Treatment Type 2 diabetes can sometimes be reversed with lifestyle changes, especially losing weight with exercise and by eating healthier foods. Some cases of type 2 diabetes can also be improved with weight loss surgery. There is no cure for type 1 diabetes (except for a pancreas or islet cell transplant). Treating either type 1 diabetes or type 2 diabetes involves nutrition, activity and medicines to control blood sugar level. Everyone with diabetes should receive proper education and support about the best ways to manage their diabetes. Ask your provider about seeing a certified diabetes educator (CDE). Getting better control over your blood sugar, cholesterol, and blood pressure levels helps reduce the risk for kidney disease, eye disease, nervous system disease, heart attack, and stroke. To prevent diabetes complications, visit your provider at least 2 to 4 times a year. Talk about any problems you are having. Follow your provider's instructions on managing your diabetes. Support Groups Many resources can help you understand more about diabetes. If you have diabetes, you can also learn ways to manage your condition and prevent diabetes complications. Outlook (Prognosis) Diabetes is a lifelong disease for most people who have it. Tight control of blood glucose can prevent or delay diabetes complications. But these problems can occur, even in people with good diabetes control. Possible Complications After many years, diabetes can lead to serious health problems: You could have eye problems, including trouble seeing (especially at night), and light sensitivity. You could become blind. Your feet and skin can develop sores and infections. After a long time, your foot or leg may need to be amputated. Infection can also cause pain and itching in other parts of the body. Diabetes may make it harder to control your blood pressure and cholesterol. This can lead to a heart attack, stroke, and other problems. It can become harder for blood to flow to your legs and feet. Nerves in your body can get damaged, causing pain, tingling, and numbness. Because of nerve damage, you could have problems digesting the food you eat. You could feel weakness or have trouble going to the bathroom. Nerve damage can make it harder for men to have an erection. High blood sugar and other problems can lead to kidney damage. Your kidneys may not work as well as they used to. They may even stop working so that you need dialysis or a kidney transplant. Your immune system can weaken, which can lead to frequent infections. Prevention Keeping an ideal body weight and an active lifestyle may prevent or delay the start of type 2 diabetes. If you're overweight, losing just 5% of your body weight can reduce your risk. Some medicines can also be used to delay or prevent the start of type 2 diabetes. At this time, type 1 diabetes cannot be prevented. But there is promising research that shows type 1 diabetes may be delayed in some high risk people. Review Date 2/22/2018 Updated by: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, 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": "Diabetes (Prevention): Keeping an ideal body weight and an active lifestyle may prevent or delay the start of type 2 diabetes. If you're overweight, losing just 5% to 7% of your body weight even helps. Some medicines can also be used to delay or prevent the start of type 2 diabetes. At this time, type 1 diabetes cannot be prevented. But there is promising research that shows type 1 diabetes may be delayed in some high risk people.", "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\nEllis-van Creveld syndrome (Description): Ellis-van Creveld syndrome is an inherited disorder of bone growth that results in very short stature (dwarfism). People with this condition have particularly short forearms and lower legs and a narrow chest with short ribs. Ellis-van Creveld syndrome is also characterized by the presence of extra fingers and toes (polydactyly), malformed fingernails and toenails, and dental abnormalities. More than half of affected individuals are born with a heart defect, which can cause serious or life-threatening health problems. The features of Ellis-van Creveld syndrome overlap with those of another, milder condition called Weyers acrofacial dysostosis. Like Ellis-van Creveld syndrome, Weyers acrofacial dysostosis involves tooth and nail abnormalities, although affected individuals have less pronounced short stature and typically do not have heart defects. The two conditions are caused by mutations in the same genes.", "role": "user" }, { "content": "Ellis-van Creveld syndrome is an inherited disorder of bone growth that results in very short stature (dwarfism). People with this condition have particularly short forearms and lower legs and a narrow chest with short ribs. Ellis-van Creveld syndrome is also characterized by the presence of extra fingers and toes (polydactyly), malformed fingernails and toenails, and dental abnormalities. More than half of affected individuals are born with a heart defect, which can cause serious or life-threatening health problems.", "role": "assistant" } ]
[ { "content": "how often do you need a pap smear\n\n Cervical dysplasia Cervical intraepithelial neoplasia - dysplasia CIN - dysplasia Precancerous changes of the cervix - dysplasia Cervical cancer - dysplasia Squamous intraepithelial lesion - dysplasia LSIL - dysplasia HSIL - dysplasia Low-grade dysplasia High-grade dysplasia Carcinoma in situ - dysplasia CIS - dysplasia ASCUS - dysplasia Atypical glandular cells - dysplasia AGUS - dysplasia Atypical squamous cells - dysplasia Pap smear - dysplasia HPV - dysplasia Human papilloma virus - dysplasia Cervix - dysplasia Colposcopy - dysplasia Summary Cervical dysplasia refers to abnormal changes in the cells on the surface of the cervix. The cervix is the lower part of the uterus (womb) that opens at the top of the vagina. The changes are not cancer. But they are considered to be precancerous. This means they can lead to cancer of the cervix if not treated. Causes Cervical dysplasia can develop at any age. However, follow up and treatment will depend on your age. Cervical dysplasia is caused by the human papillomavirus (HPV). HPV is a common virus that is spread through sexual contact. There are many types of HPV. Some types lead to cervical dysplasia or cancer. Other types of HPV can cause genital warts. The following may increase your risk for cervical dysplasia: Having sex before age 18 Having a baby at very young age Having had multiple sexual partners Having other illnesses, such as tuberculosis or HIV Using medicines that suppress your immune system Smoking Symptoms Most of the time, there are no symptoms. Exams and Tests Your health care provider will perform a pelvic exam to check cervical dysplasia. The initial test is usually a Pap smear and a test for the presence of HPV. Cervical dysplasia that is seen on a Pap smear is called squamous intraepithelial lesion (SIL). On the Pap smear report, these changes will be described as: Low-grade (LSIL) High-grade (HSIL) Possibly cancerous (malignant) Atypical glandular cells (AGC) Atypical squamous cells (ASC) You will need more tests if a Pap smear shows abnormal cells or cervical dysplasia. If the changes were mild, follow-up Pap smears may be all that is needed. The provider may perform a biopsy to confirm the condition. This may be done with the use of colposcopy. Any areas of concern will be biopsied. The biopsies are very small and most women feel only a small cramp. Dysplasia that is seen on a biopsy of the cervix is called cervical intraepithelial neoplasia (CIN). It is grouped into 3 categories: CIN I -- mild dysplasia CIN II -- moderate to marked dysplasia CIN III -- severe dysplasia to carcinoma in situ Some strains of HPV are known to cause cervical cancer. An HPV DNA test can identify the high-risk types of HPV linked to this cancer. This test may be done: As a screening test for women over age 30 For women of any age who have a slightly abnormal Pap test result Treatment Treatment depends on the degree of dysplasia. Mild dysplasia (LSIL or CIN I) may go away without treatment. You may only need careful follow-up by your provider with repeat Pap smears every 6 to 12 months. If the changes do not go away or get worse, treatment is needed. Treatment for moderate-to-severe dysplasia or mild dysplasia that does not go away may include: Cryosurgery to freeze abnormal cells Laser therapy, which uses light to burn away abnormal tissue LEEP (loop electrosurgical excision procedure), which uses electricity to remove abnormal tissue Surgery to remove the abnormal tissue (cone biopsy) Hysterectomy (in rare cases) If you have had dysplasia, you will need to have repeat exams every 12 months or as suggested by your provider. Make sure to get the HPV vaccine when it is offered to you. This vaccine prevents many cervical cancers. Outlook (Prognosis) Early diagnosis and prompt treatment cures most cases of cervical dysplasia. However, the condition may return. Without treatment, severe cervical dysplasia may change into cervical cancer. When to Contact a Medical Professional Call your provider if your age is 21 or older and you have never had a pelvic exam and Pap smear. Prevention Ask your provider about the HPV vaccine. Girls who receive this vaccine before they become sexually active reduce their chance of getting cervical cancer. You can reduce your risk of developing cervical dysplasia by taking the following steps: Get vaccinated for HPV between ages 9 to 26. Do not smoke. Smoking increases your risk of developing more severe dysplasia and cancer. Do not have sex until you are 18 or older. Practice safe sex. Use a condom. Practice monogamy. This means you have only one sexual partner at a time. Review Date 1/14/2018 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": "Cervical dsyplasia refers to abnormal changes in the cells on the surface of the cervix. For women of any age who have a slightly abnormal Pap test result, treatment depends on the degree of the dysplasia. Mild dysplasia (LSIL or CIN I) may go away without treatment. You may only need careful follow-up by your provider with repeat Pap smears every 6 to 12 months. If the changes do not go away or get worse, treatment is needed.", "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": "Causes of peripheral neuropathy include: trauma, infections, metabolic problems, and exposure to toxins. One of the most common causes of peripheral neuropathy is diabetes mellitus. It can also be inherited.", "role": "assistant" } ]
[ { "content": "abetalipoproteimemia hi, I would like to know if there is any support for those suffering with abetalipoproteinemia? I am not diagnosed but have had many test that indicate I am suffering with this, keen to learn how to get it diagnosed and how to manage, many thanks\n\n Bassen-Kornzweig syndrome Abetalipoproteinemia Acanthocytosis Apolipoprotein B deficiency Summary Bassen-Kornzweig syndrome is a rare disease passed down through families. The person is unable to fully absorb dietary fats through the intestines. Causes Bassen-Kornzweig syndrome is caused by a defect in a gene that tells the body to create lipoproteins (molecules of fat combined with protein). The defect makes it hard for the body to properly digest fat and essential vitamins. Symptoms Symptoms include: Balance and coordination difficulties Curvature of spine Decreased vision that gets worse over time Developmental delay Failure to thrive (grow) in infancy Muscle weakness Poor muscle coordination that usually develops after age 10 Protruding abdomen Slurred speech Stool abnormalities, including fatty stools that appear pale in color, frothy stools, and abnormally foul-smelling stools Exams and Tests There may be damage to the retina of the eye (retinitis pigmentosa). Tests that may be done to help diagnose this condition include: Apolipoprotein B blood test Blood tests to look for vitamin deficiencies (fat-soluble vitamins A, D, E, and K) \"Burr-cell\" malformation of the red cells (acanthocytosis) Complete blood count (CBC) Cholesterol studies Electromyography Eye exam Nerve conduction velocity Stool sample analysis Genetic testing may be available for mutations in the <em>MTP</em> gene. Treatment Treatment involves large doses of vitamin supplements containing fat-soluble vitamins (vitamin A, vitamin D, vitamin E, and vitamin K). Linoleic acid supplements are also recommended. People with this condition should talk to a nutritionist. Diet changes are needed to prevent stomach problems. This may involve limiting intake of some types of fat. Supplements of medium-chain triglycerides are taken under the supervision of a health care provider. They should be used with caution, because they may cause liver damage. Outlook (Prognosis) How well a person does depends on the amount of brain and nervous system problems. Possible Complications Complications may include: Blindness Mental deterioration Loss of function of peripheral nerves, uncoordinated movement (ataxia) When to Contact a Medical Professional Call your provider if your infant or child has symptoms of this disease. Genetic counseling can help families understand the condition and the risks of inheriting it, and learn how to care for the person. Prevention High doses of fat-soluble vitamins may slow the progression of some problems, such as retina damage and decreased vision. 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": "Tests that may be done to help diagnose this condition include: - Apolipoprotein B blood test - Blood tests to look for vitamin deficiencies (fat-soluble vitamins A, D, E, and K) - \"Burr-cell\" malformation of the red cells (acanthocytosis) - Complete blood count (CBC) - Cholesterol studies - Electromyography - Eye exam - Nerve conduction velocity - Stool sample analysis Genetic testing may be available for mutations in the MTP gene.", "role": "assistant" } ]
[ { "content": "My daughter has menkes syndrome and would like to know how to go about. Thx\n\nWhat is Menkes syndrome?: Menkes syndrome is a disorder that affects copper levels in the body. It is characterized by sparse, kinky hair; failure to gain weight and grow at the expected rate (failure to thrive); and deterioration of the nervous system. Additional signs and symptoms include weak muscle tone (hypotonia), sagging facial features, seizures, developmental delay, and intellectual disability. Children with Menkes syndrome typically begin to develop symptoms during infancy and often do not live past age 3. Early treatment with copper may improve the prognosis in some affected individuals. In rare cases, symptoms begin later in childhood. Occipital horn syndrome (sometimes called X-linked cutis laxa) is a less severe form of Menkes syndrome that begins in early to middle childhood. It is characterized by wedge-shaped calcium deposits in a bone at the base of the skull (the occipital bone), coarse hair, and loose skin and joints.", "role": "user" }, { "content": "Menkes syndrome is a disorder that affects copper levels in the body. The symptoms include kinky hair, failure to thrive, deterioration of the nervous system, weak muscle tone (hypotonia), sagging facial features, seizures, developmental delay, and intellectual disability. Children with Menkes syndrome typically begin to develop symptoms during infancy and often do not live past age 3. Early treatment with copper may improve the prognosis in some affected individuals. In rare cases, symptoms begin later in childhood.", "role": "assistant" } ]
[ { "content": "how often do you need a pap smear\n\n Cervical cancer - screening and prevention Cancer cervix - screening HPV - cervical cancer screening Dysplasia - cervical cancer screening Cervical cancer - HPV vaccine Summary Cervical cancer is a cancer that starts in the cervix. The cervix is the lower part of the uterus (womb) that opens at the top of the vagina. There is a lot you can do to decrease your chance of having cervical cancer. Also, your health care provider can do tests to find early changes that may lead to cancer, or to find cervical cancer in the early stages. Lifestyle and Safer Sex Habits Almost all cervical cancers are caused by HPV (human papilloma virus). HPV is a common virus that spreads through sexual contact. Certain types of HPV are more likely to lead to cervical cancer. These are called high-risk types of HPV. Other types of HPV cause genital warts. HPV can be passed from person to person even when there are no visible warts or other symptoms. Vaccines to Prevent Cervical Cancer A vaccine is available to protect against the HPV types that cause most cervical cancer in women. The vaccine is: Recommended for girls and women ages 9 through 26. Given as 2 shots in girls ages 9 through 14, and as 3 shots in teens older than 14 years. Best for girls to get by age 11 or before becoming sexually active. However, girls and younger women who are already sexually active can still be protected by the vaccine if they've never been infected. These safer sex practices can also help reduce your risk of getting HPV and cervical cancer: Always use condoms. But be aware that condoms cannot fully protect you. This is because the virus or warts can also be on the nearby skin. Have only one sexual partner, whom you know is infection-free. Limit the number of sexual partners you have over time. DO NOT get involved with partners who take part in high-risk sexual activities. DO NOT smoke. Cigarette smoking increases the risk of getting cervical cancer. Pap Smears Cervical cancer often develops slowly. It starts as precancerous changes called dysplasia. Dysplasia can be detected by a medical test called a Pap smear. Dysplasia is fully treatable. That is why it is important for women to get regular Pap smears, so that precancerous cells can be removed before they can become cancer. Pap smear screening should start at age 21. After the first test: Women ages 21 through 29 should have a Pap smear every 3 years. HPV testing is not recommended for this age group. Women ages 30 through 65 should be screened with either a Pap smear every 3 years or the HPV test every 5 years. If you or your sexual partner has other new partners, you should have a Pap smear every 3 years. Women ages 65 through 70 can stop having Pap smears as long as they have had 3 normal tests within the past 10 years. Women who have been treated for precancer (cervical dysplasia) should continue to have Pap smears for 20 years after treatment or until age 65, whichever is longer. Talk with your provider about how often you should have a Pap smear or HPV test. Review Date 9/28/2017 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": "Cervical cancer usually develops slowly. It starts as precancerous changes called dysplasia, which can be detected by a test called a Pap smear. Dysplasia is fully treatable, and be detected with regular Pap smears, so that precancerous cells can removed before they become cancer. Pap smear screening should start at 21 and continue every three years. Women ages 30 through 65 should be screened with either a Pap smear every 3 years or a Pap smear and HPV test every 5 years. If you or your sexual partner has other new partners, you should have a Pap smear every 3 years. Women ages 65 through 70 can stop having Pap smears as long as they have had 3 normal tests within the past 10 years", "role": "assistant" } ]
[ { "content": "what are the causes of childhood obesity\n\nWhat causes Obesity?: Taking in more calories than your body burns can lead to obesity. This is because the body stores unused calories as fat. Obesity can be caused by: - Eating more food than your body can use - Drinking too much alcohol - Not getting enough exercise Many obese people who lose large amounts of weight and gain it back think it is their fault. They blame themselves for not having the willpower to keep the weight off. Many people regain more weight than they lost. Today, we know that biology is a big reason why some people cannot keep the weight off. Some people who live in the same place and eat the same foods become obese, while others do not. Our bodies have a complex system to keep our weight at a healthy level. In some people, this system does not work normally. The way we eat when we are children can affect the way we eat as adults. The way we eat over many years becomes a habit. It affects what we eat, when we eat, and how much we eat. We may feel that we are surrounded by things that make it easy to overeat and hard to stay active. - Many people feel they do not have time to plan and make healthy meals. - More people today work desk jobs compared to more active jobs in the past. - People with little free time may have less time to exercise. The term eating disorder means a group of medical conditions that have an unhealthy focus on eating, dieting, losing or gaining weight, and body image. A person may be obese, follow an unhealthy diet, and have an eating disorder all at the same time. Sometimes, medical problems or treatments cause weight gain, including: - Underactive thyroid (hypothyroidism) - Medicines such as birth control pills, antidepressants, and antipsychotics Other things that can cause weight gain are: - Quitting smoking. Many people who quit smoking gain 4 to 10 pounds in the first 6 months after quitting. - Stress, anxiety, feeling sad, or not sleeping well - Menopause. Women may gain 12 to 15 pounds during menopause. - Pregnancy. Women may not lose the weight they gained during pregnancy.", "role": "user" }, { "content": "Taking in more calories than your body burns can lead to obesity. This is because the body stores unused calories as fat. Obesity can be caused by eating more food than your body can use, drinking too much alcohol, or not getting enough exercise. Many obese people who lose large amounts of weight and gain it back think it is their fault. Our bodies have a complex system to keep our weight at a healthy level. In some people, this system does not work normally.", "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\nGastroparesis (Treatment): Treating gastroparesis begins with identifying and treating the underlying condition. If diabetes is causing your gastroparesis, your doctor can work with you to help you control it. Changes to your diet Maintaining adequate nutrition is the most important goal in the treatment of gastroparesis. Many people can manage gastroparesis with diet changes and dietary changes are the first step in managing this condition. Your doctor may refer you to a dietitian who can work with you to find foods that are easier for you to digest so that you're more likely to get enough calories and nutrients from the food you eat. A dietitian might suggest that you try to: - Eat smaller meals more frequently - Chew food thoroughly - Eat well-cooked fruits and vegetables rather than raw fruits and vegetables - Avoid fibrous fruits and vegetables, such as oranges and broccoli, which may cause bezoars - Choose mostly low-fat foods, but if you can tolerate them, add small servings of fatty foods to your diet - Try soups and pureed foods if liquids are easier for you to swallow - Drink about 34 to 51 ounces (1 to 1.5 liters) of water a day - Exercise gently after you eat, such as going for a walk - Avoid carbonated drinks, alcohol and smoking - Try to avoid lying down for 2 hours after a meal - Take a multivitamin daily Here's a brief list of foods recommended for people with gastroparesis (your dietitian can give you a more comprehensive list): - White bread and rolls and \"light\" whole-wheat bread without nuts or seeds - Plain or egg bagels - English muffins - Flour or corn tortillas - Pancakes - Puffed wheat and rice cereals - Cream of wheat or rice - White crackers - Potatoes, white or sweet (no skin) - Baked french fries - Rice - Pasta - Lean beef, veal and pork (not fried) - Chicken or turkey (no skin and not fried) - Crab, lobster, shrimp, clams, scallops, oysters - Tuna (packed in water) - Cottage cheese - Eggs - Tofu - Strained meat baby food - Baby food vegetables and fruits - Tomato sauce, paste, puree, juice - Carrots (cooked) - Beets (cooked) - Mushrooms (cooked) - Vegetable juice - Vegetable broth - Fruit juices and drinks - Applesauce - Bananas - Peaches and pears (canned) - Milk, if tolerated - Yogurt (without fruit pieces) - Custard and pudding - Frozen yogurt Medications Medications to treat gastroparesis may include: - Medications to stimulate the stomach muscles. These medications include metoclopramide (Reglan) and erythromycin (Eryc, E.E.S.). Metoclopramide has a risk of serious side effects. Erythromycin may lose its effectiveness over time, and can cause side effects, such as diarrhea. A newer medication, domperidone, with fewer side effects, is also available with restricted access. - Medications to control nausea and vomiting. Drugs that help ease nausea and vomiting include prochlorperazine (Compro) and diphenhydramine (Benadryl, Unisom). A class of medications that includes ondansetron (Zofran) is sometimes used to help nausea and vomiting. Surgical treatment Some people with gastroparesis may be unable to tolerate any food or liquids. In these situations, doctors may recommend a feeding tube (jejunostomy tube) be placed in the small intestine. Or doctors may recommend a gastric venting tube to help relieve pressure from gastric contents. Feeding tubes can be passed through your nose or mouth or directly into your small intestine through your skin. The tube is usually temporary and is only used when gastroparesis is severe or when blood sugar levels can't be controlled by any other method. Some people may require an IV (parenteral) feeding tube that goes directly into a vein in the chest. Treatments under investigation Researchers are continuing to investigate new medications to treat gastroparesis. One example is a new drug in development called relamorelin. The results of a phase 2 clinical trial found the drug could speed up gastric emptying and reduce vomiting. The drug is not yet approved by the Food and Drug Administration (FDA), but a larger clinical trial is currently underway. A number of new therapies are being tried with the help of endoscopy - a slender tube that's threaded down the esophagus. One procedure used endoscopy to place a small tube (stent) where the stomach connects to the small intestine (duodenum) to keep this connection open. Several research trials investigated the use of botulinum toxin administered through endoscopy without much success. This treatment is not recommended. Doctors are also studying the use of a minimally invasive surgical technique when someone needs a feeding tube placed directly into the small intestine (jejunostomy tube). Gastric electrical stimulation and pacing Gastric electrical stimulation is a surgically implanted device that provides electrical stimulation to stimulate stomach muscles to move food more efficiently. Study results have been mixed. However, the device seems to be most helpful for people with diabetic gastroparesis. The FDA allows the device to be used under a compassionate use exemption for those who can't control their gastroparesis symptoms with diet changes or medications. However, larger studies are needed. Gastric pacing also involves a surgically implanted device that stimulates the stomach muscles, but this device tries to more closely mimic normal stomach contractions. Currently, the device is too large and causes discomfort. Gastric pacing devices are only available in clinical trials right now.", "role": "user" }, { "content": "Treating gastroparesis begins with identifying and treating the underlying condition. If diabetes is causing your gastroparesis, your doctor can work with you to help you control it. Many people can manage gastroparesis with diet changes and dietary changes are the first step in managing this condition. ... Some people with gastroparesis may be unable to tolerate any food or liquids. In these situations, doctors may recommend a feeding tube (jejunostomy tube) be placed in the small intestine. Or doctors may recommend a gastric venting tube to help relieve pressure from gastric contents. Feeding tubes can be passed through your nose or mouth or directly into your small intestine through your skin. The tube is usually temporary and is only used when gastroparesis is severe or when blood sugar levels can't be controlled by any other method. Some people may require an IV (parenteral) feeding tube that goes directly into a vein in the chest. ... Researchers are continuing to investigate new medications to treat gastroparesis. One example is a new drug in development called relamorelin. The results of a phase 2 clinical trial found the drug could speed up gastric emptying and reduce vomiting. ... A number of new therapies are being tried with the help of endoscopy - a slender tube that's threaded down the esophagus. One procedure used endoscopy to place a small tube (stent) where the stomach connects to the small intestine (duodenum) to keep this connection open. ... Doctors are also studying the use of a minimally invasive surgical technique when someone needs a feeding tube placed directly into the small intestine (jejunostomy tube). Gastric electrical stimulation and pacing Gastric electrical stimulation is a surgically implanted device that provides electrical stimulation to stimulate stomach muscles to move food more efficiently. Study results have been mixed. However, the device seems to be most helpful for people with diabetic gastroparesis.", "role": "assistant" } ]
[ { "content": "what is the treatment for lymphoma\n\nWhat are the treatments for Primary lymphoma of the brain?: Primary lymphoma of the brain is usually first treated with corticosteroids to control swelling and improve symptoms. The main treatment is with chemotherapy. Younger patients may receive high-dose chemotherapy, followed by an autologous stem cell transplant. Radiation therapy of the whole brain may be done after chemotherapy. Boosting the immune system, such as in those with HIV, may also be tried.", "role": "user" }, { "content": "Primary lymphoma of the brain is usually first treated with corticosteroids to control swelling and improve symptoms. The main treatment is with chemotherapy. Younger patients may receive high-dose chemotherapy, followed by an autologous stem cell transplant. Radiation therapy of the whole brain may be done after chemotherapy. Boosting the immune system, such as in those with HIV, may also be tried.", "role": "assistant" } ]
[ { "content": "would you help me to fine article or jurnal about Cri du chat syndrome\n\n Cri du chat syndrome Cat cry syndrome 5p minus syndrome Chromosome 5p deletion syndrome Cat cry syndrome 5p minus syndrome Chromosome 5p deletion syndrome 5p- syndrome Monosomy 5p 5p deletion syndrome Chromosome 5p- syndrome See More Summary Cri du chat syndrome , also known as 5p- (5p minus) syndrome or cat cry syndrome, is a genetic condition that is caused by the deletion of genetic material on the small arm (the p arm) of . [1] [2] Infants with this condition often have a high-pitched cry that sounds like that of a cat. The disorder is characterized by intellectual disability and delayed development, small head size, low birth weight, weak muscle tone in infancy, and distinctive facial features. [2] While cri du chat syndrome is a genetic condition, most cases are not inherited . [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 80%-99% of people have these symptoms Cat cry cat-like cry 0200046 Epicanthus Eye folds Prominent eye folds 0000286 High pitched voice 0001620 Intellectual disability , severe Early and severe mental retardation Mental retardation, severe Severe mental retardation 0010864 Low-set, posteriorly rotated ears 0000368 Microcephaly Abnormally small skull Decreased circumference of cranium Decreased size of skull Reduced head circumference Small head circumference 0000252 Microretrognathia 0000308 Muscular hypotonia Low or weak muscle tone 0001252 Round face Circular face Round facial appearance Round facial shape 0000311 Severe global developmental delay 0011344 Wide nasal bridge Broad nasal bridge Broad nasal root Broadened nasal bridge Increased breadth of bridge of nose Increased breadth of nasal bridge Increased width of bridge of nose Increased width of nasal bridge Nasal bridge broad Wide bridge of nose Widened nasal bridge 0000431 30%-79% of people have these symptoms Downslanted palpebral fissures Downward slanting of the opening between the eyelids 0000494 High palate Elevated palate Increased palatal height 0000218 Hypertelorism Wide-set eyes Widely spaced eyes 0000316 Intrauterine growth retardation Prenatal growth deficiency Prenatal growth retardation 0001511 Scoliosis Abnormal curving of the spine 0002650 Short neck Decreased length of neck 0000470 Short stature Decreased body height Small stature 0004322 Small hand Disproportionately small hands 0200055 5%-29% of people have these symptoms Abnormality of bone mineral density 0004348 Abnormality of cardiovascular system morphology 0030680 Finger syndactyly 0006101 Inguinal hernia 0000023 Joint hyperflexibility Joints move beyond expected range of motion 0005692 Preauricular skin tag 0000384 Recurrent fractures Increased fracture rate Increased fractures Multiple fractures Multiple spontaneous fractures Varying degree of multiple fractures 0002757 Percent of people who have these symptoms is not available through HPO Abnormality of the kidney Abnormal kidney 0000077 Abnormality of the pinna Abnormally shaped ears Auricular malformation Deformed ears Malformed ears Simple ears 0000377 Aggressive behavior Aggression Aggressive behaviour Aggressiveness 0000718 Anterior open-bite malocclusion Absence of overlap of anterior upper and lower teeth Gap between upper and lower front teeth when biting 0009102 Anxiety Excessive, persistent worry and fear 0000739 Autism 0000717 Bifid uvula 0000193 Cataract Clouding of the lens of the eye Cloudy lens 0000518 Conspicuously happy disposition 0100024 Cryptorchidism Undescended testes Undescended testis 0000028 Delayed speech and language development Deficiency of speech development Delayed language development Delayed speech Delayed speech acquisition Delayed speech development Impaired speech and language development Impaired speech development Language delay Language delayed Language development deficit Late-onset speech development Poor language development Speech and language delay Speech and language difficulties Speech delay 0000750 Diastasis recti Gap between large left and right abdominal muscles 0001540 Difficulty walking Difficulty in walking 0002355 Downturned corners of mouth Downturned corners of the mouth Downturned mouth 0002714 Echolalia 0010529 Facial asymmetry Asymmetry of face Crooked face Unsymmetrical face 0000324 Facial grimacing 0000273 Feeding difficulties in infancy 0008872 Functional respiratory abnormality 0002795 Gastroesophageal reflux Acid reflux Acid reflux disease Heartburn 0002020 Growth delay Delayed growth Growth deficiency Growth failure Growth retardation Poor growth Retarded growth 0001510 Hearing impairment Deafness Hearing defect 0000365 High axial triradius 0001042 Hyperactivity More active than typical 0000752 Hyperacusis 0010780 Hypertonia 0001276 Hypospadias 0000047 Intellectual disability Mental deficiency Mental retardation Mental retardation, nonspecific Mental-retardation 0001249 Long face Elongation of face Increased height of face Increased length of face Vertical elongation of face Vertical enlargement of face Vertical overgrowth of face 0000276 Low-set ears Low set ears Lowset ears 0000369 Metatarsus adductus Front half of foot turns inward 0001840 Myopia Close sighted Near sighted Near sightedness Nearsightedness 0000545 Narrow face Decreased breadth of face Decreased width of face 0000275 Neonatal hypotonia Low muscle tone, in neonatal onset 0001319 Oppositional defiant disorder 0010865 Optic atrophy 0000648 Oral cleft Cleft of the mouth 0000202 Overfriendliness 0100025 Pes planus Flat feet Flat foot 0001763 Premature graying of hair Early graying Premature graying Premature greying Premature hair graying 0002216 Prominent supraorbital ridges Prominent brow 0000336 Recurrent infections in infancy and early childhood 0005437 Self-mutilation Deliberate self-harm Self mutilation 0000742 Short attention span Poor attention span Problem paying attention 0000736 Short metacarpal Shortened long bone of hand 0010049 Short metatarsal Short long bone of foot 0010743 Short philtrum 0000322 Single transverse palmar crease 0000954 Small for gestational age Birth weight less than 10th percentile Low birth weight 0001518 Sporadic No previous family history 0003745 Stenosis of the external auditory canal Narrowing of passageway from outer ear to middle ear 0000402 Stereotypy Repetitive movements Repetitive or self-injurious behavior 0000733 Strabismus Cross-eyed Squint Squint eyes 0000486 Syndactyly Webbed fingers or toes 0001159 Thick lower lip vermilion Increased volume of lower lip Plump lower lip Prominent lower lip 0000179 Showing of Cause Cri du chat syndrome is caused by a deletion of the end of the short (p) arm of chromosome 5This chromosomal change is written as 5p-. The size of the deletion varies among affected individuals but studies suggest that larger deletions tend to result in more severe intellectual disability and developmental delay than smaller deletions.[2] The signs and symptoms of cri du chat syndrome are probably related to the loss of multiple genes on the short arm of chromosome 5. Researchers believe that the loss of a specific gene, CTNND2, is associated with severe intellectual disability in some people with this condition. They are working to determine how the loss of other genes in this region contributes to the characteristic features of cri du chat syndrome.[2] Inheritance Most cases of cri du chat syndrome are not inherited . The deletion occurs most often as a random event during the formation of reproductive cells (eggs or sperm) or in early fetal development. Most affected individuals do not have a history of the disorder in their family. [2] About 10 percent of people with cri du chat syndrome inherit the chromosome abnormality from an unaffected parent. In these cases, the parent carries a chromosomal rearrangement called a balanced translocation , in which no genetic material is gained or lost. Balanced translocations usually do not cause any health problems; however, they can become unbalanced as they are passed to the next generation. Children who inherit an unbalanced translocation can have a chromosomal rearrangement with extra or missing genetic material. Individuals with cri du chat syndrome who inherit an unbalanced translocation are missing genetic material from the short arm of chromosome 5. This results in the intellectual disability and other health problems characteristic of the disorder. [2] 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 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. Treatment While there is no specific treatment available for cri du chat syndrome , early intervention is recommended in the areas of physical therapy (achieving physical and motor milestones such as sitting and standing up), communication (speech therapy, sign language instruction), behavioral modification (for hyperactivity, short attention span, aggression), and learning (special education). [3] Because symptoms may vary from individual to individual, we recommend discussing these options with a health care professional to develop a personalized plan for therapy. Prognosis Most individuals with cri du chat syndrome have a normal life expectancy. A small number of children with this condition are born with serious organ defects and other life-threatening medical problems. These children may have a worse prognosis . [1] In these cases, it is best to obtain information about prognosis from the affected person's physician. General information about prognosis for cri du chat syndrome can be accessed through Medscape Reference. 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": "While there is no specific treatment available for cri du chat syndrome, early intervention is recommended in the areas of physical therapy (achieving physical and motor milestones such as sitting and standing up), communication (speech therapy, sign language instruction), behavioral modification (for hyperactivity, short attention span, aggression), and learning (special education).", "role": "assistant" } ]
[ { "content": "abetalipoproteimemia hi, I would like to know if there is any support for those suffering with abetalipoproteinemia? I am not diagnosed but have had many test that indicate I am suffering with this, keen to learn how to get it diagnosed and how to manage, many thanks\n\nabetalipoproteinemia: Abetalipoproteinemia is an inherited disorder that affects the absorption of dietary fats, cholesterol, and fat-soluble vitamins. People affected by this disorder are not able to make certain lipoproteins, which are particles that carry fats and fat-like substances (such as cholesterol) in the blood. Specifically, people with abetalipoproteinemia are missing a group of lipoproteins called beta-lipoproteins. An inability to make beta-lipoproteins causes severely reduced absorption (malabsorption) of dietary fats and fat-soluble vitamins (vitamins A, D, E, and K) from the digestive tract into the bloodstream. Sufficient levels of fats, cholesterol, and vitamins are necessary for normal growth, development, and maintenance of the body's cells and tissues, particularly nerve cells and tissues in the eye. The signs and symptoms of abetalipoproteinemia appear in the first few months of life. They can include failure to gain weight and grow at the expected rate (failure to thrive); diarrhea; abnormal star-shaped red blood cells (acanthocytosis); and fatty, foul-smelling stools (steatorrhea). Other features of this disorder may develop later in childhood and often impair the function of the nervous system. Disturbances in nerve function may cause affected people to eventually develop poor muscle coordination and difficulty with balance and movement (ataxia). Individuals with this condition may also develop an eye disorder called retinitis pigmentosa, in which progressive degeneration of the light-sensitive layer (retina) at the back of the eye can cause vision loss. Adults in their thirties or forties may have increasing difficulty with balance and walking. Many of the signs and symptoms of abetalipoproteinemia result from a severe vitamin deficiency, especially a deficiency of vitamin E. Abetalipoproteinemia is a rare disorder with approximately 100 cases described worldwide. Mutations in the MTTP gene cause abetalipoproteinemia. The MTTP gene provides instructions for making a protein called microsomal triglyceride transfer protein, which is essential for creating beta-lipoproteins. These lipoproteins are necessary for the absorption of fats, cholesterol, and fat-soluble vitamins from the diet and the efficient transport of these substances in the bloodstream. Most of the mutations in the MTTP gene lead to the production of an abnormally short microsomal triglyceride transfer protein, which prevents the normal creation of beta-lipoproteins in the body. A lack of beta-lipoproteins causes the nutritional and neurological problems seen in people with abetalipoproteinemia. 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. Berriot-Varoqueaux N, Aggerbeck LP, Samson-Bouma M, Wetterau JR. The role of the microsomal triglygeride transfer protein in abetalipoproteinemia. Annu Rev Nutr. 2000;20:663-97. Review.", "role": "user" }, { "content": "people with abetalipoproteinemia are missing a group of lipoproteins called beta-lipoproteins. An inability to make beta-lipoproteins causes severely reduced absorption (malabsorption) of dietary fats and fat-soluble vitamins (vitamins A, D, E, and K) from the digestive tract into the bloodstream. Sufficient levels of fats, cholesterol, and vitamins are necessary for normal growth, development, and maintenance of the body's cells and tissues, particularly nerve cells and tissues in the eye.", "role": "assistant" } ]
[ { "content": "what are the risk factors of type ii diabetes\n\nRisk Factors for Type 2 Diabetes: You can take steps to help prevent or delay type 2 diabetes by losing weight if you are overweight, eating fewer calories, and being more physically active. Talk with your health care professional about any of the health conditions listed above that may require medical treatment. Managing these health problems may help reduce your chances of developing type 2 diabetes. Also, ask your health care professional about any medicines you take that might increase your risk.", "role": "user" }, { "content": "You can take steps to help prevent or delay type 2 diabetes by losing weight if you are overweight, eating fewer calories, and being more physically active. Talk with your health care professional about any of the health conditions listed above that may require medical treatment. Managing these health problems may help reduce your chances of developing type 2 diabetes. Also, ask your health care professional about any medicines you take that might increase your risk.", "role": "assistant" } ]
[ { "content": "what are the causes of pulmonary hypertension\n\nPulmonary Hypertension (Types): The World Health Organization divides pulmonary hypertension (PH) into five groups. These groups are organized based on the cause of the condition. In all groups, the average pressure in the pulmonary arteries is higher than 25 mmHg at rest or 30 mmHg during physical activity. The pressure in normal pulmonary arteries is 8–20 mmHg at rest. (Note that group 1 is called pulmonary arterial hypertension (PAH) and groups 2 through 5 are called pulmonary hypertension. However, together all groups are called pulmonary hypertension.) Group 1 Pulmonary Arterial Hypertension Group 1 PAH includes: PAH that has no known cause. PAH that's inherited (passed from parents to children through genes). PAH that's caused by drugs or toxins, such as street drugs and certain diet medicines. PAH that's caused by conditions such as: - Connective tissue diseases. (Connective tissue helps support all parts of your body, including your skin, eyes, and heart.) - HIV infection. - Liver disease. - Congenital heart disease. This is heart disease that's present at birth. - Sickle cell disease. - Schistosomiasis (SKIS-toe-so-MI-ah-sis). This is an infection caused by a parasite. Schistosomiasis is one of the most common causes of PAH in many parts of the world. Connective tissue diseases. (Connective tissue helps support all parts of your body, including your skin, eyes, and heart.) HIV infection. Liver disease. Congenital heart disease. This is heart disease that's present at birth. Sickle cell disease. Schistosomiasis (SKIS-toe-so-MI-ah-sis). This is an infection caused by a parasite. Schistosomiasis is one of the most common causes of PAH in many parts of the world. PAH that's caused by conditions that affect the veins and small blood vessels of the lungs. Group 2 Pulmonary Hypertension Group 2 includes PH with left heart disease. Conditions that affect the left side of the heart, such as mitral valve disease or long-term high blood pressure, can cause left heart disease and PH. Left heart disease is likely the most common cause of PH. Group 3 Pulmonary Hypertension Group 3 includes PH associated with lung diseases, such as COPD (chronic obstructive pulmonary disease) and interstitial (IN-ter-STISH-al) lung diseases. Interstitial lung diseases cause scarring of the lung tissue. Group 3 also includes PH associated with sleep-related breathing disorders, such as sleep apnea. Group 4 Pulmonary Hypertension Group 4 includes PH caused by blood clots in the lungs or blood clotting disorders. Group 5 Pulmonary Hypertension Group 5 includes PH caused by various other diseases or conditions. Examples include: Blood disorders, such as polycythemia vera (POL-e-si-THE-me-ah VAY-rah or VE-rah) and essential thrombocythemia (THROM-bo-si-THE-me-ah). Systemic disorders, such as sarcoidosis (sar-koy-DO-sis) and vasculitis (vas-kyu-LI-tis). Systemic disorders involve many of the body's organs. Metabolic disorders, such as thyroid disease and glycogen storage disease. (In glycogen storage disease, the body's cells don't use a form of glucose (sugar) properly.) Other conditions, such as tumors that press on the pulmonary arteries and kidney disease.", "role": "user" }, { "content": "The World Health Organization divides pulmonary hypertension (PH) into five groups. These groups are organized based on the cause of the condition. In all groups, the average pressure in the pulmonary arteries is higher than 25 mmHg at rest or 30 mmHg during physical activity. The pressure in normal pulmonary arteries is 8?20 mmHg at rest. Group 1 Pulmonary Arterial Hypertension Group 1 PAH includes: PAH that has no known cause. PAH that's inherited. PAH that's caused by drugs or toxins, such as street drugs and certain diet medicines. PAH that's caused by conditions such as: - Connective tissue diseases. - HIV infection. - Liver disease. - Congenital heart disease. Connective tissue diseases. Liver disease. Congenital heart disease. Group 2 Pulmonary Hypertension Group 2 includes PH with left heart disease. Conditions that affect the left side of the heart, such as mitral valve disease or long-term high blood pressure, can cause left heart disease and PH. Left heart disease is likely the most common cause of PH. Group 3 Pulmonary Hypertension Group 3 includes PH associated with lung diseases, such as COPD (chronic obstructive pulmonary disease) and interstitial (IN-ter-STISH-al) lung diseases. Interstitial lung diseases cause scarring of the lung tissue. Group 3 also includes PH associated with sleep-related breathing disorders, such as sleep apnea. Group 4 Pulmonary Hypertension Group 4 includes PH caused by blood clots in the lungs or blood clotting disorders. Group 5 Pulmonary Hypertension Group 5 includes PH caused by various other diseases or conditions.", "role": "assistant" } ]
[ { "content": "know more about My Daughter have Distal renal tubular acidosis. we are from Mexico, and we ae woundering if can send to us more infomation. maybe you can reccommend to us a association???? i don?t know\n\n SLC4A1-associated distal renal tubular acidosis classic distal renal tubular acidosis renal tubular acidosis type I RTA, classic type Description SLC4A1-associated distal renal tubular acidosis is a kidney (renal) disorder that sometimes includes blood cell abnormalities. The kidneys normally filter fluid and waste products from the body and remove them in urine; however, in people with distal renal tubular acidosis, the kidneys are unable to remove enough acid from the body, and the blood becomes too acidic. This chemical imbalance is called metabolic acidosis. The inability to remove acids from the body often results in slowed growth and may also lead to softening and weakening of the bones, called rickets in children and osteomalacia in adults. This bone disorder is characterized by bone pain, bowed legs, and difficulty walking. In addition, most children and adults with SLC4A1-associated distal renal tubular acidosis have excess calcium in the urine (hypercalciuria), calcium deposits in the kidneys (nephrocalcinosis), and kidney stones (nephrolithiasis). In rare cases, these kidney abnormalities lead to life-threatening kidney failure. Affected individuals may also have low levels of potassium in the blood (hypokalemia). Individuals with the features described above have complete distal renal tubular acidosis, which usually becomes apparent in childhood. Some people do not develop metabolic acidosis even though their kidneys have trouble removing acids; these individuals are said to have incomplete distal renal tubular acidosis. Additionally, these individuals may have other features of distal renal tubular acidosis, such as bone problems and kidney stones. Often, people who initially have incomplete distal renal tubular acidosis develop metabolic acidosis later in life. Some people with SLC4A1-associated distal renal tubular acidosis also have blood cell abnormalities. These can vary in severity from no symptoms to a condition called hemolytic anemia, in which red blood cells prematurely break down (undergo hemolysis), causing a shortage of red blood cells (anemia). Hemolytic anemia can lead to unusually pale skin (pallor), extreme tiredness (fatigue), shortness of breath (dyspnea), and an enlarged spleen (splenomegaly). There are two forms of SLC4A1-associated distal renal tubular acidosis; they are distinguished by their inheritance pattern. The autosomal dominant form is more common and is usually less severe than the autosomal recessive form. The autosomal dominant form can be associated with incomplete or complete distal renal tubular acidosis and is rarely associated with blood cell abnormalities. The autosomal recessive form is always associated with complete distal renal tubular acidosis and is more commonly associated with blood cell abnormalities, although not everyone with this form has abnormal blood cells. Frequency The prevalence of SLC4A1-associated distal renal tubular acidosis is unknown. The condition is most common in Southeast Asia, especially Thailand. Causes Both the autosomal dominant and autosomal recessive forms of SLC4A1-associated distal renal tubular acidosis are caused by mutations in the SLC4A1 gene. This gene provides instructions for making the anion exchanger 1 (AE1) protein, which transports negatively charged atoms (anions) across cell membranes. Specifically, AE1 exchanges negatively charged atoms of chlorine (chloride ions) for negatively charged bicarbonate molecules (bicarbonate ions). The AE1 protein is found in the cell membrane of kidney cells and red blood cells. In kidney cells, the exchange of bicarbonate through AE1 allows acid to be released from the cell into the urine. In red blood cells, AE1 attaches to other proteins that make up the structural framework (the cytoskeleton) of the cells, helping to maintain their structure. The SLC4A1 gene mutations involved in either form of SLC4A1-associated distal renal tubular acidosis lead to production of altered AE1 proteins that cannot get to the correct location in the cell membrane. In the autosomal dominant form of the condition, gene mutations affect only one copy of the SLC4A1 gene, and normal AE1 protein is produced from the other copy. However, the altered protein attaches to the normal protein and keeps it from getting to the correct location, leading to a severe reduction or absence of AE1 protein in the cell membrane. In autosomal recessive distal renal tubular acidosis, both copies of the SLC4A1 gene are mutated, so all of the protein produced from this gene is altered and not able to get to the correct location. Improper location or absence of AE1 in kidney cell membranes disrupts bicarbonate exchange, and as a result, acid cannot be released into the urine. Instead, the acid builds up in the blood in most affected individuals, leading to metabolic acidosis and the other features of complete distal renal tubular acidosis. It is not clear why some people develop metabolic acidosis and others do not. Researchers suggest that in individuals with incomplete distal renal tubular acidosis, another mechanism is able to help regulate blood acidity (pH) and keep metabolic acidosis from developing. In red blood cells, interaction with a protein called glycophorin A can often help the altered AE1 protein get to the cell membrane where it can perform its function, which explains why most people with SLC4A1-associated distal renal tubular acidosis do not have blood cell abnormalities. However, some altered AE1 proteins cannot be helped by glycophorin A and are not found in the cell membrane. Without AE1, the red blood cells are unstable; breakdown of these abnormal red blood cells may lead to hemolytic anemia. Some people have nonhereditary forms of distal renal tubular acidosis; these forms can be caused by immune system problems or other conditions that damage the kidneys. These individuals often have additional signs and symptoms related to the original condition. Inheritance Pattern SLC4A1-associated distal renal tubular acidosis can have different patterns of inheritance. It is usually inherited in an autosomal dominant pattern, which means one copy of the altered SLC4A1 gene in each cell is sufficient to cause the disorder. In most cases, an affected person inherits the mutation from one affected parent. Other cases result from new mutations in the gene and occur in people with no history of the disorder in their family. Less commonly, SLC4A1-associated distal renal tubular acidosis has an autosomal recessive pattern of inheritance, which means a mutation must occur in both copies of the SLC4A1 gene for the condition to develop. This pattern occurs with certain types of SLC4A1 gene 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 Alper SL. Molecular physiology and genetics of Na+-independent SLC4 anion exchangers. J Exp Biol. 2009 Jun;212(Pt 11):1672-83. doi: 10.1242/jeb.029454. Review. ", "role": "user" }, { "content": "SLC4A1-associated distal renal tubular acidosis is a kidney (renal) disorder that sometimes includes blood cell abnormalities. The kidneys normally filter fluid and waste products from the body and remove them in urine; however, in people with distal renal tubular acidosis, the kidneys are unable to remove enough acid from the body, and the blood becomes too acidic. This chemical imbalance is called metabolic acidosis. The inability to remove acids from the body often results in slowed growth and may also lead to softening and weakening of the bones, called rickets in children and osteomalacia in adults. This bone disorder is characterized by bone pain, bowed legs, and difficulty walking. In addition, most children and adults with SLC4A1-associated distal renal tubular acidosis have excess calcium in the urine (hypercalciuria), calcium deposits in the kidneys (nephrocalcinosis), and kidney stones (nephrolithiasis). In rare cases, these kidney abnormalities lead to life-threatening kidney failure. Affected individuals may also have low levels of potassium in the blood (hypokalemia). Individuals with the features described above have complete distal renal tubular acidosis, which usually becomes apparent in childhood. Some people do not develop metabolic acidosis even though their kidneys have trouble removing acids; these individuals are said to have incomplete distal renal tubular acidosis. Additionally, these individuals may have other features of distal renal tubular acidosis, such as bone problems and kidney stones. Often, people who initially have incomplete distal renal tubular acidosis develop metabolic acidosis later in life. Some people with SLC4A1-associated distal renal tubular acidosis also have blood cell abnormalities. These can vary in severity from no symptoms to a condition called hemolytic anemia, in which red blood cells prematurely break down (undergo hemolysis), causing a shortage of red blood cells (anemia). Hemolytic anemia can lead to unusually pale skin (pallor), extreme tiredness (fatigue), shortness of breath (dyspnea), and an enlarged spleen (splenomegaly). There are two forms of SLC4A1-associated distal renal tubular acidosis; they are distinguished by their inheritance pattern. The autosomal dominant form is more common and is usually less severe than the autosomal recessive form. The autosomal dominant form can be associated with incomplete or complete distal renal tubular acidosis and is rarely associated with blood cell abnormalities. The autosomal recessive form is always associated with complete distal renal tubular acidosis and is more commonly associated with blood cell abnormalities, although not everyone with this form has abnormal blood cells.", "role": "assistant" } ]
[ { "content": "what can cause hypoglycemia\n\nHypoglycemia (Causes): Hypoglycemia occurs when your blood sugar (glucose) level falls too low. There are several reasons why this may happen, the most common is a side effect of drugs used to treat diabetes. Blood sugar regulation But to understand how hypoglycemia happens, it helps to know how your body normally processes blood sugar. When you eat, your body breaks down carbohydrates from foods - such as bread, rice, pasta, vegetables, fruit and milk products - into various sugar molecules, including glucose. Glucose is the main energy source for your body, but it can't enter the cells of most of your tissues without the help of insulin - a hormone secreted by your pancreas. When glucose levels rise, certain cells (beta cells) in your pancreas release insulin. This allows glucose to enter the cells and provide the fuel your cells need to function properly. Any extra glucose is stored in your liver and muscles in the form of glycogen. If you haven't eaten for several hours and your blood sugar level drops, another hormone from your pancreas called glucagon signals your liver to break down the stored glycogen and release glucose back into your bloodstream. This keeps your blood sugar level within a normal range until you eat again. Aside from your liver breaking down glycogen into glucose, your body also has the ability to manufacture glucose. This process occurs primarily in your liver, but also in your kidneys. Possible causes, with diabetes People with diabetes may not make enough insulin (type 1 diabetes) or may be less responsive to it (type 2 diabetes). As a result, glucose tends to build up in the bloodstream and may reach dangerously high levels. To correct this problem, someone with diabetes may take insulin or other drugs to lower blood sugar levels. But too much insulin or other diabetes medications may cause your blood sugar level to drop too low, causing hypoglycemia. Hypoglycemia may also happen if you don't eat as much food as usual after taking diabetes medication, or if you exercise more than you normally would. Possible causes, without diabetes Hypoglycemia in people without diabetes is much less common. Causes may include the following: - Medications. Taking someone else's oral diabetes medication accidentally is a possible cause of hypoglycemia. Other medications may cause hypoglycemia, especially in children or in people with kidney failure. One example is quinine (Qualaquin), which is used to treat malaria. - Excessive alcohol consumption. Drinking heavily without eating can block your liver from releasing stored glucose into your bloodstream, causing hypoglycemia. - Some critical illnesses. Severe illnesses of the liver, such as severe hepatitis, can cause hypoglycemia. Disorders of the kidney, which can keep your body from properly excreting medications, can affect glucose levels due to a buildup of those medications. Long-term starvation, as may occur in the eating disorder anorexia nervosa, can result in the depletion of substances your body needs to generate glucose (gluconeogenesis), causing hypoglycemia. - Insulin overproduction. A rare tumor of the pancreas (insulinoma) may cause overproduction of insulin, resulting in hypoglycemia. Other tumors may result in excessive production of insulin-like substances. Enlargement of beta cells of the pancreas that produce insulin (nesidioblastosis) may result in excessive insulin release, causing hypoglycemia. - Hormone deficiencies. Certain disorders of the adrenal glands and the pituitary gland can result in a deficiency of key hormones that regulate glucose production. Children may experience hypoglycemia if they have a deficiency of growth hormone. Hypoglycemia after meals Hypoglycemia usually occurs when you haven't eaten (when you're in a fasting state), but that's not always the case. Sometimes hypoglycemia occurs after meals because the body produces more insulin than is needed. This type of hypoglycemia, called reactive or postprandial hypoglycemia, may occur in people who have had stomach surgery. It may also occur in people who haven't had this surgery.", "role": "user" }, { "content": "Hypoglycemia occurs when your blood sugar (glucose) level falls too low. There are several reasons why this may happen, the most common is a side effect of drugs used to treat diabetes. Other possible causes of hypoglycemia include not eating enough food as usual after taking diabetes medication, or exercising more than you usually would. If you don't have diabetes, hypoglycemia can be caused by accidentally taking someone else's oral diabetes medication, excessive alcohol consumption, other medications, or some illnesses such as cancer or kidney disorders.", "role": "assistant" } ]
[ { "content": "what the treatment for bronchitis\n\n Bronchitis Overview Bronchitis is an inflammation of the lining of your bronchial tubes, which carry air to and from your lungs. People who have bronchitis often cough up thickened mucus, which can be discolored. Bronchitis may be either acute or chronic. Often developing from a cold or other respiratory infection, acute bronchitis is very common. Chronic bronchitis, a more serious condition, is a constant irritation or inflammation of the lining of the bronchial tubes, often due to smoking. Acute bronchitis, also called a chest cold, usually improves within a week to 10 days without lasting effects, although the cough may linger for weeks. However, if you have repeated bouts of bronchitis, you may have chronic bronchitis, which requires medical attention. Chronic bronchitis is one of the conditions included in chronic obstructive pulmonary disease (COPD). Symptoms For either acute bronchitis or chronic bronchitis, signs and symptoms may include: - Cough - Production of mucus (sputum), which can be clear, white, yellowish-gray or green in color - rarely, it may be streaked with blood - Fatigue - Shortness of breath - Slight fever and chills - Chest discomfort If you have acute bronchitis, you might have cold symptoms, such as a mild headache or body aches. While these symptoms usually improve in about a week, you may have a nagging cough that lingers for several weeks. Chronic bronchitis is defined as a productive cough that lasts at least three months, with recurring bouts occurring for at least two consecutive years. If you have chronic bronchitis, you're likely to have periods when your cough or other symptoms worsen. At those times, you may have an acute infection on top of chronic bronchitis. See your doctor if your cough: - Lasts more than three weeks - Prevents you from sleeping - Is accompanied by fever higher than 100.4 F (38 C) - Produces discolored mucus - Produces blood - Is associated with wheezing or shortness of breath Causes Acute bronchitis is usually caused by viruses, typically the same viruses that cause colds and flu (influenza). Antibiotics don't kill viruses, so this type of medication isn't useful in most cases of bronchitis. The most common cause of chronic bronchitis is cigarette smoking. Air pollution and dust or toxic gases in the environment or workplace also can contribute to the condition. Risk factors Factors that increase your risk of bronchitis include: - Cigarette smoke. People who smoke or who live with a smoker are at higher risk of both acute bronchitis and chronic bronchitis. - Low resistance. This may result from another acute illness, such as a cold, or from a chronic condition that compromises your immune system. Older adults, infants and young children have greater vulnerability to infection. - Exposure to irritants on the job. Your risk of developing bronchitis is greater if you work around certain lung irritants, such as grains or textiles, or are exposed to chemical fumes. - Gastric reflux. Repeated bouts of severe heartburn can irritate your throat and make you more prone to developing bronchitis. Complications Although a single episode of bronchitis usually isn't cause for concern, it can lead to pneumonia in some people. Repeated bouts of bronchitis, however, may mean that you have chronic obstructive pulmonary disease (COPD). Diagnosis During the first few days of illness, it can be difficult to distinguish the signs and symptoms of bronchitis from those of a common cold. During the physical exam, your doctor will use a stethoscope to listen closely to your lungs as you breathe. In some cases, your doctor may suggest the following tests: - Chest X-ray. A chest X-ray can help determine if you have pneumonia or another condition that may explain your cough. This is especially important if you ever were or currently are a smoker. - Sputum tests. Sputum is the mucus that you cough up from your lungs. It can be tested to see if you have illnesses that could be helped by antibiotics. Sputum can also be tested for signs of allergies. - Pulmonary function test. During a pulmonary function test, you blow into a device called a spirometer, which measures how much air your lungs can hold and how quickly you can get air out of your lungs. This test checks for signs of asthma or emphysema. Treatment Most cases of acute bronchitis get better without treatment, usually within a couple of weeks. Medications Because most cases of bronchitis are caused by viral infections, antibiotics aren't effective. However, if your doctor suspects that you have a bacterial infection, he or she may prescribe an antibiotic. In some circumstances, your doctor may recommend other medications, including: - Cough medicine. If your cough keeps you from sleeping, you might try cough suppressants at bedtime. - Other medications. If you have allergies, asthma or chronic obstructive pulmonary disease (COPD), your doctor may recommend an inhaler and other medications to reduce inflammation and open narrowed passages in your lungs. Therapies If you have chronic bronchitis, you may benefit from pulmonary rehabilitation - a breathing exercise program in which a respiratory therapist teaches you how to breathe more easily and increase your ability to exercise. Lifestyle and home remedies To help you feel better, you may want to try the following self-care measures: - Avoid lung irritants. Don't smoke. Wear a mask when the air is polluted or if you're exposed to irritants, such as paint or household cleaners with strong fumes. - Use a humidifier. Warm, moist air helps relieve coughs and loosens mucus in your airways. But be sure to clean the humidifier according to the manufacturer's recommendations to avoid the growth of bacteria and fungi in the water container. - Consider a face mask outside. If cold air aggravates your cough and causes shortness of breath, put on a cold-air face mask before you go outside. ", "role": "user" }, { "content": "Most cases of acute bronchitis get better without treatment, usually within a couple of weeks. ... Because most cases of bronchitis are caused by viral infections, antibiotics aren't effective. However, if your doctor suspects that you have a bacterial infection, he or she may prescribe an antibiotic. In some circumstances, your doctor may recommend other medications, including: - Cough medicine. If your cough keeps you from sleeping, you might try cough suppressants at bedtime. - Other medications. If you have allergies, asthma or chronic obstructive pulmonary disease (COPD), your doctor may recommend an inhaler and other medications to reduce inflammation and open narrowed passages in your lungs. Therapies If you have chronic bronchitis, you may benefit from pulmonary rehabilitation - a breathing exercise program in which a respiratory therapist teaches you how to breathe more easily and increase your ability to exercise. To help you feel better, you may want to try the following self-care measures: - Avoid lung irritants. Don't smoke. Wear a mask when the air is polluted or if you're exposed to irritants, such as paint or household cleaners with strong fumes. - Use a humidifier. Warm, moist air helps relieve coughs and loosens mucus in your airways. But be sure to clean the humidifier according to the manufacturer's recommendations to avoid the growth of bacteria and fungi in the water container. - Consider a face mask outside. If cold air aggravates your cough and causes shortness of breath, put on a cold-air face mask before you go outside.", "role": "assistant" } ]
[ { "content": "Is optic atrophy ginetic and what cause it?\n\n Optic atrophy type 1 ADOA autosomal dominant optic atrophy autosomal dominant optic atrophy Kjer type DOA dominant optic atrophy Kjer type optic atrophy Kjer's optic atrophy optic atrophy, autosomal dominant optic atrophy, hereditary, autosomal dominant optic atrophy, juvenile optic atrophy, Kjer type Description Optic atrophy type 1 is a condition that often causes slowly worsening vision, usually beginning in childhood. People with optic atrophy type 1 typically experience a narrowing of their field of vision (tunnel vision). Affected individuals gradually lose their sight as their field of vision becomes smaller. Both eyes are usually affected equally, but the severity of the vision loss varies widely, even among affected members of the same family, ranging from nearly normal vision to complete blindness. In addition to vision loss, people with optic atrophy type 1 frequently have problems with color vision (color vision deficiency) that make it difficult or impossible to distinguish between shades of blue and green. In the early stages of the condition, individuals with optic atrophy type 1 experience a progressive loss of certain cells within the retina, which is a specialized light-sensitive tissue that lines the back of the eye. The loss of these cells (known as retinal ganglion cells) is followed by the degeneration (atrophy) of the nerves that relay visual information from the eye to the brain (optic nerves), which results in further vision loss. Atrophy causes these nerves to have an abnormally pale appearance (pallor), which can be seen during an eye examination. Frequency Optic atrophy type 1 is estimated to affect 1 in 35,000 people worldwide. This condition is more common in Denmark, where it affects approximately 1 in 10,000 people. Causes Optic atrophy type 1 is caused by mutations in the OPA1 gene. The protein produced from this gene is made in cells and tissues throughout the body. The OPA1 protein is found within mitochondria, which are the energy-producing centers of cells. The protein plays a key role in the organization of the shape and structure of the mitochondria and in controlled cell death (apoptosis). The OPA1 protein is also involved in a process called oxidative phosphorylation, from which cells derive much of their energy. Additionally, the protein plays a role in the maintenance of the DNA within mitochondria, called mitochondrial DNA (mtDNA). Mutations in the OPA1 gene lead to problems with mitochondrial function. The mitochondria become misshapen and disorganized and have reduced energy-producing capabilities. The maintenance of mtDNA may also be impaired, resulting in mtDNA mutations that further interfere with mitochondrial energy production. Cells that contain these poorly functioning mitochondria are more susceptible to apoptosis. In particular, cells that have high energy demands, such as retinal ganglion cells, die over time. Specialized extensions of retinal ganglion cells, called axons, form the optic nerves, so when retinal ganglion cells die, the optic nerves atrophy and cannot transmit visual information to the brain. Inheritance Pattern This condition is inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to cause the disorder. In most cases, an affected person inherits the mutation from one affected parent. Other cases result from new mutations in the gene and occur in people with no history of the disorder in their family. In rare cases, people who have an OPA1 gene mutation do not develop optic atrophy type 1, a situation known as reduced penetrance. Sources for This Page Delettre-Cribaillet C, Hamel CP, Lenaers G. Optic Atrophy Type 1. 2007 Jul 13 [updated 2015 Nov 12]. In: Pagon RA, Adam MP, Ardinger HH, Wallace SE, Amemiya A, Bean LJH, Bird TD, Ledbetter N, Mefford HC, Smith RJH, Stephens K, editors. GeneReviews [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2017. Available from http://www.ncbi.nlm.nih.gov/books/NBK1248/ ", "role": "user" }, { "content": "Optic atrophy type 1 is caused by mutations in the OPA1 gene. Mutations in the OPA1 gene lead to problems with mitochondrial function, which causes optic nerve atrophy and disruptions in transmitting visual information to the brain. This condition is inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to cause the disorder. In most cases, an affected person inherits the mutation from one affected parent. Other cases result from new mutations in the gene and occur in people with no history of the disorder in their family.", "role": "assistant" } ]
[ { "content": "what are the causes of childhood obesity\n\nChildhood obesity (Lifestyle and home remedies): Addressing a woman's health and weight before she conceives could lead to improvements in childhood obesity. If you're overweight and thinking of becoming pregnant, losing weight and eating well might affect your child's future. Eating well throughout pregnancy might also have a positive impact on your baby's later food choices. To give your infant a healthy start, the World Health Organization recommends exclusively breast-feeding for 6 months. If your child is overweight or obese, his or her best chance to achieve and maintain a healthy weight is to start eating a healthy diet and exercising more. Here are some steps you can take at home to help your child succeed: - Be a role model. Choose healthy foods and active pastimes for yourself. If you need to lose weight, doing so will motivate your child to do likewise. - Involve the whole family. Make healthy eating a priority and emphasize how important it is for everyone to be physically active. This avoids singling out the child who is overweight.", "role": "user" }, { "content": "Addressing a woman's health and weight before she conceives could lead to improvements in childhood obesity. If your child is overweight or obese, his or her best chance to achieve and maintain a healthy weight is to start eating a healthy diet and exercising more. Choose healthy foods and active pastimes for yourself. If you need to lose weight, doing so will motivate your child to do likewise.", "role": "assistant" } ]
[ { "content": "how smoking tobacco affects the brain\n\n Risks of tobacco Secondhand smoke - risks Cigarette smoking - risks Smoking and smokeless tobacco - risks Nicotine - risks Summary 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 7,000 chemicals, at least 70 of which are known to cause cancer. Tobacco that is not burned is called smokeless tobacco. Including nicotine, there are at least 30 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 attack 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 cancer of the mouth, tongue, esophagus, and pancreas 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. 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": "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": "what is epilepsy\n\nEpilepsy occipital calcifications: The following summary is from Orphanet, a European reference portal for information on rare diseases and orphan drugs. Orpha Number: 1459 Disease definition Celiac disease, epilepsy and cerebral calcification syndrome (CEC) is a rare disorder characterized by the combination of auto-immune intestinal disease, epileptic seizures and cerebral calcifications. Epidemiology CEC was first described in 1992 and fewer than 200 cases have been reported so far. Clinical description Celiac disease (CD, see this term) and epilepsy manifest at a variable age, and CD is frequently diagnosed in late childhood, when specific investigations are performed secondary to observation of epileptic seizures and cerebral calcifications (CC). CD can present in a typical form characterized by onset in the first 2 years of life, chronic diarrhea, weight loss, short stature , anorexia, and, in some cases, irritability and vomiting. CD may also present in silent or latent forms, which are characterized - in the absence of gastrointestinal symptoms - by dermatitis herpetiformis, dental enamel defects or autoimmune thyroiditis. In CEC patients, CD usually evolves into latent, silent or paucisymptomatic forms. Epilepsy onset is between infancy and adulthood; most cases occur in early childhood. Most patients present with occipital epileptic seizures, the course being highly variable, with benign, drug-resistant, or epileptic encephalopathy forms. In the latter, severe mental deterioration and/or learning disorders have been reported while a mild mental deterioration is observed in only one third of all CEC cases. CCs are seen in subcortical parieto-occipital regions. CC size does not change significantly over time, but in several cases, new CCs appeared in other regions. Patients with CCs and CD without epilepsy are considered as having an incomplete form of CEC. Some patients with epilepsy and CC without CD are considered to have a CEC with latent CD. Etiology Etiology of CEC is unclear. It is not known if epilepsy and/or CC are a consequence of CD. CD is an immune auto-inflammatory reaction occurring in predisposed gluten-intolerant individuals. It originates from the jejunal mucosa and spreads to the lamina propria, leading to the observed histopathological features (crypt hyperplasia, jejunal villous atrophy and inflammatory infiltrate in the lamina propria). CD may induce autoimmune responses outside the gastrointestinal tract. Circulating activated T cells may cross the blood-brain barrier and be toxic to myelin or myelin-producing cells. As for isolated CD, CEC is associated with the HLA-DQ2 and HLA-DQ8 genes . Diagnostic methods Diagnosis relies on anamnestic investigation and EEG to characterize epileptic seizures. Computed tomography (CT) imaging reveals CC. Laboratory findings (antiendomisium antibodies , antigliadin antibodies, anti- tissue -transglutaminase type 2 antibodies, HLA phenotype ), and histopathological analysis of small bowel biopsy (jejunal mucosa villous atrophy) enable identification of silent or latent CD in a patient with epileptic seizures and CC. Differential diagnosis Differential diagnosis of CEC includes Sturge-Weber syndrome (see this term) without nevus flammeus and other conditions such as congenital folate malabsorption or adverse effects of methotrexate, antifolate agents and radiotherapy of leukemic children. Management and treatment CD requires life-long observance of a gluten-free diet (GFD), leading to clinical and histopathological resolution of symptoms. A study has revealed that early CD diagnosis and treatment by GFD could prevent or reverse the epileptic disorder. Prognosis Early diagnosis and good compliance of GFD greatly improve outcome. On the contrary, if treatment is delayed, epilepsy may be more severe and epileptic encephalopathy may develop. Visit the Orphanet disease page for more resources. The Human Phenotype Ontology (HPO) provides the following list of features that have been reported in people with this condition. Much of the information in the HPO comes from Orphanet, a European rare disease database. If available, the list includes a rough estimate of how common a feature is (its frequency). Frequencies are based on a specific study and may not be representative of all studies. You can use the MedlinePlus Medical Dictionary for definitions of the terms below. Signs and Symptoms Approximate number of patients (when available) Celiac disease -", "role": "user" }, { "content": "Celiac disease, epilepsy and cerebral calcification syndrome (CEC) is a rare disorder characterized by the combination of auto-immune intestinal disease, epileptic seizures and cerebral calcifications. Epilepsy onset is between infancy and adulthood; most cases occur in early childhood. Most patients present with occipital epileptic seizures, the course being highly variable, with benign, drug-resistant, or epileptic encephalopathy forms. In the latter, severe mental deterioration and/or learning disorders have been reported while a mild mental deterioration is observed in only one third of all CEC cases.", "role": "assistant" } ]
[ { "content": "My cousin she is leber amaurosis she need help I don't know where to start from\n\n Leber congenital amaurosis LCA Congenital absence of the rods and cones Congenital retinal blindness LCA Congenital absence of the rods and cones Congenital retinal blindness Leber's amaurosis Leber's congenital tapetoretinal degeneration Leber's congenital tapetoretinal dysplasia See More Summary Leber congenital amaurosis (LCA) is an eye disorder that primarily affects the retina. People with this condition typically have severe visual impairment beginning in infancy. Other features include photophobia, involuntary movements of the eyes ( nystagmus ), and extreme farsightedness. The pupils also do not react normally to light. Additionally, the cornea may be cone-shaped and abnormally thin ( keratoconus). Franceschetti's oculo-digital sign is characteristic of Leber congenital amaurosis. This sign consists of poking, pressing, and rubbing the eyes with a knuckle or finger. [1] Different subtypes have been described. The different subtypes are caused by mutations in different genes . Some of these subtypes are also distinguished by their patterns of vision loss and related eye abnormalities. Treatment includes correction farsightedness and use of Symptoms Leber congenital amaurosis (LCA) primarily affects the retina, the specialized tissue at the back of the eye that detects light and color. Beginning in infancy, people with LCA typically have severe visual impairment. This is most often non-progressive, but sometimes it very slowly worsens over time. Other vision problems associated with LCA include: [2] [3] Photophobia Nystagmus Clouding of the lens of the eyes ( cataract ) Crossed eyes (strabismus) Enophthalmos (eye balls are dislocated backward) Abnormal retinal pigment Extreme farsightedness (hyperopia) Pupils that may not react normally to light; they may expand and contract more slowly than normal, or they may not respond to light at all Keratoconus, a condition in which the cornea is cone-shaped and abnormally thin, may also be present A specific behavior called Franceschetti's oculodigital sign is characteristic of LCA. This behavior consists of poking, pressing, and rubbing the eyes with a knuckle or finger. It may possibly contribute to deep-set eyes and keratoconus in affected children. In rare cases, delayed development, hearing loss , and intellectual disability have been reported in people with the features of LCA. However, it is unclear whether these people actually have LCA or another syndrome with similar signs and symptoms. [4] 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 Abnormality of retinal pigmentation 0007703 Abnormality of the optic disc 0012795 Severe vision loss Marked vision impairment Severe visual impairment Severely impaired vision 0001141 30%-79% of people have these symptoms Abnormal electroretinogram 0000512 Abnormality of neuronal migration 0002269 Aplasia/Hypoplasia of the cerebellar vermis 0006817 Cataract Clouding of the lens of the eye Cloudy lens 0000518 Encephalocele 0002084 Hemiplegia/hemiparesis Paralysis or weakness of one side of body 0004374 Keratoconus Bulging cornea 0000563 Muscular hypotonia Low or weak muscle tone 0001252 Nystagmus Involuntary, rapid, rhythmic eye movements 0000639 Seizures Seizure 0001250 5%-29% of people have these symptoms Global developmental delay 0001263 Hearing impairment Deafness Hearing defect 0000365 Intellectual disability Mental deficiency Mental retardation Mental retardation, nonspecific Mental-retardation 0001249 Showing of 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 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. Treatment FDA-Approved Treatments The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition. Learn more orphan products. National Library of Medicine Drug Information Portal 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 diagnosis includes retinitis pigmentosa, Alstrom syndrome, Joubert syndrome, Stargardt disease, Senior-Loken syndrome, Conorenal syndrome and infantile neuronal ceroid lipofuscinosis. Cortical blindness is a frequent misdiagnosis when there is limited access to functional testing or high resolution morphological examination. Visit the Orphanet disease page for more information. ", "role": "user" }, { "content": "Treatments for Leber congenital amaurosis are discussed in the linked resources. Discuss your treatment options with your healthcare provider.", "role": "assistant" } ]
[ { "content": "I am looking for information about Cancer of the Esophagus and I'm not finding anything on your website.\n\n Esophageal cancer Cancer - esophagus Summary Esophageal cancer is cancer that starts in the esophagus. This is the tube through which food moves from the mouth to the stomach. Causes Esophageal cancer is not common in the United States. It occurs most often in men over 50 years old. There are two main types of esophageal cancer: squamous cell carcinoma and adenocarcinoma. These two types look different from each other under the microscope. Squamous cell esophageal cancer is linked to smoking and drinking too much alcohol. Adenocarcinoma is the more common type of esophageal cancer. Having Barrett esophagus increases the risk of this type of cancer. Acid reflux disease (gastroesophageal reflux disease, or GERD) can develop into Barrett esophagus. Other risk factors include smoking, being male, or being obese. Symptoms Symptoms may include any of the following: Backward movement of food through the esophagus and possibly mouth (regurgitation) Chest pain not related to eating Difficulty swallowing solids or liquids Heartburn Vomiting blood Weight loss Exams and Tests Tests used to help diagnose esophageal cancer may include: Series of x-rays taken to examine the esophagus (barium swallow) Chest MRI or thoracic CT (usually used to help determine the stage of the disease) Endoscopic ultrasound (also sometimes used to determine the stage of disease) Test to examine and remove a sample of the lining of the esophagus (esophagogastroduodenoscopy, EGD) PET scan (sometimes useful for determining the stage of disease, and whether surgery is possible) Stool testing may show small amounts of blood in the stool. Treatment EGD will be used to obtain a tissue sample from the esophagus to diagnose cancer. When the cancer is only in the esophagus and has not spread, surgery will be done. The cancer and part, or all, of the esophagus is removed. The surgery may be done using: Open surgery, during which 1 or 2 larger incisions are made. Minimally invasive surgery, during which a 2 to 4 small incisions are made in the belly. A laparoscope with a tiny camera is inserted into the belly through one of the incisions. Radiation therapy may also be used instead of surgery in some cases when the cancer has not spread outside the esophagus. Either chemotherapy, radiation, or both may be used to shrink the tumor and make surgery easier to perform. If the person is too ill to have major surgery or the cancer has spread to other organs, chemotherapy or radiation may be used to help reduce symptoms. This is called palliative therapy. In such cases, the disease is usually not curable. Besides a change in diet, other treatments that may be used to help the patient swallow include: Dilating (widening) the esophagus using an endoscope. Sometimes a stent is placed to keep the esophagus open. A feeding tube into the stomach. Photodynamic therapy, in which a special drug is injected into the tumor and is then exposed to light. The light activates the medicine that attacks the tumor. Support Groups You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone Outlook (Prognosis) When the cancer has not spread outside the esophagus, surgery may improve the chance of survival. When the cancer has spread to other areas of the body, a cure is generally not possible. Treatment is directed toward relieving symptoms. Possible Complications Complications may include: Pneumonia Severe weight loss from not eating enough When to Contact a Medical Professional Call your health care provider if you have difficulty swallowing with no known cause and it does not get better. Also call if you have other symptoms of esophageal cancer. Prevention To reduce your risk of cancer of the esophagus: DO NOT smoke. Limit or DO NOT drink alcoholic beverages. Get checked by your doctor if you have severe GERD. Get regular checkups if you have Barrett esophagus. Review Date 7/10/2017 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": "Esophageal cancer is cancer that starts in the esophagus. This is the tube that moves food from the mouth to the stomach. Esophageal cancer is not common in the United States. It occurs most often in men over 50 years old. There are two main types of esophageal cancer: squamous cell carcinoma and adenocarcinoma. Squamous cell esophageal cancer is linked to smoking and drinking too much alcohol. Adenocarcinoma is the more common type of esophageal cancer. Having Barrett esophagus increases the risk of this type of cancer. Acid reflux disease (gastroesophageal reflux disease, or GERD) can develop into Barrett esophagus. Other risk factors include smoking, being male, or being obese. Symptoms may include any of the following: - Backward movement of food through the esophagus and possibly mouth (regurgitation) - Chest pain not related to eating - Difficulty swallowing solids or liquids - Heartburn - Vomiting blood - Weight loss Tests used to help diagnose esophageal cancer may include: - Barium swallow - Chest MRI or thoracic CT (usually used to help determine the stage of the disease) - Endoscopic ultrasound (also sometimes used to determine the stage of disease) - Esophagogastroduodenoscopy (EGD) and biopsy - PET scan (sometimes useful for determining the stage of disease, and whether surgery is possible) Stool testing may show small amounts of blood in the stool. Upper endoscopy (EGD) will be used to obtain a tissue sample from the esophagus to diagnose cancer. When the cancer is only in the esophagus and has not spread, surgery will be done. The cancer and part, or all, of the esophagus is removed. Radiation therapy may also be used instead of surgery in some cases when the cancer has not spread outside the esophagus. Either chemotherapy, radiation, or both may be used to shrink the tumor and make surgery easier to perform. If the person is too ill to have major surgery or the cancer has spread to other organs, chemotherapy or radiation may be used to help reduce symptoms. This is called palliative therapy. In such cases, the disease is usually not curable. Beside a change in diet, other treatments that may be used to help the patient swallow include: - Dilating (widening) the esophagus using an endoscope. Sometimes a stent is placed to keep the esophagus open. - A feeding tube into the stomach. - Photodynamic therapy, in which a special drug is injected into the tumor and is then exposed to light. The light activates the medicine that attacks the tumor. You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone When the cancer has not spread outside the esophagus, surgery may improve the chance of survival. When the cancer has spread to other areas of the body, a cure is generally not possible. Treatment is directed toward relieving symptoms. Complications may include: - Pneumonia - Severe weight loss from not eating enough", "role": "assistant" } ]
[ { "content": "how to prevent lung cancer\n\nLung cancer (Causes): Lung cancer is the deadliest type of cancer for both men and women. Each year, more people die of lung cancer than of breast, colon, and prostate cancers combined. Lung cancer is more common in older adults. It is rare in people under age 45. Cigarette smoking is the leading cause of lung cancer. The more cigarettes you smoke per day and the earlier you started smoking, the greater your risk of lung cancer. There is no evidence that smoking low-tar cigarettes lowers the risk. Lung cancer can also affect people who have never smoked. Secondhand smoke (breathing the smoke of others) increases your risk of lung cancer. The following may also increase your risk of lung cancer: - Exposure to asbestos. - Exposure to cancer-causing chemicals such as uranium, beryllium, vinyl chloride, nickel chromates, coal products, mustard gas, chloromethyl ethers, gasoline, and diesel exhaust. - Exposure to radon gas. - Family history of lung cancer. - High levels of air pollution. - High levels of arsenic in drinking water. - Radiation therapy to the lungs.", "role": "user" }, { "content": "The more cigarettes you smoke per day and the earlier you started smoking, the greater your risk of lung cancer. There is no evidence that smoking low-tar cigarettes lowers the risk. Lung cancer can also affect people who have never smoked. Secondhand smoke (breathing the smoke of others) increases your risk of lung cancer. The following may also increase your risk of lung cancer: - Exposure to asbestos. - Exposure to cancer-causing chemicals such as uranium, beryllium, vinyl chloride, nickel chromates, coal products, mustard gas, chloromethyl ethers, gasoline, and diesel exhaust. - Exposure to radon gas. - Family history of lung cancer. - High levels of air pollution. - High levels of arsenic in drinking water. - Radiation therapy to the lungs.", "role": "assistant" } ]
[ { "content": "what are the causes of pulmonary hypertension\n\nPulmonary hypertension: Pulmonary hypertension is a type of high blood pressure that affects the arteries in your lungs and the right side of your heart. In one form of pulmonary hypertension, tiny arteries in your lungs, called pulmonary arterioles, and capillaries become narrowed, blocked or destroyed. This makes it harder for blood to flow through your lungs, and raises pressure within your lungs' arteries. As the pressure builds, your heart's lower right chamber (right ventricle) must work harder to pump blood through your lungs, eventually causing your heart muscle to weaken and fail. Some forms of pulmonary hypertension are serious conditions that become progressively worse and are sometimes fatal. Although some forms of pulmonary hypertension aren't curable, treatment can help lessen symptoms and improve your quality of life. The signs and symptoms of pulmonary hypertension in its early stages might not be noticeable for months or even years. As the disease progresses, symptoms become worse. Pulmonary hypertension symptoms include: - Shortness of breath (dyspnea), initially while exercising and eventually while at rest - Fatigue - Dizziness or fainting spells (syncope) - Chest pressure or pain - Swelling (edema) in your ankles, legs and eventually in your abdomen (ascites) - Bluish color to your lips and skin (cyanosis) - Racing pulse or heart palpitations 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. Your risk of developing pulmonary hypertension may be greater if: - You're a young adult, as idiopathic pulmonary arterial hypertension is more common in younger adults - You're overweight - You have a family history of the disease - You have one of various conditions that can increase your risk of developing pulmonary hypertension - You use illegal drugs, such as cocaine - You take certain appetite-suppressant medications - You have an existing risk of developing pulmonary hypertension, such as a family history of the condition, and you live at a high altitude Pulmonary hypertension is hard to diagnose early because it's not often detected in a routine physical exam. Even when the condition is more advanced, its signs and symptoms are similar to those of other heart and lung conditions. To diagnose your condition, your doctor may review your medical and family history, discuss your signs and symptoms, and conduct a physical examination. Doctors may order several tests to diagnose pulmonary hypertension, determine the severity of your condition and find out the cause of your condition. Tests may include: - Echocardiogram. Sound waves can create moving images of the beating heart. An echocardiogram can help your doctor to check the size and functioning of the right ventricle, and the thickness of the right ventricle's wall. An echocardiogram can also show how well your heart chambers and valves are working. Doctors may also use this to measure the pressure in your pulmonary arteries. In some cases, your doctor will recommend an exercise echocardiogram to help determine how well your heart and lungs work under stress. In this test, you'll have an echocardiogram before exercising on a stationary bike or treadmill and another test immediately afterward. This could be done as an oxygen consumption test, in which you may have to wear a mask that assesses the ability of your heart and lungs to deal with oxygen and carbon dioxide. Other exercise tests may also be done. These tests can help determine the severity and cause of your condition. They may also be done at follow-up appointments to check that your treatments are working. - Chest X-ray. A chest X-ray can show images of your heart, lungs and chest. This test can show enlargement of the right ventricle of the heart or the pulmonary arteries, which can occur in pulmonary hypertension. This test can also be used to identify other conditions that may be causing pulmonary hypertension. - Electrocardiogram (ECG). This noninvasive test shows your heart's electrical patterns and can detect abnormal rhythms. Doctors may also be able to see signs of right ventricle enlargement or strain. - Right heart catheterization. After you've had an echocardiogram, if your doctor thinks you have pulmonary hypertension, you'll likely have a right heart catheterization. This test can often help confirm that you have pulmonary hypertension and determine the severity of your condition. During the procedure, a cardiologist places a thin, flexible tube (catheter) into a vein in your neck or groin. The catheter is then threaded into your right ventricle and pulmonary artery. Right heart catheterization allows your doctor to directly measure the pressure in the main pulmonary arteries and right ventricle. It's also used to see what effect different medications may have on your pulmonary hypertension. - Blood tests. Your doctor might order blood tests to check for certain substances in your blood that might show you have pulmonary hypertension or its complications. Blood tests can also test for certain conditions that may be causing your condition. Your doctor might order additional tests to check the condition of your lungs and pulmonary arteries and to determine the cause of your condition, including: - Computerized tomography (CT) scan. During a CT scan, you lie on a table inside a doughnut-shaped machine. CT scanning generates X-rays to produce cross-sectional images of your body. Doctors may inject a dye into your blood vessels that helps your arteries to be more visible on the CT pictures (CT angiography). Doctors may use this test to look at the heart's size and function and to check for blood clots in the lungs' arteries. - Magnetic resonance imaging (MRI). This test may be used to check the right ventricle's function and the blood flow in the lung's arteries. In this test, you lie on a movable table that slides into the tunnel. An MRI uses a magnetic field and pulses of radio wave energy to make pictures of the body. - Pulmonary function test. This noninvasive test measures how much air your lungs can hold, and the airflow in and out of your lungs. During the test, you'll blow into a simple instrument called a spirometer. - Polysomnogram. This test detects your brain activity, heart rate, blood pressure, oxygen levels and other factors while you sleep. It can help diagnose a sleep disorder such as obstructive sleep apnea. - Ventilation/perfusion (V/Q) scan. In this test, a tracer is injected into a vein in your arm. The tracer maps blood flow and air to your lungs. This test can be used to determine whether blood clots are causing symptoms of pulmonary hypertension. - Open-lung biopsy. Rarely, a doctor might recommend an open-lung biopsy. An open-lung biopsy is a type of surgery in which a small sample of tissue is removed from your lungs under general anesthesia to check for a possible secondary cause of pulmonary hypertension. Genetic tests If a family member has had pulmonary hypertension, your doctor might screen you for genes that are linked with pulmonary hypertension. If you test positive, your doctor might recommend that other family members be screened for the same genetic mutation. Pulmonary hypertension classifications Once you've been diagnosed with pulmonary hypertension, your doctor might classify the severity of your disease into one of several classes, including: - Class I. Although you've been diagnosed with pulmonary hypertension, you have no symptoms with normal activity. - Class II. You don't have symptoms at rest, but you experience symptoms such as fatigue, shortness of breath or chest pain with normal activity. - Class III. You're comfortable at rest, but have symptoms when you're physically active. - Class IV. You have symptoms with physical activity and while at rest. Pulmonary hypertension can't be cured, but doctors can help you manage your condition. Treatment may help improve your symptoms and slow the progress of pulmonary hypertension. It often takes some time to find the most appropriate treatment for pulmonary hypertension. The treatments are often complex and require extensive follow-up care. Your doctor might also need to change your treatment if it's no longer effective. When pulmonary hypertension is caused by another condition, your doctor will treat the underlying cause whenever possible. Medications - Blood vessel dilators (vasodilators). Vasodilators open narrowed blood vessels. One of the most commonly prescribed vasodilators for pulmonary hypertension is epoprostenol (Flolan, Veletri). The drawback to epoprostenol is that its effects last only a few minutes. This drug is continuously injected through an intravenous (IV) catheter via a small pump that you wear in a pack on your belt or shoulder. Potential side effects of epoprostenol include jaw pain, nausea, diarrhea and leg cramps, as well as pain and infection at the IV site. Another form of the drug, iloprost (Ventavis), can be inhaled six to nine times a day through a nebulizer, a machine that vaporizes your medication. Because it's inhaled, it goes directly to the lungs. Side effects associated with iloprost include chest pain - often accompanied by a headache and nausea - and breathlessness. Treprostinil (Tyvaso, Remodulin, Orenitram), another form of the drug, can be given four times a day. It can be inhaled, taken as oral medication or administered by injection. It can cause side effects such as a headache, nausea and diarrhea. - Endothelin receptor antagonists. These medications reverse the effect of endothelin, a substance in the walls of blood vessels that causes them to narrow. These drugs may improve your energy level and symptoms. However, these drugs shouldn't be taken if you're pregnant. Also, these drugs can damage your liver and you may need monthly liver monitoring. These medications include bosentan (Tracleer), macitentan (Opsumit), and ambrisentan (Letairis). - Sildenafil and tadalafil. Sildenafil (Revatio, Viagra) and tadalafil (Cialis, Adcirca) are sometimes used to treat pulmonary hypertension. These drugs work by opening the blood vessels in the lungs to allow blood to flow through more easily. Side effects can include an upset stomach, headache and vision problems. - High-dose calcium channel blockers. These drugs help relax the muscles in the walls of your blood vessels. They include medications such as amlodipine (Norvasc), diltiazem (Cardizem, Tiazac, others) and nifedipine (Procardia, others). Although calcium channel blockers can be effective, only a small number of people with pulmonary hypertension respond to them. - Soluble guanylate cyclase (SGC) stimulator. Soluble guanylate cyclase (SGC) stimulators (Adempas) interact with nitric oxide and help relax the pulmonary arteries and lower the pressure within the arteries. These medications should not be taken if you're pregnant. They can sometimes cause dizziness or nausea. - Anticoagulants. Your doctor is likely to prescribe the anticoagulant warfarin (Coumadin, Jantoven) to help prevent the formation of blood clots within the small pulmonary arteries. Because anticoagulants prevent normal blood coagulation, they increase your risk of bleeding complications. Take warfarin exactly as prescribed, because warfarin can cause severe side effects if taken incorrectly. If you're taking warfarin, your doctor will ask you to have periodic blood tests to check how well the drug is working. Many other drugs, herbal supplements and foods can interact with warfarin, so be sure your doctor knows all of the medications you're taking. - Digoxin. Digoxin (Lanoxin) can help the heart beat stronger and pump more blood. It can help control the heart rate if you experience arrhythmias. - Diuretics. Commonly known as water pills, these medications help eliminate excess fluid from your body. This reduces the amount of work your heart has to do. They may also be used to limit fluid buildup in your lungs. - Oxygen. Your doctor might suggest that you sometimes breathe pure oxygen, a treatment known as oxygen therapy, to help treat pulmonary hypertension, especially if you live at a high altitude or have sleep apnea. Some people who have pulmonary hypertension eventually require continuous oxygen therapy. Surgeries - Atrial septostomy. If medications don't control your pulmonary hypertension, this open-heart surgery might be an option. In an atrial septostomy, a surgeon will create an opening between the upper left and right chambers of your heart (atria) to relieve the pressure on the right side of your heart. Atrial septostomy can have serious complications, including heart rhythm abnormalities (arrhythmias). - Transplantation. In some cases, a lung or heart-lung transplant might be an option, especially for younger people who have idiopathic pulmonary arterial hypertension. Major risks of any type of transplantation include rejection of the transplanted organ and serious infection, and you must take immunosuppressant drugs for life to help reduce the chance of rejection. Although medical treatment can't cure pulmonary hypertension, it can lessen symptoms. Lifestyle changes also can help improve your condition. Consider these tips: - Get plenty of rest. Resting can reduce the fatigue that might come from having pulmonary hypertension. - Stay as active as possible. Even the mildest forms of activity might be too exhausting for some people who have pulmonary hypertension. For others, moderate exercise such as walking might be beneficial - especially when done with oxygen. But first, talk to your doctor about specific exercise restrictions. In most cases, it's recommended that you not lift heavy weights. Your doctor can help you plan an appropriate exercise program. - Don't smoke. If you smoke, the most important thing you can do for your heart and lungs is to stop. If you can't stop smoking by yourself, ask your doctor to prescribe a treatment plan to help you quit. Also, avoid secondhand smoke if possible. - Avoid pregnancy and birth control pills. If you're a woman of childbearing age, avoid pregnancy. Pregnancy can be life-threatening for both you and your baby. Also avoid using birth control pills, which can increase your risk of blood clots. Talk to your doctor about alternative forms of birth control. If you do become pregnant, it's important to consult with your doctor as pulmonary hypertension can cause serious complications to both you and the fetus. - Avoid traveling to or living at high altitudes. High altitudes can worsen the symptoms of pulmonary hypertension. If you live at an altitude of 8,000 feet (2,438 meters) or higher, your doctor might recommend that you move to a lower altitude. - Avoid situations that can excessively lower blood pressure. These include sitting in a hot tub or sauna or taking long hot baths or showers. These activities lower your blood pressure and can cause fainting or even death. Also avoid activities that cause prolonged straining, such as lifting heavy objects or weights. - Follow a nutritious diet and stay at a healthy weight. Aim to eat a healthy diet of whole grains, a variety of fruits and vegetables, lean meats and low-fat dairy products. Avoid saturated fat, trans fat and cholesterol. It's likely your doctor will recommend limiting the amount of salt in your diet. Aim to maintain a healthy weight. - Ask your doctor about medications. Take all your medications as prescribed. Ask your doctor about any other medications before taking them, as some can interfere with your medication or worsen your condition. - See your doctor at follow-up appointments. Your doctor may recommend regular follow-up appointments. Let your doctor know if you have any questions about your condition or medications you're taking, or if you have any symptoms or side effects from your medications. If pulmonary hypertension is affecting your quality of life, ask your doctor about options that could improve your quality of life. - Get vaccines. Your doctor may recommend getting an influenza and pneumonia vaccine, as these conditions can cause serious issues for people with pulmonary hypertension. - Get support. If you're feeling stressed or worried due to your condition, get support from family or friends. Or, consider joining a support group with others who have pulmonary hypertension.", "role": "user" }, { "content": "Pulmonary hypertension is a type of high blood pressure caused by the walls of the pulmonary arteries stiffening and thickening. These changes make it harder for blood to flow, which raises the blood pressure in the pulmonary arteries. This means that the heart has to work harder to pump blood through your lungs, which causes the heart muscle to weaken and fail.", "role": "assistant" } ]
[ { "content": "Are there any researches indicating how early an individual may experience any signs or symptoms of Rheumatoid Arthritis?\n\nrheumatoid arthritis: Rheumatoid arthritis is a disease that causes chronic abnormal inflammation, primarily affecting the joints. The most common signs and symptoms are pain, swelling, and stiffness of the joints. Small joints in the hands and feet are involved most often, although larger joints (such as the shoulders, hips, and knees) may become involved later in the disease. Joints are typically affected in a symmetrical pattern; for example, if joints in the hand are affected, both hands tend to be involved. People with rheumatoid arthritis often report that their joint pain and stiffness is worse when getting out of bed in the morning or after a long rest. Rheumatoid arthritis can also cause inflammation of other tissues and organs, including the eyes, lungs, and blood vessels. Additional signs and symptoms of the condition can include a loss of energy, a low fever, weight loss, and a shortage of red blood cells (anemia). Some affected individuals develop rheumatoid nodules, which are firm lumps of noncancerous tissue that can grow under the skin and elsewhere in the body. The signs and symptoms of rheumatoid arthritis usually appear in mid- to late adulthood. Many affected people have episodes of symptoms (flares) followed by periods with no symptoms (remissions) for the rest of their lives. In severe cases, affected individuals have continuous health problems related to the disease for many years. The abnormal inflammation can lead to severe joint damage, which limits movement and can cause significant disability. Rheumatoid arthritis affects about 1.3 million adults in the United States. Worldwide, it is estimated to occur in up to 1 percent of the population. The disease is two to three times more common in women than in men, which may be related to hormonal factors. Rheumatoid arthritis probably results from a combination of genetic and environmental factors, many of which are unknown. Rheumatoid arthritis is classified as an autoimmune disorder, one of a large group of conditions that occur when the immune system attacks the body's own tissues and organs. In people with rheumatoid arthritis, the immune system triggers abnormal inflammation in the membrane that lines the joints (the synovium). When the synovium is inflamed, it causes pain, swelling, and stiffness of the joint. In severe cases, the inflammation also affects the bone, cartilage, and other tissues within the joint, causing more serious damage. Abnormal immune reactions also underlie the features of rheumatoid arthritis affecting other parts of the body. Variations in dozens of genes have been studied as risk factors for rheumatoid arthritis. Most of these genes are known or suspected to be involved in immune system function. The most significant genetic risk factors for rheumatoid arthritis are variations in human leukocyte antigen (HLA) genes, especially the HLA-DRB1 gene. The proteins produced from HLA genes help the immune system distinguish the body's own proteins from proteins made by foreign invaders (such as viruses and bacteria). Changes in other genes appear to have a smaller impact on a person's overall risk of developing the condition. Other, nongenetic factors are also believed to play a role in rheumatoid arthritis. These factors may trigger the condition in people who are at risk, although the mechanism is unclear. Potential triggers include changes in sex hormones (particularly in women), occupational exposure to certain kinds of dust or fibers, and viral or bacterial infections. Long-term smoking is a well-established risk factor for developing rheumatoid arthritis; it is also associated with more severe signs and symptoms in people who have the disease. The inheritance pattern of rheumatoid arthritis is unclear because many genetic and environmental factors appear to be involved. However, having a close relative with rheumatoid arthritis likely increases a person's risk of developing the condition. Carmona L, Cross M, Williams B, Lassere M, March L. Rheumatoid arthritis. Best Pract Res Clin Rheumatol. 2010 Dec;24(6):733-45. doi: 10.1016/j.berh.2010.10.001. Review.", "role": "user" }, { "content": "The signs and symptoms of rheumatoid arthritis usually appear in mid- to late adulthood. Many affected people have episodes of symptoms (flares) followed by periods with no symptoms (remissions) for the rest of their lives. In severe cases, affected individuals have continuous health problems related to the disease for many years.", "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 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", "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 Adolescent idiopathic scoliosis Idiopathic adolescent scoliosis Summary Adolescent idiopathic scoliosis is an abnormal curvature of the spine that appears in late childhood or adolescence. Instead of growing straight, the spine develops a side-to-side curvature, usually in an elongated \"s\" or \"C\" shape, and the bones of the spine become slightly twisted or rotated. In many cases, the abnormal spinal curve is stable; however, in some children, the curve becomes more severe over time (progressive). For unknown reasons, severe and progressive curves occur more frequently in girls than in boys. The cause of adolescent idiopathic scoliosis is unknown. It is likely that there are both genetic and environmental factors involved. [1] Treatment may include observation, bracing and/or surgery. [2] Symptoms Adolescent idiopathic scoliosis is characterized by an abnormal curvature of the spine (usually in an elongated \"S\" or \"C\" shape), along with twisted or rotated bones of the spine. Mild scoliosis generally does not cause pain, problems with movement, or difficulty breathing. It may only be diagnosed if it is noticed during a regular physical examination or a scoliosis screening at school. The most common signs of the condition include a tilt or unevenness (asymmetry) in the shoulders, hips, or waist, or having one leg that appears longer than the other. A small percentage of affected children develop more severe, pronounced spinal curvature. [1] Scoliosis can occur as a feature of other conditions, including a variety of genetic syndromes . However, adolescent idiopathic scoliosis typically occurs by itself, without signs and symptoms affecting other parts of the body. [1] Cause The term \"idiopathic\" means that the cause of this condition is unknown. Adolescent idiopathic scoliosis probably results from a combination of genetic and environmental factors . Studies suggest that the abnormal spinal curvature may be related to hormonal problems, abnormal bone or muscle growth, nervous system abnormalities, or other factors that have not yet been identified. [1] Researchers suspect that many genes are involved in adolescent idiopathic scoliosis. Some of these genes likely contribute to causing the disorder, while others play a role in determining the severity of spinal curvature and whether the curve is stable or progressive. Although many genes have been studied, few clear and consistent genetic associations with this condition have been identified. [1] Inheritance Adolescent idiopathic scoliosis can be sporadic, which means it occurs in people without a family history of the condition, or it can cluster in families. The inheritance pattern of adolescent idiopathic scoliosis is unclear because many genetic and environmental factors appear to be involved. We do know, however, that having a close relative (such as a parent or sibling) with the condition increases a child's risk of developing it. [1] Treatment Treatment of adolescent idiopathic scoliosis may involve observation, bracing and/or surgery. Treatment recommendations are generally dependent upon the risk of curve progression. Curves progress most during the rapid growth period of the patient (adolescent or pre-adolescent growth spurt). The potential for growth is evaluated by taking into consideration the patient's age, the status of whether females have had their first menstrual period, and radiographic parameters ( x-ray studies). [2] Detailed information about these treatment options can be accessed through the Scoliosis Research Society. ", "role": "user" }, { "content": "Treatment of adolescent idiopathic scoliosis may involve observation, bracing and/or surgery. Treatment recommendations are generally dependent upon the risk of curve progression.", "role": "assistant" } ]
[ { "content": "how smoking tobacco affects the rest of the body\n\n Smoking and surgery Surgery - quitting smoking Surgery - quitting tobacco Wound healing - smoking Summary Quitting smoking and other tobacco products before surgery can improve your recovery and outcome after surgery. Most people who successfully quit smoking have tried and failed many times. DO NOT give up. Learning from your past tries can help you succeed. There Are Many Reasons to Quit Smoking Tar, nicotine, and other chemicals from smoking can increase your risk of many health problems. These include heart and blood vessel problems, such as: Blood clots and aneurysms in the brain, which can lead to strokes Coronary artery disease, including chest pain (angina) and heart attacks High blood pressure Poor blood supply to the legs Problems with erections Smoking also increases your risk for different types of cancer, including cancer of the: Lungs Mouth Larynx Esophagus Bladder Kidneys Pancreas Cervix Smoking also leads to lung problems, such as emphysema and chronic bronchitis, and makes asthma harder to control. Some smokers switch to smokeless tobacco instead of quitting tobacco completely. But using smokeless tobacco still carries health risks, such as: Developing mouth or nasal cancer Gum problems, tooth wear, and cavities Worsening high blood pressure and chest pain How Smoking Affects Surgery Smokers who have surgery have a higher chance than nonsmokers of blood clots forming in their legs. These clots may travel to and damage the lungs. Smoking decreases the amount of oxygen that reaches the cells in your surgical wound. As a result, your wound may heal more slowly and is more likely to become infected. All smokers carry an increased risk for heart and lung problems. Even when your surgery goes smoothly, smoking causes your body, heart, and lungs to work harder than if you did not smoke. Making the Decision to Quit Most doctors will tell you to stop using cigarettes and tobacco at least 4 weeks before your surgery. Stretching the time between quitting smoking and your surgery out to at least 10 weeks can decrease your risk of problems even more. Like any addiction, quitting tobacco is difficult. There are many ways to quit smoking and many resources to help you, such as: Family members, friends, and coworkers may be supportive or encouraging. Talk to your doctor about medicines, such as nicotine replacement and prescription medicines. If you join smoking cessation programs, you have a much better chance of success. Such programs are offered by hospitals, health departments, community centers, and work sites. Using nicotine gum around the time of surgery is not encouraged. The nicotine will still interfere with the healing of your surgical wound and have the same effect on your general health as using cigarettes and tobacco. Review Date 9/17/2016 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, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Tar, nicotine, and other chemicals from smoking can increase your risk of many health problems. These include heart and blood vessel problems, such as: - Blood clots and aneurysms in the brain, which can lead to strokes - Coronary artery disease, including chest pain (angina) and heart attacks - High blood pressure - Poor blood supply to the legs - Problems with erections Smoking also increases your risk for different types of cancer, including cancer of the: - Lungs - Mouth - Larynx - Esophagus - Bladder - Kidneys - Pancreas - Cervix Smoking also leads to lung problems, such as emphysema and chronic bronchitis, and makes asthma harder to control.", "role": "assistant" } ]
[ { "content": "what is the cause of the coffin lowry syndrome?\n\nWhat is Coffin Lowry Syndrome?: Coffin-Lowry syndrome is a rare genetic disorder characterized by craniofacial (head and facial) and skeletal abnormalities, delayed intellectual development, short stature, and hypotonia. Characteristic facial features may include an underdeveloped upper jaw bone (maxillary hypoplasia), a broad nose, protruding nostrils (nares), an abnormally prominent brow, down-slanting eyelid folds (palpebral fissures), widely spaced eyes (hypertelorism), large low-set ears, and unusually thick eyebrows. Skeletal abnormalities may include abnormal front-to-back and side-to-side curvature of the spine (kyphoscoliosis), unusual prominence of the breastbone (pigeon chest, or pectus carinatum), dental abnormalities, and short, hyperextensible, tapered fingers. Other features may include feeding and respiratory problems, developmental delay, hearing impairment, awkward gait, stimulus-induced drop episodes, and heart and kidney involvement. The disorder affects males and females in equal numbers, but symptoms are usually more severe in males. The disorder is caused by a defective gene, RSK2, which is found in 1996 on the X chromosome (Xp22.2-p22.1). Thus, the syndrome is typically more severe in males because males have only one X chromosome, while females have two. It is unclear how changes (mutations) in the DNA structure of the gene lead to the clinical findings.", "role": "user" }, { "content": "Coffin-Lowry syndrome is caused by a defective gene, RSK2, which is found in 1996 on the X chromosome (Xp22.2-p22.1), and is usually more severe in males because males have only one X chromosome. This rare genetic disorder is characterized by craniofacial (head and facial) and skeletal abnormalities, delayed intellectual development, short stature, and hypotonia. It is unclear how mutations in the DNA structure of the gene lead to the clinical findings.", "role": "assistant" } ]
[ { "content": "why can you not take grapefruit with felodipine\n\nGrapefruit (Are there interactions with medications?): Major Do not take this combination. Amiodarone (Cordarone) Grapefruit juice can increase how much amiodarone (Cordarone) the body absorbs. Drinking grapefruit juice while taking amiodarone (Cordarone) might increase the effects and side effects. Avoid drinking grapefruit juice if you are taking amiodarone (Cordarone). Artemether (Artenam, Paluther) The body breaks down artemether (Artenam, Paluther) to get rid of it. Grapefruit juice can decrease how quickly the body breaks down artemether (Artenam, Paluther). Drinking grapefruit juice while taking artemether (Artenam, Paluther) might increase the effects and side effects of artemether (Artenam, Paluther). Do not drink grapefruit juice if you are taking artemether (Artenam, Paluther). Atorvastatin (Lipitor) Atorvastatin (Lipitor) is a type of cholesterol lowering medication known as a \"statin.\" The body breaks down some \"statins\" to get rid of them. Grapefruit juice might decrease how quickly the body breaks down \"statins\" including atorvastatin (Lipitor). Drinking grapefruit juice while taking atorvastatin (Lipitor) or other \"statins\" might increase the effects and side effects of these medications. Grapefruit might interact with some \"statins\" including lovastatin (Mevacor), simvastatin (Zocor), and atorvastatin (Lipitor). Grapefruit juice does not interact with other \"statins\" including pravastatin (Pravachol), fluvastatin (Lescol), and rosuvastatin (Crestor). Buspirone (BuSpar) Grapefruit juice might increase how much buspirone (BuSpar) the body absorbs. Drinking grapefruit juice while taking buspirone (BuSpar) might increase the effects and side effects of buspirone (BuSpar). Carbamazepine (Tegretol) Grapefruit juice might increase how much carbamazepine (Tegretol) the body absorbs. Drinking grapefruit juice while taking carbamazepine (Tegretol) might increase the effects and side effects of carbamazepine (Tegretol). Carvedilol (Coreg) The body breaks down carvedilol (Coreg) to get rid of it. Grapefruit juice seems to decrease how quickly the body breaks down carvedilol (Coreg). Drinking grapefruit juice while taking carvedilol (Coreg) might increase the effects and side effects of carvedilol (Coreg). Celiprolol (Celicard) Grapefruit appears to decrease how much celiprolol (Celicard) is absorbed. This might decrease the effectiveness of celiprolol (Celicard). Separating administration of celiprolol (Celicard) and consumption of grapefruit by at least 4 hours. Cisapride (Propulsid) Grapefruit juice might decrease how quickly the body gets rid of cisapride (Propulsid). Drinking grapefruit juice while taking cisapride (Propulsid) might increase the effects and side effects of cisapride (Propulsid). Clomipramine (Anafranil) The body breaks down clomipramine (Anafranil) to get rid of it. Grapefruit juice might decrease how quickly the body gets rid of clomipramine (Anafranil). Taking grapefruit juice along with clomipramine (Anafranil) might increase the effects and side effects of clomipramine (Anafranil). Clopidogrel (Plavix) Clopidogrel (Plavix) is a prodrug. Prodrugs need to be activated by the body to work. Grapefruit appears to decrease how much clopidogrel (Plavix) is activated by the body. This might lead to a decreased efficacy of clopidogrel. Do not take grapefruit with clopidogrel. Cyclosporine (Neoral, Sandimmune) Grapefruit might increase how much cyclosporine (Neoral, Sandimmune) the body absorbs. Drinking grapefruit juice while taking cyclosporine (Neoral, Sandimmune) might increase the side effects of cyclosporine. Dextromethorphan (Robitussin DM, and others) The body breaks down dextromethorphan (Robitussin DM, others) to get rid of it. Grapefruit might decrease how quickly the body breaks down dextromethorphan (Robitussin DM, others). Drinking grapefruit juice while taking dextromethorphan (Robitussin DM, others) might increase the effects and side effects of dextromethorphan (Robitussin DM, others). Estrogens The body breaks down estrogens to get rid of them. Grapefruit juice seems to decrease how quickly the body breaks down estrogens and increase how much estrogen the body absorbs. Drinking grapefruit juice while taking estrogens might increase estrogen levels and side effects associated with estrogen such as breast cancer. Some estrogen pills include conjugated equine estrogens (Premarin), ethinyl estradiol, estradiol (Climara, Vivelle, Estring), and others. Etoposide (VePesid) Grapefruit might decrease how much etoposide (VePesid) the body absorbs. Drinking grapefruit juice while taking etoposide (VePesid) might decrease the effectiveness of etoposide (VePesid). To avoid this interaction, separate taking this medication from consuming grapefruit by at least 4 hours. Halofantrine The body breaks down halofantrine to get rid of it. Grapefruit juice seems to decrease how quickly the body breaks down halofantrine. Drinking grapefruit juice while taking halofantrine might increase halofantrine levels and side effects associated with halofantrine, including abnormal heartbeat. Lovastatin (Mevacor) Lovastatin (Mevacor) is a type of cholesterol lowering medication known as a \"statin.\" The body breaks down some \"statins\" to get rid of them. Grapefruit juice might decrease how quickly the body breaks down \"statins\" including lovastatin (Mevacor). Drinking grapefruit juice while taking lovastatin (Mevacor) or other \"statins\" might increase the effects and side effects of these medications. Grapefruit might interact with some \"statins\" including lovastatin (Mevacor), simvastatin (Zocor), and atorvastatin (Lipitor). Grapefruit juice does not interact with other \"statins\" including pravastatin (Pravachol), fluvastatin (Lescol), and rosuvastatin (Crestor). Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates) Some medications are changed and broken down by the liver. Grapefruit juice might decrease how quickly the liver breaks down some medications. Drinking grapefruit juice while taking some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking grapefruit, talk to your healthcare provider if you are taking any medications that are changed by the liver. Some medications changed by the liver include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and many others. Medications for high blood pressure (Calcium channel blockers) Grapefruit juice might increase how much medication for high blood pressure the body absorbs. Drinking grapefruit juice while taking some medications for high blood pressure might cause your blood pressure to go too low. Some medications for high blood pressure include nifedipine (Adalat, Procardia), verapamil (Calan, Isoptin, Verelan), diltiazem (Cardizem), isradipine (DynaCirc), felodipine (Plendil), amlodipine (Norvasc), and others. Medications moved by pumps in cells (Organic anion-transporting polypeptide substrates) Some medications are moved by pumps in cells. Grapefruit might change how these pumps work and decrease how much of some medications get absorbed by the body. This could make these medications less effective. To avoid this interaction, separate taking these medications from consuming grapefruit by at least 4 hours. Some of these medications that are moved by pumps in cells include bosentan (Tracleer), celiprolol (Celicard, others), etoposide (VePesid), fexofenadine (Allegra), fluoroquinolone antibiotics, glyburide (Micronase, Diabeta), irinotecan (Camptosar), methotrexate, paclitaxel (Taxol), saquinavir (Fortovase, Invirase), rifampin, statins, talinolol, torsemide (Demadex), troglitazone, and valsartan (Diovan). Methylprednisolone The body breaks down methylprednisolone to get rid of it. Grapefruit juice can decrease how quickly the body gets rid of methylprednisolone. Drinking grapefruit juice while taking methylprednisolone might increase the effects and side effects of methylprednisolone. Pitavastatin (Pravachol) Pitavastatin (Pravachol) is a type of cholesterol lowering medication known as a \"statin.\" The body breaks down some \"statins\" to get rid of them. Grapefruit juice might decrease how quickly the body breaks down \"statins\" including pitavastatin (Pravachol). Drinking grapefruit juice while taking pitavastatin (Pravachol) or other \"statins\" might increase the effects and side effects of these medications. Grapefruit might interact with some \"statins\" including lovastatin (Mevacor), simvastatin (Zocor), and atorvastatin (Lipitor). Grapefruit juice does not interact with other \"statins\" including pravastatin (Pravachol), fluvastatin (Lescol), and rosuvastatin (Crestor). Praziquantel (Biltricide) The body breaks down praziquantel (Biltricide) to get rid of it. Grapefruit juice can decrease how quickly the body breaks down praziquantel (Biltricide). Drinking grapefruit juice while taking praziquantel (Biltricide) might increase the effects and side effects of praziquantel (Biltricide). Quinidine The body breaks down quinidine to get rid of it. Grapefruit juice might decrease how fast the body gets rid of quinidine. Drinking grapefruit juice while taking quinidine might increase the chance of side effects. Scopolamine (Transderm Scop) The body breaks down scopolamine to get rid of it. Grapefruit juice can decrease how fast the body breaks down scopolamine. Drinking grapefruit juice while taking scopolamine might increase the effects and side effects of scopolamine. Sedative medications (Benzodiazepines) Sedative medications can cause sleepiness and drowsiness. Grapefruit juice can decrease how quickly the body breaks some sedative medications. Drinking grapefruit juice while taking some sedative medications can increase the effects and side effects of some sedative medications. Some sedative medications (benzodiazepines) that might interact with grapefruit juice include diazepam (Valium), midazolam (Versed), quazepam (Doral), and triazolam (Halcion). Sildenafil (Viagra) The body breaks down sildenafil (Viagra) to get rid of it. Grapefruit can decrease how quickly the body breaks down sildenafil (Viagra). Drinking grapefruit juice while taking sildenafil (Viagra) can increase the effects and side effects of sildenafil (Viagra). Simvastatin (Zocor) Simvastatin (Zocor) is a type of cholesterol lowering medication known as a \"statin.\" The body breaks down some \"statins\" to get rid of them. Grapefruit juice might decrease how quickly the body breaks down \"statins\" including simvastatin (Zocor). Drinking grapefruit juice while taking simvastatin (Zocor) or other \"statins\" might increase the effects and side effects of these medications. Grapefruit might interact with some \"statins\" including lovastatin (Mevacor), simvastatin (Zocor), and atorvastatin (Lipitor). Grapefruit juice does not interact with other \"statins\" including pravastatin (Pravachol), fluvastatin (Lescol), and rosuvastatin (Crestor). Terfenadine (Seldane) Grapefruit can increase how much terfenadine (Seldane) that the body absorbs. Drinking grapefruit juice while taking terfenadine (Seldane) might increase the effects and side effects of terfenadine (Seldane). Ticagrelor (Brilinta) The body breaks down ticagrelor (Brilinta) to get rid of it. Grapefruit can decrease how quickly the body breaks down ticagrelor (Brilinta). Drinking grapefruit juice while taking ticagrelor (Brilinta) can increase the effects and side effects of ticagrelor (Brilinta). Moderate Be cautious with this combination. Aliskiren (Tekturna, Rasilez) Aliskiren (Tekturna, Rasilez) is moved by pumps in cells in the body. Grapefruit might change how these pumps work and decrease how much aliskiren (Tekturna, Rasilez) gets absorbed by the body. This could make this medication less effective. To avoid this interaction, separate taking this medication from consuming grapefruit by at least 4 hours. BUDESONIDE (Pulmicort) The body breaks down budesonide (Pulmicort) to get rid of it. Grapefruit might decease how quickly the body gets rid of budesonide (Pulmicort). Drinking grapefruit while taking budesonide (Pulmicort) might increase the side effects of budesonide (Pulmicort). Caffeine The body breaks down caffeine to get rid of it. Grapefruit might decease how quickly the body gets rid of caffeine. Drinking grapefruit while taking caffeine might increase the side effects of caffeine including jitteriness, headache, and a fast heartbeat. Colchicine The body breaks down colchicine to get rid of it. Grapefruit might decrease how quickly the body gets rid of colchicine. But some research shows that grapefruit does not decrease how quickly the body gets rid of colchicine. Until more is known, follow any instructions on the colchicine label related to intake of grapefruit. Erythromycin The body breaks down erythromycin to get rid of it. Grapefruit can decrease how quickly the body gets rid of erythromycin. Taking grapefruit juice along with erythromycin might increase the effects and side effects of erythromycin. Fexofenadine (Allegra) Grapefruit might decrease how much fexofenadine (Allegra) the body absorbs. Drinking grapefruit juice while taking fexofenadine (Allegra) might decrease the effectiveness of fexofenadine (Allegra). To avoid this interaction, separate taking this medication from consuming grapefruit by at least 4 hours. Fluvoxamine (Luvox) Grapefruit juice can increase how much fluvoxamine (Luvox) the body absorbs. Drinking grapefruit juice while taking fluvoxamine (Luvox) might increase the effects and side effects of fluvoxamine (Luvox). Itraconazole (Sporanox) Itraconazole (Sporanox) is used to treat fungal infections. Grapefruit juice might affect how much itraconazole (Sporanox) the body absorbs. But there is not enough information to know if this interaction is a major concern. Levothyroxine (Synthroid, others) Levothyroxine (Synthroid, others) is moved by pumps in cells in the body. Grapefruit might change how these pumps work and decrease how much levothyroxine (Synthroid, others) gets absorbed by the body. This could make this medication less effective. To avoid this interaction, separate taking this medication from consuming grapefruit by at least 4 hours. Losartan (Cozaar) The liver activates losartan (Cozaar) to make it work. Grapefruit juice might decrease how quickly the body activates losartan (Cozaar). Drinking grapefruit juice while taking losartan (Cozaar) might decrease the effectiveness of losartan. Medications changed by the liver (Cytochrome P450 1A2 (CYP1A2) substrates) Some medications are changed and broken down by the liver. Grapefruit juice might decrease how quickly the liver breaks down some medications. Taking grapefruit juice along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking grapefruit juice talk to your healthcare provider if you take any medications that are changed by the liver. Some medications that are changed by the liver include amitriptyline (Elavil), haloperidol (Haldol), ondansetron (Zofran), propranolol (Inderal), theophylline (Theo-Dur, others), verapamil (Calan, Isoptin, others), and others. Medications changed by the liver (Cytochrome P450 2C19 (CYP2C19) substrates) Some medications are changed and broken down by the liver. Grapefruit juice might decrease how quickly the liver breaks down some medications. Taking grapefruit juice along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking grapefruit juice talk to your healthcare provider if you take any medications that are changed by the liver. Some medications that are changed by the liver include omeprazole (Prilosec), lansoprazole (Prevacid), and pantoprazole (Protonix); diazepam (Valium); carisoprodol (Soma); nelfinavir (Viracept); and others. Medications changed by the liver (Cytochrome P450 2C9 (CYP2C9) substrates) Some medications are changed and broken down by the liver. Grapefruit juice might decrease how quickly the liver breaks down some medications. Taking grapefruit juice along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking grapefruit juice talk to your healthcare provider if you take any medications that are changed by the liver. Some medications that are changed by the liver include diclofenac (Cataflam, Voltaren), ibuprofen (Motrin), meloxicam (Mobic), and piroxicam (Feldene); celecoxib (Celebrex); amitriptyline (Elavil); warfarin (Coumadin); glipizide (Glucotrol); losartan (Cozaar); and others. Methadone (Dolophine) Grapefruit juice might increase how much methadone (Dolophine) the body absorbs. Drinking grapefruit juice while taking methadone (Dolophine) might increase the effects and side effects of methadone (Dolophine). Nadolol (Corgard) Nadolol (Corgard) is moved by pumps in cells in the body. Grapefruit might change how these pumps work and decrease how much nadolol (Corgard) gets absorbed by the body. This could make this medication less effective. However, some research shows that grapefruit does not affect how much nadolol (Corgard) gets absorbed by the body. Until more is known, follow any instructions on the nadolol (Corgard) label related to intake of grapefruit. Nilotinib (Tasigna) Grapefruit juice can increase how much Nilotinib (Tasigna) the body absorbs. Drinking grapefruit juice while taking Nilotinib (Tasigna) might increase the effects and side effects. Avoid drinking grapefruit juice if you are taking Nilotinib (Tasigna). Oxycodone (Oxycontin) The body breaks down oxycodone (Oxycontin) to get rid of it. Grapefruit juice can decrease how quickly the body breaks down oxycodone (Oxycontin). Drinking grapefruit juice while taking oxycodone (Oxycontin) might increase the effects and side effects of Oxycodone (Oxycontin). Primaquine Grapefruit juice can increase how much primaquine is available in the body. It is unclear what effects this might have. Be cautious with this combination. Saquinavir (Fortovase, Invirase) Drinking grapefruit juice can increase how much saquinavir (Fortovase, Invirase) the body absorbs. Drinking grapefruit juice while taking saquinavir (Fortovase, Invirase) might increase the effects and side effects of saquinavir. Sertraline The body breaks down sertraline to get rid of it. Grapefruit can decrease how quickly the body breaks down sertraline. Drinking grapefruit juice while taking sertraline can increase the effects and side effects of sertraline. Sunitinib (Sutent) The body breaks down sunitinib (Sutent) to get rid of it. Grapefruit can decrease how quickly the body breaks down sunitinib (Sutent). Drinking grapefruit juice while taking sunitinib (Sutent) can increase the effects and side effects of sunitinib (Sutent). But some research shows that the effect of grapefruit on sunitinib (Sutent) is not a big concern. Until more is known, follow any instructions on the sunitinib (Sutent) label related to intake of grapefruit. Tacrolimus Drinking grapefruit juice might increase the concentration of tacrolimus in the blood. Drinking grapefruit juice while taking tacrolimus might increase the risk for side effects. Talinolol Grapefruit juice can reduce how much talinolol is available in the body. Drinking grapefruit juice with talinolol might reduce the effects of talinolol. Theophylline Drinking grapefruit juice might decrease the effects of theophylline. There's not enough information to know if this is a big concern. Tolvaptan (Samsca) The body breaks down tolvaptan (Samsca) to get rid of it. Grapefruit can decrease how quickly the body breaks down tolvaptan (Samsca). Drinking grapefruit juice while taking tolvaptan (Samsca) can increase the effects and side effects of tolvaptan (Samsca). Warfarin (Coumadin) Warfarin (Coumadin) is used to slow blood clotting. Drinking grapefruit juice might increase the effects of warfarin (Coumadin) and increase the chances of bruising and bleeding. Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed. Minor Be watchful with this combination. Acebutolol (Sectral) Acebutolol (Sectral) is moved by pumps in cells in the body. Grapefruit might change how these pumps work and decrease how much acebutolol (Sectral) gets absorbed by the body. This could make this medication less effective. To avoid this interaction, separate taking this medication from consuming grapefruit by at least 4 hours. Amprenavir (Agenerase) Grapefruit might slightly decrease how much amprenavir (Agenerase) is absorbed by the body. But this interaction is probably not a major concern.", "role": "user" }, { "content": "Drinking grapefruit juice while taking Felodipine (Plendil), a medication for high blood pressure might cause your blood pressure to go too low, because grapefruit juice might increase how much Felodipine the body absorbs.", "role": "assistant" } ]
[ { "content": "how do i prevent myself from having dementia\n\n Dementia Chronic brain syndrome Lewy body dementia DLB Vascular dementia Mild cognitive impairment MCI Summary Dementia is a loss of brain function that occurs with certain diseases. It affects memory, thinking, language, judgment, and behavior. Causes Dementia usually occurs in older age. Most types are rare in people under age 60. The risk of dementia increases as a person gets older. Most types of dementia are nonreversible (degenerative). Nonreversible means the changes in the brain that are causing the dementia cannot be stopped or turned back. Alzheimer disease is the most common type of dementia. Another common type of dementia is vascular dementia. It is caused by poor blood flow to the brain, such as with stroke. Lewy body disease is a common cause of dementia in older adults. People with this condition have abnormal protein structures in certain areas of the brain. The following medical conditions can also lead to dementia: Huntington disease Brain injury Multiple sclerosis Infections such as HIV/AIDS, syphilis, and Lyme disease Parkinson disease Pick disease Progressive supranuclear palsy Some causes of dementia may be stopped or reversed if they are found soon enough, including: Brain injury Brain tumors Long-term (chronic) alcohol abuse Changes in blood sugar, sodium, and calcium levels (dementia due to metabolic causes) Low vitamin B12 level Normal pressure hydrocephalus Use of certain medicines, including cimetidine and some cholesterol drugs Some brain infections Symptoms Dementia symptoms include difficulty with many areas of mental function, including: Emotional behavior or personality Language Memory Perception Thinking and judgment (cognitive skills) Dementia usually first appears as forgetfulness. Mild cognitive impairment (MCI) is the stage between normal forgetfulness due to aging and the development of dementia. People with MCI have mild problems with thinking and memory that do not interfere with daily activities. They often know about their forgetfulness. Not everyone with MCI develops dementia. Symptoms of MCI include: Difficulty doing more than one task at a time Difficulty solving problems or making decisions Forgetting recent events or conversations Taking longer to do more difficult mental activities Early symptoms of dementia can include: Difficulty with tasks that take some thought, but that used to come easily, such as balancing a checkbook, playing games (such as bridge), and learning new information or routines Getting lost on familiar routes Language problems, such as trouble with the names of familiar objects Losing interest in things previously enjoyed, flat mood Misplacing items Personality changes and loss of social skills, which can lead to inappropriate behaviors As dementia becomes worse, symptoms are more obvious and interfere with the ability to take care of oneself. Symptoms may include: Change in sleep patterns, often waking up at night Difficulty with basic tasks, such as preparing meals, choosing proper clothing, or driving Forgetting details about current events Forgetting events in one's own life history, losing self-awareness Having hallucinations, arguments, striking out, and violent behavior Having delusions, depression, and agitation More difficulty reading or writing Poor judgment and loss of ability to recognize danger Using the wrong word, not pronouncing words correctly, speaking in confusing sentences Withdrawing from social contact People with severe dementia can no longer: Perform basic activities of daily living, such as eating, dressing, and bathing Recognize family members Understand language Other symptoms that may occur with dementia: Problems controlling bowel movements or urine Swallowing problems Exams and Tests A skilled health care provider can often diagnose dementia using the following: Complete physical exam, including nervous system exam Asking about the person's medical history and symptoms Mental function tests (mental status examination) Other tests may be ordered to find out if other problems may be causing dementia or making it worse. These conditions include: Anemia Brain tumor Long-term (chronic) infection Intoxication from medicines Severe depression Thyroid disease Vitamin deficiency The following tests and procedures may be done: B12 level Blood ammonia levels Blood chemistry (chem-20) Blood gas analysis Cerebrospinal fluid (CSF) analysis Drug or alcohol levels (toxicology screen) Electroencephalograph (EEG) Head CT Mental status test MRI of head Thyroid function tests, including thyroid stimulating hormone (TSH) Thyroid stimulating hormone level Urinalysis Treatment Treatment depends on the condition causing the dementia. Some people may need to stay in the hospital for a short time. Sometimes, dementia medicine can make a person's confusion worse. Stopping or changing these medicines is part of the treatment. Certain mental exercises can help with dementia. Treating conditions that can lead to confusion often greatly improve mental function. Such conditions include: Anemia Congestive heart failure Decreased blood oxygen (hypoxia) Depression Heart failure Infections Nutritional disorders Thyroid disorders Medicines may be used to: Slow the rate at which symptoms get worse, though improvement with these drugs may be small Control problems with behavior, such as loss of judgment or confusion Someone with dementia will need support in the home as the disease gets worse. Family members or other caregivers can assist by helping the person cope with memory loss and behavior and sleep problems. It is important to make sure the homes of people who have dementia are safe for them. Outlook (Prognosis) People with MCI do not always develop dementia. When dementia does occur, it usually gets worse over time. Dementia often decreases quality of life and lifespan. Families will likely need to plan for their loved one's future care. When to Contact a Medical Professional Call your provider if: Dementia develops or a sudden change in mental status occurs The condition of a person with dementia gets worse You are unable to care for a person with dementia at home Prevention Most causes of dementia are not preventable. The risk of vascular dementia may be reduced by preventing strokes through: Eating healthy foods Exercising Quitting smoking Controlling high blood pressure Managing diabetes Review Date 1/19/2018 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": "Dementia (Prevention): Most causes of dementia are not preventable. The risk of vascular dementia may be reduced by preventing strokes through: - Eating healthy foods - Exercising - Quitting smoking - Controlling high blood pressure - Managing diabetes", "role": "assistant" } ]
[ { "content": "how common is cystic fibrosis\n\nCystic Fibrosis: Cystic fibrosis (SIS-tik fi-BRO-sis), or CF, is an inherited disease of the secretory (see-KREH-tor-ee) glands. Secretory glands include glands that make mucus and sweat. \"Inherited\" means the disease is passed from parents to children through genes. People who have CF inherit two faulty genes for the disease—one from each parent. The parents likely don't have the disease themselves. CF mainly affects the lungs, pancreas, liver, intestines, sinuses, and sex organs. Overview Mucus is a substance made by tissues that line some organs and body cavities, such as the lungs and nose. Normally, mucus is a slippery, watery substance. It keeps the linings of certain organs moist and prevents them from drying out or getting infected. If you have CF, your mucus becomes thick and sticky. It builds up in your lungs and blocks your airways. (Airways are tubes that carry air in and out of your lungs.) The buildup of mucus makes it easy for bacteria to grow. This leads to repeated, serious lung infections. Over time, these infections can severely damage your lungs. The thick, sticky mucus also can block tubes, or ducts, in your pancreas (an organ in your abdomen). As a result, the digestive enzymes that your pancreas makes can't reach your small intestine. These enzymes help break down food. Without them, your intestines can't fully absorb fats and proteins. This can cause vitamin deficiency and malnutrition because nutrients pass through your body without being used. You also may have bulky stools, intestinal gas, a swollen belly from severe constipation, and pain or discomfort. CF also causes your sweat to become very salty. Thus, when you sweat, you lose large amounts of salt. This can upset the balance of minerals in your blood and cause many health problems. Examples of these problems include dehydration (a lack of fluid in your body), increased heart rate, fatigue (tiredness), weakness, decreased blood pressure, heat stroke, and, rarely, death. If you or your child has CF, you're also at higher risk for diabetes or two bone-thinning conditions called osteoporosis (OS-te-o-po-RO-sis) and osteopenia (OS-te-o-PEE-nee-uh). CF also causes infertility in men, and the disease can make it harder for women to get pregnant. (The term \"infertility\" refers to the inability to have children.) Outlook The symptoms and severity of CF vary. If you or your child has the disease, you may have serious lung and digestive problems. If the disease is mild, symptoms may not show up until the teen or adult years. The symptoms and severity of CF also vary over time. Sometimes you'll have few symptoms. Other times, your symptoms may become more severe. As the disease gets worse, you'll have more severe symptoms more often. Lung function often starts to decline in early childhood in people who have CF. Over time, damage to the lungs can cause severe breathing problems. Respiratory failure is the most common cause of death in people who have CF. As treatments for CF continue to improve, so does life expectancy for those who have the disease. Today, some people who have CF are living into their forties or fifties, or longer. Early treatment for CF can improve your quality of life and increase your lifespan. Treatments may include nutritional and respiratory therapies, medicines, exercise, and other treatments. Your doctor also may recommend pulmonary rehabilitation (PR). PR is a broad program that helps improve the well-being of people who have chronic (ongoing) breathing problems. Cystic fibrosis of the pancreas Fibrocystic disease of the pancreas Mucoviscidosis (MU-ko-vis-ih-DO-sis) Mucoviscidosis of the pancreas Pancreas fibrocystic disease Pancreatic cystic fibrosis A defect in the CFTR gene causes cystic fibrosis (CF). This gene makes a protein that controls the movement of salt and water in and out of your body's cells. In people who have CF, the gene makes a protein that doesn't work well. This causes thick, sticky mucus and very salty sweat. Research suggests that the CFTR protein also affects the body in other ways. This may help explain other symptoms and complications of CF. More than a thousand known defects can affect the CFTR gene. The type of defect you or your child has may affect the severity of CF. Other genes also may play a role in the severity of the disease. How Is Cystic Fibrosis Inherited? Every person inherits two CFTR genes—one from each parent. Children who inherit a faulty CFTR gene from each parent will have CF. Children who inherit one faulty CFTR gene and one normal CFTR gene are \"CF carriers.\" CF carriers usually have no symptoms of CF and live normal lives. However, they can pass the faulty CFTR gene to their children. The image below shows how two parents who are both CF carriers can pass the faulty CFTR gene to their children. Example of an Inheritance Pattern for Cystic Fibrosis Cystic fibrosis (CF) affects both males and females and people from all racial and ethnic groups. However, the disease is most common among Caucasians of Northern European descent. CF also is common among Latinos and American Indians, especially the Pueblo and Zuni. The disease is less common among African Americans and Asian Americans. More than 10 million Americans are carriers of a faulty CF gene. Many of them don't know that they're CF carriers. The signs and symptoms of cystic fibrosis (CF) vary from person to person and over time. Sometimes you'll have few symptoms. Other times, your symptoms may become more severe. One of the first signs of CF that parents may notice is that their baby's skin tastes salty when kissed, or the baby doesn't pass stool when first born. Most of the other signs and symptoms of CF happen later. They're related to how CF affects the respiratory, digestive, or reproductive systems of the body. Cystic Fibrosis Respiratory System Signs and Symptoms People who have CF have thick, sticky mucus that builds up in their airways. This buildup of mucus makes it easier for bacteria to grow and cause infections. Infections can block the airways and cause frequent coughing that brings up thick sputum (spit) or mucus that's sometimes bloody. People who have CF tend to have lung infections caused by unusual germs that don't respond to standard antibiotics. For example, lung infections caused by bacteria called mucoid Pseudomonas are much more common in people who have CF than in those who don't. An infection caused by these bacteria may be a sign of CF. People who have CF have frequent bouts of sinusitis (si-nu-SI-tis), an infection of the sinuses. The sinuses are hollow air spaces around the eyes, nose, and forehead. Frequent bouts of bronchitis (bron-KI-tis) and pneumonia (nu-MO-ne-ah) also can occur. These infections can cause long-term lung damage. As CF gets worse, you may have more serious problems, such as pneumothorax (noo-mo-THOR-aks) or bronchiectasis (brong-ke-EK-ta-sis). Some people who have CF also develop nasal polyps (growths in the nose) that may require surgery. Digestive System Signs and Symptoms In CF, mucus can block tubes, or ducts, in your pancreas (an organ in your abdomen). These blockages prevent enzymes from reaching your intestines. As a result, your intestines can't fully absorb fats and proteins. This can cause ongoing diarrhea or bulky, foul-smelling, greasy stools. Intestinal blockages also may occur, especially in newborns. Too much gas or severe constipation in the intestines may cause stomach pain and discomfort. A hallmark of CF in children is poor weight gain and growth. These children are unable to get enough nutrients from their food because of the lack of enzymes to help absorb fats and proteins. As CF gets worse, other problems may occur, such as: Pancreatitis (PAN-kre-ah-TI-tis). This is a condition in which the pancreas become inflamed, which causes pain. Rectal prolapse. Frequent coughing or problems passing stools may cause rectal tissue from inside you to move out of your rectum. Liver disease due to inflamed or blocked bile ducts. Diabetes. Gallstones. Reproductive System Signs and Symptoms Men who have CF are infertile because they're born without a vas deferens. The vas deferens is a tube that delivers sperm from the testes to the penis. Women who have CF may have a hard time getting pregnant because of mucus blocking the cervix or other CF complications. Other Signs, Symptoms, and Complications Other signs and symptoms of CF are related to an upset of the balance of minerals in your blood. CF causes your sweat to become very salty. As a result, your body loses large amounts of salt when you sweat. This can cause dehydration (a lack of fluid in your body), increased heart rate, fatigue (tiredness), weakness, decreased blood pressure, heat stroke, and, rarely, death. CF also can cause clubbing and low bone density. Clubbing is the widening and rounding of the tips of your fingers and toes. This sign develops late in CF because your lungs aren't moving enough oxygen into your bloodstream. Low bone density also tends to occur late in CF. It can lead to bone-thinning disorders called osteoporosis and osteopenia. Doctors diagnose cystic fibrosis (CF) based on the results from various tests. Newborn Screening All States screen newborns for CF using a genetic test or a blood test. The genetic test shows whether a newborn has faulty CFTR genes. The blood test shows whether a newborn's pancreas is working properly. Sweat Test If a genetic test or blood test suggests CF, a doctor will confirm the diagnosis using a sweat test. This test is the most useful test for diagnosing CF. A sweat test measures the amount of salt in sweat. For this test, the doctor triggers sweating on a small patch of skin on an arm or leg. He or she rubs the skin with a sweat-producing chemical and then uses an electrode to provide a mild electrical current. This may cause a tingling or warm feeling. Sweat is collected on a pad or paper and then analyzed. The sweat test usually is done twice. High salt levels confirm a diagnosis of CF. Other Tests If you or your child has CF, your doctor may recommend other tests, such as: Genetic tests to find out what type of CFTR defect is causing your CF. A chest x ray. This test creates pictures of the structures in your chest, such as your heart, lungs, and blood vessels. A chest x ray can show whether your lungs are inflamed or scarred, or whether they trap air. A sinus x ray. This test may show signs of sinusitis, a complication of CF. Lung function tests. These tests measure how much air you can breathe in and out, how fast you can breathe air out, and how well your lungs deliver oxygen to your blood. A sputum culture. For this test, your doctor will take a sample of your sputum (spit) to see whether bacteria are growing in it. If you have bacteria called mucoid Pseudomonas, you may have more advanced CF that needs aggressive treatment. Prenatal Screening If you're pregnant, prenatal genetic tests can show whether your fetus has CF. These tests include amniocentesis (AM-ne-o-sen-TE-sis) and chorionic villus (ko-re-ON-ik VIL-us) sampling (CVS). In amniocentesis, your doctor inserts a hollow needle through your abdominal wall into your uterus. He or she removes a small amount of fluid from the sac around the baby. The fluid is tested to see whether both of the baby's CFTR genes are normal. In CVS, your doctor threads a thin tube through the vagina and cervix to the placenta. The doctor removes a tissue sample from the placenta using gentle suction. The sample is tested to see whether the baby has CF. Cystic Fibrosis Carrier Testing People who have one normal CFTR gene and one faulty CFTR gene are CF carriers. CF carriers usually have no symptoms of CF and live normal lives. However, carriers can pass faulty CFTR genes on to their children. If you have a family history of CF or a partner who has CF (or a family history of it) and you're planning a pregnancy, you may want to find out whether you're a CF carrier. A genetics counselor can test a blood or saliva sample to find out whether you have a faulty CF gene. This type of testing can detect faulty CF genes in 9 out of 10 cases. Cystic fibrosis (CF) has no cure. However, treatments have greatly improved in recent years. The goals of CF treatment include: Preventing and controlling lung infections Loosening and removing thick, sticky mucus from the lungs Preventing or treating blockages in the intestines Providing enough nutrition Preventing dehydration (a lack of fluid in the body) Depending on the severity of CF, you or your child may be treated in a hospital. Specialists Involved If you or your child has CF, you may be treated by a CF specialist. This is a doctor who is familiar with the complex nature of CF. Often, a CF specialist works with a medical team of nurses, physical therapists, dietitians, and social workers. CF specialists often are located at major medical centers. The United States also has more than 100 CF Care Centers. These centers have teams of doctors, nurses, dietitians, respiratory therapists, physical therapists, and social workers who have special training related to CF care. Most CF Care Centers have pediatric and adult programs or clinics. For more information about CF Care Centers, go to the Cystic Fibrosis Foundation's Care Center Network Web page. Treatment for Lung Problems The main treatments for lung problems in people who have CF are chest physical therapy (CPT), exercise, and medicines. Your doctor also may recommend a pulmonary rehabilitation (PR) program. Chest Physical Therapy CPT also is called chest clapping or percussion. It involves pounding your chest and back over and over with your hands or a device to loosen the mucus from your lungs so that you can cough it up. You might sit down or lie on your stomach with your head down while you do CPT. Gravity and force help drain the mucus from your lungs. Some people find CPT hard or uncomfortable to do. Several devices have been developed that may help with CPT, such as: An electric chest clapper, known as a mechanical percussor. An inflatable therapy vest that uses high-frequency airwaves to force the mucus that's deep in your lungs toward your upper airways so you can cough it up. A small, handheld device that you exhale through. The device causes vibrations that dislodge the mucus. A mask that creates vibrations that help break the mucus loose from your airway walls. Breathing techniques also may help dislodge mucus so you can cough it up. These techniques include forcing out a couple of short breaths or deeper breaths and then doing relaxed breathing. This may help loosen the mucus in your lungs and open your airways. Exercise Aerobic exercise that makes you breathe harder can help loosen the mucus in your airways so you can cough it up. Exercise also helps improve your overall physical condition. However, CF causes your sweat to become very salty. As a result, your body loses large amounts of salt when you sweat. Thus, your doctor may recommend a high-salt diet or salt supplements to maintain the balance of minerals in your blood. If you exercise regularly, you may be able to cut back on your CPT. However, you should check with your doctor first. Medicines If you have CF, your doctor may prescribe antibiotics, anti-inflammatory medicines, bronchodilators, or medicines to help clear the mucus. These medicines help treat or prevent lung infections, reduce swelling and open up the airways, and thin mucus. If you have mutations in a gene called G551D, which occurs in about 5 percent of people who have CF, your doctor may prescribe the oral medicine ivacaftor (approved for people with CF who are 6 years of age and older). Antibiotics are the main treatment to prevent or treat lung infections. Your doctor may prescribe oral, inhaled, or intravenous (IV) antibiotics. Oral antibiotics often are used to treat mild lung infections. Inhaled antibiotics may be used to prevent or control infections caused by the bacteria mucoid Pseudomonas. For severe or hard-to-treat infections, you may be given antibiotics through an IV tube (a tube inserted into a vein). This type of treatment may require you to stay in a hospital. Anti-inflammatory medicines can help reduce swelling in your airways due to ongoing infections. These medicines may be inhaled or oral. Bronchodilators help open the airways by relaxing the muscles around them. These medicines are inhaled. They're often taken just before CPT to help clear mucus out of your airways. You also may take bronchodilators before inhaling other medicines into your lungs. Your doctor may prescribe medicines to reduce the stickiness of your mucus and loosen it up. These medicines can help clear out mucus, improve lung function, and prevent worsening lung symptoms. Treatments for Advanced Lung Disease If you have advanced lung disease, you may need oxygen therapy. Oxygen usually is given through nasal prongs or a mask. If other treatments haven't worked, a lung transplant may be an option if you have severe lung disease. A lung transplant is surgery to remove a person's diseased lung and replace it with a healthy lung from a deceased donor. Pulmonary Rehabilitation Your doctor may recommend PR as part of your treatment plan. PR is a broad program that helps improve the well-being of people who have chronic (ongoing) breathing problems. PR doesn't replace medical therapy. Instead, it's used with medical therapy and may include: Exercise training Nutritional counseling Education on your lung disease or condition and how to manage it Energy-conserving techniques Breathing strategies Psychological counseling and/or group support PR has many benefits. It can improve your ability to function and your quality of life. The program also may help relieve your breathing problems. Even if you have advanced lung disease, you can still benefit from PR. For more information, go to the Health Topics Pulmonary Rehabilitation article. Treatment for Digestive Problems CF can cause many digestive problems, such as bulky stools, intestinal gas, a swollen belly, severe constipation, and pain or discomfort. Digestive problems also can lead to poor growth and development in children. Nutritional therapy can improve your strength and ability to stay active. It also can improve growth and development in children. Nutritional therapy also may make you strong enough to resist some lung infections. A nutritionist can help you create a nutritional plan that meets your needs. In addition to having a well-balanced diet that's rich in calories, fat, and protein, your nutritional therapy may include: Oral pancreatic enzymes to help you digest fats and proteins and absorb more vitamins. Supplements of vitamins A, D, E, and K to replace the fat-soluble vitamins that your intestines can't absorb. High-calorie shakes to provide you with extra nutrients. A high-salt diet or salt supplements that you take before exercising. A feeding tube to give you more calories at night while you're sleeping. The tube may be threaded through your nose and throat and into your stomach. Or, the tube may be placed directly into your stomach through a surgically made hole. Before you go to bed each night, you'll attach a bag with a nutritional solution to the entrance of the tube. It will feed you while you sleep. Other treatments for digestive problems may include enemas and mucus-thinning medicines to treat intestinal blockages. Sometimes surgery is needed to remove an intestinal blockage. Your doctor also may prescribe medicines to reduce your stomach acid and help oral pancreatic enzymes work better. Treatments for Cystic Fibrosis Complications A common complication of CF is diabetes. The type of diabetes associated with CF often requires different treatment than other types of diabetes. Another common CF complication is the bone-thinning disorder osteoporosis. Your doctor may prescribe medicines that prevent your bones from losing their density. If you or your child has cystic fibrosis (CF), you should learn as much as you can about the disease. Work closely with your doctors to learn how to manage CF. Ongoing Care Having ongoing medical care by a team of doctors, nurses, and respiratory therapists who specialize in CF is important. These specialists often are located at major medical centers or CF Care Centers. The United States has more than 100 CF Care Centers. Most of these centers have pediatric and adult programs or clinics. For more information about CF Care Centers, go to the Cystic Fibrosis Foundation's Care Center Network Web page. It's standard to have CF checkups every 3 months. Talk with your doctor about whether you should get an annual flu shot and other vaccines. Take all of your medicines as your doctor prescribes. In between checkups, be sure to contact your doctor if you have: Blood in your mucus, increased amounts of mucus, or a change in the color or consistency of your mucus. Decreased energy or appetite. Severe constipation or diarrhea, severe abdominal pain, or vomit that's dark green. A fever, which is a sign of infection. (However, you may still have a serious infection that needs treatment even if you don't have a fever.) Transition of Care Better treatments for CF allow people who have the disease to live longer now than in the past. Thus, the move from pediatric care to adult care is an important step in treatment. If your child has CF, encourage him or her to learn about the disease and take an active role in treatment. This will help prepare your child for the transition to adult care. CF Care Centers can help provide age-appropriate treatment throughout the transition period and into adulthood. They also will support the transition to adult care by balancing medical needs with other developmental factors, such as increased independence, relationships, and employment. Talk with your child's health care team for more information about how to help your child move from pediatric care to adult care. Lifestyle Changes In between medical checkups, you can practice good self-care and follow a healthy lifestyle. For example, follow a healthy diet. A healthy diet includes a variety of fruits, vegetables, and whole grains. Talk with your doctor about what types and amounts of foods you should include in your diet. Other lifestyle changes include: Not smoking and avoiding tobacco smoke Washing your hands often to lower your risk of infection Exercising regularly and drinking lots of fluids Doing chest physical therapy (as your doctor recommends) Other Concerns Although CF requires daily care, most people who have the disease are able to attend school and work. Adults who have CF can expect to have normal sex lives. Most men who have the disease are infertile (unable to have children). However, modern fertility treatments may help them. Women who have CF may find it hard to get pregnant, but they usually can have children. If you have CF, you should talk with your doctor if you're planning a pregnancy. Although CF can cause fertility problems, men and women who have the disease should still have protected sex to avoid sexually transmitted diseases. Emotional Issues Living with CF may cause fear, anxiety, depression, and stress. Talk about how you feel with your health care team. 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. Joining a patient support group may help you adjust to living with CF. You can see how other people who have the same symptoms have coped with them. Talk with your doctor about local support groups or check with an area medical center. Support from family and friends also can help relieve stress and anxiety. Let your loved ones know how you feel and what they can do to help you.", "role": "user" }, { "content": "Cystic Fibrosis affects males and females of all racial and ethnic groups. However, it is most prevalent among Latinos and American Indians, especially the Pueblo and Zuni. Cystic Fibrosis is less common among African Americans and Asian Americans. In all, more than 10 million Americans are carriers of a faulty CF gene.", "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\nEVC gene: 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. 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. 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. At least one mutation in the EVC gene has been found to cause the characteristic features of Weyers acrofacial dysostosis, affecting the development of the teeth, nails, and bones. The signs and symptoms of Weyers acrofacial dysostosis are similar to, but typically milder than, those of Ellis-van Creveld syndrome. The EVC gene mutation that causes Weyers acrofacial dysostosis occurs in one copy of the gene in each cell. It changes a single protein building block (amino acid) in the EVC protein, replacing the amino acid serine with the amino acid proline at position 307 (written as Ser307Pro). It is unclear how this genetic change leads to the specific features of Weyers acrofacial dysostosis. Studies suggest that the abnormal protein interferes with Sonic Hedgehog signaling in the developing embryo, disrupting the normal formation and growth of the teeth, nails, and bones. 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 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": "Treatment for your prostate cancer is chosen after a thorough evaluation. Your doctor will discuss the benefits and risks of each treatment. Sometimes your doctor may recommend 1 treatment for you because of your type of cancer and risk factors. Other times, there may be 2 or more treatments that could be good for you. Factors you and your doctor 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 doctor 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?", "role": "assistant" } ]
[ { "content": "what are the causes of pulmonary hypertension\n\n Pulmonary hypertension Overview Pulmonary hypertension is a type of high blood pressure that affects the arteries in your lungs and the right side of your heart. In one form of pulmonary hypertension, tiny arteries in your lungs, called pulmonary arterioles, and capillaries become narrowed, blocked or destroyed. This makes it harder for blood to flow through your lungs, and raises pressure within your lungs' arteries. As the pressure builds, your heart's lower right chamber (right ventricle) must work harder to pump blood through your lungs, eventually causing your heart muscle to weaken and fail. Some forms of pulmonary hypertension are serious conditions that become progressively worse and are sometimes fatal. Although some forms of pulmonary hypertension aren't curable, treatment can help lessen symptoms and improve your quality of life. Symptoms The signs and symptoms of pulmonary hypertension in its early stages might not be noticeable for months or even years. As the disease progresses, symptoms become worse. Pulmonary hypertension symptoms include: - Shortness of breath (dyspnea), initially while exercising and eventually while at rest - Fatigue - Dizziness or fainting spells (syncope) - Chest pressure or pain - Swelling (edema) in your ankles, legs and eventually in your abdomen (ascites) - Bluish color to your lips and skin (cyanosis) - Racing pulse or heart palpitations 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. Risk factors Your risk of developing pulmonary hypertension may be greater if: - You're a young adult, as idiopathic pulmonary arterial hypertension is more common in younger adults - You're overweight - You have a family history of the disease - You have one of various conditions that can increase your risk of developing pulmonary hypertension - You use illegal drugs, such as cocaine - You take certain appetite-suppressant medications - You have an existing risk of developing pulmonary hypertension, such as a family history of the condition, and you live at a high altitude Diagnosis Pulmonary hypertension is hard to diagnose early because it's not often detected in a routine physical exam. Even when the condition is more advanced, its signs and symptoms are similar to those of other heart and lung conditions. To diagnose your condition, your doctor may review your medical and family history, discuss your signs and symptoms, and conduct a physical examination. Doctors may order several tests to diagnose pulmonary hypertension, determine the severity of your condition and find out the cause of your condition. Tests may include: - Echocardiogram. Sound waves can create moving images of the beating heart. An echocardiogram can help your doctor to check the size and functioning of the right ventricle, and the thickness of the right ventricle's wall. An echocardiogram can also show how well your heart chambers and valves are working. Doctors may also use this to measure the pressure in your pulmonary arteries. In some cases, your doctor will recommend an exercise echocardiogram to help determine how well your heart and lungs work under stress. In this test, you'll have an echocardiogram before exercising on a stationary bike or treadmill and another test immediately afterward. This could be done as an oxygen consumption test, in which you may have to wear a mask that assesses the ability of your heart and lungs to deal with oxygen and carbon dioxide. Other exercise tests may also be done. These tests can help determine the severity and cause of your condition. They may also be done at follow-up appointments to check that your treatments are working. - Chest X-ray. A chest X-ray can show images of your heart, lungs and chest. This test can show enlargement of the right ventricle of the heart or the pulmonary arteries, which can occur in pulmonary hypertension. This test can also be used to identify other conditions that may be causing pulmonary hypertension. - Electrocardiogram (ECG). This noninvasive test shows your heart's electrical patterns and can detect abnormal rhythms. Doctors may also be able to see signs of right ventricle enlargement or strain. - Right heart catheterization. After you've had an echocardiogram, if your doctor thinks you have pulmonary hypertension, you'll likely have a right heart catheterization. This test can often help confirm that you have pulmonary hypertension and determine the severity of your condition. During the procedure, a cardiologist places a thin, flexible tube (catheter) into a vein in your neck or groin. The catheter is then threaded into your right ventricle and pulmonary artery. Right heart catheterization allows your doctor to directly measure the pressure in the main pulmonary arteries and right ventricle. It's also used to see what effect different medications may have on your pulmonary hypertension. - Blood tests. Your doctor might order blood tests to check for certain substances in your blood that might show you have pulmonary hypertension or its complications. Blood tests can also test for certain conditions that may be causing your condition. Your doctor might order additional tests to check the condition of your lungs and pulmonary arteries and to determine the cause of your condition, including: - Computerized tomography (CT) scan. During a CT scan, you lie on a table inside a doughnut-shaped machine. CT scanning generates X-rays to produce cross-sectional images of your body. Doctors may inject a dye into your blood vessels that helps your arteries to be more visible on the CT pictures (CT angiography). Doctors may use this test to look at the heart's size and function and to check for blood clots in the lungs' arteries. - Magnetic resonance imaging (MRI). This test may be used to check the right ventricle's function and the blood flow in the lung's arteries. In this test, you lie on a movable table that slides into the tunnel. An MRI uses a magnetic field and pulses of radio wave energy to make pictures of the body. - Pulmonary function test. This noninvasive test measures how much air your lungs can hold, and the airflow in and out of your lungs. During the test, you'll blow into a simple instrument called a spirometer. - Polysomnogram. This test detects your brain activity, heart rate, blood pressure, oxygen levels and other factors while you sleep. It can help diagnose a sleep disorder such as obstructive sleep apnea. - Ventilation/perfusion (V/Q) scan. In this test, a tracer is injected into a vein in your arm. The tracer maps blood flow and air to your lungs. This test can be used to determine whether blood clots are causing symptoms of pulmonary hypertension. - Open-lung biopsy. Rarely, a doctor might recommend an open-lung biopsy. An open-lung biopsy is a type of surgery in which a small sample of tissue is removed from your lungs under general anesthesia to check for a possible secondary cause of pulmonary hypertension. Genetic tests If a family member has had pulmonary hypertension, your doctor might screen you for genes that are linked with pulmonary hypertension. If you test positive, your doctor might recommend that other family members be screened for the same genetic mutation. Pulmonary hypertension classifications Once you've been diagnosed with pulmonary hypertension, your doctor might classify the severity of your disease into one of several classes, including: - Class I. Although you've been diagnosed with pulmonary hypertension, you have no symptoms with normal activity. - Class II. You don't have symptoms at rest, but you experience symptoms such as fatigue, shortness of breath or chest pain with normal activity. - Class III. You're comfortable at rest, but have symptoms when you're physically active. - Class IV. You have symptoms with physical activity and while at rest. Treatment Pulmonary hypertension can't be cured, but doctors can help you manage your condition. Treatment may help improve your symptoms and slow the progress of pulmonary hypertension. It often takes some time to find the most appropriate treatment for pulmonary hypertension. The treatments are often complex and require extensive follow-up care. Your doctor might also need to change your treatment if it's no longer effective. When pulmonary hypertension is caused by another condition, your doctor will treat the underlying cause whenever possible. Medications - Blood vessel dilators (vasodilators). Vasodilators open narrowed blood vessels. One of the most commonly prescribed vasodilators for pulmonary hypertension is epoprostenol (Flolan, Veletri). The drawback to epoprostenol is that its effects last only a few minutes. This drug is continuously injected through an intravenous (IV) catheter via a small pump that you wear in a pack on your belt or shoulder. Potential side effects of epoprostenol include jaw pain, nausea, diarrhea and leg cramps, as well as pain and infection at the IV site. Another form of the drug, iloprost (Ventavis), can be inhaled six to nine times a day through a nebulizer, a machine that vaporizes your medication. Because it's inhaled, it goes directly to the lungs. Side effects associated with iloprost include chest pain - often accompanied by a headache and nausea - and breathlessness. Treprostinil (Tyvaso, Remodulin, Orenitram), another form of the drug, can be given four times a day. It can be inhaled, taken as oral medication or administered by injection. It can cause side effects such as a headache, nausea and diarrhea. - Endothelin receptor antagonists. These medications reverse the effect of endothelin, a substance in the walls of blood vessels that causes them to narrow. These drugs may improve your energy level and symptoms. However, these drugs shouldn't be taken if you're pregnant. Also, these drugs can damage your liver and you may need monthly liver monitoring. These medications include bosentan (Tracleer), macitentan (Opsumit), and ambrisentan (Letairis). - Sildenafil and tadalafil. Sildenafil (Revatio, Viagra) and tadalafil (Cialis, Adcirca) are sometimes used to treat pulmonary hypertension. These drugs work by opening the blood vessels in the lungs to allow blood to flow through more easily. Side effects can include an upset stomach, headache and vision problems. - High-dose calcium channel blockers. These drugs help relax the muscles in the walls of your blood vessels. They include medications such as amlodipine (Norvasc), diltiazem (Cardizem, Tiazac, others) and nifedipine (Procardia, others). Although calcium channel blockers can be effective, only a small number of people with pulmonary hypertension respond to them. - Soluble guanylate cyclase (SGC) stimulator. Soluble guanylate cyclase (SGC) stimulators (Adempas) interact with nitric oxide and help relax the pulmonary arteries and lower the pressure within the arteries. These medications should not be taken if you're pregnant. They can sometimes cause dizziness or nausea. - Anticoagulants. Your doctor is likely to prescribe the anticoagulant warfarin (Coumadin, Jantoven) to help prevent the formation of blood clots within the small pulmonary arteries. Because anticoagulants prevent normal blood coagulation, they increase your risk of bleeding complications. Take warfarin exactly as prescribed, because warfarin can cause severe side effects if taken incorrectly. If you're taking warfarin, your doctor will ask you to have periodic blood tests to check how well the drug is working. Many other drugs, herbal supplements and foods can interact with warfarin, so be sure your doctor knows all of the medications you're taking. - Digoxin. Digoxin (Lanoxin) can help the heart beat stronger and pump more blood. It can help control the heart rate if you experience arrhythmias. - Diuretics. Commonly known as water pills, these medications help eliminate excess fluid from your body. This reduces the amount of work your heart has to do. They may also be used to limit fluid buildup in your lungs. - Oxygen. Your doctor might suggest that you sometimes breathe pure oxygen, a treatment known as oxygen therapy, to help treat pulmonary hypertension, especially if you live at a high altitude or have sleep apnea. Some people who have pulmonary hypertension eventually require continuous oxygen therapy. Surgeries - Atrial septostomy. If medications don't control your pulmonary hypertension, this open-heart surgery might be an option. In an atrial septostomy, a surgeon will create an opening between the upper left and right chambers of your heart (atria) to relieve the pressure on the right side of your heart. Atrial septostomy can have serious complications, including heart rhythm abnormalities (arrhythmias). - Transplantation. In some cases, a lung or heart-lung transplant might be an option, especially for younger people who have idiopathic pulmonary arterial hypertension. Major risks of any type of transplantation include rejection of the transplanted organ and serious infection, and you must take immunosuppressant drugs for life to help reduce the chance of rejection. Lifestyle and home remedies Although medical treatment can't cure pulmonary hypertension, it can lessen symptoms. Lifestyle changes also can help improve your condition. Consider these tips: - Get plenty of rest. Resting can reduce the fatigue that might come from having pulmonary hypertension. - Stay as active as possible. Even the mildest forms of activity might be too exhausting for some people who have pulmonary hypertension. For others, moderate exercise such as walking might be beneficial - especially when done with oxygen. But first, talk to your doctor about specific exercise restrictions. In most cases, it's recommended that you not lift heavy weights. Your doctor can help you plan an appropriate exercise program. - Don't smoke. If you smoke, the most important thing you can do for your heart and lungs is to stop. If you can't stop smoking by yourself, ask your doctor to prescribe a treatment plan to help you quit. Also, avoid secondhand smoke if possible. - Avoid pregnancy and birth control pills. If you're a woman of childbearing age, avoid pregnancy. Pregnancy can be life-threatening for both you and your baby. Also avoid using birth control pills, which can increase your risk of blood clots. Talk to your doctor about alternative forms of birth control. If you do become pregnant, it's important to consult with your doctor as pulmonary hypertension can cause serious complications to both you and the fetus. - Avoid traveling to or living at high altitudes. High altitudes can worsen the symptoms of pulmonary hypertension. If you live at an altitude of 8,000 feet (2,438 meters) or higher, your doctor might recommend that you move to a lower altitude. - Avoid situations that can excessively lower blood pressure. These include sitting in a hot tub or sauna or taking long hot baths or showers. These activities lower your blood pressure and can cause fainting or even death. Also avoid activities that cause prolonged straining, such as lifting heavy objects or weights. - Follow a nutritious diet and stay at a healthy weight. Aim to eat a healthy diet of whole grains, a variety of fruits and vegetables, lean meats and low-fat dairy products. Avoid saturated fat, trans fat and cholesterol. It's likely your doctor will recommend limiting the amount of salt in your diet. Aim to maintain a healthy weight. - Ask your doctor about medications. Take all your medications as prescribed. Ask your doctor about any other medications before taking them, as some can interfere with your medication or worsen your condition. - See your doctor at follow-up appointments. Your doctor may recommend regular follow-up appointments. Let your doctor know if you have any questions about your condition or medications you're taking, or if you have any symptoms or side effects from your medications. If pulmonary hypertension is affecting your quality of life, ask your doctor about options that could improve your quality of life. - Get vaccines. Your doctor may recommend getting an influenza and pneumonia vaccine, as these conditions can cause serious issues for people with pulmonary hypertension. - Get support. If you're feeling stressed or worried due to your condition, get support from family or friends. Or, consider joining a support group with others who have pulmonary hypertension. ", "role": "user" }, { "content": "Your risk of developing pulmonary hypertension may be greater if: - You're a young adult, as idiopathic pulmonary arterial hypertension is more common in younger adults - You're overweight - You have a family history of the disease - You have one of various conditions that can increase your risk of developing pulmonary hypertension - You use illegal drugs, such as cocaine - You take certain appetite-suppressant medications - You have an existing risk of developing pulmonary hypertension, such as a family history of the condition, and you live at a high altitude", "role": "assistant" } ]
[ { "content": "How bad can endometriosis get?\n\nEndometriosis: Endometriosis happens when the lining of the uterus (womb) grows outside of the uterus. It may affect more than 11% of American women between 15 and 44.1 It is especially common among women in their 30s and 40s and may make it harder to get pregnant. Several different treatment options can help manage the symptoms and improve your chances of getting pregnant. Endometriosis, sometimes called \"endo,\" is a common health problem in women. It gets its name from the word endometrium(en-doh-MEE-tree-um), the tissue that normally lines the uterus or womb. Endometriosis happens when this tissue grows outside of your uterus and on other areas in your body where it doesn't belong. Most often, endometriosis is found on the: Other sites for growths can include the vagina, cervix, vulva, bowel, bladder, or rectum. Rarely, endometriosis appears in other parts of the body, such as the lungs, brain, and skin. Symptoms of endometriosis can include: Endometriosis growths are benign (not cancerous). But they can still cause problems. Endometriosis happens when tissue that is normally on the inside of your uterus or womb grows outside of your uterus or womb where it doesn't belong. Endometriosis growths bleed in the same way the lining inside of your uterus does every month - during your menstrual period. This can cause swelling and pain because the tissue grows and bleeds in an area where it cannot easily get out of your body. The growths may also continue to expand and cause problems, such as: Endometriosis is a common health problem for women. Researchers think that at least 11% of women, or more than 6 1/2 million women in the United States, have endometriosis.1 Endometriosis can happen in any girl or woman who has menstrual periods, but it is more common in women in their 30s and 40s. You might be more likely to get endometriosis if you have: No one knows for sure what causes this disease. Researchers are studying possible causes: You can't prevent endometriosis. But you can reduce your chances of developing it by lowering the levels of the hormone estrogen in your body. Estrogen helps to thicken the lining of your uterus during your menstrual cycle. To keep lower estrogen levels in your body, you can: If you have symptoms of endometriosis, talk with your doctor. The doctor will talk to you about your symptoms and do or prescribe one or more of the following to find out if you have endometriosis: There is no cure for endometriosis, but treatments are available for the symptoms and problems it causes. Talk to your doctor about your treatment options. If you are not trying to get pregnant, hormonal birth control is generally the first step in treatment. This may include: Hormonal treatment works only as long as it is taken and is best for women who do not have severe pain or symptoms. If you are trying to get pregnant, your doctor may prescribe a gonadotropin-releasing hormone (GnRH) agonist. This medicine stops the body from making the hormones responsible for ovulation, the menstrual cycle, and the growth of endometriosis. This treatment causes a temporary menopause, but it also helps control the growth of endometriosis. Once you stop taking the medicine, your menstrual cycle returns, but you may have a better chance of getting pregnant. Surgery is usually chosen for severe symptoms, when hormones are not providing relief or if you are having fertility problems. During the operation, the surgeon can locate any areas of endometriosis and may remove the endometriosis patches. After surgery, hormone treatment is often restarted unless you are trying to get pregnant. Other treatments you can try, alone or with any of the treatments listed above, include: Learn more about endometriosis treatments. For some women, the painful symptoms of endometriosis improve after menopause. As the body stops making the hormone estrogen, the growths shrink slowly. However, some women who take menopausal hormone therapy may still have symptoms of endometriosis. If you are having symptoms of endometriosis after menopause, talk to your doctor about treatment options. Yes. Many women with endometriosis get pregnant. But, you may find it harder to get pregnant. Endometriosis affects about one-half (50%) of women with infertility.6 No one knows exactly how endometriosis might cause infertility. Some possible reasons include:7 If you have endometriosis and are having trouble getting pregnant, talk to your doctor. He or she can recommend treatments, such as surgery to remove the endometrial growths.7 Research shows a link between endometriosis and other health problems in women and their families. Some of these include: For more information about endometriosis, call the OWH Helpline at 1-800-994-9662 or contact the following organizations:", "role": "user" }, { "content": "Endometriosis happens when the lining of the uterus (womb) grows outside of the uterus. It is especially common among women in their 30s and 40s and may make it harder to get pregnant. Endometriosis growths bleed in the same way the lining inside of your uterus does every month - during your menstrual period. This can cause swelling and pain because the tissue grows and bleeds in an area where it cannot easily get out of your body.", "role": "assistant" } ]
[ { "content": "Breast cancer at 84. My mother was just diagnost with breast cancer. She is 84 years old, her tumor started in the milk duct and is small in size, their is a mass as well in the same breast. He is scheduled for a lumpectomy to remove both. Because of age we would like suggestions on treatment options after surgery.\n\nBreast cancer (Treatment): Treatment is based on many factors, including: - Type of breast cancer - Stage of the cancer (staging is a tool your providers use to find out how advanced the cancer is) - Whether the cancer is sensitive to certain hormones - Whether the cancer overproduces (overexpresses) the HER2/neu protein Cancer treatments may include: - Hormone therapy. - Chemotherapy, which uses medicines to kill cancer cells. - Radiation therapy, which is used to destroy cancerous tissue. - Surgery to remove cancerous tissue: A lumpectomy removes the breast lump. Mastectomy removes all or part of the breast and possibly nearby structures. Nearby lymph nodes may also be removed during surgery. - Targeted therapy uses medicine to attack the gene changes in cancer cells. Hormone therapy is an example of targeted therapy. It blocks certain hormones that fuel cancer growth. Cancer treatment can be local or systemic: - Local treatments involve only the area of disease. Radiation and surgery are forms of local treatment. They are most effective when the cancer has not spread outside the breast. - Systemic treatments affect the entire body. Chemotherapy and hormonal therapy are types of systemic treatment. Most women receive a combination of treatments. For women with stage I, II, or III breast cancer, the main goal is to treat the cancer and prevent it from returning (recurring). For women with stage IV cancer, the goal is to improve symptoms and help them live longer. In most cases, stage IV breast cancer cannot be cured. - Stage 0 and ductal carcinoma: Lumpectomy plus radiation or mastectomy is the standard treatment. - Stage I and II: Lumpectomy plus radiation or mastectomy with lymph node removal is the standard treatment. Chemotherapy, hormonal therapy, and other targeted therapy may also be used after surgery. - Stage III: Treatment involves surgery, possibly followed by chemotherapy, hormone therapy, and other targeted therapy. - Stage IV: Treatment may involve surgery, radiation, chemotherapy, hormone therapy, other targeted therapy, or a combination of these treatments. After treatment, some women continue to take medicines for a time. All women continue to have blood tests, mammograms, and other tests after treatment to monitor for the return of cancer or development of another breast cancer. Women who have had a mastectomy may have reconstructive breast surgery. This will be done either at the time of mastectomy or later.", "role": "user" }, { "content": "After lumpectomy your mother's doctor might prescribe medicines for a time. She will need to have blood tests, mammograms, and other tests after treatment to monitor for the return of cancer or development of another breast cancer.", "role": "assistant" } ]
[ { "content": "what is epilepsy\n\nEpilepsy: Epilepsy is a central nervous system (neurological) disorder in which brain activity becomes abnormal, causing seizures or periods of unusual behavior, sensations, and sometimes loss of awareness. Anyone can develop epilepsy. Epilepsy affects both males and females of all races, ethnic backgrounds and ages. Seizure symptoms can vary widely. Some people with epilepsy simply stare blankly for a few seconds during a seizure, while others repeatedly twitch their arms or legs. Having a single seizure doesn't mean you have epilepsy. At least two unprovoked seizures are generally required for an epilepsy diagnosis. Treatment with medications or sometimes surgery can control seizures for the majority of people with epilepsy. Some people require lifelong treatment to control seizures, but for others, the seizures eventually go away. Some children with epilepsy may outgrow the condition with age. Epilepsy care at Mayo Clinic Because epilepsy is caused by abnormal activity in the brain, seizures can affect any process your brain coordinates. Seizure signs and symptoms may include: - Temporary confusion - A staring spell - Uncontrollable jerking movements of the arms and legs - Loss of consciousness or awareness - Psychic symptoms such as fear, anxiety or deja vu Symptoms vary depending on the type of seizure. In most cases, a person with epilepsy will tend to have the same type of seizure each time, so the symptoms will be similar from episode to episode. Doctors generally classify seizures as either focal or generalized, based on how the abnormal brain activity begins. Focal seizures When seizures appear to result from abnormal activity in just one area of your brain, they're called focal (partial) seizures. These seizures fall into two categories: - Focal seizures without loss of consciousness. Once called simple partial seizures, these seizures don't cause a loss of consciousness. They may alter emotions or change the way things look, smell, feel, taste or sound. They may also result in involuntary jerking of a body part, such as an arm or leg, and spontaneous sensory symptoms such as tingling, dizziness and flashing lights. - Focal seizures with impaired awareness. Once called complex partial seizures, these seizures involve a change or loss of consciousness or awareness. During a complex partial seizure, you may stare into space and not respond normally to your environment or perform repetitive movements, such as hand rubbing, chewing, swallowing or walking in circles. Symptoms of focal seizures may be confused with other neurological disorders, such as migraine, narcolepsy or mental illness. A thorough examination and testing are needed to distinguish epilepsy from other disorders. Generalized seizures Seizures that appear to involve all areas of the brain are called generalized seizures. Six types of generalized seizures exist. - Absence seizures. Absence seizures, previously known as petit mal seizures, often occur in children and are characterized by staring into space or subtle body movements such as eye blinking or lip smacking. These seizures may occur in clusters and cause a brief loss of awareness. - Tonic seizures. Tonic seizures cause stiffening of your muscles. These seizures usually affect muscles in your back, arms and legs and may cause you to fall to the ground. - Atonic seizures. Atonic seizures, also known as drop seizures, cause a loss of muscle control, which may cause you to suddenly collapse or fall down. - Clonic seizures. Clonic seizures are associated with repeated or rhythmic, jerking muscle movements. These seizures usually affect the neck, face and arms. - Myoclonic seizures. Myoclonic seizures usually appear as sudden brief jerks or twitches of your arms and legs. - Tonic-clonic seizures. Tonic-clonic seizures, previously known as grand mal seizures, are the most dramatic type of epileptic seizure and can cause an abrupt loss of consciousness, body stiffening and shaking, and sometimes loss of bladder control or biting your tongue. When to see a doctor Seek immediate medical help if any of the following occurs: - The seizure lasts more than five minutes. - Breathing or consciousness doesn't return after the seizure stops. - A second seizure follows immediately. - You have a high fever. - You're experiencing heat exhaustion. - You're pregnant. - You have diabetes. - You've injured yourself during the seizure. If you experience a seizure for the first time, seek medical advice. Epilepsy has no identifiable cause in about half the people with the condition. In the other half, the condition may be traced to various factors, including: - Genetic influence. Some types of epilepsy, which are categorized by the type of seizure you experience or the part of the brain that is affected, run in families. In these cases, it's likely that there's a genetic influence. Researchers have linked some types of epilepsy to specific genes, but for most people, genes are only part of the cause of epilepsy. Certain genes may make a person more sensitive to environmental conditions that trigger seizures. - Head trauma. Head trauma as a result of a car accident or other traumatic injury can cause epilepsy. - Brain conditions. Brain conditions that cause damage to the brain, such as brain tumors or strokes, can cause epilepsy. Stroke is a leading cause of epilepsy in adults older than age 35. - Infectious diseases. Infectious diseases, such as meningitis, AIDS and viral encephalitis, can cause epilepsy. - Prenatal injury. Before birth, babies are sensitive to brain damage that could be caused by several factors, such as an infection in the mother, poor nutrition or oxygen deficiencies. This brain damage can result in epilepsy or cerebral palsy. - Developmental disorders. Epilepsy can sometimes be associated with developmental disorders, such as autism and neurofibromatosis. Certain factors may increase your risk of epilepsy: - Age. The onset of epilepsy is most common in children and older adults, but the condition can occur at any age. - Family history. If you have a family history of epilepsy, you may be at an increased risk of developing a seizure disorder. - Head injuries. Head injuries are responsible for some cases of epilepsy. You can reduce your risk by wearing a seat belt while riding in a car and by wearing a helmet while bicycling, skiing, riding a motorcycle or engaging in other activities with a high risk of head injury. - Stroke and other vascular diseases. Stroke and other blood vessel (vascular) diseases can lead to brain damage that may trigger epilepsy. You can take a number of steps to reduce your risk of these diseases, including limiting your intake of alcohol and avoiding cigarettes, eating a healthy diet, and exercising regularly. - Dementia. Dementia can increase the risk of epilepsy in older adults. - Brain infections. Infections such as meningitis, which causes inflammation in your brain or spinal cord, can increase your risk. - Seizures in childhood. High fevers in childhood can sometimes be associated with seizures. Children who have seizures due to high fevers generally won't develop epilepsy. The risk of epilepsy increases if a child has a long seizure, another nervous system condition or a family history of epilepsy. 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. Doctors generally begin by treating epilepsy with medication. If medications don't treat the condition, doctors may propose surgery or another type of treatment. Medication Most people with epilepsy can become seizure-free by taking one anti-seizure medication, which is also called anti-epileptic medication. Others may be able to decrease the frequency and intensity of their seizures by taking a combination of medications. Many children with epilepsy who aren't experiencing epilepsy symptoms can eventually discontinue medications and live a seizure-free life. Many adults can discontinue medications after two or more years without seizures. Your doctor will advise you about the appropriate time to stop taking medications. Finding the right medication and dosage can be complex. Your doctor will consider your condition, frequency of seizures, your age and other factors when choosing which medication to prescribe. Your doctor will also review any other medications you may be taking, to ensure the anti-epileptic medications won't interact with them. Your doctor likely will first prescribe a single medication at a relatively low dosage and may increase the dosage gradually until your seizures are well-controlled. Anti-seizure medications may have some side effects. Mild side effects include: - Fatigue - Dizziness - Weight gain - Loss of bone density - Skin rashes - Loss of coordination - Speech problems - Memory and thinking problems More-severe but rare side effects include: - Depression - Suicidal thoughts and behaviors - Severe rash - Inflammation of certain organs, such as your liver To achieve the best seizure control possible with medication, follow these steps: - Take medications exactly as prescribed. - Always call your doctor before switching to a generic version of your medication or taking other prescription medications, over-the-counter drugs or herbal remedies. - Never stop taking your medication without talking to your doctor. - Notify your doctor immediately if you notice new or increased feelings of depression, suicidal thoughts, or unusual changes in your mood or behaviors. - Tell your doctor if you have migraines. Doctors may prescribe one of the anti-epileptic medications that can prevent your migraines and treat epilepsy. At least half the people newly diagnosed with epilepsy will become seizure-free with their first medication. If anti-epileptic medications don't provide satisfactory results, your doctor may suggest surgery or other therapies. You'll have regular follow-up appointments with your doctor to evaluate your condition and medications. Surgery When medications fail to provide adequate control over seizures, surgery may be an option. With epilepsy surgery, a surgeon removes the area of your brain that's causing seizures. Doctors usually perform surgery when tests show that: - Your seizures originate in a small, well-defined area of your brain - The area in your brain to be operated on doesn't interfere with vital functions such as speech, language, motor function, vision or hearing Although many people continue to need some medication to help prevent seizures after successful surgery, you may be able to take fewer drugs and reduce your dosages. In a small number of cases, surgery for epilepsy can cause complications such as permanently altering your thinking (cognitive) abilities. Talk to your surgeon about his or her experience, success rates, and complication rates with the procedure you're considering. Therapies Apart from medications and surgery, these potential therapies offer an alternative for treating epilepsy: - Vagus nerve stimulation. In vagus nerve stimulation, doctors implant a device called a vagus nerve stimulator underneath the skin of your chest, similar to a heart pacemaker. Wires from the stimulator are connected to the vagus nerve in your neck. The battery-powered device sends bursts of electrical energy through the vagus nerve and to your brain. It's not clear how this inhibits seizures, but the device can usually reduce seizures by 20 to 40 percent. Most people still need to take anti-epileptic medication, although some people may be able to lower their medication dose. You may experience side effects from vagus nerve stimulation, such as throat pain, hoarse voice, shortness of breath or coughing. - Ketogenic diet. Some children with epilepsy have been able to reduce their seizures by following a strict diet that's high in fats and low in carbohydrates. In this diet, called a ketogenic diet, the body breaks down fats instead of carbohydrates for energy. After a few years, some children may be able to stop the ketogenic diet - under close supervision of their doctors - and remain seizure-free. Consult a doctor if you or your child is considering a ketogenic diet. It's important to make sure that your child doesn't become malnourished when following the diet. Side effects of a ketogenic diet may include dehydration, constipation, slowed growth because of nutritional deficiencies and a buildup of uric acid in the blood, which can cause kidney stones. These side effects are uncommon if the diet is properly and medically supervised. Following a ketogenic diet can be a challenge. Low-glycemic index and modified Atkins diets offer less restrictive alternatives that may still provide some benefit for seizure control. Potential future treatments Researchers are studying many potential new treatments for epilepsy, including: - Deep brain stimulation. In deep brain stimulation, surgeons implant electrodes into a specific part of your brain, typically your thalamus. The electrodes are connected to a generator implanted in your chest or the skull that sends electrical pulses to your brain and may reduce your seizures. - Responsive neurostimulation. Implantable, pacemaker-like devices that help prevent seizures are also under investigation. These responsive stimulation or closed loop devices analyze brain activity patterns to detect seizures before they happen and deliver an electrical charge or drug to stop the seizure. - Continuous stimulation of the seizure onset zone (subthreshold stimulation). Subthreshold stimulation - continuous stimulation to an area of your brain below a level that's physically noticeable - appears to improve seizure outcomes and quality of life for some people with seizures. This treatment approach may work in people who have seizures that start in an area of the brain that can't be removed because it would affect speech and motor functions (eloquent area). Or it might benefit people whose seizure characteristics mean their chances of successful treatment with responsive neurostimulation are low. - Minimally invasive surgery. New minimally invasive surgical techniques, such as MRI-guided laser ablation, show promise at reducing seizures with fewer risks than traditional open brain surgery for epilepsy. - Stereotactic laser ablation or radiosurgery. For some types of epilepsy, stereotactic laser ablation or stereotactic radiosurgery may provide effective treatment for people in which an open procedure may be too risky. In these procedures, doctors direct radiation at the specific area in the brain causing seizures, to destroy that tissue in an effort to better control the seizures. - External nerve stimulation device. Similar to vagus nerve stimulation, this device would stimulate specific nerves to reduce frequency of seizures. But unlike vagus nerve stimulation, this device would be worn externally so that no surgery to implant the device is needed. Understanding your condition can help you take better control of it: - Take your medication correctly. Don't adjust your dosage before talking to your doctor. If you feel your medication should be changed, discuss it with your doctor. - Get enough sleep. Lack of sleep can trigger seizures. Be sure to get adequate rest every night. - Wear a medical alert bracelet. This will help emergency personnel know how to treat you correctly. - Exercise. Exercising may help keep you physically healthy and reduce depression. Make sure to drink enough water, and rest if you get tired during exercise. In addition, make healthy life choices, such as managing stress, limiting alcoholic beverages and avoiding cigarettes.", "role": "user" }, { "content": "Epilepsy is a central nervous system (neurological) disorder in which brain activity becomes abnormal, causing seizures or periods of unusual behavior, sensations, and sometimes loss of awareness. A", "role": "assistant" } ]
[ { "content": "help with obesity I would like help on my obesity problem and if I can get help\n\nObesity (Treatment): CHANGING YOUR LIFESTYLE An active lifestyle and plenty of exercise, along with healthy eating, is the safest way to lose weight. Even modest weight loss can improve your health. You may need a lot of support from family and friends. Your main goal should be to learn new, healthy ways of eating and make them part of your daily routine. Many people find it hard to change their eating habits and behaviors. You may have practiced some habits for so long that you may not even know they are unhealthy, or you do them without thinking. You need to be motivated to make lifestyle changes. Make the behavior change part of your life over the long term. Know that it takes time to make and keep a change in your lifestyle. Work with your provider and dietitian to set realistic, safe daily calorie counts that help you lose weight while staying healthy. Remember that if you drop pounds slowly and steadily, you are more likely to keep them off. Your dietitian can teach you about: - Healthy food choices - Healthy snacks - Reading nutrition labels - New ways to prepare food - Portion sizes - Sweetened drinks Extreme diets (fewer than 1100 calories per day) are not thought to be safe or to work very well. These types of diets often DO NOT contain enough vitamins and minerals. Most people who lose weight this way return to overeating and become obese again. Learn ways to manage stress other than snacking. Examples may be meditation, yoga, or exercise. If you are depressed or stressed a lot, talk to your provider. MEDICINES AND HERBAL REMEDIES You may see ads for supplements and herbal remedies that claim they will help you lose weight. Some of these claims may not be true. And some of these supplements can have serious side effects. Talk to your provider before using them. You can discuss weight loss medicines with your doctor. Many people lose at least 5 pounds (2 kg) by taking these drugs, but they may regain the weight when they stop taking the medicine unless they have made lifestyle changes. SURGERY Bariatric (weight-loss) surgery can reduce the risk of certain diseases in people with severe obesity. These risks include: - Arthritis - Diabetes - Heart disease - High blood pressure - Sleep apnea - Some cancers - Stroke Surgery may help people who have been very obese for 5 years or more and have not lost weight from other treatments, such as diet, exercise, or medicine. Surgery alone is not the answer for weight loss. It can train you to eat less, but you still have to do much of the work. You must be committed to diet and exercise after surgery. Talk to your doctor to learn if surgery is a good option for you. Weight-loss surgeries include: - Laparoscopic gastric banding - Gastric bypass surgery - Sleeve gastrectomy (less common) - Duodenal switch", "role": "user" }, { "content": "An active lifestyle and plenty of exercise, along with healthy eating, is the safest way to lose weight. Make the behavior change part of your life over the long term. Know that it takes time to make and keep a change in your lifestyle. Work with your provider and dietitian to set realistic, safe daily calorie counts that help you lose weight while staying healthy. Your dietitian can teach you about: - Healthy food choices - Healthy snacks - Reading nutrition labels - New ways to prepare food - Portion sizes - Sweetened drinks Extreme diets (fewer than 1100 calories per day) are not thought to be safe or to work very well. You may see ads for supplements and herbal remedies that claim they will help you lose weight. Some of these claims may not be true. And some of these supplements can have serious side effects. Surgery may help people who have been very obese for 5 years or more and have not lost weight from other treatments, such as diet, exercise, or medicine. Surgery alone is not the answer for weight loss. It can train you to eat less, but you still have to do much of the work. You must be committed to diet and exercise after surgery. Talk to your doctor to learn if surgery is a good option for you. Weight-loss surgeries include: - Laparoscopic gastric banding - Gastric bypass surgery - Sleeve gastrectomy (less common) - Duodenal switch", "role": "assistant" } ]
[ { "content": "Are there any researches indicating how early an individual may experience any signs or symptoms of Rheumatoid Arthritis?\n\n Rheumatoid arthritis arthritis, rheumatoid RA Description Rheumatoid arthritis is a disease that causes chronic abnormal inflammation, primarily affecting the joints. The most common signs and symptoms are pain, swelling, and stiffness of the joints. Small joints in the hands and feet are involved most often, although larger joints (such as the shoulders, hips, and knees) may become involved later in the disease. Joints are typically affected in a symmetrical pattern; for example, if joints in the hand are affected, both hands tend to be involved. People with rheumatoid arthritis often report that their joint pain and stiffness is worse when getting out of bed in the morning or after a long rest. Rheumatoid arthritis can also cause inflammation of other tissues and organs, including the eyes, lungs, and blood vessels. Additional signs and symptoms of the condition can include a loss of energy, a low fever, weight loss, and a shortage of red blood cells (anemia). Some affected individuals develop rheumatoid nodules, which are firm lumps of noncancerous tissue that can grow under the skin and elsewhere in the body. The signs and symptoms of rheumatoid arthritis usually appear in mid- to late adulthood. Many affected people have episodes of symptoms (flares) followed by periods with no symptoms (remissions) for the rest of their lives. In severe cases, affected individuals have continuous health problems related to the disease for many years. The abnormal inflammation can lead to severe joint damage, which limits movement and can cause significant disability. Frequency Rheumatoid arthritis affects about 1.3 million adults in the United States. Worldwide, it is estimated to occur in up to 1 percent of the population. The disease is two to three times more common in women than in men, which may be related to hormonal factors. Causes Rheumatoid arthritis probably results from a combination of genetic and environmental factors, many of which are unknown. Rheumatoid arthritis is classified as an autoimmune disorder, one of a large group of conditions that occur when the immune system attacks the body's own tissues and organs. In people with rheumatoid arthritis, the immune system triggers abnormal inflammation in the membrane that lines the joints (the synovium). When the synovium is inflamed, it causes pain, swelling, and stiffness of the joint. In severe cases, the inflammation also affects the bone, cartilage, and other tissues within the joint, causing more serious damage. Abnormal immune reactions also underlie the features of rheumatoid arthritis affecting other parts of the body. Variations in dozens of genes have been studied as risk factors for rheumatoid arthritis. Most of these genes are known or suspected to be involved in immune system function. The most significant genetic risk factors for rheumatoid arthritis are variations in human leukocyte antigen (HLA) genes, especially the HLA-DRB1 gene. The proteins produced from HLA genes help the immune system distinguish the body's own proteins from proteins made by foreign invaders (such as viruses and bacteria). Changes in other genes appear to have a smaller impact on a person's overall risk of developing the condition. Other, nongenetic factors are also believed to play a role in rheumatoid arthritis. These factors may trigger the condition in people who are at risk, although the mechanism is unclear. Potential triggers include changes in sex hormones (particularly in women), occupational exposure to certain kinds of dust or fibers, and viral or bacterial infections. Long-term smoking is a well-established risk factor for developing rheumatoid arthritis; it is also associated with more severe signs and symptoms in people who have the disease. Inheritance Pattern The inheritance pattern of rheumatoid arthritis is unclear because many genetic and environmental factors appear to be involved. However, having a close relative with rheumatoid arthritis likely increases a person's risk of developing the condition. Sources for This Page Carmona L, Cross M, Williams B, Lassere M, March L. Rheumatoid arthritis. Best Pract Res Clin Rheumatol. 2010 Dec;24(6):733-45. doi: 10.1016/j.berh.2010.10.001. Review. ", "role": "user" }, { "content": "The signs and symptoms of rheumatoid arthritis usually appear in mid- to late adulthood. Many affected people have episodes of symptoms (flares) followed by periods with no symptoms (remissions) for the rest of their lives. In severe cases, affected individuals have continuous health problems related to the disease for many years.", "role": "assistant" } ]
[ { "content": "asthma Question. What is the consensus of medical doctors as to whether asthma can be cured? And do you have an article discussing whether asthma can be cured?\n\n Asthma Overview Asthma is a condition in which your airways narrow and swell and produce extra mucus. This can make breathing difficult and trigger coughing, wheezing and shortness of breath. For some people, asthma is a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack. Asthma can't be cured, but its symptoms can be controlled. Because asthma often changes over time, it's important that you work with your doctor to track your signs and symptoms and adjust treatment as needed. Symptoms Asthma symptoms vary from person to person. You may have infrequent asthma attacks, have symptoms only at certain times - such as when exercising - or have symptoms all the time. Asthma signs and symptoms include: - Shortness of breath - Chest tightness or pain - Trouble sleeping caused by shortness of breath, coughing or wheezing - A whistling or wheezing sound when exhaling (wheezing is a common sign of asthma in children) - Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu Signs that your asthma is probably worsening include: - Asthma signs and symptoms that are more frequent and bothersome - Increasing difficulty breathing (measurable with a peak flow meter, a device used to check how well your lungs are working) - The need to use a quick-relief inhaler more often For some people, asthma signs and symptoms flare up in certain situations: - Exercise-induced asthma, which may be worse when the air is cold and dry - Occupational asthma, triggered by workplace irritants such as chemical fumes, gases or dust - Allergy-induced asthma, triggered by airborne substances, such as pollen, mold spores, cockroach waste or particles of skin and dried saliva shed by pets (pet dander) When to see a doctor Seek emergency treatment Severe asthma attacks can be life-threatening. Work with your doctor to determine what to do when your signs and symptoms worsen - and when you need emergency treatment. Signs of an asthma emergency include: - Rapid worsening of shortness of breath or wheezing - No improvement even after using a quick-relief inhaler, such as albuterol - Shortness of breath when you are doing minimal physical activity Contact your doctor See your doctor: - If you think you have asthma. If you have frequent coughing or wheezing that lasts more than a few days or any other signs or symptoms of asthma, see your doctor. Treating asthma early may prevent long-term lung damage and help keep the condition from worsening over time. - To monitor your asthma after diagnosis. If you know you have asthma, work with your doctor to keep it under control. Good long-term control helps you feel better from day to day and can prevent a life-threatening asthma attack. - If your asthma symptoms get worse. Contact your doctor right away if your medication doesn't seem to ease your symptoms or if you need to use your quick-relief inhaler more often. Don't try to solve the problem by taking more medication without consulting your doctor. Overusing asthma medication can cause side effects and may make your asthma worse. - To review your treatment. Asthma often changes over time. Meet with your doctor regularly to discuss your symptoms and make any needed treatment adjustments. Causes It isn't clear why some people get asthma and others don't, but it's probably due to a combination of environmental and genetic (inherited) factors. Asthma triggers Exposure to various irritants and substances that trigger allergies (allergens) can trigger signs and symptoms of asthma. Asthma triggers are different from person to person and can include: - Airborne substances, such as pollen, dust mites, mold spores, pet dander or particles of cockroach waste - Respiratory infections, such as the common cold - Physical activity (exercise-induced asthma) - Cold air - Air pollutants and irritants, such as smoke - Certain medications, including beta blockers, aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve) - Strong emotions and stress - Sulfites and preservatives added to some types of foods and beverages, including shrimp, dried fruit, processed potatoes, beer and wine - Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat Risk factors A number of factors are thought to increase your chances of developing asthma. These include: - Having a blood relative (such as a parent or sibling) with asthma - Having another allergic condition, such as atopic dermatitis or allergic rhinitis (hay fever) - Being overweight - Being a smoker - Exposure to secondhand smoke - Exposure to exhaust fumes or other types of pollution - Exposure to occupational triggers, such as chemicals used in farming, hairdressing and manufacturing Complications Asthma complications include: - Signs and symptoms that interfere with sleep, work or recreational activities - Sick days from work or school during asthma flare-ups - Permanent narrowing of the bronchial tubes (airway remodeling) that affects how well you can breathe - Emergency room visits and hospitalizations for severe asthma attacks - Side effects from long-term use of some medications used to stabilize severe asthma Proper treatment makes a big difference in preventing both short-term and long-term complications caused by 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. 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: Treatment Prevention and long-term control are key in stopping asthma attacks before they start. Treatment usually involves learning to recognize your triggers, taking steps to avoid them and tracking your breathing to make sure your daily asthma medications are keeping symptoms under control. In case of an asthma flare-up, you may need to use a quick-relief inhaler, such as albuterol. Medications The right medications for you depend on a number of things - your age, symptoms, asthma triggers and what works best to keep your asthma under control. Preventive, long-term control medications reduce the inflammation in your airways that leads to symptoms. Quick-relief inhalers (bronchodilators) quickly open swollen airways that are limiting breathing. In some cases, allergy medications are necessary. Long-term asthma control medications, generally taken daily, are the cornerstone of asthma treatment. These medications keep asthma under control on a day-to-day basis and make it less likely you'll have an asthma attack. Types of long-term control medications include: - Inhaled corticosteroids. These anti-inflammatory drugs include fluticasone (Flonase, Flovent HFA), budesonide (Pulmicort Flexhaler, Rhinocort), flunisolide (Aerospan HFA), ciclesonide (Alvesco, Omnaris, Zetonna), beclomethasone (Qnasl, Qvar), mometasone (Asmanex) and fluticasone furoate (Arnuity Ellipta). You may need to use these medications for several days to weeks before they reach their maximum benefit. Unlike oral corticosteroids, these corticosteroid medications have a relatively low risk of side effects and are generally safe for long-term use. - Leukotriene modifiers. These oral medications - including montelukast (Singulair), zafirlukast (Accolate) and zileuton (Zyflo) - help relieve asthma symptoms for up to 24 hours. In rare cases, these medications have been linked to psychological reactions, such as agitation, aggression, hallucinations, depression and suicidal thinking. Seek medical advice right away for any unusual reaction. - Long-acting beta agonists. These inhaled medications, which include salmeterol (Serevent) and formoterol (Foradil, Perforomist), open the airways. Some research shows that they may increase the risk of a severe asthma attack, so take them only in combination with an inhaled corticosteroid. And because these drugs can mask asthma deterioration, don't use them for an acute asthma attack. - Combination inhalers. These medications - such as fluticasone-salmeterol (Advair Diskus), budesonide-formoterol (Symbicort) and formoterol-mometasone (Dulera) - contain a long-acting beta agonist along with a corticosteroid. Because these combination inhalers contain long-acting beta agonists, they may increase your risk of having a severe asthma attack. - Theophylline. Theophylline (Theo-24, Elixophyllin, others) is a daily pill that helps keep the airways open (bronchodilator) by relaxing the muscles around the airways. It's not used as often now as in past years. Quick-relief (rescue) medications are used as needed for rapid, short-term symptom relief during an asthma attack - or before exercise if your doctor recommends it. Types of quick-relief medications include: - Short-acting beta agonists. These inhaled, quick-relief bronchodilators act within minutes to rapidly ease symptoms during an asthma attack. They include albuterol (ProAir HFA, Ventolin HFA, others) and levalbuterol (Xopenex). Short-acting beta agonists can be taken using a portable, hand-held inhaler or a nebulizer - a machine that converts asthma medications to a fine mist - so that they can be inhaled through a face mask or a mouthpiece. - Ipratropium (Atrovent). Like other bronchodilators, ipratropium acts quickly to immediately relax your airways, making it easier to breathe. Ipratropium is mostly used for emphysema and chronic bronchitis, but it's sometimes used to treat asthma attacks. - Oral and intravenous corticosteroids. These medications - which include prednisone and methylprednisolone - relieve airway inflammation caused by severe asthma. They can cause serious side effects when used long term, so they're used only on a short-term basis to treat severe asthma symptoms. If you have an asthma flare-up, a quick-relief inhaler can ease your symptoms right away. But if your long-term control medications are working properly, you shouldn't need to use your quick-relief inhaler very often. Keep a record of how many puffs you use each week. If you need to use your quick-relief inhaler more often than your doctor recommends, see your doctor. You probably need to adjust your long-term control medication. Allergy medications may help if your asthma is triggered or worsened by allergies. These include: - Allergy shots (immunotherapy). Over time, allergy shots gradually reduce your immune system reaction to specific allergens. You generally receive shots once a week for a few months, then once a month for a period of three to five years. - Omalizumab (Xolair). This medication, given as an injection every two to four weeks, is specifically for people who have allergies and severe asthma. It acts by altering the immune system. Bronchial thermoplasty This treatment - which isn't widely available nor right for everyone - is used for severe asthma that doesn't improve with inhaled corticosteroids or other long-term asthma medications. Generally, over the span of three outpatient visits, bronchial thermoplasty heats the insides of the airways in the lungs with an electrode, reducing the smooth muscle inside the airways. This limits the ability of the airways to tighten, making breathing easier and possibly reducing asthma attacks. Treat by severity for better control: A stepwise approach Your treatment should be flexible and based on changes in your symptoms, which should be assessed thoroughly each time you see your doctor. Then your doctor can adjust your treatment accordingly. For example, if your asthma is well-controlled, your doctor may prescribe less medicine. If your asthma isn't well-controlled or is getting worse, your doctor may increase your medication and recommend more-frequent visits. Asthma action plan Work with your doctor to create an asthma action plan that outlines in writing when to take certain medications or when to increase or decrease the dose of your medications based on your symptoms. Also include a list of your triggers and the steps you need to take to avoid them. Your doctor may also recommend tracking your asthma symptoms or using a peak flow meter on a regular basis to monitor how well your treatment is controlling your asthma. Lifestyle and home remedies Although many people with asthma rely on medications to prevent and relieve symptoms, you can do several things on your own to maintain your health and lessen the possibility of asthma attacks. Avoid your triggers Taking steps to reduce your exposure asthma triggers is a key part of asthma control, including: - Use your air conditioner. Air conditioning reduces the amount of airborne pollen from trees, grasses and weeds that finds its way indoors. Air conditioning also lowers indoor humidity and can reduce your exposure to dust mites. If you don't have air conditioning, try to keep your windows closed during pollen season. - Decontaminate your decor. Minimize dust that may worsen nighttime symptoms by replacing certain items in your bedroom. For example, encase pillows, mattresses and box springs in dustproof covers. Remove carpeting and install hardwood or linoleum flooring. Use washable curtains and blinds. - Maintain optimal humidity. If you live in a damp climate, talk to your doctor about using a dehumidifier. - Prevent mold spores. Clean damp areas in the bath, kitchen and around the house to keep mold spores from developing. Get rid of moldy leaves or damp firewood in the yard. - Reduce pet dander. If you're allergic to dander, avoid pets with fur or feathers. Having pets regularly bathed or groomed also may reduce the amount of dander in your surroundings. - Clean regularly. Clean your home at least once a week. If you're likely to stir up dust, wear a mask or have someone else do the cleaning. - Cover your nose and mouth if it's cold out. If your asthma is worsened by cold or dry air, wearing a face mask can help. Stay healthy Taking care of yourself can help keep your symptoms under control, including: - Get regular exercise. Having asthma doesn't mean you have to be less active. Treatment can prevent asthma attacks and control symptoms during activity. Regular exercise can strengthen your heart and lungs, which helps relieve asthma symptoms. If you exercise in cold temperatures, wear a face mask to warm the air you breathe. - Maintain a healthy weight. Being overweight can worsen asthma symptoms, and it puts you at higher risk of other health problems. - Control heartburn and gastroesophageal reflux disease (GERD). It's possible that the acid reflux that causes heartburn may damage lung airways and worsen asthma symptoms. If you have frequent or constant heartburn, talk to your doctor about treatment options. You may need treatment for GERD before your asthma symptoms improve. Alternative medicine Certain alternative treatments may help with asthma symptoms. However, keep in mind that these treatments are not a replacement for medical treatment - especially if you have severe asthma. Talk to your doctor before taking any herbs or supplements, as some may interact with medications you take. While some alternative remedies are used for asthma, in most cases more research is needed to see how well they work and to measure the extent of possible side effects. Alternative asthma treatments include: - Breathing exercises. These exercises may reduce the amount of medication you need to keep your asthma symptoms under control. - Herbal and natural remedies. A few herbal and natural remedies that may help improve asthma symptoms include black seed, caffeine, choline and pycnogenol. ", "role": "user" }, { "content": "Asthma symptoms can be managed but not cured.", "role": "assistant" } ]
[ { "content": "Are there any researches indicating how early an individual may experience any signs or symptoms of Rheumatoid Arthritis?\n\nRheumatoid arthritis: 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. 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. 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. 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. 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. 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. 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. 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 occur at any age, but it most commonly begins between the ages of 40 and 60. Factors that may increase your risk of rheumatoid arthritis include: - Your sex. Women are more likely than men to develop rheumatoid arthritis. -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. - 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.", "role": "assistant" } ]
[ { "content": "how do you diagnose anxiety\n\nAnxiety: 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 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. 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 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. 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 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. 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. 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. 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": "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.", "role": "assistant" } ]