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[ { "content": "how do i prevent myself from having dementia\n\n Dementia VASCULAR DEMENTIA AND VASCULAR COGNITIVE IMPAIRMENT: A RESOURCE LIST Find articles, fact sheets, and other resources to help you and your family learn about vascular dementia and vascular cognitive impairment. General Vascular dementia, the second most common form of dementia in older adults after Alzheimer's disease, and vascular cognitive impairment (VCI) result from injuries to vessels that supply blood to the brain, often after a stroke or series of strokes. The symptoms of vascular dementia can be similar to those of Alzheimer's, and both conditions can occur at the same time (a condition called \"mixed dementia\"). Symptoms of vascular dementia and VCI can begin suddenly and worsen or improve over time.Caregivers of people with vascular dementia or VCI face a variety of challenges. Learning more about these disorders can help. This resource list is a place to start. All resources on this list are available free online.The items on this list are in three categories:- Vascular Dementia and Vascular Cognitive Impairment - CADASIL-a rare, inherited form of vascular dementia - Binswanger's Disease-also called Subcortical Vascular Dementia Vascular Dementia and Vascular Cognitive Impairment The Brain Needs Blood (February-March 2013)This Neurology Now magazine article offers an overview of the relationship between vascular events or disease (including stroke and mini-stroke) and cognitive impairment. Using a patient case study, it describes the differences between VCI and Alzheimer's disease. The article also discusses lesser known, possible risk factors for VCI, such as depression and sleep disorders, as well as treatment strategies.Published by the American Academy of Neurology. Free online access.The Dementias: Hope Through Research (2013)This booklet from the National Institute on Aging and the National Institute of Neurological Disorders and Stroke describes different kinds of dementia, including vascular dementia. It discusses brain changes, symptoms, and treatments for many dementias, as well as risk factors and diagnosis for dementia generally. It also summarizes dementia research supported by the National Institutes of Health. The booklet includes a glossary and list of resources.Published by the National Institutes of Health. Available from the National Institute on Aging Alzheimer's and related Dementias Education and Referral (ADEAR) Center. Phone: 1-800-438-4380. Email: [email protected]. Free online access.Vascular Cognitive Impairment (undated)This article notes the varied definitions of VCI. It describes symptoms, including problems with memory and executive function, and risk factors such as diabetes and high blood pressure. The article also gives information about diagnostic tests and treatments, as well as lifestyle changes that may reduce the risk of VCI.Published by the University of Cincinnati Memory Disorders Center. Phone: 1-866-941-8264. Free online access.Vascular Dementia (2015)In this fact sheet, vascular dementia is defined as a decline in thinking skills caused by a major stroke or multiple minor strokes. The fact sheet notes that vascular brain changes often coexist with changes linked to other types of dementia, including Alzheimer's disease. The fact sheet lists symptoms, such as confusion and trouble speaking, and discusses diagnosis, risk factors, and treatment.Published by the Alzheimer's Association. Phone: 1-800-272-3900. Email: [email protected]. Free online access.Vascular Dementia (2014)This web module offers an overview of vascular dementia. It discusses causes and risk factors, as well as symptoms, which can vary depending on the part of the brain where blood flow is impaired. The module also gives tips for preparing for a doctor's appointment and describes diagnostic tests, treatments, coping mechanisms for patients and caregivers, and prevention.Published by MayoClinic.com. Free online access.Vascular Dementia (undated)This fact sheet discusses vascular dementia as a common after-stroke problem that makes it difficult to process information. The condition can lead to memory loss, confusion, decreased attention span, other cognitive symptoms, and movement symptoms. The fact sheet offers practical tips for managing the disease and for caring for someone with vascular dementia.Published by the National Stroke Association. Phone: 1-800-787-6537. Free online access.Vascular Dementia (2015)In this overview, vascular dementia (sometimes called multi-infarct dementia) is described as dementia resulting from a series of small strokes. The article lists other risk factors, such as diabetes and smoking, and symptoms, which grow worse as the disease progresses. Also discussed are diagnosis, treatment, and possible complications.Published by the National Library of Medicine. Free online access.Multi-Infarct Dementia Information Page (2017)This web page provides an overview of multi-infarct dementia, a type of vascular dementia caused by multiple, often \"silent\" strokes. It describes symptoms, the difficulty of diagnosis, and treatment by preventing or controlling risk factors such as high cholesterol.Published by the National Institute of Neurological Disorders and Stroke. Phone: 1-800-352-9424. Free online access.What Is Vascular Dementia? (2014)This detailed fact sheet explains that vascular dementia has several types, including post-stroke, single-infarct, and subcortical dementias. It describes their separate, but related, causes and how symptoms change over time. Possible ways to stop the disease from progressing, such as controlling underlying conditions, are noted.Available from the Alzheimer's Society, London. E-mail: [email protected]. CADASIL CADASIL stands for cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy. It is a rare, inherited disorder that affects the small blood vessels in the brain and leads to vascular dementia or vascular cognitive impairment and other symptoms.CADASIL (2015)This overview explains the acronym CADASIL and describes the hallmark symptoms caused by damage to small blood vessels. It also explains that a mutation of the NOTCH3 gene causes CADASIL and discusses related disorders. The web page includes resources and references.Published by the National Organization for Rare Disorders. Phone: 1-800-999-6673. Free online access.CADASIL Information Page (2017)This web page describes CADASIL as an inherited disease caused by a genetic mutation that typically leads to cognitive problems and dementia by age 65. Symptoms and disease onset vary widely, but CADASIL often begins in a person's mid-30s. There is no cure, though drugs may alleviate some symptoms.Published by the National Institute of Neurological Disorders and Stroke. Phone: 1-800-352-9424. Free online access.Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (reviewed 2013)This web page answers questions about CADASIL-what it is, how people inherit it, and more. It explains that although the condition causes strokes, it is not associated with common risk factors for stroke such as high blood pressure. Rather, an inherited genetic mutation (in the NOTCH3 gene) affecting small blood vessels is the cause of several symptoms, including migraines and dementia. The web page includes a glossary and list of online resources.Published by the National Library of Medicine. Phone: 1-888-346-3656. Free online access.Understanding CADASIL (undated)This brief guide explains the brain changes resulting from the NOTCH3 gene mutation that causes CADASIL. It focuses on stroke and transient ischemic attack (common symptoms of CADASIL) and their effects, including cognitive impairment. It also lists medical treatments and tests to avoid because they can increase the risk of certain symptoms.Published by CADASIL Together We Have Hope. Phone: 1-877-519-4673. Email: [email protected]. Free online access. END-OF-LIFE CARE FOR PEOPLE WITH DEMENTIA Caring for a person with dementia at the end of life has special challenges. Help them have good quality of life as they're dying. General As they reach the end of life, people suffering from dementia can present special challenges for caregivers. People can live with diseases such as Alzheimer's or Parkinson's dementia for years, so it can be hard to think of these as terminal diseases. But, they do cause death. Hard Decisions Dementia causes the gradual loss of thinking, remembering, and reasoning abilities, making it difficult for those who want to provide supportive care at the end of life to know what is needed. Because people with advanced dementia can no longer communicate clearly, they cannot share their concerns. Is Uncle Bert refusing food because he's not hungry or because he's confused? Why does Grandma Sakura seem agitated? Is she in pain and needs medication to relieve it, but can't tell you?As these conditions progress, caregivers may find it hard to provide emotional or spiritual comfort. How can you let Grandpa know how much his life has meant to you? How do you make peace with your mother if she no longer knows who you are? Someone who has severe memory loss might not take spiritual comfort from sharing family memories or understand when others express what an important part of their life this person has been. Palliative care or hospice can be helpful in many ways to families of people with dementia.Sensory connections-targeting someone's senses, like hearing, touch, or sight-can bring comfort. Being touched or massaged can be soothing. Listening to music, white noise, or sounds from nature seem to relax some people and lessen their agitation.When a dementia like Alzheimer's disease is first diagnosed, if everyone understands that there is no cure, then plans for the end of life can be made before thinking and speaking abilities fail and the person with Alzheimer's can no longer legally complete documents like advance directives.Learn more about legal and financial planning for people with Alzheimer's disease.End-of-life care decisions are more complicated for caregivers if the dying person has not expressed the kind of care he or she would prefer. Someone newly diagnosed with Alzheimer's disease might not be able to imagine the later stages of the disease. Weighing Care Choices Quality of life is an important issue when making healthcare decisions for people with dementia. For example, medicines are available that may delay or keep symptoms from becoming worse for a little while. Medicines also may help control some behavioral symptoms in people with mild-to-moderate Alzheimer's disease.However, some caregivers might not want drugs prescribed for people in the later stages of Alzheimer's. They may believe that the person's quality of life is already so poor that the medicine is unlikely to make a difference. If the drug has serious side effects, they may be even more likely to decide against it.When making care decisions for someone else near the end of life, consider the goals of care and weigh the benefits, risks, and side effects of the treatment. You may have to make a treatment decision based on the person's comfort at one end of the spectrum and extending life or maintaining abilities for a little longer at the other.With dementia, a person's body may continue to be physically healthy while his or her thinking and memory are deteriorating. This means that caregivers and family members may be faced with very difficult decisions about how treatments that maintain physical health, such as installing a pacemaker, fit within the care goals. Dementia’s Unpredictable Progression Dementia often progresses slowly and unpredictably. Experts suggest that signs of the final stage of Alzheimer's disease include some of the following:- Being unable to move around on one's own - Being unable to speak or make oneself understood - Needing help with most, if not all, daily activities, such as eating and self-care - Eating problems such as difficulty swallowingBecause of their unique experience with what happens at the end of life, hospice and palliative care experts might be able to help identify when someone in the final stage of Alzheimer's disease is in the last days or weeks of life. Caregiver Support Caring for people with Alzheimer's or other dementias at home can be demanding and stressful for the family caregiver. Depression is a problem for some family caregivers, as is fatigue, because many feel they are always on call. Family caregivers may have to cut back on work hours or leave work altogether because of their caregiving responsibilities.Many family members taking care of a person with advanced dementia at home feel relief when death happens-for themselves and for the person who died. It is important to realize such feelings are normal. Hospice-whether used at home or in a facility (such as a nursing home)-gives family caregivers needed support near the end of life, as well as help with their grief, both before and after their family member dies.Caregivers, ask for help when you need it. Learn about respite care.Questions to Ask About End-of-Life Care for a Person with Dementia You will want to understand how the available medical options presented by the healthcare team fit into your family's particular needs. You might want to ask questions such as: - How will the approach the doctor is suggesting affect your relative's quality of life? Will it make a difference in comfort and well-being? - If considering home hospice for your relative with dementia, what will be needed to care for him or her? Does the facility have special experience with people with dementia? - What can I expect as the disease gets worse?Read about this topic in Spanish. Lea sobre este tema en espanol. WHAT IS MIXED DEMENTIA? Read about mixed dementia, a combination of two or more disorders. For example, older adults with dementia may have Alzheimer's and vascular dementia. General It is common for people to have mixed dementia-a combination of two or more disorders, at least one of which is dementia. A number of combinations are possible. For example, some people have both Alzheimer's disease and vascular dementia.Some studies indicate that mixed dementia is the most common cause of dementia in the elderly. For example, autopsy studies looking at the brains of people who had dementia indicate that most people age 80 and older had mixed dementia-a combination of brain changes related to Alzheimer's disease (amyloid and tau), cerebrovascular disease (such as stroke), and, in some instances, Lewy body dementia (Lewy bodies). These studies suggest that mixed dementia is caused by both Alzheimer's-related neurodegenerative processes and vascular disease-related processes.In a person with mixed dementia, it may not be clear exactly how many of a person's symptoms are due to Alzheimer's or another type of dementia. In one study, approximately 40 percent of people who were thought to have Alzheimer's were found after autopsy to also have some form of cerebrovascular disease. In addition, several studies have found that many of the major risk factors for vascular disease also may be risk factors for Alzheimer's disease.Researchers are still working to understand how underlying disease processes in mixed dementia influence each other. It is not clear, for example, if symptoms are likely to be worse when a person has brain changes reflecting multiple types of dementia. Nor do we know if a person with multiple dementias can benefit from treating one type, for example, when a person with Alzheimer's controls high blood pressure and other vascular disease risk factors. General It is common for people to have mixed dementia-a combination of two or more disorders, at least one of which is dementia. A number of combinations are possible. For example, some people have both Alzheimer's disease and vascular dementia.Some studies indicate that mixed dementia is the most common cause of dementia in the elderly. For example, autopsy studies looking at the brains of people who had dementia indicate that most people age 80 and older had mixed dementia-a combination of brain changes related to Alzheimer's disease (amyloid and tau), cerebrovascular disease (such as stroke), and, in some instances, Lewy body dementia (Lewy bodies). These studies suggest that mixed dementia is caused by both Alzheimer's-related neurodegenerative processes and vascular disease-related processes.In a person with mixed dementia, it may not be clear exactly how many of a person's symptoms are due to Alzheimer's or another type of dementia. In one study, approximately 40 percent of people who were thought to have Alzheimer's were found after autopsy to also have some form of cerebrovascular disease. In addition, several studies have found that many of the major risk factors for vascular disease also may be risk factors for Alzheimer's disease.Researchers are still working to understand how underlying disease processes in mixed dementia influence each other. It is not clear, for example, if symptoms are likely to be worse when a person has brain changes reflecting multiple types of dementia. Nor do we know if a person with multiple dementias can benefit from treating one type, for example, when a person with Alzheimer's controls high blood pressure and other vascular disease risk factors. WHAT IS VASCULAR DEMENTIA? Vascular dementia differs from Alzheimer's disease in that it is caused by stroke. Learn about types of vascular dementia as well as treatment. General 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. General 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. GETTING HELP WITH ALZHEIMER'S CAREGIVING Looking for respite care or help with Alzheimer's caregiving? Learn about supportive resources like home care, adult day care, meal services, and hospice. General Some caregivers need help when the person is in the early stages of Alzheimer's disease. Other caregivers look for help when the person is in the later stages of Alzheimer's. It's okay to seek help whenever you need it.As the person moves through the stages of Alzheimer's, he or she will need more care. One reason is that medicines used to treat Alzheimer's disease can only control symptoms; they cannot cure the disease. Symptoms, such as memory loss and confusion, will get worse over time.Because of this, you will need more help. You may feel that asking for help shows weakness or a lack of caring, but the opposite is true. Asking for help shows your strength. It means you know your limits and when to seek support. Build a Support System According to many caregivers, building a local support system is a key way to get help. Your support system might include a caregiver support group, the local chapter of the Alzheimer's Association, family, friends, and faith groups. Resources for Alzheimer’s Care Here are some places that can give you support and advice:NIA Alzheimer's and related Dementias Education and Referral (ADEAR) Center Email: [email protected] Phone: 1-800-438-4380 www.nia.nih.gov/alzheimers The ADEAR Center offers information on diagnosis, treatment, patient care, caregiver needs, long-term care, and research and clinical trials related to Alzheimer's disease. Staff can refer you to local and national resources, or you can search for information on the website. The Center is a service of the National Institute on Aging (NIA), part of the Federal Government's National Institutes of Health. They have information to help you understand Alzheimer's disease. You can also get hints on other subjects, including:- Talking with the doctor - Financial and legal planning - Medicines - Comfort care at the end of life - Paying for careAlzheimer's Association Phone: 1-800-272-3900 www.alz.orgThe Alzheimer's Association offers information, a help line, and support services to people with Alzheimer's and their caregivers. Local chapters across the country offer support groups, including many that help with early-stage Alzheimer's disease. Call or go online to find out where to get help in your area. The Association also funds Alzheimer's research.Alzheimer's Foundation of America Phone: 1-866-232-8484 www.alzfdn.orgThe Alzheimer's Foundation of America provides information about how to care for people with Alzheimer's, as well as a list of services for people with the disease. It also offers information for caregivers and their families through member organizations. Services include a toll-free hotline, publications, and other educational materials.Eldercare Locator Phone: 1-800-677-1116 www.eldercare.govCaregivers often need information about community resources, such as home care, adult day care, and nursing homes. Contact the Eldercare Locator to find these resources in your area. The Eldercare Locator is a service of the Administration on Aging. The Federal Government funds this service.National Institute on Aging Information Center Email: [email protected] Phone: 1-800-222-2225 TTY: 1-800-222-4225 www.nia.nih.gov/healthThe NIA Information Center offers free publications about aging. Many of these publications are in both English and Spanish. They can be viewed, printed, and ordered online. TYPES OF DEMENTIA Alzheimer's disease is the most common type of dementia. Learn about other dementias, including Lewy body dementia, frontotemporal disorders, vascular dementia, and mixed dementia. General Various disorders and factors contribute to the development of dementia. Neurodegenerative disorders result in a progressive and irreversible loss of neurons and brain functioning. Currently, there are no cures for these types of disorders. They include:- Alzheimer's disease - Frontotemporal disorders - Lewy body dementiaOther types of progressive brain disease include:- Vascular dementia and vascular cognitive impairment - Mixed dementia, a combination of two or more disorders, at least one of which is dementiaOther types of dementia can often be halted or even reversed with treatment. For example, normal pressure hydrocephalus, an abnormal buildup of cerebrospinal fluid in the brain, often resolves with treatment.In addition, certain medical conditions can cause serious memory problems that resemble dementia. These problems should go away once the conditions are treated. These conditions include:- Side effects of certain medicines - Depression - Certain vitamin deficiencies - Drinking too much alcohol - Blood clots or tumors in the brain - Head injury, such as a concussion from a fall or accident - Thyroid, kidney, or liver problemsDoctors have identified many other conditions that can cause dementia or dementia-like symptoms. These conditions include:- Creutzfeldt-Jakob disease, a rare brain disorder - Huntington's disease, a hereditary disorder caused by a faulty gene - Chronic traumatic encephalopathy (CTE), caused by repeated traumatic brain injury - Subdural hematoma, bleeding between the brain's surface and its outer coveringThe overlap in symptoms of various dementias can make it hard to get an accurate diagnosis. But a proper diagnosis is important to get the right treatment. Seek help from a neurologist-a doctor who specializes in disorders of the brain and nervous system-or other medical specialist who knows about dementia.Learn more about dementia from MedlinePlus. General Various disorders and factors contribute to the development of dementia. Neurodegenerative disorders result in a progressive and irreversible loss of neurons and brain functioning. Currently, there are no cures for these types of disorders. They include:- Alzheimer's disease - Frontotemporal disorders - Lewy body dementiaOther types of progressive brain disease include:- Vascular dementia and vascular cognitive impairment - Mixed dementia, a combination of two or more disorders, at least one of which is dementiaOther types of dementia can often be halted or even reversed with treatment. For example, normal pressure hydrocephalus, an abnormal buildup of cerebrospinal fluid in the brain, often resolves with treatment.In addition, certain medical conditions can cause serious memory problems that resemble dementia. These problems should go away once the conditions are treated. These conditions include:- Side effects of certain medicines - Depression - Certain vitamin deficiencies - Drinking too much alcohol - Blood clots or tumors in the brain - Head injury, such as a concussion from a fall or accident - Thyroid, kidney, or liver problemsDoctors have identified many other conditions that can cause dementia or dementia-like symptoms. These conditions include:- Creutzfeldt-Jakob disease, a rare brain disorder - Huntington's disease, a hereditary disorder caused by a faulty gene - Chronic traumatic encephalopathy (CTE), caused by repeated traumatic brain injury - Subdural hematoma, bleeding between the brain's surface and its outer coveringThe overlap in symptoms of various dementias can make it hard to get an accurate diagnosis. But a proper diagnosis is important to get the right treatment. Seek help from a neurologist-a doctor who specializes in disorders of the brain and nervous system-or other medical specialist who knows about dementia.Learn more about dementia from MedlinePlus. WHAT IS DEMENTIA? Dementia is a loss of thinking, remembering, and reasoning skills that interferes with a person's daily life and activities. While dementia is more common with advanced age, it is not a normal part of aging. Learn why. General Dementia is the loss of cognitive functioning-thinking, remembering, and reasoning-and behavioral abilities to such an extent that it interferes with a person's daily life and activities. Dementia ranges in severity from the mildest stage, when it is just beginning to affect a person's functioning, to the most severe stage, when the person must depend completely on others for basic activities of living.Signs and symptoms of dementia result when once-healthy neurons (nerve cells) in the brain stop working, lose connections with other brain cells, and die. While everyone loses some neurons as they age, people with dementia experience far greater loss.While dementia is more common as people grow older (up to half of all people age 85 or older may have some form of dementia), it is not a normal part of aging. Many people live into their 90s and beyond without any signs of dementia. One type of dementia, frontotemporal disorders, is more common in middle-aged than older adults.Memory loss, though common, is not the only sign of dementia. For a person to have dementia, he or she must have:- Two or more core mental functions that are impaired. These functions include memory, language skills, visual perception, and the ability to focus and pay attention. These also include cognitive skills such as the ability to reason and solve problems. - A loss of brain function severe enough that a person cannot do normal, everyday tasksIn addition, some people with dementia cannot control their emotions. Their personalities may change. They can have delusions, which are strong beliefs without proof, such as the idea that someone is stealing from them. They also may hallucinate, seeing or otherwise experiencing things that are not real.The causes of dementia can vary, depending on the types of brain changes that may be taking place. Other dementias include Lewy body dementia, frontotemporal disorders, and vascular dementia. It is common for people to have mixed dementia-a combination of two or more disorders, at least one of which is dementia. For example, some people have both Alzheimer's disease and vascular dementia.Learn more about dementia from MedlinePlus. General Dementia is the loss of cognitive functioning-thinking, remembering, and reasoning-and behavioral abilities to such an extent that it interferes with a person's daily life and activities. Dementia ranges in severity from the mildest stage, when it is just beginning to affect a person's functioning, to the most severe stage, when the person must depend completely on others for basic activities of living.Signs and symptoms of dementia result when once-healthy neurons (nerve cells) in the brain stop working, lose connections with other brain cells, and die. While everyone loses some neurons as they age, people with dementia experience far greater loss.While dementia is more common as people grow older (up to half of all people age 85 or older may have some form of dementia), it is not a normal part of aging. Many people live into their 90s and beyond without any signs of dementia. One type of dementia, frontotemporal disorders, is more common in middle-aged than older adults.Memory loss, though common, is not the only sign of dementia. For a person to have dementia, he or she must have:- Two or more core mental functions that are impaired. These functions include memory, language skills, visual perception, and the ability to focus and pay attention. These also include cognitive skills such as the ability to reason and solve problems. - A loss of brain function severe enough that a person cannot do normal, everyday tasksIn addition, some people with dementia cannot control their emotions. Their personalities may change. They can have delusions, which are strong beliefs without proof, such as the idea that someone is stealing from them. They also may hallucinate, seeing or otherwise experiencing things that are not real.The causes of dementia can vary, depending on the types of brain changes that may be taking place. Other dementias include Lewy body dementia, frontotemporal disorders, and vascular dementia. It is common for people to have mixed dementia-a combination of two or more disorders, at least one of which is dementia. For example, some people have both Alzheimer's disease and vascular dementia.Learn more about dementia from MedlinePlus. ASSESSING CHANGES IN MEMORY AND FUNCTION When visiting an aging relative, you might notice they have more memory problems than last time. Find info to help you assess changes in memory and cognition. General If you do not see an aging friend or relative often, changes in his or her health may seem dramatic. In contrast, the primary caregiver might not notice such changes or realize that more help, medical treatment, or supervision is needed. Or, the primary caregiver might not want to accept the fact that the health of his or her spouse or parent is failing. Sometimes a geriatric care manager or other professional is the first to notice changes.For families dealing with Alzheimer's disease or another dementia, it can be easier to cover for the person-doing things for him or her, filling in information in conversations, and so on-than to acknowledge what is happening.As a caregiver, you can provide support by helping an aging friend or relative get the care they need.A few good questions to help you start the conversation with the primary caregiver are:- If you thought there might be a change in Aunt Joan's condition, whose opinion would you seek? - I didn't notice Dad repeating himself so much the last time I was here. Do you remember when it started?Some changes may not be what you think. Occasional forgetfulness does not necessarily indicate dementia. Before you raise the issue of what needs to be done, talk to your parent and the primary caregiver about your concerns.Try not to sound critical when you raise the subject. Instead, mention your particular worry, for example, \"Mom, it looks like you don't have much food in the house-are you having trouble getting to the store?\" and explain why you are asking. Listen to what the primary caregiver says about the situation and whether he or she believes there are problems.Discuss what you think could be done. For example, you could ask:- Would you like me to arrange to have groceries delivered on a regular basis? - Do we need to get a second opinion about the diagnosis? - Can you follow the medication schedule? - Would you like some help with housework?Try to follow your suggestions with practical help, and give specific examples of what you can do. For example, you might arrange to have a personal or home health aide come in once a week. You might schedule doctors' appointments or arrange for transportation.In some cases, you may have to be forceful, especially if you feel that the situation is unhealthy or unsafe. Do not leave a frail adult at risk. If you have to act against the wishes of your parent or the primary caregiver, be direct and explain what you are going to do. Discuss your plan, and say why you are taking action.Find more tips for long-distance caregivers. DIAGNOSING DEMENTIA Doctors diagnose dementia-including Alzheimer disease, Lewy body dementia, and frontotemporal dementia-with brain scans and other tests. General To diagnose dementia, doctors first assess whether a person has an underlying treatable condition such as depression, abnormal thyroid function, normal pressure hydrocephalus, or vitamin B12 deficiency. Early diagnosis is important, as some causes for symptoms can be treated. In many cases, the specific type of dementia a person has may not be confirmed until after the person has died and the brain is examined.A medical assessment for dementia generally includes:- Patient history. Typical questions about a person's medical and family history might include asking about whether dementia runs in the family, how and when symptoms began, changes in behavior and personality, and if the person is taking certain medications that might cause or worsen symptoms. - Physical exam. Measuring blood pressure and other vital signs may help physicians detect conditions that might cause or occur with dementia. Such conditions may be treatable. - Neurological tests. Assessing balance, sensory function, reflexes, vision, eye movements, and other cognitive functions helps identify conditions that may affect the diagnosis or are treatable with drugs. Tests Used to Diagnose Dementia The following procedures also may be used to diagnose dementia:- Cognitive and neuropsychological tests. These tests measure memory, problem solving, attention, counting, language skills, and other abilities related to mental functioning. - Laboratory tests. Blood and urine tests can help find or rule out possible causes of symptoms. - Brain scans. These tests can identify strokes, tumors, and other problems that can cause dementia. Scans also identify changes in the brain's structure and function. The most common scans are: - Computed tomography (CT), which uses X-rays to produce images of the brain and other organs - Magnetic resonance imaging (MRI), which uses magnetic fields and radio waves to produce detailed images of body structures, including tissues, organs, bones, and nerves - Positron emission tomography (PET), which uses radiation to provide pictures of brain activity - Psychiatric evaluation. This evaluation will help determine if depression or another mental health condition is causing or contributing to a person's symptoms. - Genetic tests. Some dementias are caused by a known gene defect. In these cases, a genetic test can help people know if they are at risk for dementia. People should talk with family members, a primary care doctor, and a genetic counselor before getting tested. Who Can Diagnose Dementia? Visiting a family doctor is often the first step for people who are experiencing changes in thinking, movement, or behavior. However, neurologists-doctors who specialize in disorders of the brain and nervous system-generally have the expertise needed to diagnose dementia. Geriatric psychiatrists, neuropsychologists, and geriatricians may also be skilled in diagnosing the condition.If a specialist cannot be found in your community, ask the neurology department of the nearest medical school for a referral. A hospital affiliated with a medical school may also have a dementia or movement disorders clinic that provides expert evaluation. ", "role": "user" }, { "content": "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.", "role": "assistant" } ]

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

[ { "content": "how is gonorrhea diagnosed\n\n Gonorrhea Overview Gonorrhea is an infection caused by a sexually transmitted bacterium that can infect both males and females. Gonorrhea most often affects the urethra, rectum or throat. In females, gonorrhea can also infect the cervix. Gonorrhea is most commonly spread during sex. But babies can be infected during childbirth if their mothers are infected. In babies, gonorrhea most commonly affects the eyes. Gonorrhea is a common infection that, in many cases, causes no symptoms. You may not even know that you're infected. Abstaining from sex, using a condom if you do have sex and being in a mutually monogamous relationship are the best ways to prevent sexually transmitted infections. Symptoms In many cases, gonorrhea infection causes no symptoms. When symptoms do appear, gonorrhea infection can affect multiple sites in your body, but it commonly appears in the genital tract. Gonorrhea affecting the genital tract Signs and symptoms of gonorrhea infection in men include: - Painful urination - Pus-like discharge from the tip of the penis - Pain or swelling in one testicle Signs and symptoms of gonorrhea infection in women include: - Increased vaginal discharge - Painful urination - Vaginal bleeding between periods, such as after vaginal intercourse - Painful intercourse - Abdominal or pelvic pain Gonorrhea at other sites in the body Gonorrhea can also affect these parts of the body: - Rectum. Signs and symptoms include anal itching, pus-like discharge from the rectum, spots of bright red blood on toilet tissue and having to strain during bowel movements. - Eyes. Gonorrhea that affects your eyes may cause eye pain, sensitivity to light, and pus-like discharge from one or both eyes. - Throat. Signs and symptoms of a throat infection may include a sore throat and swollen lymph nodes in the neck. - Joints. If one or more joints become infected by bacteria (septic arthritis), the affected joints may be warm, red, swollen and extremely painful, especially when you move an affected joint. When to see your doctor Make an appointment with your doctor if you notice any troubling signs or symptoms, such as a burning sensation when you urinate or a pus-like discharge from your penis, vagina or rectum. Also make an appointment with your doctor if your partner has been diagnosed with gonorrhea. You may not experience signs or symptoms that prompt you to seek medical attention. But without treatment, you can reinfect your partner even after he or she has been treated for gonorrhea. Causes Gonorrhea is caused by the bacterium Neisseria gonorrhoeae. The gonorrhea bacteria are most often passed from one person to another during sexual contact, including oral, anal or vaginal intercourse. Risk factors Factors that may increase your risk of gonorrhea infection include: - Younger age - A new sex partner - A sex partner who has concurrent partners - Multiple sex partners - Previous gonorrhea diagnosis - Having other sexually transmitted infections Complications Untreated gonorrhea can lead to significant complications, such as: - Infertility in women. Untreated gonorrhea can spread into the uterus and fallopian tubes, causing pelvic inflammatory disease (PID), which may result in scarring of the tubes, greater risk of pregnancy complications and infertility. PID is a serious infection that requires immediate treatment. - Infertility in men. Men with untreated gonorrhea can experience epididymitis - inflammation of a small, coiled tube in the rear portion of the testicles where the sperm ducts are located (epididymis). Epididymitis is treatable, but if left untreated, it may lead to infertility. - Infection that spreads to the joints and other areas of your body. The bacterium that causes gonorrhea can spread through the bloodstream and infect other parts of your body, including your joints. Fever, rash, skin sores, joint pain, swelling and stiffness are possible results. - Increased risk of HIV/AIDS. Having gonorrhea makes you more susceptible to infection with human immunodeficiency virus (HIV), the virus that leads to AIDS. People who have both gonorrhea and HIV are able to pass both diseases more readily to their partners. - Complications in babies. Babies who contract gonorrhea from their mothers during birth can develop blindness, sores on the scalp and infections. Diagnosis To determine whether the gonorrhea bacterium is present in your body, your doctor will analyze a sample of cells. Samples can be collected by: - Urine test. This may help identify bacteria in your urethra. - Swab of affected area. A swab of your throat, urethra, vagina or rectum may collect bacteria that can be identified in a laboratory. For women, home test kits are available for gonorrhea. Home test kits include vaginal swabs for self-testing that are sent to a specified lab for testing. If you prefer, you can choose to be notified by email or text message when your results are ready. You may then view your results online or receive them by calling a toll-free hotline. Testing for other sexually transmitted infections Your doctor may recommend tests for other sexually transmitted infections. Gonorrhea increases your risk of these infections, particularly chlamydia, which often accompanies gonorrhea. Testing for HIV also is recommended for anyone diagnosed with a sexually transmitted infection. Depending on your risk factors, tests for additional sexually transmitted infections could be beneficial as well. Treatment Gonorrhea treatment in adults Adults with gonorrhea are treated with antibiotics. Due to emerging strains of drug-resistant Neisseria gonorrhoeae, the Centers for Disease Control and Prevention recommends that uncomplicated gonorrhea be treated only with the antibiotic ceftriaxone - given as an injection - in combination with either azithromycin (Zithromax, Zmax) or doxycycline (Monodox, Vibramycin, others) - two antibiotics that are taken orally. Some research indicates that oral gemifloxacin (Factive) or injectable gentamicin, combined with oral azithromycin, is highly successful in treating gonorrhea. This treatment may be helpful in treating people who are allergic to cephalosporin antibiotics, such as ceftriaxone. Gonorrhea treatment for partners Your partner also should undergo testing and treatment for gonorrhea, even if he or she has no signs or symptoms. Your partner receives the same treatment you do. Even if you've been treated for gonorrhea, you can be reinfected if your partner isn't treated. Gonorrhea treatment for babies Babies born to mothers with gonorrhea receive a medication in their eyes soon after birth to prevent infection. If an eye infection develops, babies can be treated with antibiotics. ", "role": "user" }, { "content": "To test for gonorrhea, your doctor will take a sample of cells from your urine, throat, or vagina, if female. This cell sample will indicate if the bacteria is present. There are also home test kits available for women.", "role": "assistant" } ]

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

[ { "content": "how do you diagnose anxiety\n\n Separation anxiety in children Summary Separation anxiety in children is a developmental stage in which the child is anxious when separated from the primary caregiver (usually the mother). Causes As infants grow, their emotions and reactions to the world around them seem to occur in a predictable order. Before 8 months, infants are so new to the world that they lack a sense of what is normal and safe and what may be dangerous. As a result, new settings or people seem to not frighten them. From 8 to 14 months, children often become frightened when they meet new people or visit new places. They recognize their parents as familiar and safe. When separated from their parents, they feel threatened and unsafe. Separation anxiety is a normal stage as a child grows and develops. It helped keep our ancestors alive and helps children learn how to master the world around them. It usually ends when the child is around 2 years old. At this age, toddlers begin to understand that parents may be out of sight now, but will return later. It's also normal for them to test their independence. To get over separation anxiety, children need to: Feel safe in their home. Trust people other than their parents. Trust that their parents will return. Even after children have mastered this stage, separation anxiety may return in times of stress. Most children will feel some degree of separation anxiety when in unfamiliar situations, most often when separated from their parents. When children are in situations (such as hospitals) and are under stress (such as illness or pain), they seek the safety, comfort, and protection of their parents. Since anxiety can worsen pain, staying with a child as much as possible can reduce the pain. Symptoms A child with severe separation anxiety may have any of the following: Excessive distress when separated from the primary caregiver Nightmares Reluctance to go to school or other places because of fear of separation Reluctance to go to sleep without the primary caregiver nearby Repeated physical complaints Worry about losing, or harm coming to the primary caregiver Exams and Tests There are no tests for this condition, because it is normal. If severe separation anxiety persists past age 2, a visit with a health care provider may help determine if the child has an anxiety disorder or other condition. Treatment No treatment is needed for normal separation anxiety. Parents can help their infant or toddler adjust to their absence by letting trusted caregivers babysit the child. This helps the child learn to trust and bond with other adults and understand that their parents will return. During medical procedures, a parent should go with the child if possible. When a parent can't go with the child, exposing the child to the situation beforehand may be helpful, such as visiting the doctor's office before a test. Some hospitals have child life specialists who can explain procedures and medical conditions to children of all ages. If your child is very anxious and needs extended medical care, ask your provider about such services. When it's not possible for parents to be with the child, such as for surgery, explain the experience to the child. Reassure the child that a parent is waiting, and where. For older children who have not outgrown separation anxiety, treatments may include: Anti-anxiety medicines Changes in parenting techniques Counseling for the parents and child Treatment for severe cases may include: Family education Family therapy Talk therapy Outlook (Prognosis) Young children with symptoms that improve after age 2 are normal, even if some anxiety comes back later during stress. When separation anxiety occurs in adolescence, it may signal the development of an anxiety disorder. When to Contact a Medical Professional Call your provider if your child has severe separation anxiety after age 2. Review Date 5/20/2018 Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "For separation anxiety in children, there are no tests as this is normal behavior. However, if the separation anxiety is severe and persists past age 2, a visit with a health care provider may help determine if the child has an anxiety disorder or other condition.", "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\nAsthma (Outlook (Prognosis)): There is no cure for asthma, although symptoms sometimes improve over time. With proper self-management and medical treatment, most people with asthma can lead a normal life.", "role": "user" }, { "content": "There is no cure for asthma, although symptoms sometimes improve over time. With proper self-management and medical treatment, most people with asthma can lead a normal life.", "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\nFacts About Glaucoma (How is glaucoma detected?): Glaucoma is detected through a comprehensive dilated eye exam that includes the following: Visual acuity test. This eye chart test measures how well you see at various distances. Visual field test. This test measures your peripheral (side vision). It helps your eye care professional tell if you have lost peripheral vision, a sign of glaucoma. Dilated eye exam. In this exam, drops are placed in your eyes to widen, or dilate, the pupils. Your eye care professional uses a special magnifying lens to examine your retina and optic nerve for signs of damage and other eye problems. After the exam, your close-up vision may remain blurred for several hours. Tonometry is the measurement of pressure inside the eye by using an instrument called a tonometer. Numbing drops may be applied to your eye for this test. A tonometer measures pressure inside the eye to detect glaucoma. Pachymetry is the measurement of the thickness of your cornea. Your eye care professional applies a numbing drop to your eye and uses an ultrasonic wave instrument to measure the thickness of your cornea.", "role": "user" }, { "content": "Comprehensive dilated eye exam is needed to diagnose glaucoma. The tests include: visual acuity, visual field test that measures peripheral vision, examination of retina, optic nerve, intraocular pressure, and thickness of the cornea.", "role": "assistant" } ]

[ { "content": "how is epidural harmful\n\nSpinal and epidural anesthesia: 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. 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. 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. 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 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 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. Most people feel no pain during spinal and epidural anesthesia and recover fully. 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": "williams sydrome conditon. i need to send me more information about Williams Syndrome and some tips how to educate people with this disorder.I hope having news from you soon!!thank you\n\n Williams syndrome Williams-Beuren syndrome Summary Williams syndrome is a rare disorder that can lead to problems with development. Causes Williams syndrome is caused by not having a copy of several genes. It may be passed down in families. Parents may not have any family history of the condition. However, people with Williams syndrome have a 50% chance of passing the disorder on to each of their children. It often occurs randomly. One of the 25 missing genes is the gene that produces elastin, a protein that allows blood vessels and other tissues in the body to stretch. It is likely that missing a copy of this gene results in the narrowing of blood vessels, stretchy skin, and flexible joints seen in this condition. Symptoms Symptoms of Williams syndrome are: Delayed speech that may later turn into strong speaking ability and strong learning by hearing Developmental delay Easily distracted, attention deficit hyperactivity disorder (ADHD) Feeding problems including colic, reflux, and vomiting Inward bend of the small finger Learning disorders Mild to moderate intellectual disability Personality traits including being very friendly, trusting strangers, fearing loud sounds or physical contact, and being interested in music Short, compared to the rest of the person's family Sunken chest The face and mouth of someone with Williams syndrome may show: A flattened nasal bridge with small upturned nose Long ridges in the skin that run from the nose to the upper lip Prominent lips with an open mouth Skin that covers the inner corner of the eye Partially missing teeth, defective tooth enamel, or small, widely spaced teeth Exams and Tests Signs include: Narrowing of some blood vessels Farsightedness High blood calcium level that may cause seizures and rigid muscles High blood pressure Slack joints that may change to stiffness as the person gets older Unusual star-like pattern in iris of the eye Tests for Williams syndrome include: Blood pressure check Blood test for a missing piece of chromosome 7 (FISH test) Echocardiography combined with Doppler ultrasound Kidney ultrasound Treatment There is no cure for Williams syndrome. Avoid taking extra calcium and vitamin D. Treat high blood calcium, if it occurs. Blood vessel narrowing can be a major health problem. It is treated based on how severe it is. Physical therapy is helpful to people with joint stiffness. Developmental and speech therapy can also help. For example, having strong verbal skills can help make up for other weaknesses. Other treatments are based on the person's symptoms. It can help to have treatment coordinated by a geneticist who is experienced with Williams syndrome. Support Groups A support group can be helpful for emotional support and for giving and receiving practical advice. The following organization provides additional information about Williams syndrome: Williams Syndrome Association -- williams-syndrome.org Outlook (Prognosis) About 75% of people with Williams syndrome have some intellectual disability. Most people will not live as long as normal due to the various medical issues and other possible complications. Most people require full-time caregivers and often live in supervised group homes. Possible Complications Complications may include: Calcium deposits in the kidney and other kidney problems Death (in rare cases from anesthesia) Heart failure due to narrowed blood vessels Pain in the abdomen When to Contact a Medical Professional Many of the symptoms and signs of Williams syndrome may not be obvious at birth. Call your health care provider if your child has features similar to those of Williams syndrome. Seek genetic counseling if you have a family history of Williams syndrome. Prevention There is no known way to prevent the genetic problem that causes Williams syndrome. Prenatal testing is available for couples with a family history of Williams syndrome who wish to conceive. Review Date 10/26/2017 Updated by: Anna C. Edens Hurst, MD, MS, Assistant Professor in Medical Genetics, The University of Alabama at Birmingham, Birmingham, AL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "75% of individuals with Williams syndrome have some intellectual disability. Most people will not live as long as those without Williams syndrome, due to medical issues and other complications. Those with Williams syndrome often require full-time caregivers and may live in supervised group homes.", "role": "assistant" } ]

[ { "content": "what causes fungal pneumonia\n\nPneumonia (Causes): Bacteria, viruses, and fungi infections can cause pneumonia. These infections cause inflammation in the air sacs, or alveoli, of the lungs. This inflammation causes the air sacs to fill with fluid and pus. Bacteria Bacteria are the most common cause of pneumonia in adults. Many types of bacteria can cause bacterial pneumonia. Streptococcus pneumoniae or pneumococcus bacteria are the most common cause of bacterial pneumonia in the United States. If your pneumonia is caused by one of the following types of bacteria, it is called atypical pneumonia. Legionella pneumophila. This type of pneumonia sometimes is called Legionnaire's disease, and it has caused serious outbreaks. Outbreaks have been linked to exposure to cooling towers, whirlpool spas, and decorative fountains. Mycoplasma pneumoniae. This is a common type of pneumonia that usually affects people younger than 40 years old. People who live or work in crowded places like schools, homeless shelters, and prisons are at higher risk for this type of pneumonia. It's usually mild and responds well to treatment with antibiotics. However, Mycoplasma pneumoniae can be very serious. It may be associated with a skin rash and hemolysis. This type of bacteria is a common cause of “walking pneumonia”. Chlamydia pneumoniae. This type of pneumonia can occur all year and often is mild. The infection is most common in people 65 to 79 years old. Bacterial pneumonia can occur on its own or develop after you've had a viral cold or the flu. Bacterial pneumonia often affects just one lobe, or area, of a lung. When this happens, the condition is called lobar pneumonia. Read more Most of the time, the body filters bacteria out of the air that we breathe to protect the lungs from infection. Your immune system, the shape of your nose and throat, your ability to cough, and fine, hair-like structures called cilia help stop the germs from reaching your lungs. Read How the Lungs Work for more information. Sometimes bacteria manage to enter the lungs and cause infections. This is more likely to occur if: Your immune system is weak A germ is very strong Your body fails to filter out the bacteria from the air that you breathe. For example, if you can't cough because you've had a stroke or are sedated, bacteria may remain in your airways. When bacteria reach your lungs, your immune system goes into action. It sends many kinds of cells to attack the bacteria. These cells cause inflammation in alveoli (air sacs) and can cause these spaces to fill up with fluid and pus. This causes the symptoms of pneumonia. Viruses Viruses that infect the respiratory tract may cause pneumonia. The influenza or flu virus is the most common cause of viral pneumonia in adults. Respiratory syncytial virus (RSV) is the most common cause of viral pneumonia in children younger than one year old.  Other viruses can cause pneumonia such as the common cold virus known as rhinovirus, human parainfluenza virus (HPIV), and human metapneumovirus (HMPV). Most cases of viral pneumonia are mild. They get better in about one to three weeks without treatment. Some cases are more serious and may require treatment in a hospital. If you have viral pneumonia, you run the risk of getting bacterial pneumonia. Fungi Pneumocystis pneumonia is a serious fungal infection caused by Pneumocystis jirovecii. It occurs in people who have weak immune systems due to HIV/AIDS or the long-term use of medicines that suppress their immune systems, such as those used to treat cancer or as part of organ or blood and marrow stem cell transplant procedures. Other fungal infections also can lead to pneumonia. The following are three fungi that occur in the soil in some parts of the United States and can cause some people to get pneumonia. Coccidioidomycosis. This fungus is found in Southern California and the desert Southwest. It is the cause of valley fever. Histoplasmosis. This fungus is found in the Ohio and Mississippi River Valleys. Cryptococcus. This fungus is found throughout the United States in bird droppings and soil contaminated with bird droppings.", "role": "user" }, { "content": "Fungi Pneumocystis pneumonia is a serious fungal infection caused by Pneumocystis jirovecii. It occurs in people who have weak immune systems due to HIV/AIDS or the long-term use of medicines that suppress their immune systems, such as those used to treat cancer or as part of organ or blood and marrow stem cell transplant procedures. Other fungal infections also can lead to pneumonia. The following are three fungi that occur in the soil in some parts of the United States and can cause some people to get pneumonia. Coccidioidomycosis. This fungus is found in Southern California and the desert Southwest. It is the cause of valley fever. Histoplasmosis. This fungus is found in the Ohio and Mississippi River Valleys. Cryptococcus. This fungus is found throughout the United States in bird droppings and soil contaminated with bird droppings.", "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\nWhat are the treatments for Typhoid fever?: 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 health care provider will check current recommendations before choosing an antibiotic.", "role": "user" }, { "content": "To treat Typhoid fever, fluids and electrolytes may be given by IV, or you may be asked to drink water with electrolyte packets. Additionally, antibiotics are given to kill the bacteria.", "role": "assistant" } ]

[ { "content": "how to deal with anxiety\n\nSeparation anxiety in children (Treatment): No treatment is needed for normal separation anxiety. Parents can help their infant or toddler adjust to their absence by letting trusted caregivers babysit the child. This helps the child learn to trust and bond with other adults and understand that their parents will return. During medical procedures, a parent should go with the child if possible. When a parent can't go with the child, exposing the child to the situation beforehand may be helpful, such as visiting the doctor's office before a test. Some hospitals have child life specialists who can explain procedures and medical conditions to children of all ages. If your child is very anxious and needs extended medical care, ask your provider about such services. When it's not possible for parents to be with the child, such as for surgery, explain the experience to the child. Reassure the child that a parent is waiting, and where. For older children who have not outgrown separation anxiety, treatments may include: - Anti-anxiety medicines - Changes in parenting techniques - Counseling for the parents and child Treatment for severe cases may include: - Family education - Family therapy - Talk therapy", "role": "user" }, { "content": "Separation anxiety in children (Treatment): No treatment is needed for normal separation anxiety. Parents can help their infant or toddler adjust to their absence by letting trusted caregivers babysit the child. This helps the child learn to trust and bond with other adults and understand that their parents will return. For older children who have not outgrown separation anxiety, treatments may include: - Anti-anxiety medicines - Changes in parenting techniques - Counseling for the parents and child Treatment for severe cases may include: - Family education - Family therapy - Talk therapy", "role": "assistant" } ]

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

[ { "content": "I have an hernia I would love to take care off it ASAP I was wondering if you guys could help me . Thanks\n\n Umbilical hernia Symptoms An umbilical hernia creates a soft swelling or bulge near the navel (umbilicus). If your baby has an umbilical hernia, you may notice the bulge only when he or she cries, coughs or strains. The bulge may disappear when your baby is calm or lies on his or her back. Umbilical hernias in children are usually painless. Umbilical hernias that appear during adulthood may cause abdominal discomfort. When to see a doctor If you suspect that your baby has an umbilical hernia, talk with your child's pediatrician. Seek emergency care if your baby has an umbilical hernia and: - Your baby appears to be in pain - Your baby begins to vomit - The bulge becomes tender, swollen or discolored Similar guidelines apply to adults. Talk with your doctor if you have a bulge near your navel. Seek emergency care if the bulge becomes painful or tender. Prompt diagnosis and treatment can help prevent complications. Causes During pregnancy, the umbilical cord passes through a small opening in the baby's abdominal muscles. The opening normally closes just after birth. If the muscles don't join together completely in the midline of the abdomen, this weakness in the abdominal wall may cause an umbilical hernia at birth or later in life. In adults, too much abdominal pressure can cause an umbilical hernia. Possible causes in adults include: - Obesity - Multiple pregnancies - Fluid in the abdominal cavity (ascites) - Previous abdominal surgery - Chronic peritoneal dialysis Risk factors Umbilical hernias are most common in infants - especially premature babies and those with low birth weights. Black infants appear to have a slightly increased risk of umbilical hernias. The condition affects boys and girls equally. For adults, being overweight or having multiple pregnancies may increase the risk of developing an umbilical hernia. This type of hernia tends to be more common in women. Diagnosis An umbilical hernia is diagnosed during a physical exam. Sometimes imaging studies - such as an abdominal ultrasound or CT scan - are used to screen for complications. Treatment Most umbilical hernias in babies close on their own by age 1 or 2. Your doctor may even be able to push the bulge back into the abdomen during a physical exam. Don't try this on your own, however. Although some people claim a hernia can be fixed by taping a coin down over the bulge, this \"fix\" doesn't help and germs may accumulate under the tape, causing infection. For children, surgery is typically reserved for umbilical hernias that: - Are painful - Are bigger than 1.5 centimeters in diameter (slightly larger than a 1/2 inch) - Are large and don't decrease in size over the first two years - Don't disappear by age 4 - Become trapped or block the intestines For adults, surgery is typically recommended to avoid possible complications - especially if the umbilical hernia gets bigger or becomes painful. During surgery, a small incision is made at the base of the bellybutton. The herniated tissue is returned to the abdominal cavity, and the opening in the abdominal wall is stitched closed. In adults, surgeons often use mesh to help strengthen the abdominal wall. ", "role": "user" }, { "content": "For adults, surgery is typically recommended to avoid possible complications - especially if the umbilical hernia gets bigger or becomes painful.", "role": "assistant" } ]

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

[ { "content": "I have an hernia I would love to take care off it ASAP I was wondering if you guys could help me . Thanks\n\n Hiatal hernia Hernia - hiatal Summary Hiatal hernia is a condition in which part of the stomach extends through an opening of the diaphragm into the chest. The diaphragm is the sheet of muscle that divides the chest from the abdomen. Causes The exact cause of hiatal hernia is unknown. The condition may be due to weakness of the supporting tissue. Your risk for the problem goes up with age, obesity, and smoking. Hiatal hernias are very common. The problem occurs often in people over 50 years. This condition may cause reflux (backflow) of gastric acid from the stomach into the esophagus. Children with this condition are most often born with it (congenital). It often occurs with gastroesophageal reflux in infants. Symptoms Symptoms may include: Chest pain Heartburn, worse when bending over or lying down Swallowing difficulty A hiatal hernia by itself rarely causes symptoms. Pain and discomfort are due to the upward flow of stomach acid, air, or bile. Exams and Tests Tests that may be used include: Barium swallow x-ray Esophagogastroduodenoscopy (EGD) Treatment The goals of treatment are to relieve symptoms and prevent complications. Treatments may include: Medicines to control stomach acid Surgery to repair the hiatal hernia and prevent reflux Other measures to reduce symptoms include: Avoiding large or heavy meals Not lying down or bending over right after a meal Reducing weight and not smoking Raising the head of the bed 4 to 6 inches (10 to 15 centimeters) If medicines and lifestyle measures do not help control symptoms, you may need surgery. Outlook (Prognosis) Treatment can relieve most symptoms of hiatal hernia. Possible Complications Complications may include: Pulmonary (lung) aspiration Slow bleeding and iron deficiency anemia (due to a large hernia) Strangulation (closing off) of the hernia When to Contact a Medical Professional Call your health care provider if: You have symptoms of a hiatal hernia. You have a hiatal hernia and your symptoms get worse or do not improve with treatment. You develop new symptoms. Prevention Controlling risk factors such as obesity may help prevent hiatal hernia. Review Date 4/24/2017 Updated by: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Hiatal hernia is a condition in which part of the stomach extends through an opening of the diaphragm into the chest. ... Treatments may include: - Medicines to control stomach acid - Surgery to repair the hiatal hernia and prevent reflux Other measures to reduce symptoms include: - Avoiding large or heavy meals - Not lying down or bending over right after a meal - Reducing weight and not smoking - Raising the head of the bed 4 to 6 inches (10 to 15 centimeters) If medicines and lifestyle measures do not help control symptoms, you may need surgery.", "role": "assistant" } ]

[ { "content": "I am 23yr boy,i have knock knees i want treatment. Please help me.\n\nKnock knees (Treatment): 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.", "role": "user" }, { "content": "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.", "role": "assistant" } ]

[ { "content": "Hello, I have a scoliosis problem plz help me I want its treatment I can send my x.ray also\n\nAdolescent idiopathic scoliosis (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 do you diagnose anxiety\n\n Anxiety disorders Overview Anxiety is a normal response to stress. But when it becomes hard to control and affects your day-to-day life, it can be disabling. Anxiety disorders affect nearly one in five adults in the United States.1 Women are more than twice as likely as men to get an anxiety disorder in their lifetime.2 Anxiety disorders are often treated with counseling, medicine, or a combination of both. Some women also find that yoga or meditation helps with anxiety disorders. What is anxiety? Anxiety is a feeling of worry, nervousness, or fear about an event or situation. It is a normal reaction to stress. It helps you stay alert for a challenging situation at work, study harder for an exam, or remain focused on an important speech. In general, it helps you cope. But anxiety can be disabling if it interferes with daily life, such as making you dread nonthreatening day-to-day activities like riding the bus or talking to a coworker. Anxiety can also be a sudden attack of terror when there is no threat. What are anxiety disorders? Anxiety disorders happen when excessive anxiety interferes with your everyday activities such as going to work or school or spending time with friends or family. Anxiety disorders are serious mental illnesses. They are the most common mental disorders in the United States. Anxiety disorders are more than twice as common in women as in men. What are the major types of anxiety disorder? The major types of anxiety disorder are: Some other conditions that are not considered anxiety disorders but are similar include: Who gets anxiety disorders? Anxiety disorders affect about 40 million American adults every year. Anxiety disorders also affect children and teens. About 8% of teens ages 13 to 18 have an anxiety disorder, with symptoms starting around age 6.5 Women are more than twice as likely as men to get an anxiety disorder in their lifetime.2 Also, some types of anxiety disorders affect some women more than others: What causes anxiety disorders? Researchers think anxiety disorders are caused by a combination of factors, which may include: What are the signs and symptoms of an anxiety disorder? Women with anxiety disorders experience a combination of anxious thoughts or beliefs, physical symptoms, and changes in behavior, including avoiding everyday activities they used to do. Each anxiety disorder has different symptoms. They all involve a fear and dread about things that may happen now or in the future. Physical symptoms may include: Physical symptoms of anxiety disorders often happen along with other mental or physical illnesses. This can cover up your anxiety symptoms or make them worse.2 How are anxiety disorders diagnosed? Your doctor or nurse will ask you questions about your symptoms and your medical history. Your doctor may also do a physical exam or other tests to rule out other health problems that could be causing your symptoms. Anxiety disorders are diagnosed when fear and dread of nonthreatening situations, events, places, or objects become excessive and are uncontrollable. Anxiety disorders are also diagnosed if the anxiety has lasted for at least six months and it interferes with social, work, family, or other aspects of daily life.2 How are anxiety disorders treated? Treatment for anxiety disorders depends on the type of anxiety disorder you have and your personal history of health problems, violence, or abuse. Often, treatment may include: How does counseling help treat anxiety disorders? Your doctor may refer you for a type of counseling for anxiety disorders called cognitive behavioral therapy (CBT). You can talk to a trained mental health professional about what caused your anxiety disorder and how to deal with the symptoms.2 For example, you can talk to a psychiatrist, psychologist, social worker, or counselor. CBT can help you change the thinking patterns around your fears. It may help you change the way you react to situations that may create anxiety. You may also learn ways to reduce feelings of anxiety and improve specific behaviors caused by chronic anxiety. These strategies may include relaxation therapy and problem solving. What types of medicine treat anxiety disorders? Several types of medicine treat anxiety disorders. These include: All medicines have risks. You should talk to your doctor about the benefits and risks of all medicines. Learn more about medicines to treat anxiety disorders. What if my anxiety disorder treatment is not working? Sometimes, you may need to work with your doctor to try several different treatments or combinations of treatments before you find one that works for you. If you are having trouble with side effects from medicines, talk to your doctor or nurse. Do not stop taking your medicine without talking to a doctor or nurse. Your doctor may adjust how much medicine you take and when you take it. What if my anxiety disorder comes back? Sometimes symptoms of an anxiety disorder come back after you have finished treatment. This may happen during or after a stressful event. It may also happen without any warning. Many people with anxiety disorders do get better with treatment. But, if your symptoms come back, your doctor will work with you to change or adjust your medicine or treatment plan. You can also talk to your doctor about ways to identify and prevent anxiety from coming back. This may include writing down your feelings or meeting with your counselor if you think your anxiety is uncontrollable. Can complementary or alternative medicine help manage anxiety disorders? Maybe. Some women say that complementary or alternative medicine (CAM) therapies helped lower their anxiety. CAM therapies that may help anxiety include: Learn more about CAM therapies for anxiety disorders. Will my anxiety disorder treatment affect my pregnancy? If your treatment is counseling, it will not affect your pregnancy. If you are on medicine to treat your anxiety disorder, talk to your doctor. Some medicines used to treat anxiety can affect your unborn baby. If I take medicine to treat my anxiety disorder, can I breastfeed my baby? It depends. Some medicines used to treat anxiety can pass through breastmilk. Certain antidepressants, such as some SSRIs, are safe to take during breastfeeding. Do not stop taking your medicine too quickly. Talk to your doctor to find out what medicine is best for you and your baby. Learn more about medicines and breastfeeding in our Breastfeeding section. You can also enter your medicine into the LactMed database to find out if your medicine passes through your breastmilk and any possible side effects for your nursing baby. How do anxiety disorders affect other health conditions? Anxiety disorders may affect other health problems that are common in women. These include: What is the latest research on anxiety disorders and women? Researchers are studying why women are more than twice as likely as men to develop anxiety disorders and depression. Changes in levels of the hormone estrogen throughout a woman's menstrual cycle and reproductive life (during the years a woman can have a baby) probably play a role. Researchers also recently studied the male hormone testosterone, which is found in women and men but typically in higher levels in men. They found that treatment with testosterone had similar effects as antianxiety and antidepressant medicine for the women in the study.15 Other research focuses on anxiety disorders and depression during and after pregnancy and among overweight and obese women. For more clinical trials related to anxiety disorders and women, visit ClinicalTrials.gov. Did we answer your question about anxiety disorders? For more information on anxiety disorders, call the OWH Helpline at 1-800-994-9662 or contact the following organizations: Sources ", "role": "user" }, { "content": "Anxiety disorders (How are anxiety disorders diagnosed?): Your doctor or nurse will ask you questions about your symptoms and your medical history. Your doctor may also do a physical exam or other tests to rule out other health problems that could be causing your symptoms. Anxiety disorders are diagnosed when fear and dread of nonthreatening situations, events, places, or objects become excessive and are uncontrollable. Anxiety disorders are also diagnosed if the anxiety has lasted for at least six months and it interferes with social, work, family, or other aspects of daily life.", "role": "assistant" } ]

[ { "content": "how to loose weight\n\n Understanding Adult Overweight & Obesity Definition and Facts The terms “overweight” and “obesity” refer to body weight that is greater than what is considered normal or healthy for a certain height. Reaching and staying at a healthy weight can be a long-term challenge for people who are overweight or have obesity. What are overweight and obesity? The terms \"overweight\" and \"obesity\" refer to body weight that is greater than what is considered normal or healthy for a certain height. Overweight is generally due to extra body fat. However, overweight may also be due to extra muscle, bone, or water. People who have obesity usually have too much body fat.Your body mass index (BMI) is one way to tell if you are at a healthy weight, overweight, or have obesity. The BMI is a measure based on your weight in relation to your height. The greater your BMI, the greater your risk of health problems from overweight and obesity.Reaching and staying at a healthy weight may be a long-term challenge if you are overweight or have obesity. Maintaining a healthy weight-or at least not gaining more weight if you are already overweight-can help lower your chance of developing certain health problems. How common is overweight and obesity? According to a national U.S. survey1,2,3more than 1 in 3 adults were considered to be overweight more than 1 in 3 adults were considered to have obesity more than 2 in 3 adults were considered to be overweight or have obesityFor more statistics on overweight and obesity in the United States, see NIDDK's Overweight & Obesity Statistics. Who is more likely to be overweight? Men are more likely than women to be overweight.3 Who is more likely to have obesity? According to a national U.S. survey, some groups are more likely to have obesity.2Among black adults, 48 out of 100 were considered to have obesity. Among Hispanic adults, 42 out of 100 were considered to have obesity. Among white adults, 36 out of 100 were considered to have obesity.Women are more likely than men to have obesity.2Many factors play a role in who is more likely to have obesity, and these factors may affect people differently. Why do people gain weight? Many factors may cause weight gain and affect how much weight your body stores. When you take in more calories from food or beverages than you use up from physical activity and through daily living, such as sitting or sleeping, your body stores the extra calories. Over time, if you continue to consume more calories than you burn off, you will likely gain weight. Excessive weight gain may lead to overweight or obesity. Who should lose weight? Medical experts recommend that people who have obesity should lose weight.Most people who are overweight and have one or more factors that raise their chance for heart disease should lose weight. These factors includediabetes prediabetes high blood pressure dyslipidemia-high levels of LDL cholesterol, low levels of HDL cholesterol, or high levels of triglycerides a large waist size-for men, greater than 40 inches; for women, greater than 35 inches Definition & Facts Factors Affecting Weight and Health Many factors can affect your weight, leading to overweight, obesity, or extreme obesity. Some of these factors may make it hard for you to lose weight or not regain weight you have lost. Being overweight or having obesity may lead to certain health problems. What factors affect weight and health? Many factors can affect your weight and lead to overweight or obesity. Some of these factors may make it hard for you to lose weight or avoid regaining weight that you've lost.Overweight and obesity tend to run in families, suggesting that genes may play a role. Your chances of being overweight are greater if one or both of your parents are overweight or have obesity. Your genes may affect the amount of fat you store in your body and where on your body you carry the extra fat.Some racial and ethnic minority groups are more likely to have obesity. Obesity rates in American adults are highest in African Americans, followed by Hispanics/Latinos, then Caucasians. This is true for men and women.4 While Asian American men and women have the lowest rates of obesity,4 they can still be at risk of diseases associated with obesity if they carry a lot of unhealthy fat in their abdomen-even when their body mass index (BMI) is lower.5Many people gain weight as they age. Adults who have a normal BMI often start to gain weight in young adulthood and continue to gain weight until they are ages 60 to 65. In addition, children who have obesity are more likely to have obesity as adults.In the United States, obesity is more common in black or Hispanic women than in black or Hispanic men.4 A person's sex may also affect where the body stores fat. Women tend to build up fat in their hips and buttocks. Men usually build up fat in their abdomen or belly. Extra fat, particularly if it is around the abdomen, may put people at risk of health problems even if they have a normal weight.Your eating and physical activity habits may raise your chances of becoming overweight and having obesity if youeat and drink a lot of foods and beverages that are high in calories, sugar, and fat drink a lot of beverages that are high in added sugars spend a lot of time sitting or lying down and have limited physical activityWhere you live, work, play, and worship may affect your eating and physical activity habits, and access to healthy foods and places to be active.For example, living in an area that has a high number of grocery stores can increase your access to better quality, lower calorie foods. Living in a neighborhood with a lot of green spaces and areas for safe physical activity may encourage you to be more physically active.Where you work and worship may also make it easier for you to eat unhealthy, high-calorie foods. Vending machines, cafeterias, or special events at your workplace or place of worship may not offer healthy, lower calorie options. Whenever possible, choose the healthier options and limit your treats to a small sliver of pie or cake.Family eating and lifestyle habits may affect your weight and health. Some families may consume foods and beverages that are high in fat, salt, and added sugars or eat large amounts of unhealthy foods at family gatherings. Some families may also spend a lot of inactive time watching TV, using a computer, or using a mobile device instead of being active.Your social, ethnic, or religious group culture may also affect your weight and health because of shared eating and lifestyle habits. Some cultures may consume foods and beverages that are high in fat, salt, and added sugars. Some common food preparation methods, such as frying, may lead to high-calorie intake. Regularly consuming foods high in calories, fat, and sugar may lead to weight gain overtime.People who don't get enough sleep may eat more calories and snack more.6 Experts recommend that adults ages 18 to 64 get 7 to 9 hours of sleep a day, and that adults ages 65 and older get 7 to 8 hours of sleep a day.7Other factors that can lead to weight gain includecertain medical conditions certain medicines binge eating disorder stress What makes it hard for some people to lose weight? Many factors can make it hard to lose weight, includingyour genes what and how much you eat not getting regular physical activity or being inactive taking certain medicines having certain medical conditions Difficulty in managing stress Factors Affecting Weight & Health Am I at a Healthy Weight? Knowing your body mass index (BMI) and waist size help tell if you are at a normal or healthy weight; are overweight; have obesity; or have extreme obesity. Your body shape may make you more likely to have certain health problems. How can I tell if I am at a healthy weight? Knowing your body mass index (BMI), waist size, and waist-to-hip ratio can help you tell if you're at a healthy weight.The BMI is the tool most commonly used to estimate and screen for overweight and obesity in adults. BMI is a measure based on your weight in relation to your height. You can easily calculate your BMI.Your BMI can tell if you are at a normal or healthy weight, are overweight, or have obesity. The greater your BMI, the greater your risk of health problems such as type 2 diabetes and heart disease.Normal or healthy weight. A person with a BMI of 18.5 to 24.9 is in the normal or healthy range. Overweight. A person with a BMI of 25 to 29.9 is considered overweight. Obesity. A person with a BMI of 30 to 39.9 is considered to have obesity. Extreme obesity. A person with a BMI of 40 or greater is considered to have extreme obesity.Because BMI doesn't measure actual body fat, a person who is very muscular, like a bodybuilder, may have a high BMI without having a lot of body fat. Also, some groups who tend to have a lower BMI, such as Asian men and women or older adults, may still have high amounts of body fat even if they are not overweight.Another important measure is your waist size. Having too much fat around your waist may raise your chances of health problems even more than having fat in other parts of your body. Women with a waist size of more than 35 inches and men with a waist size of more than 40 inches may be more likely to develop diseases related to obesity. Does my body shape matter? Doctors are concerned not only with how much body fat you have, but where the fat is located on your body. Women tend to build up fat in their hips and buttocks, giving them a \"pear\" shape. Men usually build up fat in their abdomen, giving them more of an \"apple\" shape. Of course, some men are pear-shaped, and some women are apple-shaped.Extra fat, especially in the abdomen, may put people at risk for certain health problems, even if they have a normal weight. People who are apple-shaped may be more likely to develop type 2 diabetes, heart disease, or certain types of cancer than people of the same weight who are pear-shaped. Am I at a Healthy Weight? You should seek a doctor's help if you are gaining weight quickly, have a large waist size, or a BMI of 30 or greater. You should also seek a doctor's help if you are overweight or have obesity and havea family history of certain diseases, such as type 2 diabetes or heart disease health problems such as type 2 diabetes, heart disease, or metabolic syndrome Health Risks Overweight and obesity may increase your risk for certain health problems and may be linked to certain emotional and social problems. What are some health risks of overweight and obesity? Type 2 diabetes is a disease that occurs when your blood glucose, also called blood sugar, is too high. About 8 out of 10 people with type 2 diabetes are overweight or have obesity.8 Over time, high blood glucose leads to problems such as heart disease, stroke, kidney disease, eye problems, nerve damage, and other health problems.If you are at risk for type 2 diabetes, losing 5 to 7 percent of your body weight and getting regular physical activity may prevent or delay the onset of type 2 diabetes.High blood pressure, also called hypertension, is a condition in which blood flows through your blood vessels with a force greater than normal. High blood pressure can strain your heart, damage blood vessels, and raise your risk of heart attack, stroke, kidney disease, and death.Heart disease is a term used to describe several problems that may affect your heart. If you have heart disease, you may have a heart attack, heart failure, sudden cardiac death, angina, or an abnormal heart rhythm. High blood pressure, abnormal levels of blood fats, and high blood glucose levels may raise your risk for heart disease. Blood fats, also called blood lipids, include HDL cholesterol, LDL cholesterol, and triglycerides.Losing 5 to 10 percent of your weight may lower your risk factors for developing heart disease. If you weigh 200 pounds, this means losing as little as 10 pounds. Weight loss may improve blood pressure, cholesterol levels, and blood flow.Stroke is a condition in which the blood supply to your brain is suddenly cut off, caused by a blockage or the bursting of a blood vessel in your brain or neck. A stroke can damage brain tissue and make you unable to speak or move parts of your body. High blood pressure is the leading cause of strokes.Sleep apnea is a common disorder in which you do not breathe regularly while sleeping. You may stop breathing altogether for short periods of time. Untreated sleep apnea may raise your risk of other health problems, such as type 2 diabetes and heart disease.Metabolic syndrome is a group of conditions that put you at risk for heart disease, diabetes, and stroke. These conditions arehigh blood pressure high blood glucose levels high triglyceride levels in your blood low levels of HDL cholesterol (the \"good\" cholesterol) in your blood too much fat around your waistFatty liver diseases are conditions in which fat builds up in your liver. Fatty liver diseases include nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). Fatty liver diseases may lead to severe liver damage, cirrhosis, or even liver failure.Osteoarthritis is a common, long-lasting health problem that causes pain, swelling, and reduced motion in your joints. Being overweight or having obesity may raise your risk of getting osteoarthritis by putting extra pressure on your joints and cartilage.Overweight and obesity may raise your risk of getting gallbladder diseases, such as gallstones and cholecystitis. Imbalances in substances that make up bile cause gallstones. Gallstones may form if bile contains too much cholesterol.Cancer is a collection of related diseases. In all types of cancer, some of the body's cells begin to divide without stopping and spread into surrounding tissues. Overweight and obesity may raise your risk of developing certain types of cancer.Kidney disease means that your kidneys are damaged and can't filter blood like they should. Obesity raises the risk of diabetes and high blood pressure, the most common causes of kidney disease. Even if you don't have diabetes or high blood pressure, obesity itself may promote kidney disease and quicken its progress.Overweight and obesity raise the risk of health problems that may occur during pregnancy. Pregnant women who are overweight or obese may have a greater chance ofdeveloping gestational diabetes having preeclampsia-high blood pressure during pregnancy, which can cause severe health problems for mother and baby if left untreated needing a cesarean section, or C-section and, as a result, taking longer to recover after giving birth What emotional and social problems are linked to overweight and obesity? Overweight and obesity are associated with mental health problems such as depression. People who deal with overweight and obesity may also be the subject of weight bias and stigma from others, including health care providers. This can lead to feelings of rejection, shame, or guilt-further worsening mental health problems. Health Risks Eating and Physical Activity Changing your eating habits is central to losing and maintaining your weight. To lose weight, you have to eat fewer calories and use more calories than you take in. Sticking with an eating plan may be more important than the type of eating plan you follow. What options might help you lose weight? Changing your eating habits is central to losing and maintaining your weight. To lose weight, you have to eat fewer calories and use more calories than you take in. This can be challenging for many people to do for an extended period of time. Emerging research shows that sticking with an eating plan may be more important to losing and maintaining weight than the type of eating plan you follow.All your food and beverage choices count. Eating healthy is a journey shaped by many factors, including your age, weight, metabolism, food preferences, access to food, culture, and traditions; whether you are a man or woman; and the personal decisions you make over time. A healthy eating plan includesa variety of vegetables, fruits, and whole grains, such as brown rice, oats, and whole-wheat bread fat-free or low-fat dairy products such as milk, yogurt, and cheese and similar products such as soy beverages a variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas), nuts, seeds, and soy products oils, such as olive and canola oils and those found in nuts, olives, and avocadosA healthy eating plan also includesconsuming fewer foods and beverages that have refined carbohydrates, added sugars, and salt (sodium) controlling portion sizes limiting foods with saturated fats and trans fats, like those found in desserts and fried foodsTo learn more about a healthy eating plan and the amounts of food and beverages that are right for you, visit ChooseMyPlate.gov.The Physical Activity Guidelines for Americans define regular physical activity as at least 150 minutes a week of moderate-intensity aerobic activity, such as brisk walking. A moderate-intensity aerobic activity makes your heart beat faster and makes you breathe harder but does not overwork or overheat you. This type of physical activity is safe for most people.People with physical disabilities also can do certain activities, such as wheelchair aerobics or basketball. Talk with your doctor about the types of physical activity that might work well with your abilities.If you have a health condition such as heart disease, high blood pressure, or diabetes, talk with your doctor before you start regular physical activity. Your doctor can review with you the types and amounts of physical activity that might suit your lifestyle, interests, and skills.Read Tips to Help You Get Active. What should I do to stay at a healthy weight? Recent research has found there are many reasons why it is difficult to keep weight off after losing weight. In addition to metabolism slowing during weight loss, your body needs fewer calories at your new, lower weight. Hormonal and other factors also tend to promote weight regain. People who have kept weight off long-term report needing to keep careful track of their food intake and to do high levels of physical activity. Some people who have reached a healthy weight may find it hard to keep the weight off.Weigh yourself regularly. Keep a record of your weight to help make sure you are maintaining your weight loss and not regaining weight.Continue to make healthy food choices, and make following your healthy eating plan a lifelong habit. Find healthy food options that you prefer and enjoy, as you are more likely to stick with your eating plan.Regular physical activity may help you keep from regaining weight you've lost. Aim for 200 to 300 minutes of moderate-intensity physical activity a week to prevent regaining weight.9 Make regular physical activity a lifelong habit.If you were overweight or had obesity and lost weight, your doctor may advise you to take part in a program to help you maintain your weight loss. The program may help you stick to your healthy eating and regular physical activity plan, and track your progress. Eating & Physical Activity Treatment Common treatments for losing weight include healthy eating, being physically active, and making other changes to your usual habits. If you have extreme obesity and related health problems, your doctor may consider other treatments, such as bariatric surgery. Healthy eating plan and regular physical activity Following a healthy eating plan with fewer calories is often the first step in trying to treat overweight and obesity.People who are overweight or have obesity should also start regular physical activity when they begin their healthy eating plan. Being active may help you use calories. Regular physical activity may help you stay at a healthy weight.Learn more about healthy eating and physical activity to lose or maintain weight. Changing your habits Changing your eating and physical activity habits and lifestyle is difficult, but with a plan, effort, regular support, and patience, you may be able to lose weight and improve your health. The following tips may help you think about ways to lose weight, engage in regular physical activity, and improve health over the long-term.Be prepared for setbacks-they are normal. After a setback, like overeating at a family or workplace gathering, try to regroup and focus on getting back to your healthy eating plan as soon as you can. Try to eat only when you're sitting at your dining room or kitchen table. At work, avoid areas where treats may be available. Track your progress using online food or physical activity trackers, such as the Body Weight Planner, that can help you keep track of the foods you eat, your physical activity, and your weight. These tools may help you stick with it and stay motivated. Set goals. Having specific goals can help you stay on track. Rather than \"be more active,\" set a goal to walk 15 to 30 minutes before work or at lunch on Monday and Friday. If you miss a walk on Monday, pick it up again Tuesday. Seek support. Ask for help or encouragement from your family, friends, or health care professionals. You can get support in person, through email or texting, or by talking on the phone. You can also join a support group. Specially trained health professionals can help you change your lifestyle. Weight-management programs Some people benefit from a formal weight-management program. In a weight-management program, trained weight-management specialists will design a broad plan just for you and help you carry out your plan. Plans include a lower-calorie diet, increased physical activity, and ways to help you change your habits and stick with them. You may work with the specialists on-site (that is, face-to-face) in individual or group sessions. The specialists may contact you regularly by telephone or internet to help support your plan. Devices such as smartphones, pedometers, and accelerometers may help you track how well you are sticking with your plan.Some people may also benefit from online weight-management programs or commercial weight-loss programs. Weight-loss medicines When healthy eating and physical activity habits are not enough, your doctor may prescribe medicines to treat overweight and obesity.You should try to stick with your healthy eating plan and continue getting regular physical activity while taking weight-loss medicines.You may see ads for herbal remedies and dietary supplements that claim to help you lose weight. But many of these claims are not true. Some of these supplements can even have serious side effects. Talk with your doctor before taking any over-the-counter herbal remedies or dietary supplements for the purpose of trying to lose weight. Weight-loss devices Your doctor may consider weight-loss devices if you haven't been able to lose weight or keep from gaining back any weight you lost with other treatments. Because weight-loss devices have only recently been approved, researchers do not have long-term data on their safety and effectiveness. Weight-loss devices includeElectrical stimulation system. The electrical stimulation system uses a device a surgeon places in your abdomen with laparoscopic surgery. The device blocks nerve activity between your stomach and brain. Gastric balloon system. For the gastric balloon system, a doctor places one or two balloons in your stomach through a tube that goes in your mouth. Once the balloons are in your stomach, the surgeon fills them with salt water so they take up more space in your stomach and help you feel fuller. Gastric emptying system. A gastric emptying system uses a pump to drain part of the food from your stomach after a meal. The device includes a tube that goes from the inside of your stomach to the outside of your abdomen. About 20 to 30 minutes after eating, you use the pump to drain the food from your stomach through the tube into the toilet. Bariatric surgery Bariatric surgery includes several types of operations that help you lose weight by making changes to your digestive system. Bariatric surgery may be an option if you have extreme obesity and haven't been able to lose enough weight to improve your health or keep from gaining back the weight you lost with other treatments. Bariatric surgery also may be an option at lower levels of obesity if you have serious health problems, such as type 2 diabetes or sleep apnea, related to obesity. Bariatric surgery can improve many of the medical conditions linked to obesity, especially type 2 diabetes. Special diets Your doctor may recommend a lower-calorie diet such as 1,200 to 1,500 calories a day for women and 1,500 to 1,800 calories a day for men. The calorie level depends on your body weight and physical activity level. A lower calorie diet with a variety of healthy foods will give you the nutrients you need to stay healthy.Intermittent fasting is another way of reducing food intake that is gaining attention as a strategy for weight loss and health benefits. Alternate-day fasting is one type of intermittent fasting that consists of a \"fast day\" (eating no calories to one-fourth of caloric needs) alternating with a \"fed day,\" or a day of unrestricted eating. Researchers have conducted only a few studies of intermittent fasting as a strategy for weight loss. They have no long-term data on the safety and effectiveness of intermittent fasting for long-term weight maintenance. Treatment ", "role": "user" }, { "content": "Health care providers generally agree that people who are considered to be obese (have a BMI of 30 or greater) may improve their health by losing weight.If you are overweight (BMI between 25 and 29.9), experts recommend that you avoid gaining any extra weight. If you are overweight and have other risk factors, losing weight may reduce these risks.", "role": "assistant" } ]

[ { "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": "Lung cancer - small cell (Prevention): If you smoke, now is the time to quit. If you are having trouble quitting, talk with your provider. There are many methods to help you quit, from support groups to prescription medicines. Also try to avoid secondhand smoke. If you smoke or used to smoke, talk with your provider about getting screened for lung cancer.", "role": "assistant" } ]

[ { "content": "how is gonorrhea diagnosed\n\n Gonorrhea Overview Gonorrhea is an infection caused by a sexually transmitted bacterium that can infect both males and females. Gonorrhea most often affects the urethra, rectum or throat. In females, gonorrhea can also infect the cervix. Gonorrhea is most commonly spread during sex. But babies can be infected during childbirth if their mothers are infected. In babies, gonorrhea most commonly affects the eyes. Gonorrhea is a common infection that, in many cases, causes no symptoms. You may not even know that you're infected. Abstaining from sex, using a condom if you do have sex and being in a mutually monogamous relationship are the best ways to prevent sexually transmitted infections. Symptoms In many cases, gonorrhea infection causes no symptoms. When symptoms do appear, gonorrhea infection can affect multiple sites in your body, but it commonly appears in the genital tract. Gonorrhea affecting the genital tract Signs and symptoms of gonorrhea infection in men include: - Painful urination - Pus-like discharge from the tip of the penis - Pain or swelling in one testicle Signs and symptoms of gonorrhea infection in women include: - Increased vaginal discharge - Painful urination - Vaginal bleeding between periods, such as after vaginal intercourse - Painful intercourse - Abdominal or pelvic pain Gonorrhea at other sites in the body Gonorrhea can also affect these parts of the body: - Rectum. Signs and symptoms include anal itching, pus-like discharge from the rectum, spots of bright red blood on toilet tissue and having to strain during bowel movements. - Eyes. Gonorrhea that affects your eyes may cause eye pain, sensitivity to light, and pus-like discharge from one or both eyes. - Throat. Signs and symptoms of a throat infection may include a sore throat and swollen lymph nodes in the neck. - Joints. If one or more joints become infected by bacteria (septic arthritis), the affected joints may be warm, red, swollen and extremely painful, especially when you move an affected joint. When to see your doctor Make an appointment with your doctor if you notice any troubling signs or symptoms, such as a burning sensation when you urinate or a pus-like discharge from your penis, vagina or rectum. Also make an appointment with your doctor if your partner has been diagnosed with gonorrhea. You may not experience signs or symptoms that prompt you to seek medical attention. But without treatment, you can reinfect your partner even after he or she has been treated for gonorrhea. Causes Gonorrhea is caused by the bacterium Neisseria gonorrhoeae. The gonorrhea bacteria are most often passed from one person to another during sexual contact, including oral, anal or vaginal intercourse. Risk factors Factors that may increase your risk of gonorrhea infection include: - Younger age - A new sex partner - A sex partner who has concurrent partners - Multiple sex partners - Previous gonorrhea diagnosis - Having other sexually transmitted infections Complications Untreated gonorrhea can lead to significant complications, such as: - Infertility in women. Untreated gonorrhea can spread into the uterus and fallopian tubes, causing pelvic inflammatory disease (PID), which may result in scarring of the tubes, greater risk of pregnancy complications and infertility. PID is a serious infection that requires immediate treatment. - Infertility in men. Men with untreated gonorrhea can experience epididymitis - inflammation of a small, coiled tube in the rear portion of the testicles where the sperm ducts are located (epididymis). Epididymitis is treatable, but if left untreated, it may lead to infertility. - Infection that spreads to the joints and other areas of your body. The bacterium that causes gonorrhea can spread through the bloodstream and infect other parts of your body, including your joints. Fever, rash, skin sores, joint pain, swelling and stiffness are possible results. - Increased risk of HIV/AIDS. Having gonorrhea makes you more susceptible to infection with human immunodeficiency virus (HIV), the virus that leads to AIDS. People who have both gonorrhea and HIV are able to pass both diseases more readily to their partners. - Complications in babies. Babies who contract gonorrhea from their mothers during birth can develop blindness, sores on the scalp and infections. Diagnosis To determine whether the gonorrhea bacterium is present in your body, your doctor will analyze a sample of cells. Samples can be collected by: - Urine test. This may help identify bacteria in your urethra. - Swab of affected area. A swab of your throat, urethra, vagina or rectum may collect bacteria that can be identified in a laboratory. For women, home test kits are available for gonorrhea. Home test kits include vaginal swabs for self-testing that are sent to a specified lab for testing. If you prefer, you can choose to be notified by email or text message when your results are ready. You may then view your results online or receive them by calling a toll-free hotline. Testing for other sexually transmitted infections Your doctor may recommend tests for other sexually transmitted infections. Gonorrhea increases your risk of these infections, particularly chlamydia, which often accompanies gonorrhea. Testing for HIV also is recommended for anyone diagnosed with a sexually transmitted infection. Depending on your risk factors, tests for additional sexually transmitted infections could be beneficial as well. Treatment Gonorrhea treatment in adults Adults with gonorrhea are treated with antibiotics. Due to emerging strains of drug-resistant Neisseria gonorrhoeae, the Centers for Disease Control and Prevention recommends that uncomplicated gonorrhea be treated only with the antibiotic ceftriaxone - given as an injection - in combination with either azithromycin (Zithromax, Zmax) or doxycycline (Monodox, Vibramycin, others) - two antibiotics that are taken orally. Some research indicates that oral gemifloxacin (Factive) or injectable gentamicin, combined with oral azithromycin, is highly successful in treating gonorrhea. This treatment may be helpful in treating people who are allergic to cephalosporin antibiotics, such as ceftriaxone. Gonorrhea treatment for partners Your partner also should undergo testing and treatment for gonorrhea, even if he or she has no signs or symptoms. Your partner receives the same treatment you do. Even if you've been treated for gonorrhea, you can be reinfected if your partner isn't treated. Gonorrhea treatment for babies Babies born to mothers with gonorrhea receive a medication in their eyes soon after birth to prevent infection. If an eye infection develops, babies can be treated with antibiotics. ", "role": "user" }, { "content": "To determine whether the gonorrhea bacterium is present in your body, your doctor will analyze a sample of cells. Samples can be collected by: - Urine test. This may help identify bacteria in your urethra. - Swab of affected area. A swab of your throat, urethra, vagina or rectum may collect bacteria that can be identified in a laboratory. For women, home test kits are available for gonorrhea. Home test kits include vaginal swabs for self-testing that are sent to a specified lab for testing. If you prefer, you can choose to be notified by email or text message when your results are ready. You may then view your results online or receive them by calling a toll-free hotline.", "role": "assistant" } ]

[ { "content": "what does kidney disease look like\n\nKidney disease - resources: The following organizations are good resources for information on kidney disease: - National Institute of Diabetes and Digestive and Kidney Disease -- www.niddk.nih.gov/health-information/kidney-disease - National Kidney Foundation -- www.kidney.org - American Kidney Fund -- www.kidneyfund.org - American Geriatrics Society's Health in Aging Foundation -- www.healthinaging.org/aging-and-health-a-to-z/topic:kidney-problems/ Updated by: Jennifer K. Mannheim, ARNP, Medical Staff, Department of Psychiatry and Behavioral Health, Seattle Children's Hospital, 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": "The following organizations provide good resources for information on kidney disease: www.niddk.nih.gov/health-information/kidney-disease, .kidney.org, www.kidneyfund.org, www.healthinaging.org/aging-and-health-a-to-z/topic:kidney-problems/", "role": "assistant" } ]

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

[ { "content": "what are the risk factors of type ii diabetes\n\n Type 2 diabetes Overview Type 2 diabetes, once known as adult-onset or noninsulin-dependent diabetes, is a chronic condition that affects the way your body metabolizes sugar (glucose), your body's important source of fuel. With type 2 diabetes, your body either resists the effects of insulin - a hormone that regulates the movement of sugar into your cells - or doesn't produce enough insulin to maintain a normal glucose level. More common in adults, type 2 diabetes increasingly affects children as childhood obesity increases. There's no cure for type 2 diabetes, but you may be able to manage the condition by eating well, exercising and maintaining a healthy weight. If diet and exercise aren't enough to manage your blood sugar well, you also may need diabetes medications or insulin therapy. Symptoms Signs and symptoms of type 2 diabetes often develop slowly. In fact, you can have type 2 diabetes for years and not know it. Look for: - Increased thirst and frequent urination. Excess sugar building up in your bloodstream causes fluid to be pulled from the tissues. This may leave you thirsty. As a result, you may drink - and urinate - more than usual. - Increased hunger. Without enough insulin to move sugar into your cells, your muscles and organs become depleted of energy. This triggers intense hunger. - Weight loss. Despite eating more than usual to relieve hunger, you may lose weight. Without the ability to metabolize glucose, the body uses alternative fuels stored in muscle and fat. Calories are lost as excess glucose is released in the urine. - Fatigue. If your cells are deprived of sugar, you may become tired and irritable. - Blurred vision. If your blood sugar is too high, fluid may be pulled from the lenses of your eyes. This may affect your ability to focus. - Slow-healing sores or frequent infections. Type 2 diabetes affects your ability to heal and resist infections. - Areas of darkened skin. Some people with type 2 diabetes have patches of dark, velvety skin in the folds and creases of their bodies - usually in the armpits and neck. This condition, called acanthosis nigricans, may be a sign of insulin resistance. When to see a doctor See your doctor if you notice any type 2 diabetes symptoms. Causes Type 2 diabetes develops when the body becomes resistant to insulin or when the pancreas stops producing enough insulin. Exactly why this happens is unknown, although genetics and environmental factors, such as excess weight and inactivity, seem to be contributing factors. How insulin works Insulin is a hormone that comes from the gland situated behind and below the stomach (pancreas). - The pancreas secretes insulin into the bloodstream. - The insulin circulates, enabling sugar to enter your cells. - Insulin lowers the amount of sugar in your bloodstream. - As your blood sugar level drops, so does the secretion of insulin from your pancreas. The role of glucose Glucose - a sugar - is a main source of energy for the cells that make up muscles and other tissues. - Glucose comes from two major sources: food and your liver. - Sugar is absorbed into the bloodstream, where it enters cells with the help of insulin. - Your liver stores and makes glucose. - When your glucose levels are low, such as when you haven't eaten in a while, the liver breaks down stored glycogen into glucose to keep your glucose level within a normal range. In type 2 diabetes, this process doesn't work well. Instead of moving into your cells, sugar builds up in your bloodstream. As blood sugar levels increase, the insulin-producing beta cells in the pancreas release more insulin, but eventually these cells become impaired and can't make enough insulin to meet the body's demands. In the much less common type 1 diabetes, the immune system destroys the beta cells, leaving the body with little to no insulin. Risk factors Researchers don't fully understand why some people develop type 2 diabetes and others don't. It's clear, however, that certain factors increase the risk, including: - Weight. Being overweight is a primary risk factor for type 2 diabetes. The more fatty tissue you have, the more resistant your cells become to insulin. However, you don't have to be overweight to develop type 2 diabetes. - Fat distribution. If your body stores fat primarily in your abdomen, your risk of type 2 diabetes is greater than if your body stores fat elsewhere, such as your hips and thighs. - Inactivity. The less active you are, the greater your risk of type 2 diabetes. Physical activity helps you control your weight, uses up glucose as energy and makes your cells more sensitive to insulin. - Family history. The risk of type 2 diabetes increases if your parent or sibling has type 2 diabetes. - Race. Although it's unclear why, people of certain races - including blacks, Hispanics, American Indians and Asian-Americans - are more likely to develop type 2 diabetes than whites are. - Age. The risk of type 2 diabetes increases as you get older, especially after age 45. That's probably because people tend to exercise less, lose muscle mass and gain weight as they age. But type 2 diabetes is also increasing dramatically among children, adolescents and younger adults. - Prediabetes. Prediabetes is a condition in which your blood sugar level is higher than normal, but not high enough to be classified as diabetes. Left untreated, prediabetes often progresses to type 2 diabetes. - Gestational diabetes. If you developed gestational diabetes when you were pregnant, your risk of developing type 2 diabetes increases. If you gave birth to a baby weighing more than 9 pounds (4 kilograms), you're also at risk of type 2 diabetes. - Polycystic ovarian syndrome. For women, having polycystic ovarian syndrome - a common condition characterized by irregular menstrual periods, excess hair growth and obesity - increases the risk of diabetes. Complications Type 2 diabetes can be easy to ignore, especially in the early stages when you're feeling fine. But diabetes affects many major organs, including your heart, blood vessels, nerves, eyes and kidneys. Controlling your blood sugar levels can help prevent these complications. Although long-term complications of diabetes develop gradually, they can eventually be disabling or even life-threatening. Some of the potential complications of diabetes include: - Heart and blood vessel disease. Diabetes dramatically increases the risk of various cardiovascular problems, including coronary artery disease with chest pain (angina), heart attack, stroke, narrowing of arteries (atherosclerosis) and high blood pressure. - Nerve damage (neuropathy). Excess sugar can injure the walls of the tiny blood vessels (capillaries) that nourish your nerves, especially in the legs. This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward. Poorly controlled blood sugar can eventually cause you to lose all sense of feeling in the affected limbs. Damage to the nerves that control digestion can cause problems with nausea, vomiting, diarrhea or constipation. For men, erectile dysfunction may be an issue. - Kidney damage (nephropathy). The kidneys contain millions of tiny blood vessel clusters that filter waste from your blood. Diabetes can damage this delicate filtering system. Severe damage can lead to kidney failure or irreversible end-stage kidney disease, which often eventually requires dialysis or a kidney transplant. - Eye damage. Diabetes can damage the blood vessels of the retina (diabetic retinopathy), potentially leading to blindness. Diabetes also increases the risk of other serious vision conditions, such as cataracts and glaucoma. - Foot damage. Nerve damage in the feet or poor blood flow to the feet increases the risk of various foot complications. Left untreated, cuts and blisters can become serious infections, which may heal poorly. Severe damage might require toe, foot or leg amputation. - Hearing impairment. Hearing problems are more common in people with diabetes. - Skin conditions. Diabetes may leave you more susceptible to skin problems, including bacterial and fungal infections. - Alzheimer's disease. Type 2 diabetes may increase the risk of Alzheimer's disease. The poorer your blood sugar control, the greater the risk appears to be. The exact connection between these two conditions still remains unclear. Diagnosis To diagnose type 2 diabetes, you'll be given a: - Glycated hemoglobin (A1C) test. This blood test indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells. The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. An A1C level of 6.5 percent or higher on two separate tests indicates you have diabetes. A result between 5.7 and 6.4 percent is considered prediabetes, which indicates a high risk of developing diabetes. Normal levels are below 5.7 percent. If the A1C test isn't available, or if you have certain conditions - such as if you're pregnant or have an uncommon form of hemoglobin (known as a hemoglobin variant) - that can make the A1C test inaccurate, your doctor may use the following tests to diagnose diabetes: - Random blood sugar test. A blood sample will be taken at a random time. Blood sugar values are expressed in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). Regardless of when you last ate, a random blood sugar level of 200 mg/dL (11.1 mmol/L) or higher suggests diabetes, especially when coupled with any of the signs and symptoms of diabetes, such as frequent urination and extreme thirst. - Fasting blood sugar test. A blood sample will be taken after an overnight fast. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it's 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes. - Oral glucose tolerance test. For this test, you fast overnight, and the fasting blood sugar level is measured. Then you drink a sugary liquid, and blood sugar levels are tested periodically for the next two hours. A blood sugar level less than 140 mg/dL (7.8 mmol/L) is normal. A reading between 140 and 199 mg/dL (7.8 mmol/L and 11.0 mmol/L) indicates prediabetes. A reading of 200 mg/dL (11.1 mmol/L) or higher after two hours may indicate diabetes. The American Diabetes Association recommends routine screening for type 2 diabetes beginning at age 45, especially if you're overweight. If the results are normal, repeat the test every three years. If the results are borderline, ask your doctor when to come back for another test. Screening is also recommended for people who are under 45 and overweight if there are other heart disease or diabetes risk factors present, such as a sedentary lifestyle, a family history of type 2 diabetes, a personal history of gestational diabetes or blood pressure above 140/90 millimeters of mercury (mm Hg). If you're diagnosed with diabetes, the doctor may do other tests to distinguish between type 1 and type 2 diabetes - since the two conditions often require different treatments. After the diagnosis A1C levels need to be checked between two and four times a year. Your target A1C goal may vary depending on your age and other factors. However, for most people, the American Diabetes Association recommends an A1C level below 7 percent. Ask your doctor what your A1C target is. Compared with repeated daily blood sugar tests, the A1C test is a better indicator of how well your diabetes treatment plan is working. An elevated A1C level may signal the need for a change in your medication, meal plan or activity level. In addition to the A1C test, your doctor will take blood and urine samples periodically to check your cholesterol levels, thyroid function, liver function and kidney function. The doctor will also assess your blood pressure. Regular eye and foot exams also are important. Treatment Management of type 2 diabetes includes: - Healthy eating - Regular exercise - Possibly, diabetes medication or insulin therapy - Blood sugar monitoring These steps will help keep your blood sugar level closer to normal, which can delay or prevent complications. Healthy eating Contrary to popular perception, there's no specific diabetes diet. However, it's important to center your diet on these high-fiber, low-fat foods: - Fruits - Vegetables - Whole grains You'll also need to eat fewer animal products, refined carbohydrates and sweets. Low glycemic index foods also may be helpful. The glycemic index is a measure of how quickly a food causes a rise in your blood sugar. Foods with a high glycemic index raise your blood sugar quickly. Low glycemic index foods may help you achieve a more stable blood sugar. Foods with a low glycemic index typically are foods that are higher in fiber. A registered dietitian can help you put together a meal plan that fits your health goals, food preferences and lifestyle. He or she can also teach you how to monitor your carbohydrate intake and let you know about how many carbohydrates you need to eat with your meals and snacks to keep your blood sugar levels more stable. Physical activity Everyone needs regular aerobic exercise, and people who have type 2 diabetes are no exception. Get your doctor's OK before you start an exercise program. Then choose activities you enjoy, such as walking, swimming and biking. What's most important is making physical activity part of your daily routine. Aim for at least 30 minutes of aerobic exercise five days of the week. Stretching and strength training exercises are important, too. If you haven't been active for a while, start slowly and build up gradually. A combination of exercises - aerobic exercises, such as walking or dancing on most days, combined with resistance training, such as weightlifting or yoga twice a week - often helps control blood sugar more effectively than either type of exercise alone. Remember that physical activity lowers blood sugar. Check your blood sugar level before any activity. You might need to eat a snack before exercising to help prevent low blood sugar if you take diabetes medications that lower your blood sugar. Monitoring your blood sugar Depending on your treatment plan, you may need to check and record your blood sugar level every now and then or, if you're on insulin, multiple times a day. Ask your doctor how often he or she wants you to check your blood sugar. Careful monitoring is the only way to make sure that your blood sugar level remains within your target range. Sometimes, blood sugar levels can be unpredictable. With help from your diabetes treatment team, you'll learn how your blood sugar level changes in response to food, exercise, alcohol, illness and medication. Diabetes medications and insulin therapy Some people who have type 2 diabetes can achieve their target blood sugar levels with diet and exercise alone, but many also need diabetes medications or insulin therapy. The decision about which medications are best depends on many factors, including your blood sugar level and any other health problems you have. Your doctor might even combine drugs from different classes to help you control your blood sugar in several different ways. Examples of possible treatments for type 2 diabetes include: - Metformin (Glucophage, Glumetza, others). Generally, metformin is the first medication prescribed for type 2 diabetes. It works by improving the sensitivity of your body tissues to insulin so that your body uses insulin more effectively. Metformin also lowers glucose production in the liver. Metformin may not lower blood sugar enough on its own. Your doctor will also recommend lifestyle changes, such as losing weight and becoming more active. Nausea and diarrhea are possible side effects of metformin. These side effects usually go away as your body gets used to the medicine. If metformin and lifestyles changes aren't enough to control your blood sugar level, other oral or injected medications can be added. - Sulfonylureas. These medications help your body secrete more insulin. Examples of medications in this class include glyburide (DiaBeta, Glynase), glipizide (Glucotrol) and glimepiride (Amaryl). Possible side effects include low blood sugar and weight gain. - Meglitinides. These medications work like sulfonylureas by stimulating the pancreas to secrete more insulin, but they're faster acting, and the duration of their effect in the body is shorter. They also have a risk of causing low blood sugar, but this risk is lower than with sulfonylureas. Weight gain is a possibility with this class of medications as well. Examples include repaglinide (Prandin) and nateglinide (Starlix). - Thiazolidinediones. Like metformin, these medications make the body's tissues more sensitive to insulin. This class of medications has been linked to weight gain and other more-serious side effects, such as an increased risk of heart failure and fractures. Because of these risks, these medications generally aren't a first-choice treatment. Rosiglitazone (Avandia) and pioglitazone (Actos) are examples of thiazolidinediones. - DPP-4 inhibitors. These medications help reduce blood sugar levels, but tend to have a modest effect. They don't cause weight gain. Examples of these medications are sitagliptin (Januvia), saxagliptin (Onglyza) and linagliptin (Tradjenta). - GLP-1 receptor agonists. These medications slow digestion and help lower blood sugar levels, though not as much as sulfonylureas. Their use is often associated with some weight loss. This class of medications isn't recommended for use by itself. Exenatide (Byetta) and liraglutide (Victoza) are examples of GLP-1 receptor agonists. Possible side effects include nausea and an increased risk of pancreatitis. - SGLT2 inhibitors. These are the newest diabetes drugs on the market. They work by preventing the kidneys from reabsorbing sugar into the blood. Instead, the sugar is excreted in the urine. Examples include canagliflozin (Invokana) and dapagliflozin (Farxiga). Side effects may include yeast infections and urinary tract infections, increased urination and hypotension. - Insulin therapy. Some people who have type 2 diabetes need insulin therapy as well. In the past, insulin therapy was used as a last resort, but today it's often prescribed sooner because of its benefits. Because normal digestion interferes with insulin taken by mouth, insulin must be injected. Depending on your needs, your doctor may prescribe a mixture of insulin types to use throughout the day and night. Often, people with type 2 diabetes start insulin use with one long-acting shot at night. Insulin injections involve using a fine needle and syringe or an insulin pen injector - a device that looks similar to an ink pen, except the cartridge is filled with insulin. There are many types of insulin, and they each work in a different way. Options include: - Insulin glulisine (Apidra) - Insulin lispro (Humalog) - Insulin aspart (Novolog) - Insulin glargine (Lantus) - Insulin detemir (Levemir) - Insulin isophane (Humulin N, Novolin N) Discuss the pros and cons of different drugs with your doctor. Together you can decide which medication is best for you after considering many factors, including costs and other aspects of your health. In addition to diabetes medications, your doctor might prescribe low-dose aspirin therapy as well as blood pressure and cholesterol-lowering medications to help prevent heart and blood vessel disease. Bariatric surgery If you have type 2 diabetes and your body mass index (BMI) is greater than 35, you may be a candidate for weight-loss surgery (bariatric surgery). Blood sugar levels return to normal in 55 to 95 percent of people with diabetes, depending on the procedure performed. Surgeries that bypass a portion of the small intestine have more of an effect on blood sugar levels than do other weight-loss surgeries. Drawbacks to the surgery include its high cost, and there are risks involved, including a risk of death. Additionally, drastic lifestyle changes are required and long-term complications may include nutritional deficiencies and osteoporosis. Pregnancy Women with type 2 diabetes may need to alter their treatment during pregnancy. Many women will require insulin therapy during pregnancy. Cholesterol-lowering medications and some blood pressure drugs can't be used during pregnancy. If you have signs of diabetic retinopathy, it may worsen during pregnancy. Visit your ophthalmologist during the first trimester of your pregnancy and at one year postpartum. Signs of trouble Because so many factors can affect your blood sugar, problems sometimes arise that require immediate care, such as: - High blood sugar (hyperglycemia). Your blood sugar level can rise for many reasons, including eating too much, being sick or not taking enough glucose-lowering medication. Check your blood sugar level often, and watch for signs and symptoms of high blood sugar - frequent urination, increased thirst, dry mouth, blurred vision, fatigue and nausea. If you have hyperglycemia, you'll need to adjust your meal plan, medications or both. - Hyperglycemic hyperosmolar nonketotic syndrome (HHNS). Signs and symptoms of this life-threatening condition include a blood sugar reading higher than 600 mg/dL (33.3 mmol/L), dry mouth, extreme thirst, fever greater than 101 F (38 C), drowsiness, confusion, vision loss, hallucinations and dark urine. Your blood sugar monitor may not be able to give you an exact reading at such high levels and may instead just read \"high.\" HHNS is caused by sky-high blood sugar that turns blood thick and syrupy. It tends to be more common in older people with type 2 diabetes, and it's often preceded by an illness or infection. HHNS usually develops over days or weeks. Call your doctor or seek immediate medical care if you have signs or symptoms of this condition. - Increased ketones in your urine (diabetic ketoacidosis). If your cells are starved for energy, your body may begin to break down fat. This produces toxic acids known as ketones. Watch for thirst or a very dry mouth, frequent urination, vomiting, shortness of breath, fatigue and fruity-smelling breath. You can check your urine for excess ketones with an over-the-counter ketones test kit. If you have excess ketones in your urine, consult your doctor right away or seek emergency care. This condition is more common in people with type 1 diabetes but can sometimes occur in people with type 2 diabetes. - Low blood sugar (hypoglycemia). If your blood sugar level drops below your target range, it's known as low blood sugar (hypoglycemia). Your blood sugar level can drop for many reasons, including skipping a meal, inadvertently taking more medication than usual or getting more physical activity than normal. Low blood sugar is most likely if you take glucose-lowering medications that promote the secretion of insulin or if you're taking insulin. Check your blood sugar level regularly, and watch for signs and symptoms of low blood sugar - sweating, shakiness, weakness, hunger, dizziness, headache, blurred vision, heart palpitations, slurred speech, drowsiness, confusion and seizures. If you develop hypoglycemia during the night, you might wake with sweat-soaked pajamas or a headache. Due to a natural rebound effect, nighttime hypoglycemia might cause an unusually high blood sugar reading first thing in the morning. If you have signs or symptoms of low blood sugar, drink or eat something that will quickly raise your blood sugar level - fruit juice, glucose tablets, hard candy, regular (not diet) soda or another source of sugar. Retest in 15 minutes to be sure your blood glucose levels have normalized. If they haven't, treat again and retest in another 15 minutes. If you lose consciousness, a family member or close contact may need to give you an emergency injection of glucagon, a hormone that stimulates the release of sugar into the blood. Lifestyle and home remedies Careful management of type 2 diabetes can reduce your risk of serious - even life-threatening - complications. Consider these tips: - Commit to managing your diabetes. Learn all you can about type 2 diabetes. Make healthy eating and physical activity part of your daily routine. Establish a relationship with a diabetes educator, and ask your diabetes treatment team for help when you need it. - Schedule a yearly physical exam and regular eye exams. Your regular diabetes checkups aren't meant to replace regular physicals or routine eye exams. During the physical, your doctor will look for any diabetes-related complications, as well as screen for other medical problems. Your eye care specialist will check for signs of retinal damage, cataracts and glaucoma. - Identify yourself. Wear a necklace or bracelet that says you have diabetes. - Keep your immunizations up to date. High blood sugar can weaken your immune system. Get a flu shot every year, and your doctor will likely recommend the pneumonia vaccine, as well. The Centers for Disease Control and Prevention (CDC) also recommends the hepatitis B vaccination if you haven't previously received this vaccine and you're an adult age 19 to 59 with type 1 or type 2 diabetes. The CDC advises vaccination as soon as possible after diagnosis with type 1 or type 2 diabetes. If you are age 60 or older, have diabetes and haven't previously received the vaccine, talk to your doctor about whether it's right for you. - Take care of your teeth. Diabetes may leave you prone to more-serious gum infections. Brush your teeth at least twice a day, floss your teeth once a day and schedule regular dental exams. Consult your dentist right away if your gums bleed or look red or swollen. - Pay attention to your feet. Wash your feet daily in lukewarm water. Dry them gently, especially between the toes, and moisturize with lotion. Check your feet every day for blisters, cuts, sores, redness and swelling. Consult your doctor if you have a sore or other foot problem that isn't healing. - Keep your blood pressure and cholesterol under control. Eating healthy foods and exercising regularly can go a long way toward controlling high blood pressure and cholesterol. Medication also may be needed. - If you smoke or use other types of tobacco, ask your doctor to help you quit. Smoking increases your risk of various diabetes complications. Talk to your doctor about ways to stop smoking or to stop using other types of tobacco. - If you drink alcohol, do so responsibly. Alcohol, as well as drink mixers, can cause either high or low blood sugar, depending on how much you drink and if you eat at the same time. If you choose to drink, do so in moderation and always with a meal. The recommendation is no more than one drink daily for women, no more than two drinks daily for men age 65 and younger, and one drink a day for men over 65. If you're on insulin or other medications that lower your blood sugar, check your blood sugar before you go to sleep to make sure you're at a safe level. Alternative medicine Numerous alternative medicine substances have been shown to improve insulin sensitivity in some studies, while other studies fail to find any benefit for blood sugar control or in lowering A1C levels. Because of the conflicting findings, no alternative therapies are recommended to help with blood sugar management. If you decide to try an alternative therapy, don't stop taking the medications that your doctor has prescribed. Be sure to discuss the use of any of these therapies with your doctor to make sure that they won't cause adverse reactions or interact with your medications. No treatments - alternative or conventional - can cure diabetes. So it's critical that people who are using insulin therapy for diabetes don't stop using insulin unless directed to do so by their physicians. ", "role": "user" }, { "content": "Researchers don't fully understand why some people develop type 2 diabetes and others don't. It's clear, however, that certain factors increase the risk, including: - Weight. Being overweight is a primary risk factor for type 2 diabetes. - Fat distribution. If your body stores fat primarily in your abdomen, your risk of type 2 diabetes is greater than if your body stores fat elsewhere, such as your hips and thighs. - Inactivity. The less active you are, the greater your risk of type 2 diabetes. - Family history. The risk of type 2 diabetes increases if your parent or sibling has type 2 diabetes. - Race. Although it's unclear why, people of certain races - including blacks, Hispanics, American Indians and Asian-Americans - are more likely to develop type 2 diabetes than whites are. - Age. The risk of type 2 diabetes increases as you get older, especially after age 45.", "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\nSLC4A1-associated distal renal tubular acidosis (Genetic Changes): 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.", "role": "user" }, { "content": "SLC4A1-associated distal renal tubular acidosis is caused by mutations in the SLC4A1 gene. In people with SLC4A1-associated distal renal tubular acidosis, the acid builds up in the blood, 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. 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.", "role": "assistant" } ]

[ { "content": "Please help me with my brother with locked-in syndrome in for 3 years.Somebody please help. God bless .\n\nLocked-In Syndrome (Prognosis): While in rare cases some patients may regain certain functions, the chances for motor recovery are very limited.", "role": "user" }, { "content": "Locked-In Syndrome (Prognosis): While in rare cases some patients may regain certain functions, the chances for motor recovery are very limited.", "role": "assistant" } ]

[ { "content": "what is the disorder achondroplasia\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": "Achondroplasia is a disorder of bone growth that prevents the changing of cartilage (particularly in the long bones of the arms and legs) to bone. It is characterized by dwarfism, limited range of motion at the elbows, large head size, small fingers, and normal intelligence. Achondroplasia can cause health complications such as apnea, obesity, recurrent ear infections, and lordosis of the spine. Achondroplasia is caused by mutations in the FGFR3 gene. It is inherited in an autosomal dominant fashion.", "role": "assistant" } ]

[ { "content": "If oleandor was ingested by touching the plant stems inner part and then directly eating without washing hands, how long would u exspect symptoms would start? And how severe would you say symptoms may get.\n\nOleander poisoning: Oleander poisoning occurs when someone eats the flowers or chews the leaves or stems of the oleander plant (Nerium oleander), or its relative, the yellow oleander (Cascabela thevetia). This article is for information only. DO NOT use it to treat or manage an actual poison exposure. If you or someone you are with has an exposure, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. Poisonous ingredients include: - Digitoxigenin - Neriin - Oleandrin - Oleondroside Note: This list may not include all poisonous ingredients. The poisonous substances are found in all parts of the oleander plant: - Flowers - Leaves - Stems - Twigs Oleander poisoning can affect many parts of the body. HEART AND BLOOD - Irregular or slow heartbeat - Low blood pressure - Weakness EYES, EARS, NOSE, MOUTH, AND THROAT - Blurred vision - Vision disturbances, including halos STOMACH AND INTESTINES - Diarrhea - Loss of appetite - Nausea and vomiting - Stomach pain NERVOUS SYSTEM - Confusion - Death - Depression - Disorientation - Dizziness - Drowsiness - Fainting - Headache - Lethargy SKIN - Hives - Rash Note: Depression, loss of appetite, and halos are most often seen in chronic overdose cases. Seek immediate medical help. DO NOT make a person throw up unless told to do so by poison control or a health care provider. Get the following information: - Person's age, weight, and condition - Name and part of the plant swallowed, if known - Time it was swallowed - Amount swallowed Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This hotline number will let you talk to experts in poisoning. They will give you further instructions. This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does not need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week. The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. The person may receive: - Activated charcoal - Blood and urine tests - Breathing support - Chest x-ray - EKG (electrocardiogram, or heart tracing) - Fluids through a vein (IV) - Medicines to treat symptoms including an antidote to reverse the effects of the poison - Tube through the mouth into the stomach to wash out the stomach (gastric lavage) How well you do depends on the amount of poison swallowed and how quickly treatment is received. The faster you get medical help, the better the chance for recovery. Symptoms last for 1 to 3 days and may require a hospital stay. Death is unlikely. DO NOT touch or eat any plant with which you are not familiar. Wash your hands after working in the garden or walking in the woods. Updated by: Jesse Borke, MD, FACEP, FAAEM, Attending Physician at FDR Medical Services/Millard Fillmore Suburban Hospital, Buffalo, NY. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Editorial update 10/26/2016.", "role": "user" }, { "content": "Oleander poisoning occurs when someone eats the flowers or chews the leaves or stems of the oleander plant (Nerium oleander), or its relative, the yellow oleander (Cascabela thevetia). Iff you had an exposure, call your local emergency number (such as 911.) Call the US national toll-free Poison Help hotline (1-800-222-1222) if you have any questions about poisoning or poison prevention. It does not need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week. Oleander poisoning can cause irregular or slow heartbeat, low blood pressure, weakness, blurred vision, vision disturbances, including halos, diarrhea, loss of appetite, nausea and vomiting, stomach pain, confusion, disorientation, dizziness, drowsiness, fainting, headache, lethargy, hives, and rash. Depression, loss of appetite, and halos are most often seen in chronic overdose cases. The faster you get medical help, the better the chance for recovery. Symptoms last for 1 to 3 days and may require a hospital stay. Death is unlikely.", "role": "assistant" } ]

[ { "content": "Vitelliform Macular Dystrophy Would like to obtain more info on possible treatments.\n\nBest vitelliform macular dystrophy: Best vitelliform macular dystrophy (BVMD) is a slowly progressive form of macular degeneration. It usually begins in childhood or adolescence, but age of onset and severity of vision loss can vary. Affected people first have normal vision, followed by decreased central visual acuity and distorted vision (metamorphopsia). Peripheral vision is not affected. [1] BVMD is characterized by atrophy of the retinal pigment epithelium (The retina is the back part of the eye that contains the specialized cells that respond to light, known as  photoreceptors) and impaired central visual function. [2] BVMD is usually inherited in an autosomal dominant manner, but autosomal recessive inheritance has been reported. The condition is typically caused by mutations in the BEST1 gene ; in a few cases the cause is unknown. Treatment is symptomatic and involves the use of low vision aids, and direct laser treatment or photodynamic therapy. Newer treatment includes anti-VEGF agents ( bevacizumab) and transcorneal electrical retinal stimulation. [1] 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) Cystoid macular degeneration Very frequent Metamorphopsia Very frequent Visual impairment Very frequent Abnormality of color vision Frequent Choroideremia Occasional Visual field defect Occasional Abnormal electroretinogram - Autosomal dominant inheritance - Macular dystrophy - Reduced visual acuity - Best vitelliform macular dystrophy (BVMD) is caused by changes ( mutations ) in the gene . [1] This gene gives the body instructions for making a protein called bestrophin. Bestrophin acts as a channel that controls the movement of chloride ions within the retina. It is thought that mutations in the BEST1 gene affect the shape of the channel and its ability to properly regulate the flow of chloride. However, it is unclear how exactly this relates to the specific features of BVMD. [3] Best vitelliform macular dystrophy (BVMD) is most commonly inherited in an autosomal dominant manner, although a few cases with autosomal recessive inheritance have been reported. [1] In autosomal dominant inheritance, having one changed ( mutated ) copy of the responsible gene in each cell is enough to cause symptoms of the condition. When a person with an autosomal dominant condition has children, each child has a 50% (1 in 2) chance to inherit the mutated gene. Most people with BVMD have an affected parent, but some people have the condition as the result of a new mutation that occurred for the first time. [1] Autosomal recessive inheritance means that a person must have a mutation in both copies of the responsible gene in each cell to be affected. 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. Best vitelliform macular dystrophy (BVMD) may be diagnosed based on the findings on an exam of the fundus (the interior surface of the eye opposite the lens); an electrooculogram (EOG); and the family history . An eye exam may include other tests as well. A fundus exam may show a typical yellow yolk-like macular lesion. The EOG, which reflects the retinal pigmentary epithelium function, is the most diagnostic test for evaluating vitelliform macular dystrophy. In the majority of the cases, a severe decrease occurs in light response, reflected by an Arden (light-peak/dark-trough) ratio of 1.1-1.5. (The normal Arden ratio is 1.8.) Carriers will also have an abnormal EOG result.  No correlation exists between EOG result and disease stage, visual acuity, or patient age. EOG results are usually symmetric for both eyes. [4] The family history in affected people is often consistent with either autosomal dominant or autosomal recessive inheritance. [1] Genetic testing may also be used to make a diagnosis of BVMD. A BEST1 mutation is detected in about 96% of affected people who have an affected family member. In people with no family history of BVMD, the mutation detection rate ranges between 50-70%. A mutation in BEST1 gene is more probable when a vitelliform lesion is accompanied by a reduced Arden ratio on EOG testing. The exact type of genetic test ordered to confirm a diagnosis may depend on a person's ancestry, family history, and/or whether other eye disorders are also being considered. [1] There is no specific treatment for Best vitelliform macular dystrophy (BVMD) at this time. [5] [4] Low vision aids help affected people with significant loss of visual acuity. [6] Laser photocoagulation, photodynamic therapy, and anti-VEGF (vascular endothelial growth factor) agents such as bevacizumab have shown limited success in treating some of the secondary features of BVMD such as choroidal neovascularization (when abnormal blood vessels grow under the macula and retina). [6] [5] [4] Management Guidelines GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions.", "role": "user" }, { "content": "Treatment is symptomatic and involves the use of low vision aids, and direct laser treatment or photodynamic therapy. Newer treatment includes anti-VEGF agents ( bevacizumab) and transcorneal electrical retinal stimulation.", "role": "assistant" } ]

[ { "content": "Stiff person Syndrome. Please can you tell me what are the early symptoms I have severe cramps in my feet which are twisting into an arc,muscle spasms slowly getting worse and my muscles particularly in my legs are cramping like someone has pushed a knitting needle into them. Started off at night but now happening through the day my back and neck and voice box are also effected and my chest area has now seized to the point of restricting my breathing to very shallow at times I find that I am stretching out involuntarily right through my body and this is becoming more frequent\n\nStiff-Person Syndrome: Stiff-person syndrome (SPS) is a rare neurological disorder with features of an autoimmune disease.  SPS is characterized by fluctuating muscle rigidity in the trunk and limbs and a heightened sensitivity to stimuli such as noise, touch, and emotional distress, which can set off muscle spasms.  Abnormal postures, often hunched over and stiffened, are characteristic of the disorder.  People with SPS can be too disabled to walk or move, or they are afraid to leave the house because street noises, such as the sound of a horn, can trigger spasms and falls.  SPS affects twice as many women as men.   It is frequently associated with other autoimmune diseases such as diabetes, thyroiditis, vitiligo, and pernicious anemia.  Scientists don’t yet understand what causes SPS, but research indicates that it is the result of an autoimmune response gone awry in the brain and spinal cord.  The disorder is often misdiagnosed as Parkinson’s disease, multiple sclerosis, fibromyalgia, psychosomatic illness, or anxiety and phobia.  A definitive diagnosis can be made with a blood test that measures the level of glutamic acid decarboxylase (GAD) antibodies in the blood.  People with SPS have elevated levels of GAD, an antibody that works against an enzyme involved in the synthesis of an important neurotransmitter in the brain. People with SPS respond to high doses of diazepam and several anti-convulsants, gabapentin and tiagabine.  A recent study funded by the NINDS demonstrated the effectiveness of intravenous immunoglobulin (IVIg) treatment in reducing stiffness and lowering sensitivity to noise, touch, and stress in people with SPS.  Treatment with IVIg, anti-anxiety drugs, muscle relaxants, anti-convulsants, and pain relievers will improve the symptoms of SPS, but will not cure the disorder.  Most individuals with SPS have frequent falls and because they lack the normal defensive reflexes; injuries can be severe.  With appropriate treatment, the symptoms are usually well controlled.", "role": "user" }, { "content": "Symptoms of Stiff-Person Syndrome (SPS) include fluctuating rigidity of the muscles in the body and limbs, and sensitivity to noise, touch and emotional distress that can cause muscle spasms; abnormal postures that are hunched over and stiff; and being afraid to leave the house because of the street noises that could cause spasms and falls. Twice as many women as men have SPS. It is often associated with diabetes, thyroiditis, vitiligo, and pernicious anemia. The symptoms can be mistaken for Parkinson's disease, multiple sclerosis, fibromyalgia, psychosomatic illness, or anxiety and phobia. Your doctor could order blood tests that measure the level of glutamic acid decarboxylase (GAD) antibodies in the blood to see if you have SPS.", "role": "assistant" } ]

[ { "content": "how to prevent schizophrenia\n\nSchizophrenia: 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. 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. 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 feeling - 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) 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: - 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 - About any 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. 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 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. 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 Call your provider if you (or another 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 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. Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.", "role": "user" }, { "content": "Schizophrenia is a complex illness. Mental health experts are not sure what causes it. 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 do you get pulmonary hypertension\n\nHow to diagnose Pulmonary Hypertension?: Your doctor will diagnose pulmonary hypertension (PH) based on your medical and family histories, a physical exam, and the results from tests and procedures. PH can develop slowly. In fact, you may have it for years and not know it. This is because the condition has no early signs or symptoms. When symptoms do occur, they're often like those of other heart and lung conditions, such as asthma. This makes PH hard to diagnose. Medical and Family Histories Your doctor may ask about your signs and symptoms and how and when they began. He or she also may ask whether you have other medical conditions that can cause PH. Your doctor will want to know whether you have any family members who have or have had PH. People who have a family history of PH are at higher risk for the condition. Physical Exam During the physical exam, your doctor will listen to your heart and lungs with a stethoscope. He or she also will check your ankles and legs for swelling and your lips and skin for a bluish color. These are signs of PH. Diagnostic Tests and Procedures Your doctor may recommend tests and procedures to confirm a diagnosis of PH and to look for its underlying cause. Your doctor also will use test results to find out the severity of your PH. Tests and Procedures To Confirm a Diagnosis Echocardiography. Echocardiography (EK-o-kar-de-OG-ra-fee), or echo, uses sound waves to create a moving picture of your heart. This test can estimate the pressure in your pulmonary arteries. Echo also can show the size and thickness of your right ventricle and how well it's working. Chest x ray. A chest x ray takes pictures of the structures in your chest, such as your heart, lungs, and blood vessels. This test can show whether your pulmonary arteries and right ventricle are enlarged. The pulmonary arteries and right ventricle may get larger if the right ventricle has to work hard to pump blood through the pulmonary arteries. A chest x ray also may show signs of an underlying lung disease that's causing or contributing to PH. EKG (electrocardiogram). An EKG is a simple, painless test that records the heart's electrical activity. This test also shows whether your heart's rhythm is steady or irregular. An EKG may show whether your right ventricle is enlarged or strained. Right heart catheterization. This procedure measures the pressure in your pulmonary arteries. It also shows how well your heart is pumping blood to the rest of your body. Right heart catheterization (KATH-e-ter-ih-ZA-shun) can find any leaks between the left and right side of the heart. During this procedure, a thin, flexible tube called a catheter is put into a blood vessel in your groin (upper thigh) or neck. The tube is threaded into the right side of your heart and into the pulmonary arteries. Through the tube, your doctor can do tests and treatments on your heart. Tests To Look for the Underlying Cause of Pulmonary Hypertension PH has many causes, so many tests may need to be done to find its underlying cause. Chest CT scan. A chest computed tomography (to-MOG-ra-fee) scan, or chest CT scan, creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. These pictures can show signs of PH or a condition that may be causing PH. Chest MRI. Chest magnetic resonance imaging, or chest MRI, shows how your right ventricle is working. The test also shows blood flow in your lungs. Chest MRI also can help detect signs of PH or an underlying condition causing PH. Lung function tests. Lung function 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. These tests can help detect a lung disease that may be causing PH. Polysomnogram (PSG). This test records brain activity, eye movements, heart rate, and blood pressure while you sleep. A PSG also measures the level of oxygen in your blood. A low oxygen level during sleep is common in PH, and it can make the condition worse. A PSG usually is done while you stay overnight at a sleep center. For more information about this test, go to the Diseases and Conditions Index Sleep Studies article. Lung ventilation/perfusion (VQ) scan. A lung VQ scan measures air and blood flow in your lungs. This test can help detect blood clots in your lung's blood vessels. Blood tests. Blood tests are used to rule out other diseases, such as HIV, liver disease, and autoimmune diseases (such as rheumatoid arthritis). Finding Out the Severity of Pulmonary Hypertension Exercise testing is used to find out the severity of PH. This testing consists of either a 6-minute walk test or a cardiopulmonary exercise test. A 6-minute walk test measures the distance you can quickly walk in 6 minutes. A cardiopulmonary exercise test measures how well your lungs and heart work while you exercise on a treadmill or bicycle. During exercise testing, your doctor will rate your activity level. Your level is linked to the severity of your PH. The rating system ranges from class 1 to class 4. Class 1 has no limits. You can do regular physical activities, such as walking or climbing stairs. These activities don't cause PH symptoms, such as tiredness, shortness of breath, or chest pain. Class 2 has slight or mild limits. You're comfortable while resting, but regular physical activity causes PH symptoms. Class 3 has marked or noticeable limits. You're comfortable while resting. However, walking even one or two blocks or climbing one flight of stairs can cause PH symptoms. Class 4 has severe limits. You're not able to do any physical activity without discomfort. You also may have PH symptoms while at rest. Over time, you may need more exercise tests to find out how well your treatments are working. Each time testing is done, your doctor will compare your activity level with the previous one.", "role": "user" }, { "content": "Pulmonary Hypertension PH has many causes, so many tests may need to be done to find its underlying cause.", "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": "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. Drugs originally developed for epilepsy, depression, or high blood pressure 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 may reduce the number and severity of migraine attacks. 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.", "role": "assistant" } ]

[ { "content": "how is asthma diagnosed\n\n Asthma in children Pediatric asthma Asthma - pediatric Wheezing - asthma - children Summary Asthma is a disease that causes the airways to swell and get narrow. It leads to wheezing, shortness of breath, chest tightness, and coughing. Causes Asthma is caused by swelling (inflammation) in the airways. During an asthma attack, the muscles surrounding the airways tighten. The lining of the air passages swells. As a result, less air is able to pass through. Asthma is often seen in children. It is a leading cause of missed school days and hospital visits for children. An allergic reaction is a key part of asthma in children. Asthma and allergies often occur together. In children who have sensitive airways, asthma symptoms can be triggered by breathing in substances called allergens, or triggers. Common asthma triggers include: Animals (hair or dander) Dust, mold, and pollen Aspirin and other medicines Changes in weather (most often cold weather) Chemicals in the air or in food Tobacco smoke Exercise Strong emotions Viral infections, such as the common cold Symptoms Breathing problems are common. They can include: Shortness of breath Feeling out of breath Gasping for air Trouble breathing out (exhaling) Breathing faster than normal When the child is having a hard time breathing, the skin of the chest and neck may suck inward. Other symptoms of asthma in children include: Coughing that sometimes wakes the child up at night (it may be the only symptom). Dark bags under the eyes. Feeling tired. Irritability. Tightness in the chest. A whistling sound made when breathing (wheezing). You may notice it more when the child breathes out. Your child's asthma symptoms may vary. Symptoms may appear often or develop only when triggers are present. Some children are more likely to have asthma symptoms at night. Exams and Tests The health care provider will use a stethoscope to listen to the child's lungs. The provider may be able to hear asthma sounds. However, lung sounds are often normal when the child is not having an asthma attack. The provider will have the child breathe into a device called a peak flow meter. Peak flow meters can tell how well the child can blow air out of the lungs. If the airways are narrow due to asthma, peak flow values drop. You and your child will learn to measure peak flow at home. Your child's provider may order the following tests: Allergy testing on the skin, or a blood test to see if your child is allergic to certain substances Chest x-ray Lung function tests Treatment You and your child's providers should work together as a team to create and carry out an asthma action plan. This plan will tell you how to: Avoid asthma triggers Monitor symptoms Measure peak flow Take medicines The plan should also tell you when to call the provider. It is important to know what questions to ask your child's provider. Children with asthma need a lot of support at school. Give the school staff your asthma action plan so they know how to take care of your child's asthma. Find out how to let your child take medicine during school hours. (You may need to sign a consent form.) Having asthma does not mean your child cannot exercise. Coaches, gym teachers, and your child should know what to do if your child has asthma symptoms caused by exercise. ASTHMA MEDICINES There are two basic kinds of medicine used to treat asthma. Long-term control drugs are taken every day to prevent asthma symptoms. Your child should take these medicines even if no symptoms are present. Some children may need more than one long-term control medicine. Types of long-term control medicines include: Inhaled steroids (these are usually the first choice of treatment) Long-acting bronchodilators (these are almost always used with inhaled steroids) Leukotriene inhibitors Cromolyn sodium Quick relief or rescue asthma drugs work fast to control asthma symptoms. Children take them when they are coughing, wheezing, having trouble breathing, or having an asthma attack. Some of your child's asthma medicines can be taken using an inhaler. Children who use an inhaler should use a spacer device. This helps them get the medicine into the lungs properly. If your child uses the inhaler the wrong way, less medicine gets into the lungs. Have your provider show your child how to correctly use an inhaler. Younger children can use a nebulizer instead of an inhaler to take their medicine. A nebulizer turns asthma medicine into a mist. GETTING RID OF TRIGGERS It is important to know your child's asthma triggers. Avoiding them is the first step toward helping your child feel better. Keep pets outdoor, or at least away from the child's bedroom. No one should smoke in a house or around a child with asthma. Getting rid of tobacco smoke in the home is the single most important thing a family can do to help a child with asthma. Smoking outside the house is not enough. Family members and visitors who smoke carry the smoke inside on their clothes and hair. This can trigger asthma symptoms. DO NOT use indoor fireplaces. Keep the house clean. Keep food in containers and out of bedrooms. This helps reduce the possibility of cockroaches, which can trigger asthma attacks. Cleaning products in the home should be unscented. MONITOR YOUR CHILD'S ASTHMA Checking peak flow is one of the best ways to control asthma. It can help you keep your child's asthma from getting worse. Asthma attacks usually DO NOT happen without warning. Children under age 5 may not be able to use a peak flow meter well enough for it to be helpful. However, a child should start using the peak flow meter at a young age to get used to it. An adult should always watch for a child's asthma symptoms. Outlook (Prognosis) With proper treatment, most children with asthma can live a normal life. When asthma is not well controlled, it can lead to missed school, problems playing sports, missed work for parents, and many visits to the provider's office and emergency room. Asthma symptoms often lessen or go away completely as the child gets older. Asthma that is not well controlled can lead to lasting lung problems. In rare cases, asthma is a life-threatening disease. Families need to work closely with their providers to develop a plan to care for a child with asthma. When to Contact a Medical Professional Call your child's provider if you think your child has new symptoms of asthma. If your child has been diagnosed with asthma, call the provider: After an emergency room visit When peak flow numbers have been getting lower When symptoms get more frequent and more severe, even though your child is following the asthma action plan If your child is having trouble breathing or having an asthma attack, get medical help right away. Emergency symptoms include: Difficulty breathing Bluish color to the lips and face Severe anxiety due to shortness of breath Rapid pulse Sweating Decreased level of alertness, such as severe drowsiness or confusion A child who is having a severe asthma attack may need to stay in the hospital and get oxygen and medicines through a vein (intravenous line or IV). Review Date 5/20/2018 Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Asthma - children (Exams and Tests): The health care provider will use a stethoscope to listen to the child's lungs. The provider may be able to hear asthma sounds. However, lung sounds are often normal when the child is not having an asthma episode. The provider will have the child breathe into a device called a peak flow meter. Peak flow meters can tell how well the child can blow air out of the lungs. - Allergy testing on the skin, or a blood test to see if your child is allergic to certain substances - Chest x-ray - Lung function tests", "role": "assistant" } ]

[ { "content": "williams sydrome conditon. i need to send me more information about Williams Syndrome and some tips how to educate people with this disorder.I hope having news from you soon!!thank you\n\nWhat are the complications of Williams syndrome?: - Calcium deposits in the kidney and other kidney problems - Death (in rare cases from anesthesia) - Heart failure due to narrowed blood vessels - Pain in the abdomen", "role": "user" }, { "content": "The complications of Williams syndrome are calcium deposits in the kidney, other kidney problems, death in rare cases from anesthesia, heart failure, or pain in the abdomen.", "role": "assistant" } ]

[ { "content": "how is congenital heart disease passed down\n\ncritical congenital heart disease (Inheritance Pattern): Most cases of CCHD are sporadic, which means they occur in people with no history of the disorder in their family. However, close relatives (such as siblings) of people with CCHD may have an increased risk of being born with a heart defect compared with people in the general population.", "role": "user" }, { "content": "Most cases of congenital heart disease occur in people with no history of the disorder in their family. However, close relatives of people with congenital heart disease may have an increased risk of having a heart defect.", "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": "Hemophilia A (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.", "role": "assistant" } ]

[ { "content": "If oleandor was ingested by touching the plant stems inner part and then directly eating without washing hands, how long would u exspect symptoms would start? And how severe would you say symptoms may get.\n\nWhat are the symptoms of Oleander poisoning?: Oleander poisoning can affect many parts of the body. HEART AND BLOOD - Irregular or slow heartbeat - Low blood pressure - Weakness EYES, EARS, NOSE, MOUTH, AND THROAT - Blurred vision - Vision disturbances, including halos STOMACH AND INTESTINES - Diarrhea - Loss of appetite - Nausea and vomiting - Stomach pain NERVOUS SYSTEM - Confusion - Death - Depression - Disorientation - Dizziness - Drowsiness - Fainting - Headache - Lethargy SKIN - Hives - Rash Note: Depression, loss of appetite, and halos are most often seen in chronic overdose cases.", "role": "user" }, { "content": "Oleander poisoning can cause irregular or slow heartbeat, low blood pressure, weakness, blurred vision, vision disturbances, including halos, diarrhea, loss of appetite, nausea and vomiting, stomach pain, confusion, disorientation, dizziness, drowsiness, fainting, headache, lethargy, hives, and rash. Depression, loss of appetite, and halos are most often seen in chronic overdose cases.", "role": "assistant" } ]

[ { "content": "Psoriasis for past 7-8 years I had psoriasis on my scalp for nearly 10 years. Please give suggestions and medications.\n\nPsoriasis (Treatment): The goal of treatment is to control your symptoms and prevent infection. Three treatment options are available: - Skin lotions, ointments, creams, and shampoos. These are called topical treatments. - Pills or injections that affect the body's immune response, not just the skin. These are called systemic, or body-wide, treatments. - Phototherapy, which uses ultraviolet light to treat psoriasis. TREATMENTS USED ON THE SKIN (TOPICAL) Most of the time, psoriasis is treated with medicines that are placed directly on the skin or scalp. These may include: - Cortisone creams and ointments - Creams or ointments that contain coal tar or anthralin - Creams to remove the scaling (usually salicylic acid or lactic acid) - Dandruff shampoos (over-the-counter or prescription) - Moisturizers - Prescription medicines containing vitamin D or vitamin A (retinoids) SYSTEMIC (BODY-WIDE) TREATMENTS If you have very severe psoriasis, your provider will likely recommend medicines that suppress the immune system's faulty response. These medicines include methotrexate or cyclosporine. Retinoids can also be used. Newer drugs called biologics are used when other treatments do not work. Biologics approved for the treatment of psoriasis include: - Adalimumab (Humira) - Etanercept (Enbrel) - Infliximab (Remicade) - Ustekinumab (Stelara) - Secukinumab (Cosentyx) - Apremilast (Otezla) - Ixekizumab (Taltz) PHOTOTHERAPY Some people may choose to have phototherapy: - This is treatment in which your skin is carefully exposed to ultraviolet light. - It may be given alone or after you take a drug that makes the skin sensitive to light. - Phototherapy for psoriasis can be given as ultraviolet A (UVA) or ultraviolet B (UVB) light. OTHER TREATMENTS If you have an infection, your provider will prescribe antibiotics. HOME CARE Following these tips at home may help: - Taking a daily bath or shower. Try not to scrub too hard because this can irritate the skin and trigger an attack. - Oatmeal baths may be soothing and may help to loosen scales. You can use over-the-counter oatmeal bath products. Or, you can mix 1 cup (240 mL) of oatmeal into a tub (bath) of warm water. - Keeping your skin clean and moist, and avoiding your specific psoriasis triggers may help reduce the number of flare-ups. - Sunlight may help your symptoms go away. Be careful not to get sunburned. - Relaxation and anti-stress techniques. The link between stress and flares of psoriasis is not well understood. - Limiting the alcoholic beverages you drink may help keep psoriasis from getting worse.", "role": "user" }, { "content": "Three treatment options are available: - Skin lotions, ointments, creams, and shampoos. These are called topical treatments. - Pills or injections that affect the body's immune response, not just the skin. These are called systemic, or body-wide, treatments. - Phototherapy, which uses ultraviolet light to treat psoriasis. ...Most of the time, psoriasis is treated with medicines that are placed directly on the skin or scalp. These may include: - Cortisone creams and ointments - Creams or ointments that contain coal tar or anthralin - Creams to remove the scaling (usually salicylic acid or lactic acid) - Dandruff shampoos (over-the-counter or prescription) - Moisturizers - Prescription medicines containing vitamin D or vitamin A (retinoids) ... If you have very severe psoriasis, your provider will likely recommend medicines that suppress the immune system's faulty response. These medicines include methotrexate or cyclosporine. Retinoids can also be used. Newer drugs called biologics are used when other treatments do not work. Biologics approved for the treatment of psoriasis include: - Adalimumab (Humira) - Etanercept (Enbrel) - Infliximab (Remicade) - Ustekinumab (Stelara) - Secukinumab (Cosentyx) - Apremilast (Otezla) - Ixekizumab (Taltz) ... Following these tips at home may help: - Taking a daily bath or shower. Try not to scrub too hard because this can irritate the skin and trigger an attack. - Oatmeal baths may be soothing and may help to loosen scales. Keeping your skin clean and moist, and avoiding your specific psoriasis triggers may help reduce the number of flare-ups. - Sunlight may help your symptoms go away. Be careful not to get sunburned. - Relaxation and anti-stress techniques. The link between stress and flares of psoriasis is not well understood. - Limiting the alcoholic beverages you drink may help keep psoriasis from getting worse.", "role": "assistant" } ]

[ { "content": "Achondroplasia research. Hello, We are students from and we are doing a biology project of genetic diseases. We chose Achondroplasia as our disease to research. We have a few question and we are hoping you could answer them. Our questions are, can you tell if your child will have Achondroplasia when you are pregnant? When do people usually come in when they think something isn't right with their child? what are the worse cases of Achondroplasia you've ever seen? Thank you in advance. sincerely,\n\nAchondroplasia (When to Contact a Medical Professional): If there is a family history of achondroplasia and you plan to have children, you may find it helpful to speak to your health care provider.", "role": "user" }, { "content": "If there is a family history of achondroplasia and you plan to have children, you may find it helpful to speak to your health care provider.", "role": "assistant" } ]

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

[ { "content": "how to prevent diabetes\n\nPreventing Diabetes Problems (How can I prevent hypoglycemia if I have diabetes?): If you are taking insulin, a sulfonylurea, or a meglitinide, using your diabetes management plan and working with your health care team to adjust your plan as needed can help you prevent hypoglycemia. The following actions can also help prevent hypoglycemia:Knowing your blood glucose level can help you decide how much medicine to take, what food to eat, and how physically active to be. To find out your blood glucose level, check yourself with a blood glucose meter as often as your doctor advises.Hypoglycemia unawareness. Sometimes people with diabetes don’t feel or recognize the symptoms of hypoglycemia, a problem called hypoglycemia unawareness. If you have had hypoglycemia without feeling any symptoms, you may need to check your blood glucose more often so you know when you need to treat your hypoglycemia or take steps to prevent it. Be sure to check your blood glucose before you drive.If you have hypoglycemia unawareness or have hypoglycemia often, ask your health care provider about a continuous glucose monitor (CGM). A CGM checks your blood glucose level at regular times throughout the day and night. CGMs can tell you if your blood glucose is falling quickly and sound an alarm if your blood glucose falls too low. CGM alarms can wake you up if you have hypoglycemia during sleep.Your meal plan is key to preventing hypoglycemia. Eat regular meals and snacks with the correct amount of carbohydrates to help keep your blood glucose level from going too low. Also, if you drink alcoholic beverages, it’s best to eat some food at the same time.Physical activity can lower your blood glucose during the activity and for hours afterward. To help prevent hypoglycemia, you may need to check your blood glucose before, during, and after physical activity and adjust your medicine or carbohydrate intake. For example, you might eat a snack before being physically active or decrease your insulin dose as directed by your health care provider to keep your blood glucose from dropping too low.Tell your health care team if you have had hypoglycemia. Your health care team may adjust your diabetes medicines or other aspects of your management plan. Learn about balancing your medicines, eating plan, and physical activity to prevent hypoglycemia. Ask if you should have a glucagon emergency kit to carry with you at all times.", "role": "user" }, { "content": "Work with your health care team to adjust your diabetes management plan as need to help you prevent hypoglycemia. Knowing your blood glucose level can help you decide how much medicine to take, what food to eat, and how physically active to be, which will help you prevent hypoglycemia. Learn about balancing your medicines, eating plan, and physical activity to prevent hypoglycemia. Ask if you should have a glucagon emergency kit to carry with you at all times.", "role": "assistant" } ]

[ { "content": "what is epilepsy\n\n Epilepsy Summary Epilepsy is a brain disorder that causes people to have recurring seizures. The seizures happen when clusters of nerve cells, or neurons, in the brain send out the wrong signals. People may have strange sensations and emotions or behave strangely. They may have violent muscle spasms or lose consciousness. Epilepsy has many possible causes, including illness, brain injury, and abnormal brain development. In many cases, the cause is unknown. Doctors use brain scans and other tests to diagnose epilepsy. It is important to start treatment right away. There is no cure for epilepsy, but medicines can control seizures for most people. When medicines are not working well, surgery or implanted devices such as vagus nerve stimulators may help. Special diets can help some children with epilepsy. NIH: National Institute of Neurological Disorders and Stroke ", "role": "user" }, { "content": "Epilepsy is a brain disorder that causes people to have recurring seizures. The seizures happen when clusters of nerve cells, or neurons, in the brain send out the wrong signals. People may have strange sensations and emotions or behave strangely. They may have violent muscle spasms or lose consciousness.", "role": "assistant" } ]

[ { "content": "how to treat a heart attack\n\nHeart attack (Treatment): Heart attack treatment at a hospital With each passing minute after a heart attack, more heart tissue loses oxygen and deteriorates or dies. The main way to prevent heart damage is to restore blood flow quickly. Medications Medications given to treat a heart attack include: - Aspirin. The 911 operator may instruct you to take aspirin, or emergency medical personnel may give you aspirin immediately. Aspirin reduces blood clotting, thus helping maintain blood flow through a narrowed artery. - Thrombolytics. These drugs, also called clotbusters, help dissolve a blood clot that's blocking blood flow to your heart. The earlier you receive a thrombolytic drug after a heart attack, the greater the chance you'll survive and with less heart damage. - Antiplatelet agents. Emergency room doctors may give you other drugs to help prevent new clots and keep existing clots from getting larger. These include medications, such as clopidogrel (Plavix) and others, called platelet aggregation inhibitors. - Other blood-thinning medications. You'll likely be given other medications, such as heparin, to make your blood less \"sticky\" and less likely to form clots. Heparin is given intravenously or by an injection under your skin. - Pain relievers. You may receive a pain reliever, such as morphine, to ease your discomfort. - Nitroglycerin. This medication, used to treat chest pain (angina), can help improve blood flow to the heart by widening (dilating) the blood vessels. - Beta blockers. These medications help relax your heart muscle, slow your heartbeat and decrease blood pressure, making your heart's job easier. Beta blockers can limit the amount of heart muscle damage and prevent future heart attacks. - ACE inhibitors. These drugs lower blood pressure and reduce stress on the heart. Surgical and other procedures In addition to medications, you may undergo one of the following procedures to treat your heart attack: - Coronary angioplasty and stenting. Doctors insert a long, thin tube (catheter) that's passed through an artery, usually in your leg or groin, to a blocked artery in your heart. If you've had a heart attack, this procedure is often done immediately after a cardiac catheterization, a procedure used to locate blockages. This catheter is equipped with a special balloon that, once in position, is briefly inflated to open a blocked coronary artery. A metal mesh stent may be inserted into the artery to keep it open long term, restoring blood flow to the heart. Depending on your condition, your doctor may opt to place a stent coated with a slow-releasing medication to help keep your artery open. - Coronary artery bypass surgery. In some cases, doctors may perform emergency bypass surgery at the time of a heart attack. If possible, your doctor may suggest that you have bypass surgery after your heart has had time - about three to seven days - to recover from your heart attack. Bypass surgery involves sewing veins or arteries in place beyond a blocked or narrowed coronary artery, allowing blood flow to the heart to bypass the narrowed section. Once blood flow to your heart is restored and your condition is stable, you're likely to remain in the hospital for several days.", "role": "user" }, { "content": "Heart attack (Treatment): Heart attack treatment at a hospital With each passing minute after a heart attack, more heart tissue loses oxygen and deteriorates or dies. The main way to prevent heart damage is to restore blood flow quickly. Medications Medications given to treat a heart attack include: - Aspirin. The 911 operator may instruct you to take aspirin, or emergency medical personnel may give you aspirin immediately. In addition to medications, you may undergo one of the following procedures to treat your heart attack. Once blood flow to your heart is restored and your condition is stable, you're likely to remain in the hospital for several days.", "role": "assistant" } ]

[ { "content": "I have been researching Lewy Body Disease and have a few questions.1) Is this disease hereditary2) Does alcoholism play a role in the beginning process of this disease3) What are the initial symptoms of the diseaseAny information you could forward would be greatly appreciated.\n\nLewy body dementia: Lewy body dementia is one of the most common forms of progressive dementia. People affected by this condition may experience a variety of symptoms such as changes in alertness and attention; hallucinations; problems with movement and posture; muscle stiffness; confusion; and/or memory loss. Although the exact cause of Lewy body dementia is poorly understood, symptoms are thought to result when clumps of a protein called alpha-synuclein (\"Lewy bodies\") accumulate in the brain. Lewy body dementia usually occurs sporadically in people with no family history of the condition. Rarely, more than one family member may be affected. There is currently no cure for Lewy body dementia; however, medications may be available to help manage the associated symptoms. [1] [2] [3] 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) Autosomal dominant inheritance - Delusions - Dementia - Fluctuations in consciousness - Parkinsonism - Visual hallucinations - The exact underlying cause of Lewy body dementia is poorly understood. The symptoms of the condition are thought to occur when clumps of a protein called alpha-synuclein accumulate in the regions of the brain involved in thinking, memory and movement. The build-up of these clumps (which are called \"Lewy bodies\") appears to be associated with a loss of certain neurons (nerve cells ) in the brain that produce two important neurotransmitters (chemicals that act as messengers between brain cells). The neurotransmitter, acetylcholine, is important for memory and learning. The other, dopamine, plays an important role in behavior, cognition, movement, motivation, sleep, and mood. [4] Although Lewy body dementia usually occurs sporadically, more than one family member can rarely be affected. Studies of these families suggest that there may be a genetic component to the condition in some cases. For example, copy number variants or changes ( mutations ) in the SNCA gene have been reported in a few affected families. [5] [6] The APOE ε4 allele and mutations in the GBA gene have been associated with an increased risk of Lewy body dementia and the APOE ε2 allele with a decreased risk. [5] [7] [2] Most cases of Lewy body dementia are not thought to be inherited . The condition generally occurs sporadically in people with no family history of the condition. [4] Rarely, the condition can affect more than one family member. Some of these cases appear to be due to single gene changes ( mutations ) that follow an autosomal dominant pattern of inheritance. Other familial cases do not follow a specific pattern of inheritance and likely have a multifactorial cause (associated with the effects of multiple genes in combination with lifestyle and environmental factors ). [6] [5] 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. The Lewy Body Dementia Association offers detailed and up-to-date information regarding the treatment and management of Lewy body dementia . Please click on the link to access this resource.", "role": "user" }, { "content": "Lewy body dementia is one of the most common forms of progressive dementia. People affected by this condition may experience a variety of symptoms such as changes in alertness and attention; hallucinations; problems with movement and posture; muscle stiffness; confusion; and/or memory loss. Although the exact cause of Lewy body dementia is poorly understood, symptoms are thought to result when clumps of a protein called alpha-synuclein (\"Lewy bodies\") accumulate in the brain. Lewy body dementia usually occurs sporadically in people with no family history of the condition. Rarely, more than one family member may be affected. Studies of these families suggest that there may be a genetic component to the condition in some cases. Some of these cases appear to be due to single gene mutations that follow an autosomal dominant pattern of inheritance. Other familial cases do not follow a specific pattern of inheritance and likely are associated with the effects of multiple genes in combination with lifestyle and environmental factors. Most cases of Lewy body dementia are not thought to be inherited. There is currently no cure for Lewy body dementia; however, medications may be available to help manage the associated symptoms.", "role": "assistant" } ]

[ { "content": "I am 23yr boy,i have knock knees i want treatment. Please help me.\n\n Knock knees Genu valgum Summary Knock knees are condition in which the knees touch, but the ankles do not touch. The legs turn inward. Causes 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) Exams and Tests 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. Treatment 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. Outlook (Prognosis) Children normally outgrow knock knees without treatment, unless it is caused by a disease. If surgery is needed, the results are most often good. Possible Complications Complications may include: Difficulty walking (very rare) Self-esteem changes related to cosmetic appearance of knock knees If left untreated, knock knees can lead to early arthritis of the knee When to Contact a Medical Professional Call your provider if you think your child has knock knees. Prevention There is no known prevention for normal knock knees. Review Date 12/9/2016 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": "Children normally outgrow knock knees without treatment, unless it is caused by a disease. If surgery is needed, the results are most often good.", "role": "assistant" } ]

[ { "content": "We have 14 siblings in our family , at least 10 of us has had a frozen shoulder. We are wondering why? should we be concerned?\n\nFrozen shoulder: Frozen shoulder is a condition in which the shoulder is painful and loses motion because of inflammation. The capsule of the shoulder joint has ligaments that hold the shoulder bones to each other. When the capsule becomes inflamed, the shoulder bones are unable to move freely in the joint. Most of the time, there is no cause for frozen shoulder. Risk factors include: - Diabetes - Thyroid problems - Changes in your hormones, such as during menopause - Shoulder injury - Shoulder surgery - Open heart surgery - Cervical disk disease of the neck - Women 40 to 70 years old are most affected Main symptoms of a frozen shoulder are: - Decreased motion of the shoulder - Pain - Stiffness Frozen shoulder without any known cause starts with pain. This pain prevents you from moving your arm. This lack of movement can lead to stiffness and even less motion. Over time, you are not able to do movements such as reaching over your head or behind you. Your health care provider will ask about your symptoms and examine your shoulder. A diagnosis is often made when you are not able to rotate your shoulder. You may have x-rays of the shoulder. This is to make sure there is no other problem, such as arthritis or calcium deposits. Sometimes, an MRI exam shows inflammation, but these types of imaging tests are not needed to diagnose frozen shoulder. Pain is treated with NSAIDs and steroid injections. Steroid injections and physical therapy can improve your motion. It can take a few weeks to see progress. It may take as long as 6 to 9 months for complete recovery. Physical therapy is intense and needs to be done every day. Left untreated, the condition often gets better by itself within 2 years with little loss of motion. Risk factors for frozen shoulder, such as diabetes or thyroid problems, should also be treated. Surgery is recommended if nonsurgical treatment is not effective. This procedure (shoulder arthroscopy) is done under anesthesia. During surgery the scar tissue is released (cut) by bringing the shoulder through a full range of motion. Arthroscopic surgery can also be used to cut the tight ligaments and remove the scar tissue from the shoulder. After surgery, you may receive pain blocks (shots) so you can do physical therapy. Follow instructions on caring for your shoulder at home.  Treatment with physical therapy and NSAIDs often restores motion and function of the shoulder within a year. Even untreated, the shoulder may get better by itself in 2 years. After surgery restores motion, you must continue physical therapy for several weeks or months. This is to prevent the frozen shoulder from returning. If you do not keep up with physical therapy, the frozen shoulder may come back. Complications may include: - Stiffness and pain continue even with therapy - The arm can break if the shoulder is moved forcefully during surgery If you have shoulder pain and stiffness and think you have a frozen shoulder, contact your provider for referral and treatment. Early treatment may help prevent stiffness. Call your provider if you develop shoulder pain that limits your range of motion for an extended period. People who have diabetes or thyroid problems will be less likely to get frozen shoulder if they keep their condition under control. Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.", "role": "user" }, { "content": "Most of the time, there is no cause for frozen shoulder. Risk factors include: - Diabetes - Thyroid problems - Changes in your hormones, such as during menopause - Shoulder injury - Shoulder surgery - Open heart surgery - Cervical disk disease of the neck - Women 40 to 70 years old are most affected Main symptoms of a frozen shoulder are: - Decreased motion of the shoulder - Pain - Stiffness Frozen shoulder without any known cause starts with pain. This pain prevents you from moving your arm. This lack of movement can lead to stiffness and even less motion. Over time, you are not able to do movements such as reaching over your head or behind you. ... Left untreated, the condition often gets better by itself within 2 years with little loss of motion. Risk factors for frozen shoulder, such as diabetes or thyroid problems, should also be treated.", "role": "assistant" } ]

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

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

[ { "content": "what are known causes of bipolar disorder\n\nBipolar disorder (Risk factors): Factors that may increase the risk of developing bipolar disorder or act as a trigger for the first episode include: - Having a first-degree relative, such as a parent or sibling, with bipolar disorder - Periods of high stress, such as the death of a loved one or other traumatic event - Drug or alcohol abuse", "role": "user" }, { "content": "Factors that may increase the risk of developing bipolar disorder or act as a trigger for the first episode include: - Having a first-degree relative, such as a parent or sibling, with bipolar disorder - Periods of high stress, such as the death of a loved one or other traumatic event - Drug or alcohol abuse", "role": "assistant" } ]

[ { "content": "what is the cause of congenital heart defects\n\nCongenital Heart Defects (CAUSES): If your child has a congenital heart defect, you may think you did something wrong during your pregnancy to cause the problem. However, doctors often don't know why congenital heart defects occur. Heredity may play a role in some heart defects. For example, a parent who has a congenital heart defect may be more likely than other people to have a child with the defect. Rarely, more than one child in a family is born with a heart defect. Children who have genetic disorders, such as Down syndrome, often have congenital heart defects. In fact, half of all babies who have Down syndrome have congenital heart defects. Smoking during pregnancy also has been linked to several congenital heart defects, including septal defects. Researchers continue to search for the causes of congenital heart defects.", "role": "user" }, { "content": "Causes of congenital heart defects are unknown. Heredity may play a role in some heart defects. Smoking during pregnancy also has been linked to several congenital heart defects, including septal defects.", "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: Scoliosis is a sideways curvature of the spine that occurs most often during the growth spurt just before puberty. While scoliosis can be caused by conditions such as cerebral palsy and muscular dystrophy, the cause of most scoliosis is unknown. Most cases of scoliosis are mild, but some children develop spine deformities that continue to get more severe as they grow. Severe scoliosis can be disabling. An especially severe spinal curve can reduce the amount of space within the chest, making it difficult for the lungs to function properly. Children who have mild scoliosis are monitored closely, usually with X-rays, to see if the curve is getting worse. In many cases, no treatment is necessary. Some children will need to wear a brace to stop the curve from worsening. Others may need surgery to keep the scoliosis from worsening and to straighten severe cases of scoliosis. Signs and symptoms of scoliosis may include: - Uneven shoulders - One shoulder blade that appears more prominent than the other - Uneven waist - One hip higher than the other If a scoliosis curve gets worse, the spine will also rotate or twist, in addition to curving side to side. This causes the ribs on one side of the body to stick out farther than on the other side. When to see a doctor Go to your doctor if you notice signs or symptoms of scoliosis in your child. Mild curves, however, can develop without the parent or child knowing it because they appear gradually and usually don't cause pain. Occasionally, teachers, friends and sports teammates are the first to notice a child's scoliosis. Doctors don't know what causes the most common type of scoliosis - although it appears to involve hereditary factors, because the disorder tends to run in families. Less common types of scoliosis may be caused by: - Neuromuscular conditions, such as cerebral palsy or muscular dystrophy - Birth defects affecting the development of the bones of the spine - Injuries to or infections of the spine Risk factors for developing the most common type of scoliosis include: - Age. Signs and symptoms typically begin during the growth spurt that occurs just prior to puberty. - Sex. Although both boys and girls develop mild scoliosis at about the same rate, girls have a much higher risk of the curve worsening and requiring treatment. - Family history. Scoliosis can run in families, but most children with scoliosis don't have a family history of the disease. The doctor will initially take a detailed medical history and may ask questions about recent growth. During the physical exam, your doctor may have your child stand and then bend forward from the waist, with arms hanging loosely, to see if one side of the rib cage is more prominent than the other. Your doctor may also perform a neurological exam to check for: - Muscle weakness - Numbness - Abnormal reflexes Imaging tests Plain X-rays can confirm the diagnosis of scoliosis and reveal the severity of the spinal curvature. If a doctor suspects that an underlying condition - such as a tumor - is causing the scoliosis, he or she may recommend additional imaging tests, such as an MRI. Most children with scoliosis have mild curves and probably won't need treatment with a brace or surgery. Children who have mild scoliosis may need checkups every four to six months to see if there have been changes in the curvature of their spines. While there are guidelines for mild, moderate and severe curves, the decision to begin treatment is always made on an individual basis. Factors to be considered include: - Sex. Girls have a much higher risk of progression than do boys. - Severity of curve. Larger curves are more likely to worsen with time. - Curve pattern. Double curves, also known as S-shaped curves, tend to worsen more often than do C-shaped curves. - Location of curve. Curves located in the center (thoracic) section of the spine worsen more often than do curves in the upper or lower sections of the spine. - Maturity. If a child's bones have stopped growing, the risk of curve progression is low. That also means that braces have the most effect in children whose bones are still growing. Braces If your child's bones are still growing and he or she has moderate scoliosis, your doctor may recommend a brace. Wearing a brace won't cure scoliosis or reverse the curve, but it usually prevents further progression of the curve. The most common type of brace is made of plastic and is contoured to conform to the body. This close-fitting brace is almost invisible under the clothes, as it fits under the arms and around the rib cage, lower back and hips. Most braces are worn day and night. A brace's effectiveness increases with the number of hours a day it's worn. Children who wear braces can usually participate in most activities and have few restrictions. If necessary, kids can take off the brace to participate in sports or other physical activities. Braces are discontinued after the bones stop growing. This typically occurs: - About two years after girls begin to menstruate - When boys need to shave daily - When there are no further changes in height Surgery Severe scoliosis typically progresses with time, so your doctor might suggest scoliosis surgery to reduce the severity of the spinal curve and to prevent it from getting worse. The most common type of scoliosis surgery is called spinal fusion. In spinal fusion, surgeons connect two or more of the bones in the spine (vertebrae) together, so they can't move independently. Pieces of bone or a bone-like material are placed between the vertebrae. Metal rods, hooks, screws or wires typically hold that part of the spine straight and still while the old and new bone material fuses together. If the scoliosis is progressing rapidly at a young age, surgeons can install a rod that can adjust in length as the child grows. This growing rod is attached to the top and bottom sections of the spinal curvature, and is usually lengthened every six months. Complications of spinal surgery may include bleeding, infection, pain or nerve damage. Rarely, the bone fails to heal and another surgery may be needed. Although physical therapy exercises can't stop scoliosis, general exercise or participating in sports may have the benefit of improving overall health and well-being. Studies indicate that the following treatments for scoliosis are ineffective: - Chiropractic manipulation - Electrical stimulation of muscles - Dietary supplements", "role": "user" }, { "content": "Severe scoliosis typically progresses with time, so your doctor might suggest scoliosis surgery to reduce the severity of the spinal curve and to prevent it from getting worse. The most common type of scoliosis surgery is called spinal fusion. In spinal fusion, surgeons connect two or more of the bones in the spine (vertebrae) together, so they can't move independently. Pieces of bone or a bone-like material are placed between the vertebrae. Metal rods, hooks, screws or wires typically hold that part of the spine straight and still while the old and new bone material fuses together. .... Although physical therapy exercises can't stop scoliosis, general exercise or participating in sports may have the benefit of improving overall health and well-being. Studies indicate that the following treatments for scoliosis are ineffective: - Chiropractic manipulation - Electrical stimulation of muscles - Dietary supplements", "role": "assistant" } ]

[ { "content": "what are the uses of vitamin e capsules\n\nAtaxia with vitamin E deficiency: Ataxia with vitamin E deficiency (AVED) is a progressive disease affecting motor control and movement. Symptoms of AVED include slurred speech ( dysarthria ), difficulty coordinating movements ( ataxia), numbness in the hands and feet ( peripheral neuropathy ), and progressive leg weakness. Some affected individuals may experience vision loss due to damage to the back of the eye ( retinitis pigmentosa). Symptoms typically begin during childhood or adolescence and worsen with age, resulting in the need for a wheelchair by early adulthood. AVED is caused by a mutation to the TTPA gene . When this gene is damaged, vitamin E cannot be distributed throughout the body. Vitamin E is important because it protects the cells of the neurological system (neurons) from dangerous molecules called free radicals. AVED is inherited in an autosomal recessive manner. Treatment for AVED includes vitamin E supplements, which will prevent AVED from developing if given before symptoms begin and may reverse some neurological symptoms if begun after AVED develops. [1] [2] 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) Abnormal pyramidal signs Very frequent Areflexia Very frequent Dysarthria Frequent Dysdiadochokinesis Frequent Dysmetria Frequent Gait disturbance Frequent Nyctalopia Frequent Nystagmus Frequent Pes cavus Frequent Scoliosis Frequent Sensory neuropathy Frequent Abnormality of retinal pigmentation Occasional Abnormality of visual evoked potentials Occasional Developmental regression Occasional Diabetes mellitus Occasional Dystonia Occasional Hemiplegia/hemiparesis Occasional Hypertonia Occasional Hypertrophic cardiomyopathy Occasional Mental deterioration Occasional Skeletal muscle atrophy Occasional Tremor Occasional Visual impairment Occasional Ataxia - Autosomal recessive inheritance - Hypercholesterolemia - Hypertriglyceridemia - Increased circulating low-density lipoprotein levels - Tendon xanthomatosis - Vitamin E deficiency - Xanthelasma - View complete list of signs and symptoms... AVED may be suspected in individuals who have the following findings at the beginning of puberty: [2] Progressive ataxia Clumsiness of the hands Loss of the ability to know where one's body is in space (proprioception) Absent reflexes (areflexia) The inability to perform rapid, alternating movements (dysdiadochokinesia) A tendency to sway or fall while standing upright with the feet together, arms stretched out and the eyes closed (positive Romberg sign) A nodding movement of the head (titubation) Decreased visual sharpness (acuity) Positive Babinski sign (upward movement of the big toe and fanning of the feet after the sole of the foot has been firmly stroked) Macular atrophy (wasting away of the cells that form the part of our eye responsible for central vision) Retinitis pigmentosa ( eye disease in which there is damage to the retina) Laboratory studies typically show a reduced plasma vitamin E concentration but normal levels of lipoproteins ( proteins that combine with and transport fat or other lipids in the blood). Other studies that may be useful include: nerve conduction studies, brain imaging , and studies of nerve tissues . [2] [3] Although no universal diagnostic guidelines are available, researchers suggest that diseases that cause fat malabsorption, such as abetalipoproteinemia should be ruled out. Genetic testing finding two TTPA gene mutations may be useful to confirm the diagnosis. [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 for AVED requires lifelong high dose supplementation of vitamin E. When treated early, some symptoms, such as ataxia and intellectual decline, can be reversed. In older patients, treatment may slow disease progression, but some symptoms remain. [2] [3] Research indicates that if vitamin E treatment is initiated in presymptomatic individuals with two mutations in the TTPA  gene (e.g., younger sibs of an affected individual), the symptoms of AVED will not develop. [2] Management Guidelines GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions.", "role": "user" }, { "content": "Ataxia with vitamin E deficiency (AVED) is a progressive disease affecting motor control and movement. Treatment for AVED includes vitamin E supplements, which will prevent AVED from developing if given before symptoms begin and may reverse some neurological symptoms if begun after AVED develops.", "role": "assistant" } ]

[ { "content": "I'm a 72 year old female, and have diverticulosis,gastritis, and esophagitis. I tried to see three different doctors today, but all were booked. I honestly don't know what to do. It hurts in my chest, and I can hardly talk.\n\nDo I need to see a doctor for Diverticulosis?: Call your health care provider if symptoms of diverticulitis occur.", "role": "user" }, { "content": "Call your health care provider if symptoms of diverticulitis occur.", "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 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.", "role": "assistant" } ]

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

[ { "content": "how common is cystic fibrosis\n\n Cystic fibrosis Overview Cystic fibrosis is an inherited disorder that causes severe damage to the lungs, digestive system and other organs in the body. Cystic fibrosis affects the cells that produce mucus, sweat and digestive juices. These secreted fluids are normally thin and slippery. But in people with cystic fibrosis, a defective gene causes the secretions to become sticky and thick. Instead of acting as a lubricant, the secretions plug up tubes, ducts and passageways, especially in the lungs and pancreas. Although cystic fibrosis requires daily care, people with the condition are usually able to attend school and work, and often have a better quality of life than people with cystic fibrosis had in previous decades. Improvements in screening and treatments mean people with cystic fibrosis now may live into their mid- to late 30s, on average, and some are living into their 40s and 50s. Cystic fibrosis care at Mayo Clinic Symptoms Screening of newborns for cystic fibrosis is now performed in every state in the United States. As a result, the condition can be diagnosed within the first month of life, before symptoms develop. For people born before newborn screening was performed, it's important to be aware of the signs and symptoms of cystic fibrosis. Cystic fibrosis signs and symptoms vary, depending on the severity of the disease. Even in the same person, symptoms may worsen or improve as time passes. Some people may not experience symptoms until adolescence or adulthood. People with cystic fibrosis have a higher than normal level of salt in their sweat. Parents often can taste the salt when they kiss their children. Most of the other signs and symptoms of cystic fibrosis affect the respiratory system and digestive system. However, adults diagnosed with cystic fibrosis are more likely to have atypical symptoms, such as recurring bouts of inflamed pancreas (pancreatitis), infertility and recurring pneumonia. The thick and sticky mucus associated with cystic fibrosis clogs the tubes that carry air in and out of your lungs. This can cause signs and symptoms such as: - A persistent cough that produces thick mucus (sputum) - Wheezing - Breathlessness - Exercise intolerance - Repeated lung infections - Inflamed nasal passages or a stuffy nose The thick mucus can also block tubes that carry digestive enzymes from your pancreas to your small intestine. Without these digestive enzymes, your intestines aren't able to completely absorb the nutrients in the food you eat. The result is often: - Foul-smelling, greasy stools - Poor weight gain and growth - Intestinal blockage, particularly in newborns (meconium ileus) - Severe constipation Frequent straining while passing stool can cause part of the rectum - the end of the large intestine - to protrude outside the anus (rectal prolapse). When this occurs in children, it may be a sign of cystic fibrosis. Parents should consult a physician knowledgeable about cystic fibrosis. Rectal prolapse in children may sometimes require surgery. Rectal prolapse in children with cystic fibrosis is less common than it was in the past, which may be due to earlier testing, diagnosis and treatment of cystic fibrosis. If you or your child has symptoms of cystic fibrosis - or if someone in your family has cystic fibrosis - talk with your doctor about testing for the disease. Seek immediate medical care if you or your child has difficulty breathing. Causes In cystic fibrosis, a defect (mutation) in a gene changes a protein that regulates the movement of salt in and out of cells. The result is thick, sticky mucus in the respiratory, digestive and reproductive systems, as well as increased salt in sweat. Many different defects can occur in the gene. The type of gene mutation is associated with the severity of the condition. Children need to inherit one copy of the gene from each parent in order to have the disease. If children inherit only one copy, they won't develop cystic fibrosis. However, they will be carriers and possibly pass the gene to their own children. Risk factors - Family history. Because cystic fibrosis is an inherited disorder, it runs in families. - Race. Although cystic fibrosis occurs in all races, it is most common in white people of Northern European ancestry. Complications - Damaged airways (bronchiectasis). Cystic fibrosis is one of the leading causes of bronchiectasis, a condition that damages the airways. This makes it harder to move air in and out of the lungs and clear mucus from the airways (bronchial tubes). - Chronic infections. Thick mucus in the lungs and sinuses provides an ideal breeding ground for bacteria and fungi. People with cystic fibrosis may often have sinus infections, bronchitis or pneumonia. - Growths in the nose (nasal polyps). Because the lining inside the nose is inflamed and swollen, it can develop soft, fleshy growths (polyps). - Coughing up blood (hemoptysis). Over time, cystic fibrosis can cause thinning of the airway walls. As a result, teenagers and adults with cystic fibrosis may cough up blood. - Pneumothorax. This condition, in which air collects in the space that separates the lungs from the chest wall, also is more common in older people with cystic fibrosis. Pneumothorax can cause chest pain and breathlessness. - Respiratory failure. Over time, cystic fibrosis can damage lung tissue so badly that it no longer works. Lung function usually worsens gradually, and it eventually can become life-threatening. - Acute exacerbations. People with cystic fibrosis may experience worsening of their respiratory symptoms, such as coughing and shortness of breath, for several days to weeks. This is called an acute exacerbation and requires treatment in the hospital. - Nutritional deficiencies. Thick mucus can block the tubes that carry digestive enzymes from your pancreas to your intestines. Without these enzymes, your body can't absorb protein, fats or fat-soluble vitamins. - Diabetes. The pancreas produces insulin, which your body needs to use sugar. Cystic fibrosis increases the risk of diabetes. Around 30 percent of people with cystic fibrosis develop diabetes by age 30. - Blocked bile duct. The tube that carries bile from your liver and gallbladder to your small intestine may become blocked and inflamed, leading to liver problems and sometimes gallstones. - Intestinal obstruction. Intestinal obstruction can happen to people with cystic fibrosis at all ages. Children and adults with cystic fibrosis are more likely than are infants to develop intussusception, a condition in which a section of the intestines folds in on itself like an accordion. - Distal intestinal obstruction syndrome (DIOS). DIOS is partial or complete obstruction where the small intestine meets the large intestine. Almost all men with cystic fibrosis are infertile because the tube that connects the testes and prostate gland (vas deferens) is either blocked with mucus or missing entirely. Certain fertility treatments and surgical procedures sometimes make it possible for men with cystic fibrosis to become biological fathers. Although women with cystic fibrosis may be less fertile than other women, it's possible for them to conceive and to have successful pregnancies. Still, pregnancy can worsen the signs and symptoms of cystic fibrosis, so be sure to discuss the possible risks with your doctor. - Thinning of the bones (osteoporosis). People with cystic fibrosis are at higher risk of developing a dangerous thinning of bones. - Electrolyte imbalances and dehydration. Because people with cystic fibrosis have saltier sweat, the balance of minerals in their blood may be upset. Signs and symptoms include increased heart rate, fatigue, weakness and low blood pressure. Diagnosis To diagnose cystic fibrosis, doctors may conduct several tests. Newborn screening and diagnosis Every state in the U.S. now routinely screens newborns for cystic fibrosis. Early diagnosis means treatment can begin immediately. In one screening test, a blood sample is checked for higher than normal levels of a chemical (immunoreactive trypsinogen, or IRT) released by the pancreas. A newborn's IRT levels may be high because of premature birth or a stressful delivery. For that reason other tests may be needed to confirm a diagnosis of cystic fibrosis. Genetic tests may be used in addition to checking the IRT levels to confirm the diagnosis. Doctors may also conduct genetic tests to test for specific defects on the gene responsible for cystic fibrosis. To evaluate if an infant has cystic fibrosis, doctors may also conduct a sweat test when the infant is at least 2 weeks old. In a sweat test, doctors apply a sweat-producing chemical to a small area of skin. They then collect the sweat to test it and see if it's saltier than normal. Testing may be done at a center specializing in cystic fibrosis. Testing of older children and adults Cystic fibrosis tests may be recommended for older children and adults who weren't screened at birth. Your doctor may suggest genetic and sweat tests for cystic fibrosis if you have recurring bouts of inflamed pancreas (pancreatitis), nasal polyps, chronic sinus or lung infections, bronchiectasis, or male infertility. Treatment There is no cure for cystic fibrosis, but treatment can ease symptoms and reduce complications. Close monitoring and early, aggressive intervention is recommended. Managing cystic fibrosis is complex, so consider obtaining treatment at a center staffed by doctors and other staff trained in cystic fibrosis. Doctors may work with a multidisciplinary team of doctors and medical professionals trained in cystic fibrosis to evaluate and treat your condition. The goals of treatment include: - Preventing and controlling infections that occur in the lungs - Removing and loosening mucus from the lungs - Treating and preventing intestinal blockage - Providing adequate nutrition Medications The options may include: - Antibiotics to treat and prevent lung infections - Anti-inflammatory medications to lessen swelling in the airways in your lungs - Mucus-thinning drugs to help you cough up the mucus, which can improve lung function - Inhaled medications called bronchodilators that can help keep your airways open by relaxing the muscles around your bronchial tubes - Oral pancreatic enzymes to help your digestive tract absorb nutrients For those with cystic fibrosis who have certain gene mutations, doctors may recommend a newer medication called ivacaftor (Kalydeco). This medication may improve lung function and weight, and reduce the amount of salt in sweat. It has been approved by the Food and Drug Administration for people with cystic fibrosis who are age 6 and older. The dose depends on your weight and age. Doctors may conduct liver function tests and eye examinations before prescribing ivacaftor and on a regular basis while you're taking it to check for side effects such as liver function abnormalities and cataracts. For people with a certain gene mutation who are age 12 and older, another drug (Orkambi) is available that combines ivacaftor with a medication called lumacaftor. The combination of these medications may improve lung function and reduce the risk of exacerbations. However, some people may experience side effects such as chest discomfort and shortness of breath soon after starting the medication. Some people may also have high blood pressure while taking the medication. Doctors may monitor you for any side effects. Chest physical therapy Loosening the thick mucus in the lungs makes it easier to cough up. Chest physical therapy helps loosen mucus. It is usually done from one to four times a day. A common technique is clapping with cupped hands on the front and back of the chest. Certain breathing techniques also may be used to help loosen the mucus. Your doctor will instruct you about the type of chest physical therapy he or she recommends for you. Mechanical devices also can help loosen lung mucus. These include a vibrating vest or a tube or mask you breathe into. Pulmonary rehabilitation Your doctor may recommend a long-term program that may improve your lung function and overall well-being. Pulmonary rehabilitation is usually done on an outpatient basis and may include: - Physical exercise that may improve your condition - Breathing techniques that may help loosen mucus and improve breathing - Nutritional counseling - Counseling and support - Education about your condition Surgical and other procedures - Nasal polyp removal. Your doctor may recommend surgery to remove nasal polyps that obstruct breathing. - Oxygen therapy. If your blood oxygen level declines, your doctor may recommend that you breathe pure oxygen to prevent high blood pressure in the lungs (pulmonary hypertension). - Endoscopy and lavage. Mucus may be suctioned from obstructed airways through an endoscope. - Feeding tube. Cystic fibrosis interferes with digestion, so you can't absorb nutrients from food very well. Your doctor may suggest temporarily using a feeding tube to deliver extra nutrition while you sleep. This tube may be inserted in your nose and guided to your stomach, or it may be surgically implanted into the abdomen. - Bowel surgery. If a blockage develops in your bowel, you may need surgery to remove it. Intussusception, where a section of bowel has folded in on itself, also may require surgical repair. - Lung transplant. If you have severe breathing problems, life-threatening lung complications or increasing resistance to antibiotics used to treat lung infections, lung transplantation may be an option. Because bacteria line the airways in diseases that cause permanent widening of the large airways (bronchiectasis), such as cystic fibrosis, both lungs need to be replaced. Cystic fibrosis does not recur in transplanted lungs. However, other complications associated with cystic fibrosis - such as sinus infections, diabetes, pancreas problems and osteoporosis - can still occur after a lung transplant. Lifestyle and home remedies You can manage your condition and minimize complications in several ways. Always talk to your doctor before starting home remedies. Cystic fibrosis can cause malnourishment because the enzymes needed for digestion can't reach your small intestine, preventing food from being absorbed. People with cystic fibrosis may need a significantly higher number of calories daily than do people without the condition. A healthy diet is important to maintain good lung function. It's also important to drink lots of fluids, which can help thin the mucus in your lungs. You may work with a dietitian to develop a nutrition plan. Most people with cystic fibrosis need to take pancreatic enzyme capsules with every meal and snack. In addition, your doctor may recommend: - Antacids - Supplemental high-calorie nutrition - Special fat-soluble vitamins - Extra fiber to prevent intestinal blockage - Extra salt, especially during hot weather or before exercising - Adequate water during hot weather In addition to other usual childhood vaccines, people with cystic fibrosis should have the annual flu vaccine and any other vaccines their doctor recommends. Cystic fibrosis doesn't affect the immune system, but children with cystic fibrosis are more likely to develop complications when they become sick. Regular exercise helps loosen mucus in your airways, and strengthens your heart. For many people with cystic fibrosis, participating in sports can improve confidence and self-esteem. Anything that gets you moving, including walking and biking, can help. Don't smoke in your home or car, and don't allow other people to smoke around you or your child. Secondhand smoke is harmful for everyone, but especially for people with cystic fibrosis. Teach all the members of your family to wash their hands thoroughly before eating, after using the bathroom, when coming home from work or school, and after being around a person who is sick. Hand-washing is the best way to protect against infection. You'll have ongoing care from your doctor and other medical professionals. Make sure to attend your regular follow-up appointments. Take your medications as prescribed and follow therapies as instructed. Contact your doctor if you experience any signs or symptoms such as severe constipation, more mucus than usual, blood in your mucus or reduced energy. ", "role": "user" }, { "content": "Children need to inherit one copy of the gene from each parent in order to have the disease. If children inherit only one copy, they won't develop cystic fibrosis. However, they will be carriers and possibly pass the gene to their own children. - Family history. Because cystic fibrosis is an inherited disorder, it runs in families. - Race. Although cystic fibrosis occurs in all races, it is most common in white people of Northern European ancestry. -", "role": "assistant" } ]

[ { "content": "can i take keflex to cure staph?\n\nWhat are the treatments for Staph infections - self-care at home?: If test results show you have a staph infection, treatment may include: - Taking antibiotics - Cleaning and draining the wound - Surgery to remove an infected device", "role": "user" }, { "content": "If test results show you have a staph infection, treatment may include: - Taking antibiotics", "role": "assistant" } ]

[ { "content": "how to prevent diabetes\n\n Type 2 diabetes Noninsulin-dependent diabetes Diabetes - type II Adult-onset diabetes Diabetic - type 2 diabetes Oral hypoglycemic - type 2 diabetes High blood sugar - type 2 diabetes Summary Type 2 diabetes is a lifelong (chronic) disease in which there is a high level of sugar (glucose) in the blood. Type 2 diabetes is the most common form of diabetes. Causes Insulin is a hormone produced in the pancreas by special cells, called beta cells. The pancreas is below and behind the stomach. Insulin is needed to move blood sugar (glucose) into cells. Inside the cells, glucose is stored and later used for energy. When you have type 2 diabetes, your fat, liver, and muscle cells do not respond correctly to insulin. This is called insulin resistance. As a result, blood sugar does not get into these cells to be stored for energy. When sugar cannot enter cells, a high level of sugar builds up in the blood. This is called hyperglycemia. The body is unable to use the glucose for energy. This leads to the symptoms of type 2 diabetes. Type 2 diabetes usually develops slowly over time. Most people with the disease are overweight or obese when they are diagnosed. Increased fat makes it harder for your body to use insulin the correct way. Type 2 diabetes can also develop in people who are not overweight or obese. This is more common in older adults. Family history and genes play a role in type 2 diabetes. Low activity level, poor diet, and excess body weight around the waist increase your chance of getting the disease. Symptoms People with type 2 diabetes often have no symptoms at first. They may not have symptoms for many years. Early symptoms of diabetes caused by a high blood sugar level may include: Bladder, kidney, skin, or other infections that are more frequent or heal slowly Fatigue Hunger Increased thirst Increased urination Blurred vision After many years, diabetes can lead to serious health problems, and as a result, many other symptoms. Exams and Tests Your doctor may suspect that you have diabetes if your blood sugar level is higher than 200 milligrams per deciliter (mg/dL) or 11.1 mmol/L. To confirm the diagnosis, one or more of the following tests must be done. Fasting blood glucose level -- Diabetes is diagnosed if it is higher than 126 mg/dL (7.0 mmol/L) two different times. Hemoglobin A1c (A1C) test -- Diabetes is diagnosed if the test result 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 special sugar drink. Diabetes screening is recommended for: Overweight children who have other risk factors for diabetes, starting at age 10 and repeated every 2 years Overweight adults (BMI of 25 or higher) who have other risk factors, such as high blood pressure, or having a mother, father, sister or brother with diabetes Adults starting at age 45 every 3 years, or at a younger age if the person has risk factors If you have been diagnosed with type 2 diabetes, you need to work closely with your doctor. See your doctor as often as instructed. This may be every 3 months. The following exams and tests will help you and your doctor monitor your diabetes and prevent problems. Check the skin, nerves, and joints of your feet and legs. Check if your feet are getting numb (diabetic nerve disease). Have your blood pressure checked at least once a year (blood pressure goal should be 140/80 mm Hg or lower). Have your A1C tested every 6 months if your diabetes is well controlled. Have the test every 3 months if your diabetes is not well controlled. Have your cholesterol and triglyceride levels checked once a year. Get tests once a year to make sure your kidneys are working well (microalbuminuria and serum creatinine). Visit your eye doctor at least once a year, or more often if you have signs of diabetic eye disease. See the dentist every 6 months for a thorough dental cleaning and exam. Make sure your dentist and hygienist know that you have diabetes. Your provider may want to check your vitamin B12 blood levels if you are taking the drug metformin. Treatment At first, the goal of treatment is to lower your high blood glucose level. Long-term goals are to prevent complications. These are health problems that can result from having diabetes. The most important way to treat and manage type 2 diabetes is by being active and eating healthy foods. Everyone with diabetes should receive proper education and support about the best ways to manage their diabetes. Ask your doctor about seeing a diabetes nurse educator and a dietitian. LEARN THESE SKILLS Learning diabetes management skills will help you live well with diabetes. These skills help prevent health problems and the need for medical care. Skills include: How to test and record your blood glucose What, when, and how much to eat How to safely increase your activity and control your weight How to take medicines, if needed How to recognize and treat low and high blood sugar How to handle sick days Where to buy diabetes supplies and how to store them It may take several months to learn these skills. Keep learning about diabetes, its complications, and how to control and live well with the disease. Stay up-to-date on new research and treatments. Make sure you are getting information from trustworthy sources, such as your doctor and diabetes educator. MANAGING YOUR BLOOD SUGAR Checking your blood sugar level yourself and writing down the results tells you how well you are managing your diabetes. Talk to your doctor and diabetes educator about how often to check. To check your blood sugar level, you use a device called a glucose meter. Usually, you prick your finger with a small needle, called a lancet. This gives you a tiny drop of blood. You place the blood on a test strip and put the strip into the meter. The meter gives you a reading that tells you the level of your blood sugar. Your doctor or diabetes educator will help set up a testing schedule for you. Your doctor will help you set a target range for your blood sugar numbers. Keep these factors in mind: Most people with type 2 diabetes only need to check their blood sugar once or twice a day. If your blood sugar level is under control, you may only need to check it a few times a week. You may test yourself when you wake up, before meals, and at bedtime. You may need to test more often when you are sick or under stress. You may need to test more often if you are having more frequent low blood sugar symptoms. Keep a record of your blood sugar for yourself and your doctor. Based on your numbers, you may need to make changes to your meals, activity, or medicines to keep your blood sugar level in the right range. Your doctor may recommend that you use a continuous glucose monitor (CGM) to measure blood sugar if: You are using insulin injections many times a day You have had an episode of severe low blood sugar Your blood sugar level varies a lot The CGM has a sensor that is inserted just under the skin to measure glucose in your tissue fluid every 5 minutes. HEALTHY EATING AND WEIGHT CONTROL Work closely with your health care providers to learn how much fat, protein, and carbohydrates you need in your diet. Your meal plans should fit your lifestyle and habits and should include foods that you like. Managing your weight and having a well-balanced diet are important. Some people with type 2 diabetes can stop taking medicines after losing weight. This does not mean that their diabetes is cured. They still have diabetes. Obese people whose diabetes is not well managed with diet and medicine may consider weight loss (bariatric) surgery. REGULAR PHYSICAL ACTIVITY Regular activity is important for everyone. It is even more important when you have diabetes. Exercise is good for your health because it: Lowers your blood sugar level without medicine Burns extra calories and fat to help manage your weight Improves blood flow and blood pressure Increases your energy level Improves your ability to handle stress Talk to your doctor before starting any exercise program. People with type 2 diabetes may need to take special steps before, during, and after physical activity or exercise, including adjusting doses of insulin if needed. MEDICINES TO TREAT DIABETES If diet and exercise do not help keep your blood sugar at normal or near-normal levels, your doctor may prescribe medicine. Since these drugs help lower your blood sugar level in different ways, your doctor may have you take more than one drug. Some of the most common types of medicines are listed below. They are taken by mouth or injection. Alpha-glucosidase inhibitors Biguanides Bile acid sequestrants DPP-4 inhibitors Injectable medicines (GLP-1 analogs) Meglitinides SGLT2 inhibitors Sulfonylureas Thiazolidinediones You may need to take insulin if your blood sugar cannot be controlled with any of the above medicines. Most commonly, insulin is injected under the skin using a syringe, insulin pen, or pump. Another form of insulin is the inhaled type. Insulin cannot be taken by mouth because the acid in the stomach destroys the insulin. PREVENTING COMPLICATIONS Your doctor may prescribe medicines or other treatments to reduce your chance of developing some of the more common complications of diabetes, including: Eye disease Kidney disease Heart disease and stroke FOOT CARE People with diabetes are more likely than those without diabetes to have foot problems. Diabetes damages the nerves. This can make your feet less able to feel pressure, pain, heat, or cold. You may not notice a foot injury until you have severe damage to the skin and tissue below, or you get a severe infection. Diabetes can also damage blood vessels. Small sores or breaks in the skin may become deeper skin sores (ulcers). The affected limb may need to be amputated if these skin ulcers do not heal or become larger, deeper, or infected. To prevent problems with your feet: Stop smoking if you smoke. Improve control of your blood sugar. Get a foot exam by your doctor at least twice a year to learn if you have nerve damage. Ask your doctor to check your feet for problems such as a bunion or hammertoe. These need to be treated to prevent skin breakdown and ulcers. Check and care for your feet every day. This is very important when you already have nerve or blood vessel damage or foot problems. Treat minor infections, such as athlete's foot, right away. Use moisturizing lotion on dry skin. Make sure you wear the right kind of shoes. Ask your doctor what type of shoe is right for you. EMOTIONAL HEALTH Living with diabetes can be stressful. You may feel overwhelmed by everything you need to do to manage your diabetes. But taking care of your emotional health is just as important as your physical health. Ways to relieve stress include: Listening to relaxing music Meditating to take your mind off your worries Deep breathing to help relieve physical tension Doing yoga, taichi, or progressive relaxation Feeling sad or down (depressed) or anxious sometimes is normal. But if you have these feelings often and they're getting in the way of managing your diabetes, talk with your health care team. They can find ways to help you feel better. Support Groups There are many diabetes resources that can help you understand more about type 2 diabetes. You can also learn ways to manage your condition so you can live well with diabetes. Outlook (Prognosis) Diabetes is a lifelong disease and there is no cure. Some people with type 2 diabetes no longer need medicine if they lose weight and become more active. When they reach their ideal weight, their body's own insulin and a healthy diet can control their blood sugar level. 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. If the wounds do not heal properly, your foot or leg may need to be amputated. Infections can also cause pain and itching in the skin. 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. When to Contact a Medical Professional Call 911 right away if you have: Chest pain or pressure Fainting, confusion or unconsciousness Seizure Shortness of breath These symptoms can quickly get worse and become emergency conditions (such as seizures, hypoglycemic coma or hyperglycemic coma). Also call your doctor if you have: Numbness, tingling, or pain in your feet or legs Problems with your eyesight Sores or infections on your feet Symptoms of high blood sugar (extreme thirst, blurry vision, dry skin, weakness or fatigue, the need to urinate a lot) Symptoms of low blood sugar (weakness or fatigue, trembling, sweating, irritability, trouble thinking clearly, fast heartbeat, double or blurry vision, uneasy feeling) Frequent feelings of depression or anxiety Prevention You can help prevent type 2 diabetes by staying at a healthy body weight. You can get to a healthy weight by eating healthy foods, controlling your portion sizes, and leading an active lifestyle. Some medicines can also delay or prevent type 2 diabetes in people at risk of developing the disease. 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": "You can help prevent type 2 diabetes by staying at a healthy body weight. You can get to a healthy weight by eating healthy foods, controlling your portion sizes, and leading an active lifestyle. Some medicines can also delay or prevent type 2 diabetes in people at risk of developing the disease.", "role": "assistant" } ]

[ { "content": "what the treatment for bronchitis\n\nBronchitis (Living With): If you have chronic bronchitis, you can take steps to control your symptoms. Lifestyle changes and ongoing care can help you manage the condition. Lifestyle Changes The most important step is to not start smoking or to quit smoking. Talk with your doctor about programs and products that can help you quit. For more information about how to quit smoking, go to the Diseases and Conditions Index Smoking and Your Heart article and the National Heart, Lung, and Blood Institute's (NHLBI's) \"Your Guide to a Healthy Heart.\" Although these resources focus on heart health, they include general information about how to quit smoking. Also, try to avoid other lung irritants, such as secondhand smoke, dust, fumes, vapors, and air pollution. This will help keep your lungs healthy. Wash your hands often to lower your risk for a viral or bacterial infection. Also, try to stay away from people who have colds or the flu. See your doctor right away if you have signs or symptoms of a cold or the flu. Follow a healthy diet and be as physically active as you can. A healthy diet includes a variety of fruits, vegetables, and whole grains. It also includes lean meats, poultry, fish, and fat-free or low-fat milk or milk products. A healthy diet also is low in saturated fat, trans fat, cholesterol, sodium (salt), and added sugar. For more information about following a healthy diet, go to the NHLBI's Aim for a Healthy Weight Web site, \"Your Guide to a Healthy Heart,\" and \"Your Guide to Lowering Your Blood Pressure With DASH.\" All of these resources include general advice about healthy eating. Ongoing Care See your doctor regularly and take all of your medicines as prescribed. Also, talk with your doctor about getting a yearly flu shot and a pneumonia vaccine. If you have chronic bronchitis, you may benefit from pulmonary rehabilitation (PR). PR is a broad program that helps improve the well-being of people who have chronic (ongoing) breathing problems. People who have chronic bronchitis often breathe fast. Talk with your doctor about a breathing method called pursed-lip breathing. This method decreases how often you take breaths, and it helps keep your airways open longer. This allows more air to flow in and out of your lungs so you can be more physically active. To do pursed-lip breathing, you breathe in through your nostrils. Then you slowly breathe out through slightly pursed lips, as if you're blowing out a candle. You exhale two to three times longer than you inhale. Some people find it helpful to count to two while inhaling and to four or six while exhaling.", "role": "user" }, { "content": "If you have chronic bronchitis, you can take steps to control your symptoms. Lifestyle changes and ongoing care can help you manage the condition. ... The most important step is to not start smoking or to quit smoking. ... Also, try to avoid other lung irritants, such as secondhand smoke, dust, fumes, vapors, and air pollution. ... Wash your hands often to lower your risk for a viral or bacterial infection. Also, try to stay away from people who have colds or the flu. ... Follow a healthy diet and be as physically active as you can. ... talk with your doctor about getting a yearly flu shot and a pneumonia vaccine. If you have chronic bronchitis, you may benefit from pulmonary rehabilitation (PR). ... People who have chronic bronchitis often breathe fast. Talk with your doctor about a breathing method called pursed-lip breathing.", "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 (Treatment): There is currently no cure for Milroy disease. Management is typically conservative and usually successful in most people. [3] Management of lymphedema should be guided by a lymphedema therapist. Some improvement is usually possible with the use of properly fitted compression hosiery or bandaging and well fitting, supportive shoes. Good skin care is essential. These measures may improve the cosmetic appearance of the affected areas, decrease their size, and reduce the risk of complications. [2] Decongestive physiotherapy , which combines compression bandaging, manual lymphatic drainage (a specialized massage technique), exercise, breathing exercises, dietary measures and skin care, has become the standard of care for primary lymphedema. [3] People with recurrent cellulitis may benefit from prophylactic antibiotics . [2] [3] Surgical intervention is considered a last option when other medical management fails. [3] When possible, people with Milroy disease should avoid: wounds to swollen areas (because of their reduced resistance to infection) long periods of immobility prolonged standing elevation of the affected limb certain medications (particularly calcium channel-blocking drugs that can cause increased leg swelling in some people)[2] Management Guidelines GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions.", "role": "user" }, { "content": "There is currently no cure for Milroy disease. Conservative management is usually successful in most people. Management of lymphedema should be guided by a lymphedema therapist. Some improvement is possible with the use of properly fitted compression hosiery or bandaging and well fitting, supportive shoes. Good skin care is essential. Decongestive physiotherapy, which combines compression bandaging, manual lymphatic drainage (a specialized massage technique), exercise, breathing exercises, dietary measures and skin care, is the standard of care for primary lymphedema. People with recurrent cellulitis may benefit from prophylactic antibiotics Surgical intervention is considered a last option when other medical management fails. When possible, people with Milroy disease should avoid wounds to swollen areas (because of their reduced resistance to infection,) long periods of immobility, prolonged standing, elevation of the affected limb, and calcium channel-blocking drugs that can cause increased leg swelling in some people.", "role": "assistant" } ]

[ { "content": "how to loose weight\n\n Understanding Adult Overweight & Obesity Definition and Facts The terms “overweight” and “obesity” refer to body weight that is greater than what is considered normal or healthy for a certain height. Reaching and staying at a healthy weight can be a long-term challenge for people who are overweight or have obesity. What are overweight and obesity? The terms \"overweight\" and \"obesity\" refer to body weight that is greater than what is considered normal or healthy for a certain height. Overweight is generally due to extra body fat. However, overweight may also be due to extra muscle, bone, or water. People who have obesity usually have too much body fat.Your body mass index (BMI) is one way to tell if you are at a healthy weight, overweight, or have obesity. The BMI is a measure based on your weight in relation to your height. The greater your BMI, the greater your risk of health problems from overweight and obesity.Reaching and staying at a healthy weight may be a long-term challenge if you are overweight or have obesity. Maintaining a healthy weight-or at least not gaining more weight if you are already overweight-can help lower your chance of developing certain health problems. How common is overweight and obesity? According to a national U.S. survey1,2,3more than 1 in 3 adults were considered to be overweight more than 1 in 3 adults were considered to have obesity more than 2 in 3 adults were considered to be overweight or have obesityFor more statistics on overweight and obesity in the United States, see NIDDK's Overweight & Obesity Statistics. Who is more likely to be overweight? Men are more likely than women to be overweight.3 Who is more likely to have obesity? According to a national U.S. survey, some groups are more likely to have obesity.2Among black adults, 48 out of 100 were considered to have obesity. Among Hispanic adults, 42 out of 100 were considered to have obesity. Among white adults, 36 out of 100 were considered to have obesity.Women are more likely than men to have obesity.2Many factors play a role in who is more likely to have obesity, and these factors may affect people differently. Why do people gain weight? Many factors may cause weight gain and affect how much weight your body stores. When you take in more calories from food or beverages than you use up from physical activity and through daily living, such as sitting or sleeping, your body stores the extra calories. Over time, if you continue to consume more calories than you burn off, you will likely gain weight. Excessive weight gain may lead to overweight or obesity. Who should lose weight? Medical experts recommend that people who have obesity should lose weight.Most people who are overweight and have one or more factors that raise their chance for heart disease should lose weight. These factors includediabetes prediabetes high blood pressure dyslipidemia-high levels of LDL cholesterol, low levels of HDL cholesterol, or high levels of triglycerides a large waist size-for men, greater than 40 inches; for women, greater than 35 inches Definition & Facts Factors Affecting Weight and Health Many factors can affect your weight, leading to overweight, obesity, or extreme obesity. Some of these factors may make it hard for you to lose weight or not regain weight you have lost. Being overweight or having obesity may lead to certain health problems. What factors affect weight and health? Many factors can affect your weight and lead to overweight or obesity. Some of these factors may make it hard for you to lose weight or avoid regaining weight that you've lost.Overweight and obesity tend to run in families, suggesting that genes may play a role. Your chances of being overweight are greater if one or both of your parents are overweight or have obesity. Your genes may affect the amount of fat you store in your body and where on your body you carry the extra fat.Some racial and ethnic minority groups are more likely to have obesity. Obesity rates in American adults are highest in African Americans, followed by Hispanics/Latinos, then Caucasians. This is true for men and women.4 While Asian American men and women have the lowest rates of obesity,4 they can still be at risk of diseases associated with obesity if they carry a lot of unhealthy fat in their abdomen-even when their body mass index (BMI) is lower.5Many people gain weight as they age. Adults who have a normal BMI often start to gain weight in young adulthood and continue to gain weight until they are ages 60 to 65. In addition, children who have obesity are more likely to have obesity as adults.In the United States, obesity is more common in black or Hispanic women than in black or Hispanic men.4 A person's sex may also affect where the body stores fat. Women tend to build up fat in their hips and buttocks. Men usually build up fat in their abdomen or belly. Extra fat, particularly if it is around the abdomen, may put people at risk of health problems even if they have a normal weight.Your eating and physical activity habits may raise your chances of becoming overweight and having obesity if youeat and drink a lot of foods and beverages that are high in calories, sugar, and fat drink a lot of beverages that are high in added sugars spend a lot of time sitting or lying down and have limited physical activityWhere you live, work, play, and worship may affect your eating and physical activity habits, and access to healthy foods and places to be active.For example, living in an area that has a high number of grocery stores can increase your access to better quality, lower calorie foods. Living in a neighborhood with a lot of green spaces and areas for safe physical activity may encourage you to be more physically active.Where you work and worship may also make it easier for you to eat unhealthy, high-calorie foods. Vending machines, cafeterias, or special events at your workplace or place of worship may not offer healthy, lower calorie options. Whenever possible, choose the healthier options and limit your treats to a small sliver of pie or cake.Family eating and lifestyle habits may affect your weight and health. Some families may consume foods and beverages that are high in fat, salt, and added sugars or eat large amounts of unhealthy foods at family gatherings. Some families may also spend a lot of inactive time watching TV, using a computer, or using a mobile device instead of being active.Your social, ethnic, or religious group culture may also affect your weight and health because of shared eating and lifestyle habits. Some cultures may consume foods and beverages that are high in fat, salt, and added sugars. Some common food preparation methods, such as frying, may lead to high-calorie intake. Regularly consuming foods high in calories, fat, and sugar may lead to weight gain overtime.People who don't get enough sleep may eat more calories and snack more.6 Experts recommend that adults ages 18 to 64 get 7 to 9 hours of sleep a day, and that adults ages 65 and older get 7 to 8 hours of sleep a day.7Other factors that can lead to weight gain includecertain medical conditions certain medicines binge eating disorder stress What makes it hard for some people to lose weight? Many factors can make it hard to lose weight, includingyour genes what and how much you eat not getting regular physical activity or being inactive taking certain medicines having certain medical conditions Difficulty in managing stress Factors Affecting Weight & Health Am I at a Healthy Weight? Knowing your body mass index (BMI) and waist size help tell if you are at a normal or healthy weight; are overweight; have obesity; or have extreme obesity. Your body shape may make you more likely to have certain health problems. How can I tell if I am at a healthy weight? Knowing your body mass index (BMI), waist size, and waist-to-hip ratio can help you tell if you're at a healthy weight.The BMI is the tool most commonly used to estimate and screen for overweight and obesity in adults. BMI is a measure based on your weight in relation to your height. You can easily calculate your BMI.Your BMI can tell if you are at a normal or healthy weight, are overweight, or have obesity. The greater your BMI, the greater your risk of health problems such as type 2 diabetes and heart disease.Normal or healthy weight. A person with a BMI of 18.5 to 24.9 is in the normal or healthy range. Overweight. A person with a BMI of 25 to 29.9 is considered overweight. Obesity. A person with a BMI of 30 to 39.9 is considered to have obesity. Extreme obesity. A person with a BMI of 40 or greater is considered to have extreme obesity.Because BMI doesn't measure actual body fat, a person who is very muscular, like a bodybuilder, may have a high BMI without having a lot of body fat. Also, some groups who tend to have a lower BMI, such as Asian men and women or older adults, may still have high amounts of body fat even if they are not overweight.Another important measure is your waist size. Having too much fat around your waist may raise your chances of health problems even more than having fat in other parts of your body. Women with a waist size of more than 35 inches and men with a waist size of more than 40 inches may be more likely to develop diseases related to obesity. Does my body shape matter? Doctors are concerned not only with how much body fat you have, but where the fat is located on your body. Women tend to build up fat in their hips and buttocks, giving them a \"pear\" shape. Men usually build up fat in their abdomen, giving them more of an \"apple\" shape. Of course, some men are pear-shaped, and some women are apple-shaped.Extra fat, especially in the abdomen, may put people at risk for certain health problems, even if they have a normal weight. People who are apple-shaped may be more likely to develop type 2 diabetes, heart disease, or certain types of cancer than people of the same weight who are pear-shaped. Am I at a Healthy Weight? You should seek a doctor's help if you are gaining weight quickly, have a large waist size, or a BMI of 30 or greater. You should also seek a doctor's help if you are overweight or have obesity and havea family history of certain diseases, such as type 2 diabetes or heart disease health problems such as type 2 diabetes, heart disease, or metabolic syndrome Health Risks Overweight and obesity may increase your risk for certain health problems and may be linked to certain emotional and social problems. What are some health risks of overweight and obesity? Type 2 diabetes is a disease that occurs when your blood glucose, also called blood sugar, is too high. About 8 out of 10 people with type 2 diabetes are overweight or have obesity.8 Over time, high blood glucose leads to problems such as heart disease, stroke, kidney disease, eye problems, nerve damage, and other health problems.If you are at risk for type 2 diabetes, losing 5 to 7 percent of your body weight and getting regular physical activity may prevent or delay the onset of type 2 diabetes.High blood pressure, also called hypertension, is a condition in which blood flows through your blood vessels with a force greater than normal. High blood pressure can strain your heart, damage blood vessels, and raise your risk of heart attack, stroke, kidney disease, and death.Heart disease is a term used to describe several problems that may affect your heart. If you have heart disease, you may have a heart attack, heart failure, sudden cardiac death, angina, or an abnormal heart rhythm. High blood pressure, abnormal levels of blood fats, and high blood glucose levels may raise your risk for heart disease. Blood fats, also called blood lipids, include HDL cholesterol, LDL cholesterol, and triglycerides.Losing 5 to 10 percent of your weight may lower your risk factors for developing heart disease. If you weigh 200 pounds, this means losing as little as 10 pounds. Weight loss may improve blood pressure, cholesterol levels, and blood flow.Stroke is a condition in which the blood supply to your brain is suddenly cut off, caused by a blockage or the bursting of a blood vessel in your brain or neck. A stroke can damage brain tissue and make you unable to speak or move parts of your body. High blood pressure is the leading cause of strokes.Sleep apnea is a common disorder in which you do not breathe regularly while sleeping. You may stop breathing altogether for short periods of time. Untreated sleep apnea may raise your risk of other health problems, such as type 2 diabetes and heart disease.Metabolic syndrome is a group of conditions that put you at risk for heart disease, diabetes, and stroke. These conditions arehigh blood pressure high blood glucose levels high triglyceride levels in your blood low levels of HDL cholesterol (the \"good\" cholesterol) in your blood too much fat around your waistFatty liver diseases are conditions in which fat builds up in your liver. Fatty liver diseases include nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). Fatty liver diseases may lead to severe liver damage, cirrhosis, or even liver failure.Osteoarthritis is a common, long-lasting health problem that causes pain, swelling, and reduced motion in your joints. Being overweight or having obesity may raise your risk of getting osteoarthritis by putting extra pressure on your joints and cartilage.Overweight and obesity may raise your risk of getting gallbladder diseases, such as gallstones and cholecystitis. Imbalances in substances that make up bile cause gallstones. Gallstones may form if bile contains too much cholesterol.Cancer is a collection of related diseases. In all types of cancer, some of the body's cells begin to divide without stopping and spread into surrounding tissues. Overweight and obesity may raise your risk of developing certain types of cancer.Kidney disease means that your kidneys are damaged and can't filter blood like they should. Obesity raises the risk of diabetes and high blood pressure, the most common causes of kidney disease. Even if you don't have diabetes or high blood pressure, obesity itself may promote kidney disease and quicken its progress.Overweight and obesity raise the risk of health problems that may occur during pregnancy. Pregnant women who are overweight or obese may have a greater chance ofdeveloping gestational diabetes having preeclampsia-high blood pressure during pregnancy, which can cause severe health problems for mother and baby if left untreated needing a cesarean section, or C-section and, as a result, taking longer to recover after giving birth What emotional and social problems are linked to overweight and obesity? Overweight and obesity are associated with mental health problems such as depression. People who deal with overweight and obesity may also be the subject of weight bias and stigma from others, including health care providers. This can lead to feelings of rejection, shame, or guilt-further worsening mental health problems. Health Risks Eating and Physical Activity Changing your eating habits is central to losing and maintaining your weight. To lose weight, you have to eat fewer calories and use more calories than you take in. Sticking with an eating plan may be more important than the type of eating plan you follow. What options might help you lose weight? Changing your eating habits is central to losing and maintaining your weight. To lose weight, you have to eat fewer calories and use more calories than you take in. This can be challenging for many people to do for an extended period of time. Emerging research shows that sticking with an eating plan may be more important to losing and maintaining weight than the type of eating plan you follow.All your food and beverage choices count. Eating healthy is a journey shaped by many factors, including your age, weight, metabolism, food preferences, access to food, culture, and traditions; whether you are a man or woman; and the personal decisions you make over time. A healthy eating plan includesa variety of vegetables, fruits, and whole grains, such as brown rice, oats, and whole-wheat bread fat-free or low-fat dairy products such as milk, yogurt, and cheese and similar products such as soy beverages a variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas), nuts, seeds, and soy products oils, such as olive and canola oils and those found in nuts, olives, and avocadosA healthy eating plan also includesconsuming fewer foods and beverages that have refined carbohydrates, added sugars, and salt (sodium) controlling portion sizes limiting foods with saturated fats and trans fats, like those found in desserts and fried foodsTo learn more about a healthy eating plan and the amounts of food and beverages that are right for you, visit ChooseMyPlate.gov.The Physical Activity Guidelines for Americans define regular physical activity as at least 150 minutes a week of moderate-intensity aerobic activity, such as brisk walking. A moderate-intensity aerobic activity makes your heart beat faster and makes you breathe harder but does not overwork or overheat you. This type of physical activity is safe for most people.People with physical disabilities also can do certain activities, such as wheelchair aerobics or basketball. Talk with your doctor about the types of physical activity that might work well with your abilities.If you have a health condition such as heart disease, high blood pressure, or diabetes, talk with your doctor before you start regular physical activity. Your doctor can review with you the types and amounts of physical activity that might suit your lifestyle, interests, and skills.Read Tips to Help You Get Active. What should I do to stay at a healthy weight? Recent research has found there are many reasons why it is difficult to keep weight off after losing weight. In addition to metabolism slowing during weight loss, your body needs fewer calories at your new, lower weight. Hormonal and other factors also tend to promote weight regain. People who have kept weight off long-term report needing to keep careful track of their food intake and to do high levels of physical activity. Some people who have reached a healthy weight may find it hard to keep the weight off.Weigh yourself regularly. Keep a record of your weight to help make sure you are maintaining your weight loss and not regaining weight.Continue to make healthy food choices, and make following your healthy eating plan a lifelong habit. Find healthy food options that you prefer and enjoy, as you are more likely to stick with your eating plan.Regular physical activity may help you keep from regaining weight you've lost. Aim for 200 to 300 minutes of moderate-intensity physical activity a week to prevent regaining weight.9 Make regular physical activity a lifelong habit.If you were overweight or had obesity and lost weight, your doctor may advise you to take part in a program to help you maintain your weight loss. The program may help you stick to your healthy eating and regular physical activity plan, and track your progress. Eating & Physical Activity Treatment Common treatments for losing weight include healthy eating, being physically active, and making other changes to your usual habits. If you have extreme obesity and related health problems, your doctor may consider other treatments, such as bariatric surgery. Healthy eating plan and regular physical activity Following a healthy eating plan with fewer calories is often the first step in trying to treat overweight and obesity.People who are overweight or have obesity should also start regular physical activity when they begin their healthy eating plan. Being active may help you use calories. Regular physical activity may help you stay at a healthy weight.Learn more about healthy eating and physical activity to lose or maintain weight. Changing your habits Changing your eating and physical activity habits and lifestyle is difficult, but with a plan, effort, regular support, and patience, you may be able to lose weight and improve your health. The following tips may help you think about ways to lose weight, engage in regular physical activity, and improve health over the long-term.Be prepared for setbacks-they are normal. After a setback, like overeating at a family or workplace gathering, try to regroup and focus on getting back to your healthy eating plan as soon as you can. Try to eat only when you're sitting at your dining room or kitchen table. At work, avoid areas where treats may be available. Track your progress using online food or physical activity trackers, such as the Body Weight Planner, that can help you keep track of the foods you eat, your physical activity, and your weight. These tools may help you stick with it and stay motivated. Set goals. Having specific goals can help you stay on track. Rather than \"be more active,\" set a goal to walk 15 to 30 minutes before work or at lunch on Monday and Friday. If you miss a walk on Monday, pick it up again Tuesday. Seek support. Ask for help or encouragement from your family, friends, or health care professionals. You can get support in person, through email or texting, or by talking on the phone. You can also join a support group. Specially trained health professionals can help you change your lifestyle. Weight-management programs Some people benefit from a formal weight-management program. In a weight-management program, trained weight-management specialists will design a broad plan just for you and help you carry out your plan. Plans include a lower-calorie diet, increased physical activity, and ways to help you change your habits and stick with them. You may work with the specialists on-site (that is, face-to-face) in individual or group sessions. The specialists may contact you regularly by telephone or internet to help support your plan. Devices such as smartphones, pedometers, and accelerometers may help you track how well you are sticking with your plan.Some people may also benefit from online weight-management programs or commercial weight-loss programs. Weight-loss medicines When healthy eating and physical activity habits are not enough, your doctor may prescribe medicines to treat overweight and obesity.You should try to stick with your healthy eating plan and continue getting regular physical activity while taking weight-loss medicines.You may see ads for herbal remedies and dietary supplements that claim to help you lose weight. But many of these claims are not true. Some of these supplements can even have serious side effects. Talk with your doctor before taking any over-the-counter herbal remedies or dietary supplements for the purpose of trying to lose weight. Weight-loss devices Your doctor may consider weight-loss devices if you haven't been able to lose weight or keep from gaining back any weight you lost with other treatments. Because weight-loss devices have only recently been approved, researchers do not have long-term data on their safety and effectiveness. Weight-loss devices includeElectrical stimulation system. The electrical stimulation system uses a device a surgeon places in your abdomen with laparoscopic surgery. The device blocks nerve activity between your stomach and brain. Gastric balloon system. For the gastric balloon system, a doctor places one or two balloons in your stomach through a tube that goes in your mouth. Once the balloons are in your stomach, the surgeon fills them with salt water so they take up more space in your stomach and help you feel fuller. Gastric emptying system. A gastric emptying system uses a pump to drain part of the food from your stomach after a meal. The device includes a tube that goes from the inside of your stomach to the outside of your abdomen. About 20 to 30 minutes after eating, you use the pump to drain the food from your stomach through the tube into the toilet. Bariatric surgery Bariatric surgery includes several types of operations that help you lose weight by making changes to your digestive system. Bariatric surgery may be an option if you have extreme obesity and haven't been able to lose enough weight to improve your health or keep from gaining back the weight you lost with other treatments. Bariatric surgery also may be an option at lower levels of obesity if you have serious health problems, such as type 2 diabetes or sleep apnea, related to obesity. Bariatric surgery can improve many of the medical conditions linked to obesity, especially type 2 diabetes. Special diets Your doctor may recommend a lower-calorie diet such as 1,200 to 1,500 calories a day for women and 1,500 to 1,800 calories a day for men. The calorie level depends on your body weight and physical activity level. A lower calorie diet with a variety of healthy foods will give you the nutrients you need to stay healthy.Intermittent fasting is another way of reducing food intake that is gaining attention as a strategy for weight loss and health benefits. Alternate-day fasting is one type of intermittent fasting that consists of a \"fast day\" (eating no calories to one-fourth of caloric needs) alternating with a \"fed day,\" or a day of unrestricted eating. Researchers have conducted only a few studies of intermittent fasting as a strategy for weight loss. They have no long-term data on the safety and effectiveness of intermittent fasting for long-term weight maintenance. Treatment ", "role": "user" }, { "content": "Health care providers generally agree that people who are considered to be obese (have a BMI of 30 or greater) may improve their health by losing weight.If you are overweight (BMI between 25 and 29.9), experts recommend that you avoid gaining any extra weight. If you are overweight and have other risk factors, losing weight may you reduce these risks.", "role": "assistant" } ]

[ { "content": "what is the treatment for lymphoma\n\n Primary lymphoma of the brain Brain lymphoma Cerebral lymphoma Primary lymphoma of the central nervous system PCNSL Lymphoma - brain Summary Primary lymphoma of the brain is cancer of white blood cells that starts in the brain. Causes The cause of primary brain lymphoma is not known. People with a weakened immune system are at high risk for primary lymphoma of the brain. Common causes of a weakened immune system include HIV/AIDS and having had an organ transplant (especially heart transplant). Primary lymphoma of the brain may be linked to Epstein-Barr Virus (EBV), especially in people with HIV/AIDS. EBV is the virus that causes mononucleosis. Primary brain lymphoma is more common in people ages 45 to 70. The rate of primary brain lymphoma is rising. But this cancer is still very rare. Symptoms Symptoms of primary brain lymphoma may include any of the following: Changes in speech or vision Confusion or hallucinations Fever Headaches or seizures Leaning to one side when walking Weakness in hands or loss of coordination Numbness to hot, cold, and pain Personality changes Weight loss Exams and Tests The following tests may be done to help diagnose a primary lymphoma of the brain: Biopsy of the brain Head CT scan or MRI Spinal tap (lumbar puncture) Treatment Primary lymphoma of the brain is usually first treated with corticosteroids. These medicines are used to control swelling and improve symptoms. The main treatment is with chemotherapy. Younger people may receive high-dose chemotherapy, possibly 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/AIDS, may also be tried. You and your health care provider may need to manage other concerns during your treatment, including: Having chemotherapy at home Managing your pets during chemotherapy Bleeding problems Dry mouth Eating enough calories Safe eating during cancer treatment Outlook (Prognosis) Without treatment, people with primary brain lymphoma survive for less than 2 months. Those treated with chemotherapy often survive 3 to 4 years or more. This depends on whether the tumor stays in remission. Survival may improve with autologous stem cell transplant. Possible Complications Possible complications include: Chemotherapy side effects, including low blood counts Radiation side effects, including confusion, headaches, nervous system (neurologic) problems, and tissue death Return (recurrence) of the lymphoma 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": "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": "how do you get neuromuscular disorders\n\nMyasthenia gravis (Causes): Myasthenia gravis is a type of autoimmune disorder. An autoimmune disorder occurs when the immune system mistakenly attacks healthy tissue. Antibodies are proteins made by the body's immune system when it detects harmful substances. Antibodies may be produced when the immune system mistakenly considers healthy tissue a harmful substance, such as in the case of myasthenia gravis. In people with myasthenia gravis, the body produces antibodies that block the muscle cells from receiving messages (neurotransmitters) from the nerve cells. The exact cause of myasthenia gravis is unknown. In some cases, it is linked to tumors of the thymus (an organ of the immune system). Myasthenia gravis can affect people at any age. It is most common in young women and older men.", "role": "user" }, { "content": "Myasthenia gravis is a neuromuscular disorder where the body produces antibodies that block muscle cells from receiving neurotransmitters from the nerve cells. The exact cause myasthenia gravis is unknown. In some cases, it has been linked to tumors of the thymus. Myasthenia gravis can affect people at any age, and is most common in young women and older men.", "role": "assistant" } ]

[ { "content": "I have no help its about 4 years now I have ingrown toenail i have a problem of ingrown toenail its about 4 years now I have this problem i need help\n\n Ingrown toenail removal – discharge Onychocryptosis surgery Onychomycosis Unguis incarnates surgery Ingrown toenail removal Toenail Summary You had surgery to remove part or all of your toenail. This was done to relieve pain and discomfort due to an ingrown toenail. Ingrown toenails can occurs when the edge of your toenail grows into the skin of the toe. When You're in the Hospital The health care provider will most often numb your toe with a local anesthesia before the procedure starts. The provider will cut the part of the nail that has grown into the skin of the toe. Either part of the nail or the entire nail will have been removed. The surgery took an hour or less and your provider has covered the wound with a bandage. You can go home the same day. What to Expect at Home You may feel pain once the pain-numbing medicine wears off. Take the pain reliever your provider recommends. You may notice: Some swelling in your foot Light bleeding A yellow-colored discharge from the wound At home you should: Keep your feet raised above the level of your heart to reduce swelling Rest your foot and avoid moving it Keep your wound clean and dry Dressing Change the dressing about 12 to 24 hours after the surgery. Follow your provider's instructions for changing the dressing. Your provider may recommend soaking your foot in warm water before removing the dressing. This helps the bandage not stick to the wound. Change the dressing once or twice a day or as suggested by your provider. Foot Bath Soak your feet 2 to 3 times a day in the bath containing: Epsom salts - to relieve swelling and inflammation Betadine - an antibiotic to help reduce the risk of infection Dry your feet and apply antibiotic ointment your provider has given you. Dress the wound to keep it clean. Activity Try to reduce activity and rest your foot. Avoid bumping your toe or putting a lot of pressure on it. You may want to wear open-toed shoes. If wearing closed shoes, make sure they are not too tight. Wear cotton socks. You may need to do this for about 2 weeks. You can likely resume your normal activities within a week. Getting back to sports may take a little longer. Keep your wound covered both day and night in the first week. You can let your toe remain uncovered at night in the second week. This helps the wound heal. See your provider again in 2 to 3 days or as recommended. Prevention The toenail may grow inward again. To prevent this, follow these tips: Don't wear tight-fitting shoes or high heels Don't trim your nails too short or round the corners Don't pick or tear at the corners of the nails When to Call the Doctor Call your provider if you notice: Your toenail is not healing Fever Pain, even after taking pain-relief medicine Bleeding from the toenail Pus from the toenail Swelling or redness of the toe or foot Regrowth of the nail into the skin of the toe Review Date 12/10/2016 Updated by: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, 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": "You might have surgery that removes part or all of your toenail to relieve pain and discomfort due to an ingrown toenail.", "role": "assistant" } ]

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

[ { "content": "I have an hernia I would love to take care off it ASAP I was wondering if you guys could help me . Thanks\n\n Inguinal hernia Overview An inguinal hernia occurs when tissue, such as part of the intestine, protrudes through a weak spot in the abdominal muscles. The resulting bulge can be painful, especially when you cough, bend over or lift a heavy object. An inguinal hernia isn't necessarily dangerous. It doesn't improve on its own, however, and can lead to life-threatening complications. Your doctor is likely to recommend surgery to fix an inguinal hernia that's painful or enlarging. Inguinal hernia repair is a common surgical procedure. Symptoms Inguinal hernia signs and symptoms include: - A bulge in the area on either side of your pubic bone, which becomes more obvious when you're upright, especially if you cough or strain - A burning or aching sensation at the bulge - Pain or discomfort in your groin, especially when bending over, coughing or lifting - A heavy or dragging sensation in your groin - Weakness or pressure in your groin - Occasionally, pain and swelling around the testicles when the protruding intestine descends into the scrotum You should be able to gently push the hernia back into your abdomen when you're lying down. If not, applying an ice pack to the area may reduce the swelling enough so that the hernia slides in easily. Lying with your pelvis higher than your head also may help. Incarcerated hernia If you aren't able to push the hernia in, the contents of the hernia can be trapped (incarcerated) in the abdominal wall. An incarcerated hernia can become strangulated, which cuts off the blood flow to the tissue that's trapped. A strangulated hernia can be life-threatening if it isn't treated. Signs and symptoms of a strangulated hernia include: - Nausea, vomiting or both - Fever - Sudden pain that quickly intensifies - A hernia bulge that turns red, purple or dark - Inability to move your bowels or pass gas If any of these signs or symptoms occurs, call your doctor right away. Signs and symptoms in children Inguinal hernias in newborns and children result from a weakness in the abdominal wall that's present at birth. Sometimes the hernia will be visible only when an infant is crying, coughing or straining during a bowel movement. He or she might be irritable and have less appetite than usual. In an older child, a hernia is likely to be more apparent when the child coughs, strains during a bowel movement or stands for a long period. When to see a doctor See your doctor if you have a painful or noticeable bulge in your groin on either side of your pubic bone. The bulge is likely to be more noticeable when you're standing, and you usually can feel it if you put your hand directly over the affected area. Seek immediate medical care if a hernia bulge turns red, purple or dark. Causes Some inguinal hernias have no apparent cause. Others might occur as a result of: - Increased pressure within the abdomen - A pre-existing weak spot in the abdominal wall - A combination of increased pressure within the abdomen and a pre-existing weak spot in the abdominal wall - Straining during bowel movements or urination - Strenuous activity - Pregnancy - Chronic coughing or sneezing In many people, the abdominal wall weakness that leads to an inguinal hernia occurs at birth when the abdominal lining (peritoneum) doesn't close properly. Other inguinal hernias develop later in life when muscles weaken or deteriorate due to aging, strenuous physical activity or coughing that accompanies smoking. Weaknesses can also occur in the abdominal wall later in life, especially after an injury or abdominal surgery. In men, the weak spot usually occurs in the inguinal canal, where the spermatic cord enters the scrotum. In women, the inguinal canal carries a ligament that helps hold the uterus in place, and hernias sometimes occur where connective tissue from the uterus attaches to tissue surrounding the pubic bone. Risk factors Factors that contribute to developing an inguinal hernia include: - Being male. Men are eight times more likely to develop an inguinal hernia than are women. - Being older. Muscles weaken as you age. - Being white. - Family history. You have a close relative, such as a parent or sibling, who has the condition. - Chronic cough, such as from smoking. - Chronic constipation. Constipation causes straining during bowel movements. - Pregnancy. Being pregnant can weaken the abdominal muscles and cause increased pressure inside your abdomen. - Premature birth and low birth weight. - Previous inguinal hernia or hernia repair. Even if your previous hernia occurred in childhood, you're at higher risk of developing another inguinal hernia. Complications Complications of an inguinal hernia include: - Pressure on surrounding tissues. Most inguinal hernias enlarge over time if not repaired surgically. In men, large hernias can extend into the scrotum, causing pain and swelling. - Incarcerated hernia. If the contents of the hernia become trapped in the weak point in the abdominal wall, it can obstruct the bowel, leading to severe pain, nausea, vomiting, and the inability to have a bowel movement or pass gas. - Strangulation. An incarcerated hernia can cut off blood flow to part of your intestine. Strangulation can lead to the death of the affected bowel tissue. A strangulated hernia is life-threatening and requires immediate surgery. Diagnosis A physical exam is usually all that's needed to diagnose an inguinal hernia. Your doctor will check for a bulge in the groin area. Because standing and coughing can make a hernia more prominent, you'll likely be asked to stand and cough or strain. If the diagnosis isn't readily apparent, your doctor might order an imaging test, such as an abdominal ultrasound, CT scan or MRI. Treatment If your hernia is small and isn't bothering you, your doctor might recommend watchful waiting. In children, the doctor might try applying manual pressure to reduce the bulge before considering surgery. Enlarging or painful hernias usually require surgery to relieve discomfort and prevent serious complications. There are two general types of hernia operations - open hernia repair and laparoscopic repair. Open hernia repair In this procedure, which might be done with local anesthesia and sedation or general anesthesia, the surgeon makes an incision in your groin and pushes the protruding tissue back into your abdomen. The surgeon then sews the weakened area, often reinforcing it with a synthetic mesh (hernioplasty). The opening is then closed with stitches, staples or surgical glue. After the surgery, you'll be encouraged to move about as soon as possible, but it might be several weeks before you're able to resume normal activities. Laparoscopy In this minimally invasive procedure, which requires general anesthesia, the surgeon operates through several small incisions in your abdomen. Gas is used to inflate your abdomen to make the internal organs easier to see. A small tube equipped with a tiny camera (laparoscope) is inserted into one incision. Guided by the camera, the surgeon inserts tiny instruments through other incisions to repair the hernia using synthetic mesh. People who have laparoscopic repair might have less discomfort and scarring after surgery and a quicker return to normal activities. However, some studies indicate that hernia recurrence is more likely with laparoscopic repair than with open surgery. Laparoscopy allows the surgeon to avoid scar tissue from an earlier hernia repair, so it might be a good choice for people whose hernias recur after traditional hernia surgery. It also might be a good choice for people with hernias on both sides of the body (bilateral). Some studies indicate that a laparoscopic repair can increase the risk of complications and of recurrence. Having the procedure performed by a surgeon with extensive experience in laparoscopic hernia repairs can reduce the risks. ", "role": "user" }, { "content": "If your hernia is small and isn't bothering you, your doctor might recommend watchful waiting. Enlarging or painful hernias usually require surgery to relieve discomfort and prevent serious complications.", "role": "assistant" } ]

[ { "content": "I am suffering from Kartagener's syndrome and wanted information from you or from Dr. . for this syndrome. (About fertility) and if possible other symptoms. Thank you.\n\nKartagener syndrome (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": "The long-term outlook for people with Kartagener syndrome varies widely and largely depends on timely diagnosis and treatment. ... with appropriate treatment, the progression of lung disease can be slowed and other complications such as hearing loss can be avoided.", "role": "assistant" } ]

[ { "content": "We have 14 siblings in our family , at least 10 of us has had a frozen shoulder. We are wondering why? should we be concerned?\n\nFrozen shoulder - aftercare: A frozen shoulder is shoulder pain that leads to stiffness of your shoulder. Often the pain and stiffness are present all the time. The capsule of the shoulder joint is made of strong tissue (ligaments) that hold the shoulder bones to each other. When the capsule becomes inflamed, the shoulder bones cannot move freely in the joint. This condition is called frozen shoulder. Frozen shoulder may develop with no known cause. It can also occur in people who: - Have thyroid disease, diabetes, or are going through menopause - Have a shoulder injury - Have had a stroke that makes them unable to use their arm - Have a cast on their arm that holds their arm in one position Symptoms of frozen shoulder often follow this pattern: - At first, you have a lot of pain, or a freezing feeling that prevents you from moving your arm. - Then your shoulder becomes very stiff and hard to move, but the pain lessens. It becomes hard to reach over your head or behind you. - Finally, the pain goes away and you can use your arm again. This is the thawing phase and can take months to end. It can take a few months to go through these stages of frozen shoulder. The shoulder can get very painful and stiff before it starts to loosen. It can take as long as 18 to 24 months for complete healing. To help speed healing, your health care provider will likely do the following: - Teach you exercises to restore motion in your shoulder joint. - Refer you to a physical therapist. - Prescribe medicines for you to take by mouth. These include drugs to reduce pain and inflammation in the shoulder joint. You may also receive a shot of anti-inflammatory drug directly into the joint. Most people have a full recovery with full range of motion without surgery. Using moist heat on your shoulder 3 to 4 times a day may help relieve some pain and stiffness. For pain, you can use ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), or acetaminophen (Tylenol). You can buy these pain medicines at the store. - Talk with your provider before using these medicines if you have heart disease, high blood pressure, kidney disease, or have had stomach ulcers or internal bleeding in the past. - DO NOT take more than the amount recommended on the bottle or by your provider. Get help setting up your home so that you can get to everything you need without reaching above your shoulders or behind your back. - Keep the clothes that you wear most often in drawers and shelves that are between your waist and shoulder level. - Store food in cupboards, drawers, and refrigerator shelves that are between your waist and shoulder level. Get help with house cleaning, taking out the garbage, gardening, and other household tasks. DO NOT lift heavy things or do activities that require a lot of shoulder and arm strength. You will learn some simple exercises and stretches for your shoulder. - At first, try to do these exercises once every hour, or at least 4 times a day. - It is more important to do the exercises often than to do them for a long time each time you do them. - Use moist heat before the exercises to help lessen pain and increase movement. - The exercises should focus on stretching of the shoulder and range of motion. - Avoid exercises to strengthen your shoulder until the range of motion has returned. Some of the exercises are: - Shoulder stretches - Pendulum - Wall crawl - Rope and pulley stretches - Movements to help with internal and external rotation, such as hand behind back Your provider or physical therapist will show you how to do these exercises. Call your doctor if: - The pain in your shoulder is getting worse - You re-injure your arm or shoulder - Your frozen shoulder is making you feel sad or depressed Updated by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.", "role": "user" }, { "content": "Frozen shoulder may develop without a known cause. It is more likely to occur in people who have thyroid disease, diabetes, had shoulder injury, are unable to move their arm due to cast or stroke, and in women undergoing menopause. Most people have a full recovery with full range of motion.", "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": "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. ... 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.", "role": "assistant" } ]

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

[ { "content": "what are the symptoms for prostate cancer\n\n Prostate Cancer What is Prostate Cancer? How Tumors Form The body is made up of many types of cells. Normally, cells grow, divide, and produce more cells as needed to keep the body healthy and functioning properly. Sometimes, however, the process goes wrong -- cells become abnormal and form more cells in an uncontrolled way. These extra cells form a mass of tissue, called a growth or tumor. Tumors can be benign, which means not cancerous, or malignant, which means cancerous. How Prostate Cancer Occurs Prostate cancer occurs when a tumor forms in the tissue of the prostate, a gland in the male reproductive system. In its early stage, prostate cancer needs the male hormone testosterone to grow and survive. The prostate is about the size of a large walnut. It is located below the bladder and in front of the rectum. The prostate's main function is to make fluid for semen, a white substance that carries sperm. Prostate cancer is one of the most common types of cancer among American men. It is a slow-growing disease that mostly affects older men. In fact, more than 60 percent of all prostate cancers are found in men over the age of 65. The disease rarely occurs in men younger than 40 years of age. Prostate Cancer Can Spread Sometimes, cancer cells break away from a malignant tumor in the prostate and enter the bloodstream or the lymphatic system and travel to other organs in the body. When cancer spreads from its original location in the prostate to another part of the body such as the bone, it is called metastatic prostate cancer -- not bone cancer. Doctors sometimes call this distant disease. Surviving Prostate Cancer Today, more men are surviving prostate cancer than ever before. Treatment can be effective, especially when the cancer has not spread beyond the region of the prostate. Risk Factors Scientists don't know exactly what causes prostate cancer. They cannot explain why one man gets prostate cancer and another does not. However, they have been able to identify some risk factors that are associated with the disease. A risk factor is anything that increases your chances of getting a disease. Age Age is the most important risk factor for prostate cancer. The disease is extremely rare in men under age 40, but the risk increases greatly with age. More than 60 percent of cases are diagnosed in men over age 65. The average age at the time of diagnosis is 65. Race Race is another major risk factor. In the United States, this disease is much more common in African American men than in any other group of men. It is least common in Asian and American Indian men. Family History A man's risk for developing prostate cancer is higher if his father or brother has had the disease. Other Risk Factors Scientists have wondered whether obesity, lack of exercise, smoking, radiation exposure, might increase risk. But at this time, there is no firm evidence that these factors contribute to an increased risk. Symptoms and Tests Symptoms Most cancers in their early, most treatable stages don't cause any symptoms. Early prostate cancer usually does not cause symptoms. However, if prostate cancer develops and is not treated, it can cause these symptoms: - a need to urinate frequently, especially at night - difficulty starting urination or holding back urine - inability to urinate - weak or interrupted flow of urine - painful or burning urination - difficulty in having an erection - painful ejaculation - blood in urine or semen - pain or stiffness in the lower back, hips, or upper thighs. a need to urinate frequently, especially at night difficulty starting urination or holding back urine inability to urinate weak or interrupted flow of urine painful or burning urination difficulty in having an erection painful ejaculation blood in urine or semen pain or stiffness in the lower back, hips, or upper thighs. Any of these symptoms may be caused by cancer, but more often they are due to enlargement of the prostate, which is not cancer. If You Have Symptoms If you have any of these symptoms, see your doctor or a urologist to find out if you need treatment. A urologist is a doctor who specializes in treating diseases of the genitourinary system. The doctor will ask questions about your medical history and perform an exam to try to find the cause of the prostate problems. The PSA Test The doctor may also suggest a blood test to check your prostate specific antigen, or PSA, level. PSA levels can be high not only in men who have prostate cancer, but also in men with an enlarged prostate gland and men with infections of the prostate. PSA tests may be very useful for early cancer diagnosis. However, PSA tests alone do not always tell whether or not cancer is present. PSA screening for prostate cancer is not perfect. (Screening tests check for disease in a person who shows no symptoms.) Most men with mildly elevated PSA do not have prostate cancer, and many men with prostate cancer have normal levels of PSA. A recent study revealed that men with low prostate specific antigen levels, or PSA, may still have prostate cancer. Also, the digital rectal exam can miss many prostate cancers. Other Tests The doctor may order other exams, including ultrasound, MRI, or CT scans, to learn more about the cause of the symptoms. But to confirm the presence of cancer, doctors must perform a biopsy. During a biopsy, the doctor uses needles to remove small tissue samples from the prostate and then looks at the samples under a microscope. If Cancer is Present If a biopsy shows that cancer is present, the doctor will report on the grade of the tumor. Doctors describe a tumor as low, medium, or high-grade cancer, based on the way it appears under the microscope. One way of grading prostate cancer, called the Gleason system, uses scores of 2 to 10. Another system uses G1 through G4. The higher the score, the higher the grade of the tumor. High-grade tumors grow more quickly and are more likely to spread than low-grade tumors. Planning Treatment If tests show that you have cancer, you should talk with your doctor in order to make treatment decisions. Working With a Team of Specialists A team of specialists often treats people with cancer. The team will keep the primary doctor informed about the patient's progress. The team may include a medical oncologist who is a specialist in cancer treatment, a surgeon, a radiation oncologist who is a specialist in radiation therapy, and others. Before starting treatment, you may want another doctor to review the diagnosis and treatment plan. Some insurance companies require a second opinion. Others may pay for a second opinion if you request it. Clinical Trials for Prostate Cancer Some prostate cancer patients take part in studies of new treatments. These studies -- called clinical trials -- are designed to find out whether a new treatment is safe and effective. Often, clinical trials compare a new treatment with a standard one so that doctors can learn which is more effective. Men with prostate cancer who are interested in taking part in a clinical trial should talk with their doctor. The U.S. National Institutes of Health, through its National Library of Medicine and other Institutes, maintains a database of clinical trials at ClinicalTrials.gov. Click here to see a list of the current clinical trials on prostate cancer. A separate window will open. Click the \"x\" in the upper right hand corner of the \"Clinical Trials\" window to return here. Staging What is Staging? If cancer is found in the prostate, the doctor needs to know the stage of the disease and the grade of the tumor. Staging is a careful attempt to find out whether the cancer has spread and, if so, what parts of the body are affected. The grade tells how closely the tumor resembles normal tissue in appearance under the microscope. Doctors use various blood and imaging tests to learn the stage of the disease. Imaging tests, such as ultrasound, CT scans, and magnetic resonance imaging, or MRI, produce pictures of images inside the body. In 2013, a product called UroNav was introduced. Resembling a stylized computer workstation on wheels, UroNav electronically fuses together pictures from magnetic resonance imaging (MRI) and ultrasound to create a detailed, three-dimensional view of the prostate. This image helps doctors more precisely target the area in the prostate gland that needs to be biopsied. Stages of Prostate Cancer There are four stages used to describe prostate cancer. Doctors may refer to the stages using the Roman numerals I-IV or the capital letters A-D. The higher the stage, the more advanced the cancer. Following are the main features of each stage. Stage I or Stage A -- The cancer is too small to be felt during a rectal exam and causes no symptoms. The doctor may find it by accident when performing surgery for another reason, usually an enlarged prostate. There is no evidence that the cancer has spread outside the prostate. A sub-stage, T1c, is a tumor identified by needle biopsy because of elevated PSA. Stage II or Stage B -- The tumor is still confined to the prostate but involves more tissue within the prostate. The cancer is large enough to be felt during a rectal exam, or it may be found through a biopsy that is done because of a high PSA level. There is no evidence that the cancer has spread outside the prostate. Stage III or Stage C -- The cancer has spread outside the prostate to nearby tissues. A man may be experiencing symptoms, such as problems with urination. Stage IV or Stage D -- The cancer has spread to lymph nodes or to other parts of the body. The bones are a common site of spread of prostate cancer. There may be problems with urination, fatigue, and weight loss. Standard Treatments Choosing Treatment There are a number of ways to treat prostate cancer, and the doctor will develop a treatment to fit each man's needs. The choice of treatment mostly depends on the stage of the disease and the grade of the tumor. But doctors also consider a man's age, general health, and his feelings about the treatments and their possible side effects. Treatment for prostate cancer may involve watchful waiting, surgery, radiation therapy, or hormonal therapy. Some men receive a combination of therapies. A cure is the goal for men whose prostate cancer is diagnosed early. Weighing Treatment Options You and your doctor will want to consider both the benefits and possible side effects of each option, especially the effects on sexual activity and urination, and other concerns about quality of life. Surgery, radiation therapy, and hormonal therapy all have the potential to disrupt sexual desire or performance for a short while or permanently. Discuss your concerns with your health care provider. Several options are available to help you manage sexual problems related to prostate cancer treatment. Watchful Waiting The doctor may suggest watchful waiting for some men who have prostate cancer that is found at an early stage and appears to be growing slowly. Also, watchful waiting may be advised for older men or men with other serious medical problems. For these men, the risks and possible side effects of surgery, radiation therapy, or hormonal therapy may outweigh the possible benefits. Doctors monitor these patients with regular check-ups. If symptoms appear or get worse, the doctor may recommend active treatment. Surgery Surgery is used to remove the cancer. It is a common treatment for early stage prostate cancer. The surgeon may remove the entire prostate with a type of surgery called radical prostatectomy or, in some cases, remove only part of it. Sometimes the surgeon will also remove nearby lymph nodes. Side effects of the operation may include lack of sexual function or impotence, or problems holding urine or incontinence. Improvements in surgery now make it possible for some men to keep their sexual function. In some cases, doctors can use a technique known as nerve-sparing surgery. This may save the nerves that control erection. However, men with large tumors or tumors that are very close to the nerves may not be able to have this surgery. Some men with trouble holding urine may regain control within several weeks of surgery. Others continue to have problems that require them to wear a pad. Radiation Therapy Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Doctors may recommend it instead of surgery, or after surgery, to destroy any cancer cells that may remain in the area. In advanced stages, the doctor may recommend radiation to relieve pain or other symptoms. It may also be used in combination with hormonal therapy. Radiation can cause problems with impotence and bowel function. The radiation may come from a machine, which is external radiation, or from tiny radioactive seeds placed inside or near the tumor, which is internal radiation. Men who receive only the radioactive seeds usually have small tumors. Some men receive both kinds of radiation therapy. For external radiation therapy, patients go to the hospital or clinic -- usually for several weeks. Internal radiation may require patients to stay in the hospital for a short time. Hormonal Therapy Hormonal therapy deprives cancer cells of the male hormones they need to grow and survive. This treatment is often used for prostate cancer that has spread to other parts of the body. Sometimes doctors use hormonal therapy to try to keep the cancer from coming back after surgery or radiation treatment. Side effects can include impotence, hot flashes, loss of sexual desire, and thinning of bones. Some hormone therapies increase the risk of blood clots. Monitoring Treatment Regardless of the type of treatment you receive, you will be closely monitored to see how well the treatment is working. Monitoring may include - a PSA blood test -- usually every 3 months to 1 year. - bone scan and/or CT scan to see if the cancer has spread. - a complete blood count to monitor for signs and symptoms of anemia. - looking for signs or symptoms that the disease might be progressing, such as fatigue, increased pain, or decreased bowel and bladder function. a PSA blood test -- usually every 3 months to 1 year. bone scan and/or CT scan to see if the cancer has spread. a complete blood count to monitor for signs and symptoms of anemia. looking for signs or symptoms that the disease might be progressing, such as fatigue, increased pain, or decreased bowel and bladder function. Latest Research Scientists continue to look at new ways to prevent, treat, and diagnose prostate cancer. Research has already led to a number of advances in these areas. Dietary Research Several studies are under way to explore the causes of prostate cancer. Some researchers think that diet may affect a man's chances of developing prostate cancer. For example, some studies show that prostate cancer is more common in populations that consume a high-fat diet, particularly animal fat, and in populations with diets that lack certain nutrients. Research on Testosterone Some research suggests that high levels of testosterone may increase a man's risk of prostate cancer. The difference in prostate cancer risk among racial groups could be related to high testosterone levels, but it also could result from diet or other lifestyle factors. Genetic Research Researchers are studying changes in genes that may increase the risk for developing prostate cancer. Some studies are looking at the genes of men who were diagnosed with prostate cancer at a relatively young age, such as less than 55 years old, and the genes of families who have several members with the disease. Other studies are trying to identify which genes, or arrangements of genes, are most likely to lead to prostate cancer. Much more work is needed, however, before scientists can say exactly how genetic changes relate to prostate cancer. Prevention Research Several studies have explored ways to prevent prostate cancer. In October 2008, initial results of a study on the use of the dietary supplements vitamin E and selenium found that they did not provide any benefit in reducing the number of new cases of the disease. A few studies suggest that a diet that regularly includes tomato-based foods may help protect men from prostate cancer, but there are no studies that conclusively prove this hypothesis. According to results of a study that was re-analyzed in 2013, men who took finasteride, a drug that affects male hormone levels, reduced their chances of getting prostate cancer by nearly 30 percent compared to men who took a placebo. Unlike earlier findings from this study, this new analysis showed no increased risk of late stage disease due to use of finasteride. Stopping Prostate Cancer from Returning Scientists are also looking at ways to stop prostate cancer from returning in men who have already been treated for the disease. These approaches use drugs such as finasteride, flutamide, nilutamide, and LH-RH agonists that manipulate hormone levels. In 2010, the FDA approved a therapeutic cancer vaccine, Provenge, for use in some men with metastatic prostate cancer. Provenge may provide a 4-month improvement in overall survival compared with a placebo vaccine. Other similar vaccine therapies are in development. Research on New Blood Tests Some researchers are working to develop new blood tests to detect the antibodies that the immune system produces to fight prostate cancer. When used along with PSA testing, the antibody tests may provide more accurate results about whether or not a man has prostate cancer. Researching New Approaches to Treatment Through research, doctors are trying to find new, more effective ways to treat prostate cancer. Cryosurgery -- destroying cancer by freezing it -- is under study as an alternative to surgery and radiation therapy. To avoid damaging healthy tissue, the doctor places an instrument known as a cryoprobe in direct contact with the tumor to freeze it. Doctors are studying new ways of using radiation therapy and hormonal therapy, too. Studies have shown that hormonal therapy given after radiation therapy can help certain men whose cancer has spread to nearby tissues. Scientists are also testing the effectiveness of chemotherapy and biological therapy for men whose cancer does not respond, or stops responding, to hormonal therapy. They are also exploring new ways to schedule and combine various treatments. For example, they are studying hormonal therapy to find out if using it to shrink the tumor before a man has surgery or radiation might be a useful approach. For men with early stage prostate cancer, researchers are also comparing treatment with watchful waiting. The results of this work will help doctors know whether to treat early stage prostate cancer immediately or only later on, if symptoms occur or worsen. Frequently Asked Questions What is cancer? The body is made up of many types of cells. Normally, cells grow, divide, and produce more cells as needed to keep the body healthy. Sometimes, however, the process goes wrong -- cells become abnormal and form more cells in an uncontrolled way. These extra cells form a mass of tissue, called a growth or tumor. Tumors can be benign, which means not cancerous, or malignant, which means cancerous. What is prostate cancer? The prostate is a male sex gland, about the size of a large walnut. It is located below the bladder and in front of the rectum. The prostate's main function is to make fluid for semen, a white substance that carries sperm. Prostate cancer occurs when a tumor forms in the tissue of the prostate. In its early stage, prostate cancer needs the male hormone testosterone to grow and survive. How common is prostate cancer among men in the United States? Prostate cancer is one of the most common types of cancer among American men. It is a slow-growing disease that mostly affects older men. In fact, more than 60 percent of all prostate cancers are found in men over the age of 65. The disease rarely occurs in men younger than 40 years of age. What is metastatic prostate cancer? Sometimes, cancer cells break away from the malignant tumor in the prostate and enter the bloodstream or the lymphatic system and travel to other organs in the body. When cancer spreads from its original location in the prostate to another part of the body such as the bone, it is called metastatic prostate cancer, not bone cancer. Doctors sometimes call this \"distant\" disease. Can a man survive prostate cancer? Yes. Today, more men are surviving prostate cancer than ever before. In fact, the number of deaths from prostate cancer has been declining since the early 1990s. If found early, the disease can very likely be cured. What causes prostate cancer? Scientists don't know exactly what causes prostate cancer. They cannot explain why one man gets prostate cancer and another does not. However, they have been able to identify some risk factors that are associated with the disease. A risk factor is anything that increases your chances of getting a disease. What is the most important risk factor for prostate cancer? Age is the most important risk factor for prostate cancer. The disease is extremely rare in men under age 40, but the risk increases greatly with age. More than 60 percent of cases are diagnosed in men over age 65. The average age at the time of diagnosis is 65. Are there other major risk factors for prostate cancer besides age? Yes. Race is another major risk factor. In the United States, this disease is much more common in African American men than in any other group of men. It is least common in Asian and American Indian men. A man's risk for developing prostate cancer is higher if his father or brother has had the disease. Diet also may play a role. There is some evidence that a diet high in animal fat may increase the risk of prostate cancer and a diet high in fruits and vegetables may decrease the risk. Studies to find out whether men can reduce their risk of prostate cancer by taking certain dietary supplements are ongoing. Are conditions like an enlarged prostate or obesity risk factors for prostate cancer? Scientists have wondered whether obesity, lack of exercise, smoking, and radiation exposure, might increase risk. But at this time, there is no conclusive evidence that any of these factors contribute to an increased risk. What are the symptoms of prostate cancer? - a need to urinate frequently, especially at night - difficulty starting urination or holding back urine - inability to urinate - weak or interrupted flow of urine a need to urinate frequently, especially at night difficulty starting urination or holding back urine inability to urinate weak or interrupted flow of urine If prostate cancer develops and is not treated, it can cause these symptoms: - painful or burning urination - difficulty in having an erection - painful ejaculation - blood in urine or semen - pain or stiffness in the lower back, hips, or upper thighs painful or burning urination difficulty in having an erection painful ejaculation blood in urine or semen pain or stiffness in the lower back, hips, or upper thighs Are there other conditions that have symptoms like prostate cancer? Yes. Any of the symptoms caused by prostate cancer may also be due to enlargement of the prostate, which is not cancer. If you have any of the symptoms mentioned in question #10, see your doctor or a urologist to find out if you need treatment. A urologist is a doctor who specializes in treating diseases of the genitourinary system. What tests are available for men who have prostate problems? Doctors use tests to detect prostate abnormalities, but tests cannot show whether abnormalities are cancer or another, less serious condition. The results from these tests will help the doctor decide whether to check the patient further for signs of cancer. The most common test is a blood test for prostate specific antigen or PSA -- a lab measures the levels of PSA in a blood sample. The level of PSA may rise in men who have prostate cancer, an enlarged prostate, or infection in the prostate. If initial tests show that prostate cancer might be present, what happens next? The doctor may order other exams, including ultrasound, MRI, or CT scans, to learn more about the cause of the symptoms. But to confirm the presence of cancer, doctors must perform a biopsy. During a biopsy, the doctor uses needles to remove small tissue samples from the prostate and then looks at the samples under a microscope. If a biopsy shows that cancer is present, the doctor will report on the grade of the tumor. Doctors describe a tumor as low, medium, or high-grade cancer, based on the way it appears under the microscope. If prostate cancer is found, how do doctors describe how far the cancer has spread? If cancer is found in the prostate, the doctor needs to stage the disease. Staging is a careful attempt to find out whether the cancer has spread and, if so, what parts of the body are affected. The doctor also needs to find out the grade of the cancer. The grade tells how closely the tumor resembles normal tissue. There are four stages used to describe prostate cancer. Doctors may refer to the stages using Roman numerals I-IV or capital letters A-D. The higher the stage, the more advanced the cancer. Following are the main features of each stage. Stage I or Stage A -- The cancer is too small to be felt during a rectal exam and causes no symptoms. The doctor may find it by accident when performing surgery for another reason, usually an enlarged prostate. There is no evidence that the cancer has spread outside the prostate. A sub-stage, T1c, is a tumor identified by needle biopsy because of elevated PSA. Stage II or Stage B -- The tumor is still confined to the prostate but involves more tissue within the prostate. The cancer is large enough to be felt during a rectal exam, or it may be found through a biopsy that is done because of a high PSA level. There is no evidence that the cancer has spread outside the prostate. Stage III or Stage C -- The cancer has spread outside the prostate to nearby tissues. The person may be experiencing symptoms, such as problems with urination. Stage IV or Stage D -- The cancer has spread to lymph nodes or to other parts of the body. There may be problems with urination, fatigue, and weight loss. If I do need to seek treatment for prostate cancer, what are some of my options? There are a number of ways to treat prostate cancer, and the doctor will develop a treatment to fit each man's needs. The choice of treatment mostly depends on the stage of the disease and the grade of the tumor. But doctors also consider a man's age, general health, and his feelings about the treatments and their possible side effects. Treatment for prostate cancer may involve watchful waiting, surgery, radiation therapy, or hormonal therapy. Some men receive a combination of therapies. A cure is probable for men whose prostate cancer is diagnosed early. What are some of the side effects of these treatments? Surgery, radiation therapy, and hormonal therapy all have the potential to disrupt sexual desire or performance for a short while or permanently. Discuss your concerns with your health care provider. Several options are available to help you manage sexual problems related to prostate cancer treatment. What is \"watchful waiting\" and why would I choose it as a treatment? With watchful waiting, a man's condition is closely monitored, but treatment does not begin until symptoms appear or change. The doctor may suggest watchful waiting for some men who have prostate cancer that is found at an early stage and appears to be growing slowly. Also, watchful waiting may be advised for older men or men with other serious medical problems. For these men, the risks and possible side effects of surgery, radiation therapy, or hormonal therapy may outweigh the possible benefits. Doctors monitor these patients with regular check-ups. If symptoms appear or get worse, the doctor may recommend active treatment. What types of surgery are available for men with prostate cancer? Surgery is a common treatment for early stage prostate cancer. It is used to remove the cancer. The surgeon may remove the entire prostate -- a type of surgery called radical prostatectomy -- or, in some cases, remove only part of it. Sometimes the surgeon will also remove nearby lymph nodes. Side effects may include lack of sexual function (impotence), or problems holding urine (incontinence). How is radiation used to treat prostate cancer? Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Doctors may recommend it instead of surgery or after surgery to destroy any cancer cells that may remain in the area. In advanced stages, the doctor may recommend it to relieve pain or other symptoms. Radiation can cause problems with impotence and bowel function. The radiation may come from a machine, which is external radiation, or from tiny radioactive seeds placed inside or near the tumor, which is internal radiation. Men who receive only the radioactive seeds usually have small tumors. Some men receive both kinds of radiation therapy. For external radiation therapy, patients go to the hospital or clinic -- usually 5 days a week for several weeks. Internal radiation may require patients to stay in the hospital for a short time. How is hormonal therapy used to treat prostate cancer? Hormonal therapy deprives cancer cells of the male hormones they need to grow and survive. This treatment is often used for prostate cancer that has spread to other parts of the body. Sometimes doctors use hormonal therapy to try to keep the cancer from coming back after surgery or radiation treatment. Side effects can include impotence, hot flashes, loss of sexual desire, and thinning of bones. What kinds of follow-up treatment could I have? Regardless of the type of treatment you receive, you will be closely monitored to see how well the treatment is working. Monitoring may include - a PSA blood test, usually every 3 months to 1 year. - bone scan and/or CT scan to see if the cancer has spread. a PSA blood test, usually every 3 months to 1 year. bone scan and/or CT scan to see if the cancer has spread. - a complete blood count to monitor for signs and symptoms of anemia. - looking for signs or symptoms that the disease might be progressing, such as fatigue, increased pain, or decreased bowel and bladder function. a complete blood count to monitor for signs and symptoms of anemia. looking for signs or symptoms that the disease might be progressing, such as fatigue, increased pain, or decreased bowel and bladder function. What kinds of treatments for prostate cancer are being developed? Through research, doctors are trying to find new, more effective ways to treat prostate cancer. Cryosurgery -- destroying cancer by freezing it -- is under study as an alternative to surgery and radiation therapy. To avoid damaging healthy tissue, the doctor places an instrument known as a cryoprobe in direct contact with the tumor to freeze it. Doctors are studying new ways of using radiation therapy and hormonal therapy, too. Studies have shown that hormonal therapy given after radiation therapy can help certain men whose cancer has spread to nearby tissues. Scientists are also testing the effectiveness of chemotherapy and biological therapy for men whose cancer does not respond or stops responding to hormonal therapy. They are also exploring new ways to schedule and combine various treatments. For example, they are studying hormonal therapy to find out if using it to shrink the tumor before a man has surgery or radiation might be a useful approach. They are also testing combinations of hormone therapy and vaccines to prevent recurrence of prostate cancer. In 2010, the FDA approved a therapeutic cancer vaccine, Provenge, for use in some men with metastatic prostate cancer. This approval was based on the results of a clinical trial that demonstrated a more than 4-month improvement in overall survival compared with a placebo vaccine. Other similar vaccine therapies are in development. Are there genes that put me at greater risk of getting prostate cancer? Researchers are studying changes in genes that may increase the risk for developing prostate cancer. Some studies are looking at the genes of men who were diagnosed with prostate cancer at a relatively young age, less than 55 years old, and the genes of families who have several members with the disease. Other studies are trying to identify which genes, or arrangements of genes, are most likely to lead to prostate cancer. Much more work is needed, however, before scientists can say exactly how genetic changes relate to prostate cancer. At the moment, no genetic risk has been firmly established. Are there other options for someone with prostate cancer? Some prostate cancer patients take part in studies of new treatments. These studies -- called clinical trials -- are designed to find out whether a new treatment is safe and effective. Often, clinical trials compare a new treatment with a standard one so that doctors can learn which is more effective. People with prostate cancer who are interested in taking part in a clinical trial should talk with their doctor. The U.S. National Institutes of Health, through its National Library of Medicine and other Institutes, maintains a database of clinical trials at ClinicalTrials.gov. Click here to see a list of the current clinical trials on prostate cancer. A separate window will open. Click the \"x\" in the upper right hand corner of the \"Clinical Trials\" window to return here. What role do diet and dietary supplements play in prostate cancer? One study, called SELECT, found that men taking the dietary supplements vitamin E and/or selenium saw no reduction in their risk of getting prostate cancer. At the moment, no dietary factor has been proven to change your risk of developing prostate cancer or to alter the course of the disease after diagnosis. Who can provide emotional support for someone dealing with prostate cancer? Living with a serious disease such as cancer is not easy. Some people find they need help coping with the emotional as well as the practical aspects of their disease. Patients often get together in support groups where they can share what they have learned about coping with their disease and the effects of treatment. Patients may want to talk with a member of their health care team about finding a support group. People living with cancer may worry about caring for their families, keeping their jobs, or continuing daily activities. Concerns about treatments and managing side effects, hospital stays, and medical bills are also common. Doctors, nurses, dietitians, and other members of the health care team can answer questions about treatment, working, or other activities. Meeting with a social worker, counselor, or member of the clergy can be helpful to those who want to talk about their feelings or discuss their concerns. Often, a social worker can suggest resources for help with rehabilitation, emotional support, financial aid, transportation, or home care. It is natural for a man and his partner to be concerned about the effects of prostate cancer and its treatment on their sexual relationship. They may want to talk with the doctor about possible side effects and whether these are likely to be temporary or permanent. Whatever the outlook, it is usually helpful for patients and their partners to talk about their concerns and help one another find ways to be intimate during and after treatment. ", "role": "user" }, { "content": "Early prostate cancer may not cause any symptoms. However, if prostate cancer develops and is not treated, symptoms will emerge. These include the need to urinate frequently, difficulty starting urination, inability to urinate, painful urination, painful ejaculation, blood in urine or semen, or stiffness in the lower back, hips, or upper thighs.", "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": "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", "role": "assistant" } ]

[ { "content": "Absence seizures Does any damage occurre from these spells. Mental or physical\n\nAbsence seizure: An absence seizure is the term for a type of seizure involving staring spells. This type of seizure is a brief (usually less than 15 seconds) disturbance of brain function due to abnormal electrical activity in the brain. Absence seizures occur most often in people under age 20, usually in children ages 6 to 12. In some cases, the seizures are triggered by flashing lights or when the person breathes faster and more deeply than usual (hyperventilates). They may occur with other types of seizures, such as generalized tonic-clonic seizures (grand mal seizures), twitches or jerks (myoclonus), or sudden loss of muscle strength (atonic seizures). Most absence seizures last only a few seconds. They often involve staring episodes. The episodes may: - Occur many times a day - Occur for weeks to months before being noticed - Interfere with school and learning - Be mistaken for lack of attention, daydreaming or other misbehavior Unexplained difficulties in school and learning difficulties may be the first sign of absence seizures. During the seizure, the person may: - Stop walking and start again a few seconds later - Stop talking in mid-sentence and start again a few seconds later The person usually does not fall during the seizure. Right after the seizure, the person is usually: - Wide awake - Thinking clearly - Unaware of the seizure Specific symptoms of typical absence seizures may include: - Changes in muscle activity, such as no movement, hand fumbling, fluttering eyelids, lip smacking, chewing - Changes in alertness (consciousness), such as staring episodes, lack of awareness of surroundings, sudden halt in movement, talking, and other awake activities Some absence seizures begin slower and last longer. These are called atypical absence seizures. Symptoms are similar to regular absence seizures, but muscle activity changes may be more noticeable. The doctor will perform a physical exam. This will include a detailed look at the brain and nervous system. An EEG (electroencephalogram) will be done to check the electrical activity in the brain. People with seizures often have abnormal electrical activity seen on this test. In some cases, the test shows the area in the brain where the seizures start. The brain may appear normal after a seizure or between seizures. Blood tests may also be ordered to check for other health problems that may be causing the seizures. Head CT or MRI scan may be done to find the cause and location of the problem in the brain. Treatment for absence seizures includes medicines, changes in lifestyle for adults and children, such as activity and diet, and sometimes surgery. Your doctor can tell you more about these options. Updated by: Amit M. Shelat, DO, FACP, Attending Neurologist and Assistant Professor of Clinical Neurology, SUNY Stony Brook, School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.", "role": "user" }, { "content": "Most absence seizures last only a few seconds. They often involve staring episodes. The episodes may: - Occur many times a day - Occur for weeks to months before being noticed - Interfere with school and learning - Be mistaken for lack of attention, daydreaming or other misbehavior Unexplained difficulties in school and learning difficulties may be the first sign of absence seizures.", "role": "assistant" } ]

[ { "content": "what causes bipolar disorder\n\n Bipolar disorder Overview Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts to mania or hypomania (less extreme than mania), you may feel euphoric, full of energy or unusually irritable. These mood swings can affect sleep, energy, activity, judgment, behavior and the ability to think clearly. Episodes of mood swings may occur rarely or multiple times a year. While most people will experience some emotional symptoms between episodes, some may not experience any. Although bipolar disorder is a lifelong condition, you can manage your mood swings and other symptoms by following a treatment plan. In most cases, bipolar disorder is treated with medications and psychological counseling (psychotherapy). Bipolar disorder care at Mayo Clinic Symptoms There are several types of bipolar and related disorders. They may include mania or hypomania and depression. Symptoms can cause unpredictable changes in mood and behavior, resulting in significant distress and difficulty in life. - Bipolar I disorder. You've had at least one manic episode that may be preceded or followed by hypomanic or major depressive episodes. In some cases, mania may trigger a break from reality (psychosis). - Bipolar II disorder. You've had at least one major depressive episode and at least one hypomanic episode, but you've never had a manic episode. - Cyclothymic disorder. You've had at least two years - or one year in children and teenagers - of many periods of hypomania symptoms and periods of depressive symptoms (though less severe than major depression). - Other types. These include, for example, bipolar and related disorders induced by certain drugs or alcohol or due to a medical condition, such as Cushing's disease, multiple sclerosis or stroke. Bipolar II disorder is not a milder form of bipolar I disorder, but a separate diagnosis. While the manic episodes of bipolar I disorder can be severe and dangerous, individuals with bipolar II disorder can be depressed for longer periods, which can cause significant impairment. Although bipolar disorder can occur at any age, typically it's diagnosed in the teenage years or early 20s. Symptoms can vary from person to person, and symptoms may vary over time. Mania and hypomania Mania and hypomania are two distinct types of episodes, but they have the same symptoms. Mania is more severe than hypomania and causes more noticeable problems at work, school and social activities, as well as relationship difficulties. Mania may also trigger a break from reality (psychosis) and require hospitalization. Both a manic and a hypomanic episode include three or more of these symptoms: - Abnormally upbeat, jumpy or wired - Increased activity, energy or agitation - Exaggerated sense of well-being and self-confidence (euphoria) - Decreased need for sleep - Unusual talkativeness - Racing thoughts - Distractibility - Poor decision-making - for example, going on buying sprees, taking sexual risks or making foolish investments Major depressive episode A major depressive episode includes symptoms that are severe enough to cause noticeable difficulty in day-to-day activities, such as work, school, social activities or relationships. An episode includes five or more of these symptoms: - Depressed mood, such as feeling sad, empty, hopeless or tearful (in children and teens, depressed mood can appear as irritability) - Marked loss of interest or feeling no pleasure in all - or almost all - activities - Significant weight loss when not dieting, weight gain, or decrease or increase in appetite (in children, failure to gain weight as expected can be a sign of depression) - Either insomnia or sleeping too much - Either restlessness or slowed behavior - Fatigue or loss of energy - Feelings of worthlessness or excessive or inappropriate guilt - Decreased ability to think or concentrate, or indecisiveness - Thinking about, planning or attempting suicide Other features of bipolar disorder Signs and symptoms of bipolar I and bipolar II disorders may include other features, such as anxious distress, melancholy, psychosis or others. The timing of symptoms may include diagnostic labels such as mixed or rapid cycling. In addition, bipolar symptoms may occur during pregnancy or change with the seasons. Symptoms in children and teens Symptoms of bipolar disorder can be difficult to identify in children and teens. It's often hard to tell whether these are normal ups and downs, the results of stress or trauma, or signs of a mental health problem other than bipolar disorder. Children and teens may have distinct major depressive or manic or hypomanic episodes, but the pattern can vary from that of adults with bipolar disorder. And moods can rapidly shift during episodes. Some children may have periods without mood symptoms between episodes. The most prominent signs of bipolar disorder in children and teenagers may include severe mood swings that are different from their usual mood swings. When to see a doctor Despite the mood extremes, people with bipolar disorder often don't recognize how much their emotional instability disrupts their lives and the lives of their loved ones and don't get the treatment they need. And if you're like some people with bipolar disorder, you may enjoy the feelings of euphoria and cycles of being more productive. However, this euphoria is always followed by an emotional crash that can leave you depressed, worn out - and perhaps in financial, legal or relationship trouble. If you have any symptoms of depression or mania, see your doctor or mental health professional. Bipolar disorder doesn't get better on its own. Getting treatment from a mental health professional with experience in bipolar disorder can help you get your symptoms under control. When to get emergency help Suicidal thoughts and behavior are common among people with bipolar disorder. If you have thoughts of hurting yourself, call 911 or your local emergency number immediately, go to an emergency room, or confide in a trusted relative or friend. Or call a suicide hotline number - in the United States, call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255). If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room. Causes The exact cause of bipolar disorder is unknown, but several factors may be involved, such as: - Biological differences. People with bipolar disorder appear to have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes. - Genetics. Bipolar disorder is more common in people who have a first-degree relative, such as a sibling or parent, with the condition. Researchers are trying to find genes that may be involved in causing bipolar disorder. Risk factors Factors that may increase the risk of developing bipolar disorder or act as a trigger for the first episode include: - Having a first-degree relative, such as a parent or sibling, with bipolar disorder - Periods of high stress, such as the death of a loved one or other traumatic event - Drug or alcohol abuse Complications Left untreated, bipolar disorder can result in serious problems that affect every area of your life, such as: - Problems related to drug and alcohol use - Suicide or suicide attempts - Legal or financial problems - Damaged relationships - Poor work or school performance Co-occurring conditions If you have bipolar disorder, you may also have another health condition that needs to be treated along with bipolar disorder. Some conditions can worsen bipolar disorder symptoms or make treatment less successful. Examples include: - Anxiety disorders - Eating disorders - Attention-deficit/hyperactivity disorder (ADHD) - Alcohol or drug problems - Physical health problems, such as heart disease, thyroid problems, headaches or obesity Diagnosis To determine if you have bipolar disorder, your evaluation may include: - Physical exam. Your doctor may do a physical exam and lab tests to identify any medical problems that could be causing your symptoms. - Psychiatric assessment. Your doctor may refer you to a psychiatrist, who will talk to you about your thoughts, feelings and behavior patterns. You may also fill out a psychological self-assessment or questionnaire. With your permission, family members or close friends may be asked to provide information about your symptoms. - Mood charting. You may be asked to keep a daily record of your moods, sleep patterns or other factors that could help with diagnosis and finding the right treatment. - Criteria for bipolar disorder. Your psychiatrist may compare your symptoms with the criteria for bipolar and related disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. Diagnosis in children Although diagnosis of children and teenagers with bipolar disorder includes the same criteria that are used for adults, symptoms in children and teens often have different patterns and may not fit neatly into the diagnostic categories. Also, children who have bipolar disorder are frequently also diagnosed with other mental health conditions such as attention-deficit/hyperactivity disorder (ADHD) or behavior problems, which can make diagnosis more complicated. Referral to a child psychiatrist with experience in bipolar disorder is recommended. Treatment Treatment is best guided by a medical doctor who specializes in diagnosing and treating mental health conditions (psychiatrist) who is skilled in treating bipolar and related disorders. You may have a treatment team that also includes a psychologist, social worker and psychiatric nurse. Bipolar disorder is a lifelong condition. Treatment is directed at managing symptoms. Depending on your needs, treatment may include: - Medications. Often, you'll need to start taking medications to balance your moods right away. - Continued treatment. Bipolar disorder requires lifelong treatment with medications, even during periods when you feel better. People who skip maintenance treatment are at high risk of a relapse of symptoms or having minor mood changes turn into full-blown mania or depression. - Day treatment programs. Your doctor may recommend a day treatment program. These programs provide the support and counseling you need while you get symptoms under control. - Substance abuse treatment. If you have problems with alcohol or drugs, you'll also need substance abuse treatment. Otherwise, it can be very difficult to manage bipolar disorder. - Hospitalization. Your doctor may recommend hospitalization if you're behaving dangerously, you feel suicidal or you become detached from reality (psychotic). Getting psychiatric treatment at a hospital can help keep you calm and safe and stabilize your mood, whether you're having a manic or major depressive episode. The primary treatments for bipolar disorder include medications and psychological counseling (psychotherapy) to control symptoms, and also may include education and support groups. Medications A number of medications are used to treat bipolar disorder. The types and doses of medications prescribed are based on your particular symptoms. Medications may include: - Mood stabilizers. You'll typically need mood-stabilizing medication to control manic or hypomanic episodes. Examples of mood stabilizers include lithium (Lithobid), valproic acid (Depakene), divalproex sodium (Depakote), carbamazepine (Tegretol, Equetro, others) and lamotrigine (Lamictal). - Antipsychotics. If symptoms of depression or mania persist in spite of treatment with other medications, adding an antipsychotic drug such as olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel), aripiprazole (Abilify), ziprasidone (Geodon), lurasidone (Latuda) or asenapine (Saphris) may help. Your doctor may prescribe some of these medications alone or along with a mood stabilizer. - Antidepressants. Your doctor may add an antidepressant to help manage depression. Because an antidepressant can sometimes trigger a manic episode, it's usually prescribed along with a mood stabilizer or antipsychotic. - Antidepressant-antipsychotic. The medication Symbyax combines the antidepressant fluoxetine and the antipsychotic olanzapine. It works as a depression treatment and a mood stabilizer. - Anti-anxiety medications. Benzodiazepines may help with anxiety and improve sleep, but are usually used on a short-term basis. Finding the right medication Finding the right medication or medications for you will likely take some trial and error. If one doesn't work well for you, there are several others to try. This process requires patience, as some medications need weeks to months to take full effect. Generally only one medication is changed at a time so that your doctor can identify which medications work to relieve your symptoms with the least bothersome side effects. Medications also may need to be adjusted as your symptoms change. Side effects Mild side effects often improve as you find the right medications and doses that work for you, and your body adjusts to the medications. Talk to your doctor or mental health professional if you have bothersome side effects. Don't make changes or stop taking your medications. If you stop your medication, you may experience withdrawal effects or your symptoms may worsen or return. You may become very depressed, feel suicidal, or go into a manic or hypomanic episode. If you think you need to make a change, call your doctor. Medications and pregnancy A number of medications for bipolar disorder can be associated with birth defects and can pass through breast milk to your baby. Certain medications, such as valproic acid and divalproex sodium, should not be used during pregnancy. Also, birth control medications may lose effectiveness when taken along with certain bipolar disorder medications. Discuss treatment options with your doctor before you become pregnant, if possible. If you're taking medication to treat your bipolar disorder and think you may be pregnant, talk to your doctor right away. Psychotherapy Psychotherapy is a vital part of bipolar disorder treatment and can be provided in individual, family or group settings. Several types of therapy may be helpful. These include: - Interpersonal and social rhythm therapy (IPSRT). IPSRT focuses on the stabilization of daily rhythms, such as sleeping, waking and mealtimes. A consistent routine allows for better mood management. People with bipolar disorder may benefit from establishing a daily routine for sleep, diet and exercise. - Cognitive behavioral therapy (CBT). The focus is identifying unhealthy, negative beliefs and behaviors and replacing them with healthy, positive ones. CBT can help identify what triggers your bipolar episodes. You also learn effective strategies to manage stress and to cope with upsetting situations. - Psychoeducation. Learning about bipolar disorder (psychoeducation) can help you and your loved ones understand the condition. Knowing what's going on can help you get the best support, identify issues, make a plan to prevent relapse and stick with treatment. - Family-focused therapy. Family support and communication can help you stick with your treatment plan and help you and your loved ones recognize and manage warning signs of mood swings. Other treatment options Depending on your needs, other treatments may be added to your depression therapy. During electroconvulsive therapy (ECT), electrical currents are passed through the brain, intentionally triggering a brief seizure. ECT seems to cause changes in brain chemistry that can reverse symptoms of certain mental illnesses. ECT may be an option for bipolar treatment if you don't get better with medications, can't take antidepressants for health reasons such as pregnancy or are at high risk of suicide. Transcranial magnetic stimulation (TMS) is being investigated as an option for those who haven't responded to antidepressants. Treatment in children and teenagers Treatments for children and teenagers are generally decided on a case-by-case basis, depending on symptoms, medication side effects and other factors. Generally, treatment includes: - Medications. Children and teens with bipolar disorder are often prescribed the same types of medications as those used in adults. There's less research on the safety and effectiveness of bipolar medications in children than in adults, so treatment decisions are often based on adult research. - Psychotherapy. Initial and long-term therapy can help keep symptoms from returning. Psychotherapy can help children and teens manage their routines, develop coping skills, address learning difficulties, resolve social problems, and help strengthen family bonds and communication. And, if needed, it can help treat substance abuse problems common in older children and teens with bipolar disorder. - Psychoeducation. Psychoeducation can include learning the symptoms of bipolar disorder and how they differ from behavior related to your child's developmental age, the situation and appropriate cultural behavior. Understanding about bipolar disorder can also help you support your child. - Support. Working with teachers and school counselors and encouraging support from family and friends can help identify services and encourage success. Lifestyle and home remedies You'll probably need to make lifestyle changes to stop cycles of behavior that worsen your bipolar disorder. Here are some steps to take: - Quit drinking or using recreational drugs. One of the biggest concerns with bipolar disorder is the negative consequences of risk-taking behavior and drug or alcohol abuse. Get help if you have trouble quitting on your own. - Form healthy relationships. Surround yourself with people who are a positive influence. Friends and family members can provide support and help you watch for warning signs of mood shifts. - Create a healthy routine. Having a regular routine for sleeping, eating and physical activity can help balance your moods. Check with your doctor before starting any exercise program. Eat a healthy diet. If you take lithium, talk with your doctor about appropriate fluid and salt intake. If you have trouble sleeping, talk to your doctor or mental health professional about what you can do. - Check first before taking other medications. Call the doctor who's treating you for bipolar disorder before you take medications prescribed by another doctor or any over-the-counter supplements or medications. Sometimes other medications trigger episodes of depression or mania or may interfere with medications you're taking for bipolar disorder. - Consider keeping a mood chart. Keeping a record of your daily moods, treatments, sleep, activities and feelings may help identify triggers, effective treatment options and when treatment needs to be adjusted. Alternative medicine There isn't much research on alternative or complementary medicine - sometimes called integrative medicine - and bipolar disorder. Most of the studies are on major depression, so it isn't clear how these nontraditional approaches work for bipolar disorder. If you choose to use alternative or complementary medicine in addition to your physician-recommended treatment, take some precautions first: - Don't stop taking your prescribed medications or skip therapy sessions. Alternative or complementary medicine is not a substitute for regular medical care when it comes to treating bipolar disorder. - Be honest with your doctors and mental health professionals. Tell them exactly which alternative or complementary treatments you use or would like to try. - Be aware of potential dangers. Alternative and complementary products aren't regulated the way prescription drugs are. Just because it's natural doesn't mean it's safe. Before using alternative or complementary medicine, talk to your doctor about the risks, including possible serious interactions with medications. ", "role": "user" }, { "content": "The exact cause of bipolar disorder is unknown, but several factors may be involved, such as: - Biological differences. People with bipolar disorder appear to have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes. - Genetics. Bipolar disorder is more common in people who have a first-degree relative, such as a sibling or parent, with the condition. Researchers are trying to find genes that may be involved in causing bipolar disorder. Factors that may increase the risk of developing bipolar disorder or act as a trigger for the first episode include: - Having a first-degree relative, such as a parent or sibling, with bipolar disorder - Periods of high stress, such as the death of a loved one or other traumatic event - Drug or alcohol abuse Left untreated, bipolar disorder can result in serious problems that affect every area of your life, such as: - Problems related to drug and alcohol use - Suicide or suicide attempts - Legal or financial problems - Damaged relationships - Poor work or school performance Co-occurring conditions If you have bipolar disorder, you may also have another health condition that needs to be treated along with bipolar disorder. Some conditions can worsen bipolar disorder symptoms or make treatment less successful. Examples include: - Anxiety disorders - Eating disorders - Attention-deficit/hyperactivity disorder (ADHD) - Alcohol or drug problems - Physical health problems, such as heart disease, thyroid problems, headaches or obesity", "role": "assistant" } ]

[ { "content": "how do i prevent myself from having dementia\n\nDementia: Dementia is not a specific disease. It is a descriptive term for a collection of symptoms that can be caused by a number of disorders that affect the brain. People with dementia have significantly impaired intellectual functioning that interferes with normal activities and relationships. They also lose their ability to solve problems and maintain emotional control, and they may experience personality changes and behavioral problems, such as agitation, delusions, and hallucinations. While memory loss is a common symptom of dementia, memory loss by itself does not mean that a person has dementia. Doctors diagnose dementia only if two or more brain functions - such as memory and language skills -- are significantly impaired without loss of consciousness.  Some of the diseases that can cause symptoms of dementia are Alzheimer’s disease, vascular dementia, Lewy body dementia, frontotemporal dementia, Huntington’s disease, and Creutzfeldt-Jakob disease.  Doctors have identified other conditions that can cause dementia or dementia-like symptoms including reactions to medications, metabolic problems and endocrine abnormalities, nutritional deficiencies, infections, poisoning, brain tumors, anoxia or hypoxia (conditions in which the brain’s oxygen supply is either reduced or cut off entirely), and heart and lung problems.  Although it is common in very elderly individuals, dementia is not a normal part of the aging process. Drugs to specifically treat Alzheimer’s disease and some other progressive dementias are now available.  Although these drugs do not halt the disease or reverse existing brain damage, they can improve symptoms and slow the progression of the disease. This may improve an individual’s quality of life, ease the burden on caregivers, or delay admission to a nursing home. Many researchers are also examining whether these drugs may be useful for treating other types of dementia.  Many people with dementia, particularly those in the early stages, may benefit from practicing tasks designed to improve performance in specific aspects of cognitive functioning. For example, people can sometimes be taught to use memory aids, such as mnemonics, computerized recall devices, or note taking. There are many disorders that can cause dementia. Some, such as Alzheimer’s disease or Huntington’s disease, lead to a progressive loss of mental functions. But other types of dementia can be halted or reversed with appropriate treatment. People with moderate or advanced dementia typically need round-the-clock care and supervision to prevent them from harming themselves or others. They also may need assistance with daily activities such as eating, bathing, and dressing.", "role": "user" }, { "content": "Drugs to specifically treat Alzheimer's disease and some other progressive dementia are now available. Although these drugs do not halt the disease or reverse existing brain damage, they can improve symptoms and slow the progression of the disease. This may improve an individual?s quality of life, ease the burden on caregivers, or delay admission to a nursing home. Many researchers are also examining whether these drugs may be useful for treating other types of dementia. Many people with dementia, particularly those in the early stages, may benefit from practicing tasks designed to improve performance in specific aspects of cognitive functioning. For example, people can sometimes be taught to use memory aids, such as mnemonics, computerized recall devices, or note taking. There are many disorders that can cause dementia. Some, such as Alzheimer?s disease or Huntington?s disease, lead to a progressive loss of mental functions. But other types of dementia can be halted or reversed with appropriate treatment.", "role": "assistant" } ]

[ { "content": "how do you diagnose anxiety\n\nGeneralized anxiety disorder (Exams and Tests): There is no test that can make a diagnosis of GAD. The diagnosis is based on your answers to questions about the symptoms of GAD. Your health care provider will ask about these symptoms. You will also be asked about other aspects of your mental and physical health. A physical exam or lab tests may be done to rule out other conditions that cause similar symptoms.", "role": "user" }, { "content": "There is no single test for diagnosing generalized anxiety disorder. 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": "Achondroplasia research. Hello, We are students from and we are doing a biology project of genetic diseases. We chose Achondroplasia as our disease to research. We have a few question and we are hoping you could answer them. Our questions are, can you tell if your child will have Achondroplasia when you are pregnant? When do people usually come in when they think something isn't right with their child? what are the worse cases of Achondroplasia you've ever seen? Thank you in advance. sincerely,\n\n Achondroplasia Summary Achondroplasia is a disorder of bone growth that causes the most common type of dwarfism. Causes Achondroplasia is one of a group of disorders called chondrodystrophies, or osteochondrodysplasias. Achondroplasia may be inherited as an autosomal dominant trait, which means that if a child gets the defective gene from one parent, the child will have the disorder. If one parent has achondroplasia, the infant has a 50% chance of inheriting the disorder. If both parents have the condition, the infant's chances of being affected increase to 75%. However, most cases appear as spontaneous mutations. This means that two parents without achondroplasia may give birth to a baby with the condition. Symptoms The typical appearance of achondroplastic dwarfism can be seen at birth. Symptoms may include: Abnormal hand appearance with persistent space between the long and ring fingers Bowed legs Decreased muscle tone Disproportionately large head-to-body size difference Prominent forehead (frontal bossing) Shortened arms and legs (especially the upper arm and thigh) Short stature (significantly below the average height for a person of the same age and sex) Narrowing of the spinal column (spinal stenosis) Spine curvatures called kyphosis and lordosis Exams and Tests During pregnancy, a prenatal ultrasound may show excessive amniotic fluid surrounding the unborn infant. Examination of the infant after birth shows increased front-to-back head size. There may be signs of hydrocephalus (\"water on the brain\"). X-rays of the long bones can reveal achondroplasia in the newborn. Treatment There is no specific treatment for achondroplasia. Related abnormalities, including spinal stenosis and spinal cord compression, should be treated when they cause problems. Outlook (Prognosis) People with achondroplasia seldom reach 5 feet (1.5 meters) in height. Intelligence is in the normal range. Infants who receive the abnormal gene from both parents do not often live beyond a few months. Possible Complications Health problems that may develop include: Breathing problems from a small upper airway and from pressure on the area of the brain that controls breathing Lung problems from a small ribcage When to Contact a Medical Professional If there is a family history of achondroplasia and you plan to have children, you may find it helpful to speak to your health care provider. Prevention Genetic counseling may be helpful for prospective parents when one or both have achondroplasia. However, because achondroplasia most often develops spontaneously, prevention is not always possible. Review Date 10/18/2017 Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Achondroplasia may be inherited, but most cases are spontaneous mutations in a baby of two parents without the condition.If a child gets the defective gene from one parent, the child will have the disorder. If one parent has achondroplasia, the infant has a 50% chance of inheriting it, if both parents have the condition, the chances increase to 75%.", "role": "assistant" } ]

[ { "content": "what can cause hypoglycemia\n\n Congenital hyperinsulinism hyperinsulinemia hypoglycemia of infancy infancy hyperinsulinemia hypoglycemia neonatal hyperinsulinism persistent hyperinsulinemia hypoglycemia of infancy persistent hyperinsulinemic hypoglycemia PHHI hypoglycemia Description Congenital hyperinsulinism is a condition that causes individuals to have abnormally high levels of insulin, which is a hormone that helps control blood sugar levels. People with this condition have frequent episodes of low blood sugar (hypoglycemia). In infants and young children, these episodes are characterized by a lack of energy (lethargy), irritability, or difficulty feeding. Repeated episodes of low blood sugar increase the risk for serious complications such as breathing difficulties, seizures, intellectual disability, vision loss, brain damage, and coma. The severity of congenital hyperinsulinism varies widely among affected individuals, even among members of the same family. About 60 percent of infants with this condition experience a hypoglycemic episode within the first month of life. Other affected children develop hypoglycemia by early childhood. Unlike typical episodes of hypoglycemia, which occur most often after periods without food (fasting) or after exercising, episodes of hypoglycemia in people with congenital hyperinsulinism can also occur after eating. Frequency Congenital hyperinsulinism affects approximately 1 in 50,000 newborns. This condition is more common in certain populations, affecting up to 1 in 2,500 newborns. Causes Congenital hyperinsulinism is caused by mutations in genes that regulate the release (secretion) of insulin, which is produced by beta cells in the pancreas. Insulin clears excess sugar (in the form of glucose) from the bloodstream by passing glucose into cells to be used as energy. Gene mutations that cause congenital hyperinsulinism lead to over-secretion of insulin from beta cells. Normally, insulin is secreted in response to the amount of glucose in the bloodstream: when glucose levels rise, so does insulin secretion. However, in people with congenital hyperinsulinism, insulin is secreted from beta cells regardless of the amount of glucose present in the blood. This excessive secretion of insulin results in glucose being rapidly removed from the bloodstream and passed into tissues such as muscle, liver, and fat. A lack of glucose in the blood results in frequent states of hypoglycemia in people with congenital hyperinsulinism. Insufficient blood glucose also deprives the brain of its primary source of fuel. Mutations in at least nine genes have been found to cause congenital hyperinsulinism. Mutations in the ABCC8 gene are the most common known cause of the disorder. They account for this condition in approximately 40 percent of affected individuals. Less frequently, mutations in the KCNJ11 gene have been found in people with congenital hyperinsulinism. Mutations in each of the other genes associated with this condition account for only a small percentage of cases. In approximately half of people with congenital hyperinsulinism, the cause is unknown. Inheritance Pattern Congenital hyperinsulinism can have different inheritance patterns, usually depending on the form of the condition. At least two forms of the condition have been identified. The most common form is the diffuse form, which occurs when all of the beta cells in the pancreas secrete too much insulin. The focal form of congenital hyperinsulinism occurs when only some of the beta cells over-secrete insulin. Most often, the diffuse form of congenital hyperinsulinism 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. Less frequently, the diffuse form is inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to cause the disorder. The inheritance of the focal form of congenital hyperinsulinism is more complex. For most genes, both copies are turned on (active) in all cells, but for a small subset of genes, one of the two copies is turned off (inactive). Most people with the focal form of this condition inherit one copy of the mutated, inactive gene from their unaffected father. During embryonic development, a mutation occurs in the other, active copy of the gene. This second mutation is found within only some cells in the pancreas. As a result, some pancreatic beta cells have abnormal insulin secretion, while other beta cells function normally. Sources for This Page Huopio H, Shyng SL, Otonkoski T, Nichols CG. K(ATP) channels and insulin secretion disorders. Am J Physiol Endocrinol Metab. 2002 Aug;283(2):E207-16. Review. ", "role": "user" }, { "content": "Congenital hyperinsulinism is a condition that causes individuals to have abnormally high levels of insulin, which is a hormone that helps control blood sugar levels. People with this condition have frequent episodes of low blood sugar (hypoglycemia). In infants and young children, these episodes are characterized by a lack of energy, irritability, or difficulty feeding.", "role": "assistant" } ]

[ { "content": "polymicrogyria. My 16 month old son has this. Does not sit up our crawl yet but still trying and is improving in grabbing things etc etc. Have read about other cases that seem 10000 time worse. It's it possible for this post of his brain to grown to normal and he grow out of it?\n\n Bilateral generalized polymicrogyria Bilateral generalised polymicrogyria Summary Bilateral generalized polymicrogyria is a rare neurological disorder that affects the cerebral cortex (the outer surface of the brain). [1] [2] [3] This is the most widespread form of polymicrogyria and typically affects the entire surface of the brain. [1] Signs and symptoms include severe intellectual disability , problems with movement, and seizures that are difficult or impossible to treat. [1] [2] While the exact cause of bilateral generalized polymicrogyria is not fully understood, it is thought to be due to improper brain development during embryonic growth. [2] Most cases appear to follow an autosomal recessive pattern of inheritance. Treatment is based on the signs and symptoms present in each person. [1] [2] [3] Statistics Although polymicrogyria as a broad category of disorders is collectively believed to be fairly common, each individual type (such as bilateral generalized polymicrogyria) is probably rare. [1] [2] Unfortunately for the rare diseases, there's often not a calculated incidence or prevalence; there is no official method for tracking these conditions. To our knowledge, the incidence and prevalence of bilateral generalized polymicrogyria remains unknown. [1] [2] [3] ", "role": "user" }, { "content": "Signs and symptoms of bilateral generalized polymicrogyria , the most common form of polymicrogyria, include severe intellectual disability , problems with movement, and seizures that are difficult or impossible to treat.", "role": "assistant" } ]

[ { "content": "what are the causes of headaches\n\nSinus headaches (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.", "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": "Psoriasis for past 7-8 years I had psoriasis on my scalp for nearly 10 years. Please give suggestions and medications.\n\nPsoriasis: Psoriasis is a common skin condition that speeds up the life cycle of skin cells. It causes cells to build up rapidly on the surface of the skin. The extra skin cells form scales and red patches that are itchy and sometimes painful. Psoriasis is a chronic disease that often comes and goes. The main goal of treatment is to stop the skin cells from growing so quickly. There is no cure for psoriasis, but you can manage symptoms. Lifestyle measures, such as moisturizing, quitting smoking and managing stress, may help. Psoriasis care at Mayo Clinic Psoriasis signs and symptoms are different for everyone. Common signs and symptoms include: - Red patches of skin covered with thick, silvery scales - Small scaling spots (commonly seen in children) - Dry, cracked skin that may bleed - Itching, burning or soreness - Thickened, pitted or ridged nails - Swollen and stiff joints Psoriasis patches can range from a few spots of dandruff-like scaling to major eruptions that cover large areas. Most types of psoriasis go through cycles, flaring for a few weeks or months, then subsiding for a time or even going into complete remission. There are several types of psoriasis. These include: - Plaque psoriasis. The most common form, plaque psoriasis causes dry, raised, red skin lesions (plaques) covered with silvery scales. The plaques might be itchy or painful and there may be few or many. They can occur anywhere on your body, including your genitals and the soft tissue inside your mouth. - Nail psoriasis. Psoriasis can affect fingernails and toenails, causing pitting, abnormal nail growth and discoloration. Psoriatic nails might loosen and separate from the nail bed (onycholysis). Severe cases may cause the nail to crumble. - Guttate psoriasis. This type primarily affects young adults and children. It's usually triggered by a bacterial infection such as strep throat. It's marked by small, water-drop-shaped, scaling lesions on your trunk, arms, legs and scalp. The lesions are covered by a fine scale and aren't as thick as typical plaques are. You may have a single outbreak that goes away on its own, or you may have repeated episodes. - Inverse psoriasis. This mainly affects the skin in the armpits, in the groin, under the breasts and around the genitals. Inverse psoriasis causes smooth patches of red, inflamed skin that worsen with friction and sweating. Fungal infections may trigger this type of psoriasis. - Pustular psoriasis. This uncommon form of psoriasis can occur in widespread patches (generalized pustular psoriasis) or in smaller areas on your hands, feet or fingertips. It generally develops quickly, with pus-filled blisters appearing just hours after your skin becomes red and tender. The blisters may come and go frequently. Generalized pustular psoriasis can also cause fever, chills, severe itching and diarrhea. - Erythrodermic psoriasis. The least common type of psoriasis, erythrodermic psoriasis can cover your entire body with a red, peeling rash that can itch or burn intensely. - Psoriatic arthritis. In addition to inflamed, scaly skin, psoriatic arthritis causes swollen, painful joints that are typical of arthritis. Sometimes the joint symptoms are the first or only manifestation of psoriasis or at times only nail changes are seen. Symptoms range from mild to severe, and psoriatic arthritis can affect any joint. Although the disease usually isn't as crippling as other forms of arthritis, it can cause stiffness and progressive joint damage that in the most serious cases may lead to permanent deformity. If you suspect that you may have psoriasis, see your doctor for an examination. Also, talk to your doctor if your psoriasis: - Causes you discomfort and pain - Makes performing routine tasks difficult - Causes you concern about the appearance of your skin - Leads to joint problems, such as pain, swelling or inability to perform daily tasks Seek medical advice if your signs and symptoms worsen or don't improve with treatment. You may need a different medication or a combination of treatments to manage the psoriasis. The cause of psoriasis isn't fully understood, but it's thought to be related to an immune system problem with T cells and other white blood cells, called neutrophils, in your body. T cells normally travel through the body to defend against foreign substances, such as viruses or bacteria. But if you have psoriasis, the T cells attack healthy skin cells by mistake, as if to heal a wound or to fight an infection. Overactive T cells also trigger increased production of healthy skin cells, more T cells and other white blood cells, especially neutrophils. These travel into the skin causing redness and sometimes pus in pustular lesions. Dilated blood vessels in psoriasis-affected areas create warmth and redness in the skin lesions. The process becomes an ongoing cycle in which new skin cells move to the outermost layer of skin too quickly - in days rather than weeks. Skin cells build up in thick, scaly patches on the skin's surface, continuing until treatment stops the cycle. Just what causes T cells to malfunction in people with psoriasis isn't entirely clear. Researchers believe both genetics and environmental factors play a role. Psoriasis typically starts or worsens because of a trigger that you may be able to identify and avoid. Factors that may trigger psoriasis include: - Infections, such as strep throat or skin infections - Injury to the skin, such as a cut or scrape, a bug bite, or a severe sunburn - Stress - Smoking - Heavy alcohol consumption - Vitamin D deficiency - Certain medications - including lithium, which is prescribed for bipolar disorder, high blood pressure medications such as beta blockers, antimalarial drugs, and iodides Anyone can develop psoriasis, but these factors can increase your risk of developing the disease: - Family history. This is one of the most significant risk factors. Having one parent with psoriasis increases your risk of getting the disease, and having two parents with psoriasis increases your risk even more. - Viral and bacterial infections. People with HIV are more likely to develop psoriasis than people with healthy immune systems are. Children and young adults with recurring infections, particularly strep throat, also may be at increased risk. - Stress. Because stress can impact your immune system, high stress levels may increase your risk of psoriasis. - Obesity. Excess weight increases the risk of psoriasis. Lesions (plaques) associated with all types of psoriasis often develop in skin creases and folds. - Smoking. Smoking tobacco not only increases your risk of psoriasis but also may increase the severity of the disease. Smoking may also play a role in the initial development of the disease. In most cases, diagnosis of psoriasis is fairly straightforward. - Physical exam and medical history. Your doctor usually can diagnose psoriasis by taking your medical history and examining your skin, scalp and nails. - Skin biopsy. Rarely, your doctor may take a small sample of skin (biopsy). He or she will likely first apply a local anesthetic. The sample is examined under a microscope to determine the exact type of psoriasis and to rule out other disorders. Psoriasis treatments reduce inflammation and clear the skin. Treatments can be divided into three main types: topical treatments, light therapy and systemic medications. Topical treatments Used alone, creams and ointments that you apply to your skin can effectively treat mild to moderate psoriasis. When the disease is more severe, creams are likely to be combined with oral medications or light therapy. Topical psoriasis treatments include: - Topical corticosteroids. These drugs are the most frequently prescribed medications for treating mild to moderate psoriasis. They reduce inflammation and relieve itching and may be used with other treatments. Mild corticosteroid ointments are usually recommended for sensitive areas, such as your face or skin folds, and for treating widespread patches of damaged skin. Your doctor may prescribe stronger corticosteroid ointment for smaller, less sensitive or tougher-to-treat areas. Long-term use or overuse of strong corticosteroids can cause thinning of the skin. Topical corticosteroids may stop working over time. It's usually best to use topical corticosteroids as a short-term treatment during flares. - Vitamin D analogues. These synthetic forms of vitamin D slow skin cell growth. Calcipotriene (Dovonex) is a prescription cream or solution containing a vitamin D analogue that treats mild to moderate psoriasis along with other treatments. Calcipotriene might irritate your skin. Calcitriol (Vectical) is expensive but may be equally effective and possibly less irritating than calcipotriene. - Anthralin. This medication helps slow skin cell growth. Anthralin (Dritho-Scalp) can also remove scales and make skin smoother. But anthralin can irritate skin, and it stains almost anything it touches. It's usually applied for a short time and then washed off. - Topical retinoids. These are vitamin A derivatives that may decrease inflammation. The most common side effect is skin irritation. These medications may also increase sensitivity to sunlight, so while using the medication apply sunscreen before going outdoors. The risk of birth defects is far lower for topical retinoids than for oral retinoids. But tazarotene (Tazorac, Avage) isn't recommended when you're pregnant or breast-feeding or if you intend to become pregnant. - Calcineurin inhibitors. Calcineurin inhibitors - tacrolimus (Prograf) and pimecrolimus (Elidel) - reduce inflammation and plaque buildup. Calcineurin inhibitors are not recommended for long-term or continuous use because of a potential increased risk of skin cancer and lymphoma. They may be especially helpful in areas of thin skin, such as around the eyes, where steroid creams or retinoids are too irritating or may cause harmful effects. - Salicylic acid. Available over-the-counter (nonprescription) and by prescription, salicylic acid promotes sloughing of dead skin cells and reduces scaling. Sometimes it's combined with other medications, such as topical corticosteroids or coal tar, to increase its effectiveness. Salicylic acid is available in medicated shampoos and scalp solutions to treat scalp psoriasis. - Coal tar. Derived from coal, coal tar reduces scaling, itching and inflammation. Coal tar can irritate the skin. It's also messy, stains clothing and bedding, and has a strong odor. Coal tar is available in over-the-counter shampoos, creams and oils. It's also available in higher concentrations by prescription. This treatment isn't recommended for women who are pregnant or breast-feeding. - Moisturizers. Moisturizing creams alone won't heal psoriasis, but they can reduce itching, scaling and dryness. Moisturizers in an ointment base are usually more effective than are lighter creams and lotions. Apply immediately after a bath or shower to lock in moisture. Light therapy (phototherapy) This treatment uses natural or artificial ultraviolet light. The simplest and easiest form of phototherapy involves exposing your skin to controlled amounts of natural sunlight. Other forms of light therapy include the use of artificial ultraviolet A (UVA) or ultraviolet B (UVB) light, either alone or in combination with medications. - Sunlight. Exposure to ultraviolet (UV) rays in sunlight or artificial light slows skin cell turnover and reduces scaling and inflammation. Brief, daily exposures to small amounts of sunlight may improve psoriasis, but intense sun exposure can worsen symptoms and cause skin damage. Before beginning a sunlight regimen, ask your doctor about the safest way to use natural sunlight for psoriasis treatment. - UVB phototherapy. Controlled doses of UVB light from an artificial light source may improve mild to moderate psoriasis symptoms. UVB phototherapy, also called broadband UVB, can be used to treat single patches, widespread psoriasis and psoriasis that resists topical treatments. Short-term side effects may include redness, itching and dry skin. Using a moisturizer may help decrease these side effects. - Narrow band UVB phototherapy. A newer type of psoriasis treatment, narrow band UVB phototherapy may be more effective than broadband UVB treatment. It's usually administered two or three times a week until the skin improves, and then maintenance may require only weekly sessions. Narrow band UVB phototherapy may cause more-severe and longer lasting burns, however. - Goeckerman therapy. Some doctors combine UVB treatment and coal tar treatment, which is known as Goeckerman treatment. The two therapies together are more effective than either alone because coal tar makes skin more receptive to UVB light. - Psoralen plus ultraviolet A (PUVA). This form of photochemotherapy involves taking a light-sensitizing medication (psoralen) before exposure to UVA light. UVA light penetrates deeper into the skin than does UVB light, and psoralen makes the skin more responsive to UVA exposure. This more aggressive treatment consistently improves skin and is often used for more-severe cases of psoriasis. Short-term side effects include nausea, headache, burning and itching. Long-term side effects include dry and wrinkled skin, freckles, increased sun sensitivity, and increased risk of skin cancer, including melanoma. - Excimer laser. This form of light therapy, used for mild to moderate psoriasis, treats only the involved skin without harming healthy skin. A controlled beam of UVB light is directed to the psoriasis plaques to control scaling and inflammation. Excimer laser therapy requires fewer sessions than does traditional phototherapy because more powerful UVB light is used. Side effects can include redness and blistering. Oral or injected medications If you have severe psoriasis or it's resistant to other types of treatment, your doctor may prescribe oral or injected drugs. This is known as systemic treatment. Because of severe side effects, some of these medications are used for only brief periods and may be alternated with other forms of treatment. - Retinoids. Related to vitamin A, this group of drugs may help if you have severe psoriasis that doesn't respond to other therapies. Side effects may include lip inflammation and hair loss. And because retinoids such as acitretin (Soriatane) can cause severe birth defects, women must avoid pregnancy for at least three years after taking the medication. - Methotrexate. Taken orally, methotrexate (Rheumatrex) helps psoriasis by decreasing the production of skin cells and suppressing inflammation. It may also slow the progression of psoriatic arthritis in some people. Methotrexate is generally well-tolerated in low doses but may cause upset stomach, loss of appetite and fatigue. When used for long periods, it can cause a number of serious side effects, including severe liver damage and decreased production of red and white blood cells and platelets. - Cyclosporine. Cyclosporine (Gengraf, Neoral) suppresses the immune system and is similar to methotrexate in effectiveness, but can only be taken short-term. Like other immunosuppressant drugs, cyclosporine increases your risk of infection and other health problems, including cancer. Cyclosporine also makes you more susceptible to kidney problems and high blood pressure - the risk increases with higher dosages and long-term therapy. - Drugs that alter the immune system (biologics). Several of these drugs are approved for the treatment of moderate to severe psoriasis. They include etanercept (Enbrel), infliximab (Remicade), adalimumab (Humira), ustekinumab (Stelara), golimumab (Simponi), apremilast (Otezla), secukinumab (Cosentyx) and ixekizumab (Taltz). Most of these drugs are given by injection (apremilast is oral) and are usually used for people who have failed to respond to traditional therapy or who have associated psoriatic arthritis. Biologics must be used with caution because they have strong effects on the immune system and may permit life-threatening infections. In particular, people taking these treatments must be screened for tuberculosis. - Other medications. Thioguanine (Tabloid) and hydroxyurea (Droxia, Hydrea) are medications that can be used when other drugs can't be given. Treatment considerations Although doctors choose treatments based on the type and severity of psoriasis and the areas of skin affected, the traditional approach is to start with the mildest treatments - topical creams and ultraviolet light therapy (phototherapy) - in those patients with typical skin lesions (plaques) and then progress to stronger ones only if necessary. Patients with pustular or erythrodermic psoriasis or associated arthritis usually need systemic therapy from the beginning of treatment. The goal is to find the most effective way to slow cell turnover with the fewest possible side effects. Potential future treatments There are a number of new medications currently being researched that have the potential to improve psoriasis treatment. These treatments target different proteins that work with the immune system. Alternative medicine A number of alternative therapies claim to ease the symptoms of psoriasis, including special diets, creams, dietary supplements and herbs. None have definitively been proved effective. But some alternative therapies are deemed generally safe, and they may be helpful to some people in reducing signs and symptoms, such as itching and scaling. These treatments would be most appropriate for those with milder, plaque disease and not for those with pustules, erythroderma or arthritis. - Aloe vera. Taken from the leaves of the aloe vera plant, aloe extract cream may reduce redness, scaling, itching and inflammation. You may need to use the cream several times a day for a month or more to see any improvements in your skin. - Fish oil. Omega-3 fatty acids found in fish oil supplements may reduce inflammation associated with psoriasis, although results from studies are mixed. Taking 3 grams or less of fish oil daily is generally recognized as safe, and you may find it beneficial. - Oregon grape. Also known as barberry, topical applications of Oregon grape may reduce inflammation and ease psoriasis symptoms. If you're considering dietary supplements or other alternative therapy to ease the symptoms of psoriasis, consult your doctor. He or she can help you weigh the pros and cons of specific alternative therapies. Although self-help measures won't cure psoriasis, they may help improve the appearance and feel of damaged skin. These measures may benefit you: - Take daily baths. Bathing daily helps remove scales and calm inflamed skin. Add bath oil, colloidal oatmeal, Epsom salts or Dead Sea salts to the water and soak. Avoid hot water and harsh soaps, which can worsen symptoms; use lukewarm water and mild soaps that have added oils and fats. Soak about 10 minutes then gently pat dry skin. - Use moisturizer. After bathing, apply a heavy, ointment-based moisturizer while your skin is still moist. For very dry skin, oils may be preferable - they have more staying power than creams or lotions do and are more effective at preventing water from evaporating from your skin. During cold, dry weather, you may need to apply a moisturizer several times a day. - Expose your skin to small amounts of sunlight. A controlled amount of sunlight can improve psoriasis, but too much sun can trigger or worsen outbreaks and increase the risk of skin cancer. First ask your doctor about the best way to use natural sunlight to treat your skin. Log your time in the sun, and protect skin that isn't affected by psoriasis with sunscreen. - Avoid psoriasis triggers, if possible. Find out what triggers, if any, worsen your psoriasis and take steps to prevent or avoid them. Infections, injuries to your skin, stress, smoking and intense sun exposure can all worsen psoriasis. - Avoid drinking alcohol. Alcohol consumption may decrease the effectiveness of some psoriasis treatments. If you have psoriasis, avoid alcohol. If you do drink, keep it moderate.", "role": "user" }, { "content": "Psoriasis treatments reduce inflammation and clear the skin. Treatments can be divided into three main types: topical treatments, light therapy and systemic medications. Used alone, creams and ointments that you apply to your skin can effectively treat mild to moderate psoriasis. When the disease is more severe, creams are likely to be combined with oral medications or light therapy. Topical psoriasis treatments include: - Topical corticosteroids. It's usually best to use topical corticosteroids as a short-term treatment during flares. - Vitamin D analogues. Calcipotriene (Dovonex) is a prescription cream or solution containing a vitamin D analogue that treats mild to moderate psoriasis along with other treatments. - Anthralin. This medication helps slow skin cell growth. Anthralin (Dritho-Scalp) can also remove scales and make skin smoother. But anthralin can irritate skin, and it stains almost anything it touches. It's usually applied for a short time and then washed off. - Topical retinoids. These are vitamin A derivatives that may decrease inflammation. These medications may also increase sensitivity to sunlight, so while using the medication apply sunscreen before going outdoors. Calcineurin inhibitors - tacrolimus (Prograf) and pimecrolimus (Elidel) - reduce inflammation and plaque buildup. - Salicylic acid. Available over-the-counter (nonprescription) and by prescription, salicylic acid promotes sloughing of dead skin cells and reduces scaling. Sometimes it's combined with other medications, such as topical corticosteroids or coal tar, to increase its effectiveness. Salicylic acid is available in medicated shampoos and scalp solutions to treat scalp psoriasis. - Coal tar. Derived from coal, coal tar reduces scaling, itching and inflammation. Coal tar can irritate the skin. It's also messy, stains clothing and bedding, and has a strong odor. Coal tar is available in over-the-counter shampoos, creams and oils. Light therapy (phototherapy) This treatment uses natural or artificial ultraviolet light. The simplest and easiest form of phototherapy involves exposing your skin to controlled amounts of natural sunlight. Other forms of light therapy include the use of artificial ultraviolet A (UVA) or ultraviolet B (UVB) light, either alone or in combination with medications. - Goeckerman therapy. Some doctors combine UVB treatment and coal tar treatment, which is known as Goeckerman treatment. The two therapies together are more effective than either alone because coal tar makes skin more receptive to UVB light. - Psoralen plus ultraviolet A (PUVA). This form of photochemotherapy involves taking a light-sensitizing medication (psoralen) before exposure to UVA light. If you have severe psoriasis or it's resistant to other types of treatment, your doctor may prescribe oral or injected drugs. This is known as systemic treatment. Because of severe side effects, some of these medications are used for only brief periods and may be alternated with other forms of treatment. - Retinoids. Related to vitamin A, this group of drugs may help if you have severe psoriasis that doesn't respond to other therapies. Side effects may include lip inflammation and hair loss. - Methotrexate. Taken orally, methotrexate (Rheumatrex) helps psoriasis by decreasing the production of skin cells and suppressing inflammation. It may also slow the progression of psoriatic arthritis in some people. - Cyclosporine. Cyclosporine (Gengraf, Neoral) suppresses the immune system and is similar to methotrexate in effectiveness, but can only be taken short-term. - Drugs that alter the immune system (biologics). Several of these drugs are approved for the treatment of moderate to severe psoriasis. They include etanercept (Enbrel), infliximab (Remicade), adalimumab (Humira), ustekinumab (Stelara), golimumab (Simponi), apremilast (Otezla), secukinumab (Cosentyx) and ixekizumab (Taltz). Most of these drugs are given by injection (apremilast is oral) and are usually used for people who have failed to respond to traditional therapy or who have associated psoriatic arthritis. Biologics must be used with caution because they have strong effects on the immune system and may permit life-threatening infections. In particular, people taking these treatments must be screened for tuberculosis. - Other medications. Thioguanine (Tabloid) and hydroxyurea (Droxia, Hydrea) are medications that can be used when other drugs can't be given. A number of alternative therapies claim to ease the symptoms of psoriasis, including special diets, creams, dietary supplements and herbs. None have definitively been proved effective. But some alternative therapies are deemed generally safe, and they may be helpful to some people in reducing signs and symptoms, such as itching and scaling. - Aloe vera. Taken from the leaves of the aloe vera plant, aloe extract cream may reduce redness, scaling, itching and inflammation. - Fish oil. Omega-3 fatty acids found in fish oil supplements may reduce inflammation associated with psoriasis, although results from studies are mixed. Taking 3 grams or less of fish oil daily is generally recognized as safe, and you may find it beneficial. - Oregon grape. Also known as barberry, topical applications of Oregon grape may reduce inflammation and ease psoriasis symptoms. These measures may benefit you: - Take daily baths. Bathing daily helps remove scales and calm inflamed skin. Add bath oil, colloidal oatmeal, Epsom salts or Dead Sea salts to the water and soak. Avoid hot water and harsh soaps, which can worsen symptoms; use lukewarm water and mild soaps that have added oils and fats. Soak about 10 minutes then gently pat dry skin. - Use moisturizer. After bathing, apply a heavy, ointment-based moisturizer while your skin is still moist. For very dry skin, oils may be preferable - they have more staying power than creams or lotions do and are more effective at preventing water from evaporating from your skin. During cold, dry weather, you may need to apply a moisturizer several times a day. - Expose your skin to small amounts of sunlight. A controlled amount of sunlight can improve psoriasis, but too much sun can trigger or worsen outbreaks and increase the risk of skin cancer. - Avoid psoriasis triggers, if possible. Find out what triggers, if any, worsen your psoriasis and take steps to prevent or avoid them. Infections, injuries to your skin, stress, smoking and intense sun exposure can all worsen psoriasis. - Avoid drinking alcohol. If you do drink, keep it moderate.", "role": "assistant" } ]

[ { "content": "how to loose weight\n\nVery Low-calorie Diets (Should I use a VLCD to lose weight?): Most people who need to lose weight should not use a VLCD. For many of them, a low-calorie diet (LCD) may work better (see The Low-calorie Diet (LCD)).VLCDs may be used to promote rapid weight loss among adults who have obesity. Health care providers must review risks and benefits on a case-by-case basis.In general, VLCDs are not appropriate for children. In a few cases, they may be used with some adolescents who are being treated for obesity.Not much is known about the use of VLCDs to promote weight loss among older adults. Some people over age 50 may have medical issues that may not make them good candidates for this type of diet.", "role": "user" }, { "content": "Most people who need to lose weight should not use a very low calorie diet (VLCD). For many of them, a low-calorie diet (LC) may work better. VCLDs are used for rapid weight loss among adults who have obesity and are at risk for medical issues. Your health care provider will review the risks and benefits for your specific case.", "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) Definition and Facts Irritable bowel syndrome (IBS) is a group of symptoms that occur together, including repeated pain in your abdomen and changes in your bowel movements, which may be diarrhea, constipation, or both. With IBS, you have these symptoms without any visible signs of damage or disease in your digestive tract. What is IBS? Irritable bowel syndrome (IBS) is a group of symptoms that occur together, including repeated pain in your abdomen and changes in your bowel movements, which may be diarrhea, constipation, or both. With IBS, you have these symptoms without any visible signs of damage or disease in your digestive tract.IBS is a functional gastrointestinal (GI) disorder. Functional GI disorders, which doctors now call disorders of gut-brain interactions, are related to problems with how your brain and your gut work together. These problems can cause your gut to be more sensitive and change how the muscles in your bowel contract. If your gut is more sensitive, you may feel more abdominal pain and bloating. Changes in how the muscles in your bowel contract lead to diarrhea, constipation, or both. Does IBS have another name? In the past, doctors called IBS colitis, mucous colitis, spastic colon, nervous colon, and spastic bowel. Are there different types of IBS? Three types of IBS are based on different patterns of changes in your bowel movements or abnormal bowel movements. Sometimes, it is important for your doctor to know which type of IBS you have. Some medicines work only for some types of IBS or make other types worse. Your doctor might diagnose IBS even if your bowel movement pattern does not fit one particular type.Many people with IBS have normal bowel movements on some days and abnormal bowel movements on other days.With IBS-C, on days when you have at least one abnormal bowel movementmore than a quarter of your stools are hard or lumpy and less than a quarter of your stools are loose or wateryIn IBS-D, on days when you have at least one abnormal bowel movementmore than a quarter of your stools are loose or watery and less than a quarter of your stools are hard or lumpyIn IBS-M, on days when you have at least one abnormal bowel movementmore than a quarter of your stools are hard or lumpy and more than a quarter of your stools are loose or watery How common is IBS? Studies suggest that about 12 percent of people in the United States have IBS.1 Who is more likely to develop IBS? Women are up to two times more likely than men to develop IBS.1 People younger than age 50 are more likely to develop IBS than people older than age 50.2Factors that can increase your chance of having IBS include:having a family member with IBS a history of stressful or difficult life events, such as abuse, in childhood having a severe infection in your digestive tract What other health problems do people with IBS have? People with IBS often have other health problems, including1certain conditions that involve chronic pain, such as fibromyalgia, chronic fatigue syndrome and chronic pelvic pain certain digestive diseases, such as dyspepsia and gastroesophageal reflux disease certain mental disorders, such as anxiety, depression, and somatic symptom disorder Definition & Facts Symptoms and Causes The most common symptoms of irritable bowel syndrome (IBS) are pain in your abdomen, often related to your bowel movements, and changes in your bowel movements. These changes may be diarrhea, constipation, or both, depending on what type of IBS you have. Doctors aren’t sure what causes IBS. What are the symptoms of IBS? The most common symptoms of irritable bowel syndrome (IBS) are pain in your abdomen, often related to your bowel movements, and changes in your bowel movements. These changes may be diarrhea, constipation, or both, depending on what type of IBS you have.Other symptoms of IBS may includebloating the feeling that you haven't finished a bowel movement whitish mucus in your stoolWomen with IBS often have more symptoms during their periods.IBS can be painful but doesn't lead to other health problems or damage your digestive tract.To diagnose IBS, you doctor will look for a certain pattern in your symptoms over time. IBS is a chronic disorder, meaning it lasts a long time, often years. However, the symptoms may come and go. Symptoms & Causes Doctors aren't sure what causes IBS. Experts think that a combination of problems may lead to IBS. Different factors may cause IBS in different people.Functional gastrointestinal (GI) disorders such as IBS are problems with brain-gut interaction-how your brain and gut work together. Experts think that problems with brain-gut interaction may affect how your body works and cause IBS symptoms. For example, in some people with IBS, food may move too slowly or too quickly through the digestive tract, causing changes in bowel movements. Some people with IBS may feel pain when a normal amount of gas or stool is in the gut.Certain problems are more common in people with IBS. Experts think these problems may play a role in causing IBS. These problems includestressful or difficult early life events, such as physical or sexual abuse certain mental disorders, such as depression, anxiety, and somatic symptom disorder bacterial infections in your digestive tract small intestinal bacterial overgrowth, an increase in the number or a change in the type of bacteria in your small intestine food intolerances or sensitivities, in which certain foods cause digestive symptomsResearch suggests that genes may make some people more likely to develop IBS. Diagnosis To diagnose irritable bowel syndrome (IBS), doctors review your symptoms and your medical and family history and perform a physical exam. Your doctor will look for a certain pattern in your symptoms. In some cases, doctors may order tests to rule out other health problems. How do doctors diagnose IBS? To diagnose irritable bowel syndrome (IBS), doctors review your symptoms and medical and family history and perform a physical exam. In some cases, doctors may order tests to rule out other health problems.Your doctor will ask about your symptoms and look for a certain pattern in your symptoms to diagnose IBS. Your doctor may diagnose IBS if you have pain in your abdomen along with two or more of the following symptoms:Your pain is related to your bowel movements. For example, your pain may improve or get worse after bowel movements. You notice a change in how often you have a bowel movement. You notice a change in the way your stools look.Your doctor will ask how long you've had symptoms. Your doctor may diagnose IBS ifyou've had symptoms at least once a week in the last 3 months and your symptoms first started at least 6 months agoYour doctor may diagnose IBS even if you've had symptoms for a shorter length of time. You should talk to your doctor if your symptoms are like the symptoms of IBS.Your doctor will also ask about other symptoms. Certain symptoms may suggest that you have another health problem instead of IBS. These symptoms includeanemia bleeding from your rectum bloody stools or stools that are black and tarry weight lossYour doctor will ask abouta family history of digestive diseases, such as celiac disease, colon cancer, or inflammatory bowel disease medicines you take recent infections stressful events related to the start of your symptoms what you eat your history of other health problems that are more common in people who have IBSDuring a physical exam, your doctor usuallychecks for abdominal bloating listens to sounds within your abdomen using a stethoscope taps on your abdomen checking for tenderness or pain Diagnosis In most cases, doctors don't use tests to diagnose IBS. Your doctor may order blood tests, stool tests, and other tests to check for other health problems.A health care professional will take a blood sample from you and send the sample to a lab. Doctors use blood tests to check for conditions other than IBS, including anemia, infection, and digestive diseases.Your doctor will give you a container for catching and holding a stool sample. You will receive instructions on where to send or take the kit for testing. Doctors use stool tests to check for blood in your stool or other signs of infections or diseases. Your doctor may also check for blood in your stool by examining your rectum during your physical exam.Doctors may perform other tests to rule out health problems that cause symptoms similar to IBS symptoms. Your doctor will decide whether you need other tests based onblood or stool test results whether you have a family history of digestive diseases, such as celiac disease, colon cancer, or inflammatory bowel disease whether you have symptoms that could be signs of another condition or diseaseOther tests may includehydrogen breath test to check for small intestinal bacterial overgrowth or problems digesting certain carbohydrates, such as lactose intolerance upper GI endoscopy with a biopsy to check for celiac disease colonoscopy to check for conditions such as colon cancer or inflammatory bowel disease Treatment Doctors may treat irritable bowel syndrome (IBS) by recommending changes in what you eat and other lifestyle changes, medicines, probiotics, and mental health therapies. You may have to try a few treatments to see what works best for you. Your doctor can help you find the right treatment plan. Treatment Doctors may treat irritable bowel syndrome (IBS) by recommending changes in what you eat and other lifestyle changes, medicines, probiotics, and mental health therapies. You may have to try a few treatments to see what works best for you. Your doctor can help you find the right treatment plan.Changes in what you eat may help treat your symptoms. Your doctor may recommend trying one of the following changes:eat more fiber avoid gluten follow a special eating plan called the low FODMAP dietRead more about eating, diet, and nutrition for IBS.Research suggests that other lifestyle changes may help IBS symptoms, includingincreasing your physical activity reducing stressful life situations as much as possible getting enough sleepYour doctor may recommend medicine to relieve your IBS symptoms.To treat IBS with diarrhea, your doctor may recommendloperamide rifaximin (Xifaxan), an antibiotic eluxadoline (Viberzi) alosetron (Lotronex), which is prescribed only to women and is prescribed with special warnings and precautionsTo treat IBS with constipation, your doctor may recommendfiber supplements, when increasing fiber in your diet doesn't help laxatives lubiprostone (Amitiza) linaclotide (Linzess) plecanatide (Trulance)Other medicines may help treat pain in your abdomen, includingantispasmodics antidepressants, such as low doses of tricyclic antidepressants and selective serotonin reuptake inhibitors coated peppermint oil capsulesFollow your doctor's instructions when you use medicine to treat IBS. Talk with your doctor about possible side effects and what to do if you have them.Your doctor may also recommend probiotics. Probiotics are live microorganisms, most often bacteria, that are similar to microorganisms you normally have in your digestive tract. Researchers are still studying the use of probiotics to treat IBS.To be safe, talk with your doctor before using probiotics or any other complementary or alternative medicines or practices. If your doctor recommends probiotics, talk with him or her about how much probiotics you should take and for how long.Your doctor may recommend mental health therapies to help improve your IBS symptoms. Therapies used to treat IBS includecognitive behavioral therapy, which focuses on helping you change thought and behavior patterns to improve IBS symptoms gut-directed hypnotherapy, in which a therapist uses hypnosis-a trance-like state in which you are relaxed or focused-to help improve your IBS symptoms relaxation training, which can help you relax your muscles or reduce stress Eating, Diet, and Nutrition Your doctor may recommend changes in your diet to help treat symptoms of irritable bowel syndrome. Changes may include eating more fiber, avoiding gluten, or following a special diet called the low FODMAP diet. Different changes may help different people with IBS. How can my diet help treat the symptoms of IBS? Your doctor may recommend changes in your diet to help treat symptoms of irritable bowel syndrome (IBS). Your doctor may suggest that youeat more fiber avoid gluten follow a special diet called the low FODMAP dietDifferent changes may help different people with IBS. You may need to change what you eat for several weeks to see if your symptoms improve. Your doctor may also recommend talking with a dietitian.Fiber may improve constipation in IBS because it makes stool soft and easier to pass. The 2015-2020 Dietary Guidelines for Americans recommends that adults should get 22 to 34 grams of fiber a day.3Two types of fiber aresoluble fiber, which is found in beans, fruit, and oat products insoluble fiber, which is found in whole-grain products and vegetablesResearch suggests that soluble fiber is more helpful in relieving IBS symptoms.To help your body get used to more fiber, add foods with fiber to your diet a little at a time. Too much fiber at once can cause gas, which can trigger IBS symptoms. Adding fiber to your diet slowly, by 2 to 3 grams a day, may help prevent gas and bloating.Your doctor may recommend avoiding foods that contain gluten-a protein found in wheat, barley, and rye-to see if your IBS symptoms improve. Foods that contain gluten include most cereal, grains, and pasta, and many processed foods. Some people with IBS have more symptoms after eating gluten, even though they do not have celiac disease.Your doctor may recommend that you try a special diet-called the low FODMAP diet-to reduce or avoid certain foods that contain carbohydrates that are hard to digest. These carbohydrates are called FODMAPs.Examples of foods that contain FODMAPs includefruits such as apples, apricots, blackberries, cherries, mango, nectarines, pears, plums, and watermelon, or juice containing any of these fruits canned fruit in natural fruit juice, or large amounts of fruit juice or dried fruit vegetables such as artichokes, asparagus, beans, cabbage, cauliflower, garlic and garlic salts, lentils, mushrooms, onions, and sugar snap or snow peas dairy products such as milk, milk products, soft cheeses, yogurt, custard, and ice cream wheat and rye products honey and foods with high-fructose corn syrup products, including candy and gum, with sweeteners ending in \"-ol,\" such as sorbitol, mannitol, xylitol, and maltitolYour doctor may suggest that you try the low FODMAP diet for a few weeks to see if it helps with your symptoms. If your symptoms improve, your doctor may recommend slowly adding foods that contain FODMAPs back into your diet. You may be able to eat some foods with FODMAPs without having IBS symptoms. Eating, Diet, & Nutrition ", "role": "user" }, { "content": "Your doctor can manage IBS symptoms with a combination of diet, medicines, probiotics, and therapies for mental health problems.", "role": "assistant" } ]

[ { "content": "what does kidney disease look like\n\nDiabetic Kidney Disease (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.", "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": "how do you administer lanreotide\n\n Lanreotide Injection Why is this medication prescribed? Lanreotide injection is used to treat people with acromegaly (condition in which the body produces too much growth hormone, causing enlargement of the hands, feet, and facial features; joint pain; and other symptoms) who have not successfully, or cannot be treated with surgery or radiation. Lanreotide injection is also used to treat people with neuroendocrine tumors in the gastrointestinal (GI) tract or the pancreas (GEP-NETs) that have spread or cannot be removed by surgery. Lanreotide injection is in a class of medications called somatostatin agonists. It works by decreasing the amounts of certain natural substances produced by the body. How should this medicine be used? 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. 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 receiving lanreotide injection,</h3> /h3> tell your doctor and pharmacist if you are allergic to lanreotide injection, any other medications, or any of the ingredients in lanreotide injection. Ask your pharmacist for a list of the ingredients. tell your doctor and pharmacist what other 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: beta blockers such as atenolol (Tenormin, in Tenoretic), labetalol (Trandate), metoprolol (Lopressor, Toprol XL, in Dutoprol), nadolol (Corgard, in Corzide), and propranolol (Hemangeol, Inderal, InnoPran); bromocriptine (Cycloset, Parlodel); cyclosporine (Gengraf, Neoral, Sandimmune); insulin and oral medications for diabetes; quinidine (in Nuedexta), or terfenadine (no longer available in the U.S.). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. tell your doctor if you have or have ever had diabetes, or gallbladder, heart, kidney, thyroid, or liver disease. tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while receiving lanreotide injection, call your doctor. you should know that lanreotide injection may make you drowsy or dizzy. Do not drive a car or operate machinery until you know how this medication affects you. What special dietary instructions should I follow? Unless your doctor tells you otherwise, continue your normal diet. What side effects can this medication cause? This medication may cause changes in your blood sugar. You should know the symptoms of high and low blood sugar and what to do if you have these symptoms. <h3>Lanreotide injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: </h3> /h3> diarrhea loose stools constipation gas vomiting weight loss headache redness, pain, itching, or a lump at the injection site depression <h3>Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment: </h3> /h3> pain in the upper right part of the stomach, center of the stomach, back, or shoulder muscle pain or discomfort yellowing of the skin and eyes fever with chills nausea swelling of the face, throat, tongue, lips, or eyes tightness in the throat difficulty breathing and swallowing wheezing hoarseness rash itching hives shortness of breath slowed or irregular heartbeat Lanreotide injection may cause other side effects. Call your doctor if you have any unusual problems while receiving this medication. 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? If you are storing the prefilled syringes in your home until it is time for it to be injected by your doctor or nurse, you should always store it in original carton in the refrigerator and protect it from light. Throw away any medication that is outdated or no longer needed. Talk to your healthcare provider about the proper disposal of your medication. 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 doctor will order certain lab tests to check your body's response to lanreotide injection. Do not let anyone else use 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 Somatuline Depot ", "role": "user" }, { "content": "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.", "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. 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. 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": "spina bifida; vertbral fusion;syrinx tethered cord. can u help for treatment of these problem\n\n Spina bifida Overview Spina bifida is a birth defect that occurs when the spine and spinal cord don't form properly. It falls under the broader category of neural tube defects. The neural tube is the embryonic structure that eventually develops into the baby's brain and spinal cord and the tissues that enclose them. Normally, the neural tube forms early in pregnancy, and it closes by the 28th day after conception. In babies with spina bifida, a portion of the neural tube fails to develop or close properly, causing defects in the spinal cord and in the bones of the spine. Spina bifida can range from mild to severe, depending on the type of defect, size, location and complications. When early treatment for spina bifida is necessary, it's done surgically, although such treatment doesn't always completely resolve the problem. Types Spina bifida can occur in different forms: spina bifida occulta, meningocele (muh-NING-go-seel) or myelomeningocele (my-uh-lo-muh-NING-go-seel). The severity of spina bifida depends on the type, size, location and complications. \"Occulta\" means hidden. The mildest form, spina bifida occulta results in a small separation or gap in one or more of the bones of the spine (vertebrae). Many people who have spina bifida occulta don't even know it, unless the condition is discovered during an imaging test done for unrelated reasons. In a form of spina bifida called meningocele, the protective membranes around the spinal cord (meninges) push out through the opening in the vertebrae, forming a sac filled with fluid. But this sac doesn't include the spinal cord, so nerve damage is less likely, though later complications are possible. Also known as open spina bifida, myelomeningocele is the most severe form. The spinal canal is open along several vertebrae in the lower or middle back. The membranes and spinal nerves push through this opening at birth, forming a sac on the baby's back, typically exposing tissues and nerves. This makes the baby prone to life-threatening infections. Symptoms Signs and symptoms of spina bifida vary by type and severity. Symptoms can also differ for each person. - Spina bifida occulta. Because the spinal nerves usually aren't involved, typically there are no signs or symptoms. But visible indications can sometimes be seen on the newborn's skin above the spinal defect, including an abnormal tuft of hair, or a small dimple or birthmark. - Meningocele. The membranes around the spinal cord push out through an opening in the vertebrae, forming a sac filled with fluid, but this sac doesn't include the spinal cord. - Myelomeningocele. In this severe form of spina bifida: - The spinal canal remains open along several vertebrae in the lower or middle back. - Both the membranes and the spinal cord or nerves protrude at birth, forming a sac. - Tissues and nerves usually are exposed, though sometimes skin covers the sac. When to see a doctor Typically, meningocele and myelomeningocele are diagnosed before or right after birth, when medical care is available. These children should be followed by a specialized team of doctors throughout their lives and families should be educated on the different complications to watch for. Children with spina bifida occulta typically don't have any symptoms or complications, so usually only routine pediatric care is needed. Causes Doctors aren't certain what causes spina bifida. As with many other problems, it appears to result from a combination of genetic and environmental risk factors, such as a family history of neural tube defects and folate deficiency. Risk factors Spina bifida is more common among whites and Hispanics, and females are affected more often than males. Although doctors and researchers don't know for sure why spina bifida occurs, they have identified some risk factors: - Folate deficiency. Folate (vitamin B-9) is important to the healthy development of a baby. Folate is the natural form of vitamin B-9. The synthetic form, found in supplements and fortified foods, is called folic acid. A folate deficiency increases the risk of spina bifida and other neural tube defects. - Family history of neural tube defects. Couples who've had one child with a neural tube defect have a slightly higher chance of having another baby with the same defect. That risk increases if two previous children have been affected by the condition. In addition, a woman who was born with a neural tube defect has a greater chance of giving birth to a child with spina bifida. However, most babies with spina bifida are born to parents with no known family history of the condition. - Some medications. For example, anti-seizure medications, such as valproic acid (Depakene), seem to cause neural tube defects when taken during pregnancy, possibly because they interfere with the body's ability to use folate and folic acid. - Diabetes. Women with diabetes who don't control their blood sugar well have a higher risk of having a baby with spina bifida. - Obesity. Pre-pregnancy obesity is associated with an increased risk of neural tube birth defects, including spina bifida. - Increased body temperature. Some evidence suggests that increased body temperature (hyperthermia) in the early weeks of pregnancy may increase the risk of spina bifida. Elevating your core body temperature, due to fever or the use of saunas or hot tubs, has been associated with a possible slight increased risk of spina bifida. If you have known risk factors for spina bifida, talk with your doctor to determine if you need a larger dose or prescription dose of folic acid, even before a pregnancy begins. If you take medications, tell your doctor. Some medications can be adjusted to diminish the potential risk of spina bifida, if plans are made ahead of time. Complications Spina bifida may cause minimal symptoms or only minor physical disabilities. If the spina bifida is severe, sometimes it leads to more significant physical disabilities. Severity is affected by: - The size and location of the neural tube defect - Whether skin covers the affected area - Which spinal nerves come out of the affected area of the spinal cord This list of possible complications may seem overwhelming, but not all children with spina bifida get all these complications. And these conditions can be treated. - Walking and mobility problems. The nerves that control the leg muscles don't work properly below the area of the spina bifida defect, causing muscle weakness of the legs, sometimes involving paralysis. Whether a child can walk typically depends on where the defect is, its size, and the care received before and after birth. - Orthopedic complications. Children with myelomeningocele can have a variety of problems in the legs and spine because of weak muscles in the legs and back. The types of problems depend on the level of the defect. Possible problems include a curved spine (scoliosis), abnormal growth or dislocation of the hip, bone and joint deformities, muscle contractures and other orthopedic concerns. - Bowel and bladder problems. Nerves that supply the bladder and bowels usually don't work properly when children have myelomeningocele. This is because the nerves that supply the bowel and bladder come from the lowest level of the spinal cord. - Accumulation of fluid in the brain (hydrocephalus). Babies born with myelomeningocele commonly experience accumulation of fluid in the brain, a condition known as hydrocephalus. - Shunt malfunction. Shunts can stop working or become infected. Warning signs may vary. Some of the warning signs of a shunt that isn't working include headaches, vomiting, sleepiness, irritability, swelling or redness along the shunt, confusion, changes in the eyes (fixed downward gaze), trouble feeding, or seizures. - Chiari malformation type II. Chiari malformation (kee-AH-ree mal-for-MAY-shun) type II is a common brain abnormality in children with the myelomeningocele form of spina bifida. The brainstem, or lowest part of the brain above the spinal cord, is elongated and positioned lower than usual. This can cause problems with breathing and swallowing. Rarely, compression on this area of the brain occurs and surgery is needed to relieve the pressure. - Infection in the tissues surrounding the brain (meningitis). Some babies with myelomeningocele may develop meningitis, an infection in the tissues surrounding the brain. This potentially life-threatening infection may cause brain injury. - Tethered spinal cord. Tethered spinal cord results when the spinal nerves become bound to the scar where the defect was closed surgically, making the spinal cord less able to grow as the child grows. This progressive tethering can cause loss of muscle function to the legs, bowel or bladder. Surgery can limit the degree of disability. - Sleep-disordered breathing. Both children and adults with spina bifida, particularly myelomeningocele, may have sleep apnea or other sleep disorders. Assessment for a sleep disorder in those with myelomeningocele helps detect sleep-disordered breathing, such as sleep apnea, which warrants treatment to improve health and quality of life. - Skin problems. Children with spina bifida may get wounds on their feet, legs, buttocks or back. They can't feel when they get a blister or sore. Sores or blisters can turn into deep wounds or foot infections that are hard to treat. Children with myelomeningocele have a higher risk of wound problems in casts. - Latex allergy. Children with spina bifida have a higher risk of latex allergy, an allergic reaction to natural rubber or latex products. Latex allergy may cause rash, sneezing, itching, watery eyes and a runny nose. It can also cause anaphylaxis, a potentially life-threatening condition in which swelling of the face and airways can make breathing difficult. So it's best to use latex-free gloves and equipment at delivery time and when caring for a child with spina bifida. - Other complications. More problems may arise as children with spina bifida get older, such as urinary tract infections, gastrointestinal (GI) disorders and depression. Children with myelomeningocele may develop learning disabilities, such as problems paying attention, and difficulty learning reading and math. Diagnosis If you're pregnant, you'll be offered prenatal screening tests to check for spina bifida and other birth defects. The tests aren't perfect. Some mothers who have positive blood tests have normal babies. Even if the results are negative, there's still a small chance that spina bifida is present. Talk to your doctor about prenatal testing, its risks and how you might handle the results. Blood tests Your doctor will most likely check for spina bifida by first performing these tests: - Maternal serum alpha-fetoprotein (MSAFP) test. For the MSAFP test, a sample of the mother's blood is drawn and tested for alpha-fetoprotein (AFP) - a protein produced by the baby. It's normal for a small amount of AFP to cross the placenta and enter the mother's bloodstream. But abnormally high levels of AFP suggest that the baby has a neural tube defect, such as spina bifida, though some spina bifida cases don't produce high levels of AFP. - Test to confirm high AFP levels. Varying levels of AFP can be caused by other factors - including a miscalculation in fetal age or multiple babies - so your doctor may order a follow-up blood test for confirmation. If the results are still high, you'll need further evaluation, including an ultrasound exam. - Other blood tests. Your doctor may perform the MSAFP test with two or three other blood tests. These tests are commonly done with the MSAFP test, but their objective is to screen for other abnormalities, such as trisomy 21 (Down syndrome), not neural tube defects. Ultrasound Many obstetricians rely on ultrasonography to screen for spina bifida. If blood tests indicate high AFP levels, your doctor will suggest an ultrasound exam to help determine why. The most common ultrasound exams bounce high-frequency sound waves off tissues in your body to form images on a video monitor. The information these images provide can help establish whether there's more than one baby and can help confirm gestational age, two factors that can affect AFP levels. An advanced ultrasound also can detect signs of spina bifida, such as an open spine or particular features in your baby's brain that indicate spina bifida. Amniocentesis If a blood test shows high levels of AFP in your blood but the ultrasound is normal, your doctor may offer amniocentesis. During amniocentesis, your doctor uses a needle to remove a sample of fluid from the amniotic sac that surrounds the baby. An analysis of the sample indicates the level of AFP present in the amniotic fluid. A small amount of AFP is normally found in amniotic fluid. However, when an open neural tube defect is present, the amniotic fluid contains an elevated amount of AFP because the skin surrounding the baby's spine is gone and AFP leaks into the amniotic sac. Discuss the risks of amniocentesis, including a slight risk of loss of the pregnancy, with your doctor. Treatment Spina bifida treatment depends on the severity of the condition. Spina bifida occulta often doesn't require treatment at all, but other types of spina bifida do. Surgery before birth Nerve function in babies with spina bifida can worsen after birth if it's not treated. Prenatal surgery for spina bifida (fetal surgery) takes place before the 26th week of pregnancy. Surgeons expose a pregnant mother's uterus surgically, open the uterus and repair the baby's spinal cord. Research suggests that children with spina bifida who had fetal surgery may have reduced disability and be less likely to need crutches or other walking devices. In addition, fetal surgery may reduce the risk of hydrocephalus. Ask your doctor whether this procedure may be appropriate for you. Discuss the risks, such as possible premature delivery and other complications, and potential benefits for you and your baby. It's important to have a comprehensive evaluation to determine whether fetal surgery is feasible. This specialized surgery should only be done at a health care facility that has experienced fetal surgery experts, a multispecialty team approach and neonatal intensive care. Typically the team includes a fetal surgeon, pediatric neurosurgeon, maternal-fetal medicine specialist, fetal cardiologist and neonatologist. Cesarean birth Many babies with myelomeningocele tend to be in a feet-first (breech) position. If your baby is in this position or if your doctor has detected a large cyst or sac, cesarean birth may be a safer way to deliver your baby. Surgery after birth Meningocele involves surgery to put the meninges back in place and close the opening in the vertebrae. Because the spinal cord develops normally in babies with meningocele, these membranes often can be removed by surgery with little or no damage to nerve pathways. Myelomeningocele also requires surgery. Performing the surgery early can help minimize risk of infection that's associated with the exposed nerves and may also help protect the spinal cord from more trauma. During the procedure, a neurosurgeon places the spinal cord and exposed tissue inside the baby's body and covers them with muscle and skin. Sometimes a shunt to control hydrocephalus in the baby's brain is placed during the operation on the spinal cord. Treatment for complications In babies with myelomeningocele, irreparable nerve damage has likely already occurred and ongoing care from a multispecialty team of surgeons, physicians and therapists is usually needed. Babies with myelomeningocele may need more surgery for a variety of complications. Treatment for complications - such as weak legs, bladder and bowel problems or hydrocephalus - typically begins soon after birth. Depending on the severity of spina bifida and the complications, treatment may include, for example: - Walking and mobility aids. Some babies may start exercises to prepare their legs for walking with braces or crutches when they're older. Some children may need walkers or a wheelchair. Mobility aids, along with regular physical therapy, can help a child become independent. - Bowel and bladder management. Routine bowel and bladder evaluations and management plans help reduce the risk of organ damage and illness. Evaluations include X-rays, kidney scans, ultrasounds, blood tests and bladder function studies. These evaluations will be more frequent in the first few years of life, but less often as children grow. - Bowel management may include oral medications, suppositories, enemas, surgery, or a combination of these approaches. - Bladder management may include medications, using catheters to empty the bladder, surgery, or a combination. - For children, a specialist in pediatric urology with experience in evaluating and performing surgery on children with spina bifida is the best choice. - Surgery for hydrocephalus. Most babies with myelomeningocele will need a ventricular shunt - a surgically placed tube that allows fluid in the brain to drain into the abdomen. This tube might be placed just after birth, during the surgery to close the sac on the lower back or later as fluid accumulates. A less invasive procedure, called endoscopic third ventriculostomy, may be used, but candidates must be carefully chosen and meet certain criteria. The surgeon uses a small video camera to see inside the brain and makes a hole in the bottom of or between the ventricles so cerebrospinal fluid can flow out of the brain. - Treatment and management of other complications. To help with functioning, special equipment such as bath chairs, commode chairs and standing frames may be needed. Whatever the issue - orthopedic complications, tethered spinal cord, GI issues, skin problems, or others - most spina bifida complications can be treated or at least managed to improve quality of life. Ongoing care Children with spina bifida need close follow-up care and observation. Their primary care doctors follow growth, the need for immunizations and general medical issues. They coordinate your child's medical care. Children with spina bifida also often need treatment and ongoing care from: - Physical medicine and rehabilitation - Neurology - Neurosurgery - Urology - Orthopedics - Physical therapy - Occupational therapy - Special education teachers - Social workers - Dietitians Parents and other caregivers are a key part of the team, learning how to help manage their child's condition and how to encourage and support their child emotionally and socially. Keep in mind that children with spina bifida can go on to college, hold jobs and have families. Special accommodations may be necessary along the way, but encourage your child to be as independent as possible. ", "role": "user" }, { "content": "Spina bifida treatment depends on the severity of the condition. Spina bifida occulta often doesn't require treatment at all, but other types of spina bifida do. Discuss with your doctor surgery before or after birth. Prenatal surgery for spina bifida (fetal surgery) takes place before the 26th week of pregnancy. Children with spina bifida who had fetal surgery may have reduced disability, reduced risk of hydrocephalus, and be less likely to need crutches or other walking devices. Early surgery after birth can help minimize risk of infection that's associated with the exposed nerves and may also help protect the spinal cord from more trauma. During the procedure, a neurosurgeon places the spinal cord and exposed tissue inside the baby's body and covers them with muscle and skin. Sometimes a shunt to control hydrocephalus in the baby's brain is placed during the operation on the spinal cord. Treatments for complications may include exercises to prepare the child’s legs for walking with braces or crutches when they're older. Some children may need walkers or a wheelchair. Mobility aids, along with regular physical therapy, can help a child become independent. Bowel management may include oral medications, suppositories, enemas, surgery, or a combination of these approaches. Bladder management may include medications, using catheters to empty the bladder, surgery, or a combination. To help with functioning, special equipment such as bath chairs, commode chairs and standing frames may be needed. Whatever the issue - orthopedic complications, tethered spinal cord, GI issues, skin problems, or others - most spina bifida complications can be treated or at least managed to improve quality of life. Children with spina bifida need close follow-up care and observation. Their primary care doctors follow growth, the need for immunizations and general medical issues. They coordinate your child's medical care. Children with spina bifida also often need treatment and ongoing care from physical medicine and rehabilitation, neurology, neurosurgery, urology, orthopedics, physical and occupational therapy, special education teachers, social workers, and dietitians. Parents and other caregivers are a key part of the team, learning how to help manage their child's condition and how to encourage and support their child emotionally and socially. Keep in mind that children with spina bifida can go on to college, hold jobs and have families. Special accommodations may be necessary along the way, but encourage your child to be as independent as possible.", "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 people have episodes of symptoms followed by periods with no symptoms for the rest of their lives. Some people have continuous health problems related to the disease.", "role": "assistant" } ]

[ { "content": "My daughter has menkes syndrome and would like to know how to go about. Thx\n\n ATP7A gene ATP7A_HUMAN ATPase, Cu++ transporting, alpha polypeptide ATPase, Cu++ transporting, alpha polypeptide (Menkes syndrome) ATPP1 copper pump 1 MC1 MK MNK OHS Normal Function The ATP7A gene provides instructions for making a protein that is important for regulating copper levels in the body. Copper is necessary for many cellular functions, but it is toxic when present in excessive amounts. The ATP7A protein is found throughout the body, except in liver cells. In the small intestine, this protein helps control the absorption of copper from food. In other cells, the ATP7A protein has a dual role and shuttles between two cellular locations. The protein normally resides in a cell structure called the Golgi apparatus, which modifies newly produced proteins, including enzymes. In the Golgi apparatus, the ATP7A protein supplies copper to certain enzymes that are critical for the structure and function of bone, skin, hair, blood vessels, and the nervous system. If copper levels in the cell environment are elevated, however, the ATP7A protein moves to the cell membrane and eliminates excess copper from the cell. Health Conditions Related to Genetic Changes Several mutations in the ATP7A gene are responsible for a condition called occipital horn syndrome or X-linked cutis laxa, which is considered a mild form of Menkes syndrome. Occipital horn syndrome is characterized by loose and sagging skin, wedge-shaped calcium deposits in a bone at the base of the skull (the occipital bone), coarse hair, and loose joints. Most of the mutations that cause occipital horn syndrome reduce but do not eliminate the production of the ATP7A protein. A shortage of this protein impairs the absorption of copper from food and prevents its normal distribution to cells throughout the body. The decreased supply of copper can reduce the activity of numerous copper-containing enzymes, affecting the structure and function of bone, skin, hair, blood vessels, and the nervous system. The reduced activity of these enzymes underlies the characteristic features of occipital horn syndrome. Chromosomal Location Cytogenetic Location: Xq21.1, which is the long (q) arm of the X chromosome at position 21.1 Molecular Location: base pairs 77,910,656 to 78,050,395 on the X chromosome (Homo sapiens Annotation Release 109, GRCh38.p12) (NCBI) </div> Credit: Genome Decoration Page/NCBI Sources for This Page Barnes N, Tsivkovskii R, Tsivkovskaia N, Lutsenko S. The copper-transporting ATPases, menkes and wilson disease proteins, have distinct roles in adult and developing cerebellum. J Biol Chem. 2005 Mar 11;280(10):9640-5. Epub 2005 Jan 5. ", "role": "user" }, { "content": "Mutations in the ATP7A gene cause Menkes syndrome. These mutations prevent the production of functional ATP7A protein. As a result, the absorption of copper from food is impaired, and copper is not supplied to certain enzymes. The disrupted activity of the ATP7A protein causes copper to accumulate in some tissues, such as the small intestine and kidneys, while the brain and other tissues have unusually low levels. The decreased supply of copper can reduce the activity of numerous copper-containing enzymes, affecting the structure and function of bone, skin, hair, blood vessels, and the nervous system. The signs and symptoms of Menkes syndrome are caused by the reduced activity of these copper-containing enzymes.", "role": "assistant" } ]

[ { "content": "how to loose weight\n\n Losing weight after pregnancy Summary You should plan to return to your pre-pregnancy weight by 6 to 12 months after delivery. Most women lose half of their baby weight by 6 weeks after childbirth (postpartum). The rest most often comes off over the next several months. A healthy diet with daily exercise will help you shed the pounds. Breastfeeding can also help with postpartum weight loss. Take Your Time Your body needs time to recover from childbirth. If you lose weight too soon after childbirth, it can take longer for you to recover. Give yourself until your 6-week checkup before trying to slim down. If you are breastfeeding, wait until your baby is at least 2 months old and your milk supply has normalized before drastically cutting calories. Aim for a weight loss of about a pound and a half a week. You can do this by eating healthy foods and adding in exercise once you are cleared by your health care provider for regular physical activity. Women who are exclusively breastfeeding need about 500 more calories per day than they did before pregnancy. Get these calories from healthy choices such as fruits, vegetables, whole grains, low-fat dairy, and lean protein. DO NOT drop below the minimum number of calories you need. Breastfeeding If you are breastfeeding, you will want to lose weight slowly. Weight loss that happens too fast can make you produce less milk. Losing about a pound and a half (670 grams) a week should not affect your milk supply or your health. Breastfeeding makes your body burn calories which helps you lose weight. If you are patient, you may be surprised at how much weight you lose naturally while breastfeeding. Eat to Lose Weight These healthy eating tips will help you lose weight safely. DO NOT skip meals. With a new baby, many new moms forget to eat. If you do not eat, you will have less energy, and it will not help you lose weight. Eat 5 to 6 small meals a day with healthy snacks in between (rather than 3 larger meals). Eat breakfast. Even if you do not normally eat in the mornings, get into the habit of having breakfast. It will give you energy to start your day and stop you from feeling tired later. Slow down. When you take your time eating, you will notice that it is easier to tell that you are full. It is tempting to multitask, but if you focus on your meal you will be less likely to overeat. Choose nonfat or low-fat dairy products. When you reach for a snack try to include foods with fiber and protein to help keep you full (such as raw bell pepper or carrot with bean dip, apple slices with peanut butter, or a slice of whole-wheat toast with hard-boiled egg). Drink at least 12 cups of fluid a day. Keep a water bottle near the spot where you usually feed the baby, that way you'll remember to drink when they do. Limit drinks like sodas, juices, and other fluids with added sugar and calories. They can add up and keep you from losing weight. Choose broiled or baked rather than fried foods. Limit sweets, sugar, saturated fat and trans fats. Do Not Crash and Burn DO NOT go on a crash diet (not eating enough) or a fad diet (popular diets that limit certain types of foods and nutrients). They will probably make you drop pounds at first, but those first few pounds you lose are fluid and will come back. Other pounds you lose on a crash diet may be muscle instead of fat. You will gain back any fat you lose on a crash diet once you return to normal eating. Be Realistic You may not be able to return to your exact pre-pregnancy shape. For many women, pregnancy causes lasting changes in the body. You may have a softer belly, wider hips, and a larger waistline. Make your goals about your new body realistic. Exercise A healthy diet combined with regular exercise is the best way to shed the pounds. Exercise will help you lose fat instead of muscle. Once you are ready to start losing weight, eat a little less and move a little more each day. It may be tempting to push yourself into a hard routine for fast weight loss. But rapid weight loss is not healthy and is hard on your body. DO NOT overdo it. Just a quick walk around the block with your baby in the stroller is a great way to start adding exercise to your daily routine. Review Date 2/27/2017 Updated by: Emily Wax, RD, The Brooklyn Hospital Center, Brooklyn, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "To lose weight after pregnancy, there are a few ways you can do so safely and healthily. Do not skip meals. Eat 5 to 6 meals a day, with healthy snacks in between. Make sure to eat breakfast. Choose nonfat or low-fat dairy products. Make sure to snack on foods with fiber and protein, such as carrots with bean dip, or a slice of toast with a hard-boiled egg. Choose boiled or baked rather than fried foods, and limit sweets and saturated fats. It is important to make your goals about your new body realistic.", "role": "assistant" } ]

[ { "content": "Vitelliform Macular Dystrophy Would like to obtain more info on possible treatments.\n\nAdult-onset vitelliform macular dystrophy (Treatment): There is no cure or known treatment to stop the progression of adult-onset vitelliform macular dystrophy. [2] Management usually includes a comprehensive eye examination once or twice a year to monitor progression of the disease and for complications such as choroidal neovascularization ( CNV ). [4]  CNV is sometimes associated with adult-onset vitelliform macular dystrophy because macular degeneration can damage the retinal layers. When this happens, the vascular layer of the eye between the sclera and the retina known as the choroid may produce new blood vessels (neovascularization) which grow up through the damaged layers and leak or bleed into the retina. This can cause vision loss on its own. If CNV does develop, anti-VEGF therapy such as Ranibizumab or Bevacizumab can control and even reverse the CNV. However anti-VEGF therapy does not stop or reverse the vision loss caused by adult-onset vitelliform macular dystrophy, only the extra vision loss that is due to also developing CNV. [2]  Although vision loss is usually slow, when vision is impaired significantly, people with adult-onset vitelliform macular dystrophy may be referred for low vision testing and rehabilitation. Low vision rehabilitation can help maintain and optimize reading ability and improve overall quality of life. [4] [5]", "role": "user" }, { "content": "There is no known treatment to stop the progression of adult-onset vitelliform macular dystrophy. Management of the disease includes a comprehensive eye exam once or twice a year, in order to monitor the progression of the disease and check for complications.", "role": "assistant" } ]

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

[ { "content": "what are the uses of vitamin e capsules\n\nataxia with vitamin E deficiency: Ataxia with vitamin E deficiency is a disorder that impairs the body's ability to use vitamin E obtained from the diet. Vitamin E is an antioxidant, which means that it protects cells in the body from the damaging effects of unstable molecules called free radicals. A shortage (deficiency) of vitamin E can lead to neurological problems, such as difficulty coordinating movements (ataxia) and speech (dysarthria), loss of reflexes in the legs (lower limb areflexia), and a loss of sensation in the extremities (peripheral neuropathy). Some people with this condition have developed an eye disorder called retinitis pigmentosa that causes vision loss. Most people who have ataxia with vitamin E deficiency start to experience problems with movement between the ages of 5 and 15 years. The movement problems tend to worsen with age. Ataxia with vitamin E deficiency is a rare condition; however, its prevalence is unknown. Mutations in the TTPA gene cause ataxia with vitamin E deficiency. The TTPA gene provides instructions for making the α-tocopherol transfer protein (αTTP), which is found in the liver and brain. This protein controls distribution of vitamin E obtained from the diet (also called α-tocopherol) to cells and tissues throughout the body. Vitamin E helps cells prevent damage that might be done by free radicals. TTPA gene mutations impair the activity of the αTTP protein, resulting in an inability to retain and use dietary vitamin E. As a result, vitamin E levels in the blood are greatly reduced and free radicals accumulate within cells. Nerve cells (neurons) in the brain and spinal cord (central nervous system) are particularly vulnerable to the damaging effects of free radicals and these cells die off when they are deprived of vitamin E. Nerve cell damage can lead to problems with movement and other features of ataxia with vitamin E deficiency. 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. Bromley D, Anderson PC, Daggett V. Structural consequences of mutations to the α-tocopherol transfer protein associated with the neurodegenerative disease ataxia with vitamin E deficiency. Biochemistry. 2013 Jun 18;52(24):4264-73. doi: 10.1021/bi4001084. Epub 2013 Jun 10.", "role": "user" }, { "content": "Vitamin E is an antioxidant, which means that it protects cells in the body from the damaging effects of unstable molecules called free radicals. A shortage (deficiency) of vitamin E can lead to neurological problems, such as difficulty coordinating movements (ataxia) and speech (dysarthria), loss of reflexes in the legs (lower limb areflexia), and a loss of sensation in the extremities (peripheral neuropathy).", "role": "assistant" } ]

[ { "content": "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\nTyphoid fever: Typhoid fever is caused by Salmonella typhi bacteria. Typhoid fever is rare in industrialized countries. However, it remains a serious health threat in the developing world, especially for children. Typhoid fever spreads through contaminated food and water or through close contact with someone who's infected. Signs and symptoms usually include high fever, headache, abdominal pain, and either constipation or diarrhea. Most people with typhoid fever feel better within a few days of starting antibiotic treatment, although a small number of them may die of complications. Vaccines against typhoid fever are available, but they're only partially effective. Vaccines usually are reserved for those who may be exposed to the disease or are traveling to areas where typhoid fever is common. Signs and symptoms are likely to develop gradually - often appearing one to three weeks after exposure to the disease. Early illness Once signs and symptoms do appear, you're likely to experience: - Fever that starts low and increases daily, possibly reaching as high as 104.9 F (40.5 C) - Headache - Weakness and fatigue - Muscle aches - Sweating - Dry cough - Loss of appetite and weight loss - Abdominal pain - Diarrhea or constipation - Rash - Extremely swollen abdomen Later illness If you don't receive treatment, you may: - Become delirious - Lie motionless and exhausted with your eyes half-closed in what's known as the typhoid state In addition, life-threatening complications often develop at this time. In some people, signs and symptoms may return up to two weeks after the fever has subsided. When to see a doctor See a doctor immediately if you suspect you have typhoid fever. If you become ill while traveling in a foreign country, call the U.S. Consulate for a list of doctors. Better yet, find out in advance about medical care in the areas you'll visit, and carry a list of the names, addresses and phone numbers of recommended doctors. If you develop signs and symptoms after you return home, consider consulting a doctor who focuses on international travel medicine or infectious diseases. A specialist may be able to recognize and treat your illness more quickly than can a doctor who isn't familiar with these areas. Typhoid fever is caused by virulent bacteria called Salmonella typhi (S. typhi). Although they're related, S. typhi and the bacteria responsible for salmonellosis, another serious intestinal infection, aren't the same. Fecal-oral transmission route The bacteria that cause typhoid fever spread through contaminated food or water and occasionally through direct contact with someone who is infected. In developing nations, where typhoid fever is endemic, most cases result from contaminated drinking water and poor sanitation. The majority of people in industrialized countries pick up typhoid bacteria while traveling and spread it to others through the fecal-oral route. This means that S. typhi is passed in the feces and sometimes in the urine of infected people. You can contract the infection if you eat food handled by someone with typhoid fever who hasn't washed carefully after using the toilet. You can also become infected by drinking water contaminated with the bacteria. Typhoid carriers Even after treatment with antibiotics, a small number of people who recover from typhoid fever continue to harbor the bacteria in their intestinal tracts or gallbladders, often for years. These people, called chronic carriers, shed the bacteria in their feces and are capable of infecting others, although they no longer have signs or symptoms of the disease themselves. Typhoid fever remains a serious worldwide threat - especially in the developing world - affecting an estimated 26 million or more people each year. The disease is endemic in India, Southeast Asia, Africa, South America and many other areas. Worldwide, children are at greatest risk of getting the disease, although they generally have milder symptoms than adults do. If you live in a country where typhoid fever is rare, you're at increased risk if you: - Work in or travel to areas where typhoid fever is endemic - Work as a clinical microbiologist handling Salmonella typhi bacteria - Have close contact with someone who is infected or has recently been infected with typhoid fever - Drink water contaminated by sewage that contains S. typhi Intestinal bleeding or holes The most serious complications of typhoid fever - intestinal bleeding or holes (perforations) in the intestine - may develop in the third week of illness. A perforated intestine occurs when your small intestine or large bowel develops a hole, causing intestinal contents to leak into your abdominal cavity and triggering signs and symptoms, such as severe abdominal pain, nausea, vomiting and bloodstream infection (sepsis). This life-threatening complication requires immediate medical care. Other, less common complications Other possible complications include: - Inflammation of the heart muscle (myocarditis) - Inflammation of the lining of the heart and valves (endocarditis) - Pneumonia - Inflammation of the pancreas (pancreatitis) - Kidney or bladder infections - Infection and inflammation of the membranes and fluid surrounding your brain and spinal cord (meningitis) - Psychiatric problems, such as delirium, hallucinations and paranoid psychosis With prompt treatment, nearly all people in industrialized nations recover from typhoid fever. Without treatment, some people may not survive complications of the disease. Medical and travel history Your doctor is likely to suspect typhoid fever based on your symptoms and your medical and travel history. But the diagnosis is usually confirmed by identifying S. typhi in a culture of your blood or other body fluid or tissue. Body fluid or tissue culture For the culture, a small sample of your blood, stool, urine or bone marrow is placed on a special medium that encourages the growth of bacteria. The culture is checked under a microscope for the presence of typhoid bacteria. A bone marrow culture often is the most sensitive test for S. typhi. Although performing a culture test is the mainstay for diagnosis, in some instances other testing may be used to confirm a suspected typhoid fever infection, such as a test to detect antibodies to typhoid bacteria in your blood or a test that checks for typhoid DNA in your blood. Antibiotic therapy is the only effective treatment for typhoid fever. Commonly prescribed antibiotics - Ciprofloxacin (Cipro). In the United States, doctors often prescribe this for nonpregnant adults. - Ceftriaxone (Rocephin). This injectable antibiotic is an alternative for people who may not be candidates for ciprofloxacin, such as children. These drugs can cause side effects, and long-term use can lead to the development of antibiotic-resistant strains of bacteria. Problems with antibiotic resistance In the past, the drug of choice was chloramphenicol. Doctors no longer commonly use it, however, because of side effects, a high rate of health deterioration after a period of improvement (relapse) and widespread bacterial resistance. In fact, the existence of antibiotic-resistant bacteria is a growing problem in the treatment of typhoid fever, especially in the developing world. In recent years, S. typhi also has proved resistant to trimethoprim-sulfamethoxazole and ampicillin. Other treatments Other treatments include: - Drinking fluids. This helps prevent the dehydration that results from a prolonged fever and diarrhea. If you're severely dehydrated, you may need to receive fluids through a vein (intravenously). - Surgery. If your intestines become perforated, you'll need surgery to repair the hole.", "role": "user" }, { "content": "Antibiotic therapy is the only effective treatment for typhoid fever. Commonly prescribed antibiotics - Ciprofloxacin (Cipro). In the United States, doctors often prescribe this for nonpregnant adults. - Ceftriaxone (Rocephin). This injectable antibiotic is an alternative for people who may not be candidates for ciprofloxacin, such as children. These drugs can cause side effects, and long-term use can lead to the development of antibiotic-resistant strains of bacteria. Problems with antibiotic resistance In the past, the drug of choice was chloramphenicol. Doctors no longer commonly use it, however, because of side effects, a high rate of health deterioration after a period of improvement (relapse) and widespread bacterial resistance. In fact, the existence of antibiotic-resistant bacteria is a growing problem in the treatment of typhoid fever, especially in the developing world. In recent years, S. typhi also has proved resistant to trimethoprim-sulfamethoxazole and ampicillin. Other treatments Other treatments include: - Drinking fluids. This helps prevent the dehydration that results from a prolonged fever and diarrhea. If you're severely dehydrated, you may need to receive fluids through a vein (intravenously). - Surgery. If your intestines become perforated, you'll need surgery to repair the hole.", "role": "assistant" } ]

[ { "content": "what test do you do for rheumatoid \"arthritis?\"\n\nRheumatoid Arthritis: - Rheumatoid arthritis is a disease that causes pain, swelling, and stiffness in your joints. This disease often occurs in more than one joint and can affect any joint in the body. If you have this disease, you may feel sick and tired, and sometimes get fevers. - Anyone can get arthritis, but it occurs more often in women and is most common in older people. - Genes, environmental factors, and hormones may play roles in the development of rheumatoid arthritis. - Treatment may involve medicine, surgery, and alternative therapies. - Regular rest, joint care, activity, a healthy diet, and reduced stress can ease symptoms. Rheumatoid arthritis is a disease that affects your joints. Joints are where two or more bones join together, such as at your knees, hips, or shoulders. Rheumatoid arthritis causes pain, swelling, and stiffness. If joints on one side of your body have rheumatoid arthritis, usually those joints on the other side do too. This disease often occurs in more than one joint. It can affect any joint in the body. If you have this disease, you also may feel sick and tired, and sometimes get fevers.   - Rheumatoid arthritis is a disease that causes pain, swelling, and stiffness in your joints. This disease often occurs in more than one joint and can affect any joint in the body. If you have this disease, you may feel sick and tired, and sometimes get fevers. - Anyone can get arthritis, but it occurs more often in women and is most common in older people. - Genes, environmental factors, and hormones may play roles in the development of rheumatoid arthritis. - Treatment may involve medicine, surgery, and alternative therapies. - Regular rest, joint care, activity, a healthy diet, and reduced stress can ease symptoms. - Rheumatoid arthritis is a disease that causes pain, swelling, and stiffness in your joints. This disease often occurs in more than one joint and can affect any joint in the body. If you have this disease, you may feel sick and tired, and sometimes get fevers. - Anyone can get arthritis, but it occurs more often in women and is most common in older people. - Genes, environmental factors, and hormones may play roles in the development of rheumatoid arthritis. - Treatment may involve medicine, surgery, and alternative therapies. - Regular rest, joint care, activity, a healthy diet, and reduced stress can ease symptoms. Rheumatoid arthritis is a disease that affects your joints. Joints are where two or more bones join together, such as at your knees, hips, or shoulders. Rheumatoid arthritis causes pain, swelling, and stiffness. If joints on one side of your body have rheumatoid arthritis, usually those joints on the other side do too. This disease often occurs in more than one joint. It can affect any joint in the body. If you have this disease, you also may feel sick and tired, and sometimes get fevers.   Anyone can get this disease, though it occurs more often in women. Rheumatoid arthritis often starts in middle age and is common in older people. But children and young adults can also get it. Anyone can get this disease, though it occurs more often in women. Rheumatoid arthritis often starts in middle age and is common in older people. But children and young adults can also get it. Doctors don't know the exact cause of rheumatoid arthritis. They know that with this type of arthritis, a person's immune system attacks his or her own body tissues. The immune system normally attacks invaders to the body, such as a cold virus or bacteria. Researchers are learning many things about why and how this happens. Things that may cause rheumatoid arthritis are: - Genes (passed from parent to child). - Environmental factors. - Hormones. Doctors don't know the exact cause of rheumatoid arthritis. They know that with this type of arthritis, a person's immune system attacks his or her own body tissues. The immune system normally attacks invaders to the body, such as a cold virus or bacteria. Researchers are learning many things about why and how this happens. Things that may cause rheumatoid arthritis are: - Genes (passed from parent to child). - Environmental factors. - Hormones. Doctors don't know the exact cause of rheumatoid arthritis. They know that with this type of arthritis, a person's immune system attacks his or her own body tissues. The immune system normally attacks invaders to the body, such as a cold virus or bacteria. Researchers are learning many things about why and how this happens. Things that may cause rheumatoid arthritis are: - Genes (passed from parent to child). - Environmental factors. - Hormones. Rheumatoid arthritis can be hard to diagnose because: - There is no single test for the disease. - The symptoms can be the same as in other kinds of joint disease. - The full symptoms can take time to develop. To diagnose rheumatoid arthritis, doctors use medical history, a physical exam, x-rays and other imaging tests, and lab tests. Rheumatoid arthritis can be hard to diagnose because: - There is no single test for the disease. - The symptoms can be the same as in other kinds of joint disease. - The full symptoms can take time to develop. To diagnose rheumatoid arthritis, doctors use medical history, a physical exam, x-rays and other imaging tests, and lab tests. Rheumatoid arthritis can be hard to diagnose because: - There is no single test for the disease. - The symptoms can be the same as in other kinds of joint disease. - The full symptoms can take time to develop. To diagnose rheumatoid arthritis, doctors use medical history, a physical exam, x-rays and other imaging tests, and lab tests. Doctors have many ways to treat rheumatoid arthritis. Treatment may involve: - Medicine. - Surgery. - Regular doctor visits. - Complementary therapies. The goals of treatment are to: - Take away pain. - Reduce swelling. - Slow down or stop joint damage. - Help you feel better. - Help you stay active. Medicine Most people with rheumatoid arthritis take medicine. Drugs can be used for pain relief, to reduce swelling, and to stop the disease from getting worse. What a doctor prescribes depends on: - Your general health. - How serious the rheumatoid arthritis is. - How serious the rheumatoid arthritis may become. - How long you will take the drug. - How well the drug works. - Possible side effects. Surgery There are many kinds of surgery for people with a lot of joint damage. Surgery may: - Reduce your pain. - Help your joint work better. - Help you be able to do daily activities. Surgery is not for everyone. Talk with your doctor to decide what is best for you. Regular Doctor Visits Regular medical care is important so doctors can: - See if the disease is getting worse. - See if drugs are helping. - Discuss any drug side effects. - Change treatment when needed. Complementary Therapies Special diets, vitamins, and other complementary therapies are sometimes suggested to treat rheumatoid arthritis.  Many of these treatments are not harmful, but they may not be well tested or have any real benefits. Ask your doctor about things you can do to manage your pain, such as exercise programs, support groups, and education classes. Before starting any complementary therapy, talk with your doctor to make sure it isn’t harmful. Doctors have many ways to treat rheumatoid arthritis. Treatment may involve: - Medicine. - Surgery. - Regular doctor visits. - Complementary therapies. The goals of treatment are to: - Take away pain. - Reduce swelling. - Slow down or stop joint damage. - Help you feel better. - Help you stay active. Medicine Most people with rheumatoid arthritis take medicine. Drugs can be used for pain relief, to reduce swelling, and to stop the disease from getting worse. What a doctor prescribes depends on: - Your general health. - How serious the rheumatoid arthritis is. - How serious the rheumatoid arthritis may become. - How long you will take the drug. - How well the drug works. - Possible side effects. Surgery There are many kinds of surgery for people with a lot of joint damage. Surgery may: - Reduce your pain. - Help your joint work better. - Help you be able to do daily activities. Surgery is not for everyone. Talk with your doctor to decide what is best for you. Regular Doctor Visits Regular medical care is important so doctors can: - See if the disease is getting worse. - See if drugs are helping. - Discuss any drug side effects. - Change treatment when needed. Complementary Therapies Special diets, vitamins, and other complementary therapies are sometimes suggested to treat rheumatoid arthritis.  Many of these treatments are not harmful, but they may not be well tested or have any real benefits. Ask your doctor about things you can do to manage your pain, such as exercise programs, support groups, and education classes. Before starting any complementary therapy, talk with your doctor to make sure it isn’t harmful. Doctors have many ways to treat rheumatoid arthritis. Treatment may involve: - Medicine. - Surgery. - Regular doctor visits. - Complementary therapies. The goals of treatment are to: - Take away pain. - Reduce swelling. - Slow down or stop joint damage. - Help you feel better. - Help you stay active. Medicine Most people with rheumatoid arthritis take medicine. Drugs can be used for pain relief, to reduce swelling, and to stop the disease from getting worse. What a doctor prescribes depends on: - Your general health. - How serious the rheumatoid arthritis is. - How serious the rheumatoid arthritis may become. - How long you will take the drug. - How well the drug works. - Possible side effects. Surgery There are many kinds of surgery for people with a lot of joint damage. Surgery may: - Reduce your pain. - Help your joint work better. - Help you be able to do daily activities. Surgery is not for everyone. Talk with your doctor to decide what is best for you. Regular Doctor Visits Regular medical care is important so doctors can: - See if the disease is getting worse. - See if drugs are helping. - Discuss any drug side effects. - Change treatment when needed. Complementary Therapies Special diets, vitamins, and other complementary therapies are sometimes suggested to treat rheumatoid arthritis.  Many of these treatments are not harmful, but they may not be well tested or have any real benefits. Ask your doctor about things you can do to manage your pain, such as exercise programs, support groups, and education classes. Before starting any complementary therapy, talk with your doctor to make sure it isn’t harmful. Several types of health care professionals may treat you, including:  - Internist, who diagnoses and treats adults. - Rheumatologist, who treats arthritis and other disease of the bones, joints, and muscles. - Orthopaedists, who treat and perform surgery for bone and joint diseases. - Physical therapists, who help to improve joint function. - Occupational therapists, who teach ways to protect joints, reduce pain, perform activities of daily living, and conserve energy. - Dietitians, who teach ways to use a good diet to improve health and maintain a healthy weight. Several types of health care professionals may treat you, including:  - Internist, who diagnoses and treats adults. - Rheumatologist, who treats arthritis and other disease of the bones, joints, and muscles. - Orthopaedists, who treat and perform surgery for bone and joint diseases. - Physical therapists, who help to improve joint function. - Occupational therapists, who teach ways to protect joints, reduce pain, perform activities of daily living, and conserve energy. - Dietitians, who teach ways to use a good diet to improve health and maintain a healthy weight. Several types of health care professionals may treat you, including:  - Internist, who diagnoses and treats adults. - Rheumatologist, who treats arthritis and other disease of the bones, joints, and muscles. - Orthopaedists, who treat and perform surgery for bone and joint diseases. - Physical therapists, who help to improve joint function. - Occupational therapists, who teach ways to protect joints, reduce pain, perform activities of daily living, and conserve energy. - Dietitians, who teach ways to use a good diet to improve health and maintain a healthy weight. With rheumatoid arthritis, you can still lead a full life. Besides going to your doctor and therapists regularly, you can also do these activities to help reduce your symptoms. Joint Care Look for ways to reduce stress on your joints. Some people find wearing a splint around a painful joint for a short time helps. Talk with your doctor to see if a splint may work for you. In addition, some special equipment can help such as a zipper puller or long-handled shoe horn. Rest Keep a good balance between rest and activity. Try to take frequent breaks, especially when your symptoms are bothering you. Lowering Stress Try to lower your stress by taking the time to relax, doing hobbies you enjoy, or joining a support group. Support groups can reduce your stress by helping you to: - Learn about the disease. - Cope with your emotions about your symptoms. - Feel more control over the disease. - Build confidence. A Healthy Diet Eat a healthy diet which will help you manage your weight and get a variety of nutrients for overall health. With rheumatoid arthritis, you can still lead a full life. Besides going to your doctor and therapists regularly, you can also do these activities to help reduce your symptoms. Joint Care Look for ways to reduce stress on your joints. Some people find wearing a splint around a painful joint for a short time helps. Talk with your doctor to see if a splint may work for you. In addition, some special equipment can help such as a zipper puller or long-handled shoe horn. Rest Keep a good balance between rest and activity. Try to take frequent breaks, especially when your symptoms are bothering you. Lowering Stress Try to lower your stress by taking the time to relax, doing hobbies you enjoy, or joining a support group. Support groups can reduce your stress by helping you to: - Learn about the disease. - Cope with your emotions about your symptoms. - Feel more control over the disease. - Build confidence. A Healthy Diet Eat a healthy diet which will help you manage your weight and get a variety of nutrients for overall health. You may also experience other health problems as a result of your rheumatoid arthritis. Be sure to talk with your doctor if any of these occur. Many people with rheumatoid arthritis may also have: - Anemia, a condition in which your blood has a lower than normal count of red blood cells. - Depression. - Anxiety. Other effects that occur less often include: - Neck pain. - Dry eyes. - Dry mouth. Very rarely, people may have inflammation of their: - Blood vessels. - Lining of the lungs. - Sac enclosing the heart. You may also experience other health problems as a result of your rheumatoid arthritis. Be sure to talk with your doctor if any of these occur. Many people with rheumatoid arthritis may also have: - Anemia, a condition in which your blood has a lower than normal count of red blood cells. - Depression. - Anxiety. Other effects that occur less often include: - Neck pain. - Dry eyes. - Dry mouth. Very rarely, people may have inflammation of their: - Blood vessels. - Lining of the lungs. - Sac enclosing the heart.", "role": "user" }, { "content": "Rheumatoid arthritis can be hard to diagnose because the symptoms can be the same as in other kinds of joint disease, take time to develop fully, and there is no single test for the disease. To diagnose rheumatoid arthritis, doctors use medical history, a physical exam, x-rays and other imaging tests, and lab tests.", "role": "assistant" } ]

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

[ { "content": "We have 14 siblings in our family , at least 10 of us has had a frozen shoulder. We are wondering why? should we be concerned?\n\n Frozen shoulder Overview Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness and pain in your shoulder joint. Signs and symptoms typically begin gradually, worsen over time and then resolve, usually within one to three years. Your risk of developing frozen shoulder increases if you're recovering from a medical condition or procedure that prevents you from moving your arm - such as a stroke or a mastectomy. Treatment for frozen shoulder involves range-of-motion exercises and, sometimes, corticosteroids and numbing medications injected into the joint capsule. In a small percentage of cases, arthroscopic surgery may be indicated to loosen the joint capsule so that it can move more freely. It's unusual for frozen shoulder to recur in the same shoulder, but some people can develop it in the opposite shoulder. Symptoms Frozen shoulder typically develops slowly, and in three stages. Each stage can last a number of months. - Freezing stage. Any movement of your shoulder causes pain, and your shoulder's range of motion starts to become limited. - Frozen stage. Pain may begin to diminish during this stage. However, your shoulder becomes stiffer, and using it becomes more difficult. - Thawing stage. The range of motion in your shoulder begins to improve. For some people, the pain worsens at night, sometimes disrupting sleep. Causes The bones, ligaments and tendons that make up your shoulder joint are encased in a capsule of connective tissue. Frozen shoulder occurs when this capsule thickens and tightens around the shoulder joint, restricting its movement. Doctors aren't sure why this happens to some people, although it's more likely to occur in people who have diabetes or those who recently had to immobilize their shoulder for a long period, such as after surgery or an arm fracture. Risk factors Certain factors may increase your risk of developing frozen shoulder. Age and sex People 40 and older, particularly women, are more likely to have frozen shoulder. Immobility or reduced mobility People who've had prolonged immobility or reduced mobility of the shoulder are at higher risk of developing frozen shoulder. Immobility may be the result of many factors, including: - Rotator cuff injury - Broken arm - Stroke - Recovery from surgery Systemic diseases People who have certain diseases appear more likely to develop frozen shoulder. Diseases that might increase risk include: - Diabetes - Overactive thyroid (hyperthyroidism) - Underactive thyroid (hypothyroidism) - Cardiovascular disease - Tuberculosis - Parkinson's disease Diagnosis During the physical exam, your doctor may ask you to move in certain ways to check for pain and evaluate your range of motion (active range of motion). Your doctor might then ask you to relax your muscles while he or she moves your arm (passive range of motion). Frozen shoulder affects both active and passive range of motion. In some cases, your doctor might inject your shoulder with a numbing medicine (anesthetic) to determine your passive and active range of motion. Frozen shoulder can usually be diagnosed from signs and symptoms alone. But your doctor may suggest imaging tests - such as X-rays or an MRI - to rule out other problems. Treatment Most frozen shoulder treatment involves controlling shoulder pain and preserving as much range of motion in the shoulder as possible. Medications Over-the-counter pain relievers, such as aspirin and ibuprofen (Advil, Motrin IB, others), can help reduce pain and inflammation associated with frozen shoulder. In some cases, your doctor may prescribe stronger pain-relieving and anti-inflammatory drugs. Therapy A physical therapist can teach you range-of-motion exercises to help recover as much mobility in your shoulder as possible. Your commitment to doing these exercises is important to optimize recovery of your mobility. Surgical and other procedures Most frozen shoulders get better on their own within 12 to 18 months. For persistent symptoms, your doctor may suggest: - Steroid injections. Injecting corticosteroids into your shoulder joint may help decrease pain and improve shoulder mobility, especially in the early stages of the process. - Joint distension. Injecting sterile water into the joint capsule can help stretch the tissue and make it easier to move the joint. - Shoulder manipulation. In this procedure, you receive a general anesthetic, so you'll be unconscious and feel no pain. Then the doctor moves your shoulder joint in different directions, to help loosen the tightened tissue. - Surgery. Surgery for frozen shoulder is rare, but if nothing else has helped, your doctor may recommend surgery to remove scar tissue and adhesions from inside your shoulder joint. Doctors usually perform this surgery with lighted, tubular instruments inserted through small incisions around your joint (arthroscopically). Lifestyle and home remedies Continue to use the involved shoulder and extremity as much as possible given your pain and range-of-motion limits. Applying heat or cold to your shoulder can help relieve pain. Alternative medicine Acupuncture Acupuncture involves inserting extremely fine needles in your skin at specific points on your body. Typically, the needles remain in place for 15 to 40 minutes. During that time they may be moved or manipulated. Because the needles are hair thin and flexible and are generally inserted superficially, most acupuncture treatments are relatively painless. Transcutaneous electrical nerve stimulation (TENS) A TENS unit delivers a tiny electrical current to key points on a nerve pathway. The current, delivered through electrodes taped to your skin, isn't painful or harmful. It's not known exactly how TENS works, but it's thought that it might stimulate the release of pain-inhibiting molecules (endorphins) or block pain fibers that carry pain impulses. ", "role": "user" }, { "content": "The bones, ligaments and tendons that make up your shoulder joint are encased in a capsule of connective tissue. Frozen shoulder occurs when this capsule thickens and tightens around the shoulder joint, restricting its movement. Doctors aren't sure why this happens to some people, although it's more likely to occur in people who have diabetes or those who recently had to immobilize their shoulder for a long period, such as after surgery or an arm fracture.", "role": "assistant" } ]