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[ { "content": "what are the risk factors of type ii diabetes\n\nType 2 diabetes: 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. 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 thin. 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. 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. 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 - 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 and bones on 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. The goal of treatment at first is to lower your high blood glucose level. Long-term goals are to prevent complications. These are health problems from 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. 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. 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. Very 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. 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 - DPP IV inhibitors - Injectable medicines (GLP-1 analogs) - Meglitinides - SGL T2 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. - 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. 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. 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. After many years, diabetes can lead to serious health problems: - You could have eye problems, including trouble seeing (especially at night), and light sensitivity. You could become blind. - Your feet and skin can develop sores and infections. After a long time, your foot or leg may need to be amputated. Infection can also cause pain and itching in other parts of the body. - Diabetes may make it harder to control your blood pressure and cholesterol. This can lead to a heart attack, stroke, and other problems. It can become harder for blood to flow to your legs and feet. - Nerves in your body can get damaged, causing pain, tingling, and numbness. - Because of nerve damage, you could have problems digesting the food you eat. You could feel weakness or have trouble going to the bathroom. Nerve damage can make it harder for men to have an erection. - High blood sugar and other problems can lead to kidney damage. Your kidneys may not work as well as they used to. They may even stop working so that you need dialysis or a kidney transplant. 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 convulsions, 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) 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. Updated by: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology and Nutrition, University of Washington School of Medicine, Seattle, WA. Internal review and update on 09/01/2016 by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.", "role": "user" }, { "content": "Risk factors for type 2 diabetes include family history and genes, as well as low activity level, poor diet, and excess body weight around the waist.", "role": "assistant" } ]

[ { "content": "what is acute diverticulitis\n\nDiverticulitis: Diverticula are small, bulging pouches that can form in the lining of your digestive system. They are found most often in the lower part of the large intestine (colon). Diverticula are common, especially after age 40, and seldom cause problems. Sometimes, however, one or more of the pouches become inflamed or infected. That condition is known as diverticulitis (die-vur-tik-yoo-LIE-tis). Diverticulitis can cause severe abdominal pain, fever, nausea and a marked change in your bowel habits. Mild diverticulitis can be treated with rest, changes in your diet and antibiotics. Severe or recurring diverticulitis may require surgery. The signs and symptoms of diverticulitis include: - Pain, which may be constant and persist for several days. Pain is usually felt in the lower left side of the abdomen, but may occur on the right, especially in people of Asian descent. - Nausea and vomiting. - Fever. - Abdominal tenderness. - Constipation or, less commonly, diarrhea. Diverticula usually develop when naturally weak places in your colon give way under pressure. This causes marble-sized pouches to protrude through the colon wall. Diverticulitis occurs when diverticula tear, resulting in inflammation or infection or both. Several factors may increase your risk of developing diverticulitis: - Aging. The incidence of diverticulitis increases with age. - Obesity. Being seriously overweight increases your odds of developing diverticulitis. Morbid obesity may increase your risk of needing more-invasive treatments for diverticulitis. - Smoking. People who smoke cigarettes are more likely than nonsmokers to experience diverticulitis. - Lack of exercise. Vigorous exercise appears to lower your risk of diverticulitis. - Diet high in animal fat and low in fiber, although the role of low fiber alone isn't clear. - Certain medications. Several drugs are associated with an increased risk of diverticulitis, including steroids, opiates and nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve). Diverticulitis is usually diagnosed during an acute attack. Because abdominal pain can indicate a number of problems, your doctor will need to rule out other causes for your symptoms. Your doctor will likely start with a physical examination, including checking your abdomen for tenderness. Women, in addition, generally have a pelvic examination to rule out pelvic disease. After that, your doctor will likely recommend: - Blood and urine tests, to check for signs of infection. - Pregnancy test for women of childbearing age, to rule out pregnancy as a cause of abdominal pain. - Liver function tests, to rule out other causes of abdominal pain. - Stool test, to rule out infection in people who have diarrhea. - CT scan, which can indicate inflamed or infected pouches and confirm a diagnosis of diverticulitis. CT can also indicate the severity of diverticulitis and guide treatment. Diagnosis at Mayo Clinic Diverticulitis can be difficult to diagnose because abdominal pain is a symptom of many digestive disorders. Mayo Clinic has radiologists who specialize in digestive disorders and have experience distinguishing diverticulitis from other conditions. Mayo's digestive disease specialists (gastroenterologists) have experience diagnosing the severity of diverticulitis. Precise diagnosis is important for appropriate treatment. Treatment depends on the severity of your signs and symptoms. Uncomplicated diverticulitis If your symptoms are mild, you may be treated at home. Your doctor is likely to recommend: - Antibiotics, to treat infection. - A liquid diet for a few days while your bowel heals. Once your symptoms improve, you can gradually add solid food to your diet. - An over-the-counter pain reliever, such as acetaminophen (Tylenol, others). This treatment is successful in 70 to 100 percent of people with uncomplicated diverticulitis. Complicated diverticulitis If you have a severe attack or have other health problems, you'll likely need to be hospitalized. Treatment generally involves: - Intravenous antibiotics - Insertion of a tube to drain an abscess, if one has formed Surgery You'll likely need surgery to treat diverticulitis if: - You have a complication, such as perforation, abscess, fistula or bowel obstruction - You have had multiple episodes of uncomplicated diverticulitis - You are immune compromised There are two main types of surgery: - Primary bowel resection. The surgeon removes diseased segments of your intestine and then reconnects the healthy segments (anastomosis). This allows you to have normal bowel movements. Depending on the amount of inflammation, you may have open surgery or a minimally invasive (laparoscopic) procedure. - Bowel resection with colostomy. If you have so much inflammation that it's not possible to rejoin your colon and rectum, the surgeon will perform a colostomy. An opening (stoma) in your abdominal wall is connected to the healthy part of your colon. Waste passes through the opening into a bag. Once the inflammation has eased, the colostomy may be reversed and the bowel reconnected. Follow-up care Your doctor may recommend colonoscopy six weeks after you recover from diverticulitis, especially if you haven't had the test in the previous year. There doesn't appear to be a direct link between diverticular disease and colon or rectal cancer. But colonoscopy - which isn't possible during a diverticulitis attack - can exclude colon cancer as a cause of your symptoms. Sometimes, surgery is recommended. But previous recommendations for surgery based on the number of attacks have been questioned, since most people do well even after two or more attacks. The decision on surgery is an individual one, and is often based on the frequency of attacks and whether complications have occurred. Treatment at Mayo Clinic Mayo Clinic specialists have experience treating both mild and severe diverticulitis. If you need surgery, Mayo surgeons can offer minimally invasive options - including laparoscopic, hand-assisted laparoscopic and robotic procedures - if appropriate. To help prevent diverticulitis: - Exercise regularly. Exercise promotes normal bowel function and reduces pressure inside your colon. Try to exercise at least 30 minutes on most days. - Eat more fiber. High-fiber foods, such as fresh fruits and vegetables and whole grains, soften waste material and help it pass more quickly through your colon. This reduces pressure inside your digestive tract. However, it isn't clear whether a high-fiber diet decreases the risk of diverticulitis. Eating seeds and nuts isn't associated with developing diverticulitis. - Drink plenty of fluids. Fiber works by absorbing water and increasing the soft, bulky waste in your colon. But if you don't drink enough liquid to replace what's absorbed, fiber can be constipating. Some experts suspect that people who develop diverticulitis may not have enough good bacteria in their colons. Probiotics - foods or supplements that contain beneficial bacteria - are sometimes suggested as a way to prevent diverticulitis. But that advice hasn't been scientifically validated.", "role": "user" }, { "content": "Diverticula are small, bulging pouches that can form in the lining of your digestive system. They are found most often in the lower part of the large intestine. Usually diverticula seldom cause problems; however, if one or more of the pouches become inflamed or infected, they can cause sever pain, fever, nausea, and a marked changed in your bowel habits. This is known as diverticulitis. Mild diverticulitis can be treated with rest, changes in your diet and antibiotics. Severe or recurring diverticulitis may require surgery.", "role": "assistant" } ]

[ { "content": "how do i prevent myself from having dementia\n\nDementia (Prevention): Most causes of dementia are not preventable. The risk of vascular dementia may be reduced by preventing strokes through: - Eating healthy foods - Exercising - Quitting smoking - Controlling high blood pressure - Managing diabetes", "role": "user" }, { "content": "Dementia (Prevention): Most causes of dementia are not preventable. The risk of vascular dementia may be reduced by preventing strokes through: - Eating healthy foods - Exercising - Quitting smoking - Controlling high blood pressure - Managing diabetes", "role": "assistant" } ]

[ { "content": "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 (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).", "role": "user" }, { "content": "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.", "role": "assistant" } ]

[ { "content": "how is congenital heart disease passed down\n\n Congenital heart disease Summary Congenital heart disease (CHD) is a problem with the heart's structure and function that is present at birth. Causes CHD can describe a number of different problems affecting the heart. It is the most common type of birth defect. CHD causes more deaths in the first year of life than any other birth defects. CHD is often divided into two types: cyanotic (blue skin color caused by a lack of oxygen) and non-cyanotic. The following lists cover the most common CHDs: Cyanotic: Ebstein's anomaly Hypoplastic left heart Pulmonary atresia Tetralogy of Fallot Total anomalous pulmonary venous return Transposition of the great vessels Tricuspid atresia Truncus arteriosus Non-cyanotic: Aortic stenosis Bicuspid aortic valve Atrial septal defect (ASD) Atrioventricular canal (endocardial cushion defect) Coarctation of the aorta Patent ductus arteriosus (PDA) Pulmonic stenosis Ventricular septal defect (VSD) These problems may occur alone or together. Most children with CHD do not have other types of birth defects. However, heart defects may be part of genetic and chromosomal syndromes. Some of these syndromes may be passed down through families. Examples include: DiGeorge syndrome Down syndrome Marfan syndrome Noonan syndrome Edwards syndrome Trisomy 13 Turner syndrome Often, no cause for the heart disease can be found. CHDs continue to be investigated and researched. Drugs such as retinoic acid for acne, chemicals, alcohol, and infections (such as rubella) during pregnancy can contribute to some congenital heart problems. Poorly controlled blood sugar in women who have diabetes during pregnancy has also been linked to a high rate of congenital heart defects. Symptoms Symptoms depend on the condition. Although CHD is present at birth, the symptoms may not appear right away. Defects such as coarctation of the aorta may not cause problems for years. Other problems, such as a small VSD, ASD, or PDA may never cause any problems. Exams and Tests Most congenital heart defects are found during a pregnancy ultrasound. When a defect is found, a pediatric heart doctor, surgeon, and other specialists can be there when the baby is delivered. Having medical care ready at the delivery can mean the difference between life and death for some babies. Which tests are done on the baby depend on the defect and the symptoms. Treatment Which treatment is used, and how well the baby responds to it, depends on the condition. Many defects need to be followed carefully. Some will heal over time, while others will need to be treated. Some CHDs can be treated with medicine alone. Others need to be treated with one or more heart procedures or surgeries. Prevention Women who are pregnant should get good prenatal care: Avoid alcohol and illegal drugs during pregnancy. Tell your health care provider that you are pregnant before taking any new medicines. Have a blood test early in your pregnancy to see if you are immune to rubella. If you are not immune, avoid any possible exposure to rubella and get vaccinated right after delivery. Pregnant women who have diabetes should try to get good control over their blood sugar level. Certain genes may play a role in CHD. Many family members may be affected. Talk to your provider about genetic counseling and screening if you have a family history of CHD. Review Date 12/8/2017 Updated by: Steven Kang, MD, Director, Cardiac Electrophysiology, Alta Bates Summit Medical Center, Stanford Healthcare, Oakland, CA. 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": "Heart defects may be part of genetic and chromosomal syndromes which are passed down through families. These syndromes include DiGeorge syndrome, Down syndrome, Marfan syndrome, Noonan syndrome,Trisomy 13, and Turner syndrome", "role": "assistant" } ]

[ { "content": "what test do you do for rheumatoid \"arthritis?\"\n\nRheumatoid Arthritis (Is there a test?): 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.", "role": "user" }, { "content": "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.", "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": "Children who inherit achondroplasia from both parents usually live only few months. Other people with achondroplasia may grow to be 5 feet tall and their intelligence is usually normal.", "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": "With Pulmonary hypertension, blood pressure in the pulmonary arteries is increased because the walls of the pulmonary arteries stiffen and thicken. These changes make it harder for blood to flow, which raises the blood pressure in the pulmonary arteries.", "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\nAnal fissure (Treatment): Most fissures heal on their own and do not need treatment. To prevent or treat anal fissures in infants, be sure to change diapers often and clean the area gently. CHILDREN AND ADULTS Worrying about pain during a bowel movement may cause a person to avoid them. But not having bowel movements will only cause the stools to become even harder, which can make anal fissure worse. Prevent hard stools and constipation by: - Making dietary changes -- eating more fiber or bulk, such as fruits, vegetables, and grains - Drinking more fluids - Using stool softeners Ask your provider about the following ointments or creams to help soothe the affected skin: - Numbing cream, if pain interferes with normal bowel movements - Petroleum jelly - Zinc oxide, 1% hydrocortisone cream, Preparation H, and other products A sitz bath is a warm water bath used for healing or cleansing. Sit in the bath 2 to 3 times a day. The water should cover only the hips and buttocks. If the anal fissures do not go away with home care methods, treatment may involve: - Botox injections into the muscle in the anus (anal sphincter) - Minor surgery to relax the anal muscle - Prescription creams such as nitrates or calcium channel blockers, applied over the fissure to help relax the muscles", "role": "user" }, { "content": "Prevent hard stools and constipation by: - Making dietary changes -- eating more fiber or bulk, such as fruits, vegetables, and grains - Drinking more fluids - Using stool softeners Ask your provider about the following ointments or creams to help soothe the affected skin: - Numbing cream, if pain interferes with normal bowel movements - Petroleum jelly - Zinc oxide, 1% hydrocortisone cream, Preparation H, and other products A sitz bath is a warm water bath used for healing or cleansing. Sit in the bath 2 to 3 times a day. The water should cover only the hips and buttocks. If the anal fissures do not go away with home care methods, treatment may involve: - Botox injections into the muscle in the anus (anal sphincter) - Minor surgery to relax the anal muscle - Prescription creams such as nitrates or calcium channel blockers, applied over the fissure to help relax the muscles", "role": "assistant" } ]

[ { "content": "prostate cancer using seeds aimed at maligmem tumors is this a safe decision\n\nProstate cancer - treatment: Treatment for your prostate cancer is chosen after a thorough evaluation. Your doctor will discuss the benefits and risks of each treatment. Sometimes your doctor may recommend 1 treatment for you because of your type of cancer and risk factors. Other times, there may be 2 or more treatments that could be good for you. Factors you and your doctor must think about include: - Your age and other medical problems you may have - Side effects that occur with each type of treatment - How much the prostate cancer has spread - Your Gleason score, which tells how likely it is that cancer has already spread - Your prostate-specific antigen (PSA) test result Ask your doctor to explain these things following about your treatment choices: - Which choices offer the best chance of curing your cancer or controlling its spread? - How likely is it that you will have different side effects, and how they will affect your life? Radical prostatectomy is a surgery to remove the prostate and some of the surrounding tissue. It is an option when the cancer has not spread beyond the prostate gland. Healthy men who will likely live 10 or more years after being diagnosed with prostate cancer often have this procedure. Be aware that it is not always possible to know for certain, before surgery, if the cancer has spread beyond the prostate gland. Possible problems after surgery include difficulty controlling urine and erection problems. Also, some men need further treatments after this surgery. Radiation therapy works best for treating prostate cancer that has not spread outside of the prostate. It may also be used after surgery if there is a risk that cancer cells are still present. Radiation is sometimes used for pain relief when cancer has spread to the bone. External beam radiation therapy uses high-powered x-rays pointed at the prostate gland: - Before treatment, the radiation therapist uses a special pen to mark the part of the body that is to be treated. - Radiation is delivered to the prostate gland using a machine similar to a regular x-ray machine. The treatment itself is usually painless. - Treatment is done in a radiation oncology center that is usually connected to a hospital. - Treatment is usually done 5 days a week for 6 to 8 weeks. Side effects may include: - Appetite loss - Diarrhea - Erection problems - Fatigue - Rectal burning or injury - Skin reactions - Urinary incontinence, the feeling of needing to urinate urgently, or blood in the urine There are reports of secondary cancers arising from the radiation as well. Proton therapy is another kind of radiation therapy used to treat prostate cancer. Proton beams target the tumor precisely, so there is less damage to the surrounding tissue. This therapy is not widely accepted or used. Brachytherapy is often used for small prostate cancers that are found early and are slow-growing. Brachytherapy may be combined with external beam radiation therapy for more advanced cancers. Brachytherapy involves placing radioactive seeds inside the prostate gland. - A surgeon inserts small needles through the skin beneath your scrotum to inject the seeds. The seeds are so small that you do not feel them. - The seeds are left in place permanently. Side effects may include: - Pain, swelling, or bruising in the penis or scrotum - Red-brown urine or semen - Impotence - Incontinence - Urinary retention - Diarrhea Testosterone is the main male hormone. Prostate tumors need testosterone to grow. Hormonal therapy is treatment that decreases the effect of testosterone on prostate cancer. Hormone therapy is mainly used for cancer that has spread beyond the prostate. The treatment can help relieve symptoms and prevent further growth and spread of cancer. But it does not cure the cancer. The main type of hormone therapy is called a luteinizing hormone-releasing hormones (LH-RH) agonist: - The medicine blocks the testicles from making testosterone. The drugs must be given by injection, usually every 3 to 6 months. - Possible side effects include nausea and vomiting, hot flashes, anemia, fatigue, thinning bones (osteoporosis), reduced sexual desire, decreased muscle mass, weight gain, and impotence. The other type of hormone medicine is called an androgen-blocking drug: - It is often given along with LH-RH drugs to block the effect of testosterone produced by the adrenal glands, which make a small amount of testosterone. - Possible side effects include erection problems, reduced sexual desire, liver problems, diarrhea, and enlarged breasts. Much of the body's testosterone is made by the testes. As a result, surgery to remove the testes (called orchiectomy) can also be used as a hormonal treatment. Chemotherapy and immunotherapy (medicine that helps the body's immune system fight the cancer) may be used to treat prostate cancer that no longer responds to hormone treatment. Usually a single drug or a combination of drugs is recommended. 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, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.", "role": "user" }, { "content": "Brachytherapy is often used for small prostate cancers that are found early and are slow-growing. Brachytherapy may be combined with external beam radiation therapy for more advanced cancers. Brachytherapy involves placing radioactive seeds inside the prostate gland. - A surgeon inserts small needles through the skin beneath your scrotum to inject the seeds. The seeds are so small that you do not feel them. - The seeds are left in place permanently. Side effects may include: - Pain, swelling, or bruising in the penis or scrotum - Red-brown urine or semen - Impotence - Incontinence - Urinary retention - Diarrhea", "role": "assistant" } ]

[ { "content": "what the treatment for bronchitis\n\nBronchitis: Español Bronchitis (bron-KI-tis) is a condition in which the bronchial tubes become inflamed. These tubes carry air to your lungs. (For more information about the bronchial tubes and airways, go to the Diseases and Conditions Index How the Lungs Work article.) People who have bronchitis often have a cough that brings up mucus. Mucus is a slimy substance made by the lining of the bronchial tubes. Bronchitis also may cause wheezing (a whistling or squeaky sound when you breathe), chest pain or discomfort, a low fever, and shortness of breath. Bronchitis Overview The two main types of bronchitis are acute (short term) and chronic (ongoing). Acute Bronchitis Infections or lung irritants cause acute bronchitis. The same viruses that cause colds and the flu are the most common cause of acute bronchitis. These viruses are spread through the air when people cough. They also are spread through physical contact (for example, on hands that have not been washed). Sometimes bacteria cause acute bronchitis. Acute bronchitis lasts from a few days to 10 days. However, coughing may last for several weeks after the infection is gone. Several factors increase your risk for acute bronchitis. Examples include exposure to tobacco smoke (including secondhand smoke), dust, fumes, vapors, and air pollution. Avoiding these lung irritants as much as possible can help lower your risk for acute bronchitis. Most cases of acute bronchitis go away within a few days. If you think you have acute bronchitis, see your doctor. He or she will want to rule out other, more serious health conditions that require medical care. Chronic Bronchitis Chronic bronchitis is an ongoing, serious condition. It occurs if the lining of the bronchial tubes is constantly irritated and inflamed, causing a long-term cough with mucus. Smoking is the main cause of chronic bronchitis. Viruses or bacteria can easily infect the irritated bronchial tubes. If this happens, the condition worsens and lasts longer. As a result, people who have chronic bronchitis have periods when symptoms get much worse than usual. Chronic bronchitis is a serious, long-term medical condition. Early diagnosis and treatment, combined with quitting smoking and avoiding secondhand smoke, can improve quality of life. The chance of complete recovery is low for people who have severe chronic bronchitis. Acute bronchitis Chronic bronchitis Industrial bronchitis Acute Bronchitis Infections or lung irritants cause acute bronchitis. The same viruses that cause colds and the flu are the most common cause of acute bronchitis. Sometimes bacteria can cause the condition. Certain substances can irritate your lungs and airways and raise your risk for acute bronchitis. For example, inhaling or being exposed to tobacco smoke, dust, fumes, vapors, or air pollution raises your risk for the condition. These lung irritants also can make symptoms worse. Being exposed to a high level of dust or fumes, such as from an explosion or a big fire, also may lead to acute bronchitis. Chronic Bronchitis Repeatedly breathing in fumes that irritate and damage lung and airway tissues causes chronic bronchitis. Smoking is the major cause of the condition. Breathing in air pollution and dust or fumes from the environment or workplace also can lead to chronic bronchitis. People who have chronic bronchitis go through periods when symptoms become much worse than usual. During these times, they also may have acute viral or bacterial bronchitis. Bronchitis is a very common condition. Millions of cases occur every year. Elderly people, infants, and young children are at higher risk for acute bronchitis than people in other age groups. People of all ages can develop chronic bronchitis, but it occurs more often in people who are older than 45. Also, many adults who develop chronic bronchitis are smokers. Women are more than twice as likely as men to be diagnosed with chronic bronchitis. Smoking and having an existing lung disease greatly increase your risk for bronchitis. Contact with dust, chemical fumes, and vapors from certain jobs also increases your risk for the condition. Examples include jobs in coal mining, textile manufacturing, grain handling, and livestock farming. Air pollution, infections, and allergies can worsen the symptoms of chronic bronchitis, especially if you smoke. Acute Bronchitis Acute bronchitis caused by an infection usually develops after you already have a cold or the flu. Symptoms of a cold or the flu include sore throat, fatigue (tiredness), fever, body aches, stuffy or runny nose, vomiting, and diarrhea. The main symptom of acute bronchitis is a persistent cough, which may last 10 to 20 days. The cough may produce clear mucus (a slimy substance). If the mucus is yellow or green, you may have a bacterial infection as well. Even after the infection clears up, you may still have a dry cough for days or weeks. Other symptoms of acute bronchitis include wheezing (a whistling or squeaky sound when you breathe), low fever, and chest tightness or pain. If your acute bronchitis is severe, you also may have shortness of breath, especially with physical activity. Chronic Bronchitis The signs and symptoms of chronic bronchitis include coughing, wheezing, and chest discomfort. The coughing may produce large amounts of mucus. This type of cough often is called a smoker's cough. Your doctor usually will diagnose bronchitis based on your signs and symptoms. He or she may ask questions about your cough, such as how long you've had it, what you're coughing up, and how much you cough. Your doctor also will likely ask: About your medical history Whether you've recently had a cold or the flu Whether you smoke or spend time around others who smoke Whether you've been exposed to dust, fumes, vapors, or air pollution Your doctor will use a stethoscope to listen for wheezing (a whistling or squeaky sound when you breathe) or other abnormal sounds in your lungs. He or she also may: Look at your mucus to see whether you have a bacterial infection Test the oxygen levels in your blood using a sensor attached to your fingertip or toe Recommend a chest x ray, lung function tests, or blood tests The main goals of treating acute and chronic bronchitis are to relieve symptoms and make breathing easier. If you have acute bronchitis, your doctor may recommend rest, plenty of fluids, and aspirin (for adults) or acetaminophen to treat fever. Antibiotics usually aren't prescribed for acute bronchitis. This is because they don't work against viruses—the most common cause of acute bronchitis. However, if your doctor thinks you have a bacterial infection, he or she may prescribe antibiotics. A humidifier or steam can help loosen mucus and relieve wheezing and limited air flow. If your bronchitis causes wheezing, you may need an inhaled medicine to open your airways. You take this medicine using an inhaler. This device allows the medicine to go straight to your lungs. Your doctor also may prescribe medicines to relieve or reduce your cough and treat your inflamed airways (especially if your cough persists). If you have chronic bronchitis and also have been diagnosed with COPD (chronic obstructive pulmonary disease), you may need medicines to open your airways and help clear away mucus. These medicines include bronchodilators (inhaled) and steroids (inhaled or pill form). If you have chronic bronchitis, your doctor may prescribe oxygen therapy. This treatment can help you breathe easier, and it provides your body with needed oxygen. One of the best ways to treat acute and chronic bronchitis is to remove the source of irritation and damage to your lungs. If you smoke, it's very important to quit. Talk with your doctor about programs and products that can help you quit smoking. Try to avoid secondhand smoke and other lung irritants, such as dust, fumes, vapors, and air pollution. 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 \"Your Guide to a Healthy Heart.\" Although these resources focus on heart health, they include general information about how to quit smoking. You can't always prevent acute or chronic bronchitis. However, you can take steps to lower your risk for both conditions. The most important step is to quit smoking or not start smoking. 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 \"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. For example, wear a mask over your mouth and nose when you use paint, paint remover, varnish, or other substances with strong fumes. This will help protect your lungs. Wash your hands often to limit your exposure to germs and bacteria. Your doctor also may advise you to get a yearly flu shot and a pneumonia vaccine. 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": "The main goals of treating acute and chronic bronchitis are to relieve symptoms and make breathing easier. If you have acute bronchitis, your doctor may recommend rest, plenty of fluids, and aspirin (for adults) or acetaminophen to treat fever. Antibiotics usually aren't prescribed for acute bronchitis. This is because they don't work against viruses?the most common cause of acute bronchitis. However, if your doctor thinks you have a bacterial infection, he or she may prescribe antibiotics. A humidifier or steam can help loosen mucus and relieve wheezing and limited air flow. If your bronchitis causes wheezing, you may need an inhaled medicine to open your airways. You take this medicine using an inhaler. This device allows the medicine to go straight to your lungs. Your doctor also may prescribe medicines to relieve or reduce your cough and treat your inflamed airways (especially if your cough persists). If you have chronic bronchitis and also have been diagnosed with COPD (chronic obstructive pulmonary disease), you may need medicines to open your airways and help clear away mucus. These medicines include bronchodilators (inhaled) and steroids (inhaled or pill form). If you have chronic bronchitis, your doctor may prescribe oxygen therapy. This treatment can help you breathe easier, and it provides your body with needed oxygen. One of the best ways to treat acute and chronic bronchitis is to remove the source of irritation and damage to your lungs. If you smoke, it's very important to quit. Talk with your doctor about programs and products that can help you quit smoking. Try to avoid secondhand smoke and other lung irritants, such as dust, fumes, vapors, and air pollution.", "role": "assistant" } ]

[ { "content": "Vitelliform Macular Dystrophy Would like to obtain more info on possible treatments.\n\n Vitelliform macular dystrophy vitelliform dystrophy Description Vitelliform macular dystrophy is a genetic eye disorder that can cause progressive vision loss. This disorder affects the retina, the specialized light-sensitive tissue that lines the back of the eye. Specifically, vitelliform macular dystrophy disrupts cells in a small area near the center of the retina called the macula. The macula is responsible for sharp central vision, which is needed for detailed tasks such as reading, driving, and recognizing faces. Vitelliform macular dystrophy causes a fatty yellow pigment (lipofuscin) to build up in cells underlying the macula. Over time, the abnormal accumulation of this substance can damage cells that are critical for clear central vision. As a result, people with this disorder often lose their central vision, and their eyesight may become blurry or distorted. Vitelliform macular dystrophy typically does not affect side (peripheral) vision or the ability to see at night. Researchers have described two forms of vitelliform macular dystrophy with similar features. The early-onset form (known as Best disease) usually appears in childhood; the onset of symptoms and the severity of vision loss vary widely. The adult-onset form begins later, usually in mid-adulthood, and tends to cause vision loss that worsens slowly over time. The two forms of vitelliform macular dystrophy each have characteristic changes in the macula that can be detected during an eye examination. Frequency Vitelliform macular dystrophy is a rare disorder; its incidence is unknown. Causes Mutations in the BEST1 and PRPH2 genes cause vitelliform macular dystrophy. BEST1 mutations are responsible for Best disease and for some cases of the adult-onset form of vitelliform macular dystrophy. Changes in the PRPH2 gene can also cause the adult-onset form of vitelliform macular dystrophy; however, less than a quarter of all people with this form of the condition have mutations in the BEST1 or PRPH2 gene. In most cases, the cause of the adult-onset form is unknown. The BEST1 gene provides instructions for making a protein called bestrophin. This protein acts as a channel that controls the movement of charged chlorine atoms (chloride ions) into or out of cells in the retina. Mutations in the BEST1 gene probably lead to the production of an abnormally shaped channel that cannot properly regulate the flow of chloride. Researchers have not determined how these malfunctioning channels are related to the buildup of lipofuscin in the macula and progressive vision loss. The PRPH2 gene provides instructions for making a protein called peripherin 2. This protein is essential for the normal function of light-sensing (photoreceptor) cells in the retina. Mutations in the PRPH2 gene cause vision loss by disrupting structures in these cells that contain light-sensing pigments. It is unclear why PRPH2 mutations affect only central vision in people with adult-onset vitelliform macular dystrophy. Inheritance Pattern Best disease is inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to cause the disorder. In most cases, an affected person has one parent with the condition. The inheritance pattern of adult-onset vitelliform macular dystrophy is uncertain. Some studies have suggested that this disorder may be inherited in an autosomal dominant pattern. It is difficult to be sure, however, because many affected people have no history of the disorder in their family, and only a small number of affected families have been reported. Sources for This Page Boon CJ, Klevering BJ, Leroy BP, Hoyng CB, Keunen JE, den Hollander AI. The spectrum of ocular phenotypes caused by mutations in the BEST1 gene. Prog Retin Eye Res. 2009 May;28(3):187-205. doi: 10.1016/j.preteyeres.2009.04.002. Epub 2009 Apr 16. Review. ", "role": "user" }, { "content": "Vitelliform macular dystrophy occurs as an early-onset form and an adult-onset form. The early-onset form, known as Best disease usually appears in childhood, and the onset of symptoms and the severity of vision loss can vary widely. The adult-onset form usually begins in mid-adulthood. In this form, vision loss tends to worsen slowly over time. Each of these forms of vitelliform macular dystrophy have characteristic changes that can be detected during an eye examination.", "role": "assistant" } ]

[ { "content": "how is a heart attack treated\n\n Heart attack Overview A heart attack occurs when the flow of blood to the heart is blocked, most often by a build-up of fat, cholesterol and other substances, which form a plaque in the arteries that feed the heart (coronary arteries). The interrupted blood flow can damage or destroy part of the heart muscle. A heart attack, also called a myocardial infarction, can be fatal, but treatment has improved dramatically over the years. It's crucial to call 911 or emergency medical help if you think you might be having a heart attack. Symptoms Common heart attack signs and symptoms include: - Pressure, tightness, pain, or a squeezing or aching sensation in your chest or arms that may spread to your neck, jaw or back - Nausea, indigestion, heartburn or abdominal pain - Shortness of breath - Cold sweat - Fatigue - Lightheadedness or sudden dizziness Heart attack symptoms vary Not all people who have heart attacks have the same symptoms or have the same severity of symptoms. Some people have mild pain; others have more severe pain. Some people have no symptoms, while for others, the first sign may be sudden cardiac arrest. However, the more signs and symptoms you have, the greater the likelihood you're having a heart attack. Some heart attacks strike suddenly, but many people have warning signs and symptoms hours, days or weeks in advance. The earliest warning may be recurrent chest pain (angina) that's triggered by exertion and relieved by rest. Angina is caused by a temporary decrease in blood flow to the heart. A heart attack differs from a condition in which your heart suddenly stops (sudden cardiac arrest, which occurs when an electrical disturbance disrupts your heart's pumping action and causes blood to stop flowing to the rest of your body). A heart attack can cause cardiac arrest, but it's not the only cause. When to see a doctor Act immediately. Some people wait too long because they don't recognize the important signs and symptoms. Take these steps: - Call for emergency medical help. If you suspect you're having a heart attack, don't hesitate. Immediately call 911 or your local emergency number. If you don't have access to emergency medical services, have someone drive you to the nearest hospital. Drive yourself only if there are no other options. Because your condition can worsen, driving yourself puts you and others at risk. - Take nitroglycerin, if prescribed to you by a doctor. Take it as instructed while awaiting emergency help. - Take aspirin, if recommended. Taking aspirin during a heart attack could reduce heart damage by helping to keep your blood from clotting. Aspirin can interact with other medications, however, so don't take an aspirin unless your doctor or emergency medical personnel recommend it. Don't delay calling 911 to take an aspirin. Call for emergency help first. What to do if you see someone having a heart attack If you encounter someone who is unconscious, first call for emergency medical help. Then begin CPR to keep blood flowing. Push hard and fast on the person's chest in a fairly rapid rhythm - about 100 to 120 compressions a minute. It's not necessary to check the person's airway or deliver rescue breaths unless you've been trained in CPR. Causes A heart attack occurs when one or more of your coronary arteries become blocked. Over time, a coronary artery can narrow from the buildup of various substances, including cholesterol (atherosclerosis). This condition, known as coronary artery disease, causes most heart attacks. During a heart attack, one of these plaques can rupture and spill cholesterol and other substances into the bloodstream. A blood clot forms at the site of the rupture. If large enough, the clot can completely block the flow of blood through the coronary artery. Another cause of a heart attack is a spasm of a coronary artery that shuts down blood flow to part of the heart muscle. Use of tobacco and of illicit drugs, such as cocaine, can cause a life-threatening spasm. A heart attack can also occur due to a tear in the heart artery (spontaneous coronary artery dissection). Risk factors Certain factors contribute to the unwanted buildup of fatty deposits (atherosclerosis) that narrows arteries throughout your body. You can improve or eliminate many of these risk factors to reduce your chances of having a first or subsequent heart attack. Heart attack risk factors include: - Age. Men age 45 or older and women age 55 or older are more likely to have a heart attack than are younger men and women. - Tobacco. Smoking and long-term exposure to secondhand smoke increase the risk of a heart attack. - High blood pressure. Over time, high blood pressure can damage arteries that feed your heart by accelerating atherosclerosis. High blood pressure that occurs with obesity, smoking, high cholesterol or diabetes increases your risk even more. - High blood cholesterol or triglyceride levels. A high level of low-density lipoprotein (LDL) cholesterol (the \"bad\" cholesterol) is most likely to narrow arteries. A high level of triglycerides, a type of blood fat related to your diet, also ups your risk of heart attack. However, a high level of high-density lipoprotein (HDL) cholesterol (the \"good\" cholesterol) lowers your risk of heart attack. - Diabetes. Insulin, a hormone secreted by your pancreas, allows your body to use glucose, a form of sugar. Having diabetes - not producing enough insulin or not responding to insulin properly - causes your body's blood sugar levels to rise. Diabetes, especially uncontrolled, increases your risk of a heart attack. - Family history of heart attack. If your siblings, parents or grandparents have had early heart attacks (by age 55 for male relatives and by age 65 for female relatives), you may be at increased risk. - Lack of physical activity. An inactive lifestyle contributes to high blood cholesterol levels and obesity. People who get regular aerobic exercise have better cardiovascular fitness, which decreases their overall risk of heart attack. Exercise is also beneficial in lowering high blood pressure. - Obesity. Obesity is associated with high blood cholesterol levels, high triglyceride levels, high blood pressure and diabetes. Losing just 10 percent of your body weight can lower this risk, however. - Stress. You may respond to stress in ways that can increase your risk of a heart attack. - Illegal drug use. Using stimulant drugs, such as cocaine or amphetamines, can trigger a spasm of your coronary arteries that can cause a heart attack. - A history of preeclampsia. This condition causes high blood pressure during pregnancy and increases the lifetime risk of heart disease. - A history of an autoimmune condition, such as rheumatoid arthritis or lupus. Conditions such as rheumatoid arthritis, lupus and other autoimmune conditions can increase your risk of having a heart attack. Complications Complications are often related to the damage done to your heart during an attack. Damage can lead to: - Abnormal heart rhythms (arrhythmias). Electrical \"short circuits\" can develop, resulting in abnormal heart rhythms, some of which can be serious, even fatal. - Heart failure. An attack may damage so much heart tissue that the remaining heart muscle can't adequately pump blood out of your heart. Heart failure may be temporary, or it can be a chronic condition resulting from extensive and permanent damage to your heart. - Heart rupture. Areas of heart muscle weakened by a heart attack can rupture, leaving a hole in part of the heart. This rupture is often fatal. - Valve problems. Heart valves damaged during a heart attack may develop severe leakage problems. Diagnosis Ideally, your doctor should screen you during regular physical exams for risk factors that can lead to a heart attack. If you're in an emergency setting for symptoms of a heart attack, you'll be asked to describe your symptoms and have your blood pressure, pulse and temperature checked. You'll be hooked up to a heart monitor and will almost immediately have tests to see if you're having a heart attack. Tests will help check if your signs and symptoms, such as chest pain, indicate a heart attack or another condition. These tests include: - Electrocardiogram (ECG). This first test done to diagnose a heart attack records the electrical activity of your heart via electrodes attached to your skin. Impulses are recorded as waves displayed on a monitor or printed on paper. Because injured heart muscle doesn't conduct electrical impulses normally, the ECG may show that a heart attack has occurred or is in progress. - Blood tests. Certain heart enzymes slowly leak out into your blood if your heart has been damaged by a heart attack. Emergency room doctors will take samples of your blood to test for the presence of these enzymes. Additional tests If you've had a heart attack or one is occurring, doctors will take immediate steps to treat your condition. You may also undergo these additional tests: - Chest X-ray. An X-ray image of your chest allows your doctor to check the size of your heart and its blood vessels and to look for fluid in your lungs. - Echocardiogram. During this test, sound waves directed at your heart from a wandlike device (transducer) held on your chest bounce off your heart and are processed electronically to provide video images of your heart. An echocardiogram can help identify whether an area of your heart has been damaged by a heart attack and isn't pumping normally or at peak capacity. - Coronary catheterization (angiogram). A liquid dye is injected into the arteries of your heart through a long, thin tube (catheter) that's fed through an artery, usually in your leg or groin, to the arteries in your heart. The dye makes the arteries visible on X-ray, revealing areas of blockage. - Exercise stress test. In the days or weeks after your heart attack, you may also undergo a stress test. Stress tests measure how your heart and blood vessels respond to exertion. You may walk on a treadmill or pedal a stationary bike while attached to an ECG machine. Or you may receive a drug intravenously that stimulates your heart similar to exercise. Your doctor may also order a nuclear stress test, which is similar to an exercise stress test, but uses an injected dye and special imaging techniques to produce detailed images of your heart while you're exercising. These tests can help determine your long-term treatment. - Cardiac computerized tomography (CT) or magnetic resonance imaging (MRI). These tests can be used to diagnose heart problems, including the extent of damage from heart attacks. In a cardiac CT scan, you lie on a table inside a doughnut-shaped machine. An X-ray tube inside the machine rotates around your body and collects images of your heart and chest. In a cardiac MRI, you lie on a table inside a long tubelike machine that produces a magnetic field. The magnetic field aligns atomic particles in some of your cells. When radio waves are broadcast toward these aligned particles, they produce signals that vary according to the type of tissue they are. The signals create images of your heart. 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. Lifestyle and home remedies Your lifestyle affects your heart health. The following steps can help you not only prevent but also recover from a heart attack: - Avoid smoke. The most important thing you can do to improve your heart's health is to not smoke. Also, avoid being around secondhand smoke. If you need to quit, ask your doctor for help. - Control your blood pressure and cholesterol levels. If one or both of these is high, your doctor can prescribe changes to your diet and medications. Ask your doctor how often you need to have your blood pressure and cholesterol levels monitored. - Get regular medical checkups. Some of the major risk factors for heart attack - high blood cholesterol, high blood pressure and diabetes - cause no symptoms early on. Your doctor can perform tests to check for these conditions and help you manage them, if necessary. - Exercise regularly. Regular exercise helps improve heart muscle function after a heart attack and helps prevent a heart attack by helping you to control your weight, diabetes, cholesterol and blood pressure. Exercise needn't be vigorous. Walking 30 minutes a day, five days a week can improve your health. - Maintain a healthy weight. Excess weight strains your heart and can contribute to high cholesterol, high blood pressure and diabetes. - Eat a heart-healthy diet. Saturated fat, trans fats and cholesterol in your diet can narrow arteries to your heart, and too much salt can raise blood pressure. Eat a heart-healthy diet that includes lean proteins, such as fish and beans, plenty of fruits and vegetables and whole grains. - Manage diabetes. High blood sugar is damaging to your heart. Regular exercise, eating well and losing weight all help to keep blood sugar levels at more-desirable levels. Many people also need medication to manage their diabetes. - Control stress. Reduce stress in your day-to-day activities. Rethink workaholic habits and find healthy ways to minimize or deal with stressful events in your life. - If you drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and men older than age 65, and up to two drinks a day for men age 65 and younger. ", "role": "user" }, { "content": "The following steps can help you not only prevent but also recover from a heart attack: - Avoid smoke. The most important thing you can do to improve your heart's health is to not smoke. Also, avoid being around secondhand smoke. - Control your blood pressure and cholesterol levels. If one or both of these is high, your doctor can prescribe changes to your diet and medications. Ask your doctor how often you need to have your blood pressure and cholesterol levels monitored. - Get regular medical checkups. Some of the major risk factors for heart attack - high blood cholesterol, high blood pressure and diabetes - cause no symptoms early on. Exercise regularly. Regular exercise helps improve heart muscle function after a heart attack and helps prevent a heart attack by helping you to control your weight, diabetes, cholesterol and blood pressure. Maintain a healthy weight. Excess weight strains your heart and can contribute to high cholesterol, high blood pressure and diabetes. - Eat a heart-healthy diet. Saturated fat, trans fats and cholesterol in your diet can narrow arteries to your heart, and too much salt can raise blood pressure. Control stress. Reduce stress in your day-to-day activities. Rethink workaholic habits and find healthy ways to minimize or deal with stressful events in your life.", "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 (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", "role": "assistant" } ]

[ { "content": "help with obesity I would like help on my obesity problem and if I can get help\n\nPrescription Medications to Treat Overweight and Obesity: Health care providers use the Body Mass Index (BMI), which is a measure of your weight in relation to your height, to define overweight and obesity. People who have a BMI between 25 and 30 are considered overweight. Obesity is defined as having a BMI of 30 or greater. You can calculate your BMI to learn if you are overweight or obese. Being overweight or obese may increase the risk of health problems. Your health care provider can assess your individual risk due to your weight.Obesity is a chronic condition that affects more than one in three adults in the United States. Another one in three adults is overweight. If you are struggling with your weight, you may find that a healthy eating plan and regular physical activity help you lose weight and keep it off over the long term. If these lifestyle changes are not enough to help you lose weight or maintain your weight loss, your doctor may prescribe medications as part of your weight-control program. Prescription medications to treat overweight and obesity work in different ways. For example, some medications may help you feel less hungry or full sooner. Other medications may make it harder for your body to absorb fat from the foods you eat. Weight-loss medications are meant to help people who may have health problems related to overweight or obesity. Before prescribing a weight-loss medication, your doctor also will considerthe likely benefits of weight loss the medication’s possible side effects your current health issues and other medications your family's medical history costHealth care professionals often use BMI to help decide who might benefit from weight-loss medications. Your doctor may prescribe a medication to treat your overweight or obesity if you are an adult witha BMI of 30 or more or a BMI of 27 or more and you have weight-related health problems, such as high blood pressure or type 2 diabetes.Weight-loss medications aren’t for everyone with a high BMI. Some people who are overweight or obese may lose weight with a lifestyle program that helps them change their behaviors and improve their eating and physical activity habits. A lifestyle program may also address other factors that affect weight gain, such as eating triggers and not getting enough sleep. The U.S. Food and Drug Administration (FDA) has approved most weight-loss medications only for adults. The prescription medication orlistat (Xenical) is FDA-approved for children ages 12 and older. Medications don’t replace physical activity or healthy eating habits as a way to lose weight. Studies show that weight-loss medications work best when combined with a lifestyle program. Ask your doctor or other health care professional about lifestyle treatment programs for weight management that will work for you.Weight-loss medications don’t replace physical activity and healthy eating habits. When combined with changes to behavior, including eating and physical activity habits, prescription medications may help some people lose weight. On average, people who take prescription medications as part of a lifestyle program lose between 3 and 9 percent more of their starting body weight than people in a lifestyle program who do not take medication. Research shows that some people taking prescription weight-loss medications lose 10 percent or more of their starting weight.1 Results vary by medication and by person.Weight loss of 5 to 10 percent of your starting body weight may help improve your health by lowering blood sugar, blood pressure, and triglycerides. Losing weight also can improve some other health problems related to overweight and obesity, such as joint pain or sleep apnea. Most weight loss takes place within the first 6 months of starting the medication. Experts are concerned that, in some cases, the side effects of prescription medications to treat overweight and obesity may outweigh the benefits. For this reason, you should never take a weight-loss medication only to improve the way you look. In the past, some weight-loss medications were linked to serious health problems. For example, the FDA recalled fenfluramine and dexfenfluramine (part of the “fen-phen” combination) in 1997 because of concerns related to heart valve problems.Possible side effects vary by medication and how it acts on your body. Most side effects are mild and most often improve if you continue to take the medication. Rarely, serious side effects can occur.Tips for Taking Weight-loss MedicationFollow your doctor's instructions about weight-loss medications. Buy your medication from a pharmacy or web distributor approved by your doctor. Take weight-loss medication to support your healthy eating and physical activity program. Know the side effects and warnings for taking any medication. Ask your doctor if you should stop taking your medication if you are not losing weight after 12 weeks. Discuss other medications, including supplements and vitamins, you are taking with your doctor when considering weight-loss medications. Avoid taking weight-loss medications during pregnancy or if you are planning a pregnancy. Choosing a medication to treat overweight or obesity is a decision between you and your doctor. Important factors to consider includethe likely benefits of weight loss the medication’s possible side effects your current health issues and other medications your family’s medical history costTalk with your doctor about which weight-loss medication might be right for you. How long you will need to take weight-loss medication depends on whether the drug helps you lose and maintain weight and whether you have any side effects. If you have lost enough weight to improve your health and are not having serious side effects, your doctor may advise that you stay on the medication indefinitely. If you do not lose at least 5 percent of your starting weight after 12 weeks on the full dose of your medication, your doctor will probably advise you to stop taking it. He or she may change your treatment plan or consider using a different weight-loss medication. Your doctor also may have you try different lifestyle, physical activity, or eating programs; change your other medications that cause weight gain; or refer you to a bariatric surgeon to see if weight-loss surgery might be an option for you.Because obesity is a chronic condition, you may need to continue changes to your eating and physical activity habits and other behaviors for years—or even a lifetime—to improve your health and maintain a healthy weight. You will probably regain some weight after you stop taking weight-loss medication. Developing and maintaining healthy eating habits and increasing physical activity may help you regain less weight or keep it off. Federal physical activity guidelines recommend at least 150 minutes of physical activity per week for adults—that’s about 30 minutes a day most days of the week. You may need to do more to reach or maintain your weight-loss goal. Some, but not all, insurance plans cover medications that treat overweight and obesity. Contact your insurance provider to find out if your plan covers these medications. The table below lists FDA-approved prescription medications for weight loss. The FDA has approved five of these drugs—orlistat (Xenical, Alli), lorcaserin (Belviq), phentermine-topiramate (Qsymia), naltrexone-bupropion (Contrave), and liraglutide (Saxenda)—for long-term use. You can keep taking these drugs as long as you are benefiting from treatment and not having unpleasant side-effects.Some weight-loss medications that curb appetite are approved by the FDA only for short-term use, or up to 12 weeks. Although some doctors prescribe them for longer periods of time, not many research studies have looked at how safe and effective they are for long-term use.Pregnant women should never take weight-loss medications. Women who are planning to get pregnant also should avoid these medications, as some of them may harm a fetus.Prescription Medications Approved for Overweight and Obesity TreatmentWeight-loss medication Approved for How it works Common side effects Warnings Orlistat (Xenical) Available in lower dose without prescription (Alli) Adults and children ages 12 and older Works in your gut to reduce the amount of fat your body absorbs from the food you eat diarrhea gas leakage of oily stools stomach pain Rare cases of severe liver injury have been reported. Avoid taking with cyclosporine. Take a multivitamin pill daily to make sure you get enough of certain vitamins that your body may not absorb from the food you eat. Lorcaserin (Belviq) Adults Acts on the serotonin receptors in your brain. May help you feel full after eating smaller amounts of food. constipation cough dizziness dry mouth feeling tired headaches nausea Tell your doctor if you take antidepressants or migraine medications, since some of these can cause problems when taken together. Phentermine-topiramate (Qsymia) Adults A mix of two medications: phentermine, which lessens your appetite, and topiramate, which is used to treat seizures or migraine headaches. May make you less hungry or feel full sooner. constipation dizziness dry mouth taste changes, especially with carbonated beverages tingling of your hands and feet trouble sleeping Don’t use if you have glaucoma or hyperthyroidism. Tell your doctor if you have had a heart attack or stroke, abnormal heart rhythm, kidney disease, or mood problems. MAY LEAD TO BIRTH DEFECTS. DO NOT TAKE QSYMIA IF YOU ARE PREGNANT OR PLANNING A PREGNANCY. Do not take if you are breastfeeding. Naltrexone-bupropion (Contrave) Adults A mix of two medications: naltrexone, which is used to treat alcohol and drug dependence, and bupropion, which is used to treat depression or help people quit smoking. May make you feel less hungry or full sooner. constipation diarrhea dizziness dry mouth headache increased blood pressure increased heart rate insomnia liver damage nausea vomiting Do not use if you have uncontrolled high blood pressure, seizures or a history of anorexia or bulimia nervosa. Do not use if you are dependent on opioid pain medications or withdrawing from drugs or alcohol. Do not use if you are taking bupropion (Wellbutrin, Zyban). MAY INCREASE SUICIDAL THOUGHTS OR ACTIONS. Liraglutide (Saxenda) Available by injection only Adults May make you feel less hungry or full sooner. At a lower dose under a different name, Victoza, FDA-approved to treat type 2 diabetes. nausea diarrhea constipation abdominal pain headache raised pulse May increase the chance of developing pancreatitis. Has been found to cause a rare type of thyroid tumor in animals. Other medications that curb your desire to eat include phentermine benzphetamine diethylpropion phendimetrazine Adults Increase chemicals in your brain to make you feel you are not hungry or that you are full. Note: FDA-approved only for short-term use—up to 12 weeks dry mouth constipation difficulty sleeping dizziness feeling nervous feeling restless headache raised blood pressure raised pulse Do not use if you have heart disease, uncontrolled high blood pressure, hyperthyroidism, or glaucoma. Tell your doctor if you have severe anxiety or other mental health problems. Sometimes doctors use medications in a way that’s different from what the FDA has approved, known as “off-label” use. By choosing an off-label medication to treat overweight and obesity, your doctor may prescribea drug approved for treating a different medical problem two or more drugs at the same time a drug for a longer period of time than approved by the FDAYou should feel comfortable asking your doctor if he or she is prescribing a medication that is not approved just for treating overweight and obesity. Before using a medication, learn all you need to know about it. Researchers are currently studying several new medications and combinations of medications in animals and people. Researchers are working to identify safer and more effective medications to help people who are overweight or obese lose weight and maintain a healthy weight for a long time.Future drugs may use new strategies, such as tocombine drugs that affect appetite and those that affect addiction (or craving) stimulate gut hormones that reduce appetite shrink the blood vessels that feed fat cells in the body, thereby preventing them from growing target genes that affect body weight change bacteria in the gut to control weight [1] Yanovski SZ, Yanovski JA. JAMA. Long-term drug treatment for obesity: A systematic and clinical review. 2014; 311(1):74–86.", "role": "user" }, { "content": "A healthy eating plan and regular physical activity may help you lose weight and keep it off over the long term. If these lifestyle changes are not enough, your doctor may prescribe medications. Some medications may help you feel less hungry or full sooner. Other medications may make it harder for your body to absorb fat from the foods you eat. Weight-loss medications are for people who may have health problems related to overweight or obesity. When combined with changes to behavior, including eating and physical activity habits, prescription medications may help some people lose weight.", "role": "assistant" } ]

[ { "content": "what the treatment for bronchitis\n\nBronchitis: Español Bronchitis (bron-KI-tis) is a condition in which the bronchial tubes become inflamed. These tubes carry air to your lungs. (For more information about the bronchial tubes and airways, go to the Diseases and Conditions Index How the Lungs Work article.) People who have bronchitis often have a cough that brings up mucus. Mucus is a slimy substance made by the lining of the bronchial tubes. Bronchitis also may cause wheezing (a whistling or squeaky sound when you breathe), chest pain or discomfort, a low fever, and shortness of breath. Bronchitis Overview The two main types of bronchitis are acute (short term) and chronic (ongoing). Acute Bronchitis Infections or lung irritants cause acute bronchitis. The same viruses that cause colds and the flu are the most common cause of acute bronchitis. These viruses are spread through the air when people cough. They also are spread through physical contact (for example, on hands that have not been washed). Sometimes bacteria cause acute bronchitis. Acute bronchitis lasts from a few days to 10 days. However, coughing may last for several weeks after the infection is gone. Several factors increase your risk for acute bronchitis. Examples include exposure to tobacco smoke (including secondhand smoke), dust, fumes, vapors, and air pollution. Avoiding these lung irritants as much as possible can help lower your risk for acute bronchitis. Most cases of acute bronchitis go away within a few days. If you think you have acute bronchitis, see your doctor. He or she will want to rule out other, more serious health conditions that require medical care. Chronic Bronchitis Chronic bronchitis is an ongoing, serious condition. It occurs if the lining of the bronchial tubes is constantly irritated and inflamed, causing a long-term cough with mucus. Smoking is the main cause of chronic bronchitis. Viruses or bacteria can easily infect the irritated bronchial tubes. If this happens, the condition worsens and lasts longer. As a result, people who have chronic bronchitis have periods when symptoms get much worse than usual. Chronic bronchitis is a serious, long-term medical condition. Early diagnosis and treatment, combined with quitting smoking and avoiding secondhand smoke, can improve quality of life. The chance of complete recovery is low for people who have severe chronic bronchitis. Acute bronchitis Chronic bronchitis Industrial bronchitis Acute Bronchitis Infections or lung irritants cause acute bronchitis. The same viruses that cause colds and the flu are the most common cause of acute bronchitis. Sometimes bacteria can cause the condition. Certain substances can irritate your lungs and airways and raise your risk for acute bronchitis. For example, inhaling or being exposed to tobacco smoke, dust, fumes, vapors, or air pollution raises your risk for the condition. These lung irritants also can make symptoms worse. Being exposed to a high level of dust or fumes, such as from an explosion or a big fire, also may lead to acute bronchitis. Chronic Bronchitis Repeatedly breathing in fumes that irritate and damage lung and airway tissues causes chronic bronchitis. Smoking is the major cause of the condition. Breathing in air pollution and dust or fumes from the environment or workplace also can lead to chronic bronchitis. People who have chronic bronchitis go through periods when symptoms become much worse than usual. During these times, they also may have acute viral or bacterial bronchitis. Bronchitis is a very common condition. Millions of cases occur every year. Elderly people, infants, and young children are at higher risk for acute bronchitis than people in other age groups. People of all ages can develop chronic bronchitis, but it occurs more often in people who are older than 45. Also, many adults who develop chronic bronchitis are smokers. Women are more than twice as likely as men to be diagnosed with chronic bronchitis. Smoking and having an existing lung disease greatly increase your risk for bronchitis. Contact with dust, chemical fumes, and vapors from certain jobs also increases your risk for the condition. Examples include jobs in coal mining, textile manufacturing, grain handling, and livestock farming. Air pollution, infections, and allergies can worsen the symptoms of chronic bronchitis, especially if you smoke. Acute Bronchitis Acute bronchitis caused by an infection usually develops after you already have a cold or the flu. Symptoms of a cold or the flu include sore throat, fatigue (tiredness), fever, body aches, stuffy or runny nose, vomiting, and diarrhea. The main symptom of acute bronchitis is a persistent cough, which may last 10 to 20 days. The cough may produce clear mucus (a slimy substance). If the mucus is yellow or green, you may have a bacterial infection as well. Even after the infection clears up, you may still have a dry cough for days or weeks. Other symptoms of acute bronchitis include wheezing (a whistling or squeaky sound when you breathe), low fever, and chest tightness or pain. If your acute bronchitis is severe, you also may have shortness of breath, especially with physical activity. Chronic Bronchitis The signs and symptoms of chronic bronchitis include coughing, wheezing, and chest discomfort. The coughing may produce large amounts of mucus. This type of cough often is called a smoker's cough. Your doctor usually will diagnose bronchitis based on your signs and symptoms. He or she may ask questions about your cough, such as how long you've had it, what you're coughing up, and how much you cough. Your doctor also will likely ask: About your medical history Whether you've recently had a cold or the flu Whether you smoke or spend time around others who smoke Whether you've been exposed to dust, fumes, vapors, or air pollution Your doctor will use a stethoscope to listen for wheezing (a whistling or squeaky sound when you breathe) or other abnormal sounds in your lungs. He or she also may: Look at your mucus to see whether you have a bacterial infection Test the oxygen levels in your blood using a sensor attached to your fingertip or toe Recommend a chest x ray, lung function tests, or blood tests The main goals of treating acute and chronic bronchitis are to relieve symptoms and make breathing easier. If you have acute bronchitis, your doctor may recommend rest, plenty of fluids, and aspirin (for adults) or acetaminophen to treat fever. Antibiotics usually aren't prescribed for acute bronchitis. This is because they don't work against viruses—the most common cause of acute bronchitis. However, if your doctor thinks you have a bacterial infection, he or she may prescribe antibiotics. A humidifier or steam can help loosen mucus and relieve wheezing and limited air flow. If your bronchitis causes wheezing, you may need an inhaled medicine to open your airways. You take this medicine using an inhaler. This device allows the medicine to go straight to your lungs. Your doctor also may prescribe medicines to relieve or reduce your cough and treat your inflamed airways (especially if your cough persists). If you have chronic bronchitis and also have been diagnosed with COPD (chronic obstructive pulmonary disease), you may need medicines to open your airways and help clear away mucus. These medicines include bronchodilators (inhaled) and steroids (inhaled or pill form). If you have chronic bronchitis, your doctor may prescribe oxygen therapy. This treatment can help you breathe easier, and it provides your body with needed oxygen. One of the best ways to treat acute and chronic bronchitis is to remove the source of irritation and damage to your lungs. If you smoke, it's very important to quit. Talk with your doctor about programs and products that can help you quit smoking. Try to avoid secondhand smoke and other lung irritants, such as dust, fumes, vapors, and air pollution. 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 \"Your Guide to a Healthy Heart.\" Although these resources focus on heart health, they include general information about how to quit smoking. You can't always prevent acute or chronic bronchitis. However, you can take steps to lower your risk for both conditions. The most important step is to quit smoking or not start smoking. 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 \"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. For example, wear a mask over your mouth and nose when you use paint, paint remover, varnish, or other substances with strong fumes. This will help protect your lungs. Wash your hands often to limit your exposure to germs and bacteria. Your doctor also may advise you to get a yearly flu shot and a pneumonia vaccine. 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": "Treatments for acute and chronic bronchitis relieve symptoms and make breathing easier. For acute bronchitis, your doctor may recommend rest, plenty of fluids, and aspirin (for adults) or acetaminophen to treat fever. Cases of bronchitis that are caused by viral infections do not need antibiotics. If doctors suspect that the infection is bacterial, they may prescribe an antibiotic. A humidifier or steam can help loosen mucus and relieve wheezing and limited air flow. If your bronchitis causes wheezing, you may need an inhaled medicine to open your airways. Your doctor also may prescribe medicines to relieve or reduce your cough and treat your inflamed airways. For chronic bronchitis and chronic obstructive pulmonary disease (COPD), you may need bronchodilators and steroids to open your airways and help clear away mucus. Your doctor may also prescribe oxygen therapy. One of the best ways to treat acute and chronic bronchitis is to remove the source of irritation and damage to your lungs, such as quitting smoking and avoiding secondhand smoke and other lung irritants, such as dust, fumes, vapors, and air pollution.", "role": "assistant" } ]

[ { "content": "Cervical Cancer Can a long term untreated bladder infection aid in the cause of cervical cancer? And can the fact that my mom has cervical cancer aid in my chance of getting cervical cancer?\n\n Cervical cancer Cancer - cervix Cervical cancer - HPV Cervical cancer - dysplasia Summary Cervical cancer is cancer that starts in the cervix. The cervix is the lower part of the uterus (womb) that opens at the top of the vagina. Causes Worldwide, cervical cancer is the third most common type of cancer in women. It is much less common in the United States because of the routine use of Pap smears. Cervical cancer starts in the cells on the surface of the cervix. There are two types of cells on the surface of the cervix, squamous and columnar. Most cervical cancers are from squamous cells. Cervical cancer usually develops slowly. It starts as a precancerous condition called dysplasia. This condition can be detected by a Pap smear and is 100% treatable. It can take years for dysplasia to develop into cervical cancer. Most women who are diagnosed with cervical cancer today have not had regular Pap smears, or they have not followed up on abnormal Pap smear results. Almost all cervical cancers are caused by human papillomavirus (HPV). HPV is a common virus that is spread through sexual intercourse. There are many different types (strains) of HPV. Some strains lead to cervical cancer. Other strains can cause genital warts. Others do not cause any problems at all. A woman's sexual habits and patterns can increase her risk of developing cervical cancer. Risky sexual practices include: Having sex at an early age Having multiple sexual partners Having a partner or many partners who take part in high-risk sexual activities Other risk factors for cervical cancer include: Not getting the HPV vaccine Being economically disadvantaged Having a mother who took the drug diethylstilbestrol (DES) during pregnancy in the early 1960s to prevent miscarriage Having a weakened immune system Symptoms Most of the time, early cervical cancer has no symptoms. Symptoms that may occur include: Abnormal vaginal bleeding between periods, after intercourse, or after menopause Vaginal discharge that does not stop, and may be pale, watery, pink, brown, bloody, or foul-smelling Periods that become heavier and last longer than usual Cervical cancer may spread to the bladder, intestines, lungs, and liver. Often, there are no problems until the cancer is advanced and has spread. Symptoms of advanced cervical cancer may include: Back pain Bone pain or fractures Fatigue Leaking of urine or feces from the vagina Leg pain Loss of appetite Pelvic pain Single swollen leg Weight loss Exams and Tests Precancerous changes of the cervix and cervical cancer cannot be seen with the naked eye. Special tests and tools are needed to spot such conditions: A Pap smear screens for precancers and cancer, but does not make a final diagnosis. Depending on your age, the human papillomavirus (HPV) DNA test may be done along with a Pap test. Or it may be used after a woman has had an abnormal Pap test result. It may also be used as the first test. Talk to your health care provider about which test or tests are right for you. If abnormal changes are found, the cervix is usually examined under magnification. This procedure is called colposcopy. Pieces of tissue are removed (biopsied) during this procedure. This tissue is then sent to a lab for examination. A procedure called a cone biopsy may also be done. If cervical cancer is diagnosed, the provider will order more tests. These help determine how far the cancer has spread. This is called staging. Tests may include: Chest x-ray CT scan of the pelvis Cystoscopy Intravenous pyelogram (IVP) MRI of the pelvis Treatment Treatment of cervical cancer depends on: The stage of the cancer The size and shape of the tumor The woman's age and general health Her desire to have children in the future Early cervical cancer can be cured by removing or destroying the precancerous or cancerous tissue. This is why routine Pap smears are so important to prevent cervical cancer. There are surgical ways to do this without removing the uterus or damaging the cervix, so that a woman can still have children in the future. Types of surgery for early cervical cancer include: Loop electrosurgical excision procedure (LEEP): uses electricity to remove abnormal tissue Cryotherapy: freezes abnormal cells Laser therapy: uses light to burn abnormal tissue A hysterectomy (surgery to remove the uterus but not the ovaries) is not often done for cervical cancer that has not spread. It may be done in women who have had repeated LEEP procedures. Treatment for more advanced cervical cancer may include: Radical hysterectomy, which removes the uterus and much of the surrounding tissues, including lymph nodes and the upper part of the vagina. Pelvic exenteration, an extreme type of surgery in which all of the organs of the pelvis, including the bladder and rectum, are removed. Radiation may be used to treat cancer that has spread beyond the cervix or cancer that has returned. Chemotherapy uses drugs to kill cancer. It may be given alone or with surgery or radiation. 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 the person does depends on many things, including: Type of cervical cancer Stage of cancer (how far it has spread) Age and general health If the cancer comes back after treatment Precancerous conditions can be completely cured when followed up and treated properly. Most women are alive in 5 years (5-year survival rate) for cancer that has spread to the inside of the cervix walls but not outside the cervix area. The 5-year survival rate falls as the cancer spreads outside the walls of the cervix into other areas. Possible Complications Complications can include: Risk of the cancer coming back in women who have treatment to save the uterus Problems with sexual, bowel, and bladder function after surgery or radiation When to Contact a Medical Professional Call your provider if you: Have not had regular Pap smears Have abnormal vaginal bleeding or discharge Prevention Cervical cancer can be prevented by doing the following: Get the HPV vaccine. The vaccine prevents most types of HPV infection that cause cervical cancer. Your provider can tell you if the vaccine is right for you. Practice safer sex. Using condoms during sex reduces the risk for HPV and other sexually transmitted infections (STIs). Limit the number of sexual partners you have. Avoid partners who are active in high-risk sexual behaviors. Get Pap smears as often as your provider recommends. Pap smears can help detect early changes, which can be treated before they turn into cervical cancer. Get the HPV test if recommended by your provider. It can be used along with the Pap test to screen for cervical cancer in women 30 years and older. If you smoke, quit. Smoking increases your chance of getting cervical cancer. Review Date 10/21/2017 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. ", "role": "user" }, { "content": "To prevent cervical cancer talk to your provider about the HPV vaccine, practice safe sex, get Pap smears to detect and treat early changes before they turn into cancer, and quit smoking, if you smoke.", "role": "assistant" } ]

[ { "content": "how to prevent atherosclerosis\n\n Atherosclerosis What Is... Español Atherosclerosis is a disease in which plaque builds up inside your arteries. Arteries are blood vessels that carry oxygen-rich blood to your heart and other parts of your body. Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque hardens and narrows your arteries. This limits the flow of oxygen-rich blood to your organs and other parts of your body. Atherosclerosis can lead to serious problems, including heart attack, stroke, or even death. Atherosclerosis Atherosclerosis-Related Diseases Atherosclerosis can affect any artery in the body, including arteries in the heart, brain, arms, legs, pelvis, and kidneys. As a result, different diseases may develop based on which arteries are affected. Coronary Heart Disease Coronary heart disease (CHD), also called coronary artery disease, occurs when plaque builds up in the coronary arteries. These arteries supply oxygen-rich blood to your heart. Plaque narrows the coronary arteries and reduces blood flow to your heart muscle. Plaque buildup also makes it more likely that blood clots will form in your arteries. Blood clots can partially or completely block blood flow. If blood flow to your heart muscle is reduced or blocked, you may have angina (chest pain or discomfort) or a heart attack. Plaque also can form in the heart's smallest arteries. This disease is called coronary microvascular disease (MVD). In coronary MVD, plaque doesn't cause blockages in the arteries as it does in CHD. Carotid Artery Disease Carotid (ka-ROT-id) artery disease occurs if plaque builds up in the arteries on each side of your neck (the carotid arteries). These arteries supply oxygen-rich blood to your brain. If blood flow to your brain is reduced or blocked, you may have a stroke. Peripheral Artery Disease Peripheral artery disease (P.A.D.) occurs if plaque builds up in the major arteries that supply oxygen-rich blood to your legs, arms, and pelvis. If blood flow to these parts of your body is reduced or blocked, you may have numbness, pain, and, sometimes, dangerous infections. Chronic Kidney Disease Chronic kidney disease can occur if plaque builds up in the renal arteries. These arteries supply oxygen-rich blood to your kidneys. Over time, chronic kidney disease causes a slow loss of kidney function. The main function of the kidneys is to remove waste and extra water from the body. Overview The cause of atherosclerosis isn't known. However, certain traits, conditions, or habits may raise your risk for the disease. These conditions are known as risk factors. You can control some risk factors, such as lack of physical activity, smoking, and an unhealthy diet. Others you can't control, such as age and a family history of heart disease. Some people who have atherosclerosis have no signs or symptoms. They may not be diagnosed until after a heart attack or stroke. The main treatment for atherosclerosis is lifestyle changes. You also may need medicines and medical procedures. These treatments, along with ongoing medical care, can help you live a healthier life. Outlook Improved treatments have reduced the number of deaths from atherosclerosis-related diseases. These treatments also have improved the quality of life for people who have these diseases. However, atherosclerosis remains a common health problem. You may be able to prevent or delay atherosclerosis and the diseases it can cause. Making lifestyle changes and getting ongoing care can help you avoid the problems of atherosclerosis and live a long, healthy life. OTHER NAMES Arteriosclerosis Hardening of the arteries CAUSES The exact cause of atherosclerosis isn't known. However, studies show that atherosclerosis is a slow, complex disease that may start in childhood. It develops faster as you age. Atherosclerosis may start when certain factors damage the inner layers of the arteries. These factors include: Smoking High amounts of certain fats and cholesterol in the blood High blood pressure High amounts of sugar in the blood due to insulin resistance or diabetes Plaque may begin to build up where the arteries are damaged. Over time, plaque hardens and narrows the arteries. Eventually, an area of plaque can rupture (break open). When this happens, blood cell fragments called platelets (PLATE-lets) stick to the site of the injury. They may clump together to form blood clots. Clots narrow the arteries even more, limiting the flow of oxygen-rich blood to your body. Depending on which arteries are affected, blood clots can worsen angina (chest pain) or cause a heart attack or stroke. Researchers continue to look for the causes of atherosclerosis. They hope to find answers to questions such as: Why and how do the arteries become damaged? How does plaque develop and change over time? Why does plaque rupture and lead to blood clots? WHO IS AT RISK The exact cause of atherosclerosis isn't known. However, certain traits, conditions, or habits may raise your risk for the disease. These conditions are known as risk factors. The more risk factors you have, the more likely it is that you'll develop atherosclerosis. You can control most risk factors and help prevent or delay atherosclerosis. Other risk factors can't be controlled. Major Risk Factors Unhealthy blood cholesterol levels. This includes high LDL cholesterol (sometimes called \"bad\" cholesterol) and low HDL cholesterol (sometimes called \"good\" cholesterol). High blood pressure. Blood pressure is considered high if it stays at or above 140/90 mmHg over time. If you have diabetes or chronic kidney disease, high blood pressure is defined as 130/80 mmHg or higher. (The mmHg is millimeters of mercury—the units used to measure blood pressure.) Smoking. Smoking can damage and tighten blood vessels, raise cholesterol levels, and raise blood pressure. Smoking also doesn't allow enough oxygen to reach the body's tissues. Insulin resistance. This condition occurs if the body can't use its insulin properly. Insulin is a hormone that helps move blood sugar into cells where it's used as an energy source. Insulin resistance may lead to diabetes. Diabetes. With this disease, the body's blood sugar level is too high because the body doesn't make enough insulin or doesn't use its insulin properly. Overweight or obesity. The terms \"overweight\" and \"obesity\" refer to body weight that's greater than what is considered healthy for a certain height. Lack of physical activity. A lack of physical activity can worsen other risk factors for atherosclerosis, such as unhealthy blood cholesterol levels, high blood pressure, diabetes, and overweight and obesity. Unhealthy diet. An unhealthy diet can raise your risk for atherosclerosis. Foods that are high in saturated and trans fats, cholesterol, sodium (salt), and sugar can worsen other atherosclerosis risk factors. Older age. As you get older, your risk for atherosclerosis increases. Genetic or lifestyle factors cause plaque to build up in your arteries as you age. By the time you're middle-aged or older, enough plaque has built up to cause signs or symptoms. In men, the risk increases after age 45. In women, the risk increases after age 55. Family history of early heart disease. Your risk for atherosclerosis increases if your father or a brother was diagnosed with heart disease before 55 years of age, or if your mother or a sister was diagnosed with heart disease before 65 years of age. Although age and a family history of early heart disease are risk factors, it doesn't mean that you'll develop atherosclerosis if you have one or both. Controlling other risk factors often can lessen genetic influences and prevent atherosclerosis, even in older adults. Studies show that an increasing number of children and youth are at risk for atherosclerosis. This is due to a number of causes, including rising childhood obesity rates. Emerging Risk Factors Scientists continue to study other possible risk factors for atherosclerosis. High levels of a protein called C-reactive protein (CRP) in the blood may raise the risk for atherosclerosis and heart attack. High levels of CRP are a sign of inflammation in the body. Inflammation is the body's response to injury or infection. Damage to the arteries' inner walls seems to trigger inflammation and help plaque grow. People who have low CRP levels may develop atherosclerosis at a slower rate than people who have high CRP levels. Research is under way to find out whether reducing inflammation and lowering CRP levels also can reduce the risk for atherosclerosis. High levels of triglycerides (tri-GLIH-seh-rides) in the blood also may raise the risk for atherosclerosis, especially in women. Triglycerides are a type of fat. Studies are under way to find out whether genetics may play a role in atherosclerosis risk. Other Factors That Affect Atherosclerosis Other factors also may raise your risk for atherosclerosis, such as: Sleep apnea. Sleep apnea is a disorder that causes one or more pauses in breathing or shallow breaths while you sleep. Untreated sleep apnea can raise your risk for high blood pressure, diabetes, and even a heart attack or stroke. Stress. Research shows that the most commonly reported \"trigger\" for a heart attack is an emotionally upsetting event, especially one involving anger. Alcohol. Heavy drinking can damage the heart muscle and worsen other risk factors for atherosclerosis. Men should have no more than two drinks containing alcohol a day. Women should have no more than one drink containing alcohol a day. SIGNS & SYMPTOMS Atherosclerosis usually doesn't cause signs and symptoms until it severely narrows or totally blocks an artery. Many people don't know they have the disease until they have a medical emergency, such as a heart attack or stroke. Some people may have signs and symptoms of the disease. Signs and symptoms will depend on which arteries are affected. Coronary Arteries The coronary arteries supply oxygen-rich blood to your heart. If plaque narrows or blocks these arteries (a disease called coronary heart disease, or CHD), a common symptom is angina. Angina is chest pain or discomfort that occurs when your heart muscle doesn't get enough oxygen-rich blood. Angina may feel like pressure or squeezing in your chest. You also may feel it in your shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion. The pain tends to get worse with activity and go away with rest. Emotional stress also can trigger the pain. Other symptoms of CHD are shortness of breath and arrhythmias (ah-RITH-me-ahs). Arrhythmias are problems with the rate or rhythm of the heartbeat. Plaque also can form in the heart's smallest arteries. This disease is called coronary microvascular disease (MVD). Symptoms of coronary MVD include angina, shortness of breath, sleep problems, fatigue (tiredness), and lack of energy. Carotid Arteries The carotid arteries supply oxygen-rich blood to your brain. If plaque narrows or blocks these arteries (a disease called carotid artery disease), you may have symptoms of a stroke. These symptoms may include: Sudden weakness Paralysis (an inability to move) or numbness of the face, arms, or legs, especially on one side of the body Confusion Trouble speaking or understanding speech Trouble seeing in one or both eyes Problems breathing Dizziness, trouble walking, loss of balance or coordination, and unexplained falls Loss of consciousness Sudden and severe headache Peripheral Arteries Plaque also can build up in the major arteries that supply oxygen-rich blood to the legs, arms, and pelvis (a disease called peripheral artery disease). If these major arteries are narrowed or blocked, you may have numbness, pain, and, sometimes, dangerous infections. Renal Arteries The renal arteries supply oxygen-rich blood to your kidneys. If plaque builds up in these arteries, you may develop chronic kidney disease. Over time, chronic kidney disease causes a slow loss of kidney function. Early kidney disease often has no signs or symptoms. As the disease gets worse it can cause tiredness, changes in how you urinate (more often or less often), loss of appetite, nausea (feeling sick to the stomach), swelling in the hands or feet, itchiness or numbness, and trouble concentrating. DIAGNOSIS Your doctor will diagnose atherosclerosis based on your medical and family histories, a physical exam, and test results. Specialists Involved If you have atherosclerosis, a primary care doctor, such as an internist or family practitioner, may handle your care. Your doctor may recommend other health care specialists if you need expert care, such as: A cardiologist. This is a doctor who specializes in diagnosing and treating heart diseases and conditions. You may go to a cardiologist if you have peripheral artery disease (P.A.D.) or coronary microvascular disease (MVD). A vascular specialist. This is a doctor who specializes in diagnosing and treating blood vessel problems. You may go to a vascular specialist if you have P.A.D. A neurologist. This is a doctor who specializes in diagnosing and treating nervous system disorders. You may see a neurologist if you've had a stroke due to carotid artery disease. A nephrologist. This is a doctor who specializes in diagnosing and treating kidney diseases and conditions. You may go to a nephrologist if you have chronic kidney disease. Physical Exam During the physical exam, your doctor may listen to your arteries for an abnormal whooshing sound called a bruit (broo-E). Your doctor can hear a bruit when placing a stethoscope over an affected artery. A bruit may indicate poor blood flow due to plaque buildup. Your doctor also may check to see whether any of your pulses (for example, in the leg or foot) are weak or absent. A weak or absent pulse can be a sign of a blocked artery. Diagnostic Tests Your doctor may recommend one or more tests to diagnose atherosclerosis. These tests also can help your doctor learn the extent of your disease and plan the best treatment. Blood Tests Blood tests check the levels of certain fats, cholesterol, sugar, and proteins in your blood. Abnormal levels may be a sign that you're at risk for atherosclerosis. EKG (Electrocardiogram) An EKG is a simple, painless test that detects and records the heart's electrical activity. The test shows how fast the heart is beating and its rhythm (steady or irregular). An EKG also records the strength and timing of electrical signals as they pass through the heart. An EKG can show signs of heart damage caused by CHD. The test also can show signs of a previous or current heart attack. Chest X Ray A chest x ray takes pictures of the organs and structures inside your chest, such as your heart, lungs, and blood vessels. A chest x ray can reveal signs of heart failure. Ankle/Brachial Index This test compares the blood pressure in your ankle with the blood pressure in your arm to see how well your blood is flowing. This test can help diagnose P.A.D. Echocardiography Echocardiography (echo) uses sound waves to create a moving picture of your heart. The test provides information about the size and shape of your heart and how well your heart chambers and valves are working. Echo also can identify areas of poor blood flow to the heart, areas of heart muscle that aren't contracting normally, and previous injury to the heart muscle caused by poor blood flow. Computed Tomography Scan A computed tomography (CT) scan creates computer-generated pictures of the heart, brain, or other areas of the body. The test can show hardening and narrowing of large arteries. A cardiac CT scan also can show whether calcium has built up in the walls of the coronary (heart) arteries. This may be an early sign of CHD. Stress Testing During stress testing, you exercise to make your heart work hard and beat fast while heart tests are done. If you can't exercise, you may be given medicine to make your heart work hard and beat fast. When your heart is working hard, it needs more blood and oxygen. Plaque-narrowed arteries can't supply enough oxygen-rich blood to meet your heart's needs. A stress test can show possible signs and symptoms of CHD, such as: Abnormal changes in your heart rate or blood pressure Shortness of breath or chest pain Abnormal changes in your heart rhythm or your heart's electrical activity As part of some stress tests, pictures are taken of your heart while you exercise and while you rest. These imaging stress tests can show how well blood is flowing in various parts of your heart. They also can show how well your heart pumps blood when it beats. Angiography Angiography (an-jee-OG-ra-fee) is a test that uses dye and special x rays to show the inside of your arteries. This test can show whether plaque is blocking your arteries and how severe the blockage is. A thin, flexible tube called a catheter is put into a blood vessel in your arm, groin (upper thigh), or neck. Dye that can be seen on an x-ray picture is injected through the catheter into the arteries. By looking at the x-ray picture, your doctor can see the flow of blood through your arteries. Other Tests Other tests are being studied to see whether they can give a better view of plaque buildup in the arteries. Examples of these tests include magnetic resonance imaging (MRI) and positron emission tomography (PET). TREATMENTS Treatments for atherosclerosis may include heart-healthy lifestyle changes, medicines, and medical procedures or surgery. The goals of treatment include: Lowering the risk of blood clots forming Preventing atherosclerosis-related diseases Reducing risk factors in an effort to slow or stop the buildup of plaque Relieving symptoms Widening or bypassing plaque-clogged arteries Heart-Healthy Lifestyle Changes Your doctor may recommend heart-healthy lifestyle changes if you have atherosclerosis. Heart-healthy lifestyle changes include heart-healthy eating, maintaining a healthy weight, managing stress, physical activity and quitting smoking. Heart-Healthy Eating Your doctor may recommend heart-healthy eating, which should include: Fat-free or low-fat dairy products, such as skim milk Fish high in omega-3 fatty acids, such as salmon, tuna, and trout, about twice a week Fruits, such as apples, bananas, oranges, pears, and prunes Legumes, such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans Vegetables, such as broccoli, cabbage, and carrots Whole grains, such as oatmeal, brown rice, and corn tortillas When following a heart-healthy diet, you should avoid eating: A lot of red meat Palm and coconut oils Sugary foods and beverages Two nutrients in your diet make blood cholesterol levels rise: Saturated fat—found mostly in foods that come from animals Trans fat (trans fatty acids)—found in foods made with hydrogenated oils and fats, such as stick margarine; baked goods, such as cookies, cakes, and pies; crackers; frostings; and coffee creamers. Some trans fats also occur naturally in animal fats and meats. Saturated fat raises your blood cholesterol more than anything else in your diet. When you follow a heart-healthy eating plan, only 5 percent to 6 percent of your daily calories should come from saturated fat. Food labels list the amounts of saturated fat. To help you stay on track, here are some examples: 1,200 calories a day 8 grams of saturated fat a day 1,500 calories a day 10 grams of saturated fat a day 1,800 calories a day 12 grams of saturated fat a day 2,000 calories a day 13 grams of saturated fat a day 2,500 calories a day 17 grams of saturated fat a day Not all fats are bad. Monounsaturated and polyunsaturated fats actually help lower blood cholesterol levels. Some sources of monounsaturated and polyunsaturated fats are: Avocados Corn, sunflower, and soybean oils Nuts and seeds, such as walnuts Olive, canola, peanut, safflower, and sesame oils Peanut butter Salmon and trout Tofu Sodium You should try to limit the amount of sodium that you eat. This means choosing and preparing foods that are lower in salt and sodium. Try to use low-sodium and “no added salt” foods and seasonings at the table or while cooking. Food labels tell you what you need to know about choosing foods that are lower in sodium. Try to eat no more than 2,300 milligrams of sodium a day. If you have high blood pressure, you may need to restrict your sodium intake even more. Dietary Approaches to Stop Hypertension Your doctor may recommend the Dietary Approaches to Stop Hypertension (DASH) eating plan if you have high blood pressure. The DASH eating plan focuses on fruits, vegetables, whole grains, and other foods that are heart healthy and low in fat, cholesterol, and sodium and salt. The DASH eating plan is a good heart-healthy eating plan, even for those who don’t have high blood pressure. Read more about DASH. Alcohol Try to limit alcohol intake. Too much alcohol will raise your blood pressure and triglyceride levels, a type of fat found in the blood. Alcohol also adds extra calories, which may cause weight gain. Men should have no more than two drinks containing alcohol a day. Women should have no more than one drink containing alcohol a day. One drink is: 12 ounces of beer 5 ounces of wine 1½ ounces of liquor Maintaining a Healthy Weight Maintaining a healthy weight is important for overall health and can lower your risk for coronary heart disease. Aim for a Healthy Weight by following a heart-healthy eating plan and keeping physically active. Knowing your body mass index (BMI) helps you find out if you’re a healthy weight in relation to your height and gives an estimate of your total body fat. To figure out your BMI, check out the National Heart, Lung, and Blood Institute’s online BMI calculator or talk to your doctor. A BMI: Below 18.5 is a sign that you are underweight. Between 18.5 and 24.9 is in the normal range. Between 25.0 and 29.9 is considered overweight. A BMI of 30.0 or higher is considered obese. A general goal to aim for is a BMI of less than 25. Your doctor or health care provider can help you set an appropriate BMI goal. Measuring waist circumference helps screen for possible health risks. If most of your fat is around your waist rather than at your hips, you’re at a higher risk for heart disease and type 2 diabetes. This risk may be high with a waist size that is greater than 35 inches for women or greater than 40 inches for men. To learn how to measure your waist, visit Assessing Your Weight and Health Risk. For more information about losing weight or maintaining your weight, visit Aim for a Healthy Weight. If you’re overweight or obese, try to lose weight. A loss of just 3 percent to 5 percent of your current weight can lower your triglycerides, blood glucose, and the risk of developing type 2 diabetes. Greater amounts of weight loss can improve blood pressure readings, lower LDL cholesterol, and increase HDL cholesterol. Managing Stress Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health. Consider healthy stress-reducing activities, such as: A stress management program Meditation Physical activity Relaxation therapy Talking things out with friends or family Physical Activity Regular physical activity can lower many atherosclerosis risk factors, including LDL or “bad” cholesterol, high blood pressure, and excess weight. Physical activity also can lower your risk for diabetes and raise your HDL or “good” cholesterol, which helps prevent atherosclerosis. Everyone should try to participate in moderate-intensity aerobic exercise at least 2 hours and 30 minutes per week or vigorous aerobic exercise for 1 hour and 15 minutes per week. Aerobic exercise, such as brisk walking, is any exercise in which your heart beats faster and you use more oxygen than usual. The more active you are, the more you will benefit. Participate in aerobic exercise for at least 10 minutes at a time spread throughout the week. Talk with your doctor before you start a new exercise plan. Ask your doctor how much and what kinds of physical activity are safe for you. Read more about physical activity at: Physical Activity and Your Heart U.S. Department of Health and Human Services, 2008 Physical Activity Guidelines for Americans Quitting Smoking If you smoke or use tobacco, quit. Smoking can damage and tighten blood vessels and raise your risk for atherosclerosis. Talk with your doctor about programs and products that can help you quit. Also, try to avoid secondhand smoke. If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking. For more information about how to quit smoking, visit Smoking and Your Heart. Medicines Sometimes lifestyle changes alone aren’t enough to control your cholesterol levels. For example, you also may need statin medications to control or lower your cholesterol. By lowering your blood cholesterol level, you can decrease your chance of having a heart attack or stroke. Doctors usually prescribe statins for people who have: Coronary heart disease, peripheral artery disease, or had a prior stroke Diabetes High LDL cholesterol levels Doctors may discuss beginning statin treatment with people who have an elevated risk for developing heart disease or having a stroke. Your doctor also may prescribe other medications to: Lower your blood pressure Lower your blood sugar levels Prevent blood clots, which can lead to heart attack and stroke Prevent inflammation Take all medicines regularly, as your doctor prescribes. Don’t change the amount of your medicine or skip a dose unless your doctor tells you to. You should still follow a heart healthy lifestyle, even if you take medicines to treat your atherosclerosis. Medical Procedures and Surgery If you have severe atherosclerosis, your doctor may recommend a medical procedure or surgery. Percutaneous coronary intervention (PCI), also known as coronary angioplasty, is a procedure that’s used to open blocked or narrowed coronary (heart) arteries. PCI can improve blood flow to the heart and relieve chest pain. Sometimes a small mesh tube called a stent is placed in the artery to keep it open after the procedure. Coronary artery bypass grafting (CABG) is a type of surgery. In CABG, arteries or veins from other areas in your body are used to bypass or go around your narrowed coronary arteries. CABG can improve blood flow to your heart, relieve chest pain, and possibly prevent a heart attack. Bypass grafting also can be used for leg arteries. For this surgery, a healthy blood vessel is used to bypass a narrowed or blocked artery in one of the legs. The healthy blood vessel redirects blood around the blocked artery, improving blood flow to the leg. Carotid endarterectomy is a type of surgery to remove plaque buildup from the carotid arteries in the neck. This procedure restores blood flow to the brain, which can help prevent a stroke. PREVENTION Taking action to control your risk factors can help prevent or delay atherosclerosis and its related diseases. Your risk for atherosclerosis increases with the number of risk factors you have. One step you can take is to adopt a healthy lifestyle, which can include: Heart-Healthy Eating. Adopt heart-healthy eating habits, which include eating different fruits and vegetables (including beans and peas), whole grains, lean meats, poultry without skin, seafood, and fat-free or low-fat milk and dairy products. A heart-healthy diet is low in sodium, added sugar, solid fats, and refined grains. Following a heart-healthy diet is an important part of a healthy lifestyle. Physical Activity. Be as physically active as you can. Physical activity can improve your fitness level and your health. Ask your doctor what types and amounts of activity are safe for you. Read more about Physical Activity and Your Heart. Quit Smoking. If you smoke, quit. Smoking can damage and tighten blood vessels and raise your risk for atherosclerosis. Talk with your doctor about programs and products that can help you quit. Also, try to avoid secondhand smoke. Read more about Smoking and Your Heart. Weight Control. If you’re overweight or obese, work with your doctor to create a reasonable weight-loss plan. Controlling your weight helps you control risk factors for atherosclerosis. Other steps that can prevent or delay atherosclerosis include knowing your family history of atherosclerosis. If you or someone in your family has an atherosclerosis-related disease, be sure to tell your doctor. If lifestyle changes aren’t enough, your doctor may prescribe medicines to control your atherosclerosis risk factors. Take all of your medicines as your doctor advises. LIVING WITH Improved treatments have reduced the number of deaths from atherosclerosis-related diseases. These treatments also have improved the quality of life for people who have these diseases. Adopting a healthy lifestyle may help you prevent or delay atherosclerosis and the problems it can cause. This, along with ongoing medical care, can help you avoid the problems of atherosclerosis and live a long, healthy life. Researchers continue to look for ways to improve the health of people who have atherosclerosis or may develop it. Ongoing Care If you have atherosclerosis, work closely with your doctor and other health care providers to avoid serious problems, such as heart attack and stroke. Follow your treatment plan and take all of your medicines as your doctor prescribes. Your doctor will let you know how often you should schedule office visits or blood tests. Be sure to let your doctor know if you have new or worsening symptoms. Emotional Issues and Support Having an atherosclerosis-related disease may cause fear, anxiety, depression, and stress. Talk about how you feel with your doctor. Talking to a professional counselor also can help. If you're very depressed, your doctor may recommend medicines or other treatments that can improve your quality of life. Community resources are available to help you learn more about atherosclerosis. Contact your local public health departments, hospitals, and local chapters of national health organizations to learn more about available resources in your area. Talk about your lifestyle changes with your family and friends—whoever can provide support or needs to understand why you're changing your habits. Family and friends may be able to help you make lifestyle changes. For example, they can help you plan healthier meals. Because atherosclerosis tends to run in families, your lifestyle changes may help many of your family members too. ", "role": "user" }, { "content": "treatments have reduced the number of deaths from atherosclerosis-related diseases. These treatments also have improved the quality of life for people who have these diseases. Follow your treatment plan and take all of your medicines as your doctor prescribes. Your doctor will let you know how often you should schedule office visits or blood tests. If you're very depressed, your doctor may recommend medicines or other treatments that can improve your quality of life.", "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 - aftercare Adhesive capsulitis - aftercare Frozen shoulder syndrome - aftercare Pericapsulitis - aftercare Stiff shoulder - aftercare Shoulder pain - frozen shoulder Summary A frozen shoulder is shoulder pain that leads to stiffness of your shoulder. Often the pain and stiffness are present all the time. More About Your Injury 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 What to Expect Symptoms of frozen shoulder often follow this pattern: At first, you have a lot of pain, which can come on abruptly even without an injury or trauma. Your shoulder can become very stiff and hard to move, even when the pain lessens. It becomes hard to reach over your head or behind you. This is the freezing phase. 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 each stage 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 or steroid directly into the joint. Most people have a full recovery with full range of motion without surgery. Symptom Relief 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. In Your Home 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. Shoulder Exercises 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 doctor or physical therapist will show you how to do these exercises. When to Call the Doctor Call your doctor if: The pain in your shoulder is getting much worse even if you take pain medicine You re-injure your arm or shoulder Your frozen shoulder is making you feel sad or depressed Review Date 4/9/2018 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": "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. ... Most people have a full recovery with full range of motion", "role": "assistant" } ]

[ { "content": "Hair loss Information Required Can you provide something to help grow my hair back? I need my hair back as im the spitting double of Dr evil with no hair.\n\nFemale pattern baldness (Treatment): Untreated, hair loss in female pattern baldness is permanent. In most cases, hair loss is mild to moderate. You do not need treatment if you are comfortable with your appearance. MEDICINES The only medicine approved by the United States Food and Drug Administration (FDA) to treat female pattern baldness is minoxidil: - It is applied to the scalp. - For women, the 2% solution or 5% foam is recommended. - Minoxidil may help hair grow in about 1 in 4 or 5 of women. In most women, it may slow or stop hair loss. - You must continue to use this medicine for a long time. Hair loss starts again when you stop using it. Also, the hair that it helps grow will fall out. If minoxidil does not work, your provider may recommend other medicines, such as spironolactone, cimetidine, birth control pills, ketoconazole, among others. Your provider can tell you more about these if needed. HAIR TRANSPLANT During hair transplant, tiny plugs of hair are removed from areas where hair is thicker, and placed (transplanted) in areas that are balding. Minor scarring may occur where hair is removed. There is a slight risk of skin infection. You will likely need many transplants, which can be expensive. However, the results are often excellent and permanent. OTHER SOLUTIONS Hair weaving, hairpieces, or a change in hairstyle can help hide hair loss and improve your appearance. This is often the least expensive and safest way to deal with female pattern baldness.", "role": "user" }, { "content": "The only medicine approved by the United States Food and Drug Administration (FDA) to treat female pattern baldness is minoxidil: - It is applied to the scalp. - For women, the 2% solution or 5% foam is recommended. - Minoxidil may help hair grow in about 1 in 4 or 5 of women. In most women, it may slow or stop hair loss. - You must continue to use this medicine for a long time. Hair loss starts again when you stop using it. Also, the hair that it helps grow will fall out. If minoxidil does not work, your provider may recommend other medicines, such as spironolactone, cimetidine, birth control pills, ketoconazole, among others. ... HAIR TRANSPLANT During hair transplant, tiny plugs of hair are removed from areas where hair is thicker, and placed (transplanted) in areas that are balding. ...OTHER SOLUTIONS Hair weaving, hairpieces, or a change in hairstyle can help hide hair loss and improve your appearance. This is often the least expensive and safest way to deal with female pattern baldness.", "role": "assistant" } ]

[ { "content": "what causes fungal pneumonia\n\nWhat causes Pneumonia?: Many germs can cause pneumonia. Examples include different kinds of bacteria, viruses, and, less often, fungi. Most of the time, the body filters germs 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 (SIL-e-ah) help stop the germs from reaching your lungs. (For more information, go to the Diseases and Conditions Index How the Lungs Work article.) Sometimes, though, germs 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 germs out of the air that you breathe For example, if you can't cough because you've had a stroke or are sedated, germs may remain in your airways. (\"Sedated\" means you're given medicine to make you sleepy.) When germs reach your lungs, your immune system goes into action. It sends many kinds of cells to attack the germs. These cells cause the alveoli (air sacs) to become red and inflamed and to fill up with fluid and pus. This causes the symptoms of pneumonia. Germs That Can Cause Pneumonia Bacteria Bacteria are the most common cause of pneumonia in adults. Some people, especially the elderly and those who are disabled, may get bacterial pneumonia after having the flu or even a common cold. Many types of bacteria can cause pneumonia. Bacterial pneumonia can occur on its own or develop after you've had a cold or the flu. This type of pneumonia often affects one lobe, or area, of a lung. When this happens, the condition is called lobar pneumonia. The most common cause of pneumonia in the United States is the bacterium Streptococcus (strep-to-KOK-us) pneumoniae, or pneumococcus (nu-mo-KOK-us). Lobar Pneumonia Another type of bacterial pneumonia is called atypical pneumonia. Atypical pneumonia includes: 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 pneumonia. 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 pneumonia can be very serious. It may be associated with a skin rash and hemolysis (the breakdown of red blood cells). Chlamydophila 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. Viruses Respiratory viruses cause up to one-third of the pneumonia cases in the United States each year. These viruses are the most common cause of pneumonia in children younger than 5 years old. Most cases of viral pneumonia are mild. They get better in about 1 to 3 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 as well. The flu virus is the most common cause of viral pneumonia in adults. Other viruses that cause pneumonia include respiratory syncytial virus, rhinovirus, herpes simplex virus, severe acute respiratory syndrome (SARS), and more. Fungi Three types of fungi in the soil in some parts of the United States can cause pneumonia. These fungi are: Coccidioidomycosis (kok-sid-e-OY-do-mi-KO-sis). This fungus is found in Southern California and the desert Southwest. Histoplasmosis (HIS-to-plaz-MO-sis). This fungus is found in the Ohio and Mississippi River Valleys. Cryptococcus (krip-to-KOK-us). This fungus is found throughout the United States in bird droppings and soil contaminated with bird droppings. Most people exposed to these fungi don't get sick, but some do and require treatment. Serious fungal infections are most common in people who have weak immune systems due to the long-term use of medicines to suppress their immune systems or having HIV/AIDS. Pneumocystis jiroveci (nu-mo-SIS-tis ye-RO-VECH-e), formerly Pneumocystis carinii, sometimes is considered a fungal pneumonia. However, it's not treated with the usual antifungal medicines. This type of infection is most common in people who: Have HIV/AIDS or cancer Have had an organ transplant and/or blood and marrow stem cell transplant Take medicines that affect their immune systems Other kinds of fungal infections also can lead to pneumonia.", "role": "user" }, { "content": "Fungi Three types of fungi in the soil in some parts of the United States can cause pneumonia. These fungi are: Coccidioidomycosis (kok-sid-e-OY-do-mi-KO-sis). This fungus is found in Southern California and the desert Southwest. Histoplasmosis (HIS-to-plaz-MO-sis). This fungus is found in the Ohio and Mississippi River Valleys. Cryptococcus (krip-to-KOK-us). This fungus is found throughout the United States in bird droppings and soil contaminated with bird droppings. Most people exposed to these fungi don't get sick, but some do and require treatment. Serious fungal infections are most common in people who have weak immune systems due to the long-term use of medicines to suppress their immune systems or having HIV/AIDS.", "role": "assistant" } ]

[ { "content": "how is hemophilia treated\n\nHemophilia A (Treatment): People with inherited hemophilia A require life-long care, preferably through a specialized hemophilia treatment center. Although there is no cure for hemophilia A, current treatments usually work well. Treatment primarily consists of replacing the missing clotting factor VIII ( replacement therapy) and preventing complications that are associated with the disorder. The type and frequency of treatment often depends on the severity of the disorder in each person. People with mild or moderate hemophilia A may be treated with replacement therapy as needed (for example, when a specific bleeding episode occurs). This is called episodic therapy. Some people with mild hemophilia A may be treated with desmopressin (DDAVP). Desmopressin raises the levels of factor VIII in the blood and may be taken intravenously or through a nasal spray. Drugs known as antifibrinolytics, which slow the breakdown of clotting factors in the blood, can also be used to treat those with a mild form of the disorder. Some people with severe hemophilia A may receive periodic factor VIII infusions to prevent bleeding episodes and associated complications such as joint damage. This is referred to as prophylactic therapy. People can be trained to give infusions at home. This is especially important for people with severe disease because the infusion works the best within one hour of a bleeding episode. In general, rapid treatment is important because it reduces pain and damage to the joints, muscles or other affected tissues or organs . [5] 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. The National Hemophilia Foundation Web site posts the guidelines for management of pregnancy and delivery of women with bleeding disorders and carriers of hemophilia A and B. Click on the link to view the guidelines. FDA-Approved Treatments The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition. Learn more orphan products. National Library of Medicine Drug Information Portal National Library of Medicine Drug Information Portal National Library of Medicine Drug Information Portal National Library of Medicine Drug Information Portal Medline Plus Health Information National Library of Medicine Drug Information Portal Medline Plus Health Information", "role": "user" }, { "content": "If you have inherited hemophilia A, you will require life-long care, potentially through a hemophilia treatment center. There is no cure for hemophilia A, but the available treatments usually work well. Treatment primarily involves replacing the missing clotting factor VII, as well as preventing any complications associated with the disorder. The type and frequency of of treatment depends on the severity. If your hemophilia is may, you may only need treatment when a bleeding episode occurs. However, if it is more severe, you will require routine treatments to prevent bleeding episodes and any associated complications.", "role": "assistant" } ]

[ { "content": "what are the causes of pulmonary hypertension\n\n Pulmonary hypertension Pulmonary arterial hypertension Sporadic primary pulmonary hypertension Familial primary pulmonary hypertension Idiopathic pulmonary arterial hypertension Primary pulmonary hypertension PPH Secondary pulmonary hypertension Cor pulmonale - pulmonary hypertension Summary Pulmonary hypertension is high blood pressure in the arteries of the lungs. It makes the right side of the heart work harder than normal. Causes The right side of the heart pumps blood through the lungs, where it picks up oxygen. Blood returns to the left side of the heart, where it is pumped to the rest of the body. When the small arteries (blood vessels) of the lungs become narrowed, they cannot carry as much blood. When this happens, pressure builds up. This is called pulmonary hypertension. The heart needs to work harder to force the blood through the vessels against this pressure. Over time, this causes the right side of the heart to become larger. This condition is called right-sided heart failure, or cor pulmonale. Pulmonary hypertension may be caused by: Autoimmune diseases that damage the lungs, such as scleroderma and rheumatoid arthritis Birth defects of the heart Blood clots in the lung (pulmonary embolism) Heart failure Heart valve disease HIV infection Low oxygen levels in the blood for a long time (chronic) Lung disease, such as COPD or pulmonary fibrosis or any other severe chronic lung condition Medicines (for example, certain diet drugs) Obstructive sleep apnea In rare cases, the cause of pulmonary hypertension is unknown. In this case, the condition is called idiopathic pulmonary arterial hypertension (IPAH). Idiopathic means the cause of a disease is not known. IPAH affects more women than men. If pulmonary hypertension is caused by a known medicine or medical condition, it is called secondary pulmonary hypertension. Symptoms Shortness of breath or lightheadedness during activity is often the first symptom. Fast heart rate (palpitations) may be present. Over time, symptoms occur with lighter activity or even while at rest. Other symptoms include: Ankle and leg swelling Bluish color of the lips or skin (cyanosis) Chest pain or pressure, usually in the front of the chest Dizziness or fainting spells Fatigue Increased abdomen size Weakness People with pulmonary hypertension often have symptoms that come and go. They report good days and bad days. Exams and Tests Your health care provider will perform a physical exam and ask about your symptoms. The exam may find: Abnormal heart sounds Feeling of a pulse over the breastbone Heart murmur on the right side of the heart Larger-than-normal veins in the neck Leg swelling Liver and spleen swelling Normal breath sounds if pulmonary hypertension is idiopathic or due to congenital heart disease Abnormal breath sounds if pulmonary hypertension is from other lung disease In the early stages of the disease, the exam may be normal or almost normal. The condition may take several months to diagnose. Asthma and other diseases may cause similar symptoms and must be ruled out. Tests that may be ordered include: Blood tests Cardiac catheterization Chest x-ray CT scan of the chest Echocardiogram ECG Lung function tests Nuclear lung scan Pulmonary arteriogram 6-minute walk test Sleep study Tests to check for autoimmune problems Treatment There is no cure for pulmonary hypertension. The goal of treatment is to control symptoms and prevent more lung damage. It is important to treat medical disorders that cause pulmonary hypertension, such as obstructive sleep apnea, lung conditions, and heart valve problems. Many treatment options for pulmonary arterial hypertension are available. If you are prescribed medicines, they may be taken by mouth (oral), received through the vein (intravenous, or IV), or breathed in (inhaled). Your provider will decide which medicine is best for you. You will be closely monitored during treatment to watch for side effects and to see how well you are responding to the medicine. DO NOT stop taking your medicines without talking to your provider. Other treatments may include: Blood thinners to reduce the risk of blood clots, especially if you have IPAH Oxygen therapy at home Lung, or in some cases, heart-lung transplant, if medicines do not work Other important tips to follow: Avoid pregnancy Avoid heavy physical activities and lifting Avoid traveling to high altitudes Get a yearly flu vaccine, as well as other vaccines such as the pneumonia vaccine Stop smoking Outlook (Prognosis) How well you do depends on what caused the condition. Medicines for IPAH may help slow the disease. As the illness gets worse, you will need to make changes in your home to help you get around the house. When to Contact a Medical Professional Call your provider if: You begin to develop shortness of breath when you are active Shortness of breath gets worse You develop chest pain You develop other symptoms Review Date 2/18/2018 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": "Pulmonary hypertension is high blood pressure in the arteries of the lungs. It makes the right side of the heart work harder than normal.", "role": "assistant" } ]

[ { "content": "what are some common symptoms of bulimia\n\n Bulimia nervosa Overview Bulimia (boo-LEE-me-uh) nervosa, commonly called bulimia, is a serious, potentially life-threatening eating disorder. People with bulimia may secretly binge - eating large amounts of food - and then purge, trying to get rid of the extra calories in an unhealthy way. For example, someone with bulimia may force vomiting or engage in excessive exercise. Sometimes people purge after eating only a small snack or a normal-size meal. Bulimia can be categorized in two ways: - Purging bulimia. You regularly self-induce vomiting or misuse laxatives, diuretics or enemas after bingeing. - Nonpurging bulimia. You use other methods to rid yourself of calories and prevent weight gain, such as fasting, strict dieting or excessive exercise. However, these behaviors often overlap, and the attempt to rid yourself of extra calories is usually referred to as purging, no matter what the method. If you have bulimia, you're probably preoccupied with your weight and body shape. You may judge yourself severely and harshly for self-perceived flaws. Because it's related to self-image - and not just about food - bulimia can be hard to overcome. But effective treatment can help you feel better about yourself, adopt healthier eating patterns and reverse serious complications. Bulimia care at Mayo Clinic Symptoms Bulimia signs and symptoms may include: - Being preoccupied with your body shape and weight - Living in fear of gaining weight - Feeling that you can't control your eating behavior - Eating until the point of discomfort or pain - Eating much more food in a binge episode than in a normal meal or snack - Forcing yourself to vomit or exercise too much to keep from gaining weight after bingeing - Misusing laxatives, diuretics or enemas after eating - Restricting calories or avoiding certain foods between binges - Using dietary supplements or herbal products excessively for weight loss If you have any bulimia symptoms, seek medical help as soon as possible. If left untreated, bulimia can severely impact your health. Talk to your primary care provider or a mental health provider about your bulimia symptoms and feelings. If you're reluctant to seek treatment, confide in someone about what you're going through, whether it's a friend or loved one, a teacher, a faith leader, or someone else you trust. He or she can help you take the first steps to get successful bulimia treatment. If you think a loved one may have symptoms of bulimia, have an open and honest discussion about your concerns. You can't force someone to seek professional care, but you can offer encouragement and support. You can also help find a qualified doctor or mental health provider, make an appointment, and even offer to go along. Because most people with bulimia are normal weight or slightly overweight, it may not be apparent to others that something is wrong. Red flags that family and friends may notice include: - Constantly worrying or complaining about being fat - Having a distorted, excessively negative body image - Repeatedly eating unusually large quantities of food in one sitting, especially foods the person would normally avoid - Not wanting to eat in public or in front of others - Going to the bathroom right after eating or during meals - Exercising too much - Having sores, scars or calluses on the knuckles or hands - Having damaged teeth and gums Causes The exact cause of bulimia is unknown. There are many factors that could play a role in the development of eating disorders, including biology, emotional health, societal expectations and other issues. Risk factors Factors that increase your risk of bulimia may include: - Being female. Girls and women are more likely to have bulimia than boys and men are. - Age. Bulimia often begins in the late teens or early adulthood. - Biology. People with first-degree relatives (siblings, parents or children) with an eating disorder may be more likely to develop an eating disorder, suggesting a possible genetic link. It's also possible that a deficiency in the brain chemical serotonin may play a role. And, being overweight as a child or teen may increase the risk. - Psychological and emotional issues. Psychological and emotional problems, such as anxiety disorder or low self-esteem, can contribute to eating disorders. Triggers for bingeing may include stress, poor body self-image, food, restrictive dieting or boredom. In some cases, traumatic events and environmental stress may be contributing factors. - Media and societal pressure. The media, such as TV and fashion magazines, frequently feature a parade of skinny models and actors. These images seem to equate thinness with success and popularity. But whether the media merely reflect social values or actually drive them isn't clear. - Sports, work or artistic pressures. Athletes, actors, dancers and models are at a higher risk of eating disorders. Coaches and parents may inadvertently raise the risk by encouraging young athletes to lose weight, maintain a low weight and restrict eating for better performance. Complications Bulimia may cause numerous serious and even life-threatening complications. Possible complications include: - Dehydration, which can lead to major medical problems, such as kidney failure - Heart problems, such as an irregular heartbeat or heart failure - Severe tooth decay and gum disease - Absent or irregular periods in females - Digestive problems, and possibly a dependence on laxatives to have bowel movements - Anxiety and depression - Misuse of alcohol or drugs - Suicide Diagnosis If your doctor suspects you have bulimia, he or she will typically perform: - A complete physical exam - Blood and urine tests - A psychological evaluation, including a discussion of your eating habits and attitude toward food Your doctor may also request additional tests to help pinpoint a diagnosis, rule out medical causes for weight changes and check for any related complications. Criteria for diagnosis For a diagnosis of bulimia, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, lists these points: - You recurrently have episodes of eating an abnormally large amount of food -- more than most people would eat in a similar amount of time and under similar circumstances, for example, in a two-hour time period - You feel a lack of control during bingeing, such as how much you're eating and whether you can stop eating - You get rid of the extra calories from bingeing to avoid weight gain by vomiting, excessive exercise, fasting, or misuse of laxatives, diuretics or other medications - You binge and purge at least once a week for at least three months - Your body shape and weight influence your feelings of self-worth too much - You don't have anorexia, an eating disorder with extremely restrictive eating behaviors The severity of bulimia is determined by the number of times a week that you purge. Even if you don't meet all of these criteria, you could still have an eating disorder. Don't try to diagnose yourself - get professional help if you have any eating disorder symptoms. Treatment When you have bulimia, you may need several types of treatment, although combining psychotherapy with antidepressants may be the most effective for overcoming the disorder. Treatment generally involves a team approach that includes you, your family, your primary care doctor or other health care provider, as well as a mental health provider and a dietitian experienced in treating eating disorders. You may have a case manager to coordinate your care. Here's a look at bulimia treatment options and considerations. Psychotherapy Psychotherapy, also known as talk therapy or psychological counseling, involves discussing your bulimia and related issues with a mental health provider. Evidence indicates that these types of psychotherapy help improve symptoms of bulimia: - Cognitive behavioral therapy to help you identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones - Family-based therapy to help parents intervene to stop their teenager's unhealthy eating behaviors, then to help the teen regain control over his or her own eating, and lastly to help the family deal with problems that bulimia can have on the teen's development and the family - Interpersonal psychotherapy, which addresses difficulties in your close relationships, helping to improve your communication and problem-solving skills Ask your mental health provider which psychotherapy he or she will use and what evidence exists that shows it's beneficial in treating bulimia. Medications Antidepressants may help reduce the symptoms of bulimia when used along with psychotherapy. The only antidepressant specifically approved by the Food and Drug Administration to treat bulimia is fluoxetine (Prozac), a type of selective serotonin reuptake inhibitor (SSRI), which may help even if you're not depressed. Nutrition education and healthy weight Dietitians and other health care providers can design an eating plan to help you achieve a healthy weight, normal eating habits and good nutrition. If you have bulimia, you may benefit from a medically supervised weight-loss program. Hospitalization Bulimia can usually be treated outside of the hospital. But if you have a severe form and serious health complications, you may need treatment in a hospital. Some eating disorder programs may offer day treatment rather than inpatient hospitalization. Treatment challenges in bulimia Although most people with bulimia do recover, some find that symptoms don't go away entirely. Periods of bingeing and purging may come and go through the years, depending on your life circumstances, such as recurrence during times of high stress. If you find yourself back in the binge-purge cycle, \"booster\" sessions with your health care providers may help you weather the crisis before your eating disorder spirals out of control again. Learning positive ways to cope, creating healthy relationships and managing stress can help prevent a relapse. Lifestyle and home remedies Although you can't treat bulimia on your own, in addition to professional treatment, follow these self-care tips for bulimia: - Stick to your treatment plan. Don't skip therapy sessions and try not to stray from meal plans, even if they make you uncomfortable. - Learn about bulimia. Education about your condition can empower you and motivate you to stick to your treatment plan. - Get the right nutrition. If you aren't eating well or you're frequently purging, it's likely your body isn't getting all of the nutrients it needs. Eating regularly and not restricting your food intake is the first step in overcoming bulimia. Talk to your doctor about appropriate vitamin and mineral supplements. - Stay in touch. Don't isolate yourself from caring family members and friends who want to see you get healthy. Understand that they have your best interests at heart and that nurturing, caring relationships are healthy for you. - Be kind to yourself. Resist urges to weigh yourself or check yourself in the mirror frequently. These may do nothing but fuel your drive to maintain unhealthy habits. - Be cautious with exercise. Talk to your health care provider about what kind of physical activity, if any, is appropriate for you, especially if you exercise excessively to burn off post-binge calories. Alternative medicine Dietary supplements and herbal products designed to suppress the appetite or aid in weight loss may be abused by people with eating disorders. Weight-loss supplements or herbs can have serious side effects and dangerously interact with other medications. If you use dietary supplements or herbs, discuss the potential risks with your doctor. ", "role": "user" }, { "content": "People with bulimia may secretly binge - eating large amounts of food - and then purge, trying to get rid of the extra calories in an unhealthy way. For example, someone with bulimia may force vomiting or engage in excessive exercise. Sometimes people purge after eating only a small snack or a normal-size meal. Bulimia can be categorized in two ways: - Purging bulimia. You regularly self-induce vomiting or misuse laxatives, diuretics or enemas after bingeing. - Nonpurging bulimia. You use other methods to rid yourself of calories and prevent weight gain, such as fasting, strict dieting or excessive exercise. However, these behaviors often overlap, and the attempt to rid yourself of extra calories is usually referred to as purging, no matter what the method. If you have bulimia, you're probably preoccupied with your weight and body shape. You may judge yourself severely and harshly for self-perceived flaws. Because it's related to self-image - and not just about food - bulimia can be hard to overcome.", "role": "assistant" } ]

[ { "content": "how much oxazepam could cause an overdose?\n\n Oxazepam IMPORTANT WARNING: Oxazepam may increase the risk of serious or life-threatening breathing problems, sedation, or coma if used along with certain medications. Tell your doctor if you are taking or plan to take certain opiate medications for cough such as codeine (in Triacin-C, in Tuzistra XR) or hydrocodone (in Anexsia, in Norco, in Zyfrel) or for pain such as codeine (in Fiorinal), fentanyl (Actiq, Duragesic, Subsys, others), hydromorphone (Dilaudid, Exalgo), meperidine (Demerol), methadone (Dolophine, Methadose), morphine (Astramorph, Duramorph PF, Kadian), oxycodone (in Oxycet, in Percocet, in Roxicet, others), and tramadol (Conzip, Ultram, in Ultracet). Your doctor may need to change the dosages of your medications and will monitor you carefully. If you take oxazepam with any of these medications and you develop any of the following symptoms, call your doctor immediately or seek emergency medical care immediately: unusual dizziness, lightheadedness, extreme sleepiness, slowed or difficult breathing, or unresponsiveness. Be sure that your caregiver or family members know which symptoms may be serious so they can call the doctor or emergency medical care if you are unable to seek treatment on your own. Drinking alcohol or using street drugs during your treatment with oxazepam also increases the risk that you will experience these serious, life-threatening side effects. Do not drink alcohol or use street drugs during your treatment. Why is this medication prescribed? Oxazepam is used to relieve anxiety, including anxiety caused by alcohol withdrawal (symptoms that may develop in people who stop drinking alcohol after drinking large amounts for a long time). Oxazepam is in a class of medications called benzodiazepines. It works by slowing activity in the brain to allow for relaxation. How should this medicine be used? Oxazepam comes as a capsule to take by mouth. It is usually taken three or four times a day and may be taken with or without food. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take oxazepam exactly as directed. Oxazepam can be habit-forming. Do not take a larger dose, take it more often, or take it for a longer time than prescribed by your doctor. Oxazepam may not work as well if it is taken for a long time. Oxazepam may help control your symptoms but will not cure your condition. Continue to take oxazepam even if you feel well. Do not skip doses even if you feel that you do not need them. Do not stop taking this medication without talking to your doctor. If you suddenly stop taking oxazepam, you may experience withdrawal symptoms (anxiousness, sleeplessness, and irritability). Your doctor will probably decrease your dose gradually. Other uses for this medicine Oxazepam is also used to treat irritable bowel syndrome. Talk to your doctor about the possible risks of using this medication for your condition. This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information. What special precautions should I follow? <h3>Before taking oxazepam,</h3> /h3> tell your doctor and pharmacist if you are allergic to oxazepam, any other medications, or any of the ingredients in oxazepam capsules. Ask your doctor or pharmacist for more information. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: antihistamines; digoxin (Lanoxin); levodopa (in Ritary, in Sinemet, in Stalevo); medication for depression, seizures, Parkinson's disease, asthma, colds, or allergies; muscle relaxants; oral contraceptives; phenytoin (Dilantin, Phenytek); probenecid (Probalan, in Col-Probenecid); rifampin (Rifadin, Rimactane, in Rifamate, in Rifater); sedatives; sleeping pills; theophylline (Elixophyllin, Theo 24, Theochron); or tranquilizers. 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 glaucoma or seizures, or lung, heart, or liver disease. tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking oxazepam, call your doctor immediately. talk to your doctor about the risks and benefits of taking oxazepam if you are 65 years of age or older. Older adults should take lower doses of oxazepam because higher doses may not be more effective and are more likely to cause serious side effects. if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking oxazepam. you should know that this medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you. tell your doctor if you use tobacco products. Cigarette smoking may decrease the effectiveness of this medication. What special dietary instructions should I follow? Unless your doctor tells you otherwise, continue your normal diet. What should I do if I forget a dose? Take the missed dose as soon as you remember it. However, if it is almost time for your next dose skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. What side effects can this medication cause? <h3>Oxazepam may cause side effects. Call your doctor if any of the symptoms are severe or do not go away: </h3> /h3> drowsiness dizziness tiredness weakness dry mouth diarrhea upset stomach changes in appetite restlessness or excitement constipation difficulty urinating frequent urination blurred vision changes in sex drive or ability <h3>Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately: </h3> /h3> shuffling walk persistent, fine tremor or inability to sit still fever difficulty breathing or swallowing severe skin rash yellowing of the skin or eyes irregular heartbeat Oxazepam may cause other side effects. Call your doctor if you experience any unusual problems during your treatment with oxazepam. If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088). What should I know about storage and disposal of this medication? Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program. It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location - one that is up and away and out of their sight and reach. http://www.upandaway.org 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. Do not let anyone else take your medication. Oxazepam is a controlled substance. Prescriptions may be refilled only a limited number of times; ask your pharmacist if you have any questions. 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 Serax ", "role": "user" }, { "content": "In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.", "role": "assistant" } ]

[ { "content": "what are the uses of vitamin e capsules\n\n Ataxia with vitamin E deficiency AVED Ataxia with isolated vitamin E deficiency Familial isolated deficiency of vitamin E AVED Ataxia with isolated vitamin E deficiency Familial isolated deficiency of vitamin E Friedreich-like ataxia with selective vitamin E deficiency Familial isolated vitamin E deficiency Friedreich-like ataxia Isolated vitamin E deficiency See More Summary 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] Symptoms This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom. Showing of Medical Terms Other Names Learn More: HPO ID 80%-99% of people have these symptoms Abnormal pyramidal sign 0007256 Areflexia Absent tendon reflexes 0001284 Muscle weakness Muscular weakness 0001324 30%-79% of people have these symptoms Dysarthria Difficulty articulating speech 0001260 Dysdiadochokinesis 0002075 Dysmetria Lack of coordination of movement 0001310 Gait disturbance Abnormal gait Abnormal walk Impaired gait 0001288 Nyctalopia Night blindness Night-blindness Poor night vision 0000662 Nystagmus Involuntary, rapid, rhythmic eye movements 0000639 Pes cavus High-arched foot 0001761 Scoliosis Abnormal curving of the spine 0002650 Sensory neuropathy Damage to nerves that sense feeling 0000763 5%-29% of people have these symptoms Abnormality of retinal pigmentation 0007703 Abnormality of visual evoked potentials 0000649 Arrhythmia Abnormal heart rate Heart rhythm disorders Irregular heart beat Irregular heartbeat 0011675 Developmental regression Loss of developmental milestones Mental deterioration in childhood 0002376 Diabetes mellitus 0000819 Dystonia 0001332 Hemiplegia/hemiparesis Paralysis or weakness of one side of body 0004374 Hypertonia 0001276 Hypertrophic cardiomyopathy Enlarged and thickened heart muscle 0001639 Mental deterioration Cognitive decline Cognitive decline, progressive Intellectual deterioration Progressive cognitive decline 0001268 Skeletal muscle atrophy Muscle degeneration Muscle wasting 0003202 Tremor Tremors 0001337 Visual impairment Impaired vision Loss of eyesight Poor vision 0000505 Percent of people who have these symptoms is not available through HPO Ataxia 0001251 Autosomal recessive inheritance 0000007 Hypercholesterolemia Elevated serum cholesterol Elevated total cholesterol Increased total cholesterol 0003124 Hypertriglyceridemia Increased plasma triglycerides Increased serum triglycerides Increased triglycerides 0002155 Increased LDL cholesterol concentration Increased circulating LDL level Increased LDL cholesterol 0003141 Tendon xanthomatosis 0010874 Vitamin E deficiency 0100513 Xanthelasma Fatty deposits in skin around the eyes Fatty deposits on eyelids 0001114 Showing of Diagnosis 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 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] Find a Specialist If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments. If you can't find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care. You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists. Healthcare Resources To find a medical professional who specializes in genetics, you can ask your doctor for a referral or you can search for one yourself. Online directories are provided by the American College of Medical Genetics and the National Society of Genetic Counselors. If you need additional help, contact a GARD Information Specialist. You can also learn more about genetic consultations from Genetics Home Reference. Related Diseases Related diseases are conditions that have similar signs and symptoms. A health care provider may consider these conditions in the table below when making a diagnosis. Please note that the table may not include all the possible conditions related to this disease. Conditions with similar signs and symptoms from Orphanet Differential diagnosis mainly includes Friedreich ataxia, sensory ataxic neuropathy with dysarthria and ophthalmoplegia (SANDO) and abetalipoproteinemia (see these terms). Other autosomal recessive cerebellar ataxias may be considered as well (Refsum disease, ataxia telangiectasia, Charcot-Marie-Tooth disease 1A and ataxia with oculomotor apraxia types 1 and 2 (see these terms)). Visit the Orphanet disease page for more information. ", "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": "Rubella My grandson (4 yrs old) has contracted Rubella. I know for sure he has had at least one of the vaccines. They are living in Mexico right now. Should we be worried?\n\n Rubella Overview Rubella, also called German measles or three-day measles, is a contagious viral infection best known by its distinctive red rash. Rubella is not the same as measles (rubeola), though the two illnesses do share some characteristics, including the red rash. However, rubella is caused by a different virus than measles, and is neither as infectious nor usually as severe as measles. The measles-mumps-rubella (MMR) vaccine, usually given to children in the United States twice before they reach school age, is highly effective in preventing rubella. Because of widespread use of the vaccine, the Centers for Disease Control and Prevention (CDC) has declared rubella eliminated in the United States, but cautions parents to make sure their children are vaccinated to prevent its reemergence. Symptoms The signs and symptoms of rubella are often so mild they're difficult to notice, especially in children. If signs and symptoms do occur, they generally appear between two and three weeks after exposure to the virus. They typically last about two to three days and may include: - Mild fever of 102 F (38.9 C) or lower - Headache - Stuffy or runny nose - Inflamed, red eyes - Enlarged, tender lymph nodes at the base of the skull, the back of the neck and behind the ears - A fine, pink rash that begins on the face and quickly spreads to the trunk and then the arms and legs, before disappearing in the same sequence - Aching joints, especially in young women When to see a doctor Contact your doctor if you think you or your child may have been exposed to rubella or if you have the signs or symptoms listed above. If you're contemplating getting pregnant, check your vaccination record to make sure you've received your MMR inoculations. If a pregnant woman contracts rubella, especially during her first trimester, the virus can cause death or serious birth defects in her developing fetus. Rubella during pregnancy is the most common cause of congenital deafness. It's best for women to be protected against rubella before pregnancy. If you're pregnant, you'll likely undergo a routine screening for immunity to rubella. But if you've never received the vaccine and think you might have been exposed to rubella, contact your doctor immediately. A blood test might confirm that you're already immune. Causes The cause of rubella is a virus that's passed from person to person. It can spread when an infected person coughs or sneezes, or it can spread by direct contact with an infected person's respiratory secretions, such as mucus. It can also be transmitted from a pregnant woman to her unborn child via the bloodstream. A person with rubella is contagious from 10 days before the onset of the rash until about one or two weeks after the rash disappears. An infected person can spread the illness before the person realizes he or she has it. Rubella is rare in the United States because most children receive a vaccination against the infection at an early age. However, cases of rubella do occur, mostly in unvaccinated foreign-born adults. The disease is still common in many parts of the world. The prevalence of rubella in other countries is something to consider before going abroad, especially if you're pregnant. Complications Rubella is a mild infection. Once you've had the disease, you're usually permanently immune. Some women with rubella experience arthritis in the fingers, wrists and knees, which generally lasts for about one month. In rare cases, rubella can cause an ear infection (otitis media) or inflammation of the brain (encephalitis). However, if you're pregnant when you contract rubella, the consequences for your unborn child may be severe. Up to 90 percent of infants born to mothers who had rubella during the first 12 weeks of pregnancy develop congenital rubella syndrome. This syndrome can cause one or more problems, including: - Growth retardation - Cataracts - Deafness - Congenital heart defects - Defects in other organs - Mental retardation The highest risk to the fetus is during the first trimester, but exposure later in pregnancy also is dangerous. Diagnosis The rubella rash can look like many other viral rashes. So doctors usually confirm rubella with the help of laboratory tests. You may have a virus culture or a blood test, which can detect the presence of different types of rubella antibodies in your blood. These antibodies indicate whether you've had a recent or past infection or a rubella vaccine. Treatment No treatment will shorten the course of rubella infection, and symptoms are so mild that treatment usually isn't necessary. However, doctors often recommend isolation from others - especially pregnant women - during the infectious period. If you contract rubella while you're pregnant, discuss the risks to your baby with your doctor. If you wish to continue your pregnancy, you may be given antibodies called hyperimmune globulin that can fight off the infection. This can reduce your symptoms, but doesn't eliminate the possibility of your baby developing congenital rubella syndrome. Support of an infant born with congenital rubella syndrome varies depending on the extent of the infant's problems. Children with multiple complications may require early treatment from a team of specialists. Lifestyle and home remedies In rare instances when a child or adult is infected with rubella, simple self-care measures are required: - Rest in bed as necessary. - Take acetaminophen (Tylenol, others) to relieve discomfort from fever and aches. - Tell friends, family and co-workers - especially pregnant women - about your diagnosis if they may have been exposed to the disease. - Avoid people who have conditions that cause deficient or suppressed immune systems. - Tell your child's school or child care provider that your child has rubella. ", "role": "user" }, { "content": "The measles-mumps-rubella (MMR) vaccine, usually given to children in the United States twice before they reach school age, is highly effective in preventing rubella. Rubella is a mild infection. Once you've had the disease, you're usually permanently immune. In rare cases, rubella can cause an ear infection (otitis media) or inflammation of the brain (encephalitis). No treatment will shorten the course of rubella infection, and symptoms are so mild that treatment usually isn't necessary. However, doctors often recommend isolation from others - especially pregnant women - during the infectious period. In rare instances when a child is infected with rubella, simple self-care measures are required: resting in bed as necessary, take acetaminophen (Tylenol) to relieve discomfort from fever and aches, and telling those who were or might be exposed to the infection that your child has rubella.", "role": "assistant" } ]

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

[ { "content": "how do i prevent myself from having dementia\n\n Dementia Definition 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. Treatment 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. Prognosis 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": "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": "Causes of Peripheral Neuropathy What information does the National Library of Medicine have that states causes of peripheral neuropathy?\n\n Peripheral neuropathy Overview Peripheral neuropathy, a result of damage to your peripheral nerves, often causes weakness, numbness and pain, usually in your hands and feet. It can also affect other areas of your body. Your peripheral nervous system sends information from your brain and spinal cord (central nervous system) to the rest of your body. Peripheral neuropathy can result from traumatic injuries, infections, metabolic problems, inherited causes and exposure to toxins. One of the most common causes is diabetes mellitus. People with peripheral neuropathy generally describe the pain as stabbing, burning or tingling. In many cases, symptoms improve, especially if caused by a treatable condition. Medications can reduce the pain of peripheral neuropathy. Peripheral neuropathy care at Mayo Clinic Symptoms Every nerve in your peripheral system has a specific function, so symptoms depend on the type of nerves affected. Nerves are classified into: - Sensory nerves that receive sensation, such as temperature, pain, vibration or touch, from the skin - Motor nerves that control muscle movement - Autonomic nerves that control functions such as blood pressure, heart rate, digestion and bladder Signs and symptoms of peripheral neuropathy might include: - Gradual onset of numbness, prickling or tingling in your feet or hands, which can spread upward into your legs and arms - Sharp, jabbing, throbbing, freezing or burning pain - Extreme sensitivity to touch - Lack of coordination and falling - Muscle weakness or paralysis if motor nerves are affected If autonomic nerves are affected, signs and symptoms might include: - Heat intolerance and altered sweating - Bowel, bladder or digestive problems - Changes in blood pressure, causing dizziness or lightheadedness Peripheral neuropathy can affect one nerve (mononeuropathy), two or more nerves in different areas (multiple mononeuropathy) or many nerves (polyneuropathy). Carpal tunnel syndrome is an example of mononeuropathy. Most people with peripheral neuropathy have polyneuropathy. Seek medical care right away if you notice unusual tingling, weakness or pain in your hands or feet. Early diagnosis and treatment offer the best chance for controlling your symptoms and preventing further damage to your peripheral nerves. Causes Not a single disease, peripheral neuropathy is nerve damage caused by a number of conditions. Causes of neuropathies include: - Alcoholism. Poor dietary choices made by people with alcoholism can lead to vitamin deficiencies. - Autoimmune diseases. These include Sjogren's syndrome, lupus, rheumatoid arthritis, Guillain-Barre syndrome, chronic inflammatory demyelinating polyneuropathy and necrotizing vasculitis. - Diabetes. More than half the people with diabetes develop some type of neuropathy. - Exposure to poisons. Toxic substances include heavy metals or chemicals. - Medications. Certain medications, especially those used to treat cancer (chemotherapy), can cause peripheral neuropathy. - Infections. These include certain viral or bacterial infections, including Lyme disease, shingles, Epstein-Barr virus, hepatitis C, leprosy, diphtheria and HIV. - Inherited disorders. Disorders such as Charcot-Marie-Tooth disease are hereditary types of neuropathy. - Trauma or pressure on the nerve. Traumas, such as from motor vehicle accidents, falls or sports injuries, can sever or damage peripheral nerves. Nerve pressure can result from having a cast or using crutches or repeating a motion such as typing many times. - Tumors. Growths, cancerous (malignant) and noncancerous (benign), can develop on the nerves or press nerves. Also, polyneuropathy can arise as a result of some cancers related to the body's immune response. These are a form of paraneoplastic syndrome. - Vitamin deficiencies. B vitamins - including B-1, B-6 and B-12 - vitamin E and niacin are crucial to nerve health. - Bone marrow disorders. These include abnormal protein in the blood (monoclonal gammopathies), a form of bone cancer (osteosclerotic myeloma), lymphoma and amyloidosis. - Other diseases. These include kidney disease, liver disease, connective tissue disorders and an underactive thyroid (hypothyroidism). In a number of cases, no cause can be identified (idiopathic). Risk factors Peripheral neuropathy risk factors include: - Diabetes mellitus, especially if your sugar levels are poorly controlled - Alcohol abuse - Vitamin deficiencies, particularly B vitamins - Infections, such as Lyme disease, shingles, Epstein-Barr virus, hepatitis C and HIV - Autoimmune diseases, such as rheumatoid arthritis and lupus, in which your immune system attacks your own tissues - Kidney, liver or thyroid disorders - Exposure to toxins - Repetitive motion, such as those performed for certain jobs - Family history of neuropathy Complications Complications of peripheral neuropathy can include: - Burns and skin trauma. You might not feel temperature changes or pain on parts of your body that are numb. - Infection. Your feet and other areas lacking sensation can become injured without your knowing. Check these areas regularly and treat minor injuries before they become infected, especially if you have diabetes mellitus. - Falls. Weakness and loss of sensation may be associated with lack of balance and falling. Diagnosis Peripheral neuropathy has many potential causes. Besides a physical exam, which may include blood tests, diagnosis usually requires: - A full medical history. Your doctor will review your medical history, including your symptoms, your lifestyle, exposure to toxins, drinking habits and a family history of nervous system (neurological) diseases. - Neurological examination. Your doctor might check your tendon reflexes, your muscle strength and tone, your ability to feel certain sensations, and your posture and coordination. Your doctor may order tests, including: - Blood tests. These can detect vitamin deficiencies, diabetes, abnormal immune function and other indications of conditions that can cause peripheral neuropathy. - Imaging tests. CT or MRI scans can look for herniated disks, tumors or other abnormalities. - Nerve function tests. Electromyography records electrical activity in your muscles to detect nerve damage. A probe sends electrical signals to a nerve, and an electrode placed along the nerve's pathway records the nerve's response to the signals (nerve conduction studies). - Other nerve function tests. These might include an autonomic reflex screen that records how the autonomic nerve fibers work, a sweat test, and sensory tests that record how you feel touch, vibration, cooling and heat. - Nerve biopsy. This involves removing a small portion of a nerve, usually a sensory nerve, to look for abnormalities. - Skin biopsy. Your doctor removes a small portion of skin to look for a reduction in nerve endings. Treatment Treatment goals are to manage the condition causing your neuropathy and to relieve symptoms. If your lab tests indicate no underlying condition, your doctor might recommend watchful waiting to see if your neuropathy improves. Medications Besides medications used to treat conditions associated with peripheral neuropathy, medications used to relieve peripheral neuropathy signs and symptoms include: - Pain relievers. Over-the-counter pain medications, such as nonsteroidal anti-inflammatory drugs, can relieve mild symptoms. For more-severe symptoms, your doctor might prescribe painkillers. Medications containing opioids, such as tramadol (Conzip, Ultram) or oxycodone (Oxycontin, Roxicodone, others), can lead to dependence and addiction, so these drugs generally are prescribed only when other treatments fail. - Anti-seizure medications. Medications such as gabapentin (Gralise, Neurontin) and pregabalin (Lyrica), developed to treat epilepsy, may relieve nerve pain. Side effects can include drowsiness and dizziness. - Topical treatments. Capsaicin cream, which contains a substance found in hot peppers, can cause modest improvements in peripheral neuropathy symptoms. You might have skin burning and irritation where you apply the cream, but this usually lessens over time. Some people, however, can't tolerate it. Lidocaine patches are another treatment you apply to your skin that might offer pain relief. Side effects can include drowsiness, dizziness and numbness at the site of the patch. - Antidepressants. Certain tricyclic antidepressants, such as amitriptyline, doxepin and nortriptyline (Pamelor), have been found to help relieve pain by interfering with chemical processes in your brain and spinal cord that cause you to feel pain. The serotonin and norepinephrine reuptake inhibitor duloxetine (Cymbalta) and the extended-release antidepressant venlafaxine (Effexor XR) also might ease the pain of peripheral neuropathy caused by diabetes. Side effects may include dry mouth, nausea, drowsiness, dizziness, decreased appetite and constipation. Therapies Various therapies and procedures might help ease the signs and symptoms of peripheral neuropathy. - Transcutaneous electrical nerve stimulation (TENS). Electrodes placed on the skin deliver a gentle electric current at varying frequencies. TENS should be applied for 30 minutes daily for about a month. - Plasma exchange and intravenous immune globulin. These procedures, which help suppress immune system activity, might benefit people with certain inflammatory conditions. Plasma exchange involves removing your blood, then removing antibodies and other proteins from the blood and returning the blood to your body. In immune globulin therapy, you receive high levels of proteins that work as antibodies (immunoglobulins). - Physical therapy. If you have muscle weakness, physical therapy can help improve your movements. You may also need hand or foot braces, a cane, a walker, or a wheelchair. - Surgery. If you have neuropathies caused by pressure on nerves, such as pressure from tumors, you might need surgery to reduce the pressure. Lifestyle and home remedies To help you manage peripheral neuropathy: - Take care of your feet, especially if you have diabetes. Check daily for blisters, cuts or calluses. Wear soft, loose cotton socks and padded shoes. You can use a semicircular hoop, which is available in medical supply stores, to keep bedcovers off hot or sensitive feet. - Exercise. Regular exercise, such as walking three times a week, can reduce neuropathy pain, improve muscle strength and help control blood sugar levels. Gentle routines such as yoga and tai chi might also help. - Quit smoking. Cigarette smoking can affect circulation, increasing the risk of foot problems and other neuropathy complications. - Eat healthy meals. Good nutrition is especially important to ensure that you get essential vitamins and minerals. Include fruits, vegetables, whole grains and lean protein in your diet. - Avoid excessive alcohol. Alcohol can worsen peripheral neuropathy. - Monitor your blood glucose levels. If you have diabetes, this will help keep your blood glucose under control and might help improve your neuropathy. Alternative medicine Some people with peripheral neuropathy try complementary treatments for relief. Although researchers haven't studied these techniques as thoroughly as they have most medications, the following therapies have shown some promise: - Acupuncture. Inserting thin needles into various points on your body might reduce peripheral neuropathy symptoms. You might need multiple sessions before you notice improvement. Acupuncture is generally considered safe when performed by a certified practitioner using sterile needles. - Alpha-lipoic acid. This has been used as a treatment for peripheral neuropathy in Europe for years. Discuss using alpha-lipoic acid with your doctor because it can affect blood sugar levels. Other side effects can include stomach upset and skin rash. - Herbs. Certain herbs, such as evening primrose oil, might help reduce neuropathy pain in people with diabetes. Some herbs interact with medications, so discuss herbs you're considering with your doctor. - Amino acids. Amino acids, such as acetyl-L-carnitine, might benefit people who have undergone chemotherapy and people with diabetes. Side effects might include nausea and vomiting. ", "role": "user" }, { "content": "Peripheral neuropathy is nerve damage caused by a number of conditions that include: alcoholism; autoimmune diseases; diabetes; exposure to toxins, such as heavy metals and chemicals; medications, especially those used to treat cancer; certain viral or bacterial infections; tumors; vitamin deficiencies and occasionally, kidney disease, liver disease, connective tissue disorders and an underactive thyroid.", "role": "assistant" } ]

[ { "content": "spina bifida; vertbral fusion;syrinx tethered cord. can u help for treatment of these problem\n\nSpina Bifida (Is there a cure?): There is no cure for spina bifida, but there are treatments for a wide array of related conditions. Visit the section on treatments for more information. « How is it diagnosed? Are there associated conditions? »", "role": "user" }, { "content": "There is no cure for spina bifida, but there are treatments for a wide array of related conditions.", "role": "assistant" } ]

[ { "content": "williams sydrome conditon. i need to send me more information about Williams Syndrome and some tips how to educate people with this disorder.I hope having news from you soon!!thank you\n\nWilliams syndrome (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 disorder (ADD) - 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", "role": "user" }, { "content": "There are many symptoms of Williams syndrome. These include delayed speech, attention deficit disorder, feeding issues including coli, reflux, and vomiting, learning disorders, shortness relative to one's family, sunken chest, flattened nasal bridge, and partially missing teeth.", "role": "assistant" } ]

[ { "content": "would you help me to fine article or jurnal about Cri du chat syndrome\n\nCri du chat syndrome (Summary): Cri du chat syndrome is a group of symptoms that result from missing a piece of chromosome number 5. The syndrome's name is based on the infant's cry, which is high-pitched and sounds like a cat.", "role": "user" }, { "content": "Cri du chat syndrome is a group of symptoms that result from missing a piece of chromosome number 5. The syndrome's name is based on the infant's cry, which is high-pitched and sounds like a cat.", "role": "assistant" } ]

[ { "content": "I have been suffering from lichen planus since last four years. Some time it reduces the red sign and sometime it increases and I cannot take spicy food or hot food. Could you please suggest the remedies. I had consulted the dermatologist also .He gave me some ointment named as clone taxol for applying towards the read area. Awaiting your valuable advise I this behalf. With kind regards. Sent from my iPad\n\nWhat are the treatments for Lichen planus?: The goal of treatment is to reduce symptoms and speed healing. If your symptoms are mild, you may not need treatment. Treatments may include: - Antihistamines - Medicines that calm down the immune system (in severe cases) - Lidocaine mouthwashes to numb the area and make eating more comfortable (for mouth sores) - Topical corticosteroids or oral corticosteroids to reduce swelling and lower immune responses - Corticosteroid shots into a sore - Vitamin A as a cream or taken by mouth - Other medicines that are applied to the skin - Dressings placed over your skin with medicines to keep you from scratching - Ultraviolet light therapy", "role": "user" }, { "content": "Treatments may include: - Antihistamines - Medicines that calm down the immune system (in severe cases) - Lidocaine mouthwashes to numb the area and make eating more comfortable (for mouth sores) - Topical corticosteroids or oral corticosteroids to reduce swelling and lower immune responses - Corticosteroid shots into a sore - Vitamin A as a cream or taken by mouth - Other medicines that are applied to the skin - Dressings placed over your skin with medicines to keep you from scratching - Ultraviolet light therapy", "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\nHiatal hernia: 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. 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 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. Tests that may be used include: - Barium swallow x-ray - Esophagogastroduodenoscopy (EGD) 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. Treatment can relieve most symptoms of hiatal hernia. Complications may include: - Pulmonary (lung) aspiration - Slow bleeding and iron deficiency anemia (due to a large hernia) - Strangulation (closing off) of the hernia 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. Controlling risk factors such as obesity may help prevent hiatal hernia. 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": "Treatments for hiatal hernia include medications, avoiding large or heavy meals, avoiding bending over after a meal, achieving healthy weight, quitting smoking. and raising the head of the bed. If medicines and lifestyle measures do not help control symptoms, you may need surgery.", "role": "assistant" } ]

[ { "content": "how common is cystic fibrosis\n\nCystic fibrosis: Cystic fibrosis is a disease that causes thick, sticky mucus to build up in the lungs, digestive tract, and other areas of the body. It is one of the most common chronic lung diseases in children and young adults. It is a life-threatening disorder. Cystic fibrosis (CF) is a disease that is passed down through families. It is caused by a defective gene that makes the body produce abnormally thick and sticky fluid, called mucus. This mucus builds up in the breathing passages of the lungs and in the pancreas. The buildup of mucus results in life-threatening lung infections and serious digestion problems. The disease may also affect the sweat glands and a man's reproductive system. Many people carry a CF gene, but do not have symptoms. This is because a person with CF must inherit 2 defective genes, 1 from each parent. Some white Americans have the CF gene. It is more common among those of northern or central European descent. Most children with CF are diagnosed by age 2. For a small number, the disease is not detected until age 18 or older. These children often have a milder form of the disease. Symptoms in newborns may include: - Delayed growth - Failure to gain weight normally during childhood - No bowel movements in first 24 to 48 hours of life - Salty-tasting skin Symptoms related to bowel function may include: - Belly pain from severe constipation - Increased gas, bloating, or a belly that appears swollen (distended) - Nausea and loss of appetite - Stools that are pale or clay-colored, foul smelling, have mucus, or that float - Weight loss Symptoms related to the lungs and sinuses may include: - Coughing or increased mucus in the sinuses or lungs - Fatigue - Nasal congestion caused by nasal polyps - Repeated episodes of pneumonia (symptoms of pneumonia in someone with cystic fibrosis include fever, increased coughing and shortness of breath, increased mucus, and loss of appetite) - Sinus pain or pressure caused by infection or polyps Symptoms that may be noticed later in life: - Infertility (in men) - Repeated inflammation of the pancreas (pancreatitis) - Respiratory symptoms - Clubbed fingers A blood test is done to help detect CF. The test looks for changes in the CF gene. Other tests used to diagnose CF include: - Immunoreactive trypsinogen (IRT) test is a standard newborn screening test for CF. A high level of IRT suggests possible CF and requires further testing. - Sweat chloride test is the standard diagnostic test for CF. A high salt level in the person's sweat is a sign of the disease. Other tests that identify problems that can be related to CF include: - Chest x-ray or CT scan - Fecal fat test - Lung function tests - Measurement of pancreatic function - Secretin stimulation test - Trypsin and chymotrypsin in stool - Upper GI and small bowel series An early diagnosis of CF and treatment plan can improve both survival and quality of life. Follow-up and monitoring are very important. When possible, care should be received at a cystic fibrosis specialty clinic. When children reach adulthood, they should transfer to a cystic fibrosis specialty center for adults. Treatment for lung problems includes: - Antibiotics to prevent and treat lung and sinus infections. They may be taken by mouth, or given in the veins or by breathing treatments. People with CF may take antibiotics only when needed, or all the time. Doses are often higher than normal. - Inhaled medicines to help open the airways. - Other medicines that are given by a breathing treatment to thin mucus and make it easier to cough up are DNAse enzyme. therapy and highly concentrated salt solutions (hypertonic saline). - Flu vaccine and pneumococcal polysaccharide vaccine (PPV) yearly (ask your health care provider). - Lung transplant is an option in some cases. - Oxygen therapy may be needed as lung disease gets worse. Lung problems are also treated with therapies to thin the mucus. This makes it easier to cough the mucus out of the lungs. These methods include: - Activity or exercise that causes you to breathe deeply - Devices that are used during the day to help clear the airways of too much mucus - Manual chest percussion (or chest physiotherapy), in which a family member or a therapist lightly claps the person's chest, back, and area under the arms Treatment for bowel and nutritional problems may include: - A special diet high in protein and calories for older children and adults - Pancreatic enzymes to help absorb fats and protein, which are taken with every meal - Vitamin supplements, especially vitamins A, D, E, and K - Your provider can advise other treatments if you have very hard stools Ivacaftor is a medicine that treats certain types of CF. It improves the function of one of the defective genes that causes CF. As a result, there is less buildup of thick mucus in the lungs. Other CF symptoms are improved as well. Care and monitoring at home should include: - Avoiding smoke, dust, dirt, fumes, household chemicals, fireplace smoke, and mold or mildew. - Giving plenty of fluids, especially to infants and children in hot weather, when there is diarrhea or loose stools, or during extra physical activity. - Exercising 2 or 3 times each week. Swimming, jogging, and cycling are good options. - Clearing or bringing up mucus or secretions from the airways. This must be done 1 to 4 times each day. Patients, families, and caregivers must learn about doing chest percussion and postural drainage to help keep the airways clear. You can ease the stress of illness by joining a cystic fibrosis support group. Sharing with others who have common experiences and problems can help your family to not feel alone. Most children with CF stay in good health until they reach adulthood. They are able to take part in most activities and attend school. Many young adults with CF finish college or find jobs. Lung disease eventually worsens to the point where the person is disabled. Today, the average life span for people with CF who live to adulthood is about 37 years. Death is most often caused by lung complications. The most common complication is chronic respiratory infection. Other complications include: - Bowel problems, such as gallstones, intestinal blockage, and rectal prolapse - Coughing up blood - Chronic respiratory failure - Diabetes - Infertility - Liver disease or liver failure, pancreatitis, biliary cirrhosis - Malnutrition - Nasal polyps and sinusitis - Osteoporosis and arthritis - Pneumonia that keeps coming back - Pneumothorax - Right-sided heart failure (cor pulmonale) Call your provider if an infant or child has symptoms of CF, and experiences: - Fever, increased coughing, changes in sputum or blood in sputum, loss of appetite, or other signs of pneumonia - Increased weight loss - More frequent bowel movements or stools that are foul-smelling or have more mucus - Swollen belly or increased bloating Call your provider if a person with CF develops new symptoms or if symptoms get worse, particularly severe breathing difficulty or coughing up blood. CF cannot be prevented. Screening those with a family history of the disease may detect the CF gene in many carriers. Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.", "role": "user" }, { "content": "Cystic Fibrosis is a disease that causes the build up of mucus, mainly in the lungs and digestive tract. It is one of the most common chronic lung diseases in children and young adults.", "role": "assistant" } ]

[ { "content": "how is asthma diagnosed\n\nAsthma (Exams and Tests): The health care provider will use a stethoscope to listen to your lungs. Wheezing or other asthma-related sounds may be heard. Tests that may be ordered include: - Allergy testing -- skin or a blood test to see if a person with asthma is allergic to certain substances - Arterial blood gas (usually only done with people who are having a severe asthma attack) - Chest x-ray - Lung function tests, including peak flow measurements", "role": "user" }, { "content": "Asthma (Exams and Tests): The health care provider will use a stethoscope to listen to your lungs. Wheezing or other asthma-related sounds may be heard. Tests that may be ordered include: - Allergy testing -- skin or a blood test to see if a person with asthma is allergic to certain substances - Arterial blood gas (usually only done with people who are having a severe asthma attack) - Chest x-ray - Lung function tests, including peak flow measurements", "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 (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.", "role": "user" }, { "content": "Anal fissures can cause: pain during and after bowel movements; bright red blood om stools or toilet paper; itching, irritation, visible cracks in the skin, and lumps or tags around the anus.", "role": "assistant" } ]

[ { "content": "how is asthma diagnosed\n\nAsthma - 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. If the airways are narrow due to asthma, peak flow values drop. You and your child will learn to measure peak flow at home. Tests may include: - 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": "user" }, { "content": "To diagnose asthma in children, the health care provider will use a stethoscope to listen to the child's lungs. This may allow them to hear asthma sounds. The provider will also have the child breathe into a peak flow meter, which well measure the amount of air a child can breathe out. Allergy tests may be run to further diagnose any causes of your child's asthma.", "role": "assistant" } ]

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

[ { "content": "more information in relation to Ellis van creveld syndrome Specifically in later life can they have children has it ever been reported any researchcarried out and just as much information as possible to help my understanding of what I have Many thanks\n\nEVC gene: The EVC gene provides instructions for making a protein whose function is unclear. However, it appears to be important for normal growth and development, particularly the development of bones and teeth. The EVC protein is found in primary cilia, which are microscopic, finger-like projections that stick out from the surface of cells and are involved in signaling pathways that transmit information between cells. In particular, the EVC protein is thought to help regulate a signaling pathway known as Sonic Hedgehog, which plays roles in cell growth, cell specialization, and the normal shaping (patterning) of many parts of the body. EVC and another gene, EVC2, are located very close together on chromosome 4. Researchers believe that the two genes may have related functions and that their activity may be coordinated. More than 25 mutations in the EVC gene have been reported to cause Ellis-van Creveld syndrome, an inherited disorder characterized by dwarfism, abnormal nails and teeth, and heart defects. The mutations that cause this condition occur in both copies of the EVC gene in each cell. These genetic changes disrupt the normal function of the EVC protein or lead to the production of an abnormally small, nonfunctional version of the protein. Although it is unclear how the loss of this protein's function underlies the signs and symptoms of Ellis-van Creveld syndrome, researchers believe that it may prevent normal Sonic Hedgehog signaling in the developing embryo. Problems with this signaling pathway may ultimately lead to the abnormal bone growth and heart defects seen with this condition. More than 25 mutations in the EVC gene have been reported to cause Ellis-van Creveld syndrome, an inherited disorder characterized by dwarfism, abnormal nails and teeth, and heart defects. The mutations that cause this condition occur in both copies of the EVC gene in each cell. These genetic changes disrupt the normal function of the EVC protein or lead to the production of an abnormally small, nonfunctional version of the protein. Although it is unclear how the loss of this protein's function underlies the signs and symptoms of Ellis-van Creveld syndrome, researchers believe that it may prevent normal Sonic Hedgehog signaling in the developing embryo. Problems with this signaling pathway may ultimately lead to the abnormal bone growth and heart defects seen with this condition. At least one mutation in the EVC gene has been found to cause the characteristic features of Weyers acrofacial dysostosis, affecting the development of the teeth, nails, and bones. The signs and symptoms of Weyers acrofacial dysostosis are similar to, but typically milder than, those of Ellis-van Creveld syndrome. The EVC gene mutation that causes Weyers acrofacial dysostosis occurs in one copy of the gene in each cell. It changes a single protein building block (amino acid) in the EVC protein, replacing the amino acid serine with the amino acid proline at position 307 (written as Ser307Pro). It is unclear how this genetic change leads to the specific features of Weyers acrofacial dysostosis. Studies suggest that the abnormal protein interferes with Sonic Hedgehog signaling in the developing embryo, disrupting the normal formation and growth of the teeth, nails, and bones. Blair HJ, Tompson S, Liu YN, Campbell J, MacArthur K, Ponting CP, Ruiz-Perez VL, Goodship JA. Evc2 is a positive modulator of Hedgehog signalling that interacts with Evc at the cilia membrane and is also found in the nucleus. BMC Biol. 2011 Feb 28;9:14. doi: 10.1186/1741-7007-9-14.", "role": "user" }, { "content": "More than 25 mutations in the EVC gene have been reported to cause Ellis-van Creveld syndrome, an inherited disorder characterized by dwarfism, abnormal nails and teeth, and heart defects.", "role": "assistant" } ]

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

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

[ { "content": "What is Nephrotic Syndrome. What are its causes and cures?\n\nWhat causes Nephrotic syndrome?: Nephrotic syndrome is caused by different disorders that damage the kidneys. This damage leads to the release of too much protein in the urine. The most common cause in children is minimal change disease. Membranous glomerulonephritis is the most common cause in adults.In both diseases, the glomeruli in the kidneys are damaged. Glomeruli are the structures that help filter wastes and fluids. This condition can also occur from: - Cancer - Diseases such as diabetes, systemic lupus erythematosus, multiple myeloma, and amyloidosis - Genetic disorders - Immune disorders - Infections (such as strep throat, hepatitis, or mononucleosis) - Use of certain drugs It can occur with kidney disorders such as: - Focal and segmental glomerulosclerosis - Glomerulonephritis - Mesangiocapillary glomerulonephritis Nephrotic syndrome can affect all age groups. In children, it is most common between ages 2 and 6. This disorder occurs slightly more often in males than females.", "role": "user" }, { "content": "Nephrotic syndrome is caused by different disorders that damage the kidneys., in adults, most commonly by glomerulonephritis. This damage leads to the release of too much protein in the urine. Other conditions that damage kidneys include cancer, diabetes, systemic lupus erythematosus, multiple myeloma, amyloidosis, immune disorders, and infections. Nephrotic syndrome can affect all age groups. In children, it is most common between ages 2 and 6. This disorder occurs slightly more often in males than females.", "role": "assistant" } ]

[ { "content": "Research assignment Hi, I am a grade 12 student who is doing a research assignment on neurological disorders. Do you believe that there will ever be a bonafide cure for Multiple Sclerosis? If so, what kind of time frame would put on this cure?\n\n Multiple sclerosis Overview Multiple sclerosis (MS) is a potentially disabling disease of the brain and spinal cord (central nervous system). In MS, the immune system attacks the protective sheath (myelin) that covers nerve fibers and causes communication problems between your brain and the rest of your body. Eventually, the disease can cause the nerves themselves to deteriorate or become permanently damaged. Signs and symptoms of MS vary widely and depend on the amount of nerve damage and which nerves are affected. Some people with severe MS may lose the ability to walk independently or at all, while others may experience long periods of remission without any new symptoms. There's no cure for multiple sclerosis. However, treatments can help speed recovery from attacks, modify the course of the disease and manage symptoms. Find out why Mayo Clinic is the best place for your care. Symptoms Multiple sclerosis signs and symptoms may differ greatly from person to person and over the course of the disease depending on the location of affected nerve fibers. They may include: - Numbness or weakness in one or more limbs that typically occurs on one side of your body at a time, or the legs and trunk - Partial or complete loss of vision, usually in one eye at a time, often with pain during eye movement - Prolonged double vision - Tingling or pain in parts of your body - Electric-shock sensations that occur with certain neck movements, especially bending the neck forward (Lhermitte sign) - Tremor, lack of coordination or unsteady gait - Slurred speech - Fatigue - Dizziness - Problems with bowel and bladder function When to see a doctor See a doctor if you experience any of the above symptoms for unknown reasons. Disease course Most people with MS have a relapsing-remitting disease course. They experience periods of new symptoms or relapses that develop over days or weeks and usually improve partially or completely. These relapses are followed by quiet periods of disease remission that can last months or even years. Small increases in body temperature can temporarily worsen signs and symptoms of MS, but these aren't considered disease relapses. About 60 to 70 percent of people with relapsing-remitting MS eventually develop a steady progression of symptoms, with or without periods of remission, known as secondary-progressive MS. The worsening of symptoms usually includes problems with mobility and gait. The rate of disease progression varies greatly among people with secondary-progressive MS. Some people with MS experience a gradual onset and steady progression of signs and symptoms without any relapses. This is known as primary-progressive MS. Causes The cause of multiple sclerosis is unknown. It's considered an autoimmune disease in which the body's immune system attacks its own tissues. In the case of MS, this immune system malfunction destroys myelin (the fatty substance that coats and protects nerve fibers in the brain and spinal cord). Myelin can be compared to the insulation coating on electrical wires. When the protective myelin is damaged and nerve fiber is exposed, the messages that travel along that nerve may be slowed or blocked. The nerve may also become damaged itself. It isn't clear why MS develops in some people and not others. A combination of genetics and environmental factors appears to be responsible. Risk factors These factors may increase your risk of developing multiple sclerosis: - Age. MS can occur at any age, but most commonly affects people between the ages of 15 and 60. - Sex. Women are about twice as likely as men are to develop MS. - Family history. If one of your parents or siblings has had MS, you are at higher risk of developing the disease. - Certain infections. A variety of viruses have been linked to MS, including Epstein-Barr, the virus that causes infectious mononucleosis. - Race. White people, particularly those of Northern European descent, are at highest risk of developing MS. People of Asian, African or Native American descent have the lowest risk. - Climate. MS is far more common in countries with temperate climates, including Canada, the northern United States, New Zealand, southeastern Australia and Europe. - Certain autoimmune diseases. You have a slightly higher risk of developing MS if you have thyroid disease, type 1 diabetes or inflammatory bowel disease. - Smoking. Smokers who experience an initial event of symptoms that may signal MS are more likely than nonsmokers to develop a second event that confirms relapsing-remitting MS. Diagnosis There are no specific tests for MS. Instead, a diagnosis of multiple sclerosis often relies on ruling out other conditions that might produce similar signs and symptoms, known as a differential diagnosis. Your doctor is likely to start with a thorough medical history and examination. Your doctor may then recommend: - Blood tests, to help rule out other diseases with symptoms similar to MS. Tests to check for specific biomarkers associated with MS are currently under development and may also aid in diagnosing the disease. - Lumbar puncture (spinal tap), in which a small sample of fluid is removed from your spinal canal for laboratory analysis. This sample can show abnormalities in antibodies that are associated with MS. Spinal tap can also help rule out infections and other conditions with symptoms similar to MS. - MRI, which can reveal areas of MS (lesions) on your brain and spinal cord. You may receive an intravenous injection of a contrast material to highlight lesions that indicate your disease is in an active phase. - Evoked potential tests, which record the electrical signals produced by your nervous system in response to stimuli. An evoked potential test may use visual stimuli or electrical stimuli, in which you watch a moving visual pattern, or short electrical impulses are applied to nerves in your legs or arms. Electrodes measure how quickly the information travels down your nerve pathways. In most people with relapsing-remitting MS, the diagnosis is fairly straightforward and based on a pattern of symptoms consistent with the disease and confirmed by brain imaging scans, such as MRI. Diagnosing MS can be more difficult in persons with unusual symptoms or progressive disease. In these cases, further testing with spinal fluid analysis, evoked potentials and additional imaging may be needed. Treatment There is no cure for multiple sclerosis. Treatment typically focuses on speeding recovery from attacks, slowing the progression of the disease and managing MS symptoms. Some people have such mild symptoms that no treatment is necessary. Treatments for MS attacks - Corticosteroids, such as oral prednisone and intravenous methylprednisolone, are prescribed to reduce nerve inflammation. Side effects may include insomnia, increased blood pressure, mood swings and fluid retention. - Plasma exchange (plasmapheresis). The liquid portion of part of your blood (plasma) is removed and separated from your blood cells. The blood cells are then mixed with a protein solution (albumin) and put back into your body. Plasma exchange may be used if your symptoms are new, severe and haven't responded to steroids. Treatments to modify progression For primary-progressive MS, ocrelizumab (Ocrevus) is the only FDA-approved disease-modifying therapy. It slows worsening of disability in people with this type of MS. For relapsing-remitting MS, several disease-modifying therapies are available. Much of the immune response associated with MS occurs in the early stages of the disease. Aggressive treatment with these medications as early as possible can lower the relapse rate and slow the formation of new lesions. Many of the disease-modifying therapies used to treat MS carry significant health risks. Selecting the right therapy for you will depend on careful consideration of many factors, including duration and severity of disease, effectiveness of previous MS treatments, other health issues, cost, and child-bearing status. Treatment options for relapsing-remitting MS include: - Beta interferons. These medications are among the most commonly prescribed medications to treat MS. They are injected under the skin or into muscle and can reduce the frequency and severity of relapses. Side effects of beta interferons may include flu-like symptoms and injection-site reactions. You'll need blood tests to monitor your liver enzymes because liver damage is a possible side effect of interferon use. People taking interferons may develop neutralizing antibodies that can reduce drug effectiveness. - Ocrelizumab (Ocrevus). This humanized immunoglobulin antibody medication is the only DMT approved by the FDA to treat both the relapse-remitting and primary progressive forms of MS. Clinical trials showed it reduced relapse rate in relapsing disease and slowed worsening of disability in both forms of the disease. Ocrevus is given via an intravenous infusion by a medical professional. Side effects may infusion-related reactions including irritation at the injection site, low blood pressure, fever, and nausea among others. Ocrevus may also increase the risk of some types of cancer, particularly breast cancer. - Glatiramer acetate (Copaxone). This medication may help block your immune system's attack on myelin and must be injected beneath the skin. Side effects may include skin irritation at the injection site. - Dimethyl fumarate (Tecfidera). This twice-daily oral medication can reduce relapses. Side effects may include flushing, diarrhea, nausea and lowered white blood cell count. - Fingolimod (Gilenya). This once-daily oral medication reduces relapse rate. You'll need to have your heart rate monitored for six hours after the first dose because your heartbeat may be slowed. Other side effects include headache, high blood pressure and blurred vision. - Teriflunomide (Aubagio). This once-daily medication can reduce relapse rate. Teriflunomide can cause liver damage, hair loss and other side effects. It is harmful to a developing fetus and should not be used by women who may become pregnant and are not using appropriate contraception, or their male partner. - Natalizumab (Tysabri). This medication is designed to block the movement of potentially damaging immune cells from your bloodstream to your brain and spinal cord. It may be considered a first line treatment for some people with severe MS or as a second line treatment in others. This medication increases the risk of a viral infection of the brain called progressive multifocal leukoencephalopathy in some people. - Alemtuzumab (Lemtrada). This drug helps reduce relapses of MS by targeting a protein on the surface of immune cells and depleting white blood cells. This effect can limit potential nerve damage caused by the white blood cells, but it also increases the risk of infections and autoimmune disorders. Treatment with alemtuzumab involves five consecutive days of drug infusions followed by another three days of infusions a year later. Infusion reactions are common with alemtuzumab. The drug is only available from registered providers, and people treated with the drug must be registered in a special drug safety monitoring program. - Mitoxantrone. This immunosuppressant drug can be harmful to the heart and is associated with development of blood cancers. As a result, its use in treating MS is extremely limited. Mitoxantrone is usually used only to treat severe, advanced MS. Treatments for MS signs and symptoms - Physical therapy. A physical or occupational therapist can teach you stretching and strengthening exercises and show you how to use devices to make it easier to perform daily tasks. Physical therapy along with the use of a mobility aid when necessary can also help manage leg weakness and other gait problems often associated with MS. - Muscle relaxants. You may experience painful or uncontrollable muscle stiffness or spasms, particularly in your legs. Muscle relaxants such as baclofen (Lioresal) and tizanidine (Zanaflex) may help. - Medications to reduce fatigue. - Other medications. Medications also may be prescribed for depression, pain, sexual dysfunction, and bladder or bowel control problems that are associated with MS. Lifestyle and home remedies To help relieve the signs and symptoms of MS, try to: - Get plenty of rest. - Exercise. If you have mild to moderate MS, regular exercise can help improve your strength, muscle tone, balance and coordination. Swimming or other water exercises are good options if you're bothered by heat. Other types of mild to moderate exercise recommended for people with MS include walking, stretching, low-impact aerobics, stationary bicycling, yoga and tai chi. - Cool down. MS symptoms often worsen when your body temperature rises. Avoiding exposure to heat and using devices such as cooling scarves or vests can be helpful. - Eat a balanced diet. Results of small studies suggest that a diet low in saturated fat but high in omega-3 fatty acids, such as those found in olive and fish oils, may be beneficial. But further research is needed. Studies also suggest that vitamin D may have potential benefit for people with MS. - Relieve stress. Stress may trigger or worsen your signs and symptoms. Yoga, tai chi, massage, meditation or deep breathing may help. Alternative medicine Many people with MS use a variety of alternative or complementary treatments or both to help manage their symptoms, such as fatigue and muscle pain. Activities such as exercise, meditation, yoga, massage, eating a healthier diet, acupuncture and relaxation techniques may help boost overall mental and physical well-being, but there are few studies to back up their use in managing symptoms of MS. Guidelines from the American Academy of Neurology recommend the use of oral cannabis extract for muscle spasticity and pain, but do not recommend cannabis in any other form for other MS symptoms due to a lack of evidence. The guidelines also do not recommend the use of herbal supplements such as Ginkgo biloba and bee venom or magnetic therapy for MS symptoms. ", "role": "user" }, { "content": "There is no cure for multiple sclerosis. Treatment typically focuses on speeding recovery from attacks, slowing the progression of the disease and managing MS symptoms. For primary-progressive MS, ocrelizumab (Ocrevus) is the only FDA-approved disease-modifying therapy. It slows worsening of disability in people with this type of MS. For relapsing-remitting MS, several disease-modifying therapies are available.", "role": "assistant" } ]

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

[ { "content": "how do i stop using rasagiline\n\n Rasagiline Why is this medication prescribed? Rasagiline is used alone or in combination with another medication to treat the symptoms of Parkinson's disease (a slowly progressing disease of the nervous system causing a fixed face without expression, tremor at rest, slowing of movements, walking with shuffling steps, stooped posture and muscle weakness). Rasagiline is in a class of medications called monoamine oxidase (MAO) type B inhibitors. It works by increasing the amounts of certain natural substances in the brain. How should this medicine be used? Rasagiline comes as a tablet to take by mouth. It is usually taken once a day with or without food. Take rasagiline at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take rasagiline exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Your doctor may start you on a low dose of rasagiline and may increase your dose based upon your body's response to this medication. Do not stop taking rasagiline without talking to your doctor. Your doctor will probably decrease your dose gradually. If you suddenly stop taking rasagiline, you may experience withdrawal symptoms such as a fever; muscle stiffness; unsteadiness, wobbliness, or lack of coordination; or changes in consciousness. Tell your doctor if you experience any of these symptoms when your dose of rasagiline is decreased. Other uses for this medicine This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. What special precautions should I follow? <h3>Before taking rasagiline,</h3> /h3> tell your doctor and pharmacist if you are allergic to rasagiline, any other medications, or any of the ingredients in rasagiline tablets. Ask your pharmacist for a list of the ingredients. tell your doctor if you are taking cough and cold products containing dextromethorphan (DM; Delsym, Hold, Robitussin CoughGels, Vicks 44 Cough Relief, in Robitussin DM, others), cyclobenzaprine (Flexeril), meperidine (Demerol), methadone (Dolophine, Methadose), propoxyphene (Darvon, in Darvocet-N, others), St. John's wort, or tramadol (Ultram, in Ultracet). Also tell your doctor if you are taking MAO inhibitors such as phenelzine (Nardil), selegiline (Eldepryl), or tranylcypromine (Parnate) or have stopped taking them within the past two weeks. Your doctor may tell you not to take rasagiline if you are taking one or more of these medications. 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: amphetamines (Adderall, Dexedrine, DextroStat); antidepressants; cimetidine (Tagamet); decongestants placed in the eye or nose; diet or weight-control products containing ephedrine; fluoroquinolone antibiotics including ciprofloxacin (Cipro), gatifloxacin (Tequin), levofloxacin (Levaquin), norfloxacin (Noroxin), and ofloxacin (Floxin); fluvoxamine (Luvox); medications to treat asthma; medications to treat high blood pressure; medications to treat mental illness; medications to treat pain; phenylpropanolamine (not available in the U.S.); pseudoephedrine (PediaCare, Sudafed, Suphedrine, others); and ticlopidine (Ticlid). Tell your doctor if you are taking fluoxetine (Prozac, Sarafem) or have stopped taking it within the past 5 weeks. 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 high blood pressure, mental illness or psychosis;kidney, or liver disease. tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking rasagiline, call your doctor. you should know that rasagiline may cause dizziness, lightheadedness, nausea, sweating, and fainting when you get up too quickly from a lying position. This is more common during the first 2 months of taking rasagiline. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up. you should know that rasagiline may cause serious, life-threatening high blood pressure when taken with certain medications or foods. Carefully follow your doctor's instructions about medications and foods to be avoided. Call your doctor right away if you have a severe headache, blurred vision, or any of the other symptoms listed below as serious side effects. you should know that people who have Parkinson's disease have a higher risk of melanoma (a type of skin cancer) than people who do not have Parkinson's disease. It is not known whether this increased risk is caused by Parkinson's disease, medications used for Parkinson's disease such as rasagiline, or other factors. You should have regular visits with a dermatologist to examine your skin for melanoma. you should know that some people who took rasagiline or similar medications to treat Parkinson's disease experienced intense urges to gamble, increased sexual urges, and other urges that they were unable to control. Tell your doctor if you experience new or increased gambling urges, increased sexual urges, or other intense urges while taking rasagiline. What special dietary instructions should I follow? You will need to avoid eating foods that contain very high amounts of tyramine, such as aged cheeses (e.g., Stilton or blue cheese) during your treatment with rasagiline. Talk to your doctor or dietitian about which foods you should avoid during your treatment or if you do not feel well after eating or drinking certain foods while taking rasagiline. What should I do if I forget a dose? Do not take a double dose to make up for a missed one. Skip the missed dose and take your next dose at the usual time the next day. What side effects can this medication cause? <h3>Rasagiline may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: </h3> /h3> mild headache joint or neck pain heartburn nausea vomiting stomach pain constipation diarrhea loss of appetite weight loss flu-like symptoms fever sweating red, swollen, and/or itchy eyes dry mouth swollen gums unsteadiness, wobbliness, or lack of coordination involuntary, repeated body movements lack of energy sleepiness abnormal dreams depression pain, burning, numbness, or tingling in the hands or feet rash bruising or purple discoloration on skin <h3>Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately: </h3> /h3> severe headache blurred vision seizures chest pain shortness of breath or difficulty breathing confusion unconsciousness slow or difficult speech dizziness or faintness weakness or numbness of an arm or leg hallucinating (seeing things or hearing voices that do not exist) extreme restlessness difficulty thinking clearly or understanding reality Rasagiline may cause other side effects. Call your doctor if you have any unusual problems while taking this medication. What should I know about storage and disposal of this medication? Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program. It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location - one that is up and away and out of their sight and reach. http://www.upandaway.org 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. <h3>Symptoms of rasagiline overdose may occur as late as 1 to 2 days after the overdose. Symptoms of overdose may include the following: </h3> /h3> drowsiness dizziness faintness irritability hyperactivity agitation or restlessness severe headache hallucinating confusion loss of coordination difficulty opening the mouth rigid body spasm that may include an arched back twitching muscles seizures loss of consciousness fast or irregular heart beat pain in the area between the stomach and chest difficulty breathing or slowed breathing diarrhea fever sweating cool, clammy skin shivering increase in pupil size (black circle in middle of eye) What other information should I know? Keep all appointments with your doctor. Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. Brand names Azilect ", "role": "user" }, { "content": "If you want to stop taking rasagiline, first talk to your doctor. Your doctor will be able to decrease your dose safely and gradually. This is important because if you stop taking rasagiline, you may experience withdrawal symptoms such as fever, muscle stiffness, lack of coordination, or changes in consciousness. Talk to your doctor if you experience any of these symptoms when your dose of rasagiline is decreased.", "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 (Overview): Asthma is a condition in which your airways narrow and swell and produce extra mucus. This can make breathing difficult and trigger coughing, wheezing and shortness of breath. For some people, asthma is a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack. Asthma can't be cured, but its symptoms can be controlled. Because asthma often changes over time, it's important that you work with your doctor to track your signs and symptoms and adjust treatment as needed.", "role": "user" }, { "content": "Asthma can't be cured, but its symptoms can be controlled. Because asthma often changes over time, it's important that you work with your doctor to track your signs and symptoms and adjust treatment as needed.", "role": "assistant" } ]

[ { "content": "Absence seizures Does any damage occurre from these spells. Mental or physical\n\n Epilepsy juvenile absence JAE Childhood absence epilepsy Juvenile absence epilepsy Summary The following summary is from Orphanet, a European reference portal for information on rare diseases and orphan drugs. Orpha Number: 1941 Disease definition Juvenile absence epilepsy (JAE) is a genetic epilepsy with onset occurring around puberty. JAE is characterized by sporadic occurrence of absence seizures , frequently associated with a long-life prevalence of generalized tonic-clonic seizures (GTCS) and sporadic myoclonic jerks. Epidemiology The incidence of JAE is still unknown but it accounts for approximately 2-3% of patients with adult epilepsy in general, and about 8-10% of patients with genetic generalized epilepsy (GGE). No sex predominance has been observed. Clinical description JAE is characterized by sporadic occurrence of absence seizures (only one or a few absences daily; 100% of cases), frequently associated with a long-life prevalence of generalized tonic-clonic seizures (GTCS; 80%) and sporadic myoclonic jerks (20%). The seizures onset is typically between 9 and 13 years of age and it manifests as a ''staring spell'' that can be accompanied by atonic postures such as drooping of the head and/or automatisms such as lip smacking. GTCS and myoclonic seizures often occur 1-10 years after the absence seizure onset. Patients with JAE usually develop normally, although uncontrolled absence seizures may have an impact on their ability to learn at school. Etiology The exact etiology of JAE is still elusive. However, genetic mutations for voltage-gated sodium channels ( CACNB4 gene (2q22-q23)), potassium channels ( CLCN2 gene (3q27.1)), and EFHC1 (6p12.3) may be involved in a subset of patients. Moreover, different mutations have been found in genes for GABA receptors (ligand ion channels), specifically in the GABRA1 gene (5q34). Diagnostic methods Diagnosis relies on the clinical features and on electroencephalogram (EEG) recorded awake and during sleep, that displays a generalized 3-4 Hz spike-and-slow-wave complexes. Differential diagnosis Differential diagnosis includes childhood absence epilepsy, juvenile myoclonic epilepsy, Jeavons syndrome (see these terms). Genetic counseling The transmission is still unknown although an increased risk for first degree related parents to develop JME may exist. Management and treatment The antiepileptic drugs of choice are valproic acid (VPA) and lamotrigine (LTG). In cases where VPA deals with only partial seizure control, add-on of LTG (GTCS) or ethosuximide (absence seizures) can be beneficial. Prognosis Prognosis of JAE is usually favorable with good therapy responsiveness. Generally, seizure freedom can be achieved with antiepileptic medication in 62-84% of all patients with JAE. However, the occurrence of GTCS predicts a worse prognosis. Visit the Orphanet disease page for more resources. Symptoms This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom. Showing of Medical Terms Other Names Learn More: HPO ID 80%-99% of people have these symptoms EEG with polyspike wave complexes 0002392 Generalized tonic-clonic seizures Grand mal seizures 0002069 30%-79% of people have these symptoms Abnormality of eye movement Abnormal eye movement Abnormal eye movements Eye movement abnormalities Eye movement issue 0000496 Abnormality of the mouth Abnormal mouth 0000153 5%-29% of people have these symptoms Absence seizures Brief seizures with staring spells 0002121 Febrile seizures Fever induced seizures 0002373 1%-4% of people have these symptoms Myoclonus 0001336 Percent of people who have these symptoms is not available through HPO Autosomal dominant inheritance 0000006 EEG with spike-wave complexes (>3.5 Hz) 0010849 Generalized myoclonic seizures 0002123 Generalized tonic-clonic seizures on awakening Morning generalized tonic-clonic seizures 0007193 Showing of Diagnosis Making a diagnosis for a genetic or rare disease can often be challenging. Healthcare professionals typically look at a person's medical history, symptoms, physical exam, and laboratory test results in order to make a diagnosis. The following resources provide information relating to diagnosis and testing for this condition. If you have questions about getting a diagnosis, you should contact a healthcare professional. Testing Resources The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional. Find a Specialist If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments. If you can't find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care. You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists. Healthcare Resources To find a medical professional who specializes in genetics, you can ask your doctor for a referral or you can search for one yourself. Online directories are provided by the American College of Medical Genetics and the National Society of Genetic Counselors. If you need additional help, contact a GARD Information Specialist. You can also learn more about genetic consultations from Genetics Home Reference. ", "role": "user" }, { "content": "Patients with absence seizures usually develop normally. Uncontrolled absence seizures may have an impact on their ability to learn at school. Treatment with antiepileptic medication renders 62-84% of all patients seizure-free.", "role": "assistant" } ]

[ { "content": "Is it necessary to go to the dr. when getting a skull fracture?\n\n Skull fracture Basilar skull fracture Depressed skull fracture Linear skull fracture Summary A skull fracture is a fracture or break in the cranial (skull) bones. Considerations Skull fractures may occur with head injuries. The skull provides good protection for the brain. However, a severe impact or blow can cause the skull to break. It may be accompanied by concussion or other injury to the brain. The brain can be affected directly by damage to the nervous system tissue and bleeding. The brain can also be affected by bleeding under the skull. This can compress the underlying brain tissue (subdural or epidural hematoma). A simple fracture is a break in the bone without damage to the skin. A linear skull fracture is a break in a cranial bone resembling a thin line, without splintering, depression, or distortion of bone. A depressed skull fracture is a break in a cranial bone (or \"crushed\" portion of skull) with depression of the bone in toward the brain. A compound fracture involves a break in, or loss of, skin and splintering of the bone. Causes Causes of skull fracture can include: Head trauma Falls, automobile accidents, physical assault, and sports Symptoms Symptoms may include: Bleeding from wound, ears, nose, or around eyes Bruising behind the ears or under the eyes Changes in pupils (sizes unequal, not reactive to light) Confusion Convulsions Difficulties with balance Drainage of clear or bloody fluid from ears or nose Drowsiness Headache Loss of consciousness Nausea and vomiting Restlessness, irritability Slurred speech Stiff neck Swelling Visual disturbances In some cases, the only symptom may be a bump on the head. A bump or bruise may take up to 24 hours to develop. First Aid Take the following steps if you think someone has a skull fracture: <li>Check the airways, breathing, and circulation. If necessary, begin rescue breathing and CPR.</li> <li>Avoid moving the person (unless absolutely necessary) until medical help arrives. Have someone to call 911 (or the local emergency number) for medical assistance.</li> <li>If the person must be moved, take care to stabilize the head and neck. Place your hands on both sides of the head and under the shoulders. Do not allow the head to bend forward or backward, or to twist or turn.</li> <li>Carefully check the site of injury, but do not probe in or around the site with a foreign object. It can be hard to know if the skull is fractured or depressed (dented in) at the site of injury.</li> <li>If there is bleeding, apply firm pressure with a clean cloth over a broad area to control blood loss.</li> <li>If blood soaks through, do not remove the original cloth. Instead, apply more cloths on top, and continue to apply pressure.</li> <li>If the person is vomiting, stabilize the head and neck, and carefully turn the victim to the side to prevent choking on vomit.</li> <li>If the person is conscious and experiencing any of the previously listed symptoms, transport to the nearest emergency medical facility (even if the person does not think medical help is needed).</li> DO NOT Follow these precautions: DO NOT move the person unless absolutely necessary. Head injuries may be associated with spinal injuries. DO NOT remove protruding objects. DO NOT allow the person to continue with physical activities. DO NOT forget to watch the person closely until medical help arrives. DO NOT give the person any medicines before talking to a doctor. DO NOT leave the person alone, even if there are no obvious problems. When to Contact a Medical Professional Get medical help right away if: There are problems with breathing or circulation. Direct pressure does not stop bleeding from the nose, ears, or wound. There is drainage of clear fluid from the nose or ears. There is facial swelling, bleeding, or bruising. There is an object protruding from the skull. The person is unconscious, is experiencing convulsions, has multiple injuries, appears to be in any distress, or cannot think clearly. Prevention Not all head injuries can be prevented. The following simple steps can help keep you and your child safe: <li>Always use safety equipment during activities that could cause a head injury. These include seat belts, bicycle or motorcycle helmets, and hard hats.</li> <li>Learn and follow bicycle safety recommendations.</li> <li>Do not drink and drive. Do not allow yourself to be driven by someone who may have been drinking alcohol or is otherwise impaired. </li> Review Date 10/16/2017 Updated by: Jesse Borke, MD, FACEP, FAAEM, Attending Physician at FDR Medical Services/Millard Fillmore Suburban Hospital, Buffalo, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Get medical help right away if: - There are problems with breathing or circulation. - Direct pressure does not stop bleeding from the nose, ears, or wound. - There is drainage of clear fluid from the nose or ears. - There is facial swelling, bleeding, or bruising. - There is an object protruding from the skull. - The person is unconscious, is experiencing convulsions, has multiple injuries, appears to be in any distress, or cannot think clearly.", "role": "assistant" } ]

[ { "content": "how to prevent conjunctivitis\n\nConjunctivitis or pink eye (Prevention): Good hygiene can help prevent the spread of conjunctivitis. Things you can do include: - Change pillowcases often. - DO NOT share eye makeup and replace it regularly. - DO NOT share towels or handkerchiefs. - Handle and clean contact lenses properly. - Keep hands away from the eye. - Wash your hands often.", "role": "user" }, { "content": "Good hygiene can help prevent the spread of conjunctivitis. Things you can do include change your pillowcases often, do not share eye makeup, do not share towels or handkerchiefs, handle your contact lenses properly, keep your hands away from the eye, and wash your hands often.", "role": "assistant" } ]

[ { "content": "Cervical Cancer Can a long term untreated bladder infection aid in the cause of cervical cancer? And can the fact that my mom has cervical cancer aid in my chance of getting cervical cancer?\n\nCervical cancer: Cervical cancer is cancer that starts in the cervix. The cervix is the lower part of the uterus (womb) that opens at the top of the vagina. Worldwide, cervical cancer is the third most common type of cancer in women. It is much less common in the United States because of the routine use of Pap smears. Cervical cancer starts in the cells on the surface of the cervix. There are 2 types of cells on the surface of the cervix, squamous and columnar. Most cervical cancers are from squamous cells. Cervical cancer usually develops slowly. It starts as a precancerous condition called dysplasia. This condition can be detected by a Pap smear and is 100% treatable. It can take years for dysplasia to develop into cervical cancer. Most women who are diagnosed with cervical cancer today have not had regular Pap smears, or they have not followed up on abnormal Pap smear results. Almost all cervical cancers are caused by HPV (human papillomavirus). HPV is a common virus that is spread through sexual intercourse. There are many different types (strains) of HPV. Some strains lead to cervical cancer. Other strains can cause genital warts. Others do not cause any problems at all. A woman's sexual habits and patterns can increase her risk of developing cervical cancer. Risky sexual practices include: - Having sex at an early age - Having multiple sexual partners - Having a partner or many partners who take part in high-risk sexual activities Other risk factors for cervical cancer include: - Not getting the HPV vaccine - Being economically disadvantaged - Having a mother who took the drug diethylstilbestrol (DES) during pregnancy in the early 1960s to prevent miscarriage - Having a weakened immune system Most of the time, early cervical cancer has no symptoms. Symptoms that may occur include: - Abnormal vaginal bleeding between periods, after intercourse, or after menopause - Vaginal discharge that does not stop, and may be pale, watery, pink, brown, bloody, or foul-smelling - Periods that become heavier and last longer than usual Cervical cancer may spread to the bladder, intestines, lungs, and liver. Often, there are no problems until the cancer is advanced and has spread. Symptoms of advanced cervical cancer may include: - Back pain - Bone pain or fractures - Fatigue - Leaking of urine or feces from the vagina - Leg pain - Loss of appetite - Pelvic pain - Single swollen leg - Weight loss Precancerous changes of the cervix and cervical cancer cannot be seen with the naked eye. Special tests and tools are needed to spot such conditions: - A Pap smear screens for precancers and cancer, but does not make a final diagnosis. - The human papillomavirus (HPV) DNA test may be done along with a Pap test. Or it may be used after a woman has had an abnormal Pap test result. It may also be used as the first test. - If abnormal changes are found, the cervix is usually examined under magnification. This procedure is called colposcopy. Pieces of tissue are removed (biopsied) during this procedure. This tissue is then sent to a lab for examination. - A procedure called a cone biopsy may also be done. If cervical cancer is diagnosed, the health care provider will order more tests. These help determine how far the cancer has spread. This is called staging. Tests may include: - Chest x-ray - CT scan of the pelvis - Cystoscopy - Intravenous pyelogram (IVP) - MRI of the pelvis Treatment of cervical cancer depends on: - The stage of the cancer - The size and shape of the tumor - The woman's age and general health - Her desire to have children in the future Early cervical cancer can be cured by removing or destroying the precancerous or cancerous tissue. This is why routine Pap smears are so important to prevent cervical cancer. There are surgical ways to do this without removing the uterus or damaging the cervix, so that a woman can still have children in the future. Types of surgery for early cervical cancer include: - Loop electrosurgical excision procedure (LEEP): Uses electricity to remove abnormal tissue - Cryotherapy: Freezes abnormal cells - Laser therapy: Uses light to burn abnormal tissue A hysterectomy (surgery to remove the uterus but not the ovaries) is not often done for cervical cancer that has not spread. It may be done in women who have had repeated LEEP procedures. Treatment for more advanced cervical cancer may include: - Radical hysterectomy, which removes the uterus and much of the surrounding tissues, including lymph nodes and the upper part of the vagina. - Pelvic exenteration, an extreme type of surgery in which all of the organs of the pelvis, including the bladder and rectum, are removed. Radiation may be used to treat cancer that has spread beyond the cervix or cancer that has returned. Chemotherapy uses drugs to kill cancer. It may be given alone or with surgery or radiation. 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. How well the person does depends on many things, including: - Type of cervical cancer - Stage of cancer (how far it has spread) - Age and general health - If the cancer comes back after treatment Precancerous conditions can be completely cured when followed up and treated properly. Most women are alive in 5 years (5-year survival rate) for cancer that has spread to the inside of the cervix walls but not outside the cervix area. The 5-year survival rate falls as the cancer spreads outside the walls of the cervix into other areas. Complications can include: - Risk of the cancer coming back in women who have treatment to save the uterus - Problems with sexual, bowel, and bladder function after surgery or radiation Call your provider if you: - Have not had regular Pap smears - Have abnormal vaginal bleeding or discharge Cervical cancer can be prevented by doing the following: - Get the HPV vaccine. The vaccine prevents most types of HPV infection that cause cervical cancer. Your provider can tell you if the vaccine is right for you. - Practice safer sex. Using condoms during sex reduces the risk for HPV and other sexually transmitted infections (STIs). - Limit the number of sexual partners you have. Avoid partners who are active in high-risk sexual behaviors. - Get Pap smears as often as your provider recommends. Pap smears can help detect early changes, which can be treated before they turn into cervical cancer. - Get the HPV test if recommended by your provider. It can be used along with the Pap test to screen for cervical cancer in women 30 years and older. - If you smoke, quit. Smoking increases your chance of getting cervical cancer. Updated by: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.", "role": "user" }, { "content": "A woman's sexual behavior, such as having sex at an early age and having multiple partners can increase her risk of developing cervical cancer. Other risk factors include not getting the HPV vaccine, having a weakened immune system, and having a mother who took the drug diethylstilbestrol (DES) during pregnancy.", "role": "assistant" } ]

[ { "content": "what causes bipolar disorder\n\nBipolar disorder: 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 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. 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 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 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. 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. 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 or genetic 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. 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, or drug or alcohol abuse. Left untreated, bipolar disorder can result in serious personal problems, such as drug and alcohol use, suicide or suicide attempts, legal or financial problems, damaged relationships, or poor work and school performance. 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. These can include anxiety disorders, eating disorders, heart disease, or obesity.", "role": "assistant" } ]

[ { "content": "typhoid fever Hi, My name is from X i have suffering from typhoid please give me solution i have one question i had got treatment from one year but i am not well now give me solution?\n\n Typhoid fever Overview 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. Symptoms 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. Causes 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. Risk factors 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 Complications 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. Diagnosis 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. Treatment 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 include Ciprofloxacin and Ceftriaxone. Other treatments include drinking fluids, which 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. Additionally, if your intestines become perforated, you'll need surgery to repair the hole.", "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 (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.", "role": "user" }, { "content": "Children who inherit achondroplasia from both parents usually live only few months. Other people with achondroplasia may grow to be 5 feet tall and their intelligence is usually normal.", "role": "assistant" } ]

[ { "content": "how do you get a prolapse bladder\n\n Anterior prolapse (cystocele) Overview Anterior prolapse, also known as a cystocele (SIS-toe-seel), occurs when the supportive tissue between a woman's bladder and vaginal wall weakens and stretches, allowing the bladder to bulge into the vagina. Anterior prolapse is also called a prolapsed bladder. Straining the muscles that support your pelvic organs may lead to anterior prolapse. Such straining occurs during vaginal childbirth or with chronic constipation, violent coughing or heavy lifting. Anterior prolapse also tends to cause problems after menopause, when estrogen levels decrease. For a mild or moderate anterior prolapse, nonsurgical treatment is often effective. In more severe cases, surgery may be necessary to keep the vagina and other pelvic organs in their proper positions. Symptoms In mild cases of anterior prolapse, you may not notice any signs or symptoms. When signs and symptoms occur, they may include: - A feeling of fullness or pressure in your pelvis and vagina - Increased discomfort when you strain, cough, bear down or lift - A feeling that you haven't completely emptied your bladder after urinating - Repeated bladder infections - Pain or urinary leakage during sexual intercourse - In severe cases, a bulge of tissue that protrudes through your vaginal opening and may feel like sitting on an egg Signs and symptoms often are especially noticeable after standing for long periods of time and may go away when you lie down. When to see a doctor A severely prolapsed bladder can be uncomfortable. It can make emptying your bladder difficult and may lead to bladder infections. Make an appointment with your doctor if you have any signs or symptoms that bother you. Causes Your pelvic floor consists of muscles, ligaments and connective tissues that support your bladder and other pelvic organs. The connections between your pelvic floor muscles and ligaments can weaken over time, as a result of trauma from childbirth or chronic straining of pelvic floor muscles. When this happens, your bladder can slip down lower than normal and bulge into your vagina (anterior prolapse). Possible causes of anterior prolapse include: - Pregnancy and vaginal childbirth - Being overweight or obese - Repeated heavy lifting - Straining with bowel movements - A chronic cough or bronchitis Risk factors These factors may increase your risk of anterior prolapse: - Childbirth. Women who have vaginally delivered one or more children have a higher risk of anterior prolapse. - Aging. Your risk of anterior prolapse increases as you age. This is especially true after menopause, when your body's production of estrogen - which helps keep the pelvic floor strong - decreases. - Hysterectomy. Having your uterus removed may contribute to weakness in your pelvic floor support. - Genetics. Some women are born with weaker connective tissues, making them more susceptible to anterior prolapse. - Obesity. Women who are overweight or obese are at higher risk of anterior prolapse. Diagnosis Diagnosis of anterior prolapse may involve: - A pelvic exam. You may be examined while lying down and while standing up. During the exam, your doctor looks for a tissue bulge into your vagina that indicates pelvic organ prolapse. You'll likely be asked to bear down as if during a bowel movement to see how much that affects the degree of prolapse. To check the strength of your pelvic floor muscles, you'll be asked to contract them, as if you're trying to stop the stream of urine. - Filling out a questionnaire. You may fill out a form that helps your doctor assess the degree of your prolapse and how much it affects your quality of life. Information gathered also helps guide treatment decisions. - Bladder and urine tests. If you have significant prolapse, you might be tested to see how well and completely your bladder empties. Your doctor might also run a test on a urine sample to look for signs of a bladder infection, if it seems that you're retaining more urine in your bladder than is normal after urinating. Treatment Treatment depends on how severe your anterior prolapse is and whether you have any related conditions, such as a uterus that slips into the vaginal canal (uterine prolapse). Mild cases - those with few or no obvious symptoms - typically don't require treatment. You could opt for a wait-and-see approach, with occasional visits to your doctor to see if your prolapse is worsening, along with self-care measures, such as exercises that strengthen your pelvic floor muscles. If self-care measures aren't effective, anterior prolapse treatment might involve: - A supportive device (pessary). A vaginal pessary is a plastic or rubber ring inserted into your vagina to support the bladder. Your doctor or other care provider fits you for the device and shows you how to clean and reinsert it on your own. Many women use pessaries as a temporary alternative to surgery, and some use them when surgery is too risky. - Estrogen therapy. Your doctor may recommend using estrogen - usually a vaginal cream, pill or ring - especially if you've already experienced menopause. This is because estrogen, which helps keep pelvic muscles strong, decreases after menopause. When surgery is necessary If you have noticeable, uncomfortable symptoms, anterior prolapse may require surgery. - How it's done. Often, the surgery is performed vaginally and involves lifting the prolapsed bladder back into place, removing extra tissue, and tightening the muscles and ligaments of the pelvic floor. Your doctor may use a special type of tissue graft to reinforce vaginal tissues and increase support if your vaginal tissues seem very thin. - If you have a prolapsed uterus. For anterior prolapse associated with a prolapsed uterus, your doctor may recommend removing the uterus (hysterectomy) in addition to repairing the damaged pelvic floor muscles, ligaments and other tissues. If you're thinking about becoming pregnant, your doctor may recommend that you delay surgery until after you're done having children. Using a pessary may help relieve your symptoms in the meantime. The benefits of surgery can last for many years, but there's some risk of recurrence - which may mean another surgery at some point. Dealing with incontinence If your anterior prolapse is accompanied by stress incontinence - involuntary loss of urine during strenuous activity - your doctor may recommend one of a number of procedures to support the urethra (urethral suspension) and ease your incontinence symptoms. Treatment at Mayo Clinic Urologists and urogynecologists at Mayo Clinic provide expert care for female patients of all ages who suffer from problems of the pelvic floor. Mayo physicians are leaders in clinical research that enhances the capability to offer the most advanced treatments available. Many of the urologists across all Mayo Clinic campuses have advanced training and subspecialty certification in female pelvic medicine and reconstructive surgery from the American Board of Urology. Urogynecologists at Mayo Clinic also have advanced training and certification in female urology. Specialty services offered through urology and urogynecology include: - Pelvic organ prolapse with or without incontinence diagnosis and treatment - Urodynamic evaluation - Stress urinary incontinence diagnosis and treatment - Minimally invasive injection therapies - Management of mesh complications - Urge urinary incontinence diagnosis and treatment - Overactive bladder diagnosis and treatment - Botox injections of the urinary tract - Neuromodulation for the urinary tract Lifestyle and home remedies Kegel exercises strengthen your pelvic floor muscles, which support the uterus, bladder and bowel. A strengthened pelvic floor provides better support for your pelvic organs and relief from symptoms associated with anterior prolapse. To perform Kegel exercises, follow these steps: - Tighten (contract) your pelvic floor muscles - the muscles you use to stop urinating. - Hold the contraction for five seconds, then relax for five seconds. (If this is too difficult, start by holding for two seconds and relaxing for three seconds.) - Work up to holding the contraction for 10 seconds at a time. - Do three sets of 10 repetitions of the exercises each day. Ask your health care provider for feedback on whether you're using the right muscles. Kegel exercises may be most successful when they're taught by a physical therapist and reinforced with biofeedback. Biofeedback involves using monitoring devices that help ensure you're tightening the proper muscles with optimal intensity and length of time. Once you've learned the proper method, you can do Kegel exercises discreetly just about anytime, whether you're sitting at your desk or relaxing on the couch. ", "role": "user" }, { "content": "Your pelvic floor consists of muscles, ligaments and connective tissues that support your bladder and other pelvic organs. The connections between your pelvic floor muscles and ligaments can weaken over time, as a result of trauma from childbirth or chronic straining of pelvic floor muscles. When this happens, your bladder can slip down lower than normal and bulge into your vagina (anterior prolapse). Possible causes of anterior prolapse include: - Pregnancy and vaginal childbirth - Being overweight or obese - Repeated heavy lifting - Straining with bowel movements - A chronic cough or bronchitis", "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 Overview 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. Symptoms 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. Causes 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 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. Diagnosis 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. Treatment 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. Lifestyle and home remedies 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. Alternative medicine Studies indicate that the following treatments for scoliosis are ineffective: - Chiropractic manipulation - Electrical stimulation of muscles - Dietary supplements ", "role": "user" }, { "content": "Studies indicate that the following treatments for scoliosis are ineffective: - Chiropractic manipulation - Electrical stimulation of muscles - Dietary supplements", "role": "assistant" } ]

[ { "content": "what is the disorder achondroplasia\n\nAchondroplasia: Achondroplasia is a disorder of bone growth that causes the most common type of dwarfism. 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 1 parent, the child will have the disorder. If 1 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 2 parents without achondroplasia may give birth to a baby with the condition. 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 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. There is no specific treatment for achondroplasia. Related abnormalities, including spinal stenosis and spinal cord compression, should be treated when they cause problems. 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. 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 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. Genetic counseling may be helpful for prospective parents when 1 or both have achondroplasia. However, because achondroplasia most often develops spontaneously, prevention is not always possible. Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.", "role": "user" }, { "content": "Achondroplasia is a disorder of bone growth that causes the most common type of dwarfism. Achondroplasia may be inherited as an autosomal dominant trait, which means that if a child gets the defective gene from 1 parent, the child will have the disorder. The typical appearance of achondroplastic dwarfism can be seen at birth. Symptoms may include: - Abnormal hand appearance with persistent space between the long and ring fingers - Bowed legs - Decreased muscle tone - Disproportionately large head-to-body size difference - Prominent forehead (frontal bossing) - Shortened arms and legs (especially the upper arm and thigh) - Short stature (significantly below the average height for a person of the same age and sex) - Narrowing of the spinal column spinal stenosis - Spine curvatures called kyphosis and lordosis ... Genetic counseling may be helpful for prospective parents when 1 or both have achondroplasia. However, because achondroplasia most often develops spontaneously, prevention is not always possible.", "role": "assistant" } ]

[ { "content": "how to loose weight\n\n Diet for rapid weight loss Very low-calorie diet VLCD Low-calorie diet LCD Very low energy diet Weight loss - rapid weight loss Overweight - rapid weight loss Obesity - rapid weight loss Diet - rapid weight loss Summary Rapid weight loss diet is a type of diet in which you lose more than 2 pounds (1 kilogram, kg) a week over several weeks. To lose weight this quickly you eat very few calories. How It Works These diets are most often chosen by obese people who want to lose weight quickly. These diets are rarely recommended by health care providers. People on these diets should be followed closely by a provider. Rapid weight loss is not safe for most people to do on their own. These diets are only to be used for a short time and are not recommended for more than several weeks. The types of rapid weight loss diets are described below. People who lose weight very quickly are much more likely to regain the weight over time than people who lose weight slowly through less drastic diet changes and physical activity. Very Low-Calorie Diet (VLCD) On a VLCD, you may have as few as 800 calories a day and may lose up to 3 to 5 pounds (1.5 to 2 kg) week. Most VLCDs use meal replacements, such as formulas, soups, shakes, and bars instead of regular meals. This helps ensure that you get all of the nutrients you need each day. A VLCD is only recommended for adults who are obese and need to lose weight for health reasons. These diets are often used before weight-loss surgery. You should only use a VLCD with the help of your provider. Most experts DO NOT recommend using a VLCD for more than 12 weeks. Low-Calorie Diet (LCD) These diets usually allow about 1,000 to 1,200 calories a day for women and 1,200 to 1,600 calories a day for men. An LCD is a better choice than a VLCD for most people who want to lose weight quickly. But you should still be supervised by a provider. You will not lose weight as fast with an LCD, but you can lose just as much weight with a VLCD. An LCD may use a mix of meal replacements and regular food. This makes it easier to follow than a VLCD. Fad Diets Some fad diets also severely limit calories to achieve rapid weight loss. In many cases, these diets are not safe. Once you stop the diet, you are at risk for regaining the weight if you return to your old eating habits. For most people, it is safest to choose a diet in which you lose a 1/2 pound to 1 pound (225 grams to 500 grams) a week. The Role of Exercise Rapid weight loss is more about cutting calories than exercising. Talk with your provider about what type of exercise you should do while you are on this type of diet. Your provider may suggest waiting until you are on a more long-term diet to start exercising. Health Benefits Rapid weight loss diet is usually for people who have health problems because of obesity. For these people, losing a lot of weight quickly can help improve: Diabetes High cholesterol High blood pressure Possible Health Concerns You should only follow one of these diets with the help of your provider. Losing more than 1 or 2 pounds (0.5 to 1 kg) a week is not safe for most people. It can cause you to lose muscle, water, and bone density. Rapid weight loss can also cause some side effects including: Gallstones Gout Fatigue Constipation Diarrhea Nausea People who lose weight quickly are also more likely to gain back the weight quickly. This can lead to other health problems. In general, a rapid weight loss diet is not safe for children. It may also not be safe for teens, pregnant women or older adults unless a provider recommends it. If you have a health condition, it is a good idea to talk with your provider before starting this or any diet plan to lose weight. Review Date 5/17/2018 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": "Rapid weight loss diet is usually for people who have health problems because of obesity. People on these diets should be tracked closely by a health care provider. Raid weight loss is not safe for people to do on their own. These types of diets are only to be used for a short period of time, generally no more than several weeks. Some fad diets also severely limit calories to achieve rapid weight loss. In many cases, these diets are not safe.", "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": "Surgery may be considered for knock knees that are severe and continue beyond late childhood.", "role": "assistant" } ]

[ { "content": "Research assignment Hi, I am a grade 12 student who is doing a research assignment on neurological disorders. Do you believe that there will ever be a bonafide cure for Multiple Sclerosis? If so, what kind of time frame would put on this cure?\n\nMultiple Sclerosis: An unpredictable disease of the central nervous system, multiple sclerosis (MS) can range from relatively benign to somewhat disabling to devastating, as communication between the brain and other parts of the body is disrupted.  Many investigators believe MS to be an autoimmune disease -- one in which the body, through its immune system, launches a defensive attack against its own tissues. In the case of MS, it is the nerve-insulating myelin that comes under assault. Such assaults may be linked to an unknown environmental trigger, perhaps a virus. Most people experience their first symptoms of MS between the ages of 20 and 40; the initial symptom of MS is often blurred or double vision, red-green color distortion, or even blindness in one eye.  Most MS patients experience muscle weakness in their extremities and difficulty with coordination and balance.  These symptoms may be severe enough to impair walking or even standing. In the worst cases, MS can produce partial or complete paralysis.  Most people with MS also exhibit paresthesias, transitory abnormal sensory feelings such as numbness, prickling, or \"pins and needles\" sensations.  Some may also experience pain.  Speech impediments, tremors, and dizziness are other frequent complaints. Occasionally, people with MS have hearing loss. Approximately half of all people with MS experience cognitive impairments such as difficulties with concentration, attention, memory, and poor judgment, but such symptoms are usually mild and are frequently overlooked.  Depression is another common feature of MS. Currently there is no cure for MS. Many individuals do well with no therapy at all, especially since many medications have serious side effects and some carry significant risks.  However, three forms of beta interferon (Avonex, Betaseron, and Rebif) have now been approved by the Food and Drug Administration for treatment of relapsing-remitting MS.  The FDA has also approved ocrelizumab (brand name Ocrevus) to treat adults with relapsing forms of MS and primary progressive MS. Beta interferon has been shown to reduce the number of exacerbations and may slow the progression of physical disability. When attacks do occur, they tend to be shorter and less severe.  The FDA also has approved a synthetic form of myelin basic protein, called copolymer I (Copaxone), for the treatment of relapsing-remitting MS. Copolymer I has few side effects, and studies indicate that the agent can reduce the relapse rate by almost one third.  Other FDA approved drugs to treat relapsing forms of MS in adults include teriflunomide and dimethyl fumarate.  An immunosuppressant treatment,Novantrone (mitoxantrone), is approved by the FDA for the treatment of advanced or chronic MS.  The FDA has also approved dalfampridine (Ampyra) to improve walking in individuals with MS. One monoclonal antibody, natalizumab (Tysabri), was shown in clinical trials to significantly reduce the frequency of attacks in people with relapsing forms of MS and was approved for marketing by the U.S. Food and Drug Administration (FDA) in 2004.  However, in 2005 the drug’s manufacturer voluntarily suspended marketing of the drug after several reports of significant adverse events.  In 2006, the FDA again approved sale of the drug for MS but under strict treatment guidelines involving infusion centers where patients can be monitored by specially trained physicians.  While steroids do not affect the course of MS over time, they can reduce the duration and severity of attacks in some patients.  Spasticity, which can occur either as a sustained stiffness caused by increased muscle tone or as spasms that come and go, is usually treated with muscle relaxants and tranquilizers such as baclofen, tizanidine, diazepam, clonazepam, and dantrolene. Physical therapy and exercise can help preserve remaining function, and patients may find that various aids -- such as foot braces, canes, and walkers -- can help them remain independent and mobile.  Avoiding excessive activity and avoiding heat are probably the most important measures patients can take to counter physiological fatigue.  If psychological symptoms of fatigue such as depression or apathy are evident, antidepressant medications may help.  Other drugs that may reduce fatigue in some, but not all, patients include amantadine (Symmetrel), pemoline (Cylert), and the still-experimental drug aminopyridine. Although improvement of optic symptoms usually occurs even without treatment, a short course of treatment with intravenous methylprednisolone (Solu-Medrol) followed by treatment with oral steroids is sometimes used. A physician may diagnose MS in some patients soon after the onset of the illness. In others, however, doctors may not be able to readily identify the cause of the symptoms, leading to years of uncertainty and multiple diagnoses punctuated by baffling symptoms that mysteriously wax and wane.  The vast majority of patients are mildly affected, but in the worst cases, MS can render a person unable to write, speak, or walk.  MS is a disease with a natural tendency to remit spontaneously, for which there is no universally effective treatment.", "role": "user" }, { "content": "Currently there is no cure for Multiple Sclerosis. Many individuals do well with no therapy at all, especially since many medications have serious side effects and some carry significant risks.  However, three forms of beta interferon (Avonex, Betaseron, and Rebif) are approved for treatment of relapsing-remitting MS.  Ocrelizumab (brand name Ocrevus) is approved for adults with relapsing forms of MS and primary progressive MS. Beta interferon has been shown to reduce the number of exacerbations, the severity and duration of the attacks, and may slow the progression of physical disability. A synthetic form of myelin basic protein, called copolymer I (Copaxone), is approved for the treatment of relapsing-remitting MS. Copolymer I has few side effects, and studies indicate that the agent can reduce the relapse rate by almost one third.  Other approved drugs to treat relapsing forms of MS in adults include teriflunomide and dimethyl fumarate.  An immunosuppressant treatment, Novantrone (mitoxantrone), is approved for the treatment of advanced or chronic MS.  Dalfampridine (Ampyra) may improve walking in individuals with MS. One monoclonal antibody, natalizumab (Tysabri), was shown in clinical trials to significantly reduce the frequency of attacks in people with relapsing forms of MS. This drug should be used under strict treatment guidelines involving infusion centers where patients can be monitored by specially trained physicians.  Steroids can reduce the duration and severity of attacks in some patients.  Spasticity, which can occur either as a sustained stiffness caused by increased muscle tone or as spasms that come and go, is usually treated with muscle relaxants and tranquilizers such as baclofen, tizanidine, diazepam, clonazepam, and dantrolene. Physical therapy and exercise can help preserve remaining function, and patients may find that various aids -- such as foot braces, canes, and walkers -- can help them remain independent and mobile.  Avoiding excessive activity and avoiding heat are probably the most important measures patients can take to counter physiological fatigue.  If psychological symptoms of fatigue such as depression or apathy are evident, antidepressant medications may help.  Other drugs that may reduce fatigue in some, but not all, patients include amantadine (Symmetrel), pemoline (Cylert), and aminopyridine. Although improvement of optic symptoms usually occurs even without treatment, a short course of treatment with intravenous methylprednisolone (Solu-Medrol) followed by treatment with oral steroids is sometimes used. The vast majority of patients are mildly affected, but in the worst cases, MS can render a person unable to write, speak, or walk.  MS is a disease with a natural tendency to remit spontaneously, for which there is no universally effective treatment.", "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": "There are many causes of pulmonary hypertension. For this reason, many tests may be required to find the cause of your particular case.", "role": "assistant" } ]

[ { "content": "how smoking tobacco affects the rest of the body\n\nWhat is Smoking?: There's no way around it. Smoking is bad for your health. Smoking harms nearly every organ of the body. Cigarette smoking causes 87 percent of lung cancer deaths. It is also responsible for many other cancers and health problems. These include lung disease, heart and blood vessel disease, stroke and cataracts. Women who smoke have a greater chance of certain pregnancy problems or having a baby die from sudden infant death syndrome (SIDS). Your smoke is also bad for other people - they breathe in your smoke secondhand and can get many of the same problems as smokers do. E-cigarettes often look like cigarettes, but they work differently. They are battery-operated smoking devices. Not much is known about the health risks of using them. Quitting smoking can reduce your risk of health problems. The earlier you quit, the greater the benefit. NIH: National Cancer Institute", "role": "user" }, { "content": "Smoking is responsible for many other cancers and health problems. This includes lung disease, heart and blood vessel disease, stroke and cataracts. Women who smoke have a greater chance of certain pregnancy problems or having a baby die from sudden infant death syndrome (SIDS).", "role": "assistant" } ]

[ { "content": "Can you mail me patient information about Glaucoma, I was recently diagnosed and want to learn all I can about the disease.\n\nGlaucoma (Outlook (Prognosis)): Open-angle glaucoma cannot be cured. You can manage it and keep your sight by following your provider's directions. Closed-angle glaucoma is a medical emergency. You need treatment right away to save your vision. Babies with congenital glaucoma usually do well when surgery is done early. How you do with secondary glaucoma depends on what is causing the condition.", "role": "user" }, { "content": "Open-angle glaucoma cannot be cured. You can manage it and keep your sight by following your provider's directions. Closed-angle glaucoma is a medical emergency. You need treatment right away to save your vision. How you do with secondary glaucoma depends on what is causing the condition.", "role": "assistant" } ]

[ { "content": "Would appreciate any good info on Lewy Body Dementia, we need to get people aware of this dreadful disease, all they talk about is alzheimers. Thank you\n\n Lewy body dementia Overview Lewy body dementia, also known as dementia with Lewy bodies, is the second most common type of progressive dementia after Alzheimer's disease dementia. Protein deposits, called Lewy bodies, develop in nerve cells in the brain regions involved in thinking, memory and movement (motor control). Lewy body dementia causes a progressive decline in mental abilities. People with Lewy body dementia may experience visual hallucinations, and changes in alertness and attention. Other effects include Parkinson's disease-like symptoms such as rigid muscles, slow movement and tremors. Lewy body dementia care at Mayo Clinic Symptoms Lewy body dementia signs and symptoms may include: - Visual hallucinations. Hallucinations may be one of the first symptoms, and they often recur. They may include seeing shapes, animals or people that aren't there. Sound (auditory), smell (olfactory) or touch (tactile) hallucinations are possible. - Movement disorders. Signs of Parkinson's disease (parkinsonian symptoms), such as slowed movement, rigid muscles, tremor or a shuffling walk may occur. - Poor regulation of body functions (autonomic nervous system). Blood pressure, pulse, sweating and the digestive process are regulated by a part of the nervous system that is often affected by Lewy body dementia. This can result in dizziness, falls and bowel issues such as constipation. - Cognitive problems. You may experience thinking (cognitive) problems similar to those of Alzheimer's disease, such as confusion, poor attention, visual-spatial problems and memory loss. - Sleep difficulties. You may have rapid eye movement (REM) sleep behavior disorder, which can cause you to physically act out your dreams while you're asleep. - Fluctuating attention. Episodes of drowsiness, long periods of staring into space, long naps during the day or disorganized speech are possible. - Depression. You may experience depression sometime during the course of your illness. - Apathy. You may have loss of motivation. Causes Lewy body dementia is characterized by the abnormal buildup of proteins into deposits known as Lewy bodies. This protein is also associated with Parkinson's disease. People who have Lewy bodies in their brains often have the plaques and tangles associated with Alzheimer's disease. Risk factors A few factors seem to increase the risk of developing Lewy body dementia, including: - Being older than 60 - Being male - Having a family member with Lewy body dementia or Parkinson's disease Research has indicated that depression is also associated with Lewy body dementia. Diagnosis A progressive decline in your ability to think is required to diagnose Lewy body dementia. In addition, two of the following core symptoms must be present: - Fluctuating and unpredictable alertness and thinking (cognitive) function - Repeated visual hallucinations - Parkinsonian symptoms - REM sleep behavior disorder, in which people act out their dreams during sleep In addition to the core symptoms of Lewy body dementia, tests for certain biomarkers can further support a diagnosis of Lewy body dementia. Biomarkers are substances in the blood that indicate the presence of a disease, such as Lewy body dementia. Right now there are no biomarkers to definitively diagnose Lewy body dementia, but some biomarkers support it. Biomarkers alone, without symptoms, aren't enough for a diagnosis. Biomarker tests to support Lewy body dementia diagnosis include: - Nuclear imaging tests such as single-photon emission computerized tomography (SPECT) and positron emission tomography (PET) - Tests that measure check nerve function of the heart's blood vessels (iodine-MIBG myocardial scintigraphy) - Sleep studies that examine brain wave activity Your doctor may also diagnose Lewy body dementia based on the presence of one core symptom and one or more of these biomarkers that support the diagnosis: - Autonomic dysfunction, which involves instability in blood pressure and heart rate, poor regulation of body temperature, sweating, and related symptoms - Feeling excessively sleepy during the daytime - Loss of the sense of smell There are several combinations of symptoms, features and biomarkers that help doctors diagnose Lewy body dementia. Depending on the combination, the diagnosis may be considered probable or possible. Doctors may also try to rule out other conditions that may cause similar signs and symptoms to support a diagnosis of Lewy body dementia. Tests may include: Neurological and physical examination Your doctor may check for signs of Parkinson's disease, strokes, tumors or other medical conditions that can affect the brain and physical function. The neurological examination may test: - Reflexes - Strength - Walking - Muscle tone - Eye movements - Balance - Sense of touch Assessment of mental abilities A short form of this test, which assesses your memory and thinking skills, can be done in less than 10 minutes in your doctor's office. It's not generally useful in distinguishing Lewy body dementia from Alzheimer's disease but can indicate dementia. Longer tests can take several hours, but help identify Lewy body dementia. Your doctor will compare your test results with those of people from a similar age and education level. This can help distinguish normal from abnormal cognitive aging, and may help diagnose the condition. Blood tests These can rule out physical problems that can affect brain function, such as vitamin B-12 deficiency or an underactive thyroid gland. Brain scans Your doctor may order an MRI, PET or CT scan to identify a stroke or bleeding, and to rule out the possibility of a tumor. While dementias are diagnosed based on the history and physical examination, certain features on imaging studies can suggest different types of dementia, such as Alzheimer's or Lewy body dementia. Your doctor may order a sleep evaluation to check for REM sleep behavior disorder or an autonomic function test to look for signs of heart rate and blood pressure instability. Treatment Treatment can be challenging, and there's no cure for Lewy body dementia. Doctors treat the individual symptoms. Medications - Cholinesterase inhibitors. These Alzheimer's disease medications, such as rivastigmine (Exelon), work by increasing the levels of chemical messengers believed to be important for memory, thought and judgment (neurotransmitters) in the brain. This can help improve alertness and cognition, and may help reduce hallucinations and other behavioral problems. Possible side effects may include gastrointestinal upset, excessive salivation and tearing, and frequent urination. These are not FDA approved for Lewy body dementia. - Parkinson's disease medications. These medications, such as carbidopa-levodopa (Sinemet) may help reduce parkinsonian symptoms, such as rigid muscles and slow movement. However, these medications may also increase confusion, hallucinations and delusions. - Medications to treat other symptoms. Your doctor may prescribe medications to treat other symptoms associated with Lewy body dementia, such as sleep or movement problems. If possible, avoid medications with anticholinergic properties, which can worsen cognition or dopamine agonists, which can cause hallucinations. First-generation antipsychotic medications, such as haloperidol (Haldol), should not be used to treat Lewy body dementia. They may cause severe confusion, severe Parkinsonism, sedation and sometimes even death. Very rarely, certain second-generation antipsychotics may be prescribed for a short time at a low dose but only if the benefits outweigh the risks. Therapies Because antipsychotic drugs can worsen Lewy body dementia symptoms, it might be helpful to initially try nondrug approaches, such as: - Tolerating the behavior. Many times a person with Lewy body dementia isn't distressed by the hallucinations. In these cases, the side effects of medication may be worse than the hallucinations themselves. - Modifying the environment. Reducing clutter and distracting noise can make it easier for someone with dementia to function. - Offering soothing responses. A caregiver's response may worsen behavior. Avoid correcting and quizzing a person with dementia. Offer reassurance and validation of his or her concerns. - Creating daily routines and keeping tasks simple. Break tasks into easier steps and focus on successes, not failures. Structure and routine during the day can be less confusing. Lifestyle and home remedies Symptoms and progression are different for everyone with Lewy body dementia. Caregivers may need to adapt the following tips to individual situations: - Speak clearly and simply. Maintain eye contact and speak slowly, in simple sentences, and don't rush the response. Present only one idea or instruction at a time. Use gestures and cues, such as pointing to objects. - Encourage exercise. Benefits of exercise include improvements in physical function, behavior and depression symptoms. Some research shows exercise may slow cognitive decline in people with dementia. - Provide mind stimulation. Participating in games, crossword puzzles and other activities that involve using thinking skills may help slow mental decline in people with dementia. - Establish a nighttime ritual. Behavior issues may worsen at night. Create calming bedtime rituals without the distraction of television, meal cleanup and active family members. Leave night lights on to prevent disorientation. Limiting caffeine during the day, discouraging daytime napping and offering opportunities for daytime exercise may help prevent nighttime restlessness. Alternative medicine Frustration and anxiety can worsen dementia symptoms. These techniques may help promote relaxation: - Music therapy, which involves listening to soothing music - Pet therapy, which involves the use of animals to improve moods and behaviors in dementia patients - Aromatherapy, which uses fragrant plant oils - Massage therapy ", "role": "user" }, { "content": "Treating Lewy body dementia can be challenging. Currently there is no cure, but there are treatments that can be applied depending on the individual symptoms. Alzheimer's medications can be effective to increase alertness and reduce hallucinations or other behavioral problems. Your doctor may prescribe medications to treat other symptoms associated with Lewy body dementia, such as sleep or movement problems.", "role": "assistant" } ]

[ { "content": "how to prevent diabetes\n\n Diabetes Overview Diabetes is a disease in which blood sugar (glucose) levels in your body are too high. Diabetes can cause serious health problems, including heart attack or stroke, blindness, problems during pregnancy, and kidney failure. More than 13 million women have diabetes, or about one in 10 women ages 20 and older.1 What is diabetes? Diabetes is a disease caused by high levels of blood sugar (glucose) in your body. This can happen when your body does not make insulin or does not use insulin correctly. Insulin is a hormone made in the pancreas, an organ near your stomach. Insulin helps the glucose from food get into your body's cells for energy. If your body does not make enough insulin, or your body does not use the insulin correctly, the glucose stays and builds up in your blood. Over time, this extra glucose can lead to prediabetes or diabetes. Diabetes puts you at risk for other serious and life-threatening health problems, such as heart disease, stroke, blindness, and kidney damage. What are the different types of diabetes? The three main types of diabetes are: Am I at risk for diabetes? A risk factor is something that puts you at a higher risk for a disease compared with an average person. Risk factors for type 1 diabetes in women and girls include: Risk factors for type 2 diabetes in women and girls include:4 If you have any of these risk factors, talk to your doctor about ways to lower your risk for diabetes. You can also take the Diabetes Risk Test and talk about the results with your doctor. Who gets diabetes? Type 1 diabetes usually develops in childhood, but it can happen at any age. It is more common in whites than in other racial or ethnic groups. About 5% of adults with diabetes have type 1 diabetes.1 Genes you inherit from your parents play an important role in the development of type 1 diabetes. However, where you live may also affect your risk. Type 1 diabetes develops more often in winter and in people who live in colder climates. Type 2 diabetes is more common in adults, especially in people who are overweight and have a family history of diabetes. About 95% of adults with diabetes have type 2 diabetes.1 Type 2 diabetes is becoming more common in children and teens as more of them become overweight and obese.5 Do women of color need to worry about diabetes? Yes. Certain racial and ethnic groups have a higher risk for type 2 diabetes. These groups include: How does diabetes affect women differently than men? Diabetes affects women and men in almost equal numbers. However, diabetes affects women differently than men. Compared with men with diabetes, women with diabetes have:9 Does diabetes raise my risk for other health problems? Yes. The longer you have type 2 diabetes, the higher your risk for developing serious medical problems from diabetes. Also, if you smoke and have diabetes, you are even more likely to develop serious medical problems from diabetes, compared with people who have diabetes and do not smoke.11 The extra glucose in the blood that leads to diabetes can damage your nerves and blood vessels. Nerve damage from diabetes can lead to pain or a permanent loss of feeling in your hands, feet, and other parts of your body.12 Blood vessel damage from diabetes can also lead to: Women with diabetes are also at higher risk for: What causes diabetes? Researchers do not know the exact causes of type 1 and type 2 diabetes. Researchers do know that inheriting certain genes from your family can raise your risk for developing diabetes. Obesity is also a major risk factor for type 2 diabetes. Smoking can also cause type 2 diabetes. And the more you smoke the higher your risk for type 2 diabetes and other serious health problems if you already have diabetes.13 Weight loss can help control type 2 diabetes so that you are healthier. Quitting smoking can also help you control your blood sugar levels. Being a healthy weight and not smoking can help all women be healthier. But, obesity and smoking do not always cause diabetes. Some women who are overweight or obese or smoke never develop diabetes. Also, women who are a normal weight or only slightly overweight can develop diabetes if they have other risk factors, such as a family history of diabetes. What are the signs and symptoms of diabetes? Type 1 diabetes symptoms are usually more severe and may develop suddenly. Type 2 diabetes may not cause any signs or symptoms at first. Symptoms can develop slowly over time. You may not notice them right away. Common signs and symptoms of type 1 and type 2 diabetes include: Do I need to be tested for diabetes? Maybe. You should be tested for diabetes if you are between 40 and 70 years old and are overweight or obese. Your doctor may recommend testing earlier than age 40 if you also have other risk factors for diabetes. Also, talk to your doctor about diabetes testing if you have signs or symptoms of diabetes. Your doctor will use a blood test to see if you have diabetes. If the testing shows that your blood sugar levels are high, you can begin making healthy changes to your eating habits and getting more physical activity to help prevent diabetes. What is prediabetes? Prediabetes means your blood sugar (glucose) level is higher than normal, but it is lower than the diabetes range. It also means you are at higher risk of getting type 2 diabetes and heart disease. As many as 27 million American women have prediabetes.14 If you have prediabetes, you can make healthy changes, such as doing some type of physical activity on most days, to lower your risk of getting diabetes and return to normal blood sugar levels. Losing 7% of your body weight (or 14 pounds if you weigh 200 pounds) can lower your risk for type 2 diabetes by more than half. If you have prediabetes, get your blood glucose checked every year by a doctor or nurse.15 How is diabetes treated? Diabetes treatment includes managing your blood sugar levels to control your symptoms. You can help control your blood sugar levels by eating healthy and getting regular physical activity. With type 1 diabetes, you also will need to take insulin through shots or an insulin pump. Insulin cannot be taken as a pill. Type 2 diabetes treatment also may include taking medicine to control your blood sugar. Over time, people with type 2 diabetes make less and less of their own insulin. This may mean that you will need to increase your medicines or start taking insulin shots to keep your diabetes in control. Learn more about controlling diabetes at the National Diabetes Education Program website. Is there anything I can do to prevent type 1 diabetes? Researchers do not know how to prevent type 1 diabetes. Researchers are still looking for ways to prevent type 1 diabetes in women and girls by studying their close relatives who have diabetes. Is there anything I can do to prevent type 2 diabetes? Yes. Many studies, including the large Diabetes Prevention Program study, have proven that you can prevent diabetes by losing weight. Weight loss through healthy eating and more physical activity improves the way your body uses insulin and glucose. Learn how to eat healthier and get more physical activity. Is it safe for women with diabetes to get pregnant? Yes. If you have type 1 or type 2 diabetes, you can have a healthy pregnancy. If you have diabetes and you want to have a baby, you need to plan ahead, before you get pregnant. Talk to your doctor before you get pregnant. He or she can talk to you about steps you can take to keep your baby healthy. This may include a diabetes education program to help you better understand your diabetes and how to control it during pregnancy. Did we answer your question about diabetes? For more information about diabetes, call the OWH Helpline at 1-800-994-9662 or contact the following organizations: Sources ", "role": "user" }, { "content": "Diabetes (Is there anything I can do to prevent type 2 diabetes?): Yes. Many studies, including the large Diabetes Prevention Program study, have proven that you can prevent diabetes by losing weight. Weight loss through healthy eating and more physical activity improves the way your body uses insulin and glucose.", "role": "assistant" } ]

[ { "content": "how is epidural harmful\n\nEpidural block - pregnancy: An epidural block is a numbing medicine given by injection (shot) in the back. It numbs or causes a loss of feeling in the lower half your body. This lessens the pain of contractions during childbirth. An epidural block may also be used to reduce pain during surgery on the lower extremities. This article focuses on epidural blocks during childbirth. The block or shot is given into an area over your lower back or spine. - You may be asked to lie on your side, or you may sit up. - Either way, you will be asked to pull your stomach inwards and hunch your back outwards. Your health care provider will wash the area of your back and inject a little medicine to numb the spot where the epidural needle is placed: - The provider inserts a needle into your lower back. - The needle is placed into a small space outside your spinal cord. - A small soft tube (catheter) is placed into your back, next to your spine. - The needle is removed. The numbing medicine is given through the tube for as long as it is needed. In most cases, you will receive a low dose because it is safer for you and baby. Once the medicine takes effect (10 to 20 minutes), you should feel better. You may still feel some back or rectal pressure during contractions. You may shiver after an epidural, but this is common. Many women shiver during labor even without an epidural. Many studies have shown that an epidural is a safe way to manage pain during childbirth. While rare, there are some risks. Your blood pressure may drop for a short while. This might cause the baby's heart rate to slow down. - To avoid this, you will receive fluids through an intravenous (IV) line to help keep your blood pressure stable. - If your blood pressure shows a drop, you may need to lie on your side to keep the blood moving throughout your body. - Your provider may also give you medicine to raise your blood pressure. An epidural block may change or alter labor and delivery. - If you are very numb from the block, you may have a harder time bearing down to push your baby through the birth canal. - Contractions may lessen or slow down for a little while, but labor will still move along as it should. In some cases, it may even go faster. If your labor slows down, your doctor can give you medicine to speed up your contractions. It is best to wait until you are in active labor to have the epidural placed. Other rare side effects are: - You may get a headache after your epidural but this is rare. - Medicine could enter your spinal fluid. For a short while, it could make you feel dizzy, or you might have a hard time breathing. You could also have a seizure. This is also rare. There are 2 types: - \"Walking\" epidural block. This type of epidural will lessen your pain, but you will still be able to move your legs. Most women are not really able to walk around, but they can move their legs. - Combined spinal epidural block. This combines both a spinal and epidural block. It provides pain relief much faster. The combined block is used when women are in very active labor and want relief right away. Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.", "role": "user" }, { "content": "Many studies have shown that an epidural is a safe way to manage pain during childbirth. While rare, there are some risks. Your blood pressure may drop for a short while. This might cause the baby's heart rate to slow down. - To avoid this, you will receive fluids through an intravenous (IV) line to help keep your blood pressure stable. - If your blood pressure shows a drop, you may need to lie on your side to keep the blood moving throughout your body. - Your provider may also give you medicine to raise your blood pressure. An epidural block may change or alter labor and delivery. - If you are very numb from the block, you may have a harder time bearing down to push your baby through the birth canal. - Contractions may lessen or slow down for a little while, but labor will still move along as it should. In some cases, it may even go faster. If your labor slows down, your doctor can give you medicine to speed up your contractions. It is best to wait until you are in active labor to have the epidural placed. Other rare side effects are: - You may get a headache after your epidural but this is rare. - Medicine could enter your spinal fluid. For a short while, it could make you feel dizzy, or you might have a hard time breathing. You could also have a seizure. This is also rare.", "role": "assistant" } ]

[ { "content": "what does kidney disease look like\n\nChronic kidney disease: Chronic kidney disease, also called chronic kidney failure, describes the gradual loss of kidney function. Your kidneys filter wastes and excess fluids from your blood, which are then excreted in your urine. When chronic kidney disease reaches an advanced stage, dangerous levels of fluid, electrolytes and wastes can build up in your body. In the early stages of chronic kidney disease, you may have few signs or symptoms. Chronic kidney disease may not become apparent until your kidney function is significantly impaired. Treatment for chronic kidney disease focuses on slowing the progression of the kidney damage, usually by controlling the underlying cause. Chronic kidney disease can progress to end-stage kidney failure, which is fatal without artificial filtering (dialysis) or a kidney transplant. Chronic kidney disease care at Mayo Clinic Signs and symptoms of chronic kidney disease develop over time if kidney damage progresses slowly. Signs and symptoms of kidney disease may include: - Nausea - Vomiting - Loss of appetite - Fatigue and weakness - Sleep problems - Changes in how much you urinate - Decreased mental sharpness - Muscle twitches and cramps - Swelling of feet and ankles - Persistent itching - Chest pain, if fluid builds up around the lining of the heart - Shortness of breath, if fluid builds up in the lungs - High blood pressure (hypertension) that's difficult to control Signs and symptoms of kidney disease are often nonspecific, meaning they can also be caused by other illnesses. Because your kidneys are highly adaptable and able to compensate for lost function, signs and symptoms may not appear until irreversible damage has occurred. Make an appointment with your doctor if you have any signs or symptoms of kidney disease. If you have a medical condition that increases your risk of kidney disease, your doctor is likely to monitor your blood pressure and kidney function with urine and blood tests during regular office visits. Ask your doctor whether these tests are necessary for you. Chronic kidney disease occurs when a disease or condition impairs kidney function, causing kidney damage to worsen over several months or years. Diseases and conditions that cause chronic kidney disease include: - Type 1 or type 2 diabetes - High blood pressure - Glomerulonephritis (gloe-mer-u-low-nuh-FRY-tis), an inflammation of the kidney's filtering units (glomeruli) - Interstitial nephritis (in-tur-STISH-ul nuh-FRY-tis), an inflammation of the kidney's tubules and surrounding structures - Polycystic kidney disease - Prolonged obstruction of the urinary tract, from conditions such as enlarged prostate, kidney stones and some cancers - Vesicoureteral (ves-ih-koe-yoo-REE-tur-ul) reflux, a condition that causes urine to back up into your kidneys - Recurrent kidney infection, also called pyelonephritis (pie-uh-low-nuh-FRY-tis) Factors that may increase your risk of chronic kidney disease include: - Diabetes - High blood pressure - Heart and blood vessel (cardiovascular) disease - Smoking - Obesity - Being African-American, Native American or Asian-American - Family history of kidney disease - Abnormal kidney structure - Older age Chronic kidney disease can affect almost every part of your body. Potential complications may include: - Fluid retention, which could lead to swelling in your arms and legs, high blood pressure, or fluid in your lungs (pulmonary edema) - A sudden rise in potassium levels in your blood (hyperkalemia), which could impair your heart's ability to function and may be life-threatening - Heart and blood vessel (cardiovascular) disease - Weak bones and an increased risk of bone fractures - Anemia - Decreased sex drive, erectile dysfunction or reduced fertility - Damage to your central nervous system, which can cause difficulty concentrating, personality changes or seizures - Decreased immune response, which makes you more vulnerable to infection - Pericarditis, an inflammation of the saclike membrane that envelops your heart (pericardium) - Pregnancy complications that carry risks for the mother and the developing fetus - Irreversible damage to your kidneys (end-stage kidney disease), eventually requiring either dialysis or a kidney transplant for survival As a first step toward diagnosis of kidney disease, your doctor discusses your personal and family history with you. Among other things, your doctor might ask questions about whether you've been diagnosed with high blood pressure, if you've taken a medication that might affect kidney function, if you've noticed changes in your urinary habits, and whether you have any family members who have kidney disease. Next, your doctor performs a physical exam, also checking for signs of problems with your heart or blood vessels, and conducts a neurological exam. For kidney disease diagnosis, you may also need certain tests and procedures, such as: - Blood tests. Kidney function tests look for the level of waste products, such as creatinine and urea, in your blood. - Urine tests. Analyzing a sample of your urine may reveal abnormalities that point to chronic kidney failure and help identify the cause of chronic kidney disease. - Imaging tests. Your doctor may use ultrasound to assess your kidneys' structure and size. Other imaging tests may be used in some cases. - Removing a sample of kidney tissue for testing. Your doctor may recommend a kidney biopsy to remove a sample of kidney tissue. Kidney biopsy is often done with local anesthesia using a long, thin needle that's inserted through your skin and into your kidney. The biopsy sample is sent to a lab for testing to help determine what's causing your kidney problem. Depending on the underlying cause, some types of kidney disease can be treated. Often, though, chronic kidney disease has no cure. Treatment usually consists of measures to help control signs and symptoms, reduce complications, and slow progression of the disease. If your kidneys become severely damaged, you may need treatment for end-stage kidney disease. Treating the cause Your doctor will work to slow or control the cause of your kidney disease. Treatment options vary, depending on the cause. But kidney damage can continue to worsen even when an underlying condition, such as high blood pressure, has been controlled. Treating complications Kidney disease complications can be controlled to make you more comfortable. Treatments may include: - High blood pressure medications. People with kidney disease may experience worsening high blood pressure. Your doctor may recommend medications to lower your blood pressure - commonly angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers - and to preserve kidney function. High blood pressure medications can initially decrease kidney function and change electrolyte levels, so you may need frequent blood tests to monitor your condition. Your doctor will likely also recommend a water pill (diuretic) and a low-salt diet. - Medications to lower cholesterol levels. Your doctor may recommend medications called statins to lower your cholesterol. People with chronic kidney disease often experience high levels of bad cholesterol, which can increase the risk of heart disease. - Medications to treat anemia. In certain situations, your doctor may recommend supplements of the hormone erythropoietin (uh-rith-roe-POI-uh-tin), sometimes with added iron. Erythropoietin supplements aid in production of more red blood cells, which may relieve fatigue and weakness associated with anemia. - Medications to relieve swelling. People with chronic kidney disease may retain fluids. This can lead to swelling in the legs, as well as high blood pressure. Medications called diuretics can help maintain the balance of fluids in your body. - Medications to protect your bones. Your doctor may prescribe calcium and vitamin D supplements to prevent weak bones and lower your risk of fracture. You may also take medication known as a phosphate binder to lower the amount of phosphate in your blood, and protect your blood vessels from damage by calcium deposits (calcification). - A lower protein diet to minimize waste products in your blood. As your body processes protein from foods, it creates waste products that your kidneys must filter from your blood. To reduce the amount of work your kidneys must do, your doctor may recommend eating less protein. Your doctor may also ask you to meet with a dietitian who can suggest ways to lower your protein intake while still eating a healthy diet. Your doctor may recommend follow-up testing at regular intervals to see whether your kidney disease remains stable or progresses. Treatment for end-stage kidney disease If your kidneys can't keep up with waste and fluid clearance on their own and you develop complete or near-complete kidney failure, you have end-stage kidney disease. At that point, you need dialysis or a kidney transplant. - Dialysis. Dialysis artificially removes waste products and extra fluid from your blood when your kidneys can no longer do this. In hemodialysis, a machine filters waste and excess fluids from your blood. In peritoneal dialysis, a thin tube (catheter) inserted into your abdomen fills your abdominal cavity with a dialysis solution that absorbs waste and excess fluids. After a period of time, the dialysis solution drains from your body, carrying the waste with it. - Kidney transplant. A kidney transplant involves surgically placing a healthy kidney from a donor into your body. Transplanted kidneys can come from deceased or living donors. You'll need to take medications for the rest of your life to keep your body from rejecting the new organ. You don't need to be on dialysis to have a kidney transplant. For some who choose not to have dialysis or a kidney transplant, a third option is to treat kidney failure with conservative measures. However, once you have complete kidney failure, your life expectancy generally would be only a few months. Potential future treatments Regenerative medicine holds the potential to fully heal damaged tissues and organs, offering solutions and hope for people who have conditions that today are beyond repair. Regenerative medicine approaches include: - Boosting the body's natural ability to heal itself - Using healthy cells, tissues or organs from a living or deceased donor to replace damaged ones - Delivering specific types of cells or cell products to diseased tissues or organs to restore tissue and organ function For people with chronic kidney disease, regenerative medicine approaches may be developed in the future to help slow progression of the disease. As part of your treatment for chronic kidney disease, your doctor may recommend a special diet to help support your kidneys and limit the work they must do. Ask your doctor for a referral to a dietitian who can analyze your current diet and suggest ways to make your diet easier on your kidneys. Depending on your situation, kidney function and overall health, your dietitian may recommend that you: - Avoid products with added salt. Lower the amount of sodium you eat each day by avoiding products with added salt, including many convenience foods, such as frozen dinners, canned soups and fast foods. Other foods with added salt include salty snack foods, canned vegetables, and processed meats and cheeses. - Choose lower potassium foods. Your dietitian may recommend that you choose lower potassium foods at each meal. High-potassium foods include bananas, oranges, potatoes, spinach and tomatoes. Examples of low-potassium foods include apples, cabbage, carrots, green beans, grapes and strawberries. Be aware that many salt substitutes contain potassium, so you generally should avoid them if you have kidney failure. - Limit the amount of protein you eat. Your dietitian will estimate the appropriate number of grams of protein you need each day and make recommendations based on that amount. High-protein foods include lean meats, eggs, milk, cheese and beans. Low-protein foods include vegetables, fruits, breads and cereals.", "role": "user" }, { "content": "Signs and symptoms of kidney disease may include nausea, vomiting, loss of appetite, fatigue and weakness, sleep problems, changes in how much you urinate, decreased mental sharpness, muscle twitches and cramps, swelling of feet and ankles, persistent itching, chest pain, shortness of breath, or high blood pressure. Signs and symptoms of kidney disease are often nonspecific, meaning they can also be caused by other illnesses. Because your kidneys are highly adaptable and able to compensate for lost function, signs and symptoms may not appear until irreversible damage has occurred. Make an appointment with your doctor if you have any signs or symptoms of kidney disease.", "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": "Trisomy 18 (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. 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", "role": "assistant" } ]

[ { "content": "what treatment do you use to cure chickenpox\n\n Chickenpox Overview Chickenpox (varicella) is a viral infection that causes an itchy rash with small, fluid-filled blisters. Chickenpox is highly contagious to people who haven't had the disease or been vaccinated against it. Before routine chickenpox vaccination, virtually all people had been infected by the time they reached adulthood, sometimes with serious complications. Today, the number of cases and hospitalizations is down dramatically. For most people, chickenpox is a mild disease. Still, it's better to get vaccinated. The chickenpox vaccine is a safe, effective way to prevent chickenpox and its possible complications. Symptoms Chickenpox infection appears 10 to 21 days after exposure to the virus and usually lasts about five to 10 days. The rash is the telltale indication of chickenpox. Other signs and symptoms, which may appear one to two days before the rash, include: - Fever - Loss of appetite - Headache - Tiredness and a general feeling of being unwell (malaise) Once the chickenpox rash appears, it goes through three phases: - Raised pink or red bumps (papules), which break out over several days - Small fluid-filled blisters (vesicles), forming from the raised bumps over about one day before breaking and leaking - Crusts and scabs, which cover the broken blisters and take several more days to heal New bumps continue to appear for several days. As a result, you may have all three stages of the rash - bumps, blisters and scabbed lesions - at the same time on the second day of the rash. Once infected, you can spread the virus for up to 48 hours before the rash appears, and you remain contagious until all spots crust over. The disease is generally mild in healthy children. In severe cases, the rash can spread to cover the entire body, and lesions may form in the throat, eyes and mucous membranes of the urethra, anus and vagina. New spots continue to appear for several days. When to see a doctor If you suspect that you or your child has chickenpox, consult your doctor. He or she usually can diagnose chickenpox by examining the rash and by noting the presence of accompanying symptoms. Your doctor can also prescribe medications to lessen the severity of chickenpox and treat complications, if necessary. Be sure to call ahead for an appointment and mention you think you or your child has chickenpox, to avoid waiting and possibly infecting others in a waiting room. Also, be sure to let your doctor know if any of these complications occur: - The rash spreads to one or both eyes. - The rash gets very red, warm or tender, indicating a possible secondary bacterial skin infection. - The rash is accompanied by dizziness, disorientation, rapid heartbeat, shortness of breath, tremors, loss of muscle coordination, worsening cough, vomiting, stiff neck or a fever higher than 102 F (38.9 C). - Anyone in the household is immune deficient or younger than 6 months old. Risk factors Chickenpox, which is caused by the varicella-zoster virus, is highly contagious, and it can spread quickly. The virus is transmitted by direct contact with the rash or by droplets dispersed into the air by coughing or sneezing. Your risk of catching chickenpox is higher if you: - Haven't had chickenpox - Haven't been vaccinated for chickenpox - Work in or attend a school or child care facility - Live with children Most people who have had chickenpox or have been vaccinated against chickenpox are immune to chickenpox. If you've been vaccinated and still get chickenpox, symptoms are often milder, with fewer blisters and mild or no fever. A few people can get chickenpox more than once, but this is rare. Complications Chickenpox is normally a mild disease. But it can be serious and can lead to complications or death, especially in high-risk people. Complications include: - Bacterial infections of the skin, soft tissues, bones, joints or bloodstream (sepsis) - Dehydration - Pneumonia - Inflammation of the brain (encephalitis) - Toxic shock syndrome - Reye's syndrome for people who take aspirin during chickenpox Who's at risk? Those at high risk of having complications from chickenpox include: - Newborns and infants whose mothers never had chickenpox or the vaccine - Adults - Pregnant women who haven't had chickenpox - People whose immune systems are impaired by medication, such as chemotherapy, or another disease, such as cancer or HIV - People who are taking steroid medications for another disease or condition, such as children with asthma - People taking drugs that suppress their immune systems Chickenpox and pregnancy Other complications of chickenpox affect pregnant women. Chickenpox early in pregnancy can result in a variety of problems in a newborn, including low birth weight and birth defects, such as limb abnormalities. A greater threat to a baby occurs when the mother develops chickenpox in the week before birth or within a couple of days after giving birth. Then it can cause a serious, life-threatening infection in a newborn. If you're pregnant and not immune to chickenpox, talk to your doctor about the risks to you and your unborn child. Chickenpox and shingles If you've had chickenpox, you're at risk of another disease caused by the varicella-zoster virus called shingles. After a chickenpox infection, some of the varicella-zoster virus may remain in your nerve cells. Many years later, the virus can reactivate and resurface as shingles - a painful band of short-lived blisters. The virus is more likely to reappear in older adults and people with weakened immune systems. Shingles can lead to its own complication - a condition in which the pain of shingles persists long after the blisters disappear. This complication, called postherpetic neuralgia, can be severe. A shingles vaccine (Zostavax) is available and is recommended for adults age 60 and older who have had chickenpox. Diagnosis Doctors generally diagnose chickenpox based on the telltale rash. If there's any doubt about the diagnosis, chickenpox can be confirmed with laboratory tests, including blood tests or a culture of lesion samples. Treatment In otherwise healthy children, chickenpox typically requires no medical treatment. Your doctor may prescribe an antihistamine to relieve itching. But for the most part, the disease is allowed to run its course. If you're at high risk of complications For people who have a high risk of complications from chickenpox, doctors sometimes prescribe medications to shorten the duration of the infection and to help reduce the risk of complications. If you or your child falls into a high-risk group, your doctor may suggest an antiviral drug such as acyclovir (Zovirax) or another drug called immune globulin intravenous (Privigen). These medications may lessen the severity of the disease when given within 24 hours after the rash first appears. Other antiviral drugs, such as valacyclovir (Valtrex) and famciclovir (Famvir), also may lessen the severity of the disease, but may not be approved or appropriate for all cases. In some instances, your doctor may recommend getting the chickenpox vaccine after exposure to the virus. This can prevent the disease or lessen its severity. Don't give anyone with chickenpox - child or adult - any medicine containing aspirin because this combination has been associated with a condition called Reye's syndrome. Treating complications If complications do develop, your doctor will determine the appropriate treatment. Treatment for skin infections and pneumonia may be with antibiotics. Treatment for encephalitis is usually with antiviral drugs. Hospitalization may be necessary. Lifestyle and home remedies To help ease the symptoms of an uncomplicated case of chickenpox, follow these self-care measures. Don't scratch Scratching can cause scarring, slow healing and increase the risk that the sores will become infected. If your child can't stop scratching: - Put gloves on his or her hands, especially at night - Trim his or her fingernails Relieve the itch and other symptoms The chickenpox rash can be very itchy, and broken vesicles sometimes sting. These discomforts, along with fever, headache and fatigue, can make anyone miserable. For relief, try: - A cool bath with added baking soda, uncooked oatmeal or colloidal oatmeal - a finely ground oatmeal that is made for soaking. - Calamine lotion dabbed on the spots. - A soft, bland diet if chickenpox sores develop in the mouth. - Antihistamines such as diphenhydramine (Benadryl, others) for itching. Check with your doctor to make sure your child can safely take antihistamines. - Acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, Children's Motrin, others) for a mild fever. Don't give aspirin to anyone with chickenpox because it can lead to a serious condition called Reye's syndrome. And don't treat a high fever without consulting your doctor. ", "role": "user" }, { "content": "The following self-care measures may help ease the symptoms of an uncomplicated case of chickenpox: avoid scratching that can cause scarring, slow healing and increase the risk of infecting the sores. Children need their fingernails trimmed, and they might need gloves on their hands, especially at night. To relieve the itch and other symptoms, try a cool bath with added baking soda, uncooked oatmeal or finely ground oatmeal; calamine lotion dabbed on the spots; a soft, bland diet if chickenpox sores develop in the mouth; antihistamines such as diphenhydramine (Benadryl, others) for itching, if your child can safely take antihistamines. Acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, Children's Motrin, others) for a mild fever.", "role": "assistant" } ]

[ { "content": "could tetanus be a cause of death?\n\nTetanus (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.", "role": "user" }, { "content": "Complications of tetanus infection may include death due to respiratory failure, cardiac arrest or pneumonia.", "role": "assistant" } ]

[ { "content": "what is epilepsy\n\n Progressive myoclonic epilepsy Familial progressive myoclonic epilepsy Summary Progressive myoclonus epilepsy (PME) refers to a group of inherited conditions involving the central nervous system and representing more than a dozen different diseases. These diseases share certain features, including a worsening of symptoms over time and the presence of both muscle contractions ( myoclonus) and seizures ( epilepsy). PME is different from myoclonic epilepsy. [1] Other features include dementia , dystonia , and trouble walking or speaking. These rare disorders often get worse over time and sometimes are fatal. Many of these PME diseases begin in childhood or adolescence. [2] ", "role": "user" }, { "content": "Epilepsy seizures and muscle contractions are present in a group of rare hereditary disorders called Progressive myoclonus epilepsy (PME.) Many PME diseases begin in childhood or adolescence, get worse over time and sometimes are fatal.", "role": "assistant" } ]

[ { "content": "what is acute diverticulitis\n\nDiverticulitis (Diagnosis): Diverticulitis is usually diagnosed during an acute attack. Because abdominal pain can indicate a number of problems, your doctor will need to rule out other causes for your symptoms. Your doctor will likely start with a physical examination, including checking your abdomen for tenderness. Women, in addition, generally have a pelvic examination to rule out pelvic disease. After that, your doctor will likely recommend: - Blood and urine tests, to check for signs of infection. - Pregnancy test for women of childbearing age, to rule out pregnancy as a cause of abdominal pain. - Liver function tests, to rule out other causes of abdominal pain. - Stool test, to rule out infection in people who have diarrhea. - CT scan, which can indicate inflamed or infected pouches and confirm a diagnosis of diverticulitis. CT can also indicate the severity of diverticulitis and guide treatment. Diagnosis at Mayo Clinic Diverticulitis can be difficult to diagnose because abdominal pain is a symptom of many digestive disorders. Mayo Clinic has radiologists who specialize in digestive disorders and have experience distinguishing diverticulitis from other conditions. Mayo's digestive disease specialists (gastroenterologists) have experience diagnosing the severity of diverticulitis. Precise diagnosis is important for appropriate treatment.", "role": "user" }, { "content": "Diverticulitis is usually diagnosed during an acute attack. Because abdominal pain can indicate a number of problems, your doctor will need to rule out other causes for your symptoms. Your doctor will likely start with a physical examination, including checking your abdomen for tenderness, and for women, a pelvic examination as well.", "role": "assistant" } ]

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

[ { "content": "Cushing, fybromyaglia, Chronic fatigue my main concern is no treatment and the musclar distrophy effecting my heart, legs feet, shoulders, arms, etc.\n\n Fibromyalgia Overview Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals. Symptoms sometimes begin after a physical trauma, surgery, infection or significant psychological stress. In other cases, symptoms gradually accumulate over time with no single triggering event. Women are more likely to develop fibromyalgia than are men. Many people who have fibromyalgia also have tension headaches, temporomandibular joint (TMJ) disorders, irritable bowel syndrome, anxiety and depression. While there is no cure for fibromyalgia, a variety of medications can help control symptoms. Exercise, relaxation and stress-reduction measures also may help. Symptoms Symptoms of fibromyalgia include: - Widespread pain. The pain associated with fibromyalgia often is described as a constant dull ache that has lasted for at least three months. To be considered widespread, the pain must occur on both sides of your body and above and below your waist. - Fatigue. People with fibromyalgia often awaken tired, even though they report sleeping for long periods of time. Sleep is often disrupted by pain, and many patients with fibromyalgia have other sleep disorders, such as restless legs syndrome and sleep apnea. - Cognitive difficulties. A symptom commonly referred to as \"fibro fog\" impairs the ability to focus, pay attention and concentrate on mental tasks. Fibromyalgia often co-exists with other painful conditions, such as: - Irritable bowel syndrome - Migraine and other types of headaches - Interstitial cystitis or painful bladder syndrome - Temporomandibular joint disorders Causes Doctors don't know what causes fibromyalgia, but it most likely involves a variety of factors working together. These may include: - Genetics. Because fibromyalgia tends to run in families, there may be certain genetic mutations that may make you more susceptible to developing the disorder. - Infections. Some illnesses appear to trigger or aggravate fibromyalgia. - Physical or emotional trauma. Fibromyalgia can sometimes be triggered by a physical trauma, such as a car accident. Psychological stress may also trigger the condition. Why does it hurt? Researchers believe repeated nerve stimulation causes the brains of people with fibromyalgia to change. This change involves an abnormal increase in levels of certain chemicals in the brain that signal pain (neurotransmitters). In addition, the brain's pain receptors seem to develop a sort of memory of the pain and become more sensitive, meaning they can overreact to pain signals. Risk factors Risk factors for fibromyalgia include: - Your sex. Fibromyalgia is diagnosed more often in women than in men. - Family history. You may be more likely to develop fibromyalgia if a relative also has the condition. - Other disorders. If you have osteoarthritis, rheumatoid arthritis or lupus, you may be more likely to develop fibromyalgia. Diagnosis In the past, doctors would check 18 specific points on a person's body to see how many of them were painful when pressed firmly. Newer guidelines don't require a tender point exam. Instead, a fibromyalgia diagnosis can be made if a person has had widespread pain for more than three months - with no underlying medical condition that could cause the pain. Blood tests While there is no lab test to confirm a diagnosis of fibromyalgia, your doctor may want to rule out other conditions that may have similar symptoms. Blood tests may include: - Complete blood count - Erythrocyte sedimentation rate - Cyclic citrullinated peptide test - Rheumatoid factor - Thyroid function tests Treatment In general, treatments for fibromyalgia include both medication and self-care. The emphasis is on minimizing symptoms and improving general health. No one treatment works for all symptoms. Medications Medications can help reduce the pain of fibromyalgia and improve sleep. Common choices include: - Pain relievers. Over-the-counter pain relievers such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve, others) may be helpful. Your doctor might suggest a prescription pain reliever such as tramadol (Ultram). Narcotics are not advised, because they can lead to dependence and may even worsen the pain over time. - Antidepressants. Duloxetine (Cymbalta) and milnacipran (Savella) may help ease the pain and fatigue associated with fibromyalgia. Your doctor may prescribe amitriptyline or the muscle relaxant cyclobenzaprine to help promote sleep. - Anti-seizure drugs. Medications designed to treat epilepsy are often useful in reducing certain types of pain. Gabapentin (Neurontin) is sometimes helpful in reducing fibromyalgia symptoms, while pregabalin (Lyrica) was the first drug approved by the Food and Drug Administration to treat fibromyalgia. Therapy A variety of different therapies can help reduce the effect that fibromyalgia has on your body and your life. Examples include: - Physical therapy. A physical therapist can teach you exercises that will improve your strength, flexibility and stamina. Water-based exercises might be particularly helpful. - Occupational therapy. An occupational therapist can help you make adjustments to your work area or the way you perform certain tasks that will cause less stress on your body. - Counseling. Talking with a counselor can help strengthen your belief in your abilities and teach you strategies for dealing with stressful situations. Lifestyle and home remedies Self-care is critical in the management of fibromyalgia. - Reduce stress. Develop a plan to avoid or limit overexertion and emotional stress. Allow yourself time each day to relax. That may mean learning how to say no without guilt. But try not to change your routine completely. People who quit work or drop all activity tend to do worse than do those who remain active. Try stress management techniques, such as deep-breathing exercises or meditation. - Get enough sleep. Because fatigue is one of the main characteristics of fibromyalgia, getting sufficient sleep is essential. In addition to allotting enough time for sleep, practice good sleep habits, such as going to bed and getting up at the same time each day and limiting daytime napping. - Exercise regularly. At first, exercise may increase your pain. But doing it gradually and regularly often decreases symptoms. Appropriate exercises may include walking, swimming, biking and water aerobics. A physical therapist can help you develop a home exercise program. Stretching, good posture and relaxation exercises also are helpful. - Pace yourself. Keep your activity on an even level. If you do too much on your good days, you may have more bad days. Moderation means not overdoing it on your good days, but likewise it means not self-limiting or doing too little on the days when symptoms flare. - Maintain a healthy lifestyle. Eat healthy foods. Limit your caffeine intake. Do something that you find enjoyable and fulfilling every day. Alternative medicine Complementary and alternative therapies for pain and stress management aren't new. Some, such as meditation and yoga, have been practiced for thousands of years. But their use has become more popular in recent years, especially with people who have chronic illnesses, such as fibromyalgia. Several of these treatments do appear to safely relieve stress and reduce pain, and some are gaining acceptance in mainstream medicine. But many practices remain unproved because they haven't been adequately studied. - Acupuncture. Acupuncture is a Chinese medical system based on restoring normal balance of life forces by inserting very fine needles through the skin to various depths. According to Western theories of acupuncture, the needles cause changes in blood flow and levels of neurotransmitters in the brain and spinal cord. Some studies indicate that acupuncture helps relieve fibromyalgia symptoms, while others show no benefit. - Massage therapy. This is one of the oldest methods of health care still in practice. It involves use of different manipulative techniques to move your body's muscles and soft tissues. Massage can reduce your heart rate, relax your muscles, improve range of motion in your joints and increase production of your body's natural painkillers. It often helps relieve stress and anxiety. - Yoga and tai chi. These practices combine meditation, slow movements, deep breathing and relaxation. Both have been found to be helpful in controlling fibromyalgia symptoms. ", "role": "user" }, { "content": "Treatments for fibromyalgia include medications and self-care to minimize symptoms and improve general health. Medications can help reduce the pain of fibromyalgia and improve sleep. Common choices are over-the-counter pain relievers such as acetaminophen or ibuprofen. Your doctor might suggest a prescription pain reliever or anti-seizure drugs to reduce pain, antidepressants that may help with the pain and fatigue, muscle relaxants to help with sleep. Different therapies can help reduce the effect that fibromyalgia has on your body and your life. A physical therapist can teach you exercises that will improve your strength, flexibility and stamina. An occupational therapist can help you make adjustments to your work area or the way you perform certain tasks that will cause less stress on your body. Talking with a counselor can help strengthen your belief in your abilities and teach you strategies for dealing with stressful situations.", "role": "assistant" } ]

[ { "content": "abetalipoproteimemia hi, I would like to know if there is any support for those suffering with abetalipoproteinemia? I am not diagnosed but have had many test that indicate I am suffering with this, keen to learn how to get it diagnosed and how to manage, many thanks\n\n Abetalipoproteinemia abetalipoproteinaemia abetalipoproteinemia neuropathy ABL acanthocytosis apolipoprotein B deficiency Bassen-Kornzweig disease Bassen-Kornzweig syndrome betalipoprotein deficiency disease congenital betalipoprotein deficiency syndrome microsomal triglyceride transfer protein deficiency disease MTP deficiency Description Abetalipoproteinemia is an inherited disorder that impairs the normal absorption of fats and certain vitamins from the diet. Many of the signs and symptoms of abetalipoproteinemia result from a severe shortage (deficiency) of fat-soluble vitamins (vitamins A, E, and K). The signs and symptoms of this condition primarily affect the gastrointestinal system, eyes, nervous system, and blood. The first signs and symptoms of abetalipoproteinemia appear in infancy. They often include failure to gain weight and grow at the expected rate (failure to thrive); diarrhea; and fatty, foul-smelling stools (steatorrhea). As an individual with this condition ages, additional signs and symptoms include disturbances in nerve function that may lead to poor muscle coordination and difficulty with balance and movement (ataxia). They can also experience a loss of certain reflexes, impaired speech (dysarthria), tremors or other involuntary movements (motor tics), a loss of sensation in the extremities (peripheral neuropathy), or muscle weakness. The muscle problems can disrupt skeletal development, leading to an abnormally curved lower back (lordosis), a rounded upper back that also curves to the side (kyphoscoliosis), high-arched feet (pes cavus), or an inward- and upward-turning foot (clubfoot). Individuals with this condition may also develop an eye disorder called retinitis pigmentosa, in which breakdown of the light-sensitive layer (retina) at the back of the eye can cause vision loss. In individuals with abetalipoproteinemia, the retinitis pigmentosa can result in complete vision loss. People with abetalipoproteinemia may also have other eye problems, including involuntary eye movements (nystagmus), eyes that do not look in the same direction (strabismus), and weakness of the external muscles of the eye (ophthalmoplegia). Individuals with abetalipoproteinemia usually have a low number of red blood cells (anemia) with abnormally star-shaped red blood cells (acanthocytosis) and have difficulty forming blood clots, which can cause abnormal bleeding. In some cases, a condition called fatty liver develops, which can cause liver damage. Frequency Abetalipoproteinemia is a rare disorder. More than 100 cases have been described worldwide. Causes Abetalipoproteinemia is caused by mutations in the MTTP gene, which provides instructions for making a protein called microsomal triglyceride transfer protein. This protein is essential for creating molecules called beta-lipoproteins in the liver and intestine. Beta-lipoproteins transport fats, cholesterol, and fat-soluble vitamins from the intestine to the bloodstream so these nutrients can be taken up by tissues throughout the body. Sufficient levels of fats, cholesterol, and vitamins are necessary for normal growth, development, and maintenance of the body's cells and tissues. Most MTTP gene mutations lead to the production of microsomal triglyceride transfer protein with reduced or absent function and unable to help in the formation of beta-lipoproteins. A lack of beta-lipoproteins causes severely reduced absorption (malabsorption) of dietary fats and fat-soluble vitamins from the digestive tract into the bloodstream. These nutritional deficiencies lead to health problems in people with abetalipoproteinemia. Inheritance Pattern This condition is inherited in an autosomal recessive pattern, which means both copies of the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition. Sources for This Page Hooper AJ, van Bockxmeer FM, Burnett JR. Monogenic hypocholesterolaemic lipid disorders and apolipoprotein B metabolism. Crit Rev Clin Lab Sci. 2005;42(5-6):515-45. Review. ", "role": "user" }, { "content": "People with abetalipoproteinemia are not able to make beta-lipoproteins and therefore have difficulties absorbing dietary fats and fat-soluble vitamins (vitamins A, D, E, and K) from the digestive tract into the bloodstream. Their condition is treated with sufficient levels of fats, cholesterol, and vitamins, which are necessary for normal growth, development, and maintenance of the body's cells and tissues, particularly nerve cells and tissues in the eye.", "role": "assistant" } ]

[ { "content": "what does kidney disease look like\n\n Diabetic Kidney Disease What is diabetic kidney disease? Diabetic kidney disease is a type of kidney disease caused by diabetes.Diabetes is the leading cause of kidney disease. About 1 out of 4 adults with diabetes has kidney disease.1The main job of the kidneys is to filter wastes and extra water out of your blood to make urine. Your kidneys also help control blood pressure and make hormones that your body needs to stay healthy.Your kidneys are located in the middle of your back, just below your rib cage.When your kidneys are damaged, they can’t filter blood like they should, which can cause wastes to build up in your body. Kidney damage can also cause other health problems.Kidney damage caused by diabetes usually occurs slowly, over many years. You can take steps to protect your kidneys and to prevent or delay kidney damage.Watch a video about Diabetes and Kidney Disease.What are other names for diabetic kidney disease?Diabetic kidney disease is also called DKD, chronic kidney disease, CKD, kidney disease of diabetes, or diabetic nephropathy. How does diabetes cause kidney disease? High blood glucose, also called blood sugar, can damage the blood vessels in your kidneys. When the blood vessels are damaged, they don’t work as well. Many people with diabetes also develop high blood pressure, which can also damage your kidneys. Learn more about high blood pressure and kidney disease. What increases my chances of developing diabetic kidney disease? Having diabetes for a longer time increases the chances that you will have kidney damage. If you have diabetes, you are more likely to develop kidney disease if yourblood glucose is too high blood pressure is too highAfrican Americans, American Indians, and Hispanics/Latinos develop diabetes, kidney disease, and kidney failure at a higher rate than Caucasians.You are also more likely to develop kidney disease if you have diabetes andsmoke don’t follow your diabetes eating plan eat foods high in salt are not active are overweight have heart disease have a family history of kidney failureIf you have diabetes, you are more likely to develop kidney disease if you have high blood pressure. How can I tell if I have diabetic kidney disease? Most people with diabetic kidney disease do not have symptoms. The only way to know if you have diabetic kidney disease is to get your kidneys checked.Health care professionals use blood and urine tests to check for diabetic kidney disease. Your health care professional will check your urine for albumin and will also do a blood test to see how well your kidneys are filtering your blood.You should get tested every year for kidney disease if youhave type 2 diabetes have had type 1 diabetes for more than 5 yearsHealth care professionals use blood and urine tests to check for kidney disease. How can I keep my kidneys healthy if I have diabetes? The best way to slow or prevent diabetes-related kidney disease is to try to reach your blood glucose and blood pressure goals. Healthy lifestyle habits and taking your medicines as prescribed can help you achieve these goals and improve your health overall.Reach your blood glucose goalsYour health care professional will test your A1C. The A1C is a blood test that shows your average blood glucose level over the past 3 months. This is different from the blood glucose checks that you may do yourself. The higher your A1C number, the higher your blood glucose levels have been during the past 3 months.The A1C goal for many people with diabetes is below 7 percent. Ask your health care team what your goal should be. Reaching your goal numbers will help you protect your kidneys.To reach your A1C goal, your health care professional may ask you to check your blood glucose levels. Work with your health care team to use the results to guide decisions about food, physical activity, and medicines. Ask your health care team how often you should check your blood glucose level.Protect your kidneys by keeping your blood glucose under control.Control your blood pressureBlood pressure is the force of your blood against the wall of your blood vessels. High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease.Your health care team will also work with you to help you set and reach your blood pressure goal. The blood pressure goal for most people with diabetes is below 140/90 mm Hg. Ask your health care team what your goal should be.Protect your kidneys by keeping your blood pressure under control.Medicines that lower blood pressure can also help slow kidney damage. Two types of blood pressure medicines, ACE inhibitors and ARBs, play a special role in protecting your kidneys. Each has been found to slow kidney damage in people with diabetes who have high blood pressure and DKD. The names of these medicines end in –pril or –sartan. ACE inhibitors and ARBs are not safe for women who are pregnant.Develop or maintain healthy lifestyle habitsHealthy lifestyle habits can help you reach your blood glucose and blood pressure goals. Following the steps below will also help you keep your kidneys healthy:Stop smoking. Work with a dietitian to develop a diabetes meal plan and limit salt and sodium. Make physical activity part of your routine. Stay at or get to a healthy weight. Get enough sleep. Aim for 7 to 8 hours of sleep each night.Learn more about these tips to manage diabetes.Take medicines as prescribedMedicines may be an important part of your treatment plan. Your health care professional will prescribe medicine based on your specific needs. Medicine can help you meet your blood glucose and blood pressure goals. You may need to take more than one kind of medicine to control your blood pressure.Talk to your health care professional or pharmacist about all of the medicines you take, including over-the-counter medicines. How can I cope with the stress of managing my diabetes? Managing diabetes isn’t always easy. Feeling stressed, sad, or angry is common when you are living with diabetes. You may know what to do to stay healthy but may have trouble sticking with your plan over time. Long-term stress can raise your blood glucose and blood pressure, but you can learn ways to lower your stress. Try deep breathing, gardening, taking a walk, doing yoga, meditating, doing a hobby, or listening to your favorite music. Learn more about healthy ways to cope with stress. Does diabetic kidney disease get worse over time? Kidney damage from diabetes can get worse over time. However, you can take steps to keep your kidneys healthy and help slow kidney damage to prevent or delay kidney failure. Kidney failure means that your kidneys have lost most of their ability to function—less than 15 percent of normal kidney function. However, most people with diabetes and kidney disease don’t end up with kidney failure.If your kidneys become damaged as a result of diabetes, learn how to manage kidney disease. Diabetic Kidney Disease [1] Afkarian M, Zelnick LR, Hall YN, et.al. Clinical manifestations of kidney disease among US adults with diabetes. Journal of the American Medical Association. 2016;316(6):602–610. ", "role": "user" }, { "content": "Diabetic kidney disease is a type of kidney disease caused by diabetes. Diabetes is the leading cause of kidney disease. About 1 out of 4 adults with diabetes has kidney disease. Kidney damage caused by diabetes usually occurs slowly, over many years.", "role": "assistant" } ]

[ { "content": "Is it necessary to go to the dr. when getting a skull fracture?\n\n Skull fracture Basilar skull fracture Depressed skull fracture Linear skull fracture Summary A skull fracture is a fracture or break in the cranial (skull) bones. Considerations Skull fractures may occur with head injuries. The skull provides good protection for the brain. However, a severe impact or blow can cause the skull to break. It may be accompanied by concussion or other injury to the brain. The brain can be affected directly by damage to the nervous system tissue and bleeding. The brain can also be affected by bleeding under the skull. This can compress the underlying brain tissue (subdural or epidural hematoma). A simple fracture is a break in the bone without damage to the skin. A linear skull fracture is a break in a cranial bone resembling a thin line, without splintering, depression, or distortion of bone. A depressed skull fracture is a break in a cranial bone (or \"crushed\" portion of skull) with depression of the bone in toward the brain. A compound fracture involves a break in, or loss of, skin and splintering of the bone. Causes Causes of skull fracture can include: Head trauma Falls, automobile accidents, physical assault, and sports Symptoms Symptoms may include: Bleeding from wound, ears, nose, or around eyes Bruising behind the ears or under the eyes Changes in pupils (sizes unequal, not reactive to light) Confusion Convulsions Difficulties with balance Drainage of clear or bloody fluid from ears or nose Drowsiness Headache Loss of consciousness Nausea and vomiting Restlessness, irritability Slurred speech Stiff neck Swelling Visual disturbances In some cases, the only symptom may be a bump on the head. A bump or bruise may take up to 24 hours to develop. First Aid Take the following steps if you think someone has a skull fracture: <li>Check the airways, breathing, and circulation. If necessary, begin rescue breathing and CPR.</li> <li>Avoid moving the person (unless absolutely necessary) until medical help arrives. Have someone to call 911 (or the local emergency number) for medical assistance.</li> <li>If the person must be moved, take care to stabilize the head and neck. Place your hands on both sides of the head and under the shoulders. Do not allow the head to bend forward or backward, or to twist or turn.</li> <li>Carefully check the site of injury, but do not probe in or around the site with a foreign object. It can be hard to know if the skull is fractured or depressed (dented in) at the site of injury.</li> <li>If there is bleeding, apply firm pressure with a clean cloth over a broad area to control blood loss.</li> <li>If blood soaks through, do not remove the original cloth. Instead, apply more cloths on top, and continue to apply pressure.</li> <li>If the person is vomiting, stabilize the head and neck, and carefully turn the victim to the side to prevent choking on vomit.</li> <li>If the person is conscious and experiencing any of the previously listed symptoms, transport to the nearest emergency medical facility (even if the person does not think medical help is needed).</li> DO NOT Follow these precautions: DO NOT move the person unless absolutely necessary. Head injuries may be associated with spinal injuries. DO NOT remove protruding objects. DO NOT allow the person to continue with physical activities. DO NOT forget to watch the person closely until medical help arrives. DO NOT give the person any medicines before talking to a doctor. DO NOT leave the person alone, even if there are no obvious problems. When to Contact a Medical Professional Get medical help right away if: There are problems with breathing or circulation. Direct pressure does not stop bleeding from the nose, ears, or wound. There is drainage of clear fluid from the nose or ears. There is facial swelling, bleeding, or bruising. There is an object protruding from the skull. The person is unconscious, is experiencing convulsions, has multiple injuries, appears to be in any distress, or cannot think clearly. Prevention Not all head injuries can be prevented. The following simple steps can help keep you and your child safe: <li>Always use safety equipment during activities that could cause a head injury. These include seat belts, bicycle or motorcycle helmets, and hard hats.</li> <li>Learn and follow bicycle safety recommendations.</li> <li>Do not drink and drive. Do not allow yourself to be driven by someone who may have been drinking alcohol or is otherwise impaired. </li> Review Date 10/16/2017 Updated by: Jesse Borke, MD, FACEP, FAAEM, Attending Physician at FDR Medical Services/Millard Fillmore Suburban Hospital, Buffalo, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "If you think someone has a skull fracture call 911 (or the local emergency number) for medical assistance. Check the airways, breathing, and circulation. and begin rescue breathing and CPR, if needed. Avoid moving the person (unless absolutely necessary) until medical help arrives.", "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": "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. It can help to have treatment coordinated by a geneticist who is experienced with Williams syndrome.", "role": "assistant" } ]

[ { "content": "what is the cause of congenital heart defects\n\n Congenital heart defects in children Overview If your child has a congenital heart defect, it means that your child was born with a problem in the structure of his or her heart. Some congenital heart defects in children are simple and don't need treatment. Other congenital heart defects in children are more complex and may require several surgeries performed over a period of several years. Learning about your child's congenital heart defect can help you understand the condition and know what you can expect in the coming months and years. Congenital heart defect care at Mayo Clinic Symptoms Serious congenital heart defects usually become evident soon after birth or during the first few months of life. Signs and symptoms could include: - Pale gray or blue skin color (cyanosis) - Rapid breathing - Swelling in the legs, abdomen or areas around the eyes - Shortness of breath during feedings, leading to poor weight gain Less serious congenital heart defects may not be diagnosed until later in childhood, because your child may not have any noticeable signs of a problem. If signs and symptoms are evident in older children, they may include: - Easily becoming short of breath during exercise or activity - Easily tiring during exercise or activity - Fainting during exercise or activity - Swelling in the hands, ankles or feet Serious congenital heart defects are often diagnosed before or soon after your child is born. If you notice that your baby has any of the signs or symptoms above, call your child's doctor. If your child has any of the signs or symptoms of less serious heart defects as he or she grows, call your child's doctor. Your child's doctor can let you know if your child's symptoms are due to a heart defect or another medical condition. Causes The heart is divided into four hollow chambers, two on the right and two on the left. To pump blood throughout the body, the heart uses its left and right sides for different tasks. The right side of the heart moves blood to the lungs through vessels called pulmonary arteries. In the lungs, blood picks up oxygen then returns to the heart's left side through the pulmonary veins. The left side of the heart then pumps the blood through the aorta and out to the rest of the body. During the first six weeks of pregnancy, the heart begins taking shape and starts beating. The major blood vessels that run to and from the heart also begin to form during this critical time during gestation. It's at this point in your baby's development that heart defects may begin to develop. Researchers aren't sure exactly what causes most of these defects, but they think genetics, certain medical conditions, some medications and environmental factors, such as smoking, may play a role. There are many different types of congenital heart defects, falling mainly into these categories: - Holes in the heart. Holes can form in the walls between heart chambers or between major blood vessels leaving the heart. In certain situations, these holes allow oxygen-poor blood to mix with oxygen-rich blood, resulting in less oxygen being carried to your child's body. Depending on the size of the hole, this lack of sufficient oxygen can cause your child's skin or fingernails to appear blue or possibly lead to congestive heart failure. A ventricular septal defect is a hole in the wall between the right and left chambers on the lower half of the heart (ventricles). An atrial septal defect occurs when there's a hole between the upper heart chambers (atria). Patent ductus arteriosus (PAY-tunt DUK-tus ahr-teer-e-O-sus) is a connection between the pulmonary artery (containing deoxygenated blood) and the aorta (containing oxygenated blood). A complete atrioventricular canal defect is a condition that causes a hole in the center of the heart. - Obstructed blood flow. When blood vessels or heart valves are narrow because of a heart defect, the heart must work harder to pump blood through them. Eventually, this leads to enlarging of the heart and thickening of the heart muscle. Examples of this type of defect are pulmonary stenosis or aortic stenosis (stuh-NO-sis). - Abnormal blood vessels. Several congenital heart defects happen when blood vessels going to and from the heart don't form correctly, or they're not positioned the way they're supposed to be. A defect called transposition of the great arteries occurs when the pulmonary artery and the aorta are on the wrong sides of the heart. A condition called coarctation of the aorta happens when the main blood vessel supplying blood to the body is too narrow. Total anomalous pulmonary venous connection is a defect that occurs when blood vessels from the lungs attach to wrong area of the heart. - Heart valve abnormalities. If the heart valves can't open and close correctly, blood can't flow smoothly. One example of this type of defect is called Ebstein's anomaly. In Ebstein's anomaly, the tricuspid valve - which is located between the right atrium and the right ventricle - is malformed and often leaks. Another example is pulmonary atresia, in which the pulmonary valve is missing, causing abnormal blood flow to the lungs. - An underdeveloped heart. Sometimes, a major portion of the heart fails to develop properly. For example, in hypoplastic left heart syndrome, the left side of the heart hasn't developed enough to effectively pump enough blood to the body. - A combination of defects. Some infants are born with several heart defects. Tetralogy of Fallot (teh-TRAL-uh-jee of fuh-LOW) is a combination of four defects: a hole in the wall between the heart's ventricles, a narrowed passage between the right ventricle and pulmonary artery, a shift in the connection of the aorta to the heart, and thickened muscle in the right ventricle. Risk factors Most congenital heart defects result from problems early in your child's heart development, the cause of which is unknown. However, certain environmental and genetic risk factors may play a role. They include: - Rubella (German measles). Having rubella during pregnancy can cause problems in your baby's heart development. Your doctor can test you for immunity to this viral disease before pregnancy and vaccinate you against it if you aren't immune. - Diabetes. You can reduce the risk of congenital heart defects by carefully controlling your diabetes before attempting to conceive and during pregnancy. Gestational diabetes generally doesn't increase your baby's risk of developing a heart defect. - Medications. Certain medications taken during pregnancy may cause birth defects, including congenital heart defects. Give your doctor a complete list of medications you take before attempting to become pregnant. Medications known to increase the risk of congenital heart defects include thalidomide (Thalomid), angiotensin-converting enzyme (ACE) inhibitors, statins, the acne medication isotretinoin (Absorica, Amnesteem, Claravis) and lithium. - Drinking alcohol during pregnancy. Avoid alcohol during pregnancy because it increases the risk of congenital heart defects. - Smoking. Smoking during pregnancy increases the likelihood of a congenital heart defect in the baby. - Heredity. Congenital heart defects sometimes run in families and may be associated with a genetic syndrome. Many children with Down syndrome - which is caused by an extra 21st chromosome (trisomy 21) - have heart defects. A missing piece (deletion) of genetic material on chromosome 22 also causes heart defects. Genetic testing can detect such disorders during fetal development. If you already have a child with a congenital heart defect, a genetic counselor can estimate the odds that your next child will have one. Complications Some potential complications that can occur with a congenital heart defect include: - Congestive heart failure. This serious complication may develop in babies who have a significant heart defect. Signs of congestive heart failure include rapid breathing, often with gasping breaths, and poor weight gain. - Slower growth and development. Children with more-serious congenital heart defects often develop and grow more slowly than do children who don't have heart defects. They may be smaller than other children of the same age and, if the nervous system has been affected, may learn to walk and talk later than other children. - Heart rhythm problems. Heart rhythm problems (arrhythmias) can be caused by a congenital heart defect or from scarring that forms after surgery to correct a congenital heart defect. - Cyanosis. If your child's heart defect causes oxygen-poor blood to mix with oxygen-rich blood in his or her heart, your child may develop a grayish-blue skin color, a condition called cyanosis. - Stroke. Although uncommon, some children with congenital heart defects are at increased risk of stroke due to blood clots traveling through a hole in the heart and on to the brain. - Emotional issues. Some children with congenital heart defects may feel insecure or develop emotional problems because of their size, activity restrictions or learning difficulties. Talk to your child's doctor if you're concerned about your child's moods. - A need for lifelong follow-up. Children who have heart defects should be mindful of their heart problems their entire lives, as their defect could lead to an increased risk of heart tissue infection (endocarditis), heart failure or heart valve problems. Most children with congenital heart defects will need to be seen regularly by a cardiologist throughout life. Diagnosis Your child's doctor may initially suspect a problem because he or she hears a heart murmur during a routine exam. A heart murmur is a sound that occurs when blood flows through the heart or blood vessels fast enough to make a sound that a doctor can hear with a stethoscope. Most heart murmurs are innocent, meaning that there is no heart defect and the murmur isn't dangerous to your child's health. Some murmurs, however, may mean blood is flowing through your child's heart abnormally because he or she has a heart defect. Tests to diagnose a congenital heart defect If it's possible your child has a heart defect, your doctor or your child's doctor may order several tests to see if your child has a heart problem. In addition to a regular physical exam, these could include: - Fetal echocardiogram. This test allows your doctor to see if your child has a heart defect before he or she is born, allowing your doctor to better plan treatment. In this test, your doctor performs an ultrasound. The sound waves from the ultrasound are used to create a picture of your baby's heart. - Echocardiogram. Your child's doctor may use a regular echocardiogram to diagnose a congenital heart defect after your child has been born. In this noninvasive test, your child's doctor performs an ultrasound to produce images of the heart. An echocardiogram allows the doctor to see your child's heart in motion and to identify abnormalities in the heart muscle and valves. - Electrocardiogram. This noninvasive test records the electrical activity of your child's heart and can help diagnose heart defects or rhythm problems. Electrodes connected to a computer and printer are placed on your baby's chest and show waves that indicate how your child's heart is beating. - Chest X-ray. Your child may have a chest X-ray to see if the heart is enlarged, or if the lungs have extra blood or other fluid in them. These could be signs of heart failure. - Pulse oximetry. This test measures how much oxygen is in your child's blood. A sensor is placed over the end of your child's finger to record the amount of oxygen in your child's blood. Too little oxygen could suggest your child has a heart problem. - Cardiac catheterization. In this test, a thin, flexible tube (catheter) is inserted into a blood vessel at your baby's groin and guided through it into the heart. Catheterization is sometimes necessary because it may give your child's doctor a much more detailed view of your child's heart defect than an echocardiogram. In addition, some treatment procedures can be done during cardiac catheterization. - Cardiovascular magnetic resonance imaging (MRI). This type of imaging is becoming increasingly used to diagnose and evaluate congenital heart defects in adolescents and adults. Newer MRI technology provides faster imaging and higher resolution than other methods, such as echocardiography. Treatment A congenital heart defect may have no long-term effect on your child's health - in some instances, such defects can safely go untreated. Certain defects, such as small holes, may even correct themselves as your child ages. Some heart defects, however, are serious and require treatment soon after they're found. Depending on the type of heart defect your child has, doctors treat congenital heart defects with: - Procedures using catheterization. Some children and adults now have their congenital heart defects repaired using catheterization techniques, which allow the repair to be done without surgically opening the chest and heart. Catheter procedures can often be used to fix holes or areas of narrowing. In procedures that can be done using catheterization, the doctor inserts a thin tube (catheter) into a leg vein and guides it to the heart with the help of X-ray images. Once the catheter is positioned at the site of the defect, tiny tools are threaded through the catheter to the heart to repair the defect. - Open-heart surgery. Depending on your child's condition, he or she may need surgery to repair the defect. Many congenital heart defects are corrected using open-heart surgery. In open-heart surgery, the chest has to be opened. In some cases, minimally invasive heart surgery may be an option. This type of surgery involves making small incisions between the ribs and inserting instruments through them to repair the defect. - Heart transplant. If a serious heart defect can't be repaired, a heart transplant may be an option. - Medications. Some mild congenital heart defects, especially those found later in childhood or adulthood, can be treated with medications that help the heart work more efficiently. Drugs known as angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs) and beta blockers and medications that cause fluid loss (diuretics) can help ease stress on the heart by lowering blood pressure, heart rate and the amount of fluid in the chest. Certain medications can also be prescribed to help irregular heartbeats (arrhythmias). Sometimes, a combination of treatments is necessary. In addition, some catheter or surgical procedures have to be done in steps, over a period of years. Others may need to be repeated as a child grows. Long-term treatment Some children with congenital heart defects require multiple procedures and surgeries throughout life. Although the outcomes for children with heart defects have improved dramatically, most people, except those with very simple defects, will require ongoing care, even after corrective surgery. - Lifelong monitoring and treatment. Even if your child has surgery to treat a heart defect, your child's condition will need to be monitored for the rest of his or her life. Initially, your child with a congenital heart defect will be monitored and have regular follow-up appointments with a pediatric cardiologist. As your child grows older, his or her care will transition to an adult congenital cardiologist, who can monitor his or her condition over time. A congenital heart defect can affect your child's adult life, as it can contribute to other health problems. Adults who have congenital heart defects may need other treatments for their condition. As your child ages, it's important to remind him or her of the heart condition that was corrected and the need for ongoing, lifelong care by doctors experienced in evaluating and treating congenital heart disease. Encourage your child to keep his or her doctor informed about the heart defect and the procedures performed to treat the problem. - Exercise restrictions. Parents of children with congenital heart defects may worry about the risks of rough play and activity even after treatment. Although some children may need to limit the amount or type of exercise, many can participate in normal or near-normal activity. Your child's doctor can tell you which activities are safe for your child. If some activities do pose distinct dangers, encourage your child to participate in other activities instead of focusing on what he or she can't do. Although every child is different, most children with congenital heart defects grow up to lead healthy, productive lives. - Infection prevention. Depending on the type of congenital heart defect your child had, and the surgery used to correct it, your child may need to take extra steps to prevent infection. Sometimes, a congenital heart defect can increase the risk of infections - either in the lining of the heart or heart valves (infective endocarditis). Because of this risk, your child may need to take antibiotics to prevent infection before additional surgeries or dental procedures. Children who are most likely to have a higher risk of infection include those whose defect was repaired with a prosthetic material or device, such as an artificial heart valve. Ask your child's cardiologist if preventive antibiotics are necessary for your child. ", "role": "user" }, { "content": "Most congenital heart defects result from problems early in your child's heart development, the cause of which is unknown. However, certain environmental and genetic risk factors may play a role. They include: - Rubella (German measles). Having rubella during pregnancy can cause problems in your baby's heart development. Diabetes. You can reduce the risk of congenital heart defects by carefully controlling your diabetes before attempting to conceive and during pregnancy. Certain medications taken during pregnancy may cause birth defects, including congenital heart defects. Medications known to increase the risk of congenital heart defects include thalidomide (Thalomid), angiotensin-converting enzyme (ACE) inhibitors, statins, the acne medication isotretinoin (Absorica, Amnesteem, Claravis) and lithium. - Drinking alcohol during pregnancy. Smoking during pregnancy increases the likelihood of a congenital heart defect in the baby. - Heredity. Congenital heart defects sometimes run in families and may be associated with a genetic syndrome. Many children with Down syndrome - which is caused by an extra 21st chromosome (trisomy 21) - have heart defects. A missing piece (deletion) of genetic material on chromosome 22 also causes heart defects. Genetic testing can detect such disorders during fetal development. a genetic counselor can estimate the odds that your next child will have one.", "role": "assistant" } ]

[ { "content": "how to prevent atherosclerosis\n\nArteriosclerosis / atherosclerosis: Arteriosclerosis occurs when the blood vessels that carry oxygen and nutrients from your heart to the rest of your body (arteries) become thick and stiff - sometimes restricting blood flow to your organs and tissues. Healthy arteries are flexible and elastic, but over time, the walls in your arteries can harden, a condition commonly called hardening of the arteries. Atherosclerosis is a specific type of arteriosclerosis, but the terms are sometimes used interchangeably. Atherosclerosis refers to the buildup of fats, cholesterol and other substances in and on your artery walls (plaques), which can restrict blood flow. These plaques can burst, triggering a blood clot. Although atherosclerosis is often considered a heart problem, it can affect arteries anywhere in your body. Atherosclerosis may be preventable and is treatable. Atherosclerosis develops gradually. Mild atherosclerosis usually doesn't have any symptoms. You usually won't have atherosclerosis symptoms until an artery is so narrowed or clogged that it can't supply adequate blood to your organs and tissues. Sometimes a blood clot completely blocks blood flow, or even breaks apart and can trigger a heart attack or stroke. Symptoms of moderate to severe atherosclerosis depend on which arteries are affected. For example: - If you have atherosclerosis in your heart arteries, you may have symptoms, such as chest pain or pressure (angina). - If you have atherosclerosis in the arteries leading to your brain, you may have signs and symptoms such as sudden numbness or weakness in your arms or legs, difficulty speaking or slurred speech, temporary loss of vision in one eye, or drooping muscles in your face. These signal a transient ischemic attack (TIA), which, if left untreated, may progress to a stroke. - If you have atherosclerosis in the arteries in your arms and legs, you may have symptoms of peripheral artery disease, such as leg pain when walking (claudication). - If you have atherosclerosis in the arteries leading to your kidneys, you develop high blood pressure or kidney failure. When to see a doctor If you think you have atherosclerosis, talk to your doctor. Also pay attention to early symptoms of inadequate blood flow, such as chest pain (angina), leg pain or numbness. Early diagnosis and treatment can stop atherosclerosis from worsening and prevent a heart attack, stroke or another medical emergency. Atherosclerosis is a slow, progressive disease that may begin as early as childhood. Although the exact cause is unknown, atherosclerosis may start with damage or injury to the inner layer of an artery. The damage may be caused by: - High blood pressure - High cholesterol - High triglycerides, a type of fat (lipid) in your blood - Smoking and other sources of tobacco - Insulin resistance, obesity or diabetes - Inflammation from diseases, such as arthritis, lupus or infections, or inflammation of unknown cause Once the inner wall of an artery is damaged, blood cells and other substances often clump at the injury site and build up in the inner lining of the artery. Over time, fatty deposits (plaques) made of cholesterol and other cellular products also build up at the injury site and harden, narrowing your arteries. The organs and tissues connected to the blocked arteries then don't receive enough blood to function properly. Eventually, pieces of the fatty deposits may break off and enter your bloodstream. In addition, the smooth lining of a plaque may rupture, spilling cholesterol and other substances into your bloodstream. This may cause a blood clot, which can block the blood flow to a specific part of your body, such as occurs when blocked blood flow to your heart causes a heart attack. A blood clot can also travel to other parts of your body, blocking flow to another organ. Hardening of the arteries occurs over time. Besides aging, factors that increase the risk of atherosclerosis include: - High blood pressure - High cholesterol - Diabetes - Obesity - Smoking and other tobacco use - A family history of early heart disease - Lack of exercise - An unhealthy diet The complications of atherosclerosis depend on which arteries are blocked. For example: - Coronary artery disease. When atherosclerosis narrows the arteries close to your heart, you may develop coronary artery disease, which can cause chest pain (angina), a heart attack or heart failure. - Carotid artery disease. When atherosclerosis narrows the arteries close to your brain, you may develop carotid artery disease, which can cause a transient ischemic attack (TIA) or stroke. - Peripheral artery disease. When atherosclerosis narrows the arteries in your arms or legs, you may develop circulation problems in your arms and legs called peripheral artery disease. This can make you less sensitive to heat and cold, increasing your risk of burns or frostbite. In rare cases, poor circulation in your arms or legs can cause tissue death (gangrene). - Aneurysms. Atherosclerosis can also cause aneurysms, a serious complication that can occur anywhere in your body. An aneurysm is a bulge in the wall of your artery. Most people with aneurysms have no symptoms. Pain and throbbing in the area of an aneurysm may occur and is a medical emergency. If an aneurysm bursts, you may face life-threatening internal bleeding. Although this is usually a sudden, catastrophic event, a slow leak is possible. If a blood clot within an aneurysm dislodges, it may block an artery at some distant point. - Chronic kidney disease. Atherosclerosis can cause the arteries leading to your kidneys to narrow, preventing oxygenated blood from reaching them. Over time, this can affect your kidney function, keeping waste from exiting your body. During a physical exam, your doctor may find signs of narrowed, enlarged or hardened arteries, including: - A weak or absent pulse below the narrowed area of your artery - Decreased blood pressure in an affected limb - Whooshing sounds (bruits) over your arteries, heard using a stethoscope Depending on the results of the physical exam, your doctor may suggest one or more diagnostic tests, including: - Blood tests. Lab tests can detect increased levels of cholesterol and blood sugar that may increase the risk of atherosclerosis. You'll need to go without eating or drinking anything but water for nine to 12 hours before your blood test. Your doctor should tell you ahead of time if this test will be performed during your visit. - Doppler ultrasound. Your doctor may use a special ultrasound device (Doppler ultrasound) to measure your blood pressure at various points along your arm or leg. These measurements can help your doctor gauge the degree of any blockages, as well as the speed of blood flow in your arteries. - Ankle-brachial index. This test can tell if you have atherosclerosis in the arteries in your legs and feet. Your doctor may compare the blood pressure in your ankle with the blood pressure in your arm. This is known as the ankle-brachial index. An abnormal difference may indicate peripheral vascular disease, which is usually caused by atherosclerosis. - Electrocardiogram (ECG). An electrocardiogram records electrical signals as they travel through your heart. An ECG can often reveal evidence of a previous heart attack. If your signs and symptoms occur most often during exercise, your doctor may ask you to walk on a treadmill or ride a stationary bike during an ECG. - Stress test. A stress test, also called an exercise stress test, is used to gather information about how well your heart works during physical activity. Because exercise makes your heart pump harder and faster than it does during most daily activities, an exercise stress test can reveal problems within your heart that might not be noticeable otherwise. An exercise stress test usually involves walking on a treadmill or riding a stationary bike while your heart rhythm, blood pressure and breathing are monitored. In some types of stress tests, pictures will be taken of your heart, such as during a stress echocardiogram (ultrasound) or nuclear stress test. If you're unable to exercise, you may receive a medication that mimics the effect of exercise on your heart. - Cardiac catheterization and angiogram. This test can show if your coronary arteries are narrowed or blocked. A liquid dye is injected into the arteries of your heart through a long, thin tube (catheter) that's fed through an artery, usually in your leg, to the arteries in your heart. As the dye fills your arteries, the arteries become visible on X-ray, revealing areas of blockage. - Other imaging tests. Your doctor may use ultrasound, a computerized tomography (CT) scan or magnetic resonance angiography (MRA) to study your arteries. These tests can often show hardening and narrowing of large arteries, as well as aneurysms and calcium deposits in the artery walls. Lifestyle changes, such as eating a healthy diet and exercising, are often the most appropriate treatment for atherosclerosis. Sometimes, medication or surgical procedures may be recommended as well. Medications Various drugs can slow - or even reverse - the effects of atherosclerosis. Here are some common choices: - Cholesterol medications. Aggressively lowering your low-density lipoprotein (LDL) cholesterol, the \"bad\" cholesterol, can slow, stop or even reverse the buildup of fatty deposits in your arteries. Boosting your high-density lipoprotein (HDL) cholesterol, the \"good\" cholesterol, may help, too. Your doctor can choose from a range of cholesterol medications, including drugs known as statins and fibrates. In addition to lowering cholesterol, statins have additional effects that help stabilize the lining of your heart arteries and prevent atherosclerosis. - Anti-platelet medications. Your doctor may prescribe anti-platelet medications, such as aspirin, to reduce the likelihood that platelets will clump in narrowed arteries, form a blood clot and cause further blockage. - Beta blocker medications. These medications are commonly used for coronary artery disease. They lower your heart rate and blood pressure, reducing the demand on your heart and often relieve symptoms of chest pain. Beta blockers reduce the risk of heart attacks and some heart rhythm problems. - Angiotensin-converting enzyme (ACE) inhibitors. These medications may help slow the progression of atherosclerosis by lowering blood pressure and producing other beneficial effects on the heart arteries. ACE inhibitors can also reduce the risk of recurrent heart attacks. - Calcium channel blockers. These medications lower blood pressure and are sometimes used to treat angina. - Water pills (diuretics). High blood pressure is a major risk factor for atherosclerosis. Diuretics lower blood pressure. - Other medications. Your doctor may suggest certain medications to control specific risk factors for atherosclerosis, such as diabetes. Sometimes specific medications to treat symptoms of atherosclerosis, such as leg pain during exercise, are prescribed. Surgical procedures Sometimes more aggressive treatment is needed to treat atherosclerosis. If you have severe symptoms or a blockage that threatens muscle or skin tissue survival, you may be a candidate for one of the following surgical procedures: - Angioplasty and stent placement. In this procedure, your doctor inserts a long, thin tube (catheter) into the blocked or narrowed part of your artery. A second catheter with a deflated balloon on its tip is then passed through the catheter to the narrowed area. The balloon is then inflated, compressing the deposits against your artery walls. A mesh tube (stent) is usually left in the artery to help keep the artery open. - Endarterectomy. In some cases, fatty deposits must be surgically removed from the walls of a narrowed artery. When the procedure is done on arteries in the neck (the carotid arteries), it's called a carotid endarterectomy. - Fibrinolytic therapy. If you have an artery that's blocked by a blood clot, your doctor may use a clot-dissolving drug to break it apart. - Bypass surgery. Your doctor may create a graft bypass using a vessel from another part of your body or a tube made of synthetic fabric. This allows blood to flow around the blocked or narrowed artery. Lifestyle changes can help you prevent or slow the progression of atherosclerosis. - Stop smoking. Smoking damages your arteries. If you smoke or use tobacco in any form, quitting is the best way to halt the progression of atherosclerosis and reduce your risk of complications. - Exercise most days of the week. Regular exercise can condition your muscles to use oxygen more efficiently. Physical activity can also improve circulation and promote development of new blood vessels that form a natural bypass around obstructions (collateral vessels). Exercise helps lower blood pressure and reduces your risk of diabetes. Aim to exercise at least 30 minutes most days of the week. If you can't fit it all into one session, try breaking it up into 10-minute intervals. You can take the stairs instead of the elevator, walk around the block during your lunch hour, or do some situps or pushups while watching television. - Eat healthy foods. A heart-healthy diet based on fruits, vegetables and whole grains - and low in refined carbohydrates, sugars, saturated fat and sodium - can help you control your weight, blood pressure, cholesterol and blood sugar. Try substituting whole-grain bread in place of white bread; grabbing an apple, a banana or carrot sticks as a snack; and reading nutrition labels as a guide to controlling the amount of salt and fat you eat. Use monounsaturated fats, such as olive oil, and reduce or eliminate sugar and sugar substitutes. - Lose extra pounds and maintain a healthy weight. If you're overweight, losing as few as 5 to 10 pounds (about 2.3 to 4.5 kilograms) can help reduce your risk of high blood pressure and high cholesterol, two of the major risk factors for developing atherosclerosis. Losing weight helps reduce your risk of diabetes or control your condition if you already have diabetes. - Manage stress. Reduce stress as much as possible. Practice healthy techniques for managing stress, such as muscle relaxation and deep breathing. If you have high cholesterol, high blood pressure, diabetes or another chronic disease, work with your doctor to manage the condition and promote overall health. It's thought that some foods and herbal supplements can help reduce your high cholesterol level and high blood pressure, two major risk factors for developing atherosclerosis. With your doctor's OK, you might consider these supplements and products: - Alpha-linolenic acid (ALA) - Barley - Beta-sitosterol (found in oral supplements and some margarines, such as Promise Activ) - Black tea - Blond psyllium (found in seed husk and products such as Metamucil) - Calcium - Cocoa - Cod liver oil - Coenzyme Q10 - Fish oil - Folic acid - Garlic - Green tea - Oat bran (found in oatmeal and whole oats) - Sitostanol (found in oral supplements and some margarines, such as Benecol) - Vitamin C Talk to your doctor before adding any of these supplements to your atherosclerosis treatment. Some supplements can interact with medications, causing harmful side effects. You can also practice relaxation techniques, such as yoga or deep breathing, to help you relax and reduce your stress level. These practices can temporarily reduce your blood pressure, reducing your risk of developing atherosclerosis.", "role": "user" }, { "content": "Arteriosclerosis occurs when the blood vessels that carry oxygen and nutrients from your heart to the rest of your body become thick and stiff - sometimes restricting blood flow to your organs and tissues. Early diagnosis and treatment can stop atherosclerosis from worsening and prevent a heart attack, stroke or another medical emergency. Lifestyle changes, such as eating a healthy diet and exercising, are often the most appropriate treatment for atherosclerosis. Sometimes, medication or surgical procedures may be recommended as well.", "role": "assistant" } ]

[ { "content": "what are some of the treatments available to males with klinefelter's\n\n Klinefelter syndrome 47 X-X-Y syndrome XXY syndrome XXY trisomy 47,XXY/46,XY Mosaic syndrome Poly-X Klinefelter syndrome Summary Klinefelter syndrome is a genetic condition that occurs in males when they have an extra X chromosome. Causes Most people have 46 chromosomes. Chromosomes contain all of your genes and DNA, the building blocks of the body. The 2 sex chromosomes (X and Y) determine if you become a boy or a girl. Girls normally have 2 X chromosomes. Boys normally have 1 X and 1 Y chromosome. Klinefelter syndrome results when a boy is born with at least 1 extra X chromosome. This is written as XXY. Klinefelter syndrome occurs in about 1 out of 500 to 1,000 baby boys. Women who get pregnant after age 35 are slightly more likely to have a boy with this syndrome than younger women. Symptoms Infertility is the most common symptom of Klinefelter syndrome. Symptoms may include any of the following: Abnormal body proportions (long legs, short trunk, shoulder equal to hip size) Abnormally large breasts (gynecomastia) Infertility Sexual problems Less than normal amount of pubic, armpit, and facial hair Small, firm testicles Tall height Small penis size Exams and Tests Klinefelter syndrome may first be diagnosed when a man comes to the health care provider because of infertility. The following tests may be performed: Karyotyping (checks the chromosomes) Semen count Blood tests will be done to check hormone levels including: Estradiol, a type of estrogen Follicle stimulating hormone Luteinizing hormone Testosterone Treatment Testosterone therapy may be prescribed. This can help: Grow body hair Improve appearance of muscles Improve concentration Improve mood and self esteem Increase energy and sex drive Increase strength Most men with this syndrome are not able to get a woman pregnant. But, an infertility specialist may be able to help. Seeing a doctor called an endocrinologist may also be helpful. Support Groups These groups can provide more information: The American Association for Klinefelter Syndrome Information and Support (AAKSIS) -- www.aaksis.org National Institute of Health, National Human Genome Research Institute -- www.genome.gov/19519068 Possible Complications Enlarged teeth with a thinning surface is very common in Klinefelter syndrome. This is called taurodontism. This can be seen on dental x-rays. Klinefelter syndrome also increases the risk of: Attention deficient hyperactivity disorder (ADHD) Autoimmune disorders, such as lupus, rheumatoid arthritis, and Sjogren syndrome Breast cancer in men Depression Learning disabilities, including dyslexia, which affects reading A rare type of tumor called an extragonadal germ cell tumor Lung disease Osteoporosis Varicose veins When to Contact a Medical Professional Call for an appointment with your provider if your son does not develop secondary sexual characteristics at puberty. This includes facial hair growth and a deepening of the voice. A genetics counselor can provide information about this condition and direct you to support groups in your area. Review Date 10/30/2016 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, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Testosterone therapy may be prescribed for individuals with Klinefelter syndrome. This can help increase body hair, sex drive, concentration, mood and self-esteem, and strength. Men with this syndrome may be infertile, but should talk to an infertility specialist.", "role": "assistant" } ]

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

[ { "content": "Bad Breath I have very bad breath and at times it can make myself and others sick. I need some advice as to what I need to do.\n\n Bad breath Overview Bad breath, also called halitosis, can be embarrassing and in some cases may even cause anxiety. It's no wonder that store shelves are overflowing with gum, mints, mouthwashes and other products designed to fight bad breath. But many of these products are only temporary measures because they don't address the cause of the problem. Certain foods, health conditions and habits are among the causes of bad breath. In many cases, you can improve bad breath with consistent proper dental hygiene. If simple self-care techniques don't solve the problem, see your dentist or physician to be sure a more serious condition isn't causing your bad breath. Symptoms Bad breath odors vary, depending on the source or the underlying cause. Some people worry too much about their breath even though they have little or no mouth odor, while others have bad breath and don't know it. Because it's difficult to assess how your own breath smells, ask a close friend or relative to confirm your bad-breath questions. When to see a doctor If you have bad breath, review your oral hygiene habits. Try making lifestyle changes, such as brushing your teeth and tongue after eating, using dental floss, and drinking plenty of water. If your bad breath persists after making such changes, see your dentist. If your dentist suspects a more serious condition is causing your bad breath, he or she may refer you to a physician to find the cause of the odor. Diagnosis Your dentist will likely smell both the breath from your mouth and the breath from your nose and rate the odor on a scale. Because the back of the tongue is most often the source of the smell, your dentist may also scrape it and rate its odor. There are sophisticated detectors that can identify the chemicals responsible for bad breath, though these aren't always available. Treatment To reduce bad breath, help avoid cavities and lower your risk of gum disease, consistently practice good oral hygiene. Further treatment for bad breath can vary, depending on the cause. If your bad breath is thought to be caused by an underlying health condition, your dentist will likely refer you to your primary care provider. For causes related to oral health, your dentist will work with you to help you better control that condition. Dental measures may include: - Mouth rinses and toothpastes. If your bad breath is due to a buildup of bacteria (plaque) on your teeth, your dentist may recommend a mouth rinse that kills the bacteria. Your dentist may also recommend a toothpaste that contains an antibacterial agent to kill the bacteria that cause plaque buildup. - Treatment of dental disease. If you have gum disease, you may be referred to a gum specialist (periodontist). Gum disease can cause gums to pull away from your teeth, leaving deep pockets that fill with odor-causing bacteria. Sometimes only professional cleaning removes these bacteria. Your dentist might also recommend replacing faulty tooth restorations, a breeding ground for bacteria. Lifestyle and home remedies To reduce or prevent bad breath: - Brush your teeth after you eat. Keep a toothbrush at work to use after eating. Brush using a fluoride-containing toothpaste at least twice a day, especially after meals. Toothpaste with antibacterial properties has been shown to reduce bad breath odors. - Floss at least once a day. Proper flossing removes food particles and plaque from between your teeth, helping to control bad breath. - Brush your tongue. Your tongue harbors bacteria, so carefully brushing it may reduce odors. People who have a coated tongue from a significant overgrowth of bacteria (from smoking or dry mouth, for example) may benefit from using a tongue scraper. Or use a toothbrush that has a built-in tongue cleaner. - Clean dentures or dental appliances. If you wear a bridge or a denture, clean it thoroughly at least once a day or as directed by your dentist. If you have a dental retainer or mouth guard, clean it each time before you put it in your mouth. Your dentist can recommend the best cleaning product. - Avoid dry mouth. To keep your mouth moist, avoid tobacco and drink plenty of water - not coffee, soft drinks or alcohol, which can lead to a drier mouth. Chew gum or suck on candy (preferably sugarless) to stimulate saliva. For chronic dry mouth, your dentist or physician may prescribe an artificial saliva preparation or an oral medication that stimulates the flow of saliva. - Adjust your diet. Avoid foods such as onions and garlic that can cause bad breath. Eating a lot of sugary foods is also linked with bad breath. - Regularly get a new toothbrush. Change your toothbrush when it becomes frayed, about every three to four months, and choose a soft-bristled toothbrush. - Schedule regular dental checkups. See your dentist on a regular basis - generally twice a year - to have your teeth or dentures examined and cleaned. ", "role": "user" }, { "content": "To reduce bad breath, help avoid cavities and lower your risk of gum disease, consistently practice good oral hygiene. Further treatment for bad breath can vary, depending on the cause. If your bad breath is thought to be caused by an underlying health condition, your dentist will likely refer you to your primary care provider. Dental measures may include: - Mouth rinses and toothpastes. ... Treatment of dental disease.", "role": "assistant" } ]

[ { "content": "prevention of preeclampsia I know that the jury is out on the exact causes of preeclampsia, but I am looking for some of the ways that the chances of acquiring it can be minimized.\n\n Preeclampsia and Eclampsia Overview Preeclampsia (pree-i-KLAMP-see-uh) and eclampsia (ih-KLAMP-see-uh) are pregnancy-related high blood pressure disorders. In preeclampsia, the mother’s high blood pressure reduces the blood supply to the fetus, which may get less oxygen and fewer nutrients. Eclampsia is when pregnant women with preeclampsia develop seizures or coma. NICHD and other agencies are working to understand what causes these conditions and how they can be prevented and better treated. About Preeclampsia and Eclampsia Preeclampsia and eclampsia are part of the spectrum of high blood pressure, or hypertensive, disorders that can occur during pregnancy.At the mild end of the spectrum is gestational hypertension, which occurs when a woman who previously had normal blood pressure develops high blood pressure when she is more than 20 weeks pregnant and her blood pressure returns to normal within 12 weeks after delivery. This problem usually occurs without other symptoms. In many cases, gestational hypertension does not harm the mother or fetus. Severe gestational hypertension, however, may be associated with preterm birth and infants who are small for their age at birth.1 And about 15% to 25% of women with gestational hypertension go on to develop preeclampsia.2Preeclampsia is similar to gestational hypertension, because it also describes high blood pressure at or after 20 weeks of pregnancy in a woman whose blood pressure was normal before pregnancy. But preeclampsia can also include blood pressure at or greater than 140/90 mmHg, increased swelling, and protein in the urine.3 The condition can be serious and is a leading cause of preterm birth (before 37 weeks of pregnancy).4 If it is severe enough to affect brain function, causing seizures or coma, it is called eclampsia.One of the serious complications of hypertensive disorders in pregnancy is HELLP syndrome, a situation in which a pregnant woman with preeclampsia or eclampsia suffers damage to the liver and blood cells. The letters in the name HELLP stand for the following problems:- H - Hemolysis, in which oxygen-carrying red blood cells break down - EL - Elevated Liver enzymes, showing damage to the liver - LP - Low Platelet count, meaning that the cells responsible for stopping bleeding are low What causes preeclampsia and eclampsia? The causes of preeclampsia and eclampsia are not known. These disorders previously were believed to be caused by a toxin, called “toxemia,” in the blood, but health care providers now know that is not true. Nevertheless, preeclampsia is sometimes still referred to as “toxemia.”To learn more about preeclampsia and eclampsia, scientists are investigating many factors that could contribute to the development and progression of these diseases, including:- Placental abnormalities, such as insufficient blood flow - Genetic factors - Environmental exposures - Nutritional factors - Maternal immunology and autoimmune disorders - Cardiovascular and inflammatory changes - Hormonal imbalances What are the risks of preeclampsia & eclampsia to the mother? - Risks During Pregnancy Preeclampsia during pregnancy is mild in 75% of cases.1 However, a woman can progress from mild to severe preeclampsia or to full eclampsia very quickly―even in a matter of days. Both preeclampsia and eclampsia can cause serious health problems for the mother and infant. Women with preeclampsia are at increased risk for damage to the kidneys, liver, brain, and other organ and blood systems. Preeclampsia may also affect the placenta. The condition could lead to a separation of the placenta from the uterus (referred to as placental abruption), preterm birth, and pregnancy loss or stillbirth. In some cases, preeclampsia can lead to organ failure or stroke. In severe cases, preeclampsia can develop into eclampsia, which includes seizures. Seizures in eclampsia may cause a woman to lose consciousness and twitch uncontrollably.2 If the fetus is not delivered, these conditions can cause the death of the mother and/or the fetus. Expecting mothers rarely die from preeclampsia in the developed world, but it is still a major cause of illness and death globally.3 According to the World Health Organization, preeclampsia and eclampsia cause 14% of maternal deaths each year, or about 50,000 to 75,000 women worldwide.4 - Risks After Pregnancy In “uncomplicated preeclampsia,” the mother’s high blood pressure and other symptoms usually go back to normal within 6 weeks of the infant’s birth. However, studies have shown that women who had preeclampsia are four times more likely to later develop hypertension (high blood pressure) and are twice as likely to later develop ischemic heart disease (reduced blood supply to the heart muscle, which can cause heart attacks), a blood clot in a vein, and stroke as are women who did not have preeclampsia.5 Less commonly, mothers who had preeclampsia could experience permanent damage to their organs, such as their kidneys and liver. They could also experience fluid in the lungs. In the days following birth, women with preeclampsia remain at increased risk for developing eclampsia and seizures.3,6 What are the risks of preeclampsia & eclampsia to the fetus? Preeclampsia may be related to problems with the placenta early in the pregnancy.1 Such problems pose risks to the fetus, including:- Lack of oxygen and nutrients, which can impair fetal growth - Preterm birth - Stillbirth if placental abruption (separation of the placenta from the uterine wall) leads to heavy bleeding in the mother - Death: According to the Preeclampsia Foundation , each year, about 10,500 infants in the United States and about half a million worldwide die due to preeclampsia.2 Stillbirths are more likely to occur when the mother has a more severe form of preeclampsia, including HELLP syndrome.Infants whose mothers had preeclampsia are also at increased risk for later problems, even if they were born at full term (39 weeks of pregnancy).3 Infants born preterm due to preeclampsia face a higher risk of some long-term health issues, mostly related to being born early, including learning disorders, cerebral palsy, epilepsy, deafness, and blindness. Infants born preterm may also have to be hospitalized for a long time after birth and may be smaller than infants born full term. Infants who experienced poor growth in the uterus may later be at higher risk of diabetes, congestive heart failure, and high blood pressure.4 How many women are affected by or at risk of preeclampsia? The exact number of women who develop preeclampsia is not known. Some estimates suggest that preeclampsia affects 2% to 8% of all pregnancies globally and about 3.4% in the United States.1,2The condition is estimated to account for 10% to 15% of maternal deaths worldwide.1 Disorders related to high blood pressure are the second leading cause of stillbirths and early neonatal deaths in developing nations.3In addition, HELLP syndrome occurs in about 10% to 20% of all women with severe preeclampsia or eclampsia.4Although preeclampsia occurs primarily in first pregnancies, a woman who had preeclampsia in a previous pregnancy is seven times more likely to develop preeclampsia in a later pregnancy.5Other factors that can increase a woman's risk include:5- Chronic high blood pressure or kidney disease before pregnancy - High blood pressure or preeclampsia in an earlier pregnancy - Obesity. Overweight or obese women are also more likely to have preeclampsia in more than one pregnancy.6 - Age. Women older than 40 are at higher risk. - Multiple gestation (being pregnant with more than one fetus) - African American ethnicity. Also, among women who have had preeclampsia before, non-white women are more likely than white women to develop preeclampsia again in a later pregnancy.6 - Family history of preeclampsia. According to the World Health Organization, among women who have had preeclampsia, about 20% to 40% of their daughters and 11% to 37% of their sisters also will get the disorder.7Preeclampsia is also more common among women who have histories of certain health conditions, such as migraines,8 diabetes,9 rheumatoid arthritis,10 lupus,11 scleroderma,12 urinary tract infections,13 gum disease,14 polycystic ovary syndrome,15 multiple sclerosis, gestational diabetes, and sickle cell disease.16Preeclampsia is also more common in pregnancies resulting from egg donation, donor insemination, or in vitro fertilization.The U.S. Preventative Services Task Force recommends that women who are at high risk for preeclampsia take low-dose aspirin starting after 12 weeks of pregnancy to prevent preeclampsia.17 Women who are pregnant or who are thinking about getting pregnant should talk with their health care provider about preeclampsia risk and ways to reduce the risk. What are the symptoms of preeclampsia, eclampsia, & HELLP syndrome? - Preeclampsia Possible symptoms of preeclampsia include: - High blood pressure - Too much protein in the urine - Swelling in a woman's face and hands (a woman's feet might swell too, but swollen feet are common during pregnancy and may not signal a problem) - Systemic problems, such as headache, blurred vision, and right upper quadrant abdominal pain - High blood pressure - Too much protein in the urine - Swelling in a woman's face and hands (a woman's feet might swell too, but swollen feet are common during pregnancy and may not signal a problem) - Systemic problems, such as headache, blurred vision, and right upper quadrant abdominal pain - Eclampsia The following symptoms are cause for immediate concern:1 - Seizures - Severe headache - Vision problems, such as temporary blindness - Abdominal pain, especially in the upper right area of the belly - Nausea and vomiting - Smaller urine output or not urinating very often - Seizures - Severe headache - Vision problems, such as temporary blindness - Abdominal pain, especially in the upper right area of the belly - Nausea and vomiting - Smaller urine output or not urinating very often - HELLP Syndrome HELLP syndrome can lead to serious complications, including liver failure and death.1 A pregnant woman with HELLP syndrome might bleed or bruise easily and/or experience abdominal pain, nausea or vomiting, headache, or extreme fatigue. Although most women who develop HELLP syndrome already have high blood pressure and preeclampsia, sometimes the syndrome is the first sign. In addition, HELLP syndrome can occur without a woman having either high blood pressure or protein in her urine. How do health care providers diagnose preeclampsia, eclampsia, and HELLP syndrome? A health care provider will check a pregnant woman’s blood pressure and urine during each prenatal visit. If the blood pressure reading is considered high (140/90 or higher), especially after the 20th week of pregnancy, the health care provider will likely perform blood tests and more extensive lab tests to look for extra protein in the urine (called proteinuria) as well as other symptoms.The American College of Obstetricians and Gynecologists provides the following criteria for a diagnosis of gestational hypertension, preeclampsia, eclampsia, and HELLP syndrome.Gestational hypertension is diagnosed if a pregnant woman has high blood pressure but no protein in the urine. Gestational hypertension occurs when women whose blood pressure levels were normal before pregnancy develop high blood pressure after 20 weeks of pregnancy. Gestational hypertension can progress into preeclampsia.1Mild preeclampsia is diagnosed when a pregnant woman has:2- Systolic blood pressure (top number) of 140 mmHg or higher or diastolic blood pressure (bottom number) of 90 mmHg or higher and either - Urine with 0.3 or more grams of protein in a 24-hour specimen (a collection of every drop of urine within 24 hours) or a protein-to-creatinine ratio greater than 0.3 or - Blood tests that show kidney or liver dysfunction - Fluid in the lungs and difficulty breathing - Visual impairmentsSevere preeclampsia occurs when a pregnant woman has any of the following:- Systolic blood pressure of 160 mmHg or higher or diastolic blood pressure of 110 mmHg or higher on two occasions at least 4 hours apart while the patient is on bed rest - Urine with 5 or more grams of protein in a 24-hour specimen or 3 or more grams of protein on 2 random urine samples collected at least 4 hours apart - Test results suggesting kidney or liver damage—for example, blood tests that reveal low numbers of platelets or high liver enzymes - Severe, unexplained stomach pain that does not respond to medication - Symptoms that include visual disturbances, difficulty breathing, or fluid buildup3Eclampsia occurs when women with preeclampsia develop seizures. The seizures can happen before or during labor or after the baby is delivered. HELLP syndrome is diagnosed when laboratory tests show hemolysis (burst red blood cells release hemoglobin into the blood plasma), elevated liver enzymes, and low platelets. There also may or may not be extra protein in the urine.4Some women may also be diagnosed with superimposed preeclampsia—a situation in which the woman develops preeclampsia on top of high blood pressure that was present before she got pregnant. Health care providers look for an increase in blood pressure and either protein in the urine, fluid buildup, or both for a diagnosis of superimposed preeclampsia.In addition to tests that might diagnose preeclampsia or similar problems, health care providers may do other tests to assess the health of the mother and fetus, including:- Blood tests to see how well the mother's liver and kidneys are working - Blood tests to check blood platelet levels to see how well the mother’s blood is clotting - Blood tests to count the total number of red blood cells in the mother’s blood - A maternal weight check - An ultrasound to assess the fetus’s size - A check of the fetus's heart rate - A physical exam to look for swelling in the mother’s face, hands, or legs as well as abdominal tenderness or an enlarged liver What are the treatments for preeclampsia, eclampsia, & HELLP syndrome? - Preeclampsia Treatment If the pregnancy is at 37 weeks or later, the health care provider will usually want to deliver the fetus to treat preeclampsia and avoid further complications. If the pregnancy is at less than 37 weeks, however, the woman and her health care provider may consider treatment options that give the fetus more time to develop, depending on how severe the condition is. A health care provider may consider the following options: - If the preeclampsia is mild, it may be possible to wait to deliver. To help prevent further complications, the health care provider may ask the woman to go on bed rest to try to lower blood pressure and increase the blood flow to the placenta. - Close monitoring of the woman and her fetus will be needed. Tests for the mother might include blood and urine tests to see if the preeclampsia is progressing, such as tests to assess platelet counts, liver enzymes, kidney function, and urinary protein levels. Tests for the fetus might include ultrasound, heart rate monitoring, assessment of fetal growth, and amniotic fluid assessment. - Anticonvulsive medication, such as magnesium sulfate, might be used to prevent a seizure. - In some cases, such as with severe preeclampsia, the woman will be admitted to the hospital so she can be monitored closely and continuously. Treatment in the hospital might include intravenous medication to control blood pressure and prevent seizures or other complications as well as steroid injections to help speed up the development of the fetus's lungs. When a woman has severe preeclampsia and is at 34 weeks of pregnancy or later, the American College of Obstetricians and Gynecologists recommends delivery as soon as medically possible. If the pregnancy is at less than 34 weeks, health care providers will probably prescribe corticosteroids to help speed up the maturation of the fetal lungs before attempting delivery.2 Preterm delivery may be necessary, even if that means likely complications for the infant, because of the risk of severe maternal complications. The symptoms of preeclampsia usually go away within 6 weeks of delivery.3 - If the preeclampsia is mild, it may be possible to wait to deliver. To help prevent further complications, the health care provider may ask the woman to go on bed rest to try to lower blood pressure and increase the blood flow to the placenta. - Close monitoring of the woman and her fetus will be needed. Tests for the mother might include blood and urine tests to see if the preeclampsia is progressing, such as tests to assess platelet counts, liver enzymes, kidney function, and urinary protein levels. Tests for the fetus might include ultrasound, heart rate monitoring, assessment of fetal growth, and amniotic fluid assessment. - Anticonvulsive medication, such as magnesium sulfate, might be used to prevent a seizure. - In some cases, such as with severe preeclampsia, the woman will be admitted to the hospital so she can be monitored closely and continuously. Treatment in the hospital might include intravenous medication to control blood pressure and prevent seizures or other complications as well as steroid injections to help speed up the development of the fetus's lungs. - Eclampsia Treatment Eclampsia—the onset of seizures in a woman with preeclampsia—is considered a medical emergency. Immediate treatment, usually in a hospital, is needed to stop the mother's seizures, treat blood pressure levels that are too high, and deliver the fetus. Magnesium sulfate (a type of mineral) may be given to treat active seizures and prevent future seizures. Antihypertensive medications may be given to lower the blood pressure. - HELLP Syndrome Treatment HELLP syndrome, a severe complication of preeclampsia and eclampsia, can lead to serious complications for the mother, including liver failure and death, as well as the fetus. The health care provider may consider the following treatments after a diagnosis of HELLP syndrome: - Delivery of the fetus - Hospitalization to provide intravenous medication to control blood pressure and prevent seizures or other complications as well as steroid injections to help speed up the development of the fetus's lungs.4 - Delivery of the fetus - Hospitalization to provide intravenous medication to control blood pressure and prevent seizures or other complications as well as steroid injections to help speed up the development of the fetus's lungs.4 Other FAQs - If I have high blood pressure, can I take steps to prevent problems like preeclampsia during pregnancy? If you currently have chronic hypertension (high blood pressure not due to pregnancy), you may be at higher-than-average risk for getting preeclampsia during pregnancy. Your risk is also higher if you had gestational hypertension (high blood pressure that occurs only during pregnancy) or preeclampsia with a previous pregnancy, if you are obese, or if you have other risk factors.1 Talk with your health care provider about how hypertension might affect your pregnancy and what you can do to lower your risk. Before You Get Pregnant - Visit your health care provider for a preconception visit to discuss what you can do to lower your risk. Your health care provider may recommend ways to control your blood pressure, if needed, by limiting your salt intake, exercising regularly, and losing weight if you are overweight. - If you take medication to control your blood pressure, ask your health care provider if you should change it. Some medications should not be used during pregnancy. Your health care provider may be able to recommend safer alternatives. While You Are Pregnant - Get regular prenatal care, including regular blood pressure checks, urine tests for protein, as well as regular weight checks. - Avoid alcohol and tobacco. - Talk with your health care provider about any drugs or supplements that you take or are thinking of taking, including vitamins and herbs. Follow your provider's recommendations about prescription and other medications. - If you are at very high risk of preeclampsia, your doctor may recommend that you start taking low-dose aspirin after at least 12 weeks of pregnancy.2 [top] - Visit your health care provider for a preconception visit to discuss what you can do to lower your risk. Your health care provider may recommend ways to control your blood pressure, if needed, by limiting your salt intake, exercising regularly, and losing weight if you are overweight. - If you take medication to control your blood pressure, ask your health care provider if you should change it. Some medications should not be used during pregnancy. Your health care provider may be able to recommend safer alternatives. - Get regular prenatal care, including regular blood pressure checks, urine tests for protein, as well as regular weight checks. - Avoid alcohol and tobacco. - Talk with your health care provider about any drugs or supplements that you take or are thinking of taking, including vitamins and herbs. Follow your provider's recommendations about prescription and other medications. - If you are at very high risk of preeclampsia, your doctor may recommend that you start taking low-dose aspirin after at least 12 weeks of pregnancy.2 - If I had preeclampsia with a previous pregnancy, will I have it again in later pregnancies? If you had preeclampsia during your first pregnancy, your risk of developing preeclampsia again is about 15%.3 Your risk is even higher if you delivered your first child before 28 weeks of pregnancy or if you are overweight or obese.3 Your risk of having preeclampsia again is also higher if you developed preeclampsia early in your previous pregnancy, if you developed chronic hypertension or diabetes after the first pregnancy, if you had in vitro fertilization, or if you are carrying more than one fetus. Having severe preeclampsia or HELLP syndrome during the first pregnancy also raises your risk. If you had HELLP syndrome during a pregnancy, you have about a 20% chance of getting some form of gestational hypertension again.4 [top] ", "role": "user" }, { "content": "Although preeclampsia occurs primarily in first pregnancies, a woman who had preeclampsia in a previous pregnancy is seven times more likely to develop preeclampsia in a later pregnancy. Other factors that can increase a woman's risk include chronic high blood pressure or kidney disease before pregnancy, obesity, age over 40, being pregnant with more than one fetus, African American ethnicity, family history of preeclampsia.The U.S. Preventative Services Task Force recommends that women who are at high risk for preeclampsia take low-dose aspirin starting after 12 weeks of pregnancy to prevent preeclampsia. Women who are pregnant or who are thinking about getting pregnant should talk with their health care provider about preeclampsia risk and ways to reduce the risk.", "role": "assistant" } ]

[ { "content": "Duchenne Muscular Dystrophy. I am doing a research project on this genetic disease and I would like to know more about it from a professional. I am researching the mode of inheritance, symptoms, treatments/ support groups, and relative cost to family.\n\nDuchenne muscular dystrophy: Duchenne muscular dystrophy (DMD) is a progressive form of muscular dystrophy that occurs primarily in males, though in rare cases may affect females. DMD causes progressive weakness and loss (atrophy) of skeletal and heart muscles. [1] Early signs of DMD may include delayed ability to sit, stand, or walk and difficulties learning to speak. Muscle weakness is usually noticeable by 3 or 4 years of age and begins in the hips, pelvic area, upper legs, and shoulders. The calves may be enlarged. Children with DMD may have an unusual walk and difficulty running, climbing stairs, and getting up from the floor. [2] DMD may also affect learning and memory, as well as communication and certain social emotional skills. [3] Muscle weakness worsens with age and progresses to the arms, legs and trunk. Most children with DMD use a wheelchair full time by age 13. Heart and respiratory muscle problems begin in the teen years and lead to serious, life threatening complications. [2] DMD is caused by changes ( mutations ) in the DMD gene . The DMD gene codes for the protein dystrophin. [1] [2] Dystrophin is mainly made in skeletal and heart muscle cells , but a small amount is also made in nerve cells (neurons) in specific parts of the brain. [3] DMD is  inherited in an X-linked recessive  pattern; however, it may also occur in people who do not have a family history of DMD. [2]  While there is no known cure for DMD, there are treatments that can help control symptoms. [4] Due to the advancement of medical treatment, boys with DMD may now live into young adulthood. [2] [3] Becker muscular dystrophy (BMD) is also caused by mutations in the DMD gene. People with BMD have less severe symptoms than DMD. In addition, symptoms start later in childhood or in adolescence and progress more slowly. [1] Symptoms of Duchenne muscular dystrophy (DMD) are usually noticed in boys between 1 to 6 years of age. There is a steady decline in muscle strength between the ages of 6 and 11 years. By age 10, braces may be required for walking, and by age 13, most boys with DMD are confined to a wheelchair. The signs and symptoms are as follows: [1] [2] [3] Taking longer to learn to sit, stand, or walk on own, which is known as delayed motor development. The mean age for walking in boys with DMD is 18 months. Having a waddling walk or gait, difficulty climbing stairs, and running due to progressive muscle weakness of the leg and pelvic muscles and progressive loss of muscle mass (wasting or atrophy).  Difficulty getting up from the floor. Child may walk his hands up his legs to stand which is known as the Gower maneuver. Enlargement of calf muscles due to the calf muscle cells being  Muscle weakness first affecting the muscles of the hips, pelvic area, thighs and shoulders, and later the skeletal (voluntary) muscles in the arms, legs and trunk. Tight or rigid joints (also known as contractures ) may develop as muscle loss progresses. If not treated, these will become severe, causing discomfort and restricting mobility and flexibility. Contractures can affect the knees, hips, feet, elbows, wrists and fingers. Scoliosis may develop within several years of being confined to a wheelchair. By the early teens, the respiratory and heart muscles are also affected. Breathing problems due to weakness of the diaphragm and the other muscles supporting the operation of the lungs. Skeletal changes, such as scoliosis, may also increase breathing problems. Breathing problems may become life threatening. Progressive enlargement of the heart ( cardiomyopathy ) develops. This stops the heart from pumping blood efficiently, and becomes life-threatening in many cases. Learning and memory issues (cognitive impairment) may occur in some cases, but do not worsen as the DMD progresses. Communication may be more difficult for some. Social behavior may be affected, as well as the ability to read facial cues.   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) Calf muscle hypertrophy Very frequent Cardiomyopathy Very frequent Cognitive impairment Very frequent Delayed speech and language development Very frequent Elevated serum creatine phosphokinase Very frequent Flexion contracture Very frequent Motor delay Very frequent Progressive muscle weakness Very frequent Proximal muscle weakness Very frequent Respiratory insufficiency Very frequent Scoliosis Very frequent Skeletal muscle atrophy Very frequent Specific learning disability Very frequent Waddling gait Very frequent Calf muscle pseudohypertrophy - Childhood onset - Congestive heart failure - Dilated cardiomyopathy - Generalized hypotonia - Gowers sign - Hyperlordosis - Hyporeflexia - Hypoventilation - Intellectual disability , mild - Muscular dystrophy - Respiratory failure - X-linked recessive inheritance - View complete list of signs and symptoms... Duchenne muscular dystrophy (DMD) is caused by mutations in the DMD gene . The DMD gene provides instructions for making a protein called dystrophin. Dystophin is primarily made in the muscle cells of the heart and skeletal muscle. The main job of dystrophin in muscle cells is to help stabilize and protect muscle fibers. [1] [2] [3]  DMD is caused by genetic changes in the DMD gene that stop any functional dystrophin from being made. [2] When dystrophin is missing, the muscle cells become damaged more easily. In response to the damage, inflammation occurs, which only worsens the process. Over time, the muscle cells without dystrophin weaken and die, leading to the muscle weakness and heart problems seen in DMD. [2] [3] The non-progressive memory and learning problems, as well as social behavioral problems, in some boys with DMD are most likely linked to loss of dystrophin in the neurons of the hippocampus and other parts of the brain where dystrophin is normally produced in small amounts, but at this point it is not known why this occurs and why only some people with DMD have these problems. [3]  Different genetic changes in the DMD gene can cause a spectrum of disorders known as dystrophinopathies. The dystrophinopathies can range from very mild symptoms to the more severe symptoms seen in people with DMD. Other dystrophinopathies include Becker muscular dystrophy (BMD) and DMD-associated dilated cardiomyopathy (DCM). [2] Genetic changes causing Duchenne muscular dystrophy (DMD) can be passed down in families. The DMD gene is located on the X chromosome , one of the two types of sex chromosomes . Males have an X and a Y chromosome ; whereas females have two X chromosomes . Since males only have one X chromosome, they also only have one copy of the DMD gene. If this copy has a genetic change that causes DMD, the male will have DMD. Males get their X chromosome from their mother and the Y chromosome from their father. [1] [2]  Since females have two X chromosomes, they have two copies of the DMD gene. Having two changed copies of the DMD gene that can cause DMD is unlikely, but would cause DMD in females. A female with only one changed copy of the DMD gene is called a \" carrier \". She can pass on the changed gene, but usually does not have symptoms of DMD. Carriers of changes in the DMD gene that can cause DMD are at an increased risk of developing heart problems, including cardiomyopathy . In addition, due to a process called X-inactivation , in rare cases, female carriers may have mild, moderate, or severe DMD. [2] If a man with DMD has children, all of his daughters will be carriers. Since boys inherit the Y chromosome from their father, sons will not inherit DMD from their fathers, even if the father has DMD. [1] [2] DMD DMD DMD DMD A child's doctor may suspect Duchenne muscular dystrophy (DMD) in young boys who have the signs and symptoms of DMD, including progressive muscle weakness. Family history is also important. Blood tests can be used to check for  increased levels of certain special proteins called muscle enzymes in the blood which can leak from damaged muscles. Most commonly, the blood level of the enzyme creatine phosphokinase (CPK or CK) is checked, but a doctor may also check the blood levels of transaminases such as aspartate transaminase and alanine transaminase. Finding a change in the DMD gene that can cause DMD through genetic testing confirms the diagnosis of DMD. [2] [5]   Testing for DMD may include: [2] [5]  Blood test which measures the levels of serum creatine phosphokinase Molecular genetic testing Electromyography Muscle biopsy is rarely used to diagnose DMD due to the decreased cost and higher accuracy of genetic testing. 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. There is no known cure for Duchenne muscular dystrophy (DMD) but research is ongoing. The goal of treatment is to control the symptoms of DMD and related complications caused by severe progressive muscle weakness and loss in order to maximize the quality of life. An enlarged, weakened heart (dilated cardiomyopathy ) may be treated with medications, but in severe cases a  heart transplant may be necessary. Assistive devices for breathing difficulties may be needed, especially at night and as the disease progresses. [2] [6] Physical therapy Steroids ( corticosteroids ) may improve the strength and function of muscles in people with DMD, including lung function. Steroid options include: [2] [6] Prednisone  is a steroid that has been shown to extend the ability to walk by 2 to 5 years. However, the possible side effects of prednisone include weight gain, high blood pressure , behavior changes, and delayed growth. Deflazacort (another form of prednisone), is used in Europe and believed to have fewer side effects and was recently approved in the United States by the FDA. Oxandrolone, a medication used in a research study, also has similar benefits to prednisone, but with fewer side effects. Management Guidelines Section on Cardiology and Cardiac Surgery. Cardiovascular health supervision for individuals affected by Duchenne or Becker Muscular Dystrophy. Pediatrics 2006; 116: 1569-1573. 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. Orphanet Emergency Guidelines is an article which is expert-authored and peer-reviewed that is intended to guide health care professionals in emergency situations involving this condition.   Project OrphanAnesthesia is a project whose aim is to create peer-reviewed, readily accessible guidelines for patients with rare diseases and for the anesthesiologists caring for them. The project is a collaborative effort of the German Society of Anesthesiology and Intensive Care, Orphanet, the European Society of Pediatric Anesthesia, anesthetists and rare disease experts with the aim to contribute to patient safety. FDA-Approved Treatments The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition. Learn more orphan products. National Library of Medicine Drug Information Portal National Library of Medicine Drug Information Portal Medline Plus Health Information The following diseases are related to Duchenne muscular dystrophy. If you have a question about any of these diseases, you can contact GARD. Muscular dystrophy", "role": "user" }, { "content": "Duchenne muscular dystrophy (DMD) is a progressive form of muscular dystrophy that occurs primarily in males, though in rare cases may affect females. Early signs of DMD may include delayed ability to sit, stand, or walk and difficulties learning to speak. Muscle weakness is usually noticeable by 3 or 4 years of age and begins in the hips, pelvic area, upper legs, and shoulders. DMD may also affect learning and memory, as well as communication and certain social emotional skills. Muscle weakness worsens with age and progresses to the arms, legs and trunk. Most children with DMD use a wheelchair full time by age 13. Heart and respiratory muscle problems begin in the teen years and lead to serious, life threatening complications. DMD is caused by mutations in the DMD gene, which are inherited in an X-linked recessive pattern. DMD may also occur in people who do not have a family history of the disease. While there is no known cure for DMD, there are treatments that can help control symptoms. and complications caused by severe progressive muscle weakness. An enlarged, weakened heart may be treated with medications, but in severe cases a heart transplant may be necessary. Assistive devices for breathing difficulties may be needed, especially at night and as the disease progresses. Steroids may improve the strength and function of muscles in people with DMD, including lung function. Due to the advancement of medical treatment, boys with DMD may now live into young adulthood.", "role": "assistant" } ]

[ { "content": "how do you diagnose anxiety\n\n Generalized anxiety disorder GAD Anxiety disorder Summary Generalized anxiety disorder (GAD) is a mental disorder in which a person is often worried or anxious about many things and finds it hard to control this anxiety. Causes The cause of GAD is unknown. Genes may play a role. Stress may also contribute to the development of GAD. GAD is a common condition. Anyone can develop this disorder, even children. GAD occurs more often in women than in men. Symptoms The main symptom is frequent worry or tension for at least 6 months, even when there is little or no clear cause. Worries seem to float from one problem to another. Problems may involve family, other relationships, work, school, money, and health. Even when aware that worries or fears are stronger than appropriate for the situation, a person with GAD still has difficulty controlling them. Other symptoms of GAD include: Problems concentrating Fatigue Irritability Problems falling or staying asleep, or sleep that is restless and unsatisfying Restlessness when awake The person may also have other physical symptoms. These can include muscle tension, upset stomach, sweating, or difficulty breathing. Exams and Tests There is no test that can make a diagnosis of GAD. The diagnosis is based on your answers to questions about the symptoms of GAD. Your health care provider will ask about these symptoms. You will also be asked about other aspects of your mental and physical health. A physical exam or lab tests may be done to rule out other conditions that cause similar symptoms. Treatment The goal of treatment is to help you feel better and function well in daily life. Talk therapy or medicine alone can be helpful. Sometimes, a combination of these may work best. TALK THERAPY Many types of talk therapy may be helpful for GAD. One common and effective talk therapy is cognitive-behavioral therapy (CBT). CBT can help you understand the relationship between your thoughts, behaviors, and symptoms. Often CBT involves a set number of visits. During CBT you can learn how to: Understand and gain control of distorted views of stressors, such as other people's behavior or life events. Recognize and replace panic-causing thoughts to help you feel more in control. Manage stress and relax when symptoms occur. Avoid thinking that minor problems will develop into terrible ones. Other types of talk therapy may also be helpful in managing symptoms of an anxiety disorder. MEDICINES Certain medicines, usually used to treat depression, may be very helpful for this disorder. They work by preventing your symptoms or making them less severe. You must take these medicines every day. DO NOT stop taking them without talking with your provider. Medicines called sedatives or hypnotics may also be prescribed. These medicines should only be taken under a doctor's direction. Your doctor will prescribe a limited amount of these drugs. They should not to be used everyday. They may be used when symptoms become very severe or when you are about to be exposed to something that always brings on your symptoms. If you are prescribed a sedative, do not drink alcohol while on this medicine. SELF-CARE Other than taking medicine and going to therapy, you can help yourself get better by: Reducing caffeine Not using street drugs or large amounts of alcohol Exercising, getting enough rest, and eating healthy foods Support Groups You can ease the stress of having GAD by joining a support group. Sharing with others who have common experiences and problems can help you not feel alone. Support groups are usually not a good substitute for talk therapy or taking medicine, but can be a helpful addition. Resources for more information include: Anxiety and Depression Association of America -- adaa.org National Institute of Mental Health -- www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml Outlook (Prognosis) How well a person does depends on how severe the condition is. In some cases, GAD is long-term and is difficult to treat. Most people, though, get better with medicine and/or talk therapy. Possible Complications Depression and substance abuse may occur with an anxiety disorder. When to Contact a Medical Professional Call your provider if you frequently worry or feel anxious, especially if it interferes with your daily activities. Review Date 3/26/2018 Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "There is no 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": "what are the causes of pulmonary hypertension\n\n Pulmonary Hypertension What Is... Pulmonary hypertension (PULL-mun-ary HI-per-TEN-shun), or PH, is increased pressure in the pulmonary arteries. These arteries carry blood from your heart to your lungs to pick up oxygen. PH causes symptoms such as shortness of breath during routine activity (for example, climbing two flights of stairs), tiredness, chest pain, and a racing heartbeat. As the condition worsens, its symptoms may limit all physical activity. Overview To understand PH, it helps to understand how your heart and lungs work. Your heart has two sides, separated by an inner wall called the septum. Each side of your heart has an upper and lower chamber. The lower right chamber of your heart, the right ventricle (VEN-trih-kul), pumps blood to your pulmonary arteries. The blood then travels to your lungs, where it picks up oxygen. The upper left chamber of your heart, the left atrium (AY-tree-um), receives the oxygen-rich blood from your lungs. The blood is then pumped into the lower left chamber of your heart, the left ventricle. From the left ventricle, the blood is pumped to the rest of your body through an artery called the aorta. For more information about the heart and lungs, go to the Diseases and Conditions Index How the Heart Works and How the Lungs Work articles. PH begins with inflammation and changes in the cells that line your pulmonary arteries. Other factors also can affect the pulmonary arteries and cause PH. For example, the condition may develop if: The walls of the arteries tighten. The walls of the arteries are stiff at birth or become stiff from an overgrowth of cells. Blood clots form in the arteries. These changes make it hard for your heart to push blood through your pulmonary arteries and into your lungs. As a result, the pressure in your arteries rises. Also, because your heart is working harder than normal, your right ventricle becomes strained and weak. Your heart may become so weak that it can't pump enough blood to your lungs. This causes heart failure. Heart failure is the most common cause of death in people who have PH. PH is divided into five groups based on its causes. In all groups, the average pressure in the pulmonary arteries is higher than 25 mmHg at rest or 30 mmHg during physical activity. The pressure in normal pulmonary arteries is 8–20 mmHg at rest. (The mmHg is millimeters of mercury—the units used to measure blood pressure.) Other diseases or conditions, such as heart and lung diseases or blood clots, usually cause PH. Some people inherit the condition (that is, their parents pass the genes for PH on to them). In some cases, the cause isn't known. Outlook PH has no cure. However, research for new treatments is ongoing. The earlier PH is treated, the easier it is to control. Treatments include medicines, procedures, and other therapies. These treatments can relieve PH symptoms and slow the progress of the disease. Lifestyle changes also can help control symptoms. Types The World Health Organization divides pulmonary hypertension (PH) into five groups. These groups are organized based on the cause of the condition. In all groups, the average pressure in the pulmonary arteries is higher than 25 mmHg at rest or 30 mmHg during physical activity. The pressure in normal pulmonary arteries is 8–20 mmHg at rest. (Note that group 1 is called pulmonary arterial hypertension (PAH) and groups 2 through 5 are called pulmonary hypertension. However, together all groups are called pulmonary hypertension.) Group 1 Pulmonary Arterial Hypertension Group 1 PAH includes: PAH that has no known cause. PAH that's inherited (passed from parents to children through genes). PAH that's caused by drugs or toxins, such as street drugs and certain diet medicines. PAH that's caused by conditions such as: - Connective tissue diseases. (Connective tissue helps support all parts of your body, including your skin, eyes, and heart.) - HIV infection. - Liver disease. - Congenital heart disease. This is heart disease that's present at birth. - Sickle cell disease. - Schistosomiasis (SKIS-toe-so-MI-ah-sis). This is an infection caused by a parasite. Schistosomiasis is one of the most common causes of PAH in many parts of the world. Connective tissue diseases. (Connective tissue helps support all parts of your body, including your skin, eyes, and heart.) HIV infection. Liver disease. Congenital heart disease. This is heart disease that's present at birth. Sickle cell disease. Schistosomiasis (SKIS-toe-so-MI-ah-sis). This is an infection caused by a parasite. Schistosomiasis is one of the most common causes of PAH in many parts of the world. PAH that's caused by conditions that affect the veins and small blood vessels of the lungs. Group 2 Pulmonary Hypertension Group 2 includes PH with left heart disease. Conditions that affect the left side of the heart, such as mitral valve disease or long-term high blood pressure, can cause left heart disease and PH. Left heart disease is likely the most common cause of PH. Group 3 Pulmonary Hypertension Group 3 includes PH associated with lung diseases, such as COPD (chronic obstructive pulmonary disease) and interstitial (IN-ter-STISH-al) lung diseases. Interstitial lung diseases cause scarring of the lung tissue. Group 3 also includes PH associated with sleep-related breathing disorders, such as sleep apnea. Group 4 Pulmonary Hypertension Group 4 includes PH caused by blood clots in the lungs or blood clotting disorders. Group 5 Pulmonary Hypertension Group 5 includes PH caused by various other diseases or conditions. Examples include: Blood disorders, such as polycythemia vera (POL-e-si-THE-me-ah VAY-rah or VE-rah) and essential thrombocythemia (THROM-bo-si-THE-me-ah). Systemic disorders, such as sarcoidosis (sar-koy-DO-sis) and vasculitis (vas-kyu-LI-tis). Systemic disorders involve many of the body's organs. Metabolic disorders, such as thyroid disease and glycogen storage disease. (In glycogen storage disease, the body's cells don't use a form of glucose (sugar) properly.) Other conditions, such as tumors that press on the pulmonary arteries and kidney disease. Other Names Group 1 pulmonary arterial hypertension (PAH) that occurs without a known cause often is called primary PAH or idiopathic (id-ee-o-PATH-ick) PAH. Group 1 PAH that occurs with a known cause often is called associated PAH. For example, PAH that occurs in a person who has scleroderma might be called \"PAH occurring in association with scleroderma,\" or simply \"scleroderma-associated PAH.\" Groups 2–5 pulmonary hypertension (PH) sometimes are called secondary PH. Causes Pulmonary hypertension (PH) begins with inflammation and changes in the cells that line your pulmonary arteries. Other factors also can affect the pulmonary arteries and cause PH. For example, the condition may develop if: The walls of the arteries tighten. The walls of the arteries are stiff at birth or become stiff from an overgrowth of cells. Blood clots form in the arteries. These changes make it hard for your heart to push blood through your pulmonary arteries and into your lungs. Thus, the pressure in the arteries rises, causing PH. Many factors can contribute to the process that leads to the different types of PH. Group 1 pulmonary arterial hypertension (PAH) may have no known cause, or the condition may be inherited. (\"Inherited\" means the condition is passed from parents to children through genes.) Some diseases and conditions also can cause group 1 PAH. Examples include HIV infection, congenital heart disease, and sickle cell disease. Also, the use of street drugs (such as cocaine) and certain diet medicines can lead to PAH. Many diseases and conditions can cause groups 2 through 5 PH (often called secondary PH), including: Mitral valve disease Lung diseases, such as COPD (chronic obstructive pulmonary disease) Sleep apnea Sarcoidosis For more information about the types of PH and the diseases, conditions, and factors that can cause them, go to \"Types of Pulmonary Hypertension.\" Who Is at Risk The exact number of people who have pulmonary hypertension (PH) isn't known. Group 1 pulmonary arterial hypertension (PAH) without a known cause is rare. It affects women more often than men. People who have group 1 PAH tend to be overweight. PH that occurs with another disease or condition is more common. PH usually develops between the ages of 20 and 60, but it can occur at any age. People who are at increased risk for PH include: Those who have a family history of the condition. Those who have certain diseases or conditions, such as heart and lung diseases, liver disease, HIV infection, or blood clots in the pulmonary arteries. (For more information about the diseases, conditions, and factors that cause PH, go to \"Types of Pulmonary Hypertension.\") Those who use street drugs (such as cocaine) or certain diet medicines. Those who live at high altitudes. Signs & Symptoms Signs and symptoms of pulmonary hypertension (PH) may include: Shortness of breath during routine activity, such as climbing two flights of stairs Tiredness Chest pain A racing heartbeat Pain on the upper right side of the abdomen Decreased appetite As PH worsens, you may find it hard to do any physical activities. At this point, other signs and symptoms may include: Feeling light-headed, especially during physical activity Fainting at times Swelling in your legs and ankles A bluish color on your lips and skin Diagnosis 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. Treatment Pulmonary hypertension (PH) has no cure. However, treatment may help relieve symptoms and slow the progress of the disease. PH is treated with medicines, procedures, and other therapies. Treatment will depend on what type of PH you have and its severity. (For more information, go to \"Types of Pulmonary Hypertension.\") Group 1 Pulmonary Arterial Hypertension Group 1 pulmonary arterial hypertension (PAH) includes PH that's inherited, that has no known cause, or that's caused by certain drugs or conditions. Treatments for group 1 PAH include medicines and medical procedures. Medicines Your doctor may prescribe medicines to relax the blood vessels in your lungs and reduce excess cell growth in the blood vessels. As the blood vessels relax, more blood can flow through them. Your doctor may prescribe medicines that are taken by mouth, inhaled, or injected. Examples of medicines for group 1 PAH include: Phosphodiesterase-5 inhibitors, such as sildenafil Prostanoids, such as epoprostenol Endothelin receptor antagonists, such as bosentan and ambrisentan Calcium channel blockers, such as diltiazem Your doctor may prescribe one or more of these medicines. To find out which of these medicines works best, you'll likely have an acute vasoreactivity test. This test shows how the pressure in your pulmonary arteries reacts to certain medicines. The test is done during right heart catheterization. Medical and Surgical Procedures If you have group 1 PAH, your doctor may recommend one or more of the following procedures. Atrial septostomy (sep-TOS-toe-me). For this procedure, a thin, flexible tube called a catheter is put into a blood vessel in your leg and threaded to your heart. The tube is then put through the wall that separates your right and left atria (the upper chambers of your heart). This wall is called the septum. A tiny balloon on the tip of the tube is inflated. This creates an opening between the atria. This procedure relieves the pressure in the right atria and increases blood flow. Atrial septostomy is rarely done in the United States. Lung transplant. A lung transplant is surgery to replace a person's diseased lung with a healthy lung from a deceased donor. This procedure may be used for people who have severe lung disease that's causing PAH. Heart–lung transplant. A heart–lung transplant is surgery in which both the heart and lung are replaced with healthy organs from a deceased donor. Group 2 Pulmonary Hypertension Conditions that affect the left side of the heart, such as mitral valve disease, can cause group 2 PH. Treating the underlying condition will help treat PH. Treatments may include lifestyle changes, medicines, and surgery. Group 3 Pulmonary Hypertension Lung diseases, such as COPD (chronic obstructive pulmonary disease) and interstitial lung disease, can cause group 3 PH. Certain sleep disorders, such as sleep apnea, also can cause group 3 PH. If you have this type of PH, you may need oxygen therapy. This treatment raises the level of oxygen in your blood. You'll likely get the oxygen through soft, plastic prongs that fit into your nose. Oxygen therapy can be done at home or in a hospital. Your doctor also may recommend other treatments if you have an underlying lung disease. Group 4 Pulmonary Hypertension Blood clots in the lungs or blood clotting disorders can cause group 4 PH. If you have this type of PH, your doctor will likely prescribe blood-thinning medicines. These medicines prevent clots from forming or getting larger. Sometimes doctors use surgery to remove scarring in the pulmonary arteries due to old blood clots. Group 5 Pulmonary Hypertension Various diseases and conditions, such as thyroid disease and sarcoidosis, can cause group 5 PH. An object, such as a tumor, pressing on the pulmonary arteries also can cause group 5 PH. Group 5 PH is treated by treating its cause. All Types of Pulmonary Hypertension Several treatments may be used for all types of PH. These treatments include: Diuretics, also called water pills. These medicines help reduce fluid buildup in your body, including swelling in your ankles and feet. Blood-thinning medicines. These medicines help prevent blood clots from forming or getting larger. Digoxin. This medicine helps the heart beat stronger and pump more blood. Digoxin sometimes is used to control the heart rate if abnormal heart rhythms, such as atrial fibrillation or atrial flutter, occur. Oxygen therapy. This treatment raises the level of oxygen in your blood. Physical activity. Regular activity may help improve your ability to be active. Talk with your doctor about a physical activity plan that's safe for you. Research is ongoing for better PH treatments. These treatments offer hope for the future. Living With Pulmonary hypertension (PH) has no cure. However, you can work with your doctor to manage your symptoms and slow the progress of the disease. Ongoing Care Follow your treatment plan as your doctor advises. Call your doctor if your PH symptoms worsen or change. The earlier symptoms are addressed, the easier it is to treat them. Some symptoms, such as chest pain, may require emergency treatment. Ask your doctor when you should call him or her or seek emergency care. Also, talk with your doctor before taking any over-the-counter medicines. Some medicines can make your PH worse or interfere with the medicines you're taking for PH. Ask your doctor whether you should get a pneumonia vaccine and a yearly flu shot. You may have a complex schedule for taking medicines. Call your doctor or nurse if you're having problems with this schedule. Knowing the names of your medicines and how they work is helpful. Keep a list of your medicines with you. Don't stop or change medicines unless you talk with your doctor first. Pay careful attention to your weight. You may want to keep a daily record of your weight. You should weigh yourself at the same time each day. If you notice a rapid weight gain (2 or more pounds in 1 day or 5 or more pounds in 1 week), call your doctor. This may be a sign that your PH is worsening. Pregnancy is risky for women who have PH. Consider using birth control if there is a chance you may become pregnant. Ask your doctor which birth control methods are safe for you. Lifestyle Changes Making lifestyle changes can help you manage your symptoms. These changes will depend on the type of PH you have. Talk with your doctor about which lifestyle changes can help you. Quit Smoking If you smoke, quit. Smoking makes PH symptoms worse. Ask your doctor about programs and products that can help you quit. Also, avoid exposure to secondhand smoke. 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 both include general information about how to quit smoking. Follow a Healthy Diet Following a healthy diet and maintaining a healthy weight are part of a healthy lifestyle. 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. Talk with your doctor about whether you need to limit the amount of salt and fluids in your diet. Ask him or her whether you also need to regulate foods that contain vitamin K. These foods can affect how well blood-thinning medicines work. Vitamin K is found in green leafy vegetables and some oils, such as canola and soybean oil. 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. The DASH eating plan focuses on reduced-sodium foods, which may be helpful if your doctor advises you to limit the salt in your diet. Be Physically Active Physical activity is an important part of a healthy lifestyle. Try to do physical activity, such as walking, regularly. This will keep your muscles strong and help you stay active. Ask your doctor how much activity is safe for you. Your doctor may tell you to limit or avoid certain activities, such as: Those that cause straining, such as lifting heavy objects or weights. Sitting in a hot tub or sauna or taking long baths. These activities can lower your blood pressure too much. Flying in an airplane or traveling to high-altitude areas. Your doctor may ask you to use extra oxygen during air travel. Avoid activities that cause breathing problems, dizziness, or chest pain. If you have any of these symptoms, seek care right away. Emotional Issues and Support Living with PH may cause fear, anxiety, depression, and stress. You may worry about your medical condition, treatment, finances, and other issues. Talk about how you feel with your health care team. Talking to a professional counselor also can help. If you're very depressed, your doctor may recommend medicines or other treatments that can improve your quality of life. Joining a patient support group may help you adjust to living with PH. You can see how other people who have the same symptoms have coped with them. Talk with your doctor about local support groups or check with an area medical center. Support from family and friends also can help relieve stress and anxiety. Let your loved ones know how you feel and what they can do to help you. ", "role": "user" }, { "content": "The World Health Organization divides pulmonary hypertension (PH) into five groups. These groups are organized based on the cause of the condition. In all groups, the average pressure in the pulmonary arteries is higher than 25 mmHg at rest or 30 mmHg during physical activity. The pressure in normal pulmonary arteries is 8?20 mmHg at rest. Group 1 Pulmonary Arterial Hypertension Group 1 PAH includes: PAH that has no known cause. PAH that's inherited. PAH that's caused by drugs or toxins, such as street drugs and certain diet medicines. PAH that's caused by conditions such as: - Connective tissue diseases. - HIV infection. - Liver disease. - Congenital heart disease. Connective tissue diseases. Liver disease. Congenital heart disease. Group 2 Pulmonary Hypertension Group 2 includes PH with left heart disease. Conditions that affect the left side of the heart, such as mitral valve disease or long-term high blood pressure, can cause left heart disease and PH. Left heart disease is likely the most common cause of PH. Group 3 Pulmonary Hypertension Group 3 includes PH associated with lung diseases, such as COPD (chronic obstructive pulmonary disease) and interstitial (IN-ter-STISH-al) lung diseases. Interstitial lung diseases cause scarring of the lung tissue. Group 3 also includes PH associated with sleep-related breathing disorders, such as sleep apnea. Group 4 Pulmonary Hypertension Group 4 includes PH caused by blood clots in the lungs or blood clotting disorders. Group 5 Pulmonary Hypertension Group 5 includes PH caused by various other diseases or conditions.", "role": "assistant" } ]

[ { "content": "williams sydrome conditon. i need to send me more information about Williams Syndrome and some tips how to educate people with this disorder.I hope having news from you soon!!thank you\n\nWilliams syndrome (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.", "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": "I am suffering from Kartagener's syndrome and wanted information from you or from Dr. . for this syndrome. (About fertility) and if possible other symptoms. Thank you.\n\n Kartagener syndrome Dextrocardia bronchiectasis and sinusitis Siewert syndrome Immotile cilia syndrome, Kartagener type Dextrocardia bronchiectasis and sinusitis Siewert syndrome Immotile cilia syndrome, Kartagener type Primary ciliary dyskinesia, Kartagener type Dextrocardia-bronchiectasis-sinusitis syndrome Primary ciliary dyskinesia and situs inversus See More Summary Kartagener syndrome is a type of p that is also characterized by situs inversus totalis (mirror-image reversal of internal organs ). The signs and symptoms vary but may include neonatal respiratory distress; frequent lung, sinus and middle ear infections beginning in early childhood; and infertility. [1] [2] [3] It can be cause by changes ( mutations ) in many different genes that are inherited in an autosomal recessive manner. Although scientists have identified many of the genes associated with Kartagener syndrome, the genetic cause of some cases is unknown. [4] [2] There is no cure for Kartagener syndrome. Treatment varies based on the signs and symptoms present in each person but may include airway clearance therapy and antibiotics . [1] [2] [3] Symptoms Kartagener syndrome is characterized by p and situs inversus totalis. In people affected by situs inversus totalis, the internal organs including the heart, liver, spleen and intestine are on the opposite side of the body. Although the internal organs are abnormally placed, this condition typically does not cause any health problems. [1] [2] The signs and symptoms of primary ciliary dyskinesia vary, but may include: [1] [2] [3] Neonatal respiratory distress Frequent respiratory infections that can lead to severe lung damage Chronic nasal congestion Frequent sinus infections Recurrent middle ear infections, particularly in early childhood Hearing loss Hydrocephalus Infertility Cause Kartagener syndrome can be caused by changes ( mutations ) in many different genes . These genes encode proteins that are important to the structure and function of cilia. Cilia are tiny, hair-like structures that are found on the surface of cells in various parts of the body such as the lining of the airway, the reproductive system, and other organs . The coordinated movement of cilia in wave-like motions is important to the normal functioning of certain organs and tissues throughout the body and ensures the proper placement of organs in the developing embryo. Mutations in these genes cause the cilia to be either immotile (unable to move) or dysmotile (they move incorrectly), which leads to the many signs and symptoms of Kartagener syndrome. [1] [4] [3] Scientists have identified several different genes that are associated with Kartagener syndrome; however, the genetic cause is unknown in some cases. [1] [4] [3] Inheritance Kartagener syndrome is inherited in an autosomal recessive manner. [4] This means that to be affected, a person must have a mutation in both copies of the responsible gene in each cell . The parents of an affected person usually each carry one mutated copy of the gene and are referred to as carriers . Carriers typically do not show signs or symptoms of the condition. When two carriers of an autosomal recessive condition have children, each child has a 25% (1 in 4) risk to have the condition, a 50% (1 in 2) risk to be a carrier like each of the parents, and a 25% chance to not have the condition and not be a carrier. Diagnosis Kartagener syndrome is typically suspected based on the presence of characteristic signs and symptoms. A diagnosis can be confirmed by examining a small sample of tissue ( biopsy ) from an area of the body known to have cilia such as the sinus cavities or the airway. Abnormalities in the structure of cilia, as seen in people affected by Kartagener syndrome, can be observed under a special microscope (called an electron microscope). If the disease-causing change ( mutation ) is known, genetic testing can also be used to confirm the diagnosis. [1] [2] [3] Testing Resources The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional. Treatment There is currently no cure for Kartagener syndrome . Treatment varies based on the signs and symptoms present in each person. Airway clearance therapy, similar to that used in cystic fibrosis, can loosen thick, sticky mucus so it can be cleared away. Antibiotics may be prescribed to treat respiratory, sinus, and middle ear infections and may be given on a long-term basis in people with chronic or frequent infections. Surgery to insert ear tubes may be recommended in children with chronic ear infections that are resistant to antibiotics. In people with severe lung disease, lung transplantation may be an option. [1] [2] [3] For more information on the treatment and management of Kartagener syndrome, please click here. Prognosis The long-term outlook for people with Kartagener syndrome varies widely and largely depends on timely diagnosis and treatment. Chronic childhood infections can be very debilitating. However, with appropriate treatment, the progression of lung disease can be slowed and other complications such as hearing loss can be avoided. [3] [2] [5] ", "role": "user" }, { "content": "Kartagener syndrome is inherited in an autosomal recessive manner. [4] This means that to be affected, a person must have a mutation in both copies of the responsible gene in each cell . The parents of an affected person usually each carry one mutated copy of the gene and are referred to as carriers . Carriers typically do not show signs or symptoms of the condition. When two carriers of an autosomal recessive condition have children, each child has a 25% (1 in 4) risk to have the condition, a 50% (1 in 2) risk to be a carrier like each of the parents, and a 25% chance to not have the condition and not be a carrier.", "role": "assistant" } ]

[ { "content": "how do we treat the burns caused by radiation?\n\nBurns (Treatment): Treatment of burns depends on the type and extent of the injuries. Most minor burns can be treated at home using over-the-counter products or aloe. They usually heal within a few weeks. For serious burns, after appropriate first aid care and wound assessment, your treatment may involve medications, wound dressings, therapy and surgery. The goals of treatment are to control pain, remove dead tissue, prevent infection, reduce scarring, regain function and address emotional needs. You may need months of additional treatments and therapy. This may be done during a hospital stay, on an outpatient basis or at home. Factors affecting this choice include your wishes, other conditions and abilities, such as whether you're able to change bandages. Medications and wound healing products For major burns, various medications and products are used to encourage healing. - Water-based treatments. Your care team may use techniques such as ultrasound mist therapy to clean and stimulate the wound tissue. - Fluids to prevent dehydration. You may need intravenous (IV) fluids to prevent dehydration and organ failure. - Pain and anxiety medications. Healing burns can be incredibly painful. You may need morphine and anti-anxiety medications - particularly for dressing changes. - Burn creams and ointments. Your care team can select from a variety of topical products for wound healing. These help keep the wound moist, reduce pain, prevent infection and speed healing. - Dressings. Your care team may also use various specialty wound dressings. These create a moist environment that fights infection and helps the burn heal. - Drugs that fight infection. If you develop an infection, you may need IV antibiotics. - Tetanus shot. Your doctor might recommend a tetanus shot after a burn injury. Physical and occupational therapy If the burned area is large, especially if it covers any joints, you may need physical therapy exercises. These can help stretch the skin so the joints can remain flexible. Other types of exercises can improve muscle strength and coordination. And occupational therapy may help if you have difficulty doing your normal daily activities. Surgical and other procedures You may need one or more of the following procedures: - Breathing assistance. If you've been burned on the face or neck, your throat may swell shut. If that appears likely, your doctor may insert a tube down your windpipe (trachea) to keep oxygen supplied to your lungs. - Tube feeding. Your metabolism goes into overdrive when your body starts trying to heal your burns. To provide adequate nutrition for this task, you doctor may thread a feeding tube through your nose to your stomach. - Easing blood flow around the wound. If a burn scab (eschar) goes completely around a limb, it can tighten and cut off the blood circulation. A scab (eschar) that goes completely around the chest can make it difficult to breathe. Your doctor may cut the eschar in several places to relieve this pressure. This procedure is called decompression. - Skin grafts. A skin graft is a surgical procedure in which sections of your own healthy skin are used to replace the scar tissue caused by deep burns. Donor skin from cadavers or pigs can be used as a temporary solution. - Plastic surgery. Plastic surgery (reconstruction) can improve the appearance of burn scars and increase the flexibility of joints affected by scarring.", "role": "user" }, { "content": "Treatment of burns depends on the type and extent of the injuries. Most minor burns can be treated at home using over-the-counter products or aloe. They usually heal within a few weeks. For serious burns, after appropriate first aid care and wound assessment, your treatment may involve medications, wound dressings, therapy and surgery. The goals of treatment are to control pain, remove dead tissue, prevent infection, reduce scarring, regain function and address emotional needs. You may need months of additional treatments and therapy.", "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 might require surgery. The most common type of scoliosis surgery is spinal fusion, in which surgeons connect two or more vertebrae together, so they can't move independently. Physical therapy exercises do not stop scoliosis, but general exercise or participating in sports may improve overall health and well-being. The following treatments for scoliosis are ineffective: chiropractic manipulation, electrical stimulation of muscles, and dietary supplements", "role": "assistant" } ]

[ { "content": "Please let me know where I can get literature on Cardiac amyloidosis. My uncle died yesterday from this disorder. Since this is such a rare disorder, and to honor his memory, I would like to distribute literature at his funeral service.\n\nCardiac amyloidosis (Treatment): Your health care provider may tell you to make changes to your diet, including limiting salt and fluids. You may need to take water pills (diuretics) to help your body get rid of excess fluid. The provider may tell you to weigh yourself every day. A weight gain of 3 or more pounds (1 kilogram or more) over 1 to 2 days can mean there is too much fluid in the body. Medicines including digoxin, calcium-channel blockers, and beta-blockers may be used in people with atrial fibrillation. However, the drugs must be used with caution, and the dosage must be carefully monitored. People with cardiac amyloidosis may be extra sensitive to side effects of these drugs. Other treatments may include: - Chemotherapy - Implantable cardioverter-defibrillator (AICD) - Pacemaker, if there are problems with heart signals - Prednisone, an anti-inflammatory medicine A heart transplant may be considered for people with some types of amyloidosis who have very poor heart function. People with hereditary amyloidosis may need a liver transplant.", "role": "user" }, { "content": "To treat cardiac amyloidosis you may need to make changes to your diet, including limiting salt and fluids, and take water pills (diuretics). People with cardiac amyloidosis may be extra sensitive to side effects of digoxin, calcium-channel blockers, and beta-blockers that may be used for atrial fibrillation. Your doctor may recommend chemotherapy, implantable cardioverter-defibrillator (AICD), a pacemaker for problems with heart signals, and prednisone, an anti-inflammatory medicine. A heart transplant may be considered for people with some types of amyloidosis who have very poor heart function. People with hereditary amyloidosis may need a liver transplant.", "role": "assistant" } ]

[ { "content": "what is binge eating disorder\n\nBinge eating disorder (How does binge eating disorder affect pregnancy?): Binge eating disorder can cause problems getting pregnant and during pregnancy. Pregnancy can also trigger binge eating disorder. Obesity raises the level of the hormone estrogen in your body. Higher levels of estrogen can stop you from ovulating, or releasing an egg from the ovary. This can make it more difficult to get pregnant. However, if you do not want to have children right now and have sex, you should use birth control. Overweight or obesity may also cause problems during pregnancy. Overweight and obesity raises your risk for: Pregnancy can raise the risk for binge eating disorder in women who are at higher risk for eating disorders. In one study, almost half of the women with binge eating disorder got the condition during pregnancy. The research suggests that binge eating during pregnancy may be caused by:16 After pregnancy, postpartum depression and weight from pregnancy can trigger binge eating disorder in women with a history of binge eating. Women with binge eating disorder before pregnancy often gain more weight during pregnancy than women without an eating disorder. Researchers think that weight gain during pregnancy may cause some women who had binge eating disorder before pregnancy to binge eat during pregnancy.17", "role": "user" }, { "content": "Binge eating disorder can cause problems getting pregnant and during pregnancy. Pregnancy can also trigger binge eating disorder. Pregnancy can raise the risk for binge eating disorder in women who are at higher risk for eating disorders.", "role": "assistant" } ]

[ { "content": "how nicotine effects the brain\n\nNicotine and tobacco: The nicotine in tobacco can be addictive like alcohol, cocaine, and morphine. Tobacco is a plant grown for its leaves, which are smoked, chewed, or sniffed. - Tobacco contains a chemical called nicotine. Nicotine is an addictive substance. - Millions of people in the United States have been able to quit smoking. Although the number of cigarette smokers in the United States has dropped in recent years, the number of smokeless tobacco users has steadily increased. Smokeless tobacco products are either placed in the mouth, cheek, or lip and sucked or chewed on, or placed in the nasal passage. The nicotine in these products is absorbed at the same rate as smoking tobacco, and addiction is still very strong. Both smoking and smokeless tobacco use carry many health risks. Nicotine use can have many different effects on the body. It can: - Decrease the appetite; fear of weight gain makes some people unwilling to stop smoking - Boost mood, give people a sense of well-being, and possibly even relieve minor depression - Increase activity in the intestines - Create more saliva and phlegm - Increase the heart rate by around 10 to 20 beats per minute - Increase blood pressure by 5 to 10 mm Hg - Possibly cause sweating, nausea, and diarrhea - Stimulate memory and alertness; people who use tobacco often depend on it to help them accomplish certain tasks and perform well Symptoms of nicotine withdrawal appear within 2 to 3 hours after you last use tobacco. People who smoked the longest or smoked a greater number of cigarettes each day are more likely to have withdrawal symptoms. For those who are quitting, symptoms peak about 2 to 3 days later. Common symptoms include: - Intense craving for nicotine - Anxiety - Depression - Drowsiness or trouble sleeping - Bad dreams and nightmares - Feeling tense, restless, or frustrated - Headaches - Increased appetite and weight gain - Problems concentrating You may notice some or all of these symptoms when switching from regular to low-nicotine cigarettes or reducing the number of cigarettes you smoke. It is hard to stop smoking or using smokeless tobacco, but anyone can do it. There are many ways to quit smoking. There are also resources to help you quit. Family members, friends, and co-workers may be supportive. Quitting tobacco is hard if you are trying to do it alone. To be successful, you must really want to quit. Most people who have quit smoking were unsuccessful at least once in the past. Try not to view past attempts as failures. See them as learning experiences. Most smokers find it hard to break all the habits they have created around smoking. A smoking cessation program may improve your chance for success. These programs are offered by hospitals, health departments, community centers, work sites, and national organizations. Nicotine replacement therapy may also be helpful. It involves the use of products that provide low doses of nicotine, but none of the toxins found in smoke. Nicotine replacement comes in the form of: - Gum - Inhalers - Throat lozenges - Nasal spray - Skin patches You can buy many types of nicotine replacement without a prescription. The goal is to relieve cravings for nicotine and ease your withdrawal symptoms. Health experts warn that e-cigarettes are not a replacement therapy for cigarette smoking. It is not known exactly how much nicotine is in e-cigarette cartridges, because information on labels is often wrong. Your health care provider can also prescribe other types of medicines to help you quit and prevent you from starting again. Your provider can refer you to stop smoking programs. These are offered by hospitals, health departments, community centers, work sites, and national organizations. People who are trying to quit smoking often become discouraged when they do not succeed at first. Research shows that the more times you try, the more likely you are to succeed. If you start smoking again after you have tried to quit, do not give up. Look at what worked or did not work, think of new ways to quit smoking, and try again. There are many more reasons to quit using tobacco. Knowing the serious health risks from tobacco may help motivate you to quit. Tobacco and related chemicals can increase your risk of serious health problems such as cancer, lung disease, and heart attack. See your provider if you wish to stop smoking, or have already done so and are having withdrawal symptoms. Your provider can help recommend treatments. Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta GA. Internal review and update on 09/01/2016 by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.", "role": "user" }, { "content": "The addictive ingredient of tobacco is nicotine. Nicotine can have many effects on the body: It can decrease appetite, boost mood, increase intestinal activity, increase heart rate, increase blood pressure, and stimulate memory and alertness. Symptoms of withdrawal include craving for nicotine, anxiety, depression, drowsiness, trouble sleeping, feeling tense, headaches, problems concentrating, and increased appetite.", "role": "assistant" } ]

[ { "content": "Bipolar and Generalized Anxiety Disorder I read about TMS Therapy. Do you know anything about it? Has it had success? Also wondering about ECT? Finally, I've been told acupuncture can help for mood disorders. Is that true for mixed bipolar and generalized anxiety disorder along with meds? Have you ever heard of this?\n\n Generalized anxiety disorder GAD Anxiety disorder Summary Generalized anxiety disorder (GAD) is a mental disorder in which a person is often worried or anxious about many things and finds it hard to control this anxiety. Causes The cause of GAD is unknown. Genes may play a role. Stress may also contribute to the development of GAD. GAD is a common condition. Anyone can develop this disorder, even children. GAD occurs more often in women than in men. Symptoms The main symptom is frequent worry or tension for at least 6 months, even when there is little or no clear cause. Worries seem to float from one problem to another. Problems may involve family, other relationships, work, school, money, and health. Even when aware that worries or fears are stronger than appropriate for the situation, a person with GAD still has difficulty controlling them. Other symptoms of GAD include: Problems concentrating Fatigue Irritability Problems falling or staying asleep, or sleep that is restless and unsatisfying Restlessness when awake The person may also have other physical symptoms. These can include muscle tension, upset stomach, sweating, or difficulty breathing. Exams and Tests There is no test that can make a diagnosis of GAD. The diagnosis is based on your answers to questions about the symptoms of GAD. Your health care provider will ask about these symptoms. You will also be asked about other aspects of your mental and physical health. A physical exam or lab tests may be done to rule out other conditions that cause similar symptoms. Treatment The goal of treatment is to help you feel better and function well in daily life. Talk therapy or medicine alone can be helpful. Sometimes, a combination of these may work best. TALK THERAPY Many types of talk therapy may be helpful for GAD. One common and effective talk therapy is cognitive-behavioral therapy (CBT). CBT can help you understand the relationship between your thoughts, behaviors, and symptoms. Often CBT involves a set number of visits. During CBT you can learn how to: Understand and gain control of distorted views of stressors, such as other people's behavior or life events. Recognize and replace panic-causing thoughts to help you feel more in control. Manage stress and relax when symptoms occur. Avoid thinking that minor problems will develop into terrible ones. Other types of talk therapy may also be helpful in managing symptoms of an anxiety disorder. MEDICINES Certain medicines, usually used to treat depression, may be very helpful for this disorder. They work by preventing your symptoms or making them less severe. You must take these medicines every day. DO NOT stop taking them without talking with your provider. Medicines called sedatives or hypnotics may also be prescribed. These medicines should only be taken under a doctor's direction. Your doctor will prescribe a limited amount of these drugs. They should not to be used everyday. They may be used when symptoms become very severe or when you are about to be exposed to something that always brings on your symptoms. If you are prescribed a sedative, do not drink alcohol while on this medicine. SELF-CARE Other than taking medicine and going to therapy, you can help yourself get better by: Reducing caffeine Not using street drugs or large amounts of alcohol Exercising, getting enough rest, and eating healthy foods Support Groups You can ease the stress of having GAD by joining a support group. Sharing with others who have common experiences and problems can help you not feel alone. Support groups are usually not a good substitute for talk therapy or taking medicine, but can be a helpful addition. Resources for more information include: Anxiety and Depression Association of America -- adaa.org National Institute of Mental Health -- www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml Outlook (Prognosis) How well a person does depends on how severe the condition is. In some cases, GAD is long-term and is difficult to treat. Most people, though, get better with medicine and/or talk therapy. Possible Complications Depression and substance abuse may occur with an anxiety disorder. When to Contact a Medical Professional Call your provider if you frequently worry or feel anxious, especially if it interferes with your daily activities. Review Date 3/26/2018 Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "The goal of treatment is to help you feel better and function well in daily life. Talk therapy or medicine alone can be helpful. ... One common and effective talk therapy is cognitive-behavioral therapy (CBT). CBT can help you understand the relationship between your thoughts, behaviors, and symptoms. Often CBT involves a set number of visits. During CBT you can learn how to: - Understand and gain control of distorted views of stressors, such as other people's behavior or life events. - Recognize and replace panic-causing thoughts to help you feel more in control. - Manage stress and relax when symptoms occur. - Avoid thinking that minor problems will develop into terrible ones. Other types of talk therapy may also be helpful in managing symptoms of an anxiety disorder. MEDICINES Certain medicines, usually used to treat depression, may be very helpful for this disorder. They work by preventing your symptoms or making them less severe. ... Other than taking medicine and going to therapy, you can help yourself get better by: - Reducing caffeine - Not using street drugs or large amounts of alcohol - Exercising, getting enough rest, and eating healthy foods You can ease the stress of having GAD by joining a support group. Sharing with others who have common experiences and problems can help you not feel alone. Support groups are usually not a good substitute for talk therapy or taking medicine, but can be a helpful addition.", "role": "assistant" } ]

[ { "content": "Is it necessary to go to the dr. when getting a skull fracture?\n\n Skull fracture Basilar skull fracture Depressed skull fracture Linear skull fracture Summary A skull fracture is a fracture or break in the cranial (skull) bones. Considerations Skull fractures may occur with head injuries. The skull provides good protection for the brain. However, a severe impact or blow can cause the skull to break. It may be accompanied by concussion or other injury to the brain. The brain can be affected directly by damage to the nervous system tissue and bleeding. The brain can also be affected by bleeding under the skull. This can compress the underlying brain tissue (subdural or epidural hematoma). A simple fracture is a break in the bone without damage to the skin. A linear skull fracture is a break in a cranial bone resembling a thin line, without splintering, depression, or distortion of bone. A depressed skull fracture is a break in a cranial bone (or \"crushed\" portion of skull) with depression of the bone in toward the brain. A compound fracture involves a break in, or loss of, skin and splintering of the bone. Causes Causes of skull fracture can include: Head trauma Falls, automobile accidents, physical assault, and sports Symptoms Symptoms may include: Bleeding from wound, ears, nose, or around eyes Bruising behind the ears or under the eyes Changes in pupils (sizes unequal, not reactive to light) Confusion Convulsions Difficulties with balance Drainage of clear or bloody fluid from ears or nose Drowsiness Headache Loss of consciousness Nausea and vomiting Restlessness, irritability Slurred speech Stiff neck Swelling Visual disturbances In some cases, the only symptom may be a bump on the head. A bump or bruise may take up to 24 hours to develop. First Aid Take the following steps if you think someone has a skull fracture: <li>Check the airways, breathing, and circulation. If necessary, begin rescue breathing and CPR.</li> <li>Avoid moving the person (unless absolutely necessary) until medical help arrives. Have someone to call 911 (or the local emergency number) for medical assistance.</li> <li>If the person must be moved, take care to stabilize the head and neck. Place your hands on both sides of the head and under the shoulders. Do not allow the head to bend forward or backward, or to twist or turn.</li> <li>Carefully check the site of injury, but do not probe in or around the site with a foreign object. It can be hard to know if the skull is fractured or depressed (dented in) at the site of injury.</li> <li>If there is bleeding, apply firm pressure with a clean cloth over a broad area to control blood loss.</li> <li>If blood soaks through, do not remove the original cloth. Instead, apply more cloths on top, and continue to apply pressure.</li> <li>If the person is vomiting, stabilize the head and neck, and carefully turn the victim to the side to prevent choking on vomit.</li> <li>If the person is conscious and experiencing any of the previously listed symptoms, transport to the nearest emergency medical facility (even if the person does not think medical help is needed).</li> DO NOT Follow these precautions: DO NOT move the person unless absolutely necessary. Head injuries may be associated with spinal injuries. DO NOT remove protruding objects. DO NOT allow the person to continue with physical activities. DO NOT forget to watch the person closely until medical help arrives. DO NOT give the person any medicines before talking to a doctor. DO NOT leave the person alone, even if there are no obvious problems. When to Contact a Medical Professional Get medical help right away if: There are problems with breathing or circulation. Direct pressure does not stop bleeding from the nose, ears, or wound. There is drainage of clear fluid from the nose or ears. There is facial swelling, bleeding, or bruising. There is an object protruding from the skull. The person is unconscious, is experiencing convulsions, has multiple injuries, appears to be in any distress, or cannot think clearly. Prevention Not all head injuries can be prevented. The following simple steps can help keep you and your child safe: <li>Always use safety equipment during activities that could cause a head injury. These include seat belts, bicycle or motorcycle helmets, and hard hats.</li> <li>Learn and follow bicycle safety recommendations.</li> <li>Do not drink and drive. Do not allow yourself to be driven by someone who may have been drinking alcohol or is otherwise impaired. </li> Review Date 10/16/2017 Updated by: Jesse Borke, MD, FACEP, FAAEM, Attending Physician at FDR Medical Services/Millard Fillmore Suburban Hospital, Buffalo, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Do NOT move the person unless absolutely necessary. Head injuries may be associated with spinal injuries. - Do NOT remove protruding objects. - Do NOT allow the person to continue with physical activities. - Do NOT forget to watch the person closely until medical help arrives. - Do NOT give the person any medicines before talking to a doctor. - Do NOT leave the person alone, even if there are no obvious problems.", "role": "assistant" } ]

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

[ { "content": "help with obesity I would like help on my obesity problem and if I can get help\n\nObesity (Alternative medicine): Numerous dietary supplements that promise to help you shed weight quickly are available. The effectiveness, particularly the long-term effectiveness, and safety of these products are often questionable. Herbal remedies, vitamins and minerals, all considered dietary supplements by the Food and Drug Administration, don't have the same rigorous testing and labeling process as over-the-counter and prescription medications do. Yet some of these substances, including products labeled as \"natural,\" have drug-like effects that can be dangerous. Even some vitamins and minerals can cause problems when taken in excessive amounts. Ingredients may not be standard, and they can cause unpredictable and harmful side effects. Dietary supplements also can cause dangerous interactions with prescription medications you take. Talk to your doctor before taking any dietary supplements. Mind-body therapies - such as acupuncture, mindfulness meditation and yoga - may complement other obesity treatments. However, these therapies generally haven't been well-studied in the treatment of weight loss. Talk to your doctor if you're interested in adding a mind-body therapy to your treatment.", "role": "user" }, { "content": "The effectiveness and safety of dietary supplements that promise to help loose weight are often questionable. Ask your doctor before taking any dietary supplements. Acupuncture, mindfulness meditation and yoga may complement other obesity treatments, but these mind-body therapies haven't been well-studied in the treatment of weight loss.", "role": "assistant" } ]