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<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the symptoms of Balance Problems ? [/INST] If you have a balance disorder, you may stagger when you try to walk, or teeter or fall when you try to stand up. You might experience other symptoms such as dizziness or vertigo (a spinning sensation) falling or feeling as if you are going to fall lightheadedness, faintness, or a floating sensation blurred vision confusion or disorientation. dizziness or vertigo (a spinning sensation) falling or feeling as if you are going to fall lightheadedness, faintness, or a floating sensation blurred vision confusion or disorientation. Other symptoms might include nausea and vomiting, diarrhea, changes in heart rate and blood pressure, and fear, anxiety, or panic. Symptoms may come and go over short time periods or last for a long time, and can lead to fatigue and depression.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Balance Problems ? [/INST] There are many types of balance disorders. Three of the most common are BPPV (benign paroxysmal positional vertigo), labyrinthitis, and Menieres disease. BPPV (benign paroxysmal positional vertigo) is one of the most common balance disorders among older adults. With BPPV, you experience a brief, intense feeling of vertigo that occurs when you change the position of your head. You may also experience BPPV when rolling over to the left or right upon getting out of bed, or when looking up for an object on a high shelf. In BPPV, small calcium particles in the inner ear become displaced, causing dizziness. The reason the particles get displaced is not known, although it may result from an inner ear infection, head injury, or aging. Labyrinthitis is is another type of balance disorder. The labyrinth is an organ of the inner ear that helps you maintain your balance. When the labyrinth becomes infected or swollen, it is typically accompanied by vertigo and imbalance. Upper respiratory infections and other viral infections, and, less commonly, bacterial infections, can lead to labyrinthitis. Mnire's disease is a balance disorder that causes vertigo hearing loss that comes and goes tinnitus, which is a ringing or roaring in the ears a feeling of fullness in the ear. vertigo hearing loss that comes and goes tinnitus, which is a ringing or roaring in the ears a feeling of fullness in the ear. Mnire's disease can affect adults of any age. The cause is unknown. See a fuller list of balance disorders.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What causes Balance Problems ? [/INST] Some balance disorders are caused by problems in the inner ear. The part of the inner ear that is responsible for balance is the vestibular system, often refered to as the labyrinth. When the labyrinth becomes infected or swollen a condition called labyrinthitis it is typically accompanied by vertigo and imbalance. Upper respiratory infections, other viral infections, and, less commonly, bacterial infections, can lead to labyrinthitis. Other balance disorders may involve another part of the body, such as the brain or the heart. For example, diseases of the circulatory system, such as stroke, can cause dizziness and other balance problems. Smoking and diabetes can increase the risk of stroke. Low blood pressure also can cause dizziness. Aging, infections, head injury, and many medicines may also result in a balance problem.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What causes Balance Problems ? [/INST] Yes. Many prescription medications, such as those used to lower blood pressure, can make a person feel dizzy. Other medicines might damage the inner ear. These medicines, called ototoxic medicines, can make you feel off balance. Sometimes the damage lasts only as long as you take the drug. Other times it is permanent. Groups of drugs that are more likely to be ototoxic include antidepressants antiseizure drugs (anticonvulsants) hypertensive (high blood pressure) drugs sedatives tranquilizers anxiolytics (antianxiety drugs) aminoglycosides (a type of antibiotic) diuretics vasodilators certain analgesics (painkillers) certain chemotherapeutics (anticancer drugs). antidepressants antiseizure drugs (anticonvulsants) hypertensive (high blood pressure) drugs sedatives tranquilizers anxiolytics (antianxiety drugs) aminoglycosides (a type of antibiotic) diuretics vasodilators certain analgesics (painkillers) certain chemotherapeutics (anticancer drugs).</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to prevent Balance Problems ? [/INST] An ear infection called otitis media can cause balance problems. Otitis media is most common in children, but adults can get it, too. You can help prevent otitis media by washing your hands frequently. Also, talk to your doctor about getting a yearly flu shot to stave off flurelated ear infections. If you do get an ear infection, see a doctor immediately before it becomes more serious. Learn more about otitis media and other ear infections. (Centers for Disease Control and Prevention)</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Balance Problems ? [/INST] You can help your doctor make a diagnosis by writing down key information about your dizziness or balance problem beforehand and giving the information to your doctor during the visit. Write down answers to these questions for your doctor: How would you describe your dizziness or balance problem? If the room is spinning around you, which ways does it appear to turn? How often do you have dizziness or balance problems? Have you ever fallen? If so, when did you fall, where did you fall, and how often have you fallen? Tell your doctor as much as you can. What medications do you take? Remember to include all overthecounter medicines, including aspirin, antihistamines, or sleep aids. What is the name of the medication? How much medication do you take each day? What times of the day do you take the medication? What is the health condition for which you take the medication? How would you describe your dizziness or balance problem? If the room is spinning around you, which ways does it appear to turn? How often do you have dizziness or balance problems? Have you ever fallen? If so, when did you fall, where did you fall, and how often have you fallen? Tell your doctor as much as you can. What medications do you take? Remember to include all overthecounter medicines, including aspirin, antihistamines, or sleep aids. What is the name of the medication? How much medication do you take each day? What times of the day do you take the medication? What is the health condition for which you take the medication? See a video on describing symptoms and health concerns during a doctor visit.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the treatments for Balance Problems ? [/INST] In BPPV (benign paroxysmal positional vertigo), small calcium particles in the inner ear become displaced, causing dizziness. A doctor, otolaryngologist, audiologist, or physical therapist can treat BPPV by carefully moving the head and torso to move the displaced calcium particles back to their original position Learn more about causes and treatments for BPPV. An NIDCDsupported clinical trial in BPPV showed that repositioning maneuvers work well, and offered clinicians a range of choices in selecting the treatment best suited to each individuals unique needs.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the treatments for Balance Problems ? [/INST] Mnire's disease is caused by changes in fluid volumes in the inner ear. People with Mnire's disease can help reduce its dizzying effects by lowering the amount of salt (sodium) in their diets. Limiting alcohol or caffeine also may be helpful. Some medications, such as corticosteroids or the antibiotic gentamicin, also are used to treat Mnire's disease. Although gentamicin can help reduce the dizziness that occurs with Mnire's disease, it occasionally destroys sensory cells in the inner ear, which can result in permanent hearing loss. Corticosteroids don't cause hearing loss; however, research is underway to determine if they are as effective as gentamicin Learn more about the treatments for Mnire's disease.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to prevent Balance Problems ? [/INST] Scientists are working to understand the complex interactions between the brain and the part of the inner ear responsible for balance. They are also studying the effectiveness of certain exercises as a treatment option for balance disorders. An NIDCDsupported clinical trial in benign paroxysmal positioning vertigo (BPPV) showed that repositioning maneuvers work well, and offered clinicians a range of choices in selecting the treatment best suited to each individuals unique needs. NIDCDfunded researchers have created a virtual reality grocery store. This virtual store is a computersimulated environment that seems to be a physical place in the real world. It is designed so people with balance disorders can safely walk on a treadmill as they practice looking for items on store shelves. The goal is to help reduce a person's dizziness in confusing environments. NIDCDsupported scientists are also studying the use of a vestibular implant to stop a Mnires attack by restoring normal electrical activity in the vestibular nerve. This nerve conveys balance information to the brain. The device uses the same technology found in a cochlear implant, a medical device that currently provides a sense of sound to people who are deaf or hardofhearing.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) COPD ? [/INST] Chronic obstructive pulmonary disease, or COPD, is a progressive lung disease in which the airways of the lungs become damaged, making it hard to breathe. You may also have heard COPD called other names, like emphysema or chronic bronchitis. In people who have COPD, the airways that carry air in and out of the lungs are partially blocked, making it difficult to get air in and out. COPD is a major cause of death and illness throughout the world. It kills more than 120,000 Americans each year. That's one death every 4 minutes. How COPD Affects Airways The "airways" are the tubes that carry air in and out of the lungs through the nose and mouth. The airways of the lungs branch out like an upsidedown tree. At the end of each branch are many small, balloonlike air sacs. In healthy people, the airways and air sacs are elastic (stretchy). When you breathe in, each air sac fills up with air, like a small balloon, and when you breathe out, the balloon deflates and the air goes out. In people with COPD, the airways and air sacs lose their shape and become floppy. Less air gets in and less air goes out of the airways because The airways and air sacs lose their elasticity like an old rubber band. The walls between many of the air sacs are destroyed. The walls of the airways become thick and inflamed or swollen. Cells in the airways make more mucus or sputum than usual, which tends to clog the airways. The airways and air sacs lose their elasticity like an old rubber band. The walls between many of the air sacs are destroyed. The walls of the airways become thick and inflamed or swollen. Cells in the airways make more mucus or sputum than usual, which tends to clog the airways. COPD Develops Slowly, Has No Cure When COPD is severe, shortness of breath and other symptoms of COPD can get in the way of even the most basic tasks, such as doing light housework, taking a walk, even washing and dressing. COPD develops slowly, and it may be many years before you notice symptoms like feeling short of breath. Most of the time, COPD is diagnosed in middleaged or older people. There is no cure for COPD. The damage to your airways and lungs cannot be reversed, but there are things you can do to control the disabling effects of the disease. COPD is not contagious. You cannot catch it from someone else.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What causes COPD ? [/INST] Smoking Most cases of COPD develop over time, from breathing in fumes and other things that irritate the lungs. Some of the things that put you at risk for COPD include smoking, environmental exposure, and genetic factors. Cigarette smoking is the most common cause of COPD in the United States (either current or former smokers). Pipe, cigar, and other types of tobacco smoking can also cause COPD, especially if the smoke is inhaled. Environmental Exposure COPD can also occur in people who have had longterm exposure to things that can irritate your lungs, like chemical fumes, or dust from the environment or workplace. Heavy or longterm exposure to secondhand smoke or other air pollutants may also contribute to COPD even if you have never smoked or had longterm exposure to harmful pollutants. Secondhand smoke is smoke in the air from other people smoking. Genetic Factors In a small number of people, COPD is caused by a genetic condition known as alpha1 antitrypsin, or AAT, deficiency. People who have this condition have low levels of alpha1 antitrypsin (AAT)a protein made in the liver. Having a low level of the AAT protein can lead to lung damage and COPD if you're exposed to smoke or other lung irritants. If you have this condition and smoke, COPD can worsen very quickly. While very few people know if they have AAT deficiency, it is estimated that about 1 in every 1,600 people to about 1 in every 5,000 people have it. People with AAT deficiency can get COPD even if they have never smoked or had longterm exposure to harmful pollutants. Asthma Although uncommon, some people who have asthma can develop COPD. Asthma is a chronic (longterm) lung disease that inflames and narrows the airways. Treatment usually can reverse the inflammation and narrowing. However, if not, COPD can develop.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to prevent COPD ? [/INST] If you have COPD, you can take these steps to prevent complications and control the disabling effects of the disease. Quit smoking. Avoid exposure to pollutants and lung irritants. Take precautions against the flu. Talk to your doctor about the flu and pneumonia vaccines. See your doctor on a regular basis. Follow your treatments for COPD exactly as your doctor prescribes. Quit smoking. Avoid exposure to pollutants and lung irritants. Take precautions against the flu. Talk to your doctor about the flu and pneumonia vaccines. See your doctor on a regular basis. Follow your treatments for COPD exactly as your doctor prescribes. Quit Smoking If you smoke, the most important thing you can do to prevent more lung damage is to stop smoking. Quitting can help prevent complications and slow the progress of the disease. It is also important to stay away from people who smoke and places where you know there will be smokers. To help you quit, there are many online resources and several new aids available from your doctor or health care provider. The National Cancer Institute (NCI) has information on smoking cessation. Visit SmokeFree.gov , or check out NCI's Clear Horizons, a quit smoking guide for people 50+. You can also visit The American Lung Association, or call 1800QUIT NOW (18007848669). Avoid Exposure to Pollutants and Lung Irritants Try to stay away from other things that could irritate your lungs, like dust and strong fumes. Stay indoors when the outside air quality is poor. You should also stay away from places where there might be cigarette smoke. Take Precautions Against the Flu The flu (influenza) can cause serious problems for people who have COPD. Do your best to avoid crowds during flu season. In addition to avoiding people with the flu, remembering to wash and sanitize your hands can be one of the best ways to guard against getting sick. Talk to Your Doctor About the Flu (influenza) and Pneumonia Vaccines Talk with your doctor about getting a yearly flu shot and whether and when you should get the pneumonia vaccine. Flu shots can reduce your risk of getting the flu, and the pneumonia vaccine lowers your risk for pneumococcal pneumonia (NUmoKOKal nuMOneah) and its complications. Both of these illnesses are major health risks for people who have COPD. See Your Doctor Regularly See your doctor or health care provider regularly even if you are feeling fine. Make a list of your breathing symptoms and think about any activities that you can no longer do because of shortness of breath. Be sure to bring a list of all the medicines you are taking to each office visit. Follow Your Treatments Follow your treatments for COPD exactly as your doctor prescribes. They can help you breathe easier, stay more active, and avoid or manage severe symptoms.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the symptoms of COPD ? [/INST] Common Symptoms The most common symptoms of COPD are a cough that does not go away coughing up lots of sputum (mucus). a cough that does not go away coughing up lots of sputum (mucus). These symptoms often start years before the flow of air in and out of the lungs is reduced. Not everyone who has a cough and sputum goes on to develop COPD. Other common symptoms of COPD include shortness of breath while doing activities you used to be able to do wheezing (a whistling sound when you breathe) tightness in the chest. shortness of breath while doing activities you used to be able to do wheezing (a whistling sound when you breathe) tightness in the chest. Getting a Diagnosis Your doctor will diagnose COPD based on your signs and symptoms, your medical and family histories, and test results. If your doctor thinks you may have COPD, he or she will examine you, listen to your lungs, and ask you questions about your medical history, and what lung irritants you may have been around for long periods of time. The Spirometry Test To confirm a diagnosis of COPD, your doctor will use a breathing test called spirometry. The test is easy and painless and shows how much air you can breathe out and measures how fast you can breathe it out. In a spirometry test, you breathe hard into a large hose connected to a machine called a spirometer. When you breathe out, the spirometer measures how much air your lungs can hold and how fast you can blow air out of your lungs. Spirometry can detect COPD before symptoms develop. Your doctor also might use the test results to find out how severe your COPD is and to help set your treatment goals. The test results also may help find out whether another condition, such as asthma or heart failure, is causing your symptoms. Determining COPD Severity Based on this test, your doctor can determine if you have COPD and how severe it is. There are four levels of severity for COPD: people at risk for COPD people with mild COPD people with moderate COPD people with severe COPD. people at risk for COPD people with mild COPD people with moderate COPD people with severe COPD. People at risk for developing COPD have a normal breathing test and mild symptoms such as chronic cough and sputum (mucus) production. People with mild COPD have mild breathing limitation. Symptoms may include a chronic cough and sputum (mucus) production. At this stage, you may not be aware that airflow in your lungs is reduced. People with moderate COPD have a breathing test that shows worsening airflow blockages. Symptoms may be worse than with mild COPD and you may experience shortness of breath while working hard, walking fast, or doing brisk activity. At this stage, you would seek medical attention. People with severe COPD have a breathing test that shows severe limitation of the airflow. People with severe COPD will be short of breath after just a little activity. In very severe COPD, complications like respiratory failure or signs of heart failure may develop. At this stage, quality of life is impaired and worsening symptoms may be lifethreatening. Other Tests Other tests are used to rule out other causes of the symptoms. Bronchodilator reversibility testing uses the spirometer and medications called bronchodilators to assess whether breathing problems may be caused by asthma. Bronchodilator reversibility testing uses the spirometer and medications called bronchodilators to assess whether breathing problems may be caused by asthma. A chest Xray or a chest CT scan may also be ordered by your doctor. These tests create pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. The pictures can show signs of COPD. They also may show whether another condition, such as heart failure, is causing your symptoms. A chest Xray or a chest CT scan may also be ordered by your doctor. These tests create pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. The pictures can show signs of COPD. They also may show whether another condition, such as heart failure, is causing your symptoms. An arterial blood gas test is another test that is used. This blood test shows the oxygen level in the blood to see how severe your COPD is and whether you need oxygen therapy. An arterial blood gas test is another test that is used. This blood test shows the oxygen level in the blood to see how severe your COPD is and whether you need oxygen therapy.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) COPD ? [/INST] Chronic obstructive pulmonary disease, or COPD, is a progressive lung disease in which the airways of the lungs become damaged, making it harder to breathe. With COPD, airways become blocked, making it harder to get air in and out.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What causes COPD ? [/INST] COPD is a disease that slowly worsens over time, especially if you continue to smoke. If you have COPD, you are more likely to have lung infections, which can be fatal. If the lungs are severely damaged, the heart may be affected. A person with COPD dies when the lungs and heart are unable to function and get oxygen to the body's organs and tissues, or when a complication, such as a severe infection, occurs. Treatment for COPD may help prevent complications, prolong life, and improve a person's quality of life.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What causes COPD ? [/INST] Cigarette smoking is the most common cause of COPD. Most people with COPD are smokers or have been smokers in the past. Breathing in other fumes and dusts over long periods of time can also lead to COPD. Pipe, cigar, and other types of tobacco smoking can cause COPD, especially if the smoke is inhaled. Exposure to secondhand smoke can play a role in causing COPD. Most people with COPD are at least 40 years old or around middle age when symptoms start.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the symptoms of COPD ? [/INST] The most common symptoms of COPD are a cough that does not go away and coughing up a lot of sputum (mucus). These symptoms may occur years before lung damage has reduced the flow of air in and out of the lungs. Other symptoms of COPD include shortness of breath, especially with exercise; wheezing (a whistling sound when you breathe); and tightness in the chest.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to diagnose COPD ? [/INST] To confirm a COPD diagnosis, a doctor will use a breathing test called spirometry. The test is easy and painless. It shows how well the lungs are working. The spirometer measures how much air the lungs can hold and how fast air is blown out of the lungs. Other tests, such as bronchodilator reversibility testing, a chest Xray, and arterial blood gas test, may be ordered.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the treatments for COPD ? [/INST] Treatment for COPD can be different for each person and is based on whether symptoms are mild, moderate or severe. Treatments include medication, pulmonary or lung rehabilitation, oxygen treatment, and surgery. There are also treatments to manage complications or a sudden onset of symptoms.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to diagnose COPD ? [/INST] If you have not been exercising regularly, you should get the advice of your doctor before starting. The symptoms of COPD are different for each person. People with mild COPD may not have much difficulty walking or exercising. As the symptoms of COPD get worse over time, a person may have more difficulty with walking and exercising. You should talk to your doctor about exercising and whether you would benefit from a pulmonary or lung rehabilitation program.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to prevent COPD ? [/INST] If you smoke, the most important thing you can do to prevent more lung damage is to stop smoking. It is also important to stay away from people who smoke and places where you know there will be smokers. Avoid exposure to pollutants like dust, fumes, and poor air quality, and take precautions to prevent flu and pneumonia. Following your doctor's instructions with medications and rehabilitative treatment can help alleviate COPD symptoms and control the disabling effects of the disease.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the treatments for COPD ? [/INST] Bronchodilators and inhaled steroids are two medications used to treat COPD. Bronchodilators work by relaxing the muscles around the airways, opening them and making it easier to breathe. People with mild COPD take bronchodilators using an inhaler only when needed. Those with moderate or severe COPD may need more regular treatment. Inhaled steroids also are used for people with moderate or severe COPD in order to reduce swelling in the airways.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the symptoms of COPD ? [/INST] Call your doctor right away if your symptoms worsen suddenly. People with COPD may have symptoms that suddenly get worse. When this happens, you have a much harder time catching your breath. Symptoms that worsen suddenly can include sudden chest tightness, more coughing, a change in your sputum (mucus), or fever. Your doctor will look at things that may be causing these sudden symptoms. Sometimes the symptoms are caused by a lung infection.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) COPD ? [/INST] More information on COPD is available at: What is COPD? and at the Learn More, Breathe Better Campaign For information on quitting smoking, visit http://www.surgeongeneral.gov/tobacco/ or Smokefree.gov. For information on the H1N1 flu and COPD, go to The Centers for Disease Control and Prevention.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Alzheimer's Disease ? [/INST] Alzheimers disease is a brain disease that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks. It begins slowly and gets worse over time. Currently, it has no cure. A Common Cause of Dementia Alzheimers disease is the most common cause of dementia among older people. Dementia is a loss of thinking, remembering, and reasoning skills that interferes with a persons daily life and activities. Dementia ranges in severity from the mild stage, when it is just beginning to affect a persons functioning, to the severe stage, when the person must depend completely on others for basic care. Estimates vary, but experts suggest that more than 5 million Americans may have Alzheimer's disease. Alzheimers is currently ranked as the sixth leading cause of death in the United States, but recent estimates indicate that the disorder may rank third, just behind heart disease and cancer, as a cause of death for older people Risk Increases With Age In most people with Alzheimers, symptoms first appear in their mid60s, and the risk of developing the disease increases with age. While younger people in their 30s, 40s, and 50s may get Alzheimer's disease, it is much less common. It is important to note that Alzheimer's disease is not a normal part of aging. The course of Alzheimers diseasewhich symptoms appear and how quickly changes occurvaries from person to person. The time from diagnosis to death varies, too. It can be as little as 3 or 4 years if the person is over 80 years old when diagnosed or as long as 10 years or more if the person is younger. Memory Problems: One of the First Signs Memory problems are typically one of the first signs of Alzheimers disease, though initial symptoms may vary from person to person. A decline in other aspects of thinking, such as finding the right words, vision/spatial issues, and impaired reasoning or judgment, may also signal the very early stages of Alzheimers disease. People with Alzheimers have trouble doing everyday things like driving a car, cooking a meal, or paying bills. They may ask the same questions over and over, get lost easily, lose things or put them in odd places, and find even simple things confusing. Some people become worried, angry, or violent. Other Reasons for Memory Issues Not all people with memory problems have Alzheimers disease. Mild forgetfulness can be a normal part of aging. Some people may notice that it takes longer to learn new things, remember certain words, or find their glasses. Thats different from a serious memory problem, which makes it hard to do everyday things. Sometimes memory problems are related to health issues that are treatable. For example, medication side effects, vitamin B12 deficiency, head injuries, or liver or kidney disorders can lead to memory loss or possibly dementia. Emotional problems, such as stress, anxiety, or depression, can also make a person more forgetful and may be mistaken for dementia. Read more about causes of memory loss and how to keep your memory sharp. Mild Cognitive Impairment Some older people with memory or other thinking problems have a condition called mild cognitive impairment, or MCI. MCI can be an early sign of Alzheimers, but not everyone with MCI will develop Alzheimers disease. People with MCI have more memory problems than other people their age, but they can still take care of themselves and do their normal activities. Signs of MCI may include losing things often forgetting to go to events and appointments having more trouble coming up with words than other people the same age. losing things often forgetting to go to events and appointments having more trouble coming up with words than other people the same age. If you or someone in your family thinks your forgetfulness is getting in the way of your normal routine, its time to see your doctor. Seeing the doctor when you first start having memory problems can help you find out whats causing your forgetfulness. Learn more about mild cognitive impairment (MCI). What Happens to the Brain in Alzheimers? Alzheimer's disease is named after Dr. Alois Alzheimer, a German doctor. In 1906, Dr. Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. After she died, he examined her brain and found many abnormal clumps (now called amyloid plaques) and tangled bundles of fibers (now called neurofibrillary, or tau, tangles). Plaques and tangles in the brain are two of the main features of Alzheimer's disease. Another is the loss of connections between nerve cells (neurons) in the brain. Neurons send messages between different parts of the brain, and from the brain to muscles and organs in the body. It seems likely that damage to the brain starts 10 years or more before memory or other thinking problems become obvious. During the earliest stage of Alzheimers, people are free of symptoms, but harmful changes are taking place in the brain. The damage at first appears to take place in cells of the hippocampus, the part of the brain essential in forming memories. Abnormal protein deposits form plaques and tangles in the brain. Oncehealthy nerve cells stop functioning, lose connections with each other, and die. As more nerve cells die, other parts of the brain begin to shrink. By the final stage of Alzheimers, damage is widespread, and brain tissue has shrunk significantly. Get more details about Alzheimers disease.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What causes Alzheimer's Disease ? [/INST] There are two types of Alzheimers diseaseearlyonset and lateonset. Earlyonset Alzheimers is a rare form of the disease that occurs in people age 30 to 60. It occurs in less than 5 percent of all people with Alzheimers. Almost all people with Alzheimers disease have lateonset Alzheimer's, which usually develops after age 60. Causes Not Fully Understood Scientists do not yet fully understand what causes Alzheimer's disease in most people. In earlyonset Alzheimers, a genetic mutation is usually the cause. Lateonset Alzheimers arises from a complex series of brain changes that occur over decades. The causes probably include a mix of genetic, environmental, and lifestyle factors. These factors affect each person differently. Research shows that Alzheimers disease causes changes in the brain years and even decades before the first symptoms appear, so even people who seem free of the disease today may be at risk. Scientists are developing sophisticated tests to help identify who is most likely to develop symptoms of Alzheimers. Ultimately, they hope to prevent or delay dementia in these highrisk individuals. Risk Factors Some risk factors for Alzheimers, like age and genetics, cannot be controlled. Other factors that may play a role in the development of the diseasesuch as how much a person exercises or socializescan be changed. Lifestyle factors, such as diet and physical exercise, and longterm health conditions, like high blood pressure and diabetes, might also play a role in the risk of developing Alzheimers disease. For more information, see the chapter entitled Prevention. Older AgeThe Biggest Risk Factor Increasing age is the most important known risk factor for Alzheimer's disease. The number of people with the disease doubles every 5 years beyond age 65. Nearly half of people age 85 and older may have Alzheimers. These facts are significant because the number of older adults is growing. Genetics Genetics appears to play a part in both early and lateonset Alzheimers disease. In earlyonset Alzheimers, most cases are caused by specific genetic mutations permanent changes in genes that can be passed on from a parent to a child. This results in earlyonset familial Alzheimers disease, or FAD. Most people with Alzheimers disease have lateonset Alzheimer's, in which symptoms appear in a persons mid60s. No obvious family pattern is seen in most of these cases, but certain genetic factors appear to increase a persons risk. Many studies have linked the apolipoprotein E gene to lateonset Alzheimers. One form of this gene, APOE 4, increases a persons risk of getting the disease. But many people who get Alzheimers do not have the APOE 4 gene, and some people with the gene never get Alzheimers. Scientists have identified a number of other genes in addition to APOE 4 that may increase a persons risk for lateonset Alzheimers. Knowing about these genes can help researchers more effectively test possible treatments and prevention strategies in people who are at risk of developing Alzheimers ideally, before symptoms appear. Learn more about the genetics of Alzheimers disease.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the symptoms of Alzheimer's Disease ? [/INST] Alzheimer's disease varies from person to person so not everyone will have the same symptoms. Also, the disease progresses faster in some people than in others. In general, though, Alzheimers takes many years to develop and becomes increasingly severe over time. Memory Problems A Common Early Sign Memory problems are typically one of the first signs of Alzheimers disease. However, not all memory problems are caused by Alzheimers. If you or someone in your family thinks your forgetfulness is getting in the way of your normal routine, its time to see your doctor. He or she can find out whats causing these problems. A person in the early (mild) stage of Alzheimers disease may find it hard to remember things ask the same questions over and over get lost in familiar places lose things or put them in odd places have trouble handling money and paying bills take longer than normal to finish daily tasks have some mood and personality changes. find it hard to remember things ask the same questions over and over get lost in familiar places lose things or put them in odd places have trouble handling money and paying bills take longer than normal to finish daily tasks have some mood and personality changes. Other thinking problems besides memory loss may be the first sign of Alzheimers disease. A person may have trouble finding the right words vision and spatial issues impaired reasoning or judgment. trouble finding the right words vision and spatial issues impaired reasoning or judgment. See a chart that compares signs of Alzheimers disease with signs of normal aging. Later Signs of Alzheimers As Alzheimers disease progresses to the moderate stage, memory loss and confusion grow worse, and people may have problems recognizing family and friends. Other symptoms at this stage may include difficulty learning new things and coping with new situations trouble carrying out tasks that involve multiple steps, like getting dressed impulsive behavior forgetting the names of common things hallucinations, delusions, or paranoia wandering away from home. difficulty learning new things and coping with new situations trouble carrying out tasks that involve multiple steps, like getting dressed impulsive behavior forgetting the names of common things hallucinations, delusions, or paranoia wandering away from home. Symptoms of Severe Alzheimers As Alzheimers disease becomes more severe, people lose the ability to communicate. They may sleep more, lose weight, and have trouble swallowing. Often they are incontinentthey cannot control their bladder and/or bowels. Eventually, they need total care. Benefits of Early Diagnosis An early, accurate diagnosis of Alzheimer's disease helps people and their families plan for the future. It gives them time to discuss care options, find support, and make legal and financial arrangements while the person with Alzheimers can still take part in making decisions. Also, even though no medicine or other treatment can stop or slow the disease, early diagnosis offers the best chance to treat the symptoms. How Alzheimers Is Diagnosed The only definitive way to diagnose Alzheimer's disease is to find out whether plaques and tangles exist in brain tissue. To look at brain tissue, doctors perform a brain autopsy, an examination of the brain done after a person dies. Doctors can only make a diagnosis of "possible" or probable Alzheimers disease while a person is alive. Doctors with special training can diagnose Alzheimer's disease correctly up to 90 percent of the time. Doctors who can diagnose Alzheimers include geriatricians, geriatric psychiatrists, and neurologists. A geriatrician specializes in the treatment of older adults. A geriatric psychiatrist specializes in mental problems in older adults. A neurologist specializes in brain and nervous system disorders. To diagnose Alzheimers disease, doctors may ask questions about overall health, past medical problems, ability to carry out daily activities, and changes in behavior and personality conduct tests to measure memory, problem solving, attention, counting, and language skills carry out standard medical tests, such as blood and urine tests perform brain scans to look for anything in the brain that does not look normal. ask questions about overall health, past medical problems, ability to carry out daily activities, and changes in behavior and personality conduct tests to measure memory, problem solving, attention, counting, and language skills carry out standard medical tests, such as blood and urine tests perform brain scans to look for anything in the brain that does not look normal. Test results can help doctors know if there are other possible causes of the person's symptoms. For example, thyroid problems, drug reactions, depression, brain tumors, head injury, and bloodvessel disease in the brain can cause symptoms similar to those of Alzheimer's. Many of these other conditions can be treated successfully. New Diagnostic Methods Being Studied Researchers are exploring new ways to help doctors diagnose Alzheimers disease earlier and more accurately. Some studies focus on changes in a persons memory, language, and other mental functions. Others look at changes in blood, spinal fluid, and brainscan results that may detect Alzheimers years before symptoms appear. Watch a video that explains changes in diagnostic guidelines for Alzheimers.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to prevent Alzheimer's Disease ? [/INST] Currently, no medicines or other treatments are known to prevent Alzheimers disease, but scientists are studying many possibilities. These possibilities include lifestyle factors such as exercise and physical activity, a healthy diet, and mentally stimulating activities. In addition to lifestyle factors, scientists have found clues that some longterm health conditions, like heart disease, high blood pressure, and diabetes, are related to Alzheimer's disease. Its possible that controlling these conditions will reduce the risk of developing Alzheimers. Exercise and Physical Activity Studies show that exercise and other types of physical activity are good for our hearts, waistlines, and ability to carry out everyday activities. Research suggests that exercise may also play a role in reducing risk for Alzheimers disease. Animal studies show that exercise increases both the number of small blood vessels that supply blood to the brain and the number of connections between nerve cells in older rats and mice. In addition, researchers have found that exercise raises the level of a nerve growth factor (a protein key to brain health) in an area of the brain that is important to memory and learning. See suggestions for ways older adults can start or continue to exercise. Diet and Dietary Supplements A number of studies suggest that eating certain foods may help keep the brain healthyand that others can be harmful. A diet that includes lots of fruits, vegetables, and whole grains and is low in fat and added sugar can reduce the risk of heart disease and diabetes. Researchers are looking at whether a healthy diet also can help prevent Alzheimers. One study reported that people who ate a Mediterranean diet had a 28 percent lower risk of developing MCI (mild cognitive impairment) and a 48 percent lower risk of progressing from MCI to Alzheimers disease. (MCI often, but not always, leads to Alzheimers dementia.) A Mediterranean diet includes vegetables, legumes, fruits, cereals, fish, olive oil, and low amounts of saturated fats, dairy products, meat, and poultry. For more about healthy eating as you age , see Eating Well As You Get Older. Other research has looked at the effect on brain health of several different vitamins and dietary supplements. One area of research focuses on antioxidants, natural substances that appear to fight damage caused by molecules called free radicals. Other studies are looking at resveratrol, a compound found in red grapes and red wine, as well as vitamins and other substances found in food. Chronic Diseases Agerelated diseases and conditionssuch as vascular disease, high blood pressure, heart disease, and diabetesmay increase the risk of Alzheimers. Many studies are looking at whether this risk can be reduced by preventing or controlling these diseases and conditions. For example, one clinical trial is looking at how lowering blood pressure to or below current recommended levels may affect cognitive decline and the development of MCI and Alzheimers disease. Participants are older adults with high systolic (upper number) blood pressure who have a history of heart disease or stroke, or are at risk for those conditions. Diabetes is another disease that has been linked to Alzheimers. Past research suggests that abnormal insulin production contributes to Alzheimersrelated brain changes. (Insulin is the hormone involved in diabetes.) Diabetes treatments have been tested in people with Alzheimers, but the results have not been conclusive. Keeping the Brain Active Keeping the mind sharpthrough social engagement or intellectual stimulationis associated with a lower risk of Alzheimers disease. Activities like working, volunteering, reading, going to lectures, and playing computer and other games are being studied to see if they might help prevent Alzheimers. One clinical trial is testing the impact of formal cognitive training, with and without physical exercise, in people with MCI to see if it can prevent or delay Alzheimers disease. Other trials are underway in healthy older adults to see if exercise and/or cognitive training (for example, a demanding video game) can delay or prevent agerelated cognitive decline. Find out about things you can do that may keep your brain healthy.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the treatments for Alzheimer's Disease ? [/INST] Medications Can Treat Symptoms There is no known cure for Alzheimer's disease, but there are medicines that can treat symptoms of the disease. Most Alzheimers medicines work best for people in the mild or moderate stages of the disease. For example, they can keep memory loss from getting worse for a time. Other medicines may help behavioral symptoms, such as trouble sleeping or feeling worried or depressed. All of these medicines may have side effects and may not work for everyone. A person with Alzheimer's should be under a doctor's care. He or she may see a primary care doctor or a specialist, such as a neurologist, geriatric psychiatrist, or geriatrician. The doctor can treat the person's physical and behavioral problems, answer questions, and refer the patient and caregiver to other sources of help. Medications for Alzheimers Currently, no treatment can stop Alzheimer's disease. However, four medications are used to treat its symptoms. These medicines may help maintain thinking, memory, and speaking skills for a limited time. They work by regulating certain chemicals in the brain. Most of these medicines work best for people in the early or middle stages of the disease. For people with mild to moderate Alzheimers, donepezil (Aricept), rivastigmine (Exelon), or galantamine (Razadyne) may help. Donepezil is also approved to treat symptoms of moderate to severe Alzheimer's. Another drug, memantine (Namenda), is used to treat symptoms of moderate to severe Alzheimers, although it also has limited effects. All of these medicines have possible side effects, including nausea, vomiting, diarrhea, and loss of appetite. You should report any unusual symptoms to a doctor right away. It is important to follow a doctor's instructions when taking any medication. Scientists are testing many new drugs and other treatments to see if they can help slow, delay, or prevent Alzheimers disease. Learn how Alzheimers medications work, how to take them, and where to find more information. Managing Behavioral Symptoms Certain medicines and other approaches can help control the behavioral symptoms of Alzheimer's disease. These symptoms include sleeplessness, agitation, wandering, anxiety, anger, and depression. Treating these symptoms often makes people with Alzheimers disease more comfortable and makes their care easier for caregivers. See more about medications used to treat behavioral symptoms. Some medicines must be used with caution. Memory Aids Memory aids may help some people who have mild Alzheimers disease with daytoday living. A calendar, list of daily plans, notes about simple safety measures, and written directions describing how to use common household items can be useful. Help for Caregivers Caring for a person with Alzheimers can have high physical, emotional, and financial costs. The demands of daytoday care, changing family roles, and difficult decisions about placement in a care facility can be difficult. Sometimes, taking care of the person with Alzheimers makes caregivers feel good because they are providing love and comfort. At other times, it can be overwhelming. Changes in the person can be hard to understand and cope with. Here are some ways for caregivers of people with Alzheimers to get help. Ask family and friends to help out in specific ways, like making a meal or visiting the person while they take a break. Join a caregivers support group. Use home health care, adult day care, and respite services. Ask family and friends to help out in specific ways, like making a meal or visiting the person while they take a break. Join a caregivers support group. Use home health care, adult day care, and respite services. For more information about caring for someone with Alzheimers disease, see Alzheimer's Caregiving.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>what research (or clinical trials) is being done for Alzheimer's Disease ? [/INST] Research supported by the National Institutes of Health (NIH) and other organizations has expanded knowledge of brain function in healthy older people, identified ways that may lessen agerelated cognitive decline, and deepened our understanding of Alzheimers. Many scientists and physicians are working together to untangle the genetic, biological, and environmental factors that might cause Alzheimers disease. This effort is bringing us closer to better managing and, ultimately, better treating and preventing this devastating disease. Types of Research Different types of researchbasic, translational, and clinical researchare conducted to better understand Alzheimers and find ways to treat, delay, or prevent the disease. Basic research helps scientists gain new knowledge about a disease process, including how and why it starts and progresses. Translational research grows out of basic research. It creates new medicines, devices, or behavioral interventions aimed at preventing, diagnosing, or treating a disease. Clinical research is medical research involving people. It includes clinical studies, which observe and gather information about large groups of people. It also includes clinical trials, which test a medicine, therapy, medical device, or other intervention in people to see if it is safe and effective. Basic research helps scientists gain new knowledge about a disease process, including how and why it starts and progresses. Translational research grows out of basic research. It creates new medicines, devices, or behavioral interventions aimed at preventing, diagnosing, or treating a disease. Clinical research is medical research involving people. It includes clinical studies, which observe and gather information about large groups of people. It also includes clinical trials, which test a medicine, therapy, medical device, or other intervention in people to see if it is safe and effective. See the latest Alzheimers Disease Progress Report to read about results of NIAsupported Alzheimers research. Basic Research Basic research seeks to identify the cellular, molecular, and genetic processes that lead to Alzheimers disease. Basic research has focused on two of the main signs of Alzheimers disease in the brain: plaques and tangles. Plaques are made of a protein called betaamyloid and form abnormal clumps outside nerve cells in the brain. Tangles are made from a protein called tau and form twisted bundles of fibers within nerve cells in the brain. Scientists are studying how plaques and tangles damage nerve cells in the brain. They can see betaamyloid plaques and tau tangles by making images of the brains of living people. Such imaging has led to clinical trials that are looking at ways to remove betaamyloid from the human brain or halt its production before more brain damage occurs. Scientists are also exploring the very earliest brain changes in the disease process. Findings will help them better understand the causes of Alzheimers. As they learn more, they are likely to come up with better targets for further research. Over time, this might lead to more effective therapies to delay or prevent the disease. Genetics is another important area of basic research. Discovering more about the role of genes that increase or decrease the risk of developing Alzheimers will help researchers answers questions such as What makes the disease process begin? and Why do some people with memory and other thinking problems develop Alzheimers disease while others do not? Genetics research helps scientists learn how riskfactor genes interact with other genes and lifestyle or environmental factors to affect Alzheimers risk. This research also helps identify people who are at high risk for developing Alzheimers and can participate in clinical research on new prevention and treatment approaches. Translational Research Translational research allows new knowledge from basic research to be applied to a clinical research setting. An important goal of Alzheimers translational research is to increase the number and variety of potential new medicines and other interventions that are approved for testing in humans. Scientists also examine medicines approved to treat other diseases to see they might be effective in people with Alzheimers. The most promising interventions are tested in testtube and animal studies to make sure they are safe and effective. Currently, a number of different substances are under development that may one day be used to treat or prevent the symptoms of Alzheimers disease and mild cognitive impairment. Clinical Research Clinical research is medical research involving people. It includes clinical studies, which observe and gather information about large groups of people. It also includes clinical trials, which test medicines, therapies, medical devices, or other interventions in people to see if they are safe and effective. Clinical trials are the best way to find out whether a particular intervention actually slows, delays, or prevents Alzheimers disease. Trials may compare a potential new treatment with a standard treatment or placebo (mock treatment). Or, they may study whether a certain behavior or condition affects the progress of Alzheimers or the chances of developing it. NIH, drug companies, and other research organizations are conducting many clinical trials to test possible new treatments that may improve memory, thinking, and reasoning skills in people with Alzheimers or mild cognitive impairment relieve the behavior problems of Alzheimers, such as aggression and agitation delay the progression from mild cognitive impairment (MCI) to Alzheimers prevent Alzheimers disease. improve memory, thinking, and reasoning skills in people with Alzheimers or mild cognitive impairment relieve the behavior problems of Alzheimers, such as aggression and agitation delay the progression from mild cognitive impairment (MCI) to Alzheimers prevent Alzheimers disease. A wide variety of interventions are being tested in clinical trials. They include experimental drugs as well as nondrug approaches.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>what research (or clinical trials) is being done for Alzheimer's Disease ? [/INST] All types of people are needed to volunteer for Alzheimers research. People with Alzheimer's disease or MCI, those with a family history of Alzheimers, and healthy people with no memory problems and no family history of Alzheimers may be able to take part in clinical trials. Participants in clinical trials help scientists learn about the brain in healthy aging and in Alzheimers. Results of these trials are used to improve prevention and treatment methods. The Alzheimers Disease Education and Referral (ADEAR) Centers clinical trials finder makes it easy for people to find out about studies that are sponsored by the federal government and private companies, universities, and other organizations. It includes studies testing new ways to detect, treat, delay, and prevent Alzheimers disease, other dementias, and MCI. You can search for studies about a certain topic or in a certain geographic area by going to www.nia.nih.gov/alzheimers/clinicaltrials. To find out more about Alzheimers clinical trials, talk to your health care provider or contact the ADEAR Center at 18004384380 or adear@nia.nih.gov. Also, visit its website at www.nia.nih.gov/alzheimers/volunteer.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Alzheimer's Disease ? [/INST] Alzheimers disease is a brain disease that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks. It begins slowly and gets worse over time. Currently, it has no cure. Alzheimers disease is the most common cause of dementia in older people. Get more details about Alzheimer's disease.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Alzheimer's Disease ? [/INST] Dementia is a loss of thinking, remembering, and reasoning skills that interferes with a persons daily life and activities. Alzheimers disease is the most common cause of dementia among older people. Dementia ranges in severity from the mild stage, when it is just beginning to affect a persons functioning, to the severe stage, when the person must depend completely on others for care.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Alzheimer's Disease ? [/INST] Mild cognitive impairment, or MCI, is a condition that can be an early sign of Alzheimers diseasebut not everyone with MCI will develop Alzheimers. People with MCI can still take care of themselves and do their normal activities. Signs of MCI may include losing things often forgetting to go to events and appointments having more trouble coming up with words than other people the same age. losing things often forgetting to go to events and appointments having more trouble coming up with words than other people the same age.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Alzheimer's Disease ? [/INST] Memory problems are typically one of the first signs of Alzheimers disease, though different people may have different initial symptoms. A decline in other aspects of thinking, such as finding the right words, vision/spatial issues, and impaired reasoning or judgment, may also signal the very early stages of Alzheimers disease.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Alzheimer's Disease ? [/INST] Alzheimer's disease has three stages: early (also called mild), middle (moderate), and late (severe). A person in the early stage of Alzheimers may find it hard to remember things ask the same questions over and over get lost in familiar places lose things or put them in odd places have trouble handling money and paying bills take longer than normal to finish daily tasks. find it hard to remember things ask the same questions over and over get lost in familiar places lose things or put them in odd places have trouble handling money and paying bills take longer than normal to finish daily tasks. As Alzheimers disease progresses to the middle stage, memory loss and confusion grow worse, and people may have problems recognizing family and friends. Other symptoms are this stage include difficulty learning new things and coping with new situations trouble carrying out tasks that involve multiple steps, like getting dressed impulsive behavior forgetting the names of common things hallucinations, delusions, or paranoia wandering away from home. difficulty learning new things and coping with new situations trouble carrying out tasks that involve multiple steps, like getting dressed impulsive behavior forgetting the names of common things hallucinations, delusions, or paranoia wandering away from home. As Alzheimers disease becomes more severe, people lose the ability to communicate. They may sleep more, lose weight, and have trouble swallowing. Often they are incontinentthey cannot control their bladder and/or bowels. Eventually, they need total care.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What causes Alzheimer's Disease ? [/INST] Scientists do not yet fully understand what causes Alzheimer's disease in most people. In earlyonset Alzheimers, which occurs in people between the ages of 30 and 60, a genetic mutation is usually the cause. Lateonset Alzheimers, which usually develops after age 60, arises from a complex series of brain changes that occur over decades. The causes probably include a mix of genetic, environmental, and lifestyle factors. These factors affect each person differently. Learn more about the genetics of Alzheimers disease. Increasing age is the most important known risk factor for Alzheimer's disease. Lifestyle factors, such as diet and physical exercise, and longterm health conditions, like high blood pressure and diabetes, might also play a role in the risk of developing Alzheimers disease.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to diagnose Alzheimer's Disease ? [/INST] The only definitive way to diagnose Alzheimer's disease is to find out whether plaques and tangles exist in brain tissue. To look at brain tissue, doctors perform a brain autopsy, an examination of the brain done after a person dies. Doctors can only make a diagnosis of "possible" or probable Alzheimers disease while a person is alive. Doctors with special training can diagnose Alzheimer's disease correctly up to 90 percent of the time. Doctors who can diagnose Alzheimers include geriatricians, geriatric psychiatrists, and neurologists. A geriatrician specializes in the treatment of older adults. A geriatric psychiatrist specializes in mental problems in older adults. A neurologist specializes in brain and nervous system disorders. To diagnose Alzheimer's disease, doctors may ask questions about overall health, past medical problems, ability to carry out daily activities, and changes in behavior and personality conduct tests to measure memory, problem solving, attention, counting, and language skills carry out standard medical tests, such as blood and urine tests perform brain scans to look for anything in the brain that does not look normal. ask questions about overall health, past medical problems, ability to carry out daily activities, and changes in behavior and personality conduct tests to measure memory, problem solving, attention, counting, and language skills carry out standard medical tests, such as blood and urine tests perform brain scans to look for anything in the brain that does not look normal.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to diagnose Alzheimer's Disease ? [/INST] An early, accurate diagnosis of Alzheimer's disease helps people and their families plan for the future. It gives them time to discuss care options, find support, and make legal and financial arrangements while the person with Alzheimers can still take part in making decisions. Also, even though no medicine or other treatment can stop or slow the disease, early diagnosis offers the best chance to treat the symptoms.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to diagnose Alzheimer's Disease ? [/INST] The time from diagnosis of Alzheimers disease to death varies. It can be as little as 3 or 4 years if the person is over 80 years old when diagnosed or as long as 10 years or more if the person is younger.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the treatments for Alzheimer's Disease ? [/INST] Currently, no treatment can stop Alzheimer's disease. However, four medications are used to treat its symptoms. These medicines may help maintain thinking, memory, and speaking skills for a limited time. They work by regulating certain chemicals in the brain. Most of these medicines work best for people in the early or middle stages of the disease. For people with mild or moderate Alzheimer's, donepezil (Aricept), rivastigmine (Exelon), or galantamine (Razadyne) may help. Donepezil is also approved to treat symptoms of moderate to severe Alzheimer's. Another drug, memantine (Namenda), is used to treat symptoms of moderate to severe Alzheimer's, although it also has limited effects. All of these medicines have possible side effects. Learn how Alzheimers medications work, how to take them, and where to find more information. Certain medicines and other approaches can help control the behavioral symptoms of Alzheimer's disease. These symptoms include sleeplessness, agitation, wandering, anxiety, anger, and depression. See more about medications used to treat behavioral symptoms. Some medicines must be used with caution.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to prevent Alzheimer's Disease ? [/INST] Currently, no medicines or treatments are known to prevent Alzheimer's disease, but scientists are studying many possibilities. These possibilities include lifestyle factors such as exercise and physical activity, a healthy diet, and mentally stimulating activities. In addition to lifestyle factors, scientists have found clues that some longterm health conditions, like heart disease, high blood pressure, and diabetes, are related to Alzheimer's disease. Its possible that controlling these conditions will reduce the risk of developing Alzheimers.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to prevent Alzheimer's Disease ? [/INST] Research suggests that exercise may play a role in reducing risk for Alzheimers disease. Animal studies show that exercise increases both the number of small blood vessels that supply blood to the brain and the number of connections between nerve cells in older rats and mice. In addition, researchers have found that exercise raises the level of a nerve growth factor (a protein key to brain health) in an area of the brain that is important to memory and learning. Learn more about the benefits of exercise for older adults. For more on specific exercises geared to the needs of older adults, visit Go4Life, the exercise and physical activity campaign from the National Institute on Aging.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to prevent Alzheimer's Disease ? [/INST] A number of studies suggest that eating certain foods may help keep the brain healthyand that others can be harmful. Researchers are looking at whether a healthy dietone that includes lots of fruits, vegetables, and whole grains and is low in fat and added sugarcan help prevent Alzheimers. For more information about healthy eating as you age, see Eating Well As You Get Older.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to prevent Alzheimer's Disease ? [/INST] Keeping the mind sharpthrough social engagement or intellectual stimulationis associated with a lower risk of Alzheimers disease. Activities like working, volunteering, reading, going to lectures, and playing computer and other games are being studied to see if they might help prevent Alzheimers. But we do not know with certainty whether these activities can actually prevent Alzheimers. Find out about things you can do that may keep your brain healthy.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>what research (or clinical trials) is being done for Alzheimer's Disease ? [/INST] Basic research helps scientists gain new knowledge about a disease process, including how and why it starts and progresses. In Alzheimers disease, basic research seeks to identify the cellular, molecular, and genetic processes that lead to the disease. For example, scientists are studying the ways in which plaques and tangles damage nerve cells in the brain the very earliest brain changes in the disease process the role of Alzheimers riskfactor genes in the development of the disease how riskfactor genes interact with other genes and lifestyle or environmental factors to affect Alzheimers risk. the ways in which plaques and tangles damage nerve cells in the brain the very earliest brain changes in the disease process the role of Alzheimers riskfactor genes in the development of the disease how riskfactor genes interact with other genes and lifestyle or environmental factors to affect Alzheimers risk. See the latest Alzheimers Disease Progress Report to read about results of NIAsupported Alzheimers research.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>what research (or clinical trials) is being done for Alzheimer's Disease ? [/INST] Translational research grows out of basic research. It creates new medicines, devices, or behavioral interventions aimed at preventing, diagnosing, or treating a disease. An important goal of Alzheimers translational research is to increase the number and variety of potential new medicines and other interventions that are approved for testing in humans. Scientists also examine medicines approved to treat other diseases to see they might be effective in people with Alzheimers. The most promising interventions are tested in testtube and animal studies to make sure they are safe and effective. Currently, a number of different substances are under development that may one day be used to treat the symptoms of Alzheimers disease or mild cognitive impairment. See the latest Alzheimers Disease Progress Report to read about results of NIAsupported Alzheimers research.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>what research (or clinical trials) is being done for Alzheimer's Disease ? [/INST] Clinical research is medical research involving people. It includes clinical studies, which observe and gather information about large groups of people. It also includes clinical trials, which test a medicine, therapy, medical device, or intervention in people to see if it is safe and effective. Clinical trials are the best way to find out whether a particular intervention actually slows, delays, or prevents Alzheimers disease. Trials may compare a potential new treatment with a standard treatment or placebo (mock treatment). Or, they may study whether a certain behavior or condition affects the progress of Alzheimers or the chances of developing it. See the latest Alzheimers Disease Progress Report to read about results of NIAsupported Alzheimers research.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the treatments for Alzheimer's Disease ? [/INST] People with Alzheimer's disease, those with mild cognitive impairment, those with a family history of Alzheimers, and healthy people with no memory problems who want to help scientists test new treatments may be able to take part in clinical trials. Participants in clinical trials help scientists learn about the brain in healthy aging as well as what happens in Alzheimers. Results of these trials are used to improve prevention and treatment methods. To find out more about Alzheimers clinical trials, talk to your health care provider or contact the Alzheimers Disease Education and Referral (ADEAR) Center at 18004384380. You can search for studies about a certain topic or in a certain geographic area by going to www.nia.nih.gov/alzheimers/clinicaltrials.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Colorectal Cancer ? [/INST] How Tumors Form The body is made up of many types of cells. Normally, cells grow, divide, and produce more cells as needed to keep the body healthy and functioning properly. Sometimes, however, the process goes wrong cells become abnormal and form more cells in an uncontrolled way. These extra cells form a mass of tissue, called a growth or tumor. Tumors can be benign, which means not cancerous, or malignant, which means cancerous. How Colorectal Cancer Develops Cancer of the colon or rectum is called colorectal cancer. The colon and the rectum are part of the large intestine, which is part of the digestive system. Colorectal cancer occurs when tumors form in the lining of the large intestine, also called the large bowel. Colorectal cancer accounts for almost ten percent of all cancer deaths in the United States. The risk of developing colorectal cancer rises after age 50. It is common in both men and women. Colorectal Cancer Can Spread Sometimes, cancer cells break away from the malignant tumor and enter the bloodstream or the lymphatic system where they travel to other organs in the body. Among other things, the lymphatic system transports white blood cells that fight infection. When cancer travels or spreads from its original location in the colon to another part of the body such as the liver, it is called metastatic colorectal cancer and not liver cancer. When colorectal cancer does spread, it tends to spread to the liver or lungs. Cure Rate for Early Detection Today there are more ways than ever to treat colorectal cancer. As with almost all cancers, the earlier it is found, the more likely that the treatment will be successful. If colon cancer is detected in its early stages, it is up to 90 percent curable.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>Who is at risk for Colorectal Cancer? ? [/INST] Scientists don't know exactly what causes colorectal cancer, but they have been able to identify some risk factors for the disease. A risk factor is anything that increases your chances of getting a disease. Studies show that the following risk factors may increase a person's chances of developing colorectal cancer: age, polyps, personal history, family history, and ulcerative colitis. Age Colorectal cancer is more likely to occur as people get older. It is more common in people over the age of 50, but younger people can get it, too. In rare cases, it can occur in adolescence. Polyps Polyps are benign, or noncancerous, growths on the inner wall of the colon and rectum. They are fairly common in people over age 50. Some types of polyps increase a person's risk of developing colorectal cancer. Not all polyps become cancerous, but nearly all colon cancers start as polyps. Diet The link between diet and colorectal cancer is not firmly established. There is evidence that smoking cigarettes and drinking 3 or more alcoholic beverages daily may be associated with an increased risk of colorectal cancer. Personal History Research shows that women with a history of cancer of the ovary, uterus, or breast have a somewhat increased chance of developing colorectal cancer. Also, a person who has already had colorectal cancer may develop this disease a second time. Family History The parents, siblings, and children of a person who has had colorectal cancer are somewhat more likely to develop this type of cancer themselves. This is especially true if the relative had the cancer at a young age. If many family members have had colorectal cancer, the chances increase even more. Ulcerative colitis Ulcerative colitis is a condition in which there is a chronic break in the lining of the colon. Having this condition increases a person's chance of developing colorectal cancer. Genetic Mutations Researchers have identified genetic mutations, or abnormalities, that may be linked to the development of colon cancer. They are working to unravel the exact ways these genetic changes occur. Recent results from The Cancer Genome Atlas study of colorectal cancer point to several genes (BRAF and EGRF among others) that may increase risk. If You Have Risk Factors If you have one or more of these risk factors, it doesn't mean you will get colorectal cancer. It just increases the chances. You may wish to talk to your doctor about these risk factors. He or she may be able to suggest ways you can reduce your chances of developing colorectal cancer and plan an appropriate schedule for checkups.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the symptoms of Colorectal Cancer ? [/INST] Most cancers in their early, most treatable stages don't cause any symptoms. That is why it is important to have regular tests to check for cancer even when you might not notice anything wrong. Common Signs and Symptoms When colorectal cancer first develops, there may be no symptoms at all. But as the cancer grows, it can cause changes that people should watch for. Common signs and symptoms of colorectal cancer include: a change in the frequency of bowel movements diarrhea, constipation, or feeling that the bowel does not empty completely either bright red or very dark blood in the stool stools that are narrower than usual general abdominal discomfort such as frequent gas pains, bloating, fullness, and/or cramps weight loss with no known reason constant tiredness vomiting a change in the frequency of bowel movements diarrhea, constipation, or feeling that the bowel does not empty completely either bright red or very dark blood in the stool stools that are narrower than usual general abdominal discomfort such as frequent gas pains, bloating, fullness, and/or cramps weight loss with no known reason constant tiredness vomiting These symptoms may be caused by colorectal cancer or by other conditions. It is important to check with a doctor if you have symptoms because only a doctor can make a diagnosis. Don't wait to feel pain. Early cancer usually doesn't cause pain. Lowering Your Risk Factors Lower your risk factors where possible. Colon cancer can be prevented if polyps that lead to the cancer are detected and removed. If colon cancer is found in its earliest stages, it is up to 90 percent curable. Tools for Early Detection Beginning at age 50, the following tools are all used for early detection. They can help identify precancerous conditions. If you are younger than 50 and one of your firstdegree relatives has had colon cancer, you should consult with your doctor. Tools used for early detection: A fecal occult blood test, or FOBT, is a test used to check for hidden blood in the stool. Sometimes cancers or polyps can bleed, and FOBT can detect small amounts of bleeding. Newer, geneticallybased stool tests are proving to be more accurate than older tests. A sigmoidoscopy is an examination of the rectum and lower colon or sigmoid colon using a lighted instrument called a sigmoidoscope. A colonoscopy is an examination of the rectum and the large intestine (but not the small intestine) using a lighted instrument called a colonoscope. A virtual colonoscopy, which requires the same preparation as a standard colonoscopy, is done with an external scanning machine as opposed to a device inserted into the colon, although the colon does need to be inflated with gas for proper scanning. A fecal occult blood test, or FOBT, is a test used to check for hidden blood in the stool. Sometimes cancers or polyps can bleed, and FOBT can detect small amounts of bleeding. Newer, geneticallybased stool tests are proving to be more accurate than older tests. A sigmoidoscopy is an examination of the rectum and lower colon or sigmoid colon using a lighted instrument called a sigmoidoscope. A colonoscopy is an examination of the rectum and the large intestine (but not the small intestine) using a lighted instrument called a colonoscope. A virtual colonoscopy, which requires the same preparation as a standard colonoscopy, is done with an external scanning machine as opposed to a device inserted into the colon, although the colon does need to be inflated with gas for proper scanning.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the treatments for Colorectal Cancer ? [/INST] There are several treatment options for colorectal cancer, although most treatments begin with surgical removal of either the cancerous polyp or section of the colon. The choice of treatment depends on your age and general health, the stage of cancer, whether or not it has spread beyond the colon, and other factors. If tests show that you have cancer, you should talk with your doctor and make treatment decisions as soon as possible. Studies show that early treatment leads to better outcomes. Working With a Team of Specialists A team of specialists often treats people with cancer. The team will keep the primary doctor informed about the patient's progress. The team may include a medical oncologist who is a specialist in cancer treatment, a surgeon, a radiation oncologist who is a specialist in radiation therapy, and others. Before starting treatment, you may want another doctor to review the diagnosis and treatment plan. Some insurance companies require a second opinion. Others may pay for a second opinion if you request it. Clinical Trials for Colorectal Cancer Some colorectal cancer patients take part in studies of new treatments. These studies, called clinical trials, are designed to find out whether a new treatment is safe and effective. Often, clinical trials compare a new treatment with a standard one so that doctors can learn which is more effective. People with colorectal cancer who are interested in taking part in a clinical trial should talk with their doctor. The U.S. National Institutes of Health, through its National Library of Medicine and other Institutes, maintains a database of clinical trials at ClinicalTrials.gov. Click here to see a list of the current clinical trials on colorectal cancer. A separate window will open. Click the "x" in the upper right hand corner of the "Clinical Trials" window to return here.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the treatments for Colorectal Cancer ? [/INST] Treatments are available for all patients who have colon cancer. The choice of treatment depends on the size, location, and stage of the cancer and on the patient's general health. Doctors may suggest several treatments or combinations of treatments. Surgery Is the Most Common First Step in a Treatment Regimen The three standard treatments for colon cancer are surgery, chemotherapy, and radiation. Surgery, however, is the most common first step in the treatment for all stages of colon cancer. Surgery is an operation to remove the cancer. A doctor may remove the cancer using several types of surgery. Local Excision If the cancer is found at a very early stage, the doctor may remove it without cutting through the abdominal wall. Instead, the doctor may put a tube up the rectum into the colon and cut the cancer out. This is called a local excision. If the cancer is found in a polyp, which is a small bulging piece of tissue, the operation is called a polypectomy. Colectomy If the cancer is larger, the surgeon will remove the cancer and a small amount of healthy tissue around it. This is called a colectomy. The surgeon may then sew the healthy parts of the colon together. Usually, the surgeon will also remove lymph nodes near the colon and examine them under a microscope to see whether they contain cancer. Colostomy If the doctor is not able to sew the two ends of the colon back together, an opening called a stoma is made on the abdomen for waste to pass out of the body before it reaches the rectum. This procedure is called a colostomy. Sometimes the colostomy is needed only until the lower colon has healed, and then it can be reversed. But if the doctor needs to remove the entire lower colon or rectum, the colostomy may be permanent. Adjuvant Chemotherapy Even if the doctor removes all of the cancer that can be seen at the time of the operation, many patients receive chemotherapy after surgery to kill any cancer cells that are left. Chemotherapy treatment after surgery to increase the chances of a cure is called adjuvant therapy. Researchers have found that patients who received adjuvant therapy usually survived longer and went for longer periods of time without a recurrence of colon cancer than patients treated with surgery alone. Patients age 70 and older benefited from adjuvant treatment as much as their younger counterparts. In fact, adjuvant therapy is equally as effective and no more toxic for patients 70 and older as it is for younger patients, provided the older patients have no other serious diseases. Adjuvant chemotherapy is standard treatment for patients whose cancer is operable and who are at high risk for a recurrence of the disease. Most cases of colon cancer occur in individuals age 65 and over. But studies have shown that older patients receive adjuvant chemotherapy less frequently than younger patients. Chemotherapy Chemotherapy is the use of anticancer drugs to kill cancer cells. Chemotherapy may be taken by mouth, or it may be put into the body by inserting a needle into a vein or muscle. One form of chemotherapy is called systemic treatment because the drugs enter the bloodstream, travel through the body, and can kill cancer cells throughout the body. The other form of chemotherapy is called targeted therapy because the drug affects only the factors that are causing the cancer and does not perturb the rest of the body. Radiation Therapy Radiation therapy is the use of xrays or other types of radiation to kill cancer cells and shrink tumors. Most often, doctors use it for patients whose cancer is in the rectum. Doctors may use radiation before surgery to shrink a tumor in the rectum and make it easier to remove. Or, they may use it after surgery to destroy any cancer cells that remain in the treated area. The radiation may come from a machine or from implants placed directly into or near the tumor. Radiation that comes from a machine is called external radiation. Radiation that uses implants is known as internal radiation. Some patients have both kinds of therapy.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>what research (or clinical trials) is being done for Colorectal Cancer ? [/INST] Researchers continue to look at new ways to treat, diagnose, and prevent colorectal cancer. Many are testing other types of treatments in clinical trials. Advances in Treatments Studies have found that patients who took the drug Avastin, a targeted chemotherapy drug, with their standard chemotherapy treatment had a longer progressionfree survival than those who did not take Avastin, but some studies have indicated that Avastin does not extend life. (The generic name for Avastin is bevacizumab.) Scientists are also working on vaccines therapies and monoclonal antibodies that may improve how patients' immune systems respond to colorectal cancers. Monoclonal antibodies are a single type of antibody that researchers make in large amounts in a laboratory. Surgical techniques have reduced the number of patients needing a permanent colostomy. A colostomy is an opening made in the abdomen for waste to pass out of the body before it reaches the rectum. In many cases, the surgeon can reconnect the healthy parts of the colon back together after removing the cancer. This way, the colon can function just as it did before. The PLCO Trial The National Cancer Institute's Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, or PLCO Trial, recently provided results about the role of sigmoidoscopy in reducing deaths from colon and rectal cancers. The PLCO trial, involving 148,000 volunteers aged 55 to 74, compared two groups of people over a 10year period and found that the group that received sigmoidoscopies had fewer deaths from colorectal cancer than those who did not get a sigmoidoscopy. NSAIDs and Polyp Formation Preventing colorectal cancer is a concern of many researchers. Studies have shown that nonsteroidal antiinflammatory drugs (NSAIDs) can keep largebowel polyps from forming. Bowel polyps can start out benign, or noncancerous, but can become cancerous. However, the effects that these drugs have on the heart and other parts of the body is of concern, therefore these drugs should only be used for prevention under a doctor's supervision. Genetic Research Genes involved in colorectal cancer continue to be identified and understood. Hereditary nonpolyposis colorectal cancer, or HNPCC, is one condition that causes people in a certain family to develop colorectal cancer at a young age. The discovery of four genes involved with this disease has provided crucial clues about the role of DNA repair in colorectal and other cancers. Scientists are continuing to identify genes associated with colon cancers that run in families. Using traditional screening methods on people from families that carry these genes may be another way to identify cancers at an early stage and cut deaths from colorectal cancer. Genetic screening of people at high risk may become more common in the near future Besides looking at genes in families, researchers in the The Cancer Genome Atlas study looked at the genes of actual colon tumors to better understand the contribution that genes make to cancer. By looking at the genetic composition of the tumor, researchers were able to identify new mutations (changes) in the genes that can lead to cancer, including the genes BRAF and EGRF.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Colorectal Cancer ? [/INST] The body is made up of many types of cells. Normally, cells grow, divide, and produce more cells as needed to keep the body healthy and functioning properly. Sometimes, however, the process goes wrong. Cells become abnormal and form more cells in an uncontrolled way. These extra cells form a mass of tissue, called a growth or tumor. Tumors can be benign, which means noncancerous, or malignant, which means cancerous.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Colorectal Cancer ? [/INST] Cancer of the colon or rectum is called colorectal cancer. The colon and the rectum are part of the large intestine, which is part of the digestive system. Colorectal cancer occurs when malignant tumors form in the lining of the large intestine, also called the large bowel.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How many people are affected by Colorectal Cancer ? [/INST] Colorectal cancer accounts for almost ten percent of all cancer deaths in the United States. The risk of developing colorectal cancer rises after age 50. It is common in both men and women.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>Who is at risk for Colorectal Cancer? ? [/INST] Studies show that the following risk factors may increase a person's chances of developing colorectal cancer: age, polyps, personal history, family history, and ulcerative colitis.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>Who is at risk for Colorectal Cancer? ? [/INST] Yes. Ulcerative colitis is a condition in which there is a chronic break in the lining of the colon. It has been associated with an increased risk of colon cancer.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Colorectal Cancer ? [/INST] Parents, siblings, or children of a person who has had colorectal cancer are somewhat more likely to develop this type of cancer themselves. This is especially true if the relative had the cancer at a young age. If many family members have had colorectal cancer, the chances increase even more.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the symptoms of Colorectal Cancer ? [/INST] Possible signs of colorectal cancer include: a change in the frequency of bowel movements diarrhea, constipation, or feeling that the bowel does not empty completely either bright red or very dark blood in the stool a change in the frequency of bowel movements diarrhea, constipation, or feeling that the bowel does not empty completely either bright red or very dark blood in the stool stools that are narrower than usual general abdominal discomfort such as frequent gas pains, bloating, fullness, and/or cramps weight loss with no known reason constant tiredness vomiting stools that are narrower than usual general abdominal discomfort such as frequent gas pains, bloating, fullness, and/or cramps weight loss with no known reason constant tiredness vomiting</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Colorectal Cancer ? [/INST] Here are some of the tools used to detect colorectal cancer. A fecal occult blood test, or FOBT, is a test used to check for hidden blood in the stool. Sometimes cancers or polyps can bleed, and FOBT can detect small amounts of bleeding. Newer, geneticallybased stool tests are proving to be more accurate than older tests. A fecal occult blood test, or FOBT, is a test used to check for hidden blood in the stool. Sometimes cancers or polyps can bleed, and FOBT can detect small amounts of bleeding. Newer, geneticallybased stool tests are proving to be more accurate than older tests. A sigmoidoscopy is an examination of the rectum and lower colon or sigmoid colon using a lighted instrument called a sigmoidoscope. A sigmoidoscopy is an examination of the rectum and lower colon or sigmoid colon using a lighted instrument called a sigmoidoscope. A colonoscopy is an examination of the rectum and the large intestine (but not the small intestine) using a lighted instrument called a colonoscope. A colonoscopy is an examination of the rectum and the large intestine (but not the small intestine) using a lighted instrument called a colonoscope. A virtual colonoscopy, which requires the same preparation as a standard colonoscopy, is done with an external scanning machine as opposed to a device inserted into the colon. The colon does need to be inflated with gas for proper scanning. A virtual colonoscopy, which requires the same preparation as a standard colonoscopy, is done with an external scanning machine as opposed to a device inserted into the colon. The colon does need to be inflated with gas for proper scanning.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Colorectal Cancer ? [/INST] Yes. In July 2008, the U.S. Preventive Services Task Force made its strongest ever recommendation for colorectal cancer screening: it suggested that all adults between ages 50 and 75 get screened, or tested, for the disease. The task force noted that various screening tests are available, making it possible for patients and their clinicians to decide which test is best for each person.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Colorectal Cancer ? [/INST] The three standard treatments for colon cancer are surgery, chemotherapy, and radiation. Surgery, however, is the most common first step in the treatment for all stages of colon cancer. Surgery is an operation to remove the cancer. A doctor may remove the cancer using several types of surgery. For rectal cancer, radiation treatment also is an option.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Colorectal Cancer ? [/INST] Several types of surgery are available for someone with colorectal cancer. If the cancer is found at a very early stage, the doctor may remove it without cutting through the abdominal wall. Instead, the doctor may put a tube up the rectum into the colon and cut the cancer out. This is called a local excision. If the cancer is found in a polyp, which is a small bulging piece of tissue, the operation is called a polypectomy. If the cancer is larger, the surgeon will remove the cancer and a small amount of healthy tissue around it. This is called a colectomy. The surgeon may then sew the healthy parts of the colon together. Usually, the surgeon will also remove lymph nodes near the colon and examine them under a microscope to see whether they contain cancer. If the doctor is not able to sew the two ends of the colon back together, an opening called a stoma is made on the abdomen for waste to pass out of the body before it reaches the rectum. This procedure is called a colostomy. Sometimes the colostomy is needed only until the lower colon has healed, and then it can be reversed. But if the doctor needs to remove the entire lower colon, the colostomy may be permanent.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the treatments for Colorectal Cancer ? [/INST] Even if the doctor removes all the cancer that can be seen at the time of the operation, many patients receive chemotherapy after surgery to kill any cancer cells that are left. Chemotherapy treatment after surgery to increase the chances of a cure is called adjuvant therapy. Researchers have found that patients who received adjuvant therapy usually survived longer and went for longer periods of time without a recurrence of colon cancer than patients treated with surgery alone. Patients age 70 and older benefited from adjuvant treatment as much as their younger counterparts. In fact, adjuvant therapy is equally as effective and no more toxic for patients 70 and older as it is for younger patients, provided the older patients have no other serious diseases. Adjuvant chemotherapy is standard treatment for patients whose cancer is operable and who are at high risk for a recurrence of the disease. Most cases of colon cancer occur in individuals age 65 and over. But studies have shown that older patients receive adjuvant chemotherapy less frequently than younger patients.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the treatments for Colorectal Cancer ? [/INST] For surgery, the main side effects are shortterm pain and tenderness around the area of the operation. For chemotherapy, the side effects depend on which drugs you take and what the dosages are. Most often the side effects include nausea, vomiting, and hair loss. For radiation therapy, fatigue, loss of appetite, nausea, and diarrhea may occur. There are many new drugs that have greatly reduced the degree of nausea that used to be experienced because of some of these treatments.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Colorectal Cancer ? [/INST] Various drugs are under study as possible treatments for colorectal cancer. A 2005 study found that patients who took the drug AvastinTM with their standard chemotherapy treatment had a longer progressionfree survival than those who did not take Avastin, but the evidence is mixed on whether or not Avastin can extend life. (The generic name for Avastin is bevacizumab.) Scientists are also working on vaccine therapies and monoclonal antibodies that may improve how patients' immune systems respond to colorectal cancers. Monoclonal antibodies are a single type of antibody that researchers make in large amounts in a laboratory.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to prevent Colorectal Cancer ? [/INST] Scientists have done research on chemoprevention the use of drugs to prevent cancer from developing in the first place. Most of these studies have looked at people with high risk for the disease (where it runs in families) and not in the general population. For example, researchers have found that antiinflammatory drugs helped keep intestinal tumors from forming, but serious side effects have been noted so researchers are proceeding cautiously. Studies have shown that nonsteroidal antiinflammatory drugs can keep large bowel polyps from forming. Bowel polyps can start out benign, or noncancerous, but can become cancerous. Serious cardiac effects of these drugs have been noted so researchers are also proceeding cautiously in recommending these drugs for prevention.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>Who is at risk for Colorectal Cancer? ? [/INST] Researchers are working hard to understand and identify the genes involved in colorectal cancer. Hereditary nonpolyposis colorectal cancer, or HNPCC, is one condition that causes people to develop colorectal cancer at a young age. The discovery of four genes involved with this disease has provided crucial clues about the role of DNA repair in colorectal and other cancers.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Kidney Disease ? [/INST] What the Kidneys Do You have two kidneys. They are beanshaped and about the size of a fist. They are located in the middle of your back, on the left and right of your spine, just below your rib cage. The kidneys filter your blood, removing wastes and extra water to make urine. They also help control blood pressure and make hormones that your body needs to stay healthy. When the kidneys are damaged, wastes can build up in the body. Kidney Function and Aging Kidney function may be reduced with aging. As the kidneys age, the number of filtering units in the kidney may decrease, the overall amount of kidney tissue may decrease, and the blood vessels that supply the kidney may harden, causing the kidneys to filter blood more slowly. If your kidneys begin to filter less well as you age, you may be more likely to have complications from certain medicines. There may be an unsafe buildup of medicines that are removed from your blood by your kidneys. Also, your kidneys may be more sensitive to certain medicines. For example, nonsteroidal antiinflammatory drugs (NSAIDs) and some antibiotics may harm your kidneys in some situations. The next time you pick up a prescription or buy an overthecounter medicine or supplement, ask your pharmacist how the product may affect your kidneys and interact with your other medicines. (Watch the video to learn more about what the kidneys do. To enlarge the video, click the brackets in the lower righthand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) Learn more about how the kidneys work. How Kidney Disease Occurs Kidney disease means the kidneys are damaged and can no longer remove wastes and extra water from the blood as they should. Kidney disease is most often caused by diabetes or high blood pressure. According to the Centers for Disease Control and Prevention, more than 20 million Americans may have kidney disease. Many more are at risk. The main risk factors for developing kidney disease are diabetes high blood pressure cardiovascular (heart and blood vessel) disease a family history of kidney failure. diabetes high blood pressure cardiovascular (heart and blood vessel) disease a family history of kidney failure. Each kidney contains about one million tiny filtering units made up of blood vessels. These filters are called glomeruli. Diabetes and high blood pressure damage these blood vessels, so the kidneys are not able to filter the blood as well as they used to. Usually this damage happens slowly, over many years. This is called chronic kidney disease. As more and more filtering units are damaged, the kidneys eventually are unable to maintain health. Early kidney disease usually has no symptoms, which means you will not feel different. Blood and urine tests are the only way to check for kidney damage or measure kidney function. If you have diabetes, high blood pressure, heart disease, or a family history of kidney failure, you should be tested for kidney disease. Kidney Failure Kidney disease can get worse over time, and may lead to kidney failure. Kidney failure means very advanced kidney damage with less than 15% normal function. Endstage renal disease (ESRD) is kidney failure treated by dialysis or kidney transplant. If the kidneys fail, treatment options such as dialysis or a kidney transplant can help replace kidney function. Some patients choose not to treat kidney failure with dialysis or a transplant. If your kidneys fail, talk with your health care provider about choosing a treatment that is right for you. (Watch the video to learn more about how kidney disease progresses. To enlarge the video, click the brackets in the lower righthand corner. To reduce the video, press the Escape (Esc) button on your keyboard.)</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to prevent Kidney Disease ? [/INST] Risk Factors Diabetes and high blood pressure are the two leading causes of kidney disease. Both diabetes and high blood pressure damage the small blood vessels in your kidneys and can cause kidney disease without you feeling it. Other risk factors for kidney disease include: cardiovascular (heart) disease family history if you have a mother, father, sister, or brother who has had kidney failure, then you are at increased risk. cardiovascular (heart) disease family history if you have a mother, father, sister, or brother who has had kidney failure, then you are at increased risk. Additionally, African Americans, Hispanics, and Native Americans are at high risk for developing kidney failure. This is in part due to high rates of diabetes and high blood pressure in these communities. If you have ANY of these risk factors, talk to your health care provider about getting tested for kidney disease. If you have kidney disease, you may not feel any different. It is very important to get tested if you are at risk. (Watch the video to learn more about reducing your risk for kidney disease. To enlarge the video, click the brackets in the lower righthand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) Prevention If you are at risk for kidney disease, the most important steps you can take to keep your kidneys healthy are to get your blood and urine checked for kidney disease. manage your diabetes, high blood pressure, and heart disease. get your blood and urine checked for kidney disease. manage your diabetes, high blood pressure, and heart disease. Manage your diabetes and high blood pressure, and keep your kidneys healthy by eating healthy foods: fresh fruits, fresh or frozen vegetables, whole grains, and lowfat dairy foods cutting back on salt limiting your alcohol intake being more physically active losing weight if you are overweight taking your medicines the way your provider tells you to keeping your cholesterol levels in the target range taking steps to quit, if you smoke seeing your doctor regularly. eating healthy foods: fresh fruits, fresh or frozen vegetables, whole grains, and lowfat dairy foods cutting back on salt limiting your alcohol intake being more physically active losing weight if you are overweight taking your medicines the way your provider tells you to keeping your cholesterol levels in the target range taking steps to quit, if you smoke seeing your doctor regularly. By following these steps and keeping risk factors under control especially your blood pressure you may be able to delay or even prevent kidney failure. Talk to your health care provider to find out the steps that are right for you. Learn about preventing high blood pressure. Learn about preventing type 2 diabetes.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the symptoms of Kidney Disease ? [/INST] Kidney Disease Kidney disease is often called a "silent" disease, because most people have no symptoms with early kidney disease. In fact, you might feel just fine until your kidneys have almost stopped working. Do NOT wait for symptoms! If you are at risk for kidney disease, talk to your health care provider about getting tested. (Watch the video to learn more about the symptoms of kidney disease. To enlarge the videos on this page, click the brackets in the lower righthand corner of the video screen. To reduce the videos, press the Escape (Esc) button on your keyboard.) Symptoms of Kidney Failure Kidney failure means that damaged kidneys are filtering less than 15% of the amount of blood filtered by healthy kidneys. If kidney disease progresses to kidney failure, a number of symptoms may occur. Some people experience fatigue, some lose their appetite, and some have leg cramps. These problems are caused by waste products that build up in the blood, a condition known as uremia. Healthy kidneys remove waste products from the blood. When the kidneys stop working, uremia occurs. The kidneys also make hormones and balance the minerals in the blood. When the kidneys stop working, most people develop conditions that affect the blood, bones, nerves, and skin. These problems may include itching, sleep problems, restless legs, weak bones, joint problems, and depression. How Kidney Disease Is Diagnosed Blood and urine tests are the only way to check for kidney damage or measure kidney function. It is important for you to get checked for kidney disease if you have the key risk factors, which are diabetes high blood pressure heart disease a family history of kidney failure. diabetes high blood pressure heart disease a family history of kidney failure. If you are at risk, ask about your kidneys at your next medical appointment. The sooner you know you have kidney disease, the sooner you can get treatment to help delay or prevent kidney failure. If you have diabetes, high blood pressure, heart disease, or a family history of kidney failure, you should get a blood and urine test to check your kidneys. Talk to your provider about how often you should be tested. (Watch the video to learn more about tests for kidney disease.) Blood Test The blood test checks your GFR. GFR stands for glomerular (glowMAIRyoulure) filtration rate. GFR is a measure of how much blood your kidneys filter each minute. This shows how well your kidneys are working. GFR is reported as a number. A GFR of 60 or higher is in the normal range. A GFR below 60 may mean you have kidney disease. However, because GFR decreases as people age, other information may be needed to determine if you actually have kidney disease. A GFR of 15 or lower may mean kidney failure. A GFR of 60 or higher is in the normal range. A GFR below 60 may mean you have kidney disease. However, because GFR decreases as people age, other information may be needed to determine if you actually have kidney disease. A GFR of 15 or lower may mean kidney failure. You can't raise your GFR, but you can try to keep it from going lower. Ask your healthcare provider what you can do to keep your kidneys healthy. Learn more about the GFR test. Urine Test The urine test looks for albumin (alBYOOmin), a type of protein, in your urine. A healthy kidney does not let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine. This test has several different names. You could be told that you are being screened for "proteinuria" or "albuminuria" or "microalbuminuria." Or you could be told that your "urine albumintocreatinine ratio" (UACR) is being measured. If you have albumin or protein in your urine, it could mean you have kidney disease. A urine albumin result below 30 is normal. A urine albumin result above 30 is not normal and may mean kidney disease. A urine albumin result below 30 is normal. A urine albumin result above 30 is not normal and may mean kidney disease. Learn more about the urine albumin test. Your healthcare provider might do additional tests to be sure.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the treatments for Kidney Disease ? [/INST] Different Treatments for Different Stages There are several types of treatments related to kidney disease. Some are used in earlier stages of kidney disease to protect your kidneys. These medications and lifestyle changes help you maintain kidney function and delay kidney failure. Other treatments, such as dialysis and transplantation, are used to treat kidney failure. These methods help replace kidney function if your own kidneys have stopped working. Treatments for Early Kidney Disease Treatments for early kidney disease include both diet and lifestyle changes and medications. Making hearthealthy food choices and exercising regularly to maintain a healthy weight can help prevent the diseases that cause further kidney damage. If you already have diabetes and/or high blood pressure, keeping these conditions under control can keep them from causing further damage to your kidneys. Choose and prepare foods with less salt and sodium. Aim for less than 2,300 milligrams of sodium each day. Eat the right amount of protein. Although it is important to eat enough protein to stay healthy, excess protein makes your kidneys work harder. Eating less protein may help delay progression to kidney failure. Talk to your dietitian or other health care provider about what is the right amount of protein for you. If you have been diagnosed with kidney disease, ask your doctor about seeing a dietitian. A dietitian can teach you how to choose foods that are easier on your kidneys. You will also learn about the nutrients that matter for kidney disease. You can find a dietitian near you through the Academy of Nutrition and Dietetics directory. If you smoke, take steps to quit. Cigarette smoking can make kidney damage worse. Making hearthealthy food choices and exercising regularly to maintain a healthy weight can help prevent the diseases that cause further kidney damage. If you already have diabetes and/or high blood pressure, keeping these conditions under control can keep them from causing further damage to your kidneys. Choose and prepare foods with less salt and sodium. Aim for less than 2,300 milligrams of sodium each day. Eat the right amount of protein. Although it is important to eat enough protein to stay healthy, excess protein makes your kidneys work harder. Eating less protein may help delay progression to kidney failure. Talk to your dietitian or other health care provider about what is the right amount of protein for you. If you have been diagnosed with kidney disease, ask your doctor about seeing a dietitian. A dietitian can teach you how to choose foods that are easier on your kidneys. You will also learn about the nutrients that matter for kidney disease. You can find a dietitian near you through the Academy of Nutrition and Dietetics directory. If you smoke, take steps to quit. Cigarette smoking can make kidney damage worse. Medicines Medicines can also help protect the kidneys. People with kidney disease often take medicines to lower blood pressure, control blood glucose, and lower blood cholesterol. Two types of blood pressure medicines angiotensinconverting enzyme (ACE) inhibitors, and angiotensin receptor blockers (ARBs) may protect the kidneys and delay kidney failure. These medicines may even protect kidney function in people who don't have high blood pressure. The most important step you can take to treat kidney disease is to control your blood pressure. Many people need two or more medicines to keep their blood pressure at a healthy level. For most people, the blood pressure target is less than 140/90 mm Hg. An ACE inhibitor, ARB, or diuretic (water pill) may help control blood pressure. Your healthcare provider will work with you to choose the right medicines for you. (Watch the video to learn more about medications and kidney disease. To enlarge the video, click the brackets in the lower righthand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) Be Safe With Your Medicines Some older adults with kidney disease may take medicines for other diseases as well. If you have kidney disease, you need to be careful about all the medicines you take. Your kidneys do not filter as well as they did in the past. This can cause an unsafe buildup of medicines in your blood. Some medicines can also harm your kidneys. As kidney disease progresses, your doctor may need to change the dose (or amount) of all medicines that affect the kidney or are removed by the kidney. You may need to take some medicines in smaller amounts or less often. You may also need to stop taking a medicine or switch to a different one. Effects of NSAID Drugs Nonsteroidal antiinflammatory drugs (NSAIDs) can harm your kidneys, especially if you have kidney disease, diabetes, and high blood pressure. NSAIDs include common overthecounter and prescription medicines for headaches, pain, fever, or colds. Ibuprofen and naproxen are NSAIDs, but NSAIDs are sold under many different brand names. If you have kidney disease, do not use NSAIDs. Ask your pharmacist or health care provider if the medicines you take are safe to use. You also can look for NSAIDs on Drug Facts labels.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the treatments for Kidney Disease ? [/INST] Kidney disease can get worse over time, and may lead to kidney failure. Kidney failure means advanced kidney damage with less than 15% normal function. Most people with kidney failure have symptoms from the build up of waste products and extra water in their body. Endstage renal disease (ESRD) is kidney failure treated by dialysis or kidney transplant. If kidney disease progresses to kidney failure, the goal of treatment changes. Since the kidneys no longer work well enough to maintain health, it is necessary to choose a treatment in order to maintain health. There are two main options for this: dialysis and transplantation. Some patients choose not to treat kidney failure with dialysis or a transplant. Instead, they receive supportive care to treat their symptoms. Before you and your health care team decide on a treatment plan, it is important that you understand how each treatment option is likely to affect how long you will live or how good you will feel. If your kidney disease is progressing, talk with your health care provider about choosing a treatment that is right for you. (Watch the video to learn more about dialysis decisions. To enlarge the videos on this page, click the brackets in the lower righthand corner of the video screen. To reduce the videos, press the Escape (Esc) button on your keyboard.) Two Kinds of Dialysis Dialysis is a treatment that takes waste products and extra fluid out of your body. In hemodialysis, your blood passes through a filter outside of your body and the clean blood is returned to your body. In hemodialysis, blood is run through a filter outside of your body and the clean blood is returned to the body. Hemodialysis is usually done at a dialysis center three times a week, but it can also be done at home. Each session usually lasts between three and four hours. Peritoneal dialysis is another way to remove wastes from your blood. This kind of dialysis uses the lining of your abdominal cavity (the space in your body that holds organs like the stomach, intestines, and liver) to filter your blood. It works by putting a special fluid into your abdomen that absorbs waste products in your blood as it passes through small blood vessels in this lining. This fluid with the waste products is then drained away. A key benefit of peritoneal dialysis is that it can be done at home, while you sleep. Hemodialysis and peritoneal dialysis do not cure kidney failure. They are treatments that help replace the function of the kidneys and may help you feel better and live longer. But, for some people who have many health problems and are age 75 or older, studies show that treatment with dialysis may not help. If You Are on Dialysis Although patients with kidney failure are now living longer than ever, over the years, kidney disease can cause problems such as depression heart disease bone disease arthritis nerve damage malnutrition. depression heart disease bone disease arthritis nerve damage malnutrition. To stay as healthy as possible for as long as possible while on dialysis, follow your dietitian's advice, take your medicines, and follow healthy lifestyle and diet habits to keep a healthy weight and control blood pressure, blood sugar, and cholesterol. follow your dietitian's advice, take your medicines, and follow healthy lifestyle and diet habits to keep a healthy weight and control blood pressure, blood sugar, and cholesterol. Dialysis can be a special challenge for older adults, especially those who have other diseases or conditions. For example, for hemodialysis, a person must be able to leave home, travel to the dialysis facility, and sit for 4 hours during treatment. Peritoneal dialysis can be done at home, but someone needs to help. Often, older adults need help with some or all of these activities. They and their families need to think about these issues as they choose treatment options and living facilities. Learn more about dialysis. Eating, Diet, and Nutrition on Dialysis For people who are on dialysis or approaching total kidney failure, adequate nutrition is important for maintaining energy, strength, healthy sleep patterns, bone health, heart health, and good mental health. The diet should be based on the type of treatment the person is getting. People on hemodialysis must watch how much fluid they drink and avoid eating foods with too much sodium, potassium, and phosphorus. In contrast, people on peritoneal dialysisa type of dialysis that uses the lining of the abdomen, or belly, to filter the blood inside the bodymay be able to eat more potassiumrich foods because peritoneal dialysis removes potassium from the body more efficiently than hemodialysis. Both hemodialysis and peritoneal dialysis can remove proteins from the body, so anyone on either form of dialysis should eat proteinrich foods such as meat, fish, and eggs. People on hemodialysis must watch how much fluid they drink and avoid eating foods with too much sodium, potassium, and phosphorus. In contrast, people on peritoneal dialysisa type of dialysis that uses the lining of the abdomen, or belly, to filter the blood inside the bodymay be able to eat more potassiumrich foods because peritoneal dialysis removes potassium from the body more efficiently than hemodialysis. Both hemodialysis and peritoneal dialysis can remove proteins from the body, so anyone on either form of dialysis should eat proteinrich foods such as meat, fish, and eggs. All dialysis centers have a renal dietitian, who helps people with kidney failure make healthy food choices. People who are on dialysis should talk with their clinics renal dietitian. The renal dietitian can help make a meal plan that will help their treatment work well. Kidney Transplantation Some people with kidney failure including older adults may be able to receive a kidney transplant. This involves having a healthy kidney from another person surgically placed into your body. The new, donated kidney does the work the failed kidneys used to do. The donated kidney can come from someone you dont know who has recently died, or from a living person usually a family member. But you might also be able to receive a kidney from an unrelated donor, including your spouse or a friend. Due to the shortage of kidneys, patients on the waiting list for a deceased donor kidney may wait many years. (Watch the video to learn more about kidney transplantation.) Kidney transplantation is a treatment for kidney failure not a cure. You will need to see your healthcare provider regularly. And you will need to take medicines for as long as you have your transplant. These medicines suppress your immune system so it doesn't reject the transplanted kidney. Eating, Diet, and Nutrition After a Transplant After a transplant, it is still important to make healthy food choices. It is still important to eat foods with less salt. This may help you keep a healthy blood pressure. You should also choose foods that are healthy for your heart, like fresh fruits, fresh or frozen vegetables, whole grains, and lowfat dairy foods. If you were on dialysis before the transplant, you may find that your diet after transplant is much easier to follow. You can drink more fluids and eat many of the fruits and vegetables you had to eat less of while on dialysis. You may even need to gain a little weight, but be careful not to gain weight too quickly. All transplant clinics have a renal dietitian, who helps people with kidney failure make healthy food choices. People who have had a transplant should talk with their clinics renal dietitian. The renal dietitian can help make a meal plan that will help keep the new kidney healthy. Learn more about kidney transplantation. Choosing Not to Treat With Dialysis or Transplant You may choose not to treat kidney failure with dialysis or a transplant. Instead, you may choose to focus on treating its complications. If you choose this path, you will still get care from your health care team. Your care may include medicines to protect remaining kidney function for as long as possible medicines to treat symptoms of kidney failure (such as nausea, anemia, and poor appetite) advice on diet and lifestyle choices, and care to ease symptoms, provide relief from physical and emotional pain, and enhance quality of life. medicines to protect remaining kidney function for as long as possible medicines to treat symptoms of kidney failure (such as nausea, anemia, and poor appetite) advice on diet and lifestyle choices, and care to ease symptoms, provide relief from physical and emotional pain, and enhance quality of life. You have the right to choose not to start dialysis or undergo transplant surgery. You may choose not to treat with dialysis or transplant if you feel that the burdens would outweigh the benefits. Or, you may make this choice if you feel these treatments would lower your quality of life. Only you know what it is like for you to live with kidney failure. Treatment with no dialysis or transplant may be a choice for you if you and your doctor feel dialysis or transplant will not improve your health. For some people who have many health problems and are age 75 or older, studies show that treatment with dialysis may not help. you feel youve accomplished what you wanted in life. family and friends support your decision. you and your doctor feel dialysis or transplant will not improve your health. For some people who have many health problems and are age 75 or older, studies show that treatment with dialysis may not help. you feel youve accomplished what you wanted in life. family and friends support your decision. Choosing the Right Treatment Not all treatments are right for all people. Talk to your doctor and other health professionals including nurses, dietitians, and diabetes educators to figure out the best treatment plan for you. The right choice for you depends upon your medical condition, lifestyle, and personal likes and dislikes. Each treatment option may have a different effect on how long you live your overall health what and how much you can do how well you can get around how you feel emotionally how well you can think, learn, and remember your sex life. how long you live your overall health what and how much you can do how well you can get around how you feel emotionally how well you can think, learn, and remember your sex life.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>what research (or clinical trials) is being done for Kidney Disease ? [/INST] Many areas of Research Researchers are working at every stage of kidney disease to improve diagnosis and treatment, including trying to find a better way to identify who is at greatest risk for rapidly progressing kidney disease trying to find more effective medications to treat kidney disease and its risk factors, and improving dialysis and the results of kidney transplantation. trying to find a better way to identify who is at greatest risk for rapidly progressing kidney disease trying to find more effective medications to treat kidney disease and its risk factors, and improving dialysis and the results of kidney transplantation. Several areas of research supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) hold great potential. Emphasis is being placed on research related to prevention and early intervention in kidney disease. Interaction With Other Diseases Another focus is on the interaction between kidney disease, diabetes, and cardiovascular (heart) disease. Advances in treatments for diabetes and high blood pressure may help reduce the damage these conditions do to the kidneys in the first place. Research into how to predict who will develop kidney disease may improve prevention. Disease Progression NIDDK is sponsoring a major study the Chronic Renal Insufficiency Cohort (CRIC) study to learn more about how kidney disease progresses. CRIC is following 6,000 adults with mild to moderate kidney disease. About half have diabetes. It is believed that some CRIC study participants' kidney function will decline more rapidly than others', and that some will develop cardiovascular disease while others won't. The goal of the study is to identify the factors linked to rapid decline of kidney function and the development of cardiovascular disease. The data and specimens collected from study participants will be available to other researchers who are studying kidney disease and cardiovascular disease. The CRIC study will allow future investigation into the role of genetic, environmental, behavioral, nutritional, and other factors in kidney disease. Learn more about the CRIC Study. Improving Transplants In the area of transplantation, researchers are working to develop new drugs that help the body accept donated organs. The goal is to help transplanted kidneys survive longer and work better. NIDDK scientists are also developing new techniques to improve the body's tolerance for foreign tissue even before the donated kidney is transplanted. This could help reduce or eliminate the need for drugs that suppress the immune system, which could reduce transplantation costs and complications. In the future, scientists may even develop an artificial kidney for implantation.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Kidney Disease ? [/INST] Kidney disease also known as chronic kidney disease (CKD) occurs when kidneys can no longer remove wastes and extra water from the blood or perform other functions as they should. According to the Centers for Disease Control and Prevention, more than 20 million Americans may have kidney disease. Many more are at risk. (Watch the video to learn more about kidney disease. To enlarge the video, click the brackets in the lower righthand corner. To reduce the video, press the Escape (Esc) button on your keyboard.)</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What causes Kidney Disease ? [/INST] Kidney disease is most often caused by diabetes or high blood pressure. Each kidney contains about one million tiny filters made up of blood vessels. These filters are called glomeruli. Diabetes and high blood pressure damage these blood vessels, so the kidneys are not able to filter the blood as well as they used to. Usually this damage happens slowly, over many years. As more and more filters are damaged, the kidneys eventually stop working.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>Who is at risk for Kidney Disease? ? [/INST] Diabetes and high blood pressure are the two leading risk factors for kidney disease. Both diabetes and high blood pressure damage the small blood vessels in your kidneys and can cause kidney disease without you feeling it. There are several other risk factors for kidney disease. Cardiovascular (heart) disease is a risk factor. So is family history: if you have a mother, father, sister, or brother who has had kidney disease, then you are at increased risk. African Americans, Hispanics, and Native Americans tend to have a greater risk for kidney failure. This is mostly due to higher rates of diabetes and high blood pressure in these communities, although there may be other reasons. (Watch the video to learn more about the connection between heart disease and kidney disease. To enlarge the video, click the brackets in the lower righthand corner. To reduce the video, press the Escape (Esc) button on your keyboard.)</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the symptoms of Kidney Disease ? [/INST] Kidney disease is often called a "silent" disease, because most people have no symptoms in early kidney disease. In fact, you might feel just fine until your kidneys have almost stopped working. Do NOT wait for symptoms! Blood and urine tests are the only way to check for kidney damage or measure kidney function. (Watch the video to learn more about the symptoms of kidney disease. To enlarge the video, click the brackets in the lower righthand corner. To reduce the video, press the Escape (Esc) button on your keyboard.)</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Kidney Disease ? [/INST] When you visit your doctor, here are questions to ask about your kidneys. What is my GFR? What is my urine albumin result? What is my blood pressure? What is my blood glucose (for people with diabetes)? What is my GFR? What is my urine albumin result? What is my blood pressure? What is my blood glucose (for people with diabetes)?</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the treatments for Kidney Disease ? [/INST] Treatments for early kidney disease include both diet and lifestyle changes and medications. Diet and lifestyle changes, such as eating heart healthy foods and exercising regularly to maintain a healthy weight, can help prevent the diseases that cause kidney damage. If you already have diabetes and/or high blood pressure, keeping these conditions under control can keep them from causing further damage to your kidneys. (Watch the video to learn more about dialysis decisions. To enlarge the video, click the brackets in the lower righthand corner. To reduce the video, press the Escape (Esc) button on your keyboard.)</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the treatments for Kidney Disease ? [/INST] During your next health care visit, talk to your provider about your test results and how to manage your kidney disease. Below is a list of questions you may want to ask. Add any questions you think are missing, and mark those that are most important to you. Bring your list with you. About your tests Did you check my kidney health with blood and urine tests? What was my GFR? What does that mean? Has my GFR changed since last time? What is my urine albumin level? What does that mean? Has my urine albumin changed since the last time it was checked? Is my kidney disease getting worse? Is my blood pressure where it needs to be? Will I need dialysis? When should I talk to my family about dialysis or a kidney transplant? Did you check my kidney health with blood and urine tests? What was my GFR? What does that mean? Has my GFR changed since last time? What is my urine albumin level? What does that mean? Has my urine albumin changed since the last time it was checked? Is my kidney disease getting worse? Is my blood pressure where it needs to be? Will I need dialysis? When should I talk to my family about dialysis or a kidney transplant? (Watch the video to learn more about dialysis decisions. To enlarge the videos on this page, click the brackets in the lower righthand corner of the video screen. To reduce the videos, press the Escape (Esc) button on your keyboard.) About treatment and selfcare What can I do to keep my disease from getting worse? Do any of my medicines or doses need to be changed? Do I need to change what I eat? Am I eating the right amount of protein, salt (sodium), potassium, and phosphorus? Will you refer me to a dietitian for diet counseling? When will I need to see a nephrologist (kidney specialist)? What do I need to do to protect my veins? What can I do to keep my disease from getting worse? Do any of my medicines or doses need to be changed? Do I need to change what I eat? Am I eating the right amount of protein, salt (sodium), potassium, and phosphorus? Will you refer me to a dietitian for diet counseling? When will I need to see a nephrologist (kidney specialist)? What do I need to do to protect my veins? (Watch the video to learn more about lifestyle and diet changes to make with kidney disease.) About complications What other health problems may I face because of my kidney disease? Should I be looking for any symptoms? If so, what are they? What other health problems may I face because of my kidney disease? Should I be looking for any symptoms? If so, what are they? If you're told that you need renal replacement therapy (dialysis or a transplant) How do I decide which treatment is right for me? How do I prepare for dialysis? What is an AV fistula? How soon do I begin preparing? How can my family help me? How do I decide which treatment is right for me? How do I prepare for dialysis? What is an AV fistula? How soon do I begin preparing? How can my family help me?</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Kidney Disease ? [/INST] When your kidneys fail, they are no longer able to filter blood and remove waste from your body well enough to maintain health. Kidney failure causes harmful waste and excess fluid to build up in your body. Your blood pressure may rise, and your hands and feet may swell. Since the kidneys are not working well, the goal is to find treatments that can replace kidney function in order to maintain health. There are two main options for this: dialysis and transplantation.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the treatments for Kidney Disease ? [/INST] Dialysis is a treatment to filter wastes and water from your blood. There are two major forms of dialysis: hemodialysis and peritoneal dialysis. (Watch the video to learn more about dialysis. To enlarge the video, click the brackets in the lower righthand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) In hemodialysis, blood is run through a filter outside of your body and the clean blood is returned to the body. Hemodialysis is usually done at a dialysis center three times a week, but it can also be done at home. Each session usually lasts between three and four hours. Peritoneal dialysis is another way to remove wastes from your blood. This kind of dialysis uses the lining of your abdominal cavity (the space in your body that holds organs like the stomach, intestines, and liver) to filter your blood. It works by putting a special fluid into your abdomen that absorbs waste products in your blood as it passes through small blood vessels in this lining. This fluid is then drained away. A key benefit of peritoneal dialysis is that it can be done at home, while you sleep. Get more information about dialysis.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Kidney Disease ? [/INST] Instead of dialysis, some people with kidney failure including older adults may be able to receive a kidney transplant. This involves having a healthy kidney from another person surgically placed into your body. The new, donated kidney does the work that your two failed kidneys used to do. The donated kidney can come from an anonymous donor who has recently died, or from a living person usually a relative. But you might also be able to receive a kidney from an unrelated donor, including your spouse or a friend. (Watch the video to learn more about kidney transplantation. To enlarge the video, click the brackets in the lower righthand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) Kidney transplantation is a treatment for kidney failure not a cure. You will need to see your healthcare provider regularly. And you will need to take medications for as long as you have your transplant to suppress your immune system so it doesn't reject the transplanted kidney.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>what research (or clinical trials) is being done for Kidney Disease ? [/INST] There are many researchers who are working on kidney disease. They are looking for ways to improve diagnosis, make treatments more effective, and make dialysis and transplantation work better. Several areas of research supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) hold great potential. Emphasis is being placed on research related to prevention and early intervention in kidney disease. Another focus is on the interaction between diabetes, kidney disease, and cardiovascular disease. Advances in treatments for diabetes and high blood pressure may help reduce the damage these conditions do to the kidneys in the first place. Research into how to predict who will develop kidney disease may improve prevention.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Knee Replacement ? [/INST] There are many different types and designs of artificial knees. Most consist of three components: the femoral component, which is the part that attaches to the thigh bone the tibial component, the part that attaches to the shin bone the patellar component, the knee cap. the femoral component, which is the part that attaches to the thigh bone the tibial component, the part that attaches to the shin bone the patellar component, the knee cap. Total and Partial Knee Replacement Knee replacement may be either total or partial/unicompartmental. In total knee replacement, as the name suggests, the entire knee joint is replaced. You will likely need a total knee replacement if you have damage to several parts of your knee. In partial/unicompartmental knee replacement, the surgeon replaces just the damaged part of the knee. You may be able to have a partial knee replacement if only one section of your knee is damaged. However, when one part is replaced, there is a chance that another part will develop arthritis, requiring further surgery. Cemented and Uncemented Joint Components Joint components may also be attached to your own bone in different ways. Most are cemented with a special joint glue into your existing bone; others rely on a process called biologic fixation to hold them in place. This means that the parts are made with a porous surface, and over time your own bone grows into the joint surface to secure them. In some cases, surgeons use a combination of cemented and uncemented parts. This is referred to as a hybrid implant. Minimally Invasive Surgery While some knee replacement surgery requires an 8 to 12inch incision in the front of the knee, surgeons at many medical centers are now performing what is called minimally invasive surgery using incisions of 3 to 5 inches or even smaller. Because the incision is smaller, there may be less pain and a shorter recovery time. If you think you might be interested in minimally invasive surgery, speak with your surgeon.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the complications of Knee Replacement ? [/INST] While new technology and advances in surgical techniques have greatly reduced the risks involved with knee replacements, there are still some risks you should be aware of. Two of the most common possible problems are blood clots and infection. Preventing Blood Clots Blood clots can occur in the veins of your legs after knee replacement surgery. To reduce the risk of clots, your doctor may have you elevate your leg periodically and prescribe special exercises, support hose, or blood thinners. Preventing Infections Infection can occur when bacteria enter the bloodstream from skin or urinary tract infections. To reduce the risk of infection, your doctors may prescribe antibiotics for you to take prior to your surgery and for a short time afterward. Other Complications Other complications, such as new or ongoing pain, stiffness, fracture, bleeding, or injury to the blood vessels can occur. Serious medical complications, such as heart attack or stroke, are very rare. Warning Signs To Watch For To minimize the risk of complications, it is important to recognize signs of potential problems early and contact your doctor. For example, tenderness, redness, and swelling of your calf or swelling of your thigh, ankle, calf, or foot could be warning signs of a possible blood clot. Warning signs of infection include fever or chills, tenderness and swelling of the wound, and drainage from the wound. You should call your doctor if you experience any of these symptoms. It is important to get instructions from your doctor before leaving the hospital and follow them carefully once you get home. Doing so will give you the greatest chance of a successful surgery.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is the outlook for Knee Replacement ? [/INST] Recovery from knee replacement extends long after you leave the hospital. Preparing for recovery requires learning what to expect in the days and weeks following surgery. It requires understanding what you will and wont be able to do and when. It also means arranging for social support and arranging your house to make everyday tasks easier and to help speed your recovery. Find Someone To Stay with You Because you will not be able to drive for several weeks after surgery, you will need someone to take you home from the hospital and be on hand to run errands or take you to appointments until you can drive yourself. If you live with someone, you should have them plan to stay home with you or at least stay close by, in case you need help. If you dont live with a family member or have one close by, a friend or neighbor may be able to help. Other options include staying in an extendedcare facility during your recovery or hiring someone to come to your home and help you. Your hospital social worker should be able to help you make arrangements. Prepare Your Home for Your Recovery To prepare your home for your recovery, stock up on needed items before you leave for the hospital. Make sure you have plenty of nonperishable foods on hand. Prepare meals and freeze them to put in the microwave when you need an easy meal. In the first weeks after surgery, you should avoid going up and down stairs. If your bedroom is on the second floor of your home, consider moving to a downstairs bedroom temporarily or sleeping on the sofa. Set Up a Recovery Station Set up a recovery station at home. Place a sturdy chair where you plan to spend most of your time sitting during the first weeks after surgery. The chair should be 18 to 20 inches high and should have two arms and a firm seat and back. Place a foot stool in front of the chair so you can elevate your legs, and place items you will need such as the television remote control, telephone, medicine, and tissues where you can reach them easily from the chair. Place items you use every day at arms level to avoid reaching up or bending down. Ask your doctor or physical therapist about devices and tips that may make daily activities easier once you get home. Devices you may find helpful include longhandled reachers to retrieve items placed on high shelves or dropped on the floor, aprons with pockets that allow you to carry items while leaving your hands free for crutches, shower benches that let you sit while you shower, and dressing sticks to help you get dressed without bending your new knee excessively. Safeguard Against Falls Because a fall can damage your new knee, making your home a safe place is crucial. Before your surgery, look for and correct hazards, including cluttered floors, loose electrical cords, unsecured rugs, and dark hallways. Bathrooms are likely places to fall, so particular attention is needed there. A raised toilet seat can make it easier to get up and down. Grab bars in the tub can keep you steady. Textured shapes on the shower floor can minimize slipping. Gradually Increase Activity It is also important to exercise to get stronger while avoiding any activities that can damage or dislocate your new joint. Activity should include a graduated walking program (where you slowly increase the time, distance, and pace that you walk) and specific exercises several times a day to prevent scarring, restore movement, and stabilize and strengthen your new knee. Remember Followups Your surgeon will let you know about followup visits. Even after you have healed from surgery, you will need to see your surgeon periodically for examinations and xrays to detect any potential problems with your knee. By preparing for surgery and recovery and following your doctor's advice, you can get the greatest benefits from your new knee with the least risk of complications for many years to come.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Knee Replacement ? [/INST] The main reason to have knee replacement surgery is to ease pain and disability caused by arthritis or other joint problems, while preserving movement. Less commonly, it is used to correct some kinds of knee deformity.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the treatments for Knee Replacement ? [/INST] Treatments your doctor will likely recommend before knee replacement include exercises to strengthen the muscles around the knee and improve flexibility weight loss, if needed, to reduce the load the knee must bear walking aids such as canes to reduce stress on the joint shoe inserts to improve the knees alignment medicines to relieve pain. exercises to strengthen the muscles around the knee and improve flexibility weight loss, if needed, to reduce the load the knee must bear walking aids such as canes to reduce stress on the joint shoe inserts to improve the knees alignment medicines to relieve pain.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Knee Replacement ? [/INST] Knee replacement may be either total or partial/unicompartmental. In total knee replacement, as the name suggests, the entire knee joint is replaced. You will likely need a total knee replacement if you have damage to several parts of your knee. In partial/unicompartmental knee replacement, the surgeon replaces just the damaged part of the knee. You may be able to have a partial knee replacement if only one section of your knee is damaged. However, when one part is replaced, there is a chance that another part will develop arthritis, requiring further surgery.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Knee Replacement ? [/INST] A physical therapist will teach you exercises to help your recovery. You can expect some pain, discomfort, and stiffness as you begin therapy, but to get the best results from your new knee, it is important to do all of the exercises your physical therapist recommends.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the complications of Knee Replacement ? [/INST] Two of the most common possible problems are blood clots and infection. Other complications, such as new or ongoing pain, stiffness, fracture, bleeding, or injury to the blood vessels can occur. Serious medical complications, such as heart attack or stroke, are very rare.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the complications of Knee Replacement ? [/INST] To reduce the risk of clots, your doctor may have you elevate your leg periodically and prescribe special exercises, support hose, or blood thinners. To reduce the risk of infection, your doctor may prescribe antibiotics for you to take prior to your surgery and for a short time afterward.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>Who is at risk for Knee Replacement? ? [/INST] Because a fall can damage your new knee, making your home a safe place is crucial. Before your surgery, look for and correct hazards, including cluttered floors, loose electrical cords, unsecured rugs, and dark hallways. A raised toilet seat can make it easier to get up and down. Grab bars in the tub can keep you steady.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Knee Replacement ? [/INST] You can learn more about knee replacement from the following resources. National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Information Clearinghouse National Institutes of Health 1 AMS Circle Bethesda, MD 208923675 Phone: 3014954484 Toll Free: 87722NIAMS (2264267) TTY: 3015652966 Fax: 3017186366 Email: NIAMSinfo@mail.nih.gov Website: http://www.niams.nih.gov American Physical Therapy Association Website: http://www.apta.org Arthritis Foundation Website: http://www.arthritis.org The Knee Society Website: http://www.kneesociety.org MedlinePlus Website: http://www.nlm.nih.gov/medlineplus/kneereplacement.html</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Anxiety Disorders ? [/INST] Occasional anxiety is a normal part of life. You might feel anxious when faced with a problem at work, before taking a test, or making an important decision. However, anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety does not go away and can get worse over time. These feelings can interfere with daily activities such as job performance, school work, and relationships. (Watch the video to learn about the types of anxiety disorders. To enlarge the video, click the brackets in the lower righthand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) Anxiety Disorders in Older Adults Studies estimate that anxiety disorders affect up to 15 percent of older adults in a given year. More women than men experience anxiety disorders. They tend to be less common among older adults than younger adults. But developing an anxiety disorder late in life is not a normal part of aging. Anxiety disorders commonly occur along with other mental or physical illnesses, including alcohol or substance abuse, which may mask anxiety symptoms or make them worse. In older adults, anxiety disorders often occur at the same time as depression, heart disease, diabetes, and other medical problems. In some cases, these other problems need to be treated before a person can respond well to treatment for anxiety. There are three types of anxiety disorders discussed here. generalized anxiety disorder social phobia panic disorder generalized anxiety disorder social phobia panic disorder Generalized Anxiety Disorder (GAD) All of us worry about things like health, money, or family problems. But people with generalized anxiety disorder (GAD) are extremely worried about these and many other things, even when there is little or no reason to worry about them. They are very anxious about just getting through the day. They think things will always go badly. At times, worrying keeps people with GAD from doing everyday tasks. Learn more about generalized anxiety disorder (GAD). Social Phobia In social phobia, a person fears being judged by others or of being embarrassed. This fear can get in the way of doing everyday things such as going to work, running errands, or meeting with friends. People who have social phobia often know that they shouldn't be so afraid, but they can't control their fear. Learn more about social phobia. Panic Disorder In panic disorder, a person has sudden, unexplained attacks of terror, and often feels his or her heart pounding. During a panic attack, a person feels a sense of unreality, a fear of impending doom, or a fear of losing control. Panic attacks can occur at any time. Learn more about panic disorder. Anxiety Disorders Are Treatable In general, anxiety disorders are treated with medication, specific types of psychotherapy, or both. Treatment choices depend on the type of disorder, the persons preference, and the expertise of the doctor. If you think you have an anxiety disorder, talk to your doctor.</s>