bowang0911/MedQuAD huggingface dataset:
See your health care team at least twice a year to find and treat any problems early. Ask what steps you can take to reach your goals. If you have diabetes, take these steps.  At each visit,  be sure you have a - blood pressure check  -  foot check  -  weight check  -  review of your self-care plan. blood pressure check foot check weight check review of your self-care plan.  Two times each year, get - an A1C test. It may be checked more often if it is over 7. an A1C test. It may be checked more often if it is over 7. Once each year,  be sure you have a - cholesterol test  - triglyceride (try-GLISS-er-ide) test - a type of blood fat  - complete foot exam  - dental exam to check teeth and gums. Tell your dentist you have diabetes.  - dilated eye exam to check for eye problems  - flu shot  - urine and a blood test to check for kidney problems. cholesterol test triglyceride (try-GLISS-er-ide) test - a type of blood fat complete foot exam dental exam to check teeth and gums. Tell your dentist you have diabetes. dilated eye exam to check for eye problems flu shot urine and a blood test to check for kidney problems.  At least once, get a - pneumonia (nu-MOH-nya) shot.  pneumonia (nu-MOH-nya) shot.  If you have Medicare,  ask your health care team if Medicare will cover some of the costs for -  learning about healthy eating and diabetes self-care  - special shoes, if you need them  - medical supplies  - diabetes medicines. learning about healthy eating and diabetes self-care special shoes, if you need them medical supplies diabetes medicines. (Watch the video for important things to remember when visiting your health care team. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.)
People with diabetes should - do aerobic activities,  such as brisk walking, which use the bodys large muscles to make the heart beat faster. The large muscles are those of the upper and lower arms and legs and those that control head, shoulder, and hip movements.  - do activities to strengthen muscles and bone, such as sit-ups or lifting weights. Aim for two times a week.  - stretch to increase flexibility, lower stress, and help prevent muscle soreness after physical activity.  do aerobic activities,  such as brisk walking, which use the bodys large muscles to make the heart beat faster. The large muscles are those of the upper and lower arms and legs and those that control head, shoulder, and hip movements. do activities to strengthen muscles and bone, such as sit-ups or lifting weights. Aim for two times a week. stretch to increase flexibility, lower stress, and help prevent muscle soreness after physical activity. Try to exercise almost every day for a total of about 30 minutes. If you haven't exercised lately, begin slowly. Start with 5 to 10 minutes, and then add more time. Or exercise for 10 minutes, three times a day. (Tip: you dont need to get your exercise in all at one time.) For more information on exercise and older adults, see Exercises To Try or visit  Go4Life, the exercise and physical activity campaign from the National Institute on Aging. Always talk with a doctor before starting a new physical activity program.
Your weight affects your health in many ways. Being overweight can keep your body from making and using insulin properly. It can also cause high blood pressure. If you are overweight or obese, choose sensible ways to reach and maintain a reasonable body weight. - Make healthy food choices. What you eat has a big impact on your weight and overall health. By developing healthy eating habits you can help control your body weight, blood pressure, and cholesterol. Reducing portion size, increasing the amount of fiber you consume (by eating more fruits and vegetables) and limiting fatty and salty foods are key to a healthy diet. Make healthy food choices. What you eat has a big impact on your weight and overall health. By developing healthy eating habits you can help control your body weight, blood pressure, and cholesterol. Reducing portion size, increasing the amount of fiber you consume (by eating more fruits and vegetables) and limiting fatty and salty foods are key to a healthy diet. -  Get at least 30 minutes of exercise at least five days a week. Regular exercise reduces diabetes risk in several ways: it helps you lose weight, controls your cholesterol and blood pressure, and improves your body's use of insulin. Many people make walking part of their daily routine because it's easy, fun and convenient. But you can choose any activity that gets you moving. It's fine to break up your 30 minutes of exercise into smaller increments, such as three 10-minute periods. Check with your doctor before beginning any exercise program.   Get at least 30 minutes of exercise at least five days a week. Regular exercise reduces diabetes risk in several ways: it helps you lose weight, controls your cholesterol and blood pressure, and improves your body's use of insulin. Many people make walking part of their daily routine because it's easy, fun and convenient. But you can choose any activity that gets you moving. It's fine to break up your 30 minutes of exercise into smaller increments, such as three 10-minute periods. Check with your doctor before beginning any exercise program.
Poor Tear Production Dry eye occurs when the eye does not produce tears properly, or when the tears are of poor quality and dry up quickly. The eyes need tears for overall eye health and clear vision. Dry eye can last a short time or it can be an ongoing condition. It can include a variety of symptoms, such as discomfort and pain. Your eyes may sting and burn and you may have redness and a sandy or gritty feeling, as if something is in your eye. You may have blurry vision and your eyes may feel tired. Having dry eyes can make it harder to do some activities, such as using a computer or reading for a long period of time, and it can make it hard to be in dry places, such as on an airplane.  Tears and Eye Health Tears are necessary for overall eye health and clear vision. The eye constantly makes tears to bathe, nourish, and protect the cornea. The cornea is the clear, dome-shaped outer surface that covers the eye in front of the iris, which is the colored part of the eye. The eye also makes tears in response to emergencies, such as a particle of dust in the eye, an infection or irritation of the eye, or an onset of strong emotions. Tears keep the eye moist, and wash away dust and debris. They also help protect the eye from infections. Tears are made of proteins (including growth factors), body salts, and vitamins that maintain the health of the eye surface and prevent infection.  Tear Components Tears have three major components. - an outer, oily, fat layer produced by the meibomian glands (located in the eyelids)  - a middle, watery, layer produced by the lacrimal glands (located just above the upper, outer corner of the eye)  - an inner, mucous layer produced by goblet cells (located within a thin clear layer which covers the white part of the eye and the inner surface of the eyelids called the conjunctiva). an outer, oily, fat layer produced by the meibomian glands (located in the eyelids) a middle, watery, layer produced by the lacrimal glands (located just above the upper, outer corner of the eye) an inner, mucous layer produced by goblet cells (located within a thin clear layer which covers the white part of the eye and the inner surface of the eyelids called the conjunctiva). When the lacrimal glands do not make enough tears, dry eye can result. Any disease process that changes the components of tears can make them unhealthy and result in dry eye. Type of Dry Eye There are two types of dry eye: aqueous tear-deficient dry eye and evaporative dry eye. Aqueous tear-deficient dry eye is a disorder in which the tear glands do not produce enough of the watery component of tears to maintain a healthy cornea. Evaporative dry eye may result from inflammation of the meibomian glands, located in the eyelids. These glands make the oily part of tears that slows evaporation and keeps the tears stable. Most people with dry eye will not have serious problems, but severe dry eye may lead to inflammation, ulcers, or scars on the cornea, and some loss of vision. Permanent loss of vision from dry eye is uncommon.
Many factors can lead to dry eye, including aging, medications, problems with eyelid function, disease, some types of surgery, environmental factors, and allergies. Many Older People Have Dry Eye Elderly people often have dryness of the eyes, but dry eye can occur at any age. Nearly five million Americans 50 years of age and older are estimated to have dry eye. Of these, more than three million are women and more than one and a half million are men. Tens of millions more have less severe symptoms. Dry eye is more common after menopause. Women who experience menopause prematurely are more likely to have eye surface damage from dry eye.  Medications Dry eye can be a side effect of some medications, including antihistamines, nasal decongestants, tranquilizers, certain blood pressure medicines, Parkinson's medications, and some anti-depressants. Women who are on hormone replacement therapy may experience dry eye symptoms. Eyelid Function Eyelid function can also be a factor in dry eye. Diseases that affect the eyelid, such as meibomian gland dysfunction, can also cause dry eye. Dry eye may also occur from exposure keratitis, in which the eyelids do not close properly during normal blinking or sleep. Skin diseases on or around the eyelids can result in dry eye. Infrequent blinking associated with staring at computer or video screens also may lead to dry eye symptoms. Systemic Diseases Certain diseases can cause dry eye. Chronic inflammation of the conjunctiva, or the lacrimal glands, can cause dry eye. Immune system disorders such as Sjgren's syndrome, systemic lupus erythematosus, and rheumatoid arthritis also can cause dry eye. Sjgren's syndrome leads to inflammation and dryness of the mouth, eyes, and other mucous membranes. Thyroid disease, which can sometimes cause the eye to bulge out, can also lead to dry eye by increasing the surface area of the eye exposed to the environment. Surgeries Some types of surgery can lead to dry eye. For example, dry eye can develop after the refractive surgery known as LASIK. These symptoms generally last three to six months, but may last longer in some cases. Dry eye can also occur as a result of cosmetic surgery that widens the eyelids too much and increases the surface area of the eye exposed to the environment. Environment Environmental exposure to irritants such as chemical fumes and tobacco smoke, or drafts from air conditioning or heating can cause dry eye. Wearing contact lenses over a long period of time can lead to a loss of feeling in the cornea and this can cause dry eye. Allergies also can be associated with dry eye.
Symptoms of Dry Eye Dry eye symptoms may include any of the following. - stinging or burning of the eye   - a sandy or gritty feeling as if something is in the eye   - episodes of excess tears following very dry eye periods   - a stringy discharge from the eye   - pain and redness of the eye   - episodes of blurred vision  - heavy eyelids   - inability to cry when emotionally stressed   - uncomfortable contact lenses   - decreased ability to read, work on the computer, or do any activity that requires you to use your eyes for long periods of time   - eye fatigue.  stinging or burning of the eye a sandy or gritty feeling as if something is in the eye episodes of excess tears following very dry eye periods a stringy discharge from the eye pain and redness of the eye episodes of blurred vision heavy eyelids inability to cry when emotionally stressed uncomfortable contact lenses decreased ability to read, work on the computer, or do any activity that requires you to use your eyes for long periods of time eye fatigue. If you have symptoms that you think could result from dry eye, consult an eye care professional to get an accurate diagnosis of the condition and begin treatment.  Diagnosing Dry Eye Diagnosis of dry eye requires a comprehensive eye evaluation. Your eye care professional will ask you about your symptoms, your health (conditions for which you are treated, medications that you take), your eye history (use of contact lenses, past refractive or other eye surgery), and aspects of your daily environment (exposure to environmental allergens or occupational hazards). He or she will test your vision, check your eye pressure, examine your eyelids and front eye structures, and, if necessary, may dilate the pupils to examine the inside of the eye. Your eye care professional may order a tearing test to find out if you are making enough tears to keep your eyes moist. In one type of test, called a Schirmers test, the doctor may measure your tear production by placing strips of blotting paper under your lower eyelids, usually done after numbing the eye with anesthetic drops. After a few minutes, the doctor removes the strips and measures the amount of tear production.
Dry eye occurs when the eye does not produce tears properly, or when the tears are of poor quality and dry up quickly. The eyes need tears for overall eye health and clear vision. Dry eye can last a short time or it can be an ongoing condition. It can include a variety of symptoms, such as discomfort and pain. Your eyes may sting and burn and you may have redness and a sandy or gritty feeling, as if something is in your eye. You may have blurry vision and you may feel eye fatigue. Having dry eyes can make it harder to do some activities, such as using a computer or reading for a long period of time, and it can make it hard to be in dry places, such as on an airplane. (This short video discusses causes, symptoms, and treatments for dry eye.)
There are two types of dry eye: aqueous tear-deficient dry eye and evaporative dry eye. Aqueous tear-deficient dry eye is a disorder in which the tear glands do not produce enough of the watery component of tears to maintain a healthy eye surface, called the cornea. Evaporative dry eye may result from inflammation of the meibomian glands, located in the eyelids. These glands make the oily part of tears that slows evaporation and keeps the tears stable. Dry eye can be associated with - inflammation of the surface of the eye (cornea), the lacrimal gland, or the conjunctiva (the surface layer of tissue that lines the eyelids and covers the front part of the eye)  - any disease process that alters the components of the tears  - an increase in the surface of the eye, as in thyroid disease when the eye bulges forward  - cosmetic surgery, if the eyelids are opened too widely. inflammation of the surface of the eye (cornea), the lacrimal gland, or the conjunctiva (the surface layer of tissue that lines the eyelids and covers the front part of the eye) any disease process that alters the components of the tears an increase in the surface of the eye, as in thyroid disease when the eye bulges forward cosmetic surgery, if the eyelids are opened too widely.
The cornea is the clear, dome-shaped outer surface that covers the eye in front of the iris, which is the colored part of the eye. The cornea helps protect the rest of the eye from germs, dust, and other harmful matter. The cornea is a highly organized, clear structure made up of a group of cells and proteins precisely arranged in layers, but it has no blood vessels to nourish or protect it against infection. Instead, it gets its nourishment from the tears and the watery fluid (aqueous humor) that fill the chamber behind it.
Dry eye symptoms may include any of the following. - stinging or burning of the eye   - a sandy or gritty feeling as if something is in the eye   - episodes of excess tears following very dry eye periods   - a stringy discharge from the eye   - pain and redness of the eye   - episodes of blurred vision  - heavy eyelids   - inability to cry when emotionally stressed   - uncomfortable contact lenses   - decreased ability to read, work on the computer, or do any activity that requires you to use your eyes for long periods of time   - eye fatigue.  stinging or burning of the eye a sandy or gritty feeling as if something is in the eye episodes of excess tears following very dry eye periods a stringy discharge from the eye pain and redness of the eye episodes of blurred vision heavy eyelids inability to cry when emotionally stressed uncomfortable contact lenses decreased ability to read, work on the computer, or do any activity that requires you to use your eyes for long periods of time eye fatigue. If you have symptoms that you think could result from dry eye, consult an eye care professional to get an accurate diagnosis of the condition and begin treatment.
Diagnosis of dry eye requires a comprehensive eye evaluation. Your eye care professional will ask you about your symptoms, your overall health (conditions for which you are treated, medications that you take), your eye history (use of contact lenses, past refractive or other eye surgery), and aspects of your daily environment (exposure to environmental allergens or occupational hazards). He or she will test your vision, check your eye pressure, examine your eyelids and front eye structures, and if necessary may dilate the pupils to examine the inside of the eye. Your eye care professional may order a tearing test to find out if your eyes are producing enough tears to keep them moist. In one type of test, called a Schirmers test, the doctor may measure your tear production by placing strips of blotting paper under your lower eyelids, usually done after numbing the eye with anesthetic drops. After a few minutes, the doctor removes the strips and measures the amount of tear production.
Dry eye can be a temporary or ongoing condition, so treatments can be short term or may extend over long periods of time. The goal of treatment is to keep the eyes moist and relieve symptoms. Talk to your doctor to rule out other conditions that can cause dry eye, such as Sjgren's syndrome. You may need to treat these conditions. If dry eye results from taking a medication, your doctor may recommend switching to a medication that does not cause dry eye as a side effect. Here are treatments for dry eye. Medication. Cyclosporine, an anti-inflammatory medication, is a prescription eye drop available to treat certain kinds of dry eye. In people with certain kinds of dry eye, it may decrease damage to the cornea, increase basic tear production, and reduce symptoms of dry eye. It may take three to six months of twice-a-day dosages for the medication to work. Some patients with severe dry eye may need to use corticosteroid eye drops that decrease inflammation under close observation by an eye care professional.  Nutritional Supplements. In some patients with dry eye, supplements of omega-3 fatty acids (especially DHA and EPA) may decrease symptoms of irritation. Talk with your eye care professional or your primary medical doctor about whether this is an option for you. Lenses. If dry eye is a result of wearing contact lens for too long, your eye care practitioner may recommend another type of lens or reducing the number of hours you wear your lenses. In the case of severe dry eye, your eye care professional may advise you not to wear contact lenses at all. Punctal plugs. Another option to increase the available tears on the eye surface is to plug the drainage holes, small circular openings at the inner corners of the eyelids where tears drain from the eye into the nose. Lacrimal plugs, also called punctal plugs, can be inserted painlessly by an eye care professional. These plugs are made of silicone or collagen. These plugs can be temporary or permanent. Punctal cautery. In some cases, a simple surgery called punctal cautery is recommended to permanently close the drainage holes. The procedure works similarly to installing punctal plugs, but cannot be reversed.
There are two types of Alzheimers diseaseearly-onset and late-onset. Early-onset 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 late-onset 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 early-onset Alzheimers, a genetic mutation is usually the cause. Late-onset 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 high-risk 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 long-term 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 late-onset Alzheimers disease. In early-onset 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 early-onset familial Alzheimers disease, or FAD. Most people with Alzheimers disease have late-onset Alzheimer's, in which symptoms appear in a persons mid-60s. 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 late-onset 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 late-onset 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.
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/clinical-trials. To find out more about Alzheimers clinical trials, talk to your health care provider or contact the ADEAR Center at 1-800-438-4380 or adear@nia.nih.gov. Also, visit its website at  www.nia.nih.gov/alzheimers/volunteer.