diff --git "a/TREC2017-LiveQA-Medical-Train1.jsonl" "b/TREC2017-LiveQA-Medical-Train1.jsonl" --- "a/TREC2017-LiveQA-Medical-Train1.jsonl" +++ "b/TREC2017-LiveQA-Medical-Train1.jsonl" @@ -1,254 +1,254 @@ -{"ANSWERS":[{"_answerid":"Q1-S1-A1","_pairid":"1","__text":"Cardiac amyloidosis is a disorder caused by deposits of an abnormal protein (amyloid) in the heart tissue. These deposits make it hard for the heart to work properly."},{"_answerid":"Q1-S1-A2","_pairid":"2","__text":"The term \"amyloidosis\" refers not to a single disease but to a collection of diseases in which a protein-based infiltrate deposits in tissues as beta-pleated sheets. The subtype of the disease is determined by which protein is depositing; although dozens of subtypes have been described, most are incredibly rare or of trivial importance. This analysis will focus on the main systemic forms of amyloidosis, both of which frequently involve the heart."}],"SUB_QUESTION_ID":"Q1-S1","ANNOTATIONS.FOCUS":["cardiac amyloidosis"],"ANNOTATIONS.TYPE":"information","SUBJECT":"","MESSAGE":"Literature on Cardiac amyloidosis. Please let me know where I can get literature on Cardiac amyloidosis. My uncle died yesterday from this disorder. Since this is such a rare disorder, and to honor his memory, I would like to distribute literature at his funeral service. I am a retired NIH employee, so I am familiar with the campus in case you have literature at NIH that I can come and pick up. Thank you","QUESTION_ID":"Q1","F_REF":"11373"} -{"ANSWERS":[{"_answerid":"Q2-S1-A1","_pairid":"3","__text":"There is no specific cure for migraine headaches. The goal is to treat your migraine symptoms right away, and to prevent symptoms by avoiding or changing your triggers. A key step is learning how to manage your migraines at home. A headache diary can help you identify your headache triggers. Then you and your doctor can plan how to avoid these triggers. If you have frequent migraines, your doctor may prescribe medicine to reduce the number of attacks. You need to take the medicine every day for it to be effective. Medicines may include: - Antidepressants - Blood pressure medicines - Seizure medicines Botulinum toxin type A (Botox) injections may also help reduce migraine attacks if they occur more than 15 days a month. Some people find relief with minerals and vitamins. Check with your doctor to see if riboflavin or magnesium are right for you. TREATING AN ATTACK Other medicines are taken at the first sign of a migraine attack. Over-the-counter (OTC) pain medicines, such as acetaminophen, ibuprofen, or aspirin are often helpful when your migraine is mild. Be aware that: - Taking medicines more than 3 days a week may lead to rebound headaches. These are headaches that keep coming back due to overuse of pain medicine. - Taking too much acetaminophen can damage your liver. - Too much ibuprofen or aspirin can irritate your stomach or kidneys. If these treatments do not help, ask your doctor about prescription medicines. These include nasal sprays, suppositories, or injections. Some migraine medicines narrow the blood vessels. If you are at risk for having a heart attack or have heart disease, talk with your doctor before using these medicines. Some migraine medicines should not be used by pregnant women. Talk with your doctor about which medicine is right for you if you are pregnant or planning to become pregnant. Other medicines treat symptoms of migraine, such as nausea and vomiting. They may be used alone or along with the other drugs that treat the migraine itself. Feverfew is a herb for migraines. It can be effective for some people. Before using feverfew, make sure your doctor approves. Herbal remedies sold in drugstores and health food stores are not regulated. Work with a trained herbalist when selecting herbs."},{"_answerid":"Q2-S1-A2","_pairid":"4","__text":"There is no absolute cure for migraine since its pathophysiology has yet to be fully understood. \u00a0There are two ways to approach the treatment of migraine headache with drugs: prevent the attacks, or relieve the symptoms during the attacks. Prevention involves the use of medications and behavioral changes. \u00a0Drugs originally developed for epilepsy, depression, or high blood pressure to prevent future attacks have been shown to be extremely effective in treating migraine. Botulinum toxin A has been shown to be effective in prevention of chronic migraine. \u00a0Behaviorally, stress management strategies, such as exercise, relaxation techniques, biofeedback mechanisms, and other therapies designed to limit daily discomfort, may reduce the number and severity of migraine attacks. \u00a0Making a log of personal triggers of migraine can also provide useful information for trigger-avoiding lifestyle changes, including dietary considerations, eating regularly scheduled meals with adequate hydration, stopping certain medications, and establishing a consistent sleep schedule. Hormone therapy may help some women whose migraines seem to be linked to their menstrual cycle. A weight loss program is recommended for obese individuals with migraine. Relief of symptoms, or acute treatments, during attacks consists of sumatriptan, ergotamine drugs, and analgesics such as ibuprofen and aspirin. \u00a0The sooner these treatments are administered, the more effective they are."}],"SUB_QUESTION_ID":"Q2-S1","ANNOTATIONS.FOCUS":["migraine"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"treatment options versus migraine types","MESSAGE":"Migraine seems to be a spectrum of conditions rather than only one easily diagnosed affliction. Many innovative migraine treatments are now in use, but it seems that each treatment only addresses a narrow set of conditions; for example, my daughter has tried many different treatment options (QEEG, HEG, TMS, topamax, ...) without success. Has any research been done to characterize which treatment types are effective against which migraine types?","QUESTION_ID":"Q2","F_REF":"1-136434885"} -{"ANSWERS":[{"_answerid":"Q3-S1-A1","_pairid":"5","__text":"Before taking pyridoxine, tell your doctor and pharmacist if you are allergic to pyridoxine or any other drugs. tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially levodopa (Larodopa, Sinemet), phenobarbital, phenytoin (Dilantin), and other vitamins. tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking pyridoxine, call your doctor."}],"SUB_QUESTION_ID":"Q3-S1","ANNOTATIONS.FOCUS":["pyridoxine"],"ANNOTATIONS.TYPE":"contraindication","SUBJECT":"","MESSAGE":"DO I USE PYRIDOXINE TABLETS EVEN IF IM PREGNANT?","QUESTION_ID":"Q3","F_REF":"1-123453375"} -{"ANSWERS":[{"_answerid":"Q4-S1-A1","_pairid":"6","__text":"Muscle cramps are common and often occur when a muscle is overused or injured. Working out when you have not had enough fluids (dehydration) or when you have low levels of minerals such as potassium or calcium can also make you more likely to have a muscle spasm. Muscle cramps can occur while you play tennis or golf, bowl, swim, or do any other exercise. They can also be triggered by: - Alcoholism - Hypothyroidism (underactive thyroid) - Kidney failure - Medications - Menstruation - Pregnancy"}],"SUB_QUESTION_ID":"Q4-S1","ANNOTATIONS.FOCUS":["cramp"],"ANNOTATIONS.TYPE":"cause","SUBJECT":"cramp","MESSAGE":"i have lymphoma what causes cramp after chemo treatment","QUESTION_ID":"Q4","F_REF":"1-118260435"} -{"ANSWERS":[{"_answerid":"Q5-S1-A1","_pairid":"7","__text":"These resources address the diagnosis or management of age-related macular degeneration: - BrightFocus Foundation: Macular Degeneration Treatment - Genetic Testing Registry: Age-related macular degeneration - Genetic Testing Registry: Age-related macular degeneration 1 - Genetic Testing Registry: Age-related macular degeneration 10 - Genetic Testing Registry: Age-related macular degeneration 11 - Genetic Testing Registry: Age-related macular degeneration 2 - Genetic Testing Registry: Age-related macular degeneration 3 - Genetic Testing Registry: Age-related macular degeneration 4 - Genetic Testing Registry: Age-related macular degeneration 7 - Genetic Testing Registry: Age-related macular degeneration 9 - Genetic Testing Registry: Susceptibility to age-related macular degeneration, wet type - Genetic Testing Registry: Susceptibility to neovascular type of age-related macular degeneration - Macular Degeneration Partnership: Low Vision Rehabilitation - Prevent Blindness America: Age-Related Macular Degeneration (AMD) Test - Amsler Grid These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"}],"SUB_QUESTION_ID":"Q5-S1","ANNOTATIONS.FOCUS":["macular degeneration"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"Retina","MESSAGE":"I wonder of new research and testing on macular degeneration and the opportunity to be part of this process.","QUESTION_ID":"Q5","F_REF":"1-132032443"} -{"ANSWERS":[{"_answerid":"Q6-S1-A1","_pairid":"8","__text":"Hypothyroidism is a condition in which the thyroid gland does not make enough thyroid hormone. This condition is often called underactive thyroid."},{"_answerid":"Q6-S1-A2","_pairid":"9","__text":"Summary Your thyroid is a butterfly-shaped gland in your neck, just above your collarbone. It is one of your endocrine glands, which make hormones. Thyroid hormones control the rate of many activities in your body. These include how fast you burn calories and how fast your heart beats. All of these activities are your body's metabolism. If your thyroid gland is not active enough, it does not make enough thyroid hormone to meet your body's needs. This condition is hypothyroidism. Hypothyroidism is more common in women, people with other thyroid problems, and those over 60 years old. Hashimoto's disease, an autoimmune disorder, is the most common cause. Other causes include thyroid nodules, thyroiditis, congenital hypothyroidism, surgical removal of part or all of the thyroid, radiation treatment of the thyroid, and some medicines. The symptoms can vary from person to person. They may include - Fatigue - Weight gain - A puffy face - Cold intolerance - Joint and muscle pain - Constipation - Dry skin - Dry, thinning hair - Decreased sweating - Heavy or irregular menstrual periods and fertility problems - Depression - Slowed heart rate To diagnose hypothyroidism, your doctor will look at your symptoms and blood tests. Treatment is with synthetic thyroid hormone, taken every day. NIH: National Institute of Diabetes and Digestive and Kidney Diseases"},{"_answerid":"Q6-S1-A3","_pairid":"10","__text":"Hypothyroidism is a disorder that occurs when the thyroid gland does not make enough thyroid hormone to meet the body\u2019s needs.\u00a0 Thyroid hormone regulates metabolism\u2014the way the body uses energy\u2014and affects nearly every organ in the body. Without enough thyroid hormone, many of the body\u2019s functions slow down.\u00a0 About 4.6 percent of the U.S. population age 12 and older has hypothyroidism.1"}],"SUB_QUESTION_ID":"Q6-S1","ANNOTATIONS.FOCUS":["hypothyroidism"],"ANNOTATIONS.TYPE":"information","SUBJECT":"hypothyroidism","MESSAGE":"Can you please send me as much information as possible on "hypothyroidism". I was recently diagnosed with the disease and I am struggling to figure out what it is and how I got it. My name and address is: [NAME] [LOCATION] [CONTACT] Thank you in advance for your help!!!","QUESTION_ID":"Q6","F_REF":"17730"} -{"ANSWERS":[{"_answerid":"Q6-S2-A1","_pairid":"12","__text":"The thyroid gland is an important organ of the endocrine system. It is located at the front of the neck, just above where your collarbones meet. The thyroid makes hormones that control the way every cell in the body uses energy. This process is called metabolism. Hypothyroidism is more common in women and people over age 50. The most common cause of hypothyroidism is thyroiditis. Swelling and inflammation damage the thyroid gland's cells. Causes of this problem include: - The immune system attacking the thyroid gland - Viral infections (common cold) or other respiratory infections - Pregnancy (often called postpartum thyroiditis) Other causes of hypothyroidism include: - Certain medicines, such as lithium and amiodarone - Congenital (birth) defects - Radiation treatments to the neck or brain to treat different cancers - Radioactive iodine used to treat an overactive thyroid gland - Surgical removal of part or all of the thyroid gland - Sheehan syndrome, a condition that may occur in a woman who bleeds severely during pregnancy or childbirth and causes the destruction of the pituitary gland - Pituitary tumor or pituitary surgery"},{"_answerid":"Q6-S2-A2","_pairid":"13","__text":"Hypothyroidism has several causes, including - Hashimoto\u2019s disease - thyroiditis, or inflammation of the thyroid - congenital hypothyroidism, or hypothyroidism that is present at birth - surgical removal of part or all of the thyroid - radiation treatment of the thyroid - some medications Less commonly, hypothyroidism is caused by too much or too little iodine in the diet or by abnormalities of the pituitary gland. Hashimoto\u2019s Disease Hashimoto\u2019s disease, also called chronic lymphocytic thyroiditis, is the most common cause of hypothyroidism in the United States.1\u00a0 Hashimoto\u2019s disease is a form of chronic inflammation of the thyroid gland.\u00a0 Hashimoto\u2019s disease is also an autoimmune disorder. Normally, the immune system protects the body against foreign invaders\u2014such as viruses and bacteria\u2014that can cause illness.\u00a0 But in autoimmune diseases, the immune system attacks the body\u2019s own cells and organs.\u00a0 With Hashimoto\u2019s disease, the immune system attacks the thyroid, causing inflammation and interfering with its ability to produce thyroid hormones. More information is provided in the NIDDK health topic, Hashimoto\u2019s Disease. Thyroiditis Thyroiditis causes stored thyroid hormone to leak out of the thyroid gland.\u00a0 At first, the leakage raises hormone levels in the blood, leading to hyperthyroidism\u2014when thyroid hormone levels are too high\u2013\u2013that lasts for 1 or 2 months.\u00a0 Most people then develop hypothyroidism before the thyroid is completely healed. Several types of thyroiditis can cause hyperthyroidism followed by hypothyroidism: - Subacute thyroiditis. This condition involves painful inflammation and enlargement of the thyroid.\u00a0 Experts are not sure what causes subacute thyroiditis, but it may be related to a viral or bacterial infection.\u00a0 The condition usually goes away on its own in a few months. - Postpartum thyroiditis. This type of thyroiditis develops after a woman gives birth.\u00a0 For more information, see the section titled \u201cWhat happens with pregnancy and thyroid conditions?\u201d - Silent thyroiditis. This type of thyroiditis is called \u201csilent\u201d because it is painless, as is postpartum thyroiditis, even though the thyroid may be enlarged.\u00a0 Like postpartum thyroiditis, silent thyroiditis is probably an autoimmune condition and sometimes develops into permanent hypothyroidism. Congenital Hypothyroidism Some babies are born with a thyroid that is not fully developed or does not function properly.\u00a0 If untreated, congenital hypothyroidism can lead to mental retardation and growth failure.\u00a0 Early treatment can prevent these complications, so most newborns in the United States are screened for hypothyroidism. Surgical Removal of the Thyroid When part of the thyroid is removed, the remaining part may produce normal amounts of thyroid hormone, but some people who have this surgery develop hypothyroidism.\u00a0 Removal of the entire thyroid always results in hypothyroidism. Part or all of the thyroid may be surgically removed as a treatment for - hyperthyroidism - a large goiter, which is an enlarged thyroid that may cause the neck to appear swollen and can interfere with normal breathing and swallowing - thyroid nodules, which are noncancerous tumors, called adenomas, or lumps in the thyroid that can produce excess thyroid hormone - thyroid cancer Radiation Treatment of the Thyroid Radioactive iodine, a common treatment for hyperthyroidism, gradually destroys the cells of the thyroid.\u00a0 Most people who receive radioactive iodine treatment eventually develop hypothyroidism.\u00a0 People with Hodgkin\u2019s disease, other lymphomas, and head or neck cancers are treated with radiation, which can also damage the thyroid. Medications Some drugs can interfere with thyroid hormone production and lead to hypothyroidism, including - amiodarone, a heart medication - interferon alpha, a cancer medication - lithium, a bipolar disorder medication - interleukin-2, a kidney cancer medication"}],"SUB_QUESTION_ID":"Q6-S2","ANNOTATIONS.FOCUS":["hypothyroidism"],"ANNOTATIONS.TYPE":"cause","SUBJECT":"hypothyroidism","MESSAGE":"Can you please send me as much information as possible on "hypothyroidism". I was recently diagnosed with the disease and I am struggling to figure out what it is and how I got it. My name and address is: [NAME] [LOCATION] [CONTACT] Thank you in advance for your help!!!","QUESTION_ID":"Q6","F_REF":"17730"} -{"ANSWERS":[{"_answerid":"Q7-S1-A1","_pairid":"14","__text":"Clean the wound well with soap and water, and seek professional medical help. You will need a doctor to thoroughly clean the wound and remove any foreign objects. Most of the time, stitches should not be used for animal bite wounds. If there is any risk of rabies, you will be given a series of a preventive vaccine. The vaccine is generally given in 5 doses over 28 days. Most patients also receive a treatment called human rabies immunoglobulin (HRIG). This treatment\u00a0is given the day the bite occurred. Call your doctor right away after an animal bite or after being exposed to animals such as bats, foxes, and skunks. They may carry rabies. - Call even when no bite took place. - Immunization and treatment for possible rabies are recommended for at least up to 14 days after exposure or a bite. There is no known effective treatment for people with symptoms of a rabies infection, but there have been a few reports of people surviving with experimental treatments."}],"SUB_QUESTION_ID":"Q7-S1","ANNOTATIONS.FOCUS":["rabies"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"help about rabbies","MESSAGE":"A street dog bit me five years ago, I take all the vaccine from very next day from biting, now on that spot where bite there was etching problem since few day, please guide me is there any problem will create in future if create is there any treatment for rabies.","QUESTION_ID":"Q7","F_REF":"1-123897705"} -{"ANSWERS":[{"_answerid":"Q8-S1-A1","_pairid":"15","__text":"Damage from optic nerve atrophy cannot be reversed. The underlying disease must be found and treated. Otherwise, vision loss will continue. Rarely, conditions that lead to optic atrophy may be treatable."}],"SUB_QUESTION_ID":"Q8-S1","ANNOTATIONS.FOCUS":["optic nerve atrophy"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"Dear Sir\/Madam I'm [NAME] from [LOCATION], I'm 35 years old , I'd like to ask you a\u00a0Medical Question as I've got an optic nerve atrophy in my eye and i lost my vision since i was 8 years old , Now I've got one eye just , So please is there treatment for optic nerve atrophy ! Please see the attachment which is a Medical report from [LOCATION], Best Wishes [NAME]","QUESTION_ID":"Q8","F_REF":"1-133748113"} -{"ANSWERS":[{"_answerid":"Q9-S1-A1","_pairid":"16","__text":"X-linked congenital stationary night blindness is a disorder of the retina, which is the specialized tissue at the back of the eye that detects light and color. People with this condition typically have difficulty seeing in low light (night blindness). They also have other vision problems, including loss of sharpness (reduced acuity), severe nearsightedness (high myopia), involuntary movements of the eyes (nystagmus), and eyes that do not look in the same direction (strabismus). Color vision is typically not affected by this disorder. The vision problems associated with this condition are congenital, which means they are present from birth. They tend to remain stable (stationary) over time. Researchers have identified two major types of X-linked congenital stationary night blindness: the complete form and the incomplete form. The types have very similar signs and symptoms. However, everyone with the complete form has night blindness, while not all people with the incomplete form have night blindness. The types are distinguished by their genetic cause and by the results of a test called an electroretinogram, which measures the function of the retina."}],"SUB_QUESTION_ID":"Q9-S1","ANNOTATIONS.FOCUS":["congenital night blindness"],"ANNOTATIONS.TYPE":"symptom","SUBJECT":"Night Blindness","MESSAGE":"When and how do you know when you have congenital night blindness?","QUESTION_ID":"Q9","F_REF":"1-134322567"} -{"ANSWERS":[{"_answerid":"Q10-S1-A1","_pairid":"17","__text":"Summary Lewy body disease is one of the most common causes of dementia in the elderly. Dementia is the loss of mental functions severe enough to affect normal activities and relationships. Lewy body disease happens when abnormal structures, called Lewy bodies, build up in areas of the brain. The disease may cause a wide range of symptoms, including - Changes in alertness and attention - Hallucinations - Problems with movement and posture - Muscle stiffness - Confusion - Loss of memory Lewy body disease can be hard to diagnose, because Parkinson's disease and Alzheimer's disease cause similar symptoms. Scientists think that Lewy body disease might be related to these diseases, or that they sometimes happen together. Lewy body disease usually begins between the ages of 50 and 85. The disease gets worse over time. There is no cure. Treatment focuses on drugs to help symptoms. NIH: National Institute of Neurological Disorders and Stroke"},{"_answerid":"Q10-S1-A2","_pairid":"18","__text":"Lewy body dementia is one of the most common forms of progressive dementia. People affected by this condition may experience a variety of symptoms such as changes in alertness and attention; hallucinations; problems with movement and posture; muscle stiffness; confusion; and\/or memory loss. Although the exact cause of Lewy body dementia is poorly understood, symptoms are thought to result when clumps of a protein called alpha-synuclein (\"Lewy bodies\") accumulate in the brain. Lewy body dementia usually occurs sporadically in people with no family history of the condition. Rarely, more than one family member may be affected. There is currently no cure for Lewy body dementia; however, medications may be available to help manage the associated symptoms."}],"SUB_QUESTION_ID":"Q10-S1","ANNOTATIONS.FOCUS":["lewy body dementia"],"ANNOTATIONS.TYPE":"information","SUBJECT":"","MESSAGE":"Would appreciate any good info on Lewy Body Dementia, we need to get people aware of this dreadful disease, all they talk about is alzheimers. Thank you","QUESTION_ID":"Q10","F_REF":"1-135752923"} -{"ANSWERS":[{"_answerid":"Q11-S1-A1","_pairid":"19","__text":"Mutations in the BCKDHA, BCKDHB, and DBT genes can cause maple syrup urine disease. These three genes provide instructions for making proteins that work together as a complex. The protein complex is essential for breaking down the amino acids leucine, isoleucine, and valine, which are present in many kinds of food, particularly protein-rich foods such as milk, meat, and eggs. Mutations in any of these three genes reduce or eliminate the function of the protein complex, preventing the normal breakdown of leucine, isoleucine, and valine. As a result, these amino acids and their byproducts build up in the body. Because high levels of these substances are toxic to the brain and other organs, their accumulation leads to the serious health problems associated with maple syrup urine disease."}],"SUB_QUESTION_ID":"Q11-S1","ANNOTATIONS.FOCUS":["maple syrup urine disease"],"ANNOTATIONS.TYPE":"genetic changes","SUBJECT":"Maple Syrup Urine Disease","MESSAGE":"Gene changes or chromosomal changes of MSUD? What is the technical and simple language of MSUD? Are there any treatments for MSUD?","QUESTION_ID":"Q11","F_REF":"19832"} -{"ANSWERS":[{"_answerid":"Q11-S2-A1","_pairid":"20","__text":"When the condition is diagnosed, and during episodes, treatment involves eating a protein-free diet. Fluids, sugars, and sometimes fats are given through a vein (IV). Dialysis through your belly or a vein can be done to reduce the level of abnormal substances in your blood. Long-term treatment requires a special diet. For infants, the diet includes a formula with low levels of the amino acids leucine, isoleucine, and valine. People with this condition must remain on a diet low in these amino acids for life. It is very important to always follow this diet to prevent nervous system (neurological) damage. This requires frequent blood tests and close supervision by a registered dietitian and physician, as well as cooperation by parents of children with the condition."}],"SUB_QUESTION_ID":"Q11-S2","ANNOTATIONS.FOCUS":["maple syrup urine disease"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"Maple Syrup Urine Disease","MESSAGE":"Gene changes or chromosomal changes of MSUD? What is the technical and simple language of MSUD? Are there any treatments for MSUD?","QUESTION_ID":"Q11","F_REF":"19832"} -{"ANSWERS":[{"_answerid":"Q12-S1-A1","_pairid":"21","__text":"Isolated congenital diaphragmatic hernia is rarely inherited. In almost all cases, there is only one affected individual in a family. When congenital diaphragmatic hernia occurs as a feature of a genetic syndrome or chromosomal abnormality, it may cluster in families according to the inheritance pattern for that condition."}],"SUB_QUESTION_ID":"Q12-S1","ANNOTATIONS.FOCUS":["cdh"],"ANNOTATIONS.TYPE":"inheritance","SUBJECT":"congenital diaphragmatic hernia","MESSAGE":"I need to know if CDH can be passed down to future generations. I just learned that this condition most likely caused the death of my first child back in 1971. I was then told it was merely a fluke. I had NO trauma during the full-term pregnancy, and I and my then husband were in very good health. Now my son (from a different husband) and his wife are due to have fraternal twins in [DATE] 2015. Does the term 'congenital' mean that it could be passed down to another generation? I do not want to alarm my son and his wife. I just would like to inform whatever pediatrician is caring for these babies as to my experience. Unfortunately my son and I are estranged. And I do not know who is their pediatrician. My child's CDH was very severe. I know there are far less severe cases that can go undetected &\/or undiagnosed unless there is a reason to suspect such a condition. Please respond to my concerns.","QUESTION_ID":"Q12","F_REF":"1-136400295"} -{"ANSWERS":[{"_answerid":"Q13-S1-A1","_pairid":"23","__text":"Treatment for thalassemia major often involves regular blood transfusions and folate supplements. If you receive blood transfusions, you should not take iron supplements. Doing so can cause a high amount of iron to build up in the body, which can be harmful. Persons who receive a lot of blood transfusions need a treatment called chelation therapy. This is done to remove excess iron from the body. A bone marrow transplant may help treat the disease in some patients, especially children."}],"SUB_QUESTION_ID":"Q13-S1","ANNOTATIONS.FOCUS":["thalassemia"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"about thalassemia treatment","MESSAGE":"sir,my friend is suffering from thalassemia ,in that majorly red blood anemia,white blood anemia and the blood is comming out from mouth when she got cough .her condition is very severe .in her body the red ,white blood cells are abscent .so that blood transfusion is doing for every 16-20days.then in the recent days the blood also comming out from mouth please tell me where can i get the treatment for this disease .we can travel around the world for treatment please reply me as soon as possible. thank you sir.","QUESTION_ID":"Q13","F_REF":"1-131374625"} -{"ANSWERS":[{"_answerid":"Q14-S1-A1","_pairid":"25","__text":"Lifestyle changes often can help relieve acute (short-term) insomnia. These changes might make it easier to fall asleep and stay asleep. A type of counseling called cognitive-behavioral therapy (CBT) can help relieve the anxiety linked to chronic (ongoing) insomnia. Anxiety tends to prolong insomnia. Several medicines also can help relieve insomnia and re-establish a regular sleep schedule. However, if your insomnia is the symptom or side effect of another problem, it's important to treat the underlying cause (if possible). Lifestyle Changes If you have insomnia, avoid substances that make it worse, such as: Caffeine, tobacco, and other stimulants. The effects of these substances can last as long as 8 hours. Certain over-the-counter and prescription medicines that can disrupt sleep (for example, some cold and allergy medicines). Talk with your doctor about which medicines won't disrupt your sleep. Alcohol. An alcoholic drink before bedtime might make it easier for you to fall asleep. However, alcohol triggers sleep that tends to be lighter than normal. This makes it more likely that you will wake up during the night. Try to adopt bedtime habits that make it easier to fall asleep and stay asleep. Follow a routine that helps you wind down and relax before bed. For example, read a book, listen to soothing music, or take a hot bath. Try to schedule your daily exercise at least 5 to 6 hours before going to bed. Don't eat heavy meals or drink a lot before bedtime. Make your bedroom sleep-friendly. Avoid bright lighting while winding down. Try to limit possible distractions, such as a TV, computer, or pet. Make sure the temperature of your bedroom is cool and comfortable. Your bedroom also should be dark and quiet. Go to sleep around the same time each night and wake up around the same time each morning, even on weekends. If you can, avoid night shifts, alternating schedules, or other things that may disrupt your sleep schedule. Cognitive-Behavioral Therapy CBT for insomnia targets the thoughts and actions that can disrupt sleep. This therapy encourages good sleep habits and uses several methods to relieve sleep anxiety. For example, relaxation techniques and biofeedback are used to reduce anxiety. These strategies help you better control your breathing, heart rate, muscles, and mood. CBT also aims to replace sleep anxiety with more positive thinking that links being in bed with being asleep. This method also teaches you what to do if you're unable to fall asleep within a reasonable time. CBT also may involve talking with a therapist one-on-one or in group sessions to help you consider your thoughts and feelings about sleep. This method may encourage you to describe thoughts racing through your mind in terms of how they look, feel, and sound. The goal is for your mind to settle down and stop racing. CBT also focuses on limiting the time you spend in bed while awake. This method involves setting a sleep schedule. At first, you will limit your total time in bed to the typical short length of time you're usually asleep. This schedule might make you even more tired because some of the allotted time in bed will be taken up by problems falling asleep. However, the resulting tiredness is intended to help you get to sleep more quickly. Over time, the length of time spent in bed is increased until you get a full night of sleep. For success with CBT, you may need to see a therapist who is skilled in this approach weekly over 2 to 3 months. CBT works as well as prescription medicine for many people who have chronic insomnia. It also may provide better long-term relief than medicine alone. For people who have insomnia and major depressive disorder, CBT combined with antidepression medicines has shown promise in relieving both conditions. Medicines Prescription Medicines Many prescription medicines are used to treat insomnia. Some are meant for short-term use, while others are meant for longer use. Talk to your doctor about the benefits and side effects of insomnia medicines. For example, insomnia medicines can help you fall asleep, but you may feel groggy in the morning after taking them. Rare side effects of these medicines include sleep eating, sleep walking, or driving while asleep. If you have side effects from an insomnia medicine, or if it doesn't work well, tell your doctor. He or she might prescribe a different medicine. Some insomnia medicines can be habit forming. Ask your doctor about the benefits and risks of insomnia medicines. Over-the-Counter Products Some over-the-counter (OTC) products claim to treat insomnia. These products include melatonin, L-tryptophan supplements, and valerian teas or extracts. The Food and Drug Administration doesn't regulate \u201cnatural\u201d products and some food supplements. Thus, the dose and purity of these substances can vary. How well these products work and how safe they are isn't well understood. Some OTC products that contain antihistamines are sold as sleep aids. Although these products might make you sleepy, talk to your doctor before taking them. Antihistamines pose risks for some people. Also, these products may not offer the best treatment for your insomnia. Your doctor can advise you whether these products will benefit you."}],"SUB_QUESTION_ID":"Q14-S1","ANNOTATIONS.FOCUS":["insomnia"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"insomnia","MESSAGE":"What can I give my [AGE] father to help him sleep? He said he will take whatever. He is not on any medication, not allergic to anything. Fully ambilatory!","QUESTION_ID":"Q14","F_REF":"1-133026625"} -{"ANSWERS":[{"_answerid":"Q15-S1-A1","_pairid":"26","__text":"Diabetes insipidus is an uncommon condition in which the kidneys are unable to prevent the excretion of water."},{"_answerid":"Q15-S1-A2","_pairid":"27","__text":"Summary Diabetes insipidus (DI) causes frequent urination. You become extremely thirsty, so you drink. Then you urinate. This cycle can keep you from sleeping or even make you wet the bed. Your body produces lots of urine that is almost all water. DI is different from diabetes mellitus (DM), which involves insulin problems and high blood sugar. The symptoms can be similar. However, DI is related to how your kidneys handle fluids. It's much less common than DM. Urine and blood tests can show which one you have. Usually, DI is caused by a problem with your pituitary gland or your kidneys. Treatment depends on the cause of the problem. Medicines can often help. NIH: National Institute of Diabetes and Digestive and Kidney Diseases"},{"_answerid":"Q15-S1-A3","_pairid":"30","__text":"Diabetes insipidus (DI) is a rare disease that causes frequent urination. The large volume of urine is diluted, mostly water. To make up for lost water, a person with DI may feel the need to drink large amounts and is likely to urinate frequently, even at night, which can disrupt sleep and, on occasion, cause bedwetting. Because of the excretion of abnormally large volumes of dilute urine, people with DI may quickly become dehydrated if they do not drink enough water. Children with DI may be irritable or listless and may have fever, vomiting, or diarrhea. Milder forms of DI can be managed by drinking enough water, usually between 2 and 2.5 liters a day. DI severe enough to endanger a person's health is rare."}],"SUB_QUESTION_ID":"Q15-S1","ANNOTATIONS.FOCUS":["diabetes insipidus"],"ANNOTATIONS.TYPE":"information","SUBJECT":"You know Diabetes Insipidus?","MESSAGE":"I was born with Diabetes Insipidus and have many problems since the cell was removed when I was 22 and ALL","QUESTION_ID":"Q15","F_REF":"1-135900462"} -{"ANSWERS":[{"_answerid":"Q16-S1-A1","_pairid":"36","__text":"An anal fissure is a small split or tear in the thin moist tissue (mucosa) lining the lower rectum (anus)."}],"SUB_QUESTION_ID":"Q16-S1","ANNOTATIONS.FOCUS":["anal fissures"],"ANNOTATIONS.TYPE":"information","SUBJECT":"Anal Fissure","MESSAGE":"I may have a couple anal fissures and looking to speak with someone to get some information and support.","QUESTION_ID":"Q16","F_REF":"13550"} -{"ANSWERS":[{"_answerid":"Q17-S1-A1","_pairid":"37","__text":"A gastrointestinal stromal tumor (GIST) is a type of tumor that occurs in the gastrointestinal tract, most commonly in the stomach or small intestine. The tumors are thought to grow from specialized cells found in the gastrointestinal tract called interstitial cells of Cajal (ICCs) or precursors to these cells. GISTs are usually found in adults between ages 40 and 70; rarely, children and young adults develop these tumors. The tumors can be cancerous (malignant) or noncancerous (benign). Small tumors may cause no signs or symptoms. However, some people with GISTs may experience pain or swelling in the abdomen, nausea, vomiting, loss of appetite, or weight loss. Sometimes, tumors cause bleeding, which may lead to low red blood cell counts (anemia) and, consequently, weakness and tiredness. Bleeding into the intestinal tract may cause black and tarry stools, and bleeding into the throat or stomach may cause vomiting of blood. Affected individuals with no family history of GIST typically have only one tumor (called a sporadic GIST). People with a family history of GISTs (called familial GISTs) often have multiple tumors and additional signs or symptoms, including noncancerous overgrowth (hyperplasia) of other cells in the gastrointestinal tract and patches of dark skin on various areas of the body. Some affected individuals have a skin condition called urticaria pigmentosa (also known as cutaneous mastocytosis), which is characterized by raised patches of brownish skin that sting or itch when touched."}],"SUB_QUESTION_ID":"Q17-S1","ANNOTATIONS.FOCUS":["gist"],"ANNOTATIONS.TYPE":"information","SUBJECT":"ClinicalTrials.gov - Question - general information","MESSAGE":"Hello, my dad, 68 years old, has gastritis, it did ache occasionally over the last several years. The other day, he went to hospital to have medical check-up with endoscopic ultrasonography, and found GIST with about 1cm in size. Doctor told him that he may consider surgery or not, it is up to him. What are we supposed to do? will it develop to bad condition? any suggestions? I 'm looking forward to your early reply. Thank you so much.","QUESTION_ID":"Q17","F_REF":"1-136744885"} -{"ANSWERS":[{"_answerid":"Q17-S2-A1","_pairid":"38","__text":"For patients with primary, localized gastrointestinal stromal tumors, surgery with complete excision is the treatment of choice.[1] However, surgery has limited efficacy in the treatment of recurrent and metastatic gastrointestinal stromal tumors. These tumors are also resistant to both chemotherapy and radiotherapy. In the pre-imatinib era, the 5-year survival rate after the surgical resection of gastrointestinal stromal tumors was only 43%\u201380% as there was really no efficient method to cure the disease.[2] The addition of imatinib as part of the treatment of unresectable or recurrent gastrointestinal stromal tumors has improved the management of this condition and resulted in improved patient survival.[1][2] Last updated: 4\/27\/2010 FDA-Approved Treatments The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition. Learn more orphan products. Imatinib mesylate (Brand name: Gleevec\u00ae) - Manufactured by Novartis Pharmaceuticals Corp. FDA-approved indication: Treatment of patients with Kit (CD117) positive unresectable and\/or metastatic malignant gastrointestinal stromal tumors (GIST) National Library of Medicine Drug Information Portal Regorafenib (Brand name: Stivarga) - Manufactured by Bayer HealthCare Pharmaceuticals, Inc. FDA-approved indication: Treatment of patients with locally advanced, unresectable or metastatic gastrointestinal stromal tumor (GIST) who have been previously treated with imatinib mesylate and sunitinib malate. National Library of Medicine Drug Information Portal Medline Plus Health Information Pazopanib (Brand name: Votrient) - Manufactured by GlaxoSmithKline FDA-approved indication: Advanced soft tissue sarcoma (STS) who have received prior chemotherapy. National Library of Medicine Drug Information Portal Medline Plus Health Information"}],"SUB_QUESTION_ID":"Q17-S2","ANNOTATIONS.FOCUS":["gist"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"ClinicalTrials.gov - Question - general information","MESSAGE":"Hello, my dad, 68 years old, has gastritis, it did ache occasionally over the last several years. The other day, he went to hospital to have medical check-up with endoscopic ultrasonography, and found GIST with about 1cm in size. Doctor told him that he may consider surgery or not, it is up to him. What are we supposed to do? will it develop to bad condition? any suggestions? I 'm looking forward to your early reply. Thank you so much.","QUESTION_ID":"Q17","F_REF":"1-136744885"} -{"ANSWERS":[{"_answerid":"Q18-S1-A1","_pairid":"39","__text":"Spinocerebellar ataxia type 3 (SCA3) is a condition characterized by progressive problems with movement. People with this condition initially experience problems with coordination and balance (ataxia). Other early signs and symptoms of SCA3 include speech difficulties, uncontrolled muscle tensing (dystonia), muscle stiffness (spasticity), rigidity, tremors, bulging eyes, and double vision. People with this condition may experience sleep disorders such as restless leg syndrome or REM sleep behavior disorder. Restless leg syndrome is a condition characterized by numbness or tingling in the legs accompanied by an urge to move the legs to stop the sensations. REM sleep behavior disorder is a condition in which the muscles are active during the dream (REM) stage of sleep, so an affected person often acts out his or her dreams. These sleep disorders tend to leave affected individuals feeling tired during the day. Over time, individuals with SCA3 may develop loss of sensation and weakness in the limbs (peripheral neuropathy), muscle cramps, muscle twitches (fasciculations), and swallowing difficulties. Individuals with SCA3 may have problems with memory, planning, and problem solving. Signs and symptoms of the disorder typically begin in mid-adulthood but can appear anytime from childhood to late adulthood. People with SCA3 eventually require wheelchair assistance. They usually survive 10 to 20 years after symptoms first appear."}],"SUB_QUESTION_ID":"Q18-S1","ANNOTATIONS.FOCUS":["sca3"],"ANNOTATIONS.TYPE":"information","SUBJECT":"Help for my diagnose","MESSAGE":"I have been diagnosed with SCA3. I was wondering if MedlinePlus is able to help me with resources that I may need on my journey through this disease? If not, can you help me find an organization or association that can help me.","QUESTION_ID":"Q18","F_REF":"1-132036525"} -{"ANSWERS":[{"_answerid":"Q18-S2-A1","_pairid":"40","__text":"Additional Information & Resources MedlinePlus (4 links) Encyclopedia: Movement--Uncoordinated Health Topic: Balance Problems Health Topic: Cerebellar Disorders Health Topic: Movement Disorders Genetic and Rare Diseases Information Center (1 link) Spinocerebellar ataxia 3 Additional NIH Resources (1 link) National Institute of Neurological Disorders and Stroke: Ataxias and Cerebellar or Spinocerebellar Degeneration Information Page Educational Resources (6 links) Disease InfoSearch: Spinocerebellar ataxia 3 Johns Hopkins Medicine Department of Neurology and Neurosurgery: What is Ataxia? MalaCards: machado-joseph disease Merck Manual Home Edition for Patients and Caregivers: Coordination Disorders National Ataxia Foundation: Spinocerebellar Ataxia Type 3 (PDF) Washington University, St. Louis: Neuromuscular Disease Center Patient Support and Advocacy Resources (4 links) Family Caregiver Alliance National Ataxia Foundation National Organization for Rare Disorders (NORD): Autosomal Dominant Hereditary Ataxia University of Kansas Medical Center Resource List: Ataxia GeneReviews (1 link) Spinocerebellar Ataxia Type 3 ClinicalTrials.gov (1 link) ClinicalTrials.gov Scientific Articles on PubMed (1 link) PubMed OMIM (1 link) MACHADO-JOSEPH DISEASE"}],"SUB_QUESTION_ID":"Q18-S2","ANNOTATIONS.FOCUS":["sca3"],"ANNOTATIONS.TYPE":"resources","SUBJECT":"Help for my diagnose","MESSAGE":"I have been diagnosed with SCA3. I was wondering if MedlinePlus is able to help me with resources that I may need on my journey through this disease? If not, can you help me find an organization or association that can help me.","QUESTION_ID":"Q18","F_REF":"1-132036525"} -{"ANSWERS":[{"_answerid":"Q19-S1-A1","_pairid":"41","__text":"There is no specific cure for migraine headaches. The goal is to treat your migraine symptoms right away, and to prevent symptoms by avoiding or changing your triggers. A key step is learning how to manage your migraines at home. A headache diary can help you identify your headache triggers. Then you and your doctor can plan how to avoid these triggers. If you have frequent migraines, your doctor may prescribe medicine to reduce the number of attacks. You need to take the medicine every day for it to be effective. Medicines may include: - Antidepressants - Blood pressure medicines - Seizure medicines Botulinum toxin type A (Botox) injections may also help reduce migraine attacks if they occur more than 15 days a month. Some people find relief with minerals and vitamins. Check with your doctor to see if riboflavin or magnesium are right for you. TREATING AN ATTACK Other medicines are taken at the first sign of a migraine attack. Over-the-counter (OTC) pain medicines, such as acetaminophen, ibuprofen, or aspirin are often helpful when your migraine is mild. Be aware that: - Taking medicines more than 3 days a week may lead to rebound headaches. These are headaches that keep coming back due to overuse of pain medicine. - Taking too much acetaminophen can damage your liver. - Too much ibuprofen or aspirin can irritate your stomach or kidneys. If these treatments do not help, ask your doctor about prescription medicines. These include nasal sprays, suppositories, or injections. Some migraine medicines narrow the blood vessels. If you are at risk for having a heart attack or have heart disease, talk with your doctor before using these medicines. Some migraine medicines should not be used by pregnant women. Talk with your doctor about which medicine is right for you if you are pregnant or planning to become pregnant. Other medicines treat symptoms of migraine, such as nausea and vomiting. They may be used alone or along with the other drugs that treat the migraine itself. Feverfew is a herb for migraines. It can be effective for some people. Before using feverfew, make sure your doctor approves. Herbal remedies sold in drugstores and health food stores are not regulated. Work with a trained herbalist when selecting herbs."}],"SUB_QUESTION_ID":"Q19-S1","ANNOTATIONS.FOCUS":["migraines"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"ClinicalTrials.gov - Question - general information","MESSAGE":"how do I get help with my migraines a have bad cluster migraines.","QUESTION_ID":"Q19","F_REF":"1-120034865"} -{"ANSWERS":[{"_answerid":"Q20-S1-A1","_pairid":"42","__text":"Congenital heart disease\u00a0is a problem with the heart's structure and function that is present at birth."}],"SUB_QUESTION_ID":"Q20-S1","ANNOTATIONS.FOCUS":["congenital heart disease"],"ANNOTATIONS.TYPE":"information","SUBJECT":"know more of Congenital Heart Disease","MESSAGE":"know more of Congenital Heart Disease","QUESTION_ID":"Q20","F_REF":"13506"} -{"ANSWERS":[{"_answerid":"Q21-S1-A1","_pairid":"46","__text":"Most of the time, RA affects joints on both sides of the body equally. Wrists, fingers, knees, feet, and ankles are the most commonly affected. The disease often begins slowly. Early symptoms may include minor joint pain, stiffness, and fatigue. Joint symptoms may include: - Morning stiffness, which lasts more than 1 hour, is common. Joints may feel warm, tender, and stiff when not used for an hour. - Joint pain is often felt on the same joint on both sides of the body. - Over time, joints may lose their range of motion and may become deformed. Other symptoms include: - Chest pain when taking a breath (pleurisy) - Dry eyes and mouth (Sjogren syndrome) - Eye burning, itching, and discharge - Nodules under the skin (usually a sign of more severe disease) - Numbness, tingling, or burning in the hands and feet - Sleep difficulties"},{"_answerid":"Q21-S1-A2","_pairid":"47","__text":"Swelling and Pain in the Joints Different types of arthritis have different symptoms. In general, people with most forms of arthritis have pain and stiffness in their joints. Rheumatoid arthritis is characterized by inflammation of the joint lining. This inflammation causes warmth, redness, swelling, and pain around the joints. A person also feels sick, tired, and sometimes feverish. Rheumatoid arthritis generally occurs in a symmetrical pattern. If one knee or hand is affected, the other one is also likely to be affected. Diagnostic Tests Rheumatoid arthritis can be difficult to diagnose in its early stages for several reasons. There is no single test for the disease. In addition, symptoms differ from person to person and can be more severe in some people than in others. Common tests for rheumatoid arthritis include - The rheumatoid factor test. Rheumatoid factor is an antibody that is present eventually in the blood of most people with rheumatoid arthritis However, not all people with rheumatoid arthritis test positive for rheumatoid factor, especially early in the disease. Also, some people who do test positive never develop the disease. The rheumatoid factor test. Rheumatoid factor is an antibody that is present eventually in the blood of most people with rheumatoid arthritis However, not all people with rheumatoid arthritis test positive for rheumatoid factor, especially early in the disease. Also, some people who do test positive never develop the disease. - The citrulline antibody test. This blood test detects antibodies to cyclic citrullinated peptide (anti-CCP). This test is positive in most people with rheumatoid arthritis and can even be positive years before rheumatoid arthritis symptoms develop. When used with the rheumatoid factor test, the citrulline antibody test results are very useful in confirming a rheumatoid arthritis diagnosis. The citrulline antibody test. This blood test detects antibodies to cyclic citrullinated peptide (anti-CCP). This test is positive in most people with rheumatoid arthritis and can even be positive years before rheumatoid arthritis symptoms develop. When used with the rheumatoid factor test, the citrulline antibody test results are very useful in confirming a rheumatoid arthritis diagnosis. Other common tests for rheumatoid arthritis include - the erythrocyte sedimentation rate, which indicates the presence of inflammation in the body - a test for white blood cell count and - a blood test for anemia. the erythrocyte sedimentation rate, which indicates the presence of inflammation in the body a test for white blood cell count and a blood test for anemia. Diagnosis Can Take Time Symptoms of rheumatoid arthritis can be similar to those of other types of arthritis and joint conditions, and it may take some time to rule out other conditions. The full range of symptoms develops over time, and only a few symptoms may be present in the early stages. Learn more about how rheumatoid arthritis is diagnosed."},{"_answerid":"Q21-S1-A3","_pairid":"48","__text":"Rheumatoid arthritis is characterized by inflammation of the joint lining. This inflammation causes warmth, redness, swelling, and pain around the joints. The pain of rheumatoid arthritis varies greatly from person to person, for reasons that doctors do not yet understand completely. Factors that contribute to the pain include swelling within the joint, the amount of heat or redness present, or damage that has occurred within the joint."}],"SUB_QUESTION_ID":"Q21-S1","ANNOTATIONS.FOCUS":["rheumatoid arthritis"],"ANNOTATIONS.TYPE":"symptom","SUBJECT":"Osteoarthritis","MESSAGE":"Are there any researches indicating how early an individual may experience any signs or symptoms of Rheumatoid Arthritis?","QUESTION_ID":"Q21","F_REF":"1-136858845"} -{"ANSWERS":[{"_answerid":"Q22-S1-A1","_pairid":"49","__text":"If you smoke, now is the time to quit. If you are having trouble quitting, talk with your doctor. There are many methods to help you quit, from support groups to prescription medicines. Also, try to avoid secondhand smoke."}],"SUB_QUESTION_ID":"Q22-S1","ANNOTATIONS.FOCUS":["lung cancer"],"ANNOTATIONS.TYPE":"prevention","SUBJECT":"","MESSAGE":"Genetic testing. My mother in law is in the last stage if lung cancer and only has days to live. My question is...testing her and comparing her tests with my husbands and his sisters test help to determine if it is genetic? My mother in law ([NAME]) and her mother and her mithers sister both had lung cancer and none if them were smokers. I'm real worried about my husband getting lung cancer now and I want find out what we can do to protect him.Thank you,[NAME]","QUESTION_ID":"Q22","F_REF":"5288"} -{"ANSWERS":[{"_answerid":"Q23-S1-A1","_pairid":"50","__text":"Eyes, ears, nose, mouth, and throat: - Blurred vision - Vision disturbances, including halos Gastrointestinal: - Diarrhea - Loss of appetite - Nausea - Stomach pain - Vomiting Heart and blood: - Irregular or slow heartbeat - Low blood pressure - Weakness Nervous system: - Confusion - Death - Depression - Disorientation - Dizziness - Drowsiness - Fainting - Headache - Lethargy Skin: - Hives - Rash Note: Depression, loss of appetite, and halos are usually only seen in chronic overdose cases."}],"SUB_QUESTION_ID":"Q23-S1","ANNOTATIONS.FOCUS":["oleander poisoning"],"ANNOTATIONS.TYPE":"symptom","SUBJECT":"oleander poisoning","MESSAGE":"If oleandor was ingested by touching the plant stems inner part and then directly eating without washing hands, how long would u exspect symptoms would start? And how severe would you say symptoms may get.","QUESTION_ID":"Q23","F_REF":"1-136022315"} -{"ANSWERS":[{"_answerid":"Q24-S1-A1","_pairid":"51","__text":"If you have diabetes, nerve damage in the leg or foot, poor blood circulation to your foot, or an infection around the nail, go to the doctor right away. Do\u00a0not try to treat\u00a0an ingrown nail\u00a0at home. Otherwise, to treat an ingrown nail at home: - Soak the foot in warm water 3 to 4 times a day if possible. After soaking, keep the toe dry. - Gently massage over the inflamed skin. - Place a small piece of cotton or dental floss under the nail. Wet the cotton with water or antiseptic. When trimming your toenails: - Briefly soak your foot in warm water to soften the nail. - Use a clean, sharp trimmer. - Trim toenails straight across the top. Do not taper or round the corners or trim too short. Do not try to cut out the ingrown portion of the nail yourself. This will only make the problem worse. Consider wearing sandals until the problem\u00a0goes away. Over-the-counter medicine that is applied to the ingrown toenail may help with the pain, but it\u00a0does not treat the problem. If this does not work and the ingrown nail gets worse, see your family doctor, a foot specialist (podiatrist) or a skin specialist (dermatologist). If your ingrown nail does not heal or keeps coming back, your doctor may remove part of the nail: - Numbing medicine is first injected into the toe. - The doctor uses\u00a0scissors to cut along the edge of the nail where the skin is growing over. This portion of the nail is removed. This procedure is called a partial nail avulsion. - It takes 2 to 4 months for the nail to regrow. Sometimes your doctor will use a chemical, electrical current, or another small surgical cut to destroy or remove the area from which a new nail may grow. If the toe is infected, your doctor may prescribe antibiotics."}],"SUB_QUESTION_ID":"Q24-S1","ANNOTATIONS.FOCUS":["ingrown toenail"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"I have no help its about 4 years now I have ingrown toenail","MESSAGE":"i have a problem of ingrown toenail its about 4 years now I have this problem i need help","QUESTION_ID":"Q24","F_REF":"1-135934082"} -{"ANSWERS":[{"_answerid":"Q25-S1-A1","_pairid":"52","__text":"Treatment for Friedreich ataxia includes: - Counseling - Speech therapy - Physical therapy - Walking aids or wheelchairs Orthopedic devices (braces) may be needed for scoliosis and foot problems. Treating heart disease and diabetes help people live longer and improve their quality of life."},{"_answerid":"Q25-S1-A2","_pairid":"53","__text":"These resources address the diagnosis or management of Friedreich ataxia: - Friedreich's Ataxia Research Alliance: Clinical Care Guidelines - Gene Review: Gene Review: Friedreich Ataxia - Genetic Testing Registry: Friedreich ataxia 1 - MedlinePlus Encyclopedia: Friedreich's Ataxia - MedlinePlus Encyclopedia: Hypertrophic Cardiomyopathy - National Institute of Neurological Disorders and Stroke: Friedreich's Ataxia Fact Sheet These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"},{"_answerid":"Q25-S1-A3","_pairid":"54","__text":"There is currently no effective cure or treatment for Friedreich's ataxia. However, many of the symptoms and accompanying complications can be treated to help individuals maintain optimal functioning as long as possible. Diabetes and heart problems can be treated with medications. Orthopedic problems such as foot deformities and scoliosis can be treated with braces or surgery. Physical therapy may prolong use of the arms and legs."}],"SUB_QUESTION_ID":"Q25-S1","ANNOTATIONS.FOCUS":["friedreich's ataxia"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"ClinicalTrials.gov - General Complaint","MESSAGE":"Dear sir\/ madam. I am a patient suffering from Friedreich's ataxia and i heard there was a medicine for it. In 2009 and since we are looking for the medicine kindly help on this and I have DNA report could You please help us on this as there are two people respective age 22 years and 24 years suffering from it. Looking for your help on this ASAP and please let us know when the medicine will be there in market and attaching two files for your reference","QUESTION_ID":"Q25","F_REF":"NF_61"} -{"ANSWERS":[{"_answerid":"Q26-S1-A1","_pairid":"55","__text":"Diagnostic testing does not find any physical cause for the symptoms. The doctor will do a physical exam and may order diagnostic tests. These are to make sure there are no physical causes for the symptom."}],"SUB_QUESTION_ID":"Q26-S1","ANNOTATIONS.FOCUS":["conversion disorder"],"ANNOTATIONS.TYPE":"diagnosis","SUBJECT":"","MESSAGE":"article defining 'conversion disorder' In your article defining 'conversion disorder', [http:\/\/www.nlm.nih.gov\/medlineplus\/ency\/article\/000954.htm] , the quote \"Conversion disorder is a mental health condition in which a person has blindness paralysis, or other nervous system (neurologic) symptoms that cannot be explained be medical evaluation\" , seemed to imply that the physical symptoms were valid as proving to be valid, but however the doctor could not 'figure' out why,.....but when I went to another source, another article quotes the disorder as a \"physical disability that is not caused by any physical impairment\" -so I am defining this as symptoms that are visibly correct as analyzed visually but when under examination for deadened nerves or broken bones, no evidence is found? >that is the definition I am getting from the other source about this disorder. For example, someone claims blindness, as my instructor explained, and when the person claiming blindness is placed near a ledge , does not walk off the ledge.....since I am assuming also that optical tests of the retina, or pupil proved nothing substantial?","QUESTION_ID":"Q26","F_REF":"14262"} -{"ANSWERS":[{"_answerid":"Q27-S1-A1","_pairid":"56","__text":"These resources address the diagnosis or management of spastic paraplegia type 11: - Gene Review: Gene Review: Spastic Paraplegia 11 - Genetic Testing Registry: Spastic paraplegia 11, autosomal recessive - Spastic Paraplegia Foundation, Inc.: Treatments and Therapies These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"}],"SUB_QUESTION_ID":"Q27-S1","ANNOTATIONS.FOCUS":["spg11"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"spg11","MESSAGE":"My 24 year old son was recently diagnosed with spg11 after over 15 years of trying to figure out what was wrong. We are already doing some of the common treatments. My question is, where do we go from here to give him the best chance at life,","QUESTION_ID":"Q27","F_REF":"1-136961537"} -{"ANSWERS":[{"_answerid":"Q28-S1-A1","_pairid":"57","__text":"Most fissures heal on their own and do not need treatment. To prevent or treat anal fissures in infants, be sure to change diapers often and clean the area gently. CHILDREN AND ADULTS Worrying about pain during a bowel movement may cause a person to avoid them. But not having bowel movements will only cause the stools to become even harder, which can make anal fissure worse. Prevent hard stools and constipation by: - Making dietary changes -- eating more fiber or bulk, such as fruits, vegetables, and grains - Drinking more fluids - Using stool softeners Applying the following ointments or creams to the area may soothe the skin: - Numbing cream, if pain interferes with normal bowel movements - Petroleum jelly - Zinc oxide, 1% hydrocortisone cream, Preparation H, and other products A sitz bath is a warm water bath used for healing or cleansing. You should sit in the bath two to three times a day. The water should cover only your hips and buttocks. If the anal fissures do not go away with home care methods, treatment may involve: - Botox injections into the muscle in the anus (anal sphincter) - Minor surgery to relax the anal muscle - Prescription creams such as nitrates or calcium channel blockers, applied over the fissure to help relax the muscles"}],"SUB_QUESTION_ID":"Q28-S1","ANNOTATIONS.FOCUS":["anal fissure"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"I have been battling Anal fissure for close to two years now and it has refused to heal all these while. Please what do you suggest i do? Thanks","QUESTION_ID":"Q28","F_REF":"1-134470695"} -{"ANSWERS":[{"_answerid":"Q29-S1-A1","_pairid":"58","__text":"Treatment usually only helps when started very early in the course of the disease. Injections of copper into a vein or under the skin have been used with mixed results."},{"_answerid":"Q29-S1-A2","_pairid":"59","__text":"These resources address the diagnosis or management of Menkes syndrome: - Gene Review: Gene Review: ATP7A-Related Copper Transport Disorders - Genetic Testing Registry: Menkes kinky-hair syndrome - MedlinePlus Encyclopedia: Copper in diet - MedlinePlus Encyclopedia: Menkes syndrome These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"}],"SUB_QUESTION_ID":"Q29-S1","ANNOTATIONS.FOCUS":["menkes syndrome"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"menkes syndrome \/kinky hair syndrome","MESSAGE":"My daughter has menkes syndrome and would like to know how to go about. Thx","QUESTION_ID":"Q29","F_REF":"1-132036455"} -{"ANSWERS":[{"_answerid":"Q30-S1-A1","_pairid":"60","__text":"Nephrotic syndrome is a group of symptoms that include protein in the urine, low blood protein levels in the blood, high cholesterol levels, high triglyceride levels, and swelling."}],"SUB_QUESTION_ID":"Q30-S1","ANNOTATIONS.FOCUS":["nephrotic syndrome"],"ANNOTATIONS.TYPE":"information","SUBJECT":"Nephrotic Syndrome","MESSAGE":"What is Nephrotic Syndrome. What are its causes and cures?","QUESTION_ID":"Q30","F_REF":"1-123712647"} -{"ANSWERS":[{"_answerid":"Q30-S2-A1","_pairid":"61","__text":"Nephrotic syndrome is caused by different disorders that damage the kidneys. This damage leads to the release of too much protein in the urine. The most common cause in children is minimal change disease. Membranous glomerulonephritis is the most common cause in adults.\u00a0In both diseases, the glomeruli in the kidneys are damaged. Glomeruli are the structures that help filter wastes and fluids. This condition can also occur from: - Cancer - Diseases such as diabetes, systemic lupus erythematosus, multiple myeloma, and amyloidosis - Genetic disorders - Immune disorders - Infections (such as strep throat, hepatitis, or mononucleosis) - Use of certain drugs It can occur with kidney disorders such as: - Focal and segmental glomerulosclerosis - Glomerulonephritis - Mesangiocapillary glomerulonephritis Nephrotic syndrome can affect all age groups. In children, it is most common between ages 2 and 6. This disorder occurs slightly more often in males than females."}],"SUB_QUESTION_ID":"Q30-S2","ANNOTATIONS.FOCUS":["nephrotic syndrome"],"ANNOTATIONS.TYPE":"cause","SUBJECT":"Nephrotic Syndrome","MESSAGE":"What is Nephrotic Syndrome. What are its causes and cures?","QUESTION_ID":"Q30","F_REF":"1-123712647"} -{"ANSWERS":[{"_answerid":"Q30-S3-A1","_pairid":"62","__text":"The goals of treatment are to relieve symptoms, prevent complications, and delay kidney damage. To control nephrotic syndrome, the disorder that is causing it must be treated. You may need treatment for life. Treatments may include any of the following: - Keeping blood pressure at or below 130\/80 mm Hg to delay kidney damage. Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) are the medicines most often used. ACE inhibitors and ARBs may also help decrease the amount of protein lost in the urine. - Corticosteroids and other drugs that suppress or quiet the immune system. - Treating high cholesterol to reduce the risk of heart and blood vessel problems. A low-fat, low-cholesterol diet is usually not enough for people with nephrotic syndrome. Medicines to reduce cholesterol and triglycerides (usually statins) may be needed. - A low-salt diet may help with swelling in the hands and legs. Water pills (diuretics) may also help with this problem. - Low-protein diets may be helpful. Your health care provider may suggest a moderate-protein diet (1 gram [gm] of protein per kilogram [kg] of body weight per day). - Taking\u00a0vitamin D supplements if nephrotic syndrome is long-term and is not responding to treatment. - Taking blood thinner drugs to treat or prevent blood clots."}],"SUB_QUESTION_ID":"Q30-S3","ANNOTATIONS.FOCUS":["nephrotic syndrome"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"Nephrotic Syndrome","MESSAGE":"What is Nephrotic Syndrome. What are its causes and cures?","QUESTION_ID":"Q30","F_REF":"1-123712647"} -{"ANSWERS":[{"_answerid":"Q31-S1-A1","_pairid":"63","__text":"Individual and family therapy is recommended for children to create a supportive environment at home and in school. Individual and, if appropriate, couples therapy is recommended for adults. Sex reassignment through surgery and hormonal therapy is an option. But identity problems may continue after this treatment."}],"SUB_QUESTION_ID":"Q31-S1","ANNOTATIONS.FOCUS":["gender dysphoria"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"GENDER DYSPHORIA","MESSAGE":"NO HEALTH CARE ON MY SON SUFFERING FROM GENDER DYSPHORIA WHAT CAN WE DO TO HELP HIM HE WORKED OUT OF HIGH SCHOOL NO PROBLEMS NOW NOT WORKING AND SHUTTING HIMSELF IN HIS ROOM 24\/7 THERES NOTHING ABOUT THIS CONDITION IN OUR AREA WE LIVE IN [LOCATION]. NO HELP IN AREA WHAT CAN WE DO HE HAS HAD BAD THOUGHTS ALREADY PLEASE HELP US WITH SOME SORT OF INFO THANK YUO [NAME] [LOCATION] [CONTACT]","QUESTION_ID":"Q31","F_REF":"1-131451155"} -{"ANSWERS":[{"_answerid":"Q32-S1-A1","_pairid":"64","__text":"Septic shock has a high death rate. The death rate depends on the patient's age and overall health, the cause of the infection, how many organs have failed, and how quickly and aggressively medical therapy is started."}],"SUB_QUESTION_ID":"Q32-S1","ANNOTATIONS.FOCUS":["septic shock"],"ANNOTATIONS.TYPE":"prognosis","SUBJECT":"Bowel Ischemia","MESSAGE":"My mother recently died from Bowel Ischemia and Septic Shock. My question is this, she was in the ER for 12 hours before she was even seen by the general surgeon and then he wasn't convinced that it was this condition yet. He said that he'd check on her in the morning once she was finally put into an ICU room (this was at 11 p.m.). I last spoke to her at midnight that evening and that was the last time that she was conscious. By the time she got to the ICU just 2-3 hours later, she was unresponsive and put on life support. Surgery was eventually performed later that afternoon and 90% of her small intestine had to be removed. She died early the next evening. My question to you is did they wait too long to do anything for her? Could she have been saved if surgery had been done sooner? I'm possibly thinking of bringing on a lawsuit.....Please advise with any answers to my questions that you can give. Thank you!","QUESTION_ID":"Q32","F_REF":"1-131159031"} -{"ANSWERS":[{"_answerid":"Q33-S1-A1","_pairid":"65","__text":"Treatment depends on the cause. Cushing syndrome caused by corticosteroid use: - Your doctor will instruct you to slowly decrease the medicine dosage. Stopping the medicine suddenly can be dangerous. - If you cannot stop taking the medicine because of disease, your high blood sugar, high cholesterol levels, and bone thinning or osteoporosis should be closely monitored. With Cushing syndrome caused by a pituitary or a tumor that releases ACTH (Cushing disease), you may need: - Surgery to remove the tumor. - Radiation after removal of a pituitary tumor in some cases. - Cortisol replacement therapy after surgery and possibly for the rest of your life. With Cushing syndrome due to an adrenal tumor\u00a0or other tumors: - You may need surgery to remove the tumor. - If the tumor cannot be removed, you may need medicines to help block the release of cortisol."}],"SUB_QUESTION_ID":"Q33-S1","ANNOTATIONS.FOCUS":["cushing"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"Cushing, fybromyaglia, Chronic fatigue","MESSAGE":"my main concern is no treatment and the musclar distrophy effecting my heart, legs feet, shoulders, arms, etc.","QUESTION_ID":"Q33","F_REF":"1-132773127"} -{"ANSWERS":[{"_answerid":"Q34-S1-A1","_pairid":"66","__text":"Treatment usually cures the infection. About 3% of people who get this disease will die."}],"SUB_QUESTION_ID":"Q34-S1","ANNOTATIONS.FOCUS":["rocky mountain spotted fever"],"ANNOTATIONS.TYPE":"prognosis","SUBJECT":"tick bites","MESSAGE":"my husband was diagnosed with Rocky Mountain Spotted fever about 6 1\/2 years ago. Then about 1 1\/2 years ago he was diagnosed with Lyme Disease. With him having had both what damage if any to his body could possibly happen. He has had alot of medical problems since. Now has been diagnosed with type II diabetes.","QUESTION_ID":"Q34","F_REF":"1-132036805"} -{"ANSWERS":[{"_answerid":"Q34-S2-A1","_pairid":"67","__text":"If diagnosed in the early stages, Lyme disease can be cured with antibiotics. Without treatment, complications involving the joints, heart, and nervous system can occur. But these symptoms are still treatable and curable. In rare cases, a person keeps having symptoms that interfere with daily life after they have been treated with antibiotics. This is also known as post-Lyme disease syndrome. The cause of this syndrome is unknown. Symptoms that occur after antibiotics are stopped may not be signs of active infection and may not respond to antibiotic treatment."}],"SUB_QUESTION_ID":"Q34-S2","ANNOTATIONS.FOCUS":["lyme disease"],"ANNOTATIONS.TYPE":"prognosis","SUBJECT":"tick bites","MESSAGE":"my husband was diagnosed with Rocky Mountain Spotted fever about 6 1\/2 years ago. Then about 1 1\/2 years ago he was diagnosed with Lyme Disease. With him having had both what damage if any to his body could possibly happen. He has had alot of medical problems since. Now has been diagnosed with type II diabetes.","QUESTION_ID":"Q34","F_REF":"1-132036805"} -{"ANSWERS":[{"_answerid":"Q35-S1-A1","_pairid":"68","__text":"Controlling blood pressure will slow further kidney damage. Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) are used most often. The goal is to keep blood pressure at or below 130\/80 mm Hg. Making lifestyle changes can help protect the kidneys, and prevent heart disease and stroke, such as: DO NOT smoke.\nEat meals that are low in fat and cholesterol. Get regular exercise (talk to your doctor or nurse before starting to exercise). Take drugs to lower your cholesterol, if needed. Keep your blood sugar under control. Avoid eating too much salt or potassium. Always talk to your kidney specialist before taking any over-the-counter medicine. This includes vitamins, herbs and supplements. Make sure all of the providers you visit know you have CKD. Other treatments may include: Medicines called phosphate binders, to help prevent high phosphorous levels Extra iron in the diet, iron pills, iron given through a vein (intravenous iron) special shots of a medicine called erythropoietin, and blood transfusions to treat anemia Extra calcium and vitamin D (always talk to your provider before taking) Your provider may have you follow a special diet for CKD. Limiting fluids Eating less protein Restricting salt, potassium, phosphorous, and other electrolytes Getting enough calories to prevent weight loss All people with CKD should be up-to-date on the following vaccinations: Hepatitis A vaccine Hepatitis B vaccine Flu vaccine Pneumonia vaccine (PPV)"}],"SUB_QUESTION_ID":"Q35-S1","ANNOTATIONS.FOCUS":["chronic renal failure"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"Please help me. have the honor to write to YOU. and I heard about your humanity and my hope in you a great And ask you for help I need you and I Will Be very very grateful to you. I am 30 years [NAME] state of Algeria , Batna. I suffer from a disease of chronic renal failure, dialysis was carried out 10 years ago. (Dialysis 3 times \/ week) continuous arteriovenous fistulas and the surgery (4till now). I live a hard life with illness and suffering continues to require a kidney transplant in order to get rid of this suffering Because the process of kidney transplantation in Algeria is slow and very rare, especially those without a family donor like me. Almost no hope for them. Please help me great hope in you (I'm sorry for writing bad because I do not know English we","QUESTION_ID":"Q35","F_REF":"11559"} -{"ANSWERS":[{"_answerid":"Q36-S1-A1","_pairid":"70","__text":"Leber congenital amaurosis is an eye disorder that primarily affects the retina, which is the specialized tissue at the back of the eye that detects light and color. People with this disorder typically have severe visual impairment beginning in infancy. The visual impairment tends to be stable, although it may worsen very slowly over time. Leber congenital amaurosis is also associated with other vision problems, including an increased sensitivity to light (photophobia), involuntary movements of the eyes (nystagmus), and extreme farsightedness (hyperopia). The pupils, which usually expand and contract in response to the amount of light entering the eye, do not react normally to light. Instead, they expand and contract more slowly than normal, or they may not respond to light at all. Additionally, the clear front covering of the eye (the cornea) may be cone-shaped and abnormally thin, a condition known as keratoconus. A specific behavior called Franceschetti's oculo-digital sign is characteristic of Leber congenital amaurosis. This sign consists of poking, pressing, and rubbing the eyes with a knuckle or finger. Researchers suspect that this behavior may contribute to deep-set eyes and keratoconus in affected children. In rare cases, delayed development and intellectual disability have been reported in people with the features of Leber congenital amaurosis. However, researchers are uncertain whether these individuals actually have Leber congenital amaurosis or another syndrome with similar signs and symptoms. At least 13 types of Leber congenital amaurosis have been described. The types are distinguished by their genetic cause, patterns of vision loss, and related eye abnormalities."}],"SUB_QUESTION_ID":"Q36-S1","ANNOTATIONS.FOCUS":["leber amaurosis"],"ANNOTATIONS.TYPE":"information","SUBJECT":"ClinicalTrials.gov - Question - general information","MESSAGE":"My cousin she is leber amaurosis she need help I don't know where to start from","QUESTION_ID":"Q36","F_REF":"19946"} -{"ANSWERS":[{"_answerid":"Q37-S1-A1","_pairid":"71","__text":"When possible, the cause of cardiomyopathy is treated. Medicines and lifestyle changes are often needed to treat the symptoms of heart failure, angina, and abnormal heart rhythms. Procedures or surgeries may also be used, including: - A defibrillator that sends an electrical pulse to stop life-threatening abnormal heart rhythms - A pacemaker that treats a slow heart rate or helps both sides of the heart beat at the same time - Coronary artery bypass (CABG) surgery or angioplasty\u00a0that may\u00a0improve blood flow to the damaged or weakened heart muscle - Heart transplant that may be tried when all other treatments have failed Recently, implantable artificial heart pumps have been developed. These may be used for very severe cases. However, not all patients need or are able to have this advanced treatment."},{"_answerid":"Q37-S1-A2","_pairid":"72","__text":"People who have cardiomyopathy but no signs or symptoms may not need treatment. Sometimes, dilated cardiomyopathy that comes on suddenly may go away on its own. For other people who have cardiomyopathy, treatment is needed. Treatment depends on the type of cardiomyopathy you have, the severity of your symptoms and complications, and your age and overall health. Treatments may include: Heart-healthy lifestyle changes Medicines Nonsurgical procedure Surgery and implanted devices The main goals of treating cardiomyopathy include: Controlling signs and symptoms so that you can live as normally as possible Managing any conditions that cause or contribute to the disease Reducing complications and the risk of sudden cardiac arrest Stopping the disease from getting worse Heart-Healthy Lifestyle Changes Your doctor may suggest lifestyle changes to manage a condition that\u2019s causing your cardiomyopathy including: Heart-healthy eating Maintaining a healthy weight Managing stress Physical activity Quitting smoking Heart-Healthy Eating Your doctor may recommend heart-healthy eating, which should include: Fat-free or low-fat dairy products, such as fat-free milk Fish high in omega-3 fatty acids, such as salmon, tuna, and trout, about twice a week Fruits, such as apples, bananas, oranges, pears, and prunes Legumes, such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans Vegetables, such as broccoli, cabbage, and carrots Whole grains, such as oatmeal, brown rice, and corn tortillas When following a heart-healthy diet, you should avoid eating: A lot of red meat Palm and coconut oils Sugary foods and beverages Two nutrients in your diet make blood cholesterol levels rise: Saturated fat\u2014found mostly in foods that come from animals Trans fat (trans fatty acids)\u2014found in foods made with hydrogenated oils and fats such as stick margarine;\u00a0baked goods such as, cookies, cakes, and pies, crackers, frostings, and coffee creamers. Some trans fats also occur naturally in animal fats and meats. Saturated fat raises your blood cholesterol more than anything else in your diet. When you follow a heart-healthy eating plan, only 5 percent to 6\u00a0percent of your daily calories should come from saturated fat. Food labels list the amounts of saturated fat. To help you stay on track, here are some examples: Not all fats are bad. Monounsaturated and polyunsaturated fats actually help lower blood cholesterol levels. Some sources of monounsaturated and polyunsaturated fats are: Avocados Corn, sunflower, and soybean oils Nuts and seeds, such as walnuts Olive, canola, peanut, safflower, and sesame oils Peanut butter Salmon and trout Tofu Sodium Try to limit the amount of sodium that you eat. This means choosing and preparing foods that are lower in salt and sodium. Try to use low-sodium and \u201cno added salt\u201d foods and seasonings at the table or while cooking. Food labels tell you what you need to know about choosing foods that are lower in sodium. Try to eat no more than 2,300 milligrams of sodium a day. If you have high blood pressure, you may need to restrict your sodium intake even more. Dietary Approaches to Stop Hypertension Your doctor may recommend the Dietary Approaches to Stop Hypertension (DASH) eating plan if you have high blood pressure. The DASH eating plan focuses on fruits, vegetables, whole grains, and other foods that are heart healthy and low in fat, cholesterol, and sodium and salt. The DASH eating plan is a good heart-healthy eating plan, even for those who don\u2019t have high blood pressure. Read more about DASH. Alcohol Talk to your doctor about how much alcohol you drink. Too much alcohol can\u00a0raise your blood pressure and triglyceride levels, a type of fat found in the blood. Alcohol also adds extra calories, which may cause weight gain. Your doctor may recommend that you reduce the amount of alcohol you drink\u00a0or stop drinking alcohol. Maintaining a Healthy Weight Maintaining a healthy weight is important for overall health and can lower your risk for coronary heart disease. Aim for a Healthy Weight by following a heart-healthy eating plan and keeping physically active. Knowing your body mass index (BMI) helps you find out if you\u2019re a healthy weight in relation to your height and gives an estimate of your total body fat. To figure out your BMI, check out the National Heart, Lung, and Blood Institute\u2019s (NHLBI) online\u00a0BMI calculator\u00a0or talk to your doctor.\u00a0A BMI: Below 18.5 is a sign that you are underweight. Between 18.5 and 24.9 is in the normal range. Between 25 and 29.9 is considered overweight. Of 30 or more is considered obese. A general goal to aim for is a BMI of less than 25. Your doctor or health care provider can help you set an appropriate BMI goal. Measuring waist circumference helps screen for possible health risks. If most of your fat is around your waist rather than at your hips, you\u2019re at a higher risk for heart disease and type 2 diabetes. This risk may be high with a waist size that is greater than 35 inches for women or greater than 40 inches for men. To learn how to measure your waist, visit\u00a0Assessing Your Weight and Health Risk. If you\u2019re overweight or obese, try to lose weight. A loss of just 3 percent to 5 percent of your current weight can lower your triglycerides, blood glucose, and the risk of developing type 2 diabetes. Greater amounts of weight loss can improve blood pressure readings, lower LDL cholesterol, and increase HDL cholesterol.\u00a0 Managing Stress Research shows that the most commonly reported \u201ctrigger\u201d for a heart attack is an emotionally upsetting event\u2014particularly one involving anger. Also, some of the ways people cope with stress\u2014such as drinking, smoking, or overeating\u2014aren\u2019t healthy. Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health.\u00a0Consider healthy stress-reducing activities, such as: A stress management program Meditation Physical activity Relaxation therapy Talking things out with friends or family\u00a0 Physical Activity Routine physical activity can lower many risk factors for coronary heart disease, including LDL (\u201cbad\u201d) cholesterol, high blood pressure, and excess weight. Physical activity also can lower your risk for diabetes and raise your HDL cholesterol level. HDL is the \u201cgood\u201d cholesterol that helps prevent coronary heart disease. Everyone should try to participate in moderate intensity aerobic exercise at least 2\u00a0hours and 30\u00a0minutes per week, or vigorous intensity aerobic exercise for 1\u00a0hour and 15\u00a0minutes per week. Aerobic exercise, such as brisk walking, is any exercise in which your heart beats faster\u00a0and you use more oxygen than usual. The more active you are, the more you will benefit. Participate in aerobic exercise for at least 10 minutes at a time spread throughout the week. Read more about physical activity at: Physical Activity and Your Heart U.S. Department of Health and Human Services\u2019 2008 Physical Activity Guidelines for\u00a0Americans Talk with your doctor before you start a new exercise plan. Ask your doctor how much and what kinds of physical activity are safe for you. Quitting Smoking If you smoke, quit. Smoking can raise your risk for coronary heart disease and heart attack and worsen other coronary heart disease risk factors. Talk with your doctor about programs and products that can help you quit smoking. Also, try to avoid secondhand smoke. If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking. Read more about quitting smoking at Smoking and Your Heart. \u00a0 Medicines Many medicines are used to treat cardiomyopathy. Your doctor may prescribe medicines to: Balance electrolytes in your body. Electrolytes are minerals that help maintain fluid levels and acid-base balance in the body. They also help muscle and nerve tissues work properly. Abnormal electrolyte levels may be a sign of dehydration (lack of fluid in your body), heart failure, high blood pressure, or other disorders. Aldosterone blockers are an example of a medicine used to balance electrolytes. Keep your heart beating with a normal rhythm. These medicines, called antiarrhythmics, help prevent arrhythmias. Lower your blood pressure. ACE inhibitors, angiotensin II receptor blockers, beta blockers, and calcium channel blockers are examples of medicines that lower blood pressure. Prevent blood clots from forming. Anticoagulants, or blood thinners, are an example of a medicine that prevents blood clots. Blood thinners often are used to prevent blood clots from forming in people who have dilated cardiomyopathy. Reduce inflammation. Corticosteroids are an example of a medicine used to reduce inflammation.\u00a0 Remove excess sodium from your body. Diuretics, or water pills, are an example of medicines that help remove excess sodium from the body, which reduces the amount of fluid in your blood. Slow your heart rate. Beta blockers, calcium channel blockers, and digoxin are examples of medicines that slow the heart rate. Beta blockers and calcium channel blockers also are used to lower blood pressure. Take all medicines regularly, as your doctor prescribes. Don\u2019t change the amount of your medicine or skip a dose unless your doctor tells you to. \u200bSurgery and Implanted Devices Doctors use several types of surgery to treat cardiomyopathy, including septal myectomy, surgically implanted devices, and heart transplant. Septal Myectomy Septal myectomy is open-heart surgery and is used to treat people who have hypertrophic cardiomyopathy and severe symptoms. This surgery generally is used for younger patients and for people whose medicines aren\u2019t working well. A surgeon removes part of the thickened septum that\u2019s bulging into the left ventricle. This improves blood flow through the heart and out to the body. The removed tissue doesn\u2019t grow back. If needed, the surgeon also can repair or replace the mitral valve at the same time. Septal myectomy often is successful and allows you to return to a normal life with no\u00a0symptoms. Surgically Implanted Devices Surgeons can place several types of devices in the heart to improve function and symptoms, including: Cardiac resynchronization therapy (CRT) device. A CRT device coordinates contractions between the heart\u2019s left and right ventricles. Implantable cardioverter defibrillator\u00a0(ICD). An ICD helps control life-threatening arrhythmias that may lead to\u00a0sudden cardiac arrest. This small device is implanted in the chest or abdomen and connected to the heart with wires. If an ICD senses a dangerous change in heart rhythm, it will send an electric shock to the heart to restore a normal heartbeat. Left ventricular assist device (LVAD). This device helps the heart pump blood to the body. An LVAD can be used as a long-term therapy or as a short-term treatment for people who are waiting for a heart transplant. Pacemaker. This small device is placed under the skin of your chest or abdomen to help control arrhythmias. The device uses electrical pulses to prompt the heart to beat at a normal rate. Heart Transplant For this surgery, a surgeon replaces a person\u2019s diseased heart with a healthy heart from a deceased donor. A heart transplant is a last resort treatment for people who have end-stage heart failure. \u201cEnd-stage\u201d means the condition has become so severe that all treatments, other than heart transplant, have failed. For more information about this treatment, go to the Heart Transplant Health Topic. Nonsurgical Procedure Doctors may use a nonsurgical procedure called alcohol septal ablation to treat cardiomyopathy. During this procedure, the doctor injects ethanol (a type of alcohol) through a tube into the small artery that supplies blood to the thickened area of heart muscle. The alcohol kills cells, and the thickened tissue shrinks to a more normal size. This procedure allows blood to flow freely through the ventricle, which improves symptoms."}],"SUB_QUESTION_ID":"Q37-S1","ANNOTATIONS.FOCUS":["cardiomyopathy"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"My father is having cardiomyopathy through genes. He is 83 now. He was absoulutely normal till now. recently he is getting breathlessness. and he was admitted to the hospital twice. The doctors are telling that multi dieases are attacking his heart. I just want to know exactly what is happening and what precautions that he should take in future. What are the chances of survival? Please help.","QUESTION_ID":"Q37","F_REF":"52"} -{"ANSWERS":[{"_answerid":"Q37-S2-A1","_pairid":"73","__text":"The outlook depends on many different things, including: - Cause and type of cardiomyopathy - How well the condition responds to treatment - The severity of the heart problem Heart failure is usually a long-term (chronic) illness. It may get worse over time. Some people develop severe heart failure. In this case, medicines, surgery, and other treatments may no longer help. Patients with certain types of cardiomyopathy are at risk for dangerous heart rhythm problems."}],"SUB_QUESTION_ID":"Q37-S2","ANNOTATIONS.FOCUS":["cardiomyopathy"],"ANNOTATIONS.TYPE":"prognosis","SUBJECT":"","MESSAGE":"My father is having cardiomyopathy through genes. He is 83 now. He was absoulutely normal till now. recently he is getting breathlessness. and he was admitted to the hospital twice. The doctors are telling that multi dieases are attacking his heart. I just want to know exactly what is happening and what precautions that he should take in future. What are the chances of survival? Please help.","QUESTION_ID":"Q37","F_REF":"52"} -{"ANSWERS":[{"_answerid":"Q38-S1-A1","_pairid":"74","__text":"Albinism is a defect of melanin production that results in little or no color (pigment) in the skin, hair, and eyes."},{"_answerid":"Q38-S1-A2","_pairid":"75","__text":"Albinism is a group of inherited disorders that results in little or no production of the pigment melanin, which determines the color of the skin, hair and eyes. Melanin also plays a role in the development of certain optical nerves, so all forms of albinism cause problems with the development and function of the eyes. Other symptoms can include light skin or changes in skin color; very white to brown hair; very light blue to brown eye color that may appear red in some light and may change with age; sensitivity to sun exposure; and increased risk of developing skin cancer. Albinism is caused by mutations in one of several genes, and most types are inherited in an autosomal recessive manner. Although there's no cure, people with the disorder can take steps to improve vision and avoid too much sun exposure."}],"SUB_QUESTION_ID":"Q38-S1","ANNOTATIONS.FOCUS":["albinism"],"ANNOTATIONS.TYPE":"information","SUBJECT":"Questions on albinism","MESSAGE":"Hello my name is [NAME] and I'm hoping you can help me. When i was born my doctor diagnosed me with albinism. I have color in my hair (brown) and in my eyes (hazel) they do not shake. My skin is fair but my markings are visible. It is not one solid fair white on all of me. I apparently have 3 different levels. most of my body is covered by level 1 pigmentation (the fairest) i have level 2 on some as well and a small patch of my arm of level (3) it basically looks like a huge birthmark that goes from my right side of the body to the left. When I was born the doctors still didn't know much about Albinism and I\"m hoping to learn more myself. For instance what type this would fall under... I hope you can help.","QUESTION_ID":"Q38","F_REF":"1-135928507"} -{"ANSWERS":[{"_answerid":"Q39-S1-A1","_pairid":"78","__text":"Fluids and electrolytes may be given by IV (into a vein) or you may be asked to drink water with electrolyte packets. Antibiotics are given to kill the bacteria. There are increasing rates of antibiotic resistance throughout the world, so your health care provider will check current recommendations before choosing an antibiotic."}],"SUB_QUESTION_ID":"Q39-S1","ANNOTATIONS.FOCUS":["typhoid"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"typhoid fever","MESSAGE":"Hi, My name is [NAME] from india i have suffering from typhoid please give me solution i have one question i had got treatment from one year but i am not well now give me solution?","QUESTION_ID":"Q39","F_REF":"1-132341355"} -{"ANSWERS":[{"_answerid":"Q40-S1-A1","_pairid":"79","__text":"You can make many lifestyle changes to help treat your symptoms. Other tips include: - If you are overweight or obese, in many cases, losing weight can help. - Avoid drugs such as aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn). Take acetaminophen (Tylenol) to relieve pain. - Take all of your medicines with plenty of water. When your doctor gives you a new medicine, ask whether it will make your heartburn worse. You may use over-the-counter antacids after meals and at bedtime, although the relief may not last very long. Common side effects of antacids include diarrhea or constipation. Other over-the-counter and prescription drugs can treat GERD. They work more slowly than antacids, but give you longer relief. Your pharmacist, doctor, or nurse can tell you how to take these drugs. - Proton pump inhibitors (PPIs) decrease the amount of acid produced in your stomach - H2 blockers also lower the amount of acid released in the stomach Anti-reflux surgery may be an option for people whose symptoms do not go away with lifestyle changes and medicines. Heartburn and other symptoms should improve after surgery. But you may still need to take drugs for your heartburn. There are also new therapies for reflux that can be performed through an endoscope (a flexible tube passed through the mouth into the stomach)."}],"SUB_QUESTION_ID":"Q40-S1","ANNOTATIONS.FOCUS":["gerd"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"GERD. I'm a 72 year old female, and have diverticulosis,gastritis, and esophagitis. I tried to see three different doctors today, but all were booked. I honestly don't know what to do. It hurts in my chest, and I can hardly talk.","QUESTION_ID":"Q40","F_REF":"11788"} -{"ANSWERS":[{"_answerid":"Q41-S1-A1","_pairid":"81","__text":"Most often, hemophilia is diagnosed after a person has an abnormal bleeding episode. It can also be diagnosed by a blood test done to detect the problem, if other family members have the condition."},{"_answerid":"Q41-S1-A2","_pairid":"82","__text":"If you or your child appears to have a bleeding problem, your doctor will ask about your personal and family medical histories. This will reveal whether you or your family members, including women and girls, have bleeding problems. However, some people who have hemophilia have no recent family history of the disease. You or your child also will likely have a physical exam and blood tests to diagnose hemophilia. Blood tests are used to find out: How long it takes for your blood to clot Whether your blood has low levels of any clotting factors Whether any clotting factors are completely missing from your blood The test results will show whether you have hemophilia, what type of hemophilia you have, and how severe it is. Hemophilia A and B are classified as mild, moderate, or severe, depending on the amount of clotting factor VIII or IX in the blood. The severity of symptoms can overlap between the categories. For example, some people who have mild hemophilia may have bleeding problems almost as often or as severe as some people who have moderate hemophilia. Severe hemophilia can cause serious bleeding problems in babies. Thus, children who have severe hemophilia usually are diagnosed during the first year of life. People who have milder forms of hemophilia may not be diagnosed until they're adults. The bleeding problems of hemophilia A and hemophilia B are the same. Only special blood tests can tell which type of the disorder you or your child has. Knowing which type is important because the treatments are different. Pregnant women who are known hemophilia carriers can have the disorder diagnosed in their unborn babies as early as 12 weeks into their pregnancies. Women who are hemophilia carriers also can have \"preimplantation diagnosis\" to have children who don't have hemophilia. For this process, women have their eggs removed and fertilized by sperm in a laboratory. The embryos are then tested for hemophilia. Only embryos without the disorder are implanted in the womb."}],"SUB_QUESTION_ID":"Q41-S1","ANNOTATIONS.FOCUS":["hemophilia"],"ANNOTATIONS.TYPE":"diagnosis","SUBJECT":"","MESSAGE":"Tests for Haemophilia. Hi, I was wondering if blood clotting assays are always positive if one has mild-moderate hemophilia and what the name is of the genetic tests for hemophilia? I have a history of internal spontaneous bleeding into the joints or with eating garlic or onions (in large amounts).I also hemmorhage after injuries (arm injury, head injury hemmorhage, and pregnancy birth hemmorhage--both times). I've had to have blood transfusions and shots to control the bleeding but it's usually possible to control it. I believe I may have passed this on to my son as he was determined by a doctor to be a heavy bleeder at circumcision. While on the [LOCATION]t, I was asked by a [LOCATION] if anyone had done a work-up on me for hemophilia or any clotting disorder and I said not to my knowledge. I asked if they were going to do it and she said to follow up with a primary doctor for it. She also said it could be expensive. This is why I'm asking, if I go to a medical appointment as a private-pay patient, and want to have testing done, which tests would you recommend? [NAME]","QUESTION_ID":"Q41","F_REF":"63"} -{"ANSWERS":[{"_answerid":"Q42-S1-A1","_pairid":"83","__text":"Knock knees are not treated in most cases. If the problem continues after age 7, the child may use a night brace. This brace is attached to a shoe. Surgery may be considered for knock knees that are severe and continue beyond late childhood."}],"SUB_QUESTION_ID":"Q42-S1","ANNOTATIONS.FOCUS":["knock knees"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"I am 23yr boy,i have knock knees i want treatment. Please help me.","QUESTION_ID":"Q42","F_REF":"1-122892655"} -{"ANSWERS":[{"_answerid":"Q43-S1-A1","_pairid":"84","__text":"You can make many lifestyle changes to help treat your symptoms. Other tips include: - If you are overweight or obese, in many cases, losing weight can help. - Avoid drugs such as aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn). Take acetaminophen (Tylenol) to relieve pain. - Take all of your medicines with plenty of water. When your doctor gives you a new medicine, ask whether it will make your heartburn worse. You may use over-the-counter antacids after meals and at bedtime, although the relief may not last very long. Common side effects of antacids include diarrhea or constipation. Other over-the-counter and prescription drugs can treat GERD. They work more slowly than antacids, but give you longer relief. Your pharmacist, doctor, or nurse can tell you how to take these drugs. - Proton pump inhibitors (PPIs) decrease the amount of acid produced in your stomach - H2 blockers also lower the amount of acid released in the stomach Anti-reflux surgery may be an option for people whose symptoms do not go away with lifestyle changes and medicines. Heartburn and other symptoms should improve after surgery. But you may still need to take drugs for your heartburn. There are also new therapies for reflux that can be performed through an endoscope (a flexible tube passed through the mouth into the stomach)."}],"SUB_QUESTION_ID":"Q43-S1","ANNOTATIONS.FOCUS":["gerd"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"Gastroesophageal Reflux Disease","MESSAGE":"Can GERD BE CURED? I AM SUFFERING FROM THIS DISEASE FOR ALMOST THREE YEARS NOW.I HAVE GONE TO MANY HOSPITALS BUT STILL CAN'T BE CURED.I HAVE BEEN GIVEN OMEPRAZOLE CAPSULES MANY TIMES.PLEASE HELP ME.","QUESTION_ID":"Q43","F_REF":"NF_211"} -{"ANSWERS":[{"_answerid":"Q44-S1-A1","_pairid":"85","__text":"OI is most often suspected in children whose bones break with very little force. A physical exam may show that the whites of their eyes have a blue tint. A definitive diagnosis may be made using a skin punch biopsy. Family members may be given a DNA blood test. If there is a family history of OI, chorionic villus sampling may be done during pregnancy to determine if the baby has the condition. However, because so many different mutations can cause OI, some forms cannot be diagnosed with a genetic test. The severe form of type II OI can be seen on ultrasound when the fetus is as young as 16 weeks."}],"SUB_QUESTION_ID":"Q44-S1","ANNOTATIONS.FOCUS":["oi"],"ANNOTATIONS.TYPE":"diagnosis","SUBJECT":"","MESSAGE":"diagnosis of OI\/ resources. I was writing to inquire about more information regarding the diagnosis of OI. We have family members who are in the process of waiting for genetic testing to come back but are under allegations of child abuse. Is there any information and \/ or resources that may be helpful to us? Any help is appreciated. Thank you,[NAME]","QUESTION_ID":"Q44","F_REF":"50"} -{"ANSWERS":[{"_answerid":"Q45-S1-A1","_pairid":"89","__text":"Most patients with pneumonia due to mycoplasma or chlamydophila get better with the right antibiotics. Legionella pneumonia can be severe. It can lead to problems, especially in patients with kidney failure, diabetes, COPD, or a weak immune system. It can also lead to death."}],"SUB_QUESTION_ID":"Q45-S1","ANNOTATIONS.FOCUS":["atypical pneumonia"],"ANNOTATIONS.TYPE":"prognosis","SUBJECT":"","MESSAGE":"atypical pnuemonia. what is the possibility of atypical pneumonia occurring again less than a month after treatment?","QUESTION_ID":"Q45","F_REF":"11781"} -{"ANSWERS":[{"_answerid":"Q46-S1-A1","_pairid":"90","__text":"Fibromyalgia is a common syndrome in which a person has long-term pain, spread throughout the body. The pain is most often linked to fatigue, sleep problems, headaches, depression, and anxiety. People with fibromalgia may also have tenderness in the joints, muscles, tendons, and other soft tissues."},{"_answerid":"Q46-S1-A2","_pairid":"91","__text":"Summary Fibromyalgia is a disorder that causes muscle pain and fatigue. People with fibromyalgia have \"tender points\" on the body. Tender points are specific places on the neck, shoulders, back, hips, arms, and legs. These points hurt when pressure is put on them. People with fibromyalgia may also have other symptoms, such as - Trouble sleeping - Morning stiffness - Headaches - Painful menstrual periods - Tingling or numbness in hands and feet - Problems with thinking and memory (sometimes called \"fibro fog\") No one knows what causes fibromyalgia. Anyone can get it, but it is most common in middle-aged women. People with rheumatoid arthritis and other autoimmune diseases are particularly likely to develop fibromyalgia. There is no cure for fibromyalgia, but medicine can help you manage your symptoms. Getting enough sleep, exercising, and eating well may also help. NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases"}],"SUB_QUESTION_ID":"Q46-S1","ANNOTATIONS.FOCUS":["fibromyalgia"],"ANNOTATIONS.TYPE":"information","SUBJECT":"","MESSAGE":"Can u please send stuff on fibromyalgia as well","QUESTION_ID":"Q46","F_REF":"1-131441670"} -{"ANSWERS":[{"_answerid":"Q47-S1-A1","_pairid":"92","__text":"Your health care provider can treat a wart if you do not like how it looks or if it is painful. Do NOT attempt to remove a wart yourself by burning, cutting, tearing, picking, or by any other method. MEDICINES Over-the-counter medicines are available to remove warts. Do NOT use over-the-counter wart medicines on your face or genitals. Warts in these areas need to be treated by a health care provider. To use wart-removal medicine: - File the wart with a nail file or emery board when your skin is damp (for example, after a shower or bath). This helps remove dead tissue. Do not use the same emery board on your nails. - Put the medicine on the wart every day for several weeks or months. Follow the instructions on the label. - Cover the wart with a bandage to prevent it from spreading.\u00a0 OTHER TREATMENTS Special foot cushions can help ease the pain from plantar warts. You can buy these at drugstores without a prescription. Use socks. Wear shoes with plenty of room. Avoid high heels. Your health care provider may need to trim away thick skin or calluses that form over warts on your foot or around nails. Your provider may recommend the following treatments if your warts do not go away: - Stronger (prescription) medicines - A blistering solution - Freezing the wart (cryotherapy) to remove it - Burning the wart (electrocautery) to remove it - Laser treatment for difficult to remove warts - Immunotherapy, which gives you a shot of a substance that causes an allergic reaction and helps the wart go away - Skin medicine called imiquimod Genital warts are treated in a different way than most other warts. A medicine called veregen may be used on genital warts, as well as on other warts."}],"SUB_QUESTION_ID":"Q47-S1","ANNOTATIONS.FOCUS":["warts"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"genital warts on penis","MESSAGE":"i have taken two treatment of this but still i have small warts please tell me which is the best madcine or cream","QUESTION_ID":"Q47","F_REF":"1-133767535"} -{"ANSWERS":[{"_answerid":"Q48-S1-A1","_pairid":"93","__text":"These resources address the diagnosis or management of X-linked congenital stationary night blindness: - American Optometric Association: Infant Vision - Gene Review: Gene Review: X-Linked Congenital Stationary Night Blindness - Genetic Testing Registry: Congenital stationary night blindness - Genetic Testing Registry: Congenital stationary night blindness, type 1A - Genetic Testing Registry: Congenital stationary night blindness, type 2A - MedlinePlus Encyclopedia: Electroretinography - MedlinePlus Encyclopedia: Eye movements - Uncontrollable - MedlinePlus Encyclopedia: Nearsightedness - MedlinePlus Encyclopedia: Strabismus - MedlinePlus Encyclopedia: Vision - Night Blindness These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"}],"SUB_QUESTION_ID":"Q48-S1","ANNOTATIONS.FOCUS":["x-linked congenital stationary night blindness"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"X-linked congenital stationary night blindness","MESSAGE":"i m suffering from similar or same decease.my mothers father suffered from same & my brother also.we have problem in low light infact cant view in damp conditions during day also have myopia but still not normal myopia cant see little object with clarity.life is looking like imprisonment.is there any chance for our recovery from this x linked decease.will we be able to see like normal ones.plz help. my age 38 y brother 44.address [LOCATION]","QUESTION_ID":"Q48","F_REF":"1-137191537"} -{"ANSWERS":[{"_answerid":"Q49-S1-A1","_pairid":"94","__text":"Hormone therapy and laparoscopy cannot cure endometriosis. However, in some women, these treatments may help relieve symptoms for years. Removal of the uterus, fallopian tubes, and both ovaries (a hysterectomy) gives you the best chance for a cure."}],"SUB_QUESTION_ID":"Q49-S1","ANNOTATIONS.FOCUS":["endometriosis"],"ANNOTATIONS.TYPE":"prognosis","SUBJECT":"","MESSAGE":"How bad can endometriosis get?","QUESTION_ID":"Q49","F_REF":"1-123117975"} -{"ANSWERS":[{"_answerid":"Q50-S1-A1","_pairid":"95","__text":"Gastroparesis is a condition that reduces the ability of the stomach to empty its contents. It does not involve a blockage (obstruction)."},{"_answerid":"Q50-S1-A2","_pairid":"96","__text":"Gastroparesis, also called delayed gastric emptying, is a disorder that slows or stops the movement of food from the stomach to the small intestine. Normally, the muscles of the stomach, which are controlled by the vagus nerve, contract to break up food and move it through the gastrointestinal (GI) tract. The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anus. The movement of muscles in the GI tract, along with the release of hormones and enzymes, allows for the digestion of food. Gastroparesis can occur when the vagus nerve is damaged by illness or injury and the stomach muscles stop working normally. Food then moves slowly from the stomach to the small intestine or stops moving altogether."},{"_answerid":"Q50-S1-A3","_pairid":"97","__text":"The problems of gastroparesis can include - severe dehydration due to persistent vomiting - gastroesophageal reflux disease (GERD), which is GER that occurs more than twice a week for a few weeks; GERD can lead to esophagitis\u2014 irritation of the esophagus - bezoars, which can cause nausea, vomiting, obstruction, or interfere with absorption of some medications in pill form - difficulty managing blood glucose levels in people with diabetes - malnutrition due to poor absorption of nutrients or a low calorie intake - decreased quality of life, including work absences due to severe symptoms"}],"SUB_QUESTION_ID":"Q50-S1","ANNOTATIONS.FOCUS":["gastroparesis"],"ANNOTATIONS.TYPE":"information","SUBJECT":"Gastroparesis","MESSAGE":"I am a current Gastroparesis fighter with a GJ feeding tube. I am also one of the admins for a GP support group and an advocacy group. I have become a volunteer advocater. I would appreciate any info you can share about Gastroparesis, Feeding tubes, and even TPN. Thanks","QUESTION_ID":"Q50","F_REF":"1-135563187"} -{"ANSWERS":[{"_answerid":"Q51-S1-A1","_pairid":"98","__text":"After many years, diabetes can lead to serious health problems: - You could have eye problems, including trouble seeing (especially at night) and sensitivity to light. You could become blind. - Your feet and skin could develop sores and infections. If you have these sores for too long, your foot or leg may need to be amputated. Infection can also cause pain and itching. - Diabetes may make it harder to control your blood pressure and cholesterol. This can lead to heart attack, stroke, and other problems. It can become harder for blood to flow to the legs and feet. - Nerves in the body can become damaged, causing pain, itching, tingling, and numbness. - Because of nerve damage, you could have problems digesting the food you eat. You could feel weakness or have trouble going to the bathroom. Nerve damage can also make it harder for men to have an erection. - High blood sugar and other problems can lead to kidney damage. The kidneys may not work as well as they used to. They may even stop working, so that you would need dialysis or a kidney transplant."}],"SUB_QUESTION_ID":"Q51-S1","ANNOTATIONS.FOCUS":["type 1 diabetes"],"ANNOTATIONS.TYPE":"complication","SUBJECT":"diabetes","MESSAGE":"It was really helpful after reading about type 1 diabetes but would like some more suggestions from you .my friend is 35 year old and its been 1 year of his diabetes n his sugar level is around 100 or 120 OR SO.. each time he tests his sugar level. is there ANY COMPLICATIONS? HE ALSO GO FOR EXERCISES AND BLOOD TEST EVERY 2 OR 3 MONTHS N TAKES A PROPER DIET LIKE GREEN JUICE,OLIVE OIL AND ALL. WAITING FOR YOUR FEED BACK. THANK YOU.","QUESTION_ID":"Q51","F_REF":"1-122891932"} -{"ANSWERS":[{"_answerid":"Q52-S1-A1","_pairid":"99","__text":"If the underlying cause of burning mouth syndrome is determined, treatment is aimed at the triggering factor(s). If no cause can be found, treatment can be challenging. The following are potential therapies for burning mouth syndrome; we strongly recommend that you work with your health care provider in determining which therapy is right for you. A lozenge-type form of the anticonvulsant medication clonazepam (Klonopin) Oral thrush medications Medications that block nerve pan Certain antidepressants B vitamins Cognitive behavioral therapy Special oral rinses or mouth washes Saliva replacement products Capsaicin In addition to these medications, the following measures may be helpful in reducing symptoms of burning mouth syndrome: Sip water frequently Suck on ice chips Chew sugarless gum Avoid irritating substances like tobacco, hot or spicy foods, alcoholic beverages, mouthwashes that contain alcohol, and products high in acid, like citrus fruits and juices, as well as cinnamon or mint."}],"SUB_QUESTION_ID":"Q52-S1","ANNOTATIONS.FOCUS":["burning mouth syndrome"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"I just read an article submitted by you that stated your research shows that you've identified the mechanism that causes burning mouth syndrome. Also because of these findings you can find a treatment. I've had this for 15 yrs and am just holding on. When will a good treatment be available?? I belong to a group of over 500 bmsers. We're suffering terribly and were from all over the world. What would the treatment be?","QUESTION_ID":"Q52","F_REF":"15061"} -{"ANSWERS":[{"_answerid":"Q53-S1-A1","_pairid":"100","__text":"Low blood pressure occurs when blood pressure is much lower than normal. This means the heart, brain, and other parts of the body do not get enough blood. Normal blood pressure is usually between 90\/60 mmHg and 120\/80 mmHg. The medical name for low blood pressure is hypotension."},{"_answerid":"Q53-S1-A2","_pairid":"101","__text":"Summary You've probably heard that high blood pressure is a problem. Sometimes blood pressure that is too low can also cause problems. Blood pressure is the force of your blood pushing against the walls of your arteries. Each time your heart beats, it pumps out blood into the arteries. Your blood pressure is highest when your heart beats, pumping the blood. This is called systolic pressure. When your heart is at rest, between beats, your blood pressure falls. This is the diastolic pressure. Your blood pressure reading uses these two numbers. Usually they're written one above or before the other, such as 120\/80. If your blood pressure reading is 90\/60 or lower, you have low blood pressure. Some people have low blood pressure all the time. They have no symptoms and their low readings are normal for them. In other people, blood pressure drops below normal because of a medical condition or certain medicines. Some people may have symptoms of low blood pressure when standing up too quickly. Low blood pressure is a problem only if it causes dizziness, fainting or in extreme cases, shock. NIH: National Heart, Lung, and Blood Institute"},{"_answerid":"Q53-S1-A3","_pairid":"102","__text":"Hypotension (HI-po-TEN-shun) is abnormally low blood pressure. Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps out blood. Blood pressure is measured as systolic (sis-TOL-ik) and diastolic (di-a-STOL-ik) pressures. \"Systolic\" refers to blood pressure when the heart beats while pumping blood. \"Diastolic\" refers to blood pressure when the heart is at rest between beats. You most often will see blood pressure numbers written with the systolic number above or before the diastolic number, such as 120\/80 mmHg. (The mmHg is millimeters of mercury\u2014the units used to measure blood pressure.) Normal blood pressure in adults is lower than 120\/80 mmHg. Hypotension is blood pressure that's lower than 90\/60 mmHg. Overview Blood pressure doesn't stay the same all the time. It lowers as you sleep and rises when you wake up. Blood pressure also rises when you're excited, nervous, or active. Your body is very sensitive to changes in blood pressure. For example, if you stand up quickly, your blood pressure may drop for a short time. Your body adjusts your blood pressure to make sure enough blood and oxygen are flowing to your brain, kidneys, and other vital organs. Most forms of hypotension happen because your body can't bring blood pressure back to normal or can't do it fast enough. Some people have low blood pressure all the time. They have no signs or symptoms, and their low blood pressure is normal for them. In other people, certain conditions or factors cause abnormally low blood pressure. As a result, less blood and oxygen flow to the body's organs. For the most part, hypotension is a medical concern only if it causes signs or symptoms or is linked to a serious condition, such as heart disease. Signs and symptoms of hypotension may include dizziness, fainting, cold and sweaty skin, fatigue (tiredness), blurred vision, or nausea (feeling sick to your stomach). In extreme cases, hypotension can lead to shock. Outlook In a healthy person, low blood pressure without signs or symptoms usually isn't a problem and needs no treatment. If it causes signs or symptoms, your doctor will try to find and treat the condition that's causing it. Hypotension can be dangerous. It can make you fall because of dizziness or fainting. Shock, a severe form of hypotension, is a condition that's often fatal if not treated right away. With prompt and proper treatment, shock can be successfully treated."}],"SUB_QUESTION_ID":"Q53-S1","ANNOTATIONS.FOCUS":["hypotension"],"ANNOTATIONS.TYPE":"information","SUBJECT":"Hypotension","MESSAGE":"I'm looking for books about hypotension\/low blood pressure. Can you suggest any that I might be able to purchase?","QUESTION_ID":"Q53","F_REF":"13600"} -{"ANSWERS":[{"_answerid":"Q54-S1-A1","_pairid":"106","__text":"The goal of treatment is to reduce symptoms and speed healing. If your symptoms are mild, you may not need treatment. Treatments may include: - Antihistamines - Medicines that calm down the immune system (in severe cases) - Lidocaine mouthwashes to numb the area and make eating more comfortable (for mouth sores) - Topical corticosteroids or oral corticosteroids to reduce swelling and lower immune responses - Corticosteroid shots into a sore - Vitamin A as a cream or taken by mouth - Other medicines that are applied to the skin - Dressings placed over your skin with medicines to keep you from scratching - Ultraviolet light therapy"}],"SUB_QUESTION_ID":"Q54-S1","ANNOTATIONS.FOCUS":["lichen planus"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"I have been suffering from lichen planus since last four years. Some time it reduces the red sign and sometime it increases and I cannot take spicy food or hot food. Could you please suggest the remedies. I had consulted the dermatologist also .He gave me some ointment named as clone taxol for applying towards the read area. Awaiting your valuable advise I this behalf. With kind regards. Sent from my iPad","QUESTION_ID":"Q54","F_REF":"1-131441708"} -{"ANSWERS":[{"_answerid":"Q55-S1-A1","_pairid":"107","__text":"Distal renal tubular acidosis is a disease that occurs when the kidneys do not properly remove acids from the blood into the urine. As a result, too much acid remains in the blood (called acidosis)."}],"SUB_QUESTION_ID":"Q55-S1","ANNOTATIONS.FOCUS":["distal renal tubular acidosis"],"ANNOTATIONS.TYPE":"information","SUBJECT":"know more about","MESSAGE":"My Daughter have Distal renal tubular acidosis. we are from Mexico, and we ae woundering if can send to us more infomation. maybe you can reccommend to us a association???? i don?t know","QUESTION_ID":"Q55","F_REF":"NF_272"} -{"ANSWERS":[{"_answerid":"Q56-S1-A1","_pairid":"109","__text":"Klinefelter syndrome is a genetic condition that occurs in males when they have an extra X chromosome."},{"_answerid":"Q56-S1-A2","_pairid":"110","__text":"Summary Klinefelter syndrome (KS) is a condition that occurs in men who have an extra X chromosome. The syndrome can affect different stages of physical, language, and social development. The most common symptom is infertility. Boys may be taller than other boys their age, with more fat around the belly. After puberty, KS boys may have - Smaller testes and penis - Breast growth - Less facial and body hair - Reduced muscle tone - Narrower shoulders and wider hips - Weaker bones - Decreased sexual interest - Lower energy KS males may have learning or language problems. They may be quiet and shy and have trouble fitting in. A genetic test can diagnose KS. There is no cure, but treatments are available. It is important to start treatment as early as possible. With treatment, most boys grow up to have normal lives. Treatments include testosterone replacement therapy and breast reduction surgery. If needed, physical, speech, language, and occupational therapy may also help. NIH: National Institute of Child Health and Human Development"},{"_answerid":"Q56-S1-A3","_pairid":"112","__text":"Klinefelter syndrome is a chromosomal condition that affects male physical and cognitive development. Its signs and symptoms vary among affected individuals. Affected individuals typically have small testes that do not produce as much testosterone as usual. Testosterone is the hormone that directs male sexual development before birth and during puberty. A shortage of testosterone can lead to delayed or incomplete puberty, breast enlargement (gynecomastia), reduced facial and body hair, and an inability to have biological children (infertility). Some affected individuals also have genital differences including undescended testes (cryptorchidism), the opening of the urethra on the underside of the penis (hypospadias), or an unusually small penis (micropenis). Older children and adults with Klinefelter syndrome tend to be taller than their peers. Compared with unaffected men, adults with Klinefelter syndrome have an increased risk of developing breast cancer and a chronic inflammatory disease called systemic lupus erythematosus. Their chance of developing these disorders is similar to that of women in the general population. Children with Klinefelter syndrome may have learning disabilities and delayed speech and language development. They tend to be quiet, sensitive, and unassertive, but personality characteristics vary among affected individuals."}],"SUB_QUESTION_ID":"Q56-S1","ANNOTATIONS.FOCUS":["klinefelter syndrome"],"ANNOTATIONS.TYPE":"information","SUBJECT":"Klinefelter Syndrome","MESSAGE":"I would like to learn more about my condition. Please send me any literature you feel I could use. thanks, [NAME]","QUESTION_ID":"Q56","F_REF":"1-132454692"} -{"ANSWERS":[{"_answerid":"Q57-S1-A1","_pairid":"118","__text":"It may take 4 weeks or longer before you feel the full benefit of bupropion. Continue to take bupropion even if you feel well. Do not stop taking bupropion without talking to your doctor. Your doctor may decrease your dose gradually."}],"SUB_QUESTION_ID":"Q57-S1","ANNOTATIONS.FOCUS":["Wellbutrin"],"ANNOTATIONS.TYPE":"tapering","SUBJECT":"Decreasing Wellbutrin HCL XL","MESSAGE":"Hello, I'm not sure if this is something you can help me with, but I thought that I would ask, as your organization is affiliated with trusted mental health and general health organizations. I was recently taken off of Wellbutrin HCL XL completely without any tapering. I'm having a difficult time finding out online if this is safe (to \"go cold turkey\") or if I should have been given the medication in slowly-decreasing doses. Can you please offer some guidance? Thank you. [NAME]","QUESTION_ID":"Q57","F_REF":"1-122992555"} -{"ANSWERS":[{"_answerid":"Q58-S1-A1","_pairid":"119","__text":"To get rid of lice, take the following important steps: - Bathe regularly to get rid of lice and their eggs. - Change your clothes often. - Wash clothes in hot water (at least 130\u00b0F\/54\u00b0C) and machine dry using the hot cycle.\u00a0 - Items that can't be washed, such as stuffed toys, mattresses, or furniture, can be thoroughly vacuumed to get rid of lice and eggs that have fallen off the body. Your provider may prescribe a skin cream or a wash that contains permethrin, malathione, or benzyl alcohol. If your case is severe, the provider may prescribe medicine that you take by mouth."}],"SUB_QUESTION_ID":"Q58-S1","ANNOTATIONS.FOCUS":["body lice"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"Body Lice","MESSAGE":"How do I get rid of these little devils? Me and My mom have tried so many things to get rid of these bugs and they just don't go away were the family that takes 2 showers and now about 3 showers a day we never understood how they could have infected us but I was just wondering is washing our clothes the best bet to get rid of these things, because apparently it hasn't worked for us. So is there any suggestions?","QUESTION_ID":"Q58","F_REF":"17014"} -{"ANSWERS":[{"_answerid":"Q59-S1-A1","_pairid":"122","__text":"The goal of treatment is to reduce the amount of copper in the tissues. This is done by a procedure called chelation -- certain medications can bind to copper and help remove it through the kidneys or gut. Treatment must be lifelong. The following medications may be used: - Penicillamine (Cuprimine, Depen) binds to copper and leads to increased release of copper in the urine. - Trientine (Syprine) binds (chelates) the copper and increases its release through the urine. - Zinc acetate (Galzin) blocks copper from being absorbed in the intestinal tract. Vitamin E supplements may also be used. Sometimes, medications that chelate copper (especially penicillamine) can affect the function of the brain and nervous system (neurological function). Other medications under investigation may bind copper without affecting neurological function. A low-copper diet may also be recommended. Foods to avoid include: - Chocolate - Dried fruit - Liver - Mushrooms - Nuts - Shellfish You may want to drink distilled water because most tap water flows through copper pipes. Avoid using copper cooking utensils. Symptoms may be treated with exercise or physical therapy. People who are confused or unable to care for themselves may need special protective measures. A liver transplant may be considered in cases where the liver is severely damaged by the disease."},{"_answerid":"Q59-S1-A2","_pairid":"124","__text":"These resources address the diagnosis or management of Wilson disease: - Gene Review: Gene Review: Wilson Disease - Genetic Testing Registry: Wilson's disease - MedlinePlus Encyclopedia: Wilson's disease - National Human Genome Research Institute These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"}],"SUB_QUESTION_ID":"Q59-S1","ANNOTATIONS.FOCUS":["wilson's disease"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"ClinicalTrials.gov - Suggestion","MESSAGE":"We appreciate your response. My son is 24 years old. We cannot find any drugs, treatments as well as hospitals to fight against Wilson's disease in Mongolia. Currently there is only person with Wilson's disease in Mongolia who is my son. We cannot find anything good to help my son at the moment. Therefore, we need somewhere where my son can get help. We are also lack of financial condition to support full treatment for my son. However, we wish to have good medication with less expense if possible. We want to get diagnosed my son's other infected organs and want to know how we can help to get them recovered well. Regards","QUESTION_ID":"Q59","F_REF":"1-135658132"} -{"ANSWERS":[{"_answerid":"Q60-S1-A1","_pairid":"125","__text":"There is no specific treatment for scleroderma. Your provider will assess the extent of disease in the lungs, kidneys, heart, and gastrointestinal tract. You will be prescribed medicines and other treatments to control your symptoms and prevent complications. Medicines used to treat scleroderma include: - Corticosteroids such as prednisone. Doses above 10 mg per day are not recommended. - Drugs that suppress the immune system such as methotrexate - Nonsteroidal anti-inflammatory drugs (NSAIDs) Other treatments for specific symptoms may include: - Medicines for heartburn or swallowing problems - Blood pressure medicines (such as ACE inhibitors) for high blood pressure or kidney problems - Light therapy to relieve skin thickening - Medicines to improve breathing (bosentan) - Treatments to improve Raynaud phenomenon, including medicines, gloves to keep the hands warm, and avoiding smoking Treatment often involves physical therapy as well."},{"_answerid":"Q60-S1-A2","_pairid":"126","__text":"Currently, there is not a cure for scleroderma, however treatments are available to relieve symptoms and limit damage. Treatment will vary depending on your symptoms."},{"_answerid":"Q60-S1-A3","_pairid":"127","__text":"These resources address the diagnosis or management of systemic scleroderma: - Cedars-Sinai Medical Center - Genetic Testing Registry: Scleroderma, familial progressive - University of Maryland Medical Center These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"}],"SUB_QUESTION_ID":"Q60-S1","ANNOTATIONS.FOCUS":["systemic sclerosis"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"Scleroderma (Systemic Sclerosis). i am 22yrs now and was 18th when i was detected with the disease in [DATE] 2010 after the conduction of Biopsy. there after i had taken PSS- Pulse for Systemic Sclerosis in which i was given Solumedrol for 9 months. and then after a gap of 6 months since the disease activity progressed i was given PSS again -Dexa for 3 months. along with this i am under medication with medicines as follows Depin, HCQS, Antoxid, Cyra, Omnacortil and Folitrax(weekly on saturdays and sundays). currently am under PSS which is done once in Every 6 months. but i am getting bad digital ulcers on my fingure tips on hands and legs both. i seriously need your help for this as to what else treatment can be done to it. please revert back soon","QUESTION_ID":"Q60","F_REF":"30"} -{"ANSWERS":[{"_answerid":"Q61-S1-A1","_pairid":"128","__text":"The goal of treatment is to relieve symptoms. - The underlying cause of the ulcer should be treated if it is known. - Gently cleaning your mouth and teeth may help relieve your symptoms. - Medicines that you rub directly on the ulcer such as antihistamines, antacids, and corticosteroids may help soothe discomfort. - Avoid hot or spicy foods until the ulcer is healed."}],"SUB_QUESTION_ID":"Q61-S1","ANNOTATIONS.FOCUS":["mouth ulcer"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"how to remove my mouth ulcer\/canker","MESSAGE":"Hello dear Dr, i am an afghan student in [LOCATION], the mouth ulcer problem is the worst problem in my lifetime, even three or four times the ulcer grow up in the mouth during of a month. even i can not eat or drink, even though i take care of my mouth every day, so i wish you to consult me about of removing of these ulcer forever. thank you so much","QUESTION_ID":"Q61","F_REF":"14801"} -{"ANSWERS":[{"_answerid":"Q62-S1-A1","_pairid":"129","__text":"If you have low vision, eyeglasses, contact lenses, medicine, or surgery may not help. Activities like reading, shopping, cooking, writing, and watching TV may be hard to do. The leading causes of low vision and blindness in the United States are age-related eye diseases: macular degeneration, cataract and glaucoma. Other eye disorders, eye injuries, and birth defects can also cause vision loss. Whatever the cause, lost vision cannot be restored. It can, however, be managed. A loss of vision means that you may have to reorganize your life and learn new ways of doing things. If you have some vision, visual aids such as special glasses and large print books can make life easier. There are also devices to help those with no vision, like text-reading software and braille books. The sooner vision loss or eye disease is found and treated, the greater your chances of keeping your remaining vision. You should have regular comprehensive eye exams by an eye care professional."}],"SUB_QUESTION_ID":"Q62-S1","ANNOTATIONS.FOCUS":["visual impairment"],"ANNOTATIONS.TYPE":"information","SUBJECT":"Visual impairment","MESSAGE":"Dear Sir, My mother is 80 years old. Her eye sight has nearly vanished. Years back left eye sight ended due to optical nerve rupture. On the right eye a white growth has now covered almost the whole retina. The specialists say that this growth is a result of eye surgeries she got years back and now there is no solution for this. Now she can hardly see the shadow things lying very close to her. I would be grateful if you kindly guide me if there is any solution for this. Thanks","QUESTION_ID":"Q62","F_REF":"1-123361245"} -{"ANSWERS":[{"_answerid":"Q63-S1-A1","_pairid":"130","__text":"Clubfoot is when the foot turns inward and downward. It is a congenital condition, which means it is present at birth."},{"_answerid":"Q63-S1-A2","_pairid":"131","__text":"Talipes equinovarus is a congenital (present from birth) condition where the foot turns inward and downward. The cause of this condition is not known, although it may be passed down through families in some cases. This condition occurs in about 1 out of every 1,000 births. Treatment may involve moving the foot into the correct position and using a cast to keep it there. This process is done in small increments over a period of time. In severe cases, surgery may be needed."}],"SUB_QUESTION_ID":"Q63-S1","ANNOTATIONS.FOCUS":["clubfoot"],"ANNOTATIONS.TYPE":"information","SUBJECT":"list of questions","MESSAGE":"I have a list of questions about Tay sachs disease and clubfoot 1. what is TSD\/Clubfoot, and how does it effect a baby 2. what causes both? can it be prevented, treated, or cured 3. How common is TSD? how common is Clubfoot 4. How can your "agency" help a women\/couple who are concerned about this congenital condition, and is there a cost? If you can answer these few questions I would be thankful, please get back as soon as you can.","QUESTION_ID":"Q63","F_REF":"12748"} -{"ANSWERS":[{"_answerid":"Q63-S2-A1","_pairid":"132","__text":"Clubfoot is the most common congenital disorder of the legs. It can range from mild and flexible to severe and rigid. The cause is not known, but the condition may be passed down through families in some cases. Risk factors include a family history of the disorder and being male. The condition occurs in about 1 out of every 1,000 live births."}],"SUB_QUESTION_ID":"Q63-S2","ANNOTATIONS.FOCUS":["clubfoot"],"ANNOTATIONS.TYPE":"cause","SUBJECT":"list of questions","MESSAGE":"I have a list of questions about Tay sachs disease and clubfoot 1. what is TSD\/Clubfoot, and how does it effect a baby 2. what causes both? can it be prevented, treated, or cured 3. How common is TSD? how common is Clubfoot 4. How can your "agency" help a women\/couple who are concerned about this congenital condition, and is there a cost? If you can answer these few questions I would be thankful, please get back as soon as you can.","QUESTION_ID":"Q63","F_REF":"12748"} -{"ANSWERS":[{"_answerid":"Q63-S3-A1","_pairid":"133","__text":"Treatment may involve moving the foot into the correct position and using a cast to keep it there. This is often done by an orthopedic specialist. Treatment should be started as early as possible -- ideally, shortly after birth -- when it is easiest to\u00a0reshape the foot. Gentle stretching and recasting\u00a0will be done\u00a0every week to improve the position of the foot. Generally, five to 10 casts are needed. The final cast\u00a0will stay\u00a0in place for 3 weeks. After the foot is in the correct position, the child will wear a special brace nearly full time for 3 months. Then, the child will wear the brace at night and during naps for up to 3 years. Often, the problem is a tightened Achilles tendon, and a simple procedure is needed to release it. Some severe cases of clubfoot will\u00a0need surgery if other treatments do not work, or if the problem returns. The child should be monitored by a\u00a0health care provider\u00a0until the foot is fully grown. See: Clubfoot repair"}],"SUB_QUESTION_ID":"Q63-S3","ANNOTATIONS.FOCUS":["clubfoot"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"list of questions","MESSAGE":"I have a list of questions about Tay sachs disease and clubfoot 1. what is TSD\/Clubfoot, and how does it effect a baby 2. what causes both? can it be prevented, treated, or cured 3. How common is TSD? how common is Clubfoot 4. How can your "agency" help a women\/couple who are concerned about this congenital condition, and is there a cost? If you can answer these few questions I would be thankful, please get back as soon as you can.","QUESTION_ID":"Q63","F_REF":"12748"} -{"ANSWERS":[{"_answerid":"Q63-S4-A1","_pairid":"134","__text":"Tay-Sachs disease is a life-threatening disease of the nervous system passed down through families."},{"_answerid":"Q63-S4-A2","_pairid":"135","__text":"Summary Tay-Sachs disease is a rare, inherited disorder. It causes too much of a fatty substance to build up in the brain. This buildup destroys nerve cells, causing mental and physical problems. Infants with Tay-Sachs disease appear to develop normally for the first few months of life. Then mental and physical abilities decline. The child becomes blind, deaf, and unable to swallow. Muscles begin to waste away and paralysis sets in. Even with the best of care, children with Tay-Sachs disease usually die by age 4. The cause is a gene mutation which is most common in Eastern European Ashkenazi Jews. To get the disease, both parents must have the gene. If they do, there is a 25% chance of the child having the disease. A blood test and prenatal tests can check for the gene or the disease. There is no cure. Medicines and good nutrition can help some symptoms. Some children need feeding tubes. NIH: National Institute of Neurological Disorders and Stroke"},{"_answerid":"Q63-S4-A3","_pairid":"136","__text":"Tay-Sachs disease is a rare inherited disorder that causes progressive destruction of nerve cells in the brain and spinal cord. Tay-Sachs is caused by the absence of a vital enzyme called hexosaminidase-A (Hex-A). Without Hex-A, a fatty substance, or lipid, called GM2 ganglioside accumulates abnormally in cells, especially in the nerve cells of the brain. This ongoing accumulation causes progressive damage to the cells. Tay-Sachs disease is inherited in an autosomal recessive pattern."},{"_answerid":"Q63-S4-A4","_pairid":"137","__text":"Tay-Sachs disease is a rare inherited disorder that progressively destroys nerve cells (neurons) in the brain and spinal cord. The most common form of Tay-Sachs disease becomes apparent in infancy. Infants with this disorder typically appear normal until the age of 3 to 6 months, when their development slows and muscles used for movement weaken. Affected infants lose motor skills such as turning over, sitting, and crawling. They also develop an exaggerated startle reaction to loud noises. As the disease progresses, children with Tay-Sachs disease experience seizures, vision and hearing loss, intellectual disability, and paralysis. An eye abnormality called a cherry-red spot, which can be identified with an eye examination, is characteristic of this disorder. Children with this severe infantile form of Tay-Sachs disease usually live only into early childhood. Other forms of Tay-Sachs disease are very rare. Signs and symptoms can appear in childhood, adolescence, or adulthood and are usually milder than those seen with the infantile form. Characteristic features include muscle weakness, loss of muscle coordination (ataxia) and other problems with movement, speech problems, and mental illness. These signs and symptoms vary widely among people with late-onset forms of Tay-Sachs disease."}],"SUB_QUESTION_ID":"Q63-S4","ANNOTATIONS.FOCUS":["tsd"],"ANNOTATIONS.TYPE":"information","SUBJECT":"list of questions","MESSAGE":"I have a list of questions about Tay sachs disease and clubfoot 1. what is TSD\/Clubfoot, and how does it effect a baby 2. what causes both? can it be prevented, treated, or cured 3. How common is TSD? how common is Clubfoot 4. How can your "agency" help a women\/couple who are concerned about this congenital condition, and is there a cost? If you can answer these few questions I would be thankful, please get back as soon as you can.","QUESTION_ID":"Q63","F_REF":"12748"} -{"ANSWERS":[{"_answerid":"Q63-S5-A1","_pairid":"138","__text":"Tay-Sachs disease occurs when the body lacks hexosaminidase A. This is a protein that helps break down a group of chemicals found in nerve tissue called gangliosides. Without this protein, gangliosides, particularly ganglioside GM2, build up in cells, especially nerve cells in the brain. Tay-Sachs disease is caused by a defective gene on chromosome 15. When both parents carry the defective Tay-Sachs gene, a child has a 25% chance of developing the disease. The child must receive two copies of the defective gene, one from each parent, in order to become sick. If only one parent passes the defective gene to the child, the child is called a carrier. They will not be sick, but may pass the disease to their own children. Anyone can be a carrier of Tay-Sachs. But, the disease is most common among the Ashkenazi Jewish population. 1 in every 27 members of the population carries the Tay-Sachs gene. Tay-Sachs is divided into infantile, juvenile, and adult forms, depending on the symptoms and when they first appear. Most people with Tay-Sachs have the infantile form. In this form, the nerve damage usually begins while the baby is still in the womb. Symptoms usually appear when the child is 3 to 6 months old. The disease tends to get worse very quickly, and the child usually dies by age 4 or 5. Late-onset Tay-Sachs disease, which affects adults, is very rare."}],"SUB_QUESTION_ID":"Q63-S5","ANNOTATIONS.FOCUS":["tsd"],"ANNOTATIONS.TYPE":"cause","SUBJECT":"list of questions","MESSAGE":"I have a list of questions about Tay sachs disease and clubfoot 1. what is TSD\/Clubfoot, and how does it effect a baby 2. what causes both? can it be prevented, treated, or cured 3. How common is TSD? how common is Clubfoot 4. How can your "agency" help a women\/couple who are concerned about this congenital condition, and is there a cost? If you can answer these few questions I would be thankful, please get back as soon as you can.","QUESTION_ID":"Q63","F_REF":"12748"} -{"ANSWERS":[{"_answerid":"Q63-S6-A1","_pairid":"139","__text":"There is no known way to prevent this disorder. Genetic testing can detect if you are a carrier of the gene for this disorder. If you or your partner are from an at-risk population, it is recommended that you undergo testing before starting a family. Testing the amniotic fluid can diagnose Tay-Sachs disease in the womb."}],"SUB_QUESTION_ID":"Q63-S6","ANNOTATIONS.FOCUS":["tsd"],"ANNOTATIONS.TYPE":"prevention","SUBJECT":"list of questions","MESSAGE":"I have a list of questions about Tay sachs disease and clubfoot 1. what is TSD\/Clubfoot, and how does it effect a baby 2. what causes both? can it be prevented, treated, or cured 3. How common is TSD? how common is Clubfoot 4. How can your "agency" help a women\/couple who are concerned about this congenital condition, and is there a cost? If you can answer these few questions I would be thankful, please get back as soon as you can.","QUESTION_ID":"Q63","F_REF":"12748"} -{"ANSWERS":[{"_answerid":"Q63-S7-A1","_pairid":"140","__text":"There is no treatment for Tay-Sachs disease itself, only ways to make the person more comfortable."},{"_answerid":"Q63-S7-A2","_pairid":"141","__text":"Although several attempts have been made at purified enzyme replacement therapy for children with Tay-Sachs disease, none has been successful. Cellular infusions and even bone marrow transplantation have been attempted with no evidence of benefit. Because no specific treatment is available for Tay-Sachs disease, treatment is directed at the symptoms and major associated conditions. Treatment is supportive and aimed at providing adequate nutrition and hydration. The airway must be protected. Seizures can be controlled initially with conventional anticonvulsant medications such as benzodiazepines, phenytoins, and\/or barbiturates, but the progressive nature of the disease may require alteration of dosage or medication. Infectious diseases should be managed. In advanced disease, good bowel movement should be maintained and severe constipation should be avoided. Good hydration, food additives, stool softeners, laxatives, and other measures should be employed to avoid severe constipation."},{"_answerid":"Q63-S7-A3","_pairid":"142","__text":"These resources address the diagnosis or management of Tay-Sachs disease: - Gene Review: Gene Review: Hexosaminidase A Deficiency - Genetic Testing Registry: Tay-Sachs disease - MedlinePlus Encyclopedia: Tay-Sachs Disease These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"}],"SUB_QUESTION_ID":"Q63-S7","ANNOTATIONS.FOCUS":["tsd"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"list of questions","MESSAGE":"I have a list of questions about Tay sachs disease and clubfoot 1. what is TSD\/Clubfoot, and how does it effect a baby 2. what causes both? can it be prevented, treated, or cured 3. How common is TSD? how common is Clubfoot 4. How can your "agency" help a women\/couple who are concerned about this congenital condition, and is there a cost? If you can answer these few questions I would be thankful, please get back as soon as you can.","QUESTION_ID":"Q63","F_REF":"12748"} -{"ANSWERS":[{"_answerid":"Q64-S1-A1","_pairid":"143","__text":"Treatment depends on many things: - The cause of scoliosis - Where the curve is in your spine - How big the curve is - If your body is still growing Most people with idiopathic scoliosis do not need treatment. But you should still be checked by a doctor about every 6 months. If you are still growing, your doctor might recommend a back brace. A back brace prevents further curving. There are many different types of braces. What kind you get depends on the size and location of your curve. Your provider will pick the best one for you and show you how to use it. Back braces can be adjusted as you grow. Back braces work best in people over age 10. Braces do not work for those with congenital or neuromuscular scoliosis. You may need surgery if the spine curve is severe or getting worse very quickly. Surgery involves correcting the curve as much as possible: - Surgery is done with a cut through the back, belly area, or beneath the ribs. - The spine bones are held in place with 1 or 2 metal rods. The rods are held down with hooks and screws until the bone heals together. - After surgery, you may need to wear a brace for a while to keep the spine still. Scoliosis treatment may also include: - Emotional support: Some children, especially teens, may be self-conscious when using a back brace. - Physical therapy and other specialists to help explain the treatments and make sure the brace fits correctly."}],"SUB_QUESTION_ID":"Q64-S1","ANNOTATIONS.FOCUS":["scoliosis"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"Hello, I have a scoliosis problem plz help me I want its treatment I can send my x.ray also *** This message has been sent using QMobile A2 Classic ***","QUESTION_ID":"Q64","F_REF":"1-135366282"} -{"ANSWERS":[{"_answerid":"Q65-S1-A1","_pairid":"144","__text":"A substance called plaque can build up in the walls of your coronary arteries. This plaque is made up of cholesterol and other cells. A heart attack may occur when: - A tear in the plaque occurs. This triggers blood platelets and other substances to form a blood a clot at the site that blocks most or all of the oxygen-carrying blood from flowing to a part of the heart muscle. This is the most common cause of heart attack. - A slow buildup of plaque may narrow one of the coronary arteries so that it is almost blocked. In either case, there is not enough blood flow to the heart muscle and heart muscle dies. The cause of heart attack is not always known. Heart attack may occur: - When you are resting or asleep - After a sudden increase in physical activity - When you are active outside in cold weather - After sudden, severe emotional or physical stress, including an illness Many risk factors may lead to the development of plaque buildup and a heart attack."},{"_answerid":"Q65-S1-A2","_pairid":"145","__text":"Coronary Heart Disease A heart attack happens if the flow of oxygen-rich blood to a section of heart muscle suddenly becomes blocked and the heart can't get oxygen. Most heart attacks occur as a result of coronary heart disease (CHD). CHD is a condition in which a waxy substance called plaque builds up inside of the coronary arteries. These arteries supply oxygen-rich blood to your heart. When plaque builds up in the arteries, the condition is called atherosclerosis. The buildup of plaque occurs over many years. Eventually, an area of plaque can rupture (break open) inside of an artery. This causes a blood clot to form on the plaque's surface. If the clot becomes large enough, it can mostly or completely block blood flow through a coronary artery. If the blockage isn't treated quickly, the portion of heart muscle fed by the artery begins to die. Healthy heart tissue is replaced with scar tissue. This heart damage may not be obvious, or it may cause severe or long-lasting problems. Coronary Artery Spasm A less common cause of heart attack is a severe spasm (tightening) of a coronary artery. The spasm cuts off blood flow through the artery. Spasms can occur in coronary arteries that aren't affected by atherosclerosis. What causes a coronary artery to spasm isn't always clear. A spasm may be related to: Taking certain drugs, such as cocaine Emotional stress or pain Exposure to extreme cold Cigarette smoking The animation below shows how plaque buildup or a coronary artery spasm can lead to a heart attack. Click the \"start\" button to play the animation. Written and spoken explanations are provided with each frame. Use the buttons in the lower right corner to pause, restart, or replay the animation, or use the scroll bar below the buttons to move through the frames. The animation shows how blocked blood flow in a coronary artery can lead to a heart attack."},{"_answerid":"Q65-S1-A3","_pairid":"146","__text":"Most heart attacks are caused by a blood clot that blocks one of the coronary arteries, the blood vessels that bring blood and oxygen to the heart muscle. When blood cannot reach part of your heart, that area starves for oxygen. If the blockage continues long enough, cells in the affected area die. The Most Common Cause Coronary heart disease (CHD)is the most common underlying cause of a heart attack. CHD, also called coronary artery disease, is the hardening and narrowing of the coronary arteries caused by the buildup of plaque inside the walls of the arteries. When plaque builds up in the arteries, the condition is called atherosclerosis (ath-er-o-skler-O-sis). The buildup of plaque occurs over many years. Over time, an area of plaque can rupture (break open) inside of an artery. This causes a blood clot to form on the plaque's surface. If the clot becomes large enough, it can mostly or completely block blood flow through a coronary artery. If the blockage isn't treated quickly, the portion of heart muscle fed by the artery begins to die. Healthy heart tissue is replaced with scar tissue. This heart damage may not be obvious, or it may cause severe or long-lasting problems. Other Causes Heart attack also can occur due to problems with the very small, microscopic blood vessels of the heart. This condition is called microvascular disease. It's believed to be more common in women than in men. A less common cause of heart attacks is a severe spasm or tightening of the coronary artery that cuts off blood flow to the heart. These spasms can occur in persons with or without coronary artery disease. What causes a coronary artery to spasm isn't always clear. A spasm may be related to emotional stress or pain, exposure to extreme cold, cigarette smoking, or by taking certain drugs like cocaine. Risk Factors You Cannot Change Certain factors make it more likely that you will develop coronary artery disease and have a heart attack. These risk factors include some things you cannot change. If you are a man over age 45 or a woman over age 55, you are at greater risk. Having a family history of early heart disease, diagnosed in a father or brother before age 55 or in a mother or sister before age 65, is another risk factor. You are also at risk if you have a personal history of angina or previous heart attack, or if you have had a heart procedure such as percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG). Risk Factors You Can Change Importantly, there are many risk factors that you can change. These include - smoking - being overweight or obese - physical inactivity - high blood pressure - high blood cholesterol - high blood sugar due to insulin resistance or diabetes - an unhealthy diet (for example, a diet high in saturated fat, trans fat, cholesterol, and sodium). smoking being overweight or obese physical inactivity high blood pressure high blood cholesterol high blood sugar due to insulin resistance or diabetes an unhealthy diet (for example, a diet high in saturated fat, trans fat, cholesterol, and sodium). Metabolic Syndrome Some of these risk factors\u2014such as obesity, high blood pressure, and high blood sugar\u2014tend to occur together. When they do, it's called metabolic syndrome. In general, a person with metabolic syndrome is twice as likely to develop heart disease and five times as likely to develop diabetes as someone without metabolic syndrome."}],"SUB_QUESTION_ID":"Q65-S1","ANNOTATIONS.FOCUS":["heart attack"],"ANNOTATIONS.TYPE":"cause","SUBJECT":"EAR LOBE CREASES","MESSAGE":"Are ear lobe creases always heart disease and 100% heart attack pending? What are other causes? I'm 56 have pierced ears but haven't wore earrings in years. In the last 7 years I rarely eat meat and when I do it's chicken or fish maybe beef every 5 years or so and its maybe a hamburger lean. If you do have arteriosclerosis is there anyway to reverse it?","QUESTION_ID":"Q65","F_REF":"NF_197"} -{"ANSWERS":[{"_answerid":"Q65-S2-A1","_pairid":"147","__text":"Treatments for atherosclerosis may include heart-healthy lifestyle changes, medicines, and medical procedures or surgery. The goals of treatment include: Lowering the risk of blood clots forming Preventing atherosclerosis-related diseases Reducing risk factors in an effort to slow or stop the buildup of plaque Relieving symptoms Widening or bypassing plaque-clogged arteries Heart-Healthy Lifestyle Changes Your doctor may recommend heart-healthy lifestyle changes if you have atherosclerosis. Heart-healthy lifestyle changes include heart-healthy eating, aiming for a healthy weight, managing stress, physical activity and quitting smoking. Medicines Sometimes lifestyle changes alone aren\u2019t enough to control your cholesterol levels. For example, you also may need statin medications to control or lower your cholesterol. By lowering your blood cholesterol level, you can decrease your chance of having a heart attack or stroke. Doctors usually prescribe statins for people who have: Coronary heart disease, peripheral artery disease, or had a prior stroke Diabetes High LDL cholesterol levels Doctors may discuss beginning statin treatment with people who have an elevated risk for developing heart disease or having a stroke. Your doctor also may prescribe other medications to: Lower your blood pressure Lower your blood sugar levels Prevent blood clots, which can lead to heart attack and stroke Prevent inflammation Take all medicines regularly, as your doctor prescribes. Don\u2019t change the amount of your medicine or skip a dose unless your doctor tells you to. You should still follow a heart healthy lifestyle, even if you take medicines to treat your atherosclerosis. Medical Procedures and Surgery If you have severe atherosclerosis, your doctor may recommend a medical procedure or surgery. Percutaneous coronary intervention (PCI), also known as coronary angioplasty, is a procedure that\u2019s used to open blocked or narrowed coronary (heart) arteries. PCI can improve blood flow to the heart and relieve chest pain. Sometimes a small mesh tube called a stent is placed in the artery to keep it open after the procedure. Coronary artery bypass grafting (CABG) is a type of surgery. In CABG, arteries or veins from other areas in your body are used to bypass or go around your narrowed coronary arteries. CABG can improve blood flow to your heart, relieve chest pain, and possibly prevent a heart attack. Bypass grafting also can be used for leg arteries. For this surgery, a healthy blood vessel is used to bypass a narrowed or blocked artery in one of the legs. The healthy blood vessel redirects blood around the blocked artery, improving blood flow to the leg. Carotid endarterectomy is a type of surgery to remove plaque buildup from the carotid arteries in the neck. This procedure restores blood flow to the brain, which can help prevent a stroke."}],"SUB_QUESTION_ID":"Q65-S2","ANNOTATIONS.FOCUS":["arteriosclerosis"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"EAR LOBE CREASES","MESSAGE":"Are ear lobe creases always heart disease and 100% heart attack pending? What are other causes? I'm 56 have pierced ears but haven't wore earrings in years. In the last 7 years I rarely eat meat and when I do it's chicken or fish maybe beef every 5 years or so and its maybe a hamburger lean. If you do have arteriosclerosis is there anyway to reverse it?","QUESTION_ID":"Q65","F_REF":"NF_197"} -{"ANSWERS":[{"_answerid":"Q66-S1-A1","_pairid":"148","__text":"Worldwide, cervical cancer is the third most common type of cancer in women. It is much less common in the United States because of the routine use of Pap smears. Cervical cancer starts in the cells on the surface of the cervix. There are two types of cells on the surface of the cervix, squamous and columnar. Most cervical cancers are from squamous cells. Cervical cancer usually develops slowly. It starts as a precancerous condition called dysplasia. This condition can be detected by a Pap smear and is 100% treatable. It can take years for dysplasia to develop into cervical cancer. Most women who are diagnosed with cervical cancer today have not had regular Pap smears, or they have not followed up on abnormal Pap smear results. Almost all cervical cancers are caused by HPV (human papillomavirus). HPV is a common virus that is spread through sexual intercourse. There are many different types (strains) of HPV. Some strains lead to cervical cancer. Other strains can cause genital warts. Others do not cause any problems at all. A woman's sexual habits and patterns can increase her risk of developing cervical cancer. Risky sexual practices include: - Having sex at an early age - Having multiple sexual partners - Having a partner or many partners who take part in high-risk sexual activities Other risk factors for cervical cancer include: - Not getting the HPV vaccine - Being economically disadvantaged - Having a mother who took the drug diethylstilbestrol (DES) during pregnancy in the early 1960s to prevent miscarriage - Having a weakened immune system"}],"SUB_QUESTION_ID":"Q66-S1","ANNOTATIONS.FOCUS":["cervical cancer"],"ANNOTATIONS.TYPE":"cause","SUBJECT":"Cervical Cancer","MESSAGE":"Can a long term untreated bladder infection aid in the cause of cervical cancer? And can the fact that my mom has cervical cancer aid in my chance of getting cervical cancer?","QUESTION_ID":"Q66","F_REF":"13629"} -{"ANSWERS":[{"_answerid":"Q67-S1-A1","_pairid":"149","__text":"The goal of treatment is to relieve symptoms. In some cases of IBS, lifestyle changes can help. For example, regular exercise and improved sleep habits may reduce anxiety and help relieve bowel symptoms. Dietary changes can be helpful. However, no specific diet can be recommended for IBS because the condition differs from one person to another. The following changes may help: - Avoiding foods and drinks that stimulate the intestines (such as caffeine, tea, or colas) - Eating smaller meals - Increasing fiber in the diet (this may improve constipation or diarrhea, but make bloating worse) Talk with your provider before taking over-the-counter medicines. No one medicine works for everyone. Some that your provider may suggest include: - Anticholinergic medicines (dicyclomine, propantheline, belladonna, and hyoscyamine) taken about a half-hour before eating to control intestinal muscle spasms - Bisacodyl to treat constipation - Loperamide to treat diarrhea - Low doses of tricyclic antidepressants to help relieve intestinal pain - Lubiprostone for constipation symptoms - Rifaximin, an antibiotic Psychological therapy or medicines for anxiety or depression may help with the problem."}],"SUB_QUESTION_ID":"Q67-S1","ANNOTATIONS.FOCUS":["ibs"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"father suffering from IBS","MESSAGE":"My father is suffering from IBS and is loosing weight day by day.sometimes he even faints due to weakness.He cannot digest food .please help us and suggest us upon this problem.","QUESTION_ID":"Q67","F_REF":"1-118298035"} -{"ANSWERS":[{"_answerid":"Q68-S1-A1","_pairid":"150","__text":"Most cases of Lewy body dementia are not thought to be inherited. The condition generally occurs sporadically in people with no family history of the condition. Rarely, the condition can affect more than one family member. Some of these cases appear to be due to single gene changes (mutations) that follow an autosomal dominant pattern of inheritance. Other familial cases do not follow a specific pattern of inheritance and likely have a multifactorial cause (associated with the effects of multiple genes in combination with lifestyle and environmental factors)."}],"SUB_QUESTION_ID":"Q68-S1","ANNOTATIONS.FOCUS":["lewy body disease"],"ANNOTATIONS.TYPE":"inheritance","SUBJECT":"","MESSAGE":"Lewy Body Disease. I have been researching Lewy Body Disease and have a few questions.1) Is this disease hereditary2) Does alcoholism play a role in the beginning process of this disease3) What are the initial symptoms of the diseaseAny information you could forward would be greatly appreciated.","QUESTION_ID":"Q68","F_REF":"26"} -{"ANSWERS":[{"_answerid":"Q68-S2-A1","_pairid":"151","__text":"Lewy body dementia is characterized by the abnormal buildup of proteins into masses known as Lewy bodies. This protein is also associated with Parkinson's disease. People who have Lewy bodies in their brains also have the plaques and tangles associated with Alzheimer's disease."}],"SUB_QUESTION_ID":"Q68-S2","ANNOTATIONS.FOCUS":["lewy body disease"],"ANNOTATIONS.TYPE":"cause","SUBJECT":"","MESSAGE":"Lewy Body Disease. I have been researching Lewy Body Disease and have a few questions.1) Is this disease hereditary2) Does alcoholism play a role in the beginning process of this disease3) What are the initial symptoms of the diseaseAny information you could forward would be greatly appreciated.","QUESTION_ID":"Q68","F_REF":"26"} -{"ANSWERS":[{"_answerid":"Q68-S3-A1","_pairid":"152","__text":"The Human Phenotype Ontology provides the following list of signs and symptoms for Lewy body dementia. If the information is available, the table below includes how often the symptom is seen in people with this condition. You can use the MedlinePlus Medical Dictionary to look up the definitions for these medical terms. Signs and Symptoms Approximate number of patients (when available) Abnormality of extrapyramidal motor function 90% Abnormality of the autonomic nervous system 90% Developmental regression 90% EEG abnormality 90% Hallucinations 90% Hypertonia 90% Hypotension 90% Sleep disturbance 90% Sudden cardiac death 90% Gait disturbance 50% Incoordination 50% Neurological speech impairment 50% Abnormality of the sense of smell 7.5% Feeding difficulties in infancy 7.5% Involuntary movements 7.5% Restrictive lung disease 7.5% Skin ulcer 7.5% Tremor 7.5% Autosomal dominant inheritance - Delusions - Dementia - Fluctuations in consciousness - Parkinsonism - Visual hallucinations - The Human Phenotype Ontology (HPO) has collected information on how often a sign or symptom occurs in a condition. Much of this information comes from Orphanet, a European rare disease database. The frequency of a sign or symptom is usually listed as a rough estimate of the percentage of patients who have that feature. The frequency may also be listed as a fraction. The first number of the fraction is how many people had the symptom, and the second number is the total number of people who were examined in one study. For example, a frequency of 25\/25 means that in a study of 25 people all patients were found to have that symptom. Because these frequencies are based on a specific study, the fractions may be different if another group of patients are examined. Sometimes, no information on frequency is available. In these cases, the sign or symptom may be rare or common."}],"SUB_QUESTION_ID":"Q68-S3","ANNOTATIONS.FOCUS":["lewy body disease"],"ANNOTATIONS.TYPE":"symptom","SUBJECT":"","MESSAGE":"Lewy Body Disease. I have been researching Lewy Body Disease and have a few questions.1) Is this disease hereditary2) Does alcoholism play a role in the beginning process of this disease3) What are the initial symptoms of the diseaseAny information you could forward would be greatly appreciated.","QUESTION_ID":"Q68","F_REF":"26"} -{"ANSWERS":[{"_answerid":"Q69-S1-A1","_pairid":"153","__text":"Hypotrichosis-lymphedema-telangiectasia syndrome (HLTS) is a rare condition that, as the name suggests, is associated with sparse hair (hypotrichosis), lymphedema, and telangiectasia, particularly on the palms of the hands. Symptoms usually begin at birth or in early childhood and become worse over time. HLTS is thought to be caused by changes (mutations) in the SOX18 gene. It can follow both an autosomal dominant or an autosomal recessive pattern of inheritance, depending on the affected family. There is currently no cure for the condition. Treatment is based on the signs and symptoms present in each person."}],"SUB_QUESTION_ID":"Q69-S1","ANNOTATIONS.FOCUS":["hypotrichosis-lymphedema-telangiectasia syndrome"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"Genetic mutaion","MESSAGE":"my son born with alopicia totalis and swealling around the eyes , we have done for him Whole Exome Sequencing , they identified a heterozygous likely pathogenic variant in the SOX18 gene, which supports the clinical diagnosis of hypotrichosis-lymphedema-telangiectasia syndrome , i would like to know if i can trat this or any thing that we can do to help the symptos ,pleae help","QUESTION_ID":"Q69","F_REF":"1-136476177"} -{"ANSWERS":[{"_answerid":"Q70-S1-A1","_pairid":"154","__text":"When listening to the chest with a stethoscope, the\u00a0doctor may hear crackling sounds called rales. These tests may help diagnose the disease: - Chest x-ray - CT scan of the lungs - Pulmonary function tests"}],"SUB_QUESTION_ID":"Q70-S1","ANNOTATIONS.FOCUS":["asbestosis"],"ANNOTATIONS.TYPE":"diagnosis","SUBJECT":"Medical Diagnosis of Asbestosis","MESSAGE":"My doctors hint that I have asbestosis but do not say I have asbestosis. All the medical information that I have read from the CDC, Medlin and NIH all say that the symptoms presented are related to a high level of asbestos. Why won't the doctor say it?","QUESTION_ID":"Q70","F_REF":"14325"} -{"ANSWERS":[{"_answerid":"Q71-S1-A1","_pairid":"155","__text":"Hairy cell leukemia (HCL) is an unusual cancer of the blood. It affects B cells, a type of white blood cell (lymphocyte)."},{"_answerid":"Q71-S1-A2","_pairid":"156","__text":"Hairy cell leukemia is a rare, slow-growing cancer of the blood in which the bone marrow makes too many B cells (lymphocytes), a type of white blood cell that fights infection. The condition is named after these excess B cells which look 'hairy' under a microscope. As the number of leukemia cells increases, fewer healthy white blood cells, red blood cells and platelets are produced. The underlying cause of this condition is unknown. While there is no cure, treatment can lead to remission which can last for years."}],"SUB_QUESTION_ID":"Q71-S1","ANNOTATIONS.FOCUS":["hairy cell leukemia"],"ANNOTATIONS.TYPE":"information","SUBJECT":"Asking about Hairy cell leukemia","MESSAGE":"I get report for my father from hospital it is saying that he have Hairy cell leukemia i am here to ask if this dissease dangerous and there is treatment for it Also if The one who have it will live for long or not ? My father age is 55 We discover the dissease by blood test","QUESTION_ID":"Q71","F_REF":"1-135981085"} -{"ANSWERS":[{"_answerid":"Q71-S2-A1","_pairid":"157","__text":"Treatment may not be needed for the early stages of this disease. Some patients may need an occasional blood transfusion. If treatment is needed because of very low blood counts, chemotherapy drugs can be used. In most cases, chemotherapy can relieve the symptoms for many years. (When the signs and symptoms go away, you are said to be in remission.) Removing the spleen may improve blood counts, but is unlikely to cure the disease. Antibiotics can be used to treat infections. People with low blood counts will receive growth factors and, possibly, transfusions."}],"SUB_QUESTION_ID":"Q71-S2","ANNOTATIONS.FOCUS":["hairy cell leukemia"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"Asking about Hairy cell leukemia","MESSAGE":"I get report for my father from hospital it is saying that he have Hairy cell leukemia i am here to ask if this dissease dangerous and there is treatment for it Also if The one who have it will live for long or not ? My father age is 55 We discover the dissease by blood test","QUESTION_ID":"Q71","F_REF":"1-135981085"} -{"ANSWERS":[{"_answerid":"Q71-S3-A1","_pairid":"158","__text":"Most patients with hairy cell leukemia can expect to live 10 years or longer after diagnosis and treatment."}],"SUB_QUESTION_ID":"Q71-S3","ANNOTATIONS.FOCUS":["hairy cell leukemia"],"ANNOTATIONS.TYPE":"prognosis","SUBJECT":"Asking about Hairy cell leukemia","MESSAGE":"I get report for my father from hospital it is saying that he have Hairy cell leukemia i am here to ask if this dissease dangerous and there is treatment for it Also if The one who have it will live for long or not ? My father age is 55 We discover the dissease by blood test","QUESTION_ID":"Q71","F_REF":"1-135981085"} -{"ANSWERS":[{"_answerid":"Q72-S1-A1","_pairid":"159","__text":"Type 2 diabetes may be reversed with lifestyle changes, especially losing weight\u00a0with exercise\u00a0and by\u00a0eating healthier foods. Some cases of type 2 diabetes can also\u00a0be improved with weight-loss surgery. There is no cure for type 1 diabetes. Treating\u00a0either type 1 diabetes\u00a0or type 2 diabetes involves medicines, diet, and exercise to control blood sugar level. Everyone with diabetes should receive proper education and support about the best ways to manage their diabetes. Ask your provider about seeing a diabetes nurse educator. Getting better control over your blood sugar, cholesterol, and blood pressure levels helps reduce the risk of kidney disease, eye disease, nervous system disease, heart attack, and stroke. To prevent diabetes complications, visit your provider at least 2 to 4 times a year. Talk about any problems you are having. Follow your provider's instructions on managing your diabetes."},{"_answerid":"Q72-S1-A2","_pairid":"160","__text":"The goal of treatment at first is to lower your high blood glucose levels. Long-term goals are to prevent problems from diabetes. The most important way to treat and manage type 2 diabetes is with activity and healthy eating. Everyone with diabetes should receive proper education and support about the best ways to manage their diabetes. Ask your healthcare provider about seeing a diabetes educator. LEARN THESE SKILLS Learning diabetes management skills will help you live well with diabetes. These skills help prevent health problems and the need for medical care. Skills include: - How to test and record your blood glucose - What and when to eat - How to safely increase your activity and control your weight - How to take medications, if needed - How to recognize and treat low and high blood sugar - How to handle sick days - Where to buy diabetes supplies and how to store them It may take several months to learn these skills. Keep learning about diabetes, its complications, and how to control and live well\u00a0with the disease. Stay up-to-date on new research and treatments. MANAGING YOUR BLOOD SUGAR Checking your blood sugar levels yourself and writing down the results tells you how well you are managing your diabetes. Talk to your doctor and diabetes educator about how often to check. To check your blood sugar level, you use a device called a glucose meter. Usually, you prick your finger with a small needle called a lancet. This gives you a tiny drop of blood. You place the blood on a test strip and put the strip into the meter. The meter gives you a reading that tells you the level of your blood sugar. Your doctor or diabetes educator will help set up a testing schedule for you. Your doctor will help you set a target range for your blood sugar numbers. Keep these factors in mind: - Most people with type 2 diabetes only need to check their blood sugar once or twice a day. - If your blood sugar level is under control, you may only need to check it a few times a week. - You may test yourself when you wake up, before meals, and at bedtime. - You may need to test more often when you are sick or under stress. Keep a record of your blood sugar for yourself and your doctor. Based on your numbers, you may need to make changes to your meals, activity, or medicines to keep your blood sugar level in the right range. HEALTHY EATING AND WEIGHT CONTROL Work closely with your doctor, nurse, and dietitian to learn how much fat, protein, and carbohydrates you need in your diet. Your meal plans should fit your lifestyle and habits and should include foods that you like. Managing your weight and having a well-balanced diet are important. Some people with type 2 diabetes can stop taking medicines after losing weight. This does not mean that their diabetes is cured. They still have diabetes. Very obese patients whose diabetes is not well managed with diet and medicine may consider weight loss (bariatric) surgery. REGULAR PHYSICAL ACTIVITY Regular activity is important for everyone. It is even more important when you have diabetes. Exercise is good for your health because it: - Lowers your blood sugar level without medicine - Burns extra calories and fat to help manage your weight - Improves blood flow and blood pressure - Increases your energy level - Improves your ability to handle stress Talk to your doctor before starting any exercise program. People with type 2 diabetes may need to take special steps before, during, and after physical activity or exercise. MEDICATIONS TO TREAT DIABETES If diet and exercise do not help keep your blood sugar at normal or near-normal levels, your doctor may prescribe medication. Since these drugs help lower your blood sugar levels in different ways, your doctor may have you take more than one drug. Some of the most common types of medication are listed below. They are taken by mouth or injection. - Alpha-glucosidase inhibitors - Biguanides - DPP IV inhibitors - Injectable medicines (GLP-1 analogs) - Meglitinides - SGL T2 inhibitors - Sulfonylureas - Thiazolidinediones You may need to take insulin if your blood sugar cannot be controlled with any of the above medicines. Insulin must be injected under the skin using a syringe, insulin pen, or pump. It cannot be taken by mouth because the acid in the stomach destroys insulin. PREVENTING COMPLICATIONS Your doctor may prescribe medicines or other treatments to reduce your chance of developing some of the more common complications of diabetes, including: - Eye disease - Kidney disease - Heart disease and stroke FOOT CARE People with diabetes are more likely than those without diabetes to have foot problems. Diabetes damages the nerves. This can make you less able to feel pressure on the foot. You many not notice a foot injury until you get a severe infection. Diabetes can also damage blood vessels. Small sores or breaks in the skin may become deeper skin sores (ulcers). The affected limb may need to be amputated if these skin ulcers do not heal or become larger, deeper, or infected. To prevent problems with your feet: - Stop smoking if you smoke. - Improve control of your blood sugar. - Get a foot exam by your doctor at least twice a year and learn if you have nerve damage. - Check and care for your feet every day. This is very important when you already have nerve or blood vessel damage or foot problems. - Treat minor infections, such as athlete's foot, right away. - Use moisturizing lotion on dry skin. - Make sure you wear the right kind of shoes. Ask your doctor what type of shoe is right for you."}],"SUB_QUESTION_ID":"Q72-S1","ANNOTATIONS.FOCUS":["diabetes type 2"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"Diabetes Type 2","MESSAGE":"I test before going to bed and the reading is 94 but when I test again in the morning, the reading is 165. How can I lower it? I eat dinner around 8PM and nothing until the next morning.","QUESTION_ID":"Q72","F_REF":"1-135130065"} -{"ANSWERS":[{"_answerid":"Q73-S1-A1","_pairid":"161","__text":"Most cases of Angelman syndrome are not inherited, particularly those caused by a deletion in the maternal chromosome 15 or by paternal uniparental disomy. These genetic changes occur as random events during the formation of reproductive cells (eggs and sperm) or in early embryonic development. In these instances, people typically have no history of the disorder in their family. Rarely, a genetic change responsible for Angelman syndrome can be inherited. For example, it is possible for a mutation in the UBE3A gene or in the nearby region of DNA that controls gene activation to be passed from one generation to the next."}],"SUB_QUESTION_ID":"Q73-S1","ANNOTATIONS.FOCUS":["angelman syndrome"],"ANNOTATIONS.TYPE":"inheritance","SUBJECT":"","MESSAGE":"Angelman syndrome. Can a person with Angelman Syndrome have children? If so, can the disorder be passed on to offspring?","QUESTION_ID":"Q73","F_REF":"65"} -{"ANSWERS":[{"_answerid":"Q74-S1-A1","_pairid":"165","__text":"Summary Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. Insulin is a hormone that helps the glucose get into your cells to give them energy. With type 1 diabetes, your body does not make insulin. With type 2 diabetes, the more common type, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood. You can also have prediabetes. This means that your blood sugar is higher than normal but not high enough to be called diabetes. Having prediabetes puts you at a higher risk of getting type 2 diabetes. Over time, having too much glucose in your blood can cause serious problems. It can damage your eyes, kidneys, and nerves. Diabetes can also cause heart disease, stroke and even the need to remove a limb. Pregnant women can also get diabetes, called gestational diabetes. Blood tests can show if you have diabetes. One type of test, the A1C, can also check on how you are managing your diabetes. Exercise, weight control and sticking to your meal plan can help control your diabetes. You should also monitor your blood glucose level and take medicine if prescribed. NIH: National Institute of Diabetes and Digestive and Kidney Diseases"},{"_answerid":"Q74-S1-A2","_pairid":"166","__text":"Summary Diabetes means your blood glucose, or blood sugar, levels are too high. With type 2 diabetes, the more common type, your body does not make or use insulin well. Insulin is a hormone that helps glucose get into your cells to give them energy. Without insulin, too much glucose stays in your blood. Over time, high blood glucose can lead to serious problems with your heart, eyes, kidneys, nerves, and gums and teeth. You have a higher risk of type 2 diabetes if you are older, obese, have a family history of diabetes, or do not exercise. Having prediabetes also increases your risk. Prediabetes means that your blood sugar is higher than normal but not high enough to be called diabetes. The symptoms of type 2 diabetes appear slowly. Some people do not notice symptoms at all. The symptoms can include - Being very thirsty - Urinating often - Feeling very hungry or tired - Losing weight without trying - Having sores that heal slowly - Having blurry eyesight Blood tests can show if you have diabetes. One type of test, the A1C, can also check on how you are managing your diabetes. Many people can manage their diabetes through healthy eating, physical activity, and blood glucose testing. Some people also need to take diabetes medicines. NIH: National Institute of Diabetes and Digestive and Kidney Diseases"},{"_answerid":"Q74-S1-A3","_pairid":"167","__text":"Too Much Glucose in the Blood Diabetes means your blood glucose (often called blood sugar) is too high. Your blood always has some glucose in it because your body needs glucose for energy to keep you going. But too much glucose in the blood isn't good for your health. Glucose comes from the food you eat and is also made in your liver and muscles. Your blood carries the glucose to all of the cells in your body. Insulin is a chemical (a hormone) made by the pancreas. The pancreas releases insulin into the blood. Insulin helps the glucose from food get into your cells. If your body does not make enough insulin or if the insulin doesn't work the way it should, glucose can't get into your cells. It stays in your blood instead. Your blood glucose level then gets too high, causing pre-diabetes or diabetes. Types of Diabetes There are three main kinds of diabetes: type 1, type 2, and gestational diabetes. The result of type 1 and type 2 diabetes is the same: glucose builds up in the blood, while the cells are starved of energy. Over the years, high blood glucose damages nerves and blood vessels, oftentimes leading to complications such as heart disease, stroke, blindness, kidney disease, nerve problems, gum infections, and amputation. Type 1 Diabetes Type 1 diabetes, which used to be called called juvenile diabetes or insulin-dependent diabetes, develops most often in young people. However, type 1 diabetes can also develop in adults. With this form of diabetes, your body no longer makes insulin or doesn\u2019t make enough insulin because your immune system has attacked and destroyed the insulin-producing cells. About 5 to 10 percent of people with diabetes have type 1 diabetes. To survive, people with type 1 diabetes must have insulin delivered by injection or a pump. Learn more about type 1 diabetes here. Type 2 Diabetes Type 2 diabetes, which used to be called adult-onset diabetes or non insulin-dependent diabetes, is the most common form of diabetes. Although people can develop type 2 diabetes at any age -- even during childhood -- type 2 diabetes develops most often in middle-aged and older people. Type 2 diabetes usually begins with insulin resistance\u2014a condition that occurs when fat, muscle, and liver cells do not use insulin to carry glucose into the body\u2019s cells to use for energy. As a result, the body needs more insulin to help glucose enter cells. At first, the pancreas keeps up with the added demand by making more insulin. Over time, the pancreas doesn\u2019t make enough insulin when blood sugar levels increase, such as after meals. If your pancreas can no longer make enough insulin, you will need to treat your type 2 diabetes. Learn more about type 2 diabetes here. Gestational Diabetes Some women develop gestational diabetes during the late stages of pregnancy. Gestational diabetes is caused by the hormones of pregnancy or a shortage of insulin. Although this form of diabetes usually goes away after the baby is born, a woman who has had it and her child are more likely to develop diabetes later in life. Prediabetes Prediabetes means your blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. People with prediabetes are at an increased risk for developing type 2 diabetes and for heart disease and stroke. The good news is that if you have prediabetes, you can reduce your risk of getting type 2 diabetes. With modest weight loss and moderate physical activity, you can delay or prevent type 2 diabetes. Learn more about prediabetes here. Signs of Diabetes Many people with diabetes experience one or more symptoms, including extreme thirst or hunger, a frequent need to urinate and\/or fatigue. Some lose weight without trying. Additional signs include sores that heal slowly, dry, itchy skin, loss of feeling or tingling in the feet and blurry eyesight. Some people with diabetes, however, have no symptoms at all. How Many Have Diabetes? Nearly 29 million Americans age 20 or older (12.3 percent of all people in this age group) have diabetes, according to 2014 estimates from the Centers for Disease Control and Prevention (CDC). About 1.9 million people aged 20 years or older were newly diagnosed with diabetes in 2010 alone. People can get diabetes at any age, but the risk increases as we get older. In 2014, over 11 million older adults living in the U.S -- nearly 26 percent of people 65 or older -- had diabetes. See more statistics about diabetes from the National Diabetes Statistics Report 2014. (Centers for Disease Control and Prevention.) If Diabetes is Not Managed Diabetes is a very serious disease. Over time, diabetes that is not well managed causes serious damage to the eyes, kidneys, nerves, heart, gums and teeth. If you have diabetes, you are more likely than people without diabetes to have heart disease or a stroke. People with diabetes also tend to develop heart disease or stroke at an earlier age than others. The best way to protect yourself from the serious complications of diabetes is to manage your blood glucose, blood pressure and cholesterol and to avoid smoking. It is not always easy, but people who make an ongoing effort to manage their diabetes can greatly improve their overall health."},{"_answerid":"Q74-S1-A4","_pairid":"168","__text":"Diabetes means your blood glucose (often called blood sugar) is too high. Your blood always has some glucose in it because your body needs glucose for energy to keep you going. But too much glucose in the blood isn't good for your health. Glucose comes from the food you eat and is also made in your liver and muscles. Your blood carries the glucose to all of the cells in your body. Insulin is a chemical (a hormone) made by the pancreas. The pancreas releases insulin into the blood. Insulin helps the glucose from food get into your cells. If your body does not make enough insulin or if the insulin doesn't work the way it should, glucose can't get into your cells. It stays in your blood instead. Your blood glucose level then gets too high, causing pre-diabetes or diabetes."}],"SUB_QUESTION_ID":"Q74-S1","ANNOTATIONS.FOCUS":["diabetes"],"ANNOTATIONS.TYPE":"information","SUBJECT":"Diabetes on sugar level","MESSAGE":"What happen to diabetes patient Getting blood sugar increase by which of body in brain or stomach or urine bladder.why urine bladder become more weight that any other part of body.","QUESTION_ID":"Q74","F_REF":"1-136136912"} -{"ANSWERS":[{"_answerid":"Q75-S1-A1","_pairid":"174","__text":"Trimethylaminuria is a disorder in which the body is unable to break down trimethylamine, a chemical compound that has a pungent odor. Trimethylamine has been described as smelling like rotting fish, rotting eggs, garbage, or urine. As this compound builds up in the body, it causes affected people to give off a strong odor in their sweat, urine, and breath. The intensity of the odor may vary over time. The odor can interfere with many aspects of daily life, affecting a person's relationships, social life, and career. Some people with trimethylaminuria experience depression and social isolation as a result of this condition."}],"SUB_QUESTION_ID":"Q75-S1","ANNOTATIONS.FOCUS":["tmau"],"ANNOTATIONS.TYPE":"information","SUBJECT":"","MESSAGE":"TMAU. Please find a way to research TMAU And how to cure it with gene therapy. I'm tired kg smelling like fish\/feces And getting talked about everyday of my life.","QUESTION_ID":"Q75","F_REF":"10136"} -{"ANSWERS":[{"_answerid":"Q75-S2-A1","_pairid":"175","__text":"Although there is no cure for trimethylaminuria, the following are some ways to reduce symptoms of odor:[1][3] Avoidance of foods that contain trimethylamine and its precursors (choline, lecithin, and trimethylamine N-oxide). Trimethylamine is present in high levels in milk obtained from wheat-fed cows. Choline is present in high amounts in: eggs, liver, kidney, peas, beans, peanuts, soy products, brussels sprouts, broccoli, cabbage, and cauliflower. Trimethylamine N-oxide is present in seafood Low doses of antibiotics. This decreases the amount of trimethylamine that is made by bacteria in the intestines Laxatives can decrease the amount of time food remains in the intestines and therefore reduce the amount of trimethylamine made Nutritional supplements (activated charcoal and copper chlorophyllin) can decrease the concentration of trimethylamine in the urine Soaps with a moderate pH (between 5.5 and 6.5) can help remove the secreted trimethylamine from the skin Riboflavin (vitamin B2) supplements can enhance any existing FMO3 enzyme activity (which breaks down trimethylamine) Avoidance of exercise, stress, emotional upsets, and other factors that can promote sweating People with trimethylaminuria may also find the following to be helpful:[1] Behavioral counseling to help with depression and other psychological symptoms Genetic counseling to better understand how they developed trimethylaminuria and the risks of passing the condition on to their children NOTE: People should follow the treatment advice of their healthcare provider and should not attempt to self-administer these treatment approaches. Medications and supplements can have unintended interactions, and dietary restrictions can result in nutritional deficits. Last updated: 1\/24\/2017"}],"SUB_QUESTION_ID":"Q75-S2","ANNOTATIONS.FOCUS":["tmau"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"TMAU. Please find a way to research TMAU And how to cure it with gene therapy. I'm tired kg smelling like fish\/feces And getting talked about everyday of my life.","QUESTION_ID":"Q75","F_REF":"10136"} -{"ANSWERS":[{"_answerid":"Q76-S1-A1","_pairid":"176","__text":"There is no cure for locked-in syndrome, nor is there a standard course of treatment. A therapy called functional neuromuscular stimulation, which uses electrodes to stimulate muscle reflexes, may help activate some paralyzed muscles. Several devices to help communication are available. Other treatment is symptomatic and supportive."}],"SUB_QUESTION_ID":"Q76-S1","ANNOTATIONS.FOCUS":["locked-in syndrome"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"ClinicalTrials.gov - Suggestion","MESSAGE":"Please help me with my brother with locked-in syndrome in [LOCATION] for 3 years.Somebody please help. God bless .[NAME] [CONTACT]","QUESTION_ID":"Q76","F_REF":"16154"} -{"ANSWERS":[{"_answerid":"Q77-S1-A1","_pairid":"177","__text":"A stroke is a medical emergency. Quick treatment is needed. Call 9-1-1 or your local emergency number right away or seek urgent medical care at the first signs of a stroke. People who are having stroke symptoms need to get to a hospital as quickly as possible. - If the stroke is caused by a blood clot, a clot-busting drug may be given to dissolve the clot. - To be effective, this treatment must be started within 3 to 4 1\/2 hours of when the symptoms first started. The sooner this treatment is started, the better the chance of a good outcome. Other treatments given in the hospital depend on the cause of the stroke. These may include: - Blood thinners such as heparin, warfarin (Coumadin), aspirin, or clopidogrel (Plavix) - Medicine to control risk factors, such as high blood pressure, diabetes, and high cholesterol - Special procedures or surgery to relieve symptoms or prevent more strokes - Nutrients and fluids Physical therapy, occupational therapy, speech therapy, and swallowing therapy will all begin in the hospital. If the person has severe swallowing problems, a feeding tube in the stomach (gastrostomy tube) will likely be needed. The goal of treatment after a stroke is to help you recover as much function as possible and prevent future strokes. Recovery from your stroke will begin while you are still in the hospital or at a rehabilitation center. It will continue when you go home from the hospital or center. Be sure to follow up with your health care provider after you go home."},{"_answerid":"Q77-S1-A2","_pairid":"178","__text":"Generally there are three treatment stages for stroke: prevention, therapy immediately after the stroke, and post-stroke rehabilitation. Therapies to prevent a first or recurrent stroke are based on treating an individual's underlying risk factors for stroke, such as hypertension, atrial fibrillation, and diabetes. Acute stroke therapies try to stop a stroke while it is happening by quickly dissolving the blood clot causing an ischemic stroke or by stopping the bleeding of a hemorrhagic stroke. Post-stroke rehabilitation helps individuals overcome disabilities that result from stroke damage. Medication or drug therapy is the most common treatment for stroke. The most popular classes of drugs used to prevent or treat stroke are antithrombotics (antiplatelet agents and anticoagulants) and thrombolytics."},{"_answerid":"Q77-S1-A3","_pairid":"179","__text":"With stroke, treatment depends on the stage of the disease. There are three treatment stages for stroke: prevention, therapy immediately after stroke, and rehabilitation after stroke. Stroke treatments include medications, surgery, and rehabilitation."}],"SUB_QUESTION_ID":"Q77-S1","ANNOTATIONS.FOCUS":["stroke"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"I would appreciate it if you can send me or email me some exercises for a person who is a stroke victim. I am unable to walk due to a arthritic knee. otherwise I am flexable.. my home address is [CONTACT], My email is [CONTACT] (mailto:[CONTACT]) Thank you, [NAME]","QUESTION_ID":"Q77","F_REF":"1-132221211"} -{"ANSWERS":[{"_answerid":"Q78-S1-A1","_pairid":"182","__text":"The goal of treatment is to control your symptoms and prevent infection. Three treatment options are available: - Skin lotions, ointments, creams, and shampoos. These are called topical treatments. - Pills or injections that affect the body's immune response, not just the skin. These are called systemic, or body-wide, treatments. - Phototherapy, which uses ultraviolet light to treat psoriasis. TREATMENTS USED ON THE SKIN (TOPICAL) Most of the time, psoriasis is treated with medicines that are placed directly on the skin or scalp. These may include: - Cortisone creams and ointments - Creams or ointments that contain coal tar or anthralin - Creams to remove the scaling (usually salicylic acid or lactic acid) - Dandruff shampoos (over-the-counter or prescription) - Moisturizers - Prescription medicines containing vitamin D or vitamin A (retinoids) SYSTEMIC (BODY-WIDE) TREATMENTS If you have very severe psoriasis, your provider will likely recommend medicines that suppress the immune system's faulty response. These medicines include methotrexate or cyclosporine. Retinoids can also be used. Newer drugs called biologics are used when other treatments do not work. Biologics approved for the treatment of psoriasis include: - Adalimumab (Humira) - Etanercept (Enbrel) - Infliximab (Remicade) - Ustekinumab (Stelara) - Secukinumab (Cosentyx) - Apremilast (Otezla) PHOTOTHERAPY Some people may choose to have phototherapy: - This is treatment in which your skin is carefully exposed to ultraviolet light. - It may be given alone or after you take a drug that makes the skin sensitive to light. - Phototherapy for psoriasis can be given as ultraviolet A (UVA) or ultraviolet B (UVB) light. OTHER TREATMENTS If you have an infection, your provider will prescribe antibiotics. HOME CARE Following these tips at home may help: - Taking a daily bath or shower. Try not to scrub too hard because this can irritate the skin and trigger an attack. - Oatmeal baths may be soothing and may help to loosen scales. You can use over-the-counter oatmeal bath products. Or, you can mix 1 cup of oatmeal into a tub of warm water. - Keeping your skin clean and moist, and avoiding your specific psoriasis triggers may help reduce the number of flare-ups. - Sunlight may help your symptoms go away. Be careful not to get sunburned. - Relaxation and anti-stress techniques. The link between stress and flares of psoriasis is not well understood. - Limiting the alcoholic beverages you drink may help keep psoriasis from getting worse."},{"_answerid":"Q78-S1-A2","_pairid":"184","__text":"The goals of psoriasis treatment are to change the course of the disease by interfering with the increased production of skin cells, and to remove scales and smooth rough skin. There are many types of treatments. Many are medicines and other treatments your doctor will have to prescribe. But there are other types of treatments you can buy without a prescription or try on your own. Some treatments for psoriasis are applied directly to the skin. Some use light to treat skin lesions. Others are taken by mouth or injected. This chapter focuses on treatments that are applied directly to the skin -- also called topical treatments or light therapy. Topical Treatments Here are some different types of topical treatments for psoriasis. - helps soften and loosen skin scales - comes as a cream, lotion, liquid, gel, ointment or shampoo. helps soften and loosen skin scales comes as a cream, lotion, liquid, gel, ointment or shampoo. - reduce inflammation and slow the growth and build-up of skin cells - are used in different strengths for different parts of the body. reduce inflammation and slow the growth and build-up of skin cells are used in different strengths for different parts of the body. - works by slowing the production of skin cells - is often combined with a steroid for added effects - may be used with UVB light. works by slowing the production of skin cells is often combined with a steroid for added effects may be used with UVB light. - is used to treat long-term psoriasis and hard-to-treat plaques - reduces inflammation - slows down the growth of skin cells. is used to treat long-term psoriasis and hard-to-treat plaques reduces inflammation slows down the growth of skin cells. - cause the skin to shed dead cells - slow the growth of skin cells - decrease itching. cause the skin to shed dead cells slow the growth of skin cells decrease itching. - are believed to work by reducing skin cell overgrowth - decrease inflammation - are often used with other treatments. are believed to work by reducing skin cell overgrowth decrease inflammation are often used with other treatments. - slow down the growth of skin cells - may be used with steroid creams for added effects. slow down the growth of skin cells may be used with steroid creams for added effects. Regardless of the topical medication your doctor prescribes, it is important to follow directions carefully. Some can be messy and stain your clothing and bedding. Others can have potentially dangerous side effects. Light Therapy Light therapy, also called phototherapy, uses ultraviolet light to treat skin lesions. Laser therapy delivers intense, focused doses of light to specific areas of the skin to clear lesions without harming surrounding tissues. Here are some different kinds of light therapy. UVB phototherapy - penetrates the skin to slow the growth of affected cells - is given at home or at the doctor\u2019s office - may be combined with topical treatments or injected or oral medicines to increase effectiveness. penetrates the skin to slow the growth of affected cells is given at home or at the doctor\u2019s office may be combined with topical treatments or injected or oral medicines to increase effectiveness. Excimer laser - targets select areas of skin with a beam of high-intensity UVB light - is used to treat chronic, localized psoriasis plaques - may take 4 to 10 sessions to see results . targets select areas of skin with a beam of high-intensity UVB light is used to treat chronic, localized psoriasis plaques may take 4 to 10 sessions to see results . Pulsed dye laser - uses a dye and different wavelength of light from other skin treatments - destroys tiny blood vessels that help psoriasis lesions form - may take 4 to 6 sessions to clear treated lesions. uses a dye and different wavelength of light from other skin treatments destroys tiny blood vessels that help psoriasis lesions form may take 4 to 6 sessions to clear treated lesions."},{"_answerid":"Q78-S1-A3","_pairid":"185","__text":"While many psoriasis treatments are applied directly to the skin, your doctor may prescribe others that must be taken by mouth or injected. There are also some natural treatments, taken by mouth or applied to the skin, that you can try on your own. Systemic Therapies These therapies, prescribed by your doctor, work in different ways to help control the underlying disease process. It is important to learn as much as you can about these medications and to take them exactly as prescribed by your doctor. Oral or injected medications for psoriasis include the following. - is used to treat severe psoriasis (meaning more than 20 percent of skin is affected) - slows the rapid growth of skin cells - is taken by mouth or injected. is used to treat severe psoriasis (meaning more than 20 percent of skin is affected) slows the rapid growth of skin cells is taken by mouth or injected. - may be used for severe psoriasis not controlled by methotrexate - suppresses overactive T cells that play a role in psoriasis - is taken by mouth or injected. may be used for severe psoriasis not controlled by methotrexate suppresses overactive T cells that play a role in psoriasis is taken by mouth or injected. - are man-made drugs related to vitamin A - help slow the production of skin cells - reduce inflammation. are man-made drugs related to vitamin A help slow the production of skin cells reduce inflammation. - are made from living cells grown in a laboratory - block the action of specific cells and proteins that play a role in psoriasis - must be injected beneath the skin or given intravenously (by IV). are made from living cells grown in a laboratory block the action of specific cells and proteins that play a role in psoriasis must be injected beneath the skin or given intravenously (by IV). Natural Treatments For many people, natural treatments can help relieve the symptoms of psoriasis. There are many natural treatments you can try on your own, but you should never use them to replace the treatment your doctor prescribes. Here are some natural treatments you may want to try. Spending a few minutes in the summer sun can help your psoriasis, but be sure to use sun block and increase time spent in the sun gradually. Applying cream from the aloe vera plant improves symptoms for some people. You should avoid aloe vera tablets. Taking fish oil orally helps some people with psoriasis. If you want to try fish oil, first speak with your doctor, as it may interact with other medications you are taking. Soaking in a solution of Dead Sea salts may improve scaling and itching. Be sure to apply moisturizer when you get out of the tub. Capsaicin, the ingredient that makes cayenne peppers hot, is the active ingredient in some topical pain-relievers. Some people find they relieve pain and itching."}],"SUB_QUESTION_ID":"Q78-S1","ANNOTATIONS.FOCUS":["psoriasis"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"Psoriasis for past 7-8 years","MESSAGE":"I had psoriasis on my scalp for nearly 10 years. Please give suggestions and medications.","QUESTION_ID":"Q78","F_REF":"NF_233"} -{"ANSWERS":[{"_answerid":"Q79-S1-A1","_pairid":"186","__text":"Ataxia-telangiectasia is inherited in an autosomal recessive pattern, which means both copies of the ATM gene in each cell have mutations. Most often, the parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but do not show signs and symptoms of the condition. About 1 percent of the United States population carries one mutated copy and one normal copy of the ATM gene in each cell. These individuals are called carriers. Although ATM mutation carriers do not have ataxia-telangiectasia, they are more likely than people without an ATM mutation to develop cancer; female carriers are particularly at risk for developing breast cancer. Carriers of a mutation in the ATM gene also may have an increased risk of heart disease."}],"SUB_QUESTION_ID":"Q79-S1","ANNOTATIONS.FOCUS":["louis bar syndrome"],"ANNOTATIONS.TYPE":"inheritance","SUBJECT":"Louis Bar Syndrome","MESSAGE":"My brother died young from Louis Bar Syndrome. Of six pregnancies, four children either did not survive pregnancy or died very young. I would like to know is it possible that other children (like me) could have the syndrome symptoms to a lesser or greater degree:i.e., is there a continuum???","QUESTION_ID":"Q79","F_REF":"1-137041975"} -{"ANSWERS":[{"_answerid":"Q80-S1-A1","_pairid":"187","__text":"People can clench and grind without being aware of it. It can happen during both the day and night, although sleep-related bruxism is often a bigger problem because it is harder to control. There is some disagreement about the cause of bruxism. Daily stress may be the trigger in many people. Some people probably clench their teeth and never feel symptoms. Factors that influence whether or not bruxism causes pain and other problems will vary from person to person. They may include: - How much stress you are under - How long and tightly you clench and grind - Whether your teeth are misaligned - Your posture - Your ability to relax - Your diet - Your sleeping habits"}],"SUB_QUESTION_ID":"Q80-S1","ANNOTATIONS.FOCUS":["bruxism"],"ANNOTATIONS.TYPE":"cause","SUBJECT":"Bruxism","MESSAGE":"I understand that bruxism may be a result of tension or anxiety, but why that particular release? Why don't people clench their fists during sleep, or kick, or any number of activities? In other words, why is the jaw the most common location?","QUESTION_ID":"Q80","F_REF":"12318"} -{"ANSWERS":[{"_answerid":"Q80-S2-A1","_pairid":"188","__text":"Bruxism (BRUK-siz-um) is a condition in which you grind, gnash or clench your teeth. If you have bruxism, you may unconsciously clench your teeth together during the day, or clench or grind them at night (sleep bruxism). Sleep bruxism is considered a sleep-related movement disorder. People who clench or grind their teeth (brux) during sleep are more likely to have other sleep disorders, such as snoring and pauses in breathing (sleep apnea). Mild bruxism may not require treatment. However, in some people, bruxism can be frequent and severe enough to lead to jaw disorders, headaches, damaged teeth and other problems. Because you may have sleep bruxism and be unaware of it until complications develop, it's important to know the signs and symptoms of bruxism and to seek regular dental care."}],"SUB_QUESTION_ID":"Q80-S2","ANNOTATIONS.FOCUS":["bruxism"],"ANNOTATIONS.TYPE":"information","SUBJECT":"Bruxism","MESSAGE":"I understand that bruxism may be a result of tension or anxiety, but why that particular release? Why don't people clench their fists during sleep, or kick, or any number of activities? In other words, why is the jaw the most common location?","QUESTION_ID":"Q80","F_REF":"12318"} -{"ANSWERS":[{"_answerid":"Q81-S1-A1","_pairid":"192","__text":"Secondary Insomnia Secondary insomnia is the symptom or side effect of another problem. This type of insomnia often is a symptom of an emotional, neurological, or other medical or sleep disorder. Emotional disorders that can cause insomnia include depression, anxiety, and posttraumatic stress disorder. Alzheimer's disease and Parkinson's disease are examples of neurological disorders that can cause insomnia. Many other disorders or factors also can cause insomnia, such as: Conditions that cause chronic (ongoing) pain, such as arthritis and headache disorders Conditions that make it hard to breathe, such as asthma and heart failure An overactive thyroid Gastrointestinal disorders, such as heartburn Stroke Sleep disorders, such as restless legs syndrome and sleep-related breathing problems Menopause and hot flashes Secondary insomnia also can be a side effect of some medicines. For example, certain asthma medicines, such as theophylline, and some allergy and cold medicines can cause insomnia. Beta blockers also can cause the condition. These medicines are used to treat heart conditions. Commonly used substances also can cause insomnia. Examples include caffeine and other stimulants, tobacco and other nicotine products, and alcohol and other sedatives. Primary Insomnia Primary insomnia isn't a symptom or side effect of another medical condition. It is its own distinct disorder, and its cause isn\u2019t well understood. Primary insomnia usually lasts for at least 1 month. Many life changes can trigger primary insomnia. It may be due to major or long-lasting stress or emotional upset. Travel or other factors, such as work schedules that disrupt your sleep routine, also may trigger primary insomnia. Even if these issues are resolved, the insomnia may not go away. Trouble sleeping can persist because of habits formed to deal with the lack of sleep. These habits might include taking naps, worrying about sleep, and going to bed early. Researchers continue to try to find out whether some people are born with an increased risk for primary insomnia."}],"SUB_QUESTION_ID":"Q81-S1","ANNOTATIONS.FOCUS":["insomnia"],"ANNOTATIONS.TYPE":"cause","SUBJECT":"Insomnia (special case)","MESSAGE":"Hi, Im 40 years old male. I was suffering from social anxiety since I was child. Last year, I decided to go to a psychologist. She advised me to practice meditation, mindfulness and CBT as well. She explained to me the great positive impact of the meditation, mindfulness on the brain activity (neuroplasticity). Since then, I've been practicing these techniques. The result was awesome. I no longer suffer from my social anxiety and my life has completely changed to the positive side. No more worry, stress, anxiety, etc. But at the same time, I started to suffer from chronic insomnia until now. Of course, Im always in touch with my psychiatrist who has prescribed me the necessary and still following me up. Even tough, my insomnia doesn't improved. Unfortunately, nobody can determine the real cause of my insomnia. If I know the cause, I'll do my best to find the key to resolve this problem. According to my mentioned story, can you help me to find the real cause of my insomnia? Thank you, Your answer is very appreciable and important to me. [NAME].","QUESTION_ID":"Q81","F_REF":"1-133026025"} -{"ANSWERS":[{"_answerid":"Q82-S1-A1","_pairid":"194","__text":"Cri-du-chat (cat's cry) syndrome, also known as 5p- (5p minus) syndrome, is a chromosomal condition that results when a piece of chromosome 5 is missing. Infants with this condition often have a high-pitched cry that sounds like that of a cat. The disorder is characterized by intellectual disability and delayed development, small head size (microcephaly), low birth weight, and weak muscle tone (hypotonia) in infancy. Affected individuals also have distinctive facial features, including widely set eyes (hypertelorism), low-set ears, a small jaw, and a rounded face. Some children with cri-du-chat syndrome are born with a heart defect. These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional. Where to Start Genetics Home Reference (GHR) contains information on Cri du chat syndrome. This website is maintained by the National Library of Medicine. MedlinePlus was designed by the National Library of Medicine to help you research your health questions, and it provides more information about this topic. The National Human Genome Research Institute's (NHGRI) website has an information page on this topic. NHGRI is part of the National Institutes of Health and supports research on the structure and function of the human genome and its role in health and disease. The National Organization for Rare Disorders (NORD) has a report for patients and families about this condition. NORD is a patient advocacy organization for individuals with rare diseases and the organizations that serve them. In-Depth Information Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free. The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch\u2019s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition. Online Mendelian Inheritance in Man (OMIM) is a catalog of human genes and genetic disorders. Each entry has a summary of related medical articles. It is meant for health care professionals and researchers. OMIM is maintained by Johns Hopkins University School of Medicine. Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge. PubMed is a searchable database of medical literature and lists journal articles that discuss Cri du chat syndrome. Click on the link to view a sample search on this topic. Selected Full-Text Journal Articles Nguyen JM et al., 5p deletions: Current knowledge and future directions. Am J Med Genet C Semin Med Genet. 2015 Sep;169(3):224-38. Boultwood J et al., Advances in the 5q- syndrome. Blood. 2010 Dec 23;116(26):5803-11. Pituch KA et al., Educational Priorities for Children with Cri-Du-Chat Syndrome. J Dev Phys Disabil. 2010 Feb;22(1):65-81. Rodr\u00edguez-Caballero A et al., Cri du chat syndrome: a critical review. Med Oral Patol Oral Cir Bucal. 2010 May 1;15(3):e473-8. Cornish K, Bramble D. Cri du chat syndrome: genotype-phenotype correlations and recommendations for clinical management. Dev Med Child Neurol. 2002 Jul;44(7):494-7."}],"SUB_QUESTION_ID":"Q82-S1","ANNOTATIONS.FOCUS":["cri du chat syndrome"],"ANNOTATIONS.TYPE":"information","SUBJECT":"","MESSAGE":"would you help me to fine article or jurnal about Cri du chat syndrome","QUESTION_ID":"Q82","F_REF":"11446"} -{"ANSWERS":[{"_answerid":"Q83-S1-A1","_pairid":"195","__text":"Clopidogrel may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: excessive tiredness headache dizziness nausea vomiting stomach pain diarrhea nosebleed Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately: hives rash itching difficulty breathing or swallowing swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs hoarseness black and tarry stools red blood in stools bloody vomit vomit that looks like coffee grounds unusual bleeding or bruising pink or brown urine slow or difficult speech weakness or numbness of an arm or a leg changes in vision fever shortness of breath fast heartbeat pale skin purple patches or bleeding under the skin confusion yellowing of the skin or eyes seizures Clopidogrel may cause other side effects. Call your doctor if you have any unusual problems while taking this medication. If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http:\/\/www.fda.gov\/Safety\/MedWatch) or by phone (1-800-332-1088)."}],"SUB_QUESTION_ID":"Q83-S1","ANNOTATIONS.FOCUS":["Plavix"],"ANNOTATIONS.TYPE":"side effects","SUBJECT":"taking multiple meds","MESSAGE":"Plavix,linisopril,simvastatin,melotonin: What possible side effects should I be aware of when taking all of these daily?","QUESTION_ID":"Q83","F_REF":"1-120034945"} -{"ANSWERS":[{"_answerid":"Q83-S2-A1","_pairid":"196","__text":"Lisinopril and hydrochlorothiazide may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: dizziness headache cough excessive tiredness pain, burning, or tingling in the hands or feet decrease in sexual ability heartburn Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately: swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs hoarseness difficulty breathing or swallowing stomach pain upset stomach vomiting fever, sore throat, chills, and other signs of infection muscle pain, cramps, or weakness yellowing of the skin or eyes dry mouth thirst weakness restlessness confusion seizures decrease in urination lightheadedness fainting chest pain rapid, pounding, slow, or irregular heartbeat pain in big toe tingling in arms and legs loss of muscle tone weakness or heaviness in legs lack of energy cold, gray skin Lisinopril and hydrochlorothiazide may cause other side effects. Call your doctor if you have any unusual problems while taking this medication. If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http:\/\/www.fda.gov\/Safety\/MedWatch) or by phone (1-800-332-1088)."}],"SUB_QUESTION_ID":"Q83-S2","ANNOTATIONS.FOCUS":["linisopril"],"ANNOTATIONS.TYPE":"side effects","SUBJECT":"taking multiple meds","MESSAGE":"Plavix,linisopril,simvastatin,melotonin: What possible side effects should I be aware of when taking all of these daily?","QUESTION_ID":"Q83","F_REF":"1-120034945"} -{"ANSWERS":[{"_answerid":"Q83-S3-A1","_pairid":"197","__text":"Simvastatin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: constipation stomach pain nausea headache memory loss or forgetfulness confusion Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately or get emergency medical help. muscle pain, tenderness, or weakness dark red urine decreased urination lack of energy, tiredness, or weakness loss of appetite pain in the upper right part of the stomach yellowing of the skin or eyes dark colored urine fever or chills flushing blisters rash hives itching swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs difficulty breathing or swallowing hoarseness joint pain sensitivity to light This medication may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication. If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http:\/\/www.fda.gov\/Safety\/MedWatch) or by phone (1-800-332-1088)."}],"SUB_QUESTION_ID":"Q83-S3","ANNOTATIONS.FOCUS":["simvastatin"],"ANNOTATIONS.TYPE":"side effects","SUBJECT":"taking multiple meds","MESSAGE":"Plavix,linisopril,simvastatin,melotonin: What possible side effects should I be aware of when taking all of these daily?","QUESTION_ID":"Q83","F_REF":"1-120034945"} -{"ANSWERS":[{"_answerid":"Q83-S4-A1","_pairid":"198","__text":"Side effects of melatonin are uncommon but can include drowsiness, headache, dizziness, or nausea. There have been no reports of significant side effects of melatonin in children."}],"SUB_QUESTION_ID":"Q83-S4","ANNOTATIONS.FOCUS":["melotonin"],"ANNOTATIONS.TYPE":"side effects","SUBJECT":"taking multiple meds","MESSAGE":"Plavix,linisopril,simvastatin,melotonin: What possible side effects should I be aware of when taking all of these daily?","QUESTION_ID":"Q83","F_REF":"1-120034945"} -{"ANSWERS":[{"_answerid":"Q84-S1-A1","_pairid":"199","__text":"There may be damage to the retina of the eye (retinitis pigmentosa). Tests that may be done to help diagnose this condition include: - Apolipoprotein B blood test - Blood tests to look for vitamin deficiencies (fat-soluble vitamins A, D, E, and K) - \"Burr-cell\" malformation of the red cells (acanthocytosis) - Complete blood count (CBC) - Cholesterol studies - Electromyography - Eye exam - Nerve conduction velocity - Stool sample analysis Genetic testing may be available for mutations in the MTP gene."},{"_answerid":"Q84-S1-A2","_pairid":"200","__text":"The Genetic Testing Registry (GTR) provides information about the genetic tests available for abetalipoproteinemia. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional. Prenatal testing may also be available for pregnancies at increased risk if the mutations in the family have been identified."}],"SUB_QUESTION_ID":"Q84-S1","ANNOTATIONS.FOCUS":["abetalipoproteinemia"],"ANNOTATIONS.TYPE":"diagnosis","SUBJECT":"abetalipoproteimemia","MESSAGE":"hi, I would like to know if there is any support for those suffering with abetalipoproteinemia? I am not diagnosed but have had many test that indicate I am suffering with this, keen to learn how to get it diagnosed and how to manage, many thanks","QUESTION_ID":"Q84","F_REF":"1-132462207"} -{"ANSWERS":[{"_answerid":"Q84-S2-A1","_pairid":"201","__text":"Treatment involves large doses of vitamin supplements containing fat-soluble vitamins (vitamin A, vitamin D, vitamin E, and vitamin K). Linoleic acid supplements are also recommended. People with this condition should talk to a nutritionist. Diet changes are needed to prevent stomach problems. This involves: - Limiting fat intake to 5 to 20 grams per day. - Do not eat more than 5 ounces daily of lean meat, fish, or poultry. - Use skim milk instead of whole milk. Supplements of medium-chain triglycerides are taken under the supervision of a health care provider. They should be used with caution, because they may cause liver damage."},{"_answerid":"Q84-S2-A2","_pairid":"202","__text":"A nutritionist or other qualified medical professional should be consulted for specific dietary instruction in people with abetalipoproteinemia. Treatment involves very large doses of vitamin E, as well as large doses of vitamin supplements containing other fat-soluble vitamins (vitamin A, vitamin D, and vitamin K). Linoleic acid supplements are also recommended. Several diet changes and\/or restrictions are also needed to prevent stomach problems. A low-fat diet may help with digestive symptoms; medium chain triglycerides may be used (under supervision of a specialist) as a source of fat in the diet. Management in adults typically focuses on specific complications associated with the disorder, and depends on the signs and symptoms present. Affected people may need consultations with several other types of specialists, including a lipidologist, gastroenterologist, hepatologist, ophthalmologist, and neurologist."},{"_answerid":"Q84-S2-A3","_pairid":"203","__text":"These resources address the diagnosis or management of abetalipoproteinemia: - Genetic Testing Registry: Abetalipoproteinaemia - MedlinePlus Encyclopedia: Bassen-Kornzweig syndrome - MedlinePlus Encyclopedia: Malabsorption - MedlinePlus Encyclopedia: Retinitis pigmentosa - MedlinePlus Encyclopedia: Stools - floating These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"}],"SUB_QUESTION_ID":"Q84-S2","ANNOTATIONS.FOCUS":["abetalipoproteinemia"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"abetalipoproteimemia","MESSAGE":"hi, I would like to know if there is any support for those suffering with abetalipoproteinemia? I am not diagnosed but have had many test that indicate I am suffering with this, keen to learn how to get it diagnosed and how to manage, many thanks","QUESTION_ID":"Q84","F_REF":"1-132462207"} -{"ANSWERS":[{"_answerid":"Q85-S1-A1","_pairid":"204","__text":"There is no known way to prevent preeclampsia. It is important for all pregnant women to start prenatal care early and continue it through the pregnancy."}],"SUB_QUESTION_ID":"Q85-S1","ANNOTATIONS.FOCUS":["preeclampsia"],"ANNOTATIONS.TYPE":"prevention","SUBJECT":"prevention of preeclampsia","MESSAGE":"I know that the jury is out on the exact causes of preeclampsia, but I am looking for some of the ways that the chances of acquiring it can be minimized.","QUESTION_ID":"Q85","F_REF":"NF_214"} -{"ANSWERS":[{"_answerid":"Q86-S1-A1","_pairid":"206","__text":"Treatment depends on many things, including the stage of the cancer. Treatments may include: - Surgery to remove the tumor - Chemotherapy to kill cancer cells - Radiation therapy to destroy cancerous tissue - Targeted therapy to keep cancer from growing and spreading\u00a0 Surgery Stage 0 colon cancer may be treated by removing the tumor. This is done using colonoscopy. For stages I, II, and III cancer, more extensive surgery is needed to remove the part of the colon that is cancerous. This surgery is called colon resection\u00a0(colectomy). Chemotherapy Almost all people with stage III colon cancer receive chemotherapy after surgery for 6 to 8 months. This is called adjuvant chemotherapy. Even though the tumor was removed, chemotherapy is given to treat any cancer cells that may be left. Chemotherapy is also used to improve symptoms and prolong survival in people with stage IV colon cancer. You may receive just one type of medicine or a combination of medicines. Radiation Radiation therapy is sometimes used for colon cancer. It is usually used in combination with chemotherapy for people with stage III rectal cancer. For people with stage IV disease that has spread to the liver, treatment directed at the liver can be used. This may include: - Burning the cancer (ablation) - Delivering chemotherapy or radiation directly into the liver - Freezing the cancer (cryotherapy) - Surgery Targeted Therapy - Targeted treatment zeroes in on specific targets (molecules) in cancer cells. These targets play a role in how cancer cells grow and survive. Using these targets, the drug disables the cancer cells so they cannot spread. Targeted therapy may be given as pills or may be injected into a vein. - You may have targeted therapy along with surgery, chemotherapy, or radiation treatment."}],"SUB_QUESTION_ID":"Q86-S1","ANNOTATIONS.FOCUS":["colon cancer"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"Colon cancer cure seen on tv. My father has colon cancer and said he saw a commercial on tv about a cure for colon cancer. He cannot remember any details about it. I was wondering if you know anything about something like this. Please let me know. Thank you, [NAME]","QUESTION_ID":"Q86","F_REF":"11901"} -{"ANSWERS":[{"_answerid":"Q87-S1-A1","_pairid":"207","__text":"Hypertrophic cardiomyopathy (HCM) is a condition in which the heart muscle becomes thick. Often, only 1 part of the heart is thicker than the other parts. The thickening can make it harder for blood to leave the heart, forcing the heart to work harder to pump blood. It also can make it harder for the heart to relax and fill with blood."}],"SUB_QUESTION_ID":"Q87-S1","ANNOTATIONS.FOCUS":["IHSS heart condition"],"ANNOTATIONS.TYPE":"information","SUBJECT":"IHSS heart condition and WPW heart condition","MESSAGE":"Is there any way you could send me information on both these heart conditions? My son has to get tested for them eventually and I would just like information to understand the conditions of both of them more.","QUESTION_ID":"Q87","F_REF":"1-137083655"} -{"ANSWERS":[{"_answerid":"Q87-S2-A1","_pairid":"208","__text":"Wolff-Parkinson-White syndrome is a condition in which there is an extra electrical pathway of the heart. The condition can lead to periods of rapid heart rate (tachycardia). Wolff-Parkinson-White syndrome is one of the most common causes of fast heart rate problems in infants and children."},{"_answerid":"Q87-S2-A2","_pairid":"209","__text":"Wolff-Parkinson-White syndrome is a condition characterized by abnormal electrical pathways in the heart that cause a disruption of the heart's normal rhythm (arrhythmia). The heartbeat is controlled by electrical signals that move through the heart in a highly coordinated way. A specialized cluster of cells called the atrioventricular node conducts electrical impulses from the heart's upper chambers (the atria) to the lower chambers (the ventricles). Impulses move through the atrioventricular node during each heartbeat, stimulating the ventricles to contract slightly later than the atria. People with Wolff-Parkinson-White syndrome are born with an extra connection in the heart, called an accessory pathway, that allows electrical signals to bypass the atrioventricular node and move from the atria to the ventricles faster than usual. The accessory pathway may also transmit electrical impulses abnormally from the ventricles back to the atria. This extra connection can disrupt the coordinated movement of electrical signals through the heart, leading to an abnormally fast heartbeat (tachycardia) and other arrhythmias. Resulting symptoms include dizziness, a sensation of fluttering or pounding in the chest (palpitations), shortness of breath, and fainting (syncope). In rare cases, arrhythmias associated with Wolff-Parkinson-White syndrome can lead to cardiac arrest and sudden death. The most common arrhythmia associated with Wolff-Parkinson-White syndrome is called paroxysmal supraventricular tachycardia. Complications of Wolff-Parkinson-White syndrome can occur at any age, although some individuals born with an accessory pathway in the heart never experience any health problems associated with the condition. Wolff-Parkinson-White syndrome often occurs with other structural abnormalities of the heart or underlying heart disease. The most common heart defect associated with the condition is Ebstein anomaly, which affects the valve that allows blood to flow from the right atrium to the right ventricle (the tricuspid valve). Additionally, Wolff-Parkinson-White syndrome can be a component of several other genetic syndromes, including hypokalemic periodic paralysis (a condition that causes episodes of extreme muscle weakness), Pompe disease (a disorder characterized by the storage of excess glycogen), and tuberous sclerosis (a condition that results in the growth of noncancerous tumors in many parts of the body)."}],"SUB_QUESTION_ID":"Q87-S2","ANNOTATIONS.FOCUS":["wpw"],"ANNOTATIONS.TYPE":"information","SUBJECT":"IHSS heart condition and WPW heart condition","MESSAGE":"Is there any way you could send me information on both these heart conditions? My son has to get tested for them eventually and I would just like information to understand the conditions of both of them more.","QUESTION_ID":"Q87","F_REF":"1-137083655"} -{"ANSWERS":[{"_answerid":"Q88-S1-A1","_pairid":"210","__text":"A stroke is a medical emergency. Quick treatment is needed. Call 9-1-1 or your local emergency number right away or seek urgent medical care at the first signs of a stroke. People who are having stroke symptoms need to get to a hospital as quickly as possible. - If the stroke is caused by a blood clot, a clot-busting drug may be given to dissolve the clot. - To be effective, this treatment must be started within 3 to 4 1\/2 hours of when the symptoms first started. The sooner this treatment is started, the better the chance of a good outcome. Other treatments given in the hospital depend on the cause of the stroke. These may include: - Blood thinners such as heparin, warfarin (Coumadin), aspirin, or clopidogrel (Plavix) - Medicine to control risk factors, such as high blood pressure, diabetes, and high cholesterol - Special procedures or surgery to relieve symptoms or prevent more strokes - Nutrients and fluids Physical therapy, occupational therapy, speech therapy, and swallowing therapy will all begin in the hospital. If the person has severe swallowing problems, a feeding tube in the stomach (gastrostomy tube) will likely be needed. The goal of treatment after a stroke is to help you recover as much function as possible and prevent future strokes. Recovery from your stroke will begin while you are still in the hospital or at a rehabilitation center. It will continue when you go home from the hospital or center. Be sure to follow up with your health care provider after you go home."},{"_answerid":"Q88-S1-A2","_pairid":"211","__text":"Generally there are three treatment stages for stroke: prevention, therapy immediately after the stroke, and post-stroke rehabilitation. Therapies to prevent a first or recurrent stroke are based on treating an individual's underlying risk factors for stroke, such as hypertension, atrial fibrillation, and diabetes. Acute stroke therapies try to stop a stroke while it is happening by quickly dissolving the blood clot causing an ischemic stroke or by stopping the bleeding of a hemorrhagic stroke. Post-stroke rehabilitation helps individuals overcome disabilities that result from stroke damage. Medication or drug therapy is the most common treatment for stroke. The most popular classes of drugs used to prevent or treat stroke are antithrombotics (antiplatelet agents and anticoagulants) and thrombolytics."},{"_answerid":"Q88-S1-A3","_pairid":"212","__text":"With stroke, treatment depends on the stage of the disease. There are three treatment stages for stroke: prevention, therapy immediately after stroke, and rehabilitation after stroke. Stroke treatments include medications, surgery, and rehabilitation."},{"_answerid":"Q88-S1-A4","_pairid":"213","__text":"Medication or drug therapy is the most common treatment for stroke. The most popular kinds of drugs to prevent or treat stroke are antithrombotics -- which include antiplatelet agents and anticoagulants -- and thrombolytics. Antithrombotics prevent the formation of blood clots that can become stuck in an artery of the brain and cause strokes. - In the case of stroke, doctors prescribe antiplatelet drugs mainly for prevention. The most widely known and used antiplatelet drug is aspirin. Other antiplatelet drugs include clopidogrel, ticlopidine, and dipyridamole. In the case of stroke, doctors prescribe antiplatelet drugs mainly for prevention. The most widely known and used antiplatelet drug is aspirin. Other antiplatelet drugs include clopidogrel, ticlopidine, and dipyridamole. - Anticoagulants reduce the risk of stroke by reducing the clotting property of the blood. The most commonly used oral anticoagulants include warfarin, also known as Coumadin\u00ae, dabigatran (Pradaxa) and rivaroxaban (Xarelto). Injectable anticoagulants include heparin, enoxaparin (Lovenox), and dalteparin (Fragmin). Anticoagulants reduce the risk of stroke by reducing the clotting property of the blood. The most commonly used oral anticoagulants include warfarin, also known as Coumadin\u00ae, dabigatran (Pradaxa) and rivaroxaban (Xarelto). Injectable anticoagulants include heparin, enoxaparin (Lovenox), and dalteparin (Fragmin). Thrombolytic drugs halt the stroke by dissolving the blood clot that is blocking blood flow to the brain. Ischemic strokes -- the most common kind -- can be treated with thrombolytic drugs. But a person needs to be at the hospital as soon as possible after symptoms start to be evaluated and receive treatment. A thrombolytic drug known as t-PA can be effective if a person receives it intravenously (in a vein) within 3 hours after his or her stroke symptoms have started. Because there is such a narrow time window for giving t-PA, it is important to note the time any stroke symptoms appear. Since thrombolytic drugs can increase bleeding, t-PA should be used only after the doctor is certain that the patient has suffered an ischemic and not a hemorrhagic stroke. Neuroprotectants are medications or other treatments that protect the brain from secondary injury caused by stroke. Although the FDA (Food and Drug Administration) has not approved any neuroprotectants for use in stroke at this time, many have been tested or are being tested in clinical trials. Cooling of the brain (hypothermia) is beneficial for improving neurological function after a cardiac arrest."},{"_answerid":"Q88-S1-A5","_pairid":"214","__text":"Surgery can be used to prevent stroke, to treat stroke, or to repair damage to the blood vessels or malformations in and around the brain. - Carotid endarterectomy is a surgical procedure in which a surgeon removes fatty deposits, or plaque, from the inside of one of the carotid arteries. The procedure is performed to prevent stroke. The carotid arteries are located in the neck and are the main suppliers of blood to the brain. Carotid endarterectomy is a surgical procedure in which a surgeon removes fatty deposits, or plaque, from the inside of one of the carotid arteries. The procedure is performed to prevent stroke. The carotid arteries are located in the neck and are the main suppliers of blood to the brain. Vascular Interventions In addition to surgery, a variety of techniques have been developed to allow certain vascular problems to be treated from inside the artery using specialized catheters with the goal of improving blood flow. (Vascular is a word that refers to blood vessels, arteries, and veins that carry blood throughout the body.) A catheter is a very thin, flexible tube that can be inserted into one of the major arteries of the leg or arm and then directed through the blood vessels to the diseased artery. Physicians trained in this technique called angiography undergo additional training to treat problems in the arteries of the brain or spinal cord. These physicians are called neurointerventionalists. - Angioplasty is widely used by angiographers to open blocked heart arteries, and is also used to prevent stroke. Angioplasty is a procedure in which a special catheter is inserted into the narrowed artery and then a balloon at the tip of the catheter is inflated to open the blocked artery. The procedure improves blood flow to the brain. Angioplasty is widely used by angiographers to open blocked heart arteries, and is also used to prevent stroke. Angioplasty is a procedure in which a special catheter is inserted into the narrowed artery and then a balloon at the tip of the catheter is inflated to open the blocked artery. The procedure improves blood flow to the brain. - Stenting is another procedure used to prevent stroke. In this procedure an angiographer inserts a catheter into the artery in the groin and then positions the tip of the catheter inside the narrowed artery. A stent is a tube-like device made of a mesh-like material that can be slipped into position over the catheter. When positioned inside the narrowed segment the stent is expanded to widen the artery and the catheter is removed. Angioplasty or stenting of the carotid artery can cause pieces of the diseased plaque to loosen. An umbrella-like device is often temporarily expanded above to prevent these pieces from traveling to the brain. Stenting is another procedure used to prevent stroke. In this procedure an angiographer inserts a catheter into the artery in the groin and then positions the tip of the catheter inside the narrowed artery. A stent is a tube-like device made of a mesh-like material that can be slipped into position over the catheter. When positioned inside the narrowed segment the stent is expanded to widen the artery and the catheter is removed. Angioplasty or stenting of the carotid artery can cause pieces of the diseased plaque to loosen. An umbrella-like device is often temporarily expanded above to prevent these pieces from traveling to the brain. - Angiographers also sometimes use clot removal devices to treat stroke patients in the very early stage. One device involves threading a catheter through the artery to the site of the blockage and then vacuuming out the clot. Another corkscrew-like device can be extended from the tip of a catheter and used to grab the clot and pull it out. Drugs can also be injected through the catheter directly into the clot to help dissolve the clot. Angiographers also sometimes use clot removal devices to treat stroke patients in the very early stage. One device involves threading a catheter through the artery to the site of the blockage and then vacuuming out the clot. Another corkscrew-like device can be extended from the tip of a catheter and used to grab the clot and pull it out. Drugs can also be injected through the catheter directly into the clot to help dissolve the clot."}],"SUB_QUESTION_ID":"Q88-S1","ANNOTATIONS.FOCUS":["stroke"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"striving to recove speech arti\\culutation when traditional therapies have failed","MESSAGE":"I'm a vietnam navy veteran whose traditional stroke thearapy has failed miserably","QUESTION_ID":"Q88","F_REF":"1-132291442"} -{"ANSWERS":[{"_answerid":"Q89-S1-A1","_pairid":"216","__text":"Your provider may recommend that you do the following: Avoid activities that cause pain. Put ice on the heel several times a day. Take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. Try using over-the-counter or custom heel wedges in your shoe to help decrease stress on the heel. Try ultrasound treatment during physical therapy to reduce inflammation. Have physical therapy to improve flexibility and strength around the ankle. The focus will be on stretching your Achilles tendon. This can help the bursitis improve and prevent it from coming back. If these treatments DO NOT work, your provider may inject a small amount of steroid medicine into the bursa. After the injection, you should avoid overstretching the tendon because it can break open (rupture). If the condition is connected to Achilles tendinitis, you may need to wear a cast on the ankle for several weeks. Very rarely, surgery may be needed to remove the inflamed bursa."}],"SUB_QUESTION_ID":"Q89-S1","ANNOTATIONS.FOCUS":["haglund's deformity"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"Subcutaneous retrocalcaneal bursitis","MESSAGE":"Haglund's deformity of the calcaneum. I have this problem. Can you please help to overcome this?","QUESTION_ID":"Q89","F_REF":"1-131053785"} -{"ANSWERS":[{"_answerid":"Q90-S1-A1","_pairid":"217","__text":"Williams syndrome is a developmental disorder that affects many parts of the body. This condition is characterized by mild to moderate intellectual disability or learning problems, unique personality characteristics, distinctive facial features, and heart and blood vessel (cardiovascular) problems. People with Williams syndrome typically have difficulty with visual-spatial tasks such as drawing and assembling puzzles, but they tend to do well on tasks that involve spoken language, music, and learning by repetition (rote memorization). Affected individuals have outgoing, engaging personalities and tend to take an extreme interest in other people. Attention deficit disorder (ADD), problems with anxiety, and phobias are common among people with this disorder. Young children with Williams syndrome have distinctive facial features including a broad forehead, a short nose with a broad tip, full cheeks, and a wide mouth with full lips. Many affected people have dental problems such as teeth that are small, widely spaced, crooked, or missing. In older children and adults, the face appears longer and more gaunt. A form of cardiovascular disease called supravalvular aortic stenosis (SVAS) occurs frequently in people with Williams syndrome. Supravalvular aortic stenosis is a narrowing of the large blood vessel that carries blood from the heart to the rest of the body (the aorta). If this condition is not treated, the aortic narrowing can lead to shortness of breath, chest pain, and heart failure. Other problems with the heart and blood vessels, including high blood pressure (hypertension), have also been reported in people with Williams syndrome. Additional signs and symptoms of Williams syndrome include abnormalities of connective tissue (tissue that supports the body's joints and organs) such as joint problems and soft, loose skin. Affected people may also have increased calcium levels in the blood (hypercalcemia) in infancy, developmental delays, problems with coordination, and short stature. Medical problems involving the eyes and vision, the digestive tract, and the urinary system are also possible."},{"_answerid":"Q90-S1-A2","_pairid":"218","__text":"Williams Syndrome (WS) is a rare genetic disorder characterized by mild to moderate delays in cognitive development or learning difficulties, a distinctive facial appearance, and a unique personality that combines over-friendliness and high levels of empathy with anxiety. The most significant medical problem associated with WS is cardiovascular disease caused by narrowed arteries. WS is also associated with elevated blood calcium levels in infancy. A random genetic mutation (deletion of a small piece of chromosome 7), rather than inheritance, most often causes the disorder.\u00a0 However, individuals who have WS have a 50 percent chance of passing it on if they decide to have children.\u00a0 The characteristic facial features of WS include puffiness around the eyes, a short nose with a broad nasal tip, wide mouth, full cheeks, full lips, and a small chin. People with WS are also likely to have a long neck, sloping shoulders, short stature, limited mobility in their joints, and curvature of the spine.\u00a0 Some individuals with WS have a star-like pattern in the iris of their eyes.\u00a0 Infants with WS are often irritable and colicky, with feeding problems that keep them from gaining weight.\u00a0 Chronic abdominal pain is common in adolescents and adults. By age 30, the majority of individuals with WS have diabetes or pre-diabetes and mild to moderate sensorineural hearing loss (a form of deafness due to disturbed function of the auditory nerve).\u00a0 For some people, hearing loss may begin as early as late childhood. WS also is associated with a characteristic \u201ccognitive profile\u201d of mental strengths and weaknesses composed of strengths in verbal short-term memory and language, combined with severe weakness in visuospatial construction (the skills used to copy patterns, draw, or write). Within language, the strongest skills are typically in concrete, practical vocabulary, which in many cases is in the low average to average range for the general population. Abstract or conceptual-relational vocabulary is much more limited. Most older children and adults with WS speak fluently and use good grammar.\u00a0 More than 50% of children with WS have attention deficit disorders (ADD or ADHD), and about 50% have specific phobias, such as a fear of loud noises. The majority of individuals with WS worry excessively. The National Institutes of Health (NIH), and the National Institute of Neurological Disorders and Stroke (NINDS), have funded many of the research studies exploring the genetic and neurobiological origins of WS.\u00a0 In the early 1990s, researchers located and identified the genetic mutation responsible for the disorder: the deletion of a small section of chromosome 7 that contains approximately 25 genes.\u00a0 NINDS continues to support WS researchers including, for example, groups that are attempting to link specific genes with the corresponding facial, cognitive, personality, and neurological characteristics of WS."}],"SUB_QUESTION_ID":"Q90-S1","ANNOTATIONS.FOCUS":["williams syndrome"],"ANNOTATIONS.TYPE":"information","SUBJECT":"","MESSAGE":"williams sydrome conditon. i need to send me more information about Williams Syndrome and some tips how to educate people with this disorder.I hope having news from you soon!!thank you","QUESTION_ID":"Q90","F_REF":"11709"} -{"ANSWERS":[{"_answerid":"Q91-S1-A1","_pairid":"224","__text":"Most women have some adenomyosis as they get close to menopause. However, only a few will have symptoms. Most women do not need treatment. Birth control pills and a progesterone-containing intrauterine device (IUD) can help decrease heavy bleeding. Anti-inflammatory medication such as ibuprofen or naproxen can also help manage symptoms. A hysterectomy may be necessary in women with severe symptoms."}],"SUB_QUESTION_ID":"Q91-S1","ANNOTATIONS.FOCUS":["adenomyosis"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"Please i want to know the cure to Adenomyosis. I have been going through alot of pains during my menstruation. I want to see a specialist doctor to help me out. I am dying with pains.","QUESTION_ID":"Q91","F_REF":"1-135933942"} -{"ANSWERS":[{"_answerid":"Q92-S1-A1","_pairid":"225","__text":"There are no known cures for the various muscular dystrophies. The goal of treatment is to control symptoms. Physical therapy may help maintain muscle strength and function. Leg braces and a wheelchair can improve mobility and self-care. In some cases, surgery on the spine or legs may help improve function. Corticosteroids taken by mouth are sometimes prescribed to children with certain muscular dystrophies to keep them walking for as long as possible. The person should be as active as possible. No activity at all (such as bedrest) can make the disease worse."},{"_answerid":"Q92-S1-A2","_pairid":"226","__text":"There is no specific treatment to stop or reverse any form of MD. Treatment may include physical therapy, respiratory therapy, speech therapy, orthopedic appliances used for support, and corrective orthopedic surgery. Drug therapy includes corticosteroids to slow muscle degeneration, anticonvulsants to control seizures and some muscle activity, immunosuppressants to delay some damage to dying muscle cells, and antibiotics to fight respiratory infections. Some individuals may benefit from occupational therapy and assistive technology. Some patients may need assisted ventilation to treat respiratory muscle weakness and a pacemaker for cardiac abnormalities."}],"SUB_QUESTION_ID":"Q92-S1","ANNOTATIONS.FOCUS":["muscular dystrophy"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"muscular dystrophy medicine","MESSAGE":"My brother need treatment for muscular dystrophy","QUESTION_ID":"Q92","F_REF":"1-133480747"} -{"ANSWERS":[{"_answerid":"Q93-S1-A1","_pairid":"227","__text":"Initial Treatment Celexa (citalopram HBr) should be administered at an initial dose of 20 mg once daily, generally with an increase to a dose of 40 mg\/day. Dose increases should usually occur in increments of 20 mg at intervals of no less than one week. Although certain patients may require a dose of 60 mg\/day, the only study pertinent to dose response for effectiveness did not demonstrate an advantage for the 60 mg\/day dose over the 40 mg\/day dose; doses above 40 mg are therefore not ordinarily recommended. Celexa should be administered once daily, in the morning or evening, with or without food. Special Populations 20 mg\/day is the recommended dose for most elderly patients and patients with hepatic impairment, with titration to 40 mg\/day only for nonresponding patients. No dosage adjustment is necessary for patients with mild or moderate renal impairment. Celexa should be used with caution in patients with severe renal impairment. Treatment of Pregnant Women During the Third Trimester Neonates exposed to Celexa and other SSRIs or SNRIs, late in the third trimester, have developed complications requiring prolonged hospitalization, respiratory support, and tube feeding (see PRECAUTIONS). When treating pregnant women with Celexa during the third trimester, the physician should carefully consider the potential risks and benefits of treatment. The physician may consider tapering Celexa in the third trimester. Maintenance Treatment It is generally agreed that acute episodes of depression require several months or longer of sustained pharmacologic therapy. Systematic evaluation of Celexa in two studies has shown that its antidepressant efficacy is maintained for periods of up to 24 weeks following 6 or 8 weeks of initial treatment (32 weeks total). In one study, patients were assigned randomly to placebo or to the same dose of Celexa (20-60 mg\/day) during maintenance treatment as they had received during the acute stabilization phase, while in the other study, patients were assigned randomly to continuation of Celexa 20 or 40 mg\/day, or placebo, for maintenance treatment. In the latter study, the rates of relapse to depression were similar for the two dose groups (see Clinical Trials under CLINICAL PHARMACOLOGY). Based on these limited data, it is not known whether the dose of citalopram needed to maintain euthymia is identical to the dose needed to induce remission. If adverse reactions are bothersome, a decrease in dose to 20 mg\/day can be considered. Discontinuation of Treatment with Celexa Symptoms associated with discontinuation of Celexa and other SSRIs and SNRIs have been reported (see PRECAUTIONS). Patients should be monitored for these symptoms when discontinuing treatment. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose but at a more gradual rate. Switching Patients To or From a Monoamine Oxidase Inhibitor At least 14 days should elapse between discontinuation of an MAOI and initiation of Celexa therapy. Similarly, at least 14 days should be allowed after stopping Celexa before starting an MAOI (see CONTRAINDICATIONS and WARNINGS)."}],"SUB_QUESTION_ID":"Q93-S1","ANNOTATIONS.FOCUS":["Citalopram"],"ANNOTATIONS.TYPE":"dosage","SUBJECT":"","MESSAGE":"What ia the lowest starting dose of Citalopram?","QUESTION_ID":"Q93","F_REF":"1-123031525"} -{"ANSWERS":[{"_answerid":"Q94-S1-A1","_pairid":"228","__text":"If ADHD is suspected, the person should be evaluated by a health care professional. There is no test that can make or exclude a diagnosis of ADHD. The diagnosis is based on a pattern of the symptoms listed below. When the person with suspected ADHD is a child, parents and teachers are usually involved during the evaluation process. Most children with ADHD have at least one other developmental or mental health problem. This problem may be a mood, anxiety or substance use disorder; a learning disability; or a tic disorder. A doctor can help determine whether these other conditions are present. Symptoms ADHD symptoms fall into three groups: Not being able to focus (inattentiveness) Being extremely active (hyperactivity) Not being able to control behavior (impulsivity) Some people with ADHD have mainly inattentive symptoms. Some have mainly hyperactive and impulsive symptoms. Others have a combination of these behaviors. INATTENTIVE SYMPTOMS Doesn't pay attention to details or makes careless mistakes in schoolwork Has problems focusing during tasks or play Doesn't listen when spoken to directly Doesn't follow through on instructions and doesn't finish schoolwork or chores Has problems organizing tasks and activities Avoids or doesn't like tasks that require mental effort (such as schoolwork) Often loses things, such as homework or toys Is easily distracted Is often forgetful HYPERACTIVITY SYMPTOMS Fidgets or squirms in seat Leaves their seat when they should stay in their seat Runs about or climbs when they shouldn't be doing so Has problems playing or working quietly Is often \"on the go,\" acts as if \"driven by a motor\" Talks all the time IMPULSIVITY SYMPTOMS Blurts out answers before questions have been completed Has problems awaiting their turn Interrupts or intrudes on others (butts into conversations or games) Many of the above findings are present in children as they grow. For these problems to be diagnosed as ADHD, they must be out of the normal range for a person's age and development."}],"SUB_QUESTION_ID":"Q94-S1","ANNOTATIONS.FOCUS":["adhd"],"ANNOTATIONS.TYPE":"diagnosis","SUBJECT":"","MESSAGE":"ClinicalTrials.gov - General Complaint. I have had undisguised ADHD since I was 8 years old. I sold illicit drugs from 1979-1989 in large quantity's & self medicated with amphetamines as an adolescent which damaged my Brian & worsened my symptoms. Because I have had several drug induced psychotic episodes since I was busted for trafficking in 1989 & was unable to self medicate on a daily basis. I was wrongly diagnosed with schizophrenia 9years ago. The community psychiatrist's have treated me with all the wrong medication's that have made my ADHD symptoms worse & forced me to self medicate until now. I have no assets or money & I don't think it is worth while going on with out being put on the right medication Ritalin. When I take Meth amphetamines my symptoms improve & I haven't had any anti psychotic medication for 13 month's & have not gone psychotic or had any negative symptoms of schizophrenia. Can you suggest any type of tests I can do to prove I have Adult ADHD or a psychiatrist I can see in [LOCATION] Australia. Who can help me","QUESTION_ID":"Q94","F_REF":"11579"} -{"ANSWERS":[{"_answerid":"Q95-S1-A1","_pairid":"229","__text":"There is no known cure for MS at this time. But, there are treatments that may slow the disease. The goal of treatment is to control symptoms and help you maintain a normal quality of life. Medicines are often taken long-term. These include: - Medicines to slow the disease - Steroids to decrease the severity of attacks - Medicines to control symptoms such as muscle spasms, urinary problems, fatigue, or mood problems Medicines are more effective for the relapsing-remitting form than for other forms of MS. The following may also be helpful for people with MS: - Physical therapy, speech therapy, occupational therapy, and support groups - Assistive devices, such as wheelchairs, bed lifts, shower chairs, walkers, and wall bars - A planned exercise program early in the course of the disorder - A healthy lifestyle, with good nutrition and enough rest and relaxation - Avoiding fatigue, stress, temperature extremes, and illness - Changes in what you eat or drink if there are swallowing problems - Making changes around the home to prevent falls - Social workers or other counseling services to help you cope with the disorder and get assistance - Vitamin D or other supplements (talk to your provider first) - Complementary and alternative approaches, such as acupressure or cannabis, to help with muscle problems"},{"_answerid":"Q95-S1-A2","_pairid":"230","__text":"These resources address the diagnosis or management of multiple sclerosis: - Gene Review: Gene Review: Multiple Sclerosis Overview - Multiple Sclerosis Association of America: Treatments for MS - Multiple Sclerosis International Federation: About MS--Diagnosis - National Multiple Sclerosis Society: Diagnosing Tools These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"},{"_answerid":"Q95-S1-A3","_pairid":"231","__text":"There is as yet no cure for MS. Many patients do well with no therapy at all, especially since many medications have serious side effects and some carry significant risks.\u00a0 However, three forms of beta interferon (Avonex, Betaseron, and Rebif) have now been approved by the Food and Drug Administration for treatment of relapsing-remitting MS. Beta interferon has been shown to reduce the number of exacerbations and may slow the progression of physical disability. When attacks do occur, they tend to be shorter and less severe.\u00a0 The FDA also has approved a synthetic form of myelin basic protein, called copolymer I (Copaxone), for the treatment of relapsing-remitting MS. Copolymer I has few side effects, and studies indicate that the agent can reduce the relapse rate by almost one third. \u00a0Other FDA approved drugs to treat relapsing forms of MS in adults include teriflunomide and dimethyl fumarate. \u00a0An immunosuppressant treatment, Novantrone (mitoxantrone), is\u00a0approved by the FDA for the treatment of advanced or chronic MS. \u00a0The FDA has also approved dalfampridine (Ampyra) to improve walking in individuals with MS. One monoclonal antibody, natalizumab (Tysabri), was shown in clinical trials to significantly reduce the frequency of attacks in people with relapsing forms of MS and was approved for marketing by the U.S. Food and Drug Administration (FDA) in 2004.\u00a0 However, in 2005 the drug\u2019s manufacturer voluntarily suspended marketing of the drug after several reports of significant adverse events.\u00a0 In 2006, the FDA again approved sale of the drug for MS but under strict treatment guidelines involving infusion centers where patients can be monitored by specially trained physicians. \u00a0While steroids do not affect the course of MS over time, they can reduce the duration and severity of attacks in some patients.\u00a0 Spasticity, which can occur either as a sustained stiffness caused by increased muscle tone or as spasms that come and go, is usually treated with muscle relaxants and tranquilizers such as baclofen, tizanidine, diazepam, clonazepam, and dantrolene. Physical therapy and exercise can help preserve remaining function, and patients may find that various aids -- such as foot braces, canes, and walkers -- can help them remain independent and mobile.\u00a0 Avoiding excessive activity and avoiding heat are probably the most important measures patients can take to counter physiological fatigue.\u00a0 If psychological symptoms of fatigue such as depression or apathy are evident, antidepressant medications may help.\u00a0 Other drugs that may reduce fatigue in some, but not all, patients include amantadine (Symmetrel), pemoline (Cylert), and the still-experimental drug aminopyridine. Although improvement of optic symptoms usually occurs even without treatment, a short course of treatment with intravenous methylprednisolone (Solu-Medrol) followed by treatment with oral steroids is sometimes used."}],"SUB_QUESTION_ID":"Q95-S1","ANNOTATIONS.FOCUS":["multiple sclerosis"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"Research assignment","MESSAGE":"Hi, I am a grade 12 student who is doing a research assignment on neurological disorders. Do you believe that there will ever be a bonafide cure for Multiple Sclerosis? If so, what kind of time frame would put on this cure?","QUESTION_ID":"Q95","F_REF":"12751"} -{"ANSWERS":[{"_answerid":"Q96-S1-A1","_pairid":"232","__text":"Your doctor may diagnose your child with achondroplasia while you\u2019re pregnant or after your infant is born. Diagnosis During Pregnancy Some characteristics of achondroplasia are detectable during an ultrasound. These include hydrocephalus, or an abnormally large head. If your doctor suspects achondroplasia, genetic tests may be ordered. These tests look for the defective FGFR3 gene in a sample of amniotic fluid, which is the fluid that surrounds the fetus in the womb. Diagnosis After Your Child Is Born Your doctor can diagnose your child by looking at his or her features. The doctor may also order X-rays to measure the length of your infant\u2019s bones. This can help confirm a diagnosis. Blood tests may also be ordered to look for the defective FGFR3 gene."}],"SUB_QUESTION_ID":"Q96-S1","ANNOTATIONS.FOCUS":["achondroplasia"],"ANNOTATIONS.TYPE":"diagnosis","SUBJECT":"","MESSAGE":"Achondroplasia research. Hello, We are students from [LOCATION] and we are doing a biology project of genetic diseases. We chose Achondroplasia as our disease to research. We have a few question and we are hoping you could answer them. Our questions are, can you tell if your child will have Achondroplasia when you are pregnant? When do people usually come in when they think something isn't right with their child? what are the worse cases of Achondroplasia you've ever seen? Thank you in advance. sincerely, [NAME]","QUESTION_ID":"Q96","F_REF":"10189"} -{"ANSWERS":[{"_answerid":"Q96-S2-A1","_pairid":"233","__text":"People with achondroplasia seldom reach 5 feet in height. Intelligence is in the normal range. Infants who receive the abnormal gene from both parents do not often live beyond a few months."}],"SUB_QUESTION_ID":"Q96-S2","ANNOTATIONS.FOCUS":["achondroplasia"],"ANNOTATIONS.TYPE":"prognosis","SUBJECT":"","MESSAGE":"Achondroplasia research. Hello, We are students from [LOCATION] and we are doing a biology project of genetic diseases. We chose Achondroplasia as our disease to research. We have a few question and we are hoping you could answer them. Our questions are, can you tell if your child will have Achondroplasia when you are pregnant? When do people usually come in when they think something isn't right with their child? what are the worse cases of Achondroplasia you've ever seen? Thank you in advance. sincerely, [NAME]","QUESTION_ID":"Q96","F_REF":"10189"} -{"ANSWERS":[{"_answerid":"Q97-S1-A1","_pairid":"234","__text":"Risperidone is used to treat the symptoms of schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions) in adults and teenagers 13 years of age and older. It is also used to treat episodes of mania (frenzied, abnormally excited, or irritated mood) or mixed episodes (symptoms of mania and depression that happen together) in adults and in teenagers and children 10 years of age and older with bipolar disorder (manic depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods). Risperidone is also used to treat behavior problems such as aggression, self-injury, and sudden mood changes in teenagers and children 5 to 16 years of age who have autism (a condition that causes repetitive behavior, difficulty interacting with others, and problems with communication). Risperidone is in a class of medications called atypical antipsychotics. It works by changing the activity of certain natural substances in the brain."}],"SUB_QUESTION_ID":"Q97-S1","ANNOTATIONS.FOCUS":["Risperdoine"],"ANNOTATIONS.TYPE":"information","SUBJECT":"Subject","MESSAGE":"I'm calling because I would like to know more advice on crating Risperdoine medicine and gain experiences on the medication. And creating the medication","QUESTION_ID":"Q97","F_REF":"1-121832945"} -{"ANSWERS":[{"_answerid":"Q98-S1-A1","_pairid":"235","__text":"There are many causes of optic atrophy. The most common is poor blood flow. This is called ischemic optic neuropathy. The problem most often affects older adults. The optic nerve can also be damaged by shock, toxins, radiation, and trauma. Eye diseases, such as glaucoma, can also cause a form of optic nerve atrophy. The condition can also be caused by diseases of the brain and central nervous system. These may include: - Brain tumor - Cranial arteritis (sometimes called temporal arteritis) - Multiple sclerosis - Stroke There are also rare forms of hereditary optic nerve atrophy that affect children and young adults."}],"SUB_QUESTION_ID":"Q98-S1","ANNOTATIONS.FOCUS":["optic atrophy"],"ANNOTATIONS.TYPE":"cause","SUBJECT":"optic atrophy","MESSAGE":"Is optic atrophy ginetic and what cause it?","QUESTION_ID":"Q98","F_REF":"1-136965327"} -{"ANSWERS":[{"_answerid":"Q99-S1-A1","_pairid":"236","__text":"Essential tremor is the most common movement disorder. It is characterized by involuntary and rhythmic shaking (tremor), especially in the hands, without any other signs or symptoms. It is distinguished from tremor that results from other disorders or known causes, such as tremors seen with Parkinson disease or head trauma. Most cases of essential tremor are hereditary. There are five forms of essential tremor that are based on different genetic causes. Several genes as well as lifestyle and environmental factors likely play a role in a person's risk of developing this complex condition. In mild cases, treatment may not be necessary. In cases where symptoms interfere with daily living, medications may help to relieve symptoms."},{"_answerid":"Q99-S1-A2","_pairid":"237","__text":"Essential tremor is a movement disorder that causes involuntary, rhythmic shaking (tremor), especially in the hands. It is distinguished from tremor that results from other disorders or known causes, such as Parkinson disease or head trauma. Essential tremor usually occurs alone, without other neurological signs or symptoms. However, some experts think that essential tremor can include additional features, such as mild balance problems. Essential tremor usually occurs with movements and can occur during many different types of activities, such as eating, drinking, or writing. Essential tremor can also occur when the muscles are opposing gravity, such as when the hands are extended. It is usually not evident at rest. In addition to the hands and arms, muscles of the trunk, face, head, and neck may also exhibit tremor in this disorder; the legs and feet are less often involved. Head tremor may appear as a \"yes-yes\" or \"no-no\" movement while the affected individual is seated or standing. In some people with essential tremor, the tremor may affect the voice (vocal tremor). Essential tremor does not shorten the lifespan. However, it may interfere with fine motor skills such as using eating utensils, writing, shaving, or applying makeup, and in some cases these and other activities of daily living can be greatly impaired. Symptoms of essential tremor may be aggravated by emotional stress, anxiety, fatigue, hunger, caffeine, cigarette smoking, or temperature extremes. Essential tremor may appear at any age but is most common in the elderly. Some studies have suggested that people with essential tremor have a higher than average risk of developing neurological conditions including Parkinson disease or sensory problems such as hearing loss, especially in individuals whose tremor appears after age 65."}],"SUB_QUESTION_ID":"Q99-S1","ANNOTATIONS.FOCUS":["essential tremor"],"ANNOTATIONS.TYPE":"information","SUBJECT":"Essential Tremor information","MESSAGE":"What is the connection (if any) between Essential Tremor and Parkinsons and what is the best treatment for Essential Tremor?","QUESTION_ID":"Q99","F_REF":"1-137215802"} -{"ANSWERS":[{"_answerid":"Q99-S2-A1","_pairid":"238","__text":"Treatment may not be needed unless the tremors interfere with your daily activities or cause embarrassment. HOME CARE For tremors made worse by stress, try techniques that help you relax. For tremors of any cause, avoid caffeine and get enough sleep. For tremors caused or made worse by a medication, talk to your doctor about stopping the drug, reducing the dosage, or switching. Do not change or stop medications on your own. Severe tremors make it harder to do daily activities. You may need help with these activities. Things that can help include: - Buying clothes with Velcro fasteners, or using button hooks - Cooking or eating with utensils that have a larger handle - Using straws to drink - Wearing slip-on shoes and using shoehorns MEDICINES FOR TREMOR Medicines may help relieve symptoms. The most commonly used drugs include: - Propranolol, a beta blocker - Primidone, a drug used to treat seizures These drugs can have side effects. - Propranolol may cause fatigue, stuffy nose, or slow heartbeat, and it may make asthma worse. - Primidone may cause drowsiness, problems concentrating, nausea, and problems with walking, balance, and coordination. Other medications that may reduce tremors include: - Antiseizure drugs - Mild tranquilizers - Blood pressure drugs called calcium-channel blockers Botox injections given in the hand may be tried to reduce tremors. SURGERY In severe cases, surgery may be tried. This may include: - Focusing high-powered x-rays on a small area of the brain (stereotactic radiosurgery) - Implanting a stimulating device in the brain to signal the area that controls movement"},{"_answerid":"Q99-S2-A2","_pairid":"239","__text":"Treatment for essential tremor may not be necessary unless the tremors interfere with daily activities or cause embarrassment. Although there is no definitive cure for essential tremor, medicines may help relieve symptoms. How well medicines work depend on the individual patient. Two medications used to treat tremors include: Propranolol, a drug that blocks the action of stimulating substances called neurotransmitters, particularly those related to adrenaline Primidone, an antiseizure drug that also control the function of some neurotransmitters These drugs can have significant side effects. Eliminating tremor \"triggers\" such as caffeine and other stimulants from the diet is often recommended. Physical therapy may help to reduce tremor and improve coordination and muscle control for some patients. More details about the management of essential tremor can be accessed through the following web links: http:\/\/www.mayoclinic.com\/print\/essential-tremor\/DS00367\/METHOD=print&DSECTION=all http:\/\/emedicine.medscape.com\/article\/1150290-treatment"},{"_answerid":"Q99-S2-A3","_pairid":"240","__text":"These resources address the diagnosis or management of essential tremor: - Genetic Testing Registry: Hereditary essential tremor 1 - Johns Hopkins Movement Disorders Center - MedlinePlus Encyclopedia: Essential Tremor These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"},{"_answerid":"Q99-S2-A4","_pairid":"241","__text":"There is no definitive cure for essential tremor. Symptomatic drug therapy may include propranolol or other beta blockers and primidone, an anticonvulsant drug. Eliminating tremor \"triggers\" such as caffeine and other stimulants from the diet is often recommended. Physical and occupational therapy may help to reduce tremor and improve coordination and muscle control for some individuals. \u00a0Deep brain stimulation uses a surgically implanted, battery-operated medical device called a neurostimulator to delivery electrical stimulation to targeted areas of the brain that control movement, temporarily blocking the nerve signals that cause tremor. \u00a0Other surgical intervention is effective but may have side effects."}],"SUB_QUESTION_ID":"Q99-S2","ANNOTATIONS.FOCUS":["essential tremor"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"Essential Tremor information","MESSAGE":"What is the connection (if any) between Essential Tremor and Parkinsons and what is the best treatment for Essential Tremor?","QUESTION_ID":"Q99","F_REF":"1-137215802"} -{"ANSWERS":[{"_answerid":"Q100-S1-A1","_pairid":"242","__text":"Treatment for Dry Mouth Dry mouth treatment will depend on what is causing the problem. If you think you have dry mouth, see your dentist or physician. He or she can help to determine what is causing your dry mouth. If your dry mouth is caused by medicine, your physician might change your medicine or adjust the dosage. If your salivary glands are not working right but can still produce some saliva, your dentist or physician might give you a medicine that helps the glands work better. Your dentist or physician might also suggest that you use artificial saliva to keep your mouth wet. Do's and Don'ts Do's - Do drink water or sugarless drinks often. That will make chewing and swallowing easier when eating. - Do chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow. - Do use a humidifier at night to promote moisture in the air while you sleep. Do drink water or sugarless drinks often. That will make chewing and swallowing easier when eating. Do chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow. Do use a humidifier at night to promote moisture in the air while you sleep. Don\u2019ts - Don't consume drinks with caffeine such as coffee, tea, and some sodas. Caffeine can dry out the mouth. - Don't use tobacco or alcohol. They dry out the mouth. Don't consume drinks with caffeine such as coffee, tea, and some sodas. Caffeine can dry out the mouth. Don't use tobacco or alcohol. They dry out the mouth. Gene Therapy Research for Salivary Gland Dysfunction Scientists at NIH\u2019s National Institute of Dental and Craniofacial Research (NIDCR) are exploring the potential use of gene therapy to treat salivary gland dysfunction. The idea is to transfer additional or replacement genes into the salivary glands of people with Sj\u00f6gren's syndrome and cancer patients whose salivary glands were damaged during radiation treatment. The hope is that these genes will increase the production of saliva and eliminate the chronic parched sensation that bothers people with dry mouth conditions. NIDCR recently completed a clinical study, a research study in humans, on gene therapy for radiation-damaged salivary glands. The study showed that gene therapy can be safely performed in salivary glands and that it has the potential to help head and neck cancer survivors with dry mouth. Read NIDCR\u2019s news release to learn more about the study\u2019s findings. Based on the promising results of this trial, similar clinical trials are planned in the near future. Research on Sj\u00f6gren\u2019s Syndrome and Other Diseases Affecting Salivary Glands NIDCR is also conducting clinical trials to study new approaches for improving salivary flow in patients with Sjogren\u2019s syndrome. Such studies include testing the effectiveness of a monoclonal antibody as well as a corticosteroid to see whether either of these treatments helps improve salivary flow. Other studies are focused on learning how diseases such as diabetes, auto inflammatory diseases, and granulomatous diseases cause salivary gland dysfunction. Such studies could one day lead to better ways of preventing and treating salivary gland conditions. To stay abreast of any new studies on gene therapy and salivary gland function, visit ClinicalTrials.gov. ClinicalTrials.gov lists all federally and many privately funded clinical trials in the U.S. and around the world; the web site is updated frequently."},{"_answerid":"Q100-S1-A2","_pairid":"243","__text":"Dry mouth treatment will depend on what is causing the problem. If you think you have dry mouth, see your dentist or physician. He or she can help to determine what is causing your dry mouth. If your dry mouth is caused by medicine, your physician might change your medicine or adjust the dosage. If your salivary glands are not working right, but can still produce some saliva, your dentist or physician might give you a special medicine that helps the glands work better. He or she might suggest that you use artificial saliva to keep your mouth wet. (Watch the video to learn how dry mouth is treated. 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.)"}],"SUB_QUESTION_ID":"Q100-S1","ANNOTATIONS.FOCUS":["dry mouth"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"dry mouth","MESSAGE":"My doctor does not know of a medication that can be used in the mouth for dry mouth. Through research, I think the medication is there, I just can't find the name of it for him to prescribe forme. Can you help me. I'm using the across the counter Biotene but would like something that works a little better.","QUESTION_ID":"Q100","F_REF":"NF_240"} -{"ANSWERS":[{"_answerid":"Q101-S1-A1","_pairid":"244","__text":"Summary If you have lupus, your immune system attacks healthy cells and tissues by mistake. This can damage your joints, skin, blood vessels and organs. There are many kinds of lupus. The most common type, systemic lupus erythematosus, affects many parts of the body. Discoid lupus causes a rash that doesn't go away. Subacute cutaneous lupus causes sores after being out in the sun. Another type can be caused by medication. Neonatal lupus, which is rare, affects newborns. Anyone can get lupus, but women are most at risk. Lupus is also more common in African American, Hispanic, Asian and Native American women. The cause of lupus is not known. Lupus has many symptoms. Some common ones are - Joint pain or swelling - Muscle pain - Fever with no known cause - Fatigue - Red rashes, often on the face (also called the \"butterfly rash\") There is no one test to diagnose lupus, and it may take months or years to make the diagnosis. There is no cure for lupus, but medicines and lifestyle changes can help control it. NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases"}],"SUB_QUESTION_ID":"Q101-S1","ANNOTATIONS.FOCUS":["lupus"],"ANNOTATIONS.TYPE":"information","SUBJECT":"lupus","MESSAGE":"Hi, I want to know about Lupus and its treatment. Best, [NAME]","QUESTION_ID":"Q101","F_REF":"15240"} -{"ANSWERS":[{"_answerid":"Q101-S2-A1","_pairid":"245","__text":"You may need special kinds of doctors to treat the many symptoms of lupus. \u2026. You should report new symptoms to your doctor right away so that treatment can be changed if needed. The goals of the treatment plan are to: Prevent flares Treat flares when they occur Reduce organ damage and other problems. Treatments may include drugs to: Reduce swelling and pain Prevent or reduce flares Help the immune system Reduce or prevent damage to joints Balance the hormones. In addition to medications for lupus itself, sometimes other medications are needed for problems related to lupus such as high cholesterol, high blood pressure, or infection. Alternative treatments are those that are not part of standard treatment. No research shows that this kind of treatment works for people with lupus. You should talk to your doctor about alternative treatments."},{"_answerid":"Q101-S2-A2","_pairid":"246","__text":"There is no cure for lupus, but medicines and lifestyle changes can help control it. People with lupus often need to see different doctors. You will have a primary care doctor and a rheumatologist (a doctor who specializes in the diseases of joints and muscles). Which other specialists you see depends on how lupus affects your body. For example, if lupus damages your heart or blood vessels, you would see a cardiologist."}],"SUB_QUESTION_ID":"Q101-S2","ANNOTATIONS.FOCUS":["lupus"],"ANNOTATIONS.TYPE":"Treatment","SUBJECT":"lupus","MESSAGE":"Hi, I want to know about Lupus and its treatment. Best, [NAME]","QUESTION_ID":"Q101","F_REF":"15240"} -{"ANSWERS":[{"_answerid":"Q102-S1-A1","_pairid":"247","__text":"Your health care provider can most often diagnose chickenpox by looking at the rash and asking questions about the person's medical history. Small blisters on the scalp confirm the diagnosis in most cases. Lab tests can help confirm the diagnosis, if needed."}],"SUB_QUESTION_ID":"Q102-S1","ANNOTATIONS.FOCUS":["chicken pox"],"ANNOTATIONS.TYPE":"diagnosis","SUBJECT":"varicella shingles","MESSAGE":"How can I determine whether or not I've had chicken pox. If there is a test for it, what are the results of the tests I need to know that will tell me whether or not I have had chicken pox? I want to know this to determine if I should have shingles vaccine (Zostavax) Thank you.","QUESTION_ID":"Q102","F_REF":"1-135130005"} -{"ANSWERS":[{"_answerid":"Q103-S1-A1","_pairid":"248","__text":"Some cases of chronic myelomonocytic leukemia (CMML) are linked to cancer treatment, but in most cases the cause is unknown. Over the past few years, scientists have made progress in understanding how certain changes in the DNA of bone marrow cells may cause CMML to develop. DNA is the chemical that carries the instructions for nearly everything our cells do. We usually look like our parents because they are the source of our DNA. However, DNA affects more than the way we look. Some genes (parts of DNA) control a cell\u2019s growth and division process. Genes that promote cell division are called oncogenes. Other genes called tumor suppressor genes can slow down cell division or even make cells die at an appropriate time. Cancers can be caused by DNA mutations (gene defects) that turn on oncogenes or turn off tumor suppressor genes. In some diseases, mutations may be passed down from a parent. Inherited mutations do not seem to cause CMML. Instead, the mutations are acquired during the person\u2019s lifetime. Exposure to radiation or cancer-causing chemicals can cause mutations that lead to CMML. Sometimes these gene changes occur for no apparent reason. Every time a cell prepares to divide into 2 new cells, it must copy its DNA. This process is not perfect, and copying errors can occur. Fortunately, cells have repair enzymes that read and fix DNA. However, some errors may slip past, especially if the cells are growing rapidly. Human DNA is packaged in 23 pairs of chromosomes. In up to half of patients, CMML cells contain altered chromosomes. Sometimes part of one chromosome attaches to a different chromosome. This is called a translocation. Like mutations, translocations can turn on oncogenes or turn off tumor suppressor genes. Acquired translocations are seen in some cases of CMML. Another chromosome abnormality that can be seen in CMML is called a deletion. This involves the loss of all or part of a chromosome. Another type of chromosome abnormality is called a duplication. This is when there is an extra copy of all or part of a chromosome."}],"SUB_QUESTION_ID":"Q103-S1","ANNOTATIONS.FOCUS":["leukemia"],"ANNOTATIONS.TYPE":"cause","SUBJECT":"","MESSAGE":"Project. Hi my name is [NAME] and I'm doing a school project about leukemia and I was wondering if you can anwser some of my questions please.1. What cause leukemia cancer?2. Can you survive leukemia?3. How does leukemia affect your body?4. Is leukemia inherited?5. What is advanced leukemia?6. How long can someone with leukemia expect to live?7. Can you tell if you have leukemia?8. What treatments do you need to take?9. What are the signs of leukemia?10. What is the difference between AML and CML ?","QUESTION_ID":"Q103","F_REF":"44"} -{"ANSWERS":[{"_answerid":"Q103-S2-A1","_pairid":"249","__text":"People with acute myelogenous leukemia (AML) may have questions about their prognosis and survival. Prognosis and survival depend on many factors. Only a doctor familiar with a person\u2019s medical history, type of cancer, stage, characteristics of the cancer, treatments chosen and response to treatment can put all of this information together with survival statistics to arrive at a prognosis. A prognosis is the doctor\u2019s best estimate of how cancer will affect a person and how it will respond to treatment. A prognostic factor is an aspect of the cancer or a characteristic of the person that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together and they both play a part in deciding on a treatment plan and a prognosis."}],"SUB_QUESTION_ID":"Q103-S2","ANNOTATIONS.FOCUS":["leukemia"],"ANNOTATIONS.TYPE":"prognosis","SUBJECT":"","MESSAGE":"Project. Hi my name is [NAME] and I'm doing a school project about leukemia and I was wondering if you can anwser some of my questions please.1. What cause leukemia cancer?2. Can you survive leukemia?3. How does leukemia affect your body?4. Is leukemia inherited?5. What is advanced leukemia?6. How long can someone with leukemia expect to live?7. Can you tell if you have leukemia?8. What treatments do you need to take?9. What are the signs of leukemia?10. What is the difference between AML and CML ?","QUESTION_ID":"Q103","F_REF":"44"} -{"ANSWERS":[{"_answerid":"Q102-S3-A1","_pairid":"250","__text":"Leukemia is a cancer of the blood cells. It is the most common type of blood cancer and affects 10 times as many adults as children. Most people diagnosed with leukemia are over 50 years old. Leukemia Starts in Bone Marrow Types of blood cells made by the bone marrow and a description of their functions. - Click to enlarge in new window. Click for more information Leukemia usually begins in the bone marrow, the soft material in the center of most bones where blood cells are formed. The bone marrow makes three types of blood cells, and each type has a special function. White blood cells fight infection and disease. Red blood cells carry oxygen throughout the body. Platelets help control bleeding by forming blood clots. In people with leukemia, the bone marrow produces abnormal white blood cells, called leukemia cells. At first, leukemia cells function almost normally. But over time, as more leukemia cells are produced, they may crowd out the healthy white blood cells, red blood cells, and platelets. This makes it difficult for the blood to carry out its normal functions. There are four common types of adult leukemia. Two are chronic, meaning they get worse over a longer period of time. The other two are acute, meaning they get worse quickly. chronic lymphocytic leukemia chronic myeloid leukemia acute myeloid leukemia acute lymphocytic leukemia"}],"SUB_QUESTION_ID":"Q103-S3","ANNOTATIONS.FOCUS":["leukemia"],"ANNOTATIONS.TYPE":"information","SUBJECT":"","MESSAGE":"Project. Hi my name is [NAME] and I'm doing a school project about leukemia and I was wondering if you can anwser some of my questions please.1. What cause leukemia cancer?2. Can you survive leukemia?3. How does leukemia affect your body?4. Is leukemia inherited?5. What is advanced leukemia?6. How long can someone with leukemia expect to live?7. Can you tell if you have leukemia?8. What treatments do you need to take?9. What are the signs of leukemia?10. What is the difference between AML and CML ?","QUESTION_ID":"Q103","F_REF":"44"} -{"ANSWERS":[{"_answerid":"Q102-S4-A1","_pairid":"251","__text":"Sometimes people inherit DNA mutations from a parent that greatly increase their risk of getting certain types of cancer. But inherited mutations rarely cause CLL. DNA changes related to CLL usually occur during the person's lifetime, rather than having been inherited before birth."}],"SUB_QUESTION_ID":"Q103-S4","ANNOTATIONS.FOCUS":["leukemia"],"ANNOTATIONS.TYPE":"inheritance","SUBJECT":"","MESSAGE":"Project. Hi my name is [NAME] and I'm doing a school project about leukemia and I was wondering if you can anwser some of my questions please.1. What cause leukemia cancer?2. Can you survive leukemia?3. How does leukemia affect your body?4. Is leukemia inherited?5. What is advanced leukemia?6. How long can someone with leukemia expect to live?7. Can you tell if you have leukemia?8. What treatments do you need to take?9. What are the signs of leukemia?10. What is the difference between AML and CML ?","QUESTION_ID":"Q103","F_REF":"44"} -{"ANSWERS":[{"_answerid":"Q102-S5-A1","_pairid":"252","__text":"Diagnosing Leukemia: Physical Exam, Blood Tests, Biopsy To find the cause of leukemia symptoms, the doctor will ask about medical history and conduct a physical exam. During the exam, the doctor will check for signs of disease such as lumps, swelling in the lymph nodes, spleen, and liver, or anything else that seems unusual. The doctor will need to do blood tests that check the levels and types of blood cells and look for changes in the shape of blood cells. The doctor also may look at certain factors in the blood to see if leukemia has affected other organs such as the liver or kidneys. Pathologist examining samples under a microscope. - Click to enlarge in new window. Click for more information Even if blood tests suggest leukemia, the doctor may look for signs of leukemia in the bone marrow by doing a biopsy before making a diagnosis. A biopsy is a procedure where a small amount of bone marrow is removed from a bone. A pathologist examines the sample under a microscope to look for abnormal cells. There are two ways the doctor can obtain bone marrow. In a bone marrow aspiration, marrow is collected by inserting a needle into the hipbone or another large bone and removing a small amount of bone marrow. A bone marrow biopsy is performed with a larger needle and removes bone marrow and a small piece of bone. If Leukemia Cells Are Found If leukemia cells are found in the bone marrow sample, the doctor may perform more tests to determine if the disease has spread to other parts of the body. The doctor may collect a sample of the fluid around the brain and spinal cord by performing a spinal tap and checking for leukemia cells or other signs of problems. Computed tomography (CT) scans, and ultrasounds are tests used to determine if leukemia has spread from the bone marrow. These tests produce pictures of the inside of the body. With these tests, the doctor looks for abnormalities such as enlarged organs or signs of infection."}],"SUB_QUESTION_ID":"Q103-S5","ANNOTATIONS.FOCUS":["leukemia"],"ANNOTATIONS.TYPE":"diagnosis","SUBJECT":"","MESSAGE":"Project. Hi my name is [NAME] and I'm doing a school project about leukemia and I was wondering if you can anwser some of my questions please.1. What cause leukemia cancer?2. Can you survive leukemia?3. How does leukemia affect your body?4. Is leukemia inherited?5. What is advanced leukemia?6. How long can someone with leukemia expect to live?7. Can you tell if you have leukemia?8. What treatments do you need to take?9. What are the signs of leukemia?10. What is the difference between AML and CML ?","QUESTION_ID":"Q103","F_REF":"44"} -{"ANSWERS":[{"_answerid":"Q103-S6-A1","_pairid":"253","__text":"There are many treatment options for people with leukemia. The choice of treatment depends on your age and general health, the type of leukemia you have, whether or not it has spread outside the bone marrow, and other factors. If tests show that you have leukemia, you should talk with your doctor and make treatment decisions as soon as possible, although many patients with chronic lymphocytic leukemia do not require treatment for many years. Working With a Team of Specialists A team of specialists often treats people with leukemia. The team will keep the primary doctor informed about the patient's progress. The team may include a hematologist who is a specialist in blood and blood-forming tissues, a medical oncologist who is a specialist in cancer treatment, and a radiation oncologist who is a specialist in radiation therapy. 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 or your doctor requests it. Clinical Trials for Leukemia Some leukemia 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 and better than current treatments. Talk to your doctor if you are interested in taking part in a clinical trial. 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 search for current clinical trials on leukemia."},{"_answerid":"Q103-S6-A2","_pairid":"254","__text":"Unlike other types of cancer, leukemia isn't a tumor that your doctor can surgically remove. Leukemia cells are produced in the bone marrow and travel throughout the body. The Goal of Treatment The goal of treatment for leukemia is to destroy the leukemia cells and allow normal cells to form in the bone marrow. Depending on the type and extent of the disease, patients may have chemotherapy, biological therapy, radiation therapy, or stem cell transplantation. Some patients receive a combination of treatments. Treatment depends on a number of factors, including the type of leukemia, the patient's age and general health, whether leukemia cells are present in the fluid around the brain or spinal cord, and whether the leukemia has been treated before. It also may depend on certain features of the leukemia cells and the patient's symptoms. Acute Leukemia or Chronic Leukemia? If a person has acute leukemia, they will need treatment right away. The purpose of treatment is to stop the rapid growth of leukemia cells and to bring about remission, meaning the cancer is under control. In many cases, a person will continue treatment after signs and symptoms disappear to prevent the disease from coming back. Some people with acute leukemia can be cured. Learn more about treatments for acute myeloid leukemia. Learn more about treatments for chronic lymphocytic leukemia. Chronic leukemia may not need to be treated until symptoms appear. Treatment can often control the disease and its symptoms. Types of Treatments Some, but not all, forms of treatment for leukemia include - chemotherapy - biological therapy - radiation therapy. chemotherapy biological therapy radiation therapy. Chemotherapy Chemotherapy uses drugs to kill cancer cells. This a common treatment for some types of leukemia. Chemotherapy may be taken by mouth in pill form, by injection directly into a vein, or through a catheter. If leukemia cells are found in the fluid around the brain or spinal cord, the doctor may inject drugs directly into the fluid to ensure that the drugs reach the leukemia cells in the brain. Biological Therapy Biological therapy uses special substances that improve the body's natural defenses against cancer. Some patients with chronic lymphocytic leukemia receive monoclonal antibodies, which are man-made proteins that can identify leukemia cells. Monoclonal antibodies bind to the cells and assist the body in killing them. Although monoclonal antibodies are being used to treat leukemia, researchers are studying more innovative ways to use them in treatment. Some antibodies are used alone to try to prompt the immune system to attack leukemia cells. Other antibodies are attached to substances that can deliver poison to cancer cells. These modified antibodies, called immunotoxins, deliver the toxins directly to the cancer cells. Lately, precision medicine trials have shown evidence that single targeted therapies taken in pill form can prolong survival. Radiation Therapy Radiation therapy uses high-energy X-rays to destroy cancer cells. A machine outside the body directs high-energy beams at the spleen, the brain, or other parts of the body where leukemia cells have collected. Radiation therapy is used primarily to control disease in bones that are at risk of fracture or at sites that are causing pain."},{"_answerid":"Q103-S6-A3","_pairid":"255","__text":"Treatment depends on a number of factors, including the type of leukemia, the patient's age and general health, where leukemia cells have collected in the body, and whether the leukemia has been treated before. Certain features of the leukemia cells and the patient's symptoms also may determine treatment options."},{"_answerid":"Q103-S6-A4","_pairid":"256","__text":"Standard treatments for leukemia include chemotherapy, biological therapy, radiation therapy, and immunotherapy. Some patients receive a combination of treatments. Learn more about treatments for acute myeloid leukemia. Learn more about treatments for chronic lymphocytic leukemia."},{"_answerid":"Q103-S6-A5","_pairid":"257","__text":"Researchers are studying various drugs, immunotherapies, and other types of treatments. Because leukemia is a complicated disease, researchers are also studying the effectiveness of using combinations of treatments. Following are a few examples of some areas of current research. The drug imatinib (Gleevec\u00ae) is important in the treatment of chronic myeloid leukemia. However, imatinib stops working in some people with leukemia because the cells become resistant. Fortunately, two drugs, dasatinib (Sprycel\u00ae) and nilotinib (Tasigna\u00ae), are being used to treat people who stop responding to imatinib. Both are approved by the FDA for use in patients. These drugs work against the same abnormal protein targeted by imatinib, but in different ways. Gene therapy -- replacing, manipulating, or supplementing nonfunctional genes with healthy genes -- is being explored for treatment of leukemia. It is being studied as a way to stimulate a patient's immune system to kill leukemia cells and also to interfere with the production of proteins that cause cells to become cancerous. Learn more about ongoing leukemia research."}],"SUB_QUESTION_ID":"Q103-S6","ANNOTATIONS.FOCUS":["leukemia"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"Project. Hi my name is [NAME] and I'm doing a school project about leukemia and I was wondering if you can anwser some of my questions please.1. What cause leukemia cancer?2. Can you survive leukemia?3. How does leukemia affect your body?4. Is leukemia inherited?5. What is advanced leukemia?6. How long can someone with leukemia expect to live?7. Can you tell if you have leukemia?8. What treatments do you need to take?9. What are the signs of leukemia?10. What is the difference between AML and CML ?","QUESTION_ID":"Q103","F_REF":"44"} -{"ANSWERS":[{"_answerid":"Q103-S7-A1","_pairid":"258","__text":"During the early stages of leukemia, there may be no symptoms. Many of the symptoms of leukemia don't become apparent until a large number of normal blood cells are crowded out by leukemia cells. Symptoms of Chronic and Acute Leukemia In chronic leukemia, symptoms develop gradually and, in the beginning, are generally not as severe as in acute leukemia. Chronic leukemia is usually found during a routine doctor's exam before symptoms are present. When symptoms appear, they generally are mild at first and gradually get worse, but sometimes they don't worsen until many years after an initial diagnosis. Recently, researchers discovered that abnormal white blood cells can be present in the blood of chronic lymphocytic leukemia patients a number of years before a diagnosis. This finding may lead to a better understanding of the cellular changes that occur in the earliest stages of the disease and how the disease progresses. In acute leukemia, symptoms usually appear and get worse quickly. People with this disease usually go to their doctor because they feel sick. White Blood Cell Levels May Be High People with leukemia may have very high levels of white blood cells, but because the cells are abnormal, they are unable to fight infection. Therefore, patients may develop frequent fevers or infections. A shortage of red blood cells, called anemia, can cause a person to feel tired. Not having enough blood platelets may cause a person to bleed and bruise easily. Some symptoms depend on where leukemia cells collect in the body. Leukemia cells can collect in many different tissues and organs, such as the digestive tract, kidneys, lungs, lymph nodes, or other parts of the body, including the eyes, brain, and testicles. Other Common Symptoms Other common symptoms of leukemia include headache, weight loss, pain in the bones or joints, swelling or discomfort in the abdomen (from an enlarged spleen), and swollen lymph nodes, especially in the neck or armpit. Symptoms of acute leukemia may include vomiting, confusion, loss of muscle control, and seizures. Some of the symptoms of leukemia are similar to those caused by the flu or other common diseases, so these symptoms are not sure signs of leukemia. It is important to check with your doctor if you have these symptoms. Only a doctor can diagnose and treat leukemia. Diagnosing Leukemia: Physical Exam, Blood Tests, Biopsy To find the cause of leukemia symptoms, the doctor will ask about medical history and conduct a physical exam. During the exam, the doctor will check for signs of disease such as lumps, swelling in the lymph nodes, spleen, and liver, or anything else that seems unusual. The doctor will need to do blood tests that check the levels and types of blood cells and look for changes in the shape of blood cells. The doctor also may look at certain factors in the blood to see if leukemia has affected other organs such as the liver or kidneys. Even if blood tests suggest leukemia, the doctor may look for signs of leukemia in the bone marrow by doing a biopsy before making a diagnosis. A biopsy is a procedure where a small amount of bone marrow is removed from a bone. A pathologist examines the sample under a microscope to look for abnormal cells. There are two ways the doctor can obtain bone marrow. In a bone marrow aspiration, marrow is collected by inserting a needle into the hipbone or another large bone and removing a small amount of bone marrow. A bone marrow biopsy is performed with a larger needle and removes bone marrow and a small piece of bone. If Leukemia Cells Are Found If leukemia cells are found in the bone marrow sample, the doctor may perform more tests to determine if the disease has spread to other parts of the body. The doctor may collect a sample of the fluid around the brain and spinal cord by performing a spinal tap and checking for leukemia cells or other signs of problems. Computed tomography (CT) scans, and ultrasounds are tests used to determine if leukemia has spread from the bone marrow. These tests produce pictures of the inside of the body. With these tests, the doctor looks for abnormalities such as enlarged organs or signs of infection."},{"_answerid":"Q103-S7-A2","_pairid":"259","__text":"Common symptoms of leukemia may include - fevers - frequent infections - feeling weak or tired - headache - bleeding and bruising easily - pain in the bones or joints - swelling or discomfort in the abdomen (from an enlarged spleen) - swollen lymph nodes, especially in the neck or armpit - weight loss. fevers frequent infections feeling weak or tired headache bleeding and bruising easily pain in the bones or joints swelling or discomfort in the abdomen (from an enlarged spleen) swollen lymph nodes, especially in the neck or armpit weight loss. Symptoms of acute leukemia may include vomiting, confusion, loss of muscle control, and seizures."}],"SUB_QUESTION_ID":"Q103-S7","ANNOTATIONS.FOCUS":["leukemia"],"ANNOTATIONS.TYPE":"symptom","SUBJECT":"","MESSAGE":"Project. Hi my name is [NAME] and I'm doing a school project about leukemia and I was wondering if you can anwser some of my questions please.1. What cause leukemia cancer?2. Can you survive leukemia?3. How does leukemia affect your body?4. Is leukemia inherited?5. What is advanced leukemia?6. How long can someone with leukemia expect to live?7. Can you tell if you have leukemia?8. What treatments do you need to take?9. What are the signs of leukemia?10. What is the difference between AML and CML ?","QUESTION_ID":"Q103","F_REF":"44"} -{"ANSWERS":[{"_answerid":"Q104-S1-A1","_pairid":"260","__text":"Lupus can have many symptoms, and they differ from person to person. Some of the more common ones are Pain or swelling in joints Muscle pain Fever with no known cause Red rashes, most often on the face (also called the \"butterfly rash\") Chest pain when taking a deep breath Hair loss Pale or purple fingers or toes Sensitivity to the sun Swelling in legs or around eyes Mouth ulcers Swollen glands Feeling very tired Symptoms may come and go. When you are having symptoms, it is called a flare. Flares can range from mild to severe. New symptoms may appear at any time."}],"SUB_QUESTION_ID":"Q104-S1","ANNOTATIONS.FOCUS":["lupus"],"ANNOTATIONS.TYPE":"symptom","SUBJECT":"","MESSAGE":"I have been dealing with an autoimmune disease for almost 4 years now, I've been tested for many things and the doctors can't seem to find what excactly is wrong. It began with pain, swelling and stiffness in my feet and toes.A lot of the pain is joint stiff n ess and my skin feels like its being burned. Over time it has moved into my knees also. I am always tired. Recently I've been getting pains in my stomache and feeling sick. Does any of this sound like Lupus?? I've tested negative for it before, but the more I read about it I feel that's what i could have. Any ideas would be greatly appreciated.","QUESTION_ID":"Q104","F_REF":"1-119980475"} -{"ANSWERS":[{"_answerid":"Q105-S1-A1","_pairid":"261","__text":"A number of different antibiotics may be used for treating this type of infection. - You may receive one large dose of oral antibiotics or take a smaller dose for seven days. - You may be given an antibiotic injection or shot, and then perhaps be sent home with antibiotic pills. - More severe cases of PID (pelvic inflammatory disease) may require you to stay in the hospital. Antibiotics are first given by IV. - Never treat yourself without being seen by your doctor first. Your health care provider will determine the best treatment. About half of the women with gonorrhea are also infected with chlamydia. Chlamydia is treated at the same time as a gonorrhea infection. You will need a follow-up visit 7 days after if your symptoms include joint pain, skin rash, or more severe pelvic or belly pain. Tests will be done to make sure the infection is gone. Sexual partners must be tested and treated to prevent passing the infection back and forth. You and your partner must finish all of the antibiotics. Use condoms until you both have finished taking your antibiotics. All sexual contacts of the person with gonorrhea should be contacted and tested. This helps prevent further spread of the infection. - In some places you may be able to take information and medicines to your sexual partner yourself. - In other places, the health department will contact your partner."}],"SUB_QUESTION_ID":"Q105-S1","ANNOTATIONS.FOCUS":["gonorrhea"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"EMAIL: [EMAIL] FROM: http:\/\/m.medlineplus.gov\/medlineplus.htm BROWSER: NokiaX2-01\/5.0 (07.10) Profile\/MIDP-2.1 Configuration\/CLDC-1.1 Mozilla\/5.0 AppleWebKit\/420 (KHTML, like Gecko) Safari\/420 DATE: 01\/06\/2014 MESSAGE: My question is.wat is the treatment for chronic gonorrhea, massive growth?","QUESTION_ID":"Q105","F_REF":"1-118350915"} -{"ANSWERS":[{"_answerid":"Q106-S1-A1","_pairid":"262","__text":"Treatment depends on many things, including your Gleason score and your overall health. Your doctor will discuss your treatment options with you. If the cancer has not spread outside the prostate gland, common treatments include: - Surgery (radical prostatectomy) - Radiation therapy, including brachytherapy and proton therapy If you are older, your doctor may recommend simply monitoring the cancer with PSA tests and biopsies. Hormone therapy is mainly used for cancer that has spread beyond the prostate. It helps relieve symptoms and prevents further growth and spread of the cancer. But it does not cure the cancer. If prostate cancer spreads even after hormone therapy, surgery, or radiation has been tried, treatment may include: - Chemotherapy - Immunotherapy (medicine to trigger the immune system to attack and kill cancer cells) Surgery, radiation therapy, and hormone therapy can affect your sexual performance. Problems with urine control are possible after surgery and radiation therapy. Discuss your concerns with your health care provider. After treatment for prostate cancer, you will be closely watched to make sure the cancer does not spread. This involves routine checkups, including PSA blood tests (usually every 3 months to 1 year)."},{"_answerid":"Q106-S1-A2","_pairid":"263","__text":"These resources address the diagnosis or management of prostate cancer: - American College of Radiology: Prostate Cancer Radiation Treatment - Genetic Testing Registry: Familial prostate cancer - Genetic Testing Registry: Prostate cancer, hereditary, 2 - MedlinePlus Encyclopedia: Prostate Brachytherapy - MedlinePlus Encyclopedia: Prostate Cancer Staging - MedlinePlus Encyclopedia: Prostate Cancer Treatment - MedlinePlus Encyclopedia: Prostate-Specific Antigen (PSA) Blood Test - MedlinePlus Encyclopedia: Radical Prostatectomy - MedlinePlus Health Topic: Prostate Cancer Screening - National Cancer Institute: Prostate-Specific Antigen (PSA) Test - U.S. Preventive Services Task Force These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"},{"_answerid":"Q106-S1-A3","_pairid":"264","__text":"If tests show that you have cancer, you should talk with your doctor in order to make treatment decisions. Working With a Team of Specialists A team of specialists often treats people with cancer. The team will keep the primary doctor informed about the patient's progress. The team may include a medical oncologist who is a specialist in cancer treatment, a surgeon, a radiation oncologist who is a specialist in radiation therapy, and others. Before starting treatment, you may want another doctor to review the diagnosis and treatment plan. Some insurance companies require a second opinion. Others may pay for a second opinion if you request it. Clinical Trials for Prostate Cancer Some prostate cancer patients take part in studies of new treatments. These studies -- called clinical trials -- are designed to find out whether a new treatment is safe and effective. Often, clinical trials compare a new treatment with a standard one so that doctors can learn which is more effective. Men with prostate cancer who are interested in taking part in a clinical trial should talk with their doctor. The U.S. National Institutes of Health, through its National Library of Medicine and other Institutes, maintains a database of clinical trials at ClinicalTrials.gov. Click here to see a list of the current clinical trials on prostate cancer. A separate window will open. Click the \"x\" in the upper right hand corner of the \"Clinical Trials\" window to return here."},{"_answerid":"Q106-S1-A4","_pairid":"265","__text":"Choosing Treatment There are a number of ways to treat prostate cancer, and the doctor will develop a treatment to fit each man's needs. The choice of treatment mostly depends on the stage of the disease and the grade of the tumor. But doctors also consider a man's age, general health, and his feelings about the treatments and their possible side effects. Treatment for prostate cancer may involve watchful waiting, surgery, radiation therapy, or hormonal therapy. Some men receive a combination of therapies. A cure is the goal for men whose prostate cancer is diagnosed early. Weighing Treatment Options You and your doctor will want to consider both the benefits and possible side effects of each option, especially the effects on sexual activity and urination, and other concerns about quality of life. Surgery, radiation therapy, and hormonal therapy all have the potential to disrupt sexual desire or performance for a short while or permanently. Discuss your concerns with your health care provider. Several options are available to help you manage sexual problems related to prostate cancer treatment. Watchful Waiting The doctor may suggest watchful waiting for some men who have prostate cancer that is found at an early stage and appears to be growing slowly. Also, watchful waiting may be advised for older men or men with other serious medical problems. For these men, the risks and possible side effects of surgery, radiation therapy, or hormonal therapy may outweigh the possible benefits. Doctors monitor these patients with regular check-ups. If symptoms appear or get worse, the doctor may recommend active treatment. Surgery Surgery is used to remove the cancer. It is a common treatment for early stage prostate cancer. The surgeon may remove the entire prostate with a type of surgery called radical prostatectomy or, in some cases, remove only part of it. Sometimes the surgeon will also remove nearby lymph nodes. Side effects of the operation may include lack of sexual function or impotence, or problems holding urine or incontinence. Improvements in surgery now make it possible for some men to keep their sexual function. In some cases, doctors can use a technique known as nerve-sparing surgery. This may save the nerves that control erection. However, men with large tumors or tumors that are very close to the nerves may not be able to have this surgery. Some men with trouble holding urine may regain control within several weeks of surgery. Others continue to have problems that require them to wear a pad. Radiation Therapy Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Doctors may recommend it instead of surgery, or after surgery, to destroy any cancer cells that may remain in the area. In advanced stages, the doctor may recommend radiation to relieve pain or other symptoms. It may also be used in combination with hormonal therapy. Radiation can cause problems with impotence and bowel function. The radiation may come from a machine, which is external radiation, or from tiny radioactive seeds placed inside or near the tumor, which is internal radiation. Men who receive only the radioactive seeds usually have small tumors. Some men receive both kinds of radiation therapy. For external radiation therapy, patients go to the hospital or clinic -- usually for several weeks. Internal radiation may require patients to stay in the hospital for a short time. Hormonal Therapy Hormonal therapy deprives cancer cells of the male hormones they need to grow and survive. This treatment is often used for prostate cancer that has spread to other parts of the body. Sometimes doctors use hormonal therapy to try to keep the cancer from coming back after surgery or radiation treatment. Side effects can include impotence, hot flashes, loss of sexual desire, and thinning of bones. Some hormone therapies increase the risk of blood clots. Monitoring Treatment Regardless of the type of treatment you receive, you will be closely monitored to see how well the treatment is working. Monitoring may include - a PSA blood test -- usually every 3 months to 1 year. - bone scan and\/or CT scan to see if the cancer has spread. - a complete blood count to monitor for signs and symptoms of anemia. - looking for signs or symptoms that the disease might be progressing, such as fatigue, increased pain, or decreased bowel and bladder function. a PSA blood test -- usually every 3 months to 1 year. bone scan and\/or CT scan to see if the cancer has spread. a complete blood count to monitor for signs and symptoms of anemia. looking for signs or symptoms that the disease might be progressing, such as fatigue, increased pain, or decreased bowel and bladder function."},{"_answerid":"Q106-S1-A5","_pairid":"266","__text":"There are a number of ways to treat prostate cancer, and the doctor will develop a treatment to fit each man's needs. The choice of treatment mostly depends on the stage of the disease and the grade of the tumor. But doctors also consider a man's age, general health, and his feelings about the treatments and their possible side effects. Treatment for prostate cancer may involve watchful waiting, surgery, radiation therapy, or hormonal therapy. Some men receive a combination of therapies. A cure is probable for men whose prostate cancer is diagnosed early."},{"_answerid":"Q106-S1-A6","_pairid":"267","__text":"Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Doctors may recommend it instead of surgery or after surgery to destroy any cancer cells that may remain in the area. In advanced stages, the doctor may recommend it to relieve pain or other symptoms. Radiation can cause problems with impotence and bowel function. The radiation may come from a machine, which is external radiation, or from tiny radioactive seeds placed inside or near the tumor, which is internal radiation. Men who receive only the radioactive seeds usually have small tumors. Some men receive both kinds of radiation therapy. For external radiation therapy, patients go to the hospital or clinic -- usually 5 days a week for several weeks. Internal radiation may require patients to stay in the hospital for a short time."},{"_answerid":"Q106-S1-A7","_pairid":"268","__text":"Hormonal therapy deprives cancer cells of the male hormones they need to grow and survive. This treatment is often used for prostate cancer that has spread to other parts of the body. Sometimes doctors use hormonal therapy to try to keep the cancer from coming back after surgery or radiation treatment. Side effects can include impotence, hot flashes, loss of sexual desire, and thinning of bones."},{"_answerid":"Q106-S1-A8","_pairid":"269","__text":"Through research, doctors are trying to find new, more effective ways to treat prostate cancer. Cryosurgery -- destroying cancer by freezing it -- is under study as an alternative to surgery and radiation therapy. To avoid damaging healthy tissue, the doctor places an instrument known as a cryoprobe in direct contact with the tumor to freeze it. Doctors are studying new ways of using radiation therapy and hormonal therapy, too. Studies have shown that hormonal therapy given after radiation therapy can help certain men whose cancer has spread to nearby tissues. Scientists are also testing the effectiveness of chemotherapy and biological therapy for men whose cancer does not respond or stops responding to hormonal therapy. They are also exploring new ways to schedule and combine various treatments. For example, they are studying hormonal therapy to find out if using it to shrink the tumor before a man has surgery or radiation might be a useful approach. They are also testing combinations of hormone therapy and vaccines to prevent recurrence of prostate cancer. In 2010, the FDA approved a therapeutic cancer vaccine, Provenge, for use in some men with metastatic prostate cancer. This approval was based on the results of a clinical trial that demonstrated a more than 4-month improvement in overall survival compared with a placebo vaccine. Other similar vaccine therapies are in development."}],"SUB_QUESTION_ID":"Q106-S1","ANNOTATIONS.FOCUS":["prostate cancer"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"prostate cancer using seeds aimed at maligmem tumors","MESSAGE":"is this a safe decision","QUESTION_ID":"Q106","F_REF":"1-121817635"} -{"ANSWERS":[{"_answerid":"Q107-S1-A1","_pairid":"270","__text":"If hair loss is not widespread, the hair will\u00a0often regrow in a few months without treatment. For more severe hair loss, it is not clear how much treatment can help change the course of the condition. Common treatments may include: - Steroid injection under the skin surface - Medicines\u00a0applied to\u00a0the skin - Ultraviolet light therapy Wigs may be used to hide areas of hair loss."},{"_answerid":"Q107-S1-A2","_pairid":"271","__text":"\u2022 Hair Transplants (American Society for Dermatologic Surgery) \u2022 Lavender"}],"SUB_QUESTION_ID":"Q107-S1","ANNOTATIONS.FOCUS":["hair loss"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"Hair loss Information Required","MESSAGE":"Can you provide something to help grow my hair back? I need my hair back as im the spitting double of Dr evil with no hair.","QUESTION_ID":"Q107","F_REF":"1-135502685"} -{"ANSWERS":[{"_answerid":"Q108-S1-A1","_pairid":"272","__text":"CHANGING YOUR LIFESTYLE An active lifestyle and plenty of exercise, along with healthy eating, is the safest way to lose weight. Even modest weight loss can improve your health. You may need a lot of support from family and friends. Your main goal should be to learn new, healthy ways of eating and make them part of your daily routine. Many people find it hard to change their eating habits and behaviors. You may have practiced some habits for so long that you may not even know they are unhealthy, or you do them without thinking. You need to be motivated to make lifestyle changes. Make the behavior change part of your life over the long term. Know that it takes time to make and keep a change in your lifestyle. Work with your health care provider and dietitian to set realistic, safe daily calorie counts that help you lose weight while staying healthy. Remember that if you drop pounds slowly and steadily, you are more likely to keep them off. Your dietitian can teach you about: - Healthy food choices - Healthy snacks - Reading nutrition labels - New ways to prepare food - Portion sizes - Sweetened drinks Extreme diets (fewer than 1,100 calories per day) are not thought to be safe or to work very well. These types of diets often do not contain enough vitamins and minerals. Most people who lose weight this way return to overeating and become obese again. Learn ways to manage stress other than snacking. Examples may be meditation, yoga, or exercise. If you are depressed or stressed a lot, talk to your provider. MEDICINES AND HERBAL REMEDIES You may see ads for supplements and herbal remedies that claim they will help you lose weight. Some of these claims may not be true. And some of these supplements can have serious side effects. Talk to your provider before using them. You can discuss weight loss medicines with your doctor. Many people lose at least 5 pounds by taking these drugs, but they may regain the weight when they stop taking the medicine unless they have made lifestyle changes. SURGERY Bariatric (weight-loss) surgery can reduce the risk of certain diseases in people with severe obesity. These risks include: - Arthritis - Diabetes - Heart disease - High blood pressure - Sleep apnea - Some cancers - Stroke Surgery may help people who have been very obese for 5 years or more and have not lost weight from other treatments, such as diet, exercise, or medicine. Surgery alone is not the answer for weight loss. It can train you to eat less, but you still have to do much of the work. You must be committed to diet and exercise after surgery. Talk to your doctor to learn if surgery is a good option for you. Weight-loss surgeries include: - Laparoscopic gastric banding - Gastric bypass surgery - Sleeve gastrectomy (less common) - Duodenal switch"},{"_answerid":"Q108-S1-A2","_pairid":"273","__text":"CHANGING YOUR LIFESTYLE An active lifestyle and plenty of exercise, along with healthy eating, is the safest way to lose weight. Even modest weight loss can improve your health. You may need a lot of support from family and friends. Your main goal should be to learn new, healthy ways of eating and make them part of your daily routine. Many people find it hard to change their eating habits and behaviors. You may have practiced some habits for so long that you may not even know they are unhealthy, or you do them without thinking. You need to be motivated to make lifestyle changes. Make the behavior change part of your life over the long term. Know that it takes time to make and keep a change in your lifestyle. Work with your health care provider and dietitian to set realistic, safe daily calorie counts that help you lose weight while staying healthy. Remember that if you drop pounds slowly and steadily, you are more likely to keep them off. Your dietitian can teach you about: - Healthy food choices - Healthy snacks - Reading nutrition labels - New ways to prepare food - Portion sizes - Sweetened drinks Extreme diets (fewer than 1,100 calories per day) are not thought to be safe or to work very well. These types of diets often do not contain enough vitamins and minerals. Most people who lose weight this way return to overeating and become obese again. Learn ways to manage stress other than snacking. Examples may be meditation, yoga, or exercise. If you are depressed or stressed a lot, talk to your provider. MEDICINES AND HERBAL REMEDIES You may see ads for supplements and herbal remedies that claim they will help you lose weight. Some of these claims may not be true. And some of these supplements can have serious side effects. Talk to your provider before using them. You can discuss weight loss medicines with your doctor. Many people lose at least 5 pounds by taking these drugs, but they may regain the weight when they stop taking the medicine unless they have made lifestyle changes. SURGERY Bariatric (weight-loss) surgery can reduce the risk of certain diseases in people with severe obesity. These risks include: - Arthritis - Diabetes - Heart disease - High blood pressure - Sleep apnea - Some cancers - Stroke Surgery may help people who have been very obese for 5 years or more and have not lost weight from other treatments, such as diet, exercise, or medicine. Surgery alone is not the answer for weight loss. It can train you to eat less, but you still have to do much of the work. You must be committed to diet and exercise after surgery. Talk to your doctor to learn if surgery is a good option for you. Weight-loss surgeries include: - Laparoscopic gastric banding - Gastric bypass surgery - Sleeve gastrectomy (less common) - Duodenal switch"}],"SUB_QUESTION_ID":"Q108-S1","ANNOTATIONS.FOCUS":["obesity"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"help with obesity","MESSAGE":"I would like help on my obesity problem and if I can get help","QUESTION_ID":"Q108","F_REF":"1-136475237"} -{"ANSWERS":[{"_answerid":"Q109-S1-A1","_pairid":"274","__text":"You will have a pelvic exam. It may show: - Swelling and redness of the skin of the vulva, in the vagina, and on the cervix - Dry, white spots on the vaginal wall - Cracks in the skin of the vulva. A small amount of the vaginal discharge is examined using a microscope. This is called a wet mount and KOH test. Sometimes, a culture is taken when the infection does not get better with treatment or comes back many times. Your health care provider may order other tests to rule out other causes of your symptoms."}],"SUB_QUESTION_ID":"Q109-S1","ANNOTATIONS.FOCUS":["vaginal yeast infection"],"ANNOTATIONS.TYPE":"diagnosis","SUBJECT":"vaginal yeast infection","MESSAGE":"Hey, my name is [NAME]. Last night my vaginal area was itching but I didn't think to much of it. Well when I woke up this morning it started itching out of control. I don't see discharge coming from the vaginal area. Now I do use Summer's Eve vaginal spray, I don't know if it is a vaginal yeast infection or not, but how should I go about this process.","QUESTION_ID":"Q109","F_REF":"15696"} -{"ANSWERS":[{"_answerid":"Q109-S2-A1","_pairid":"275","__text":"Medicines to treat vaginal yeast infections are available as creams, ointments, vaginal tablets or suppositories. Most can be bought without needing to see your health care provider. Treating yourself at home is probably\u00a0OK if: - Your symptoms are mild and you do not have pelvic pain or a fever - This is not your first yeast infection and you have not had many yeast infections in the past - You are not pregnant - You are not worried about other sexually transmitted infections from recent sexual contact Medicines you can buy yourself to treat a vaginal yeast infection are: - Miconazole - Clotrimazole - Tioconazole - Butoconazole When using these medicines: - Read the packages carefully and use them as directed. - You will need to take the medicine for 1 - 7 days, depending on which medicine you buy. (If you do not get repeated infections, a 1-day medicine might work for you.) - Do not stop using these medicines early because your symptoms are better. You doctor can also prescribe a pill that you only take by mouth once. If your symptoms are worse or you get vaginal yeast infections often, you may need: - Medicine for up to 14 days - Clotrimazole vaginal suppository or fluconazole pill every week to prevent new infections To help prevent and treat vaginal discharge: - Keep your genital area clean and dry. Avoid soap and rinse with water only. Sitting in a warm, but not hot, bath may help your symptoms. - Avoid douching. Although many women feel cleaner if they douche after their period or intercourse, it may worsen vaginal discharge. Douching removes healthy bacteria lining the vagina that protect against infection. - Eat yogurt with live cultures or take Lactobacillus acidophilus tablets when you are on antibiotics. This will help to prevent a yeast infection. - Use condoms to avoid catching or spreading infections. - Avoid using feminine hygiene sprays, fragrances, or powders in the genital area. - Avoid wearing tight-fitting pants or shorts, which may cause irritation. - Wear cotton underwear or cotton-crotch pantyhose. Avoid underwear made of silk or nylon, because they can increase sweating in the genital area, which can cause irritation. - Use pads and not tampons. - Keep your blood sugar levels under good control if you have diabetes. - Avoid wearing wet bathing suits or exercise clothing for long periods of time. Wash sweaty or wet clothes after each use."},{"_answerid":"Q109-S2-A2","_pairid":"276","__text":"Medicines to treat vaginal yeast infections are available as creams, ointments, vaginal tablets or suppositories. Most can be bought without needing to see your health care provider. Treating yourself at home is probably\u00a0OK if: - Your symptoms are mild and you do not have pelvic pain or a fever - This is not your first yeast infection and you have not had many yeast infections in the past - You are not pregnant - You are not worried about other sexually transmitted infections from recent sexual contact Medicines you can buy yourself to treat a vaginal yeast infection are: - Miconazole - Clotrimazole - Tioconazole - Butoconazole When using these medicines: - Read the packages carefully and use them as directed. - You will need to take the medicine for 1 - 7 days, depending on which medicine you buy. (If you do not get repeated infections, a 1-day medicine might work for you.) - Do not stop using these medicines early because your symptoms are better. You doctor can also prescribe a pill that you only take by mouth once. If your symptoms are worse or you get vaginal yeast infections often, you may need: - Medicine for up to 14 days - Clotrimazole vaginal suppository or fluconazole pill every week to prevent new infections To help prevent and treat vaginal discharge: - Keep your genital area clean and dry. Avoid soap and rinse with water only. Sitting in a warm, but not hot, bath may help your symptoms. - Avoid douching. Although many women feel cleaner if they douche after their period or intercourse, it may worsen vaginal discharge. Douching removes healthy bacteria lining the vagina that protect against infection. - Eat yogurt with live cultures or take Lactobacillus acidophilus tablets when you are on antibiotics. This will help to prevent a yeast infection. - Use condoms to avoid catching or spreading infections. - Avoid using feminine hygiene sprays, fragrances, or powders in the genital area. - Avoid wearing tight-fitting pants or shorts, which may cause irritation. - Wear cotton underwear or cotton-crotch pantyhose. Avoid underwear made of silk or nylon, because they can increase sweating in the genital area, which can cause irritation. - Use pads and not tampons. - Keep your blood sugar levels under good control if you have diabetes. - Avoid wearing wet bathing suits or exercise clothing for long periods of time. Wash sweaty or wet clothes after each use."}],"SUB_QUESTION_ID":"Q109-S2","ANNOTATIONS.FOCUS":["vaginal yeast infection"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"vaginal yeast infection","MESSAGE":"Hey, my name is [NAME]. Last night my vaginal area was itching but I didn't think to much of it. Well when I woke up this morning it started itching out of control. I don't see discharge coming from the vaginal area. Now I do use Summer's Eve vaginal spray, I don't know if it is a vaginal yeast infection or not, but how should I go about this process.","QUESTION_ID":"Q109","F_REF":"15696"} -{"ANSWERS":[{"_answerid":"Q110-S1-A1","_pairid":"277","__text":"These resources address the diagnosis or management of Milroy disease: - Gene Review: Gene Review: Milroy Disease - Genetic Testing Registry: Hereditary lymphedema type I - MedlinePlus Encyclopedia: Lymphatic Obstruction These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"}],"SUB_QUESTION_ID":"Q110-S1","ANNOTATIONS.FOCUS":["milroy disease"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"milroy disease","MESSAGE":"hello , my daughter has lymph edema her both legs and left hand is swelling , this problem started when she was of 3 months now she is 16 months , her swelling is growing day by day , im clue less what to do and what kind of treatment i should do plz help and suggest us ,","QUESTION_ID":"Q110","F_REF":"1-137169665"} -{"ANSWERS":[{"_answerid":"Q111-S1-A1","_pairid":"278","__text":"Duchenne muscular dystrophy is an inherited disorder that involves muscle weakness, which quickly gets worse."},{"_answerid":"Q111-S1-A2","_pairid":"279","__text":"Duchenne muscular dystrophy (DMD) is a rapidly progressive form of muscular dystrophy that occurs primarily in boys. It is caused by an alteration (mutation) in a gene, called the DMD gene that can be inherited in families in an X-linked recessive fashion, but it often occurs in people from families without a known family history of the condition. Individuals who have DMD have progressive loss of muscle function and weakness, which begins in the lower limbs. The DMD gene is the second largest gene to date, which encodes the muscle protein, dystrophin. Boys with Duchenne muscular dystrophy do not make the dystrophin protein in their muscles. Duchenne muscular dystrophy affects approximately 1 in 3500 male births worldwide. Because this is an inherited disorder, risks include a family history of Duchenne muscular dystrophy."}],"SUB_QUESTION_ID":"Q111-S1","ANNOTATIONS.FOCUS":["duchenne muscular dystrophy"],"ANNOTATIONS.TYPE":"information","SUBJECT":"","MESSAGE":"Duchenne Muscular Dystrophy. I am doing a research project on this genetic disease and I would like to know more about it from a professional. I am researching the mode of inheritance, symptoms, treatments\/ support groups, and relative cost to family.","QUESTION_ID":"Q111","F_REF":"43"} -{"ANSWERS":[{"_answerid":"Q111-S2-A1","_pairid":"280","__text":"Duchenne muscular dystrophy is inherited in an X-linked recessive pattern. Males have only one copy of the X chromosome from their mother and one copy of the Y chromosome from their father. If their X chromosome has a DMD gene mutation, they will have Duchenne muscular dystrophy. Females, on the other hand, have two copies of the X chromosomes.. Since females have two copies of this gene, if one copy does not work, they have a second back up copy to produce the dystrophin protein. A woman who has a genetic change in one of her two copies is said to be \"a carrier\" of Duchenne muscular dystrophy. Carriers do not have Duchenne muscular dystrophy and most are unaware that they even carry this change in their genetic material unless they have a family history. However, recent studies have shown that some carrier females (approximately 20 percent) will show symptoms of DMD, including muscle weakness and cardiac abnormalities. With an X-linked recessive condition, the chance of passing on the changed (non-working) copy of the gene to a child is different for males and females. Females who carry the changed copy of the gene have a 50 percent chance of passing it on with each pregnancy. Thus, there is a 25 percent chance of having a affected child with DMD (eg., 50 percent of boys have the chance of having DMD and 50 percent of girls will be carriers). The chance of a woman who has one affected son (and no family history) of being a carrier of the changed DMD gene is approximately 2\/3. However, in the remaining third of individuals with DMD, the change in the dystrophin gene is a new genetic change, or de novo change and about 10 percent of new mutations are due to gonadal mosaicism. Gonadal mosaicism refers to a condition where an individual has two or more cell populations that differ in genetic makeup in their eggs or sperm. Males who inherit or are born with a changed copy of the DMD gene will have DMD since they have a Y chromosome, and do not have back-up X chromosome. If a male with DMD were to have children, all of his daughters would be carriers and none of his sons would be affected. Currently various reproductive options are available to families. The preconception options include MicroSort which is a technology that can separate sperm containing X chromosomes allowing for an increase in chances of having a female. The second reproductive option is preimplantation genetic diagnosis (PGD), which is a technique that can allow the cells of a fertilized egg to be tested to determine if it contains a change in the DMD gene and then implant those eggs which do not. The post conception options include Chorionic Villus Sampling (CVS) and amniocentesis which analyze sampled cells derived from the developing fetus. Several of the prenatal testing options for pregnancies at increased risk are available when the DMD disease-causing mutation has been identified in a family member, or if informative, genetically-linked markers have been identified."}],"SUB_QUESTION_ID":"Q111-S2","ANNOTATIONS.FOCUS":["duchenne muscular dystrophy"],"ANNOTATIONS.TYPE":"inheritance","SUBJECT":"","MESSAGE":"Duchenne Muscular Dystrophy. I am doing a research project on this genetic disease and I would like to know more about it from a professional. I am researching the mode of inheritance, symptoms, treatments\/ support groups, and relative cost to family.","QUESTION_ID":"Q111","F_REF":"43"} -{"ANSWERS":[{"_answerid":"Q111-S3-A1","_pairid":"281","__text":"Symptoms usually appear before age 6 and may appear as early as infancy. They may include: - Fatigue - Learning difficulties (the IQ can be below 75) - Intellectual disability (possible, but does not get worse over time) Muscle weakness: - Begins in the legs and pelvis, but also occurs less severely in the arms, neck, and other areas of the body - Problems with motor skills (running, hopping, jumping) - Frequent falls - Trouble getting up from a lying position or climbing stairs - Weakness quickly gets worse Progressive difficulty walking: - Ability to walk may be lost by age 12, and the child\u00a0will have\u00a0to use a wheelchair - Breathing difficulties and heart disease usually start by age 20"},{"_answerid":"Q111-S3-A2","_pairid":"282","__text":"The symptoms usually appear before age 6 and may appear as early as infancy. Typically, the first noticeable symptom is delay of motor milestones, including sitting and standing independently. The mean age for walking in boys with Duchenne muscular dystrophy is 18 months. There is progressive muscle weakness of the legs and pelvic muscles, which is associated with a loss of muscle mass (wasting). This muscle weakness causes a waddling gait and difficulty climbing stairs. Muscle weakness also occurs in the arms, neck, and other areas, but not as severely or as early as in the lower half of the body. Calf muscles initially enlarge and the enlarged muscle tissue is eventually replaced with fat and connective tissue (pseudohypertrophy). Muscle contractures occur in the legs, making the muscles unusable because the muscle fibers shorten and fibrosis occurs in connective tissue. Occasionally, there can be pain in the calves. Symptoms usually appear in boys aged 1 to 6. There is a steady decline in muscle strength between the ages of 6 and 11 years. By age 10, braces may be required for walking, and by age 12, most boys are confined to a wheelchair. Bones develop abnormally, causing skeletal deformities of the spine and other areas. Muscular weakness and skeletal deformities frequently contribute to breathing disorders. Cardiomyopathy (enlarged heart) occurs in almost all cases, beginning in the early teens in some, and in all after the age of 18 years. Intellectual impairment may occur, but it is not inevitable and does not worsen as the disorder progresses. Few individuals with DMD live beyond their 30s. Breathing complications and cardiomyopathy are common causes of death."}],"SUB_QUESTION_ID":"Q111-S3","ANNOTATIONS.FOCUS":["duchenne muscular dystrophy"],"ANNOTATIONS.TYPE":"symptom","SUBJECT":"","MESSAGE":"Duchenne Muscular Dystrophy. I am doing a research project on this genetic disease and I would like to know more about it from a professional. I am researching the mode of inheritance, symptoms, treatments\/ support groups, and relative cost to family.","QUESTION_ID":"Q111","F_REF":"43"} -{"ANSWERS":[{"_answerid":"Q111-S4-A1","_pairid":"283","__text":"There is no known cure for Duchenne muscular dystrophy. Treatment aims to control symptoms to\u00a0improve quality of life. Steroid drugs can slow the loss of muscle strength. They may be started when the child is diagnosed or when muscle strength begins to decline. Other treatments may include: - Albuterol--a drug used for people with asthma - Amino acids - Carnitine - Coenzyme Q10 - Creatine - Fish oil - Green tea extracts - Vitamin E However, the effects of these treatments have not been proven. Stem cells and gene therapy may be used in the future. Activity is encouraged. Inactivity (such as bedrest) can\u00a0make the muscle disease worse. Physical therapy may help to maintain muscle strength and function. Speech therapy is often needed. Other treatments may include: - Assisted ventilation (used during the day or night) - Drugs to help heart function, such as angiotensin-converting-enzyme inhibitors, beta-blockers, and diuretics - Orthopedic appliances (such as braces and wheelchairs) to improve mobility - Proton pump inhibitors (for people with gastroesophageal reflux) Several new treatments are being studied in trials."},{"_answerid":"Q111-S4-A2","_pairid":"284","__text":"Treatment for Duchenne muscular dystrophy is aimed at the symptoms. Aggressive management of dilated cardiomyopathy with anti-congestive medications is used, including cardiac transplantation in severe cases. Assistive devices for respiratory complications may be needed, especially at night. The medication prednisone - a steroid - is given to improve the strength and function of individuals with DMD. Prednisone has been shown to prolong the ability to walk by 2 to 5 years. However, the possible side effects of prednisone include weight gain, high blood pressure, behavior changes, and delayed growth. A synthetic form of prednisilone, called Deflazacort, is used in Europe and believed to have fewer side effects than prednisone. A medication called cyclosporine has been used and has improved clinical function in children, but its use is controversial due to cyclosporine-induced myopathy. Oxandrolone, a medication used in a research study, has similar effects to prednisone with fewer side effects. Several other therapies are also under investigation, including coenzyme Q10, glutamine, pentoxifylline, and PTC124 (see clinical research below). Physical therapy is used to promote mobility and prevent contractures. Surgery may be needed for severe contractures and scoliosis."}],"SUB_QUESTION_ID":"Q111-S4","ANNOTATIONS.FOCUS":["duchenne muscular dystrophy"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"Duchenne Muscular Dystrophy. I am doing a research project on this genetic disease and I would like to know more about it from a professional. I am researching the mode of inheritance, symptoms, treatments\/ support groups, and relative cost to family.","QUESTION_ID":"Q111","F_REF":"43"} -{"ANSWERS":[{"_answerid":"Q111-S5-A1","_pairid":"285","__text":"Additional Resources for Duchenne Muscular Dystrophy Duchenne muscular dystrophy [nlm.nih.gov] From Medline Plus Muscular Dystrophy [nlm.nih.gov] From MEDLINEplus, the National Library of Medicine Web site Duchenne and Becker muscular dystrophy [ghr.nlm.nih.gov] From Genetics Home Reference DMD [ghr.nlm.nih.gov] Information on the DMD Gene: from Genetics HOME Reference The National Organization for Rare Disorders (NORD) [rarediseases.org] A federation of more than 130 nonprofit voluntary health organizations serving people with rare disorders. A printed report on Duchenne muscular dystrophy can be obtained through NORDs Web site, or by calling or writing the NORD offices. Scientists Come Step Closer to New Muscular Dystrophy Treatment [niams.nih.gov] January 2005 research press release on DMD from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) NINDS Muscular Dystrophy Information Page [ninds.nih.gov] From the National Institute of Neurological Disorders and Stroke (NINDS) The Muscular Dystrophy Association (MDA) [mdausa.org] An advocacy group for muscular dystrophy. Muscular Dystrophy Family Foundation [mdff.org] Funds adaptive equipment, from wheelchairs to van lifts to communication devices and beyond. Parent Project for Muscular Dystrophy Research [parentprojectmd.org] A digest of breaking research news on Duchenne Muscular Dystrophy (DMD) and Becker Muscular Dystrophy (BMD) Accurate and Affordable Diagnosis of Duchenne Muscular Distrophy [ninds.nih.gov] A new release from the National Institute of Neurological Disorders and Stroke. Duchenne muscular dystrophy [rarediseases.info.nih.gov] Information from the Genetics and Rare Diseases Information Center. Finding Reliable Health Information Online A listing of information and links for finding comprehensive genetics health information online."}],"SUB_QUESTION_ID":"Q111-S5","ANNOTATIONS.FOCUS":["duchenne muscular dystrophy"],"ANNOTATIONS.TYPE":"resources","SUBJECT":"","MESSAGE":"Duchenne Muscular Dystrophy. I am doing a research project on this genetic disease and I would like to know more about it from a professional. I am researching the mode of inheritance, symptoms, treatments\/ support groups, and relative cost to family.","QUESTION_ID":"Q111","F_REF":"43"} -{"ANSWERS":[{"_answerid":"Q112-S1-A1","_pairid":"286","__text":"The first treatment for a slipped disk is a short period of rest with medicines for the pain. This is followed by physical therapy. Most people who follow these treatments recover and return to normal activities. Some people will need to have more treatment. This may include steroid injections or surgery. MEDICINES Medicines can help with your pain. Your doctor may prescribe any of the following: - Nonsteroidal anti-inflammatory drugs (NSAIDs) for long-term pain control - Narcotics if the pain is severe and does not respond to NSAIDs - Medicines to calm the nerves - Muscle relaxants to relieve back spasms LIFESTYLE CHANGES If you are overweight, diet and exercise are very important for improving back pain. Physical therapy is important for nearly everyone with disk disease. Therapists will teach you how to properly lift, dress, walk, and perform other activities. They teach you how to strengthen muscles that help support the spine. You will also learn how to increase flexibility in your spine and legs. Take care of your back at home: - Reduce activity for the first few days. Slowly restart your usual activities. - Avoid heavy lifting or twisting your back for the first 6 weeks after the pain starts. - After 2 to 3 weeks, gradually start exercising again. INJECTIONS Steroid medicine injections into the back in the area of the herniated disk may help control pain for several months. These injections reduce swelling around the disk and relieve many symptoms. Spinal injections are usually done in your doctor's office. SURGERY Surgery may be an option if your symptoms do not go away with other treatments and time. Diskectomy is surgery to remove all or part of a disk. Discuss with your doctor which treatment options are best for you."}],"SUB_QUESTION_ID":"Q112-S1","ANNOTATIONS.FOCUS":["herniated disc"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"DISC HERNIA","MESSAGE":"GOOD AFTERNOON I HAVE wanted to say a herniated disc in L4 L5 S1 L3 8 MONTHS I HAVE DECREASED IN PAIN TREATMENT BUT HERE IN [LOCATION] GIVE ME NO WARRANTIES OF OPERATION WOULD LIKE TO KNOW IF THERE IS SOMETHING COULD Q DO IN MY CASE TOOK ME AND CONTRAST MAGNETIC RESONANCE","QUESTION_ID":"Q112","F_REF":"17055"} -{"ANSWERS":[{"_answerid":"Q113-S1-A1","_pairid":"287","__text":"The Human Phenotype Ontology (HPO) provides the following list of features that have been reported in people with this condition. Much of the information in the HPO comes from Orphanet, a European rare disease database. If available, the list includes a rough estimate of how common a feature is (its frequency). Frequencies are based on a specific study and may not be representative of all studies. You can use the MedlinePlus Medical Dictionary for definitions of the terms below."}],"SUB_QUESTION_ID":"Q113-S1","ANNOTATIONS.FOCUS":["stiff person syndrome"],"ANNOTATIONS.TYPE":"symptom","SUBJECT":"ClinicalTrials.gov - Question - general information","MESSAGE":"Stiff person Syndrome. Please can you tell me what are the early symptoms I have severe cramps in my feet which are twisting into an arc,muscle spasms slowly getting worse and my muscles particularly in my legs are cramping like someone has pushed a knitting needle into them. Started off at night but now happening through the day my back and neck and voice box are also effected and my chest area has now seized to the point of restricting my breathing to very shallow at times I find that I am stretching out involuntarily right through my body and this is becoming more frequent","QUESTION_ID":"Q113","F_REF":"1-137137005"} -{"ANSWERS":[{"_answerid":"Q114-S1-A1","_pairid":"288","__text":"Treatment varies based on: - Type of tumor - Whether it is cancer - Location of the tumor You may not need treatment if the tumor is: - Noncancerous (benign)\u00a0 - In\u00a0a \"safe\" area where it will not cause symptoms or problems with the way an organ works Sometimes benign tumors may be removed for cosmetic reasons. Benign tumors of the brain may be removed because of their location or harmful effect on the surrounding normal brain tissue. If a tumor is cancer, possible treatments may\u00a0include: - Chemotherapy - Radiation - Surgery - Targeted cancer therapy - Biologic therapy - Other treatment options"},{"_answerid":"Q114-S1-A2","_pairid":"289","__text":"TA specialized team of doctors advises and assists individuals throughout treatment and rehabilitation.\u00a0 These doctors may include: A\u00a0neurologist is a specialist in nervous system disorders. An oncologist is a specialist in cancer. A neuro-oncologist is a neurologist or oncologist who specializes in nervous system tumors. A\u00a0neuroradiologist is a doctor trained in reading diagnostic imaging results who\u00a0specializes in the CNS. A\u00a0pathologist is a clinical physician who diagnoses diseases of tissues or cells using a variety of laboratory tests. A\u00a0neurosurgeon is a brain or spinal cord surgeon. A\u00a0radiation oncologist is a doctor who specializes in using radiation to treat individuals with cancer. This team will recommend a treatment plan based on the tumor's location, type, size and aggressiveness, as well as on the individual\u2019s medical history, age, and general health. Initial treatment for a CNS tumor may involve a variety of drugs, including anticonvulsants to treat seizures, pain medications, steroids or other anti-inflammatory drugs to reduce swelling and improve blood flow, antidepressants to treat anxiety or ease depression that might occur following a tumor diagnosis, and drugs to fight nausea caused by various treatments. Malignant tumors require some form of treatment, while some small benign tumors may need only\u00a0periodic monitoring.\u00a0 The three standard treatment options for malignant CNS tumors are neurosurgery, radiation therapy, and chemotherapy.\u00a0 Some patients may receive a combination of treatments."}],"SUB_QUESTION_ID":"Q114-S1","ANNOTATIONS.FOCUS":["tumors in brain and spine"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"My Brother named [NAME] Has Multiple tumors in brain and spine. after gone through 3 major surgeries he can not walk properly as he has 3 tumors still in brain and spine. and after surgery his right eyesight has been lost and he can not hear. Is there any research done by your sight and found medicines which can remove his remaining tumors. Please give me suggestion regarding this matter. I can provide all the necessary medical reports if you need.","QUESTION_ID":"Q114","F_REF":"1-134274435"} -{"ANSWERS":[{"_answerid":"Q115-S1-A1","_pairid":"290","__text":"Asthma is caused by swelling (inflammation) in the airways. When an asthma attack occurs, the lining of the air passages swells and the muscles surrounding the airways become tight. This reduces the amount of air that can pass through the airway. In people who have sensitive airways, asthma symptoms can be triggered by breathing in\u00a0substances called allergens or triggers. Common asthma triggers include: - Animals (pet hair or dander) - Dust mites - Certain medicines (aspirin and other NSAIDS) - Changes in weather (most often cold weather) - Chemicals in the air or in food - Exercise - Mold - Pollen - Respiratory infections, such as the common cold - Strong emotions (stress) - Tobacco smoke Substances in some workplaces can also trigger asthma symptoms, leading to occupational asthma. The most common triggers are wood dust, grain dust, animal dander, fungi, or chemicals. Many people with asthma have a personal or family history of allergies, such as hay fever (allergic rhinitis) or eczema. Others have no history of allergies."},{"_answerid":"Q115-S1-A2","_pairid":"291","__text":"The exact cause of asthma isn't known. Researchers think some genetic and environmental factors interact to cause asthma, most often early in life. These factors include: An inherited tendency to develop allergies, called atopy (AT-o-pe) Parents who have asthma Certain respiratory infections during childhood Contact with some airborne allergens or exposure to some viral infections in infancy or in early childhood when the immune system is developing If asthma or atopy runs in your family, exposure to irritants (for example, tobacco smoke) may make your airways more reactive to substances in the air. Some factors may be more likely to cause asthma in some people than in others. Researchers continue to explore what causes asthma. The \"Hygiene Hypothesis\" One theory researchers have for what causes asthma is the \"hygiene hypothesis.\" They believe that our Western lifestyle\u2014with its emphasis on hygiene and sanitation\u2014has resulted in changes in our living conditions and an overall decline in infections in early childhood. Many young children no longer have the same types of environmental exposures and infections as children did in the past. This affects the way that young children's immune systems develop during very early childhood, and it may increase their risk for atopy and asthma. This is especially true for children who have close family members with one or both of these conditions."}],"SUB_QUESTION_ID":"Q115-S1","ANNOTATIONS.FOCUS":["asthma"],"ANNOTATIONS.TYPE":"cause","SUBJECT":"Asthma","MESSAGE":"I have been treated for breast cancer and had chemotherapy and readiation. I am on many drugs but since stopping treatment I have now presented as having asthma. I take Letrozole. 2.5 to block any estrogen in my body as my tumor was estrogen positive. What type of drugs impact asthma symptoms? Please advise","QUESTION_ID":"Q115","F_REF":"15794"} -{"ANSWERS":[{"_answerid":"Q116-S1-A1","_pairid":"294","__text":"Most cases of Turner syndrome are not inherited. Most commonly, Turner syndrome occurs due to a random event during the formation of an egg or sperm cell in a parent (prior to conception). For example, if an egg or sperm cell mistakenly loses a sex chromosome, and joins at conception with an egg or sperm containing an X chromosome, the resulting child will have a single X chromosome in each cell. Mosaic Turner syndrome, occurring when a person has some cells with one X chromosome and some cells with two sex chromosomes, is also not inherited. This also occurs due to a random event, during early fetal development rather than before conception. In rare cases, Turner syndrome may be caused by a missing piece (partial deletion) of the X chromosome. A deletion can be inherited from a parent. Genetic testing of an affected fetus or child can identify the type of Turner syndrome present and may help to estimate the risk of recurrence. People with questions about genetic testing or recurrence risks for Turner syndrome are encouraged to speak with a genetic counselor or other genetics professional."},{"_answerid":"Q116-S1-A2","_pairid":"295","__text":"Most cases of Turner syndrome are not inherited. When this condition results from monosomy X, the chromosomal abnormality occurs as a random event during the formation of reproductive cells (eggs and sperm) in the affected person's parent. An error in cell division called nondisjunction can result in reproductive cells with an abnormal number of chromosomes. For example, an egg or sperm cell may lose a sex chromosome as a result of nondisjunction. If one of these atypical reproductive cells contributes to the genetic makeup of a child, the child will have a single X chromosome in each cell and will be missing the other sex chromosome. Mosaic Turner syndrome is also not inherited. In an affected individual, it occurs as a random event during cell division in early fetal development. As a result, some of an affected person's cells have the usual two sex chromosomes, and other cells have only one copy of the X chromosome. Other sex chromosome abnormalities are also possible in females with X chromosome mosaicism. Rarely, Turner syndrome caused by a partial deletion of the X chromosome can be passed from one generation to the next."}],"SUB_QUESTION_ID":"Q116-S1","ANNOTATIONS.FOCUS":["turner syndrome"],"ANNOTATIONS.TYPE":"inheritance","SUBJECT":"","MESSAGE":"Customer Service Request. My daughter has Turner syndrome but she's beaten all odds. She developed on our own, got her period on her own, she is now pregnant on her own with identical twins. My question is can she have normal children or do they have more of a chance of having Turner syndrome. My daughter has been tested many times to confirm her diagnosis of Turner syndrome and she is a full XO not mosaic but still does not display many of the characteristics. Again, I am just questioning the safety of the pregnancy and the health of the babies. Thank you for your help","QUESTION_ID":"Q116","F_REF":"10599"} -{"ANSWERS":[{"_answerid":"Q117-S1-A1","_pairid":"296","__text":"These resources address the diagnosis or management of vitelliform macular dystrophy: - Gene Review: Gene Review: Best Vitelliform Macular Dystrophy - Genetic Testing Registry: Macular dystrophy, vitelliform, adult-onset - Genetic Testing Registry: Vitelliform dystrophy - MedlinePlus Encyclopedia: Macula (image) These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"}],"SUB_QUESTION_ID":"Q117-S1","ANNOTATIONS.FOCUS":["vitelliform macular dystrophy"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"Vitelliform Macular Dystrophy","MESSAGE":"Would like to obtain more info on possible treatments.","QUESTION_ID":"Q117","F_REF":"NF_172"} -{"ANSWERS":[{"_answerid":"Q118-S1-A1","_pairid":"297","__text":"Treatment for Dry Mouth Dry mouth treatment will depend on what is causing the problem. If you think you have dry mouth, see your dentist or physician. He or she can help to determine what is causing your dry mouth. If your dry mouth is caused by medicine, your physician might change your medicine or adjust the dosage. If your salivary glands are not working right but can still produce some saliva, your dentist or physician might give you a medicine that helps the glands work better. Your dentist or physician might also suggest that you use artificial saliva to keep your mouth wet. Do's and Don'ts Do's - Do drink water or sugarless drinks often. That will make chewing and swallowing easier when eating. - Do chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow. - Do use a humidifier at night to promote moisture in the air while you sleep. Do drink water or sugarless drinks often. That will make chewing and swallowing easier when eating. Do chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow. Do use a humidifier at night to promote moisture in the air while you sleep. Don\u2019ts - Don't consume drinks with caffeine such as coffee, tea, and some sodas. Caffeine can dry out the mouth. - Don't use tobacco or alcohol. They dry out the mouth. Don't consume drinks with caffeine such as coffee, tea, and some sodas. Caffeine can dry out the mouth. Don't use tobacco or alcohol. They dry out the mouth. Gene Therapy Research for Salivary Gland Dysfunction Scientists at NIH\u2019s National Institute of Dental and Craniofacial Research (NIDCR) are exploring the potential use of gene therapy to treat salivary gland dysfunction. The idea is to transfer additional or replacement genes into the salivary glands of people with Sj\u00f6gren's syndrome and cancer patients whose salivary glands were damaged during radiation treatment. The hope is that these genes will increase the production of saliva and eliminate the chronic parched sensation that bothers people with dry mouth conditions. NIDCR recently completed a clinical study, a research study in humans, on gene therapy for radiation-damaged salivary glands. The study showed that gene therapy can be safely performed in salivary glands and that it has the potential to help head and neck cancer survivors with dry mouth. Read NIDCR\u2019s news release to learn more about the study\u2019s findings. Based on the promising results of this trial, similar clinical trials are planned in the near future. Research on Sj\u00f6gren\u2019s Syndrome and Other Diseases Affecting Salivary Glands NIDCR is also conducting clinical trials to study new approaches for improving salivary flow in patients with Sjogren\u2019s syndrome. Such studies include testing the effectiveness of a monoclonal antibody as well as a corticosteroid to see whether either of these treatments helps improve salivary flow. Other studies are focused on learning how diseases such as diabetes, auto inflammatory diseases, and granulomatous diseases cause salivary gland dysfunction. Such studies could one day lead to better ways of preventing and treating salivary gland conditions. To stay abreast of any new studies on gene therapy and salivary gland function, visit ClinicalTrials.gov. ClinicalTrials.gov lists all federally and many privately funded clinical trials in the U.S. and around the world; the web site is updated frequently."},{"_answerid":"Q118-S1-A2","_pairid":"298","__text":"Dry mouth treatment will depend on what is causing the problem. If you think you have dry mouth, see your dentist or physician. He or she can help to determine what is causing your dry mouth. If your dry mouth is caused by medicine, your physician might change your medicine or adjust the dosage. If your salivary glands are not working right, but can still produce some saliva, your dentist or physician might give you a special medicine that helps the glands work better. He or she might suggest that you use artificial saliva to keep your mouth wet. (Watch the video to learn how dry mouth is treated. 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.)"},{"_answerid":"Q118-S1-A3","_pairid":"299","__text":"Treatment for Dry Mouth Dry mouth treatment will depend on what is causing the problem. If you think you have dry mouth, see your dentist or physician. He or she can help to determine what is causing your dry mouth. If your dry mouth is caused by medicine, your physician might change your medicine or adjust the dosage. If your salivary glands are not working right but can still produce some saliva, your dentist or physician might give you a medicine that helps the glands work better. Your dentist or physician might also suggest that you use artificial saliva to keep your mouth wet. Do's and Don'ts Do's - Do drink water or sugarless drinks often. That will make chewing and swallowing easier when eating. - Do chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow. - Do use a humidifier at night to promote moisture in the air while you sleep. Do drink water or sugarless drinks often. That will make chewing and swallowing easier when eating. Do chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow. Do use a humidifier at night to promote moisture in the air while you sleep. Don\u2019ts - Don't consume drinks with caffeine such as coffee, tea, and some sodas. Caffeine can dry out the mouth. - Don't use tobacco or alcohol. They dry out the mouth. Don't consume drinks with caffeine such as coffee, tea, and some sodas. Caffeine can dry out the mouth. Don't use tobacco or alcohol. They dry out the mouth. Gene Therapy Research for Salivary Gland Dysfunction Scientists at NIH\u2019s National Institute of Dental and Craniofacial Research (NIDCR) are exploring the potential use of gene therapy to treat salivary gland dysfunction. The idea is to transfer additional or replacement genes into the salivary glands of people with Sj\u00f6gren's syndrome and cancer patients whose salivary glands were damaged during radiation treatment. The hope is that these genes will increase the production of saliva and eliminate the chronic parched sensation that bothers people with dry mouth conditions. NIDCR recently completed a clinical study, a research study in humans, on gene therapy for radiation-damaged salivary glands. The study showed that gene therapy can be safely performed in salivary glands and that it has the potential to help head and neck cancer survivors with dry mouth. Read NIDCR\u2019s news release to learn more about the study\u2019s findings. Based on the promising results of this trial, similar clinical trials are planned in the near future. Research on Sj\u00f6gren\u2019s Syndrome and Other Diseases Affecting Salivary Glands NIDCR is also conducting clinical trials to study new approaches for improving salivary flow in patients with Sjogren\u2019s syndrome. Such studies include testing the effectiveness of a monoclonal antibody as well as a corticosteroid to see whether either of these treatments helps improve salivary flow. Other studies are focused on learning how diseases such as diabetes, auto inflammatory diseases, and granulomatous diseases cause salivary gland dysfunction. Such studies could one day lead to better ways of preventing and treating salivary gland conditions. To stay abreast of any new studies on gene therapy and salivary gland function, visit ClinicalTrials.gov. ClinicalTrials.gov lists all federally and many privately funded clinical trials in the U.S. and around the world; the web site is updated frequently."}],"SUB_QUESTION_ID":"Q118-S1","ANNOTATIONS.FOCUS":["dry mouth"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"treatment for dry mouth caused by necessary medicine","MESSAGE":"My provider can't help (I asked.) I am intolerant of all the \"sugar alcohols\" such as maltilol, sorbitol, xylitol, etc. and need something for dry mouth caused by med which I have to take. Biotene products help for only about two minutes.","QUESTION_ID":"Q118","F_REF":"1-118317205"} -{"ANSWERS":[{"_answerid":"Q119-S1-A1","_pairid":"303","__text":"The outlook depends on the type of cancer and the stage of the cancer when diagnosed.\u00a0\u00a0 Some cancers can be cured. Other cancers that are not curable can still be treated effectively. Some patients can live for many years with cancer. Other tumors are quickly life threatening."}],"SUB_QUESTION_ID":"Q119-S1","ANNOTATIONS.FOCUS":["cancer"],"ANNOTATIONS.TYPE":"prognosis","SUBJECT":"","MESSAGE":"Hello dear sir\/madam I just want to knw if any cancer person had all treatment done then cancer gonna be again or not.how long person can live after cancer treatment.please reply me as Soon as possible. Thank you Sent from my iPhone","QUESTION_ID":"Q119","F_REF":"1-136814529"} -{"ANSWERS":[{"_answerid":"Q120-S1-A1","_pairid":"305","__text":"People with pulmonary arterial hypertension (PAH) benefit from receiving treatment at specialized centers. The Pulmonary Hypertension Association offers a Find a Doctor tool which may aid you in locating your nearest center. Treatment of serious or life threatening PAH may involve continuous IV epoprostenol. Other treatment options, include treprostinil, iloprost, bosentan, ambrisentan, sildenafil, and tadalafil. Many of these treatments can be administered in various forms, such as by shot, IV, or inhalation. A small number of people with PAH respond well to long term oral calcium channel blockers. Blood thinners, diuretics, and supplemental oxygen may be prescribed as needed. Many drugs can be harmful to people with PAH. The following should be avoided: appetite suppressants, cocaine, amphetamines (and related compounds), low oxygen environments (such as high altitudes), and possibly estrogen compounds (oral contraceptives and hormone replacement therapy)."},{"_answerid":"Q120-S1-A2","_pairid":"306","__text":"These resources address the diagnosis or management of pulmonary arterial hypertension: - Gene Review: Gene Review: Heritable Pulmonary Arterial Hypertension - Genetic Testing Registry: Primary pulmonary hypertension - Genetic Testing Registry: Primary pulmonary hypertension 2 - Genetic Testing Registry: Primary pulmonary hypertension 3 - Genetic Testing Registry: Primary pulmonary hypertension 4 - MedlinePlus Encyclopedia: Pulmonary hypertension These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"}],"SUB_QUESTION_ID":"Q120-S1","ANNOTATIONS.FOCUS":["pulmonary arterial hypertension"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"My mother has Pulmonary ARTERIAL hypertension in the left side of her heart. Is there anything that can be done to improve her health.","QUESTION_ID":"Q120","F_REF":"1-131596745"} -{"ANSWERS":[{"_answerid":"Q121-S1-A1","_pairid":"307","__text":"Most men ejaculate within a few minutes of starting to thrust during intercourse. Men with delayed ejaculation may be unable to ejaculate or may only be able to ejaculate with great effort after having intercourse for a long time (for example, 30 to 45 minutes). Delayed ejaculation can have psychological or physical causes. Common psychological causes include: - Religious background that makes the person view sex as sinful - Lack of attraction for a partner - Conditioning caused by a habit of excessive masturbation - Traumatic events (such as being discovered masturbating or having illicit sex, or learning one's partner is having an affair) Some factors, such as anger toward the partner, may be involved. Physical causes may include: - Blockage of the ducts that semen passes through - Use of certain drugs (such as prozac, mellaril, and guanethidine) - Nervous system diseases, such as stroke or nerve damage to the spinal cord or back - Testosterone deficiency - Nerve damage during surgery in the pelvis"}],"SUB_QUESTION_ID":"Q121-S1","ANNOTATIONS.FOCUS":["delayed ejaculation"],"ANNOTATIONS.TYPE":"cause","SUBJECT":"delayed ejaculation","MESSAGE":"i 25 year old i have problem of delayed ejaculation.even after taking several minutes im not able to ejaculate.but im getting regular night falls.what is the cause,which doctor should i consult.","QUESTION_ID":"Q121","F_REF":"12277"} -{"ANSWERS":[{"_answerid":"Q122-S1-A1","_pairid":"308","__text":"Adrenoleukodystrophy describes several closely related inherited disorders that disrupt the breakdown (metabolism) of certain fats (very long chain fatty acids)."},{"_answerid":"Q122-S1-A2","_pairid":"309","__text":"X-linked Adrenoleukodystrophy (ALD) is one of a group of genetic disorders called the leukodystrophies that cause damage to the myelin sheath, an insulating membrane that surrounds nerve cells in the brain. Women have two X chromosomes and are the carriers of the disease, but since men only have one X chromosome and lack the protective effect of the extra X chromosome, they are more severely affected. \u00a0People with X-ALD accumulate high levels of saturated, very long chain fatty acids (VLCFA) in the brain and adrenal cortex. The loss of myelin and the progressive dysfunction of the adrenal gland are the primary characteristics of X-ALD. While nearly all patients with X-ALD suffer from adrenal insufficiency, also known as Addison's disease, the neurological symptoms can begin either in childhood or in adulthood. The childhood cerebral form is the most severe, with onset between ages 4 and 10. The most common symptoms are usually behavioral changes such as abnormal withdrawal or aggression, poor memory, and poor school performance. Other symptoms include visual loss, learning disabilities, seizures, poorly articulated speech, difficulty swallowing, deafness, disturbances of gait and coordination, fatigue, intermittent vomiting, increased skin pigmentation, and progressive dementia. The milder adult-onset form is also known as adrenomyeloneuropathy (AMN), which typically begins between ages 21 and 35. \u00a0Symptoms may include progressive stiffness, weakness or paralysis of the lower limbs, and ataxia. Although adult-onset ALD progresses more slowly than the classic childhood form, it can also result in deterioration of brain function. Almost half the women who are carriers of X-ALS will develop a milder form of AMN but almost never will develop symptoms seen in boys the X-ALD. \u00a0X-ALD should not be confused with neonatal adrenoleukodsystrophy, which is a disease of newborns and young infants and belongs to the group of peroxisomal biogenesis disorders."},{"_answerid":"Q122-S1-A3","_pairid":"310","__text":"The NINDS supports research on genetic disorders such as ALD. The aim of this research is to find ways to prevent, treat, and cure these disorders. Studies are currently underway to identify new biomarkers of disease progression and to determine which patients will develop the childhood cerebral form of X-ALD. \u00a0A recent case study in Europe demonstrated that the combination of gene therapy with bone marrow transplantation, using the patient's own bone marrow cells, may arrest disease progression in childhood cerebral X-ALD. \u00a0A therapeutic trail in the United States is currently being discussed with the U.S. Food and Drug Administration."}],"SUB_QUESTION_ID":"Q122-S1","ANNOTATIONS.FOCUS":["adrenoleukodystrophy"],"ANNOTATIONS.TYPE":"information","SUBJECT":"adrenoleukodystrophy","MESSAGE":"A child I have been asked to work with has been diagnosed with this condition.I am so far unable to find info pertaining to this illness. Can you help??","QUESTION_ID":"Q122","F_REF":"NF_183"} -{"ANSWERS":[{"_answerid":"Q123-S1-A1","_pairid":"313","__text":"HIV\/AIDS is treated with medicines that stop the virus from multiplying. This treatment is called antiretroviral therapy (ART). In the past, people with HIV infection would start antiretroviral treatment after their CD4 count dropped or they developed HIV complications. Today, HIV treatment is recommended for all people with HIV infection, even if their CD4 count is still normal. Regular blood tests are needed to make sure the virus level in the blood (viral load) is kept low, or suppressed. The goal of treatment is to lower the HIV virus in the blood to a level that is so low that the test can't detect it. This is called an undetectable viral load. If the CD4 count already dropped before treatment was started, it will usually slowly go up. HIV complications often disappear as the immune system recovers."}],"SUB_QUESTION_ID":"Q123-S1","ANNOTATIONS.FOCUS":["hiv\/aids"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"hi my name is [NAME] I'm currently working with [LOCATION] and I was wondering I came across some of you healthy tip fliers for HIV\/Aids treatment .at the moment we have a study going on that helps HIV positive transgender women into HIV quality care .so it would be great to have some more information on HIV\/Aids treatment","QUESTION_ID":"Q123","F_REF":"14038"} -{"ANSWERS":[{"_answerid":"Q124-S1-A1","_pairid":"314","__text":"The Leptospira bacteria can be found in fresh water that has been contaminated by animal urine. The infection occurs in warmer climates. Leptospirosis\u00a0is not spread from person to person, except in vary rare cases. It occasionally spreads through sexual intercourse,\u00a0breast milk, or from a mother to her unborn child. Risk factors include: - Occupational exposure -- farmers, ranchers, slaughterhouse workers, trappers, veterinarians, loggers, sewer workers, rice field workers, and military personnel - Recreational activities -- fresh water swimming, canoeing, kayaking, and trail biking in warm areas - Household exposure -- pet dogs, domesticated livestock, rainwater catchment systems, and infected rodents Leptospirosis is rare in the continental United States. Hawaii has the highest number of cases in the United States."}],"SUB_QUESTION_ID":"Q124-S1","ANNOTATIONS.FOCUS":["leptospirosis"],"ANNOTATIONS.TYPE":"cause","SUBJECT":"Leptospirosis","MESSAGE":"what causes leptospirosis to spread in the human body","QUESTION_ID":"Q124","F_REF":"1-136964717"} -{"ANSWERS":[{"_answerid":"Q125-S1-A1","_pairid":"315","__text":"Type 2 diabetes may be reversed with lifestyle changes, especially losing weight\u00a0with exercise\u00a0and by\u00a0eating healthier foods. Some cases of type 2 diabetes can also\u00a0be improved with weight-loss surgery. There is no cure for type 1 diabetes. Treating\u00a0either type 1 diabetes\u00a0or type 2 diabetes involves medicines, diet, and exercise to control blood sugar level. Everyone with diabetes should receive proper education and support about the best ways to manage their diabetes. Ask your provider about seeing a diabetes nurse educator. Getting better control over your blood sugar, cholesterol, and blood pressure levels helps reduce the risk of kidney disease, eye disease, nervous system disease, heart attack, and stroke. To prevent diabetes complications, visit your provider at least 2 to 4 times a year. Talk about any problems you are having. Follow your provider's instructions on managing your diabetes."},{"_answerid":"Q125-S1-A2","_pairid":"316","__text":"The goal of treatment at first is to lower your high blood glucose levels. Long-term goals are to prevent problems from diabetes. The most important way to treat and manage type 2 diabetes is with activity and healthy eating. Everyone with diabetes should receive proper education and support about the best ways to manage their diabetes. Ask your healthcare provider about seeing a diabetes educator. LEARN THESE SKILLS Learning diabetes management skills will help you live well with diabetes. These skills help prevent health problems and the need for medical care. Skills include: - How to test and record your blood glucose - What and when to eat - How to safely increase your activity and control your weight - How to take medications, if needed - How to recognize and treat low and high blood sugar - How to handle sick days - Where to buy diabetes supplies and how to store them It may take several months to learn these skills. Keep learning about diabetes, its complications, and how to control and live well\u00a0with the disease. Stay up-to-date on new research and treatments. MANAGING YOUR BLOOD SUGAR Checking your blood sugar levels yourself and writing down the results tells you how well you are managing your diabetes. Talk to your doctor and diabetes educator about how often to check. To check your blood sugar level, you use a device called a glucose meter. Usually, you prick your finger with a small needle called a lancet. This gives you a tiny drop of blood. You place the blood on a test strip and put the strip into the meter. The meter gives you a reading that tells you the level of your blood sugar. Your doctor or diabetes educator will help set up a testing schedule for you. Your doctor will help you set a target range for your blood sugar numbers. Keep these factors in mind: - Most people with type 2 diabetes only need to check their blood sugar once or twice a day. - If your blood sugar level is under control, you may only need to check it a few times a week. - You may test yourself when you wake up, before meals, and at bedtime. - You may need to test more often when you are sick or under stress. Keep a record of your blood sugar for yourself and your doctor. Based on your numbers, you may need to make changes to your meals, activity, or medicines to keep your blood sugar level in the right range. HEALTHY EATING AND WEIGHT CONTROL Work closely with your doctor, nurse, and dietitian to learn how much fat, protein, and carbohydrates you need in your diet. Your meal plans should fit your lifestyle and habits and should include foods that you like. Managing your weight and having a well-balanced diet are important. Some people with type 2 diabetes can stop taking medicines after losing weight. This does not mean that their diabetes is cured. They still have diabetes. Very obese patients whose diabetes is not well managed with diet and medicine may consider weight loss (bariatric) surgery. REGULAR PHYSICAL ACTIVITY Regular activity is important for everyone. It is even more important when you have diabetes. Exercise is good for your health because it: - Lowers your blood sugar level without medicine - Burns extra calories and fat to help manage your weight - Improves blood flow and blood pressure - Increases your energy level - Improves your ability to handle stress Talk to your doctor before starting any exercise program. People with type 2 diabetes may need to take special steps before, during, and after physical activity or exercise. MEDICATIONS TO TREAT DIABETES If diet and exercise do not help keep your blood sugar at normal or near-normal levels, your doctor may prescribe medication. Since these drugs help lower your blood sugar levels in different ways, your doctor may have you take more than one drug. Some of the most common types of medication are listed below. They are taken by mouth or injection. - Alpha-glucosidase inhibitors - Biguanides - DPP IV inhibitors - Injectable medicines (GLP-1 analogs) - Meglitinides - SGL T2 inhibitors - Sulfonylureas - Thiazolidinediones You may need to take insulin if your blood sugar cannot be controlled with any of the above medicines. Insulin must be injected under the skin using a syringe, insulin pen, or pump. It cannot be taken by mouth because the acid in the stomach destroys insulin. PREVENTING COMPLICATIONS Your doctor may prescribe medicines or other treatments to reduce your chance of developing some of the more common complications of diabetes, including: - Eye disease - Kidney disease - Heart disease and stroke FOOT CARE People with diabetes are more likely than those without diabetes to have foot problems. Diabetes damages the nerves. This can make you less able to feel pressure on the foot. You many not notice a foot injury until you get a severe infection. Diabetes can also damage blood vessels. Small sores or breaks in the skin may become deeper skin sores (ulcers). The affected limb may need to be amputated if these skin ulcers do not heal or become larger, deeper, or infected. To prevent problems with your feet: - Stop smoking if you smoke. - Improve control of your blood sugar. - Get a foot exam by your doctor at least twice a year and learn if you have nerve damage. - Check and care for your feet every day. This is very important when you already have nerve or blood vessel damage or foot problems. - Treat minor infections, such as athlete's foot, right away. - Use moisturizing lotion on dry skin. - Make sure you wear the right kind of shoes. Ask your doctor what type of shoe is right for you."},{"_answerid":"Q125-S1-A3","_pairid":"317","__text":"Diabetes cannot be cured, but it can be managed. Managing blood glucose (blood sugar) as well as blood pressure and cholesterol is the best defense against the serious complications of diabetes. Know What To Do Every Day To manage your diabetes, here are things to do every day. - Take your medicines. - Keep track of your blood glucose (blood sugar). - Check your blood pressure if your doctor advises. - Check your feet. - Brush your teeth and floss. - Stop smoking. - Eat well. - Be active. Take your medicines. Keep track of your blood glucose (blood sugar). Check your blood pressure if your doctor advises. Check your feet. Brush your teeth and floss. Stop smoking. Eat well. Be active. (Watch the video to learn more about what one woman does to manage her diabetes every day. 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.) Take Your Diabetes Medicines People with type 1 diabetes control their blood sugar with insulin -- delivered either by injection or with a pump. Many people with type 2 diabetes can control blood glucose levels with diet and exercise alone. Others require oral medications or insulin, and some may need both, as well as lifestyle modification. Ask your doctor if you need to take aspirin every day to prevent a heart attack or stroke. Keep Track of Your Blood Glucose One of the best ways to find out how well you are taking care of your diabetes is to check your blood to see how much glucose is in it. If your blood has too much or too little glucose, you may need a change in your meal plan, exercise plan, or medication. Ask your doctor how often you should check your blood glucose. Some people check their blood glucose once a day. Others do it three a day or even more. You may be told to check before eating, before bed, and sometimes in the middle of the night. Your doctor or diabetes educator will show you how to check your blood using a blood glucose meter. Your health insurance or Medicare may pay for some of the supplies and equipment you need to check your glucose levels. See what diabetes supplies and services Medicare covers. Check Your Blood Pressure Check your blood pressure if your doctor advises and keep a record of it. You can check your pressure at home with a home blood pressure measurement device or monitor. Blood pressure monitors can be bought at discount chain stores and drug stores. When you are taking your blood pressure at home, sit with your back supported and your feet flat on the floor. Rest your arm on a table at the level of your heart. Check with your health care provider to make sure you are using the monitor correctly. Check Your Feet Foot care is very important for people with diabetes. High blood glucose levels and a reduced blood supply to the limbs cause nerve damage that reduces feeling in the feet. Someone with nerve damage may not feel a pebble inside his or her sock that is causing a sore. Or a blister caused by poorly fitting shoes may go unnoticed. Foot injuries such as these can cause ulcers, which may, if not cared for, ultimately lead to the need for amputation. If you have diabetes, - check your feet every day and watch for any cuts, sores, red spots, swelling, and infected toenails. - report sores, blisters, breaks in the skin, infections, or buildup of calluses to a podiatrist or a family doctor. - never walk barefoot. - have your feet checked at every doctor visit. - take your shoes and socks off when you go into the examining room. This will remind the doctor to check your feet. check your feet every day and watch for any cuts, sores, red spots, swelling, and infected toenails. report sores, blisters, breaks in the skin, infections, or buildup of calluses to a podiatrist or a family doctor. never walk barefoot. have your feet checked at every doctor visit. take your shoes and socks off when you go into the examining room. This will remind the doctor to check your feet. Learn more about taking care of your feet. Brush Your Teeth and Floss People with diabetes can have tooth and gum problems more often if their blood glucose stays high. High blood glucose also can make tooth and gum problems worse. You can even lose your teeth. Here are ways to protect your teeth and gums. - Keep your blood glucose as close to normal as possible. - Use dental floss at least once a day. Flossing helps prevent the buildup of plaque on your teeth. Plaque can harden and grow under your gums and cause problems. Using a sawing motion, gently bring the floss between the teeth, scraping from bottom to top several times. - Brush your teeth after each meal and snack. Use a soft toothbrush. Turn the bristles against the gum line and brush gently. Use small, circular motions. Brush the front, back, and top of each tooth. - If you wear false teeth, keep them clean. - Call your dentist right away if you have problems with your teeth and gums. Keep your blood glucose as close to normal as possible. Use dental floss at least once a day. Flossing helps prevent the buildup of plaque on your teeth. Plaque can harden and grow under your gums and cause problems. Using a sawing motion, gently bring the floss between the teeth, scraping from bottom to top several times. Brush your teeth after each meal and snack. Use a soft toothbrush. Turn the bristles against the gum line and brush gently. Use small, circular motions. Brush the front, back, and top of each tooth. If you wear false teeth, keep them clean. Call your dentist right away if you have problems with your teeth and gums. Learn more about how diabetes can affect your mouth and teeth. Stop Smoking If you smoke, stop. Smoking raises your risk for many diabetes problems, including heart attack and stroke. Ask for help to quit. Call 1-800 QUITNOW (1-800-784-8669). For more information on smoking and older adults, see Quitting Smoking for Older Adults. Eat Well People with diabetes don't need to buy or prepare special foods. The foods that are best for someone with diabetes are excellent choices for everyone: foods that are low in fat, salt, and sugar, and high in fiber, such as beans, fruits, vegetables, and whole grains. These foods help you reach and stay at a weight that's good for your body, keep your blood pressure, glucose and cholesterol in a desirable range, and prevent or delay heart and blood vessel disease. For more on healthy eating, see Small Steps for Eating Healthy Foods. Be Active Try to exercise almost every day for a total of about 30 to 60 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 don\u2019t need to get your exercise in all at one time.) For more information on exercise and older adults, see Exercise: How to Get Started or visit Go4Life\u00ae, the exercise and physical activity campaign for older adults from the National Institute on Aging. Be sure to check with your doctor before starting an exercise program. Other Areas To Manage Here are other areas to manage if you have diabetes. - Take care of your eyes. - Protect your kidneys. - Protect your skin. - Learn how to cope with stress. Take care of your eyes. Protect your kidneys. Protect your skin. Learn how to cope with stress. Take Care of Your Eyes High blood glucose and high blood pressure from diabetes can hurt your eyes. It can even cause blindness, or other painful eye problems. Here are ways to prevent diabetes eye problems. - Keep your blood glucose and blood pressure as close to normal as you can. - Have an eye care professional examine your eyes once a year. Have this exam even if your vision is okay. Keep your blood glucose and blood pressure as close to normal as you can. Have an eye care professional examine your eyes once a year. Have this exam even if your vision is okay. Learn more about eye disease and diabetes. Protect Your Kidneys High blood glucose and high blood pressure may damage the kidneys. Damaged kidneys do not do a good job of filtering out wastes and extra fluid. Here are ways to prevent diabetes kidney problems. - Keep your blood glucose and blood pressure as close to your target goal as you can. - Get tested at least once a year for kidney disease. Ask your doctor if you should be tested. - Follow the healthy eating plan you work out with your doctor or dietitian. If you already have kidney problems, your dietitian may suggest you cut back on protein. Keep your blood glucose and blood pressure as close to your target goal as you can. Get tested at least once a year for kidney disease. Ask your doctor if you should be tested. Follow the healthy eating plan you work out with your doctor or dietitian. If you already have kidney problems, your dietitian may suggest you cut back on protein. Learn more about keeping your kidneys healthy. Protect Your Skin Skin care is very important, too. Because people with diabetes may have more injuries and infections, they should protect their skin by keeping it clean and taking care of minor cuts and bruises. Learn How To Cope With Stress Stress can raise your blood glucose (blood sugar). While it is hard to remove stress from your life, you can learn to handle it. Try deep breathing, gardening, taking a walk, meditating, working on your hobby, or listening to your favorite music."},{"_answerid":"Q125-S1-A4","_pairid":"318","__text":"People with type 1 diabetes control their blood sugar with insulin -- either with shots or an insulin pen. Many people with type 2 diabetes can control blood glucose levels with diet and exercise alone. Others require oral medications or insulin, and some people may need to take both, along with lifestyle modification. (Watch the video to learn how one woman manages her type 2 diabetes. 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.) To manage your diabetes, here are things to do every day. - Take your medicines for diabetes and for any other health problems, even when you feel good. Take your medicines for diabetes and for any other health problems, even when you feel good. - Keep track of your blood glucose (blood sugar). You may want to check it one or more times a day. Be sure to talk about it with your health care team. Keep track of your blood glucose (blood sugar). You may want to check it one or more times a day. Be sure to talk about it with your health care team. - Check your blood pressure if your doctor advises and keep a record of it. Check your blood pressure if your doctor advises and keep a record of it. - Check your feet every day for cuts, blisters, red spots and swelling. Call your health care team right away about any sores that do not go away. Check your feet every day for cuts, blisters, red spots and swelling. Call your health care team right away about any sores that do not go away. - Brush your teeth and floss every day to keep your mouth, teeth and gums healthy. Brush your teeth and floss every day to keep your mouth, teeth and gums healthy. - Stop smoking. Ask for help to quit. Call 1-800 QUIT NOW ( 1-800-784-8669) Stop smoking. Ask for help to quit. Call 1-800 QUIT NOW ( 1-800-784-8669) - Eat well. Ask your doctor to give you the name of someone trained to help you create a healthy eating plan, such as a dietitian. See small steps for eating healthy foods. Eat well. Ask your doctor to give you the name of someone trained to help you create a healthy eating plan, such as a dietitian. See small steps for eating healthy foods. - Be active. Try to exercise almost every day for a total of about 30 minutes. If you haven't exercised lately, begin slowly. To learn more, see Exercise: How To Get Started, or visit Go4Life\u00ae, the exercise and physical activity campaign for older adults from the National Institute on Aging. Be active. Try to exercise almost every day for a total of about 30 minutes. If you haven't exercised lately, begin slowly. To learn more, see Exercise: How To Get Started, or visit Go4Life\u00ae, the exercise and physical activity campaign for older adults from the National Institute on Aging."},{"_answerid":"Q125-S1-A5","_pairid":"319","__text":"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.)"}],"SUB_QUESTION_ID":"Q125-S1","ANNOTATIONS.FOCUS":["diabetes"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"Good day doctor.... My name is [NAME] from Nigeria in West Africa. Please I'll appreciate so much if you will reach me urgently with any advice that can be valuable to a total cure of the diabetes that I came down with since the year 2008... at \"[CONTACT]\" . I'll be eagerly waiting for your response soonest, please.... Thanks for your anticipated corporation. [NAME]","QUESTION_ID":"Q125","F_REF":"1-137108915"} -{"ANSWERS":[{"_answerid":"Q126-S1-A1","_pairid":"321","__text":"Neuropathy is very common. There are many types and causes. Often, no cause can be found. Some nerve diseases run in families. Diabetes is the most common cause of this type of nerve problem. High blood sugar levels over a long time can damage your nerves. Other health conditions that may cause neuropathy are: - Autoimmune disorders, such as rheumatoid arthritis or lupus - Chronic kidney disease - HIV - Liver infections - Low levels of vitamin B12 or other vitamins - Metabolic disease - Poisoning due to heavy metals, such as lead - Poor blood flow to the legs - Underactive thyroid gland Other things that can lead to nerve damage are: - Broken bone that affects a nerve - Long-term, heavy alcohol use - Glue, lead, mercury, and solvent poisoning - Drugs that treat infections, cancer, seizures, and high blood pressure - Pressure on a nerve, such as from carpal tunnel syndrome - Being exposed to cold temperatures for a long period of time - Pressure from bad-fitting casts, splints, a brace, or crutches"}],"SUB_QUESTION_ID":"Q126-S1","ANNOTATIONS.FOCUS":["peripheral neuropathy"],"ANNOTATIONS.TYPE":"cause","SUBJECT":"Causes of Peripheral Neuropathy","MESSAGE":"What information does the National Library of Medicine have that states causes of peripheral neuropathy?","QUESTION_ID":"Q126","F_REF":"1-133002297"} -{"ANSWERS":[{"_answerid":"Q127-S1-A1","_pairid":"323","__text":"Before taking any supplement, talk to a doctor or dietitian. If you take supplements, don't exceed the recommended doses. Some supplements in high amounts can be dangerous, particularly fat-soluble vitamins, such as A, D, E, and K. Here are some special concerns: Vitamin E supplements do not have benefits, though it used to be believed that Vitamin E prevented heart disease. High doses (greater than 400 IU\/day) can have be dangerous."}],"SUB_QUESTION_ID":"Q127-S1","ANNOTATIONS.FOCUS":["hepatitis c","vitamin E"],"ANNOTATIONS.TYPE":"association","SUBJECT":"hepatitis C","MESSAGE":"My doctor advised me to take vitamin E and biletan forte since my protombin time is 70, he told me it's too low. I've been reading about the effects of Vitamin E and one possibility is bleeding. What would you suggest me to do?","QUESTION_ID":"Q127","F_REF":"12574"} -{"ANSWERS":[{"_answerid":"Q128-S1-A1","_pairid":"324","__text":"Summary If you have lupus, your immune system attacks healthy cells and tissues by mistake. This can damage your joints, skin, blood vessels and organs. There are many kinds of lupus. The most common type, systemic lupus erythematosus, affects many parts of the body. Discoid lupus causes a rash that doesn't go away. Subacute cutaneous lupus causes sores after being out in the sun. Another type can be caused by medication. Neonatal lupus, which is rare, affects newborns. Anyone can get lupus, but women are most at risk. Lupus is also more common in African American, Hispanic, Asian and Native American women. The cause of lupus is not known. Lupus has many symptoms. Some common ones are - Joint pain or swelling - Muscle pain - Fever with no known cause - Fatigue - Red rashes, often on the face (also called the \"butterfly rash\") There is no one test to diagnose lupus, and it may take months or years to make the diagnosis. There is no cure for lupus, but medicines and lifestyle changes can help control it. NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases"},{"_answerid":"Q128-S1-A2","_pairid":"326","__text":"Summary If you have lupus, your immune system attacks healthy cells and tissues by mistake. This can damage your joints, skin, blood vessels and organs. There are many kinds of lupus. The most common type, systemic lupus erythematosus, affects many parts of the body. Discoid lupus causes a rash that doesn't go away. Subacute cutaneous lupus causes sores after being out in the sun. Another type can be caused by medication. Neonatal lupus, which is rare, affects newborns. Anyone can get lupus, but women are most at risk. Lupus is also more common in African American, Hispanic, Asian and Native American women. The cause of lupus is not known. Lupus has many symptoms. Some common ones are - Joint pain or swelling - Muscle pain - Fever with no known cause - Fatigue - Red rashes, often on the face (also called the \"butterfly rash\") There is no one test to diagnose lupus, and it may take months or years to make the diagnosis. There is no cure for lupus, but medicines and lifestyle changes can help control it. NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases"}],"SUB_QUESTION_ID":"Q128-S1","ANNOTATIONS.FOCUS":["lupus"],"ANNOTATIONS.TYPE":"information","SUBJECT":"lupus an info on the diseise","MESSAGE":"Need all up date on lupus an send by mail informations on this subject..please i need more information to see if what i am exprienceing is in fact related to lupus ...thank you.","QUESTION_ID":"Q128","F_REF":"1-122785307"} -{"ANSWERS":[{"_answerid":"Q129-S1-A1","_pairid":"328","__text":"Treatment depends on the type of stone and the severity of your symptoms. Kidney stones that are small most often pass through your system on their own. - Your urine should be strained so the stone can be saved and tested. - Drink at least 6 to 8 glasses of water per day to produce a large amount of urine. This will help the stone pass. - Pain can be very bad. Over-the-counter pain medicines (for example, ibuprofen and naproxen), either alone or along with narcotics, can be very effective. Some people with severe pain from kidney stones need to stay in the hospital. You may need to get fluids through a vein. For some types of stones, your provider may prescribe medicine to prevent stones from forming or help break down and remove the material that is causing the stone. These medicines can include: - Allopurinol (for uric acid stones) - Antibiotics (for struvite stones) - Diuretics - Phosphate solutions - Sodium bicarbonate or sodium citrate - Water pills (thiazide diuretics) - Tamsulosin to relax the ureter and help the stone pass Surgery is often needed if: - The stone is too large to pass on its own - The stone is growing - The stone is blocking urine flow and causing an infection or kidney damage - The pain cannot be controlled Today, most treatments are much less invasive than in the past. - Lithotripsy is used to remove stones slightly smaller than a half an inch that are located in the kidney or ureter. It uses sound or shock waves to break up stones. Then, the stone fragments leave the body in the urine. It is also called extracorporeal shock-wave lithotripsy or ESWL. - Procedures performed by passing a special instrument through a small surgical cut in your skin and into your kidney or ureters are used for large stones, or when the kidneys or surrounding areas are incorrectly formed. The stone is removed with a tube (endoscope). - Ureteroscopy may be used for stones in the lower urinary tract. - Rarely, open surgery (nephrolithotomy) may be needed if other methods do not work or are not possible. Talk to your provider about what treatment options may work for you."}],"SUB_QUESTION_ID":"Q129-S1","ANNOTATIONS.FOCUS":["kidney stone"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"Kidney Stone","MESSAGE":"Hello Dr.,In a case of patient with Kidney Stone size of 1.2mm x 2.3mm. What can i do? Pls i need your advice.","QUESTION_ID":"Q129","F_REF":"1-118342705"} -{"ANSWERS":[{"_answerid":"Q130-S1-A1","_pairid":"329","__text":"The risk of sepsis can be reduced by getting all recommended vaccines. In the hospital, careful hand washing can help prevent infections that lead to sepsis. Prompt removal of urinary catheters and IV lines when they are no longer needed can also help prevent infections that lead to sepsis."}],"SUB_QUESTION_ID":"Q130-S1","ANNOTATIONS.FOCUS":["sepsis"],"ANNOTATIONS.TYPE":"prevention","SUBJECT":"","MESSAGE":"sepsis. Can sepsis be prevented. Can someone get this from a hospital?","QUESTION_ID":"Q130","F_REF":"5507"} -{"ANSWERS":[{"_answerid":"Q131-S1-A1","_pairid":"330","__text":"LIFESTYLE CHANGES The condition that causes ascites will be treated, if possible. Treatments for fluid build-up may include lifestyle changes: - Avoiding alcohol - Lowering salt in your diet (no more than 1,500 mg\/day of sodium) - Limiting fluid intake You may also get medicines from your doctor, including: - \"Water pills\" (diuretics) to get rid of extra fluid - Antibiotics for infections Other things you can do to help take care of your liver disease are: - Get vaccinated for diseases such as influenza, hepatitis A and hepatitis B, and pneumococcal pneumonia - Talk to your doctor about all medicines you take, including herbs and supplements and over-the-counter medicines Procedures that you may have are: - Inserting a needle into the belly to remove large volumes of fluid (called a paracentesis) - Placing a special tube or shunt inside your liver (TIPS) to repair blood flow to the liver People with end-stage liver disease may need a liver transplant."}],"SUB_QUESTION_ID":"Q131-S1","ANNOTATIONS.FOCUS":["ascites"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"Please help me","MESSAGE":"I have been dealing with undiagnosed issues. It started 3 years ago as nausea and dull achy pain. Doctors decided to remove my gallbladder, even though it only had scarring. Since the surgery ([DATE]) I have had a sharp, stabbing random pain in that area and around it. I also get dull, crampy pain. Finally, the surgeon ordered a CT scan because the pain is so bad. His nurse called and said everything was fine. So I went to my primary, who noticed that I have ascites on my liver. My side is slightly bloated, was not before. And I am scared because I don't know what I'm supposed to do. No one will help me and I do not want to be on pain meds my whole life. Please let me know your thoughts or guide me in the direction I need, please. I live in south carolina, i dont know why when I made my email it had the co.uk","QUESTION_ID":"Q131","F_REF":"12281"} -{"ANSWERS":[{"_answerid":"Q132-S1-A1","_pairid":"331","__text":"Letrozole is used treat early breast cancer in women who have experienced menopause (change of life; end of monthly menstrual periods) and who have had other treatments, such as radiation or surgery to remove the tumor. It is also used to treat early breast cancer in women who have experienced menopause and who have already been treated with a medication called tamoxifen (Nolvadex) for 5 years. Letrozole is also used in women who have experienced menopause as a first treatment of breast cancer that has spread within the breast or to other areas of the body or in women whose breast cancer has worsened while they were taking tamoxifen. Letrozole is in a class of medications called nonsteroidal aromatase inhibitors. It works by decreasing the amount of estrogen produced by the body. This can slow or stop the growth of some types of breast cancer cells that need estrogen to grow."}],"SUB_QUESTION_ID":"Q132-S1","ANNOTATIONS.FOCUS":["Letrozole"],"ANNOTATIONS.TYPE":"indication","SUBJECT":"Letrozole","MESSAGE":"Since taking Letrozole the last 4.6 months, I now have a 4 cm. csyst in front of my right ovary that must be removed. Why am I prescribed a drug that is also prescribed for young women trying to conceive. I am post menopausal and had early stage breast cancer in 2010. Now, that I am ending my 5 year run with this drug, I have adverse affects with a cysts. Is a cysts an egg that was not fertilized from the Follupian Tubes. I cannot understand this logic of giving me this drug?","QUESTION_ID":"Q132","F_REF":"1-135048025"} -{"ANSWERS":[{"_answerid":"Q133-S1-A1","_pairid":"332","__text":"Ochoa syndrome is a disorder characterized by urinary problems and unusual facial expressions. The urinary problems associated with Ochoa syndrome typically become apparent in early childhood or adolescence. People with this disorder may have difficulty controlling the flow of urine (incontinence), which can lead to bedwetting. Individuals with Ochoa syndrome may be unable to completely empty the bladder, often resulting in vesicoureteral reflux, a condition in which urine backs up into the ducts that normally carry it from each kidney to the bladder (the ureters). Urine may also accumulate in the kidneys (hydronephrosis). Vesicoureteral reflux and hydronephrosis can lead to frequent infections of the urinary tract and kidney inflammation (pyelonephritis), causing damage that may eventually result in kidney failure. Individuals with Ochoa syndrome also exhibit a characteristic frown-like facial grimace when they try to smile or laugh, often described as inversion of facial expression. While this feature may appear earlier than the urinary tract symptoms, perhaps as early as an infant begins to smile, it is often not brought to medical attention. Approximately two-thirds of individuals with Ochoa syndrome also experience problems with bowel function, such as constipation, loss of bowel control, or muscle spasms of the anus."}],"SUB_QUESTION_ID":"Q133-S1","ANNOTATIONS.FOCUS":["ochoa syndrome"],"ANNOTATIONS.TYPE":"information","SUBJECT":"Ochoa syndrome","MESSAGE":"Where could I find more information about the rare disease, Ochoa syndrome. I think a sibling of mine might have it.","QUESTION_ID":"Q133","F_REF":"1-135386347"} -{"ANSWERS":[{"_answerid":"Q134-S1-A1","_pairid":"333","__text":"Jock itch usually responds to self-care within a couple of weeks: - Keep the skin clean and dry in the groin area. - Do not wear clothing that rubs and irritates the area. Wear loose-fitting underwear. - Wash athletic supporters frequently. - Over-the-counter antifungal or drying powders can help control the infection. These contain medicine, such as miconazole, clotrimazole, terbinafine, or tolnaftate. You may need treatment by a provider if your infection lasts longer than 2 weeks, is severe, or frequently returns.\u00a0The provider may prescribe: - Stronger topical (applied to the skin) antifungal medicines or oral antifungal\u00a0medicines - Antibiotics may be needed to treat bacterial infections that occur from scratching the area If you tend to get jock itch, continue to apply antifungal or drying powders after bathing, even when you do not have jock itch."}],"SUB_QUESTION_ID":"Q134-S1","ANNOTATIONS.FOCUS":["jock itch"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"ClinicalTrials.gov - Question - specific study","MESSAGE":"My name is [NAME] and I am 76 years old. I have had jock itch (just itch no rash) for 7 years. When I try to stop the itch comes back with a vengeance. I am currently using Ketoconazole 2% cream to control the itch. It appears that I am doomed to no cure but I hope I may be wrong.","QUESTION_ID":"Q134","F_REF":"1-133036745"} -{"ANSWERS":[{"_answerid":"Q135-S1-A1","_pairid":"334","__text":"The results show a lower than expected prevalence of PTSD among IBS patients, which is similar to that of the general population. Thus, we did not find that PTSD is over-represented in a sample population of IBS patients."}],"SUB_QUESTION_ID":"Q135-S1","ANNOTATIONS.FOCUS":["ibs","PTSD"],"ANNOTATIONS.TYPE":"association","SUBJECT":"PTSD and IBS","MESSAGE":"I am looking for research on IBS and the link to PTSD. Thank you","QUESTION_ID":"Q135","F_REF":"16563"} -{"ANSWERS":[{"_answerid":"Q136-S1-A1","_pairid":"338","__text":"A health care provider may use several tests and exams to diagnose Whipple disease, including the following: medical and family history physical exam blood tests upper GI endoscopy and enteroscopy A patient may be referred to a gastroenterologist\u2014a doctor who specializes in digestive diseases. A health care provider may first try to rule out more common conditions with similar symptoms, including inflammatory rheumatic disease\u2014characterized by inflammation and loss of function in one or more connecting or supporting structures of the body. celiac disease\u2014a digestive disease that damages the small intestine and interferes with the absorption of nutrients from food. People who have celiac disease cannot tolerate gluten, a protein in wheat, rye, and barley. neurologic diseases\u2014disorders of the central nervous system. intra-abdominal lymphoma\u2014abdominal cancer in part of the immune system called the lymphatic system. Mycobacterium avium complex\u2014an infection that affects people with AIDS."}],"SUB_QUESTION_ID":"Q136-S1","ANNOTATIONS.FOCUS":["whipple's disease"],"ANNOTATIONS.TYPE":"diagnosis","SUBJECT":"Whipple's Disease","MESSAGE":"Your information about Whipple's Disease says that it is fatal if left untreated, but there is no information about HOW LONG a person can have it. I have been sick for 6 years and am having no luck getting a diagnosis, and it would be most helpful in ruling things out if I knew whether or not a particular illness would kill a person within a shorter time period than 6 years. Thank you.","QUESTION_ID":"Q136","F_REF":"NF_208"} -{"ANSWERS":[{"_answerid":"Q136-S2-A1","_pairid":"339","__text":"Without treatment, the condition is most often fatal. Treatment relieves symptoms and can cure the disease."}],"SUB_QUESTION_ID":"Q136-S2","ANNOTATIONS.FOCUS":["whipple's disease"],"ANNOTATIONS.TYPE":"prognosis","SUBJECT":"Whipple's Disease","MESSAGE":"Your information about Whipple's Disease says that it is fatal if left untreated, but there is no information about HOW LONG a person can have it. I have been sick for 6 years and am having no luck getting a diagnosis, and it would be most helpful in ruling things out if I knew whether or not a particular illness would kill a person within a shorter time period than 6 years. Thank you.","QUESTION_ID":"Q136","F_REF":"NF_208"} -{"ANSWERS":[{"_answerid":"Q137-S1-A1","_pairid":"341","__text":"Damage from optic nerve atrophy cannot be reversed. The underlying disease must be found and treated. Otherwise, vision loss will continue. Rarely, conditions that lead to optic atrophy may be treatable."}],"SUB_QUESTION_ID":"Q137-S1","ANNOTATIONS.FOCUS":["optic nerve atrophy"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"Treatment for optic nerve atrophy. Hello Name's case :[NAME] Sex : Male Date of Birth : 1964 Nationality : Libyan Diagnosis : optic nerve atrophy . i am suffering from optic atrophy, which led to loss of vision and inability to see, I suffer from this case from 1998 saluting suffered a fall on the head, which led to began this case even lost look, and have been performed process surgery in [LOCATION] in 1998-1999 . And then in 2009 cured by reactive optic nerve by Russian Professor . i want know you hospital have treatment for optic nerve atrophy , and what this treatment i need more information about treatment of optic nerve because now 16 years old I can not vision, and I wish could belive hope for treatment of my case. And i want know the cost of treatment . Thank you Regards \/ [NAME]","QUESTION_ID":"Q137","F_REF":"10847"} -{"ANSWERS":[{"_answerid":"Q137-S2-A1","_pairid":"342","__text":"Vision lost to optic nerve atrophy cannot be recovered. It is very important to protect the other eye."}],"SUB_QUESTION_ID":"Q137-S2","ANNOTATIONS.FOCUS":["optic nerve atrophy"],"ANNOTATIONS.TYPE":"prognosis","SUBJECT":"","MESSAGE":"Treatment for optic nerve atrophy. Hello Name's case :[NAME] Sex : Male Date of Birth : 1964 Nationality : Libyan Diagnosis : optic nerve atrophy . i am suffering from optic atrophy, which led to loss of vision and inability to see, I suffer from this case from 1998 saluting suffered a fall on the head, which led to began this case even lost look, and have been performed process surgery in [LOCATION] in 1998-1999 . And then in 2009 cured by reactive optic nerve by Russian Professor . i want know you hospital have treatment for optic nerve atrophy , and what this treatment i need more information about treatment of optic nerve because now 16 years old I can not vision, and I wish could belive hope for treatment of my case. And i want know the cost of treatment . Thank you Regards \/ [NAME]","QUESTION_ID":"Q137","F_REF":"10847"} -{"ANSWERS":[{"_answerid":"Q138-S1-A1","_pairid":"343","__text":"Signs of mild to moderate dehydration: - Thirst - Dry or sticky mouth - Not urinating much - Darker yellow urine - Dry, cool skin - Headache - Muscle cramps Signs of severe dehydration: - Not urinating, or very dark yellow or amber-colored urine - Dry, shriveled skin - Irritability or confusion - Dizziness or light-headedness - Rapid heartbeat - Rapid breathing - Sunken eyes - Listlessness - Shock (not enough blood flow through the body) - Unconsciousness or delirium"}],"SUB_QUESTION_ID":"Q138-S1","ANNOTATIONS.FOCUS":["dehydration"],"ANNOTATIONS.TYPE":"symptom","SUBJECT":"symptoms of dehydration","MESSAGE":"When a person is very dehydrated do they sometimes get a tight pain in their chest (right below the breasts) right before they faint\/pass out?","QUESTION_ID":"Q138","F_REF":"1-122992425"} -{"ANSWERS":[{"_answerid":"Q139-S1-A1","_pairid":"344","__text":"An insulinoma is a tumor in the pancreas that produces too much insulin."}],"SUB_QUESTION_ID":"Q139-S1","ANNOTATIONS.FOCUS":["insulinoma"],"ANNOTATIONS.TYPE":"information","SUBJECT":"","MESSAGE":"Name: [NAME] Date and Time of Contact: Thu, 1 Jan 2015 16:10:06 GMT Application: myncbi SessionId: CE9069DE4A56A0A1_0093SID MyNCBI UserName: Host: portal205 Snapshot: \/projects\/MyNCBI\/myncbiPortal@2.45 Browser's user agent header: Mozilla\/4.0 (compatible; MSIE 8.0; Windows NT 6.1; WOW64; Trident\/4.0; SLCC2; .NET CLR 2.0.50727; .NET CLR 3.5.30729; .NET CLR 3.0.30729; Media Center PC 6.0; InfoPath.2) Application Page Generation Time: 2015-01-01T11:03:27-05:00 Page: recentactivity Message Body: We live in [LOCATION] and my husband has been detected an insulinoma.Need further information on the matter as doctors have not seen one here. Greatly appreciate your reply. Happy New Year to you all and many many tahanks for your help.","QUESTION_ID":"Q139","F_REF":"1-130899901"} -{"ANSWERS":[{"_answerid":"Q140-S1-A1","_pairid":"345","__text":"Because chickenpox is airborne and spreads very easily even before the rash appears, it is hard to avoid. A vaccine to prevent chickenpox is part of a child's routine vaccine schedule. The vaccine often prevents the chickenpox disease completely or makes the illness very mild. Talk to your provider if you think your child might be at high risk for complications and might have been exposed. Taking preventive steps right away may be important. Giving the vaccine early after exposure may still reduce the severity of the disease."}],"SUB_QUESTION_ID":"Q140-S1","ANNOTATIONS.FOCUS":["chickenpox"],"ANNOTATIONS.TYPE":"prevention","SUBJECT":"chickenpox","MESSAGE":"I do not know if I had chickenpox. Is there a blood test available to tell me ? And if not which vaccine should I get, if any ?","QUESTION_ID":"Q140","F_REF":"NF_73"} -{"ANSWERS":[{"_answerid":"Q141-S1-A1","_pairid":"346","__text":"Keloids often do not need treatment. If the keloid bothers you, these things can be done to reduce the size: - Corticosteroid injections - Freezing (cryotherapy) - Laser treatments - Radiation - Surgical removal - Silicone gel or patches Sometimes these treatments cause the keloid scar to become larger."}],"SUB_QUESTION_ID":"Q141-S1","ANNOTATIONS.FOCUS":["keloids"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"Does either of these help with skin keloids? What would help keloids?","QUESTION_ID":"Q141","F_REF":"12317"} -{"ANSWERS":[{"_answerid":"Q142-S1-A1","_pairid":"347","__text":"RA most often requires lifelong treatment, including medicines, physical therapy, exercise, education, and possibly surgery. Early, aggressive treatment for RA can with newer drug categories can be very helpful slowing joint destruction and preventing deformities. MEDICINES Disease modifying antirheumatic drugs (DMARDs): These are often the drugs that are tried first in people with RA. They are prescribed along with rest, strengthening exercise, and anti-inflammatory drugs. - Methotrexate (Rheumatrex) is the most commonly used DMARD for rheumatoid arthritis. Leflunomide (Arava) and hydroxychloroquine may also be used. - Sulfasalazine is an anti-inflammatory drug that is often combined with methotrexate and hydroxychloroquine (triple therapy). - These drugs may have serious side effects, so you will need frequent blood tests when taking them. Anti-inflammatory medications: These include aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen. - Although NSAIDs work well, long-term use can cause stomach problems, including ulcers and bleeding, and possible heart problems. - Celecoxib (Celebrex) is another anti-inflammatory drug. Drugs in this class (COX-2 inhibitors) may increase heart attack and stroke risk for some people. Talk to your doctor about whether these medicines are right for you. Antimalarial medications: This group of medicines includes hydroxychloroquine (Plaquenil). They are most often used along with methotrexate. It may be weeks or months before you see any benefit from these drugs. Corticosteroids: These medicines work very well to reduce joint swelling and inflammation, but they can have long-term side effects. Therefore, they should be taken only for a short time and in low doses when possible. Biologic agents: These drugs are designed to affect parts of the immune system that play a role in the disease process of rheumatoid arthritis. They may be given when other medicines for rheumatoid arthritis have not worked. Sometimes biologic drugs are started sooner, along with other rheumatoid arthritis drugs. Most of them are given either under the skin (subcutaneously) or into a vein (intravenously). There are different types of biologic agents: - White blood cell modulators include: abatacept (Orencia) and rituximab (Rituxan) - Tumor necrosis factor (TNF) inhibitors include: adalimumab (Humira), etanercept (Enbrel), infliximab (Remicade), golimumab (Simponi), and certolizumab (Cimzia) - Interleukin-6 (IL-6) inhibitors: tocilizumab (Actemra) Biologic agents can be very helpful in treating rheumatoid arthritis. However, people taking these drugs must be watched very closely because of serious risk factors: - Infections from bacteria, viruses, and fungi - Leukemia or lymphoma - Psoriasis - Allergic reactions Other drugs: - Janus kinase inhibitor: Tofacitinib (Xeljanz). This is a medicine taken by mouth that is now approved for treating RA. SURGERY Surgery may be needed to correct severely damaged joints. Surgery may include: - Removal of the joint lining (synovectomy) - Total joint replacement in extreme cases; may include total knee, hip replacement, ankle replacement, shoulder replacement, and others PHYSICAL THERAPY Range-of-motion exercises and exercise programs prescribed by a physical therapist can delay the loss of joint function and help keep muscles strong. Sometimes, therapists will use special machines to apply deep heat or electrical stimulation to reduce pain and improve joint movement. Other therapies that may help ease joint pain include: - Joint protection techniques - Heat and cold treatments - Splints or orthotic devices to support and align joints - Frequent rest periods between activities, as well as 8 to 10 hours of sleep per night NUTRITION Some people with RA may have intolerance or allergies to certain foods. A balanced nutritious diet is recommended. It may be helpful to eat foods rich in fish oils (omega-3 fatty acids). Smoking cigarettes should be stopped. Excessive alcohol should also be avoided."},{"_answerid":"Q142-S1-A2","_pairid":"348","__text":"These resources address the diagnosis or management of rheumatoid arthritis: - American College of Rheumatology: ACR-Endorsed Criteria for Rheumatic Diseases - American College of Rheumatology: Treatment for Rheumatic Diseases - Genetic Testing Registry: Rheumatoid arthritis These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"},{"_answerid":"Q142-S1-A3","_pairid":"349","__text":"Most Symptoms Are Treatable Doctors use a variety of approaches to treat rheumatoid arthritis. The goals of treatment are to help relieve pain, reduce swelling, slow down or help prevent joint damage, increase the ability to function, and improve the sense of well-being. Current treatment approaches include - lifestyle modification - medications - surgery - routine monitoring and ongoing care. lifestyle modification medications surgery routine monitoring and ongoing care. Balance Rest and Exercise People with rheumatoid arthritis need a good balance between rest and exercise; they should rest more when the disease is active and exercise more when it is not. Rest helps to reduce active joint inflammation and pain and to fight fatigue. The length of time for rest will vary from person to person, but in general, shorter rest breaks every now and then are more helpful than long times spent in bed. Exercise is important for maintaining healthy and strong muscles, preserving joint mobility, and maintaining flexibility. Exercise can also help people sleep well, reduce pain, maintain a positive attitude, and manage weight. Exercise programs should take into account the person\u2019s physical abilities, limitations, and changing needs. Learn more about the health benefits of exercise for older adults. More information about exercise and physical activity for older adults can be found at Go4Life\u00ae, the exercise and physical activity campaign from the National Institute on Aging. Reduce Stress People with rheumatoid arthritis face emotional challenges as well as physical ones. The emotions they feel because of the disease\u2014fear, anger, and frustration\u2014combined with any pain and physical limitations can increase their stress level. Finding ways to reduce stress is important. Regular rest periods can help and so can relaxation, distraction, or visualization exercises. Exercise programs, participation in support groups, and good communication with the health care team are other ways to reduce stress. For more information on exercise classes, you may want to contact the Arthritis Foundation at 1-800-283-7800. Learn about relaxation techniques that may relieve tension. Eat a Healthful Diet Special diets, vitamin supplements, and other alternative approaches have been suggested for treating rheumatoid arthritis. Although such approaches may not be harmful, scientific studies have not yet shown any benefits. Special diets, vitamin supplements, and other alternative approaches have been suggested for treating rheumatoid arthritis. Although such approaches may not be harmful, scientific studies have not yet shown any benefits. See Eating Well as You Get Older for more about healthy eating. Reduce Stress on Joints Some people find using a splint for a short time around a painful joint reduces pain and swelling by supporting the joint and letting it rest. Splints are used mostly on wrists and hands, but also on ankles and feet. A doctor or a physical or occupational therapist can help a person choose a splint and make sure it fits properly. Other ways to reduce stress on joints include - self-help devices (for example, zipper pullers, long-handled shoe horns) - devices to help with getting on and off chairs, toilet seats, and beds - changes in the ways that a person carries out daily activities. self-help devices (for example, zipper pullers, long-handled shoe horns) devices to help with getting on and off chairs, toilet seats, and beds changes in the ways that a person carries out daily activities. Medications Most people who have rheumatoid arthritis take medications. Some drugs only provide relief for pain; others reduce inflammation. Still others, called disease-modifying anti-rheumatic drugs or DMARDs, can often slow the course of the disease. - DMARDs include methotrexate, leflunomide, sulfasalazine, and cyclosporine. DMARDs include methotrexate, leflunomide, sulfasalazine, and cyclosporine. - Steroids, which are also called corticosteroids, are another type of drug used to reduce inflammation for people with rheumatoid arthritis. Cortisone, hydrocortisone, and prednisone are some commonly used steroids. Steroids, which are also called corticosteroids, are another type of drug used to reduce inflammation for people with rheumatoid arthritis. Cortisone, hydrocortisone, and prednisone are some commonly used steroids. - DMARDS called biologic response modifiers also can help reduce joint damage. These drugs include etanercept, infliximab, anakinra, golimumab, adalimumab, rituximab, and abatacept. DMARDS called biologic response modifiers also can help reduce joint damage. These drugs include etanercept, infliximab, anakinra, golimumab, adalimumab, rituximab, and abatacept. - Another DMARD, tofacitinib, from a new class of drugs called jak kinase (JAK) inhibitors is also available. Another DMARD, tofacitinib, from a new class of drugs called jak kinase (JAK) inhibitors is also available. Early treatment with powerful drugs and drug combinations -- including biologic response modifiers and DMARDs -- instead of single drugs may help prevent the disease from progressing and greatly reduce joint damage. Surgery In some cases, a doctor will recommend surgery to restore function or relieve pain in a damaged joint. Surgery may also improve a person's ability to perform daily activities. Joint replacement and tendon reconstruction are two types of surgery available to patients with severe joint damage. Routine Monitoring and Ongoing Care Regular medical care is important to monitor the course of the disease, determine the effectiveness and any negative effects of medications, and change therapies as needed. Monitoring typically includes regular visits to the doctor. It also may include blood, urine, and other laboratory tests and x rays. Monitor Osteoporosis Risk People with rheumatoid arthritis may want to discuss preventing osteoporosis with their doctors as part of their long-term, ongoing care. Osteoporosis is a condition in which bones become weakened and fragile. Having rheumatoid arthritis increases the risk of developing osteoporosis for both men and women, particularly if a person takes corticosteroids. Such patients may want to discuss with their doctors the potential benefits of calcium and vitamin D supplements or other treatments for osteoporosis. See What is Osteoporosis? to learn more about this disease."},{"_answerid":"Q142-S1-A4","_pairid":"350","__text":"Medication, exercise, and, in some cases, surgery are common treatments for this disease. Most people who have rheumatoid arthritis take medications. Some drugs only provide relief for pain; others reduce inflammation. People with rheumatoid arthritis can also benefit from exercise, but they need to maintain a good balance between rest and exercise. They should get rest when the disease is active and get more exercise when it is not. In some cases, a doctor will recommend surgery to restore function or relieve pain in a damaged joint. Several types of surgery are available to patients with severe joint damage. Joint replacement and tendon reconstruction are examples."},{"_answerid":"Q142-S1-A5","_pairid":"351","__text":"Most people who have rheumatoid arthritis take medications. Some drugs only provide relief for pain; others reduce inflammation. Still others, called disease-modifying anti-rheumatic drugs or DMARDs, can often slow the course of the disease. - DMARDs include methotrexate, leflunomide, sulfasalazine, and cyclosporine. - Steroids, which are also called corticosteroids, are another type of drug used to reduce inflammation for people with rheumatoid arthritis. Cortisone, hydrocortisone, and prednisone are some commonly used steroids. - DMARDs called biological response modifiers also can help reduce joint damage. These drugs include etanercept, infliximab, and anakinra. - Another DMARD, tofacitinib, from a new class of drugs called jak kinase (JAK) inhibitors is also available. DMARDs include methotrexate, leflunomide, sulfasalazine, and cyclosporine. Steroids, which are also called corticosteroids, are another type of drug used to reduce inflammation for people with rheumatoid arthritis. Cortisone, hydrocortisone, and prednisone are some commonly used steroids. DMARDs called biological response modifiers also can help reduce joint damage. These drugs include etanercept, infliximab, and anakinra. Another DMARD, tofacitinib, from a new class of drugs called jak kinase (JAK) inhibitors is also available. Early treatment with powerful drugs and drug combinations -- including biological response modifiers and DMARDs -- instead of single drugs may help prevent the disease from progressing and greatly reduce joint damage."}],"SUB_QUESTION_ID":"Q142-S1","ANNOTATIONS.FOCUS":["rheumatoid arthritis"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"Rheumatoid arthritis","MESSAGE":"Dear Sir- my wife is suffering from subject since last couples of years, and recently diagnose that she is effected with subject. therefore i need your kind support for treatment and percussion step. awaiting your kind reply and action. thanks and best Regards","QUESTION_ID":"Q142","F_REF":"1-132341725"} -{"ANSWERS":[{"_answerid":"Q143-S1-A1","_pairid":"352","__text":"Treatment for adenocarcinoma\u00a0depends on the stage of the tumor. Surgery may be done if the tumor has not spread or has spread very little. Along with surgery, chemotherapy or radiation therapy or both may be used before or after surgery. A small number of people can be cured with this treatment approach. When the tumor has not spread out of the pancreas but cannot be surgically removed, chemotherapy and radiation therapy together may be recommended. When the tumor has spread (metastasized) to other organs such as the liver, chemotherapy alone is usually used. With advanced cancer, the goal of treatment is to\u00a0manage pain and other symptoms. For example, if the tube that carries bile is blocked by the pancreatic tumor, a procedure to place a tiny metal tube (stent) may be done to open the blockage. This can help relieve loss of appetite, jaundice, and itching of the skin."}],"SUB_QUESTION_ID":"Q143-S1","ANNOTATIONS.FOCUS":["pancreatic cancer"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"ClinicalTrials.gov - Question - general information","MESSAGE":"Dear Sir. I am [NAME] from India gujarat state. My father is 61 years older suffering with Pancreatic cancer and it's in 3\/4 Rd stage. All doctors are help less for us as they told my father can't leave more then 4 months. . I want to take your suggestions and help for my father's Pancreatic cancer. I want to save my father's life . If any type of treatment is available then please help me. Please contact me on my below mobile no. [CONTACT]","QUESTION_ID":"Q143","F_REF":"17991"} -{"ANSWERS":[{"_answerid":"Q144-S1-A1","_pairid":"354","__text":"Summary Osteoporosis makes your bones weak and more likely to break. Anyone can develop osteoporosis, but it is common in older women. As many as half of all women and a quarter of men older than 50 will break a bone due to osteoporosis. Risk factors include - Getting older - Being small and thin - Having a family history of osteoporosis - Taking certain medicines - Being a white or Asian woman - Having osteopenia, which is low bone density Osteoporosis is a silent disease. You might not know you have it until you break a bone. A bone mineral density test is the best way to check your bone health. To keep bones strong, eat a diet rich in calcium and vitamin D, exercise and do not smoke. If needed, medicines can also help. NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases"},{"_answerid":"Q144-S1-A2","_pairid":"355","__text":"A Bone Disease Osteoporosis is a disease that thins and weakens the bones to the point that they become fragile and break easily. Women and men with osteoporosis most often break bones in the hip, spine, and wrist, but any bone can be affected. You can't \"catch\" osteoporosis or give it to someone else. In the United States, more than 53 million people either already have osteoporosis or are at high risk due to low bone mass, placing them at risk for more serious bone loss and fractures. Although osteoporosis can strike at any age, it is most common among older people, especially older women. How Bone Loss Occurs Bone is living tissue. Throughout our lives, the body breaks down old bone and replaces it with new bone. But as people age, more bone is broken down than is replaced. The inside of a bone normally looks like a honeycomb, but when a person has osteoporosis, the spaces inside this honeycomb become larger, reflecting the loss of bone density and strength. (The word \"osteoporosis\" means \"porous bone.\") The outside of long bones -- called the cortex -- also thins, further weakening the bone. Sometime around the age of 30, bone mass stops increasing, and the goal for bone health is to keep as much bone as possible for as long as you can. In most women, the rate of bone loss increases for several years after menopause, then slows down again, but continues. In men, the bone loss occurs more slowly. But by age 65 or 70, most men and women are losing bone at the same rate. Weak Bones Can Lead to Fractures Osteoporosis is often called \"silent\" because bone loss occurs without symptoms. People may not know that they have osteoporosis until a sudden strain, bump, or fall causes a bone to break. This can result in a trip to the hospital, surgery, and possibly a long-term disabling condition. Broken bones in your spine are painful and very slow to heal. People with weak bones in their spine gradually lose height and their posture becomes hunched over. Over time a bent spine can make it hard to walk or even sit up. Broken hips are a very serious problem as we age. They greatly increase the risk of death, especially during the year after they break. People who break a hip might not recover for months or even years. Because they often cannot care for themselves, they are more likely to have to live in a nursing home. Prevention and Treatment The good news is that osteoporosis can often be prevented and treated. Healthy lifestyle choices such as proper diet, exercise, and treatment medications can help prevent further bone loss and reduce the risk of fractures."},{"_answerid":"Q144-S1-A3","_pairid":"356","__text":"Scientists are pursuing a wide range of basic and clinical studies on osteoporosis. Significant advances in preventing and treating osteoporosis continue to be made. Such advances are the direct result of research focused on - determining the causes and consequences of bone loss at the cellular and tissue levels - assessing risk factors - developing new strategies to maintain and even enhance bone density and reduce fracture risk - exploring the roles of such factors as genetics, hormones, calcium, vitamin D, drugs, and exercise on bone mass. determining the causes and consequences of bone loss at the cellular and tissue levels assessing risk factors developing new strategies to maintain and even enhance bone density and reduce fracture risk exploring the roles of such factors as genetics, hormones, calcium, vitamin D, drugs, and exercise on bone mass. Get more information about ongoing research on osteoporosis from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) at NIH."},{"_answerid":"Q144-S1-A4","_pairid":"357","__text":"Osteoporosis is a disease that thins and weakens the bones to the point that they break easily. Women and men with osteoporosis most often break bones in the hip, spine, and wrist, but osteoporosis can be the cause of bone fractures anywhere."}],"SUB_QUESTION_ID":"Q144-S1","ANNOTATIONS.FOCUS":["osteoporosis"],"ANNOTATIONS.TYPE":"information","SUBJECT":"","MESSAGE":"printed materials on osteoporosis. Is there any way you can please mail me literature on osteoporosis, I was just diagnosed. Thank you, [NAME] [LOCATION] [LOCATION] [LOCATION] [LOCATION]","QUESTION_ID":"Q144","F_REF":"11719"} -{"ANSWERS":[{"_answerid":"Q145-S1-A1","_pairid":"368","__text":"Tests you may have include: - Blood tests to measure hormone levels - MRI of the head to rule out other pituitary problems, such as a tumor"},{"_answerid":"Q145-S1-A2","_pairid":"369","__text":"Diagnosis of Sheehan syndrome can be difficult. The diagnosis is based on clinical evidence of hypopituitarism in a woman with a history of severe postpartum bleeding. Blood tests to measure hormone levels and CT scan of the head (to rule out other pituitary problems such as a tumor) may help to confirm the diagnosis."}],"SUB_QUESTION_ID":"Q145-S1","ANNOTATIONS.FOCUS":["sheehans syndrome"],"ANNOTATIONS.TYPE":"diagnosis","SUBJECT":"Sheehan's Syndrome","MESSAGE":"I was diagnosed with sheehans syndrome almost 14 years after almost dying after the birth of my daughter. My blood level fell to 1.3 I had a partial hysterectomy following the birth. I recently had my thyroid removed after diagnosis of cancer and was told that I am post menopause, I am only 39 years old. Do you have any information regarding diagnosis and misdiagnosis. What should the medical care have done to identify the syndrome?","QUESTION_ID":"Q145","F_REF":"12520"} -{"ANSWERS":[{"_answerid":"Q146-S1-A1","_pairid":"372","__text":"The capsule of the shoulder joint has ligaments that hold the shoulder bones to each other. When the capsule becomes inflamed, the shoulder bones are unable to move freely in the joint. Most of the time, there is no cause for frozen shoulder. Risk factors include: - Diabetes - Thyroid problems - Changes in your hormones, such as during menopause - Shoulder injury - Shoulder surgery - Open heart surgery - Cervical disk disease of the neck"}],"SUB_QUESTION_ID":"Q146-S1","ANNOTATIONS.FOCUS":["frozen shoulder"],"ANNOTATIONS.TYPE":"cause","SUBJECT":"frozen shoulder","MESSAGE":"We have 14 siblings in our family , at least 10 of us has had a frozen shoulder. We are wondering why? should we be concerned?","QUESTION_ID":"Q146","F_REF":"1-134274365"} -{"ANSWERS":[{"_answerid":"Q146-S2-A1","_pairid":"373","__text":"Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness and pain in your shoulder joint. Signs and symptoms typically begin gradually, worsen over time and then resolve, usually within one to three years. Your risk of developing frozen shoulder increases if you're recovering from a medical condition or procedure that prevents you from moving your arm \u2014 such as a stroke or a mastectomy. Treatment for frozen shoulder involves range-of-motion exercises and, sometimes, corticosteroids and numbing medications injected into the joint capsule. In a small percentage of cases, arthroscopic surgery may be indicated to loosen the joint capsule so that it can move more freely. It's unusual for frozen shoulder to recur in the same shoulder, but some people can develop it in the opposite shoulder."}],"SUB_QUESTION_ID":"Q146-S2","ANNOTATIONS.FOCUS":["frozen shoulder"],"ANNOTATIONS.TYPE":"information","SUBJECT":"frozen shoulder","MESSAGE":"We have 14 siblings in our family , at least 10 of us has had a frozen shoulder. We are wondering why? should we be concerned?","QUESTION_ID":"Q146","F_REF":"1-134274365"} -{"ANSWERS":[{"_answerid":"Q147-S1-A1","_pairid":"376","__text":"The health care provider will use a stethoscope to listen to\u00a0your lungs. Wheezing or other asthma-related sounds may be heard. Tests that may be ordered include: - Allergy testing\u00a0- skin\u00a0or a blood test to see if a person with asthma is allergic to certain substances - Arterial blood gas (usually only done with patients who are having a severe asthma attack) - Chest x-ray - Lung function tests, including peak flow measurements"},{"_answerid":"Q147-S1-A2","_pairid":"377","__text":"Your primary care doctor will diagnose asthma based on your medical and family histories, a physical exam, and test results. Your doctor also will figure out the severity of your asthma\u2014that is, whether it's intermittent, mild, moderate, or severe. The level of severity will determine what treatment you'll start on. You may need to see an asthma specialist if: You need special tests to help diagnose asthma You've had a life-threatening asthma attack You need more than one kind of medicine or higher doses of medicine to control your asthma, or if you have overall problems getting your asthma well controlled You're thinking about getting allergy treatments Medical and Family Histories Your doctor may ask about your family history of asthma and allergies. He or she also may ask whether you have asthma symptoms and when and how often they occur. Let your doctor know whether your symptoms seem to happen only during certain times of the year or in certain places, or if they get worse at night. Your doctor also may want to know what factors seem to trigger your symptoms or worsen them. For more information about possible asthma triggers, go to \"What Are the Signs and Symptoms of Asthma?\" Your doctor may ask you about related health conditions that can interfere with asthma management. These conditions include a runny nose, sinus infections, reflux disease, psychological stress, and sleep apnea. Physical Exam Your doctor will listen to your breathing and look for signs of asthma or allergies. These signs include wheezing, a runny nose or swollen nasal passages, and allergic skin conditions (such as eczema). Keep in mind that you can still have asthma even if you don't have these signs on the day that your doctor examines you. Diagnostic Tests Lung Function Test Your doctor will use a test called spirometry (spi-ROM-eh-tre) to check how your lungs are working. This test measures how much air you can breathe in and out. It also measures how fast you can blow air out. Your doctor also may give you medicine and then test you again to see whether the results have improved. If the starting results are lower than normal and improve with the medicine, and if your medical history shows a pattern of asthma symptoms, your diagnosis will likely be asthma. Other Tests Your doctor may recommend other tests if he or she needs more information to make a diagnosis. Other tests may include: Allergy testing to find out which allergens affect you, if any. A test to measure how sensitive your airways are. This is called a bronchoprovocation (brong-KO-prav-eh-KA-shun) test. Using spirometry, this test repeatedly measures your lung function during physical activity or after you receive increasing doses of cold air or a special chemical to breathe in. A test to show whether you have another condition with the same symptoms as asthma, such as reflux disease, vocal cord dysfunction, or sleep apnea. A chest x ray or an EKG (electrocardiogram). These tests will help find out whether a foreign object or other disease may be causing your symptoms. Diagnosing Asthma in Young Children Most children who have asthma develop their first symptoms before 5 years of age. However, asthma in young children (aged 0 to 5 years) can be hard to diagnose. Sometimes it's hard to tell whether a child has asthma or another childhood condition. This is because the symptoms of asthma also occur with other conditions. Also, many young children who wheeze when they get colds or respiratory infections don't go on to have asthma after they're 6 years old. A child may wheeze because he or she has small airways that become even narrower during colds or respiratory infections. The airways grow as the child grows older, so wheezing no longer occurs when the child gets colds. A young child who has frequent wheezing with colds or respiratory infections is more likely to have asthma if: One or both parents have asthma The child has signs of allergies, including the allergic skin condition eczema The child has allergic reactions to pollens or other airborne allergens The child wheezes even when he or she doesn't have a cold or other infection The most certain way to diagnose asthma is with a lung function test, a medical history, and a physical exam. However, it's hard to do lung function tests in children younger than 5 years. Thus, doctors must rely on children's medical histories, signs and symptoms, and physical exams to make a diagnosis. Doctors also may use a 4\u20136 week trial of asthma medicines to see how well a child responds."}],"SUB_QUESTION_ID":"Q147-S1","ANNOTATIONS.FOCUS":["asthma"],"ANNOTATIONS.TYPE":"diagnosis","SUBJECT":"","MESSAGE":"Name: [NAME] Date and Time of Contact: Mon, 19 Jan 2015 19:48:21 GMT Application: entrez Database: pubmed SessionId: 39700B4F4BD5E951_0188SID MyNCBI UserName: Browser's user agent header: Mozilla\/5.0 (Macintosh; Intel Mac OS X 10_10) AppleWebKit\/600.1.25 (KHTML, like Gecko) Version\/8.0 Safari\/600.1.25 Message Body: how are you 100% sure if you have asthma?","QUESTION_ID":"Q147","F_REF":"1-131503031"} -{"ANSWERS":[{"_answerid":"Q148-S1-A1","_pairid":"378","__text":"Blood pressure is a measurement of the force exerted against the walls of your arteries as your heart pumps blood to your body. Hypertension is the term used to describe high blood pressure. Blood pressure readings are given as two numbers. The top number is called the systolic blood pressure. The bottom number is called the diastolic blood pressure. For example, 120 over 80 (written as 120\/80 mmHg). One or both of these numbers can be too high. (Note: These numbers apply to people who are not taking medicines for blood pressure and are not ill.) - Normal blood pressure is when your blood pressure is lower than 120\/80 mmHg most of the time. - High blood pressure (hypertension) is when your blood pressure is 140\/90 mmHg or above most of the time. - If your blood pressure numbers are 120\/80 or higher, but below 140\/90, it is called pre-hypertension. If you have heart or kidney problems, or you had a stroke, your doctor may want your blood pressure to be even lower than that of people who do not have these conditions."},{"_answerid":"Q148-S1-A2","_pairid":"379","__text":"Summary Blood pressure is the force of your blood pushing against the walls of your arteries. Each time your heart beats, it pumps blood into the arteries. Your blood pressure is highest when your heart beats, pumping the blood. This is called systolic pressure. When your heart is at rest, between beats, your blood pressure falls. This is called diastolic pressure. Your blood pressure reading uses these two numbers. Usually the systolic number comes before or above the diastolic number. A reading of - 119\/79 or lower is normal blood pressure - 140\/90 or higher is high blood pressure - Between 120 and 139 for the top number, or between 80 and 89 for the bottom number is called prehypertension. Prehypertension means you may end up with high blood pressure, unless you take steps to prevent it. High blood pressure usually has no symptoms, but it can cause serious problems such as stroke, heart failure, heart attack and kidney failure. You can control high blood pressure through healthy lifestyle habits such as exercise and the DASH diet and taking medicines, if needed. NIH: National Heart, Lung, and Blood Institute"}],"SUB_QUESTION_ID":"Q148-S1","ANNOTATIONS.FOCUS":["hypertension"],"ANNOTATIONS.TYPE":"information","SUBJECT":"","MESSAGE":"I want more information on Hypertension and fibromyalgia, I seem to be getting only topics on diabetes and I do not have this. I enjoy reading the current info. thanks [NAME]","QUESTION_ID":"Q148","F_REF":"14881"} -{"ANSWERS":[{"_answerid":"Q148-S2-A1","_pairid":"380","__text":"Fibromyalgia is a common syndrome in which a person has long-term pain, spread throughout the body. The pain is most often linked to fatigue, sleep problems, headaches, depression, and anxiety. People with fibromalgia may also have tenderness in the joints, muscles, tendons, and other soft tissues."},{"_answerid":"Q148-S2-A2","_pairid":"381","__text":"Summary Fibromyalgia is a disorder that causes muscle pain and fatigue. People with fibromyalgia have \"tender points\" on the body. Tender points are specific places on the neck, shoulders, back, hips, arms, and legs. These points hurt when pressure is put on them. People with fibromyalgia may also have other symptoms, such as - Trouble sleeping - Morning stiffness - Headaches - Painful menstrual periods - Tingling or numbness in hands and feet - Problems with thinking and memory (sometimes called \"fibro fog\") No one knows what causes fibromyalgia. Anyone can get it, but it is most common in middle-aged women. People with rheumatoid arthritis and other autoimmune diseases are particularly likely to develop fibromyalgia. There is no cure for fibromyalgia, but medicine can help you manage your symptoms. Getting enough sleep, exercising, and eating well may also help. NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases"}],"SUB_QUESTION_ID":"Q148-S2","ANNOTATIONS.FOCUS":["fibromyalgia"],"ANNOTATIONS.TYPE":"information","SUBJECT":"","MESSAGE":"I want more information on Hypertension and fibromyalgia, I seem to be getting only topics on diabetes and I do not have this. I enjoy reading the current info. thanks [NAME]","QUESTION_ID":"Q148","F_REF":"14881"} -{"ANSWERS":[{"_answerid":"Q149-S1-A1","_pairid":"382","__text":"The goals of treatment are: - Control airway swelling - Stay away from\u00a0substances that trigger your symptoms\u00a0 - Help you to be able to do normal activities without asthma symptoms You and your doctor should work as a team to manage your asthma. Follow your doctor's instructions on taking medicines, eliminating asthma triggers, and monitoring symptoms. MEDICINES FOR ASTHMA\u00a0 There are two kinds of medicines for treating asthma: - Control medicines to help prevent attacks - Quick-relief (rescue)\u00a0medicines for use during attacks LONG-TERM MEDICINES These are also called maintenance or control medicines.\u00a0They are used to prevent symptoms in people with moderate to severe asthma. You must take them every day for them to work. Take them even when you feel OK. Some long-term medicines are breathed in (inhaled), such as steroids and long-acting beta-agonists. Others are taken by mouth (orally). Your doctor will prescribe the right medicine for you. QUICK-RELIEF MEDICINES These are also called rescue medicines. They are taken: - For coughing, wheezing, trouble breathing, or an asthma attack - Just before exercising to help prevent asthma symptoms caused by exercise Tell your doctor if you are using quick-relief medicines twice a week or more. If so, your asthma may not be under control and your doctor may need to change your dose of daily control drugs. Quick-relief\u00a0medicines include: - Short-acting inhaled bronchodilators - Oral corticosteroids for\u00a0when you have an asthma attack that is not going away A severe asthma attack requires a checkup by a doctor. You may also need a hospital stay. There, you will likely be given\u00a0oxygen, breathing assistance, and medicines given through a vein (IV). ASTHMA CARE AT HOME - Know the asthma symptoms to watch for. - Know how to take your peak flow reading and what it means. - Know which triggers make your asthma worse and what to do when this happens. - Know how to care for your asthma when you exercise. Asthma action plans are written documents for managing asthma. An asthma action plan should include: - Instructions for taking asthma medicines when your condition is stable - A list of asthma triggers and how to avoid them - How to recognize when your asthma is getting worse, and when to call your doctor or nurse A peak flow meter is a simple device to measure how quickly you can move air out of your lungs. - It can help you see if an attack is coming, sometimes even before symptoms appear. Peak flow measurements help\u00a0let you know\u00a0when you need to take\u00a0medicine or other action. - Peak flow values of 50 to 80% of\u00a0your best results are a sign of a moderate asthma attack.\u00a0Numbers below 50% are a sign of a severe attack."},{"_answerid":"Q149-S1-A2","_pairid":"383","__text":"Asthma is a long-term disease that has no cure. The goal of asthma treatment is to control the disease. Good asthma control will: Prevent chronic and troublesome symptoms, such as coughing and shortness of breath Reduce your need for quick-relief medicines (see below) Help you maintain good lung function Let you maintain your normal activity level and sleep through the night Prevent asthma attacks that could result in an emergency room visit or hospital stay To control asthma, partner with your doctor to manage your asthma or your child's asthma. Children aged 10 or older\u2014and younger children who are able\u2014should take an active role in their asthma care. Taking an active role to control your asthma involves: Working with your doctor to treat other conditions that can interfere with asthma management. Avoiding things that worsen your asthma (asthma triggers). However, one trigger you should not avoid is physical activity. Physical activity is an important part of a healthy lifestyle. Talk with your doctor about medicines that can help you stay active. Working with your doctor and other health care providers to create and follow an asthma action plan. An asthma action plan gives guidance on taking your medicines properly, avoiding asthma triggers (except physical activity), tracking your level of asthma control, responding to worsening symptoms, and seeking emergency care when needed. Asthma is treated with two types of medicines: long-term control and quick-relief medicines. Long-term control medicines help reduce airway inflammation and prevent asthma symptoms. Quick-relief, or \"rescue,\" medicines relieve asthma symptoms that may flare up. Your initial treatment will depend on the severity of your asthma. Followup asthma treatment will depend on how well your asthma action plan is controlling your symptoms and preventing asthma attacks. Your level of asthma control can vary over time and with changes in your home, school, or work environments. These changes can alter how often you're exposed to the factors that can worsen your asthma. Your doctor may need to increase your medicine if your asthma doesn't stay under control. On the other hand, if your asthma is well controlled for several months, your doctor may decrease your medicine. These adjustments to your medicine will help you maintain the best control possible with the least amount of medicine necessary. Asthma treatment for certain groups of people\u2014such as children, pregnant women, or those for whom exercise brings on asthma symptoms\u2014will be adjusted to meet their special needs. Follow an Asthma Action Plan You can work with your doctor to create a personal asthma action plan. The plan will describe your daily treatments, such as which medicines to take and when to take them. The plan also will explain when to call your doctor or go to the emergency room. If your child has asthma, all of the people who care for him or her should know about the child's asthma action plan. This includes babysitters and workers at daycare centers, schools, and camps. These caretakers can help your child follow his or her action plan. Go to the National Heart, Lung, and Blood Institute's (NHLBI's) \"Asthma Action Plan\" for a sample plan. Avoid Things That Can Worsen Your Asthma Many common things (called asthma triggers) can set off or worsen your asthma symptoms. Once you know what these things are, you can take steps to control many of them. (For more information about asthma triggers, go to \"What Are the Signs and Symptoms of Asthma?\") For example, exposure to pollens or air pollution might make your asthma worse. If so, try to limit time outdoors when the levels of these substances in the outdoor air are high. If animal fur triggers your asthma symptoms, keep pets with fur out of your home or bedroom. One possible asthma trigger you shouldn\u2019t avoid is physical activity. Physical activity is an important part of a healthy lifestyle. Talk with your doctor about medicines that can help you stay active. The NHLBI offers many useful tips for controlling asthma triggers. For more information, go to page 2 of NHLBI's \"Asthma Action Plan.\" If your asthma symptoms are clearly related to allergens, and you can't avoid exposure to those allergens, your doctor may advise you to get allergy shots. You may need to see a specialist if you're thinking about getting allergy shots. These shots can lessen or prevent your asthma symptoms, but they can't cure your asthma. Several health conditions can make asthma harder to manage. These conditions include runny nose, sinus infections, reflux disease, psychological stress, and sleep apnea. Your doctor will treat these conditions as well. Medicines Your doctor will consider many things when deciding which asthma medicines are best for you. He or she will check to see how well a medicine works for you. Then, he or she will adjust the dose or medicine as needed. Asthma medicines can be taken in pill form, but most are taken using a device called an inhaler. An inhaler allows the medicine to go directly to your lungs. Not all inhalers are used the same way. Ask your doctor or another health care provider to show you the right way to use your inhaler. Review the way you use your inhaler at every medical visit. Long-Term Control Medicines Most people who have asthma need to take long-term control medicines daily to help prevent symptoms. The most effective long-term medicines reduce airway inflammation, which helps prevent symptoms from starting. These medicines don't give you quick relief from symptoms. Inhaled corticosteroids. Inhaled corticosteroids are the preferred medicine for long-term control of asthma. They're the most effective option for long-term relief of the inflammation and swelling that makes your airways sensitive to certain inhaled substances. Reducing inflammation helps prevent the chain reaction that causes asthma symptoms. Most people who take these medicines daily find they greatly reduce the severity of symptoms and how often they occur. Inhaled corticosteroids generally are safe when taken as prescribed. These medicines are different from the illegal anabolic steroids taken by some athletes. Inhaled corticosteroids aren't habit-forming, even if you take them every day for many years. Like many other medicines, though, inhaled corticosteroids can have side effects. Most doctors agree that the benefits of taking inhaled corticosteroids and preventing asthma attacks far outweigh the risk of side effects. One common side effect from inhaled corticosteroids is a mouth infection called thrush. You might be able to use a spacer or holding chamber on your inhaler to avoid thrush. These devices attach to your inhaler. They help prevent the medicine from landing in your mouth or on the back of your throat. Check with your doctor to see whether a spacer or holding chamber should be used with the inhaler you have. Also, work with your health care team if you have any questions about how to use a spacer or holding chamber. Rinsing your mouth out with water after taking inhaled corticosteroids also can lower your risk for thrush. If you have severe asthma, you may have to take corticosteroid pills or liquid for short periods to get your asthma under control. If taken for long periods, these medicines raise your risk for cataracts and osteoporosis (OS-te-o-po-RO-sis). A cataract is the clouding of the lens in your eye. Osteoporosis is a disorder that makes your bones weak and more likely to break. Your doctor may have you add another long-term asthma control medicine so he or she can lower your dose of corticosteroids. Or, your doctor may suggest you take calcium and vitamin D pills to protect your bones. Other long-term control medicines. Other long-term control medicines include: Cromolyn. This medicine is taken using a device called a nebulizer. As you breathe in, the nebulizer sends a fine mist of medicine to your lungs. Cromolyn helps prevent airway inflammation. Omalizumab (anti-IgE). This medicine is given as a shot (injection) one or two times a month. It helps prevent your body from reacting to asthma triggers, such as pollen and dust mites. Anti-IgE might be used if other asthma medicines have not worked well. \u00a0A rare, but possibly life-threatening allergic reaction called anaphylaxis might occur when the Omalizumab injection is given. If you take this medication, work with your doctor to make sure you understand the signs and symptoms of anaphylaxis and what actions you \u00a0should take. Inhaled long-acting beta2-agonists. These medicines open the airways. They might be added to inhaled corticosteroids to improve asthma control. Inhaled long-acting beta2-agonists should never be used on their own for long-term asthma control. They must used with inhaled corticosteroids. Leukotriene modifiers. These medicines are taken by mouth. They help block the chain reaction that increases inflammation in your airways. Theophylline. This medicine is taken by mouth. Theophylline helps open the airways. If your doctor prescribes a long-term control medicine, take it every day to control your asthma. Your asthma symptoms will likely return or get worse if you stop taking your medicine. Long-term control medicines can have side effects. Talk with your doctor about these side effects and ways to reduce or avoid them. With some medicines, like theophylline, your doctor will check the level of medicine in your blood. This helps ensure that you\u2019re getting enough medicine to relieve your asthma symptoms, but not so much that it causes dangerous side effects. Quick-Relief Medicines All people who have asthma need quick-relief medicines to help relieve asthma symptoms that may flare up. Inhaled short-acting beta2-agonists are the first choice for quick relief. These medicines act quickly to relax tight muscles around your airways when you're having a flareup. This allows the airways to open up so air can flow through them. You should take your quick-relief medicine when you first notice asthma symptoms. If you use this medicine more than 2 days a week, talk with your doctor about your asthma control. You may need to make changes to your asthma action plan. Carry your quick-relief inhaler with you at all times in case you need it. If your child has asthma, make sure that anyone caring for him or her has the child's quick-relief medicines, including staff at the child's school. They should understand when and how to use these medicines and when to seek medical care for your child. You shouldn't use quick-relief medicines in place of prescribed long-term control medicines. Quick-relief medicines don't reduce inflammation. Track Your Asthma To track your asthma, keep records of your symptoms, check your peak flow number using a peak flow meter, and get regular asthma checkups. Record Your Symptoms You can record your asthma symptoms in a diary to see how well your treatments are controlling your asthma. Asthma is well controlled if: You have symptoms no more than 2 days a week, and these symptoms don't wake you from sleep more than 1 or 2 nights a month. You can do all your normal activities. You take quick-relief medicines no more than 2 days a week. You have no more than one asthma attack a year that requires you to take corticosteroids by mouth. Your peak flow doesn't drop below 80 percent of your personal best number. If your asthma isn't well controlled, contact your doctor. He or she may need to change your asthma action plan. Use a Peak Flow Meter This small, hand-held device shows how well air moves out of your lungs. You blow into the device and it gives you a score, or peak flow number. Your score shows how well your lungs are working at the time of the test. Your doctor will tell you how and when to use your peak flow meter. He or she also will teach you how to take your medicines based on your score. Your doctor and other health care providers may ask you to use your peak flow meter each morning and keep a record of your results. You may find it very useful to record peak flow scores for a couple of weeks before each medical visit and take the results with you. When you're first diagnosed with asthma, it's important to find your \"personal best\" peak flow number. To do this, you record your score each day for a 2- to 3-week period when your asthma is well-controlled. The highest number you get during that time is your personal best. You can compare this number to future numbers to make sure your asthma is controlled. Your peak flow meter can help warn you of an asthma attack, even before you notice symptoms. If your score shows that your breathing is getting worse, you should take your quick-relief medicines the way your asthma action plan directs. Then you can use the peak flow meter to check how well the medicine worked. Get Asthma Checkups When you first begin treatment, you'll see your doctor about every 2 to 6 weeks. Once your asthma is controlled, your doctor may want to see you from once a month to twice a year. During these checkups, your doctor may ask whether you've had an asthma attack since the last visit or any changes in symptoms or peak flow measurements. He or she also may ask about your daily activities. This information will help your doctor assess your level of asthma control. Your doctor also may ask whether you have any problems or concerns with taking your medicines or following your asthma action plan. Based on your answers to these questions, your doctor may change the dose of your medicine or give you a new medicine. If your control is very good, you might be able to take less medicine. The goal is to use the least amount of medicine needed to control your asthma. Emergency Care Most people who have asthma, including many children, can safely manage their symptoms by following their asthma action plans. However, you might need medical attention at times. Call your doctor for advice if: Your medicines don't relieve an asthma attack. Your peak flow is less than half of your personal best peak flow number. Call 9\u20131\u20131 for emergency care if: You have trouble walking and talking because you're out of breath. You have blue lips or fingernails. At the hospital, you'll be closely watched and given oxygen and more medicines, as well as medicines at higher doses than you take at home. Such treatment can save your life. Asthma Treatment for Special Groups The treatments described above generally apply to all people who have asthma. However, some aspects of treatment differ for people in certain age groups and those who have special needs. Children It's hard to diagnose asthma in children younger than 5 years. Thus, it's hard to know whether young children who wheeze or have other asthma symptoms will benefit from long-term control medicines. (Quick-relief medicines tend to relieve wheezing in young children whether they have asthma or not.) Doctors will treat infants and young children who have asthma symptoms with long-term control medicines if, after assessing a child, they feel that the symptoms are persistent and likely to continue after 6 years of age. (For more information, go to \"How Is Asthma Diagnosed?\") Inhaled corticosteroids are the preferred treatment for young children. Montelukast and cromolyn are other options. Treatment might be given for a trial period of 1\u00a0month to 6 weeks. Treatment usually is stopped if benefits aren't seen during that time and the doctor and parents are confident the medicine was used properly. Inhaled corticosteroids can possibly slow the growth of children of all ages. Slowed growth usually is apparent in the first several months of treatment, is generally small, and doesn't get worse over time. Poorly controlled asthma also may reduce a child's growth rate. Many experts think the benefits of inhaled corticosteroids for children who need them to control their asthma far outweigh the risk of slowed growth. Older Adults Doctors may need to adjust asthma treatment for older adults who take certain other medicines, such as beta blockers, aspirin and other pain relievers, and anti-inflammatory medicines. These medicines can prevent asthma medicines from working well and may worsen asthma symptoms. Be sure to tell your doctor about all of the medicines you take, including over-the-counter medicines. Older adults may develop weak bones from using inhaled corticosteroids, especially at high doses. Talk with your doctor about taking calcium and vitamin D pills, as well as other ways to help keep your bones strong. Pregnant Women Pregnant women who have asthma need to control the disease to ensure a good supply of oxygen to their babies. Poor asthma control increases the risk of preeclampsia, a condition in which a pregnant woman develops high blood pressure and protein in the urine. Poor asthma control also increases the risk that a baby will be born early and have a low birth weight. Studies show that it's safer to take asthma medicines while pregnant than to risk having an asthma attack. Talk with your doctor if you have asthma and are pregnant or planning a pregnancy. Your level of asthma control may get better or it may get worse while you're pregnant. Your health care team will check your asthma control often and adjust your treatment as needed. People Whose Asthma Symptoms Occur With Physical Activity Physical activity is an important part of a healthy lifestyle. Adults need physical activity to maintain good health. Children need it for growth and development. In some people, however, physical activity can trigger asthma symptoms. If this happens to you or your child, talk with your doctor about the best ways to control asthma so you can stay active. The following medicines may help prevent asthma symptoms caused by physical activity: Short-acting beta2-agonists (quick-relief medicine) taken shortly before physical activity can last 2 to 3 hours and prevent exercise-related symptoms in most people who take them. Long-acting beta2-agonists can be protective for up to 12 hours. However, with daily use, they'll no longer give up to 12 hours of protection. Also, frequent use of these medicines for physical activity might be a sign that asthma is poorly controlled. Leukotriene modifiers. These pills are taken several hours before physical activity. They can help relieve asthma symptoms brought on by physical activity. Long-term control medicines. Frequent or severe symptoms due to physical activity may suggest poorly controlled asthma and the need to either start or increase long-term control medicines that reduce inflammation. This will help prevent exercise-related symptoms. Easing into physical activity with a warmup period may be helpful. You also may want to wear a mask or scarf over your mouth when exercising in cold weather. If you use your asthma medicines as your doctor directs, you should be able to take part in any physical activity or sport you choose. People Having Surgery Asthma may add to the risk of having problems during and after surgery. For instance, having a tube put into your throat may cause an asthma attack. Tell your surgeon about your asthma when you first talk with him or her. The surgeon can take steps to lower your risk, such as giving you asthma medicines before or during surgery."}],"SUB_QUESTION_ID":"Q149-S1","ANNOTATIONS.FOCUS":["asthma"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"asthma","MESSAGE":"Question. What is the consensus of medical doctors as to whether asthma can be cured? And do you have an article discussing whether asthma can be cured?","QUESTION_ID":"Q149","F_REF":"NF_202"} -{"ANSWERS":[{"_answerid":"Q150-S1-A1","_pairid":"390","__text":"The goal of treatment is to reduce your blood pressure so that you have a lower risk of complications. You and your provider should set a blood pressure goal for you. If you have pre-hypertension, your provider will recommend lifestyle changes to bring your blood pressure down to a normal range. Medicines are rarely used for pre-hypertension. LIFESTYLE CHANGES You can do many things to help control your blood pressure at home, including: - Eat a heart-healthy diet, including potassium and fiber. - Drink plenty of water. - Exercise regularly for at least 30 minutes of aerobic exercise a day. - If you smoke, quit. - Limit how much alcohol you drink to 1 drink a day for women, and 2 a day for men. - Limit the amount of sodium (salt) you eat. Aim for less than 1,500 mg per day. - Reduce stress. Try to avoid things that cause you stress, and try meditation or yoga to de-stress. - Stay at a healthy body weight. Your provider can help you find programs for losing weight, stopping smoking, and exercising. You can also get a referral to a dietitian, who can help you plan a diet that is healthy for you. How low your blood pressure should be and at what level you need to start treatment is individualized, based on your age and any medical problems you have. MEDICINES FOR HYPERTENSION Most of the time, your provider will try lifestyle changes first and check your BP 2 or more times. Medicines will likely be started if your BP readings remain at or above these levels: - Top number (systolic pressure) of 140 or more in people younger than 60 years - Top number of 150 or more in people 60 years and older - Bottom number (diastolic pressure) of 90 or more If you have diabetes, heart problems, or a history of a stroke, medicines may be started at lower blood pressure reading. The most commonly used blood pressure targets for people with these medical problems are below 130 to 140\/80 mmHg. There are many different medicines to treat high blood pressure. - Often, a single blood pressure drug may not be enough to control your blood pressure, and you may need to take two or more drugs. - It is very important that you take the medicines prescribed to you. - If you have side effects, your doctor can substitute a different medicine."}],"SUB_QUESTION_ID":"Q150-S1","ANNOTATIONS.FOCUS":["hypertension"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"how to reduced hypertension","QUESTION_ID":"Q150","F_REF":"NF_56"} -{"ANSWERS":[{"_answerid":"Q151-S1-A1","_pairid":"391","__text":"Treatment for Dry Mouth Dry mouth treatment will depend on what is causing the problem. If you think you have dry mouth, see your dentist or physician. He or she can help to determine what is causing your dry mouth. If your dry mouth is caused by medicine, your physician might change your medicine or adjust the dosage. If your salivary glands are not working right but can still produce some saliva, your dentist or physician might give you a medicine that helps the glands work better. Your dentist or physician might also suggest that you use artificial saliva to keep your mouth wet. Do's and Don'ts Do's - Do drink water or sugarless drinks often. That will make chewing and swallowing easier when eating. - Do chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow. - Do use a humidifier at night to promote moisture in the air while you sleep. Do drink water or sugarless drinks often. That will make chewing and swallowing easier when eating. Do chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow. Do use a humidifier at night to promote moisture in the air while you sleep. Don\u2019ts - Don't consume drinks with caffeine such as coffee, tea, and some sodas. Caffeine can dry out the mouth. - Don't use tobacco or alcohol. They dry out the mouth. Don't consume drinks with caffeine such as coffee, tea, and some sodas. Caffeine can dry out the mouth. Don't use tobacco or alcohol. They dry out the mouth. Gene Therapy Research for Salivary Gland Dysfunction Scientists at NIH\u2019s National Institute of Dental and Craniofacial Research (NIDCR) are exploring the potential use of gene therapy to treat salivary gland dysfunction. The idea is to transfer additional or replacement genes into the salivary glands of people with Sj\u00f6gren's syndrome and cancer patients whose salivary glands were damaged during radiation treatment. The hope is that these genes will increase the production of saliva and eliminate the chronic parched sensation that bothers people with dry mouth conditions. NIDCR recently completed a clinical study, a research study in humans, on gene therapy for radiation-damaged salivary glands. The study showed that gene therapy can be safely performed in salivary glands and that it has the potential to help head and neck cancer survivors with dry mouth. Read NIDCR\u2019s news release to learn more about the study\u2019s findings. Based on the promising results of this trial, similar clinical trials are planned in the near future. Research on Sj\u00f6gren\u2019s Syndrome and Other Diseases Affecting Salivary Glands NIDCR is also conducting clinical trials to study new approaches for improving salivary flow in patients with Sjogren\u2019s syndrome. Such studies include testing the effectiveness of a monoclonal antibody as well as a corticosteroid to see whether either of these treatments helps improve salivary flow. Other studies are focused on learning how diseases such as diabetes, auto inflammatory diseases, and granulomatous diseases cause salivary gland dysfunction. Such studies could one day lead to better ways of preventing and treating salivary gland conditions. To stay abreast of any new studies on gene therapy and salivary gland function, visit ClinicalTrials.gov. ClinicalTrials.gov lists all federally and many privately funded clinical trials in the U.S. and around the world; the web site is updated frequently."},{"_answerid":"Q151-S1-A2","_pairid":"393","__text":"Dry mouth treatment will depend on what is causing the problem. If you think you have dry mouth, see your dentist or physician. He or she can help to determine what is causing your dry mouth. If your dry mouth is caused by medicine, your physician might change your medicine or adjust the dosage. If your salivary glands are not working right, but can still produce some saliva, your dentist or physician might give you a special medicine that helps the glands work better. He or she might suggest that you use artificial saliva to keep your mouth wet. (Watch the video to learn how dry mouth is treated. 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.)"}],"SUB_QUESTION_ID":"Q151-S1","ANNOTATIONS.FOCUS":["dry mouth"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"Chronic Dry mouth.","MESSAGE":"How can I relieve dry mouth.","QUESTION_ID":"Q151","F_REF":"1-131590835"} -{"ANSWERS":[{"_answerid":"Q152-S1-A1","_pairid":"394","__text":"An inguinal hernia happens when contents of the abdomen\u2014usually fat or part of the small intestine\u2014bulge through a weak area in the lower abdominal wall. The abdomen is the area between the chest and the hips. The area of the lower abdominal wall is also called the inguinal or groin region. Two types of inguinal hernias are - indirect inguinal hernias, which are caused by a defect in the abdominal wall that is congenital, or present at birth - direct inguinal hernias, which usually occur only in male adults and are caused by a weakness in the muscles of the abdominal wall that develops over time Inguinal hernias occur at the inguinal canal in the groin region."}],"SUB_QUESTION_ID":"Q152-S1","ANNOTATIONS.FOCUS":["inguinal hernia"],"ANNOTATIONS.TYPE":"information","SUBJECT":"inguinal hernia","MESSAGE":"I am a 75 year old man. I have 2 inguinal hernia. Do you offer any written pamplets on these.","QUESTION_ID":"Q152","F_REF":"NF_226"} -{"ANSWERS":[{"_answerid":"Q153-S1-A1","_pairid":"396","__text":"CHANGING YOUR LIFESTYLE An active lifestyle and plenty of exercise, along with healthy eating, is the safest way to lose weight. Even modest weight loss can improve your health. You may need a lot of support from family and friends. Your main goal should be to learn new, healthy ways of eating and make them part of your daily routine. Many people find it hard to change their eating habits and behaviors. You may have practiced some habits for so long that you may not even know they are unhealthy, or you do them without thinking. You need to be motivated to make lifestyle changes. Make the behavior change part of your life over the long term. Know that it takes time to make and keep a change in your lifestyle. Work with your health care provider and dietitian to set realistic, safe daily calorie counts that help you lose weight while staying healthy. Remember that if you drop pounds slowly and steadily, you are more likely to keep them off. Your dietitian can teach you about: - Healthy food choices - Healthy snacks - Reading nutrition labels - New ways to prepare food - Portion sizes - Sweetened drinks Extreme diets (fewer than 1,100 calories per day) are not thought to be safe or to work very well. These types of diets often do not contain enough vitamins and minerals. Most people who lose weight this way return to overeating and become obese again. Learn ways to manage stress other than snacking. Examples may be meditation, yoga, or exercise. If you are depressed or stressed a lot, talk to your provider. MEDICINES AND HERBAL REMEDIES You may see ads for supplements and herbal remedies that claim they will help you lose weight. Some of these claims may not be true. And some of these supplements can have serious side effects. Talk to your provider before using them. You can discuss weight loss medicines with your doctor. Many people lose at least 5 pounds by taking these drugs, but they may regain the weight when they stop taking the medicine unless they have made lifestyle changes. SURGERY Bariatric (weight-loss) surgery can reduce the risk of certain diseases in people with severe obesity. These risks include: - Arthritis - Diabetes - Heart disease - High blood pressure - Sleep apnea - Some cancers - Stroke Surgery may help people who have been very obese for 5 years or more and have not lost weight from other treatments, such as diet, exercise, or medicine. Surgery alone is not the answer for weight loss. It can train you to eat less, but you still have to do much of the work. You must be committed to diet and exercise after surgery. Talk to your doctor to learn if surgery is a good option for you. Weight-loss surgeries include: - Laparoscopic gastric banding - Gastric bypass surgery - Sleeve gastrectomy (less common) - Duodenal switch"}],"SUB_QUESTION_ID":"Q153-S1","ANNOTATIONS.FOCUS":["obesity"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"obesity","MESSAGE":"I need to lose fat","QUESTION_ID":"Q153","F_REF":"1-136400615"} -{"ANSWERS":[{"_answerid":"Q154-S1-A1","_pairid":"397","__text":"Treatment for PTSD involves talk therapy (counseling), medicines, or both. TALK THERAPY During talk therapy, you talk with a mental health professional, such as a psychiatrist or therapist, in a calm and accepting setting. They can help you manage your PTSD symptoms. They will also guide you as you work through your feelings about the trauma. There are many types of talk therapy. One type that is often used for PTSD is called desensitization. During therapy, you are encouraged to remember the traumatic event and express your feelings about it. Over time, memories of the event become less frightening. During talk therapy, you may also learn ways to relax, especially when you start to have flashbacks. MEDICINES Your provider may suggest that you take medicines. They can help ease your depression or anxiety. They can also help you sleep better. Medicines need time to work. Do not stop taking them or change the amount (dosage) you take without talking to your provider. Ask your provider about possible side effects and what to do if you experience them."}],"SUB_QUESTION_ID":"Q154-S1","ANNOTATIONS.FOCUS":["ptsd"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"I am trying to get specific citations for Treatment outcome for PTSD, especially reviews. When I tried to limit using advance search, the response was no finding, which I know is incorrect. Otherwise I get thousands of possibilities. Can you help me limit to that specific question?","QUESTION_ID":"Q154","F_REF":"12231"} -{"ANSWERS":[{"_answerid":"Q155-S1-A1","_pairid":"399","__text":"Treatment of breast papillomas often entails surgical duct excision for symptomatic relief and histopathological examination. Recently, more conservative approach has been adapted. MD-assisted microdochectomy should be considered the procedure of choice for a papilloma-related single duct discharge. Furthermore, there is increasing evidence that MD has the potential to reduce the number of duct excision procedures and minimise the extent of surgical resection. Imaging-guided vacuum-assisted core biopsy can be diagnostic and therapeutic for papillomas seen on mammography and\/or ultrasound. Patients with multiple papillomas do have an increased risk of developing cancer and should be kept under annual review with regular mammography (preferably digital mammography) if treated conservatively. Magnetic resonance (MR) can be also used in surveillance in view of its high sensitivity. Because the risk is small, long term and affects both breasts, long-term follow-up is more appropriate than prophylactic mastectomy. Patients who prove to have solitary duct papilloma have insufficient increase in the risk of subsequent malignancy to justify routine follow-up."}],"SUB_QUESTION_ID":"Q155-S1","ANNOTATIONS.FOCUS":["intraductal papilloma"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"intraductal papilloma","MESSAGE":"What if you do not have surgery to remove a papilloma?","QUESTION_ID":"Q155","F_REF":"NF_317"} -{"ANSWERS":[{"_answerid":"Q156-S1-A1","_pairid":"400","__text":"Obesity means having too much body fat. It is not the same as being overweight, which means weighing too much. A person may be overweight from extra muscle or water, as well as from having too much fat. Both terms mean that a person's weight is higher than what is thought to be healthy for his or her height."},{"_answerid":"Q156-S1-A2","_pairid":"401","__text":"Summary Obesity means having too much body fat. It is different from being overweight, which means weighing too much. The weight may come from muscle, bone, fat, and\/or body water. Both terms mean that a person's weight is greater than what's considered healthy for his or her height. Obesity occurs over time when you eat more calories than you use. The balance between calories-in and calories-out differs for each person. Factors that might affect your weight include your genetic makeup, overeating, eating high-fat foods, and not being physically active. Being obese increases your risk of diabetes, heart disease, stroke, arthritis, and some cancers. If you are obese, losing even 5 to 10 percent of your weight can delay or prevent some of these diseases. For example, that means losing 10 to 20 pounds if you weigh 200 pounds. NIH: National Institute of Diabetes and Digestive and Kidney Diseases"}],"SUB_QUESTION_ID":"Q156-S1","ANNOTATIONS.FOCUS":["obesity"],"ANNOTATIONS.TYPE":"information","SUBJECT":"ClinicalTrials.gov - Question - general information","MESSAGE":"I would like info on my obesity problem and if I can get help","QUESTION_ID":"Q156","F_REF":"1-136400675"} -{"ANSWERS":[{"_answerid":"Q156-S2-A1","_pairid":"402","__text":"CHANGING YOUR LIFESTYLE An active lifestyle and plenty of exercise, along with healthy eating, is the safest way to lose weight. Even modest weight loss can improve your health. You may need a lot of support from family and friends. Your main goal should be to learn new, healthy ways of eating and make them part of your daily routine. Many people find it hard to change their eating habits and behaviors. You may have practiced some habits for so long that you may not even know they are unhealthy, or you do them without thinking. You need to be motivated to make lifestyle changes. Make the behavior change part of your life over the long term. Know that it takes time to make and keep a change in your lifestyle. Work with your health care provider and dietitian to set realistic, safe daily calorie counts that help you lose weight while staying healthy. Remember that if you drop pounds slowly and steadily, you are more likely to keep them off. Your dietitian can teach you about: - Healthy food choices - Healthy snacks - Reading nutrition labels - New ways to prepare food - Portion sizes - Sweetened drinks Extreme diets (fewer than 1,100 calories per day) are not thought to be safe or to work very well. These types of diets often do not contain enough vitamins and minerals. Most people who lose weight this way return to overeating and become obese again. Learn ways to manage stress other than snacking. Examples may be meditation, yoga, or exercise. If you are depressed or stressed a lot, talk to your provider. MEDICINES AND HERBAL REMEDIES You may see ads for supplements and herbal remedies that claim they will help you lose weight. Some of these claims may not be true. And some of these supplements can have serious side effects. Talk to your provider before using them. You can discuss weight loss medicines with your doctor. Many people lose at least 5 pounds by taking these drugs, but they may regain the weight when they stop taking the medicine unless they have made lifestyle changes. SURGERY Bariatric (weight-loss) surgery can reduce the risk of certain diseases in people with severe obesity. These risks include: - Arthritis - Diabetes - Heart disease - High blood pressure - Sleep apnea - Some cancers - Stroke Surgery may help people who have been very obese for 5 years or more and have not lost weight from other treatments, such as diet, exercise, or medicine. Surgery alone is not the answer for weight loss. It can train you to eat less, but you still have to do much of the work. You must be committed to diet and exercise after surgery. Talk to your doctor to learn if surgery is a good option for you. Weight-loss surgeries include: - Laparoscopic gastric banding - Gastric bypass surgery - Sleeve gastrectomy (less common) - Duodenal switch"}],"SUB_QUESTION_ID":"Q156-S2","ANNOTATIONS.FOCUS":["obesity"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"ClinicalTrials.gov - Question - general information","MESSAGE":"I would like info on my obesity problem and if I can get help","QUESTION_ID":"Q156","F_REF":"1-136400675"} -{"ANSWERS":[{"_answerid":"Q157-S1-A1","_pairid":"403","__text":"Esophageal cancer is cancer that starts in the esophagus. This is the tube that moves food from the mouth to the stomach."},{"_answerid":"Q157-S1-A2","_pairid":"404","__text":"Summary The esophagus is a hollow tube that carries food and liquids from your throat to your stomach. Early esophageal cancer usually does not cause symptoms. Later, you may have symptoms such as - Painful or difficult swallowing - Weight loss - A hoarse voice or cough that doesn't go away You're at greater risk for getting esophageal cancer if you smoke, drink heavily, or have acid reflux. Your risk also goes up as you age Your doctor uses imaging tests and a biopsy to diagnose esophageal cancer. Treatments include surgery, radiation, and chemotherapy. You might also need nutritional support, since the cancer or treatment may make it hard to swallow. NIH: National Cancer Institute"},{"_answerid":"Q157-S1-A3","_pairid":"405","__text":"Esophageal cancer is a cancer of the esophagus, the hollow tube that carries food and liquids from the throat to the stomach. As the cancer grows, symptoms may include painful or difficult swallowing, weight loss and coughing up blood. The exact cause is usually not known, but both environmental and genetic factors are throught to play a role in the development of this condition. In the United States, risk factors for developing esophageal cancer include smoking, heavy drinking, obesity, and damage from acid reflux. Treatments include surgery, radiation, chemotherapy, and laser therapy. Some patients may also need nutritional support, since the cancer or treatment may make it hard to swallow."}],"SUB_QUESTION_ID":"Q157-S1","ANNOTATIONS.FOCUS":["cancer of the esophagus"],"ANNOTATIONS.TYPE":"information","SUBJECT":"Esophageal Cancer","MESSAGE":"I am looking for information about Cancer of the Esophagus and I'm not finding anything on your website.","QUESTION_ID":"Q157","F_REF":"1-135712015"} -{"ANSWERS":[{"_answerid":"Q158-S1-A1","_pairid":"406","__text":"MEDICINES Pubic lice are often treated with medicines that contain a substance called permethrin. To use this medicine: - Thoroughly work the medicine into your pubic hair and surrounding area. Leave it on for at least 5 to 10 minutes, or as directed by your health care provider. - Rinse well. - Comb your pubic hair with a fine-toothed comb to remove eggs (nits). Applying vinegar to pubic hair before combing may help loosen the nits. Most people need only 1 treatment. If a second treatment is needed, it should be done 4 days to 1 week later. Over-the-counter medicines to treat lice include Rid and Nix. Malathione lotion is another option. OTHER CARE While you are treating pubic lice: - Wash all clothing and bedding in hot water. - Spray items that cannot be washed with a medicated spray that you can buy at the store. You can also seal items in plastic bags for 10 to 14 days to smother the lice. - Makes sure anyone with whom you have had sexual contact or shared a bed is treated at the same time. People with pubic lice should be checked for other sexually-transmitted infections when lice are discovered."}],"SUB_QUESTION_ID":"Q158-S1","ANNOTATIONS.FOCUS":["pubic lice"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"pubic lice. What are some treatments for pubic lice","QUESTION_ID":"Q158","F_REF":"5228"} -{"ANSWERS":[{"_answerid":"Q159-S1-A1","_pairid":"407","__text":"Taking in more calories than your body burns can lead to obesity. This is because the body stores unused calories as fat. Obesity can be caused by: - Eating more food than your body can use - Drinking too much alcohol - Not getting enough exercise Many obese people who lose large amounts of weight and gain it back think it is their fault. They blame themselves for not having the willpower to keep the weight off. Many people regain more weight than they lost. Today, we know that biology is a big reason why some people cannot keep the weight off. Some people who live in the same place and eat the same foods become obese, while others do not. Our bodies have a complex system to keep our weight at a healthy level. In some people, this system does not work normally. The way we eat when we are children can affect the way we eat as adults. The way we eat over many years becomes a habit. It affects what we eat, when we eat, and how much we eat. We may feel that we are surrounded by things that make it easy to overeat and hard to stay active. - Many people feel they do not have time to plan and make healthy meals. - More people today work desk jobs compared to more active jobs in the past. - People with little free time may have less time to exercise. The term eating disorder means a group of medical conditions that have an unhealthy focus on eating, dieting, losing or gaining weight, and body image. A person may be obese, follow an unhealthy diet, and have an eating disorder all at the same time. Sometimes, medical problems or treatments cause weight gain, including: - Underactive thyroid (hypothyroidism) - Medicines such as birth control pills, antidepressants, and antipsychotics Other things that can cause weight gain are: - Quitting smoking. Many people who quit smoking gain 4 to 10 pounds in the first 6 months after quitting. - Stress, anxiety, feeling sad, or not sleeping well - Menopause. Women may gain 12 to 15 pounds during menopause. - Pregnancy. Women may not lose the weight they gained during pregnancy."}],"SUB_QUESTION_ID":"Q159-S1","ANNOTATIONS.FOCUS":["obesity"],"ANNOTATIONS.TYPE":"cause","SUBJECT":"Obesity Questions","MESSAGE":"Hello. My name is [NAME] and I am a junior in high school. I am currently doing a research topic on obesity and was wondering if you would be able to answer a few questions. It would be greatly appreciated if you could! Thank you! 1)What\/Who is to blame for obesity? 2)Do you think putting a tax on junk food will reduce the amount of obese people? Why or why not? 3)How can we prevent obesity? 4)What are the benefits of getting 30 minutes of exercise daily and eating healthy? 5)Should the government be more involved in the help to stop obesity? Why or why not? 6)What is the number one thing we should eat less of\/ cut out of our diets? (such as, fats, carbs, sugars,etc) Thank you for your time!","QUESTION_ID":"Q159","F_REF":"17757"} -{"ANSWERS":[{"_answerid":"Q159-S2-A1","_pairid":"408","__text":"CHANGING YOUR LIFESTYLE An active lifestyle and plenty of exercise, along with healthy eating, is the safest way to lose weight. Even modest weight loss can improve your health. You may need a lot of support from family and friends. Your main goal should be to learn new, healthy ways of eating and make them part of your daily routine. Many people find it hard to change their eating habits and behaviors. You may have practiced some habits for so long that you may not even know they are unhealthy, or you do them without thinking. You need to be motivated to make lifestyle changes. Make the behavior change part of your life over the long term. Know that it takes time to make and keep a change in your lifestyle. Work with your health care provider and dietitian to set realistic, safe daily calorie counts that help you lose weight while staying healthy. Remember that if you drop pounds slowly and steadily, you are more likely to keep them off. Your dietitian can teach you about: - Healthy food choices - Healthy snacks - Reading nutrition labels - New ways to prepare food - Portion sizes - Sweetened drinks Extreme diets (fewer than 1,100 calories per day) are not thought to be safe or to work very well. These types of diets often do not contain enough vitamins and minerals. Most people who lose weight this way return to overeating and become obese again. Learn ways to manage stress other than snacking. Examples may be meditation, yoga, or exercise. If you are depressed or stressed a lot, talk to your provider. MEDICINES AND HERBAL REMEDIES You may see ads for supplements and herbal remedies that claim they will help you lose weight. Some of these claims may not be true. And some of these supplements can have serious side effects. Talk to your provider before using them. You can discuss weight loss medicines with your doctor. Many people lose at least 5 pounds by taking these drugs, but they may regain the weight when they stop taking the medicine unless they have made lifestyle changes. SURGERY Bariatric (weight-loss) surgery can reduce the risk of certain diseases in people with severe obesity. These risks include: - Arthritis - Diabetes - Heart disease - High blood pressure - Sleep apnea - Some cancers - Stroke Surgery may help people who have been very obese for 5 years or more and have not lost weight from other treatments, such as diet, exercise, or medicine. Surgery alone is not the answer for weight loss. It can train you to eat less, but you still have to do much of the work. You must be committed to diet and exercise after surgery. Talk to your doctor to learn if surgery is a good option for you. Weight-loss surgeries include: - Laparoscopic gastric banding - Gastric bypass surgery - Sleeve gastrectomy (less common) - Duodenal switch"}],"SUB_QUESTION_ID":"Q159-S2","ANNOTATIONS.FOCUS":["obesity"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"Obesity Questions","MESSAGE":"Hello. My name is [NAME] and I am a junior in high school. I am currently doing a research topic on obesity and was wondering if you would be able to answer a few questions. It would be greatly appreciated if you could! Thank you! 1)What\/Who is to blame for obesity? 2)Do you think putting a tax on junk food will reduce the amount of obese people? Why or why not? 3)How can we prevent obesity? 4)What are the benefits of getting 30 minutes of exercise daily and eating healthy? 5)Should the government be more involved in the help to stop obesity? Why or why not? 6)What is the number one thing we should eat less of\/ cut out of our diets? (such as, fats, carbs, sugars,etc) Thank you for your time!","QUESTION_ID":"Q159","F_REF":"17757"} -{"ANSWERS":[{"_answerid":"Q160-S1-A1","_pairid":"411","__text":"Lynch syndrome is an inherited condition that causes an increased risk of developing cancer. Individuals with Lynch syndrome have a higher risk of developing colon and rectal cancer, as well as cancers of the stomach, small intestine, liver, gallbladder ducts, upper urinary tract, brain, skin, and prostate. Women with Lynch syndrome also have a high risk of developing uterine cancer (also called endometrial cancer) and ovarian cancer. Even though the disorder was originally described as not involving noncancerous (benign) growths (polyps) in the colon, people with Lynch syndrome may occasionally have colon polyps. Lynch syndrome has an autosomal dominant pattern of inheritance and is caused by a mutation in the MLH1, MSH2, MSH6, PMS2 or EPCAM gene."},{"_answerid":"Q160-S1-A2","_pairid":"412","__text":"Lynch syndrome, often called hereditary nonpolyposis colorectal cancer (HNPCC), is an inherited disorder that increases the risk of many types of cancer, particularly cancers of the colon (large intestine) and rectum, which are collectively referred to as colorectal cancer. People with Lynch syndrome also have an increased risk of cancers of the stomach, small intestine, liver, gallbladder ducts, upper urinary tract, brain, and skin. Additionally, women with this disorder have a high risk of cancer of the ovaries and lining of the uterus (the endometrium). People with Lynch syndrome may occasionally have noncancerous (benign) growths (polyps) in the colon, called colon polyps. In individuals with this disorder, colon polyps occur earlier but not in greater numbers than they do in the general population."}],"SUB_QUESTION_ID":"Q160-S1","ANNOTATIONS.FOCUS":["lynch syndrome"],"ANNOTATIONS.TYPE":"information","SUBJECT":"mailed information on Lynch syndrome","MESSAGE":"Please mail me information of Lynch Syndrome as I do not have a computer and my doctor has told me that I have this.","QUESTION_ID":"Q160","F_REF":"18019"} -{"ANSWERS":[{"_answerid":"Q161-S1-A1","_pairid":"419","__text":"Glaucoma is a group of eye conditions that can damage the optic nerve. This nerve sends the images you see to your brain. Most often, optic nerve damage is caused by increased pressure in the eye. This is called intraocular pressure. Watch this video about: Glaucoma"},{"_answerid":"Q161-S1-A2","_pairid":"420","__text":"Summary Glaucoma is a group of diseases that can damage the eye's optic nerve. It is a leading cause of blindness in the United States. It usually happens when the fluid pressure inside the eyes slowly rises, damaging the optic nerve. Often there are no symptoms at first. Without treatment, people with glaucoma will slowly lose their peripheral, or side vision. They seem to be looking through a tunnel. Over time, straight-ahead vision may decrease until no vision remains. A comprehensive eye exam can tell if you have glaucoma. People at risk should get eye exams at least every two years. They include - African Americans over age 40 - People over age 60, especially Mexican Americans - People with a family history of glaucoma There is no cure, but glaucoma can usually be controlled. Early treatment can help protect your eyes against vision loss. Treatments usually include prescription eyedrops and\/or surgery. NIH: National Eye Institute"},{"_answerid":"Q161-S1-A3","_pairid":"421","__text":"Glaucoma is a group of diseases that can damage the eye's optic nerve and result in vision loss and blindness. While glaucoma can strike anyone, the risk is much greater for people over 60. How Glaucoma Develops There are several different types of glaucoma. Most of these involve the drainage system within the eye. At the front of the eye there is a small space called the anterior chamber. A clear fluid flows through this chamber and bathes and nourishes the nearby tissues. (Watch the video to learn more about glaucoma. 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.) In glaucoma, for still unknown reasons, the fluid drains too slowly out of the eye. As the fluid builds up, the pressure inside the eye rises. Unless this pressure is controlled, it may cause damage to the optic nerve and other parts of the eye and result in loss of vision. Open-angle Glaucoma The most common type of glaucoma is called open-angle glaucoma. In the normal eye, the clear fluid leaves the anterior chamber at the open angle where the cornea and iris meet. When fluid reaches the angle, it flows through a spongy meshwork, like a drain, and leaves the eye. Sometimes, when the fluid reaches the angle, it passes too slowly through the meshwork drain, causing the pressure inside the eye to build. If the pressure damages the optic nerve, open-angle glaucoma -- and vision loss -- may result. There is no cure for glaucoma. Vision lost from the disease cannot be restored. However, there are treatments that may save remaining vision. That is why early diagnosis is important. See this graphic for a quick overview of glaucoma, including how many people it affects, who\u2019s at risk, what to do if you have it, and how to learn more. See a glossary of glaucoma terms."},{"_answerid":"Q161-S1-A4","_pairid":"422","__text":"Glaucoma is a group of diseases that can damage the eye's optic nerve and result in vision loss and blindness. The most common form of the disease is open-angle glaucoma. With early treatment, you can often protect your eyes against serious vision loss. (Watch the video to learn more about glaucoma. 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.) See this graphic for a quick overview of glaucoma, including how many people it affects, who\u2019s at risk, what to do if you have it, and how to learn more. See a glossary of glaucoma terms."},{"_answerid":"Q161-S1-A5","_pairid":"425","__text":"Through studies in the laboratory and with patients, the National Eye Institute is seeking better ways to detect, treat, and prevent vision loss in people with glaucoma. For example, researchers have discovered genes that could help explain how glaucoma damages the eye. NEI also is supporting studies to learn more about who is likely to get glaucoma, when to treat people who have increased eye pressure, and which treatment to use first."}],"SUB_QUESTION_ID":"Q161-S1","ANNOTATIONS.FOCUS":["glaucoma"],"ANNOTATIONS.TYPE":"information","SUBJECT":"Glaucoma","MESSAGE":"Can you mail me patient information about Glaucoma, I was recently diagnosed and want to learn all I can about the disease.","QUESTION_ID":"Q161","F_REF":"NF_231"} -{"ANSWERS":[{"_answerid":"Q162-S1-A1","_pairid":"427","__text":"Diagnosis is based on a review of a person's medical history, a physical examination, and laboratory tests. X-rays of the adrenal or pituitary glands can be useful in locating tumors."}],"SUB_QUESTION_ID":"Q162-S1","ANNOTATIONS.FOCUS":["cushing's syndrome"],"ANNOTATIONS.TYPE":"diagnosis","SUBJECT":"","MESSAGE":"EMAIL: [EMAIL] Hello - I suspect my son has Cushing's Syndrome. His recent U-Creatinine Excretion 24 hr urine test showed 21.6H nnol\/d. The lab range for normal is 7.0-17.0. I suspect this may be the result of muscle waste. Can you please tell me what this measure means in terms of the scale of the result - what does this difference represent and what can be expected as a result. Also how can we determine whether it is muscle waste that is the issue? Please help","QUESTION_ID":"Q162","F_REF":"10025"} -{"ANSWERS":[{"_answerid":"Q163-S1-A1","_pairid":"435","__text":"These resources address the diagnosis or management of spina bifida: - Benioff Children's Hospital, University of California, San Francisco: Treatment of Spina Bifida - Centers for Disease Control and Prevention: Living with Spina Bifida - GeneFacts: Spina Bifida: Diagnosis - GeneFacts: Spina Bifida: Management - Genetic Testing Registry: Neural tube defect - Genetic Testing Registry: Neural tube defects, folate-sensitive - Spina Bifida Association: Urologic Care and Management - University of California, San Francisco Fetal Treatment Center These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"},{"_answerid":"Q163-S1-A2","_pairid":"436","__text":"There is no cure for SB because the nerve tissue cannot be replaced or repaired. Treatment for the variety of effects of SB may include surgery, medication, and physiotherapy. Many individuals with SB will need assistive devices such as braces, crutches, or wheelchairs. Ongoing therapy, medical care, and\/or surgical treatments may be necessary to prevent and manage complications throughout the individual's life. Surgery to close the newborn's spinal opening is generally performed within 24 hours after birth to minimize the risk of infection and to preserve existing function in the spinal cord."}],"SUB_QUESTION_ID":"Q163-S1","ANNOTATIONS.FOCUS":["spina bifida"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"spina bifida; vertbral fusion;syrinx tethered cord. can u help for treatment of these problem","QUESTION_ID":"Q163","F_REF":"22"} -{"ANSWERS":[{"_answerid":"Q164-S1-A1","_pairid":"437","__text":"No treatment is necessary for Gilbert disease."},{"_answerid":"Q164-S1-A2","_pairid":"438","__text":"These resources address the diagnosis or management of Gilbert syndrome: - Genetic Testing Registry: Gilbert's syndrome These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"}],"SUB_QUESTION_ID":"Q164-S1","ANNOTATIONS.FOCUS":["gilberts disease"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"gilberts diseases","MESSAGE":"my name is [NAME]. 5days later i admitted in a hospital in treatment of viral fever.In hospital lot of tests blood,urine,ultrasound scan.In all tests my organs (lever,kidney,etc) are normal but my bilirubin Total is higher than normal. In my admission in hospital bilirubin is 3.2. Day by day my bilirubin decreased in the way of 2.8, 2.6, 2.4, 2.6, 2.5, respectevely. The other contents of blood and urine are normal at all. Hepatitis A,B,C are also negative.Today Bilirubin direct is 0.8. Doctor says it is Gilberts disease. Sir what can i do?. what is the reason for this?. what is your opinion sir? please reply soon .","QUESTION_ID":"Q164","F_REF":"1-136905355"} -{"ANSWERS":[{"_answerid":"Q164-S2-A1","_pairid":"439","__text":"An abnormal gene you inherit from your parents causes Gilbert's syndrome. The gene normally controls an enzyme that helps break down bilirubin in your liver. With an ineffective gene, excess amounts of bilirubin build in your blood. How the body normally processes bilirubin Bilirubin is a yellowish pigment made when your body breaks down old red blood cells. Bilirubin travels through your bloodstream to the liver, where normally an enzyme breaks down the bilirubin and removes it from the bloodstream. The bilirubin passes from the liver into the intestines with bile. It's then excreted in stool. A small amount of bilirubin remains in the blood. How the abnormal gene is passed through families The abnormal gene that causes Gilbert's syndrome is common. Many people carry one copy of this gene. In most cases, two abnormal copies are needed to cause Gilbert's syndrome."}],"SUB_QUESTION_ID":"Q164-S2","ANNOTATIONS.FOCUS":["gilberts disease"],"ANNOTATIONS.TYPE":"cause","SUBJECT":"gilberts diseases","MESSAGE":"my name is [NAME]. 5days later i admitted in a hospital in treatment of viral fever.In hospital lot of tests blood,urine,ultrasound scan.In all tests my organs (lever,kidney,etc) are normal but my bilirubin Total is higher than normal. In my admission in hospital bilirubin is 3.2. Day by day my bilirubin decreased in the way of 2.8, 2.6, 2.4, 2.6, 2.5, respectevely. The other contents of blood and urine are normal at all. Hepatitis A,B,C are also negative.Today Bilirubin direct is 0.8. Doctor says it is Gilberts disease. Sir what can i do?. what is the reason for this?. what is your opinion sir? please reply soon .","QUESTION_ID":"Q164","F_REF":"1-136905355"} -{"ANSWERS":[{"_answerid":"Q165-S1-A1","_pairid":"440","__text":"Treatment depends on the source of the problem, but may involve: - Injections of testosterone (in males) - Slow-release testosterone skin patch (in males) - Testosterone gels (in males) - Estrogen and progesterone pills or skin patches (in females) - GnRH injections"},{"_answerid":"Q165-S1-A2","_pairid":"441","__text":"Testosterone therapy may be prescribed. This can help: - Grow body hair - Improve appearance of muscles - Improve concentration - Improve mood and self esteem - Increase energy and sex drive - Increase strength Most men with this syndrome are not able to get a woman pregnant. But, an infertility specialist may be able to help. Seeing a doctor called an endocrinologist may also be helpful."},{"_answerid":"Q165-S1-A3","_pairid":"442","__text":"These resources address the diagnosis or management of Klinefelter syndrome: - Genetic Testing Registry: Klinefelter's syndrome, XXY - MedlinePlus Encyclopedia: Klinefelter Syndrome - MedlinePlus Encyclopedia: Testicular Failure These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"}],"SUB_QUESTION_ID":"Q165-S1","ANNOTATIONS.FOCUS":["klinefelter syndrome"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"ks","MESSAGE":"hi doctor my name is [NAME] m from [LOCATION] its almost a 2yrs i m not getting pregnant.. i have done few tests of my husband the sperm count is nil and i have done molecular biology karyotyping test and its a klinefelter syndrome. is dere any chance of getting pregnant? is dere any treatment for this ?please kindly help me.....if u need more details i would send u d reports( sir pls help me)","QUESTION_ID":"Q165","F_REF":"1-123737547"} -{"ANSWERS":[{"_answerid":"Q166-S1-A1","_pairid":"443","__text":"Treatment is based on many factors, including: - Type and stage of the cancer - Whether the cancer is sensitive to certain hormones - Whether the cancer overproduces (overexpresses) the HER2\/neu gene Cancer treatments may include: - Chemotherapy, which uses medicines to kill cancer cells. - Radiation therapy, which is used to destroy cancerous tissue. - Surgery to remove cancerous tissue: A lumpectomy removes the breast lump; mastectomy removes all or part of the breast and possibly nearby structures. - Targeted therapy uses medicine to attack the gene changes in cancer cells. Hormone therapy is an example of targeted therapy. It blocks certain hormones that fuel cancer growth. Cancer treatment can be local or systemic: - Local treatments involve only the area of disease. Radiation and surgery are forms of local treatment. They are most effective when the cancer has not spread outside the breast. - Systemic treatments affect the entire body. Chemotherapy and hormonal therapy are types of systemic treatment. Most women receive a combination of treatments. For women with stage I, II, or III breast cancer, the main goal is to treat the cancer and prevent it from returning (curing). For women with stage IV cancer, the goal is to improve symptoms and help them live longer. In most cases, stage IV breast cancer cannot be cured. - Stage 0 and ductal carcinoma -- Lumpectomy plus radiation or mastectomy is the standard treatment. - Stage I and II -- Lumpectomy plus radiation or mastectomy with lymph node removal is the standard treatment. Chemotherapy, hormonal therapy, and other targeted therapy may also be used after surgery. - Stage III -- Treatment involves surgery, possibly followed by chemotherapy, hormone therapy, and other targeted therapy. - Stage IV -- Treatment may involve surgery, radiation, chemotherapy, hormone therapy, other targeted therapy, or a combination of these treatments. After treatment, some women continue to take medicines for a time. All women continue to have blood tests, mammograms, and other tests after treatment. Women who have had a mastectomy may have reconstructive breast surgery. This will be done either at the time of mastectomy or later."},{"_answerid":"Q166-S1-A2","_pairid":"444","__text":"These resources address the diagnosis or management of breast cancer: - Gene Review: Gene Review: BRCA1 and BRCA2 Hereditary Breast\/Ovarian Cancer - Gene Review: Gene Review: Hereditary Diffuse Gastric Cancer - Gene Review: Gene Review: Li-Fraumeni Syndrome - Gene Review: Gene Review: PTEN Hamartoma Tumor Syndrome (PHTS) - Gene Review: Gene Review: Peutz-Jeghers Syndrome - Genetic Testing Registry: Familial cancer of breast - Genomics Education Programme (UK): Hereditary Breast and Ovarian Cancer - National Cancer Institute: Breast Cancer Risk Assessment Tool - National Cancer Institute: Genetic Testing for BRCA1 and BRCA2: It's Your Choice - National Cancer Institute: Genetic Testing for Hereditary Cancer Syndromes These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"},{"_answerid":"Q166-S1-A3","_pairid":"445","__text":"There are many treatment options for women with breast cancer. The choice of treatment depends on your age and general health, the stage of the cancer, whether or not it has spread beyond the breast, 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 People with cancer often are treated by a team of specialists. 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. (Watch the video about this breast cancer survivor's treatment. 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.) Clinical Trials for Breast Cancer Some breast cancer patients take part in studies of new treatments. These studies, called clinical trials, are designed to find out whether a new treatment is both safe and effective. Often, clinical trials compare a new treatment with a standard one so that doctors can learn which is more effective. Women with breast cancer who are interested in taking part in a clinical trial should talk to 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. See a list of the current clinical trials on breast cancer."},{"_answerid":"Q166-S1-A4","_pairid":"446","__text":"There are a number of treatments for breast cancer, but the ones women choose most often -- alone or in combination -- are surgery, hormone therapy, radiation therapy, and chemotherapy. What Standard Treatments Do Here is what the standard cancer treatments are designed to do. - Surgery takes out the cancer and some surrounding tissue. - Hormone therapy keeps cancer cells from getting most of the hormones they need to survive and grow. - Radiation therapy uses high-energy beams to kill cancer cells and shrink tumors and some surrounding tissue. - Chemotherapy uses anti-cancer drugs to kill most cancer cells. Surgery takes out the cancer and some surrounding tissue. Hormone therapy keeps cancer cells from getting most of the hormones they need to survive and grow. Radiation therapy uses high-energy beams to kill cancer cells and shrink tumors and some surrounding tissue. Chemotherapy uses anti-cancer drugs to kill most cancer cells. Treatment for breast cancer may involve local or whole body therapy. Doctors use local therapies, such as surgery or radiation, to remove or destroy breast cancer in a specific area. Whole body, or systemic, treatments like chemotherapy, hormonal, or biological therapies are used to destroy or control cancer throughout the body. Some patients have both kinds of treatment. Treating Early-Stage Breast Cancer If you have early-stage breast cancer, one common treatment available to you is a lumpectomy combined with radiation therapy. A lumpectomy is surgery that preserves a woman's breast. In a lumpectomy, the surgeon removes only the tumor and a small amount of the surrounding tissue. The survival rate for a woman who has this therapy plus radiation is similar to that for a woman who chooses a radical mastectomy, which is complete removal of a breast. If Cancer Has Spread Locally If you have breast cancer that has spread locally -- just to other parts of the breast -- your treatment may involve a combination of chemotherapy and surgery. Doctors usually first shrink the tumor with chemotherapy and then remove it through surgery. Shrinking the tumor before surgery may allow a woman to avoid a mastectomy and keep her breast. In the past, doctors would remove a lot of lymph nodes near breast tumors to see if the cancer had spread. Some doctors also use a method called sentinel node biopsy. Using a dye or radioactive tracer, surgeons locate the first or sentinel lymph node closest to the tumor, and remove only that node to see if the cancer has spread. If Cancer Has Spread Beyond the Breast If the breast cancer has spread to other parts of the body, such as the lung or bone, you might receive chemotherapy and\/or hormonal therapy to destroy cancer cells and control the disease. Radiation therapy may also be useful to control tumors in other parts of the body. Get more information about treatment options for breast cancer and for recurrent breast cancer."},{"_answerid":"Q166-S1-A5","_pairid":"449","__text":"Standard treatments for breast cancer include - surgery that takes out the cancer and some surrounding tissue - radiation therapy that uses high-energy beams to kill cancer cells and shrink tumors and some surrounding tissue. - chemotherapy that uses anti-cancer drugs to kill cancer most cells - hormone therapy that keeps cancer cells from getting most of the hormones they need to survive and grow. surgery that takes out the cancer and some surrounding tissue radiation therapy that uses high-energy beams to kill cancer cells and shrink tumors and some surrounding tissue. chemotherapy that uses anti-cancer drugs to kill cancer most cells hormone therapy that keeps cancer cells from getting most of the hormones they need to survive and grow. (Watch the video to learn about one breast cancer survivor's story. 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.)"},{"_answerid":"Q166-S1-A6","_pairid":"450","__text":"Even if the surgeon removes all of the cancer that can be seen at the time of surgery, a woman may still receive follow-up treatment. This may include radiation therapy, chemotherapy, or hormone therapy to try to kill any cancer cells that may be left. Treatment that a patient receives after surgery to increase the chances of a cure is called adjuvant therapy."},{"_answerid":"Q166-S1-A7","_pairid":"451","__text":"Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells and shrink tumors. This therapy often follows a lumpectomy, and is sometimes used after mastectomy. During radiation therapy, a machine outside the body sends high-energy beams to kill the cancer cells that may still be present in the affected breast or in nearby lymph nodes. Doctors sometimes use radiation therapy along with chemotherapy, or before or instead of surgery."},{"_answerid":"Q166-S1-A8","_pairid":"452","__text":"Chemotherapy is the use of drugs to kill cancer cells. A patient may take chemotherapy by mouth in pill form, or it may be put into the body by inserting a needle into a vein or muscle. Chemotherapy is called whole body or systemic treatment if the drug(s) enter the bloodstream, travel through the body, and kill cancer cells throughout the body. Treatment with standard chemotherapy can be as short as two months or as long as two years. Targeted therapies, usually in pill form, have become more common and focus on either a gene or protein abnormality and usually have few adverse side-effects as they directly affect the abnormality and not other cells or tissues in the body. Sometimes chemotherapy is the only treatment the doctor will recommend. More often, however, chemotherapy is used in addition to surgery, radiation therapy, and\/or biological therapy."},{"_answerid":"Q166-S1-A9","_pairid":"453","__text":"Hormonal therapy keeps cancer cells from getting the hormones they need to grow. This treatment may include the use of drugs that change the way hormones work. Sometimes it includes surgery to remove the ovaries, which make female hormones. Like chemotherapy, hormonal therapy can affect cancer cells throughout the body. Often, women with early-stage breast cancer and those with metastatic breast cancer -- meaning cancer that has spread to other parts of the body -- receive hormone therapy in the form of tamoxifen. Hormone therapy with tamoxifen or estrogens can act on cells all over the body. However, it may increase the chance of developing endometrial cancer. If you take tamoxifen, you should have a pelvic examination every year to look for any signs of cancer. A woman should report any vaginal bleeding, other than menstrual bleeding, to her doctor as soon as possible."},{"_answerid":"Q166-S1-A10","_pairid":"454","__text":"Certain drugs that have been used successfully in other cancers are now being used to treat some breast cancers. A mix of drugs may increase the length of time you will live, or the length of time you will live without cancer. In addition, certain drugs like Herceptin\u00ae and Tykerb\u00ae taken in combination with chemotherapy, can help women with specific genetic breast cancer mutations better than chemotherapy alone."}],"SUB_QUESTION_ID":"Q166-S1","ANNOTATIONS.FOCUS":["breast cancer"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"Breast cancer at 84. My mother was just diagnost with breast cancer. She is 84 years old, her tumor started in the milk duct and is small in size, their is a mass as well in the same breast. He is scheduled for a lumpectomy to remove both. Because of age we would like suggestions on treatment options after surgery.","QUESTION_ID":"Q166","F_REF":"10475"} -{"ANSWERS":[{"_answerid":"Q167-S1-A1","_pairid":"455","__text":"Polymicrogyria is a condition characterized by abnormal development of the brain before birth. The surface of the brain normally has many ridges or folds, called gyri. In people with polymicrogyria, the brain develops too many folds, and the folds are unusually small. The name of this condition literally means too many (poly-) small (micro-) folds (-gyria) in the surface of the brain. Polymicrogyria can affect part of the brain or the whole brain. When the condition affects one side of the brain, researchers describe it as unilateral. When it affects both sides of the brain, it is described as bilateral. The signs and symptoms associated with polymicrogyria depend on how much of the brain, and which particular brain regions, are affected. Researchers have identified multiple forms of polymicrogyria. The mildest form is known as unilateral focal polymicrogyria. This form of the condition affects a relatively small area on one side of the brain. It may cause minor neurological problems, such as mild seizures that can be easily controlled with medication. Some people with unilateral focal polymicrogyria do not have any problems associated with the condition. Bilateral forms of polymicrogyria tend to cause more severe neurological problems. Signs and symptoms of these conditions can include recurrent seizures (epilepsy), delayed development, crossed eyes, problems with speech and swallowing, and muscle weakness or paralysis. The most severe form of the disorder, bilateral generalized polymicrogyria, affects the entire brain. This condition causes severe intellectual disability, problems with movement, and seizures that are difficult or impossible to control with medication. Polymicrogyria most often occurs as an isolated feature, although it can occur with other brain abnormalities. It is also a feature of several genetic syndromes characterized by intellectual disability and multiple birth defects. These include 22q11.2 deletion syndrome, Adams-Oliver syndrome, Aicardi syndrome, Galloway-Mowat syndrome, Joubert syndrome, and Zellweger spectrum disorder."}],"SUB_QUESTION_ID":"Q167-S1","ANNOTATIONS.FOCUS":["polymicrogyria"],"ANNOTATIONS.TYPE":"information","SUBJECT":"","MESSAGE":"polymicrogyria. My 16 month old son has this. Does not sit up our crawl yet but still trying and is improving in grabbing things etc etc. Have read about other cases that seem 10000 time worse. It's it possible for this post of his brain to grown to normal and he grow out of it?","QUESTION_ID":"Q167","F_REF":"87"} -{"ANSWERS":[{"_answerid":"Q167-S2-A1","_pairid":"456","__text":"Researchers have identified multiple forms of polymicrogyria. The mildest form is known as unilateral focal polymicrogyria. This form of the condition affects a relatively small area on one side of the brain. It may cause minor neurological problems, such as mild seizures that can be easily controlled with medication. Some people with unilateral focal polymicrogyria do not have any problems associated with the condition. Bilateral forms of polymicrogyria tend to cause more severe neurological problems. Signs and symptoms of these conditions can include recurrent seizures (epilepsy), delayed development, crossed eyes, problems with speech and swallowing, and muscle weakness or paralysis. The most severe form of the disorder, bilateral generalized polymicrogyria, affects the entire brain. This condition causes severe intellectual disability, problems with movement, and seizures that are difficult or impossible to control with medication."}],"SUB_QUESTION_ID":"Q167-S2","ANNOTATIONS.FOCUS":["polymicrogyria"],"ANNOTATIONS.TYPE":"prognosis","SUBJECT":"","MESSAGE":"polymicrogyria. My 16 month old son has this. Does not sit up our crawl yet but still trying and is improving in grabbing things etc etc. Have read about other cases that seem 10000 time worse. It's it possible for this post of his brain to grown to normal and he grow out of it?","QUESTION_ID":"Q167","F_REF":"87"} -{"ANSWERS":[{"_answerid":"Q168-S1-A1","_pairid":"457","__text":"Sudden infant death syndrome (SIDS) is the unexpected, sudden death of a child under age 1. An autopsy does not show an explainable cause of death."},{"_answerid":"Q168-S1-A2","_pairid":"458","__text":"Summary Sudden infant death syndrome (SIDS) is the sudden, unexplained death of an infant younger than one year old. Some people call SIDS \"crib death\" because many babies who die of SIDS are found in their cribs. SIDS is the leading cause of death in children between one month and one year old. Most SIDS deaths occur when babies are between two months and four months old. Premature babies, boys, African Americans, and American Indian\/Alaska Native infants have a higher risk of SIDS. Although health care professionals don't know what causes SIDS, they do know ways to reduce the risk. These include - Placing babies on their backs to sleep, even for short naps. \"Tummy time\" is for when babies are awake and someone is watching - Using a firm sleep surface, such as a crib mattress covered with a fitted sheet - Keeping soft objects and loose bedding away from sleep area - Making sure babies don't get too hot. Keep the room at a comfortable temperature for an adult. - Don't smoke during pregnancy or allow anyone to smoke near your baby NIH: National Institute of Child Health and Human Development"}],"SUB_QUESTION_ID":"Q168-S1","ANNOTATIONS.FOCUS":["sids"],"ANNOTATIONS.TYPE":"information","SUBJECT":"","MESSAGE":"Hello, my name is [NAME] and i am a student at [LOCATION] here in [LOCATION]. I am composing a research report on SIDS and i was hoping you could help me with some information. I was particularly interested in learning weather parents should be worried about cribs death and if you could direct me to some resources on that, or even allow me to interview you. Thank you for your time. If you have anything else that might help me, i would really appreciate it. You can email me at [CONTACT] or contact me by my phone at [CONTACT]. Thanks again.","QUESTION_ID":"Q168","F_REF":"16734"} -{"ANSWERS":[{"_answerid":"Q169-S1-A1","_pairid":"459","__text":"Surgery is the only treatment that can permanently fix a hernia. Surgery may be more risky for people with serious medical problems. Surgery repairs the weakened abdominal wall tissue (fascia) and closes any holes. Most hernias are closed with stitches and sometimes with mesh patches to plug the hole. An umbilical hernia that does not heal on its own by the time a child is 5 years old will likely be repaired."}],"SUB_QUESTION_ID":"Q169-S1","ANNOTATIONS.FOCUS":["hernia"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"EMAIL: [EMAIL] I have an hernia I would love to take care off it ASAP I was wondering if you guys could help me . Thanks","QUESTION_ID":"Q169","F_REF":"12051"} -{"ANSWERS":[{"_answerid":"Q170-S1-A1","_pairid":"460","__text":"Most pregnant teenage girls did not plan to get pregnant. If you are a pregnant teen, it is very important to get health care during your pregnancy. Know that there are extra health risks for both you and your baby."},{"_answerid":"Q170-S1-A2","_pairid":"461","__text":"Summary Most teenage girls don't plan to get pregnant, but many do. Teen pregnancies carry extra health risks to both the mother and the baby. Often, teens don't get prenatal care soon enough, which can lead to problems later on. They have a higher risk for pregnancy-related high blood pressure and its complications. Risks for the baby include premature birth and a low birth weight. If you're a pregnant teen, you can help yourself and your baby by - Getting regular prenatal care - Taking your prenatal vitamins for your health and to prevent some birth defects - Avoiding smoking, alcohol, and drugs - Using a condom, if you are having sex, to prevent sexually transmitted diseases that could hurt your baby"}],"SUB_QUESTION_ID":"Q170-S1","ANNOTATIONS.FOCUS":["teen pregnancy"],"ANNOTATIONS.TYPE":"information","SUBJECT":"Teen pregnancy","MESSAGE":"Good morning, I am a student from Carver Military Academy on the far south side of Chicago. My fellow classmates and I are conducting a research project on social issues and problems we are affected by everyday mine is Teen Pregnancy. Since I am a teenager I know how having a child can really affect our young lives. They can stop our achievements in school, goals for the future,all our fun would stop,and our dreams. I would like to ask someone from your organization a few questions because it seems as though your organization could provide me with valuable information about teen pregnancy,statistics,facts, and your opinion about it. Your time and assistance would be greatly appreciated and I hope to hear from you soon. Thank you, [NAME]","QUESTION_ID":"Q170","F_REF":"13614"} -{"ANSWERS":[{"_answerid":"Q171-S1-A1","_pairid":"462","__text":"There are two major types of stroke: - Ischemic stroke - Hemorrhagic stroke Ischemic stroke occurs when a blood vessel that supplies blood to the brain is blocked by a blood clot. This may happen in two ways: - A clot may form in an artery that is already very narrow. This is called a thrombotic stroke. - A clot may break off from another place in the blood vessels of the brain, or from some other part of the body, and travel up to the brain. This is called cerebral embolism, or an embolic stroke. Ischemic strokes may also be caused by a sticky substance called plaque that can clog arteries. Watch this video about: Stroke Watch this video about: Stroke - secondary to cardiogenic embolism A hemorrhagic stroke occurs when a blood vessel in part of the brain becomes weak and bursts open. This causes blood to leak into the brain. Some people have defects in the blood vessels of the brain that make this more likely. These defects may include: - Aneurysm - Arteriovenous malformation (AVM) Hemorrhagic strokes may also occur when someone is taking blood thinners, such as warfarin (Coumadin). Very high blood pressure may cause blood vessels to burst, leading to hemorrhagic stroke. An ischemic stroke can develop bleeding and become a hemorrhagic stroke. High blood pressure is the main risk factor for strokes. Other major risk factors are: - Irregular heartbeat, called atrial fibrillation - Diabetes - Family history of stroke - High cholesterol - Increasing age, especially after age 55 - Ethnicity (African Americans are more likely to die of a stroke) Watch this video about: Hypertension - overview Stroke risk is also higher in: - People who have heart disease or poor blood flow in their legs caused by narrowed arteries - People who have unhealthy lifestyle habits such as smoking, a high-fat diet, and lack of exercise - Women who take birth control pills (especially those who smoke and are older than 35) - Women who are pregnant have an increased risk while pregnant - Women who take hormone replacement therapy"}],"SUB_QUESTION_ID":"Q171-S1","ANNOTATIONS.FOCUS":["stroke"],"ANNOTATIONS.TYPE":"cause","SUBJECT":"Stroke Due to Aneurysm?","MESSAGE":"My son had a hemmorhagic stroke at 4 weeks of age....he is now 31 years old. In the week leading up to the stroke he had a head cold and I had been giving him infant cold drops. After he had the stroke the doctors at the time could only say that it was a 'fluke' and would probably never happen again. The reason for the stroke has haunted me ever since. Now we just recently found out that my mother has a cerebral aneurysm and they say this can be hereditary. So my question now is 'did my son have an aneurysm that burst or was it caused by a blood clot?...is there anyway of knowing or getting an answer to that question after the event has happened?","QUESTION_ID":"Q171","F_REF":"1-134591345"} -{"ANSWERS":[{"_answerid":"Q172-S1-A1","_pairid":"463","__text":"These resources address the diagnosis or management of Meesmann corneal dystrophy: - Genetic Testing Registry: Meesman's corneal dystrophy - Merck Manual Home Health Handbook: Tests for Eye Disorders: The Eye Examination These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"}],"SUB_QUESTION_ID":"Q172-S1","ANNOTATIONS.FOCUS":["meesmann corneal dystrophy"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"seeking help for a loved one","MESSAGE":"Hello I am seeking help for my partner. He has Meesmann Corneal Dystrophy. He has had this condition since birth but was not diagnosed until he was 28. He has had epithelial debriding and laser keratectomy. He has used many different drops and has also tried contact lenses. Each treatment has been unsuccessful and his symptoms are getting worse. He has excruciating pain during flair ups as well as photosensitivity and compromised vision. We have children and he can not work because of his condition. Any help or information you can give us is greatly appreciated. Thank you [NAME]","QUESTION_ID":"Q172","F_REF":"1-135810627"} -{"ANSWERS":[{"_answerid":"Q172-S2-A1","_pairid":"464","__text":"Meesmann corneal dystrophy is an eye disease that affects the cornea, which is the clear front covering of the eye. This condition is characterized by the formation of tiny round cysts in the outermost layer of the cornea, called the corneal epithelium. This part of the cornea acts as a barrier to help prevent foreign materials, such as dust and bacteria, from entering the eye. In people with Meesmann corneal dystrophy, cysts can appear as early as the first year of life. They usually affect both eyes and increase in number over time. The cysts usually do not cause any symptoms until late adolescence or adulthood, when they start to break open (rupture) on the surface of the cornea and cause irritation. The resulting symptoms typically include increased sensitivity to light (photophobia), twitching of the eyelids (blepharospasm), increased tear production, the sensation of having a foreign object in the eye, and an inability to tolerate wearing contact lenses. Some affected individuals also have temporary episodes of blurred vision."}],"SUB_QUESTION_ID":"Q172-S2","ANNOTATIONS.FOCUS":["meesmann corneal dystrophy"],"ANNOTATIONS.TYPE":"information","SUBJECT":"seeking help for a loved one","MESSAGE":"Hello I am seeking help for my partner. He has Meesmann Corneal Dystrophy. He has had this condition since birth but was not diagnosed until he was 28. He has had epithelial debriding and laser keratectomy. He has used many different drops and has also tried contact lenses. Each treatment has been unsuccessful and his symptoms are getting worse. He has excruciating pain during flair ups as well as photosensitivity and compromised vision. We have children and he can not work because of his condition. Any help or information you can give us is greatly appreciated. Thank you [NAME]","QUESTION_ID":"Q172","F_REF":"1-135810627"} -{"ANSWERS":[{"_answerid":"Q173-S1-A1","_pairid":"465","__text":"Ovarian cancer is rarely diagnosed in its early stages. It is usually quite advanced by the time diagnosis is made: - 3 of 4 women with ovarian cancer survive 1 year after diagnosis - Nearly half of women live longer than 5 years after diagnosis - If diagnosis is made early in the disease and treatment is received before the cancer spreads outside the ovary, the 5-year survival rate is high"}],"SUB_QUESTION_ID":"Q173-S1","ANNOTATIONS.FOCUS":["ovarian cancer"],"ANNOTATIONS.TYPE":"prognosis","SUBJECT":"High Intensity Focused Ultrasound","MESSAGE":"Have any follow ups on women with ovarian cancer taken place?","QUESTION_ID":"Q173","F_REF":"14557"} -{"ANSWERS":[{"_answerid":"Q174-S1-A1","_pairid":"466","__text":"Summary Pneumonia is an infection in one or both of the lungs. Many germs, such as bacteria, viruses, and fungi, can cause pneumonia. You can also get pneumonia by inhaling a liquid or chemical. People most at risk are older than 65 or younger than 2 years of age, or already have health problems. Symptoms of pneumonia vary from mild to severe. See your doctor promptly if you - Have a high fever - Have shaking chills - Have a cough with phlegm that doesn't improve or gets worse - Develop shortness of breath with normal daily activities - Have chest pain when you breathe or cough - Feel suddenly worse after a cold or the flu Your doctor will use your medical history, a physical exam, and lab tests to diagnose pneumonia. Treatment depends on what kind you have. If bacteria are the cause, antibiotics should help. If you have viral pneumonia, your doctor may prescribe an antiviral medicine to treat it. Preventing pneumonia is always better than treating it. Vaccines are available to prevent pneumococcal pneumonia and the flu. Other preventive measures include washing your hands frequently and not smoking. NIH: National Heart, Lung, and Blood Institute"},{"_answerid":"Q174-S1-A2","_pairid":"467","__text":"Pneumonia (nu-MO-ne-ah) is an infection in one or both of the lungs. Many germs\u2014such as bacteria, viruses, and fungi\u2014can cause pneumonia. The infection inflames your lungs' air sacs, which are called alveoli (al-VEE-uhl-eye). The air sacs may fill up with fluid or pus, causing symptoms such as a cough with phlegm (a slimy substance), fever, chills, and trouble breathing. Overview Pneumonia and its symptoms can vary from mild to severe. Many factors affect how serious pneumonia is, such as the type of germ causing the infection and your age and overall health. Pneumonia tends to be more serious for: Infants and young children. Older adults (people 65 years or older). People who have other health problems, such as heart failure, diabetes, or COPD (chronic obstructive pulmonary disease). People who have weak immune systems as a result of diseases or other factors. Examples of these diseases and factors include HIV\/AIDS, chemotherapy (a treatment for cancer), and an organ transplant or blood and marrow stem cell transplant. Outlook Pneumonia is common in the United States. Treatment for pneumonia depends on its cause, how severe your symptoms are, and your age and overall health. Many people can be treated at home, often with oral antibiotics. Children usually start to feel better in 1 to 2 days. For adults, it usually takes 2 to 3 days. Anyone who has worsening symptoms should see a doctor. People who have severe symptoms or underlying health problems may need treatment in a hospital. It may take 3 weeks or more before they can go back to their normal routines. Fatigue (tiredness) from pneumonia can last for a month or more."}],"SUB_QUESTION_ID":"Q174-S1","ANNOTATIONS.FOCUS":["pneumonia"],"ANNOTATIONS.TYPE":"information","SUBJECT":"CURE FOR PNEUMONIA","MESSAGE":"Dear DR, please i have a friend that has the above illness..I want to find out...since i want to marry her...is it an infectious illness,,and can it be totally cured. And how can i help her to get this cured..Please i really need your reply urgently","QUESTION_ID":"Q174","F_REF":"1-123968715"} -{"ANSWERS":[{"_answerid":"Q174-S2-A1","_pairid":"468","__text":"Treatment for pneumonia depends on the type of pneumonia you have and how severe it is. Most people who have community-acquired pneumonia\u2014the most common type of pneumonia\u2014are treated at home. The goals of treatment are to cure the infection and prevent complications. General Treatment If you have pneumonia, follow your treatment plan, take all medicines as prescribed, and get ongoing medical care. Ask your doctor when you should schedule followup care. Your doctor may want you to have a chest x ray to make sure the pneumonia is gone. Although you may start feeling better after a few days or weeks, fatigue (tiredness) can persist for up to a month or more. People who are treated in the hospital may need at least 3 weeks before they can go back to their normal routines. Bacterial Pneumonia Bacterial pneumonia is treated with medicines called antibiotics. You should take antibiotics as your doctor prescribes. You may start to feel better before you finish the medicine, but you should continue taking it as prescribed. If you stop too soon, the pneumonia may come back. Most people begin to improve after 1 to 3 days of antibiotic treatment. This means that they should feel better and have fewer symptoms, such as cough and fever. Viral Pneumonia Antibiotics don't work when the cause of pneumonia is a virus. If you have viral pneumonia, your doctor may prescribe an antiviral medicine to treat it. Viral pneumonia usually improves in 1 to 3 weeks. Treating Severe Symptoms You may need to be treated in a hospital if: Your symptoms are severe You're at risk for complications because of other health problems If the level of oxygen in your bloodstream is low, you may receive oxygen therapy. If you have bacterial pneumonia, your doctor may give you antibiotics through an intravenous (IV) line inserted into a vein."},{"_answerid":"Q174-S2-A2","_pairid":"469","__text":"Treatment for pneumonia depends on the type of pneumonia you have and how severe it is. Most people who have community-acquired pneumonia\u2014the most common type of pneumonia\u2014are treated at home. The goals of treatment are to cure the infection and prevent complications. General Treatment If you have pneumonia, follow your treatment plan, take all medicines as prescribed, and get ongoing medical care. Ask your doctor when you should schedule followup care. Your doctor may want you to have a chest x ray to make sure the pneumonia is gone. Although you may start feeling better after a few days or weeks, fatigue (tiredness) can persist for up to a month or more. People who are treated in the hospital may need at least 3 weeks before they can go back to their normal routines. Bacterial Pneumonia Bacterial pneumonia is treated with medicines called antibiotics. You should take antibiotics as your doctor prescribes. You may start to feel better before you finish the medicine, but you should continue taking it as prescribed. If you stop too soon, the pneumonia may come back. Most people begin to improve after 1 to 3 days of antibiotic treatment. This means that they should feel better and have fewer symptoms, such as cough and fever. Viral Pneumonia Antibiotics don't work when the cause of pneumonia is a virus. If you have viral pneumonia, your doctor may prescribe an antiviral medicine to treat it. Viral pneumonia usually improves in 1 to 3 weeks. Treating Severe Symptoms You may need to be treated in a hospital if: Your symptoms are severe You're at risk for complications because of other health problems If the level of oxygen in your bloodstream is low, you may receive oxygen therapy. If you have bacterial pneumonia, your doctor may give you antibiotics through an intravenous (IV) line inserted into a vein."}],"SUB_QUESTION_ID":"Q174-S2","ANNOTATIONS.FOCUS":["pneumonia"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"CURE FOR PNEUMONIA","MESSAGE":"Dear DR, please i have a friend that has the above illness..I want to find out...since i want to marry her...is it an infectious illness,,and can it be totally cured. And how can i help her to get this cured..Please i really need your reply urgently","QUESTION_ID":"Q174","F_REF":"1-123968715"} -{"ANSWERS":[{"_answerid":"Q175-S1-A1","_pairid":"470","__text":"Most low back pain can be treated without surgery. Treatment involves using over-the-counter pain relievers to reduce discomfort and anti-inflammatory drugs to reduce inflammation. The goal of treatment is to restore proper function and strength to the back, and prevent recurrence of the injury. Medications are often used to treat acute and chronic low back pain. Effective pain relief may involve a combination of prescription drugs and over-the-counter remedies. Although the use of cold and hot compresses has never been scientifically proven to quickly resolve low back injury, compresses may help reduce pain and inflammation and allow greater mobility for some individuals. Bed rest is recommended for only 1\u20132 days at most. Individuals should resume activities as soon as possible. Exercise may be the most effective way to speed recovery from low back pain and help strengthen back and abdominal muscles. In the most serious cases, when the condition does not respond to other therapies, surgery may relieve pain caused by back problems or serious musculoskeletal injuries."}],"SUB_QUESTION_ID":"Q175-S1","ANNOTATIONS.FOCUS":["back pain"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"help","MESSAGE":"I have back pain. Please help.","QUESTION_ID":"Q175","F_REF":"18410"} -{"ANSWERS":[{"_answerid":"Q176-S1-A1","_pairid":"471","__text":"Rubella is most often a mild infection. After an infection, people have immunity to the disease for the rest of their lives."}],"SUB_QUESTION_ID":"Q176-S1","ANNOTATIONS.FOCUS":["rubella"],"ANNOTATIONS.TYPE":"prognosis","SUBJECT":"Rubella","MESSAGE":"My grandson (4 yrs old) has contracted Rubella. I know for sure he has had at least one of the vaccines. They are living in Mexico right now. Should we be worried?","QUESTION_ID":"Q176","F_REF":"12233"} -{"ANSWERS":[{"_answerid":"Q177-S1-A1","_pairid":"472","__text":"How well a person does after a stroke depends on: - The type of stroke - How much brain tissue is damaged - What body functions have been affected - How quickly treatment is given Problems moving, thinking, and talking often improve in the weeks to months after a stroke. Many people who have had a stroke will keep improving in the months or years after their stroke. Over half of people who have a stroke are able to function and live at home. Others are not able to care for themselves. If treatment with clot-busting drugs is successful, the symptoms of a stroke may go away. However, patients often do not get to the hospital soon enough to receive these drugs, or they can't take these drugs because of a health condition. People who have a stroke from a blood clot (ischemic stroke) have a better chance of surviving than those who have a stroke from bleeding in the brain (hemorrhagic stroke). The risk for a second stroke is highest during the weeks or months after the first stroke. The risk begins to decrease after this period."},{"_answerid":"Q177-S1-A2","_pairid":"473","__text":"Although stroke is a disease of the brain, it can affect the entire body. A common disability that results from stroke is complete paralysis on one side of the body, called hemiplegia. A related disability that is not as debilitating as paralysis is one-sided weakness or hemiparesis. Stroke may cause problems with thinking, awareness, attention, learning, judgment, and memory. Stroke survivors often have problems understanding or forming speech. A stroke can lead to emotional problems. Stroke patients may have difficulty controlling their emotions or may express inappropriate emotions. Many stroke patients experience depression. Stroke survivors may also have numbness or strange sensations. The pain is often worse in the hands and feet and is made worse by movement and temperature changes, especially cold temperatures. Recurrent stroke is frequent; about 25 percent of people who recover from their first stroke will have another stroke within 5 years."}],"SUB_QUESTION_ID":"Q177-S1","ANNOTATIONS.FOCUS":["stroke"],"ANNOTATIONS.TYPE":"prognosis","SUBJECT":"recovery after stroke?","MESSAGE":"what is the pattern of recovery after stroke?","QUESTION_ID":"Q177","F_REF":"1-120005227"} -{"ANSWERS":[{"_answerid":"Q178-S1-A1","_pairid":"476","__text":"Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur: Less common Bone fracture breast pain chest pain chills, fever, or flu-like symptoms mental depression shortness of breath swelling of the feet or lower legs Rare Continuing or severe nervousness cough dizziness or lightheadedness fainting fast heartbeat heart attack increased sweating nausea pain in the chest, groin, or legs, especially the calves severe and sudden, unexplained shortness of breath severe, sudden headache slurred speech sudden loss of coordination sudden, severe weakness or numbness in the arm or leg vaginal bleeding vision changes Incidence not known Black, tarry stools blindness blurred vision burning, crawling, itching, numbness, prickling, \"pins and needles\", or tingling feelings chest discomfort decreased vision dilated neck veins extreme fatigue increased need to urinate irregular breathing irregular heartbeat painful or difficult urination passing urine more often sore throat sores, ulcers, or white spots on the lips or in the mouth swollen glands unusual bleeding or bruising unusual tiredness or weakness weight gain wheezing white or brownish vaginal discharge Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: More common Back pain bone pain hot flashes (sudden sweating and feeling of warmth) joint pain muscle pain Less common Anxiety confusion constipation diarrhea dry mouth headache increased thirst loss of appetite or weight loss metallic taste skin rash or itching sleepiness spinning or whirling sensation causing loss of balance stomach pain or upset trouble sleeping vomiting weakness Incidence not known Bad, unusual, or unpleasant (after) taste and thirst being forgetful change in taste dryness of the skin hair loss hives or welts increased appetite irritability nervousness red, sore eyes redness of the skin swelling or inflammation of the mouth Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088."}],"SUB_QUESTION_ID":"Q178-S1","ANNOTATIONS.FOCUS":["Letrozole"],"ANNOTATIONS.TYPE":"side effects","SUBJECT":"Letrozole","MESSAGE":"Is there information available from women who have or are using it? I'd like to know what their reactions to the drug are. Thank you for your help.","QUESTION_ID":"Q178","F_REF":"1-121844935"} -{"ANSWERS":[{"_answerid":"Q179-S1-A1","_pairid":"477","__text":"No cure has yet been found for ALS. However, the drug riluzole--the only prescribed drug approved by the Food and Drug Administration (FDA) to treat ALS--prolongs life by 2-3 months but does not relieve symptoms. \u00a0The FDA has also approved the NeuRx Diaphragm Pacing System, which uses implanted electrodes and a battery pack to cause the diaphragm (breathing muscle) to contract, to help certain individuals who have ALS and breathing problems an average benefit of 16 months before onset of severe respiratory failure. Other treatments are designed to relieve symptoms and improve the quality of life for people with ALS.\u00a0 Drugs are available to help individuals with spasticity, pain, panic attacks, and depression. \u00a0Physical therapy, occupational therapy, and rehabilitation may help to prevent joint immobility and slow muscle weakness and atrophy. \u00a0Individuals with ALS may eventually consider forms of mechanical ventilation (respirators)."}],"SUB_QUESTION_ID":"Q179-S1","ANNOTATIONS.FOCUS":["als"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"meidcation for ALS patient","MESSAGE":"what medication and food that can give to ALS patient to help with the slow progession of the disease","QUESTION_ID":"Q179","F_REF":"1-131099935"} -{"ANSWERS":[{"_answerid":"Q180-S1-A1","_pairid":"478","__text":"Vitiligo is a skin condition in which there is a loss of brown color (pigment) from areas of skin, resulting in irregular white patches that feel like normal skin."},{"_answerid":"Q180-S1-A2","_pairid":"479","__text":"Summary Vitiligo causes white patches on your skin. It can also affect your eyes, mouth, and nose. It occurs when the cells that give your skin its color are destroyed. No one knows what destroys them. It is more common in people with autoimmune diseases, and it might run in families. It usually starts before age 40. The white patches are more common where your skin is exposed to the sun. In some cases, the patches spread. Vitiligo can cause your hair to gray early. If you have dark skin, you may lose color inside your mouth. Using sunscreen will help protect your skin, and cosmetics can cover up the patches. Treatments for vitiligo include medicines, light therapy, and surgery. Not every treatment is right for everyone. Many have side effects. Some take a long time. Some do not always work. NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases"},{"_answerid":"Q180-S1-A3","_pairid":"480","__text":"Vitiligo is a condition that causes patchy loss of skin coloring (pigmentation). The average age of onset of vitiligo is in the mid-twenties, but it can appear at any age. It tends to progress over time, with larger areas of the skin losing pigment. Some people with vitiligo also have patches of pigment loss affecting the hair on their scalp or body. Researchers have identified several forms of vitiligo. Generalized vitiligo (also called nonsegmental vitiligo), which is the most common form, involves loss of pigment (depigmentation) in patches of skin all over the body. Depigmentation typically occurs on the face, neck, and scalp, and around body openings such as the mouth and genitals. Sometimes pigment is lost in mucous membranes, such as the lips. Loss of pigmentation is also frequently seen in areas that tend to experience rubbing, impact, or other trauma, such as the hands, arms, and places where bones are close to the skin surface (bony prominences). Another form called segmental vitiligo is associated with smaller patches of depigmented skin that appear on one side of the body in a limited area; this occurs in about 10 percent of affected individuals. Vitiligo is generally considered to be an autoimmune disorder. Autoimmune disorders occur when the immune system attacks the body's own tissues and organs. In people with vitiligo the immune system appears to attack the pigment cells (melanocytes) in the skin. About 15 to 25 percent of people with vitiligo are also affected by at least one other autoimmune disorder, particularly autoimmune thyroid disease, rheumatoid arthritis, type 1 diabetes, psoriasis, pernicious anemia, Addison disease, or systemic lupus erythematosus. In the absence of other autoimmune conditions, vitiligo does not affect general health or physical functioning. However, concerns about appearance and ethnic identity are significant issues for many affected individuals."}],"SUB_QUESTION_ID":"Q180-S1","ANNOTATIONS.FOCUS":["vitiligo"],"ANNOTATIONS.TYPE":"information","SUBJECT":"ClinicalTrials.gov - Question - general information","MESSAGE":"Trying to talk to someone about Vitiligo","QUESTION_ID":"Q180","F_REF":"1-131989675"} -{"ANSWERS":[{"_answerid":"Q181-S1-A1","_pairid":"481","__text":"Pregabalin comes as a capsule to take by mouth. It is usually taken with or without food two or three times a day. Take pregabalin at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Your doctor will probably start you on a low dose of pregabalin and may gradually increase your dose during the first week of treatment. Take pregabalin exactly as directed. Pregabalin may be habit forming. Do not take a larger dose, take it more often, or take it for a longer period of time than prescribed by your doctor. Pregabalin may help control your symptoms but will not cure your condition. It may take several weeks or longer before you feel the full benefit of pregabalin. Continue to take pregabalin even if you feel well. Do not stop taking pregabalin without talking to your doctor, even if you experience side effects such as unusual changes in behavior or mood. If you suddenly stop taking pregabalin, you may experience withdrawal symptoms, including trouble falling asleep or staying asleep, nausea, diarrhea, headaches, or seizures. Your doctor will probably decrease your dose gradually over at least one week. Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with pregabalin and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http:\/\/www.fda.gov\/Drugs) or the manufacturer's website to obtain the Medication Guide."}],"SUB_QUESTION_ID":"Q181-S1","ANNOTATIONS.FOCUS":["pregabalin"],"ANNOTATIONS.TYPE":"tapering","SUBJECT":"stopping pregabalin","MESSAGE":"why is there no info on the withdrawal symptems when stopping pregabalin","QUESTION_ID":"181","F_REF":"1-122818715"} -{"ANSWERS":[{"_answerid":"Q182-S1-A1","_pairid":"482","__text":"There were no interactions found in our database between Advair Diskus and Spiriva However, this does not necessarily mean no interactions exist. Always consult with your doctor or pharmacist. Advair Diskus is in the drug class bronchodilator combinations. Advair Diskus is used to treat the following conditions: Asthma, Maintenance, COPD, Maintenance. Spiriva is a member of the drug class anticholinergic bronchodilators. Spiriva is used to treat COPD, Maintenance."}],"SUB_QUESTION_ID":"Q182-S1","ANNOTATIONS.FOCUS":["Advair","Spiriva"],"ANNOTATIONS.TYPE":"interaction","SUBJECT":"","MESSAGE":"should Advair and Spiriva be used together? It is my understanding that they are both control meds","QUESTION_ID":"182","F_REF":"1-122827845"} -{"ANSWERS":[{"_answerid":"Q183-S1-A1","_pairid":"483","__text":"Kartagener syndrome is a type of primary ciliary dyskinesia that is also characterized by situs inversus totalis (mirror-image reversal of internal organs). The signs and symptoms vary but may include neonatal respiratory distress; frequent lung, sinus and middle ear infections beginning in early childhood; and infertility.[1][2][3] It can be cause by changes (mutations) in many different genes that are inherited in an autosomal recessive manner. Although scientists have identified many of the genes associated with Kartagener syndrome, the genetic cause of some cases is unknown.[4][2] There is no cure for Kartagener syndrome. Treatment varies based on the signs and symptoms present in each person but may include airway clearance therapy and antibiotics.[1][2][3]"}],"SUB_QUESTION_ID":"Q183-S1","ANNOTATIONS.FOCUS":["kartagener's syndrome"],"ANNOTATIONS.TYPE":"information","SUBJECT":"","MESSAGE":"Kartagener's syndrome. I am suffering from Kartagener's syndrome and wanted information from you or from Dr. [NAME]. for this syndrome. (About fertility) and if possible other symptoms. Thank you.","QUESTION_ID":"Q183","F_REF":"92"} -{"ANSWERS":[{"_answerid":"Q184-S1-A1","_pairid":"484","__text":"Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication."}],"SUB_QUESTION_ID":"Q184-S1","ANNOTATIONS.FOCUS":["Ciprofloxacin Ophthalmic"],"ANNOTATIONS.TYPE":"storage and disposal","SUBJECT":"","MESSAGE":"can I use 1yr expired Ciprofloxacin Ophthalmic?","QUESTION_ID":"Q184","F_REF":"1-122925195"} -{"ANSWERS":[{"_answerid":"Q185-S1-A1","_pairid":"485","__text":"AZITHROMYCIN TABLETS 250 mg and 500 mg To reduce the development of drug-resistant bacteria and maintain the effectiveness of azithromycin and other antibacterial drugs, azithromycin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria. DESCRIPTION Azithromycin for oral suspension, USP contain the active ingredient azithromycin, an azalide, a subclass of macrolide antibiotics, for oral administration. Azithromycin has the chemical name (2R,3S,4R,5R,8R,10R,11R,12S,13S,14R)-13-[(2,6-dideoxy-3-C-methyl-3-O-methyl-\u03b1-L-ribohexopyranosyl) oxy]-2-ethyl-3,4,10-trihydroxy-3,5,6,8,10,12,14-heptamethyl-11-[[3,4,6-trideoxy-3- (dimethylamino)-\u03b2-D-xylo-hexopyranosyl]oxy]-1-oxa-6-azacyclopentadecan-15-one. Azithromycin is derived from erythromycin; however, it differs chemically from erythromycin in that a methyl-substituted nitrogen atom is incorporated into the lactone ring. Its molecular formula is C38H72N2O12, and its molecular weight is 749.00. Azithromycin has the following structural formula: Azithromycin, as the monohydrate, is a white crystalline powder with a molecular formula of C38H72N2O12\u2022H2O and a molecular weight of 767.0. Each tablet for oral administration contains azithromycin monohydrate equivalent to either 250 mg or 500 mg azithromycin. In addition each tablet contains the following inactive ingredients: croscarmellose sodium, dibasic calcium phosphate anhydrous, hypromellose, lactose monohydrate, polyethylene glycol, magnesium stearate, microcrystalline cellulose, partially pregelantinized starch, sodium citrate, sodium lauryl sulfate, titanium dioxide and FD&C Blue No. 2 (500 mg only)."}],"SUB_QUESTION_ID":"Q185-S1","ANNOTATIONS.FOCUS":["Azithromycin 250mg tabs"],"ANNOTATIONS.TYPE":"ingredient","SUBJECT":"Azithromycin 250mg gluten","MESSAGE":"Hello can you please tell me if your Azithromycin 250mg tabs are gluten free? Thank you!","QUESTION_ID":"Q185","F_REF":"1-122963347"} -{"ANSWERS":[{"_answerid":"Q186-S1-A1","_pairid":"486","__text":"Lightheadedness occurs when your brain does not get enough blood. This may occur if: - You have a sudden drop in blood pressure. - Your body does not have enough water (is dehydrated) because of vomiting, diarrhea, fever, and other conditions. - You get up too quickly after sitting or lying down (this is more common in older people). Lightheadedness may also occur if you have the flu, low blood sugar, a cold, or allergies. More serious conditions that can lead to light-headedness include: - Heart problems, such as a heart attack or abnormal heart beat - Stroke - Bleeding inside the body - Shock (extreme drop in blood pressure) If any of these serious disorders are present, you will usually also have symptoms like chest pain, a feeling of a racing heart, loss of speech, change in vision, or other symptoms. Vertigo may be due to: - Benign positional vertigo, a spinning feeling that occurs when you move your head - Labyrinthitis, a viral infection of the inner ear that usually follows a cold or flu - Meniere's disease, a common inner ear problem Other causes of lightheadedness or vertigo may include: - Use of certain medicines - Stroke - Multiple sclerosis - Seizures - Brain tumor - Bleeding in the brain"}],"SUB_QUESTION_ID":"Q186-S1","ANNOTATIONS.FOCUS":["dizziness"],"ANNOTATIONS.TYPE":"cause","SUBJECT":"subjective vertigo","MESSAGE":"Can macular degeneration in only one eye cause dizziness?","QUESTION_ID":"Q186","F_REF":"1-120018325"} -{"ANSWERS":[{"_answerid":"Q187-S1-A1","_pairid":"487","__text":"Before taking allopurinol, tell your doctor and pharmacist if you are allergic to allopurinol or any other medications. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: amoxicillin (Amoxil, Trimox); ampicillin (Polycillin, Principen); anticoagulants ('blood thinners') such as warfarin (Coumadin); cancer chemotherapy drugs such as cyclophosphamide (Cytoxan) and mercaptopurine (Purinethol); chlorpropamide (Diabinese); diuretics ('water pills'); medications that suppress the immune system such as azathioprine (Imuran) and cyclosporine (Neoral, Sandimmune); other medications for gout such as probenecid (Benemid) and sulfinpyrazone (Anturane); and tolbutamide (Orinase). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. tell your doctor if you have or have ever had kidney or liver disease or heart failure. tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking allopurinol, call your doctor. you should know that allopurinol may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you. ask your doctor about the safe use of alcoholic beverages while you are taking allopurinol. Alcohol may decrease the effectiveness of allopurinol."}],"SUB_QUESTION_ID":"Q187-S1","ANNOTATIONS.FOCUS":["allopurinol","diuretics"],"ANNOTATIONS.TYPE":"interaction","SUBJECT":"allopurinol and diuretics","MESSAGE":"I am presently taking 200mg Allopurinol daily for the treatment of Gout. My feet swell. How dangerous is it to take a diuretic.","QUESTION_ID":"Q187","F_REF":"1-122992685"} -{"ANSWERS":[{"_answerid":"Q188-S1-A1","_pairid":"488","__text":"In most cases of diarrhea, the only treatment necessary is replacing lost fluids and electrolytes to prevent dehydration. Over-the-counter medicines such as loperamide (Imodium) and bismuth subsalicylate (Pepto-Bismol and Kaopectate) may help stop diarrhea in adults. However, people with bloody diarrhea\u2014a sign of bacterial or parasitic infection\u2014should not use these medicines. If diarrhea is caused by bacteria or parasites, over-the-counter medicines may prolong the problem, so doctors usually prescribe antibiotics instead. Medications to treat diarrhea in adults can be dangerous for infants and children and should only be given with a doctor\u2019s guidance."}],"SUB_QUESTION_ID":"Q188-S1","ANNOTATIONS.FOCUS":["diarrhea"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"diarrhea","MESSAGE":"i had bad diarrhea over the weekend and though how my mother used paregoric, went to the drug store to get some, he said they dont sell it any more HELP","QUESTION_ID":"Q188","F_REF":"1-132341335"} -{"ANSWERS":[{"_answerid":"Q189-S1-A1","_pairid":"489","__text":"The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. For chronic pain: For oral dosage form (extended-release tablets): Adults\u2014At first, 100 milligrams (mg) once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 300 mg per day. Children\u2014Use and dose must be determined by your doctor. For oral dosage form (tablets): Adults and teenagers 16 years of age and older\u2014At first, 50 to 100 milligrams (mg) every four to six hours as needed. Your doctor may increase your dose as needed. However, the dose is usually not more than 400 mg per day. Children younger than 16 years of age\u2014Use and dose must be determined by your doctor. For moderate to severe pain: For oral dosage form (disintegrating tablets): Adults and teenagers 16 years of age and older\u2014At first, 50 to 100 milligrams (mg) every four to six hours as needed. Your doctor may increase your dose as needed. However, the dose is usually not more than 400 mg per day. Children younger than 16 years of age\u2014Use and dose must be determined by your doctor. For oral dosage form (tablets): Adults and teenagers 16 years of age and older\u2014At first, 25 milligrams (mg) per day, taken every morning. Your doctor may increase your dose as needed. However, the dose is usually not more than 400 mg per day. Children younger than 16 years of age\u2014Use and dose must be determined by your doctor."}],"SUB_QUESTION_ID":"Q189-S1","ANNOTATIONS.FOCUS":["tramadol"],"ANNOTATIONS.TYPE":"dosage","SUBJECT":"tramadol","MESSAGE":"how strong is 50mg of tramadol taken twice daily","QUESTION_ID":"Q189","F_REF":"1-123487175"} -{"ANSWERS":[{"_answerid":"Q190-S1-A1","_pairid":"490","__text":"Use of PLAQUENIL is contraindicated in patients with known hypersensitivity to 4-aminoquinoline compounds."}],"SUB_QUESTION_ID":"Q190-S1","ANNOTATIONS.FOCUS":["plaquenil"],"ANNOTATIONS.TYPE":"contraindication","SUBJECT":"Plaquenil","MESSAGE":"I was recently diagnosed with lupus. A few months prior I had a terrible reaction to levofloxacin. My doctor wants to give me plaquenil. I am concerned as this is in the quinolone family. Should I be concerned? Is this a quinolone drug?","QUESTION_ID":"Q190","F_REF":"1-123493445"} -{"ANSWERS":[{"_answerid":"Q190-S2-A1","_pairid":"491","__text":"Description and Brand Names Drug information provided by: Micromedex US Brand Name Plaquenil Descriptions Hydroxychloroquine belongs to the family of medicines called antiprotozoals. Protozoa are tiny, one-celled animals. Some are parasites that can cause many different kinds of infections in the body. This medicine is used to prevent and to treat malaria and to treat some conditions such as liver disease caused by protozoa. It is also used in the treatment of arthritis to help relieve inflammation, swelling, stiffness, and joint pain and to help control the symptoms of lupus erythematosus (lupus; SLE). This medicine may be given alone or with one or more other medicines. It may also be used for other conditions as determined by your doctor. Hydroxychloroquine is available only with your doctor's prescription. This product is available in the following dosage forms: Tablet"}],"SUB_QUESTION_ID":"Q190-S2","ANNOTATIONS.FOCUS":["plaquenil"],"ANNOTATIONS.TYPE":"information","SUBJECT":"Plaquenil","MESSAGE":"I was recently diagnosed with lupus. A few months prior I had a terrible reaction to levofloxacin. My doctor wants to give me plaquenil. I am concerned as this is in the quinolone family. Should I be concerned? Is this a quinolone drug?","QUESTION_ID":"Q190","F_REF":"1-123493445"} -{"ANSWERS":[{"_answerid":"Q191-S1-A1","_pairid":"492","__text":"Children should get 2 doses of MMR vaccine: First Dose: 12-15 months of age Second Dose: 4-6 years of age (may be given earlier, if at least 28 days after the 1st dose) Some infants younger than 12 months should get a dose of MMR if they are traveling out of the country. (This dose will not count toward their routine series.) Some adults should also get MMR vaccine: Generally, anyone 18 years of age or older who was born after 1956 should get at least one dose of MMR vaccine, unless they can show that they have either been vaccinated or had all three diseases. MMR vaccine may be given at the same time as other vaccines. Children between 1 and 12 years of age can get a \"combination\" vaccine called MMRV, which contains both MMR and varicella (chickenpox) vaccines. There is a separate Vaccine Information Statement for MMRV."}],"SUB_QUESTION_ID":"Q191-S1","ANNOTATIONS.FOCUS":["MMR Vaccine"],"ANNOTATIONS.TYPE":"usage","SUBJECT":"MMR Vaccine","MESSAGE":"If you are vaccinated at childhood, do you need to get the vaccine again if you are going to country where there is a measles epidemic?","QUESTION_ID":"Q191","F_REF":"1-123603375"} -{"ANSWERS":[{"_answerid":"Q192-S1-A1","_pairid":"493","__text":"To reduce the development of drug-resistant bacteria and maintain the effectiveness of Bactrim (sulfamethoxazole and trimethoprim) tablets and other antibacterial drugs, Bactrim (sulfamethoxazole and trimethoprim) tablets should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to empiric selection of therapy. Urinary Tract Infections: For the treatment of urinary tract infections due to susceptible strains of the following organisms: Escherichia coli, Klebsiella species, Enterobacter species, Morganella morganii, Proteus mirabilis and Proteus vulgaris. It is recommended that initial episodes of uncomplicated urinary tract infections be treated with a single effective antibacterial agent rather than the combination. Acute Otitis Media: For the treatment of acute otitis media in pediatric patients due to susceptible strains of Streptococcus pneumoniae or Haemophilus influenzae when in the judgment of the physician sulfamethoxazole and trimethoprim offers some advantage over the use of other antimicrobial agents. To date, there are limited data on the safety of repeated use of BACTRIM in pediatric patients under two years of age. BACTRIM is not indicated for prophylactic or prolonged administration in otitis media at any age. Acute Exacerbations of Chronic Bronchitis in Adults: For the treatment of acute exacerbations of chronic bronchitis due to susceptible strains of Streptococcus pneumoniae or Haemophilus influenzae when a physician deems that BACTRIM could offer some advantage over the use of a single antimicrobial agent. Shigellosis: For the treatment of enteritis caused by susceptible strains of Shigella flexneri and Shigella sonnei when antibacterial therapy is indicated. Pneumocystis jiroveci Pneumonia: For the treatment of documented Pneumocystis jiroveci pneumonia and for prophylaxis against P. jiroveci pneumonia in individuals who are immunosuppressed and considered to be at an increased risk of developing P. jiroveci pneumonia. Traveler's Diarrhea in Adults: For the treatment of traveler's diarrhea due to susceptible strains of enterotoxigenic E. coli."}],"SUB_QUESTION_ID":"Q192-S1","ANNOTATIONS.FOCUS":["Trimethoprim\/ sulfamethozle"],"ANNOTATIONS.TYPE":"indication","SUBJECT":"Arthritis","MESSAGE":"Is the medication Trimethoprim\/ sulfamethozle useful in arthritis.? Thank you","QUESTION_ID":"Q192","F_REF":"1-123566082"} -{"ANSWERS":[{"_answerid":"Q193-S1-A1","_pairid":"494","__text":"Lidocaine comes as a patch to apply to the skin. It is applied only once a day as needed for pain. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use lidocaine patches exactly as directed. Your doctor will tell you how many lidocaine patches you may use at one time and the length of time you may wear the patches. Never apply more than three patches at one time, and never wear patches for more than 12 hours per day. Using too many patches or leaving patches on for too long may cause serious side effects. To apply the patches, follow these steps: Look at the skin that you plan to cover with a lidocaine patch. If the skin is broken or blistered, do not apply a patch to that area. Use scissors to remove the outer seal from the package. Then pull apart the zipper seal. Remove up to three patches from the package and press the zipper seal tightly together. The remaining patches may dry out if the zipper seal is not tightly closed. Cut patch(es) to the size and shape that will cover your most painful area. Peel the transparent liner off the back of the patch(es). Press the patch(es) firmly onto your skin. If you are applying a patch to your face, be careful not to let it touch your eyes. If you do get lidocaine in your eye, wash it with plenty of water or saline solution. Wash your hands after handling lidocaine patches. Do not reuse lidocaine patches. After you are finished using a patch, remove it and dispose of it out of reach of children and pets. Used patches contain enough medication to seriously harm a child or pet."}],"SUB_QUESTION_ID":"Q193-S1","ANNOTATIONS.FOCUS":["lidocaine patch"],"ANNOTATIONS.TYPE":"usage","SUBJECT":"bathing","MESSAGE":"Can I go in tub , pool or shower while wearing the lidocaine patch? If not, can I take off the patch (2or 3), and put a new one on in a different area for the remainder of the 12 hr. \"on\" period","QUESTION_ID":"Q193","F_REF":"1-123604235"} -{"ANSWERS":[{"_answerid":"Q194-S1-A1","_pairid":"495","__text":"Bupropion hydrochloride extended-release tablets USP (SR) are indicated for the treatment of major depressive disorder. The efficacy of bupropion in the treatment of a major depressive episode was established in two 4-week controlled trials of depressed inpatients and in one 6-week controlled trial of depressed outpatients whose diagnoses corresponded most closely to the Major Depression category of the APA Diagnostic and Statistical Manual (DSM) (see CLINICAL PHARMACOLOGY). A major depressive episode (DSM-IV) implies the presence of 1) depressed mood or 2) loss of interest or pleasure; in addition, at least 5 of the following symptoms have been present during the same 2-week period and represent a change from previous functioning: depressed mood, markedly diminished interest or pleasure in usual activities, significant change in weight and\/or appetite, insomnia or hypersomnia, psychomotor agitation or retardation, increased fatigue, feelings of guilt or worthlessness, slowed thinking or impaired concentration, a suicide attempt or suicidal ideation. The efficacy of bupropion hydrochloride extended-release tablets USP (SR) in maintaining an antidepressant response for up to 44 weeks following 8 weeks of acute treatment was demonstrated in a placebo-controlled trial (see CLINICAL PHARMACOLOGY). Nevertheless, the physician who elects to use bupropion hydrochloride extended-release tablets USP (SR) for extended periods should periodically reevaluate the long-term usefulness of the drug for the individual patient."}],"SUB_QUESTION_ID":"Q194-S1","ANNOTATIONS.FOCUS":["BUPROPION"],"ANNOTATIONS.TYPE":"usage","SUBJECT":"inf-medication","MESSAGE":"I would like information on this medicinal - BUPROPION 100MG To use it and what are the side effects of the drug.","QUESTION_ID":"Q194","F_REF":"1-123636565"} -{"ANSWERS":[{"_answerid":"Q194-S2-A1","_pairid":"496","__text":"The information included under the Incidence in Controlled Trials subsection of ADVERSE REACTIONS is based primarily on data from controlled clinical trials with Bupropion Hydrochloride Extended-Release Tablets (SR). Information on additional adverse events associated with the extended-release formulation of bupropion in smoking cessation trials, as well as the immediate-release formulation of bupropion, is included in a separate section (see ADVERSE REACTIONS, Other Events Observed During the Clinical Development and Postmarketing Experience of Bupropion). Incidence in Controlled Trials with Bupropion Hydrochloride Extended-Release Tablets (SR) Adverse Events Associated with Discontinuation of Treatment Among Patients Treated with Bupropion Hydrochloride Extended-Release Tablets (SR) In placebo-controlled clinical trials, 9% and 11% of patients treated with 300 mg\/day and 400 mg\/day, respectively, of bupropion hydrochloride extended-release tablets (SR) and 4% of patients treated with placebo discontinued treatment due to adverse events. The specific adverse events in these trials that led to discontinuation in at least 1% of patients treated with either 300 mg\/day or 400 mg\/day of bupropion hydrochloride extended-release tablets (SR) and at a rate at least twice the placebo rate are listed in Table 4. Adverse Events Occurring at an Incidence of 1% or More Among Patients Treated with Bupropion Hydrochloride Extended-Release Tablets (SR) Table 5 enumerates treatment-emergent adverse events that occurred among patients treated with 300 mg\/day and 400 mg\/day of bupropion hydrochloride extended-release tablets (SR) and with placebo in placebo-controlled trials. Events that occurred in either the 300-mg\/day or 400-mg\/day group at an incidence of 1% or more and were more frequent than in the placebo group are included. Reported adverse events were classified using a COSTART-based Dictionary. Accurate estimates of the incidence of adverse events associated with the use of any drug are difficult to obtain. Estimates are influenced by drug dose, detection technique, setting, physician judgments, etc. The figures cited cannot be used to predict precisely the incidence of untoward events in the course of usual medical practice where patient characteristics and other factors differ from those that prevailed in the clinical trials. These incidence figures also cannot be compared with those obtained from other clinical studies involving related drug products as each group of drug trials is conducted under a different set of conditions. Finally, it is important to emphasize that the tabulation does not reflect the relative severity and\/or clinical importance of the events. A better perspective on the serious adverse events associated with the use of bupropion hydrochloride extended-release tablets (SR) is provided in the WARNINGSand PRECAUTIONSsections. Incidence of Commonly Observed Adverse Events in Controlled Clinical Trials Adverse events from Table 5 occurring in at least 5% of patients treated with bupropion hydrochloride extended-release tablets (SR) and at a rate at least twice the placebo rate are listed below for the 300-mg\/day and 400-mg\/day dose groups. Bupropion Hydrochloride Extended-Release Tablets (SR) 300 mg\/day: Anorexia, dry mouth, rash, sweating, tinnitus and tremor. Bupropion Hydrochloride Extended-Release Tablets (SR) 400 mg\/day: Abdominal pain, agitation, anxiety, dizziness, dry mouth, insomnia, myalgia, nausea, palpitation, pharyngitis, sweating, tinnitus and urinary frequency. Other Events Observed During the Clinical Development and Postmarketing Experience of Bupropion In addition to the adverse events noted above, the following events have been reported in clinical trials and postmarketing experience with the extended-release (SR) formulation of bupropion in depressed patients and in nondepressed smokers, as well as in clinical trials and postmarketing clinical experience with the immediate-release formulation of bupropion. Adverse events for which frequencies are provided below occurred in clinical trials with the extended-release formulation of bupropion (SR). The frequencies represent the proportion of patients who experienced a treatment-emergent adverse event on at least one occasion in placebo-controlled studies for depression (n = 987) or smoking cessation (n = 1,013) or patients who experienced an adverse event requiring discontinuation of treatment in an open-label surveillance study with bupropion hydrochloride extended-release tablets (SR) (n = 3,100). All treatment-emergent adverse events are included except those listed in Tables 2 through 5, those events listed in other safety-related sections, those adverse events subsumed under COSTART terms that are either overly general or excessively specific so as to be uninformative, those events not reasonably associated with the use of the drug and those events that were not serious and occurred in fewer than 2 patients. Events of major clinical importance are described in the WARNINGSand PRECAUTIONSsections of the labeling. Events are further categorized by body system and listed in order of decreasing frequency according to the following definitions of frequency: Frequent adverse events are defined as those occurring in at least 1\/100 patients. Infrequent adverse events are those occurring in 1\/100 to 1\/1,000 patients, while rare events are those occurring in less than 1\/1,000 patients. Adverse events for which frequencies are not provided occurred in clinical trials or postmarketing experience with bupropion. Only those adverse events not previously listed for extended-release bupropion (SR) are included. The extent to which these events may be associated with bupropion hydrochloride extended-release tablets (SR) are unknown. Body (General):Infrequent were chills, facial edema, musculoskeletal chest pain and photosensitivity. Rare was malaise. Also observed were arthralgia, myalgia and fever with rash and other symptoms suggestive of delayed hypersensitivity. These symptoms may resemble serum sickness (see PRECAUTIONS). Cardiovascular:Infrequent were postural hypotension, stroke, tachycardia and vasodilation. Rare was syncope. Also observed were complete atrioventricular block, extrasystoles, hypotension, hypertension (in some cases severe, see PRECAUTIONS), myocardial infarction, phlebitis and pulmonary embolism. Digestive:Infrequent were abnormal liver function, bruxism, gastric reflux, gingivitis, glossitis, increased salivation, jaundice, mouth ulcers, stomatitis and thirst. Rare was edema of tongue. Also observed were colitis, esophagitis, gastrointestinal hemorrhage, gum hemorrhage, hepatitis, intestinal perforation, liver damage, pancreatitis and stomach ulcer. Endocrine:Also observed were hyperglycemia, hypoglycemia and syndrome of inappropriate antidiuretic hormone. Hemic and Lymphatic:Infrequent was ecchymosis. Also observed were anemia, leukocytosis, leukopenia, lymphadenopathy, pancytopenia and thrombocytopenia. Altered PT and\/or INR, infrequently associated with hemorrhagic or thrombotic complications, were observed when bupropion was co-administered with warfarin. Metabolic and Nutritional:Infrequent were edema and peripheral edema. Also observed was glycosuria. Musculoskeletal:Infrequent were leg cramps. Also observed were muscle rigidity\/fever\/rhabdomyolysis and muscle weakness. Nervous System:Infrequent were abnormal coordination, decreased libido, depersonalization, dysphoria, emotional lability, hostility, hyperkinesia, hypertonia, hypesthesia, suicidal ideation and vertigo. Rare were amnesia, ataxia, derealization and hypomania. Also observed were abnormal electroencephalogram (EEG), akinesia, aggression, aphasia, coma, completed suicide, delirium, delusions, dysarthria, dyskinesia, dystonia, euphoria, extrapyramidal syndrome, hallucinations, hypokinesia, increased libido, manic reaction, neuralgia, neuropathy, paranoid ideation, restlessness, suicide attempt and unmasking tardive dyskinesia. Respiratory:Rare was bronchospasm. Also observed was pneumonia. Skin:Rare was maculopapular rash. Also observed were alopecia, angioedema, exfoliative dermatitis and hirsutism. Special Senses:Infrequent were accommodation abnormality and dry eye. Also observed were deafness, diplopia, increased intraocular pressure and mydriasis. Urogenital:Infrequent were impotence, polyuria and prostate disorder. Also observed were abnormal ejaculation, cystitis, dyspareunia, dysuria, gynecomastia, menopause, painful erection, salpingitis, urinary incontinence, urinary retention and vaginitis."}],"SUB_QUESTION_ID":"Q194-S2","ANNOTATIONS.FOCUS":["BUPROPION"],"ANNOTATIONS.TYPE":"side effects","SUBJECT":"inf-medication","MESSAGE":"I would like information on this medicinal - BUPROPION 100MG To use it and what are the side effects of the drug.","QUESTION_ID":"Q194","F_REF":"1-123636565"} -{"ANSWERS":[{"_answerid":"Q195-S1-A1","_pairid":"497","__text":"This condition is inherited in an autosomal recessive pattern, which means both copies of the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition."}],"SUB_QUESTION_ID":"Q195-S1","ANNOTATIONS.FOCUS":["Ellis-Van Crevald Syndrome"],"ANNOTATIONS.TYPE":"inheritance","SUBJECT":"","MESSAGE":"If both parents carry the EVC gene which is responsible for the Ellis-Van Crevald Syndrome, will all their offspring be affected with the syndrome?","QUESTION_ID":"Q195","F_REF":"1-123639875"} -{"ANSWERS":[{"_answerid":"Q196-S1-A1","_pairid":"498","__text":"Guanfacine tablets (Tenex) are used alone or in combination with other medications to treat high blood pressure. Guanfacine extended-release (long-acting) tablets (Intuniv) are used as part of a treatment program to control symptoms of attention deficit hyperactivity disorder (ADHD; more difficulty focusing, controlling actions, and remaining still or quiet than other people who are the same age) in children. Guanfacine is in a class of medications called centrally acting alpha2A-adrenergic receptor agonists. Guanfacine treats high blood pressure by decreasing heart rate and relaxing the blood vessels so that blood can flow more easily through the body. Guanfacine extended-release tablets may treat ADHD by affecting the part of the brain that controls attention and impulsivity. High blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation."},{"_answerid":"Q196-S1-A2","_pairid":"499","__text":"Guanfacine is used to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled. Guanfacine works by controlling the nerve impulses along certain nerve pathways. As a result, it relaxes the blood vessels so that blood passes through them more easily. This helps to lower blood pressure. Guanfacine extended-release tablets are also used alone or together with other medicines to treat attention deficit hyperactivity disorder (ADHD) in children and adolescents. It works in the treatment of ADHD by increasing attention and decreasing restlessness in children and adults who are overactive, cannot concentrate for very long, or are easily distracted and impulsive. This medicine is used as part of a total treatment program that also includes social, educational, and psychological treatment. This medicine is available only with your doctor's prescription. This product is available in the following dosage forms: Tablet Tablet, Extended Release"}],"SUB_QUESTION_ID":"Q196-S1","ANNOTATIONS.FOCUS":["Guanfacine"],"ANNOTATIONS.TYPE":"indication","SUBJECT":"","MESSAGE":"Is there any information regarding adults having any benefits from taking Guanfacine extended-release (long-acting) tablets for ADHD?","QUESTION_ID":"Q196","F_REF":"1-123705112"} -{"ANSWERS":[{"_answerid":"Q197-S1-A1","_pairid":"500","__text":"Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication."}],"SUB_QUESTION_ID":"Q197-S1","ANNOTATIONS.FOCUS":["tetracycline"],"ANNOTATIONS.TYPE":"storage and disposal","SUBJECT":"outdated tetracycline","MESSAGE":"Is it safe to take outdated tetracycline?","QUESTION_ID":"Q197","F_REF":"1-123777085"} -{"ANSWERS":[{"_answerid":"Q198-S1-A1","_pairid":"501","__text":"Duloxetine comes as a delayed-release (releases the medication in the intestine to prevent break-down of the medication by stomach acids) capsule to take by mouth. When duloxetine is used to treat depression, it is usually taken once or twice a day with or without food. When duloxetine is used to treat generalized anxiety disorder, the pain of diabetic neuropathy, fibromyalgia, or ongoing bone or muscle pain, it is usually taken once a day with or without food. Take duloxetine at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take duloxetine exactly as directed. Do not take more or less of it, take it more often, or take it for a longer time than prescribed by your doctor. Swallow the delayed-release capsules whole; do not split, chew, or crush them. Do not open the delayed-release capsules and mix the contents with liquids or sprinkle the contents on food. Your doctor may start you on a low dose of medication and increase your dose after one week. Duloxetine may help control your symptoms but will not cure your condition. It may take 1 to 4 weeks or longer before you feel the full benefit of duloxetine. Continue to take duloxetine even if you feel well. Do not stop taking duloxetine without talking to your doctor. Your doctor will probably decrease your dose gradually. If you suddenly stop taking duloxetine, you may experience withdrawal symptoms such as nausea; vomiting; diarrhea; anxiety; dizziness; tiredness; headache; pain, burning, numbness, or tingling in the hands or feet; irritability; difficulty falling asleep or staying asleep; sweating; and nightmares. Tell your doctor if you experience any of these symptoms when your dose of duloxetine is decreased."}],"SUB_QUESTION_ID":"Q198-S1","ANNOTATIONS.FOCUS":["Duloxetine"],"ANNOTATIONS.TYPE":"usage","SUBJECT":"Duloxetine Hcl Dr","MESSAGE":"When is the best time of day to take Duloxetine Hcl Caps AM or PM","QUESTION_ID":"Q198","F_REF":"1-123779475"} -{"ANSWERS":[{"_answerid":"Q199-S1-A1","_pairid":"502","__text":"Liver warning: This product contains acetaminophen. Severe liver damage may occur if: \u2022 adult takes more than 12 caplets in 24 hours, which is the maximum daily amount \u2022 child takes more than 5 doses in 24 hours, which is the maximum daily amount \u2022 taken with other drugs containing acetaminophen \u2022 adult has 3 or more alcoholic drinks every day while using this product. Do not use \u2022 with any other drug containing acetaminophen (prescription or nonprescription). If you are not sure whether a drug contains acetaminophen, ask a doctor or pharmacist. \u2022 if you are allergic to acetaminophen or any of the inactive ingredients in this product Stop use and ask a doctor if \u2022 pain gets worse or lasts more than 10 days in adults \u2022 pain gets worse or lasts more than 5 days in children under 12 years \u2022 fever gets worse or lasts more than 3 days \u2022 new symptoms occur \u2022 redness or swelling is present These could be signs of a serious condition. If pregnant or breast-feeding, ask a health professional before use. Keep out of reach of children. Ask a doctor before use if the user has liver disease Ask a doctor or pharmacist before use if the user is taking blood thinning drug warfarin."}],"SUB_QUESTION_ID":"Q199-S1","ANNOTATIONS.FOCUS":["Tylenol"],"ANNOTATIONS.TYPE":"contraindication","SUBJECT":"Peptic Ulcers & Tylenol","MESSAGE":"I have a history of peptic ulcers, so I don't take aspirin or anything that contains it. However, I still experience ulcerative pain when I take Tylenol, especially on the second day of it's administration in recommended doses. Why is this so?","QUESTION_ID":"Q199","F_REF":"1-123857315"} -{"ANSWERS":[{"_answerid":"Q200-S1-A1","_pairid":"503","__text":"Nephrotic syndrome is a collection of symptoms that indicate kidney damage. Nephrotic syndrome includes the following: proteinuria\u2014large amounts of protein in the urine hyperlipidemia\u2014higher than normal fat and cholesterol levels in the blood edema, or swelling, usually in the legs, feet, or ankles and less often in the hands or face hypoalbuminia\u2014low levels of albumin in the blood Albumin is a protein that acts like a sponge, drawing extra fluid from the body into the bloodstream where it remains until removed by the kidneys. When albumin leaks into the urine, the blood loses its capacity to absorb extra fluid from the body, causing edema. Nephrotic syndrome results from a problem with the kidneys\u2019 filters, called glomeruli. Glomeruli are tiny blood vessels in the kidneys that remove wastes and excess fluids from the blood and send them to the bladder as urine. As blood passes through healthy kidneys, the glomeruli filter out the waste products and allow the blood to retain cells and proteins the body needs. However, proteins from the blood, such as albumin, can leak into the urine when the glomeruli are damaged. In nephrotic syndrome, damaged glomeruli allow 3 grams or more of protein to leak into the urine when measured over a 24-hour period, which is more than 20 times the amount that healthy glomeruli allow."}],"SUB_QUESTION_ID":"Q200-S1","ANNOTATIONS.FOCUS":["Nephrotic Syndrome"],"ANNOTATIONS.TYPE":"information","SUBJECT":"","MESSAGE":"What is Nephrotic Syndrome. What are its causes and cures?","QUESTION_ID":"Q200","F_REF":"1-123712647"} -{"ANSWERS":[{"_answerid":"Q200-S2-A1","_pairid":"504","__text":"Nephrotic syndrome can be caused by diseases that affect only the kidneys, such as focal segmental glomerulosclerosis (FSGS) or membranous nephropathy. Diseases that affect only the kidneys are called primary causes of nephrotic syndrome. The glomeruli are usually the targets of these diseases for reasons that are not fully understood. In FSGS\u2014the most common primary cause of nephrotic syndrome\u2014scar tissue forms in parts of the glomeruli. In membranous nephropathy, immune molecules form harmful deposits on the glomeruli. Nephrotic syndrome can also be caused by systemic diseases, which are diseases that affect many parts of the body, such as diabetes or lupus. Systemic diseases that affect the kidneys are called secondary causes of nephrotic syndrome. More than 50 percent of nephrotic syndrome cases in adults have secondary causes, with diabetes being the most common."}],"SUB_QUESTION_ID":"Q200-S2","ANNOTATIONS.FOCUS":["Nephrotic Syndrome"],"ANNOTATIONS.TYPE":"cause","SUBJECT":"","MESSAGE":"What is Nephrotic Syndrome. What are its causes and cures?","QUESTION_ID":"Q200","F_REF":"1-123712647"} -{"ANSWERS":[{"_answerid":"Q200-S3-A1","_pairid":"505","__text":"Treating nephrotic syndrome includes addressing the underlying cause as well as taking steps to reduce high blood pressure, edema, high cholesterol, and the risks of infection. Treatment usually includes medications and changes in diet. Medications that lower blood pressure can also significantly slow the progression of kidney disease causing nephrotic syndrome. Two types of blood pressure lowering medications, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), have proven effective in slowing the progression of kidney disease by reducing the pressure inside the glomeruli and thereby reducing proteinuria. Many people require two or more medications to control their blood pressure. In addition to an ACE inhibitor or an ARB, a diuretic\u2014a medication that aids the kidneys in removing fluid from the blood\u2014can also be useful in helping to reduce blood pressure as well as edema. Beta blockers, calcium channel blockers, and other blood pressure medications may also be needed. Statin medications may be given to lower cholesterol. People with nephrotic syndrome should receive the pneumococcal vaccine, which helps protect against a bacterium that commonly causes infection, and yearly flu shots. Blood thinning medications are usually only given to people with nephrotic syndrome who develop a blood clot; these medications are not used as a preventive measure. Nephrotic syndrome may go away once the underlying cause has been treated. More information about treating the underlying causes of nephrotic syndrome is provided in the NIDDK health topic, Glomerular Diseases."}],"SUB_QUESTION_ID":"Q200-S3","ANNOTATIONS.FOCUS":["Nephrotic Syndrome"],"ANNOTATIONS.TYPE":"treatment","SUBJECT":"","MESSAGE":"What is Nephrotic Syndrome. What are its causes and cures?","QUESTION_ID":"Q200","F_REF":"1-123712647"} +{"ANSWERS":[{"_answerid":"Q1-S1-A1","_pairid":"1","__text":"Cardiac amyloidosis is a disorder caused by deposits of an abnormal protein (amyloid) in the heart tissue. These deposits make it hard for the heart to work properly."},{"_answerid":"Q1-S1-A2","_pairid":"2","__text":"The term \"amyloidosis\" refers not to a single disease but to a collection of diseases in which a protein-based infiltrate deposits in tissues as beta-pleated sheets. The subtype of the disease is determined by which protein is depositing; although dozens of subtypes have been described, most are incredibly rare or of trivial importance. This analysis will focus on the main systemic forms of amyloidosis, both of which frequently involve the heart."}],"SUB_QUESTION_ID":"Q1-S1","ANNOTATIONS_FOCUS":["cardiac amyloidosis"],"ANNOTATIONS_TYPE":"information","SUBJECT":"","MESSAGE":"Literature on Cardiac amyloidosis. Please let me know where I can get literature on Cardiac amyloidosis. My uncle died yesterday from this disorder. Since this is such a rare disorder, and to honor his memory, I would like to distribute literature at his funeral service. I am a retired NIH employee, so I am familiar with the campus in case you have literature at NIH that I can come and pick up. Thank you","QUESTION_ID":"Q1","F_REF":"11373"} +{"ANSWERS":[{"_answerid":"Q2-S1-A1","_pairid":"3","__text":"There is no specific cure for migraine headaches. The goal is to treat your migraine symptoms right away, and to prevent symptoms by avoiding or changing your triggers. A key step is learning how to manage your migraines at home. A headache diary can help you identify your headache triggers. Then you and your doctor can plan how to avoid these triggers. If you have frequent migraines, your doctor may prescribe medicine to reduce the number of attacks. You need to take the medicine every day for it to be effective. Medicines may include: - Antidepressants - Blood pressure medicines - Seizure medicines Botulinum toxin type A (Botox) injections may also help reduce migraine attacks if they occur more than 15 days a month. Some people find relief with minerals and vitamins. Check with your doctor to see if riboflavin or magnesium are right for you. TREATING AN ATTACK Other medicines are taken at the first sign of a migraine attack. Over-the-counter (OTC) pain medicines, such as acetaminophen, ibuprofen, or aspirin are often helpful when your migraine is mild. Be aware that: - Taking medicines more than 3 days a week may lead to rebound headaches. These are headaches that keep coming back due to overuse of pain medicine. - Taking too much acetaminophen can damage your liver. - Too much ibuprofen or aspirin can irritate your stomach or kidneys. If these treatments do not help, ask your doctor about prescription medicines. These include nasal sprays, suppositories, or injections. Some migraine medicines narrow the blood vessels. If you are at risk for having a heart attack or have heart disease, talk with your doctor before using these medicines. Some migraine medicines should not be used by pregnant women. Talk with your doctor about which medicine is right for you if you are pregnant or planning to become pregnant. Other medicines treat symptoms of migraine, such as nausea and vomiting. They may be used alone or along with the other drugs that treat the migraine itself. Feverfew is a herb for migraines. It can be effective for some people. Before using feverfew, make sure your doctor approves. Herbal remedies sold in drugstores and health food stores are not regulated. Work with a trained herbalist when selecting herbs."},{"_answerid":"Q2-S1-A2","_pairid":"4","__text":"There is no absolute cure for migraine since its pathophysiology has yet to be fully understood. \u00a0There are two ways to approach the treatment of migraine headache with drugs: prevent the attacks, or relieve the symptoms during the attacks. Prevention involves the use of medications and behavioral changes. \u00a0Drugs originally developed for epilepsy, depression, or high blood pressure to prevent future attacks have been shown to be extremely effective in treating migraine. Botulinum toxin A has been shown to be effective in prevention of chronic migraine. \u00a0Behaviorally, stress management strategies, such as exercise, relaxation techniques, biofeedback mechanisms, and other therapies designed to limit daily discomfort, may reduce the number and severity of migraine attacks. \u00a0Making a log of personal triggers of migraine can also provide useful information for trigger-avoiding lifestyle changes, including dietary considerations, eating regularly scheduled meals with adequate hydration, stopping certain medications, and establishing a consistent sleep schedule. Hormone therapy may help some women whose migraines seem to be linked to their menstrual cycle. A weight loss program is recommended for obese individuals with migraine. Relief of symptoms, or acute treatments, during attacks consists of sumatriptan, ergotamine drugs, and analgesics such as ibuprofen and aspirin. \u00a0The sooner these treatments are administered, the more effective they are."}],"SUB_QUESTION_ID":"Q2-S1","ANNOTATIONS_FOCUS":["migraine"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"treatment options versus migraine types","MESSAGE":"Migraine seems to be a spectrum of conditions rather than only one easily diagnosed affliction. Many innovative migraine treatments are now in use, but it seems that each treatment only addresses a narrow set of conditions; for example, my daughter has tried many different treatment options (QEEG, HEG, TMS, topamax, ...) without success. Has any research been done to characterize which treatment types are effective against which migraine types?","QUESTION_ID":"Q2","F_REF":"1-136434885"} +{"ANSWERS":[{"_answerid":"Q3-S1-A1","_pairid":"5","__text":"Before taking pyridoxine, tell your doctor and pharmacist if you are allergic to pyridoxine or any other drugs. tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially levodopa (Larodopa, Sinemet), phenobarbital, phenytoin (Dilantin), and other vitamins. tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking pyridoxine, call your doctor."}],"SUB_QUESTION_ID":"Q3-S1","ANNOTATIONS_FOCUS":["pyridoxine"],"ANNOTATIONS_TYPE":"contraindication","SUBJECT":"","MESSAGE":"DO I USE PYRIDOXINE TABLETS EVEN IF IM PREGNANT?","QUESTION_ID":"Q3","F_REF":"1-123453375"} +{"ANSWERS":[{"_answerid":"Q4-S1-A1","_pairid":"6","__text":"Muscle cramps are common and often occur when a muscle is overused or injured. Working out when you have not had enough fluids (dehydration) or when you have low levels of minerals such as potassium or calcium can also make you more likely to have a muscle spasm. Muscle cramps can occur while you play tennis or golf, bowl, swim, or do any other exercise. They can also be triggered by: - Alcoholism - Hypothyroidism (underactive thyroid) - Kidney failure - Medications - Menstruation - Pregnancy"}],"SUB_QUESTION_ID":"Q4-S1","ANNOTATIONS_FOCUS":["cramp"],"ANNOTATIONS_TYPE":"cause","SUBJECT":"cramp","MESSAGE":"i have lymphoma what causes cramp after chemo treatment","QUESTION_ID":"Q4","F_REF":"1-118260435"} +{"ANSWERS":[{"_answerid":"Q5-S1-A1","_pairid":"7","__text":"These resources address the diagnosis or management of age-related macular degeneration: - BrightFocus Foundation: Macular Degeneration Treatment - Genetic Testing Registry: Age-related macular degeneration - Genetic Testing Registry: Age-related macular degeneration 1 - Genetic Testing Registry: Age-related macular degeneration 10 - Genetic Testing Registry: Age-related macular degeneration 11 - Genetic Testing Registry: Age-related macular degeneration 2 - Genetic Testing Registry: Age-related macular degeneration 3 - Genetic Testing Registry: Age-related macular degeneration 4 - Genetic Testing Registry: Age-related macular degeneration 7 - Genetic Testing Registry: Age-related macular degeneration 9 - Genetic Testing Registry: Susceptibility to age-related macular degeneration, wet type - Genetic Testing Registry: Susceptibility to neovascular type of age-related macular degeneration - Macular Degeneration Partnership: Low Vision Rehabilitation - Prevent Blindness America: Age-Related Macular Degeneration (AMD) Test - Amsler Grid These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"}],"SUB_QUESTION_ID":"Q5-S1","ANNOTATIONS_FOCUS":["macular degeneration"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"Retina","MESSAGE":"I wonder of new research and testing on macular degeneration and the opportunity to be part of this process.","QUESTION_ID":"Q5","F_REF":"1-132032443"} +{"ANSWERS":[{"_answerid":"Q6-S1-A1","_pairid":"8","__text":"Hypothyroidism is a condition in which the thyroid gland does not make enough thyroid hormone. This condition is often called underactive thyroid."},{"_answerid":"Q6-S1-A2","_pairid":"9","__text":"Summary Your thyroid is a butterfly-shaped gland in your neck, just above your collarbone. It is one of your endocrine glands, which make hormones. Thyroid hormones control the rate of many activities in your body. These include how fast you burn calories and how fast your heart beats. All of these activities are your body's metabolism. If your thyroid gland is not active enough, it does not make enough thyroid hormone to meet your body's needs. This condition is hypothyroidism. Hypothyroidism is more common in women, people with other thyroid problems, and those over 60 years old. Hashimoto's disease, an autoimmune disorder, is the most common cause. Other causes include thyroid nodules, thyroiditis, congenital hypothyroidism, surgical removal of part or all of the thyroid, radiation treatment of the thyroid, and some medicines. The symptoms can vary from person to person. They may include - Fatigue - Weight gain - A puffy face - Cold intolerance - Joint and muscle pain - Constipation - Dry skin - Dry, thinning hair - Decreased sweating - Heavy or irregular menstrual periods and fertility problems - Depression - Slowed heart rate To diagnose hypothyroidism, your doctor will look at your symptoms and blood tests. Treatment is with synthetic thyroid hormone, taken every day. NIH: National Institute of Diabetes and Digestive and Kidney Diseases"},{"_answerid":"Q6-S1-A3","_pairid":"10","__text":"Hypothyroidism is a disorder that occurs when the thyroid gland does not make enough thyroid hormone to meet the body\u2019s needs.\u00a0 Thyroid hormone regulates metabolism\u2014the way the body uses energy\u2014and affects nearly every organ in the body. Without enough thyroid hormone, many of the body\u2019s functions slow down.\u00a0 About 4.6 percent of the U.S. population age 12 and older has hypothyroidism.1"}],"SUB_QUESTION_ID":"Q6-S1","ANNOTATIONS_FOCUS":["hypothyroidism"],"ANNOTATIONS_TYPE":"information","SUBJECT":"hypothyroidism","MESSAGE":"Can you please send me as much information as possible on "hypothyroidism". I was recently diagnosed with the disease and I am struggling to figure out what it is and how I got it. My name and address is: [NAME] [LOCATION] [CONTACT] Thank you in advance for your help!!!","QUESTION_ID":"Q6","F_REF":"17730"} +{"ANSWERS":[{"_answerid":"Q6-S2-A1","_pairid":"12","__text":"The thyroid gland is an important organ of the endocrine system. It is located at the front of the neck, just above where your collarbones meet. The thyroid makes hormones that control the way every cell in the body uses energy. This process is called metabolism. Hypothyroidism is more common in women and people over age 50. The most common cause of hypothyroidism is thyroiditis. Swelling and inflammation damage the thyroid gland's cells. Causes of this problem include: - The immune system attacking the thyroid gland - Viral infections (common cold) or other respiratory infections - Pregnancy (often called postpartum thyroiditis) Other causes of hypothyroidism include: - Certain medicines, such as lithium and amiodarone - Congenital (birth) defects - Radiation treatments to the neck or brain to treat different cancers - Radioactive iodine used to treat an overactive thyroid gland - Surgical removal of part or all of the thyroid gland - Sheehan syndrome, a condition that may occur in a woman who bleeds severely during pregnancy or childbirth and causes the destruction of the pituitary gland - Pituitary tumor or pituitary surgery"},{"_answerid":"Q6-S2-A2","_pairid":"13","__text":"Hypothyroidism has several causes, including - Hashimoto\u2019s disease - thyroiditis, or inflammation of the thyroid - congenital hypothyroidism, or hypothyroidism that is present at birth - surgical removal of part or all of the thyroid - radiation treatment of the thyroid - some medications Less commonly, hypothyroidism is caused by too much or too little iodine in the diet or by abnormalities of the pituitary gland. Hashimoto\u2019s Disease Hashimoto\u2019s disease, also called chronic lymphocytic thyroiditis, is the most common cause of hypothyroidism in the United States.1\u00a0 Hashimoto\u2019s disease is a form of chronic inflammation of the thyroid gland.\u00a0 Hashimoto\u2019s disease is also an autoimmune disorder. Normally, the immune system protects the body against foreign invaders\u2014such as viruses and bacteria\u2014that can cause illness.\u00a0 But in autoimmune diseases, the immune system attacks the body\u2019s own cells and organs.\u00a0 With Hashimoto\u2019s disease, the immune system attacks the thyroid, causing inflammation and interfering with its ability to produce thyroid hormones. More information is provided in the NIDDK health topic, Hashimoto\u2019s Disease. Thyroiditis Thyroiditis causes stored thyroid hormone to leak out of the thyroid gland.\u00a0 At first, the leakage raises hormone levels in the blood, leading to hyperthyroidism\u2014when thyroid hormone levels are too high\u2013\u2013that lasts for 1 or 2 months.\u00a0 Most people then develop hypothyroidism before the thyroid is completely healed. Several types of thyroiditis can cause hyperthyroidism followed by hypothyroidism: - Subacute thyroiditis. This condition involves painful inflammation and enlargement of the thyroid.\u00a0 Experts are not sure what causes subacute thyroiditis, but it may be related to a viral or bacterial infection.\u00a0 The condition usually goes away on its own in a few months. - Postpartum thyroiditis. This type of thyroiditis develops after a woman gives birth.\u00a0 For more information, see the section titled \u201cWhat happens with pregnancy and thyroid conditions?\u201d - Silent thyroiditis. This type of thyroiditis is called \u201csilent\u201d because it is painless, as is postpartum thyroiditis, even though the thyroid may be enlarged.\u00a0 Like postpartum thyroiditis, silent thyroiditis is probably an autoimmune condition and sometimes develops into permanent hypothyroidism. Congenital Hypothyroidism Some babies are born with a thyroid that is not fully developed or does not function properly.\u00a0 If untreated, congenital hypothyroidism can lead to mental retardation and growth failure.\u00a0 Early treatment can prevent these complications, so most newborns in the United States are screened for hypothyroidism. Surgical Removal of the Thyroid When part of the thyroid is removed, the remaining part may produce normal amounts of thyroid hormone, but some people who have this surgery develop hypothyroidism.\u00a0 Removal of the entire thyroid always results in hypothyroidism. Part or all of the thyroid may be surgically removed as a treatment for - hyperthyroidism - a large goiter, which is an enlarged thyroid that may cause the neck to appear swollen and can interfere with normal breathing and swallowing - thyroid nodules, which are noncancerous tumors, called adenomas, or lumps in the thyroid that can produce excess thyroid hormone - thyroid cancer Radiation Treatment of the Thyroid Radioactive iodine, a common treatment for hyperthyroidism, gradually destroys the cells of the thyroid.\u00a0 Most people who receive radioactive iodine treatment eventually develop hypothyroidism.\u00a0 People with Hodgkin\u2019s disease, other lymphomas, and head or neck cancers are treated with radiation, which can also damage the thyroid. Medications Some drugs can interfere with thyroid hormone production and lead to hypothyroidism, including - amiodarone, a heart medication - interferon alpha, a cancer medication - lithium, a bipolar disorder medication - interleukin-2, a kidney cancer medication"}],"SUB_QUESTION_ID":"Q6-S2","ANNOTATIONS_FOCUS":["hypothyroidism"],"ANNOTATIONS_TYPE":"cause","SUBJECT":"hypothyroidism","MESSAGE":"Can you please send me as much information as possible on "hypothyroidism". I was recently diagnosed with the disease and I am struggling to figure out what it is and how I got it. My name and address is: [NAME] [LOCATION] [CONTACT] Thank you in advance for your help!!!","QUESTION_ID":"Q6","F_REF":"17730"} +{"ANSWERS":[{"_answerid":"Q7-S1-A1","_pairid":"14","__text":"Clean the wound well with soap and water, and seek professional medical help. You will need a doctor to thoroughly clean the wound and remove any foreign objects. Most of the time, stitches should not be used for animal bite wounds. If there is any risk of rabies, you will be given a series of a preventive vaccine. The vaccine is generally given in 5 doses over 28 days. Most patients also receive a treatment called human rabies immunoglobulin (HRIG). This treatment\u00a0is given the day the bite occurred. Call your doctor right away after an animal bite or after being exposed to animals such as bats, foxes, and skunks. They may carry rabies. - Call even when no bite took place. - Immunization and treatment for possible rabies are recommended for at least up to 14 days after exposure or a bite. There is no known effective treatment for people with symptoms of a rabies infection, but there have been a few reports of people surviving with experimental treatments."}],"SUB_QUESTION_ID":"Q7-S1","ANNOTATIONS_FOCUS":["rabies"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"help about rabbies","MESSAGE":"A street dog bit me five years ago, I take all the vaccine from very next day from biting, now on that spot where bite there was etching problem since few day, please guide me is there any problem will create in future if create is there any treatment for rabies.","QUESTION_ID":"Q7","F_REF":"1-123897705"} +{"ANSWERS":[{"_answerid":"Q8-S1-A1","_pairid":"15","__text":"Damage from optic nerve atrophy cannot be reversed. The underlying disease must be found and treated. Otherwise, vision loss will continue. Rarely, conditions that lead to optic atrophy may be treatable."}],"SUB_QUESTION_ID":"Q8-S1","ANNOTATIONS_FOCUS":["optic nerve atrophy"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"Dear Sir\/Madam I'm [NAME] from [LOCATION], I'm 35 years old , I'd like to ask you a\u00a0Medical Question as I've got an optic nerve atrophy in my eye and i lost my vision since i was 8 years old , Now I've got one eye just , So please is there treatment for optic nerve atrophy ! Please see the attachment which is a Medical report from [LOCATION], Best Wishes [NAME]","QUESTION_ID":"Q8","F_REF":"1-133748113"} +{"ANSWERS":[{"_answerid":"Q9-S1-A1","_pairid":"16","__text":"X-linked congenital stationary night blindness is a disorder of the retina, which is the specialized tissue at the back of the eye that detects light and color. People with this condition typically have difficulty seeing in low light (night blindness). They also have other vision problems, including loss of sharpness (reduced acuity), severe nearsightedness (high myopia), involuntary movements of the eyes (nystagmus), and eyes that do not look in the same direction (strabismus). Color vision is typically not affected by this disorder. The vision problems associated with this condition are congenital, which means they are present from birth. They tend to remain stable (stationary) over time. Researchers have identified two major types of X-linked congenital stationary night blindness: the complete form and the incomplete form. The types have very similar signs and symptoms. However, everyone with the complete form has night blindness, while not all people with the incomplete form have night blindness. The types are distinguished by their genetic cause and by the results of a test called an electroretinogram, which measures the function of the retina."}],"SUB_QUESTION_ID":"Q9-S1","ANNOTATIONS_FOCUS":["congenital night blindness"],"ANNOTATIONS_TYPE":"symptom","SUBJECT":"Night Blindness","MESSAGE":"When and how do you know when you have congenital night blindness?","QUESTION_ID":"Q9","F_REF":"1-134322567"} +{"ANSWERS":[{"_answerid":"Q10-S1-A1","_pairid":"17","__text":"Summary Lewy body disease is one of the most common causes of dementia in the elderly. Dementia is the loss of mental functions severe enough to affect normal activities and relationships. Lewy body disease happens when abnormal structures, called Lewy bodies, build up in areas of the brain. The disease may cause a wide range of symptoms, including - Changes in alertness and attention - Hallucinations - Problems with movement and posture - Muscle stiffness - Confusion - Loss of memory Lewy body disease can be hard to diagnose, because Parkinson's disease and Alzheimer's disease cause similar symptoms. Scientists think that Lewy body disease might be related to these diseases, or that they sometimes happen together. Lewy body disease usually begins between the ages of 50 and 85. The disease gets worse over time. There is no cure. Treatment focuses on drugs to help symptoms. NIH: National Institute of Neurological Disorders and Stroke"},{"_answerid":"Q10-S1-A2","_pairid":"18","__text":"Lewy body dementia is one of the most common forms of progressive dementia. People affected by this condition may experience a variety of symptoms such as changes in alertness and attention; hallucinations; problems with movement and posture; muscle stiffness; confusion; and\/or memory loss. Although the exact cause of Lewy body dementia is poorly understood, symptoms are thought to result when clumps of a protein called alpha-synuclein (\"Lewy bodies\") accumulate in the brain. Lewy body dementia usually occurs sporadically in people with no family history of the condition. Rarely, more than one family member may be affected. There is currently no cure for Lewy body dementia; however, medications may be available to help manage the associated symptoms."}],"SUB_QUESTION_ID":"Q10-S1","ANNOTATIONS_FOCUS":["lewy body dementia"],"ANNOTATIONS_TYPE":"information","SUBJECT":"","MESSAGE":"Would appreciate any good info on Lewy Body Dementia, we need to get people aware of this dreadful disease, all they talk about is alzheimers. Thank you","QUESTION_ID":"Q10","F_REF":"1-135752923"} +{"ANSWERS":[{"_answerid":"Q11-S1-A1","_pairid":"19","__text":"Mutations in the BCKDHA, BCKDHB, and DBT genes can cause maple syrup urine disease. These three genes provide instructions for making proteins that work together as a complex. The protein complex is essential for breaking down the amino acids leucine, isoleucine, and valine, which are present in many kinds of food, particularly protein-rich foods such as milk, meat, and eggs. Mutations in any of these three genes reduce or eliminate the function of the protein complex, preventing the normal breakdown of leucine, isoleucine, and valine. As a result, these amino acids and their byproducts build up in the body. Because high levels of these substances are toxic to the brain and other organs, their accumulation leads to the serious health problems associated with maple syrup urine disease."}],"SUB_QUESTION_ID":"Q11-S1","ANNOTATIONS_FOCUS":["maple syrup urine disease"],"ANNOTATIONS_TYPE":"genetic changes","SUBJECT":"Maple Syrup Urine Disease","MESSAGE":"Gene changes or chromosomal changes of MSUD? What is the technical and simple language of MSUD? Are there any treatments for MSUD?","QUESTION_ID":"Q11","F_REF":"19832"} +{"ANSWERS":[{"_answerid":"Q11-S2-A1","_pairid":"20","__text":"When the condition is diagnosed, and during episodes, treatment involves eating a protein-free diet. Fluids, sugars, and sometimes fats are given through a vein (IV). Dialysis through your belly or a vein can be done to reduce the level of abnormal substances in your blood. Long-term treatment requires a special diet. For infants, the diet includes a formula with low levels of the amino acids leucine, isoleucine, and valine. People with this condition must remain on a diet low in these amino acids for life. It is very important to always follow this diet to prevent nervous system (neurological) damage. This requires frequent blood tests and close supervision by a registered dietitian and physician, as well as cooperation by parents of children with the condition."}],"SUB_QUESTION_ID":"Q11-S2","ANNOTATIONS_FOCUS":["maple syrup urine disease"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"Maple Syrup Urine Disease","MESSAGE":"Gene changes or chromosomal changes of MSUD? What is the technical and simple language of MSUD? Are there any treatments for MSUD?","QUESTION_ID":"Q11","F_REF":"19832"} +{"ANSWERS":[{"_answerid":"Q12-S1-A1","_pairid":"21","__text":"Isolated congenital diaphragmatic hernia is rarely inherited. In almost all cases, there is only one affected individual in a family. When congenital diaphragmatic hernia occurs as a feature of a genetic syndrome or chromosomal abnormality, it may cluster in families according to the inheritance pattern for that condition."}],"SUB_QUESTION_ID":"Q12-S1","ANNOTATIONS_FOCUS":["cdh"],"ANNOTATIONS_TYPE":"inheritance","SUBJECT":"congenital diaphragmatic hernia","MESSAGE":"I need to know if CDH can be passed down to future generations. I just learned that this condition most likely caused the death of my first child back in 1971. I was then told it was merely a fluke. I had NO trauma during the full-term pregnancy, and I and my then husband were in very good health. Now my son (from a different husband) and his wife are due to have fraternal twins in [DATE] 2015. Does the term 'congenital' mean that it could be passed down to another generation? I do not want to alarm my son and his wife. I just would like to inform whatever pediatrician is caring for these babies as to my experience. Unfortunately my son and I are estranged. And I do not know who is their pediatrician. My child's CDH was very severe. I know there are far less severe cases that can go undetected &\/or undiagnosed unless there is a reason to suspect such a condition. Please respond to my concerns.","QUESTION_ID":"Q12","F_REF":"1-136400295"} +{"ANSWERS":[{"_answerid":"Q13-S1-A1","_pairid":"23","__text":"Treatment for thalassemia major often involves regular blood transfusions and folate supplements. If you receive blood transfusions, you should not take iron supplements. Doing so can cause a high amount of iron to build up in the body, which can be harmful. Persons who receive a lot of blood transfusions need a treatment called chelation therapy. This is done to remove excess iron from the body. A bone marrow transplant may help treat the disease in some patients, especially children."}],"SUB_QUESTION_ID":"Q13-S1","ANNOTATIONS_FOCUS":["thalassemia"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"about thalassemia treatment","MESSAGE":"sir,my friend is suffering from thalassemia ,in that majorly red blood anemia,white blood anemia and the blood is comming out from mouth when she got cough .her condition is very severe .in her body the red ,white blood cells are abscent .so that blood transfusion is doing for every 16-20days.then in the recent days the blood also comming out from mouth please tell me where can i get the treatment for this disease .we can travel around the world for treatment please reply me as soon as possible. thank you sir.","QUESTION_ID":"Q13","F_REF":"1-131374625"} +{"ANSWERS":[{"_answerid":"Q14-S1-A1","_pairid":"25","__text":"Lifestyle changes often can help relieve acute (short-term) insomnia. These changes might make it easier to fall asleep and stay asleep. A type of counseling called cognitive-behavioral therapy (CBT) can help relieve the anxiety linked to chronic (ongoing) insomnia. Anxiety tends to prolong insomnia. Several medicines also can help relieve insomnia and re-establish a regular sleep schedule. However, if your insomnia is the symptom or side effect of another problem, it's important to treat the underlying cause (if possible). Lifestyle Changes If you have insomnia, avoid substances that make it worse, such as: Caffeine, tobacco, and other stimulants. The effects of these substances can last as long as 8 hours. Certain over-the-counter and prescription medicines that can disrupt sleep (for example, some cold and allergy medicines). Talk with your doctor about which medicines won't disrupt your sleep. Alcohol. An alcoholic drink before bedtime might make it easier for you to fall asleep. However, alcohol triggers sleep that tends to be lighter than normal. This makes it more likely that you will wake up during the night. Try to adopt bedtime habits that make it easier to fall asleep and stay asleep. Follow a routine that helps you wind down and relax before bed. For example, read a book, listen to soothing music, or take a hot bath. Try to schedule your daily exercise at least 5 to 6 hours before going to bed. Don't eat heavy meals or drink a lot before bedtime. Make your bedroom sleep-friendly. Avoid bright lighting while winding down. Try to limit possible distractions, such as a TV, computer, or pet. Make sure the temperature of your bedroom is cool and comfortable. Your bedroom also should be dark and quiet. Go to sleep around the same time each night and wake up around the same time each morning, even on weekends. If you can, avoid night shifts, alternating schedules, or other things that may disrupt your sleep schedule. Cognitive-Behavioral Therapy CBT for insomnia targets the thoughts and actions that can disrupt sleep. This therapy encourages good sleep habits and uses several methods to relieve sleep anxiety. For example, relaxation techniques and biofeedback are used to reduce anxiety. These strategies help you better control your breathing, heart rate, muscles, and mood. CBT also aims to replace sleep anxiety with more positive thinking that links being in bed with being asleep. This method also teaches you what to do if you're unable to fall asleep within a reasonable time. CBT also may involve talking with a therapist one-on-one or in group sessions to help you consider your thoughts and feelings about sleep. This method may encourage you to describe thoughts racing through your mind in terms of how they look, feel, and sound. The goal is for your mind to settle down and stop racing. CBT also focuses on limiting the time you spend in bed while awake. This method involves setting a sleep schedule. At first, you will limit your total time in bed to the typical short length of time you're usually asleep. This schedule might make you even more tired because some of the allotted time in bed will be taken up by problems falling asleep. However, the resulting tiredness is intended to help you get to sleep more quickly. Over time, the length of time spent in bed is increased until you get a full night of sleep. For success with CBT, you may need to see a therapist who is skilled in this approach weekly over 2 to 3 months. CBT works as well as prescription medicine for many people who have chronic insomnia. It also may provide better long-term relief than medicine alone. For people who have insomnia and major depressive disorder, CBT combined with antidepression medicines has shown promise in relieving both conditions. Medicines Prescription Medicines Many prescription medicines are used to treat insomnia. Some are meant for short-term use, while others are meant for longer use. Talk to your doctor about the benefits and side effects of insomnia medicines. For example, insomnia medicines can help you fall asleep, but you may feel groggy in the morning after taking them. Rare side effects of these medicines include sleep eating, sleep walking, or driving while asleep. If you have side effects from an insomnia medicine, or if it doesn't work well, tell your doctor. He or she might prescribe a different medicine. Some insomnia medicines can be habit forming. Ask your doctor about the benefits and risks of insomnia medicines. Over-the-Counter Products Some over-the-counter (OTC) products claim to treat insomnia. These products include melatonin, L-tryptophan supplements, and valerian teas or extracts. The Food and Drug Administration doesn't regulate \u201cnatural\u201d products and some food supplements. Thus, the dose and purity of these substances can vary. How well these products work and how safe they are isn't well understood. Some OTC products that contain antihistamines are sold as sleep aids. Although these products might make you sleepy, talk to your doctor before taking them. Antihistamines pose risks for some people. Also, these products may not offer the best treatment for your insomnia. Your doctor can advise you whether these products will benefit you."}],"SUB_QUESTION_ID":"Q14-S1","ANNOTATIONS_FOCUS":["insomnia"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"insomnia","MESSAGE":"What can I give my [AGE] father to help him sleep? He said he will take whatever. He is not on any medication, not allergic to anything. Fully ambilatory!","QUESTION_ID":"Q14","F_REF":"1-133026625"} +{"ANSWERS":[{"_answerid":"Q15-S1-A1","_pairid":"26","__text":"Diabetes insipidus is an uncommon condition in which the kidneys are unable to prevent the excretion of water."},{"_answerid":"Q15-S1-A2","_pairid":"27","__text":"Summary Diabetes insipidus (DI) causes frequent urination. You become extremely thirsty, so you drink. Then you urinate. This cycle can keep you from sleeping or even make you wet the bed. Your body produces lots of urine that is almost all water. DI is different from diabetes mellitus (DM), which involves insulin problems and high blood sugar. The symptoms can be similar. However, DI is related to how your kidneys handle fluids. It's much less common than DM. Urine and blood tests can show which one you have. Usually, DI is caused by a problem with your pituitary gland or your kidneys. Treatment depends on the cause of the problem. Medicines can often help. NIH: National Institute of Diabetes and Digestive and Kidney Diseases"},{"_answerid":"Q15-S1-A3","_pairid":"30","__text":"Diabetes insipidus (DI) is a rare disease that causes frequent urination. The large volume of urine is diluted, mostly water. To make up for lost water, a person with DI may feel the need to drink large amounts and is likely to urinate frequently, even at night, which can disrupt sleep and, on occasion, cause bedwetting. Because of the excretion of abnormally large volumes of dilute urine, people with DI may quickly become dehydrated if they do not drink enough water. Children with DI may be irritable or listless and may have fever, vomiting, or diarrhea. Milder forms of DI can be managed by drinking enough water, usually between 2 and 2.5 liters a day. DI severe enough to endanger a person's health is rare."}],"SUB_QUESTION_ID":"Q15-S1","ANNOTATIONS_FOCUS":["diabetes insipidus"],"ANNOTATIONS_TYPE":"information","SUBJECT":"You know Diabetes Insipidus?","MESSAGE":"I was born with Diabetes Insipidus and have many problems since the cell was removed when I was 22 and ALL","QUESTION_ID":"Q15","F_REF":"1-135900462"} +{"ANSWERS":[{"_answerid":"Q16-S1-A1","_pairid":"36","__text":"An anal fissure is a small split or tear in the thin moist tissue (mucosa) lining the lower rectum (anus)."}],"SUB_QUESTION_ID":"Q16-S1","ANNOTATIONS_FOCUS":["anal fissures"],"ANNOTATIONS_TYPE":"information","SUBJECT":"Anal Fissure","MESSAGE":"I may have a couple anal fissures and looking to speak with someone to get some information and support.","QUESTION_ID":"Q16","F_REF":"13550"} +{"ANSWERS":[{"_answerid":"Q17-S1-A1","_pairid":"37","__text":"A gastrointestinal stromal tumor (GIST) is a type of tumor that occurs in the gastrointestinal tract, most commonly in the stomach or small intestine. The tumors are thought to grow from specialized cells found in the gastrointestinal tract called interstitial cells of Cajal (ICCs) or precursors to these cells. GISTs are usually found in adults between ages 40 and 70; rarely, children and young adults develop these tumors. The tumors can be cancerous (malignant) or noncancerous (benign). Small tumors may cause no signs or symptoms. However, some people with GISTs may experience pain or swelling in the abdomen, nausea, vomiting, loss of appetite, or weight loss. Sometimes, tumors cause bleeding, which may lead to low red blood cell counts (anemia) and, consequently, weakness and tiredness. Bleeding into the intestinal tract may cause black and tarry stools, and bleeding into the throat or stomach may cause vomiting of blood. Affected individuals with no family history of GIST typically have only one tumor (called a sporadic GIST). People with a family history of GISTs (called familial GISTs) often have multiple tumors and additional signs or symptoms, including noncancerous overgrowth (hyperplasia) of other cells in the gastrointestinal tract and patches of dark skin on various areas of the body. Some affected individuals have a skin condition called urticaria pigmentosa (also known as cutaneous mastocytosis), which is characterized by raised patches of brownish skin that sting or itch when touched."}],"SUB_QUESTION_ID":"Q17-S1","ANNOTATIONS_FOCUS":["gist"],"ANNOTATIONS_TYPE":"information","SUBJECT":"ClinicalTrials.gov - Question - general information","MESSAGE":"Hello, my dad, 68 years old, has gastritis, it did ache occasionally over the last several years. The other day, he went to hospital to have medical check-up with endoscopic ultrasonography, and found GIST with about 1cm in size. Doctor told him that he may consider surgery or not, it is up to him. What are we supposed to do? will it develop to bad condition? any suggestions? I 'm looking forward to your early reply. Thank you so much.","QUESTION_ID":"Q17","F_REF":"1-136744885"} +{"ANSWERS":[{"_answerid":"Q17-S2-A1","_pairid":"38","__text":"For patients with primary, localized gastrointestinal stromal tumors, surgery with complete excision is the treatment of choice.[1] However, surgery has limited efficacy in the treatment of recurrent and metastatic gastrointestinal stromal tumors. These tumors are also resistant to both chemotherapy and radiotherapy. In the pre-imatinib era, the 5-year survival rate after the surgical resection of gastrointestinal stromal tumors was only 43%\u201380% as there was really no efficient method to cure the disease.[2] The addition of imatinib as part of the treatment of unresectable or recurrent gastrointestinal stromal tumors has improved the management of this condition and resulted in improved patient survival.[1][2] Last updated: 4\/27\/2010 FDA-Approved Treatments The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition. Learn more orphan products. Imatinib mesylate (Brand name: Gleevec\u00ae) - Manufactured by Novartis Pharmaceuticals Corp. FDA-approved indication: Treatment of patients with Kit (CD117) positive unresectable and\/or metastatic malignant gastrointestinal stromal tumors (GIST) National Library of Medicine Drug Information Portal Regorafenib (Brand name: Stivarga) - Manufactured by Bayer HealthCare Pharmaceuticals, Inc. FDA-approved indication: Treatment of patients with locally advanced, unresectable or metastatic gastrointestinal stromal tumor (GIST) who have been previously treated with imatinib mesylate and sunitinib malate. National Library of Medicine Drug Information Portal Medline Plus Health Information Pazopanib (Brand name: Votrient) - Manufactured by GlaxoSmithKline FDA-approved indication: Advanced soft tissue sarcoma (STS) who have received prior chemotherapy. National Library of Medicine Drug Information Portal Medline Plus Health Information"}],"SUB_QUESTION_ID":"Q17-S2","ANNOTATIONS_FOCUS":["gist"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"ClinicalTrials.gov - Question - general information","MESSAGE":"Hello, my dad, 68 years old, has gastritis, it did ache occasionally over the last several years. The other day, he went to hospital to have medical check-up with endoscopic ultrasonography, and found GIST with about 1cm in size. Doctor told him that he may consider surgery or not, it is up to him. What are we supposed to do? will it develop to bad condition? any suggestions? I 'm looking forward to your early reply. Thank you so much.","QUESTION_ID":"Q17","F_REF":"1-136744885"} +{"ANSWERS":[{"_answerid":"Q18-S1-A1","_pairid":"39","__text":"Spinocerebellar ataxia type 3 (SCA3) is a condition characterized by progressive problems with movement. People with this condition initially experience problems with coordination and balance (ataxia). Other early signs and symptoms of SCA3 include speech difficulties, uncontrolled muscle tensing (dystonia), muscle stiffness (spasticity), rigidity, tremors, bulging eyes, and double vision. People with this condition may experience sleep disorders such as restless leg syndrome or REM sleep behavior disorder. Restless leg syndrome is a condition characterized by numbness or tingling in the legs accompanied by an urge to move the legs to stop the sensations. REM sleep behavior disorder is a condition in which the muscles are active during the dream (REM) stage of sleep, so an affected person often acts out his or her dreams. These sleep disorders tend to leave affected individuals feeling tired during the day. Over time, individuals with SCA3 may develop loss of sensation and weakness in the limbs (peripheral neuropathy), muscle cramps, muscle twitches (fasciculations), and swallowing difficulties. Individuals with SCA3 may have problems with memory, planning, and problem solving. Signs and symptoms of the disorder typically begin in mid-adulthood but can appear anytime from childhood to late adulthood. People with SCA3 eventually require wheelchair assistance. They usually survive 10 to 20 years after symptoms first appear."}],"SUB_QUESTION_ID":"Q18-S1","ANNOTATIONS_FOCUS":["sca3"],"ANNOTATIONS_TYPE":"information","SUBJECT":"Help for my diagnose","MESSAGE":"I have been diagnosed with SCA3. I was wondering if MedlinePlus is able to help me with resources that I may need on my journey through this disease? If not, can you help me find an organization or association that can help me.","QUESTION_ID":"Q18","F_REF":"1-132036525"} +{"ANSWERS":[{"_answerid":"Q18-S2-A1","_pairid":"40","__text":"Additional Information & Resources MedlinePlus (4 links) Encyclopedia: Movement--Uncoordinated Health Topic: Balance Problems Health Topic: Cerebellar Disorders Health Topic: Movement Disorders Genetic and Rare Diseases Information Center (1 link) Spinocerebellar ataxia 3 Additional NIH Resources (1 link) National Institute of Neurological Disorders and Stroke: Ataxias and Cerebellar or Spinocerebellar Degeneration Information Page Educational Resources (6 links) Disease InfoSearch: Spinocerebellar ataxia 3 Johns Hopkins Medicine Department of Neurology and Neurosurgery: What is Ataxia? MalaCards: machado-joseph disease Merck Manual Home Edition for Patients and Caregivers: Coordination Disorders National Ataxia Foundation: Spinocerebellar Ataxia Type 3 (PDF) Washington University, St. Louis: Neuromuscular Disease Center Patient Support and Advocacy Resources (4 links) Family Caregiver Alliance National Ataxia Foundation National Organization for Rare Disorders (NORD): Autosomal Dominant Hereditary Ataxia University of Kansas Medical Center Resource List: Ataxia GeneReviews (1 link) Spinocerebellar Ataxia Type 3 ClinicalTrials.gov (1 link) ClinicalTrials.gov Scientific Articles on PubMed (1 link) PubMed OMIM (1 link) MACHADO-JOSEPH DISEASE"}],"SUB_QUESTION_ID":"Q18-S2","ANNOTATIONS_FOCUS":["sca3"],"ANNOTATIONS_TYPE":"resources","SUBJECT":"Help for my diagnose","MESSAGE":"I have been diagnosed with SCA3. I was wondering if MedlinePlus is able to help me with resources that I may need on my journey through this disease? If not, can you help me find an organization or association that can help me.","QUESTION_ID":"Q18","F_REF":"1-132036525"} +{"ANSWERS":[{"_answerid":"Q19-S1-A1","_pairid":"41","__text":"There is no specific cure for migraine headaches. The goal is to treat your migraine symptoms right away, and to prevent symptoms by avoiding or changing your triggers. A key step is learning how to manage your migraines at home. A headache diary can help you identify your headache triggers. Then you and your doctor can plan how to avoid these triggers. If you have frequent migraines, your doctor may prescribe medicine to reduce the number of attacks. You need to take the medicine every day for it to be effective. Medicines may include: - Antidepressants - Blood pressure medicines - Seizure medicines Botulinum toxin type A (Botox) injections may also help reduce migraine attacks if they occur more than 15 days a month. Some people find relief with minerals and vitamins. Check with your doctor to see if riboflavin or magnesium are right for you. TREATING AN ATTACK Other medicines are taken at the first sign of a migraine attack. Over-the-counter (OTC) pain medicines, such as acetaminophen, ibuprofen, or aspirin are often helpful when your migraine is mild. Be aware that: - Taking medicines more than 3 days a week may lead to rebound headaches. These are headaches that keep coming back due to overuse of pain medicine. - Taking too much acetaminophen can damage your liver. - Too much ibuprofen or aspirin can irritate your stomach or kidneys. If these treatments do not help, ask your doctor about prescription medicines. These include nasal sprays, suppositories, or injections. Some migraine medicines narrow the blood vessels. If you are at risk for having a heart attack or have heart disease, talk with your doctor before using these medicines. Some migraine medicines should not be used by pregnant women. Talk with your doctor about which medicine is right for you if you are pregnant or planning to become pregnant. Other medicines treat symptoms of migraine, such as nausea and vomiting. They may be used alone or along with the other drugs that treat the migraine itself. Feverfew is a herb for migraines. It can be effective for some people. Before using feverfew, make sure your doctor approves. Herbal remedies sold in drugstores and health food stores are not regulated. Work with a trained herbalist when selecting herbs."}],"SUB_QUESTION_ID":"Q19-S1","ANNOTATIONS_FOCUS":["migraines"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"ClinicalTrials.gov - Question - general information","MESSAGE":"how do I get help with my migraines a have bad cluster migraines.","QUESTION_ID":"Q19","F_REF":"1-120034865"} +{"ANSWERS":[{"_answerid":"Q20-S1-A1","_pairid":"42","__text":"Congenital heart disease\u00a0is a problem with the heart's structure and function that is present at birth."}],"SUB_QUESTION_ID":"Q20-S1","ANNOTATIONS_FOCUS":["congenital heart disease"],"ANNOTATIONS_TYPE":"information","SUBJECT":"know more of Congenital Heart Disease","MESSAGE":"know more of Congenital Heart Disease","QUESTION_ID":"Q20","F_REF":"13506"} +{"ANSWERS":[{"_answerid":"Q21-S1-A1","_pairid":"46","__text":"Most of the time, RA affects joints on both sides of the body equally. Wrists, fingers, knees, feet, and ankles are the most commonly affected. The disease often begins slowly. Early symptoms may include minor joint pain, stiffness, and fatigue. Joint symptoms may include: - Morning stiffness, which lasts more than 1 hour, is common. Joints may feel warm, tender, and stiff when not used for an hour. - Joint pain is often felt on the same joint on both sides of the body. - Over time, joints may lose their range of motion and may become deformed. Other symptoms include: - Chest pain when taking a breath (pleurisy) - Dry eyes and mouth (Sjogren syndrome) - Eye burning, itching, and discharge - Nodules under the skin (usually a sign of more severe disease) - Numbness, tingling, or burning in the hands and feet - Sleep difficulties"},{"_answerid":"Q21-S1-A2","_pairid":"47","__text":"Swelling and Pain in the Joints Different types of arthritis have different symptoms. In general, people with most forms of arthritis have pain and stiffness in their joints. Rheumatoid arthritis is characterized by inflammation of the joint lining. This inflammation causes warmth, redness, swelling, and pain around the joints. A person also feels sick, tired, and sometimes feverish. Rheumatoid arthritis generally occurs in a symmetrical pattern. If one knee or hand is affected, the other one is also likely to be affected. Diagnostic Tests Rheumatoid arthritis can be difficult to diagnose in its early stages for several reasons. There is no single test for the disease. In addition, symptoms differ from person to person and can be more severe in some people than in others. Common tests for rheumatoid arthritis include - The rheumatoid factor test. Rheumatoid factor is an antibody that is present eventually in the blood of most people with rheumatoid arthritis However, not all people with rheumatoid arthritis test positive for rheumatoid factor, especially early in the disease. Also, some people who do test positive never develop the disease. The rheumatoid factor test. Rheumatoid factor is an antibody that is present eventually in the blood of most people with rheumatoid arthritis However, not all people with rheumatoid arthritis test positive for rheumatoid factor, especially early in the disease. Also, some people who do test positive never develop the disease. - The citrulline antibody test. This blood test detects antibodies to cyclic citrullinated peptide (anti-CCP). This test is positive in most people with rheumatoid arthritis and can even be positive years before rheumatoid arthritis symptoms develop. When used with the rheumatoid factor test, the citrulline antibody test results are very useful in confirming a rheumatoid arthritis diagnosis. The citrulline antibody test. This blood test detects antibodies to cyclic citrullinated peptide (anti-CCP). This test is positive in most people with rheumatoid arthritis and can even be positive years before rheumatoid arthritis symptoms develop. When used with the rheumatoid factor test, the citrulline antibody test results are very useful in confirming a rheumatoid arthritis diagnosis. Other common tests for rheumatoid arthritis include - the erythrocyte sedimentation rate, which indicates the presence of inflammation in the body - a test for white blood cell count and - a blood test for anemia. the erythrocyte sedimentation rate, which indicates the presence of inflammation in the body a test for white blood cell count and a blood test for anemia. Diagnosis Can Take Time Symptoms of rheumatoid arthritis can be similar to those of other types of arthritis and joint conditions, and it may take some time to rule out other conditions. The full range of symptoms develops over time, and only a few symptoms may be present in the early stages. Learn more about how rheumatoid arthritis is diagnosed."},{"_answerid":"Q21-S1-A3","_pairid":"48","__text":"Rheumatoid arthritis is characterized by inflammation of the joint lining. This inflammation causes warmth, redness, swelling, and pain around the joints. The pain of rheumatoid arthritis varies greatly from person to person, for reasons that doctors do not yet understand completely. Factors that contribute to the pain include swelling within the joint, the amount of heat or redness present, or damage that has occurred within the joint."}],"SUB_QUESTION_ID":"Q21-S1","ANNOTATIONS_FOCUS":["rheumatoid arthritis"],"ANNOTATIONS_TYPE":"symptom","SUBJECT":"Osteoarthritis","MESSAGE":"Are there any researches indicating how early an individual may experience any signs or symptoms of Rheumatoid Arthritis?","QUESTION_ID":"Q21","F_REF":"1-136858845"} +{"ANSWERS":[{"_answerid":"Q22-S1-A1","_pairid":"49","__text":"If you smoke, now is the time to quit. If you are having trouble quitting, talk with your doctor. There are many methods to help you quit, from support groups to prescription medicines. Also, try to avoid secondhand smoke."}],"SUB_QUESTION_ID":"Q22-S1","ANNOTATIONS_FOCUS":["lung cancer"],"ANNOTATIONS_TYPE":"prevention","SUBJECT":"","MESSAGE":"Genetic testing. My mother in law is in the last stage if lung cancer and only has days to live. My question is...testing her and comparing her tests with my husbands and his sisters test help to determine if it is genetic? My mother in law ([NAME]) and her mother and her mithers sister both had lung cancer and none if them were smokers. I'm real worried about my husband getting lung cancer now and I want find out what we can do to protect him.Thank you,[NAME]","QUESTION_ID":"Q22","F_REF":"5288"} +{"ANSWERS":[{"_answerid":"Q23-S1-A1","_pairid":"50","__text":"Eyes, ears, nose, mouth, and throat: - Blurred vision - Vision disturbances, including halos Gastrointestinal: - Diarrhea - Loss of appetite - Nausea - Stomach pain - Vomiting Heart and blood: - Irregular or slow heartbeat - Low blood pressure - Weakness Nervous system: - Confusion - Death - Depression - Disorientation - Dizziness - Drowsiness - Fainting - Headache - Lethargy Skin: - Hives - Rash Note: Depression, loss of appetite, and halos are usually only seen in chronic overdose cases."}],"SUB_QUESTION_ID":"Q23-S1","ANNOTATIONS_FOCUS":["oleander poisoning"],"ANNOTATIONS_TYPE":"symptom","SUBJECT":"oleander poisoning","MESSAGE":"If oleandor was ingested by touching the plant stems inner part and then directly eating without washing hands, how long would u exspect symptoms would start? And how severe would you say symptoms may get.","QUESTION_ID":"Q23","F_REF":"1-136022315"} +{"ANSWERS":[{"_answerid":"Q24-S1-A1","_pairid":"51","__text":"If you have diabetes, nerve damage in the leg or foot, poor blood circulation to your foot, or an infection around the nail, go to the doctor right away. Do\u00a0not try to treat\u00a0an ingrown nail\u00a0at home. Otherwise, to treat an ingrown nail at home: - Soak the foot in warm water 3 to 4 times a day if possible. After soaking, keep the toe dry. - Gently massage over the inflamed skin. - Place a small piece of cotton or dental floss under the nail. Wet the cotton with water or antiseptic. When trimming your toenails: - Briefly soak your foot in warm water to soften the nail. - Use a clean, sharp trimmer. - Trim toenails straight across the top. Do not taper or round the corners or trim too short. Do not try to cut out the ingrown portion of the nail yourself. This will only make the problem worse. Consider wearing sandals until the problem\u00a0goes away. Over-the-counter medicine that is applied to the ingrown toenail may help with the pain, but it\u00a0does not treat the problem. If this does not work and the ingrown nail gets worse, see your family doctor, a foot specialist (podiatrist) or a skin specialist (dermatologist). If your ingrown nail does not heal or keeps coming back, your doctor may remove part of the nail: - Numbing medicine is first injected into the toe. - The doctor uses\u00a0scissors to cut along the edge of the nail where the skin is growing over. This portion of the nail is removed. This procedure is called a partial nail avulsion. - It takes 2 to 4 months for the nail to regrow. Sometimes your doctor will use a chemical, electrical current, or another small surgical cut to destroy or remove the area from which a new nail may grow. If the toe is infected, your doctor may prescribe antibiotics."}],"SUB_QUESTION_ID":"Q24-S1","ANNOTATIONS_FOCUS":["ingrown toenail"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"I have no help its about 4 years now I have ingrown toenail","MESSAGE":"i have a problem of ingrown toenail its about 4 years now I have this problem i need help","QUESTION_ID":"Q24","F_REF":"1-135934082"} +{"ANSWERS":[{"_answerid":"Q25-S1-A1","_pairid":"52","__text":"Treatment for Friedreich ataxia includes: - Counseling - Speech therapy - Physical therapy - Walking aids or wheelchairs Orthopedic devices (braces) may be needed for scoliosis and foot problems. Treating heart disease and diabetes help people live longer and improve their quality of life."},{"_answerid":"Q25-S1-A2","_pairid":"53","__text":"These resources address the diagnosis or management of Friedreich ataxia: - Friedreich's Ataxia Research Alliance: Clinical Care Guidelines - Gene Review: Gene Review: Friedreich Ataxia - Genetic Testing Registry: Friedreich ataxia 1 - MedlinePlus Encyclopedia: Friedreich's Ataxia - MedlinePlus Encyclopedia: Hypertrophic Cardiomyopathy - National Institute of Neurological Disorders and Stroke: Friedreich's Ataxia Fact Sheet These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"},{"_answerid":"Q25-S1-A3","_pairid":"54","__text":"There is currently no effective cure or treatment for Friedreich's ataxia. However, many of the symptoms and accompanying complications can be treated to help individuals maintain optimal functioning as long as possible. Diabetes and heart problems can be treated with medications. Orthopedic problems such as foot deformities and scoliosis can be treated with braces or surgery. Physical therapy may prolong use of the arms and legs."}],"SUB_QUESTION_ID":"Q25-S1","ANNOTATIONS_FOCUS":["friedreich's ataxia"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"ClinicalTrials.gov - General Complaint","MESSAGE":"Dear sir\/ madam. I am a patient suffering from Friedreich's ataxia and i heard there was a medicine for it. In 2009 and since we are looking for the medicine kindly help on this and I have DNA report could You please help us on this as there are two people respective age 22 years and 24 years suffering from it. Looking for your help on this ASAP and please let us know when the medicine will be there in market and attaching two files for your reference","QUESTION_ID":"Q25","F_REF":"NF_61"} +{"ANSWERS":[{"_answerid":"Q26-S1-A1","_pairid":"55","__text":"Diagnostic testing does not find any physical cause for the symptoms. The doctor will do a physical exam and may order diagnostic tests. These are to make sure there are no physical causes for the symptom."}],"SUB_QUESTION_ID":"Q26-S1","ANNOTATIONS_FOCUS":["conversion disorder"],"ANNOTATIONS_TYPE":"diagnosis","SUBJECT":"","MESSAGE":"article defining 'conversion disorder' In your article defining 'conversion disorder', [http:\/\/www.nlm.nih.gov\/medlineplus\/ency\/article\/000954.htm] , the quote \"Conversion disorder is a mental health condition in which a person has blindness paralysis, or other nervous system (neurologic) symptoms that cannot be explained be medical evaluation\" , seemed to imply that the physical symptoms were valid as proving to be valid, but however the doctor could not 'figure' out why,.....but when I went to another source, another article quotes the disorder as a \"physical disability that is not caused by any physical impairment\" -so I am defining this as symptoms that are visibly correct as analyzed visually but when under examination for deadened nerves or broken bones, no evidence is found? >that is the definition I am getting from the other source about this disorder. For example, someone claims blindness, as my instructor explained, and when the person claiming blindness is placed near a ledge , does not walk off the ledge.....since I am assuming also that optical tests of the retina, or pupil proved nothing substantial?","QUESTION_ID":"Q26","F_REF":"14262"} +{"ANSWERS":[{"_answerid":"Q27-S1-A1","_pairid":"56","__text":"These resources address the diagnosis or management of spastic paraplegia type 11: - Gene Review: Gene Review: Spastic Paraplegia 11 - Genetic Testing Registry: Spastic paraplegia 11, autosomal recessive - Spastic Paraplegia Foundation, Inc.: Treatments and Therapies These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"}],"SUB_QUESTION_ID":"Q27-S1","ANNOTATIONS_FOCUS":["spg11"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"spg11","MESSAGE":"My 24 year old son was recently diagnosed with spg11 after over 15 years of trying to figure out what was wrong. We are already doing some of the common treatments. My question is, where do we go from here to give him the best chance at life,","QUESTION_ID":"Q27","F_REF":"1-136961537"} +{"ANSWERS":[{"_answerid":"Q28-S1-A1","_pairid":"57","__text":"Most fissures heal on their own and do not need treatment. To prevent or treat anal fissures in infants, be sure to change diapers often and clean the area gently. CHILDREN AND ADULTS Worrying about pain during a bowel movement may cause a person to avoid them. But not having bowel movements will only cause the stools to become even harder, which can make anal fissure worse. Prevent hard stools and constipation by: - Making dietary changes -- eating more fiber or bulk, such as fruits, vegetables, and grains - Drinking more fluids - Using stool softeners Applying the following ointments or creams to the area may soothe the skin: - Numbing cream, if pain interferes with normal bowel movements - Petroleum jelly - Zinc oxide, 1% hydrocortisone cream, Preparation H, and other products A sitz bath is a warm water bath used for healing or cleansing. You should sit in the bath two to three times a day. The water should cover only your hips and buttocks. If the anal fissures do not go away with home care methods, treatment may involve: - Botox injections into the muscle in the anus (anal sphincter) - Minor surgery to relax the anal muscle - Prescription creams such as nitrates or calcium channel blockers, applied over the fissure to help relax the muscles"}],"SUB_QUESTION_ID":"Q28-S1","ANNOTATIONS_FOCUS":["anal fissure"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"I have been battling Anal fissure for close to two years now and it has refused to heal all these while. Please what do you suggest i do? Thanks","QUESTION_ID":"Q28","F_REF":"1-134470695"} +{"ANSWERS":[{"_answerid":"Q29-S1-A1","_pairid":"58","__text":"Treatment usually only helps when started very early in the course of the disease. Injections of copper into a vein or under the skin have been used with mixed results."},{"_answerid":"Q29-S1-A2","_pairid":"59","__text":"These resources address the diagnosis or management of Menkes syndrome: - Gene Review: Gene Review: ATP7A-Related Copper Transport Disorders - Genetic Testing Registry: Menkes kinky-hair syndrome - MedlinePlus Encyclopedia: Copper in diet - MedlinePlus Encyclopedia: Menkes syndrome These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"}],"SUB_QUESTION_ID":"Q29-S1","ANNOTATIONS_FOCUS":["menkes syndrome"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"menkes syndrome \/kinky hair syndrome","MESSAGE":"My daughter has menkes syndrome and would like to know how to go about. Thx","QUESTION_ID":"Q29","F_REF":"1-132036455"} +{"ANSWERS":[{"_answerid":"Q30-S1-A1","_pairid":"60","__text":"Nephrotic syndrome is a group of symptoms that include protein in the urine, low blood protein levels in the blood, high cholesterol levels, high triglyceride levels, and swelling."}],"SUB_QUESTION_ID":"Q30-S1","ANNOTATIONS_FOCUS":["nephrotic syndrome"],"ANNOTATIONS_TYPE":"information","SUBJECT":"Nephrotic Syndrome","MESSAGE":"What is Nephrotic Syndrome. What are its causes and cures?","QUESTION_ID":"Q30","F_REF":"1-123712647"} +{"ANSWERS":[{"_answerid":"Q30-S2-A1","_pairid":"61","__text":"Nephrotic syndrome is caused by different disorders that damage the kidneys. This damage leads to the release of too much protein in the urine. The most common cause in children is minimal change disease. Membranous glomerulonephritis is the most common cause in adults.\u00a0In both diseases, the glomeruli in the kidneys are damaged. Glomeruli are the structures that help filter wastes and fluids. This condition can also occur from: - Cancer - Diseases such as diabetes, systemic lupus erythematosus, multiple myeloma, and amyloidosis - Genetic disorders - Immune disorders - Infections (such as strep throat, hepatitis, or mononucleosis) - Use of certain drugs It can occur with kidney disorders such as: - Focal and segmental glomerulosclerosis - Glomerulonephritis - Mesangiocapillary glomerulonephritis Nephrotic syndrome can affect all age groups. In children, it is most common between ages 2 and 6. This disorder occurs slightly more often in males than females."}],"SUB_QUESTION_ID":"Q30-S2","ANNOTATIONS_FOCUS":["nephrotic syndrome"],"ANNOTATIONS_TYPE":"cause","SUBJECT":"Nephrotic Syndrome","MESSAGE":"What is Nephrotic Syndrome. What are its causes and cures?","QUESTION_ID":"Q30","F_REF":"1-123712647"} +{"ANSWERS":[{"_answerid":"Q30-S3-A1","_pairid":"62","__text":"The goals of treatment are to relieve symptoms, prevent complications, and delay kidney damage. To control nephrotic syndrome, the disorder that is causing it must be treated. You may need treatment for life. Treatments may include any of the following: - Keeping blood pressure at or below 130\/80 mm Hg to delay kidney damage. Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) are the medicines most often used. ACE inhibitors and ARBs may also help decrease the amount of protein lost in the urine. - Corticosteroids and other drugs that suppress or quiet the immune system. - Treating high cholesterol to reduce the risk of heart and blood vessel problems. A low-fat, low-cholesterol diet is usually not enough for people with nephrotic syndrome. Medicines to reduce cholesterol and triglycerides (usually statins) may be needed. - A low-salt diet may help with swelling in the hands and legs. Water pills (diuretics) may also help with this problem. - Low-protein diets may be helpful. Your health care provider may suggest a moderate-protein diet (1 gram [gm] of protein per kilogram [kg] of body weight per day). - Taking\u00a0vitamin D supplements if nephrotic syndrome is long-term and is not responding to treatment. - Taking blood thinner drugs to treat or prevent blood clots."}],"SUB_QUESTION_ID":"Q30-S3","ANNOTATIONS_FOCUS":["nephrotic syndrome"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"Nephrotic Syndrome","MESSAGE":"What is Nephrotic Syndrome. What are its causes and cures?","QUESTION_ID":"Q30","F_REF":"1-123712647"} +{"ANSWERS":[{"_answerid":"Q31-S1-A1","_pairid":"63","__text":"Individual and family therapy is recommended for children to create a supportive environment at home and in school. Individual and, if appropriate, couples therapy is recommended for adults. Sex reassignment through surgery and hormonal therapy is an option. But identity problems may continue after this treatment."}],"SUB_QUESTION_ID":"Q31-S1","ANNOTATIONS_FOCUS":["gender dysphoria"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"GENDER DYSPHORIA","MESSAGE":"NO HEALTH CARE ON MY SON SUFFERING FROM GENDER DYSPHORIA WHAT CAN WE DO TO HELP HIM HE WORKED OUT OF HIGH SCHOOL NO PROBLEMS NOW NOT WORKING AND SHUTTING HIMSELF IN HIS ROOM 24\/7 THERES NOTHING ABOUT THIS CONDITION IN OUR AREA WE LIVE IN [LOCATION]. NO HELP IN AREA WHAT CAN WE DO HE HAS HAD BAD THOUGHTS ALREADY PLEASE HELP US WITH SOME SORT OF INFO THANK YUO [NAME] [LOCATION] [CONTACT]","QUESTION_ID":"Q31","F_REF":"1-131451155"} +{"ANSWERS":[{"_answerid":"Q32-S1-A1","_pairid":"64","__text":"Septic shock has a high death rate. The death rate depends on the patient's age and overall health, the cause of the infection, how many organs have failed, and how quickly and aggressively medical therapy is started."}],"SUB_QUESTION_ID":"Q32-S1","ANNOTATIONS_FOCUS":["septic shock"],"ANNOTATIONS_TYPE":"prognosis","SUBJECT":"Bowel Ischemia","MESSAGE":"My mother recently died from Bowel Ischemia and Septic Shock. My question is this, she was in the ER for 12 hours before she was even seen by the general surgeon and then he wasn't convinced that it was this condition yet. He said that he'd check on her in the morning once she was finally put into an ICU room (this was at 11 p.m.). I last spoke to her at midnight that evening and that was the last time that she was conscious. By the time she got to the ICU just 2-3 hours later, she was unresponsive and put on life support. Surgery was eventually performed later that afternoon and 90% of her small intestine had to be removed. She died early the next evening. My question to you is did they wait too long to do anything for her? Could she have been saved if surgery had been done sooner? I'm possibly thinking of bringing on a lawsuit.....Please advise with any answers to my questions that you can give. Thank you!","QUESTION_ID":"Q32","F_REF":"1-131159031"} +{"ANSWERS":[{"_answerid":"Q33-S1-A1","_pairid":"65","__text":"Treatment depends on the cause. Cushing syndrome caused by corticosteroid use: - Your doctor will instruct you to slowly decrease the medicine dosage. Stopping the medicine suddenly can be dangerous. - If you cannot stop taking the medicine because of disease, your high blood sugar, high cholesterol levels, and bone thinning or osteoporosis should be closely monitored. With Cushing syndrome caused by a pituitary or a tumor that releases ACTH (Cushing disease), you may need: - Surgery to remove the tumor. - Radiation after removal of a pituitary tumor in some cases. - Cortisol replacement therapy after surgery and possibly for the rest of your life. With Cushing syndrome due to an adrenal tumor\u00a0or other tumors: - You may need surgery to remove the tumor. - If the tumor cannot be removed, you may need medicines to help block the release of cortisol."}],"SUB_QUESTION_ID":"Q33-S1","ANNOTATIONS_FOCUS":["cushing"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"Cushing, fybromyaglia, Chronic fatigue","MESSAGE":"my main concern is no treatment and the musclar distrophy effecting my heart, legs feet, shoulders, arms, etc.","QUESTION_ID":"Q33","F_REF":"1-132773127"} +{"ANSWERS":[{"_answerid":"Q34-S1-A1","_pairid":"66","__text":"Treatment usually cures the infection. About 3% of people who get this disease will die."}],"SUB_QUESTION_ID":"Q34-S1","ANNOTATIONS_FOCUS":["rocky mountain spotted fever"],"ANNOTATIONS_TYPE":"prognosis","SUBJECT":"tick bites","MESSAGE":"my husband was diagnosed with Rocky Mountain Spotted fever about 6 1\/2 years ago. Then about 1 1\/2 years ago he was diagnosed with Lyme Disease. With him having had both what damage if any to his body could possibly happen. He has had alot of medical problems since. Now has been diagnosed with type II diabetes.","QUESTION_ID":"Q34","F_REF":"1-132036805"} +{"ANSWERS":[{"_answerid":"Q34-S2-A1","_pairid":"67","__text":"If diagnosed in the early stages, Lyme disease can be cured with antibiotics. Without treatment, complications involving the joints, heart, and nervous system can occur. But these symptoms are still treatable and curable. In rare cases, a person keeps having symptoms that interfere with daily life after they have been treated with antibiotics. This is also known as post-Lyme disease syndrome. The cause of this syndrome is unknown. Symptoms that occur after antibiotics are stopped may not be signs of active infection and may not respond to antibiotic treatment."}],"SUB_QUESTION_ID":"Q34-S2","ANNOTATIONS_FOCUS":["lyme disease"],"ANNOTATIONS_TYPE":"prognosis","SUBJECT":"tick bites","MESSAGE":"my husband was diagnosed with Rocky Mountain Spotted fever about 6 1\/2 years ago. Then about 1 1\/2 years ago he was diagnosed with Lyme Disease. With him having had both what damage if any to his body could possibly happen. He has had alot of medical problems since. Now has been diagnosed with type II diabetes.","QUESTION_ID":"Q34","F_REF":"1-132036805"} +{"ANSWERS":[{"_answerid":"Q35-S1-A1","_pairid":"68","__text":"Controlling blood pressure will slow further kidney damage. Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) are used most often. The goal is to keep blood pressure at or below 130\/80 mm Hg. Making lifestyle changes can help protect the kidneys, and prevent heart disease and stroke, such as: DO NOT smoke.\nEat meals that are low in fat and cholesterol. Get regular exercise (talk to your doctor or nurse before starting to exercise). Take drugs to lower your cholesterol, if needed. Keep your blood sugar under control. Avoid eating too much salt or potassium. Always talk to your kidney specialist before taking any over-the-counter medicine. This includes vitamins, herbs and supplements. Make sure all of the providers you visit know you have CKD. Other treatments may include: Medicines called phosphate binders, to help prevent high phosphorous levels Extra iron in the diet, iron pills, iron given through a vein (intravenous iron) special shots of a medicine called erythropoietin, and blood transfusions to treat anemia Extra calcium and vitamin D (always talk to your provider before taking) Your provider may have you follow a special diet for CKD. Limiting fluids Eating less protein Restricting salt, potassium, phosphorous, and other electrolytes Getting enough calories to prevent weight loss All people with CKD should be up-to-date on the following vaccinations: Hepatitis A vaccine Hepatitis B vaccine Flu vaccine Pneumonia vaccine (PPV)"}],"SUB_QUESTION_ID":"Q35-S1","ANNOTATIONS_FOCUS":["chronic renal failure"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"Please help me. have the honor to write to YOU. and I heard about your humanity and my hope in you a great And ask you for help I need you and I Will Be very very grateful to you. I am 30 years [NAME] state of Algeria , Batna. I suffer from a disease of chronic renal failure, dialysis was carried out 10 years ago. (Dialysis 3 times \/ week) continuous arteriovenous fistulas and the surgery (4till now). I live a hard life with illness and suffering continues to require a kidney transplant in order to get rid of this suffering Because the process of kidney transplantation in Algeria is slow and very rare, especially those without a family donor like me. Almost no hope for them. Please help me great hope in you (I'm sorry for writing bad because I do not know English we","QUESTION_ID":"Q35","F_REF":"11559"} +{"ANSWERS":[{"_answerid":"Q36-S1-A1","_pairid":"70","__text":"Leber congenital amaurosis is an eye disorder that primarily affects the retina, which is the specialized tissue at the back of the eye that detects light and color. People with this disorder typically have severe visual impairment beginning in infancy. The visual impairment tends to be stable, although it may worsen very slowly over time. Leber congenital amaurosis is also associated with other vision problems, including an increased sensitivity to light (photophobia), involuntary movements of the eyes (nystagmus), and extreme farsightedness (hyperopia). The pupils, which usually expand and contract in response to the amount of light entering the eye, do not react normally to light. Instead, they expand and contract more slowly than normal, or they may not respond to light at all. Additionally, the clear front covering of the eye (the cornea) may be cone-shaped and abnormally thin, a condition known as keratoconus. A specific behavior called Franceschetti's oculo-digital sign is characteristic of Leber congenital amaurosis. This sign consists of poking, pressing, and rubbing the eyes with a knuckle or finger. Researchers suspect that this behavior may contribute to deep-set eyes and keratoconus in affected children. In rare cases, delayed development and intellectual disability have been reported in people with the features of Leber congenital amaurosis. However, researchers are uncertain whether these individuals actually have Leber congenital amaurosis or another syndrome with similar signs and symptoms. At least 13 types of Leber congenital amaurosis have been described. The types are distinguished by their genetic cause, patterns of vision loss, and related eye abnormalities."}],"SUB_QUESTION_ID":"Q36-S1","ANNOTATIONS_FOCUS":["leber amaurosis"],"ANNOTATIONS_TYPE":"information","SUBJECT":"ClinicalTrials.gov - Question - general information","MESSAGE":"My cousin she is leber amaurosis she need help I don't know where to start from","QUESTION_ID":"Q36","F_REF":"19946"} +{"ANSWERS":[{"_answerid":"Q37-S1-A1","_pairid":"71","__text":"When possible, the cause of cardiomyopathy is treated. Medicines and lifestyle changes are often needed to treat the symptoms of heart failure, angina, and abnormal heart rhythms. Procedures or surgeries may also be used, including: - A defibrillator that sends an electrical pulse to stop life-threatening abnormal heart rhythms - A pacemaker that treats a slow heart rate or helps both sides of the heart beat at the same time - Coronary artery bypass (CABG) surgery or angioplasty\u00a0that may\u00a0improve blood flow to the damaged or weakened heart muscle - Heart transplant that may be tried when all other treatments have failed Recently, implantable artificial heart pumps have been developed. These may be used for very severe cases. However, not all patients need or are able to have this advanced treatment."},{"_answerid":"Q37-S1-A2","_pairid":"72","__text":"People who have cardiomyopathy but no signs or symptoms may not need treatment. Sometimes, dilated cardiomyopathy that comes on suddenly may go away on its own. For other people who have cardiomyopathy, treatment is needed. Treatment depends on the type of cardiomyopathy you have, the severity of your symptoms and complications, and your age and overall health. Treatments may include: Heart-healthy lifestyle changes Medicines Nonsurgical procedure Surgery and implanted devices The main goals of treating cardiomyopathy include: Controlling signs and symptoms so that you can live as normally as possible Managing any conditions that cause or contribute to the disease Reducing complications and the risk of sudden cardiac arrest Stopping the disease from getting worse Heart-Healthy Lifestyle Changes Your doctor may suggest lifestyle changes to manage a condition that\u2019s causing your cardiomyopathy including: Heart-healthy eating Maintaining a healthy weight Managing stress Physical activity Quitting smoking Heart-Healthy Eating Your doctor may recommend heart-healthy eating, which should include: Fat-free or low-fat dairy products, such as fat-free milk Fish high in omega-3 fatty acids, such as salmon, tuna, and trout, about twice a week Fruits, such as apples, bananas, oranges, pears, and prunes Legumes, such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans Vegetables, such as broccoli, cabbage, and carrots Whole grains, such as oatmeal, brown rice, and corn tortillas When following a heart-healthy diet, you should avoid eating: A lot of red meat Palm and coconut oils Sugary foods and beverages Two nutrients in your diet make blood cholesterol levels rise: Saturated fat\u2014found mostly in foods that come from animals Trans fat (trans fatty acids)\u2014found in foods made with hydrogenated oils and fats such as stick margarine;\u00a0baked goods such as, cookies, cakes, and pies, crackers, frostings, and coffee creamers. Some trans fats also occur naturally in animal fats and meats. Saturated fat raises your blood cholesterol more than anything else in your diet. When you follow a heart-healthy eating plan, only 5 percent to 6\u00a0percent of your daily calories should come from saturated fat. Food labels list the amounts of saturated fat. To help you stay on track, here are some examples: Not all fats are bad. Monounsaturated and polyunsaturated fats actually help lower blood cholesterol levels. Some sources of monounsaturated and polyunsaturated fats are: Avocados Corn, sunflower, and soybean oils Nuts and seeds, such as walnuts Olive, canola, peanut, safflower, and sesame oils Peanut butter Salmon and trout Tofu Sodium Try to limit the amount of sodium that you eat. This means choosing and preparing foods that are lower in salt and sodium. Try to use low-sodium and \u201cno added salt\u201d foods and seasonings at the table or while cooking. Food labels tell you what you need to know about choosing foods that are lower in sodium. Try to eat no more than 2,300 milligrams of sodium a day. If you have high blood pressure, you may need to restrict your sodium intake even more. Dietary Approaches to Stop Hypertension Your doctor may recommend the Dietary Approaches to Stop Hypertension (DASH) eating plan if you have high blood pressure. The DASH eating plan focuses on fruits, vegetables, whole grains, and other foods that are heart healthy and low in fat, cholesterol, and sodium and salt. The DASH eating plan is a good heart-healthy eating plan, even for those who don\u2019t have high blood pressure. Read more about DASH. Alcohol Talk to your doctor about how much alcohol you drink. Too much alcohol can\u00a0raise your blood pressure and triglyceride levels, a type of fat found in the blood. Alcohol also adds extra calories, which may cause weight gain. Your doctor may recommend that you reduce the amount of alcohol you drink\u00a0or stop drinking alcohol. Maintaining a Healthy Weight Maintaining a healthy weight is important for overall health and can lower your risk for coronary heart disease. Aim for a Healthy Weight by following a heart-healthy eating plan and keeping physically active. Knowing your body mass index (BMI) helps you find out if you\u2019re a healthy weight in relation to your height and gives an estimate of your total body fat. To figure out your BMI, check out the National Heart, Lung, and Blood Institute\u2019s (NHLBI) online\u00a0BMI calculator\u00a0or talk to your doctor.\u00a0A BMI: Below 18.5 is a sign that you are underweight. Between 18.5 and 24.9 is in the normal range. Between 25 and 29.9 is considered overweight. Of 30 or more is considered obese. A general goal to aim for is a BMI of less than 25. Your doctor or health care provider can help you set an appropriate BMI goal. Measuring waist circumference helps screen for possible health risks. If most of your fat is around your waist rather than at your hips, you\u2019re at a higher risk for heart disease and type 2 diabetes. This risk may be high with a waist size that is greater than 35 inches for women or greater than 40 inches for men. To learn how to measure your waist, visit\u00a0Assessing Your Weight and Health Risk. If you\u2019re overweight or obese, try to lose weight. A loss of just 3 percent to 5 percent of your current weight can lower your triglycerides, blood glucose, and the risk of developing type 2 diabetes. Greater amounts of weight loss can improve blood pressure readings, lower LDL cholesterol, and increase HDL cholesterol.\u00a0 Managing Stress Research shows that the most commonly reported \u201ctrigger\u201d for a heart attack is an emotionally upsetting event\u2014particularly one involving anger. Also, some of the ways people cope with stress\u2014such as drinking, smoking, or overeating\u2014aren\u2019t healthy. Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health.\u00a0Consider healthy stress-reducing activities, such as: A stress management program Meditation Physical activity Relaxation therapy Talking things out with friends or family\u00a0 Physical Activity Routine physical activity can lower many risk factors for coronary heart disease, including LDL (\u201cbad\u201d) cholesterol, high blood pressure, and excess weight. Physical activity also can lower your risk for diabetes and raise your HDL cholesterol level. HDL is the \u201cgood\u201d cholesterol that helps prevent coronary heart disease. Everyone should try to participate in moderate intensity aerobic exercise at least 2\u00a0hours and 30\u00a0minutes per week, or vigorous intensity aerobic exercise for 1\u00a0hour and 15\u00a0minutes per week. Aerobic exercise, such as brisk walking, is any exercise in which your heart beats faster\u00a0and you use more oxygen than usual. The more active you are, the more you will benefit. Participate in aerobic exercise for at least 10 minutes at a time spread throughout the week. Read more about physical activity at: Physical Activity and Your Heart U.S. Department of Health and Human Services\u2019 2008 Physical Activity Guidelines for\u00a0Americans Talk with your doctor before you start a new exercise plan. Ask your doctor how much and what kinds of physical activity are safe for you. Quitting Smoking If you smoke, quit. Smoking can raise your risk for coronary heart disease and heart attack and worsen other coronary heart disease risk factors. Talk with your doctor about programs and products that can help you quit smoking. Also, try to avoid secondhand smoke. If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking. Read more about quitting smoking at Smoking and Your Heart. \u00a0 Medicines Many medicines are used to treat cardiomyopathy. Your doctor may prescribe medicines to: Balance electrolytes in your body. Electrolytes are minerals that help maintain fluid levels and acid-base balance in the body. They also help muscle and nerve tissues work properly. Abnormal electrolyte levels may be a sign of dehydration (lack of fluid in your body), heart failure, high blood pressure, or other disorders. Aldosterone blockers are an example of a medicine used to balance electrolytes. Keep your heart beating with a normal rhythm. These medicines, called antiarrhythmics, help prevent arrhythmias. Lower your blood pressure. ACE inhibitors, angiotensin II receptor blockers, beta blockers, and calcium channel blockers are examples of medicines that lower blood pressure. Prevent blood clots from forming. Anticoagulants, or blood thinners, are an example of a medicine that prevents blood clots. Blood thinners often are used to prevent blood clots from forming in people who have dilated cardiomyopathy. Reduce inflammation. Corticosteroids are an example of a medicine used to reduce inflammation.\u00a0 Remove excess sodium from your body. Diuretics, or water pills, are an example of medicines that help remove excess sodium from the body, which reduces the amount of fluid in your blood. Slow your heart rate. Beta blockers, calcium channel blockers, and digoxin are examples of medicines that slow the heart rate. Beta blockers and calcium channel blockers also are used to lower blood pressure. Take all medicines regularly, as your doctor prescribes. Don\u2019t change the amount of your medicine or skip a dose unless your doctor tells you to. \u200bSurgery and Implanted Devices Doctors use several types of surgery to treat cardiomyopathy, including septal myectomy, surgically implanted devices, and heart transplant. Septal Myectomy Septal myectomy is open-heart surgery and is used to treat people who have hypertrophic cardiomyopathy and severe symptoms. This surgery generally is used for younger patients and for people whose medicines aren\u2019t working well. A surgeon removes part of the thickened septum that\u2019s bulging into the left ventricle. This improves blood flow through the heart and out to the body. The removed tissue doesn\u2019t grow back. If needed, the surgeon also can repair or replace the mitral valve at the same time. Septal myectomy often is successful and allows you to return to a normal life with no\u00a0symptoms. Surgically Implanted Devices Surgeons can place several types of devices in the heart to improve function and symptoms, including: Cardiac resynchronization therapy (CRT) device. A CRT device coordinates contractions between the heart\u2019s left and right ventricles. Implantable cardioverter defibrillator\u00a0(ICD). An ICD helps control life-threatening arrhythmias that may lead to\u00a0sudden cardiac arrest. This small device is implanted in the chest or abdomen and connected to the heart with wires. If an ICD senses a dangerous change in heart rhythm, it will send an electric shock to the heart to restore a normal heartbeat. Left ventricular assist device (LVAD). This device helps the heart pump blood to the body. An LVAD can be used as a long-term therapy or as a short-term treatment for people who are waiting for a heart transplant. Pacemaker. This small device is placed under the skin of your chest or abdomen to help control arrhythmias. The device uses electrical pulses to prompt the heart to beat at a normal rate. Heart Transplant For this surgery, a surgeon replaces a person\u2019s diseased heart with a healthy heart from a deceased donor. A heart transplant is a last resort treatment for people who have end-stage heart failure. \u201cEnd-stage\u201d means the condition has become so severe that all treatments, other than heart transplant, have failed. For more information about this treatment, go to the Heart Transplant Health Topic. Nonsurgical Procedure Doctors may use a nonsurgical procedure called alcohol septal ablation to treat cardiomyopathy. During this procedure, the doctor injects ethanol (a type of alcohol) through a tube into the small artery that supplies blood to the thickened area of heart muscle. The alcohol kills cells, and the thickened tissue shrinks to a more normal size. This procedure allows blood to flow freely through the ventricle, which improves symptoms."}],"SUB_QUESTION_ID":"Q37-S1","ANNOTATIONS_FOCUS":["cardiomyopathy"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"My father is having cardiomyopathy through genes. He is 83 now. He was absoulutely normal till now. recently he is getting breathlessness. and he was admitted to the hospital twice. The doctors are telling that multi dieases are attacking his heart. I just want to know exactly what is happening and what precautions that he should take in future. What are the chances of survival? Please help.","QUESTION_ID":"Q37","F_REF":"52"} +{"ANSWERS":[{"_answerid":"Q37-S2-A1","_pairid":"73","__text":"The outlook depends on many different things, including: - Cause and type of cardiomyopathy - How well the condition responds to treatment - The severity of the heart problem Heart failure is usually a long-term (chronic) illness. It may get worse over time. Some people develop severe heart failure. In this case, medicines, surgery, and other treatments may no longer help. Patients with certain types of cardiomyopathy are at risk for dangerous heart rhythm problems."}],"SUB_QUESTION_ID":"Q37-S2","ANNOTATIONS_FOCUS":["cardiomyopathy"],"ANNOTATIONS_TYPE":"prognosis","SUBJECT":"","MESSAGE":"My father is having cardiomyopathy through genes. He is 83 now. He was absoulutely normal till now. recently he is getting breathlessness. and he was admitted to the hospital twice. The doctors are telling that multi dieases are attacking his heart. I just want to know exactly what is happening and what precautions that he should take in future. What are the chances of survival? Please help.","QUESTION_ID":"Q37","F_REF":"52"} +{"ANSWERS":[{"_answerid":"Q38-S1-A1","_pairid":"74","__text":"Albinism is a defect of melanin production that results in little or no color (pigment) in the skin, hair, and eyes."},{"_answerid":"Q38-S1-A2","_pairid":"75","__text":"Albinism is a group of inherited disorders that results in little or no production of the pigment melanin, which determines the color of the skin, hair and eyes. Melanin also plays a role in the development of certain optical nerves, so all forms of albinism cause problems with the development and function of the eyes. Other symptoms can include light skin or changes in skin color; very white to brown hair; very light blue to brown eye color that may appear red in some light and may change with age; sensitivity to sun exposure; and increased risk of developing skin cancer. Albinism is caused by mutations in one of several genes, and most types are inherited in an autosomal recessive manner. Although there's no cure, people with the disorder can take steps to improve vision and avoid too much sun exposure."}],"SUB_QUESTION_ID":"Q38-S1","ANNOTATIONS_FOCUS":["albinism"],"ANNOTATIONS_TYPE":"information","SUBJECT":"Questions on albinism","MESSAGE":"Hello my name is [NAME] and I'm hoping you can help me. When i was born my doctor diagnosed me with albinism. I have color in my hair (brown) and in my eyes (hazel) they do not shake. My skin is fair but my markings are visible. It is not one solid fair white on all of me. I apparently have 3 different levels. most of my body is covered by level 1 pigmentation (the fairest) i have level 2 on some as well and a small patch of my arm of level (3) it basically looks like a huge birthmark that goes from my right side of the body to the left. When I was born the doctors still didn't know much about Albinism and I\"m hoping to learn more myself. For instance what type this would fall under... I hope you can help.","QUESTION_ID":"Q38","F_REF":"1-135928507"} +{"ANSWERS":[{"_answerid":"Q39-S1-A1","_pairid":"78","__text":"Fluids and electrolytes may be given by IV (into a vein) or you may be asked to drink water with electrolyte packets. Antibiotics are given to kill the bacteria. There are increasing rates of antibiotic resistance throughout the world, so your health care provider will check current recommendations before choosing an antibiotic."}],"SUB_QUESTION_ID":"Q39-S1","ANNOTATIONS_FOCUS":["typhoid"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"typhoid fever","MESSAGE":"Hi, My name is [NAME] from india i have suffering from typhoid please give me solution i have one question i had got treatment from one year but i am not well now give me solution?","QUESTION_ID":"Q39","F_REF":"1-132341355"} +{"ANSWERS":[{"_answerid":"Q40-S1-A1","_pairid":"79","__text":"You can make many lifestyle changes to help treat your symptoms. Other tips include: - If you are overweight or obese, in many cases, losing weight can help. - Avoid drugs such as aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn). Take acetaminophen (Tylenol) to relieve pain. - Take all of your medicines with plenty of water. When your doctor gives you a new medicine, ask whether it will make your heartburn worse. You may use over-the-counter antacids after meals and at bedtime, although the relief may not last very long. Common side effects of antacids include diarrhea or constipation. Other over-the-counter and prescription drugs can treat GERD. They work more slowly than antacids, but give you longer relief. Your pharmacist, doctor, or nurse can tell you how to take these drugs. - Proton pump inhibitors (PPIs) decrease the amount of acid produced in your stomach - H2 blockers also lower the amount of acid released in the stomach Anti-reflux surgery may be an option for people whose symptoms do not go away with lifestyle changes and medicines. Heartburn and other symptoms should improve after surgery. But you may still need to take drugs for your heartburn. There are also new therapies for reflux that can be performed through an endoscope (a flexible tube passed through the mouth into the stomach)."}],"SUB_QUESTION_ID":"Q40-S1","ANNOTATIONS_FOCUS":["gerd"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"GERD. I'm a 72 year old female, and have diverticulosis,gastritis, and esophagitis. I tried to see three different doctors today, but all were booked. I honestly don't know what to do. It hurts in my chest, and I can hardly talk.","QUESTION_ID":"Q40","F_REF":"11788"} +{"ANSWERS":[{"_answerid":"Q41-S1-A1","_pairid":"81","__text":"Most often, hemophilia is diagnosed after a person has an abnormal bleeding episode. It can also be diagnosed by a blood test done to detect the problem, if other family members have the condition."},{"_answerid":"Q41-S1-A2","_pairid":"82","__text":"If you or your child appears to have a bleeding problem, your doctor will ask about your personal and family medical histories. This will reveal whether you or your family members, including women and girls, have bleeding problems. However, some people who have hemophilia have no recent family history of the disease. You or your child also will likely have a physical exam and blood tests to diagnose hemophilia. Blood tests are used to find out: How long it takes for your blood to clot Whether your blood has low levels of any clotting factors Whether any clotting factors are completely missing from your blood The test results will show whether you have hemophilia, what type of hemophilia you have, and how severe it is. Hemophilia A and B are classified as mild, moderate, or severe, depending on the amount of clotting factor VIII or IX in the blood. The severity of symptoms can overlap between the categories. For example, some people who have mild hemophilia may have bleeding problems almost as often or as severe as some people who have moderate hemophilia. Severe hemophilia can cause serious bleeding problems in babies. Thus, children who have severe hemophilia usually are diagnosed during the first year of life. People who have milder forms of hemophilia may not be diagnosed until they're adults. The bleeding problems of hemophilia A and hemophilia B are the same. Only special blood tests can tell which type of the disorder you or your child has. Knowing which type is important because the treatments are different. Pregnant women who are known hemophilia carriers can have the disorder diagnosed in their unborn babies as early as 12 weeks into their pregnancies. Women who are hemophilia carriers also can have \"preimplantation diagnosis\" to have children who don't have hemophilia. For this process, women have their eggs removed and fertilized by sperm in a laboratory. The embryos are then tested for hemophilia. Only embryos without the disorder are implanted in the womb."}],"SUB_QUESTION_ID":"Q41-S1","ANNOTATIONS_FOCUS":["hemophilia"],"ANNOTATIONS_TYPE":"diagnosis","SUBJECT":"","MESSAGE":"Tests for Haemophilia. Hi, I was wondering if blood clotting assays are always positive if one has mild-moderate hemophilia and what the name is of the genetic tests for hemophilia? I have a history of internal spontaneous bleeding into the joints or with eating garlic or onions (in large amounts).I also hemmorhage after injuries (arm injury, head injury hemmorhage, and pregnancy birth hemmorhage--both times). I've had to have blood transfusions and shots to control the bleeding but it's usually possible to control it. I believe I may have passed this on to my son as he was determined by a doctor to be a heavy bleeder at circumcision. While on the [LOCATION]t, I was asked by a [LOCATION] if anyone had done a work-up on me for hemophilia or any clotting disorder and I said not to my knowledge. I asked if they were going to do it and she said to follow up with a primary doctor for it. She also said it could be expensive. This is why I'm asking, if I go to a medical appointment as a private-pay patient, and want to have testing done, which tests would you recommend? [NAME]","QUESTION_ID":"Q41","F_REF":"63"} +{"ANSWERS":[{"_answerid":"Q42-S1-A1","_pairid":"83","__text":"Knock knees are not treated in most cases. If the problem continues after age 7, the child may use a night brace. This brace is attached to a shoe. Surgery may be considered for knock knees that are severe and continue beyond late childhood."}],"SUB_QUESTION_ID":"Q42-S1","ANNOTATIONS_FOCUS":["knock knees"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"I am 23yr boy,i have knock knees i want treatment. Please help me.","QUESTION_ID":"Q42","F_REF":"1-122892655"} +{"ANSWERS":[{"_answerid":"Q43-S1-A1","_pairid":"84","__text":"You can make many lifestyle changes to help treat your symptoms. Other tips include: - If you are overweight or obese, in many cases, losing weight can help. - Avoid drugs such as aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn). Take acetaminophen (Tylenol) to relieve pain. - Take all of your medicines with plenty of water. When your doctor gives you a new medicine, ask whether it will make your heartburn worse. You may use over-the-counter antacids after meals and at bedtime, although the relief may not last very long. Common side effects of antacids include diarrhea or constipation. Other over-the-counter and prescription drugs can treat GERD. They work more slowly than antacids, but give you longer relief. Your pharmacist, doctor, or nurse can tell you how to take these drugs. - Proton pump inhibitors (PPIs) decrease the amount of acid produced in your stomach - H2 blockers also lower the amount of acid released in the stomach Anti-reflux surgery may be an option for people whose symptoms do not go away with lifestyle changes and medicines. Heartburn and other symptoms should improve after surgery. But you may still need to take drugs for your heartburn. There are also new therapies for reflux that can be performed through an endoscope (a flexible tube passed through the mouth into the stomach)."}],"SUB_QUESTION_ID":"Q43-S1","ANNOTATIONS_FOCUS":["gerd"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"Gastroesophageal Reflux Disease","MESSAGE":"Can GERD BE CURED? I AM SUFFERING FROM THIS DISEASE FOR ALMOST THREE YEARS NOW.I HAVE GONE TO MANY HOSPITALS BUT STILL CAN'T BE CURED.I HAVE BEEN GIVEN OMEPRAZOLE CAPSULES MANY TIMES.PLEASE HELP ME.","QUESTION_ID":"Q43","F_REF":"NF_211"} +{"ANSWERS":[{"_answerid":"Q44-S1-A1","_pairid":"85","__text":"OI is most often suspected in children whose bones break with very little force. A physical exam may show that the whites of their eyes have a blue tint. A definitive diagnosis may be made using a skin punch biopsy. Family members may be given a DNA blood test. If there is a family history of OI, chorionic villus sampling may be done during pregnancy to determine if the baby has the condition. However, because so many different mutations can cause OI, some forms cannot be diagnosed with a genetic test. The severe form of type II OI can be seen on ultrasound when the fetus is as young as 16 weeks."}],"SUB_QUESTION_ID":"Q44-S1","ANNOTATIONS_FOCUS":["oi"],"ANNOTATIONS_TYPE":"diagnosis","SUBJECT":"","MESSAGE":"diagnosis of OI\/ resources. I was writing to inquire about more information regarding the diagnosis of OI. We have family members who are in the process of waiting for genetic testing to come back but are under allegations of child abuse. Is there any information and \/ or resources that may be helpful to us? Any help is appreciated. Thank you,[NAME]","QUESTION_ID":"Q44","F_REF":"50"} +{"ANSWERS":[{"_answerid":"Q45-S1-A1","_pairid":"89","__text":"Most patients with pneumonia due to mycoplasma or chlamydophila get better with the right antibiotics. Legionella pneumonia can be severe. It can lead to problems, especially in patients with kidney failure, diabetes, COPD, or a weak immune system. It can also lead to death."}],"SUB_QUESTION_ID":"Q45-S1","ANNOTATIONS_FOCUS":["atypical pneumonia"],"ANNOTATIONS_TYPE":"prognosis","SUBJECT":"","MESSAGE":"atypical pnuemonia. what is the possibility of atypical pneumonia occurring again less than a month after treatment?","QUESTION_ID":"Q45","F_REF":"11781"} +{"ANSWERS":[{"_answerid":"Q46-S1-A1","_pairid":"90","__text":"Fibromyalgia is a common syndrome in which a person has long-term pain, spread throughout the body. The pain is most often linked to fatigue, sleep problems, headaches, depression, and anxiety. People with fibromalgia may also have tenderness in the joints, muscles, tendons, and other soft tissues."},{"_answerid":"Q46-S1-A2","_pairid":"91","__text":"Summary Fibromyalgia is a disorder that causes muscle pain and fatigue. People with fibromyalgia have \"tender points\" on the body. Tender points are specific places on the neck, shoulders, back, hips, arms, and legs. These points hurt when pressure is put on them. People with fibromyalgia may also have other symptoms, such as - Trouble sleeping - Morning stiffness - Headaches - Painful menstrual periods - Tingling or numbness in hands and feet - Problems with thinking and memory (sometimes called \"fibro fog\") No one knows what causes fibromyalgia. Anyone can get it, but it is most common in middle-aged women. People with rheumatoid arthritis and other autoimmune diseases are particularly likely to develop fibromyalgia. There is no cure for fibromyalgia, but medicine can help you manage your symptoms. Getting enough sleep, exercising, and eating well may also help. NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases"}],"SUB_QUESTION_ID":"Q46-S1","ANNOTATIONS_FOCUS":["fibromyalgia"],"ANNOTATIONS_TYPE":"information","SUBJECT":"","MESSAGE":"Can u please send stuff on fibromyalgia as well","QUESTION_ID":"Q46","F_REF":"1-131441670"} +{"ANSWERS":[{"_answerid":"Q47-S1-A1","_pairid":"92","__text":"Your health care provider can treat a wart if you do not like how it looks or if it is painful. Do NOT attempt to remove a wart yourself by burning, cutting, tearing, picking, or by any other method. MEDICINES Over-the-counter medicines are available to remove warts. Do NOT use over-the-counter wart medicines on your face or genitals. Warts in these areas need to be treated by a health care provider. To use wart-removal medicine: - File the wart with a nail file or emery board when your skin is damp (for example, after a shower or bath). This helps remove dead tissue. Do not use the same emery board on your nails. - Put the medicine on the wart every day for several weeks or months. Follow the instructions on the label. - Cover the wart with a bandage to prevent it from spreading.\u00a0 OTHER TREATMENTS Special foot cushions can help ease the pain from plantar warts. You can buy these at drugstores without a prescription. Use socks. Wear shoes with plenty of room. Avoid high heels. Your health care provider may need to trim away thick skin or calluses that form over warts on your foot or around nails. Your provider may recommend the following treatments if your warts do not go away: - Stronger (prescription) medicines - A blistering solution - Freezing the wart (cryotherapy) to remove it - Burning the wart (electrocautery) to remove it - Laser treatment for difficult to remove warts - Immunotherapy, which gives you a shot of a substance that causes an allergic reaction and helps the wart go away - Skin medicine called imiquimod Genital warts are treated in a different way than most other warts. A medicine called veregen may be used on genital warts, as well as on other warts."}],"SUB_QUESTION_ID":"Q47-S1","ANNOTATIONS_FOCUS":["warts"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"genital warts on penis","MESSAGE":"i have taken two treatment of this but still i have small warts please tell me which is the best madcine or cream","QUESTION_ID":"Q47","F_REF":"1-133767535"} +{"ANSWERS":[{"_answerid":"Q48-S1-A1","_pairid":"93","__text":"These resources address the diagnosis or management of X-linked congenital stationary night blindness: - American Optometric Association: Infant Vision - Gene Review: Gene Review: X-Linked Congenital Stationary Night Blindness - Genetic Testing Registry: Congenital stationary night blindness - Genetic Testing Registry: Congenital stationary night blindness, type 1A - Genetic Testing Registry: Congenital stationary night blindness, type 2A - MedlinePlus Encyclopedia: Electroretinography - MedlinePlus Encyclopedia: Eye movements - Uncontrollable - MedlinePlus Encyclopedia: Nearsightedness - MedlinePlus Encyclopedia: Strabismus - MedlinePlus Encyclopedia: Vision - Night Blindness These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"}],"SUB_QUESTION_ID":"Q48-S1","ANNOTATIONS_FOCUS":["x-linked congenital stationary night blindness"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"X-linked congenital stationary night blindness","MESSAGE":"i m suffering from similar or same decease.my mothers father suffered from same & my brother also.we have problem in low light infact cant view in damp conditions during day also have myopia but still not normal myopia cant see little object with clarity.life is looking like imprisonment.is there any chance for our recovery from this x linked decease.will we be able to see like normal ones.plz help. my age 38 y brother 44.address [LOCATION]","QUESTION_ID":"Q48","F_REF":"1-137191537"} +{"ANSWERS":[{"_answerid":"Q49-S1-A1","_pairid":"94","__text":"Hormone therapy and laparoscopy cannot cure endometriosis. However, in some women, these treatments may help relieve symptoms for years. Removal of the uterus, fallopian tubes, and both ovaries (a hysterectomy) gives you the best chance for a cure."}],"SUB_QUESTION_ID":"Q49-S1","ANNOTATIONS_FOCUS":["endometriosis"],"ANNOTATIONS_TYPE":"prognosis","SUBJECT":"","MESSAGE":"How bad can endometriosis get?","QUESTION_ID":"Q49","F_REF":"1-123117975"} +{"ANSWERS":[{"_answerid":"Q50-S1-A1","_pairid":"95","__text":"Gastroparesis is a condition that reduces the ability of the stomach to empty its contents. It does not involve a blockage (obstruction)."},{"_answerid":"Q50-S1-A2","_pairid":"96","__text":"Gastroparesis, also called delayed gastric emptying, is a disorder that slows or stops the movement of food from the stomach to the small intestine. Normally, the muscles of the stomach, which are controlled by the vagus nerve, contract to break up food and move it through the gastrointestinal (GI) tract. The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anus. The movement of muscles in the GI tract, along with the release of hormones and enzymes, allows for the digestion of food. Gastroparesis can occur when the vagus nerve is damaged by illness or injury and the stomach muscles stop working normally. Food then moves slowly from the stomach to the small intestine or stops moving altogether."},{"_answerid":"Q50-S1-A3","_pairid":"97","__text":"The problems of gastroparesis can include - severe dehydration due to persistent vomiting - gastroesophageal reflux disease (GERD), which is GER that occurs more than twice a week for a few weeks; GERD can lead to esophagitis\u2014 irritation of the esophagus - bezoars, which can cause nausea, vomiting, obstruction, or interfere with absorption of some medications in pill form - difficulty managing blood glucose levels in people with diabetes - malnutrition due to poor absorption of nutrients or a low calorie intake - decreased quality of life, including work absences due to severe symptoms"}],"SUB_QUESTION_ID":"Q50-S1","ANNOTATIONS_FOCUS":["gastroparesis"],"ANNOTATIONS_TYPE":"information","SUBJECT":"Gastroparesis","MESSAGE":"I am a current Gastroparesis fighter with a GJ feeding tube. I am also one of the admins for a GP support group and an advocacy group. I have become a volunteer advocater. I would appreciate any info you can share about Gastroparesis, Feeding tubes, and even TPN. Thanks","QUESTION_ID":"Q50","F_REF":"1-135563187"} +{"ANSWERS":[{"_answerid":"Q51-S1-A1","_pairid":"98","__text":"After many years, diabetes can lead to serious health problems: - You could have eye problems, including trouble seeing (especially at night) and sensitivity to light. You could become blind. - Your feet and skin could develop sores and infections. If you have these sores for too long, your foot or leg may need to be amputated. Infection can also cause pain and itching. - Diabetes may make it harder to control your blood pressure and cholesterol. This can lead to heart attack, stroke, and other problems. It can become harder for blood to flow to the legs and feet. - Nerves in the body can become damaged, causing pain, itching, tingling, and numbness. - Because of nerve damage, you could have problems digesting the food you eat. You could feel weakness or have trouble going to the bathroom. Nerve damage can also make it harder for men to have an erection. - High blood sugar and other problems can lead to kidney damage. The kidneys may not work as well as they used to. They may even stop working, so that you would need dialysis or a kidney transplant."}],"SUB_QUESTION_ID":"Q51-S1","ANNOTATIONS_FOCUS":["type 1 diabetes"],"ANNOTATIONS_TYPE":"complication","SUBJECT":"diabetes","MESSAGE":"It was really helpful after reading about type 1 diabetes but would like some more suggestions from you .my friend is 35 year old and its been 1 year of his diabetes n his sugar level is around 100 or 120 OR SO.. each time he tests his sugar level. is there ANY COMPLICATIONS? HE ALSO GO FOR EXERCISES AND BLOOD TEST EVERY 2 OR 3 MONTHS N TAKES A PROPER DIET LIKE GREEN JUICE,OLIVE OIL AND ALL. WAITING FOR YOUR FEED BACK. THANK YOU.","QUESTION_ID":"Q51","F_REF":"1-122891932"} +{"ANSWERS":[{"_answerid":"Q52-S1-A1","_pairid":"99","__text":"If the underlying cause of burning mouth syndrome is determined, treatment is aimed at the triggering factor(s). If no cause can be found, treatment can be challenging. The following are potential therapies for burning mouth syndrome; we strongly recommend that you work with your health care provider in determining which therapy is right for you. A lozenge-type form of the anticonvulsant medication clonazepam (Klonopin) Oral thrush medications Medications that block nerve pan Certain antidepressants B vitamins Cognitive behavioral therapy Special oral rinses or mouth washes Saliva replacement products Capsaicin In addition to these medications, the following measures may be helpful in reducing symptoms of burning mouth syndrome: Sip water frequently Suck on ice chips Chew sugarless gum Avoid irritating substances like tobacco, hot or spicy foods, alcoholic beverages, mouthwashes that contain alcohol, and products high in acid, like citrus fruits and juices, as well as cinnamon or mint."}],"SUB_QUESTION_ID":"Q52-S1","ANNOTATIONS_FOCUS":["burning mouth syndrome"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"I just read an article submitted by you that stated your research shows that you've identified the mechanism that causes burning mouth syndrome. Also because of these findings you can find a treatment. I've had this for 15 yrs and am just holding on. When will a good treatment be available?? I belong to a group of over 500 bmsers. We're suffering terribly and were from all over the world. What would the treatment be?","QUESTION_ID":"Q52","F_REF":"15061"} +{"ANSWERS":[{"_answerid":"Q53-S1-A1","_pairid":"100","__text":"Low blood pressure occurs when blood pressure is much lower than normal. This means the heart, brain, and other parts of the body do not get enough blood. Normal blood pressure is usually between 90\/60 mmHg and 120\/80 mmHg. The medical name for low blood pressure is hypotension."},{"_answerid":"Q53-S1-A2","_pairid":"101","__text":"Summary You've probably heard that high blood pressure is a problem. Sometimes blood pressure that is too low can also cause problems. Blood pressure is the force of your blood pushing against the walls of your arteries. Each time your heart beats, it pumps out blood into the arteries. Your blood pressure is highest when your heart beats, pumping the blood. This is called systolic pressure. When your heart is at rest, between beats, your blood pressure falls. This is the diastolic pressure. Your blood pressure reading uses these two numbers. Usually they're written one above or before the other, such as 120\/80. If your blood pressure reading is 90\/60 or lower, you have low blood pressure. Some people have low blood pressure all the time. They have no symptoms and their low readings are normal for them. In other people, blood pressure drops below normal because of a medical condition or certain medicines. Some people may have symptoms of low blood pressure when standing up too quickly. Low blood pressure is a problem only if it causes dizziness, fainting or in extreme cases, shock. NIH: National Heart, Lung, and Blood Institute"},{"_answerid":"Q53-S1-A3","_pairid":"102","__text":"Hypotension (HI-po-TEN-shun) is abnormally low blood pressure. Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps out blood. Blood pressure is measured as systolic (sis-TOL-ik) and diastolic (di-a-STOL-ik) pressures. \"Systolic\" refers to blood pressure when the heart beats while pumping blood. \"Diastolic\" refers to blood pressure when the heart is at rest between beats. You most often will see blood pressure numbers written with the systolic number above or before the diastolic number, such as 120\/80 mmHg. (The mmHg is millimeters of mercury\u2014the units used to measure blood pressure.) Normal blood pressure in adults is lower than 120\/80 mmHg. Hypotension is blood pressure that's lower than 90\/60 mmHg. Overview Blood pressure doesn't stay the same all the time. It lowers as you sleep and rises when you wake up. Blood pressure also rises when you're excited, nervous, or active. Your body is very sensitive to changes in blood pressure. For example, if you stand up quickly, your blood pressure may drop for a short time. Your body adjusts your blood pressure to make sure enough blood and oxygen are flowing to your brain, kidneys, and other vital organs. Most forms of hypotension happen because your body can't bring blood pressure back to normal or can't do it fast enough. Some people have low blood pressure all the time. They have no signs or symptoms, and their low blood pressure is normal for them. In other people, certain conditions or factors cause abnormally low blood pressure. As a result, less blood and oxygen flow to the body's organs. For the most part, hypotension is a medical concern only if it causes signs or symptoms or is linked to a serious condition, such as heart disease. Signs and symptoms of hypotension may include dizziness, fainting, cold and sweaty skin, fatigue (tiredness), blurred vision, or nausea (feeling sick to your stomach). In extreme cases, hypotension can lead to shock. Outlook In a healthy person, low blood pressure without signs or symptoms usually isn't a problem and needs no treatment. If it causes signs or symptoms, your doctor will try to find and treat the condition that's causing it. Hypotension can be dangerous. It can make you fall because of dizziness or fainting. Shock, a severe form of hypotension, is a condition that's often fatal if not treated right away. With prompt and proper treatment, shock can be successfully treated."}],"SUB_QUESTION_ID":"Q53-S1","ANNOTATIONS_FOCUS":["hypotension"],"ANNOTATIONS_TYPE":"information","SUBJECT":"Hypotension","MESSAGE":"I'm looking for books about hypotension\/low blood pressure. Can you suggest any that I might be able to purchase?","QUESTION_ID":"Q53","F_REF":"13600"} +{"ANSWERS":[{"_answerid":"Q54-S1-A1","_pairid":"106","__text":"The goal of treatment is to reduce symptoms and speed healing. If your symptoms are mild, you may not need treatment. Treatments may include: - Antihistamines - Medicines that calm down the immune system (in severe cases) - Lidocaine mouthwashes to numb the area and make eating more comfortable (for mouth sores) - Topical corticosteroids or oral corticosteroids to reduce swelling and lower immune responses - Corticosteroid shots into a sore - Vitamin A as a cream or taken by mouth - Other medicines that are applied to the skin - Dressings placed over your skin with medicines to keep you from scratching - Ultraviolet light therapy"}],"SUB_QUESTION_ID":"Q54-S1","ANNOTATIONS_FOCUS":["lichen planus"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"I have been suffering from lichen planus since last four years. Some time it reduces the red sign and sometime it increases and I cannot take spicy food or hot food. Could you please suggest the remedies. I had consulted the dermatologist also .He gave me some ointment named as clone taxol for applying towards the read area. Awaiting your valuable advise I this behalf. With kind regards. Sent from my iPad","QUESTION_ID":"Q54","F_REF":"1-131441708"} +{"ANSWERS":[{"_answerid":"Q55-S1-A1","_pairid":"107","__text":"Distal renal tubular acidosis is a disease that occurs when the kidneys do not properly remove acids from the blood into the urine. As a result, too much acid remains in the blood (called acidosis)."}],"SUB_QUESTION_ID":"Q55-S1","ANNOTATIONS_FOCUS":["distal renal tubular acidosis"],"ANNOTATIONS_TYPE":"information","SUBJECT":"know more about","MESSAGE":"My Daughter have Distal renal tubular acidosis. we are from Mexico, and we ae woundering if can send to us more infomation. maybe you can reccommend to us a association???? i don?t know","QUESTION_ID":"Q55","F_REF":"NF_272"} +{"ANSWERS":[{"_answerid":"Q56-S1-A1","_pairid":"109","__text":"Klinefelter syndrome is a genetic condition that occurs in males when they have an extra X chromosome."},{"_answerid":"Q56-S1-A2","_pairid":"110","__text":"Summary Klinefelter syndrome (KS) is a condition that occurs in men who have an extra X chromosome. The syndrome can affect different stages of physical, language, and social development. The most common symptom is infertility. Boys may be taller than other boys their age, with more fat around the belly. After puberty, KS boys may have - Smaller testes and penis - Breast growth - Less facial and body hair - Reduced muscle tone - Narrower shoulders and wider hips - Weaker bones - Decreased sexual interest - Lower energy KS males may have learning or language problems. They may be quiet and shy and have trouble fitting in. A genetic test can diagnose KS. There is no cure, but treatments are available. It is important to start treatment as early as possible. With treatment, most boys grow up to have normal lives. Treatments include testosterone replacement therapy and breast reduction surgery. If needed, physical, speech, language, and occupational therapy may also help. NIH: National Institute of Child Health and Human Development"},{"_answerid":"Q56-S1-A3","_pairid":"112","__text":"Klinefelter syndrome is a chromosomal condition that affects male physical and cognitive development. Its signs and symptoms vary among affected individuals. Affected individuals typically have small testes that do not produce as much testosterone as usual. Testosterone is the hormone that directs male sexual development before birth and during puberty. A shortage of testosterone can lead to delayed or incomplete puberty, breast enlargement (gynecomastia), reduced facial and body hair, and an inability to have biological children (infertility). Some affected individuals also have genital differences including undescended testes (cryptorchidism), the opening of the urethra on the underside of the penis (hypospadias), or an unusually small penis (micropenis). Older children and adults with Klinefelter syndrome tend to be taller than their peers. Compared with unaffected men, adults with Klinefelter syndrome have an increased risk of developing breast cancer and a chronic inflammatory disease called systemic lupus erythematosus. Their chance of developing these disorders is similar to that of women in the general population. Children with Klinefelter syndrome may have learning disabilities and delayed speech and language development. They tend to be quiet, sensitive, and unassertive, but personality characteristics vary among affected individuals."}],"SUB_QUESTION_ID":"Q56-S1","ANNOTATIONS_FOCUS":["klinefelter syndrome"],"ANNOTATIONS_TYPE":"information","SUBJECT":"Klinefelter Syndrome","MESSAGE":"I would like to learn more about my condition. Please send me any literature you feel I could use. thanks, [NAME]","QUESTION_ID":"Q56","F_REF":"1-132454692"} +{"ANSWERS":[{"_answerid":"Q57-S1-A1","_pairid":"118","__text":"It may take 4 weeks or longer before you feel the full benefit of bupropion. Continue to take bupropion even if you feel well. Do not stop taking bupropion without talking to your doctor. Your doctor may decrease your dose gradually."}],"SUB_QUESTION_ID":"Q57-S1","ANNOTATIONS_FOCUS":["Wellbutrin"],"ANNOTATIONS_TYPE":"tapering","SUBJECT":"Decreasing Wellbutrin HCL XL","MESSAGE":"Hello, I'm not sure if this is something you can help me with, but I thought that I would ask, as your organization is affiliated with trusted mental health and general health organizations. I was recently taken off of Wellbutrin HCL XL completely without any tapering. I'm having a difficult time finding out online if this is safe (to \"go cold turkey\") or if I should have been given the medication in slowly-decreasing doses. Can you please offer some guidance? Thank you. [NAME]","QUESTION_ID":"Q57","F_REF":"1-122992555"} +{"ANSWERS":[{"_answerid":"Q58-S1-A1","_pairid":"119","__text":"To get rid of lice, take the following important steps: - Bathe regularly to get rid of lice and their eggs. - Change your clothes often. - Wash clothes in hot water (at least 130\u00b0F\/54\u00b0C) and machine dry using the hot cycle.\u00a0 - Items that can't be washed, such as stuffed toys, mattresses, or furniture, can be thoroughly vacuumed to get rid of lice and eggs that have fallen off the body. Your provider may prescribe a skin cream or a wash that contains permethrin, malathione, or benzyl alcohol. If your case is severe, the provider may prescribe medicine that you take by mouth."}],"SUB_QUESTION_ID":"Q58-S1","ANNOTATIONS_FOCUS":["body lice"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"Body Lice","MESSAGE":"How do I get rid of these little devils? Me and My mom have tried so many things to get rid of these bugs and they just don't go away were the family that takes 2 showers and now about 3 showers a day we never understood how they could have infected us but I was just wondering is washing our clothes the best bet to get rid of these things, because apparently it hasn't worked for us. So is there any suggestions?","QUESTION_ID":"Q58","F_REF":"17014"} +{"ANSWERS":[{"_answerid":"Q59-S1-A1","_pairid":"122","__text":"The goal of treatment is to reduce the amount of copper in the tissues. This is done by a procedure called chelation -- certain medications can bind to copper and help remove it through the kidneys or gut. Treatment must be lifelong. The following medications may be used: - Penicillamine (Cuprimine, Depen) binds to copper and leads to increased release of copper in the urine. - Trientine (Syprine) binds (chelates) the copper and increases its release through the urine. - Zinc acetate (Galzin) blocks copper from being absorbed in the intestinal tract. Vitamin E supplements may also be used. Sometimes, medications that chelate copper (especially penicillamine) can affect the function of the brain and nervous system (neurological function). Other medications under investigation may bind copper without affecting neurological function. A low-copper diet may also be recommended. Foods to avoid include: - Chocolate - Dried fruit - Liver - Mushrooms - Nuts - Shellfish You may want to drink distilled water because most tap water flows through copper pipes. Avoid using copper cooking utensils. Symptoms may be treated with exercise or physical therapy. People who are confused or unable to care for themselves may need special protective measures. A liver transplant may be considered in cases where the liver is severely damaged by the disease."},{"_answerid":"Q59-S1-A2","_pairid":"124","__text":"These resources address the diagnosis or management of Wilson disease: - Gene Review: Gene Review: Wilson Disease - Genetic Testing Registry: Wilson's disease - MedlinePlus Encyclopedia: Wilson's disease - National Human Genome Research Institute These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"}],"SUB_QUESTION_ID":"Q59-S1","ANNOTATIONS_FOCUS":["wilson's disease"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"ClinicalTrials.gov - Suggestion","MESSAGE":"We appreciate your response. My son is 24 years old. We cannot find any drugs, treatments as well as hospitals to fight against Wilson's disease in Mongolia. Currently there is only person with Wilson's disease in Mongolia who is my son. We cannot find anything good to help my son at the moment. Therefore, we need somewhere where my son can get help. We are also lack of financial condition to support full treatment for my son. However, we wish to have good medication with less expense if possible. We want to get diagnosed my son's other infected organs and want to know how we can help to get them recovered well. Regards","QUESTION_ID":"Q59","F_REF":"1-135658132"} +{"ANSWERS":[{"_answerid":"Q60-S1-A1","_pairid":"125","__text":"There is no specific treatment for scleroderma. Your provider will assess the extent of disease in the lungs, kidneys, heart, and gastrointestinal tract. You will be prescribed medicines and other treatments to control your symptoms and prevent complications. Medicines used to treat scleroderma include: - Corticosteroids such as prednisone. Doses above 10 mg per day are not recommended. - Drugs that suppress the immune system such as methotrexate - Nonsteroidal anti-inflammatory drugs (NSAIDs) Other treatments for specific symptoms may include: - Medicines for heartburn or swallowing problems - Blood pressure medicines (such as ACE inhibitors) for high blood pressure or kidney problems - Light therapy to relieve skin thickening - Medicines to improve breathing (bosentan) - Treatments to improve Raynaud phenomenon, including medicines, gloves to keep the hands warm, and avoiding smoking Treatment often involves physical therapy as well."},{"_answerid":"Q60-S1-A2","_pairid":"126","__text":"Currently, there is not a cure for scleroderma, however treatments are available to relieve symptoms and limit damage. Treatment will vary depending on your symptoms."},{"_answerid":"Q60-S1-A3","_pairid":"127","__text":"These resources address the diagnosis or management of systemic scleroderma: - Cedars-Sinai Medical Center - Genetic Testing Registry: Scleroderma, familial progressive - University of Maryland Medical Center These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"}],"SUB_QUESTION_ID":"Q60-S1","ANNOTATIONS_FOCUS":["systemic sclerosis"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"Scleroderma (Systemic Sclerosis). i am 22yrs now and was 18th when i was detected with the disease in [DATE] 2010 after the conduction of Biopsy. there after i had taken PSS- Pulse for Systemic Sclerosis in which i was given Solumedrol for 9 months. and then after a gap of 6 months since the disease activity progressed i was given PSS again -Dexa for 3 months. along with this i am under medication with medicines as follows Depin, HCQS, Antoxid, Cyra, Omnacortil and Folitrax(weekly on saturdays and sundays). currently am under PSS which is done once in Every 6 months. but i am getting bad digital ulcers on my fingure tips on hands and legs both. i seriously need your help for this as to what else treatment can be done to it. please revert back soon","QUESTION_ID":"Q60","F_REF":"30"} +{"ANSWERS":[{"_answerid":"Q61-S1-A1","_pairid":"128","__text":"The goal of treatment is to relieve symptoms. - The underlying cause of the ulcer should be treated if it is known. - Gently cleaning your mouth and teeth may help relieve your symptoms. - Medicines that you rub directly on the ulcer such as antihistamines, antacids, and corticosteroids may help soothe discomfort. - Avoid hot or spicy foods until the ulcer is healed."}],"SUB_QUESTION_ID":"Q61-S1","ANNOTATIONS_FOCUS":["mouth ulcer"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"how to remove my mouth ulcer\/canker","MESSAGE":"Hello dear Dr, i am an afghan student in [LOCATION], the mouth ulcer problem is the worst problem in my lifetime, even three or four times the ulcer grow up in the mouth during of a month. even i can not eat or drink, even though i take care of my mouth every day, so i wish you to consult me about of removing of these ulcer forever. thank you so much","QUESTION_ID":"Q61","F_REF":"14801"} +{"ANSWERS":[{"_answerid":"Q62-S1-A1","_pairid":"129","__text":"If you have low vision, eyeglasses, contact lenses, medicine, or surgery may not help. Activities like reading, shopping, cooking, writing, and watching TV may be hard to do. The leading causes of low vision and blindness in the United States are age-related eye diseases: macular degeneration, cataract and glaucoma. Other eye disorders, eye injuries, and birth defects can also cause vision loss. Whatever the cause, lost vision cannot be restored. It can, however, be managed. A loss of vision means that you may have to reorganize your life and learn new ways of doing things. If you have some vision, visual aids such as special glasses and large print books can make life easier. There are also devices to help those with no vision, like text-reading software and braille books. The sooner vision loss or eye disease is found and treated, the greater your chances of keeping your remaining vision. You should have regular comprehensive eye exams by an eye care professional."}],"SUB_QUESTION_ID":"Q62-S1","ANNOTATIONS_FOCUS":["visual impairment"],"ANNOTATIONS_TYPE":"information","SUBJECT":"Visual impairment","MESSAGE":"Dear Sir, My mother is 80 years old. Her eye sight has nearly vanished. Years back left eye sight ended due to optical nerve rupture. On the right eye a white growth has now covered almost the whole retina. The specialists say that this growth is a result of eye surgeries she got years back and now there is no solution for this. Now she can hardly see the shadow things lying very close to her. I would be grateful if you kindly guide me if there is any solution for this. Thanks","QUESTION_ID":"Q62","F_REF":"1-123361245"} +{"ANSWERS":[{"_answerid":"Q63-S1-A1","_pairid":"130","__text":"Clubfoot is when the foot turns inward and downward. It is a congenital condition, which means it is present at birth."},{"_answerid":"Q63-S1-A2","_pairid":"131","__text":"Talipes equinovarus is a congenital (present from birth) condition where the foot turns inward and downward. The cause of this condition is not known, although it may be passed down through families in some cases. This condition occurs in about 1 out of every 1,000 births. Treatment may involve moving the foot into the correct position and using a cast to keep it there. This process is done in small increments over a period of time. In severe cases, surgery may be needed."}],"SUB_QUESTION_ID":"Q63-S1","ANNOTATIONS_FOCUS":["clubfoot"],"ANNOTATIONS_TYPE":"information","SUBJECT":"list of questions","MESSAGE":"I have a list of questions about Tay sachs disease and clubfoot 1. what is TSD\/Clubfoot, and how does it effect a baby 2. what causes both? can it be prevented, treated, or cured 3. How common is TSD? how common is Clubfoot 4. How can your "agency" help a women\/couple who are concerned about this congenital condition, and is there a cost? If you can answer these few questions I would be thankful, please get back as soon as you can.","QUESTION_ID":"Q63","F_REF":"12748"} +{"ANSWERS":[{"_answerid":"Q63-S2-A1","_pairid":"132","__text":"Clubfoot is the most common congenital disorder of the legs. It can range from mild and flexible to severe and rigid. The cause is not known, but the condition may be passed down through families in some cases. Risk factors include a family history of the disorder and being male. The condition occurs in about 1 out of every 1,000 live births."}],"SUB_QUESTION_ID":"Q63-S2","ANNOTATIONS_FOCUS":["clubfoot"],"ANNOTATIONS_TYPE":"cause","SUBJECT":"list of questions","MESSAGE":"I have a list of questions about Tay sachs disease and clubfoot 1. what is TSD\/Clubfoot, and how does it effect a baby 2. what causes both? can it be prevented, treated, or cured 3. How common is TSD? how common is Clubfoot 4. How can your "agency" help a women\/couple who are concerned about this congenital condition, and is there a cost? If you can answer these few questions I would be thankful, please get back as soon as you can.","QUESTION_ID":"Q63","F_REF":"12748"} +{"ANSWERS":[{"_answerid":"Q63-S3-A1","_pairid":"133","__text":"Treatment may involve moving the foot into the correct position and using a cast to keep it there. This is often done by an orthopedic specialist. Treatment should be started as early as possible -- ideally, shortly after birth -- when it is easiest to\u00a0reshape the foot. Gentle stretching and recasting\u00a0will be done\u00a0every week to improve the position of the foot. Generally, five to 10 casts are needed. The final cast\u00a0will stay\u00a0in place for 3 weeks. After the foot is in the correct position, the child will wear a special brace nearly full time for 3 months. Then, the child will wear the brace at night and during naps for up to 3 years. Often, the problem is a tightened Achilles tendon, and a simple procedure is needed to release it. Some severe cases of clubfoot will\u00a0need surgery if other treatments do not work, or if the problem returns. The child should be monitored by a\u00a0health care provider\u00a0until the foot is fully grown. See: Clubfoot repair"}],"SUB_QUESTION_ID":"Q63-S3","ANNOTATIONS_FOCUS":["clubfoot"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"list of questions","MESSAGE":"I have a list of questions about Tay sachs disease and clubfoot 1. what is TSD\/Clubfoot, and how does it effect a baby 2. what causes both? can it be prevented, treated, or cured 3. How common is TSD? how common is Clubfoot 4. How can your "agency" help a women\/couple who are concerned about this congenital condition, and is there a cost? If you can answer these few questions I would be thankful, please get back as soon as you can.","QUESTION_ID":"Q63","F_REF":"12748"} +{"ANSWERS":[{"_answerid":"Q63-S4-A1","_pairid":"134","__text":"Tay-Sachs disease is a life-threatening disease of the nervous system passed down through families."},{"_answerid":"Q63-S4-A2","_pairid":"135","__text":"Summary Tay-Sachs disease is a rare, inherited disorder. It causes too much of a fatty substance to build up in the brain. This buildup destroys nerve cells, causing mental and physical problems. Infants with Tay-Sachs disease appear to develop normally for the first few months of life. Then mental and physical abilities decline. The child becomes blind, deaf, and unable to swallow. Muscles begin to waste away and paralysis sets in. Even with the best of care, children with Tay-Sachs disease usually die by age 4. The cause is a gene mutation which is most common in Eastern European Ashkenazi Jews. To get the disease, both parents must have the gene. If they do, there is a 25% chance of the child having the disease. A blood test and prenatal tests can check for the gene or the disease. There is no cure. Medicines and good nutrition can help some symptoms. Some children need feeding tubes. NIH: National Institute of Neurological Disorders and Stroke"},{"_answerid":"Q63-S4-A3","_pairid":"136","__text":"Tay-Sachs disease is a rare inherited disorder that causes progressive destruction of nerve cells in the brain and spinal cord. Tay-Sachs is caused by the absence of a vital enzyme called hexosaminidase-A (Hex-A). Without Hex-A, a fatty substance, or lipid, called GM2 ganglioside accumulates abnormally in cells, especially in the nerve cells of the brain. This ongoing accumulation causes progressive damage to the cells. Tay-Sachs disease is inherited in an autosomal recessive pattern."},{"_answerid":"Q63-S4-A4","_pairid":"137","__text":"Tay-Sachs disease is a rare inherited disorder that progressively destroys nerve cells (neurons) in the brain and spinal cord. The most common form of Tay-Sachs disease becomes apparent in infancy. Infants with this disorder typically appear normal until the age of 3 to 6 months, when their development slows and muscles used for movement weaken. Affected infants lose motor skills such as turning over, sitting, and crawling. They also develop an exaggerated startle reaction to loud noises. As the disease progresses, children with Tay-Sachs disease experience seizures, vision and hearing loss, intellectual disability, and paralysis. An eye abnormality called a cherry-red spot, which can be identified with an eye examination, is characteristic of this disorder. Children with this severe infantile form of Tay-Sachs disease usually live only into early childhood. Other forms of Tay-Sachs disease are very rare. Signs and symptoms can appear in childhood, adolescence, or adulthood and are usually milder than those seen with the infantile form. Characteristic features include muscle weakness, loss of muscle coordination (ataxia) and other problems with movement, speech problems, and mental illness. These signs and symptoms vary widely among people with late-onset forms of Tay-Sachs disease."}],"SUB_QUESTION_ID":"Q63-S4","ANNOTATIONS_FOCUS":["tsd"],"ANNOTATIONS_TYPE":"information","SUBJECT":"list of questions","MESSAGE":"I have a list of questions about Tay sachs disease and clubfoot 1. what is TSD\/Clubfoot, and how does it effect a baby 2. what causes both? can it be prevented, treated, or cured 3. How common is TSD? how common is Clubfoot 4. How can your "agency" help a women\/couple who are concerned about this congenital condition, and is there a cost? If you can answer these few questions I would be thankful, please get back as soon as you can.","QUESTION_ID":"Q63","F_REF":"12748"} +{"ANSWERS":[{"_answerid":"Q63-S5-A1","_pairid":"138","__text":"Tay-Sachs disease occurs when the body lacks hexosaminidase A. This is a protein that helps break down a group of chemicals found in nerve tissue called gangliosides. Without this protein, gangliosides, particularly ganglioside GM2, build up in cells, especially nerve cells in the brain. Tay-Sachs disease is caused by a defective gene on chromosome 15. When both parents carry the defective Tay-Sachs gene, a child has a 25% chance of developing the disease. The child must receive two copies of the defective gene, one from each parent, in order to become sick. If only one parent passes the defective gene to the child, the child is called a carrier. They will not be sick, but may pass the disease to their own children. Anyone can be a carrier of Tay-Sachs. But, the disease is most common among the Ashkenazi Jewish population. 1 in every 27 members of the population carries the Tay-Sachs gene. Tay-Sachs is divided into infantile, juvenile, and adult forms, depending on the symptoms and when they first appear. Most people with Tay-Sachs have the infantile form. In this form, the nerve damage usually begins while the baby is still in the womb. Symptoms usually appear when the child is 3 to 6 months old. The disease tends to get worse very quickly, and the child usually dies by age 4 or 5. Late-onset Tay-Sachs disease, which affects adults, is very rare."}],"SUB_QUESTION_ID":"Q63-S5","ANNOTATIONS_FOCUS":["tsd"],"ANNOTATIONS_TYPE":"cause","SUBJECT":"list of questions","MESSAGE":"I have a list of questions about Tay sachs disease and clubfoot 1. what is TSD\/Clubfoot, and how does it effect a baby 2. what causes both? can it be prevented, treated, or cured 3. How common is TSD? how common is Clubfoot 4. How can your "agency" help a women\/couple who are concerned about this congenital condition, and is there a cost? If you can answer these few questions I would be thankful, please get back as soon as you can.","QUESTION_ID":"Q63","F_REF":"12748"} +{"ANSWERS":[{"_answerid":"Q63-S6-A1","_pairid":"139","__text":"There is no known way to prevent this disorder. Genetic testing can detect if you are a carrier of the gene for this disorder. If you or your partner are from an at-risk population, it is recommended that you undergo testing before starting a family. Testing the amniotic fluid can diagnose Tay-Sachs disease in the womb."}],"SUB_QUESTION_ID":"Q63-S6","ANNOTATIONS_FOCUS":["tsd"],"ANNOTATIONS_TYPE":"prevention","SUBJECT":"list of questions","MESSAGE":"I have a list of questions about Tay sachs disease and clubfoot 1. what is TSD\/Clubfoot, and how does it effect a baby 2. what causes both? can it be prevented, treated, or cured 3. How common is TSD? how common is Clubfoot 4. How can your "agency" help a women\/couple who are concerned about this congenital condition, and is there a cost? If you can answer these few questions I would be thankful, please get back as soon as you can.","QUESTION_ID":"Q63","F_REF":"12748"} +{"ANSWERS":[{"_answerid":"Q63-S7-A1","_pairid":"140","__text":"There is no treatment for Tay-Sachs disease itself, only ways to make the person more comfortable."},{"_answerid":"Q63-S7-A2","_pairid":"141","__text":"Although several attempts have been made at purified enzyme replacement therapy for children with Tay-Sachs disease, none has been successful. Cellular infusions and even bone marrow transplantation have been attempted with no evidence of benefit. Because no specific treatment is available for Tay-Sachs disease, treatment is directed at the symptoms and major associated conditions. Treatment is supportive and aimed at providing adequate nutrition and hydration. The airway must be protected. Seizures can be controlled initially with conventional anticonvulsant medications such as benzodiazepines, phenytoins, and\/or barbiturates, but the progressive nature of the disease may require alteration of dosage or medication. Infectious diseases should be managed. In advanced disease, good bowel movement should be maintained and severe constipation should be avoided. Good hydration, food additives, stool softeners, laxatives, and other measures should be employed to avoid severe constipation."},{"_answerid":"Q63-S7-A3","_pairid":"142","__text":"These resources address the diagnosis or management of Tay-Sachs disease: - Gene Review: Gene Review: Hexosaminidase A Deficiency - Genetic Testing Registry: Tay-Sachs disease - MedlinePlus Encyclopedia: Tay-Sachs Disease These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"}],"SUB_QUESTION_ID":"Q63-S7","ANNOTATIONS_FOCUS":["tsd"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"list of questions","MESSAGE":"I have a list of questions about Tay sachs disease and clubfoot 1. what is TSD\/Clubfoot, and how does it effect a baby 2. what causes both? can it be prevented, treated, or cured 3. How common is TSD? how common is Clubfoot 4. How can your "agency" help a women\/couple who are concerned about this congenital condition, and is there a cost? If you can answer these few questions I would be thankful, please get back as soon as you can.","QUESTION_ID":"Q63","F_REF":"12748"} +{"ANSWERS":[{"_answerid":"Q64-S1-A1","_pairid":"143","__text":"Treatment depends on many things: - The cause of scoliosis - Where the curve is in your spine - How big the curve is - If your body is still growing Most people with idiopathic scoliosis do not need treatment. But you should still be checked by a doctor about every 6 months. If you are still growing, your doctor might recommend a back brace. A back brace prevents further curving. There are many different types of braces. What kind you get depends on the size and location of your curve. Your provider will pick the best one for you and show you how to use it. Back braces can be adjusted as you grow. Back braces work best in people over age 10. Braces do not work for those with congenital or neuromuscular scoliosis. You may need surgery if the spine curve is severe or getting worse very quickly. Surgery involves correcting the curve as much as possible: - Surgery is done with a cut through the back, belly area, or beneath the ribs. - The spine bones are held in place with 1 or 2 metal rods. The rods are held down with hooks and screws until the bone heals together. - After surgery, you may need to wear a brace for a while to keep the spine still. Scoliosis treatment may also include: - Emotional support: Some children, especially teens, may be self-conscious when using a back brace. - Physical therapy and other specialists to help explain the treatments and make sure the brace fits correctly."}],"SUB_QUESTION_ID":"Q64-S1","ANNOTATIONS_FOCUS":["scoliosis"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"Hello, I have a scoliosis problem plz help me I want its treatment I can send my x.ray also *** This message has been sent using QMobile A2 Classic ***","QUESTION_ID":"Q64","F_REF":"1-135366282"} +{"ANSWERS":[{"_answerid":"Q65-S1-A1","_pairid":"144","__text":"A substance called plaque can build up in the walls of your coronary arteries. This plaque is made up of cholesterol and other cells. A heart attack may occur when: - A tear in the plaque occurs. This triggers blood platelets and other substances to form a blood a clot at the site that blocks most or all of the oxygen-carrying blood from flowing to a part of the heart muscle. This is the most common cause of heart attack. - A slow buildup of plaque may narrow one of the coronary arteries so that it is almost blocked. In either case, there is not enough blood flow to the heart muscle and heart muscle dies. The cause of heart attack is not always known. Heart attack may occur: - When you are resting or asleep - After a sudden increase in physical activity - When you are active outside in cold weather - After sudden, severe emotional or physical stress, including an illness Many risk factors may lead to the development of plaque buildup and a heart attack."},{"_answerid":"Q65-S1-A2","_pairid":"145","__text":"Coronary Heart Disease A heart attack happens if the flow of oxygen-rich blood to a section of heart muscle suddenly becomes blocked and the heart can't get oxygen. Most heart attacks occur as a result of coronary heart disease (CHD). CHD is a condition in which a waxy substance called plaque builds up inside of the coronary arteries. These arteries supply oxygen-rich blood to your heart. When plaque builds up in the arteries, the condition is called atherosclerosis. The buildup of plaque occurs over many years. Eventually, an area of plaque can rupture (break open) inside of an artery. This causes a blood clot to form on the plaque's surface. If the clot becomes large enough, it can mostly or completely block blood flow through a coronary artery. If the blockage isn't treated quickly, the portion of heart muscle fed by the artery begins to die. Healthy heart tissue is replaced with scar tissue. This heart damage may not be obvious, or it may cause severe or long-lasting problems. Coronary Artery Spasm A less common cause of heart attack is a severe spasm (tightening) of a coronary artery. The spasm cuts off blood flow through the artery. Spasms can occur in coronary arteries that aren't affected by atherosclerosis. What causes a coronary artery to spasm isn't always clear. A spasm may be related to: Taking certain drugs, such as cocaine Emotional stress or pain Exposure to extreme cold Cigarette smoking The animation below shows how plaque buildup or a coronary artery spasm can lead to a heart attack. Click the \"start\" button to play the animation. Written and spoken explanations are provided with each frame. Use the buttons in the lower right corner to pause, restart, or replay the animation, or use the scroll bar below the buttons to move through the frames. The animation shows how blocked blood flow in a coronary artery can lead to a heart attack."},{"_answerid":"Q65-S1-A3","_pairid":"146","__text":"Most heart attacks are caused by a blood clot that blocks one of the coronary arteries, the blood vessels that bring blood and oxygen to the heart muscle. When blood cannot reach part of your heart, that area starves for oxygen. If the blockage continues long enough, cells in the affected area die. The Most Common Cause Coronary heart disease (CHD)is the most common underlying cause of a heart attack. CHD, also called coronary artery disease, is the hardening and narrowing of the coronary arteries caused by the buildup of plaque inside the walls of the arteries. When plaque builds up in the arteries, the condition is called atherosclerosis (ath-er-o-skler-O-sis). The buildup of plaque occurs over many years. Over time, an area of plaque can rupture (break open) inside of an artery. This causes a blood clot to form on the plaque's surface. If the clot becomes large enough, it can mostly or completely block blood flow through a coronary artery. If the blockage isn't treated quickly, the portion of heart muscle fed by the artery begins to die. Healthy heart tissue is replaced with scar tissue. This heart damage may not be obvious, or it may cause severe or long-lasting problems. Other Causes Heart attack also can occur due to problems with the very small, microscopic blood vessels of the heart. This condition is called microvascular disease. It's believed to be more common in women than in men. A less common cause of heart attacks is a severe spasm or tightening of the coronary artery that cuts off blood flow to the heart. These spasms can occur in persons with or without coronary artery disease. What causes a coronary artery to spasm isn't always clear. A spasm may be related to emotional stress or pain, exposure to extreme cold, cigarette smoking, or by taking certain drugs like cocaine. Risk Factors You Cannot Change Certain factors make it more likely that you will develop coronary artery disease and have a heart attack. These risk factors include some things you cannot change. If you are a man over age 45 or a woman over age 55, you are at greater risk. Having a family history of early heart disease, diagnosed in a father or brother before age 55 or in a mother or sister before age 65, is another risk factor. You are also at risk if you have a personal history of angina or previous heart attack, or if you have had a heart procedure such as percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG). Risk Factors You Can Change Importantly, there are many risk factors that you can change. These include - smoking - being overweight or obese - physical inactivity - high blood pressure - high blood cholesterol - high blood sugar due to insulin resistance or diabetes - an unhealthy diet (for example, a diet high in saturated fat, trans fat, cholesterol, and sodium). smoking being overweight or obese physical inactivity high blood pressure high blood cholesterol high blood sugar due to insulin resistance or diabetes an unhealthy diet (for example, a diet high in saturated fat, trans fat, cholesterol, and sodium). Metabolic Syndrome Some of these risk factors\u2014such as obesity, high blood pressure, and high blood sugar\u2014tend to occur together. When they do, it's called metabolic syndrome. In general, a person with metabolic syndrome is twice as likely to develop heart disease and five times as likely to develop diabetes as someone without metabolic syndrome."}],"SUB_QUESTION_ID":"Q65-S1","ANNOTATIONS_FOCUS":["heart attack"],"ANNOTATIONS_TYPE":"cause","SUBJECT":"EAR LOBE CREASES","MESSAGE":"Are ear lobe creases always heart disease and 100% heart attack pending? What are other causes? I'm 56 have pierced ears but haven't wore earrings in years. In the last 7 years I rarely eat meat and when I do it's chicken or fish maybe beef every 5 years or so and its maybe a hamburger lean. If you do have arteriosclerosis is there anyway to reverse it?","QUESTION_ID":"Q65","F_REF":"NF_197"} +{"ANSWERS":[{"_answerid":"Q65-S2-A1","_pairid":"147","__text":"Treatments for atherosclerosis may include heart-healthy lifestyle changes, medicines, and medical procedures or surgery. The goals of treatment include: Lowering the risk of blood clots forming Preventing atherosclerosis-related diseases Reducing risk factors in an effort to slow or stop the buildup of plaque Relieving symptoms Widening or bypassing plaque-clogged arteries Heart-Healthy Lifestyle Changes Your doctor may recommend heart-healthy lifestyle changes if you have atherosclerosis. Heart-healthy lifestyle changes include heart-healthy eating, aiming for a healthy weight, managing stress, physical activity and quitting smoking. Medicines Sometimes lifestyle changes alone aren\u2019t enough to control your cholesterol levels. For example, you also may need statin medications to control or lower your cholesterol. By lowering your blood cholesterol level, you can decrease your chance of having a heart attack or stroke. Doctors usually prescribe statins for people who have: Coronary heart disease, peripheral artery disease, or had a prior stroke Diabetes High LDL cholesterol levels Doctors may discuss beginning statin treatment with people who have an elevated risk for developing heart disease or having a stroke. Your doctor also may prescribe other medications to: Lower your blood pressure Lower your blood sugar levels Prevent blood clots, which can lead to heart attack and stroke Prevent inflammation Take all medicines regularly, as your doctor prescribes. Don\u2019t change the amount of your medicine or skip a dose unless your doctor tells you to. You should still follow a heart healthy lifestyle, even if you take medicines to treat your atherosclerosis. Medical Procedures and Surgery If you have severe atherosclerosis, your doctor may recommend a medical procedure or surgery. Percutaneous coronary intervention (PCI), also known as coronary angioplasty, is a procedure that\u2019s used to open blocked or narrowed coronary (heart) arteries. PCI can improve blood flow to the heart and relieve chest pain. Sometimes a small mesh tube called a stent is placed in the artery to keep it open after the procedure. Coronary artery bypass grafting (CABG) is a type of surgery. In CABG, arteries or veins from other areas in your body are used to bypass or go around your narrowed coronary arteries. CABG can improve blood flow to your heart, relieve chest pain, and possibly prevent a heart attack. Bypass grafting also can be used for leg arteries. For this surgery, a healthy blood vessel is used to bypass a narrowed or blocked artery in one of the legs. The healthy blood vessel redirects blood around the blocked artery, improving blood flow to the leg. Carotid endarterectomy is a type of surgery to remove plaque buildup from the carotid arteries in the neck. This procedure restores blood flow to the brain, which can help prevent a stroke."}],"SUB_QUESTION_ID":"Q65-S2","ANNOTATIONS_FOCUS":["arteriosclerosis"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"EAR LOBE CREASES","MESSAGE":"Are ear lobe creases always heart disease and 100% heart attack pending? What are other causes? I'm 56 have pierced ears but haven't wore earrings in years. In the last 7 years I rarely eat meat and when I do it's chicken or fish maybe beef every 5 years or so and its maybe a hamburger lean. If you do have arteriosclerosis is there anyway to reverse it?","QUESTION_ID":"Q65","F_REF":"NF_197"} +{"ANSWERS":[{"_answerid":"Q66-S1-A1","_pairid":"148","__text":"Worldwide, cervical cancer is the third most common type of cancer in women. It is much less common in the United States because of the routine use of Pap smears. Cervical cancer starts in the cells on the surface of the cervix. There are two types of cells on the surface of the cervix, squamous and columnar. Most cervical cancers are from squamous cells. Cervical cancer usually develops slowly. It starts as a precancerous condition called dysplasia. This condition can be detected by a Pap smear and is 100% treatable. It can take years for dysplasia to develop into cervical cancer. Most women who are diagnosed with cervical cancer today have not had regular Pap smears, or they have not followed up on abnormal Pap smear results. Almost all cervical cancers are caused by HPV (human papillomavirus). HPV is a common virus that is spread through sexual intercourse. There are many different types (strains) of HPV. Some strains lead to cervical cancer. Other strains can cause genital warts. Others do not cause any problems at all. A woman's sexual habits and patterns can increase her risk of developing cervical cancer. Risky sexual practices include: - Having sex at an early age - Having multiple sexual partners - Having a partner or many partners who take part in high-risk sexual activities Other risk factors for cervical cancer include: - Not getting the HPV vaccine - Being economically disadvantaged - Having a mother who took the drug diethylstilbestrol (DES) during pregnancy in the early 1960s to prevent miscarriage - Having a weakened immune system"}],"SUB_QUESTION_ID":"Q66-S1","ANNOTATIONS_FOCUS":["cervical cancer"],"ANNOTATIONS_TYPE":"cause","SUBJECT":"Cervical Cancer","MESSAGE":"Can a long term untreated bladder infection aid in the cause of cervical cancer? And can the fact that my mom has cervical cancer aid in my chance of getting cervical cancer?","QUESTION_ID":"Q66","F_REF":"13629"} +{"ANSWERS":[{"_answerid":"Q67-S1-A1","_pairid":"149","__text":"The goal of treatment is to relieve symptoms. In some cases of IBS, lifestyle changes can help. For example, regular exercise and improved sleep habits may reduce anxiety and help relieve bowel symptoms. Dietary changes can be helpful. However, no specific diet can be recommended for IBS because the condition differs from one person to another. The following changes may help: - Avoiding foods and drinks that stimulate the intestines (such as caffeine, tea, or colas) - Eating smaller meals - Increasing fiber in the diet (this may improve constipation or diarrhea, but make bloating worse) Talk with your provider before taking over-the-counter medicines. No one medicine works for everyone. Some that your provider may suggest include: - Anticholinergic medicines (dicyclomine, propantheline, belladonna, and hyoscyamine) taken about a half-hour before eating to control intestinal muscle spasms - Bisacodyl to treat constipation - Loperamide to treat diarrhea - Low doses of tricyclic antidepressants to help relieve intestinal pain - Lubiprostone for constipation symptoms - Rifaximin, an antibiotic Psychological therapy or medicines for anxiety or depression may help with the problem."}],"SUB_QUESTION_ID":"Q67-S1","ANNOTATIONS_FOCUS":["ibs"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"father suffering from IBS","MESSAGE":"My father is suffering from IBS and is loosing weight day by day.sometimes he even faints due to weakness.He cannot digest food .please help us and suggest us upon this problem.","QUESTION_ID":"Q67","F_REF":"1-118298035"} +{"ANSWERS":[{"_answerid":"Q68-S1-A1","_pairid":"150","__text":"Most cases of Lewy body dementia are not thought to be inherited. The condition generally occurs sporadically in people with no family history of the condition. Rarely, the condition can affect more than one family member. Some of these cases appear to be due to single gene changes (mutations) that follow an autosomal dominant pattern of inheritance. Other familial cases do not follow a specific pattern of inheritance and likely have a multifactorial cause (associated with the effects of multiple genes in combination with lifestyle and environmental factors)."}],"SUB_QUESTION_ID":"Q68-S1","ANNOTATIONS_FOCUS":["lewy body disease"],"ANNOTATIONS_TYPE":"inheritance","SUBJECT":"","MESSAGE":"Lewy Body Disease. I have been researching Lewy Body Disease and have a few questions.1) Is this disease hereditary2) Does alcoholism play a role in the beginning process of this disease3) What are the initial symptoms of the diseaseAny information you could forward would be greatly appreciated.","QUESTION_ID":"Q68","F_REF":"26"} +{"ANSWERS":[{"_answerid":"Q68-S2-A1","_pairid":"151","__text":"Lewy body dementia is characterized by the abnormal buildup of proteins into masses known as Lewy bodies. This protein is also associated with Parkinson's disease. People who have Lewy bodies in their brains also have the plaques and tangles associated with Alzheimer's disease."}],"SUB_QUESTION_ID":"Q68-S2","ANNOTATIONS_FOCUS":["lewy body disease"],"ANNOTATIONS_TYPE":"cause","SUBJECT":"","MESSAGE":"Lewy Body Disease. I have been researching Lewy Body Disease and have a few questions.1) Is this disease hereditary2) Does alcoholism play a role in the beginning process of this disease3) What are the initial symptoms of the diseaseAny information you could forward would be greatly appreciated.","QUESTION_ID":"Q68","F_REF":"26"} +{"ANSWERS":[{"_answerid":"Q68-S3-A1","_pairid":"152","__text":"The Human Phenotype Ontology provides the following list of signs and symptoms for Lewy body dementia. If the information is available, the table below includes how often the symptom is seen in people with this condition. You can use the MedlinePlus Medical Dictionary to look up the definitions for these medical terms. Signs and Symptoms Approximate number of patients (when available) Abnormality of extrapyramidal motor function 90% Abnormality of the autonomic nervous system 90% Developmental regression 90% EEG abnormality 90% Hallucinations 90% Hypertonia 90% Hypotension 90% Sleep disturbance 90% Sudden cardiac death 90% Gait disturbance 50% Incoordination 50% Neurological speech impairment 50% Abnormality of the sense of smell 7.5% Feeding difficulties in infancy 7.5% Involuntary movements 7.5% Restrictive lung disease 7.5% Skin ulcer 7.5% Tremor 7.5% Autosomal dominant inheritance - Delusions - Dementia - Fluctuations in consciousness - Parkinsonism - Visual hallucinations - The Human Phenotype Ontology (HPO) has collected information on how often a sign or symptom occurs in a condition. Much of this information comes from Orphanet, a European rare disease database. The frequency of a sign or symptom is usually listed as a rough estimate of the percentage of patients who have that feature. The frequency may also be listed as a fraction. The first number of the fraction is how many people had the symptom, and the second number is the total number of people who were examined in one study. For example, a frequency of 25\/25 means that in a study of 25 people all patients were found to have that symptom. Because these frequencies are based on a specific study, the fractions may be different if another group of patients are examined. Sometimes, no information on frequency is available. In these cases, the sign or symptom may be rare or common."}],"SUB_QUESTION_ID":"Q68-S3","ANNOTATIONS_FOCUS":["lewy body disease"],"ANNOTATIONS_TYPE":"symptom","SUBJECT":"","MESSAGE":"Lewy Body Disease. I have been researching Lewy Body Disease and have a few questions.1) Is this disease hereditary2) Does alcoholism play a role in the beginning process of this disease3) What are the initial symptoms of the diseaseAny information you could forward would be greatly appreciated.","QUESTION_ID":"Q68","F_REF":"26"} +{"ANSWERS":[{"_answerid":"Q69-S1-A1","_pairid":"153","__text":"Hypotrichosis-lymphedema-telangiectasia syndrome (HLTS) is a rare condition that, as the name suggests, is associated with sparse hair (hypotrichosis), lymphedema, and telangiectasia, particularly on the palms of the hands. Symptoms usually begin at birth or in early childhood and become worse over time. HLTS is thought to be caused by changes (mutations) in the SOX18 gene. It can follow both an autosomal dominant or an autosomal recessive pattern of inheritance, depending on the affected family. There is currently no cure for the condition. Treatment is based on the signs and symptoms present in each person."}],"SUB_QUESTION_ID":"Q69-S1","ANNOTATIONS_FOCUS":["hypotrichosis-lymphedema-telangiectasia syndrome"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"Genetic mutaion","MESSAGE":"my son born with alopicia totalis and swealling around the eyes , we have done for him Whole Exome Sequencing , they identified a heterozygous likely pathogenic variant in the SOX18 gene, which supports the clinical diagnosis of hypotrichosis-lymphedema-telangiectasia syndrome , i would like to know if i can trat this or any thing that we can do to help the symptos ,pleae help","QUESTION_ID":"Q69","F_REF":"1-136476177"} +{"ANSWERS":[{"_answerid":"Q70-S1-A1","_pairid":"154","__text":"When listening to the chest with a stethoscope, the\u00a0doctor may hear crackling sounds called rales. These tests may help diagnose the disease: - Chest x-ray - CT scan of the lungs - Pulmonary function tests"}],"SUB_QUESTION_ID":"Q70-S1","ANNOTATIONS_FOCUS":["asbestosis"],"ANNOTATIONS_TYPE":"diagnosis","SUBJECT":"Medical Diagnosis of Asbestosis","MESSAGE":"My doctors hint that I have asbestosis but do not say I have asbestosis. All the medical information that I have read from the CDC, Medlin and NIH all say that the symptoms presented are related to a high level of asbestos. Why won't the doctor say it?","QUESTION_ID":"Q70","F_REF":"14325"} +{"ANSWERS":[{"_answerid":"Q71-S1-A1","_pairid":"155","__text":"Hairy cell leukemia (HCL) is an unusual cancer of the blood. It affects B cells, a type of white blood cell (lymphocyte)."},{"_answerid":"Q71-S1-A2","_pairid":"156","__text":"Hairy cell leukemia is a rare, slow-growing cancer of the blood in which the bone marrow makes too many B cells (lymphocytes), a type of white blood cell that fights infection. The condition is named after these excess B cells which look 'hairy' under a microscope. As the number of leukemia cells increases, fewer healthy white blood cells, red blood cells and platelets are produced. The underlying cause of this condition is unknown. While there is no cure, treatment can lead to remission which can last for years."}],"SUB_QUESTION_ID":"Q71-S1","ANNOTATIONS_FOCUS":["hairy cell leukemia"],"ANNOTATIONS_TYPE":"information","SUBJECT":"Asking about Hairy cell leukemia","MESSAGE":"I get report for my father from hospital it is saying that he have Hairy cell leukemia i am here to ask if this dissease dangerous and there is treatment for it Also if The one who have it will live for long or not ? My father age is 55 We discover the dissease by blood test","QUESTION_ID":"Q71","F_REF":"1-135981085"} +{"ANSWERS":[{"_answerid":"Q71-S2-A1","_pairid":"157","__text":"Treatment may not be needed for the early stages of this disease. Some patients may need an occasional blood transfusion. If treatment is needed because of very low blood counts, chemotherapy drugs can be used. In most cases, chemotherapy can relieve the symptoms for many years. (When the signs and symptoms go away, you are said to be in remission.) Removing the spleen may improve blood counts, but is unlikely to cure the disease. Antibiotics can be used to treat infections. People with low blood counts will receive growth factors and, possibly, transfusions."}],"SUB_QUESTION_ID":"Q71-S2","ANNOTATIONS_FOCUS":["hairy cell leukemia"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"Asking about Hairy cell leukemia","MESSAGE":"I get report for my father from hospital it is saying that he have Hairy cell leukemia i am here to ask if this dissease dangerous and there is treatment for it Also if The one who have it will live for long or not ? My father age is 55 We discover the dissease by blood test","QUESTION_ID":"Q71","F_REF":"1-135981085"} +{"ANSWERS":[{"_answerid":"Q71-S3-A1","_pairid":"158","__text":"Most patients with hairy cell leukemia can expect to live 10 years or longer after diagnosis and treatment."}],"SUB_QUESTION_ID":"Q71-S3","ANNOTATIONS_FOCUS":["hairy cell leukemia"],"ANNOTATIONS_TYPE":"prognosis","SUBJECT":"Asking about Hairy cell leukemia","MESSAGE":"I get report for my father from hospital it is saying that he have Hairy cell leukemia i am here to ask if this dissease dangerous and there is treatment for it Also if The one who have it will live for long or not ? My father age is 55 We discover the dissease by blood test","QUESTION_ID":"Q71","F_REF":"1-135981085"} +{"ANSWERS":[{"_answerid":"Q72-S1-A1","_pairid":"159","__text":"Type 2 diabetes may be reversed with lifestyle changes, especially losing weight\u00a0with exercise\u00a0and by\u00a0eating healthier foods. Some cases of type 2 diabetes can also\u00a0be improved with weight-loss surgery. There is no cure for type 1 diabetes. Treating\u00a0either type 1 diabetes\u00a0or type 2 diabetes involves medicines, diet, and exercise to control blood sugar level. Everyone with diabetes should receive proper education and support about the best ways to manage their diabetes. Ask your provider about seeing a diabetes nurse educator. Getting better control over your blood sugar, cholesterol, and blood pressure levels helps reduce the risk of kidney disease, eye disease, nervous system disease, heart attack, and stroke. To prevent diabetes complications, visit your provider at least 2 to 4 times a year. Talk about any problems you are having. Follow your provider's instructions on managing your diabetes."},{"_answerid":"Q72-S1-A2","_pairid":"160","__text":"The goal of treatment at first is to lower your high blood glucose levels. Long-term goals are to prevent problems from diabetes. The most important way to treat and manage type 2 diabetes is with activity and healthy eating. Everyone with diabetes should receive proper education and support about the best ways to manage their diabetes. Ask your healthcare provider about seeing a diabetes educator. LEARN THESE SKILLS Learning diabetes management skills will help you live well with diabetes. These skills help prevent health problems and the need for medical care. Skills include: - How to test and record your blood glucose - What and when to eat - How to safely increase your activity and control your weight - How to take medications, if needed - How to recognize and treat low and high blood sugar - How to handle sick days - Where to buy diabetes supplies and how to store them It may take several months to learn these skills. Keep learning about diabetes, its complications, and how to control and live well\u00a0with the disease. Stay up-to-date on new research and treatments. MANAGING YOUR BLOOD SUGAR Checking your blood sugar levels yourself and writing down the results tells you how well you are managing your diabetes. Talk to your doctor and diabetes educator about how often to check. To check your blood sugar level, you use a device called a glucose meter. Usually, you prick your finger with a small needle called a lancet. This gives you a tiny drop of blood. You place the blood on a test strip and put the strip into the meter. The meter gives you a reading that tells you the level of your blood sugar. Your doctor or diabetes educator will help set up a testing schedule for you. Your doctor will help you set a target range for your blood sugar numbers. Keep these factors in mind: - Most people with type 2 diabetes only need to check their blood sugar once or twice a day. - If your blood sugar level is under control, you may only need to check it a few times a week. - You may test yourself when you wake up, before meals, and at bedtime. - You may need to test more often when you are sick or under stress. Keep a record of your blood sugar for yourself and your doctor. Based on your numbers, you may need to make changes to your meals, activity, or medicines to keep your blood sugar level in the right range. HEALTHY EATING AND WEIGHT CONTROL Work closely with your doctor, nurse, and dietitian to learn how much fat, protein, and carbohydrates you need in your diet. Your meal plans should fit your lifestyle and habits and should include foods that you like. Managing your weight and having a well-balanced diet are important. Some people with type 2 diabetes can stop taking medicines after losing weight. This does not mean that their diabetes is cured. They still have diabetes. Very obese patients whose diabetes is not well managed with diet and medicine may consider weight loss (bariatric) surgery. REGULAR PHYSICAL ACTIVITY Regular activity is important for everyone. It is even more important when you have diabetes. Exercise is good for your health because it: - Lowers your blood sugar level without medicine - Burns extra calories and fat to help manage your weight - Improves blood flow and blood pressure - Increases your energy level - Improves your ability to handle stress Talk to your doctor before starting any exercise program. People with type 2 diabetes may need to take special steps before, during, and after physical activity or exercise. MEDICATIONS TO TREAT DIABETES If diet and exercise do not help keep your blood sugar at normal or near-normal levels, your doctor may prescribe medication. Since these drugs help lower your blood sugar levels in different ways, your doctor may have you take more than one drug. Some of the most common types of medication are listed below. They are taken by mouth or injection. - Alpha-glucosidase inhibitors - Biguanides - DPP IV inhibitors - Injectable medicines (GLP-1 analogs) - Meglitinides - SGL T2 inhibitors - Sulfonylureas - Thiazolidinediones You may need to take insulin if your blood sugar cannot be controlled with any of the above medicines. Insulin must be injected under the skin using a syringe, insulin pen, or pump. It cannot be taken by mouth because the acid in the stomach destroys insulin. PREVENTING COMPLICATIONS Your doctor may prescribe medicines or other treatments to reduce your chance of developing some of the more common complications of diabetes, including: - Eye disease - Kidney disease - Heart disease and stroke FOOT CARE People with diabetes are more likely than those without diabetes to have foot problems. Diabetes damages the nerves. This can make you less able to feel pressure on the foot. You many not notice a foot injury until you get a severe infection. Diabetes can also damage blood vessels. Small sores or breaks in the skin may become deeper skin sores (ulcers). The affected limb may need to be amputated if these skin ulcers do not heal or become larger, deeper, or infected. To prevent problems with your feet: - Stop smoking if you smoke. - Improve control of your blood sugar. - Get a foot exam by your doctor at least twice a year and learn if you have nerve damage. - Check and care for your feet every day. This is very important when you already have nerve or blood vessel damage or foot problems. - Treat minor infections, such as athlete's foot, right away. - Use moisturizing lotion on dry skin. - Make sure you wear the right kind of shoes. Ask your doctor what type of shoe is right for you."}],"SUB_QUESTION_ID":"Q72-S1","ANNOTATIONS_FOCUS":["diabetes type 2"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"Diabetes Type 2","MESSAGE":"I test before going to bed and the reading is 94 but when I test again in the morning, the reading is 165. How can I lower it? I eat dinner around 8PM and nothing until the next morning.","QUESTION_ID":"Q72","F_REF":"1-135130065"} +{"ANSWERS":[{"_answerid":"Q73-S1-A1","_pairid":"161","__text":"Most cases of Angelman syndrome are not inherited, particularly those caused by a deletion in the maternal chromosome 15 or by paternal uniparental disomy. These genetic changes occur as random events during the formation of reproductive cells (eggs and sperm) or in early embryonic development. In these instances, people typically have no history of the disorder in their family. Rarely, a genetic change responsible for Angelman syndrome can be inherited. For example, it is possible for a mutation in the UBE3A gene or in the nearby region of DNA that controls gene activation to be passed from one generation to the next."}],"SUB_QUESTION_ID":"Q73-S1","ANNOTATIONS_FOCUS":["angelman syndrome"],"ANNOTATIONS_TYPE":"inheritance","SUBJECT":"","MESSAGE":"Angelman syndrome. Can a person with Angelman Syndrome have children? If so, can the disorder be passed on to offspring?","QUESTION_ID":"Q73","F_REF":"65"} +{"ANSWERS":[{"_answerid":"Q74-S1-A1","_pairid":"165","__text":"Summary Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. Insulin is a hormone that helps the glucose get into your cells to give them energy. With type 1 diabetes, your body does not make insulin. With type 2 diabetes, the more common type, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood. You can also have prediabetes. This means that your blood sugar is higher than normal but not high enough to be called diabetes. Having prediabetes puts you at a higher risk of getting type 2 diabetes. Over time, having too much glucose in your blood can cause serious problems. It can damage your eyes, kidneys, and nerves. Diabetes can also cause heart disease, stroke and even the need to remove a limb. Pregnant women can also get diabetes, called gestational diabetes. Blood tests can show if you have diabetes. One type of test, the A1C, can also check on how you are managing your diabetes. Exercise, weight control and sticking to your meal plan can help control your diabetes. You should also monitor your blood glucose level and take medicine if prescribed. NIH: National Institute of Diabetes and Digestive and Kidney Diseases"},{"_answerid":"Q74-S1-A2","_pairid":"166","__text":"Summary Diabetes means your blood glucose, or blood sugar, levels are too high. With type 2 diabetes, the more common type, your body does not make or use insulin well. Insulin is a hormone that helps glucose get into your cells to give them energy. Without insulin, too much glucose stays in your blood. Over time, high blood glucose can lead to serious problems with your heart, eyes, kidneys, nerves, and gums and teeth. You have a higher risk of type 2 diabetes if you are older, obese, have a family history of diabetes, or do not exercise. Having prediabetes also increases your risk. Prediabetes means that your blood sugar is higher than normal but not high enough to be called diabetes. The symptoms of type 2 diabetes appear slowly. Some people do not notice symptoms at all. The symptoms can include - Being very thirsty - Urinating often - Feeling very hungry or tired - Losing weight without trying - Having sores that heal slowly - Having blurry eyesight Blood tests can show if you have diabetes. One type of test, the A1C, can also check on how you are managing your diabetes. Many people can manage their diabetes through healthy eating, physical activity, and blood glucose testing. Some people also need to take diabetes medicines. NIH: National Institute of Diabetes and Digestive and Kidney Diseases"},{"_answerid":"Q74-S1-A3","_pairid":"167","__text":"Too Much Glucose in the Blood Diabetes means your blood glucose (often called blood sugar) is too high. Your blood always has some glucose in it because your body needs glucose for energy to keep you going. But too much glucose in the blood isn't good for your health. Glucose comes from the food you eat and is also made in your liver and muscles. Your blood carries the glucose to all of the cells in your body. Insulin is a chemical (a hormone) made by the pancreas. The pancreas releases insulin into the blood. Insulin helps the glucose from food get into your cells. If your body does not make enough insulin or if the insulin doesn't work the way it should, glucose can't get into your cells. It stays in your blood instead. Your blood glucose level then gets too high, causing pre-diabetes or diabetes. Types of Diabetes There are three main kinds of diabetes: type 1, type 2, and gestational diabetes. The result of type 1 and type 2 diabetes is the same: glucose builds up in the blood, while the cells are starved of energy. Over the years, high blood glucose damages nerves and blood vessels, oftentimes leading to complications such as heart disease, stroke, blindness, kidney disease, nerve problems, gum infections, and amputation. Type 1 Diabetes Type 1 diabetes, which used to be called called juvenile diabetes or insulin-dependent diabetes, develops most often in young people. However, type 1 diabetes can also develop in adults. With this form of diabetes, your body no longer makes insulin or doesn\u2019t make enough insulin because your immune system has attacked and destroyed the insulin-producing cells. About 5 to 10 percent of people with diabetes have type 1 diabetes. To survive, people with type 1 diabetes must have insulin delivered by injection or a pump. Learn more about type 1 diabetes here. Type 2 Diabetes Type 2 diabetes, which used to be called adult-onset diabetes or non insulin-dependent diabetes, is the most common form of diabetes. Although people can develop type 2 diabetes at any age -- even during childhood -- type 2 diabetes develops most often in middle-aged and older people. Type 2 diabetes usually begins with insulin resistance\u2014a condition that occurs when fat, muscle, and liver cells do not use insulin to carry glucose into the body\u2019s cells to use for energy. As a result, the body needs more insulin to help glucose enter cells. At first, the pancreas keeps up with the added demand by making more insulin. Over time, the pancreas doesn\u2019t make enough insulin when blood sugar levels increase, such as after meals. If your pancreas can no longer make enough insulin, you will need to treat your type 2 diabetes. Learn more about type 2 diabetes here. Gestational Diabetes Some women develop gestational diabetes during the late stages of pregnancy. Gestational diabetes is caused by the hormones of pregnancy or a shortage of insulin. Although this form of diabetes usually goes away after the baby is born, a woman who has had it and her child are more likely to develop diabetes later in life. Prediabetes Prediabetes means your blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. People with prediabetes are at an increased risk for developing type 2 diabetes and for heart disease and stroke. The good news is that if you have prediabetes, you can reduce your risk of getting type 2 diabetes. With modest weight loss and moderate physical activity, you can delay or prevent type 2 diabetes. Learn more about prediabetes here. Signs of Diabetes Many people with diabetes experience one or more symptoms, including extreme thirst or hunger, a frequent need to urinate and\/or fatigue. Some lose weight without trying. Additional signs include sores that heal slowly, dry, itchy skin, loss of feeling or tingling in the feet and blurry eyesight. Some people with diabetes, however, have no symptoms at all. How Many Have Diabetes? Nearly 29 million Americans age 20 or older (12.3 percent of all people in this age group) have diabetes, according to 2014 estimates from the Centers for Disease Control and Prevention (CDC). About 1.9 million people aged 20 years or older were newly diagnosed with diabetes in 2010 alone. People can get diabetes at any age, but the risk increases as we get older. In 2014, over 11 million older adults living in the U.S -- nearly 26 percent of people 65 or older -- had diabetes. See more statistics about diabetes from the National Diabetes Statistics Report 2014. (Centers for Disease Control and Prevention.) If Diabetes is Not Managed Diabetes is a very serious disease. Over time, diabetes that is not well managed causes serious damage to the eyes, kidneys, nerves, heart, gums and teeth. If you have diabetes, you are more likely than people without diabetes to have heart disease or a stroke. People with diabetes also tend to develop heart disease or stroke at an earlier age than others. The best way to protect yourself from the serious complications of diabetes is to manage your blood glucose, blood pressure and cholesterol and to avoid smoking. It is not always easy, but people who make an ongoing effort to manage their diabetes can greatly improve their overall health."},{"_answerid":"Q74-S1-A4","_pairid":"168","__text":"Diabetes means your blood glucose (often called blood sugar) is too high. Your blood always has some glucose in it because your body needs glucose for energy to keep you going. But too much glucose in the blood isn't good for your health. Glucose comes from the food you eat and is also made in your liver and muscles. Your blood carries the glucose to all of the cells in your body. Insulin is a chemical (a hormone) made by the pancreas. The pancreas releases insulin into the blood. Insulin helps the glucose from food get into your cells. If your body does not make enough insulin or if the insulin doesn't work the way it should, glucose can't get into your cells. It stays in your blood instead. Your blood glucose level then gets too high, causing pre-diabetes or diabetes."}],"SUB_QUESTION_ID":"Q74-S1","ANNOTATIONS_FOCUS":["diabetes"],"ANNOTATIONS_TYPE":"information","SUBJECT":"Diabetes on sugar level","MESSAGE":"What happen to diabetes patient Getting blood sugar increase by which of body in brain or stomach or urine bladder.why urine bladder become more weight that any other part of body.","QUESTION_ID":"Q74","F_REF":"1-136136912"} +{"ANSWERS":[{"_answerid":"Q75-S1-A1","_pairid":"174","__text":"Trimethylaminuria is a disorder in which the body is unable to break down trimethylamine, a chemical compound that has a pungent odor. Trimethylamine has been described as smelling like rotting fish, rotting eggs, garbage, or urine. As this compound builds up in the body, it causes affected people to give off a strong odor in their sweat, urine, and breath. The intensity of the odor may vary over time. The odor can interfere with many aspects of daily life, affecting a person's relationships, social life, and career. Some people with trimethylaminuria experience depression and social isolation as a result of this condition."}],"SUB_QUESTION_ID":"Q75-S1","ANNOTATIONS_FOCUS":["tmau"],"ANNOTATIONS_TYPE":"information","SUBJECT":"","MESSAGE":"TMAU. Please find a way to research TMAU And how to cure it with gene therapy. I'm tired kg smelling like fish\/feces And getting talked about everyday of my life.","QUESTION_ID":"Q75","F_REF":"10136"} +{"ANSWERS":[{"_answerid":"Q75-S2-A1","_pairid":"175","__text":"Although there is no cure for trimethylaminuria, the following are some ways to reduce symptoms of odor:[1][3] Avoidance of foods that contain trimethylamine and its precursors (choline, lecithin, and trimethylamine N-oxide). Trimethylamine is present in high levels in milk obtained from wheat-fed cows. Choline is present in high amounts in: eggs, liver, kidney, peas, beans, peanuts, soy products, brussels sprouts, broccoli, cabbage, and cauliflower. Trimethylamine N-oxide is present in seafood Low doses of antibiotics. This decreases the amount of trimethylamine that is made by bacteria in the intestines Laxatives can decrease the amount of time food remains in the intestines and therefore reduce the amount of trimethylamine made Nutritional supplements (activated charcoal and copper chlorophyllin) can decrease the concentration of trimethylamine in the urine Soaps with a moderate pH (between 5.5 and 6.5) can help remove the secreted trimethylamine from the skin Riboflavin (vitamin B2) supplements can enhance any existing FMO3 enzyme activity (which breaks down trimethylamine) Avoidance of exercise, stress, emotional upsets, and other factors that can promote sweating People with trimethylaminuria may also find the following to be helpful:[1] Behavioral counseling to help with depression and other psychological symptoms Genetic counseling to better understand how they developed trimethylaminuria and the risks of passing the condition on to their children NOTE: People should follow the treatment advice of their healthcare provider and should not attempt to self-administer these treatment approaches. Medications and supplements can have unintended interactions, and dietary restrictions can result in nutritional deficits. Last updated: 1\/24\/2017"}],"SUB_QUESTION_ID":"Q75-S2","ANNOTATIONS_FOCUS":["tmau"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"TMAU. Please find a way to research TMAU And how to cure it with gene therapy. I'm tired kg smelling like fish\/feces And getting talked about everyday of my life.","QUESTION_ID":"Q75","F_REF":"10136"} +{"ANSWERS":[{"_answerid":"Q76-S1-A1","_pairid":"176","__text":"There is no cure for locked-in syndrome, nor is there a standard course of treatment. A therapy called functional neuromuscular stimulation, which uses electrodes to stimulate muscle reflexes, may help activate some paralyzed muscles. Several devices to help communication are available. Other treatment is symptomatic and supportive."}],"SUB_QUESTION_ID":"Q76-S1","ANNOTATIONS_FOCUS":["locked-in syndrome"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"ClinicalTrials.gov - Suggestion","MESSAGE":"Please help me with my brother with locked-in syndrome in [LOCATION] for 3 years.Somebody please help. God bless .[NAME] [CONTACT]","QUESTION_ID":"Q76","F_REF":"16154"} +{"ANSWERS":[{"_answerid":"Q77-S1-A1","_pairid":"177","__text":"A stroke is a medical emergency. Quick treatment is needed. Call 9-1-1 or your local emergency number right away or seek urgent medical care at the first signs of a stroke. People who are having stroke symptoms need to get to a hospital as quickly as possible. - If the stroke is caused by a blood clot, a clot-busting drug may be given to dissolve the clot. - To be effective, this treatment must be started within 3 to 4 1\/2 hours of when the symptoms first started. The sooner this treatment is started, the better the chance of a good outcome. Other treatments given in the hospital depend on the cause of the stroke. These may include: - Blood thinners such as heparin, warfarin (Coumadin), aspirin, or clopidogrel (Plavix) - Medicine to control risk factors, such as high blood pressure, diabetes, and high cholesterol - Special procedures or surgery to relieve symptoms or prevent more strokes - Nutrients and fluids Physical therapy, occupational therapy, speech therapy, and swallowing therapy will all begin in the hospital. If the person has severe swallowing problems, a feeding tube in the stomach (gastrostomy tube) will likely be needed. The goal of treatment after a stroke is to help you recover as much function as possible and prevent future strokes. Recovery from your stroke will begin while you are still in the hospital or at a rehabilitation center. It will continue when you go home from the hospital or center. Be sure to follow up with your health care provider after you go home."},{"_answerid":"Q77-S1-A2","_pairid":"178","__text":"Generally there are three treatment stages for stroke: prevention, therapy immediately after the stroke, and post-stroke rehabilitation. Therapies to prevent a first or recurrent stroke are based on treating an individual's underlying risk factors for stroke, such as hypertension, atrial fibrillation, and diabetes. Acute stroke therapies try to stop a stroke while it is happening by quickly dissolving the blood clot causing an ischemic stroke or by stopping the bleeding of a hemorrhagic stroke. Post-stroke rehabilitation helps individuals overcome disabilities that result from stroke damage. Medication or drug therapy is the most common treatment for stroke. The most popular classes of drugs used to prevent or treat stroke are antithrombotics (antiplatelet agents and anticoagulants) and thrombolytics."},{"_answerid":"Q77-S1-A3","_pairid":"179","__text":"With stroke, treatment depends on the stage of the disease. There are three treatment stages for stroke: prevention, therapy immediately after stroke, and rehabilitation after stroke. Stroke treatments include medications, surgery, and rehabilitation."}],"SUB_QUESTION_ID":"Q77-S1","ANNOTATIONS_FOCUS":["stroke"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"I would appreciate it if you can send me or email me some exercises for a person who is a stroke victim. I am unable to walk due to a arthritic knee. otherwise I am flexable.. my home address is [CONTACT], My email is [CONTACT] (mailto:[CONTACT]) Thank you, [NAME]","QUESTION_ID":"Q77","F_REF":"1-132221211"} +{"ANSWERS":[{"_answerid":"Q78-S1-A1","_pairid":"182","__text":"The goal of treatment is to control your symptoms and prevent infection. Three treatment options are available: - Skin lotions, ointments, creams, and shampoos. These are called topical treatments. - Pills or injections that affect the body's immune response, not just the skin. These are called systemic, or body-wide, treatments. - Phototherapy, which uses ultraviolet light to treat psoriasis. TREATMENTS USED ON THE SKIN (TOPICAL) Most of the time, psoriasis is treated with medicines that are placed directly on the skin or scalp. These may include: - Cortisone creams and ointments - Creams or ointments that contain coal tar or anthralin - Creams to remove the scaling (usually salicylic acid or lactic acid) - Dandruff shampoos (over-the-counter or prescription) - Moisturizers - Prescription medicines containing vitamin D or vitamin A (retinoids) SYSTEMIC (BODY-WIDE) TREATMENTS If you have very severe psoriasis, your provider will likely recommend medicines that suppress the immune system's faulty response. These medicines include methotrexate or cyclosporine. Retinoids can also be used. Newer drugs called biologics are used when other treatments do not work. Biologics approved for the treatment of psoriasis include: - Adalimumab (Humira) - Etanercept (Enbrel) - Infliximab (Remicade) - Ustekinumab (Stelara) - Secukinumab (Cosentyx) - Apremilast (Otezla) PHOTOTHERAPY Some people may choose to have phototherapy: - This is treatment in which your skin is carefully exposed to ultraviolet light. - It may be given alone or after you take a drug that makes the skin sensitive to light. - Phototherapy for psoriasis can be given as ultraviolet A (UVA) or ultraviolet B (UVB) light. OTHER TREATMENTS If you have an infection, your provider will prescribe antibiotics. HOME CARE Following these tips at home may help: - Taking a daily bath or shower. Try not to scrub too hard because this can irritate the skin and trigger an attack. - Oatmeal baths may be soothing and may help to loosen scales. You can use over-the-counter oatmeal bath products. Or, you can mix 1 cup of oatmeal into a tub of warm water. - Keeping your skin clean and moist, and avoiding your specific psoriasis triggers may help reduce the number of flare-ups. - Sunlight may help your symptoms go away. Be careful not to get sunburned. - Relaxation and anti-stress techniques. The link between stress and flares of psoriasis is not well understood. - Limiting the alcoholic beverages you drink may help keep psoriasis from getting worse."},{"_answerid":"Q78-S1-A2","_pairid":"184","__text":"The goals of psoriasis treatment are to change the course of the disease by interfering with the increased production of skin cells, and to remove scales and smooth rough skin. There are many types of treatments. Many are medicines and other treatments your doctor will have to prescribe. But there are other types of treatments you can buy without a prescription or try on your own. Some treatments for psoriasis are applied directly to the skin. Some use light to treat skin lesions. Others are taken by mouth or injected. This chapter focuses on treatments that are applied directly to the skin -- also called topical treatments or light therapy. Topical Treatments Here are some different types of topical treatments for psoriasis. - helps soften and loosen skin scales - comes as a cream, lotion, liquid, gel, ointment or shampoo. helps soften and loosen skin scales comes as a cream, lotion, liquid, gel, ointment or shampoo. - reduce inflammation and slow the growth and build-up of skin cells - are used in different strengths for different parts of the body. reduce inflammation and slow the growth and build-up of skin cells are used in different strengths for different parts of the body. - works by slowing the production of skin cells - is often combined with a steroid for added effects - may be used with UVB light. works by slowing the production of skin cells is often combined with a steroid for added effects may be used with UVB light. - is used to treat long-term psoriasis and hard-to-treat plaques - reduces inflammation - slows down the growth of skin cells. is used to treat long-term psoriasis and hard-to-treat plaques reduces inflammation slows down the growth of skin cells. - cause the skin to shed dead cells - slow the growth of skin cells - decrease itching. cause the skin to shed dead cells slow the growth of skin cells decrease itching. - are believed to work by reducing skin cell overgrowth - decrease inflammation - are often used with other treatments. are believed to work by reducing skin cell overgrowth decrease inflammation are often used with other treatments. - slow down the growth of skin cells - may be used with steroid creams for added effects. slow down the growth of skin cells may be used with steroid creams for added effects. Regardless of the topical medication your doctor prescribes, it is important to follow directions carefully. Some can be messy and stain your clothing and bedding. Others can have potentially dangerous side effects. Light Therapy Light therapy, also called phototherapy, uses ultraviolet light to treat skin lesions. Laser therapy delivers intense, focused doses of light to specific areas of the skin to clear lesions without harming surrounding tissues. Here are some different kinds of light therapy. UVB phototherapy - penetrates the skin to slow the growth of affected cells - is given at home or at the doctor\u2019s office - may be combined with topical treatments or injected or oral medicines to increase effectiveness. penetrates the skin to slow the growth of affected cells is given at home or at the doctor\u2019s office may be combined with topical treatments or injected or oral medicines to increase effectiveness. Excimer laser - targets select areas of skin with a beam of high-intensity UVB light - is used to treat chronic, localized psoriasis plaques - may take 4 to 10 sessions to see results . targets select areas of skin with a beam of high-intensity UVB light is used to treat chronic, localized psoriasis plaques may take 4 to 10 sessions to see results . Pulsed dye laser - uses a dye and different wavelength of light from other skin treatments - destroys tiny blood vessels that help psoriasis lesions form - may take 4 to 6 sessions to clear treated lesions. uses a dye and different wavelength of light from other skin treatments destroys tiny blood vessels that help psoriasis lesions form may take 4 to 6 sessions to clear treated lesions."},{"_answerid":"Q78-S1-A3","_pairid":"185","__text":"While many psoriasis treatments are applied directly to the skin, your doctor may prescribe others that must be taken by mouth or injected. There are also some natural treatments, taken by mouth or applied to the skin, that you can try on your own. Systemic Therapies These therapies, prescribed by your doctor, work in different ways to help control the underlying disease process. It is important to learn as much as you can about these medications and to take them exactly as prescribed by your doctor. Oral or injected medications for psoriasis include the following. - is used to treat severe psoriasis (meaning more than 20 percent of skin is affected) - slows the rapid growth of skin cells - is taken by mouth or injected. is used to treat severe psoriasis (meaning more than 20 percent of skin is affected) slows the rapid growth of skin cells is taken by mouth or injected. - may be used for severe psoriasis not controlled by methotrexate - suppresses overactive T cells that play a role in psoriasis - is taken by mouth or injected. may be used for severe psoriasis not controlled by methotrexate suppresses overactive T cells that play a role in psoriasis is taken by mouth or injected. - are man-made drugs related to vitamin A - help slow the production of skin cells - reduce inflammation. are man-made drugs related to vitamin A help slow the production of skin cells reduce inflammation. - are made from living cells grown in a laboratory - block the action of specific cells and proteins that play a role in psoriasis - must be injected beneath the skin or given intravenously (by IV). are made from living cells grown in a laboratory block the action of specific cells and proteins that play a role in psoriasis must be injected beneath the skin or given intravenously (by IV). Natural Treatments For many people, natural treatments can help relieve the symptoms of psoriasis. There are many natural treatments you can try on your own, but you should never use them to replace the treatment your doctor prescribes. Here are some natural treatments you may want to try. Spending a few minutes in the summer sun can help your psoriasis, but be sure to use sun block and increase time spent in the sun gradually. Applying cream from the aloe vera plant improves symptoms for some people. You should avoid aloe vera tablets. Taking fish oil orally helps some people with psoriasis. If you want to try fish oil, first speak with your doctor, as it may interact with other medications you are taking. Soaking in a solution of Dead Sea salts may improve scaling and itching. Be sure to apply moisturizer when you get out of the tub. Capsaicin, the ingredient that makes cayenne peppers hot, is the active ingredient in some topical pain-relievers. Some people find they relieve pain and itching."}],"SUB_QUESTION_ID":"Q78-S1","ANNOTATIONS_FOCUS":["psoriasis"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"Psoriasis for past 7-8 years","MESSAGE":"I had psoriasis on my scalp for nearly 10 years. Please give suggestions and medications.","QUESTION_ID":"Q78","F_REF":"NF_233"} +{"ANSWERS":[{"_answerid":"Q79-S1-A1","_pairid":"186","__text":"Ataxia-telangiectasia is inherited in an autosomal recessive pattern, which means both copies of the ATM gene in each cell have mutations. Most often, the parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but do not show signs and symptoms of the condition. About 1 percent of the United States population carries one mutated copy and one normal copy of the ATM gene in each cell. These individuals are called carriers. Although ATM mutation carriers do not have ataxia-telangiectasia, they are more likely than people without an ATM mutation to develop cancer; female carriers are particularly at risk for developing breast cancer. Carriers of a mutation in the ATM gene also may have an increased risk of heart disease."}],"SUB_QUESTION_ID":"Q79-S1","ANNOTATIONS_FOCUS":["louis bar syndrome"],"ANNOTATIONS_TYPE":"inheritance","SUBJECT":"Louis Bar Syndrome","MESSAGE":"My brother died young from Louis Bar Syndrome. Of six pregnancies, four children either did not survive pregnancy or died very young. I would like to know is it possible that other children (like me) could have the syndrome symptoms to a lesser or greater degree:i.e., is there a continuum???","QUESTION_ID":"Q79","F_REF":"1-137041975"} +{"ANSWERS":[{"_answerid":"Q80-S1-A1","_pairid":"187","__text":"People can clench and grind without being aware of it. It can happen during both the day and night, although sleep-related bruxism is often a bigger problem because it is harder to control. There is some disagreement about the cause of bruxism. Daily stress may be the trigger in many people. Some people probably clench their teeth and never feel symptoms. Factors that influence whether or not bruxism causes pain and other problems will vary from person to person. They may include: - How much stress you are under - How long and tightly you clench and grind - Whether your teeth are misaligned - Your posture - Your ability to relax - Your diet - Your sleeping habits"}],"SUB_QUESTION_ID":"Q80-S1","ANNOTATIONS_FOCUS":["bruxism"],"ANNOTATIONS_TYPE":"cause","SUBJECT":"Bruxism","MESSAGE":"I understand that bruxism may be a result of tension or anxiety, but why that particular release? Why don't people clench their fists during sleep, or kick, or any number of activities? In other words, why is the jaw the most common location?","QUESTION_ID":"Q80","F_REF":"12318"} +{"ANSWERS":[{"_answerid":"Q80-S2-A1","_pairid":"188","__text":"Bruxism (BRUK-siz-um) is a condition in which you grind, gnash or clench your teeth. If you have bruxism, you may unconsciously clench your teeth together during the day, or clench or grind them at night (sleep bruxism). Sleep bruxism is considered a sleep-related movement disorder. People who clench or grind their teeth (brux) during sleep are more likely to have other sleep disorders, such as snoring and pauses in breathing (sleep apnea). Mild bruxism may not require treatment. However, in some people, bruxism can be frequent and severe enough to lead to jaw disorders, headaches, damaged teeth and other problems. Because you may have sleep bruxism and be unaware of it until complications develop, it's important to know the signs and symptoms of bruxism and to seek regular dental care."}],"SUB_QUESTION_ID":"Q80-S2","ANNOTATIONS_FOCUS":["bruxism"],"ANNOTATIONS_TYPE":"information","SUBJECT":"Bruxism","MESSAGE":"I understand that bruxism may be a result of tension or anxiety, but why that particular release? Why don't people clench their fists during sleep, or kick, or any number of activities? In other words, why is the jaw the most common location?","QUESTION_ID":"Q80","F_REF":"12318"} +{"ANSWERS":[{"_answerid":"Q81-S1-A1","_pairid":"192","__text":"Secondary Insomnia Secondary insomnia is the symptom or side effect of another problem. This type of insomnia often is a symptom of an emotional, neurological, or other medical or sleep disorder. Emotional disorders that can cause insomnia include depression, anxiety, and posttraumatic stress disorder. Alzheimer's disease and Parkinson's disease are examples of neurological disorders that can cause insomnia. Many other disorders or factors also can cause insomnia, such as: Conditions that cause chronic (ongoing) pain, such as arthritis and headache disorders Conditions that make it hard to breathe, such as asthma and heart failure An overactive thyroid Gastrointestinal disorders, such as heartburn Stroke Sleep disorders, such as restless legs syndrome and sleep-related breathing problems Menopause and hot flashes Secondary insomnia also can be a side effect of some medicines. For example, certain asthma medicines, such as theophylline, and some allergy and cold medicines can cause insomnia. Beta blockers also can cause the condition. These medicines are used to treat heart conditions. Commonly used substances also can cause insomnia. Examples include caffeine and other stimulants, tobacco and other nicotine products, and alcohol and other sedatives. Primary Insomnia Primary insomnia isn't a symptom or side effect of another medical condition. It is its own distinct disorder, and its cause isn\u2019t well understood. Primary insomnia usually lasts for at least 1 month. Many life changes can trigger primary insomnia. It may be due to major or long-lasting stress or emotional upset. Travel or other factors, such as work schedules that disrupt your sleep routine, also may trigger primary insomnia. Even if these issues are resolved, the insomnia may not go away. Trouble sleeping can persist because of habits formed to deal with the lack of sleep. These habits might include taking naps, worrying about sleep, and going to bed early. Researchers continue to try to find out whether some people are born with an increased risk for primary insomnia."}],"SUB_QUESTION_ID":"Q81-S1","ANNOTATIONS_FOCUS":["insomnia"],"ANNOTATIONS_TYPE":"cause","SUBJECT":"Insomnia (special case)","MESSAGE":"Hi, Im 40 years old male. I was suffering from social anxiety since I was child. Last year, I decided to go to a psychologist. She advised me to practice meditation, mindfulness and CBT as well. She explained to me the great positive impact of the meditation, mindfulness on the brain activity (neuroplasticity). Since then, I've been practicing these techniques. The result was awesome. I no longer suffer from my social anxiety and my life has completely changed to the positive side. No more worry, stress, anxiety, etc. But at the same time, I started to suffer from chronic insomnia until now. Of course, Im always in touch with my psychiatrist who has prescribed me the necessary and still following me up. Even tough, my insomnia doesn't improved. Unfortunately, nobody can determine the real cause of my insomnia. If I know the cause, I'll do my best to find the key to resolve this problem. According to my mentioned story, can you help me to find the real cause of my insomnia? Thank you, Your answer is very appreciable and important to me. [NAME].","QUESTION_ID":"Q81","F_REF":"1-133026025"} +{"ANSWERS":[{"_answerid":"Q82-S1-A1","_pairid":"194","__text":"Cri-du-chat (cat's cry) syndrome, also known as 5p- (5p minus) syndrome, is a chromosomal condition that results when a piece of chromosome 5 is missing. Infants with this condition often have a high-pitched cry that sounds like that of a cat. The disorder is characterized by intellectual disability and delayed development, small head size (microcephaly), low birth weight, and weak muscle tone (hypotonia) in infancy. Affected individuals also have distinctive facial features, including widely set eyes (hypertelorism), low-set ears, a small jaw, and a rounded face. Some children with cri-du-chat syndrome are born with a heart defect. These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional. Where to Start Genetics Home Reference (GHR) contains information on Cri du chat syndrome. This website is maintained by the National Library of Medicine. MedlinePlus was designed by the National Library of Medicine to help you research your health questions, and it provides more information about this topic. The National Human Genome Research Institute's (NHGRI) website has an information page on this topic. NHGRI is part of the National Institutes of Health and supports research on the structure and function of the human genome and its role in health and disease. The National Organization for Rare Disorders (NORD) has a report for patients and families about this condition. NORD is a patient advocacy organization for individuals with rare diseases and the organizations that serve them. In-Depth Information Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free. The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch\u2019s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition. Online Mendelian Inheritance in Man (OMIM) is a catalog of human genes and genetic disorders. Each entry has a summary of related medical articles. It is meant for health care professionals and researchers. OMIM is maintained by Johns Hopkins University School of Medicine. Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge. PubMed is a searchable database of medical literature and lists journal articles that discuss Cri du chat syndrome. Click on the link to view a sample search on this topic. Selected Full-Text Journal Articles Nguyen JM et al., 5p deletions: Current knowledge and future directions. Am J Med Genet C Semin Med Genet. 2015 Sep;169(3):224-38. Boultwood J et al., Advances in the 5q- syndrome. Blood. 2010 Dec 23;116(26):5803-11. Pituch KA et al., Educational Priorities for Children with Cri-Du-Chat Syndrome. J Dev Phys Disabil. 2010 Feb;22(1):65-81. Rodr\u00edguez-Caballero A et al., Cri du chat syndrome: a critical review. Med Oral Patol Oral Cir Bucal. 2010 May 1;15(3):e473-8. Cornish K, Bramble D. Cri du chat syndrome: genotype-phenotype correlations and recommendations for clinical management. Dev Med Child Neurol. 2002 Jul;44(7):494-7."}],"SUB_QUESTION_ID":"Q82-S1","ANNOTATIONS_FOCUS":["cri du chat syndrome"],"ANNOTATIONS_TYPE":"information","SUBJECT":"","MESSAGE":"would you help me to fine article or jurnal about Cri du chat syndrome","QUESTION_ID":"Q82","F_REF":"11446"} +{"ANSWERS":[{"_answerid":"Q83-S1-A1","_pairid":"195","__text":"Clopidogrel may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: excessive tiredness headache dizziness nausea vomiting stomach pain diarrhea nosebleed Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately: hives rash itching difficulty breathing or swallowing swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs hoarseness black and tarry stools red blood in stools bloody vomit vomit that looks like coffee grounds unusual bleeding or bruising pink or brown urine slow or difficult speech weakness or numbness of an arm or a leg changes in vision fever shortness of breath fast heartbeat pale skin purple patches or bleeding under the skin confusion yellowing of the skin or eyes seizures Clopidogrel may cause other side effects. Call your doctor if you have any unusual problems while taking this medication. If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http:\/\/www.fda.gov\/Safety\/MedWatch) or by phone (1-800-332-1088)."}],"SUB_QUESTION_ID":"Q83-S1","ANNOTATIONS_FOCUS":["Plavix"],"ANNOTATIONS_TYPE":"side effects","SUBJECT":"taking multiple meds","MESSAGE":"Plavix,linisopril,simvastatin,melotonin: What possible side effects should I be aware of when taking all of these daily?","QUESTION_ID":"Q83","F_REF":"1-120034945"} +{"ANSWERS":[{"_answerid":"Q83-S2-A1","_pairid":"196","__text":"Lisinopril and hydrochlorothiazide may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: dizziness headache cough excessive tiredness pain, burning, or tingling in the hands or feet decrease in sexual ability heartburn Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately: swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs hoarseness difficulty breathing or swallowing stomach pain upset stomach vomiting fever, sore throat, chills, and other signs of infection muscle pain, cramps, or weakness yellowing of the skin or eyes dry mouth thirst weakness restlessness confusion seizures decrease in urination lightheadedness fainting chest pain rapid, pounding, slow, or irregular heartbeat pain in big toe tingling in arms and legs loss of muscle tone weakness or heaviness in legs lack of energy cold, gray skin Lisinopril and hydrochlorothiazide may cause other side effects. Call your doctor if you have any unusual problems while taking this medication. If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http:\/\/www.fda.gov\/Safety\/MedWatch) or by phone (1-800-332-1088)."}],"SUB_QUESTION_ID":"Q83-S2","ANNOTATIONS_FOCUS":["linisopril"],"ANNOTATIONS_TYPE":"side effects","SUBJECT":"taking multiple meds","MESSAGE":"Plavix,linisopril,simvastatin,melotonin: What possible side effects should I be aware of when taking all of these daily?","QUESTION_ID":"Q83","F_REF":"1-120034945"} +{"ANSWERS":[{"_answerid":"Q83-S3-A1","_pairid":"197","__text":"Simvastatin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: constipation stomach pain nausea headache memory loss or forgetfulness confusion Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately or get emergency medical help. muscle pain, tenderness, or weakness dark red urine decreased urination lack of energy, tiredness, or weakness loss of appetite pain in the upper right part of the stomach yellowing of the skin or eyes dark colored urine fever or chills flushing blisters rash hives itching swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs difficulty breathing or swallowing hoarseness joint pain sensitivity to light This medication may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication. If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http:\/\/www.fda.gov\/Safety\/MedWatch) or by phone (1-800-332-1088)."}],"SUB_QUESTION_ID":"Q83-S3","ANNOTATIONS_FOCUS":["simvastatin"],"ANNOTATIONS_TYPE":"side effects","SUBJECT":"taking multiple meds","MESSAGE":"Plavix,linisopril,simvastatin,melotonin: What possible side effects should I be aware of when taking all of these daily?","QUESTION_ID":"Q83","F_REF":"1-120034945"} +{"ANSWERS":[{"_answerid":"Q83-S4-A1","_pairid":"198","__text":"Side effects of melatonin are uncommon but can include drowsiness, headache, dizziness, or nausea. There have been no reports of significant side effects of melatonin in children."}],"SUB_QUESTION_ID":"Q83-S4","ANNOTATIONS_FOCUS":["melotonin"],"ANNOTATIONS_TYPE":"side effects","SUBJECT":"taking multiple meds","MESSAGE":"Plavix,linisopril,simvastatin,melotonin: What possible side effects should I be aware of when taking all of these daily?","QUESTION_ID":"Q83","F_REF":"1-120034945"} +{"ANSWERS":[{"_answerid":"Q84-S1-A1","_pairid":"199","__text":"There may be damage to the retina of the eye (retinitis pigmentosa). Tests that may be done to help diagnose this condition include: - Apolipoprotein B blood test - Blood tests to look for vitamin deficiencies (fat-soluble vitamins A, D, E, and K) - \"Burr-cell\" malformation of the red cells (acanthocytosis) - Complete blood count (CBC) - Cholesterol studies - Electromyography - Eye exam - Nerve conduction velocity - Stool sample analysis Genetic testing may be available for mutations in the MTP gene."},{"_answerid":"Q84-S1-A2","_pairid":"200","__text":"The Genetic Testing Registry (GTR) provides information about the genetic tests available for abetalipoproteinemia. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional. Prenatal testing may also be available for pregnancies at increased risk if the mutations in the family have been identified."}],"SUB_QUESTION_ID":"Q84-S1","ANNOTATIONS_FOCUS":["abetalipoproteinemia"],"ANNOTATIONS_TYPE":"diagnosis","SUBJECT":"abetalipoproteimemia","MESSAGE":"hi, I would like to know if there is any support for those suffering with abetalipoproteinemia? I am not diagnosed but have had many test that indicate I am suffering with this, keen to learn how to get it diagnosed and how to manage, many thanks","QUESTION_ID":"Q84","F_REF":"1-132462207"} +{"ANSWERS":[{"_answerid":"Q84-S2-A1","_pairid":"201","__text":"Treatment involves large doses of vitamin supplements containing fat-soluble vitamins (vitamin A, vitamin D, vitamin E, and vitamin K). Linoleic acid supplements are also recommended. People with this condition should talk to a nutritionist. Diet changes are needed to prevent stomach problems. This involves: - Limiting fat intake to 5 to 20 grams per day. - Do not eat more than 5 ounces daily of lean meat, fish, or poultry. - Use skim milk instead of whole milk. Supplements of medium-chain triglycerides are taken under the supervision of a health care provider. They should be used with caution, because they may cause liver damage."},{"_answerid":"Q84-S2-A2","_pairid":"202","__text":"A nutritionist or other qualified medical professional should be consulted for specific dietary instruction in people with abetalipoproteinemia. Treatment involves very large doses of vitamin E, as well as large doses of vitamin supplements containing other fat-soluble vitamins (vitamin A, vitamin D, and vitamin K). Linoleic acid supplements are also recommended. Several diet changes and\/or restrictions are also needed to prevent stomach problems. A low-fat diet may help with digestive symptoms; medium chain triglycerides may be used (under supervision of a specialist) as a source of fat in the diet. Management in adults typically focuses on specific complications associated with the disorder, and depends on the signs and symptoms present. Affected people may need consultations with several other types of specialists, including a lipidologist, gastroenterologist, hepatologist, ophthalmologist, and neurologist."},{"_answerid":"Q84-S2-A3","_pairid":"203","__text":"These resources address the diagnosis or management of abetalipoproteinemia: - Genetic Testing Registry: Abetalipoproteinaemia - MedlinePlus Encyclopedia: Bassen-Kornzweig syndrome - MedlinePlus Encyclopedia: Malabsorption - MedlinePlus Encyclopedia: Retinitis pigmentosa - MedlinePlus Encyclopedia: Stools - floating These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"}],"SUB_QUESTION_ID":"Q84-S2","ANNOTATIONS_FOCUS":["abetalipoproteinemia"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"abetalipoproteimemia","MESSAGE":"hi, I would like to know if there is any support for those suffering with abetalipoproteinemia? I am not diagnosed but have had many test that indicate I am suffering with this, keen to learn how to get it diagnosed and how to manage, many thanks","QUESTION_ID":"Q84","F_REF":"1-132462207"} +{"ANSWERS":[{"_answerid":"Q85-S1-A1","_pairid":"204","__text":"There is no known way to prevent preeclampsia. It is important for all pregnant women to start prenatal care early and continue it through the pregnancy."}],"SUB_QUESTION_ID":"Q85-S1","ANNOTATIONS_FOCUS":["preeclampsia"],"ANNOTATIONS_TYPE":"prevention","SUBJECT":"prevention of preeclampsia","MESSAGE":"I know that the jury is out on the exact causes of preeclampsia, but I am looking for some of the ways that the chances of acquiring it can be minimized.","QUESTION_ID":"Q85","F_REF":"NF_214"} +{"ANSWERS":[{"_answerid":"Q86-S1-A1","_pairid":"206","__text":"Treatment depends on many things, including the stage of the cancer. Treatments may include: - Surgery to remove the tumor - Chemotherapy to kill cancer cells - Radiation therapy to destroy cancerous tissue - Targeted therapy to keep cancer from growing and spreading\u00a0 Surgery Stage 0 colon cancer may be treated by removing the tumor. This is done using colonoscopy. For stages I, II, and III cancer, more extensive surgery is needed to remove the part of the colon that is cancerous. This surgery is called colon resection\u00a0(colectomy). Chemotherapy Almost all people with stage III colon cancer receive chemotherapy after surgery for 6 to 8 months. This is called adjuvant chemotherapy. Even though the tumor was removed, chemotherapy is given to treat any cancer cells that may be left. Chemotherapy is also used to improve symptoms and prolong survival in people with stage IV colon cancer. You may receive just one type of medicine or a combination of medicines. Radiation Radiation therapy is sometimes used for colon cancer. It is usually used in combination with chemotherapy for people with stage III rectal cancer. For people with stage IV disease that has spread to the liver, treatment directed at the liver can be used. This may include: - Burning the cancer (ablation) - Delivering chemotherapy or radiation directly into the liver - Freezing the cancer (cryotherapy) - Surgery Targeted Therapy - Targeted treatment zeroes in on specific targets (molecules) in cancer cells. These targets play a role in how cancer cells grow and survive. Using these targets, the drug disables the cancer cells so they cannot spread. Targeted therapy may be given as pills or may be injected into a vein. - You may have targeted therapy along with surgery, chemotherapy, or radiation treatment."}],"SUB_QUESTION_ID":"Q86-S1","ANNOTATIONS_FOCUS":["colon cancer"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"Colon cancer cure seen on tv. My father has colon cancer and said he saw a commercial on tv about a cure for colon cancer. He cannot remember any details about it. I was wondering if you know anything about something like this. Please let me know. Thank you, [NAME]","QUESTION_ID":"Q86","F_REF":"11901"} +{"ANSWERS":[{"_answerid":"Q87-S1-A1","_pairid":"207","__text":"Hypertrophic cardiomyopathy (HCM) is a condition in which the heart muscle becomes thick. Often, only 1 part of the heart is thicker than the other parts. The thickening can make it harder for blood to leave the heart, forcing the heart to work harder to pump blood. It also can make it harder for the heart to relax and fill with blood."}],"SUB_QUESTION_ID":"Q87-S1","ANNOTATIONS_FOCUS":["IHSS heart condition"],"ANNOTATIONS_TYPE":"information","SUBJECT":"IHSS heart condition and WPW heart condition","MESSAGE":"Is there any way you could send me information on both these heart conditions? My son has to get tested for them eventually and I would just like information to understand the conditions of both of them more.","QUESTION_ID":"Q87","F_REF":"1-137083655"} +{"ANSWERS":[{"_answerid":"Q87-S2-A1","_pairid":"208","__text":"Wolff-Parkinson-White syndrome is a condition in which there is an extra electrical pathway of the heart. The condition can lead to periods of rapid heart rate (tachycardia). Wolff-Parkinson-White syndrome is one of the most common causes of fast heart rate problems in infants and children."},{"_answerid":"Q87-S2-A2","_pairid":"209","__text":"Wolff-Parkinson-White syndrome is a condition characterized by abnormal electrical pathways in the heart that cause a disruption of the heart's normal rhythm (arrhythmia). The heartbeat is controlled by electrical signals that move through the heart in a highly coordinated way. A specialized cluster of cells called the atrioventricular node conducts electrical impulses from the heart's upper chambers (the atria) to the lower chambers (the ventricles). Impulses move through the atrioventricular node during each heartbeat, stimulating the ventricles to contract slightly later than the atria. People with Wolff-Parkinson-White syndrome are born with an extra connection in the heart, called an accessory pathway, that allows electrical signals to bypass the atrioventricular node and move from the atria to the ventricles faster than usual. The accessory pathway may also transmit electrical impulses abnormally from the ventricles back to the atria. This extra connection can disrupt the coordinated movement of electrical signals through the heart, leading to an abnormally fast heartbeat (tachycardia) and other arrhythmias. Resulting symptoms include dizziness, a sensation of fluttering or pounding in the chest (palpitations), shortness of breath, and fainting (syncope). In rare cases, arrhythmias associated with Wolff-Parkinson-White syndrome can lead to cardiac arrest and sudden death. The most common arrhythmia associated with Wolff-Parkinson-White syndrome is called paroxysmal supraventricular tachycardia. Complications of Wolff-Parkinson-White syndrome can occur at any age, although some individuals born with an accessory pathway in the heart never experience any health problems associated with the condition. Wolff-Parkinson-White syndrome often occurs with other structural abnormalities of the heart or underlying heart disease. The most common heart defect associated with the condition is Ebstein anomaly, which affects the valve that allows blood to flow from the right atrium to the right ventricle (the tricuspid valve). Additionally, Wolff-Parkinson-White syndrome can be a component of several other genetic syndromes, including hypokalemic periodic paralysis (a condition that causes episodes of extreme muscle weakness), Pompe disease (a disorder characterized by the storage of excess glycogen), and tuberous sclerosis (a condition that results in the growth of noncancerous tumors in many parts of the body)."}],"SUB_QUESTION_ID":"Q87-S2","ANNOTATIONS_FOCUS":["wpw"],"ANNOTATIONS_TYPE":"information","SUBJECT":"IHSS heart condition and WPW heart condition","MESSAGE":"Is there any way you could send me information on both these heart conditions? My son has to get tested for them eventually and I would just like information to understand the conditions of both of them more.","QUESTION_ID":"Q87","F_REF":"1-137083655"} +{"ANSWERS":[{"_answerid":"Q88-S1-A1","_pairid":"210","__text":"A stroke is a medical emergency. Quick treatment is needed. Call 9-1-1 or your local emergency number right away or seek urgent medical care at the first signs of a stroke. People who are having stroke symptoms need to get to a hospital as quickly as possible. - If the stroke is caused by a blood clot, a clot-busting drug may be given to dissolve the clot. - To be effective, this treatment must be started within 3 to 4 1\/2 hours of when the symptoms first started. The sooner this treatment is started, the better the chance of a good outcome. Other treatments given in the hospital depend on the cause of the stroke. These may include: - Blood thinners such as heparin, warfarin (Coumadin), aspirin, or clopidogrel (Plavix) - Medicine to control risk factors, such as high blood pressure, diabetes, and high cholesterol - Special procedures or surgery to relieve symptoms or prevent more strokes - Nutrients and fluids Physical therapy, occupational therapy, speech therapy, and swallowing therapy will all begin in the hospital. If the person has severe swallowing problems, a feeding tube in the stomach (gastrostomy tube) will likely be needed. The goal of treatment after a stroke is to help you recover as much function as possible and prevent future strokes. Recovery from your stroke will begin while you are still in the hospital or at a rehabilitation center. It will continue when you go home from the hospital or center. Be sure to follow up with your health care provider after you go home."},{"_answerid":"Q88-S1-A2","_pairid":"211","__text":"Generally there are three treatment stages for stroke: prevention, therapy immediately after the stroke, and post-stroke rehabilitation. Therapies to prevent a first or recurrent stroke are based on treating an individual's underlying risk factors for stroke, such as hypertension, atrial fibrillation, and diabetes. Acute stroke therapies try to stop a stroke while it is happening by quickly dissolving the blood clot causing an ischemic stroke or by stopping the bleeding of a hemorrhagic stroke. Post-stroke rehabilitation helps individuals overcome disabilities that result from stroke damage. Medication or drug therapy is the most common treatment for stroke. The most popular classes of drugs used to prevent or treat stroke are antithrombotics (antiplatelet agents and anticoagulants) and thrombolytics."},{"_answerid":"Q88-S1-A3","_pairid":"212","__text":"With stroke, treatment depends on the stage of the disease. There are three treatment stages for stroke: prevention, therapy immediately after stroke, and rehabilitation after stroke. Stroke treatments include medications, surgery, and rehabilitation."},{"_answerid":"Q88-S1-A4","_pairid":"213","__text":"Medication or drug therapy is the most common treatment for stroke. The most popular kinds of drugs to prevent or treat stroke are antithrombotics -- which include antiplatelet agents and anticoagulants -- and thrombolytics. Antithrombotics prevent the formation of blood clots that can become stuck in an artery of the brain and cause strokes. - In the case of stroke, doctors prescribe antiplatelet drugs mainly for prevention. The most widely known and used antiplatelet drug is aspirin. Other antiplatelet drugs include clopidogrel, ticlopidine, and dipyridamole. In the case of stroke, doctors prescribe antiplatelet drugs mainly for prevention. The most widely known and used antiplatelet drug is aspirin. Other antiplatelet drugs include clopidogrel, ticlopidine, and dipyridamole. - Anticoagulants reduce the risk of stroke by reducing the clotting property of the blood. The most commonly used oral anticoagulants include warfarin, also known as Coumadin\u00ae, dabigatran (Pradaxa) and rivaroxaban (Xarelto). Injectable anticoagulants include heparin, enoxaparin (Lovenox), and dalteparin (Fragmin). Anticoagulants reduce the risk of stroke by reducing the clotting property of the blood. The most commonly used oral anticoagulants include warfarin, also known as Coumadin\u00ae, dabigatran (Pradaxa) and rivaroxaban (Xarelto). Injectable anticoagulants include heparin, enoxaparin (Lovenox), and dalteparin (Fragmin). Thrombolytic drugs halt the stroke by dissolving the blood clot that is blocking blood flow to the brain. Ischemic strokes -- the most common kind -- can be treated with thrombolytic drugs. But a person needs to be at the hospital as soon as possible after symptoms start to be evaluated and receive treatment. A thrombolytic drug known as t-PA can be effective if a person receives it intravenously (in a vein) within 3 hours after his or her stroke symptoms have started. Because there is such a narrow time window for giving t-PA, it is important to note the time any stroke symptoms appear. Since thrombolytic drugs can increase bleeding, t-PA should be used only after the doctor is certain that the patient has suffered an ischemic and not a hemorrhagic stroke. Neuroprotectants are medications or other treatments that protect the brain from secondary injury caused by stroke. Although the FDA (Food and Drug Administration) has not approved any neuroprotectants for use in stroke at this time, many have been tested or are being tested in clinical trials. Cooling of the brain (hypothermia) is beneficial for improving neurological function after a cardiac arrest."},{"_answerid":"Q88-S1-A5","_pairid":"214","__text":"Surgery can be used to prevent stroke, to treat stroke, or to repair damage to the blood vessels or malformations in and around the brain. - Carotid endarterectomy is a surgical procedure in which a surgeon removes fatty deposits, or plaque, from the inside of one of the carotid arteries. The procedure is performed to prevent stroke. The carotid arteries are located in the neck and are the main suppliers of blood to the brain. Carotid endarterectomy is a surgical procedure in which a surgeon removes fatty deposits, or plaque, from the inside of one of the carotid arteries. The procedure is performed to prevent stroke. The carotid arteries are located in the neck and are the main suppliers of blood to the brain. Vascular Interventions In addition to surgery, a variety of techniques have been developed to allow certain vascular problems to be treated from inside the artery using specialized catheters with the goal of improving blood flow. (Vascular is a word that refers to blood vessels, arteries, and veins that carry blood throughout the body.) A catheter is a very thin, flexible tube that can be inserted into one of the major arteries of the leg or arm and then directed through the blood vessels to the diseased artery. Physicians trained in this technique called angiography undergo additional training to treat problems in the arteries of the brain or spinal cord. These physicians are called neurointerventionalists. - Angioplasty is widely used by angiographers to open blocked heart arteries, and is also used to prevent stroke. Angioplasty is a procedure in which a special catheter is inserted into the narrowed artery and then a balloon at the tip of the catheter is inflated to open the blocked artery. The procedure improves blood flow to the brain. Angioplasty is widely used by angiographers to open blocked heart arteries, and is also used to prevent stroke. Angioplasty is a procedure in which a special catheter is inserted into the narrowed artery and then a balloon at the tip of the catheter is inflated to open the blocked artery. The procedure improves blood flow to the brain. - Stenting is another procedure used to prevent stroke. In this procedure an angiographer inserts a catheter into the artery in the groin and then positions the tip of the catheter inside the narrowed artery. A stent is a tube-like device made of a mesh-like material that can be slipped into position over the catheter. When positioned inside the narrowed segment the stent is expanded to widen the artery and the catheter is removed. Angioplasty or stenting of the carotid artery can cause pieces of the diseased plaque to loosen. An umbrella-like device is often temporarily expanded above to prevent these pieces from traveling to the brain. Stenting is another procedure used to prevent stroke. In this procedure an angiographer inserts a catheter into the artery in the groin and then positions the tip of the catheter inside the narrowed artery. A stent is a tube-like device made of a mesh-like material that can be slipped into position over the catheter. When positioned inside the narrowed segment the stent is expanded to widen the artery and the catheter is removed. Angioplasty or stenting of the carotid artery can cause pieces of the diseased plaque to loosen. An umbrella-like device is often temporarily expanded above to prevent these pieces from traveling to the brain. - Angiographers also sometimes use clot removal devices to treat stroke patients in the very early stage. One device involves threading a catheter through the artery to the site of the blockage and then vacuuming out the clot. Another corkscrew-like device can be extended from the tip of a catheter and used to grab the clot and pull it out. Drugs can also be injected through the catheter directly into the clot to help dissolve the clot. Angiographers also sometimes use clot removal devices to treat stroke patients in the very early stage. One device involves threading a catheter through the artery to the site of the blockage and then vacuuming out the clot. Another corkscrew-like device can be extended from the tip of a catheter and used to grab the clot and pull it out. Drugs can also be injected through the catheter directly into the clot to help dissolve the clot."}],"SUB_QUESTION_ID":"Q88-S1","ANNOTATIONS_FOCUS":["stroke"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"striving to recove speech arti\\culutation when traditional therapies have failed","MESSAGE":"I'm a vietnam navy veteran whose traditional stroke thearapy has failed miserably","QUESTION_ID":"Q88","F_REF":"1-132291442"} +{"ANSWERS":[{"_answerid":"Q89-S1-A1","_pairid":"216","__text":"Your provider may recommend that you do the following: Avoid activities that cause pain. Put ice on the heel several times a day. Take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. Try using over-the-counter or custom heel wedges in your shoe to help decrease stress on the heel. Try ultrasound treatment during physical therapy to reduce inflammation. Have physical therapy to improve flexibility and strength around the ankle. The focus will be on stretching your Achilles tendon. This can help the bursitis improve and prevent it from coming back. If these treatments DO NOT work, your provider may inject a small amount of steroid medicine into the bursa. After the injection, you should avoid overstretching the tendon because it can break open (rupture). If the condition is connected to Achilles tendinitis, you may need to wear a cast on the ankle for several weeks. Very rarely, surgery may be needed to remove the inflamed bursa."}],"SUB_QUESTION_ID":"Q89-S1","ANNOTATIONS_FOCUS":["haglund's deformity"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"Subcutaneous retrocalcaneal bursitis","MESSAGE":"Haglund's deformity of the calcaneum. I have this problem. Can you please help to overcome this?","QUESTION_ID":"Q89","F_REF":"1-131053785"} +{"ANSWERS":[{"_answerid":"Q90-S1-A1","_pairid":"217","__text":"Williams syndrome is a developmental disorder that affects many parts of the body. This condition is characterized by mild to moderate intellectual disability or learning problems, unique personality characteristics, distinctive facial features, and heart and blood vessel (cardiovascular) problems. People with Williams syndrome typically have difficulty with visual-spatial tasks such as drawing and assembling puzzles, but they tend to do well on tasks that involve spoken language, music, and learning by repetition (rote memorization). Affected individuals have outgoing, engaging personalities and tend to take an extreme interest in other people. Attention deficit disorder (ADD), problems with anxiety, and phobias are common among people with this disorder. Young children with Williams syndrome have distinctive facial features including a broad forehead, a short nose with a broad tip, full cheeks, and a wide mouth with full lips. Many affected people have dental problems such as teeth that are small, widely spaced, crooked, or missing. In older children and adults, the face appears longer and more gaunt. A form of cardiovascular disease called supravalvular aortic stenosis (SVAS) occurs frequently in people with Williams syndrome. Supravalvular aortic stenosis is a narrowing of the large blood vessel that carries blood from the heart to the rest of the body (the aorta). If this condition is not treated, the aortic narrowing can lead to shortness of breath, chest pain, and heart failure. Other problems with the heart and blood vessels, including high blood pressure (hypertension), have also been reported in people with Williams syndrome. Additional signs and symptoms of Williams syndrome include abnormalities of connective tissue (tissue that supports the body's joints and organs) such as joint problems and soft, loose skin. Affected people may also have increased calcium levels in the blood (hypercalcemia) in infancy, developmental delays, problems with coordination, and short stature. Medical problems involving the eyes and vision, the digestive tract, and the urinary system are also possible."},{"_answerid":"Q90-S1-A2","_pairid":"218","__text":"Williams Syndrome (WS) is a rare genetic disorder characterized by mild to moderate delays in cognitive development or learning difficulties, a distinctive facial appearance, and a unique personality that combines over-friendliness and high levels of empathy with anxiety. The most significant medical problem associated with WS is cardiovascular disease caused by narrowed arteries. WS is also associated with elevated blood calcium levels in infancy. A random genetic mutation (deletion of a small piece of chromosome 7), rather than inheritance, most often causes the disorder.\u00a0 However, individuals who have WS have a 50 percent chance of passing it on if they decide to have children.\u00a0 The characteristic facial features of WS include puffiness around the eyes, a short nose with a broad nasal tip, wide mouth, full cheeks, full lips, and a small chin. People with WS are also likely to have a long neck, sloping shoulders, short stature, limited mobility in their joints, and curvature of the spine.\u00a0 Some individuals with WS have a star-like pattern in the iris of their eyes.\u00a0 Infants with WS are often irritable and colicky, with feeding problems that keep them from gaining weight.\u00a0 Chronic abdominal pain is common in adolescents and adults. By age 30, the majority of individuals with WS have diabetes or pre-diabetes and mild to moderate sensorineural hearing loss (a form of deafness due to disturbed function of the auditory nerve).\u00a0 For some people, hearing loss may begin as early as late childhood. WS also is associated with a characteristic \u201ccognitive profile\u201d of mental strengths and weaknesses composed of strengths in verbal short-term memory and language, combined with severe weakness in visuospatial construction (the skills used to copy patterns, draw, or write). Within language, the strongest skills are typically in concrete, practical vocabulary, which in many cases is in the low average to average range for the general population. Abstract or conceptual-relational vocabulary is much more limited. Most older children and adults with WS speak fluently and use good grammar.\u00a0 More than 50% of children with WS have attention deficit disorders (ADD or ADHD), and about 50% have specific phobias, such as a fear of loud noises. The majority of individuals with WS worry excessively. The National Institutes of Health (NIH), and the National Institute of Neurological Disorders and Stroke (NINDS), have funded many of the research studies exploring the genetic and neurobiological origins of WS.\u00a0 In the early 1990s, researchers located and identified the genetic mutation responsible for the disorder: the deletion of a small section of chromosome 7 that contains approximately 25 genes.\u00a0 NINDS continues to support WS researchers including, for example, groups that are attempting to link specific genes with the corresponding facial, cognitive, personality, and neurological characteristics of WS."}],"SUB_QUESTION_ID":"Q90-S1","ANNOTATIONS_FOCUS":["williams syndrome"],"ANNOTATIONS_TYPE":"information","SUBJECT":"","MESSAGE":"williams sydrome conditon. i need to send me more information about Williams Syndrome and some tips how to educate people with this disorder.I hope having news from you soon!!thank you","QUESTION_ID":"Q90","F_REF":"11709"} +{"ANSWERS":[{"_answerid":"Q91-S1-A1","_pairid":"224","__text":"Most women have some adenomyosis as they get close to menopause. However, only a few will have symptoms. Most women do not need treatment. Birth control pills and a progesterone-containing intrauterine device (IUD) can help decrease heavy bleeding. Anti-inflammatory medication such as ibuprofen or naproxen can also help manage symptoms. A hysterectomy may be necessary in women with severe symptoms."}],"SUB_QUESTION_ID":"Q91-S1","ANNOTATIONS_FOCUS":["adenomyosis"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"Please i want to know the cure to Adenomyosis. I have been going through alot of pains during my menstruation. I want to see a specialist doctor to help me out. I am dying with pains.","QUESTION_ID":"Q91","F_REF":"1-135933942"} +{"ANSWERS":[{"_answerid":"Q92-S1-A1","_pairid":"225","__text":"There are no known cures for the various muscular dystrophies. The goal of treatment is to control symptoms. Physical therapy may help maintain muscle strength and function. Leg braces and a wheelchair can improve mobility and self-care. In some cases, surgery on the spine or legs may help improve function. Corticosteroids taken by mouth are sometimes prescribed to children with certain muscular dystrophies to keep them walking for as long as possible. The person should be as active as possible. No activity at all (such as bedrest) can make the disease worse."},{"_answerid":"Q92-S1-A2","_pairid":"226","__text":"There is no specific treatment to stop or reverse any form of MD. Treatment may include physical therapy, respiratory therapy, speech therapy, orthopedic appliances used for support, and corrective orthopedic surgery. Drug therapy includes corticosteroids to slow muscle degeneration, anticonvulsants to control seizures and some muscle activity, immunosuppressants to delay some damage to dying muscle cells, and antibiotics to fight respiratory infections. Some individuals may benefit from occupational therapy and assistive technology. Some patients may need assisted ventilation to treat respiratory muscle weakness and a pacemaker for cardiac abnormalities."}],"SUB_QUESTION_ID":"Q92-S1","ANNOTATIONS_FOCUS":["muscular dystrophy"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"muscular dystrophy medicine","MESSAGE":"My brother need treatment for muscular dystrophy","QUESTION_ID":"Q92","F_REF":"1-133480747"} +{"ANSWERS":[{"_answerid":"Q93-S1-A1","_pairid":"227","__text":"Initial Treatment Celexa (citalopram HBr) should be administered at an initial dose of 20 mg once daily, generally with an increase to a dose of 40 mg\/day. Dose increases should usually occur in increments of 20 mg at intervals of no less than one week. Although certain patients may require a dose of 60 mg\/day, the only study pertinent to dose response for effectiveness did not demonstrate an advantage for the 60 mg\/day dose over the 40 mg\/day dose; doses above 40 mg are therefore not ordinarily recommended. Celexa should be administered once daily, in the morning or evening, with or without food. Special Populations 20 mg\/day is the recommended dose for most elderly patients and patients with hepatic impairment, with titration to 40 mg\/day only for nonresponding patients. No dosage adjustment is necessary for patients with mild or moderate renal impairment. Celexa should be used with caution in patients with severe renal impairment. Treatment of Pregnant Women During the Third Trimester Neonates exposed to Celexa and other SSRIs or SNRIs, late in the third trimester, have developed complications requiring prolonged hospitalization, respiratory support, and tube feeding (see PRECAUTIONS). When treating pregnant women with Celexa during the third trimester, the physician should carefully consider the potential risks and benefits of treatment. The physician may consider tapering Celexa in the third trimester. Maintenance Treatment It is generally agreed that acute episodes of depression require several months or longer of sustained pharmacologic therapy. Systematic evaluation of Celexa in two studies has shown that its antidepressant efficacy is maintained for periods of up to 24 weeks following 6 or 8 weeks of initial treatment (32 weeks total). In one study, patients were assigned randomly to placebo or to the same dose of Celexa (20-60 mg\/day) during maintenance treatment as they had received during the acute stabilization phase, while in the other study, patients were assigned randomly to continuation of Celexa 20 or 40 mg\/day, or placebo, for maintenance treatment. In the latter study, the rates of relapse to depression were similar for the two dose groups (see Clinical Trials under CLINICAL PHARMACOLOGY). Based on these limited data, it is not known whether the dose of citalopram needed to maintain euthymia is identical to the dose needed to induce remission. If adverse reactions are bothersome, a decrease in dose to 20 mg\/day can be considered. Discontinuation of Treatment with Celexa Symptoms associated with discontinuation of Celexa and other SSRIs and SNRIs have been reported (see PRECAUTIONS). Patients should be monitored for these symptoms when discontinuing treatment. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose but at a more gradual rate. Switching Patients To or From a Monoamine Oxidase Inhibitor At least 14 days should elapse between discontinuation of an MAOI and initiation of Celexa therapy. Similarly, at least 14 days should be allowed after stopping Celexa before starting an MAOI (see CONTRAINDICATIONS and WARNINGS)."}],"SUB_QUESTION_ID":"Q93-S1","ANNOTATIONS_FOCUS":["Citalopram"],"ANNOTATIONS_TYPE":"dosage","SUBJECT":"","MESSAGE":"What ia the lowest starting dose of Citalopram?","QUESTION_ID":"Q93","F_REF":"1-123031525"} +{"ANSWERS":[{"_answerid":"Q94-S1-A1","_pairid":"228","__text":"If ADHD is suspected, the person should be evaluated by a health care professional. There is no test that can make or exclude a diagnosis of ADHD. The diagnosis is based on a pattern of the symptoms listed below. When the person with suspected ADHD is a child, parents and teachers are usually involved during the evaluation process. Most children with ADHD have at least one other developmental or mental health problem. This problem may be a mood, anxiety or substance use disorder; a learning disability; or a tic disorder. A doctor can help determine whether these other conditions are present. Symptoms ADHD symptoms fall into three groups: Not being able to focus (inattentiveness) Being extremely active (hyperactivity) Not being able to control behavior (impulsivity) Some people with ADHD have mainly inattentive symptoms. Some have mainly hyperactive and impulsive symptoms. Others have a combination of these behaviors. INATTENTIVE SYMPTOMS Doesn't pay attention to details or makes careless mistakes in schoolwork Has problems focusing during tasks or play Doesn't listen when spoken to directly Doesn't follow through on instructions and doesn't finish schoolwork or chores Has problems organizing tasks and activities Avoids or doesn't like tasks that require mental effort (such as schoolwork) Often loses things, such as homework or toys Is easily distracted Is often forgetful HYPERACTIVITY SYMPTOMS Fidgets or squirms in seat Leaves their seat when they should stay in their seat Runs about or climbs when they shouldn't be doing so Has problems playing or working quietly Is often \"on the go,\" acts as if \"driven by a motor\" Talks all the time IMPULSIVITY SYMPTOMS Blurts out answers before questions have been completed Has problems awaiting their turn Interrupts or intrudes on others (butts into conversations or games) Many of the above findings are present in children as they grow. For these problems to be diagnosed as ADHD, they must be out of the normal range for a person's age and development."}],"SUB_QUESTION_ID":"Q94-S1","ANNOTATIONS_FOCUS":["adhd"],"ANNOTATIONS_TYPE":"diagnosis","SUBJECT":"","MESSAGE":"ClinicalTrials.gov - General Complaint. I have had undisguised ADHD since I was 8 years old. I sold illicit drugs from 1979-1989 in large quantity's & self medicated with amphetamines as an adolescent which damaged my Brian & worsened my symptoms. Because I have had several drug induced psychotic episodes since I was busted for trafficking in 1989 & was unable to self medicate on a daily basis. I was wrongly diagnosed with schizophrenia 9years ago. The community psychiatrist's have treated me with all the wrong medication's that have made my ADHD symptoms worse & forced me to self medicate until now. I have no assets or money & I don't think it is worth while going on with out being put on the right medication Ritalin. When I take Meth amphetamines my symptoms improve & I haven't had any anti psychotic medication for 13 month's & have not gone psychotic or had any negative symptoms of schizophrenia. Can you suggest any type of tests I can do to prove I have Adult ADHD or a psychiatrist I can see in [LOCATION] Australia. Who can help me","QUESTION_ID":"Q94","F_REF":"11579"} +{"ANSWERS":[{"_answerid":"Q95-S1-A1","_pairid":"229","__text":"There is no known cure for MS at this time. But, there are treatments that may slow the disease. The goal of treatment is to control symptoms and help you maintain a normal quality of life. Medicines are often taken long-term. These include: - Medicines to slow the disease - Steroids to decrease the severity of attacks - Medicines to control symptoms such as muscle spasms, urinary problems, fatigue, or mood problems Medicines are more effective for the relapsing-remitting form than for other forms of MS. The following may also be helpful for people with MS: - Physical therapy, speech therapy, occupational therapy, and support groups - Assistive devices, such as wheelchairs, bed lifts, shower chairs, walkers, and wall bars - A planned exercise program early in the course of the disorder - A healthy lifestyle, with good nutrition and enough rest and relaxation - Avoiding fatigue, stress, temperature extremes, and illness - Changes in what you eat or drink if there are swallowing problems - Making changes around the home to prevent falls - Social workers or other counseling services to help you cope with the disorder and get assistance - Vitamin D or other supplements (talk to your provider first) - Complementary and alternative approaches, such as acupressure or cannabis, to help with muscle problems"},{"_answerid":"Q95-S1-A2","_pairid":"230","__text":"These resources address the diagnosis or management of multiple sclerosis: - Gene Review: Gene Review: Multiple Sclerosis Overview - Multiple Sclerosis Association of America: Treatments for MS - Multiple Sclerosis International Federation: About MS--Diagnosis - National Multiple Sclerosis Society: Diagnosing Tools These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"},{"_answerid":"Q95-S1-A3","_pairid":"231","__text":"There is as yet no cure for MS. Many patients do well with no therapy at all, especially since many medications have serious side effects and some carry significant risks.\u00a0 However, three forms of beta interferon (Avonex, Betaseron, and Rebif) have now been approved by the Food and Drug Administration for treatment of relapsing-remitting MS. Beta interferon has been shown to reduce the number of exacerbations and may slow the progression of physical disability. When attacks do occur, they tend to be shorter and less severe.\u00a0 The FDA also has approved a synthetic form of myelin basic protein, called copolymer I (Copaxone), for the treatment of relapsing-remitting MS. Copolymer I has few side effects, and studies indicate that the agent can reduce the relapse rate by almost one third. \u00a0Other FDA approved drugs to treat relapsing forms of MS in adults include teriflunomide and dimethyl fumarate. \u00a0An immunosuppressant treatment, Novantrone (mitoxantrone), is\u00a0approved by the FDA for the treatment of advanced or chronic MS. \u00a0The FDA has also approved dalfampridine (Ampyra) to improve walking in individuals with MS. One monoclonal antibody, natalizumab (Tysabri), was shown in clinical trials to significantly reduce the frequency of attacks in people with relapsing forms of MS and was approved for marketing by the U.S. Food and Drug Administration (FDA) in 2004.\u00a0 However, in 2005 the drug\u2019s manufacturer voluntarily suspended marketing of the drug after several reports of significant adverse events.\u00a0 In 2006, the FDA again approved sale of the drug for MS but under strict treatment guidelines involving infusion centers where patients can be monitored by specially trained physicians. \u00a0While steroids do not affect the course of MS over time, they can reduce the duration and severity of attacks in some patients.\u00a0 Spasticity, which can occur either as a sustained stiffness caused by increased muscle tone or as spasms that come and go, is usually treated with muscle relaxants and tranquilizers such as baclofen, tizanidine, diazepam, clonazepam, and dantrolene. Physical therapy and exercise can help preserve remaining function, and patients may find that various aids -- such as foot braces, canes, and walkers -- can help them remain independent and mobile.\u00a0 Avoiding excessive activity and avoiding heat are probably the most important measures patients can take to counter physiological fatigue.\u00a0 If psychological symptoms of fatigue such as depression or apathy are evident, antidepressant medications may help.\u00a0 Other drugs that may reduce fatigue in some, but not all, patients include amantadine (Symmetrel), pemoline (Cylert), and the still-experimental drug aminopyridine. Although improvement of optic symptoms usually occurs even without treatment, a short course of treatment with intravenous methylprednisolone (Solu-Medrol) followed by treatment with oral steroids is sometimes used."}],"SUB_QUESTION_ID":"Q95-S1","ANNOTATIONS_FOCUS":["multiple sclerosis"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"Research assignment","MESSAGE":"Hi, I am a grade 12 student who is doing a research assignment on neurological disorders. Do you believe that there will ever be a bonafide cure for Multiple Sclerosis? If so, what kind of time frame would put on this cure?","QUESTION_ID":"Q95","F_REF":"12751"} +{"ANSWERS":[{"_answerid":"Q96-S1-A1","_pairid":"232","__text":"Your doctor may diagnose your child with achondroplasia while you\u2019re pregnant or after your infant is born. Diagnosis During Pregnancy Some characteristics of achondroplasia are detectable during an ultrasound. These include hydrocephalus, or an abnormally large head. If your doctor suspects achondroplasia, genetic tests may be ordered. These tests look for the defective FGFR3 gene in a sample of amniotic fluid, which is the fluid that surrounds the fetus in the womb. Diagnosis After Your Child Is Born Your doctor can diagnose your child by looking at his or her features. The doctor may also order X-rays to measure the length of your infant\u2019s bones. This can help confirm a diagnosis. Blood tests may also be ordered to look for the defective FGFR3 gene."}],"SUB_QUESTION_ID":"Q96-S1","ANNOTATIONS_FOCUS":["achondroplasia"],"ANNOTATIONS_TYPE":"diagnosis","SUBJECT":"","MESSAGE":"Achondroplasia research. Hello, We are students from [LOCATION] and we are doing a biology project of genetic diseases. We chose Achondroplasia as our disease to research. We have a few question and we are hoping you could answer them. Our questions are, can you tell if your child will have Achondroplasia when you are pregnant? When do people usually come in when they think something isn't right with their child? what are the worse cases of Achondroplasia you've ever seen? Thank you in advance. sincerely, [NAME]","QUESTION_ID":"Q96","F_REF":"10189"} +{"ANSWERS":[{"_answerid":"Q96-S2-A1","_pairid":"233","__text":"People with achondroplasia seldom reach 5 feet in height. Intelligence is in the normal range. Infants who receive the abnormal gene from both parents do not often live beyond a few months."}],"SUB_QUESTION_ID":"Q96-S2","ANNOTATIONS_FOCUS":["achondroplasia"],"ANNOTATIONS_TYPE":"prognosis","SUBJECT":"","MESSAGE":"Achondroplasia research. Hello, We are students from [LOCATION] and we are doing a biology project of genetic diseases. We chose Achondroplasia as our disease to research. We have a few question and we are hoping you could answer them. Our questions are, can you tell if your child will have Achondroplasia when you are pregnant? When do people usually come in when they think something isn't right with their child? what are the worse cases of Achondroplasia you've ever seen? Thank you in advance. sincerely, [NAME]","QUESTION_ID":"Q96","F_REF":"10189"} +{"ANSWERS":[{"_answerid":"Q97-S1-A1","_pairid":"234","__text":"Risperidone is used to treat the symptoms of schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions) in adults and teenagers 13 years of age and older. It is also used to treat episodes of mania (frenzied, abnormally excited, or irritated mood) or mixed episodes (symptoms of mania and depression that happen together) in adults and in teenagers and children 10 years of age and older with bipolar disorder (manic depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods). Risperidone is also used to treat behavior problems such as aggression, self-injury, and sudden mood changes in teenagers and children 5 to 16 years of age who have autism (a condition that causes repetitive behavior, difficulty interacting with others, and problems with communication). Risperidone is in a class of medications called atypical antipsychotics. It works by changing the activity of certain natural substances in the brain."}],"SUB_QUESTION_ID":"Q97-S1","ANNOTATIONS_FOCUS":["Risperdoine"],"ANNOTATIONS_TYPE":"information","SUBJECT":"Subject","MESSAGE":"I'm calling because I would like to know more advice on crating Risperdoine medicine and gain experiences on the medication. And creating the medication","QUESTION_ID":"Q97","F_REF":"1-121832945"} +{"ANSWERS":[{"_answerid":"Q98-S1-A1","_pairid":"235","__text":"There are many causes of optic atrophy. The most common is poor blood flow. This is called ischemic optic neuropathy. The problem most often affects older adults. The optic nerve can also be damaged by shock, toxins, radiation, and trauma. Eye diseases, such as glaucoma, can also cause a form of optic nerve atrophy. The condition can also be caused by diseases of the brain and central nervous system. These may include: - Brain tumor - Cranial arteritis (sometimes called temporal arteritis) - Multiple sclerosis - Stroke There are also rare forms of hereditary optic nerve atrophy that affect children and young adults."}],"SUB_QUESTION_ID":"Q98-S1","ANNOTATIONS_FOCUS":["optic atrophy"],"ANNOTATIONS_TYPE":"cause","SUBJECT":"optic atrophy","MESSAGE":"Is optic atrophy ginetic and what cause it?","QUESTION_ID":"Q98","F_REF":"1-136965327"} +{"ANSWERS":[{"_answerid":"Q99-S1-A1","_pairid":"236","__text":"Essential tremor is the most common movement disorder. It is characterized by involuntary and rhythmic shaking (tremor), especially in the hands, without any other signs or symptoms. It is distinguished from tremor that results from other disorders or known causes, such as tremors seen with Parkinson disease or head trauma. Most cases of essential tremor are hereditary. There are five forms of essential tremor that are based on different genetic causes. Several genes as well as lifestyle and environmental factors likely play a role in a person's risk of developing this complex condition. In mild cases, treatment may not be necessary. In cases where symptoms interfere with daily living, medications may help to relieve symptoms."},{"_answerid":"Q99-S1-A2","_pairid":"237","__text":"Essential tremor is a movement disorder that causes involuntary, rhythmic shaking (tremor), especially in the hands. It is distinguished from tremor that results from other disorders or known causes, such as Parkinson disease or head trauma. Essential tremor usually occurs alone, without other neurological signs or symptoms. However, some experts think that essential tremor can include additional features, such as mild balance problems. Essential tremor usually occurs with movements and can occur during many different types of activities, such as eating, drinking, or writing. Essential tremor can also occur when the muscles are opposing gravity, such as when the hands are extended. It is usually not evident at rest. In addition to the hands and arms, muscles of the trunk, face, head, and neck may also exhibit tremor in this disorder; the legs and feet are less often involved. Head tremor may appear as a \"yes-yes\" or \"no-no\" movement while the affected individual is seated or standing. In some people with essential tremor, the tremor may affect the voice (vocal tremor). Essential tremor does not shorten the lifespan. However, it may interfere with fine motor skills such as using eating utensils, writing, shaving, or applying makeup, and in some cases these and other activities of daily living can be greatly impaired. Symptoms of essential tremor may be aggravated by emotional stress, anxiety, fatigue, hunger, caffeine, cigarette smoking, or temperature extremes. Essential tremor may appear at any age but is most common in the elderly. Some studies have suggested that people with essential tremor have a higher than average risk of developing neurological conditions including Parkinson disease or sensory problems such as hearing loss, especially in individuals whose tremor appears after age 65."}],"SUB_QUESTION_ID":"Q99-S1","ANNOTATIONS_FOCUS":["essential tremor"],"ANNOTATIONS_TYPE":"information","SUBJECT":"Essential Tremor information","MESSAGE":"What is the connection (if any) between Essential Tremor and Parkinsons and what is the best treatment for Essential Tremor?","QUESTION_ID":"Q99","F_REF":"1-137215802"} +{"ANSWERS":[{"_answerid":"Q99-S2-A1","_pairid":"238","__text":"Treatment may not be needed unless the tremors interfere with your daily activities or cause embarrassment. HOME CARE For tremors made worse by stress, try techniques that help you relax. For tremors of any cause, avoid caffeine and get enough sleep. For tremors caused or made worse by a medication, talk to your doctor about stopping the drug, reducing the dosage, or switching. Do not change or stop medications on your own. Severe tremors make it harder to do daily activities. You may need help with these activities. Things that can help include: - Buying clothes with Velcro fasteners, or using button hooks - Cooking or eating with utensils that have a larger handle - Using straws to drink - Wearing slip-on shoes and using shoehorns MEDICINES FOR TREMOR Medicines may help relieve symptoms. The most commonly used drugs include: - Propranolol, a beta blocker - Primidone, a drug used to treat seizures These drugs can have side effects. - Propranolol may cause fatigue, stuffy nose, or slow heartbeat, and it may make asthma worse. - Primidone may cause drowsiness, problems concentrating, nausea, and problems with walking, balance, and coordination. Other medications that may reduce tremors include: - Antiseizure drugs - Mild tranquilizers - Blood pressure drugs called calcium-channel blockers Botox injections given in the hand may be tried to reduce tremors. SURGERY In severe cases, surgery may be tried. This may include: - Focusing high-powered x-rays on a small area of the brain (stereotactic radiosurgery) - Implanting a stimulating device in the brain to signal the area that controls movement"},{"_answerid":"Q99-S2-A2","_pairid":"239","__text":"Treatment for essential tremor may not be necessary unless the tremors interfere with daily activities or cause embarrassment. Although there is no definitive cure for essential tremor, medicines may help relieve symptoms. How well medicines work depend on the individual patient. Two medications used to treat tremors include: Propranolol, a drug that blocks the action of stimulating substances called neurotransmitters, particularly those related to adrenaline Primidone, an antiseizure drug that also control the function of some neurotransmitters These drugs can have significant side effects. Eliminating tremor \"triggers\" such as caffeine and other stimulants from the diet is often recommended. Physical therapy may help to reduce tremor and improve coordination and muscle control for some patients. More details about the management of essential tremor can be accessed through the following web links: http:\/\/www.mayoclinic.com\/print\/essential-tremor\/DS00367\/METHOD=print&DSECTION=all http:\/\/emedicine.medscape.com\/article\/1150290-treatment"},{"_answerid":"Q99-S2-A3","_pairid":"240","__text":"These resources address the diagnosis or management of essential tremor: - Genetic Testing Registry: Hereditary essential tremor 1 - Johns Hopkins Movement Disorders Center - MedlinePlus Encyclopedia: Essential Tremor These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"},{"_answerid":"Q99-S2-A4","_pairid":"241","__text":"There is no definitive cure for essential tremor. Symptomatic drug therapy may include propranolol or other beta blockers and primidone, an anticonvulsant drug. Eliminating tremor \"triggers\" such as caffeine and other stimulants from the diet is often recommended. Physical and occupational therapy may help to reduce tremor and improve coordination and muscle control for some individuals. \u00a0Deep brain stimulation uses a surgically implanted, battery-operated medical device called a neurostimulator to delivery electrical stimulation to targeted areas of the brain that control movement, temporarily blocking the nerve signals that cause tremor. \u00a0Other surgical intervention is effective but may have side effects."}],"SUB_QUESTION_ID":"Q99-S2","ANNOTATIONS_FOCUS":["essential tremor"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"Essential Tremor information","MESSAGE":"What is the connection (if any) between Essential Tremor and Parkinsons and what is the best treatment for Essential Tremor?","QUESTION_ID":"Q99","F_REF":"1-137215802"} +{"ANSWERS":[{"_answerid":"Q100-S1-A1","_pairid":"242","__text":"Treatment for Dry Mouth Dry mouth treatment will depend on what is causing the problem. If you think you have dry mouth, see your dentist or physician. He or she can help to determine what is causing your dry mouth. If your dry mouth is caused by medicine, your physician might change your medicine or adjust the dosage. If your salivary glands are not working right but can still produce some saliva, your dentist or physician might give you a medicine that helps the glands work better. Your dentist or physician might also suggest that you use artificial saliva to keep your mouth wet. Do's and Don'ts Do's - Do drink water or sugarless drinks often. That will make chewing and swallowing easier when eating. - Do chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow. - Do use a humidifier at night to promote moisture in the air while you sleep. Do drink water or sugarless drinks often. That will make chewing and swallowing easier when eating. Do chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow. Do use a humidifier at night to promote moisture in the air while you sleep. Don\u2019ts - Don't consume drinks with caffeine such as coffee, tea, and some sodas. Caffeine can dry out the mouth. - Don't use tobacco or alcohol. They dry out the mouth. Don't consume drinks with caffeine such as coffee, tea, and some sodas. Caffeine can dry out the mouth. Don't use tobacco or alcohol. They dry out the mouth. Gene Therapy Research for Salivary Gland Dysfunction Scientists at NIH\u2019s National Institute of Dental and Craniofacial Research (NIDCR) are exploring the potential use of gene therapy to treat salivary gland dysfunction. The idea is to transfer additional or replacement genes into the salivary glands of people with Sj\u00f6gren's syndrome and cancer patients whose salivary glands were damaged during radiation treatment. The hope is that these genes will increase the production of saliva and eliminate the chronic parched sensation that bothers people with dry mouth conditions. NIDCR recently completed a clinical study, a research study in humans, on gene therapy for radiation-damaged salivary glands. The study showed that gene therapy can be safely performed in salivary glands and that it has the potential to help head and neck cancer survivors with dry mouth. Read NIDCR\u2019s news release to learn more about the study\u2019s findings. Based on the promising results of this trial, similar clinical trials are planned in the near future. Research on Sj\u00f6gren\u2019s Syndrome and Other Diseases Affecting Salivary Glands NIDCR is also conducting clinical trials to study new approaches for improving salivary flow in patients with Sjogren\u2019s syndrome. Such studies include testing the effectiveness of a monoclonal antibody as well as a corticosteroid to see whether either of these treatments helps improve salivary flow. Other studies are focused on learning how diseases such as diabetes, auto inflammatory diseases, and granulomatous diseases cause salivary gland dysfunction. Such studies could one day lead to better ways of preventing and treating salivary gland conditions. To stay abreast of any new studies on gene therapy and salivary gland function, visit ClinicalTrials.gov. ClinicalTrials.gov lists all federally and many privately funded clinical trials in the U.S. and around the world; the web site is updated frequently."},{"_answerid":"Q100-S1-A2","_pairid":"243","__text":"Dry mouth treatment will depend on what is causing the problem. If you think you have dry mouth, see your dentist or physician. He or she can help to determine what is causing your dry mouth. If your dry mouth is caused by medicine, your physician might change your medicine or adjust the dosage. If your salivary glands are not working right, but can still produce some saliva, your dentist or physician might give you a special medicine that helps the glands work better. He or she might suggest that you use artificial saliva to keep your mouth wet. (Watch the video to learn how dry mouth is treated. 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.)"}],"SUB_QUESTION_ID":"Q100-S1","ANNOTATIONS_FOCUS":["dry mouth"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"dry mouth","MESSAGE":"My doctor does not know of a medication that can be used in the mouth for dry mouth. Through research, I think the medication is there, I just can't find the name of it for him to prescribe forme. Can you help me. I'm using the across the counter Biotene but would like something that works a little better.","QUESTION_ID":"Q100","F_REF":"NF_240"} +{"ANSWERS":[{"_answerid":"Q101-S1-A1","_pairid":"244","__text":"Summary If you have lupus, your immune system attacks healthy cells and tissues by mistake. This can damage your joints, skin, blood vessels and organs. There are many kinds of lupus. The most common type, systemic lupus erythematosus, affects many parts of the body. Discoid lupus causes a rash that doesn't go away. Subacute cutaneous lupus causes sores after being out in the sun. Another type can be caused by medication. Neonatal lupus, which is rare, affects newborns. Anyone can get lupus, but women are most at risk. Lupus is also more common in African American, Hispanic, Asian and Native American women. The cause of lupus is not known. Lupus has many symptoms. Some common ones are - Joint pain or swelling - Muscle pain - Fever with no known cause - Fatigue - Red rashes, often on the face (also called the \"butterfly rash\") There is no one test to diagnose lupus, and it may take months or years to make the diagnosis. There is no cure for lupus, but medicines and lifestyle changes can help control it. NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases"}],"SUB_QUESTION_ID":"Q101-S1","ANNOTATIONS_FOCUS":["lupus"],"ANNOTATIONS_TYPE":"information","SUBJECT":"lupus","MESSAGE":"Hi, I want to know about Lupus and its treatment. Best, [NAME]","QUESTION_ID":"Q101","F_REF":"15240"} +{"ANSWERS":[{"_answerid":"Q101-S2-A1","_pairid":"245","__text":"You may need special kinds of doctors to treat the many symptoms of lupus. \u2026. You should report new symptoms to your doctor right away so that treatment can be changed if needed. The goals of the treatment plan are to: Prevent flares Treat flares when they occur Reduce organ damage and other problems. Treatments may include drugs to: Reduce swelling and pain Prevent or reduce flares Help the immune system Reduce or prevent damage to joints Balance the hormones. In addition to medications for lupus itself, sometimes other medications are needed for problems related to lupus such as high cholesterol, high blood pressure, or infection. Alternative treatments are those that are not part of standard treatment. No research shows that this kind of treatment works for people with lupus. You should talk to your doctor about alternative treatments."},{"_answerid":"Q101-S2-A2","_pairid":"246","__text":"There is no cure for lupus, but medicines and lifestyle changes can help control it. People with lupus often need to see different doctors. You will have a primary care doctor and a rheumatologist (a doctor who specializes in the diseases of joints and muscles). Which other specialists you see depends on how lupus affects your body. For example, if lupus damages your heart or blood vessels, you would see a cardiologist."}],"SUB_QUESTION_ID":"Q101-S2","ANNOTATIONS_FOCUS":["lupus"],"ANNOTATIONS_TYPE":"Treatment","SUBJECT":"lupus","MESSAGE":"Hi, I want to know about Lupus and its treatment. Best, [NAME]","QUESTION_ID":"Q101","F_REF":"15240"} +{"ANSWERS":[{"_answerid":"Q102-S1-A1","_pairid":"247","__text":"Your health care provider can most often diagnose chickenpox by looking at the rash and asking questions about the person's medical history. Small blisters on the scalp confirm the diagnosis in most cases. Lab tests can help confirm the diagnosis, if needed."}],"SUB_QUESTION_ID":"Q102-S1","ANNOTATIONS_FOCUS":["chicken pox"],"ANNOTATIONS_TYPE":"diagnosis","SUBJECT":"varicella shingles","MESSAGE":"How can I determine whether or not I've had chicken pox. If there is a test for it, what are the results of the tests I need to know that will tell me whether or not I have had chicken pox? I want to know this to determine if I should have shingles vaccine (Zostavax) Thank you.","QUESTION_ID":"Q102","F_REF":"1-135130005"} +{"ANSWERS":[{"_answerid":"Q103-S1-A1","_pairid":"248","__text":"Some cases of chronic myelomonocytic leukemia (CMML) are linked to cancer treatment, but in most cases the cause is unknown. Over the past few years, scientists have made progress in understanding how certain changes in the DNA of bone marrow cells may cause CMML to develop. DNA is the chemical that carries the instructions for nearly everything our cells do. We usually look like our parents because they are the source of our DNA. However, DNA affects more than the way we look. Some genes (parts of DNA) control a cell\u2019s growth and division process. Genes that promote cell division are called oncogenes. Other genes called tumor suppressor genes can slow down cell division or even make cells die at an appropriate time. Cancers can be caused by DNA mutations (gene defects) that turn on oncogenes or turn off tumor suppressor genes. In some diseases, mutations may be passed down from a parent. Inherited mutations do not seem to cause CMML. Instead, the mutations are acquired during the person\u2019s lifetime. Exposure to radiation or cancer-causing chemicals can cause mutations that lead to CMML. Sometimes these gene changes occur for no apparent reason. Every time a cell prepares to divide into 2 new cells, it must copy its DNA. This process is not perfect, and copying errors can occur. Fortunately, cells have repair enzymes that read and fix DNA. However, some errors may slip past, especially if the cells are growing rapidly. Human DNA is packaged in 23 pairs of chromosomes. In up to half of patients, CMML cells contain altered chromosomes. Sometimes part of one chromosome attaches to a different chromosome. This is called a translocation. Like mutations, translocations can turn on oncogenes or turn off tumor suppressor genes. Acquired translocations are seen in some cases of CMML. Another chromosome abnormality that can be seen in CMML is called a deletion. This involves the loss of all or part of a chromosome. Another type of chromosome abnormality is called a duplication. This is when there is an extra copy of all or part of a chromosome."}],"SUB_QUESTION_ID":"Q103-S1","ANNOTATIONS_FOCUS":["leukemia"],"ANNOTATIONS_TYPE":"cause","SUBJECT":"","MESSAGE":"Project. Hi my name is [NAME] and I'm doing a school project about leukemia and I was wondering if you can anwser some of my questions please.1. What cause leukemia cancer?2. Can you survive leukemia?3. How does leukemia affect your body?4. Is leukemia inherited?5. What is advanced leukemia?6. How long can someone with leukemia expect to live?7. Can you tell if you have leukemia?8. What treatments do you need to take?9. What are the signs of leukemia?10. What is the difference between AML and CML ?","QUESTION_ID":"Q103","F_REF":"44"} +{"ANSWERS":[{"_answerid":"Q103-S2-A1","_pairid":"249","__text":"People with acute myelogenous leukemia (AML) may have questions about their prognosis and survival. Prognosis and survival depend on many factors. Only a doctor familiar with a person\u2019s medical history, type of cancer, stage, characteristics of the cancer, treatments chosen and response to treatment can put all of this information together with survival statistics to arrive at a prognosis. A prognosis is the doctor\u2019s best estimate of how cancer will affect a person and how it will respond to treatment. A prognostic factor is an aspect of the cancer or a characteristic of the person that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together and they both play a part in deciding on a treatment plan and a prognosis."}],"SUB_QUESTION_ID":"Q103-S2","ANNOTATIONS_FOCUS":["leukemia"],"ANNOTATIONS_TYPE":"prognosis","SUBJECT":"","MESSAGE":"Project. Hi my name is [NAME] and I'm doing a school project about leukemia and I was wondering if you can anwser some of my questions please.1. What cause leukemia cancer?2. Can you survive leukemia?3. How does leukemia affect your body?4. Is leukemia inherited?5. What is advanced leukemia?6. How long can someone with leukemia expect to live?7. Can you tell if you have leukemia?8. What treatments do you need to take?9. What are the signs of leukemia?10. What is the difference between AML and CML ?","QUESTION_ID":"Q103","F_REF":"44"} +{"ANSWERS":[{"_answerid":"Q102-S3-A1","_pairid":"250","__text":"Leukemia is a cancer of the blood cells. It is the most common type of blood cancer and affects 10 times as many adults as children. Most people diagnosed with leukemia are over 50 years old. Leukemia Starts in Bone Marrow Types of blood cells made by the bone marrow and a description of their functions. - Click to enlarge in new window. Click for more information Leukemia usually begins in the bone marrow, the soft material in the center of most bones where blood cells are formed. The bone marrow makes three types of blood cells, and each type has a special function. White blood cells fight infection and disease. Red blood cells carry oxygen throughout the body. Platelets help control bleeding by forming blood clots. In people with leukemia, the bone marrow produces abnormal white blood cells, called leukemia cells. At first, leukemia cells function almost normally. But over time, as more leukemia cells are produced, they may crowd out the healthy white blood cells, red blood cells, and platelets. This makes it difficult for the blood to carry out its normal functions. There are four common types of adult leukemia. Two are chronic, meaning they get worse over a longer period of time. The other two are acute, meaning they get worse quickly. chronic lymphocytic leukemia chronic myeloid leukemia acute myeloid leukemia acute lymphocytic leukemia"}],"SUB_QUESTION_ID":"Q103-S3","ANNOTATIONS_FOCUS":["leukemia"],"ANNOTATIONS_TYPE":"information","SUBJECT":"","MESSAGE":"Project. Hi my name is [NAME] and I'm doing a school project about leukemia and I was wondering if you can anwser some of my questions please.1. What cause leukemia cancer?2. Can you survive leukemia?3. How does leukemia affect your body?4. Is leukemia inherited?5. What is advanced leukemia?6. How long can someone with leukemia expect to live?7. Can you tell if you have leukemia?8. What treatments do you need to take?9. What are the signs of leukemia?10. What is the difference between AML and CML ?","QUESTION_ID":"Q103","F_REF":"44"} +{"ANSWERS":[{"_answerid":"Q102-S4-A1","_pairid":"251","__text":"Sometimes people inherit DNA mutations from a parent that greatly increase their risk of getting certain types of cancer. But inherited mutations rarely cause CLL. DNA changes related to CLL usually occur during the person's lifetime, rather than having been inherited before birth."}],"SUB_QUESTION_ID":"Q103-S4","ANNOTATIONS_FOCUS":["leukemia"],"ANNOTATIONS_TYPE":"inheritance","SUBJECT":"","MESSAGE":"Project. Hi my name is [NAME] and I'm doing a school project about leukemia and I was wondering if you can anwser some of my questions please.1. What cause leukemia cancer?2. Can you survive leukemia?3. How does leukemia affect your body?4. Is leukemia inherited?5. What is advanced leukemia?6. How long can someone with leukemia expect to live?7. Can you tell if you have leukemia?8. What treatments do you need to take?9. What are the signs of leukemia?10. What is the difference between AML and CML ?","QUESTION_ID":"Q103","F_REF":"44"} +{"ANSWERS":[{"_answerid":"Q102-S5-A1","_pairid":"252","__text":"Diagnosing Leukemia: Physical Exam, Blood Tests, Biopsy To find the cause of leukemia symptoms, the doctor will ask about medical history and conduct a physical exam. During the exam, the doctor will check for signs of disease such as lumps, swelling in the lymph nodes, spleen, and liver, or anything else that seems unusual. The doctor will need to do blood tests that check the levels and types of blood cells and look for changes in the shape of blood cells. The doctor also may look at certain factors in the blood to see if leukemia has affected other organs such as the liver or kidneys. Pathologist examining samples under a microscope. - Click to enlarge in new window. Click for more information Even if blood tests suggest leukemia, the doctor may look for signs of leukemia in the bone marrow by doing a biopsy before making a diagnosis. A biopsy is a procedure where a small amount of bone marrow is removed from a bone. A pathologist examines the sample under a microscope to look for abnormal cells. There are two ways the doctor can obtain bone marrow. In a bone marrow aspiration, marrow is collected by inserting a needle into the hipbone or another large bone and removing a small amount of bone marrow. A bone marrow biopsy is performed with a larger needle and removes bone marrow and a small piece of bone. If Leukemia Cells Are Found If leukemia cells are found in the bone marrow sample, the doctor may perform more tests to determine if the disease has spread to other parts of the body. The doctor may collect a sample of the fluid around the brain and spinal cord by performing a spinal tap and checking for leukemia cells or other signs of problems. Computed tomography (CT) scans, and ultrasounds are tests used to determine if leukemia has spread from the bone marrow. These tests produce pictures of the inside of the body. With these tests, the doctor looks for abnormalities such as enlarged organs or signs of infection."}],"SUB_QUESTION_ID":"Q103-S5","ANNOTATIONS_FOCUS":["leukemia"],"ANNOTATIONS_TYPE":"diagnosis","SUBJECT":"","MESSAGE":"Project. Hi my name is [NAME] and I'm doing a school project about leukemia and I was wondering if you can anwser some of my questions please.1. What cause leukemia cancer?2. Can you survive leukemia?3. How does leukemia affect your body?4. Is leukemia inherited?5. What is advanced leukemia?6. How long can someone with leukemia expect to live?7. Can you tell if you have leukemia?8. What treatments do you need to take?9. What are the signs of leukemia?10. What is the difference between AML and CML ?","QUESTION_ID":"Q103","F_REF":"44"} +{"ANSWERS":[{"_answerid":"Q103-S6-A1","_pairid":"253","__text":"There are many treatment options for people with leukemia. The choice of treatment depends on your age and general health, the type of leukemia you have, whether or not it has spread outside the bone marrow, and other factors. If tests show that you have leukemia, you should talk with your doctor and make treatment decisions as soon as possible, although many patients with chronic lymphocytic leukemia do not require treatment for many years. Working With a Team of Specialists A team of specialists often treats people with leukemia. The team will keep the primary doctor informed about the patient's progress. The team may include a hematologist who is a specialist in blood and blood-forming tissues, a medical oncologist who is a specialist in cancer treatment, and a radiation oncologist who is a specialist in radiation therapy. 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 or your doctor requests it. Clinical Trials for Leukemia Some leukemia 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 and better than current treatments. Talk to your doctor if you are interested in taking part in a clinical trial. 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 search for current clinical trials on leukemia."},{"_answerid":"Q103-S6-A2","_pairid":"254","__text":"Unlike other types of cancer, leukemia isn't a tumor that your doctor can surgically remove. Leukemia cells are produced in the bone marrow and travel throughout the body. The Goal of Treatment The goal of treatment for leukemia is to destroy the leukemia cells and allow normal cells to form in the bone marrow. Depending on the type and extent of the disease, patients may have chemotherapy, biological therapy, radiation therapy, or stem cell transplantation. Some patients receive a combination of treatments. Treatment depends on a number of factors, including the type of leukemia, the patient's age and general health, whether leukemia cells are present in the fluid around the brain or spinal cord, and whether the leukemia has been treated before. It also may depend on certain features of the leukemia cells and the patient's symptoms. Acute Leukemia or Chronic Leukemia? If a person has acute leukemia, they will need treatment right away. The purpose of treatment is to stop the rapid growth of leukemia cells and to bring about remission, meaning the cancer is under control. In many cases, a person will continue treatment after signs and symptoms disappear to prevent the disease from coming back. Some people with acute leukemia can be cured. Learn more about treatments for acute myeloid leukemia. Learn more about treatments for chronic lymphocytic leukemia. Chronic leukemia may not need to be treated until symptoms appear. Treatment can often control the disease and its symptoms. Types of Treatments Some, but not all, forms of treatment for leukemia include - chemotherapy - biological therapy - radiation therapy. chemotherapy biological therapy radiation therapy. Chemotherapy Chemotherapy uses drugs to kill cancer cells. This a common treatment for some types of leukemia. Chemotherapy may be taken by mouth in pill form, by injection directly into a vein, or through a catheter. If leukemia cells are found in the fluid around the brain or spinal cord, the doctor may inject drugs directly into the fluid to ensure that the drugs reach the leukemia cells in the brain. Biological Therapy Biological therapy uses special substances that improve the body's natural defenses against cancer. Some patients with chronic lymphocytic leukemia receive monoclonal antibodies, which are man-made proteins that can identify leukemia cells. Monoclonal antibodies bind to the cells and assist the body in killing them. Although monoclonal antibodies are being used to treat leukemia, researchers are studying more innovative ways to use them in treatment. Some antibodies are used alone to try to prompt the immune system to attack leukemia cells. Other antibodies are attached to substances that can deliver poison to cancer cells. These modified antibodies, called immunotoxins, deliver the toxins directly to the cancer cells. Lately, precision medicine trials have shown evidence that single targeted therapies taken in pill form can prolong survival. Radiation Therapy Radiation therapy uses high-energy X-rays to destroy cancer cells. A machine outside the body directs high-energy beams at the spleen, the brain, or other parts of the body where leukemia cells have collected. Radiation therapy is used primarily to control disease in bones that are at risk of fracture or at sites that are causing pain."},{"_answerid":"Q103-S6-A3","_pairid":"255","__text":"Treatment depends on a number of factors, including the type of leukemia, the patient's age and general health, where leukemia cells have collected in the body, and whether the leukemia has been treated before. Certain features of the leukemia cells and the patient's symptoms also may determine treatment options."},{"_answerid":"Q103-S6-A4","_pairid":"256","__text":"Standard treatments for leukemia include chemotherapy, biological therapy, radiation therapy, and immunotherapy. Some patients receive a combination of treatments. Learn more about treatments for acute myeloid leukemia. Learn more about treatments for chronic lymphocytic leukemia."},{"_answerid":"Q103-S6-A5","_pairid":"257","__text":"Researchers are studying various drugs, immunotherapies, and other types of treatments. Because leukemia is a complicated disease, researchers are also studying the effectiveness of using combinations of treatments. Following are a few examples of some areas of current research. The drug imatinib (Gleevec\u00ae) is important in the treatment of chronic myeloid leukemia. However, imatinib stops working in some people with leukemia because the cells become resistant. Fortunately, two drugs, dasatinib (Sprycel\u00ae) and nilotinib (Tasigna\u00ae), are being used to treat people who stop responding to imatinib. Both are approved by the FDA for use in patients. These drugs work against the same abnormal protein targeted by imatinib, but in different ways. Gene therapy -- replacing, manipulating, or supplementing nonfunctional genes with healthy genes -- is being explored for treatment of leukemia. It is being studied as a way to stimulate a patient's immune system to kill leukemia cells and also to interfere with the production of proteins that cause cells to become cancerous. Learn more about ongoing leukemia research."}],"SUB_QUESTION_ID":"Q103-S6","ANNOTATIONS_FOCUS":["leukemia"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"Project. Hi my name is [NAME] and I'm doing a school project about leukemia and I was wondering if you can anwser some of my questions please.1. What cause leukemia cancer?2. Can you survive leukemia?3. How does leukemia affect your body?4. Is leukemia inherited?5. What is advanced leukemia?6. How long can someone with leukemia expect to live?7. Can you tell if you have leukemia?8. What treatments do you need to take?9. What are the signs of leukemia?10. What is the difference between AML and CML ?","QUESTION_ID":"Q103","F_REF":"44"} +{"ANSWERS":[{"_answerid":"Q103-S7-A1","_pairid":"258","__text":"During the early stages of leukemia, there may be no symptoms. Many of the symptoms of leukemia don't become apparent until a large number of normal blood cells are crowded out by leukemia cells. Symptoms of Chronic and Acute Leukemia In chronic leukemia, symptoms develop gradually and, in the beginning, are generally not as severe as in acute leukemia. Chronic leukemia is usually found during a routine doctor's exam before symptoms are present. When symptoms appear, they generally are mild at first and gradually get worse, but sometimes they don't worsen until many years after an initial diagnosis. Recently, researchers discovered that abnormal white blood cells can be present in the blood of chronic lymphocytic leukemia patients a number of years before a diagnosis. This finding may lead to a better understanding of the cellular changes that occur in the earliest stages of the disease and how the disease progresses. In acute leukemia, symptoms usually appear and get worse quickly. People with this disease usually go to their doctor because they feel sick. White Blood Cell Levels May Be High People with leukemia may have very high levels of white blood cells, but because the cells are abnormal, they are unable to fight infection. Therefore, patients may develop frequent fevers or infections. A shortage of red blood cells, called anemia, can cause a person to feel tired. Not having enough blood platelets may cause a person to bleed and bruise easily. Some symptoms depend on where leukemia cells collect in the body. Leukemia cells can collect in many different tissues and organs, such as the digestive tract, kidneys, lungs, lymph nodes, or other parts of the body, including the eyes, brain, and testicles. Other Common Symptoms Other common symptoms of leukemia include headache, weight loss, pain in the bones or joints, swelling or discomfort in the abdomen (from an enlarged spleen), and swollen lymph nodes, especially in the neck or armpit. Symptoms of acute leukemia may include vomiting, confusion, loss of muscle control, and seizures. Some of the symptoms of leukemia are similar to those caused by the flu or other common diseases, so these symptoms are not sure signs of leukemia. It is important to check with your doctor if you have these symptoms. Only a doctor can diagnose and treat leukemia. Diagnosing Leukemia: Physical Exam, Blood Tests, Biopsy To find the cause of leukemia symptoms, the doctor will ask about medical history and conduct a physical exam. During the exam, the doctor will check for signs of disease such as lumps, swelling in the lymph nodes, spleen, and liver, or anything else that seems unusual. The doctor will need to do blood tests that check the levels and types of blood cells and look for changes in the shape of blood cells. The doctor also may look at certain factors in the blood to see if leukemia has affected other organs such as the liver or kidneys. Even if blood tests suggest leukemia, the doctor may look for signs of leukemia in the bone marrow by doing a biopsy before making a diagnosis. A biopsy is a procedure where a small amount of bone marrow is removed from a bone. A pathologist examines the sample under a microscope to look for abnormal cells. There are two ways the doctor can obtain bone marrow. In a bone marrow aspiration, marrow is collected by inserting a needle into the hipbone or another large bone and removing a small amount of bone marrow. A bone marrow biopsy is performed with a larger needle and removes bone marrow and a small piece of bone. If Leukemia Cells Are Found If leukemia cells are found in the bone marrow sample, the doctor may perform more tests to determine if the disease has spread to other parts of the body. The doctor may collect a sample of the fluid around the brain and spinal cord by performing a spinal tap and checking for leukemia cells or other signs of problems. Computed tomography (CT) scans, and ultrasounds are tests used to determine if leukemia has spread from the bone marrow. These tests produce pictures of the inside of the body. With these tests, the doctor looks for abnormalities such as enlarged organs or signs of infection."},{"_answerid":"Q103-S7-A2","_pairid":"259","__text":"Common symptoms of leukemia may include - fevers - frequent infections - feeling weak or tired - headache - bleeding and bruising easily - pain in the bones or joints - swelling or discomfort in the abdomen (from an enlarged spleen) - swollen lymph nodes, especially in the neck or armpit - weight loss. fevers frequent infections feeling weak or tired headache bleeding and bruising easily pain in the bones or joints swelling or discomfort in the abdomen (from an enlarged spleen) swollen lymph nodes, especially in the neck or armpit weight loss. Symptoms of acute leukemia may include vomiting, confusion, loss of muscle control, and seizures."}],"SUB_QUESTION_ID":"Q103-S7","ANNOTATIONS_FOCUS":["leukemia"],"ANNOTATIONS_TYPE":"symptom","SUBJECT":"","MESSAGE":"Project. Hi my name is [NAME] and I'm doing a school project about leukemia and I was wondering if you can anwser some of my questions please.1. What cause leukemia cancer?2. Can you survive leukemia?3. How does leukemia affect your body?4. Is leukemia inherited?5. What is advanced leukemia?6. How long can someone with leukemia expect to live?7. Can you tell if you have leukemia?8. What treatments do you need to take?9. What are the signs of leukemia?10. What is the difference between AML and CML ?","QUESTION_ID":"Q103","F_REF":"44"} +{"ANSWERS":[{"_answerid":"Q104-S1-A1","_pairid":"260","__text":"Lupus can have many symptoms, and they differ from person to person. Some of the more common ones are Pain or swelling in joints Muscle pain Fever with no known cause Red rashes, most often on the face (also called the \"butterfly rash\") Chest pain when taking a deep breath Hair loss Pale or purple fingers or toes Sensitivity to the sun Swelling in legs or around eyes Mouth ulcers Swollen glands Feeling very tired Symptoms may come and go. When you are having symptoms, it is called a flare. Flares can range from mild to severe. New symptoms may appear at any time."}],"SUB_QUESTION_ID":"Q104-S1","ANNOTATIONS_FOCUS":["lupus"],"ANNOTATIONS_TYPE":"symptom","SUBJECT":"","MESSAGE":"I have been dealing with an autoimmune disease for almost 4 years now, I've been tested for many things and the doctors can't seem to find what excactly is wrong. It began with pain, swelling and stiffness in my feet and toes.A lot of the pain is joint stiff n ess and my skin feels like its being burned. Over time it has moved into my knees also. I am always tired. Recently I've been getting pains in my stomache and feeling sick. Does any of this sound like Lupus?? I've tested negative for it before, but the more I read about it I feel that's what i could have. Any ideas would be greatly appreciated.","QUESTION_ID":"Q104","F_REF":"1-119980475"} +{"ANSWERS":[{"_answerid":"Q105-S1-A1","_pairid":"261","__text":"A number of different antibiotics may be used for treating this type of infection. - You may receive one large dose of oral antibiotics or take a smaller dose for seven days. - You may be given an antibiotic injection or shot, and then perhaps be sent home with antibiotic pills. - More severe cases of PID (pelvic inflammatory disease) may require you to stay in the hospital. Antibiotics are first given by IV. - Never treat yourself without being seen by your doctor first. Your health care provider will determine the best treatment. About half of the women with gonorrhea are also infected with chlamydia. Chlamydia is treated at the same time as a gonorrhea infection. You will need a follow-up visit 7 days after if your symptoms include joint pain, skin rash, or more severe pelvic or belly pain. Tests will be done to make sure the infection is gone. Sexual partners must be tested and treated to prevent passing the infection back and forth. You and your partner must finish all of the antibiotics. Use condoms until you both have finished taking your antibiotics. All sexual contacts of the person with gonorrhea should be contacted and tested. This helps prevent further spread of the infection. - In some places you may be able to take information and medicines to your sexual partner yourself. - In other places, the health department will contact your partner."}],"SUB_QUESTION_ID":"Q105-S1","ANNOTATIONS_FOCUS":["gonorrhea"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"EMAIL: [EMAIL] FROM: http:\/\/m.medlineplus.gov\/medlineplus.htm BROWSER: NokiaX2-01\/5.0 (07.10) Profile\/MIDP-2.1 Configuration\/CLDC-1.1 Mozilla\/5.0 AppleWebKit\/420 (KHTML, like Gecko) Safari\/420 DATE: 01\/06\/2014 MESSAGE: My question is.wat is the treatment for chronic gonorrhea, massive growth?","QUESTION_ID":"Q105","F_REF":"1-118350915"} +{"ANSWERS":[{"_answerid":"Q106-S1-A1","_pairid":"262","__text":"Treatment depends on many things, including your Gleason score and your overall health. Your doctor will discuss your treatment options with you. If the cancer has not spread outside the prostate gland, common treatments include: - Surgery (radical prostatectomy) - Radiation therapy, including brachytherapy and proton therapy If you are older, your doctor may recommend simply monitoring the cancer with PSA tests and biopsies. Hormone therapy is mainly used for cancer that has spread beyond the prostate. It helps relieve symptoms and prevents further growth and spread of the cancer. But it does not cure the cancer. If prostate cancer spreads even after hormone therapy, surgery, or radiation has been tried, treatment may include: - Chemotherapy - Immunotherapy (medicine to trigger the immune system to attack and kill cancer cells) Surgery, radiation therapy, and hormone therapy can affect your sexual performance. Problems with urine control are possible after surgery and radiation therapy. Discuss your concerns with your health care provider. After treatment for prostate cancer, you will be closely watched to make sure the cancer does not spread. This involves routine checkups, including PSA blood tests (usually every 3 months to 1 year)."},{"_answerid":"Q106-S1-A2","_pairid":"263","__text":"These resources address the diagnosis or management of prostate cancer: - American College of Radiology: Prostate Cancer Radiation Treatment - Genetic Testing Registry: Familial prostate cancer - Genetic Testing Registry: Prostate cancer, hereditary, 2 - MedlinePlus Encyclopedia: Prostate Brachytherapy - MedlinePlus Encyclopedia: Prostate Cancer Staging - MedlinePlus Encyclopedia: Prostate Cancer Treatment - MedlinePlus Encyclopedia: Prostate-Specific Antigen (PSA) Blood Test - MedlinePlus Encyclopedia: Radical Prostatectomy - MedlinePlus Health Topic: Prostate Cancer Screening - National Cancer Institute: Prostate-Specific Antigen (PSA) Test - U.S. Preventive Services Task Force These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"},{"_answerid":"Q106-S1-A3","_pairid":"264","__text":"If tests show that you have cancer, you should talk with your doctor in order to make treatment decisions. Working With a Team of Specialists A team of specialists often treats people with cancer. The team will keep the primary doctor informed about the patient's progress. The team may include a medical oncologist who is a specialist in cancer treatment, a surgeon, a radiation oncologist who is a specialist in radiation therapy, and others. Before starting treatment, you may want another doctor to review the diagnosis and treatment plan. Some insurance companies require a second opinion. Others may pay for a second opinion if you request it. Clinical Trials for Prostate Cancer Some prostate cancer patients take part in studies of new treatments. These studies -- called clinical trials -- are designed to find out whether a new treatment is safe and effective. Often, clinical trials compare a new treatment with a standard one so that doctors can learn which is more effective. Men with prostate cancer who are interested in taking part in a clinical trial should talk with their doctor. The U.S. National Institutes of Health, through its National Library of Medicine and other Institutes, maintains a database of clinical trials at ClinicalTrials.gov. Click here to see a list of the current clinical trials on prostate cancer. A separate window will open. Click the \"x\" in the upper right hand corner of the \"Clinical Trials\" window to return here."},{"_answerid":"Q106-S1-A4","_pairid":"265","__text":"Choosing Treatment There are a number of ways to treat prostate cancer, and the doctor will develop a treatment to fit each man's needs. The choice of treatment mostly depends on the stage of the disease and the grade of the tumor. But doctors also consider a man's age, general health, and his feelings about the treatments and their possible side effects. Treatment for prostate cancer may involve watchful waiting, surgery, radiation therapy, or hormonal therapy. Some men receive a combination of therapies. A cure is the goal for men whose prostate cancer is diagnosed early. Weighing Treatment Options You and your doctor will want to consider both the benefits and possible side effects of each option, especially the effects on sexual activity and urination, and other concerns about quality of life. Surgery, radiation therapy, and hormonal therapy all have the potential to disrupt sexual desire or performance for a short while or permanently. Discuss your concerns with your health care provider. Several options are available to help you manage sexual problems related to prostate cancer treatment. Watchful Waiting The doctor may suggest watchful waiting for some men who have prostate cancer that is found at an early stage and appears to be growing slowly. Also, watchful waiting may be advised for older men or men with other serious medical problems. For these men, the risks and possible side effects of surgery, radiation therapy, or hormonal therapy may outweigh the possible benefits. Doctors monitor these patients with regular check-ups. If symptoms appear or get worse, the doctor may recommend active treatment. Surgery Surgery is used to remove the cancer. It is a common treatment for early stage prostate cancer. The surgeon may remove the entire prostate with a type of surgery called radical prostatectomy or, in some cases, remove only part of it. Sometimes the surgeon will also remove nearby lymph nodes. Side effects of the operation may include lack of sexual function or impotence, or problems holding urine or incontinence. Improvements in surgery now make it possible for some men to keep their sexual function. In some cases, doctors can use a technique known as nerve-sparing surgery. This may save the nerves that control erection. However, men with large tumors or tumors that are very close to the nerves may not be able to have this surgery. Some men with trouble holding urine may regain control within several weeks of surgery. Others continue to have problems that require them to wear a pad. Radiation Therapy Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Doctors may recommend it instead of surgery, or after surgery, to destroy any cancer cells that may remain in the area. In advanced stages, the doctor may recommend radiation to relieve pain or other symptoms. It may also be used in combination with hormonal therapy. Radiation can cause problems with impotence and bowel function. The radiation may come from a machine, which is external radiation, or from tiny radioactive seeds placed inside or near the tumor, which is internal radiation. Men who receive only the radioactive seeds usually have small tumors. Some men receive both kinds of radiation therapy. For external radiation therapy, patients go to the hospital or clinic -- usually for several weeks. Internal radiation may require patients to stay in the hospital for a short time. Hormonal Therapy Hormonal therapy deprives cancer cells of the male hormones they need to grow and survive. This treatment is often used for prostate cancer that has spread to other parts of the body. Sometimes doctors use hormonal therapy to try to keep the cancer from coming back after surgery or radiation treatment. Side effects can include impotence, hot flashes, loss of sexual desire, and thinning of bones. Some hormone therapies increase the risk of blood clots. Monitoring Treatment Regardless of the type of treatment you receive, you will be closely monitored to see how well the treatment is working. Monitoring may include - a PSA blood test -- usually every 3 months to 1 year. - bone scan and\/or CT scan to see if the cancer has spread. - a complete blood count to monitor for signs and symptoms of anemia. - looking for signs or symptoms that the disease might be progressing, such as fatigue, increased pain, or decreased bowel and bladder function. a PSA blood test -- usually every 3 months to 1 year. bone scan and\/or CT scan to see if the cancer has spread. a complete blood count to monitor for signs and symptoms of anemia. looking for signs or symptoms that the disease might be progressing, such as fatigue, increased pain, or decreased bowel and bladder function."},{"_answerid":"Q106-S1-A5","_pairid":"266","__text":"There are a number of ways to treat prostate cancer, and the doctor will develop a treatment to fit each man's needs. The choice of treatment mostly depends on the stage of the disease and the grade of the tumor. But doctors also consider a man's age, general health, and his feelings about the treatments and their possible side effects. Treatment for prostate cancer may involve watchful waiting, surgery, radiation therapy, or hormonal therapy. Some men receive a combination of therapies. A cure is probable for men whose prostate cancer is diagnosed early."},{"_answerid":"Q106-S1-A6","_pairid":"267","__text":"Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Doctors may recommend it instead of surgery or after surgery to destroy any cancer cells that may remain in the area. In advanced stages, the doctor may recommend it to relieve pain or other symptoms. Radiation can cause problems with impotence and bowel function. The radiation may come from a machine, which is external radiation, or from tiny radioactive seeds placed inside or near the tumor, which is internal radiation. Men who receive only the radioactive seeds usually have small tumors. Some men receive both kinds of radiation therapy. For external radiation therapy, patients go to the hospital or clinic -- usually 5 days a week for several weeks. Internal radiation may require patients to stay in the hospital for a short time."},{"_answerid":"Q106-S1-A7","_pairid":"268","__text":"Hormonal therapy deprives cancer cells of the male hormones they need to grow and survive. This treatment is often used for prostate cancer that has spread to other parts of the body. Sometimes doctors use hormonal therapy to try to keep the cancer from coming back after surgery or radiation treatment. Side effects can include impotence, hot flashes, loss of sexual desire, and thinning of bones."},{"_answerid":"Q106-S1-A8","_pairid":"269","__text":"Through research, doctors are trying to find new, more effective ways to treat prostate cancer. Cryosurgery -- destroying cancer by freezing it -- is under study as an alternative to surgery and radiation therapy. To avoid damaging healthy tissue, the doctor places an instrument known as a cryoprobe in direct contact with the tumor to freeze it. Doctors are studying new ways of using radiation therapy and hormonal therapy, too. Studies have shown that hormonal therapy given after radiation therapy can help certain men whose cancer has spread to nearby tissues. Scientists are also testing the effectiveness of chemotherapy and biological therapy for men whose cancer does not respond or stops responding to hormonal therapy. They are also exploring new ways to schedule and combine various treatments. For example, they are studying hormonal therapy to find out if using it to shrink the tumor before a man has surgery or radiation might be a useful approach. They are also testing combinations of hormone therapy and vaccines to prevent recurrence of prostate cancer. In 2010, the FDA approved a therapeutic cancer vaccine, Provenge, for use in some men with metastatic prostate cancer. This approval was based on the results of a clinical trial that demonstrated a more than 4-month improvement in overall survival compared with a placebo vaccine. Other similar vaccine therapies are in development."}],"SUB_QUESTION_ID":"Q106-S1","ANNOTATIONS_FOCUS":["prostate cancer"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"prostate cancer using seeds aimed at maligmem tumors","MESSAGE":"is this a safe decision","QUESTION_ID":"Q106","F_REF":"1-121817635"} +{"ANSWERS":[{"_answerid":"Q107-S1-A1","_pairid":"270","__text":"If hair loss is not widespread, the hair will\u00a0often regrow in a few months without treatment. For more severe hair loss, it is not clear how much treatment can help change the course of the condition. Common treatments may include: - Steroid injection under the skin surface - Medicines\u00a0applied to\u00a0the skin - Ultraviolet light therapy Wigs may be used to hide areas of hair loss."},{"_answerid":"Q107-S1-A2","_pairid":"271","__text":"\u2022 Hair Transplants (American Society for Dermatologic Surgery) \u2022 Lavender"}],"SUB_QUESTION_ID":"Q107-S1","ANNOTATIONS_FOCUS":["hair loss"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"Hair loss Information Required","MESSAGE":"Can you provide something to help grow my hair back? I need my hair back as im the spitting double of Dr evil with no hair.","QUESTION_ID":"Q107","F_REF":"1-135502685"} +{"ANSWERS":[{"_answerid":"Q108-S1-A1","_pairid":"272","__text":"CHANGING YOUR LIFESTYLE An active lifestyle and plenty of exercise, along with healthy eating, is the safest way to lose weight. Even modest weight loss can improve your health. You may need a lot of support from family and friends. Your main goal should be to learn new, healthy ways of eating and make them part of your daily routine. Many people find it hard to change their eating habits and behaviors. You may have practiced some habits for so long that you may not even know they are unhealthy, or you do them without thinking. You need to be motivated to make lifestyle changes. Make the behavior change part of your life over the long term. Know that it takes time to make and keep a change in your lifestyle. Work with your health care provider and dietitian to set realistic, safe daily calorie counts that help you lose weight while staying healthy. Remember that if you drop pounds slowly and steadily, you are more likely to keep them off. Your dietitian can teach you about: - Healthy food choices - Healthy snacks - Reading nutrition labels - New ways to prepare food - Portion sizes - Sweetened drinks Extreme diets (fewer than 1,100 calories per day) are not thought to be safe or to work very well. These types of diets often do not contain enough vitamins and minerals. Most people who lose weight this way return to overeating and become obese again. Learn ways to manage stress other than snacking. Examples may be meditation, yoga, or exercise. If you are depressed or stressed a lot, talk to your provider. MEDICINES AND HERBAL REMEDIES You may see ads for supplements and herbal remedies that claim they will help you lose weight. Some of these claims may not be true. And some of these supplements can have serious side effects. Talk to your provider before using them. You can discuss weight loss medicines with your doctor. Many people lose at least 5 pounds by taking these drugs, but they may regain the weight when they stop taking the medicine unless they have made lifestyle changes. SURGERY Bariatric (weight-loss) surgery can reduce the risk of certain diseases in people with severe obesity. These risks include: - Arthritis - Diabetes - Heart disease - High blood pressure - Sleep apnea - Some cancers - Stroke Surgery may help people who have been very obese for 5 years or more and have not lost weight from other treatments, such as diet, exercise, or medicine. Surgery alone is not the answer for weight loss. It can train you to eat less, but you still have to do much of the work. You must be committed to diet and exercise after surgery. Talk to your doctor to learn if surgery is a good option for you. Weight-loss surgeries include: - Laparoscopic gastric banding - Gastric bypass surgery - Sleeve gastrectomy (less common) - Duodenal switch"},{"_answerid":"Q108-S1-A2","_pairid":"273","__text":"CHANGING YOUR LIFESTYLE An active lifestyle and plenty of exercise, along with healthy eating, is the safest way to lose weight. Even modest weight loss can improve your health. You may need a lot of support from family and friends. Your main goal should be to learn new, healthy ways of eating and make them part of your daily routine. Many people find it hard to change their eating habits and behaviors. You may have practiced some habits for so long that you may not even know they are unhealthy, or you do them without thinking. You need to be motivated to make lifestyle changes. Make the behavior change part of your life over the long term. Know that it takes time to make and keep a change in your lifestyle. Work with your health care provider and dietitian to set realistic, safe daily calorie counts that help you lose weight while staying healthy. Remember that if you drop pounds slowly and steadily, you are more likely to keep them off. Your dietitian can teach you about: - Healthy food choices - Healthy snacks - Reading nutrition labels - New ways to prepare food - Portion sizes - Sweetened drinks Extreme diets (fewer than 1,100 calories per day) are not thought to be safe or to work very well. These types of diets often do not contain enough vitamins and minerals. Most people who lose weight this way return to overeating and become obese again. Learn ways to manage stress other than snacking. Examples may be meditation, yoga, or exercise. If you are depressed or stressed a lot, talk to your provider. MEDICINES AND HERBAL REMEDIES You may see ads for supplements and herbal remedies that claim they will help you lose weight. Some of these claims may not be true. And some of these supplements can have serious side effects. Talk to your provider before using them. You can discuss weight loss medicines with your doctor. Many people lose at least 5 pounds by taking these drugs, but they may regain the weight when they stop taking the medicine unless they have made lifestyle changes. SURGERY Bariatric (weight-loss) surgery can reduce the risk of certain diseases in people with severe obesity. These risks include: - Arthritis - Diabetes - Heart disease - High blood pressure - Sleep apnea - Some cancers - Stroke Surgery may help people who have been very obese for 5 years or more and have not lost weight from other treatments, such as diet, exercise, or medicine. Surgery alone is not the answer for weight loss. It can train you to eat less, but you still have to do much of the work. You must be committed to diet and exercise after surgery. Talk to your doctor to learn if surgery is a good option for you. Weight-loss surgeries include: - Laparoscopic gastric banding - Gastric bypass surgery - Sleeve gastrectomy (less common) - Duodenal switch"}],"SUB_QUESTION_ID":"Q108-S1","ANNOTATIONS_FOCUS":["obesity"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"help with obesity","MESSAGE":"I would like help on my obesity problem and if I can get help","QUESTION_ID":"Q108","F_REF":"1-136475237"} +{"ANSWERS":[{"_answerid":"Q109-S1-A1","_pairid":"274","__text":"You will have a pelvic exam. It may show: - Swelling and redness of the skin of the vulva, in the vagina, and on the cervix - Dry, white spots on the vaginal wall - Cracks in the skin of the vulva. A small amount of the vaginal discharge is examined using a microscope. This is called a wet mount and KOH test. Sometimes, a culture is taken when the infection does not get better with treatment or comes back many times. Your health care provider may order other tests to rule out other causes of your symptoms."}],"SUB_QUESTION_ID":"Q109-S1","ANNOTATIONS_FOCUS":["vaginal yeast infection"],"ANNOTATIONS_TYPE":"diagnosis","SUBJECT":"vaginal yeast infection","MESSAGE":"Hey, my name is [NAME]. Last night my vaginal area was itching but I didn't think to much of it. Well when I woke up this morning it started itching out of control. I don't see discharge coming from the vaginal area. Now I do use Summer's Eve vaginal spray, I don't know if it is a vaginal yeast infection or not, but how should I go about this process.","QUESTION_ID":"Q109","F_REF":"15696"} +{"ANSWERS":[{"_answerid":"Q109-S2-A1","_pairid":"275","__text":"Medicines to treat vaginal yeast infections are available as creams, ointments, vaginal tablets or suppositories. Most can be bought without needing to see your health care provider. Treating yourself at home is probably\u00a0OK if: - Your symptoms are mild and you do not have pelvic pain or a fever - This is not your first yeast infection and you have not had many yeast infections in the past - You are not pregnant - You are not worried about other sexually transmitted infections from recent sexual contact Medicines you can buy yourself to treat a vaginal yeast infection are: - Miconazole - Clotrimazole - Tioconazole - Butoconazole When using these medicines: - Read the packages carefully and use them as directed. - You will need to take the medicine for 1 - 7 days, depending on which medicine you buy. (If you do not get repeated infections, a 1-day medicine might work for you.) - Do not stop using these medicines early because your symptoms are better. You doctor can also prescribe a pill that you only take by mouth once. If your symptoms are worse or you get vaginal yeast infections often, you may need: - Medicine for up to 14 days - Clotrimazole vaginal suppository or fluconazole pill every week to prevent new infections To help prevent and treat vaginal discharge: - Keep your genital area clean and dry. Avoid soap and rinse with water only. Sitting in a warm, but not hot, bath may help your symptoms. - Avoid douching. Although many women feel cleaner if they douche after their period or intercourse, it may worsen vaginal discharge. Douching removes healthy bacteria lining the vagina that protect against infection. - Eat yogurt with live cultures or take Lactobacillus acidophilus tablets when you are on antibiotics. This will help to prevent a yeast infection. - Use condoms to avoid catching or spreading infections. - Avoid using feminine hygiene sprays, fragrances, or powders in the genital area. - Avoid wearing tight-fitting pants or shorts, which may cause irritation. - Wear cotton underwear or cotton-crotch pantyhose. Avoid underwear made of silk or nylon, because they can increase sweating in the genital area, which can cause irritation. - Use pads and not tampons. - Keep your blood sugar levels under good control if you have diabetes. - Avoid wearing wet bathing suits or exercise clothing for long periods of time. Wash sweaty or wet clothes after each use."},{"_answerid":"Q109-S2-A2","_pairid":"276","__text":"Medicines to treat vaginal yeast infections are available as creams, ointments, vaginal tablets or suppositories. Most can be bought without needing to see your health care provider. Treating yourself at home is probably\u00a0OK if: - Your symptoms are mild and you do not have pelvic pain or a fever - This is not your first yeast infection and you have not had many yeast infections in the past - You are not pregnant - You are not worried about other sexually transmitted infections from recent sexual contact Medicines you can buy yourself to treat a vaginal yeast infection are: - Miconazole - Clotrimazole - Tioconazole - Butoconazole When using these medicines: - Read the packages carefully and use them as directed. - You will need to take the medicine for 1 - 7 days, depending on which medicine you buy. (If you do not get repeated infections, a 1-day medicine might work for you.) - Do not stop using these medicines early because your symptoms are better. You doctor can also prescribe a pill that you only take by mouth once. If your symptoms are worse or you get vaginal yeast infections often, you may need: - Medicine for up to 14 days - Clotrimazole vaginal suppository or fluconazole pill every week to prevent new infections To help prevent and treat vaginal discharge: - Keep your genital area clean and dry. Avoid soap and rinse with water only. Sitting in a warm, but not hot, bath may help your symptoms. - Avoid douching. Although many women feel cleaner if they douche after their period or intercourse, it may worsen vaginal discharge. Douching removes healthy bacteria lining the vagina that protect against infection. - Eat yogurt with live cultures or take Lactobacillus acidophilus tablets when you are on antibiotics. This will help to prevent a yeast infection. - Use condoms to avoid catching or spreading infections. - Avoid using feminine hygiene sprays, fragrances, or powders in the genital area. - Avoid wearing tight-fitting pants or shorts, which may cause irritation. - Wear cotton underwear or cotton-crotch pantyhose. Avoid underwear made of silk or nylon, because they can increase sweating in the genital area, which can cause irritation. - Use pads and not tampons. - Keep your blood sugar levels under good control if you have diabetes. - Avoid wearing wet bathing suits or exercise clothing for long periods of time. Wash sweaty or wet clothes after each use."}],"SUB_QUESTION_ID":"Q109-S2","ANNOTATIONS_FOCUS":["vaginal yeast infection"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"vaginal yeast infection","MESSAGE":"Hey, my name is [NAME]. Last night my vaginal area was itching but I didn't think to much of it. Well when I woke up this morning it started itching out of control. I don't see discharge coming from the vaginal area. Now I do use Summer's Eve vaginal spray, I don't know if it is a vaginal yeast infection or not, but how should I go about this process.","QUESTION_ID":"Q109","F_REF":"15696"} +{"ANSWERS":[{"_answerid":"Q110-S1-A1","_pairid":"277","__text":"These resources address the diagnosis or management of Milroy disease: - Gene Review: Gene Review: Milroy Disease - Genetic Testing Registry: Hereditary lymphedema type I - MedlinePlus Encyclopedia: Lymphatic Obstruction These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"}],"SUB_QUESTION_ID":"Q110-S1","ANNOTATIONS_FOCUS":["milroy disease"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"milroy disease","MESSAGE":"hello , my daughter has lymph edema her both legs and left hand is swelling , this problem started when she was of 3 months now she is 16 months , her swelling is growing day by day , im clue less what to do and what kind of treatment i should do plz help and suggest us ,","QUESTION_ID":"Q110","F_REF":"1-137169665"} +{"ANSWERS":[{"_answerid":"Q111-S1-A1","_pairid":"278","__text":"Duchenne muscular dystrophy is an inherited disorder that involves muscle weakness, which quickly gets worse."},{"_answerid":"Q111-S1-A2","_pairid":"279","__text":"Duchenne muscular dystrophy (DMD) is a rapidly progressive form of muscular dystrophy that occurs primarily in boys. It is caused by an alteration (mutation) in a gene, called the DMD gene that can be inherited in families in an X-linked recessive fashion, but it often occurs in people from families without a known family history of the condition. Individuals who have DMD have progressive loss of muscle function and weakness, which begins in the lower limbs. The DMD gene is the second largest gene to date, which encodes the muscle protein, dystrophin. Boys with Duchenne muscular dystrophy do not make the dystrophin protein in their muscles. Duchenne muscular dystrophy affects approximately 1 in 3500 male births worldwide. Because this is an inherited disorder, risks include a family history of Duchenne muscular dystrophy."}],"SUB_QUESTION_ID":"Q111-S1","ANNOTATIONS_FOCUS":["duchenne muscular dystrophy"],"ANNOTATIONS_TYPE":"information","SUBJECT":"","MESSAGE":"Duchenne Muscular Dystrophy. I am doing a research project on this genetic disease and I would like to know more about it from a professional. I am researching the mode of inheritance, symptoms, treatments\/ support groups, and relative cost to family.","QUESTION_ID":"Q111","F_REF":"43"} +{"ANSWERS":[{"_answerid":"Q111-S2-A1","_pairid":"280","__text":"Duchenne muscular dystrophy is inherited in an X-linked recessive pattern. Males have only one copy of the X chromosome from their mother and one copy of the Y chromosome from their father. If their X chromosome has a DMD gene mutation, they will have Duchenne muscular dystrophy. Females, on the other hand, have two copies of the X chromosomes.. Since females have two copies of this gene, if one copy does not work, they have a second back up copy to produce the dystrophin protein. A woman who has a genetic change in one of her two copies is said to be \"a carrier\" of Duchenne muscular dystrophy. Carriers do not have Duchenne muscular dystrophy and most are unaware that they even carry this change in their genetic material unless they have a family history. However, recent studies have shown that some carrier females (approximately 20 percent) will show symptoms of DMD, including muscle weakness and cardiac abnormalities. With an X-linked recessive condition, the chance of passing on the changed (non-working) copy of the gene to a child is different for males and females. Females who carry the changed copy of the gene have a 50 percent chance of passing it on with each pregnancy. Thus, there is a 25 percent chance of having a affected child with DMD (eg., 50 percent of boys have the chance of having DMD and 50 percent of girls will be carriers). The chance of a woman who has one affected son (and no family history) of being a carrier of the changed DMD gene is approximately 2\/3. However, in the remaining third of individuals with DMD, the change in the dystrophin gene is a new genetic change, or de novo change and about 10 percent of new mutations are due to gonadal mosaicism. Gonadal mosaicism refers to a condition where an individual has two or more cell populations that differ in genetic makeup in their eggs or sperm. Males who inherit or are born with a changed copy of the DMD gene will have DMD since they have a Y chromosome, and do not have back-up X chromosome. If a male with DMD were to have children, all of his daughters would be carriers and none of his sons would be affected. Currently various reproductive options are available to families. The preconception options include MicroSort which is a technology that can separate sperm containing X chromosomes allowing for an increase in chances of having a female. The second reproductive option is preimplantation genetic diagnosis (PGD), which is a technique that can allow the cells of a fertilized egg to be tested to determine if it contains a change in the DMD gene and then implant those eggs which do not. The post conception options include Chorionic Villus Sampling (CVS) and amniocentesis which analyze sampled cells derived from the developing fetus. Several of the prenatal testing options for pregnancies at increased risk are available when the DMD disease-causing mutation has been identified in a family member, or if informative, genetically-linked markers have been identified."}],"SUB_QUESTION_ID":"Q111-S2","ANNOTATIONS_FOCUS":["duchenne muscular dystrophy"],"ANNOTATIONS_TYPE":"inheritance","SUBJECT":"","MESSAGE":"Duchenne Muscular Dystrophy. I am doing a research project on this genetic disease and I would like to know more about it from a professional. I am researching the mode of inheritance, symptoms, treatments\/ support groups, and relative cost to family.","QUESTION_ID":"Q111","F_REF":"43"} +{"ANSWERS":[{"_answerid":"Q111-S3-A1","_pairid":"281","__text":"Symptoms usually appear before age 6 and may appear as early as infancy. They may include: - Fatigue - Learning difficulties (the IQ can be below 75) - Intellectual disability (possible, but does not get worse over time) Muscle weakness: - Begins in the legs and pelvis, but also occurs less severely in the arms, neck, and other areas of the body - Problems with motor skills (running, hopping, jumping) - Frequent falls - Trouble getting up from a lying position or climbing stairs - Weakness quickly gets worse Progressive difficulty walking: - Ability to walk may be lost by age 12, and the child\u00a0will have\u00a0to use a wheelchair - Breathing difficulties and heart disease usually start by age 20"},{"_answerid":"Q111-S3-A2","_pairid":"282","__text":"The symptoms usually appear before age 6 and may appear as early as infancy. Typically, the first noticeable symptom is delay of motor milestones, including sitting and standing independently. The mean age for walking in boys with Duchenne muscular dystrophy is 18 months. There is progressive muscle weakness of the legs and pelvic muscles, which is associated with a loss of muscle mass (wasting). This muscle weakness causes a waddling gait and difficulty climbing stairs. Muscle weakness also occurs in the arms, neck, and other areas, but not as severely or as early as in the lower half of the body. Calf muscles initially enlarge and the enlarged muscle tissue is eventually replaced with fat and connective tissue (pseudohypertrophy). Muscle contractures occur in the legs, making the muscles unusable because the muscle fibers shorten and fibrosis occurs in connective tissue. Occasionally, there can be pain in the calves. Symptoms usually appear in boys aged 1 to 6. There is a steady decline in muscle strength between the ages of 6 and 11 years. By age 10, braces may be required for walking, and by age 12, most boys are confined to a wheelchair. Bones develop abnormally, causing skeletal deformities of the spine and other areas. Muscular weakness and skeletal deformities frequently contribute to breathing disorders. Cardiomyopathy (enlarged heart) occurs in almost all cases, beginning in the early teens in some, and in all after the age of 18 years. Intellectual impairment may occur, but it is not inevitable and does not worsen as the disorder progresses. Few individuals with DMD live beyond their 30s. Breathing complications and cardiomyopathy are common causes of death."}],"SUB_QUESTION_ID":"Q111-S3","ANNOTATIONS_FOCUS":["duchenne muscular dystrophy"],"ANNOTATIONS_TYPE":"symptom","SUBJECT":"","MESSAGE":"Duchenne Muscular Dystrophy. I am doing a research project on this genetic disease and I would like to know more about it from a professional. I am researching the mode of inheritance, symptoms, treatments\/ support groups, and relative cost to family.","QUESTION_ID":"Q111","F_REF":"43"} +{"ANSWERS":[{"_answerid":"Q111-S4-A1","_pairid":"283","__text":"There is no known cure for Duchenne muscular dystrophy. Treatment aims to control symptoms to\u00a0improve quality of life. Steroid drugs can slow the loss of muscle strength. They may be started when the child is diagnosed or when muscle strength begins to decline. Other treatments may include: - Albuterol--a drug used for people with asthma - Amino acids - Carnitine - Coenzyme Q10 - Creatine - Fish oil - Green tea extracts - Vitamin E However, the effects of these treatments have not been proven. Stem cells and gene therapy may be used in the future. Activity is encouraged. Inactivity (such as bedrest) can\u00a0make the muscle disease worse. Physical therapy may help to maintain muscle strength and function. Speech therapy is often needed. Other treatments may include: - Assisted ventilation (used during the day or night) - Drugs to help heart function, such as angiotensin-converting-enzyme inhibitors, beta-blockers, and diuretics - Orthopedic appliances (such as braces and wheelchairs) to improve mobility - Proton pump inhibitors (for people with gastroesophageal reflux) Several new treatments are being studied in trials."},{"_answerid":"Q111-S4-A2","_pairid":"284","__text":"Treatment for Duchenne muscular dystrophy is aimed at the symptoms. Aggressive management of dilated cardiomyopathy with anti-congestive medications is used, including cardiac transplantation in severe cases. Assistive devices for respiratory complications may be needed, especially at night. The medication prednisone - a steroid - is given to improve the strength and function of individuals with DMD. Prednisone has been shown to prolong the ability to walk by 2 to 5 years. However, the possible side effects of prednisone include weight gain, high blood pressure, behavior changes, and delayed growth. A synthetic form of prednisilone, called Deflazacort, is used in Europe and believed to have fewer side effects than prednisone. A medication called cyclosporine has been used and has improved clinical function in children, but its use is controversial due to cyclosporine-induced myopathy. Oxandrolone, a medication used in a research study, has similar effects to prednisone with fewer side effects. Several other therapies are also under investigation, including coenzyme Q10, glutamine, pentoxifylline, and PTC124 (see clinical research below). Physical therapy is used to promote mobility and prevent contractures. Surgery may be needed for severe contractures and scoliosis."}],"SUB_QUESTION_ID":"Q111-S4","ANNOTATIONS_FOCUS":["duchenne muscular dystrophy"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"Duchenne Muscular Dystrophy. I am doing a research project on this genetic disease and I would like to know more about it from a professional. I am researching the mode of inheritance, symptoms, treatments\/ support groups, and relative cost to family.","QUESTION_ID":"Q111","F_REF":"43"} +{"ANSWERS":[{"_answerid":"Q111-S5-A1","_pairid":"285","__text":"Additional Resources for Duchenne Muscular Dystrophy Duchenne muscular dystrophy [nlm.nih.gov] From Medline Plus Muscular Dystrophy [nlm.nih.gov] From MEDLINEplus, the National Library of Medicine Web site Duchenne and Becker muscular dystrophy [ghr.nlm.nih.gov] From Genetics Home Reference DMD [ghr.nlm.nih.gov] Information on the DMD Gene: from Genetics HOME Reference The National Organization for Rare Disorders (NORD) [rarediseases.org] A federation of more than 130 nonprofit voluntary health organizations serving people with rare disorders. A printed report on Duchenne muscular dystrophy can be obtained through NORDs Web site, or by calling or writing the NORD offices. Scientists Come Step Closer to New Muscular Dystrophy Treatment [niams.nih.gov] January 2005 research press release on DMD from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) NINDS Muscular Dystrophy Information Page [ninds.nih.gov] From the National Institute of Neurological Disorders and Stroke (NINDS) The Muscular Dystrophy Association (MDA) [mdausa.org] An advocacy group for muscular dystrophy. Muscular Dystrophy Family Foundation [mdff.org] Funds adaptive equipment, from wheelchairs to van lifts to communication devices and beyond. Parent Project for Muscular Dystrophy Research [parentprojectmd.org] A digest of breaking research news on Duchenne Muscular Dystrophy (DMD) and Becker Muscular Dystrophy (BMD) Accurate and Affordable Diagnosis of Duchenne Muscular Distrophy [ninds.nih.gov] A new release from the National Institute of Neurological Disorders and Stroke. Duchenne muscular dystrophy [rarediseases.info.nih.gov] Information from the Genetics and Rare Diseases Information Center. Finding Reliable Health Information Online A listing of information and links for finding comprehensive genetics health information online."}],"SUB_QUESTION_ID":"Q111-S5","ANNOTATIONS_FOCUS":["duchenne muscular dystrophy"],"ANNOTATIONS_TYPE":"resources","SUBJECT":"","MESSAGE":"Duchenne Muscular Dystrophy. I am doing a research project on this genetic disease and I would like to know more about it from a professional. I am researching the mode of inheritance, symptoms, treatments\/ support groups, and relative cost to family.","QUESTION_ID":"Q111","F_REF":"43"} +{"ANSWERS":[{"_answerid":"Q112-S1-A1","_pairid":"286","__text":"The first treatment for a slipped disk is a short period of rest with medicines for the pain. This is followed by physical therapy. Most people who follow these treatments recover and return to normal activities. Some people will need to have more treatment. This may include steroid injections or surgery. MEDICINES Medicines can help with your pain. Your doctor may prescribe any of the following: - Nonsteroidal anti-inflammatory drugs (NSAIDs) for long-term pain control - Narcotics if the pain is severe and does not respond to NSAIDs - Medicines to calm the nerves - Muscle relaxants to relieve back spasms LIFESTYLE CHANGES If you are overweight, diet and exercise are very important for improving back pain. Physical therapy is important for nearly everyone with disk disease. Therapists will teach you how to properly lift, dress, walk, and perform other activities. They teach you how to strengthen muscles that help support the spine. You will also learn how to increase flexibility in your spine and legs. Take care of your back at home: - Reduce activity for the first few days. Slowly restart your usual activities. - Avoid heavy lifting or twisting your back for the first 6 weeks after the pain starts. - After 2 to 3 weeks, gradually start exercising again. INJECTIONS Steroid medicine injections into the back in the area of the herniated disk may help control pain for several months. These injections reduce swelling around the disk and relieve many symptoms. Spinal injections are usually done in your doctor's office. SURGERY Surgery may be an option if your symptoms do not go away with other treatments and time. Diskectomy is surgery to remove all or part of a disk. Discuss with your doctor which treatment options are best for you."}],"SUB_QUESTION_ID":"Q112-S1","ANNOTATIONS_FOCUS":["herniated disc"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"DISC HERNIA","MESSAGE":"GOOD AFTERNOON I HAVE wanted to say a herniated disc in L4 L5 S1 L3 8 MONTHS I HAVE DECREASED IN PAIN TREATMENT BUT HERE IN [LOCATION] GIVE ME NO WARRANTIES OF OPERATION WOULD LIKE TO KNOW IF THERE IS SOMETHING COULD Q DO IN MY CASE TOOK ME AND CONTRAST MAGNETIC RESONANCE","QUESTION_ID":"Q112","F_REF":"17055"} +{"ANSWERS":[{"_answerid":"Q113-S1-A1","_pairid":"287","__text":"The Human Phenotype Ontology (HPO) provides the following list of features that have been reported in people with this condition. Much of the information in the HPO comes from Orphanet, a European rare disease database. If available, the list includes a rough estimate of how common a feature is (its frequency). Frequencies are based on a specific study and may not be representative of all studies. You can use the MedlinePlus Medical Dictionary for definitions of the terms below."}],"SUB_QUESTION_ID":"Q113-S1","ANNOTATIONS_FOCUS":["stiff person syndrome"],"ANNOTATIONS_TYPE":"symptom","SUBJECT":"ClinicalTrials.gov - Question - general information","MESSAGE":"Stiff person Syndrome. Please can you tell me what are the early symptoms I have severe cramps in my feet which are twisting into an arc,muscle spasms slowly getting worse and my muscles particularly in my legs are cramping like someone has pushed a knitting needle into them. Started off at night but now happening through the day my back and neck and voice box are also effected and my chest area has now seized to the point of restricting my breathing to very shallow at times I find that I am stretching out involuntarily right through my body and this is becoming more frequent","QUESTION_ID":"Q113","F_REF":"1-137137005"} +{"ANSWERS":[{"_answerid":"Q114-S1-A1","_pairid":"288","__text":"Treatment varies based on: - Type of tumor - Whether it is cancer - Location of the tumor You may not need treatment if the tumor is: - Noncancerous (benign)\u00a0 - In\u00a0a \"safe\" area where it will not cause symptoms or problems with the way an organ works Sometimes benign tumors may be removed for cosmetic reasons. Benign tumors of the brain may be removed because of their location or harmful effect on the surrounding normal brain tissue. If a tumor is cancer, possible treatments may\u00a0include: - Chemotherapy - Radiation - Surgery - Targeted cancer therapy - Biologic therapy - Other treatment options"},{"_answerid":"Q114-S1-A2","_pairid":"289","__text":"TA specialized team of doctors advises and assists individuals throughout treatment and rehabilitation.\u00a0 These doctors may include: A\u00a0neurologist is a specialist in nervous system disorders. An oncologist is a specialist in cancer. A neuro-oncologist is a neurologist or oncologist who specializes in nervous system tumors. A\u00a0neuroradiologist is a doctor trained in reading diagnostic imaging results who\u00a0specializes in the CNS. A\u00a0pathologist is a clinical physician who diagnoses diseases of tissues or cells using a variety of laboratory tests. A\u00a0neurosurgeon is a brain or spinal cord surgeon. A\u00a0radiation oncologist is a doctor who specializes in using radiation to treat individuals with cancer. This team will recommend a treatment plan based on the tumor's location, type, size and aggressiveness, as well as on the individual\u2019s medical history, age, and general health. Initial treatment for a CNS tumor may involve a variety of drugs, including anticonvulsants to treat seizures, pain medications, steroids or other anti-inflammatory drugs to reduce swelling and improve blood flow, antidepressants to treat anxiety or ease depression that might occur following a tumor diagnosis, and drugs to fight nausea caused by various treatments. Malignant tumors require some form of treatment, while some small benign tumors may need only\u00a0periodic monitoring.\u00a0 The three standard treatment options for malignant CNS tumors are neurosurgery, radiation therapy, and chemotherapy.\u00a0 Some patients may receive a combination of treatments."}],"SUB_QUESTION_ID":"Q114-S1","ANNOTATIONS_FOCUS":["tumors in brain and spine"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"My Brother named [NAME] Has Multiple tumors in brain and spine. after gone through 3 major surgeries he can not walk properly as he has 3 tumors still in brain and spine. and after surgery his right eyesight has been lost and he can not hear. Is there any research done by your sight and found medicines which can remove his remaining tumors. Please give me suggestion regarding this matter. I can provide all the necessary medical reports if you need.","QUESTION_ID":"Q114","F_REF":"1-134274435"} +{"ANSWERS":[{"_answerid":"Q115-S1-A1","_pairid":"290","__text":"Asthma is caused by swelling (inflammation) in the airways. When an asthma attack occurs, the lining of the air passages swells and the muscles surrounding the airways become tight. This reduces the amount of air that can pass through the airway. In people who have sensitive airways, asthma symptoms can be triggered by breathing in\u00a0substances called allergens or triggers. Common asthma triggers include: - Animals (pet hair or dander) - Dust mites - Certain medicines (aspirin and other NSAIDS) - Changes in weather (most often cold weather) - Chemicals in the air or in food - Exercise - Mold - Pollen - Respiratory infections, such as the common cold - Strong emotions (stress) - Tobacco smoke Substances in some workplaces can also trigger asthma symptoms, leading to occupational asthma. The most common triggers are wood dust, grain dust, animal dander, fungi, or chemicals. Many people with asthma have a personal or family history of allergies, such as hay fever (allergic rhinitis) or eczema. Others have no history of allergies."},{"_answerid":"Q115-S1-A2","_pairid":"291","__text":"The exact cause of asthma isn't known. Researchers think some genetic and environmental factors interact to cause asthma, most often early in life. These factors include: An inherited tendency to develop allergies, called atopy (AT-o-pe) Parents who have asthma Certain respiratory infections during childhood Contact with some airborne allergens or exposure to some viral infections in infancy or in early childhood when the immune system is developing If asthma or atopy runs in your family, exposure to irritants (for example, tobacco smoke) may make your airways more reactive to substances in the air. Some factors may be more likely to cause asthma in some people than in others. Researchers continue to explore what causes asthma. The \"Hygiene Hypothesis\" One theory researchers have for what causes asthma is the \"hygiene hypothesis.\" They believe that our Western lifestyle\u2014with its emphasis on hygiene and sanitation\u2014has resulted in changes in our living conditions and an overall decline in infections in early childhood. Many young children no longer have the same types of environmental exposures and infections as children did in the past. This affects the way that young children's immune systems develop during very early childhood, and it may increase their risk for atopy and asthma. This is especially true for children who have close family members with one or both of these conditions."}],"SUB_QUESTION_ID":"Q115-S1","ANNOTATIONS_FOCUS":["asthma"],"ANNOTATIONS_TYPE":"cause","SUBJECT":"Asthma","MESSAGE":"I have been treated for breast cancer and had chemotherapy and readiation. I am on many drugs but since stopping treatment I have now presented as having asthma. I take Letrozole. 2.5 to block any estrogen in my body as my tumor was estrogen positive. What type of drugs impact asthma symptoms? Please advise","QUESTION_ID":"Q115","F_REF":"15794"} +{"ANSWERS":[{"_answerid":"Q116-S1-A1","_pairid":"294","__text":"Most cases of Turner syndrome are not inherited. Most commonly, Turner syndrome occurs due to a random event during the formation of an egg or sperm cell in a parent (prior to conception). For example, if an egg or sperm cell mistakenly loses a sex chromosome, and joins at conception with an egg or sperm containing an X chromosome, the resulting child will have a single X chromosome in each cell. Mosaic Turner syndrome, occurring when a person has some cells with one X chromosome and some cells with two sex chromosomes, is also not inherited. This also occurs due to a random event, during early fetal development rather than before conception. In rare cases, Turner syndrome may be caused by a missing piece (partial deletion) of the X chromosome. A deletion can be inherited from a parent. Genetic testing of an affected fetus or child can identify the type of Turner syndrome present and may help to estimate the risk of recurrence. People with questions about genetic testing or recurrence risks for Turner syndrome are encouraged to speak with a genetic counselor or other genetics professional."},{"_answerid":"Q116-S1-A2","_pairid":"295","__text":"Most cases of Turner syndrome are not inherited. When this condition results from monosomy X, the chromosomal abnormality occurs as a random event during the formation of reproductive cells (eggs and sperm) in the affected person's parent. An error in cell division called nondisjunction can result in reproductive cells with an abnormal number of chromosomes. For example, an egg or sperm cell may lose a sex chromosome as a result of nondisjunction. If one of these atypical reproductive cells contributes to the genetic makeup of a child, the child will have a single X chromosome in each cell and will be missing the other sex chromosome. Mosaic Turner syndrome is also not inherited. In an affected individual, it occurs as a random event during cell division in early fetal development. As a result, some of an affected person's cells have the usual two sex chromosomes, and other cells have only one copy of the X chromosome. Other sex chromosome abnormalities are also possible in females with X chromosome mosaicism. Rarely, Turner syndrome caused by a partial deletion of the X chromosome can be passed from one generation to the next."}],"SUB_QUESTION_ID":"Q116-S1","ANNOTATIONS_FOCUS":["turner syndrome"],"ANNOTATIONS_TYPE":"inheritance","SUBJECT":"","MESSAGE":"Customer Service Request. My daughter has Turner syndrome but she's beaten all odds. She developed on our own, got her period on her own, she is now pregnant on her own with identical twins. My question is can she have normal children or do they have more of a chance of having Turner syndrome. My daughter has been tested many times to confirm her diagnosis of Turner syndrome and she is a full XO not mosaic but still does not display many of the characteristics. Again, I am just questioning the safety of the pregnancy and the health of the babies. Thank you for your help","QUESTION_ID":"Q116","F_REF":"10599"} +{"ANSWERS":[{"_answerid":"Q117-S1-A1","_pairid":"296","__text":"These resources address the diagnosis or management of vitelliform macular dystrophy: - Gene Review: Gene Review: Best Vitelliform Macular Dystrophy - Genetic Testing Registry: Macular dystrophy, vitelliform, adult-onset - Genetic Testing Registry: Vitelliform dystrophy - MedlinePlus Encyclopedia: Macula (image) These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"}],"SUB_QUESTION_ID":"Q117-S1","ANNOTATIONS_FOCUS":["vitelliform macular dystrophy"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"Vitelliform Macular Dystrophy","MESSAGE":"Would like to obtain more info on possible treatments.","QUESTION_ID":"Q117","F_REF":"NF_172"} +{"ANSWERS":[{"_answerid":"Q118-S1-A1","_pairid":"297","__text":"Treatment for Dry Mouth Dry mouth treatment will depend on what is causing the problem. If you think you have dry mouth, see your dentist or physician. He or she can help to determine what is causing your dry mouth. If your dry mouth is caused by medicine, your physician might change your medicine or adjust the dosage. If your salivary glands are not working right but can still produce some saliva, your dentist or physician might give you a medicine that helps the glands work better. Your dentist or physician might also suggest that you use artificial saliva to keep your mouth wet. Do's and Don'ts Do's - Do drink water or sugarless drinks often. That will make chewing and swallowing easier when eating. - Do chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow. - Do use a humidifier at night to promote moisture in the air while you sleep. Do drink water or sugarless drinks often. That will make chewing and swallowing easier when eating. Do chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow. Do use a humidifier at night to promote moisture in the air while you sleep. Don\u2019ts - Don't consume drinks with caffeine such as coffee, tea, and some sodas. Caffeine can dry out the mouth. - Don't use tobacco or alcohol. They dry out the mouth. Don't consume drinks with caffeine such as coffee, tea, and some sodas. Caffeine can dry out the mouth. Don't use tobacco or alcohol. They dry out the mouth. Gene Therapy Research for Salivary Gland Dysfunction Scientists at NIH\u2019s National Institute of Dental and Craniofacial Research (NIDCR) are exploring the potential use of gene therapy to treat salivary gland dysfunction. The idea is to transfer additional or replacement genes into the salivary glands of people with Sj\u00f6gren's syndrome and cancer patients whose salivary glands were damaged during radiation treatment. The hope is that these genes will increase the production of saliva and eliminate the chronic parched sensation that bothers people with dry mouth conditions. NIDCR recently completed a clinical study, a research study in humans, on gene therapy for radiation-damaged salivary glands. The study showed that gene therapy can be safely performed in salivary glands and that it has the potential to help head and neck cancer survivors with dry mouth. Read NIDCR\u2019s news release to learn more about the study\u2019s findings. Based on the promising results of this trial, similar clinical trials are planned in the near future. Research on Sj\u00f6gren\u2019s Syndrome and Other Diseases Affecting Salivary Glands NIDCR is also conducting clinical trials to study new approaches for improving salivary flow in patients with Sjogren\u2019s syndrome. Such studies include testing the effectiveness of a monoclonal antibody as well as a corticosteroid to see whether either of these treatments helps improve salivary flow. Other studies are focused on learning how diseases such as diabetes, auto inflammatory diseases, and granulomatous diseases cause salivary gland dysfunction. Such studies could one day lead to better ways of preventing and treating salivary gland conditions. To stay abreast of any new studies on gene therapy and salivary gland function, visit ClinicalTrials.gov. ClinicalTrials.gov lists all federally and many privately funded clinical trials in the U.S. and around the world; the web site is updated frequently."},{"_answerid":"Q118-S1-A2","_pairid":"298","__text":"Dry mouth treatment will depend on what is causing the problem. If you think you have dry mouth, see your dentist or physician. He or she can help to determine what is causing your dry mouth. If your dry mouth is caused by medicine, your physician might change your medicine or adjust the dosage. If your salivary glands are not working right, but can still produce some saliva, your dentist or physician might give you a special medicine that helps the glands work better. He or she might suggest that you use artificial saliva to keep your mouth wet. (Watch the video to learn how dry mouth is treated. 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.)"},{"_answerid":"Q118-S1-A3","_pairid":"299","__text":"Treatment for Dry Mouth Dry mouth treatment will depend on what is causing the problem. If you think you have dry mouth, see your dentist or physician. He or she can help to determine what is causing your dry mouth. If your dry mouth is caused by medicine, your physician might change your medicine or adjust the dosage. If your salivary glands are not working right but can still produce some saliva, your dentist or physician might give you a medicine that helps the glands work better. Your dentist or physician might also suggest that you use artificial saliva to keep your mouth wet. Do's and Don'ts Do's - Do drink water or sugarless drinks often. That will make chewing and swallowing easier when eating. - Do chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow. - Do use a humidifier at night to promote moisture in the air while you sleep. Do drink water or sugarless drinks often. That will make chewing and swallowing easier when eating. Do chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow. Do use a humidifier at night to promote moisture in the air while you sleep. Don\u2019ts - Don't consume drinks with caffeine such as coffee, tea, and some sodas. Caffeine can dry out the mouth. - Don't use tobacco or alcohol. They dry out the mouth. Don't consume drinks with caffeine such as coffee, tea, and some sodas. Caffeine can dry out the mouth. Don't use tobacco or alcohol. They dry out the mouth. Gene Therapy Research for Salivary Gland Dysfunction Scientists at NIH\u2019s National Institute of Dental and Craniofacial Research (NIDCR) are exploring the potential use of gene therapy to treat salivary gland dysfunction. The idea is to transfer additional or replacement genes into the salivary glands of people with Sj\u00f6gren's syndrome and cancer patients whose salivary glands were damaged during radiation treatment. The hope is that these genes will increase the production of saliva and eliminate the chronic parched sensation that bothers people with dry mouth conditions. NIDCR recently completed a clinical study, a research study in humans, on gene therapy for radiation-damaged salivary glands. The study showed that gene therapy can be safely performed in salivary glands and that it has the potential to help head and neck cancer survivors with dry mouth. Read NIDCR\u2019s news release to learn more about the study\u2019s findings. Based on the promising results of this trial, similar clinical trials are planned in the near future. Research on Sj\u00f6gren\u2019s Syndrome and Other Diseases Affecting Salivary Glands NIDCR is also conducting clinical trials to study new approaches for improving salivary flow in patients with Sjogren\u2019s syndrome. Such studies include testing the effectiveness of a monoclonal antibody as well as a corticosteroid to see whether either of these treatments helps improve salivary flow. Other studies are focused on learning how diseases such as diabetes, auto inflammatory diseases, and granulomatous diseases cause salivary gland dysfunction. Such studies could one day lead to better ways of preventing and treating salivary gland conditions. To stay abreast of any new studies on gene therapy and salivary gland function, visit ClinicalTrials.gov. ClinicalTrials.gov lists all federally and many privately funded clinical trials in the U.S. and around the world; the web site is updated frequently."}],"SUB_QUESTION_ID":"Q118-S1","ANNOTATIONS_FOCUS":["dry mouth"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"treatment for dry mouth caused by necessary medicine","MESSAGE":"My provider can't help (I asked.) I am intolerant of all the \"sugar alcohols\" such as maltilol, sorbitol, xylitol, etc. and need something for dry mouth caused by med which I have to take. Biotene products help for only about two minutes.","QUESTION_ID":"Q118","F_REF":"1-118317205"} +{"ANSWERS":[{"_answerid":"Q119-S1-A1","_pairid":"303","__text":"The outlook depends on the type of cancer and the stage of the cancer when diagnosed.\u00a0\u00a0 Some cancers can be cured. Other cancers that are not curable can still be treated effectively. Some patients can live for many years with cancer. Other tumors are quickly life threatening."}],"SUB_QUESTION_ID":"Q119-S1","ANNOTATIONS_FOCUS":["cancer"],"ANNOTATIONS_TYPE":"prognosis","SUBJECT":"","MESSAGE":"Hello dear sir\/madam I just want to knw if any cancer person had all treatment done then cancer gonna be again or not.how long person can live after cancer treatment.please reply me as Soon as possible. Thank you Sent from my iPhone","QUESTION_ID":"Q119","F_REF":"1-136814529"} +{"ANSWERS":[{"_answerid":"Q120-S1-A1","_pairid":"305","__text":"People with pulmonary arterial hypertension (PAH) benefit from receiving treatment at specialized centers. The Pulmonary Hypertension Association offers a Find a Doctor tool which may aid you in locating your nearest center. Treatment of serious or life threatening PAH may involve continuous IV epoprostenol. Other treatment options, include treprostinil, iloprost, bosentan, ambrisentan, sildenafil, and tadalafil. Many of these treatments can be administered in various forms, such as by shot, IV, or inhalation. A small number of people with PAH respond well to long term oral calcium channel blockers. Blood thinners, diuretics, and supplemental oxygen may be prescribed as needed. Many drugs can be harmful to people with PAH. The following should be avoided: appetite suppressants, cocaine, amphetamines (and related compounds), low oxygen environments (such as high altitudes), and possibly estrogen compounds (oral contraceptives and hormone replacement therapy)."},{"_answerid":"Q120-S1-A2","_pairid":"306","__text":"These resources address the diagnosis or management of pulmonary arterial hypertension: - Gene Review: Gene Review: Heritable Pulmonary Arterial Hypertension - Genetic Testing Registry: Primary pulmonary hypertension - Genetic Testing Registry: Primary pulmonary hypertension 2 - Genetic Testing Registry: Primary pulmonary hypertension 3 - Genetic Testing Registry: Primary pulmonary hypertension 4 - MedlinePlus Encyclopedia: Pulmonary hypertension These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"}],"SUB_QUESTION_ID":"Q120-S1","ANNOTATIONS_FOCUS":["pulmonary arterial hypertension"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"My mother has Pulmonary ARTERIAL hypertension in the left side of her heart. Is there anything that can be done to improve her health.","QUESTION_ID":"Q120","F_REF":"1-131596745"} +{"ANSWERS":[{"_answerid":"Q121-S1-A1","_pairid":"307","__text":"Most men ejaculate within a few minutes of starting to thrust during intercourse. Men with delayed ejaculation may be unable to ejaculate or may only be able to ejaculate with great effort after having intercourse for a long time (for example, 30 to 45 minutes). Delayed ejaculation can have psychological or physical causes. Common psychological causes include: - Religious background that makes the person view sex as sinful - Lack of attraction for a partner - Conditioning caused by a habit of excessive masturbation - Traumatic events (such as being discovered masturbating or having illicit sex, or learning one's partner is having an affair) Some factors, such as anger toward the partner, may be involved. Physical causes may include: - Blockage of the ducts that semen passes through - Use of certain drugs (such as prozac, mellaril, and guanethidine) - Nervous system diseases, such as stroke or nerve damage to the spinal cord or back - Testosterone deficiency - Nerve damage during surgery in the pelvis"}],"SUB_QUESTION_ID":"Q121-S1","ANNOTATIONS_FOCUS":["delayed ejaculation"],"ANNOTATIONS_TYPE":"cause","SUBJECT":"delayed ejaculation","MESSAGE":"i 25 year old i have problem of delayed ejaculation.even after taking several minutes im not able to ejaculate.but im getting regular night falls.what is the cause,which doctor should i consult.","QUESTION_ID":"Q121","F_REF":"12277"} +{"ANSWERS":[{"_answerid":"Q122-S1-A1","_pairid":"308","__text":"Adrenoleukodystrophy describes several closely related inherited disorders that disrupt the breakdown (metabolism) of certain fats (very long chain fatty acids)."},{"_answerid":"Q122-S1-A2","_pairid":"309","__text":"X-linked Adrenoleukodystrophy (ALD) is one of a group of genetic disorders called the leukodystrophies that cause damage to the myelin sheath, an insulating membrane that surrounds nerve cells in the brain. Women have two X chromosomes and are the carriers of the disease, but since men only have one X chromosome and lack the protective effect of the extra X chromosome, they are more severely affected. \u00a0People with X-ALD accumulate high levels of saturated, very long chain fatty acids (VLCFA) in the brain and adrenal cortex. The loss of myelin and the progressive dysfunction of the adrenal gland are the primary characteristics of X-ALD. While nearly all patients with X-ALD suffer from adrenal insufficiency, also known as Addison's disease, the neurological symptoms can begin either in childhood or in adulthood. The childhood cerebral form is the most severe, with onset between ages 4 and 10. The most common symptoms are usually behavioral changes such as abnormal withdrawal or aggression, poor memory, and poor school performance. Other symptoms include visual loss, learning disabilities, seizures, poorly articulated speech, difficulty swallowing, deafness, disturbances of gait and coordination, fatigue, intermittent vomiting, increased skin pigmentation, and progressive dementia. The milder adult-onset form is also known as adrenomyeloneuropathy (AMN), which typically begins between ages 21 and 35. \u00a0Symptoms may include progressive stiffness, weakness or paralysis of the lower limbs, and ataxia. Although adult-onset ALD progresses more slowly than the classic childhood form, it can also result in deterioration of brain function. Almost half the women who are carriers of X-ALS will develop a milder form of AMN but almost never will develop symptoms seen in boys the X-ALD. \u00a0X-ALD should not be confused with neonatal adrenoleukodsystrophy, which is a disease of newborns and young infants and belongs to the group of peroxisomal biogenesis disorders."},{"_answerid":"Q122-S1-A3","_pairid":"310","__text":"The NINDS supports research on genetic disorders such as ALD. The aim of this research is to find ways to prevent, treat, and cure these disorders. Studies are currently underway to identify new biomarkers of disease progression and to determine which patients will develop the childhood cerebral form of X-ALD. \u00a0A recent case study in Europe demonstrated that the combination of gene therapy with bone marrow transplantation, using the patient's own bone marrow cells, may arrest disease progression in childhood cerebral X-ALD. \u00a0A therapeutic trail in the United States is currently being discussed with the U.S. Food and Drug Administration."}],"SUB_QUESTION_ID":"Q122-S1","ANNOTATIONS_FOCUS":["adrenoleukodystrophy"],"ANNOTATIONS_TYPE":"information","SUBJECT":"adrenoleukodystrophy","MESSAGE":"A child I have been asked to work with has been diagnosed with this condition.I am so far unable to find info pertaining to this illness. Can you help??","QUESTION_ID":"Q122","F_REF":"NF_183"} +{"ANSWERS":[{"_answerid":"Q123-S1-A1","_pairid":"313","__text":"HIV\/AIDS is treated with medicines that stop the virus from multiplying. This treatment is called antiretroviral therapy (ART). In the past, people with HIV infection would start antiretroviral treatment after their CD4 count dropped or they developed HIV complications. Today, HIV treatment is recommended for all people with HIV infection, even if their CD4 count is still normal. Regular blood tests are needed to make sure the virus level in the blood (viral load) is kept low, or suppressed. The goal of treatment is to lower the HIV virus in the blood to a level that is so low that the test can't detect it. This is called an undetectable viral load. If the CD4 count already dropped before treatment was started, it will usually slowly go up. HIV complications often disappear as the immune system recovers."}],"SUB_QUESTION_ID":"Q123-S1","ANNOTATIONS_FOCUS":["hiv\/aids"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"hi my name is [NAME] I'm currently working with [LOCATION] and I was wondering I came across some of you healthy tip fliers for HIV\/Aids treatment .at the moment we have a study going on that helps HIV positive transgender women into HIV quality care .so it would be great to have some more information on HIV\/Aids treatment","QUESTION_ID":"Q123","F_REF":"14038"} +{"ANSWERS":[{"_answerid":"Q124-S1-A1","_pairid":"314","__text":"The Leptospira bacteria can be found in fresh water that has been contaminated by animal urine. The infection occurs in warmer climates. Leptospirosis\u00a0is not spread from person to person, except in vary rare cases. It occasionally spreads through sexual intercourse,\u00a0breast milk, or from a mother to her unborn child. Risk factors include: - Occupational exposure -- farmers, ranchers, slaughterhouse workers, trappers, veterinarians, loggers, sewer workers, rice field workers, and military personnel - Recreational activities -- fresh water swimming, canoeing, kayaking, and trail biking in warm areas - Household exposure -- pet dogs, domesticated livestock, rainwater catchment systems, and infected rodents Leptospirosis is rare in the continental United States. Hawaii has the highest number of cases in the United States."}],"SUB_QUESTION_ID":"Q124-S1","ANNOTATIONS_FOCUS":["leptospirosis"],"ANNOTATIONS_TYPE":"cause","SUBJECT":"Leptospirosis","MESSAGE":"what causes leptospirosis to spread in the human body","QUESTION_ID":"Q124","F_REF":"1-136964717"} +{"ANSWERS":[{"_answerid":"Q125-S1-A1","_pairid":"315","__text":"Type 2 diabetes may be reversed with lifestyle changes, especially losing weight\u00a0with exercise\u00a0and by\u00a0eating healthier foods. Some cases of type 2 diabetes can also\u00a0be improved with weight-loss surgery. There is no cure for type 1 diabetes. Treating\u00a0either type 1 diabetes\u00a0or type 2 diabetes involves medicines, diet, and exercise to control blood sugar level. Everyone with diabetes should receive proper education and support about the best ways to manage their diabetes. Ask your provider about seeing a diabetes nurse educator. Getting better control over your blood sugar, cholesterol, and blood pressure levels helps reduce the risk of kidney disease, eye disease, nervous system disease, heart attack, and stroke. To prevent diabetes complications, visit your provider at least 2 to 4 times a year. Talk about any problems you are having. Follow your provider's instructions on managing your diabetes."},{"_answerid":"Q125-S1-A2","_pairid":"316","__text":"The goal of treatment at first is to lower your high blood glucose levels. Long-term goals are to prevent problems from diabetes. The most important way to treat and manage type 2 diabetes is with activity and healthy eating. Everyone with diabetes should receive proper education and support about the best ways to manage their diabetes. Ask your healthcare provider about seeing a diabetes educator. LEARN THESE SKILLS Learning diabetes management skills will help you live well with diabetes. These skills help prevent health problems and the need for medical care. Skills include: - How to test and record your blood glucose - What and when to eat - How to safely increase your activity and control your weight - How to take medications, if needed - How to recognize and treat low and high blood sugar - How to handle sick days - Where to buy diabetes supplies and how to store them It may take several months to learn these skills. Keep learning about diabetes, its complications, and how to control and live well\u00a0with the disease. Stay up-to-date on new research and treatments. MANAGING YOUR BLOOD SUGAR Checking your blood sugar levels yourself and writing down the results tells you how well you are managing your diabetes. Talk to your doctor and diabetes educator about how often to check. To check your blood sugar level, you use a device called a glucose meter. Usually, you prick your finger with a small needle called a lancet. This gives you a tiny drop of blood. You place the blood on a test strip and put the strip into the meter. The meter gives you a reading that tells you the level of your blood sugar. Your doctor or diabetes educator will help set up a testing schedule for you. Your doctor will help you set a target range for your blood sugar numbers. Keep these factors in mind: - Most people with type 2 diabetes only need to check their blood sugar once or twice a day. - If your blood sugar level is under control, you may only need to check it a few times a week. - You may test yourself when you wake up, before meals, and at bedtime. - You may need to test more often when you are sick or under stress. Keep a record of your blood sugar for yourself and your doctor. Based on your numbers, you may need to make changes to your meals, activity, or medicines to keep your blood sugar level in the right range. HEALTHY EATING AND WEIGHT CONTROL Work closely with your doctor, nurse, and dietitian to learn how much fat, protein, and carbohydrates you need in your diet. Your meal plans should fit your lifestyle and habits and should include foods that you like. Managing your weight and having a well-balanced diet are important. Some people with type 2 diabetes can stop taking medicines after losing weight. This does not mean that their diabetes is cured. They still have diabetes. Very obese patients whose diabetes is not well managed with diet and medicine may consider weight loss (bariatric) surgery. REGULAR PHYSICAL ACTIVITY Regular activity is important for everyone. It is even more important when you have diabetes. Exercise is good for your health because it: - Lowers your blood sugar level without medicine - Burns extra calories and fat to help manage your weight - Improves blood flow and blood pressure - Increases your energy level - Improves your ability to handle stress Talk to your doctor before starting any exercise program. People with type 2 diabetes may need to take special steps before, during, and after physical activity or exercise. MEDICATIONS TO TREAT DIABETES If diet and exercise do not help keep your blood sugar at normal or near-normal levels, your doctor may prescribe medication. Since these drugs help lower your blood sugar levels in different ways, your doctor may have you take more than one drug. Some of the most common types of medication are listed below. They are taken by mouth or injection. - Alpha-glucosidase inhibitors - Biguanides - DPP IV inhibitors - Injectable medicines (GLP-1 analogs) - Meglitinides - SGL T2 inhibitors - Sulfonylureas - Thiazolidinediones You may need to take insulin if your blood sugar cannot be controlled with any of the above medicines. Insulin must be injected under the skin using a syringe, insulin pen, or pump. It cannot be taken by mouth because the acid in the stomach destroys insulin. PREVENTING COMPLICATIONS Your doctor may prescribe medicines or other treatments to reduce your chance of developing some of the more common complications of diabetes, including: - Eye disease - Kidney disease - Heart disease and stroke FOOT CARE People with diabetes are more likely than those without diabetes to have foot problems. Diabetes damages the nerves. This can make you less able to feel pressure on the foot. You many not notice a foot injury until you get a severe infection. Diabetes can also damage blood vessels. Small sores or breaks in the skin may become deeper skin sores (ulcers). The affected limb may need to be amputated if these skin ulcers do not heal or become larger, deeper, or infected. To prevent problems with your feet: - Stop smoking if you smoke. - Improve control of your blood sugar. - Get a foot exam by your doctor at least twice a year and learn if you have nerve damage. - Check and care for your feet every day. This is very important when you already have nerve or blood vessel damage or foot problems. - Treat minor infections, such as athlete's foot, right away. - Use moisturizing lotion on dry skin. - Make sure you wear the right kind of shoes. Ask your doctor what type of shoe is right for you."},{"_answerid":"Q125-S1-A3","_pairid":"317","__text":"Diabetes cannot be cured, but it can be managed. Managing blood glucose (blood sugar) as well as blood pressure and cholesterol is the best defense against the serious complications of diabetes. Know What To Do Every Day To manage your diabetes, here are things to do every day. - Take your medicines. - Keep track of your blood glucose (blood sugar). - Check your blood pressure if your doctor advises. - Check your feet. - Brush your teeth and floss. - Stop smoking. - Eat well. - Be active. Take your medicines. Keep track of your blood glucose (blood sugar). Check your blood pressure if your doctor advises. Check your feet. Brush your teeth and floss. Stop smoking. Eat well. Be active. (Watch the video to learn more about what one woman does to manage her diabetes every day. 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.) Take Your Diabetes Medicines People with type 1 diabetes control their blood sugar with insulin -- delivered either by injection or with a pump. Many people with type 2 diabetes can control blood glucose levels with diet and exercise alone. Others require oral medications or insulin, and some may need both, as well as lifestyle modification. Ask your doctor if you need to take aspirin every day to prevent a heart attack or stroke. Keep Track of Your Blood Glucose One of the best ways to find out how well you are taking care of your diabetes is to check your blood to see how much glucose is in it. If your blood has too much or too little glucose, you may need a change in your meal plan, exercise plan, or medication. Ask your doctor how often you should check your blood glucose. Some people check their blood glucose once a day. Others do it three a day or even more. You may be told to check before eating, before bed, and sometimes in the middle of the night. Your doctor or diabetes educator will show you how to check your blood using a blood glucose meter. Your health insurance or Medicare may pay for some of the supplies and equipment you need to check your glucose levels. See what diabetes supplies and services Medicare covers. Check Your Blood Pressure Check your blood pressure if your doctor advises and keep a record of it. You can check your pressure at home with a home blood pressure measurement device or monitor. Blood pressure monitors can be bought at discount chain stores and drug stores. When you are taking your blood pressure at home, sit with your back supported and your feet flat on the floor. Rest your arm on a table at the level of your heart. Check with your health care provider to make sure you are using the monitor correctly. Check Your Feet Foot care is very important for people with diabetes. High blood glucose levels and a reduced blood supply to the limbs cause nerve damage that reduces feeling in the feet. Someone with nerve damage may not feel a pebble inside his or her sock that is causing a sore. Or a blister caused by poorly fitting shoes may go unnoticed. Foot injuries such as these can cause ulcers, which may, if not cared for, ultimately lead to the need for amputation. If you have diabetes, - check your feet every day and watch for any cuts, sores, red spots, swelling, and infected toenails. - report sores, blisters, breaks in the skin, infections, or buildup of calluses to a podiatrist or a family doctor. - never walk barefoot. - have your feet checked at every doctor visit. - take your shoes and socks off when you go into the examining room. This will remind the doctor to check your feet. check your feet every day and watch for any cuts, sores, red spots, swelling, and infected toenails. report sores, blisters, breaks in the skin, infections, or buildup of calluses to a podiatrist or a family doctor. never walk barefoot. have your feet checked at every doctor visit. take your shoes and socks off when you go into the examining room. This will remind the doctor to check your feet. Learn more about taking care of your feet. Brush Your Teeth and Floss People with diabetes can have tooth and gum problems more often if their blood glucose stays high. High blood glucose also can make tooth and gum problems worse. You can even lose your teeth. Here are ways to protect your teeth and gums. - Keep your blood glucose as close to normal as possible. - Use dental floss at least once a day. Flossing helps prevent the buildup of plaque on your teeth. Plaque can harden and grow under your gums and cause problems. Using a sawing motion, gently bring the floss between the teeth, scraping from bottom to top several times. - Brush your teeth after each meal and snack. Use a soft toothbrush. Turn the bristles against the gum line and brush gently. Use small, circular motions. Brush the front, back, and top of each tooth. - If you wear false teeth, keep them clean. - Call your dentist right away if you have problems with your teeth and gums. Keep your blood glucose as close to normal as possible. Use dental floss at least once a day. Flossing helps prevent the buildup of plaque on your teeth. Plaque can harden and grow under your gums and cause problems. Using a sawing motion, gently bring the floss between the teeth, scraping from bottom to top several times. Brush your teeth after each meal and snack. Use a soft toothbrush. Turn the bristles against the gum line and brush gently. Use small, circular motions. Brush the front, back, and top of each tooth. If you wear false teeth, keep them clean. Call your dentist right away if you have problems with your teeth and gums. Learn more about how diabetes can affect your mouth and teeth. Stop Smoking If you smoke, stop. Smoking raises your risk for many diabetes problems, including heart attack and stroke. Ask for help to quit. Call 1-800 QUITNOW (1-800-784-8669). For more information on smoking and older adults, see Quitting Smoking for Older Adults. Eat Well People with diabetes don't need to buy or prepare special foods. The foods that are best for someone with diabetes are excellent choices for everyone: foods that are low in fat, salt, and sugar, and high in fiber, such as beans, fruits, vegetables, and whole grains. These foods help you reach and stay at a weight that's good for your body, keep your blood pressure, glucose and cholesterol in a desirable range, and prevent or delay heart and blood vessel disease. For more on healthy eating, see Small Steps for Eating Healthy Foods. Be Active Try to exercise almost every day for a total of about 30 to 60 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 don\u2019t need to get your exercise in all at one time.) For more information on exercise and older adults, see Exercise: How to Get Started or visit Go4Life\u00ae, the exercise and physical activity campaign for older adults from the National Institute on Aging. Be sure to check with your doctor before starting an exercise program. Other Areas To Manage Here are other areas to manage if you have diabetes. - Take care of your eyes. - Protect your kidneys. - Protect your skin. - Learn how to cope with stress. Take care of your eyes. Protect your kidneys. Protect your skin. Learn how to cope with stress. Take Care of Your Eyes High blood glucose and high blood pressure from diabetes can hurt your eyes. It can even cause blindness, or other painful eye problems. Here are ways to prevent diabetes eye problems. - Keep your blood glucose and blood pressure as close to normal as you can. - Have an eye care professional examine your eyes once a year. Have this exam even if your vision is okay. Keep your blood glucose and blood pressure as close to normal as you can. Have an eye care professional examine your eyes once a year. Have this exam even if your vision is okay. Learn more about eye disease and diabetes. Protect Your Kidneys High blood glucose and high blood pressure may damage the kidneys. Damaged kidneys do not do a good job of filtering out wastes and extra fluid. Here are ways to prevent diabetes kidney problems. - Keep your blood glucose and blood pressure as close to your target goal as you can. - Get tested at least once a year for kidney disease. Ask your doctor if you should be tested. - Follow the healthy eating plan you work out with your doctor or dietitian. If you already have kidney problems, your dietitian may suggest you cut back on protein. Keep your blood glucose and blood pressure as close to your target goal as you can. Get tested at least once a year for kidney disease. Ask your doctor if you should be tested. Follow the healthy eating plan you work out with your doctor or dietitian. If you already have kidney problems, your dietitian may suggest you cut back on protein. Learn more about keeping your kidneys healthy. Protect Your Skin Skin care is very important, too. Because people with diabetes may have more injuries and infections, they should protect their skin by keeping it clean and taking care of minor cuts and bruises. Learn How To Cope With Stress Stress can raise your blood glucose (blood sugar). While it is hard to remove stress from your life, you can learn to handle it. Try deep breathing, gardening, taking a walk, meditating, working on your hobby, or listening to your favorite music."},{"_answerid":"Q125-S1-A4","_pairid":"318","__text":"People with type 1 diabetes control their blood sugar with insulin -- either with shots or an insulin pen. Many people with type 2 diabetes can control blood glucose levels with diet and exercise alone. Others require oral medications or insulin, and some people may need to take both, along with lifestyle modification. (Watch the video to learn how one woman manages her type 2 diabetes. 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.) To manage your diabetes, here are things to do every day. - Take your medicines for diabetes and for any other health problems, even when you feel good. Take your medicines for diabetes and for any other health problems, even when you feel good. - Keep track of your blood glucose (blood sugar). You may want to check it one or more times a day. Be sure to talk about it with your health care team. Keep track of your blood glucose (blood sugar). You may want to check it one or more times a day. Be sure to talk about it with your health care team. - Check your blood pressure if your doctor advises and keep a record of it. Check your blood pressure if your doctor advises and keep a record of it. - Check your feet every day for cuts, blisters, red spots and swelling. Call your health care team right away about any sores that do not go away. Check your feet every day for cuts, blisters, red spots and swelling. Call your health care team right away about any sores that do not go away. - Brush your teeth and floss every day to keep your mouth, teeth and gums healthy. Brush your teeth and floss every day to keep your mouth, teeth and gums healthy. - Stop smoking. Ask for help to quit. Call 1-800 QUIT NOW ( 1-800-784-8669) Stop smoking. Ask for help to quit. Call 1-800 QUIT NOW ( 1-800-784-8669) - Eat well. Ask your doctor to give you the name of someone trained to help you create a healthy eating plan, such as a dietitian. See small steps for eating healthy foods. Eat well. Ask your doctor to give you the name of someone trained to help you create a healthy eating plan, such as a dietitian. See small steps for eating healthy foods. - Be active. Try to exercise almost every day for a total of about 30 minutes. If you haven't exercised lately, begin slowly. To learn more, see Exercise: How To Get Started, or visit Go4Life\u00ae, the exercise and physical activity campaign for older adults from the National Institute on Aging. Be active. Try to exercise almost every day for a total of about 30 minutes. If you haven't exercised lately, begin slowly. To learn more, see Exercise: How To Get Started, or visit Go4Life\u00ae, the exercise and physical activity campaign for older adults from the National Institute on Aging."},{"_answerid":"Q125-S1-A5","_pairid":"319","__text":"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.)"}],"SUB_QUESTION_ID":"Q125-S1","ANNOTATIONS_FOCUS":["diabetes"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"Good day doctor.... My name is [NAME] from Nigeria in West Africa. Please I'll appreciate so much if you will reach me urgently with any advice that can be valuable to a total cure of the diabetes that I came down with since the year 2008... at \"[CONTACT]\" . I'll be eagerly waiting for your response soonest, please.... Thanks for your anticipated corporation. [NAME]","QUESTION_ID":"Q125","F_REF":"1-137108915"} +{"ANSWERS":[{"_answerid":"Q126-S1-A1","_pairid":"321","__text":"Neuropathy is very common. There are many types and causes. Often, no cause can be found. Some nerve diseases run in families. Diabetes is the most common cause of this type of nerve problem. High blood sugar levels over a long time can damage your nerves. Other health conditions that may cause neuropathy are: - Autoimmune disorders, such as rheumatoid arthritis or lupus - Chronic kidney disease - HIV - Liver infections - Low levels of vitamin B12 or other vitamins - Metabolic disease - Poisoning due to heavy metals, such as lead - Poor blood flow to the legs - Underactive thyroid gland Other things that can lead to nerve damage are: - Broken bone that affects a nerve - Long-term, heavy alcohol use - Glue, lead, mercury, and solvent poisoning - Drugs that treat infections, cancer, seizures, and high blood pressure - Pressure on a nerve, such as from carpal tunnel syndrome - Being exposed to cold temperatures for a long period of time - Pressure from bad-fitting casts, splints, a brace, or crutches"}],"SUB_QUESTION_ID":"Q126-S1","ANNOTATIONS_FOCUS":["peripheral neuropathy"],"ANNOTATIONS_TYPE":"cause","SUBJECT":"Causes of Peripheral Neuropathy","MESSAGE":"What information does the National Library of Medicine have that states causes of peripheral neuropathy?","QUESTION_ID":"Q126","F_REF":"1-133002297"} +{"ANSWERS":[{"_answerid":"Q127-S1-A1","_pairid":"323","__text":"Before taking any supplement, talk to a doctor or dietitian. If you take supplements, don't exceed the recommended doses. Some supplements in high amounts can be dangerous, particularly fat-soluble vitamins, such as A, D, E, and K. Here are some special concerns: Vitamin E supplements do not have benefits, though it used to be believed that Vitamin E prevented heart disease. High doses (greater than 400 IU\/day) can have be dangerous."}],"SUB_QUESTION_ID":"Q127-S1","ANNOTATIONS_FOCUS":["hepatitis c","vitamin E"],"ANNOTATIONS_TYPE":"association","SUBJECT":"hepatitis C","MESSAGE":"My doctor advised me to take vitamin E and biletan forte since my protombin time is 70, he told me it's too low. I've been reading about the effects of Vitamin E and one possibility is bleeding. What would you suggest me to do?","QUESTION_ID":"Q127","F_REF":"12574"} +{"ANSWERS":[{"_answerid":"Q128-S1-A1","_pairid":"324","__text":"Summary If you have lupus, your immune system attacks healthy cells and tissues by mistake. This can damage your joints, skin, blood vessels and organs. There are many kinds of lupus. The most common type, systemic lupus erythematosus, affects many parts of the body. Discoid lupus causes a rash that doesn't go away. Subacute cutaneous lupus causes sores after being out in the sun. Another type can be caused by medication. Neonatal lupus, which is rare, affects newborns. Anyone can get lupus, but women are most at risk. Lupus is also more common in African American, Hispanic, Asian and Native American women. The cause of lupus is not known. Lupus has many symptoms. Some common ones are - Joint pain or swelling - Muscle pain - Fever with no known cause - Fatigue - Red rashes, often on the face (also called the \"butterfly rash\") There is no one test to diagnose lupus, and it may take months or years to make the diagnosis. There is no cure for lupus, but medicines and lifestyle changes can help control it. NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases"},{"_answerid":"Q128-S1-A2","_pairid":"326","__text":"Summary If you have lupus, your immune system attacks healthy cells and tissues by mistake. This can damage your joints, skin, blood vessels and organs. There are many kinds of lupus. The most common type, systemic lupus erythematosus, affects many parts of the body. Discoid lupus causes a rash that doesn't go away. Subacute cutaneous lupus causes sores after being out in the sun. Another type can be caused by medication. Neonatal lupus, which is rare, affects newborns. Anyone can get lupus, but women are most at risk. Lupus is also more common in African American, Hispanic, Asian and Native American women. The cause of lupus is not known. Lupus has many symptoms. Some common ones are - Joint pain or swelling - Muscle pain - Fever with no known cause - Fatigue - Red rashes, often on the face (also called the \"butterfly rash\") There is no one test to diagnose lupus, and it may take months or years to make the diagnosis. There is no cure for lupus, but medicines and lifestyle changes can help control it. NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases"}],"SUB_QUESTION_ID":"Q128-S1","ANNOTATIONS_FOCUS":["lupus"],"ANNOTATIONS_TYPE":"information","SUBJECT":"lupus an info on the diseise","MESSAGE":"Need all up date on lupus an send by mail informations on this subject..please i need more information to see if what i am exprienceing is in fact related to lupus ...thank you.","QUESTION_ID":"Q128","F_REF":"1-122785307"} +{"ANSWERS":[{"_answerid":"Q129-S1-A1","_pairid":"328","__text":"Treatment depends on the type of stone and the severity of your symptoms. Kidney stones that are small most often pass through your system on their own. - Your urine should be strained so the stone can be saved and tested. - Drink at least 6 to 8 glasses of water per day to produce a large amount of urine. This will help the stone pass. - Pain can be very bad. Over-the-counter pain medicines (for example, ibuprofen and naproxen), either alone or along with narcotics, can be very effective. Some people with severe pain from kidney stones need to stay in the hospital. You may need to get fluids through a vein. For some types of stones, your provider may prescribe medicine to prevent stones from forming or help break down and remove the material that is causing the stone. These medicines can include: - Allopurinol (for uric acid stones) - Antibiotics (for struvite stones) - Diuretics - Phosphate solutions - Sodium bicarbonate or sodium citrate - Water pills (thiazide diuretics) - Tamsulosin to relax the ureter and help the stone pass Surgery is often needed if: - The stone is too large to pass on its own - The stone is growing - The stone is blocking urine flow and causing an infection or kidney damage - The pain cannot be controlled Today, most treatments are much less invasive than in the past. - Lithotripsy is used to remove stones slightly smaller than a half an inch that are located in the kidney or ureter. It uses sound or shock waves to break up stones. Then, the stone fragments leave the body in the urine. It is also called extracorporeal shock-wave lithotripsy or ESWL. - Procedures performed by passing a special instrument through a small surgical cut in your skin and into your kidney or ureters are used for large stones, or when the kidneys or surrounding areas are incorrectly formed. The stone is removed with a tube (endoscope). - Ureteroscopy may be used for stones in the lower urinary tract. - Rarely, open surgery (nephrolithotomy) may be needed if other methods do not work or are not possible. Talk to your provider about what treatment options may work for you."}],"SUB_QUESTION_ID":"Q129-S1","ANNOTATIONS_FOCUS":["kidney stone"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"Kidney Stone","MESSAGE":"Hello Dr.,In a case of patient with Kidney Stone size of 1.2mm x 2.3mm. What can i do? Pls i need your advice.","QUESTION_ID":"Q129","F_REF":"1-118342705"} +{"ANSWERS":[{"_answerid":"Q130-S1-A1","_pairid":"329","__text":"The risk of sepsis can be reduced by getting all recommended vaccines. In the hospital, careful hand washing can help prevent infections that lead to sepsis. Prompt removal of urinary catheters and IV lines when they are no longer needed can also help prevent infections that lead to sepsis."}],"SUB_QUESTION_ID":"Q130-S1","ANNOTATIONS_FOCUS":["sepsis"],"ANNOTATIONS_TYPE":"prevention","SUBJECT":"","MESSAGE":"sepsis. Can sepsis be prevented. Can someone get this from a hospital?","QUESTION_ID":"Q130","F_REF":"5507"} +{"ANSWERS":[{"_answerid":"Q131-S1-A1","_pairid":"330","__text":"LIFESTYLE CHANGES The condition that causes ascites will be treated, if possible. Treatments for fluid build-up may include lifestyle changes: - Avoiding alcohol - Lowering salt in your diet (no more than 1,500 mg\/day of sodium) - Limiting fluid intake You may also get medicines from your doctor, including: - \"Water pills\" (diuretics) to get rid of extra fluid - Antibiotics for infections Other things you can do to help take care of your liver disease are: - Get vaccinated for diseases such as influenza, hepatitis A and hepatitis B, and pneumococcal pneumonia - Talk to your doctor about all medicines you take, including herbs and supplements and over-the-counter medicines Procedures that you may have are: - Inserting a needle into the belly to remove large volumes of fluid (called a paracentesis) - Placing a special tube or shunt inside your liver (TIPS) to repair blood flow to the liver People with end-stage liver disease may need a liver transplant."}],"SUB_QUESTION_ID":"Q131-S1","ANNOTATIONS_FOCUS":["ascites"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"Please help me","MESSAGE":"I have been dealing with undiagnosed issues. It started 3 years ago as nausea and dull achy pain. Doctors decided to remove my gallbladder, even though it only had scarring. Since the surgery ([DATE]) I have had a sharp, stabbing random pain in that area and around it. I also get dull, crampy pain. Finally, the surgeon ordered a CT scan because the pain is so bad. His nurse called and said everything was fine. So I went to my primary, who noticed that I have ascites on my liver. My side is slightly bloated, was not before. And I am scared because I don't know what I'm supposed to do. No one will help me and I do not want to be on pain meds my whole life. Please let me know your thoughts or guide me in the direction I need, please. I live in south carolina, i dont know why when I made my email it had the co.uk","QUESTION_ID":"Q131","F_REF":"12281"} +{"ANSWERS":[{"_answerid":"Q132-S1-A1","_pairid":"331","__text":"Letrozole is used treat early breast cancer in women who have experienced menopause (change of life; end of monthly menstrual periods) and who have had other treatments, such as radiation or surgery to remove the tumor. It is also used to treat early breast cancer in women who have experienced menopause and who have already been treated with a medication called tamoxifen (Nolvadex) for 5 years. Letrozole is also used in women who have experienced menopause as a first treatment of breast cancer that has spread within the breast or to other areas of the body or in women whose breast cancer has worsened while they were taking tamoxifen. Letrozole is in a class of medications called nonsteroidal aromatase inhibitors. It works by decreasing the amount of estrogen produced by the body. This can slow or stop the growth of some types of breast cancer cells that need estrogen to grow."}],"SUB_QUESTION_ID":"Q132-S1","ANNOTATIONS_FOCUS":["Letrozole"],"ANNOTATIONS_TYPE":"indication","SUBJECT":"Letrozole","MESSAGE":"Since taking Letrozole the last 4.6 months, I now have a 4 cm. csyst in front of my right ovary that must be removed. Why am I prescribed a drug that is also prescribed for young women trying to conceive. I am post menopausal and had early stage breast cancer in 2010. Now, that I am ending my 5 year run with this drug, I have adverse affects with a cysts. Is a cysts an egg that was not fertilized from the Follupian Tubes. I cannot understand this logic of giving me this drug?","QUESTION_ID":"Q132","F_REF":"1-135048025"} +{"ANSWERS":[{"_answerid":"Q133-S1-A1","_pairid":"332","__text":"Ochoa syndrome is a disorder characterized by urinary problems and unusual facial expressions. The urinary problems associated with Ochoa syndrome typically become apparent in early childhood or adolescence. People with this disorder may have difficulty controlling the flow of urine (incontinence), which can lead to bedwetting. Individuals with Ochoa syndrome may be unable to completely empty the bladder, often resulting in vesicoureteral reflux, a condition in which urine backs up into the ducts that normally carry it from each kidney to the bladder (the ureters). Urine may also accumulate in the kidneys (hydronephrosis). Vesicoureteral reflux and hydronephrosis can lead to frequent infections of the urinary tract and kidney inflammation (pyelonephritis), causing damage that may eventually result in kidney failure. Individuals with Ochoa syndrome also exhibit a characteristic frown-like facial grimace when they try to smile or laugh, often described as inversion of facial expression. While this feature may appear earlier than the urinary tract symptoms, perhaps as early as an infant begins to smile, it is often not brought to medical attention. Approximately two-thirds of individuals with Ochoa syndrome also experience problems with bowel function, such as constipation, loss of bowel control, or muscle spasms of the anus."}],"SUB_QUESTION_ID":"Q133-S1","ANNOTATIONS_FOCUS":["ochoa syndrome"],"ANNOTATIONS_TYPE":"information","SUBJECT":"Ochoa syndrome","MESSAGE":"Where could I find more information about the rare disease, Ochoa syndrome. I think a sibling of mine might have it.","QUESTION_ID":"Q133","F_REF":"1-135386347"} +{"ANSWERS":[{"_answerid":"Q134-S1-A1","_pairid":"333","__text":"Jock itch usually responds to self-care within a couple of weeks: - Keep the skin clean and dry in the groin area. - Do not wear clothing that rubs and irritates the area. Wear loose-fitting underwear. - Wash athletic supporters frequently. - Over-the-counter antifungal or drying powders can help control the infection. These contain medicine, such as miconazole, clotrimazole, terbinafine, or tolnaftate. You may need treatment by a provider if your infection lasts longer than 2 weeks, is severe, or frequently returns.\u00a0The provider may prescribe: - Stronger topical (applied to the skin) antifungal medicines or oral antifungal\u00a0medicines - Antibiotics may be needed to treat bacterial infections that occur from scratching the area If you tend to get jock itch, continue to apply antifungal or drying powders after bathing, even when you do not have jock itch."}],"SUB_QUESTION_ID":"Q134-S1","ANNOTATIONS_FOCUS":["jock itch"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"ClinicalTrials.gov - Question - specific study","MESSAGE":"My name is [NAME] and I am 76 years old. I have had jock itch (just itch no rash) for 7 years. When I try to stop the itch comes back with a vengeance. I am currently using Ketoconazole 2% cream to control the itch. It appears that I am doomed to no cure but I hope I may be wrong.","QUESTION_ID":"Q134","F_REF":"1-133036745"} +{"ANSWERS":[{"_answerid":"Q135-S1-A1","_pairid":"334","__text":"The results show a lower than expected prevalence of PTSD among IBS patients, which is similar to that of the general population. Thus, we did not find that PTSD is over-represented in a sample population of IBS patients."}],"SUB_QUESTION_ID":"Q135-S1","ANNOTATIONS_FOCUS":["ibs","PTSD"],"ANNOTATIONS_TYPE":"association","SUBJECT":"PTSD and IBS","MESSAGE":"I am looking for research on IBS and the link to PTSD. Thank you","QUESTION_ID":"Q135","F_REF":"16563"} +{"ANSWERS":[{"_answerid":"Q136-S1-A1","_pairid":"338","__text":"A health care provider may use several tests and exams to diagnose Whipple disease, including the following: medical and family history physical exam blood tests upper GI endoscopy and enteroscopy A patient may be referred to a gastroenterologist\u2014a doctor who specializes in digestive diseases. A health care provider may first try to rule out more common conditions with similar symptoms, including inflammatory rheumatic disease\u2014characterized by inflammation and loss of function in one or more connecting or supporting structures of the body. celiac disease\u2014a digestive disease that damages the small intestine and interferes with the absorption of nutrients from food. People who have celiac disease cannot tolerate gluten, a protein in wheat, rye, and barley. neurologic diseases\u2014disorders of the central nervous system. intra-abdominal lymphoma\u2014abdominal cancer in part of the immune system called the lymphatic system. Mycobacterium avium complex\u2014an infection that affects people with AIDS."}],"SUB_QUESTION_ID":"Q136-S1","ANNOTATIONS_FOCUS":["whipple's disease"],"ANNOTATIONS_TYPE":"diagnosis","SUBJECT":"Whipple's Disease","MESSAGE":"Your information about Whipple's Disease says that it is fatal if left untreated, but there is no information about HOW LONG a person can have it. I have been sick for 6 years and am having no luck getting a diagnosis, and it would be most helpful in ruling things out if I knew whether or not a particular illness would kill a person within a shorter time period than 6 years. Thank you.","QUESTION_ID":"Q136","F_REF":"NF_208"} +{"ANSWERS":[{"_answerid":"Q136-S2-A1","_pairid":"339","__text":"Without treatment, the condition is most often fatal. Treatment relieves symptoms and can cure the disease."}],"SUB_QUESTION_ID":"Q136-S2","ANNOTATIONS_FOCUS":["whipple's disease"],"ANNOTATIONS_TYPE":"prognosis","SUBJECT":"Whipple's Disease","MESSAGE":"Your information about Whipple's Disease says that it is fatal if left untreated, but there is no information about HOW LONG a person can have it. I have been sick for 6 years and am having no luck getting a diagnosis, and it would be most helpful in ruling things out if I knew whether or not a particular illness would kill a person within a shorter time period than 6 years. Thank you.","QUESTION_ID":"Q136","F_REF":"NF_208"} +{"ANSWERS":[{"_answerid":"Q137-S1-A1","_pairid":"341","__text":"Damage from optic nerve atrophy cannot be reversed. The underlying disease must be found and treated. Otherwise, vision loss will continue. Rarely, conditions that lead to optic atrophy may be treatable."}],"SUB_QUESTION_ID":"Q137-S1","ANNOTATIONS_FOCUS":["optic nerve atrophy"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"Treatment for optic nerve atrophy. Hello Name's case :[NAME] Sex : Male Date of Birth : 1964 Nationality : Libyan Diagnosis : optic nerve atrophy . i am suffering from optic atrophy, which led to loss of vision and inability to see, I suffer from this case from 1998 saluting suffered a fall on the head, which led to began this case even lost look, and have been performed process surgery in [LOCATION] in 1998-1999 . And then in 2009 cured by reactive optic nerve by Russian Professor . i want know you hospital have treatment for optic nerve atrophy , and what this treatment i need more information about treatment of optic nerve because now 16 years old I can not vision, and I wish could belive hope for treatment of my case. And i want know the cost of treatment . Thank you Regards \/ [NAME]","QUESTION_ID":"Q137","F_REF":"10847"} +{"ANSWERS":[{"_answerid":"Q137-S2-A1","_pairid":"342","__text":"Vision lost to optic nerve atrophy cannot be recovered. It is very important to protect the other eye."}],"SUB_QUESTION_ID":"Q137-S2","ANNOTATIONS_FOCUS":["optic nerve atrophy"],"ANNOTATIONS_TYPE":"prognosis","SUBJECT":"","MESSAGE":"Treatment for optic nerve atrophy. Hello Name's case :[NAME] Sex : Male Date of Birth : 1964 Nationality : Libyan Diagnosis : optic nerve atrophy . i am suffering from optic atrophy, which led to loss of vision and inability to see, I suffer from this case from 1998 saluting suffered a fall on the head, which led to began this case even lost look, and have been performed process surgery in [LOCATION] in 1998-1999 . And then in 2009 cured by reactive optic nerve by Russian Professor . i want know you hospital have treatment for optic nerve atrophy , and what this treatment i need more information about treatment of optic nerve because now 16 years old I can not vision, and I wish could belive hope for treatment of my case. And i want know the cost of treatment . Thank you Regards \/ [NAME]","QUESTION_ID":"Q137","F_REF":"10847"} +{"ANSWERS":[{"_answerid":"Q138-S1-A1","_pairid":"343","__text":"Signs of mild to moderate dehydration: - Thirst - Dry or sticky mouth - Not urinating much - Darker yellow urine - Dry, cool skin - Headache - Muscle cramps Signs of severe dehydration: - Not urinating, or very dark yellow or amber-colored urine - Dry, shriveled skin - Irritability or confusion - Dizziness or light-headedness - Rapid heartbeat - Rapid breathing - Sunken eyes - Listlessness - Shock (not enough blood flow through the body) - Unconsciousness or delirium"}],"SUB_QUESTION_ID":"Q138-S1","ANNOTATIONS_FOCUS":["dehydration"],"ANNOTATIONS_TYPE":"symptom","SUBJECT":"symptoms of dehydration","MESSAGE":"When a person is very dehydrated do they sometimes get a tight pain in their chest (right below the breasts) right before they faint\/pass out?","QUESTION_ID":"Q138","F_REF":"1-122992425"} +{"ANSWERS":[{"_answerid":"Q139-S1-A1","_pairid":"344","__text":"An insulinoma is a tumor in the pancreas that produces too much insulin."}],"SUB_QUESTION_ID":"Q139-S1","ANNOTATIONS_FOCUS":["insulinoma"],"ANNOTATIONS_TYPE":"information","SUBJECT":"","MESSAGE":"Name: [NAME] Date and Time of Contact: Thu, 1 Jan 2015 16:10:06 GMT Application: myncbi SessionId: CE9069DE4A56A0A1_0093SID MyNCBI UserName: Host: portal205 Snapshot: \/projects\/MyNCBI\/myncbiPortal@2.45 Browser's user agent header: Mozilla\/4.0 (compatible; MSIE 8.0; Windows NT 6.1; WOW64; Trident\/4.0; SLCC2; .NET CLR 2.0.50727; .NET CLR 3.5.30729; .NET CLR 3.0.30729; Media Center PC 6.0; InfoPath.2) Application Page Generation Time: 2015-01-01T11:03:27-05:00 Page: recentactivity Message Body: We live in [LOCATION] and my husband has been detected an insulinoma.Need further information on the matter as doctors have not seen one here. Greatly appreciate your reply. Happy New Year to you all and many many tahanks for your help.","QUESTION_ID":"Q139","F_REF":"1-130899901"} +{"ANSWERS":[{"_answerid":"Q140-S1-A1","_pairid":"345","__text":"Because chickenpox is airborne and spreads very easily even before the rash appears, it is hard to avoid. A vaccine to prevent chickenpox is part of a child's routine vaccine schedule. The vaccine often prevents the chickenpox disease completely or makes the illness very mild. Talk to your provider if you think your child might be at high risk for complications and might have been exposed. Taking preventive steps right away may be important. Giving the vaccine early after exposure may still reduce the severity of the disease."}],"SUB_QUESTION_ID":"Q140-S1","ANNOTATIONS_FOCUS":["chickenpox"],"ANNOTATIONS_TYPE":"prevention","SUBJECT":"chickenpox","MESSAGE":"I do not know if I had chickenpox. Is there a blood test available to tell me ? And if not which vaccine should I get, if any ?","QUESTION_ID":"Q140","F_REF":"NF_73"} +{"ANSWERS":[{"_answerid":"Q141-S1-A1","_pairid":"346","__text":"Keloids often do not need treatment. If the keloid bothers you, these things can be done to reduce the size: - Corticosteroid injections - Freezing (cryotherapy) - Laser treatments - Radiation - Surgical removal - Silicone gel or patches Sometimes these treatments cause the keloid scar to become larger."}],"SUB_QUESTION_ID":"Q141-S1","ANNOTATIONS_FOCUS":["keloids"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"Does either of these help with skin keloids? What would help keloids?","QUESTION_ID":"Q141","F_REF":"12317"} +{"ANSWERS":[{"_answerid":"Q142-S1-A1","_pairid":"347","__text":"RA most often requires lifelong treatment, including medicines, physical therapy, exercise, education, and possibly surgery. Early, aggressive treatment for RA can with newer drug categories can be very helpful slowing joint destruction and preventing deformities. MEDICINES Disease modifying antirheumatic drugs (DMARDs): These are often the drugs that are tried first in people with RA. They are prescribed along with rest, strengthening exercise, and anti-inflammatory drugs. - Methotrexate (Rheumatrex) is the most commonly used DMARD for rheumatoid arthritis. Leflunomide (Arava) and hydroxychloroquine may also be used. - Sulfasalazine is an anti-inflammatory drug that is often combined with methotrexate and hydroxychloroquine (triple therapy). - These drugs may have serious side effects, so you will need frequent blood tests when taking them. Anti-inflammatory medications: These include aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen. - Although NSAIDs work well, long-term use can cause stomach problems, including ulcers and bleeding, and possible heart problems. - Celecoxib (Celebrex) is another anti-inflammatory drug. Drugs in this class (COX-2 inhibitors) may increase heart attack and stroke risk for some people. Talk to your doctor about whether these medicines are right for you. Antimalarial medications: This group of medicines includes hydroxychloroquine (Plaquenil). They are most often used along with methotrexate. It may be weeks or months before you see any benefit from these drugs. Corticosteroids: These medicines work very well to reduce joint swelling and inflammation, but they can have long-term side effects. Therefore, they should be taken only for a short time and in low doses when possible. Biologic agents: These drugs are designed to affect parts of the immune system that play a role in the disease process of rheumatoid arthritis. They may be given when other medicines for rheumatoid arthritis have not worked. Sometimes biologic drugs are started sooner, along with other rheumatoid arthritis drugs. Most of them are given either under the skin (subcutaneously) or into a vein (intravenously). There are different types of biologic agents: - White blood cell modulators include: abatacept (Orencia) and rituximab (Rituxan) - Tumor necrosis factor (TNF) inhibitors include: adalimumab (Humira), etanercept (Enbrel), infliximab (Remicade), golimumab (Simponi), and certolizumab (Cimzia) - Interleukin-6 (IL-6) inhibitors: tocilizumab (Actemra) Biologic agents can be very helpful in treating rheumatoid arthritis. However, people taking these drugs must be watched very closely because of serious risk factors: - Infections from bacteria, viruses, and fungi - Leukemia or lymphoma - Psoriasis - Allergic reactions Other drugs: - Janus kinase inhibitor: Tofacitinib (Xeljanz). This is a medicine taken by mouth that is now approved for treating RA. SURGERY Surgery may be needed to correct severely damaged joints. Surgery may include: - Removal of the joint lining (synovectomy) - Total joint replacement in extreme cases; may include total knee, hip replacement, ankle replacement, shoulder replacement, and others PHYSICAL THERAPY Range-of-motion exercises and exercise programs prescribed by a physical therapist can delay the loss of joint function and help keep muscles strong. Sometimes, therapists will use special machines to apply deep heat or electrical stimulation to reduce pain and improve joint movement. Other therapies that may help ease joint pain include: - Joint protection techniques - Heat and cold treatments - Splints or orthotic devices to support and align joints - Frequent rest periods between activities, as well as 8 to 10 hours of sleep per night NUTRITION Some people with RA may have intolerance or allergies to certain foods. A balanced nutritious diet is recommended. It may be helpful to eat foods rich in fish oils (omega-3 fatty acids). Smoking cigarettes should be stopped. Excessive alcohol should also be avoided."},{"_answerid":"Q142-S1-A2","_pairid":"348","__text":"These resources address the diagnosis or management of rheumatoid arthritis: - American College of Rheumatology: ACR-Endorsed Criteria for Rheumatic Diseases - American College of Rheumatology: Treatment for Rheumatic Diseases - Genetic Testing Registry: Rheumatoid arthritis These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"},{"_answerid":"Q142-S1-A3","_pairid":"349","__text":"Most Symptoms Are Treatable Doctors use a variety of approaches to treat rheumatoid arthritis. The goals of treatment are to help relieve pain, reduce swelling, slow down or help prevent joint damage, increase the ability to function, and improve the sense of well-being. Current treatment approaches include - lifestyle modification - medications - surgery - routine monitoring and ongoing care. lifestyle modification medications surgery routine monitoring and ongoing care. Balance Rest and Exercise People with rheumatoid arthritis need a good balance between rest and exercise; they should rest more when the disease is active and exercise more when it is not. Rest helps to reduce active joint inflammation and pain and to fight fatigue. The length of time for rest will vary from person to person, but in general, shorter rest breaks every now and then are more helpful than long times spent in bed. Exercise is important for maintaining healthy and strong muscles, preserving joint mobility, and maintaining flexibility. Exercise can also help people sleep well, reduce pain, maintain a positive attitude, and manage weight. Exercise programs should take into account the person\u2019s physical abilities, limitations, and changing needs. Learn more about the health benefits of exercise for older adults. More information about exercise and physical activity for older adults can be found at Go4Life\u00ae, the exercise and physical activity campaign from the National Institute on Aging. Reduce Stress People with rheumatoid arthritis face emotional challenges as well as physical ones. The emotions they feel because of the disease\u2014fear, anger, and frustration\u2014combined with any pain and physical limitations can increase their stress level. Finding ways to reduce stress is important. Regular rest periods can help and so can relaxation, distraction, or visualization exercises. Exercise programs, participation in support groups, and good communication with the health care team are other ways to reduce stress. For more information on exercise classes, you may want to contact the Arthritis Foundation at 1-800-283-7800. Learn about relaxation techniques that may relieve tension. Eat a Healthful Diet Special diets, vitamin supplements, and other alternative approaches have been suggested for treating rheumatoid arthritis. Although such approaches may not be harmful, scientific studies have not yet shown any benefits. Special diets, vitamin supplements, and other alternative approaches have been suggested for treating rheumatoid arthritis. Although such approaches may not be harmful, scientific studies have not yet shown any benefits. See Eating Well as You Get Older for more about healthy eating. Reduce Stress on Joints Some people find using a splint for a short time around a painful joint reduces pain and swelling by supporting the joint and letting it rest. Splints are used mostly on wrists and hands, but also on ankles and feet. A doctor or a physical or occupational therapist can help a person choose a splint and make sure it fits properly. Other ways to reduce stress on joints include - self-help devices (for example, zipper pullers, long-handled shoe horns) - devices to help with getting on and off chairs, toilet seats, and beds - changes in the ways that a person carries out daily activities. self-help devices (for example, zipper pullers, long-handled shoe horns) devices to help with getting on and off chairs, toilet seats, and beds changes in the ways that a person carries out daily activities. Medications Most people who have rheumatoid arthritis take medications. Some drugs only provide relief for pain; others reduce inflammation. Still others, called disease-modifying anti-rheumatic drugs or DMARDs, can often slow the course of the disease. - DMARDs include methotrexate, leflunomide, sulfasalazine, and cyclosporine. DMARDs include methotrexate, leflunomide, sulfasalazine, and cyclosporine. - Steroids, which are also called corticosteroids, are another type of drug used to reduce inflammation for people with rheumatoid arthritis. Cortisone, hydrocortisone, and prednisone are some commonly used steroids. Steroids, which are also called corticosteroids, are another type of drug used to reduce inflammation for people with rheumatoid arthritis. Cortisone, hydrocortisone, and prednisone are some commonly used steroids. - DMARDS called biologic response modifiers also can help reduce joint damage. These drugs include etanercept, infliximab, anakinra, golimumab, adalimumab, rituximab, and abatacept. DMARDS called biologic response modifiers also can help reduce joint damage. These drugs include etanercept, infliximab, anakinra, golimumab, adalimumab, rituximab, and abatacept. - Another DMARD, tofacitinib, from a new class of drugs called jak kinase (JAK) inhibitors is also available. Another DMARD, tofacitinib, from a new class of drugs called jak kinase (JAK) inhibitors is also available. Early treatment with powerful drugs and drug combinations -- including biologic response modifiers and DMARDs -- instead of single drugs may help prevent the disease from progressing and greatly reduce joint damage. Surgery In some cases, a doctor will recommend surgery to restore function or relieve pain in a damaged joint. Surgery may also improve a person's ability to perform daily activities. Joint replacement and tendon reconstruction are two types of surgery available to patients with severe joint damage. Routine Monitoring and Ongoing Care Regular medical care is important to monitor the course of the disease, determine the effectiveness and any negative effects of medications, and change therapies as needed. Monitoring typically includes regular visits to the doctor. It also may include blood, urine, and other laboratory tests and x rays. Monitor Osteoporosis Risk People with rheumatoid arthritis may want to discuss preventing osteoporosis with their doctors as part of their long-term, ongoing care. Osteoporosis is a condition in which bones become weakened and fragile. Having rheumatoid arthritis increases the risk of developing osteoporosis for both men and women, particularly if a person takes corticosteroids. Such patients may want to discuss with their doctors the potential benefits of calcium and vitamin D supplements or other treatments for osteoporosis. See What is Osteoporosis? to learn more about this disease."},{"_answerid":"Q142-S1-A4","_pairid":"350","__text":"Medication, exercise, and, in some cases, surgery are common treatments for this disease. Most people who have rheumatoid arthritis take medications. Some drugs only provide relief for pain; others reduce inflammation. People with rheumatoid arthritis can also benefit from exercise, but they need to maintain a good balance between rest and exercise. They should get rest when the disease is active and get more exercise when it is not. In some cases, a doctor will recommend surgery to restore function or relieve pain in a damaged joint. Several types of surgery are available to patients with severe joint damage. Joint replacement and tendon reconstruction are examples."},{"_answerid":"Q142-S1-A5","_pairid":"351","__text":"Most people who have rheumatoid arthritis take medications. Some drugs only provide relief for pain; others reduce inflammation. Still others, called disease-modifying anti-rheumatic drugs or DMARDs, can often slow the course of the disease. - DMARDs include methotrexate, leflunomide, sulfasalazine, and cyclosporine. - Steroids, which are also called corticosteroids, are another type of drug used to reduce inflammation for people with rheumatoid arthritis. Cortisone, hydrocortisone, and prednisone are some commonly used steroids. - DMARDs called biological response modifiers also can help reduce joint damage. These drugs include etanercept, infliximab, and anakinra. - Another DMARD, tofacitinib, from a new class of drugs called jak kinase (JAK) inhibitors is also available. DMARDs include methotrexate, leflunomide, sulfasalazine, and cyclosporine. Steroids, which are also called corticosteroids, are another type of drug used to reduce inflammation for people with rheumatoid arthritis. Cortisone, hydrocortisone, and prednisone are some commonly used steroids. DMARDs called biological response modifiers also can help reduce joint damage. These drugs include etanercept, infliximab, and anakinra. Another DMARD, tofacitinib, from a new class of drugs called jak kinase (JAK) inhibitors is also available. Early treatment with powerful drugs and drug combinations -- including biological response modifiers and DMARDs -- instead of single drugs may help prevent the disease from progressing and greatly reduce joint damage."}],"SUB_QUESTION_ID":"Q142-S1","ANNOTATIONS_FOCUS":["rheumatoid arthritis"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"Rheumatoid arthritis","MESSAGE":"Dear Sir- my wife is suffering from subject since last couples of years, and recently diagnose that she is effected with subject. therefore i need your kind support for treatment and percussion step. awaiting your kind reply and action. thanks and best Regards","QUESTION_ID":"Q142","F_REF":"1-132341725"} +{"ANSWERS":[{"_answerid":"Q143-S1-A1","_pairid":"352","__text":"Treatment for adenocarcinoma\u00a0depends on the stage of the tumor. Surgery may be done if the tumor has not spread or has spread very little. Along with surgery, chemotherapy or radiation therapy or both may be used before or after surgery. A small number of people can be cured with this treatment approach. When the tumor has not spread out of the pancreas but cannot be surgically removed, chemotherapy and radiation therapy together may be recommended. When the tumor has spread (metastasized) to other organs such as the liver, chemotherapy alone is usually used. With advanced cancer, the goal of treatment is to\u00a0manage pain and other symptoms. For example, if the tube that carries bile is blocked by the pancreatic tumor, a procedure to place a tiny metal tube (stent) may be done to open the blockage. This can help relieve loss of appetite, jaundice, and itching of the skin."}],"SUB_QUESTION_ID":"Q143-S1","ANNOTATIONS_FOCUS":["pancreatic cancer"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"ClinicalTrials.gov - Question - general information","MESSAGE":"Dear Sir. I am [NAME] from India gujarat state. My father is 61 years older suffering with Pancreatic cancer and it's in 3\/4 Rd stage. All doctors are help less for us as they told my father can't leave more then 4 months. . I want to take your suggestions and help for my father's Pancreatic cancer. I want to save my father's life . If any type of treatment is available then please help me. Please contact me on my below mobile no. [CONTACT]","QUESTION_ID":"Q143","F_REF":"17991"} +{"ANSWERS":[{"_answerid":"Q144-S1-A1","_pairid":"354","__text":"Summary Osteoporosis makes your bones weak and more likely to break. Anyone can develop osteoporosis, but it is common in older women. As many as half of all women and a quarter of men older than 50 will break a bone due to osteoporosis. Risk factors include - Getting older - Being small and thin - Having a family history of osteoporosis - Taking certain medicines - Being a white or Asian woman - Having osteopenia, which is low bone density Osteoporosis is a silent disease. You might not know you have it until you break a bone. A bone mineral density test is the best way to check your bone health. To keep bones strong, eat a diet rich in calcium and vitamin D, exercise and do not smoke. If needed, medicines can also help. NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases"},{"_answerid":"Q144-S1-A2","_pairid":"355","__text":"A Bone Disease Osteoporosis is a disease that thins and weakens the bones to the point that they become fragile and break easily. Women and men with osteoporosis most often break bones in the hip, spine, and wrist, but any bone can be affected. You can't \"catch\" osteoporosis or give it to someone else. In the United States, more than 53 million people either already have osteoporosis or are at high risk due to low bone mass, placing them at risk for more serious bone loss and fractures. Although osteoporosis can strike at any age, it is most common among older people, especially older women. How Bone Loss Occurs Bone is living tissue. Throughout our lives, the body breaks down old bone and replaces it with new bone. But as people age, more bone is broken down than is replaced. The inside of a bone normally looks like a honeycomb, but when a person has osteoporosis, the spaces inside this honeycomb become larger, reflecting the loss of bone density and strength. (The word \"osteoporosis\" means \"porous bone.\") The outside of long bones -- called the cortex -- also thins, further weakening the bone. Sometime around the age of 30, bone mass stops increasing, and the goal for bone health is to keep as much bone as possible for as long as you can. In most women, the rate of bone loss increases for several years after menopause, then slows down again, but continues. In men, the bone loss occurs more slowly. But by age 65 or 70, most men and women are losing bone at the same rate. Weak Bones Can Lead to Fractures Osteoporosis is often called \"silent\" because bone loss occurs without symptoms. People may not know that they have osteoporosis until a sudden strain, bump, or fall causes a bone to break. This can result in a trip to the hospital, surgery, and possibly a long-term disabling condition. Broken bones in your spine are painful and very slow to heal. People with weak bones in their spine gradually lose height and their posture becomes hunched over. Over time a bent spine can make it hard to walk or even sit up. Broken hips are a very serious problem as we age. They greatly increase the risk of death, especially during the year after they break. People who break a hip might not recover for months or even years. Because they often cannot care for themselves, they are more likely to have to live in a nursing home. Prevention and Treatment The good news is that osteoporosis can often be prevented and treated. Healthy lifestyle choices such as proper diet, exercise, and treatment medications can help prevent further bone loss and reduce the risk of fractures."},{"_answerid":"Q144-S1-A3","_pairid":"356","__text":"Scientists are pursuing a wide range of basic and clinical studies on osteoporosis. Significant advances in preventing and treating osteoporosis continue to be made. Such advances are the direct result of research focused on - determining the causes and consequences of bone loss at the cellular and tissue levels - assessing risk factors - developing new strategies to maintain and even enhance bone density and reduce fracture risk - exploring the roles of such factors as genetics, hormones, calcium, vitamin D, drugs, and exercise on bone mass. determining the causes and consequences of bone loss at the cellular and tissue levels assessing risk factors developing new strategies to maintain and even enhance bone density and reduce fracture risk exploring the roles of such factors as genetics, hormones, calcium, vitamin D, drugs, and exercise on bone mass. Get more information about ongoing research on osteoporosis from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) at NIH."},{"_answerid":"Q144-S1-A4","_pairid":"357","__text":"Osteoporosis is a disease that thins and weakens the bones to the point that they break easily. Women and men with osteoporosis most often break bones in the hip, spine, and wrist, but osteoporosis can be the cause of bone fractures anywhere."}],"SUB_QUESTION_ID":"Q144-S1","ANNOTATIONS_FOCUS":["osteoporosis"],"ANNOTATIONS_TYPE":"information","SUBJECT":"","MESSAGE":"printed materials on osteoporosis. Is there any way you can please mail me literature on osteoporosis, I was just diagnosed. Thank you, [NAME] [LOCATION] [LOCATION] [LOCATION] [LOCATION]","QUESTION_ID":"Q144","F_REF":"11719"} +{"ANSWERS":[{"_answerid":"Q145-S1-A1","_pairid":"368","__text":"Tests you may have include: - Blood tests to measure hormone levels - MRI of the head to rule out other pituitary problems, such as a tumor"},{"_answerid":"Q145-S1-A2","_pairid":"369","__text":"Diagnosis of Sheehan syndrome can be difficult. The diagnosis is based on clinical evidence of hypopituitarism in a woman with a history of severe postpartum bleeding. Blood tests to measure hormone levels and CT scan of the head (to rule out other pituitary problems such as a tumor) may help to confirm the diagnosis."}],"SUB_QUESTION_ID":"Q145-S1","ANNOTATIONS_FOCUS":["sheehans syndrome"],"ANNOTATIONS_TYPE":"diagnosis","SUBJECT":"Sheehan's Syndrome","MESSAGE":"I was diagnosed with sheehans syndrome almost 14 years after almost dying after the birth of my daughter. My blood level fell to 1.3 I had a partial hysterectomy following the birth. I recently had my thyroid removed after diagnosis of cancer and was told that I am post menopause, I am only 39 years old. Do you have any information regarding diagnosis and misdiagnosis. What should the medical care have done to identify the syndrome?","QUESTION_ID":"Q145","F_REF":"12520"} +{"ANSWERS":[{"_answerid":"Q146-S1-A1","_pairid":"372","__text":"The capsule of the shoulder joint has ligaments that hold the shoulder bones to each other. When the capsule becomes inflamed, the shoulder bones are unable to move freely in the joint. Most of the time, there is no cause for frozen shoulder. Risk factors include: - Diabetes - Thyroid problems - Changes in your hormones, such as during menopause - Shoulder injury - Shoulder surgery - Open heart surgery - Cervical disk disease of the neck"}],"SUB_QUESTION_ID":"Q146-S1","ANNOTATIONS_FOCUS":["frozen shoulder"],"ANNOTATIONS_TYPE":"cause","SUBJECT":"frozen shoulder","MESSAGE":"We have 14 siblings in our family , at least 10 of us has had a frozen shoulder. We are wondering why? should we be concerned?","QUESTION_ID":"Q146","F_REF":"1-134274365"} +{"ANSWERS":[{"_answerid":"Q146-S2-A1","_pairid":"373","__text":"Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness and pain in your shoulder joint. Signs and symptoms typically begin gradually, worsen over time and then resolve, usually within one to three years. Your risk of developing frozen shoulder increases if you're recovering from a medical condition or procedure that prevents you from moving your arm \u2014 such as a stroke or a mastectomy. Treatment for frozen shoulder involves range-of-motion exercises and, sometimes, corticosteroids and numbing medications injected into the joint capsule. In a small percentage of cases, arthroscopic surgery may be indicated to loosen the joint capsule so that it can move more freely. It's unusual for frozen shoulder to recur in the same shoulder, but some people can develop it in the opposite shoulder."}],"SUB_QUESTION_ID":"Q146-S2","ANNOTATIONS_FOCUS":["frozen shoulder"],"ANNOTATIONS_TYPE":"information","SUBJECT":"frozen shoulder","MESSAGE":"We have 14 siblings in our family , at least 10 of us has had a frozen shoulder. We are wondering why? should we be concerned?","QUESTION_ID":"Q146","F_REF":"1-134274365"} +{"ANSWERS":[{"_answerid":"Q147-S1-A1","_pairid":"376","__text":"The health care provider will use a stethoscope to listen to\u00a0your lungs. Wheezing or other asthma-related sounds may be heard. Tests that may be ordered include: - Allergy testing\u00a0- skin\u00a0or a blood test to see if a person with asthma is allergic to certain substances - Arterial blood gas (usually only done with patients who are having a severe asthma attack) - Chest x-ray - Lung function tests, including peak flow measurements"},{"_answerid":"Q147-S1-A2","_pairid":"377","__text":"Your primary care doctor will diagnose asthma based on your medical and family histories, a physical exam, and test results. Your doctor also will figure out the severity of your asthma\u2014that is, whether it's intermittent, mild, moderate, or severe. The level of severity will determine what treatment you'll start on. You may need to see an asthma specialist if: You need special tests to help diagnose asthma You've had a life-threatening asthma attack You need more than one kind of medicine or higher doses of medicine to control your asthma, or if you have overall problems getting your asthma well controlled You're thinking about getting allergy treatments Medical and Family Histories Your doctor may ask about your family history of asthma and allergies. He or she also may ask whether you have asthma symptoms and when and how often they occur. Let your doctor know whether your symptoms seem to happen only during certain times of the year or in certain places, or if they get worse at night. Your doctor also may want to know what factors seem to trigger your symptoms or worsen them. For more information about possible asthma triggers, go to \"What Are the Signs and Symptoms of Asthma?\" Your doctor may ask you about related health conditions that can interfere with asthma management. These conditions include a runny nose, sinus infections, reflux disease, psychological stress, and sleep apnea. Physical Exam Your doctor will listen to your breathing and look for signs of asthma or allergies. These signs include wheezing, a runny nose or swollen nasal passages, and allergic skin conditions (such as eczema). Keep in mind that you can still have asthma even if you don't have these signs on the day that your doctor examines you. Diagnostic Tests Lung Function Test Your doctor will use a test called spirometry (spi-ROM-eh-tre) to check how your lungs are working. This test measures how much air you can breathe in and out. It also measures how fast you can blow air out. Your doctor also may give you medicine and then test you again to see whether the results have improved. If the starting results are lower than normal and improve with the medicine, and if your medical history shows a pattern of asthma symptoms, your diagnosis will likely be asthma. Other Tests Your doctor may recommend other tests if he or she needs more information to make a diagnosis. Other tests may include: Allergy testing to find out which allergens affect you, if any. A test to measure how sensitive your airways are. This is called a bronchoprovocation (brong-KO-prav-eh-KA-shun) test. Using spirometry, this test repeatedly measures your lung function during physical activity or after you receive increasing doses of cold air or a special chemical to breathe in. A test to show whether you have another condition with the same symptoms as asthma, such as reflux disease, vocal cord dysfunction, or sleep apnea. A chest x ray or an EKG (electrocardiogram). These tests will help find out whether a foreign object or other disease may be causing your symptoms. Diagnosing Asthma in Young Children Most children who have asthma develop their first symptoms before 5 years of age. However, asthma in young children (aged 0 to 5 years) can be hard to diagnose. Sometimes it's hard to tell whether a child has asthma or another childhood condition. This is because the symptoms of asthma also occur with other conditions. Also, many young children who wheeze when they get colds or respiratory infections don't go on to have asthma after they're 6 years old. A child may wheeze because he or she has small airways that become even narrower during colds or respiratory infections. The airways grow as the child grows older, so wheezing no longer occurs when the child gets colds. A young child who has frequent wheezing with colds or respiratory infections is more likely to have asthma if: One or both parents have asthma The child has signs of allergies, including the allergic skin condition eczema The child has allergic reactions to pollens or other airborne allergens The child wheezes even when he or she doesn't have a cold or other infection The most certain way to diagnose asthma is with a lung function test, a medical history, and a physical exam. However, it's hard to do lung function tests in children younger than 5 years. Thus, doctors must rely on children's medical histories, signs and symptoms, and physical exams to make a diagnosis. Doctors also may use a 4\u20136 week trial of asthma medicines to see how well a child responds."}],"SUB_QUESTION_ID":"Q147-S1","ANNOTATIONS_FOCUS":["asthma"],"ANNOTATIONS_TYPE":"diagnosis","SUBJECT":"","MESSAGE":"Name: [NAME] Date and Time of Contact: Mon, 19 Jan 2015 19:48:21 GMT Application: entrez Database: pubmed SessionId: 39700B4F4BD5E951_0188SID MyNCBI UserName: Browser's user agent header: Mozilla\/5.0 (Macintosh; Intel Mac OS X 10_10) AppleWebKit\/600.1.25 (KHTML, like Gecko) Version\/8.0 Safari\/600.1.25 Message Body: how are you 100% sure if you have asthma?","QUESTION_ID":"Q147","F_REF":"1-131503031"} +{"ANSWERS":[{"_answerid":"Q148-S1-A1","_pairid":"378","__text":"Blood pressure is a measurement of the force exerted against the walls of your arteries as your heart pumps blood to your body. Hypertension is the term used to describe high blood pressure. Blood pressure readings are given as two numbers. The top number is called the systolic blood pressure. The bottom number is called the diastolic blood pressure. For example, 120 over 80 (written as 120\/80 mmHg). One or both of these numbers can be too high. (Note: These numbers apply to people who are not taking medicines for blood pressure and are not ill.) - Normal blood pressure is when your blood pressure is lower than 120\/80 mmHg most of the time. - High blood pressure (hypertension) is when your blood pressure is 140\/90 mmHg or above most of the time. - If your blood pressure numbers are 120\/80 or higher, but below 140\/90, it is called pre-hypertension. If you have heart or kidney problems, or you had a stroke, your doctor may want your blood pressure to be even lower than that of people who do not have these conditions."},{"_answerid":"Q148-S1-A2","_pairid":"379","__text":"Summary Blood pressure is the force of your blood pushing against the walls of your arteries. Each time your heart beats, it pumps blood into the arteries. Your blood pressure is highest when your heart beats, pumping the blood. This is called systolic pressure. When your heart is at rest, between beats, your blood pressure falls. This is called diastolic pressure. Your blood pressure reading uses these two numbers. Usually the systolic number comes before or above the diastolic number. A reading of - 119\/79 or lower is normal blood pressure - 140\/90 or higher is high blood pressure - Between 120 and 139 for the top number, or between 80 and 89 for the bottom number is called prehypertension. Prehypertension means you may end up with high blood pressure, unless you take steps to prevent it. High blood pressure usually has no symptoms, but it can cause serious problems such as stroke, heart failure, heart attack and kidney failure. You can control high blood pressure through healthy lifestyle habits such as exercise and the DASH diet and taking medicines, if needed. NIH: National Heart, Lung, and Blood Institute"}],"SUB_QUESTION_ID":"Q148-S1","ANNOTATIONS_FOCUS":["hypertension"],"ANNOTATIONS_TYPE":"information","SUBJECT":"","MESSAGE":"I want more information on Hypertension and fibromyalgia, I seem to be getting only topics on diabetes and I do not have this. I enjoy reading the current info. thanks [NAME]","QUESTION_ID":"Q148","F_REF":"14881"} +{"ANSWERS":[{"_answerid":"Q148-S2-A1","_pairid":"380","__text":"Fibromyalgia is a common syndrome in which a person has long-term pain, spread throughout the body. The pain is most often linked to fatigue, sleep problems, headaches, depression, and anxiety. People with fibromalgia may also have tenderness in the joints, muscles, tendons, and other soft tissues."},{"_answerid":"Q148-S2-A2","_pairid":"381","__text":"Summary Fibromyalgia is a disorder that causes muscle pain and fatigue. People with fibromyalgia have \"tender points\" on the body. Tender points are specific places on the neck, shoulders, back, hips, arms, and legs. These points hurt when pressure is put on them. People with fibromyalgia may also have other symptoms, such as - Trouble sleeping - Morning stiffness - Headaches - Painful menstrual periods - Tingling or numbness in hands and feet - Problems with thinking and memory (sometimes called \"fibro fog\") No one knows what causes fibromyalgia. Anyone can get it, but it is most common in middle-aged women. People with rheumatoid arthritis and other autoimmune diseases are particularly likely to develop fibromyalgia. There is no cure for fibromyalgia, but medicine can help you manage your symptoms. Getting enough sleep, exercising, and eating well may also help. NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases"}],"SUB_QUESTION_ID":"Q148-S2","ANNOTATIONS_FOCUS":["fibromyalgia"],"ANNOTATIONS_TYPE":"information","SUBJECT":"","MESSAGE":"I want more information on Hypertension and fibromyalgia, I seem to be getting only topics on diabetes and I do not have this. I enjoy reading the current info. thanks [NAME]","QUESTION_ID":"Q148","F_REF":"14881"} +{"ANSWERS":[{"_answerid":"Q149-S1-A1","_pairid":"382","__text":"The goals of treatment are: - Control airway swelling - Stay away from\u00a0substances that trigger your symptoms\u00a0 - Help you to be able to do normal activities without asthma symptoms You and your doctor should work as a team to manage your asthma. Follow your doctor's instructions on taking medicines, eliminating asthma triggers, and monitoring symptoms. MEDICINES FOR ASTHMA\u00a0 There are two kinds of medicines for treating asthma: - Control medicines to help prevent attacks - Quick-relief (rescue)\u00a0medicines for use during attacks LONG-TERM MEDICINES These are also called maintenance or control medicines.\u00a0They are used to prevent symptoms in people with moderate to severe asthma. You must take them every day for them to work. Take them even when you feel OK. Some long-term medicines are breathed in (inhaled), such as steroids and long-acting beta-agonists. Others are taken by mouth (orally). Your doctor will prescribe the right medicine for you. QUICK-RELIEF MEDICINES These are also called rescue medicines. They are taken: - For coughing, wheezing, trouble breathing, or an asthma attack - Just before exercising to help prevent asthma symptoms caused by exercise Tell your doctor if you are using quick-relief medicines twice a week or more. If so, your asthma may not be under control and your doctor may need to change your dose of daily control drugs. Quick-relief\u00a0medicines include: - Short-acting inhaled bronchodilators - Oral corticosteroids for\u00a0when you have an asthma attack that is not going away A severe asthma attack requires a checkup by a doctor. You may also need a hospital stay. There, you will likely be given\u00a0oxygen, breathing assistance, and medicines given through a vein (IV). ASTHMA CARE AT HOME - Know the asthma symptoms to watch for. - Know how to take your peak flow reading and what it means. - Know which triggers make your asthma worse and what to do when this happens. - Know how to care for your asthma when you exercise. Asthma action plans are written documents for managing asthma. An asthma action plan should include: - Instructions for taking asthma medicines when your condition is stable - A list of asthma triggers and how to avoid them - How to recognize when your asthma is getting worse, and when to call your doctor or nurse A peak flow meter is a simple device to measure how quickly you can move air out of your lungs. - It can help you see if an attack is coming, sometimes even before symptoms appear. Peak flow measurements help\u00a0let you know\u00a0when you need to take\u00a0medicine or other action. - Peak flow values of 50 to 80% of\u00a0your best results are a sign of a moderate asthma attack.\u00a0Numbers below 50% are a sign of a severe attack."},{"_answerid":"Q149-S1-A2","_pairid":"383","__text":"Asthma is a long-term disease that has no cure. The goal of asthma treatment is to control the disease. Good asthma control will: Prevent chronic and troublesome symptoms, such as coughing and shortness of breath Reduce your need for quick-relief medicines (see below) Help you maintain good lung function Let you maintain your normal activity level and sleep through the night Prevent asthma attacks that could result in an emergency room visit or hospital stay To control asthma, partner with your doctor to manage your asthma or your child's asthma. Children aged 10 or older\u2014and younger children who are able\u2014should take an active role in their asthma care. Taking an active role to control your asthma involves: Working with your doctor to treat other conditions that can interfere with asthma management. Avoiding things that worsen your asthma (asthma triggers). However, one trigger you should not avoid is physical activity. Physical activity is an important part of a healthy lifestyle. Talk with your doctor about medicines that can help you stay active. Working with your doctor and other health care providers to create and follow an asthma action plan. An asthma action plan gives guidance on taking your medicines properly, avoiding asthma triggers (except physical activity), tracking your level of asthma control, responding to worsening symptoms, and seeking emergency care when needed. Asthma is treated with two types of medicines: long-term control and quick-relief medicines. Long-term control medicines help reduce airway inflammation and prevent asthma symptoms. Quick-relief, or \"rescue,\" medicines relieve asthma symptoms that may flare up. Your initial treatment will depend on the severity of your asthma. Followup asthma treatment will depend on how well your asthma action plan is controlling your symptoms and preventing asthma attacks. Your level of asthma control can vary over time and with changes in your home, school, or work environments. These changes can alter how often you're exposed to the factors that can worsen your asthma. Your doctor may need to increase your medicine if your asthma doesn't stay under control. On the other hand, if your asthma is well controlled for several months, your doctor may decrease your medicine. These adjustments to your medicine will help you maintain the best control possible with the least amount of medicine necessary. Asthma treatment for certain groups of people\u2014such as children, pregnant women, or those for whom exercise brings on asthma symptoms\u2014will be adjusted to meet their special needs. Follow an Asthma Action Plan You can work with your doctor to create a personal asthma action plan. The plan will describe your daily treatments, such as which medicines to take and when to take them. The plan also will explain when to call your doctor or go to the emergency room. If your child has asthma, all of the people who care for him or her should know about the child's asthma action plan. This includes babysitters and workers at daycare centers, schools, and camps. These caretakers can help your child follow his or her action plan. Go to the National Heart, Lung, and Blood Institute's (NHLBI's) \"Asthma Action Plan\" for a sample plan. Avoid Things That Can Worsen Your Asthma Many common things (called asthma triggers) can set off or worsen your asthma symptoms. Once you know what these things are, you can take steps to control many of them. (For more information about asthma triggers, go to \"What Are the Signs and Symptoms of Asthma?\") For example, exposure to pollens or air pollution might make your asthma worse. If so, try to limit time outdoors when the levels of these substances in the outdoor air are high. If animal fur triggers your asthma symptoms, keep pets with fur out of your home or bedroom. One possible asthma trigger you shouldn\u2019t avoid is physical activity. Physical activity is an important part of a healthy lifestyle. Talk with your doctor about medicines that can help you stay active. The NHLBI offers many useful tips for controlling asthma triggers. For more information, go to page 2 of NHLBI's \"Asthma Action Plan.\" If your asthma symptoms are clearly related to allergens, and you can't avoid exposure to those allergens, your doctor may advise you to get allergy shots. You may need to see a specialist if you're thinking about getting allergy shots. These shots can lessen or prevent your asthma symptoms, but they can't cure your asthma. Several health conditions can make asthma harder to manage. These conditions include runny nose, sinus infections, reflux disease, psychological stress, and sleep apnea. Your doctor will treat these conditions as well. Medicines Your doctor will consider many things when deciding which asthma medicines are best for you. He or she will check to see how well a medicine works for you. Then, he or she will adjust the dose or medicine as needed. Asthma medicines can be taken in pill form, but most are taken using a device called an inhaler. An inhaler allows the medicine to go directly to your lungs. Not all inhalers are used the same way. Ask your doctor or another health care provider to show you the right way to use your inhaler. Review the way you use your inhaler at every medical visit. Long-Term Control Medicines Most people who have asthma need to take long-term control medicines daily to help prevent symptoms. The most effective long-term medicines reduce airway inflammation, which helps prevent symptoms from starting. These medicines don't give you quick relief from symptoms. Inhaled corticosteroids. Inhaled corticosteroids are the preferred medicine for long-term control of asthma. They're the most effective option for long-term relief of the inflammation and swelling that makes your airways sensitive to certain inhaled substances. Reducing inflammation helps prevent the chain reaction that causes asthma symptoms. Most people who take these medicines daily find they greatly reduce the severity of symptoms and how often they occur. Inhaled corticosteroids generally are safe when taken as prescribed. These medicines are different from the illegal anabolic steroids taken by some athletes. Inhaled corticosteroids aren't habit-forming, even if you take them every day for many years. Like many other medicines, though, inhaled corticosteroids can have side effects. Most doctors agree that the benefits of taking inhaled corticosteroids and preventing asthma attacks far outweigh the risk of side effects. One common side effect from inhaled corticosteroids is a mouth infection called thrush. You might be able to use a spacer or holding chamber on your inhaler to avoid thrush. These devices attach to your inhaler. They help prevent the medicine from landing in your mouth or on the back of your throat. Check with your doctor to see whether a spacer or holding chamber should be used with the inhaler you have. Also, work with your health care team if you have any questions about how to use a spacer or holding chamber. Rinsing your mouth out with water after taking inhaled corticosteroids also can lower your risk for thrush. If you have severe asthma, you may have to take corticosteroid pills or liquid for short periods to get your asthma under control. If taken for long periods, these medicines raise your risk for cataracts and osteoporosis (OS-te-o-po-RO-sis). A cataract is the clouding of the lens in your eye. Osteoporosis is a disorder that makes your bones weak and more likely to break. Your doctor may have you add another long-term asthma control medicine so he or she can lower your dose of corticosteroids. Or, your doctor may suggest you take calcium and vitamin D pills to protect your bones. Other long-term control medicines. Other long-term control medicines include: Cromolyn. This medicine is taken using a device called a nebulizer. As you breathe in, the nebulizer sends a fine mist of medicine to your lungs. Cromolyn helps prevent airway inflammation. Omalizumab (anti-IgE). This medicine is given as a shot (injection) one or two times a month. It helps prevent your body from reacting to asthma triggers, such as pollen and dust mites. Anti-IgE might be used if other asthma medicines have not worked well. \u00a0A rare, but possibly life-threatening allergic reaction called anaphylaxis might occur when the Omalizumab injection is given. If you take this medication, work with your doctor to make sure you understand the signs and symptoms of anaphylaxis and what actions you \u00a0should take. Inhaled long-acting beta2-agonists. These medicines open the airways. They might be added to inhaled corticosteroids to improve asthma control. Inhaled long-acting beta2-agonists should never be used on their own for long-term asthma control. They must used with inhaled corticosteroids. Leukotriene modifiers. These medicines are taken by mouth. They help block the chain reaction that increases inflammation in your airways. Theophylline. This medicine is taken by mouth. Theophylline helps open the airways. If your doctor prescribes a long-term control medicine, take it every day to control your asthma. Your asthma symptoms will likely return or get worse if you stop taking your medicine. Long-term control medicines can have side effects. Talk with your doctor about these side effects and ways to reduce or avoid them. With some medicines, like theophylline, your doctor will check the level of medicine in your blood. This helps ensure that you\u2019re getting enough medicine to relieve your asthma symptoms, but not so much that it causes dangerous side effects. Quick-Relief Medicines All people who have asthma need quick-relief medicines to help relieve asthma symptoms that may flare up. Inhaled short-acting beta2-agonists are the first choice for quick relief. These medicines act quickly to relax tight muscles around your airways when you're having a flareup. This allows the airways to open up so air can flow through them. You should take your quick-relief medicine when you first notice asthma symptoms. If you use this medicine more than 2 days a week, talk with your doctor about your asthma control. You may need to make changes to your asthma action plan. Carry your quick-relief inhaler with you at all times in case you need it. If your child has asthma, make sure that anyone caring for him or her has the child's quick-relief medicines, including staff at the child's school. They should understand when and how to use these medicines and when to seek medical care for your child. You shouldn't use quick-relief medicines in place of prescribed long-term control medicines. Quick-relief medicines don't reduce inflammation. Track Your Asthma To track your asthma, keep records of your symptoms, check your peak flow number using a peak flow meter, and get regular asthma checkups. Record Your Symptoms You can record your asthma symptoms in a diary to see how well your treatments are controlling your asthma. Asthma is well controlled if: You have symptoms no more than 2 days a week, and these symptoms don't wake you from sleep more than 1 or 2 nights a month. You can do all your normal activities. You take quick-relief medicines no more than 2 days a week. You have no more than one asthma attack a year that requires you to take corticosteroids by mouth. Your peak flow doesn't drop below 80 percent of your personal best number. If your asthma isn't well controlled, contact your doctor. He or she may need to change your asthma action plan. Use a Peak Flow Meter This small, hand-held device shows how well air moves out of your lungs. You blow into the device and it gives you a score, or peak flow number. Your score shows how well your lungs are working at the time of the test. Your doctor will tell you how and when to use your peak flow meter. He or she also will teach you how to take your medicines based on your score. Your doctor and other health care providers may ask you to use your peak flow meter each morning and keep a record of your results. You may find it very useful to record peak flow scores for a couple of weeks before each medical visit and take the results with you. When you're first diagnosed with asthma, it's important to find your \"personal best\" peak flow number. To do this, you record your score each day for a 2- to 3-week period when your asthma is well-controlled. The highest number you get during that time is your personal best. You can compare this number to future numbers to make sure your asthma is controlled. Your peak flow meter can help warn you of an asthma attack, even before you notice symptoms. If your score shows that your breathing is getting worse, you should take your quick-relief medicines the way your asthma action plan directs. Then you can use the peak flow meter to check how well the medicine worked. Get Asthma Checkups When you first begin treatment, you'll see your doctor about every 2 to 6 weeks. Once your asthma is controlled, your doctor may want to see you from once a month to twice a year. During these checkups, your doctor may ask whether you've had an asthma attack since the last visit or any changes in symptoms or peak flow measurements. He or she also may ask about your daily activities. This information will help your doctor assess your level of asthma control. Your doctor also may ask whether you have any problems or concerns with taking your medicines or following your asthma action plan. Based on your answers to these questions, your doctor may change the dose of your medicine or give you a new medicine. If your control is very good, you might be able to take less medicine. The goal is to use the least amount of medicine needed to control your asthma. Emergency Care Most people who have asthma, including many children, can safely manage their symptoms by following their asthma action plans. However, you might need medical attention at times. Call your doctor for advice if: Your medicines don't relieve an asthma attack. Your peak flow is less than half of your personal best peak flow number. Call 9\u20131\u20131 for emergency care if: You have trouble walking and talking because you're out of breath. You have blue lips or fingernails. At the hospital, you'll be closely watched and given oxygen and more medicines, as well as medicines at higher doses than you take at home. Such treatment can save your life. Asthma Treatment for Special Groups The treatments described above generally apply to all people who have asthma. However, some aspects of treatment differ for people in certain age groups and those who have special needs. Children It's hard to diagnose asthma in children younger than 5 years. Thus, it's hard to know whether young children who wheeze or have other asthma symptoms will benefit from long-term control medicines. (Quick-relief medicines tend to relieve wheezing in young children whether they have asthma or not.) Doctors will treat infants and young children who have asthma symptoms with long-term control medicines if, after assessing a child, they feel that the symptoms are persistent and likely to continue after 6 years of age. (For more information, go to \"How Is Asthma Diagnosed?\") Inhaled corticosteroids are the preferred treatment for young children. Montelukast and cromolyn are other options. Treatment might be given for a trial period of 1\u00a0month to 6 weeks. Treatment usually is stopped if benefits aren't seen during that time and the doctor and parents are confident the medicine was used properly. Inhaled corticosteroids can possibly slow the growth of children of all ages. Slowed growth usually is apparent in the first several months of treatment, is generally small, and doesn't get worse over time. Poorly controlled asthma also may reduce a child's growth rate. Many experts think the benefits of inhaled corticosteroids for children who need them to control their asthma far outweigh the risk of slowed growth. Older Adults Doctors may need to adjust asthma treatment for older adults who take certain other medicines, such as beta blockers, aspirin and other pain relievers, and anti-inflammatory medicines. These medicines can prevent asthma medicines from working well and may worsen asthma symptoms. Be sure to tell your doctor about all of the medicines you take, including over-the-counter medicines. Older adults may develop weak bones from using inhaled corticosteroids, especially at high doses. Talk with your doctor about taking calcium and vitamin D pills, as well as other ways to help keep your bones strong. Pregnant Women Pregnant women who have asthma need to control the disease to ensure a good supply of oxygen to their babies. Poor asthma control increases the risk of preeclampsia, a condition in which a pregnant woman develops high blood pressure and protein in the urine. Poor asthma control also increases the risk that a baby will be born early and have a low birth weight. Studies show that it's safer to take asthma medicines while pregnant than to risk having an asthma attack. Talk with your doctor if you have asthma and are pregnant or planning a pregnancy. Your level of asthma control may get better or it may get worse while you're pregnant. Your health care team will check your asthma control often and adjust your treatment as needed. People Whose Asthma Symptoms Occur With Physical Activity Physical activity is an important part of a healthy lifestyle. Adults need physical activity to maintain good health. Children need it for growth and development. In some people, however, physical activity can trigger asthma symptoms. If this happens to you or your child, talk with your doctor about the best ways to control asthma so you can stay active. The following medicines may help prevent asthma symptoms caused by physical activity: Short-acting beta2-agonists (quick-relief medicine) taken shortly before physical activity can last 2 to 3 hours and prevent exercise-related symptoms in most people who take them. Long-acting beta2-agonists can be protective for up to 12 hours. However, with daily use, they'll no longer give up to 12 hours of protection. Also, frequent use of these medicines for physical activity might be a sign that asthma is poorly controlled. Leukotriene modifiers. These pills are taken several hours before physical activity. They can help relieve asthma symptoms brought on by physical activity. Long-term control medicines. Frequent or severe symptoms due to physical activity may suggest poorly controlled asthma and the need to either start or increase long-term control medicines that reduce inflammation. This will help prevent exercise-related symptoms. Easing into physical activity with a warmup period may be helpful. You also may want to wear a mask or scarf over your mouth when exercising in cold weather. If you use your asthma medicines as your doctor directs, you should be able to take part in any physical activity or sport you choose. People Having Surgery Asthma may add to the risk of having problems during and after surgery. For instance, having a tube put into your throat may cause an asthma attack. Tell your surgeon about your asthma when you first talk with him or her. The surgeon can take steps to lower your risk, such as giving you asthma medicines before or during surgery."}],"SUB_QUESTION_ID":"Q149-S1","ANNOTATIONS_FOCUS":["asthma"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"asthma","MESSAGE":"Question. What is the consensus of medical doctors as to whether asthma can be cured? And do you have an article discussing whether asthma can be cured?","QUESTION_ID":"Q149","F_REF":"NF_202"} +{"ANSWERS":[{"_answerid":"Q150-S1-A1","_pairid":"390","__text":"The goal of treatment is to reduce your blood pressure so that you have a lower risk of complications. You and your provider should set a blood pressure goal for you. If you have pre-hypertension, your provider will recommend lifestyle changes to bring your blood pressure down to a normal range. Medicines are rarely used for pre-hypertension. LIFESTYLE CHANGES You can do many things to help control your blood pressure at home, including: - Eat a heart-healthy diet, including potassium and fiber. - Drink plenty of water. - Exercise regularly for at least 30 minutes of aerobic exercise a day. - If you smoke, quit. - Limit how much alcohol you drink to 1 drink a day for women, and 2 a day for men. - Limit the amount of sodium (salt) you eat. Aim for less than 1,500 mg per day. - Reduce stress. Try to avoid things that cause you stress, and try meditation or yoga to de-stress. - Stay at a healthy body weight. Your provider can help you find programs for losing weight, stopping smoking, and exercising. You can also get a referral to a dietitian, who can help you plan a diet that is healthy for you. How low your blood pressure should be and at what level you need to start treatment is individualized, based on your age and any medical problems you have. MEDICINES FOR HYPERTENSION Most of the time, your provider will try lifestyle changes first and check your BP 2 or more times. Medicines will likely be started if your BP readings remain at or above these levels: - Top number (systolic pressure) of 140 or more in people younger than 60 years - Top number of 150 or more in people 60 years and older - Bottom number (diastolic pressure) of 90 or more If you have diabetes, heart problems, or a history of a stroke, medicines may be started at lower blood pressure reading. The most commonly used blood pressure targets for people with these medical problems are below 130 to 140\/80 mmHg. There are many different medicines to treat high blood pressure. - Often, a single blood pressure drug may not be enough to control your blood pressure, and you may need to take two or more drugs. - It is very important that you take the medicines prescribed to you. - If you have side effects, your doctor can substitute a different medicine."}],"SUB_QUESTION_ID":"Q150-S1","ANNOTATIONS_FOCUS":["hypertension"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"how to reduced hypertension","QUESTION_ID":"Q150","F_REF":"NF_56"} +{"ANSWERS":[{"_answerid":"Q151-S1-A1","_pairid":"391","__text":"Treatment for Dry Mouth Dry mouth treatment will depend on what is causing the problem. If you think you have dry mouth, see your dentist or physician. He or she can help to determine what is causing your dry mouth. If your dry mouth is caused by medicine, your physician might change your medicine or adjust the dosage. If your salivary glands are not working right but can still produce some saliva, your dentist or physician might give you a medicine that helps the glands work better. Your dentist or physician might also suggest that you use artificial saliva to keep your mouth wet. Do's and Don'ts Do's - Do drink water or sugarless drinks often. That will make chewing and swallowing easier when eating. - Do chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow. - Do use a humidifier at night to promote moisture in the air while you sleep. Do drink water or sugarless drinks often. That will make chewing and swallowing easier when eating. Do chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow. Do use a humidifier at night to promote moisture in the air while you sleep. Don\u2019ts - Don't consume drinks with caffeine such as coffee, tea, and some sodas. Caffeine can dry out the mouth. - Don't use tobacco or alcohol. They dry out the mouth. Don't consume drinks with caffeine such as coffee, tea, and some sodas. Caffeine can dry out the mouth. Don't use tobacco or alcohol. They dry out the mouth. Gene Therapy Research for Salivary Gland Dysfunction Scientists at NIH\u2019s National Institute of Dental and Craniofacial Research (NIDCR) are exploring the potential use of gene therapy to treat salivary gland dysfunction. The idea is to transfer additional or replacement genes into the salivary glands of people with Sj\u00f6gren's syndrome and cancer patients whose salivary glands were damaged during radiation treatment. The hope is that these genes will increase the production of saliva and eliminate the chronic parched sensation that bothers people with dry mouth conditions. NIDCR recently completed a clinical study, a research study in humans, on gene therapy for radiation-damaged salivary glands. The study showed that gene therapy can be safely performed in salivary glands and that it has the potential to help head and neck cancer survivors with dry mouth. Read NIDCR\u2019s news release to learn more about the study\u2019s findings. Based on the promising results of this trial, similar clinical trials are planned in the near future. Research on Sj\u00f6gren\u2019s Syndrome and Other Diseases Affecting Salivary Glands NIDCR is also conducting clinical trials to study new approaches for improving salivary flow in patients with Sjogren\u2019s syndrome. Such studies include testing the effectiveness of a monoclonal antibody as well as a corticosteroid to see whether either of these treatments helps improve salivary flow. Other studies are focused on learning how diseases such as diabetes, auto inflammatory diseases, and granulomatous diseases cause salivary gland dysfunction. Such studies could one day lead to better ways of preventing and treating salivary gland conditions. To stay abreast of any new studies on gene therapy and salivary gland function, visit ClinicalTrials.gov. ClinicalTrials.gov lists all federally and many privately funded clinical trials in the U.S. and around the world; the web site is updated frequently."},{"_answerid":"Q151-S1-A2","_pairid":"393","__text":"Dry mouth treatment will depend on what is causing the problem. If you think you have dry mouth, see your dentist or physician. He or she can help to determine what is causing your dry mouth. If your dry mouth is caused by medicine, your physician might change your medicine or adjust the dosage. If your salivary glands are not working right, but can still produce some saliva, your dentist or physician might give you a special medicine that helps the glands work better. He or she might suggest that you use artificial saliva to keep your mouth wet. (Watch the video to learn how dry mouth is treated. 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.)"}],"SUB_QUESTION_ID":"Q151-S1","ANNOTATIONS_FOCUS":["dry mouth"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"Chronic Dry mouth.","MESSAGE":"How can I relieve dry mouth.","QUESTION_ID":"Q151","F_REF":"1-131590835"} +{"ANSWERS":[{"_answerid":"Q152-S1-A1","_pairid":"394","__text":"An inguinal hernia happens when contents of the abdomen\u2014usually fat or part of the small intestine\u2014bulge through a weak area in the lower abdominal wall. The abdomen is the area between the chest and the hips. The area of the lower abdominal wall is also called the inguinal or groin region. Two types of inguinal hernias are - indirect inguinal hernias, which are caused by a defect in the abdominal wall that is congenital, or present at birth - direct inguinal hernias, which usually occur only in male adults and are caused by a weakness in the muscles of the abdominal wall that develops over time Inguinal hernias occur at the inguinal canal in the groin region."}],"SUB_QUESTION_ID":"Q152-S1","ANNOTATIONS_FOCUS":["inguinal hernia"],"ANNOTATIONS_TYPE":"information","SUBJECT":"inguinal hernia","MESSAGE":"I am a 75 year old man. I have 2 inguinal hernia. Do you offer any written pamplets on these.","QUESTION_ID":"Q152","F_REF":"NF_226"} +{"ANSWERS":[{"_answerid":"Q153-S1-A1","_pairid":"396","__text":"CHANGING YOUR LIFESTYLE An active lifestyle and plenty of exercise, along with healthy eating, is the safest way to lose weight. Even modest weight loss can improve your health. You may need a lot of support from family and friends. Your main goal should be to learn new, healthy ways of eating and make them part of your daily routine. Many people find it hard to change their eating habits and behaviors. You may have practiced some habits for so long that you may not even know they are unhealthy, or you do them without thinking. You need to be motivated to make lifestyle changes. Make the behavior change part of your life over the long term. Know that it takes time to make and keep a change in your lifestyle. Work with your health care provider and dietitian to set realistic, safe daily calorie counts that help you lose weight while staying healthy. Remember that if you drop pounds slowly and steadily, you are more likely to keep them off. Your dietitian can teach you about: - Healthy food choices - Healthy snacks - Reading nutrition labels - New ways to prepare food - Portion sizes - Sweetened drinks Extreme diets (fewer than 1,100 calories per day) are not thought to be safe or to work very well. These types of diets often do not contain enough vitamins and minerals. Most people who lose weight this way return to overeating and become obese again. Learn ways to manage stress other than snacking. Examples may be meditation, yoga, or exercise. If you are depressed or stressed a lot, talk to your provider. MEDICINES AND HERBAL REMEDIES You may see ads for supplements and herbal remedies that claim they will help you lose weight. Some of these claims may not be true. And some of these supplements can have serious side effects. Talk to your provider before using them. You can discuss weight loss medicines with your doctor. Many people lose at least 5 pounds by taking these drugs, but they may regain the weight when they stop taking the medicine unless they have made lifestyle changes. SURGERY Bariatric (weight-loss) surgery can reduce the risk of certain diseases in people with severe obesity. These risks include: - Arthritis - Diabetes - Heart disease - High blood pressure - Sleep apnea - Some cancers - Stroke Surgery may help people who have been very obese for 5 years or more and have not lost weight from other treatments, such as diet, exercise, or medicine. Surgery alone is not the answer for weight loss. It can train you to eat less, but you still have to do much of the work. You must be committed to diet and exercise after surgery. Talk to your doctor to learn if surgery is a good option for you. Weight-loss surgeries include: - Laparoscopic gastric banding - Gastric bypass surgery - Sleeve gastrectomy (less common) - Duodenal switch"}],"SUB_QUESTION_ID":"Q153-S1","ANNOTATIONS_FOCUS":["obesity"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"obesity","MESSAGE":"I need to lose fat","QUESTION_ID":"Q153","F_REF":"1-136400615"} +{"ANSWERS":[{"_answerid":"Q154-S1-A1","_pairid":"397","__text":"Treatment for PTSD involves talk therapy (counseling), medicines, or both. TALK THERAPY During talk therapy, you talk with a mental health professional, such as a psychiatrist or therapist, in a calm and accepting setting. They can help you manage your PTSD symptoms. They will also guide you as you work through your feelings about the trauma. There are many types of talk therapy. One type that is often used for PTSD is called desensitization. During therapy, you are encouraged to remember the traumatic event and express your feelings about it. Over time, memories of the event become less frightening. During talk therapy, you may also learn ways to relax, especially when you start to have flashbacks. MEDICINES Your provider may suggest that you take medicines. They can help ease your depression or anxiety. They can also help you sleep better. Medicines need time to work. Do not stop taking them or change the amount (dosage) you take without talking to your provider. Ask your provider about possible side effects and what to do if you experience them."}],"SUB_QUESTION_ID":"Q154-S1","ANNOTATIONS_FOCUS":["ptsd"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"I am trying to get specific citations for Treatment outcome for PTSD, especially reviews. When I tried to limit using advance search, the response was no finding, which I know is incorrect. Otherwise I get thousands of possibilities. Can you help me limit to that specific question?","QUESTION_ID":"Q154","F_REF":"12231"} +{"ANSWERS":[{"_answerid":"Q155-S1-A1","_pairid":"399","__text":"Treatment of breast papillomas often entails surgical duct excision for symptomatic relief and histopathological examination. Recently, more conservative approach has been adapted. MD-assisted microdochectomy should be considered the procedure of choice for a papilloma-related single duct discharge. Furthermore, there is increasing evidence that MD has the potential to reduce the number of duct excision procedures and minimise the extent of surgical resection. Imaging-guided vacuum-assisted core biopsy can be diagnostic and therapeutic for papillomas seen on mammography and\/or ultrasound. Patients with multiple papillomas do have an increased risk of developing cancer and should be kept under annual review with regular mammography (preferably digital mammography) if treated conservatively. Magnetic resonance (MR) can be also used in surveillance in view of its high sensitivity. Because the risk is small, long term and affects both breasts, long-term follow-up is more appropriate than prophylactic mastectomy. Patients who prove to have solitary duct papilloma have insufficient increase in the risk of subsequent malignancy to justify routine follow-up."}],"SUB_QUESTION_ID":"Q155-S1","ANNOTATIONS_FOCUS":["intraductal papilloma"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"intraductal papilloma","MESSAGE":"What if you do not have surgery to remove a papilloma?","QUESTION_ID":"Q155","F_REF":"NF_317"} +{"ANSWERS":[{"_answerid":"Q156-S1-A1","_pairid":"400","__text":"Obesity means having too much body fat. It is not the same as being overweight, which means weighing too much. A person may be overweight from extra muscle or water, as well as from having too much fat. Both terms mean that a person's weight is higher than what is thought to be healthy for his or her height."},{"_answerid":"Q156-S1-A2","_pairid":"401","__text":"Summary Obesity means having too much body fat. It is different from being overweight, which means weighing too much. The weight may come from muscle, bone, fat, and\/or body water. Both terms mean that a person's weight is greater than what's considered healthy for his or her height. Obesity occurs over time when you eat more calories than you use. The balance between calories-in and calories-out differs for each person. Factors that might affect your weight include your genetic makeup, overeating, eating high-fat foods, and not being physically active. Being obese increases your risk of diabetes, heart disease, stroke, arthritis, and some cancers. If you are obese, losing even 5 to 10 percent of your weight can delay or prevent some of these diseases. For example, that means losing 10 to 20 pounds if you weigh 200 pounds. NIH: National Institute of Diabetes and Digestive and Kidney Diseases"}],"SUB_QUESTION_ID":"Q156-S1","ANNOTATIONS_FOCUS":["obesity"],"ANNOTATIONS_TYPE":"information","SUBJECT":"ClinicalTrials.gov - Question - general information","MESSAGE":"I would like info on my obesity problem and if I can get help","QUESTION_ID":"Q156","F_REF":"1-136400675"} +{"ANSWERS":[{"_answerid":"Q156-S2-A1","_pairid":"402","__text":"CHANGING YOUR LIFESTYLE An active lifestyle and plenty of exercise, along with healthy eating, is the safest way to lose weight. Even modest weight loss can improve your health. You may need a lot of support from family and friends. Your main goal should be to learn new, healthy ways of eating and make them part of your daily routine. Many people find it hard to change their eating habits and behaviors. You may have practiced some habits for so long that you may not even know they are unhealthy, or you do them without thinking. You need to be motivated to make lifestyle changes. Make the behavior change part of your life over the long term. Know that it takes time to make and keep a change in your lifestyle. Work with your health care provider and dietitian to set realistic, safe daily calorie counts that help you lose weight while staying healthy. Remember that if you drop pounds slowly and steadily, you are more likely to keep them off. Your dietitian can teach you about: - Healthy food choices - Healthy snacks - Reading nutrition labels - New ways to prepare food - Portion sizes - Sweetened drinks Extreme diets (fewer than 1,100 calories per day) are not thought to be safe or to work very well. These types of diets often do not contain enough vitamins and minerals. Most people who lose weight this way return to overeating and become obese again. Learn ways to manage stress other than snacking. Examples may be meditation, yoga, or exercise. If you are depressed or stressed a lot, talk to your provider. MEDICINES AND HERBAL REMEDIES You may see ads for supplements and herbal remedies that claim they will help you lose weight. Some of these claims may not be true. And some of these supplements can have serious side effects. Talk to your provider before using them. You can discuss weight loss medicines with your doctor. Many people lose at least 5 pounds by taking these drugs, but they may regain the weight when they stop taking the medicine unless they have made lifestyle changes. SURGERY Bariatric (weight-loss) surgery can reduce the risk of certain diseases in people with severe obesity. These risks include: - Arthritis - Diabetes - Heart disease - High blood pressure - Sleep apnea - Some cancers - Stroke Surgery may help people who have been very obese for 5 years or more and have not lost weight from other treatments, such as diet, exercise, or medicine. Surgery alone is not the answer for weight loss. It can train you to eat less, but you still have to do much of the work. You must be committed to diet and exercise after surgery. Talk to your doctor to learn if surgery is a good option for you. Weight-loss surgeries include: - Laparoscopic gastric banding - Gastric bypass surgery - Sleeve gastrectomy (less common) - Duodenal switch"}],"SUB_QUESTION_ID":"Q156-S2","ANNOTATIONS_FOCUS":["obesity"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"ClinicalTrials.gov - Question - general information","MESSAGE":"I would like info on my obesity problem and if I can get help","QUESTION_ID":"Q156","F_REF":"1-136400675"} +{"ANSWERS":[{"_answerid":"Q157-S1-A1","_pairid":"403","__text":"Esophageal cancer is cancer that starts in the esophagus. This is the tube that moves food from the mouth to the stomach."},{"_answerid":"Q157-S1-A2","_pairid":"404","__text":"Summary The esophagus is a hollow tube that carries food and liquids from your throat to your stomach. Early esophageal cancer usually does not cause symptoms. Later, you may have symptoms such as - Painful or difficult swallowing - Weight loss - A hoarse voice or cough that doesn't go away You're at greater risk for getting esophageal cancer if you smoke, drink heavily, or have acid reflux. Your risk also goes up as you age Your doctor uses imaging tests and a biopsy to diagnose esophageal cancer. Treatments include surgery, radiation, and chemotherapy. You might also need nutritional support, since the cancer or treatment may make it hard to swallow. NIH: National Cancer Institute"},{"_answerid":"Q157-S1-A3","_pairid":"405","__text":"Esophageal cancer is a cancer of the esophagus, the hollow tube that carries food and liquids from the throat to the stomach. As the cancer grows, symptoms may include painful or difficult swallowing, weight loss and coughing up blood. The exact cause is usually not known, but both environmental and genetic factors are throught to play a role in the development of this condition. In the United States, risk factors for developing esophageal cancer include smoking, heavy drinking, obesity, and damage from acid reflux. Treatments include surgery, radiation, chemotherapy, and laser therapy. Some patients may also need nutritional support, since the cancer or treatment may make it hard to swallow."}],"SUB_QUESTION_ID":"Q157-S1","ANNOTATIONS_FOCUS":["cancer of the esophagus"],"ANNOTATIONS_TYPE":"information","SUBJECT":"Esophageal Cancer","MESSAGE":"I am looking for information about Cancer of the Esophagus and I'm not finding anything on your website.","QUESTION_ID":"Q157","F_REF":"1-135712015"} +{"ANSWERS":[{"_answerid":"Q158-S1-A1","_pairid":"406","__text":"MEDICINES Pubic lice are often treated with medicines that contain a substance called permethrin. To use this medicine: - Thoroughly work the medicine into your pubic hair and surrounding area. Leave it on for at least 5 to 10 minutes, or as directed by your health care provider. - Rinse well. - Comb your pubic hair with a fine-toothed comb to remove eggs (nits). Applying vinegar to pubic hair before combing may help loosen the nits. Most people need only 1 treatment. If a second treatment is needed, it should be done 4 days to 1 week later. Over-the-counter medicines to treat lice include Rid and Nix. Malathione lotion is another option. OTHER CARE While you are treating pubic lice: - Wash all clothing and bedding in hot water. - Spray items that cannot be washed with a medicated spray that you can buy at the store. You can also seal items in plastic bags for 10 to 14 days to smother the lice. - Makes sure anyone with whom you have had sexual contact or shared a bed is treated at the same time. People with pubic lice should be checked for other sexually-transmitted infections when lice are discovered."}],"SUB_QUESTION_ID":"Q158-S1","ANNOTATIONS_FOCUS":["pubic lice"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"pubic lice. What are some treatments for pubic lice","QUESTION_ID":"Q158","F_REF":"5228"} +{"ANSWERS":[{"_answerid":"Q159-S1-A1","_pairid":"407","__text":"Taking in more calories than your body burns can lead to obesity. This is because the body stores unused calories as fat. Obesity can be caused by: - Eating more food than your body can use - Drinking too much alcohol - Not getting enough exercise Many obese people who lose large amounts of weight and gain it back think it is their fault. They blame themselves for not having the willpower to keep the weight off. Many people regain more weight than they lost. Today, we know that biology is a big reason why some people cannot keep the weight off. Some people who live in the same place and eat the same foods become obese, while others do not. Our bodies have a complex system to keep our weight at a healthy level. In some people, this system does not work normally. The way we eat when we are children can affect the way we eat as adults. The way we eat over many years becomes a habit. It affects what we eat, when we eat, and how much we eat. We may feel that we are surrounded by things that make it easy to overeat and hard to stay active. - Many people feel they do not have time to plan and make healthy meals. - More people today work desk jobs compared to more active jobs in the past. - People with little free time may have less time to exercise. The term eating disorder means a group of medical conditions that have an unhealthy focus on eating, dieting, losing or gaining weight, and body image. A person may be obese, follow an unhealthy diet, and have an eating disorder all at the same time. Sometimes, medical problems or treatments cause weight gain, including: - Underactive thyroid (hypothyroidism) - Medicines such as birth control pills, antidepressants, and antipsychotics Other things that can cause weight gain are: - Quitting smoking. Many people who quit smoking gain 4 to 10 pounds in the first 6 months after quitting. - Stress, anxiety, feeling sad, or not sleeping well - Menopause. Women may gain 12 to 15 pounds during menopause. - Pregnancy. Women may not lose the weight they gained during pregnancy."}],"SUB_QUESTION_ID":"Q159-S1","ANNOTATIONS_FOCUS":["obesity"],"ANNOTATIONS_TYPE":"cause","SUBJECT":"Obesity Questions","MESSAGE":"Hello. My name is [NAME] and I am a junior in high school. I am currently doing a research topic on obesity and was wondering if you would be able to answer a few questions. It would be greatly appreciated if you could! Thank you! 1)What\/Who is to blame for obesity? 2)Do you think putting a tax on junk food will reduce the amount of obese people? Why or why not? 3)How can we prevent obesity? 4)What are the benefits of getting 30 minutes of exercise daily and eating healthy? 5)Should the government be more involved in the help to stop obesity? Why or why not? 6)What is the number one thing we should eat less of\/ cut out of our diets? (such as, fats, carbs, sugars,etc) Thank you for your time!","QUESTION_ID":"Q159","F_REF":"17757"} +{"ANSWERS":[{"_answerid":"Q159-S2-A1","_pairid":"408","__text":"CHANGING YOUR LIFESTYLE An active lifestyle and plenty of exercise, along with healthy eating, is the safest way to lose weight. Even modest weight loss can improve your health. You may need a lot of support from family and friends. Your main goal should be to learn new, healthy ways of eating and make them part of your daily routine. Many people find it hard to change their eating habits and behaviors. You may have practiced some habits for so long that you may not even know they are unhealthy, or you do them without thinking. You need to be motivated to make lifestyle changes. Make the behavior change part of your life over the long term. Know that it takes time to make and keep a change in your lifestyle. Work with your health care provider and dietitian to set realistic, safe daily calorie counts that help you lose weight while staying healthy. Remember that if you drop pounds slowly and steadily, you are more likely to keep them off. Your dietitian can teach you about: - Healthy food choices - Healthy snacks - Reading nutrition labels - New ways to prepare food - Portion sizes - Sweetened drinks Extreme diets (fewer than 1,100 calories per day) are not thought to be safe or to work very well. These types of diets often do not contain enough vitamins and minerals. Most people who lose weight this way return to overeating and become obese again. Learn ways to manage stress other than snacking. Examples may be meditation, yoga, or exercise. If you are depressed or stressed a lot, talk to your provider. MEDICINES AND HERBAL REMEDIES You may see ads for supplements and herbal remedies that claim they will help you lose weight. Some of these claims may not be true. And some of these supplements can have serious side effects. Talk to your provider before using them. You can discuss weight loss medicines with your doctor. Many people lose at least 5 pounds by taking these drugs, but they may regain the weight when they stop taking the medicine unless they have made lifestyle changes. SURGERY Bariatric (weight-loss) surgery can reduce the risk of certain diseases in people with severe obesity. These risks include: - Arthritis - Diabetes - Heart disease - High blood pressure - Sleep apnea - Some cancers - Stroke Surgery may help people who have been very obese for 5 years or more and have not lost weight from other treatments, such as diet, exercise, or medicine. Surgery alone is not the answer for weight loss. It can train you to eat less, but you still have to do much of the work. You must be committed to diet and exercise after surgery. Talk to your doctor to learn if surgery is a good option for you. Weight-loss surgeries include: - Laparoscopic gastric banding - Gastric bypass surgery - Sleeve gastrectomy (less common) - Duodenal switch"}],"SUB_QUESTION_ID":"Q159-S2","ANNOTATIONS_FOCUS":["obesity"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"Obesity Questions","MESSAGE":"Hello. My name is [NAME] and I am a junior in high school. I am currently doing a research topic on obesity and was wondering if you would be able to answer a few questions. It would be greatly appreciated if you could! Thank you! 1)What\/Who is to blame for obesity? 2)Do you think putting a tax on junk food will reduce the amount of obese people? Why or why not? 3)How can we prevent obesity? 4)What are the benefits of getting 30 minutes of exercise daily and eating healthy? 5)Should the government be more involved in the help to stop obesity? Why or why not? 6)What is the number one thing we should eat less of\/ cut out of our diets? (such as, fats, carbs, sugars,etc) Thank you for your time!","QUESTION_ID":"Q159","F_REF":"17757"} +{"ANSWERS":[{"_answerid":"Q160-S1-A1","_pairid":"411","__text":"Lynch syndrome is an inherited condition that causes an increased risk of developing cancer. Individuals with Lynch syndrome have a higher risk of developing colon and rectal cancer, as well as cancers of the stomach, small intestine, liver, gallbladder ducts, upper urinary tract, brain, skin, and prostate. Women with Lynch syndrome also have a high risk of developing uterine cancer (also called endometrial cancer) and ovarian cancer. Even though the disorder was originally described as not involving noncancerous (benign) growths (polyps) in the colon, people with Lynch syndrome may occasionally have colon polyps. Lynch syndrome has an autosomal dominant pattern of inheritance and is caused by a mutation in the MLH1, MSH2, MSH6, PMS2 or EPCAM gene."},{"_answerid":"Q160-S1-A2","_pairid":"412","__text":"Lynch syndrome, often called hereditary nonpolyposis colorectal cancer (HNPCC), is an inherited disorder that increases the risk of many types of cancer, particularly cancers of the colon (large intestine) and rectum, which are collectively referred to as colorectal cancer. People with Lynch syndrome also have an increased risk of cancers of the stomach, small intestine, liver, gallbladder ducts, upper urinary tract, brain, and skin. Additionally, women with this disorder have a high risk of cancer of the ovaries and lining of the uterus (the endometrium). People with Lynch syndrome may occasionally have noncancerous (benign) growths (polyps) in the colon, called colon polyps. In individuals with this disorder, colon polyps occur earlier but not in greater numbers than they do in the general population."}],"SUB_QUESTION_ID":"Q160-S1","ANNOTATIONS_FOCUS":["lynch syndrome"],"ANNOTATIONS_TYPE":"information","SUBJECT":"mailed information on Lynch syndrome","MESSAGE":"Please mail me information of Lynch Syndrome as I do not have a computer and my doctor has told me that I have this.","QUESTION_ID":"Q160","F_REF":"18019"} +{"ANSWERS":[{"_answerid":"Q161-S1-A1","_pairid":"419","__text":"Glaucoma is a group of eye conditions that can damage the optic nerve. This nerve sends the images you see to your brain. Most often, optic nerve damage is caused by increased pressure in the eye. This is called intraocular pressure. Watch this video about: Glaucoma"},{"_answerid":"Q161-S1-A2","_pairid":"420","__text":"Summary Glaucoma is a group of diseases that can damage the eye's optic nerve. It is a leading cause of blindness in the United States. It usually happens when the fluid pressure inside the eyes slowly rises, damaging the optic nerve. Often there are no symptoms at first. Without treatment, people with glaucoma will slowly lose their peripheral, or side vision. They seem to be looking through a tunnel. Over time, straight-ahead vision may decrease until no vision remains. A comprehensive eye exam can tell if you have glaucoma. People at risk should get eye exams at least every two years. They include - African Americans over age 40 - People over age 60, especially Mexican Americans - People with a family history of glaucoma There is no cure, but glaucoma can usually be controlled. Early treatment can help protect your eyes against vision loss. Treatments usually include prescription eyedrops and\/or surgery. NIH: National Eye Institute"},{"_answerid":"Q161-S1-A3","_pairid":"421","__text":"Glaucoma is a group of diseases that can damage the eye's optic nerve and result in vision loss and blindness. While glaucoma can strike anyone, the risk is much greater for people over 60. How Glaucoma Develops There are several different types of glaucoma. Most of these involve the drainage system within the eye. At the front of the eye there is a small space called the anterior chamber. A clear fluid flows through this chamber and bathes and nourishes the nearby tissues. (Watch the video to learn more about glaucoma. 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.) In glaucoma, for still unknown reasons, the fluid drains too slowly out of the eye. As the fluid builds up, the pressure inside the eye rises. Unless this pressure is controlled, it may cause damage to the optic nerve and other parts of the eye and result in loss of vision. Open-angle Glaucoma The most common type of glaucoma is called open-angle glaucoma. In the normal eye, the clear fluid leaves the anterior chamber at the open angle where the cornea and iris meet. When fluid reaches the angle, it flows through a spongy meshwork, like a drain, and leaves the eye. Sometimes, when the fluid reaches the angle, it passes too slowly through the meshwork drain, causing the pressure inside the eye to build. If the pressure damages the optic nerve, open-angle glaucoma -- and vision loss -- may result. There is no cure for glaucoma. Vision lost from the disease cannot be restored. However, there are treatments that may save remaining vision. That is why early diagnosis is important. See this graphic for a quick overview of glaucoma, including how many people it affects, who\u2019s at risk, what to do if you have it, and how to learn more. See a glossary of glaucoma terms."},{"_answerid":"Q161-S1-A4","_pairid":"422","__text":"Glaucoma is a group of diseases that can damage the eye's optic nerve and result in vision loss and blindness. The most common form of the disease is open-angle glaucoma. With early treatment, you can often protect your eyes against serious vision loss. (Watch the video to learn more about glaucoma. 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.) See this graphic for a quick overview of glaucoma, including how many people it affects, who\u2019s at risk, what to do if you have it, and how to learn more. See a glossary of glaucoma terms."},{"_answerid":"Q161-S1-A5","_pairid":"425","__text":"Through studies in the laboratory and with patients, the National Eye Institute is seeking better ways to detect, treat, and prevent vision loss in people with glaucoma. For example, researchers have discovered genes that could help explain how glaucoma damages the eye. NEI also is supporting studies to learn more about who is likely to get glaucoma, when to treat people who have increased eye pressure, and which treatment to use first."}],"SUB_QUESTION_ID":"Q161-S1","ANNOTATIONS_FOCUS":["glaucoma"],"ANNOTATIONS_TYPE":"information","SUBJECT":"Glaucoma","MESSAGE":"Can you mail me patient information about Glaucoma, I was recently diagnosed and want to learn all I can about the disease.","QUESTION_ID":"Q161","F_REF":"NF_231"} +{"ANSWERS":[{"_answerid":"Q162-S1-A1","_pairid":"427","__text":"Diagnosis is based on a review of a person's medical history, a physical examination, and laboratory tests. X-rays of the adrenal or pituitary glands can be useful in locating tumors."}],"SUB_QUESTION_ID":"Q162-S1","ANNOTATIONS_FOCUS":["cushing's syndrome"],"ANNOTATIONS_TYPE":"diagnosis","SUBJECT":"","MESSAGE":"EMAIL: [EMAIL] Hello - I suspect my son has Cushing's Syndrome. His recent U-Creatinine Excretion 24 hr urine test showed 21.6H nnol\/d. The lab range for normal is 7.0-17.0. I suspect this may be the result of muscle waste. Can you please tell me what this measure means in terms of the scale of the result - what does this difference represent and what can be expected as a result. Also how can we determine whether it is muscle waste that is the issue? Please help","QUESTION_ID":"Q162","F_REF":"10025"} +{"ANSWERS":[{"_answerid":"Q163-S1-A1","_pairid":"435","__text":"These resources address the diagnosis or management of spina bifida: - Benioff Children's Hospital, University of California, San Francisco: Treatment of Spina Bifida - Centers for Disease Control and Prevention: Living with Spina Bifida - GeneFacts: Spina Bifida: Diagnosis - GeneFacts: Spina Bifida: Management - Genetic Testing Registry: Neural tube defect - Genetic Testing Registry: Neural tube defects, folate-sensitive - Spina Bifida Association: Urologic Care and Management - University of California, San Francisco Fetal Treatment Center These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"},{"_answerid":"Q163-S1-A2","_pairid":"436","__text":"There is no cure for SB because the nerve tissue cannot be replaced or repaired. Treatment for the variety of effects of SB may include surgery, medication, and physiotherapy. Many individuals with SB will need assistive devices such as braces, crutches, or wheelchairs. Ongoing therapy, medical care, and\/or surgical treatments may be necessary to prevent and manage complications throughout the individual's life. Surgery to close the newborn's spinal opening is generally performed within 24 hours after birth to minimize the risk of infection and to preserve existing function in the spinal cord."}],"SUB_QUESTION_ID":"Q163-S1","ANNOTATIONS_FOCUS":["spina bifida"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"spina bifida; vertbral fusion;syrinx tethered cord. can u help for treatment of these problem","QUESTION_ID":"Q163","F_REF":"22"} +{"ANSWERS":[{"_answerid":"Q164-S1-A1","_pairid":"437","__text":"No treatment is necessary for Gilbert disease."},{"_answerid":"Q164-S1-A2","_pairid":"438","__text":"These resources address the diagnosis or management of Gilbert syndrome: - Genetic Testing Registry: Gilbert's syndrome These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"}],"SUB_QUESTION_ID":"Q164-S1","ANNOTATIONS_FOCUS":["gilberts disease"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"gilberts diseases","MESSAGE":"my name is [NAME]. 5days later i admitted in a hospital in treatment of viral fever.In hospital lot of tests blood,urine,ultrasound scan.In all tests my organs (lever,kidney,etc) are normal but my bilirubin Total is higher than normal. In my admission in hospital bilirubin is 3.2. Day by day my bilirubin decreased in the way of 2.8, 2.6, 2.4, 2.6, 2.5, respectevely. The other contents of blood and urine are normal at all. Hepatitis A,B,C are also negative.Today Bilirubin direct is 0.8. Doctor says it is Gilberts disease. Sir what can i do?. what is the reason for this?. what is your opinion sir? please reply soon .","QUESTION_ID":"Q164","F_REF":"1-136905355"} +{"ANSWERS":[{"_answerid":"Q164-S2-A1","_pairid":"439","__text":"An abnormal gene you inherit from your parents causes Gilbert's syndrome. The gene normally controls an enzyme that helps break down bilirubin in your liver. With an ineffective gene, excess amounts of bilirubin build in your blood. How the body normally processes bilirubin Bilirubin is a yellowish pigment made when your body breaks down old red blood cells. Bilirubin travels through your bloodstream to the liver, where normally an enzyme breaks down the bilirubin and removes it from the bloodstream. The bilirubin passes from the liver into the intestines with bile. It's then excreted in stool. A small amount of bilirubin remains in the blood. How the abnormal gene is passed through families The abnormal gene that causes Gilbert's syndrome is common. Many people carry one copy of this gene. In most cases, two abnormal copies are needed to cause Gilbert's syndrome."}],"SUB_QUESTION_ID":"Q164-S2","ANNOTATIONS_FOCUS":["gilberts disease"],"ANNOTATIONS_TYPE":"cause","SUBJECT":"gilberts diseases","MESSAGE":"my name is [NAME]. 5days later i admitted in a hospital in treatment of viral fever.In hospital lot of tests blood,urine,ultrasound scan.In all tests my organs (lever,kidney,etc) are normal but my bilirubin Total is higher than normal. In my admission in hospital bilirubin is 3.2. Day by day my bilirubin decreased in the way of 2.8, 2.6, 2.4, 2.6, 2.5, respectevely. The other contents of blood and urine are normal at all. Hepatitis A,B,C are also negative.Today Bilirubin direct is 0.8. Doctor says it is Gilberts disease. Sir what can i do?. what is the reason for this?. what is your opinion sir? please reply soon .","QUESTION_ID":"Q164","F_REF":"1-136905355"} +{"ANSWERS":[{"_answerid":"Q165-S1-A1","_pairid":"440","__text":"Treatment depends on the source of the problem, but may involve: - Injections of testosterone (in males) - Slow-release testosterone skin patch (in males) - Testosterone gels (in males) - Estrogen and progesterone pills or skin patches (in females) - GnRH injections"},{"_answerid":"Q165-S1-A2","_pairid":"441","__text":"Testosterone therapy may be prescribed. This can help: - Grow body hair - Improve appearance of muscles - Improve concentration - Improve mood and self esteem - Increase energy and sex drive - Increase strength Most men with this syndrome are not able to get a woman pregnant. But, an infertility specialist may be able to help. Seeing a doctor called an endocrinologist may also be helpful."},{"_answerid":"Q165-S1-A3","_pairid":"442","__text":"These resources address the diagnosis or management of Klinefelter syndrome: - Genetic Testing Registry: Klinefelter's syndrome, XXY - MedlinePlus Encyclopedia: Klinefelter Syndrome - MedlinePlus Encyclopedia: Testicular Failure These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"}],"SUB_QUESTION_ID":"Q165-S1","ANNOTATIONS_FOCUS":["klinefelter syndrome"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"ks","MESSAGE":"hi doctor my name is [NAME] m from [LOCATION] its almost a 2yrs i m not getting pregnant.. i have done few tests of my husband the sperm count is nil and i have done molecular biology karyotyping test and its a klinefelter syndrome. is dere any chance of getting pregnant? is dere any treatment for this ?please kindly help me.....if u need more details i would send u d reports( sir pls help me)","QUESTION_ID":"Q165","F_REF":"1-123737547"} +{"ANSWERS":[{"_answerid":"Q166-S1-A1","_pairid":"443","__text":"Treatment is based on many factors, including: - Type and stage of the cancer - Whether the cancer is sensitive to certain hormones - Whether the cancer overproduces (overexpresses) the HER2\/neu gene Cancer treatments may include: - Chemotherapy, which uses medicines to kill cancer cells. - Radiation therapy, which is used to destroy cancerous tissue. - Surgery to remove cancerous tissue: A lumpectomy removes the breast lump; mastectomy removes all or part of the breast and possibly nearby structures. - Targeted therapy uses medicine to attack the gene changes in cancer cells. Hormone therapy is an example of targeted therapy. It blocks certain hormones that fuel cancer growth. Cancer treatment can be local or systemic: - Local treatments involve only the area of disease. Radiation and surgery are forms of local treatment. They are most effective when the cancer has not spread outside the breast. - Systemic treatments affect the entire body. Chemotherapy and hormonal therapy are types of systemic treatment. Most women receive a combination of treatments. For women with stage I, II, or III breast cancer, the main goal is to treat the cancer and prevent it from returning (curing). For women with stage IV cancer, the goal is to improve symptoms and help them live longer. In most cases, stage IV breast cancer cannot be cured. - Stage 0 and ductal carcinoma -- Lumpectomy plus radiation or mastectomy is the standard treatment. - Stage I and II -- Lumpectomy plus radiation or mastectomy with lymph node removal is the standard treatment. Chemotherapy, hormonal therapy, and other targeted therapy may also be used after surgery. - Stage III -- Treatment involves surgery, possibly followed by chemotherapy, hormone therapy, and other targeted therapy. - Stage IV -- Treatment may involve surgery, radiation, chemotherapy, hormone therapy, other targeted therapy, or a combination of these treatments. After treatment, some women continue to take medicines for a time. All women continue to have blood tests, mammograms, and other tests after treatment. Women who have had a mastectomy may have reconstructive breast surgery. This will be done either at the time of mastectomy or later."},{"_answerid":"Q166-S1-A2","_pairid":"444","__text":"These resources address the diagnosis or management of breast cancer: - Gene Review: Gene Review: BRCA1 and BRCA2 Hereditary Breast\/Ovarian Cancer - Gene Review: Gene Review: Hereditary Diffuse Gastric Cancer - Gene Review: Gene Review: Li-Fraumeni Syndrome - Gene Review: Gene Review: PTEN Hamartoma Tumor Syndrome (PHTS) - Gene Review: Gene Review: Peutz-Jeghers Syndrome - Genetic Testing Registry: Familial cancer of breast - Genomics Education Programme (UK): Hereditary Breast and Ovarian Cancer - National Cancer Institute: Breast Cancer Risk Assessment Tool - National Cancer Institute: Genetic Testing for BRCA1 and BRCA2: It's Your Choice - National Cancer Institute: Genetic Testing for Hereditary Cancer Syndromes These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"},{"_answerid":"Q166-S1-A3","_pairid":"445","__text":"There are many treatment options for women with breast cancer. The choice of treatment depends on your age and general health, the stage of the cancer, whether or not it has spread beyond the breast, 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 People with cancer often are treated by a team of specialists. 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. (Watch the video about this breast cancer survivor's treatment. 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.) Clinical Trials for Breast Cancer Some breast cancer patients take part in studies of new treatments. These studies, called clinical trials, are designed to find out whether a new treatment is both safe and effective. Often, clinical trials compare a new treatment with a standard one so that doctors can learn which is more effective. Women with breast cancer who are interested in taking part in a clinical trial should talk to 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. See a list of the current clinical trials on breast cancer."},{"_answerid":"Q166-S1-A4","_pairid":"446","__text":"There are a number of treatments for breast cancer, but the ones women choose most often -- alone or in combination -- are surgery, hormone therapy, radiation therapy, and chemotherapy. What Standard Treatments Do Here is what the standard cancer treatments are designed to do. - Surgery takes out the cancer and some surrounding tissue. - Hormone therapy keeps cancer cells from getting most of the hormones they need to survive and grow. - Radiation therapy uses high-energy beams to kill cancer cells and shrink tumors and some surrounding tissue. - Chemotherapy uses anti-cancer drugs to kill most cancer cells. Surgery takes out the cancer and some surrounding tissue. Hormone therapy keeps cancer cells from getting most of the hormones they need to survive and grow. Radiation therapy uses high-energy beams to kill cancer cells and shrink tumors and some surrounding tissue. Chemotherapy uses anti-cancer drugs to kill most cancer cells. Treatment for breast cancer may involve local or whole body therapy. Doctors use local therapies, such as surgery or radiation, to remove or destroy breast cancer in a specific area. Whole body, or systemic, treatments like chemotherapy, hormonal, or biological therapies are used to destroy or control cancer throughout the body. Some patients have both kinds of treatment. Treating Early-Stage Breast Cancer If you have early-stage breast cancer, one common treatment available to you is a lumpectomy combined with radiation therapy. A lumpectomy is surgery that preserves a woman's breast. In a lumpectomy, the surgeon removes only the tumor and a small amount of the surrounding tissue. The survival rate for a woman who has this therapy plus radiation is similar to that for a woman who chooses a radical mastectomy, which is complete removal of a breast. If Cancer Has Spread Locally If you have breast cancer that has spread locally -- just to other parts of the breast -- your treatment may involve a combination of chemotherapy and surgery. Doctors usually first shrink the tumor with chemotherapy and then remove it through surgery. Shrinking the tumor before surgery may allow a woman to avoid a mastectomy and keep her breast. In the past, doctors would remove a lot of lymph nodes near breast tumors to see if the cancer had spread. Some doctors also use a method called sentinel node biopsy. Using a dye or radioactive tracer, surgeons locate the first or sentinel lymph node closest to the tumor, and remove only that node to see if the cancer has spread. If Cancer Has Spread Beyond the Breast If the breast cancer has spread to other parts of the body, such as the lung or bone, you might receive chemotherapy and\/or hormonal therapy to destroy cancer cells and control the disease. Radiation therapy may also be useful to control tumors in other parts of the body. Get more information about treatment options for breast cancer and for recurrent breast cancer."},{"_answerid":"Q166-S1-A5","_pairid":"449","__text":"Standard treatments for breast cancer include - surgery that takes out the cancer and some surrounding tissue - radiation therapy that uses high-energy beams to kill cancer cells and shrink tumors and some surrounding tissue. - chemotherapy that uses anti-cancer drugs to kill cancer most cells - hormone therapy that keeps cancer cells from getting most of the hormones they need to survive and grow. surgery that takes out the cancer and some surrounding tissue radiation therapy that uses high-energy beams to kill cancer cells and shrink tumors and some surrounding tissue. chemotherapy that uses anti-cancer drugs to kill cancer most cells hormone therapy that keeps cancer cells from getting most of the hormones they need to survive and grow. (Watch the video to learn about one breast cancer survivor's story. 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.)"},{"_answerid":"Q166-S1-A6","_pairid":"450","__text":"Even if the surgeon removes all of the cancer that can be seen at the time of surgery, a woman may still receive follow-up treatment. This may include radiation therapy, chemotherapy, or hormone therapy to try to kill any cancer cells that may be left. Treatment that a patient receives after surgery to increase the chances of a cure is called adjuvant therapy."},{"_answerid":"Q166-S1-A7","_pairid":"451","__text":"Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells and shrink tumors. This therapy often follows a lumpectomy, and is sometimes used after mastectomy. During radiation therapy, a machine outside the body sends high-energy beams to kill the cancer cells that may still be present in the affected breast or in nearby lymph nodes. Doctors sometimes use radiation therapy along with chemotherapy, or before or instead of surgery."},{"_answerid":"Q166-S1-A8","_pairid":"452","__text":"Chemotherapy is the use of drugs to kill cancer cells. A patient may take chemotherapy by mouth in pill form, or it may be put into the body by inserting a needle into a vein or muscle. Chemotherapy is called whole body or systemic treatment if the drug(s) enter the bloodstream, travel through the body, and kill cancer cells throughout the body. Treatment with standard chemotherapy can be as short as two months or as long as two years. Targeted therapies, usually in pill form, have become more common and focus on either a gene or protein abnormality and usually have few adverse side-effects as they directly affect the abnormality and not other cells or tissues in the body. Sometimes chemotherapy is the only treatment the doctor will recommend. More often, however, chemotherapy is used in addition to surgery, radiation therapy, and\/or biological therapy."},{"_answerid":"Q166-S1-A9","_pairid":"453","__text":"Hormonal therapy keeps cancer cells from getting the hormones they need to grow. This treatment may include the use of drugs that change the way hormones work. Sometimes it includes surgery to remove the ovaries, which make female hormones. Like chemotherapy, hormonal therapy can affect cancer cells throughout the body. Often, women with early-stage breast cancer and those with metastatic breast cancer -- meaning cancer that has spread to other parts of the body -- receive hormone therapy in the form of tamoxifen. Hormone therapy with tamoxifen or estrogens can act on cells all over the body. However, it may increase the chance of developing endometrial cancer. If you take tamoxifen, you should have a pelvic examination every year to look for any signs of cancer. A woman should report any vaginal bleeding, other than menstrual bleeding, to her doctor as soon as possible."},{"_answerid":"Q166-S1-A10","_pairid":"454","__text":"Certain drugs that have been used successfully in other cancers are now being used to treat some breast cancers. A mix of drugs may increase the length of time you will live, or the length of time you will live without cancer. In addition, certain drugs like Herceptin\u00ae and Tykerb\u00ae taken in combination with chemotherapy, can help women with specific genetic breast cancer mutations better than chemotherapy alone."}],"SUB_QUESTION_ID":"Q166-S1","ANNOTATIONS_FOCUS":["breast cancer"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"Breast cancer at 84. My mother was just diagnost with breast cancer. She is 84 years old, her tumor started in the milk duct and is small in size, their is a mass as well in the same breast. He is scheduled for a lumpectomy to remove both. Because of age we would like suggestions on treatment options after surgery.","QUESTION_ID":"Q166","F_REF":"10475"} +{"ANSWERS":[{"_answerid":"Q167-S1-A1","_pairid":"455","__text":"Polymicrogyria is a condition characterized by abnormal development of the brain before birth. The surface of the brain normally has many ridges or folds, called gyri. In people with polymicrogyria, the brain develops too many folds, and the folds are unusually small. The name of this condition literally means too many (poly-) small (micro-) folds (-gyria) in the surface of the brain. Polymicrogyria can affect part of the brain or the whole brain. When the condition affects one side of the brain, researchers describe it as unilateral. When it affects both sides of the brain, it is described as bilateral. The signs and symptoms associated with polymicrogyria depend on how much of the brain, and which particular brain regions, are affected. Researchers have identified multiple forms of polymicrogyria. The mildest form is known as unilateral focal polymicrogyria. This form of the condition affects a relatively small area on one side of the brain. It may cause minor neurological problems, such as mild seizures that can be easily controlled with medication. Some people with unilateral focal polymicrogyria do not have any problems associated with the condition. Bilateral forms of polymicrogyria tend to cause more severe neurological problems. Signs and symptoms of these conditions can include recurrent seizures (epilepsy), delayed development, crossed eyes, problems with speech and swallowing, and muscle weakness or paralysis. The most severe form of the disorder, bilateral generalized polymicrogyria, affects the entire brain. This condition causes severe intellectual disability, problems with movement, and seizures that are difficult or impossible to control with medication. Polymicrogyria most often occurs as an isolated feature, although it can occur with other brain abnormalities. It is also a feature of several genetic syndromes characterized by intellectual disability and multiple birth defects. These include 22q11.2 deletion syndrome, Adams-Oliver syndrome, Aicardi syndrome, Galloway-Mowat syndrome, Joubert syndrome, and Zellweger spectrum disorder."}],"SUB_QUESTION_ID":"Q167-S1","ANNOTATIONS_FOCUS":["polymicrogyria"],"ANNOTATIONS_TYPE":"information","SUBJECT":"","MESSAGE":"polymicrogyria. My 16 month old son has this. Does not sit up our crawl yet but still trying and is improving in grabbing things etc etc. Have read about other cases that seem 10000 time worse. It's it possible for this post of his brain to grown to normal and he grow out of it?","QUESTION_ID":"Q167","F_REF":"87"} +{"ANSWERS":[{"_answerid":"Q167-S2-A1","_pairid":"456","__text":"Researchers have identified multiple forms of polymicrogyria. The mildest form is known as unilateral focal polymicrogyria. This form of the condition affects a relatively small area on one side of the brain. It may cause minor neurological problems, such as mild seizures that can be easily controlled with medication. Some people with unilateral focal polymicrogyria do not have any problems associated with the condition. Bilateral forms of polymicrogyria tend to cause more severe neurological problems. Signs and symptoms of these conditions can include recurrent seizures (epilepsy), delayed development, crossed eyes, problems with speech and swallowing, and muscle weakness or paralysis. The most severe form of the disorder, bilateral generalized polymicrogyria, affects the entire brain. This condition causes severe intellectual disability, problems with movement, and seizures that are difficult or impossible to control with medication."}],"SUB_QUESTION_ID":"Q167-S2","ANNOTATIONS_FOCUS":["polymicrogyria"],"ANNOTATIONS_TYPE":"prognosis","SUBJECT":"","MESSAGE":"polymicrogyria. My 16 month old son has this. Does not sit up our crawl yet but still trying and is improving in grabbing things etc etc. Have read about other cases that seem 10000 time worse. It's it possible for this post of his brain to grown to normal and he grow out of it?","QUESTION_ID":"Q167","F_REF":"87"} +{"ANSWERS":[{"_answerid":"Q168-S1-A1","_pairid":"457","__text":"Sudden infant death syndrome (SIDS) is the unexpected, sudden death of a child under age 1. An autopsy does not show an explainable cause of death."},{"_answerid":"Q168-S1-A2","_pairid":"458","__text":"Summary Sudden infant death syndrome (SIDS) is the sudden, unexplained death of an infant younger than one year old. Some people call SIDS \"crib death\" because many babies who die of SIDS are found in their cribs. SIDS is the leading cause of death in children between one month and one year old. Most SIDS deaths occur when babies are between two months and four months old. Premature babies, boys, African Americans, and American Indian\/Alaska Native infants have a higher risk of SIDS. Although health care professionals don't know what causes SIDS, they do know ways to reduce the risk. These include - Placing babies on their backs to sleep, even for short naps. \"Tummy time\" is for when babies are awake and someone is watching - Using a firm sleep surface, such as a crib mattress covered with a fitted sheet - Keeping soft objects and loose bedding away from sleep area - Making sure babies don't get too hot. Keep the room at a comfortable temperature for an adult. - Don't smoke during pregnancy or allow anyone to smoke near your baby NIH: National Institute of Child Health and Human Development"}],"SUB_QUESTION_ID":"Q168-S1","ANNOTATIONS_FOCUS":["sids"],"ANNOTATIONS_TYPE":"information","SUBJECT":"","MESSAGE":"Hello, my name is [NAME] and i am a student at [LOCATION] here in [LOCATION]. I am composing a research report on SIDS and i was hoping you could help me with some information. I was particularly interested in learning weather parents should be worried about cribs death and if you could direct me to some resources on that, or even allow me to interview you. Thank you for your time. If you have anything else that might help me, i would really appreciate it. You can email me at [CONTACT] or contact me by my phone at [CONTACT]. Thanks again.","QUESTION_ID":"Q168","F_REF":"16734"} +{"ANSWERS":[{"_answerid":"Q169-S1-A1","_pairid":"459","__text":"Surgery is the only treatment that can permanently fix a hernia. Surgery may be more risky for people with serious medical problems. Surgery repairs the weakened abdominal wall tissue (fascia) and closes any holes. Most hernias are closed with stitches and sometimes with mesh patches to plug the hole. An umbilical hernia that does not heal on its own by the time a child is 5 years old will likely be repaired."}],"SUB_QUESTION_ID":"Q169-S1","ANNOTATIONS_FOCUS":["hernia"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"EMAIL: [EMAIL] I have an hernia I would love to take care off it ASAP I was wondering if you guys could help me . Thanks","QUESTION_ID":"Q169","F_REF":"12051"} +{"ANSWERS":[{"_answerid":"Q170-S1-A1","_pairid":"460","__text":"Most pregnant teenage girls did not plan to get pregnant. If you are a pregnant teen, it is very important to get health care during your pregnancy. Know that there are extra health risks for both you and your baby."},{"_answerid":"Q170-S1-A2","_pairid":"461","__text":"Summary Most teenage girls don't plan to get pregnant, but many do. Teen pregnancies carry extra health risks to both the mother and the baby. Often, teens don't get prenatal care soon enough, which can lead to problems later on. They have a higher risk for pregnancy-related high blood pressure and its complications. Risks for the baby include premature birth and a low birth weight. If you're a pregnant teen, you can help yourself and your baby by - Getting regular prenatal care - Taking your prenatal vitamins for your health and to prevent some birth defects - Avoiding smoking, alcohol, and drugs - Using a condom, if you are having sex, to prevent sexually transmitted diseases that could hurt your baby"}],"SUB_QUESTION_ID":"Q170-S1","ANNOTATIONS_FOCUS":["teen pregnancy"],"ANNOTATIONS_TYPE":"information","SUBJECT":"Teen pregnancy","MESSAGE":"Good morning, I am a student from Carver Military Academy on the far south side of Chicago. My fellow classmates and I are conducting a research project on social issues and problems we are affected by everyday mine is Teen Pregnancy. Since I am a teenager I know how having a child can really affect our young lives. They can stop our achievements in school, goals for the future,all our fun would stop,and our dreams. I would like to ask someone from your organization a few questions because it seems as though your organization could provide me with valuable information about teen pregnancy,statistics,facts, and your opinion about it. Your time and assistance would be greatly appreciated and I hope to hear from you soon. Thank you, [NAME]","QUESTION_ID":"Q170","F_REF":"13614"} +{"ANSWERS":[{"_answerid":"Q171-S1-A1","_pairid":"462","__text":"There are two major types of stroke: - Ischemic stroke - Hemorrhagic stroke Ischemic stroke occurs when a blood vessel that supplies blood to the brain is blocked by a blood clot. This may happen in two ways: - A clot may form in an artery that is already very narrow. This is called a thrombotic stroke. - A clot may break off from another place in the blood vessels of the brain, or from some other part of the body, and travel up to the brain. This is called cerebral embolism, or an embolic stroke. Ischemic strokes may also be caused by a sticky substance called plaque that can clog arteries. Watch this video about: Stroke Watch this video about: Stroke - secondary to cardiogenic embolism A hemorrhagic stroke occurs when a blood vessel in part of the brain becomes weak and bursts open. This causes blood to leak into the brain. Some people have defects in the blood vessels of the brain that make this more likely. These defects may include: - Aneurysm - Arteriovenous malformation (AVM) Hemorrhagic strokes may also occur when someone is taking blood thinners, such as warfarin (Coumadin). Very high blood pressure may cause blood vessels to burst, leading to hemorrhagic stroke. An ischemic stroke can develop bleeding and become a hemorrhagic stroke. High blood pressure is the main risk factor for strokes. Other major risk factors are: - Irregular heartbeat, called atrial fibrillation - Diabetes - Family history of stroke - High cholesterol - Increasing age, especially after age 55 - Ethnicity (African Americans are more likely to die of a stroke) Watch this video about: Hypertension - overview Stroke risk is also higher in: - People who have heart disease or poor blood flow in their legs caused by narrowed arteries - People who have unhealthy lifestyle habits such as smoking, a high-fat diet, and lack of exercise - Women who take birth control pills (especially those who smoke and are older than 35) - Women who are pregnant have an increased risk while pregnant - Women who take hormone replacement therapy"}],"SUB_QUESTION_ID":"Q171-S1","ANNOTATIONS_FOCUS":["stroke"],"ANNOTATIONS_TYPE":"cause","SUBJECT":"Stroke Due to Aneurysm?","MESSAGE":"My son had a hemmorhagic stroke at 4 weeks of age....he is now 31 years old. In the week leading up to the stroke he had a head cold and I had been giving him infant cold drops. After he had the stroke the doctors at the time could only say that it was a 'fluke' and would probably never happen again. The reason for the stroke has haunted me ever since. Now we just recently found out that my mother has a cerebral aneurysm and they say this can be hereditary. So my question now is 'did my son have an aneurysm that burst or was it caused by a blood clot?...is there anyway of knowing or getting an answer to that question after the event has happened?","QUESTION_ID":"Q171","F_REF":"1-134591345"} +{"ANSWERS":[{"_answerid":"Q172-S1-A1","_pairid":"463","__text":"These resources address the diagnosis or management of Meesmann corneal dystrophy: - Genetic Testing Registry: Meesman's corneal dystrophy - Merck Manual Home Health Handbook: Tests for Eye Disorders: The Eye Examination These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care"}],"SUB_QUESTION_ID":"Q172-S1","ANNOTATIONS_FOCUS":["meesmann corneal dystrophy"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"seeking help for a loved one","MESSAGE":"Hello I am seeking help for my partner. He has Meesmann Corneal Dystrophy. He has had this condition since birth but was not diagnosed until he was 28. He has had epithelial debriding and laser keratectomy. He has used many different drops and has also tried contact lenses. Each treatment has been unsuccessful and his symptoms are getting worse. He has excruciating pain during flair ups as well as photosensitivity and compromised vision. We have children and he can not work because of his condition. Any help or information you can give us is greatly appreciated. Thank you [NAME]","QUESTION_ID":"Q172","F_REF":"1-135810627"} +{"ANSWERS":[{"_answerid":"Q172-S2-A1","_pairid":"464","__text":"Meesmann corneal dystrophy is an eye disease that affects the cornea, which is the clear front covering of the eye. This condition is characterized by the formation of tiny round cysts in the outermost layer of the cornea, called the corneal epithelium. This part of the cornea acts as a barrier to help prevent foreign materials, such as dust and bacteria, from entering the eye. In people with Meesmann corneal dystrophy, cysts can appear as early as the first year of life. They usually affect both eyes and increase in number over time. The cysts usually do not cause any symptoms until late adolescence or adulthood, when they start to break open (rupture) on the surface of the cornea and cause irritation. The resulting symptoms typically include increased sensitivity to light (photophobia), twitching of the eyelids (blepharospasm), increased tear production, the sensation of having a foreign object in the eye, and an inability to tolerate wearing contact lenses. Some affected individuals also have temporary episodes of blurred vision."}],"SUB_QUESTION_ID":"Q172-S2","ANNOTATIONS_FOCUS":["meesmann corneal dystrophy"],"ANNOTATIONS_TYPE":"information","SUBJECT":"seeking help for a loved one","MESSAGE":"Hello I am seeking help for my partner. He has Meesmann Corneal Dystrophy. He has had this condition since birth but was not diagnosed until he was 28. He has had epithelial debriding and laser keratectomy. He has used many different drops and has also tried contact lenses. Each treatment has been unsuccessful and his symptoms are getting worse. He has excruciating pain during flair ups as well as photosensitivity and compromised vision. We have children and he can not work because of his condition. Any help or information you can give us is greatly appreciated. Thank you [NAME]","QUESTION_ID":"Q172","F_REF":"1-135810627"} +{"ANSWERS":[{"_answerid":"Q173-S1-A1","_pairid":"465","__text":"Ovarian cancer is rarely diagnosed in its early stages. It is usually quite advanced by the time diagnosis is made: - 3 of 4 women with ovarian cancer survive 1 year after diagnosis - Nearly half of women live longer than 5 years after diagnosis - If diagnosis is made early in the disease and treatment is received before the cancer spreads outside the ovary, the 5-year survival rate is high"}],"SUB_QUESTION_ID":"Q173-S1","ANNOTATIONS_FOCUS":["ovarian cancer"],"ANNOTATIONS_TYPE":"prognosis","SUBJECT":"High Intensity Focused Ultrasound","MESSAGE":"Have any follow ups on women with ovarian cancer taken place?","QUESTION_ID":"Q173","F_REF":"14557"} +{"ANSWERS":[{"_answerid":"Q174-S1-A1","_pairid":"466","__text":"Summary Pneumonia is an infection in one or both of the lungs. Many germs, such as bacteria, viruses, and fungi, can cause pneumonia. You can also get pneumonia by inhaling a liquid or chemical. People most at risk are older than 65 or younger than 2 years of age, or already have health problems. Symptoms of pneumonia vary from mild to severe. See your doctor promptly if you - Have a high fever - Have shaking chills - Have a cough with phlegm that doesn't improve or gets worse - Develop shortness of breath with normal daily activities - Have chest pain when you breathe or cough - Feel suddenly worse after a cold or the flu Your doctor will use your medical history, a physical exam, and lab tests to diagnose pneumonia. Treatment depends on what kind you have. If bacteria are the cause, antibiotics should help. If you have viral pneumonia, your doctor may prescribe an antiviral medicine to treat it. Preventing pneumonia is always better than treating it. Vaccines are available to prevent pneumococcal pneumonia and the flu. Other preventive measures include washing your hands frequently and not smoking. NIH: National Heart, Lung, and Blood Institute"},{"_answerid":"Q174-S1-A2","_pairid":"467","__text":"Pneumonia (nu-MO-ne-ah) is an infection in one or both of the lungs. Many germs\u2014such as bacteria, viruses, and fungi\u2014can cause pneumonia. The infection inflames your lungs' air sacs, which are called alveoli (al-VEE-uhl-eye). The air sacs may fill up with fluid or pus, causing symptoms such as a cough with phlegm (a slimy substance), fever, chills, and trouble breathing. Overview Pneumonia and its symptoms can vary from mild to severe. Many factors affect how serious pneumonia is, such as the type of germ causing the infection and your age and overall health. Pneumonia tends to be more serious for: Infants and young children. Older adults (people 65 years or older). People who have other health problems, such as heart failure, diabetes, or COPD (chronic obstructive pulmonary disease). People who have weak immune systems as a result of diseases or other factors. Examples of these diseases and factors include HIV\/AIDS, chemotherapy (a treatment for cancer), and an organ transplant or blood and marrow stem cell transplant. Outlook Pneumonia is common in the United States. Treatment for pneumonia depends on its cause, how severe your symptoms are, and your age and overall health. Many people can be treated at home, often with oral antibiotics. Children usually start to feel better in 1 to 2 days. For adults, it usually takes 2 to 3 days. Anyone who has worsening symptoms should see a doctor. People who have severe symptoms or underlying health problems may need treatment in a hospital. It may take 3 weeks or more before they can go back to their normal routines. Fatigue (tiredness) from pneumonia can last for a month or more."}],"SUB_QUESTION_ID":"Q174-S1","ANNOTATIONS_FOCUS":["pneumonia"],"ANNOTATIONS_TYPE":"information","SUBJECT":"CURE FOR PNEUMONIA","MESSAGE":"Dear DR, please i have a friend that has the above illness..I want to find out...since i want to marry her...is it an infectious illness,,and can it be totally cured. And how can i help her to get this cured..Please i really need your reply urgently","QUESTION_ID":"Q174","F_REF":"1-123968715"} +{"ANSWERS":[{"_answerid":"Q174-S2-A1","_pairid":"468","__text":"Treatment for pneumonia depends on the type of pneumonia you have and how severe it is. Most people who have community-acquired pneumonia\u2014the most common type of pneumonia\u2014are treated at home. The goals of treatment are to cure the infection and prevent complications. General Treatment If you have pneumonia, follow your treatment plan, take all medicines as prescribed, and get ongoing medical care. Ask your doctor when you should schedule followup care. Your doctor may want you to have a chest x ray to make sure the pneumonia is gone. Although you may start feeling better after a few days or weeks, fatigue (tiredness) can persist for up to a month or more. People who are treated in the hospital may need at least 3 weeks before they can go back to their normal routines. Bacterial Pneumonia Bacterial pneumonia is treated with medicines called antibiotics. You should take antibiotics as your doctor prescribes. You may start to feel better before you finish the medicine, but you should continue taking it as prescribed. If you stop too soon, the pneumonia may come back. Most people begin to improve after 1 to 3 days of antibiotic treatment. This means that they should feel better and have fewer symptoms, such as cough and fever. Viral Pneumonia Antibiotics don't work when the cause of pneumonia is a virus. If you have viral pneumonia, your doctor may prescribe an antiviral medicine to treat it. Viral pneumonia usually improves in 1 to 3 weeks. Treating Severe Symptoms You may need to be treated in a hospital if: Your symptoms are severe You're at risk for complications because of other health problems If the level of oxygen in your bloodstream is low, you may receive oxygen therapy. If you have bacterial pneumonia, your doctor may give you antibiotics through an intravenous (IV) line inserted into a vein."},{"_answerid":"Q174-S2-A2","_pairid":"469","__text":"Treatment for pneumonia depends on the type of pneumonia you have and how severe it is. Most people who have community-acquired pneumonia\u2014the most common type of pneumonia\u2014are treated at home. The goals of treatment are to cure the infection and prevent complications. General Treatment If you have pneumonia, follow your treatment plan, take all medicines as prescribed, and get ongoing medical care. Ask your doctor when you should schedule followup care. Your doctor may want you to have a chest x ray to make sure the pneumonia is gone. Although you may start feeling better after a few days or weeks, fatigue (tiredness) can persist for up to a month or more. People who are treated in the hospital may need at least 3 weeks before they can go back to their normal routines. Bacterial Pneumonia Bacterial pneumonia is treated with medicines called antibiotics. You should take antibiotics as your doctor prescribes. You may start to feel better before you finish the medicine, but you should continue taking it as prescribed. If you stop too soon, the pneumonia may come back. Most people begin to improve after 1 to 3 days of antibiotic treatment. This means that they should feel better and have fewer symptoms, such as cough and fever. Viral Pneumonia Antibiotics don't work when the cause of pneumonia is a virus. If you have viral pneumonia, your doctor may prescribe an antiviral medicine to treat it. Viral pneumonia usually improves in 1 to 3 weeks. Treating Severe Symptoms You may need to be treated in a hospital if: Your symptoms are severe You're at risk for complications because of other health problems If the level of oxygen in your bloodstream is low, you may receive oxygen therapy. If you have bacterial pneumonia, your doctor may give you antibiotics through an intravenous (IV) line inserted into a vein."}],"SUB_QUESTION_ID":"Q174-S2","ANNOTATIONS_FOCUS":["pneumonia"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"CURE FOR PNEUMONIA","MESSAGE":"Dear DR, please i have a friend that has the above illness..I want to find out...since i want to marry her...is it an infectious illness,,and can it be totally cured. And how can i help her to get this cured..Please i really need your reply urgently","QUESTION_ID":"Q174","F_REF":"1-123968715"} +{"ANSWERS":[{"_answerid":"Q175-S1-A1","_pairid":"470","__text":"Most low back pain can be treated without surgery. Treatment involves using over-the-counter pain relievers to reduce discomfort and anti-inflammatory drugs to reduce inflammation. The goal of treatment is to restore proper function and strength to the back, and prevent recurrence of the injury. Medications are often used to treat acute and chronic low back pain. Effective pain relief may involve a combination of prescription drugs and over-the-counter remedies. Although the use of cold and hot compresses has never been scientifically proven to quickly resolve low back injury, compresses may help reduce pain and inflammation and allow greater mobility for some individuals. Bed rest is recommended for only 1\u20132 days at most. Individuals should resume activities as soon as possible. Exercise may be the most effective way to speed recovery from low back pain and help strengthen back and abdominal muscles. In the most serious cases, when the condition does not respond to other therapies, surgery may relieve pain caused by back problems or serious musculoskeletal injuries."}],"SUB_QUESTION_ID":"Q175-S1","ANNOTATIONS_FOCUS":["back pain"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"help","MESSAGE":"I have back pain. Please help.","QUESTION_ID":"Q175","F_REF":"18410"} +{"ANSWERS":[{"_answerid":"Q176-S1-A1","_pairid":"471","__text":"Rubella is most often a mild infection. After an infection, people have immunity to the disease for the rest of their lives."}],"SUB_QUESTION_ID":"Q176-S1","ANNOTATIONS_FOCUS":["rubella"],"ANNOTATIONS_TYPE":"prognosis","SUBJECT":"Rubella","MESSAGE":"My grandson (4 yrs old) has contracted Rubella. I know for sure he has had at least one of the vaccines. They are living in Mexico right now. Should we be worried?","QUESTION_ID":"Q176","F_REF":"12233"} +{"ANSWERS":[{"_answerid":"Q177-S1-A1","_pairid":"472","__text":"How well a person does after a stroke depends on: - The type of stroke - How much brain tissue is damaged - What body functions have been affected - How quickly treatment is given Problems moving, thinking, and talking often improve in the weeks to months after a stroke. Many people who have had a stroke will keep improving in the months or years after their stroke. Over half of people who have a stroke are able to function and live at home. Others are not able to care for themselves. If treatment with clot-busting drugs is successful, the symptoms of a stroke may go away. However, patients often do not get to the hospital soon enough to receive these drugs, or they can't take these drugs because of a health condition. People who have a stroke from a blood clot (ischemic stroke) have a better chance of surviving than those who have a stroke from bleeding in the brain (hemorrhagic stroke). The risk for a second stroke is highest during the weeks or months after the first stroke. The risk begins to decrease after this period."},{"_answerid":"Q177-S1-A2","_pairid":"473","__text":"Although stroke is a disease of the brain, it can affect the entire body. A common disability that results from stroke is complete paralysis on one side of the body, called hemiplegia. A related disability that is not as debilitating as paralysis is one-sided weakness or hemiparesis. Stroke may cause problems with thinking, awareness, attention, learning, judgment, and memory. Stroke survivors often have problems understanding or forming speech. A stroke can lead to emotional problems. Stroke patients may have difficulty controlling their emotions or may express inappropriate emotions. Many stroke patients experience depression. Stroke survivors may also have numbness or strange sensations. The pain is often worse in the hands and feet and is made worse by movement and temperature changes, especially cold temperatures. Recurrent stroke is frequent; about 25 percent of people who recover from their first stroke will have another stroke within 5 years."}],"SUB_QUESTION_ID":"Q177-S1","ANNOTATIONS_FOCUS":["stroke"],"ANNOTATIONS_TYPE":"prognosis","SUBJECT":"recovery after stroke?","MESSAGE":"what is the pattern of recovery after stroke?","QUESTION_ID":"Q177","F_REF":"1-120005227"} +{"ANSWERS":[{"_answerid":"Q178-S1-A1","_pairid":"476","__text":"Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur: Less common Bone fracture breast pain chest pain chills, fever, or flu-like symptoms mental depression shortness of breath swelling of the feet or lower legs Rare Continuing or severe nervousness cough dizziness or lightheadedness fainting fast heartbeat heart attack increased sweating nausea pain in the chest, groin, or legs, especially the calves severe and sudden, unexplained shortness of breath severe, sudden headache slurred speech sudden loss of coordination sudden, severe weakness or numbness in the arm or leg vaginal bleeding vision changes Incidence not known Black, tarry stools blindness blurred vision burning, crawling, itching, numbness, prickling, \"pins and needles\", or tingling feelings chest discomfort decreased vision dilated neck veins extreme fatigue increased need to urinate irregular breathing irregular heartbeat painful or difficult urination passing urine more often sore throat sores, ulcers, or white spots on the lips or in the mouth swollen glands unusual bleeding or bruising unusual tiredness or weakness weight gain wheezing white or brownish vaginal discharge Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: More common Back pain bone pain hot flashes (sudden sweating and feeling of warmth) joint pain muscle pain Less common Anxiety confusion constipation diarrhea dry mouth headache increased thirst loss of appetite or weight loss metallic taste skin rash or itching sleepiness spinning or whirling sensation causing loss of balance stomach pain or upset trouble sleeping vomiting weakness Incidence not known Bad, unusual, or unpleasant (after) taste and thirst being forgetful change in taste dryness of the skin hair loss hives or welts increased appetite irritability nervousness red, sore eyes redness of the skin swelling or inflammation of the mouth Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088."}],"SUB_QUESTION_ID":"Q178-S1","ANNOTATIONS_FOCUS":["Letrozole"],"ANNOTATIONS_TYPE":"side effects","SUBJECT":"Letrozole","MESSAGE":"Is there information available from women who have or are using it? I'd like to know what their reactions to the drug are. Thank you for your help.","QUESTION_ID":"Q178","F_REF":"1-121844935"} +{"ANSWERS":[{"_answerid":"Q179-S1-A1","_pairid":"477","__text":"No cure has yet been found for ALS. However, the drug riluzole--the only prescribed drug approved by the Food and Drug Administration (FDA) to treat ALS--prolongs life by 2-3 months but does not relieve symptoms. \u00a0The FDA has also approved the NeuRx Diaphragm Pacing System, which uses implanted electrodes and a battery pack to cause the diaphragm (breathing muscle) to contract, to help certain individuals who have ALS and breathing problems an average benefit of 16 months before onset of severe respiratory failure. Other treatments are designed to relieve symptoms and improve the quality of life for people with ALS.\u00a0 Drugs are available to help individuals with spasticity, pain, panic attacks, and depression. \u00a0Physical therapy, occupational therapy, and rehabilitation may help to prevent joint immobility and slow muscle weakness and atrophy. \u00a0Individuals with ALS may eventually consider forms of mechanical ventilation (respirators)."}],"SUB_QUESTION_ID":"Q179-S1","ANNOTATIONS_FOCUS":["als"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"meidcation for ALS patient","MESSAGE":"what medication and food that can give to ALS patient to help with the slow progession of the disease","QUESTION_ID":"Q179","F_REF":"1-131099935"} +{"ANSWERS":[{"_answerid":"Q180-S1-A1","_pairid":"478","__text":"Vitiligo is a skin condition in which there is a loss of brown color (pigment) from areas of skin, resulting in irregular white patches that feel like normal skin."},{"_answerid":"Q180-S1-A2","_pairid":"479","__text":"Summary Vitiligo causes white patches on your skin. It can also affect your eyes, mouth, and nose. It occurs when the cells that give your skin its color are destroyed. No one knows what destroys them. It is more common in people with autoimmune diseases, and it might run in families. It usually starts before age 40. The white patches are more common where your skin is exposed to the sun. In some cases, the patches spread. Vitiligo can cause your hair to gray early. If you have dark skin, you may lose color inside your mouth. Using sunscreen will help protect your skin, and cosmetics can cover up the patches. Treatments for vitiligo include medicines, light therapy, and surgery. Not every treatment is right for everyone. Many have side effects. Some take a long time. Some do not always work. NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases"},{"_answerid":"Q180-S1-A3","_pairid":"480","__text":"Vitiligo is a condition that causes patchy loss of skin coloring (pigmentation). The average age of onset of vitiligo is in the mid-twenties, but it can appear at any age. It tends to progress over time, with larger areas of the skin losing pigment. Some people with vitiligo also have patches of pigment loss affecting the hair on their scalp or body. Researchers have identified several forms of vitiligo. Generalized vitiligo (also called nonsegmental vitiligo), which is the most common form, involves loss of pigment (depigmentation) in patches of skin all over the body. Depigmentation typically occurs on the face, neck, and scalp, and around body openings such as the mouth and genitals. Sometimes pigment is lost in mucous membranes, such as the lips. Loss of pigmentation is also frequently seen in areas that tend to experience rubbing, impact, or other trauma, such as the hands, arms, and places where bones are close to the skin surface (bony prominences). Another form called segmental vitiligo is associated with smaller patches of depigmented skin that appear on one side of the body in a limited area; this occurs in about 10 percent of affected individuals. Vitiligo is generally considered to be an autoimmune disorder. Autoimmune disorders occur when the immune system attacks the body's own tissues and organs. In people with vitiligo the immune system appears to attack the pigment cells (melanocytes) in the skin. About 15 to 25 percent of people with vitiligo are also affected by at least one other autoimmune disorder, particularly autoimmune thyroid disease, rheumatoid arthritis, type 1 diabetes, psoriasis, pernicious anemia, Addison disease, or systemic lupus erythematosus. In the absence of other autoimmune conditions, vitiligo does not affect general health or physical functioning. However, concerns about appearance and ethnic identity are significant issues for many affected individuals."}],"SUB_QUESTION_ID":"Q180-S1","ANNOTATIONS_FOCUS":["vitiligo"],"ANNOTATIONS_TYPE":"information","SUBJECT":"ClinicalTrials.gov - Question - general information","MESSAGE":"Trying to talk to someone about Vitiligo","QUESTION_ID":"Q180","F_REF":"1-131989675"} +{"ANSWERS":[{"_answerid":"Q181-S1-A1","_pairid":"481","__text":"Pregabalin comes as a capsule to take by mouth. It is usually taken with or without food two or three times a day. Take pregabalin at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Your doctor will probably start you on a low dose of pregabalin and may gradually increase your dose during the first week of treatment. Take pregabalin exactly as directed. Pregabalin may be habit forming. Do not take a larger dose, take it more often, or take it for a longer period of time than prescribed by your doctor. Pregabalin may help control your symptoms but will not cure your condition. It may take several weeks or longer before you feel the full benefit of pregabalin. Continue to take pregabalin even if you feel well. Do not stop taking pregabalin without talking to your doctor, even if you experience side effects such as unusual changes in behavior or mood. If you suddenly stop taking pregabalin, you may experience withdrawal symptoms, including trouble falling asleep or staying asleep, nausea, diarrhea, headaches, or seizures. Your doctor will probably decrease your dose gradually over at least one week. Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with pregabalin and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http:\/\/www.fda.gov\/Drugs) or the manufacturer's website to obtain the Medication Guide."}],"SUB_QUESTION_ID":"Q181-S1","ANNOTATIONS_FOCUS":["pregabalin"],"ANNOTATIONS_TYPE":"tapering","SUBJECT":"stopping pregabalin","MESSAGE":"why is there no info on the withdrawal symptems when stopping pregabalin","QUESTION_ID":"181","F_REF":"1-122818715"} +{"ANSWERS":[{"_answerid":"Q182-S1-A1","_pairid":"482","__text":"There were no interactions found in our database between Advair Diskus and Spiriva However, this does not necessarily mean no interactions exist. Always consult with your doctor or pharmacist. Advair Diskus is in the drug class bronchodilator combinations. Advair Diskus is used to treat the following conditions: Asthma, Maintenance, COPD, Maintenance. Spiriva is a member of the drug class anticholinergic bronchodilators. Spiriva is used to treat COPD, Maintenance."}],"SUB_QUESTION_ID":"Q182-S1","ANNOTATIONS_FOCUS":["Advair","Spiriva"],"ANNOTATIONS_TYPE":"interaction","SUBJECT":"","MESSAGE":"should Advair and Spiriva be used together? It is my understanding that they are both control meds","QUESTION_ID":"182","F_REF":"1-122827845"} +{"ANSWERS":[{"_answerid":"Q183-S1-A1","_pairid":"483","__text":"Kartagener syndrome is a type of primary ciliary dyskinesia that is also characterized by situs inversus totalis (mirror-image reversal of internal organs). The signs and symptoms vary but may include neonatal respiratory distress; frequent lung, sinus and middle ear infections beginning in early childhood; and infertility.[1][2][3] It can be cause by changes (mutations) in many different genes that are inherited in an autosomal recessive manner. Although scientists have identified many of the genes associated with Kartagener syndrome, the genetic cause of some cases is unknown.[4][2] There is no cure for Kartagener syndrome. Treatment varies based on the signs and symptoms present in each person but may include airway clearance therapy and antibiotics.[1][2][3]"}],"SUB_QUESTION_ID":"Q183-S1","ANNOTATIONS_FOCUS":["kartagener's syndrome"],"ANNOTATIONS_TYPE":"information","SUBJECT":"","MESSAGE":"Kartagener's syndrome. I am suffering from Kartagener's syndrome and wanted information from you or from Dr. [NAME]. for this syndrome. (About fertility) and if possible other symptoms. Thank you.","QUESTION_ID":"Q183","F_REF":"92"} +{"ANSWERS":[{"_answerid":"Q184-S1-A1","_pairid":"484","__text":"Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication."}],"SUB_QUESTION_ID":"Q184-S1","ANNOTATIONS_FOCUS":["Ciprofloxacin Ophthalmic"],"ANNOTATIONS_TYPE":"storage and disposal","SUBJECT":"","MESSAGE":"can I use 1yr expired Ciprofloxacin Ophthalmic?","QUESTION_ID":"Q184","F_REF":"1-122925195"} +{"ANSWERS":[{"_answerid":"Q185-S1-A1","_pairid":"485","__text":"AZITHROMYCIN TABLETS 250 mg and 500 mg To reduce the development of drug-resistant bacteria and maintain the effectiveness of azithromycin and other antibacterial drugs, azithromycin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria. DESCRIPTION Azithromycin for oral suspension, USP contain the active ingredient azithromycin, an azalide, a subclass of macrolide antibiotics, for oral administration. Azithromycin has the chemical name (2R,3S,4R,5R,8R,10R,11R,12S,13S,14R)-13-[(2,6-dideoxy-3-C-methyl-3-O-methyl-\u03b1-L-ribohexopyranosyl) oxy]-2-ethyl-3,4,10-trihydroxy-3,5,6,8,10,12,14-heptamethyl-11-[[3,4,6-trideoxy-3- (dimethylamino)-\u03b2-D-xylo-hexopyranosyl]oxy]-1-oxa-6-azacyclopentadecan-15-one. Azithromycin is derived from erythromycin; however, it differs chemically from erythromycin in that a methyl-substituted nitrogen atom is incorporated into the lactone ring. Its molecular formula is C38H72N2O12, and its molecular weight is 749.00. Azithromycin has the following structural formula: Azithromycin, as the monohydrate, is a white crystalline powder with a molecular formula of C38H72N2O12\u2022H2O and a molecular weight of 767.0. Each tablet for oral administration contains azithromycin monohydrate equivalent to either 250 mg or 500 mg azithromycin. In addition each tablet contains the following inactive ingredients: croscarmellose sodium, dibasic calcium phosphate anhydrous, hypromellose, lactose monohydrate, polyethylene glycol, magnesium stearate, microcrystalline cellulose, partially pregelantinized starch, sodium citrate, sodium lauryl sulfate, titanium dioxide and FD&C Blue No. 2 (500 mg only)."}],"SUB_QUESTION_ID":"Q185-S1","ANNOTATIONS_FOCUS":["Azithromycin 250mg tabs"],"ANNOTATIONS_TYPE":"ingredient","SUBJECT":"Azithromycin 250mg gluten","MESSAGE":"Hello can you please tell me if your Azithromycin 250mg tabs are gluten free? Thank you!","QUESTION_ID":"Q185","F_REF":"1-122963347"} +{"ANSWERS":[{"_answerid":"Q186-S1-A1","_pairid":"486","__text":"Lightheadedness occurs when your brain does not get enough blood. This may occur if: - You have a sudden drop in blood pressure. - Your body does not have enough water (is dehydrated) because of vomiting, diarrhea, fever, and other conditions. - You get up too quickly after sitting or lying down (this is more common in older people). Lightheadedness may also occur if you have the flu, low blood sugar, a cold, or allergies. More serious conditions that can lead to light-headedness include: - Heart problems, such as a heart attack or abnormal heart beat - Stroke - Bleeding inside the body - Shock (extreme drop in blood pressure) If any of these serious disorders are present, you will usually also have symptoms like chest pain, a feeling of a racing heart, loss of speech, change in vision, or other symptoms. Vertigo may be due to: - Benign positional vertigo, a spinning feeling that occurs when you move your head - Labyrinthitis, a viral infection of the inner ear that usually follows a cold or flu - Meniere's disease, a common inner ear problem Other causes of lightheadedness or vertigo may include: - Use of certain medicines - Stroke - Multiple sclerosis - Seizures - Brain tumor - Bleeding in the brain"}],"SUB_QUESTION_ID":"Q186-S1","ANNOTATIONS_FOCUS":["dizziness"],"ANNOTATIONS_TYPE":"cause","SUBJECT":"subjective vertigo","MESSAGE":"Can macular degeneration in only one eye cause dizziness?","QUESTION_ID":"Q186","F_REF":"1-120018325"} +{"ANSWERS":[{"_answerid":"Q187-S1-A1","_pairid":"487","__text":"Before taking allopurinol, tell your doctor and pharmacist if you are allergic to allopurinol or any other medications. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: amoxicillin (Amoxil, Trimox); ampicillin (Polycillin, Principen); anticoagulants ('blood thinners') such as warfarin (Coumadin); cancer chemotherapy drugs such as cyclophosphamide (Cytoxan) and mercaptopurine (Purinethol); chlorpropamide (Diabinese); diuretics ('water pills'); medications that suppress the immune system such as azathioprine (Imuran) and cyclosporine (Neoral, Sandimmune); other medications for gout such as probenecid (Benemid) and sulfinpyrazone (Anturane); and tolbutamide (Orinase). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. tell your doctor if you have or have ever had kidney or liver disease or heart failure. tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking allopurinol, call your doctor. you should know that allopurinol may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you. ask your doctor about the safe use of alcoholic beverages while you are taking allopurinol. Alcohol may decrease the effectiveness of allopurinol."}],"SUB_QUESTION_ID":"Q187-S1","ANNOTATIONS_FOCUS":["allopurinol","diuretics"],"ANNOTATIONS_TYPE":"interaction","SUBJECT":"allopurinol and diuretics","MESSAGE":"I am presently taking 200mg Allopurinol daily for the treatment of Gout. My feet swell. How dangerous is it to take a diuretic.","QUESTION_ID":"Q187","F_REF":"1-122992685"} +{"ANSWERS":[{"_answerid":"Q188-S1-A1","_pairid":"488","__text":"In most cases of diarrhea, the only treatment necessary is replacing lost fluids and electrolytes to prevent dehydration. Over-the-counter medicines such as loperamide (Imodium) and bismuth subsalicylate (Pepto-Bismol and Kaopectate) may help stop diarrhea in adults. However, people with bloody diarrhea\u2014a sign of bacterial or parasitic infection\u2014should not use these medicines. If diarrhea is caused by bacteria or parasites, over-the-counter medicines may prolong the problem, so doctors usually prescribe antibiotics instead. Medications to treat diarrhea in adults can be dangerous for infants and children and should only be given with a doctor\u2019s guidance."}],"SUB_QUESTION_ID":"Q188-S1","ANNOTATIONS_FOCUS":["diarrhea"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"diarrhea","MESSAGE":"i had bad diarrhea over the weekend and though how my mother used paregoric, went to the drug store to get some, he said they dont sell it any more HELP","QUESTION_ID":"Q188","F_REF":"1-132341335"} +{"ANSWERS":[{"_answerid":"Q189-S1-A1","_pairid":"489","__text":"The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. For chronic pain: For oral dosage form (extended-release tablets): Adults\u2014At first, 100 milligrams (mg) once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 300 mg per day. Children\u2014Use and dose must be determined by your doctor. For oral dosage form (tablets): Adults and teenagers 16 years of age and older\u2014At first, 50 to 100 milligrams (mg) every four to six hours as needed. Your doctor may increase your dose as needed. However, the dose is usually not more than 400 mg per day. Children younger than 16 years of age\u2014Use and dose must be determined by your doctor. For moderate to severe pain: For oral dosage form (disintegrating tablets): Adults and teenagers 16 years of age and older\u2014At first, 50 to 100 milligrams (mg) every four to six hours as needed. Your doctor may increase your dose as needed. However, the dose is usually not more than 400 mg per day. Children younger than 16 years of age\u2014Use and dose must be determined by your doctor. For oral dosage form (tablets): Adults and teenagers 16 years of age and older\u2014At first, 25 milligrams (mg) per day, taken every morning. Your doctor may increase your dose as needed. However, the dose is usually not more than 400 mg per day. Children younger than 16 years of age\u2014Use and dose must be determined by your doctor."}],"SUB_QUESTION_ID":"Q189-S1","ANNOTATIONS_FOCUS":["tramadol"],"ANNOTATIONS_TYPE":"dosage","SUBJECT":"tramadol","MESSAGE":"how strong is 50mg of tramadol taken twice daily","QUESTION_ID":"Q189","F_REF":"1-123487175"} +{"ANSWERS":[{"_answerid":"Q190-S1-A1","_pairid":"490","__text":"Use of PLAQUENIL is contraindicated in patients with known hypersensitivity to 4-aminoquinoline compounds."}],"SUB_QUESTION_ID":"Q190-S1","ANNOTATIONS_FOCUS":["plaquenil"],"ANNOTATIONS_TYPE":"contraindication","SUBJECT":"Plaquenil","MESSAGE":"I was recently diagnosed with lupus. A few months prior I had a terrible reaction to levofloxacin. My doctor wants to give me plaquenil. I am concerned as this is in the quinolone family. Should I be concerned? Is this a quinolone drug?","QUESTION_ID":"Q190","F_REF":"1-123493445"} +{"ANSWERS":[{"_answerid":"Q190-S2-A1","_pairid":"491","__text":"Description and Brand Names Drug information provided by: Micromedex US Brand Name Plaquenil Descriptions Hydroxychloroquine belongs to the family of medicines called antiprotozoals. Protozoa are tiny, one-celled animals. Some are parasites that can cause many different kinds of infections in the body. This medicine is used to prevent and to treat malaria and to treat some conditions such as liver disease caused by protozoa. It is also used in the treatment of arthritis to help relieve inflammation, swelling, stiffness, and joint pain and to help control the symptoms of lupus erythematosus (lupus; SLE). This medicine may be given alone or with one or more other medicines. It may also be used for other conditions as determined by your doctor. Hydroxychloroquine is available only with your doctor's prescription. This product is available in the following dosage forms: Tablet"}],"SUB_QUESTION_ID":"Q190-S2","ANNOTATIONS_FOCUS":["plaquenil"],"ANNOTATIONS_TYPE":"information","SUBJECT":"Plaquenil","MESSAGE":"I was recently diagnosed with lupus. A few months prior I had a terrible reaction to levofloxacin. My doctor wants to give me plaquenil. I am concerned as this is in the quinolone family. Should I be concerned? Is this a quinolone drug?","QUESTION_ID":"Q190","F_REF":"1-123493445"} +{"ANSWERS":[{"_answerid":"Q191-S1-A1","_pairid":"492","__text":"Children should get 2 doses of MMR vaccine: First Dose: 12-15 months of age Second Dose: 4-6 years of age (may be given earlier, if at least 28 days after the 1st dose) Some infants younger than 12 months should get a dose of MMR if they are traveling out of the country. (This dose will not count toward their routine series.) Some adults should also get MMR vaccine: Generally, anyone 18 years of age or older who was born after 1956 should get at least one dose of MMR vaccine, unless they can show that they have either been vaccinated or had all three diseases. MMR vaccine may be given at the same time as other vaccines. Children between 1 and 12 years of age can get a \"combination\" vaccine called MMRV, which contains both MMR and varicella (chickenpox) vaccines. There is a separate Vaccine Information Statement for MMRV."}],"SUB_QUESTION_ID":"Q191-S1","ANNOTATIONS_FOCUS":["MMR Vaccine"],"ANNOTATIONS_TYPE":"usage","SUBJECT":"MMR Vaccine","MESSAGE":"If you are vaccinated at childhood, do you need to get the vaccine again if you are going to country where there is a measles epidemic?","QUESTION_ID":"Q191","F_REF":"1-123603375"} +{"ANSWERS":[{"_answerid":"Q192-S1-A1","_pairid":"493","__text":"To reduce the development of drug-resistant bacteria and maintain the effectiveness of Bactrim (sulfamethoxazole and trimethoprim) tablets and other antibacterial drugs, Bactrim (sulfamethoxazole and trimethoprim) tablets should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to empiric selection of therapy. Urinary Tract Infections: For the treatment of urinary tract infections due to susceptible strains of the following organisms: Escherichia coli, Klebsiella species, Enterobacter species, Morganella morganii, Proteus mirabilis and Proteus vulgaris. It is recommended that initial episodes of uncomplicated urinary tract infections be treated with a single effective antibacterial agent rather than the combination. Acute Otitis Media: For the treatment of acute otitis media in pediatric patients due to susceptible strains of Streptococcus pneumoniae or Haemophilus influenzae when in the judgment of the physician sulfamethoxazole and trimethoprim offers some advantage over the use of other antimicrobial agents. To date, there are limited data on the safety of repeated use of BACTRIM in pediatric patients under two years of age. BACTRIM is not indicated for prophylactic or prolonged administration in otitis media at any age. Acute Exacerbations of Chronic Bronchitis in Adults: For the treatment of acute exacerbations of chronic bronchitis due to susceptible strains of Streptococcus pneumoniae or Haemophilus influenzae when a physician deems that BACTRIM could offer some advantage over the use of a single antimicrobial agent. Shigellosis: For the treatment of enteritis caused by susceptible strains of Shigella flexneri and Shigella sonnei when antibacterial therapy is indicated. Pneumocystis jiroveci Pneumonia: For the treatment of documented Pneumocystis jiroveci pneumonia and for prophylaxis against P. jiroveci pneumonia in individuals who are immunosuppressed and considered to be at an increased risk of developing P. jiroveci pneumonia. Traveler's Diarrhea in Adults: For the treatment of traveler's diarrhea due to susceptible strains of enterotoxigenic E. coli."}],"SUB_QUESTION_ID":"Q192-S1","ANNOTATIONS_FOCUS":["Trimethoprim\/ sulfamethozle"],"ANNOTATIONS_TYPE":"indication","SUBJECT":"Arthritis","MESSAGE":"Is the medication Trimethoprim\/ sulfamethozle useful in arthritis.? Thank you","QUESTION_ID":"Q192","F_REF":"1-123566082"} +{"ANSWERS":[{"_answerid":"Q193-S1-A1","_pairid":"494","__text":"Lidocaine comes as a patch to apply to the skin. It is applied only once a day as needed for pain. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use lidocaine patches exactly as directed. Your doctor will tell you how many lidocaine patches you may use at one time and the length of time you may wear the patches. Never apply more than three patches at one time, and never wear patches for more than 12 hours per day. Using too many patches or leaving patches on for too long may cause serious side effects. To apply the patches, follow these steps: Look at the skin that you plan to cover with a lidocaine patch. If the skin is broken or blistered, do not apply a patch to that area. Use scissors to remove the outer seal from the package. Then pull apart the zipper seal. Remove up to three patches from the package and press the zipper seal tightly together. The remaining patches may dry out if the zipper seal is not tightly closed. Cut patch(es) to the size and shape that will cover your most painful area. Peel the transparent liner off the back of the patch(es). Press the patch(es) firmly onto your skin. If you are applying a patch to your face, be careful not to let it touch your eyes. If you do get lidocaine in your eye, wash it with plenty of water or saline solution. Wash your hands after handling lidocaine patches. Do not reuse lidocaine patches. After you are finished using a patch, remove it and dispose of it out of reach of children and pets. Used patches contain enough medication to seriously harm a child or pet."}],"SUB_QUESTION_ID":"Q193-S1","ANNOTATIONS_FOCUS":["lidocaine patch"],"ANNOTATIONS_TYPE":"usage","SUBJECT":"bathing","MESSAGE":"Can I go in tub , pool or shower while wearing the lidocaine patch? If not, can I take off the patch (2or 3), and put a new one on in a different area for the remainder of the 12 hr. \"on\" period","QUESTION_ID":"Q193","F_REF":"1-123604235"} +{"ANSWERS":[{"_answerid":"Q194-S1-A1","_pairid":"495","__text":"Bupropion hydrochloride extended-release tablets USP (SR) are indicated for the treatment of major depressive disorder. The efficacy of bupropion in the treatment of a major depressive episode was established in two 4-week controlled trials of depressed inpatients and in one 6-week controlled trial of depressed outpatients whose diagnoses corresponded most closely to the Major Depression category of the APA Diagnostic and Statistical Manual (DSM) (see CLINICAL PHARMACOLOGY). A major depressive episode (DSM-IV) implies the presence of 1) depressed mood or 2) loss of interest or pleasure; in addition, at least 5 of the following symptoms have been present during the same 2-week period and represent a change from previous functioning: depressed mood, markedly diminished interest or pleasure in usual activities, significant change in weight and\/or appetite, insomnia or hypersomnia, psychomotor agitation or retardation, increased fatigue, feelings of guilt or worthlessness, slowed thinking or impaired concentration, a suicide attempt or suicidal ideation. The efficacy of bupropion hydrochloride extended-release tablets USP (SR) in maintaining an antidepressant response for up to 44 weeks following 8 weeks of acute treatment was demonstrated in a placebo-controlled trial (see CLINICAL PHARMACOLOGY). Nevertheless, the physician who elects to use bupropion hydrochloride extended-release tablets USP (SR) for extended periods should periodically reevaluate the long-term usefulness of the drug for the individual patient."}],"SUB_QUESTION_ID":"Q194-S1","ANNOTATIONS_FOCUS":["BUPROPION"],"ANNOTATIONS_TYPE":"usage","SUBJECT":"inf-medication","MESSAGE":"I would like information on this medicinal - BUPROPION 100MG To use it and what are the side effects of the drug.","QUESTION_ID":"Q194","F_REF":"1-123636565"} +{"ANSWERS":[{"_answerid":"Q194-S2-A1","_pairid":"496","__text":"The information included under the Incidence in Controlled Trials subsection of ADVERSE REACTIONS is based primarily on data from controlled clinical trials with Bupropion Hydrochloride Extended-Release Tablets (SR). Information on additional adverse events associated with the extended-release formulation of bupropion in smoking cessation trials, as well as the immediate-release formulation of bupropion, is included in a separate section (see ADVERSE REACTIONS, Other Events Observed During the Clinical Development and Postmarketing Experience of Bupropion). Incidence in Controlled Trials with Bupropion Hydrochloride Extended-Release Tablets (SR) Adverse Events Associated with Discontinuation of Treatment Among Patients Treated with Bupropion Hydrochloride Extended-Release Tablets (SR) In placebo-controlled clinical trials, 9% and 11% of patients treated with 300 mg\/day and 400 mg\/day, respectively, of bupropion hydrochloride extended-release tablets (SR) and 4% of patients treated with placebo discontinued treatment due to adverse events. The specific adverse events in these trials that led to discontinuation in at least 1% of patients treated with either 300 mg\/day or 400 mg\/day of bupropion hydrochloride extended-release tablets (SR) and at a rate at least twice the placebo rate are listed in Table 4. Adverse Events Occurring at an Incidence of 1% or More Among Patients Treated with Bupropion Hydrochloride Extended-Release Tablets (SR) Table 5 enumerates treatment-emergent adverse events that occurred among patients treated with 300 mg\/day and 400 mg\/day of bupropion hydrochloride extended-release tablets (SR) and with placebo in placebo-controlled trials. Events that occurred in either the 300-mg\/day or 400-mg\/day group at an incidence of 1% or more and were more frequent than in the placebo group are included. Reported adverse events were classified using a COSTART-based Dictionary. Accurate estimates of the incidence of adverse events associated with the use of any drug are difficult to obtain. Estimates are influenced by drug dose, detection technique, setting, physician judgments, etc. The figures cited cannot be used to predict precisely the incidence of untoward events in the course of usual medical practice where patient characteristics and other factors differ from those that prevailed in the clinical trials. These incidence figures also cannot be compared with those obtained from other clinical studies involving related drug products as each group of drug trials is conducted under a different set of conditions. Finally, it is important to emphasize that the tabulation does not reflect the relative severity and\/or clinical importance of the events. A better perspective on the serious adverse events associated with the use of bupropion hydrochloride extended-release tablets (SR) is provided in the WARNINGSand PRECAUTIONSsections. Incidence of Commonly Observed Adverse Events in Controlled Clinical Trials Adverse events from Table 5 occurring in at least 5% of patients treated with bupropion hydrochloride extended-release tablets (SR) and at a rate at least twice the placebo rate are listed below for the 300-mg\/day and 400-mg\/day dose groups. Bupropion Hydrochloride Extended-Release Tablets (SR) 300 mg\/day: Anorexia, dry mouth, rash, sweating, tinnitus and tremor. Bupropion Hydrochloride Extended-Release Tablets (SR) 400 mg\/day: Abdominal pain, agitation, anxiety, dizziness, dry mouth, insomnia, myalgia, nausea, palpitation, pharyngitis, sweating, tinnitus and urinary frequency. Other Events Observed During the Clinical Development and Postmarketing Experience of Bupropion In addition to the adverse events noted above, the following events have been reported in clinical trials and postmarketing experience with the extended-release (SR) formulation of bupropion in depressed patients and in nondepressed smokers, as well as in clinical trials and postmarketing clinical experience with the immediate-release formulation of bupropion. Adverse events for which frequencies are provided below occurred in clinical trials with the extended-release formulation of bupropion (SR). The frequencies represent the proportion of patients who experienced a treatment-emergent adverse event on at least one occasion in placebo-controlled studies for depression (n = 987) or smoking cessation (n = 1,013) or patients who experienced an adverse event requiring discontinuation of treatment in an open-label surveillance study with bupropion hydrochloride extended-release tablets (SR) (n = 3,100). All treatment-emergent adverse events are included except those listed in Tables 2 through 5, those events listed in other safety-related sections, those adverse events subsumed under COSTART terms that are either overly general or excessively specific so as to be uninformative, those events not reasonably associated with the use of the drug and those events that were not serious and occurred in fewer than 2 patients. Events of major clinical importance are described in the WARNINGSand PRECAUTIONSsections of the labeling. Events are further categorized by body system and listed in order of decreasing frequency according to the following definitions of frequency: Frequent adverse events are defined as those occurring in at least 1\/100 patients. Infrequent adverse events are those occurring in 1\/100 to 1\/1,000 patients, while rare events are those occurring in less than 1\/1,000 patients. Adverse events for which frequencies are not provided occurred in clinical trials or postmarketing experience with bupropion. Only those adverse events not previously listed for extended-release bupropion (SR) are included. The extent to which these events may be associated with bupropion hydrochloride extended-release tablets (SR) are unknown. Body (General):Infrequent were chills, facial edema, musculoskeletal chest pain and photosensitivity. Rare was malaise. Also observed were arthralgia, myalgia and fever with rash and other symptoms suggestive of delayed hypersensitivity. These symptoms may resemble serum sickness (see PRECAUTIONS). Cardiovascular:Infrequent were postural hypotension, stroke, tachycardia and vasodilation. Rare was syncope. Also observed were complete atrioventricular block, extrasystoles, hypotension, hypertension (in some cases severe, see PRECAUTIONS), myocardial infarction, phlebitis and pulmonary embolism. Digestive:Infrequent were abnormal liver function, bruxism, gastric reflux, gingivitis, glossitis, increased salivation, jaundice, mouth ulcers, stomatitis and thirst. Rare was edema of tongue. Also observed were colitis, esophagitis, gastrointestinal hemorrhage, gum hemorrhage, hepatitis, intestinal perforation, liver damage, pancreatitis and stomach ulcer. Endocrine:Also observed were hyperglycemia, hypoglycemia and syndrome of inappropriate antidiuretic hormone. Hemic and Lymphatic:Infrequent was ecchymosis. Also observed were anemia, leukocytosis, leukopenia, lymphadenopathy, pancytopenia and thrombocytopenia. Altered PT and\/or INR, infrequently associated with hemorrhagic or thrombotic complications, were observed when bupropion was co-administered with warfarin. Metabolic and Nutritional:Infrequent were edema and peripheral edema. Also observed was glycosuria. Musculoskeletal:Infrequent were leg cramps. Also observed were muscle rigidity\/fever\/rhabdomyolysis and muscle weakness. Nervous System:Infrequent were abnormal coordination, decreased libido, depersonalization, dysphoria, emotional lability, hostility, hyperkinesia, hypertonia, hypesthesia, suicidal ideation and vertigo. Rare were amnesia, ataxia, derealization and hypomania. Also observed were abnormal electroencephalogram (EEG), akinesia, aggression, aphasia, coma, completed suicide, delirium, delusions, dysarthria, dyskinesia, dystonia, euphoria, extrapyramidal syndrome, hallucinations, hypokinesia, increased libido, manic reaction, neuralgia, neuropathy, paranoid ideation, restlessness, suicide attempt and unmasking tardive dyskinesia. Respiratory:Rare was bronchospasm. Also observed was pneumonia. Skin:Rare was maculopapular rash. Also observed were alopecia, angioedema, exfoliative dermatitis and hirsutism. Special Senses:Infrequent were accommodation abnormality and dry eye. Also observed were deafness, diplopia, increased intraocular pressure and mydriasis. Urogenital:Infrequent were impotence, polyuria and prostate disorder. Also observed were abnormal ejaculation, cystitis, dyspareunia, dysuria, gynecomastia, menopause, painful erection, salpingitis, urinary incontinence, urinary retention and vaginitis."}],"SUB_QUESTION_ID":"Q194-S2","ANNOTATIONS_FOCUS":["BUPROPION"],"ANNOTATIONS_TYPE":"side effects","SUBJECT":"inf-medication","MESSAGE":"I would like information on this medicinal - BUPROPION 100MG To use it and what are the side effects of the drug.","QUESTION_ID":"Q194","F_REF":"1-123636565"} +{"ANSWERS":[{"_answerid":"Q195-S1-A1","_pairid":"497","__text":"This condition is inherited in an autosomal recessive pattern, which means both copies of the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition."}],"SUB_QUESTION_ID":"Q195-S1","ANNOTATIONS_FOCUS":["Ellis-Van Crevald Syndrome"],"ANNOTATIONS_TYPE":"inheritance","SUBJECT":"","MESSAGE":"If both parents carry the EVC gene which is responsible for the Ellis-Van Crevald Syndrome, will all their offspring be affected with the syndrome?","QUESTION_ID":"Q195","F_REF":"1-123639875"} +{"ANSWERS":[{"_answerid":"Q196-S1-A1","_pairid":"498","__text":"Guanfacine tablets (Tenex) are used alone or in combination with other medications to treat high blood pressure. Guanfacine extended-release (long-acting) tablets (Intuniv) are used as part of a treatment program to control symptoms of attention deficit hyperactivity disorder (ADHD; more difficulty focusing, controlling actions, and remaining still or quiet than other people who are the same age) in children. Guanfacine is in a class of medications called centrally acting alpha2A-adrenergic receptor agonists. Guanfacine treats high blood pressure by decreasing heart rate and relaxing the blood vessels so that blood can flow more easily through the body. Guanfacine extended-release tablets may treat ADHD by affecting the part of the brain that controls attention and impulsivity. High blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation."},{"_answerid":"Q196-S1-A2","_pairid":"499","__text":"Guanfacine is used to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled. Guanfacine works by controlling the nerve impulses along certain nerve pathways. As a result, it relaxes the blood vessels so that blood passes through them more easily. This helps to lower blood pressure. Guanfacine extended-release tablets are also used alone or together with other medicines to treat attention deficit hyperactivity disorder (ADHD) in children and adolescents. It works in the treatment of ADHD by increasing attention and decreasing restlessness in children and adults who are overactive, cannot concentrate for very long, or are easily distracted and impulsive. This medicine is used as part of a total treatment program that also includes social, educational, and psychological treatment. This medicine is available only with your doctor's prescription. This product is available in the following dosage forms: Tablet Tablet, Extended Release"}],"SUB_QUESTION_ID":"Q196-S1","ANNOTATIONS_FOCUS":["Guanfacine"],"ANNOTATIONS_TYPE":"indication","SUBJECT":"","MESSAGE":"Is there any information regarding adults having any benefits from taking Guanfacine extended-release (long-acting) tablets for ADHD?","QUESTION_ID":"Q196","F_REF":"1-123705112"} +{"ANSWERS":[{"_answerid":"Q197-S1-A1","_pairid":"500","__text":"Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication."}],"SUB_QUESTION_ID":"Q197-S1","ANNOTATIONS_FOCUS":["tetracycline"],"ANNOTATIONS_TYPE":"storage and disposal","SUBJECT":"outdated tetracycline","MESSAGE":"Is it safe to take outdated tetracycline?","QUESTION_ID":"Q197","F_REF":"1-123777085"} +{"ANSWERS":[{"_answerid":"Q198-S1-A1","_pairid":"501","__text":"Duloxetine comes as a delayed-release (releases the medication in the intestine to prevent break-down of the medication by stomach acids) capsule to take by mouth. When duloxetine is used to treat depression, it is usually taken once or twice a day with or without food. When duloxetine is used to treat generalized anxiety disorder, the pain of diabetic neuropathy, fibromyalgia, or ongoing bone or muscle pain, it is usually taken once a day with or without food. Take duloxetine at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take duloxetine exactly as directed. Do not take more or less of it, take it more often, or take it for a longer time than prescribed by your doctor. Swallow the delayed-release capsules whole; do not split, chew, or crush them. Do not open the delayed-release capsules and mix the contents with liquids or sprinkle the contents on food. Your doctor may start you on a low dose of medication and increase your dose after one week. Duloxetine may help control your symptoms but will not cure your condition. It may take 1 to 4 weeks or longer before you feel the full benefit of duloxetine. Continue to take duloxetine even if you feel well. Do not stop taking duloxetine without talking to your doctor. Your doctor will probably decrease your dose gradually. If you suddenly stop taking duloxetine, you may experience withdrawal symptoms such as nausea; vomiting; diarrhea; anxiety; dizziness; tiredness; headache; pain, burning, numbness, or tingling in the hands or feet; irritability; difficulty falling asleep or staying asleep; sweating; and nightmares. Tell your doctor if you experience any of these symptoms when your dose of duloxetine is decreased."}],"SUB_QUESTION_ID":"Q198-S1","ANNOTATIONS_FOCUS":["Duloxetine"],"ANNOTATIONS_TYPE":"usage","SUBJECT":"Duloxetine Hcl Dr","MESSAGE":"When is the best time of day to take Duloxetine Hcl Caps AM or PM","QUESTION_ID":"Q198","F_REF":"1-123779475"} +{"ANSWERS":[{"_answerid":"Q199-S1-A1","_pairid":"502","__text":"Liver warning: This product contains acetaminophen. Severe liver damage may occur if: \u2022 adult takes more than 12 caplets in 24 hours, which is the maximum daily amount \u2022 child takes more than 5 doses in 24 hours, which is the maximum daily amount \u2022 taken with other drugs containing acetaminophen \u2022 adult has 3 or more alcoholic drinks every day while using this product. Do not use \u2022 with any other drug containing acetaminophen (prescription or nonprescription). If you are not sure whether a drug contains acetaminophen, ask a doctor or pharmacist. \u2022 if you are allergic to acetaminophen or any of the inactive ingredients in this product Stop use and ask a doctor if \u2022 pain gets worse or lasts more than 10 days in adults \u2022 pain gets worse or lasts more than 5 days in children under 12 years \u2022 fever gets worse or lasts more than 3 days \u2022 new symptoms occur \u2022 redness or swelling is present These could be signs of a serious condition. If pregnant or breast-feeding, ask a health professional before use. Keep out of reach of children. Ask a doctor before use if the user has liver disease Ask a doctor or pharmacist before use if the user is taking blood thinning drug warfarin."}],"SUB_QUESTION_ID":"Q199-S1","ANNOTATIONS_FOCUS":["Tylenol"],"ANNOTATIONS_TYPE":"contraindication","SUBJECT":"Peptic Ulcers & Tylenol","MESSAGE":"I have a history of peptic ulcers, so I don't take aspirin or anything that contains it. However, I still experience ulcerative pain when I take Tylenol, especially on the second day of it's administration in recommended doses. Why is this so?","QUESTION_ID":"Q199","F_REF":"1-123857315"} +{"ANSWERS":[{"_answerid":"Q200-S1-A1","_pairid":"503","__text":"Nephrotic syndrome is a collection of symptoms that indicate kidney damage. Nephrotic syndrome includes the following: proteinuria\u2014large amounts of protein in the urine hyperlipidemia\u2014higher than normal fat and cholesterol levels in the blood edema, or swelling, usually in the legs, feet, or ankles and less often in the hands or face hypoalbuminia\u2014low levels of albumin in the blood Albumin is a protein that acts like a sponge, drawing extra fluid from the body into the bloodstream where it remains until removed by the kidneys. When albumin leaks into the urine, the blood loses its capacity to absorb extra fluid from the body, causing edema. Nephrotic syndrome results from a problem with the kidneys\u2019 filters, called glomeruli. Glomeruli are tiny blood vessels in the kidneys that remove wastes and excess fluids from the blood and send them to the bladder as urine. As blood passes through healthy kidneys, the glomeruli filter out the waste products and allow the blood to retain cells and proteins the body needs. However, proteins from the blood, such as albumin, can leak into the urine when the glomeruli are damaged. In nephrotic syndrome, damaged glomeruli allow 3 grams or more of protein to leak into the urine when measured over a 24-hour period, which is more than 20 times the amount that healthy glomeruli allow."}],"SUB_QUESTION_ID":"Q200-S1","ANNOTATIONS_FOCUS":["Nephrotic Syndrome"],"ANNOTATIONS_TYPE":"information","SUBJECT":"","MESSAGE":"What is Nephrotic Syndrome. What are its causes and cures?","QUESTION_ID":"Q200","F_REF":"1-123712647"} +{"ANSWERS":[{"_answerid":"Q200-S2-A1","_pairid":"504","__text":"Nephrotic syndrome can be caused by diseases that affect only the kidneys, such as focal segmental glomerulosclerosis (FSGS) or membranous nephropathy. Diseases that affect only the kidneys are called primary causes of nephrotic syndrome. The glomeruli are usually the targets of these diseases for reasons that are not fully understood. In FSGS\u2014the most common primary cause of nephrotic syndrome\u2014scar tissue forms in parts of the glomeruli. In membranous nephropathy, immune molecules form harmful deposits on the glomeruli. Nephrotic syndrome can also be caused by systemic diseases, which are diseases that affect many parts of the body, such as diabetes or lupus. Systemic diseases that affect the kidneys are called secondary causes of nephrotic syndrome. More than 50 percent of nephrotic syndrome cases in adults have secondary causes, with diabetes being the most common."}],"SUB_QUESTION_ID":"Q200-S2","ANNOTATIONS_FOCUS":["Nephrotic Syndrome"],"ANNOTATIONS_TYPE":"cause","SUBJECT":"","MESSAGE":"What is Nephrotic Syndrome. What are its causes and cures?","QUESTION_ID":"Q200","F_REF":"1-123712647"} +{"ANSWERS":[{"_answerid":"Q200-S3-A1","_pairid":"505","__text":"Treating nephrotic syndrome includes addressing the underlying cause as well as taking steps to reduce high blood pressure, edema, high cholesterol, and the risks of infection. Treatment usually includes medications and changes in diet. Medications that lower blood pressure can also significantly slow the progression of kidney disease causing nephrotic syndrome. Two types of blood pressure lowering medications, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), have proven effective in slowing the progression of kidney disease by reducing the pressure inside the glomeruli and thereby reducing proteinuria. Many people require two or more medications to control their blood pressure. In addition to an ACE inhibitor or an ARB, a diuretic\u2014a medication that aids the kidneys in removing fluid from the blood\u2014can also be useful in helping to reduce blood pressure as well as edema. Beta blockers, calcium channel blockers, and other blood pressure medications may also be needed. Statin medications may be given to lower cholesterol. People with nephrotic syndrome should receive the pneumococcal vaccine, which helps protect against a bacterium that commonly causes infection, and yearly flu shots. Blood thinning medications are usually only given to people with nephrotic syndrome who develop a blood clot; these medications are not used as a preventive measure. Nephrotic syndrome may go away once the underlying cause has been treated. More information about treating the underlying causes of nephrotic syndrome is provided in the NIDDK health topic, Glomerular Diseases."}],"SUB_QUESTION_ID":"Q200-S3","ANNOTATIONS_FOCUS":["Nephrotic Syndrome"],"ANNOTATIONS_TYPE":"treatment","SUBJECT":"","MESSAGE":"What is Nephrotic Syndrome. What are its causes and cures?","QUESTION_ID":"Q200","F_REF":"1-123712647"}