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[ { "content": "what causes bipolar disorder\n\nBipolar disorder (Causes): The exact cause of bipolar disorder is unknown, but several factors may be involved, such as: - Biological differences. People with bipolar disorder appear to have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes. - Genetics. Bipolar disorder is more common in people who have a first-degree relative, such as a sibling or parent, with the condition. Researchers are trying to find genes that may be involved in causing bipolar disorder.", "role": "user" }, { "content": "The exact cause of bipolar disorder is unknown, but several factors may be involved, such as: - Biological differences. People with bipolar disorder appear to have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes. Bipolar disorder is more common in people who have a first-degree relative, such as a sibling or parent, with the condition. Researchers are trying to find genes that may be involved in causing bipolar disorder.", "role": "assistant" } ]

[ { "content": "what treatment do you use to cure chickenpox\n\nChickenpox (Lifestyle and home remedies): To help ease the symptoms of an uncomplicated case of chickenpox, follow these self-care measures. Don't scratch Scratching can cause scarring, slow healing and increase the risk that the sores will become infected. If your child can't stop scratching: - Put gloves on his or her hands, especially at night - Trim his or her fingernails Relieve the itch and other symptoms The chickenpox rash can be very itchy, and broken vesicles sometimes sting. These discomforts, along with fever, headache and fatigue, can make anyone miserable. For relief, try: - A cool bath with added baking soda, uncooked oatmeal or colloidal oatmeal - a finely ground oatmeal that is made for soaking. - Calamine lotion dabbed on the spots. - A soft, bland diet if chickenpox sores develop in the mouth. - Antihistamines such as diphenhydramine (Benadryl, others) for itching. Check with your doctor to make sure your child can safely take antihistamines. - Acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, Children's Motrin, others) for a mild fever. Don't give aspirin to anyone with chickenpox because it can lead to a serious condition called Reye's syndrome. And don't treat a high fever without consulting your doctor.", "role": "user" }, { "content": "The following self-care measures may help ease the symptoms of an uncomplicated case of chickenpox: avoid scratching that can cause scarring, slow healing and increase the risk of infecting the sores. Children need their fingernails trimmed, and they might need gloves on their hands, especially at night. To relieve the itch and other symptoms, try a cool bath with added baking soda, uncooked oatmeal or finely ground oatmeal; calamine lotion dabbed on the spots; a soft, bland diet if chickenpox sores develop in the mouth; antihistamines such as diphenhydramine (Benadryl, others) for itching, if your child can safely take antihistamines. Acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, Children's Motrin, others) for a mild fever.", "role": "assistant" } ]

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

[ { "content": "Are there any researches indicating how early an individual may experience any signs or symptoms of Rheumatoid Arthritis?\n\n Rheumatoid Arthritis What is it? Points To Remember About Rheumatoid Arthritis What is rheumatoid arthritis? Rheumatoid arthritis is a disease that causes pain, swelling, and stiffness in your joints. This disease often occurs in more than one joint and can affect any joint in the body. If you have this disease, you may feel sick and tired, and sometimes get fevers.Anyone can get rheumatoid arthritis, but it occurs more often in women and is most common in older people.Genes, environmental factors, and hormones may play roles in the development of rheumatoid arthritis.Treatment may involve medicine, surgery, and alternative therapies.Regular rest, joint care, activity, a healthy diet, and reduced stress can ease symptoms.Rheumatoid arthritis is a disease that affects your joints. Joints are where two or more bones join together, such as at your knees, hips, or shoulders. Rheumatoid arthritis causes pain, swelling, and stiffness. If joints on one side of your body have rheumatoid arthritis, usually those joints on the other side do too. This disease often occurs in more than one joint. It can affect any joint in the body.If you have this disease, you also may feel sick and tired, and sometimes get fevers. Rheumatoid arthritis is a disease that causes pain, swelling, and stiffness in your joints. This disease often occurs in more than one joint and can affect any joint in the body. If you have this disease, you may feel sick and tired, and sometimes get fevers.Anyone can get rheumatoid arthritis, but it occurs more often in women and is most common in older people.Genes, environmental factors, and hormones may play roles in the development of rheumatoid arthritis.Treatment may involve medicine, surgery, and alternative therapies.Regular rest, joint care, activity, a healthy diet, and reduced stress can ease symptoms. Rheumatoid arthritis is a disease that causes pain, swelling, and stiffness in your joints. This disease often occurs in more than one joint and can affect any joint in the body. If you have this disease, you may feel sick and tired, and sometimes get fevers.Anyone can get rheumatoid arthritis, but it occurs more often in women and is most common in older people.Genes, environmental factors, and hormones may play roles in the development of rheumatoid arthritis.Treatment may involve medicine, surgery, and alternative therapies.Regular rest, joint care, activity, a healthy diet, and reduced stress can ease symptoms.Rheumatoid arthritis is a disease that affects your joints. Joints are where two or more bones join together, such as at your knees, hips, or shoulders. Rheumatoid arthritis causes pain, swelling, and stiffness. If joints on one side of your body have rheumatoid arthritis, usually those joints on the other side do too. This disease often occurs in more than one joint. It can affect any joint in the body.If you have this disease, you also may feel sick and tired, and sometimes get fevers. Who gets it? Who gets rheumatoid arthritis? Anyone can get this disease, though it occurs more often in women. Rheumatoid arthritis often starts in middle age and is common in older people. But children and young adults can also get it.Anyone can get this disease, though it occurs more often in women. Rheumatoid arthritis often starts in middle age and is common in older people. But children and young adults can also get it. What causes it? What causes rheumatoid arthritis? Doctors don't know the exact cause of rheumatoid arthritis. They know that with this type of arthritis, a person's immune system attacks his or her own body tissues. The immune system normally attacks invaders to the body, such as a cold virus or bacteria. Researchers are learning many things about why and how this happens. Things that may cause rheumatoid arthritis are: Genes (passed from parent to child).Environmental factors.Hormones.Doctors don't know the exact cause of rheumatoid arthritis. They know that with this type of arthritis, a person's immune system attacks his or her own body tissues. The immune system normally attacks invaders to the body, such as a cold virus or bacteria. Researchers are learning many things about why and how this happens. Things that may cause rheumatoid arthritis are: Genes (passed from parent to child).Environmental factors.Hormones.Doctors don't know the exact cause of rheumatoid arthritis. They know that with this type of arthritis, a person's immune system attacks his or her own body tissues. The immune system normally attacks invaders to the body, such as a cold virus or bacteria. Researchers are learning many things about why and how this happens. Things that may cause rheumatoid arthritis are: Genes (passed from parent to child).Environmental factors.Hormones. Is there a test? Is there a test for rheumatoid arthritis? Rheumatoid arthritis can be hard to diagnose because: There is no single test for the disease.The symptoms can be the same as in other kinds of joint disease.The full symptoms can take time to develop.To diagnose rheumatoid arthritis, doctors use medical history, a physical exam, x-rays and other imaging tests, and lab tests.Rheumatoid arthritis can be hard to diagnose because: There is no single test for the disease.The symptoms can be the same as in other kinds of joint disease.The full symptoms can take time to develop.To diagnose rheumatoid arthritis, doctors use medical history, a physical exam, x-rays and other imaging tests, and lab tests.Rheumatoid arthritis can be hard to diagnose because: There is no single test for the disease.The symptoms can be the same as in other kinds of joint disease.The full symptoms can take time to develop.To diagnose rheumatoid arthritis, doctors use medical history, a physical exam, x-rays and other imaging tests, and lab tests. How is it treated? How is rheumatoid arthritis treated? Doctors have many ways to treat rheumatoid arthritis. Treatment may involve: Medicine.Surgery.Regular doctor visits.Complementary therapies.The goals of treatment are to: Take away pain.Reduce swelling.Slow down or stop joint damage.Help you feel better.Help you stay active. <h3>Medicine</h3> Most people with rheumatoid arthritis take medicine. Drugs can be used for pain relief, to reduce swelling, and to stop the disease from getting worse. What a doctor prescribes depends on: Your general health.How serious the rheumatoid arthritis is.How serious the rheumatoid arthritis may become.How long you will take the drug.How well the drug works.Possible side effects. <h3>How is it treated?</h3> <h3>Surgery</h3> There are many kinds of surgery for people with a lot of joint damage. Surgery may: Reduce your pain.Help your joint work better.Help you be able to do daily activities.Surgery is not for everyone. Talk with your doctor to decide what is best for you. <h3>Regular Doctor Visits</h3> Regular medical care is important so doctors can: See if the disease is getting worse.See if drugs are helping.Discuss any drug side effects.Change treatment when needed. <h3>Complementary Therapies</h3> Special diets, vitamins, and other complementary therapies are sometimes suggested to treat rheumatoid arthritis. Many of these treatments are not harmful, but they may not be well tested or have any real benefits.Ask your doctor about things you can do to manage your pain, such as exercise programs, support groups, and education classes. Before starting any complementary therapy, talk with your doctor to make sure it isn't harmful.Doctors have many ways to treat rheumatoid arthritis. Treatment may involve: Medicine.Surgery.Regular doctor visits.Complementary therapies.The goals of treatment are to: Take away pain.Reduce swelling.Slow down or stop joint damage.Help you feel better.Help you stay active. <h3>Medicine</h3> Most people with rheumatoid arthritis take medicine. Drugs can be used for pain relief, to reduce swelling, and to stop the disease from getting worse. What a doctor prescribes depends on: Your general health.How serious the rheumatoid arthritis is.How serious the rheumatoid arthritis may become.How long you will take the drug.How well the drug works.Possible side effects. <h3>How is it treated?</h3> <h3>Surgery</h3> There are many kinds of surgery for people with a lot of joint damage. Surgery may: Reduce your pain.Help your joint work better.Help you be able to do daily activities.Surgery is not for everyone. Talk with your doctor to decide what is best for you. <h3>Regular Doctor Visits</h3> Regular medical care is important so doctors can: See if the disease is getting worse.See if drugs are helping.Discuss any drug side effects.Change treatment when needed. <h3>Complementary Therapies</h3> Special diets, vitamins, and other complementary therapies are sometimes suggested to treat rheumatoid arthritis. Many of these treatments are not harmful, but they may not be well tested or have any real benefits.Ask your doctor about things you can do to manage your pain, such as exercise programs, support groups, and education classes. Before starting any complementary therapy, talk with your doctor to make sure it isn't harmful.Doctors have many ways to treat rheumatoid arthritis. Treatment may involve: Medicine.Surgery.Regular doctor visits.Complementary therapies.The goals of treatment are to: Take away pain.Reduce swelling.Slow down or stop joint damage.Help you feel better.Help you stay active. <h3>Medicine</h3> Most people with rheumatoid arthritis take medicine. Drugs can be used for pain relief, to reduce swelling, and to stop the disease from getting worse. What a doctor prescribes depends on: Your general health.How serious the rheumatoid arthritis is.How serious the rheumatoid arthritis may become.How long you will take the drug.How well the drug works.Possible side effects. <h3>How is it treated?</h3> <h3>Surgery</h3> There are many kinds of surgery for people with a lot of joint damage. Surgery may: Reduce your pain.Help your joint work better.Help you be able to do daily activities.Surgery is not for everyone. Talk with your doctor to decide what is best for you. <h3>Regular Doctor Visits</h3> Regular medical care is important so doctors can: See if the disease is getting worse.See if drugs are helping.Discuss any drug side effects.Change treatment when needed. <h3>Complementary Therapies</h3> Special diets, vitamins, and other complementary therapies are sometimes suggested to treat rheumatoid arthritis. Many of these treatments are not harmful, but they may not be well tested or have any real benefits.Ask your doctor about things you can do to manage your pain, such as exercise programs, support groups, and education classes. Before starting any complementary therapy, talk with your doctor to make sure it isn't harmful. Who treats it? Who treats rheumatoid arthritis? Several types of health care professionals may treat you, including: Internist, who diagnoses and treats adults.Rheumatologist, who treats arthritis and other disease of the bones, joints, and muscles.Orthopaedists, who treat and perform surgery for bone and joint diseases.Physical therapists, who help to improve joint function.Occupational therapists, who teach ways to protect joints, reduce pain, perform activities of daily living, and conserve energy.Dietitians, who teach ways to use a good diet to improve health and maintain a healthy weight.Several types of health care professionals may treat you, including: Internist, who diagnoses and treats adults.Rheumatologist, who treats arthritis and other disease of the bones, joints, and muscles.Orthopaedists, who treat and perform surgery for bone and joint diseases.Physical therapists, who help to improve joint function.Occupational therapists, who teach ways to protect joints, reduce pain, perform activities of daily living, and conserve energy.Dietitians, who teach ways to use a good diet to improve health and maintain a healthy weight.Several types of health care professionals may treat you, including: Internist, who diagnoses and treats adults.Rheumatologist, who treats arthritis and other disease of the bones, joints, and muscles.Orthopaedists, who treat and perform surgery for bone and joint diseases.Physical therapists, who help to improve joint function.Occupational therapists, who teach ways to protect joints, reduce pain, perform activities of daily living, and conserve energy.Dietitians, who teach ways to use a good diet to improve health and maintain a healthy weight. Living with It Living with rheumatoid arthritis With rheumatoid arthritis, you can still lead a full life. Besides going to your doctor and therapists regularly, you can also do these activities to help reduce your symptoms. <h3>Joint Care</h3> Look for ways to reduce stress on your joints. Some people find wearing a splint around a painful joint for a short time helps. Talk with your doctor to see if a splint may work for you. In addition, some special equipment can help such as a zipper puller or long-handled shoe horn. <h3>Rest</h3> Keep a good balance between rest and activity. Try to take frequent breaks, especially when your symptoms are bothering you. <h3>Lowering Stress</h3> Try to lower your stress by taking the time to relax, doing hobbies you enjoy, or joining a support group. Support groups can reduce your stress by helping you to: Learn about the disease.Cope with your emotions about your symptoms.Feel more control over the disease.Build confidence. <h3>A Healthy Diet</h3> Eat a healthy diet which will help you manage your weight and get a variety of nutrients for overall health.With rheumatoid arthritis, you can still lead a full life. Besides going to your doctor and therapists regularly, you can also do these activities to help reduce your symptoms. <h3>Joint Care</h3> Look for ways to reduce stress on your joints. Some people find wearing a splint around a painful joint for a short time helps. Talk with your doctor to see if a splint may work for you. In addition, some special equipment can help such as a zipper puller or long-handled shoe horn. <h3>Rest</h3> Keep a good balance between rest and activity. Try to take frequent breaks, especially when your symptoms are bothering you. <h3>Lowering Stress</h3> Try to lower your stress by taking the time to relax, doing hobbies you enjoy, or joining a support group. Support groups can reduce your stress by helping you to: Learn about the disease.Cope with your emotions about your symptoms.Feel more control over the disease.Build confidence. <h3>A Healthy Diet</h3> Eat a healthy diet which will help you manage your weight and get a variety of nutrients for overall health. Other Medical Problems Other medical problems related to rheumatoid arthritis You may also experience other health problems as a result of your rheumatoid arthritis. Be sure to talk with your doctor if any of these occur.Many people with rheumatoid arthritis may also have: Anemia, a condition in which your blood has a lower than normal count of red blood cells.Depression.Anxiety.Other effects that occur less often include: Neck pain.Dry eyes.Dry mouth.Very rarely, people may have inflammation of their: Blood vessels.Lining of the lungs.Sac enclosing the heart.You may also experience other health problems as a result of your rheumatoid arthritis. Be sure to talk with your doctor if any of these occur.Many people with rheumatoid arthritis may also have: Anemia, a condition in which your blood has a lower than normal count of red blood cells.Depression.Anxiety.Other effects that occur less often include: Neck pain.Dry eyes.Dry mouth.Very rarely, people may have inflammation of their: Blood vessels.Lining of the lungs.Sac enclosing the heart. ", "role": "user" }, { "content": "Anyone can get arthritis, but it occurs more often in women and is most common in older people. Genes, environmental factors, and hormones may play roles in the development of rheumatoid arthritis.", "role": "assistant" } ]

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

[ { "content": "symptoms of dehydration 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?\n\n Dehydration Vomiting - dehydration Diarrhea - dehydration Diabetes - dehydration Stomach flu - dehydration Gastroenteritis - dehydration Excessive sweating - dehydration Summary Dehydration occurs when your body does not have as much water and fluids as it needs. Dehydration can be mild, moderate, or severe, based on how much of your body's fluid is lost or not replaced. Severe dehydration is a life-threatening emergency. Causes You can become dehydrated if you lose too much fluid, do not drink enough water or fluids, or both. Your body may lose a lot of fluid from: Sweating too much, for example, from exercising in hot weather Fever Vomiting or diarrhea Urinating too much (uncontrolled diabetes or some medications, like diuretics, can cause you to urinate a lot) You might not drink enough fluids because: You do not feel like eating or drinking because you are sick You are nauseated You have a sore throat or mouth sores Older adults and people with certain diseases, such as diabetes, are also at higher risk for dehydration. Symptoms 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 lightheadedness Rapid heartbeat Rapid breathing Sunken eyes Listlessness Shock (not enough blood flow through the body) Unconsciousness or delirium Exams and Tests Your health care provider will look for these signs of dehydration: Low blood pressure. Blood pressure that drops when you stand up after lying down. White finger tips that do not return to a pink color after your provider presses the fingertip. Skin that is not as elastic as normal. When the provider pinches it into a fold, it may slowly sag back into place. Normally, skin springs back right away. Rapid heart rate. Your provider may do lab tests such as: Blood tests to check kidney function Urine tests to see what may be causing dehydration Other tests to see what may be causing dehydration (blood sugar test for diabetes) Treatment To treat dehydration: Try sipping water or sucking on ice cubes. Try drinking water or sports drinks that contain electrolytes. Do not take salt tablets. They can cause serious complications. Ask your provider what you should eat if you have diarrhea. For more severe dehydration or heat emergency, you may need to stay in a hospital and receive fluid through a vein (IV). The provider will also treat the cause of the dehydration. Dehydration caused by a stomach virus should get better on its own after a few days. Outlook (Prognosis) If you notice signs of dehydration and treat it quickly, you should recover completely. Possible Complications Untreated severe dehydration may cause: Death Permanent brain damage Seizures When to Contact a Medical Professional You should call 911 if: The person loses consciousness at any time. There is any other change in the person's alertness (for example, confusion or seizures). The person has a fever over 102F (38.8C). You notice symptoms of heatstroke (such as rapid pulse or rapid breathing). The person's condition does not improve or gets worse despite treatment. Prevention To prevent dehydration: Drink plenty of fluids every day, even when you are well. Drink more when the weather is hot or you are exercising. If anyone in your family is ill, pay attention to how much they are able to drink. Pay close attention to children and older adults. Anyone with a fever, vomiting, or diarrhea should drink plenty of fluids. DO NOT wait for signs of dehydration. If you think you or someone in your family may become dehydrated, call your provider. Do this before the person becomes dehydrated. Review Date 9/5/2017 Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Moderate dehydration causes dry mouth, thirst, headache, muscle cramps, and reduced urination and dark urine. As dehydration becomes severe, urination might stop, you might experience irritability, confusion, dizziness, rapid heartbeat, rapid breathing, lack of energy, shock, and unconsciousness or delirium.", "role": "assistant" } ]

[ { "content": "I have an hernia I would love to take care off it ASAP I was wondering if you guys could help me . Thanks\n\nHernia (Treatment): 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.", "role": "user" }, { "content": "Surgery to repair abdomen wall is the only treatment that can permanently fix a hernia. Sometimes mesh patches are used to close the holes in the abdominal tissues.", "role": "assistant" } ]

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

[ { "content": "how to loose weight\n\n Overweight, obesity, and weight loss Overview Over 60 percent of U.S. adult women are overweight, according to 2007 estimates from the National Center for Health Statistics of the Center for Disease Control and Prevention. Just over one-third of overweight adult women are obese. How do I know if I'm overweight or obese? Find out your body mass index (BMI). BMI is a measure of body fat based on height and weight. People with a BMI of 25 to 29.9 are considered overweight. People with a BMI of 30 or more are considered obese. You can find out your BMI by using this calculator or the chart. What causes someone to become overweight or obese? You can become overweight or obese when you eat more calories (KAL-oh-rees) than you use. A calorie is a unit of energy in the food you eat. Your body needs this energy to function and to be active. But if you take in more energy than your body uses, you will gain weight. Many factors can play a role in becoming overweight or obese. These factors include: Overweight and obesity problems keep getting worse in the United States. Some cultural reasons for this include: What are the health effects of being overweight or obese? Being overweight or obese can increase your risk of: But excess body weight isn't the only health risk. The places where you store your body fat also affect your health. Women with a \"pear\" shape tend to store fat in their hips and buttocks. Women with an \"apple\" shape store fat around their waists. If your waist is more than 35 inches, you may have a higher risk of weight-related health problems. What is the best way for me to lose weight? The best way to lose weight is to use more calories than you take in. You can do this by following a healthy eating plan and being more active. Before you start a weight-loss program, talk to your doctor. Safe weight-loss programs that work well: How can I make healthier food choices? The U.S. Department of Health and Human Services (HHS) and Department of Agriculture (USDA) offer tips for healthy eating in Dietary Guidelines for All Americans. How can physical activity help? The new 2008 Physical Activity Guidelines for Americans state that an active lifestyle can lower your risk of early death from a variety of causes. There is strong evidence that regular physical activity can also lower your risk of: Regular activity can help prevent unhealthy weight gain and also help with weight loss, when combined with lower calorie intake. If you are overweight or obese, losing weight can lower your risk for many diseases. Being overweight or obese increases your risk of heart disease, high blood pressure, stroke, type 2 diabetes, breathing problems, osteoarthritis, gallbladder disease, sleep apnea (breathing problems while sleeping), and some cancers. Regular physical activity can also improve your cardiorespiratory (heart, lungs, and blood vessels) and muscular fitness. For older adults, activity can improve mental function. Physical activity may also help: Health benefits are gained by doing the following each week: This physical activity should be in addition to your routine activities of daily living, such as cleaning or spending a few minutes walking from the parking lot to your office. If you want to lose a substantial (more than 5 percent of body weight) amount of weight, you need a high amount of physical activity unless you also lower calorie intake. This is also the case if you are trying to keep the weight off. Many people need to do more than 300 minutes of moderate-intensity activity a week to meet weight-control goals. During moderate-intensity activities you should notice an increase in your heart rate, but you should still be able to talk comfortably. An example of a moderate-intensity activity is walking on a level surface at a brisk pace (about 3 to 4 miles per hour). Other examples include ballroom dancing, leisurely bicycling, moderate housework, and waiting tables. If your heart rate increases a lot and you are breathing so hard that it is difficult to carry on a conversation, you are probably doing vigorous-intensity activity. Examples of vigorous-intensity activities include jogging, bicycling fast or uphill, singles tennis, and pushing a hand mower. How you can increase your physical activity What medicines are approved for long-term treatment of obesity? The Food and Drug Administration has approved two medicines for long-term treatment of obesity: These medicines are for people who: If you take these medicines, you will need to follow a healthy eating and physical activity plan at the same time. Before taking these medicines, talk with your doctor about the benefits and the side effects. What surgical options are used to treat obesity? Weight loss surgeries - also called bariatric (bair-ee-AT-rik) surgeries - can help treat obesity. You should only consider surgical treatment for weight loss if you: Common types of weight loss surgeries are: If you are thinking about weight-loss surgery, talk with your doctor about changes you will need to make after the surgery. You will need to: You should also talk to your doctor about risks and side effects of weight loss surgery. Side effects may include: Is liposuction a treatment for obesity? Liposuction (LY-poh-suhk-shuhn) is not a treatment for obesity. In this procedure, a surgeon removes fat from under the skin. Liposuction can be used to reshape parts of your body. But this surgery does not promise lasting weight loss. I'm concerned about my children's eating and physical activity levels. How can I help improve their habits? The things children learn when they are young are hard to change as they get older. This is true for their eating and physical activity habits. Many children have a poor diet and are not very active. They may eat foods high in calories and fat and not eat enough fruits and vegetables. They also may watch TV, play video games, or use the computer instead of being active. Kids who are overweight have a greater chance of becoming obese adults. Overweight children may develop weight-related health problems like high blood pressure and diabetes at a young age. You can find out if your child is overweight or obese by using this Body Mass Index calculator for children and teens. You can help your child build healthy eating and activity habits. We know children do what they see - not always what they are told. Set a good example for your children. Your kids will learn to eat right and be active by watching you. Setting a good example can mean a lifetime of good habits for you and your kids. Did we answer your question about overweight, obesity, and weight loss? For more information about overweight, obesity, and weight loss, call womenshealth.gov at 1-800-994-9662 (TDD: 888-220-5446) or contact the following organizations: ", "role": "user" }, { "content": "The best way to lose weight is to use more calories than you take in. You can do this by following a healthy eating plan and being more active. Before you start a weight-loss program, talk to your doctor.", "role": "assistant" } ]

[ { "content": "Diabetes Type 2 I test before going to bed and the reading is 94 but when I test again in the morning, the reading is 165. How can I lower it? I eat dinner around 8PM and nothing until the next morning.\n\nDiabetes type 2 - meal planning (Function): Your main focus is on keeping your blood sugar (glucose) level in your target range. To help manage your blood sugar, follow a meal plan that has: - Food from all the food groups - Fewer calories - About the same amount of carbohydrates at each meal and snack - Healthy fats Along with healthy eating, you can help keep your blood sugar in target range by maintaining a healthy weight. Persons with type 2 diabetes are often overweight. Losing just 10 pounds (4.5 kilograms) can help you manage your diabetes better. Eating healthy foods and staying active (for example, 30 to 60 minutes of walking per day) can help you meet and maintain your weight loss goal. HOW CARBOHYDRATES AFFECT BLOOD SUGAR Carbohydrates in food give your body energy. You need to eat carbohydrates to maintain your energy. But carbohydrates also raise your blood sugar higher and faster than other kinds of food. The main kinds of carbohydrates are starches, sugars, and fiber. Learn which foods have carbohydrates. This will help with meal planning so that you can keep your blood sugar in your target range. MEAL PLANNING FOR CHILDREN WITH TYPE 2 DIABETES Meal plans should consider the amount of calories children need to grow. In general, three small meals and three snacks a day can help meet calorie needs. Many children with type 2 diabetes are overweight. The goal should be a healthy weight by eating healthy foods and getting more activity (60 minutes each day). Work with a registered dietitian to design a meal plan for your child. A registered dietitian is an expert in food and nutrition. The following tips can help your child stay on track: - No food is off-limits. Knowing how different foods affect your child's blood sugar helps you and your child keep it in target range. - Help your child learn how much food is a healthy amount. This is called portion control. - Have your family gradually switch from drinking soda and other sugary drinks, such as sports drinks and juices, to plain water or low-fat milk. PLANNING MEALS Everyone has individual needs. Work with your doctor, registered dietitian, or diabetes educator to develop a meal plan that works for you. When shopping, read food labels to make better food choices. A good way to make sure you get all the nutrients you need during meals is to use the plate method. This is a visual food guide that helps you choose the best types and right amounts of food to eat. It encourages larger portions of non-starchy vegetables (half the plate) and moderate portions of protein (one quarter of the plate) and starch (one quarter of the plate). You can find more information about the plate method at the American Diabetes Association website: www.diabetes.org/food-and-fitness/food/planning-meals/create-your-plate. EAT A VARIETY OF FOODS Eating a wide variety of foods helps you stay healthy. Try to include foods from all the food groups at each meal. VEGETABLES (2½ to 3 cups or 450 to 550 grams a day) Choose fresh or frozen vegetables without added sauces, fats, or salt. Non-starchy vegetables include dark green and deep yellow vegetables, such as cucumber, spinach, broccoli, romaine lettuce, cabbage, chard, and bell peppers. Starchy vegetables include corn, green peas, lima beans, carrots, yams and taro. Note that potato should be considered a pure starch, like white bread or white rice, instead of a vegetable. FRUITS (1½ to 2 cups or 240 to 320 grams a day) Choose fresh, frozen, canned (without added sugar or syrup), or unsweetened dried fruits. Try apples, bananas, berries, cherries, fruit cocktail, grapes, melon, oranges, peaches, pears, papaya, pineapple, and raisins. Drink juices that are 100% fruit with no added sweeteners or syrups. GRAINS (3 to 4 ounces or 85 to 115 grams a day) There are 2 types of grains: - Whole grains are unprocessed and have the entire grain kernel. Examples are whole-wheat flour, oatmeal, whole cornmeal, amaranth, barley, brown and wild rice, buckwheat, and quinoa. - Refined grains have been processed (milled) to remove the bran and germ. Examples are white flour, de-germed cornmeal, white bread, and white rice. Grains have starch, a type of carbohydrate. Carbohydrates raise your blood sugar level. For healthy eating, make sure half of the grains you eat each day are whole grains. Whole grains have lots of fiber. Fiber in the diet keeps your blood sugar level from rising too fast. PROTEIN FOODS (5 to 6½ ounces or 140 to 184 grams a day) Protein foods include meat, poultry, seafood, eggs, beans and peas, nuts, seeds, and processed soy foods. Eat fish and poultry more often. Remove the skin from chicken and turkey. Select lean cuts of beef, veal, pork, or wild game. Trim all visible fat from meat. Bake, roast, broil, grill, or boil instead of frying. When frying proteins, use healthy oils such as olive oil. DAIRY (3 cups or 245 grams a day) Choose low-fat dairy products. Be aware that milk, yogurt, and other dairy foods have natural sugar, even when they do not contain added sugar. Take this into account when planning meals to stay in your blood sugar target range. Some non-fat dairy products have a lot of added sugar. Be sure to read the label. OILS/FATS (no more than 7 teaspoons or 35 milliliters a day) Oils are not considered a food group. But they have nutrients that help your body stay healthy. Oils are different from fats in that oils remain liquid at room temperature. Fats remain solid at room temperature. Limit your intake of fatty foods, especially those high in saturated fat, such as hamburgers, deep-fried foods, bacon, and butter. Instead, choose foods that are high in polyunsaturated or monounsaturated fats. These include fish, nuts, and vegetable oils. Oils can raise your blood sugar, but not as fast as starch. Oils are also high in calories. Try to use no more than the recommended daily limit of 7 teaspoons (35 milliliters). WHAT ABOUT ALCOHOL AND SWEETS? If you choose to drink alcohol, limit the amount and have it with a meal. Check with your health care provider about how alcohol will affect your blood sugar and to determine a safe amount for you. Sweets are high in fat and sugar. Keep portion sizes small. Here are tips to help avoid eating too many sweets: - Ask for extra spoons and forks and split your dessert with others. - Eat sweets that are sugar-free. - Always ask for the smallest serving size or children's size. YOUR DIABETES CARE TEAM IS THERE TO HELP YOU In the beginning, meal planning may be overwhelming. But it will become easier as your knowledge grows about foods and their effects on your blood sugar. If you're having problems with meal planning, talk with your diabetes care team. They are there to help you.", "role": "user" }, { "content": "To keep your blood sugar in your target range, follow a meal plan that includes a variety of foods, about the same amount of carbohydrates at each meal and snack, and healthy fats. Carbohydrates in food give you energy, but carbohydrates also raise your blood sugar higher and faster than other kinds of food. The main kinds of carbohydrates are starches, sugars, and fiber. The plate method could help getting all the nutrients you need during meals. This method encourages larger portions of non-starchy vegetables (half the plate) and moderate portions of protein (one quarter of the plate) and starch (one quarter of the plate). If you are overweight, losing 10 pounds can help. You can achieve and maintain your desired weight by eating healthy foods and staying active, for example, walking 30 to 60 minutes of per day.", "role": "assistant" } ]

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

[ { "content": "what are the causes of pulmonary hypertension\n\n Pulmonary Hypertension What Is... Pulmonary hypertension (PULL-mun-ary HI-per-TEN-shun), or PH, is increased pressure in the pulmonary arteries. These arteries carry blood from your heart to your lungs to pick up oxygen. PH causes symptoms such as shortness of breath during routine activity (for example, climbing two flights of stairs), tiredness, chest pain, and a racing heartbeat. As the condition worsens, its symptoms may limit all physical activity. Overview To understand PH, it helps to understand how your heart and lungs work. Your heart has two sides, separated by an inner wall called the septum. Each side of your heart has an upper and lower chamber. The lower right chamber of your heart, the right ventricle (VEN-trih-kul), pumps blood to your pulmonary arteries. The blood then travels to your lungs, where it picks up oxygen. The upper left chamber of your heart, the left atrium (AY-tree-um), receives the oxygen-rich blood from your lungs. The blood is then pumped into the lower left chamber of your heart, the left ventricle. From the left ventricle, the blood is pumped to the rest of your body through an artery called the aorta. For more information about the heart and lungs, go to the Diseases and Conditions Index How the Heart Works and How the Lungs Work articles. PH begins with inflammation and changes in the cells that line your pulmonary arteries. Other factors also can affect the pulmonary arteries and cause PH. For example, the condition may develop if: The walls of the arteries tighten. The walls of the arteries are stiff at birth or become stiff from an overgrowth of cells. Blood clots form in the arteries. These changes make it hard for your heart to push blood through your pulmonary arteries and into your lungs. As a result, the pressure in your arteries rises. Also, because your heart is working harder than normal, your right ventricle becomes strained and weak. Your heart may become so weak that it can't pump enough blood to your lungs. This causes heart failure. Heart failure is the most common cause of death in people who have PH. PH is divided into five groups based on its causes. In all groups, the average pressure in the pulmonary arteries is higher than 25 mmHg at rest or 30 mmHg during physical activity. The pressure in normal pulmonary arteries is 8–20 mmHg at rest. (The mmHg is millimeters of mercury—the units used to measure blood pressure.) Other diseases or conditions, such as heart and lung diseases or blood clots, usually cause PH. Some people inherit the condition (that is, their parents pass the genes for PH on to them). In some cases, the cause isn't known. Outlook PH has no cure. However, research for new treatments is ongoing. The earlier PH is treated, the easier it is to control. Treatments include medicines, procedures, and other therapies. These treatments can relieve PH symptoms and slow the progress of the disease. Lifestyle changes also can help control symptoms. Types The World Health Organization divides pulmonary hypertension (PH) into five groups. These groups are organized based on the cause of the condition. In all groups, the average pressure in the pulmonary arteries is higher than 25 mmHg at rest or 30 mmHg during physical activity. The pressure in normal pulmonary arteries is 8–20 mmHg at rest. (Note that group 1 is called pulmonary arterial hypertension (PAH) and groups 2 through 5 are called pulmonary hypertension. However, together all groups are called pulmonary hypertension.) Group 1 Pulmonary Arterial Hypertension Group 1 PAH includes: PAH that has no known cause. PAH that's inherited (passed from parents to children through genes). PAH that's caused by drugs or toxins, such as street drugs and certain diet medicines. PAH that's caused by conditions such as: - Connective tissue diseases. (Connective tissue helps support all parts of your body, including your skin, eyes, and heart.) - HIV infection. - Liver disease. - Congenital heart disease. This is heart disease that's present at birth. - Sickle cell disease. - Schistosomiasis (SKIS-toe-so-MI-ah-sis). This is an infection caused by a parasite. Schistosomiasis is one of the most common causes of PAH in many parts of the world. Connective tissue diseases. (Connective tissue helps support all parts of your body, including your skin, eyes, and heart.) HIV infection. Liver disease. Congenital heart disease. This is heart disease that's present at birth. Sickle cell disease. Schistosomiasis (SKIS-toe-so-MI-ah-sis). This is an infection caused by a parasite. Schistosomiasis is one of the most common causes of PAH in many parts of the world. PAH that's caused by conditions that affect the veins and small blood vessels of the lungs. Group 2 Pulmonary Hypertension Group 2 includes PH with left heart disease. Conditions that affect the left side of the heart, such as mitral valve disease or long-term high blood pressure, can cause left heart disease and PH. Left heart disease is likely the most common cause of PH. Group 3 Pulmonary Hypertension Group 3 includes PH associated with lung diseases, such as COPD (chronic obstructive pulmonary disease) and interstitial (IN-ter-STISH-al) lung diseases. Interstitial lung diseases cause scarring of the lung tissue. Group 3 also includes PH associated with sleep-related breathing disorders, such as sleep apnea. Group 4 Pulmonary Hypertension Group 4 includes PH caused by blood clots in the lungs or blood clotting disorders. Group 5 Pulmonary Hypertension Group 5 includes PH caused by various other diseases or conditions. Examples include: Blood disorders, such as polycythemia vera (POL-e-si-THE-me-ah VAY-rah or VE-rah) and essential thrombocythemia (THROM-bo-si-THE-me-ah). Systemic disorders, such as sarcoidosis (sar-koy-DO-sis) and vasculitis (vas-kyu-LI-tis). Systemic disorders involve many of the body's organs. Metabolic disorders, such as thyroid disease and glycogen storage disease. (In glycogen storage disease, the body's cells don't use a form of glucose (sugar) properly.) Other conditions, such as tumors that press on the pulmonary arteries and kidney disease. Other Names Group 1 pulmonary arterial hypertension (PAH) that occurs without a known cause often is called primary PAH or idiopathic (id-ee-o-PATH-ick) PAH. Group 1 PAH that occurs with a known cause often is called associated PAH. For example, PAH that occurs in a person who has scleroderma might be called \"PAH occurring in association with scleroderma,\" or simply \"scleroderma-associated PAH.\" Groups 2–5 pulmonary hypertension (PH) sometimes are called secondary PH. Causes Pulmonary hypertension (PH) begins with inflammation and changes in the cells that line your pulmonary arteries. Other factors also can affect the pulmonary arteries and cause PH. For example, the condition may develop if: The walls of the arteries tighten. The walls of the arteries are stiff at birth or become stiff from an overgrowth of cells. Blood clots form in the arteries. These changes make it hard for your heart to push blood through your pulmonary arteries and into your lungs. Thus, the pressure in the arteries rises, causing PH. Many factors can contribute to the process that leads to the different types of PH. Group 1 pulmonary arterial hypertension (PAH) may have no known cause, or the condition may be inherited. (\"Inherited\" means the condition is passed from parents to children through genes.) Some diseases and conditions also can cause group 1 PAH. Examples include HIV infection, congenital heart disease, and sickle cell disease. Also, the use of street drugs (such as cocaine) and certain diet medicines can lead to PAH. Many diseases and conditions can cause groups 2 through 5 PH (often called secondary PH), including: Mitral valve disease Lung diseases, such as COPD (chronic obstructive pulmonary disease) Sleep apnea Sarcoidosis For more information about the types of PH and the diseases, conditions, and factors that can cause them, go to \"Types of Pulmonary Hypertension.\" Who Is at Risk The exact number of people who have pulmonary hypertension (PH) isn't known. Group 1 pulmonary arterial hypertension (PAH) without a known cause is rare. It affects women more often than men. People who have group 1 PAH tend to be overweight. PH that occurs with another disease or condition is more common. PH usually develops between the ages of 20 and 60, but it can occur at any age. People who are at increased risk for PH include: Those who have a family history of the condition. Those who have certain diseases or conditions, such as heart and lung diseases, liver disease, HIV infection, or blood clots in the pulmonary arteries. (For more information about the diseases, conditions, and factors that cause PH, go to \"Types of Pulmonary Hypertension.\") Those who use street drugs (such as cocaine) or certain diet medicines. Those who live at high altitudes. Signs & Symptoms Signs and symptoms of pulmonary hypertension (PH) may include: Shortness of breath during routine activity, such as climbing two flights of stairs Tiredness Chest pain A racing heartbeat Pain on the upper right side of the abdomen Decreased appetite As PH worsens, you may find it hard to do any physical activities. At this point, other signs and symptoms may include: Feeling light-headed, especially during physical activity Fainting at times Swelling in your legs and ankles A bluish color on your lips and skin Diagnosis Your doctor will diagnose pulmonary hypertension (PH) based on your medical and family histories, a physical exam, and the results from tests and procedures. PH can develop slowly. In fact, you may have it for years and not know it. This is because the condition has no early signs or symptoms. When symptoms do occur, they're often like those of other heart and lung conditions, such as asthma. This makes PH hard to diagnose. Medical and Family Histories Your doctor may ask about your signs and symptoms and how and when they began. He or she also may ask whether you have other medical conditions that can cause PH. Your doctor will want to know whether you have any family members who have or have had PH. People who have a family history of PH are at higher risk for the condition. Physical Exam During the physical exam, your doctor will listen to your heart and lungs with a stethoscope. He or she also will check your ankles and legs for swelling and your lips and skin for a bluish color. These are signs of PH. Diagnostic Tests and Procedures Your doctor may recommend tests and procedures to confirm a diagnosis of PH and to look for its underlying cause. Your doctor also will use test results to find out the severity of your PH. Tests and Procedures To Confirm a Diagnosis Echocardiography. Echocardiography (EK-o-kar-de-OG-ra-fee), or echo, uses sound waves to create a moving picture of your heart. This test can estimate the pressure in your pulmonary arteries. Echo also can show the size and thickness of your right ventricle and how well it's working. Chest x ray. A chest x ray takes pictures of the structures in your chest, such as your heart, lungs, and blood vessels. This test can show whether your pulmonary arteries and right ventricle are enlarged. The pulmonary arteries and right ventricle may get larger if the right ventricle has to work hard to pump blood through the pulmonary arteries. A chest x ray also may show signs of an underlying lung disease that's causing or contributing to PH. EKG (electrocardiogram). An EKG is a simple, painless test that records the heart's electrical activity. This test also shows whether your heart's rhythm is steady or irregular. An EKG may show whether your right ventricle is enlarged or strained. Right heart catheterization. This procedure measures the pressure in your pulmonary arteries. It also shows how well your heart is pumping blood to the rest of your body. Right heart catheterization (KATH-e-ter-ih-ZA-shun) can find any leaks between the left and right side of the heart. During this procedure, a thin, flexible tube called a catheter is put into a blood vessel in your groin (upper thigh) or neck. The tube is threaded into the right side of your heart and into the pulmonary arteries. Through the tube, your doctor can do tests and treatments on your heart. Tests To Look for the Underlying Cause of Pulmonary Hypertension PH has many causes, so many tests may need to be done to find its underlying cause. Chest CT scan. A chest computed tomography (to-MOG-ra-fee) scan, or chest CT scan, creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. These pictures can show signs of PH or a condition that may be causing PH. Chest MRI. Chest magnetic resonance imaging, or chest MRI, shows how your right ventricle is working. The test also shows blood flow in your lungs. Chest MRI also can help detect signs of PH or an underlying condition causing PH. Lung function tests. Lung function tests measure how much air you can breathe in and out, how fast you can breathe air out, and how well your lungs deliver oxygen to your blood. These tests can help detect a lung disease that may be causing PH. Polysomnogram (PSG). This test records brain activity, eye movements, heart rate, and blood pressure while you sleep. A PSG also measures the level of oxygen in your blood. A low oxygen level during sleep is common in PH, and it can make the condition worse. A PSG usually is done while you stay overnight at a sleep center. For more information about this test, go to the Diseases and Conditions Index Sleep Studies article. Lung ventilation/perfusion (VQ) scan. A lung VQ scan measures air and blood flow in your lungs. This test can help detect blood clots in your lung's blood vessels. Blood tests. Blood tests are used to rule out other diseases, such as HIV, liver disease, and autoimmune diseases (such as rheumatoid arthritis). Finding Out the Severity of Pulmonary Hypertension Exercise testing is used to find out the severity of PH. This testing consists of either a 6-minute walk test or a cardiopulmonary exercise test. A 6-minute walk test measures the distance you can quickly walk in 6 minutes. A cardiopulmonary exercise test measures how well your lungs and heart work while you exercise on a treadmill or bicycle. During exercise testing, your doctor will rate your activity level. Your level is linked to the severity of your PH. The rating system ranges from class 1 to class 4. Class 1 has no limits. You can do regular physical activities, such as walking or climbing stairs. These activities don't cause PH symptoms, such as tiredness, shortness of breath, or chest pain. Class 2 has slight or mild limits. You're comfortable while resting, but regular physical activity causes PH symptoms. Class 3 has marked or noticeable limits. You're comfortable while resting. However, walking even one or two blocks or climbing one flight of stairs can cause PH symptoms. Class 4 has severe limits. You're not able to do any physical activity without discomfort. You also may have PH symptoms while at rest. Over time, you may need more exercise tests to find out how well your treatments are working. Each time testing is done, your doctor will compare your activity level with the previous one. Treatment Pulmonary hypertension (PH) has no cure. However, treatment may help relieve symptoms and slow the progress of the disease. PH is treated with medicines, procedures, and other therapies. Treatment will depend on what type of PH you have and its severity. (For more information, go to \"Types of Pulmonary Hypertension.\") Group 1 Pulmonary Arterial Hypertension Group 1 pulmonary arterial hypertension (PAH) includes PH that's inherited, that has no known cause, or that's caused by certain drugs or conditions. Treatments for group 1 PAH include medicines and medical procedures. Medicines Your doctor may prescribe medicines to relax the blood vessels in your lungs and reduce excess cell growth in the blood vessels. As the blood vessels relax, more blood can flow through them. Your doctor may prescribe medicines that are taken by mouth, inhaled, or injected. Examples of medicines for group 1 PAH include: Phosphodiesterase-5 inhibitors, such as sildenafil Prostanoids, such as epoprostenol Endothelin receptor antagonists, such as bosentan and ambrisentan Calcium channel blockers, such as diltiazem Your doctor may prescribe one or more of these medicines. To find out which of these medicines works best, you'll likely have an acute vasoreactivity test. This test shows how the pressure in your pulmonary arteries reacts to certain medicines. The test is done during right heart catheterization. Medical and Surgical Procedures If you have group 1 PAH, your doctor may recommend one or more of the following procedures. Atrial septostomy (sep-TOS-toe-me). For this procedure, a thin, flexible tube called a catheter is put into a blood vessel in your leg and threaded to your heart. The tube is then put through the wall that separates your right and left atria (the upper chambers of your heart). This wall is called the septum. A tiny balloon on the tip of the tube is inflated. This creates an opening between the atria. This procedure relieves the pressure in the right atria and increases blood flow. Atrial septostomy is rarely done in the United States. Lung transplant. A lung transplant is surgery to replace a person's diseased lung with a healthy lung from a deceased donor. This procedure may be used for people who have severe lung disease that's causing PAH. Heart–lung transplant. A heart–lung transplant is surgery in which both the heart and lung are replaced with healthy organs from a deceased donor. Group 2 Pulmonary Hypertension Conditions that affect the left side of the heart, such as mitral valve disease, can cause group 2 PH. Treating the underlying condition will help treat PH. Treatments may include lifestyle changes, medicines, and surgery. Group 3 Pulmonary Hypertension Lung diseases, such as COPD (chronic obstructive pulmonary disease) and interstitial lung disease, can cause group 3 PH. Certain sleep disorders, such as sleep apnea, also can cause group 3 PH. If you have this type of PH, you may need oxygen therapy. This treatment raises the level of oxygen in your blood. You'll likely get the oxygen through soft, plastic prongs that fit into your nose. Oxygen therapy can be done at home or in a hospital. Your doctor also may recommend other treatments if you have an underlying lung disease. Group 4 Pulmonary Hypertension Blood clots in the lungs or blood clotting disorders can cause group 4 PH. If you have this type of PH, your doctor will likely prescribe blood-thinning medicines. These medicines prevent clots from forming or getting larger. Sometimes doctors use surgery to remove scarring in the pulmonary arteries due to old blood clots. Group 5 Pulmonary Hypertension Various diseases and conditions, such as thyroid disease and sarcoidosis, can cause group 5 PH. An object, such as a tumor, pressing on the pulmonary arteries also can cause group 5 PH. Group 5 PH is treated by treating its cause. All Types of Pulmonary Hypertension Several treatments may be used for all types of PH. These treatments include: Diuretics, also called water pills. These medicines help reduce fluid buildup in your body, including swelling in your ankles and feet. Blood-thinning medicines. These medicines help prevent blood clots from forming or getting larger. Digoxin. This medicine helps the heart beat stronger and pump more blood. Digoxin sometimes is used to control the heart rate if abnormal heart rhythms, such as atrial fibrillation or atrial flutter, occur. Oxygen therapy. This treatment raises the level of oxygen in your blood. Physical activity. Regular activity may help improve your ability to be active. Talk with your doctor about a physical activity plan that's safe for you. Research is ongoing for better PH treatments. These treatments offer hope for the future. Living With Pulmonary hypertension (PH) has no cure. However, you can work with your doctor to manage your symptoms and slow the progress of the disease. Ongoing Care Follow your treatment plan as your doctor advises. Call your doctor if your PH symptoms worsen or change. The earlier symptoms are addressed, the easier it is to treat them. Some symptoms, such as chest pain, may require emergency treatment. Ask your doctor when you should call him or her or seek emergency care. Also, talk with your doctor before taking any over-the-counter medicines. Some medicines can make your PH worse or interfere with the medicines you're taking for PH. Ask your doctor whether you should get a pneumonia vaccine and a yearly flu shot. You may have a complex schedule for taking medicines. Call your doctor or nurse if you're having problems with this schedule. Knowing the names of your medicines and how they work is helpful. Keep a list of your medicines with you. Don't stop or change medicines unless you talk with your doctor first. Pay careful attention to your weight. You may want to keep a daily record of your weight. You should weigh yourself at the same time each day. If you notice a rapid weight gain (2 or more pounds in 1 day or 5 or more pounds in 1 week), call your doctor. This may be a sign that your PH is worsening. Pregnancy is risky for women who have PH. Consider using birth control if there is a chance you may become pregnant. Ask your doctor which birth control methods are safe for you. Lifestyle Changes Making lifestyle changes can help you manage your symptoms. These changes will depend on the type of PH you have. Talk with your doctor about which lifestyle changes can help you. Quit Smoking If you smoke, quit. Smoking makes PH symptoms worse. Ask your doctor about programs and products that can help you quit. Also, avoid exposure to secondhand smoke. For more information about how to quit smoking, go to the Diseases and Conditions Index Smoking and Your Heart article and the National Heart, Lung, and Blood Institute's (NHLBI's) \"Your Guide to a Healthy Heart.\" Although these resources focus on heart health, they both include general information about how to quit smoking. Follow a Healthy Diet Following a healthy diet and maintaining a healthy weight are part of a healthy lifestyle. A healthy diet includes a variety of fruits, vegetables, and whole grains. It also includes lean meats, poultry, fish, and fat-free or low-fat milk or milk products. A healthy diet also is low in saturated fat, trans fat, cholesterol, sodium (salt), and added sugar. Talk with your doctor about whether you need to limit the amount of salt and fluids in your diet. Ask him or her whether you also need to regulate foods that contain vitamin K. These foods can affect how well blood-thinning medicines work. Vitamin K is found in green leafy vegetables and some oils, such as canola and soybean oil. For more information about following a healthy diet, go to the NHLBI's Aim for a Healthy Weight Web site, \"Your Guide to a Healthy Heart,\" and \"Your Guide to Lowering Your Blood Pressure With DASH.\" All of these resources include general advice about healthy eating. The DASH eating plan focuses on reduced-sodium foods, which may be helpful if your doctor advises you to limit the salt in your diet. Be Physically Active Physical activity is an important part of a healthy lifestyle. Try to do physical activity, such as walking, regularly. This will keep your muscles strong and help you stay active. Ask your doctor how much activity is safe for you. Your doctor may tell you to limit or avoid certain activities, such as: Those that cause straining, such as lifting heavy objects or weights. Sitting in a hot tub or sauna or taking long baths. These activities can lower your blood pressure too much. Flying in an airplane or traveling to high-altitude areas. Your doctor may ask you to use extra oxygen during air travel. Avoid activities that cause breathing problems, dizziness, or chest pain. If you have any of these symptoms, seek care right away. Emotional Issues and Support Living with PH may cause fear, anxiety, depression, and stress. You may worry about your medical condition, treatment, finances, and other issues. Talk about how you feel with your health care team. Talking to a professional counselor also can help. If you're very depressed, your doctor may recommend medicines or other treatments that can improve your quality of life. Joining a patient support group may help you adjust to living with PH. You can see how other people who have the same symptoms have coped with them. Talk with your doctor about local support groups or check with an area medical center. Support from family and friends also can help relieve stress and anxiety. Let your loved ones know how you feel and what they can do to help you. ", "role": "user" }, { "content": "The World Health Organization divides pulmonary hypertension (PH) into five groups. These groups are organized based on the cause of the condition. In all groups, the average pressure in the pulmonary arteries is higher than 25 mmHg at rest or 30 mmHg during physical activity. For example group 1 PAH includes PAH that has no known cause. Group 2 includes PH with left heart disease. Group 3 includes PH associated with lung diseases, such as COPD (chronic obstructive pulmonary disease) and interstitial (IN-ter-STISH-al) lung diseases. Group 4 includes PH caused by blood clots in the lungs or blood clotting disorders. Group 5 includes PH caused by various other diseases or conditions.", "role": "assistant" } ]

[ { "content": "what is the treatment for lymphoma\n\n Hodgkin lymphoma Lymphoma - Hodgkin Hodgkin disease Cancer - Hodgkin lymphoma Summary Hodgkin lymphoma is a cancer of lymph tissue. Lymph tissue is found in the lymph nodes, spleen, liver, bone marrow, and other sites. Causes The cause of Hodgkin lymphoma is not known. Hodgkin lymphoma is most common among people 15 to 35 years old and 50 to 70 years old. Past infection with the Epstein-Barr virus (EBV) is thought to contribute to some cases. People with HIV infection are at increased risk compared to the general population. Symptoms The first sign of Hodgkin lymphoma is often a swollen lymph node that appears without a known cause. The disease can spread to nearby lymph nodes. Later it may spread to the spleen, liver, bone marrow, or other organs. Symptoms may include any of the following: Feeling very tired all the time Fever and chills that come and go Itching all over the body that cannot be explained Loss of appetite Drenching night sweats Painless swelling of the lymph nodes in the neck, armpits, or groin (swollen glands) Weight loss that cannot be explained Other symptoms that may occur with this disease: Coughing, chest pains, or breathing problems if there are swollen lymph nodes in the chest Excessive sweating Pain or feeling of fullness below the ribs due to swollen spleen or liver Pain in lymph nodes after drinking alcohol Skin blushing or flushing Symptoms caused by Hodgkin lymphoma may occur with other conditions. Talk to your health care provider about the meaning of your specific symptoms. Exams and Tests The provider will perform a physical exam and check body areas with lymph nodes to feel if they are swollen. The disease is often diagnosed after a biopsy of suspected tissue, usually a lymph node. The following procedures will usually be done: Blood chemistry tests including protein levels, liver function tests, kidney function tests, and uric acid level Bone marrow biopsy CT scans of the chest, abdomen, and pelvis Complete blood count (CBC) to check for anemia and white blood count PET scan If tests show that you have Hodgkin lymphoma, more tests will be done to see how far the cancer has spread. This is called staging. Staging helps guide treatment and follow-up. Treatment Treatment depends on the following: The type of Hodgkin lymphoma (there are different forms of Hodgkin lymphoma) The stage (where the disease has spread) Your age and other medical issues Other factors, including weight loss, night sweats, and fever You may receive chemotherapy, radiation therapy, or both. Your provider can tell you more about your specific treatment. High-dose chemotherapy may be given when Hodgkin lymphoma returns after treatment or does not respond to the first treatment. This is followed by a stem cell transplant that uses your own stem cells. You and your provider may need to manage other concerns during your treatment, including: Managing your pets during chemotherapy Bleeding problems Dry mouth Eating enough calories Support Groups You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences can help you not feel alone. Outlook (Prognosis) Hodgkin lymphoma is one of the most curable cancers. Cure is even more likely if it is diagnosed and treated early. Unlike other cancers, Hodgkin lymphoma is also very curable in its late stages. You will need to have regular exams for years after your treatment. This helps your provider check for signs of the cancer returning and for any long-term treatment effects. Possible Complications Treatments for Hodgkin lymphoma can have complications. Long-term complications of chemotherapy or radiation therapy include: Bone marrow diseases (such as leukemia) Heart disease Inability to have children (infertility) Lung problems Other cancers Thyroid problems Keep following up with a provider who knows about monitoring and preventing these complications. When to Contact a Medical Professional Call your provider if: You have symptoms of Hodgkin lymphoma You have Hodgkin lymphoma and you have side effects from the treatment Review Date 8/14/2017 Updated by: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 11/07/2018. ", "role": "user" }, { "content": "Hodgkin lymphoma is treated with chemotherapy, radiation therapy, or both. High-dose chemotherapy may be given when Hodgkin lymphoma returns after treatment or does not respond to the first treatment. This is followed by a stem cell transplant.", "role": "assistant" } ]

[ { "content": "how to prevent diabetes\n\nDiabetes (Is there anything I can do to prevent type 2 diabetes?): Yes. Many studies, including the large Diabetes Prevention Program study, have proven that you can prevent diabetes by losing weight. Weight loss through healthy eating and more physical activity improves the way your body uses insulin and glucose. Learn how to eat healthier and get more physical activity.", "role": "user" }, { "content": "Diabetes (Is there anything I can do to prevent type 2 diabetes?): Yes. Many studies, including the large Diabetes Prevention Program study, have proven that you can prevent diabetes by losing weight. Weight loss through healthy eating and more physical activity improves the way your body uses insulin and glucose.", "role": "assistant" } ]

[ { "content": "Would appreciate any good info on Lewy Body Dementia, we need to get people aware of this dreadful disease, all they talk about is alzheimers. Thank you\n\n Dementia With Lewy Bodies What is Dementia With Lewy Bodies? Dementia with Lewy bodies (DLB) is one of the most common types of progressive dementia. The central features of DLB include progressive cognitive decline, “fluctuations” in alertness and attention, visual hallucinations, and parkinsonian motor symptoms, such as slowness of movement, difficulty walking, or rigidity. People may also suffer from depression. The symptoms of DLB are caused by the build-up of Lewy bodies – accumulated bits of alpha-synuclein protein -- inside the nuclei of neurons in areas of the brain that control particular aspects of memory and motor control. Researchers don’t know exactly why alpha-synuclein accumulates into Lewy bodies or how Lewy bodies cause the symptoms of DLB, but they do know that alpha-synuclein accumulation is also linked to Parkinson's disease, multiple system atrophy, and several other disorders, which are referred to as the \"synucleinopathies.\" The similarity of symptoms between DLB and Parkinson’s disease, and between DLB and Alzheimer’s disease, can often make it difficult for a doctor to make a definitive diagnosis. In addition, Lewy bodies are often also found in the brains of people with Parkinson's and Alzheimer’s diseases. These findings suggest that either DLB is related to these other causes of dementia or that an individual can have both diseases at the same time. DLB usually occurs sporadically, in people with no known family history of the disease. However, rare familial cases have occasionally been reported. Is there any treatment? There is no cure for DLB. Treatments are aimed at controlling the cognitive, psychiatric, and motor symptoms of the disorder. Acetylcholinesterase inhibitors, such as donepezil and rivastigmine, are primarily used to treat the cognitive symptoms of DLB, but they may also be of some benefit in reducing the psychiatric and motor symptoms. Doctors tend to avoid prescribing antipsychotics for hallucinatory symptoms of DLB because of the risk that neuroleptic sensitivity could worsen the motor symptoms. Some individuals with DLB may benefit from the use of levodopa for their rigidity and loss of spontaneous movement. What is the prognosis? Like Alzheimer’s disease and Parkinson’s disease, DLB is a neurodegenerative disorder that results in progressive intellectual and functional deterioration. There are no known therapies to stop or slow the progression of DLB. Average survival after the time of diagnosis is similar to that in Alzheimer’s disease, about 8 years, with progressively increasing disability. What research is being done? The National Institute of Neurological Disorders and Stroke (NINDS) and other institutes of the National Institutes of Health conduct research related to DLB in laboratories at the NIH and support additional research through grants to major medical institutions across the country. Much of this research focuses on searching for the genetic roots of DLB, exploring the molecular mechanisms of alpha-synuclein accumulation, and discovering how Lewy bodies cause the particular symptoms of DLB and the other synucleinopathies. The goal of NINDS research is to find better ways to prevent, treat, and ultimately cure disorders such as DLB. ", "role": "user" }, { "content": "There is no cure for DLB. Treatments are aimed at controlling the cognitive, psychiatric, and motor symptoms of the disorder. Acetylcholinesterase inhibitors, such as donepezil and rivastigmine, are primarily used to treat the cognitive symptoms of DLB, but they may also be of some benefit in reducing the psychiatric and motor symptoms. Doctors tend to avoid prescribing antipsychotics for hallucinatory symptoms of DLB because of the risk that neuroleptic sensitivity could worsen the motor symptoms. Some individuals with DLB may benefit from the use of levodopa for their rigidity and loss of spontaneous movement.", "role": "assistant" } ]

[ { "content": "more information in relation to Ellis van creveld syndrome Specifically in later life can they have children has it ever been reported any researchcarried out and just as much information as possible to help my understanding of what I have Many thanks\n\nEllis-van Creveld syndrome (Treatment): Treatment depends on which body system is affected and the severity of the problem. The condition itself is not treatable, but many of the complications can be treated.", "role": "user" }, { "content": "Ellis-van Creveld syndrome (Treatment): Treatment depends on which body system is affected and the severity of the problem. The condition itself is not treatable, but many of the complications can be treated.", "role": "assistant" } ]

[ { "content": "polymicrogyria. My 16 month old son has this. Does not sit up our crawl yet but still trying and is improving in grabbing things etc etc. Have read about other cases that seem 10000 time worse. It's it possible for this post of his brain to grown to normal and he grow out of it?\n\n Polymicrogyria Summary Polymicrogyria is a condition characterized by abnormal development of the brain before birth. Specifically, the surface of the brain develops too many folds which are unusually small. The signs and symptoms associated with the condition vary based on how much of the brain and which areas of the brain are affected; however, affected people may experience recurrent seizures ( epilepsy ); delayed development; crossed eyes ; problems with speech and swallowing; and muscle weakness or paralysis. Bilateral forms (affecting both sides of the brain) tend to cause more severe neurological problems. Polymicrogyria can result from both genetic and environmental causes. It may occur as an isolated finding or as part of a syndrome . Treatment is based on the signs and symptoms present in each person. [1] [2] Symptoms A wide variety of symptoms may be observed in people with polymicrogyria, depending on the areas of the brain implicated and whether or not it is part of a larger syndrome . Signs and symptoms may include: [3] [4] Developmental delay Crossed eyes Epilepsy Paralysis of the face, throat, and tongue Difficulty with speech and swallowing Drooling Diagnosis The diagnosis of polymicrogyria is made by imaging brain structures using MRI . Typical findings include areas of the cerebral cortex with a complex set of small gyri that appear fused to each other and separated by shallow sulci. These findings may be isolated to one side of the brain (unilateral) or may involve both sides of the brain (bilateral). [3] [4] ", "role": "user" }, { "content": "Polymicrogyria is a condition characterized by abnormal development of the brain before birth. Symptoms of polymicrogyria vary depending on how much of the brain and which areas of the brain are affected and whether or not it is part of a larger syndrome . Affected people may experience recurrent epileptic seizures; delayed development; crossed eyes; problems with speech and swallowing; and muscle weakness or paralysis. Bilateral forms, which affect both sides of the brain, cause more severe neurological problems.", "role": "assistant" } ]

[ { "content": "what is the treatment for lymphoma\n\n Lymphoma Overview Lymphoma is a cancer of the lymphatic system, which is part of the body's germ-fighting network. The lymphatic system includes the lymph nodes (lymph glands), spleen, thymus gland and bone marrow. Lymphoma can affect all those areas as well as other organs throughout the body. Many types of lymphoma exist. The main subtypes are: - Hodgkin's lymphoma (formerly called Hodgkin's disease) - Non-Hodgkin's lymphoma What lymphoma treatment is best for you depends on your lymphoma type and its severity. Lymphoma treatment may involve chemotherapy, immunotherapy medications, radiation therapy, a bone marrow transplant or some combination of these. Lymphoma care at Mayo Clinic Symptoms Signs and symptoms of lymphoma may include: - Painless swelling of lymph nodes in your neck, armpits or groin - Persistent fatigue - Fever - Night sweats - Shortness of breath - Unexplained weight loss When to see a doctor Make an appointment with your doctor if you have any persistent signs or symptoms that worry you. Causes Doctors aren't sure what causes lymphoma. But it begins when a disease-fighting white blood cell called a lymphocyte develops a genetic mutation. The mutation tells the cell to multiply rapidly, causing many diseased lymphocytes that continue multiplying. The mutation also allows the cells to go on living when other cells would die. This causes too many diseased and ineffective lymphocytes in your lymph nodes and causes the lymph nodes to swell. Diagnosis Tests and procedures used to diagnose lymphoma include: - Physical exam. Your doctor checks for swollen lymph nodes, including in your neck, underarm and groin, as well as a swollen spleen or liver. - Removing a lymph node for testing. Your doctor may recommend a lymph node biopsy procedure to remove all or part of a lymph node for laboratory testing. Advanced tests can determine if lymphoma cells are present and what types of cells are involved. - Blood tests. Blood tests to count the number of cells in a sample of your blood can give your doctor clues about your diagnosis. - Removing a sample of bone marrow for testing. A bone marrow aspiration and biopsy procedure involves inserting a needle into your hipbone to remove a sample of bone marrow. The sample is analyzed to look for lymphoma cells. - Imaging tests. Your doctor may recommend imaging tests to look for signs of lymphoma in other areas of your body. Tests may include CT, MRI and positron emission tomography (PET). Other tests and procedures may be used depending on your situation. Many types of lymphoma exist, including rare forms that are difficult for inexperienced pathologists to identify. An accurate diagnosis is key to developing a treatment plan. Research shows that review of biopsy tests by pathologists who aren't experienced with lymphoma results in a significant proportion of misdiagnoses. Get a second opinion from a specialist. Treatment Which lymphoma treatments are right for you depends on the type and stage of your disease, your overall health, and your preferences. The goal of treatment is to destroy as many cancer cells as possible and bring the disease into remission. Lymphoma treatments include: - Active surveillance. Some forms of lymphoma are very slow growing. You and your doctor may decide to wait to treat your lymphoma when it causes signs and symptoms that interfere with your daily activities. Until then, you may undergo periodic tests to monitor your condition. - Chemotherapy. Chemotherapy uses drugs to destroy fast-growing cells, such as cancer cells. The drugs are usually administered through a vein, but can also be taken as a pill, depending on the specific drugs you receive. - Other drug therapy. Other drugs used to treat lymphoma include targeted drugs that focus on specific abnormalities in your cancer cells. Immunotherapy drugs use your immune system to kill cancer cells. - Radiation therapy. Radiation therapy uses high-powered beams of energy, such as X-rays and protons, to kill cancer cells. - Bone marrow transplant. A bone marrow transplant, also known as a stem cell transplant, involves using high doses of chemotherapy and radiation to suppress your bone marrow. Then healthy bone marrow stem cells from your body or from a donor are infused into your blood where they travel to your bones and rebuild your bone marrow. Alternative medicine No supplements have been found to treat lymphoma. But integrative medicine may help you cope with the stress of a cancer diagnosis and the side effects of cancer treatment. Talk to your doctor about your options, such as: - Physical activity - Art therapy - Meditation - Music therapy - Relaxation exercises - Acupuncture - Massage ", "role": "user" }, { "content": "Which lymphoma treatments are right for you depends on the type and stage of your disease, your overall health, and your preferences. Lymphoma treatments include: - Active surveillance. Some forms of lymphoma are very slow growing. Chemotherapy uses drugs to destroy fast-growing cells, such as cancer cells. Other drugs used to treat lymphoma include targeted drugs that focus on specific abnormalities in your cancer cells. Immunotherapy drugs use your immune system to kill cancer cells. - Radiation therapy. Radiation therapy uses high-powered beams of energy, such as X-rays and protons, to kill cancer cells. - Bone marrow transplant.", "role": "assistant" } ]

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

[ { "content": "Can you mail me patient information about Glaucoma, I was recently diagnosed and want to learn all I can about the disease.\n\n Glaucoma Open-angle glaucoma Chronic glaucoma Chronic open-angle glaucoma Primary open-angle glaucoma Closed-angle glaucoma Narrow-angle glaucoma Angle-closure glaucoma Acute glaucoma Secondary glaucoma Congenital glaucoma Vision loss - glaucoma Summary 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 </div> </div> Causes Glaucoma is the second most common cause of blindness in the United States. There are four major types of glaucoma: Open-angle glaucoma Angle-closure glaucoma, also called closed-angle glaucoma Congenital glaucoma Secondary glaucoma The front part of the eye is filled with a clear fluid called aqueous humor. This fluid is made in an area behind the colored part of the eye (iris). It leaves the eye through channels where the iris and cornea meet. This area is called the anterior chamber angle, or the angle. The cornea is the clear covering on the front of the eye that covers the iris, pupil, and angle. Anything that slows or blocks the flow of this fluid will cause pressure to build up in the eye. In open-angle glaucoma, the increase in pressure is often small and slow. In closed-angle glaucoma, the increase is often high and sudden. Either type can damage the optic nerve. <strong>Open-angle glaucoma</strong> is the most common type of glaucoma. The cause is unknown. The increase in eye pressure happens slowly over time. You cannot feel it. The increased pressure pushes on the optic nerve. Damage to the optic nerve causes blind spots in your vision. Open-angle glaucoma tends to run in families. Your risk is higher if you have a parent or grandparent with open-angle glaucoma. People of African descent are also at higher risk for this disease. <strong>Closed-angle glaucoma</strong> occurs when the fluid is suddenly blocked and cannot flow out of the eye. This causes a quick, severe rise in eye pressure. Dilating eye drops and certain medicines may trigger an acute glaucoma attack. Closed-angle glaucoma is an emergency. If you have had acute glaucoma in one eye, you are at risk for it in the second eye. Your health care provider is likely to treat your second eye to prevent a first attack in that eye. <strong>Secondary glaucoma</strong> occurs due to a known cause. Both open- and closed-angle glaucoma can be secondary when caused by something known. Causes include: Drugs such as corticosteroids Eye diseases such as uveitis (an infection of the middle layer of the eye) Diseases such as diabetes Eye injury <strong>Congenital glaucoma</strong> occurs in babies. It often runs in families. It is present at birth. It is caused when the eye does not develop normally. Symptoms OPEN-ANGLE GLAUCOMA Most people have no symptoms. Once you are aware of vision loss, the damage is already severe. Slow loss of side (peripheral) vision (also called tunnel vision). Advanced glaucoma can lead to blindness. ANGLE-CLOSURE GLAUCOMA Symptoms may come and go at first, or steadily become worse. You may notice: Sudden, severe pain in one eye Decreased or cloudy vision, often called \"steamy\" vision Nausea and vomiting Rainbow-like halos around lights Red eye Eye feels swollen CONGENITAL GLAUCOMA Symptoms are most often noticed when the child is a few months old. Cloudiness of the front of the eye Enlargement of one eye or both eyes Red eye Sensitivity to light Tearing SECONDARY GLAUCOMA Symptoms are most often related to the underlying problem causing the glaucoma. Depending on the cause, symptoms may either be like open-angle glaucoma or angle-closure glaucoma. Exams and Tests The only way to diagnose glaucoma is by having a complete eye exam. You will be given a test to check your eye pressure. This is called tonometry. In most cases, you will be given eye drops to widen (dilate) your pupil. When your pupil is dilated, your eye doctor will look at the inside of your eye and the optic nerve. Eye pressure is different at different times of the day. Eye pressure can even be normal in some people with glaucoma. So you will need other tests to confirm glaucoma. They may include: Using a special lens to look at the angle of the eye (gonioscopy). Photographs or laser scanning images of the inside of your eye (optic nerve imaging). Laser scanning images of the angle of the eye. Checking your retina -- The retina is the light-sensitive tissue at the back of your eye. Checking how your pupil responds to light (pupillary reflex response). 3-D view of your eye (slit lamp examination). Testing the clearness of your vision (visual acuity). Testing your field of vision (visual field measurement). Treatment The goal of treatment is to reduce your eye pressure. Treatment depends on the type of glaucoma that you have. OPEN-ANGLE GLAUCOMA If you have open-angle glaucoma, you will probably be given eye drops. You may need more than one type. Most people can be treated with eye drops. Most of the eye drops used today have fewer side effects than those used in the past. You also may be given pills to lower pressure in the eye. If drops alone do not work, you may need other treatment: Laser treatment uses a painless laser to open the channels where fluid flows out. If drops and laser treatment do not work, you may need surgery. The doctor will open a new channel so fluid can escape. This will help lower your pressure. Recently, new implants have been developed that can help treat glaucoma in people having cataract surgery. ACUTE ANGLE GLAUCOMA An acute angle-closure attack is a medical emergency. You can become blind in a few days if you are not treated. You may be given drops, pills, and medicine given through a vein (by IV) to lower your eye pressure. Some people also need an emergency operation, called an iridotomy. The doctor uses a laser to open a new channel in the iris. Sometimes this is done with surgery. The new channel relieves the attack and will prevent another attack. To help prevent an attack in the other eye, the procedure will often be performed on the other eye. This may be done even if it has never had an attack. CONGENITAL GLAUCOMA Congenital glaucoma is almost always treated with surgery. This is done using general anesthesia. This means the child is asleep and feels no pain. SECONDARY GLAUCOMA If you have secondary glaucoma, treating the cause may help your symptoms go away. Other treatments also may be needed. Outlook (Prognosis) Open-angle glaucoma cannot be cured. You can manage it and keep your sight by following your provider's directions. Closed-angle glaucoma is a medical emergency. You need treatment right away to save your vision. Babies with congenital glaucoma usually do well when surgery is done early. How you do with secondary glaucoma depends on what is causing the condition. When to Contact a Medical Professional If you have severe eye pain or a sudden loss of vision, get immediate medical help. These may be signs of closed-angle glaucoma. Prevention You cannot prevent open-angle glaucoma. Most people have no symptoms. But you can help prevent vision loss. A complete eye exam can help find open-angle glaucoma early, when it is easier to treat. All adults should have a complete eye exam by the age of 40. If you are at risk for glaucoma, you should have a complete eye exam sooner than age 40. You should have regular eye exams as recommended by your provider. If you are at risk for closed-angle glaucoma, your provider may recommend treatment before you have an attack to help prevent eye damage and vision loss. Review Date 2/19/2018 Updated by: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "The only way to diagnose glaucoma is by having a complete eye exam. You will be given a test to check your eye pressure. This is called tonometry. -Eye pressure is different at different times of the day. Eye pressure can even be normal in some people with glaucoma. So you will need other tests to confirm glaucoma. They may include: - Using a special lens to look at the angle of the eye (gonioscopy). - Photographs or laser scanning images of the inside of your eye (optic nerve imaging). - Checking your retina. The retina is the light-sensitive tissue at the back of your eye. - Checking how your pupil responds to light (pupillary reflex response). - 3-D view of your eye (slit lamp examination). - Testing the clearness of your vision (visual acuity). - Testing your field of vision (visual field measurement).", "role": "assistant" } ]

[ { "content": "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\n\n Gastroparesis Definition and Facts Gastroparesis, also called delayed gastric emptying, is a disorder that slows or stops the movement of food from your stomach to your small intestine, even though there is no blockage in the stomach or intestines. What is gastroparesis? Gastroparesis, also called delayed gastric emptying, is a disorder that slows or stops the movement of food from your stomach to your small intestine. Normally, after you swallow food, the muscles in the wall of your stomach grind the food into smaller pieces and push them into your small intestine to continue digestion. When you have gastroparesis, your stomach muscles work poorly or not at all, and your stomach takes too long to empty its contents. Gastroparesis can delay digestion, which can lead to various symptoms and complications. How common is gastroparesis? Gastroparesis is not common. Out of 100,000 people, about 10 men and about 40 women have gastroparesis1. However, symptoms that are similar to those of gastroparesis occur in about 1 out of 4 adults in the United States2, 3. Who is more likely to get gastroparesis? You are more likely to get gastroparesis if youhave diabetes had surgery on your esophagus, stomach, or small intestine, which may injure the vagus nerve . The vagus nerve controls the muscles of the stomach and small intestine. had certain cancer treatments, such as radiation therapy on your chest or stomach area What other health problems do people with gastroparesis have? People with gastroparesis may have other health problems, such asdiabetes scleroderma hypothyroidism nervous system disorders, such as migraine, Parkinson's disease, and multiple sclerosis gastroesophageal reflux disease (GERD) eating disorders amyloidosis What are the complications of gastroparesis? Complications of gastroparesis may includedehydration due to repeated vomiting malnutrition due to poor absorption of nutrients blood glucose, also called blood sugar, levels that are harder to control, which can worsen diabetes low calorie intake bezoars losing weight without trying lower quality of life Definition & Facts Symptoms and Causes The symptoms of gastroparesis may include feeling full shortly after starting a meal, feeling full long after eating a meal, nausea, and vomiting. Diabetes is the most common known cause of gastroparesis. What are the symptoms of gastroparesis? The symptoms of gastroparesis may includefeeling full soon after starting a meal feeling full long after eating a meal nausea vomiting too much bloating too much belching pain in your upper abdomen heartburn poor appetiteCertain medicines may delay gastric emptying or affect motility, resulting in symptoms that are similar to those of gastroparesis. If you have been diagnosed with gastroparesis, these medicines may make your symptoms worse. Medicines that may delay gastric emptying or make symptoms worse include the following:narcotic pain medicines, such as codeine , hydrocodone , morphine , oxycodone , and tapentadol some antidepressants , such as amitriptyline , nortriptyline , and venlafaxine some anticholinergics -medicines that block certain nerve signals some medicines used to treat overactive bladder pramlintideThese medicines do not cause gastroparesis. When should I seek a doctor’s help? You should seek a doctor's help right away if you have any of the following signs or symptoms:severe pain or cramping in your abdomen blood glucose levels that are too high or too low red blood in your vomit, or vomit that looks like coffee grounds sudden, sharp stomach pain that doesn't go away vomiting for more than an hour feeling extremely weak or fainting difficulty breathing feverYou should seek a doctor's help if you have any signs or symptoms of dehydration, which may includeextreme thirst and dry mouth urinating less than usual feeling tired dark-colored urine decreased skin turgor, meaning that when your skin is pinched and released, the skin does not flatten back to normal right away sunken eyes or cheeks light-headedness or faintingYou should seek a doctor's help if you have any signs or symptoms of malnutrition, which may includefeeling tired or weak all the time losing weight without trying feeling dizzy loss of appetite abnormal paleness of the skin Symptoms & Causes In most cases, doctors aren't able to find the underlying cause of gastroparesis, even with medical tests. Gastroparesis without a known cause is called idiopathic gastroparesis.Diabetes is the most common known underlying cause of gastroparesis. Diabetes can damage nerves, such as the vagus nerve and nerves and special cells, called pacemaker cells, in the wall of the stomach. The vagus nerve controls the muscles of the stomach and small intestine. If the vagus nerve is damaged or stops working, the muscles of the stomach and small intestine do not work normally. The movement of food through the digestive tract is then slowed or stopped. Similarly, if nerves or pacemaker cells in the wall of the stomach are damaged or do not work normally, the stomach does not empty.In addition to diabetes, other known causes of gastroparesis includeinjury to the vagus nerve due to surgery on your esophagus, stomach, or small intestine hypothyroidism certain autoimmune diseases, such as scleroderma certain nervous system disorders, such as Parkinson's disease and multiple sclerosis viral infections of your stomach Diagnosis Doctors diagnose gastroparesis based on your medical history, a physical exam, symptoms, and medical tests, such as tests to measure stomach emptying. Your doctor may use medical tests to look for gastroparesis complications. How do doctors diagnose gastroparesis? Doctors diagnose gastroparesis based on your medical history, a physical exam, your symptoms, and medical tests. Your doctor may also perform medical tests to look for signs of gastroparesis complications and to rule out other health problems that may be causing your symptoms.Your doctor will ask about your medical history. He or she will ask for details about your current symptoms and medicines, and current and past health problems such as diabetes, scleroderma, nervous system disorders, and hypothyroidism.Your doctor may also ask aboutthe types of medicines you are taking. Be sure to tell your doctor about all prescription medicines, over-the-counter medicines, and dietary supplements you are taking. whether you've had surgery on your esophagus, stomach, or small intestine whether you've had radiation therapy on your chest or stomach areaDuring a physical exam, your doctor willcheck your blood pressure, temperature, and heart rate check for signs of dehydration and malnutrition check your abdomen for unusual sounds, tenderness, or pain Diagnosis Doctors use lab tests, upper gastrointestinal (GI) endoscopy, imaging tests, and tests to measure how fast your stomach is emptying its contents to diagnose gastroparesis.Your doctor may use the following lab tests:Blood tests can show signs of dehydration, malnutrition, inflammation, and infection. Blood tests can also show whether your blood glucose levels are too high or too low. Urine tests can show signs of diabetes, dehydration, infection, and kidney problems.Your doctor may perform an upper GI endoscopy to look for problems in your upper digestive tract that may be causing your symptoms.Imaging tests can show problems, such as stomach blockage or intestinal obstruction, that may be causing your symptoms. Your doctor may perform the following imaging tests:upper GI series ultrasound of your abdomenYour doctor may perform one of more of the following tests to see how fast your stomach is emptying its contents.Gastric emptying scan, also called gastric emptying scintigraphy. For this test, you eat a bland meal-such as eggs or an egg substitute-that contains a small amount of radioactive material. A camera outside your body scans your abdomen to show where the radioactive material is located. By tracking the radioactive material, a health care professional can measure how fast your stomach empties after the meal. The scan usually takes about 4 hours. Gastric emptying breath test. For this test, you eat a meal that contains a substance that is absorbed in your intestines and eventually passed into your breath. After you eat the meal, a health care professional collects samples of your breath over a period of a few hours-usually about 4 hours. The test can show how fast your stomach empties after the meal by measuring the amount of the substance in your breath. Wireless motility capsule, also called a SmartPill. The SmartPill is a small electronic device that you swallow. The capsule moves through your entire digestive tract and sends information to a recorder hung around your neck or clipped to your belt. A health care professional uses the information to find out how fast or slow your stomach empties, and how fast liquid and food move through your small intestine and large intestine. The capsule will pass naturally out of your body with a bowel movement. Treatment How doctors treat gastroparesis depends on the cause, how bad your symptoms and complications are, and how well you respond to different treatments. If diabetes is causing your gastroparesis, your doctor will help you control your blood glucose levels. How do doctors treat gastroparesis? How doctors treat gastroparesis depends on the cause, how severe your symptoms and complications are, and how well you respond to different treatments. Sometimes, treating the cause may stop gastroparesis. If diabetes is causing your gastroparesis, your health care professional will work with you to help control your blood glucose levels. When the cause of your gastroparesis is not known, your doctor will provide treatments to help relieve your symptoms and treat complications.Changing your eating habits can help control gastroparesis and make sure you get the right amount of nutrients, calories, and liquids. Getting the right amount of nutrients, calories, and liquids can also treat the disorder's two main complications: malnutrition and dehydration.Your doctor may recommend that youeat foods low in fat and fiber eat five or six small, nutritious meals a day instead of two or three large meals chew your food thoroughly eat soft, well-cooked foods avoid carbonated, or fizzy, beverages avoid alcohol drink plenty of water or liquids that contain glucose and electrolytes, such as low-fat broths or clear soups naturally sweetened, low-fiber fruit and vegetable juices sports drinks oral rehydration solutions do some gentle physical activity after a meal, such as taking a walk avoid lying down for 2 hours after a meal take a multivitamin each dayIf your symptoms are moderate to severe, your doctor may recommend drinking only liquids or eating well-cooked solid foods that have been processed into very small pieces or paste in a blender.If you have gastroparesis and diabetes, you will need to control your blood glucose levels, especially hyperglycemia. Hyperglycemia may further delay the emptying of food from your stomach. Your doctor will work with you to make sure your blood glucose levels are not too high or too low and don't keep going up or down. Your doctor may recommendtaking insulin more often, or changing the type of insulin you take taking insulin after, instead of before, meals checking your blood glucose levels often after you eat, and taking insulin when you need itYour doctor will give you specific instructions for taking insulin based on your needs and the severity of your gastroparesis.Your doctor may prescribe medicines that help the muscles in the wall of your stomach work better. He or she may also prescribe medicines to control nausea and vomiting and reduce pain.Your doctor may prescribe one or more of the following medicines:Metoclopramide. This medicine increases the tightening, or contraction, of the muscles in the wall of your stomach and may improve gastric emptying. Metoclopramide may also help relieve nausea and vomiting. Domperidone. This medicine also increases the contraction of the muscles in the wall of your stomach and may improve gastric emptying. However, this medicine is available for use only under a special program administered by the U.S. Food and Drug Administration. Erythromycin. This medicine also increases stomach muscle contraction and may improve gastric emptying. Antiemetics. Antiemetics are medicines that help relieve nausea and vomiting. Prescription antiemetics include ondansetron , prochlorperazine , and promethazine. Over-the-counter antiemetics include bismuth subsalicylate and diphenhydramine . Antiemetics do not improve gastric emptying. Antidepressants. Certain antidepressants, such as mirtazapine, may help relieve nausea and vomiting. These medicines may not improve gastric emptying. Pain medicines. Pain medicines that are not narcotic pain medicines may reduce pain in your abdomen due to gastroparesis.In some cases, your doctor may recommend oral or nasal tube feeding to make sure you're getting the right amount of nutrients and calories. A health care professional will put a tube either into your mouth or nose, through your esophagus and stomach, to your small intestine. Oral and nasal tube feeding bypass your stomach and deliver a special liquid food directly into your small intestine.If you aren't getting enough nutrients and calories from other treatments, your doctor may recommend jejunostomy tube feeding. Jejunostomy feedings are a longer term method of feeding, compared to oral or nasal tube feeding.Jejunostomy tube feeding is a way to feed you through a tube placed into part of your small intestine called the jejunum. To place the tube into the jejunum, a doctor creates an opening, called a jejunostomy, in your abdominal wall that goes into your jejunum. The feeding tube bypasses your stomach and delivers a liquid food directly into your jejunum.Your doctor may recommend parenteral, or intravenous (IV), nutrition if your gastroparesis is so severe that other treatments are not helping. Parenteral nutrition delivers liquid nutrients directly into your bloodstream. Parenteral nutrition may be short term, until you can eat again. Parenteral nutrition may also be used until a tube can be placed for oral, nasal, or jejunostomy tube feeding. In some cases, parental nutrition may be long term.Your doctor may recommend a venting gastrostomy to relieve pressure inside your stomach. A doctor creates an opening, called a gastrostomy, in your abdominal wall and into your stomach. The doctor then places a tube through the gastrostomy into your stomach. Stomach contents can then flow out of the tube and relieve pressure inside your stomach.Gastric electrical stimulation (GES) uses a small, battery-powered device to send mild electrical pulses to the nerves and muscles in the lower stomach. A surgeon puts the device under the skin in your lower abdomen and attaches wires from the device to the muscles in the wall of your stomach. GES can help decrease long-term nausea and vomiting.GES is used to treat people with gastroparesis due to diabetes or unknown causes only, and only in people whose symptoms can't be controlled with medicines. Treatment Gastroparesis without a known cause, called idiopathic gastroparesis, cannot be prevented.If you have diabetes, you can prevent or delay nerve damage that can cause gastroparesis by keeping your blood glucose levels within the target range that your doctor thinks is best for you. Meal planning, physical activity, and medicines, if needed, can help you keep your blood glucose levels within your target range. Eating, Diet, and Nutrition What you eat can help relieve gastroparesis symptoms. What you eat can also help make sure you get the right amount of nutrients, calories, and liquids if you are malnourished or dehydrated due to gastroparesis. How can my diet help prevent or relieve gastroparesis? What you eat can help prevent or relieve your gastroparesis symptoms. If you have diabetes, following a healthy meal plan can help you manage your blood glucose levels. What you eat can also help make sure you get the right amount of nutrients, calories, and liquids if you are malnourished or dehydrated from gastroparesis. What should I eat and drink if I have gastroparesis? If you have gastroparesis, your doctor may recommend that you eat or drinkfoods and beverages that are low in fat foods and beverages that are low in fiber five or six small, nutritious meals a day instead of two or three large meals soft, well-cooked foodsIf you are unable to eat solid foods, your doctor may recommend that you drinkliquid nutrition meals solid foods pureed in a blenderYour doctor may also recommend that you drink plenty of water or liquids that contain glucose and electrolytes, such aslow-fat broths and clear soups low-fiber fruit and vegetable juices sports drinks oral rehydration solutionsIf your symptoms are moderate to severe, your doctor may recommend drinking only liquids or eating well-cooked solid foods that have been processed into very small pieces or paste in a blender. Eating, Diet, & Nutrition If you have gastroparesis, you should avoidfoods and beverages that are high in fat foods and beverages that are high in fiber foods that can't be chewed easily carbonated, or fizzy, beverages alcoholYour doctor may refer you to a dietitian to help you plan healthy meals that are easy for you to digest and give you the right amount of nutrients, calories, and liquids. ", "role": "user" }, { "content": "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. Most people diagnosed with gastroparesis have idiopathic gastroparesis, which means a health care provider cannot identify the cause, even with medical tests. Diabetes is the most common known cause of gastroparesis. The most common symptoms of gastroparesis are nausea, a feeling of fullness after eating only a small amount of food, and vomiting undigested food? sometimes several hours after a meal. Other common symptoms include gastroesophageal reflux (GER), pain in the stomach area, abdominal bloating, and lack of appetite. Gastroparesis is diagnosed through a physical exam, medical history, blood tests, tests to rule out blockage or structural problems in the gastrointestinal (GI) tract, and gastric emptying tests. Changing eating habits can sometimes help control the severity of gastroparesis symptoms. A health care provider may suggest eating six small meals a day instead of three large ones. When a person has severe symptoms, a liquid or puréed diet may be prescribed. Treatment of gastroparesis may include medications, botulinum toxin, gastric electrical stimulation, jejunostomy, and parenteral nutrition. For people with gastroparesis and diabetes, a health care provider will likely adjust the person?s insulin regimen.", "role": "assistant" } ]

[ { "content": "how do you diagnose anxiety\n\n Separation anxiety in children Summary Separation anxiety in children is a developmental stage in which the child is anxious when separated from the primary caregiver (usually the mother). Causes As infants grow, their emotions and reactions to the world around them seem to occur in a predictable order. Before 8 months, infants are so new to the world that they lack a sense of what is normal and safe and what may be dangerous. As a result, new settings or people seem to not frighten them. From 8 to 14 months, children often become frightened when they meet new people or visit new places. They recognize their parents as familiar and safe. When separated from their parents, they feel threatened and unsafe. Separation anxiety is a normal stage as a child grows and develops. It helped keep our ancestors alive and helps children learn how to master the world around them. It usually ends when the child is around 2 years old. At this age, toddlers begin to understand that parents may be out of sight now, but will return later. It's also normal for them to test their independence. To get over separation anxiety, children need to: Feel safe in their home. Trust people other than their parents. Trust that their parents will return. Even after children have mastered this stage, separation anxiety may return in times of stress. Most children will feel some degree of separation anxiety when in unfamiliar situations, most often when separated from their parents. When children are in situations (such as hospitals) and are under stress (such as illness or pain), they seek the safety, comfort, and protection of their parents. Since anxiety can worsen pain, staying with a child as much as possible can reduce the pain. Symptoms A child with severe separation anxiety may have any of the following: Excessive distress when separated from the primary caregiver Nightmares Reluctance to go to school or other places because of fear of separation Reluctance to go to sleep without the primary caregiver nearby Repeated physical complaints Worry about losing, or harm coming to the primary caregiver Exams and Tests There are no tests for this condition, because it is normal. If severe separation anxiety persists past age 2, a visit with a health care provider may help determine if the child has an anxiety disorder or other condition. Treatment No treatment is needed for normal separation anxiety. Parents can help their infant or toddler adjust to their absence by letting trusted caregivers babysit the child. This helps the child learn to trust and bond with other adults and understand that their parents will return. During medical procedures, a parent should go with the child if possible. When a parent can't go with the child, exposing the child to the situation beforehand may be helpful, such as visiting the doctor's office before a test. Some hospitals have child life specialists who can explain procedures and medical conditions to children of all ages. If your child is very anxious and needs extended medical care, ask your provider about such services. When it's not possible for parents to be with the child, such as for surgery, explain the experience to the child. Reassure the child that a parent is waiting, and where. For older children who have not outgrown separation anxiety, treatments may include: Anti-anxiety medicines Changes in parenting techniques Counseling for the parents and child Treatment for severe cases may include: Family education Family therapy Talk therapy Outlook (Prognosis) Young children with symptoms that improve after age 2 are normal, even if some anxiety comes back later during stress. When separation anxiety occurs in adolescence, it may signal the development of an anxiety disorder. When to Contact a Medical Professional Call your provider if your child has severe separation anxiety after age 2. Review Date 5/20/2018 Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Separation anxiety in children (Exams and Tests): There are no tests for this condition, because it is normal. If severe separation anxiety persists past age 2, a visit with a health care provider may help determine if the child has an anxiety disorder or other condition.", "role": "assistant" } ]

[ { "content": "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.\n\n Breast cancer Cancer - breast Carcinoma - ductal Carcinoma - lobular DCIS LCIS HER2-positive breast cancer ER-positive breast cancer Ductal carcinoma in situ Lobular carcinoma in situ Summary Breast cancer is cancer that starts in the tissues of the breast. There are two main types of breast cancer: Ductal carcinoma starts in the tubes (ducts) that carry milk from the breast to the nipple. Most breast cancers are of this type. Lobular carcinoma starts in the parts of the breast, called lobules, which produce milk. In rare cases, breast cancer can start in other areas of the breast. Causes Breast cancer risk factors are things that increase the chance that you could develop breast cancer: Some risk factors you can control, such as drinking alcohol. Others, such as family history, you cannot control. The more risk factors you have, the more your risk increases. But, it does not mean you will develop cancer. Many women who develop breast cancer do not have any known risk factors or a family history. Understanding your risk factors can help you know how to prevent breast cancer. Breast implants, using antiperspirants, and wearing underwire bras do not increase the risk for breast cancer. There is also no evidence of a direct link between breast cancer and pesticides. Symptoms Early breast cancer often does not cause symptoms. This is why regular breast exams and mammograms are important, so cancers that don't have symptoms may be found earlier. As the cancer grows, symptoms may include: Breast lump or lump in the armpit that is hard, has uneven edges, and usually does not hurt. Change in the size, shape, or feel of the breast or nipple. For example, you may have redness, dimpling, or puckering that looks like the skin of an orange. Fluid from the nipple. Fluid may be bloody, clear to yellow, green, or look like pus. In men, breast cancer symptoms include breast lump and breast pain and tenderness. Symptoms of advanced breast cancer may include: Bone pain Breast pain or discomfort Skin ulcers Swelling of the lymph nodes in the armpit (next to the breast with cancer) Weight loss Exams and Tests The health care provider will ask about your symptoms and risk factors. Then the provider will perform a physical exam. The exam includes both breasts, armpits, and the neck and chest area. Women are encouraged to perform breast self-exams each month. However, the importance of self-exams for detecting breast cancer is debatable. Tests used to diagnose and monitor people with breast cancer may include: Breast MRI to help better identify the breast lump or evaluate an abnormal change on a mammogram Breast ultrasound to show whether the lump is solid or fluid-filled Breast biopsy, using methods such as needle aspiration, ultrasound-guided, stereotactic, or open CT scan to check if the cancer has spread outside the breast Mammography to screen for breast cancer or help identify the breast lump PET scan to check if the cancer has spread Sentinel lymph node biopsy to check if the cancer has spread to the lymph nodes If your doctor learns that you do have breast cancer, more tests will be done. This is called staging, which checks if the cancer has spread. Staging helps guide treatment and follow-up. It also gives you an idea of what to expect in the future. Breast cancer stages range from 0 to IV. The higher the stage, the more advanced the cancer. Treatment Treatment is based on many factors, including: Type of breast cancer Stage of the cancer (staging is a tool your providers use to find out how advanced the cancer is) Whether the cancer is sensitive to certain hormones Whether the cancer overproduces (overexpresses) the HER2/neu protein Cancer treatments may include: Hormone therapy. 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. Nearby lymph nodes may also be removed during surgery. 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 (recurring). 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 to monitor for the return of cancer or development of another breast cancer. Women who have had a mastectomy may have reconstructive breast surgery. This will be done either at the time of mastectomy or later. Support Groups You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone. Outlook (Prognosis) New, improved treatments are helping people with breast cancer live longer. Even with treatment, breast cancer can spread to other parts of the body. Sometimes, cancer returns, even after the entire tumor has been removed and nearby lymph nodes are found to be cancer-free. Some women who have had breast cancer develop a new breast cancer that is not related to the original tumor. How well you do after being treated for breast cancer depends on many things. The more advanced your cancer, the poorer the outcome. Other factors that determine the risk for recurrence and the likelihood of successful treatment include: Location of the tumor and how far it has spread Whether the tumor is hormone receptor-positive or -negative Tumor markers Gene expression Tumor size and shape Rate of cell division or how quickly the tumor is growing After considering all of the above, your provider can discuss your risk of having a recurrence of breast cancer. Possible Complications You may experience side effects or complications from cancer treatment. These may include temporary pain or swelling of the breast and surrounding area. Ask your provider about the possible side effects from treatment. When to Contact a Medical Professional Contact your provider if: You have a breast or armpit lump You have nipple discharge After being treated for breast cancer, call your provider if you develop symptoms such as: Nipple discharge Rash on the breast New lumps in the breast Swelling in the area Pain, especially chest pain, abdominal pain, or bone pain Prevention Talk to your provider about how often you should have a mammogram or other tests to screen for breast cancer. Early breast cancers found by a mammogram have a good chance of being cured. Tamoxifen is approved for breast cancer prevention in women age 35 and older who are at high risk. Discuss this with your provider. Women at very high risk for breast cancer may consider preventive (prophylactic) mastectomy. This is surgery to remove the breasts before breast cancer is diagnosed. Possible candidates include: Women who have already had one breast removed due to cancer Women with a strong family history of breast cancer Women with genes or genetic mutations that raise their risk for breast cancer (such as BRCA1 or BRCA2) Many risk factors, such as your genes and family history, cannot be controlled. But making healthy lifestyle changes may reduce your overall chance of getting cancer. This includes: Eating healthy foods Maintaining a healthy weight Limiting alcohol consumption to 1 drink per day Review Date 10/21/2017 Updated by: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Cancer treatment can be local or systemic: - Local treatments involve only the area of disease. Radiation and surgery are forms of local treatment. ... A lumpectomy removes the breast lump. .. 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. 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 to monitor for the return of cancer or development of another breast cancer.", "role": "assistant" } ]

[ { "content": "williams sydrome conditon. i need to send me more information about Williams Syndrome and some tips how to educate people with this disorder.I hope having news from you soon!!thank you\n\nWilliams syndrome (When to Contact a Medical Professional): Many of the symptoms and signs of Williams syndrome may not be obvious at birth. Call your health care provider if your child has features similar to those of Williams syndrome. Seek genetic counseling if you have a family history of Williams syndrome.", "role": "user" }, { "content": "Williams syndrome (When to Contact a Medical Professional): Many of the symptoms and signs of Williams syndrome may not be obvious at birth. Call your health care provider if your child has features similar to those of Williams syndrome. Seek genetic counseling if you have a family history of Williams syndrome.", "role": "assistant" } ]

[ { "content": "Anal Fissure I may have a couple anal fissures and looking to speak with someone to get some information and support.\n\nAnal fissure (Diagnosis): If possible, your doctor will perform a digital rectal exam, which involves inserting a gloved finger into your anal canal, or use a short, lighted tube (anoscope) to inspect your anal canal. However, if this is too painful for you, your doctor may be able to diagnose an anal fissure only by observation. An acute anal fissure looks like a fresh tear, somewhat like a paper cut. A chronic anal fissure likely has the tear, as well as two separate lumps or tags of skin, one internal (sentinel pile) and one external (hypertrophied papilla). The fissure's location offers clues about its cause. A fissure that occurs on the side of the anal opening, rather than the back or front, is more likely to be a sign of another disorder, such as Crohn's disease. Your doctor may recommend further testing if he or she thinks you have an underlying condition: - Flexible sigmoidoscopy. Your doctor will insert a thin, flexible tube with a tiny video into the bottom portion of your colon. This test may be done if you're younger than 50 and have no risk factors for intestinal diseases or colon cancer. - Colonoscopy. Your doctor will insert a flexible tube into your rectum to inspect the entire colon. This test may be done if you are older than age 50 or you have risk factors for colon cancer, signs of other conditions, or other symptoms such as abdominal pain or diarrhea.", "role": "user" }, { "content": "Anal fissure (Diagnosis): If possible, your doctor will perform a digital rectal exam, which involves inserting a gloved finger into your anal canal, or use a short, lighted tube (anoscope) to inspect your anal canal. However, if this is too painful for you, your doctor may be able to diagnose an anal fissure only by observation. Your doctor may recommend further testing if he or she thinks you have an underlying condition.", "role": "assistant" } ]

[ { "content": "how to prevent diabetes\n\nDiabetes (Is there anything I can do to prevent type 1 diabetes?): Researchers do not know how to prevent type 1 diabetes. Researchers are still looking for ways to prevent type 1 diabetes in women and girls by studying their close relatives who have diabetes.", "role": "user" }, { "content": "At this time, researchers do not know how to prevent type 1 diabetes. There is currently research in preventing type 1 diabetes in women and girls with close relatives with diabetes.", "role": "assistant" } ]

[ { "content": "can i take keflex to cure staph?\n\n Staph infections - self-care at home Staphylococcus infections - self care at home Methicillin-resistant staphylococcus aureus infections - self care at home MRSA infections - self care at home Summary Staph (pronounced staff) is short for Staphylococcus. Staph is a type of germ (bacteria) that can cause infections almost anywhere in the body. One type of staph germ, called methicillin-resistant <em>Staphylococcus aureus </em>(MRSA), is harder to treat. This is because MRSA is not killed by certain medicines used to treat other staph germs. How Does Staph Spread? Many healthy people normally have staph on their skin, in their noses, or other body areas. Most of the time, the germ does not cause an infection or symptoms. This is called being colonized with staph. These persons are known as carriers. They can spread staph to others. Some people colonized by staph develop an actual staph infection that makes them sick. Most staph germs are spread by skin-to-skin contact. They can also be spread when you touch something that has the staph germ on it, such as clothing or a towel. Staph germs can then enter a break in the skin, such as cuts, scratches, or pimples. Usually the infection is minor and stays in the skin. But the infection can spread deeper and affect the blood, bones, or joints. Organs such as the lungs, heart, or brain can also be affected. Serious cases can be life-threatening. What are the Risk Factors for Staph Infection? You are more likely to get a staph infection if you: Have an open cut or sore Inject illegal drugs Have a medical tube such as urinary catheter or feeding tube Have a medical device inside your body such as an artificial joint Have a weakened immune system or ongoing (chronic) illness Live with or have close contact with a person who has staph Play contact sports or share athletic equipment Share items such as towels, razors, or cosmetics with others Recently stayed in a hospital or long-term care facility How Do You Know If You Have a Staph Infection? Symptoms depend on where the infection is located. For example, with a skin infection you may have a boil or a painful rash called impetigo. With a serious infection, such as toxic shock syndrome, you may have a high fever, nausea and vomiting, and a sunburn-like rash. The only way to know for sure if you have a staph infection is by seeing a health care provider. A cotton swab is used to collect a sample from an open skin rash or skin sore. A blood, urine, or sputum sample may also be collected. The sample is sent to a lab to test for staph. If staph is found, it will be tested to see which antibiotic should be used to treat your infection. Treatment If test results show you have a staph infection, treatment may include: Taking antibiotics Cleaning and draining the wound Surgery to remove an infected device Preventing Staph Infection Follow these steps to avoid a staph infection and prevent it from spreading. Keep your hands clean by washing them thoroughly with soap and water. Or use an alcohol-based hand sanitizer. Keep cuts and scrapes clean and covered with bandages until they heal. Avoid contact with other people's wounds or bandages. Do not share personal items such as towels, clothing, or cosmetics. Simple steps for athletes include: Cover wounds with a clean bandage. Do not touch other people's bandages. Wash your hands well before and after playing sports. Shower right after exercising. Do not share soap, razors, or towels. If you share sports equipment, clean it first with antiseptic solution or wipes. Use clothing or a towel between your skin and the equipment. Do not use a common whirlpool or sauna if another person with an open sore used it. Always use clothing or a towel as a barrier. Do not share splints, bandages, or braces. Check that shared shower facilities are clean. If they are not clean, shower at home. Review Date 5/21/2017 Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "If test results show you have a staph infection, treatment may include: - Taking antibiotics", "role": "assistant" } ]

[ { "content": "Absence seizures Does any damage occurre from these spells. Mental or physical\n\n Absence seizure Seizure - petit mal Seizure - absence Petit mal seizure Epilepsy - absence seizure Summary An absence seizure is the term for a type of seizure involving staring spells. This type of seizure is a brief (usually less than 15 seconds) disturbance of brain function due to abnormal electrical activity in the brain. Causes Seizures result from overactivity in the brain. Absence seizures occur most often in people under age 20, usually in children ages 6 to 12. In some cases, the seizures are triggered by flashing lights or when the person breathes faster and more deeply than usual (hyperventilates). They may occur with other types of seizures, such as generalized tonic-clonic seizures (grand mal seizures), twitches or jerks (myoclonus), or sudden loss of muscle strength (atonic seizures). Symptoms Most absence seizures last only a few seconds. They often involve staring episodes. The episodes may: Occur many times a day Occur for weeks to months before being noticed Interfere with school and learning Be mistaken for lack of attention, daydreaming or other misbehavior Unexplained difficulties in school and learning difficulties may be the first sign of absence seizures. During the seizure, the person may: Stop walking and start again a few seconds later Stop talking in mid-sentence and start again a few seconds later The person usually does not fall during the seizure. Right after the seizure, the person is usually: Wide awake Thinking clearly Unaware of the seizure Specific symptoms of typical absence seizures may include: Changes in muscle activity, such as no movement, hand fumbling, fluttering eyelids, lip smacking, chewing Changes in alertness (consciousness), such as staring episodes, lack of awareness of surroundings, sudden halt in movement, talking, and other awake activities Some absence seizures begin slower and last longer. These are called atypical absence seizures. Symptoms are similar to regular absence seizures, but muscle activity changes may be more noticeable. Exams and Tests The doctor will perform a physical exam. This will include a detailed look at the brain and nervous system. An EEG (electroencephalogram) will be done to check the electrical activity in the brain. People with seizures often have abnormal electrical activity seen on this test. In some cases, the test shows the area in the brain where the seizures start. The brain may appear normal after a seizure or between seizures. Blood tests may also be ordered to check for other health problems that may be causing the seizures. Head CT or MRI scan may be done to find the cause and location of the problem in the brain. Treatment Treatment for absence seizures includes medicines, changes in lifestyle for adults and children, such as activity and diet, and sometimes surgery. Your doctor can tell you more about these options. Review Date 2/27/2018 Updated by: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Most absence seizures last only a few seconds. They often involve staring episodes. The episodes may: - Occur many times a day - Occur for weeks to months before being noticed - Interfere with school and learning - Be mistaken for lack of attention, daydreaming or other misbehavior Unexplained difficulties in school and learning difficulties may be the first sign of absence seizures.", "role": "assistant" } ]

[ { "content": "how to treat a heart attack\n\nHeart attack (Treatment): IMMEDIATE TREATMENT - You will be hooked up to a heart monitor, so the health care team can see how regularly your heart is beating. - You will receive oxygen so that your heart doesn't have to work as hard. - An intravenous line (IV) will be placed into one of your veins. Medicines and fluids pass through this IV. - You may get nitroglycerin and morphine to help reduce chest pain. - You may receive aspirin, unless it would not be safe for you. In that case, you will be given another medicine that prevents blood clots. - Dangerous abnormal heartbeats (arrhythmias) may be treated with medicine or electric shocks. EMERGENCY PROCEDURES Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart. - Angioplasty is often the first choice of treatment. It should be done within 90 minutes after you get to the hospital, and usually no later than 12 hours after a heart attack. - A stent is a small, metal mesh tube that opens up (expands) inside a coronary artery. A stent is usually placed after or during angioplasty. It helps prevent the artery from closing up again. You may be given drugs to break up the clot. This is called thrombolytic therapy. It is best if these drugs are given soon after the onset of symptoms, usually no later than 12 hours after it and ideally within 30 minutes of arriving to the hospital. Some people may also have heart bypass surgery to open narrowed or blocked blood vessels that supply blood to the heart. This procedure is also called coronary artery bypass grafting and/or open heart surgery. TREATMENT AFTER A HEART ATTACK After several days, you will be discharged from the hospital. You will likely need to take medicines, some for the rest of your life. Always talk to your provider before stopping or changing how you take any medicines. Stopping certain medicines can be deadly. While under the care of your health care team, you will learn: - How to take medicines to treat your heart problem and prevent more heart attacks - How to eat a heart-healthy diet - How to be active and exercise safely - What to do when you have chest pain - How to stop smoking Strong emotions are common after a heart attack. - You may feel sad - You may feel anxious and worry about being careful about everything you do All of these feelings are normal. They go away for most people after 2 or 3 weeks. You may also feel tired when you leave the hospital to go home. Most people who have had a heart attack take part in a cardiac rehabilitation program.", "role": "user" }, { "content": "For immediate treatment for a heart attack, you will be hooked up to a heart monitor, so the health care team can can monitor your heartbeat. You will receive oxygen so that your heart doesn't have to work as hard. An intravenous line (IV) will be placed into one of your veins so you can receive pain relievers and medicine to reduce the risk of blood clots. If necessary, angioplasty will be performed and a stent may be placed inside a coronary artery.", "role": "assistant" } ]

[ { "content": "Can you mail me patient information about Glaucoma, I was recently diagnosed and want to learn all I can about the disease.\n\nGlaucoma (Treatment): The goal of treatment is to reduce your eye pressure. Treatment depends on the type of glaucoma that you have. OPEN-ANGLE GLAUCOMA - If you have open-angle glaucoma, you will probably be given eye drops. - You may need more than one type. Most people can be treated with eye drops. - Most of the eye drops used today have fewer side effects than those used in the past. - You also may be given pills to lower pressure in the eye. If drops alone do not work, you may need other treatment: - Laser treatment uses a painless laser to open the channels where fluid flows out. - If drops and laser treatment do not work, you may need surgery. The doctor will open a new channel so fluid can escape. This will help lower your pressure. - Recently, new implants have been developed that can help treat glaucoma in people having cataract surgery. ACUTE ANGLE GLAUCOMA An acute angle-closure attack is a medical emergency. You can become blind in a few days if you are not treated. - You may be given drops, pills, and medicine given through a vein (by IV) to lower your eye pressure. - Some people also need an emergency operation, called an iridotomy. The doctor uses a laser to open a new channel in the iris. Sometimes this is done with surgery. The new channel relieves the attack and will prevent another attack. - To help prevent an attack in the other eye, the procedure will often be performed on the other eye. This may be done even if it has never had an attack. CONGENITAL GLAUCOMA - Congenital glaucoma is almost always treated with surgery. - This is done using general anesthesia. This means the child is asleep and feels no pain. SECONDARY GLAUCOMA If you have secondary glaucoma, treating the cause may help your symptoms go away. Other treatments also may be needed.", "role": "user" }, { "content": "The goal of treatment is to reduce your eye pressure. Treatment depends on the type of glaucoma that you have. OPEN-ANGLE GLAUCOMA - If you have open-angle glaucoma, you will probably be given eye drops. You also may be given pills to lower pressure in the eye. If drops alone do not work, you may need other treatment: - Laser treatment uses a painless laser to open the channels where fluid flows out. - If drops and laser treatment do not work, you may need surgery. The doctor will open a new channel so fluid can escape. This will help lower your pressure. - Recently, new implants have been developed that can help treat glaucoma in people having cataract surgery. ACUTE ANGLE GLAUCOMA An acute angle-closure attack is a medical emergency. You can become blind in a few days if you are not treated. - You may be given drops, pills, and medicine given through a vein (by IV) to lower your eye pressure. - Some people also need an emergency operation, called an iridotomy. The doctor uses a laser to open a new channel in the iris. Sometimes this is done with surgery. The new channel relieves the attack and will prevent another attack. - To help prevent an attack in the other eye, the procedure will often be performed on the other eye. This may be done even if it has never had an attack.", "role": "assistant" } ]

[ { "content": "how is epidural harmful\n\n Epidural block - pregnancy Delivery - epidural Labor - epidural Summary An epidural block is a numbing medicine given by injection (shot) in the back. It numbs or causes a loss of feeling in the lower half your body. This lessens the pain of contractions during childbirth. An epidural block may also be used to reduce pain during surgery on the lower extremities. This article focuses on epidural blocks during childbirth. How is the Epidural Given? The block or shot is given into an area over your lower back or spine. You may be asked to lie on your side, or you may sit up. Either way, you will be asked to pull your stomach inward and hunch your back outward. Your health care provider will wash the area of your back and inject a little medicine to numb the spot where the epidural needle is placed: The provider inserts a needle into your lower back. The needle is placed into a small space outside your spinal cord. A small soft tube (catheter) is placed into your back, next to your spine. The needle is removed. The numbing medicine is given through the tube for as long as it is needed. In most cases, you will receive a low dose because it is safer for you and baby. Once the medicine takes effect (10 to 20 minutes), you should feel better. You may still feel some back or rectal pressure during contractions. You may shiver after an epidural, but this is common. Many women shiver during labor even without an epidural. Is an Epidural Safe? Many studies have shown that an epidural is a safe way to manage pain during childbirth. While rare, there are some risks. Your blood pressure may drop for a short while. This might cause the baby's heart rate to slow down. To avoid this, you will receive fluids through an intravenous (IV) line to help keep your blood pressure stable. If your blood pressure shows a drop, you may need to lie on your side to keep the blood moving throughout your body. Your provider may also give you medicine to raise your blood pressure. An epidural block may change or alter labor and delivery. If you are very numb from the block, you may have a harder time bearing down to push your baby through the birth canal. Contractions may lessen or slow down for a little while, but labor will still move along as it should. In some cases, it may even go faster. If your labor slows down, your doctor can give you medicine to speed up your contractions. It is best to wait until you are in active labor to have the epidural placed. Other rare side effects are: You may get a headache after your epidural but this is rare. Medicine could enter your spinal fluid. For a short while, it could make you feel dizzy, or you might have a hard time breathing. You could also have a seizure. This is also rare. What Types of Epidurals are There? There are 2 types: \"Walking\" epidural block. This type of epidural will lessen your pain, but you will still be able to move your legs. Most women are not really able to walk around, but they can move their legs. Combined spinal epidural block. This combines both a spinal and epidural block. It provides pain relief much faster. The combined block is used when women are in very active labor and want relief right away. Review Date 4/19/2018 Updated by: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Many studies have shown that an epidural is a safe way to manage pain during childbirth. While rare, there are some risks. Your blood pressure may drop for a short while. This might cause the baby's heart rate to slow down. - To avoid this, you will receive fluids through an intravenous (IV) line to help keep your blood pressure stable. An epidural block may change or alter labor and delivery. - If you are very numb from the block, you may have a harder time bearing down to push your baby through the birth canal. - Contractions may lessen or slow down for a little while, but labor will still move along as it should. Other rare side effects are: - You may get a headache after your epidural but this is rare. - Medicine could enter your spinal fluid. For a short while, it could make you feel dizzy, or you might have a hard time breathing. You could also have a seizure. This is also rare.", "role": "assistant" } ]

[ { "content": "I am looking for information about Cancer of the Esophagus and I'm not finding anything on your website.\n\n Esophageal cancer Esophagus cancer Summary Esophageal cancer is a cancer of the esophagus, the hollow tube that carries foods and liquids from the throat to the stomach. Symptoms that may develop as the cancer grows include heartburn, pain when swallowing, difficulty swallowing, a hoarse voice, a cough that does not go away, weight loss, and coughing up blood. [1] [2] The exact cause of esophageal cancer usually is not known, but both environmental and genetic factors are thought to play a role in its development. For example, variations or mutations in any of several genes may cause susceptibility to esophageal cancer. [3] Environmental factors that may increase a person's chance to develop esophageal cancer include tobacco use, heavy alcohol use, older age, obesity, and damage to the esophagus from acid reflux ( Barrett esophagus). [1] [2] The diagnosis may be based on imaging studies and tests such as chest X-ray , upper endoscopy , and a biopsy of tissue from the esophagus. Treatment options and the chance of recovery depend on the stage of the cancer, whether it can be surgically removed, and a person's general health. Treatment options may include surgery, radiation therapy , chemotherapy , laser therapy, and electrocoagulation. Other treatment options, such as targeted therapy, are being studied in clinical trials . When it is found very early, there is a better chance of recovery. When the cancer is more advanced, it can be treated but rarely can be cured. [2] Symptoms This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom. Showing of Medical Terms Other Names Learn More: HPO ID Percent of people who have these symptoms is not available through HPO Autosomal dominant inheritance 0000006 Squamous cell carcinoma 0002860 Showing of Diagnosis Making a diagnosis for a genetic or rare disease can often be challenging. Healthcare professionals typically look at a person's medical history, symptoms, physical exam, and laboratory test results in order to make a diagnosis. The following resources provide information relating to diagnosis and testing for this condition. If you have questions about getting a diagnosis, you should contact a healthcare professional. Testing Resources The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional. Treatment FDA-Approved Treatments The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition. Learn more orphan products. National Library of Medicine Drug Information Portal Find a Specialist If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments. If you can't find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care. You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists. Healthcare Resources To find a medical professional who specializes in genetics, you can ask your doctor for a referral or you can search for one yourself. Online directories are provided by the American College of Medical Genetics and the National Society of Genetic Counselors. If you need additional help, contact a GARD Information Specialist. You can also learn more about genetic consultations from Genetics Home Reference. ", "role": "user" }, { "content": "Esophageal cancer affects the esophagus, the tube that carries food and liquids from the throat to the stomach. Symptoms of esophageal cancer may include painful or difficult swallowing, weight loss and coughing up blood. The exact cause is not known, but environmental and genetic factors play a role in the development of this condition. The risk factors 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.", "role": "assistant" } ]

[ { "content": "what are the main causes tooth loss?\n\nCavities/tooth decay (Complications): Cavities and tooth decay are so common that you may not take them seriously. And you may think that it doesn't matter if children get cavities in their baby teeth. However, cavities and tooth decay can have serious and lasting complications, even for children who don't have their permanent teeth yet. Complications of cavities may include: - Pain - Tooth abscess - Swelling or pus around a tooth - Damage or broken teeth - Chewing problems - Positioning shifts of teeth after tooth loss When cavities and decay become severe, you may have: - Pain that interferes with daily living - Weight loss or nutrition problems from painful or difficult eating or chewing - Tooth loss, which may affect your appearance, as well as your confidence and self-esteem - In rare cases, a tooth abscess - a pocket of pus that's caused by bacterial infection - which can lead to more serious or even life-threatening infections", "role": "user" }, { "content": "Cavities and tooth decay are so common that you may not take them seriously. And you may think that it doesn't matter if children get cavities in their baby teeth. However, cavities and tooth decay can have serious and lasting complications, even for children who don't have their permanent teeth yet.", "role": "assistant" } ]

[ { "content": "treatment options versus migraine types Migraine seems to be a spectrum of conditions rather than only one easily diagnosed affliction. Many innovative migraine treatments are now in use, but it seems that each treatment only addresses a narrow set of conditions; for example, my daughter has tried many different treatment options (QEEG, HEG, TMS, topamax, ...) without success. Has any research been done to characterize which treatment types are effective against which migraine types?\n\nMigraine (Treatment): There is no absolute cure for migraine since its pathophysiology has yet to be fully understood.  There are two ways to approach the treatment of migraine headache with drugs: prevent the attacks, or relieve the symptoms during the attacks. Prevention involves the use of medications and behavioral changes.  Drugs originally developed for epilepsy, depression, or high blood pressure to prevent future attacks have been shown to be extremely effective in treating migraine. Botulinum toxin A has been shown to be effective in prevention of chronic migraine.  Behaviorally, stress management strategies, such as exercise, relaxation techniques, biofeedback mechanisms, and other therapies designed to limit daily discomfort, may reduce the number and severity of migraine attacks.  Making a log of personal triggers of migraine can also provide useful information for trigger-avoiding lifestyle changes, including dietary considerations, eating regularly scheduled meals with adequate hydration, stopping certain medications, and establishing a consistent sleep schedule. Hormone therapy may help some women whose migraines seem to be linked to their menstrual cycle. A weight loss program is recommended for obese individuals with migraine. Relief of symptoms, or acute treatments, during attacks consists of sumatriptan, ergotamine drugs, and analgesics such as ibuprofen and aspirin.  The sooner these treatments are administered, the more effective they are.", "role": "user" }, { "content": "While there is no cure to migraine, there are two approaches to prevention: prevent the attacks, or relieve the symptoms during the attacks. For prevention, drugs, such as those used for epilepsy, have shown to be effective. Botulinum toxin A has been shown to be effective in prevention of chronic migraine. Behavioral approaches such as exercise, a consistent sleep schedule and stress management techniques may reduce the number and severity of attacks. For relief of symptoms, sumatriptan, ergotamines, and analgesics such as ibuprofen and aspirin may help, especially if administered soon after onset of the symptoms.", "role": "assistant" } ]

[ { "content": "williams sydrome conditon. i need to send me more information about Williams Syndrome and some tips how to educate people with this disorder.I hope having news from you soon!!thank you\n\n Williams syndrome Williams-Beuren syndrome Summary Williams syndrome is a rare disorder that can lead to problems with development. Causes Williams syndrome is caused by not having a copy of several genes. It may be passed down in families. Parents may not have any family history of the condition. However, people with Williams syndrome have a 50% chance of passing the disorder on to each of their children. It often occurs randomly. One of the 25 missing genes is the gene that produces elastin, a protein that allows blood vessels and other tissues in the body to stretch. It is likely that missing a copy of this gene results in the narrowing of blood vessels, stretchy skin, and flexible joints seen in this condition. Symptoms Symptoms of Williams syndrome are: Delayed speech that may later turn into strong speaking ability and strong learning by hearing Developmental delay Easily distracted, attention deficit hyperactivity disorder (ADHD) Feeding problems including colic, reflux, and vomiting Inward bend of the small finger Learning disorders Mild to moderate intellectual disability Personality traits including being very friendly, trusting strangers, fearing loud sounds or physical contact, and being interested in music Short, compared to the rest of the person's family Sunken chest The face and mouth of someone with Williams syndrome may show: A flattened nasal bridge with small upturned nose Long ridges in the skin that run from the nose to the upper lip Prominent lips with an open mouth Skin that covers the inner corner of the eye Partially missing teeth, defective tooth enamel, or small, widely spaced teeth Exams and Tests Signs include: Narrowing of some blood vessels Farsightedness High blood calcium level that may cause seizures and rigid muscles High blood pressure Slack joints that may change to stiffness as the person gets older Unusual star-like pattern in iris of the eye Tests for Williams syndrome include: Blood pressure check Blood test for a missing piece of chromosome 7 (FISH test) Echocardiography combined with Doppler ultrasound Kidney ultrasound Treatment There is no cure for Williams syndrome. Avoid taking extra calcium and vitamin D. Treat high blood calcium, if it occurs. Blood vessel narrowing can be a major health problem. It is treated based on how severe it is. Physical therapy is helpful to people with joint stiffness. Developmental and speech therapy can also help. For example, having strong verbal skills can help make up for other weaknesses. Other treatments are based on the person's symptoms. It can help to have treatment coordinated by a geneticist who is experienced with Williams syndrome. Support Groups A support group can be helpful for emotional support and for giving and receiving practical advice. The following organization provides additional information about Williams syndrome: Williams Syndrome Association -- williams-syndrome.org Outlook (Prognosis) About 75% of people with Williams syndrome have some intellectual disability. Most people will not live as long as normal due to the various medical issues and other possible complications. Most people require full-time caregivers and often live in supervised group homes. Possible Complications Complications may include: Calcium deposits in the kidney and other kidney problems Death (in rare cases from anesthesia) Heart failure due to narrowed blood vessels Pain in the abdomen When to Contact a Medical Professional Many of the symptoms and signs of Williams syndrome may not be obvious at birth. Call your health care provider if your child has features similar to those of Williams syndrome. Seek genetic counseling if you have a family history of Williams syndrome. Prevention There is no known way to prevent the genetic problem that causes Williams syndrome. Prenatal testing is available for couples with a family history of Williams syndrome who wish to conceive. Review Date 10/26/2017 Updated by: Anna C. Edens Hurst, MD, MS, Assistant Professor in Medical Genetics, The University of Alabama at Birmingham, Birmingham, AL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Symptoms of Williams syndrome are: - Delayed speech that may later turn into strong speaking ability and strong learning by hearing - Developmental delay - Easily distracted, attention deficit disorder (ADD) - Feeding problems including colic, reflux, and vomiting - Inward bend of the small finger - Learning disorders - Mild to moderate intellectual disability - Personality traits including being very friendly, trusting strangers, fearing loud sounds or physical contact, and being interested in music - Short, compared to the rest of the person's family - Sunken chest The face and mouth of someone with Williams syndrome may show: - A flattened nasal bridge with small upturned nose - Long ridges in the skin that run from the nose to the upper lip - Prominent lips with an open mouth - Skin that covers the inner corner of the eye - Partially missing teeth, defective tooth enamel, or small, widely spaced teeth", "role": "assistant" } ]

[ { "content": "what is epilepsy\n\nProgressive myoclonic epilepsy: Progressive myoclonus epilepsy (PME) refers to a group of inherited conditions involving the central nervous system and representing more than a dozen different diseases. These diseases share certain features, including a worsening of symptoms over time and the presence of both muscle contractions ( myoclonus) and seizures ( epilepsy). PME is different from myoclonic epilepsy. [1] Other features include  dementia , dystonia , and trouble walking or speaking. These rare disorders often get worse over time and sometimes are fatal. Many of these PME diseases begin in childhood or adolescence. [2] The following diseases are related to Progressive myoclonic epilepsy. If you have a question about any of these diseases, you can contact GARD. Familial encephalopathy with neuroserpin inclusion bodies Lafora disease Unverricht-Lundborg disease", "role": "user" }, { "content": "Progressive myoclonus epilepsy (PME) refers to a group of inherited conditions involving the central nervous system and representing more than a dozen different diseases. These diseases share certain features, including a worsening of symptoms over time and the presence of both muscle contractions ( myoclonus) and seizures ( epilepsy). These rare disorders often get worse over time and sometimes are fatal. Many of these PME diseases begin in childhood or adolescence", "role": "assistant" } ]

[ { "content": "Rubella My grandson (4 yrs old) has contracted Rubella. I know for sure he has had at least one of the vaccines. They are living in Mexico right now. Should we be worried?\n\nRubella (Complications): Rubella is a mild infection. Once you've had the disease, you're usually permanently immune. Some women with rubella experience arthritis in the fingers, wrists and knees, which generally lasts for about one month. In rare cases, rubella can cause an ear infection (otitis media) or inflammation of the brain (encephalitis). However, if you're pregnant when you contract rubella, the consequences for your unborn child may be severe. Up to 90 percent of infants born to mothers who had rubella during the first 12 weeks of pregnancy develop congenital rubella syndrome. This syndrome can cause one or more problems, including: - Growth retardation - Cataracts - Deafness - Congenital heart defects - Defects in other organs - Mental retardation The highest risk to the fetus is during the first trimester, but exposure later in pregnancy also is dangerous.", "role": "user" }, { "content": "Rubella is a mild infection. Once you've had the disease, you're usually permanently immune. . In rare cases, rubella can cause an ear infection (otitis media) or inflammation of the brain (encephalitis).", "role": "assistant" } ]

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

[ { "content": "how is klineflyers syndrome screened\n\n Klinefelter syndrome Klinefelter's syndrome XXY syndrome 47,XXY syndrome Summary Klinefelter syndrome (KS) is a condition that occurs in males when they have an extra X chromosome . Some males with KS have no obvious signs or symptoms while others may have varying degrees of cognitive, social, behavioral, and learning difficulties. Adults with Klinefelter syndrome may also have primary hypogonadism (decreased testosterone production), small and/or undescendent testes (cryptorchidism), enlarged breast tissue ( gynecomastia ), tall stature, and/or inability to have biological children (infertility), as well as an abnormal opening of the penis (hypospadias), and an small penis (micropenis). KS is not inherited , but usually occurs as a random event during the formation of reproductive cells (eggs and sperm) that results in the presence of one extra copy of the X chromosome in each cell (47,XXY). KS treatment is based on the signs and symptoms present in each person. [1] [2] [3] Life expectancy is usually normal and many people with KS have normal life. There is a very small risk of developing breast cancer and other conditions such as a chronic inflammatory disease called systemic lupus erythematosus. [3] In some cases, there is more than one X chromosome in each cell (for example, 48,XXXY or 49,XXXXY). These conditions, which are often called \"variants of Klinefelter\" syndrome usually have more serious problems ( intellectual disability , skeletal problems, and poor coordination) than classic Klinefelter syndrome (47,XXY). [3] Symptoms The signs and symptoms of Klinefelter syndrome (KS) vary among affected people. Some men with KS have no symptoms of the condition or are only mildy affected. In these cases, they may not even know that they are affected by KS. When present, symptoms may include: [1] [2] [3] Small, firm testicles Delayed or incomplete puberty with lack of secondary sexual characteristics resulting in sparse facial, body, or sexual hair a high-pitched voice and body fat distribution resulting in a rounder, lower half of the body, with more fat deposited in the hips, buttocks and thigh instead of around the chest and abdomen Breast growth ( gynecomastia ) Reduced facial and body hair Infertility Tall stature Abnormal body proportions (long legs, short trunk, shoulder equal to hip size) Learning disablity Speech delay Crypthochirdism Opening (meatus) of the urethra (the tube that carries urine and sperm through the penis to the outside) on the underside of the penis (hypospadias) instead of the tip of the head of the penis Social, psychologic and behavioral problems Whether or not a male with KS has visible symptoms depends on many factors, including how much testosterone his body makes, if he is mosaic (with both XY and XXY cells ), and his age when the condition is diagnosed and treated. [1] Some people have a slightly increased risk of developing breast cancer , a rare extragonadal germ cell tumor, lung disease, varicose veins and osteoporosis as well as some autoimmune disorders such as systemic lupus erythematosus, rheumatoid arthritis and Sjogren's syndrome. [2] [4] Some people with features of Klinefelter syndrome have more than one extra X chromosome in each cell (such as 48,XXXY or 49,XXXXY). In these cases, known as \"variants of Klinefelter syndrome\", the signs and symptoms can be more severe and may include: [1] [2] [4] Intellectual disability Distinctive facial features Skeletal abnormalities Poor coordination Severe speech difficulties Behavioral problems Heart defects Teeth problems. Cause Klinefelter syndrome usually occurs as a random event during the formation of reproductive cells (eggs and sperm). An error in cell division called nondisjunction results in a reproductive cell with an abnormal number of chromosomes . For example, an egg or sperm cell may gain one or more extra copies of the X 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 one or more extra X chromosomes in each of the body's cells. [2] Most often, Klinefelter syndrome is caused by a single extra copy of the X chromosome, resulting in a total of 47 chromosomes per cell. Males normally have one X chromosome and one Y chromosome in each cell (46, XY), while females have two X chromosomes (46, XX). People with Klinefelter syndrome usually have two X chromosomes and one Y chromosome (47, XXY). Some people with Klinefelter syndrome have the extra X chromosome in only some of their cells; these people are said to have mosaic Klinefelter syndrome. [2] It is estimated that about half of the time, the cell division error occurs during development of the sperm, while the remainder are due to errors in egg development. Women who have pregnancies after age 35 have a slightly increased chance of having offspring with this syndrome. [5] The features of Klinefelter syndrome are due to the extra copies of genes on the extra X chromosome, which can alter male sexual development. [3] Some people with features of Klinefelter syndrome have conditions known as \"variants of Klinefelter syndrome\" where there is more than one extra sex chromosome in each cell ( 48,XXXY, 48,XXYY and 49,XXXXY). [5] Inheritance Klinefelter syndrome is not inherited , but usually occurs as a random event during the formation of reproductive cells (eggs and sperm). 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 gain one or more extra copies of the X chromosome as a result of nondisjunction. If one of these reproductive cells contributes to the genetic makeup of a child, the child will have one or several extra X chromosomes in each of the body's cells. [2] Diagnosis A diagnosis of Klinefelter syndrome is often suspected based on the presence of characteristic signs and symptoms. Additional testing can then be ordered to confirm the diagnosis. This generally includes a chromosomal analysis (called a karyotype ). [3] [6] It is also possible to diagnosis Klinefelter syndrome before birth through chorionic villous sampling or amniocentesis . [6] Treatment Because symptoms of Klinefelter syndrome (KS) can sometimes be very mild, many people are never diagnosed or treated. When a diagnosis is made, treatment is based on the signs and symptoms present in each person, especially the problems related to hypogonadism , gynecomastia , and psychosocial problems. Treatment may include: [1] [3] [4] Testosterone replacement: About half of people with SK have low testosterone levels, which may be raised by taking supplemental testosterone. Having a more normal testosterone level can help affected people develop bigger muscles, a deeper voice, and facial and body hair, and may also increase sexual desire, enlarge the testes , improve mood, self-image, and behavior; it may also protect against osteoporosis and decrease the risks of autoimmune disease and breast cancer . Breast removal or reduction surgery. Educational interventions: As children, many people with Klinefelter syndrome qualify for special services to help them in school. Teachers can also help by using certain methods in the classroom, such as breaking bigger tasks into small steps. Several forms of therapy such as physical, speech, occupational, behavioral, mental health, and family therapy can often help reduce or eliminate some of the symptoms of Klinefelter syndrome such as poor muscle tone; speech and language problems; or low self-confidence. Prognosis Babies with the 47, XXY form of Klinefelter differ little from healthy children. The results of one study on non- mosaic XXY infants younger than 2 years indicated that most XXY babies had normal external genitalia and facial features with height and weight in the normal range. Genetic testing had been performed due to a delay in walking and/or speech. Early diagnosis of Klinefelter syndrome is shown to be important to monitor potential developmental problems. [4] Boys with the 47, XXY karyotype may struggle through adolescence with academics, various frustrations, and, in a few instances, serious emotional or behavioral difficulties. However, most move toward full independence from their families as they enter adulthood. Some have completed graduate education and have a normal level of functioning. Lifespan is not affected by Klinefelter syndrome. [4] Statistics It is estimated that 1 in every 500 to 1,000 newborn males has an extra X chromosome, making Klinefelter syndrome one of the most common chromosomal disorders seen among newborns. Variants of Klinefelter syndrome (such as 48,XXXY, 49,XXXXY) are much rarer, occurring in 1 in 50,000 to 1 in 85,000 or fewer newborns. [1] [7] It is suspected that Klinefelter syndrome is underdiagnosed because mild cases may not be identified. In addition, the features of this condition vary and can overlap significantly with those of other conditions. [7] ", "role": "user" }, { "content": "Once the characteristic signs and symptoms of Klinefelter syndrome have been observed, testing can be ordered to confirm the diagnosis. The includes a chromosomal analysis, called a karyotype, which shows the arrangement of your chromosomes. It is also possible to diagnose Kinefelter syndrome before birth through chorionic villous sampling or amniocentesis.", "role": "assistant" } ]

[ { "content": "What is Nephrotic Syndrome. What are its causes and cures?\n\n Nephrotic syndrome Nephrosis Summary 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, increased blood clot risk, and swelling. Causes Nephrotic syndrome is caused by different disorders that damage the kidneys. This damage leads to the release of too much protein in the urine. The most common cause in children is minimal change disease. Membranous glomerulonephritis is the most common cause in adults. In both diseases, the glomeruli in the kidneys are damaged. Glomeruli are the structures that help filter wastes and fluids. This condition can also occur from: Cancer Diseases such as diabetes, systemic lupus erythematosus, multiple myeloma, and amyloidosis Genetic disorders Immune disorders Infections (such as strep throat, hepatitis, or mononucleosis) Use of certain drugs It can occur with kidney disorders such as: Focal and segmental glomerulosclerosis Glomerulonephritis Mesangiocapillary glomerulonephritis Nephrotic syndrome can affect all age groups. In children, it is most common between ages 2 and 6. This disorder occurs slightly more often in males than females. Symptoms Swelling (edema) is the most common symptom. It may occur: In the face and around the eyes (facial swelling) In the arms and legs, especially in the feet and ankles In the belly area (swollen abdomen) Other symptoms include: Skin rash or sores Foamy appearance of the urine Poor appetite Weight gain (unintentional) from fluid retention Seizures Exams and Tests The health care provider will perform a physical exam. Laboratory tests will be done to see how well the kidneys are working. They include: Albumin blood test Blood chemistry tests, such as basic metabolic panel or comprehensive metabolic panel Blood urea nitrogen (BUN) Creatinine - blood test Creatinine clearance - urine test Urinalysis Fats are often also present in the urine. Blood cholesterol and triglyceride levels may be high. A kidney biopsy may be needed to find the cause of the disorder. Tests to rule out various causes may include the following: Antinuclear antibody Cryoglobulins Complement levels Glucose tolerance test Hepatitis B and C antibodies HIV test Rheumatoid factor Serum protein electrophoresis (SPEP) Syphilis serology Urine protein electrophoresis (UPEP) This disease may also change the results of the following tests: Vitamin D level Serum iron Urinary casts Treatment 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-sodium 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 provider may suggest a moderate-protein diet (1 gram of protein per kilogram of body weight per day). Taking vitamin D supplements if nephrotic syndrome is long-term and is not responding to treatment. Taking blood thinner drugs to treat or prevent blood clots. Outlook (Prognosis) Outcome varies. Some people recover from the condition. Others develop long-term kidney disease and need dialysis and eventually a kidney transplant. Possible Complications Health problems that may result from nephrotic syndrome include: Acute kidney failure Hardening of the arteries and related heart diseases Chronic kidney disease Fluid overload, heart failure, fluid buildup in lungs Infections, including pneumococcal pneumonia Malnutrition Renal vein thrombosis When to Contact a Medical Professional Call your provider if: You develop symptoms of nephrotic syndrome, including swelling in face, belly, or arms and legs, or skin sores You're being treated for nephrotic syndrome, but your symptoms don't improve New symptoms develop, including cough, decreased urine output, discomfort with urination, fever, severe headache Go to the emergency room or call the local emergency number (such as 911) if you have seizures. Prevention Treating conditions that can cause nephrotic syndrome may help prevent the syndrome. Review Date 8/1/2017 Updated by: Walead Latif, MD, Nephrologist and Clinical Associate Professor, Rutgers Medical School, Newark, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Nephrotic syndrome is caused by different disorders that damage the kidneys., in adults, most commonly by glomerulonephritis. This damage leads to the release of too much protein in the urine. Other conditions that damage kidneys include cancer, diabetes, systemic lupus erythematosus, multiple myeloma, amyloidosis, immune disorders, and infections. Nephrotic syndrome can affect all age groups. In children, it is most common between ages 2 and 6. This disorder occurs slightly more often in males than females.", "role": "assistant" } ]

[ { "content": "Rubella My grandson (4 yrs old) has contracted Rubella. I know for sure he has had at least one of the vaccines. They are living in Mexico right now. Should we be worried?\n\nRubella (Lifestyle and home remedies): In rare instances when a child or adult is infected with rubella, simple self-care measures are required: - Rest in bed as necessary. - Take acetaminophen (Tylenol, others) to relieve discomfort from fever and aches. - Tell friends, family and co-workers - especially pregnant women - about your diagnosis if they may have been exposed to the disease. - Avoid people who have conditions that cause deficient or suppressed immune systems. - Tell your child's school or child care provider that your child has rubella.", "role": "user" }, { "content": "In rare instances when a child is infected with rubella, simple self-care measures are required: resting in bed as necessary, take acetaminophen (Tylenol) to relieve discomfort from fever and aches, and telling those who were or might be exposed to the infection that your child has rubella.", "role": "assistant" } ]

[ { "content": "symptoms of dehydration 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?\n\nDehydration: Dehydration occurs when you use or lose more fluid than you take in, and your body doesn't have enough water and other fluids to carry out its normal functions. If you don't replace lost fluids, you will get dehydrated. Anyone may become dehydrated, but the condition is especially dangerous for young children and older adults. The most common cause of dehydration in young children is severe diarrhea and vomiting. Older adults naturally have a lower volume of water in their bodies, and may have conditions or take medications that increase the risk of dehydration. This means that even minor illnesses, such as infections affecting the lungs or bladder, can result in dehydration in older adults. Dehydration also can occur in any age group if you don't drink enough water during hot weather - especially if you are exercising vigorously. You can usually reverse mild to moderate dehydration by drinking more fluids, but severe dehydration needs immediate medical treatment. Thirst isn't always a reliable early indicator of the body's need for water. Many people, particularly older adults, don't feel thirsty until they're already dehydrated. That's why it's important to increase water intake during hot weather or when you're ill. The signs and symptoms of dehydration also may differ by age. - Dry mouth and tongue - No tears when crying - No wet diapers for three hours - Sunken eyes, cheeks - Sunken soft spot on top of skull - Listlessness or irritability - Extreme thirst - Less frequent urination - Dark-colored urine - Fatigue - Dizziness - Confusion Call your family doctor if you or a loved one: - Has had diarrhea for 24 hours or more - Is irritable or disoriented and much sleepier or less active than usual - Can't keep down fluids - Has bloody or black stool Sometimes dehydration occurs for simple reasons: You don't drink enough because you're sick or busy, or because you lack access to safe drinking water when you're traveling, hiking or camping. Other dehydration causes include: - Diarrhea, vomiting. Severe, acute diarrhea - that is, diarrhea that comes on suddenly and violently - can cause a tremendous loss of water and electrolytes in a short amount of time. If you have vomiting along with diarrhea, you lose even more fluids and minerals. - Fever. In general, the higher your fever, the more dehydrated you may become. The problem worsens if you have a fever in addition to diarrhea and vomiting. - Excessive sweating. You lose water when you sweat. If you do vigorous activity and don't replace fluids as you go along, you can become dehydrated. Hot, humid weather increases the amount you sweat and the amount of fluid you lose. - Increased urination. This may be due to undiagnosed or uncontrolled diabetes. Certain medications, such as diuretics and some blood pressure medications, also can lead to dehydration, generally because they cause you to urinate more. Anyone can become dehydrated, but certain people are at greater risk: - Infants and children. The most likely group to experience severe diarrhea and vomiting, infants and children are especially vulnerable to dehydration. Having a higher surface area to volume area, they also lose a higher proportion of their fluids from a high fever or burns. Young children often can't tell you that they're thirsty, nor can they get a drink for themselves. - Older adults. As you age, your body's fluid reserve becomes smaller, your ability to conserve water is reduced and your thirst sense becomes less acute. These problems are compounded by chronic illnesses such as diabetes and dementia, and by the use of certain medications. Older adults also may have mobility problems that limit their ability to obtain water for themselves. - People with chronic illnesses. Having uncontrolled or untreated diabetes puts you at high risk of dehydration. Kidney disease also increases your risk, as do medications that increase urination. Even having a cold or sore throat makes you more susceptible to dehydration because you're less likely to feel like eating or drinking when you're sick. - People who work or exercise outside. When it's hot and humid, your risk of dehydration and heat illness increases. That's because when the air is humid, sweat can't evaporate and cool you as quickly as it normally does, and this can lead to an increased body temperature and the need for more fluids. Dehydration can lead to serious complications, including: - Heat injury. If you don't drink enough fluids when you're exercising vigorously and perspiring heavily, you may end up with a heat injury, ranging in severity from mild heat cramps to heat exhaustion or potentially life-threatening heatstroke. - Urinary and kidney problems. Prolonged or repeated bouts of dehydration can cause urinary tract infections, kidney stones and even kidney failure. - Seizures. Electrolytes - such as potassium and sodium - help carry electrical signals from cell to cell. If your electrolytes are out of balance, the normal electrical messages can become mixed up, which can lead to involuntary muscle contractions and sometimes to a loss of consciousness. - Low blood volume shock (hypovolemic shock). This is one of the most serious, and sometimes life-threatening, complications of dehydration. It occurs when low blood volume causes a drop in blood pressure and a drop in the amount of oxygen in your body. Your doctor can often diagnose dehydration on the basis of physical signs and symptoms. If you're dehydrated, you're also likely to have low blood pressure, especially when moving from a lying to a standing position, a faster than normal heart rate and reduced blood flow to your extremities. To help confirm the diagnosis and pinpoint the degree of dehydration, you may have other tests, such as: - Blood tests. Blood samples may be used to check for a number of factors, such as the levels of your electrolytes - especially sodium and potassium - and how well your kidneys are working. - Urinalysis. Tests done on your urine can help show whether you're dehydrated and to what degree. They also can check for signs of a bladder infection. The only effective treatment for dehydration is to replace lost fluids and lost electrolytes. The best approach to dehydration treatment depends on age, the severity of dehydration and its cause. For infants and children who have become dehydrated from diarrhea, vomiting or fever, use an over-the-counter oral rehydration solution. These solutions contain water and salts in specific proportions to replenish both fluids and electrolytes. Start with about a teaspoon (5 milliliters) every one to five minutes and increase as tolerated. It may be easier to use a syringe for very young children. Older children can be given diluted sports drinks. Use 1 part sports drink to 1 part water. Most adults with mild to moderate dehydration from diarrhea, vomiting or fever can improve their condition by drinking more water or other liquids. Diarrhea may be worsened by full-strength fruit juice and soft drinks. If you work or exercise outdoors during hot or humid weather, cool water is your best bet. Sports drinks containing electrolytes and a carbohydrate solution also may be helpful. Children and adults who are severely dehydrated should be treated by emergency personnel arriving in an ambulance or in a hospital emergency room. Salts and fluids delivered through a vein (intravenously) are absorbed quickly and speed recovery.", "role": "user" }, { "content": "Dehydration causes dry mouth, thirst, reduced urination, dark urine, irritability, lack of energy, fatigue, confusion, and dizziness.", "role": "assistant" } ]

[ { "content": "prevention of preeclampsia I know that the jury is out on the exact causes of preeclampsia, but I am looking for some of the ways that the chances of acquiring it can be minimized.\n\n Preeclampsia Toxemia Pregnancy-induced hypertension (PIH) Gestational hypertension High blood pressure - preeclampsia Summary Preeclampsia is high blood pressure and signs of liver or kidney damage that occur in women after the 20th week of pregnancy. While rare, preeclampsia also may occur in a woman after delivering her baby, most often within 48 hours. This is called postpartum preeclampsia. Watch this video about: Preeclampsia </div> </div> Causes The exact cause of preeclampsia is unknown. It occurs in about 3% to 7% of all pregnancies. The condition is thought to start in the placenta. Factors that may lead to preeclampsia developing include: Autoimmune disorders Blood vessel problems Your diet Your genes Risk factors for the condition include: First pregnancy Past history of preeclampsia Multiple pregnancy (twins or more) Family history of preeclampsia Obesity Being older than age 35 Being African-American History of diabetes, high blood pressure, or kidney disease Symptoms Often, women who have preeclampsia do not feel sick. Symptoms of preeclampsia can include: Swelling of the hands and face or eyes (edema) Sudden weight gain over 1 to 2 days or more than 2 pounds (0.9 kg) a week Note: Some swelling of the feet and ankles is considered normal during pregnancy. Symptoms of severe preeclampsia include: Headache that does not go away or becomes worse. Trouble breathing. Belly pain on the right side, below the ribs. Pain may also be felt in the right shoulder, and can be confused with heartburn, gallbladder pain, a stomach virus, or kicking by the baby. Not urinating very often. Nausea and vomiting (a worrisome sign). Vision changes, including temporary blindness, seeing flashing lights or spots, sensitivity to light, and blurry vision. Feel lightheaded or faint. Exams and Tests The health care provider will do a physical exam. This may show: High blood pressure, often higher than 140/90 mm Hg Swelling in the hands and face Weight gain Blood and urine tests will be done. This may show: Protein in the urine (proteinuria) Higher-than-normal liver enzymes Platelet count that is low Higher-than-normal creatinine levels in your blood Tests will also be done to: See how well your blood clots Monitor the baby's health The results of a pregnancy ultrasound, non-stress test, and other tests will help your provider decide whether your baby needs to be delivered right away. Women who had low blood pressure at the start of their pregnancy, followed by a significant rise in blood pressure need to be watched closely for other signs of preeclampsia. Treatment Preeclampsia often resolves after the baby is born and the placenta is delivered. However, it may persist or even begin after delivery. Most often, at 37 weeks, your baby is developed enough to be healthy outside of the womb. As a result, your provider will likely want your baby to be delivered so the preeclampsia does not get worse. You may get medicines to help trigger labor, or you may need a C-section. If your baby is not fully developed and you have mild preeclampsia, the disease can often be managed at home until your baby has matured. The provider will recommend: Frequent doctor visits to make sure you and your baby are doing well. Medicines to lower your blood pressure (sometimes). The severity of preeclampsia may change quickly, so you'll need very careful follow-up. Complete bed rest is no longer recommended. Sometimes, a pregnant woman with preeclampsia is admitted to the hospital. This allows the health care team to watch the baby and mother more closely. Treatment in the hospital may include: Close monitoring of the mother and baby Medicines to control blood pressure and prevent seizures and other complications Steroid injections for pregnancies under 34 weeks gestation to help speed up the development of the baby's lungs You and your provider will continue to discuss the safest time to deliver your baby, considering: How close you are to your due date. The severity of the preeclampsia. Preeclampsia has many severe complications that can harm the mother. How well the baby is doing in the womb. The baby must be delivered if there are signs of severe preeclampsia. These include: Tests that show your baby is not growing well or is not getting enough blood and oxygen. The bottom number of your blood pressure is over 110 mm Hg or is greater than 100 mm Hg consistently over a 24-hour period. Abnormal liver function test results. Severe headaches. Pain in the belly area (abdomen). Seizures or changes in mental function (eclampsia). Fluid buildup in the mother's lungs. HELLP syndrome (rare). Low platelet count or bleeding. Low urine output, a lot of protein in the urine, and other signs that your kidneys are not working properly. Outlook (Prognosis) Sign and symptoms of preeclampsia most often go away within 6 weeks after delivery. However, the high blood pressure sometimes gets worse the first few days after delivery. You are still at risk for preeclampsia for up to 6 weeks after delivery. This postpartum preeclampsia carries a higher risk of death. If you notice any symptoms of preeclampsia, contact your health care provider right away. If you have had preeclampsia, you are more likely to develop it again during another pregnancy. In most cases, it is not as severe as the first time. If you have high blood pressure during more than one pregnancy, you are more likely to have high blood pressure when you get older. Possible Complications Rare but severe immediate complications for the mother can include: Bleeding problems Seizure (eclampsia) Fetal growth retardation Premature separation of the placenta from the uterus before the baby is born Rupture of the liver Stroke Death (rarely) Having a history of preeclampsia makes a woman a higher risk for future problems such as: Heart disease Diabetes Kidney disease When to Contact a Medical Professional Call your provider if you have symptoms of preeclampsia during your pregnancy or after delivery. Prevention There is no sure way to prevent preeclampsia. If your doctor thinks you are at high risk of developing preeclampsia, they may suggest that you start baby aspirin (81 mg) daily late in the first trimester or early in the second trimester of your pregnancy. However, DO NOT start baby aspirin unless you have consulted with your doctor first. If your doctor thinks your calcium intake is low, they may suggest that you take a calcium supplement daily. There are no other specific preventive measures for preeclampsia. It is important for all pregnant women to start prenatal care early and continue it through the pregnancy and after delivery. Review Date 4/19/2018 Updated by: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 08/20/2018. ", "role": "user" }, { "content": "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.", "role": "assistant" } ]

[ { "content": "how do you get neuromuscular disorders\n\n Myasthenia gravis Neuromuscular disorder - myasthenia gravis Summary Myasthenia gravis is a neuromuscular disorder. Neuromuscular disorders involve the muscles and the nerves that control them. Causes Myasthenia gravis is a type of autoimmune disorder. An autoimmune disorder occurs when the immune system mistakenly attacks healthy tissue. Antibodies are proteins made by the body's immune system when it detects harmful substances. Antibodies may be produced when the immune system mistakenly considers healthy tissue to be a harmful substance, such as in the case of myasthenia gravis. In people with myasthenia gravis, the body produces antibodies that block the muscle cells from receiving messages (neurotransmitters) from the nerve cells. In some cases, myasthenia gravis is linked to tumors of the thymus (an organ of the immune system). Myasthenia gravis can affect people at any age. It is most common in young women and older men. Symptoms Myasthenia gravis causes weakness of the voluntary muscles. These are muscles that you can control. Autonomic muscles of the heart and digestive tract are usually not affected. The muscle weakness of myasthenia gravis worsens with activity and improves with rest. This muscle weakness can lead to a variety of symptoms, including: Breathing difficulty because of weakness of the chest wall muscles Chewing or swallowing difficulty, causing frequent gagging, choking, or drooling Difficulty climbing stairs, lifting objects, or rising from a seated position Difficulty talking Drooping head and eyelids Facial paralysis or weakness of the facial muscles Fatigue Hoarseness or changing voice Double vision Difficulty maintaining steady gaze Exams and Tests The health care provider will perform a physical exam. This includes a detailed nervous system (neurological) examination. This may show: Muscle weakness, with eye muscles usually affected first Normal reflexes and feeling (sensation) Tests that may be done include: Acetylcholine receptor antibodies associated with this disease CT or MRI scan of the chest to look for a tumor Nerve conduction studies to test how fast electrical signals move through a nerve EMG to test the health of the muscles and the nerves that control the muscles Pulmonary function tests to measure breathing and how well the lungs are functioning Edrophonium test to see if this medicine reverses the symptoms for a short time Treatment There is no known cure for myasthenia gravis. Treatment may allow you to have periods without any symptoms (remission). Lifestyle changes can often help you continue your daily activities. The following may be recommended: Resting throughout the day Using an eye patch if double vision is bothersome Avoiding stress and heat exposure, which can make symptoms worse Medicines that may be prescribed include: Neostigmine or pyridostigmine to improve communication between the nerves and muscles Prednisone and other drugs (such as azathioprine, cyclosporine, or mycophenolate mofetil) to suppress the immune system response if you have severe symptoms and other medicines have not worked well. Crisis situations are attacks of weakness of the breathing muscles. These attacks can occur without warning when either too much or too little medicine is taken. These attacks usually last no longer than a few weeks. You may need to be admitted to the hospital, where you may need breathing assistance with a ventilator. A procedure called plasmapheresis may also be used to help end the crisis. This procedure involves removing the clear part of the blood (plasma), which contains the antibodies. This is replaced with donated plasma that is free of antibodies, or with other fluids. Plasmapheresis may also help reduce symptoms for 4 to 6 weeks and is often used before surgery. A medicine called intravenous immunoglobulin (IVIg) may also be used Surgery to remove the thymus (thymectomy) may result in permanent remission or less need for medicines, especially when there is a tumor present. If you have eye problems, your doctor may suggest lens prisms to improve vision. Surgery may also be recommended to treat your eye muscles. Physical therapy can help maintain your muscle strength. This is especially important for the muscles that support breathing. Some medicines can worsen symptoms and should be avoided. Before taking any medicine, ask your doctor whether it is OK for you to take it. Support Groups You can ease the stress of illness by joining a myasthenia gravis support group. Sharing with others who have common experiences and problems can help you not feel alone. Outlook (Prognosis) There is no cure, but long-term remission is possible. You may have to restrict some daily activities. People who have only eye symptoms (ocular myasthenia gravis), may develop generalized myasthenia over time. A woman with myasthenia gravis can get pregnant, but careful prenatal care is important. The baby may be weak and require medications for a few weeks after birth, but usually will not develop the disorder. Possible Complications The condition may cause life-threatening breathing problems. This is called a myasthenic crisis. People with myasthenia gravis are at higher risk for other autoimmune disorders, such as thyrotoxicosis, rheumatoid arthritis, and systemic lupus erythematosus (lupus). When to Contact a Medical Professional Call your health care provider if you develop symptoms of myasthenia gravis. Go to the emergency room or call the local emergency number (such as 911) if you have breathing difficulty or swallowing problems. Review Date 5/15/2017 Updated by: Amit M. Shelat, DO, FACP, Attending Neurologist and Assistant Professor of Clinical Neurology, SUNY Stony Brook, School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "In people with myasthenia gravis, the body produces antibodies that block the muscle cells from receiving messages (neurotransmitters) from the nerve cells. The exact cause of myasthenia gravis is unknown. In some cases, it is linked to tumors of the thymus (an organ of the immune system). Myasthenia gravis can affect people at any age. It is most common in young women and older men.", "role": "assistant" } ]

[ { "content": "how to prevent atherosclerosis\n\n Hardening of the arteries Atherosclerosis Arteriosclerosis Plaque buildup - arteries Hyperlipidemia - atherosclerosis Cholesterol - atherosclerosis Summary Hardening of the arteries, also called atherosclerosis, occurs when fat, cholesterol, and other substances build up in the walls of arteries. These deposits are called plaques. Over time, these plaques can narrow or completely block the arteries and cause problems throughout the body. Hardening of the arteries is a common disorder. Causes Watch this video about: Atherosclerosis </div> </div> Hardening of the arteries often occurs with aging. As you grow older, plaque buildup narrows your arteries and makes them stiffer. These changes make it harder for blood to flow through them. Clots may form in these narrowed arteries and block blood flow. Pieces of plaque can also break off and move to smaller blood vessels, blocking them. These blockages starve tissues of blood and oxygen. This can result in damage or tissue death. It is a common cause of heart attack and stroke. High blood cholesterol levels can cause hardening of the arteries at a younger age. For many people, high cholesterol levels are due to a diet that is too high in saturated fats and trans fats. Other factors that can contribute to hardening of the arteries include: Diabetes Family history of hardening of the arteries High blood pressure Lack of exercise Being overweight or obese Smoking Symptoms Hardening of the arteries does not cause symptoms until blood flow to part of the body becomes slowed or blocked. If the arteries supplying the heart become narrow, blood flow can slow down or stop. This can cause chest pain (stable angina), shortness of breath, and other symptoms. Narrowed or blocked arteries may also cause problems in the intestines, kidneys, legs, and brain. Exams and Tests A health care provider will perform a physical exam and listen to the heart and lungs with a stethoscope. Hardening of the arteries can create a whooshing or blowing sound (\"bruit\") over an artery. All adults over the age of 18 should have their blood pressure checked every year . More frequent measurement may be needed for those with a history of high blood pressure readings or those with risk factors for high blood pressure. Cholesterol testing is recommended in all adults. The major national guidelines differ on the suggested age to start testing. Screening should begin between ages 20 to 35 for men and ages 20 to 45 for women. Repeat testing is not needed for five years for most adults with normal cholesterol levels. Repeat testing may be needed if lifestyle changes occur, such as large increase in weight or a change in diet. More frequent testing is needed for adults with a history of high cholesterol, diabetes, kidney problems, heart disease, stroke, and other conditions A number of imaging tests may be used to see how well blood moves through your arteries. Doppler tests that use ultrasound or sound waves Magnetic resonance arteriography (MRA), a special type of MRI scan Special CT scans called CT angiography Arteriograms or angiography that use x-rays and contrast material (sometimes called \"dye\") to see the path of blood flow inside the arteries Treatment Lifestyle changes will reduce your risk of hardening of the arteries. Things you can do include: Quit smoking: This is the single most important change you can make to reduce your risk of heart disease and stroke. Avoid fatty foods: Eat well-balanced meals that are low in fat and cholesterol. Include several daily servings of fruits and vegetables. Adding fish to your diet at least twice a week may be helpful. However, do not eat fried fish. Limit how much alcohol you drink: Recommended limits are one drink a day for women, two a day for men. Get regular physical activity: Exercise with moderate intensity (such as brisk walking) 5 days a week for 30 minutes a day if you are at a healthy weight. For weight loss, exercise for 60 to 90 minutes a day. Talk to your provider before starting a new exercise plan, especially if you have been diagnosed with heart disease or you have ever had a heart attack. If your blood pressure is high, it is important for you to lower it and keep it under control. The goal of treatment is to reduce your blood pressure so that you have a lower risk of health problems caused by high blood pressure. You and your provider should set a blood pressure goal for you. Do not stop or change high blood pressure medicines without talking to your provider. Your provider may want you to take medicine for abnormal cholesterol levels or for high blood pressure if lifestyle changes do not work. This will depend on: Your age The medicines you take Your risk of side effects from possible medicines Whether you have heart disease or other blood flow problems Whether you smoke or are overweight Whether you have diabetes or other heart disease risk factors Whether you have any other medical problems, such as kidney disease Your provider may suggest taking aspirin or another medicine to help prevent blood clots from forming in your arteries. These medicines are called antiplatelet drugs. DO NOT take aspirin without first talking to your provider. Losing weight if you are overweight and reducing blood sugar if you have diabetes or pre-diabetes can help reduce the risk of developing atherosclerosis. Outlook (Prognosis) Hardening of the arteries cannot be reversed once it has occurred. However, lifestyle changes and treating high cholesterol levels can prevent or slow the process from becoming worse. This can help reduce the chances of having a heart attack and stroke as a result of atherosclerosis. Possible Complications In some cases, the plaque is part of a process that causes a weakening of the wall of an artery. This can lead to a bulge in an artery called an aneurysm. Aneurysms can break open (rupture). This causes bleeding that can be life threatening. Review Date 2/22/2018 Updated by: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Hardening of the arteries cannot be reversed once it has occurred. However, lifestyle changes and treating high cholesterol levels can prevent or slow the process from becoming worse. This can help reduce the chances of having a heart attack and stroke as a result of atherosclerosis.", "role": "assistant" } ]

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

[ { "content": "who is at risk for contracting dengue fever? is there a certain age group or race that contracts dengue fever?\n\n Dengue fever Dengue hemorrhagic fever Dengue shock syndrome Philippine hemorrhagic fever Dengue hemorrhagic fever Dengue shock syndrome Philippine hemorrhagic fever Thai hemorrhagic fever Singapore hemorrhagic fever Hemorrhagic dengue DF Dengue virus infection See More Summary The following summary is from Orphanet, a European reference portal for information on rare diseases and orphan drugs. Orpha Number: 99828 Disease definition Dengue fever (DF), caused by dengue virus , is an arboviral disease characterized by an initial non-specific febrile illness that can sometimes progress to more severe forms manifesting capillary leakage and hemorrhage (dengue hemorrhagic fever, or DHF) and shock (dengue shock syndrome , or DSS). Epidemiology DF is found in the tropics worldwide, especially in Southeast Asia, the Pacific region, and the Americas, with 40% of the global population at risk. An estimated 50 to 100 million cases of DF, 500,000 hospitalizations, and 20,000 deaths occur yearly worldwide. Clinical description The vast majority of dengue virus infections result in DF, which is characterized by sudden onset of fever, malaise, headache (classically retro-orbital), and myalgia/arthralgia, often followed soon after by a petechial rash, which may be pruritic. In most cases, symptoms will resolve within 7 days without further complications. However, in a small minority of patients, a brief period of deffervescence is followed by worsening abdominal symptoms (pain, nausea, vomiting, diarrhea), thrombocytopenia , hemorrhage (DHF: epistaxis, bleeding gums, gastrointestinal bleeding) and a capillary leak syndrome (DSS: hemoconcentration, hypoalbuminemia, pleural effusion, shock). DHF/DSS are seen most often in children under the age of 15 years. Risk is greater with secondary heterologous infection by one of the four dengue virus serotypes, but severe disease may be seen with first infections. Etiology Over 25 different viruses cause viral hemorrhagic fever. Dengue virus belongs to the Flaviviridae family, genus Flavivirus. Four distinct serotypes, with significant strain variation, are recognized. Dengue viruses are maintained in humans and transmitted between them by the bite of infected mosquitoes, most commonly Aedes aegypti but also Aedes albopictus). Person-to-person transmission has not been reported. Diagnostic methods Common diagnostic modalities include serologic testing by enzyme linked immunosorbent assay (ELISA) and reverse transcription polymerase chain reaction (RT-PCR). Virus isolation may also be performed in specialized laboratories. The viremic phase of DF/DHF is usually brief (first 3-5 days of illness), after which time detection of anti-dengue IgM antibodies , which appear as early as 2-4 days after disease onset, is the mainstay. Numerous commercial ELISA assays are available with varying degrees of sensitivity and specificity. Differential diagnosis DF is difficult to distinguish from a host of other febrile illnesses such as malaria and typhoid fever (see these terms), especially early in the course of disease before the rash appears. For DHF/DSS, other viral hemorrhagic fevers, leptospirosis, rickettsial infection (see these terms) and meningococcemia need to be excluded. Management and treatment As there is presently no antiviral drug available for DF/DHF, treatment is supportive, following the guidelines for treatment of severe septicemia. Insecticide-treated bed nets, room screens and elimination of larval development sites should be used in open-air settings to prevent further transmission. Prognosis Case-fatality rates for DF are less than 1% but may rise to as high as 40% in DHF/DSS, largely dependent upon whether access to advanced medical care exists. Children and persons with underlying chronic diseases such as diabetes, heart disease, and asthma are at increased risk. The most severe phase of disease usually lasts only a few days and survivors generally have no lasting sequelae. Visit the Orphanet disease page for more resources. Symptoms This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom. Showing of Medical Terms Other Names Learn More: HPO ID 80%-99% of people have these symptoms Fever 0001945 Headache Headaches 0002315 30%-79% of people have these symptoms Abdominal pain Pain in stomach Stomach pain 0002027 Arthralgia Joint pain 0002829 Pruritus Itching Itchy skin Skin itching 0000989 Skin rash 0000988 5%-29% of people have these symptoms Ascites Accumulation of fluid in the abdomen 0001541 Bruising susceptibility Bruise easily Easy bruisability Easy bruising 0000978 Cardiorespiratory arrest 0006543 Cerebral hemorrhage Bleeding in brain 0001342 Diarrhea Watery stool 0002014 Epistaxis Bloody nose Frequent nosebleeds Nose bleeding Nosebleed 0000421 Gastrointestinal hemorrhage Gastrointestinal bleeding 0002239 Gingival bleeding Bleeding gums 0000225 Hepatomegaly Enlarged liver 0002240 Hypoproteinemia 0003075 Hypotension Low blood pressure 0002615 Lethargy 0001254 Leukopenia Decreased blood leukocyte number Low white blood cell count 0001882 Nausea and vomiting 0002017 Petechiae 0000967 Thrombocytopenia Low platelet count 0001873 Showing of ", "role": "user" }, { "content": "DF is found in the tropics worldwide, especially in Southeast Asia, the Pacific region, and the Americas, with 40% of the global population at risk. An estimated 50 to 100 million cases of DF, 500,000 hospitalizations, and 20,000 deaths occur yearly worldwide. DHF/DSS are seen most often in children under the age of 15 years.", "role": "assistant" } ]

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

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

[ { "content": "My daughter has menkes syndrome and would like to know how to go about. Thx\n\nMenkes syndrome: In Menkes syndrome, cells in the body can absorb copper, but they are unable to release it. It is one of several conditions called an \"inborn error of metabolism.\" Menkes syndrome is caused by a defect in the ATP7A gene. The defect makes it hard for the body to distribute copper in food from the intestines into the bloodstream for use in other areas. As a result, the brain and other parts of the body do not get enough copper. Copper can build up in the small intestine and kidneys, but low copper levels in other areas can affect the structure of bone, skin, hair, and blood vessels, and interfere with nerve function. Menkes syndrome is inherited, which means it runs in families. The gene is on the X-chromosome, so if a mother carries the defective gene, each of her sons has a 50% (1 in 2) chance of developing the disease, and 50% of her daughters will be a carrier of the disease. Symptoms of Menkes syndrome are: - Bone spurs - Brittle, kinky hair - Feeding difficulties - Irritability - Lack of muscle tone, floppiness - Low body temperature - Mental deterioration - Pudgy, rosy cheeks - Seizures - Skeletal changes There is often a history of Menkes syndrome in a male relative. Signs include: - Abnormal appearance of the hair under a microscope - Abnormally low body temperature - Bleeding in the brain - Slow growth in the womb In males, all of the hairs will be abnormal. In females who carry this trait, half of them may have areas of abnormal hair. Tests may include: - Serum ceruloplasmin (substance that transports copper in the blood) - Serum copper level - Skin cell culture - X-ray of the skeleton or x-ray of the skull Genetic testing may show a change (mutation) in the ATP7A gene. 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. Most people with this condition die within the first few years of life. - Seizures - Death Talk to your health care provider if you have a family history of Menkes syndrome and you plan to have children. A baby with this condition will often show symptoms early in infancy. See a genetic counselor if you want to have children and you have a family history of Menkes syndrome. Maternal relatives (relatives on the mother's side of the family) of a boy with this syndrome should be seen by a geneticist to find out if they are carriers. Updated by: Chad Haldeman-Englert, MD, FACMG, Wake Forest School of Medicine, Department of Pediatrics, Section on Medical Genetics, Winston-Salem, NC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.", "role": "user" }, { "content": "Menkes syndrome is caused by a defect in the ATP7A gene. The defect makes it hard for the body to distribute copper in food from the intestines into the bloodstream for use in other areas. As a result, the brain and other parts of the body do not get enough copper. Copper can build up in the small intestine and kidneys, but low copper levels in other areas can affect the structure of bone, skin, hair, and blood vessels, and interfere with nerve function. Menkes syndrome is inherited, which means it runs in families. There is often a history of Menkes syndrome in a male relative. Symptoms of Menkes syndrome are bone spurs, brittle, kinky hair, feeding difficulties, irritability, lack of muscle tone, floppiness, low body temperature, mental deterioration, pudgy, rosy cheeks, seizures, skeletal changes, abnormal appearance of the hair, abnormally low body temperature, bleeding in the brain. slow growth in the womb. 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. Most people with this condition die within the first few years of life.", "role": "assistant" } ]

[ { "content": "My daughter has menkes syndrome and would like to know how to go about. Thx\n\n Menkes disease Steely hair disease Menkes kinky hair syndrome Kinky hair disease Copper transport disease Trichopoliodystrophy X-linked copper deficiency Summary Menkes disease is an inherited disorder in which the body has a problem absorbing copper. The disease affects development, both mental and physical. Causes Menkes disease is caused by a defect in the <em>ATP7A</em> gene. The defect makes it hard for the body to properly distribute (transport) copper throughout the body. As a result, the brain and other parts of the body do not get enough copper, while it builds up in the small intestine and kidneys. A low copper level can affect the structure of bone, skin, hair, and blood vessels, and interfere with nerve function. Menkes syndrome is usually inherited, which means it runs in families. The gene is on the X-chromosome, so if a mother carries the defective gene, each of her sons has a 50% (1 in 2) chance of developing the disease, and 50% of her daughters will be a carrier of the disease. This kind of gene inheritance is called X-linked recessive. In some people, the disease is not inherited. Instead, the gene defect occurs after birth. Symptoms Common symptoms of Menkes disease in infants are: Brittle, kinky, steely, sparse, or tangled hair Pudgy, rosy cheeks, sagging facial skin Feeding difficulties Irritability Lack of muscle tone, floppiness Low body temperature Intellectual disability and developmental delay Seizures Skeletal changes Exams and Tests Once Menkes disease is suspected, tests that may be done include: Ceruloplasmin blood test (substance that transports copper in the blood) Copper blood test Skin cell culture X-ray of the skeleton or x-ray of the skull Gene testing to check for defect of the <em>ATP7A</em> gene Treatment 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 and depends on whether the <em>ATP7A</em> gene still has some activity. Support Groups These resources can provide more information on Menkes syndrome: National Organization for Rare Disorders -- rarediseases.org/rare-diseases/menkes-disease NIH/NLM Genetics Home Reference -- ghr.nlm.nih.gov/condition/menkes-syndrome Outlook (Prognosis) Most children with this disease die within the first few years of life. When to Contact a Medical Professional Talk to your health care provider if you have a family history of Menkes syndrome and you plan to have children. A baby with this condition will often show symptoms early in infancy. Prevention See a genetic counselor if you want to have children and you have a family history of Menkes syndrome. Maternal relatives (relatives on the mother's side of the family) of a boy with this syndrome should be seen by a geneticist to find out if they are carriers. Review Date 5/1/2017 Updated by: Anna C. Edens Hurst, MD, MS, Assistant Professor in Medical Genetics, The University of Alabama at Birmingham, Birmingham, AL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Symptoms of Menkes syndrome are: - Bone spurs - Brittle, kinky hair - Feeding difficulties - Irritability - Lack of muscle tone, floppiness - Low body temperature - Mental deterioration - Pudgy, rosy cheeks - Seizures - Skeletal changes", "role": "assistant" } ]

[ { "content": "what medications are prescribed for brucellosis\n\nBrucellosis (Overview): Brucellosis is a bacterial infection that spreads from animals to people - most often via unpasteurized milk, cheese and other dairy products. More rarely, the bacteria that cause brucellosis can spread through the air or through direct contact with infected animals. Brucellosis symptoms may include fever, joint pain and fatigue. The infection can usually be treated successfully with antibiotics. Treatment takes several weeks to months, however, and relapses are common. While brucellosis is uncommon in the United States, the disease affects hundreds of thousands of people and animals worldwide. Avoiding unpasteurized dairy products and taking precautions when working with animals or in a laboratory can help prevent brucellosis.", "role": "user" }, { "content": "Brucellosis is treated successfully with antibiotics. Treatment takes several weeks to months, however, and relapses are common.", "role": "assistant" } ]

[ { "content": "what are the causes of pulmonary hypertension\n\nPulmonary hypertension (Risk factors): Your risk of developing pulmonary hypertension may be greater if: - You're a young adult, as idiopathic pulmonary arterial hypertension is more common in younger adults - You're overweight - You have a family history of the disease - You have one of various conditions that can increase your risk of developing pulmonary hypertension - You use illegal drugs, such as cocaine - You take certain appetite-suppressant medications - You have an existing risk of developing pulmonary hypertension, such as a family history of the condition, and you live at a high altitude", "role": "user" }, { "content": "Your risk of developing pulmonary hypertension may be greater if: - You're a young adult, as idiopathic pulmonary arterial hypertension is more common in younger adults - You're overweight - You have a family history of the disease - You have one of various conditions that can increase your risk of developing pulmonary hypertension - You use illegal drugs, such as cocaine - You take certain appetite-suppressant medications - You have an existing risk of developing pulmonary hypertension, such as a family history of the condition, and you live at a high altitude", "role": "assistant" } ]

[ { "content": "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 &quot;agency&quot; 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.\n\n Tay-Sachs disease Overview Tay-Sachs disease is a rare disorder passed from parents to child. It's caused by the absence of an enzyme that helps break down fatty substances. These fatty substances, called gangliosides, build up to toxic levels in the child's brain and affect the function of the nerve cells. As the disease progresses, the child loses muscle control. Eventually, this leads to blindness, paralysis and death. If you have a family history of Tay-Sachs disease or if you're a member of a high-risk group and plan to have children, doctors strongly recommend genetic testing and genetic counseling. Symptoms In the most common form, an infant usually begins showing symptoms by about 6 months of age. Signs and symptoms of Tay-Sachs disease can include the following: - Loss of motor skills, including turning over, crawling and sitting up - Exaggerated reactions when the baby hears loud noises - Seizures - Vision and hearing loss - \"Cherry-red\" spots in the eyes - Muscle weakness - Movement problems When to see a doctor If your child has any of the signs or symptoms listed above, schedule an appointment with your child's doctor. Causes Tay-Sachs disease is a genetic disorder that is passed from parents to their children. It occurs when a child inherits the gene from both parents. Diagnosis To confirm that your baby has Tay-Sachs disease, your doctor will ask you about the child's symptoms and any hereditary family disorders and will order a diagnostic blood test. The blood test checks the levels of an enzyme called hexosaminidase in the child's blood. The levels are low or absent in Tay-Sachs disease. While performing a careful eye exam of your child, the doctor may see a cherry-red spot in the back of the child's eyes, which is a sign of the disease. You may need to see a pediatric neurologist and an ophthalmologist for nervous system and eye examinations. Treatment There is no cure for Tay-Sachs disease, but some treatments can help in managing symptoms. The goal of treatment is support and comfort. Supportive treatments include: - Medication. To reduce your child's symptoms, a number of prescription medications are available, including anti-seizure medications. - Respiratory care. Children who have Tay-Sachs disease are at high risk of lung infections that cause breathing problems and frequently accumulate mucus in their lungs. Your child may need the mucus using chest physiotherapy (CPT) to help remove mucus from the lungs. - Feeding tubes. Your child may have trouble swallowing, or develop respiratory problems by inhaling food or liquid into the lungs while eating. To prevent those problems, your doctor may recommend an assistive feeding device such as a gastrostomy tube, which is inserted through your child's nose and goes to your child's stomach. Or, a doctor trained in stomach surgery may surgically insert an esophagogastrostomy tube. - Physical therapy. As the disease progresses, your child may benefit from physical therapy to help keep joints flexible and maintain as much ability to move (range of motion) as possible. Physical therapy can delay joint stiffness and reduce or delay the loss of function and pain that can result from shortened muscles. Potential future treatments Gene therapy or enzyme replacement therapy research may eventually lead to a cure or treatment to slow the progression of Tay-Sachs disease. ", "role": "user" }, { "content": "There is no cure for Tay-Sachs disease, but some treatments can help in managing symptoms. To reduce your child's symptoms, a number of prescription medications are available, including anti-seizure medications. Children who have Tay-Sachs disease are at high risk of lung infections that cause breathing problems and frequently accumulate mucus in their lungs. Your child may need the mucus using chest physiotherapy (CPT) to help remove mucus from the lungs. Your child may have trouble swallowing, or develop respiratory problems by inhaling food or liquid into the lungs while eating. To prevent those problems, your doctor may recommend an assistive feeding device ... As the disease progresses, your child may benefit from physical therapy to help keep joints flexible and maintain as much ability to move (range of motion) as possible. Physical therapy can delay joint stiffness and reduce or delay the loss of function and pain that can result from shortened muscles. Gene therapy or enzyme replacement therapy research may eventually lead to a cure or treatment to slow the progression of Tay-Sachs disease.", "role": "assistant" } ]

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

[ { "content": "Are there any researches indicating how early an individual may experience any signs or symptoms of Rheumatoid Arthritis?\n\nRheumatoid arthritis (Symptoms): Signs and symptoms of rheumatoid arthritis may include: - Tender, warm, swollen joints - Joint stiffness that is usually worse in the mornings and after inactivity - Fatigue, fever and weight loss Early rheumatoid arthritis tends to affect your smaller joints first - particularly the joints that attach your fingers to your hands and your toes to your feet. As the disease progresses, symptoms often spread to the wrists, knees, ankles, elbows, hips and shoulders. In most cases, symptoms occur in the same joints on both sides of your body. About 40 percent of the people who have rheumatoid arthritis also experience signs and symptoms that don't involve the joints. Rheumatoid arthritis can affect many nonjoint structures, including: - Skin - Eyes - Lungs - Heart - Kidneys - Salivary glands - Nerve tissue - Bone marrow - Blood vessels Rheumatoid arthritis signs and symptoms may vary in severity and may even come and go. Periods of increased disease activity, called flares, alternate with periods of relative remission - when the swelling and pain fade or disappear. Over time, rheumatoid arthritis can cause joints to deform and shift out of place. Make an appointment with your doctor if you have persistent discomfort and swelling in your joints.", "role": "user" }, { "content": "Early rheumatoid arthritis tends to affect your smaller joints first - particularly the joints that attach your fingers to your hands and your toes to your feet.", "role": "assistant" } ]

[ { "content": "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\n\nGastroparesis (Treatment): Treating gastroparesis begins with identifying and treating the underlying condition. If diabetes is causing your gastroparesis, your doctor can work with you to help you control it. Changes to your diet Maintaining adequate nutrition is the most important goal in the treatment of gastroparesis. Many people can manage gastroparesis with diet changes and dietary changes are the first step in managing this condition. Your doctor may refer you to a dietitian who can work with you to find foods that are easier for you to digest so that you're more likely to get enough calories and nutrients from the food you eat. A dietitian might suggest that you try to: - Eat smaller meals more frequently - Chew food thoroughly - Eat well-cooked fruits and vegetables rather than raw fruits and vegetables - Avoid fibrous fruits and vegetables, such as oranges and broccoli, which may cause bezoars - Choose mostly low-fat foods, but if you can tolerate them, add small servings of fatty foods to your diet - Try soups and pureed foods if liquids are easier for you to swallow - Drink about 34 to 51 ounces (1 to 1.5 liters) of water a day - Exercise gently after you eat, such as going for a walk - Avoid carbonated drinks, alcohol and smoking - Try to avoid lying down for 2 hours after a meal - Take a multivitamin daily Here's a brief list of foods recommended for people with gastroparesis (your dietitian can give you a more comprehensive list): - White bread and rolls and \"light\" whole-wheat bread without nuts or seeds - Plain or egg bagels - English muffins - Flour or corn tortillas - Pancakes - Puffed wheat and rice cereals - Cream of wheat or rice - White crackers - Potatoes, white or sweet (no skin) - Baked french fries - Rice - Pasta - Lean beef, veal and pork (not fried) - Chicken or turkey (no skin and not fried) - Crab, lobster, shrimp, clams, scallops, oysters - Tuna (packed in water) - Cottage cheese - Eggs - Tofu - Strained meat baby food - Baby food vegetables and fruits - Tomato sauce, paste, puree, juice - Carrots (cooked) - Beets (cooked) - Mushrooms (cooked) - Vegetable juice - Vegetable broth - Fruit juices and drinks - Applesauce - Bananas - Peaches and pears (canned) - Milk, if tolerated - Yogurt (without fruit pieces) - Custard and pudding - Frozen yogurt Medications Medications to treat gastroparesis may include: - Medications to stimulate the stomach muscles. These medications include metoclopramide (Reglan) and erythromycin (Eryc, E.E.S.). Metoclopramide has a risk of serious side effects. Erythromycin may lose its effectiveness over time, and can cause side effects, such as diarrhea. A newer medication, domperidone, with fewer side effects, is also available with restricted access. - Medications to control nausea and vomiting. Drugs that help ease nausea and vomiting include prochlorperazine (Compro) and diphenhydramine (Benadryl, Unisom). A class of medications that includes ondansetron (Zofran) is sometimes used to help nausea and vomiting. Surgical treatment Some people with gastroparesis may be unable to tolerate any food or liquids. In these situations, doctors may recommend a feeding tube (jejunostomy tube) be placed in the small intestine. Or doctors may recommend a gastric venting tube to help relieve pressure from gastric contents. Feeding tubes can be passed through your nose or mouth or directly into your small intestine through your skin. The tube is usually temporary and is only used when gastroparesis is severe or when blood sugar levels can't be controlled by any other method. Some people may require an IV (parenteral) feeding tube that goes directly into a vein in the chest. Treatments under investigation Researchers are continuing to investigate new medications to treat gastroparesis. One example is a new drug in development called relamorelin. The results of a phase 2 clinical trial found the drug could speed up gastric emptying and reduce vomiting. The drug is not yet approved by the Food and Drug Administration (FDA), but a larger clinical trial is currently underway. A number of new therapies are being tried with the help of endoscopy - a slender tube that's threaded down the esophagus. One procedure used endoscopy to place a small tube (stent) where the stomach connects to the small intestine (duodenum) to keep this connection open. Several research trials investigated the use of botulinum toxin administered through endoscopy without much success. This treatment is not recommended. Doctors are also studying the use of a minimally invasive surgical technique when someone needs a feeding tube placed directly into the small intestine (jejunostomy tube). Gastric electrical stimulation and pacing Gastric electrical stimulation is a surgically implanted device that provides electrical stimulation to stimulate stomach muscles to move food more efficiently. Study results have been mixed. However, the device seems to be most helpful for people with diabetic gastroparesis. The FDA allows the device to be used under a compassionate use exemption for those who can't control their gastroparesis symptoms with diet changes or medications. However, larger studies are needed. Gastric pacing also involves a surgically implanted device that stimulates the stomach muscles, but this device tries to more closely mimic normal stomach contractions. Currently, the device is too large and causes discomfort. Gastric pacing devices are only available in clinical trials right now.", "role": "user" }, { "content": "Gastroparesis could be caused by diabetes and other underlying conditions that your doctor could help to control. If gastroparesis cannot be controlled with diet and you are unable to tolerate any food or liquid, your doctor could recommend a feeding tube (jejunostomy tube) that is placed in the small intestine or a gastric venting tube to help relieve pressure from gastric contents. Temporary feeding tubes can be passed through your nose or mouth or directly into your small intestine through your skin. Some people may require an IV (parenteral) feeding tube that goes directly into a vein in the chest. Experimental treatments include: a drug called relamorelin to reduce vomiting and speed up gastric emptying; endoscopic procedures that place stents that keep the connection between the stomach and the intestines open; and a surgically implanted device that stimulates stomach muscles (gastric electrical stimulation.)", "role": "assistant" } ]

[ { "content": "Can you mail me patient information about Glaucoma, I was recently diagnosed and want to learn all I can about the disease.\n\nGlaucoma (Symptoms): OPEN-ANGLE GLAUCOMA - Most people have no symptoms. - Once vision loss occurs, the damage is already severe. - Slow loss of side (peripheral) vision (also called tunnel vision). - Advanced glaucoma can lead to blindness. ANGLE-CLOSURE GLAUCOMA Symptoms may come and go at first, or steadily become worse. You may notice: - Sudden, severe pain in one eye - Decreased or cloudy vision, often called \"steamy\" vision - Nausea and vomiting - Rainbow-like halos around lights - Red eye - Eye feels swollen CONGENITAL GLAUCOMA Symptoms are most often noticed when the child is a few months old. - Cloudiness of the front of the eye - Enlargement of one eye or both eyes - Red eye - Sensitivity to light - Tearing SECONDARY GLAUCOMA - Symptoms are most often related to the underlying problem causing the glaucoma. - Depending on the cause, symptoms may either be like open-angle glaucoma or angle-closure glaucoma.", "role": "user" }, { "content": "OPEN-ANGLE GLAUCOMA - Most people have no symptoms. - Once vision loss occurs, the damage is already severe. - Slow loss of side (peripheral) vision (also called tunnel vision). - Advanced glaucoma can lead to blindness. ANGLE-CLOSURE GLAUCOMA Symptoms may come and go at first, or steadily become worse. You may notice: - Sudden, severe pain in one eye - Decreased or cloudy vision, often called \"steamy\" vision - Nausea and vomiting - Rainbow-like halos around lights - Red eye - Eye feels swollen .. SECONDARY GLAUCOMA - Symptoms are most often related to the underlying problem causing the glaucoma. - Depending on the cause, symptoms may either be like open-angle glaucoma or angle-closure glaucoma.", "role": "assistant" } ]

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

[ { "content": "Vitelliform Macular Dystrophy Would like to obtain more info on possible treatments.\n\n Best vitelliform macular dystrophy Best disease Best macular dystrophy Macular degeneration, polymorphic vitelline Best disease Best macular dystrophy Macular degeneration, polymorphic vitelline Vitelliform macular dystrophy type 2 VMD2 BVMD Early-onset vitelliform macular dystrophy Juvenile-onset vitelliform macular dystrophy Polymorphic vitelline macular degeneration See More Summary Best vitelliform macular dystrophy (BVMD) is a slowly progressive form of macular degeneration. It usually begins in childhood or adolescence, but age of onset and severity of vision loss can vary. Affected people first have normal vision, followed by decreased central visual acuity and distorted vision (metamorphopsia). Peripheral vision is not affected. [1] BVMD is characterized by atrophy of the retinal pigment epithelium (The retina is the back part of the eye that contains the specialized cells that respond to light, known as photoreceptors) and impaired central visual function. [2] BVMD is usually inherited in an autosomal dominant manner, but autosomal recessive inheritance has been reported. The condition is typically caused by mutations in the BEST1 gene ; in a few cases the cause is unknown. Treatment is symptomatic and involves the use of low vision aids, and direct laser treatment or photodynamic therapy. Newer treatment includes anti-VEGF agents ( bevacizumab) and transcorneal electrical retinal stimulation. [1] Symptoms This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom. Showing of Medical Terms Other Names Learn More: HPO ID 80%-99% of people have these symptoms Cystoid macular degeneration 0008028 Metamorphopsia 0012508 30%-79% of people have these symptoms Abnormality of color vision Abnormal color vision 0000551 5%-29% of people have these symptoms Choroideremia 0001139 Visual field defect Partial loss of field of vision 0001123 Percent of people who have these symptoms is not available through HPO Abnormal electroretinogram 0000512 Autosomal dominant inheritance 0000006 Macular dystrophy 0007754 Reduced visual acuity Decreased clarity of vision 0007663 Subretinal fluid 0031526 Visual impairment Impaired vision Loss of eyesight Poor vision 0000505 Showing of Cause Best vitelliform macular dystrophy (BVMD) is caused by changes ( mutations ) in the gene . [1] This gene gives the body instructions for making a protein called bestrophin. Bestrophin acts as a channel that controls the movement of chloride ions within the retina. It is thought that mutations in the BEST1 gene affect the shape of the channel and its ability to properly regulate the flow of chloride. However, it is unclear how exactly this relates to the specific features of BVMD. [3] Inheritance Best vitelliform macular dystrophy (BVMD) is most commonly inherited in an autosomal dominant manner, although a few cases with autosomal recessive inheritance have been reported. [1] In autosomal dominant inheritance, having one changed ( mutated ) copy of the responsible gene in each cell is enough to cause symptoms of the condition. When a person with an autosomal dominant condition has children, each child has a 50% (1 in 2) chance to inherit the mutated gene. Most people with BVMD have an affected parent, but some people have the condition as the result of a new mutation that occurred for the first time. [1] Autosomal recessive inheritance means that a person must have a mutation in both copies of the responsible gene in each cell to be affected. The parents of an affected person usually each carry one mutated copy of the gene and are referred to as carriers . Carriers typically do not show signs or symptoms of the condition. When two carriers of an autosomal recessive condition have children, each child has a 25% (1 in 4) risk to have the condition, a 50% (1 in 2) risk to be a carrier like each of the parents, and a 25% chance to not have the condition and not be a carrier. Diagnosis Best vitelliform macular dystrophy (BVMD) may be diagnosed based on the findings on an exam of the fundus (the interior surface of the eye opposite the lens); an electrooculogram (EOG); and the family history . An eye exam may include other tests as well. A fundus exam may show a typical yellow yolk-like macular lesion. The EOG, which reflects the retinal pigmentary epithelium function, is the most diagnostic test for evaluating vitelliform macular dystrophy. In the majority of the cases, a severe decrease occurs in light response, reflected by an Arden (light-peak/dark-trough) ratio of 1.1-1.5. (The normal Arden ratio is 1.8.) Carriers will also have an abnormal EOG result. No correlation exists between EOG result and disease stage, visual acuity, or patient age. EOG results are usually symmetric for both eyes. [4] The family history in affected people is often consistent with either autosomal dominant or autosomal recessive inheritance. [1] Genetic testing may also be used to make a diagnosis of BVMD. A BEST1 mutation is detected in about 96% of affected people who have an affected family member. In people with no family history of BVMD, the mutation detection rate ranges between 50-70%. A mutation in BEST1 gene is more probable when a vitelliform lesion is accompanied by a reduced Arden ratio on EOG testing. The exact type of genetic test ordered to confirm a diagnosis may depend on a person's ancestry, family history, and/or whether other eye disorders are also being considered. [1] Treatment There is no specific treatment for Best vitelliform macular dystrophy (BVMD) at this time. [5] [4] Low vision aids help affected people with significant loss of visual acuity. [6] Laser photocoagulation, photodynamic therapy, and anti-VEGF (vascular endothelial growth factor) agents such as bevacizumab have shown limited success in treating some of the secondary features of BVMD such as choroidal neovascularization (when abnormal blood vessels grow under the macula and retina). [6] [5] [4] Find a Specialist If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments. If you can't find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care. You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists. Healthcare Resources To find a medical professional who specializes in genetics, you can ask your doctor for a referral or you can search for one yourself. Online directories are provided by the American College of Medical Genetics and the National Society of Genetic Counselors. If you need additional help, contact a GARD Information Specialist. You can also learn more about genetic consultations from Genetics Home Reference. Related Diseases Related diseases are conditions that have similar signs and symptoms. A health care provider may consider these conditions in the table below when making a diagnosis. Please note that the table may not include all the possible conditions related to this disease. Conditions with similar signs and symptoms from Orphanet Differential diagnosis of BVMD includes adult-onset foveomacular vitelliform dystrophy, age-related macular degeneration, autosomal recessive bestrophinopathy, autosomal dominant vitreoretinochoroidopathy, retinitis pigmentosa (see these terms) and Bull's-eye maculopathy. Visit the Orphanet disease page for more information. ", "role": "user" }, { "content": "Treatment is symptomatic and involves the use of low vision aids, and direct laser treatment or photodynamic therapy. Newer treatment includes anti-VEGF agents ( bevacizumab) and transcorneal electrical retinal stimulation.", "role": "assistant" } ]

[ { "content": "Duchenne Muscular Dystrophy. I am doing a research project on this genetic disease and I would like to know more about it from a professional. I am researching the mode of inheritance, symptoms, treatments/ support groups, and relative cost to family.\n\n Duchenne muscular dystrophy Pseudohypertrophic muscular dystrophy Muscular dystrophy - Duchenne type Summary Duchenne muscular dystrophy is an inherited disorder. It involves muscle weakness, which quickly gets worse. Causes Duchenne muscular dystrophy is a form of muscular dystrophy. It worsens quickly. Other muscular dystrophies (including Becker muscular dystrophy) get worse much more slowly. Duchenne muscular dystrophy is caused by a defective gene for dystrophin (a protein in the muscles). However, it often occurs in people without a known family history of the condition. The condition most often affects boys due to the way the disease is inherited. The sons of women who are carriers of the disease (women with a defective gene, but no symptoms themselves) each have a 50% chance of having the disease. The daughters each have a 50% chance of being carriers. Very rarely, a female can be affected by the disease. Duchenne muscular dystrophy occurs in about 1 out of every 3,600 male infants. Because this is an inherited disorder, risks include a family history of Duchenne muscular dystrophy. Symptoms Symptoms most often appear before age 6. They may come on as early as infancy. Most boys show no symptoms in the first few years of life. Symptoms 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 Shortness of breath, fatigue and swelling of the feet due to a weakening of the heart muscle Problem breathing due to a weakening of the respiratory muscles Gradual worsening of muscle weakness Progressive difficulty walking: Ability to walk may be lost by age 12, and the child will have to use a wheelchair. Breathing difficulties and heart disease often start by age 20. Exams and Tests A complete nervous system (neurological), heart, lung, and muscle exam may show: Abnormal heart muscle (cardiomyopathy) becomes evident by the age of 10. Congestive heart failure or irregular heart rhythm (arrhythmia) is present in all people with Duchenne muscular dystrophy by the age of 18. Deformities of the chest and back (scoliosis). Enlarged muscles of the calves, buttocks, and shoulders (around age 4 or 5). These muscles are eventually replaced by fat and connective tissue (pseudohypertrophy). Loss of muscle mass (wasting). Muscle contractures in the heels, legs. Muscle deformities. Respiratory disorders, including pneumonia and swallowing with food or fluid passing into the lungs (in late stages of the disease). Tests may include: Electromyography (EMG) Genetic tests Muscle biopsy Serum CPK Treatment There is no known cure for Duchenne muscular dystrophy. Treatment aims to control symptoms to improve 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. The use of steroids and the lack of physical activity can lead to excessive weight gain. Activity is encouraged. Inactivity (such as bedrest) can make 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 Spine surgery to treat progressive scoliosis for some people Proton pump inhibitors (for people with gastroesophageal reflux) Several new treatments are being studied in trials. Support Groups You can ease the stress of illness by joining a support group where members share common experiences and problems. The Muscular Dystrophy Association is an excellent source of information on this disease. Outlook (Prognosis) Duchenne muscular dystrophy leads to progressively worsening disability. Death often occurs by age 25, typically from lung disorders. However, advances in supportive care have resulted in many men living longer. Possible Complications Complications may include: Cardiomyopathy (can also occur in female carriers, who should also be screened) Congestive heart failure (rare) Deformities Heart arrhythmias (rare) Mental impairment (varies, usually minimal) Permanent, progressive disability, including decreased mobility and decreased ability to care for self Pneumonia or other respiratory infections Respiratory failure When to Contact a Medical Professional Call your health care provider if: Your child has symptoms of Duchenne muscular dystrophy. Symptoms get worse or new symptoms develop, particularly fever with cough or breathing problems. Prevention People with a family history of the disorder may want to seek genetic counseling. Genetic studies done during pregnancy are very accurate in detecting Duchenne muscular dystrophy. Review Date 11/22/2017 Updated by: Luc Jasmin, MD, PhD, FRCS (C), FACS, Department of Surgery at Providence Medical Center, Medford OR; Department of Surgery at Ashland Community Hospital, Ashland OR; Department of Maxillofacial Surgery at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Duchenne muscular dystrophy is caused by a defective gene, however, it often occurs in people without a known family history of the condition. The sons of women who are carriers of the disease (women with a defective gene, but no symptoms themselves) have a 50% chance of having the disease. The daughters each have a 50% chance of being carriers. Very rarely, a female can be affected by the disease. Duchenne muscular dystrophy occurs in about 1 out of every 3,600 male infants.", "role": "assistant" } ]

[ { "content": "how is epidural harmful\n\n Epidural block - pregnancy Delivery - epidural Labor - epidural Summary An epidural block is a numbing medicine given by injection (shot) in the back. It numbs or causes a loss of feeling in the lower half your body. This lessens the pain of contractions during childbirth. An epidural block may also be used to reduce pain during surgery on the lower extremities. This article focuses on epidural blocks during childbirth. How is the Epidural Given? The block or shot is given into an area over your lower back or spine. You may be asked to lie on your side, or you may sit up. Either way, you will be asked to pull your stomach inward and hunch your back outward. Your health care provider will wash the area of your back and inject a little medicine to numb the spot where the epidural needle is placed: The provider inserts a needle into your lower back. The needle is placed into a small space outside your spinal cord. A small soft tube (catheter) is placed into your back, next to your spine. The needle is removed. The numbing medicine is given through the tube for as long as it is needed. In most cases, you will receive a low dose because it is safer for you and baby. Once the medicine takes effect (10 to 20 minutes), you should feel better. You may still feel some back or rectal pressure during contractions. You may shiver after an epidural, but this is common. Many women shiver during labor even without an epidural. Is an Epidural Safe? Many studies have shown that an epidural is a safe way to manage pain during childbirth. While rare, there are some risks. Your blood pressure may drop for a short while. This might cause the baby's heart rate to slow down. To avoid this, you will receive fluids through an intravenous (IV) line to help keep your blood pressure stable. If your blood pressure shows a drop, you may need to lie on your side to keep the blood moving throughout your body. Your provider may also give you medicine to raise your blood pressure. An epidural block may change or alter labor and delivery. If you are very numb from the block, you may have a harder time bearing down to push your baby through the birth canal. Contractions may lessen or slow down for a little while, but labor will still move along as it should. In some cases, it may even go faster. If your labor slows down, your doctor can give you medicine to speed up your contractions. It is best to wait until you are in active labor to have the epidural placed. Other rare side effects are: You may get a headache after your epidural but this is rare. Medicine could enter your spinal fluid. For a short while, it could make you feel dizzy, or you might have a hard time breathing. You could also have a seizure. This is also rare. What Types of Epidurals are There? There are 2 types: \"Walking\" epidural block. This type of epidural will lessen your pain, but you will still be able to move your legs. Most women are not really able to walk around, but they can move their legs. Combined spinal epidural block. This combines both a spinal and epidural block. It provides pain relief much faster. The combined block is used when women are in very active labor and want relief right away. Review Date 4/19/2018 Updated by: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Many studies have shown that epidural is a safe way to manage pain during childbirth. However, there are some rare risks. Your blood pressure may drop, and if this occurs, you will receive fluids through an intravenous line to help keep your blood pressure stable. The epidural may change your labor and delivery. For example, if you are very numb from the block, you may have a harder time bearing down to push your baby through the birth canal. Your contractions may slow down for a little while, but your labor will still continue as it should. Other rare side effects include a headache with the epidural, dizziness, or, also rarely, a seizure.", "role": "assistant" } ]

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

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

[ { "content": "what are the main causes tooth loss?\n\n Cavities/tooth decay Overview Cavities are permanently damaged areas in the hard surface of your teeth that develop into tiny openings or holes. Cavities, also called tooth decay or caries, are caused by a combination of factors, including bacteria in your mouth, frequent snacking, sipping sugary drinks and not cleaning your teeth well. Cavities and tooth decay are among the world's most common health problems. They're especially common in children, teenagers and older adults. But anyone who has teeth can get cavities, including infants. If cavities aren't treated, they get larger and affect deeper layers of your teeth. They can lead to a severe toothache, infection and tooth loss. Regular dental visits and good brushing and flossing habits are your best protection against cavities and tooth decay. Symptoms The signs and symptoms of cavities vary, depending on their extent and location. When a cavity is just beginning, you may not have any symptoms at all. As the decay gets larger, it may cause signs and symptoms such as: - Toothache, spontaneous pain or pain that occurs without any apparent cause - Tooth sensitivity - Mild to sharp pain when eating or drinking something sweet, hot or cold - Visible holes or pits in your teeth - Brown, black or white staining on any surface of a tooth - Pain when you bite down When to see a dentist You may not be aware that a cavity is forming. That's why it's important to have regular dental checkups and cleanings, even when your mouth feels fine. However, if you experience a toothache or mouth pain, see your dentist as soon as possible. Causes Cavities are caused by tooth decay - a process that occurs over time. Here's how tooth decay develops: - Plaque forms. Dental plaque is a clear sticky film that coats your teeth. It's due to eating a lot of sugars and starches and not cleaning your teeth well. When sugars and starches aren't cleaned off your teeth, bacteria quickly begin feeding on them and form plaque. Plaque that stays on your teeth can harden under or above your gum line into tartar (calculus). Tartar makes plaque more difficult to remove and creates a shield for bacteria. - Plaque attacks. The acids in plaque remove minerals in your tooth's hard, outer enamel. This erosion causes tiny openings or holes in the enamel - the first stage of cavities. Once areas of enamel are worn away, the bacteria and acid can reach the next layer of your teeth, called dentin. This layer is softer than enamel and less resistant to acid. Dentin has tiny tubes that directly communicate with the nerve of the tooth causing sensitivity. - Destruction continues. As tooth decay develops, the bacteria and acid continue their march through your teeth, moving next to the inner tooth material (pulp) that contains nerves and blood vessels. The pulp becomes swollen and irritated from the bacteria. Because there is no place for the swelling to expand inside of a tooth, the nerve becomes pressed, causing pain. Discomfort can even extend outside of the tooth root to the bone. Risk factors Everyone who has teeth is at risk of getting cavities, but the following factors can increase risk: - Tooth location. Decay most often occurs in your back teeth (molars and premolars). These teeth have lots of grooves, pits and crannies, and multiple roots that can collect food particles. As a result, they're harder to keep clean than your smoother, easy-to-reach front teeth. - Certain foods and drinks. Foods that cling to your teeth for a long time - such as milk, ice cream, honey, sugar, soda, dried fruit, cake, cookies, hard candy and mints, dry cereal, and chips - are more likely to cause decay than foods that are easily washed away by saliva. - Frequent snacking or sipping. When you steadily snack or sip sugary drinks, you give mouth bacteria more fuel to produce acids that attack your teeth and wear them down. And sipping soda or other acidic drinks throughout the day helps create a continual acid bath over your teeth. - Bedtime infant feeding. When babies are given bedtime bottles filled with milk, formula, juice or other sugar-containing liquids, these beverages remain on their teeth for hours while they sleep, feeding decay-causing bacteria. This damage is often called baby bottle tooth decay. Similar damage can occur when toddlers wander around drinking from a sippy cup filled with these beverages. - Inadequate brushing. If you don't clean your teeth soon after eating and drinking, plaque forms quickly and the first stages of decay can begin. - Not getting enough fluoride. Fluoride, a naturally occurring mineral, helps prevent cavities and can even reverse the earliest stages of tooth damage. Because of its benefits for teeth, fluoride is added to many public water supplies. It's also a common ingredient in toothpaste and mouth rinses. But bottled water usually does not contain fluoride. - Younger or older age. In the United States, cavities are common in very young children and teenagers. Older adults also are at higher risk. Over time, teeth can wear down and gums may recede, making teeth more vulnerable to root decay. Older adults also may use more medications that reduce saliva flow, increasing the risk of tooth decay. - Dry mouth. Dry mouth is caused by a lack of saliva, which helps prevent tooth decay by washing away food and plaque from your teeth. Substances found in saliva also help counter the acid produced by bacteria. Certain medications, some medical conditions, radiation to your head or neck, or certain chemotherapy drugs can increase your risk of cavities by reducing saliva production. - Worn fillings or dental devices. Over the years, dental fillings can weaken, begin to break down or develop rough edges. This allows plaque to build up more easily and makes it harder to remove. Dental devices can stop fitting well, allowing decay to begin underneath them. - Heartburn. Heartburn or gastroesophageal reflux disease (GERD) can cause stomach acid to flow into your mouth (reflux), wearing away the enamel of your teeth and causing significant tooth damage. This exposes more of the dentin to attack by bacteria, creating tooth decay. Your dentist may recommend that you consult your doctor to see if gastric reflux is the cause of your enamel loss. - Eating disorders. Anorexia and bulimia can lead to significant tooth erosion and cavities. Stomach acid from repeated vomiting (purging) washes over the teeth and begins dissolving the enamel. Eating disorders also can interfere with saliva production. Complications Cavities and tooth decay are so common that you may not take them seriously. And you may think that it doesn't matter if children get cavities in their baby teeth. However, cavities and tooth decay can have serious and lasting complications, even for children who don't have their permanent teeth yet. Complications of cavities may include: - Pain - Tooth abscess - Swelling or pus around a tooth - Damage or broken teeth - Chewing problems - Positioning shifts of teeth after tooth loss When cavities and decay become severe, you may have: - Pain that interferes with daily living - Weight loss or nutrition problems from painful or difficult eating or chewing - Tooth loss, which may affect your appearance, as well as your confidence and self-esteem - In rare cases, a tooth abscess - a pocket of pus that's caused by bacterial infection - which can lead to more serious or even life-threatening infections Diagnosis Your dentist can usually detect tooth decay by: - Asking about tooth pain and sensitivity - Examining your mouth and teeth - Probing your teeth with dental instruments to check for soft areas - Looking at dental X-rays, which can show the extent of cavities and decay Your dentist will also be able to tell you which of the three types of cavities you have - smooth surface, pit and fissure, or root. Treatment Regular checkups can identify cavities and other dental conditions before they cause troubling symptoms and lead to more-serious problems. The sooner you seek care, the better your chances of reversing the earliest stages of tooth decay and preventing its progression. If a cavity is treated before it starts causing pain, you probably won't need extensive treatment. Treatment of cavities depends on how severe they are and your particular situation. Treatment options include: - Fluoride treatments. If your cavity just started, a fluoride treatment may help restore your tooth's enamel and can sometimes reverse a cavity in the very early stages. Professional fluoride treatments contain more fluoride than the amount found in tap water, toothpaste and mouth rinses. Fluoride treatments may be liquid, gel, foam or varnish that's brushed onto your teeth or placed in a small tray that fits over your teeth. - Fillings. Fillings, also called restorations, are the main treatment option when decay has progressed beyond the earliest stage. Fillings are made of various materials, such as tooth-colored composite resins, porcelain or dental amalgam that is a combination of several materials. - Crowns. For extensive decay or weakened teeth, you may need a crown - a custom-fitted covering that replaces your tooth's entire natural crown. Your dentist drills away all the decayed area and enough of the rest of your tooth to ensure a good fit. Crowns may be made of gold, high strength porcelain, resin, porcelain fused to metal or other materials. - Root canals. When decay reaches the inner material of your tooth (pulp), you may need a root canal. This is a treatment to repair and save a badly damaged or infected tooth instead of removing it. The diseased tooth pulp is removed. Medication is sometimes put into the root canal to clear any infection. Then the pulp is replaced with a filling. - Tooth extractions. Some teeth become so severely decayed that they can't be restored and must be removed. Having a tooth pulled can leave a gap that allows your other teeth to shift. If possible, consider getting a bridge or a dental implant to replace the missing tooth. ", "role": "user" }, { "content": "Cavities and tooth decay are so common that you may not take them seriously. And you may think that it doesn't matter if children get cavities in their baby teeth. However, cavities and tooth decay can have serious and lasting complications, even for children who don't have their permanent teeth yet.", "role": "assistant" } ]

[ { "content": "Diabetes Type 2 I test before going to bed and the reading is 94 but when I test again in the morning, the reading is 165. How can I lower it? I eat dinner around 8PM and nothing until the next morning.\n\n Type 2 diabetes - what to ask your doctor What to ask your provider about diabetes - type 2 Summary Type 2 diabetes is a lifelong disease that causes a high level of sugar (glucose) in your blood. It can damage your organs. It can also lead to a heart attack or stroke and cause many other health problems. You can do many things to control your symptoms, prevent damage due to diabetes, and make your life better. Below are questions you may want to ask your health care provider to help you take care of your diabetes. Questions Ask your provider to check the nerves, skin, and pulses in your feet. Also ask these questions: How often should I check my feet? What should I do when I check them? What problems should I call my provider about? Who should trim my toenails? Is it OK if I trim them? How should I take care of my feet every day? What type of shoes and socks should I wear? Should I see a foot doctor (podiatrist)? Ask your provider about getting exercise: Before I start, do I need to have my heart checked? My eyes? My feet? What type of exercise program should I do? What type of activities should I avoid? When should I check my blood sugar when I exercise? What should I bring with me when I exercise? Should I eat before or during exercise? Do I need to adjust my medicines when I exercise? When should I next have an eye doctor check my eyes? What eye problems should I call my doctor about? Ask your provider about meeting with a dietitian. Questions for the dietitian may include: What foods increase my blood sugar the most? What foods can help me with my weight loss goals? Ask your provider about your diabetes medicines: When should I take them? What should I do if I miss a dose? Are there any side effects? How often should I check my blood sugar level at home? Should I do it at different times of the day? What is too low? What is too high? What should I do if my blood sugar is too low or too high? Should I get a medical alert bracelet or necklace? Should I have glucagon at home? Ask your provider about symptoms that you are having if they have not been discussed. Tell your provider about blurred vision, skin changes, depression, reactions at injection sites, sexual dysfunction, tooth pain, muscle pain, or nausea. Ask your provider about other tests you may need, such as cholesterol, A1C, and a urine test to check for kidney problems. Ask your provider about vaccinations you should have like the flu shot, hepatitis B, or pneumonia vaccines. How should I take care of my diabetes when I travel? Ask your provider how you should take care of your diabetes when you are sick: What should I eat or drink? How should I take my diabetes medicines? How often should I check my blood sugar? When should I call the provider? Review Date 7/12/2018 Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Ask your provider about symptoms that you are having if they have not been discussed. Your provider will set the target range for your blood sugar, clarify what type of exercise you need and if you need to see a dietitian for discussing healthy eating and weight loss or maintenance goals. Your provider will tell you how often and when you need to check your blood sugar levels, and what to do if they are out of range.", "role": "assistant" } ]

[ { "content": "what are the causes of pulmonary hypertension\n\nPulmonary hypertension (Risk factors): Your risk of developing pulmonary hypertension may be greater if: - You're a young adult, as idiopathic pulmonary arterial hypertension is more common in younger adults - You're overweight - You have a family history of the disease - You have one of various conditions that can increase your risk of developing pulmonary hypertension - You use illegal drugs, such as cocaine - You take certain appetite-suppressant medications - You have an existing risk of developing pulmonary hypertension, such as a family history of the condition, and you live at a high altitude", "role": "user" }, { "content": "Your risk of developing pulmonary hypertension (PH) may be greater if you're a young adult, overweight, have a family history of PH, have a condition that increases the risk of PH, use illegal drugs, or have another existing risk of developing PH.", "role": "assistant" } ]

[ { "content": "Can you mail me patient information about Glaucoma, I was recently diagnosed and want to learn all I can about the disease.\n\nGlaucoma (Symptoms): OPEN-ANGLE GLAUCOMA - Most people have no symptoms. - Once vision loss occurs, the damage is already severe. - Slow loss of side (peripheral) vision (also called tunnel vision). - Advanced glaucoma can lead to blindness. ANGLE-CLOSURE GLAUCOMA Symptoms may come and go at first, or steadily become worse. You may notice: - Sudden, severe pain in one eye - Decreased or cloudy vision, often called \"steamy\" vision - Nausea and vomiting - Rainbow-like halos around lights - Red eye - Eye feels swollen CONGENITAL GLAUCOMA Symptoms are most often noticed when the child is a few months old. - Cloudiness of the front of the eye - Enlargement of one eye or both eyes - Red eye - Sensitivity to light - Tearing SECONDARY GLAUCOMA - Symptoms are most often related to the underlying problem causing the glaucoma. - Depending on the cause, symptoms may either be like open-angle glaucoma or angle-closure glaucoma.", "role": "user" }, { "content": "Most people have no symptoms of open-angle glaucoma, which causes slow loss of side (peripheral) vision. The symptoms of angle-closure glaucoma steadily become worse and include: sudden, severe pain in one eye decreased or cloudy vision, nausea and vomiting, rainbow-like halos around lights, red eye and feeling that the eye is swollen. Symptoms of secondary glaucoma are related to the underlying problem causing it. Depending on the cause, symptoms may be like open-angle glaucoma or angle-closure glaucoma.", "role": "assistant" } ]

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

[ { "content": "what are the causes of pulmonary hypertension\n\nPulmonary hypertension (Risk factors): Your risk of developing pulmonary hypertension may be greater if: - You're a young adult, as idiopathic pulmonary arterial hypertension is more common in younger adults - You're overweight - You have a family history of the disease - You have one of various conditions that can increase your risk of developing pulmonary hypertension - You use illegal drugs, such as cocaine - You take certain appetite-suppressant medications - You have an existing risk of developing pulmonary hypertension, such as a family history of the condition, and you live at a high altitude", "role": "user" }, { "content": "Your risk of developing pulmonary hypertension may be greater for a few reasons. These include if you're a young adult, you're overweight, you have a family history of the disease, you use illegal drugs, you take certain appetite-suppressant medications, you have an existing risk of developing pulmonary hypertension, or you live at a high altitude.", "role": "assistant" } ]

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

[ { "content": "what the treatment for bronchitis\n\nBronchitis: Bronchitis is an inflammation of the lining of your bronchial tubes, which carry air to and from your lungs. People who have bronchitis often cough up thickened mucus, which can be discolored. Bronchitis may be either acute or chronic. Often developing from a cold or other respiratory infection, acute bronchitis is very common. Chronic bronchitis, a more serious condition, is a constant irritation or inflammation of the lining of the bronchial tubes, often due to smoking. Acute bronchitis, also called a chest cold, usually improves within a week to 10 days without lasting effects, although the cough may linger for weeks. However, if you have repeated bouts of bronchitis, you may have chronic bronchitis, which requires medical attention. Chronic bronchitis is one of the conditions included in chronic obstructive pulmonary disease (COPD). For either acute bronchitis or chronic bronchitis, signs and symptoms may include: - Cough - Production of mucus (sputum), which can be clear, white, yellowish-gray or green in color - rarely, it may be streaked with blood - Fatigue - Shortness of breath - Slight fever and chills - Chest discomfort If you have acute bronchitis, you might have cold symptoms, such as a mild headache or body aches. While these symptoms usually improve in about a week, you may have a nagging cough that lingers for several weeks. Chronic bronchitis is defined as a productive cough that lasts at least three months, with recurring bouts occurring for at least two consecutive years. If you have chronic bronchitis, you're likely to have periods when your cough or other symptoms worsen. At those times, you may have an acute infection on top of chronic bronchitis. See your doctor if your cough: - Lasts more than three weeks - Prevents you from sleeping - Is accompanied by fever higher than 100.4 F (38 C) - Produces discolored mucus - Produces blood - Is associated with wheezing or shortness of breath Acute bronchitis is usually caused by viruses, typically the same viruses that cause colds and flu (influenza). Antibiotics don't kill viruses, so this type of medication isn't useful in most cases of bronchitis. The most common cause of chronic bronchitis is cigarette smoking. Air pollution and dust or toxic gases in the environment or workplace also can contribute to the condition. Factors that increase your risk of bronchitis include: - Cigarette smoke. People who smoke or who live with a smoker are at higher risk of both acute bronchitis and chronic bronchitis. - Low resistance. This may result from another acute illness, such as a cold, or from a chronic condition that compromises your immune system. Older adults, infants and young children have greater vulnerability to infection. - Exposure to irritants on the job. Your risk of developing bronchitis is greater if you work around certain lung irritants, such as grains or textiles, or are exposed to chemical fumes. - Gastric reflux. Repeated bouts of severe heartburn can irritate your throat and make you more prone to developing bronchitis. Although a single episode of bronchitis usually isn't cause for concern, it can lead to pneumonia in some people. Repeated bouts of bronchitis, however, may mean that you have chronic obstructive pulmonary disease (COPD). During the first few days of illness, it can be difficult to distinguish the signs and symptoms of bronchitis from those of a common cold. During the physical exam, your doctor will use a stethoscope to listen closely to your lungs as you breathe. In some cases, your doctor may suggest the following tests: - Chest X-ray. A chest X-ray can help determine if you have pneumonia or another condition that may explain your cough. This is especially important if you ever were or currently are a smoker. - Sputum tests. Sputum is the mucus that you cough up from your lungs. It can be tested to see if you have illnesses that could be helped by antibiotics. Sputum can also be tested for signs of allergies. - Pulmonary function test. During a pulmonary function test, you blow into a device called a spirometer, which measures how much air your lungs can hold and how quickly you can get air out of your lungs. This test checks for signs of asthma or emphysema. Most cases of acute bronchitis get better without treatment, usually within a couple of weeks. Medications Because most cases of bronchitis are caused by viral infections, antibiotics aren't effective. However, if your doctor suspects that you have a bacterial infection, he or she may prescribe an antibiotic. In some circumstances, your doctor may recommend other medications, including: - Cough medicine. If your cough keeps you from sleeping, you might try cough suppressants at bedtime. - Other medications. If you have allergies, asthma or chronic obstructive pulmonary disease (COPD), your doctor may recommend an inhaler and other medications to reduce inflammation and open narrowed passages in your lungs. Therapies If you have chronic bronchitis, you may benefit from pulmonary rehabilitation - a breathing exercise program in which a respiratory therapist teaches you how to breathe more easily and increase your ability to exercise. To help you feel better, you may want to try the following self-care measures: - Avoid lung irritants. Don't smoke. Wear a mask when the air is polluted or if you're exposed to irritants, such as paint or household cleaners with strong fumes. - Use a humidifier. Warm, moist air helps relieve coughs and loosens mucus in your airways. But be sure to clean the humidifier according to the manufacturer's recommendations to avoid the growth of bacteria and fungi in the water container. - Consider a face mask outside. If cold air aggravates your cough and causes shortness of breath, put on a cold-air face mask before you go outside.", "role": "user" }, { "content": "Most cases of acute bronchitis get better without treatment, usually within a couple of weeks. ... Because most cases of bronchitis are caused by viral infections, antibiotics aren't effective. However, if your doctor suspects that you have a bacterial infection, he or she may prescribe an antibiotic. In some circumstances, your doctor may recommend other medications, including: - Cough medicine. If your cough keeps you from sleeping, you might try cough suppressants at bedtime. - Other medications. If you have allergies, asthma or chronic obstructive pulmonary disease (COPD), your doctor may recommend an inhaler and other medications to reduce inflammation and open narrowed passages in your lungs. Therapies If you have chronic bronchitis, you may benefit from pulmonary rehabilitation - a breathing exercise program in which a respiratory therapist teaches you how to breathe more easily and increase your ability to exercise. To help you feel better, you may want to try the following self-care measures: - Avoid lung irritants. Don't smoke. Wear a mask when the air is polluted or if you're exposed to irritants, such as paint or household cleaners with strong fumes. - Use a humidifier. Warm, moist air helps relieve coughs and loosens mucus in your airways. But be sure to clean the humidifier according to the manufacturer's recommendations to avoid the growth of bacteria and fungi in the water container. - Consider a face mask outside. If cold air aggravates your cough and causes shortness of breath, put on a cold-air face mask before you go outside.", "role": "assistant" } ]

[ { "content": "how to prevent schizophrenia\n\n Childhood schizophrenia Overview Childhood schizophrenia is an uncommon but severe mental disorder in which children interpret reality abnormally. Schizophrenia involves a range of problems with thinking (cognitive), behavior or emotions. It may result in some combination of hallucinations, delusions, and extremely disordered thinking and behavior that impairs your child's ability to function. Childhood schizophrenia is essentially the same as schizophrenia in adults, but it occurs early in life and has a profound impact on a child's behavior and development. With childhood schizophrenia, the early age of onset presents special challenges for diagnosis, treatment, education, and emotional and social development. Schizophrenia is a chronic condition that requires lifelong treatment. Identifying and starting treatment for childhood schizophrenia as early as possible may significantly improve your child's long-term outcome. Symptoms Schizophrenia involves a range of problems with thinking, behavior or emotions. Signs and symptoms may vary, but usually involve delusions, hallucinations or disorganized speech, and reflect an impaired ability to function. The effect can be disabling. Schizophrenia symptoms generally start in the mid- to late 20s. It's uncommon for children to be diagnosed with schizophrenia. Early-onset schizophrenia occurs before age 18. Very early-onset schizophrenia in children younger than age 13 is extremely rare. Symptoms can vary in type and severity over time, with periods of worsening and remission of symptoms. Some symptoms may always be present. Schizophrenia can be difficult to recognize in the early phases. The earliest indications of childhood schizophrenia may include developmental problems, such as: - Language delays - Late or unusual crawling - Late walking - Other abnormal motor behaviors - for example, rocking or arm flapping Some of these signs and symptoms are also common in children with pervasive developmental disorders, such as autism spectrum disorder. So ruling out these developmental disorders is one of the first steps in diagnosis. Schizophrenia symptoms in teenagers are similar to those in adults, but the condition may be more difficult to recognize in this age group. This may be in part because some of the early symptoms of schizophrenia in teenagers are common for typical development during teen years, such as: - Withdrawal from friends and family - A drop in performance at school - Trouble sleeping - Irritability or depressed mood - Lack of motivation - Strange behavior - Substance use Compared with schizophrenia symptoms in adults, teens may be: - Less likely to have delusions - More likely to have visual hallucinations As children with schizophrenia age, more typical signs and symptoms of the disorder begin to appear. Signs and symptoms may include: - Delusions. These are false beliefs that are not based in reality. For example, you think that you're being harmed or harassed; that certain gestures or comments are directed at you; that you have exceptional ability or fame; that another person is in love with you; or that a major catastrophe is about to occur. Delusions occur in most people with schizophrenia. - Hallucinations. These usually involve seeing or hearing things that don't exist. Yet for the person with schizophrenia, hallucinations have the full force and impact of a normal experience. Hallucinations can be in any of the senses, but hearing voices is the most common hallucination. - Disorganized thinking. Disorganized thinking is inferred from disorganized speech. Effective communication can be impaired, and answers to questions may be partially or completely unrelated. Rarely, speech may include putting together meaningless words that can't be understood, sometimes known as word salad. - Extremely disorganized or abnormal motor behavior. This may show in several ways, from childlike silliness to unpredictable agitation. Behavior is not focused on a goal, which makes it hard to do tasks. Behavior can include resistance to instructions, inappropriate or bizarre posture, a complete lack of response, or useless and excessive movement. - Negative symptoms. This refers to reduced or lack of ability to function normally. For example, the person may neglect personal hygiene or appear to lack emotion -- doesn't make eye contact, doesn't change facial expressions, speaks in a monotone, or doesn't add hand or head movements that normally occur when speaking. Also, the person may have reduced ability to engage in activities, such as a loss of interest in everyday activities, social withdrawal or lack ability to experience pleasure. When childhood schizophrenia begins early in life, symptoms may build up gradually. The early signs and symptoms may be so vague that you can't recognize what's wrong, or you may attribute them to a developmental phase. As time goes on, symptoms may become more severe and more noticeable. Eventually, your child may develop the symptoms of psychosis, including hallucinations, delusions and difficulty organizing thoughts. As thoughts become more disorganized, there's often a \"break from reality\" (psychosis) frequently requiring hospitalization and treatment with medication. When to see a doctor It can be difficult to know how to handle vague behavioral changes in your child. You may be afraid of rushing to conclusions that label your child with a mental illness. Your child's teacher or other school staff may alert you to changes in your child's behavior. Seek medical advice if your child: - Has developmental delays compared with other siblings or peers - Has stopped meeting daily expectations, such as bathing or dressing - No longer wants to socialize - Is slipping in academic performance - Has strange eating rituals - Shows excessive suspicion of others - Shows a lack of emotion or shows emotions inappropriate for the situation - Has strange ideas and fears - Confuses dreams or television for reality - Has bizarre ideas, behavior or speech - Has violent or aggressive behavior or agitation These general signs and symptoms don't necessarily mean your child has childhood schizophrenia. These could indicate a phase, another mental health disorder such as depression or an anxiety disorder, or a medical condition. Seek medical care as soon as possible if you have concerns about your child's behavior or development. Suicidal thoughts and behavior are common among people with schizophrenia. If you have a child or teen who is in danger of attempting suicide or has made a suicide attempt, make sure someone stays with him or her. Call 911 or your local emergency number immediately. Or if you think you can do so safely, take your child to the nearest hospital emergency room. Causes It's not known what causes childhood schizophrenia, but it's thought that it develops in the same way as adult schizophrenia does. Researchers believe that a combination of genetics, brain chemistry and environment contributes to development of the disorder. It's not clear why schizophrenia starts so early in life for some and not for others. Problems with certain naturally occurring brain chemicals, including neurotransmitters called dopamine and glutamate, may contribute to schizophrenia. Neuroimaging studies show differences in the brain structure and central nervous system of people with schizophrenia. While researchers aren't certain about the significance of these changes, they indicate that schizophrenia is a brain disease. Risk factors Although the precise cause of schizophrenia isn't known, certain factors seem to increase the risk of developing or triggering schizophrenia, including: - Having a family history of schizophrenia - Increased immune system activation, such as from inflammation or autoimmune diseases - Older age of the father - Some pregnancy and birth complications, such as malnutrition or exposure to toxins or viruses that may impact brain development - Taking mind-altering (psychoactive or psychoactive) drugs during teen years Complications Left untreated, childhood schizophrenia can result in severe emotional, behavioral and health problems. Complications associated with schizophrenia may occur in childhood or later, such as: - Suicide, suicide attempts and thoughts of suicide - Self-injury - Anxiety disorders, panic disorders and obsessive-compulsive disorder (OCD) - Depression - Abuse of alcohol or other drugs, including tobacco - Family conflicts - Inability to live independently, attend school or work - Social isolation - Health and medical problems - Being victimized - Legal and financial problems, and homelessness - Aggressive behavior, although uncommon Diagnosis Diagnosis of childhood schizophrenia involves ruling out other mental health disorders and determining that symptoms aren't due to substance abuse, medication or a medical condition. The process of diagnosis may involve: - Physical exam. This may be done to help rule out other problems that could be causing symptoms and to check for any related complications. - Tests and screenings. These may include tests that help rule out conditions with similar symptoms, and screening for alcohol and drugs. The doctor may also request imaging studies, such as an MRI or CT scan. - Psychological evaluation. This includes observing appearance and demeanor, asking about thoughts, feelings and behavior patterns, including any thoughts of self-harm or harming others, evaluating ability to think and function at an age-appropriate level, and assessing mood, anxiety and possible psychotic symptoms. This also includes a discussion of family and personal history. - Diagnostic criteria for schizophrenia. Your doctor or mental health professional may use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. Diagnostic criteria for childhood schizophrenia are generally the same as for adult schizophrenia. Challenging process The path to diagnosing childhood schizophrenia can sometimes be long and challenging. In part, this is because other conditions, such as depression or bipolar disorder, can have similar symptoms. A child psychiatrist may want to monitor your child's behaviors, perceptions and thinking patterns for six months or more. As thinking and behavior patterns and signs and symptoms become clearer over time, a diagnosis of schizophrenia may be made. In some cases, a psychiatrist may recommend starting medications before an official diagnosis is made. This is especially important for symptoms of aggression or self-injury. Some medications can help limit these types of behavior and restore a sense of normalcy. Treatment Schizophrenia in children requires lifelong treatment, even during periods when symptoms seem to go away. Treatment is a particular challenge for children with schizophrenia. Treatment team Childhood schizophrenia treatment is usually guided by a child psychiatrist experienced in treating schizophrenia. The team approach may be available in clinics with expertise in schizophrenia treatment. The team may include, for example, your: - Psychiatrist, psychologist or other therapist - Psychiatric nurse - Social worker - Family members - Pharmacist - Case manager to coordinate care Main treatment options The main treatments for childhood schizophrenia are: - Medications - Psychotherapy - Life skills training - Hospitalization Medications Most of the antipsychotics used in children are the same as those used for adults with schizophrenia. Antipsychotic drugs are often effective at managing symptoms such as delusions, hallucinations, loss of motivation and lack of emotion. In general, the goal of treatment with antipsychotics is to effectively manage symptoms at the lowest possible dose. Over time, your child's doctor may try combinations, different medications or different doses. Depending on the symptoms, other medications also may help, such as antidepressants or anti-anxiety drugs. It can take several weeks after starting a medication to notice an improvement in symptoms. Second-generation antipsychotics Newer, second-generation medications are generally preferred because they have fewer side effects than do first-generation antipsychotics. However, they can cause weight gain, high blood sugar, high cholesterol and heart disease. Examples of second-generation antipsychotics approved by the Food and Drug Administration (FDA) to treat schizophrenia in teenagers age 13 and older include: - Aripiprazole (Abilify) - Olanzapine (Zyprexa) - Quetiapine (Seroquel) - Risperidone (Risperdal) Paliperidone (Invega) is FDA-approved for children 12 years of age and older. First-generation antipsychotics These first-generation medications are usually as effective as second-generation antipsychotics in controlling delusions and hallucinations. In addition to having side effects similar to those of second-generation antipsychotics, first-generation antipsychotics also may have frequent and potentially significant neurological side effects. These can include the possibility of developing a movement disorder (tardive dyskinesia) that may or may not be reversible. Because of the increased risk of serious side effects with first-generation antipsychotics, they often aren't recommended for use in children until other options have been tried without success. Examples of first-generation antipsychotics approved by the FDA to treat schizophrenia in children and teens include: - Chlorpromazine for children 13 and older - Haloperidol for children 3 years and older - Perphenazine for children 12 years and older First-generation antipsychotics are often cheaper than second-generation antipsychotics, especially the generic versions, which can be an important consideration when long-term treatment is necessary. Medication side effects and risks All antipsychotic medications have side effects and possible health risks, some life-threatening. Side effects in children and teenagers may not be the same as those in adults, and sometimes they may be more serious. Children, especially very young children, may not have the capacity to understand or communicate about medication problems. Talk to your child's doctor about possible side effects and how to manage them. Be alert for problems in your child, and report side effects to the doctor as soon as possible. The doctor may be able to adjust the dose or change medications and limit side effects. Also, antipsychotic medications can have dangerous interactions with other substances. Tell your child's doctor about all medications and over-the-counter products your child takes, including vitamins, minerals and herbal supplements. Psychotherapy In addition to medication, psychotherapy, sometimes called talk therapy, can help manage symptoms and help you and your child cope with the disorder. Psychotherapy may include: - Individual therapy. Psychotherapy, such as cognitive behavioral therapy, with a skilled mental health professional can help your child learn ways to deal with the stress and daily life challenges brought on by schizophrenia. Therapy can help reduce symptoms and help your child make friends and succeed at school. Learning about schizophrenia can help your child understand the condition, cope with symptoms and stick to a treatment plan. - Family therapy. Your child and your family may benefit from therapy that provides support and education to families. Involved, caring family members who understand childhood schizophrenia can be extremely helpful to children living with this condition. Family therapy can also help you and your family to improve communication, work out conflicts and cope with stress related to your child's condition. Life skills training Treatment plans that include building life skills can help your child function at age-appropriate levels when possible. Skills training may include: - Social and academic skills training. Training in social and academic skills is an important part of treatment for childhood schizophrenia. Children with schizophrenia often have troubled relationships and school problems. They may have difficulty carrying out normal daily tasks, such as bathing or dressing. - Vocational rehabilitation and supported employment. This focuses on helping people with schizophrenia prepare for, find and keep jobs. Hospitalization During crisis periods or times of severe symptoms, hospitalization may be necessary. This can help ensure your child's safety and make sure that he or she is getting proper nutrition, sleep and hygiene. Sometimes the hospital setting is the safest and best way to get symptoms under control quickly. Partial hospitalization and residential care may be options, but severe symptoms are usually stabilized in the hospital before moving to these levels of care. Lifestyle and home remedies Although childhood schizophrenia requires professional treatment, it's critical to be an active participant in your child's care. Here are ways to get the most out of the treatment plan. - Follow directions for medications. Try to make sure that your child takes medications as prescribed, even if he or she is feeling well and has no current symptoms. If medications are stopped or taken infrequently, the symptoms are likely to come back and your doctor will have a hard time knowing what the best and safest dose is. - Check first before taking other medications. Contact the doctor who's treating your child for schizophrenia before your child takes medications prescribed by another doctor or before taking any over-the-counter medications, vitamins, minerals, herbs or other supplements. These can interact with schizophrenia medications. - Pay attention to warning signs. You and your child may have identified things that may trigger symptoms, cause a relapse or prevent your child from carrying out daily activities. Make a plan so that you know what to do if symptoms return. Contact your child's doctor or therapist if you notice any changes in symptoms, to prevent the situation from worsening. - Make physical activity and healthy eating a priority. Some medications for schizophrenia are associated with an increased risk of weight gain and high cholesterol in children. Work with your child's doctor to make a nutrition and physical activity plan for your child that will help manage weight and benefit heart health. - Avoid alcohol, street drugs and tobacco. Alcohol, street drugs and tobacco can worsen schizophrenia symptoms or interfere with antipsychotic medications. Talk to your child about avoiding drugs and alcohol and not smoking. If necessary, get appropriate treatment for a substance use problem. ", "role": "user" }, { "content": "Childhood schizophrenia (Lifestyle and home remedies): Although childhood schizophrenia requires professional treatment, it's critical to be an active participant in your child's care. Contact the doctor who's treating your child for schizophrenia before your child takes medications prescribed by another doctor or before taking any over-the-counter medications, vitamins, minerals, herbs or other supplements.", "role": "assistant" } ]

[ { "content": "what are the causes of pulmonary hypertension\n\nPulmonary Hypertension (Types): The World Health Organization divides pulmonary hypertension (PH) into five groups. These groups are organized based on the cause of the condition. In all groups, the average pressure in the pulmonary arteries is higher than 25 mmHg at rest or 30 mmHg during physical activity. The pressure in normal pulmonary arteries is 8–20 mmHg at rest. (Note that group 1 is called pulmonary arterial hypertension (PAH) and groups 2 through 5 are called pulmonary hypertension. However, together all groups are called pulmonary hypertension.) Group 1 Pulmonary Arterial Hypertension Group 1 PAH includes: PAH that has no known cause. PAH that's inherited (passed from parents to children through genes). PAH that's caused by drugs or toxins, such as street drugs and certain diet medicines. PAH that's caused by conditions such as: - Connective tissue diseases. (Connective tissue helps support all parts of your body, including your skin, eyes, and heart.) - HIV infection. - Liver disease. - Congenital heart disease. This is heart disease that's present at birth. - Sickle cell disease. - Schistosomiasis (SKIS-toe-so-MI-ah-sis). This is an infection caused by a parasite. Schistosomiasis is one of the most common causes of PAH in many parts of the world. Connective tissue diseases. (Connective tissue helps support all parts of your body, including your skin, eyes, and heart.) HIV infection. Liver disease. Congenital heart disease. This is heart disease that's present at birth. Sickle cell disease. Schistosomiasis (SKIS-toe-so-MI-ah-sis). This is an infection caused by a parasite. Schistosomiasis is one of the most common causes of PAH in many parts of the world. PAH that's caused by conditions that affect the veins and small blood vessels of the lungs. Group 2 Pulmonary Hypertension Group 2 includes PH with left heart disease. Conditions that affect the left side of the heart, such as mitral valve disease or long-term high blood pressure, can cause left heart disease and PH. Left heart disease is likely the most common cause of PH. Group 3 Pulmonary Hypertension Group 3 includes PH associated with lung diseases, such as COPD (chronic obstructive pulmonary disease) and interstitial (IN-ter-STISH-al) lung diseases. Interstitial lung diseases cause scarring of the lung tissue. Group 3 also includes PH associated with sleep-related breathing disorders, such as sleep apnea. Group 4 Pulmonary Hypertension Group 4 includes PH caused by blood clots in the lungs or blood clotting disorders. Group 5 Pulmonary Hypertension Group 5 includes PH caused by various other diseases or conditions. Examples include: Blood disorders, such as polycythemia vera (POL-e-si-THE-me-ah VAY-rah or VE-rah) and essential thrombocythemia (THROM-bo-si-THE-me-ah). Systemic disorders, such as sarcoidosis (sar-koy-DO-sis) and vasculitis (vas-kyu-LI-tis). Systemic disorders involve many of the body's organs. Metabolic disorders, such as thyroid disease and glycogen storage disease. (In glycogen storage disease, the body's cells don't use a form of glucose (sugar) properly.) Other conditions, such as tumors that press on the pulmonary arteries and kidney disease.", "role": "user" }, { "content": "The World Health Organization divides pulmonary hypertension (PH) into five groups. These groups are organized based on the cause of the condition. In all groups, the average pressure in the pulmonary arteries is higher than 25 mmHg at rest or 30 mmHg during physical activity. For example group 1 PAH includes PAH that has no known cause. Group 2 includes PH with left heart disease. Group 3 includes PH associated with lung diseases, such as COPD (chronic obstructive pulmonary disease) and interstitial (IN-ter-STISH-al) lung diseases. Group 4 includes PH caused by blood clots in the lungs or blood clotting disorders. Group 5 includes PH caused by various other diseases or conditions.", "role": "assistant" } ]

[ { "content": "Can you mail me patient information about Glaucoma, I was recently diagnosed and want to learn all I can about the disease.\n\n Glaucoma Open-angle glaucoma Chronic glaucoma Chronic open-angle glaucoma Primary open-angle glaucoma Closed-angle glaucoma Narrow-angle glaucoma Angle-closure glaucoma Acute glaucoma Secondary glaucoma Congenital glaucoma Vision loss - glaucoma Summary 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 </div> </div> Causes Glaucoma is the second most common cause of blindness in the United States. There are four major types of glaucoma: Open-angle glaucoma Angle-closure glaucoma, also called closed-angle glaucoma Congenital glaucoma Secondary glaucoma The front part of the eye is filled with a clear fluid called aqueous humor. This fluid is made in an area behind the colored part of the eye (iris). It leaves the eye through channels where the iris and cornea meet. This area is called the anterior chamber angle, or the angle. The cornea is the clear covering on the front of the eye that covers the iris, pupil, and angle. Anything that slows or blocks the flow of this fluid will cause pressure to build up in the eye. In open-angle glaucoma, the increase in pressure is often small and slow. In closed-angle glaucoma, the increase is often high and sudden. Either type can damage the optic nerve. <strong>Open-angle glaucoma</strong> is the most common type of glaucoma. The cause is unknown. The increase in eye pressure happens slowly over time. You cannot feel it. The increased pressure pushes on the optic nerve. Damage to the optic nerve causes blind spots in your vision. Open-angle glaucoma tends to run in families. Your risk is higher if you have a parent or grandparent with open-angle glaucoma. People of African descent are also at higher risk for this disease. <strong>Closed-angle glaucoma</strong> occurs when the fluid is suddenly blocked and cannot flow out of the eye. This causes a quick, severe rise in eye pressure. Dilating eye drops and certain medicines may trigger an acute glaucoma attack. Closed-angle glaucoma is an emergency. If you have had acute glaucoma in one eye, you are at risk for it in the second eye. Your health care provider is likely to treat your second eye to prevent a first attack in that eye. <strong>Secondary glaucoma</strong> occurs due to a known cause. Both open- and closed-angle glaucoma can be secondary when caused by something known. Causes include: Drugs such as corticosteroids Eye diseases such as uveitis (an infection of the middle layer of the eye) Diseases such as diabetes Eye injury <strong>Congenital glaucoma</strong> occurs in babies. It often runs in families. It is present at birth. It is caused when the eye does not develop normally. Symptoms OPEN-ANGLE GLAUCOMA Most people have no symptoms. Once you are aware of vision loss, the damage is already severe. Slow loss of side (peripheral) vision (also called tunnel vision). Advanced glaucoma can lead to blindness. ANGLE-CLOSURE GLAUCOMA Symptoms may come and go at first, or steadily become worse. You may notice: Sudden, severe pain in one eye Decreased or cloudy vision, often called \"steamy\" vision Nausea and vomiting Rainbow-like halos around lights Red eye Eye feels swollen CONGENITAL GLAUCOMA Symptoms are most often noticed when the child is a few months old. Cloudiness of the front of the eye Enlargement of one eye or both eyes Red eye Sensitivity to light Tearing SECONDARY GLAUCOMA Symptoms are most often related to the underlying problem causing the glaucoma. Depending on the cause, symptoms may either be like open-angle glaucoma or angle-closure glaucoma. Exams and Tests The only way to diagnose glaucoma is by having a complete eye exam. You will be given a test to check your eye pressure. This is called tonometry. In most cases, you will be given eye drops to widen (dilate) your pupil. When your pupil is dilated, your eye doctor will look at the inside of your eye and the optic nerve. Eye pressure is different at different times of the day. Eye pressure can even be normal in some people with glaucoma. So you will need other tests to confirm glaucoma. They may include: Using a special lens to look at the angle of the eye (gonioscopy). Photographs or laser scanning images of the inside of your eye (optic nerve imaging). Laser scanning images of the angle of the eye. Checking your retina -- The retina is the light-sensitive tissue at the back of your eye. Checking how your pupil responds to light (pupillary reflex response). 3-D view of your eye (slit lamp examination). Testing the clearness of your vision (visual acuity). Testing your field of vision (visual field measurement). Treatment The goal of treatment is to reduce your eye pressure. Treatment depends on the type of glaucoma that you have. OPEN-ANGLE GLAUCOMA If you have open-angle glaucoma, you will probably be given eye drops. You may need more than one type. Most people can be treated with eye drops. Most of the eye drops used today have fewer side effects than those used in the past. You also may be given pills to lower pressure in the eye. If drops alone do not work, you may need other treatment: Laser treatment uses a painless laser to open the channels where fluid flows out. If drops and laser treatment do not work, you may need surgery. The doctor will open a new channel so fluid can escape. This will help lower your pressure. Recently, new implants have been developed that can help treat glaucoma in people having cataract surgery. ACUTE ANGLE GLAUCOMA An acute angle-closure attack is a medical emergency. You can become blind in a few days if you are not treated. You may be given drops, pills, and medicine given through a vein (by IV) to lower your eye pressure. Some people also need an emergency operation, called an iridotomy. The doctor uses a laser to open a new channel in the iris. Sometimes this is done with surgery. The new channel relieves the attack and will prevent another attack. To help prevent an attack in the other eye, the procedure will often be performed on the other eye. This may be done even if it has never had an attack. CONGENITAL GLAUCOMA Congenital glaucoma is almost always treated with surgery. This is done using general anesthesia. This means the child is asleep and feels no pain. SECONDARY GLAUCOMA If you have secondary glaucoma, treating the cause may help your symptoms go away. Other treatments also may be needed. Outlook (Prognosis) Open-angle glaucoma cannot be cured. You can manage it and keep your sight by following your provider's directions. Closed-angle glaucoma is a medical emergency. You need treatment right away to save your vision. Babies with congenital glaucoma usually do well when surgery is done early. How you do with secondary glaucoma depends on what is causing the condition. When to Contact a Medical Professional If you have severe eye pain or a sudden loss of vision, get immediate medical help. These may be signs of closed-angle glaucoma. Prevention You cannot prevent open-angle glaucoma. Most people have no symptoms. But you can help prevent vision loss. A complete eye exam can help find open-angle glaucoma early, when it is easier to treat. All adults should have a complete eye exam by the age of 40. If you are at risk for glaucoma, you should have a complete eye exam sooner than age 40. You should have regular eye exams as recommended by your provider. If you are at risk for closed-angle glaucoma, your provider may recommend treatment before you have an attack to help prevent eye damage and vision loss. Review Date 2/19/2018 Updated by: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "OPEN-ANGLE GLAUCOMA - Most people have no symptoms. - Once vision loss occurs, the damage is already severe. - Slow loss of side (peripheral) vision (also called tunnel vision). - Advanced glaucoma can lead to blindness. ANGLE-CLOSURE GLAUCOMA Symptoms may come and go at first, or steadily become worse. You may notice: - Sudden, severe pain in one eye - Decreased or cloudy vision, often called \"steamy\" vision - Nausea and vomiting - Rainbow-like halos around lights - Red eye - Eye feels swollen .. SECONDARY GLAUCOMA - Symptoms are most often related to the underlying problem causing the glaucoma. - Depending on the cause, symptoms may either be like open-angle glaucoma or angle-closure glaucoma.", "role": "assistant" } ]

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

[ { "content": "I'm a 72 year old female, and have diverticulosis,gastritis, and esophagitis. I tried to see three different doctors today, but all were booked. I honestly don't know what to do. It hurts in my chest, and I can hardly talk.\n\n Gastritis What is gastritis? Gastritis is a condition in which the stomach lining-known as the mucosa-is inflamed, or swollen. The stomach lining contains glands that produce stomach acid and an enzyme called pepsin. The stomach acid breaks down food and pepsin digests protein. A thick layer of mucus coats the stomach lining and helps prevent the acidic digestive juice from dissolving the stomach tissue. When the stomach lining is inflamed, it produces less acid and fewer enzymes. However, the stomach lining also produces less mucus and other substances that normally protect the stomach lining from acidic digestive juice.Gastritis may be acute or chronic:Acute gastritis starts suddenly and lasts for a short time. Chronic gastritis is long lasting. If chronic gastritis is not treated, it may last for years or even a lifetime.Gastritis can be erosive or nonerosive:Erosive gastritis can cause the stomach lining to wear away, causing erosions-shallow breaks in the stomach lining-or ulcers-deep sores in the stomach lining. Nonerosive gastritis causes inflammation in the stomach lining; however, erosions or ulcers do not accompany nonerosive gastritis.A health care provider may refer a person with gastritis to a gastroenterologist-a doctor who specializes in digestive diseases. What causes gastritis? Common causes of gastritis includeHelicobacter pylori (H. pylori) infection damage to the stomach lining, which leads to reactive gastritis an autoimmune responseH. pylori infection. H. pylori is a type of bacteria-organisms that may cause an infection. H. pylori infectioncauses most cases of gastritis typically causes nonerosive gastritis may cause acute or chronic gastritisH. pylori infection is common, particularly in developing countries, and the infection often begins in childhood. Many people who are infected with H. pylori never have any symptoms. Adults are more likely to show symptoms when symptoms do occur.Researchers are not sure how the H. pylori infection spreads, although they think contaminated food, water, or eating utensils may transmit the bacteria. Some infected people have H. pylori in their saliva, which suggests that infection can spread through direct contact with saliva or other body fluids.Damage to the stomach lining, which leads to reactive gastritis. Some people who have damage to the stomach lining can develop reactive gastritis.Reactive gastritismay be acute or chronic may cause erosions may cause little or no inflammationReactive gastritis may also be called reactive gastropathy when it causes little or no inflammation.The causes of reactive gastritis may includenonsteroidal anti-inflammatory drugs (NSAIDs), a type of over-the-counter medication. Aspirin and ibuprofen are common types of NSAIDs. drinking alcohol. using cocaine. exposure to radiation or having radiation treatments. reflux of bile from the small intestine into the stomach. Bile reflux may occur in people who have had part of their stomach removed. a reaction to stress caused by traumatic injuries, critical illness, severe burns, and major surgery. This type of reactive gastritis is called stress gastritis.An autoimmune response. In autoimmune gastritis, the immune system attacks healthy cells in the stomach lining. The immune system normally protects people from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances. Autoimmune gastritis is chronic and typically nonerosive.Less common causes of gastritis may includeCrohn's disease, which causes inflammation and irritation of any part of the gastrointestinal (GI) tract. sarcoidosis, a disease that causes inflammation that will not go away. The chronic inflammation causes tiny clumps of abnormal tissue to form in various organs in the body. The disease typically starts in the lungs, skin, and lymph nodes. allergies to food, such as cow's milk and soy, especially in children. infections with viruses, parasites, fungi, and bacteria other than H. pylori, typically in people with weakened immune systems. What are the signs and symptoms of gastritis? Some people who have gastritis have pain or discomfort in the upper part of the abdomen-the area between the chest and hips. However, many people with gastritis do not have any signs and symptoms. The relationship between gastritis and a person's symptoms is not clear. The term \"gastritis\" is sometimes mistakenly used to describe any symptoms of pain or discomfort in the upper abdomen.When symptoms are present, they may includeupper abdominal discomfort or pain nausea vomitingSeek Help for Symptoms of Bleeding in the Stomach Erosive gastritis may cause ulcers or erosions in the stomach lining that can bleed. Signs and symptoms of bleeding in the stomach include shortness of breath dizziness or feeling faint red blood in vomit black, tarry stools red blood in the stool weakness paleness A person with any signs or symptoms of bleeding in the stomach should call or see a health care provider right away. What are the complications of chronic and acute gastritis? The complications of chronic gastritis may includepeptic ulcers. Peptic ulcers are sores involving the lining of the stomach or duodenum, the first part of the small intestine. NSAID use and H. pylori gastritis increase the chance of developing peptic ulcers. atrophic gastritis. Atrophic gastritis happens when chronic inflammation of the stomach lining causes the loss of the stomach lining and glands. Chronic gastritis can progress to atrophic gastritis. anemia. Erosive gastritis can cause chronic bleeding in the stomach, and the blood loss can lead to anemia. Anemia is a condition in which red blood cells are fewer or smaller than normal, which prevents the body's cells from getting enough oxygen. Red blood cells contain hemoglobin, an iron-rich protein that gives blood its red color and enables the red blood cells to transport oxygen from the lungs to the tissues of the body. Research suggests that H. pylori gastritis and autoimmune atrophic gastritis can interfere with the body's ability to absorb iron from food, which may also cause anemia. vitamin B12 deficiency and pernicious anemia. People with autoimmune atrophic gastritis do not produce enough intrinsic factor. Intrinsic factor is a protein made in the stomach and helps the intestines absorb vitamin B12. The body needs vitamin B12 to make red blood cells and nerve cells. Poor absorption of vitamin B12 may lead to a type of anemia called pernicious anemia. growths in the stomach lining. Chronic gastritis increases the chance of developing benign, or noncancerous, and malignant, or cancerous, growths in the stomach lining. Chronic H. pylori gastritis increases the chance of developing a type of cancer called gastric mucosa-associated lymphoid tissue (MALT) lymphoma. Read more about MALT lymphoma and gastric cancer at www.cancer.gov.In most cases, acute gastritis does not lead to complications. In rare cases, acute stress gastritis can cause severe bleeding that can be life threatening. How is gastritis diagnosed? A health care provider diagnoses gastritis based on the following:medical history physical exam upper GI endoscopy other testsMedical HistoryTaking a medical history may help the health care provider diagnose gastritis. He or she will ask the patient to provide a medical history. The history may include questions about chronic symptoms and travel to developing countries.Physical ExamA physical exam may help diagnose gastritis. During a physical exam, a health care provider usuallyexamines a patient's body uses a stethoscope to listen to sounds in the abdomen taps on the abdomen checking for tenderness or painUpper Gastrointestinal EndoscopyUpper GI endoscopy is a procedure that uses an endoscope-a small, flexible camera with a light-to see the upper GI tract. A health care provider performs the test at a hospital or an outpatient center. The health care provider carefully feeds the endoscope down the esophagus and into the stomach and duodenum. The small camera built into the endoscope transmits a video image to a monitor, allowing close examination of the GI lining. A health care provider may give a patient a liquid anesthetic to gargle or may spray anesthetic on the back of the patient's throat before inserting the endoscope. A health care provider will place an intravenous (IV) needle in a vein in the arm to administer sedation. Sedatives help patients stay relaxed and comfortable. The test may show signs of inflammation or erosions in the stomach lining.The health care provider can use tiny tools passed through the endoscope to perform biopsies. A biopsy is a procedure that involves taking a piece of tissue for examination with a microscope by a pathologist-a doctor who specializes in examining tissues to diagnose diseases. A health care provider may use the biopsy to diagnose gastritis, find the cause of gastritis, and find out if chronic gastritis has progressed to atrophic gastritis.Other TestsA health care provider may have a patient complete other tests to identify the cause of gastritis or any complications. These tests may include the following:Upper GI series. Upper GI series is an x-ray exam that provides a look at the shape of the upper GI tract. An x-ray technician performs this test at a hospital or an outpatient center, and a radiologist-a doctor who specializes in medical imaging-interprets the images. This test does not require anesthesia. A patient should not eat or drink before the procedure, as directed by the health care provider. Patients should check with their health care provider about what to do to prepare for an upper GI series. During the procedure, the patient will stand or sit in front of an x-ray machine and drink barium, a chalky liquid. Barium coats the esophagus, stomach, and small intestine so the radiologist and health care provider can see these organs' shapes more clearly on x-rays. A patient may experience bloating and nausea for a short time after the test. For several days afterward, barium liquid in the GI tract may cause white or light-colored stools. A health care provider will give the patient specific instructions about eating and drinking after the test. Blood tests. A health care provider may use blood tests to check for anemia or H. pylori. A health care provider draws a blood sample during an office visit or at a commercial facility and sends the sample to a lab for analysis. Stool test. A health care provider may use a stool test to check for blood in the stool, another sign of bleeding in the stomach, and for H. pylori infection. A stool test is an analysis of a sample of stool. The health care provider will give the patient a container for catching and storing the stool. The patient returns the sample to the health care provider or a commercial facility that will send the sample to a lab for analysis. Urea breath test. A health care provider may use a urea breath test to check for H. pylori infection. The patient swallows a capsule, liquid, or pudding that contains urea-a waste product the body produces as it breaks down protein. The urea is \"labeled\" with a special carbon atom. If H. pylori are present, the bacteria will convert the urea into carbon dioxide. After a few minutes, the patient breathes into a container, exhaling carbon dioxide. A nurse or technician will perform this test at a health care provider's office or a commercial facility and send the samples to a lab. If the test detects the labeled carbon atoms in the exhaled breath, the health care provider will confirm an H. pylori infection in the GI tract. How is gastritis treated? Health care providers treat gastritis with medications toreduce the amount of acid in the stomach treat the underlying causeReduce the Amount of Acid in the StomachThe stomach lining of a person with gastritis may have less protection from acidic digestive juice. Reducing acid can promote healing of the stomach lining. Medications that reduce acid includeantacids, such as Alka-Seltzer, Maalox, Mylanta, Rolaids, and Riopan. Many brands use different combinations of three basic salts-magnesium, aluminum, and calcium-along with hydroxide or bicarbonate ions to neutralize stomach acid. Antacids, however, can have side effects. Magnesium salt can lead to diarrhea, and aluminum salt can cause constipation. Magnesium and aluminum salts are often combined in a single product to balance these effects. Calcium carbonate antacids, such as Tums, Titralac, and Alka-2, can cause constipation. H2 blockers, such as cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR), and ranitidine (Zantac 75). H2 blockers decrease acid production. They are available in both over-the-counter and prescription strengths. proton pump inhibitors (PPIs) include omeprazole (Prilosec, Zegerid), lansoprazole (Prevacid), dexlansoprazole (Dexilant), pantoprazole (Protonix), rabeprazole (AcipHex), and esomeprazole (Nexium). PPIs decrease acid production more effectively than H2 blockers. All of these medications are available by prescription. Omeprazole and lansoprazole are also available in over-the-counter strength.Treat the Underlying CauseDepending on the cause of gastritis, a health care provider may recommend additional treatments.Treating H. pylori infection with antibiotics is important, even if a person does not have symptoms from the infection. Curing the infection often cures the gastritis and decreases the chance of developing complications, such as peptic ulcer disease, MALT lymphoma, and gastric cancer. Avoiding the cause of reactive gastritis can provide some people with a cure. For example, if prolonged NSAID use is the cause of the gastritis, a health care provider may advise the patient to stop taking the NSAIDs, reduce the dose, or change pain medications. Health care providers may prescribe medications to prevent or treat stress gastritis in a patient who is critically ill or injured. Medications to protect the stomach lining include sucralfate (Carafate), H2 blockers, and PPIs. Treating the underlying illness or injury most often cures stress gastritis. Health care providers may treat people with pernicious anemia due to autoimmune atrophic gastritis with vitamin B12 injections. How can gastritis be prevented? People may be able to reduce their chances of getting gastritis by preventing H. pylori infection. No one knows for sure how H. pylori infection spreads, so prevention is difficult. To help prevent infection, health care providers advise people towash their hands with soap and water after using the bathroom and before eating eat food that has been washed well and cooked properly drink water from a clean, safe source Eating, Diet, and Nutrition Researchers have not found that eating, diet, and nutrition play a major role in causing or preventing gastritis. Gastritis The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.What are clinical trials, and are they right for you?Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.What clinical trials are open?Clinical trials that are currently open and are recruiting can be viewed at www.ClinicalTrials.gov. ", "role": "user" }, { "content": "Your doctor will treat gastritis with medications to reduce the amount of acid in the stomach and treat the underlying cause.", "role": "assistant" } ]

[ { "content": "what is the cause of ocd\n\nObsessive-compulsive disorder (OCD) (Causes): The cause of obsessive-compulsive disorder isn't fully understood. Main theories include: - Biology. OCD may be a result of changes in your body's own natural chemistry or brain functions. - Genetics. OCD may have a genetic component, but specific genes have yet to be identified. - Environment. Some environmental factors such as infections are suggested as a trigger for OCD, but more research is needed.", "role": "user" }, { "content": "The cause of obsessive-compulsive disorder isn't fully understood. Main theories include: - Biology. OCD may be a result of changes in your body's own natural chemistry or brain functions. - Genetics. OCD may have a genetic component, but specific genes have yet to be identified. - Environment. Some environmental factors such as infections are suggested as a trigger for OCD", "role": "assistant" } ]

[ { "content": "symptoms of dehydration 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?\n\nDehydration: Dehydration occurs when your body does not have as much water and fluids as it should. Dehydration can be mild, moderate, or severe, based on how much of your body's fluid is lost or not replaced. Severe dehydration is a life-threatening emergency. You can become dehydrated if you lose too much fluid, do not drink enough water or fluids, or both. Your body may lose a lot of fluid from: - Sweating too much, for example, from exercising in hot weather - Fever - Vomiting or diarrhea - Urinating too much (uncontrolled diabetes or some medications, like diuretics, can cause you to urinate a lot) You might not drink enough fluids because: - You do not feel like eating or drinking because you are sick - You are nauseated - You have a sore throat or mouth sores Older adults and people with certain diseases, such as diabetes, are also at higher risk for dehydration. 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 Your health care provider will look for these signs of dehydration: - Low blood pressure - Blood pressure that drops when you stand up after lying down - White finger tips that do not return to a pink color after your doctor presses the fingertip - Skin that is not as elastic as normal. When the provider pinches it into a fold, it may slowly sag back into place. Normally, skin springs back right away. - Rapid heart rate Your doctor may do lab tests: - Blood tests to check kidney function - Urine tests to see what may be causing dehydration - Other tests to see what may be causing dehydration (blood sugar test for diabetes) To treat dehydration: - Try sipping water or sucking on ice cubes. - Try drinking water or sports drinks that contain electrolytes. - Do not take salt tablets. They can cause serious complications. - Ask your provider what you should eat if you have diarrhea. For more severe dehydration or heat emergency, you may need to stay in a hospital and receive fluid through a vein (IV). The provider will also treat the cause of the dehydration. Dehydration caused by a stomach virus should get better on its own after a few days. If you notice signs of dehydration and treat it quickly, you should recover completely. Untreated severe dehydration may cause: - Death - Permanent brain damage - Seizures You should call 911 if: - The person loses consciousness at any time. - There is any other change in the person's alertness (for example, confusion or seizures). - The person has a fever over 102°F (38.8°C). - You notice symptoms of heatstroke (such as rapid pulse or rapid breathing). - The person's condition does not improve or gets worse despite treatment. To prevent dehydration: - Drink plenty of fluids every day, even when you are well. Drink more when the weather is hot or you are exercising. - If anyone in your family is ill, pay attention to how much they are able to drink. Pay close attention to children and older adults. - Anyone with a fever, vomiting, or diarrhea should drink plenty of fluids. DO NOT wait for signs of dehydration. - If you think you or someone in your family may become dehydrated, call your provider. Do this before the person becomes dehydrated. Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.", "role": "user" }, { "content": "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", "role": "assistant" } ]

[ { "content": "what are the causes of headaches\n\nSex headaches (Causes): Any type of sexual activity that leads to orgasm can trigger sex headaches. Abrupt-onset and slow-to-build sex headaches can be primary headache disorders not associated with any underlying condition. Sex headaches that come on suddenly are more likely to be associated with: - A widening or bubble in the wall of an artery inside your head (intracranial aneurysm) - An abnormal connection between arteries and veins in the brain (arteriovenous malformation) that bleeds into the spinal fluid-filled space in and around the brain - Bleeding into the wall of an artery leading to the brain (dissection) - Stroke - Coronary artery disease - Use of some medications, such as birth control pills - Inflammation from certain infections Sex headaches associated with loss of consciousness, vomiting, stiff neck, other neurological symptoms and severe pain lasting more than 24 hours are more likely to be due to an underlying cause.", "role": "user" }, { "content": "Sex headaches are headaches caused by any type of sexual activity. They may be associated with the following: a widening or bubble in the wall of an artery inside your head (intracranial aneurysm); an abnormal connection between arteries and veins in the brain (arteriovenous malformation) that bleeds into the spinal fluid-filled space in and around the brain; bleeding into the wall of an artery leading to the brain (dissection); stroke; coronary artery disease; or use of some medications, such as birth control pills.", "role": "assistant" } ]

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

[ { "content": "what does kidney disease look like\n\n Kidney disease - resources Resources - kidney disease Summary The following organizations are good resources for information on kidney disease: National Institute of Diabetes and Digestive and Kidney Disease -- www.niddk.nih.gov/health-information/kidney-disease National Kidney Foundation -- www.kidney.org American Kidney Fund -- www.kidneyfund.org American Geriatrics Society's Health in Aging Foundation -- www.healthinaging.org/aging-and-health-a-to-z/topic:kidney-problems/ Review Date 11/12/2016 Updated by: Jennifer K. Mannheim, ARNP, Medical Staff, Department of Psychiatry and Behavioral Health, Seattle Children's Hospital, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "The following organizations provide good resources for information on kidney disease: www.niddk.nih.gov/health-information/kidney-disease, .kidney.org, www.kidneyfund.org, www.healthinaging.org/aging-and-health-a-to-z/topic:kidney-problems/", "role": "assistant" } ]

[ { "content": "what are the causes of headaches\n\n Headache Pain - head Rebound headaches Medication overuse headaches Medicine overuse headaches Summary A headache is pain or discomfort in the head, scalp, or neck. Serious causes of headaches are rare. Most people with headaches can feel much better by making lifestyle changes, learning ways to relax, and sometimes by taking medicines. Causes The most common type of headache is tension headache. It is likely caused by tight muscles in your shoulders, neck, scalp, and jaw. A tension headache: May be related to stress, depression, anxiety, a head injury, or holding your head and neck in an abnormal position. Tends to be on both sides of your head. It often starts at the back of the head and spreads forward. The pain may feel dull or squeezing, like a tight band or vice. Your shoulders, neck, or jaw may feel tight or sore. A migraine headache involves severe pain. It usually occurs with other symptoms, such as vision changes, sensitivity to sound or light, or nausea. With a migraine: The pain may be throbbing, pounding, or pulsating. It tends to begin on one side of your head. It may spread to both sides. The headache may be associated with an aura. This is a group of warning symptoms that start before your headache. The pain usually gets worse as you try to move around. Migraines may be triggered by foods, such as chocolate, certain cheeses, or monosodium glutamate (MSG). Caffeine withdrawal, lack of sleep, and alcohol may also be triggers. Rebound headaches are headaches that keep coming back. They often occur from overuse of pain medicines. For this reason, these headaches are also called medicine overuse headaches. People who take pain medicine more than 3 days a week on a regular basis can develop this type of headache. Other types of headaches: Cluster headache is a sharp, very painful headache that occurs daily, sometimes up to several times a day for months. It then goes away for weeks to months. In some people, the headaches never come back. The headache usually lasts less than an hour. It tends to occur at the same times every day. Sinus headache causes pain in the front of the head and face. It is due to swelling in the sinus passages behind the cheeks, nose, and eyes. The pain is worse when you bend forward and when you first wake up in the morning. Headaches may occur if you have a cold, the flu, a fever, or premenstrual syndrome. Headache due to a disorder called temporal arteritis. This is a swollen, inflamed artery that supplies blood to part of the head, temple, and neck area. In rare cases, a headache can be a sign of something more serious, such as: Bleeding in the area between the brain and the thin tissue that covers the brain (subarachnoid hemorrhage) Blood pressure that is very high Brain infection, such as meningitis or encephalitis, or abscess Brain tumor Buildup of fluid inside the skull that leads to brain swelling (hydrocephalus) Buildup of pressure inside the skull that appears to be, but is not a tumor (pseudotumor cerebri) Carbon monoxide poisoning Lack of oxygen during sleep (sleep apnea) Problems with the blood vessels and bleeding in the brain, such as arteriovenous malformation (AVM), brain aneurysm, or stroke Home Care There are things you can do to manage headaches at home, especially migraines or tension headaches. Try to treat the symptoms right away. When migraine symptoms begin: Drink water to avoid getting dehydrated, especially if you have vomited. Rest in a quiet, dark room. Place a cool cloth on your head. Use any relaxation techniques you have learned. A headache diary can help you identify your headache triggers. When you get a headache, write down the following: Day and time the pain began What you ate and drank over the past 24 hours How much you slept What you were doing and where you were right before the pain started How long the headache lasted and what made it stop Review your diary with your health care provider to identify triggers or a pattern to your headaches. This can help you and your provider create a treatment plan. Knowing your triggers can help you avoid them. Your provider may have already prescribed medicine to treat your type of headache. If so, take the medicine as instructed. For tension headaches, try acetaminophen, aspirin, or ibuprofen. Talk to your provider if you are taking pain medicines 3 or more days a week. When to Contact a Medical Professional Some headaches may be a sign of a more serious illness. Seek medical help right away for any of the following: This is the first headache you have ever had in your life and it interferes with your daily activities. Your headache comes on suddenly and is explosive or violent. Your headache is \"the worst ever,\" even if you regularly get headaches. You also have slurred speech, a change in vision, problems moving your arms or legs, loss of balance, confusion, or memory loss with your headache. Your headache gets worse over 24 hours. You also have a fever, stiff neck, nausea, and vomiting with your headache. Your headache occurs with a head injury. Your headache is severe and just in one eye, with redness in that eye. You just started getting headaches, especially if you are older than 50. Your headaches are associated with vision problems, pain while chewing, or weight loss. You have a history of cancer or immune system problem (such as HIV/AIDS) and develop a new headache. What to Expect at Your Office Visit Your provider will take a medical history and will examine your head, eyes, ears, nose, throat, neck, and nervous system. Your provider will ask many questions to learn about your headaches. Diagnosis is usually based on your history of symptoms. Tests may include: Blood tests or a lumbar puncture if you may have an infection Head CT scan or MRI if you have any danger signs or you have been having headaches for a while Sinus x-rays CT or MR angiography Review Date 11/22/2017 Updated by: Luc Jasmin, MD, PhD, FRCS (C), FACS, Department of Surgery at Providence Medical Center, Medford OR; Department of Surgery at Ashland Community Hospital, Ashland OR; Department of Maxillofacial Surgery at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "The most common type of headache is tension headache. It is likely caused by tight muscles in your shoulders, neck, scalp, and jaw. A tension headache: - May be related to stress, depression, anxiety, a head injury, or holding your head and neck in an abnormal position. A migraine headache involves severe pain. It usually occurs with other symptoms, such as vision changes, sensitivity to sound or light, or nausea. - Migraines may be triggered by foods, such as chocolate, certain cheeses, or monosodium glutamate (MSG). Caffeine withdrawal, lack of sleep, and alcohol may also be triggers. Rebound headaches are headaches that keep coming back. They often occur from overuse of pain medicines. Other types of headaches: - Cluster headache is a sharp, very painful headache that occurs daily, sometimes up to several times a day for months. It then goes away for weeks to months. In some people, the headaches never come back. - Sinus headache causes pain in the front of the head and face. It is due to swelling in the sinus passages behind the cheeks, nose, and eyes. The pain is worse when you bend forward and when you first wake up in the morning. - Headaches may occur if you have a cold, the flu, a fever, or premenstrual syndrome.", "role": "assistant" } ]

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

[ { "content": "Diabetes Type 2 I test before going to bed and the reading is 94 but when I test again in the morning, the reading is 165. How can I lower it? I eat dinner around 8PM and nothing until the next morning.\n\nDiabetes type 2 - meal planning (Function): Your main focus is on keeping your blood sugar (glucose) level in your target range. To help manage your blood sugar, follow a meal plan that has: - Food from all the food groups - Fewer calories - About the same amount of carbohydrates at each meal and snack - Healthy fats Along with healthy eating, you can help keep your blood sugar in target range by maintaining a healthy weight. Persons with type 2 diabetes are often overweight. Losing just 10 pounds (4.5 kilograms) can help you manage your diabetes better. Eating healthy foods and staying active (for example, 30 to 60 minutes of walking per day) can help you meet and maintain your weight loss goal. HOW CARBOHYDRATES AFFECT BLOOD SUGAR Carbohydrates in food give your body energy. You need to eat carbohydrates to maintain your energy. But carbohydrates also raise your blood sugar higher and faster than other kinds of food. The main kinds of carbohydrates are starches, sugars, and fiber. Learn which foods have carbohydrates. This will help with meal planning so that you can keep your blood sugar in your target range. MEAL PLANNING FOR CHILDREN WITH TYPE 2 DIABETES Meal plans should consider the amount of calories children need to grow. In general, three small meals and three snacks a day can help meet calorie needs. Many children with type 2 diabetes are overweight. The goal should be a healthy weight by eating healthy foods and getting more activity (60 minutes each day). Work with a registered dietitian to design a meal plan for your child. A registered dietitian is an expert in food and nutrition. The following tips can help your child stay on track: - No food is off-limits. Knowing how different foods affect your child's blood sugar helps you and your child keep it in target range. - Help your child learn how much food is a healthy amount. This is called portion control. - Have your family gradually switch from drinking soda and other sugary drinks, such as sports drinks and juices, to plain water or low-fat milk. PLANNING MEALS Everyone has individual needs. Work with your doctor, registered dietitian, or diabetes educator to develop a meal plan that works for you. When shopping, read food labels to make better food choices. A good way to make sure you get all the nutrients you need during meals is to use the plate method. This is a visual food guide that helps you choose the best types and right amounts of food to eat. It encourages larger portions of non-starchy vegetables (half the plate) and moderate portions of protein (one quarter of the plate) and starch (one quarter of the plate). You can find more information about the plate method at the American Diabetes Association website: www.diabetes.org/food-and-fitness/food/planning-meals/create-your-plate. EAT A VARIETY OF FOODS Eating a wide variety of foods helps you stay healthy. Try to include foods from all the food groups at each meal. VEGETABLES (2½ to 3 cups or 450 to 550 grams a day) Choose fresh or frozen vegetables without added sauces, fats, or salt. Non-starchy vegetables include dark green and deep yellow vegetables, such as cucumber, spinach, broccoli, romaine lettuce, cabbage, chard, and bell peppers. Starchy vegetables include corn, green peas, lima beans, carrots, yams and taro. Note that potato should be considered a pure starch, like white bread or white rice, instead of a vegetable. FRUITS (1½ to 2 cups or 240 to 320 grams a day) Choose fresh, frozen, canned (without added sugar or syrup), or unsweetened dried fruits. Try apples, bananas, berries, cherries, fruit cocktail, grapes, melon, oranges, peaches, pears, papaya, pineapple, and raisins. Drink juices that are 100% fruit with no added sweeteners or syrups. GRAINS (3 to 4 ounces or 85 to 115 grams a day) There are 2 types of grains: - Whole grains are unprocessed and have the entire grain kernel. Examples are whole-wheat flour, oatmeal, whole cornmeal, amaranth, barley, brown and wild rice, buckwheat, and quinoa. - Refined grains have been processed (milled) to remove the bran and germ. Examples are white flour, de-germed cornmeal, white bread, and white rice. Grains have starch, a type of carbohydrate. Carbohydrates raise your blood sugar level. For healthy eating, make sure half of the grains you eat each day are whole grains. Whole grains have lots of fiber. Fiber in the diet keeps your blood sugar level from rising too fast. PROTEIN FOODS (5 to 6½ ounces or 140 to 184 grams a day) Protein foods include meat, poultry, seafood, eggs, beans and peas, nuts, seeds, and processed soy foods. Eat fish and poultry more often. Remove the skin from chicken and turkey. Select lean cuts of beef, veal, pork, or wild game. Trim all visible fat from meat. Bake, roast, broil, grill, or boil instead of frying. When frying proteins, use healthy oils such as olive oil. DAIRY (3 cups or 245 grams a day) Choose low-fat dairy products. Be aware that milk, yogurt, and other dairy foods have natural sugar, even when they do not contain added sugar. Take this into account when planning meals to stay in your blood sugar target range. Some non-fat dairy products have a lot of added sugar. Be sure to read the label. OILS/FATS (no more than 7 teaspoons or 35 milliliters a day) Oils are not considered a food group. But they have nutrients that help your body stay healthy. Oils are different from fats in that oils remain liquid at room temperature. Fats remain solid at room temperature. Limit your intake of fatty foods, especially those high in saturated fat, such as hamburgers, deep-fried foods, bacon, and butter. Instead, choose foods that are high in polyunsaturated or monounsaturated fats. These include fish, nuts, and vegetable oils. Oils can raise your blood sugar, but not as fast as starch. Oils are also high in calories. Try to use no more than the recommended daily limit of 7 teaspoons (35 milliliters). WHAT ABOUT ALCOHOL AND SWEETS? If you choose to drink alcohol, limit the amount and have it with a meal. Check with your health care provider about how alcohol will affect your blood sugar and to determine a safe amount for you. Sweets are high in fat and sugar. Keep portion sizes small. Here are tips to help avoid eating too many sweets: - Ask for extra spoons and forks and split your dessert with others. - Eat sweets that are sugar-free. - Always ask for the smallest serving size or children's size. YOUR DIABETES CARE TEAM IS THERE TO HELP YOU In the beginning, meal planning may be overwhelming. But it will become easier as your knowledge grows about foods and their effects on your blood sugar. If you're having problems with meal planning, talk with your diabetes care team. They are there to help you.", "role": "user" }, { "content": "Your main focus is on keeping your blood sugar (glucose) level in your target range. To help manage your blood sugar, follow a meal plan that has: - Food from all the food groups - Fewer calories - About the same amount of carbohydrates at each meal and snack - Healthy fats Along with healthy eating, you can help keep your blood sugar in target range by maintaining a healthy weight. Persons with type 2 diabetes are often overweight. Losing just 10 pounds (4.5 kilograms) can help you manage your diabetes better. Eating healthy foods and staying active (for example, 30 to 60 minutes of walking per day) can help you meet and maintain your weight loss goal. ... Carbohydrates in food give your body energy. You need to eat carbohydrates to maintain your energy. But carbohydrates also raise your blood sugar higher and faster than other kinds of food. The main kinds of carbohydrates are starches, sugars, and fiber. Learn which foods have carbohydrates. This will help with meal planning so that you can keep your blood sugar in your target range. ... PLANNING MEALS Everyone has individual needs. Work with your doctor, registered dietitian, or diabetes educator to develop a meal plan that works for you. ... A good way to make sure you get all the nutrients you need during meals is to use the plate method. This is a visual food guide that helps you choose the best types and right amounts of food to eat. It encourages larger portions of non-starchy vegetables (half the plate) and moderate portions of protein (one quarter of the plate) and starch (one quarter of the plate).", "role": "assistant" } ]

[ { "content": "williams sydrome conditon. i need to send me more information about Williams Syndrome and some tips how to educate people with this disorder.I hope having news from you soon!!thank you\n\nWilliams Syndrome (Treatment): There is no cure for Williams syndrome, nor is there a standard course of treatment. Because WS is an uncommon and complex disorder, multidisciplinary clinics have been established at several centers in the United States. Treatments are based on an individual’s particular symptoms. People with WS require regular cardiovascular monitoring for potential medical problems, such as symptomatic narrowing of the blood vessels, high blood pressure, and heart failure.", "role": "user" }, { "content": "There is no cure for Williams syndrome, nor is there a standard course of treatment. Because WS is an uncommon and complex disorder, multidisciplinary clinics have been established at several centers in the United States. Treatments are based on an individual?s particular symptoms. People with WS require regular cardiovascular monitoring for potential medical problems, such as symptomatic narrowing of the blood vessels, high blood pressure, and heart failure.", "role": "assistant" } ]

[ { "content": "how do you diagnose anxiety\n\nAnxiety (Diagnosis): You may start by seeing your primary care doctor to find out if your anxiety could be related to your physical health. Your doctor can check for signs of an underlying medical condition that may need treatment. However, you may need to see a mental health specialist if you have severe anxiety. A psychiatrist is a medical doctor who specializes in diagnosing and treating mental health conditions. A psychologist and certain other mental health professionals can diagnose anxiety and provide counseling (psychotherapy). To help diagnose an anxiety disorder and rule out other conditions, your provider may: - Give you a psychological evaluation. This involves describing your thoughts, feelings and behavior to help pinpoint a diagnosis and check for related complications. Anxiety disorders often occur along with other mental health problems - such as depression or substance abuse - which can make diagnosis more challenging. - Compare your symptoms to the criteria in the DSM-5. Many doctors use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to diagnose an anxiety disorder.", "role": "user" }, { "content": "Talk to your primary care doctor to find out if your anxiety could be related to your physical health. However, if you have severe anxiety, you may need to see a mental health specialist such as a psychiatrist, psychologist, or other mental health professional. To help diagnose an anxiety disorder, your provider may give you a psychological evaluation. This includes describing your thoughts, feelings and behavior to help pinpoint a diagnosis and check for related complications. Many doctors use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to diagnose an anxiety disorder.", "role": "assistant" } ]

[ { "content": "how do you check for lupus?\n\n Systemic Lupus Erythematosus (Lupus) What is it? Points To Remember About Systemic Lupus Erythematosus (Lupus) What is systemic lupus erythematosus (lupus)? Lupus can affect many body parts, including the joints, skin, kidneys, heart, lungs, blood vessels, or brain.You will have periods of illness (flares) and wellness.Anyone can get lupus, but it most often affects women. Lupus is also more common among African American, Hispanic, Asian, and Native American women.Genes play an important role in lupus, but other factors are also involved.Most people will see a rheumatologist for their lupus treatment. Treatment generally consists of a team approach.Learning to recognize the warning signs of a flare can help with reducing or preventing the flares.Systemic lupus erythematosus (lupus) happens when the body's defense system attacks healthy cells and tissues, instead of viruses and bacteria. This can damage many parts of the body such as the: Joints.Skin.Kidneys.Heart.Lungs.Blood vessels.Brain.You can't catch lupus from another person. If you have lupus you will have periods of illness (flares) and wellness. Lupus can affect many body parts, including the joints, skin, kidneys, heart, lungs, blood vessels, or brain.You will have periods of illness (flares) and wellness.Anyone can get lupus, but it most often affects women. Lupus is also more common among African American, Hispanic, Asian, and Native American women.Genes play an important role in lupus, but other factors are also involved.Most people will see a rheumatologist for their lupus treatment. Treatment generally consists of a team approach.Learning to recognize the warning signs of a flare can help with reducing or preventing the flares. Lupus can affect many body parts, including the joints, skin, kidneys, heart, lungs, blood vessels, or brain.You will have periods of illness (flares) and wellness.Anyone can get lupus, but it most often affects women. Lupus is also more common among African American, Hispanic, Asian, and Native American women.Genes play an important role in lupus, but other factors are also involved.Most people will see a rheumatologist for their lupus treatment. Treatment generally consists of a team approach.Learning to recognize the warning signs of a flare can help with reducing or preventing the flares.Systemic lupus erythematosus (lupus) happens when the body's defense system attacks healthy cells and tissues, instead of viruses and bacteria. This can damage many parts of the body such as the: Joints.Skin.Kidneys.Heart.Lungs.Blood vessels.Brain.You can't catch lupus from another person. If you have lupus you will have periods of illness (flares) and wellness. Who gets it? Who gets systemic lupus erythematosus (lupus)? Anyone can get systemic lupus erythematosus (lupus), but it most often affects women. Lupus is also more common in African American, Hispanic, Asian, and Native American women than in white women.Anyone can get systemic lupus erythematosus (lupus), but it most often affects women. Lupus is also more common in African American, Hispanic, Asian, and Native American women than in white women. What causes it? What causes systemic lupus erythematosus (lupus)? No one knows what causes systemic lupus erythematosus (lupus). Research suggests that genes play an important role, but genes alone do not determine who gets lupus. It is likely that many factors trigger the disease.No one knows what causes systemic lupus erythematosus (lupus). Research suggests that genes play an important role, but genes alone do not determine who gets lupus. It is likely that many factors trigger the disease.No one knows what causes systemic lupus erythematosus (lupus). Research suggests that genes play an important role, but genes alone do not determine who gets lupus. It is likely that many factors trigger the disease. Is there a test for it? Is there a test for systemic lupus erythematosus (lupus)? There is no single test to diagnose systemic lupus erythematosus (lupus). It may take months or years for your doctor to diagnose the disease. Your doctor may use many tools to make a diagnosis: Medical history.Complete physical exam.Samples from the blood, skin, or kidneys for laboratory tests.There is no single test to diagnose systemic lupus erythematosus (lupus). It may take months or years for your doctor to diagnose the disease. Your doctor may use many tools to make a diagnosis: Medical history.Complete physical exam.Samples from the blood, skin, or kidneys for laboratory tests.There is no single test to diagnose systemic lupus erythematosus (lupus). It may take months or years for your doctor to diagnose the disease. Your doctor may use many tools to make a diagnosis: Medical history.Complete physical exam.Samples from the blood, skin, or kidneys for laboratory tests. How is it treated? How is systemic lupus erythematosus (lupus) treated? Your doctor will develop a treatment plan to fit your needs. You and your doctor should review the plan often to be sure it's working. You should report new symptoms to your doctor right away so that treatment can be changed if needed.Treatments may include: <strong>Medicines</strong> to: <ul> Reduce swelling and pain.Prevent or reduce flares.Help the immune system.Reduce or prevent damage to joints.Balance the hormones.Treat problems related to lupus, such as high cholesterol, high blood pressure, or infection. <li><strong>Alternative treatments</strong> may improve symptoms. No research shows that this kind of treatment works for people with lupus. You should talk to your doctor about alternative treatments.</li> </ul> Your doctor will develop a treatment plan to fit your needs. You and your doctor should review the plan often to be sure it's working. You should report new symptoms to your doctor right away so that treatment can be changed if needed.Treatments may include: <strong>Medicines</strong> to: <ul> Reduce swelling and pain.Prevent or reduce flares.Help the immune system.Reduce or prevent damage to joints.Balance the hormones.Treat problems related to lupus, such as high cholesterol, high blood pressure, or infection. <li><strong>Alternative treatments</strong> may improve symptoms. No research shows that this kind of treatment works for people with lupus. You should talk to your doctor about alternative treatments.</li> </ul> Your doctor will develop a treatment plan to fit your needs. You and your doctor should review the plan often to be sure it's working. You should report new symptoms to your doctor right away so that treatment can be changed if needed.Treatments may include: <strong>Medicines</strong> to: <ul> Reduce swelling and pain.Prevent or reduce flares.Help the immune system.Reduce or prevent damage to joints.Balance the hormones.Treat problems related to lupus, such as high cholesterol, high blood pressure, or infection. <li><strong>Alternative treatments</strong> may improve symptoms. No research shows that this kind of treatment works for people with lupus. You should talk to your doctor about alternative treatments.</li> </ul> Who treats it? Who treats systemic lupus erythematosus (lupus)? Most people will see a rheumatologist for their systemic lupus erythematosus (lupus) treatment. Treatment generally consists of a team approach and may include: Family doctors, who can work with your other doctors to coordinate your care.Clinical immunologists, who treat problems with the immune system.Nephrologists, who treat kidney disease.Hematologists, who treat blood disorders.Dermatologists, who treat skin problems.Neurologists, who treat problems of the brain and spinal cord.Cardiologists, who treat problems with your heart and blood vessels.Endocrinologists, who treat problems related to the glands and hormones.Nurses.Psychologists.Social workers.Most people will see a rheumatologist for their systemic lupus erythematosus (lupus) treatment. Treatment generally consists of a team approach and may include: Family doctors, who can work with your other doctors to coordinate your care.Clinical immunologists, who treat problems with the immune system.Nephrologists, who treat kidney disease.Hematologists, who treat blood disorders.Dermatologists, who treat skin problems.Neurologists, who treat problems of the brain and spinal cord.Cardiologists, who treat problems with your heart and blood vessels.Endocrinologists, who treat problems related to the glands and hormones.Nurses.Psychologists.Social workers.Most people will see a rheumatologist for their systemic lupus erythematosus (lupus) treatment. Treatment generally consists of a team approach and may include: Family doctors, who can work with your other doctors to coordinate your care.Clinical immunologists, who treat problems with the immune system.Nephrologists, who treat kidney disease.Hematologists, who treat blood disorders.Dermatologists, who treat skin problems.Neurologists, who treat problems of the brain and spinal cord.Cardiologists, who treat problems with your heart and blood vessels.Endocrinologists, who treat problems related to the glands and hormones.Nurses.Psychologists.Social workers. Living With It Living with systemic lupus erythematosus (lupus) Dealing with a long-lasting disease like systemic lupus erythematosus (lupus) can be hard on the emotions. You might think that your friends, family, and coworkers do not understand how you feel. Sadness and anger are common reactions.Besides working with your doctor to determine a treatment plan, there are a few things you can do to help you live with lupus: Learn to recognize the warning signs of a flare so that you and your doctor might reduce or prevent them. These warning signs include: <ul> Feeling more tired.Pain.Rash.Fever.Stomachache.Headache.Dizziness. <li>Eat a proper diet, exercise, and learn relaxation techniques to help cope with stress. A healthy lifestyle, as well as quitting smoking, will also reduce your risk for heart disease associated with lupus. Talk to your doctor before starting an exercise program.</li> <li>Develop and maintain a good support system of family, friends, medical professionals, community organizations, and support groups.</li> </ul> <h3>Pregnancy and Contraception for Women With Lupus</h3> Pregnancy in women with lupus is considered high risk, but most women with lupus carry their babies safely. There are a few things to keep in mind: Talk to your doctor if you plan to become pregnant.See your doctor often once you are pregnant.Good nutrition during pregnancy is important.Lupus can flare during pregnancy.Recent studies have shown that birth control pills are safe for women with lupus.Dealing with a long-lasting disease like systemic lupus erythematosus (lupus) can be hard on the emotions. You might think that your friends, family, and coworkers do not understand how you feel. Sadness and anger are common reactions.Besides working with your doctor to determine a treatment plan, there are a few things you can do to help you live with lupus: Learn to recognize the warning signs of a flare so that you and your doctor might reduce or prevent them. These warning signs include: <ul> Feeling more tired.Pain.Rash.Fever.Stomachache.Headache.Dizziness. <li>Eat a proper diet, exercise, and learn relaxation techniques to help cope with stress. A healthy lifestyle, as well as quitting smoking, will also reduce your risk for heart disease associated with lupus. Talk to your doctor before starting an exercise program.</li> <li>Develop and maintain a good support system of family, friends, medical professionals, community organizations, and support groups.</li> </ul> <h3>Pregnancy and Contraception for Women With Lupus</h3> Pregnancy in women with lupus is considered high risk, but most women with lupus carry their babies safely. There are a few things to keep in mind: Talk to your doctor if you plan to become pregnant.See your doctor often once you are pregnant.Good nutrition during pregnancy is important.Lupus can flare during pregnancy.Recent studies have shown that birth control pills are safe for women with lupus. ", "role": "user" }, { "content": "There is no single test to diagnose systemic lupus erythematosus (lupus). It may take months or years for your doctor to diagnose the disease. Your doctor may use many tools to make a diagnosis: - Medical history. - Complete physical exam. - Samples from the blood, skin, or kidneys for laboratory tests.", "role": "assistant" } ]

[ { "content": "how is epilepsy diagnosed\n\n Epilepsy Overview Epilepsy is a central nervous system (neurological) disorder in which brain activity becomes abnormal, causing seizures or periods of unusual behavior, sensations, and sometimes loss of awareness. Anyone can develop epilepsy. Epilepsy affects both males and females of all races, ethnic backgrounds and ages. Seizure symptoms can vary widely. Some people with epilepsy simply stare blankly for a few seconds during a seizure, while others repeatedly twitch their arms or legs. Having a single seizure doesn't mean you have epilepsy. At least two unprovoked seizures are generally required for an epilepsy diagnosis. Treatment with medications or sometimes surgery can control seizures for the majority of people with epilepsy. Some people require lifelong treatment to control seizures, but for others, the seizures eventually go away. Some children with epilepsy may outgrow the condition with age. Epilepsy care at Mayo Clinic Symptoms Because epilepsy is caused by abnormal activity in the brain, seizures can affect any process your brain coordinates. Seizure signs and symptoms may include: - Temporary confusion - A staring spell - Uncontrollable jerking movements of the arms and legs - Loss of consciousness or awareness - Psychic symptoms such as fear, anxiety or deja vu Symptoms vary depending on the type of seizure. In most cases, a person with epilepsy will tend to have the same type of seizure each time, so the symptoms will be similar from episode to episode. Doctors generally classify seizures as either focal or generalized, based on how the abnormal brain activity begins. Focal seizures When seizures appear to result from abnormal activity in just one area of your brain, they're called focal (partial) seizures. These seizures fall into two categories: - Focal seizures without loss of consciousness. Once called simple partial seizures, these seizures don't cause a loss of consciousness. They may alter emotions or change the way things look, smell, feel, taste or sound. They may also result in involuntary jerking of a body part, such as an arm or leg, and spontaneous sensory symptoms such as tingling, dizziness and flashing lights. - Focal seizures with impaired awareness. Once called complex partial seizures, these seizures involve a change or loss of consciousness or awareness. During a complex partial seizure, you may stare into space and not respond normally to your environment or perform repetitive movements, such as hand rubbing, chewing, swallowing or walking in circles. Symptoms of focal seizures may be confused with other neurological disorders, such as migraine, narcolepsy or mental illness. A thorough examination and testing are needed to distinguish epilepsy from other disorders. Generalized seizures Seizures that appear to involve all areas of the brain are called generalized seizures. Six types of generalized seizures exist. - Absence seizures. Absence seizures, previously known as petit mal seizures, often occur in children and are characterized by staring into space or subtle body movements such as eye blinking or lip smacking. These seizures may occur in clusters and cause a brief loss of awareness. - Tonic seizures. Tonic seizures cause stiffening of your muscles. These seizures usually affect muscles in your back, arms and legs and may cause you to fall to the ground. - Atonic seizures. Atonic seizures, also known as drop seizures, cause a loss of muscle control, which may cause you to suddenly collapse or fall down. - Clonic seizures. Clonic seizures are associated with repeated or rhythmic, jerking muscle movements. These seizures usually affect the neck, face and arms. - Myoclonic seizures. Myoclonic seizures usually appear as sudden brief jerks or twitches of your arms and legs. - Tonic-clonic seizures. Tonic-clonic seizures, previously known as grand mal seizures, are the most dramatic type of epileptic seizure and can cause an abrupt loss of consciousness, body stiffening and shaking, and sometimes loss of bladder control or biting your tongue. When to see a doctor Seek immediate medical help if any of the following occurs: - The seizure lasts more than five minutes. - Breathing or consciousness doesn't return after the seizure stops. - A second seizure follows immediately. - You have a high fever. - You're experiencing heat exhaustion. - You're pregnant. - You have diabetes. - You've injured yourself during the seizure. If you experience a seizure for the first time, seek medical advice. Causes Epilepsy has no identifiable cause in about half the people with the condition. In the other half, the condition may be traced to various factors, including: - Genetic influence. Some types of epilepsy, which are categorized by the type of seizure you experience or the part of the brain that is affected, run in families. In these cases, it's likely that there's a genetic influence. Researchers have linked some types of epilepsy to specific genes, but for most people, genes are only part of the cause of epilepsy. Certain genes may make a person more sensitive to environmental conditions that trigger seizures. - Head trauma. Head trauma as a result of a car accident or other traumatic injury can cause epilepsy. - Brain conditions. Brain conditions that cause damage to the brain, such as brain tumors or strokes, can cause epilepsy. Stroke is a leading cause of epilepsy in adults older than age 35. - Infectious diseases. Infectious diseases, such as meningitis, AIDS and viral encephalitis, can cause epilepsy. - Prenatal injury. Before birth, babies are sensitive to brain damage that could be caused by several factors, such as an infection in the mother, poor nutrition or oxygen deficiencies. This brain damage can result in epilepsy or cerebral palsy. - Developmental disorders. Epilepsy can sometimes be associated with developmental disorders, such as autism and neurofibromatosis. Risk factors Certain factors may increase your risk of epilepsy: - Age. The onset of epilepsy is most common in children and older adults, but the condition can occur at any age. - Family history. If you have a family history of epilepsy, you may be at an increased risk of developing a seizure disorder. - Head injuries. Head injuries are responsible for some cases of epilepsy. You can reduce your risk by wearing a seat belt while riding in a car and by wearing a helmet while bicycling, skiing, riding a motorcycle or engaging in other activities with a high risk of head injury. - Stroke and other vascular diseases. Stroke and other blood vessel (vascular) diseases can lead to brain damage that may trigger epilepsy. You can take a number of steps to reduce your risk of these diseases, including limiting your intake of alcohol and avoiding cigarettes, eating a healthy diet, and exercising regularly. - Dementia. Dementia can increase the risk of epilepsy in older adults. - Brain infections. Infections such as meningitis, which causes inflammation in your brain or spinal cord, can increase your risk. - Seizures in childhood. High fevers in childhood can sometimes be associated with seizures. Children who have seizures due to high fevers generally won't develop epilepsy. The risk of epilepsy increases if a child has a long seizure, another nervous system condition or a family history of epilepsy. Diagnosis To diagnose your condition, your doctor will review your symptoms and medical history. Your doctor may order several tests to diagnose epilepsy and determine the cause of seizures. Your evaluation may include: - A neurological exam. Your doctor may test your behavior, motor abilities, mental function and other areas to diagnose your condition and determine the type of epilepsy you may have. - Blood tests. Your doctor may take a blood sample to check for signs of infections, genetic conditions or other conditions that may be associated with seizures. Your doctor may also suggest tests to detect brain abnormalities, such as: - Electroencephalogram (EEG). This is the most common test used to diagnose epilepsy. In this test, doctors attach electrodes to your scalp with a paste-like substance. The electrodes record the electrical activity of your brain. If you have epilepsy, it's common to have changes in your normal pattern of brain waves, even when you're not having a seizure. Your doctor may monitor you on video while conducting an EEG while you're awake or asleep, to record any seizures you experience. Recording the seizures may help the doctor determine what kind of seizures you're having or rule out other conditions. Your doctor may give you instructions to do something that will cause seizures, such as getting little sleep prior to the test. - High-density EEG. In a variation of an EEG test, your doctor may recommend high-density EEG, which spaces electrodes more closely than conventional EEG - about a half a centimeter apart. High-density EEG may help your doctor more precisely determine which areas of your brain are affected by seizures. - Computerized tomography (CT) scan. A CT scan uses X-rays to obtain cross-sectional images of your brain. CT scans can reveal abnormalities in your brain that might be causing your seizures, such as tumors, bleeding and cysts. - Magnetic resonance imaging (MRI). An MRI uses powerful magnets and radio waves to create a detailed view of your brain. Your doctor may be able to detect lesions or abnormalities in your brain that could be causing your seizures. - Functional MRI (fMRI). A functional MRI measures the changes in blood flow that occur when specific parts of your brain are working. Doctors may use an fMRI before surgery to identify the exact locations of critical functions, such as speech and movement, so that surgeons can avoid injuring those places while operating. - Positron emission tomography (PET). PET scans use a small amount of low-dose radioactive material that's injected into a vein to help visualize active areas of the brain and detect abnormalities. - Single-photon emission computerized tomography (SPECT). This type of test is used primarily if you've had an MRI and EEG that didn't pinpoint the location in your brain where the seizures are originating. A SPECT test uses a small amount of low-dose radioactive material that's injected into a vein to create a detailed, 3-D map of the blood flow activity in your brain during seizures. Doctors also may conduct a form of a SPECT test called subtraction ictal SPECT coregistered to MRI (SISCOM), which may provide even more-detailed results. - Neuropsychological tests. In these tests, doctors assess your thinking, memory and speech skills. The test results help doctors determine which areas of your brain are affected. Along with your test results, your doctor may use a combination of analysis techniques to help pinpoint where in the brain seizures start: - Statistical parametric mapping (SPM). SPM is a method of comparing areas of the brain that have increased metabolism during seizures to normal brains, which can give doctors an idea of where seizures begin. - Curry analysis. Curry analysis is a technique that takes EEG data and projects it onto an MRI of the brain to show doctors where seizures are occurring. - Magnetoencephalography (MEG). MEG measures the magnetic fields produced by brain activity to identify potential areas of seizure onset. Accurate diagnosis of your seizure type and where seizures begin gives you the best chance for finding an effective treatment. Treatment Doctors generally begin by treating epilepsy with medication. If medications don't treat the condition, doctors may propose surgery or another type of treatment. Medication Most people with epilepsy can become seizure-free by taking one anti-seizure medication, which is also called anti-epileptic medication. Others may be able to decrease the frequency and intensity of their seizures by taking a combination of medications. Many children with epilepsy who aren't experiencing epilepsy symptoms can eventually discontinue medications and live a seizure-free life. Many adults can discontinue medications after two or more years without seizures. Your doctor will advise you about the appropriate time to stop taking medications. Finding the right medication and dosage can be complex. Your doctor will consider your condition, frequency of seizures, your age and other factors when choosing which medication to prescribe. Your doctor will also review any other medications you may be taking, to ensure the anti-epileptic medications won't interact with them. Your doctor likely will first prescribe a single medication at a relatively low dosage and may increase the dosage gradually until your seizures are well-controlled. Anti-seizure medications may have some side effects. Mild side effects include: - Fatigue - Dizziness - Weight gain - Loss of bone density - Skin rashes - Loss of coordination - Speech problems - Memory and thinking problems More-severe but rare side effects include: - Depression - Suicidal thoughts and behaviors - Severe rash - Inflammation of certain organs, such as your liver To achieve the best seizure control possible with medication, follow these steps: - Take medications exactly as prescribed. - Always call your doctor before switching to a generic version of your medication or taking other prescription medications, over-the-counter drugs or herbal remedies. - Never stop taking your medication without talking to your doctor. - Notify your doctor immediately if you notice new or increased feelings of depression, suicidal thoughts, or unusual changes in your mood or behaviors. - Tell your doctor if you have migraines. Doctors may prescribe one of the anti-epileptic medications that can prevent your migraines and treat epilepsy. At least half the people newly diagnosed with epilepsy will become seizure-free with their first medication. If anti-epileptic medications don't provide satisfactory results, your doctor may suggest surgery or other therapies. You'll have regular follow-up appointments with your doctor to evaluate your condition and medications. Surgery When medications fail to provide adequate control over seizures, surgery may be an option. With epilepsy surgery, a surgeon removes the area of your brain that's causing seizures. Doctors usually perform surgery when tests show that: - Your seizures originate in a small, well-defined area of your brain - The area in your brain to be operated on doesn't interfere with vital functions such as speech, language, motor function, vision or hearing Although many people continue to need some medication to help prevent seizures after successful surgery, you may be able to take fewer drugs and reduce your dosages. In a small number of cases, surgery for epilepsy can cause complications such as permanently altering your thinking (cognitive) abilities. Talk to your surgeon about his or her experience, success rates, and complication rates with the procedure you're considering. Therapies Apart from medications and surgery, these potential therapies offer an alternative for treating epilepsy: - Vagus nerve stimulation. In vagus nerve stimulation, doctors implant a device called a vagus nerve stimulator underneath the skin of your chest, similar to a heart pacemaker. Wires from the stimulator are connected to the vagus nerve in your neck. The battery-powered device sends bursts of electrical energy through the vagus nerve and to your brain. It's not clear how this inhibits seizures, but the device can usually reduce seizures by 20 to 40 percent. Most people still need to take anti-epileptic medication, although some people may be able to lower their medication dose. You may experience side effects from vagus nerve stimulation, such as throat pain, hoarse voice, shortness of breath or coughing. - Ketogenic diet. Some children with epilepsy have been able to reduce their seizures by following a strict diet that's high in fats and low in carbohydrates. In this diet, called a ketogenic diet, the body breaks down fats instead of carbohydrates for energy. After a few years, some children may be able to stop the ketogenic diet - under close supervision of their doctors - and remain seizure-free. Consult a doctor if you or your child is considering a ketogenic diet. It's important to make sure that your child doesn't become malnourished when following the diet. Side effects of a ketogenic diet may include dehydration, constipation, slowed growth because of nutritional deficiencies and a buildup of uric acid in the blood, which can cause kidney stones. These side effects are uncommon if the diet is properly and medically supervised. Following a ketogenic diet can be a challenge. Low-glycemic index and modified Atkins diets offer less restrictive alternatives that may still provide some benefit for seizure control. Potential future treatments Researchers are studying many potential new treatments for epilepsy, including: - Deep brain stimulation. In deep brain stimulation, surgeons implant electrodes into a specific part of your brain, typically your thalamus. The electrodes are connected to a generator implanted in your chest or the skull that sends electrical pulses to your brain and may reduce your seizures. - Responsive neurostimulation. Implantable, pacemaker-like devices that help prevent seizures are also under investigation. These responsive stimulation or closed loop devices analyze brain activity patterns to detect seizures before they happen and deliver an electrical charge or drug to stop the seizure. - Continuous stimulation of the seizure onset zone (subthreshold stimulation). Subthreshold stimulation - continuous stimulation to an area of your brain below a level that's physically noticeable - appears to improve seizure outcomes and quality of life for some people with seizures. This treatment approach may work in people who have seizures that start in an area of the brain that can't be removed because it would affect speech and motor functions (eloquent area). Or it might benefit people whose seizure characteristics mean their chances of successful treatment with responsive neurostimulation are low. - Minimally invasive surgery. New minimally invasive surgical techniques, such as MRI-guided laser ablation, show promise at reducing seizures with fewer risks than traditional open brain surgery for epilepsy. - Stereotactic laser ablation or radiosurgery. For some types of epilepsy, stereotactic laser ablation or stereotactic radiosurgery may provide effective treatment for people in which an open procedure may be too risky. In these procedures, doctors direct radiation at the specific area in the brain causing seizures, to destroy that tissue in an effort to better control the seizures. - External nerve stimulation device. Similar to vagus nerve stimulation, this device would stimulate specific nerves to reduce frequency of seizures. But unlike vagus nerve stimulation, this device would be worn externally so that no surgery to implant the device is needed. Lifestyle and home remedies Understanding your condition can help you take better control of it: - Take your medication correctly. Don't adjust your dosage before talking to your doctor. If you feel your medication should be changed, discuss it with your doctor. - Get enough sleep. Lack of sleep can trigger seizures. Be sure to get adequate rest every night. - Wear a medical alert bracelet. This will help emergency personnel know how to treat you correctly. - Exercise. Exercising may help keep you physically healthy and reduce depression. Make sure to drink enough water, and rest if you get tired during exercise. In addition, make healthy life choices, such as managing stress, limiting alcoholic beverages and avoiding cigarettes. ", "role": "user" }, { "content": "To diagnose epilepsy, your doctor will review your symptoms and medical history. Your doctor may also order several tests. This may include a neurological exam, blood tests, an electroencephalogram, a computerized tomography scan, or magnetic resonance imaging. The electroencephalogram is the most common way to diagnose epilepsy. The more accurate your doctor knows about your seizure type and where the seizures begin in your brain, the better your chance for finding an effective treatment.", "role": "assistant" } ]

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

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

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

[ { "content": "Asking about Hairy cell leukemia 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\n\n Hairy cell leukemia Overview Hairy cell leukemia is a rare, slow-growing cancer of the blood in which your bone marrow makes too many B cells (lymphocytes), a type of white blood cell that fights infection. These excess B cells are abnormal and look \"hairy\" under a microscope. As the number of leukemia cells increases, fewer healthy white blood cells, red blood cells and platelets are produced. Hairy cell leukemia affects more men than women, and it occurs most commonly in middle-aged or older adults. Hairy cell leukemia is considered a chronic disease because it may never completely disappear, although treatment can lead to a remission for years. Symptoms Some people have no signs or symptoms of hairy cell leukemia, but a blood test for another disease or condition may inadvertently reveal hairy cell leukemia. Other times people with hairy cell leukemia experience signs and symptoms common to a number of diseases and conditions, such as: - A feeling of fullness in your abdomen that may make it uncomfortable to eat more than a little at a time - Fatigue - Easy bruising - Recurring infections - Weakness - Weight loss When to see a doctor Make an appointment with your doctor if you have any persistent signs and symptoms that worry you. Causes It's not clear what causes hairy cell leukemia. Doctors know that cancer occurs when cells develop errors in their DNA. In the case of hairy cell leukemia, mutations in the DNA cause your bone marrow stem cells to create too many white blood cells that don't work properly. Doctors don't know what causes the DNA mutations that lead to hairy cell leukemia. Risk factors Certain factors may increase your risk of developing hairy cell leukemia. Not all research studies agree on what factors increase your risk of the disease. Some research indicates that your risk of hairy cell leukemia increases based on your: - Exposure to radiation. People exposed to radiation, such as those who work around X-ray machines or those who received radiation treatment for cancer, may have a higher risk of developing hairy cell leukemia, but the evidence is inconclusive. - Exposure to chemicals. Industrial and agricultural chemicals could play a role in hairy cell leukemia development. However, some studies have found this not to be the case. - Exposure to sawdust. Some studies have found a link between working with wood and sawdust and an increased risk of hairy cell leukemia. But this connection hasn't been proved conclusively. - Ethnicity. Hairy cell leukemia affects men of Ashkenazi Jewish ancestry more frequently than men of other ethnic groups. Diagnosis To diagnose hairy cell leukemia, your doctor may recommend tests and procedures that include: - Physical exam. By feeling your spleen - an oval-shaped organ on the left side of your upper abdomen - your doctor can determine if it's enlarged. An enlarged spleen may cause a sensation of fullness in your abdomen that makes it uncomfortable to eat. Your doctor may also check for enlarged lymph nodes that may contain leukemia cells. - Blood tests. Your doctor uses blood tests, such as the complete blood count, to monitor the levels of blood cells in your blood. People with hairy cell leukemia have low levels of all three types of blood cells - red blood cells, white blood cells and platelets. Another blood test called a peripheral blood smear looks for hairy cell leukemia cells in a sample of your blood. - Bone marrow biopsy. During a bone marrow biopsy, a small amount of bone marrow is removed from your hip area. This sample is used to look for hairy cell leukemia cells and to monitor your healthy blood cells. - Computerized tomography (CT) scan. A CT scan shows detailed images of the inside of your body. Your doctor may order a CT scan to detect enlargement of your spleen and your lymph nodes. Treatment Treatment isn't always necessary for people with hairy cell leukemia. Because this cancer progresses very slowly and sometimes doesn't progress at all, some people prefer to wait to treat their cancer only if it causes signs and symptoms. The majority of people with hairy cell leukemia eventually need treatment. If your hairy cell leukemia causes signs and symptoms, you may decide to undergo treatment. There is no cure for hairy cell leukemia. But treatments are effective at putting hairy cell leukemia in remission for years. Chemotherapy Doctors consider chemotherapy drugs the first line of treatment for hairy cell leukemia. The great majority of people will experience complete or partial remission through the use of chemotherapy. Two chemotherapy drugs are used in hairy cell leukemia: - Cladribine. Treatment for hairy cell leukemia typically begins with cladribine. You receive a continuous infusion of the drug into a vein over several days. Most people who receive cladribine experience a complete remission that can last for several years. If your hairy cell leukemia returns, you can be treated with cladribine again. Side effects of cladribine may include infection and fever. - Pentostatin (Nipent). Pentostatin causes remission rates similar to cladribine, but it's given on a different schedule. People who take pentostatin receive infusions every other week for three to six months. Side effects of pentostatin may include fever, nausea and infection. Biological treatments Biological therapy attempts to make cancer cells more recognizable to your immune system. Once your immune system identifies cancer cells as intruders, it can set about destroying your cancer. Two types of biological treatments are used in hairy cell leukemia: - Interferon. Currently, the role of interferon in hairy cell leukemia treatment is limited. You might receive interferon if chemotherapy hasn't been effective or if you can't take chemotherapy. Most people experience partial remission with interferon, which is taken for a year. Side effects include flu-like symptoms, such as fever and fatigue. - Rituximab (Rituxan). Rituximab is a monoclonal antibody approved to treat non-Hodgkin lymphoma and chronic lymphocytic leukemia, though it's sometimes used in hairy cell leukemia. If chemotherapy drugs haven't worked for you or you can't take chemotherapy, your doctor might consider rituximab. Side effects of rituximab include fever and infection. Surgery Surgery to remove your spleen (splenectomy) might be an option if your spleen ruptures or if it's enlarged and causing pain. Though removing your spleen can't cure hairy cell leukemia, it can usually restore normal blood counts. Splenectomy isn't commonly used to treat hairy cell leukemia, but it may be helpful in certain situations. Any surgery carries a risk of bleeding and infection. Alternative medicine Some people with cancer find that complementary and alternative treatments can help them cope with side effects of cancer treatment. Complementary and alternative medicine can't cure your hairy cell leukemia, but it may offer helpful ways to cope during and after treatment. Talk to your doctor if you're interested in trying: - Acupuncture. A practitioner inserts tiny needles into your skin at precise points during an acupuncture session. Acupuncture may help relieve nausea and vomiting caused by chemotherapy. Acupuncture can be safe when done by a certified practitioner. Your doctor may be able to recommend a practitioner in your community. Acupuncture isn't safe if you have low blood counts or if you're taking blood thinners. - Aromatherapy. Aromatherapy uses fragrant oils that give off pleasant scents, such as lavender. Oils can be massaged into your skin, added to bath water or heated to release their scents. Aromatherapy may help improve your mood and relieve stress. Aromatherapy is safe, but oils applied to your skin can cause allergic reactions, so check the ingredients first. - Massage. A massage therapist uses his or her hands to knead your muscles and soft tissues. Massage may help relieve anxiety and fatigue. Many cancer centers have massage therapists who work with people who have cancer. People with cancer shouldn't have a massage if their blood counts are low. Ask the massage therapist to avoid using deep pressure. A massage shouldn't hurt, so speak up if you feel pain during a massage. - Mind-body therapies. Mind-body therapies may help you relax, and they may help reduce pain. Mind-body therapies include meditation and relaxation techniques, such as guided imagery. Mind-body therapies are generally safe. A therapist can help you with these therapies or you can do them on your own. ", "role": "user" }, { "content": "Hairy cell leukemia progresses slowly and might not require treatment if it does not cause any symptoms. Although there is no treatment, chemotherapy or biological treatment that stimulates the immune system to fight cancer cells could put hairy cell leukemia in remission for years. Sometimes, removal of the spleen restores normal blood counts.", "role": "assistant" } ]

[ { "content": "Psoriasis for past 7-8 years I had psoriasis on my scalp for nearly 10 years. Please give suggestions and medications.\n\n Psoriasis Summary Psoriasis is a skin disease that causes itchy or sore patches of thick, red skin with silvery scales. The skin on the elbows, knees, scalp, back, face, palms and feet is most often affected, but other parts of the body can be affected as well. A problem with the immune system causes psoriasis. In a process called cell turnover, skin cells that grow deep in the skin rise to the surface. Normally, this takes a month. In psoriasis, it happens in just days because the cells rise too fast. Although symptoms may come and go, for many, psoriasis is a lifelong condition. Infections, stress, dry skin and certain medications may make symptoms worse. Psoriasis usually occurs in adults. It sometimes runs in families. Treatments include creams, medications and light therapy. [1] [2] ", "role": "user" }, { "content": "Infections, stress, dry skin and certain medications may make symptoms worse. Treatments include creams, medications and light therapy.", "role": "assistant" } ]

[ { "content": "why can you not take grapefruit with felodipine\n\nFelodipine: Felodipine is used to treat high blood pressure. Felodipine is in a class of medications called calcium channel blockers. It works by relaxing the blood vessels so your heart does not have to pump as hard. 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. Felodipine comes as an extended release tablet to take by mouth. It is usually taken once a day. To help you remember to take felodipine, take it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take felodipine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Swallow the tablets whole; do not split, chew, or crush them. Felodipine controls high blood pressure but does not cure it. Continue to take felodipine even if you feel well. Do not stop taking felodipine without talking to your doctor. This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. Before taking felodipine, - tell your doctor and pharmacist if you are allergic to felodipine, any other medications, or any ingredients in felodipine tablets. Ask your pharmacist for a list of the ingredients. - tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: antiseizure medicines such as carbamazepine (Carbatrol, Equetro, Tegretol), phenytoin (Dilantin, Phenytek), and phenobarbital; cimetidine (Tagamet); erythromycin (E.E.S., Eryc, Ery-tab); itraconazole (Sporanox); ketoconazole (Nizoral); ranitidine (Zantac); and tacrolimus (Astagraf SL, Prograf). - tell your doctor if you have or have ever had heart, liver, or kidney disease. - tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking felodipine, call your doctor. - if you are having surgery, including dental surgery, tell your doctor or dentist that you take felodipine. Talk to your doctor about drinking grapefruit juice or eating grapefruit while taking felodipine. Talk to your doctor before using salt substitutes containing potassium. If your doctor prescribes a low-salt or low-sodium diet, follow these directions carefully. Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. Felodipine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: - headache - flushing - dizziness or lightheadedness - weakness - fast heartbeat - heartburn - constipation - enlargement of gum tissue around teeth Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment: - swelling of the face, eyes, lips, tongue, arms, or legs - difficulty breathing or swallowing - fainting - rash 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). 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. It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911. Keep all appointments with your doctor and the laboratory. Your blood pressure should be checked regularly to determine your response to felodipine. Good dental hygiene decreases the chance and severity of gum swelling. Brush your teeth regularly and schedule dental cleanings every 6 months. Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. - Plendil® - Lexxel® (containing Enalapril, Felodipine)¶", "role": "user" }, { "content": "Talk to your doctor about drinking grapefruit juice or eating grapefruit while taking felodipine.", "role": "assistant" } ]

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

[ { "content": "Project. Hi my name is 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 ?\n\n Leukemia Overview Leukemia is cancer of the body's blood-forming tissues, including the bone marrow and the lymphatic system. Many types of leukemia exist. Some forms of leukemia are more common in children. Other forms of leukemia occur mostly in adults. Leukemia usually involves the white blood cells. Your white blood cells are potent infection fighters - they normally grow and divide in an orderly way, as your body needs them. But in people with leukemia, the bone marrow produces abnormal white blood cells, which don't function properly. Treatment for leukemia can be complex - depending on the type of leukemia and other factors. But there are strategies and resources that can help to make your treatment successful. Leukemia care at Mayo Clinic Symptoms Leukemia symptoms vary, depending on the type of leukemia. Common leukemia signs and symptoms include: - Fever or chills - Persistent fatigue, weakness - Frequent or severe infections - Losing weight without trying - Swollen lymph nodes, enlarged liver or spleen - Easy bleeding or bruising - Recurrent nosebleeds - Tiny red spots in your skin (petechiae) - Excessive sweating, especially at night - Bone pain or tenderness When to see a doctor Make an appointment with your doctor if you have any persistent signs or symptoms that worry you. Leukemia symptoms are often vague and not specific. You may overlook early leukemia symptoms because they may resemble symptoms of the flu and other common illnesses. Rarely, leukemia may be discovered during blood tests for some other condition. Causes Scientists don't understand the exact causes of leukemia. It seems to develop from a combination of genetic and environmental factors. How leukemia forms In general, leukemia is thought to occur when some blood cells acquire mutations in their DNA - the instructions inside each cell that guide its action. There may be other changes in the cells that have yet to be fully understood that could contribute to leukemia. Certain abnormalities cause the cell to grow and divide more rapidly and to continue living when normal cells would die. Over time, these abnormal cells can crowd out healthy blood cells in the bone marrow, leading to fewer healthy white blood cells, red blood cells and platelets, causing the signs and symptoms of leukemia. How leukemia is classified Doctors classify leukemia based on its speed of progression and the type of cells involved. The first type of classification is by how fast the leukemia progresses: - Acute leukemia. In acute leukemia, the abnormal blood cells are immature blood cells (blasts). They can't carry out their normal functions, and they multiply rapidly, so the disease worsens quickly. Acute leukemia requires aggressive, timely treatment. - Chronic leukemia. There are many types of chronic leukemias. Some produce too many cells and some cause too few cells to be produced. Chronic leukemia involves more mature blood cells. These blood cells replicate or accumulate more slowly and can function normally for a period of time. Some forms of chronic leukemia initially produce no early symptoms and can go unnoticed or undiagnosed for years. The second type of classification is by type of white blood cell affected: - Lymphocytic leukemia. This type of leukemia affects the lymphoid cells (lymphocytes), which form lymphoid or lymphatic tissue. Lymphatic tissue makes up your immune system. - Myelogenous (my-uh-LOHJ-uh-nus) leukemia. This type of leukemia affects the myeloid cells. Myeloid cells give rise to red blood cells, white blood cells and platelet-producing cells. Types of leukemia The major types of leukemia are: - Acute lymphocytic leukemia (ALL). This is the most common type of leukemia in young children. ALL can also occur in adults. - Acute myelogenous leukemia (AML). AML is a common type of leukemia. It occurs in children and adults. AML is the most common type of acute leukemia in adults. - Chronic lymphocytic leukemia (CLL). With CLL, the most common chronic adult leukemia, you may feel well for years without needing treatment. - Chronic myelogenous leukemia (CML). This type of leukemia mainly affects adults. A person with CML may have few or no symptoms for months or years before entering a phase in which the leukemia cells grow more quickly. - Other types. Other, rarer types of leukemia exist, including hairy cell leukemia, myelodysplastic syndromes and myeloproliferative disorders. Diagnosis Doctors may find chronic leukemia in a routine blood test, before symptoms begin. If this happens, or if you have signs or symptoms that suggest leukemia, you may undergo the following diagnostic exams: - Physical exam. Your doctor will look for physical signs of leukemia, such as pale skin from anemia, swelling of your lymph nodes, and enlargement of your liver and spleen. - Blood tests. By looking at a sample of your blood, your doctor can determine if you have abnormal levels of red or white blood cells or platelets - which may suggest leukemia. - Bone marrow test. Your doctor may recommend a procedure to remove a sample of bone marrow from your hipbone. The bone marrow is removed using a long, thin needle. The sample is sent to a laboratory to look for leukemia cells. Specialized tests of your leukemia cells may reveal certain characteristics that are used to determine your treatment options. Treatment Treatment for your leukemia depends on many factors. Your doctor determines your leukemia treatment options based on your age and overall health, the type of leukemia you have, and whether it has spread to other parts of your body, including the central nervous system. Common treatments used to fight leukemia include: - Chemotherapy. Chemotherapy is the major form of treatment for leukemia. This drug treatment uses chemicals to kill leukemia cells. Depending on the type of leukemia you have, you may receive a single drug or a combination of drugs. These drugs may come in a pill form, or they may be injected directly into a vein. - Biological therapy. Biological therapy works by using treatments that help your immune system recognize and attack leukemia cells. - Targeted therapy. Targeted therapy uses drugs that attack specific vulnerabilities within your cancer cells. For example, the drug imatinib (Gleevec) stops the action of a protein within the leukemia cells of people with chronic myelogenous leukemia. This can help control the disease. - Radiation therapy. Radiation therapy uses X-rays or other high-energy beams to damage leukemia cells and stop their growth. During radiation therapy, you lie on a table while a large machine moves around you, directing the radiation to precise points on your body. You may receive radiation in one specific area of your body where there is a collection of leukemia cells, or you may receive radiation over your whole body. Radiation therapy may be used to prepare for a stem cell transplant. - Stem cell transplant. A stem cell transplant is a procedure to replace your diseased bone marrow with healthy bone marrow. Before a stem cell transplant, you receive high doses of chemotherapy or radiation therapy to destroy your diseased bone marrow. Then you receive an infusion of blood-forming stem cells that help to rebuild your bone marrow. You may receive stem cells from a donor, or in some cases you may be able to use your own stem cells. A stem cell transplant is very similar to a bone marrow transplant. ", "role": "user" }, { "content": "Leukemia treatments are based on the patient’s age and overall health, the type of leukemia, and whether it has spread to other parts of the body. Common treatments used to fight leukemia include chemotherapy, radiation therapy, biological therapy that helps the immune system recognize and attack leukemia cells, and targeted therapy that attacks specific vulnerabilities within cancer cells. For example, the drug imatinib (Gleevec) stops the action of a protein within the leukemia cells of people with chronic myelogenous leukemia.", "role": "assistant" } ]

[ { "content": "more information in relation to Ellis van creveld syndrome Specifically in later life can they have children has it ever been reported any researchcarried out and just as much information as possible to help my understanding of what I have Many thanks\n\nEllis-van Creveld syndrome (Treatment): Treatment depends on which body system is affected and the severity of the problem. The condition itself is not treatable, but many of the complications can be treated.", "role": "user" }, { "content": "There is no cure for Ellis-van Creveld syndrome. The treatments for complications depend on which body system is affected and the severity of the problem.", "role": "assistant" } ]

[ { "content": "how is asthma diagnosed\n\n Asthma Overview Asthma is a condition in which your airways narrow and swell and produce extra mucus. This can make breathing difficult and trigger coughing, wheezing and shortness of breath. For some people, asthma is a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack. Asthma can't be cured, but its symptoms can be controlled. Because asthma often changes over time, it's important that you work with your doctor to track your signs and symptoms and adjust treatment as needed. Symptoms Asthma symptoms vary from person to person. You may have infrequent asthma attacks, have symptoms only at certain times - such as when exercising - or have symptoms all the time. Asthma signs and symptoms include: - Shortness of breath - Chest tightness or pain - Trouble sleeping caused by shortness of breath, coughing or wheezing - A whistling or wheezing sound when exhaling (wheezing is a common sign of asthma in children) - Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu Signs that your asthma is probably worsening include: - Asthma signs and symptoms that are more frequent and bothersome - Increasing difficulty breathing (measurable with a peak flow meter, a device used to check how well your lungs are working) - The need to use a quick-relief inhaler more often For some people, asthma signs and symptoms flare up in certain situations: - Exercise-induced asthma, which may be worse when the air is cold and dry - Occupational asthma, triggered by workplace irritants such as chemical fumes, gases or dust - Allergy-induced asthma, triggered by airborne substances, such as pollen, mold spores, cockroach waste or particles of skin and dried saliva shed by pets (pet dander) When to see a doctor Seek emergency treatment Severe asthma attacks can be life-threatening. Work with your doctor to determine what to do when your signs and symptoms worsen - and when you need emergency treatment. Signs of an asthma emergency include: - Rapid worsening of shortness of breath or wheezing - No improvement even after using a quick-relief inhaler, such as albuterol - Shortness of breath when you are doing minimal physical activity Contact your doctor See your doctor: - If you think you have asthma. If you have frequent coughing or wheezing that lasts more than a few days or any other signs or symptoms of asthma, see your doctor. Treating asthma early may prevent long-term lung damage and help keep the condition from worsening over time. - To monitor your asthma after diagnosis. If you know you have asthma, work with your doctor to keep it under control. Good long-term control helps you feel better from day to day and can prevent a life-threatening asthma attack. - If your asthma symptoms get worse. Contact your doctor right away if your medication doesn't seem to ease your symptoms or if you need to use your quick-relief inhaler more often. Don't try to solve the problem by taking more medication without consulting your doctor. Overusing asthma medication can cause side effects and may make your asthma worse. - To review your treatment. Asthma often changes over time. Meet with your doctor regularly to discuss your symptoms and make any needed treatment adjustments. Causes It isn't clear why some people get asthma and others don't, but it's probably due to a combination of environmental and genetic (inherited) factors. Asthma triggers Exposure to various irritants and substances that trigger allergies (allergens) can trigger signs and symptoms of asthma. Asthma triggers are different from person to person and can include: - Airborne substances, such as pollen, dust mites, mold spores, pet dander or particles of cockroach waste - Respiratory infections, such as the common cold - Physical activity (exercise-induced asthma) - Cold air - Air pollutants and irritants, such as smoke - Certain medications, including beta blockers, aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve) - Strong emotions and stress - Sulfites and preservatives added to some types of foods and beverages, including shrimp, dried fruit, processed potatoes, beer and wine - Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat Risk factors A number of factors are thought to increase your chances of developing asthma. These include: - Having a blood relative (such as a parent or sibling) with asthma - Having another allergic condition, such as atopic dermatitis or allergic rhinitis (hay fever) - Being overweight - Being a smoker - Exposure to secondhand smoke - Exposure to exhaust fumes or other types of pollution - Exposure to occupational triggers, such as chemicals used in farming, hairdressing and manufacturing Complications Asthma complications include: - Signs and symptoms that interfere with sleep, work or recreational activities - Sick days from work or school during asthma flare-ups - Permanent narrowing of the bronchial tubes (airway remodeling) that affects how well you can breathe - Emergency room visits and hospitalizations for severe asthma attacks - Side effects from long-term use of some medications used to stabilize severe asthma Proper treatment makes a big difference in preventing both short-term and long-term complications caused by asthma. Diagnosis Physical exam To rule out other possible conditions - such as a respiratory infection or chronic obstructive pulmonary disease (COPD) - your doctor will do a physical exam and ask you questions about your signs and symptoms and about any other health problems. Tests to measure lung function You may also be given lung (pulmonary) function tests to determine how much air moves in and out as you breathe. These tests may include: - Spirometry. This test estimates the narrowing of your bronchial tubes by checking how much air you can exhale after a deep breath and how fast you can breathe out. - Peak flow. A peak flow meter is a simple device that measures how hard you can breathe out. Lower than usual peak flow readings are a sign your lungs may not be working as well and that your asthma may be getting worse. Your doctor will give you instructions on how to track and deal with low peak flow readings. Lung function tests often are done before and after taking a medication called a bronchodilator (brong-koh-DIE-lay-tur), such as albuterol, to open your airways. If your lung function improves with use of a bronchodilator, it's likely you have asthma. Additional tests Other tests to diagnose asthma include: - Methacholine challenge. Methacholine is a known asthma trigger that, when inhaled, will cause mild constriction of your airways. If you react to the methacholine, you likely have asthma. This test may be used even if your initial lung function test is normal. - Nitric oxide test. This test, though not widely available, measures the amount of the gas, nitric oxide, that you have in your breath. When your airways are inflamed - a sign of asthma - you may have higher than normal nitric oxide levels. - Imaging tests. A chest X-ray and high-resolution computerized tomography (CT) scan of your lungs and nose cavities (sinuses) can identify any structural abnormalities or diseases (such as infection) that can cause or aggravate breathing problems. - Allergy testing. This can be performed by a skin test or blood test. Allergy tests can identify allergy to pets, dust, mold and pollen. If important allergy triggers are identified, this can lead to a recommendation for allergen immunotherapy. - Sputum eosinophils. This test looks for certain white blood cells (eosinophils) in the mixture of saliva and mucus (sputum) you discharge during coughing. Eosinophils are present when symptoms develop and become visible when stained with a rose-colored dye (eosin). - Provocative testing for exercise and cold-induced asthma. In these tests, your doctor measures your airway obstruction before and after you perform vigorous physical activity or take several breaths of cold air. How asthma is classified To classify your asthma severity, your doctor considers your answers to questions about symptoms (such as how often you have asthma attacks and how bad they are), along with the results of your physical exam and diagnostic tests. Determining your asthma severity helps your doctor choose the best treatment. Asthma severity often changes over time, requiring treatment adjustments. Asthma is classified into four general categories: Treatment Prevention and long-term control are key in stopping asthma attacks before they start. Treatment usually involves learning to recognize your triggers, taking steps to avoid them and tracking your breathing to make sure your daily asthma medications are keeping symptoms under control. In case of an asthma flare-up, you may need to use a quick-relief inhaler, such as albuterol. Medications The right medications for you depend on a number of things - your age, symptoms, asthma triggers and what works best to keep your asthma under control. Preventive, long-term control medications reduce the inflammation in your airways that leads to symptoms. Quick-relief inhalers (bronchodilators) quickly open swollen airways that are limiting breathing. In some cases, allergy medications are necessary. Long-term asthma control medications, generally taken daily, are the cornerstone of asthma treatment. These medications keep asthma under control on a day-to-day basis and make it less likely you'll have an asthma attack. Types of long-term control medications include: - Inhaled corticosteroids. These anti-inflammatory drugs include fluticasone (Flonase, Flovent HFA), budesonide (Pulmicort Flexhaler, Rhinocort), flunisolide (Aerospan HFA), ciclesonide (Alvesco, Omnaris, Zetonna), beclomethasone (Qnasl, Qvar), mometasone (Asmanex) and fluticasone furoate (Arnuity Ellipta). You may need to use these medications for several days to weeks before they reach their maximum benefit. Unlike oral corticosteroids, these corticosteroid medications have a relatively low risk of side effects and are generally safe for long-term use. - Leukotriene modifiers. These oral medications - including montelukast (Singulair), zafirlukast (Accolate) and zileuton (Zyflo) - help relieve asthma symptoms for up to 24 hours. In rare cases, these medications have been linked to psychological reactions, such as agitation, aggression, hallucinations, depression and suicidal thinking. Seek medical advice right away for any unusual reaction. - Long-acting beta agonists. These inhaled medications, which include salmeterol (Serevent) and formoterol (Foradil, Perforomist), open the airways. Some research shows that they may increase the risk of a severe asthma attack, so take them only in combination with an inhaled corticosteroid. And because these drugs can mask asthma deterioration, don't use them for an acute asthma attack. - Combination inhalers. These medications - such as fluticasone-salmeterol (Advair Diskus), budesonide-formoterol (Symbicort) and formoterol-mometasone (Dulera) - contain a long-acting beta agonist along with a corticosteroid. Because these combination inhalers contain long-acting beta agonists, they may increase your risk of having a severe asthma attack. - Theophylline. Theophylline (Theo-24, Elixophyllin, others) is a daily pill that helps keep the airways open (bronchodilator) by relaxing the muscles around the airways. It's not used as often now as in past years. Quick-relief (rescue) medications are used as needed for rapid, short-term symptom relief during an asthma attack - or before exercise if your doctor recommends it. Types of quick-relief medications include: - Short-acting beta agonists. These inhaled, quick-relief bronchodilators act within minutes to rapidly ease symptoms during an asthma attack. They include albuterol (ProAir HFA, Ventolin HFA, others) and levalbuterol (Xopenex). Short-acting beta agonists can be taken using a portable, hand-held inhaler or a nebulizer - a machine that converts asthma medications to a fine mist - so that they can be inhaled through a face mask or a mouthpiece. - Ipratropium (Atrovent). Like other bronchodilators, ipratropium acts quickly to immediately relax your airways, making it easier to breathe. Ipratropium is mostly used for emphysema and chronic bronchitis, but it's sometimes used to treat asthma attacks. - Oral and intravenous corticosteroids. These medications - which include prednisone and methylprednisolone - relieve airway inflammation caused by severe asthma. They can cause serious side effects when used long term, so they're used only on a short-term basis to treat severe asthma symptoms. If you have an asthma flare-up, a quick-relief inhaler can ease your symptoms right away. But if your long-term control medications are working properly, you shouldn't need to use your quick-relief inhaler very often. Keep a record of how many puffs you use each week. If you need to use your quick-relief inhaler more often than your doctor recommends, see your doctor. You probably need to adjust your long-term control medication. Allergy medications may help if your asthma is triggered or worsened by allergies. These include: - Allergy shots (immunotherapy). Over time, allergy shots gradually reduce your immune system reaction to specific allergens. You generally receive shots once a week for a few months, then once a month for a period of three to five years. - Omalizumab (Xolair). This medication, given as an injection every two to four weeks, is specifically for people who have allergies and severe asthma. It acts by altering the immune system. Bronchial thermoplasty This treatment - which isn't widely available nor right for everyone - is used for severe asthma that doesn't improve with inhaled corticosteroids or other long-term asthma medications. Generally, over the span of three outpatient visits, bronchial thermoplasty heats the insides of the airways in the lungs with an electrode, reducing the smooth muscle inside the airways. This limits the ability of the airways to tighten, making breathing easier and possibly reducing asthma attacks. Treat by severity for better control: A stepwise approach Your treatment should be flexible and based on changes in your symptoms, which should be assessed thoroughly each time you see your doctor. Then your doctor can adjust your treatment accordingly. For example, if your asthma is well-controlled, your doctor may prescribe less medicine. If your asthma isn't well-controlled or is getting worse, your doctor may increase your medication and recommend more-frequent visits. Asthma action plan Work with your doctor to create an asthma action plan that outlines in writing when to take certain medications or when to increase or decrease the dose of your medications based on your symptoms. Also include a list of your triggers and the steps you need to take to avoid them. Your doctor may also recommend tracking your asthma symptoms or using a peak flow meter on a regular basis to monitor how well your treatment is controlling your asthma. Lifestyle and home remedies Although many people with asthma rely on medications to prevent and relieve symptoms, you can do several things on your own to maintain your health and lessen the possibility of asthma attacks. Avoid your triggers Taking steps to reduce your exposure asthma triggers is a key part of asthma control, including: - Use your air conditioner. Air conditioning reduces the amount of airborne pollen from trees, grasses and weeds that finds its way indoors. Air conditioning also lowers indoor humidity and can reduce your exposure to dust mites. If you don't have air conditioning, try to keep your windows closed during pollen season. - Decontaminate your decor. Minimize dust that may worsen nighttime symptoms by replacing certain items in your bedroom. For example, encase pillows, mattresses and box springs in dustproof covers. Remove carpeting and install hardwood or linoleum flooring. Use washable curtains and blinds. - Maintain optimal humidity. If you live in a damp climate, talk to your doctor about using a dehumidifier. - Prevent mold spores. Clean damp areas in the bath, kitchen and around the house to keep mold spores from developing. Get rid of moldy leaves or damp firewood in the yard. - Reduce pet dander. If you're allergic to dander, avoid pets with fur or feathers. Having pets regularly bathed or groomed also may reduce the amount of dander in your surroundings. - Clean regularly. Clean your home at least once a week. If you're likely to stir up dust, wear a mask or have someone else do the cleaning. - Cover your nose and mouth if it's cold out. If your asthma is worsened by cold or dry air, wearing a face mask can help. Stay healthy Taking care of yourself can help keep your symptoms under control, including: - Get regular exercise. Having asthma doesn't mean you have to be less active. Treatment can prevent asthma attacks and control symptoms during activity. Regular exercise can strengthen your heart and lungs, which helps relieve asthma symptoms. If you exercise in cold temperatures, wear a face mask to warm the air you breathe. - Maintain a healthy weight. Being overweight can worsen asthma symptoms, and it puts you at higher risk of other health problems. - Control heartburn and gastroesophageal reflux disease (GERD). It's possible that the acid reflux that causes heartburn may damage lung airways and worsen asthma symptoms. If you have frequent or constant heartburn, talk to your doctor about treatment options. You may need treatment for GERD before your asthma symptoms improve. Alternative medicine Certain alternative treatments may help with asthma symptoms. However, keep in mind that these treatments are not a replacement for medical treatment - especially if you have severe asthma. Talk to your doctor before taking any herbs or supplements, as some may interact with medications you take. While some alternative remedies are used for asthma, in most cases more research is needed to see how well they work and to measure the extent of possible side effects. Alternative asthma treatments include: - Breathing exercises. These exercises may reduce the amount of medication you need to keep your asthma symptoms under control. - Herbal and natural remedies. A few herbal and natural remedies that may help improve asthma symptoms include black seed, caffeine, choline and pycnogenol. ", "role": "user" }, { "content": "Asthma (Diagnosis): Physical exam To rule out other possible conditions - such as a respiratory infection or chronic obstructive pulmonary disease (COPD) - your doctor will do a physical exam and ask you questions about your signs and symptoms and about any other health problems. You may also be given lung (pulmonary) function tests to determine how much air moves in and out as you breathe. These tests may include: Spirometry. This test estimates the narrowing of your bronchial tubes by checking how much air you can exhale after a deep breath and how fast you can breathe out. Peak flow. A peak flow meter is a simple device that measures how hard you can breathe out. Lower than usual peak flow readings are a sign your lungs may not be working as well and that your asthma may be getting worse. A chest X-ray and high-resolution computerized tomography (CT) scan of your lungs and nose cavities (sinuses) can identify any structural abnormalities or diseases (such as infection) that can cause or aggravate breathing problems. Allergy tests can identify allergy to pets, dust, mold and pollen.", "role": "assistant" } ]

[ { "content": "Stem Cell Therapy for Muccular Dystrophy I have read the Medline Abstracts 98,99 of 'Limb-girdle muscular dystrophy'. Please could you tell me how I contact a specialist to enquire further with this...Thank you...\n\n Limb-girdle muscular dystrophy Limb girdle muscular dystrophy LGMD Summary Limb-girdle muscular dystrophy is a group of disorders which affect the voluntary muscles around the hips and shoulders. The conditions are progressive, leading to a loss of muscle strength and bulk over a number of years. Onset may occur in childhood, adolescence, young adulthood, or even later. Males and females are affected in equal numbers. [1] Most forms of limb girdle muscular dystrophy are inherited in an autosomal recessive manner. Several rare forms are inherited in an autosomal dominant pattern. [2] While there are no treatments which directly reverse the muscle weakness associated with this condition, supportive treatment can decrease the complications. [3] There are at least 20 different types of limb-girdle muscular dystrophy. [1] Inheritance Limb-girdle muscular dystrophy (LGMD) is most often inherited in an autosomal recessive manner; less commonly, rare sub-types may be inherited in an autosomal dominant manner. There may be difficulties diagnosing the condition accurately, and often the mode of inheritance cannot be determined. Therefore, it may be challenging to determine the exact recurrence risks for some families. Establishing the type of LGMD in an affected individual can be useful for discussing the clinical course of the disease as well as for determining who else in the family may be at risk for the condition. [4] Diagnosis Making a diagnosis for a genetic or rare disease can often be challenging. Healthcare professionals typically look at a person's medical history, symptoms, physical exam, and laboratory test results in order to make a diagnosis. The following resources provide information relating to diagnosis and testing for this condition. If you have questions about getting a diagnosis, you should contact a healthcare professional. Testing Resources Orphanet lists international laboratories offering diagnostic testing for this condition. Treatment Unfortunately, no definitive treatments for LGMD exist. Management depends on each individual and the specific type of LGMD that the individual has. However, the American Academy of Neurology has developed guidelines for treatment of LGMD including: [5] [6] Weight control to avoid obesity Physical therapy and stretching exercises to promote mobility and prevent contractures (fixed tightening of the muscles) Use of mechanical aids such as canes, walkers, orthotics, and wheelchairs as needed to help ambulation and mobility Monitoring and surgical intervention as needed for orthopedic complications, such as foot deformity and scoliosis cardiomyopathy A team approach to treatment is recommended including a neurologist , pulmonologist , cardiologist , orthopedic surgeon, physiatrist , physical/occupational/ speech therapist , nutritionist , orthopedist , mental health counselors, and geneticist / genetic counselor . [5] [6] While not a currently available treatment option, some studies have shown promising results with the use of gene therapy . More research is needed to prove the safety and efficacy of this treatment approach. [6] Management Guidelines The American Academy of Neurology (AAN), the medical specialty society of neurologists, offers a summary of recommended guidelines for Limb-girdle muscular dystrophy Project OrphanAnesthesia is a project whose aim is to create peer-reviewed, readily accessible guidelines for patients with rare diseases and for the anesthesiologists caring for them. The project is a collaborative effort of the German Society of Anesthesiology and Intensive Care, Orphanet, the European Society of Pediatric Anesthesia, anesthetists and rare disease experts with the aim to contribute to patient safety. Related Diseases Related diseases are conditions that have similar signs and symptoms. A health care provider may consider these conditions in the table below when making a diagnosis. Please note that the table may not include all the possible conditions related to this disease. Conditions with similar signs and symptoms from Orphanet The differential diagnosis of LGMD includes facioscapulohumeral muscular dystrophy, Emery-Dreifuss muscular dystrophy, congenital muscular dystrophy, polymyositis, myotonic, myofibrillar, distal and metabolic myopathy, collagen 6-related disorders and dermatomyosistis. Visit the Orphanet disease page for more information. ", "role": "user" }, { "content": "Management depends on each individual and the specific type of LGMD that the individual has. However, the American Academy of Neurology has developed guidelines for treatment of LGMD including: Weight control to avoid obesity Physical therapy and stretching exercises to promote mobility and prevent contractures (fixed tightening of the muscles) Use of mechanical aids such as canes, walkers, orthotics, and wheelchairs as needed to help ambulation and mobility Monitoring and surgical intervention as needed for orthopedic complications, such as foot deformity and scoliosis cardiomyopathy A team approach to treatment is recommended including a neurologist , pulmonologist , cardiologist , orthopedic surgeon, physiatrist , physical/occupational/ speech therapist , nutritionist , orthopedist , mental health counselors, and geneticist / genetic counselor . While not a currently available treatment option, some studies have shown promising results with the use of gene therapy . More research is needed to prove the safety and efficacy of this treatment approach.", "role": "assistant" } ]