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[ { "content": "Bad Breath I have very bad breath and at times it can make myself and others sick. I need some advice as to what I need to do.\n\nBreath odor (Home Care): Use proper dental hygiene, especially flossing. Remember that mouthwashes are not effective in treating the underlying problem. Fresh parsley or a strong mint is often an effective way to fight temporary bad breath. Avoid smoking. Otherwise, follow your health care provider's instructions to treat any underlying cause of bad breath.", "role": "user" }, { "content": "Use proper dental hygiene, especially flossing. Remember that mouthwashes are not effective in treating the underlying problem. Fresh parsley or a strong mint is often an effective way to fight temporary bad breath. Avoid smoking. Otherwise, follow your health care provider's instructions to treat any underlying cause of bad breath.", "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": "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", "role": "assistant" } ]

[ { "content": "help with obesity I would like help on my obesity problem and if I can get help\n\nOverweight and Obesity (Treatment): Treatment for overweight and obesity depends on the cause and severity of your condition. Possible treatments include healthy lifestyle changes, behavioral weight-loss treatment programs, medicines, and possibly surgery. You may need treatments for any complications that you have. Healthy lifestyle changes To help you aim for and maintain a healthy weight, your doctor may recommend that you adopt lifelong healthy lifestyle changes. Heart-healthy eating. Learn about which foods and nutrients are part of a healthy eating pattern. It’s important to eat the right amount of calories to maintain a healthy weight. If you need to lose weight, try to reduce your total daily calories gradually. Use the Body Weight Planner to find out your daily calorie needs and to set goals. Visit healthy recipes and plan for success. Talk with your doctor before beginning any diet or eating plan. Visit Chose My Plate or 2015-2020 Dietary Guidelines for Americans for more information. Physical activity. Many health benefits are associated with physical activity and getting the recommended amount of physical activity needed each week. Physical activity is an important factor in determining whether a person can maintain a healthy body weight, lose excess body weight, or maintain successful weight loss. Before starting any exercise program, ask your doctor about what level of physical activity is right for you. Visit Physical Activity Has Many Health Benefits for more information. Healthy Sleep. Studies have shown some relationship between lack of sleep and obesity. Read Sleep Deprivation and Deficiency more information. Making lifelong healthy lifestyle changes, such as heart-healthy eating and physical activity, can help you modify your energy balance to help you aim for and maintain a healthy weight. For example: To aim for a healthy weight, or lose weight, you want your energy OUT to be more than your energy IN. To maintain weight loss you want your energy IN and energy OUT to be the same.  Behavioral weight-loss programs Your doctor may recommend you enroll in individual or group behavioral weight-loss programs to treat your overweight and obesity. In these programs, a trained healthcare professional will customize a weight-loss plan for you. This plan will include a moderately-reduced calorie diet, physical activity goals, and behavioral strategies to help you make and maintain these lifestyle changes. Read Living With for more information about required follow-up for these behavioral treatment programs. Read more Did you know your brain’s pleasure and reward centers can be stimulated by food and the act of eating, making it harder to change eating patterns and lose weight? Researchers know that our brains can become patterned so that we feel pleasure or reward from eating. This can make us unconsciously crave food so our bodies feel that sense of pleasure. It can also make it hard to change our eating patterns, lose weight, or maintain a healthy weight. Researchers are studying whether cognitive behavioral therapies can be an effective treatment for overweight and obesity by retraining the brain to not associate pleasure with food and the act of eating. Medicines When healthy lifestyle changes are not enough, your doctor may treat your overweight and obesity with FDA-approved medicines. These medicines work in the following parts of your body. Brain. Several medicines change the way the brain regulates the urge to eat, which can help to decrease appetite. Some examples of these medicines are diethylpropion, phendimetrazine, lorcaserin, naltrexone/bupropion, and liraglutide. Gastrointestinal tract. Orlistat is the only available medicine. It blocks your intestines from absorbing fat from foods in your diet. Weight loss medicines are not recommended as a single treatment for weight loss. These medicines can help you lose weight but when combined with lifestyle changes may result in greater weight loss. Some of these medicines should not be used if you have certain conditions or are taking certain medicines. Also, these medicines have side effects. Talk to your doctor if you are pregnant, planning to get pregnant, breast feeding, or have a family history of cardiovascular diseases such as high blood pressure, heart attack, or stroke. Surgical procedures Some patients with obesity do not respond to healthy lifestyle changes and medicines. When these patients develop certain obesity-related complications, they may be eligible for the following surgeries. Gastric bypass surgery. A small part of the stomach is connected to the middle part of the intestine, bypassing the first part of intestine. This decreases the amount of food that you can eat and the amount of fat your body can take in and store. Gastrectomy. A big portion of the stomach is removed to decrease the amount of food that you can eat. Gastric banding. A hollow band is placed around the upper part of the stomach creating a smaller stomach. This decreases the amount of food you can eat. Talk to your doctor to learn more about the benefits and risks of each type of surgery. Possible complications include bleeding, infection, internal rupture of sutures, or even death. Read gastric bypass surgery for more information. Read more Interested in learning why these surgeries lead to weight loss in some patients? First, these surgeries reduce the amount of food stored in the stomach and the amount of calories your body can take in. This can help your body restore energy balance. Second, these surgeries change the levels of certain hormones and the way the brain responds to these hormones to control hunger urges. After surgery, some people are less interested in eating or they prefer to eat healthier foods. In some cases, genetic differences may affect how much weight loss patients experience after bariatric surgery. Look for Living With will explain recommendations that your doctor may give, including lifelong healthy lifestyle changes and medical care to prevent your condition from recurring, getting worse, or causing complications. Research for Your Health will explain how we are using current research and advancing research to treat people with overweight and obesity. Participate in NHLBI Clinical Trials will discuss our ongoing clinical studies that are investigating treatments for overweight and obesity.", "role": "user" }, { "content": "Treatment for obesity includes lifestyle changes, such as gradually decreasing total calorie intake, eating healthy, getting the physical activity recommended by your doctor, and getting enough sleep. Behavioral weight-loss treatment programs may be needed to help you make and maintain these lifestyle changes. When healthy lifestyle changes are not enough, your doctor may consider medications that decrease appetite, such as diethylpropion, phendimetrazine, lorcaserin, naltrexone/bupropion, and liraglutide. Alternatively, orlistat blocks intestines from absorbing fat from foods. Patients who do not respond to lifestyle changes and medications, and develop complications, may be eligible for gastric bypass, gastrectomy. or gastric banding. Talk to your doctor to learn more about the benefits and risks of each type of surgery. Genetic differences may affect how much weight loss patients experience after bariatric surgery.", "role": "assistant" } ]

[ { "content": "how is hemophilia treated\n\nHemophilia (Treatment): The most common treatment is to replace the missing clotting factor in the blood through a vein (intravenous infusions). Special care during surgery needs to be taken if you have this bleeding disorder. So, be sure to tell your surgeon that you have this disorder. It is also very important to share information about your disorder with blood relatives as they may also be affected.", "role": "user" }, { "content": "Hemophilia (Treatment): The most common treatment is to replace the missing clotting factor in the blood through a vein (intravenous infusions). Special care during surgery needs to be taken if you have this bleeding disorder. So, be sure to tell your surgeon that you have this disorder. It is also very important to share information about your disorder with blood relatives as they may also be affected.", "role": "assistant" } ]

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

[ { "content": "how is gonorrhea diagnosed\n\nGonorrhea (Diagnosis): To determine whether the gonorrhea bacterium is present in your body, your doctor will analyze a sample of cells. Samples can be collected by: - Urine test. This may help identify bacteria in your urethra. - Swab of affected area. A swab of your throat, urethra, vagina or rectum may collect bacteria that can be identified in a laboratory. For women, home test kits are available for gonorrhea. Home test kits include vaginal swabs for self-testing that are sent to a specified lab for testing. If you prefer, you can choose to be notified by email or text message when your results are ready. You may then view your results online or receive them by calling a toll-free hotline. Testing for other sexually transmitted infections Your doctor may recommend tests for other sexually transmitted infections. Gonorrhea increases your risk of these infections, particularly chlamydia, which often accompanies gonorrhea. Testing for HIV also is recommended for anyone diagnosed with a sexually transmitted infection. Depending on your risk factors, tests for additional sexually transmitted infections could be beneficial as well.", "role": "user" }, { "content": "To test for gonorrhea, your doctor will take a sample of cells from your urine, throat, or vagina, if female. This cell sample will indicate if the bacteria is present. There are also home test kits available for women.", "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\nTay-Sachs disease (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, such as anti-seizure medications, can help in managing symptoms. Children with Tay-Sachs disease are at high risk of lung infections and may need chest physiotherapy (CPT) to help remove mucus from the lungs. Your child may have trouble swallowing, or inhale food or liquid into the lungs while eating. To prevent resulting respiratory problems, your doctor may recommend an assistive feeding device. As the disease progresses, physical therapy may help keep joints flexible and maintain the range of motion. 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 to prevent atherosclerosis\n\nAtherosclerosis (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.", "role": "user" }, { "content": "You can control most risk factors and help prevent or delay atherosclerosis. Major risk factors include unhealthy blood cholesterol levels, high LDL cholesterol, low HDL cholesterol, an unhealthy diet, or a family history of heart disease.", "role": "assistant" } ]

[ { "content": "how to prevent conjunctivitis\n\n Conjunctivitis or pink eye Inflammation - conjunctiva Pink eye Chemical conjunctivitis, Pinkeye Pink-eye Summary The conjunctiva is a clear layer of tissue lining the eyelids and covering the white of the eye. Conjunctivitis occurs when the conjunctiva becomes swollen or inflamed. This swelling can be due to an infection, an irritant, dry eyes, or an allergy. Causes Tears most often protect the eyes by washing away the germs and irritants. Tears contain proteins and antibodies that kill germs. Pink eye is most often caused by viruses and bacteria. Certain forms of pink eye can spread easily among children. Newborns can be infected by bacteria in the birth canal. It must be treated at once to preserve eyesight. Allergic conjunctivitis occurs when the conjunctiva becomes inflamed due to a reaction to pollen, dander, mold, or other allergy-causing substances. Anything which irritates the eye may cause pink eye also. These include: Chemical exposure. Smoke. Use of contact lenses (often with extended-wear lenses). Dry eyes, which can develop when the eye is unable to maintain a healthy coating of tears. Dry eyes may be caused by wind or sun, heat, problems with your eyelids, or certain rare immune disorders. Symptoms Symptoms include: Blurred vision Crusts that form on the eyelid overnight (most often caused by bacteria) Eye pain Gritty feeling in the eyes Increased tearing Itching of the eye Redness in the eyes Sensitivity to light Exams and Tests Your health care provider will: Examine your eyes Swab the conjunctiva to get a sample for analysis Treatment Treatment of conjunctivitis depends on the cause. Allergic conjunctivitis may improve when allergies are treated. It may go away on its own when you avoid your allergy triggers. Cool compresses may help soothe allergic conjunctivitis. Antibiotic medicines work well to treat pinkeye caused by bacteria. These are most often given in the form of eye drops. Viral pink eye will go away on its own without antibiotics. Mild steroid eye drops may help ease discomfort. Dry eyes may be treated with artificial tears or ointments. There are other treatments or helpful steps you can take. You can soothe your eyes by applying warm compresses. Press clean cloths soaked in warm water to your closed eyes. Other helpful steps include: DO NOT smoke and avoid secondhand smoke, direct wind, and air conditioning. Use a humidifier, such as in the winter. Limit medicines that may dry you out and worsen your symptoms. Clean eyelashes regularly and apply warm compresses. Outlook (Prognosis) The outcome is most often good with treatment of infections. It can come back if you do not take steps to prevent it from spreading. Pinkeye caused by viruses or bacteria can spread through contact. These have been known to spread through entire households or classrooms. Long-term (chronic) swelling of the outer lining of the eyes may occur in those with chronic allergies or asthma. It is called vernal conjunctivitis. It is most common in young males, and most often occurs during the spring and summer. When to Contact a Medical Professional Contact your provider if: Your symptoms last longer than 3 or 4 days. Your vision is affected. You develop eye pain that is severe or becoming worse. Your eyelids or the skin around your eyes becomes swollen or red. You have a headache in addition to your other symptom. Prevention Good hygiene can help prevent the spread of conjunctivitis. Things you can do include: Change pillowcases often. DO NOT share eye makeup and replace it regularly. DO NOT share towels or handkerchiefs. Handle and clean contact lenses properly. Keep hands away from the eye. Wash your hands often. Review Date 8/20/2016 Updated by: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Conjunctivitis or pink eye (Prevention): Good hygiene can help prevent the spread of conjunctivitis. Things you can do include: - Change pillowcases often. - DO NOT share eye makeup and replace it regularly. - DO NOT share towels or handkerchiefs. - Handle and clean contact lenses properly. - Keep hands away from the eye. - Wash your hands often.", "role": "assistant" } ]

[ { "content": "what is the cause of the coffin lowry syndrome?\n\nWhat is Coffin Lowry Syndrome?: Coffin-Lowry syndrome is a rare genetic disorder characterized by craniofacial (head and facial) and skeletal abnormalities, delayed intellectual development, short stature, and hypotonia. Characteristic facial features may include an underdeveloped upper jaw bone (maxillary hypoplasia), a broad nose, protruding nostrils (nares), an abnormally prominent brow, down-slanting eyelid folds (palpebral fissures), widely spaced eyes (hypertelorism), large low-set ears, and unusually thick eyebrows. Skeletal abnormalities may include abnormal front-to-back and side-to-side curvature of the spine (kyphoscoliosis), unusual prominence of the breastbone (pigeon chest, or pectus carinatum), dental abnormalities, and short, hyperextensible, tapered fingers. Other features may include feeding and respiratory problems, developmental delay, hearing impairment, awkward gait, stimulus-induced drop episodes, and heart and kidney involvement. The disorder affects males and females in equal numbers, but symptoms are usually more severe in males. The disorder is caused by a defective gene, RSK2, which is found in 1996 on the X chromosome (Xp22.2-p22.1). Thus, the syndrome is typically more severe in males because males have only one X chromosome, while females have two. It is unclear how changes (mutations) in the DNA structure of the gene lead to the clinical findings.", "role": "user" }, { "content": "Coffin-Lowry syndrome is a rare genetic disorder characterized by craniofacial (head and facial) and skeletal abnormalities, delayed intellectual development, short stature, and hypotonia. The disorder is caused by a defective gene, RSK2, which is found in 1996 on the X chromosome (Xp22.2-p22.1). Thus, the syndrome is typically more severe in males because males have only one X chromosome, while females have two. It is unclear how changes (mutations) in the DNA structure of the gene lead to the clinical findings.", "role": "assistant" } ]

[ { "content": "How bad can endometriosis get?\n\n Living with endometriosis Pelvic pain - living with endometriosis Endometrial implant - living with endometriosis Endometrioma - living with endometriosis Summary You have a condition called endometriosis. Symptoms of endometriosis include: Heavy menstrual bleeding Bleeding between periods Problems getting pregnant Having this condition can interfere with your social and work life. No one knows what causes endometriosis. There is also no cure. However, there are different ways to treat the symptoms. These treatments can also help relieve menstrual pain. Learning how to manage your symptoms can make it easier to live with endometriosis. Medicines to Treat Endometriosis Your health care provider may prescribe different types of hormone therapy. These may be birth control pills or injections. Be sure to follow your provider's directions for taking these medicines. DO NOT stop taking them without talking with your provider. Be sure to tell your provider about any side effects. Over-the-counter pain relievers can reduce the pain of endometriosis. These include: Ibuprofen (Advil) Naproxen (Aleve) Acetaminophen (Tylenol) If the pain is worse during your periods, try starting these medicines 1 to 2 days before your period begins. You may be receiving hormone therapy to prevent the endometriosis from becoming worse, such as: Birth control pills. Medicines that cause a menopause-like state. Side effects include hot flashes, vaginal dryness, and mood changes. Self-care Apply a hot water bottle or heating pad to your lower stomach. This can get blood flowing and relax your muscles. Warm baths also may help relieve pain. Lie down and rest. Place a pillow under your knees when lying on your back. If you prefer to lie on your side, pull your knees up toward your chest. These positions help take the pressure off your back. Get regular exercise. Exercise helps improve blood flow. It also triggers your body's natural painkillers, called endorphins. Eat a balanced, healthy diet. Maintaining a healthy weight will help improve your overall health. Eating plenty of fiber can help keep you regular so you don't have to strain during bowel movements. Techniques that also offer ways to relax and may help relieve pain include: Muscle relaxation Deep breathing Visualization Biofeedback Yoga Some women find that acupuncture helps ease painful periods. Some studies show it also helps with long-term (chronic) pain. If self-care for pain does not help, talk with your provider about other treatment options. When to Call the Doctor Call your provider right away if you have severe pelvic pain. Call your provider for an appointment if: You have pain during or after sex Your periods become more painful You have blood in your urine or pain when you urinate You have blood in your stool, painful bowel movements, or a change in your bowel movements You are unable to become pregnant after trying for 1 year Review Date 1/14/2018 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": "Symptoms of endometriosis include heavy menstrual bleeding, bleeding between periods, problems getting pregnant.", "role": "assistant" } ]

[ { "content": "could tetanus be a cause of death?\n\n Tetanus Lockjaw Trismus Summary Tetanus is an infection of the nervous system with a type of bacteria that is potentially deadly, called <em>Clostridium tetani (C tetani)</em>. Causes Spores of the bacterium <em>C tetani</em> are found in the soil, and in animal feces and mouth (gastrointestinal tract). In the spore form, <em>C tetani</em> can remain inactive in the soil. But it can remain infectious for more than 40 years. You can get tetanus infection when the spores enter your body through an injury or wound. The spores become active bacteria that spread in the body and make a poison called tetanus toxin (also known as tetanospasmin). This poison blocks nerve signals from your spinal cord to your muscles, causing severe muscle spasms. The spasms can be so powerful that they tear the muscles or cause fractures of the spine. The time between infection and the first sign of symptoms is about 7 to 21 days. Most cases of tetanus in the United States occur in those who have not been properly vaccinated against the disease. Symptoms Tetanus often begins with mild spasms in the jaw muscles (lockjaw). The spasms can also affect your chest, neck, back, and abdominal muscles. Back muscle spasms often cause arching, called opisthotonos. Sometimes, the spasms affect muscles that help with breathing, which can lead to breathing problems. Prolonged muscular action causes sudden, powerful, and painful contractions of muscle groups. This is called tetany. These are the episodes that can cause fractures and muscle tears. Other symptoms include: Drooling Excessive sweating Fever Hand or foot spasms Irritability Swallowing difficulty Uncontrolled urination or defecation Exams and Tests Your doctor will perform a physical exam and ask about your medical history. No specific lab test is available to diagnose tetanus. Tests may be used to rule out meningitis, rabies, strychnine poisoning, and other diseases with similar symptoms. Treatment Treatment may include: Antibiotics Bedrest with a calm environment (dim light, reduced noise, and stable temperature) Medicine to reverse the poison (tetanus immune globulin) Muscle relaxers, such as diazepam Sedatives Surgery to clean the wound and remove the source of the poison (debridement) Breathing support with oxygen, a breathing tube, and a breathing machine may be necessary. Outlook (Prognosis) Without treatment, 1 out of 4 infected people die. The death rate for newborns with untreated tetanus is even higher. With proper treatment, less than 15% of infected people die. Wounds on the head or face seem to be more dangerous than those on other parts of the body. If the person survives the acute illness, recovery is generally complete. Uncorrected episodes of hypoxia (lack of oxygen) caused by muscle spasms in the throat may lead to irreversible brain damage. Possible Complications Complications that may result from tetanus include: Airway obstruction Respiratory arrest Heart failure Pneumonia Damage to muscles Fractures Brain damage due to lack of oxygen during spasms When to Contact a Medical Professional Call your health care provider right away if you have an open wound, particularly if: You are injured outdoors. The wound has been in contact with soil. You have not received a tetanus booster (vaccine) within 10 years or you are not sure of your vaccination status. Call for an appointment with your provider if you have never been immunized against tetanus as an adult or child. Also call if your children have not been immunized, or if you are unsure of your tetanus immunization (vaccine) status. Prevention IMMUNIZATION Tetanus is completely preventable by being immunized (vaccinated). Immunization usually protects against tetanus infection for 10 years. In the United States, immunizations begin in infancy with the DTaP series of shots. The DTaP vaccine is a 3-in-1 vaccine that protects against diphtheria, pertussis, and tetanus. Td vaccine or Tdap vaccine is used to maintain immunity in people age 7 and older. Tdap vaccine should be given once, before age 65, as a substitute for Td for those who have not had Tdap. Td boosters are recommended every 10 years starting at age 19. Older teenagers and adults who get injuries, especially puncture-type wounds, should get a tetanus booster if it has been more than 10 years since the last booster. If you have been injured outside or in any way that makes contact with soil likely, contact your provider about your risk of getting a tetanus infection. Injuries and wounds should be thoroughly cleaned right away. If the tissue of the wound is dying, a doctor will need to remove the tissue. You may have heard that you can get tetanus if you are injured by a rusty nail. This is true only if the nail is dirty and has the tetanus bacteria on it. It is the dirt on the nail, not the rust that carries the risk for tetanus. Review Date 12/13/2017 Updated by: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Tetanus is an infection of the nervous system with a type of bacteria that is potentially deadly", "role": "assistant" } ]

[ { "content": "how is edward's syndrome diagnosed\n\nTrisomy 18: Trisomy 18 is a genetic disorder in which a person has a third copy of material from chromosome 18, instead of the usual 2 copies. Trisomy 18 occurs in 1 in 6,000 live births. It is 3 times more common in girls than boys. The syndrome occurs when there is extra material from chromosome 18. The extra material affects normal development. Symptoms may include: - Clenched hands - Crossed legs - Feet with a rounded bottom (rocker-bottom feet) - Low birth weight - Low-set ears - Mental delay - Poorly developed fingernails - Small head (microcephaly) - Small jaw (micrognathia) - Undescended testicle - Unusual shaped chest (pectus carinatum) An exam during pregnancy may show an unusually large uterus and extra amniotic fluid. There may be an unusually small placenta when the baby is born. A physical exam of the infant may show unusual fingerprint patterns. X-rays may show a short breast bone. Chromosome studies will show trisomy 18. The chromosome abnormality may be present in every cell or present in only a certain percentage of the cells (called mosaicism). Studies may also show part of the chromosome in some cells. Rarely, part of the chromosome 18 becomes attached to another chromosome. This is called translocation. Other signs include: - Hole, split, or cleft in the iris of the eye (coloboma) - Separation between the left and right side of the abdominal muscle (diastasis recti) - Umbilical hernia or inguinal hernia There are often signs of congenital heart disease, such as: - Atrial septal defect (ASD) - Patent ductus arteriosus (PDA) - Ventricular septal defect (VSD) Tests may also show kidney problems, including: - Horseshoe kidney - Hydronephrosis - Polycystic kidney There are no specific treatments for trisomy 18. Which treatments are used depend on the person's individual condition. Support groups include: - Support Organization for Trisomy 18, 13 and Related Disorders (SOFT): trisomy.org - Trisomy 18 Foundation: www.trisomy18.org - Hope for Trisomy 13 and 18: www.hopefortrisomy13and18.org Half of infants with this condition do not survive beyond the first week of life. Nine out of 10 children will die by 1 year of age. Some children have survived to the teenage years, but with serious medical and developmental problems. Complications depend on the specific defects and symptoms. Genetic counseling can help families understand the condition, the risks of inheriting it, and how to care for the person. Tests can be done during pregnancy to find out if the child has this syndrome. Genetic testing is recommended for parents who have a child with this syndrome and who want to have more children. Updated by: Chad Haldeman-Englert, MD, FACMG, Fullerton Genetics Center, Asheville, 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": "An unusually small placenta when the baby is born is a sign of Edward's syndrome. A physical exam of the infant may show unusual fingerprint patterns, and X-rays may reveal a short breastbone. To accurately diagnose Edward's syndrome, chromosome studies should be performed.", "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": "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", "role": "assistant" } ]

[ { "content": "how is hemophilia treated\n\n Hemophilia What Is... Español Hemophilia (heem-o-FILL-ee-ah) is a rare bleeding disorder in which the blood doesn't clot normally. If you have hemophilia, you may bleed for a longer time than others after an injury. You also may bleed inside your body (internally), especially in your knees, ankles, and elbows. This bleeding can damage your organs and tissues and may be life threatening. Overview Hemophilia usually is inherited. \"Inherited” means that the disorder is passed from parents to children through genes. People born with hemophilia have little or no clotting factor. Clotting factor is a protein needed for normal blood clotting. There are several types of clotting factors. These proteins work with platelets (PLATE-lets) to help the blood clot. Platelets are small blood cell fragments that form in the bone marrow—a sponge-like tissue in the bones. Platelets play a major role in blood clotting. When blood vessels are injured, clotting factors help platelets stick together to plug cuts and breaks on the vessels and stop bleeding. The two main types of hemophilia are A and B. If you have hemophilia A, you're missing or have low levels of clotting factor VIII (8). About 8 out of 10 people who have hemophilia have type A. If you have hemophilia B, you're missing or have low levels of clotting factor IX (9). Rarely, hemophilia can be acquired. \"Acquired” means you aren't born with the disorder, but you develop it during your lifetime. This can happen if your body forms antibodies (proteins) that attack the clotting factors in your bloodstream. The antibodies can prevent the clotting factors from working. This article focuses on inherited hemophilia. Outlook Hemophilia can be mild, moderate, or severe, depending on how much clotting factor is in your blood. About 7 out of 10 people who have hemophilia A have the severe form of the disorder. People who don't have hemophilia have a factor VIII activity of 100 percent. People who have severe hemophilia A have a factor VIII activity of less than 1 percent. Hemophilia usually occurs in males (with rare exceptions). About 1 in 5,000 males are born with hemophilia each year. Other Names Hemophilia A Classic hemophilia Factor VIII deficiency Hemophilia B Christmas disease Factor IX deficiency Causes A defect in one of the genes that determines how the body makes blood clotting factor VIII or IX causes hemophilia. These genes are located on the X chromosomes (KRO-muh-somz). Chromosomes come in pairs. Females have two X chromosomes, while males have one X and one Y chromosome. Only the X chromosome carries the genes related to clotting factors. A male who has a hemophilia gene on his X chromosome will have hemophilia. When a female has a hemophilia gene on only one of her X chromosomes, she is a \"hemophilia carrier” and can pass the gene to her children. Sometimes carriers have low levels of clotting factor and have symptoms of hemophilia, including bleeding. Clotting factors are proteins in the blood that work together with platelets to stop or control bleeding. Very rarely, a girl may be born with a very low clotting factor level and have a greater risk for bleeding, similar to boys who have hemophilia and very low levels of clotting factor. There are several hereditary and genetic causes of this much rarer form of hemophilia in females. Some males who have the disorder are born to mothers who aren't carriers. In these cases, a mutation (random change) occurs in the gene as it is passed to the child. Below are two examples of how the hemophilia gene is inherited. Inheritance Pattern for Hemophilia—Example 1 Each daughter has a 50 percent chance of inheriting the hemophilia gene from her mother and being a carrier. Each son has a 50 percent chance of inheriting the hemophilia gene from his mother and having hemophilia. Inheritance Pattern for Hemophilia—Example 2 Each daughter will inherit the hemophilia gene from her father and be a carrier. None of the sons will inherit the hemophilia gene from their father; thus, none will have hemophilia. Signs & Symptoms The major signs and symptoms of hemophilia are excessive bleeding and easy bruising. Excessive Bleeding The extent of bleeding depends on how severe the hemophilia is. Children who have mild hemophilia may not have signs unless they have excessive bleeding from a dental procedure, an accident, or surgery. Males who have severe hemophilia may bleed heavily after circumcision. Bleeding can occur on the body's surface (external bleeding) or inside the body (internal bleeding). Signs of external bleeding may include: Bleeding in the mouth from a cut or bite or from cutting or losing a tooth Nosebleeds for no obvious reason Heavy bleeding from a minor cut Bleeding from a cut that resumes after stopping for a short time Signs of internal bleeding may include: Blood in the urine (from bleeding in the kidneys or bladder) Blood in the stool (from bleeding in the intestines or stomach) Large bruises (from bleeding into the large muscles of the body) Bleeding in the Joints Bleeding in the knees, elbows, or other joints is another common form of internal bleeding in people who have hemophilia. This bleeding can occur without obvious injury. At first, the bleeding causes tightness in the joint with no real pain or any visible signs of bleeding. The joint then becomes swollen, hot to touch, and painful to bend. Swelling continues as bleeding continues. Eventually, movement in the joint is temporarily lost. Pain can be severe. Joint bleeding that isn't treated quickly can damage the joint. Bleeding in the Brain Internal bleeding in the brain is a very serious complication of hemophilia. It can happen after a simple bump on the head or a more serious injury. The signs and symptoms of bleeding in the brain include: Long-lasting, painful headaches or neck pain or stiffness Repeated vomiting Sleepiness or changes in behavior Sudden weakness or clumsiness of the arms or legs or problems walking Double vision Convulsions or seizures Diagnosis If you or your child appears to have a bleeding problem, your doctor will ask about your personal and family medical histories. This will reveal whether you or your family members, including women and girls, have bleeding problems. However, some people who have hemophilia have no recent family history of the disease. You or your child also will likely have a physical exam and blood tests to diagnose hemophilia. Blood tests are used to find out: How long it takes for your blood to clot Whether your blood has low levels of any clotting factors Whether any clotting factors are completely missing from your blood The test results will show whether you have hemophilia, what type of hemophilia you have, and how severe it is. Hemophilia A and B are classified as mild, moderate, or severe, depending on the amount of clotting factor VIII or IX in the blood. The severity of symptoms can overlap between the categories. For example, some people who have mild hemophilia may have bleeding problems almost as often or as severe as some people who have moderate hemophilia. Severe hemophilia can cause serious bleeding problems in babies. Thus, children who have severe hemophilia usually are diagnosed during the first year of life. People who have milder forms of hemophilia may not be diagnosed until they're adults. The bleeding problems of hemophilia A and hemophilia B are the same. Only special blood tests can tell which type of the disorder you or your child has. Knowing which type is important because the treatments are different. Pregnant women who are known hemophilia carriers can have the disorder diagnosed in their unborn babies as early as 12 weeks into their pregnancies. Women who are hemophilia carriers also can have \"preimplantation diagnosis\" to have children who don't have hemophilia. For this process, women have their eggs removed and fertilized by sperm in a laboratory. The embryos are then tested for hemophilia. Only embryos without the disorder are implanted in the womb. Treatments Treatment With Replacement Therapy The main treatment for hemophilia is called replacement therapy. Concentrates of clotting factor VIII (for hemophilia A) or clotting factor IX (for hemophilia B) are slowly dripped or injected into a vein. These infusions help replace the clotting factor that's missing or low. Clotting factor concentrates can be made from human blood. The blood is treated to prevent the spread of diseases, such as hepatitis. With the current methods of screening and treating donated blood, the risk of getting an infectious disease from human clotting factors is very small. To further reduce the risk, you or your child can take clotting factor concentrates that aren't made from human blood. These are called recombinant clotting factors. Clotting factors are easy to store, mix, and use at home—it only takes about 15 minutes to receive the factor. You may have replacement therapy on a regular basis to prevent bleeding. This is called preventive or prophylactic (PRO-fih-lac-tik) therapy. Or, you may only need replacement therapy to stop bleeding when it occurs. This use of the treatment, on an as-needed basis, is called demand therapy. Demand therapy is less intensive and expensive than preventive therapy. However, there's a risk that bleeding will cause damage before you receive the demand therapy. Complications of Replacement Therapy Complications of replacement therapy include: Developing antibodies (proteins) that attack the clotting factor Developing viral infections from human clotting factors Damage to joints, muscles, or other parts of the body resulting from delays in treatment Antibodies to the clotting factor. Antibodies can destroy the clotting factor before it has a chance to work. This is a very serious problem. It prevents the main treatment for hemophilia (replacement therapy) from working. These antibodies, also called inhibitors, develop in about 20–30 percent of people who have severe hemophilia A. Inhibitors develop in 2–5 percent of people who have hemophilia B. When antibodies develop, doctors may use larger doses of clotting factor or try different clotting factor sources. Sometimes the antibodies go away. Researchers are studying new ways to deal with antibodies to clotting factors. Viruses from human clotting factors. Clotting factors made from human blood can carry the viruses that cause HIV/AIDS and hepatitis. However, the risk of getting an infectious disease from human clotting factors is very small due to: Careful screening of blood donors Testing of donated blood products Treating donated blood products with a detergent and heat to destroy viruses Vaccinating people who have hemophilia for hepatitis A and B Damage to joints, muscles, and other parts of the body. Delays in treatment can cause damage such as: Bleeding into a joint. If this happens many times, it can lead to changes in the shape of the joint and impair the joint's function. Swelling of the membrane around a joint. Pain, swelling, and redness of a joint. Pressure on a joint from swelling, which can destroy the joint. Home Treatment With Replacement Therapy You can do both preventive (ongoing) and demand (as-needed) replacement therapy at home. Many people learn to do the infusions at home for their child or for themselves. Home treatment has several advantages: You or your child can get quicker treatment when bleeding happens. Early treatment lowers the risk of complications. Fewer visits to the doctor or emergency room are needed. Home treatment costs less than treatment in a medical care setting. Home treatment helps children accept treatment and take responsibility for their own health. Discuss options for home treatment with your doctor or your child's doctor. A doctor or other health care provider can teach you the steps and safety procedures for home treatment. Hemophilia treatment centers are another good resource for learning about home treatment (discussed in \"Living With Hemophilia”). Doctors can surgically implant vein access devices to make it easier for you to access a vein for treatment with replacement therapy. These devices can be helpful if treatment occurs often. However, infections can be a problem with these devices. Your doctor can help you decide whether this type of device is right for you or your child. Other Types of Treatment Desmopressin Desmopressin (DDAVP) is a man-made hormone used to treat people who have mild hemophilia A. DDAVP isn't used to treat hemophilia B or severe hemophilia A. DDAVP stimulates the release of stored factor VIII and von Willebrand factor; it also increases the level of these proteins in your blood. Von Willebrand factor carries and binds factor VIII, which can then stay in the bloodstream longer. DDAVP usually is given by injection or as nasal spray. Because the effect of this medicine wears off if it's used often, the medicine is given only in certain situations. For example, you may take this medicine prior to dental work or before playing certain sports to prevent or reduce bleeding. Antifibrinolytic Medicines Antifibrinolytic medicines (including tranexamic acid and epsilon aminocaproic acid) may be used with replacement therapy. They're usually given as a pill, and they help keep blood clots from breaking down. These medicines most often are used before dental work or to treat bleeding from the mouth or nose or mild intestinal bleeding. Gene Therapy Researchers are trying to find ways to correct the faulty genes that cause hemophilia. Gene therapy hasn't yet developed to the point that it's an accepted treatment for hemophilia. However, researchers continue to test gene therapy in clinical trials. For more information, go to the \"Clinical Trials\" section of this article. Treatment of a Specific Bleeding Site Pain medicines, steroids, and physical therapy may be used to reduce pain and swelling in an affected joint. Talk with your doctor or pharmacist about which medicines are safe for you to take. Which Treatment Is Best for You? The type of treatment you or your child receives depends on several things, including how severe the hemophilia is, the activities you'll be doing, and the dental or medical procedures you'll be having. Mild hemophilia—Replacement therapy usually isn't needed for mild hemophilia. Sometimes, though, DDAVP is given to raise the body's level of factor VIII. Moderate hemophilia—You may need replacement therapy only when bleeding occurs or to prevent bleeding that could occur when doing certain activities. Your doctor also may recommend DDAVP prior to having a procedure or doing an activity that increases the risk of bleeding. Severe hemophilia—You usually need replacement therapy to prevent bleeding that could damage your joints, muscles, or other parts of your body. Typically, replacement therapy is given at home two or three times a week. This preventive therapy usually is started in patients at a young age and may need to continue for life. For both types of hemophilia, getting quick treatment for bleeding is important. Quick treatment can limit damage to your body. If you or your child has hemophilia, learn to recognize signs of bleeding. Other family members also should learn to watch for signs of bleeding in a child who has hemophilia. Children sometimes ignore signs of bleeding because they want to avoid the discomfort of treatment. Living With If you or your child has hemophilia, you can take steps to prevent bleeding problems. Thanks to improvements in treatment, a child who has hemophilia today is likely to live a normal lifespan. Hemophilia Treatment Centers The Federal Government funds a nationwide network of hemophilia treatment centers (HTCs). These centers are an important resource for people who have hemophilia and their families. The medical experts at HTCs provide treatment, education, and support. They can teach you or your family members how to do home treatments. Center staff also can provide your doctor with information. People who get care at HTCs are less likely than those who get care elsewhere to have bleeding complications and hospitalizations. They're also more likely to have a better quality of life. This may be due to the centers' emphasis on bleeding prevention and the education and support provided to patients and their caregivers. More than 100 federally funded HTCs are located throughout the United States. Many HTCs are located at major university medical and research centers. The hemophilia teams at these centers include: Nurse coordinators Pediatricians (doctors who treat children) and adult and pediatric hematologists (doctors who specialize in blood disorders) Social workers (who can help with financial issues, transportation, mental health, and other issues) Physical therapists and orthopedists (doctors who specialize in disorders of the bones and joints) Dentists To find an HTC located near you, go to the directory of HTCs on the Centers for Disease Control and Prevention's Web site. Many people who have hemophilia go to HTCs for annual checkups, even if it means traveling some distance to do so. At an HTC, you or your child may be able to take part in clinical research and benefit from the latest hemophilia research findings. The HTC team also will work with your local health care providers to help meet your needs or your child's needs. Ongoing Care If you have hemophilia, you can take steps to avoid complications. For example: Follow your treatment plan exactly as your doctor prescribes. Have regular checkups and vaccinations as recommended. Tell all of your health care providers—such as your doctor, dentist, and pharmacist—that you have hemophilia. You also may want to tell people like your employee health nurse, gym trainer, and sports coach about your condition. Have regular dental care. Dentists at the HTCs are experts in providing dental care for people who have hemophilia. If you see another dentist, tell him or her that you have hemophilia. The dentist can provide medicine that will reduce bleeding during dental work. Know the signs and symptoms of bleeding in joints and other parts of the body. Know when to call your doctor or go to the emergency room. For example, you'll need care if you have: - Heavy bleeding that can't be stopped or a wound that continues to ooze blood. - Any signs or symptoms of bleeding in the brain. Such bleeding is life threatening and requires emergency care. - Limited motion, pain, or swelling of any joint. Heavy bleeding that can't be stopped or a wound that continues to ooze blood. Any signs or symptoms of bleeding in the brain. Such bleeding is life threatening and requires emergency care. Limited motion, pain, or swelling of any joint. It's a good idea to keep a record of all previous treatments. Be sure to take this information with you to medical appointments and to the hospital or emergency room. If Your Child Is Diagnosed With Hemophilia You may have emotional, financial, social, or other strains as you adjust to having a child who has hemophilia. Learn all you can about the disorder and get the support you need. Talk with doctors and other health care providers about treatment, prevention of bleeding, and what to do during an emergency. The care teams at HTCs can provide your child with treatment and help educate and support you. The social worker on the team can help with emotional issues, financial and transportation problems, and other concerns. Seek the many resources available through the Web, books, and other materials, including those provided by national and local hemophilia organizations. Look into support groups that offer a variety of activities for children who have hemophilia and for family members. Some groups offer summer camps for children who have hemophilia. Ask your doctor, nurse coordinator, or social worker about these groups and camps. Challenges will occur as your child grows and becomes more active. In addition to treatment and regular health and dental care, your child needs information about hemophilia that he or she can understand. Children who have hemophilia also need ongoing support, and they need to be reassured that the condition isn't their fault. Young children who have hemophilia need extra protection from things in the home and elsewhere that could cause injuries and bleeding: Protect toddlers with kneepads, elbow pads, and protective helmets. All children should wear safety helmets when riding tricycles or bicycles. Be sure to use the safety belts and straps in highchairs, car seats, and strollers to protect your child from falls. Remove furniture with sharp corners or pad them while your child is a toddler. Keep out of reach or locked away small and sharp objects and other items that could cause bleeding or harm. Check play equipment and outdoor play areas for possible hazards. You also should learn how to examine your child for and recognize signs of bleeding. Learn to prepare for bleeding episodes when they occur. Keep a cold pack in the freezer ready to use as directed or to take along with you to treat bumps and bruises. Popsicles work fine when there is minor bleeding in the mouth. You also might want to keep a bag ready to go with items you'll need if you must take your child to the emergency room or elsewhere. Be sure that anyone who is responsible for your child knows that he or she has hemophilia. Talk with your child's babysitters, daycare providers, teachers, other school staff, and coaches or leaders of afterschool activities about when to contact you or to call 9–1–1 for emergency care. Your child should wear a medical ID bracelet or necklace. If your child is injured, the ID will alert anyone caring for your child about his or her hemophilia. Physical Activity and Hemophilia Physical activity helps keep muscles flexible, strengthens joints, and helps maintain a healthy weight. Children and adults who have hemophilia should be physically active, but they may have limits on what they can do safely. People who have mild hemophilia can take part in many activities. Those who have severe hemophilia should avoid contact sports and other activities that are likely to lead to injuries that could cause bleeding. Examples of these activities include football, hockey, and wrestling. Physical therapists at HTCs can develop exercise programs tailored to your needs and teach you how to exercise safely. Talk with your doctor or physical therapist about recommended types of physical activity and sports. In general, some safe physical activities are swimming, biking (wearing a helmet), walking, and golf. To prevent bleeding, you also may be able to take clotting factors prior to exercise or a sporting event. Medicine Precautions Some medicines increase the risk of bleeding, such as: Aspirin and other medicines that contain salicylates (sa-LIH-sil-ates) Ibuprofen, naproxen, and some other nonsteroidal anti-inflammatory medicines Talk with your doctor or pharmacist about which medicines are safe for you to take. Treatment at Home and When Traveling Home treatment with replacement therapy has many benefits. It lets you treat bleeding early, before complications are likely to develop. Home treatment also can prevent frequent trips to the doctor's office or hospital. This can give you more independence and control over your hemophilia. However, if you're treating yourself or your child with clotting factors at home, you should take some steps for safety: Follow instructions for storage, preparation, and use of clotting factors and treatment materials. Keep a record of all medical treatment. Know the signs and symptoms of bleeding, infection, or an allergic reaction, and know the correct way to respond. Have someone with you when you treat yourself. Know when to call the doctor or 9–1–1. When you're traveling, be sure to take enough treatment supplies along. You also should carry a letter from your doctor describing your hemophilia and treatment. It's a good idea to find out in advance where to go for care when out of town. Cost Issues Clotting factors are very costly. Many health insurance companies will only pay for clotting factors on a case-by-case basis. It's important to know: What your insurance covers Whether your insurance has a limit on the dollar amount it will cover and what that amount is Whether restrictions or waiting periods apply As children grow, it's important to learn about available options for insurance. Look into what kinds of health insurance are offered when seeking a job. ", "role": "user" }, { "content": "The main way to treat hemophilia is with replacement therapy. This is where clotting factor VIII (for hemophilia A) or clotting factor IX (for hemophilia B) are dripped or injected intravenously. These infusions help replenish the missing or low clotting factor. You may receive a preventative treatment, or you may receive treatment only to stop bleeding when it occurs. However, the latter treatment may not be able to stop damage before it occurs.", "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": "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": "I have no help its about 4 years now I have ingrown toenail i have a problem of ingrown toenail its about 4 years now I have this problem i need help\n\nIngrown toenail removal – discharge (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.", "role": "user" }, { "content": "You might have surgery that removes part or all of your toenail to relieve pain and discomfort due to an ingrown toenail.", "role": "assistant" } ]

[ { "content": "how do i stop using rasagiline\n\nHow should Rasagiline be used and what is the dosage?: Rasagiline comes as a tablet to take by mouth. It is usually taken once a day with or without food. Take rasagiline at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take rasagiline exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Your doctor may start you on a low dose of rasagiline and may increase your dose based upon your body's response to this medication. Do not stop taking rasagiline without talking to your doctor. Your doctor will probably decrease your dose gradually. If you suddenly stop taking rasagiline, you may experience withdrawal symptoms such as a fever; muscle stiffness; unsteadiness, wobbliness, or lack of coordination; or changes in consciousness. Tell your doctor if you experience any of these symptoms when your dose of rasagiline is decreased.", "role": "user" }, { "content": "Do not stop taking rasagiline without talking to your doctor. Your doctor will probably decrease your dose gradually. If you suddenly stop taking rasagiline, you may experience withdrawal symptoms such as a fever; muscle stiffness; unsteadiness, wobbliness, or lack of coordination; or changes in consciousness. Tell your doctor if you experience any of these symptoms when your dose of rasagiline is decreased.", "role": "assistant" } ]

[ { "content": "what is the disorder achondroplasia\n\nAchondroplasia (Prevention): Genetic counseling may be helpful for prospective parents when 1 or both have achondroplasia. However, because achondroplasia most often develops spontaneously, prevention is not always possible.", "role": "user" }, { "content": "achondroplasia most often develops spontaneously,", "role": "assistant" } ]

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

[ { "content": "Please let me know where I can get literature on Cardiac amyloidosis. My uncle died yesterday from this disorder. Since this is such a rare disorder, and to honor his memory, I would like to distribute literature at his funeral service.\n\n Cardiac amyloidosis Amyloidosis - cardiac Primary cardiac amyloidosis - AL type Secondary cardiac amyloidosis - AA type Stiff heart syndrome Senile amyloidosis Summary Cardiac amyloidosis is a disorder caused by deposits of an abnormal protein (amyloid) in the heart tissue. These deposits make it hard for the heart to work properly. Causes Amyloidosis is a group of diseases in which clumps of proteins called amyloids build up in body tissues. Over time, these proteins replace normal tissue, leading to failure of the involved organ. There are many forms of amyloidosis. Cardiac amyloidosis (\"stiff heart syndrome\") occurs when amyloid deposits take the place of normal heart muscle. It is the most typical type of restrictive cardiomyopathy. Cardiac amyloidosis may affect the way electrical signals move through the heart (conduction system). This can lead to abnormal heartbeats (arrhythmias) and faulty heart signals (heart block). The condition can be inherited. This is called familial cardiac amyloidosis. It can also develop as the result of another disease such as a type of bone and blood cancer, or as the result of another medical problem causing inflammation. Cardiac amyloidosis is more common in men than in women. The disease is rare in people under age 40. Symptoms Some people may have no symptoms. When present, symptoms may include: Excessive urination at night Fatigue, reduced exercise ability Palpitations (sensation of feeling heartbeat) Shortness of breath with activity Swelling of the abdomen, legs, ankles, or other part of the body Trouble breathing while lying down Exams and Tests The signs of cardiac amyloidosis can be related to a number of different conditions. This can make the problem hard to diagnose. Signs may include: Abnormal sounds in the lung (lung crackles) or a heart murmur Blood pressure that is low or drops when you stand up Enlarged neck veins Swollen liver The following tests may be done: Chest or abdomen CT scan (considered the \"gold standard\" to help diagnose this condition) Coronary angiography Electrocardiogram (ECG) Echocardiogram Magnetic resonance imaging (MRI) Nuclear heart scans (MUGA, RNV) Positron emission tomography (PET) An ECG may show problems with the heartbeat or heart signals. It may also show low signals (called \"low voltage\"). A cardiac biopsy is used to confirm the diagnosis. A biopsy of another area, such as the abdomen, kidney, or bone marrow, is often done as well. Treatment Your health care provider may tell you to make changes to your diet, including limiting salt and fluids. You may need to take water pills (diuretics) to help your body get rid of excess fluid. The provider may tell you to weigh yourself every day. A weight gain of 3 or more pounds (1 kilogram or more) over 1 to 2 days can mean there is too much fluid in the body. Medicines including digoxin, calcium-channel blockers, and beta-blockers may be used in people with atrial fibrillation. However, the drugs must be used with caution, and the dosage must be carefully monitored. People with cardiac amyloidosis may be extra sensitive to side effects of these drugs. Other treatments may include: Chemotherapy Implantable cardioverter-defibrillator (AICD) Pacemaker, if there are problems with heart signals Prednisone, an anti-inflammatory medicine A heart transplant may be considered for people with some types of amyloidosis who have very poor heart function. People with hereditary amyloidosis may need a liver transplant. Outlook (Prognosis) In the past, cardiac amyloidosis was thought to be an untreatable and rapidly fatal disease. However, the field is changing rapidly. Different types of amyloidosis can affect the heart in different ways. Some types are more severe than others. Many people can now expect to survive and experience a good quality of life for several years after diagnosis. Possible Complications Complications may include: Atrial fibrillation or ventricular arrhythmias Congestive heart failure Fluid buildup in the abdomen (ascites) Increased sensitivity to digoxin Low blood pressure and dizziness from excessive urination (due to medicine) Sick sinus syndrome Symptomatic cardiac conduction system disease (arrhythmias related to abnormal conduction of impulses through the heart muscle) When to Contact a Medical Professional Call your provider if you have this disorder and develop new symptoms such as: Dizziness when you change position Excessive weight (fluid) gain Excessive weight loss Fainting spells Severe breathing problems Review Date 5/16/2018 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": "The complications of cardiac amyloidosis include atrial fibrillation or ventricular arrhythmias, congestive heart failure, fluid buildup in the abdomen (ascites), increased sensitivity to digoxin, low blood pressure and dizziness from excessive urination, sick sinus syndrome, and cardiac conduction system disease (arrhythmias)", "role": "assistant" } ]

[ { "content": "Bad Breath I have very bad breath and at times it can make myself and others sick. I need some advice as to what I need to do.\n\nBad breath (Treatment): To reduce bad breath, help avoid cavities and lower your risk of gum disease, consistently practice good oral hygiene. Further treatment for bad breath can vary, depending on the cause. If your bad breath is thought to be caused by an underlying health condition, your dentist will likely refer you to your primary care provider. For causes related to oral health, your dentist will work with you to help you better control that condition. Dental measures may include: - Mouth rinses and toothpastes. If your bad breath is due to a buildup of bacteria (plaque) on your teeth, your dentist may recommend a mouth rinse that kills the bacteria. Your dentist may also recommend a toothpaste that contains an antibacterial agent to kill the bacteria that cause plaque buildup. - Treatment of dental disease. If you have gum disease, you may be referred to a gum specialist (periodontist). Gum disease can cause gums to pull away from your teeth, leaving deep pockets that fill with odor-causing bacteria. Sometimes only professional cleaning removes these bacteria. Your dentist might also recommend replacing faulty tooth restorations, a breeding ground for bacteria.", "role": "user" }, { "content": "Practice good oral hygiene to reduce bad breath. To find out if your bad breath is caused by an underlying health condition visit your primary care provider. Treatment of dental disease and mouth rinses and toothpaste that kill bacteria could make your breath fresher.", "role": "assistant" } ]

[ { "content": "how smoking tobacco affects the rest of the body\n\nBenefits of quitting tobacco (Summary): If you smoke, you should quit. But quitting can be hard. Most people who have quit smoking have tried at least once, without success, in the past. View any past attempts to quit as a learning experience, not a failure. There are many reasons to quit using tobacco. Long-term use of tobacco can increase your risk of many serious health problems. THE BENEFITS OF QUITTING You may enjoy the following when you quit smoking. - Your breath, clothes, and hair will smell better. - Your sense of smell will return. Food will taste better. - Your fingers and fingernails will slowly appear less yellow. - Your stained teeth may slowly become whiter. - Your children will be healthier and will be less likely to start smoking. - It will be easier and cheaper to find an apartment or hotel room. - You may have an easier time getting a job. - Friends may be more willing to be in your car or home. - It may be easier to find a date. Many people do not smoke and do not like to be around people who smoke. - You will save money. If you smoke a pack a day, you spend about $2,000 a year on cigarettes. HEALTH BENEFITS Some health benefits begin almost immediately. Every week, month, and year without tobacco further improves your health. - Within 20 minutes of quitting: Your blood pressure and pulse rate drop to normal and the temperature of your hands and feet increases to normal. - Within 8 hours of quitting: Your blood carbon monoxide levels drop and your blood oxygen levels increase to normal levels. - Within 24 hours of quitting: Your risk of a sudden heart attack goes down. - Within 48 hours of quitting: Your nerve endings begin to regrow. Your senses of smell and taste begin to return to normal. - Within 2 weeks to 3 months of quitting: Your circulation improves. Walking becomes easier. Your lungs work better. Wounds heal more quickly. - Within 1 to 9 months of quitting: You have more energy. Smoking-related symptoms, such as coughing, nasal congestion, fatigue, and shortness of breath improve. You will have fewer illnesses, colds, and asthma attacks. You will gradually no longer be short of breath with everyday activities. - Within 1 year of quitting: Your risk of coronary heart disease is half that of someone still using tobacco. - Within 5 years of quitting: Your risk of mouth, throat, esophagus, and bladder cancers are reduced by half. - Within 10 years of quitting: Your risk of dying from lung cancer is about one half that of a person who still smokes. Other health benefits of quitting smoking include: - Lower chance of blood clots in the legs, which may travel to the lungs - Lower risk of erectile dysfunction - Fewer problems during pregnancy, such as babies born at low birth weight, premature labor, miscarriage, and cleft lip - Lower risk of infertility due to damaged sperm - Healthier teeth, gums, and skin Infants and children who you live with will have: - Asthma that is easier to control - Fewer visits to the emergency room - Fewer colds, ear infections, and pneumonia - Reduced risk of sudden infant death syndrome (SIDS) MAKING THE DECISION Like any addiction, quitting tobacco is difficult, especially if you do it alone. There are a lot of ways to quit smoking and many resources to help you. Talk to your health care provider about nicotine replacement therapy and smoking cessation medications. If you join smoking cessation programs, you have a much better chance of success. Such programs are offered by hospitals, health departments, community centers, and work sites.", "role": "user" }, { "content": "Long-term use of tobacco can increase your risk of many serious health problems. The health benefits of quitting include decrease in blood pressure and pulse, improved circulation, improved nasal congestion, less fatigue, fewer illnesses, and decreased risk of many types of cancer.", "role": "assistant" } ]

[ { "content": "We have 14 siblings in our family , at least 10 of us has had a frozen shoulder. We are wondering why? should we be concerned?\n\n Frozen shoulder Adhesive capsulitis Shoulder pain - frozen Summary Frozen shoulder is a condition in which the shoulder is painful and loses motion because of inflammation. Causes The capsule of the shoulder joint has ligaments that hold the shoulder bones to each other. When the capsule becomes inflamed, the shoulder bones are unable to move freely in the joint. Most of the time, there is no cause for frozen shoulder. Risk factors include: Diabetes Thyroid problems Changes in your hormones, such as during menopause Shoulder injury Shoulder surgery Open heart surgery Cervical disk disease of the neck Women 40 to 70 years old are most affected Symptoms Main symptoms of a frozen shoulder are: Decreased motion of the shoulder Pain Stiffness Frozen shoulder without any known cause starts with pain. This pain prevents you from moving your arm. This lack of movement can lead to stiffness and even less motion. Over time, you are not able to do movements such as reaching over your head or behind you. Exams and Tests Your health care provider will ask about your symptoms and examine your shoulder. A diagnosis is often made when you are not able to rotate your shoulder. You may have x-rays of the shoulder. This is to make sure there is no other problem, such as arthritis or calcium deposits. Sometimes, an MRI exam shows inflammation, but these types of imaging tests are not needed to diagnose frozen shoulder. Treatment Pain is treated with NSAIDs and steroid injections. Steroid injections and physical therapy can improve your motion. It can take a few weeks to see progress. It may take as long as 6 to 9 months for complete recovery. Physical therapy is intense and needs to be done every day. Left untreated, the condition often gets better by itself within 2 years with little loss of motion. Risk factors for frozen shoulder, such as diabetes or thyroid problems, should also be treated. Surgery is recommended if nonsurgical treatment is not effective. This procedure (shoulder arthroscopy) is done under anesthesia. During surgery the scar tissue is released (cut) by bringing the shoulder through a full range of motion. Arthroscopic surgery can also be used to cut the tight ligaments and remove the scar tissue from the shoulder. After surgery, you may receive pain blocks (shots) so you can do physical therapy. Follow instructions on caring for your shoulder at home. Outlook (Prognosis) Treatment with physical therapy and NSAIDs often restores motion and function of the shoulder within a year. Even untreated, the shoulder may get better by itself in 2 years. After surgery restores motion, you must continue physical therapy for several weeks or months. This is to prevent the frozen shoulder from returning. If you do not keep up with physical therapy, the frozen shoulder may come back. Possible Complications Complications may include: Stiffness and pain continue even with therapy The arm can break if the shoulder is moved forcefully during surgery When to Contact a Medical Professional If you have shoulder pain and stiffness and think you have a frozen shoulder, contact your provider for referral and treatment. Prevention Early treatment may help prevent stiffness. Call your provider if you develop shoulder pain that limits your range of motion for an extended period. People who have diabetes or thyroid problems will be less likely to get frozen shoulder if they keep their condition under control. Review Date 11/27/2016 Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "What are the complications of Frozen shoulder?: Complications may include: - Stiffness and pain continue even with therapy - The arm can break if the shoulder is moved forcefully during surgery", "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": "Heart 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. 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. A stent is usually placed after or during angioplasty. It helps prevent the artery from closing up again.", "role": "assistant" } ]

[ { "content": "adrenoleukodystrophy A child I have been asked to work with has been diagnosed with this condition.I am so far unable to find info pertaining to this illness. Can you help??\n\nX-linked adrenoleukodystrophy (Summary): X-linked adrenoleukodystrophy (X-ALD) is an inherited  condition that occurs mostly in males.  The condition mainly affects the nervous system and the adrenal glands (small glands located on top of each kidney). People with this disorder often have progressive destruction of the fatty covering ( myelin ) that insulates nerves in the brain and spinal cord. They may also have a shortage of certain hormones caused by damage to the outer layer of the adrenal glands (adrenal cortex), called adrenocortical insufficiency.  X-ALD is caused by mutations in the  gene . These gene mutations cause a shortage (deficiency) of a protein  called adrenoleukodystrophy protein (ALDP).  A deficiency of this protein leads to an abnormally high level of fat molecules called very long-chain fatty acids (VLCFA) to build up in the body.  High levels of VLCFA may be toxic to the adrenal cortex and myelin.   There are several forms of X-ALD including: a childhood cerebral form, an adrenomyeloneuropathy (AMN) type, and an adrenal insufficiency-only type. Another form of ALD is occasionally seen in women who are carriers of the condition [1] A specific treatment for X-ALD is not currently available, but eating a diet low in VLCFA and taking special oils can lower the blood levels of VLCFA.  Bone marrow transplantation (BMT) may be an option for boys and adolescents in early stages who have evidence of brain involvement on MRI . [2]  Adrenocortical insufficiency is treated with cortisone replacement.", "role": "user" }, { "content": "X-linked adrenoleukodystrophy (X-ALD) is an inherited condition that occurs mostly in males. The condition mainly affects the nervous system and the adrenal glands (small glands located on top of each kidney). People with this disorder often have progressive destruction of the fatty covering ( myelin ) that insulates nerves in the brain and spinal cord. ... X-ALD is caused by mutations in the gene . These gene mutations cause a shortage (deficiency) of a protein called adrenoleukodystrophy protein (ALDP). A deficiency of this protein leads to an abnormally high level of fat molecules called very long-chain fatty acids (VLCFA) to build up in the body. High levels of VLCFA may be toxic to the adrenal cortex and myelin. There are several forms of X-ALD including: a childhood cerebral form, an adrenomyeloneuropathy (AMN) type, and an adrenal insufficiency-only type. Another form of ALD is occasionally seen in women who are carriers of the condition [1] A specific treatment for X-ALD is not currently available, but eating a diet low in VLCFA and taking special oils can lower the blood levels of VLCFA. Bone marrow transplantation (BMT) may be an option for boys and adolescents in early stages who have evidence of brain involvement on MRI . [2] Adrenocortical insufficiency is treated with cortisone replacement.", "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\nPsoriasis (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.", "role": "user" }, { "content": "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.", "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 dystrophies Muscular dystrophy - limb-girdle type (LGMD) Summary Limb-girdle muscular dystrophies include at least 18 different inherited disorders. (There are 16 known genetic forms.) These disorders first affect the muscles around the shoulder girdle and hips. These diseases get worse. Eventually, it may involve other muscles. Causes Limb-girdle muscular dystrophies are a large group of genetic diseases in which there is muscle weakness and wasting (muscular dystrophy). In most cases, both parents must pass on the non-working (defective) gene for a child to have the disease (autosomal recessive inheritance). In some rare types, only one parent needs to pass on the non-working gene to affect the child. This is called autosomal dominant inheritance. For 16 of these conditions, the defective gene has been discovered. For others, the gene is not yet known. An important risk factor is having a family member with muscular dystrophy. Symptoms Most often, the first sign is pelvic muscle weakness. Examples of this include trouble standing from a sitting position without using the arms, or difficulty climbing stairs. The weakness starts in childhood to young adulthood. Other symptoms include: Abnormal, sometimes waddling, walk Joints that are fixed in a contracted position (late in the disease) Large and muscular-looking calves (pseudohypertrophy), which are not actually strong Loss of muscle mass, thinning of certain body parts Low back pain Palpitations or passing-out spells Shoulder weakness Weakness of the muscles in the face (later in the disease) Weakness in the muscles of the lower legs, feet, lower arms, and hands (later in the disease) Exams and Tests Tests may include: Blood creatine kinase levels DNA testing (molecular genetic testing) Echocardiogram or ECG Electromyogram (EMG) testing Muscle biopsy Treatment There are no known treatments that reverse the muscle weakness. Gene therapy may become available in the future. Supportive treatment can decrease the complications of the disease. The condition is managed based on the person's symptoms. It includes: Heart monitoring Mobility aids Physical therapy Respiratory care Weight control Surgery is sometimes needed for any bone or joint problems. Support Groups The Muscular Dystrophy Association is an excellent resource: www.mda.org Outlook (Prognosis) In general, people tend to have weakness that slowly gets worse in affected muscles and spreads. The disease causes loss of movement. The person may be dependent on a wheelchair within 20 to 30 years. Heart muscle weakness and abnormal electrical activity of the heart can increase the risk for palpitations, fainting, and sudden death. Most people with this group of diseases live into adulthood, but do not reach their full life expectancy. Possible Complications People with limb-girdle muscular dystrophies may experience complications such as: Abnormal heart rhythms Contractures of the joints Difficulties with activities of daily living due to shoulder weakness Progressive weakness, which may lead to needing a wheelchair When to Contact a Medical Professional Call your health care provider if you or your child feels weak while rising from a squatting position. Call a geneticist if you or a family member has been diagnosed with muscular dystrophy and you are planning a pregnancy. Prevention Genetic counseling is now offered to affected individuals and their families. Soon molecular testing will involve whole genome sequencing on patients and their relatives to better establish the diagnosis. Genetic counseling may help some couples and families learn about the risks and help with family planning. It also allows connecting patients with diseases registries and patient organizations. Some of the complications can be prevented with appropriate treatment. For example, a cardiac pacemaker or defibrillator can greatly reduce the risk for sudden death due to an abnormal heart rhythm. Physical therapy may be able to prevent or delay contractures and improve quality of life. Affected people may want to do DNA banking. DNA testing is recommended for those who are affected. This helps to identify the family gene mutation. Once the mutation is found, prenatal DNA testing, testing for carriers, and pre-implantation genetic diagnosis are possible. 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": "There are no known treatments that reverse the muscle weakness. Gene therapy may become available in the future. Supportive treatment can decrease the complications of the disease. The condition is managed based on the symptoms and may include heart monitoring, mobility aids, physical therapy, respiratory care, weight control and surgery.", "role": "assistant" } ]

[ { "content": "Rubella My grandson (4 yrs old) has contracted Rubella. I know for sure he has had at least one of the vaccines. They are living in Mexico right now. Should we be worried?\n\n Rubella Overview Rubella, also called German measles or three-day measles, is a contagious viral infection best known by its distinctive red rash. Rubella is not the same as measles (rubeola), though the two illnesses do share some characteristics, including the red rash. However, rubella is caused by a different virus than measles, and is neither as infectious nor usually as severe as measles. The measles-mumps-rubella (MMR) vaccine, usually given to children in the United States twice before they reach school age, is highly effective in preventing rubella. Because of widespread use of the vaccine, the Centers for Disease Control and Prevention (CDC) has declared rubella eliminated in the United States, but cautions parents to make sure their children are vaccinated to prevent its reemergence. Symptoms The signs and symptoms of rubella are often so mild they're difficult to notice, especially in children. If signs and symptoms do occur, they generally appear between two and three weeks after exposure to the virus. They typically last about two to three days and may include: - Mild fever of 102 F (38.9 C) or lower - Headache - Stuffy or runny nose - Inflamed, red eyes - Enlarged, tender lymph nodes at the base of the skull, the back of the neck and behind the ears - A fine, pink rash that begins on the face and quickly spreads to the trunk and then the arms and legs, before disappearing in the same sequence - Aching joints, especially in young women When to see a doctor Contact your doctor if you think you or your child may have been exposed to rubella or if you have the signs or symptoms listed above. If you're contemplating getting pregnant, check your vaccination record to make sure you've received your MMR inoculations. If a pregnant woman contracts rubella, especially during her first trimester, the virus can cause death or serious birth defects in her developing fetus. Rubella during pregnancy is the most common cause of congenital deafness. It's best for women to be protected against rubella before pregnancy. If you're pregnant, you'll likely undergo a routine screening for immunity to rubella. But if you've never received the vaccine and think you might have been exposed to rubella, contact your doctor immediately. A blood test might confirm that you're already immune. Causes The cause of rubella is a virus that's passed from person to person. It can spread when an infected person coughs or sneezes, or it can spread by direct contact with an infected person's respiratory secretions, such as mucus. It can also be transmitted from a pregnant woman to her unborn child via the bloodstream. A person with rubella is contagious from 10 days before the onset of the rash until about one or two weeks after the rash disappears. An infected person can spread the illness before the person realizes he or she has it. Rubella is rare in the United States because most children receive a vaccination against the infection at an early age. However, cases of rubella do occur, mostly in unvaccinated foreign-born adults. The disease is still common in many parts of the world. The prevalence of rubella in other countries is something to consider before going abroad, especially if you're pregnant. Complications Rubella is a mild infection. Once you've had the disease, you're usually permanently immune. Some women with rubella experience arthritis in the fingers, wrists and knees, which generally lasts for about one month. In rare cases, rubella can cause an ear infection (otitis media) or inflammation of the brain (encephalitis). However, if you're pregnant when you contract rubella, the consequences for your unborn child may be severe. Up to 90 percent of infants born to mothers who had rubella during the first 12 weeks of pregnancy develop congenital rubella syndrome. This syndrome can cause one or more problems, including: - Growth retardation - Cataracts - Deafness - Congenital heart defects - Defects in other organs - Mental retardation The highest risk to the fetus is during the first trimester, but exposure later in pregnancy also is dangerous. Diagnosis The rubella rash can look like many other viral rashes. So doctors usually confirm rubella with the help of laboratory tests. You may have a virus culture or a blood test, which can detect the presence of different types of rubella antibodies in your blood. These antibodies indicate whether you've had a recent or past infection or a rubella vaccine. Treatment No treatment will shorten the course of rubella infection, and symptoms are so mild that treatment usually isn't necessary. However, doctors often recommend isolation from others - especially pregnant women - during the infectious period. If you contract rubella while you're pregnant, discuss the risks to your baby with your doctor. If you wish to continue your pregnancy, you may be given antibodies called hyperimmune globulin that can fight off the infection. This can reduce your symptoms, but doesn't eliminate the possibility of your baby developing congenital rubella syndrome. Support of an infant born with congenital rubella syndrome varies depending on the extent of the infant's problems. Children with multiple complications may require early treatment from a team of specialists. Lifestyle and home remedies In rare instances when a child or adult is infected with rubella, simple self-care measures are required: - Rest in bed as necessary. - Take acetaminophen (Tylenol, others) to relieve discomfort from fever and aches. - Tell friends, family and co-workers - especially pregnant women - about your diagnosis if they may have been exposed to the disease. - Avoid people who have conditions that cause deficient or suppressed immune systems. - Tell your child's school or child care provider that your child has rubella. ", "role": "user" }, { "content": "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 your child's school or child care provider that your child has rubella.", "role": "assistant" } ]

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

[ { "content": "how is klineflyers syndrome screened\n\nKlinefelter syndrome: 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 experience primary hypogonadism (decreased testosterone production), small testes , enlarged breast tissue ( gynecomastia ), tall stature, and/or infertility. KS is not inherited , but usually occurs as a random event during the formation of reproductive cells (eggs and sperm). Treatment is based on the signs and symptoms present in each person. [1] [2] [3] 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 Breast growth ( gynecomastia ) Reduced facial and body hair Infertility Tall height Abnormal body proportions (long legs, short trunk, shoulder equal to hip size) Learning disablity Speech delay 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] 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. [4] 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] 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] 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] [5]  It is also possible to diagnosis Klinefelter syndrome before birth through chorionic villous sampling or amniocentesis . [5] 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. This may include: [1] [3] [6] 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. Therapeutic options - A variety of therapists, such as physical, speech, occupational, behavioral, mental health, and family therapists 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. Medical management - About half of people with KS 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. Many healthcare providers recommend testosterone therapy when a boy reaches puberty. However, not all males with KS benefit from testosterone therapy. Some affected people may opt to have breast removal or reduction surgery. The Eunice Kennedy Shriver National Institute of Child Health and Human Development's Web site offers more specific information on the treatment and management of Klinefelter syndrome. Please click on the link to access this resource. 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 detection of Klinefelter syndrome is shown to be important to monitor potential developmental problems. [6] 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. [6] 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] The following diseases are related to Klinefelter syndrome. If you have a question about any of these diseases, you can contact GARD. 47, XXY", "role": "user" }, { "content": "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] [5] It is also possible to diagnosis Klinefelter syndrome before birth through chorionic villous sampling or amniocentesis.", "role": "assistant" } ]

[ { "content": "adrenoleukodystrophy A child I have been asked to work with has been diagnosed with this condition.I am so far unable to find info pertaining to this illness. Can you help??\n\nWhat is Adrenoleukodystrophy?: X-linked Adrenoleukodystrophy (ALD) is one of a group of genetic disorders called the leukodystrophies that cause damage to the myelin sheath, an insulating membrane that surrounds nerve cells in the brain. Women have two X chromosomes and are the carriers of the disease, but since men only have one X chromosome and lack the protective effect of the extra X chromosome, they are more severely affected. People with X-ALD accumulate high levels of saturated, very long chain fatty acids (VLCFA) in the brain and adrenal cortex. The loss of myelin and the progressive dysfunction of the adrenal gland are the primary characteristics of X-ALD. While nearly all patients with X-ALD suffer from adrenal insufficiency, also known as Addison's disease, the neurological symptoms can begin either in childhood or in adulthood. The childhood cerebral form is the most severe, with onset between ages 4 and 10. The most common symptoms are usually behavioral changes such as abnormal withdrawal or aggression, poor memory, and poor school performance. Other symptoms include visual loss, learning disabilities, seizures, poorly articulated speech, difficulty swallowing, deafness, disturbances of gait and coordination, fatigue, intermittent vomiting, increased skin pigmentation, and progressive dementia. The milder adult-onset form is also known as adrenomyeloneuropathy (AMN), which typically begins between ages 21 and 35. Symptoms may include progressive stiffness, weakness or paralysis of the lower limbs, and ataxia. Although adult-onset ALD progresses more slowly than the classic childhood form, it can also result in deterioration of brain function. Almost half the women who are carriers of X-ALS will develop a milder form of AMN but almost never will develop symptoms seen in boys the X-ALD. X-ALD should not be confused with neonatal adrenoleukodsystrophy, which is a disease of newborns and young infants and belongs to the group of peroxisomal biogenesis disorders.", "role": "user" }, { "content": "Adrenoleukodystrophy is a genetic disorder that causes damage to the myelin sheath, an insulating membrane that surrounds nerve cells in the brain. The childhood cerebral form is the most severe, with onset between ages 4 and 10. The most common symptoms are usually behavioral changes such as abnormal withdrawal or aggression, poor memory, and poor school performance. Other symptoms include visual loss, learning disabilities, seizures, poorly articulated speech, difficulty swallowing, deafness, disturbances of gait and coordination, fatigue, intermittent vomiting, increased skin pigmentation, and progressive dementia.", "role": "assistant" } ]

[ { "content": "how do you diagnose anxiety\n\n Social anxiety disorder Phobia - social Anxiety disorder - social Social phobia SAD - social anxiety disorder Summary Social anxiety disorder is a persistent and irrational fear of situations that may involve scrutiny or judgment by others, such as at parties and other social events. Causes People with social anxiety disorder fear and avoid situations in which they may be judged by others. It may begin in the teens and may have to do with overprotective parents or limited social opportunities. Men and women are affected equally with this disorder. People with social phobia are at high risk for alcohol or other drug use. This is because they may come to rely on these substances to relax in social situations. Symptoms People with social anxiety become very anxious and self-conscious in everyday social situations. They have an intense, persistent, and chronic fear of being watched and judged by others, and of doing things that will embarrass them. They can worry for days or weeks before a dreaded situation. This fear may become so severe that it interferes with work, school, and other ordinary activities, and can make it hard to make and keep friends. Some of the most common fears of people with this disorder include: Attending parties and other social occasions Eating, drinking, and writing in public Meeting new people Speaking in public Using public restrooms Physical symptoms that often occur include: Blushing Difficulty talking Nausea Profuse sweating Trembling Social anxiety disorder is different from shyness. Shy people are able to participate in social functions. Social anxiety disorder affects the ability to function in work and relationships. Exams and Tests The health care provider will look at your history of social anxiety and will get a description of the behavior from you, your family, and friends. Treatment The goal of treatment is to help you function effectively. The success of the treatment usually depends on the severity of your fears. Behavioral treatment is often tried first and may have long-lasting benefits: Cognitive behavioral therapy helps you understand and change the thoughts that are causing your condition, as well as learn to recognize and replace panic-causing thoughts. Systematic desensitization or exposure therapy may be used. You are asked to relax, then imagine the situations that cause the anxiety, working from the least fearful to the most fearful. Gradual exposure to the real-life situation has also been used with success to help people overcome their fears. Social skills training may involve social contact in a group therapy situation to practice social skills. Role playing and modeling are techniques used to help you become more comfortable relating to others in a social situation. Certain medicines, usually used to treat depression, may be very helpful for this disorder. They work by preventing your symptoms or making them less severe. You must take these medicines every day. DO NOT stop taking them without talking with your provider. Medicines called sedatives (or hypnotics) may also be prescribed. These medicines should only be taken under a doctor's direction. Your doctor will prescribe a limited amount of these drugs. They should not to be used every day. They may be used when symptoms become very severe or when you are about to be exposed to something that always brings on your symptoms. If you are prescribed a sedative, do not drink alcohol while on this medicine. Lifestyle changes may help reduce how often the attacks occur. Get regular exercise, enough sleep, and regularly scheduled meals. Reduce or avoid the use of caffeine, some over-the-counter cold medicines, and other stimulants. Support Groups You can ease the stress of having social anxiety by joining a support group. Sharing with others who have common experiences and problems can help you not feel alone. Support groups are usually not a good substitute for talk therapy or taking medicine, but can be a helpful addition. Resources for more information include: Anxiety and Depression Association of America -- adaa.org National Institute of Mental Health -- www.nimh.nih.gov/health/publications/social-anxiety-disorder-more-than-just-shyness/index.shtml Outlook (Prognosis) The outcome is often good with treatment. Antidepressant medicines can also be effective. Possible Complications Alcohol or other drug use may occur with social anxiety disorder. Loneliness and social isolation may occur. When to Contact a Medical Professional Call your provider if fear is affecting your work and relationships with others. Review Date 3/26/2018 Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Social anxiety disorder (Exams and Tests): The health care provider will look at your history of social anxiety and will get a description of the behavior from you, your family, and friends.", "role": "assistant" } ]

[ { "content": "Subcutaneous retrocalcaneal bursitis Haglund's deformity of the calcaneum. I have this problem. Can you please help to overcome this?\n\n Bursitis of the heel Insertional heel pain Retrocalcaneal bursitis Summary Bursitis of the heel is swelling of the fluid-filled sac (bursa) at the back of the heel bone. Causes A bursa acts as a cushion and lubricant between tendons or muscles sliding over bone. There are bursas around most large joints in the body, including the ankle. The retrocalcaneal bursa is located in the back of the ankle by the heel. It is where the large Achilles tendon connects the calf muscles to the heel bone. Repeated or too much use of the ankle can cause this bursa to become irritated and inflamed. It may be caused by too much walking, running, or jumping. This condition is very often linked to Achilles tendinitis. Sometimes retrocalcaneal bursitis may be mistaken for Achilles tendinitis. Risks for this condition include: Starting a very intense workout schedule Suddenly increasing activity level without the right conditioning Changes in activity level History of arthritis that is caused by inflammation Symptoms Symptoms include: Pain in the heel, especially with walking, running, or when the area is touched Pain may get worse when rising on the toes (standing on tiptoes) Red, warm skin over the back of the heel Exams and Tests Your health care provider will take a history to find out if you have symptoms of retrocalcaneal bursitis. An exam will be done to find the location of the pain. The provider will also look for tenderness and redness in the back of the heel. The pain may be worse when your ankle is bent upward (dorsiflex). Or, the pain may be worse when you rise on your toes. Most of the time, you will not need imaging studies such as x-ray and MRI at first. You may need these tests later if the first treatments DO NOT lead to improvement. Inflammation may show on a MRI. Treatment Your provider may recommend that you do the following: Avoid activities that cause pain. Put ice on the heel several times a day. Take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. Try using over-the-counter or custom heel wedges in your shoe to help decrease stress on the heel. Try ultrasound treatment during physical therapy to reduce inflammation. Have physical therapy to improve flexibility and strength around the ankle. The focus will be on stretching your Achilles tendon. This can help the bursitis improve and prevent it from coming back. If these treatments DO NOT work, your provider may inject a small amount of steroid medicine into the bursa. After the injection, you should avoid overstretching the tendon because it can break open (rupture). If the condition is connected to Achilles tendinitis, you may need to wear a cast on the ankle for several weeks. Very rarely, surgery may be needed to remove the inflamed bursa. Outlook (Prognosis) This condition most often gets better in several weeks with the proper treatment. When to Contact a Medical Professional Call your provider if you have heel pain or symptoms of retrocalcaneal bursitis that DO NOT improve with rest. Prevention Things you can do to prevent the problem include: Use proper form when exercising. Maintain as good flexibility and strength around the ankle to help prevent this condition. Stretch the Achilles tendon to help prevent injury. Wear shoes with enough arch support to decrease the amount of stress on the tendon and inflammation in the bursa. Review Date 9/22/2016 Updated by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Your provider may recommend that you avoid activities that cause pain. Put ice on the heel several times a day. Take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. Try using over-the-counter or custom heel wedges in your shoe to help decrease stress on the heel. Try ultrasound treatment during physical therapy to reduce inflammation. Have physical therapy to improve flexibility and strength around the ankle. The focus will be on stretching your Achilles tendon. This can help the bursitis improve and prevent it from coming back. If these treatments do not work, your provider may inject steroid medicine into the bursa. If the condition is connected to Achilles tendinitis, you may need to wear a cast on the ankle for several weeks. Very rarely, surgery may be needed to remove the inflamed bursa. This condition most often gets better in several weeks with the proper treatment. To prevent the problem, maintain proper form when exercising and good flexibility and strength around the ankle. Wear shoes with enough arch support to decrease the amount of stress on the tendon and inflammation in the bursa.", "role": "assistant" } ]

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

[ { "content": "Please let me know where I can get literature on Cardiac amyloidosis. My uncle died yesterday from this disorder. Since this is such a rare disorder, and to honor his memory, I would like to distribute literature at his funeral service.\n\nWhat are the complications of Cardiac amyloidosis?: - Atrial fibrillation or ventricular arrhythmias - Congestive heart failure - Fluid buildup in the abdomen (ascites) - Increased sensitivity to digoxin - Low blood pressure and dizziness from excessive urination (due to medication) - Sick sinus syndrome - Symptomatic cardiac conduction system disease (arrhythmias related to abnormal conduction of impulses through the heart muscle)", "role": "user" }, { "content": "What are the complications of Cardiac amyloidosis?: - Atrial fibrillation or ventricular arrhythmias - Congestive heart failure - Fluid buildup in the abdomen (ascites) - Increased sensitivity to digoxin - Low blood pressure and dizziness from excessive urination (due to medication) - Sick sinus syndrome - Symptomatic cardiac conduction system disease (arrhythmias related to abnormal conduction of impulses through the heart muscle)", "role": "assistant" } ]

[ { "content": "what are pancreatic enzymes?\n\n Pancreatic cancer Overview Pancreatic cancer begins in the tissues of your pancreas - an organ in your abdomen that lies horizontally behind the lower part of your stomach. Your pancreas releases enzymes that aid digestion and hormones that help manage your blood sugar. Pancreatic cancer typically spreads rapidly to nearby organs. It is seldom detected in its early stages. But for people with pancreatic cysts or a family history of pancreatic cancer, some screening steps might help detect a problem early. One sign of pancreatic cancer is diabetes, especially when it occurs with weight loss, jaundice or pain in the upper abdomen that spreads to the back. Treatment may include surgery, chemotherapy, radiation therapy or a combination of these. Pancreatic cancer care at Mayo Clinic Symptoms Signs and symptoms of pancreatic cancer often don't occur until the disease is advanced. They may include: - Pain in the upper abdomen that radiates to your back - Loss of appetite or unintended weight loss - Depression - New-onset diabetes - Blood clots - Fatigue - Yellowing of your skin and the whites of your eyes (jaundice) When to see a doctor See your doctor if you experience unexplained weight loss or if you have persistent fatigue, abdominal pain, jaundice, or other signs and symptoms that bother you. Many conditions can cause these symptoms, so your doctor may check for these conditions as well as for pancreatic cancer. Causes It's not clear what causes pancreatic cancer in most cases. Doctors have identified factors, such as smoking, that increase your risk of developing the disease. Understanding your pancreas Your pancreas is about 6 inches (15 centimeters) long and looks something like a pear lying on its side. It releases (secretes) hormones, including insulin, to help your body process sugar in the foods you eat. And it produces digestive juices to help your body digest food. How pancreatic cancer forms Pancreatic cancer occurs when cells in your pancreas develop mutations in their DNA. These mutations cause cells to grow uncontrollably and to continue living after normal cells would die. These accumulating cells can form a tumor. Untreated pancreatic cancer spreads to nearby organs and blood vessels. Most pancreatic cancer begins in the cells that line the ducts of the pancreas. This type of cancer is called pancreatic adenocarcinoma or pancreatic exocrine cancer. Rarely, cancer can form in the hormone-producing cells or the neuroendocrine cells of the pancreas. These types of cancer are called islet cell tumors, pancreatic endocrine cancer and pancreatic neuroendocrine tumors. Risk factors Factors that may increase your risk of pancreatic cancer include: - Chronic inflammation of the pancreas (pancreatitis) - Diabetes - Family history of genetic syndromes that can increase cancer risk, including a BRCA2 gene mutation, Lynch syndrome and familial atypical mole-malignant melanoma (FAMMM) syndrome - Family history of pancreatic cancer - Smoking - Obesity - Older age, as most people are diagnosed after age 65 A large study demonstrated that the combination of smoking, long-standing diabetes and a poor diet increases the risk of pancreatic cancer beyond the risk of any one of these factors alone. Complications As pancreatic cancer progresses, it can cause complications such as: - Weight loss. A number of factors may cause weight loss in people with pancreatic cancer. The cancer itself may cause weight loss. Nausea and vomiting caused by cancer treatments or a tumor pressing on your stomach may make it difficult to eat. Or your body may have difficulty processing nutrients from food because your pancreas isn't making enough digestive juices. Your doctor may recommend pancreatic enzyme supplements to aid in digestion. Try to maintain your weight by adding extra calories where you can and making mealtime as pleasant and relaxed as possible. - Jaundice. Pancreatic cancer that blocks the liver's bile duct can cause jaundice. Signs include yellow skin and eyes, dark-colored urine, and pale-colored stools. Jaundice usually occurs without abdominal pain. Your doctor may recommend that a plastic or metal tube (stent) be placed inside the bile duct to hold it open. This is done with the help of a procedure called endoscopic retrograde cholangiopancreatography (ERCP). During ERCP an endoscope is passed down your throat, through your stomach and into the upper part of your small intestine. A dye is then injected into the pancreatic and bile ducts through a small hollow tube (catheter) that's passed through the endoscope. Finally, images are taken of the ducts. - Pain. A growing tumor may press on nerves in your abdomen, causing pain that can become severe. Pain medications can help you feel more comfortable. Radiation therapy might help stop tumor growth temporarily to give you some relief. In severe cases, your doctor might recommend a procedure to inject alcohol into the nerves that control pain in your abdomen (celiac plexus block). This procedure stops the nerves from sending pain signals to your brain. - Bowel obstruction. Pancreatic cancer that grows into or presses on the first part of the small intestine (duodenum) can block the flow of digested food from your stomach into your intestines. Your doctor may recommend a tube (stent) be placed in your small intestine to hold it open. Or surgery may be necessary to attach your stomach to a lower point in your intestines that isn't blocked by cancer. Diagnosis If your doctor suspects pancreatic cancer, he or she may have you undergo one or more of the following tests: - Imaging tests that create pictures of your internal organs. These tests help your doctors visualize your internal organs, including the pancreas. Techniques used to diagnose pancreatic cancer include ultrasound, computerized tomography (CT) scans, magnetic resonance imaging (MRI) and, sometimes, positron emission tomography (PET) scans. - Using a scope to create ultrasound pictures of your pancreas. An endoscopic ultrasound (EUS) uses an ultrasound device to make images of your pancreas from inside your abdomen. The device is passed through a thin, flexible tube (endoscope) down your esophagus and into your stomach in order to obtain the images. - Removing a tissue sample for testing (biopsy). A biopsy is a procedure to remove a small sample of tissue for examination under a microscope. Your doctor may obtain a sample of tissue from the pancreas by inserting a needle through your skin and into your pancreas (fine-needle aspiration). Or he or she may remove a sample during EUS, guiding special tools into the pancreas. - Blood test. Your doctor may test your blood for specific proteins (tumor markers) shed by pancreatic cancer cells. One tumor marker test used in pancreatic cancer is called CA19-9. But the test isn't always reliable, and it isn't clear how best to use the CA19-9 test results. Some doctors measure your levels before, during and after treatment. If your doctor confirms a diagnosis of pancreatic cancer, he or she tries to determine the extent (stage) of the cancer. Using information from staging tests, your doctor assigns your pancreatic cancer a stage, which helps determine what treatments are most likely to benefit to you. The stages of pancreatic cancer are indicated by Roman numerals ranging from 0 to IV. The lowest stages indicate that the cancer is confined to the pancreas. By stage IV, the cancer has spread to other parts of the body. The cancer staging system continues to evolve and is becoming more complex as doctors improve cancer diagnosis and treatment. Your doctor uses your cancer stage to select the treatments that are right for you. Don't hesitate to ask your doctor about his or her experience with diagnosing pancreatic cancer. If you have any doubts, get a second opinion. Treatment Treatment for pancreatic cancer depends on the stage and location of the cancer as well as on your overall health and personal preferences. For most people, the first goal of pancreatic cancer treatment is to eliminate the cancer, when possible. When that isn't an option, the focus may be on improving your quality of life and preventing the cancer from growing or causing more harm. Treatment may include surgery, radiation, chemotherapy or a combination of these. When pancreatic cancer is advanced and these treatments aren't likely to offer a benefit, your doctor will offer symptom relief (palliative care) that makes you as comfortable as possible. Surgery Operations used in people with pancreatic cancer include: - Surgery for tumors in the pancreatic head. If your cancer is located in the head of the pancreas, you may consider an operation called a Whipple procedure (pancreaticoduodenectomy). The Whipple procedure is technically difficult operation to remove the head of the pancreas, the first part of the small intestine (duodenum), the gallbladder and part of the bile duct. In some situations, part of the stomach and nearby lymph nodes may be removed as well. Your surgeon reconnects the remaining parts of your pancreas, stomach and intestines to allow you to digest food. - Surgery for tumors in the pancreatic body and tail. Surgery to remove the left side (body and tail) of the pancreas is called distal pancreatectomy. Your surgeon may also remove your spleen. - Surgery to remove the entire pancreas. In some people, the entire pancreas may need to be removed. This is called total pancreatectomy. You can live relatively normally without a pancreas but do need lifelong insulin and enzyme replacement. - Surgery for tumors affecting nearby blood vessels. Many people with advanced pancreatic cancer are not considered eligible for the Whipple procedure or other pancreatic surgeries if their tumors involve nearby blood vessels. At a very few medical centers in the United States, highly specialized and experienced surgeons will safely perform these operations with removal and reconstruction of parts of blood vessels in select patients. Each of these surgeries carries the risk of bleeding and infection. After surgery some people experience nausea and vomiting if the stomach has difficulty emptying (delayed gastric emptying). Expect a long recovery after any of these procedures. You'll spend several days in the hospital and then recover for several weeks at home. Extensive research shows pancreatic cancer surgery tends to cause fewer complications when done by highly experienced surgeons at centers that do many of these operations. Don't hesitate to ask about your surgeon's and hospital's experience with pancreatic cancer surgery. If you have any doubts, get a second opinion. Chemotherapy Chemotherapy uses drugs to help kill cancer cells. These drugs can be injected into a vein or taken orally. You may receive one chemotherapy drug or a combination of them. Chemotherapy can also be combined with radiation therapy (chemoradiation). Chemoradiation is typically used to treat cancer that has spread beyond the pancreas, but only to nearby organs and not to distant regions of the body. At specialized medical centers, this combination may be used before surgery to help shrink the tumor. Sometimes it is used after surgery to reduce the risk that pancreatic cancer may recur. In people with advanced pancreatic cancer, chemotherapy is often used to control cancer growth and prolong survival. Radiation therapy Radiation therapy uses high-energy beams, such as those made from X-rays and protons, to destroy cancer cells. You may receive radiation treatments before or after cancer surgery, often in combination with chemotherapy. Or your doctor may recommend a combination of radiation and chemotherapy treatments when your cancer can't be treated surgically. Radiation therapy usually comes from a machine that moves around you, directing radiation to specific points on your body (external beam radiation). In specialized medical centers, radiation therapy may be delivered during surgery (intraoperative radiation). Radiation therapy traditionally uses X-rays to treat cancer. Some medical centers offer proton beam radiation therapy, which may be a treatment option for some people with advanced pancreatic cancer. Clinical trials Clinical trials are studies to test new treatments, such as systemic therapy, and new approaches to surgery or radiation therapy. If the treatment being studied proves to be safer and more effective than are current treatments, it can become the new standard of care. Clinical trials for pancreatic cancer might give you a chance to try new targeted therapy, chemotherapy drugs, immunotherapy treatments or vaccines. Clinical trials can't guarantee a cure, and they might have serious or unexpected side effects. On the other hand, cancer clinical trials are closely monitored to ensure they're conducted as safely as possible. And they offer access to treatments that wouldn't otherwise be available to you. Talk to your doctor about what clinical trials might be appropriate for you. Supportive (palliative) care Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care. Palliative care can be used while undergoing aggressive treatments, such as surgery, chemotherapy and radiation therapy. When palliative care is used along with other appropriate treatments - even soon after the diagnosis - people with cancer may feel better and live longer. Palliative care is provided by teams of doctors, nurses and other specially trained professionals. These teams aim to improve the quality of life for people with cancer and their families. Palliative care is not the same as hospice care or end-of-life care. Alternative medicine Some integrative and alternative medicine approaches may help with signs and symptoms you experience due to your cancer or cancer treatments. Treatments to help you cope with distress People with cancer frequently experience distress. Some research suggests distress is more common in people with pancreatic cancer than it is in people with other types of cancer. If you're distressed, you may have difficulty sleeping and find yourself constantly thinking about your cancer. You may feel angry or sad. Discuss your feelings with your doctor. Specialists can help you sort through your feelings and help you devise strategies for coping. In some cases, medications may help. Integrative medicine and alternative therapies may also help you cope with distress. Examples include: - Art therapy - Exercise - Meditation - Music therapy - Relaxation exercises - Spirituality Talk with your doctor if you're interested in these treatment options. ", "role": "user" }, { "content": "Your pancreas releases enzymes that aid digestion and hormones that help manage your blood sugar.", "role": "assistant" } ]

[ { "content": "how to prevent diabetes\n\n Diabetes Diabetes - type 1 Diabetes - type 2 Diabetes - gestational Type 1 diabetes Type 2 diabetes Gestational diabetes Diabetes mellitus Summary Diabetes is a long-term (chronic) disease in which the body cannot regulate the amount of sugar in the blood. Causes Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both. To understand diabetes, it is important to first understand the normal process by which food is broken down and used by the body for energy. Several things happen when food is digested and absorbed: A sugar called glucose enters the bloodstream. Glucose is a source of fuel for the body. An organ called the pancreas makes insulin. The role of insulin is to move glucose from the bloodstream into muscle, fat, and other cells, where it can be stored or used as fuel. People with diabetes have high blood sugar because their body cannot move sugar from the blood into muscle and fat cells to be burned or stored for energy, and/or because their liver makes too much glucose and releases it into the blood. This is because either: Their pancreas does not make enough insulin Their cells do not respond to insulin normally Both of the above There are two major types of diabetes. The causes and risk factors are different for each type: Type 1 diabetes is less common. It can occur at any age, but it is most often diagnosed in children, teens, or young adults. In this disease, the body makes little or no insulin. This is because the pancreas cells that make insulin stop working. Daily injections of insulin are needed. The exact cause of the failure to make enough insulin is unknown. Type 2 diabetes is more common. It most often occurs in adulthood, but because of high obesity rates, children and teens are now being diagnosed with this disease. Some people with type 2 diabetes do not know they have it. With type 2 diabetes, the body is resistant to insulin and doesn't use insulin as well as it should. Not all people with type 2 diabetes are overweight or obese. There are other causes of diabetes, and some people cannot be classified as type 1 or type 2. Gestational diabetes is high blood sugar that develops at any time during pregnancy in a woman who does not have diabetes. If your parent, brother, or sister has diabetes, you may be more likely to develop the disease. Symptoms A high blood sugar level can cause several symptoms, including: Blurry vision Excess thirst Fatigue Frequent urination Hunger Weight loss Because type 2 diabetes develops slowly, some people with high blood sugar have no symptoms. Symptoms of type 1 diabetes develop over a short period. People may be very sick by the time they are diagnosed. After many years, diabetes can lead to other serious problems. These problems are known as diabetes complications, and include: Eye problems, including trouble seeing (especially at night), light sensitivity, and blindness Sores and infections of the leg or foot, which if untreated, can lead to amputation of the leg or foot Damage to nerves in the body, causing pain, tingling, a loss of feeling, problems digesting food, and erectile dysfunction Kidney problems, which can lead to kidney failure Weakened immune system, which can lead to more frequent infections Increased chance of having a heart attack or stroke Exams and Tests A urine analysis may show high blood sugar. But a urine test alone does not diagnose diabetes. Your health care provider may suspect that you have diabetes if your blood sugar level is higher than 200 mg/dL (11.1 mmol/L). To confirm the diagnosis, one or more of the following tests must be done. Blood tests: Fasting blood glucose level. Diabetes is diagnosed if the fasting glucose level is higher than 126 mg/dL (7.0 mmol/L) on two different tests. Levels between 100 and 126 mg/dL (5.5 and 7.0 mmol/L) are called impaired fasting glucose or prediabetes. These levels are risk factors for type 2 diabetes. Hemoglobin A1c (A1C) test. Normal is less than 5.7%; prediabetes is 5.7% to 6.4%; and diabetes is 6.5% or higher. Oral glucose tolerance test. Diabetes is diagnosed if the glucose level is higher than 200 mg/dL (11.1 mmol/L) 2 hours after drinking a sugar drink (this test is used more often for type 2 diabetes). Screening for type 2 diabetes in people who have no symptoms is recommended for: Overweight children who have other risk factors for diabetes, starting at age 10 and repeated every 3 years. Overweight adults (BMI of 25 or higher) who have other risk factors such as having high blood pressure, or having a mother, father, sister or brother with diabetes. Adults over age 45, repeated every 3 years. Treatment Type 2 diabetes can sometimes be reversed with lifestyle changes, especially losing weight with exercise and by eating healthier foods. Some cases of type 2 diabetes can also be improved with weight loss surgery. There is no cure for type 1 diabetes (except for a pancreas or islet cell transplant). Treating either type 1 diabetes or type 2 diabetes involves nutrition, activity and medicines to control blood sugar level. Everyone with diabetes should receive proper education and support about the best ways to manage their diabetes. Ask your provider about seeing a certified diabetes educator (CDE). Getting better control over your blood sugar, cholesterol, and blood pressure levels helps reduce the risk for kidney disease, eye disease, nervous system disease, heart attack, and stroke. To prevent diabetes complications, visit your provider at least 2 to 4 times a year. Talk about any problems you are having. Follow your provider's instructions on managing your diabetes. Support Groups Many resources can help you understand more about diabetes. If you have diabetes, you can also learn ways to manage your condition and prevent diabetes complications. Outlook (Prognosis) Diabetes is a lifelong disease for most people who have it. Tight control of blood glucose can prevent or delay diabetes complications. But these problems can occur, even in people with good diabetes control. Possible Complications After many years, diabetes can lead to serious health problems: You could have eye problems, including trouble seeing (especially at night), and light sensitivity. You could become blind. Your feet and skin can develop sores and infections. After a long time, your foot or leg may need to be amputated. Infection can also cause pain and itching in other parts of the body. Diabetes may make it harder to control your blood pressure and cholesterol. This can lead to a heart attack, stroke, and other problems. It can become harder for blood to flow to your legs and feet. Nerves in your body can get damaged, causing pain, tingling, and numbness. Because of nerve damage, you could have problems digesting the food you eat. You could feel weakness or have trouble going to the bathroom. Nerve damage can make it harder for men to have an erection. High blood sugar and other problems can lead to kidney damage. Your kidneys may not work as well as they used to. They may even stop working so that you need dialysis or a kidney transplant. Your immune system can weaken, which can lead to frequent infections. Prevention Keeping an ideal body weight and an active lifestyle may prevent or delay the start of type 2 diabetes. If you're overweight, losing just 5% of your body weight can reduce your risk. Some medicines can also be used to delay or prevent the start of type 2 diabetes. At this time, type 1 diabetes cannot be prevented. But there is promising research that shows type 1 diabetes may be delayed in some high risk people. Review Date 2/22/2018 Updated by: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Keeping an ideal body weight and an active lifestyle may prevent or delay the start of type 2 diabetes. If you're overweight, losing just 5% to 7% of your body weight even helps. Some medicines can also be used to delay or prevent the start of type 2 diabetes. At this time, type 1 diabetes cannot be prevented. But there is promising research that shows type 1 diabetes may be delayed in some high risk people.", "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 - aftercare IBS Mucus colitis IBS-D IBS-C Summary Irritable bowel syndrome (IBS) is a disorder that leads to abdominal pain and bowel changes. Your health care provider will talk about things you can do at home to manage your condition. What to Expect at Home Irritable bowel syndrome (IBS) may be a lifelong condition. You may be suffering from cramping and loose stools, diarrhea, constipation, or some combination of these symptoms. For some people, IBS symptoms may interfere with work, travel, and attending social events. But taking medicines and making lifestyle changes can help you manage your symptoms. Diet Changes in your diet may be helpful. However, IBS varies from person to person. So the same changes may not work for everyone. Keep track of your symptoms and the foods you are eating. This will help you look for a pattern of foods that may make your symptoms worse. Avoid foods that cause symptoms. These may include fatty or fried foods, dairy products, caffeine, sodas, alcohol, chocolate, and grains such as wheat, rye, and barley. Eat 4 to 5 smaller meals a day, rather than 3 larger ones. Increase the fiber in your diet to relieve symptoms of constipation. Fiber is found in whole grain breads and cereals, beans, fruits, and vegetables. Since fiber may cause gas, it is best to add these foods to your diet slowly. Medicines No one drug will work for everyone. Medicines your provider may have you try include: Antispasmodic medicines that you take before eating to control colon muscle spasms and abdominal cramping Antidiarrheal medicines such as loperamide Laxatives, such as lubiprostone, bisacodyl , and other ones bought without a prescription Antidepressants to help relieve pain or discomfort Rifaximin, an antibiotic that is not absorbed from your intestines It is very important to follow your provider's instructions when using medicines for IBS. Taking different medicines or not taking medicines the way you have been advised can lead to more problems. Stress Stress may cause your intestines to be more sensitive and contract more. Many things can cause stress, including: Not being able to do activities because of your pain Changes or problems at work or at home A busy schedule Spending too much time alone Having other medical problems A first step toward reducing your stress is to figure out what makes you feel stressed. Look at the things in your life that cause you the most worry. Keep a diary of the experiences and thoughts that seem to be related to your anxiety and see if you can make changes to these situations. Reach out to other people. Find someone you trust (such as a friend, family member, neighbor, or clergy member) who will listen to you. Often, just talking to someone helps relieve anxiety and stress. When to Call the Doctor Call your provider if: You develop a fever You have gastrointestinal bleeding You have bad pain that does not go away You lose over 5 to 10 pounds (2 to 4.5 kilograms) when you are not trying to lose weight Review Date 4/24/2017 Updated by: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Look for foods that make the symptoms worse and change your diet to avoid such foods. These may include fatty or fried foods, dairy products, caffeine, sodas, alcohol, chocolate, and grains such as wheat, rye, and barley. Eat 4 or five smaller meals a day and follow your doctor's instructions to take medicines.", "role": "assistant" } ]

[ { "content": "what is binge eating disorder\n\n Binge eating disorder Overview Binge eating disorder is the most common type of eating disorder in the United States. People with binge eating disorder often feel out of control and eat a large amount of food at one time (called a binge). Unlike other eating disorders, people who have binge eating disorder do not throw up the food or exercise too much. Binge eating disorder is a serious health problem, but people with binge eating disorder can get better with treatment. What is binge eating disorder? Binge eating disorder is a type of eating disorder. Eating disorders are mental health problems that cause extreme and dangerous eating behaviors. These extreme eating behaviors cause other serious health problems and sometimes death. Some eating disorders also involve extreme exercise. According to the American Psychiatric Association, women with binge eating disorder feel out of control and eat too much (binge), at least once a week for at least three months. During binges women with binge eating disorder usually eat faster than normal, eat until they are uncomfortable, eat when they are not physically hungry, and feel embarrassed, disgusted, or depressed because of the binges. Women with this type of eating disorder may be overweight or obese. What is the difference between binge eating disorder and other eating disorders? Women with eating disorders, such as binge eating disorder, bulimia, and anorexia, have a mental health condition that affects how they eat, and sometimes how they exercise. These eating disorders threaten their health. Unlike people with anorexia or bulimia, people with binge eating disorder do not throw up their food, exercise a lot, or starve themselves. People with binge eating disorder are often overweight or obese. But not all people with binge eating disorder are overweight, and being overweight does not always mean you have binge eating disorder. It is possible to have more than one eating disorder in your lifetime. Regardless of what type of eating disorder you may have, you can get better with treatment. Who is at risk for binge eating disorder? Binge eating disorder affects more than 3% of women in the United States. More than half of people with binge eating disorder are women.1 Binge eating disorder affects women of all races and ethnicities. It is the most common eating disorder among Hispanic, Asian-American, and African-American women.2,3,4 Some women may be more at risk for binge eating disorder. What are the symptoms of binge eating disorder? It can be difficult to tell whether someone has binge eating disorder. Many women with binge eating disorder hide their behavior because they are embarrassed. You may have binge eating disorder if, for at least once a week over the past three months, you have binged. Binge eating disorder means you have at least three of these symptoms while binging:8 People with binge eating disorder may also have other mental health problems, such as depression, anxiety, or substance abuse. What causes binge eating disorder? Researchers are not sure exactly what causes binge eating disorder and other eating disorders. Researchers think that eating disorders might happen because of a combination of a person's biology and life events. This combination includes having specific genes, a person's biology, body image and self-esteem, social experiences, family health history, and sometimes other mental health illnesses. Studies suggest that people with binge eating disorder may use overeating as a way to deal with anger, sadness, boredom, anxiety, or stress.9,10 Researchers are studying how changing levels of brain chemicals may affect eating habits. Neuroimaging, or pictures of the brain, may lead to a better understanding of binge eating disorder.11 Learn more about current research on binge eating disorder. How does binge eating disorder affect a woman's health? Many, but not all, women with binge eating disorder are overweight or obese. Obesity raises your risk for many serious health problems:12 People with binge eating disorder often have other serious mental health illnesses such as depression, anxiety, or substance abuse. These problems can seriously affect a woman's everyday life and can be treated. How is binge eating disorder diagnosed? Your doctor or nurse will ask you questions about your symptoms and medical history. It may be difficult to talk to a doctor or nurse about secret eating behaviors. But doctors and nurses want to help you be healthy. Being honest about your eating behaviors with a doctor or nurse is a good way to ask for help. Your doctor may also do blood, urine, or other tests for other health problems, such as heart problems or gallbladder disease, that can be caused by binge eating disorder. How is binge eating disorder treated? Your doctor may refer you to a team of doctors, nutritionists, and therapists who will work to help you get better. Treatment plans may include one or more of the following: Most girls and women do get better with treatment and are able to eat in healthy ways again.14 Some may get better after the first treatment. Others get well but may relapse and need treatment again. How does binge eating disorder affect pregnancy? Binge eating disorder can cause problems getting pregnant and during pregnancy. Pregnancy can also trigger binge eating disorder. Obesity raises the level of the hormone estrogen in your body. Higher levels of estrogen can stop you from ovulating, or releasing an egg from the ovary. This can make it more difficult to get pregnant. However, if you do not want to have children right now and have sex, you should use birth control. Overweight or obesity may also cause problems during pregnancy. Overweight and obesity raises your risk for: Pregnancy can raise the risk for binge eating disorder in women who are at higher risk for eating disorders. In one study, almost half of the women with binge eating disorder got the condition during pregnancy. The research suggests that binge eating during pregnancy may be caused by:16 After pregnancy, postpartum depression and weight from pregnancy can trigger binge eating disorder in women with a history of binge eating. Women with binge eating disorder before pregnancy often gain more weight during pregnancy than women without an eating disorder. Researchers think that weight gain during pregnancy may cause some women who had binge eating disorder before pregnancy to binge eat during pregnancy.17 If I had an eating disorder in the past, can I still get pregnant? Yes. Women who have recovered from binge eating disorder, are at a healthy weight, and have normal menstrual cycles have a better chance of getting pregnant and having a safe and healthy pregnancy. Tell your doctor if you had an eating disorder in the past and are trying to become pregnant. If I take medicine to treat binge eating disorder, can I breastfeed my baby? Maybe. Some medicines used to treat binge eating disorder can pass through breastmilk. Certain antidepressants can be used safely during breastfeeding. Talk to your doctor to find out what medicine works best for you. Learn more about medicines and breastfeeding in our Breastfeeding. You can also enter a medicine into the LactMed database to find out if the medicine passes through breastmilk and about any possible side effects for your nursing baby. Did we answer your question about binge eating disorder? For more information about binge eating disorder, call the OWH Helpline at 1-800-994-9662 or contact the following organizations: Sources ", "role": "user" }, { "content": "Binge eating disorder can cause problems getting pregnant and during pregnancy. Pregnancy can also trigger binge eating disorder. Pregnancy can raise the risk for binge eating disorder in women who are at higher risk for eating disorders.", "role": "assistant" } ]

[ { "content": "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": "The signs and symptoms of dehydration may differ by age. - Dry mouth and tongue - No tears when crying Sunken eyes, cheeks - Listlessness or irritability - Extreme thirst - Less frequent urination - Dark-colored urine - Fatigue - Dizziness - Confusion", "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 (Points to Remember): Gastroparesis, also called delayed gastric emptying, is a disorder that slows or stops the movement of food from the stomach to the small intestine. 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. People with diabetes have high levels of blood glucose, also called blood sugar. Over time, high blood glucose levels can damage the vagus nerve. 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.Gastroparesis, also called delayed gastric emptying, is a disorder that slows or stops the movement of food from the stomach to the small intestine.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. People with diabetes have high levels of blood glucose, also called blood sugar. Over time, high blood glucose levels can damage the vagus nerve.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": "user" }, { "content": "Gastroparesis occurs when food moves slowly from the stomach to the small intestine or stops moving altogether. In most cases, the causes of gastroparesis are unknown. 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; vomiting undigested food, sometimes several hours after a meal; gastroesophageal reflux (GER); pain in the stomach area; abdominal bloating; and lack of appetite. Your doctor will diagnose gastroparesis through a physical examination, medical history, blood tests, tests to rule out blockage or structural problems in the gastrointestinal tract, and gastric emptying tests. Treatment of gastroparesis may include medications, botulinum toxin, gastric electrical stimulation, jejunostomy (surgery to place a feeding tube through the abdominal wall directly into a part of the small intestine called the jejunum), and parenteral nutrition.", "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 a bacterial infection that spreads from animals to people - most often via unpasteurized milk, cheese and other dairy products. The infection can usually be treated successfully with antibiotics. Treatment takes several weeks to months, however, and relapses are common.", "role": "assistant" } ]

[ { "content": "how do you administer lanreotide\n\nLanreotide Injection: Lanreotide injection is used to treat people with acromegaly (condition in which the body produces too much growth hormone, causing enlargement of the hands, feet, and facial features; joint pain; and other symptoms) who have not successfully, or cannot be treated with surgery or radiation. Lanreotide injection is also used to treat people with neuroendocrine tumors in the gastrointestinal (GI) tract or the pancreas (GEP-NETs) that have spread or cannot be removed by surgery. Lanreotide injection is in a class of medications called somatostatin agonists. It works by decreasing the amounts of certain natural substances produced by the body. Lanreotide comes as a long-acting solution (liquid) to be injected subcutaneously (under the skin) into the upper outer area of your buttock by a doctor or nurse. Lanreotide long-acting injection is usually injected once every 4 weeks. Ask your doctor or pharmacist to explain any part you do not understand. Your doctor will probably adjust your dose or the length of time between doses depending on your lab results. Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient. This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. Before receiving lanreotide injection, - tell your doctor and pharmacist if you are allergic to lanreotide injection, any other medications, or any of the ingredients in lanreotide injection. Ask your pharmacist for a list of the ingredients. - tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: beta blockers such as atenolol (Tenormin, in Tenoretic), labetalol (Trandate), metoprolol (Lopressor, Toprol XL, in Dutoprol), nadolol (Corgard, in Corzide), and propranolol (Hemangeol, Inderal, InnoPran); bromocriptine (Cycloset, Parlodel); cyclosporine (Gengraf, Neoral, Sandimmune); insulin and oral medications for diabetes; quinidine (in Nuedexta), or terfenadine (no longer available in the U.S.). 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 diabetes, or gallbladder, heart, kidney, thyroid, or liver disease. - tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while receiving lanreotide injection, call your doctor. - you should know that lanreotide injection may make you drowsy or dizzy. Do not drive a car or operate machinery until you know how this medication affects you. Unless your doctor tells you otherwise, continue your normal diet. This medication may cause changes in your blood sugar. You should know the symptoms of high and low blood sugar and what to do if you have these symptoms. Lanreotide injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: - diarrhea - loose stools - constipation - gas - vomiting - weight loss - headache - redness, pain, itching, or a lump at the injection site - depression Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment: - pain in the upper right part of the stomach, center of the stomach, back, or shoulder - muscle pain or discomfort - yellowing of the skin and eyes - fever with chills - nausea - swelling of the face, throat, tongue, lips, or eyes - tightness in the throat - difficulty breathing and swallowing - wheezing - hoarseness - rash - itching - hives - shortness of breath - slowed or irregular heartbeat Lanreotide injection may cause other side effects. Call your doctor if you have any unusual problems while receiving this medication. If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088). If you are storing the prefilled syringes in your home until it is time for it to be injected by your doctor or nurse, you should always store it in original carton in the refrigerator and protect it from light. Throw away any medication that is outdated or no longer needed. Talk to your healthcare provider about the proper disposal of your medication. 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 doctor will order certain lab tests to check your body's response to lanreotide injection. Do not let anyone else use 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. - Somatuline Depot®", "role": "user" }, { "content": "Lanreotide may be administered under the skin (subcutaneously), into the upper area of the buttock. A nurse or doctor will be able to do this for you.", "role": "assistant" } ]

[ { "content": "what are the causes of childhood obesity\n\nChildhood obesity (Lifestyle and home remedies): Addressing a woman's health and weight before she conceives could lead to improvements in childhood obesity. If you're overweight and thinking of becoming pregnant, losing weight and eating well might affect your child's future. Eating well throughout pregnancy might also have a positive impact on your baby's later food choices. To give your infant a healthy start, the World Health Organization recommends exclusively breast-feeding for 6 months. If your child is overweight or obese, his or her best chance to achieve and maintain a healthy weight is to start eating a healthy diet and exercising more. Here are some steps you can take at home to help your child succeed: - Be a role model. Choose healthy foods and active pastimes for yourself. If you need to lose weight, doing so will motivate your child to do likewise. - Involve the whole family. Make healthy eating a priority and emphasize how important it is for everyone to be physically active. This avoids singling out the child who is overweight.", "role": "user" }, { "content": "The health and weight of the mother before she conceives can affect childhood obesity. If your child is obese, a healthy diet and exercise can increase their chances of losing weight and maintaining a healthy weight. Choose healthy foods will also contribute to this, as well as the food choices of the parent.", "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 occurs when food moves slowly from the stomach to the small intestine or stops moving altogether. In most cases, the causes of gastroparesis are unknown. 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; vomiting undigested food, sometimes several hours after a meal; gastroesophageal reflux (GER); pain in the stomach area; abdominal bloating; and lack of appetite. Your doctor will diagnose gastroparesis through a physical examination, medical history, blood tests, tests to rule out blockage or structural problems in the gastrointestinal tract, and gastric emptying tests. Treatment of gastroparesis may include medications, botulinum toxin, gastric electrical stimulation, jejunostomy (surgery to place a feeding tube through the abdominal wall directly into a part of the small intestine called the jejunum), and parenteral nutrition.", "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": "The complications of Williams syndrome are calcium deposits in the kidney, other kidney problems, death in rare cases from anesthesia, heart failure, or pain in the abdomen.", "role": "assistant" } ]

[ { "content": "adrenoleukodystrophy A child I have been asked to work with has been diagnosed with this condition.I am so far unable to find info pertaining to this illness. Can you help??\n\n Adrenoleukodystrophy What is Adrenoleukodystrophy? X-linked Adrenoleukodystrophy (ALD) is one of a group of genetic disorders called the leukodystrophies that cause damage to the myelin sheath, an insulating membrane that surrounds nerve cells in the brain. Women have two X chromosomes and are the carriers of the disease, but since men only have one X chromosome and lack the protective effect of the extra X chromosome, they are more severely affected. People with X-ALD accumulate high levels of saturated, very long chain fatty acids (VLCFA) in the brain and adrenal cortex. The loss of myelin and the progressive dysfunction of the adrenal gland are the primary characteristics of X-ALD. While nearly all patients with X-ALD suffer from adrenal insufficiency, also known as Addison's disease, the neurological symptoms can begin either in childhood or in adulthood. The childhood cerebral form is the most severe, with onset between ages 4 and 10. The most common symptoms are usually behavioral changes such as abnormal withdrawal or aggression, poor memory, and poor school performance. Other symptoms include visual loss, learning disabilities, seizures, poorly articulated speech, difficulty swallowing, deafness, disturbances of gait and coordination, fatigue, intermittent vomiting, increased skin pigmentation, and progressive dementia. The milder adult-onset form is also known as adrenomyeloneuropathy (AMN), which typically begins between ages 21 and 35. Symptoms may include progressive stiffness, weakness or paralysis of the lower limbs, and ataxia. Although adult-onset ALD progresses more slowly than the classic childhood form, it can also result in deterioration of brain function. Almost half the women who are carriers of X-ALS will develop a milder form of AMN but almost never will develop symptoms seen in boys the X-ALD. X-ALD should not be confused with neonatal adrenoleukodsystrophy, which is a disease of newborns and young infants and belongs to the group of peroxisomal biogenesis disorders. Is there any treatment? Adrenal function must be tested periodically in all patients with ALD. Treatment with adrenal hormones can be lifesaving. Symptomatic and supportive treatments for ALD include physical therapy, psychological support, and special education. Recent evidence suggests that a mixture of oleic acid and erucic acid, known as \"Lorenzo's Oil,\" administered to boys with X-ALD prior to symptom onset can prevent or delay the appearance of the childhood cerebral form It is not known whether Lorenzo's Oil will have any beneficial effects in AMN. Furthermore, Lorenzo's Oil has no beneficial effect in symptomatic boys with X-ALD. Bone marrow transplantations can provide long-term benefit to boys who have early evidence of the childhood cerebral form of X-ALD, but the procedure carries risk of mortality and morbidity and is not recommended for those whose symptoms are already severe or who have the adult-onset or neonatal forms. What is the prognosis? Prognosis for patients with childhood cerebral X-ALD is generally poor due to progressive neurological deterioration unless bone marrow transplantation is performed early. Death usually occurs within 1 to 10 years after the onset of symptoms. Adult-onset AMN will progress over decades. What research is being done? The NINDS supports research on genetic disorders such as ALD. The aim of this research is to find ways to prevent, treat, and cure these disorders. Studies are currently underway to identify new biomarkers of disease progression and to determine which patients will develop the childhood cerebral form of X-ALD. A recent case study in Europe demonstrated that the combination of gene therapy with bone marrow transplantation, using the patient's own bone marrow cells, may arrest disease progression in childhood cerebral X-ALD. A therapeutic trail in the United States is currently being discussed with the U.S. Food and Drug Administration. ", "role": "user" }, { "content": "Adrenoleukodystrophy is a genetic disorder that causes damage to the myelin sheath, an insulating membrane that surrounds nerve cells in the brain. The childhood cerebral form is the most severe, with onset between ages 4 and 10. The most common symptoms are usually behavioral changes such as abnormal withdrawal or aggression, poor memory, and poor school performance. Other symptoms include visual loss, learning disabilities, seizures, poorly articulated speech, difficulty swallowing, deafness, disturbances of gait and coordination, fatigue, intermittent vomiting, increased skin pigmentation, and progressive dementia.", "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 goal of glaucoma treatment is to reduce eye pressure with eye drops, laser or surgery. Acute angle-closure attack is an emergency: you can become blind if you are not treated.", "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\n Ellis-van Creveld syndrome chondroectodermal dysplasia Ellis-van Creveld dysplasia Description Ellis-van Creveld syndrome is an inherited disorder of bone growth that results in very short stature (dwarfism). People with this condition have particularly short forearms and lower legs and a narrow chest with short ribs. Ellis-van Creveld syndrome is also characterized by the presence of extra fingers and toes (polydactyly), malformed fingernails and toenails, and dental abnormalities. More than half of affected individuals are born with a heart defect, which can cause serious or life-threatening health problems. The features of Ellis-van Creveld syndrome overlap with those of another, milder condition called Weyers acrofacial dysostosis. Like Ellis-van Creveld syndrome, Weyers acrofacial dysostosis involves tooth and nail abnormalities, although affected individuals have less pronounced short stature and typically do not have heart defects. The two conditions are caused by mutations in the same genes. Frequency In most parts of the world, Ellis-van Creveld syndrome occurs in 1 in 60,000 to 200,000 newborns. It is difficult to estimate the exact prevalence because the disorder is very rare in the general population. This condition is much more common in the Old Order Amish population of Lancaster County, Pennsylvania, and in the indigenous (native) population of Western Australia. Causes Ellis-van Creveld syndrome can be caused by mutations in the EVC or EVC2 gene. Little is known about the function of these genes, although they appear to play important roles in cell-to-cell signaling during development. In particular, the proteins produced from the EVC and EVC2 genes are thought to help regulate the Sonic Hedgehog signaling pathway. This pathway plays roles in cell growth, cell specialization, and the normal shaping (patterning) of many parts of the body. The mutations that cause Ellis-van Creveld syndrome result in the production of an abnormally small, nonfunctional version of the EVC or EVC2 protein. It is unclear how the defective proteins lead to the specific signs and symptoms of this condition. Studies suggest that they prevent normal Sonic Hedgehog signaling in the developing embryo, disrupting the formation and growth of the bones, teeth, and other parts of the body. Together, mutations in the EVC and EVC2 genes account for more than half of all cases of Ellis-van Creveld syndrome. The cause of the remaining cases 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 Baujat G, Le Merrer M. Ellis-van Creveld syndrome. Orphanet J Rare Dis. 2007 Jun 4;2:27. Review. ", "role": "user" }, { "content": "Ellis-van Creveld syndrome is an inherited disorder of bone growth that results in very short stature (dwarfism). People with this condition have particularly short forearms and lower legs and a narrow chest with short ribs. Ellis-van Creveld syndrome is also characterized by the presence of extra fingers and toes (polydactyly), malformed fingernails and toenails, and dental abnormalities. More than half of affected individuals are born with a heart defect, which can cause serious or life-threatening health problems.", "role": "assistant" } ]

[ { "content": "Please let me know where I can get literature on Cardiac amyloidosis. My uncle died yesterday from this disorder. Since this is such a rare disorder, and to honor his memory, I would like to distribute literature at his funeral service.\n\n Cardiac amyloidosis Amyloidosis - cardiac Primary cardiac amyloidosis - AL type Secondary cardiac amyloidosis - AA type Stiff heart syndrome Senile amyloidosis Summary Cardiac amyloidosis is a disorder caused by deposits of an abnormal protein (amyloid) in the heart tissue. These deposits make it hard for the heart to work properly. Causes Amyloidosis is a group of diseases in which clumps of proteins called amyloids build up in body tissues. Over time, these proteins replace normal tissue, leading to failure of the involved organ. There are many forms of amyloidosis. Cardiac amyloidosis (\"stiff heart syndrome\") occurs when amyloid deposits take the place of normal heart muscle. It is the most typical type of restrictive cardiomyopathy. Cardiac amyloidosis may affect the way electrical signals move through the heart (conduction system). This can lead to abnormal heartbeats (arrhythmias) and faulty heart signals (heart block). The condition can be inherited. This is called familial cardiac amyloidosis. It can also develop as the result of another disease such as a type of bone and blood cancer, or as the result of another medical problem causing inflammation. Cardiac amyloidosis is more common in men than in women. The disease is rare in people under age 40. Symptoms Some people may have no symptoms. When present, symptoms may include: Excessive urination at night Fatigue, reduced exercise ability Palpitations (sensation of feeling heartbeat) Shortness of breath with activity Swelling of the abdomen, legs, ankles, or other part of the body Trouble breathing while lying down Exams and Tests The signs of cardiac amyloidosis can be related to a number of different conditions. This can make the problem hard to diagnose. Signs may include: Abnormal sounds in the lung (lung crackles) or a heart murmur Blood pressure that is low or drops when you stand up Enlarged neck veins Swollen liver The following tests may be done: Chest or abdomen CT scan (considered the \"gold standard\" to help diagnose this condition) Coronary angiography Electrocardiogram (ECG) Echocardiogram Magnetic resonance imaging (MRI) Nuclear heart scans (MUGA, RNV) Positron emission tomography (PET) An ECG may show problems with the heartbeat or heart signals. It may also show low signals (called \"low voltage\"). A cardiac biopsy is used to confirm the diagnosis. A biopsy of another area, such as the abdomen, kidney, or bone marrow, is often done as well. Treatment Your health care provider may tell you to make changes to your diet, including limiting salt and fluids. You may need to take water pills (diuretics) to help your body get rid of excess fluid. The provider may tell you to weigh yourself every day. A weight gain of 3 or more pounds (1 kilogram or more) over 1 to 2 days can mean there is too much fluid in the body. Medicines including digoxin, calcium-channel blockers, and beta-blockers may be used in people with atrial fibrillation. However, the drugs must be used with caution, and the dosage must be carefully monitored. People with cardiac amyloidosis may be extra sensitive to side effects of these drugs. Other treatments may include: Chemotherapy Implantable cardioverter-defibrillator (AICD) Pacemaker, if there are problems with heart signals Prednisone, an anti-inflammatory medicine A heart transplant may be considered for people with some types of amyloidosis who have very poor heart function. People with hereditary amyloidosis may need a liver transplant. Outlook (Prognosis) In the past, cardiac amyloidosis was thought to be an untreatable and rapidly fatal disease. However, the field is changing rapidly. Different types of amyloidosis can affect the heart in different ways. Some types are more severe than others. Many people can now expect to survive and experience a good quality of life for several years after diagnosis. Possible Complications Complications may include: Atrial fibrillation or ventricular arrhythmias Congestive heart failure Fluid buildup in the abdomen (ascites) Increased sensitivity to digoxin Low blood pressure and dizziness from excessive urination (due to medicine) Sick sinus syndrome Symptomatic cardiac conduction system disease (arrhythmias related to abnormal conduction of impulses through the heart muscle) When to Contact a Medical Professional Call your provider if you have this disorder and develop new symptoms such as: Dizziness when you change position Excessive weight (fluid) gain Excessive weight loss Fainting spells Severe breathing problems Review Date 5/16/2018 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": "Cardiac amyloidosis (\"stiff heart syndrome\") occurs when clumps of proteins called amyloids build up in the heart muscle and replace the normal tissues. Cardiac amyloidosis is more common in men and occurs mostly after 40. Cardiac amyloidosis affects the way electrical signals move through the heart, which can lead to abnormal heartbeats (arrhythmias) and faulty heart signals (heart block). The condition can be inherited. This is called familial cardiac amyloidosis. It can also develop as the result of another disease such as a type of bone and blood cancer, or as the result of inflammation.", "role": "assistant" } ]

[ { "content": "what are the risk factors of type ii diabetes\n\nType 2 diabetes: Type 2 diabetes is a lifelong (chronic) disease in which there is a high level of sugar (glucose) in the blood. Type 2 diabetes is the most common form of diabetes. Insulin is a hormone produced in the pancreas by special cells, called beta cells. The pancreas is below and behind the stomach. Insulin is needed to move blood sugar (glucose) into cells. Inside the cells, glucose is stored and later used for energy. When you have type 2 diabetes, your fat, liver, and muscle cells do not respond correctly to insulin. This is called insulin resistance. As a result, blood sugar does not get into these cells to be stored for energy. When sugar cannot enter cells, a high level of sugar builds up in the blood. This is called hyperglycemia. The body is unable to use the glucose for energy. This leads to the symptoms of type 2 diabetes. Type 2 diabetes usually develops slowly over time. Most people with the disease are overweight or obese when they are diagnosed. Increased fat makes it harder for your body to use insulin the correct way. Type 2 diabetes can also develop in people who are thin. This is more common in older adults. Family history and genes play a role in type 2 diabetes. Low activity level, poor diet, and excess body weight around the waist increase your chance of getting the disease. People with type 2 diabetes often have no symptoms at first. They may not have symptoms for many years. Early symptoms of diabetes caused by a high blood sugar level may include: - Bladder, kidney, skin, or other infections that are more frequent or heal slowly - Fatigue - Hunger - Increased thirst - Increased urination - Blurred vision After many years, diabetes can lead to serious health problems, and as a result, many other symptoms. Your doctor may suspect that you have diabetes if your blood sugar level is higher than 200 milligrams per deciliter (mg/dL) or 11.1 mmol/L. To confirm the diagnosis, one or more of the following tests must be done. - Fasting blood glucose level. Diabetes is diagnosed if it is higher than 126 mg/dL (7.0 mmol/L) two different times. - Hemoglobin A1c (A1C) test. Diabetes is diagnosed if the test result is 6.5% or higher. - Oral glucose tolerance test. Diabetes is diagnosed if the glucose level is higher than 200 mg/dL (11.1 mmol/L) 2 hours after drinking a special sugar drink. Diabetes screening is recommended for: - Overweight children who have other risk factors for diabetes, starting at age 10 and repeated every 2 years - Overweight adults (BMI of 25 or higher) who have other risk factors - Adults starting at age 45 every 3 years, or at a younger age if the person has risk factors If you have been diagnosed with type 2 diabetes, you need to work closely with your doctor. See your doctor as often as instructed. This may be every 3 months. The following exams and tests will help you and your doctor monitor your diabetes and prevent problems. - Check the skin and bones on your feet and legs. - Check if your feet are getting numb (diabetic nerve disease). - Have your blood pressure checked at least once a year (blood pressure goal should be 140/80 mm Hg or lower). - Have your A1C tested every 6 months if your diabetes is well controlled. Have the test every 3 months if your diabetes is not well controlled. - Have your cholesterol and triglyceride levels checked once a year. - Get tests once a year to make sure your kidneys are working well (microalbuminuria and serum creatinine). - Visit your eye doctor at least once a year, or more often if you have signs of diabetic eye disease. - See the dentist every 6 months for a thorough dental cleaning and exam. Make sure your dentist and hygienist know that you have diabetes. The goal of treatment at first is to lower your high blood glucose level. Long-term goals are to prevent complications. These are health problems from diabetes. The most important way to treat and manage type 2 diabetes is by being active and eating healthy foods. Everyone with diabetes should receive proper education and support about the best ways to manage their diabetes. Ask your doctor about seeing a diabetes nurse educator and a dietitian. LEARN THESE SKILLS Learning diabetes management skills will help you live well with diabetes. These skills help prevent health problems and the need for medical care. Skills include: - How to test and record your blood glucose - What, when, and how much to eat - How to safely increase your activity and control your weight - How to take medicines, if needed - How to recognize and treat low and high blood sugar - How to handle sick days - Where to buy diabetes supplies and how to store them It may take several months to learn these skills. Keep learning about diabetes, its complications, and how to control and live well with the disease. Stay up-to-date on new research and treatments. MANAGING YOUR BLOOD SUGAR Checking your blood sugar level yourself and writing down the results tells you how well you are managing your diabetes. Talk to your doctor and diabetes educator about how often to check. To check your blood sugar level, you use a device called a glucose meter. Usually, you prick your finger with a small needle called a lancet. This gives you a tiny drop of blood. You place the blood on a test strip and put the strip into the meter. The meter gives you a reading that tells you the level of your blood sugar. Your doctor or diabetes educator will help set up a testing schedule for you. Your doctor will help you set a target range for your blood sugar numbers. Keep these factors in mind: - Most people with type 2 diabetes only need to check their blood sugar once or twice a day. - If your blood sugar level is under control, you may only need to check it a few times a week. - You may test yourself when you wake up, before meals, and at bedtime. - You may need to test more often when you are sick or under stress. - You may need to test more often if you are having more frequent low blood sugar symptoms. Keep a record of your blood sugar for yourself and your doctor. Based on your numbers, you may need to make changes to your meals, activity, or medicines to keep your blood sugar level in the right range. HEALTHY EATING AND WEIGHT CONTROL Work closely with your health care providers to learn how much fat, protein, and carbohydrates you need in your diet. Your meal plans should fit your lifestyle and habits and should include foods that you like. Managing your weight and having a well-balanced diet are important. Some people with type 2 diabetes can stop taking medicines after losing weight. This does not mean that their diabetes is cured. They still have diabetes. Very obese people whose diabetes is not well managed with diet and medicine may consider weight loss (bariatric) surgery. REGULAR PHYSICAL ACTIVITY Regular activity is important for everyone. It is even more important when you have diabetes. Exercise is good for your health because it: - Lowers your blood sugar level without medicine - Burns extra calories and fat to help manage your weight - Improves blood flow and blood pressure - Increases your energy level - Improves your ability to handle stress Talk to your doctor before starting any exercise program. People with type 2 diabetes may need to take special steps before, during, and after physical activity or exercise. MEDICINES TO TREAT DIABETES If diet and exercise do not help keep your blood sugar at normal or near-normal levels, your doctor may prescribe medicine. Since these drugs help lower your blood sugar level in different ways, your doctor may have you take more than one drug. Some of the most common types of medicines are listed below. They are taken by mouth or injection. - Alpha-glucosidase inhibitors - Biguanides - DPP IV inhibitors - Injectable medicines (GLP-1 analogs) - Meglitinides - SGL T2 inhibitors - Sulfonylureas - Thiazolidinediones You may need to take insulin if your blood sugar cannot be controlled with any of the above medicines. Most commonly, insulin is injected under the skin using a syringe, insulin pen, or pump. Another form of insulin is the inhaled type. Insulin cannot be taken by mouth because the acid in the stomach destroys the insulin. PREVENTING COMPLICATIONS Your doctor may prescribe medicines or other treatments to reduce your chance of developing some of the more common complications of diabetes, including: - Eye disease - Kidney disease - Heart disease and stroke FOOT CARE People with diabetes are more likely than those without diabetes to have foot problems. Diabetes damages the nerves. This can make your feet less able to feel pressure, pain, heat, or cold. You may not notice a foot injury until you have severe damage to the skin and tissue below, or you get a severe infection. Diabetes can also damage blood vessels. Small sores or breaks in the skin may become deeper skin sores (ulcers). The affected limb may need to be amputated if these skin ulcers do not heal or become larger, deeper, or infected. To prevent problems with your feet: - Stop smoking if you smoke. - Improve control of your blood sugar. - Get a foot exam by your doctor at least twice a year to learn if you have nerve damage. - Check and care for your feet every day. This is very important when you already have nerve or blood vessel damage or foot problems. - Treat minor infections, such as athlete's foot, right away. - Use moisturizing lotion on dry skin. - Make sure you wear the right kind of shoes. Ask your doctor what type of shoe is right for you. There are many diabetes resources that can help you understand more about type 2 diabetes. You can also learn ways to manage your condition so you can live well with diabetes. Diabetes is a lifelong disease and there is no cure. Some people with type 2 diabetes no longer need medicine if they lose weight and become more active. When they reach their ideal weight, their body's own insulin and a healthy diet can control their blood sugar level. After many years, diabetes can lead to serious health problems: - You could have eye problems, including trouble seeing (especially at night), and light sensitivity. You could become blind. - Your feet and skin can develop sores and infections. After a long time, your foot or leg may need to be amputated. Infection can also cause pain and itching in other parts of the body. - Diabetes may make it harder to control your blood pressure and cholesterol. This can lead to a heart attack, stroke, and other problems. It can become harder for blood to flow to your legs and feet. - Nerves in your body can get damaged, causing pain, tingling, and numbness. - Because of nerve damage, you could have problems digesting the food you eat. You could feel weakness or have trouble going to the bathroom. Nerve damage can make it harder for men to have an erection. - High blood sugar and other problems can lead to kidney damage. Your kidneys may not work as well as they used to. They may even stop working so that you need dialysis or a kidney transplant. Call 911 right away if you have: - Chest pain or pressure - Fainting, confusion or unconsciousness - Seizure - Shortness of breath These symptoms can quickly get worse and become emergency conditions (such as convulsions, hypoglycemic coma or hyperglycemic coma). Also call your doctor if you have: - Numbness, tingling, or pain in your feet or legs - Problems with your eyesight - Sores or infections on your feet - Symptoms of high blood sugar (extreme thirst, blurry vision, dry skin, weakness or fatigue, the need to urinate a lot) - Symptoms of low blood sugar (weakness or fatigue, trembling, sweating, irritability, trouble thinking clearly, fast heartbeat, double or blurry vision, uneasy feeling) You can help prevent type 2 diabetes by staying at a healthy body weight. You can get to a healthy weight by eating healthy foods, controlling your portion sizes, and leading an active lifestyle. Some medicines can also delay or prevent type 2 diabetes in people at risk of developing the disease. Updated by: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology and Nutrition, University of Washington School of Medicine, Seattle, WA. Internal review and update on 09/01/2016 by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.", "role": "user" }, { "content": "Family history and genes play a role in type 2 diabetes. Low activity level, poor diet, and excess body weight around the waist increase your chance of getting the disease.", "role": "assistant" } ]

[ { "content": "how to prevent diabetes\n\nDiabetes (Prevention): Keeping an ideal body weight and an active lifestyle may prevent or delay the start of type 2 diabetes. If you're overweight, losing just 5% to 7% of your body weight even helps. Some medicines can also be used to delay or prevent the start of type 2 diabetes. At this time, type 1 diabetes cannot be prevented. But there is promising research that shows type 1 diabetes may be delayed in some high risk people.", "role": "user" }, { "content": "Diabetes (Prevention): Keeping an ideal body weight and an active lifestyle may prevent or delay the start of type 2 diabetes. If you're overweight, losing just 5% to 7% of your body weight even helps. Some medicines can also be used to delay or prevent the start of type 2 diabetes. At this time, type 1 diabetes cannot be prevented. But there is promising research that shows type 1 diabetes may be delayed in some high risk people.", "role": "assistant" } ]

[ { "content": "how smoking tobacco affects the rest of the body\n\n Smoking and surgery Surgery - quitting smoking Surgery - quitting tobacco Wound healing - smoking Summary Quitting smoking and other tobacco products before surgery can improve your recovery and outcome after surgery. Most people who successfully quit smoking have tried and failed many times. DO NOT give up. Learning from your past tries can help you succeed. There Are Many Reasons to Quit Smoking Tar, nicotine, and other chemicals from smoking can increase your risk of many health problems. These include heart and blood vessel problems, such as: Blood clots and aneurysms in the brain, which can lead to strokes Coronary artery disease, including chest pain (angina) and heart attacks High blood pressure Poor blood supply to the legs Problems with erections Smoking also increases your risk for different types of cancer, including cancer of the: Lungs Mouth Larynx Esophagus Bladder Kidneys Pancreas Cervix Smoking also leads to lung problems, such as emphysema and chronic bronchitis, and makes asthma harder to control. Some smokers switch to smokeless tobacco instead of quitting tobacco completely. But using smokeless tobacco still carries health risks, such as: Developing mouth or nasal cancer Gum problems, tooth wear, and cavities Worsening high blood pressure and chest pain How Smoking Affects Surgery Smokers who have surgery have a higher chance than nonsmokers of blood clots forming in their legs. These clots may travel to and damage the lungs. Smoking decreases the amount of oxygen that reaches the cells in your surgical wound. As a result, your wound may heal more slowly and is more likely to become infected. All smokers carry an increased risk for heart and lung problems. Even when your surgery goes smoothly, smoking causes your body, heart, and lungs to work harder than if you did not smoke. Making the Decision to Quit Most doctors will tell you to stop using cigarettes and tobacco at least 4 weeks before your surgery. Stretching the time between quitting smoking and your surgery out to at least 10 weeks can decrease your risk of problems even more. Like any addiction, quitting tobacco is difficult. There are many ways to quit smoking and many resources to help you, such as: Family members, friends, and coworkers may be supportive or encouraging. Talk to your doctor about medicines, such as nicotine replacement and prescription medicines. If you join smoking cessation programs, you have a much better chance of success. Such programs are offered by hospitals, health departments, community centers, and work sites. Using nicotine gum around the time of surgery is not encouraged. The nicotine will still interfere with the healing of your surgical wound and have the same effect on your general health as using cigarettes and tobacco. Review Date 9/17/2016 Updated by: Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Smoking tobacco can increase you risk for many health problems. These include heart and blood vessel problems, lung problems, and different types of cancer.", "role": "assistant" } ]

[ { "content": "what is the treatment for lymphoma\n\nHodgkin lymphoma (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) - Whether the tumor is more than 4 inches (10 cm) wide - Your age and other medical issues - Other factors, including weight loss, night sweats, and fever You may receive chemotherapy, radiation therapy, or both. Your doctor 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 health care provider may need to manage other concerns during your leukemia treatment, including: - Having chemotherapy at home - Managing your pets during chemotherapy - Bleeding problems - Dry mouth - Eating enough calories - Safe eating during cancer treatment", "role": "user" }, { "content": "Hodgkin lymphoma (Treatment): You may receive 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 that uses your own stem cells.", "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\nPreeclampsia: 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. 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. 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. 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. 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. 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. 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": "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.", "role": "assistant" } ]

[ { "content": "how do we treat the burns caused by radiation?\n\n Burns Overview Burns can be minor medical problems or life-threatening emergencies. Many people die each year from fire-related burn injuries. Electricity and chemicals also cause severe burns. Scalding liquids are the most common cause of burns in children. Treatment of burns depends on the location and severity of the injury. Sunburns and small scalds can usually be treated at home. Deep or widespread burns need immediate medical attention. People with severe burns often require treatment at specialized burn centers. They may need skin grafts to cover large wounds or to minimize scarring with deep wounds. And they may need emotional support and months of follow-up care, such as physical therapy. Symptoms Burns don't affect the skin uniformly, so a single injury can reach varying depths. Distinguishing a minor burn from a more serious burn involves determining the extent of tissue damage. The following are three classifications of burns: - First-degree burn. This minor burn affects only the outer layer of the skin (epidermis). It may cause redness, swelling and pain. It usually heals with first-aid measures within several days to a week. Sunburn is a classic example. - Second-degree burn. This type of burn affects both the epidermis and the second layer of skin (dermis). It may cause red, white or splotchy skin, pain, and swelling. And the wound often looks wet or moist. Blisters may develop, and pain can be severe. Deep second-degree burns can cause scarring. - Third-degree burn. This burn reaches into the fat layer beneath the skin. Burned areas may be charred black or white. The skin may look waxy or leathery. Third-degree burns can destroy nerves, causing numbness. A person with this type of burn may also have difficulty breathing or experience smoke inhalation or carbon monoxide poisoning. When to see a doctor Seek emergency medical assistance for: - Burns that cover the hands, feet, face, groin, buttocks, a major joint or a large area of the body - Deep burns, which means burns affecting all layers of the skin and even other tissues - Burns caused by chemicals or electricity - Difficulty breathing or burns to the airway Minor burns can be cared for at home, but call your doctor if you experience: - Large blisters - Signs of infection, such as oozing from the wound, increased pain, redness and swelling - A burn or blister that doesn't heal in several weeks - New, unexplained symptoms - Significant scarring Causes Many things can cause burns, including: - Fire - Hot liquid or steam - Hot metal, glass or other objects - Electrical currents - Radiation from X-rays or radiation therapy to treat cancer - Sunlight or ultraviolet light from a sunlamp or tanning bed - Chemicals such as strong acids, lye, paint thinner or gasoline - Abuse Complications Deep or widespread burns can lead to many complications, including: - Infection. Burns can leave skin vulnerable to bacterial infection and increase your risk of sepsis. Sepsis is a life-threatening infection that travels through the bloodstream and affects your whole body. It progresses rapidly and can cause shock and organ failure. - Low blood volume. Burns can damage blood vessels and cause fluid loss. This may result in low blood volume (hypovolemia). Severe blood and fluid loss prevents the heart from pumping enough blood to the body. - Dangerously low body temperature. The skin helps control the body's temperature, so when a large portion of the skin is injured, you lose body heat. This increases your risk of a dangerously low body temperature (hypothermia). Hypothermia is a condition in which the body loses heat faster than it can produce heat. - Breathing problems. Breathing hot air or smoke can burn airways and cause breathing (respiratory) difficulties. Smoke inhalation damages the lungs and can cause respiratory failure. - Scarring. Burns can cause scars and ridged areas caused by an overgrowth of scar tissue (keloids). - Bone and joint problems. Deep burns can limit movement of the bones and joints. Scar tissue can form and cause shortening and tightening of skin, muscles or tendons (contractures). This condition may permanently pull joints out of position. Diagnosis During the physical exam, your doctor will examine your burned skin and determine what percentage of your total body surface area is involved. In general, an area of skin roughly equal to the size of your palm equals 1 percent of your total body surface area. For people ages 10 to 40, the American Burn Association defines a severe burn as one that involves 25 percent total body surface area or any burn involving the eyes, ears, face, hands, feet or groin. You'll also be examined for other injuries and to determine whether the burn has affected the rest of your body. You may need lab tests, X-rays or other diagnostic procedures. Treatment Treatment of burns depends on the type and extent of the injuries. Most minor burns can be treated at home using over-the-counter products or aloe. They usually heal within a few weeks. For serious burns, after appropriate first aid care and wound assessment, your treatment may involve medications, wound dressings, therapy and surgery. The goals of treatment are to control pain, remove dead tissue, prevent infection, reduce scarring, regain function and address emotional needs. You may need months of additional treatments and therapy. This may be done during a hospital stay, on an outpatient basis or at home. Factors affecting this choice include your wishes, other conditions and abilities, such as whether you're able to change bandages. Medications and wound healing products For major burns, various medications and products are used to encourage healing. - Water-based treatments. Your care team may use techniques such as ultrasound mist therapy to clean and stimulate the wound tissue. - Fluids to prevent dehydration. You may need intravenous (IV) fluids to prevent dehydration and organ failure. - Pain and anxiety medications. Healing burns can be incredibly painful. You may need morphine and anti-anxiety medications - particularly for dressing changes. - Burn creams and ointments. Your care team can select from a variety of topical products for wound healing. These help keep the wound moist, reduce pain, prevent infection and speed healing. - Dressings. Your care team may also use various specialty wound dressings. These create a moist environment that fights infection and helps the burn heal. - Drugs that fight infection. If you develop an infection, you may need IV antibiotics. - Tetanus shot. Your doctor might recommend a tetanus shot after a burn injury. Physical and occupational therapy If the burned area is large, especially if it covers any joints, you may need physical therapy exercises. These can help stretch the skin so the joints can remain flexible. Other types of exercises can improve muscle strength and coordination. And occupational therapy may help if you have difficulty doing your normal daily activities. Surgical and other procedures You may need one or more of the following procedures: - Breathing assistance. If you've been burned on the face or neck, your throat may swell shut. If that appears likely, your doctor may insert a tube down your windpipe (trachea) to keep oxygen supplied to your lungs. - Tube feeding. Your metabolism goes into overdrive when your body starts trying to heal your burns. To provide adequate nutrition for this task, you doctor may thread a feeding tube through your nose to your stomach. - Easing blood flow around the wound. If a burn scab (eschar) goes completely around a limb, it can tighten and cut off the blood circulation. A scab (eschar) that goes completely around the chest can make it difficult to breathe. Your doctor may cut the eschar in several places to relieve this pressure. This procedure is called decompression. - Skin grafts. A skin graft is a surgical procedure in which sections of your own healthy skin are used to replace the scar tissue caused by deep burns. Donor skin from cadavers or pigs can be used as a temporary solution. - Plastic surgery. Plastic surgery (reconstruction) can improve the appearance of burn scars and increase the flexibility of joints affected by scarring. Lifestyle and home remedies To treat minor burns, follow these steps: - Cool the burn. Run cool (not cold) tap water over the burn for 10 to 15 minutes or until the pain eases. Or apply a clean towel dampened with cool tap water. Don't use ice. Putting ice directly on a burn can cause further damage to the tissue. - Remove rings or other tight items from the burned area. Try to do this quickly and gently, before the area swells. - Don't break small blisters (no bigger than your little fingernail). If blisters break, gently clean the area with mild soap and water, apply an antibiotic ointment, and cover it with a nonstick gauze bandage. - Apply moisturizer or aloe vera lotion or gel. This may soothe the area and prevent dryness as the wound heals. - If needed, take an over-the-counter pain reliever. Nonprescription products include ibuprofen (Advil, Motrin IB, others), naproxen (Aleve) and acetaminophen (Tylenol, others). - Consider a tetanus shot. Make sure that your tetanus booster is up to date. Doctors recommend people get a tetanus shot at least every 10 years. Whether your burn was minor or serious, use sunscreen and moisturizer regularly once the wound is healed. ", "role": "user" }, { "content": "Treatment of burns depends on the type and extent of the injuries. Most minor burns can be treated at home using over-the-counter products or aloe. They usually heal within a few weeks. For serious burns, after appropriate first aid care and wound assessment, your treatment may involve medications, wound dressings, therapy and surgery. The goals of treatment are to control pain, remove dead tissue, prevent infection, reduce scarring, regain function and address emotional needs. You may need months of additional treatments and therapy.", "role": "assistant" } ]

[ { "content": "what are autoimmune blood disorders\n\n Autoimmune disorders Summary An autoimmune disorder occurs when the body's immune system attacks and destroys healthy body tissue by mistake. There are more than 80 types of autoimmune disorders. Causes The blood cells in the body's immune system help protect against harmful substances. Examples include bacteria, viruses, toxins, cancer cells, and blood and tissue from outside the body. These substances contain antigens. The immune system produces antibodies against these antigens that enable it to destroy these harmful substances. When you have an autoimmune disorder, your immune system does not distinguish between healthy tissue and antigens. As a result, the body sets off a reaction that destroys normal tissues. The exact cause of autoimmune disorders is unknown. One theory is that some microorganisms (such as bacteria or viruses) or drugs may trigger changes that confuse the immune system. This may happen more often in people who have genes that make them more prone to autoimmune disorders. An autoimmune disorder may result in: The destruction of body tissue Abnormal growth of an organ Changes in organ function An autoimmune disorder may affect one or more organ or tissue types. Areas often affected by autoimmune disorders include: Blood vessels Connective tissues Endocrine glands such as the thyroid or pancreas Joints Muscles Red blood cells Skin A person may have more than one autoimmune disorder at the same time. Common autoimmune disorders include: Addison disease Celiac disease - sprue (gluten-sensitive enteropathy) Dermatomyositis Graves disease Hashimoto thyroiditis Multiple sclerosis Myasthenia gravis Pernicious anemia Reactive arthritis Rheumatoid arthritis Sjogren syndrome Systemic lupus erythematosus Type I diabetes Symptoms Symptoms will vary, based on the type and location of the faulty immune response. Common symptoms include: Fatigue Fever General ill feeling (malaise) Joint pain Rash Exams and Tests The health care provider will do a physical exam. Signs depend on the type of disease. Tests that may be done to diagnose an autoimmune disorder include: Antinuclear antibody tests Autoantibody tests CBC Comprehensive metabolic panel C-reactive protein (CRP) Erythrocyte sedimentation rate (ESR) Urinalysis Treatment The goals of treatment are to: Reduce symptoms Control the autoimmune process Maintain the body's ability to fight disease Treatments will depend on your disease and symptoms. Types of treatments include: Supplements to replace a substance that the body lacks, such as thyroid hormone, vitamin B12, or insulin, due to the autoimmune disease Blood transfusions if blood is affected Physical therapy to help with movement if the bones, joints, or muscles are affected Many people take medicines to reduce the immune system's abnormal response. These are often called immunosuppressive medicines. Examples include corticosteroids (such as prednisone) and nonsteroid drugs such as azathioprine, cyclophosphamide, mycophenolate, sirolimus, or tacrolimus. Targeted drugs such as tumor necrosis factor (TNF) blockers and Interleukin inhibitors can be used for some diseases. Outlook (Prognosis) The outcome depends on the disease. Most autoimmune diseases are chronic, but many can be controlled with treatment. Symptoms of autoimmune disorders can come and go. When symptoms get worse, it is called a flare-up. Possible Complications Complications depend on the disease. Medicines used to suppress the immune system can cause severe side effects, such as higher risk of infections. When to Contact a Medical Professional Call your provider if you develop symptoms of an autoimmune disorder. Prevention There is no known prevention for most autoimmune disorders. 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": "An autoimmune disorder occurs when the body's immune system attacks and destroys healthy body tissue by mistake. There are more than 80 types of autoimmune disorders. The blood cells in the body's immune system help protect against harmful substances. These substances contain antigens. The immune system produces antibodies against these antigens that enable it to destroy these harmful substances. When you have an autoimmune disorder, your immune system does not distinguish between healthy tissue and antigens. As a result, the body sets off a reaction that destroys normal tissues.", "role": "assistant" } ]

[ { "content": "how do i prevent myself from having dementia\n\n Dementia Chronic brain syndrome Lewy body dementia DLB Vascular dementia Mild cognitive impairment MCI Summary Dementia is a loss of brain function that occurs with certain diseases. It affects memory, thinking, language, judgment, and behavior. Causes Dementia usually occurs in older age. Most types are rare in people under age 60. The risk of dementia increases as a person gets older. Most types of dementia are nonreversible (degenerative). Nonreversible means the changes in the brain that are causing the dementia cannot be stopped or turned back. Alzheimer disease is the most common type of dementia. Another common type of dementia is vascular dementia. It is caused by poor blood flow to the brain, such as with stroke. Lewy body disease is a common cause of dementia in older adults. People with this condition have abnormal protein structures in certain areas of the brain. The following medical conditions can also lead to dementia: Huntington disease Brain injury Multiple sclerosis Infections such as HIV/AIDS, syphilis, and Lyme disease Parkinson disease Pick disease Progressive supranuclear palsy Some causes of dementia may be stopped or reversed if they are found soon enough, including: Brain injury Brain tumors Long-term (chronic) alcohol abuse Changes in blood sugar, sodium, and calcium levels (dementia due to metabolic causes) Low vitamin B12 level Normal pressure hydrocephalus Use of certain medicines, including cimetidine and some cholesterol drugs Some brain infections Symptoms Dementia symptoms include difficulty with many areas of mental function, including: Emotional behavior or personality Language Memory Perception Thinking and judgment (cognitive skills) Dementia usually first appears as forgetfulness. Mild cognitive impairment (MCI) is the stage between normal forgetfulness due to aging and the development of dementia. People with MCI have mild problems with thinking and memory that do not interfere with daily activities. They often know about their forgetfulness. Not everyone with MCI develops dementia. Symptoms of MCI include: Difficulty doing more than one task at a time Difficulty solving problems or making decisions Forgetting recent events or conversations Taking longer to do more difficult mental activities Early symptoms of dementia can include: Difficulty with tasks that take some thought, but that used to come easily, such as balancing a checkbook, playing games (such as bridge), and learning new information or routines Getting lost on familiar routes Language problems, such as trouble with the names of familiar objects Losing interest in things previously enjoyed, flat mood Misplacing items Personality changes and loss of social skills, which can lead to inappropriate behaviors As dementia becomes worse, symptoms are more obvious and interfere with the ability to take care of oneself. Symptoms may include: Change in sleep patterns, often waking up at night Difficulty with basic tasks, such as preparing meals, choosing proper clothing, or driving Forgetting details about current events Forgetting events in one's own life history, losing self-awareness Having hallucinations, arguments, striking out, and violent behavior Having delusions, depression, and agitation More difficulty reading or writing Poor judgment and loss of ability to recognize danger Using the wrong word, not pronouncing words correctly, speaking in confusing sentences Withdrawing from social contact People with severe dementia can no longer: Perform basic activities of daily living, such as eating, dressing, and bathing Recognize family members Understand language Other symptoms that may occur with dementia: Problems controlling bowel movements or urine Swallowing problems Exams and Tests A skilled health care provider can often diagnose dementia using the following: Complete physical exam, including nervous system exam Asking about the person's medical history and symptoms Mental function tests (mental status examination) Other tests may be ordered to find out if other problems may be causing dementia or making it worse. These conditions include: Anemia Brain tumor Long-term (chronic) infection Intoxication from medicines Severe depression Thyroid disease Vitamin deficiency The following tests and procedures may be done: B12 level Blood ammonia levels Blood chemistry (chem-20) Blood gas analysis Cerebrospinal fluid (CSF) analysis Drug or alcohol levels (toxicology screen) Electroencephalograph (EEG) Head CT Mental status test MRI of head Thyroid function tests, including thyroid stimulating hormone (TSH) Thyroid stimulating hormone level Urinalysis Treatment Treatment depends on the condition causing the dementia. Some people may need to stay in the hospital for a short time. Sometimes, dementia medicine can make a person's confusion worse. Stopping or changing these medicines is part of the treatment. Certain mental exercises can help with dementia. Treating conditions that can lead to confusion often greatly improve mental function. Such conditions include: Anemia Congestive heart failure Decreased blood oxygen (hypoxia) Depression Heart failure Infections Nutritional disorders Thyroid disorders Medicines may be used to: Slow the rate at which symptoms get worse, though improvement with these drugs may be small Control problems with behavior, such as loss of judgment or confusion Someone with dementia will need support in the home as the disease gets worse. Family members or other caregivers can assist by helping the person cope with memory loss and behavior and sleep problems. It is important to make sure the homes of people who have dementia are safe for them. Outlook (Prognosis) People with MCI do not always develop dementia. When dementia does occur, it usually gets worse over time. Dementia often decreases quality of life and lifespan. Families will likely need to plan for their loved one's future care. When to Contact a Medical Professional Call your provider if: Dementia develops or a sudden change in mental status occurs The condition of a person with dementia gets worse You are unable to care for a person with dementia at home Prevention Most causes of dementia are not preventable. The risk of vascular dementia may be reduced by preventing strokes through: Eating healthy foods Exercising Quitting smoking Controlling high blood pressure Managing diabetes Review Date 1/19/2018 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 causes of dementia are not preventable. The risk of vascular dementia may be reduced by lowering the risk of having a stroke. It is possible to do so by eating healthy foods, exercising, quitting smoking, controlling high blood pressure, and managing diabetes.", "role": "assistant" } ]

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

[ { "content": "how to loose weight\n\nDiet for rapid weight loss: Rapid weight loss diet is a type of diet in which you lose more than 2 pounds (1 kilogram, kg) a week over several weeks. To lose weight this quickly you eat very few calories. These diets are most often for obese people who need to lose weight quickly because of a health problem. People on these diets should be followed closely by a health care provider. Rapid weight loss is not safe for most people to do on their own. These diets are only to be used for a short time and are not recommended for more than several weeks. The types of rapid weight loss diets are described below. On a VLCD, you may have as few as 800 calories a day and may lose up to 3 to 5 pounds (1.5 to 2 kg) week. Most VLCDs use meal replacements, such as formulas, soups, shakes, and bars instead of regular meals. This helps ensure that you get all of the nutrients you need each day. A VLCD is only recommended for adults who are obese and need to lose weight for health reasons. These diets are often used before weight-loss surgery. You should only use a VLCD with the help of your health care provider. Most experts DO NOT recommend using a VLCD for more than 12 weeks. These diets usually allow about 1000 to 1200 calories a day for women and 1200 to 1600 calories a day for men. An LCD is a better choice than a VLCD for most people who want to lose weight quickly. But you should still be supervised by a provider. You will not lose weight as fast with an LCD, but you can lose just as much weight with a VLCD. An LCD may use a mix of meal replacements and regular food. This makes it easier to follow than a VLCD. Some fad diets also severely limit calories to achieve rapid weight loss. In many cases, these diets are not safe. Once you stop the diet, you are at risk for regaining the weight if you return to your old eating habits. For most people, it is safest to choose a diet in which you lose a 1/2 pound to 2 pounds (225 grams to 1 kg) a week. Rapid weight loss is more about cutting calories than exercising. Talk with your provider about what type of exercise you should do while you are on this type of diet. Your provider may suggest waiting until you are on a more long-term diet to start exercising. Rapid weight loss diet is usually for people who have health problems because of obesity. For these people, losing a lot of weight quickly can help improve: - Diabetes - High cholesterol - High blood pressure You should only follow one of these diets with the help of your provider. Losing more than one 1 or 2 pounds (0.5 to 1 kg) a week is not safe for most people. It can cause you to lose muscle, water, and bone density. Rapid weight loss can also cause some side effects including: - Gallstones - Gout - Fatigue - Constipation - Diarrhea - Nausea People who lose weight quickly are also more likely to gain back the weight quickly. This can lead to other health problems. In general, a rapid weight loss diet is not safe for children. It may also not be safe for teens, pregnant women or older adults unless a provider recommends it. If you have a health condition, it is a good idea to talk with your provider before starting this or any diet plan to lose weight. Updated by: Emily Wax, RD, The Brooklyn Hospital Center, Brooklyn, NY. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.", "role": "user" }, { "content": "Diet for rapid weight loss: Rapid weight loss diet is usually for people who have health problems because of obesity. Rapid weight loss diet is a type of diet in which you lose more than 2 pounds (1 kilogram, kg) a week over several weeks. To lose weight this quickly you eat very few calories. These diets are most often for obese people who need to lose weight quickly because of a health problem. People on these diets should be followed closely by a health care provider. Rapid weight loss is not safe for most people to do on their own. These diets are only to be used for a short time and are not recommended for more than several weeks. Some fad diets also severely limit calories to achieve rapid weight loss. In many cases, these diets are not safe.", "role": "assistant" } ]

[ { "content": "what test do you do for 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": "Rheumatoid arthritis can be hard to diagnose because: - There is no single test for the disease. - The symptoms can be the same as in other kinds of joint disease. - The full symptoms can take time to develop. To diagnose rheumatoid arthritis, doctors use medical history, a physical exam, x-rays and other imaging tests, and lab tests.", "role": "assistant" } ]

[ { "content": "know more about My Daughter have Distal renal tubular acidosis. we are from Mexico, and we ae woundering if can send to us more infomation. maybe you can reccommend to us a association???? i don?t know\n\nSLC4A1-associated distal renal tubular acidosis (Inheritance Pattern): SLC4A1-associated distal renal tubular acidosis can have different patterns of inheritance. It is usually inherited in an autosomal dominant pattern, which means one copy of the altered SLC4A1 gene in each cell is sufficient to cause the disorder. In most cases, an affected person inherits the mutation from one affected parent. Other cases result from new mutations in the gene and occur in people with no history of the disorder in their family. Less commonly, SLC4A1-associated distal renal tubular acidosis has an autosomal recessive pattern of inheritance, which means a mutation must occur in both copies of the SLC4A1 gene for the condition to develop. This pattern occurs with certain types of SLC4A1 gene 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.", "role": "user" }, { "content": "SLC4A1-associated distal renal tubular acidosis can have different patterns of inheritance. In most cases, an affected person inherits the mutation from one affected parent. Other cases result from new mutations in the gene and occur in people with no history of the disorder in their family.", "role": "assistant" } ]

[ { "content": "How bad can endometriosis get?\n\n Endometriosis Overview Endometriosis is a disease in which tissue that normally grows inside the uterus grows outside the uterus. It is one of the most common gynecological diseases, and its primary symptoms include pain and infertility. About Endometriosis ​ What causes endometriosis? ​ The exact cause of endometriosis is not known, but researchers have some theories.The female reproductive organs are shown with red patches representing endometriosis. The arrows indicate that the menstrual flow is going backwards into the fallopian tubes instead of out of the body as it should.One theory suggests that endometriosis may result from something called \"retrograde menstrual flow,\" in which some of the tissue that a woman sheds during her period flows through her fallopian tubes into her pelvis. While most women have some retrograde menstrual flow during their periods, not all of these women have endometriosis. Researchers are trying to uncover what other factors might cause the tissue to attach and grow in some women, but not in others.1,2​Researchers believe that endometriosis likely results from a combination of factors, including (but not limited to) some of the following:- Because endometriosis runs in families, genes are probably involved with endometriosis to some degree. - Estrogen (a hormone involved in the female reproductive cycle) also likely contributes to endometriosis, because endometriosis is an estrogen-dependent, inflammatory disease. - In endometriosis, the endometrium may not respond as it should to progesterone, another hormone involved in the female reproductive cycle. This means that the endometrium has \"progesterone resistance.\" - In some cases of endometriosis, the immune system fails to destroy endometrial tissue, which enables it to grow outside the uterus. This means immune system dysfunction plays a role in these cases. - Environmental exposures in the womb, such as to chemicals like dioxin and organochlorine pesticides, have also been linked to developing endometriosis.1,2NICHD’s Endometriosis: Natural History, Diagnosis, and Outcomes (ENDO) Study conducted by the Division of Intramural Population Health Research examines risk factors associated with endometriosis. The study has found evidence of increased risk of endometriosis associated with environmental exposures:- Exposure to certain phthalates (chemicals used in plastics and other everyday products)3 - Exposure to certain industrial chemicals called “persistent organochlorine pollutants”4 - Exposure to some perfluoroalkyl and polyfluoroalkyl substances (PFAAs)5 - A specific ultraviolet filter (sunscreen) used in cosmetics6 - High urine concentrations of chromium and copper7 How many people are affected by or at risk for endometriosis?​​​ ​​- Factors that May Increase the Risk of Endometriosis Studies show that women are at higher risk for endometriosis if their: - Mother, sister, or daughter had endometriosis (raises the risk about sixfold)2 - Periods started at an early age (before age 11)3 - Monthly cycles are short (less than 27 days)3 - Menstrual cycles are heavy and last more than 7 days3 - Mother, sister, or daughter had endometriosis (raises the risk about sixfold)2 - Periods started at an early age (before age 11)3 - Monthly cycles are short (less than 27 days)3 - Menstrual cycles are heavy and last more than 7 days3 - Factors that May Lower the Risk of Endometriosis Studies also show that some factors may lower the risk for endometriosis, including: - Pregnancy - Starting menstruation late in adolescence4 - Regular exercise of more than 4 hours a week3 - Low amount of body fat - Pregnancy - Starting menstruation late in adolescence4 - Regular exercise of more than 4 hours a week3 - Low amount of body fat What are the symptoms of endometriosis? The primary symptoms of endometriosis are pain and infertility.- Among women with pelvic pain, endometriosis may occur in about 75%.1,2 - Among women with fertility problems, endometriosis may occur in as many as 50%.1Other common symptoms of endometriosis include:- Painful, even debilitating, menstrual cramps, which may get worse over time - Pain during or after sex - Pain in the intestine or lower abdomen - Painful bowel movements or painful urination during menstrual periods - Heavy menstrual periods - Premenstrual spotting or bleeding between periodsIn addition, women who are diagnosed with endometriosis may have painful bladder syndrome, digestive or gastrointestinal symptoms similar to a bowel disorder, as well as fatigue, tiredness, or lack of energy.2For some women, the pain symptoms associated with endometriosis get milder after menopause, but this is not always the case. Hormone therapy such as estrogen or birth control pills, given to reduce menopausal symptoms, may cause these endometriosis symptoms to continue.Researchers know that pain is a primary symptom of endometriosis, but it is not known how pain arises in women with endometriosis.The severity of pain does not correspond with the number, location, or extent of endometriosis lesions. Some women with only a few small lesions experience severe pain; other women may have very large patches of endometriosis, but only experience little pain.3,4Current evidence suggests several possible explanations for pain associated with endometriosis, including (but not limited to):3,4- Patches of endometriosis respond to hormones in a similar way as the lining of the uterus. These tissues may bleed or have evidence of inflammation every month, similar to a regular menstrual period. However, the blood and tissue shed from endometriosis patches stay in the body and are irritants, which can cause pain. - In some cases, inflammation and chemicals produced by the endometriosis areas can cause the pelvic organs to adhere, or stick together, causing scar tissue. This makes the uterus, ovaries, and fallopian tubes, as well as the bladder and rectum, appear as one large organ. - Hormones and chemicals released by endometriosis tissue also may irritate nearby tissue and cause the release of other chemicals known to cause pain. - Over time, some endometriosis areas may form nodules or bumps as they create lesions on the surface of pelvic organs or can become cysts (fluid-filled sacs) on the ovaries. - Some endometriosis lesions have nerves in them, tying the patches directly into the central nervous system. These nerves may be more sensitive to pain-causing chemicals released in the lesions and surrounding areas. Over time, they may be more easily activated by the chemicals than normal nerve cells are. - Patches of endometriosis might also press against nearby nerve cells to cause pain. - Some women report less endometriosis pain after pregnancy, but the reason for this is unclear. Researchers are trying to determine if the reduction results from the hormones released by the body during pregnancy, or from changes in the cervix, uterus, or endometrium that occur during pregnancy and delivery.Pain from endometriosis can be severe, interfering with day-to-day activities. Understanding how endometriosis is related to pain is a very active area of research because it could allow for more effective treatments for this specific type of pain. How do health care providers diagnose endometriosis?​ Surgery is currently the only way to confirm a diagnosis of endometriosis.The most common surgery is called laparoscopy (pronounced lap-uh-ROS-kuh-pee). In this procedure:- The surgeon uses an instrument to inflate the abdomen slightly with a harmless gas. - After making a small cut in the abdomen, the surgeon uses a small viewing instrument with a light, called a laparoscope (pronounced LAP-er-uh-skohp), to look at the reproductive organs, intestines, and other surfaces to see if there is any endometriosis. - He or she can make a diagnosis based on how the patches of endometriosis look. - In some cases, the surgeon will also do a biopsy, which involves taking a small tissue sample and studying it under a microscope, to confirm the diagnosis.1 - While the most common surgery is a laparoscopy, sometimes a laparotomy—a surgical procedure involving a larger incision—is used to make a diagnosis.Health care providers may also use imaging methods to produce a \"picture\" of the inside of the body to help detect endometriosis. Imaging allows them to locate larger endometriosis areas, such as nodules or cysts. The two most common imaging tests are ultrasound, which uses sound waves to make the picture, and magnetic resonance imaging (MRI), which uses magnets and radio waves to make the picture. These types of imaging will not aid in the diagnosis of small lesions or adhesions.1Your health care provider will perform a laparoscopy only after learning your full medical history and giving you a complete physical and pelvic exam. This information, in addition to the results of an ultrasound or MRI, will help you and your health care provider make more informed decisions about treatment.Researchers are also seeking less invasive ways to diagnose endometriosis and to determine how severe the disease is. NICHD-funded researchers in the National Centers for Translational Research in Reproduction and Infertility created a “diagnostic classifier” for endometriosis based on the presence of particular genes. The classifier was 90% to 100% accurate. Once the classifier is validated, a simple biopsy in the doctor’s office may be a non-surgical way to diagnose endometriosis in most women.2 What are the treatments for endometriosis?​ ​​- Treatments for Pain from Endometriosis Treatments for endometriosis pain fall into three general categories: - Pain medications - Hormone therapy - Surgical treatment Pain Medications Pain medications may work well if your pain or other symptoms are mild. These medications range from over-the-counter pain relievers to strong prescription pain relievers. The most common types of pain relievers are nonsteroidal anti-inflammatory drugs, also called NSAIDS (pronounced ENN-sedds), and opioids (pronounced OH-pee-oyds), strong pain drugs that interact directly with the nervous system. Evidence on the effectiveness of these medications for relieving endometriosis-associated pain is limited. Understanding which drugs relieve pain associated with endometriosis could also shed light on how endometriosis causes pain.1,2 Hormone Treatments Because hormones cause endometriosis patches to go through a cycle similar to the menstrual cycle, hormones also can be effective in treating the symptoms of endometriosis. Additionally, our perception of pain may be altered by different hormones. Hormone therapy is used to treat endometriosis-associated pain. Hormones come in the form of a pill, a shot or injection, or a nasal spray. Hormone treatments stop the ovaries from producing hormones, including estrogen, and usually prevent ovulation. This may help slow the growth and local activity of both the endometrium and the endometrial lesions. Treatment also prevents the growth of new areas and scars (adhesions), but it will not make existing adhesions go away. Health care providers may suggest one of the hormone treatments described below to treat pain from endometriosis:3,2,4 - Oral contraceptives, or birth control pills. These help make your period lighter, more regular, and shorter. Women prescribed contraceptives also report relief from pain.5 - In general, the therapy contains two hormones-estrogen and progestin, a progesterone-like hormone. Women who can't take estrogen because of cardiovascular disease or a high risk of blood clots can use progestin-only pills to reduce menstrual flow. - Typically, a woman takes the pill for 21 days and then takes sugar pills for 7 days to mimic the natural menstrual cycle. Some women take birth control pills continuously, without using the sugar pills that signal the body to go through menstruation. Taken without the sugar pills, birth control pills may stop the menstrual period altogether, which can reduce or eliminate the pain. There are also birth control pills available that provide only a couple days of sugar pills every 3 months; these also help reduce or eliminate pain. - Pain relief usually lasts only while taking the pills, while the endometriosis is suppressed. When treatment stops, the symptoms of endometriosis may return (along with the ability to get pregnant). Many women continue treatment indefinitely. Occasionally, some women have no pain for several years after stopping treatment. - There are some mild side effects from these hormones, such as weight gain, bloating, and bleeding between periods (especially when women first start to take the pills continuously). - Progesterone and progestin, taken as a pill, by injection, or through an intrauterine device (IUD), improve symptoms by reducing a woman's period or stopping it completely. This also prevents pregnancy. - As a pill taken daily, these hormones reduce menstrual flow without causing the uterus lining to grow. As soon as a woman stops taking the progestin pill, symptoms may return and pregnancy is possible. - An IUD containing progestin, such as Mirena®, may be effective in reducing endometriosis-associated pain. It reduces the size of lesions and reduces menstrual flow (one third of women no longer get their period after a year of use).6 - As an injection taken every 3 months, these hormones usually stop menstrual flow. However, one-third of women bleed several times in the first year of injection use. During these times of bleeding, pain may occur. Additionally, it may take a few months for a period to return after stopping the injections. When menstruation starts again, the ability to get pregnant returns. - Women taking these hormones may gain weight, feel depressed, or have irregular vaginal bleeding. - Gonadotropin-releasing hormone (GnRH) agonists (pronounced AG-uh-nists) stop the production of certain hormones to prevent ovulation, menstruation, and the growth of endometriosis. This treatment sends the body into a \"menopausal\" state. - GnRH agonists come in a nose spray taken daily, as an injection given once a month, or as an injection given every 3 months. - Most health care providers recommend staying on GnRH agonists for only about 6 months at a time, with several months between treatments if they are repeated. The risk for heart complications and bone loss can rise when taking them longer.2 After stopping the GnRH agonist, the body comes out of the menopausal state, menstruation begins, and pregnancy is possible.7 - As with all hormonal treatments, endometriosis symptoms return after women stop taking GnRH agonists. - These medications also have side effects, including hot flashes, tiredness, problems sleeping, headache, depression, joint and muscle stiffness, bone loss, and vaginal dryness. - Danazol (pronounced DAY-nuh-zawl, also called Danocrine®) treatment stops the release of hormones that are involved in the menstrual cycle. While taking this drug, women will have a period only now and then or sometimes not at all. - Common side effects include oily skin, pimples or acne, weight gain, muscle cramps, tiredness, smaller breasts, and sore breasts. Headaches, dizziness, weakness, hot flashes, or a deepening of the voice may also occur while on this treatment. Danazol's side effects are more severe than those from other hormone treatment options.2 - Danazol can harm a developing fetus. Therefore, it is important to prevent pregnancy while on this medication. Hormonal birth control methods are not recommended while on danazol. Instead, health care providers recommend using barrier methods of birth control, such as condoms or a diaphragm. Researchers are exploring the use of other hormones for treating endometriosis and the pain related to it. One example is gestrinone (pronounced GES-trih-nohn), which has been used in Europe but is not available in the United States. Drugs that lower the amount of estrogen in the body, called aromatase (pronounced uh-ROH-muh-tase) inhibitors, are also being studied. Some research shows that they can be effective in reducing endometriosis pain, but they are still considered experimental in the United States. They are not approved by the Food and Drug Administration for treatment of endometriosis.8 Surgical Treatments Research shows that some surgical treatments can provide significant, although short-term, pain relief from endometriosis,2 so health care providers may recommend surgery to treat severe pain from endometriosis. During the operation, the surgeon can locate any areas of endometriosis and examine the size and degree of growth; he or she also may remove the endometriosis patches at that time. It is important to understand what is planned during surgery as some procedures cannot be reversed and others can affect a woman's fertility. Therefore, a woman should have a detailed discussion with a health care provider about all available options before making final decisions about treatment. Health care providers may suggest one of the following surgical treatments for pain from endometriosis.1,2,3 - Laparoscopy. The surgeon uses an instrument to inflate the abdomen slightly with a harmless gas and then inserts a small viewing instrument with a light, called a laparoscope, into the abdomen through a small cut to see the growths. - To remove the endometriosis, the surgeon makes at least two more small cuts in the abdomen and inserts lasers or other surgical instruments to: - Remove the lesions, which is a process called excising (pronounced eks-SIZE-ing). - Destroy the lesions with intense heat and seal the blood vessels without stitches, a process called cauterizing (pronounced KAW-tur-ize-ing) or vaporizing. - Some surgeons also will remove scar tissue at this time because it may be contributing to endometriosis-associated pain. - The goal is to treat the endometriosis without harming the healthy tissue around it. - Although most women have relief from pain with surgery in the short term, pain often returns.2 The excision of deep lesions seems to be associated with long-term pain relief. - Some evidence shows that surgical treatment for endometriosis-related pain is actually more effective in women who have moderate endometriosis rather than minimal endometriosis. The reason is that women with minimal endometriosis may have changes in their pain perception that persist after the lesions are removed.1,6 - Laparotomy. In this major abdominal surgery procedure, the surgeon may remove the endometriosis patches. Sometimes, the endometriosis lesions are too small to see in a laparotomy. - During this procedure, the surgeon may also remove the uterus. Removing the uterus is called hysterectomy (pronounced his-tuh-REK-tuh-mee). - If the ovaries have endometriosis on them or if damage is severe, the surgeon may remove the ovaries and fallopian tubes along with the uterus. This process is called total hysterectomy and bilateral (meaning \"on both sides\") salpingo-oophorectomy (pronounced sal-PING-go ooh-for-EK-toh-mee). - When possible, health care providers will try to leave the ovaries in place because of the important role ovaries play in overall health. - Health care providers recommend major surgery as a last resort for endometriosis treatment. - Having a hysterectomy or salpingo-oophorectomy does not guarantee that the lesions will not return or that the pain will go away. Endometriosis symptoms and lesions may come back in as many as 15% of women who have a total hysterectomy with bilateral salpingo-oophorectomy.2 - Surgery to sever pelvic nerves. If the pain is located in the center of the abdomen, health care providers may recommend cutting nerves in the pelvis to lessen the pain. This can be done during either laparoscopy or laparotomy.2 - Two procedures are used to sever different nerves in the pelvis. - Presacral neurectomy (pronounced pree-SEY-kruhl [or pree-SAK-ruhl]) nyoo-REK-tuh-mee). This procedure severs the nerves connected to the uterus. Research shows that this procedure can be useful in relieving pain along the center of the abdomen.6,8 - Laparoscopic uterine nerve ablation (pronounced a-BLEY-shuhn) (LUNA) This procedure involves severing nerves in the ligaments that secure the uterus. However, studies have shown that LUNA did not relieve pain any better than laparoscopy alone. For this reason, it is generally not recommended for treatment of endometriosis-associated pain.2,6,8 - The American College of Obstetricians and Gynecologists (ACOG) reports several clinical trials that showed these procedures to be ineffective at relieving pain from endometriosis. These procedures are not currently included in the ACOG recommendations for management of endometriosis.2 In some cases, hormone therapy is used before or after surgery to reduce pain and/or continue treatment. Current evidence supports the use of an intrauterine device (IUD) containing progestin after surgery to reduce pain.6 Currently, the only such device approved by the FDA is Mirena®. [top] - Pain medications - Hormone therapy - Surgical treatment - Oral contraceptives, or birth control pills. These help make your period lighter, more regular, and shorter. Women prescribed contraceptives also report relief from pain.5 - In general, the therapy contains two hormones-estrogen and progestin, a progesterone-like hormone. Women who can't take estrogen because of cardiovascular disease or a high risk of blood clots can use progestin-only pills to reduce menstrual flow. - Typically, a woman takes the pill for 21 days and then takes sugar pills for 7 days to mimic the natural menstrual cycle. Some women take birth control pills continuously, without using the sugar pills that signal the body to go through menstruation. Taken without the sugar pills, birth control pills may stop the menstrual period altogether, which can reduce or eliminate the pain. There are also birth control pills available that provide only a couple days of sugar pills every 3 months; these also help reduce or eliminate pain. - Pain relief usually lasts only while taking the pills, while the endometriosis is suppressed. When treatment stops, the symptoms of endometriosis may return (along with the ability to get pregnant). Many women continue treatment indefinitely. Occasionally, some women have no pain for several years after stopping treatment. - There are some mild side effects from these hormones, such as weight gain, bloating, and bleeding between periods (especially when women first start to take the pills continuously). - Progesterone and progestin, taken as a pill, by injection, or through an intrauterine device (IUD), improve symptoms by reducing a woman's period or stopping it completely. This also prevents pregnancy. - As a pill taken daily, these hormones reduce menstrual flow without causing the uterus lining to grow. As soon as a woman stops taking the progestin pill, symptoms may return and pregnancy is possible. - An IUD containing progestin, such as Mirena®, may be effective in reducing endometriosis-associated pain. It reduces the size of lesions and reduces menstrual flow (one third of women no longer get their period after a year of use).6 - As an injection taken every 3 months, these hormones usually stop menstrual flow. However, one-third of women bleed several times in the first year of injection use. During these times of bleeding, pain may occur. Additionally, it may take a few months for a period to return after stopping the injections. When menstruation starts again, the ability to get pregnant returns. - Women taking these hormones may gain weight, feel depressed, or have irregular vaginal bleeding. - Gonadotropin-releasing hormone (GnRH) agonists (pronounced AG-uh-nists) stop the production of certain hormones to prevent ovulation, menstruation, and the growth of endometriosis. This treatment sends the body into a \"menopausal\" state. - GnRH agonists come in a nose spray taken daily, as an injection given once a month, or as an injection given every 3 months. - Most health care providers recommend staying on GnRH agonists for only about 6 months at a time, with several months between treatments if they are repeated. The risk for heart complications and bone loss can rise when taking them longer.2 After stopping the GnRH agonist, the body comes out of the menopausal state, menstruation begins, and pregnancy is possible.7 - As with all hormonal treatments, endometriosis symptoms return after women stop taking GnRH agonists. - These medications also have side effects, including hot flashes, tiredness, problems sleeping, headache, depression, joint and muscle stiffness, bone loss, and vaginal dryness. - Danazol (pronounced DAY-nuh-zawl, also called Danocrine®) treatment stops the release of hormones that are involved in the menstrual cycle. While taking this drug, women will have a period only now and then or sometimes not at all. - Common side effects include oily skin, pimples or acne, weight gain, muscle cramps, tiredness, smaller breasts, and sore breasts. Headaches, dizziness, weakness, hot flashes, or a deepening of the voice may also occur while on this treatment. Danazol's side effects are more severe than those from other hormone treatment options.2 - Danazol can harm a developing fetus. Therefore, it is important to prevent pregnancy while on this medication. Hormonal birth control methods are not recommended while on danazol. Instead, health care providers recommend using barrier methods of birth control, such as condoms or a diaphragm. - Laparoscopy. The surgeon uses an instrument to inflate the abdomen slightly with a harmless gas and then inserts a small viewing instrument with a light, called a laparoscope, into the abdomen through a small cut to see the growths. - To remove the endometriosis, the surgeon makes at least two more small cuts in the abdomen and inserts lasers or other surgical instruments to: - Remove the lesions, which is a process called excising (pronounced eks-SIZE-ing). - Destroy the lesions with intense heat and seal the blood vessels without stitches, a process called cauterizing (pronounced KAW-tur-ize-ing) or vaporizing. - Remove the lesions, which is a process called excising (pronounced eks-SIZE-ing). - Destroy the lesions with intense heat and seal the blood vessels without stitches, a process called cauterizing (pronounced KAW-tur-ize-ing) or vaporizing. - Some surgeons also will remove scar tissue at this time because it may be contributing to endometriosis-associated pain. - The goal is to treat the endometriosis without harming the healthy tissue around it. - Although most women have relief from pain with surgery in the short term, pain often returns.2 The excision of deep lesions seems to be associated with long-term pain relief. - Some evidence shows that surgical treatment for endometriosis-related pain is actually more effective in women who have moderate endometriosis rather than minimal endometriosis. The reason is that women with minimal endometriosis may have changes in their pain perception that persist after the lesions are removed.1,6 - Laparotomy. In this major abdominal surgery procedure, the surgeon may remove the endometriosis patches. Sometimes, the endometriosis lesions are too small to see in a laparotomy. - During this procedure, the surgeon may also remove the uterus. Removing the uterus is called hysterectomy (pronounced his-tuh-REK-tuh-mee). - If the ovaries have endometriosis on them or if damage is severe, the surgeon may remove the ovaries and fallopian tubes along with the uterus. This process is called total hysterectomy and bilateral (meaning \"on both sides\") salpingo-oophorectomy (pronounced sal-PING-go ooh-for-EK-toh-mee). - When possible, health care providers will try to leave the ovaries in place because of the important role ovaries play in overall health. - Health care providers recommend major surgery as a last resort for endometriosis treatment. - Having a hysterectomy or salpingo-oophorectomy does not guarantee that the lesions will not return or that the pain will go away. Endometriosis symptoms and lesions may come back in as many as 15% of women who have a total hysterectomy with bilateral salpingo-oophorectomy.2 - Surgery to sever pelvic nerves. If the pain is located in the center of the abdomen, health care providers may recommend cutting nerves in the pelvis to lessen the pain. This can be done during either laparoscopy or laparotomy.2 - Two procedures are used to sever different nerves in the pelvis. - Presacral neurectomy (pronounced pree-SEY-kruhl [or pree-SAK-ruhl]) nyoo-REK-tuh-mee). This procedure severs the nerves connected to the uterus. Research shows that this procedure can be useful in relieving pain along the center of the abdomen.6,8 - Laparoscopic uterine nerve ablation (pronounced a-BLEY-shuhn) (LUNA) This procedure involves severing nerves in the ligaments that secure the uterus. However, studies have shown that LUNA did not relieve pain any better than laparoscopy alone. For this reason, it is generally not recommended for treatment of endometriosis-associated pain.2,6,8 - Presacral neurectomy (pronounced pree-SEY-kruhl [or pree-SAK-ruhl]) nyoo-REK-tuh-mee). This procedure severs the nerves connected to the uterus. Research shows that this procedure can be useful in relieving pain along the center of the abdomen.6,8 - Laparoscopic uterine nerve ablation (pronounced a-BLEY-shuhn) (LUNA) This procedure involves severing nerves in the ligaments that secure the uterus. However, studies have shown that LUNA did not relieve pain any better than laparoscopy alone. For this reason, it is generally not recommended for treatment of endometriosis-associated pain.2,6,8 - The American College of Obstetricians and Gynecologists (ACOG) reports several clinical trials that showed these procedures to be ineffective at relieving pain from endometriosis. These procedures are not currently included in the ACOG recommendations for management of endometriosis.2 - Treatments for Infertility Related to Endometriosis In most cases, health care providers will recommend laparoscopy to remove or vaporize the growths as a way to also improve fertility in women who have mild or minimal endometriosis.6 Although studies show improved pregnancy rates following this type of surgery, the success rate is not clear. If pregnancy does not occur after laparoscopic treatment, in vitro fertilization (IVF) may be the best option to improve fertility. Taking any other hormonal therapy usually used for endometriosis-associated pain will only suppress ovulation and delay pregnancy. Performing another laparoscopy is not the preferred approach to improving fertility unless symptoms of pain prevent undergoing IVF. Multiple surgeries, especially those that remove cysts from the ovaries, may reduce ovarian function and hamper the success of IVF.6 IVF makes it possible to combine sperm and eggs in a laboratory to make an embryo. Then the resulting embryos are placed into the woman's uterus. IVF is one type of assisted reproductive technology that may be an option for women and families affected by infertility related to endometriosis. In general, the process of IVF involves the following steps. First, a woman takes hormones to cause \"superovulation,\" which triggers her body to produce many eggs at one time. Once mature, the eggs are collected from the woman, using a probe inserted into the vagina and guided by ultrasound. The collected eggs are placed in a dish for fertilization with a man's sperm. The fertilized cells are then placed in an incubator, a machine that keeps them warm and allows them to develop into embryos. After 3 to 5 days, the embryos are transferred to the woman's uterus. It takes about 2 weeks to know if the process is successful. Even though the use of hormones in IVF is successful in treating infertility related to endometriosis, other forms of hormone therapy are not as successful. For instance, ACOG does not recommend using oral contraceptive pills or GnRH agonists to treat endometriosis-related infertility. The use of these hormonal agents prevents ovulation and delays pregnancy.2,9 In addition, the hormones used during IVF do not cure the endometriosis lesions, which means that pain may recur after pregnancy and that not all women with endometriosis are able to become pregnant with IVF. Researchers are still looking for hormone treatments for infertility due to endometriosis. Other Endometriosis FAQs - If I have endometriosis, will I be able to get pregnant? Among women with fertility problems, endometriosis may occur in as many as 50%.1 But exactly how endometriosis causes infertility is not clear. Some evidence suggests that infertility is related to the extent of the endometriosis patches, because the patches can distort the pelvic anatomy. This would make it difficult for sperm to travel to the ovary or a fertilized egg to travel to the uterus.2,3 Other evidence suggests that the inflammation in the abdomen may disrupt ovulation or fertilization, or that the endometrium may not develop properly, hampering the attachment of the embryo to the uterus. There are treatments for endometriosis-related infertility that may help women get pregnant even with endometriosis. - Is endometriosis the same as endometrial cancer? Endometriosis and endometrial cancer are not the same. The word \"endometrium\" describes the tissue that lines the inside of the uterus. Endometrial cancer is a type of cancer that affects the lining of the inside of the uterus. Endometriosis itself is not a form of cancer. - Can endometriosis lead to cancer? There is a slight increase in the risk of ovarian cancer among women with endometriosis, particularly among women who were diagnosed with the condition at an early age. However, it is unclear whether endometriosis causes ovarian cancer or if the two conditions share risk factors or disease mechanisms that make them more likely to occur together.3,4 In some cases, women with endometriosis also have breast cancer or non-Hodgkin's lymphoma. However, these situations are rare.5 - Does endometriosis ever go away? For about one-quarter of women diagnosed with endometriosis, endometriosis patches go away on their own.6 Also, after menopause, symptoms of endometriosis typically lessen because there is a drop in the woman's natural hormones and the growths gradually shrink. However, this is not true for all women. If a woman takes hormones for menopausal symptoms, both her pain symptoms and the growths may return. Women with endometriosis who are experiencing symptoms, especially after menopause, should talk with their health care providers about treatment options. ", "role": "user" }, { "content": "The primary symptoms of endometriosis are pain and infertility. Other common symptoms of endometriosis include: painful, even debilitating, menstrual cramps, pain during or after sex, pain in the intestine or lower abdomen, painful bowel movements or painful urination during menstrual periods, heavy menstrual periods, premenstrual spotting or bleeding between periods, painful bladder syndrome, digestive or gastrointestinal symptoms similar to a bowel disorder, as well as fatigue, tiredness, or lack of energy. Endometriosis pain may get milder after pregnancy or menopause. In some cases, inflammation and chemicals produced by the endometriosis patches can cause the pelvic organs to stick together, causing scar tissue. This makes the uterus, ovaries, and fallopian tubes, as well as the bladder and rectum, appear as one large organ. Over time, some endometriosis areas may form nodules or bumps as they create lesions on the surface of pelvic organs or can become cysts (fluid-filled sacs) on the ovaries. Some endometriosis lesions have nerves in them. Pain from endometriosis can be severe, interfering with day-to-day activities.", "role": "assistant" } ]

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

[ { "content": "what are the causes of childhood obesity\n\nWhat causes Obesity?: Taking in more calories than your body burns can lead to obesity. This is because the body stores unused calories as fat. Obesity can be caused by: - Eating more food than your body can use - Drinking too much alcohol - Not getting enough exercise Many obese people who lose large amounts of weight and gain it back think it is their fault. They blame themselves for not having the willpower to keep the weight off. Many people regain more weight than they lost. Today, we know that biology is a big reason why some people cannot keep the weight off. Some people who live in the same place and eat the same foods become obese, while others do not. Our bodies have a complex system to keep our weight at a healthy level. In some people, this system does not work normally. The way we eat when we are children can affect the way we eat as adults. The way we eat over many years becomes a habit. It affects what we eat, when we eat, and how much we eat. We may feel that we are surrounded by things that make it easy to overeat and hard to stay active. - Many people feel they do not have time to plan and make healthy meals. - More people today work desk jobs compared to more active jobs in the past. - People with little free time may have less time to exercise. The term eating disorder means a group of medical conditions that have an unhealthy focus on eating, dieting, losing or gaining weight, and body image. A person may be obese, follow an unhealthy diet, and have an eating disorder all at the same time. Sometimes, medical problems or treatments cause weight gain, including: - Underactive thyroid (hypothyroidism) - Medicines such as birth control pills, antidepressants, and antipsychotics Other things that can cause weight gain are: - Quitting smoking. Many people who quit smoking gain 4 to 10 pounds in the first 6 months after quitting. - Stress, anxiety, feeling sad, or not sleeping well - Menopause. Women may gain 12 to 15 pounds during menopause. - Pregnancy. Women may not lose the weight they gained during pregnancy.", "role": "user" }, { "content": "Taking in more calories than your body burns can lead to obesity. This is because the body stores unused calories as fat. Obesity can be caused by: - Eating more food than your body can use - Drinking too much alcohol - Not getting enough exercise. Many obese people who lose large amounts of weight and gain it back think it is their fault. Our bodies have a complex system to keep our weight at a healthy level. In some people, this system does not work normally.", "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\n Hiatal hernia Hernia - hiatal Summary Hiatal hernia is a condition in which part of the stomach extends through an opening of the diaphragm into the chest. The diaphragm is the sheet of muscle that divides the chest from the abdomen. Causes The exact cause of hiatal hernia is unknown. The condition may be due to weakness of the supporting tissue. Your risk for the problem goes up with age, obesity, and smoking. Hiatal hernias are very common. The problem occurs often in people over 50 years. This condition may cause reflux (backflow) of gastric acid from the stomach into the esophagus. Children with this condition are most often born with it (congenital). It often occurs with gastroesophageal reflux in infants. Symptoms Symptoms may include: Chest pain Heartburn, worse when bending over or lying down Swallowing difficulty A hiatal hernia by itself rarely causes symptoms. Pain and discomfort are due to the upward flow of stomach acid, air, or bile. Exams and Tests Tests that may be used include: Barium swallow x-ray Esophagogastroduodenoscopy (EGD) Treatment The goals of treatment are to relieve symptoms and prevent complications. Treatments may include: Medicines to control stomach acid Surgery to repair the hiatal hernia and prevent reflux Other measures to reduce symptoms include: Avoiding large or heavy meals Not lying down or bending over right after a meal Reducing weight and not smoking Raising the head of the bed 4 to 6 inches (10 to 15 centimeters) If medicines and lifestyle measures do not help control symptoms, you may need surgery. Outlook (Prognosis) Treatment can relieve most symptoms of hiatal hernia. Possible Complications Complications may include: Pulmonary (lung) aspiration Slow bleeding and iron deficiency anemia (due to a large hernia) Strangulation (closing off) of the hernia When to Contact a Medical Professional Call your health care provider if: You have symptoms of a hiatal hernia. You have a hiatal hernia and your symptoms get worse or do not improve with treatment. You develop new symptoms. Prevention Controlling risk factors such as obesity may help prevent hiatal hernia. Review Date 4/24/2017 Updated by: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Treatments for hiatal hernia include medications, avoiding large or heavy meals, avoiding bending over after a meal, achieving healthy weight, quitting smoking. and raising the head of the bed. If medicines and lifestyle measures do not help control symptoms, you may need surgery.", "role": "assistant" } ]

[ { "content": "how do i prevent myself from having dementia\n\nDementia (Prognosis): There are many disorders that can cause dementia. Some, such as Alzheimer’s disease or Huntington’s disease, lead to a progressive loss of mental functions. But other types of dementia can be halted or reversed with appropriate treatment. People with moderate or advanced dementia typically need round-the-clock care and supervision to prevent them from harming themselves or others. They also may need assistance with daily activities such as eating, bathing, and dressing.", "role": "user" }, { "content": "There are many disorders that can cause dementia. Some, such as Alzheimer?s disease or Huntington?s disease, lead to a progressive loss of mental functions. But other types of dementia can be halted or reversed with appropriate treatment.", "role": "assistant" } ]

[ { "content": "how to prevent diabetes\n\nType 2 diabetes (Prevention): You can help prevent type 2 diabetes by staying at a healthy body weight. You can get to a healthy weight by eating healthy foods, controlling your portion sizes, and leading an active lifestyle. Some medicines can also delay or prevent type 2 diabetes in people at risk of developing the disease.", "role": "user" }, { "content": "You can help prevent type 2 diabetes by staying at a healthy body weight. You can get to a healthy weight by eating healthy foods, controlling your portion sizes, and leading an active lifestyle. Some medicines can also delay or prevent type 2 diabetes in people at risk of developing the disease.", "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\nInguinal hernia (Treatment): If your hernia is small and isn't bothering you, your doctor might recommend watchful waiting. In children, the doctor might try applying manual pressure to reduce the bulge before considering surgery. Enlarging or painful hernias usually require surgery to relieve discomfort and prevent serious complications. There are two general types of hernia operations - open hernia repair and laparoscopic repair. Open hernia repair In this procedure, which might be done with local anesthesia and sedation or general anesthesia, the surgeon makes an incision in your groin and pushes the protruding tissue back into your abdomen. The surgeon then sews the weakened area, often reinforcing it with a synthetic mesh (hernioplasty). The opening is then closed with stitches, staples or surgical glue. After the surgery, you'll be encouraged to move about as soon as possible, but it might be several weeks before you're able to resume normal activities. Laparoscopy In this minimally invasive procedure, which requires general anesthesia, the surgeon operates through several small incisions in your abdomen. Gas is used to inflate your abdomen to make the internal organs easier to see. A small tube equipped with a tiny camera (laparoscope) is inserted into one incision. Guided by the camera, the surgeon inserts tiny instruments through other incisions to repair the hernia using synthetic mesh. People who have laparoscopic repair might have less discomfort and scarring after surgery and a quicker return to normal activities. However, some studies indicate that hernia recurrence is more likely with laparoscopic repair than with open surgery. Laparoscopy allows the surgeon to avoid scar tissue from an earlier hernia repair, so it might be a good choice for people whose hernias recur after traditional hernia surgery. It also might be a good choice for people with hernias on both sides of the body (bilateral). Some studies indicate that a laparoscopic repair can increase the risk of complications and of recurrence. Having the procedure performed by a surgeon with extensive experience in laparoscopic hernia repairs can reduce the risks.", "role": "user" }, { "content": "Small asymptomatic hernias do not require treatments. If the hernia increases in size or becomes painful, it will need surgery.", "role": "assistant" } ]

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

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

[ { "content": "how to deal with anxiety\n\n Social anxiety disorder Phobia - social Anxiety disorder - social Social phobia SAD - social anxiety disorder Summary Social anxiety disorder is a persistent and irrational fear of situations that may involve scrutiny or judgment by others, such as at parties and other social events. Causes People with social anxiety disorder fear and avoid situations in which they may be judged by others. It may begin in the teens and may have to do with overprotective parents or limited social opportunities. Men and women are affected equally with this disorder. People with social phobia are at high risk for alcohol or other drug use. This is because they may come to rely on these substances to relax in social situations. Symptoms People with social anxiety become very anxious and self-conscious in everyday social situations. They have an intense, persistent, and chronic fear of being watched and judged by others, and of doing things that will embarrass them. They can worry for days or weeks before a dreaded situation. This fear may become so severe that it interferes with work, school, and other ordinary activities, and can make it hard to make and keep friends. Some of the most common fears of people with this disorder include: Attending parties and other social occasions Eating, drinking, and writing in public Meeting new people Speaking in public Using public restrooms Physical symptoms that often occur include: Blushing Difficulty talking Nausea Profuse sweating Trembling Social anxiety disorder is different from shyness. Shy people are able to participate in social functions. Social anxiety disorder affects the ability to function in work and relationships. Exams and Tests The health care provider will look at your history of social anxiety and will get a description of the behavior from you, your family, and friends. Treatment The goal of treatment is to help you function effectively. The success of the treatment usually depends on the severity of your fears. Behavioral treatment is often tried first and may have long-lasting benefits: Cognitive behavioral therapy helps you understand and change the thoughts that are causing your condition, as well as learn to recognize and replace panic-causing thoughts. Systematic desensitization or exposure therapy may be used. You are asked to relax, then imagine the situations that cause the anxiety, working from the least fearful to the most fearful. Gradual exposure to the real-life situation has also been used with success to help people overcome their fears. Social skills training may involve social contact in a group therapy situation to practice social skills. Role playing and modeling are techniques used to help you become more comfortable relating to others in a social situation. Certain medicines, usually used to treat depression, may be very helpful for this disorder. They work by preventing your symptoms or making them less severe. You must take these medicines every day. DO NOT stop taking them without talking with your provider. Medicines called sedatives (or hypnotics) may also be prescribed. These medicines should only be taken under a doctor's direction. Your doctor will prescribe a limited amount of these drugs. They should not to be used every day. They may be used when symptoms become very severe or when you are about to be exposed to something that always brings on your symptoms. If you are prescribed a sedative, do not drink alcohol while on this medicine. Lifestyle changes may help reduce how often the attacks occur. Get regular exercise, enough sleep, and regularly scheduled meals. Reduce or avoid the use of caffeine, some over-the-counter cold medicines, and other stimulants. Support Groups You can ease the stress of having social anxiety by joining a support group. Sharing with others who have common experiences and problems can help you not feel alone. Support groups are usually not a good substitute for talk therapy or taking medicine, but can be a helpful addition. Resources for more information include: Anxiety and Depression Association of America -- adaa.org National Institute of Mental Health -- www.nimh.nih.gov/health/publications/social-anxiety-disorder-more-than-just-shyness/index.shtml Outlook (Prognosis) The outcome is often good with treatment. Antidepressant medicines can also be effective. Possible Complications Alcohol or other drug use may occur with social anxiety disorder. Loneliness and social isolation may occur. When to Contact a Medical Professional Call your provider if fear is affecting your work and relationships with others. Review Date 3/26/2018 Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "For social anxiety disorder, treatment may help you learn to function effectively. The success of treatment depends on the severity of your fears. Cognitive behavioral therapy helps you understand and change the thoughts that are causing your condition. Systematic desensitization or exposure therapy may also be used to help you work through your fears. Group therapy may help you practice social skills. There are also medicines that may help make your symptoms less severe. Lifestyle changes can reduce the frequency of the attacks, such as getting regular exercise, enough sleep, and regular meals.", "role": "assistant" } ]

[ { "content": "what are the causes of childhood obesity\n\n Childhood obesity Overview Childhood obesity is a serious medical condition that affects children and adolescents. Children who are obese are above the normal weight for their age and height. Childhood obesity is particularly troubling because the extra pounds often start children on the path to health problems that were once considered adult problems - diabetes, high blood pressure and high cholesterol. Many obese children become obese adults, especially if one or both parents are obese. Childhood obesity can also lead to poor self-esteem and depression. One of the best strategies to reduce childhood obesity is to improve the eating and exercise habits of your entire family. Treating and preventing childhood obesity helps protect your child's health now and in the future. Symptoms Not all children carrying extra pounds are overweight or obese. Some children have larger than average body frames. And children normally carry different amounts of body fat at the various stages of development. So you might not know just by looking at your child if weight is a health concern. The body mass index (BMI), which provides a guideline of weight in relation to height, is the accepted measure of overweight and obesity. Your child's doctor can help you figure out if your child's weight could pose health problems by using growth charts, the BMI and, if necessary, other tests. When to see a doctor If you're worried that your child is putting on too much weight, talk to his or her doctor. Your child's doctor will consider your child's history of growth and development, your family's weight-for-height history, and where your child lands on the growth charts. This can help determine if your child's weight is in an unhealthy range. Causes Lifestyle issues - too little activity and too many calories from food and drinks - are the main contributors to childhood obesity. But genetic and hormonal factors might play a role as well. For example, recent research has found that changes in digestive hormones can affect the signals that let you know you're full. Risk factors Many factors - usually working in combination - increase your child's risk of becoming overweight: - Diet. Regularly eating high-calorie foods, such as fast foods, baked goods and vending machine snacks, can easily cause your child to gain weight. Candy and desserts also can cause weight gain, and more and more evidence points to sugary drinks, including fruit juices, as culprits in obesity in some people. - Lack of exercise. Children who don't exercise much are more likely to gain weight because they don't burn as many calories. Too much time spent in sedentary activities, such as watching television or playing video games, also contributes to the problem. - Family factors. If your child comes from a family of overweight people, he or she may be more likely to put on weight. This is especially true in an environment where high-calorie foods are always available and physical activity isn't encouraged. - Psychological factors. Personal, parental and family stress can increase a child's risk of obesity. Some children overeat to cope with problems or to deal with emotions, such as stress, or to fight boredom. Their parents may have similar tendencies. - Socioeconomic factors. People in some communities have limited resources and limited access to supermarkets. As a result, they may opt for convenience foods that don't spoil quickly, such as frozen meals, crackers and cookies. In addition, people who live in lower income neighborhoods might not have access to a safe place to exercise. Complications Childhood obesity can have complications for your child's physical, social and emotional well-being. Physical complications - Type 2 diabetes. This chronic condition affects the way your child's body uses sugar (glucose). Obesity and a sedentary lifestyle increase the risk of type 2 diabetes. - Metabolic syndrome. This cluster of conditions can put your child at risk of heart disease, diabetes or other health problems. Conditions include high blood pressure, high blood sugar, high triglycerides, low HDL (\"good\") cholesterol and excess abdominal fat. - High cholesterol and high blood pressure. A poor diet can cause your child to develop one or both of these conditions. These factors can contribute to the buildup of plaques in the arteries. These plaques can cause arteries to narrow and harden, which can lead to a heart attack or stroke later in life. - Asthma. Children who are overweight or obese might be more likely to have asthma. - Sleep disorders. Obstructive sleep apnea is a potentially serious disorder in which a child's breathing repeatedly stops and starts during sleep. - Nonalcoholic fatty liver disease (NAFLD). This disorder, which usually causes no symptoms, causes fatty deposits to build up in the liver. NAFLD can lead to scarring and liver damage. Social and emotional complications - Low self-esteem and being bullied. Children often tease or bully their overweight peers, who suffer a loss of self-esteem and an increased risk of depression as a result. - Behavior and learning problems. Overweight children tend to have more anxiety and poorer social skills than normal-weight children do. These problems might lead children who are overweight to act out and disrupt their classrooms at one extreme, or to withdraw socially at the other. - Depression. Low self-esteem can create overwhelming feelings of hopelessness, which can lead to depression in some children who are overweight. Diagnosis As part of regular well-child care, the doctor calculates your child's BMI and determines where it falls on the BMI-for-age growth chart. The BMI helps indicate if your child is overweight for his or her age and height. Using the growth chart, your doctor determines your child's percentile, meaning how your child compares with other children of the same sex and age. For example, if your child is in the 80th percentile, it means that compared with other children of the same sex and age, 80 percent have a lower weight or BMI. Cutoff points on these growth charts, established by the Centers for Disease Control and Prevention, help identify children who are overweight and obese: - BMI between 85th and 94th percentiles - overweight - BMI 95th percentile or above - obesity Because BMI doesn't consider things such as being muscular or having a larger than average body frame and because growth patterns vary greatly among children, your doctor also factors in your child's growth and development. This helps determine whether your child's weight is a health concern. In addition to BMI and charting weight on the growth charts, the doctor evaluates: - Your family's history of obesity and weight-related health problems, such as diabetes - Your child's eating habits - Your child's activity level - Other health conditions your child may have - Psychosocial history, including incidences of depression and sleep disturbances and sadness and whether your child has friends or is the target of bullying Blood tests Your child's doctor might order blood tests if he or she finds that your child is obese. These tests might include: - A cholesterol test - A blood sugar test - Other blood tests to check for hormone imbalances, vitamin D deficiency or other conditions associated with obesity Some of these tests require that your child not eat or drink anything before the test. Ask if your child needs to fast before a blood test and for how long. Treatment Treatment for childhood obesity is based on your child's age and if he or she has other medical conditions. Treatment usually includes changes in your child's eating habits and physical activity level. In certain circumstances, treatment might include medications or weight-loss surgery. Treatment for children who are overweight The American Academy of Pediatrics recommends that children older than 2 and adolescents whose weight falls in the overweight category be put on a weight-maintenance program to slow the progress of weight gain. This strategy allows the child to add inches in height but not pounds, causing BMI to drop over time into a healthier range. Treatment for children who are obese Children ages 6 to 11 who are obese might be encouraged to modify their eating habits for gradual weight loss of no more than 1 pound (or about 0.5 kilogram) a month. Older children and adolescents who are obese or severely obese might be encouraged to modify their eating habits to aim for weight loss of up to 2 pounds (or about 1 kilogram) a week. The methods for maintaining your child's current weight or losing weight are the same: Your child needs to eat a healthy diet - both in terms of type and amount of food - and increase physical activity. Success depends largely on your commitment to helping your child make these changes. Healthy eating Parents are the ones who buy groceries, cook meals and decide where the food is eaten. Even small changes can make a big difference in your child's health. - When food shopping, choose fruits and vegetables. Cut back on convenience foods - such as cookies, crackers and prepared meals - which are often high in sugar, fat and calories. Always have healthy snacks available. - Limit sweetened beverages. This includes those that contain fruit juice. These drinks provide little nutritional value in exchange for their high calories. They also can make your child feel too full to eat healthier foods. - Limit fast food. Many of the menu options are high in fat and calories. - Sit down together for family meals. Make it an event - a time to share news and tell stories. Discourage eating in front of a TV, computer or video game screen, which can lead to fast eating and lowered awareness of amount eaten. - Serve appropriate portion sizes. Children don't need as much food as adults do. Allow your child to eat until he or she is full, even if that means leaving food on the plate. And remember, when you eat out, restaurant portion sizes are often significantly oversized. Physical activity A critical part of achieving and maintaining a healthy weight, especially for children, is physical activity. It burns calories, strengthens bones and muscles, and helps children sleep well at night and stay alert during the day. Good habits established in childhood help adolescents maintain healthy weights despite the hormonal changes, rapid growth and social influences that often lead to overeating. And active children are more likely to become fit adults. To increase your child's activity level: - Limit TV and recreational computer time. Time spent watching television or using computers, smartphones or tablets is known as screen time. Children younger than 18 months should avoid all screen time, except for video-chatting with family and friends. For older preschooolers, limit screen use to 1 hour per day of high-quality programming. - Emphasize activity, not exercise. Children should be moderately to vigorously active for at least an hour a day. Your child's activity doesn't have to be a structured exercise program - the object is to get him or her moving. Free-play activities - such as playing hide-and-seek, tag or jump-rope - can be great for burning calories and improving fitness. - Find activities your child likes. For instance, if your child is artistically inclined, go on a nature hike to collect leaves and rocks that your child can use to make a collage. If your child likes to climb, head for the nearest neighborhood jungle gym or climbing wall. If your child likes to read, then walk or bike to the neighborhood library for a book. Medications Medication might be prescribed for some adolescents as part of an overall weight-loss plan. The risks of taking a prescription medication over the long term are unknown, and the medication's effect on weight loss and weight maintenance for adolescents is still in question. Weight-loss surgery Weight-loss surgery may be an option for severely obese adolescents who have been unable to lose weight through lifestyle changes. However, as with any type of surgery, there are potential risks and long-term complications. Also, the long-term effects of weight-loss surgery on future growth and development are largely unknown. Weight-loss surgery in adolescents is uncommon. But your doctor might recommend this surgery if your child's weight poses a greater health threat than do the potential risks of surgery. It's important that a child being considered for weight-loss surgery meet with a team of pediatric specialists, including a pediatric endocrinologist, psychologist and dietitian. Weight-loss surgery isn't a miracle cure. It doesn't guarantee that an adolescent will lose all of his or her excess weight or be able to keep it off long term. And surgery doesn't replace the need for a healthy diet and regular physical activity. Lifestyle and home remedies Addressing a woman's health and weight before she conceives could lead to improvements in childhood obesity. If you're overweight and thinking of becoming pregnant, losing weight and eating well might affect your child's future. Eating well throughout pregnancy might also have a positive impact on your baby's later food choices. To give your infant a healthy start, the World Health Organization recommends exclusively breast-feeding for 6 months. If your child is overweight or obese, his or her best chance to achieve and maintain a healthy weight is to start eating a healthy diet and exercising more. Here are some steps you can take at home to help your child succeed: - Be a role model. Choose healthy foods and active pastimes for yourself. If you need to lose weight, doing so will motivate your child to do likewise. - Involve the whole family. Make healthy eating a priority and emphasize how important it is for everyone to be physically active. This avoids singling out the child who is overweight. ", "role": "user" }, { "content": "Childhood obesity can be caused by too little activity and too many calories from food or drinks. These are the main contributors to childhood obesity. Genetic and hormonal factors also play a role as well.", "role": "assistant" } ]

[ { "content": "what are the risk factors of type ii diabetes\n\n Diabetes What is Diabetes? Too Much Glucose in the Blood Diabetes means your blood glucose (often called blood sugar) is too high. Your blood always has some glucose in it because your body needs glucose for energy to keep you going. But too much glucose in the blood isn't good for your health. Glucose comes from the food you eat and is also made in your liver and muscles. Your blood carries the glucose to all of the cells in your body. Insulin is a chemical (a hormone) made by the pancreas. The pancreas releases insulin into the blood. Insulin helps the glucose from food get into your cells. If your body does not make enough insulin or if the insulin doesn't work the way it should, glucose can't get into your cells. It stays in your blood instead. Your blood glucose level then gets too high, causing pre-diabetes or diabetes. Types of Diabetes There are three main kinds of diabetes: type 1, type 2, and gestational diabetes. The result of type 1 and type 2 diabetes is the same: glucose builds up in the blood, while the cells are starved of energy. Over the years, high blood glucose damages nerves and blood vessels, oftentimes leading to complications such as heart disease, stroke, blindness, kidney disease, nerve problems, gum infections, and amputation. Type 1 Diabetes Type 1 diabetes, which used to be called called juvenile diabetes or insulin-dependent diabetes, develops most often in young people. However, type 1 diabetes can also develop in adults. With this form of diabetes, your body no longer makes insulin or doesn’t make enough insulin because your immune system has attacked and destroyed the insulin-producing cells. About 5 to 10 percent of people with diabetes have type 1 diabetes. To survive, people with type 1 diabetes must have insulin delivered by injection or a pump. Learn more about type 1 diabetes here. Type 2 Diabetes Type 2 diabetes, which used to be called adult-onset diabetes or non insulin-dependent diabetes, is the most common form of diabetes. Although people can develop type 2 diabetes at any age -- even during childhood -- type 2 diabetes develops most often in middle-aged and older people. Type 2 diabetes usually begins with insulin resistance—a condition that occurs when fat, muscle, and liver cells do not use insulin to carry glucose into the body’s cells to use for energy. As a result, the body needs more insulin to help glucose enter cells. At first, the pancreas keeps up with the added demand by making more insulin. Over time, the pancreas doesn’t make enough insulin when blood sugar levels increase, such as after meals. If your pancreas can no longer make enough insulin, you will need to treat your type 2 diabetes. Learn more about type 2 diabetes here. Gestational Diabetes Some women develop gestational diabetes during the late stages of pregnancy. Gestational diabetes is caused by the hormones of pregnancy or a shortage of insulin. Although this form of diabetes usually goes away after the baby is born, a woman who has had it and her child are more likely to develop diabetes later in life. Prediabetes Prediabetes means your blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. People with prediabetes are at an increased risk for developing type 2 diabetes and for heart disease and stroke. The good news is that if you have prediabetes, you can reduce your risk of getting type 2 diabetes. With modest weight loss and moderate physical activity, you can delay or prevent type 2 diabetes. Learn more about prediabetes here. Signs of Diabetes Many people with diabetes experience one or more symptoms, including extreme thirst or hunger, a frequent need to urinate and/or fatigue. Some lose weight without trying. Additional signs include sores that heal slowly, dry, itchy skin, loss of feeling or tingling in the feet and blurry eyesight. Some people with diabetes, however, have no symptoms at all. How Many Have Diabetes? Nearly 29 million Americans age 20 or older (12.3 percent of all people in this age group) have diabetes, according to 2014 estimates from the Centers for Disease Control and Prevention (CDC). About 1.9 million people aged 20 years or older were newly diagnosed with diabetes in 2010 alone. People can get diabetes at any age, but the risk increases as we get older. In 2014, over 11 million older adults living in the U.S -- nearly 26 percent of people 65 or older -- had diabetes. See more statistics about diabetes from the National Diabetes Statistics Report 2014. (Centers for Disease Control and Prevention.) If Diabetes is Not Managed Diabetes is a very serious disease. Over time, diabetes that is not well managed causes serious damage to the eyes, kidneys, nerves, heart, gums and teeth. If you have diabetes, you are more likely than people without diabetes to have heart disease or a stroke. People with diabetes also tend to develop heart disease or stroke at an earlier age than others. The best way to protect yourself from the serious complications of diabetes is to manage your blood glucose, blood pressure and cholesterol and to avoid smoking. It is not always easy, but people who make an ongoing effort to manage their diabetes can greatly improve their overall health. Risk Factors Diabetes is a serious, life-long disease. It can lead to problems such as heart disease, stroke, vision loss, kidney disease, and nerve damage. More than 8 million people in the United States have type 2 diabetes and don’t know it. Many people don’t find out they have diabetes until they are faced with problems such as blurry vision or heart trouble. Certain factors can increase your risk for diabetes, and it’s important to know what they are. Type 1 Diabetes Type 1 diabetes is an autoimmune disease. In an autoimmune reaction, antibodies, or immune cells, attach to the body’s own healthy tissues by mistake, signaling the body to attack them. At present, scientists do not know exactly what causes the body's immune system to attack the cells, but many believe that both genetic factors and environmental factors, such as viruses, are involved. Studies are now underway to identify these factors and prevent type 1 diabetes in people at risk. Learn more about the causes of type 1 diabetes. Type 2 Diabetes Type 2 diabetes -- the most common form -- is linked closely to overweight and obesity, high blood pressure, and abnormal cholesterol levels. Many people with type 2 diabetes are overweight. Being overweight can keep your body from using insulin properly. Genes also play an important role in a person's risk for type 2 diabetes. Having certain genes or combinations of genes may increase or decrease a person’s risk for developing the disease. Here are the risk factors for type 2 diabetes. - being over 45 years of age - being overweight or obese - having a first-degree relative -- a parent, brother, or sister -- with diabetes - being African American, American Indian or Alaska Native, Asian American or Pacific Islander, or Hispanic American/Latino. (Watch the video to learn more about native Americans and diabetes risk. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) being over 45 years of age being overweight or obese having a first-degree relative -- a parent, brother, or sister -- with diabetes being African American, American Indian or Alaska Native, Asian American or Pacific Islander, or Hispanic American/Latino. (Watch the video to learn more about native Americans and diabetes risk. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) - having gestational diabetes, or giving birth to at least one baby weighing more than 9 pounds - having blood pressure of 140/90 or higher, or having been told that you have high blood pressure. - having abnormal cholesterol levels -- an HDL cholesterol level of 35 or lower, or a triglyceride level of 250 or higher - being inactive or exercising fewer than three times a week. - having polycystic ovary syndrome, also called PCOS (women only) - on previous testing, having prediabetes (an A1C level of 5.7 to 6.4 percent), impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) - history of cardiovascular disease (disease affecting the heart and blood vessels). having gestational diabetes, or giving birth to at least one baby weighing more than 9 pounds having blood pressure of 140/90 or higher, or having been told that you have high blood pressure. having abnormal cholesterol levels -- an HDL cholesterol level of 35 or lower, or a triglyceride level of 250 or higher being inactive or exercising fewer than three times a week. having polycystic ovary syndrome, also called PCOS (women only) on previous testing, having prediabetes (an A1C level of 5.7 to 6.4 percent), impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) history of cardiovascular disease (disease affecting the heart and blood vessels). Learn more about the causes of type 2 diabetes. Prediabetes and Type 2 Diabetes Before people develop type 2 diabetes, they usually have prediabetes -- a condition in which blood glucose levels are higher than normal, but not high enough for a diagnosis of diabetes. People with prediabetes are more likely to develop diabetes within 10 years and also are more likely to have a heart attack or stroke. Prediabetes is increasingly common in the U.S. adult population. In 2012, about 86 million people in the U.S. had pre-diabetes, and 51% of those 65 or older had prediabetes. Learn more about prediabetes. Gestational Diabetes Some women develop diabetes during the late stages of pregnancy. This is called gestational diabetes. Although this form of diabetes usually goes away after the baby is born, a woman who has had it has a lifelong risk for developing diabetes, mostly type 2. Prevention The two most common forms of diabetes are type 1 and type 2. Currently, there is no way to delay or prevent type 1 diabetes. However, research has shown that type 2 diabetes can be prevented or delayed in people at risk for the disease. Preventing type 2 diabetes can mean a healthier and longer life without serious complications from the disease such as heart disease, stroke, blindness, kidney failure, and amputations. Preventing Type 2 Diabetes Before people develop type 2 diabetes, they usually have prediabetes -- a condition in which blood glucose levels are higher than normal, but not yet high enough for a diagnosis of diabetes. The good news is that if you have prediabetes, there are ways to reduce your risk of getting type 2 diabetes. With modest weight loss and moderate physical activity, you can delay or prevent type 2 diabetes Benefits of Weight Loss and Exercise The Diabetes Prevention Program (DPP) is a landmark study by the National Institute of Diabetes and Digestive and Kidney Diseases. DPP researchers found that adults at high risk for type 2 diabetes were able to cut their risk in half by losing a modest amount of weight and being active almost every day. This means losing 5 to 7 percent of body weight (that's 10 pounds if you weigh 200 pounds) and getting 150 minutes of physical activity a week. The drug metformin reduced the risk of type 2 diabetes by 34 percent but was more effective in younger and heavier adults. (Watch the video to learn more about preventing type 2 diabetes. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) The benefits of weight loss and regular exercise have long-lasting value. In a DPP follow-up trial known as the Diabetes Prevention Program Outcome Study (DPPOS), people at risk of type 2 diabetes who kept off the weight they had lost and who continued to exercise regularly delayed the onset of type 2 diabetes by about 4 years. The DPP study also showed that modest weight loss (achieved by following a low calorie, low-fat diet) and moderate physical activity were especially effective in preventing or delaying the development of diabetes in older people. In fact, people over the age of 60 were able to reduce their risk for developing type 2 diabetes by 71 percent. How to Lower Your Risk Making modest lifestyle changes can help prevent or delay type 2 diabetes in people who are at risk. Here are some tips. Reach and Maintain a Reasonable Body Weight Your weight affects your health in many ways. Being overweight can keep your body from making and using insulin properly. It can also cause high blood pressure. The Body Mass Index chart (seen here) can be used to find out whether someone is normal weight, overweight, or obese. Body mass index is a measurement of body weight relative to height for adults age 20 or older. To use the chart - find the person's height in the left-hand column - move across the row to find the number closest to the person's weight - find the number at the top of that column - The number at the top of the column is the person’s BMI. find the person's height in the left-hand column move across the row to find the number closest to the person's weight find the number at the top of that column The number at the top of the column is the person’s BMI. The words above the BMI number indicate whether the person is normal weight, overweight, or obese. People who are overweight or obese should consider talking with a health care provider about ways to lose weight and reduce the risk of diabetes. The BMI has certain limitations. The BMI may overestimate body fat in athletes and others who have a muscular build and underestimate body fat in older adults and others who have lost muscle. Waist Measurement. In addition to weight, the location of excess fat on the body can be important. A waist measurement of 40 inches or more for men and 35 inches or more for women is linked to insulin resistance and increases a person’s risk for type 2 diabetes. This is true even if a person’s body mass index (BMI) falls within the normal range. To measure the waist, a person should - place a tape measure around the bare abdomen just above the hip bone - make sure the tape is snug but isn’t digging into the skin and is parallel to the floor - relax, exhale, and measure. place a tape measure around the bare abdomen just above the hip bone make sure the tape is snug but isn’t digging into the skin and is parallel to the floor relax, exhale, and measure. Make Healthy Food Choices What you eat has a big impact on your weight and overall health. By developing healthy eating habits, you can help manage your body weight, blood pressure, and cholesterol. Reducing portion size, increasing the amount of fiber you consume (by eating more fruits and vegetables) and limiting fatty and salty foods are key to a healthy diet. Here are more tips for eating well with diabetes. - Make a diabetes meal plan with help from your health care team. - Choose foods that are lower in calories, saturated fat, trans fat, sugar, and salt. - Eat foods with more fiber, such as whole grain cereals, breads, crackers, rice, or pasta. - Choose foods such as fruits, vegetables, whole grains, bread and cereals, and low-fat or skim milk and cheese. - Drink water instead of juice and regular soda. - When eating a meal, fill half of your plate with fruits and vegetables, one quarter with a lean protein, such as beans, or chicken or turkey without the skin, and one quarter with a whole grain, such as brown rice or whole wheat pasta. Make a diabetes meal plan with help from your health care team. Choose foods that are lower in calories, saturated fat, trans fat, sugar, and salt. Eat foods with more fiber, such as whole grain cereals, breads, crackers, rice, or pasta. Choose foods such as fruits, vegetables, whole grains, bread and cereals, and low-fat or skim milk and cheese. Drink water instead of juice and regular soda. When eating a meal, fill half of your plate with fruits and vegetables, one quarter with a lean protein, such as beans, or chicken or turkey without the skin, and one quarter with a whole grain, such as brown rice or whole wheat pasta. For more about healthy eating and older adults see \"Eating Well as You Get Older.\" Be Physically Active Get at least 30 minutes of exercise at least five days a week. Regular exercise reduces diabetes risk in several ways. It - helps you lose weight - controls your cholesterol and blood pressure - improves your body's use of insulin. helps you lose weight controls your cholesterol and blood pressure improves your body's use of insulin. Many people make walking part of their daily routine because it’s easy, fun and convenient. But you can choose any activity that gets you moving. It’s fine to break up your 30 minutes of exercise into smaller increments, such as three 10-minute periods. Check with your doctor before beginning any exercise program. Many people make walking part of their daily routine because it’s easy, fun and convenient. But you can choose any activity that gets you moving. It’s fine to break up your 30 minutes of exercise into smaller increments, such as three 10-minute periods. Check with your doctor before beginning any exercise program. For more information on exercise and older adults, see Exercises to Try or visit Go4Life®, the exercise and physical activity campaign for older adults from the National Institute on Aging. Signs and Diagnosis Diabetes is often called a \"silent\" disease because it can cause serious complications even before you have symptoms. Symptoms can also be so mild that you don’t notice them. An estimated 8 million people in the United States have type 2 diabetes and don’t know it, according to 2012 estimates by the Centers for Disease Control and Prevention (CDC). Common Signs Some common symptoms of diabetes are: - being very thirsty - frequent urination - feeling very hungry or tired - losing weight without trying - having sores that heal slowly - having dry, itchy skin - loss of feeling or tingling in the feet - having blurry eyesight. being very thirsty frequent urination feeling very hungry or tired losing weight without trying having sores that heal slowly having dry, itchy skin loss of feeling or tingling in the feet having blurry eyesight. Signs of type 1 diabetes usually develop over a short period of time. The signs for type 2 diabetes develop more gradually. Tests for Diabetes The following tests are used to diagnose diabetes or prediabetes. - An A1C test measures your average blood glucose levels over the past 3 months. It can be used to diagnose type 2 diabetes and prediabetes. It does not require fasting and blood can be drawn for the test any time of the day. An A1C test measures your average blood glucose levels over the past 3 months. It can be used to diagnose type 2 diabetes and prediabetes. It does not require fasting and blood can be drawn for the test any time of the day. - A fasting plasma glucose, or FPG test, measures your blood glucose after you have gone at least 8 hours without eating. Doctors use this test to detect diabetes or prediabetes. A fasting plasma glucose, or FPG test, measures your blood glucose after you have gone at least 8 hours without eating. Doctors use this test to detect diabetes or prediabetes. - In a random plasma glucose test, your doctor checks your blood glucose without regard to when you ate your last meal. This test, along with an assessment of symptoms, is used to diagnose diabetes but not prediabetes. In a random plasma glucose test, your doctor checks your blood glucose without regard to when you ate your last meal. This test, along with an assessment of symptoms, is used to diagnose diabetes but not prediabetes. - An oral glucose tolerance test, or OGTT, measures your blood glucose after you have gone at least 8 hours without eating and 2 hours after you drink a sweet beverage. Doctors also use the oral glucose tolerance test to diagnose gestational diabetes in pregnant women. An oral glucose tolerance test, or OGTT, measures your blood glucose after you have gone at least 8 hours without eating and 2 hours after you drink a sweet beverage. Doctors also use the oral glucose tolerance test to diagnose gestational diabetes in pregnant women. If any of these tests show that you might have diabetes, your doctor will need to repeat the test with a second measurement unless there are clear symptoms of diabetes. Get more details about tests for diabetes. Who Should Get Tested? Because type 2 diabetes is more common in older people, anyone who is 45 or older should consider getting tested. If you are 45 or older and overweight, getting tested is strongly recommended. If you are younger than 45, overweight, and have one or more risk factors, you also should talk with your doctor about being tested. See risk factors for type 2 diabetes. Why Early Detection is Important Diabetes is a serious disease that can lead to a number of health problems such as heart disease, stroke, vision problems, kidney disease and even death. Sometimes people have symptoms but do not suspect diabetes. They delay scheduling a checkup because they do not feel sick. Many people do not find out they have the disease until they have diabetes complications, such as a heart attack or stroke. Finding out early if you have diabetes is important because treatment can prevent or delay the complications of the disease. Diet and Exercise Manage Your Diabetes Diabetes cannot be cured, but it can be managed. Managing blood glucose (blood sugar) as well as blood pressure and cholesterol is the best defense against the serious complications of diabetes. People with type 1 diabetes manage their blood sugar with insulin -- either delivered by injection or a pump. Many people with type 2 diabetes can manage blood glucose levels with diet and exercise alone. Others require oral medications or insulin, and some may need both. Diabetes is a progressive disease and, over time, people with diabetes may need both lifestyle modification and medications. Follow a Meal Plan Making healthy food choices is very important to help keep your blood glucose level under control. A registered dietitian can work with you to develop a healthy eating plan. He or she can help you design a meal plan that takes into consideration various factors including your weight and daily physical activity, blood glucose levels, other health conditions and medications. If you are overweight, a plan to help you achieve a weight that is right for you will help manage your blood glucose. Your dietitian can help you plan meals to include foods that you and your family like to eat and that are good for you. (Watch the video to learn about eating healthy with diabetes. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) What to Eat People with diabetes don't need to buy or prepare special foods. The foods that are best for someone with diabetes are excellent choices for everyone: foods that are low in fat, salt, and sugar, and high in fiber, such as beans, fruits, vegetables, and whole grains. These foods help you reach and stay at a weight that's good for your body, keep your blood pressure, glucose and cholesterol in your target range, and prevent or delay heart and blood vessel disease. For more information on nutrition and older adults, see Eating Well As You Get Older. Get Regular Physical Activity Regular physical activity is important for people with diabetes. Being physically active has been shown to improve blood glucose levels in older people whose levels are high. Exercise is especially good for people with diabetes because it - helps manage weight - helps insulin work better to lower blood glucose - is good for your heart and lungs - gives you more energy. helps manage weight helps insulin work better to lower blood glucose is good for your heart and lungs gives you more energy. Safety First Before you begin physical activity, talk with your doctor. Your doctor may check your heart and your feet to be sure you have no special problems. If you have high blood pressure or eye problems, some activities like weightlifting may not be safe. Your health care team can help you find safe ways to be active. For tips on safety issues older adults should consider before starting a new exercise program, see Exercise: Safety First Walking, swimming, dancing, riding a bicycle, playing baseball, and bowling are all good ways to be physically active. You can even get exercise when you clean house or work in your garden. How Much? How Often? Try to be active almost every day for a total of about 30 to 60 minutes. If you haven't exercised lately, begin slowly. Start with 5 to 10 minutes, and then add more time. Or exercise for 10 minutes, three times a day. (Tip: you don’t need to get your exercise in all at one time.) To see examples of exercises for older adults, see Exercises to Try. Or visit Go4Life®, the exercise and physical activity campaign from the National Institute on Aging. Medications Manage Your Diabetes Diabetes cannot be cured, but it can be managed. Managing blood glucose (blood sugar) as well as blood pressure and cholesterol is the best defense against the serious complications of diabetes. Diabetes pills and insulin and diabetes pills are the two kinds of medicines used to lower blood glucose. People with type 1 diabetes control their blood sugar with insulin -- either delivered by injection or a pump. Many people with type 2 diabetes can control blood glucose levels with diet and exercise alone. Others require oral medications or insulin, and some may need both, as well as lifestyle modification. Taking Diabetes Pills If your body is still making some insulin, but not enough to keep your blood glucose levels under control, you may need diabetes pills. Some medications are taken once a day; others must be taken more often. Ask your health care team when you should take your pills. Remember to take your medicines every day, even when you feel well. Be sure to tell your doctor if your pills make you feel sick or if you have any other problems. Remember, diabetes pills don't lower blood glucose all by themselves. You will still want to follow a meal plan and exercise to help lower your blood glucose. Taking Insulin You need insulin if your body has stopped making insulin or if your body doesn't make enough. Everyone with type 1 diabetes needs insulin, and many people with type 2 diabetes do, too. Insulin can't be taken as a pill. It is usually taken by shots or with an insulin pump or insulin pen. Insulin pumps are small machines, usually worn on the hip, that contain insulin and deliver small steady doses of insulin throughout the day, Some pumps are attached directly to the skin. Other people use an insulin pen, which holds a cartridge of insulin that is dialed to the prescribed dose of insulin and then injected. Sometimes, people who take diabetes pills may need insulin shots for a while. If you get sick or have surgery, the diabetes pills may no longer work to lower your blood glucose. Get more information about taking diabetes medicines. Know Your Diabetes ABCs Heart disease and stroke are the leading causes of death for people with diabetes. Controlling the ABCs of diabetes -- your blood glucose, your blood pressure, and your cholesterol as well as stopping smoking -- can help prevent these and other complications from diabetes. - A is for the A1C test - B is for Blood pressure - C is for Cholesterol A is for the A1C test B is for Blood pressure C is for Cholesterol The A1C Test The A1C test (A-one-C), also called the hemoglobin A1C test, shows overall blood glucose for the past 3 months. Your health care provider does this test to see what your blood glucose level is most of the time. This test should be done at least twice a year for all people with diabetes and for some people more often as needed. For many people with diabetes, an A1C test result of under 7 percent usually means that their diabetes treatment is working well and their blood glucose is under control. If your A1C is above your target goal, take action. You may need a change in your meal plan, your level of physical activity, or the medications you take to lower your chance of getting diabetes problems like heart disease or kidney damage. Talk with your health care provider about your A1C goal and how to reach it. Learn more about the A1C test. Check Your Blood Pressure High blood pressure makes your heart work too hard. This can lead to a stroke and other problems such as kidney disease. Your blood pressure should be checked at every doctor visit. The target blood pressure for most people with diabetes is less than 140/90 but may be different for you. Talk with your health care provider about your blood pressure goal. Learn about ways to check your blood pressure. Have Your LDL Cholesterol Checked Low density lipoprotein, or LDL cholesterol, is the bad cholesterol that builds up in your blood vessels. It causes the vessels to narrow and harden, which can lead to a heart attack. Your doctor should check your LDL at least once a year. Talk with your health care provider about your cholesterol goal. Learn more about lowering LDL cholesterol. Stop Smoking Smoking and diabetes are a dangerous mix. Smoking raises your risk for many diabetes problems. If you quit smoking, - you will lower your risk for heart attack, stroke, nerve disease, kidney disease, and amputation - your cholesterol and blood pressure levels might improve - your blood circulation will improve. you will lower your risk for heart attack, stroke, nerve disease, kidney disease, and amputation your cholesterol and blood pressure levels might improve your blood circulation will improve. If you smoke, stop smoking. Ask for help so that you don’t have to do it alone. You can start by calling 1–800–QUITNOW or 1–800–784–8669. For more on how to quit smoking, see Quitting Smoking for Older Adults. Manage Your Diabetes Every Day Diabetes cannot be cured, but it can be managed. Managing blood glucose (blood sugar) as well as blood pressure and cholesterol is the best defense against the serious complications of diabetes. Know What To Do Every Day To manage your diabetes, here are things to do every day. - Take your medicines. - Keep track of your blood glucose (blood sugar). - Check your blood pressure if your doctor advises. - Check your feet. - Brush your teeth and floss. - Stop smoking. - Eat well. - Be active. Take your medicines. Keep track of your blood glucose (blood sugar). Check your blood pressure if your doctor advises. Check your feet. Brush your teeth and floss. Stop smoking. Eat well. Be active. (Watch the video to learn more about what one woman does to manage her diabetes every day. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) Take Your Diabetes Medicines People with type 1 diabetes control their blood sugar with insulin -- delivered either by injection or with a pump. Many people with type 2 diabetes can control blood glucose levels with diet and exercise alone. Others require oral medications or insulin, and some may need both, as well as lifestyle modification. Ask your doctor if you need to take aspirin every day to prevent a heart attack or stroke. Keep Track of Your Blood Glucose One of the best ways to find out how well you are taking care of your diabetes is to check your blood to see how much glucose is in it. If your blood has too much or too little glucose, you may need a change in your meal plan, exercise plan, or medication. Ask your doctor how often you should check your blood glucose. Some people check their blood glucose once a day. Others do it three a day or even more. You may be told to check before eating, before bed, and sometimes in the middle of the night. Your doctor or diabetes educator will show you how to check your blood using a blood glucose meter. Your health insurance or Medicare may pay for some of the supplies and equipment you need to check your glucose levels. See what diabetes supplies and services Medicare covers. Check Your Blood Pressure Check your blood pressure if your doctor advises and keep a record of it. You can check your pressure at home with a home blood pressure measurement device or monitor. Blood pressure monitors can be bought at discount chain stores and drug stores. When you are taking your blood pressure at home, sit with your back supported and your feet flat on the floor. Rest your arm on a table at the level of your heart. Check with your health care provider to make sure you are using the monitor correctly. Check Your Feet Foot care is very important for people with diabetes. High blood glucose levels and a reduced blood supply to the limbs cause nerve damage that reduces feeling in the feet. Someone with nerve damage may not feel a pebble inside his or her sock that is causing a sore. Or a blister caused by poorly fitting shoes may go unnoticed. Foot injuries such as these can cause ulcers, which may, if not cared for, ultimately lead to the need for amputation. If you have diabetes, - check your feet every day and watch for any cuts, sores, red spots, swelling, and infected toenails. - report sores, blisters, breaks in the skin, infections, or buildup of calluses to a podiatrist or a family doctor. - never walk barefoot. - have your feet checked at every doctor visit. - take your shoes and socks off when you go into the examining room. This will remind the doctor to check your feet. check your feet every day and watch for any cuts, sores, red spots, swelling, and infected toenails. report sores, blisters, breaks in the skin, infections, or buildup of calluses to a podiatrist or a family doctor. never walk barefoot. have your feet checked at every doctor visit. take your shoes and socks off when you go into the examining room. This will remind the doctor to check your feet. Learn more about taking care of your feet. Brush Your Teeth and Floss People with diabetes can have tooth and gum problems more often if their blood glucose stays high. High blood glucose also can make tooth and gum problems worse. You can even lose your teeth. Here are ways to protect your teeth and gums. - Keep your blood glucose as close to normal as possible. - Use dental floss at least once a day. Flossing helps prevent the buildup of plaque on your teeth. Plaque can harden and grow under your gums and cause problems. Using a sawing motion, gently bring the floss between the teeth, scraping from bottom to top several times. - Brush your teeth after each meal and snack. Use a soft toothbrush. Turn the bristles against the gum line and brush gently. Use small, circular motions. Brush the front, back, and top of each tooth. - If you wear false teeth, keep them clean. - Call your dentist right away if you have problems with your teeth and gums. Keep your blood glucose as close to normal as possible. Use dental floss at least once a day. Flossing helps prevent the buildup of plaque on your teeth. Plaque can harden and grow under your gums and cause problems. Using a sawing motion, gently bring the floss between the teeth, scraping from bottom to top several times. Brush your teeth after each meal and snack. Use a soft toothbrush. Turn the bristles against the gum line and brush gently. Use small, circular motions. Brush the front, back, and top of each tooth. If you wear false teeth, keep them clean. Call your dentist right away if you have problems with your teeth and gums. Learn more about how diabetes can affect your mouth and teeth. Stop Smoking If you smoke, stop. Smoking raises your risk for many diabetes problems, including heart attack and stroke. Ask for help to quit. Call 1-800 QUITNOW (1-800-784-8669). For more information on smoking and older adults, see Quitting Smoking for Older Adults. Eat Well People with diabetes don't need to buy or prepare special foods. The foods that are best for someone with diabetes are excellent choices for everyone: foods that are low in fat, salt, and sugar, and high in fiber, such as beans, fruits, vegetables, and whole grains. These foods help you reach and stay at a weight that's good for your body, keep your blood pressure, glucose and cholesterol in a desirable range, and prevent or delay heart and blood vessel disease. For more on healthy eating, see Small Steps for Eating Healthy Foods. Be Active Try to exercise almost every day for a total of about 30 to 60 minutes. If you haven't exercised lately, begin slowly. Start with 5 to 10 minutes, and then add more time. Or exercise for 10 minutes, three times a day. (Tip: you don’t need to get your exercise in all at one time.) For more information on exercise and older adults, see Exercise: How to Get Started or visit Go4Life®, the exercise and physical activity campaign for older adults from the National Institute on Aging. Be sure to check with your doctor before starting an exercise program. Other Areas To Manage Here are other areas to manage if you have diabetes. - Take care of your eyes. - Protect your kidneys. - Protect your skin. - Learn how to cope with stress. Take care of your eyes. Protect your kidneys. Protect your skin. Learn how to cope with stress. Take Care of Your Eyes High blood glucose and high blood pressure from diabetes can hurt your eyes. It can even cause blindness, or other painful eye problems. Here are ways to prevent diabetes eye problems. - Keep your blood glucose and blood pressure as close to normal as you can. - Have an eye care professional examine your eyes once a year. Have this exam even if your vision is okay. Keep your blood glucose and blood pressure as close to normal as you can. Have an eye care professional examine your eyes once a year. Have this exam even if your vision is okay. Learn more about eye disease and diabetes. Protect Your Kidneys High blood glucose and high blood pressure may damage the kidneys. Damaged kidneys do not do a good job of filtering out wastes and extra fluid. Here are ways to prevent diabetes kidney problems. - Keep your blood glucose and blood pressure as close to your target goal as you can. - Get tested at least once a year for kidney disease. Ask your doctor if you should be tested. - Follow the healthy eating plan you work out with your doctor or dietitian. If you already have kidney problems, your dietitian may suggest you cut back on protein. Keep your blood glucose and blood pressure as close to your target goal as you can. Get tested at least once a year for kidney disease. Ask your doctor if you should be tested. Follow the healthy eating plan you work out with your doctor or dietitian. If you already have kidney problems, your dietitian may suggest you cut back on protein. Learn more about keeping your kidneys healthy. Protect Your Skin Skin care is very important, too. Because people with diabetes may have more injuries and infections, they should protect their skin by keeping it clean and taking care of minor cuts and bruises. Learn How To Cope With Stress Stress can raise your blood glucose (blood sugar). While it is hard to remove stress from your life, you can learn to handle it. Try deep breathing, gardening, taking a walk, meditating, working on your hobby, or listening to your favorite music. Frequently Asked Questions What is diabetes? Diabetes means your blood glucose (often called blood sugar) is too high. Your blood always has some glucose in it because your body needs glucose for energy to keep you going. But too much glucose in the blood isn't good for your health. Glucose comes from the food you eat and is also made in your liver and muscles. Your blood carries the glucose to all of the cells in your body. Insulin is a chemical (a hormone) made by the pancreas. The pancreas releases insulin into the blood. Insulin helps the glucose from food get into your cells. If your body does not make enough insulin or if the insulin doesn't work the way it should, glucose can't get into your cells. It stays in your blood instead. Your blood glucose level then gets too high, causing pre-diabetes or diabetes. What is the difference between type 1 and type 2 diabetes? Type 1 diabetes, which used to be called called juvenile diabetes or insulin-dependent diabetes, develops most often in young people. However, type 1 diabetes can also develop in adults. With this form of diabetes, your body no longer makes insulin or doesn’t make enough insulin because your immune system has attacked and destroyed the insulin-producing cells. About 5 to 10 percent of people with diabetes have type 1 diabetes. To survive, people with type 1 diabetes must have insulin delivered by injection or a pump. Learn more about type 1 diabetes here. Learn more about type 1 diabetes here. Type 2 diabetes, which used to be called adult-onset diabetes or non insulin-dependent diabetes, is the most common form of diabetes. Although people can develop type 2 diabetes at any age -- even during childhood -- type 2 diabetes develops most often in middle-aged and older people. Type 2 diabetes usually begins with insulin resistance—a condition that occurs when fat, muscle, and liver cells do not use insulin to carry glucose into the body’s cells to use for energy. As a result, the body needs more insulin to help glucose enter cells. At first, the pancreas keeps up with the added demand by making more insulin. Over time, the pancreas doesn’t make enough insulin when blood sugar levels increase, such as after meals. If your pancreas can no longer make enough insulin, you will need to treat your type 2 diabetes. Learn more about type 2 diabetes here. How many people have diabetes? Nearly 29 million Americans age 20 or older (12.3 percent of all people in this age group) have diabetes, according to 2014 estimates from the Centers for Disease Control and Prevention (CDC). About 1.9 million people aged 20 years or older were newly diagnosed with diabetes in 2010 alone. People can get diabetes at any age, but the risk increases as we get older. In 2014, over 11 million older adults living in the U.S -- nearly 26 percent of people 65 or older -- had diabetes. See more statistics about diabetes from the National Diabetes Statistics Report 2014. (Centers for Disease Control and Prevention.) What is prediabetes? Prediabetes means your blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. In 2012, about 86 million people in the U.S. had prediabetes, and 51% of those 65 or older had prediabetes. People with prediabetes are at an increased risk for developing type 2 diabetes and for heart disease and stroke. The good news is that if you have prediabetes, you can reduce your risk of getting type 2 diabetes. With modest weight loss and moderate physical activity, you can delay or prevent type 2 diabetes. Learn more about prediabetes here. Why can I do about prediabetes? Studies have shown that most people with prediabetes develop type 2 diabetes within a few years, unless they change their lifestyle. Most people with prediabetes don’t have any symptoms. Your doctor can test your blood to find out if your blood glucose levels are higher than normal. Losing weight—at least 5 to 10 percent of your starting weight—can prevent or delay diabetes or even reverse prediabetes. That’s 10 to 20 pounds for someone who weighs 200 pounds. You can lose weight by cutting the amount of calories and fat you consume and by being physically active at least 30 to 60 minutes every day. Physical activity also helps your body use the hormone insulin properly. Your body needs insulin to use glucose for energy. Medicine can help control the amount of glucose in your blood. Ask your doctor if medicine to control glucose is right for you. Learn more about prediabetes here. What are the signs of diabetes? Many people with diabetes experience one or more symptoms, including extreme thirst or hunger, a frequent need to urinate and/or fatigue. Some lose weight without trying. Additional signs include sores that heal slowly, dry, itchy skin, loss of feeling or tingling in the feet and blurry eyesight. Some people with diabetes, however, have no symptoms at all. What causes diabetes? Type 1 diabetes is an autoimmune disease. In an autoimmune reaction, antibodies, or immune cells, attach to the body's own healthy tissues by mistake, signaling the body to attack them. At present, scientists do not know exactly what causes the body's immune system to attack the insulin-producing cells in the pancreas in people with type 1 diabetes. However, many believe that both genetic factors and environmental factors are involved. Studies now are underway to identify these factors and prevent type 1 diabetes in people at risk. Type 2 diabetes—the most common form of diabetes—is caused by a combination of factors, including insulin resistance, a condition in which the body’s muscle, fat, and liver cells do not use insulin effectively. Type 2 diabetes develops when the body can no longer produce enough insulin to compensate for the impaired ability to use insulin. Get more details about who should be tested for diabetes. If diabetes is not managed, what problems might occur? Diabetes is a very serious disease. Over time, diabetes that is not well managed causes serious damage to the eyes, kidneys, nerves, and heart, gums and teeth. If you have diabetes, you are more likely than someone who does not have diabetes to have heart disease or a stroke. People with diabetes also tend to develop heart disease or stroke at an earlier age than others. The best way to protect yourself from the serious complications of diabetes is to manage your blood glucose, blood pressure, and cholesterol and avoid smoking. It is not always easy, but people who make an ongoing effort to manage their diabetes can greatly improve their overall health. Who is at risk for developing type 2 diabetes? Here are the risk factors for type 2 diabetes. - being over 45 years of age - being overweight or obese - having a first-degree relative -- a parent, brother, or sister -- with diabetes - being African American, American Indian or Alaska Native, Asian American or Pacific Islander, or Hispanic American/Latino. (Watch the video to learn more about native Americans and diabetes risk. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) - having gestational diabetes, or giving birth to at least one baby weighing more than 9 pounds - having blood pressure of 140/90 or higher, or having been told that you have high blood pressure. - having abnormal cholesterol levels -- an HDL cholesterol level of 35 or lower, or a triglyceride level of 250 or higher - being inactive or exercising fewer than three times a week. - having polycystic ovary syndrome, also called PCOS (women only) - on previous testing, having prediabetes (an A1C level of 5.7 to 6.4 percent), impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) - history of cardiovascular disease (disease affecting the heart and blood vessels). being over 45 years of age being overweight or obese having a first-degree relative -- a parent, brother, or sister -- with diabetes being African American, American Indian or Alaska Native, Asian American or Pacific Islander, or Hispanic American/Latino. (Watch the video to learn more about native Americans and diabetes risk. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) having gestational diabetes, or giving birth to at least one baby weighing more than 9 pounds having blood pressure of 140/90 or higher, or having been told that you have high blood pressure. having abnormal cholesterol levels -- an HDL cholesterol level of 35 or lower, or a triglyceride level of 250 or higher being inactive or exercising fewer than three times a week. having polycystic ovary syndrome, also called PCOS (women only) on previous testing, having prediabetes (an A1C level of 5.7 to 6.4 percent), impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) history of cardiovascular disease (disease affecting the heart and blood vessels). Can diabetes be prevented? The two most common forms of diabetes are type 1 and type 2. Currently, there is no way to delay or prevent type 1 diabetes. However, research has shown that making modest lifestyle changes can prevent or delay type 2 diabetes in people at risk for the disease. In the Diabetes Prevention Program (DPP), a landmark study by the National Institute of Diabetes and Digestive and Kidney Diseases, researchers found that adults at high risk for type 2 diabetes were able to cut their risk in half by losing a modest amount of weight and being active almost every day. This means losing 5 to 7 percent of body weight (that's 10 pounds if you weigh 200 pounds) and getting 150 minutes of physical activity a week. The DPP study also showed that modest weight loss (achieved by following a low calorie, low-fat diet) and moderate physical activity were especially effective in preventing or delaying the development of diabetes in older people. In fact, people over the age of 60 were able to reduce their risk for developing type 2 diabetes by 71 percent. (Watch the video to learn more about preventing type 2 diabetes. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) What kind of meal plan should a person with diabetes follow? Ask your doctor to give you the name of someone trained to help you create a healthy eating plan, such as a dietitian. This plan, often called medical nutrition therapy, will include regular monitoring by your dietitian and education about how to adjust your eating habits as the need occurs. Medical nutrition therapy is usually covered by insurance or Medicare as long as your doctor refers you. Your dietitian can help you plan meals that include foods that you and your family like and that are good for you. Your healthy eating plan will include - breads, cereals, rice, and whole grains - fruits and vegetables - meat and meat substitutes - dairy products - healthy fats. breads, cereals, rice, and whole grains fruits and vegetables meat and meat substitutes dairy products healthy fats. Your plan will also help you learn how to eat the right amount, or portions, of food. Making good food choices will - help you reach and stay at a healthy weight - keep your blood glucose, blood pressure, and cholesterol levels under control - prevent heart and blood vessel disease. help you reach and stay at a healthy weight keep your blood glucose, blood pressure, and cholesterol levels under control prevent heart and blood vessel disease. (Watch the video to learn more about eating healthy with diabetes. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) If I have diabetes, should I avoid all sweets and sugars? If you have diabetes you should limit the amount of fats and sweets you eat. These foods have calories, but not much nutrition. Some contain saturated fats and cholesterol that increase your risk of heart disease. Limiting these foods will help you lose weight and keep your blood glucose and blood fats under control. It is okay to have sweets once in a while. Try having sugar-free popsicles, diet soda, fat-free ice cream or frozen yogurt, or sugar-free hot cocoa mix to satisfy a \"sweet tooth.\" Remember, fat-free and low sugar foods still have calories. Talk with your diabetes educator about how to fit sweets into your meal plan. Who should be tested for diabetes? Because type 2 diabetes is more common in older people, anyone who is 45 or older should consider getting tested. If you are 45 or older and overweight, getting tested is strongly recommended. If you are younger than 45, overweight, and have one or more risk factors, you also should talk with your doctor about being tested. Get more information about tests for diabetes. How do doctors diagnose diabetes and pre-diabetes? Doctors use the following tests to diagnose diabetes. - An A1C test measures your average blood glucose levels over the past 3 months. It can be used to diagnose type 2 diabetes and pre-diabetes. It does not require fasting and blood can be drawn for the test any time of the day. An A1C test measures your average blood glucose levels over the past 3 months. It can be used to diagnose type 2 diabetes and pre-diabetes. It does not require fasting and blood can be drawn for the test any time of the day. - A fasting plasma glucose, or FPG test measures your blood glucose after you have gone at least 8 hours without eating. Doctors use this test to detect diabetes or prediabetes. A fasting plasma glucose, or FPG test measures your blood glucose after you have gone at least 8 hours without eating. Doctors use this test to detect diabetes or prediabetes. - In a random plasma glucose test, the doctor checks your blood glucose without regard to when you ate your last meal. This test, along with an assessment of symptoms, is used to diagnose diabetes but not pre-diabetes. In a random plasma glucose test, the doctor checks your blood glucose without regard to when you ate your last meal. This test, along with an assessment of symptoms, is used to diagnose diabetes but not pre-diabetes. - An oral glucose tolerance test, or OGTT measures your blood glucose after you have gone at least 8 hours without eating and 2 hours after you drink a sweet beverage. Doctors also use the oral glucose tolerance test to diagnose gestational diabetes in pregnant women. An oral glucose tolerance test, or OGTT measures your blood glucose after you have gone at least 8 hours without eating and 2 hours after you drink a sweet beverage. Doctors also use the oral glucose tolerance test to diagnose gestational diabetes in pregnant women. If any of these tests show that you might have diabetes, your doctor will need to repeat the test with a second measurement unless there are clear symptoms of diabetes. How do I manage my diabetes every day? People with type 1 diabetes control their blood sugar with insulin -- either with shots or an insulin pen. Many people with type 2 diabetes can control blood glucose levels with diet and exercise alone. Others require oral medications or insulin, and some people may need to take both, along with lifestyle modification. (Watch the video to learn how one woman manages her type 2 diabetes. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) To manage your diabetes, here are things to do every day. - Take your medicines for diabetes and for any other health problems, even when you feel good. Take your medicines for diabetes and for any other health problems, even when you feel good. - Keep track of your blood glucose (blood sugar). You may want to check it one or more times a day. Be sure to talk about it with your health care team. Keep track of your blood glucose (blood sugar). You may want to check it one or more times a day. Be sure to talk about it with your health care team. - Check your blood pressure if your doctor advises and keep a record of it. Check your blood pressure if your doctor advises and keep a record of it. - Check your feet every day for cuts, blisters, red spots and swelling. Call your health care team right away about any sores that do not go away. Check your feet every day for cuts, blisters, red spots and swelling. Call your health care team right away about any sores that do not go away. - Brush your teeth and floss every day to keep your mouth, teeth and gums healthy. Brush your teeth and floss every day to keep your mouth, teeth and gums healthy. - Stop smoking. Ask for help to quit. Call 1-800 QUIT NOW ( 1-800-784-8669) Stop smoking. Ask for help to quit. Call 1-800 QUIT NOW ( 1-800-784-8669) - Eat well. Ask your doctor to give you the name of someone trained to help you create a healthy eating plan, such as a dietitian. See small steps for eating healthy foods. Eat well. Ask your doctor to give you the name of someone trained to help you create a healthy eating plan, such as a dietitian. See small steps for eating healthy foods. - Be active. Try to exercise almost every day for a total of about 30 minutes. If you haven't exercised lately, begin slowly. To learn more, see Exercise: How To Get Started, or visit Go4Life®, the exercise and physical activity campaign for older adults from the National Institute on Aging. Be active. Try to exercise almost every day for a total of about 30 minutes. If you haven't exercised lately, begin slowly. To learn more, see Exercise: How To Get Started, or visit Go4Life®, the exercise and physical activity campaign for older adults from the National Institute on Aging. How should I take care of my feet? Foot care is very important for people with diabetes. High blood glucose levels and a reduced blood supply to the limbs cause nerve damage that reduces feeling in the feet. Someone with nerve damage may not feel a pebble inside his or her sock that is causing a sore. Or a blister caused by poorly fitting shoes may go unnoticed. Foot injuries such as these can cause ulcers, which may, if not cared for, ultimately lead to the need for amputation. If you have diabetes, - check your feet every day and watch for any cuts, sores, red spots, swelling, and infected toenails. - report sores, blisters, breaks in the skin, infections, or buildup of calluses to a podiatrist or a family doctor. - never walk barefoot. - have your feet checked at every doctor visit. - take your shoes and socks off when you go into the examining room. This will remind the doctor to check your feet. check your feet every day and watch for any cuts, sores, red spots, swelling, and infected toenails. report sores, blisters, breaks in the skin, infections, or buildup of calluses to a podiatrist or a family doctor. never walk barefoot. have your feet checked at every doctor visit. take your shoes and socks off when you go into the examining room. This will remind the doctor to check your feet. Learn more about taking care of your feet. How can diabetes affect my teeth and gums? People with diabetes can have tooth and gum problems more often if their blood glucose stays high. Glucose is present in your saliva—the fluid in your mouth that makes it wet. When diabetes is not controlled, high glucose levels in your saliva help harmful bacteria grow. These bacteria combine with food to form a soft, sticky film called plaque. Plaque also comes from eating foods that contain sugars or starches. Some types of plaque cause tooth decay or cavities. Other types of plaque cause gum disease and bad breath. The most common mouth problems from diabetes are - gingivitis (unhealthy or inflamed gums) - periodontitis (an infection of the gums) - thrush or candidiasis - dry mouth - oral burning (a burning sensation inside the mouth). gingivitis (unhealthy or inflamed gums) periodontitis (an infection of the gums) thrush or candidiasis dry mouth oral burning (a burning sensation inside the mouth). How can I protect my teeth and gums? Here are ways to protect your teeth and gums. - Keep your blood glucose as close to normal as possible. - Use dental floss at least once a day. Flossing helps prevent the buildup of plaque on your teeth. Plaque can harden and grow under your gums and cause problems. Using a sawing motion, gently bring the floss between the teeth, scraping from bottom to top several times. - Brush your teeth after each meal and snack. Use a soft toothbrush. Turn the bristles against the gum line and brush gently. Use small, circular motions. Brush the front, back, and top of each tooth. - If you wear false teeth, keep them clean. - Call your dentist right away if you have problems with your teeth and gums. Keep your blood glucose as close to normal as possible. Use dental floss at least once a day. Flossing helps prevent the buildup of plaque on your teeth. Plaque can harden and grow under your gums and cause problems. Using a sawing motion, gently bring the floss between the teeth, scraping from bottom to top several times. Brush your teeth after each meal and snack. Use a soft toothbrush. Turn the bristles against the gum line and brush gently. Use small, circular motions. Brush the front, back, and top of each tooth. If you wear false teeth, keep them clean. Call your dentist right away if you have problems with your teeth and gums. What kinds of medication do people take for diabetes? Controlling blood glucose (blood sugar) is the best defense against the serious complications of diabetes. Insulin and diabetes pills are the two kinds of medicines used to lower blood glucose. You need insulin if your body has stopped making insulin or if it doesn't make enough. Everyone with type 1 diabetes needs insulin, and many people with type 2 diabetes do, too. If your body makes insulin but the insulin doesn't lower your blood glucose, you may need diabetes pills. What are the ABCs of diabetes? Heart disease and stroke are the leading causes of death for people with diabetes. Controlling the ABCs of diabetes -- your blood glucose, your blood pressure, and your cholesterol, as well as stopping smoking -- can help prevent these and other complications from diabetes. - A is for the A1C test - B is for Blood pressure - C is for Cholesterol. A is for the A1C test B is for Blood pressure C is for Cholesterol. - The A1C test (A-one-C) shows you what your blood glucose has been over the last three months. Your health care provider does this test to see what your blood glucose level is most of the time. This test should be done at least twice a year for all people with diabetes and for some people more often as needed. For many people with diabetes, an A1C test result of under 7 percent usually means that their diabetes treatment is working well and their blood glucose is under control. The A1C test (A-one-C) shows you what your blood glucose has been over the last three months. Your health care provider does this test to see what your blood glucose level is most of the time. This test should be done at least twice a year for all people with diabetes and for some people more often as needed. For many people with diabetes, an A1C test result of under 7 percent usually means that their diabetes treatment is working well and their blood glucose is under control. - B is for Blood pressure. The goal for most people is 140/90 but may be different for you. High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease. Your blood pressure should be checked at every doctor visit. Talk with your health care provider about your blood pressure goal. B is for Blood pressure. The goal for most people is 140/90 but may be different for you. High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease. Your blood pressure should be checked at every doctor visit. Talk with your health care provider about your blood pressure goal. - C is for Cholesterol (ko-LES-ter-ol). The LDL goal for most people is less than 100. Low density lipoprotein, or LDL-cholesterol, is the bad cholesterol that builds up in your blood vessels. It causes the vessels to narrow and harden, which can lead to a heart attack. Your doctor should check your LDL at least once a year. Talk with your health care provider about your cholesterol goal. C is for Cholesterol (ko-LES-ter-ol). The LDL goal for most people is less than 100. Low density lipoprotein, or LDL-cholesterol, is the bad cholesterol that builds up in your blood vessels. It causes the vessels to narrow and harden, which can lead to a heart attack. Your doctor should check your LDL at least once a year. Talk with your health care provider about your cholesterol goal. Ask your health care team - what your A1C, blood pressure, and cholesterol numbers are. - what your ABCs should be. - what you can do to reach your target. what your A1C, blood pressure, and cholesterol numbers are. what your ABCs should be. what you can do to reach your target. How should I work with my health care team to manage my diabetes? See your health care team at least twice a year to find and treat any problems early. Ask what steps you can take to reach your goals. If you have diabetes, take these steps. At each visit, be sure you have a - blood pressure check - foot check - weight check - review of your self-care plan. blood pressure check foot check weight check review of your self-care plan. Two times each year, get - an A1C test. It may be checked more often if it is over 7. an A1C test. It may be checked more often if it is over 7. Once each year, be sure you have a - cholesterol test - triglyceride (try-GLISS-er-ide) test - a type of blood fat - complete foot exam - dental exam to check teeth and gums. Tell your dentist you have diabetes. - dilated eye exam to check for eye problems - flu shot - urine and a blood test to check for kidney problems. cholesterol test triglyceride (try-GLISS-er-ide) test - a type of blood fat complete foot exam dental exam to check teeth and gums. Tell your dentist you have diabetes. dilated eye exam to check for eye problems flu shot urine and a blood test to check for kidney problems. At least once, get a - pneumonia (nu-MOH-nya) shot. pneumonia (nu-MOH-nya) shot. If you have Medicare, ask your health care team if Medicare will cover some of the costs for - learning about healthy eating and diabetes self-care - special shoes, if you need them - medical supplies - diabetes medicines. learning about healthy eating and diabetes self-care special shoes, if you need them medical supplies diabetes medicines. (Watch the video for important things to remember when visiting your health care team. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) Why is exercise important in controlling diabetes? Exercise is especially good for people with diabetes because it - helps control weight - helps insulin work better to lower blood glucose - is good for your heart and lungs - gives you more energy. helps control weight helps insulin work better to lower blood glucose is good for your heart and lungs gives you more energy. Before you begin exercising, talk with your doctor. Your doctor may check your heart and your feet to be sure you have no special problems. If you have high blood pressure or eye problems, some exercises may not be safe. Your health care team can help you find safe exercises. What types of exercise should I do, and how often? People with diabetes should - do aerobic activities, such as brisk walking, which use the body’s large muscles to make the heart beat faster. The large muscles are those of the upper and lower arms and legs and those that control head, shoulder, and hip movements. - do activities to strengthen muscles and bone, such as sit-ups or lifting weights. Aim for two times a week. - stretch to increase flexibility, lower stress, and help prevent muscle soreness after physical activity. do aerobic activities, such as brisk walking, which use the body’s large muscles to make the heart beat faster. The large muscles are those of the upper and lower arms and legs and those that control head, shoulder, and hip movements. do activities to strengthen muscles and bone, such as sit-ups or lifting weights. Aim for two times a week. stretch to increase flexibility, lower stress, and help prevent muscle soreness after physical activity. Try to exercise almost every day for a total of about 30 minutes. If you haven't exercised lately, begin slowly. Start with 5 to 10 minutes, and then add more time. Or exercise for 10 minutes, three times a day. (Tip: you don’t need to get your exercise in all at one time.) For more information on exercise and older adults, see Exercises To Try or visit Go4Life®, the exercise and physical activity campaign from the National Institute on Aging. Always talk with a doctor before starting a new physical activity program. What steps can I take to lose weight to prevent or delay type 2 diabetes? Your weight affects your health in many ways. Being overweight can keep your body from making and using insulin properly. It can also cause high blood pressure. If you are overweight or obese, choose sensible ways to reach and maintain a reasonable body weight. - Make healthy food choices. What you eat has a big impact on your weight and overall health. By developing healthy eating habits you can help control your body weight, blood pressure, and cholesterol. Reducing portion size, increasing the amount of fiber you consume (by eating more fruits and vegetables) and limiting fatty and salty foods are key to a healthy diet. Make healthy food choices. What you eat has a big impact on your weight and overall health. By developing healthy eating habits you can help control your body weight, blood pressure, and cholesterol. Reducing portion size, increasing the amount of fiber you consume (by eating more fruits and vegetables) and limiting fatty and salty foods are key to a healthy diet. - Get at least 30 minutes of exercise at least five days a week. Regular exercise reduces diabetes risk in several ways: it helps you lose weight, controls your cholesterol and blood pressure, and improves your body's use of insulin. Many people make walking part of their daily routine because it's easy, fun and convenient. But you can choose any activity that gets you moving. It's fine to break up your 30 minutes of exercise into smaller increments, such as three 10-minute periods. Check with your doctor before beginning any exercise program. Get at least 30 minutes of exercise at least five days a week. Regular exercise reduces diabetes risk in several ways: it helps you lose weight, controls your cholesterol and blood pressure, and improves your body's use of insulin. Many people make walking part of their daily routine because it's easy, fun and convenient. But you can choose any activity that gets you moving. It's fine to break up your 30 minutes of exercise into smaller increments, such as three 10-minute periods. Check with your doctor before beginning any exercise program. Does Medicare help pay for services and supplies for people with diabetes? Medicare helps pay for certain services and supplies for people with diabetes who have Medicare Part B. All require a doctor's prescription. The diabetes-related services and supplies that are covered include - blood sugar monitor and supplies - an A1C test, which is a lab test that measures how well your blood glucose has been controlled over the past 3 months. - dilated eye examinations to check for diabetic eye diseases - glaucoma screening - flu and pneumonia shots - diabetes self-management training - medical nutrition therapy services. blood sugar monitor and supplies an A1C test, which is a lab test that measures how well your blood glucose has been controlled over the past 3 months. dilated eye examinations to check for diabetic eye diseases glaucoma screening flu and pneumonia shots diabetes self-management training medical nutrition therapy services. Get more information about the diabetes supplies and services covered by Medicare. You can also contact the Centers for Medicare and Medicaid Services at 1-800-MEDICARE, or 1-800-633-4227. TTY users dial 1-877-486-2048. ", "role": "user" }, { "content": "Here are the risk factors for type 2 diabetes. - being over 45 years of age - being overweight or obese - having a first-degree relative -- a parent, brother, or sister -- with diabetes - being African American, American Indian or Alaska Native, Asian American or Pacific Islander, or Hispanic American/Latino. - having gestational diabetes, or giving birth to at least one baby weighing more than 9 pounds - having blood pressure of 140/90 or higher, or having been told that you have high blood pressure. - having abnormal cholesterol levels -- an HDL cholesterol level of 35 or lower, or a triglyceride level of 250 or higher - being inactive or exercising fewer than three times a week.", "role": "assistant" } ]

[ { "content": "what are pancreatic enzymes?\n\nPancreatic Cancer: The pancreas lies behind the stomach and in front of the spine. There are two kinds of cells in the pancreas. Exocrine pancreas cells make enzymes that are released into the small intestine to help the body digest food. Neuroendocrine pancreas cells (such as islet cells) make several hormones, including insulin and glucagon, that help control sugar levels in the blood. Most pancreatic cancers form in exocrine cells. These tumors do not secrete hormones and do not cause signs or symptoms. This makes it hard to diagnose this type of pancreatic cancer early. For most patients with exocrine pancreatic cancer, current treatments do not cure the cancer. Some types of malignant pancreatic neuroendocrine tumors, such as islet cell tumors, have a better prognosis than pancreatic exocrine cancers. - Pancreatic cancer is a disease in which malignant (cancer) cells form in the tissues of the pancreas. - Smoking and health history can affect the risk of pancreatic cancer. - Signs and symptoms of pancreatic cancer include jaundice, pain, and weight loss. - Pancreatic cancer is difficult to detect (find) and diagnose early. - Tests that examine the pancreas are used to detect (find), diagnose, and stage pancreatic cancer. - Certain factors affect prognosis (chance of recovery) and treatment options. - Pancreatic cancer is a disease in which malignant (cancer) cells form in the tissues of the pancreas. - Smoking and health history can affect the risk of pancreatic cancer. - Signs and symptoms of pancreatic cancer include jaundice, pain, and weight loss. - Pancreatic cancer is difficult to detect (find) and diagnose early. - Tests that examine the pancreas are used to detect (find), diagnose, and stage pancreatic cancer. - Certain factors affect prognosis (chance of recovery) and treatment options. - Tests and procedures to stage pancreatic cancer are usually done at the same time as diagnosis. - There are three ways that cancer spreads in the body. - Cancer may spread from where it began to other parts of the body. - The following stages are used for pancreatic cancer: - Stage 0 (Carcinoma in Situ) - Stage I - Stage II - Stage III - Stage IV - Tests and procedures to stage pancreatic cancer are usually done at the same time as diagnosis. - There are three ways that cancer spreads in the body. - Cancer may spread from where it began to other parts of the body. - The following stages are used for pancreatic cancer: - Stage 0 (Carcinoma in Situ) - Stage I - Stage II - Stage III - Stage IV - There are different types of treatment for patients with pancreatic cancer. - Five types of standard treatment are used: - Surgery - Radiation therapy - Chemotherapy - Chemoradiation therapy - Targeted therapy - There are treatments for pain caused by pancreatic cancer. - Patients with pancreatic cancer have special nutritional needs. - New types of treatment are being tested in clinical trials. - Biologic therapy - Patients may want to think about taking part in a clinical trial. - Patients can enter clinical trials before, during, or after starting their cancer treatment. - Follow-up tests may be needed - There are different types of treatment for patients with pancreatic cancer. - Five types of standard treatment are used: - Surgery - Radiation therapy - Chemotherapy - Chemoradiation therapy - Targeted therapy - There are treatments for pain caused by pancreatic cancer. - Patients with pancreatic cancer have special nutritional needs. - New types of treatment are being tested in clinical trials. - Biologic therapy - Patients may want to think about taking part in a clinical trial. - Patients can enter clinical trials before, during, or after starting their cancer treatment. - Follow-up tests may be needed Stages I and II Pancreatic Cancer Treatment of stage I and stage II pancreatic cancer may include the following: - Surgery. - Surgery followed by chemotherapy. - Surgery followed by chemoradiation. - A clinical trial of combination chemotherapy. - A clinical trial of chemotherapy and targeted therapy, with or without chemoradiation. - A clinical trial of chemotherapy and/or radiation therapy before surgery. Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.\t\t\tStage III Pancreatic Cancer Treatment of stage III pancreatic cancer may include the following: - Palliative surgery or stent placement to bypass blocked areas in ducts or the small intestine. - Chemotherapy followed by chemoradiation. - Chemoradiation followed by chemotherapy. - Chemotherapy with or without targeted therapy. - A clinical trial of new anticancer therapies together with chemotherapy or chemoradiation. - A clinical trial of radiation therapy given during surgery or internal radiation therapy. Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.\t\t\tStage IV Pancreatic Cancer Treatment of stage IV pancreatic cancer may include the following: - Palliative treatments to relieve pain, such as nerve blocks, and other supportive care. - Palliative surgery or stent placement to bypass blocked areas in ducts or the small intestine. - Chemotherapy with or without targeted therapy. - Clinical trials of new anticancer agents with or without chemotherapy. Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available. - Pancreatic neuroendocrine tumors form in hormone-making cells (islet cells) of the pancreas. - Pancreatic NETs may or may not cause signs or symptoms. - There are different kinds of functional pancreatic NETs. - Having certain syndromes can increase the risk of pancreatic NETs. - Different types of pancreatic NETs have different signs and symptoms. - Lab tests and imaging tests are used to detect (find) and diagnose pancreatic NETs. - Other kinds of lab tests are used to check for the specific type of pancreatic NETs. - Certain factors affect prognosis (chance of recovery) and treatment options. - Pancreatic neuroendocrine tumors form in hormone-making cells (islet cells) of the pancreas. - Pancreatic NETs may or may not cause signs or symptoms. - There are different kinds of functional pancreatic NETs. - Having certain syndromes can increase the risk of pancreatic NETs. - Different types of pancreatic NETs have different signs and symptoms. - Lab tests and imaging tests are used to detect (find) and diagnose pancreatic NETs. - Other kinds of lab tests are used to check for the specific type of pancreatic NETs. - Certain factors affect prognosis (chance of recovery) and treatment options. - The plan for cancer treatment depends on where the NET is found in the pancreas and whether it has spread. - There are three ways that cancer spreads in the body. - Cancer may spread from where it began to other parts of the body. - The plan for cancer treatment depends on where the NET is found in the pancreas and whether it has spread. - There are three ways that cancer spreads in the body. - Cancer may spread from where it began to other parts of the body. - There are different types of treatment for patients with pancreatic NETs. - Six types of standard treatment are used: - Surgery - Chemotherapy - Hormone therapy - Hepatic arterial occlusion or chemoembolization - Targeted therapy - Supportive care - New types of treatment are being tested in clinical trials. - Treatment for pancreatic neuroendocrine tumors may cause side effects. - Patients may want to think about taking part in a clinical trial. - Patients can enter clinical trials before, during, or after starting their cancer treatment. - Follow-up tests may be needed. - There are different types of treatment for patients with pancreatic NETs. - Six types of standard treatment are used: - Surgery - Chemotherapy - Hormone therapy - Hepatic arterial occlusion or chemoembolization - Targeted therapy - Supportive care - New types of treatment are being tested in clinical trials. - Treatment for pancreatic neuroendocrine tumors may cause side effects. - Patients may want to think about taking part in a clinical trial. - Patients can enter clinical trials before, during, or after starting their cancer treatment. - Follow-up tests may be needed. Gastrinoma Treatment of gastrinoma may include supportive care and the following: - For symptoms caused by too much stomach acid, treatment may be a drug that decreases the amount of acid made by the stomach. - For a single tumor in the head of the pancreas: - Surgery to remove the tumor. - Surgery to cut the nerve that causes stomach cells to make acid and treatment with a drug that decreases stomach acid. - Surgery to remove the whole stomach (rare). - For a single tumor in the body or tail of the pancreas, treatment is usually surgery to remove the body or tail of the pancreas. - For several tumors in the pancreas, treatment is usually surgery to remove the body or tail of the pancreas. If tumor remains after surgery, treatment may include either: - Surgery to cut the nerve that causes stomach cells to make acid and treatment with a drug that decreases stomach acid; or - Surgery to remove the whole stomach (rare). - For one or more tumors in the duodenum (the part of the small intestine that connects to the stomach), treatment is usually pancreatoduodenectomy (surgery to remove the head of the pancreas, the gallbladder, nearby lymph nodes and part of the stomach, small intestine, and bile duct). - If no tumor is found, treatment may include the following: - Surgery to cut the nerve that causes stomach cells to make acid and treatment with a drug that decreases stomach acid. - Surgery to remove the whole stomach (rare). - If the cancer has spread to the liver, treatment may include: - Surgery to remove part or all of the liver. - Radiofrequency ablation or cryosurgical ablation. - Chemoembolization. - If cancer has spread to other parts of the body or does not get better with surgery or drugs to decrease stomach acid, treatment may include: - Chemotherapy. - Hormone therapy. - If the cancer mostly affects the liver and the patient has severe symptoms from hormones or from the size of tumor, treatment may include: - Hepatic arterial occlusion, with or without systemic chemotherapy. - Chemoembolization, with or without systemic chemotherapy. Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.\t\t\tInsulinoma Treatment of insulinoma may include the following: - For one small tumor in the head or tail of the pancreas, treatment is usually surgery to remove the tumor. - For one large tumor in the head of the pancreas that cannot be removed by surgery, treatment is usually pancreatoduodenectomy (surgery to remove the head of the pancreas, the gallbladder, nearby lymph nodes and part of the stomach, small intestine, and bile duct). - For one large tumor in the body or tail of the pancreas, treatment is usually a distal pancreatectomy (surgery to remove the body and tail of the pancreas). - For more than one tumor in the pancreas, treatment is usually surgery to remove any tumors in the head of the pancreas and the body and tail of the pancreas. - For tumors that cannot be removed by surgery, treatment may include the following: - Combination chemotherapy. - Palliative drug therapy to decrease the amount of insulin made by the pancreas. - Hormone therapy. - Radiofrequency ablation or cryosurgical ablation. - For cancer that has spread to lymph nodes or other parts of the body, treatment may include the following: - Surgery to remove the cancer. - Radiofrequency ablation or cryosurgical ablation, if the cancer cannot be removed by surgery. - If the cancer mostly affects the liver and the patient has severe symptoms from hormones or from the size of tumor, treatment may include: - Hepatic arterial occlusion, with or without systemic chemotherapy. - Chemoembolization, with or without systemic chemotherapy. Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.\t\t\tGlucagonoma Treatment may include the following: - For one small tumor in the head or tail of the pancreas, treatment is usually surgery to remove the tumor. - For one large tumor in the head of the pancreas that cannot be removed by surgery, treatment is usually pancreatoduodenectomy (surgery to remove the head of the pancreas, the gallbladder, nearby lymph nodes and part of the stomach, small intestine, and bile duct). - For more than one tumor in the pancreas, treatment is usually surgery to remove the tumor or surgery to remove the body and tail of the pancreas. - For tumors that cannot be removed by surgery, treatment may include the following: - Combination chemotherapy. - Hormone therapy. - Radiofrequency ablation or cryosurgical ablation. - For cancer that has spread to lymph nodes or other parts of the body, treatment may include the following: - Surgery to remove the cancer. - Radiofrequency ablation or cryosurgical ablation, if the cancer cannot be removed by surgery. - If the cancer mostly affects the liver and the patient has severe symptoms from hormones or from the size of tumor, treatment may include: - Hepatic arterial occlusion, with or without systemic chemotherapy. - Chemoembolization, with or without systemic chemotherapy. Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.\t\t\tOther Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) For VIPoma, treatment may include the following: - Fluids and hormone therapy to replace fluids and electrolytes that have been lost from the body. - Surgery to remove the tumor and nearby lymph nodes. - Surgery to remove as much of the tumor as possible when the tumor cannot be completely removed or has spread to distant parts of the body. This is palliative therapy to relieve symptoms and improve the quality of life. - For tumors that have spread to lymph nodes or other parts of the body, treatment may include the following: - Surgery to remove the tumor. - Radiofrequency ablation or cryosurgical ablation, if the tumor cannot be removed by surgery. - For tumors that continue to grow during treatment or have spread to other parts of the body, treatment may include the following: - Chemotherapy. - Targeted therapy. For somatostatinoma, treatment may include the following: - Surgery to remove the tumor. - For cancer that has spread to distant parts of the body, surgery to remove as much of the cancer as possible to relieve symptoms and improve quality of life. - For tumors that continue to grow during treatment or have spread to other parts of the body, treatment may include the following: - Chemotherapy. - Targeted therapy. Treatment of other types of pancreatic neuroendocrine tumors (NETs) may include the following: - Surgery to remove the tumor. - For cancer that has spread to distant parts of the body, surgery to remove as much of the cancer as possible or hormone therapy to relieve symptoms and improve quality of life. - For tumors that continue to grow during treatment or have spread to other parts of the body, treatment may include the following: - Chemotherapy. - Targeted therapy. Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.\t\t\tRecurrent or Progressive Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Treatment of pancreatic neuroendocrine tumors (NETs) that continue to grow during treatment or recur (come back) may include the following: - Surgery to remove the tumor. - Chemotherapy. - Hormone therapy. - Targeted therapy. - For liver metastases: - Regional chemotherapy. - Hepatic arterial occlusion or chemoembolization, with or without systemic chemotherapy. - A clinical trial of a new therapy. Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.", "role": "user" }, { "content": "Exocrine pancreas cells make enzymes that are released into the small intestine to help the body digest food.", "role": "assistant" } ]

[ { "content": "how is edward's syndrome diagnosed\n\n Trisomy 18 Edwards syndrome Summary Trisomy 18 is a genetic disorder in which a person has a third copy of material from chromosome 18, instead of the usual 2 copies. Causes Trisomy 18 occurs in 1 in 6,000 live births. It is 3 times more common in girls than boys. The syndrome occurs when there is extra material from chromosome 18. The extra material affects normal development. Symptoms Symptoms may include: Clenched hands Crossed legs Feet with a rounded bottom (rocker-bottom feet) Low birth weight Low-set ears Mental delay Poorly developed fingernails Small head (microcephaly) Small jaw (micrognathia) Undescended testicle Unusual shaped chest (pectus carinatum) Exams and Tests An exam during pregnancy may show an unusually large uterus and extra amniotic fluid. There may be an unusually small placenta when the baby is born. A physical exam of the infant may show unusual fingerprint patterns. X-rays may show a short breast bone. Chromosome studies will show trisomy 18. The chromosome abnormality may be present in every cell or present in only a certain percentage of the cells (called mosaicism). Studies may also show part of the chromosome in some cells. Rarely, part of the chromosome 18 becomes attached to another chromosome. This is called translocation. Other signs include: Hole, split, or cleft in the iris of the eye (coloboma) Separation between the left and right side of the abdominal muscle (diastasis recti) Umbilical hernia or inguinal hernia There are often signs of congenital heart disease, such as: Atrial septal defect (ASD) Patent ductus arteriosus (PDA) Ventricular septal defect (VSD) Tests may also show kidney problems, including: Horseshoe kidney Hydronephrosis Polycystic kidney Treatment There are no specific treatments for trisomy 18. Which treatments are used depend on the person's individual condition. Support Groups Support groups include: Support Organization for Trisomy 18, 13 and Related Disorders (SOFT): trisomy.org Trisomy 18 Foundation: www.trisomy18.org Hope for Trisomy 13 and 18: www.hopefortrisomy13and18.org Outlook (Prognosis) Half of infants with this condition do not survive beyond the first week of life. Nine out of ten children will die by 1 year of age. Some children have survived to the teenage years, but with serious medical and developmental problems. Possible Complications Complications depend on the specific defects and symptoms. When to Contact a Medical Professional Genetic counseling can help families understand the condition, the risks of inheriting it, and how to care for the person. Prevention Tests can be done during pregnancy to find out if the child has this syndrome. Genetic counseling is recommended for parents who have a child with this syndrome and who want to have more children. Review Date 8/6/2017 Updated by: Anna C. Edens Hurst, MD, MS, Assistant Professor in Medical Genetics, The University of Alabama at Birmingham, Birmingham, AL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "An unusually small placenta when the baby is born is a sign of Edward's syndrome. A physical exam of the infant may show unusual fingerprint patterns, and X-rays may reveal a short breastbone. To accurately diagnose Edward's syndrome, chromosome studies should be performed.", "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. You may even 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": "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\nLewy body dementia (Treatment): Treatment can be challenging, and there's no cure for Lewy body dementia. Doctors treat the individual symptoms. Medications - Cholinesterase inhibitors. These Alzheimer's disease medications, such as rivastigmine (Exelon), work by increasing the levels of chemical messengers believed to be important for memory, thought and judgment (neurotransmitters) in the brain. This can help improve alertness and cognition, and may help reduce hallucinations and other behavioral problems. Possible side effects may include gastrointestinal upset, excessive salivation and tearing, and frequent urination. These are not FDA approved for Lewy body dementia. - Parkinson's disease medications. These medications, such as carbidopa-levodopa (Sinemet) may help reduce parkinsonian symptoms, such as rigid muscles and slow movement. However, these medications may also increase confusion, hallucinations and delusions. - Medications to treat other symptoms. Your doctor may prescribe medications to treat other symptoms associated with Lewy body dementia, such as sleep or movement problems. If possible, avoid medications with anticholinergic properties, which can worsen cognition or dopamine agonists, which can cause hallucinations. First-generation antipsychotic medications, such as haloperidol (Haldol), should not be used to treat Lewy body dementia. They may cause severe confusion, severe Parkinsonism, sedation and sometimes even death. Very rarely, certain second-generation antipsychotics may be prescribed for a short time at a low dose but only if the benefits outweigh the risks. Therapies Because antipsychotic drugs can worsen Lewy body dementia symptoms, it might be helpful to initially try nondrug approaches, such as: - Tolerating the behavior. Many times a person with Lewy body dementia isn't distressed by the hallucinations. In these cases, the side effects of medication may be worse than the hallucinations themselves. - Modifying the environment. Reducing clutter and distracting noise can make it easier for someone with dementia to function. - Offering soothing responses. A caregiver's response may worsen behavior. Avoid correcting and quizzing a person with dementia. Offer reassurance and validation of his or her concerns. - Creating daily routines and keeping tasks simple. Break tasks into easier steps and focus on successes, not failures. Structure and routine during the day can be less confusing.", "role": "user" }, { "content": "Treating Lewy body dementia can be challenging. Currently there is no cure, but there are treatments that can be applied depending on the individual symptoms. Alzheimer's medications can be effective to increase alertness and reduce hallucinations or other behavioral problems. Your doctor may prescribe medications to treat other symptoms associated with Lewy body dementia, such as sleep or movement problems.", "role": "assistant" } ]

[ { "content": "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 (Causes): The exact cause of gastroparesis is unknown. It may be caused by a disruption of nerve signals to the stomach. The condition is a common complication of diabetes. It can also follow some surgeries. Risk factors for gastroparesis include: - Diabetes - Gastrectomy (surgery to remove part of the stomach) - Systemic sclerosis - Use of medicine that blocks certain nerve signals (anticholinergic medicine)", "role": "user" }, { "content": "Causes of gastroparesis are mostly unknown. It is a common complication of diabetes, and sometimes surgeries.", "role": "assistant" } ]

[ { "content": "what treatment do you use to cure chickenpox\n\nChickenpox: Chickenpox (varicella) is a viral infection that causes an itchy rash with small, fluid-filled blisters. Chickenpox is highly contagious to people who haven't had the disease or been vaccinated against it. Before routine chickenpox vaccination, virtually all people had been infected by the time they reached adulthood, sometimes with serious complications. Today, the number of cases and hospitalizations is down dramatically. For most people, chickenpox is a mild disease. Still, it's better to get vaccinated. The chickenpox vaccine is a safe, effective way to prevent chickenpox and its possible complications. Chickenpox infection appears 10 to 21 days after exposure to the virus and usually lasts about five to 10 days. The rash is the telltale indication of chickenpox. Other signs and symptoms, which may appear one to two days before the rash, include: - Fever - Loss of appetite - Headache - Tiredness and a general feeling of being unwell (malaise) Once the chickenpox rash appears, it goes through three phases: - Raised pink or red bumps (papules), which break out over several days - Small fluid-filled blisters (vesicles), forming from the raised bumps over about one day before breaking and leaking - Crusts and scabs, which cover the broken blisters and take several more days to heal New bumps continue to appear for several days. As a result, you may have all three stages of the rash - bumps, blisters and scabbed lesions - at the same time on the second day of the rash. Once infected, you can spread the virus for up to 48 hours before the rash appears, and you remain contagious until all spots crust over. The disease is generally mild in healthy children. In severe cases, the rash can spread to cover the entire body, and lesions may form in the throat, eyes and mucous membranes of the urethra, anus and vagina. New spots continue to appear for several days. When to see a doctor If you suspect that you or your child has chickenpox, consult your doctor. He or she usually can diagnose chickenpox by examining the rash and by noting the presence of accompanying symptoms. Your doctor can also prescribe medications to lessen the severity of chickenpox and treat complications, if necessary. Be sure to call ahead for an appointment and mention you think you or your child has chickenpox, to avoid waiting and possibly infecting others in a waiting room. Also, be sure to let your doctor know if any of these complications occur: - The rash spreads to one or both eyes. - The rash gets very red, warm or tender, indicating a possible secondary bacterial skin infection. - The rash is accompanied by dizziness, disorientation, rapid heartbeat, shortness of breath, tremors, loss of muscle coordination, worsening cough, vomiting, stiff neck or a fever higher than 102 F (38.9 C). - Anyone in the household is immune deficient or younger than 6 months old. Chickenpox, which is caused by the varicella-zoster virus, is highly contagious, and it can spread quickly. The virus is transmitted by direct contact with the rash or by droplets dispersed into the air by coughing or sneezing. Your risk of catching chickenpox is higher if you: - Haven't had chickenpox - Haven't been vaccinated for chickenpox - Work in or attend a school or child care facility - Live with children Most people who have had chickenpox or have been vaccinated against chickenpox are immune to chickenpox. If you've been vaccinated and still get chickenpox, symptoms are often milder, with fewer blisters and mild or no fever. A few people can get chickenpox more than once, but this is rare. Chickenpox is normally a mild disease. But it can be serious and can lead to complications or death, especially in high-risk people. Complications include: - Bacterial infections of the skin, soft tissues, bones, joints or bloodstream (sepsis) - Dehydration - Pneumonia - Inflammation of the brain (encephalitis) - Toxic shock syndrome - Reye's syndrome for people who take aspirin during chickenpox Who's at risk? Those at high risk of having complications from chickenpox include: - Newborns and infants whose mothers never had chickenpox or the vaccine - Adults - Pregnant women who haven't had chickenpox - People whose immune systems are impaired by medication, such as chemotherapy, or another disease, such as cancer or HIV - People who are taking steroid medications for another disease or condition, such as children with asthma - People taking drugs that suppress their immune systems Chickenpox and pregnancy Other complications of chickenpox affect pregnant women. Chickenpox early in pregnancy can result in a variety of problems in a newborn, including low birth weight and birth defects, such as limb abnormalities. A greater threat to a baby occurs when the mother develops chickenpox in the week before birth or within a couple of days after giving birth. Then it can cause a serious, life-threatening infection in a newborn. If you're pregnant and not immune to chickenpox, talk to your doctor about the risks to you and your unborn child. Chickenpox and shingles If you've had chickenpox, you're at risk of another disease caused by the varicella-zoster virus called shingles. After a chickenpox infection, some of the varicella-zoster virus may remain in your nerve cells. Many years later, the virus can reactivate and resurface as shingles - a painful band of short-lived blisters. The virus is more likely to reappear in older adults and people with weakened immune systems. Shingles can lead to its own complication - a condition in which the pain of shingles persists long after the blisters disappear. This complication, called postherpetic neuralgia, can be severe. A shingles vaccine (Zostavax) is available and is recommended for adults age 60 and older who have had chickenpox. Doctors generally diagnose chickenpox based on the telltale rash. If there's any doubt about the diagnosis, chickenpox can be confirmed with laboratory tests, including blood tests or a culture of lesion samples. In otherwise healthy children, chickenpox typically requires no medical treatment. Your doctor may prescribe an antihistamine to relieve itching. But for the most part, the disease is allowed to run its course. If you're at high risk of complications For people who have a high risk of complications from chickenpox, doctors sometimes prescribe medications to shorten the duration of the infection and to help reduce the risk of complications. If you or your child falls into a high-risk group, your doctor may suggest an antiviral drug such as acyclovir (Zovirax) or another drug called immune globulin intravenous (Privigen). These medications may lessen the severity of the disease when given within 24 hours after the rash first appears. Other antiviral drugs, such as valacyclovir (Valtrex) and famciclovir (Famvir), also may lessen the severity of the disease, but may not be approved or appropriate for all cases. In some instances, your doctor may recommend getting the chickenpox vaccine after exposure to the virus. This can prevent the disease or lessen its severity. Don't give anyone with chickenpox - child or adult - any medicine containing aspirin because this combination has been associated with a condition called Reye's syndrome. Treating complications If complications do develop, your doctor will determine the appropriate treatment. Treatment for skin infections and pneumonia may be with antibiotics. Treatment for encephalitis is usually with antiviral drugs. Hospitalization may be necessary. 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": "In otherwise healthy children, chickenpox typically requires no medical treatment. Your doctor may prescribe an antihistamine to relieve itching. But for the most part, the disease is allowed to run its course. If you're at high risk of complications For people who have a high risk of complications from chickenpox, doctors sometimes prescribe medications to shorten the duration of the infection and to help reduce the risk of complications. If you or your child falls into a high-risk group, your doctor may suggest an antiviral drug such as acyclovir (Zovirax) or another drug called immune globulin intravenous (Privigen). These medications may lessen the severity of the disease when given within 24 hours after the rash first appears. Other antiviral drugs, such as valacyclovir (Valtrex) and famciclovir (Famvir), also may lessen the severity of the disease, but may not be approved or appropriate for all cases. In some instances, your doctor may recommend getting the chickenpox vaccine after exposure to the virus. This can prevent the disease or lessen its severity.", "role": "assistant" } ]

[ { "content": "how to prevent conjunctivitis\n\n Neonatal conjunctivitis Newborn conjunctivitis Conjunctivitis of the newborn Ophthalmia neonatorum Eye infection - neonatal conjunctivitis Summary Conjunctivitis is swelling or infection of the membrane that lines the eyelids and covers the white part of the eye. Conjunctivitis may occur in a newborn child. Causes Swollen or inflamed eyes are most commonly caused by: A blocked tear duct Eye drops with antibiotics, given right after birth Infection by bacteria or viruses Bacteria that normally live in a woman's vagina may be passed to the baby during childbirth. More serious eye damage may be caused by: Gonorrhea and chlamydia: These are infections spread from sexual contact. The viruses that cause genital and oral herpes: These may lead to severe eye damage. Herpes eye infections are less common than those caused by gonorrhea and chlamydia. The mother may not have symptoms at the time of delivery. She still may carry bacteria or viruses that can cause this problem. Symptoms Infected newborn infants develop drainage from the eyes within 1 day to 2 weeks after birth. The eyelids become puffy, red, and tender. There may be watery, bloody, or thick pus-like drainage from the infant's eyes. Exams and Tests The health care provider will perform an eye exam on the baby. If the eye does not appear normal, the following tests may be done: Culture of the drainage from the eye to look for bacteria or viruses Slit-lamp exam to look for damage to the surface of the eyeball Treatment Eye swelling that is caused by the eye drops given at birth should go away on its own. For a blocked tear duct, gentle warm massage between the eye and nasal area may help. This is most often tried before starting antibiotics. Surgery may be needed if a blocked tear duct has not cleared up by the time the baby is 1 year old. Antibiotics are often needed for eye infections caused by bacteria. Eye drops and ointments may also be used. Salt water eye drops may be used to remove sticky yellow drainage. Special antiviral eye drops or ointments are used for herpes infections of the eye. Outlook (Prognosis) Quick diagnosis and treatment often leads to good outcomes. Possible Complications Complications may include: Blindness Inflammation of the iris Scar or hole in the cornea -- the clear structure that is over the colored part of the eye (the iris) When to Contact a Medical Professional Talk to your provider if you have given birth (or expect to give birth) in a place where antibiotic or silver nitrate drops are not routinely placed in the infant's eyes. An example would be having an unsupervised birth at home. This is very important if you have or are at risk for any sexually transmitted disease. Prevention Pregnant women should get treatment for diseases spread through sexual contact to prevent newborn conjunctivitis caused by these infections. Putting eye drops into all infants' eyes in the delivery room right after birth can help prevent many infections. (Most states have laws requiring this treatment.) When a mother has active herpes sores at the time of delivery, a Cesarean section (C-section) is recommended to prevent serious illness in the baby. Review Date 10/18/2017 Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Pregnant women should get treatment for diseases spread through sexual contact to prevent newborn conjunctivitis caused by these infections. Putting eye drops into all infants' eyes in the delivery room right after birth can help prevent many infections. (Most states have laws requiring this treatment.) When a mother has active herpes sores at the time of delivery, a Cesarean section (C-section) is recommended to prevent serious illness in the baby.", "role": "assistant" } ]

[ { "content": "what are known causes of 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", "role": "assistant" } ]

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

[ { "content": "what is the disorder achondroplasia\n\nWhat is Achondroplasia?: Achondroplasia is a disorder of bone growth that prevents the changing of cartilage (particularly in the long bones of the arms and legs) to bone. It is characterized by dwarfism, limited range of motion at the elbows, large head size, small fingers, and normal intelligence. Achondroplasia can cause health complications such as apnea, obesity, recurrent ear infections, and lordosis of the spine. Achondroplasia is caused by mutations in the FGFR3 gene. It is inherited in an autosomal dominant fashion.", "role": "user" }, { "content": "Achondroplasia is a disorder of bone growth that prevents the changing of cartilage (particularly in the long bones of the arms and legs) to bone. It is characterized by dwarfism, limited range of motion at the elbows, large head size, small fingers, and normal intelligence. Achondroplasia can cause health complications such as apnea, obesity, recurrent ear infections, and lordosis of the spine. Achondroplasia is caused by mutations in the FGFR3 gene. It is inherited in an autosomal dominant fashion.", "role": "assistant" } ]

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

[ { "content": "Achondroplasia research. Hello, We are students from and we are doing a biology project of genetic diseases. We chose Achondroplasia as our disease to research. We have a few question and we are hoping you could answer them. Our questions are, can you tell if your child will have Achondroplasia when you are pregnant? When do people usually come in when they think something isn't right with their child? what are the worse cases of Achondroplasia you've ever seen? Thank you in advance. sincerely,\n\nAchondroplasia (Outlook (Prognosis)): People with achondroplasia seldom reach 5 feet (1.5 meters) in height. Intelligence is in the normal range. Infants who receive the abnormal gene from both parents do not often live beyond a few months.", "role": "user" }, { "content": "People with achondroplasia seldom reach 5 feet (1.5 meters) in height. Intelligence is in the normal range. Infants who receive the abnormal gene from both parents do not often live beyond a few months.", "role": "assistant" } ]

[ { "content": "how smoking tobacco affects the brain\n\n Smoking and surgery Surgery - quitting smoking Surgery - quitting tobacco Wound healing - smoking Summary Quitting smoking and other tobacco products before surgery can improve your recovery and outcome after surgery. Most people who successfully quit smoking have tried and failed many times. DO NOT give up. Learning from your past tries can help you succeed. There Are Many Reasons to Quit Smoking Tar, nicotine, and other chemicals from smoking can increase your risk of many health problems. These include heart and blood vessel problems, such as: Blood clots and aneurysms in the brain, which can lead to strokes Coronary artery disease, including chest pain (angina) and heart attacks High blood pressure Poor blood supply to the legs Problems with erections Smoking also increases your risk for different types of cancer, including cancer of the: Lungs Mouth Larynx Esophagus Bladder Kidneys Pancreas Cervix Smoking also leads to lung problems, such as emphysema and chronic bronchitis, and makes asthma harder to control. Some smokers switch to smokeless tobacco instead of quitting tobacco completely. But using smokeless tobacco still carries health risks, such as: Developing mouth or nasal cancer Gum problems, tooth wear, and cavities Worsening high blood pressure and chest pain How Smoking Affects Surgery Smokers who have surgery have a higher chance than nonsmokers of blood clots forming in their legs. These clots may travel to and damage the lungs. Smoking decreases the amount of oxygen that reaches the cells in your surgical wound. As a result, your wound may heal more slowly and is more likely to become infected. All smokers carry an increased risk for heart and lung problems. Even when your surgery goes smoothly, smoking causes your body, heart, and lungs to work harder than if you did not smoke. Making the Decision to Quit Most doctors will tell you to stop using cigarettes and tobacco at least 4 weeks before your surgery. Stretching the time between quitting smoking and your surgery out to at least 10 weeks can decrease your risk of problems even more. Like any addiction, quitting tobacco is difficult. There are many ways to quit smoking and many resources to help you, such as: Family members, friends, and coworkers may be supportive or encouraging. Talk to your doctor about medicines, such as nicotine replacement and prescription medicines. If you join smoking cessation programs, you have a much better chance of success. Such programs are offered by hospitals, health departments, community centers, and work sites. Using nicotine gum around the time of surgery is not encouraged. The nicotine will still interfere with the healing of your surgical wound and have the same effect on your general health as using cigarettes and tobacco. Review Date 9/17/2016 Updated by: Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Tar, nicotine, and other chemicals from smoking can increase your risk of many health problems. These include heart and blood vessel problems, such as: - Blood clots and aneurysms in the brain, which can lead to strokes. - Coronary artery disease, including chest pain (angina) and heart attacks - High blood pressure - Poor blood supply to the legs - Problems with erections Smoking also increases your risk for different types of cancer, including cancer of the: - Lungs - Mouth - Larynx - Esophagus - Bladder - Kidneys - Pancreas - Cervix Smoking also leads to lung problems, such as emphysema and chronic bronchitis, and makes asthma harder to control. Some smokers switch to smokeless tobacco instead of quitting tobacco completely.", "role": "assistant" } ]

[ { "content": "how do you get a prolapse bladder\n\nAnterior prolapse (cystocele) (Causes): Your pelvic floor consists of muscles, ligaments and connective tissues that support your bladder and other pelvic organs. The connections between your pelvic floor muscles and ligaments can weaken over time, as a result of trauma from childbirth or chronic straining of pelvic floor muscles. When this happens, your bladder can slip down lower than normal and bulge into your vagina (anterior prolapse). Possible causes of anterior prolapse include: - Pregnancy and vaginal childbirth - Being overweight or obese - Repeated heavy lifting - Straining with bowel movements - A chronic cough or bronchitis", "role": "user" }, { "content": "Your pelvic floor consists of muscles, ligaments and connective tissues that support your bladder and other pelvic organs. When the connections between your pelvic floor muscles and the ligaments weaken, your bladder or other pelvic organs can slip lower than normal and bulge into your vagina. This can happen because of pregnancy, childbirth, being overweight or obese, strain due to heavy lifting or bowel movements, or a chronic cough or bronchitis.", "role": "assistant" } ]

[ { "content": "how to manage prostate cancer\n\nProstate cancer - treatment (Hormonal Therapy): Testosterone is the main male hormone. Prostate tumors need testosterone to grow. Hormonal therapy is treatment that decreases the effect of testosterone on prostate cancer. Hormone therapy is mainly used for cancer that has spread beyond the prostate. The treatment can help relieve symptoms and prevent further growth and spread of cancer. But it does not cure the cancer. The main type of hormone therapy is called a luteinizing hormone-releasing hormones (LH-RH) agonist: - The medicine blocks the testicles from making testosterone. The drugs must be given by injection, usually every 3 to 6 months. - Possible side effects include nausea and vomiting, hot flashes, anemia, fatigue, thinning bones (osteoporosis), reduced sexual desire, decreased muscle mass, weight gain, and impotence. 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.", "role": "user" }, { "content": "Hormonal therapy is a treatment for prostate cancer. Because prostate tumors need testosterone to grow, hormonal therapy can decrease the effect of testosterone on prostate cancer. It does not cure the cancer, but it can relieve symptoms and prevent further growth and spread of the cancer.", "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\nIrritable Bowel Syndrome (IBS) (How can my diet treat the symptoms of IBS?): 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.Fiber may improve constipation symptoms caused by IBS because it makes stool soft and easier to pass. Fiber is a part of foods such as whole-grain breads and cereals, beans, fruits, and vegetables. The U.S. Department of Agriculture and U.S. Department of Health and Human Services state in its Dietary Guidelines for Americans, 2010 (PDF, 2.963 MB) that adults should get 22 to 34 grams of fiber a day.3While fiber may help constipation, it may not reduce the abdominal discomfort or pain of IBS. In fact, some people with IBS may feel a bit more abdominal discomfort after adding more fiber to their diet. 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": "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": "what is the disorder achondroplasia\n\n Achondroplasia Summary Achondroplasia is a disorder of bone growth that causes the most common type of dwarfism. Causes Achondroplasia is one of a group of disorders called chondrodystrophies, or osteochondrodysplasias. Achondroplasia may be inherited as an autosomal dominant trait, which means that if a child gets the defective gene from one parent, the child will have the disorder. If one parent has achondroplasia, the infant has a 50% chance of inheriting the disorder. If both parents have the condition, the infant's chances of being affected increase to 75%. However, most cases appear as spontaneous mutations. This means that two parents without achondroplasia may give birth to a baby with the condition. Symptoms The typical appearance of achondroplastic dwarfism can be seen at birth. Symptoms may include: Abnormal hand appearance with persistent space between the long and ring fingers Bowed legs Decreased muscle tone Disproportionately large head-to-body size difference Prominent forehead (frontal bossing) Shortened arms and legs (especially the upper arm and thigh) Short stature (significantly below the average height for a person of the same age and sex) Narrowing of the spinal column (spinal stenosis) Spine curvatures called kyphosis and lordosis Exams and Tests During pregnancy, a prenatal ultrasound may show excessive amniotic fluid surrounding the unborn infant. Examination of the infant after birth shows increased front-to-back head size. There may be signs of hydrocephalus (\"water on the brain\"). X-rays of the long bones can reveal achondroplasia in the newborn. Treatment There is no specific treatment for achondroplasia. Related abnormalities, including spinal stenosis and spinal cord compression, should be treated when they cause problems. Outlook (Prognosis) People with achondroplasia seldom reach 5 feet (1.5 meters) in height. Intelligence is in the normal range. Infants who receive the abnormal gene from both parents do not often live beyond a few months. Possible Complications Health problems that may develop include: Breathing problems from a small upper airway and from pressure on the area of the brain that controls breathing Lung problems from a small ribcage When to Contact a Medical Professional If there is a family history of achondroplasia and you plan to have children, you may find it helpful to speak to your health care provider. Prevention Genetic counseling may be helpful for prospective parents when one or both have achondroplasia. However, because achondroplasia most often develops spontaneously, prevention is not always possible. Review Date 10/18/2017 Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Achondroplasia is a disorder of bone growth that causes the most common type of dwarfism. Achondroplasia may be inherited as an autosomal dominant trait, which means that if a child gets the defective gene from 1 parent, the child will have the disorder. The typical appearance of achondroplastic dwarfism can be seen at birth. Symptoms may include: abnormal hands, bowed legs, decreased muscle tone, disproportionately large head, prominent forehead, shortened arms and legs, short stature, spinal stenosis, and spine curvatures called kyphosis and lordosis. Achondroplasia most often develops spontaneously and prevention is not always possible.", "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: Gastroparesis, also called delayed gastric emptying, is a disorder that slows or stops the movement of food from the stomach to the small intestine. Normally, the muscles of the stomach, which are controlled by the vagus nerve, contract to break up food and move it through the gastrointestinal (GI) tract. The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anus. The movement of muscles in the GI tract, along with the release of hormones and enzymes, allows for the digestion of food. Gastroparesis can occur when the vagus nerve is damaged by illness or injury and the stomach muscles stop working normally. Food then moves slowly from the stomach to the small intestine or stops moving altogether.Gastroparesis slows or stops the movement of food from the stomach to the small intestine.Gastroparesis slows or stops the movement of food from the stomach to the small intestine. 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. People with diabetes have high levels of blood glucose, also called blood sugar. Over time, high blood glucose levels can damage the vagus nerve. Other identifiable causes of gastroparesis include intestinal surgery and nervous system diseases such as Parkinson’s disease or multiple sclerosis. For reasons that are still unclear, gastroparesis is more commonly found in women than in men. 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 symptoms of gastroparesis includegastroesophageal reflux (GER), also called acid reflux or acid regurgitation—a condition in which stomach contents flow back up into the esophagus, the organ that connects the mouth to the stomach pain in the stomach area abdominal bloating lack of appetitegastroesophageal reflux (GER), also called acid reflux or acid regurgitation—a condition in which stomach contents flow back up into the esophagus, the organ that connects the mouth to the stomachpain in the stomach areaabdominal bloatinglack of appetiteSymptoms may be aggravated by eating greasy or rich foods, large quantities of foods with fiber—such as raw fruits and vegetables—or drinking beverages high in fat or carbonation. Symptoms may be mild or severe, and they can occur frequently in some people and less often in others. The symptoms of gastroparesis may also vary in intensity over time in the same individual. Sometimes gastroparesis is difficult to diagnose because people experience a range of symptoms similar to those of other diseases. Gastroparesis is diagnosed through a physical exam, medical history, blood tests, tests to rule out blockage or structural problems in the GI tract, and gastric emptying tests. Tests may also identify a nutritional disorder or underlying disease. To rule out any blockage or other structural problems, the health care provider may perform one or more of the following tests:Upper gastrointestinal (GI) endoscopy. This procedure involves using an endoscope—a small, flexible tube with a light—to see the upper GI tract, which includes the esophagus, stomach, and duodenum—the first part of the small intestine. The test is performed at a hospital or outpatient center by a gastroenterologist—a doctor who specializes in digestive diseases. The endoscope is carefully fed down the esophagus and into the stomach and duodenum. A small camera mounted on the endoscope transmits a video image to a monitor, allowing close examination of the intestinal lining. A person may receive a liquid anesthetic that is gargled or sprayed on the back of the throat. An intravenous (IV) needle is placed in a vein in the arm if general anesthesia is given. The test may show blockage or large bezoars—solid collections of food, mucus, vegetable fiber, hair, or other material that cannot be digested in the stomach—that are sometimes softened, dissolved, or broken up during an upper GI endoscopy. Upper GI series. An upper GI series may be done to look at the small intestine. The test is performed at a hospital or outpatient center by an x-ray technician, and the images are interpreted by a radiologist—a doctor who specializes in medical imaging. Anesthesia is not needed. No eating or drinking is allowed for 8 hours before the procedure, if possible. If the person has diabetes, a health care provider may give different instructions about fasting before the test. During the procedure, the person will stand or sit in front of an x-ray machine and drink barium, a chalky liquid. Barium coats the small intestine, making signs of gastroparesis show up more clearly on x rays. Gastroparesis is likely if the x ray shows food in the stomach after fasting. A person may experience bloating and nausea for a short time after the test. For several days afterward, barium liquid in the GI tract causes stools to be white or light colored. A health care provider will give the person specific instructions about eating and drinking after the test. Ultrasound. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. The procedure is performed in a health care provider’s office, outpatient center, or hospital by a specially trained technician, and the images are interpreted by a radiologist; anesthesia is not needed. The images can show whether gallbladder disease and pancreatitis could be the cause of a person’s digestive symptoms, rather than gastroparesis. Gastric emptying scintigraphy. The test involves eating a bland meal—such as eggs or an egg substitute—that contains a small amount of radioactive material. The test is performed in a radiology center or hospital by a specially trained technician and interpreted by a radiologist; anesthesia is not needed. An external camera scans the abdomen to show where the radioactive material is located. The radiologist is then able to measure the rate of gastric emptying at 1, 2, 3, and 4 hours after the meal. If more than 10 percent of the meal is still in the stomach at 4 hours, the diagnosis of gastroparesis is confirmed. SmartPill. The SmartPill is a small electronic device in capsule form. The SmartPill test is available at specialized outpatient centers. The images are interpreted by a radiologist. The device is swallowed and moves through the entire digestive tract, sending information to a cell-phone-sized receiver worn around the person’s waist or neck. The recorded information provides a detailed record of how quickly food travels through each part of the digestive tract. Gastric emptying breath test. With this test, the person eats a special test meal that includes a natural material with a special type of carbon in it. Then, breath samples are taken over a period of several hours to measure the amount of the material in the exhaled breath. The results allow the health care provider to calculate how fast the stomach is emptying.Upper gastrointestinal (GI) endoscopy. This procedure involves using an endoscope—a small, flexible tube with a light—to see the upper GI tract, which includes the esophagus, stomach, and duodenum—the first part of the small intestine. The test is performed at a hospital or outpatient center by a gastroenterologist—a doctor who specializes in digestive diseases. The endoscope is carefully fed down the esophagus and into the stomach and duodenum. A small camera mounted on the endoscope transmits a video image to a monitor, allowing close examination of the intestinal lining. A person may receive a liquid anesthetic that is gargled or sprayed on the back of the throat. An intravenous (IV) needle is placed in a vein in the arm if general anesthesia is given. The test may show blockage or large bezoars—solid collections of food, mucus, vegetable fiber, hair, or other material that cannot be digested in the stomach—that are sometimes softened, dissolved, or broken up during an upper GI endoscopy.Upper gastrointestinal (GI) endoscopy.Upper GI series. An upper GI series may be done to look at the small intestine. The test is performed at a hospital or outpatient center by an x-ray technician, and the images are interpreted by a radiologist—a doctor who specializes in medical imaging. Anesthesia is not needed. No eating or drinking is allowed for 8 hours before the procedure, if possible. If the person has diabetes, a health care provider may give different instructions about fasting before the test. During the procedure, the person will stand or sit in front of an x-ray machine and drink barium, a chalky liquid. Barium coats the small intestine, making signs of gastroparesis show up more clearly on x rays. Gastroparesis is likely if the x ray shows food in the stomach after fasting. A person may experience bloating and nausea for a short time after the test. For several days afterward, barium liquid in the GI tract causes stools to be white or light colored. A health care provider will give the person specific instructions about eating and drinking after the test.Upper GI series.Ultrasound. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. The procedure is performed in a health care provider’s office, outpatient center, or hospital by a specially trained technician, and the images are interpreted by a radiologist; anesthesia is not needed. The images can show whether gallbladder disease and pancreatitis could be the cause of a person’s digestive symptoms, rather than gastroparesis.Ultrasound.Gastric emptying scintigraphy. The test involves eating a bland meal—such as eggs or an egg substitute—that contains a small amount of radioactive material. The test is performed in a radiology center or hospital by a specially trained technician and interpreted by a radiologist; anesthesia is not needed. An external camera scans the abdomen to show where the radioactive material is located. The radiologist is then able to measure the rate of gastric emptying at 1, 2, 3, and 4 hours after the meal. If more than 10 percent of the meal is still in the stomach at 4 hours, the diagnosis of gastroparesis is confirmed.Gastric emptying scintigraphy.SmartPill. The SmartPill is a small electronic device in capsule form. The SmartPill test is available at specialized outpatient centers. The images are interpreted by a radiologist. The device is swallowed and moves through the entire digestive tract, sending information to a cell-phone-sized receiver worn around the person’s waist or neck. The recorded information provides a detailed record of how quickly food travels through each part of the digestive tract.SmartPill.Gastric emptying breath test. With this test, the person eats a special test meal that includes a natural material with a special type of carbon in it. Then, breath samples are taken over a period of several hours to measure the amount of the material in the exhaled breath. The results allow the health care provider to calculate how fast the stomach is emptying.Gastric emptying breath test. Treatment of gastroparesis depends on the severity of the person’s symptoms. In most cases, treatment does not cure gastroparesis, which is usually a chronic, or long-lasting, condition. Gastroparesis is also a relapsing condition—the symptoms can come and go for periods of time. Treatment helps people manage the condition so they can be as comfortable and active as possible. 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. If less food enters the stomach each time a person eats, the stomach may not become overly full, allowing it to empty more easily. Chewing food well, drinking noncarbonated liquids with a meal, and walking or sitting for 2 hours after a meal—instead of lying down—may assist with gastric emptying.A health care provider may also recommend avoiding high-fat and fibrous foods. Fat naturally slows digestion and some raw vegetables and fruits are more difficult to digest than other foods. Some foods, such as oranges and broccoli, contain fibrous parts that do not digest well. People with gastroparesis should minimize their intake of large portions of these foods because the undigested parts may remain in the stomach too long. Sometimes, the undigested parts form bezoars.When a person has severe symptoms, a liquid or puréed diet may be prescribed. As liquids tend to empty more quickly from the stomach, some people may find a puréed diet helps improve symptoms. Puréed fresh or cooked fruits and vegetables can be incorporated into shakes and soups. A health care provider may recommend a dietitian to help a person plan meals that minimize symptoms and ensure all nutritional needs are met.When the most extreme cases of gastroparesis lead to severe nausea, vomiting, and dehydration, urgent care may be required at a medical facility where IV fluids can be given.MedicationsSeveral prescription medications are available to treat gastroparesis. A combination of medications may be used to find the most effective treatment.Metoclopramide (Reglan). This medication stimulates stomach muscle contractions to help with gastric emptying. Metoclopramide also helps reduce nausea and vomiting. The medication is taken 20 to 30 minutes before meals and at bedtime. Possible side effects of metoclopramide include fatigue, sleepiness, and depression. Currently, this is the only medication approved by the FDA for treatment of gastroparesis. However, the FDA has placed a black box warning on this medication because of rare reports of it causing an irreversible neurologic side effect called tardive dyskinesia—a disorder that affects movement.Metoclopramide (Reglan).Erythromycin. This antibiotic, prescribed at low doses, may improve gastric emptying. Like metaclopramide, erythromycin works by increasing the contractions that move food through the stomach. Possible side effects of erythromycin include nausea, vomiting, and abdominal cramps.Erythromycin.Other medications. Other medications may be used to treat symptoms and problems related to gastroparesis. For example, medications known as antiemetics are used to help control nausea and vomiting.Other medications.Botulinum ToxinBotulinum toxin is a nerve blocking agent also known as Botox. After passing an endoscope into the stomach, a health care provider injects the Botox into the pylorus, the opening from the stomach into the duodenum. Botox is supposed to help keep the pylorus open for longer periods of time and improve symptoms of gastroparesis. Although some initial research trials showed modest improvement in gastroparesis symptoms and the rate of gastric emptying following the injections, other studies have failed to show the same degree of effectiveness of the Botox injections.11Gastric Electrical StimulationThis treatment alternative may be effective for some people whose nausea and vomiting do not improve with dietary changes or medications. A gastric neurostimulator is a surgically implanted battery-operated device that sends mild electrical pulses to the stomach muscles to help control nausea and vomiting. The procedure may be performed at a hospital or outpatient center by a gastroenterologist. General anesthesia may be required. The gastroenterologist makes several tiny incisions in the abdomen and inserts a laparoscope—a thin tube with a tiny video camera attached. The camera sends a magnified image from inside the stomach to a video monitor, giving the gastroenterologist a close-up view of the tissues. Once implanted, the settings on the battery-operated device can be adjusted to determine the settings that best control symptoms.JejunostomyIf medications and dietary changes don’t work, and the person is losing weight or requires frequent hospitalization for dehydration, a health care provider may recommend surgically placing a feeding tube through the abdominal wall directly into a part of the small intestine called the jejunum. The surgical procedure is known as a jejunostomy. The procedure is performed by a surgeon at a hospital or outpatient center. Anesthesia is needed. The feeding tube bypasses the stomach and delivers a special liquid food with nutrients directly into the jejunum. The jejunostomy is used only when gastroparesis is extremely severe.Parenteral NutritionWhen gastroparesis is so severe that dietary measures and other treatments are not helping, a health care provider may recommend parenteral nutrition—an IV liquid food mixture supplied through a special tube in the chest. The procedure is performed by a surgeon at a hospital or outpatient center; anesthesia is needed. The surgeon inserts a thin, flexible tube called a catheter into a chest vein, with the catheter opening outside the skin. A bag containing liquid nutrients is attached to the catheter, and the nutrients are transported through the catheter into the chest vein and into the bloodstream. This approach is a less preferable alternative to a jejunostomy and is usually a temporary treatment to get through a difficult period of gastroparesis. An elevated blood glucose level directly interferes with normal stomach emptying, so good blood glucose control in people with diabetes is important. However, gastroparesis can make blood glucose control difficult. When food that has been delayed in the stomach finally enters the small intestine and is absorbed, blood glucose levels rise. Gastric emptying is unpredictable with gastroparesis, causing a person’s blood glucose levels to be erratic and difficult to control.The primary treatment goals for gastroparesis related to diabetes are to improve gastric emptying and regain control of blood glucose levels. In addition to the dietary changes and treatments already described, a health care provider will likely adjust the person’s insulin regimen.To better control blood glucose, people with diabetes and gastroparesis may need totake insulin more often or change the type of insulin they take take insulin after meals, instead of before check blood glucose levels frequently after eating and administer insulin when necessarytake insulin more often or change the type of insulin they taketake insulin after meals, instead of beforecheck blood glucose levels frequently after eating and administer insulin when necessaryA health care provider will give specific instructions for taking insulin based on the individual’s needs and the severity of gastroparesis.In some cases, the dietitian may suggest eating several liquid or puréed meals a day until gastroparesis symptoms improve and blood glucose levels are more stable. The problems of gastroparesis can includesevere dehydration due to persistent vomiting gastroesophageal reflux disease (GERD), which is GER that occurs more than twice a week for a few weeks; GERD can lead to esophagitis— irritation of the esophagus bezoars, which can cause nausea, vomiting, obstruction, or interfere with absorption of some medications in pill form difficulty managing blood glucose levels in people with diabetes malnutrition due to poor absorption of nutrients or a low calorie intake decreased quality of life, including work absences due to severe symptomssevere dehydration due to persistent vomitinggastroesophageal reflux disease (GERD), which is GER that occurs more than twice a week for a few weeks; GERD can lead to esophagitis— irritation of the esophagusbezoars, which can cause nausea, vomiting, obstruction, or interfere with absorption of some medications in pill formdifficulty managing blood glucose levels in people with diabetesmalnutrition due to poor absorption of nutrients or a low calorie intakedecreased quality of life, including work absences due to severe symptoms Gastroparesis, also called delayed gastric emptying, is a disorder that slows or stops the movement of food from the stomach to the small intestine. 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. People with diabetes have high levels of blood glucose, also called blood sugar. Over time, high blood glucose levels can damage the vagus nerve. 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.Gastroparesis, also called delayed gastric emptying, is a disorder that slows or stops the movement of food from the stomach to the small intestine.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. People with diabetes have high levels of blood glucose, also called blood sugar. Over time, high blood glucose levels can damage the vagus nerve.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. 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.Find out if clinical trials are right for youWhat clinical trials are open?Clinical trials that are currently open and are recruiting can be viewed at www.ClinicalTrials.gov.www.ClinicalTrials.govThis information may contain content about medications and, when taken as prescribed, the conditions they treat. When prepared, this content included the most current information available. For updates or for questions about any medications, contact the U.S. Food and Drug Administration toll-free at 1-888-INFO-FDA (1-888-463-6332) or visit www.fda.gov. Consult your health care provider for more information.This information may contain content about medications and, when taken as prescribed, the conditions they treat. When prepared, this content included the most current information available. For updates or for questions about any medications, contact the U.S. Food and Drug Administration toll-free at 1-888-INFO-FDA (1-888-463-6332) or visit www.fda.gov. Consult your health care provider for more information.www.fda.govThe U.S. Government does not endorse or favor any specific commercial product or company. Trade, proprietary, or company names appearing in this document are used only because they are considered necessary in the context of the information provided. If a product is not mentioned, the omission does not mean or imply that the product is unsatisfactory.The U.S. Government does not endorse or favor any specific commercial product or company. Trade, proprietary, or company names appearing in this document are used only because they are considered necessary in the context of the information provided. If a product is not mentioned, the omission does not mean or imply that the product is unsatisfactory.What is gastroparesis? Gastroparesis, also called delayed gastric emptying, is a disorder that slows or stops the movement of food from the stomach to the small intestine. Normally, the muscles of the stomach, which are controlled by the vagus nerve, contract to break up food and move it through the gastrointestinal (GI) tract. The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anus. The movement of muscles in the GI tract, along with the release of hormones and enzymes, allows for the digestion of food. Gastroparesis can occur when the vagus nerve is damaged by illness or injury and the stomach muscles stop working normally. Food then moves slowly from the stomach to the small intestine or stops moving altogether. Gastroparesis slows or stops the movement of food from the stomach to the small intestine. What causes gastroparesis? 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. People with diabetes have high levels of blood glucose, also called blood sugar. Over time, high blood glucose levels can damage the vagus nerve. Other identifiable causes of gastroparesis include intestinal surgery and nervous system diseases such as Parkinson’s disease or multiple sclerosis. For reasons that are still unclear, gastroparesis is more commonly found in women than in men. What are the symptoms 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 symptoms of gastroparesis include gastroesophageal reflux (GER), also called acid reflux or acid regurgitation—a condition in which stomach contents flow back up into the esophagus, the organ that connects the mouth to the stomach pain in the stomach area abdominal bloating lack of appetite Symptoms may be aggravated by eating greasy or rich foods, large quantities of foods with fiber—such as raw fruits and vegetables—or drinking beverages high in fat or carbonation. Symptoms may be mild or severe, and they can occur frequently in some people and less often in others. The symptoms of gastroparesis may also vary in intensity over time in the same individual. Sometimes gastroparesis is difficult to diagnose because people experience a range of symptoms similar to those of other diseases. How is gastroparesis diagnosed? Gastroparesis is diagnosed through a physical exam, medical history, blood tests, tests to rule out blockage or structural problems in the GI tract, and gastric emptying tests. Tests may also identify a nutritional disorder or underlying disease. To rule out any blockage or other structural problems, the health care provider may perform one or more of the following tests: Upper gastrointestinal (GI) endoscopy. This procedure involves using an endoscope—a small, flexible tube with a light—to see the upper GI tract, which includes the esophagus, stomach, and duodenum—the first part of the small intestine. The test is performed at a hospital or outpatient center by a gastroenterologist—a doctor who specializes in digestive diseases. The endoscope is carefully fed down the esophagus and into the stomach and duodenum. A small camera mounted on the endoscope transmits a video image to a monitor, allowing close examination of the intestinal lining. A person may receive a liquid anesthetic that is gargled or sprayed on the back of the throat. An intravenous (IV) needle is placed in a vein in the arm if general anesthesia is given. The test may show blockage or large bezoars—solid collections of food, mucus, vegetable fiber, hair, or other material that cannot be digested in the stomach—that are sometimes softened, dissolved, or broken up during an upper GI endoscopy. Upper GI series. An upper GI series may be done to look at the small intestine. The test is performed at a hospital or outpatient center by an x-ray technician, and the images are interpreted by a radiologist—a doctor who specializes in medical imaging. Anesthesia is not needed. No eating or drinking is allowed for 8 hours before the procedure, if possible. If the person has diabetes, a health care provider may give different instructions about fasting before the test. During the procedure, the person will stand or sit in front of an x-ray machine and drink barium, a chalky liquid. Barium coats the small intestine, making signs of gastroparesis show up more clearly on x rays. Gastroparesis is likely if the x ray shows food in the stomach after fasting. A person may experience bloating and nausea for a short time after the test. For several days afterward, barium liquid in the GI tract causes stools to be white or light colored. A health care provider will give the person specific instructions about eating and drinking after the test. Ultrasound. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. The procedure is performed in a health care provider’s office, outpatient center, or hospital by a specially trained technician, and the images are interpreted by a radiologist; anesthesia is not needed. The images can show whether gallbladder disease and pancreatitis could be the cause of a person’s digestive symptoms, rather than gastroparesis. Gastric emptying scintigraphy. The test involves eating a bland meal—such as eggs or an egg substitute—that contains a small amount of radioactive material. The test is performed in a radiology center or hospital by a specially trained technician and interpreted by a radiologist; anesthesia is not needed. An external camera scans the abdomen to show where the radioactive material is located. The radiologist is then able to measure the rate of gastric emptying at 1, 2, 3, and 4 hours after the meal. If more than 10 percent of the meal is still in the stomach at 4 hours, the diagnosis of gastroparesis is confirmed. SmartPill. The SmartPill is a small electronic device in capsule form. The SmartPill test is available at specialized outpatient centers. The images are interpreted by a radiologist. The device is swallowed and moves through the entire digestive tract, sending information to a cell-phone-sized receiver worn around the person’s waist or neck. The recorded information provides a detailed record of how quickly food travels through each part of the digestive tract. Gastric emptying breath test. With this test, the person eats a special test meal that includes a natural material with a special type of carbon in it. Then, breath samples are taken over a period of several hours to measure the amount of the material in the exhaled breath. The results allow the health care provider to calculate how fast the stomach is emptying. How is gastroparesis treated? Treatment of gastroparesis depends on the severity of the person’s symptoms. In most cases, treatment does not cure gastroparesis, which is usually a chronic, or long-lasting, condition. Gastroparesis is also a relapsing condition—the symptoms can come and go for periods of time. Treatment helps people manage the condition so they can be as comfortable and active as possible. Eating, Diet, and Nutrition 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. If less food enters the stomach each time a person eats, the stomach may not become overly full, allowing it to empty more easily. Chewing food well, drinking noncarbonated liquids with a meal, and walking or sitting for 2 hours after a meal—instead of lying down—may assist with gastric emptying. A health care provider may also recommend avoiding high-fat and fibrous foods. Fat naturally slows digestion and some raw vegetables and fruits are more difficult to digest than other foods. Some foods, such as oranges and broccoli, contain fibrous parts that do not digest well. People with gastroparesis should minimize their intake of large portions of these foods because the undigested parts may remain in the stomach too long. Sometimes, the undigested parts form bezoars. When a person has severe symptoms, a liquid or puréed diet may be prescribed. As liquids tend to empty more quickly from the stomach, some people may find a puréed diet helps improve symptoms. Puréed fresh or cooked fruits and vegetables can be incorporated into shakes and soups. A health care provider may recommend a dietitian to help a person plan meals that minimize symptoms and ensure all nutritional needs are met. When the most extreme cases of gastroparesis lead to severe nausea, vomiting, and dehydration, urgent care may be required at a medical facility where IV fluids can be given. Medications Several prescription medications are available to treat gastroparesis. A combination of medications may be used to find the most effective treatment. Metoclopramide (Reglan). This medication stimulates stomach muscle contractions to help with gastric emptying. Metoclopramide also helps reduce nausea and vomiting. The medication is taken 20 to 30 minutes before meals and at bedtime. Possible side effects of metoclopramide include fatigue, sleepiness, and depression. Currently, this is the only medication approved by the FDA for treatment of gastroparesis. However, the FDA has placed a black box warning on this medication because of rare reports of it causing an irreversible neurologic side effect called tardive dyskinesia—a disorder that affects movement. Erythromycin. This antibiotic, prescribed at low doses, may improve gastric emptying. Like metaclopramide, erythromycin works by increasing the contractions that move food through the stomach. Possible side effects of erythromycin include nausea, vomiting, and abdominal cramps. Other medications. Other medications may be used to treat symptoms and problems related to gastroparesis. For example, medications known as antiemetics are used to help control nausea and vomiting. Botulinum Toxin Botulinum toxin is a nerve blocking agent also known as Botox. After passing an endoscope into the stomach, a health care provider injects the Botox into the pylorus, the opening from the stomach into the duodenum. Botox is supposed to help keep the pylorus open for longer periods of time and improve symptoms of gastroparesis. Although some initial research trials showed modest improvement in gastroparesis symptoms and the rate of gastric emptying following the injections, other studies have failed to show the same degree of effectiveness of the Botox injections.1 Gastric Electrical Stimulation This treatment alternative may be effective for some people whose nausea and vomiting do not improve with dietary changes or medications. A gastric neurostimulator is a surgically implanted battery-operated device that sends mild electrical pulses to the stomach muscles to help control nausea and vomiting. The procedure may be performed at a hospital or outpatient center by a gastroenterologist. General anesthesia may be required. The gastroenterologist makes several tiny incisions in the abdomen and inserts a laparoscope—a thin tube with a tiny video camera attached. The camera sends a magnified image from inside the stomach to a video monitor, giving the gastroenterologist a close-up view of the tissues. Once implanted, the settings on the battery-operated device can be adjusted to determine the settings that best control symptoms. Jejunostomy If medications and dietary changes don’t work, and the person is losing weight or requires frequent hospitalization for dehydration, a health care provider may recommend surgically placing a feeding tube through the abdominal wall directly into a part of the small intestine called the jejunum. The surgical procedure is known as a jejunostomy. The procedure is performed by a surgeon at a hospital or outpatient center. Anesthesia is needed. The feeding tube bypasses the stomach and delivers a special liquid food with nutrients directly into the jejunum. The jejunostomy is used only when gastroparesis is extremely severe. Parenteral Nutrition When gastroparesis is so severe that dietary measures and other treatments are not helping, a health care provider may recommend parenteral nutrition—an IV liquid food mixture supplied through a special tube in the chest. The procedure is performed by a surgeon at a hospital or outpatient center; anesthesia is needed. The surgeon inserts a thin, flexible tube called a catheter into a chest vein, with the catheter opening outside the skin. A bag containing liquid nutrients is attached to the catheter, and the nutrients are transported through the catheter into the chest vein and into the bloodstream. This approach is a less preferable alternative to a jejunostomy and is usually a temporary treatment to get through a difficult period of gastroparesis. How is gastroparesis treated if a person has diabetes? An elevated blood glucose level directly interferes with normal stomach emptying, so good blood glucose control in people with diabetes is important. However, gastroparesis can make blood glucose control difficult. When food that has been delayed in the stomach finally enters the small intestine and is absorbed, blood glucose levels rise. Gastric emptying is unpredictable with gastroparesis, causing a person’s blood glucose levels to be erratic and difficult to control. The primary treatment goals for gastroparesis related to diabetes are to improve gastric emptying and regain control of blood glucose levels. In addition to the dietary changes and treatments already described, a health care provider will likely adjust the person’s insulin regimen. To better control blood glucose, people with diabetes and gastroparesis may need to take insulin more often or change the type of insulin they take take insulin after meals, instead of before check blood glucose levels frequently after eating and administer insulin when necessary A health care provider will give specific instructions for taking insulin based on the individual’s needs and the severity of gastroparesis. In some cases, the dietitian may suggest eating several liquid or puréed meals a day until gastroparesis symptoms improve and blood glucose levels are more stable. What are the problems of gastroparesis? The problems of gastroparesis can include severe dehydration due to persistent vomiting gastroesophageal reflux disease (GERD), which is GER that occurs more than twice a week for a few weeks; GERD can lead to esophagitis— irritation of the esophagus bezoars, which can cause nausea, vomiting, obstruction, or interfere with absorption of some medications in pill form difficulty managing blood glucose levels in people with diabetes malnutrition due to poor absorption of nutrients or a low calorie intake decreased quality of life, including work absences due to severe symptoms Points to Remember Gastroparesis, also called delayed gastric emptying, is a disorder that slows or stops the movement of food from the stomach to the small intestine. 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. People with diabetes have high levels of blood glucose, also called blood sugar. Over time, high blood glucose levels can damage the vagus nerve. 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. References [1] Bai Y, Xu MJ, Yang X, et al. A systematic review on intrapyloric botulinum toxin injection for gastroparesis. Digestion. 2010;81(1):27–34. Clinical Trials 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. This information may contain content about medications and, when taken as prescribed, the conditions they treat. When prepared, this content included the most current information available. For updates or for questions about any medications, contact the U.S. Food and Drug Administration toll-free at 1-888-INFO-FDA (1-888-463-6332) or visit www.fda.gov. Consult your health care provider for more information. The U.S. Government does not endorse or favor any specific commercial product or company. Trade, proprietary, or company names appearing in this document are used only because they are considered necessary in the context of the information provided. If a product is not mentioned, the omission does not mean or imply that the product is unsatisfactory.", "role": "user" }, { "content": "Gastroparesis, also called delayed gastric emptying, is a disorder that slows or stops the movement of food from the stomach to the small intestine. ... For reasons that are still unclear, gastroparesis is more commonly found in women than in men. 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 symptoms of gastroparesis includegastroesophageal reflux (GER), 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. ... 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. ... 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. ... a health care provider may recommend surgically placing a feeding tube through the abdominal wall directly into a part of the small intestine called the jejunum. The surgical procedure is known as a jejunostomy.", "role": "assistant" } ]

[ { "content": "subjective vertigo Can macular degeneration in only one eye cause dizziness?\n\n Dizziness Overview Dizziness is a term used to describe a range of sensations, such as feeling faint, woozy, weak or unsteady. Dizziness that creates the false sense that you or your surroundings are spinning or moving is called vertigo. Dizziness is one of the more common reasons adults visit their doctors. Frequent dizzy spells or constant dizziness can significantly affect your life. But dizziness rarely signals a life-threatening condition. Treatment of dizziness depends on the cause and your symptoms. It's usually effective, but the problem may recur. Symptoms People experiencing dizziness may describe it as any of a number of sensations, such as: - A false sense of motion or spinning (vertigo) - Lightheadedness or feeling faint - Unsteadiness or a loss of balance - A feeling of floating, wooziness or heavy-headedness These feelings may be triggered or worsened by walking, standing up or moving your head. Your dizziness may accompanied by nausea or be so sudden or severe that you need to sit or lie down. The episode may last seconds or days and may recur. When to see a doctor Call 911 or seek emergency medical help if you experience dizziness with: - A sudden or severe headache - Ongoing vomiting - A sudden change in speech, vision or hearing - Stumbling or difficulty walking - Fainting - Chest pain or an irregular heart rate - Numbness or weakness - Shortness of breath - A high fever - A very stiff neck - A head injury - Seizures Consult with your doctor if you experience recurrent, sudden, severe dizziness or prolonged episodes of dizziness, faintness, lightheadedness or vertigo. Causes Dizziness has many possible causes, including inner ear disturbance, motion sickness and medication effects. Sometimes it's caused by an underlying health condition, such as poor circulation, infection or injury. The way dizziness makes you feel and your triggers provide clues for possible causes. How long the dizziness lasts and any other symptoms you have also help pinpoint the cause. Inner ear problems that cause dizziness (vertigo) Your sense of balance depends on the combined input from the various parts of your sensory system. These include your: - Eyes, which help you determine where your body is in space and how it's moving - Sensory nerves, which send messages to your brain about body movements and positions - Inner ear, which houses sensors that help detect gravity and back-and-forth motion Vertigo is the false sense that your surroundings are spinning or moving. With inner ear disorders, your brain receives signals from the inner ear that aren't consistent with what your eyes and sensory nerves are receiving. Vertigo is what results as your brain works to sort out the confusion. - Benign paroxysmal positional vertigo (BPPV). This condition causes an intense and brief but false sense that you're spinning or moving. These episodes are triggered by a rapid change in head movement, such as when you turn over in bed, sit up or experience a blow to the head. BPPV is the most common cause of vertigo. - Infection. A viral infection of the vestibular nerve, called vestibular neuritis, can cause intense, constant vertigo. If you also have sudden hearing loss, you may have labyrinthitis. - Meniere's disease. This disease involves the excessive buildup of fluid in your inner ear. It's characterized by sudden episodes of vertigo lasting as long as several hours. You may also experience fluctuating hearing loss, ringing in the ear and the feeling of a plugged ear. - Migraine. People who experience migraines may have episodes of vertigo or other types of dizziness even when they're not having a severe headache. Such vertigo episodes can last minutes to hours and may be associated with headache as well as light and noise sensitivity. Circulation problems that cause dizziness You may feel dizzy, faint or off balance if your heart isn't pumping enough blood to your brain. Causes include: - Drop in blood pressure. A dramatic drop in your systolic blood pressure - the higher number in your blood pressure reading - may result in brief lightheadedness or a feeling of faintness. It can occur after sitting up or standing too quickly. This condition is also called orthostatic hypotension. - Poor blood circulation. Conditions such as cardiomyopathy, heart attack, heart arrhythmia and transient ischemic attack could cause dizziness. And a decrease in blood volume may cause inadequate blood flow to your brain or inner ear. Other causes of dizziness - Neurological conditions. Some neurological disorders - such as Parkinson's disease and multiple sclerosis - can lead to progressive loss of balance. - Medications. Dizziness can be a side effect of certain medications - such as anti-seizure drugs, antidepressants, sedatives and tranquilizers. In particular, blood pressure lowering medications may cause faintness if they lower your blood pressure too much. - Anxiety disorders. Certain anxiety disorders may cause lightheadedness or a woozy feeling often referred to as dizziness. These include panic attacks and a fear of leaving home or being in large, open spaces (agoraphobia). - Low iron levels (anemia). Other signs and symptoms that may occur along with dizziness if you have anemia include fatigue, weakness and pale skin. - Low blood sugar (hypoglycemia). This condition generally occurs in people with diabetes who use insulin. Dizziness (lightheadedness) may be accompanied by sweating and anxiety. - Overheating and dehydration. If you're active in hot weather, or if you don't drink enough fluids, you may feel dizzy from overheating (hyperthermia) or from dehydration. This is especially true if you take certain heart medications. Risk factors Factors that may increase your risk of getting dizzy include: - Age. Older adults are more likely to have medical conditions that cause dizziness, especially a sense of imbalance. They're also more likely to take medications that can cause dizziness. - A past episode of dizziness. If you've experienced dizziness before, you're more likely to get dizzy in the future. Diagnosis If your doctor suspects you're having or may have had a stroke, are older or suffered a blow to the head, he or she may immediately order an MRI or CT scan. Most people visiting their doctor because of dizziness will first be asked about their symptoms and medications and then be given a physical examination. During this exam, your doctor will check how you walk and maintain your balance and how the major nerves of your central nervous system are working. You may also need a hearing test and balance tests, including: - Eye movement testing. Your doctor may watch the path of your eyes when you track a moving object. And you may be given an eye motion test in which cold and warm water or air are placed in your ear canal. - Head movement testing. If your doctor suspects your vertigo is caused by benign paroxysmal positional vertigo, he or she may do a simple head movement test called the Dix-Hallpike maneuver to verify the diagnosis. - Posturography. This test tells your doctor which parts of the balance system you rely on the most and which parts may be giving you problems. You stand in your bare feet on a platform and try to keep your balance under various conditions. - Rotary-chair testing. During this test you sit in a computer-controlled chair that moves very slowly in a full circle. At faster speeds, it moves back and forth in a very small arc. In addition, you may be given blood tests to check for infection and other tests to check heart and blood vessel health. Treatment Dizziness often gets better without treatment. Within a couple of weeks, the body usually adapts to whatever is causing it. If you seek treatment, your doctor will base it on the cause of your condition and your symptoms. It may include medications and balance exercises. Even if no cause is found or if your dizziness persists, prescription drugs and other treatments may make your symptoms more manageable. Medications - Water pills. If you have Meniere's disease, your doctor may prescribe a water pill (diuretic). This along with a low-salt diet may help reduce how often you have dizziness episodes. - Medications that reduce the dizziness. Antihistamines such as meclizine (Antivert) may offer short-term relief from vertigo. Anticholinergics help reduce dizziness. They include scopolamine skin patches (Transderm Scop). - Anti-nausea medications. Your doctor may prescribe a drug to provide immediate relief of nausea. Some of these can cause drowsiness. - Anti-anxiety medications. Diazepam (Valium) and alprazolam (Xanax) are in a class of drugs called benzodiazepines, which may cause addiction. They may also cause drowsiness. - Preventive medicine for migraine. Certain medicines may help prevent attacks of migraine. Therapy - Head position maneuvers. A technique called canalith repositioning (or Epley maneuver) usually helps resolve benign paroxysmal positional vertigo more quickly than simply waiting for your dizziness to go away. It can be done by your doctor, an audiologist or a physical therapist and involves maneuvering the position of your head. It's usually effective after one or two treatments. Before undergoing this procedure, tell your care provider if you have a neck or back condition, a detached retina or blood vessel problems. - Balance therapy. You may learn specific exercises to help make your balance system less sensitive to motion. This physical therapy technique is called vestibular rehabilitation. It is used for people with dizziness from inner ear conditions such as vestibular neuritis. - Psychotherapy. This type of therapy may help people whose dizziness is caused by anxiety disorders. Surgical or other procedures - Injections. Your doctor may inject your inner ear with the antibiotic gentamicin to disable the balance function. The unaffected ear takes over that function. - Removal of the inner ear sense organ. A procedure that's rarely used is called labyrinthectomy. It disables the vestibular labyrinth in the affected ear. The other ear takes over the balance function. This technique may be used if you have serious hearing loss and your dizziness hasn't responded to other treatments. Lifestyle and home remedies Dizziness usually goes away on its own. If you tend to experience repeated episodes of dizziness, consider these tips: - Be aware of the possibility of losing your balance, which can lead to falling and serious injury. - Avoid moving suddenly and walk with a cane for stability, if needed. - Fall-proof your home by removing tripping hazards such as area rugs and exposed electrical cords. Use nonslip mats on your bath and shower floors. Use good lighting. - Sit or lie down immediately when you feel dizzy. Lie still with your eyes closed in a darkened room if you're experiencing a severe episode of vertigo. - Avoid driving a car or operating heavy machinery if you experience frequent dizziness without warning. - Avoid using caffeine, alcohol, salt and tobacco. Excessive use of these substances can worsen your signs and symptoms. - Drink enough fluids, eat a healthy diet, get enough sleep and avoid stress. - If your dizziness is caused by a medication, talk with your doctor about discontinuing it or lowering the dose. - If your dizziness comes with nausea, try an over-the-counter (nonprescription) antihistamine, such as meclizine (Antivert) or one containing dimenhydrinate (Dramamine). These may cause drowsiness. Nondrowsy antihistamines aren't as effective. - If your dizziness is caused by overheating or dehydration, rest in a cool place and drink water or a sports drink (Gatorade, Powerade, others). ", "role": "user" }, { "content": "Dizziness has many possible causes, including inner ear disturbance, motion sickness and medication effects. Sometimes it's caused by an underlying health condition, such as poor circulation, infection or injury. The way dizziness makes you feel and your triggers provide clues for possible causes. How long the dizziness lasts and any other symptoms you have also help pinpoint the cause. Inner ear problems that cause dizziness (vertigo) Your sense of balance depends on the combined input from the various parts of your sensory system. These include your: - Eyes, which help you determine where your body is in space and how it's moving - Sensory nerves, which send messages to your brain about body movements and positions - Inner ear, which houses sensors that help detect gravity and back-and-forth motion Vertigo is the false sense that your surroundings are spinning or moving. With inner ear disorders, your brain receives signals from the inner ear that aren't consistent with what your eyes and sensory nerves are receiving. Vertigo is what results as your brain works to sort out the confusion.", "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\nIrritable Bowel Syndrome (IBS) (How can my diet treat the symptoms of IBS?): 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.Fiber may improve constipation symptoms caused by IBS because it makes stool soft and easier to pass. Fiber is a part of foods such as whole-grain breads and cereals, beans, fruits, and vegetables. The U.S. Department of Agriculture and U.S. Department of Health and Human Services state in its Dietary Guidelines for Americans, 2010 (PDF, 2.963 MB) that adults should get 22 to 34 grams of fiber a day.3While fiber may help constipation, it may not reduce the abdominal discomfort or pain of IBS. In fact, some people with IBS may feel a bit more abdominal discomfort after adding more fiber to their diet. 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": "user" }, { "content": "Changing your diet to eat smaller portions and smaller meals more often may help your irritable bowel syndrome (IBS.) Foods that are low in fat and high in carbohydrates, such as pasta, rice, whole-grain breads and cereals, fruits, and vegetables, may also help. Add these foods to the diet slowly, increasing by 2-3 grams a day to prevent causing gas and triggering IBS symptoms.", "role": "assistant" } ]

[ { "content": "what is copd\n\nWhat is COPD?: Chronic obstructive pulmonary disease, or COPD, is a progressive lung disease in which the airways of the lungs become damaged, making it hard to breathe. You may also have heard COPD called other names, like emphysema or chronic bronchitis. In people who have COPD, the airways that carry air in and out of the lungs are partially blocked, making it difficult to get air in and out. COPD is a major cause of death and illness throughout the world. It kills more than 120,000 Americans each year. That's one death every 4 minutes. How COPD Affects Airways The \"airways\" are the tubes that carry air in and out of the lungs through the nose and mouth. The airways of the lungs branch out like an upside-down tree. At the end of each branch are many small, balloon-like air sacs. In healthy people, the airways and air sacs are elastic (stretchy). When you breathe in, each air sac fills up with air, like a small balloon, and when you breathe out, the balloon deflates and the air goes out. In people with COPD, the airways and air sacs lose their shape and become floppy. Less air gets in and less air goes out of the airways because - The airways and air sacs lose their elasticity like an old rubber band. - The walls between many of the air sacs are destroyed. - The walls of the airways become thick and inflamed or swollen. - Cells in the airways make more mucus or sputum than usual, which tends to clog the airways. The airways and air sacs lose their elasticity like an old rubber band. The walls between many of the air sacs are destroyed. The walls of the airways become thick and inflamed or swollen. Cells in the airways make more mucus or sputum than usual, which tends to clog the airways. COPD Develops Slowly, Has No Cure When COPD is severe, shortness of breath and other symptoms of COPD can get in the way of even the most basic tasks, such as doing light housework, taking a walk, even washing and dressing. COPD develops slowly, and it may be many years before you notice symptoms like feeling short of breath. Most of the time, COPD is diagnosed in middle-aged or older people. There is no cure for COPD. The damage to your airways and lungs cannot be reversed, but there are things you can do to control the disabling effects of the disease. COPD is not contagious. You cannot catch it from someone else.", "role": "user" }, { "content": "Chronic obstructive pulmonary disease, or COPD, is a progressive lung disease in which the airways of the lungs become damaged, making it hard to breathe. When COPD is severe, shortness of breath and other symptoms of COPD can get in the way of even the most basic tasks, such as doing light housework, taking a walk, even washing and dressing. COPD develops slowly, and it may be many years before you notice symptoms like feeling short of breath. Most of the time, COPD is diagnosed in middle-aged or older people. There is no cure for COPD. The damage to your airways and lungs cannot be reversed, but there are things you can do to control the disabling effects of the disease. COPD is not contagious. You cannot catch it from someone else.", "role": "assistant" } ]

[ { "content": "how to deal with anxiety\n\nSeparation anxiety in children (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", "role": "user" }, { "content": "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. For older children who have not outgrown separation anxiety, treatments may include anti-anxiety medicines, new parenting techniques, and counseling.", "role": "assistant" } ]

[ { "content": "what is the treatment for lymphoma\n\n Primary lymphoma of the brain Brain lymphoma Cerebral lymphoma Primary lymphoma of the central nervous system PCNSL Lymphoma - brain Summary Primary lymphoma of the brain is cancer of white blood cells that starts in the brain. Causes The cause of primary brain lymphoma is not known. People with a weakened immune system are at high risk for primary lymphoma of the brain. Common causes of a weakened immune system include HIV/AIDS and having had an organ transplant (especially heart transplant). Primary lymphoma of the brain may be linked to Epstein-Barr Virus (EBV), especially in people with HIV/AIDS. EBV is the virus that causes mononucleosis. Primary brain lymphoma is more common in people ages 45 to 70. The rate of primary brain lymphoma is rising. But this cancer is still very rare. Symptoms Symptoms of primary brain lymphoma may include any of the following: Changes in speech or vision Confusion or hallucinations Fever Headaches or seizures Leaning to one side when walking Weakness in hands or loss of coordination Numbness to hot, cold, and pain Personality changes Weight loss Exams and Tests The following tests may be done to help diagnose a primary lymphoma of the brain: Biopsy of the brain Head CT scan or MRI Spinal tap (lumbar puncture) Treatment Primary lymphoma of the brain is usually first treated with corticosteroids. These medicines are used to control swelling and improve symptoms. The main treatment is with chemotherapy. Younger people may receive high-dose chemotherapy, possibly followed by an autologous stem cell transplant. Radiation therapy of the whole brain may be done after chemotherapy. Boosting the immune system, such as in those with HIV/AIDS, may also be tried. You and your health care provider may need to manage other concerns during your treatment, including: Having chemotherapy at home Managing your pets during chemotherapy Bleeding problems Dry mouth Eating enough calories Safe eating during cancer treatment Outlook (Prognosis) Without treatment, people with primary brain lymphoma survive for less than 2 months. Those treated with chemotherapy often survive 3 to 4 years or more. This depends on whether the tumor stays in remission. Survival may improve with autologous stem cell transplant. Possible Complications Possible complications include: Chemotherapy side effects, including low blood counts Radiation side effects, including confusion, headaches, nervous system (neurologic) problems, and tissue death Return (recurrence) of the lymphoma Review Date 1/19/2018 Updated by: Richard LoCicero, MD, private practice specializing in hematology and medical oncology, Longstreet Cancer Center, Gainesville, GA. 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": "Primary lymphoma of the brain is usually first treated with corticosteroids to control swelling and improve symptoms. The main treatment is with chemotherapy. Younger patients may receive high-dose chemotherapy, followed by an autologous stem cell transplant. Radiation therapy of the whole brain may be done after chemotherapy. Boosting the immune system, such as in those with HIV, may also be tried.", "role": "assistant" } ]

[ { "content": "how to prevent conjunctivitis\n\nNeonatal conjunctivitis (Prevention): Pregnant women should get treatment for diseases spread through sexual contact to prevent newborn conjunctivitis caused by these infections. Putting eye drops into all infants' eyes in the delivery room right after birth can help prevent many infections. (Most states have laws requiring this treatment.) When a mother has active herpes sores at the time of delivery, a Cesarean section (C-section) is recommended to prevent serious illness in the baby.", "role": "user" }, { "content": "To help prevent newborn conjunctivitis, pregnant women should get treatment for diseases spread through sexual contact. Putting eye drops into all infants' eyes in the delivery room after birth can also help prevent infections.", "role": "assistant" } ]

[ { "content": "what are the risk factors of type ii diabetes\n\n Risk Factors for Type 2 Diabetes Risk Factors for Type 2 Diabetes You can take steps to help prevent or delay type 2 diabetes by losing weight if you are overweight, eating fewer calories, and being more physically active. Talk with your health care professional about any of the health conditions listed above that may require medical treatment. Managing these health problems may help reduce your chances of developing type 2 diabetes. Also, ask your health care professional about any medicines you take that might increase your risk. ", "role": "user" }, { "content": "You can take steps to help prevent or delay type 2 diabetes by losing weight if you are overweight, eating fewer calories, and being more physically active. Talk with your health care professional about any of the health conditions listed above that may require medical treatment. Managing these health problems may help reduce your chances of developing type 2 diabetes. Also, ask your health care professional about any medicines you take that might increase your risk.", "role": "assistant" } ]