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[ { "content": "prostate cancer using seeds aimed at maligmem tumors is this a safe decision\n\n Prostate Cancer Overview The prostate gland makes fluid that forms part of semen. The prostate lies just below the bladder in front of the rectum. It surrounds the urethra (the tube that carries urine and semen through the penis and out of the body). Prostate cancer is the most common cancer in men in the United States, after skin cancer. It is the second leading cause of death from cancer in men. Prostate cancer occurs more often in African-American men than in white men. African-American men with prostate cancer are more likely to die from the disease than white men with prostate cancer. Almost all prostate cancers are adenocarcinomas (cancers that begin in cells that make and release mucus and other fluids). Prostate cancer often has no early symptoms. Advanced prostate cancer can cause men to urinate more often or have a weaker flow of urine, but these symptoms can also be caused by benign prostate conditions. Prostate cancer usually grows very slowly. Most men with prostate cancer are older than 65 years and do not die from the disease. Finding and treating prostate cancer before symptoms occur may not improve health or help you live longer. Talk to your doctor about your risk of prostate cancer and whether you need screening tests. General Information About Prostate Cancer Key Points - Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the prostate. - Signs of prostate cancer include a weak flow of urine or frequent urination. - Tests that examine the prostate and blood are used to detect (find) and diagnose prostate cancer. - Certain factors affect prognosis (chance of recovery) and treatment options. Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the prostate. The prostate is a gland in the male reproductive system. It lies just below the bladder (the organ that collects and empties urine) and in front of the rectum (the lower part of the intestine). It is about the size of a walnut and surrounds part of the urethra (the tube that empties urine from the bladder). The prostate gland makes fluid that is part of the semen. Enlarge Anatomy of the male reproductive and urinary systems, showing the prostate, testicles, bladder, and other organs. Prostate cancer is most common in older men. In the U.S., about 1 out of 5 men will be diagnosed with prostate cancer. Signs of prostate cancer include a weak flow of urine or frequent urination. These and other signs and symptoms may be caused by prostate cancer or by other conditions. Check with your doctor if you have any of the following: - Weak or interrupted (\"stop-and-go\") flow of urine. - Sudden urge to urinate. - Frequent urination (especially at night). - Trouble starting the flow of urine. - Trouble emptying the bladder completely. - Pain or burning while urinating. - Blood in the urine or semen. - A pain in the back, hips, or pelvis that doesn't go away. - Shortness of breath, feeling very tired, fast heartbeat, dizziness, or pale skin caused by anemia. Other conditions may cause the same symptoms. As men age, the prostate may get bigger and block the urethra or bladder. This may cause trouble urinating or sexual problems. The condition is called benign prostatic hyperplasia (BPH), and although it is not cancer, surgery may be needed. The symptoms of benign prostatic hyperplasia or of other problems in the prostate may be like symptoms of prostate cancer. Enlarge Normal prostate and benign prostatic hyperplasia (BPH). A normal prostate does not block the flow of urine from the bladder. An enlarged prostate presses on the bladder and urethra and blocks the flow of urine. Tests that examine the prostate and blood are used to detect (find) and diagnose prostate cancer. The following tests and procedures may be used: - Physical exam and history : An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments will also be taken. - Digital rectal exam (DRE): An exam of the rectum. The doctor or nurse inserts a lubricated, gloved finger into the rectum and feels the prostate through the rectal wall for lumps or abnormal areas. Enlarge Digital rectal exam (DRE). The doctor inserts a gloved, lubricated finger into the rectum and feels the prostate to check for anything abnormal. - Prostate-specific antigen (PSA) test : A test that measures the level of PSA in the blood. PSA is a substance made by the prostate that may be found in an increased amount in the blood of men who have prostate cancer. PSA levels may also be high in men who have an infection or inflammation of the prostate or BPH (an enlarged, but noncancerous, prostate). - Transrectal ultrasound : A procedure in which a probe that is about the size of a finger is inserted into the rectum to check the prostate. The probe is used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. Transrectal ultrasound may be used during a biopsy procedure. Enlarge Transrectal ultrasound. An ultrasound probe is inserted into the rectum to check the prostate. The probe bounces sound waves off body tissues to make echoes that form a sonogram (computer picture) of the prostate. - Transrectal magnetic resonance imaging (MRI): A procedure that uses a strong magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. A probe that gives off radio waves is inserted into the rectum near the prostate. This helps the MRI machine make clearer pictures of the prostate and nearby tissue. A transrectal MRI is done to find out if the cancer has spread outside the prostate into nearby tissues. This procedure is also called nuclear magnetic resonance imaging (NMRI). - Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist. The pathologist will check the tissue sample to see if there are cancer cells and find out the Gleason score. The Gleason score ranges from 2-10 and describes how likely it is that a tumor will spread. The lower the number, the less likely the tumor is to spread. A transrectal biopsy is used to diagnose prostate cancer. A transrectal biopsy is the removal of tissue from the prostate by inserting a thin needle through the rectum and into the prostate. This procedure is usually done using transrectal ultrasound to help guide where samples of tissue are taken from. A pathologist views the tissue under a microscope to look for cancer cells. Enlarge Transrectal biopsy. An ultrasound probe is inserted into the rectum to show where the tumor is. Then a needle is inserted through the rectum into the prostate to remove tissue from the prostate. Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery) and treatment options depend on the following: - The stage of the cancer (level of PSA, Gleason score, grade of the tumor, how much of the prostate is affected by the cancer, and whether the cancer has spread to other places in the body). - The patient's age. - Whether the cancer has just been diagnosed or has recurred (come back). Treatment options also may depend on the following: - Whether the patient has other health problems. - The expected side effects of treatment. - Past treatment for prostate cancer. - The wishes of the patient. Most men diagnosed with prostate cancer do not die of it. Stages of Prostate Cancer Key Points - After prostate cancer has been diagnosed, tests are done to find out if cancer cells have spread within the prostate or to other parts of the body. - 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 prostate cancer: - Stage I - Stage II - Stage III - Stage IV After prostate cancer has been diagnosed, tests are done to find out if cancer cells have spread within the prostate or to other parts of the body. The process used to find out if cancer has spread within the prostate or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The results of the tests used to diagnose prostate cancer are often also used to stage the disease. (See the General Information section.) In prostate cancer, staging tests may not be done unless the patient has symptoms or signs that the cancer has spread, such as bone pain, a high PSA level, or a high Gleason score. The following tests and procedures also may be used in the staging process: - Bone scan : A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones with cancer and is detected by a scanner. Enlarge Bone scan. A small amount of radioactive material is injected into the patient's bloodstream and collects in abnormal cells in the bones. As the patient lies on a table that slides under the scanner, the radioactive material is detected and images are made on a computer screen or film. - MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI). - CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. - Pelvic lymphadenectomy : A surgical procedure to remove the lymph nodes in the pelvis. A pathologist views the tissue under a microscope to look for cancer cells. - Seminal vesicle biopsy : The removal of fluid from the seminal vesicles (glands that make semen) using a needle. A pathologist views the fluid under a microscope to look for cancer cells. - ProstaScint scan : A procedure to check for cancer that has spread from the prostate to other parts of the body, such as the lymph nodes. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material attaches to prostate cancer cells and is detected by a scanner. The radioactive material shows up as a bright spot on the picture in areas where there are a lot of prostate cancer cells. The stage of the cancer is based on the results of the staging and diagnostic tests, including the prostate-specific antigen (PSA) test and the Gleason score. The tissue samples removed during the biopsy are used to find out the Gleason score. The Gleason score ranges from 2-10 and describes how different the cancer cells look from normal cells and how likely it is that the tumor will spread. The lower the number, the less likely the tumor is to spread. There are three ways that cancer spreads in the body. Cancer can spread through tissue, the lymph system, and the blood: - Tissue. The cancer spreads from where it began by growing into nearby areas. - Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body. - Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body. Cancer may spread from where it began to other parts of the body. When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood. - Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body. - Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body. The metastatic tumor is the same type of cancer as the primary tumor. For example, if prostate cancer spreads to the bone, the cancer cells in the bone are actually prostate cancer cells. The disease is metastatic prostate cancer, not bone cancer. Denosumab, a monoclonal antibody, may be used to prevent bone metastases. The following stages are used for prostate cancer: Enlarge As prostate cancer progresses from Stage I to Stage IV, the cancer cells grow within the prostate, through the outer layer of the prostate into nearby tissue, and then to lymph nodes or other parts of the body. Stage I In stage I, cancer is found in the prostate only. The cancer: - is found by needle biopsy (done for a high PSA level) or in a small amount of tissue during surgery for other reasons (such as benign prostatic hyperplasia). The PSA level is lower than 10 and the Gleason score is 6 or lower; or - is found in one-half or less of one lobe of the prostate. The PSA level is lower than 10 and the Gleason score is 6 or lower; or - cannot be felt during a digital rectal exam and cannot be seen in imaging tests. Cancer is found in one-half or less of one lobe of the prostate. The PSA level and the Gleason score are not known. Stage II In stage II, cancer is more advanced than in stage I, but has not spread outside the prostate. Stage II is divided into stages IIA and IIB. In stage IIA, cancer: - is found by needle biopsy (done for a high PSA level) or in a small amount of tissue during surgery for other reasons (such as benign prostatic hyperplasia). The PSA level is lower than 20 and the Gleason score is 7; or - is found by needle biopsy (done for a high PSA level) or in a small amount of tissue during surgery for other reasons (such as benign prostatic hyperplasia). The PSA level is at least 10 but lower than 20 and the Gleason score is 6 or lower; or - is found in one-half or less of one lobe of the prostate. The PSA level is at least 10 but lower than 20 and the Gleason score is 6 or lower; or - is found in one-half or less of one lobe of the prostate. The PSA level is lower than 20 and the Gleason score is 7; or - is found in more than one-half of one lobe of the prostate. In stage IIB, cancer: - is found in opposite sides of the prostate. The PSA can be any level and the Gleason score can range from 2 to 10; or - cannot be felt during a digital rectal exam and cannot be seen in imaging tests. The PSA level is 20 or higher and the Gleason score can range from 2 to 10; or - cannot be felt during a digital rectal exam and cannot be seen in imaging tests. The PSA can be any level and the Gleason score is 8 or higher. Stage III In stage III, cancer has spread beyond the outer layer of the prostate and may have spread to the seminal vesicles. The PSA can be any level and the Gleason score can range from 2 to 10. Stage IV In stage IV, the PSA can be any level and the Gleason score can range from 2 to 10. Also, cancer: - has spread beyond the seminal vesicles to nearby tissue or organs, such as the rectum, bladder, or pelvic wall; or - may have spread to the seminal vesicles or to nearby tissue or organs, such as the rectum, bladder, or pelvic wall. Cancer has spread to nearby lymph nodes; or - has spread to distant parts of the body, which may include lymph nodes or bones. Prostate cancer often spreads to the bones. Stage I In stage I, cancer is found in the prostate only. The cancer: - is found by needle biopsy (done for a high PSA level) or in a small amount of tissue during surgery for other reasons (such as benign prostatic hyperplasia). The PSA level is lower than 10 and the Gleason score is 6 or lower; or - is found in one-half or less of one lobe of the prostate. The PSA level is lower than 10 and the Gleason score is 6 or lower; or - cannot be felt during a digital rectal exam and cannot be seen in imaging tests. Cancer is found in one-half or less of one lobe of the prostate. The PSA level and the Gleason score are not known. Stage II In stage II, cancer is more advanced than in stage I, but has not spread outside the prostate. Stage II is divided into stages IIA and IIB. In stage IIA, cancer: - is found by needle biopsy (done for a high PSA level) or in a small amount of tissue during surgery for other reasons (such as benign prostatic hyperplasia). The PSA level is lower than 20 and the Gleason score is 7; or - is found by needle biopsy (done for a high PSA level) or in a small amount of tissue during surgery for other reasons (such as benign prostatic hyperplasia). The PSA level is at least 10 but lower than 20 and the Gleason score is 6 or lower; or - is found in one-half or less of one lobe of the prostate. The PSA level is at least 10 but lower than 20 and the Gleason score is 6 or lower; or - is found in one-half or less of one lobe of the prostate. The PSA level is lower than 20 and the Gleason score is 7; or - is found in more than one-half of one lobe of the prostate. In stage IIB, cancer: - is found in opposite sides of the prostate. The PSA can be any level and the Gleason score can range from 2 to 10; or - cannot be felt during a digital rectal exam and cannot be seen in imaging tests. The PSA level is 20 or higher and the Gleason score can range from 2 to 10; or - cannot be felt during a digital rectal exam and cannot be seen in imaging tests. The PSA can be any level and the Gleason score is 8 or higher. Stage III In stage III, cancer has spread beyond the outer layer of the prostate and may have spread to the seminal vesicles. The PSA can be any level and the Gleason score can range from 2 to 10. Stage IV In stage IV, the PSA can be any level and the Gleason score can range from 2 to 10. Also, cancer: - has spread beyond the seminal vesicles to nearby tissue or organs, such as the rectum, bladder, or pelvic wall; or - may have spread to the seminal vesicles or to nearby tissue or organs, such as the rectum, bladder, or pelvic wall. Cancer has spread to nearby lymph nodes; or - has spread to distant parts of the body, which may include lymph nodes or bones. Prostate cancer often spreads to the bones. Recurrent Prostate Cancer Treatment Option Overview Key Points - There are different types of treatment for patients with prostate cancer. - Seven types of standard treatment are used: - Watchful waiting or active surveillance - Surgery - Radiation therapy and radiopharmaceutical therapy - Hormone therapy - Chemotherapy - Biologic therapy - Bisphosphonate therapy - There are treatments for bone pain caused by bone metastases or hormone therapy. - New types of treatment are being tested in clinical trials. - Cryosurgery - High-intensity-focused ultrasound therapy - Proton beam radiation 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 prostate cancer. Different types of treatment are available for patients with prostate cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment. Seven types of standard treatment are used: Watchful waiting or active surveillance Watchful waiting and active surveillance are treatments used for older men who do not have signs or symptoms or have other medical conditions and for men whose prostate cancer is found during a screening test. Watchful waiting is closely monitoring a patient's condition without giving any treatment until signs or symptoms appear or change. Treatment is given to relieve symptoms and improve quality of life. Active surveillance is closely following a patient's condition without giving any treatment unless there are changes in test results. It is used to find early signs that the condition is getting worse. In active surveillance, patients are given certain exams and tests, including digital rectal exam, PSA test, transrectal ultrasound, and transrectal needle biopsy, to check if the cancer is growing. When the cancer begins to grow, treatment is given to cure the cancer. Other terms that are used to describe not giving treatment to cure prostate cancer right after diagnosis are observation, watch and wait, and expectant management. Surgery Patients in good health whose tumor is in the prostate gland only may be treated with surgery to remove the tumor. The following types of surgery are used: - Radical prostatectomy: A surgical procedure to remove the prostate, surrounding tissue, and seminal vesicles. There are two types of radical prostatectomy: - Retropubic prostatectomy: A surgical procedure to remove the prostate through an incision (cut) in the abdominal wall. Removal of nearby lymph nodes may be done at the same time. - Perineal prostatectomy: A surgical procedure to remove the prostate through an incision (cut) made in the perineum (area between the scrotum and anus). Nearby lymph nodes may also be removed through a separate incision in the abdomen. Enlarge Two types of radical prostatectomy. In a retropubic prostatectomy, the prostate is removed through an incision in the wall of the abdomen. In a perineal prostatectomy, the prostate is removed through an incision in the area between the scrotum and the anus. - Pelvic lymphadenectomy: A surgical procedure to remove the lymph nodes in the pelvis. A pathologist views the tissue under a microscope to look for cancer cells. If the lymph nodes contain cancer, the doctor will not remove the prostate and may recommend other treatment. - Transurethral resection of the prostate (TURP): A surgical procedure to remove tissue from the prostate using a resectoscope (a thin, lighted tube with a cutting tool) inserted through the urethra. This procedure is done to treat benign prostatic hypertrophy and it is sometimes done to relieve symptoms caused by a tumor before other cancer treatment is given. TURP may also be done in men whose tumor is in the prostate only and who cannot have a radical prostatectomy. Enlarge Transurethral resection of the prostate (TURP). Tissue is removed from the prostate using a resectoscope (a thin, lighted tube with a cutting tool at the end) inserted through the urethra. Prostate tissue that is blocking the urethra is cut away and removed through the resectoscope. In some cases, nerve-sparing surgery can be done. This type of surgery may save the nerves that control erection. However, men with large tumors or tumors that are very close to the nerves may not be able to have this surgery. Possible problems after prostate cancer surgery include the following: - Impotence. - Leakage of urine from the bladder or stool from the rectum. - Shortening of the penis (1 to 2 centimeters). The exact reason for this is not known. - Inguinal hernia (bulging of fat or part of the small intestine through weak muscles into the groin). Inguinal hernia may occur more often in men treated with radical prostatectomy than in men who have some other types of prostate surgery, radiation therapy, or prostate biopsy alone. It is most likely to occur within the first 2 years after radical prostatectomy. Radiation therapy and radiopharmaceutical therapy Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are different types of radiation therapy: - External radiation therapy uses a machine outside the body to send radiation toward the cancer. Conformal radiation is a type of external radiation therapy that uses a computer to make a 3-dimensional (3-D) picture of the tumor and shapes the radiation beams to fit the tumor. This allows a high dose of radiation to reach the tumor and causes less damage to nearby healthy tissue. Hypofractionated radiation therapy may be given because it has a more convenient treatment schedule. Hypofractionated radiation therapy is radiation treatment in which a larger than usual total dose of radiation is given once a day over a shorter period of time (fewer days) compared to standard radiation therapy. Hypofractionated radiation therapy may have worse side effects than standard radiation therapy, depending on the schedules used. - Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. In early-stage prostate cancer, the radioactive seeds are placed in the prostate using needles that are inserted through the skin between the scrotum and rectum. The placement of the radioactive seeds in the prostate is guided by images from transrectal ultrasound or computed tomography (CT). The needles are removed after the radioactive seeds are placed in the prostate. - Radiopharmaceutical therapy uses a radioactive substance to treat cancer. Radiopharmaceutical therapy includes the following: - Alpha emitter radiation therapy uses a radioactive substance to treat prostate cancer that has spread to the bone. A radioactive substance called radium-223 is injected into a vein and travels through the bloodstream. The radium-223 collects in areas of bone with cancer and kills the cancer cells. The way the radiation therapy is given depends on the type and stage of the cancer being treated. External radiation therapy, internal radiation therapy, and radiopharmaceutical therapy are used to treat prostate cancer. Men treated with radiation therapy for prostate cancer have an increased risk of having bladder and/or gastrointestinal cancer. Radiation therapy can cause impotence and urinary problems that may get worse with age. Hormone therapy Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances made by glands in the body and circulated in the bloodstream. In prostate cancer, male sex hormones can cause prostate cancer to grow. Drugs, surgery, or other hormones are used to reduce the amount of male hormones or block them from working. Hormone therapy for prostate cancer may include the following: - Abiraterone acetate can prevent prostate cancer cells from making androgens. It is used in men with advanced prostate cancer that has not gotten better with other hormone therapy. - Orchiectomy is a surgical procedure to remove one or both testicles, the main source of male hormones, such as testosterone, to decrease the amount of hormone being made. - Estrogens (hormones that promote female sex characteristics) can prevent the testicles from making testosterone. However, estrogens are seldom used today in the treatment of prostate cancer because of the risk of serious side effects. - Luteinizing hormone-releasing hormone agonists can stop the testicles from making testosterone. Examples are leuprolide, goserelin, and buserelin. - Antiandrogens can block the action of androgens (hormones that promote male sex characteristics), such as testosterone. Examples are flutamide, bicalutamide, enzalutamide, and nilutamide. - Drugs that can prevent the adrenal glands from making androgens include ketoconazole and aminoglutethimide. Hot flashes, impaired sexual function, loss of desire for sex, and weakened bones may occur in men treated with hormone therapy. Other side effects include diarrhea, nausea, and itching. See Drugs Approved for Prostate Cancer for more information. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated. See Drugs Approved for Prostate Cancer for more information. Biologic therapy Biologic therapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. Sipuleucel-T is a type of biologic therapy used to treat prostate cancer that has metastasized (spread to other parts of the body). See Drugs Approved for Prostate Cancer for more information. Bisphosphonate therapy Bisphosphonate drugs, such as clodronate or zoledronate, reduce bone disease when cancer has spread to the bone. Men who are treated with antiandrogen therapy or orchiectomy are at an increased risk of bone loss. In these men, bisphosphonate drugs lessen the risk of bone fracture (breaks). The use of bisphosphonate drugs to prevent or slow the growth of bone metastases is being studied in clinical trials. Watchful waiting or active surveillance Watchful waiting and active surveillance are treatments used for older men who do not have signs or symptoms or have other medical conditions and for men whose prostate cancer is found during a screening test. Watchful waiting is closely monitoring a patient's condition without giving any treatment until signs or symptoms appear or change. Treatment is given to relieve symptoms and improve quality of life. Active surveillance is closely following a patient's condition without giving any treatment unless there are changes in test results. It is used to find early signs that the condition is getting worse. In active surveillance, patients are given certain exams and tests, including digital rectal exam, PSA test, transrectal ultrasound, and transrectal needle biopsy, to check if the cancer is growing. When the cancer begins to grow, treatment is given to cure the cancer. Other terms that are used to describe not giving treatment to cure prostate cancer right after diagnosis are observation, watch and wait, and expectant management. Surgery Patients in good health whose tumor is in the prostate gland only may be treated with surgery to remove the tumor. The following types of surgery are used: - Radical prostatectomy: A surgical procedure to remove the prostate, surrounding tissue, and seminal vesicles. There are two types of radical prostatectomy: - Retropubic prostatectomy: A surgical procedure to remove the prostate through an incision (cut) in the abdominal wall. Removal of nearby lymph nodes may be done at the same time. - Perineal prostatectomy: A surgical procedure to remove the prostate through an incision (cut) made in the perineum (area between the scrotum and anus). Nearby lymph nodes may also be removed through a separate incision in the abdomen. Enlarge Two types of radical prostatectomy. In a retropubic prostatectomy, the prostate is removed through an incision in the wall of the abdomen. In a perineal prostatectomy, the prostate is removed through an incision in the area between the scrotum and the anus. - Pelvic lymphadenectomy: A surgical procedure to remove the lymph nodes in the pelvis. A pathologist views the tissue under a microscope to look for cancer cells. If the lymph nodes contain cancer, the doctor will not remove the prostate and may recommend other treatment. - Transurethral resection of the prostate (TURP): A surgical procedure to remove tissue from the prostate using a resectoscope (a thin, lighted tube with a cutting tool) inserted through the urethra. This procedure is done to treat benign prostatic hypertrophy and it is sometimes done to relieve symptoms caused by a tumor before other cancer treatment is given. TURP may also be done in men whose tumor is in the prostate only and who cannot have a radical prostatectomy. Enlarge Transurethral resection of the prostate (TURP). Tissue is removed from the prostate using a resectoscope (a thin, lighted tube with a cutting tool at the end) inserted through the urethra. Prostate tissue that is blocking the urethra is cut away and removed through the resectoscope. In some cases, nerve-sparing surgery can be done. This type of surgery may save the nerves that control erection. However, men with large tumors or tumors that are very close to the nerves may not be able to have this surgery. Possible problems after prostate cancer surgery include the following: - Impotence. - Leakage of urine from the bladder or stool from the rectum. - Shortening of the penis (1 to 2 centimeters). The exact reason for this is not known. - Inguinal hernia (bulging of fat or part of the small intestine through weak muscles into the groin). Inguinal hernia may occur more often in men treated with radical prostatectomy than in men who have some other types of prostate surgery, radiation therapy, or prostate biopsy alone. It is most likely to occur within the first 2 years after radical prostatectomy. Radiation therapy and radiopharmaceutical therapy Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are different types of radiation therapy: - External radiation therapy uses a machine outside the body to send radiation toward the cancer. Conformal radiation is a type of external radiation therapy that uses a computer to make a 3-dimensional (3-D) picture of the tumor and shapes the radiation beams to fit the tumor. This allows a high dose of radiation to reach the tumor and causes less damage to nearby healthy tissue. Hypofractionated radiation therapy may be given because it has a more convenient treatment schedule. Hypofractionated radiation therapy is radiation treatment in which a larger than usual total dose of radiation is given once a day over a shorter period of time (fewer days) compared to standard radiation therapy. Hypofractionated radiation therapy may have worse side effects than standard radiation therapy, depending on the schedules used. - Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. In early-stage prostate cancer, the radioactive seeds are placed in the prostate using needles that are inserted through the skin between the scrotum and rectum. The placement of the radioactive seeds in the prostate is guided by images from transrectal ultrasound or computed tomography (CT). The needles are removed after the radioactive seeds are placed in the prostate. - Radiopharmaceutical therapy uses a radioactive substance to treat cancer. Radiopharmaceutical therapy includes the following: - Alpha emitter radiation therapy uses a radioactive substance to treat prostate cancer that has spread to the bone. A radioactive substance called radium-223 is injected into a vein and travels through the bloodstream. The radium-223 collects in areas of bone with cancer and kills the cancer cells. The way the radiation therapy is given depends on the type and stage of the cancer being treated. External radiation therapy, internal radiation therapy, and radiopharmaceutical therapy are used to treat prostate cancer. Men treated with radiation therapy for prostate cancer have an increased risk of having bladder and/or gastrointestinal cancer. Radiation therapy can cause impotence and urinary problems that may get worse with age. Hormone therapy Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances made by glands in the body and circulated in the bloodstream. In prostate cancer, male sex hormones can cause prostate cancer to grow. Drugs, surgery, or other hormones are used to reduce the amount of male hormones or block them from working. Hormone therapy for prostate cancer may include the following: - Abiraterone acetate can prevent prostate cancer cells from making androgens. It is used in men with advanced prostate cancer that has not gotten better with other hormone therapy. - Orchiectomy is a surgical procedure to remove one or both testicles, the main source of male hormones, such as testosterone, to decrease the amount of hormone being made. - Estrogens (hormones that promote female sex characteristics) can prevent the testicles from making testosterone. However, estrogens are seldom used today in the treatment of prostate cancer because of the risk of serious side effects. - Luteinizing hormone-releasing hormone agonists can stop the testicles from making testosterone. Examples are leuprolide, goserelin, and buserelin. - Antiandrogens can block the action of androgens (hormones that promote male sex characteristics), such as testosterone. Examples are flutamide, bicalutamide, enzalutamide, and nilutamide. - Drugs that can prevent the adrenal glands from making androgens include ketoconazole and aminoglutethimide. Hot flashes, impaired sexual function, loss of desire for sex, and weakened bones may occur in men treated with hormone therapy. Other side effects include diarrhea, nausea, and itching. See Drugs Approved for Prostate Cancer for more information. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated. See Drugs Approved for Prostate Cancer for more information. Biologic therapy Biologic therapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. Sipuleucel-T is a type of biologic therapy used to treat prostate cancer that has metastasized (spread to other parts of the body). See Drugs Approved for Prostate Cancer for more information. Bisphosphonate therapy Bisphosphonate drugs, such as clodronate or zoledronate, reduce bone disease when cancer has spread to the bone. Men who are treated with antiandrogen therapy or orchiectomy are at an increased risk of bone loss. In these men, bisphosphonate drugs lessen the risk of bone fracture (breaks). The use of bisphosphonate drugs to prevent or slow the growth of bone metastases is being studied in clinical trials. There are treatments for bone pain caused by bone metastases or hormone therapy. Prostate cancer that has spread to the bone and certain types of hormone therapy can weaken bones and lead to bone pain. Treatments for bone pain include the following: - Pain medicine. - External radiation therapy. - Strontium-89 (a radioisotope). - Targeted therapy with a monoclonal antibody, such as denosumab. - Bisphosphonate therapy. - Corticosteroids. See the PDQ summary on Pain for more information. New types of treatment are being tested in clinical trials. This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI website. Cryosurgery Cryosurgery is a treatment that uses an instrument to freeze and destroy prostate cancer cells. Ultrasound is used to find the area that will be treated. This type of treatment is also called cryotherapy. Cryosurgery can cause impotence and leakage of urine from the bladder or stool from the rectum. High-intensity-focused ultrasound therapy High-intensity-focused ultrasound therapy is a treatment that uses ultrasound (high-energy sound waves) to destroy cancer cells. To treat prostate cancer, an endorectal probe is used to make the sound waves. Proton beam radiation therapy Proton beam radiation therapy is a type of high-energy, external radiation therapy that targets tumors with streams of protons (small, positively charged particles). This type of radiation therapy is being studied in the treatment of prostate cancer. Cryosurgery Cryosurgery is a treatment that uses an instrument to freeze and destroy prostate cancer cells. Ultrasound is used to find the area that will be treated. This type of treatment is also called cryotherapy. Cryosurgery can cause impotence and leakage of urine from the bladder or stool from the rectum. High-intensity-focused ultrasound therapy High-intensity-focused ultrasound therapy is a treatment that uses ultrasound (high-energy sound waves) to destroy cancer cells. To treat prostate cancer, an endorectal probe is used to make the sound waves. Proton beam radiation therapy Proton beam radiation therapy is a type of high-energy, external radiation therapy that targets tumors with streams of protons (small, positively charged particles). This type of radiation therapy is being studied in the treatment of prostate cancer. Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI's clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website. Follow-up tests may be needed. Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups. Treatment Options by Stage Stage I Prostate Cancer Standard treatment of stage I prostate cancer may include the following: - Watchful waiting. - Active surveillance. If the cancer begins to grow, hormone therapy may be given. - Radical prostatectomy, usually with pelvic lymphadenectomy. Radiation therapy may be given after surgery. - External radiation therapy. Hormone therapy may be given after radiation therapy. - Internal radiation therapy with radioactive seeds. - A clinical trial of high-intensity-focused ultrasound therapy. - A clinical trial of cryosurgery. 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. Stage II Prostate Cancer Standard treatment of stage II prostate cancer may include the following: - Watchful waiting. - Active surveillance. If the cancer begins to grow, hormone therapy may be given. - Radical prostatectomy, usually with pelvic lymphadenectomy. Radiation therapy may be given after surgery. - External radiation therapy. Hormone therapy may be given after radiation therapy. - Internal radiation therapy with radioactive seeds. - A clinical trial of cryosurgery. - A clinical trial of high-intensity-focused ultrasound therapy. - A clinical trial of proton beam radiation therapy. - Clinical trials of new types of treatment, such as hormone therapy followed by radical prostatectomy. 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. Stage III Prostate Cancer Standard treatment of stage III prostate cancer may include the following: - External radiation therapy. Hormone therapy may be given after radiation therapy. - Hormone therapy. Radiation therapy may be given after hormone therapy. - Radical prostatectomy. Radiation therapy may be given after surgery. - Watchful waiting. - Active surveillance. If the cancer begins to grow, hormone therapy may be given. Treatment to control cancer that is in the prostate and lessen urinary symptoms may include the following: - External radiation therapy. - Internal radiation therapy with radioactive seeds. - Hormone therapy. - Transurethral resection of the prostate (TURP). - A clinical trial of new types of radiation therapy. - A clinical trial of cryosurgery. 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. Stage IV Prostate Cancer Standard treatment of stage IV prostate cancer may include the following: - Hormone therapy. - Hormone therapy combined with chemotherapy. - Bisphosphonate therapy. - External radiation therapy. Hormone therapy may be given after radiation therapy. - Alpha emitter radiation therapy. - Watchful waiting. - Active surveillance. If the cancer begins to grow, hormone therapy may be given. - A clinical trial of radical prostatectomy with orchiectomy. Treatment to control cancer that is in the prostate and lessen urinary symptoms may include the following: - Transurethral resection of the prostate (TURP). - 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. Treatment Options for Recurrent Prostate Cancer ", "role": "user" }, { "content": "Standard treatments for prostate cancer include internal radiation therapy with radioactive seeds, as an alternative or combined with hormone therapy, surgery, external radiation, biologics, and bisphosphonate therapy.", "role": "assistant" } ]
[ { "content": "how do you catch hepatitis c\n\nWhat is Hepatitis C?: Your liver is the largest organ inside your body. It helps your body digest food, store energy, and remove poisons. Hepatitis is an inflammation of the liver. One type, hepatitis C, is caused by the hepatitis C virus (HCV). It usually spreads through contact with infected blood. It can also spread through sex with an infected person and from mother to baby during childbirth. Most people who are infected with hepatitis C don't have any symptoms for years. If you do get symptoms, you may feel as if you have the flu. You may also have jaundice, a yellowing of skin and eyes, dark-colored urine, and pale bowel movements. A blood test can tell if you have it. Usually, hepatitis C does not get better by itself. The infection can last a lifetime and may lead to scarring of the liver or liver cancer. Medicines sometimes help, but side effects can be a problem. Serious cases may need a liver transplant. There is no vaccine for HCV. NIH: National Institute of Diabetes and Digestive and Kidney Diseases", "role": "user" }, { "content": "Hepatitis C can be spread through contact with blood already infected by the virus. It can be spread through sex sex with an affected individual, or from the mother to her child during birth.", "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 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. 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. Many health benefits are associated with physical activity and getting the recommended amount of physical activity needed each week. Before starting any exercise program, ask your doctor about what level of physical activity is right for you. Studies have shown some relationship between lack of sleep and obesity. 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. When healthy lifestyle changes are not enough, your doctor may treat your overweight and obesity with FDA-approved medicines. 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. 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. Gastrectomy. Gastric banding. Talk to your doctor to learn more about the benefits and risks of each type of surgery. 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.", "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\nLimb-girdle muscular dystrophy (Treatment): Unfortunately, no definitive treatments for LGMD exist. Management depends on each individual and the specific type of LGMD that the individual has. However, the American Academy of Neurology has developed guidelines for treatment of LGMD including: [5] [6] Weight control to avoid obesity Physical therapy and stretching exercises to promote mobility and prevent contractures (fixed tightening of the muscles) Use of mechanical aids such as canes, walkers, orthotics, and wheelchairs as needed to help ambulation and mobility Monitoring and surgical intervention as needed for orthopedic complications, such as foot deformity and scoliosis cardiomyopathy A team approach to treatment is recommended including a neurologist , pulmonologist , cardiologist , orthopedic surgeon, physiatrist , physical/occupational/ speech therapist , nutritionist , orthopedist , mental health counselors, and geneticist / genetic counselor . [5] [6] While not a currently available treatment option, some studies have shown promising results with the use of gene therapy . More research is needed to prove the safety and efficacy of this treatment approach. [6] Management Guidelines The American Academy of Neurology (AAN), the medical specialty society of neurologists, offers a summary of recommended guidelines for Limb-girdle muscular dystrophy GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions. Project OrphanAnesthesia is a project whose aim is to create peer-reviewed, readily accessible guidelines for patients with rare diseases and for the anesthesiologists caring for them. The project is a collaborative effort of the German Society of Anesthesiology and Intensive Care, Orphanet, the European Society of Pediatric Anesthesia, anesthetists and rare disease experts with the aim to contribute to patient safety.", "role": "user" }, { "content": "Management depends on each individual and the specific type of LGMD that the individual has. However, the American Academy of Neurology has developed guidelines for treatment of LGMD including: Weight control to avoid obesity Physical therapy and stretching exercises to promote mobility and prevent contractures (fixed tightening of the muscles) Use of mechanical aids such as canes, walkers, orthotics, and wheelchairs as needed to help ambulation and mobility Monitoring and surgical intervention as needed for orthopedic complications, such as foot deformity and scoliosis cardiomyopathy A team approach to treatment is recommended including a neurologist , pulmonologist , cardiologist , orthopedic surgeon, physiatrist , physical/occupational/ speech therapist , nutritionist , orthopedist , mental health counselors, and geneticist / genetic counselor . While not a currently available treatment option, some studies have shown promising results with the use of gene therapy . More research is needed to prove the safety and efficacy of this treatment approach.", "role": "assistant" } ]
[ { "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": "what treatment do you use to cure chickenpox\n\n Chickenpox Varicella Chicken pox Summary Chickenpox is a viral infection in which a person develops very itchy blisters all over the body. It was more common in the past. The illness is rare today because of the chickenpox vaccine. Causes Chickenpox is caused by the varicella-zoster virus. It is a member of the herpesvirus family. The same virus also causes shingles in adults. Chickenpox can be spread very easily to others from 1 to 2 days before blisters appear until all the blisters have crusted over. You may get chickenpox: From touching the fluids from a chickenpox blister If someone with the disease coughs or sneezes near you Most cases of chickenpox occur in children younger than age 10. The disease is most often mild, although serious complications may occur. Adults and older children get sicker than younger children in most cases. Children whose mothers have had chickenpox or have received the chickenpox vaccine are not very likely to catch it before they are 1 year old. If they do catch chickenpox, they often have mild cases. This is because antibodies from their mothers' blood help protect them. Children under 1 year old whose mothers have not had chickenpox or the vaccine can get severe chickenpox. Severe chickenpox symptoms are more common in children whose immune system does not work well. Symptoms Most children with chickenpox have the following symptoms before the rash appears: Fever Headache Stomach ache The chickenpox rash occurs about 10 to 21 days after coming into contact with someone who had the disease. In most cases, a child will develop 250 to 500 small, itchy, fluid-filled blisters over red spots on the skin. The blisters are most often first seen on the face, middle of the body, or scalp. After a day or two, the blisters become cloudy and then scab. Meanwhile, new blisters form in groups. They often appear in the mouth, in the vagina, and on the eyelids. Children with skin problems, such as eczema, may get thousands of blisters. Most pox will not leave scars unless they become infected with bacteria from scratching. Some children who have had the vaccine will still develop a mild case of chickenpox. In most cases, they recover much more quickly and have only a few poxes (fewer than 30). These cases are often harder to diagnose. However, these children can still spread chickenpox to others. Exams and Tests Your health care provider can most often diagnose chickenpox by looking at the rash and asking questions about the person's medical history. Small blisters on the scalp confirm the diagnosis in most cases. Lab tests can help confirm the diagnosis, if needed. Treatment Treatment involves keeping the person as comfortable as possible. Here are things to try: Avoid scratching or rubbing the itchy areas. Keep fingernails short to avoid damaging the skin from scratching. Wear cool, light, loose bedclothes. Avoid wearing rough clothing, particularly wool, over an itchy area. Take lukewarm baths using little soap and rinse thoroughly. Try a skin-soothing oatmeal or cornstarch bath. Apply a soothing moisturizer after bathing to soften and cool the skin. Avoid prolonged exposure to excessive heat and humidity. Try over-the-counter oral antihistamines such as diphenhydramine (Benadryl), but be aware of possible side effects, such as drowsiness. Try over-the-counter hydrocortisone cream on itchy areas. Medicines that fight the chickenpox virus are available, but not given to everyone. To work well, the medicine should be started within the first 24 hours of the rash. Antiviral drugs are not very often prescribed to otherwise healthy children who do not have severe symptoms. Adults and teens, who are at risk for more severe symptoms, may benefit from antiviral medicine if it is given early. Antiviral medicine may be very important for those who have skin conditions (such as eczema or recent sunburn), lung conditions (such as asthma), or who have recently taken steroids. Some providers also give antiviral medicines to people in the same household who also develop chickenpox, because they will most often develop more severe symptoms. DO NOT give aspirin or ibuprofen to someone who may have chickenpox. Use of aspirin has been associated with a serious condition called Reye syndrome. Ibuprofen has been associated with more severe secondary infections. Acetaminophen (Tylenol) may be used. A child with chickenpox should not return to school or play with other children until all chickenpox sores have crusted over or dried out. Adults should follow this same rule while considering when to return to work or be around others. Outlook (Prognosis) In most cases, a person recovers without complications. Once you have had chickenpox, the virus often remains dormant or asleep in your body for your lifetime. About 1 in 10 adults will have shingles when the virus re-emerges during a period of stress. Possible Complications Rarely, infection of the brain has occurred. Other problems may include: Reye syndrome Infection of the heart muscle Pneumonia Joint pain or swelling Cerebellar ataxia may appear during the recovery phase or later. This involves a very unsteady walk. Women who get chickenpox during pregnancy can pass the infection to the developing baby. Newborns are at risk for severe infection. When to Contact a Medical Professional Call your provider if you think that your child has chickenpox or if your child is over 12 months of age and has not been vaccinated against chickenpox. Prevention Because chickenpox is airborne and spreads very easily even before the rash appears, it is hard to avoid. A vaccine to prevent chickenpox is part of a child's routine vaccine schedule. The vaccine often prevents the chickenpox disease completely or makes the illness very mild. Talk to your provider if you think your child might be at high risk for complications and might have been exposed. Taking preventive steps right away may be important. Giving the vaccine early after exposure may still reduce the severity of the disease. 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": "Medicines that fight the chickenpox virus are available, but not given to everyone. To work well, the medicine should be started within the first 24 hours of the rash. - Antiviral drugs are not very often prescribed to otherwise healthy children who do not have severe symptoms. Adults and teens, who are at risk for more severe symptoms, may benefit from antiviral medicine if it is given early. ... Treatment involves keeping the person as comfortable as possible. Here are things to try: - Avoid scratching or rubbing the itchy areas. Keep fingernails short to avoid damaging the skin from scratching. - Wear cool, light, loose bedclothes. Avoid wearing rough clothing, particularly wool, over an itchy area. - Take lukewarm baths using little soap and rinse thoroughly. Try a skin-soothing oatmeal or cornstarch bath. - Apply a soothing moisturizer after bathing to soften and cool the skin. - Avoid prolonged exposure to excessive heat and humidity. - Try over-the-counter oral antihistamines such as diphenhydramine (Benadryl), but be aware of possible side effects, such as drowsiness. - Try over-the-counter hydrocortisone cream on itchy areas. Do NOT give aspirin or ibuprofen to someone who may have chickenpox. Use of aspirin has been associated with a serious condition called Reyes syndrome. Ibuprofen has been associated with more severe secondary infections. Acetaminophen (Tylenol) may be used.", "role": "assistant" } ]
[ { "content": "what are the symptoms for cystic fibrosis\n\n Cystic fibrosis Overview Cystic fibrosis is an inherited disorder that causes severe damage to the lungs, digestive system and other organs in the body. Cystic fibrosis affects the cells that produce mucus, sweat and digestive juices. These secreted fluids are normally thin and slippery. But in people with cystic fibrosis, a defective gene causes the secretions to become sticky and thick. Instead of acting as a lubricant, the secretions plug up tubes, ducts and passageways, especially in the lungs and pancreas. Although cystic fibrosis requires daily care, people with the condition are usually able to attend school and work, and often have a better quality of life than people with cystic fibrosis had in previous decades. Improvements in screening and treatments mean people with cystic fibrosis now may live into their mid- to late 30s, on average, and some are living into their 40s and 50s. Cystic fibrosis care at Mayo Clinic Symptoms Screening of newborns for cystic fibrosis is now performed in every state in the United States. As a result, the condition can be diagnosed within the first month of life, before symptoms develop. For people born before newborn screening was performed, it's important to be aware of the signs and symptoms of cystic fibrosis. Cystic fibrosis signs and symptoms vary, depending on the severity of the disease. Even in the same person, symptoms may worsen or improve as time passes. Some people may not experience symptoms until adolescence or adulthood. People with cystic fibrosis have a higher than normal level of salt in their sweat. Parents often can taste the salt when they kiss their children. Most of the other signs and symptoms of cystic fibrosis affect the respiratory system and digestive system. However, adults diagnosed with cystic fibrosis are more likely to have atypical symptoms, such as recurring bouts of inflamed pancreas (pancreatitis), infertility and recurring pneumonia. The thick and sticky mucus associated with cystic fibrosis clogs the tubes that carry air in and out of your lungs. This can cause signs and symptoms such as: - A persistent cough that produces thick mucus (sputum) - Wheezing - Breathlessness - Exercise intolerance - Repeated lung infections - Inflamed nasal passages or a stuffy nose The thick mucus can also block tubes that carry digestive enzymes from your pancreas to your small intestine. Without these digestive enzymes, your intestines aren't able to completely absorb the nutrients in the food you eat. The result is often: - Foul-smelling, greasy stools - Poor weight gain and growth - Intestinal blockage, particularly in newborns (meconium ileus) - Severe constipation Frequent straining while passing stool can cause part of the rectum - the end of the large intestine - to protrude outside the anus (rectal prolapse). When this occurs in children, it may be a sign of cystic fibrosis. Parents should consult a physician knowledgeable about cystic fibrosis. Rectal prolapse in children may sometimes require surgery. Rectal prolapse in children with cystic fibrosis is less common than it was in the past, which may be due to earlier testing, diagnosis and treatment of cystic fibrosis. If you or your child has symptoms of cystic fibrosis - or if someone in your family has cystic fibrosis - talk with your doctor about testing for the disease. Seek immediate medical care if you or your child has difficulty breathing. Causes In cystic fibrosis, a defect (mutation) in a gene changes a protein that regulates the movement of salt in and out of cells. The result is thick, sticky mucus in the respiratory, digestive and reproductive systems, as well as increased salt in sweat. Many different defects can occur in the gene. The type of gene mutation is associated with the severity of the condition. Children need to inherit one copy of the gene from each parent in order to have the disease. If children inherit only one copy, they won't develop cystic fibrosis. However, they will be carriers and possibly pass the gene to their own children. Risk factors - Family history. Because cystic fibrosis is an inherited disorder, it runs in families. - Race. Although cystic fibrosis occurs in all races, it is most common in white people of Northern European ancestry. Complications - Damaged airways (bronchiectasis). Cystic fibrosis is one of the leading causes of bronchiectasis, a condition that damages the airways. This makes it harder to move air in and out of the lungs and clear mucus from the airways (bronchial tubes). - Chronic infections. Thick mucus in the lungs and sinuses provides an ideal breeding ground for bacteria and fungi. People with cystic fibrosis may often have sinus infections, bronchitis or pneumonia. - Growths in the nose (nasal polyps). Because the lining inside the nose is inflamed and swollen, it can develop soft, fleshy growths (polyps). - Coughing up blood (hemoptysis). Over time, cystic fibrosis can cause thinning of the airway walls. As a result, teenagers and adults with cystic fibrosis may cough up blood. - Pneumothorax. This condition, in which air collects in the space that separates the lungs from the chest wall, also is more common in older people with cystic fibrosis. Pneumothorax can cause chest pain and breathlessness. - Respiratory failure. Over time, cystic fibrosis can damage lung tissue so badly that it no longer works. Lung function usually worsens gradually, and it eventually can become life-threatening. - Acute exacerbations. People with cystic fibrosis may experience worsening of their respiratory symptoms, such as coughing and shortness of breath, for several days to weeks. This is called an acute exacerbation and requires treatment in the hospital. - Nutritional deficiencies. Thick mucus can block the tubes that carry digestive enzymes from your pancreas to your intestines. Without these enzymes, your body can't absorb protein, fats or fat-soluble vitamins. - Diabetes. The pancreas produces insulin, which your body needs to use sugar. Cystic fibrosis increases the risk of diabetes. Around 30 percent of people with cystic fibrosis develop diabetes by age 30. - Blocked bile duct. The tube that carries bile from your liver and gallbladder to your small intestine may become blocked and inflamed, leading to liver problems and sometimes gallstones. - Intestinal obstruction. Intestinal obstruction can happen to people with cystic fibrosis at all ages. Children and adults with cystic fibrosis are more likely than are infants to develop intussusception, a condition in which a section of the intestines folds in on itself like an accordion. - Distal intestinal obstruction syndrome (DIOS). DIOS is partial or complete obstruction where the small intestine meets the large intestine. Almost all men with cystic fibrosis are infertile because the tube that connects the testes and prostate gland (vas deferens) is either blocked with mucus or missing entirely. Certain fertility treatments and surgical procedures sometimes make it possible for men with cystic fibrosis to become biological fathers. Although women with cystic fibrosis may be less fertile than other women, it's possible for them to conceive and to have successful pregnancies. Still, pregnancy can worsen the signs and symptoms of cystic fibrosis, so be sure to discuss the possible risks with your doctor. - Thinning of the bones (osteoporosis). People with cystic fibrosis are at higher risk of developing a dangerous thinning of bones. - Electrolyte imbalances and dehydration. Because people with cystic fibrosis have saltier sweat, the balance of minerals in their blood may be upset. Signs and symptoms include increased heart rate, fatigue, weakness and low blood pressure. Diagnosis To diagnose cystic fibrosis, doctors may conduct several tests. Newborn screening and diagnosis Every state in the U.S. now routinely screens newborns for cystic fibrosis. Early diagnosis means treatment can begin immediately. In one screening test, a blood sample is checked for higher than normal levels of a chemical (immunoreactive trypsinogen, or IRT) released by the pancreas. A newborn's IRT levels may be high because of premature birth or a stressful delivery. For that reason other tests may be needed to confirm a diagnosis of cystic fibrosis. Genetic tests may be used in addition to checking the IRT levels to confirm the diagnosis. Doctors may also conduct genetic tests to test for specific defects on the gene responsible for cystic fibrosis. To evaluate if an infant has cystic fibrosis, doctors may also conduct a sweat test when the infant is at least 2 weeks old. In a sweat test, doctors apply a sweat-producing chemical to a small area of skin. They then collect the sweat to test it and see if it's saltier than normal. Testing may be done at a center specializing in cystic fibrosis. Testing of older children and adults Cystic fibrosis tests may be recommended for older children and adults who weren't screened at birth. Your doctor may suggest genetic and sweat tests for cystic fibrosis if you have recurring bouts of inflamed pancreas (pancreatitis), nasal polyps, chronic sinus or lung infections, bronchiectasis, or male infertility. Treatment There is no cure for cystic fibrosis, but treatment can ease symptoms and reduce complications. Close monitoring and early, aggressive intervention is recommended. Managing cystic fibrosis is complex, so consider obtaining treatment at a center staffed by doctors and other staff trained in cystic fibrosis. Doctors may work with a multidisciplinary team of doctors and medical professionals trained in cystic fibrosis to evaluate and treat your condition. The goals of treatment include: - Preventing and controlling infections that occur in the lungs - Removing and loosening mucus from the lungs - Treating and preventing intestinal blockage - Providing adequate nutrition Medications The options may include: - Antibiotics to treat and prevent lung infections - Anti-inflammatory medications to lessen swelling in the airways in your lungs - Mucus-thinning drugs to help you cough up the mucus, which can improve lung function - Inhaled medications called bronchodilators that can help keep your airways open by relaxing the muscles around your bronchial tubes - Oral pancreatic enzymes to help your digestive tract absorb nutrients For those with cystic fibrosis who have certain gene mutations, doctors may recommend a newer medication called ivacaftor (Kalydeco). This medication may improve lung function and weight, and reduce the amount of salt in sweat. It has been approved by the Food and Drug Administration for people with cystic fibrosis who are age 6 and older. The dose depends on your weight and age. Doctors may conduct liver function tests and eye examinations before prescribing ivacaftor and on a regular basis while you're taking it to check for side effects such as liver function abnormalities and cataracts. For people with a certain gene mutation who are age 12 and older, another drug (Orkambi) is available that combines ivacaftor with a medication called lumacaftor. The combination of these medications may improve lung function and reduce the risk of exacerbations. However, some people may experience side effects such as chest discomfort and shortness of breath soon after starting the medication. Some people may also have high blood pressure while taking the medication. Doctors may monitor you for any side effects. Chest physical therapy Loosening the thick mucus in the lungs makes it easier to cough up. Chest physical therapy helps loosen mucus. It is usually done from one to four times a day. A common technique is clapping with cupped hands on the front and back of the chest. Certain breathing techniques also may be used to help loosen the mucus. Your doctor will instruct you about the type of chest physical therapy he or she recommends for you. Mechanical devices also can help loosen lung mucus. These include a vibrating vest or a tube or mask you breathe into. Pulmonary rehabilitation Your doctor may recommend a long-term program that may improve your lung function and overall well-being. Pulmonary rehabilitation is usually done on an outpatient basis and may include: - Physical exercise that may improve your condition - Breathing techniques that may help loosen mucus and improve breathing - Nutritional counseling - Counseling and support - Education about your condition Surgical and other procedures - Nasal polyp removal. Your doctor may recommend surgery to remove nasal polyps that obstruct breathing. - Oxygen therapy. If your blood oxygen level declines, your doctor may recommend that you breathe pure oxygen to prevent high blood pressure in the lungs (pulmonary hypertension). - Endoscopy and lavage. Mucus may be suctioned from obstructed airways through an endoscope. - Feeding tube. Cystic fibrosis interferes with digestion, so you can't absorb nutrients from food very well. Your doctor may suggest temporarily using a feeding tube to deliver extra nutrition while you sleep. This tube may be inserted in your nose and guided to your stomach, or it may be surgically implanted into the abdomen. - Bowel surgery. If a blockage develops in your bowel, you may need surgery to remove it. Intussusception, where a section of bowel has folded in on itself, also may require surgical repair. - Lung transplant. If you have severe breathing problems, life-threatening lung complications or increasing resistance to antibiotics used to treat lung infections, lung transplantation may be an option. Because bacteria line the airways in diseases that cause permanent widening of the large airways (bronchiectasis), such as cystic fibrosis, both lungs need to be replaced. Cystic fibrosis does not recur in transplanted lungs. However, other complications associated with cystic fibrosis - such as sinus infections, diabetes, pancreas problems and osteoporosis - can still occur after a lung transplant. Lifestyle and home remedies You can manage your condition and minimize complications in several ways. Always talk to your doctor before starting home remedies. Cystic fibrosis can cause malnourishment because the enzymes needed for digestion can't reach your small intestine, preventing food from being absorbed. People with cystic fibrosis may need a significantly higher number of calories daily than do people without the condition. A healthy diet is important to maintain good lung function. It's also important to drink lots of fluids, which can help thin the mucus in your lungs. You may work with a dietitian to develop a nutrition plan. Most people with cystic fibrosis need to take pancreatic enzyme capsules with every meal and snack. In addition, your doctor may recommend: - Antacids - Supplemental high-calorie nutrition - Special fat-soluble vitamins - Extra fiber to prevent intestinal blockage - Extra salt, especially during hot weather or before exercising - Adequate water during hot weather In addition to other usual childhood vaccines, people with cystic fibrosis should have the annual flu vaccine and any other vaccines their doctor recommends. Cystic fibrosis doesn't affect the immune system, but children with cystic fibrosis are more likely to develop complications when they become sick. Regular exercise helps loosen mucus in your airways, and strengthens your heart. For many people with cystic fibrosis, participating in sports can improve confidence and self-esteem. Anything that gets you moving, including walking and biking, can help. Don't smoke in your home or car, and don't allow other people to smoke around you or your child. Secondhand smoke is harmful for everyone, but especially for people with cystic fibrosis. Teach all the members of your family to wash their hands thoroughly before eating, after using the bathroom, when coming home from work or school, and after being around a person who is sick. Hand-washing is the best way to protect against infection. You'll have ongoing care from your doctor and other medical professionals. Make sure to attend your regular follow-up appointments. Take your medications as prescribed and follow therapies as instructed. Contact your doctor if you experience any signs or symptoms such as severe constipation, more mucus than usual, blood in your mucus or reduced energy. ", "role": "user" }, { "content": "Cystic fibrosis signs and symptoms vary, depending on the severity of the disease. People with cystic fibrosis have a higher than normal level of salt in their sweat. Parents often can taste the salt when they kiss their children. Most of the other signs and symptoms of cystic fibrosis affect the respiratory system and digestive system. However, adults diagnosed with cystic fibrosis are more likely to have atypical symptoms, such as recurring bouts of inflamed pancreas (pancreatitis), infertility and recurring pneumonia. The thick and sticky mucus associated with cystic fibrosis clogs the tubes that carry air in and out of your lungs. This can cause signs and symptoms such as: - A persistent cough that produces thick mucus (sputum) - Wheezing - Breathlessness - Exercise intolerance - Repeated lung infections - Inflamed nasal passages or a stuffy nose The thick mucus can also block tubes that carry digestive enzymes from your pancreas to your small intestine. Without these digestive enzymes, your intestines aren't able to completely absorb the nutrients in the food you eat. The result is often: - Foul-smelling, greasy stools - Poor weight gain and growth - Intestinal blockage, particularly in newborns (meconium ileus) - Severe constipation Frequent straining while passing stool can cause part of the rectum - the end of the large intestine - to protrude outside the anus (rectal prolapse).", "role": "assistant" } ]
[ { "content": "Asking about Hairy cell leukemia I get report for my father from hospital it is saying that he have Hairy cell leukemia i am here to ask if this dissease dangerous and there is treatment for it Also if The one who have it will live for long or not ? My father age is 55 We discover the dissease by blood test\n\nHairy cell leukemia (Treatment): Treatment isn't always necessary for people with hairy cell leukemia. Because this cancer progresses very slowly and sometimes doesn't progress at all, some people prefer to wait to treat their cancer only if it causes signs and symptoms. The majority of people with hairy cell leukemia eventually need treatment. If your hairy cell leukemia causes signs and symptoms, you may decide to undergo treatment. There is no cure for hairy cell leukemia. But treatments are effective at putting hairy cell leukemia in remission for years. Chemotherapy Doctors consider chemotherapy drugs the first line of treatment for hairy cell leukemia. The great majority of people will experience complete or partial remission through the use of chemotherapy. Two chemotherapy drugs are used in hairy cell leukemia: - Cladribine. Treatment for hairy cell leukemia typically begins with cladribine. You receive a continuous infusion of the drug into a vein over several days. Most people who receive cladribine experience a complete remission that can last for several years. If your hairy cell leukemia returns, you can be treated with cladribine again. Side effects of cladribine may include infection and fever. - Pentostatin (Nipent). Pentostatin causes remission rates similar to cladribine, but it's given on a different schedule. People who take pentostatin receive infusions every other week for three to six months. Side effects of pentostatin may include fever, nausea and infection. Biological treatments Biological therapy attempts to make cancer cells more recognizable to your immune system. Once your immune system identifies cancer cells as intruders, it can set about destroying your cancer. Two types of biological treatments are used in hairy cell leukemia: - Interferon. Currently, the role of interferon in hairy cell leukemia treatment is limited. You might receive interferon if chemotherapy hasn't been effective or if you can't take chemotherapy. Most people experience partial remission with interferon, which is taken for a year. Side effects include flu-like symptoms, such as fever and fatigue. - Rituximab (Rituxan). Rituximab is a monoclonal antibody approved to treat non-Hodgkin lymphoma and chronic lymphocytic leukemia, though it's sometimes used in hairy cell leukemia. If chemotherapy drugs haven't worked for you or you can't take chemotherapy, your doctor might consider rituximab. Side effects of rituximab include fever and infection. Surgery Surgery to remove your spleen (splenectomy) might be an option if your spleen ruptures or if it's enlarged and causing pain. Though removing your spleen can't cure hairy cell leukemia, it can usually restore normal blood counts. Splenectomy isn't commonly used to treat hairy cell leukemia, but it may be helpful in certain situations. Any surgery carries a risk of bleeding and infection.", "role": "user" }, { "content": "Hairy cell leukemia progresses slowly and might not require treatment if it does not cause any symptoms. Although there is no treatment, chemotherapy or biological treatment that stimulates the immune system to fight cancer cells could put hairy cell leukemia in remission for years. Sometimes, removal of the spleen restores normal blood counts.", "role": "assistant" } ]
[ { "content": "what can cause hypoglycemia\n\n Hypoglycemia Overview Hypoglycemia is a condition caused by a very low level of blood sugar (glucose), your body's main energy source. Hypoglycemia is often related to the treatment of diabetes. However, a variety of conditions - many rare - can cause low blood sugar in people without diabetes. Like fever, hypoglycemia isn't a disease itself - it's an indicator of a health problem. Immediate treatment of hypoglycemia is necessary when blood sugar levels are at 70 milligrams per deciliter (mg/dL) or 3.9 millimoles per liter (mmol/L) or below. Treatment involves quick steps to get your blood sugar level back into a normal range either with high-sugar foods or drinks or with medications. Long-term treatment requires identifying and treating the underlying cause of hypoglycemia. Symptoms If blood sugar levels become too low, signs and symptoms may include: - An irregular heart rhythm - Fatigue - Pale skin - Shakiness - Anxiety - Sweating - Hunger - Irritability - Tingling sensation around the mouth - Crying out during sleep As hypoglycemia worsens, signs and symptoms may include: - Confusion, abnormal behavior or both, such as the inability to complete routine tasks - Visual disturbances, such as blurred vision - Seizures - Loss of consciousness People with severe hypoglycemia may appear as if they're intoxicated. They may slur their words and move clumsily. When to see a doctor Seek a doctor's help immediately if: - You have what may be symptoms of hypoglycemia and you don't have diabetes. - You have diabetes and hypoglycemia isn't responding to treatment. Initial treatment of hypoglycemia is drinking juice or regular soft drinks, eating candy or taking glucose tablets. If this treatment doesn't raise your blood sugar and improve your symptoms, contact your doctor right away. Seek emergency help if: - Someone with diabetes or a history of recurring hypoglycemia has symptoms of severe hypoglycemia or loses consciousness Causes Hypoglycemia occurs when your blood sugar (glucose) level falls too low. There are several reasons why this may happen, the most common is a side effect of drugs used to treat diabetes. Blood sugar regulation But to understand how hypoglycemia happens, it helps to know how your body normally processes blood sugar. When you eat, your body breaks down carbohydrates from foods - such as bread, rice, pasta, vegetables, fruit and milk products - into various sugar molecules, including glucose. Glucose is the main energy source for your body, but it can't enter the cells of most of your tissues without the help of insulin - a hormone secreted by your pancreas. When glucose levels rise, certain cells (beta cells) in your pancreas release insulin. This allows glucose to enter the cells and provide the fuel your cells need to function properly. Any extra glucose is stored in your liver and muscles in the form of glycogen. If you haven't eaten for several hours and your blood sugar level drops, another hormone from your pancreas called glucagon signals your liver to break down the stored glycogen and release glucose back into your bloodstream. This keeps your blood sugar level within a normal range until you eat again. Aside from your liver breaking down glycogen into glucose, your body also has the ability to manufacture glucose. This process occurs primarily in your liver, but also in your kidneys. Possible causes, with diabetes People with diabetes may not make enough insulin (type 1 diabetes) or may be less responsive to it (type 2 diabetes). As a result, glucose tends to build up in the bloodstream and may reach dangerously high levels. To correct this problem, someone with diabetes may take insulin or other drugs to lower blood sugar levels. But too much insulin or other diabetes medications may cause your blood sugar level to drop too low, causing hypoglycemia. Hypoglycemia may also happen if you don't eat as much food as usual after taking diabetes medication, or if you exercise more than you normally would. Possible causes, without diabetes Hypoglycemia in people without diabetes is much less common. Causes may include the following: - Medications. Taking someone else's oral diabetes medication accidentally is a possible cause of hypoglycemia. Other medications may cause hypoglycemia, especially in children or in people with kidney failure. One example is quinine (Qualaquin), which is used to treat malaria. - Excessive alcohol consumption. Drinking heavily without eating can block your liver from releasing stored glucose into your bloodstream, causing hypoglycemia. - Some critical illnesses. Severe illnesses of the liver, such as severe hepatitis, can cause hypoglycemia. Disorders of the kidney, which can keep your body from properly excreting medications, can affect glucose levels due to a buildup of those medications. Long-term starvation, as may occur in the eating disorder anorexia nervosa, can result in the depletion of substances your body needs to generate glucose (gluconeogenesis), causing hypoglycemia. - Insulin overproduction. A rare tumor of the pancreas (insulinoma) may cause overproduction of insulin, resulting in hypoglycemia. Other tumors may result in excessive production of insulin-like substances. Enlargement of beta cells of the pancreas that produce insulin (nesidioblastosis) may result in excessive insulin release, causing hypoglycemia. - Hormone deficiencies. Certain disorders of the adrenal glands and the pituitary gland can result in a deficiency of key hormones that regulate glucose production. Children may experience hypoglycemia if they have a deficiency of growth hormone. Hypoglycemia after meals Hypoglycemia usually occurs when you haven't eaten (when you're in a fasting state), but that's not always the case. Sometimes hypoglycemia occurs after meals because the body produces more insulin than is needed. This type of hypoglycemia, called reactive or postprandial hypoglycemia, may occur in people who have had stomach surgery. It may also occur in people who haven't had this surgery. Complications If you ignore the symptoms of hypoglycemia too long, you may lose consciousness. That's because your brain needs glucose to function properly. Recognize the signs and symptoms of hypoglycemia early because untreated hypoglycemia can lead to: - Seizure - Loss of consciousness - Death Hypoglcemia can also contribute to: - Falls - Injuries - Motor vehicle accidents Hypoglycemia unawareness Over time, repeated episodes of hypoglycemia can lead to hypoglycemia unawareness. The body and brain no longer produce signs and symptoms that warn of a low blood sugar, such as shakiness or irregular heartbeats. When this happens, the risk of severe, life-threatening hypoglycemia is increased. Undertreated diabetes If you have diabetes, episodes of low blood sugar are uncomfortable and can be frightening. Repeated episodes of hypoglycemia may cause you to take less insulin to ensure that your blood sugar level doesn't go too low. But long-term high blood sugar levels can be dangerous too, possibly causing damage to your nerves, blood vessels and various organs. Diagnosis If you use insulin or another diabetes medication known to lower blood sugar, and you have signs and symptoms of hypoglycemia, test your blood sugar levels with a blood glucose meter. If the result shows low blood sugar (under 70 mg/dL), treat accordingly. If you don't use medications known to cause hypoglycemia, your doctor will want to know: - What were your signs and symptoms? You may not exhibit signs and symptoms of hypoglycemia during your initial visit with your doctor. In this case, your doctor may have you fast overnight (or for a longer period). This will allow low blood sugar symptoms to occur so that he or she can make a diagnosis. It's also possible that you'll need to undergo an extended fast in a hospital setting. Or if your symptoms occur after a meal, your doctor will want to test your glucose levels after a meal. - What is your blood sugar level when you're having symptoms? Your doctor will draw a sample of your blood to be analyzed in the laboratory. - Do your symptoms disappear when blood sugar levels increase? In addition, your doctor will likely conduct a physical examination and review your medical history. Treatment Treatment of hypoglycemia involves: - Immediate initial treatment to raise your blood sugar level - Treatment of the underlying condition that's causing your hypoglycemia to prevent it from recurring Immediate initial treatment The initial treatment depends on your symptoms. Early symptoms can usually be treated by consuming 15 to 20 grams of a fast-acting carbohydrate. Fast-acting carbohydrates are foods that are easily converted to sugar in the body, such as glucose tablets or gel, fruit juice, regular - not diet - soft drinks, and sugary candy such as licorice. Foods containing fat or protein aren't good treatments for hypoglycemia, because they affect the body's absorption of sugar. Recheck blood sugar levels 15 minutes after treatment. If blood sugar levels are still under 70 mg/dL (3.9 mmol/L), treat with another 15 to 20 grams of fast-acting carbohydrate, and recheck the blood sugar level again in 15 minutes. Repeat these steps until the blood sugar is above 70 mg/dL (3.9 mmol/L). Once the blood sugar levels are back to normal, it's important to have a snack or meal to help stabilize your blood sugar. This also helps the body replenish glycogen stores that may have been depleted during hypoglycemia. If your symptoms are more severe, impairing your ability to take sugar by mouth, you may need an injection of glucagon or intravenous glucose. Do not give food or drink to someone who is unconscious, as he or she may aspirate these substances into the lungs. If you're prone to severe episodes of hypoglycemia, ask your doctor if a home glucagon kit might be appropriate for you. In general, people with diabetes who are treated with insulin should have a glucagon kit for low blood sugar emergencies. Family and friends need to know where to find the kit, and need to be taught how to use it before an emergency occurs. Treatment of the underlying condition Preventing recurrent hypoglycemia requires your doctor to identify the underlying condition and treat it. Depending on the underlying cause, treatment may involve: - Medications. If a medication is the cause of your hypoglycemia, your doctor will likely suggest changing the medication or adjusting the dosage. - Tumor treatment. A tumor in your pancreas is treated by surgical removal of the tumor. In some cases, partial removal of the pancreas is necessary. ", "role": "user" }, { "content": "Hypoglycemia occurs when your blood sugar (glucose) level falls too low. There are several reasons why this may happen, the most common is a side effect of drugs used to treat diabetes. Hypoglycemia may also happen if you don't eat as much food as usual after taking diabetes medication, or if you exercise more than you normally would. Possible causes, without diabetes Hypoglycemia in people without diabetes is much less common. Causes may include the following: - Medications. Taking someone else's oral diabetes medication accidentally is a possible cause of hypoglycemia. Other medications may cause hypoglycemia, especially in children or in people with kidney failure. One example is quinine (Qualaquin), which is used to treat malaria. - Excessive alcohol consumption. Drinking heavily without eating can block your liver from releasing stored glucose into your bloodstream, causing hypoglycemia. - Some critical illnesses.", "role": "assistant" } ]
[ { "content": "how is hemophilia treated\n\n Hemophilia Hemophilia A Classic hemophilia Factor VIII deficiency Hemophilia B Christmas disease Factor IX deficiency Bleeding disorder - hemophilia Summary Hemophilia refers to a group of bleeding disorders in which blood clotting takes a long time. There are two forms of hemophilia: Hemophilia A (classic hemophilia, or factor VIII deficiency) Hemophilia B (Christmas disease, or factor IX deficiency) Causes When you bleed, a series of reactions take place in the body that helps blood clots form. This process is called the coagulation cascade. It involves special proteins called coagulation, or clotting factors. You may have a higher chance of excess bleeding if one or more of these factors are missing or aren't functioning like they should. Hemophilia is caused by the lack of clotting factor VIII or IX in the blood. In most cases, hemophilia is passed down through families (inherited). Most of the time, it is passed to male children. Symptoms The main symptom of hemophilia is bleeding. Mild cases may not be detected until later in life, after excessive bleeding following surgery or an injury. In the worst cases, bleeding occurs for no reason. Internal bleeding may occur anywhere and bleeding into joints is common. Exams and Tests Most often, hemophilia is diagnosed after a person has an abnormal bleeding episode. It can also be diagnosed by a blood test done to detect the problem, if other family members have the condition. 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. Support Groups Joining a support group where members share common issues can relieve the stress of a long-term (chronic) disease. Outlook (Prognosis) Most people with hemophilia are able to do normal activities. But some people have bleeding into the joints, which may limit their activity. A small number of people with hemophilia may die of severe bleeding. Review Date 2/1/2017 Updated by: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "The most common way to treat hemophilia is to replace the missing clotting factor intravenously. If you need to have surgery, be sure to tell your doctor that you have hemophilia.", "role": "assistant" } ]
[ { "content": "what is epilepsy\n\n Epilepsy occipital calcifications Epilepsy with bilateral occipital calcifications Bilateral occipital calcifications with epilepsy Familial unilateral and bilateral occipital calcifications and epilepsy Epilepsy with bilateral occipital calcifications Bilateral occipital calcifications with epilepsy Familial unilateral and bilateral occipital calcifications and epilepsy Celiac disease epilepsy occipital calcifications See More Summary The following summary is from Orphanet, a European reference portal for information on rare diseases and orphan drugs. Orpha Number: 1459 Disease definition Celiac disease, epilepsy and cerebral calcification syndrome (CEC) is a rare disorder characterized by the combination of auto-immune intestinal disease, epileptic seizures and cerebral calcifications. Epidemiology CEC was first described in 1992 and fewer than 200 cases have been reported so far. Clinical description Celiac disease (CD, see this term) and epilepsy manifest at a variable age, and CD is frequently diagnosed in late childhood, when specific investigations are performed secondary to observation of epileptic seizures and cerebral calcifications (CC). CD can present in a typical form characterized by onset in the first 2 years of life, chronic diarrhea, weight loss, short stature , anorexia, and, in some cases, irritability and vomiting. CD may also present in silent or latent forms, which are characterized - in the absence of gastrointestinal symptoms - by dermatitis herpetiformis, dental enamel defects or autoimmune thyroiditis. In CEC patients, CD usually evolves into latent, silent or paucisymptomatic forms. Epilepsy onset is between infancy and adulthood; most cases occur in early childhood. Most patients present with occipital epileptic seizures, the course being highly variable, with benign, drug-resistant, or epileptic encephalopathy forms. In the latter, severe mental deterioration and/or learning disorders have been reported while a mild mental deterioration is observed in only one third of all CEC cases. CCs are seen in subcortical parieto-occipital regions. CC size does not change significantly over time, but in several cases, new CCs appeared in other regions. Patients with CCs and CD without epilepsy are considered as having an incomplete form of CEC. Some patients with epilepsy and CC without CD are considered to have a CEC with latent CD. Etiology Etiology of CEC is unclear. It is not known if epilepsy and/or CC are a consequence of CD. CD is an immune auto-inflammatory reaction occurring in predisposed gluten-intolerant individuals. It originates from the jejunal mucosa and spreads to the lamina propria, leading to the observed histopathological features (crypt hyperplasia, jejunal villous atrophy and inflammatory infiltrate in the lamina propria). CD may induce autoimmune responses outside the gastrointestinal tract. Circulating activated T cells may cross the blood-brain barrier and be toxic to myelin or myelin-producing cells. As for isolated CD, CEC is associated with the HLA-DQ2 and HLA-DQ8 genes . Diagnostic methods Diagnosis relies on anamnestic investigation and EEG to characterize epileptic seizures. Computed tomography (CT) imaging reveals CC. Laboratory findings (antiendomisium antibodies , antigliadin antibodies, anti- tissue -transglutaminase type 2 antibodies, HLA phenotype ), and histopathological analysis of small bowel biopsy (jejunal mucosa villous atrophy) enable identification of silent or latent CD in a patient with epileptic seizures and CC. Differential diagnosis Differential diagnosis of CEC includes Sturge-Weber syndrome (see this term) without nevus flammeus and other conditions such as congenital folate malabsorption or adverse effects of methotrexate, antifolate agents and radiotherapy of leukemic children. Management and treatment CD requires life-long observance of a gluten-free diet (GFD), leading to clinical and histopathological resolution of symptoms. A study has revealed that early CD diagnosis and treatment by GFD could prevent or reverse the epileptic disorder. Prognosis Early diagnosis and good compliance of GFD greatly improve outcome. On the contrary, if treatment is delayed, epilepsy may be more severe and epileptic encephalopathy may develop. Visit the Orphanet disease page for more resources. Symptoms This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom. Showing of Medical Terms Other Names Learn More: HPO ID Percent of people who have these symptoms is not available through HPO Celiac disease 0002608 Showing of Find a Specialist If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments. If you can't find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care. You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists. Healthcare Resources To find a medical professional who specializes in genetics, you can ask your doctor for a referral or you can search for one yourself. Online directories are provided by the American College of Medical Genetics and the National Society of Genetic Counselors. If you need additional help, contact a GARD Information Specialist. You can also learn more about genetic consultations from Genetics Home Reference. ", "role": "user" }, { "content": "Celiac disease, epilepsy and cerebral calcification syndrome (CEC) is a rare disorder characterized by the combination of auto-immune intestinal disease, epileptic seizures and cerebral calcifications. Epilepsy onset is between infancy and adulthood; most cases occur in early childhood. Most patients present with occipital epileptic seizures, the course being highly variable, with benign, drug-resistant, or epileptic encephalopathy forms. In the latter, severe mental deterioration and/or learning disorders have been reported while a mild mental deterioration is observed in only one third of all CEC cases.", "role": "assistant" } ]
[ { "content": "what are the causes of headaches\n\n Headaches - danger signs Migraine headache - danger signs Tension headache - danger signs Cluster headache - danger signs Vascular headache - danger signs Summary A headache is a pain or discomfort in the head, scalp, or neck. Common types of headaches include tension headaches, migraine or cluster headaches, sinus headaches, and headaches that begin in your neck. You may have a mild headache with a cold, the flu, or other viral illnesses when you also have a low fever. Most people with headaches feel better by making lifestyle changes, such as learning ways to relax. Taking certain medicines, such as pain medicine, may also help. Emergency Causes of Headaches Problems with blood vessels and bleeding in the brain can cause a headache. These problems include: Abnormal connection between the arteries and veins in the brain that usually forms before birth. This problem is called an arteriovenous malformation, or AVM. Blood flow to part of the brain stops. This is called a stroke. Weakening of the wall of a blood vessel that can break open and bleed into the brain. This is known as a brain aneurysm. Bleeding in the brain. This is called an intracerebral hematoma. Bleeding around the brain. This can be a subarachnoid hemorrhage, a subdural hematoma, or an epidural hematoma. Other causes of headaches that should be checked by a health care provider right away include: Acute hydrocephalus, which results from an interruption of cerebrospinal fluid flow. Blood pressure that is very high. Brain tumor. Brain swelling (brain edema) from altitude sickness, carbon monoxide poisoning, or acute brain injury. Buildup of pressure inside the skull that appears to be, but is not, a tumor (pseudotumor cerebri). Infection in the brain or the tissue that surrounds the brain, as well as a brain abscess. Swollen, inflamed artery that supplies blood to part of the head, temple, and neck area (temporal arteritis). When to Call the Doctor If you cannot see your provider right away, go to the emergency room or call 911 if: This is the first severe headache you have ever had in your life and it interferes with your daily activities. You develop a headache right after activities such as weightlifting, aerobics, jogging, or sex. Your headache comes on suddenly and is explosive or violent. Your headache is \"the worst ever,\" even if you regularly get headaches. You also have slurred speech, a change in vision, problems moving your arms or legs, loss of balance, confusion, or memory loss with your headache. Your headache gets worse over 24 hours. You also have fever, stiff neck, nausea, and vomiting with your headache. Your headache occurs with a head injury. Your headache is severe and just in one eye, with redness in that eye. You just started getting headaches, especially if your are older than 50. You have headaches along with vision problems and pain while chewing, or weight loss. You have a history of cancer and develop a new headache. Your immune system is weakened by disease (such as HIV infection) or by medicines (such as chemotherapy drugs and steroids). See your provider soon if: Your headaches wake you up from sleep. A headache lasts more than a few days. Headaches are worse in the morning. You have a history of headaches but they have changed in pattern or intensity . You have headaches often and there is no known cause. 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": "What causes Headaches - danger signs? Problems with blood vessels and bleeding in the brain can cause as a headache. These include: - Abnormal connection between the arteries and veins in the brain that usually forms before birth. This problem is called an arteriovenous malformation, or AVM. - Blood flow to part of the brain stops. This is called a stroke. - Weakening of the wall of a blood vessel that can break open and bleed into the brain. This is known as a brain aneurysm. - Bleeding in the area between the brain and the thin tissue that covers the brain.", "role": "assistant" } ]
[ { "content": "how is gonorrhea diagnosed\n\nGonorrhea (Exams and Tests): Gonorrhea can be quickly detected by looking at a sample of discharge or tissue under the microscope. This is called a gram stain. This method is fast, but it is not the most certain. Gonorrhea is most accurately detected with DNA tests. DNA tests are useful for screening. The ligase chain reaction (LCR) test is one of the tests. DNA tests are quicker than cultures. These tests can be performed on urine samples, which are easier to collect than samples from the genital area. Prior to DNA tests, cultures (cells that grow in a lab dish) were used to provide proof of gonorrhea, but are less commonly used now. Samples for a culture are most often taken from the cervix, vagina, urethra, anus, or throat. - Rarely they are taken from joint fluid or blood - Cultures can often provide an early diagnosis within 24 hours. A confirmed diagnosis is available within 72 hours. If you have gonorrhea, you should ask to be tested for other sexually transmitted infections, including chlamydia, syphilis, and HIV herpes and hepatitis.", "role": "user" }, { "content": "Gonorrhea can be detected by looking at a tissue or discharge sample under a microscope. Though this method is fast, it is not the most accurate. Gonorrhea is most accurately detected with DNA tests.", "role": "assistant" } ]
[ { "content": "typhoid fever Hi, My name is from X i have suffering from typhoid please give me solution i have one question i had got treatment from one year but i am not well now give me solution?\n\n Typhoid fever Enteric fever Summary Typhoid fever is an infection that causes diarrhea and a rash. It is most commonly caused due to a bacteria called <em>Salmonella typhi</em> (<em>S typhi</em>). Causes <em>S typhi</em> is spread through contaminated food, drink, or water. If you eat or drink something that is contaminated with the bacteria, the bacteria enter your body. They travel into your intestines, and then into your blood. In the blood, they travel to your lymph nodes, gallbladder, liver, spleen, and other parts of the body. Some people become carriers of <em>S typhi</em> and continue to release the bacteria in their stools for years, spreading the disease. Typhoid fever is common in developing countries. Most cases in the United States are brought in from other countries where typhoid fever is common. Symptoms Early symptoms include fever, general ill-feeling, and abdominal pain. High fever (103F, or 39.5C) or higher and severe diarrhea occur as the disease gets worse. Some people develop a rash called \"rose spots,\" which are small red spots on the abdomen and chest. Other symptoms that occur include: Bloody stools Chills Agitation, confusion, delirium, seeing or hearing things that are not there (hallucinations) Difficulty paying attention (attention deficit) Nosebleeds Severe fatigue Slow, sluggish, weak feeling Exams and Tests The health care provider will perform a physical exam and ask about the symptoms. A complete blood count (CBC) will show a high number of white blood cells. A blood culture during the first week of the fever can show <em>S typhi</em> bacteria. Other tests that can help diagnose this condition include: ELISA blood test to look for antibodies to the <em>S typhi</em> bacteria Fluorescent antibody study to look for substances that are specific to <em>S typhi</em> bacteria Platelet count (platelet count may be low) Stool culture Treatment Fluids and electrolytes may be given by IV (into a vein) or you may be asked to drink water with electrolyte packets. Antibiotics are given to kill the bacteria. There are increasing rates of antibiotic resistance throughout the world, so your provider will check current recommendations before choosing an antibiotic. Outlook (Prognosis) Symptoms usually improve in 2 to 4 weeks with treatment. The outcome is likely to be good with early treatment, but becomes poor if complications develop. Symptoms may return if the treatment has not completely cured the infection. Possible Complications Health problems that may develop include: Intestinal hemorrhage (severe GI bleeding) Intestinal perforation Kidney failure Peritonitis When to Contact a Medical Professional Contact your provider if you have any of the following: You know you have been exposed to someone who has typhoid fever You have been in an area where there are people who have typhoid fever and you develop symptoms of typhoid fever You have had typhoid fever and the symptoms return You develop severe abdominal pain, decreased urine output, or other new symptoms Prevention A vaccine is recommended for travel outside of the United States to places where there is typhoid fever. The Centers for Disease Control and Prevention website has information about where typhoid fever is common -- www.cdc.gov/typhoid-fever/index.html. Ask your provider if you should bring electrolyte packets in case you get sick. When traveling, drink only boiled or bottled water and eat well-cooked food. Wash you hands thoroughly before eating. Water treatment, waste disposal, and protecting the food supply from contamination are important public health measures. Carriers of typhoid must not be allowed to work as food handlers. Review Date 5/18/2017 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": "Typhoid fever (Prevention): A vaccine is recommended for travel outside of the US to places where there is typhoid fever. Ask your provider if you should bring electrolyte packets in case you get sick. When traveling, drink only boiled or bottled water and eat well-cooked food.", "role": "assistant" } ]
[ { "content": "When and how do you know when you have congenital night blindness?\n\n X-linked congenital stationary night blindness X-linked CSNB Congenital stationary night blindness with myopia Hemeralopia-myopia X-linked CSNB Congenital stationary night blindness with myopia Hemeralopia-myopia Myopia-night blindness See More Summary X-linked congenital stationary night blindness (XLCSNB) is a disorder of the retina. People with this condition typically experience night blindness and other vision problems, including loss of sharpness ( reduced visual acuity), severe nearsightedness (myopia), nystagmus , and strabismus . Color vision is typically not affected. These vision problems are usually evident at birth, but tend to be stable (stationary) over time. There are two major types of XLCSNB: the complete form and the incomplete form. Both types have very similar signs and symptoms. However, everyone with the complete form has night blindness, while not all people with the incomplete form have night blindness. The types are distinguished by their genetic cause. [1] Symptoms This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom. Showing of Medical Terms Other Names Learn More: HPO ID 30%-79% of people have these symptoms Abnormality of macular pigmentation 0008002 High myopia Severe near sightedness Severely close sighted Severely near sighted 0011003 Nyctalopia Night blindness Night-blindness Poor night vision 0000662 Optic disc hypoplasia 0007766 Reduced visual acuity Decreased clarity of vision 0007663 5%-29% of people have these symptoms Nystagmus Involuntary, rapid, rhythmic eye movements 0000639 Strabismus Cross-eyed Squint Squint eyes 0000486 Percent of people who have these symptoms is not available through HPO Congenital stationary night blindness Night blindness since birth 0007642 Hemeralopia Day blindness 0012047 Myopia Close sighted Near sighted Near sightedness Nearsightedness 0000545 X-linked inheritance 0001417 X-linked recessive inheritance 0001419 Showing of Diagnosis Yes. About 45% of individuals with XLCSNB have the complete form, which is caused by mutations in the NYX gene . The other 55% have the incomplete form, which is caused by mutations in the CACNA1F gene. [2] The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional. Find a Specialist If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments. If you can't find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care. You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists. Healthcare Resources To find a medical professional who specializes in genetics, you can ask your doctor for a referral or you can search for one yourself. Online directories are provided by the American College of Medical Genetics and the National Society of Genetic Counselors. If you need additional help, contact a GARD Information Specialist. You can also learn more about genetic consultations from Genetics Home Reference. ", "role": "user" }, { "content": "X-linked congenital stationary night blindness (XLCSNB) is a disorder of the retina. People with this condition typically experience night blindness and other vision problems, including loss of sharpness ( reduced visual acuity), severe nearsightedness (myopia), nystagmus , and strabismus . Color vision is typically not affected. These vision problems are usually evident at birth, but tend to be stable (stationary) over time.", "role": "assistant" } ]
[ { "content": "If oleandor was ingested by touching the plant stems inner part and then directly eating without washing hands, how long would u exspect symptoms would start? And how severe would you say symptoms may get.\n\n Oleander poisoning Rosebay poisoning Yellow oleander poisoning Thevetia peruviana poisoning Summary Oleander poisoning occurs when someone eats the flowers or chews the leaves or stems of the oleander plant (<em>Nerium oleander</em>), or its relative, the yellow oleander (<em>Cascabela thevetia</em>). This article is for information only. DO NOT use it to treat or manage an actual poison exposure. If you or someone you are with has an exposure, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. Poisonous Ingredient Poisonous ingredients include: Digitoxigenin Neriin Oleandrin Oleondroside <strong>Note:</strong> This list may not include all poisonous ingredients. Where Found The poisonous substances are found in all parts of the oleander plant: Flowers Leaves Stems Twigs Symptoms Oleander poisoning can affect many parts of the body. HEART AND BLOOD Irregular or slow heartbeat Low blood pressure Weakness EYES, EARS, NOSE, MOUTH, AND THROAT Blurred vision Vision disturbances, including halos STOMACH AND INTESTINES Diarrhea Loss of appetite Nausea and vomiting Stomach pain NERVOUS SYSTEM Confusion Death Depression Disorientation Dizziness Drowsiness Fainting Headache Lethargy SKIN Hives Rash <strong>Note:</strong> Depression, loss of appetite, and halos are most often seen in chronic overdose cases. Home Care Seek immediate medical help. DO NOT make a person throw up unless told to do so by poison control or a health care provider. Before Calling Emergency Get the following information: Person's age, weight, and condition Name and part of the plant swallowed, if known Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This hotline number will let you talk to experts in poisoning. They will give you further instructions. This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does not need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week. What to Expect at the Emergency Room The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. The person may receive: Activated charcoal Blood and urine tests Breathing support Chest x-ray ECG (electrocardiogram, or heart tracing) Fluids through a vein (IV) Medicines to treat symptoms including an antidote to reverse the effects of the poison Tube through the mouth into the stomach to wash out the stomach (gastric lavage) Outlook (Prognosis) How well you do depends on the amount of poison swallowed and how quickly treatment is received. The faster you get medical help, the better the chance for recovery. Symptoms last for 1 to 3 days and may require a hospital stay. Death is unlikely. DO NOT touch or eat any plant with which you are not familiar. Wash your hands after working in the garden or walking in the woods. 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": "Oleander poisoning can affect many parts of the body. HEART AND BLOOD - Irregular or slow heartbeat - Low blood pressure - Weakness EYES, EARS, NOSE, MOUTH, AND THROAT - Blurred vision - Vision disturbances, including halos STOMACH AND INTESTINES - Diarrhea - Loss of appetite - Nausea and vomiting - Stomach pain NERVOUS SYSTEM - Confusion - Death - Depression - Disorientation - Dizziness - Drowsiness - Fainting - Headache - Lethargy SKIN - Hives - Rash Note: Depression, loss of appetite, and halos are most often seen in chronic overdose cases.", "role": "assistant" } ]
[ { "content": "polymicrogyria. My 16 month old son has this. Does not sit up our crawl yet but still trying and is improving in grabbing things etc etc. Have read about other cases that seem 10000 time worse. It's it possible for this post of his brain to grown to normal and he grow out of it?\n\nPolymicrogyria: Polymicrogyria is a condition characterized by abnormal development of the brain before birth. Specifically, the surface of the brain develops too many folds which are unusually small. The signs and symptoms associated with the condition vary based on how much of the brain and which areas of the brain are affected; however, affected people may experience recurrent seizures ( epilepsy ); delayed development; crossed eyes ; problems with speech and swallowing; and muscle weakness or paralysis. Bilateral forms (affecting both sides of the brain) tend to cause more severe neurological problems. Polymicrogyria can result from both genetic and environmental causes. It may occur as an isolated finding or as part of a syndrome . Treatment is based on the signs and symptoms present in each person. [1] [2] A wide variety of symptoms may be observed in people with polymicrogyria, depending on the areas of the brain implicated and whether or not it is part of a larger syndrome . Signs and symptoms may include: [3] [4] Developmental delay Crossed eyes Epilepsy Paralysis of the face, throat, and tongue Difficulty with speech and swallowing Drooling The diagnosis of polymicrogyria is made by imaging brain structures using MRI . Typical findings include areas of the cerebral cortex with a complex set of small gyri that appear fused to each other and separated by shallow sulci. These findings may be isolated to one side of the brain (unilateral) or may involve both sides of the brain (bilateral). [3] [4] The resources below provide information about treatment options for this condition. If you have questions about which treatment is right for you, talk to your healthcare professional. Management Guidelines GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions. The following diseases are related to Polymicrogyria. If you have a question about any of these diseases, you can contact GARD. Bilateral frontal polymicrogyria Bilateral frontoparietal polymicrogyria Bilateral generalized polymicrogyria Bilateral parasagittal parieto-occipital polymicrogyria Bilateral perisylvian polymicrogyria", "role": "user" }, { "content": "Polymicrogyria is a condition characterized by abnormal development of the brain before birth. Symptoms of polymicrogyria vary depending on how much of the brain and which areas of the brain are affected and whether or not it is part of a larger syndrome . Affected people may experience recurrent epileptic seizures; delayed development; crossed eyes; problems with speech and swallowing; and muscle weakness or paralysis. Bilateral forms, which affect both sides of the brain, cause more severe neurological problems.", "role": "assistant" } ]
[ { "content": "I have been suffering from lichen planus since last four years. Some time it reduces the red sign and sometime it increases and I cannot take spicy food or hot food. Could you please suggest the remedies. I had consulted the dermatologist also .He gave me some ointment named as clone taxol for applying towards the read area. Awaiting your valuable advise I this behalf. With kind regards. Sent from my iPad\n\n Lichen planus Summary Lichen planus is a condition that forms an itchy rash on the skin or in the mouth. Causes The exact cause of lichen planus is unknown. It may be related to an allergic or immune reaction. Risks for the condition include: Exposure to certain medicines, dyes, and other chemicals (including gold, antibiotics, arsenic, iodides, chloroquine, quinacrine, quinide, phenothiazines, and diuretics) Diseases such as hepatitis C Lichen planus mostly affects middle-aged adults. It is less common in children. Symptoms Mouth sores are one symptom of lichen planus. They: May be tender or painful (mild cases may not cause pain) Are located on the sides of the tongue, inside of the cheek, or on the gums Look like bluish-white spots or pimples Form lines in a lacy network Gradually increase in size Sometimes form painful ulcers Skin sores are another symptom of lichen planus. They: Usually appear on the inner wrist, legs, torso, or genitals Are itchy Have even sides (symmetrical) and sharp borders Occur alone or in clusters, often at the site of a skin injury May be covered with thin white streaks or scratch marks Are shiny or scaly looking Have a dark, violet color May develop blisters or ulcers Other symptoms of lichen planus are: Dry mouth Hair loss Metallic taste in the mouth Ridges in the nails Exams and Tests Your health care provider may make the diagnosis based on the appearance of your skin or mouth lesions. A skin lesion biopsy or biopsy of a mouth lesion can confirm the diagnosis. Treatment The goal of treatment is to reduce symptoms and speed healing. If your symptoms are mild, you may not need treatment. Treatments may include: Antihistamines Medicines that calm down the immune system (in severe cases) Lidocaine mouthwashes to numb the area and make eating more comfortable (for mouth sores) Topical corticosteroids or oral corticosteroids to reduce swelling and lower immune responses Corticosteroid shots into a sore Vitamin A as a cream or taken by mouth Other medicines that are applied to the skin Dressings placed over your skin with medicines to keep you from scratching Ultraviolet light therapy Outlook (Prognosis) Lichen planus is usually not harmful. Most often it gets better with treatment. The condition often clears up within 18 months, but may come and go for years. If lichen planus is caused by a medicine you are taking, the rash should go away once you stop the medicine. Possible Complications Mouth ulcers that are present for a long time may develop into oral cancer. When to Contact a Medical Professional Call your provider if: Your skin or mouth lesions change in appearance The condition continues or gets worse, even with treatment Your dentist recommends changing your medicines or treating conditions that trigger the disorder Review Date 10/24/2016 Updated by: David L. Swanson, MD, Vice Chair of Medical Dermatology, Associate Professor of Dermatology, Mayo Medical School, Scottsdale, AZ. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Treatments for Lichen planus may include: antihistamines (in severe cases) that calm down the immune system; lidocaine mouthwashes for mouth sores, to numb the area and make eating more comfortable; topical corticosteroids or oral corticosteroids to reduce swelling and lower immune responses; corticosteroid shots into a sore, vitamin A as a cream or taken by mouth; dressings placed over your skin with medicines to keep you from scratching, and ultraviolet light therapy.", "role": "assistant" } ]
[ { "content": "how to loose weight\n\nLosing weight after pregnancy: You should plan to return to your pre-pregnancy weight by 6 to 12 months after delivery. Most women lose half of their baby weight by 6 weeks after childbirth (postpartum). The rest most often comes off over the next several months. A healthy diet with daily exercise will help you shed the pounds. Breastfeeding can also help with postpartum weight loss. Your body needs time to recover from childbirth. If you lose weight too soon after childbirth, it can take longer for you to recover. Give yourself until your 6-week checkup before trying to slim down. If you are breastfeeding, wait until your baby is at least 2 months old and your milk supply has normalized before drastically cutting calories. - Aim for a weight loss of about a pound and a half a week. You can do this by eating healthy foods and adding in exercise once you are cleared by your health care provider for regular physical activity. - Women who are exclusively breastfeeding need about 500 more calories per day than they did before pregnancy. Get these calories from healthy choices such as fruits, vegetables, whole grains, low-fat dairy, and lean protein. - DO NOT drop below the minimum number of calories you need. If you are breastfeeding, you will want to lose weight slowly. Weight loss that happens too fast can make you produce less milk. Losing about a pound and a half (670 grams) a week should not affect your milk supply or your health. Breastfeeding makes your body burn calories which helps you lose weight. If you are patient, you may be surprised at how much weight you lose naturally while breastfeeding. These healthy eating tips will help you lose weight safely. - DO NOT skip meals. With a new baby, many new moms forget to eat. If you do not eat, you will have less energy, and it will not help you lose weight. - Eat 5 to 6 small meals a day with healthy snacks in between (rather than 3 larger meals). - Eat breakfast. Even if you do not normally eat in the mornings, get into the habit of having breakfast. It will give you energy to start your day and stop you from feeling tired later. - Slow down. When you take your time eating, you will notice that it is easier to tell that you are full. It is tempting to multitask, but if you focus on your meal you will be less likely to overeat. - Choose nonfat or low-fat dairy products. - When you reach for a snack try to include foods with fiber and protein to help keep you full (such as raw bell pepper or carrot with bean dip, apple slices with peanut butter, or a slice of whole-wheat toast with hard-boiled egg). Drink at least 12 cups of fluid a day. - Keep a water bottle near the spot where you usually feed the baby, that way you'll remember to drink when they do. - Limit drinks like sodas, juices, and other fluids with added sugar and calories. They can add up and keep you from losing weight. - Choose broiled or baked rather than fried foods. - Limit sweets, sugar, saturated fat and trans fats. DO NOT go on a crash diet (not eating enough) or a fad diet (popular diets that limit certain types of foods and nutrients). They will probably make you drop pounds at first, but those first few pounds you lose are fluid and will come back. Other pounds you lose on a crash diet may be muscle instead of fat. You will gain back any fat you lose on a crash diet once you return to normal eating. You may not be able to return to your exact pre-pregnancy shape. For many women, pregnancy causes lasting changes in the body. You may have a softer belly, wider hips, and a larger waistline. Make your goals about your new body realistic. A healthy diet combined with regular exercise is the best way to shed the pounds. Exercise will help you lose fat instead of muscle. Once you are ready to start losing weight, eat a little less and move a little more each day. It may be tempting to push yourself into a hard routine for fast weight loss. But rapid weight loss is not healthy and is hard on your body. DO NOT overdo it. Just a quick walk around the block with your baby in the stroller is a great way to start adding exercise to your daily routine. Updated by: Emily Wax, RD, The Brooklyn Hospital Center, Brooklyn, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.", "role": "user" }, { "content": "To lose weight after pregnancy, there are a few ways you can do so safely and healthily. Do not skip meals. Eat 5 to 6 meals a day, with healthy snacks in between. Make sure to eat breakfast. Choose nonfat or low-fat dairy products. Make sure to snack on foods with fiber and protein, such as carrots with bean dip, or a slice of toast with a hard-boiled egg. Choose boiled or baked rather than fried foods, and limit sweets and saturated fats. It is important to make your goals about your new body realistic.", "role": "assistant" } ]
[ { "content": "what are some of the treatments available to males with klinefelter's\n\n Klinefelter syndrome 47 X-X-Y syndrome XXY syndrome XXY trisomy 47,XXY/46,XY Mosaic syndrome Poly-X Klinefelter syndrome Summary Klinefelter syndrome is a genetic condition that occurs in males when they have an extra X chromosome. Causes Most people have 46 chromosomes. Chromosomes contain all of your genes and DNA, the building blocks of the body. The 2 sex chromosomes (X and Y) determine if you become a boy or a girl. Girls normally have 2 X chromosomes. Boys normally have 1 X and 1 Y chromosome. Klinefelter syndrome results when a boy is born with at least 1 extra X chromosome. This is written as XXY. Klinefelter syndrome occurs in about 1 out of 500 to 1,000 baby boys. Women who get pregnant after age 35 are slightly more likely to have a boy with this syndrome than younger women. Symptoms Infertility is the most common symptom of Klinefelter syndrome. Symptoms may include any of the following: Abnormal body proportions (long legs, short trunk, shoulder equal to hip size) Abnormally large breasts (gynecomastia) Infertility Sexual problems Less than normal amount of pubic, armpit, and facial hair Small, firm testicles Tall height Small penis size Exams and Tests Klinefelter syndrome may first be diagnosed when a man comes to the health care provider because of infertility. The following tests may be performed: Karyotyping (checks the chromosomes) Semen count Blood tests will be done to check hormone levels including: Estradiol, a type of estrogen Follicle stimulating hormone Luteinizing hormone Testosterone Treatment Testosterone therapy may be prescribed. This can help: Grow body hair Improve appearance of muscles Improve concentration Improve mood and self esteem Increase energy and sex drive Increase strength Most men with this syndrome are not able to get a woman pregnant. But, an infertility specialist may be able to help. Seeing a doctor called an endocrinologist may also be helpful. Support Groups These groups can provide more information: The American Association for Klinefelter Syndrome Information and Support (AAKSIS) -- www.aaksis.org National Institute of Health, National Human Genome Research Institute -- www.genome.gov/19519068 Possible Complications Enlarged teeth with a thinning surface is very common in Klinefelter syndrome. This is called taurodontism. This can be seen on dental x-rays. Klinefelter syndrome also increases the risk of: Attention deficient hyperactivity disorder (ADHD) Autoimmune disorders, such as lupus, rheumatoid arthritis, and Sjogren syndrome Breast cancer in men Depression Learning disabilities, including dyslexia, which affects reading A rare type of tumor called an extragonadal germ cell tumor Lung disease Osteoporosis Varicose veins When to Contact a Medical Professional Call for an appointment with your provider if your son does not develop secondary sexual characteristics at puberty. This includes facial hair growth and a deepening of the voice. A genetics counselor can provide information about this condition and direct you to support groups in your area. Review Date 10/30/2016 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, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "What are the treatments for Klinefelter syndrome?: Testosterone therapy may be prescribed. This can help: - Grow body hair - Improve appearance of muscles - Improve concentration - Improve mood and self esteem - Increase energy and sex drive - Increase strength Most men with this syndrome are not able to get a woman pregnant. But, an infertility specialist may be able to help. Seeing a doctor called an endocrinologist may also be helpful.", "role": "assistant" } ]
[ { "content": "what are the symptoms for cystic fibrosis\n\n Cystic fibrosis Overview Cystic fibrosis is an inherited disorder that causes severe damage to the lungs, digestive system and other organs in the body. Cystic fibrosis affects the cells that produce mucus, sweat and digestive juices. These secreted fluids are normally thin and slippery. But in people with cystic fibrosis, a defective gene causes the secretions to become sticky and thick. Instead of acting as a lubricant, the secretions plug up tubes, ducts and passageways, especially in the lungs and pancreas. Although cystic fibrosis requires daily care, people with the condition are usually able to attend school and work, and often have a better quality of life than people with cystic fibrosis had in previous decades. Improvements in screening and treatments mean people with cystic fibrosis now may live into their mid- to late 30s, on average, and some are living into their 40s and 50s. Cystic fibrosis care at Mayo Clinic Symptoms Screening of newborns for cystic fibrosis is now performed in every state in the United States. As a result, the condition can be diagnosed within the first month of life, before symptoms develop. For people born before newborn screening was performed, it's important to be aware of the signs and symptoms of cystic fibrosis. Cystic fibrosis signs and symptoms vary, depending on the severity of the disease. Even in the same person, symptoms may worsen or improve as time passes. Some people may not experience symptoms until adolescence or adulthood. People with cystic fibrosis have a higher than normal level of salt in their sweat. Parents often can taste the salt when they kiss their children. Most of the other signs and symptoms of cystic fibrosis affect the respiratory system and digestive system. However, adults diagnosed with cystic fibrosis are more likely to have atypical symptoms, such as recurring bouts of inflamed pancreas (pancreatitis), infertility and recurring pneumonia. The thick and sticky mucus associated with cystic fibrosis clogs the tubes that carry air in and out of your lungs. This can cause signs and symptoms such as: - A persistent cough that produces thick mucus (sputum) - Wheezing - Breathlessness - Exercise intolerance - Repeated lung infections - Inflamed nasal passages or a stuffy nose The thick mucus can also block tubes that carry digestive enzymes from your pancreas to your small intestine. Without these digestive enzymes, your intestines aren't able to completely absorb the nutrients in the food you eat. The result is often: - Foul-smelling, greasy stools - Poor weight gain and growth - Intestinal blockage, particularly in newborns (meconium ileus) - Severe constipation Frequent straining while passing stool can cause part of the rectum - the end of the large intestine - to protrude outside the anus (rectal prolapse). When this occurs in children, it may be a sign of cystic fibrosis. Parents should consult a physician knowledgeable about cystic fibrosis. Rectal prolapse in children may sometimes require surgery. Rectal prolapse in children with cystic fibrosis is less common than it was in the past, which may be due to earlier testing, diagnosis and treatment of cystic fibrosis. If you or your child has symptoms of cystic fibrosis - or if someone in your family has cystic fibrosis - talk with your doctor about testing for the disease. Seek immediate medical care if you or your child has difficulty breathing. Causes In cystic fibrosis, a defect (mutation) in a gene changes a protein that regulates the movement of salt in and out of cells. The result is thick, sticky mucus in the respiratory, digestive and reproductive systems, as well as increased salt in sweat. Many different defects can occur in the gene. The type of gene mutation is associated with the severity of the condition. Children need to inherit one copy of the gene from each parent in order to have the disease. If children inherit only one copy, they won't develop cystic fibrosis. However, they will be carriers and possibly pass the gene to their own children. Risk factors - Family history. Because cystic fibrosis is an inherited disorder, it runs in families. - Race. Although cystic fibrosis occurs in all races, it is most common in white people of Northern European ancestry. Complications - Damaged airways (bronchiectasis). Cystic fibrosis is one of the leading causes of bronchiectasis, a condition that damages the airways. This makes it harder to move air in and out of the lungs and clear mucus from the airways (bronchial tubes). - Chronic infections. Thick mucus in the lungs and sinuses provides an ideal breeding ground for bacteria and fungi. People with cystic fibrosis may often have sinus infections, bronchitis or pneumonia. - Growths in the nose (nasal polyps). Because the lining inside the nose is inflamed and swollen, it can develop soft, fleshy growths (polyps). - Coughing up blood (hemoptysis). Over time, cystic fibrosis can cause thinning of the airway walls. As a result, teenagers and adults with cystic fibrosis may cough up blood. - Pneumothorax. This condition, in which air collects in the space that separates the lungs from the chest wall, also is more common in older people with cystic fibrosis. Pneumothorax can cause chest pain and breathlessness. - Respiratory failure. Over time, cystic fibrosis can damage lung tissue so badly that it no longer works. Lung function usually worsens gradually, and it eventually can become life-threatening. - Acute exacerbations. People with cystic fibrosis may experience worsening of their respiratory symptoms, such as coughing and shortness of breath, for several days to weeks. This is called an acute exacerbation and requires treatment in the hospital. - Nutritional deficiencies. Thick mucus can block the tubes that carry digestive enzymes from your pancreas to your intestines. Without these enzymes, your body can't absorb protein, fats or fat-soluble vitamins. - Diabetes. The pancreas produces insulin, which your body needs to use sugar. Cystic fibrosis increases the risk of diabetes. Around 30 percent of people with cystic fibrosis develop diabetes by age 30. - Blocked bile duct. The tube that carries bile from your liver and gallbladder to your small intestine may become blocked and inflamed, leading to liver problems and sometimes gallstones. - Intestinal obstruction. Intestinal obstruction can happen to people with cystic fibrosis at all ages. Children and adults with cystic fibrosis are more likely than are infants to develop intussusception, a condition in which a section of the intestines folds in on itself like an accordion. - Distal intestinal obstruction syndrome (DIOS). DIOS is partial or complete obstruction where the small intestine meets the large intestine. Almost all men with cystic fibrosis are infertile because the tube that connects the testes and prostate gland (vas deferens) is either blocked with mucus or missing entirely. Certain fertility treatments and surgical procedures sometimes make it possible for men with cystic fibrosis to become biological fathers. Although women with cystic fibrosis may be less fertile than other women, it's possible for them to conceive and to have successful pregnancies. Still, pregnancy can worsen the signs and symptoms of cystic fibrosis, so be sure to discuss the possible risks with your doctor. - Thinning of the bones (osteoporosis). People with cystic fibrosis are at higher risk of developing a dangerous thinning of bones. - Electrolyte imbalances and dehydration. Because people with cystic fibrosis have saltier sweat, the balance of minerals in their blood may be upset. Signs and symptoms include increased heart rate, fatigue, weakness and low blood pressure. Diagnosis To diagnose cystic fibrosis, doctors may conduct several tests. Newborn screening and diagnosis Every state in the U.S. now routinely screens newborns for cystic fibrosis. Early diagnosis means treatment can begin immediately. In one screening test, a blood sample is checked for higher than normal levels of a chemical (immunoreactive trypsinogen, or IRT) released by the pancreas. A newborn's IRT levels may be high because of premature birth or a stressful delivery. For that reason other tests may be needed to confirm a diagnosis of cystic fibrosis. Genetic tests may be used in addition to checking the IRT levels to confirm the diagnosis. Doctors may also conduct genetic tests to test for specific defects on the gene responsible for cystic fibrosis. To evaluate if an infant has cystic fibrosis, doctors may also conduct a sweat test when the infant is at least 2 weeks old. In a sweat test, doctors apply a sweat-producing chemical to a small area of skin. They then collect the sweat to test it and see if it's saltier than normal. Testing may be done at a center specializing in cystic fibrosis. Testing of older children and adults Cystic fibrosis tests may be recommended for older children and adults who weren't screened at birth. Your doctor may suggest genetic and sweat tests for cystic fibrosis if you have recurring bouts of inflamed pancreas (pancreatitis), nasal polyps, chronic sinus or lung infections, bronchiectasis, or male infertility. Treatment There is no cure for cystic fibrosis, but treatment can ease symptoms and reduce complications. Close monitoring and early, aggressive intervention is recommended. Managing cystic fibrosis is complex, so consider obtaining treatment at a center staffed by doctors and other staff trained in cystic fibrosis. Doctors may work with a multidisciplinary team of doctors and medical professionals trained in cystic fibrosis to evaluate and treat your condition. The goals of treatment include: - Preventing and controlling infections that occur in the lungs - Removing and loosening mucus from the lungs - Treating and preventing intestinal blockage - Providing adequate nutrition Medications The options may include: - Antibiotics to treat and prevent lung infections - Anti-inflammatory medications to lessen swelling in the airways in your lungs - Mucus-thinning drugs to help you cough up the mucus, which can improve lung function - Inhaled medications called bronchodilators that can help keep your airways open by relaxing the muscles around your bronchial tubes - Oral pancreatic enzymes to help your digestive tract absorb nutrients For those with cystic fibrosis who have certain gene mutations, doctors may recommend a newer medication called ivacaftor (Kalydeco). This medication may improve lung function and weight, and reduce the amount of salt in sweat. It has been approved by the Food and Drug Administration for people with cystic fibrosis who are age 6 and older. The dose depends on your weight and age. Doctors may conduct liver function tests and eye examinations before prescribing ivacaftor and on a regular basis while you're taking it to check for side effects such as liver function abnormalities and cataracts. For people with a certain gene mutation who are age 12 and older, another drug (Orkambi) is available that combines ivacaftor with a medication called lumacaftor. The combination of these medications may improve lung function and reduce the risk of exacerbations. However, some people may experience side effects such as chest discomfort and shortness of breath soon after starting the medication. Some people may also have high blood pressure while taking the medication. Doctors may monitor you for any side effects. Chest physical therapy Loosening the thick mucus in the lungs makes it easier to cough up. Chest physical therapy helps loosen mucus. It is usually done from one to four times a day. A common technique is clapping with cupped hands on the front and back of the chest. Certain breathing techniques also may be used to help loosen the mucus. Your doctor will instruct you about the type of chest physical therapy he or she recommends for you. Mechanical devices also can help loosen lung mucus. These include a vibrating vest or a tube or mask you breathe into. Pulmonary rehabilitation Your doctor may recommend a long-term program that may improve your lung function and overall well-being. Pulmonary rehabilitation is usually done on an outpatient basis and may include: - Physical exercise that may improve your condition - Breathing techniques that may help loosen mucus and improve breathing - Nutritional counseling - Counseling and support - Education about your condition Surgical and other procedures - Nasal polyp removal. Your doctor may recommend surgery to remove nasal polyps that obstruct breathing. - Oxygen therapy. If your blood oxygen level declines, your doctor may recommend that you breathe pure oxygen to prevent high blood pressure in the lungs (pulmonary hypertension). - Endoscopy and lavage. Mucus may be suctioned from obstructed airways through an endoscope. - Feeding tube. Cystic fibrosis interferes with digestion, so you can't absorb nutrients from food very well. Your doctor may suggest temporarily using a feeding tube to deliver extra nutrition while you sleep. This tube may be inserted in your nose and guided to your stomach, or it may be surgically implanted into the abdomen. - Bowel surgery. If a blockage develops in your bowel, you may need surgery to remove it. Intussusception, where a section of bowel has folded in on itself, also may require surgical repair. - Lung transplant. If you have severe breathing problems, life-threatening lung complications or increasing resistance to antibiotics used to treat lung infections, lung transplantation may be an option. Because bacteria line the airways in diseases that cause permanent widening of the large airways (bronchiectasis), such as cystic fibrosis, both lungs need to be replaced. Cystic fibrosis does not recur in transplanted lungs. However, other complications associated with cystic fibrosis - such as sinus infections, diabetes, pancreas problems and osteoporosis - can still occur after a lung transplant. Lifestyle and home remedies You can manage your condition and minimize complications in several ways. Always talk to your doctor before starting home remedies. Cystic fibrosis can cause malnourishment because the enzymes needed for digestion can't reach your small intestine, preventing food from being absorbed. People with cystic fibrosis may need a significantly higher number of calories daily than do people without the condition. A healthy diet is important to maintain good lung function. It's also important to drink lots of fluids, which can help thin the mucus in your lungs. You may work with a dietitian to develop a nutrition plan. Most people with cystic fibrosis need to take pancreatic enzyme capsules with every meal and snack. In addition, your doctor may recommend: - Antacids - Supplemental high-calorie nutrition - Special fat-soluble vitamins - Extra fiber to prevent intestinal blockage - Extra salt, especially during hot weather or before exercising - Adequate water during hot weather In addition to other usual childhood vaccines, people with cystic fibrosis should have the annual flu vaccine and any other vaccines their doctor recommends. Cystic fibrosis doesn't affect the immune system, but children with cystic fibrosis are more likely to develop complications when they become sick. Regular exercise helps loosen mucus in your airways, and strengthens your heart. For many people with cystic fibrosis, participating in sports can improve confidence and self-esteem. Anything that gets you moving, including walking and biking, can help. Don't smoke in your home or car, and don't allow other people to smoke around you or your child. Secondhand smoke is harmful for everyone, but especially for people with cystic fibrosis. Teach all the members of your family to wash their hands thoroughly before eating, after using the bathroom, when coming home from work or school, and after being around a person who is sick. Hand-washing is the best way to protect against infection. You'll have ongoing care from your doctor and other medical professionals. Make sure to attend your regular follow-up appointments. Take your medications as prescribed and follow therapies as instructed. Contact your doctor if you experience any signs or symptoms such as severe constipation, more mucus than usual, blood in your mucus or reduced energy. ", "role": "user" }, { "content": "The symptoms of cystic fibrosis vary depending on the severity of the disease. People with cystic fibrosis have a higher than normal level of salt in their sweat. Parents may be able to taste the salt when they kiss their children. The other symptoms of cystic fibrosis affect the respiratory system and the digestive system. Adults diagnosed with cystic fibrosis are more likely to have atypical symptoms, such as recurring bouts of inflamed pancreas, infertility, and recurring pneumonia. The thick and sticky mucus associated with cystic fibrosis can cause signs and symptoms such a persistent cough, wheezing, breathlessness, exercise intolerance, repeated lung infections, inflamed nasal passages or a stuffy nose. The thick mucus can also block tubes that carry digestive enzymes from your pancreas to your small intestine. The result is often foul-smelling, greasy stools, poor weight gain and growth, intestinal blockage, particularly in newborns, and severe constipation.", "role": "assistant" } ]
[ { "content": "what treatment do you use to cure chickenpox\n\nWhat are the treatments for Chickenpox?: Treatment involves keeping the person as comfortable as possible. Here are things to try: - Avoid scratching or rubbing the itchy areas. Keep fingernails short to avoid damaging the skin from scratching. - Wear cool, light, loose bedclothes. Avoid wearing rough clothing, particularly wool, over an itchy area. - Take lukewarm baths using little soap and rinse thoroughly. Try a skin-soothing oatmeal or cornstarch bath. - Apply a soothing moisturizer after bathing to soften and cool the skin. - Avoid prolonged exposure to excessive heat and humidity. - Try over-the-counter oral antihistamines such as diphenhydramine (Benadryl), but be aware of possible side effects, such as drowsiness. - Try over-the-counter hydrocortisone cream on itchy areas. Medicines that fight the chickenpox virus are available, but not given to everyone. To work well, the medicine should be started within the first 24 hours of the rash. - Antiviral drugs are not very often prescribed to otherwise healthy children who do not have severe symptoms. Adults and teens, who are at risk for more severe symptoms, may benefit from antiviral medicine if it is given early. - Antiviral medicine may be very important forthose who have skin conditions (such as eczema or recent sunburn), lung conditions (such as asthma), or who have recently taken steroids. - Some providers also give antiviral medicines to people in the same household who also develop chickenpox, because they will most often develop more severe symptoms. Do NOT give aspirin or ibuprofen to someone who may have chickenpox. Use of aspirin has been associated with a serious condition called Reyes syndrome. Ibuprofen has been associated with more severe secondary infections. Acetaminophen (Tylenol) may be used. A child with chickenpox should not return to school or play with other children until all chickenpox sores have crusted over or dried out. Adults should follow this same rule while considering when to return to work or be around others.", "role": "user" }, { "content": "Medicines that fight the chickenpox virus are available, but not given to everyone. To work well, the medicine should be started within the first 24 hours of the rash. - Antiviral drugs are not very often prescribed to otherwise healthy children who do not have severe symptoms. Adults and teens, who are at risk for more severe symptoms, may benefit from antiviral medicine if it is given early. ... Treatment involves keeping the person as comfortable as possible. Here are things to try: - Avoid scratching or rubbing the itchy areas. Keep fingernails short to avoid damaging the skin from scratching. - Wear cool, light, loose bedclothes. Avoid wearing rough clothing, particularly wool, over an itchy area. - Take lukewarm baths using little soap and rinse thoroughly. Try a skin-soothing oatmeal or cornstarch bath. - Apply a soothing moisturizer after bathing to soften and cool the skin. - Avoid prolonged exposure to excessive heat and humidity. - Try over-the-counter oral antihistamines such as diphenhydramine (Benadryl), but be aware of possible side effects, such as drowsiness. - Try over-the-counter hydrocortisone cream on itchy areas. Do NOT give aspirin or ibuprofen to someone who may have chickenpox. Use of aspirin has been associated with a serious condition called Reyes syndrome. Ibuprofen has been associated with more severe secondary infections. Acetaminophen (Tylenol) may be used.", "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 - aftercare Adhesive capsulitis - aftercare Frozen shoulder syndrome - aftercare Pericapsulitis - aftercare Stiff shoulder - aftercare Shoulder pain - frozen shoulder Summary A frozen shoulder is shoulder pain that leads to stiffness of your shoulder. Often the pain and stiffness are present all the time. More About Your Injury The capsule of the shoulder joint is made of strong tissue (ligaments) that hold the shoulder bones to each other. When the capsule becomes inflamed, the shoulder bones cannot move freely in the joint. This condition is called frozen shoulder. Frozen shoulder may develop with no known cause. It can also occur in people who: Have thyroid disease, diabetes, or are going through menopause Have a shoulder injury Have had a stroke that makes them unable to use their arm Have a cast on their arm that holds their arm in one position What to Expect Symptoms of frozen shoulder often follow this pattern: At first, you have a lot of pain, which can come on abruptly even without an injury or trauma. Your shoulder can become very stiff and hard to move, even when the pain lessens. It becomes hard to reach over your head or behind you. This is the freezing phase. Finally, the pain goes away and you can use your arm again. This is the thawing phase and can take months to end. It can take a few months to go through each stage of frozen shoulder. The shoulder can get very painful and stiff before it starts to loosen. It can take as long as 18 to 24 months for complete healing. To help speed healing, your health care provider will likely do the following: Teach you exercises to restore motion in your shoulder joint. Refer you to a physical therapist. Prescribe medicines for you to take by mouth. These include drugs to reduce pain and inflammation in the shoulder joint. You may also receive a shot of anti-inflammatory drug or steroid directly into the joint. Most people have a full recovery with full range of motion without surgery. Symptom Relief Using moist heat on your shoulder 3 to 4 times a day may help relieve some pain and stiffness. For pain, you can use ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), or acetaminophen (Tylenol). You can buy these pain medicines at the store. Talk with your provider before using these medicines if you have heart disease, high blood pressure, kidney disease, or have had stomach ulcers or internal bleeding in the past. DO NOT take more than the amount recommended on the bottle or by your provider. In Your Home Get help setting up your home so that you can get to everything you need without reaching above your shoulders or behind your back. Keep the clothes that you wear most often in drawers and shelves that are between your waist and shoulder level. Store food in cupboards, drawers, and refrigerator shelves that are between your waist and shoulder level. Get help with house cleaning, taking out the garbage, gardening, and other household tasks. DO NOT lift heavy things or do activities that require a lot of shoulder and arm strength. Shoulder Exercises You will learn some simple exercises and stretches for your shoulder. At first, try to do these exercises once every hour, or at least 4 times a day. It is more important to do the exercises often than to do them for a long time each time you do them. Use moist heat before the exercises to help lessen pain and increase movement. The exercises should focus on stretching of the shoulder and range of motion. Avoid exercises to strengthen your shoulder until the range of motion has returned. Some of the exercises are: Shoulder stretches Pendulum Wall crawl Rope and pulley stretches Movements to help with internal and external rotation, such as hand behind back Your doctor or physical therapist will show you how to do these exercises. When to Call the Doctor Call your doctor if: The pain in your shoulder is getting much worse even if you take pain medicine You re-injure your arm or shoulder Your frozen shoulder is making you feel sad or depressed Review Date 4/9/2018 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": "Frozen shoulder may develop without a known cause. It is more likely to occur in people who have thyroid disease, diabetes, had shoulder injury, are unable to move their arm due to cast or stroke, and in women undergoing menopause. Most people have a full recovery with full range of motion.", "role": "assistant" } ]
[ { "content": "what are the main causes tooth loss?\n\n Cavities/tooth decay Overview Cavities are permanently damaged areas in the hard surface of your teeth that develop into tiny openings or holes. Cavities, also called tooth decay or caries, are caused by a combination of factors, including bacteria in your mouth, frequent snacking, sipping sugary drinks and not cleaning your teeth well. Cavities and tooth decay are among the world's most common health problems. They're especially common in children, teenagers and older adults. But anyone who has teeth can get cavities, including infants. If cavities aren't treated, they get larger and affect deeper layers of your teeth. They can lead to a severe toothache, infection and tooth loss. Regular dental visits and good brushing and flossing habits are your best protection against cavities and tooth decay. Symptoms The signs and symptoms of cavities vary, depending on their extent and location. When a cavity is just beginning, you may not have any symptoms at all. As the decay gets larger, it may cause signs and symptoms such as: - Toothache, spontaneous pain or pain that occurs without any apparent cause - Tooth sensitivity - Mild to sharp pain when eating or drinking something sweet, hot or cold - Visible holes or pits in your teeth - Brown, black or white staining on any surface of a tooth - Pain when you bite down When to see a dentist You may not be aware that a cavity is forming. That's why it's important to have regular dental checkups and cleanings, even when your mouth feels fine. However, if you experience a toothache or mouth pain, see your dentist as soon as possible. Causes Cavities are caused by tooth decay - a process that occurs over time. Here's how tooth decay develops: - Plaque forms. Dental plaque is a clear sticky film that coats your teeth. It's due to eating a lot of sugars and starches and not cleaning your teeth well. When sugars and starches aren't cleaned off your teeth, bacteria quickly begin feeding on them and form plaque. Plaque that stays on your teeth can harden under or above your gum line into tartar (calculus). Tartar makes plaque more difficult to remove and creates a shield for bacteria. - Plaque attacks. The acids in plaque remove minerals in your tooth's hard, outer enamel. This erosion causes tiny openings or holes in the enamel - the first stage of cavities. Once areas of enamel are worn away, the bacteria and acid can reach the next layer of your teeth, called dentin. This layer is softer than enamel and less resistant to acid. Dentin has tiny tubes that directly communicate with the nerve of the tooth causing sensitivity. - Destruction continues. As tooth decay develops, the bacteria and acid continue their march through your teeth, moving next to the inner tooth material (pulp) that contains nerves and blood vessels. The pulp becomes swollen and irritated from the bacteria. Because there is no place for the swelling to expand inside of a tooth, the nerve becomes pressed, causing pain. Discomfort can even extend outside of the tooth root to the bone. Risk factors Everyone who has teeth is at risk of getting cavities, but the following factors can increase risk: - Tooth location. Decay most often occurs in your back teeth (molars and premolars). These teeth have lots of grooves, pits and crannies, and multiple roots that can collect food particles. As a result, they're harder to keep clean than your smoother, easy-to-reach front teeth. - Certain foods and drinks. Foods that cling to your teeth for a long time - such as milk, ice cream, honey, sugar, soda, dried fruit, cake, cookies, hard candy and mints, dry cereal, and chips - are more likely to cause decay than foods that are easily washed away by saliva. - Frequent snacking or sipping. When you steadily snack or sip sugary drinks, you give mouth bacteria more fuel to produce acids that attack your teeth and wear them down. And sipping soda or other acidic drinks throughout the day helps create a continual acid bath over your teeth. - Bedtime infant feeding. When babies are given bedtime bottles filled with milk, formula, juice or other sugar-containing liquids, these beverages remain on their teeth for hours while they sleep, feeding decay-causing bacteria. This damage is often called baby bottle tooth decay. Similar damage can occur when toddlers wander around drinking from a sippy cup filled with these beverages. - Inadequate brushing. If you don't clean your teeth soon after eating and drinking, plaque forms quickly and the first stages of decay can begin. - Not getting enough fluoride. Fluoride, a naturally occurring mineral, helps prevent cavities and can even reverse the earliest stages of tooth damage. Because of its benefits for teeth, fluoride is added to many public water supplies. It's also a common ingredient in toothpaste and mouth rinses. But bottled water usually does not contain fluoride. - Younger or older age. In the United States, cavities are common in very young children and teenagers. Older adults also are at higher risk. Over time, teeth can wear down and gums may recede, making teeth more vulnerable to root decay. Older adults also may use more medications that reduce saliva flow, increasing the risk of tooth decay. - Dry mouth. Dry mouth is caused by a lack of saliva, which helps prevent tooth decay by washing away food and plaque from your teeth. Substances found in saliva also help counter the acid produced by bacteria. Certain medications, some medical conditions, radiation to your head or neck, or certain chemotherapy drugs can increase your risk of cavities by reducing saliva production. - Worn fillings or dental devices. Over the years, dental fillings can weaken, begin to break down or develop rough edges. This allows plaque to build up more easily and makes it harder to remove. Dental devices can stop fitting well, allowing decay to begin underneath them. - Heartburn. Heartburn or gastroesophageal reflux disease (GERD) can cause stomach acid to flow into your mouth (reflux), wearing away the enamel of your teeth and causing significant tooth damage. This exposes more of the dentin to attack by bacteria, creating tooth decay. Your dentist may recommend that you consult your doctor to see if gastric reflux is the cause of your enamel loss. - Eating disorders. Anorexia and bulimia can lead to significant tooth erosion and cavities. Stomach acid from repeated vomiting (purging) washes over the teeth and begins dissolving the enamel. Eating disorders also can interfere with saliva production. Complications Cavities and tooth decay are so common that you may not take them seriously. And you may think that it doesn't matter if children get cavities in their baby teeth. However, cavities and tooth decay can have serious and lasting complications, even for children who don't have their permanent teeth yet. Complications of cavities may include: - Pain - Tooth abscess - Swelling or pus around a tooth - Damage or broken teeth - Chewing problems - Positioning shifts of teeth after tooth loss When cavities and decay become severe, you may have: - Pain that interferes with daily living - Weight loss or nutrition problems from painful or difficult eating or chewing - Tooth loss, which may affect your appearance, as well as your confidence and self-esteem - In rare cases, a tooth abscess - a pocket of pus that's caused by bacterial infection - which can lead to more serious or even life-threatening infections Diagnosis Your dentist can usually detect tooth decay by: - Asking about tooth pain and sensitivity - Examining your mouth and teeth - Probing your teeth with dental instruments to check for soft areas - Looking at dental X-rays, which can show the extent of cavities and decay Your dentist will also be able to tell you which of the three types of cavities you have - smooth surface, pit and fissure, or root. Treatment Regular checkups can identify cavities and other dental conditions before they cause troubling symptoms and lead to more-serious problems. The sooner you seek care, the better your chances of reversing the earliest stages of tooth decay and preventing its progression. If a cavity is treated before it starts causing pain, you probably won't need extensive treatment. Treatment of cavities depends on how severe they are and your particular situation. Treatment options include: - Fluoride treatments. If your cavity just started, a fluoride treatment may help restore your tooth's enamel and can sometimes reverse a cavity in the very early stages. Professional fluoride treatments contain more fluoride than the amount found in tap water, toothpaste and mouth rinses. Fluoride treatments may be liquid, gel, foam or varnish that's brushed onto your teeth or placed in a small tray that fits over your teeth. - Fillings. Fillings, also called restorations, are the main treatment option when decay has progressed beyond the earliest stage. Fillings are made of various materials, such as tooth-colored composite resins, porcelain or dental amalgam that is a combination of several materials. - Crowns. For extensive decay or weakened teeth, you may need a crown - a custom-fitted covering that replaces your tooth's entire natural crown. Your dentist drills away all the decayed area and enough of the rest of your tooth to ensure a good fit. Crowns may be made of gold, high strength porcelain, resin, porcelain fused to metal or other materials. - Root canals. When decay reaches the inner material of your tooth (pulp), you may need a root canal. This is a treatment to repair and save a badly damaged or infected tooth instead of removing it. The diseased tooth pulp is removed. Medication is sometimes put into the root canal to clear any infection. Then the pulp is replaced with a filling. - Tooth extractions. Some teeth become so severely decayed that they can't be restored and must be removed. Having a tooth pulled can leave a gap that allows your other teeth to shift. If possible, consider getting a bridge or a dental implant to replace the missing tooth. ", "role": "user" }, { "content": "Cavities and tooth decay are so common that you may not take them seriously. 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": "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": "To diagnose social anxiety disorder, your 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": "I have been researching Lewy Body Disease and have a few questions.1) Is this disease hereditary2) Does alcoholism play a role in the beginning process of this disease3) What are the initial symptoms of the diseaseAny information you could forward would be greatly appreciated.\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": "Lewy body dementia signs and symptoms may include visual, sound (auditory), smell (olfactory) or touch (tactile) hallucinations hallucinations. Parkinsonian symptoms, such as slowed movement, rigid muscles, tremor or a shuffling walk may occur. 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. You may experience cognitive problems similar to those of Alzheimer's disease, such as confusion, poor attention, visual-spatial problems and memory loss. You may have rapid eye movement (REM) sleep behavior disorder, which can cause you to physically act out your dreams while you're asleep. Episodes of drowsiness, long periods of staring into space, long naps during the day or disorganized speech are possible. You may experience depression and loss of motivation.", "role": "assistant" } ]
[ { "content": "I am suffering from Kartagener's syndrome and wanted information from you or from Dr. . for this syndrome. (About fertility) and if possible other symptoms. Thank you.\n\nKartagener syndrome (Symptoms): Kartagener syndrome is characterized by p and situs inversus totalis. In people affected by situs inversus totalis, the internal organs including the heart, liver, spleen and intestine are on the opposite side of the body. Although the internal organs are abnormally placed, this condition typically does not cause any health problems. [1] [2] The signs and symptoms of primary ciliary dyskinesia vary, but may include: [1] [2] [3] Neonatal respiratory distress Frequent respiratory infections that can lead to severe lung damage Chronic nasal congestion Frequent sinus infections Recurrent middle ear infections, particularly in early childhood Hearing loss Hydrocephalus Infertility", "role": "user" }, { "content": "Kartagener syndrome is characterized by primary ciliary dyskinesia and situs inversus totalis. In people affected by situs inversus totalis, the internal organs including the heart, liver, spleen and intestine are on the opposite side of the body. This condition typically does not cause any health problems. The signs and symptoms of primary ciliary dyskinesia may include frequent respiratory infections that can lead to severe lung damage, chronic nasal congestion, frequent sinus infections, recurrent middle ear infections, particularly in early childhood, hearing loss, hydrocephalus, and Infertility.", "role": "assistant" } ]
[ { "content": "how is congenital heart disease passed down\n\n Critical congenital heart disease CCHD critical congenital heart defects Description Critical congenital heart disease (CCHD) is a term that refers to a group of serious heart defects that are present from birth. These abnormalities result from problems with the formation of one or more parts of the heart during the early stages of embryonic development. CCHD prevents the heart from pumping blood effectively or reduces the amount of oxygen in the blood. As a result, organs and tissues throughout the body do not receive enough oxygen, which can lead to organ damage and life-threatening complications. Individuals with CCHD usually require surgery soon after birth. Although babies with CCHD may appear healthy for the first few hours or days of life, signs and symptoms soon become apparent. These can include an abnormal heart sound during a heartbeat (heart murmur), rapid breathing (tachypnea), low blood pressure (hypotension), low levels of oxygen in the blood (hypoxemia), and a blue or purple tint to the skin caused by a shortage of oxygen (cyanosis). If untreated, CCHD can lead to shock, coma, and death. However, most people with CCHD now survive past infancy due to improvements in early detection, diagnosis, and treatment. Some people with treated CCHD have few related health problems later in life. However, long-term effects of CCHD can include delayed development and reduced stamina during exercise. Adults with these heart defects have an increased risk of abnormal heart rhythms, heart failure, sudden cardiac arrest, stroke, and premature death. Each of the heart defects associated with CCHD affects the flow of blood into, out of, or through the heart. Some of the heart defects involve structures within the heart itself, such as the two lower chambers of the heart (the ventricles) or the valves that control blood flow through the heart. Others affect the structure of the large blood vessels leading into and out of the heart (including the aorta and pulmonary artery). Still others involve a combination of these structural abnormalities. People with CCHD have one or more specific heart defects. The heart defects classified as CCHD include coarctation of the aorta, double-outlet right ventricle, D-transposition of the great arteries, Ebstein anomaly, hypoplastic left heart syndrome, interrupted aortic arch, pulmonary atresia with intact septum, single ventricle, total anomalous pulmonary venous connection, tetralogy of Fallot, tricuspid atresia, and truncus arteriosus. Frequency Heart defects are the most common type of birth defect, accounting for more than 30 percent of all infant deaths due to birth defects. CCHD represents some of the most serious types of heart defects. About 7,200 newborns, or 18 per 10,000, in the United States are diagnosed with CCHD each year. Causes In most cases, the cause of CCHD is unknown. A variety of genetic and environmental factors likely contribute to this complex condition. Changes in single genes have been associated with CCHD. Studies suggest that these genes are involved in normal heart development before birth. Most of the identified mutations reduce the amount or function of the protein that is produced from a specific gene, which likely impairs the normal formation of structures in the heart. Studies have also suggested that having more or fewer copies of particular genes compared with other people, a phenomenon known as copy number variation, may play a role in CCHD. However, it is unclear whether genes affected by copy number variation are involved in heart development and how having missing or extra copies of those genes could lead to heart defects. Researchers believe that single-gene mutations and copy number variation account for a relatively small percentage of all CCHD. CCHD is usually isolated, which means it occurs alone (without signs and symptoms affecting other parts of the body). However, the heart defects associated with CCHD can also occur as part of genetic syndromes that have additional features. Some of these genetic conditions, such as Down syndrome, Turner syndrome, and 22q11.2 deletion syndrome, result from changes in the number or structure of particular chromosomes. Other conditions, including Noonan syndrome and Alagille syndrome, result from mutations in single genes. Environmental factors may also contribute to the development of CCHD. Potential risk factors that have been studied include exposure to certain chemicals or drugs before birth, viral infections (such as rubella and influenza) that occur during pregnancy, and other maternal illnesses including diabetes and phenylketonuria. Although researchers are examining risk factors that may be associated with this complex condition, many of these factors remain unknown. Inheritance Pattern Most cases of CCHD are sporadic, which means they occur in people with no history of the disorder in their family. However, close relatives (such as siblings) of people with CCHD may have an increased risk of being born with a heart defect compared with people in the general population. Sources for This Page Fahed AC, Gelb BD, Seidman JG, Seidman CE. Genetics of congenital heart disease: the glass half empty. Circ Res. 2013 Feb 15;112(4):707-20. doi: 10.1161/CIRCRESAHA.112.300853. Review. Erratum in: Circ Res. 2013 Jun 7;112(12):e182. ", "role": "user" }, { "content": "Most cases of congenital heart disease occur in people with no history of the disorder in their family. However, close relatives of people with congenital heart disease may have an increased risk of having a heart defect.", "role": "assistant" } ]
[ { "content": "Research assignment Hi, I am a grade 12 student who is doing a research assignment on neurological disorders. Do you believe that there will ever be a bonafide cure for Multiple Sclerosis? If so, what kind of time frame would put on this cure?\n\n Multiple sclerosis Overview Multiple sclerosis (MS) is a potentially disabling disease of the brain and spinal cord (central nervous system). In MS, the immune system attacks the protective sheath (myelin) that covers nerve fibers and causes communication problems between your brain and the rest of your body. Eventually, the disease can cause the nerves themselves to deteriorate or become permanently damaged. Signs and symptoms of MS vary widely and depend on the amount of nerve damage and which nerves are affected. Some people with severe MS may lose the ability to walk independently or at all, while others may experience long periods of remission without any new symptoms. There's no cure for multiple sclerosis. However, treatments can help speed recovery from attacks, modify the course of the disease and manage symptoms. Find out why Mayo Clinic is the best place for your care. Symptoms Multiple sclerosis signs and symptoms may differ greatly from person to person and over the course of the disease depending on the location of affected nerve fibers. They may include: - Numbness or weakness in one or more limbs that typically occurs on one side of your body at a time, or the legs and trunk - Partial or complete loss of vision, usually in one eye at a time, often with pain during eye movement - Prolonged double vision - Tingling or pain in parts of your body - Electric-shock sensations that occur with certain neck movements, especially bending the neck forward (Lhermitte sign) - Tremor, lack of coordination or unsteady gait - Slurred speech - Fatigue - Dizziness - Problems with bowel and bladder function When to see a doctor See a doctor if you experience any of the above symptoms for unknown reasons. Disease course Most people with MS have a relapsing-remitting disease course. They experience periods of new symptoms or relapses that develop over days or weeks and usually improve partially or completely. These relapses are followed by quiet periods of disease remission that can last months or even years. Small increases in body temperature can temporarily worsen signs and symptoms of MS, but these aren't considered disease relapses. About 60 to 70 percent of people with relapsing-remitting MS eventually develop a steady progression of symptoms, with or without periods of remission, known as secondary-progressive MS. The worsening of symptoms usually includes problems with mobility and gait. The rate of disease progression varies greatly among people with secondary-progressive MS. Some people with MS experience a gradual onset and steady progression of signs and symptoms without any relapses. This is known as primary-progressive MS. Causes The cause of multiple sclerosis is unknown. It's considered an autoimmune disease in which the body's immune system attacks its own tissues. In the case of MS, this immune system malfunction destroys myelin (the fatty substance that coats and protects nerve fibers in the brain and spinal cord). Myelin can be compared to the insulation coating on electrical wires. When the protective myelin is damaged and nerve fiber is exposed, the messages that travel along that nerve may be slowed or blocked. The nerve may also become damaged itself. It isn't clear why MS develops in some people and not others. A combination of genetics and environmental factors appears to be responsible. Risk factors These factors may increase your risk of developing multiple sclerosis: - Age. MS can occur at any age, but most commonly affects people between the ages of 15 and 60. - Sex. Women are about twice as likely as men are to develop MS. - Family history. If one of your parents or siblings has had MS, you are at higher risk of developing the disease. - Certain infections. A variety of viruses have been linked to MS, including Epstein-Barr, the virus that causes infectious mononucleosis. - Race. White people, particularly those of Northern European descent, are at highest risk of developing MS. People of Asian, African or Native American descent have the lowest risk. - Climate. MS is far more common in countries with temperate climates, including Canada, the northern United States, New Zealand, southeastern Australia and Europe. - Certain autoimmune diseases. You have a slightly higher risk of developing MS if you have thyroid disease, type 1 diabetes or inflammatory bowel disease. - Smoking. Smokers who experience an initial event of symptoms that may signal MS are more likely than nonsmokers to develop a second event that confirms relapsing-remitting MS. Diagnosis There are no specific tests for MS. Instead, a diagnosis of multiple sclerosis often relies on ruling out other conditions that might produce similar signs and symptoms, known as a differential diagnosis. Your doctor is likely to start with a thorough medical history and examination. Your doctor may then recommend: - Blood tests, to help rule out other diseases with symptoms similar to MS. Tests to check for specific biomarkers associated with MS are currently under development and may also aid in diagnosing the disease. - Lumbar puncture (spinal tap), in which a small sample of fluid is removed from your spinal canal for laboratory analysis. This sample can show abnormalities in antibodies that are associated with MS. Spinal tap can also help rule out infections and other conditions with symptoms similar to MS. - MRI, which can reveal areas of MS (lesions) on your brain and spinal cord. You may receive an intravenous injection of a contrast material to highlight lesions that indicate your disease is in an active phase. - Evoked potential tests, which record the electrical signals produced by your nervous system in response to stimuli. An evoked potential test may use visual stimuli or electrical stimuli, in which you watch a moving visual pattern, or short electrical impulses are applied to nerves in your legs or arms. Electrodes measure how quickly the information travels down your nerve pathways. In most people with relapsing-remitting MS, the diagnosis is fairly straightforward and based on a pattern of symptoms consistent with the disease and confirmed by brain imaging scans, such as MRI. Diagnosing MS can be more difficult in persons with unusual symptoms or progressive disease. In these cases, further testing with spinal fluid analysis, evoked potentials and additional imaging may be needed. Treatment There is no cure for multiple sclerosis. Treatment typically focuses on speeding recovery from attacks, slowing the progression of the disease and managing MS symptoms. Some people have such mild symptoms that no treatment is necessary. Treatments for MS attacks - Corticosteroids, such as oral prednisone and intravenous methylprednisolone, are prescribed to reduce nerve inflammation. Side effects may include insomnia, increased blood pressure, mood swings and fluid retention. - Plasma exchange (plasmapheresis). The liquid portion of part of your blood (plasma) is removed and separated from your blood cells. The blood cells are then mixed with a protein solution (albumin) and put back into your body. Plasma exchange may be used if your symptoms are new, severe and haven't responded to steroids. Treatments to modify progression For primary-progressive MS, ocrelizumab (Ocrevus) is the only FDA-approved disease-modifying therapy. It slows worsening of disability in people with this type of MS. For relapsing-remitting MS, several disease-modifying therapies are available. Much of the immune response associated with MS occurs in the early stages of the disease. Aggressive treatment with these medications as early as possible can lower the relapse rate and slow the formation of new lesions. Many of the disease-modifying therapies used to treat MS carry significant health risks. Selecting the right therapy for you will depend on careful consideration of many factors, including duration and severity of disease, effectiveness of previous MS treatments, other health issues, cost, and child-bearing status. Treatment options for relapsing-remitting MS include: - Beta interferons. These medications are among the most commonly prescribed medications to treat MS. They are injected under the skin or into muscle and can reduce the frequency and severity of relapses. Side effects of beta interferons may include flu-like symptoms and injection-site reactions. You'll need blood tests to monitor your liver enzymes because liver damage is a possible side effect of interferon use. People taking interferons may develop neutralizing antibodies that can reduce drug effectiveness. - Ocrelizumab (Ocrevus). This humanized immunoglobulin antibody medication is the only DMT approved by the FDA to treat both the relapse-remitting and primary progressive forms of MS. Clinical trials showed it reduced relapse rate in relapsing disease and slowed worsening of disability in both forms of the disease. Ocrevus is given via an intravenous infusion by a medical professional. Side effects may infusion-related reactions including irritation at the injection site, low blood pressure, fever, and nausea among others. Ocrevus may also increase the risk of some types of cancer, particularly breast cancer. - Glatiramer acetate (Copaxone). This medication may help block your immune system's attack on myelin and must be injected beneath the skin. Side effects may include skin irritation at the injection site. - Dimethyl fumarate (Tecfidera). This twice-daily oral medication can reduce relapses. Side effects may include flushing, diarrhea, nausea and lowered white blood cell count. - Fingolimod (Gilenya). This once-daily oral medication reduces relapse rate. You'll need to have your heart rate monitored for six hours after the first dose because your heartbeat may be slowed. Other side effects include headache, high blood pressure and blurred vision. - Teriflunomide (Aubagio). This once-daily medication can reduce relapse rate. Teriflunomide can cause liver damage, hair loss and other side effects. It is harmful to a developing fetus and should not be used by women who may become pregnant and are not using appropriate contraception, or their male partner. - Natalizumab (Tysabri). This medication is designed to block the movement of potentially damaging immune cells from your bloodstream to your brain and spinal cord. It may be considered a first line treatment for some people with severe MS or as a second line treatment in others. This medication increases the risk of a viral infection of the brain called progressive multifocal leukoencephalopathy in some people. - Alemtuzumab (Lemtrada). This drug helps reduce relapses of MS by targeting a protein on the surface of immune cells and depleting white blood cells. This effect can limit potential nerve damage caused by the white blood cells, but it also increases the risk of infections and autoimmune disorders. Treatment with alemtuzumab involves five consecutive days of drug infusions followed by another three days of infusions a year later. Infusion reactions are common with alemtuzumab. The drug is only available from registered providers, and people treated with the drug must be registered in a special drug safety monitoring program. - Mitoxantrone. This immunosuppressant drug can be harmful to the heart and is associated with development of blood cancers. As a result, its use in treating MS is extremely limited. Mitoxantrone is usually used only to treat severe, advanced MS. Treatments for MS signs and symptoms - Physical therapy. A physical or occupational therapist can teach you stretching and strengthening exercises and show you how to use devices to make it easier to perform daily tasks. Physical therapy along with the use of a mobility aid when necessary can also help manage leg weakness and other gait problems often associated with MS. - Muscle relaxants. You may experience painful or uncontrollable muscle stiffness or spasms, particularly in your legs. Muscle relaxants such as baclofen (Lioresal) and tizanidine (Zanaflex) may help. - Medications to reduce fatigue. - Other medications. Medications also may be prescribed for depression, pain, sexual dysfunction, and bladder or bowel control problems that are associated with MS. Lifestyle and home remedies To help relieve the signs and symptoms of MS, try to: - Get plenty of rest. - Exercise. If you have mild to moderate MS, regular exercise can help improve your strength, muscle tone, balance and coordination. Swimming or other water exercises are good options if you're bothered by heat. Other types of mild to moderate exercise recommended for people with MS include walking, stretching, low-impact aerobics, stationary bicycling, yoga and tai chi. - Cool down. MS symptoms often worsen when your body temperature rises. Avoiding exposure to heat and using devices such as cooling scarves or vests can be helpful. - Eat a balanced diet. Results of small studies suggest that a diet low in saturated fat but high in omega-3 fatty acids, such as those found in olive and fish oils, may be beneficial. But further research is needed. Studies also suggest that vitamin D may have potential benefit for people with MS. - Relieve stress. Stress may trigger or worsen your signs and symptoms. Yoga, tai chi, massage, meditation or deep breathing may help. Alternative medicine Many people with MS use a variety of alternative or complementary treatments or both to help manage their symptoms, such as fatigue and muscle pain. Activities such as exercise, meditation, yoga, massage, eating a healthier diet, acupuncture and relaxation techniques may help boost overall mental and physical well-being, but there are few studies to back up their use in managing symptoms of MS. Guidelines from the American Academy of Neurology recommend the use of oral cannabis extract for muscle spasticity and pain, but do not recommend cannabis in any other form for other MS symptoms due to a lack of evidence. The guidelines also do not recommend the use of herbal supplements such as Ginkgo biloba and bee venom or magnetic therapy for MS symptoms. ", "role": "user" }, { "content": "There is no cure for multiple sclerosis. Treatment typically focuses on speeding recovery from attacks, slowing the progression of the disease and managing MS symptoms. For primary-progressive MS, ocrelizumab (Ocrevus) is the only FDA-approved disease-modifying therapy. It slows worsening of disability in people with this type of MS. For relapsing-remitting MS, several disease-modifying therapies are available.", "role": "assistant" } ]
[ { "content": "how do you get a prolapse bladder\n\n Pelvic organ prolapse Overview Pelvic organ prolapse happens when the muscles and tissues supporting the pelvic organs (the uterus, bladder, or rectum) become weak or loose. This allows one or more of the pelvic organs to drop or press into or out of the vagina. Many women are embarrassed to talk to their doctor about their symptoms or think that their symptoms are normal. But pelvic organ prolapse is treatable. What is pelvic organ prolapse? The pelvic muscles and tissues support the pelvic organs like a hammock. The pelvic organs include the bladder, uterus and cervix, vagina, and rectum, which is part of the bowel. A prolapse happens when the pelvis muscles and tissues can no longer support these organs because the muscles and tissues are weak or damaged. This causes one or more pelvic organs to drop or press into or out of the vagina. Pelvic organ prolapse is a type of pelvic floor disorder. The most common pelvic floor disorders are: What are the different types of pelvic organ prolapse? The different types of pelvic organ prolapse depend on the pelvic organ affected. The most common types include: Although it is rare, pelvic organ prolapse can also happen after a hysterectomy. Any part of the vaginal wall may drop, causing a bulge into or out of the vagina. Who gets pelvic organ prolapse? Pelvic floor disorders (urinary incontinence, fecal incontinence, and pelvic organ prolapse) affect one in five women in the United States.1 Pelvic organ prolapse is less common than urinary or fecal incontinence but affects almost 3% of U.S. women.1 Pelvic organ prolapse happens more often in older women and in white and Hispanic women than in younger women or women of other racial and ethnic groups.2,3 Some women develop more than one pelvic floor disorder, such as pelvic organ prolapse with urinary incontinence. What are the symptoms of pelvic organ prolapse? The pressure from prolapse can cause a bulge in the vagina that can sometimes be felt or seen. Women with pelvic organ prolapse may feel uncomfortable pressure during physical activity or sex. Other symptoms of pelvic organ prolapse include: Some women say that their symptoms are worse at certain times of the day, during physical activity, or after standing for a long time. Talk to your doctor or nurse about your symptoms. What causes pelvic organ prolapse? Pelvic organ prolapse happens when the muscles or connective tissues of the pelvis do not work as they should. The most common risk factors are: How is pelvic organ prolapse diagnosed? Your doctor will talk to you about your symptoms and do a pelvic exam. You may be asked to strain or cough during the exam so your doctor can see whether these actions cause prolapse or urine leakage. Your doctor may also do other tests to see whether you can completely empty your bladder when you go to the bathroom. How is pelvic organ prolapse treated? Treatment for pelvic organ prolapse depends on the type of prolapse you have, your symptoms, your age, other health problems, and whether you are sexually active. Your treatment may include one or more of the following: How can I prevent pelvic organ prolapse? Researchers are studying ways to prevent pelvic organ prolapse. The following steps may reduce your risk of getting a pelvic floor problem: Did we answer your question about pelvic organ prolapse? For more information about pelvic organ prolapse, call the OWH Helpline at 1-800-994-9662 or contact the following organizations: Sources ", "role": "user" }, { "content": "Pelvic organ prolapse occurs when the muscles and tissues supporting the pelvic organs become weak or loose, and do not work as they should. This allows one or more of the pelvic organs to drop or press into/out of the vagina.", "role": "assistant" } ]
[ { "content": "CURE FOR PNEUMONIA Dear DR, please i have a friend that has the above illness..I want to find out...since i want to marry her...is it an infectious illness,,and can it be totally cured. And how can i help her to get this cured..Please i really need your reply urgently\n\nViral pneumonia (Treatment): Antibiotics do not treat this type of lung infection. Medicines that treat viruses may work against some pneumonias caused by influenza and the herpes family of viruses. These medicines may be tried if the infection is caught early. Treatment may also involve: - Corticosteroid medicines - Increased fluids - Oxygen - Use of humidified air A hospital stay may be needed if you are unable to drink enough and to help with breathing if oxygen levels are too low. People are more likely to be admitted to the hospital if they: - Are older than 65 years or are children - Are unable to care for themselves at home, eat, or drink - Have another serious medical problem, such as a heart or kidney problem - Have been taking antibiotics at home and are not getting better - Have severe symptoms However, many people can be treated at home. You can take these steps at home: - Control your fever with aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen or naproxen), or acetaminophen. DO NOT give aspirin to children because it may cause a dangerous illness called Reye syndrome. - DO NOT take cough medicines without first talking to your provider. Cough medicines may make it harder for your body to cough up sputum. - Drink plenty of fluids to help loosen secretions and bring up phlegm. - Get a lot of rest. Have someone else do chores.", "role": "user" }, { "content": "Viral pneumonias may be treated with anti-viral medications at the early stages of the infection. Treatments may also include corticosteroids, increased fluid intake, oxygen and humidified air. If you are unable to stay hydrated or need help with breathing, you might be hospitalized. At home, you could take drugs that control fever, such as ibuprofen or acetaminophen, drink plenty of fluids and get a lot of rest.", "role": "assistant" } ]
[ { "content": "what the treatment for bronchitis\n\nIndustrial bronchitis (Treatment): The goal of treatment is to reduce the irritation. Getting more air into the workplace or wearing masks to filter out the offending dust particles may help. Some people may need to be taken out of the workplace. Some cases of industrial bronchitis go away without treatment. Other times, a person may need inhaled anti-inflammatory medicines. If you are at risk or have experienced this problem and you smoke, stop smoking. Helpful measures include: - Breathing humidified air - Increasing fluid intake - Resting", "role": "user" }, { "content": "If bronchitis occurs due to working around certain dusts, fumes, smoke, or other substances, the goal of treatment is to reduce the irritation by getting more air into the workplace or wearing masks. Some cases of such industrial bronchitis go away without treatment. Other, may need inhaled anti-inflammatory medicines. Helpful measures include: stopping smoking, breathing humidified air, increasing fluid intake, and resting.", "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": "Lewy body dementia, or dementia with Lewy bodies, is the second most common type of progressive dementia, after Alzheimer's disease. The name Lewy bodies comes from protein deposits which develop in nerve cells in the brain regions involved in thinking, memory, and motor control. This causes a progressive decline in mental abilities. Symptoms of Lewy body dementia include visual hallucinations, and changes in alertness and attention. Other symptoms include those similar to Parkinson's disease, such as rigid muscles, slow movement, and tremors.", "role": "assistant" } ]
[ { "content": "what are the risk factors of type ii 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": "Type 1 and type 2 are the two major types of diabetes. In type 1 diabetes, most often diagnosed in children or young adults, the body makes little or no insulin. The exact cause is unknown. In type 2 diabetes, the body doesn't use insulin as well as it should.", "role": "assistant" } ]
[ { "content": "how do i stop using rasagiline\n\n Rasagiline Why is this medication prescribed? Rasagiline is used alone or in combination with another medication to treat the symptoms of Parkinson's disease (a slowly progressing disease of the nervous system causing a fixed face without expression, tremor at rest, slowing of movements, walking with shuffling steps, stooped posture and muscle weakness). Rasagiline is in a class of medications called monoamine oxidase (MAO) type B inhibitors. It works by increasing the amounts of certain natural substances in the brain. How should this medicine be used? 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. Other uses for this medicine This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. What special precautions should I follow? <h3>Before taking rasagiline,</h3> /h3> tell your doctor and pharmacist if you are allergic to rasagiline, any other medications, or any of the ingredients in rasagiline tablets. Ask your pharmacist for a list of the ingredients. tell your doctor if you are taking cough and cold products containing dextromethorphan (DM; Delsym, Hold, Robitussin CoughGels, Vicks 44 Cough Relief, in Robitussin DM, others), cyclobenzaprine (Flexeril), meperidine (Demerol), methadone (Dolophine, Methadose), propoxyphene (Darvon, in Darvocet-N, others), St. John's wort, or tramadol (Ultram, in Ultracet). Also tell your doctor if you are taking MAO inhibitors such as phenelzine (Nardil), selegiline (Eldepryl), or tranylcypromine (Parnate) or have stopped taking them within the past two weeks. Your doctor may tell you not to take rasagiline if you are taking one or more of these medications. 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: amphetamines (Adderall, Dexedrine, DextroStat); antidepressants; cimetidine (Tagamet); decongestants placed in the eye or nose; diet or weight-control products containing ephedrine; fluoroquinolone antibiotics including ciprofloxacin (Cipro), gatifloxacin (Tequin), levofloxacin (Levaquin), norfloxacin (Noroxin), and ofloxacin (Floxin); fluvoxamine (Luvox); medications to treat asthma; medications to treat high blood pressure; medications to treat mental illness; medications to treat pain; phenylpropanolamine (not available in the U.S.); pseudoephedrine (PediaCare, Sudafed, Suphedrine, others); and ticlopidine (Ticlid). Tell your doctor if you are taking fluoxetine (Prozac, Sarafem) or have stopped taking it within the past 5 weeks. 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 high blood pressure, mental illness or psychosis;kidney, or liver disease. tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking rasagiline, call your doctor. you should know that rasagiline may cause dizziness, lightheadedness, nausea, sweating, and fainting when you get up too quickly from a lying position. This is more common during the first 2 months of taking rasagiline. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up. you should know that rasagiline may cause serious, life-threatening high blood pressure when taken with certain medications or foods. Carefully follow your doctor's instructions about medications and foods to be avoided. Call your doctor right away if you have a severe headache, blurred vision, or any of the other symptoms listed below as serious side effects. you should know that people who have Parkinson's disease have a higher risk of melanoma (a type of skin cancer) than people who do not have Parkinson's disease. It is not known whether this increased risk is caused by Parkinson's disease, medications used for Parkinson's disease such as rasagiline, or other factors. You should have regular visits with a dermatologist to examine your skin for melanoma. you should know that some people who took rasagiline or similar medications to treat Parkinson's disease experienced intense urges to gamble, increased sexual urges, and other urges that they were unable to control. Tell your doctor if you experience new or increased gambling urges, increased sexual urges, or other intense urges while taking rasagiline. What special dietary instructions should I follow? You will need to avoid eating foods that contain very high amounts of tyramine, such as aged cheeses (e.g., Stilton or blue cheese) during your treatment with rasagiline. Talk to your doctor or dietitian about which foods you should avoid during your treatment or if you do not feel well after eating or drinking certain foods while taking rasagiline. What should I do if I forget a dose? Do not take a double dose to make up for a missed one. Skip the missed dose and take your next dose at the usual time the next day. What side effects can this medication cause? <h3>Rasagiline may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: </h3> /h3> mild headache joint or neck pain heartburn nausea vomiting stomach pain constipation diarrhea loss of appetite weight loss flu-like symptoms fever sweating red, swollen, and/or itchy eyes dry mouth swollen gums unsteadiness, wobbliness, or lack of coordination involuntary, repeated body movements lack of energy sleepiness abnormal dreams depression pain, burning, numbness, or tingling in the hands or feet rash bruising or purple discoloration on skin <h3>Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately: </h3> /h3> severe headache blurred vision seizures chest pain shortness of breath or difficulty breathing confusion unconsciousness slow or difficult speech dizziness or faintness weakness or numbness of an arm or leg hallucinating (seeing things or hearing voices that do not exist) extreme restlessness difficulty thinking clearly or understanding reality Rasagiline may cause other side effects. Call your doctor if you have any unusual problems while taking this medication. What should I know about storage and disposal of this medication? Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program. It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location - one that is up and away and out of their sight and reach. http://www.upandaway.org In case of emergency/overdose In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911. <h3>Symptoms of rasagiline overdose may occur as late as 1 to 2 days after the overdose. Symptoms of overdose may include the following: </h3> /h3> drowsiness dizziness faintness irritability hyperactivity agitation or restlessness severe headache hallucinating confusion loss of coordination difficulty opening the mouth rigid body spasm that may include an arched back twitching muscles seizures loss of consciousness fast or irregular heart beat pain in the area between the stomach and chest difficulty breathing or slowed breathing diarrhea fever sweating cool, clammy skin shivering increase in pupil size (black circle in middle of eye) What other information should I know? Keep all appointments with your doctor. Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. Brand names Azilect ", "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": "CURE FOR PNEUMONIA Dear DR, please i have a friend that has the above illness..I want to find out...since i want to marry her...is it an infectious illness,,and can it be totally cured. And how can i help her to get this cured..Please i really need your reply urgently\n\nAtypical pneumonia (Treatment): To feel better, you can take these self-care measures at home: - Control your fever with aspirin, NSAIDs (such as ibuprofen or naproxen), or acetaminophen. DO NOT give aspirin to children because it may cause a dangerous illness called Reye syndrome. - DO NOT take cough medicines without first talking to your provider. Cough medicines may make it harder for your body to cough up the extra sputum. - Drink plenty of fluids to help loosen secretions and bring up phlegm. - Get a lot of rest. Have someone else do household chores. Antibiotics are used to treat atypical pneumonia. - You may be able to take antibiotics by mouth at home. - If your condition is severe, you will likely be admitted to a hospital. There, you will be given antibiotics through a vein (intravenously), as well as oxygen. - Antibiotics might be used for 2 weeks or more. - Finish all the antibiotics you've been prescribed, even if you feel better. If you stop the medicine too soon, the pneumonia can return and may be harder to treat.", "role": "user" }, { "content": "To treat pneumonia, you might be prescribed antibiotics, all of which you should finish, even if you feel better. If you stop taking the antibiotics too soon, the pneumonia may return and be harder to treat. To feel better, you could take drugs that control fever, such as ibuprofen or acetaminophen, drink plenty of fluids and get a lot of rest.", "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) (Treatment): Though irritable bowel syndrome (IBS) doesn’t have a cure, your doctor can manage the symptoms with a combination of diet, medicines, probiotics, and therapies for mental health problems. You may have to try a few treatments to see what works best for you. Your doctor can help you find the right treatment plan.Changes in eating, diet, and nutrition, such as following a FODMAP diet, can help treat your symptoms.Your doctor may recommend medicine to relieve your symptoms.Fiber supplements to relieve constipation when increasing fiber in your diet doesn’t help. Laxatives to help with constipation. Laxatives work in different ways, and your doctor can recommend a laxative that’s right for you. Loperamide to reduce diarrhea by slowing the movement of stool through your colon. Loperamide is an antidiarrheal that reduces diarrhea in people with IBS, though it doesn’t reduce pain, bloating, or other symptoms. Antispasmodics, such as hyoscine, cimetropium, and pinaverium, help to control colon muscle spasms and reduce pain in your abdomen. Antidepressants, such as low doses of tricyclic antidepressants and selective serotonin reuptake inhibitors, to relieve IBS symptoms, including abdominal pain. In theory, because of their effect on colon transit, tricyclic antidepressants should be better for people with IBS with diarrhea, or IBS-D, and selective serotonin reuptake inhibitors should be better for people with IBS with constipation, or IBS-C, although studies haven’t confirmed this theory. Tricyclic antidepressants work in people with IBS by reducing their sensitivity to pain in the gastrointestinal (GI) tract as well as normalizing their GI motility and secretion. Lubiprostone (Amitiza) for people who have IBS-C to improve abdominal pain or discomfort and constipation symptoms. Linaclotide (Linzess) for people who have IBS-C to relieve abdominal pain and increase how often you have bowel movements. The antibiotic rifaximin to reduce bloating by treating small intestinal bacterial overgrowth. However, experts are still debating and researching the use of antibiotics to treat IBS. Coated peppermint oil capsules to reduce IBS symptoms.Follow your doctor’s instructions when you use medicine to treat IBS. Talk with your doctor about possible side effects and what to do if you have them.Some medicines can cause side effects. Ask your doctor and your pharmacist about side effects before taking any medicine. MedlinePlus maintains the latest information about side effects and drug warnings.Your doctor may also recommend probiotics. Probiotics are live microorganisms—tiny organisms that can be seen only with a microscope. These microorganisms, most often bacteria, are like the microorganisms that are normally present in your GI tract. Studies have found that taking large enough amounts of probiotics, specifically Bifidobacteria and certain probiotic combinations, can improve symptoms of IBS. However, researchers are still studying the use of probiotics to treat IBS.You can find probiotics in dietary supplements, such as capsules, tablets, and powders, and in some foods, such as yogurt.Discuss your use of complementary and alternative medical practices, including probiotics and dietary supplements, with your doctor.Psychological therapies may improve your IBS symptoms.Managing StressLearning to reduce stress can help improve IBS. With less stress, you may find you have less cramping and pain. You may also find it easier to manage your symptoms.Some options for managing stress includetaking part in stress reduction and relaxation therapies such as meditation getting counseling and support taking part in regular exercise such as walking or yoga reducing stressful life situations as much as possible getting enough sleepTalk TherapyTalk therapy may reduce stress and improve your IBS symptoms. Two types of talk therapy that health care professionals use to treat IBS are cognitive behavioral therapy and psychodynamic, or interpersonal, therapy. Cognitive behavioral therapy focuses on your thoughts and actions. Psychodynamic therapy focuses on how your emotions affect your IBS symptoms. This type of therapy often involves relaxation and stress management techniques.Gut-Directed HypnotherapyIn gut-directed hypnotherapy, a therapist uses hypnosis to help you relax the muscles in the colon.Mindfulness TrainingMindfulness training can teach you to focus your attention on sensations occurring at the moment and to avoid catastrophizing, or worrying about the meaning of those sensations.", "role": "user" }, { "content": "Your doctor can manage IBS symptoms with a combination of diet, medicines, probiotics, and therapies for mental health problems.", "role": "assistant" } ]
[ { "content": "I have been battling Anal fissure for close to two years now and it has refused to heal all these while. Please what do you suggest i do? Thanks\n\nAnal fissure (Treatment): Most fissures heal on their own and do not need treatment. To prevent or treat anal fissures in infants, be sure to change diapers often and clean the area gently. CHILDREN AND ADULTS Worrying about pain during a bowel movement may cause a person to avoid them. But not having bowel movements will only cause the stools to become even harder, which can make anal fissure worse. Prevent hard stools and constipation by: - Making dietary changes -- eating more fiber or bulk, such as fruits, vegetables, and grains - Drinking more fluids - Using stool softeners Ask your provider about the following ointments or creams to help soothe the affected skin: - Numbing cream, if pain interferes with normal bowel movements - Petroleum jelly - Zinc oxide, 1% hydrocortisone cream, Preparation H, and other products A sitz bath is a warm water bath used for healing or cleansing. Sit in the bath 2 to 3 times a day. The water should cover only the hips and buttocks. If the anal fissures do not go away with home care methods, treatment may involve: - Botox injections into the muscle in the anus (anal sphincter) - Minor surgery to relax the anal muscle - Prescription creams such as nitrates or calcium channel blockers, applied over the fissure to help relax the muscles", "role": "user" }, { "content": "Home remedies for anal fissures include preventing hard stools and constipation by eating more fiber, such as fruits, vegetables, and grains, drinking more fluids, and using stool softeners. Your doctor may recommend ointments or creams to help soothe the affected skin, such as numbing cream, petroleum jelly, zinc oxide, 1% hydrocortisone cream, and Preparation H. A warm water bath 2 to 3 times a day may help healing and cleansing. The water should cover only the hips and buttocks. If the anal fissures do not go away with home care methods, your doctor may recommend botox injections into the muscle in the anus (anal sphincter), minor surgery to relax the anal muscle, prescription creams such as nitrates or calcium channel blockers, applied over the fissure to help relax the muscles.", "role": "assistant" } ]
[ { "content": "how do i prevent myself from having dementia\n\n Dementia Definition Dementia is not a specific disease. It is a descriptive term for a collection of symptoms that can be caused by a number of disorders that affect the brain. People with dementia have significantly impaired intellectual functioning that interferes with normal activities and relationships. They also lose their ability to solve problems and maintain emotional control, and they may experience personality changes and behavioral problems, such as agitation, delusions, and hallucinations. While memory loss is a common symptom of dementia, memory loss by itself does not mean that a person has dementia. Doctors diagnose dementia only if two or more brain functions - such as memory and language skills -- are significantly impaired without loss of consciousness. Some of the diseases that can cause symptoms of dementia are Alzheimer’s disease, vascular dementia, Lewy body dementia, frontotemporal dementia, Huntington’s disease, and Creutzfeldt-Jakob disease. Doctors have identified other conditions that can cause dementia or dementia-like symptoms including reactions to medications, metabolic problems and endocrine abnormalities, nutritional deficiencies, infections, poisoning, brain tumors, anoxia or hypoxia (conditions in which the brain’s oxygen supply is either reduced or cut off entirely), and heart and lung problems. Although it is common in very elderly individuals, dementia is not a normal part of the aging process. Treatment Drugs to specifically treat Alzheimer’s disease and some other progressive dementias are now available. Although these drugs do not halt the disease or reverse existing brain damage, they can improve symptoms and slow the progression of the disease. This may improve an individual’s quality of life, ease the burden on caregivers, or delay admission to a nursing home. Many researchers are also examining whether these drugs may be useful for treating other types of dementia. Many people with dementia, particularly those in the early stages, may benefit from practicing tasks designed to improve performance in specific aspects of cognitive functioning. For example, people can sometimes be taught to use memory aids, such as mnemonics, computerized recall devices, or note taking. 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": "Drugs to specifically treat Alzheimer's disease and some other progressive dementia are now available. Although these drugs do not halt the disease or reverse existing brain damage, they can improve symptoms and slow the progression of the disease. This may improve an individual?s quality of life, ease the burden on caregivers, or delay admission to a nursing home. Many researchers are also examining whether these drugs may be useful for treating other types of dementia. Many people with dementia, particularly those in the early stages, may benefit from practicing tasks designed to improve performance in specific aspects of cognitive functioning. For example, people can sometimes be taught to use memory aids, such as mnemonics, computerized recall devices, or note taking. 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": "what is acute diverticulitis\n\nWhat is Diverticulitis?: Diverticulitis occurs when small, bulging sacs or pouches that form on the inner wall of the intestine (diverticula) become inflamed or infected. Most often, these pouches are in the large intestine (colon).", "role": "user" }, { "content": "Diverticulitis occurs when small, bulging sacs or pouches that form on the inner wall of the intestine (diverticula) become inflamed or infected. Most often, these pouches are in the large intestine (colon).", "role": "assistant" } ]
[ { "content": "how do i prevent myself from having dementia\n\n Dementia Overview Dementia isn't a specific disease. Instead, dementia describes a group of symptoms affecting memory, thinking and social abilities severely enough to interfere with daily functioning. Though dementia generally involves memory loss, memory loss has different causes. So memory loss alone doesn't mean you have dementia. Alzheimer's disease is the most common cause of a progressive dementia in older adults, but there are a number of causes of dementia. Depending on the cause, some dementia symptoms can be reversed. Dementia care at Mayo Clinic Symptoms Dementia symptoms vary depending on the cause, but common signs and symptoms include: Cognitive changes - Memory loss, which is usually noticed by a spouse or someone else - Difficulty communicating or finding words - Difficulty reasoning or problem-solving - Difficulty handling complex tasks - Difficulty with planning and organizing - Difficulty with coordination and motor functions - Confusion and disorientation Psychological changes - Personality changes - Depression - Anxiety - Inappropriate behavior - Paranoia - Agitation - Hallucinations When to see a doctor See a doctor if you or a loved one has memory problems or other dementia symptoms. Some treatable medical conditions can cause dementia symptoms, so it's important to determine the underlying cause. Causes Dementia involves damage of nerve cells in the brain, which can occur in several areas of the brain. Dementia affects people differently, depending on the area of the brain affected. Dementias are often grouped by what they have in common, such as the part of the brain that's affected or whether they worsen over time (progressive dementias). Some dementias, such as those caused by a reaction to medications or vitamin deficiencies, might improve with treatment. Progressive dementias Types of dementias that progress and aren't reversible include: - Alzheimer's disease. In people age 65 and older, Alzheimer's disease is the most common cause of dementia. Although the cause of Alzheimer's disease isn't known, plaques and tangles are often found in the brains of people with Alzheimer's. Plaques are clumps of a protein called beta-amyloid, and tangles are fibrous tangles made up of tau protein. Certain genetic factors might make it more likely that people will develop Alzheimer's. - Vascular dementia. This second most common type of dementia occurs as a result of damage to the vessels that supply blood to your brain. Blood vessel problems can be caused by stroke or other blood vessel conditions. - Lewy body dementia. Lewy bodies are abnormal clumps of protein that have been found in the brains of people with Lewy body dementia, Alzheimer's disease and Parkinson's disease. This is one of the more common types of progressive dementia. - Frontotemporal dementia. This is a group of diseases characterized by the breakdown (degeneration) of nerve cells in the frontal and temporal lobes of the brain, the areas generally associated with personality, behavior and language. As with other dementias, the cause isn't known. - Mixed dementia. Autopsy studies of the brains of people 80 and older who had dementia indicate that many had a combination of Alzheimer's disease, vascular dementia and Lewy body dementia. Studies are ongoing to determine how having mixed dementia affects symptoms and treatments. Other disorders linked to dementia - Huntington's disease. Caused by a genetic mutation, this disease causes certain nerve cells in your brain and spinal cord to waste away. Signs and symptoms, including a severe decline in thinking (cognitive) skills usually appear around age 30 or 40. - Traumatic brain injury. This condition is caused by repetitive head trauma, such as experienced by boxers, football players or soldiers. Depending on the part of the brain that's injured, this condition can cause dementia signs and symptoms, such as depression, explosiveness, memory loss, uncoordinated movement and impaired speech, as well as slow movement, tremors and rigidity (parkinsonism). Symptoms might not appear until years after the trauma. - Creutzfeldt-Jakob disease. This rare brain disorder usually occurs in people without known risk factors. This condition might be due to an abnormal form of a protein. Creutzfeldt-Jakob disease can be inherited or caused by exposure to diseased brain or nervous system tissue. Signs and symptoms of this fatal condition usually appear around age 60. - Parkinson's disease. Many people with Parkinson's disease eventually develop dementia symptoms (Parkinson's disease dementia). Dementia-like conditions that can be reversed Some causes of dementia or dementia-like symptoms can be reversed with treatment. They include: - Infections and immune disorders. Dementia-like symptoms can result from fever or other side effects of your body's attempt to fight off an infection. Conditions such as multiple sclerosis that result from the body's immune system attacking nerve cells also can cause dementia. - Metabolic problems and endocrine abnormalities. People with thyroid problems, low blood sugar (hypoglycemia), too little or too much sodium or calcium, or an impaired ability to absorb vitamin B-12 can develop dementia-like symptoms or other personality changes. - Nutritional deficiencies. Not drinking enough liquids (dehydration); not getting enough thiamin (vitamin B-1), which is common in people with chronic alcoholism; and not getting enough vitamins B-6 and B-12 in your diet can cause dementia-like symptoms. - Reactions to medications. A reaction to a medication or an interaction of several medications can cause dementia-like symptoms. - Subdural hematomas. Bleeding between the surface of the brain and the covering over the brain, which is common in the elderly after a fall, can cause symptoms similar to dementia. - Poisoning. Exposure to heavy metals, such as lead, and other poisons, such as pesticides, as well as alcohol abuse or recreational drug use can lead to symptoms of dementia. Symptoms might resolve with treatment. - Brain tumors. Rarely, dementia can result from damage caused by a brain tumor. - Anoxia. This condition, also called hypoxia, occurs when organ tissues aren't getting enough oxygen. Anoxia can occur due to severe asthma, heart attack, carbon monoxide poisoning or other causes. - Normal-pressure hydrocephalus. This condition, which is caused by enlarged ventricles in the brain, can cause walking problems, urinary difficulty and memory loss. Risk factors Many factors can eventually lead to dementia. Some factors, such as age, can't be changed. Others can be addressed to reduce your risk. Risk factors that can't be changed - Age. The risk rises as you age, especially after age 65. However, dementia isn't a normal part of aging, and dementia can occur in younger people. - Family history. Having a family history of dementia puts you at greater risk of developing the condition. However, many people with a family history never develop symptoms, and many people without a family history do. Tests to determine whether you have certain genetic mutations are available. - Down syndrome. By middle age, many people with Down syndrome develop early-onset Alzheimer's disease. - Mild cognitive impairment. This involves difficulties with memory but without loss of daily function. It puts people at higher risk of dementia. Risk factors you can change You might be able to control the following risk factors of dementia. - Heavy alcohol use. If you drink large amounts of alcohol, you might have a higher risk of dementia. Some studies, however, have shown that moderate amounts of alcohol might have a protective effect. - Cardiovascular risk factors. These include high blood pressure (hypertension), high cholesterol, buildup of fats in your artery walls (atherosclerosis) and obesity. - Depression. Although not yet well-understood, late-life depression might indicate the development of dementia. - Diabetes. If you have diabetes, you might have an increased risk of dementia, especially if it's poorly controlled. - Smoking. Smoking might increase your risk of developing dementia and blood vessel (vascular) diseases. - Sleep apnea. People who snore and have episodes where they frequently stop breathing while asleep may have reversible memory loss. Complications Dementia can affect many body systems and, therefore, the ability to function. Dementia can lead to: - Inadequate nutrition. Many people with dementia eventually reduce or stop their intake of nutrients. Ultimately, they may be unable to chew and swallow. - Pneumonia. Difficulty swallowing increases the risk of choking or aspirating food into the lungs, which can block breathing and cause pneumonia. - Inability to perform self-care tasks. As dementia progresses, it can interfere with bathing, dressing, brushing hair or teeth, using the toilet independently and taking medications accurately. - Personal safety challenges. Some day-to-day situations can present safety issues for people with dementia, including driving, cooking and walking alone. - Death. Late-stage dementia results in coma and death, often from infection. Diagnosis Diagnosing dementia and determining what type it is can be challenging. A diagnosis of dementia requires that at least two core mental functions be impaired enough to interfere with daily living. They are memory, language skills, ability to focus and pay attention, ability to reason and problem-solve, and visual perception. Your doctor will review your medical history and symptoms and conduct a physical examination. He or she will likely ask someone close to you about your symptoms, as well. No single test can diagnose dementia, so doctors are likely to run a number of tests that can help pinpoint the problem. Cognitive and neuropsychological tests Doctors will evaluate your thinking (cognitive) function. A number of tests measure thinking skills such as memory, orientation, reasoning and judgment, language skills, and attention. Neurological evaluation Doctors evaluate your memory, language, visual perception, attention, problem-solving, movement, senses, balance, reflexes and other areas. Brain scans - CT or MRI. These scans can check for evidence of stroke or bleeding or tumor or hydrocephalus. - PET scans. These can show patterns of brain activity and if the amyloid protein, a hallmark of Alzheimer's disease, has been deposited in the brain. Laboratory tests Simple blood tests can detect physical problems that can affect brain function, such as vitamin B-12 deficiency or an underactive thyroid gland. Sometimes the spinal fluid is examined for infection, inflammation or markers of some degenerative diseases. Psychiatric evaluation A mental health professional can determine whether depression or another mental health condition is contributing to your symptoms. Treatment Most types of dementia can't be cured, but there are ways to manage your symptoms. Medications The following are used to temporarily improve dementia symptoms. - Cholinesterase inhibitors. These medications - including donepezil (Aricept), rivastigmine (Exelon) and galantamine (Razadyne) - work by boosting levels of a chemical messenger involved in memory and judgment. Although primarily used to treat Alzheimer's disease, these medications might also be prescribed for other dementias, including vascular dementia, Parkinson's disease dementia and Lewy body dementia. Side effects can include nausea, vomiting and diarrhea. - Memantine. Memantine (Namenda) works by regulating the activity of glutamate, another chemical messenger involved in brain functions, such as learning and memory. In some cases, memantine is prescribed with a cholinesterase inhibitor. A common side effect of memantine is dizziness. - Other medications. Your doctor might prescribe medications to treat other symptoms or conditions, such as depression, sleep disturbances or agitation. Therapies Several dementia symptoms and behavior problems might be treated initially using nondrug approaches, such as: - Occupational therapy. An occupational therapist can show you how to make your home safer and teach coping behaviors. The purpose is to prevent accidents, such as falls; manage behavior; and prepare you for the dementia progression. - Modifying the environment. Reducing clutter and noise can make it easier for someone with dementia to focus and function. You might need to hide objects that can threaten safety, such as knives and car keys. Monitoring systems can alert you if the person with dementia wanders. - Modifying tasks. Break tasks into easier steps and focus on success, not failure. Structure and routine also help reduce confusion in people with dementia. Lifestyle and home remedies Dementia symptoms and behavior problems will progress over time. Caregivers might try the following suggestions: - Enhance communication. When talking with your loved one, maintain eye contact. Speak slowly in simple sentences, and don't rush the response. Present one idea or instruction at a time. Use gestures and cues, such as pointing to objects. - Encourage exercise. Exercise benefits everyone, including people with dementia. The main benefits of exercise include improved strength and cardiovascular health. There is growing evidence that exercise also protects the brain from dementia, especially when combined with a healthy diet and treatment for risk factors for cardiovascular disease. Some research also shows physical activity might slow the progression of impaired thinking in people with Alzheimer's disease. And it can lessen symptoms of depression. - Encourage activity. Plan activities the person with dementia enjoys and can do. Dancing, painting, gardening, cooking, singing and others can be fun, can help you connect with your loved one, and can help your loved one focus on what he or she can still do. - Establish a nighttime ritual. Behavior is often worse at night. Try to establish going-to-bed rituals that are calming and away from the noise of television, meal cleanup and active family members. Leave nightlights on in the bedroom, hall and bathroom to prevent disorientation. Limiting caffeine, discouraging napping and offering opportunities for exercise during the day might ease nighttime restlessness. - Encourage keeping a calendar. A calendar might help your loved one remember upcoming events, daily activities and medication schedules. Consider sharing a calendar with your loved one. - Plan for the future. Develop a plan with your loved one while he or she is able to participate that identifies goals for future care. Support groups, legal advisers, family members and others might be able to help. You'll need to consider financial and legal issues, safety and daily living concerns, and long-term care options. Alternative medicine Several dietary supplements, herbal remedies and therapies have been studied for people with dementia. Some may be beneficial. Use caution when considering taking dietary supplements, vitamins or herbal remedies, especially if you're taking other medications. These remedies aren't regulated, and claims about their benefits aren't always based on scientific research. Some alternative medicines for Alzheimer's disease and other forms of dementia that have been studied include: - Vitamin E. Evidence for taking vitamin E to slow Alzheimer disease is soft. Doctors warn against taking large doses of vitamin E because it may have a higher risk of mortality, especially in people with heart disease. - Omega-3 fatty acids. There is some evidence that eating fish three times a week might lower your risk of dementia. However, in clinical studies, omega-3 fatty acids haven't significantly slowed cognitive decline in mild to moderate Alzheimer's disease. More research is needed. - Ginkgo. Although ginkgo is considered safe, study results have been inconsistent in determining whether ginkgo helps people with dementia. The following techniques may help reduce agitation and promote relaxation in people with dementia. - Music therapy, which involves listening to soothing music - Pet therapy, which involves use of animals, such as visits from dogs, to promote improved moods and behaviors in people with dementia - Aromatherapy, which uses fragrant plant oils - Massage therapy - Art therapy, which involves creating art, focusing on the process rather than the outcome Other therapies The following techniques may help reduce agitation and promote relaxation in people with dementia. - Music therapy, which involves listening to soothing music - Pet therapy, which involves use of animals, such as visits from dogs, to promote improved moods and behaviors in people with dementia - Aromatherapy, which uses fragrant plant oils - Massage therapy - Art therapy, which involves creating art, focusing on the process rather than the outcome ", "role": "user" }, { "content": "There is no cure for most types of dementia, but there are treatments to manage your symptoms. Medications such as donepezil (Aricept), rivastigmine (Exelon) and galantamine (Razadyne) work by boosting levels of a chemical messenger involved in memory and judgement. There are also nondrug approaches such as occupational therapy. An occupational therapist can teach you behaviors to make living with dementia easier. They can help you prevent accidents such as falls, and prepare you for the progression of the disease.", "role": "assistant" } ]
[ { "content": "what are the causes of headaches\n\n Headache Pain - head Rebound headaches Medication overuse headaches Medicine overuse headaches Summary A headache is pain or discomfort in the head, scalp, or neck. Serious causes of headaches are rare. Most people with headaches can feel much better by making lifestyle changes, learning ways to relax, and sometimes by taking medicines. Causes The most common type of headache is tension headache. It is likely caused by tight muscles in your shoulders, neck, scalp, and jaw. A tension headache: May be related to stress, depression, anxiety, a head injury, or holding your head and neck in an abnormal position. Tends to be on both sides of your head. It often starts at the back of the head and spreads forward. The pain may feel dull or squeezing, like a tight band or vice. Your shoulders, neck, or jaw may feel tight or sore. A migraine headache involves severe pain. It usually occurs with other symptoms, such as vision changes, sensitivity to sound or light, or nausea. With a migraine: The pain may be throbbing, pounding, or pulsating. It tends to begin on one side of your head. It may spread to both sides. The headache may be associated with an aura. This is a group of warning symptoms that start before your headache. The pain usually gets worse as you try to move around. Migraines may be triggered by foods, such as chocolate, certain cheeses, or monosodium glutamate (MSG). Caffeine withdrawal, lack of sleep, and alcohol may also be triggers. Rebound headaches are headaches that keep coming back. They often occur from overuse of pain medicines. For this reason, these headaches are also called medicine overuse headaches. People who take pain medicine more than 3 days a week on a regular basis can develop this type of headache. Other types of headaches: Cluster headache is a sharp, very painful headache that occurs daily, sometimes up to several times a day for months. It then goes away for weeks to months. In some people, the headaches never come back. The headache usually lasts less than an hour. It tends to occur at the same times every day. Sinus headache causes pain in the front of the head and face. It is due to swelling in the sinus passages behind the cheeks, nose, and eyes. The pain is worse when you bend forward and when you first wake up in the morning. Headaches may occur if you have a cold, the flu, a fever, or premenstrual syndrome. Headache due to a disorder called temporal arteritis. This is a swollen, inflamed artery that supplies blood to part of the head, temple, and neck area. In rare cases, a headache can be a sign of something more serious, such as: Bleeding in the area between the brain and the thin tissue that covers the brain (subarachnoid hemorrhage) Blood pressure that is very high Brain infection, such as meningitis or encephalitis, or abscess Brain tumor Buildup of fluid inside the skull that leads to brain swelling (hydrocephalus) Buildup of pressure inside the skull that appears to be, but is not a tumor (pseudotumor cerebri) Carbon monoxide poisoning Lack of oxygen during sleep (sleep apnea) Problems with the blood vessels and bleeding in the brain, such as arteriovenous malformation (AVM), brain aneurysm, or stroke Home Care There are things you can do to manage headaches at home, especially migraines or tension headaches. Try to treat the symptoms right away. When migraine symptoms begin: Drink water to avoid getting dehydrated, especially if you have vomited. Rest in a quiet, dark room. Place a cool cloth on your head. Use any relaxation techniques you have learned. A headache diary can help you identify your headache triggers. When you get a headache, write down the following: Day and time the pain began What you ate and drank over the past 24 hours How much you slept What you were doing and where you were right before the pain started How long the headache lasted and what made it stop Review your diary with your health care provider to identify triggers or a pattern to your headaches. This can help you and your provider create a treatment plan. Knowing your triggers can help you avoid them. Your provider may have already prescribed medicine to treat your type of headache. If so, take the medicine as instructed. For tension headaches, try acetaminophen, aspirin, or ibuprofen. Talk to your provider if you are taking pain medicines 3 or more days a week. When to Contact a Medical Professional Some headaches may be a sign of a more serious illness. Seek medical help right away for any of the following: This is the first headache you have ever had in your life and it interferes with your daily activities. Your headache comes on suddenly and is explosive or violent. Your headache is \"the worst ever,\" even if you regularly get headaches. You also have slurred speech, a change in vision, problems moving your arms or legs, loss of balance, confusion, or memory loss with your headache. Your headache gets worse over 24 hours. You also have a fever, stiff neck, nausea, and vomiting with your headache. Your headache occurs with a head injury. Your headache is severe and just in one eye, with redness in that eye. You just started getting headaches, especially if you are older than 50. Your headaches are associated with vision problems, pain while chewing, or weight loss. You have a history of cancer or immune system problem (such as HIV/AIDS) and develop a new headache. What to Expect at Your Office Visit Your provider will take a medical history and will examine your head, eyes, ears, nose, throat, neck, and nervous system. Your provider will ask many questions to learn about your headaches. Diagnosis is usually based on your history of symptoms. Tests may include: Blood tests or a lumbar puncture if you may have an infection Head CT scan or MRI if you have any danger signs or you have been having headaches for a while Sinus x-rays CT or MR angiography Review Date 11/22/2017 Updated by: Luc Jasmin, MD, PhD, FRCS (C), FACS, Department of Surgery at Providence Medical Center, Medford OR; Department of Surgery at Ashland Community Hospital, Ashland OR; Department of Maxillofacial Surgery at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Serious causes of headaches are rare. Most people with headaches can feel much better by making lifestyle changes, learning ways to relax, and sometimes by taking medicines. The most common type of headache is tension headache, which may be related to stress, depression, anxiety, a head injury, or holding your head and neck in an abnormal position. Migraines may be triggered by foods, such as chocolate, certain cheeses, or monosodium glutamate (MSG). Caffeine withdrawal, lack of sleep, and alcohol may also be triggers. Rebound headaches are headaches that keep coming back. They often occur from overuse of pain medicines. Other types of headaches include cluster headache, which is a sharp, very painful headache that occurs daily, sometimes up to several times a day for months. It then goes away for weeks to months. In some people, the headaches never come back. Sinus headaches cause pain in the front of the head and face. It is due to swelling in the sinus passages behind the cheeks, nose, and eyes. The pain is worse when you bend forward and when you first wake up in the morning. Headaches may occur if you have a cold, the flu, a fever, or premenstrual syndrome. Additional, more serious causes of headaches include brain tumor, carbon monoxide poisoning, high blood pressure, or brain swelling.", "role": "assistant" } ]
[ { "content": "how do you check for lupus?\n\n Lupus nephritis Nephritis - lupus Lupus glomerular disease Summary Lupus nephritis, which is a kidney disorder, is a complication of systemic lupus erythematosus. Causes Systemic lupus erythematosus (SLE, or lupus) is an autoimmune disease. This means there is a problem with the body's immune system. Normally, the immune system helps protect the body from infection or harmful substances. But in people with an autoimmune disease, the immune system cannot tell the difference between harmful substances and healthy ones. As a result, the immune system attacks otherwise healthy cells and tissues. SLE may damage different parts of the kidney. This can lead to disorders such as interstitial nephritis, nephrotic syndrome, and membranous glomerulonephritis. Over time, kidney failure can result. Symptoms Symptoms of lupus nephritis include: Blood in the urine Foamy appearance to urine Swelling (edema) of any area of the body High blood pressure Exams and Tests The health care provider will perform a physical exam and ask about your symptoms. Abnormal sounds may be heard when the provider listens to your heart and lungs. Tests that may be done include: ANA titer BUN and creatinine Complement levels Urinalysis Urine protein Kidney biopsy, to determine appropriate treatment Treatment The goal of treatment is to improve kidney function and to delay kidney failure. Medicines may include drugs that suppress the immune system, such as corticosteroids, cyclophosphamide, mycophenolate mofetil, or azathioprine. You may need dialysis to control symptoms of kidney failure, sometimes for only a while. A kidney transplant may be recommended. People with active lupus should not have a transplant because the condition can occur in the transplanted kidney. Outlook (Prognosis) How well you do, depends on the specific form of lupus nephritis. You may have flareups, and then times when you do not have any symptoms. Some people with this condition develop chronic kidney failure. Although lupus nephritis may return in a transplanted kidney, it rarely leads to end-stage kidney disease. Possible Complications Complications that may result from lupus nephritis include: Acute renal failure Chronic renal failure When to Contact a Medical Professional Call your provider if you have blood in your urine or swelling of your body. If you have lupus nephritis, call your provider if you notice decreased urine output. Prevention Treating lupus may help prevent or delay onset of lupus nephritis. Review Date 8/1/2017 Updated by: Walead Latif, MD, Nephrologist and Clinical Associate Professor, Rutgers Medical School, Newark, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Tests to determine the appropriate treatment for lupus include ANA titer, urinalysis, and kidney biopsy.", "role": "assistant" } ]
[ { "content": "Hello, I have a scoliosis problem plz help me I want its treatment I can send my x.ray also\n\nScoliosis (Outlook (Prognosis)): How well a person with scoliosis does depends on the type, cause, and severity of the curve. The more severe the curving, the more likely it will get worse after the child stops growing. People with mild scoliosis do well with braces. They usually do not have long-term problems. Back pain may be more likely when the person gets older. Outlook for those with neuromuscular or congenital scoliosis varies. They may have another serious disorder, such as cerebral palsy or muscular dystrophy, so their goals are much different. Often, the goal of surgery is simply to allow a child to be able to sit upright in a wheelchair. Congenital scoliosis is difficult to treat and usually requires many surgeries.", "role": "user" }, { "content": "Outlook for people with scoliosis depends on the type, cause, and severity of the curve. People with mild scoliosis do well with braces. As people get older, they might experience back pain.", "role": "assistant" } ]
[ { "content": "what the treatment for bronchitis\n\n Bronchitis Overview Bronchitis is an inflammation of the lining of your bronchial tubes, which carry air to and from your lungs. People who have bronchitis often cough up thickened mucus, which can be discolored. Bronchitis may be either acute or chronic. Often developing from a cold or other respiratory infection, acute bronchitis is very common. Chronic bronchitis, a more serious condition, is a constant irritation or inflammation of the lining of the bronchial tubes, often due to smoking. Acute bronchitis, also called a chest cold, usually improves within a week to 10 days without lasting effects, although the cough may linger for weeks. However, if you have repeated bouts of bronchitis, you may have chronic bronchitis, which requires medical attention. Chronic bronchitis is one of the conditions included in chronic obstructive pulmonary disease (COPD). Symptoms For either acute bronchitis or chronic bronchitis, signs and symptoms may include: - Cough - Production of mucus (sputum), which can be clear, white, yellowish-gray or green in color - rarely, it may be streaked with blood - Fatigue - Shortness of breath - Slight fever and chills - Chest discomfort If you have acute bronchitis, you might have cold symptoms, such as a mild headache or body aches. While these symptoms usually improve in about a week, you may have a nagging cough that lingers for several weeks. Chronic bronchitis is defined as a productive cough that lasts at least three months, with recurring bouts occurring for at least two consecutive years. If you have chronic bronchitis, you're likely to have periods when your cough or other symptoms worsen. At those times, you may have an acute infection on top of chronic bronchitis. See your doctor if your cough: - Lasts more than three weeks - Prevents you from sleeping - Is accompanied by fever higher than 100.4 F (38 C) - Produces discolored mucus - Produces blood - Is associated with wheezing or shortness of breath Causes Acute bronchitis is usually caused by viruses, typically the same viruses that cause colds and flu (influenza). Antibiotics don't kill viruses, so this type of medication isn't useful in most cases of bronchitis. The most common cause of chronic bronchitis is cigarette smoking. Air pollution and dust or toxic gases in the environment or workplace also can contribute to the condition. Risk factors Factors that increase your risk of bronchitis include: - Cigarette smoke. People who smoke or who live with a smoker are at higher risk of both acute bronchitis and chronic bronchitis. - Low resistance. This may result from another acute illness, such as a cold, or from a chronic condition that compromises your immune system. Older adults, infants and young children have greater vulnerability to infection. - Exposure to irritants on the job. Your risk of developing bronchitis is greater if you work around certain lung irritants, such as grains or textiles, or are exposed to chemical fumes. - Gastric reflux. Repeated bouts of severe heartburn can irritate your throat and make you more prone to developing bronchitis. Complications Although a single episode of bronchitis usually isn't cause for concern, it can lead to pneumonia in some people. Repeated bouts of bronchitis, however, may mean that you have chronic obstructive pulmonary disease (COPD). Diagnosis During the first few days of illness, it can be difficult to distinguish the signs and symptoms of bronchitis from those of a common cold. During the physical exam, your doctor will use a stethoscope to listen closely to your lungs as you breathe. In some cases, your doctor may suggest the following tests: - Chest X-ray. A chest X-ray can help determine if you have pneumonia or another condition that may explain your cough. This is especially important if you ever were or currently are a smoker. - Sputum tests. Sputum is the mucus that you cough up from your lungs. It can be tested to see if you have illnesses that could be helped by antibiotics. Sputum can also be tested for signs of allergies. - Pulmonary function test. During a pulmonary function test, you blow into a device called a spirometer, which measures how much air your lungs can hold and how quickly you can get air out of your lungs. This test checks for signs of asthma or emphysema. Treatment Most cases of acute bronchitis get better without treatment, usually within a couple of weeks. Medications Because most cases of bronchitis are caused by viral infections, antibiotics aren't effective. However, if your doctor suspects that you have a bacterial infection, he or she may prescribe an antibiotic. In some circumstances, your doctor may recommend other medications, including: - Cough medicine. If your cough keeps you from sleeping, you might try cough suppressants at bedtime. - Other medications. If you have allergies, asthma or chronic obstructive pulmonary disease (COPD), your doctor may recommend an inhaler and other medications to reduce inflammation and open narrowed passages in your lungs. Therapies If you have chronic bronchitis, you may benefit from pulmonary rehabilitation - a breathing exercise program in which a respiratory therapist teaches you how to breathe more easily and increase your ability to exercise. Lifestyle and home remedies To help you feel better, you may want to try the following self-care measures: - Avoid lung irritants. Don't smoke. Wear a mask when the air is polluted or if you're exposed to irritants, such as paint or household cleaners with strong fumes. - Use a humidifier. Warm, moist air helps relieve coughs and loosens mucus in your airways. But be sure to clean the humidifier according to the manufacturer's recommendations to avoid the growth of bacteria and fungi in the water container. - Consider a face mask outside. If cold air aggravates your cough and causes shortness of breath, put on a cold-air face mask before you go outside. ", "role": "user" }, { "content": "Most cases of acute bronchitis get better without treatment, usually within a couple of weeks. Because most cases of bronchitis are caused by viral infections, antibiotics aren't effective. If doctors suspect that the infection is bacterial, they may prescribe an antibiotic. Doctors may also recommend cough medicine and cough suppressants at bedtime. For patients who have allergies, asthma or chronic obstructive pulmonary disease (COPD), doctors may recommend an inhaler to reduce inflammation and open narrowed passages in the lungs. For chronic bronchitis, pulmonary rehabilitation - a breathing exercise program that teaches how to breathe more easily and increase ability to exercise, may help. The following self-care measures may also help: avoiding lung irritants; avoiding smoking; wearing a mask when the air is polluted or contains irritants, such as paint or household cleaners with strong fumes; wearing cold-air face mask outside; using a humidifier. Warm, moist air helps relieve coughs and loosens mucus in the airways.", "role": "assistant" } ]
[ { "content": "what are pancreatic enzymes?\n\n Pancreatic cysts Overview Pancreatic cysts are saclike pockets of fluid on or in your pancreas, a large organ behind the stomach that produces hormones and enzymes that help digest food. Most pancreatic cysts aren't cancerous, and many don't cause symptoms. They're typically found during imaging testing for another problem. Some are actually noncancerous (benign) pockets of fluids lined with scar or inflammatory tissue, not the type of cells found in true cysts (pseudocysts). But some pancreatic cysts can be or can become cancerous. Your doctor might take a sample of the pancreatic cyst fluid to determine if cancer cells are present. Or your doctor might recommend monitoring a cyst over time for changes that indicate cancer. Symptoms You may not have symptoms from pancreatic cysts, which are often found when imaging tests of the abdomen are done for another reason. When signs or symptoms of pancreatic cysts do occur, they typically include: - Persistent abdominal pain, which may radiate to your back - A mass you can feel in your upper abdomen - Nausea and vomiting When to see a doctor Rarely, cysts can become infected. See a doctor if you have a fever and persistent abdominal pain. A ruptured pseudocyst can be a medical emergency, but fortunately is rare. Fluid released by the pseudocyst can damage nearby blood vessels and cause massive bleeding. A ruptured pseudocyst can also cause infection of the abdominal cavity (peritonitis). Seek emergency medical treatment if you have signs or symptoms of internal bleeding and shock, including: - Fainting - Severe abdominal pain - Decreased consciousness - Weak and rapid heartbeat - Vomiting of blood Causes The cause of most pancreatic cysts is unknown. Some cysts are associated with rare illnesses including von Hippel-Lindau disease, a genetic disorder that can affect the pancreas and other organs. Pseudocysts often follow a bout of a painful condition in which digestive enzymes become prematurely active and irritate the pancreas (pancreatitis). Pseudocysts can also result from injury to the abdomen, such as from a car accident. Risk factors Heavy alcohol use and gallstones are risk factors for pancreatitis, and pancreatitis is a risk factor for pseudocysts. Abdominal injury is also a risk factor for pseudocysts. Diagnosis Pancreatic cysts are diagnosed more often than in the past because improved imaging technology finds them more readily. Many pancreatic cysts are found during abdominal scans for other problems. The main challenge in diagnosis is to determine whether the cyst might become cancerous. These procedures are often used to help with diagnosis and treatment planning: - Medical history. Previous abdominal injury or pancreatitis might indicate a pseudocyst. - CT scan. This imaging test can provide detailed information about the size and structure of a pancreatic cyst. - MRI scan. This imaging test can highlight subtle details of a pancreatic cyst, including whether it has any components that suggest a higher risk of cancer. - Endoscopic ultrasound. This test, like MRI, can provide a detailed image of the cyst. Also, fluid can be collected from the cyst for analysis in a laboratory for possible signs of cancer. The characteristics and location of the pancreatic cyst, with your age and sex, can help doctors pinpoint the type of cyst you have: - Serous cystadenoma can become large enough to displace nearby organs, causing abdominal pain and a feeling of fullness. Serous cystadenomas occur most frequently in women older than 60 and only rarely become cancerous. - Mucinous cystadenoma is usually situated in the body or tail of the pancreas and occurs most often in middle-aged women. Mucinous cystadenoma is precancerous, which means it might become cancer if left untreated. Larger cysts might already be cancerous when found. - Intraductal papillary mucinous neoplasm (IPMN) is a growth in the main pancreatic duct or one of its side branches. IPMN may be precancerous or cancerous. It occurs most often in men and women older than 50. Depending on its location and other factors, IPMN may require surgical removal. - Papillary cystic tumor is usually situated in the body or tail of the pancreas and occurs most often in women younger than 35. Also known as papillary cystic neoplasm, it's rare and usually cancerous. - Cystic islet cell tumor is mostly solid but can have cystlike components. Cystic islet cell tumors are rare. They can be confused with other pancreatic cysts and may be precancerous or cancerous. Treatment Watchful waiting or treatment depends on the type of cyst you have, its size, its characteristics and whether it's causing symptoms. Watchful waiting A benign pseudocyst, even a large one, can be left alone as long as it isn't bothering you. Serous cystadenoma rarely becomes cancerous, so it also can be left alone unless it causes symptoms or grows. But all pancreatic cysts should be monitored. Drainage A pseudocyst that is causing bothersome symptoms or growing larger can be drained. A small flexible tube (endoscope) is passed through your mouth to your stomach and small intestine. The endoscope is equipped with an ultrasound probe (endoscopic ultrasound) and a needle to drain the cyst. Sometimes drainage through the skin is necessary. Surgery Surgery might be needed to remove an enlarged pseudocyst or a serous cystadenoma that's causing pain or other symptoms. Other types of pancreatic cysts generally require surgical removal because of the risk of cancer. A pseudocyst may recur if you have ongoing pancreatitis. ", "role": "user" }, { "content": "pancreas, a large organ behind the stomach that produces hormones and enzymes that help digest food.", "role": "assistant" } ]
[ { "content": "spina bifida; vertbral fusion;syrinx tethered cord. can u help for treatment of these problem\n\n Spina bifida Overview Spina bifida is a birth defect that occurs when the spine and spinal cord don't form properly. It falls under the broader category of neural tube defects. The neural tube is the embryonic structure that eventually develops into the baby's brain and spinal cord and the tissues that enclose them. Normally, the neural tube forms early in pregnancy, and it closes by the 28th day after conception. In babies with spina bifida, a portion of the neural tube fails to develop or close properly, causing defects in the spinal cord and in the bones of the spine. Spina bifida can range from mild to severe, depending on the type of defect, size, location and complications. When early treatment for spina bifida is necessary, it's done surgically, although such treatment doesn't always completely resolve the problem. Types Spina bifida can occur in different forms: spina bifida occulta, meningocele (muh-NING-go-seel) or myelomeningocele (my-uh-lo-muh-NING-go-seel). The severity of spina bifida depends on the type, size, location and complications. \"Occulta\" means hidden. The mildest form, spina bifida occulta results in a small separation or gap in one or more of the bones of the spine (vertebrae). Many people who have spina bifida occulta don't even know it, unless the condition is discovered during an imaging test done for unrelated reasons. In a form of spina bifida called meningocele, the protective membranes around the spinal cord (meninges) push out through the opening in the vertebrae, forming a sac filled with fluid. But this sac doesn't include the spinal cord, so nerve damage is less likely, though later complications are possible. Also known as open spina bifida, myelomeningocele is the most severe form. The spinal canal is open along several vertebrae in the lower or middle back. The membranes and spinal nerves push through this opening at birth, forming a sac on the baby's back, typically exposing tissues and nerves. This makes the baby prone to life-threatening infections. Symptoms Signs and symptoms of spina bifida vary by type and severity. Symptoms can also differ for each person. - Spina bifida occulta. Because the spinal nerves usually aren't involved, typically there are no signs or symptoms. But visible indications can sometimes be seen on the newborn's skin above the spinal defect, including an abnormal tuft of hair, or a small dimple or birthmark. - Meningocele. The membranes around the spinal cord push out through an opening in the vertebrae, forming a sac filled with fluid, but this sac doesn't include the spinal cord. - Myelomeningocele. In this severe form of spina bifida: - The spinal canal remains open along several vertebrae in the lower or middle back. - Both the membranes and the spinal cord or nerves protrude at birth, forming a sac. - Tissues and nerves usually are exposed, though sometimes skin covers the sac. When to see a doctor Typically, meningocele and myelomeningocele are diagnosed before or right after birth, when medical care is available. These children should be followed by a specialized team of doctors throughout their lives and families should be educated on the different complications to watch for. Children with spina bifida occulta typically don't have any symptoms or complications, so usually only routine pediatric care is needed. Causes Doctors aren't certain what causes spina bifida. As with many other problems, it appears to result from a combination of genetic and environmental risk factors, such as a family history of neural tube defects and folate deficiency. Risk factors Spina bifida is more common among whites and Hispanics, and females are affected more often than males. Although doctors and researchers don't know for sure why spina bifida occurs, they have identified some risk factors: - Folate deficiency. Folate (vitamin B-9) is important to the healthy development of a baby. Folate is the natural form of vitamin B-9. The synthetic form, found in supplements and fortified foods, is called folic acid. A folate deficiency increases the risk of spina bifida and other neural tube defects. - Family history of neural tube defects. Couples who've had one child with a neural tube defect have a slightly higher chance of having another baby with the same defect. That risk increases if two previous children have been affected by the condition. In addition, a woman who was born with a neural tube defect has a greater chance of giving birth to a child with spina bifida. However, most babies with spina bifida are born to parents with no known family history of the condition. - Some medications. For example, anti-seizure medications, such as valproic acid (Depakene), seem to cause neural tube defects when taken during pregnancy, possibly because they interfere with the body's ability to use folate and folic acid. - Diabetes. Women with diabetes who don't control their blood sugar well have a higher risk of having a baby with spina bifida. - Obesity. Pre-pregnancy obesity is associated with an increased risk of neural tube birth defects, including spina bifida. - Increased body temperature. Some evidence suggests that increased body temperature (hyperthermia) in the early weeks of pregnancy may increase the risk of spina bifida. Elevating your core body temperature, due to fever or the use of saunas or hot tubs, has been associated with a possible slight increased risk of spina bifida. If you have known risk factors for spina bifida, talk with your doctor to determine if you need a larger dose or prescription dose of folic acid, even before a pregnancy begins. If you take medications, tell your doctor. Some medications can be adjusted to diminish the potential risk of spina bifida, if plans are made ahead of time. Complications Spina bifida may cause minimal symptoms or only minor physical disabilities. If the spina bifida is severe, sometimes it leads to more significant physical disabilities. Severity is affected by: - The size and location of the neural tube defect - Whether skin covers the affected area - Which spinal nerves come out of the affected area of the spinal cord This list of possible complications may seem overwhelming, but not all children with spina bifida get all these complications. And these conditions can be treated. - Walking and mobility problems. The nerves that control the leg muscles don't work properly below the area of the spina bifida defect, causing muscle weakness of the legs, sometimes involving paralysis. Whether a child can walk typically depends on where the defect is, its size, and the care received before and after birth. - Orthopedic complications. Children with myelomeningocele can have a variety of problems in the legs and spine because of weak muscles in the legs and back. The types of problems depend on the level of the defect. Possible problems include a curved spine (scoliosis), abnormal growth or dislocation of the hip, bone and joint deformities, muscle contractures and other orthopedic concerns. - Bowel and bladder problems. Nerves that supply the bladder and bowels usually don't work properly when children have myelomeningocele. This is because the nerves that supply the bowel and bladder come from the lowest level of the spinal cord. - Accumulation of fluid in the brain (hydrocephalus). Babies born with myelomeningocele commonly experience accumulation of fluid in the brain, a condition known as hydrocephalus. - Shunt malfunction. Shunts can stop working or become infected. Warning signs may vary. Some of the warning signs of a shunt that isn't working include headaches, vomiting, sleepiness, irritability, swelling or redness along the shunt, confusion, changes in the eyes (fixed downward gaze), trouble feeding, or seizures. - Chiari malformation type II. Chiari malformation (kee-AH-ree mal-for-MAY-shun) type II is a common brain abnormality in children with the myelomeningocele form of spina bifida. The brainstem, or lowest part of the brain above the spinal cord, is elongated and positioned lower than usual. This can cause problems with breathing and swallowing. Rarely, compression on this area of the brain occurs and surgery is needed to relieve the pressure. - Infection in the tissues surrounding the brain (meningitis). Some babies with myelomeningocele may develop meningitis, an infection in the tissues surrounding the brain. This potentially life-threatening infection may cause brain injury. - Tethered spinal cord. Tethered spinal cord results when the spinal nerves become bound to the scar where the defect was closed surgically, making the spinal cord less able to grow as the child grows. This progressive tethering can cause loss of muscle function to the legs, bowel or bladder. Surgery can limit the degree of disability. - Sleep-disordered breathing. Both children and adults with spina bifida, particularly myelomeningocele, may have sleep apnea or other sleep disorders. Assessment for a sleep disorder in those with myelomeningocele helps detect sleep-disordered breathing, such as sleep apnea, which warrants treatment to improve health and quality of life. - Skin problems. Children with spina bifida may get wounds on their feet, legs, buttocks or back. They can't feel when they get a blister or sore. Sores or blisters can turn into deep wounds or foot infections that are hard to treat. Children with myelomeningocele have a higher risk of wound problems in casts. - Latex allergy. Children with spina bifida have a higher risk of latex allergy, an allergic reaction to natural rubber or latex products. Latex allergy may cause rash, sneezing, itching, watery eyes and a runny nose. It can also cause anaphylaxis, a potentially life-threatening condition in which swelling of the face and airways can make breathing difficult. So it's best to use latex-free gloves and equipment at delivery time and when caring for a child with spina bifida. - Other complications. More problems may arise as children with spina bifida get older, such as urinary tract infections, gastrointestinal (GI) disorders and depression. Children with myelomeningocele may develop learning disabilities, such as problems paying attention, and difficulty learning reading and math. Diagnosis If you're pregnant, you'll be offered prenatal screening tests to check for spina bifida and other birth defects. The tests aren't perfect. Some mothers who have positive blood tests have normal babies. Even if the results are negative, there's still a small chance that spina bifida is present. Talk to your doctor about prenatal testing, its risks and how you might handle the results. Blood tests Your doctor will most likely check for spina bifida by first performing these tests: - Maternal serum alpha-fetoprotein (MSAFP) test. For the MSAFP test, a sample of the mother's blood is drawn and tested for alpha-fetoprotein (AFP) - a protein produced by the baby. It's normal for a small amount of AFP to cross the placenta and enter the mother's bloodstream. But abnormally high levels of AFP suggest that the baby has a neural tube defect, such as spina bifida, though some spina bifida cases don't produce high levels of AFP. - Test to confirm high AFP levels. Varying levels of AFP can be caused by other factors - including a miscalculation in fetal age or multiple babies - so your doctor may order a follow-up blood test for confirmation. If the results are still high, you'll need further evaluation, including an ultrasound exam. - Other blood tests. Your doctor may perform the MSAFP test with two or three other blood tests. These tests are commonly done with the MSAFP test, but their objective is to screen for other abnormalities, such as trisomy 21 (Down syndrome), not neural tube defects. Ultrasound Many obstetricians rely on ultrasonography to screen for spina bifida. If blood tests indicate high AFP levels, your doctor will suggest an ultrasound exam to help determine why. The most common ultrasound exams bounce high-frequency sound waves off tissues in your body to form images on a video monitor. The information these images provide can help establish whether there's more than one baby and can help confirm gestational age, two factors that can affect AFP levels. An advanced ultrasound also can detect signs of spina bifida, such as an open spine or particular features in your baby's brain that indicate spina bifida. Amniocentesis If a blood test shows high levels of AFP in your blood but the ultrasound is normal, your doctor may offer amniocentesis. During amniocentesis, your doctor uses a needle to remove a sample of fluid from the amniotic sac that surrounds the baby. An analysis of the sample indicates the level of AFP present in the amniotic fluid. A small amount of AFP is normally found in amniotic fluid. However, when an open neural tube defect is present, the amniotic fluid contains an elevated amount of AFP because the skin surrounding the baby's spine is gone and AFP leaks into the amniotic sac. Discuss the risks of amniocentesis, including a slight risk of loss of the pregnancy, with your doctor. Treatment Spina bifida treatment depends on the severity of the condition. Spina bifida occulta often doesn't require treatment at all, but other types of spina bifida do. Surgery before birth Nerve function in babies with spina bifida can worsen after birth if it's not treated. Prenatal surgery for spina bifida (fetal surgery) takes place before the 26th week of pregnancy. Surgeons expose a pregnant mother's uterus surgically, open the uterus and repair the baby's spinal cord. Research suggests that children with spina bifida who had fetal surgery may have reduced disability and be less likely to need crutches or other walking devices. In addition, fetal surgery may reduce the risk of hydrocephalus. Ask your doctor whether this procedure may be appropriate for you. Discuss the risks, such as possible premature delivery and other complications, and potential benefits for you and your baby. It's important to have a comprehensive evaluation to determine whether fetal surgery is feasible. This specialized surgery should only be done at a health care facility that has experienced fetal surgery experts, a multispecialty team approach and neonatal intensive care. Typically the team includes a fetal surgeon, pediatric neurosurgeon, maternal-fetal medicine specialist, fetal cardiologist and neonatologist. Cesarean birth Many babies with myelomeningocele tend to be in a feet-first (breech) position. If your baby is in this position or if your doctor has detected a large cyst or sac, cesarean birth may be a safer way to deliver your baby. Surgery after birth Meningocele involves surgery to put the meninges back in place and close the opening in the vertebrae. Because the spinal cord develops normally in babies with meningocele, these membranes often can be removed by surgery with little or no damage to nerve pathways. Myelomeningocele also requires surgery. Performing the surgery early can help minimize risk of infection that's associated with the exposed nerves and may also help protect the spinal cord from more trauma. During the procedure, a neurosurgeon places the spinal cord and exposed tissue inside the baby's body and covers them with muscle and skin. Sometimes a shunt to control hydrocephalus in the baby's brain is placed during the operation on the spinal cord. Treatment for complications In babies with myelomeningocele, irreparable nerve damage has likely already occurred and ongoing care from a multispecialty team of surgeons, physicians and therapists is usually needed. Babies with myelomeningocele may need more surgery for a variety of complications. Treatment for complications - such as weak legs, bladder and bowel problems or hydrocephalus - typically begins soon after birth. Depending on the severity of spina bifida and the complications, treatment may include, for example: - Walking and mobility aids. Some babies may start exercises to prepare their legs for walking with braces or crutches when they're older. Some children may need walkers or a wheelchair. Mobility aids, along with regular physical therapy, can help a child become independent. - Bowel and bladder management. Routine bowel and bladder evaluations and management plans help reduce the risk of organ damage and illness. Evaluations include X-rays, kidney scans, ultrasounds, blood tests and bladder function studies. These evaluations will be more frequent in the first few years of life, but less often as children grow. - Bowel management may include oral medications, suppositories, enemas, surgery, or a combination of these approaches. - Bladder management may include medications, using catheters to empty the bladder, surgery, or a combination. - For children, a specialist in pediatric urology with experience in evaluating and performing surgery on children with spina bifida is the best choice. - Surgery for hydrocephalus. Most babies with myelomeningocele will need a ventricular shunt - a surgically placed tube that allows fluid in the brain to drain into the abdomen. This tube might be placed just after birth, during the surgery to close the sac on the lower back or later as fluid accumulates. A less invasive procedure, called endoscopic third ventriculostomy, may be used, but candidates must be carefully chosen and meet certain criteria. The surgeon uses a small video camera to see inside the brain and makes a hole in the bottom of or between the ventricles so cerebrospinal fluid can flow out of the brain. - Treatment and management of other complications. To help with functioning, special equipment such as bath chairs, commode chairs and standing frames may be needed. Whatever the issue - orthopedic complications, tethered spinal cord, GI issues, skin problems, or others - most spina bifida complications can be treated or at least managed to improve quality of life. Ongoing care Children with spina bifida need close follow-up care and observation. Their primary care doctors follow growth, the need for immunizations and general medical issues. They coordinate your child's medical care. Children with spina bifida also often need treatment and ongoing care from: - Physical medicine and rehabilitation - Neurology - Neurosurgery - Urology - Orthopedics - Physical therapy - Occupational therapy - Special education teachers - Social workers - Dietitians Parents and other caregivers are a key part of the team, learning how to help manage their child's condition and how to encourage and support their child emotionally and socially. Keep in mind that children with spina bifida can go on to college, hold jobs and have families. Special accommodations may be necessary along the way, but encourage your child to be as independent as possible. ", "role": "user" }, { "content": "Spina bifida may cause minimal symptoms or only minor physical disabilities. If the spina bifida is severe, sometimes it leads to more significant physical disabilities. This list of possible complications may seem overwhelming, but not all children with spina bifida get all these complications. And these conditions can be treated.", "role": "assistant" } ]
[ { "content": "I am looking for information about Cancer of the Esophagus and I'm not finding anything on your website.\n\nEsophageal cancer: Esophageal cancer is a cancer of the esophagus, the hollow tube that carries food and liquids from the throat to the stomach. As the cancer grows, symptoms may include painful or difficult swallowing, weight loss and coughing up blood. The exact cause is usually not known, but both environmental and genetic factors are throught to play a role in the development of this condition. In the United States, risk factors for developing esophageal cancer include smoking, heavy drinking, obesity, and damage from acid reflux. Treatments include surgery, radiation, chemotherapy , and laser therapy. Some patients may also need nutritional support, since the cancer or treatment may make it hard to swallow. [1] [2] The Human Phenotype Ontology (HPO) provides the following list of features that have been reported in people with this condition. Much of the information in the HPO comes from Orphanet, a European rare disease database. If available, the list includes a rough estimate of how common a feature is (its frequency). Frequencies are based on a specific study and may not be representative of all studies. You can use the MedlinePlus Medical Dictionary for definitions of the terms below. Signs and Symptoms Approximate number of patients (when available) Autosomal dominant inheritance - Squamous cell carcinoma - Making a diagnosis for a genetic or rare disease can often be challenging. Healthcare professionals typically look at a person’s medical history, symptoms, physical exam, and laboratory test results in order to make a diagnosis. The following resources provide information relating to diagnosis and testing for this condition. If you have questions about getting a diagnosis, you should contact a healthcare professional. Testing Resources The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional. FDA-Approved Treatments The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition. Learn more orphan products. National Library of Medicine Drug Information Portal", "role": "user" }, { "content": "Esophageal cancer is a cancer of the esophagus, the hollow tube that carries food and liquids from the throat to the stomach. As the cancer grows, symptoms may include painful or difficult swallowing, weight loss and coughing up blood. The exact cause is usually not known, but both environmental and genetic factors are throught to play a role in the development of this condition. In the United States, risk factors for developing esophageal cancer include smoking, heavy drinking, obesity, and damage from acid reflux. Treatments include surgery, radiation, chemotherapy , and laser therapy. Some patients may also need nutritional support, since the cancer or treatment may make it hard to swallow.", "role": "assistant" } ]
[ { "content": "prostate cancer using seeds aimed at maligmem tumors is this a safe decision\n\n Prostate cancer treatment Summary Treatment for your prostate cancer is chosen after a thorough evaluation. Your health care provider will discuss the benefits and risks of each treatment. Sometimes your provider may recommend one treatment for you because of your type of cancer and risk factors. Other times, there may be two or more treatments that could be good for you. Factors you and your provider must think about include: Your age and other medical problems you may have Side effects that occur with each type of treatment How much the prostate cancer has spread Your Gleason score, which tells how likely it is that cancer has already spread Your prostate-specific antigen (PSA) test result Ask your provider to explain these things following about your treatment choices: Which choices offer the best chance of curing your cancer or controlling its spread? How likely is it that you will have different side effects, and how they will affect your life? Radical Prostatectomy (Prostate Removal) Radical prostatectomy is a surgery to remove the prostate and some of the surrounding tissue. It is an option when the cancer has not spread beyond the prostate gland. Healthy men who will likely live 10 or more years after being diagnosed with prostate cancer often have this procedure. Be aware that it is not always possible to know for certain, before surgery, if the cancer has spread beyond the prostate gland. Possible problems after surgery include difficulty controlling urine and erection problems. Also, some men need further treatments after this surgery. Radiation Therapy Radiation therapy works best for treating prostate cancer that has not spread outside of the prostate. It may also be used after surgery if there is a risk that cancer cells are still present. Radiation is sometimes used for pain relief when cancer has spread to the bone. External beam radiation therapy uses high-powered x-rays pointed at the prostate gland: Before treatment, the radiation therapist uses a special pen to mark the part of the body that is to be treated. Radiation is delivered to the prostate gland using a machine similar to a regular x-ray machine. The treatment itself is usually painless. Treatment is done in a radiation oncology center that is usually connected to a hospital. Treatment is usually done 5 days a week for 6 to 8 weeks. Side effects may include: Appetite loss Diarrhea Erection problems Fatigue Rectal burning or injury Skin reactions Urinary incontinence, the feeling of needing to urinate urgently, or blood in the urine There are reports of secondary cancers arising from the radiation as well. Proton therapy is another kind of radiation therapy used to treat prostate cancer. Proton beams target the tumor precisely, so there is less damage to the surrounding tissue. This therapy is not widely accepted or used. Prostate Brachytherapy Brachytherapy is often used for small prostate cancers that are found early and are slow-growing. Brachytherapy may be combined with external beam radiation therapy for more advanced cancers. Brachytherapy involves placing radioactive seeds inside the prostate gland. A surgeon inserts small needles through the skin beneath your scrotum to inject the seeds. The seeds are so small that you do not feel them. The seeds are left in place permanently. Side effects may include: Pain, swelling, or bruising in the penis or scrotum Red-brown urine or semen Impotence Incontinence Urinary retention Diarrhea Hormonal Therapy Testosterone is the main male hormone. Prostate tumors need testosterone to grow. Hormonal therapy is treatment that decreases the effect of testosterone on prostate cancer. Hormone therapy is mainly used for cancer that has spread beyond the prostate. The treatment can help relieve symptoms and prevent further growth and spread of cancer. But it does not cure the cancer. The main type of hormone therapy is called a luteinizing hormone-releasing hormones (LH-RH) agonist: The medicine blocks the testicles from making testosterone. The drugs must be given by injection, usually every 3 to 6 months. Possible side effects include nausea and vomiting, hot flashes, anemia, fatigue, thinning bones (osteoporosis), reduced sexual desire, decreased muscle mass, weight gain, and impotence. The other type of hormone medicine is called an androgen-blocking drug: It is often given along with LH-RH drugs to block the effect of testosterone produced by the adrenal glands, which make a small amount of testosterone. Possible side effects include erection problems, reduced sexual desire, liver problems, diarrhea, and enlarged breasts. Much of the body's testosterone is made by the testes. As a result, surgery to remove the testes (called orchiectomy) can also be used as a hormonal treatment. Chemotherapy Chemotherapy and immunotherapy (medicine that helps the body's immune system fight the cancer) may be used to treat prostate cancer that no longer responds to hormone treatment. Usually a single drug or a combination of drugs is recommended. Cryotherapy Cryotherapy uses very cold temperatures to freeze and kill prostate cancer cells. The goal of cryosurgery is to destroy the entire prostate gland and possibly surrounding tissue. Cryosurgery is generally not used as a first treatment for prostate cancer. Review Date 10/10/2017 Updated by: Jennifer Sobol, DO, Urologist with the Michigan Institute of Urology, West Bloomfield, MI. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Placing radioactive seeds inside the prostate gland (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. A surgeon inserts small needles through the skin beneath the scrotum to inject small seeds that you do not feel. The seeds are left in place permanently. Side effects may include pain, swelling, or bruising in the penis or scrotum; red-brown urine or semen; impotence; incontinence, urinary retention, diarrhea.", "role": "assistant" } ]
[ { "content": "help with obesity I would like help on my obesity problem and if I can get help\n\nPrescription Medications to Treat Overweight and Obesity (How do doctors use prescription medications “off-label” to treat overweight and obesity?): Sometimes doctors use medications in a way that’s different from what the FDA has approved, known as “off-label” use. By choosing an off-label medication to treat overweight and obesity, your doctor may prescribea drug approved for treating a different medical problem two or more drugs at the same time a drug for a longer period of time than approved by the FDAYou should feel comfortable asking your doctor if he or she is prescribing a medication that is not approved just for treating overweight and obesity. Before using a medication, learn all you need to know about it.", "role": "user" }, { "content": "By choosing an off-label medication to treat overweight and obesity, your doctor may prescribea drug approved for treating a different medical problem two or more drugs at the same time a drug for a longer period of time than approved by the FDAYou should feel comfortable asking your doctor if he or she is prescribing a medication that is not approved just for treating overweight and obesity. Before using a medication, learn all you need to know about it.", "role": "assistant" } ]
[ { "content": "Treatment for optic nerve atrophy. Hello Name's case : Sex : Male Date of Birth : 1964 Nationality : X Diagnosis : optic nerve atrophy . i am suffering from optic atrophy, which led to loss of vision and inability to see, I suffer from this case from 1998 saluting suffered a fall on the head, which led to began this case even lost look, and have been performed process surgery in in 1998-1999 . And then in 2009 cured by reactive optic nerve by Russian Professor . i want know you hospital have treatment for optic nerve atrophy , and what this treatment i need more information about treatment of optic nerve because now 16 years old I can not vision, and I wish could belive hope for treatment of my case. And i want know the cost of treatment . Thank you Regards /\n\nOptic nerve atrophy (Treatment): Damage from optic nerve atrophy cannot be reversed. The underlying disease must be found and treated. Otherwise, vision loss will continue. Rarely, conditions that lead to optic atrophy may be treatable.", "role": "user" }, { "content": "If the underlying disease causing the damage to the optic nerve is not diagnosed, vision loss will continue. In rare cases this is treatable.", "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": "Most people have no symptoms of open-angle glaucoma, which causes slow loss of side (peripheral) vision. The symptoms of angle-closure glaucoma steadily become worse and include: sudden, severe pain in one eye decreased or cloudy vision, nausea and vomiting, rainbow-like halos around lights, red eye and feeling that the eye is swollen. Symptoms of secondary glaucoma are related to the underlying problem causing it. Depending on the cause, symptoms may be like open-angle glaucoma or angle-closure glaucoma.", "role": "assistant" } ]
[ { "content": "how to loose weight\n\nUnderstanding Adult Overweight and Obesity (Who should lose weight?): Health care providers generally agree that people who are considered to be obese (have a BMI of 30 or greater) may improve their health by losing weight.If you are overweight (BMI between 25 and 29.9), experts recommend that you avoid gaining any extra weight. If you are overweight and have other risk factors (see below), losing weight may reduce these risks. Experts recommend you try to lose weight if you have two or more of the following:Family history of certain chronic diseases. If you have close relatives who have had diseases such as heart disease or diabetes, you may be more likely to develop these problems. Pre-existing medical problems. High blood pressure, high LDL (bad) cholesterol levels, low HDL (good) cholesterol levels, high triglycerides, and high blood sugar (prediabetes or diabetes) are all warning signs of some diseases linked to obesity. Large waist size. Men who have waist sizes greater than 40 inches and women who have waist sizes greater than 35 inches are at higher risk of diabetes, unhealthy blood fats (high cholesterol and triglycerides), high blood pressure, and heart disease.Fortunately, losing even a small amount of weight can help improve your health. This weight loss may lower your blood pressure and improve other risk factors.For example, research shows that people at high risk for type 2 diabetes who lose a modest amount of weight and increase their physical activity may prevent or delay type 2 diabetes.", "role": "user" }, { "content": "Health care providers generally agree that people who are considered to be obese (have a BMI of 30 or greater) may improve their health by losing weight.If you are overweight (BMI between 25 and 29.9), experts recommend that you avoid gaining any extra weight. If you are overweight and have other risk factors, losing weight may you reduce these risks.", "role": "assistant" } ]
[ { "content": "how is gonorrhea diagnosed\n\nGonorrhea (Exams and Tests): Gonorrhea can be quickly detected by looking at a sample of discharge or tissue under the microscope. This is called a gram stain. This method is fast, but it is not the most certain. Gonorrhea is most accurately detected with DNA tests. DNA tests are useful for screening. The ligase chain reaction (LCR) test is one of the tests. DNA tests are quicker than cultures. These tests can be performed on urine samples, which are easier to collect than samples from the genital area. Prior to DNA tests, cultures (cells that grow in a lab dish) were used to provide proof of gonorrhea, but are less commonly used now. Samples for a culture are most often taken from the cervix, vagina, urethra, anus, or throat. - Rarely they are taken from joint fluid or blood - Cultures can often provide an early diagnosis within 24 hours. A confirmed diagnosis is available within 72 hours. If you have gonorrhea, you should ask to be tested for other sexually transmitted infections, including chlamydia, syphilis, and HIV herpes and hepatitis.", "role": "user" }, { "content": "Gonorrhea can be quickly detected by looking at a sample of discharge or tissue under the microscope. This is called a gram stain. This method is fast, but it is not the most certain. Gonorrhea is most accurately detected with DNA tests.", "role": "assistant" } ]
[ { "content": "who is at higher risk for calcium overdose?\n\n Calcium carbonate overdose Tums overdose Calcium overdose Summary Calcium carbonate is commonly found in antacids (for heartburn) and some dietary supplements. Calcium carbonate overdose occurs when someone takes more than the normal or recommended amount of a product containing this substance. This can be by accident or on purpose. This is for information only and not for use in the treatment or management of an actual overdose. DO NOT use it to treat or manage an actual overdose. If you or someone you are with overdoses, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. Poisonous Ingredient Calcium carbonate can be dangerous in large amounts. Where Found Products that contain calcium carbonate are certain: Antacids (Tums, Chooz) Mineral supplements Hand lotions Vitamin and mineral supplements Other products may also contain calcium carbonate. Symptoms Symptoms of a calcium carbonate overdose include: Abdominal pain Bone pain Coma Confusion Constipation Depression Diarrhea Headache Irregular heartbeat Loss of appetite Muscle twitching Nausea, vomiting Thirst Home Care Seek medical help right away. DO NOT make the person throw up unless poison control or a health care provider tells you to. Before Calling Emergency Have this information ready: Person's age, weight, and condition The name of the product (ingredients and strength, if known) When it was swallowed The amount swallowed Poison Control Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions. This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison control. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week. What to Expect at the Emergency Room Take the container with you to the hospital, if possible. The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Tests that may be done include: Blood and urine tests Chest x-ray ECG (electrocardiogram, or heart tracing) Treatment may include: Intravenous fluids (through a vein) Medicine to treat symptoms Activated charcoal Laxatives Tube through the mouth into the stomach to empty the stomach (gastric lavage) Breathing support, including tube through the mouth into the lungs and connected to a ventilator (breathing machine) Outlook (Prognosis) Calcium carbonate is not very poisonous. Recovery is quite likely. But, long-term overuse is more serious than a single overdose, because it can cause kidney damage. Few people die from an antacid overdose. Keep all medicines in child-proof bottles and out of the reach of children. Review Date 9/23/2017 Updated by: Jacob L. Heller, MD, MHA, Emergency Medicine, Emeritus, Virginia Mason Medical Center, 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": "People can take more than the normal or recommended amount of antacids or dietary supplements containing Calcium carbonate by accident or on purpose. Long-term overuse of antacids or dietary supplements is more serious than a single overdose, because it can cause kidney damage.", "role": "assistant" } ]
[ { "content": "what is the cause of the coffin lowry syndrome?\n\n Coffin-Lowry syndrome CLS Mental retardation with osteocartilaginous abnormalities Description Coffin-Lowry syndrome is a condition that affects many parts of the body. The signs and symptoms are usually more severe in males than in females, although the features of this disorder range from very mild to severe in affected women. Males with Coffin-Lowry syndrome typically have severe to profound intellectual disability and delayed development. Affected women may be cognitively normal, or they may have intellectual disability ranging from mild to profound. Beginning in childhood or adolescence, some people with this condition experience brief episodes of collapse when excited or startled by a loud noise. These attacks are called stimulus-induced drop episodes (SIDEs). Most affected males and some affected females have distinctive facial features including a prominent forehead, widely spaced and downward-slanting eyes, a short nose with a wide tip, and a wide mouth with full lips. These features become more pronounced with age. Soft hands with short, tapered fingers are also characteristic of Coffin-Lowry syndrome. Additional features of this condition include short stature, an unusually small head (microcephaly), progressive abnormal curvature of the spine (kyphoscoliosis), and other skeletal abnormalities. Frequency The incidence of this condition is uncertain, but researchers estimate that the disorder affects 1 in 40,000 to 50,000 people. Causes Mutations in the RPS6KA3 gene cause Coffin-Lowry syndrome. This gene provides instructions for making a protein that is involved in signaling within cells. Researchers believe that this protein helps control the activity of other genes and plays an important role in the brain. The protein is involved in cell signaling pathways that are required for learning, the formation of long-term memories, and the survival of nerve cells. Gene mutations result in the production of little or no RPS6KA3 protein, but it is unclear how a lack of this protein causes the signs and symptoms of Coffin-Lowry syndrome. Some people with the features of Coffin-Lowry syndrome do not have identified mutations in the RPS6KA3 gene. In these cases, the cause of the condition is unknown. Inheritance Pattern This condition is inherited in an X-linked dominant pattern. A condition is considered X-linked if the mutated gene that causes the disorder is located on the X chromosome, one of the two sex chromosomes. The inheritance is dominant if one copy of the altered gene in each cell is sufficient to cause the condition. In most cases, males (who have one X chromosome in each cell) experience more severe signs and symptoms of the disorder than females (who have two X chromosomes in each cell). A characteristic of X-linked inheritance is that fathers cannot pass X-linked traits to their sons. Between 70 percent and 80 percent of people with Coffin-Lowry syndrome have no history of the condition in their families. These cases are caused by new mutations in the RPS6KA3 gene. The remaining 20 percent to 30 percent of affected individuals have other family members with Coffin-Lowry syndrome. Sources for This Page Hanauer A, Young ID. Coffin-Lowry syndrome: clinical and molecular features. J Med Genet. 2002 Oct;39(10):705-13. Review. ", "role": "user" }, { "content": "Mutations in the RPS6KA3 gene cause Coffin-Lowry syndrome. This gene provides instructions for making a protein that is involved in signaling within cells. Researchers believe that this protein helps control the activity of other genes and plays an important role in the brain. The protein is involved in cell signaling pathways that are required for learning, the formation of long-term memories, and the survival of nerve cells. Gene mutations result in the production of little or no RPS6KA3 protein, but it is unclear how a lack of this protein causes the signs and symptoms of Coffin-Lowry syndrome. Some people with the features of Coffin-Lowry syndrome do not have identified mutations in the RPS6KA3 gene. In these cases, the cause of the condition is unknown. This condition is inherited in an X-linked dominant pattern. A condition is considered X-linked if the mutated gene that causes the disorder is located on the X chromosome, one of the two sex chromosomes. The inheritance is dominant if one copy of the altered gene in each cell is sufficient to cause the condition.", "role": "assistant" } ]
[ { "content": "CURE FOR PNEUMONIA Dear DR, please i have a friend that has the above illness..I want to find out...since i want to marry her...is it an infectious illness,,and can it be totally cured. And how can i help her to get this cured..Please i really need your reply urgently\n\n Viral pneumonia Pneumonia - viral Walking pneumonia - viral Summary Pneumonia is inflamed or swollen lung tissue due to infection with a germ. Viral pneumonia is caused by a virus. Causes Viral pneumonia is more likely to occur in young children and older adults. This is because their bodies have a harder time fighting off the virus than people with a strong immune system. Viral pneumonia is most often caused by one of several viruses: Respiratory syncytial virus (RSV) Influenza Parainfluenza Adenovirus (less common) Measles Serious viral pneumonia is more likely to happen in those with a weakened immune system, such as: Babies who are born too early Children with heart and lung problems People who have HIV/AIDS People receiving chemotherapy for cancer, or other medicines that weaken the immune system People who have had an organ transplant Symptoms Symptoms of viral pneumonia often begin slowly and may not be severe at first. The most common symptoms of pneumonia are: Cough (with some pneumonias you may cough up mucus, or even bloody mucus) Fever Shaking chills Shortness of breath (may only occur when you exert yourself) Other symptoms include: Confusion, often in older people Excessive sweating and clammy skin Headache Loss of appetite, low energy, and fatigue Sharp or stabbing chest pain that gets worse when you breathe deeply or cough Fatigue Exams and Tests The health care provider will perform a physical exam and ask about the symptoms. If the provider thinks you have pneumonia, you will also have a chest x-ray. This is because the physical exam may not be able to tell pneumonia from other respiratory infections. Depending on how severe your symptoms are, other tests may be done, including: Complete blood count (CBC) CT scan of the chest Blood cultures to check for viruses in the blood (or bacteria that might cause secondary infections) Bronchoscopy (rarely needed) Throat and nose swab tests to check for viruses such as the flu Open lung biopsy (only done in very serious illnesses when the diagnosis cannot be made from other sources) Sputum culture (to rule out other causes) Measuring levels of oxygen and carbon dioxide in the blood Treatment Antibiotics do not treat this type of lung infection. Medicines that treat viruses may work against some pneumonias caused by influenza and the herpes family of viruses. These medicines may be tried if the infection is caught early. Treatment may also involve: Corticosteroid medicines Increased fluids Oxygen Use of humidified air A hospital stay may be needed if you are unable to drink enough and to help with breathing if oxygen levels are too low. People are more likely to be admitted to the hospital if they: Are older than 65 years or are children Are unable to care for themselves at home, eat, or drink Have another serious medical problem, such as a heart or kidney problem Have been taking antibiotics at home and are not getting better Have severe symptoms However, many people can be treated at home. You can take these steps at home: Control your fever with aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen or naproxen), or acetaminophen. DO NOT give aspirin to children because it may cause a dangerous illness called Reye syndrome. DO NOT take cough medicines without first talking to your provider. Cough medicines may make it harder for your body to cough up sputum. Drink plenty of fluids to help loosen secretions and bring up phlegm. Get a lot of rest. Have someone else do chores. Outlook (Prognosis) Most cases of viral pneumonia are mild and get better without treatment within 1 to 3 weeks. Some cases are more serious and require a hospital stay. Possible Complications More serious infections can result in respiratory failure, liver failure, and heart failure. Sometimes, bacterial infections occur during or just after viral pneumonia, which may lead to more serious forms of pneumonia. When to Contact a Medical Professional Call your provider if symptoms of viral pneumonia develop or your condition gets worse after starting to improve. Prevention Wash your hands often, after blowing your nose, going to the bathroom, diapering a baby, and before eating or preparing food. DO NOT smoke. Tobacco damages your lungs' ability to ward off infection. A medicine called palivizumab (Synagis) may be given to children under 24 months old to prevent RSV. The flu vaccine, is given each year to prevent pneumonia caused by the flu virus. Those who are older and those with diabetes, asthma, chronic obstructive pulmonary disease (COPD), cancer, or weakened immune systems should be sure to get the flu vaccine. If your immune system is weak, stay away from crowds. Ask visitors who have a cold to wear a mask and wash their hands. Review Date 7/28/2018 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": "Viral pneumonias may be treated with anti-viral medications at the early stages of the infection. Treatments may also include corticosteroids, increased fluid intake, oxygen and humidified air. If you are unable to stay hydrated or need help with breathing, you might be hospitalized. At home, you could take drugs that control fever, such as ibuprofen or acetaminophen, drink plenty of fluids and get a lot of rest.", "role": "assistant" } ]
[ { "content": "My daughter has menkes syndrome and would like to know how to go about. Thx\n\nATP7A gene (Menkes syndrome): Researchers have identified more than 150 mutations in the ATP7A gene that cause Menkes syndrome. Many of these mutations delete part of the gene and likely result in a shortened ATP7A protein. Other mutations insert additional DNA building blocks (nucleotides) into the gene or change single nucleotides. All of these mutations prevent the production of functional ATP7A protein. As a result, the absorption of copper from food is impaired, and copper is not supplied to certain enzymes. The abnormal protein may get stuck in the cell membrane and become unable to shuttle back and forth from the Golgi apparatus. The disrupted activity of the ATP7A protein causes copper to be poorly distributed to cells in the body. Copper accumulates in some tissues, such as the small intestine and kidneys, while the brain and other tissues have unusually low levels. The decreased supply of copper can reduce the activity of numerous copper-containing enzymes, affecting the structure and function of bone, skin, hair, blood vessels, and the nervous system. The signs and symptoms of Menkes syndrome are caused by the reduced activity of these copper-containing enzymes.", "role": "user" }, { "content": "Researchers have identified more than 150 mutations in the ATP7A gene that cause Menkes syndrome. All of these mutations prevent the production of functional ATP7A protein. As a result, the absorption of copper from food is impaired, and copper is not supplied to certain enzymes. The disrupted activity of the ATP7A protein causes copper to be poorly distributed to cells in the body. Copper accumulates in some tissues, such as the small intestine and kidneys, while the brain and other tissues have unusually low levels. The decreased supply of copper can reduce the activity of numerous copper-containing enzymes, affecting the structure and function of bone, skin, hair, blood vessels, and the nervous system. The signs and symptoms of Menkes syndrome are caused by the reduced activity of these copper-containing enzymes.", "role": "assistant" } ]
[ { "content": "what is epilepsy\n\n Epilepsy Definition The epilepsies are a spectrum of brain disorders ranging from severe, life-threatening and disabling, to ones that are much more benign. In epilepsy, the normal pattern of neuronal activity becomes disturbed, causing strange sensations, emotions, and behavior or sometimes convulsions, muscle spasms, and loss of consciousness. The epilepsies have many possible causes and there are several types of seizures. Anything that disturbs the normal pattern of neuron activity—from illness to brain damage to abnormal brain development—can lead to seizures. Epilepsy may develop because of an abnormality in brain wiring, an imbalance of nerve signaling chemicals called neurotransmitters, changes in important features of brain cells called channels, or some combination of these and other factors. Having a single seizure as the result of a high fever (called febrile seizure) or head injury does not necessarily mean that a person has epilepsy. Only when a person has had two or more seizures is he or she considered to have epilepsy. A measurement of electrical activity in the brain and brain scans such as magnetic resonance imaging or computed tomography are common diagnostic tests for epilepsy. Treatment Once epilepsy is diagnosed, it is important to begin treatment as soon as possible. For about 70 percent of those diagnosed with epilepsy, seizures can be controlled with modern medicines and surgical techniques. Some drugs are more effective for specific types of seizures. An individual with seizures, particularly those that are not easily controlled, may want to see a neurologist specifically trained to treat epilepsy. In some children, special diets may help to control seizures when medications are either not effective or cause serious side effects. Prognosis While epilepsy cannot be cured, for some people the seizures can be controlled with medication, diet, devices, and/or surgery. Most seizures do not cause brain damage, but ongoing uncontrolled seizures may cause brain damage. It is not uncommon for people with epilepsy, especially children, to develop behavioral and emotional problems in conjunction with seizures. Issues may also arise as a result of the stigma attached to having epilepsy, which can led to embarrassment and frustration or bullying, teasing, or avoidance in school and other social settings. For many people with epilepsy, the risk of seizures restricts their independence (some states refuse drivers licenses to people with epilepsy) and recreational activities. Epilepsy can be a life-threatening condition. Some people with epilepsy are at special risk for abnormally prolonged seizures or sudden unexplained death in epilepsy. ", "role": "user" }, { "content": "Epilepsy is a brain disorder in which the activity of brain cells is disturbed, which, in turn, causes strange sensations, emotions, and behavior or sometimes convulsions, muscle spasms, and loss of consciousness.", "role": "assistant" } ]
[ { "content": "how smoking tobacco affects the rest of the body\n\nWhat is Smoking?: There's no way around it. Smoking is bad for your health. Smoking harms nearly every organ of the body. Cigarette smoking causes 87 percent of lung cancer deaths. It is also responsible for many other cancers and health problems. These include lung disease, heart and blood vessel disease, stroke and cataracts. Women who smoke have a greater chance of certain pregnancy problems or having a baby die from sudden infant death syndrome (SIDS). Your smoke is also bad for other people - they breathe in your smoke secondhand and can get many of the same problems as smokers do. E-cigarettes often look like cigarettes, but they work differently. They are battery-operated smoking devices. Not much is known about the health risks of using them. Quitting smoking can reduce your risk of health problems. The earlier you quit, the greater the benefit. NIH: National Cancer Institute", "role": "user" }, { "content": "Smoking harms nearly every organ of the body. Cigarette smoking causes 87 percent of lung cancer deaths. It is also responsible for many other cancers and health problems. These include lung disease, heart and blood vessel disease, stroke and cataracts. Women who smoke have a greater chance of certain pregnancy problems or having a baby die from sudden infant death syndrome (SIDS).", "role": "assistant" } ]
[ { "content": "treatment options versus migraine types Migraine seems to be a spectrum of conditions rather than only one easily diagnosed affliction. Many innovative migraine treatments are now in use, but it seems that each treatment only addresses a narrow set of conditions; for example, my daughter has tried many different treatment options (QEEG, HEG, TMS, topamax, ...) without success. Has any research been done to characterize which treatment types are effective against which migraine types?\n\nMigraine (Treatment): There is no specific cure for migraine headaches. The goal is to treat your migraine symptoms right away, and to prevent symptoms by avoiding or changing your triggers. A key step is learning how to manage your migraines at home. A headache diary can help you identify your headache triggers. Then you and your doctor can plan how to avoid these triggers. If you have frequent migraines, your doctor may prescribe medicine to reduce the number of attacks. You need to take the medicine every day for it to be effective. Medicines may include: - Antidepressants - Blood pressure medicines - Seizure medicines Botulinum toxin type A (Botox) injections may also help reduce migraine attacks if they occur more than 15 days a month. Some people find relief with minerals and vitamins. Check with your doctor to see if riboflavin or magnesium is right for you. TREATING AN ATTACK Other medicines are taken at the first sign of a migraine attack. Over-the-counter (OTC) pain medicines, such as acetaminophen, ibuprofen, or aspirin are often helpful when your migraine is mild. Be aware that: - Taking medicines more than 3 days a week may lead to rebound headaches. These are headaches that keep coming back due to overuse of pain medicine. - Taking too much acetaminophen can damage your liver. - Too much ibuprofen or aspirin can irritate your stomach or kidneys. If these treatments do not help, ask your doctor about prescription medicines. These include nasal sprays, suppositories, or injections. The group of medicines most often used is called triptans. Some migraine medicines narrow the blood vessels. If you are at risk for having a heart attack or have heart disease, talk with your doctor before using these medicines. Some migraine medicines should not be used by pregnant women. Talk with your doctor about which medicine is right for you if you are pregnant or planning to become pregnant. Other medicines treat symptoms of migraine, such as nausea and vomiting. They may be used alone or along with the other drugs that treat the migraine itself. Feverfew is an herb for migraines. It can be effective for some people. Before using feverfew, make sure your provider approves. Herbal remedies sold in drugstores and health food stores are not regulated. Work with a trained herbalist when selecting herbs.", "role": "user" }, { "content": "There is no specific cure for migraine headaches. The goal is to treat your migraine symptoms right away, and to prevent symptoms by avoiding or changing your triggers. If you have frequent migraines, your doctor may prescribe medicine to reduce the number of attacks. Medicines may include: - Antidepressants - Blood pressure medicines - Seizure medicines Botulinum toxin type A (Botox) injections may also help reduce migraine attacks if they occur more than 15 days a month. Some people find relief with minerals and vitamins. Over-the-counter (OTC) pain medicines, such as acetaminophen, ibuprofen, or aspirin are often helpful when your migraine is mild. If these treatments do not help, ask your doctor about prescription medicines. The group of medicines most often used is called triptans. Feverfew is an herb for migraines. It can be effective for some people.", "role": "assistant" } ]
[ { "content": "what test do you do for rheumatoid \"arthritis?\"\n\nRheumatoid arthritis (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.", "role": "user" }, { "content": "Rheumatoid arthritis can be difficult to diagnose in its early stages because the symptoms can be the same as in other kinds of joint disease. There is no one blood test or physical finding to confirm the diagnosis. To diagnose rheumatoid arthritis, doctors use medical history, a physical exam, x-rays and other imaging tests, such as MRI and ultrasound tests, and lab tests. During physical exams doctors may check your reflexes and muscle strength. Blood tests often show 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.", "role": "assistant" } ]
[ { "content": "what is epilepsy\n\nEpilepsy: The epilepsies are a spectrum of brain disorders ranging from severe, life-threatening and disabling, to ones that are much more benign. In epilepsy, the normal pattern of neuronal activity becomes disturbed, causing strange sensations, emotions, and behavior or sometimes convulsions, muscle spasms, and loss of consciousness. The epilepsies have many possible causes and there are several types of seizures. Anything that disturbs the normal pattern of neuron activity—from illness to brain damage to abnormal brain development—can lead to seizures. Epilepsy may develop because of an abnormality in brain wiring, an imbalance of nerve signaling chemicals called neurotransmitters, changes in important features of brain cells called channels, or some combination of these and other factors. Having a single seizure as the result of a high fever (called febrile seizure) or head injury does not necessarily mean that a person has epilepsy. Only when a person has had two or more seizures is he or she considered to have epilepsy. A measurement of electrical activity in the brain and brain scans such as magnetic resonance imaging or computed tomography are common diagnostic tests for epilepsy. Once epilepsy is diagnosed, it is important to begin treatment as soon as possible. For about 70 percent of those diagnosed with epilepsy, seizures can be controlled with modern medicines and surgical techniques. Some drugs are more effective for specific types of seizures. An individual with seizures, particularly those that are not easily controlled, may want to see a neurologist specifically trained to treat epilepsy. In some children, special diets may help to control seizures when medications are either not effective or cause serious side effects. While epilepsy cannot be cured, for some people the seizures can be controlled with medication, diet, devices, and/or surgery. Most seizures do not cause brain damage, but ongoing uncontrolled seizures may cause brain damage. It is not uncommon for people with epilepsy, especially children, to develop behavioral and emotional problems in conjunction with seizures. Issues may also arise as a result of the stigma attached to having epilepsy, which can led to embarrassment and frustration or bullying, teasing, or avoidance in school and other social settings. For many people with epilepsy, the risk of seizures restricts their independence (some states refuse drivers licenses to people with epilepsy) and recreational activities. Epilepsy can be a life-threatening condition. Some people with epilepsy are at special risk for abnormally prolonged seizures or sudden unexplained death in epilepsy.", "role": "user" }, { "content": "The epilepsies are a spectrum of brain disorders ranging from severe, life-threatening and disabling, to ones that are much more benign. In epilepsy, the normal pattern of neuronal activity becomes disturbed, causing strange sensations, emotions, and behavior or sometimes convulsions, muscle spasms, and loss of consciousness.", "role": "assistant" } ]
[ { "content": "What is Nephrotic Syndrome. What are its causes and cures?\n\n Nephrotic syndrome Nephrosis Summary Nephrotic syndrome is a group of symptoms that include protein in the urine, low blood protein levels in the blood, high cholesterol levels, high triglyceride levels, increased blood clot risk, and swelling. Causes Nephrotic syndrome is caused by different disorders that damage the kidneys. This damage leads to the release of too much protein in the urine. The most common cause in children is minimal change disease. Membranous glomerulonephritis is the most common cause in adults. In both diseases, the glomeruli in the kidneys are damaged. Glomeruli are the structures that help filter wastes and fluids. This condition can also occur from: Cancer Diseases such as diabetes, systemic lupus erythematosus, multiple myeloma, and amyloidosis Genetic disorders Immune disorders Infections (such as strep throat, hepatitis, or mononucleosis) Use of certain drugs It can occur with kidney disorders such as: Focal and segmental glomerulosclerosis Glomerulonephritis Mesangiocapillary glomerulonephritis Nephrotic syndrome can affect all age groups. In children, it is most common between ages 2 and 6. This disorder occurs slightly more often in males than females. Symptoms Swelling (edema) is the most common symptom. It may occur: In the face and around the eyes (facial swelling) In the arms and legs, especially in the feet and ankles In the belly area (swollen abdomen) Other symptoms include: Skin rash or sores Foamy appearance of the urine Poor appetite Weight gain (unintentional) from fluid retention Seizures Exams and Tests The health care provider will perform a physical exam. Laboratory tests will be done to see how well the kidneys are working. They include: Albumin blood test Blood chemistry tests, such as basic metabolic panel or comprehensive metabolic panel Blood urea nitrogen (BUN) Creatinine - blood test Creatinine clearance - urine test Urinalysis Fats are often also present in the urine. Blood cholesterol and triglyceride levels may be high. A kidney biopsy may be needed to find the cause of the disorder. Tests to rule out various causes may include the following: Antinuclear antibody Cryoglobulins Complement levels Glucose tolerance test Hepatitis B and C antibodies HIV test Rheumatoid factor Serum protein electrophoresis (SPEP) Syphilis serology Urine protein electrophoresis (UPEP) This disease may also change the results of the following tests: Vitamin D level Serum iron Urinary casts Treatment The goals of treatment are to relieve symptoms, prevent complications, and delay kidney damage. To control nephrotic syndrome, the disorder that is causing it must be treated. You may need treatment for life. Treatments may include any of the following: Keeping blood pressure at or below 130/80 mm Hg to delay kidney damage. Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) are the medicines most often used. ACE inhibitors and ARBs may also help decrease the amount of protein lost in the urine. Corticosteroids and other drugs that suppress or quiet the immune system. Treating high cholesterol to reduce the risk of heart and blood vessel problems -- A low-fat, low-cholesterol diet is usually not enough for people with nephrotic syndrome. Medicines to reduce cholesterol and triglycerides (usually statins) may be needed. A low-sodium diet may help with swelling in the hands and legs. Water pills (diuretics) may also help with this problem. Low-protein diets may be helpful. Your provider may suggest a moderate-protein diet (1 gram of protein per kilogram of body weight per day). Taking vitamin D supplements if nephrotic syndrome is long-term and is not responding to treatment. Taking blood thinner drugs to treat or prevent blood clots. Outlook (Prognosis) Outcome varies. Some people recover from the condition. Others develop long-term kidney disease and need dialysis and eventually a kidney transplant. Possible Complications Health problems that may result from nephrotic syndrome include: Acute kidney failure Hardening of the arteries and related heart diseases Chronic kidney disease Fluid overload, heart failure, fluid buildup in lungs Infections, including pneumococcal pneumonia Malnutrition Renal vein thrombosis When to Contact a Medical Professional Call your provider if: You develop symptoms of nephrotic syndrome, including swelling in face, belly, or arms and legs, or skin sores You're being treated for nephrotic syndrome, but your symptoms don't improve New symptoms develop, including cough, decreased urine output, discomfort with urination, fever, severe headache Go to the emergency room or call the local emergency number (such as 911) if you have seizures. Prevention Treating conditions that can cause nephrotic syndrome may help prevent the syndrome. Review Date 8/1/2017 Updated by: Walead Latif, MD, Nephrologist and Clinical Associate Professor, Rutgers Medical School, Newark, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "To control nephrotic syndrome, the disorder that is causing it must be treated. Potentially life=long treatments may be needed to keep blood pressure at or below 130/80 mm Hg to delay kidney damage, most often using angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs). ACE inhibitors and ARBs may also help decrease the amount of protein lost in the urine. To reduce the immune system response, corticosteroids and other suppressants could be used. To reduce the risk of heart and blood vessel problems, high cholesterol needs to be reduced and blood thinners might be prescribed. A low-fat, low-cholesterol, low-protein diet may need to be supplemented with statins. To reduce swelling in the hands and legs, you may need a low-salt diet and diuretics.", "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 "agency" help a women/couple who are concerned about this congenital condition, and is there a cost? If you can answer these few questions I would be thankful, please get back as soon as you can.\n\nTay-Sachs Disease: Tay-Sachs disease is a inherited metabolic disease caused by the harmful buildup of lipids (fatty materials such as oils and acids) in various cells and tissues in the body. It is part of a group of genetic disorders called the GM2 gangliosidoses. Tay-Sachs and its variant form are caused by a deficiency in the enzyme hexosaminidase A. Affected children appear to develop normally until about age 6 months. Then, symptoms begin and include progressive loss of mental ability, dementia, blindness, increased startle reflex to noise, progressive loss of hearing leading to deafness, and difficulty with swallowing. Seizures may begin in the child's second year. Persons with Tay-Sachs also have \"cherry-red\" spots in their eyes. A much rarer form of the disorder, called late-onset Tay-Sachs disease, occurs in individuals in their twenties and early thirties and is characterized by an unsteady gait and progressive neurological deterioration. The incidence of Tay-Sachs has been particularly high among people of Eastern European and Askhenazi Jewish descent., as well as in certain French Canadians and Louisiana Cajuns. Affected individuals and carriers of Tay-Sachs disease can be identified by a blood test that measures hexosaminidase A activity. Both parents must carry the mutated gene in order to have an affected child. In these instances, there is a 25 percent chance with each pregnancy that the child will be affected with Tay-Sachs disease. Prenatal diagnosis is available if desired. A very severe form of Tay-Sachs disease is know as Sandhoff disease, which is not limited to any ethnic group. Presently there is no specific treatment for Tay-Sachs disease. Anticonvulsant medicine may initially control seizures. Other supportive treatment includes proper nutrition and hydration and techniques to keep the airway open. Children may eventually need a feeding tube. Even with the best of care, children with Tay-Sachs disease usually die by age 4, from recurring infection.", "role": "user" }, { "content": "Tay-Sachs disease is caused by the harmful buildup of lipids in various cells and tissues in the body. Affected children appear to develop normally until about age 6 months. Then, symptoms begin and include progressive loss of mental ability, dementia, blindness, increased startle reflex to noise, progressive loss of hearing leading to deafness, and difficulty with swallowing. Seizures may begin in the child's second year. Persons with Tay-Sachs also have \"cherry-red\" spots in their eyes. Affected individuals and carriers of Tay-Sachs disease can be identified by a blood test. Both parents of a child that inherits this metabolic disease must have the mutated gene. There is no specific treatment for Tay-Sachs disease. Anticonvulsant medicine may initially control seizures. Other supportive treatments include proper nutrition and hydration and techniques to keep the airway open. Children may eventually need a feeding tube. Even with the best of care, children with Tay-Sachs disease usually die by age 4, from recurring infection.", "role": "assistant" } ]
[ { "content": "what is the cause of congenital heart defects\n\nCongenital heart defects in children (Risk factors): Most congenital heart defects result from problems early in your child's heart development, the cause of which is unknown. However, certain environmental and genetic risk factors may play a role. They include: - Rubella (German measles). Having rubella during pregnancy can cause problems in your baby's heart development. Your doctor can test you for immunity to this viral disease before pregnancy and vaccinate you against it if you aren't immune. - Diabetes. You can reduce the risk of congenital heart defects by carefully controlling your diabetes before attempting to conceive and during pregnancy. Gestational diabetes generally doesn't increase your baby's risk of developing a heart defect. - Medications. Certain medications taken during pregnancy may cause birth defects, including congenital heart defects. Give your doctor a complete list of medications you take before attempting to become pregnant. Medications known to increase the risk of congenital heart defects include thalidomide (Thalomid), angiotensin-converting enzyme (ACE) inhibitors, statins, the acne medication isotretinoin (Absorica, Amnesteem, Claravis) and lithium. - Drinking alcohol during pregnancy. Avoid alcohol during pregnancy because it increases the risk of congenital heart defects. - Smoking. Smoking during pregnancy increases the likelihood of a congenital heart defect in the baby. - Heredity. Congenital heart defects sometimes run in families and may be associated with a genetic syndrome. Many children with Down syndrome - which is caused by an extra 21st chromosome (trisomy 21) - have heart defects. A missing piece (deletion) of genetic material on chromosome 22 also causes heart defects. Genetic testing can detect such disorders during fetal development. If you already have a child with a congenital heart defect, a genetic counselor can estimate the odds that your next child will have one.", "role": "user" }, { "content": "Most congenital heart defects result from problems early in your child's heart development, the cause of which is unknown. However, certain environmental and genetic risk factors may play a role. They include: - Rubella (German measles). Having rubella during pregnancy can cause problems in your baby's heart development. Diabetes. You can reduce the risk of congenital heart defects by carefully controlling your diabetes before attempting to conceive and during pregnancy. Certain medications taken during pregnancy may cause birth defects, including congenital heart defects. Medications known to increase the risk of congenital heart defects include thalidomide (Thalomid), angiotensin-converting enzyme (ACE) inhibitors, statins, the acne medication isotretinoin (Absorica, Amnesteem, Claravis) and lithium. - Drinking alcohol during pregnancy. Smoking during pregnancy increases the likelihood of a congenital heart defect in the baby. - Heredity. Congenital heart defects sometimes run in families and may be associated with a genetic syndrome. Many children with Down syndrome - which is caused by an extra 21st chromosome (trisomy 21) - have heart defects. A missing piece (deletion) of genetic material on chromosome 22 also causes heart defects. Genetic testing can detect such disorders during fetal development. a genetic counselor can estimate the odds that your next child will have one.", "role": "assistant" } ]
[ { "content": "what are some common symptoms of bulimia\n\nWhat are the symptoms of Bulimia?: With bulimia, eating binges may occur as often as several times a day for many months. The person often eats large amounts of high-calorie foods, usually in secret. During these episodes, the person feels a lack of control over the eating. Binges lead to self-disgust, which causes purging to prevent weight gain. Purging may include: - Forcing oneself to vomit - Excessive exercise - Using laxatives, enemas, or diuretics (water pills) Purging often brings a sense of relief. People with bulimia are often at a normal weight, but they may see themselves as being overweight. Because the person's weight is often normal, other people may not notice this eating disorder. Symptoms that other people can see include: - Spending a lot of time exercising - Suddenly eating large amounts of food or buying large amounts of food that disappear right away - Regularly going to the bathroom right after meals - Throwing away packages of laxatives, diet pills, emetics (drugs that cause vomiting), or diuretics", "role": "user" }, { "content": "For people with bulimia, eating binges may occur as often as several times a day for many months. he person often eats large amounts of high-calorie foods, usually in secret. During these episodes, the person feels a lack of control over the eating. Binges lead to self-disgust, which causes purging to prevent weight gain. Purging may include using laxatives, enemas, or diuretics. People with bulimia are often at a normal weight, but they may see themselves as being overweight. Because the person's weight is often normal, other people may not notice this eating disorder. Symptoms that other people can see include spending a large amount of time exercising, suddenly eating large amounts of food, regularly going to the bathroom after meals, or throwing away packages of laxatives, diet pills, emetics (drugs that cause vomiting), or diuretics.", "role": "assistant" } ]
[ { "content": "what is the disorder achondroplasia\n\nAchondroplasia: Achondroplasia is a disorder of bone growth that causes the most common type of dwarfism. 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 1 parent, the child will have the disorder. If 1 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 2 parents without achondroplasia may give birth to a baby with the condition. 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 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. There is no specific treatment for achondroplasia. Related abnormalities, including spinal stenosis and spinal cord compression, should be treated when they cause problems. 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. 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 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. 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. Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, 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": "how common is cystic fibrosis\n\n Cystic Fibrosis What Is... Cystic fibrosis (SIS-tik fi-BRO-sis), or CF, is an inherited disease of the secretory (see-KREH-tor-ee) glands. Secretory glands include glands that make mucus and sweat. \"Inherited\" means the disease is passed from parents to children through genes. People who have CF inherit two faulty genes for the disease—one from each parent. The parents likely don't have the disease themselves. CF mainly affects the lungs, pancreas, liver, intestines, sinuses, and sex organs. Overview Mucus is a substance made by tissues that line some organs and body cavities, such as the lungs and nose. Normally, mucus is a slippery, watery substance. It keeps the linings of certain organs moist and prevents them from drying out or getting infected. If you have CF, your mucus becomes thick and sticky. It builds up in your lungs and blocks your airways. (Airways are tubes that carry air in and out of your lungs.) The buildup of mucus makes it easy for bacteria to grow. This leads to repeated, serious lung infections. Over time, these infections can severely damage your lungs. The thick, sticky mucus also can block tubes, or ducts, in your pancreas (an organ in your abdomen). As a result, the digestive enzymes that your pancreas makes can't reach your small intestine. These enzymes help break down food. Without them, your intestines can't fully absorb fats and proteins. This can cause vitamin deficiency and malnutrition because nutrients pass through your body without being used. You also may have bulky stools, intestinal gas, a swollen belly from severe constipation, and pain or discomfort. CF also causes your sweat to become very salty. Thus, when you sweat, you lose large amounts of salt. This can upset the balance of minerals in your blood and cause many health problems. Examples of these problems include dehydration (a lack of fluid in your body), increased heart rate, fatigue (tiredness), weakness, decreased blood pressure, heat stroke, and, rarely, death. If you or your child has CF, you're also at higher risk for diabetes or two bone-thinning conditions called osteoporosis (OS-te-o-po-RO-sis) and osteopenia (OS-te-o-PEE-nee-uh). CF also causes infertility in men, and the disease can make it harder for women to get pregnant. (The term \"infertility\" refers to the inability to have children.) Outlook The symptoms and severity of CF vary. If you or your child has the disease, you may have serious lung and digestive problems. If the disease is mild, symptoms may not show up until the teen or adult years. The symptoms and severity of CF also vary over time. Sometimes you'll have few symptoms. Other times, your symptoms may become more severe. As the disease gets worse, you'll have more severe symptoms more often. Lung function often starts to decline in early childhood in people who have CF. Over time, damage to the lungs can cause severe breathing problems. Respiratory failure is the most common cause of death in people who have CF. As treatments for CF continue to improve, so does life expectancy for those who have the disease. Today, some people who have CF are living into their forties or fifties, or longer. Early treatment for CF can improve your quality of life and increase your lifespan. Treatments may include nutritional and respiratory therapies, medicines, exercise, and other treatments. Your doctor also may recommend pulmonary rehabilitation (PR). PR is a broad program that helps improve the well-being of people who have chronic (ongoing) breathing problems. Other Names Cystic fibrosis of the pancreas Fibrocystic disease of the pancreas Mucoviscidosis (MU-ko-vis-ih-DO-sis) Mucoviscidosis of the pancreas Pancreas fibrocystic disease Pancreatic cystic fibrosis Causes A defect in the CFTR gene causes cystic fibrosis (CF). This gene makes a protein that controls the movement of salt and water in and out of your body's cells. In people who have CF, the gene makes a protein that doesn't work well. This causes thick, sticky mucus and very salty sweat. Research suggests that the CFTR protein also affects the body in other ways. This may help explain other symptoms and complications of CF. More than a thousand known defects can affect the CFTR gene. The type of defect you or your child has may affect the severity of CF. Other genes also may play a role in the severity of the disease. How Is Cystic Fibrosis Inherited? Every person inherits two CFTR genes—one from each parent. Children who inherit a faulty CFTR gene from each parent will have CF. Children who inherit one faulty CFTR gene and one normal CFTR gene are \"CF carriers.\" CF carriers usually have no symptoms of CF and live normal lives. However, they can pass the faulty CFTR gene to their children. The image below shows how two parents who are both CF carriers can pass the faulty CFTR gene to their children. Example of an Inheritance Pattern for Cystic Fibrosis Who Is at Risk Cystic fibrosis (CF) affects both males and females and people from all racial and ethnic groups. However, the disease is most common among Caucasians of Northern European descent. CF also is common among Latinos and American Indians, especially the Pueblo and Zuni. The disease is less common among African Americans and Asian Americans. More than 10 million Americans are carriers of a faulty CF gene. Many of them don't know that they're CF carriers. Signs & Symptoms The signs and symptoms of cystic fibrosis (CF) vary from person to person and over time. Sometimes you'll have few symptoms. Other times, your symptoms may become more severe. One of the first signs of CF that parents may notice is that their baby's skin tastes salty when kissed, or the baby doesn't pass stool when first born. Most of the other signs and symptoms of CF happen later. They're related to how CF affects the respiratory, digestive, or reproductive systems of the body. Cystic Fibrosis Respiratory System Signs and Symptoms People who have CF have thick, sticky mucus that builds up in their airways. This buildup of mucus makes it easier for bacteria to grow and cause infections. Infections can block the airways and cause frequent coughing that brings up thick sputum (spit) or mucus that's sometimes bloody. People who have CF tend to have lung infections caused by unusual germs that don't respond to standard antibiotics. For example, lung infections caused by bacteria called mucoid Pseudomonas are much more common in people who have CF than in those who don't. An infection caused by these bacteria may be a sign of CF. People who have CF have frequent bouts of sinusitis (si-nu-SI-tis), an infection of the sinuses. The sinuses are hollow air spaces around the eyes, nose, and forehead. Frequent bouts of bronchitis (bron-KI-tis) and pneumonia (nu-MO-ne-ah) also can occur. These infections can cause long-term lung damage. As CF gets worse, you may have more serious problems, such as pneumothorax (noo-mo-THOR-aks) or bronchiectasis (brong-ke-EK-ta-sis). Some people who have CF also develop nasal polyps (growths in the nose) that may require surgery. Digestive System Signs and Symptoms In CF, mucus can block tubes, or ducts, in your pancreas (an organ in your abdomen). These blockages prevent enzymes from reaching your intestines. As a result, your intestines can't fully absorb fats and proteins. This can cause ongoing diarrhea or bulky, foul-smelling, greasy stools. Intestinal blockages also may occur, especially in newborns. Too much gas or severe constipation in the intestines may cause stomach pain and discomfort. A hallmark of CF in children is poor weight gain and growth. These children are unable to get enough nutrients from their food because of the lack of enzymes to help absorb fats and proteins. As CF gets worse, other problems may occur, such as: Pancreatitis (PAN-kre-ah-TI-tis). This is a condition in which the pancreas become inflamed, which causes pain. Rectal prolapse. Frequent coughing or problems passing stools may cause rectal tissue from inside you to move out of your rectum. Liver disease due to inflamed or blocked bile ducts. Diabetes. Gallstones. Reproductive System Signs and Symptoms Men who have CF are infertile because they're born without a vas deferens. The vas deferens is a tube that delivers sperm from the testes to the penis. Women who have CF may have a hard time getting pregnant because of mucus blocking the cervix or other CF complications. Other Signs, Symptoms, and Complications Other signs and symptoms of CF are related to an upset of the balance of minerals in your blood. CF causes your sweat to become very salty. As a result, your body loses large amounts of salt when you sweat. This can cause dehydration (a lack of fluid in your body), increased heart rate, fatigue (tiredness), weakness, decreased blood pressure, heat stroke, and, rarely, death. CF also can cause clubbing and low bone density. Clubbing is the widening and rounding of the tips of your fingers and toes. This sign develops late in CF because your lungs aren't moving enough oxygen into your bloodstream. Low bone density also tends to occur late in CF. It can lead to bone-thinning disorders called osteoporosis and osteopenia. Diagnosis Doctors diagnose cystic fibrosis (CF) based on the results from various tests. Newborn Screening All States screen newborns for CF using a genetic test or a blood test. The genetic test shows whether a newborn has faulty CFTR genes. The blood test shows whether a newborn's pancreas is working properly. Sweat Test If a genetic test or blood test suggests CF, a doctor will confirm the diagnosis using a sweat test. This test is the most useful test for diagnosing CF. A sweat test measures the amount of salt in sweat. For this test, the doctor triggers sweating on a small patch of skin on an arm or leg. He or she rubs the skin with a sweat-producing chemical and then uses an electrode to provide a mild electrical current. This may cause a tingling or warm feeling. Sweat is collected on a pad or paper and then analyzed. The sweat test usually is done twice. High salt levels confirm a diagnosis of CF. Other Tests If you or your child has CF, your doctor may recommend other tests, such as: Genetic tests to find out what type of CFTR defect is causing your CF. A chest x ray. This test creates pictures of the structures in your chest, such as your heart, lungs, and blood vessels. A chest x ray can show whether your lungs are inflamed or scarred, or whether they trap air. A sinus x ray. This test may show signs of sinusitis, a complication of CF. Lung function tests. These tests measure how much air you can breathe in and out, how fast you can breathe air out, and how well your lungs deliver oxygen to your blood. A sputum culture. For this test, your doctor will take a sample of your sputum (spit) to see whether bacteria are growing in it. If you have bacteria called mucoid Pseudomonas, you may have more advanced CF that needs aggressive treatment. Prenatal Screening If you're pregnant, prenatal genetic tests can show whether your fetus has CF. These tests include amniocentesis (AM-ne-o-sen-TE-sis) and chorionic villus (ko-re-ON-ik VIL-us) sampling (CVS). In amniocentesis, your doctor inserts a hollow needle through your abdominal wall into your uterus. He or she removes a small amount of fluid from the sac around the baby. The fluid is tested to see whether both of the baby's CFTR genes are normal. In CVS, your doctor threads a thin tube through the vagina and cervix to the placenta. The doctor removes a tissue sample from the placenta using gentle suction. The sample is tested to see whether the baby has CF. Cystic Fibrosis Carrier Testing People who have one normal CFTR gene and one faulty CFTR gene are CF carriers. CF carriers usually have no symptoms of CF and live normal lives. However, carriers can pass faulty CFTR genes on to their children. If you have a family history of CF or a partner who has CF (or a family history of it) and you're planning a pregnancy, you may want to find out whether you're a CF carrier. A genetics counselor can test a blood or saliva sample to find out whether you have a faulty CF gene. This type of testing can detect faulty CF genes in 9 out of 10 cases. Treatments Cystic fibrosis (CF) has no cure. However, treatments have greatly improved in recent years. The goals of CF treatment include: Preventing and controlling lung infections Loosening and removing thick, sticky mucus from the lungs Preventing or treating blockages in the intestines Providing enough nutrition Preventing dehydration (a lack of fluid in the body) Depending on the severity of CF, you or your child may be treated in a hospital. Specialists Involved If you or your child has CF, you may be treated by a CF specialist. This is a doctor who is familiar with the complex nature of CF. Often, a CF specialist works with a medical team of nurses, physical therapists, dietitians, and social workers. CF specialists often are located at major medical centers. The United States also has more than 100 CF Care Centers. These centers have teams of doctors, nurses, dietitians, respiratory therapists, physical therapists, and social workers who have special training related to CF care. Most CF Care Centers have pediatric and adult programs or clinics. For more information about CF Care Centers, go to the Cystic Fibrosis Foundation's Care Center Network Web page. Treatment for Lung Problems The main treatments for lung problems in people who have CF are chest physical therapy (CPT), exercise, and medicines. Your doctor also may recommend a pulmonary rehabilitation (PR) program. Chest Physical Therapy CPT also is called chest clapping or percussion. It involves pounding your chest and back over and over with your hands or a device to loosen the mucus from your lungs so that you can cough it up. You might sit down or lie on your stomach with your head down while you do CPT. Gravity and force help drain the mucus from your lungs. Some people find CPT hard or uncomfortable to do. Several devices have been developed that may help with CPT, such as: An electric chest clapper, known as a mechanical percussor. An inflatable therapy vest that uses high-frequency airwaves to force the mucus that's deep in your lungs toward your upper airways so you can cough it up. A small, handheld device that you exhale through. The device causes vibrations that dislodge the mucus. A mask that creates vibrations that help break the mucus loose from your airway walls. Breathing techniques also may help dislodge mucus so you can cough it up. These techniques include forcing out a couple of short breaths or deeper breaths and then doing relaxed breathing. This may help loosen the mucus in your lungs and open your airways. Exercise Aerobic exercise that makes you breathe harder can help loosen the mucus in your airways so you can cough it up. Exercise also helps improve your overall physical condition. However, CF causes your sweat to become very salty. As a result, your body loses large amounts of salt when you sweat. Thus, your doctor may recommend a high-salt diet or salt supplements to maintain the balance of minerals in your blood. If you exercise regularly, you may be able to cut back on your CPT. However, you should check with your doctor first. Medicines If you have CF, your doctor may prescribe antibiotics, anti-inflammatory medicines, bronchodilators, or medicines to help clear the mucus. These medicines help treat or prevent lung infections, reduce swelling and open up the airways, and thin mucus. If you have mutations in a gene called G551D, which occurs in about 5 percent of people who have CF, your doctor may prescribe the oral medicine ivacaftor (approved for people with CF who are 6 years of age and older). Antibiotics are the main treatment to prevent or treat lung infections. Your doctor may prescribe oral, inhaled, or intravenous (IV) antibiotics. Oral antibiotics often are used to treat mild lung infections. Inhaled antibiotics may be used to prevent or control infections caused by the bacteria mucoid Pseudomonas. For severe or hard-to-treat infections, you may be given antibiotics through an IV tube (a tube inserted into a vein). This type of treatment may require you to stay in a hospital. Anti-inflammatory medicines can help reduce swelling in your airways due to ongoing infections. These medicines may be inhaled or oral. Bronchodilators help open the airways by relaxing the muscles around them. These medicines are inhaled. They're often taken just before CPT to help clear mucus out of your airways. You also may take bronchodilators before inhaling other medicines into your lungs. Your doctor may prescribe medicines to reduce the stickiness of your mucus and loosen it up. These medicines can help clear out mucus, improve lung function, and prevent worsening lung symptoms. Treatments for Advanced Lung Disease If you have advanced lung disease, you may need oxygen therapy. Oxygen usually is given through nasal prongs or a mask. If other treatments haven't worked, a lung transplant may be an option if you have severe lung disease. A lung transplant is surgery to remove a person's diseased lung and replace it with a healthy lung from a deceased donor. Pulmonary Rehabilitation Your doctor may recommend PR as part of your treatment plan. PR is a broad program that helps improve the well-being of people who have chronic (ongoing) breathing problems. PR doesn't replace medical therapy. Instead, it's used with medical therapy and may include: Exercise training Nutritional counseling Education on your lung disease or condition and how to manage it Energy-conserving techniques Breathing strategies Psychological counseling and/or group support PR has many benefits. It can improve your ability to function and your quality of life. The program also may help relieve your breathing problems. Even if you have advanced lung disease, you can still benefit from PR. For more information, go to the Health Topics Pulmonary Rehabilitation article. Treatment for Digestive Problems CF can cause many digestive problems, such as bulky stools, intestinal gas, a swollen belly, severe constipation, and pain or discomfort. Digestive problems also can lead to poor growth and development in children. Nutritional therapy can improve your strength and ability to stay active. It also can improve growth and development in children. Nutritional therapy also may make you strong enough to resist some lung infections. A nutritionist can help you create a nutritional plan that meets your needs. In addition to having a well-balanced diet that's rich in calories, fat, and protein, your nutritional therapy may include: Oral pancreatic enzymes to help you digest fats and proteins and absorb more vitamins. Supplements of vitamins A, D, E, and K to replace the fat-soluble vitamins that your intestines can't absorb. High-calorie shakes to provide you with extra nutrients. A high-salt diet or salt supplements that you take before exercising. A feeding tube to give you more calories at night while you're sleeping. The tube may be threaded through your nose and throat and into your stomach. Or, the tube may be placed directly into your stomach through a surgically made hole. Before you go to bed each night, you'll attach a bag with a nutritional solution to the entrance of the tube. It will feed you while you sleep. Other treatments for digestive problems may include enemas and mucus-thinning medicines to treat intestinal blockages. Sometimes surgery is needed to remove an intestinal blockage. Your doctor also may prescribe medicines to reduce your stomach acid and help oral pancreatic enzymes work better. Treatments for Cystic Fibrosis Complications A common complication of CF is diabetes. The type of diabetes associated with CF often requires different treatment than other types of diabetes. Another common CF complication is the bone-thinning disorder osteoporosis. Your doctor may prescribe medicines that prevent your bones from losing their density. Living With If you or your child has cystic fibrosis (CF), you should learn as much as you can about the disease. Work closely with your doctors to learn how to manage CF. Ongoing Care Having ongoing medical care by a team of doctors, nurses, and respiratory therapists who specialize in CF is important. These specialists often are located at major medical centers or CF Care Centers. The United States has more than 100 CF Care Centers. Most of these centers have pediatric and adult programs or clinics. For more information about CF Care Centers, go to the Cystic Fibrosis Foundation's Care Center Network Web page. It's standard to have CF checkups every 3 months. Talk with your doctor about whether you should get an annual flu shot and other vaccines. Take all of your medicines as your doctor prescribes. In between checkups, be sure to contact your doctor if you have: Blood in your mucus, increased amounts of mucus, or a change in the color or consistency of your mucus. Decreased energy or appetite. Severe constipation or diarrhea, severe abdominal pain, or vomit that's dark green. A fever, which is a sign of infection. (However, you may still have a serious infection that needs treatment even if you don't have a fever.) Transition of Care Better treatments for CF allow people who have the disease to live longer now than in the past. Thus, the move from pediatric care to adult care is an important step in treatment. If your child has CF, encourage him or her to learn about the disease and take an active role in treatment. This will help prepare your child for the transition to adult care. CF Care Centers can help provide age-appropriate treatment throughout the transition period and into adulthood. They also will support the transition to adult care by balancing medical needs with other developmental factors, such as increased independence, relationships, and employment. Talk with your child's health care team for more information about how to help your child move from pediatric care to adult care. Lifestyle Changes In between medical checkups, you can practice good self-care and follow a healthy lifestyle. For example, follow a healthy diet. A healthy diet includes a variety of fruits, vegetables, and whole grains. Talk with your doctor about what types and amounts of foods you should include in your diet. Other lifestyle changes include: Not smoking and avoiding tobacco smoke Washing your hands often to lower your risk of infection Exercising regularly and drinking lots of fluids Doing chest physical therapy (as your doctor recommends) Other Concerns Although CF requires daily care, most people who have the disease are able to attend school and work. Adults who have CF can expect to have normal sex lives. Most men who have the disease are infertile (unable to have children). However, modern fertility treatments may help them. Women who have CF may find it hard to get pregnant, but they usually can have children. If you have CF, you should talk with your doctor if you're planning a pregnancy. Although CF can cause fertility problems, men and women who have the disease should still have protected sex to avoid sexually transmitted diseases. Emotional Issues Living with CF may cause fear, anxiety, depression, and stress. Talk about how you feel with your health care team. Talking to a professional counselor also can help. If you're very depressed, your doctor may recommend medicines or other treatments that can improve your quality of life. Joining a patient support group may help you adjust to living with CF. You can see how other people who have the same symptoms have coped with them. Talk with your doctor about local support groups or check with an area medical center. Support from family and friends also can help relieve stress and anxiety. Let your loved ones know how you feel and what they can do to help you. ", "role": "user" }, { "content": "Cystic fibrosis (CF) affects both males and females and people from all racial and ethnic groups. However, the disease is most common among Caucasians of Northern European descent. CF also is common among Latinos and American Indians, especially the Pueblo and Zuni. The disease is less common among African Americans and Asian Americans. More than 10 million Americans are carriers of a faulty CF gene. Many of them don't know that they're CF carriers.", "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: - Psoriasis is an autoimmune disease that causes red, scaly skin. - It is caused by genes, meaning it runs in families, but some outside factors can make it worse or trigger flares. - Psoriasis can be hard to diagnose because it can look like other skin diseases. - Your doctor may recommend creams, ultraviolet light therapy, prescription medications, shots, or some combination of these treatments. - You may have to try a couple of different treatments before finding one that helps you. - Joining a support group helps some people with psoriasis cope with the disease. Psoriasis is a skin disease that causes red, scaly skin that may feel painful, swollen or hot. If you have psoriasis, you are more likely to get some other conditions, including: - Psoriatic arthritis, a condition that causes joint pain and swelling. - Cardiovascular problems, which affect the heart and blood circulation system. - Obesity. - High blood pressure. - Diabetes. Some treatments for psoriasis can have serious side effects, so be sure to talk about them with your doctor and keep all your appointments. - Psoriasis is an autoimmune disease that causes red, scaly skin. - It is caused by genes, meaning it runs in families, but some outside factors can make it worse or trigger flares. - Psoriasis can be hard to diagnose because it can look like other skin diseases. - Your doctor may recommend creams, ultraviolet light therapy, prescription medications, shots, or some combination of these treatments. - You may have to try a couple of different treatments before finding one that helps you. - Joining a support group helps some people with psoriasis cope with the disease. - Psoriasis is an autoimmune disease that causes red, scaly skin. - It is caused by genes, meaning it runs in families, but some outside factors can make it worse or trigger flares. - Psoriasis can be hard to diagnose because it can look like other skin diseases. - Your doctor may recommend creams, ultraviolet light therapy, prescription medications, shots, or some combination of these treatments. - You may have to try a couple of different treatments before finding one that helps you. - Joining a support group helps some people with psoriasis cope with the disease. Psoriasis is a skin disease that causes red, scaly skin that may feel painful, swollen or hot. If you have psoriasis, you are more likely to get some other conditions, including: - Psoriatic arthritis, a condition that causes joint pain and swelling. - Cardiovascular problems, which affect the heart and blood circulation system. - Obesity. - High blood pressure. - Diabetes. Some treatments for psoriasis can have serious side effects, so be sure to talk about them with your doctor and keep all your appointments. Anyone can get psoriasis, but it is more common in adults. Certain genes have been linked to psoriasis, so you are more likely to get it if someone else in your family has it. Anyone can get psoriasis, but it is more common in adults. Certain genes have been linked to psoriasis, so you are more likely to get it if someone else in your family has it. There are several different types of psoriasis. Here are a few examples: - Plaque psoriasis, which causes patches of skin that are red at the base and covered by silvery scales. - Guttate psoriasis, which causes small, drop-shaped lesions on your trunk, limbs, and scalp. This type of psoriasis is most often triggered by upper respiratory infections, such as strep throat. - Pustular psoriasis, which causes pus-filled blisters. Attacks or flares can be caused by medications, infections, stress, or certain chemicals. - Inverse psoriasis, which causes smooth, red patches in folds of skin near the genitals, under the breasts or in the armpits. Rubbing and sweating can make this type of psoriasis worse. - Erythrodermic psoriasis, which causes red and scaly skin over much of your body. This can be a reaction to a bad sunburn or taking certain medications, such as corticosteroids. It can also happen if you have a different type of psoriasis that is not well controlled. This type of psoriasis can be very serious, so if you have it, you should see a doctor immediately. There are several different types of psoriasis. Here are a few examples: - Plaque psoriasis, which causes patches of skin that are red at the base and covered by silvery scales. - Guttate psoriasis, which causes small, drop-shaped lesions on your trunk, limbs, and scalp. This type of psoriasis is most often triggered by upper respiratory infections, such as strep throat. - Pustular psoriasis, which causes pus-filled blisters. Attacks or flares can be caused by medications, infections, stress, or certain chemicals. - Inverse psoriasis, which causes smooth, red patches in folds of skin near the genitals, under the breasts or in the armpits. Rubbing and sweating can make this type of psoriasis worse. - Erythrodermic psoriasis, which causes red and scaly skin over much of your body. This can be a reaction to a bad sunburn or taking certain medications, such as corticosteroids. It can also happen if you have a different type of psoriasis that is not well controlled. This type of psoriasis can be very serious, so if you have it, you should see a doctor immediately. Psoriasis is an autoimmune disease, which means that your body’s immune system – which protects you from diseases – starts overacting and causing problems. If you have psoriasis, a type of white blood cells called the T cells become so active that they trigger other immune system responses, including swelling and fast turnover of skin cells. Your skin cells grow deep in the skin and rise slowly to the surface. This is called cell turnover, and it usually takes about a month. If you have psoriasis, though, cell turnover can take only a few days. Your skin cells rise too fast and pile up on the surface, causing your skin to look red and scaly. Some things may cause a flare, meaning your psoriasis becomes worse for a while, including: - Infections. - Stress. - Changes in the weather that dry out your skin. - Certain medicines. - Cuts, scratches or sunburns. Certain genes have been linked to psoriasis, meaning it runs in families. Psoriasis is an autoimmune disease, which means that your body’s immune system – which protects you from diseases – starts overacting and causing problems. If you have psoriasis, a type of white blood cells called the T cells become so active that they trigger other immune system responses, including swelling and fast turnover of skin cells. Your skin cells grow deep in the skin and rise slowly to the surface. This is called cell turnover, and it usually takes about a month. If you have psoriasis, though, cell turnover can take only a few days. Your skin cells rise too fast and pile up on the surface, causing your skin to look red and scaly. Some things may cause a flare, meaning your psoriasis becomes worse for a while, including: - Infections. - Stress. - Changes in the weather that dry out your skin. - Certain medicines. - Cuts, scratches or sunburns. Certain genes have been linked to psoriasis, meaning it runs in families. Psoriasis is an autoimmune disease, which means that your body’s immune system – which protects you from diseases – starts overacting and causing problems. If you have psoriasis, a type of white blood cells called the T cells become so active that they trigger other immune system responses, including swelling and fast turnover of skin cells. Your skin cells grow deep in the skin and rise slowly to the surface. This is called cell turnover, and it usually takes about a month. If you have psoriasis, though, cell turnover can take only a few days. Your skin cells rise too fast and pile up on the surface, causing your skin to look red and scaly. Some things may cause a flare, meaning your psoriasis becomes worse for a while, including: - Infections. - Stress. - Changes in the weather that dry out your skin. - Certain medicines. - Cuts, scratches or sunburns. Certain genes have been linked to psoriasis, meaning it runs in families. Psoriasis can be hard to diagnose because it can look like other skin diseases. Your doctor may look at a small sample of your skin under a microscope to help them figure out if psoriasis is causing your skin condition. Psoriasis can be hard to diagnose because it can look like other skin diseases. Your doctor may look at a small sample of your skin under a microscope to help them figure out if psoriasis is causing your skin condition. Psoriasis can be hard to diagnose because it can look like other skin diseases. Your doctor may look at a small sample of your skin under a microscope to help them figure out if psoriasis is causing your skin condition. There are several different types of treatment for psoriasis. Your doctor may recommend that you try one of these or a combination of them: - Topical treatment, which means putting creams on your skin. - Light therapy, which involves a doctor shining an ultraviolet light on your skin or getting more sunlight. It’s important that a doctor controls the amount of light you are getting from this therapy, because too much ultraviolet light may make your psoriasis worse. - Systemic treatment, which can include taking prescription medicines or getting shots of medicine. There are several different types of treatment for psoriasis. Your doctor may recommend that you try one of these or a combination of them: - Topical treatment, which means putting creams on your skin. - Light therapy, which involves a doctor shining an ultraviolet light on your skin or getting more sunlight. It’s important that a doctor controls the amount of light you are getting from this therapy, because too much ultraviolet light may make your psoriasis worse. - Systemic treatment, which can include taking prescription medicines or getting shots of medicine. There are several different types of treatment for psoriasis. Your doctor may recommend that you try one of these or a combination of them: - Topical treatment, which means putting creams on your skin. - Light therapy, which involves a doctor shining an ultraviolet light on your skin or getting more sunlight. It’s important that a doctor controls the amount of light you are getting from this therapy, because too much ultraviolet light may make your psoriasis worse. - Systemic treatment, which can include taking prescription medicines or getting shots of medicine. Several types of health care professionals may treat you, including: - Dermatologists, who treat skin problems. - Internists, who diagnose and treat adults. Several types of health care professionals may treat you, including: - Dermatologists, who treat skin problems. - Internists, who diagnose and treat adults. Several types of health care professionals may treat you, including: - Dermatologists, who treat skin problems. - Internists, who diagnose and treat adults. Psoriasis is a chronic disease, which means it lasts a long time. You can take an active role in treating your psoriasis. Besides going to your doctor regularly, here are some things you can try to help manage your symptoms: - Keeping your skin well moisturized. - Staying healthy overall. - Joining support groups or counseling to help you realize you are not alone in dealing with psoriasis and to share ideas for coping with the disease. Psoriasis is a chronic disease, which means it lasts a long time. You can take an active role in treating your psoriasis. Besides going to your doctor regularly, here are some things you can try to help manage your symptoms: - Keeping your skin well moisturized. - Staying healthy overall. - Joining support groups or counseling to help you realize you are not alone in dealing with psoriasis and to share ideas for coping with the disease.", "role": "user" }, { "content": "Your doctor may recommend creams, ultraviolet light therapy, prescription medications, shots, or some combination of these treatments. - You may have to try a couple of different treatments before finding one that helps you. - Joining a support group helps some people with psoriasis cope with the disease. There are several different types of treatment for psoriasis. Your doctor may recommend that you try one of these or a combination of them: - Topical treatment, which means putting creams on your skin. - Light therapy, which involves a doctor shining an ultraviolet light on your skin or getting more sunlight. It?s important that a doctor controls the amount of light you are getting from this therapy, because too much ultraviolet light may make your psoriasis worse. - Systemic treatment, which can include taking prescription medicines or getting shots of medicine. You can take an active role in treating your psoriasis. Besides going to your doctor regularly, here are some things you can try to help manage your symptoms: - Keeping your skin well moisturized. - Staying healthy overall. -", "role": "assistant" } ]
[ { "content": "Anal Fissure I may have a couple anal fissures and looking to speak with someone to get some information and support.\n\nAnal fissure (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.", "role": "user" }, { "content": "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. ... Your doctor may recommend: - Externally applied nitroglycerin (Rectiv), to help increase blood flow to the fissure and promote healing and to help relax the anal sphincter. ... Topical anesthetic creams such as lidocaine hydrochloride (Xylocaine) may be helpful for pain relief. - Botulinum toxin type A (Botox) injection, to paralyze the anal sphincter muscle and relax spasms. - Blood pressure medications, such as oral nifedipine (Procardia) or diltiazem (Cardizem) can help relax the anal sphincter. ... 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.", "role": "assistant" } ]
[ { "content": "how do you get pulmonary hypertension\n\nPulmonary hypertension (Causes): Your heart has two upper chambers (atria) and two lower chambers (ventricles). Each time blood passes through your heart, the lower right chamber (right ventricle) pumps blood to your lungs through a large blood vessel (pulmonary artery). In your lungs, the blood releases carbon dioxide and picks up oxygen. The oxygen-rich blood then flows through blood vessels in your lungs (pulmonary arteries, capillaries and veins) to the left side of your heart. Ordinarily, the blood flows easily through the vessels in your lungs, so blood pressure is usually much lower in your lungs. With pulmonary hypertension, the rise in blood pressure is caused by changes in the cells that line your pulmonary arteries. These changes can cause the walls of the arteries to become stiff and thick, and extra tissue may form. The blood vessels may also become inflamed and tight. These changes in the pulmonary arteries can reduce or block blood flow through the blood vessels. This makes it harder for blood to flow, raising the blood pressure in the pulmonary arteries. Pulmonary hypertension is classified into five groups, depending on the cause. Group 1: Pulmonary arterial hypertension - Cause unknown, known as idiopathic pulmonary arterial hypertension - A specific gene mutation that can cause pulmonary hypertension to develop in families, also called heritable pulmonary arterial hypertension - Certain drugs - such as certain prescription diet drugs or illegal drugs such as methamphetamines - or certain toxins - Heart abnormalities present at birth (congenital heart disease) - Other conditions, such as connective tissue disorders (scleroderma, lupus, others), HIV infection or chronic liver disease (cirrhosis) Group 2: Pulmonary hypertension caused by left-sided heart disease - Left-sided valvular heart disease, such as mitral valve or aortic valve disease - Failure of the lower left heart chamber (left ventricle) Group 3: Pulmonary hypertension caused by lung disease - Chronic obstructive pulmonary disease, such as emphysema - Lung disease such as pulmonary fibrosis, a condition that causes scarring in the tissue between the lungs' air sacs (interstitium) - Sleep apnea and other sleep disorders - Long-term exposure to high altitudes in people who may be at higher risk of pulmonary hypertension Group 4: Pulmonary hypertension caused by chronic blood clots - Chronic blood clots in the lungs (pulmonary emboli) Group 5: Pulmonary hypertension associated with other conditions that have unclear reasons why the pulmonary hypertension occurs - Blood disorders - Disorders that affect several organs in the body, such as sarcoidosis - Metabolic disorders, such as glycogen storage disease - Tumors pressing against pulmonary arteries Eisenmenger syndrome and pulmonary hypertension Eisenmenger syndrome, a type of congenital heart disease, causes pulmonary hypertension. It's most commonly caused by a large hole in your heart between the two lower heart chambers (ventricles), called a ventricular septal defect. This hole in your heart causes blood to circulate abnormally in your heart. Oxygen-carrying blood (red blood) mixes with oxygen-poor blood (blue blood). The blood then returns to your lungs instead of going to the rest of your body, increasing the pressure in the pulmonary arteries and causing pulmonary hypertension.", "role": "user" }, { "content": "Your heart has two upper chambers (atria) and two lower chambers (ventricles). Each time blood passes through your heart, the lower right chamber (right ventricle) pumps blood to your lungs through a large blood vessel (pulmonary artery). In your lungs, the blood releases carbon dioxide and picks up oxygen. The oxygen-rich blood then flows through blood vessels in your lungs (pulmonary arteries, capillaries and veins) to the left side of your heart. Ordinarily, the blood flows easily through the vessels in your lungs, so blood pressure is usually much lower in your lungs. With pulmonary hypertension, the rise in blood pressure is caused by changes in the cells that line your pulmonary arteries. These changes can cause the walls of the arteries to become stiff and thick, and extra tissue may form. The blood vessels may also become inflamed and tight. These changes in the pulmonary arteries can reduce or block blood flow through the blood vessels. This makes it harder for blood to flow, raising the blood pressure in the pulmonary arteries.", "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": "Breast cancer at 84. My mother was just diagnost with breast cancer. She is 84 years old, her tumor started in the milk duct and is small in size, their is a mass as well in the same breast. He is scheduled for a lumpectomy to remove both. Because of age we would like suggestions on treatment options after surgery.\n\nBreast cancer (Treatment): Treatment is based on many factors, including: - Type of breast cancer - Stage of the cancer (staging is a tool your providers use to find out how advanced the cancer is) - Whether the cancer is sensitive to certain hormones - Whether the cancer overproduces (overexpresses) the HER2/neu protein Cancer treatments may include: - Hormone therapy. - Chemotherapy, which uses medicines to kill cancer cells. - Radiation therapy, which is used to destroy cancerous tissue. - Surgery to remove cancerous tissue: A lumpectomy removes the breast lump. Mastectomy removes all or part of the breast and possibly nearby structures. Nearby lymph nodes may also be removed during surgery. - Targeted therapy uses medicine to attack the gene changes in cancer cells. Hormone therapy is an example of targeted therapy. It blocks certain hormones that fuel cancer growth. Cancer treatment can be local or systemic: - Local treatments involve only the area of disease. Radiation and surgery are forms of local treatment. They are most effective when the cancer has not spread outside the breast. - Systemic treatments affect the entire body. Chemotherapy and hormonal therapy are types of systemic treatment. Most women receive a combination of treatments. For women with stage I, II, or III breast cancer, the main goal is to treat the cancer and prevent it from returning (recurring). For women with stage IV cancer, the goal is to improve symptoms and help them live longer. In most cases, stage IV breast cancer cannot be cured. - Stage 0 and ductal carcinoma: Lumpectomy plus radiation or mastectomy is the standard treatment. - Stage I and II: Lumpectomy plus radiation or mastectomy with lymph node removal is the standard treatment. Chemotherapy, hormonal therapy, and other targeted therapy may also be used after surgery. - Stage III: Treatment involves surgery, possibly followed by chemotherapy, hormone therapy, and other targeted therapy. - Stage IV: Treatment may involve surgery, radiation, chemotherapy, hormone therapy, other targeted therapy, or a combination of these treatments. After treatment, some women continue to take medicines for a time. All women continue to have blood tests, mammograms, and other tests after treatment to monitor for the return of cancer or development of another breast cancer. Women who have had a mastectomy may have reconstructive breast surgery. This will be done either at the time of mastectomy or later.", "role": "user" }, { "content": "Cancer treatment can be local or systemic: - Local treatments involve only the area of disease. Radiation and surgery are forms of local treatment. ... A lumpectomy removes the breast lump. .. They are most effective when the cancer has not spread outside the breast. - Systemic treatments affect the entire body. Chemotherapy and hormonal therapy are types of systemic treatment. Most women receive a combination of treatments. Treatment may involve surgery, radiation, chemotherapy, hormone therapy, other targeted therapy, or a combination of these treatments. After treatment, some women continue to take medicines for a time. All women continue to have blood tests, mammograms, and other tests after treatment to monitor for the return of cancer or development of another breast cancer.", "role": "assistant" } ]
[ { "content": "what are symptoms of a nonfunctioning gallbladder\n\n Gallbladder removal - open Cholecystectomy - open Gallbladder - open cholecystectomy Cholecystitis - open cholecystectomy Gallstones - open cholecystectomy Summary Open gallbladder removal is surgery to remove the gallbladder through a large cut in your abdomen. Description Surgery is done while you are under general anesthesia so you will be asleep and pain-free. To perform the surgery: The surgeon makes a 5 to 7 inch (12.5 to 17.5 centimeters) cut in the upper right part of your belly, just below your ribs. The area is opened up so the surgeon can view the gallbladder and separate it from the other organs. The surgeon cuts the bile duct and blood vessels that lead to the gallbladder. The gallbladder is gently lifted out and removed from your body. An x-ray called a cholangiogram may be done during your surgery. To do this test, dye is injected into your common bile duct and an x-ray is taken. The dye helps find stones that may be outside your gallbladder. If other stones are found, the surgeon may remove them with a special instrument. The surgery takes about 1 hour. Why the Procedure is Performed You may need this surgery if you have pain or other symptoms from gallstones. You may also need surgery if your gallbladder is not working normally. Common symptoms may include: Indigestion, including bloating, heartburn, and gas Nausea and vomiting Pain after eating, usually in the upper right or upper middle area of your belly (epigastric pain) The most common way to remove the gallbladder is by using a medical instrument called a laparoscope (laparoscopic cholecystectomy). Open gallbladder surgery is used when laparoscopic surgery cannot be done safely. In some cases, the surgeon needs to switch to an open surgery if laparoscopic surgery cannot be successfully continued. Other reasons for removing the gallbladder by open surgery: Unexpected bleeding during the laparoscopic operation Obesity Pancreatitis (inflammation in the pancreas) Pregnancy (third trimester) Severe liver problems Past surgeries in the same area of your belly Risks Risks of anesthesia and surgery in general are: Reactions to medicines Breathing problems Bleeding, blood clots Infection Risks of gallbladder surgery are: Damage to the blood vessels that go to the liver Injury to the common bile duct Injury to the small or large intestine Pancreatitis (inflammation of the pancreas) Before the Procedure Your may have the following tests done before surgery: Blood tests (complete blood count, electrolytes, liver and kidney tests) Chest x-ray or electrocardiogram (EKG), for some patients Several x-rays of the gallbladder Ultrasound of the gallbladder Tell your doctor or nurse: If you are or might be pregnant Which drugs, vitamins, and other supplements you are taking, even ones you bought without a prescription During the week before surgery: You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), vitamin E, warfarin (Coumadin), and any other drugs that put you at a higher risk of bleeding during surgery. Ask your doctor which drugs you should still take on the day of your surgery. Prepare your home for any problems you might have getting around after the surgery. You'll be told when to arrive at the hospital. On the day of surgery: Follow instructions about when to stop eating and drinking. Take the drugs your doctor told you to take with a small sip of water. Shower the night before or the morning of your surgery. Arrive at the hospital on time. After the Procedure You may need to stay in the hospital for 3 to 5 days after open gallbladder removal. During that time: You may be asked to breathe into a device called an incentive spirometer. This helps keep your lungs working well so that you do not get pneumonia. The nurse will help you sit up in bed, hang your legs over the side, and then stand up and start to walk. At first, you will receive fluids into your vein through an intravenous (IV) tube. Soon after, you will be asked to start drinking liquids and eating foods. You will be able to shower while you are still in the hospital. You may be asked to wear pressure stockings on your legs to help prevent a blood clot from forming. If there were problems during your surgery, or if you have bleeding, a lot of pain, or a fever, you may need to stay in the hospital longer. Your doctor or nurses will tell you how to care for yourself after you leave the hospital. Outlook (Prognosis) Most people recover quickly and have good results from this procedure. Review Date 9/9/2017 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, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "You may also need surgery if your gallbladder is not working normally. Common symptoms may include: - Indigestion, including bloating, heartburn, and gas - Nausea and vomiting - Pain after eating, usually in the upper right or upper middle area of your belly (epigastric pain)", "role": "assistant" } ]
[ { "content": "Angelman syndrome. Can a person with Angelman Syndrome have children? If so, can the disorder be passed on to offspring?\n\nAngelman syndrome: Angelman syndrome is a complex genetic disorder that primarily affects the nervous system. Characteristic features of this condition include delayed development, intellectual disability, severe speech impairment, and problems with movement and balance (ataxia). Most affected children also have recurrent seizures (epilepsy) and a small head size (microcephaly). Delayed development becomes noticeable by the age of 6 to 12 months, and other common signs and symptoms usually appear in early childhood. Children with Angelman syndrome typically have a happy, excitable demeanor with frequent smiling, laughter, and hand-flapping movements. Hyperactivity, a short attention span, and a fascination with water are common. Most affected children also have difficulty sleeping and need less sleep than usual. With age, people with Angelman syndrome become less excitable, and the sleeping problems tend to improve. However, affected individuals continue to have intellectual disability, severe speech impairment, and seizures throughout their lives. Adults with Angelman syndrome have distinctive facial features that may be described as \"coarse.\" Other common features include unusually fair skin with light-colored hair and an abnormal side-to-side curvature of the spine (scoliosis). The life expectancy of people with this condition appears to be nearly normal. Angelman syndrome affects an estimated 1 in 12,000 to 20,000 people. Many of the characteristic features of Angelman syndrome result from the loss of function of a gene called UBE3A. People normally inherit one copy of the UBE3A gene from each parent. Both copies of this gene are turned on (active) in many of the body's tissues. In certain areas of the brain, however, only the copy inherited from a person's mother (the maternal copy) is active. This parent-specific gene activation is caused by a phenomenon called genomic imprinting. If the maternal copy of the UBE3A gene is lost because of a chromosomal change or a gene mutation, a person will have no active copies of the gene in some parts of the brain. Several different genetic mechanisms can inactivate or delete the maternal copy of the UBE3A gene. Most cases of Angelman syndrome (about 70 percent) occur when a segment of the maternal chromosome 15 containing this gene is deleted. In other cases (about 11 percent), Angelman syndrome is caused by a mutation in the maternal copy of the UBE3A gene. In a small percentage of cases, Angelman syndrome results when a person inherits two copies of chromosome 15 from his or her father (paternal copies) instead of one copy from each parent. This phenomenon is called paternal uniparental disomy. Rarely, Angelman syndrome can also be caused by a chromosomal rearrangement called a translocation, or by a mutation or other defect in the region of DNA that controls activation of the UBE3A gene. These genetic changes can abnormally turn off (inactivate) UBE3A or other genes on the maternal copy of chromosome 15. The causes of Angelman syndrome are unknown in 10 to 15 percent of affected individuals. Changes involving other genes or chromosomes may be responsible for the disorder in these cases. In some people who have Angelman syndrome, the loss of a gene called OCA2 is associated with light-colored hair and fair skin. The OCA2 gene is located on the segment of chromosome 15 that is often deleted in people with this disorder. However, loss of the OCA2 gene does not cause the other signs and symptoms of Angelman syndrome. The protein produced from this gene helps determine the coloring (pigmentation) of the skin, hair, and eyes. Most cases of Angelman syndrome are not inherited, particularly those caused by a deletion in the maternal chromosome 15 or by paternal uniparental disomy. These genetic changes occur as random events during the formation of reproductive cells (eggs and sperm) or in early embryonic development. Affected people typically have no history of the disorder in their family. Rarely, a genetic change responsible for Angelman syndrome can be inherited. For example, it is possible for a mutation in the UBE3A gene or in the nearby region of DNA that controls gene activation to be passed from one generation to the next. Buiting K. Prader-Willi syndrome and Angelman syndrome. Am J Med Genet C Semin Med Genet. 2010 Aug 15;154C(3):365-76. doi: 10.1002/ajmg.c.30273. Review.", "role": "user" }, { "content": "Angelman syndrome is rarely inherited from a parent. Mostly, random genetic changes in the parents' reproductive cells cause this disorder.", "role": "assistant" } ]
[ { "content": "Hello, I have a scoliosis problem plz help me I want its treatment I can send my x.ray also\n\nScoliosis (Treatment): Most children with scoliosis have mild curves and probably won't need treatment with a brace or surgery. Children who have mild scoliosis may need checkups every four to six months to see if there have been changes in the curvature of their spines. While there are guidelines for mild, moderate and severe curves, the decision to begin treatment is always made on an individual basis. Factors to be considered include: - Sex. Girls have a much higher risk of progression than do boys. - Severity of curve. Larger curves are more likely to worsen with time. - Curve pattern. Double curves, also known as S-shaped curves, tend to worsen more often than do C-shaped curves. - Location of curve. Curves located in the center (thoracic) section of the spine worsen more often than do curves in the upper or lower sections of the spine. - Maturity. If a child's bones have stopped growing, the risk of curve progression is low. That also means that braces have the most effect in children whose bones are still growing. Braces If your child's bones are still growing and he or she has moderate scoliosis, your doctor may recommend a brace. Wearing a brace won't cure scoliosis or reverse the curve, but it usually prevents further progression of the curve. The most common type of brace is made of plastic and is contoured to conform to the body. This close-fitting brace is almost invisible under the clothes, as it fits under the arms and around the rib cage, lower back and hips. Most braces are worn day and night. A brace's effectiveness increases with the number of hours a day it's worn. Children who wear braces can usually participate in most activities and have few restrictions. If necessary, kids can take off the brace to participate in sports or other physical activities. Braces are discontinued after the bones stop growing. This typically occurs: - About two years after girls begin to menstruate - When boys need to shave daily - When there are no further changes in height Surgery Severe scoliosis typically progresses with time, so your doctor might suggest scoliosis surgery to reduce the severity of the spinal curve and to prevent it from getting worse. The most common type of scoliosis surgery is called spinal fusion. In spinal fusion, surgeons connect two or more of the bones in the spine (vertebrae) together, so they can't move independently. Pieces of bone or a bone-like material are placed between the vertebrae. Metal rods, hooks, screws or wires typically hold that part of the spine straight and still while the old and new bone material fuses together. If the scoliosis is progressing rapidly at a young age, surgeons can install a rod that can adjust in length as the child grows. This growing rod is attached to the top and bottom sections of the spinal curvature, and is usually lengthened every six months. Complications of spinal surgery may include bleeding, infection, pain or nerve damage. Rarely, the bone fails to heal and another surgery may be needed.", "role": "user" }, { "content": "Most children with scoliosis have mild curves and do not need treatment. If your child's bones are still growing and he or she has moderate scoliosis, your doctor may recommend a brace. To start treatment with braces the doctors will consider the following: risk of progression is higher in girls, larger or double curves, also known as S-shaped curves are more likely to worsen, curves located in the center (thoracic) section of the spine worsen more often, and child's age. If a child's bones have stopped growing, the risk of curve progression is low. For severe scoliosis, your doctor might suggest surgery to reduce the severity of the spinal curve and to prevent it from getting worse. The most common type of scoliosis surgery is called spinal fusion. In spinal fusion, surgeons connect two or more of the bones in the spine (vertebrae) together.", "role": "assistant" } ]
[ { "content": "what the treatment for bronchitis\n\nBronchitis: Bronchitis is an inflammation of the lining of your bronchial tubes, which carry air to and from your lungs. People who have bronchitis often cough up thickened mucus, which can be discolored. Bronchitis may be either acute or chronic. Often developing from a cold or other respiratory infection, acute bronchitis is very common. Chronic bronchitis, a more serious condition, is a constant irritation or inflammation of the lining of the bronchial tubes, often due to smoking. Acute bronchitis, also called a chest cold, usually improves within a week to 10 days without lasting effects, although the cough may linger for weeks. However, if you have repeated bouts of bronchitis, you may have chronic bronchitis, which requires medical attention. Chronic bronchitis is one of the conditions included in chronic obstructive pulmonary disease (COPD). For either acute bronchitis or chronic bronchitis, signs and symptoms may include: - Cough - Production of mucus (sputum), which can be clear, white, yellowish-gray or green in color - rarely, it may be streaked with blood - Fatigue - Shortness of breath - Slight fever and chills - Chest discomfort If you have acute bronchitis, you might have cold symptoms, such as a mild headache or body aches. While these symptoms usually improve in about a week, you may have a nagging cough that lingers for several weeks. Chronic bronchitis is defined as a productive cough that lasts at least three months, with recurring bouts occurring for at least two consecutive years. If you have chronic bronchitis, you're likely to have periods when your cough or other symptoms worsen. At those times, you may have an acute infection on top of chronic bronchitis. See your doctor if your cough: - Lasts more than three weeks - Prevents you from sleeping - Is accompanied by fever higher than 100.4 F (38 C) - Produces discolored mucus - Produces blood - Is associated with wheezing or shortness of breath Acute bronchitis is usually caused by viruses, typically the same viruses that cause colds and flu (influenza). Antibiotics don't kill viruses, so this type of medication isn't useful in most cases of bronchitis. The most common cause of chronic bronchitis is cigarette smoking. Air pollution and dust or toxic gases in the environment or workplace also can contribute to the condition. Factors that increase your risk of bronchitis include: - Cigarette smoke. People who smoke or who live with a smoker are at higher risk of both acute bronchitis and chronic bronchitis. - Low resistance. This may result from another acute illness, such as a cold, or from a chronic condition that compromises your immune system. Older adults, infants and young children have greater vulnerability to infection. - Exposure to irritants on the job. Your risk of developing bronchitis is greater if you work around certain lung irritants, such as grains or textiles, or are exposed to chemical fumes. - Gastric reflux. Repeated bouts of severe heartburn can irritate your throat and make you more prone to developing bronchitis. Although a single episode of bronchitis usually isn't cause for concern, it can lead to pneumonia in some people. Repeated bouts of bronchitis, however, may mean that you have chronic obstructive pulmonary disease (COPD). During the first few days of illness, it can be difficult to distinguish the signs and symptoms of bronchitis from those of a common cold. During the physical exam, your doctor will use a stethoscope to listen closely to your lungs as you breathe. In some cases, your doctor may suggest the following tests: - Chest X-ray. A chest X-ray can help determine if you have pneumonia or another condition that may explain your cough. This is especially important if you ever were or currently are a smoker. - Sputum tests. Sputum is the mucus that you cough up from your lungs. It can be tested to see if you have illnesses that could be helped by antibiotics. Sputum can also be tested for signs of allergies. - Pulmonary function test. During a pulmonary function test, you blow into a device called a spirometer, which measures how much air your lungs can hold and how quickly you can get air out of your lungs. This test checks for signs of asthma or emphysema. Most cases of acute bronchitis get better without treatment, usually within a couple of weeks. Medications Because most cases of bronchitis are caused by viral infections, antibiotics aren't effective. However, if your doctor suspects that you have a bacterial infection, he or she may prescribe an antibiotic. In some circumstances, your doctor may recommend other medications, including: - Cough medicine. If your cough keeps you from sleeping, you might try cough suppressants at bedtime. - Other medications. If you have allergies, asthma or chronic obstructive pulmonary disease (COPD), your doctor may recommend an inhaler and other medications to reduce inflammation and open narrowed passages in your lungs. Therapies If you have chronic bronchitis, you may benefit from pulmonary rehabilitation - a breathing exercise program in which a respiratory therapist teaches you how to breathe more easily and increase your ability to exercise. To help you feel better, you may want to try the following self-care measures: - Avoid lung irritants. Don't smoke. Wear a mask when the air is polluted or if you're exposed to irritants, such as paint or household cleaners with strong fumes. - Use a humidifier. Warm, moist air helps relieve coughs and loosens mucus in your airways. But be sure to clean the humidifier according to the manufacturer's recommendations to avoid the growth of bacteria and fungi in the water container. - Consider a face mask outside. If cold air aggravates your cough and causes shortness of breath, put on a cold-air face mask before you go outside.", "role": "user" }, { "content": "Most cases of acute bronchitis get better without treatment, usually within a couple of weeks. Because most cases of bronchitis are caused by viral infections, antibiotics aren't effective. If doctors suspect that the infection is bacterial, they may prescribe an antibiotic. Doctors may also recommend cough medicine and cough suppressants at bedtime. For patients who have allergies, asthma or chronic obstructive pulmonary disease (COPD), doctors may recommend an inhaler to reduce inflammation and open narrowed passages in the lungs. For chronic bronchitis, pulmonary rehabilitation - a breathing exercise program that teaches how to breathe more easily and increase ability to exercise, may help. The following self-care measures may also help: avoiding lung irritants; avoiding smoking; wearing a mask when the air is polluted or contains irritants, such as paint or household cleaners with strong fumes; wearing cold-air face mask outside; using a humidifier. Warm, moist air helps relieve coughs and loosens mucus in the airways.", "role": "assistant" } ]
[ { "content": "I am 23yr boy,i have knock knees i want treatment. Please help me.\n\n Knock knees Genu valgum Summary Knock knees are condition in which the knees touch, but the ankles do not touch. The legs turn inward. Causes Infants start out with bowlegs because of their folded position while in their mother's womb. The legs begin to straighten once the child starts to walk (at about 12 to 18 months). By age 3, the child becomes knock-kneed. When the child stands, the knees touch but the ankles are apart. By puberty, the legs straighten out and most children can stand with the knees and ankles touching (without forcing the position). Knock knees can also develop as a result of a medical problem or disease, such as: Injury of the shinbone (only one leg will be knock-kneed) Osteomyelitis (bone infection) Overweight or obesity Rickets (a disease caused by a lack of vitamin D) Exams and Tests A health care provider will examine your child. Tests will be done if there are signs that knock knees are not a part of normal development. Treatment Knock knees are not treated in most cases. If the problem continues after age 7, the child may use a night brace. This brace is attached to a shoe. Surgery may be considered for knock knees that are severe and continue beyond late childhood. Outlook (Prognosis) Children normally outgrow knock knees without treatment, unless it is caused by a disease. If surgery is needed, the results are most often good. Possible Complications Complications may include: Difficulty walking (very rare) Self-esteem changes related to cosmetic appearance of knock knees If left untreated, knock knees can lead to early arthritis of the knee When to Contact a Medical Professional Call your provider if you think your child has knock knees. Prevention There is no known prevention for normal knock knees. Review Date 12/9/2016 Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant 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": "Knock knees are not treated in most cases. If the problem continues after age 7, the child may use a night brace. This brace is attached to a shoe. Surgery may be considered for knock knees that are severe and continue beyond late childhood.", "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 and Eclampsia: Preeclampsia (pree-i-KLAMP-see-uh) and eclampsia (ih-KLAMP-see-uh) are pregnancy-related high blood pressure disorders. In preeclampsia, the mother’s high blood pressure reduces the blood supply to the fetus, which may get less oxygen and fewer nutrients. Eclampsia is when pregnant women with preeclampsia develop seizures or coma. NICHD and other agencies are working to understand what causes these conditions and how they can be prevented and better treated. Preeclampsia and eclampsia are part of the spectrum of high blood pressure, or hypertensive, disorders that can occur during pregnancy.At the mild end of the spectrum is gestational hypertension, which occurs when a woman who previously had normal blood pressure develops high blood pressure when she is more than 20 weeks pregnant and her blood pressure returns to normal within 12 weeks after delivery. This problem usually occurs without other symptoms. In many cases, gestational hypertension does not harm the mother or fetus. Severe gestational hypertension, however, may be associated with preterm birth and infants who are small for their age at birth.1 And about 15% to 25% of women with gestational hypertension go on to develop preeclampsia.2Preeclampsia is similar to gestational hypertension, because it also describes high blood pressure at or after 20 weeks of pregnancy in a woman whose blood pressure was normal before pregnancy. But preeclampsia can also include blood pressure at or greater than 140/90 mmHg, increased swelling, and protein in the urine.3 The condition can be serious and is a leading cause of preterm birth (before 37 weeks of pregnancy).4 If it is severe enough to affect brain function, causing seizures or coma, it is called eclampsia.One of the serious complications of hypertensive disorders in pregnancy is HELLP syndrome, a situation in which a pregnant woman with preeclampsia or eclampsia suffers damage to the liver and blood cells. The letters in the name HELLP stand for the following problems:- H - Hemolysis, in which oxygen-carrying red blood cells break down - EL - Elevated Liver enzymes, showing damage to the liver - LP - Low Platelet count, meaning that the cells responsible for stopping bleeding are low The causes of preeclampsia and eclampsia are not known. These disorders previously were believed to be caused by a toxin, called “toxemia,” in the blood, but health care providers now know that is not true. Nevertheless, preeclampsia is sometimes still referred to as “toxemia.”To learn more about preeclampsia and eclampsia, scientists are investigating many factors that could contribute to the development and progression of these diseases, including:- Placental abnormalities, such as insufficient blood flow - Genetic factors - Environmental exposures - Nutritional factors - Maternal immunology and autoimmune disorders - Cardiovascular and inflammatory changes - Hormonal imbalances - Risks During Pregnancy Preeclampsia during pregnancy is mild in 75% of cases.1 However, a woman can progress from mild to severe preeclampsia or to full eclampsia very quickly―even in a matter of days. Both preeclampsia and eclampsia can cause serious health problems for the mother and infant. Women with preeclampsia are at increased risk for damage to the kidneys, liver, brain, and other organ and blood systems. Preeclampsia may also affect the placenta. The condition could lead to a separation of the placenta from the uterus (referred to as placental abruption), preterm birth, and pregnancy loss or stillbirth. In some cases, preeclampsia can lead to organ failure or stroke. In severe cases, preeclampsia can develop into eclampsia, which includes seizures. Seizures in eclampsia may cause a woman to lose consciousness and twitch uncontrollably.2 If the fetus is not delivered, these conditions can cause the death of the mother and/or the fetus. Expecting mothers rarely die from preeclampsia in the developed world, but it is still a major cause of illness and death globally.3 According to the World Health Organization, preeclampsia and eclampsia cause 14% of maternal deaths each year, or about 50,000 to 75,000 women worldwide.4 - Risks After Pregnancy In “uncomplicated preeclampsia,” the mother’s high blood pressure and other symptoms usually go back to normal within 6 weeks of the infant’s birth. However, studies have shown that women who had preeclampsia are four times more likely to later develop hypertension (high blood pressure) and are twice as likely to later develop ischemic heart disease (reduced blood supply to the heart muscle, which can cause heart attacks), a blood clot in a vein, and stroke as are women who did not have preeclampsia.5 Less commonly, mothers who had preeclampsia could experience permanent damage to their organs, such as their kidneys and liver. They could also experience fluid in the lungs. In the days following birth, women with preeclampsia remain at increased risk for developing eclampsia and seizures.3,6 Preeclampsia may be related to problems with the placenta early in the pregnancy.1 Such problems pose risks to the fetus, including:- Lack of oxygen and nutrients, which can impair fetal growth - Preterm birth - Stillbirth if placental abruption (separation of the placenta from the uterine wall) leads to heavy bleeding in the mother - Death: According to the Preeclampsia Foundation , each year, about 10,500 infants in the United States and about half a million worldwide die due to preeclampsia.2 Stillbirths are more likely to occur when the mother has a more severe form of preeclampsia, including HELLP syndrome.Infants whose mothers had preeclampsia are also at increased risk for later problems, even if they were born at full term (39 weeks of pregnancy).3 Infants born preterm due to preeclampsia face a higher risk of some long-term health issues, mostly related to being born early, including learning disorders, cerebral palsy, epilepsy, deafness, and blindness. Infants born preterm may also have to be hospitalized for a long time after birth and may be smaller than infants born full term. Infants who experienced poor growth in the uterus may later be at higher risk of diabetes, congestive heart failure, and high blood pressure.4 The exact number of women who develop preeclampsia is not known. Some estimates suggest that preeclampsia affects 2% to 8% of all pregnancies globally and about 3.4% in the United States.1,2The condition is estimated to account for 10% to 15% of maternal deaths worldwide.1 Disorders related to high blood pressure are the second leading cause of stillbirths and early neonatal deaths in developing nations.3In addition, HELLP syndrome occurs in about 10% to 20% of all women with severe preeclampsia or eclampsia.4Although preeclampsia occurs primarily in first pregnancies, a woman who had preeclampsia in a previous pregnancy is seven times more likely to develop preeclampsia in a later pregnancy.5Other factors that can increase a woman's risk include:5- Chronic high blood pressure or kidney disease before pregnancy - High blood pressure or preeclampsia in an earlier pregnancy - Obesity. Overweight or obese women are also more likely to have preeclampsia in more than one pregnancy.6 - Age. Women older than 40 are at higher risk. - Multiple gestation (being pregnant with more than one fetus) - African American ethnicity. Also, among women who have had preeclampsia before, non-white women are more likely than white women to develop preeclampsia again in a later pregnancy.6 - Family history of preeclampsia. According to the World Health Organization, among women who have had preeclampsia, about 20% to 40% of their daughters and 11% to 37% of their sisters also will get the disorder.7Preeclampsia is also more common among women who have histories of certain health conditions, such as migraines,8 diabetes,9 rheumatoid arthritis,10 lupus,11 scleroderma,12 urinary tract infections,13 gum disease,14 polycystic ovary syndrome,15 multiple sclerosis, gestational diabetes, and sickle cell disease.16Preeclampsia is also more common in pregnancies resulting from egg donation, donor insemination, or in vitro fertilization.The U.S. Preventative Services Task Force recommends that women who are at high risk for preeclampsia take low-dose aspirin starting after 12 weeks of pregnancy to prevent preeclampsia.17 Women who are pregnant or who are thinking about getting pregnant should talk with their health care provider about preeclampsia risk and ways to reduce the risk. - Preeclampsia Possible symptoms of preeclampsia include: - High blood pressure - Too much protein in the urine - Swelling in a woman's face and hands (a woman's feet might swell too, but swollen feet are common during pregnancy and may not signal a problem) - Systemic problems, such as headache, blurred vision, and right upper quadrant abdominal pain - High blood pressure - Too much protein in the urine - Swelling in a woman's face and hands (a woman's feet might swell too, but swollen feet are common during pregnancy and may not signal a problem) - Systemic problems, such as headache, blurred vision, and right upper quadrant abdominal pain - Eclampsia The following symptoms are cause for immediate concern:1 - Seizures - Severe headache - Vision problems, such as temporary blindness - Abdominal pain, especially in the upper right area of the belly - Nausea and vomiting - Smaller urine output or not urinating very often - Seizures - Severe headache - Vision problems, such as temporary blindness - Abdominal pain, especially in the upper right area of the belly - Nausea and vomiting - Smaller urine output or not urinating very often - HELLP Syndrome HELLP syndrome can lead to serious complications, including liver failure and death.1 A pregnant woman with HELLP syndrome might bleed or bruise easily and/or experience abdominal pain, nausea or vomiting, headache, or extreme fatigue. Although most women who develop HELLP syndrome already have high blood pressure and preeclampsia, sometimes the syndrome is the first sign. In addition, HELLP syndrome can occur without a woman having either high blood pressure or protein in her urine. A health care provider will check a pregnant woman’s blood pressure and urine during each prenatal visit. If the blood pressure reading is considered high (140/90 or higher), especially after the 20th week of pregnancy, the health care provider will likely perform blood tests and more extensive lab tests to look for extra protein in the urine (called proteinuria) as well as other symptoms.The American College of Obstetricians and Gynecologists provides the following criteria for a diagnosis of gestational hypertension, preeclampsia, eclampsia, and HELLP syndrome.Gestational hypertension is diagnosed if a pregnant woman has high blood pressure but no protein in the urine. Gestational hypertension occurs when women whose blood pressure levels were normal before pregnancy develop high blood pressure after 20 weeks of pregnancy. Gestational hypertension can progress into preeclampsia.1Mild preeclampsia is diagnosed when a pregnant woman has:2- Systolic blood pressure (top number) of 140 mmHg or higher or diastolic blood pressure (bottom number) of 90 mmHg or higher and either - Urine with 0.3 or more grams of protein in a 24-hour specimen (a collection of every drop of urine within 24 hours) or a protein-to-creatinine ratio greater than 0.3 or - Blood tests that show kidney or liver dysfunction - Fluid in the lungs and difficulty breathing - Visual impairmentsSevere preeclampsia occurs when a pregnant woman has any of the following:- Systolic blood pressure of 160 mmHg or higher or diastolic blood pressure of 110 mmHg or higher on two occasions at least 4 hours apart while the patient is on bed rest - Urine with 5 or more grams of protein in a 24-hour specimen or 3 or more grams of protein on 2 random urine samples collected at least 4 hours apart - Test results suggesting kidney or liver damage—for example, blood tests that reveal low numbers of platelets or high liver enzymes - Severe, unexplained stomach pain that does not respond to medication - Symptoms that include visual disturbances, difficulty breathing, or fluid buildup3Eclampsia occurs when women with preeclampsia develop seizures. The seizures can happen before or during labor or after the baby is delivered. HELLP syndrome is diagnosed when laboratory tests show hemolysis (burst red blood cells release hemoglobin into the blood plasma), elevated liver enzymes, and low platelets. There also may or may not be extra protein in the urine.4Some women may also be diagnosed with superimposed preeclampsia—a situation in which the woman develops preeclampsia on top of high blood pressure that was present before she got pregnant. Health care providers look for an increase in blood pressure and either protein in the urine, fluid buildup, or both for a diagnosis of superimposed preeclampsia.In addition to tests that might diagnose preeclampsia or similar problems, health care providers may do other tests to assess the health of the mother and fetus, including:- Blood tests to see how well the mother's liver and kidneys are working - Blood tests to check blood platelet levels to see how well the mother’s blood is clotting - Blood tests to count the total number of red blood cells in the mother’s blood - A maternal weight check - An ultrasound to assess the fetus’s size - A check of the fetus's heart rate - A physical exam to look for swelling in the mother’s face, hands, or legs as well as abdominal tenderness or an enlarged liver - Preeclampsia Treatment If the pregnancy is at 37 weeks or later, the health care provider will usually want to deliver the fetus to treat preeclampsia and avoid further complications. If the pregnancy is at less than 37 weeks, however, the woman and her health care provider may consider treatment options that give the fetus more time to develop, depending on how severe the condition is. A health care provider may consider the following options: - If the preeclampsia is mild, it may be possible to wait to deliver. To help prevent further complications, the health care provider may ask the woman to go on bed rest to try to lower blood pressure and increase the blood flow to the placenta. - Close monitoring of the woman and her fetus will be needed. Tests for the mother might include blood and urine tests to see if the preeclampsia is progressing, such as tests to assess platelet counts, liver enzymes, kidney function, and urinary protein levels. Tests for the fetus might include ultrasound, heart rate monitoring, assessment of fetal growth, and amniotic fluid assessment. - Anticonvulsive medication, such as magnesium sulfate, might be used to prevent a seizure. - In some cases, such as with severe preeclampsia, the woman will be admitted to the hospital so she can be monitored closely and continuously. Treatment in the hospital might include intravenous medication to control blood pressure and prevent seizures or other complications as well as steroid injections to help speed up the development of the fetus's lungs. When a woman has severe preeclampsia and is at 34 weeks of pregnancy or later, the American College of Obstetricians and Gynecologists recommends delivery as soon as medically possible. If the pregnancy is at less than 34 weeks, health care providers will probably prescribe corticosteroids to help speed up the maturation of the fetal lungs before attempting delivery.2 Preterm delivery may be necessary, even if that means likely complications for the infant, because of the risk of severe maternal complications. The symptoms of preeclampsia usually go away within 6 weeks of delivery.3 - If the preeclampsia is mild, it may be possible to wait to deliver. To help prevent further complications, the health care provider may ask the woman to go on bed rest to try to lower blood pressure and increase the blood flow to the placenta. - Close monitoring of the woman and her fetus will be needed. Tests for the mother might include blood and urine tests to see if the preeclampsia is progressing, such as tests to assess platelet counts, liver enzymes, kidney function, and urinary protein levels. Tests for the fetus might include ultrasound, heart rate monitoring, assessment of fetal growth, and amniotic fluid assessment. - Anticonvulsive medication, such as magnesium sulfate, might be used to prevent a seizure. - In some cases, such as with severe preeclampsia, the woman will be admitted to the hospital so she can be monitored closely and continuously. Treatment in the hospital might include intravenous medication to control blood pressure and prevent seizures or other complications as well as steroid injections to help speed up the development of the fetus's lungs. - Eclampsia Treatment Eclampsia—the onset of seizures in a woman with preeclampsia—is considered a medical emergency. Immediate treatment, usually in a hospital, is needed to stop the mother's seizures, treat blood pressure levels that are too high, and deliver the fetus. Magnesium sulfate (a type of mineral) may be given to treat active seizures and prevent future seizures. Antihypertensive medications may be given to lower the blood pressure. - HELLP Syndrome Treatment HELLP syndrome, a severe complication of preeclampsia and eclampsia, can lead to serious complications for the mother, including liver failure and death, as well as the fetus. The health care provider may consider the following treatments after a diagnosis of HELLP syndrome: - Delivery of the fetus - Hospitalization to provide intravenous medication to control blood pressure and prevent seizures or other complications as well as steroid injections to help speed up the development of the fetus's lungs.4 - Delivery of the fetus - Hospitalization to provide intravenous medication to control blood pressure and prevent seizures or other complications as well as steroid injections to help speed up the development of the fetus's lungs.4 - If I have high blood pressure, can I take steps to prevent problems like preeclampsia during pregnancy? If you currently have chronic hypertension (high blood pressure not due to pregnancy), you may be at higher-than-average risk for getting preeclampsia during pregnancy. Your risk is also higher if you had gestational hypertension (high blood pressure that occurs only during pregnancy) or preeclampsia with a previous pregnancy, if you are obese, or if you have other risk factors.1 Talk with your health care provider about how hypertension might affect your pregnancy and what you can do to lower your risk. Before You Get Pregnant - Visit your health care provider for a preconception visit to discuss what you can do to lower your risk. Your health care provider may recommend ways to control your blood pressure, if needed, by limiting your salt intake, exercising regularly, and losing weight if you are overweight. - If you take medication to control your blood pressure, ask your health care provider if you should change it. Some medications should not be used during pregnancy. Your health care provider may be able to recommend safer alternatives. While You Are Pregnant - Get regular prenatal care, including regular blood pressure checks, urine tests for protein, as well as regular weight checks. - Avoid alcohol and tobacco. - Talk with your health care provider about any drugs or supplements that you take or are thinking of taking, including vitamins and herbs. Follow your provider's recommendations about prescription and other medications. - If you are at very high risk of preeclampsia, your doctor may recommend that you start taking low-dose aspirin after at least 12 weeks of pregnancy.2 [top] - Visit your health care provider for a preconception visit to discuss what you can do to lower your risk. Your health care provider may recommend ways to control your blood pressure, if needed, by limiting your salt intake, exercising regularly, and losing weight if you are overweight. - If you take medication to control your blood pressure, ask your health care provider if you should change it. Some medications should not be used during pregnancy. Your health care provider may be able to recommend safer alternatives. - Get regular prenatal care, including regular blood pressure checks, urine tests for protein, as well as regular weight checks. - Avoid alcohol and tobacco. - Talk with your health care provider about any drugs or supplements that you take or are thinking of taking, including vitamins and herbs. Follow your provider's recommendations about prescription and other medications. - If you are at very high risk of preeclampsia, your doctor may recommend that you start taking low-dose aspirin after at least 12 weeks of pregnancy.2 - If I had preeclampsia with a previous pregnancy, will I have it again in later pregnancies? If you had preeclampsia during your first pregnancy, your risk of developing preeclampsia again is about 15%.3 Your risk is even higher if you delivered your first child before 28 weeks of pregnancy or if you are overweight or obese.3 Your risk of having preeclampsia again is also higher if you developed preeclampsia early in your previous pregnancy, if you developed chronic hypertension or diabetes after the first pregnancy, if you had in vitro fertilization, or if you are carrying more than one fetus. Having severe preeclampsia or HELLP syndrome during the first pregnancy also raises your risk. If you had HELLP syndrome during a pregnancy, you have about a 20% chance of getting some form of gestational hypertension again.4 [top]", "role": "user" }, { "content": "Although preeclampsia occurs primarily in first pregnancies, a woman who had preeclampsia in a previous pregnancy is seven times more likely to develop preeclampsia in a later pregnancy.5Other factors that can increase a woman's risk include:5- Chronic high blood pressure or kidney disease before pregnancy - High blood pressure or preeclampsia in an earlier pregnancy - Obesity. Overweight or obese women are also more likely to have preeclampsia in more than one pregnancy. - Age. Women older than 40 are at higher risk. - Multiple gestation (being pregnant with more than one fetus) - African American ethnicity. Also, among women who have had preeclampsia before, non-white women are more likely than white women to develop preeclampsia again in a later pregnancy.6 - Family history of preeclampsia. According to the World Health Organization, among women who have had preeclampsia, about 20% to 40% of their daughters and 11% to 37% of their sisters also will get the disorder.7Preeclampsia is also more common among women who have histories of certain health conditions, such as migraines,8 diabetes,9 rheumatoid arthritis,10 lupus,11 scleroderma,12 urinary tract infections,13 gum disease,14 polycystic ovary syndrome,15 multiple sclerosis, gestational diabetes, and sickle cell disease.16Preeclampsia is also more common in pregnancies resulting from egg donation, donor insemination, or in vitro fertilization. If you are at very high risk of preeclampsia, your doctor may recommend that you start taking low-dose aspirin after at least 12 weeks of pregnancy.2 [top] - Visit your health care provider for a preconception visit to discuss what you can do to lower your risk. Your health care provider may recommend ways to control your blood pressure, if needed, by limiting your salt intake, exercising regularly, and losing weight if you are overweight. - If you take medication to control your blood pressure, ask your health care provider if you should change it. Some medications should not be used during pregnancy. Your health care provider may be able to recommend safer alternatives. - Get regular prenatal care, including regular blood pressure checks, urine tests for protein, as well as regular weight checks. - Avoid alcohol and tobacco. - Talk with your health care provider about any drugs or supplements that you take or are thinking of taking, including vitamins and herbs. Follow your provider's recommendations about prescription and other medications. -", "role": "assistant" } ]
[ { "content": "what are the causes of pulmonary hypertension\n\n Pulmonary hypertension Overview Pulmonary hypertension is a type of high blood pressure that affects the arteries in your lungs and the right side of your heart. In one form of pulmonary hypertension, tiny arteries in your lungs, called pulmonary arterioles, and capillaries become narrowed, blocked or destroyed. This makes it harder for blood to flow through your lungs, and raises pressure within your lungs' arteries. As the pressure builds, your heart's lower right chamber (right ventricle) must work harder to pump blood through your lungs, eventually causing your heart muscle to weaken and fail. Some forms of pulmonary hypertension are serious conditions that become progressively worse and are sometimes fatal. Although some forms of pulmonary hypertension aren't curable, treatment can help lessen symptoms and improve your quality of life. Symptoms The signs and symptoms of pulmonary hypertension in its early stages might not be noticeable for months or even years. As the disease progresses, symptoms become worse. Pulmonary hypertension symptoms include: - Shortness of breath (dyspnea), initially while exercising and eventually while at rest - Fatigue - Dizziness or fainting spells (syncope) - Chest pressure or pain - Swelling (edema) in your ankles, legs and eventually in your abdomen (ascites) - Bluish color to your lips and skin (cyanosis) - Racing pulse or heart palpitations Causes Your heart has two upper chambers (atria) and two lower chambers (ventricles). Each time blood passes through your heart, the lower right chamber (right ventricle) pumps blood to your lungs through a large blood vessel (pulmonary artery). In your lungs, the blood releases carbon dioxide and picks up oxygen. The oxygen-rich blood then flows through blood vessels in your lungs (pulmonary arteries, capillaries and veins) to the left side of your heart. Ordinarily, the blood flows easily through the vessels in your lungs, so blood pressure is usually much lower in your lungs. With pulmonary hypertension, the rise in blood pressure is caused by changes in the cells that line your pulmonary arteries. These changes can cause the walls of the arteries to become stiff and thick, and extra tissue may form. The blood vessels may also become inflamed and tight. These changes in the pulmonary arteries can reduce or block blood flow through the blood vessels. This makes it harder for blood to flow, raising the blood pressure in the pulmonary arteries. Pulmonary hypertension is classified into five groups, depending on the cause. Group 1: Pulmonary arterial hypertension - Cause unknown, known as idiopathic pulmonary arterial hypertension - A specific gene mutation that can cause pulmonary hypertension to develop in families, also called heritable pulmonary arterial hypertension - Certain drugs - such as certain prescription diet drugs or illegal drugs such as methamphetamines - or certain toxins - Heart abnormalities present at birth (congenital heart disease) - Other conditions, such as connective tissue disorders (scleroderma, lupus, others), HIV infection or chronic liver disease (cirrhosis) Group 2: Pulmonary hypertension caused by left-sided heart disease - Left-sided valvular heart disease, such as mitral valve or aortic valve disease - Failure of the lower left heart chamber (left ventricle) Group 3: Pulmonary hypertension caused by lung disease - Chronic obstructive pulmonary disease, such as emphysema - Lung disease such as pulmonary fibrosis, a condition that causes scarring in the tissue between the lungs' air sacs (interstitium) - Sleep apnea and other sleep disorders - Long-term exposure to high altitudes in people who may be at higher risk of pulmonary hypertension Group 4: Pulmonary hypertension caused by chronic blood clots - Chronic blood clots in the lungs (pulmonary emboli) Group 5: Pulmonary hypertension associated with other conditions that have unclear reasons why the pulmonary hypertension occurs - Blood disorders - Disorders that affect several organs in the body, such as sarcoidosis - Metabolic disorders, such as glycogen storage disease - Tumors pressing against pulmonary arteries Eisenmenger syndrome and pulmonary hypertension Eisenmenger syndrome, a type of congenital heart disease, causes pulmonary hypertension. It's most commonly caused by a large hole in your heart between the two lower heart chambers (ventricles), called a ventricular septal defect. This hole in your heart causes blood to circulate abnormally in your heart. Oxygen-carrying blood (red blood) mixes with oxygen-poor blood (blue blood). The blood then returns to your lungs instead of going to the rest of your body, increasing the pressure in the pulmonary arteries and causing pulmonary hypertension. Risk factors Your risk of developing pulmonary hypertension may be greater if: - You're a young adult, as idiopathic pulmonary arterial hypertension is more common in younger adults - You're overweight - You have a family history of the disease - You have one of various conditions that can increase your risk of developing pulmonary hypertension - You use illegal drugs, such as cocaine - You take certain appetite-suppressant medications - You have an existing risk of developing pulmonary hypertension, such as a family history of the condition, and you live at a high altitude Diagnosis Pulmonary hypertension is hard to diagnose early because it's not often detected in a routine physical exam. Even when the condition is more advanced, its signs and symptoms are similar to those of other heart and lung conditions. To diagnose your condition, your doctor may review your medical and family history, discuss your signs and symptoms, and conduct a physical examination. Doctors may order several tests to diagnose pulmonary hypertension, determine the severity of your condition and find out the cause of your condition. Tests may include: - Echocardiogram. Sound waves can create moving images of the beating heart. An echocardiogram can help your doctor to check the size and functioning of the right ventricle, and the thickness of the right ventricle's wall. An echocardiogram can also show how well your heart chambers and valves are working. Doctors may also use this to measure the pressure in your pulmonary arteries. In some cases, your doctor will recommend an exercise echocardiogram to help determine how well your heart and lungs work under stress. In this test, you'll have an echocardiogram before exercising on a stationary bike or treadmill and another test immediately afterward. This could be done as an oxygen consumption test, in which you may have to wear a mask that assesses the ability of your heart and lungs to deal with oxygen and carbon dioxide. Other exercise tests may also be done. These tests can help determine the severity and cause of your condition. They may also be done at follow-up appointments to check that your treatments are working. - Chest X-ray. A chest X-ray can show images of your heart, lungs and chest. This test can show enlargement of the right ventricle of the heart or the pulmonary arteries, which can occur in pulmonary hypertension. This test can also be used to identify other conditions that may be causing pulmonary hypertension. - Electrocardiogram (ECG). This noninvasive test shows your heart's electrical patterns and can detect abnormal rhythms. Doctors may also be able to see signs of right ventricle enlargement or strain. - Right heart catheterization. After you've had an echocardiogram, if your doctor thinks you have pulmonary hypertension, you'll likely have a right heart catheterization. This test can often help confirm that you have pulmonary hypertension and determine the severity of your condition. During the procedure, a cardiologist places a thin, flexible tube (catheter) into a vein in your neck or groin. The catheter is then threaded into your right ventricle and pulmonary artery. Right heart catheterization allows your doctor to directly measure the pressure in the main pulmonary arteries and right ventricle. It's also used to see what effect different medications may have on your pulmonary hypertension. - Blood tests. Your doctor might order blood tests to check for certain substances in your blood that might show you have pulmonary hypertension or its complications. Blood tests can also test for certain conditions that may be causing your condition. Your doctor might order additional tests to check the condition of your lungs and pulmonary arteries and to determine the cause of your condition, including: - Computerized tomography (CT) scan. During a CT scan, you lie on a table inside a doughnut-shaped machine. CT scanning generates X-rays to produce cross-sectional images of your body. Doctors may inject a dye into your blood vessels that helps your arteries to be more visible on the CT pictures (CT angiography). Doctors may use this test to look at the heart's size and function and to check for blood clots in the lungs' arteries. - Magnetic resonance imaging (MRI). This test may be used to check the right ventricle's function and the blood flow in the lung's arteries. In this test, you lie on a movable table that slides into the tunnel. An MRI uses a magnetic field and pulses of radio wave energy to make pictures of the body. - Pulmonary function test. This noninvasive test measures how much air your lungs can hold, and the airflow in and out of your lungs. During the test, you'll blow into a simple instrument called a spirometer. - Polysomnogram. This test detects your brain activity, heart rate, blood pressure, oxygen levels and other factors while you sleep. It can help diagnose a sleep disorder such as obstructive sleep apnea. - Ventilation/perfusion (V/Q) scan. In this test, a tracer is injected into a vein in your arm. The tracer maps blood flow and air to your lungs. This test can be used to determine whether blood clots are causing symptoms of pulmonary hypertension. - Open-lung biopsy. Rarely, a doctor might recommend an open-lung biopsy. An open-lung biopsy is a type of surgery in which a small sample of tissue is removed from your lungs under general anesthesia to check for a possible secondary cause of pulmonary hypertension. Genetic tests If a family member has had pulmonary hypertension, your doctor might screen you for genes that are linked with pulmonary hypertension. If you test positive, your doctor might recommend that other family members be screened for the same genetic mutation. Pulmonary hypertension classifications Once you've been diagnosed with pulmonary hypertension, your doctor might classify the severity of your disease into one of several classes, including: - Class I. Although you've been diagnosed with pulmonary hypertension, you have no symptoms with normal activity. - Class II. You don't have symptoms at rest, but you experience symptoms such as fatigue, shortness of breath or chest pain with normal activity. - Class III. You're comfortable at rest, but have symptoms when you're physically active. - Class IV. You have symptoms with physical activity and while at rest. Treatment Pulmonary hypertension can't be cured, but doctors can help you manage your condition. Treatment may help improve your symptoms and slow the progress of pulmonary hypertension. It often takes some time to find the most appropriate treatment for pulmonary hypertension. The treatments are often complex and require extensive follow-up care. Your doctor might also need to change your treatment if it's no longer effective. When pulmonary hypertension is caused by another condition, your doctor will treat the underlying cause whenever possible. Medications - Blood vessel dilators (vasodilators). Vasodilators open narrowed blood vessels. One of the most commonly prescribed vasodilators for pulmonary hypertension is epoprostenol (Flolan, Veletri). The drawback to epoprostenol is that its effects last only a few minutes. This drug is continuously injected through an intravenous (IV) catheter via a small pump that you wear in a pack on your belt or shoulder. Potential side effects of epoprostenol include jaw pain, nausea, diarrhea and leg cramps, as well as pain and infection at the IV site. Another form of the drug, iloprost (Ventavis), can be inhaled six to nine times a day through a nebulizer, a machine that vaporizes your medication. Because it's inhaled, it goes directly to the lungs. Side effects associated with iloprost include chest pain - often accompanied by a headache and nausea - and breathlessness. Treprostinil (Tyvaso, Remodulin, Orenitram), another form of the drug, can be given four times a day. It can be inhaled, taken as oral medication or administered by injection. It can cause side effects such as a headache, nausea and diarrhea. - Endothelin receptor antagonists. These medications reverse the effect of endothelin, a substance in the walls of blood vessels that causes them to narrow. These drugs may improve your energy level and symptoms. However, these drugs shouldn't be taken if you're pregnant. Also, these drugs can damage your liver and you may need monthly liver monitoring. These medications include bosentan (Tracleer), macitentan (Opsumit), and ambrisentan (Letairis). - Sildenafil and tadalafil. Sildenafil (Revatio, Viagra) and tadalafil (Cialis, Adcirca) are sometimes used to treat pulmonary hypertension. These drugs work by opening the blood vessels in the lungs to allow blood to flow through more easily. Side effects can include an upset stomach, headache and vision problems. - High-dose calcium channel blockers. These drugs help relax the muscles in the walls of your blood vessels. They include medications such as amlodipine (Norvasc), diltiazem (Cardizem, Tiazac, others) and nifedipine (Procardia, others). Although calcium channel blockers can be effective, only a small number of people with pulmonary hypertension respond to them. - Soluble guanylate cyclase (SGC) stimulator. Soluble guanylate cyclase (SGC) stimulators (Adempas) interact with nitric oxide and help relax the pulmonary arteries and lower the pressure within the arteries. These medications should not be taken if you're pregnant. They can sometimes cause dizziness or nausea. - Anticoagulants. Your doctor is likely to prescribe the anticoagulant warfarin (Coumadin, Jantoven) to help prevent the formation of blood clots within the small pulmonary arteries. Because anticoagulants prevent normal blood coagulation, they increase your risk of bleeding complications. Take warfarin exactly as prescribed, because warfarin can cause severe side effects if taken incorrectly. If you're taking warfarin, your doctor will ask you to have periodic blood tests to check how well the drug is working. Many other drugs, herbal supplements and foods can interact with warfarin, so be sure your doctor knows all of the medications you're taking. - Digoxin. Digoxin (Lanoxin) can help the heart beat stronger and pump more blood. It can help control the heart rate if you experience arrhythmias. - Diuretics. Commonly known as water pills, these medications help eliminate excess fluid from your body. This reduces the amount of work your heart has to do. They may also be used to limit fluid buildup in your lungs. - Oxygen. Your doctor might suggest that you sometimes breathe pure oxygen, a treatment known as oxygen therapy, to help treat pulmonary hypertension, especially if you live at a high altitude or have sleep apnea. Some people who have pulmonary hypertension eventually require continuous oxygen therapy. Surgeries - Atrial septostomy. If medications don't control your pulmonary hypertension, this open-heart surgery might be an option. In an atrial septostomy, a surgeon will create an opening between the upper left and right chambers of your heart (atria) to relieve the pressure on the right side of your heart. Atrial septostomy can have serious complications, including heart rhythm abnormalities (arrhythmias). - Transplantation. In some cases, a lung or heart-lung transplant might be an option, especially for younger people who have idiopathic pulmonary arterial hypertension. Major risks of any type of transplantation include rejection of the transplanted organ and serious infection, and you must take immunosuppressant drugs for life to help reduce the chance of rejection. Lifestyle and home remedies Although medical treatment can't cure pulmonary hypertension, it can lessen symptoms. Lifestyle changes also can help improve your condition. Consider these tips: - Get plenty of rest. Resting can reduce the fatigue that might come from having pulmonary hypertension. - Stay as active as possible. Even the mildest forms of activity might be too exhausting for some people who have pulmonary hypertension. For others, moderate exercise such as walking might be beneficial - especially when done with oxygen. But first, talk to your doctor about specific exercise restrictions. In most cases, it's recommended that you not lift heavy weights. Your doctor can help you plan an appropriate exercise program. - Don't smoke. If you smoke, the most important thing you can do for your heart and lungs is to stop. If you can't stop smoking by yourself, ask your doctor to prescribe a treatment plan to help you quit. Also, avoid secondhand smoke if possible. - Avoid pregnancy and birth control pills. If you're a woman of childbearing age, avoid pregnancy. Pregnancy can be life-threatening for both you and your baby. Also avoid using birth control pills, which can increase your risk of blood clots. Talk to your doctor about alternative forms of birth control. If you do become pregnant, it's important to consult with your doctor as pulmonary hypertension can cause serious complications to both you and the fetus. - Avoid traveling to or living at high altitudes. High altitudes can worsen the symptoms of pulmonary hypertension. If you live at an altitude of 8,000 feet (2,438 meters) or higher, your doctor might recommend that you move to a lower altitude. - Avoid situations that can excessively lower blood pressure. These include sitting in a hot tub or sauna or taking long hot baths or showers. These activities lower your blood pressure and can cause fainting or even death. Also avoid activities that cause prolonged straining, such as lifting heavy objects or weights. - Follow a nutritious diet and stay at a healthy weight. Aim to eat a healthy diet of whole grains, a variety of fruits and vegetables, lean meats and low-fat dairy products. Avoid saturated fat, trans fat and cholesterol. It's likely your doctor will recommend limiting the amount of salt in your diet. Aim to maintain a healthy weight. - Ask your doctor about medications. Take all your medications as prescribed. Ask your doctor about any other medications before taking them, as some can interfere with your medication or worsen your condition. - See your doctor at follow-up appointments. Your doctor may recommend regular follow-up appointments. Let your doctor know if you have any questions about your condition or medications you're taking, or if you have any symptoms or side effects from your medications. If pulmonary hypertension is affecting your quality of life, ask your doctor about options that could improve your quality of life. - Get vaccines. Your doctor may recommend getting an influenza and pneumonia vaccine, as these conditions can cause serious issues for people with pulmonary hypertension. - Get support. If you're feeling stressed or worried due to your condition, get support from family or friends. Or, consider joining a support group with others who have pulmonary hypertension. ", "role": "user" }, { "content": "Pulmonary hypertension: Pulmonary hypertension is a type of high blood pressure that affects the arteries in your lungs and the right side of your heart. With pulmonary hypertension, the rise in blood pressure is caused by changes in the cells that line your pulmonary arteries. These changes can cause the walls of the arteries to become stiff and thick, and extra tissue may form. The blood vessels may also become inflamed and tight. These changes in the pulmonary arteries can reduce or block blood flow through the blood vessels. This makes it harder for blood to flow, raising the blood pressure in the pulmonary arteries. As the pressure builds, your heart's lower right chamber (right ventricle) must work harder to pump blood through your lungs, eventually causing your heart muscle to weaken and fail.", "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": "Lifestyle changes that prevent constipation and soften stools may promote healing of an anal fissure. These changes include: gradually adding up to 25-30 grams of fiber, such as fruits, vegetables, nuts and whole grains to your diet; drinking sufficient amount of fluids; regular moderate exercise, such as walking. Additionally, avoid straining during bowel movements.", "role": "assistant" } ]
[ { "content": "how is hemophilia treated\n\nHemophilia A (Treatment): People with inherited hemophilia A require life-long care, preferably through a specialized hemophilia treatment center. Although there is no cure for hemophilia A, current treatments usually work well. Treatment primarily consists of replacing the missing clotting factor VIII ( replacement therapy) and preventing complications that are associated with the disorder. The type and frequency of treatment often depends on the severity of the disorder in each person. People with mild or moderate hemophilia A may be treated with replacement therapy as needed (for example, when a specific bleeding episode occurs). This is called episodic therapy. Some people with mild hemophilia A may be treated with desmopressin (DDAVP). Desmopressin raises the levels of factor VIII in the blood and may be taken intravenously or through a nasal spray. Drugs known as antifibrinolytics, which slow the breakdown of clotting factors in the blood, can also be used to treat those with a mild form of the disorder. Some people with severe hemophilia A may receive periodic factor VIII infusions to prevent bleeding episodes and associated complications such as joint damage. This is referred to as prophylactic therapy. People can be trained to give infusions at home. This is especially important for people with severe disease because the infusion works the best within one hour of a bleeding episode. In general, rapid treatment is important because it reduces pain and damage to the joints, muscles or other affected tissues or organs . [5] Management Guidelines GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions. The National Hemophilia Foundation Web site posts the guidelines for management of pregnancy and delivery of women with bleeding disorders and carriers of hemophilia A and B. Click on the link to view the guidelines. FDA-Approved Treatments The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition. Learn more orphan products. National Library of Medicine Drug Information Portal National Library of Medicine Drug Information Portal National Library of Medicine Drug Information Portal National Library of Medicine Drug Information Portal Medline Plus Health Information National Library of Medicine Drug Information Portal Medline Plus Health Information", "role": "user" }, { "content": "Hemophilia A (Treatment): People with inherited hemophilia A require life-long care, preferably through a specialized hemophilia treatment center. Although there is no cure for hemophilia A, current treatments usually work well. Treatment primarily consists of replacing the missing clotting factor VIII ( replacement therapy) and preventing complications that are associated with the disorder. The type and frequency of treatment often depends on the severity of the disorder in each person. People with mild or moderate hemophilia A may be treated with replacement therapy as needed (for example, when a specific bleeding episode occurs). This is called episodic therapy. Some people with mild hemophilia A may be treated with desmopressin (DDAVP). Desmopressin raises the levels of factor VIII in the blood and may be taken intravenously or through a nasal spray. Drugs known as antifibrinolytics, which slow the breakdown of clotting factors in the blood, can also be used to treat those with a mild form of the disorder. Some people with severe hemophilia A may receive periodic factor VIII infusions to prevent bleeding episodes and associated complications such as joint damage.", "role": "assistant" } ]
[ { "content": "what are known causes of bipolar disorder\n\nBipolar disorder (Causes): The exact cause of bipolar disorder is unknown, but several factors may be involved, such as: - Biological differences. People with bipolar disorder appear to have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes. - Genetics. Bipolar disorder is more common in people who have a first-degree relative, such as a sibling or parent, with the condition. Researchers are trying to find genes that may be involved in causing bipolar disorder.", "role": "user" }, { "content": "The exact cause of bipolar disorder is unknown, but several factors may be involved. These include biological differences, such as physical changes in the brain, and genetics, where bipolar disorder is more common in people who have a first degree relative with the condition. Researchers are currently studying genes that may be involved in causing bipolar disorder.", "role": "assistant" } ]
[ { "content": "how is gonorrhea diagnosed\n\nGonorrhea: Gonorrhea is a sexually transmitted infection (STI). It is usually spread by having vaginal, oral, or anal sex. In 2014, gonorrhea affected more than 162,000 women in the United States.1 Antibiotics can treat gonorrhea. If left untreated, it can cause serious health problems, including problems getting pregnant. Gonorrhea is an STI that is caused by the bacteria Neisseria gonorrhoeae. It is an especially serious problem for women because it can damage the female reproductive organs. In 2014, gonorrhea affected more than 162,000 women in the United States.1 Gonorrhea most often affects women ages 15 to 24. But, gonorrhea is becoming more common in older women too.1 Gonorrhea is spread through: Most women with gonorrhea do not have any signs or symptoms. If you do get symptoms, they are often mild and can be mistaken for a bladder or vaginal infection. Signs or symptoms of gonorrhea depend on where you are first infected by the gonorrhea bacteria. Signs and symptoms in the genital area can include: Signs and symptoms in other parts of the body include: Gonorrhea can cause serious health problems, even if you do not have any signs or symptoms. You also need to get tested if you have any symptoms of gonorrhea. Testing is very important, because women with untreated gonorrhea can develop serious health problems. If you are tested for gonorrhea, you also need to get tested for other STIs, including chlamydia, syphilis, and HIV. There are two ways that a doctor or nurse tests for gonorrhea: A Pap test is not used to detect gonorrhea. Your doctor or nurse will give you antibiotics to treat gonorrhea. The antibiotics are usually a pill you swallow. Although antibiotics can cure gonorrhea, they cannot fix any permanent damage done to your body. For this reason, it is important to get tested and to take the antibiotics as soon as possible. For the antibiotics to work, you must finish all of the antibiotics that your doctor gives you, even if the symptoms go away. Do not share your antibiotics for gonorrhea with anyone. If symptoms do not go away after treatment, see your doctor or nurse. It is possible to get gonorrhea again if you have sex with someone who has gonorrhea. Tell your recent sex partner(s) so they can be tested and treated. Gonorrhea that is not treated can cause serious health problems in women:3 Gonorrhea is easy to treat. But you need to get tested and treated as soon as possible. If you have gonorrhea: For pregnant women, untreated gonorrhea raises the risk of: Babies born to infected mothers are at risk for: Treatment of gonorrhea as soon as it is found in pregnant women will lower the risk of these problems for both mother and baby. Your baby will get antibiotics if you have gonorrhea or if your baby has a gonorrheal eye infection. The best way to prevent gonorrhea or any STI is to not have vaginal, oral, or anal sex. If you do have sex, lower your risk of getting an STI with the following steps: The steps work best when used together. No single step can protect you from every single type of STI. Yes. It is possible to get gonorrhea, or any other STI, if you are a woman who has sex only with women. Talk to your partner about her sexual history before having sex, and ask your doctor about getting tested if you have signs or symptoms of gonorrhea. For more information about gonorrhea, call the OWH Helpline at 1-800-994-9662 or contact the following organizations:", "role": "user" }, { "content": "If you suspect you have gonorrhea, it is very important you get tested. In women, untreated gonorrhea can lead to serious health issues. If you are tested for gonorrhea, you also need to get tested for other STIs, such as chlamydia, syphilis, and HIV.", "role": "assistant" } ]
[ { "content": "how do i prevent myself from having dementia\n\nDementia: Dementia is not a specific disease. It is a descriptive term for a collection of symptoms that can be caused by a number of disorders that affect the brain. People with dementia have significantly impaired intellectual functioning that interferes with normal activities and relationships. They also lose their ability to solve problems and maintain emotional control, and they may experience personality changes and behavioral problems, such as agitation, delusions, and hallucinations. While memory loss is a common symptom of dementia, memory loss by itself does not mean that a person has dementia. Doctors diagnose dementia only if two or more brain functions - such as memory and language skills -- are significantly impaired without loss of consciousness. Some of the diseases that can cause symptoms of dementia are Alzheimer’s disease, vascular dementia, Lewy body dementia, frontotemporal dementia, Huntington’s disease, and Creutzfeldt-Jakob disease. Doctors have identified other conditions that can cause dementia or dementia-like symptoms including reactions to medications, metabolic problems and endocrine abnormalities, nutritional deficiencies, infections, poisoning, brain tumors, anoxia or hypoxia (conditions in which the brain’s oxygen supply is either reduced or cut off entirely), and heart and lung problems. Although it is common in very elderly individuals, dementia is not a normal part of the aging process. Drugs to specifically treat Alzheimer’s disease and some other progressive dementias are now available. Although these drugs do not halt the disease or reverse existing brain damage, they can improve symptoms and slow the progression of the disease. This may improve an individual’s quality of life, ease the burden on caregivers, or delay admission to a nursing home. Many researchers are also examining whether these drugs may be useful for treating other types of dementia. Many people with dementia, particularly those in the early stages, may benefit from practicing tasks designed to improve performance in specific aspects of cognitive functioning. For example, people can sometimes be taught to use memory aids, such as mnemonics, computerized recall devices, or note taking. 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": "Some types of dementia cannot be prevented, such as Alzheimer's, though their progression can be slowed. Others can be halted or reversed with appropriate treatment. There are drug-based and treatment-based treatments for dementia. There are drugs that specifically treat Alzheimers disease and other progressive dementias. These drugs do not halt or reverse the disease, but they can slow its progression. The therapeutic-based approaches include practicing tasks designed to improve memory, attention, and other cognitive abilities. These tasks are not designed to prevent dementia but slow its progression.", "role": "assistant" } ]
[ { "content": "what the treatment for bronchitis\n\nBronchitis (Treatment): Most cases of acute bronchitis get better without treatment, usually within a couple of weeks. Medications Because most cases of bronchitis are caused by viral infections, antibiotics aren't effective. However, if your doctor suspects that you have a bacterial infection, he or she may prescribe an antibiotic. In some circumstances, your doctor may recommend other medications, including: - Cough medicine. If your cough keeps you from sleeping, you might try cough suppressants at bedtime. - Other medications. If you have allergies, asthma or chronic obstructive pulmonary disease (COPD), your doctor may recommend an inhaler and other medications to reduce inflammation and open narrowed passages in your lungs. Therapies If you have chronic bronchitis, you may benefit from pulmonary rehabilitation - a breathing exercise program in which a respiratory therapist teaches you how to breathe more easily and increase your ability to exercise.", "role": "user" }, { "content": "Most cases of acute bronchitis get better without treatment, usually within a couple of weeks. ... Because most cases of bronchitis are caused by viral infections, antibiotics aren't effective. However, if your doctor suspects that you have a bacterial infection, he or she may prescribe an antibiotic. In some circumstances, your doctor may recommend other medications, including: - Cough medicine. If your cough keeps you from sleeping, you might try cough suppressants at bedtime. - Other medications. If you have allergies, asthma or chronic obstructive pulmonary disease (COPD), your doctor may recommend an inhaler and other medications to reduce inflammation and open narrowed passages in your lungs. Therapies If you have chronic bronchitis, you may benefit from pulmonary rehabilitation - a breathing exercise program in which a respiratory therapist teaches you how to breathe more easily and increase your ability to exercise.", "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 (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": "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": "assistant" } ]
[ { "content": "Breast cancer at 84. My mother was just diagnost with breast cancer. She is 84 years old, her tumor started in the milk duct and is small in size, their is a mass as well in the same breast. He is scheduled for a lumpectomy to remove both. Because of age we would like suggestions on treatment options after surgery.\n\n Breast cancer Cancer - breast Carcinoma - ductal Carcinoma - lobular DCIS LCIS HER2-positive breast cancer ER-positive breast cancer Ductal carcinoma in situ Lobular carcinoma in situ Summary Breast cancer is cancer that starts in the tissues of the breast. There are two main types of breast cancer: Ductal carcinoma starts in the tubes (ducts) that carry milk from the breast to the nipple. Most breast cancers are of this type. Lobular carcinoma starts in the parts of the breast, called lobules, which produce milk. In rare cases, breast cancer can start in other areas of the breast. Causes Breast cancer risk factors are things that increase the chance that you could develop breast cancer: Some risk factors you can control, such as drinking alcohol. Others, such as family history, you cannot control. The more risk factors you have, the more your risk increases. But, it does not mean you will develop cancer. Many women who develop breast cancer do not have any known risk factors or a family history. Understanding your risk factors can help you know how to prevent breast cancer. Breast implants, using antiperspirants, and wearing underwire bras do not increase the risk for breast cancer. There is also no evidence of a direct link between breast cancer and pesticides. Symptoms Early breast cancer often does not cause symptoms. This is why regular breast exams and mammograms are important, so cancers that don't have symptoms may be found earlier. As the cancer grows, symptoms may include: Breast lump or lump in the armpit that is hard, has uneven edges, and usually does not hurt. Change in the size, shape, or feel of the breast or nipple. For example, you may have redness, dimpling, or puckering that looks like the skin of an orange. Fluid from the nipple. Fluid may be bloody, clear to yellow, green, or look like pus. In men, breast cancer symptoms include breast lump and breast pain and tenderness. Symptoms of advanced breast cancer may include: Bone pain Breast pain or discomfort Skin ulcers Swelling of the lymph nodes in the armpit (next to the breast with cancer) Weight loss Exams and Tests The health care provider will ask about your symptoms and risk factors. Then the provider will perform a physical exam. The exam includes both breasts, armpits, and the neck and chest area. Women are encouraged to perform breast self-exams each month. However, the importance of self-exams for detecting breast cancer is debatable. Tests used to diagnose and monitor people with breast cancer may include: Breast MRI to help better identify the breast lump or evaluate an abnormal change on a mammogram Breast ultrasound to show whether the lump is solid or fluid-filled Breast biopsy, using methods such as needle aspiration, ultrasound-guided, stereotactic, or open CT scan to check if the cancer has spread outside the breast Mammography to screen for breast cancer or help identify the breast lump PET scan to check if the cancer has spread Sentinel lymph node biopsy to check if the cancer has spread to the lymph nodes If your doctor learns that you do have breast cancer, more tests will be done. This is called staging, which checks if the cancer has spread. Staging helps guide treatment and follow-up. It also gives you an idea of what to expect in the future. Breast cancer stages range from 0 to IV. The higher the stage, the more advanced the cancer. Treatment Treatment is based on many factors, including: Type of breast cancer Stage of the cancer (staging is a tool your providers use to find out how advanced the cancer is) Whether the cancer is sensitive to certain hormones Whether the cancer overproduces (overexpresses) the HER2/neu protein Cancer treatments may include: Hormone therapy. Chemotherapy, which uses medicines to kill cancer cells. Radiation therapy, which is used to destroy cancerous tissue. Surgery to remove cancerous tissue: A lumpectomy removes the breast lump. Mastectomy removes all or part of the breast and possibly nearby structures. Nearby lymph nodes may also be removed during surgery. Targeted therapy uses medicine to attack the gene changes in cancer cells. Hormone therapy is an example of targeted therapy. It blocks certain hormones that fuel cancer growth. Cancer treatment can be local or systemic: Local treatments involve only the area of disease. Radiation and surgery are forms of local treatment. They are most effective when the cancer has not spread outside the breast. Systemic treatments affect the entire body. Chemotherapy and hormonal therapy are types of systemic treatment. Most women receive a combination of treatments. For women with stage I, II, or III breast cancer, the main goal is to treat the cancer and prevent it from returning (recurring). For women with stage IV cancer, the goal is to improve symptoms and help them live longer. In most cases, stage IV breast cancer cannot be cured. Stage 0 and ductal carcinoma: Lumpectomy plus radiation or mastectomy is the standard treatment. Stage I and II: Lumpectomy plus radiation or mastectomy with lymph node removal is the standard treatment. Chemotherapy, hormonal therapy, and other targeted therapy may also be used after surgery. Stage III: Treatment involves surgery, possibly followed by chemotherapy, hormone therapy, and other targeted therapy. Stage IV: Treatment may involve surgery, radiation, chemotherapy, hormone therapy, other targeted therapy, or a combination of these treatments. After treatment, some women continue to take medicines for a time. All women continue to have blood tests, mammograms, and other tests after treatment to monitor for the return of cancer or development of another breast cancer. Women who have had a mastectomy may have reconstructive breast surgery. This will be done either at the time of mastectomy or later. Support Groups You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone. Outlook (Prognosis) New, improved treatments are helping people with breast cancer live longer. Even with treatment, breast cancer can spread to other parts of the body. Sometimes, cancer returns, even after the entire tumor has been removed and nearby lymph nodes are found to be cancer-free. Some women who have had breast cancer develop a new breast cancer that is not related to the original tumor. How well you do after being treated for breast cancer depends on many things. The more advanced your cancer, the poorer the outcome. Other factors that determine the risk for recurrence and the likelihood of successful treatment include: Location of the tumor and how far it has spread Whether the tumor is hormone receptor-positive or -negative Tumor markers Gene expression Tumor size and shape Rate of cell division or how quickly the tumor is growing After considering all of the above, your provider can discuss your risk of having a recurrence of breast cancer. Possible Complications You may experience side effects or complications from cancer treatment. These may include temporary pain or swelling of the breast and surrounding area. Ask your provider about the possible side effects from treatment. When to Contact a Medical Professional Contact your provider if: You have a breast or armpit lump You have nipple discharge After being treated for breast cancer, call your provider if you develop symptoms such as: Nipple discharge Rash on the breast New lumps in the breast Swelling in the area Pain, especially chest pain, abdominal pain, or bone pain Prevention Talk to your provider about how often you should have a mammogram or other tests to screen for breast cancer. Early breast cancers found by a mammogram have a good chance of being cured. Tamoxifen is approved for breast cancer prevention in women age 35 and older who are at high risk. Discuss this with your provider. Women at very high risk for breast cancer may consider preventive (prophylactic) mastectomy. This is surgery to remove the breasts before breast cancer is diagnosed. Possible candidates include: Women who have already had one breast removed due to cancer Women with a strong family history of breast cancer Women with genes or genetic mutations that raise their risk for breast cancer (such as BRCA1 or BRCA2) Many risk factors, such as your genes and family history, cannot be controlled. But making healthy lifestyle changes may reduce your overall chance of getting cancer. This includes: Eating healthy foods Maintaining a healthy weight Limiting alcohol consumption to 1 drink per day Review Date 10/21/2017 Updated by: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "After lumpectomy your mother's doctor might prescribe medicines for a time. She will need to have blood tests, mammograms, and other tests after treatment to monitor for the return of cancer or development of another breast cancer.", "role": "assistant" } ]
[ { "content": "I have no help its about 4 years now I have ingrown toenail i have a problem of ingrown toenail its about 4 years now I have this problem i need help\n\n Ingrown toenail Onychocryptosis Unguis incarnates Surgical nail avulsion Matrix excision Ingrown toenail removal Summary An ingrown toenail occurs when the edge of the nail grows into the skin of the toe. Causes An ingrown toenail can result from a number of things. Poorly fitting shoes and toenails that are not properly trimmed are the most common causes. The skin along the edge of a toenail may become red and infected. The great toe is affected most often, but any toenail can become ingrown. An ingrown toenail may occur when extra pressure is placed on your toe. This pressure is caused by shoes that are too tight or fit poorly. If you walk often or play sports, a shoe that is even a little tight can cause this problem. Deformities of the foot or toes can also place extra pressure on the toe. Nails that are not trimmed properly can also cause ingrown toenails: Toenails that are trimmed too short, or if the edges are rounded rather than cut straight across may cause the nail to curl and grow into the skin. Poor eyesight, inability to reach the toes easily, or having thick nails can make it hard to properly trim nails. Picking or tearing at the corners of the nails can also cause an ingrown toenail. Some people are born with nails that are curved and grow into the skin. Others have toenails that are too large for their toes. Stubbing your toe or other injuries can also lead to an ingrown toenail. Symptoms There may be pain, redness and swelling around the nail. Exams and Tests Your health care provider will examine your toenail and ask about your symptoms. Tests or x-rays aren't usually needed. Treatment If you have diabetes, nerve problem in the leg or foot, poor blood circulation to your foot, or an infection around the nail, see a provider right away. Don't try to treat an ingrown nail at home. Otherwise, to treat an ingrown nail at home: Soak the foot in warm water 3 to 4 times a day if possible. After soaking, keep the toe dry. Gently massage over the inflamed skin. Place a small piece of cotton or dental floss under the nail. Wet the cotton or floss with water or antiseptic. When trimming your toenails: Briefly soak your foot in warm water to soften the nails. Use a clean, sharp trimmer. Trim toenails straight across the top. Do not taper or round the corners or trim too short. Do not try to cut out the ingrown portion of the nail yourself. This will only make the problem worse. Consider wearing sandals until the problem goes away. Over-the-counter medicine that is applied to the ingrown toenail may help with the pain, but it does not treat the problem. If this doesn't work and the ingrown nail gets worse, see your family doctor, a foot specialist (podiatrist), or a skin specialist (dermatologist). If the ingrown nail doesn't heal or keeps coming back, your provider may remove part of the nail: Numbing medicine is first injected into the toe. The ingrown part of the nail is removed. This procedure is called a partial nail avulsion. It takes 2 to 4 months for the nail to regrow. If the toe is infected, your doctor may prescribe antibiotics. After the procedure, follow any instructions for helping your nail heal. Outlook (Prognosis) Treatment usually controls the infection and relieves pain. The condition is likely to return if you don't practice good foot care. This condition may become serious in people with diabetes, poor blood circulation, and nerve problems. Possible Complications In severe cases, the infection can spread through the toe and into the bone. When to Contact a Medical Professional Call your provider if you: Are not able to treat an ingrown toenail at home Have severe pain, redness, swelling, or fever Have diabetes, nerve damage in the leg or foot, poor circulation to your foot, or an infection around the nail Prevention Wear shoes that fit properly. Shoes that you wear every day should have plenty of room around your toes. Shoes that you wear for walking briskly or for playing sports should also have plenty of room, but not be too loose. When trimming your toenails: Briefly soak your foot in warm water to soften the nail. Use a clean, sharp nail trimmer. Trim toenails straight across the top. Do not taper or round the corners or trim too short. Do not pick or tear at the nails. Keep your feet clean and dry. People with diabetes should have routine foot exams and nail care. Review Date 4/12/2017 Updated by: Thomas N. Joseph, MD, Private Practice specializing in Orthopaedics, Subspecialty Foot and Ankle, Camden Bone and Joint, Camden, SC. 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": "If you have diabetes, nerve problem in the leg or foot, poor blood circulation to your foot, or an infection around the nail, see a provider right away. Don't try to treat an ingrown nail at home. Otherwise, to treat an ingrown nail at home: - Soak the foot in warm water 3 to 4 times a day if possible. After soaking, keep the toe dry. - Gently massage over the inflamed skin. - Place a small piece of cotton or dental floss under the nail. Wet the cotton or floss with water or antiseptic. When trimming your toenails: - Briefly soak your foot in warm water to soften the nails. - Use a clean, sharp trimmer. - Trim toenails straight across the top. Do not taper or round the corners or trim too short. - Do not try to cut out the ingrown portion of the nail yourself. This will only make the problem worse. Consider wearing sandals until the problem goes away. Over-the-counter medicine that is applied to the ingrown toenail may help with the pain, but it does not treat the problem. If this doesn't work and the ingrown nail gets worse, see your family doctor, a foot specialist (podiatrist), or a skin specialist (dermatologist). If the ingrown nail doesn't heal or keeps coming back, your provider may remove part of the nail: - Numbing medicine is first injected into the toe. - The ingrown part of the nail is removed. This procedure is called a partial nail avulsion. - It takes 2 to 4 months for the nail to regrow. If the toe is infected, your doctor may prescribe antibiotics. After the procedure, follow any instructions for helping your nail heal.", "role": "assistant" } ]
[ { "content": "Angelman syndrome. Can a person with Angelman Syndrome have children? If so, can the disorder be passed on to offspring?\n\n Angelman syndrome Overview Angelman syndrome is a genetic disorder. It causes developmental disabilities, neurological problems and sometimes, seizures. People with Angelman syndrome often smile and laugh frequently, and have happy, excitable personalities. Developmental delays, between about 6 and 12 months of age, are usually the first signs of Angelman syndrome. Seizures often begin between the ages of 2 and 3 years old. People with Angelman syndrome tend to live a normal life span, but the disease cannot be cured. Treatment focuses on managing medical and developmental issues. Symptoms Angelman syndrome signs and symptoms include: - Developmental delays, including no crawling or babbling at 6 to 12 months - Intellectual disability - No speech or minimal speech - Difficulty walking, moving or balancing well (ataxia) - Frequent smiling and laughter - Happy, excitable personality People who have Angelman syndrome may also have other signs and symptoms, including: - Seizures, usually beginning between 2 and 3 years of age - Stiff or jerky movements - Small head size, with flatness in the back of the head (microbrachycephaly) - Tongue thrusting - Hair, skin and eyes that are light in color (hypopigmentation) - Unusual behaviors, such as hand flapping and arms uplifted while walking Most babies with Angelman syndrome don't show signs or symptoms at birth. The first signs of Angelman syndrome are usually developmental delays, such as lack of crawling or babbling, between 6 and 12 months. If your child seems to have developmental delays or if your child has other signs or symptoms of Angelman syndrome, make an appointment with your child's doctor. Causes Angelman syndrome is a genetic disorder. It's usually caused by problems with a gene located on chromosome 15 called the ubiquitin protein ligase E3A (UBE3A) gene. You receive your pairs of genes from your parents - one copy from your mother (maternal copy) and the other from your father (paternal copy). Your cells typically use information from both copies, but in a small number of genes, only one copy is active. Normally, only the maternal copy of the UBE3A gene is active in the brain. Most cases of Angelman syndrome occur when part of the maternal copy is missing or damaged. In a few cases, Angelman syndrome is caused when two paternal copies of the gene are inherited, instead of one from each parent. Risk factors Angelman syndrome is rare. Researchers usually don't know what causes the genetic changes that result in Angelman syndrome. Most people with Angelman syndrome don't have a family history of the disease. Occasionally, Angelman syndrome may be inherited from a parent. A family history of the disease may increase a baby's risk of developing Angelman syndrome. Complications Complications associated with Angelman syndrome include: - Feeding difficulties. Difficulty coordinating sucking and swallowing may cause feeding problems in infants. Your pediatrician may recommend a high-calorie formula to help your baby gain weight. - Hyperactivity. Children with Angelman syndrome often move quickly from one activity to another, have a short attention span, and keep their hands or a toy in their mouths. Hyperactivity often decreases with age, and medication usually isn't necessary. - Sleep disorders. People with Angelman syndrome often have abnormal sleep-wake patterns and need less sleep than most people. Sleep difficulties may improve with age. Medication and behavior therapy may help control sleep disorders. - Curving of the spine (scoliosis). Some people with Angelman syndrome develop an abnormal side-to-side spinal curvature over time. - Obesity. Older children with Angelman syndrome tend to have large appetites, which may lead to obesity. Diagnosis Your child's doctor may suspect Angelman syndrome if your child has developmental delays and other signs and symptoms of the disorder, such as problems with movement and balance, small head size, flatness in the back of the head, and frequent laughter. Confirming a diagnosis of Angelman syndrome requires taking a blood sample from your child for genetic studies. A combination of genetic tests can reveal the chromosome defects related to Angelman syndrome. These tests may review: - Parental DNA pattern. This test, known as a DNA methylation test, screens for three of the four known genetic abnormalities that cause Angelman syndrome. - Missing chromosomes. Either a fluorescence in situ hybridization (FISH) test or a comparative genomic hybridization test (CGH) can show if portions of chromosomes are missing. - Gene mutation. Rarely, Angelman syndrome may occur when a person's maternal copy of the UBE3A gene is active, but mutated. If results from a DNA methylation test are normal, your child's doctor may order a UBE3A gene sequencing test to look for a maternal mutation. Treatment There's no cure for Angelman syndrome. Research is focusing on targeting specific genes for treatment. Current treatment focuses on managing the medical and developmental issues. A team of health care professionals will likely work with you to manage your child's condition. Depending on your child's signs and symptoms, treatment for Angelman syndrome may involve: - Anti-seizure medication to control seizures - Physical therapy to help with walking and movement problems - Communication therapy, which may include sign language and picture communication - Behavior therapy to help overcome hyperactivity and a short attention span and to aid in development ", "role": "user" }, { "content": "Researchers usually don't know what causes the genetic changes that result in Angelman syndrome. Most people with Angelman syndrome don't have a family history of the disease. Occasionally, Angelman syndrome may be inherited from a parent. A family history of the disease may increase a baby's risk of developing Angelman syndrome.", "role": "assistant" } ]
[ { "content": "would you help me to fine article or jurnal about Cri du chat syndrome\n\nCri du chat syndrome (Causes): Cri du chat syndrome is rare. It is caused by a missing piece of chromosome 5. Most cases are believed to occur during the development of the egg or sperm. A small number of cases occur when a parent passes a different, rearranged form of the chromosome to their child.", "role": "user" }, { "content": "Cri du chat syndrome (Causes): Cri du chat syndrome is rare. It is caused by a missing piece of chromosome 5. Most cases are believed to occur during the development of the egg or sperm.", "role": "assistant" } ]
[ { "content": "Iron Overdose Um...i took 25 iron pills...what do i do...this was last night\n\n Iron overdose Ferrous sulfate overdose Ferrous gluconate overdose Ferrous fumarate overdose Summary Iron is a mineral found in many over-the-counter supplements. Iron overdose occurs when someone takes more than the normal or recommended amount of this mineral. This can be by accident or on purpose. Iron overdose is especially dangerous for children. A severe overdose can happen if a child eats adult multivitamins, such as prenatal vitamins. If the child eats too many pediatric multivitamins, the effect is usually minor. This article is for information only. DO NOT use it to treat or manage an actual overdose. If you or someone you are with has an overdose, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. Poisonous Ingredient Iron can be harmful in large amounts. Where Found Iron is an ingredient in many mineral and vitamin supplements. Iron supplements are also sold by themselves. Types include: Ferrous sulfate (Feosol, Slow Fe) Ferrous gluconate (Fergon) Ferrous fumarate (Femiron, Feostat) Other products may also contain iron. Symptoms Below are symptoms of an iron overdose in different parts of the body. AIRWAYS AND LUNGS Buildup of fluids in the lungs STOMACH AND INTESTINES Black, and possibly bloody stools Diarrhea Liver damage Metallic taste in mouth Nausea Vomiting blood HEART AND BLOOD Dehydration Low blood pressure Fast and weak pulse Shock NERVOUS SYSTEM Chills Coma (decreased level of consciousness and lack of responsiveness, may occur within 1/2 hour to 1 hour after overdose) Convulsions Dizziness Drowsiness Fever Headache Lack of desire to do anything SKIN Bluish-colored lips and fingernails Flushing Loss of color from the skin (pallor) Note: Symptoms may go away in a few hours, then return again after 1 day or later. Before Calling Emergency Have this information ready: Person's age, weight, and condition Name of the product (ingredients and strength, if known) Time it was swallowed Amount swallowed If the medicine was prescribed for the person Poison Control Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions. This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week. What to Expect at the Emergency Room Take the container to the hospital with you, if possible. The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated. Tests that may done include: Blood and urine tests, including tests to check iron levels ECG (electrocardiogram, or heart tracing) X-ray to detect and track iron tablets through the stomach and intestines Treatment may include: Fluids through a vein (by IV) Medicine to help remove iron from the body and treat symptoms Endoscopy -- camera and tube placed down the throat to view the esophagus and the stomach and to remove pills or stop internal bleeding Whole bowel irrigation with a special solution to quickly flush the iron through the stomach and intestines (taken by mouth or through a tube through the nose into the stomach) Breathing support, including tube through the mouth into the lungs and connected to a breathing machine (ventilator) Outlook (Prognosis) There is a good chance of recovery if the person's symptoms are gone 48 hours after the iron overdose. But, severe liver damage can occur 2 to 5 days after the overdose. Some people have died up to a week after an iron overdose. The more quickly the person receives treatment, the better the chance for survival. Iron overdose can be very severe in children. Children may sometimes eat large amounts of iron pills because they look like candy. Many manufacturers have changed their pills so they no longer look like candy. Review Date 10/8/2017 Updated by: Jacob L. Heller, MD, MHA, Emergency Medicine, Emeritus, Virginia Mason Medical Center, 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": "For overdoses, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.", "role": "assistant" } ]
[ { "content": "typhoid fever Hi, My name is from X i have suffering from typhoid please give me solution i have one question i had got treatment from one year but i am not well now give me solution?\n\nTyphoid fever (Prevention): A vaccine is recommended for travel outside of the US to places where there is typhoid fever. The Centers for Disease Control and Prevention website has information about where typhoid fever is common -- www.cdc.gov/nczved/divisions/dfbmd/diseases/typhoid_fever. Ask your provider if you should bring electrolyte packets in case you get sick. When traveling, drink only boiled or bottled water and eat well-cooked food. Water treatment, waste disposal, and protecting the food supply from contamination are important public health measures. Carriers of typhoid must not be allowed to work as food handlers.", "role": "user" }, { "content": "To prevent Typhoid fever while traveling outside of the US, a vaccine is recommend. While traveling, drink only boiled or bottled water, and eat well-cooked food. Ask you r provider if you should bring electrolyte packets in case you get sick.", "role": "assistant" } ]
[ { "content": "how to prevent lung cancer\n\n Lung cancer Cancer - lung Summary Lung cancer is cancer that starts in the lungs. The lungs are located in the chest. When you breathe, air goes through your nose, down your windpipe (trachea), and into the lungs, where it flows through tubes called bronchi. Most lung cancer begins in the cells that line these tubes. There are two main types of lung cancer: Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. Small cell lung cancer (SCLC) makes up about 20% of all lung cancer cases. If the lung cancer is made up of both types, it is called mixed small cell/large cell cancer. If the cancer started somewhere else in the body and spreads to the lungs, it is called metastatic cancer to the lung. Causes Lung cancer is the deadliest type of cancer for both men and women. Each year, more people die of lung cancer than of breast, colon, and prostate cancers combined. Lung cancer is more common in older adults. It is rare in people under age 45. Cigarette smoking is the leading cause of lung cancer. The more cigarettes you smoke per day and the earlier you started smoking, the greater your risk for lung cancer. There is no evidence that smoking low-tar cigarettes lowers the risk. Lung cancer can also affect people who have never smoked. Secondhand smoke (breathing the smoke of others) increases your risk for lung cancer. The following may also increase your risk for lung cancer: Exposure to asbestos Exposure to cancer-causing chemicals such as uranium, beryllium, vinyl chloride, nickel chromates, coal products, mustard gas, chloromethyl ethers, gasoline, and diesel exhaust Exposure to radon gas Family history of lung cancer High levels of air pollution High levels of arsenic in drinking water Radiation therapy to the lungs Symptoms Early lung cancer may not cause any symptoms. Symptoms depend on the type of cancer you have, but may include: Chest pain Cough that does not go away Coughing up blood Fatigue Losing weight without trying Loss of appetite Shortness of breath Wheezing Other symptoms that may also occur with lung cancer, often in the late stages: Bone pain or tenderness Eyelid drooping Facial paralysis Hoarseness or changing voice Joint pain Nail problems Shoulder pain Swallowing difficulty Swelling of the face or arms Weakness These symptoms can also be due to other, less serious conditions, so it is important to talk to your health care provider. Exams and Tests Lung cancer is often found when an x-ray or CT scan is done for another reason. If lung cancer is suspected, the provider will perform a physical exam and ask about your medical history. You will be asked if you smoke. If so, you'll be asked how much you smoke and for how long you have smoked. You will also be asked about other things that may have put you at risk for lung cancer, such as exposure to certain chemicals. When listening to the chest with a stethoscope, the provider may hear fluid around the lungs. This may suggest cancer. Tests that may be done to diagnose lung cancer or see if it has spread include: Bone scan Chest x-ray Complete blood count (CBC) CT scan of the chest MRI of the chest Positron emission tomography (PET) scan Sputum test to look for cancer cells Thoracentesis (sampling of fluid buildup around the lung) In most cases, a piece of tissue is removed from your lungs for examination under a microscope. This is called a biopsy. There are several ways to do this: Bronchoscopy combined with biopsy CT-scan-directed needle biopsy Endoscopic esophageal ultrasound (EUS) with biopsy Mediastinoscopy with biopsy Open lung biopsy Pleural biopsy If the biopsy shows cancer, more imaging tests are done to find out the stage of the cancer. Stage means how big the tumor is and how far it has spread. Staging helps guide treatment and follow-up and gives you an idea of what to expect. Treatment Treatment for lung cancer depends on the type of cancer, how advanced it is, and how healthy you are: Surgery to remove the tumor may be done when it has not spread beyond nearby lymph nodes. Chemotherapy uses drugs to kill cancer cells and stop new cells from growing. Radiation therapy uses powerful x-rays or other forms of radiation to kill cancer cells. The above treatments may be done alone or in combination. Your provider can tell you more about the specific treatment you will receive, depending on the specific type of lung cancer and what stage it is. Support Groups You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone. Outlook (Prognosis) How well you do depends mostly on how much the lung cancer has spread. When to Contact a Medical Professional Call your provider if you have symptoms of lung cancer, particularly if you smoke. Prevention If you smoke, now is the time to quit. If you are having trouble quitting, talk with your provider. There are many methods to help you quit, from support groups to prescription medicines. Also, try to avoid secondhand smoke. Review Date 1/16/2018 Updated by: Richard LoCicero, MD, private practice specializing in Hematology and Medical Oncology, Longsteet 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": "The risk of lung cancer is increased by smoking, secondhand smoke, exposure to asbestos, carcinogenic chemicals, air pollution, family history of lung cancer, or radiation therapy.", "role": "assistant" } ]
[ { "content": "Subcutaneous retrocalcaneal bursitis Haglund's deformity of the calcaneum. I have this problem. Can you please help to overcome this?\n\nBursitis of the heel: Bursitis of the heel is swelling of the fluid-filled sac (bursa) at the back of the heel bone. 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 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 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. 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. This condition most often gets better in several weeks with the proper treatment. Call your provider if you have heel pain or symptoms of retrocalcaneal bursitis that DO NOT improve with rest. 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. 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": "Bipolar and Generalized Anxiety Disorder I read about TMS Therapy. Do you know anything about it? Has it had success? Also wondering about ECT? Finally, I've been told acupuncture can help for mood disorders. Is that true for mixed bipolar and generalized anxiety disorder along with meds? Have you ever heard of this?\n\nGeneralized anxiety disorder (Treatment): Treatment decisions are based on how significantly generalized anxiety disorder is affecting your ability to function in your daily life. The two main treatments for generalized anxiety disorder are psychotherapy and medications. You may benefit most from a combination of the two. It may take some trial and error to discover which treatments work best for you. Psychotherapy Also known as talk therapy or psychological counseling, psychotherapy involves working with a therapist to reduce your anxiety symptoms. Cognitive behavioral therapy is the most effective form of psychotherapy for generalized anxiety disorder. Generally a short-term treatment, cognitive behavioral therapy focuses on teaching you specific skills to directly manage your worries and help you gradually return to the activities you've avoided because of anxiety. Through this process, your symptoms improve as you build on your initial success. Medications Several types of medications are used to treat generalized anxiety disorder, including those below. Talk with your doctor about benefits, risks and possible side effects. - Antidepressants. Antidepressants, including medications in the selective serotonin reuptake inhibitor (SSRI) and serotonin and norepinephrine reuptake inhibitor (SNRI) classes, are the first line medication treatments. Examples of antidepressants used to treat generalized anxiety disorder include escitalopram (Lexapro), duloxetine (Cymbalta), venlafaxine (Effexor XR) and paroxetine (Paxil, Pexeva). Your doctor also may recommend other antidepressants. - Buspirone. An anti-anxiety medication called buspirone may be used on an ongoing basis. As with most antidepressants, it typically takes up to several weeks to become fully effective. - Benzodiazepines. In limited circumstances, your doctor may prescribe a benzodiazepine for relief of anxiety symptoms. These sedatives are generally used only for relieving acute anxiety on a short-term basis. Because they can be habit-forming, these medications aren't a good choice if you have or had problems with alcohol or drug abuse.", "role": "user" }, { "content": "The two main treatments for generalized anxiety disorder are psychotherapy and medications. You may benefit most from a combination of the two. ... Cognitive behavioral therapy is the most effective form of psychotherapy for generalized anxiety disorder. Generally a short-term treatment, cognitive behavioral therapy focuses on teaching you specific skills to directly manage your worries and help you gradually return to the activities you've avoided because of anxiety. ... Several types of medications are used to treat generalized anxiety disorder ... Antidepressants, including medications in the selective serotonin reuptake inhibitor (SSRI) and serotonin and norepinephrine reuptake inhibitor (SNRI) classes, are the first line medication treatments.", "role": "assistant" } ]
[ { "content": "congenital diaphragmatic hernia I need to know if CDH can be passed down to future generations. I just learned that this condition most likely caused the death of my first child back in 1971. I was then told it was merely a fluke. I had NO trauma during the full-term pregnancy, and I and my then husband were in very good health. Now my son (from a different husband) and his wife are due to have fraternal twins in 2015. Does the term 'congenital' mean that it could be passed down to another generation? I do not want to alarm my son and his wife. I just would like to inform whatever pediatrician is caring for these babies as to my experience. Unfortunately my son and I are estranged. And I do not know who is their pediatrician. My child's CDH was very severe. I know there are far less severe cases that can go undetected &/or undiagnosed unless there is a reason to suspect such a condition. Please respond to my concerns.\n\n Congenital diaphragmatic hernia congenital diaphragmatic defect Description Congenital diaphragmatic hernia is a defect in the diaphragm. The diaphragm, which is composed of muscle and other fibrous tissue, separates the organs in the abdomen from those in the chest. Abnormal development of the diaphragm before birth leads to defects ranging from a thinned area in the diaphragm to its complete absence. An absent or partially formed diaphragm results in an abnormal opening (hernia) that allows the stomach and intestines to move into the chest cavity and crowd the heart and lungs. This crowding can lead to underdevelopment of the lungs (pulmonary hypoplasia), potentially resulting in life-threatening breathing difficulties that are apparent from birth. In 5 to 10 percent of affected individuals, signs and symptoms of congenital diaphragmatic hernia appear later in life and may include breathing problems or abdominal pain from protrusion of the intestine into the chest cavity. In about 1 percent of cases, congenital diaphragmatic hernia has no symptoms; it may be detected incidentally when medical imaging is done for other reasons. Congenital diaphragmatic hernias are often classified by their position. A Bochdalek hernia is a defect in the side or back of the diaphragm. Between 80 and 90 percent of congenital diaphragmatic hernias are of this type. A Morgnani hernia is a defect involving the front part of the diaphragm. This type of congenital diaphragmatic hernia, which accounts for approximately 2 percent of cases, is less likely to cause severe symptoms at birth. Other types of congenital diaphragmatic hernia, such as those affecting the central region of the diaphragm, or those in which the diaphragm muscle is absent with only a thin membrane in its place, are rare. Frequency Congenital diaphragmatic hernia affects approximately 1 in 2,500 newborns. Causes Congenital diaphragmatic hernia has many different causes. In 10 to 15 percent of affected individuals, the condition appears as a feature of a disorder that affects many body systems, called a syndrome. Donnai-Barrow syndrome, Fryns syndrome, and Pallister-Killian mosaic syndrome are among several syndromes in which congenital diaphragmatic hernia may occur. Some of these syndromes are caused by changes in single genes, and others are caused by chromosomal abnormalities that affect several genes. About 25 percent of individuals with congenital diaphragmatic hernia that is not associated with a known syndrome also have abnormalities of one or more major body systems. Affected body systems can include the heart, brain, skeleton, intestines, genitals, kidneys, or eyes. In these individuals, the multiple abnormalities likely result from a common underlying disruption in development that affects more than one area of the body, but the specific mechanism responsible for this disruption is not clear. Approximately 50 to 60 percent of congenital diaphragmatic hernia cases are isolated, which means that affected individuals have no other major malformations. More than 80 percent of individuals with congenital diaphragmatic hernia have no known genetic syndrome or chromosomal abnormality. In these cases, the cause of the condition is unknown. Researchers are studying changes in several genes involved in the development of the diaphragm as possible causes of congenital diaphragmatic hernia. Some of these genes are transcription factors, which provide instructions for making proteins that help control the activity of particular genes (gene expression). Others provide instructions for making proteins involved in cell structure or the movement (migration) of cells in the embryo. Environmental factors that influence development before birth may also increase the risk of congenital diaphragmatic hernia, but these environmental factors have not been identified. Inheritance Pattern Isolated congenital diaphragmatic hernia is rarely inherited. In almost all cases, there is only one affected individual in a family. When congenital diaphragmatic hernia occurs as a feature of a genetic syndrome or chromosomal abnormality, it may cluster in families according to the inheritance pattern for that condition. Sources for This Page Bielinska M, Jay PY, Erlich JM, Mannisto S, Urban Z, Heikinheimo M, Wilson DB. Molecular genetics of congenital diaphragmatic defects. Ann Med. 2007;39(4):261-74. Review. ", "role": "user" }, { "content": "More than 80 percent of congenital diaphragmatic hernia are not associated with a genetic syndrome or chromosomal abnormality. In these cases the causes of the hernia are not known, although environmental factors may play a role. In other individuals the condition is caused by changes in single genes or chromosomal abnormalities that affect several genes.", "role": "assistant" } ]
[ { "content": "help with obesity I would like help on my obesity problem and if I can get help\n\n Obesity Morbid obesity Fat - obese Summary Obesity means having too much body fat. It is not the same as being overweight, which means weighing too much. A person may be overweight from extra muscle or water, as well as from having too much fat. Both terms mean that a person's weight is higher than what is thought to be healthy for his or her height. Causes 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 (lb) or 2 to 5 kilograms (kg) in the first 6 months after quitting. Stress, anxiety, feeling sad, or not sleeping well. Menopause -- Women may gain 12 to 15 lb (5.5 to 7 kg) during menopause. Pregnancy -- Women may not lose the weight they gained during pregnancy. Exams and Tests The health care provider will perform a physical exam and ask about your medical history, eating habits, and exercise routine. The two most common ways to assess your weight and measure health risks related to your weight are: Body mass index (BMI) Waist circumference (your waist measurement in inches or centimeters) BMI is calculated using height and weight. You and your provider can use your BMI to estimate how much body fat you have. Your waist measurement is another way to estimate how much body fat you have. Extra weight around your middle or stomach area increases your risk for type 2 diabetes, heart disease, and stroke. People with \"apple-shaped\" bodies (meaning they tend to store fat around their waist and have a slim lower body) also have an increased risk for these diseases. Skin fold measurements may be taken to check your body fat percentage. Blood tests may be done to look for thyroid or hormone problems that could lead to weight gain. Treatment CHANGING YOUR LIFESTYLE An active lifestyle and plenty of exercise, along with healthy eating, is the safest way to lose weight. Even modest weight loss can improve your health. You may need a lot of support from family and friends. Your main goal should be to learn new, healthy ways of eating and make them part of your daily routine. Many people find it hard to change their eating habits and behaviors. You may have practiced some habits for so long that you may not even know they are unhealthy, or you do them without thinking. You need to be motivated to make lifestyle changes. Make the behavior change part of your life over the long term. Know that it takes time to make and keep a change in your lifestyle. Work with your provider and dietitian to set realistic, safe daily calorie counts that help you lose weight while staying healthy. Remember that if you drop weight slowly and steadily, you are more likely to keep it off. Your dietitian can teach you about: Healthy food choices at home and in restaurants Healthy snacks Reading nutrition labels and healthy grocery shopping New ways to prepare food Portion sizes Sweetened drinks Extreme diets (fewer than 1,100 calories per day) are not thought to be safe or to work very well. These types of diets often do not contain enough vitamins and minerals. Most people who lose weight this way return to overeating and become obese again. Learn ways to manage stress other than snacking. Examples may be meditation, yoga, or exercise. If you are depressed or stressed a lot, talk to your provider. MEDICINES AND HERBAL REMEDIES You may see ads for supplements and herbal remedies that claim they will help you lose weight. Some of these claims may not be true. And some of these supplements can have serious side effects. Talk to your provider before using them. You can discuss weight loss medicines with your provider. Many people lose at least 5 lb (2 kg) by taking these drugs, but they may regain the weight when they stop taking the medicine unless they have made lifestyle changes. SURGERY Bariatric (weight-loss) surgery can reduce the risk of certain diseases in people with severe obesity. These risks include: Arthritis Diabetes Heart disease High blood pressure Sleep apnea Some cancers Stroke Surgery may help people who have been very obese for 5 years or more and have not lost weight from other treatments, such as diet, exercise, or medicine. Surgery alone is not the answer for weight loss. It can train you to eat less, but you still have to do much of the work. You must be committed to diet and exercise after surgery. Talk to your provider to learn if surgery is a good option for you. Weight-loss surgeries include: Laparoscopic gastric banding Gastric bypass surgery Sleeve gastrectomy Duodenal switch Support Groups Many people find it easier to follow a diet and exercise program if they join a group of people with similar problems. Possible Complications Obesity is a major health threat. The extra weight creates many risks to your health. Review Date 2/12/2018 Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "The safest way to lose weight is to change your behavior for a long term and lead an active lifestyle, exercise and eat healthy. Work with your doctor and dietitian to lose weight while staying healthy. Make healthy food choices, read nutritional labels, and change the way you prepare food and snack. Reduce portion sizes and avoid sweetened drinks and extreme diets. Discuss supplements and herbal remedies with your doctor. If diet, exercise, or medicine do not help, discuss with your doctor if one of the following surgeries is a good option for you: laparoscopic gastric banding, gastric bypass surgery, sleeve gastrectomy, or duodenal switch.", "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 and Eclampsia (How many women are affected by or at risk of preeclampsia?): The exact number of women who develop preeclampsia is not known. Some estimates suggest that preeclampsia affects 2% to 8% of all pregnancies globally and about 3.4% in the United States.1,2The condition is estimated to account for 10% to 15% of maternal deaths worldwide.1 Disorders related to high blood pressure are the second leading cause of stillbirths and early neonatal deaths in developing nations.3In addition, HELLP syndrome occurs in about 10% to 20% of all women with severe preeclampsia or eclampsia.4Although preeclampsia occurs primarily in first pregnancies, a woman who had preeclampsia in a previous pregnancy is seven times more likely to develop preeclampsia in a later pregnancy.5Other factors that can increase a woman's risk include:5- Chronic high blood pressure or kidney disease before pregnancy - High blood pressure or preeclampsia in an earlier pregnancy - Obesity. Overweight or obese women are also more likely to have preeclampsia in more than one pregnancy.6 - Age. Women older than 40 are at higher risk. - Multiple gestation (being pregnant with more than one fetus) - African American ethnicity. Also, among women who have had preeclampsia before, non-white women are more likely than white women to develop preeclampsia again in a later pregnancy.6 - Family history of preeclampsia. According to the World Health Organization, among women who have had preeclampsia, about 20% to 40% of their daughters and 11% to 37% of their sisters also will get the disorder.7Preeclampsia is also more common among women who have histories of certain health conditions, such as migraines,8 diabetes,9 rheumatoid arthritis,10 lupus,11 scleroderma,12 urinary tract infections,13 gum disease,14 polycystic ovary syndrome,15 multiple sclerosis, gestational diabetes, and sickle cell disease.16Preeclampsia is also more common in pregnancies resulting from egg donation, donor insemination, or in vitro fertilization.The U.S. Preventative Services Task Force recommends that women who are at high risk for preeclampsia take low-dose aspirin starting after 12 weeks of pregnancy to prevent preeclampsia.17 Women who are pregnant or who are thinking about getting pregnant should talk with their health care provider about preeclampsia risk and ways to reduce the risk.", "role": "user" }, { "content": "Although preeclampsia occurs primarily in first pregnancies, a woman who had preeclampsia in a previous pregnancy is seven times more likely to develop preeclampsia in a later pregnancy. Other factors that can increase a woman's risk include chronic high blood pressure or kidney disease before pregnancy, obesity, age over 40, being pregnant with more than one fetus, African American ethnicity, family history of preeclampsia.The U.S. Preventative Services Task Force recommends that women who are at high risk for preeclampsia take low-dose aspirin starting after 12 weeks of pregnancy to prevent preeclampsia. Women who are pregnant or who are thinking about getting pregnant should talk with their health care provider about preeclampsia risk and ways to reduce the risk.", "role": "assistant" } ]