message stringlengths 1 35.3k | message_type stringclasses 3 values | message_id int64 0 2 | conversation_id int64 33 898k | cluster float64 63 63 | __index_level_0__ int64 99 2.69M |
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asthma Question. What is the consensus of medical doctors as to whether asthma can be cured? And do you have an article discussing whether asthma can be cured? | instruction | 0 | 33 | 63 | 99 |
Asthma symptoms can be managed but not cured. | output | 1 | 33 | 63 | 100 |
Asthma (Overview): Asthma is a condition in which your airways narrow and swell and produce extra mucus. This can make breathing difficult and trigger coughing, wheezing and shortness of breath. For some people, asthma is a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack. Asthma can't be cured, but its symptoms can be controlled. Because asthma often changes over time, it's important that you work with your doctor to track your signs and symptoms and adjust treatment as needed. | input | 2 | 33 | 63 | 101 |
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. | instruction | 0 | 153 | 63 | 459 |
There is currently no cure for Kartagener syndrome. Antibiotics may be prescribed to treat respiratory, sinus, and middle ear infections and may be given on a long-term basis in people with chronic or frequent infections. For lung disease, airway clearance therapy, similar to that used in cystic fibrosis, can loosen thick, sticky mucus so it can be cleared away. In people with severe lung disease, lung transplantation may be an option. | output | 1 | 153 | 63 | 460 |
Kartagener syndrome (Treatment): There is currently no cure for Kartagener syndrome . Treatment varies based on the signs and symptoms present in each person. Airway clearance therapy, similar to that used in cystic fibrosis, can loosen thick, sticky mucus so it can be cleared away. Antibiotics may be prescribed to treat respiratory, sinus, and middle ear infections and may be given on a long-term basis in people with chronic or frequent infections. Surgery to insert ear tubes may be recommended in children with chronic ear infections that are resistant to antibiotics. In people with severe lung disease, lung transplantation may be an option. [1] [2] [3] For more information on the treatment and management of Kartagener syndrome, please click here. 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. | input | 2 | 153 | 63 | 461 |
milroy disease hello , my daughter has lymph edema her both legs and left hand is swelling , this problem started when she was of 3 months now she is 16 months , her swelling is growing day by day , im clue less what to do and what kind of treatment i should do plz help and suggest us | instruction | 0 | 178 | 63 | 534 |
There is currently no cure for Milroy disease. Conservative management is usually successful in most people. Management of lymphedema should be guided by a lymphedema therapist. Some improvement is possible with the use of properly fitted compression hosiery or bandaging and well fitting, supportive shoes. Good skin care is essential. Decongestive physiotherapy, which combines compression bandaging, manual lymphatic drainage (a specialized massage technique), exercise, breathing exercises, dietary measures and skin care, is the standard of care for primary lymphedema. People with recurrent cellulitis may benefit from prophylactic antibiotics Surgical intervention is considered a last option when other medical management fails. When possible, people with Milroy disease should avoid wounds to swollen areas (because of their reduced resistance to infection,) long periods of immobility, prolonged standing, elevation of the affected limb, and calcium channel-blocking drugs that can cause increased leg swelling in some people. | output | 1 | 178 | 63 | 535 |
Milroy disease (Treatment): There is currently no cure for Milroy disease. Management is typically conservative and usually successful in most people. [3] Management of lymphedema should be guided by a lymphedema therapist. Some improvement is usually possible with the use of properly fitted compression hosiery or bandaging and well fitting, supportive shoes. Good skin care is essential. These measures may improve the cosmetic appearance of the affected areas, decrease their size, and reduce the risk of complications. [2] Decongestive physiotherapy , which combines compression bandaging, manual lymphatic drainage (a specialized massage technique), exercise, breathing exercises, dietary measures and skin care, has become the standard of care for primary lymphedema. [3] People with recurrent cellulitis may benefit from prophylactic antibiotics . [2] [3] Surgical intervention is considered a last option when other medical management fails. [3] When possible, people with Milroy disease should avoid: wounds to swollen areas (because of their reduced resistance to infection) long periods of immobility prolonged standing elevation of the affected limb certain medications (particularly calcium channel-blocking drugs that can cause increased leg swelling in some people)[2] 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. | input | 2 | 178 | 63 | 536 |
milroy disease hello , my daughter has lymph edema her both legs and left hand is swelling , this problem started when she was of 3 months now she is 16 months , her swelling is growing day by day , im clue less what to do and what kind of treatment i should do plz help and suggest us | instruction | 0 | 179 | 63 | 537 |
The symptoms and severity of Milroy disease can vary among affected people, however, it rarely causes significant complications. . Swelling can be disabling and disfiguring, it sometimes progresses, but in some cases can improve (particularly in early years). Complications of lymphedema include recurrent bouts of cellulitis and/or lymphangitis, bacterial and fungal infections, deep venous thrombosis, functional impairment, cosmetic embarrassment, and amputation. Complications following surgery are common. | output | 1 | 179 | 63 | 538 |
Milroy disease (Prognosis): The symptoms and severity of Milroy disease can vary among affected people (even within the same family), so the long-term effects of the condition may be difficult to predict. [2] Swelling varies in degree and distribution, and can be disabling and disfiguring. [3] For some people the outlook depends on how chronic the lymphedema is, as well as whether complications arise. [4] However, Milroy disease is rarely associated with significant complications. [3] The degree of edema sometimes progresses, but in some cases can improve (particularly in early years). [2] Complications of lymphedema may include recurrent bouts of cellulitis and/or lymphangitis, bacterial and fungal infections, deep venous thrombosis, functional impairment, cosmetic embarrassment, and amputation. Complications following surgery are common. [4] It has also been reported that people with chronic lymphedema for many years may have a significantly higher risk to develop lymphangiosarcoma (a type of angiosarcoma). This type of tumor is highly aggressive and has a very poor prognosis . [4] | input | 2 | 179 | 63 | 539 |
Are there any researches indicating how early an individual may experience any signs or symptoms of Rheumatoid Arthritis? | instruction | 0 | 196 | 63 | 588 |
Anyone can get arthritis, but it occurs more often in women and is most common in older people. Genes, environmental factors, and hormones may play roles in the development of rheumatoid arthritis. | output | 1 | 196 | 63 | 589 |
Rheumatoid Arthritis (What is it? Points To Remember About 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 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 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 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. | input | 2 | 196 | 63 | 590 |
Are there any researches indicating how early an individual may experience any signs or symptoms of Rheumatoid Arthritis? | instruction | 0 | 197 | 63 | 591 |
Rheumatoid arthritis can occur at any age, but it most commonly begins between the ages of 40 and 60. Factors that may increase your risk of rheumatoid arthritis include sex, family history, smoking, environmental exposures, and obesity. Women are more likely than men to develop rheumatoid arthritis. If a member of your family has rheumatoid arthritis, you may have an increased risk of the disease. Cigarette smoking also increases your risk of developing rheumatoid arthritis, particularly if you have a genetic predisposition for developing the disease. Smoking also appears to be associated with greater disease severity. Although uncertain and poorly understood, some environmental exposures such as asbestos or silica may increase the risk for developing rheumatoid arthritis. People who are overweight or obese appear to be at somewhat higher risk of developing rheumatoid arthritis, especially in women diagnosed with the disease when they were 55 or younger. | output | 1 | 197 | 63 | 592 |
Rheumatoid arthritis: Rheumatoid arthritis is a chronic inflammatory disorder that can affect more than just your joints. In some people, the condition also can damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels. An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body's tissues. Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity. The inflammation associated with rheumatoid arthritis is what can damage other parts of the body as well. While new types of medications have improved treatment options dramatically, severe rheumatoid arthritis can still cause physical disabilities. Signs and symptoms of rheumatoid arthritis may include: - Tender, warm, swollen joints - Joint stiffness that is usually worse in the mornings and after inactivity - Fatigue, fever and weight loss Early rheumatoid arthritis tends to affect your smaller joints first - particularly the joints that attach your fingers to your hands and your toes to your feet. As the disease progresses, symptoms often spread to the wrists, knees, ankles, elbows, hips and shoulders. In most cases, symptoms occur in the same joints on both sides of your body. About 40 percent of the people who have rheumatoid arthritis also experience signs and symptoms that don't involve the joints. Rheumatoid arthritis can affect many nonjoint structures, including: - Skin - Eyes - Lungs - Heart - Kidneys - Salivary glands - Nerve tissue - Bone marrow - Blood vessels Rheumatoid arthritis signs and symptoms may vary in severity and may even come and go. Periods of increased disease activity, called flares, alternate with periods of relative remission - when the swelling and pain fade or disappear. Over time, rheumatoid arthritis can cause joints to deform and shift out of place. Make an appointment with your doctor if you have persistent discomfort and swelling in your joints. Rheumatoid arthritis occurs when your immune system attacks the synovium - the lining of the membranes that surround your joints. The resulting inflammation thickens the synovium, which can eventually destroy the cartilage and bone within the joint. The tendons and ligaments that hold the joint together weaken and stretch. Gradually, the joint loses its shape and alignment. Doctors don't know what starts this process, although a genetic component appears likely. While your genes don't actually cause rheumatoid arthritis, they can make you more susceptible to environmental factors - such as infection with certain viruses and bacteria - that may trigger the disease. Factors that may increase your risk of rheumatoid arthritis include: - Your sex. Women are more likely than men to develop rheumatoid arthritis. - Age. Rheumatoid arthritis can occur at any age, but it most commonly begins between the ages of 40 and 60. - Family history. If a member of your family has rheumatoid arthritis, you may have an increased risk of the disease. - Smoking. Cigarette smoking increases your risk of developing rheumatoid arthritis, particularly if you have a genetic predisposition for developing the disease. Smoking also appears to be associated with greater disease severity. - Environmental exposures. Although uncertain and poorly understood, some exposures such as asbestos or silica may increase the risk for developing rheumatoid arthritis. Emergency workers exposed to dust from the collapse of the World Trade Center are at higher risk of autoimmune diseases such as rheumatoid arthritis. - Obesity. People who are overweight or obese appear to be at somewhat higher risk of developing rheumatoid arthritis, especially in women diagnosed with the disease when they were 55 or younger. 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. There is no cure for rheumatoid arthritis. But recent discoveries indicate that remission of symptoms is more likely when treatment begins early with strong medications known as disease-modifying antirheumatic drugs (DMARDs). Medications The types of medications recommended by your doctor will depend on the severity of your symptoms and how long you've had rheumatoid arthritis. - NSAIDs. Nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain and reduce inflammation. Over-the-counter NSAIDs include ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve). Stronger NSAIDs are available by prescription. Side effects may include ringing in your ears, stomach irritation, heart problems, and liver and kidney damage. - Steroids. Corticosteroid medications, such as prednisone, reduce inflammation and pain and slow joint damage. Side effects may include thinning of bones, weight gain and diabetes. Doctors often prescribe a corticosteroid to relieve acute symptoms, with the goal of gradually tapering off the medication. - Disease-modifying antirheumatic drugs (DMARDs). These drugs can slow the progression of rheumatoid arthritis and save the joints and other tissues from permanent damage. Common DMARDs include methotrexate (Trexall, Otrexup, Rasuvo), leflunomide (Arava), hydroxychloroquine (Plaquenil) and sulfasalazine (Azulfidine). Side effects vary but may include liver damage, bone marrow suppression and severe lung infections. - Biologic agents. Also known as biologic response modifiers, this newer class of DMARDs includes abatacept (Orencia), adalimumab (Humira), anakinra (Kineret), certolizumab (Cimzia), etanercept (Enbrel), golimumab (Simponi), infliximab (Remicade), rituximab (Rituxan), tocilizumab (Actemra) and tofacitinib (Xeljanz). These drugs can target parts of the immune system that trigger inflammation that causes joint and tissue damage. These types of drugs also increase the risk of infections. Biologic DMARDs are usually most effective when paired with a nonbiologic DMARD, such as methotrexate. Therapy Your doctor may send you to a physical or occupational therapist who can teach you exercises to help keep your joints flexible. The therapist may also suggest new ways to do daily tasks, which will be easier on your joints. For example, if your fingers are sore, you may want to pick up an object using your forearms. Assistive devices can make it easier to avoid stressing your painful joints. For instance, a kitchen knife equipped with a saw handle helps protect your finger and wrist joints. Certain tools, such as buttonhooks, can make it easier to get dressed. Catalogs and medical supply stores are good places to look for ideas. Surgery If medications fail to prevent or slow joint damage, you and your doctor may consider surgery to repair damaged joints. Surgery may help restore your ability to use your joint. It can also reduce pain and correct deformities. Rheumatoid arthritis surgery may involve one or more of the following procedures: - Synovectomy. Surgery to remove the inflamed synovium (lining of the joint). Synovectomy can be performed on knees, elbows, wrists, fingers and hips. - Tendon repair. Inflammation and joint damage may cause tendons around your joint to loosen or rupture. Your surgeon may be able to repair the tendons around your joint. - Joint fusion. Surgically fusing a joint may be recommended to stabilize or realign a joint and for pain relief when a joint replacement isn't an option. - Total joint replacement. During joint replacement surgery, your surgeon removes the damaged parts of your joint and inserts a prosthesis made of metal and plastic. Surgery carries a risk of bleeding, infection and pain. Discuss the benefits and risks with your doctor. You can take steps to care for your body if you have rheumatoid arthritis. These self-care measures, when used along with your rheumatoid arthritis medications, can help you manage your signs and symptoms: - Exercise regularly. Gentle exercise can help strengthen the muscles around your joints, and it can help fight fatigue you might feel. Check with your doctor before you start exercising. If you're just getting started, begin by taking a walk. Try swimming or gentle water aerobics. Avoid exercising tender, injured or severely inflamed joints. - Apply heat or cold. Heat can help ease your pain and relax tense, painful muscles. Cold may dull the sensation of pain. Cold also has a numbing effect and decreases muscle spasms. - Relax. Find ways to cope with pain by reducing stress in your life. Techniques such as guided imagery, distraction and muscle relaxation can all be used to control pain. Some common complementary and alternative treatments that have shown promise for rheumatoid arthritis include: - Fish oil. Some preliminary studies have found that fish oil supplements may reduce rheumatoid arthritis pain and stiffness. Side effects can include nausea, belching and a fishy taste in the mouth. Fish oil can interfere with medications, so check with your doctor first. - Plant oils. The seeds of evening primrose, borage and black currant contain a type of fatty acid that may help with rheumatoid arthritis pain and morning stiffness. Side effects may include nausea, diarrhea and gas. Some plant oils can cause liver damage or interfere with medications, so check with your doctor first. - Tai chi. This movement therapy involves gentle exercises and stretches combined with deep breathing. Many people use tai chi to relieve stress in their lives. Small studies have found that tai chi may reduce rheumatoid arthritis pain. When led by a knowledgeable instructor, tai chi is safe. But don't do any moves that cause pain. | input | 2 | 197 | 63 | 593 |
Are there any researches indicating how early an individual may experience any signs or symptoms of Rheumatoid Arthritis? | instruction | 0 | 198 | 63 | 594 |
Early rheumatoid arthritis tends to affect the smaller joints and hands and feet first. | output | 1 | 198 | 63 | 595 |
Rheumatoid arthritis (Symptoms): Signs and symptoms of rheumatoid arthritis may include: - Tender, warm, swollen joints - Joint stiffness that is usually worse in the mornings and after inactivity - Fatigue, fever and weight loss Early rheumatoid arthritis tends to affect your smaller joints first - particularly the joints that attach your fingers to your hands and your toes to your feet. As the disease progresses, symptoms often spread to the wrists, knees, ankles, elbows, hips and shoulders. In most cases, symptoms occur in the same joints on both sides of your body. About 40 percent of the people who have rheumatoid arthritis also experience signs and symptoms that don't involve the joints. Rheumatoid arthritis can affect many nonjoint structures, including: - Skin - Eyes - Lungs - Heart - Kidneys - Salivary glands - Nerve tissue - Bone marrow - Blood vessels Rheumatoid arthritis signs and symptoms may vary in severity and may even come and go. Periods of increased disease activity, called flares, alternate with periods of relative remission - when the swelling and pain fade or disappear. Over time, rheumatoid arthritis can cause joints to deform and shift out of place. Make an appointment with your doctor if you have persistent discomfort and swelling in your joints. | input | 2 | 198 | 63 | 596 |
Are there any researches indicating how early an individual may experience any signs or symptoms of Rheumatoid Arthritis? | instruction | 0 | 199 | 63 | 597 |
Rheumatoid arthritis can be difficult to diagnose in its early stages because the early signs and symptoms mimic those of many other diseases. | output | 1 | 199 | 63 | 598 |
Rheumatoid 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. | input | 2 | 199 | 63 | 599 |
Are there any researches indicating how early an individual may experience any signs or symptoms of Rheumatoid Arthritis? | instruction | 0 | 200 | 63 | 600 |
The signs and symptoms of rheumatoid arthritis usually appear in mid- to late adulthood. Many people have episodes of symptoms followed by periods with no symptoms for the rest of their lives. Some people have continuous health problems related to the disease. | output | 1 | 200 | 63 | 601 |
rheumatoid arthritis: Rheumatoid arthritis is a disease that causes chronic abnormal inflammation, primarily affecting the joints. The most common signs and symptoms are pain, swelling, and stiffness of the joints. Small joints in the hands and feet are involved most often, although larger joints (such as the shoulders, hips, and knees) may become involved later in the disease. Joints are typically affected in a symmetrical pattern; for example, if joints in the hand are affected, both hands tend to be involved. People with rheumatoid arthritis often report that their joint pain and stiffness is worse when getting out of bed in the morning or after a long rest. Rheumatoid arthritis can also cause inflammation of other tissues and organs, including the eyes, lungs, and blood vessels. Additional signs and symptoms of the condition can include a loss of energy, a low fever, weight loss, and a shortage of red blood cells (anemia). Some affected individuals develop rheumatoid nodules, which are firm lumps of noncancerous tissue that can grow under the skin and elsewhere in the body. The signs and symptoms of rheumatoid arthritis usually appear in mid- to late adulthood. Many affected people have episodes of symptoms (flares) followed by periods with no symptoms (remissions) for the rest of their lives. In severe cases, affected individuals have continuous health problems related to the disease for many years. The abnormal inflammation can lead to severe joint damage, which limits movement and can cause significant disability. Rheumatoid arthritis affects about 1.3 million adults in the United States. Worldwide, it is estimated to occur in up to 1 percent of the population. The disease is two to three times more common in women than in men, which may be related to hormonal factors. Rheumatoid arthritis probably results from a combination of genetic and environmental factors, many of which are unknown. Rheumatoid arthritis is classified as an autoimmune disorder, one of a large group of conditions that occur when the immune system attacks the body's own tissues and organs. In people with rheumatoid arthritis, the immune system triggers abnormal inflammation in the membrane that lines the joints (the synovium). When the synovium is inflamed, it causes pain, swelling, and stiffness of the joint. In severe cases, the inflammation also affects the bone, cartilage, and other tissues within the joint, causing more serious damage. Abnormal immune reactions also underlie the features of rheumatoid arthritis affecting other parts of the body. Variations in dozens of genes have been studied as risk factors for rheumatoid arthritis. Most of these genes are known or suspected to be involved in immune system function. The most significant genetic risk factors for rheumatoid arthritis are variations in human leukocyte antigen (HLA) genes, especially the HLA-DRB1 gene. The proteins produced from HLA genes help the immune system distinguish the body's own proteins from proteins made by foreign invaders (such as viruses and bacteria). Changes in other genes appear to have a smaller impact on a person's overall risk of developing the condition. Other, nongenetic factors are also believed to play a role in rheumatoid arthritis. These factors may trigger the condition in people who are at risk, although the mechanism is unclear. Potential triggers include changes in sex hormones (particularly in women), occupational exposure to certain kinds of dust or fibers, and viral or bacterial infections. Long-term smoking is a well-established risk factor for developing rheumatoid arthritis; it is also associated with more severe signs and symptoms in people who have the disease. The inheritance pattern of rheumatoid arthritis is unclear because many genetic and environmental factors appear to be involved. However, having a close relative with rheumatoid arthritis likely increases a person's risk of developing the condition. Carmona L, Cross M, Williams B, Lassere M, March L. Rheumatoid arthritis. Best Pract Res Clin Rheumatol. 2010 Dec;24(6):733-45. doi: 10.1016/j.berh.2010.10.001. Review. | input | 2 | 200 | 63 | 602 |
Psoriasis for past 7-8 years I had psoriasis on my scalp for nearly 10 years. Please give suggestions and medications. | instruction | 0 | 214 | 63 | 642 |
Your doctor may recommend creams, ultraviolet light therapy, prescription medications, shots, or some combination of these treatments. You will need to find the treatment that helps you. Joining a support group helps some people with psoriasis cope with the disease. Your doctor may recommend that you try one of these treatments or a combination of them: putting creams on your skin. ultraviolet light, which should be controlled by your doctor, and getting more sunlight. You can take an active role in treating your psoriasis. Besides going to your doctor regularly, you can keeping your skin well moisturized and stay healthy overall. | output | 1 | 214 | 63 | 643 |
Psoriasis: - 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. | input | 2 | 214 | 63 | 644 |
Psoriasis for past 7-8 years I had psoriasis on my scalp for nearly 10 years. Please give suggestions and medications. | instruction | 0 | 216 | 63 | 648 |
Infections, stress, dry skin and certain medications may make symptoms worse. Treatments include creams, medications and light therapy. | output | 1 | 216 | 63 | 649 |
Psoriasis (Summary): Psoriasis is a skin disease that causes itchy or sore patches of thick, red skin with silvery scales. The skin on the elbows, knees, scalp, back, face, palms and feet is most often affected, but other parts of the body can be affected as well. A problem with the immune system causes psoriasis. In a process called cell turnover, skin cells that grow deep in the skin rise to the surface. Normally, this takes a month. In psoriasis, it happens in just days because the cells rise too fast. Although symptoms may come and go, for many, psoriasis is a lifelong condition. Infections, stress, dry skin and certain medications may make symptoms worse. Psoriasis usually occurs in adults. It sometimes runs in families. Treatments include creams, medications and light therapy. [1] [2] | input | 2 | 216 | 63 | 650 |
Psoriasis for past 7-8 years I had psoriasis on my scalp for nearly 10 years. Please give suggestions and medications. | instruction | 0 | 217 | 63 | 651 |
Keeping the skin clean and moist and avoiding your psoriasis triggers may help reduce the number of flare-ups. Providers recommend daily baths or showers for people with psoriasis. Avoid scrubbing too hard, because this can irritate the skin and trigger an attack. | output | 1 | 217 | 63 | 652 |
Psoriasis (Prevention): There is no known way to prevent psoriasis. Keeping the skin clean and moist and avoiding your psoriasis triggers may help reduce the number of flare-ups. Providers recommend daily baths or showers for people with psoriasis. Avoid scrubbing too hard, because this can irritate the skin and trigger an attack. | input | 2 | 217 | 63 | 653 |
Subcutaneous retrocalcaneal bursitis Haglund's deformity of the calcaneum. I have this problem. Can you please help to overcome this? | instruction | 0 | 241 | 63 | 723 |
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. | output | 1 | 241 | 63 | 724 |
Bursitis 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. | input | 2 | 241 | 63 | 725 |
what is copd | instruction | 0 | 266 | 63 | 798 |
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Symptoms of COPD usually begin in people who are at least 40 years old and include breathing difficulty, cough, sputum production and wheezing. People with COPD are at increased risk of developing heart disease, lung cancer and other complications. Emphysema and chronic bronchitis are the two most common conditions that contribute to COPD. | output | 1 | 266 | 63 | 799 |
COPD: Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Symptoms include breathing difficulty, cough, mucus (sputum) production and wheezing. It's caused by long-term exposure to irritating gases or particulate matter, most often from cigarette smoke. People with COPD are at increased risk of developing heart disease, lung cancer and a variety of other conditions. Emphysema and chronic bronchitis are the two most common conditions that contribute to COPD. Chronic bronchitis is inflammation of the lining of the bronchial tubes, which carry air to and from the air sacs (alveoli) of the lungs. It's characterized by daily cough and mucus (sputum) production. Emphysema is a condition in which the alveoli at the end of the smallest air passages (bronchioles) of the lungs are destroyed as a result of damaging exposure to cigarette smoke and other irritating gases and particulate matter. COPD is treatable. With proper management, most people with COPD can achieve good symptom control and quality of life, as well as reduced risk of other associated conditions. COPD care at Mayo Clinic COPD symptoms often don't appear until significant lung damage has occurred, and they usually worsen over time, particularly if smoking exposure continues. For chronic bronchitis, the main symptom is a daily cough and mucus (sputum) production at least three months a year for two consecutive years. Other signs and symptoms of COPD may include: - Shortness of breath, especially during physical activities - Wheezing - Chest tightness - Having to clear your throat first thing in the morning, due to excess mucus in your lungs - A chronic cough that may produce mucus (sputum) that may be clear, white, yellow or greenish - Blueness of the lips or fingernail beds (cyanosis) - Frequent respiratory infections - Lack of energy - Unintended weight loss (in later stages) - Swelling in ankles, feet or legs People with COPD are also likely to experience episodes called exacerbations, during which their symptoms become worse than usual day-to-day variation and persist for at least several days. The main cause of COPD in developed countries is tobacco smoking. In the developing world, COPD often occurs in people exposed to fumes from burning fuel for cooking and heating in poorly ventilated homes. Only about 20 to 30 percent of chronic smokers may develop clinically apparent COPD, although many smokers with long smoking histories may develop reduced lung function. Some smokers develop less common lung conditions. They may be misdiagnosed as having COPD until a more thorough evaluation is performed. Air travels down your windpipe (trachea) and into your lungs through two large tubes (bronchi). Inside your lungs, these tubes divide many times - like the branches of a tree - into many smaller tubes (bronchioles) that end in clusters of tiny air sacs (alveoli). The air sacs have very thin walls full of tiny blood vessels (capillaries). The oxygen in the air you inhale passes into these blood vessels and enters your bloodstream. At the same time, carbon dioxide - a gas that is a waste product of metabolism - is exhaled. Your lungs rely on the natural elasticity of the bronchial tubes and air sacs to force air out of your body. COPD causes them to lose their elasticity and overexpand, which leaves some air trapped in your lungs when you exhale. Causes of airway obstruction include: - Emphysema. This lung disease causes destruction of the fragile walls and elastic fibers of the alveoli. Small airways collapse when you exhale, impairing airflow out of your lungs. - Chronic bronchitis. In this condition, your bronchial tubes become inflamed and narrowed and your lungs produce more mucus, which can further block the narrowed tubes. You develop a chronic cough trying to clear your airways. In the vast majority of cases, the lung damage that leads to COPD is caused by long-term cigarette smoking. But there are likely other factors at play in the development of COPD, such as a genetic susceptibility to the disease, because only about 20 to 30 percent of smokers may develop COPD. Other irritants can cause COPD, including cigar smoke, secondhand smoke, pipe smoke, air pollution and workplace exposure to dust, smoke or fumes. In about 1 percent of people with COPD, the disease results from a genetic disorder that causes low levels of a protein called alpha-1-antitrypsin. Alpha-1-antitrypsin (AAt) is made in the liver and secreted into the bloodstream to help protect the lungs. Alpha-1-antitrypsin deficiency can affect the liver as well as the lungs. Damage to the lung can occur in infants and children, not only adults with long smoking histories. For adults with COPD related to AAt deficiency, treatment options include those used for people with more-common types of COPD. In addition, some people can be treated by replacing the missing AAt protein, which may prevent further damage to the lungs. Risk factors for COPD include: - Exposure to tobacco smoke. The most significant risk factor for COPD is long-term cigarette smoking. The more years you smoke and the more packs you smoke, the greater your risk. Pipe smokers, cigar smokers and marijuana smokers also may be at risk, as well as people exposed to large amounts of secondhand smoke. - People with asthma who smoke. The combination of asthma, a chronic inflammatory airway disease, and smoking increases the risk of COPD even more. - Occupational exposure to dusts and chemicals. Long-term exposure to chemical fumes, vapors and dusts in the workplace can irritate and inflame your lungs. - Exposure to fumes from burning fuel. In the developing world, people exposed to fumes from burning fuel for cooking and heating in poorly ventilated homes are at higher risk of developing COPD. - Age. COPD develops slowly over years, so most people are at least 40 years old when symptoms begin. - Genetics. The uncommon genetic disorder alpha-1-antitrypsin deficiency is the cause of some cases of COPD. Other genetic factors likely make certain smokers more susceptible to the disease. COPD can cause many complications, including: - Respiratory infections. People with COPD are more likely to catch colds, the flu and pneumonia. Any respiratory infection can make it much more difficult to breathe and could cause further damage to lung tissue. An annual flu vaccination and regular vaccination against pneumococcal pneumonia can prevent some infections. - Heart problems. For reasons that aren't fully understood, COPD can increase your risk of heart disease, including heart attack. Quitting smoking may reduce this risk. - Lung cancer. People with COPD have a higher risk of developing lung cancer. Quitting smoking may reduce this risk. - High blood pressure in lung arteries. COPD may cause high blood pressure in the arteries that bring blood to your lungs (pulmonary hypertension). - Depression. Difficulty breathing can keep you from doing activities that you enjoy. And dealing with serious illness can contribute to development of depression. Talk to your doctor if you feel sad or helpless or think that you may be experiencing depression. COPD is commonly misdiagnosed - former smokers may sometimes be told they have COPD, when in reality they may have simple deconditioning or another less common lung condition. Likewise, many people who have COPD may not be diagnosed until the disease is advanced and interventions are less effective. To diagnose your condition, your doctor will review your signs and symptoms, discuss your family and medical history, and discuss any exposure you've had to lung irritants - especially cigarette smoke. Your doctor may order several tests to diagnose your condition. Tests may include: - Lung (pulmonary) function tests. Pulmonary function tests measure the amount of air you can inhale and exhale, and if your lungs are delivering enough oxygen to your blood. Spirometry is the most common lung function test. During this test, you'll be asked to blow into a large tube connected to a small machine called a spirometer. This machine measures how much air your lungs can hold and how fast you can blow the air out of your lungs. Spirometry can detect COPD even before you have symptoms of the disease. It can also be used to track the progression of disease and to monitor how well treatment is working. Spirometry often includes measurement of the effect of bronchodilator administration. Other lung function tests include measurement of lung volumes, diffusing capacity and pulse oximetry. - Chest X-ray. A chest X-ray can show emphysema, one of the main causes of COPD. An X-ray can also rule out other lung problems or heart failure. - CT scan. A CT scan of your lungs can help detect emphysema and help determine if you might benefit from surgery for COPD. CT scans can also be used to screen for lung cancer. - Arterial blood gas analysis. This blood test measures how well your lungs are bringing oxygen into your blood and removing carbon dioxide. - Laboratory tests. Laboratory tests aren't used to diagnose COPD, but they may be used to determine the cause of your symptoms or rule out other conditions. For example, laboratory tests may be used to determine if you have the genetic disorder alpha-1-antitrypsin (AAt) deficiency, which may be the cause of some cases of COPD. This test may be done if you have a family history of COPD and develop COPD at a young age, such as under age 45. A diagnosis of COPD is not the end of the world. Most people have mild forms of the disease for which little therapy is needed other than smoking cessation. Even for more advanced stages of disease, effective therapy is available that can control symptoms, reduce your risk of complications and exacerbations, and improve your ability to lead an active life. Smoking cessation The most essential step in any treatment plan for COPD is to stop all smoking. It's the only way to keep COPD from getting worse - which can eventually reduce your ability to breathe. But quitting smoking isn't easy. And this task may seem particularly daunting if you've tried to quit and have been unsuccessful. Talk to your doctor about nicotine replacement products and medications that might help, as well as how to handle relapses. Your doctor may also recommend a support group for people who want to quit smoking. It's also a good idea to avoid secondhand smoke exposure whenever possible. Medications Doctors use several kinds of medications to treat the symptoms and complications of COPD. You may take some medications on a regular basis and others as needed. These medications - which usually come in an inhaler - relax the muscles around your airways. This can help relieve coughing and shortness of breath and make breathing easier. Depending on the severity of your disease, you may need a short-acting bronchodilator before activities, a long-acting bronchodilator that you use every day or both. Short-acting bronchodilators include albuterol (ProAir HFA, Ventolin HFA, others), levalbuterol (Xopenex HFA), and ipratropium (Atrovent). The long-acting bronchodilators include tiotropium (Spiriva), salmeterol (Serevent), formoterol (Foradil, Perforomist), arformoterol (Brovana), indacaterol (Arcapta) and aclidinium (Tudorza). Inhaled corticosteroid medications can reduce airway inflammation and help prevent exacerbations. Side effects may include bruising, oral infections and hoarseness. These medications are useful for people with frequent exacerbations of COPD. Fluticasone (Flovent HFA, Flonase, others) and budesonide (Pulmicort Flexhaler, Uceris, others) are examples of inhaled steroids. Some medications combine bronchodilators and inhaled steroids. Salmeterol and fluticasone (Advair) and formoterol and budesonide (Symbicort) are examples of combination inhalers. For people who have a moderate or severe acute exacerbation, short courses (for example, five days) of oral corticosteroids prevent further worsening of COPD. However, long-term use of these medications can have serious side effects, such as weight gain, diabetes, osteoporosis, cataracts and an increased risk of infection. A new type of medication approved for people with severe COPD and symptoms of chronic bronchitis is roflumilast (Daliresp), a phosphodiesterase-4 inhibitor. This drug decreases airway inflammation and relaxes the airways. Common side effects include diarrhea and weight loss. This very inexpensive medication may help improve breathing and prevent exacerbations. Side effects may include nausea, headache, fast heartbeat and tremor. Side effects are dose related, and low doses are recommended. Respiratory infections, such as acute bronchitis, pneumonia and influenza, can aggravate COPD symptoms. Antibiotics help treat acute exacerbations, but they aren't generally recommended for prevention. However, a recent study shows that the antibiotic azithromycin prevents exacerbations, but it isn't clear whether this is due to its antibiotic effect or its anti-inflammatory properties. Lung therapies Doctors often use these additional therapies for people with moderate or severe COPD: - Oxygen therapy. If there isn't enough oxygen in your blood, you may need supplemental oxygen. There are several devices to deliver oxygen to your lungs, including lightweight, portable units that you can take with you to run errands and get around town. Some people with COPD use oxygen only during activities or while sleeping. Others use oxygen all the time. Oxygen therapy can improve quality of life and is the only COPD therapy proven to extend life. Talk to your doctor about your needs and options. - Pulmonary rehabilitation program. These programs generally combine education, exercise training, nutrition advice and counseling. You'll work with a variety of specialists, who can tailor your rehabilitation program to meet your needs. Pulmonary rehabilitation may shorten hospitalizations, increase your ability to participate in everyday activities and improve your quality of life. Talk to your doctor about referral to a program. Managing exacerbations Even with ongoing treatment, you may experience times when symptoms become worse for days or weeks. This is called an acute exacerbation, and it may lead to lung failure if you don't receive prompt treatment. Exacerbations may be caused by a respiratory infection, air pollution or other triggers of inflammation. Whatever the cause, it's important to seek prompt medical help if you notice a sustained increase in coughing, a change in your mucus or if you have a harder time breathing. When exacerbations occur, you may need additional medications (such as antibiotics, steroids or both), supplemental oxygen or treatment in the hospital. Once symptoms improve, your doctor will talk with you about measures to prevent future exacerbations, such as quitting smoking, taking inhaled steroids, long-acting bronchodilators or other medications, getting your annual flu vaccine, and avoiding air pollution whenever possible. Surgery Surgery is an option for some people with some forms of severe emphysema who aren't helped sufficiently by medications alone. Surgical options include: - Lung volume reduction surgery. In this surgery, your surgeon removes small wedges of damaged lung tissue from the upper lungs. This creates extra space in your chest cavity so that the remaining healthier lung tissue can expand and the diaphragm can work more efficiently. In some people, this surgery can improve quality of life and prolong survival. - Lung transplant. Lung transplantation may be an option for certain people who meet specific criteria. Transplantation can improve your ability to breathe and to be active. However, it's a major operation that has significant risks, such as organ rejection, and it's necessary to take lifelong immune-suppressing medications. - Bullectomy. Large air spaces (bullae) form in the lungs when the walls of the air sacs are destroyed. These bullae can become very large and cause breathing problems. In a bullectomy, doctors remove bullae from the lungs to help improve air flow. If you have COPD, you can take steps to feel better and slow the damage to your lungs: - Control your breathing. Talk to your doctor or respiratory therapist about techniques for breathing more efficiently throughout the day. Also be sure to discuss breathing positions and relaxation techniques that you can use when you're short of breath. - Clear your airways. With COPD, mucus tends to collect in your air passages and can be difficult to clear. Controlled coughing, drinking plenty of water and using a humidifier may help. - Exercise regularly. It may seem difficult to exercise when you have trouble breathing, but regular exercise can improve your overall strength and endurance and strengthen your respiratory muscles. Discuss with your doctor which activities are appropriate for you. - Eat healthy foods. A healthy diet can help you maintain your strength. If you're underweight, your doctor may recommend nutritional supplements. If you're overweight, losing weight can significantly help your breathing, especially during times of exertion. - Avoid smoke and air pollution. In addition to quitting smoking, it's important to avoid places where others smoke. Secondhand smoke may contribute to further lung damage. Other types of air pollution also can irritate your lungs. - See your doctor regularly. Stick to your appointment schedule, even if you're feeling fine. It's important to steadily monitor your lung function. And be sure to get your annual flu vaccine in the fall to help prevent infections that can worsen your COPD. Ask your doctor when you need the pneumococcal vaccine. Let your doctor know if you have worsening symptoms or you notice signs of infection. | input | 2 | 266 | 63 | 800 |
what is copd | instruction | 0 | 267 | 63 | 801 |
COPD, Chronic obstructive pulmonary disease, is a progressive lung disease in which the airways of the lungs become damaged and blocked, making it harder to breathe. | output | 1 | 267 | 63 | 802 |
What is COPD?: Chronic obstructive pulmonary disease, or COPD, is a progressive lung disease in which the airways of the lungs become damaged, making it harder to breathe. With COPD, airways become blocked, making it harder to get air in and out. | input | 2 | 267 | 63 | 803 |
what is copd | instruction | 0 | 268 | 63 | 804 |
COPD, Chronic obstructive pulmonary disease, is a progressive lung disease in which the airways of the lungs become damaged and blocked, making it harder to breathe. The damage to the airways and lungs is not reversible, but the effects of the disease can be controlled. COPD is not contagious. COPD develops slowly, and people are usually middle-aged or older when they notice symptoms, such as feeling short of breath. | output | 1 | 268 | 63 | 805 |
What is COPD?: Chronic obstructive pulmonary disease, or COPD, is a progressive lung disease in which the airways of the lungs become damaged, making it hard to breathe. You may also have heard COPD called other names, like emphysema or chronic bronchitis. In people who have COPD, the airways that carry air in and out of the lungs are partially blocked, making it difficult to get air in and out. COPD is a major cause of death and illness throughout the world. It kills more than 120,000 Americans each year. That's one death every 4 minutes. How COPD Affects Airways The "airways" are the tubes that carry air in and out of the lungs through the nose and mouth. The airways of the lungs branch out like an upside-down tree. At the end of each branch are many small, balloon-like air sacs. In healthy people, the airways and air sacs are elastic (stretchy). When you breathe in, each air sac fills up with air, like a small balloon, and when you breathe out, the balloon deflates and the air goes out. In people with COPD, the airways and air sacs lose their shape and become floppy. Less air gets in and less air goes out of the airways because - The airways and air sacs lose their elasticity like an old rubber band. - The walls between many of the air sacs are destroyed. - The walls of the airways become thick and inflamed or swollen. - Cells in the airways make more mucus or sputum than usual, which tends to clog the airways. The airways and air sacs lose their elasticity like an old rubber band. The walls between many of the air sacs are destroyed. The walls of the airways become thick and inflamed or swollen. Cells in the airways make more mucus or sputum than usual, which tends to clog the airways. COPD Develops Slowly, Has No Cure When COPD is severe, shortness of breath and other symptoms of COPD can get in the way of even the most basic tasks, such as doing light housework, taking a walk, even washing and dressing. COPD develops slowly, and it may be many years before you notice symptoms like feeling short of breath. Most of the time, COPD is diagnosed in middle-aged or older people. There is no cure for COPD. The damage to your airways and lungs cannot be reversed, but there are things you can do to control the disabling effects of the disease. COPD is not contagious. You cannot catch it from someone else. | input | 2 | 268 | 63 | 806 |
what is copd | instruction | 0 | 269 | 63 | 807 |
COPD (chronic obstructive pulmonary disease) makes it hard for you to breathe. COPD is diagnosed using lung function tests, imaging tests, and blood tests. Your doctor may prescribe medicines, oxygen therapy, surgery, or a lung transplant to relieve symptoms of COPD. | output | 1 | 269 | 63 | 808 |
What is COPD?: COPD (chronic obstructive pulmonary disease) makes it hard for you to breathe. The two main types are chronic bronchitis and emphysema. The main cause of COPD is long-term exposure to substances that irritate and damage the lungs. This is usually cigarette smoke. Air pollution, chemical fumes, or dust can also cause it. At first, COPD may cause no symptoms or only mild symptoms. As the disease gets worse, symptoms usually become more severe. They include - A cough that produces a lot of mucus - Shortness of breath, especially with physical activity - Wheezing - Chest tightness Doctors use lung function tests, imaging tests, and blood tests to diagnose COPD. There is no cure. Treatments may relieve symptoms. They include medicines, oxygen therapy, surgery, or a lung transplant. Quitting smoking is the most important step you can take to treat COPD. NIH: National Heart, Lung, and Blood Institute | input | 2 | 269 | 63 | 809 |
what is copd | instruction | 0 | 270 | 63 | 810 |
COPD, or chronic obstructive pulmonary disease, is a progressive disease that makes it hard to breathe. COPD can cause coughing that produces large amounts of mucus, wheezing, shortness of breath, chest tightness, and other symptoms. Cigarette smoking is the leading cause of COPD. COPD develops slowly, and most of the time, COPD is diagnosed in middle-aged or older adults. . Severe COPD may prevent you from doing even basic activities like walking, cooking, or taking care of yourself. The disease is not contagious. COPD has no cure yet, and the damage to the lungs is not reversible, but treatments and lifestyle changes can help you feel better, stay more active, and slow the progress of the disease. | output | 1 | 270 | 63 | 811 |
COPD: Español Also known as chronic obstructive pulmonary disease; chronic bronchitis; or emphysema. COPD, or chronic obstructive pulmonary disease, is a progressive disease that makes it hard to breathe. Progressive means the disease gets worse over time. COPD can cause coughing that produces large amounts of a slimy substance called mucus, wheezing, shortness of breath, chest tightness, and other symptoms. Cigarette smoking is the leading cause of COPD. Most people who have COPD smoke or used to smoke. However, up to 25 percent of people with COPD never smoked. Long-term exposure to other lung irritants—such as air pollution, chemical fumes, or dusts—also may contribute to COPD. A rare genetic condition called alpha-1 antitrypsin (AAT) deficiency can also cause the disease. Overview To understand COPD, it helps to understand how the lungs work. The air that you breathe goes down your windpipe into tubes in your lungs called bronchial tubes or airways. Within the lungs, your bronchial tubes branch many times into thousands of smaller, thinner tubes called bronchioles. These tubes end in bunches of tiny round air sacs called alveoli. Small blood vessels called capillaries run along the walls of the air sacs. When air reaches the air sacs, oxygen passes through the air sac walls into the blood in the capillaries. At the same time, a waste product, called carbon dioxide (CO2) gas, moves from the capillaries into the air sacs. This process, called gas exchange, brings in oxygen for the body to use for vital functions and removes the CO2. The airways and air sacs are elastic or stretchy. When you breathe in, each air sac fills up with air, like a small balloon. When you breathe out, the air sacs deflate and the air goes out. In COPD, less air flows in and out of the airways because of one or more of the following: The airways and air sacs lose their elastic quality. The walls between many of the air sacs are destroyed. The walls of the airways become thick and inflamed. The airways make more mucus than usual and can become clogged. Normal Lungs and Lungs With COPD In the United States, the term COPD includes two main conditions—emphysema and chronic bronchitis. In emphysema, the walls between many of the air sacs are damaged. As a result, the air sacs lose their shape and become floppy. This damage also can destroy the walls of the air sacs, leading to fewer and larger air sacs instead of many tiny ones. If this happens, the amount of gas exchange in the lungs is reduced. In chronic bronchitis, the lining of the airways stays constantly irritated and inflamed, and this causes the lining to swell. Lots of thick mucus forms in the airways, making it hard to breathe. Most people who have COPD have both emphysema and chronic bronchitis, but the severity of each condition varies from person to person. Thus, the general term COPD is more accurate. Outlook COPD is a major cause of disability, and it is the third leading cause of death in the United States. Currently, 16 million people are diagnosed with COPD. Many more people may have the disease and not even know it. COPD develops slowly. Symptoms often worsen over time and can limit your ability to do routine activities. Severe COPD may prevent you from doing even basic activities like walking, cooking, or taking care of yourself. Most of the time, COPD is diagnosed in middle-aged or older adults. The disease is not contagious, meaning it cannot be passed from person to person. COPD has no cure yet, and doctors do not know how to reverse the damage to the lungs. However, treatments and lifestyle changes can help you feel better, stay more active, and slow the progress of the disease. | input | 2 | 270 | 63 | 812 |
what test do you do for rheumatoid "arthritis?" | instruction | 0 | 295 | 63 | 885 |
Rheumatoid arthritis can be hard to diagnose because the symptoms can be the same as in other kinds of joint disease, take time to develop fully, and there is no single test for the disease. To diagnose rheumatoid arthritis, doctors use medical history, a physical exam, x-rays and other imaging tests, and lab tests. | output | 1 | 295 | 63 | 886 |
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 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 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 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. 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. 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. 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. 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. Medicine 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. Surgery 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. Regular Doctor Visits 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. Complementary Therapies 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. Medicine 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. Surgery 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. Regular Doctor Visits 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. Complementary Therapies 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. Medicine 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. Surgery 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. Regular Doctor Visits 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. Complementary Therapies 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. 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. 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. Joint Care 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. Rest Keep a good balance between rest and activity. Try to take frequent breaks, especially when your symptoms are bothering you. Lowering Stress 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. A Healthy Diet 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. Joint Care 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. Rest Keep a good balance between rest and activity. Try to take frequent breaks, especially when your symptoms are bothering you. Lowering Stress 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. A Healthy Diet Eat a healthy diet which will help you manage your weight and get a variety of nutrients for overall health. 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. | input | 2 | 295 | 63 | 887 |
what test do you do for rheumatoid "arthritis?" | instruction | 0 | 296 | 63 | 888 |
Rheumatoid arthritis can be hard to diagnose because the symptoms can be the same as in other kinds of joint disease, take time to develop fully, and there is no single test for the disease. To diagnose rheumatoid arthritis, doctors use medical history, a physical exam, x-rays and other imaging tests, and lab tests. | output | 1 | 296 | 63 | 889 |
Rheumatoid Arthritis (Is there a test?): 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. | input | 2 | 296 | 63 | 890 |
what test do you do for rheumatoid "arthritis?" | instruction | 0 | 297 | 63 | 891 |
Rheumatoid arthritis can be difficult to diagnose in its early stages 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. | output | 1 | 297 | 63 | 892 |
Rheumatoid arthritis: Rheumatoid arthritis is a chronic inflammatory disorder that can affect more than just your joints. In some people, the condition also can damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels. An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body's tissues. Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity. The inflammation associated with rheumatoid arthritis is what can damage other parts of the body as well. While new types of medications have improved treatment options dramatically, severe rheumatoid arthritis can still cause physical disabilities. Signs and symptoms of rheumatoid arthritis may include: - Tender, warm, swollen joints - Joint stiffness that is usually worse in the mornings and after inactivity - Fatigue, fever and weight loss Early rheumatoid arthritis tends to affect your smaller joints first - particularly the joints that attach your fingers to your hands and your toes to your feet. As the disease progresses, symptoms often spread to the wrists, knees, ankles, elbows, hips and shoulders. In most cases, symptoms occur in the same joints on both sides of your body. About 40 percent of the people who have rheumatoid arthritis also experience signs and symptoms that don't involve the joints. Rheumatoid arthritis can affect many nonjoint structures, including: - Skin - Eyes - Lungs - Heart - Kidneys - Salivary glands - Nerve tissue - Bone marrow - Blood vessels Rheumatoid arthritis signs and symptoms may vary in severity and may even come and go. Periods of increased disease activity, called flares, alternate with periods of relative remission - when the swelling and pain fade or disappear. Over time, rheumatoid arthritis can cause joints to deform and shift out of place. Make an appointment with your doctor if you have persistent discomfort and swelling in your joints. Rheumatoid arthritis occurs when your immune system attacks the synovium - the lining of the membranes that surround your joints. The resulting inflammation thickens the synovium, which can eventually destroy the cartilage and bone within the joint. The tendons and ligaments that hold the joint together weaken and stretch. Gradually, the joint loses its shape and alignment. Doctors don't know what starts this process, although a genetic component appears likely. While your genes don't actually cause rheumatoid arthritis, they can make you more susceptible to environmental factors - such as infection with certain viruses and bacteria - that may trigger the disease. Factors that may increase your risk of rheumatoid arthritis include: - Your sex. Women are more likely than men to develop rheumatoid arthritis. - Age. Rheumatoid arthritis can occur at any age, but it most commonly begins between the ages of 40 and 60. - Family history. If a member of your family has rheumatoid arthritis, you may have an increased risk of the disease. - Smoking. Cigarette smoking increases your risk of developing rheumatoid arthritis, particularly if you have a genetic predisposition for developing the disease. Smoking also appears to be associated with greater disease severity. - Environmental exposures. Although uncertain and poorly understood, some exposures such as asbestos or silica may increase the risk for developing rheumatoid arthritis. Emergency workers exposed to dust from the collapse of the World Trade Center are at higher risk of autoimmune diseases such as rheumatoid arthritis. - Obesity. People who are overweight or obese appear to be at somewhat higher risk of developing rheumatoid arthritis, especially in women diagnosed with the disease when they were 55 or younger. 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. There is no cure for rheumatoid arthritis. But recent discoveries indicate that remission of symptoms is more likely when treatment begins early with strong medications known as disease-modifying antirheumatic drugs (DMARDs). Medications The types of medications recommended by your doctor will depend on the severity of your symptoms and how long you've had rheumatoid arthritis. - NSAIDs. Nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain and reduce inflammation. Over-the-counter NSAIDs include ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve). Stronger NSAIDs are available by prescription. Side effects may include ringing in your ears, stomach irritation, heart problems, and liver and kidney damage. - Steroids. Corticosteroid medications, such as prednisone, reduce inflammation and pain and slow joint damage. Side effects may include thinning of bones, weight gain and diabetes. Doctors often prescribe a corticosteroid to relieve acute symptoms, with the goal of gradually tapering off the medication. - Disease-modifying antirheumatic drugs (DMARDs). These drugs can slow the progression of rheumatoid arthritis and save the joints and other tissues from permanent damage. Common DMARDs include methotrexate (Trexall, Otrexup, Rasuvo), leflunomide (Arava), hydroxychloroquine (Plaquenil) and sulfasalazine (Azulfidine). Side effects vary but may include liver damage, bone marrow suppression and severe lung infections. - Biologic agents. Also known as biologic response modifiers, this newer class of DMARDs includes abatacept (Orencia), adalimumab (Humira), anakinra (Kineret), certolizumab (Cimzia), etanercept (Enbrel), golimumab (Simponi), infliximab (Remicade), rituximab (Rituxan), tocilizumab (Actemra) and tofacitinib (Xeljanz). These drugs can target parts of the immune system that trigger inflammation that causes joint and tissue damage. These types of drugs also increase the risk of infections. Biologic DMARDs are usually most effective when paired with a nonbiologic DMARD, such as methotrexate. Therapy Your doctor may send you to a physical or occupational therapist who can teach you exercises to help keep your joints flexible. The therapist may also suggest new ways to do daily tasks, which will be easier on your joints. For example, if your fingers are sore, you may want to pick up an object using your forearms. Assistive devices can make it easier to avoid stressing your painful joints. For instance, a kitchen knife equipped with a saw handle helps protect your finger and wrist joints. Certain tools, such as buttonhooks, can make it easier to get dressed. Catalogs and medical supply stores are good places to look for ideas. Surgery If medications fail to prevent or slow joint damage, you and your doctor may consider surgery to repair damaged joints. Surgery may help restore your ability to use your joint. It can also reduce pain and correct deformities. Rheumatoid arthritis surgery may involve one or more of the following procedures: - Synovectomy. Surgery to remove the inflamed synovium (lining of the joint). Synovectomy can be performed on knees, elbows, wrists, fingers and hips. - Tendon repair. Inflammation and joint damage may cause tendons around your joint to loosen or rupture. Your surgeon may be able to repair the tendons around your joint. - Joint fusion. Surgically fusing a joint may be recommended to stabilize or realign a joint and for pain relief when a joint replacement isn't an option. - Total joint replacement. During joint replacement surgery, your surgeon removes the damaged parts of your joint and inserts a prosthesis made of metal and plastic. Surgery carries a risk of bleeding, infection and pain. Discuss the benefits and risks with your doctor. You can take steps to care for your body if you have rheumatoid arthritis. These self-care measures, when used along with your rheumatoid arthritis medications, can help you manage your signs and symptoms: - Exercise regularly. Gentle exercise can help strengthen the muscles around your joints, and it can help fight fatigue you might feel. Check with your doctor before you start exercising. If you're just getting started, begin by taking a walk. Try swimming or gentle water aerobics. Avoid exercising tender, injured or severely inflamed joints. - Apply heat or cold. Heat can help ease your pain and relax tense, painful muscles. Cold may dull the sensation of pain. Cold also has a numbing effect and decreases muscle spasms. - Relax. Find ways to cope with pain by reducing stress in your life. Techniques such as guided imagery, distraction and muscle relaxation can all be used to control pain. Some common complementary and alternative treatments that have shown promise for rheumatoid arthritis include: - Fish oil. Some preliminary studies have found that fish oil supplements may reduce rheumatoid arthritis pain and stiffness. Side effects can include nausea, belching and a fishy taste in the mouth. Fish oil can interfere with medications, so check with your doctor first. - Plant oils. The seeds of evening primrose, borage and black currant contain a type of fatty acid that may help with rheumatoid arthritis pain and morning stiffness. Side effects may include nausea, diarrhea and gas. Some plant oils can cause liver damage or interfere with medications, so check with your doctor first. - Tai chi. This movement therapy involves gentle exercises and stretches combined with deep breathing. Many people use tai chi to relieve stress in their lives. Small studies have found that tai chi may reduce rheumatoid arthritis pain. When led by a knowledgeable instructor, tai chi is safe. But don't do any moves that cause pain. | input | 2 | 297 | 63 | 893 |
what test do you do for rheumatoid "arthritis?" | instruction | 0 | 298 | 63 | 894 |
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. | output | 1 | 298 | 63 | 895 |
Rheumatoid 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. | input | 2 | 298 | 63 | 896 |
what test do you do for rheumatoid "arthritis?" | instruction | 0 | 299 | 63 | 897 |
Rheumatoid arthritis can be difficult to diagnose in its early stages because the full range of symptoms develops over time, and the symptoms can be the same as in other kinds of joint disease. To diagnose rheumatoid arthritis, doctors look for symptoms such as swelling, warmth, pain, and limitations in joint motion. | output | 1 | 299 | 63 | 898 |
How to diagnose Rheumatoid Arthritis?: Rheumatoid arthritis can be difficult to diagnose in its early stages because the full range of symptoms develops over time, and only a few symptoms may be present in the early stages. As part of the diagnosis, your doctor will look for symptoms such as swelling, warmth, pain, and limitations in joint motion throughout your body. Your doctor may ask you questions about the intensity of your pain symptoms, how often they occur, and what makes the pain better or worse. | input | 2 | 299 | 63 | 899 |
what the treatment for bronchitis | instruction | 0 | 300 | 63 | 900 |
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. | output | 1 | 300 | 63 | 901 |
Bronchitis: 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. | input | 2 | 300 | 63 | 902 |
what the treatment for bronchitis | instruction | 0 | 301 | 63 | 903 |
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, resting, and stopping being exposed to the irritant. | output | 1 | 301 | 63 | 904 |
Industrial bronchitis: Industrial bronchitis is swelling (inflammation) of the large airways of the lungs that occurs in some people who work around certain dusts, fumes, smoke, or other substances. Exposure to dusts, fumes, strong acids, and other chemicals in the air causes this type of bronchitis. Smoking may also contribute. You may be at risk if you are exposed to dusts that contain: - Asbestos - Coal - Cotton - Flax - Latex - Metals - Silica - Talc - Toluene diisocyanate - Western red cedar Symptoms may include any of the following: - Cough that brings up mucus (sputum) - Shortness of breath - Wheezing The health care provider will listen to your lungs using a stethoscope. Wheezing sounds or crackles may be heard. Tests that may be ordered include: - Chest CT scan - Chest x-ray - Pulmonary function tests (to measure breathing and how well the lungs are functioning) 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 The outcome may be good as long as you can stop being exposed to the irritant. Chronic disability from industrial bronchitis is rare. Continued exposure to irritating gases, fumes, or other substances can lead to permanent lung damage. Call your provider if you are regularly exposed to dusts, fumes, strong acids, or other chemicals that can affect the lungs and you develop symptoms of bronchitis. Control dust in industrial settings by wearing face masks and protective clothing, and by treating textiles. Stop smoking if you are at risk. Get early screening by a doctor if you are exposed to chemicals that can cause this condition. If you think a chemical you work with is affecting your breathing, ask your employer for a copy of the Material Safety Data Sheet. Bring it with you to your provider. 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. | input | 2 | 301 | 63 | 905 |
what the treatment for bronchitis | instruction | 0 | 303 | 63 | 909 |
The following lifestyle changes and ongoing care can help manage chronic bronchitis: quitting smoking and avoiding other lung irritants, such as secondhand smoke, dust, fumes, vapors, and air pollution; washing hands often to lower risk for a viral or bacterial infection, and staying away from people who have colds or the flu. Following a healthy diet and being physically active also helps, as well as getting a yearly flu shot and a pneumonia vaccine. Pulmonary rehabilitation and a breathing method called pursed-lip breathing could also help. | output | 1 | 303 | 63 | 910 |
Bronchitis (Living With): If you have chronic bronchitis, you can take steps to control your symptoms. Lifestyle changes and ongoing care can help you manage the condition. Lifestyle Changes The most important step is to not start smoking or to quit smoking. Talk with your doctor about programs and products that can help you quit. For more information about how to quit smoking, go to the Diseases and Conditions Index Smoking and Your Heart article and the National Heart, Lung, and Blood Institute's (NHLBI's) "Your Guide to a Healthy Heart." Although these resources focus on heart health, they include general information about how to quit smoking. Also, try to avoid other lung irritants, such as secondhand smoke, dust, fumes, vapors, and air pollution. This will help keep your lungs healthy. Wash your hands often to lower your risk for a viral or bacterial infection. Also, try to stay away from people who have colds or the flu. See your doctor right away if you have signs or symptoms of a cold or the flu. Follow a healthy diet and be as physically active as you can. A healthy diet includes a variety of fruits, vegetables, and whole grains. It also includes lean meats, poultry, fish, and fat-free or low-fat milk or milk products. A healthy diet also is low in saturated fat, trans fat, cholesterol, sodium (salt), and added sugar. For more information about following a healthy diet, go to the NHLBI's Aim for a Healthy Weight Web site, "Your Guide to a Healthy Heart," and "Your Guide to Lowering Your Blood Pressure With DASH." All of these resources include general advice about healthy eating. Ongoing Care See your doctor regularly and take all of your medicines as prescribed. Also, talk with your doctor about getting a yearly flu shot and a pneumonia vaccine. If you have chronic bronchitis, you may benefit from pulmonary rehabilitation (PR). PR is a broad program that helps improve the well-being of people who have chronic (ongoing) breathing problems. People who have chronic bronchitis often breathe fast. Talk with your doctor about a breathing method called pursed-lip breathing. This method decreases how often you take breaths, and it helps keep your airways open longer. This allows more air to flow in and out of your lungs so you can be more physically active. To do pursed-lip breathing, you breathe in through your nostrils. Then you slowly breathe out through slightly pursed lips, as if you're blowing out a candle. You exhale two to three times longer than you inhale. Some people find it helpful to count to two while inhaling and to four or six while exhaling. | input | 2 | 303 | 63 | 911 |
what the treatment for bronchitis | instruction | 0 | 304 | 63 | 912 |
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. | output | 1 | 304 | 63 | 913 |
Industrial 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 | input | 2 | 304 | 63 | 914 |
what the treatment for bronchitis | instruction | 0 | 306 | 63 | 918 |
Treatments for acute and chronic bronchitis relieve symptoms and make breathing easier. For acute bronchitis, your doctor may recommend rest, plenty of fluids, and aspirin (for adults) or acetaminophen to treat fever. Cases of bronchitis that are caused by viral infections do not need antibiotics. If doctors suspect that the infection is bacterial, they may prescribe an antibiotic. A humidifier or steam can help loosen mucus and relieve wheezing and limited air flow. If your bronchitis causes wheezing, you may need an inhaled medicine to open your airways. Your doctor also may prescribe medicines to relieve or reduce your cough and treat your inflamed airways. For chronic bronchitis and chronic obstructive pulmonary disease (COPD), you may need bronchodilators and steroids to open your airways and help clear away mucus. Your doctor may also prescribe oxygen therapy. One of the best ways to treat acute and chronic bronchitis is to remove the source of irritation and damage to your lungs, such as quitting smoking and avoiding secondhand smoke and other lung irritants, such as dust, fumes, vapors, and air pollution. | output | 1 | 306 | 63 | 919 |
Bronchitis: Español Bronchitis (bron-KI-tis) is a condition in which the bronchial tubes become inflamed. These tubes carry air to your lungs. (For more information about the bronchial tubes and airways, go to the Diseases and Conditions Index How the Lungs Work article.) People who have bronchitis often have a cough that brings up mucus. Mucus is a slimy substance made by the lining of the bronchial tubes. Bronchitis also may cause wheezing (a whistling or squeaky sound when you breathe), chest pain or discomfort, a low fever, and shortness of breath. Bronchitis Overview The two main types of bronchitis are acute (short term) and chronic (ongoing). Acute Bronchitis Infections or lung irritants cause acute bronchitis. The same viruses that cause colds and the flu are the most common cause of acute bronchitis. These viruses are spread through the air when people cough. They also are spread through physical contact (for example, on hands that have not been washed). Sometimes bacteria cause acute bronchitis. Acute bronchitis lasts from a few days to 10 days. However, coughing may last for several weeks after the infection is gone. Several factors increase your risk for acute bronchitis. Examples include exposure to tobacco smoke (including secondhand smoke), dust, fumes, vapors, and air pollution. Avoiding these lung irritants as much as possible can help lower your risk for acute bronchitis. Most cases of acute bronchitis go away within a few days. If you think you have acute bronchitis, see your doctor. He or she will want to rule out other, more serious health conditions that require medical care. Chronic Bronchitis Chronic bronchitis is an ongoing, serious condition. It occurs if the lining of the bronchial tubes is constantly irritated and inflamed, causing a long-term cough with mucus. Smoking is the main cause of chronic bronchitis. Viruses or bacteria can easily infect the irritated bronchial tubes. If this happens, the condition worsens and lasts longer. As a result, people who have chronic bronchitis have periods when symptoms get much worse than usual. Chronic bronchitis is a serious, long-term medical condition. Early diagnosis and treatment, combined with quitting smoking and avoiding secondhand smoke, can improve quality of life. The chance of complete recovery is low for people who have severe chronic bronchitis. Acute bronchitis Chronic bronchitis Industrial bronchitis Acute Bronchitis Infections or lung irritants cause acute bronchitis. The same viruses that cause colds and the flu are the most common cause of acute bronchitis. Sometimes bacteria can cause the condition. Certain substances can irritate your lungs and airways and raise your risk for acute bronchitis. For example, inhaling or being exposed to tobacco smoke, dust, fumes, vapors, or air pollution raises your risk for the condition. These lung irritants also can make symptoms worse. Being exposed to a high level of dust or fumes, such as from an explosion or a big fire, also may lead to acute bronchitis. Chronic Bronchitis Repeatedly breathing in fumes that irritate and damage lung and airway tissues causes chronic bronchitis. Smoking is the major cause of the condition. Breathing in air pollution and dust or fumes from the environment or workplace also can lead to chronic bronchitis. People who have chronic bronchitis go through periods when symptoms become much worse than usual. During these times, they also may have acute viral or bacterial bronchitis. Bronchitis is a very common condition. Millions of cases occur every year. Elderly people, infants, and young children are at higher risk for acute bronchitis than people in other age groups. People of all ages can develop chronic bronchitis, but it occurs more often in people who are older than 45. Also, many adults who develop chronic bronchitis are smokers. Women are more than twice as likely as men to be diagnosed with chronic bronchitis. Smoking and having an existing lung disease greatly increase your risk for bronchitis. Contact with dust, chemical fumes, and vapors from certain jobs also increases your risk for the condition. Examples include jobs in coal mining, textile manufacturing, grain handling, and livestock farming. Air pollution, infections, and allergies can worsen the symptoms of chronic bronchitis, especially if you smoke. Acute Bronchitis Acute bronchitis caused by an infection usually develops after you already have a cold or the flu. Symptoms of a cold or the flu include sore throat, fatigue (tiredness), fever, body aches, stuffy or runny nose, vomiting, and diarrhea. The main symptom of acute bronchitis is a persistent cough, which may last 10 to 20 days. The cough may produce clear mucus (a slimy substance). If the mucus is yellow or green, you may have a bacterial infection as well. Even after the infection clears up, you may still have a dry cough for days or weeks. Other symptoms of acute bronchitis include wheezing (a whistling or squeaky sound when you breathe), low fever, and chest tightness or pain. If your acute bronchitis is severe, you also may have shortness of breath, especially with physical activity. Chronic Bronchitis The signs and symptoms of chronic bronchitis include coughing, wheezing, and chest discomfort. The coughing may produce large amounts of mucus. This type of cough often is called a smoker's cough. Your doctor usually will diagnose bronchitis based on your signs and symptoms. He or she may ask questions about your cough, such as how long you've had it, what you're coughing up, and how much you cough. Your doctor also will likely ask: About your medical history Whether you've recently had a cold or the flu Whether you smoke or spend time around others who smoke Whether you've been exposed to dust, fumes, vapors, or air pollution Your doctor will use a stethoscope to listen for wheezing (a whistling or squeaky sound when you breathe) or other abnormal sounds in your lungs. He or she also may: Look at your mucus to see whether you have a bacterial infection Test the oxygen levels in your blood using a sensor attached to your fingertip or toe Recommend a chest x ray, lung function tests, or blood tests The main goals of treating acute and chronic bronchitis are to relieve symptoms and make breathing easier. If you have acute bronchitis, your doctor may recommend rest, plenty of fluids, and aspirin (for adults) or acetaminophen to treat fever. Antibiotics usually aren't prescribed for acute bronchitis. This is because they don't work against viruses—the most common cause of acute bronchitis. However, if your doctor thinks you have a bacterial infection, he or she may prescribe antibiotics. A humidifier or steam can help loosen mucus and relieve wheezing and limited air flow. If your bronchitis causes wheezing, you may need an inhaled medicine to open your airways. You take this medicine using an inhaler. This device allows the medicine to go straight to your lungs. Your doctor also may prescribe medicines to relieve or reduce your cough and treat your inflamed airways (especially if your cough persists). If you have chronic bronchitis and also have been diagnosed with COPD (chronic obstructive pulmonary disease), you may need medicines to open your airways and help clear away mucus. These medicines include bronchodilators (inhaled) and steroids (inhaled or pill form). If you have chronic bronchitis, your doctor may prescribe oxygen therapy. This treatment can help you breathe easier, and it provides your body with needed oxygen. One of the best ways to treat acute and chronic bronchitis is to remove the source of irritation and damage to your lungs. If you smoke, it's very important to quit. Talk with your doctor about programs and products that can help you quit smoking. Try to avoid secondhand smoke and other lung irritants, such as dust, fumes, vapors, and air pollution. For more information about how to quit smoking, go to the Diseases and Conditions Index Smoking and Your Heart article and the National Heart, Lung, and Blood Institute's "Your Guide to a Healthy Heart." Although these resources focus on heart health, they include general information about how to quit smoking. You can't always prevent acute or chronic bronchitis. However, you can take steps to lower your risk for both conditions. The most important step is to quit smoking or not start smoking. For more information about how to quit smoking, go to the Diseases and Conditions Index Smoking and Your Heart article and the National Heart, Lung, and Blood Institute's "Your Guide to a Healthy Heart." Although these resources focus on heart health, they include general information about how to quit smoking. Also, try to avoid other lung irritants, such as secondhand smoke, dust, fumes, vapors, and air pollution. For example, wear a mask over your mouth and nose when you use paint, paint remover, varnish, or other substances with strong fumes. This will help protect your lungs. Wash your hands often to limit your exposure to germs and bacteria. Your doctor also may advise you to get a yearly flu shot and a pneumonia vaccine. If you have chronic bronchitis, you can take steps to control your symptoms. Lifestyle changes and ongoing care can help you manage the condition. Lifestyle Changes The most important step is to not start smoking or to quit smoking. Talk with your doctor about programs and products that can help you quit. For more information about how to quit smoking, go to the Diseases and Conditions Index Smoking and Your Heart article and the National Heart, Lung, and Blood Institute's (NHLBI's) "Your Guide to a Healthy Heart." Although these resources focus on heart health, they include general information about how to quit smoking. Also, try to avoid other lung irritants, such as secondhand smoke, dust, fumes, vapors, and air pollution. This will help keep your lungs healthy. Wash your hands often to lower your risk for a viral or bacterial infection. Also, try to stay away from people who have colds or the flu. See your doctor right away if you have signs or symptoms of a cold or the flu. Follow a healthy diet and be as physically active as you can. A healthy diet includes a variety of fruits, vegetables, and whole grains. It also includes lean meats, poultry, fish, and fat-free or low-fat milk or milk products. A healthy diet also is low in saturated fat, trans fat, cholesterol, sodium (salt), and added sugar. For more information about following a healthy diet, go to the NHLBI's Aim for a Healthy Weight Web site, "Your Guide to a Healthy Heart," and "Your Guide to Lowering Your Blood Pressure With DASH." All of these resources include general advice about healthy eating. Ongoing Care See your doctor regularly and take all of your medicines as prescribed. Also, talk with your doctor about getting a yearly flu shot and a pneumonia vaccine. If you have chronic bronchitis, you may benefit from pulmonary rehabilitation (PR). PR is a broad program that helps improve the well-being of people who have chronic (ongoing) breathing problems. People who have chronic bronchitis often breathe fast. Talk with your doctor about a breathing method called pursed-lip breathing. This method decreases how often you take breaths, and it helps keep your airways open longer. This allows more air to flow in and out of your lungs so you can be more physically active. To do pursed-lip breathing, you breathe in through your nostrils. Then you slowly breathe out through slightly pursed lips, as if you're blowing out a candle. You exhale two to three times longer than you inhale. Some people find it helpful to count to two while inhaling and to four or six while exhaling. | input | 2 | 306 | 63 | 920 |
could tetanus be a cause of death? | instruction | 0 | 320 | 63 | 960 |
Complications of tetanus infection may include death due to respiratory failure, cardiac arrest or pneumonia. | output | 1 | 320 | 63 | 961 |
Tetanus: Tetanus is a serious bacterial disease that affects your nervous system, leading to painful muscle contractions, particularly of your jaw and neck muscles. Tetanus can interfere with your ability to breathe and can threaten your life. Tetanus is commonly known as "lockjaw." Thanks to the tetanus vaccine, cases of tetanus are rare in the United States and other parts of the developed world. However, the disease remains a threat to those who aren't up to date on their vaccinations, and is more common in developing countries. There's no cure for tetanus. Treatment focuses on managing complications until the effects of the tetanus toxin resolve. Signs and symptoms of tetanus appear anytime from a few days to several weeks after tetanus bacteria enter your body through a wound. The average incubation period is seven to 10 days. Common signs and symptoms of tetanus include: - Spasms and stiffness in your jaw muscles (trismus) - Stiffness of your neck muscles - Difficulty swallowing - Stiffness of your abdominal muscles - Painful body spasms lasting for several minutes, typically triggered by minor occurrences, such as a draft, loud noise, physical touch or light Possible other signs and symptoms include: - Fever - Sweating - Elevated blood pressure - Rapid heart rate See your doctor for a tetanus booster shot if you have a deep or dirty wound and you haven't had a booster shot in five years. If you aren't sure of when your last booster was, get a booster. Or see your doctor about a tetanus booster for any wound - especially if it might have been contaminated with dirt, animal feces or manure - if you haven't had a booster shot within the past 10 years or aren't sure of when you were last vaccinated. Spores of the bacteria that cause tetanus, Clostridium tetani, are found in soil, dust and animal feces. When they enter a deep flesh wound, spores grow into bacteria that can produce a powerful toxin, tetanospasmin, which impairs the nerves that control your muscles (motor neurons). The toxin can cause muscle stiffness and spasms - the major signs of tetanus. Nearly all cases of tetanus occur in people who have never been vaccinated or adults who haven't kept up with their 10-year booster shots. You can't catch tetanus from a person who has it. The following increase your likelihood of getting tetanus: - Failure to get vaccinated or to keep up to date with booster shots against tetanus - An injury that lets tetanus spores into the wound - A foreign body, such as a nail or splinter Tetanus cases have developed from the following: - Puncture wounds - including from splinters, body piercings, tattoos, injection drugs - Gunshot wounds - Compound fractures - Burns - Surgical wounds - Injection drug use - Animal or insect bites - Infected foot ulcers - Dental infections - Infected umbilical stumps in newborns born of inadequately immunized mothers Once tetanus toxin has bonded to your nerve endings it is impossible to remove. Complete recovery from a tetanus infection requires new nerve endings to grow, which can take up to several months. Complications of tetanus infection may include: - Broken bones. The severity of spasms may cause the spine and other bones to break. - Blockage of a lung artery (pulmonary embolism). A blood clot that has traveled from elsewhere in your body can block the main artery of the lung or one of its branches. - Death. Severe tetanus-induced (tetanic) muscle spasms can interfere with or stop your breathing. Respiratory failure is the most common cause of death. Lack of oxygen may also induce cardiac arrest and death. Pneumonia is another cause of death. Doctors diagnose tetanus based on a physical exam, medical and immunization history, and the signs and symptoms of muscle spasms, stiffness and pain. Laboratory tests generally aren't helpful for diagnosing tetanus. Since there's no cure for tetanus, treatment consists of wound care, medications to ease symptoms and supportive care. Wound care Cleaning the wound is essential to preventing growth of tetanus spores. This involves removing dirt, foreign objects and dead tissue from the wound. Medications - Antitoxin. Your doctor may give you a tetanus antitoxin, such as tetanus immune globulin. However, the antitoxin can neutralize only toxin that hasn't yet bonded to nerve tissue. - Antibiotics. Your doctor may also give you antibiotics, either orally or by injection, to fight tetanus bacteria. - Vaccine. All people with tetanus should receive the tetanus vaccine as soon as they're diagnosed with the condition. - Sedatives. Doctors generally use powerful sedatives to control muscle spasms. - Other drugs. Other medications, such as magnesium sulfate and certain beta blockers, might be used to regulate involuntary muscle activity, such as your heartbeat and breathing. Morphine might be used for this purpose as well as sedation. Supportive therapies Severe tetanus infection often requires a long stay in an intensive care setting. Since sedatives can inhibit breathing, you might temporarily need a ventilator. Puncture wounds or other deep cuts, animal bites, or particularly dirty wounds put you at increased risk of tetanus infection. Get medical attention if the wound is deep and dirty, and particularly if you're unsure of when you were last vaccinated. Leave unclean wounds open to avoid trapping bacteria in the wound with a bandage. Your doctor may need to clean the wound, prescribe an antibiotic and give you a booster shot of the tetanus toxoid vaccine. If you've previously been immunized, your body should quickly make the needed antibodies to protect you against tetanus. If you have a minor wound, these steps will help prevent tetanus: - Control bleeding. Apply direct pressure to control bleeding. - Keep the wound clean. After the bleeding stops, rinse the wound thoroughly with clean running water. Clean the area around the wound with soap and a washcloth. If something is embedded in a wound, see your doctor. - Use an antibiotic. After you clean the wound, apply a thin layer of an antibiotic cream or ointment, such as the multi-ingredient antibiotics Neosporin and Polysporin. These antibiotics won't make the wound heal faster, but they can discourage bacterial growth and infection. Certain ingredients in some ointments can cause a mild rash in some people. If a rash appears, stop using the ointment. - Cover the wound. Exposure to the air might speed healing, but bandages can keep the wound clean and keep harmful bacteria out. Blisters that are draining are vulnerable. Keep them covered until a scab forms. - Change the dressing. Apply a new dressing at least once a day or whenever the dressing becomes wet or dirty to help prevent infection. If you're allergic to the adhesive used in most bandages, switch to adhesive-free dressings or sterile gauze and paper tape. | input | 2 | 320 | 63 | 962 |
how common is cystic fibrosis | instruction | 0 | 333 | 63 | 999 |
Cystic Fibrosis affects males and females of all racial and ethnic groups. However, it is most prevalent among Latinos and American Indians, especially the Pueblo and Zuni. Cystic Fibrosis is less common among African Americans and Asian Americans. In all, more than 10 million Americans are carriers of a faulty CF gene. | output | 1 | 333 | 63 | 1,000 |
Cystic Fibrosis: 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. 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 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 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. 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. 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. 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. 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. | input | 2 | 333 | 63 | 1,001 |
how common is cystic fibrosis | instruction | 0 | 335 | 63 | 1,005 |
Cystic Fibrosis is a disease that causes the build up of mucus, mainly in the lungs and digestive tract. It is one of the most common chronic lung diseases in children and young adults. | output | 1 | 335 | 63 | 1,006 |
Cystic fibrosis: Cystic fibrosis is a disease that causes thick, sticky mucus to build up in the lungs, digestive tract, and other areas of the body. It is one of the most common chronic lung diseases in children and young adults. It is a life-threatening disorder. Cystic fibrosis (CF) is a disease that is passed down through families. It is caused by a defective gene that makes the body produce abnormally thick and sticky fluid, called mucus. This mucus builds up in the breathing passages of the lungs and in the pancreas. The buildup of mucus results in life-threatening lung infections and serious digestion problems. The disease may also affect the sweat glands and a man's reproductive system. Many people carry a CF gene, but do not have symptoms. This is because a person with CF must inherit 2 defective genes, 1 from each parent. Some white Americans have the CF gene. It is more common among those of northern or central European descent. Most children with CF are diagnosed by age 2. For a small number, the disease is not detected until age 18 or older. These children often have a milder form of the disease. Symptoms in newborns may include: - Delayed growth - Failure to gain weight normally during childhood - No bowel movements in first 24 to 48 hours of life - Salty-tasting skin Symptoms related to bowel function may include: - Belly pain from severe constipation - Increased gas, bloating, or a belly that appears swollen (distended) - Nausea and loss of appetite - Stools that are pale or clay-colored, foul smelling, have mucus, or that float - Weight loss Symptoms related to the lungs and sinuses may include: - Coughing or increased mucus in the sinuses or lungs - Fatigue - Nasal congestion caused by nasal polyps - Repeated episodes of pneumonia (symptoms of pneumonia in someone with cystic fibrosis include fever, increased coughing and shortness of breath, increased mucus, and loss of appetite) - Sinus pain or pressure caused by infection or polyps Symptoms that may be noticed later in life: - Infertility (in men) - Repeated inflammation of the pancreas (pancreatitis) - Respiratory symptoms - Clubbed fingers A blood test is done to help detect CF. The test looks for changes in the CF gene. Other tests used to diagnose CF include: - Immunoreactive trypsinogen (IRT) test is a standard newborn screening test for CF. A high level of IRT suggests possible CF and requires further testing. - Sweat chloride test is the standard diagnostic test for CF. A high salt level in the person's sweat is a sign of the disease. Other tests that identify problems that can be related to CF include: - Chest x-ray or CT scan - Fecal fat test - Lung function tests - Measurement of pancreatic function - Secretin stimulation test - Trypsin and chymotrypsin in stool - Upper GI and small bowel series An early diagnosis of CF and treatment plan can improve both survival and quality of life. Follow-up and monitoring are very important. When possible, care should be received at a cystic fibrosis specialty clinic. When children reach adulthood, they should transfer to a cystic fibrosis specialty center for adults. Treatment for lung problems includes: - Antibiotics to prevent and treat lung and sinus infections. They may be taken by mouth, or given in the veins or by breathing treatments. People with CF may take antibiotics only when needed, or all the time. Doses are often higher than normal. - Inhaled medicines to help open the airways. - Other medicines that are given by a breathing treatment to thin mucus and make it easier to cough up are DNAse enzyme. therapy and highly concentrated salt solutions (hypertonic saline). - Flu vaccine and pneumococcal polysaccharide vaccine (PPV) yearly (ask your health care provider). - Lung transplant is an option in some cases. - Oxygen therapy may be needed as lung disease gets worse. Lung problems are also treated with therapies to thin the mucus. This makes it easier to cough the mucus out of the lungs. These methods include: - Activity or exercise that causes you to breathe deeply - Devices that are used during the day to help clear the airways of too much mucus - Manual chest percussion (or chest physiotherapy), in which a family member or a therapist lightly claps the person's chest, back, and area under the arms Treatment for bowel and nutritional problems may include: - A special diet high in protein and calories for older children and adults - Pancreatic enzymes to help absorb fats and protein, which are taken with every meal - Vitamin supplements, especially vitamins A, D, E, and K - Your provider can advise other treatments if you have very hard stools Ivacaftor is a medicine that treats certain types of CF. It improves the function of one of the defective genes that causes CF. As a result, there is less buildup of thick mucus in the lungs. Other CF symptoms are improved as well. Care and monitoring at home should include: - Avoiding smoke, dust, dirt, fumes, household chemicals, fireplace smoke, and mold or mildew. - Giving plenty of fluids, especially to infants and children in hot weather, when there is diarrhea or loose stools, or during extra physical activity. - Exercising 2 or 3 times each week. Swimming, jogging, and cycling are good options. - Clearing or bringing up mucus or secretions from the airways. This must be done 1 to 4 times each day. Patients, families, and caregivers must learn about doing chest percussion and postural drainage to help keep the airways clear. You can ease the stress of illness by joining a cystic fibrosis support group. Sharing with others who have common experiences and problems can help your family to not feel alone. Most children with CF stay in good health until they reach adulthood. They are able to take part in most activities and attend school. Many young adults with CF finish college or find jobs. Lung disease eventually worsens to the point where the person is disabled. Today, the average life span for people with CF who live to adulthood is about 37 years. Death is most often caused by lung complications. The most common complication is chronic respiratory infection. Other complications include: - Bowel problems, such as gallstones, intestinal blockage, and rectal prolapse - Coughing up blood - Chronic respiratory failure - Diabetes - Infertility - Liver disease or liver failure, pancreatitis, biliary cirrhosis - Malnutrition - Nasal polyps and sinusitis - Osteoporosis and arthritis - Pneumonia that keeps coming back - Pneumothorax - Right-sided heart failure (cor pulmonale) Call your provider if an infant or child has symptoms of CF, and experiences: - Fever, increased coughing, changes in sputum or blood in sputum, loss of appetite, or other signs of pneumonia - Increased weight loss - More frequent bowel movements or stools that are foul-smelling or have more mucus - Swollen belly or increased bloating Call your provider if a person with CF develops new symptoms or if symptoms get worse, particularly severe breathing difficulty or coughing up blood. CF cannot be prevented. Screening those with a family history of the disease may detect the CF gene in many carriers. 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. | input | 2 | 335 | 63 | 1,007 |
how do you check for lupus? | instruction | 0 | 352 | 63 | 1,056 |
It may take months or years for your doctor to diagnose lupus (system lupus erythematosus). Your doctor may use many tools to make a diagnosis, as there is no single test to diagnose lupus. These will include examination of your medical history, a complete physical exam, blood samples, or kidneys for laboratory tests. | output | 1 | 352 | 63 | 1,057 |
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