diff --git "a/validate.csv" "b/validate.csv" new file mode 100644--- /dev/null +++ "b/validate.csv" @@ -0,0 +1,243 @@ +key,question,text,summ_abs,summ_ext +10,What bone graft materials are used for spinal fusion?,"A bone graft can be taken from the person's own healthy bone (this is called an autograft).Or, it can be taken from frozen, donated bone (allograft).In some cases, a manmade (synthetic) bone substitute is used.You will be asleep and feel no pain (general anesthesia).During surgery, the surgeon makes a cut over the bone defect.The bone graft can be taken from areas close to the bone defect or more commonly from the pelvis.The bone graft is shaped and inserted into and around the area.The bone graft can be held in place with pins, plates, or screws. +You will be asleep and feel no pain (general anesthesia).The doctor will make a surgical cut (incision)to view the spine.Other surgery, such as a diskectomy, laminectomy, or a foraminotomy, is almost always done first.Spinal fusionmay be done: - On your back or neck over the spine.You will be lying face down.Muscles and tissue will be separated to expose the spine.- On your side, if you are having surgery on your lower back.The surgeon will use tools called retractors to gently separate, hold the soft tissues and blood vessels apart, and have room to work. -With a cut on the front of the neck, toward the side.The surgeon will use a graft (such as bone) to hold (or fuse) the bones together permanently.There are several ways of fusing vertebrae together: - Strips of bone graft materialmay be placed over the back part of the spine.- Bone graft material may be placed between the vertebrae.- Special cages may be placed between the vertebrae.These cages are packed with bone graft material.The surgeon may get the bone graft from different places: - From another part of your body (usually around your pelvic bone).This is called an autograft.Your surgeon will make a small cut over your hip and remove some bone from the back of the rim of the pelvis.- From a bone bank.This is called an allograft.- A synthetic bone substitute can also be used.The vertebrae may also fixed together with rods, screws, plates, or cages.They are used to keep the vertebrae from moving until the bone grafts are fully healed.Surgery can take 3to 4 hours. +","Bone grafts called autograft can be taken from person's own body.If other person's bone is used, it is called allograft.Synthetic bone materials could also be used.Metal rods and screws could be used to hold bone grafts in place.","A bone graft can be taken from the person's own healthy bone (this is called an autograft).Or, it can be taken from frozen, donated bone (allograft).In some cases, a manmade (synthetic) bone substitute is used.The vertebrae may also fixed together with rods, screws, plates, or cages.They are used to keep the vertebrae from moving until the bone grafts are fully healed." +14,What treats herpes simplex?,"Antiviral eye drops Antiviral drugs taken by mouth or vein Corticosteroid eye drops and drops that dilate the pupilSometimes removal of infected and damaged eye cells Treatment of herpes simplex keratitis should be started as soon as possible.The doctor may prescribe an antiviral drug, such as trifluridine eye drop or ganciclovir eye gel.Acyclovir, another antiviral drug, can be taken by mouth or by vein (intravenously).The antiviral drug valacyclovir can also be taken by mouth.Deep infections that cause a lot of inflammation may require use of corticosteroid drops and drops that dilate the pupil, such as cyclopentolate, atropine or scopolamine.Occasionally, to help speed healing, an ophthalmologist (a medical doctor who specializes in the evaluation and treatmentsurgical and nonsurgicalof eye disorders) gently swabs the cornea with a soft cotton-tipped applicator to remove infected and damaged cells. +Herpes simplex encephalitis is a rare neurological condition that is characterized by inflammation of the brain (encephalitis).People affected by this condition may experience a headache and fever for up to 5 days, followed by personality and behavioral changes; seizures ; hallucinations; and altered levels of consciousness.Without early diagnosis and treatment, severe brain damage or even death may occur.Herpes simplex encephalitis is caused by a virus called the herpes simplex virus.Most cases are associated with herpes simplex virus type I (the cause of cold sores or fever blisters), although rare cases can be caused by herpes simplex virus type II (genital herpes).It is poorly understood why some people who are infected with herpes simplex virus develop herpes simplex encephalitis while others do not.Changes ( mutations ) in genes such as TLR3 and TRAF3 have been observed suggesting there may be a genetic component in some cases.Treatment consists of antiviral therapy.[1][2] +No current antiviral treatments can eradicate HSV infection, and treatment of a first oral or genital infection does not prevent chronic infection of nerves.However, during recurrences, antiviral drugs such as acyclovir, valacyclovir, or famciclovir, may relieve discomfort slightly and help symptoms resolve a day or two sooner (see table Some Antiviral Drugs for Herpesvirus Infections).Treatment is most effective if started early, usually within a few hours after symptoms startpreferably at the first sign of tingling or discomfort, before blisters appear.For people who have frequent, painful attacks, the number of outbreaks can be reduced by taking antiviral drugs every day indefinitely (called suppressive therapy).However, taking antiviral drugs does not necessarily prevent infected people from transmitting the infection.Most antiviral drugs are available by prescription only.Penciclovir cream, applied every 2 hours during waking hours, can shorten the healing time and duration of symptoms of a cold sore by about a day.Nonprescription creams containing docosanol (applied 5 times a day) may provide some relief.Acyclovir, valacyclovir, or famciclovir taken by mouth for up to a few days may be the most effective treatment for recurring cold sores.Severe HSV infections, including herpes encephalitis and infections in newborns, are treated with acyclovir given intravenously.If the virus becomes resistant to acyclovir, which is very rare, foscarnet can be given intravenously.People with herpes simplex keratitis may be given trifluridine eye drops.An ophthalmologist should supervise treatment. +","Antiviral drugs relieve discomfort and resolve the symptoms of herpes virus up to two days sooner, if the treatment is started before the blisters form.For cold sores caused by the virus, doctors might recommend acyclovir, valacyclovir, or famciclovir taken by mouth.Severe infections, such as encephalitis or herpes infection in newborns, are treated with acyclovir intravenously.For eye infections, the doctors may also prescribe trifluridine eye drops or ganciclovir eye gel.","No current antiviral treatments can eradicate HSV infection, and treatment of a first oral or genital infection does not prevent chronic infection of nerves.However, during recurrences, antiviral drugs such as acyclovir, valacyclovir, or famciclovir, may relieve discomfort slightly and help symptoms resolve a day or two sooner.Treatment is most effective if started early, usually within a few hours after symptoms start, preferably at the first sign of tingling or discomfort, before blisters appear.Acyclovir, valacyclovir, or famciclovir taken by mouth for up to a few days may be the most effective treatment for recurring cold sores.Treatment of herpes simplex keratitis should be started as soon as possible.The doctor may prescribe an antiviral drug, such as trifluridine eye drop or ganciclovir eye gel.Acyclovir, another antiviral drug, can be taken by mouth or by vein (intravenously).The antiviral drug valacyclovir can also be taken by mouth. Herpes simplex encephalitis is a rare neurological condition that is characterized by inflammation of the brain (encephalitis) Severe HSV infections, including herpes encephalitis and infections in newborns, are treated with acyclovir given intravenously.If the virus becomes resistant to acyclovir, which is very rare, foscarnet can be given intravenously." +19,Is there a cure for pulsatile tinnitus?,"The following tests may be done: Audiometry to test hearing loss Head CT scan Head MRI scan Blood vessel studies (angiography) TREATMENTFixing the problem, if it can be found, may make your symptoms go away.(For example, your provider may remove ear wax.)If TMJ is the cause, your dentist may suggest dental appliances or home exercises to treat teeth clenching and grinding.Talk to your provider about all your current medicines to see if a drug may be causing the problem.This may include over-the-counter drugs, vitamins, and supplements.Do not stop taking any medicine without talking to your provider.Many medicines are used to relieve symptoms of tinnitus, but no drug works for everyone.Your provider may have you try different medicines or combinations of medicines to see what works for you.A tinnitus masker worn like a hearing aid helps some people.It delivers low-level sound directly into the ear to cover the ear noise.A hearing aid may help reduce ear noise and make outside sounds louder.Counseling may help you learn to live with tinnitus.Your provider may suggest biofeedback training to help with stress.Some people have tried alternative therapies to treat tinnitus.These methods have not been proven, so talk to your provider before trying them.Tinnitus can be managed.Talk with your provider about a management plan that works for you.The American Tinnitus Association offers a good resource center and support group. +

Summary

Tinnitus is often described as a ringing in the ears.It also can sound like roaring, clicking, hissing, or buzzing.It may be soft or loud, high pitched or low pitched.You might hear it in either one or both ears.Millions of Americans have tinnitus.People with severe tinnitus may have trouble hearing, working or even sleeping.Causes of tinnitus include Hearing loss in older people Exposure to loud noises Ear and sinus infections Heart or blood vessel problems Meniere's disease Brain tumors Hormonal changes in women Thyroid problems Certain medicines Treatment depends on the cause.Treatments may include hearing aids, sound-masking devices, medicines, and ways to learn how to cope with the noise.NIH: National Institute on Deafness and Other Communication Disorders +Tinnitus can be masked by other sounds: - Low-level music, ticking clocks, or other noises may help you not notice the tinnitus.- Tinnitus is often more noticeable when you go to bed at night because your surroundings are quieter.Any noise in the room, like a humidifier, white noise machine, or dishwasher, can help mask tinnitus and make it less irritating.Learn ways to relax.Stress does not cause tinnitus, but feeling stressed or anxious can worsen it.Avoid caffeine, alcohol, and smoking.Get enough rest.Try sleeping with your head propped up in an elevated position.This lessens head congestion and may make noises less noticeable.Protect your ears and hearing from further damage.Avoid loud places and sounds.Use earplugs if you need them.To prevent tinnitus, wear ear protection when ear damage is possible (such as when you are at loud concerts or around jackhammers).If you have hearing loss, stay away from very loud noises to protect your hearing. +","Tinnitus symptoms may be relieved by medications.Hearing aids, masking by other sounds, such as low-level music or alternative medicine may help managing tinnitus.","Treatment depends on the cause.Treatments may include hearing aids, sound-masking devices, medicines, and ways to learn how to cope with the noise..Many medicines are used to relieve symptoms of tinnitus, but no drug works for everyone.Your provider may have you try different medicines or combinations of medicines to see what works for you.A tinnitus masker worn like a hearing aid helps some people.It delivers low-level sound directly into the ear to cover the ear noise.A hearing aid may help reduce ear noise and make outside sounds louder.Counseling may help you learn to live with tinnitus.Your provider may suggest biofeedback training to help with stress.Some people have tried alternative therapies to treat tinnitus.These methods have not been proven, so talk to your provider before trying them.Tinnitus can be managed.Talk with your provider about a management plan that works for you. Tinnitus can be masked by other sounds: - Low-level music, ticking clocks, or other noises may help you not notice the tinnitus.-" +21,What can diabetic neuropathy lead to?,"Peripheral neuropathy can cause foot problems that lead to blisters and sores.If peripheral neuropathy causes you to lose feeling in your feet, you may not notice pressure or injuries that lead to blisters and sores.Diabetes can make these wounds difficult to heal and increase the chance of infections.These sores and infections can lead to the loss of a toe, foot, or part of your leg.Finding and treating foot problems early can lower the chances that you will develop serious infections.This type of diabetes-related nerve damage can also cause changes to the shape of your feet and toes.A rare condition that can occur in some people with diabetes is Charcot's foot, a problem in which the bones and tissue in your foot are damaged.Peripheral neuropathy can make you more likely to lose your balance and fall, which can increase your chance of fractures and other injuries.The chronic pain of peripheral neuropathy can also lead to grief, anxiety, and depression. +Diabetic neuropathy is a peripheral nerve disorder caused by diabetes or poor blood sugar control.The most common types of diabetic neuropathy result in problems with sensation in the feet.It can develop slowly after many years of diabetes or may occur early in the disease.The symptoms are numbness, pain, or tingling in the feet or lower legs.The pain can be intense and require treatment to relieve the discomfort.The loss of sensation in the feet may also increase the possibility that foot injuries will go unnoticed and develop into ulcers or lesions that become infected.In some cases, diabetic neuropathy can be associated with difficulty walking and some weakness in the foot muscles.There are other types of diabetic-related neuropathies that affect specific parts of the body.For example, diabetic amyotrophy causes pain, weakness and wasting of the thigh muscles, or cranial nerve infarcts that may result in double vision, a drooping eyelid, or dizziness.Diabetes can also affect the autonomic nerves that control blood pressure, the digestive tract, bladder function, and sexual organs.Problems with the autonomic nerves may cause lightheadedness, indigestion, diarrhea or constipation, difficulty with bladder control, and impotence. +Autonomic neuropathy is damage to nerves that control your internal organs.Autonomic neuropathy can lead to problems with yourheart rate and blood pressure digestive system bladder sex organs sweat glands eyes ability to sense hypoglycemia, also called low blood glucose or low blood sugar-a condition called hypoglycemia unawareness +Although different types of diabetic neuropathy can affect people who have diabetes, research suggests that up to one-half of people with diabetes have peripheral neuropathy.1,2 More than 30 percent of people with diabetes have autonomic neuropathy.2The most common type of focal neuropathy is carpal tunnel syndrome, in which a nerve in your wrist is compressed.Although less than 10 percent of people with diabetes feel symptoms of carpal tunnel syndrome, about 25 percent of people with diabetes have some nerve compression at the wrist.2Other focal neuropathies and proximal neuropathy are less common. +Your symptoms depend on which type of diabetic neuropathy you have.In peripheral neuropathy, some people may have a loss of sensation in their feet, while others may have burning or shooting pain in their lower legs.Most nerve damage develops over many years, and some people may not notice symptoms of mild nerve damage for a long time.In some people, severe pain begins suddenly. +","Diabetic neuropathy can lead to various complications depending on the type of neuropathy.Peripheral neuropathy leads to loss of sensation in the legs and feet, which in turn, could lead to unnoticed injuries that could develop into ulcers or deformities.Alternatively, peripheral neuropathy could cause burning pains in the feet that could cause depression and anxiety. Focal neuropathy could cause carpal tunnel syndrome.Diabetic amyotrophy causes pain, weakness and atrophy of the muscles or damage to cranial nerves that could cause double vision, drooping eyelid, or dizziness.Damage to the autonomic nerves might cause lightheadedness, indigestion, diarrhea or constipation, difficulty with bladder control, and impotence.","Your symptoms depend on which type of diabetic neuropathy you have.In peripheral neuropathy, some people may have a loss of sensation in their feet, while others may have burning or shooting pain in their lower legs.The loss of sensation in the feet may also increase the possibility that foot injuries will go unnoticed and develop into ulcers or lesions that become infected.In some cases, diabetic neuropathy can be associated with difficulty walking and some weakness in the foot muscles.A rare condition that can occur in some people with diabetes is Charcot's foot, a problem in which the bones and tissue in your foot are damaged.Peripheral neuropathy can make you more likely to lose your balance and fall, which can increase your chance of fractures and other injuries.The chronic pain of peripheral neuropathy can also lead to grief, anxiety, and depression.The most common type of focal neuropathy is carpal tunnel syndrome, in which a nerve in your wrist is compressed.diabetic amyotrophy causes pain, weakness and wasting of the thigh muscles, or cranial nerve infarcts that may result in double vision, a drooping eyelid, or dizziness.Diabetes can also affect the autonomic nerves that control blood pressure, the digestive tract, bladder function, and sexual organs.Problems with the autonomic nerves may cause lightheadedness, indigestion, diarrhea or constipation, difficulty with bladder control, and impotence." +22,Is it safe to have ultrasound with a defibrillator?,"Summary : Ultrasound uses high-frequency sound waves to make images of organs and structures inside the body.How the Test is Performed : An ultrasound machine makes images so that organs inside the body can be examined.The machine sends out high-frequency sound waves, which reflect off body structures.A computer receives the waves and uses them to create a picture.Unlike with an x-ray or CT scan, this test does not use ionizing radiation.The test is done in the ultrasound or radiology department.- You will lie down for the test.- A clear, water-based gel is applied to the skin on the area to be examined.The gel helps with the transmission of the sound waves.- A handheld probe called a transducer is moved over the area being examined.You may need to change position so that other areas can be examined.How to Prepare for the Test : Your preparation will depend on the part of the body being examined.How the Test Will Feel : Most of the time, ultrasound procedures do not cause discomfort.The conducting gel may feel a little cold and wet.Why the Test is Performed : The reason for the test will depend on your symptoms.Normal Results : Results are considered normal if the organs and structures being examined look ok.What Abnormal Results Mean : The meaning of abnormal results will depend on the part of the body being examined and the problem found.Talk to your health care provider about your questions and concerns.Risks : There are no known risks.The test does not use ionizing radiation.Considerations : Some types of ultrasound tests need to be done with a probe that is inserted into your body.Talk to your provider about how your test will be done. +Current ultrasound techniques appear to be safe.Ultrasound does not involve radiation. +",There are no known risks or contraindications for ultrasound tests.,Ultrasound uses high-frequency sound waves to make images of organs and structures inside the body.Risks : There are no known risks. Current ultrasound techniques appear to be safe.Ultrasound does not involve radiation. +26,What are the recommended treatments for primary biliary cholangitis (PBC)?,"There is no known cure.Treatment includes Drugs to relieve symptoms, primarily itching Ursodeoxycholic acid to slow the progression of liver damage Obeticholic acid is a new medication that was approved by the Food and Drug Administration (FDA) in 2016 for the treatment of primary biliary cholangitis (PBC).This medication is intended for use in people in whom ursodeoxycholic acid is not working well.It should be used with caution in people with advanced liver disease.Treatment of complications Eventually liver transplantationNo alcohol should be consumed.Drugs that may damage the liver are stopped.Cholestyramine may control itchiness, as may rifampin, naltrexone (an opioid), sertraline, or ursodeoxycholic acid plus ultraviolet light.Ursodeoxycholic acid, particularly if used before the disorder is advanced, reduces liver damage, prolongs life, and delays the need for liver transplantation.Obetacholic acid is a newly FDA-approved medication which has been proven to improve liver-related blood tests in many people with PBC for whom ursodeoxycholic acid alone is not effective.Supplements of calcium and vitamin D are needed to help prevent osteoporosis or slow its progression.Weight-bearing exercises, bisphosphonates, or raloxifene may also help prevent or slow osteoporosis.Vitamin A, D, E, and K supplements may be needed to correct vitamin deficiencies.Vitamins A, D, and E can be taken by mouth.Vitamin K is given by injection.Liver transplantation is the best treatment when the disorder is advanced.It can prolong life.After transplantation, PBC recurs in some people, but it rarely becomes severe. +You should eat a well-balanced and nutritious diet.Good nutrition is important in all stages of primary biliary cholangitis to help your liver work properly and manage complications.When primary biliary cholangitis leads to cirrhosis, you may develop malnutrition because cirrhosis can causeloss of appetite, which will cause you to eat less changes in your metabolism reduced absorption of nutrientsYour doctor can recommend a healthy eating plan that is well balanced and provides enough calories and nutrients.If you have vitamin deficiencies, your doctor may recommend foods that are high in vitamins A, D, E, and K. Your doctor may recommend that you eat foods high in calcium and vitamin D to help prevent osteoporosis. +You should avoid eating raw shellfish such as oysters, which can have bacteria that may cause severe infections in people with liver disease.Your doctor may recommend that you make healthy food choices and avoid high-salt foods and foods that are high in fat and carbohydrates, especially those with added sugars.If you have primary biliary cholangitis, your doctor will recommend that you quit smoking and stop drinking alcohol or, at least, limit your intake to no more than one or two drinks per week.If you have primary biliary cholangitis and cirrhosis, your doctor will recommend complete avoidance of alcohol. +Doctors treat the complications of primary biliary cholangitis with medicines and dietary supplements.Your doctor may recommend changes in your diet and lifestyle.High blood cholesterol levels.If you have higher-than-normal blood cholesterol levels, your doctor may prescribe medicines called statins and recommend lifestyle changes.Osteoporosis.For osteoporosis, your doctor may prescribe medicines that slow or stop bone loss and improve bone density.Your doctor may recommend dietary supplements of calcium and vitamin D.Fat-soluble vitamin deficiencies.For fat-soluble vitamin deficiencies, your doctor may recommend dietary supplements of vitamins A, D, E, and K. Follow your doctor's instructions on the type and amount of vitamins you should take.Cirrhosis.If primary biliary cholangitis leads to cirrhosis, doctors can treat the health problems related to cirrhosis with medicines, surgery, and other medical procedures.If cirrhosis leads to liver failure, you may need a liver transplant. +The cause is not clear but is probably an autoimmune reaction (in which the immune system attacks the bodys own tissues).Primary biliary cholangitis often occurs in people with autoimmune disorders, such as rheumatoid arthritis, scleroderma, Sjgren syndrome, or autoimmune thyroiditis.An autoimmune cause is also thought possible because more than 95% of people with PBC have certain abnormal antibodies in their blood.These antibodies attack mitochondria (tiny structures that produce energy in cells).However, these antibodies are not involved in the destruction of the bile ducts.Other immune cells attack the bile ducts.What triggers this attack is unknown, but it may be exposure to a virus or a toxic substance. +","Treatments for primary biliary cholangitis (PBC) include drugs to relieve symptoms, such as itchiness that may be relieved by Cholestyramine, rifampin, naltrexone (an opioid), sertraline, or ursodeoxycholic acid plus ultraviolet light.Ursodeoxycholic acid may also reduces liver damage, alone or in combination with obetacholic acid. These drugs may delay the need for liver transplantation.Changes in diet and lifestyle are recommended: quitting smoking and drinking alcohol, taking calcium and vitamin D weight-bearing exercises, bisphosphonates, or raloxifene to prevent or slow osteoporosis.Vitamin deficiencies may require taking A, D, E, and K supplements.","Primary biliary cholangitis often occurs in people with autoimmune disorders, such as rheumatoid arthritis, scleroderma, Sjgren syndrome, or autoimmune thyroiditis.An autoimmune cause is also thought possible because more than 95% of people with PBC have certain abnormal antibodies in their blood..Ifyou have primary biliary cholangitis, your doctor will recommend that you quit smoking and stop drinking alcohol or, at least, limit your intake to no more than one or two drinks per week. There is no known cure.Treatment includes Drugs to relieve symptoms, primarily itching Ursodeoxycholic acid to slow the progression of liver damage Cholestyramine may control itchiness, as may rifampin, naltrexone (an opioid), sertraline, or ursodeoxycholic acid plus ultraviolet light.Ursodeoxycholic acid, particularly if used before the disorder is advanced, reduces liver damage, prolongs life, and delays the need for liver transplantation.Obetacholic acid is a newly FDA-approved medication which has been proven to improve liver-related blood tests in many people with PBC for whom ursodeoxycholic acid alone is not effective.Doctors treat the complications of primary biliary cholangitis with medicines and dietary supplements.Your doctor may recommend changes in your diet and lifestyle.Supplements of calcium and vitamin D are needed to help prevent osteoporosis or slow its progression.Weight-bearing exercises, bisphosphonates, or raloxifene may also help prevent or slow osteoporosis.Vitamin A, D, E, and K supplements may be needed to correct vitamin deficiencies." +27,Is there a link between the post-concussion syndrome and occipital and trigeminal neuralgias?,"Post-concussion syndrome is when you have symptoms after your concussion.You may have: Headaches Dizziness and light-headedness Being tired, easily annoyed, or sensitive to light or noise Trouble paying attention Poor memory Depression and anxiety Usually these symptoms go away in a week or two.Less often, these symptoms last for months. +Trigeminal neuralgia (TN), also called tic douloureux, is a chronic pain condition that causes extreme, sporadic, sudden burning or shock-like face pain.The painseldomlasts more than a few seconds or a minute or twoper episode.The intensity of pain can be physically and mentally incapacitating.TN pain is typically felt on one side of the jaw or cheek.Episodes can last for days, weeks, or months at a time and then disappear for months or years.In the days before an episode begins, some patients may experience a tingling or numbing sensation or a somewhat constant and aching pain.The attacks often worsen over time, with fewer and shorter pain-free periods before they recur.The intense flashes of pain can be triggered by vibration or contact with the cheek (such as when shaving, washing the face, or applying makeup), brushing teeth, eating, drinking, talking, or being exposed to the wind.TN occurs most often in people over age 50, but it can occur at any age, and is more common in women than in men.There is some evidence that the disorder runs in families, perhaps because of an inherited pattern of blood vessel formation.Although sometimes debilitating, the disorder is not life-threatening.The presumed cause of TN is a blood vessel pressing on the trigeminal nerve in the head as it exits the brainstem.TN may be part of the normal aging process but in some cases it is the associated with another disorder, such as multiple sclerosis or other disorders characterized by damage to the myelin sheath that covers certain nerves. +Trigeminal neuralgia (TN) is a type of chronic pain that affects your face.It causes extreme, sudden burning or shock-like pain.It usually affects one side of the face.Any vibration on your face, even from talking, can set it off.The condition may come and go, disappearing for days or even months.But the longer you have it, the less often it goes away.TN usually affects people over 50, especially women.The cause is probably a blood vessel pressing on the trigeminal nerve, one of the largest nerves in the head.Tumors and multiple sclerosis can also cause TN, but in some cases the cause is unknown.There is no single test to diagnose TN.It can be hard to diagnose, since many other conditions can cause facial pain.Treatment options include medicines, surgery, and complementary techniques.NIH: National Institute of Neurological Disorders and Stroke +","Post-concussion syndrome is characterized by the following symptoms that last a week or two, or less often for months: headaches, dizziness and light-headedness, fatigue, being, easily annoyed, or sensitive to light or noise, troubles concentrating, poor memory, depression and anxiety.Whereas ttrigeminal neuralgia (TN) typically affects one side of the face, with attacks lasting days, weeks or months and worsening over time.TN could be caused by a blood vessel pressing on the trigeminal nerve, tumor or multiple sclerosis.Sometimes the causes are unknown.","Post-concussion syndrome is when you have symptoms after your concussion.You may have: Headaches Dizziness and light-headedness Being tired, easily annoyed, or sensitive to light or noise Trouble paying attention Poor memory Depression and anxiety Usually these symptoms go away in a week or two.Less often, these symptoms last for months.TN pain is typically felt on one side of the jaw or cheek.Episodes can last for days, weeks, or months at a time and then disappear for months or years.In the days before an episode begins, some patients may experience a tingling or numbing sensation or a somewhat constant and aching pain.The attacks often worsen over time, with fewer and shorter pain-free periods before they recur.TN usually affects people over 50, especially women.The cause is probably a blood vessel pressing on the trigeminal nerve, one of the largest nerves in the head.Tumors and multiple sclerosis can also cause TN, but in some cases the cause is unknown. There is some evidence that the disorder runs in families, perhaps because of an inherited pattern of blood vessel formation.TN may be part of the normal aging process but in some cases it is the associated with another disorder, such as multiple sclerosis or other disorders characterized by damage to the myelin sheath that covers certain nerves." +28,Can you help me find a clinic that specializes in treatment for atopic eczema?,"NIAID conducts and supports basic research in allergy and immunology that increases our understanding of the immune system and how it contributes to the development of atopic dermatitis and its complications.NIAID also funds patient-centered research to explore the genetic determinants of eczema and to evaluate new strategies to prevent and treat the disease.To learn about risk factors for eczema, different types of eczema and current prevention and treatment strategies visit the National Library of Medicine page on eczema. +SKIN CARE AT HOME Keep the skin moistby lubricating or moisturizing the skin.Use ointments (such as petroleum jelly), creams, or lotions.Moisturizers: - Should be free of alcohol, scents, dyes, fragrances, or other chemicals.- Work best when they're applied to skin that is wet or damp.After washing or bathing, pat the skin dry and then apply the moisturizer right away.- May be used at different times of the day.For the most part, you can apply these substances as often as you need to keep your skin soft.MEDICINES Medicines that help relieve itching can be bought without a prescription.- Take an anti-itch medicine before bed if you scratch in your sleep.- Some antihistamines cause little or no sleepiness.These include fexofenadine (Allegra), loratadine (Claritin, Alavert), cetirizine (Zyrtec) - Others can make you sleepy, including diphenhydramine (Benadryl).Your doctor may prescribe topical medicines.These are ointments or creams that are applied to the skin.Types include: - Corticosteroids, which calm swollen or inflamed skin - Immunomodulators, which help keep the immune system from reacting too strongly Follow instructions on how to apply these medicines.Do not apply more than you're supposed to use.If symptoms are severe, you may need other treatments, such as: - Corticosteroid pills - Corticosteroid shots - Coal tar preparations - Phototherapy (ultraviolet light therapy) +Eczema Wet Wrap TreatmentCreditNIAIDResearchers at NIAID and other institutions are studying an innovative treatment for severe eczema called wet wrap therapy.It includes three lukewarm baths a day, each followed by an application of topical medicines and moisturizer that is sealed in by a wrap of wet gauze.People with severe eczema have come to the National Institutes of Health Clinical Center in Bethesda, Maryland, for research evaluation.Treatment may include wet wrap therapy to bring the condition under control.Patients and their caregivers also receive training on home-based skin care to properly manage flare-ups once they leave the hospital.For more information, see the NIAID Eczema Photo Essay and video, Helping Kids with Severe Eczema. +Measures to relieve itching Sometimes corticosteroids, immune system?modulating drugs, or ultraviolet light therapyNo cure exists, but itching can be relieved with topical drugs or drugs taken by mouth.Treatments of itching can usually be given at home, but people who have exfoliative dermatitis, cellulitis, or eczema herpeticum may need to be hospitalized.Certain skin care measures are helpful: Using soap substitutes instead of regular soap Keeping the skin moist, either with commercial moisturizers or with petroleum jelly after exposure to water Applying moisturizers immediately after bathing, while the skin is damp Bathing only once a day Bathing in water diluted with added colloidal oatmeal Blotting or patting the skin dry after bathing rather than rubbing Parents should cut their children's fingernails short to minimize scratching and thus reduce the risk of infection.If a skin infection does occur, antibiotics may be given by mouth, applied to the skin, or both.Specific treatments include applying a corticosteroid ointment or cream.To limit the use of corticosteroids in people being treated for long periods (because long-term use can lead to thinning of the skin), doctors sometimes replace the corticosteroids with petroleum jelly or noncorticosteroid treatments for eczema, for a week or more at a time.Ointments or creams containing an immune system?modulating drug, such as tacrolimus or pimecrolimus, also are helpful and can limit the need for long-term corticosteroid use.Some doctors prescribe such drugs first (for example, possibly crisaborole ointment).Phototherapy (exposure to ultraviolet light) may help, especially therapy using narrowband ultraviolet B light.For severe cases, wet wraps (corticosteroid or immunomodulator applied to wet skin, wrapped with a moist layer and then a dry layer) are helpful.Also, the immune system can be suppressed with cyclosporine, azathioprine, or mycophenolate mofetil taken by mouth, or injections of biologics such as dupilumab.Eczema herpeticum is treated with the antiviral drug acyclovir. +Doctors cant cure eczema, but to help with your symptoms, they may suggest that you: Apply medicines, such as corticosteroid and other creams to lessen itching and heal your skin Keep your skin moist with cool water compresses, lotions, petroleum jelly, or vegetable oil after baths or showers Take a bath or shower only once a day to keep your skin from getting dry Take a bath in water with a small amount of bleach, colloidal oatmeal (a product made of finely ground oatmeal), ortar medicine Blot your skin dry after a bath or shower instead of rubbing it dry If your eczema is severe, your doctor may prescribe corticosteroid pills or other medicines that slow down your immune system.If you're an adult, your doctor may try phototherapy.With phototherapy your skin is exposed to a special ultraviolet light (similar to lights used for tanning).Doctors usually don't use phototherapy on children or adolescents with eczema. +SKIN CARE AT HOMEDaily skin care may cut down on the need for medicines.To help you avoid scratching your rash or skin: Use a moisturizer, topical steroid cream, or other medicine your provider prescribes.Take antihistamine medicines by mouth to reduce severe itching.Keep your fingernails cut short.Wear light gloves during sleep if nighttime scratching is a problem.Keep your skin moist by using ointments (such as petroleum jelly), creams, or lotions 2 to 3 times a day.Choose skin products that do not contain alcohol, scents, dyes, and other chemicals.A humidifier to keep home air moist will also help.Avoid things that make symptoms worse, such as: Foods, such as eggs, that may cause an allergic reaction in a very young child, (always talk to your provider first) Irritants, such as wool and lanolin Strong soaps or detergents, as well as chemicals and solvents Sudden changes in body temperature and stress, which may cause sweating Triggers that cause allergy symptoms When washing or bathing: Expose your skin to water for as short a time as possible.Short, cooler baths are better than long, hot baths.Use gentle body washes and cleansers instead of regular soaps.Do not scrub or dry your skin too hard or for too long.Apply lubricating creams, lotions, or ointment to your skin while it is still damp after bathing.This will help trap moisture in your skin.MEDICINESAt this time, allergy shots are not used to treat atopic dermatitis.Antihistamines taken by mouth may help with itching or allergies.You can often buy these medicines without a prescription.Atopic dermatitis is usually treated with medicines placed directly on the skin or scalp.These are called topical medicines: You will probably be prescribed a mild cortisone (steroid) cream or ointment at first.You may need a stronger medicine if this does not work.Medicines called topical immunomodulators (TIMs) may be prescribed for anyone over 2 years old.Ask your provider about concerns over a possible cancer risk with the use of these medicines.Creams or ointments that contain coal tar or anthralin may be used for thickened areas.Barrier repair creams containing ceramides may be used.Wet-wrap treatment with topical corticosteroids may help control the condition.But, it may lead to an infection.Other treatments that may be used include: Antibiotic creams or pills if your skin is infected Drugs that suppress the immune system Targeted biologic medicines that are designed to affect parts of the immune system involved in atopic dermatitis Phototherapy, a treatment in which your skin is carefully exposed to ultraviolet (UV) light Short-term use of systemic steroids (steroids given by mouth or through a vein) +","The National Institutes of Health supports research of innovative treatments for atopic dermatitis (eczema,) such as wet wrap that seals medications and moisturizers in place.Most treatments can be given at home and daily skin care may reduce the need for medicines.Severe itching can be reduced by antihistamine.To avoid complications, such as inflammation, keep the skin moist with ointments that do not contain irritants, such as alcohol, scents and dyes and avoid other irritants, e.g., foods that cause allergic reactions, wearing wool or using strong detergents.","People with severe eczema have come to the National Institutes of Health Clinical Center in Bethesda, Maryland, for research evaluation.NIAID conducts and supports basic research in allergy and immunology that increases our understanding of the immune system and how it contributes to the development of atopic dermatitis and its complications.NIAID also funds patient-centered research to explore the genetic determinants of eczema and to evaluate new strategies to prevent and treat the disease.Researchers at NIAID and other institutions are studying an innovative treatment for severe eczema called wet wrap therapy.It includes three lukewarm baths a day, each followed by an application of topical medicines and moisturizer that is sealed in by a wrap of wet gauze.Treatments of itching can usually be given at home, but people who have exfoliative dermatitis, cellulitis, or eczema herpeticum may need to be hospitalized. SKIN CARE AT HOME Daily skin care may cut down on the need for medicines.To help you avoid scratching your rash or skin: Use a moisturizer, topical steroid cream, or other medicine your provider prescribes.Take antihistamine medicines by mouth to reduce severe itching.Keep your fingernails cut short.Wear light gloves during sleep if nighttime scratching is a problem.Keep your skin moist by using ointments (such as petroleum jelly), creams, or lotions 2 to 3 times a day.Choose skin products that do not contain alcohol, scents, dyes, and other chemicals.A humidifier to keep home air moist will also help.Avoid things that make symptoms worse, such as: Foods, such as eggs, that may cause an allergic reaction in a very young child, (always talk to your provider first) Irritants, such as wool and lanolin Strong soaps or detergents, as well as chemicals and solvents Sudden changes in body temperature and stress, which may cause sweating" +29,What are the minimally invasive procedures for localized prostate cancer?,"The prostate is a gland found only in men.It's located just below a mans bladder.The tube (urethra) that carries urine from the bladder and out the penis runs right through the middle of the prostate.The prostate also makes fluid that helps keep sperm healthy.Prostate cancer is out-of-control growth of cells in your prostate.Prostate cancer is the most common cancer in men over 50 in the United States Your chance of getting prostate cancer goes up as you get older Prostate cancer may grow very slowly and cause no problems or it may grow quickly and be fatal You usually have no symptoms for a long time As the cancer gets bigger, you may have trouble peeing or see blood in your urine Doctors may suggest screening tests for men over 50, or for those over 40 with risk factors Doctors treat most prostate cancer with surgery or radiation therapy Male Reproductive Organs +Since prostate cancer with a low Gleason score grows very slowly, you may choose not to be treated right away, especially if youre older.Older men with many health problems often die of those conditions before the prostate cancer gets bad.Doctors will do regular checkups and measure your PSA level.They'll do more biopsies to see whether your cancer is growing and needs treatment. +This therapy is not as commonly used and is not as well accepted as other treatments for prostate cancer.Doctors do not know for certain how well cryosurgery works over time.There is not enough data to compare it with standard prostatectomy, radiation treatment, or brachytherapy.It can only treat prostate cancer that has not spread beyond the prostate.Men who cannot have surgery because of their age or other health problems may have cryosurgery instead.It also may be used if cancer comes back after other treatments.It is generally not helpful for men with very large prostate glands. +","Localized prostate cancer that grows slowly may not require treatment, particularly in older men.Regular checkups, PSA-level tests and biopsies will help your doctor decide if you need treatment.Most doctors treat prostate cancer with surgery or radiation therapy.Cryosurgery could be used in some cases, but it is not known yet how well it works compared to brachytherapy (a form of radiation treatment) and surgery.","Since prostate cancer with a low Gleason score grows very slowly, you may choose not to be treated right away, especially if youre older. Doctors will do regular checkups and measure your PSA level.They'll do more biopsies to see whether your cancer is growing and needs treatment.Doctors treat most prostate cancer with surgery or radiation therapy. Doctors do not know for certain how well cryosurgery works over time.There is not enough data to compare it with standard prostatectomy, radiation treatment, or brachytherapy.It can only treat prostate cancer that has not spread beyond the prostate.Men who cannot have surgery because of their age or other health problems may have cryosurgery instead.It also may be used if cancer comes back after other treatments.It is generally not helpful for men with very large prostate glands." +3,Should I leave a meniscus tear untreated if it does not cause problems?,"Two cartilage rings are in the center of each knee.One is on the inside (medial meniscus) and one is on the outside (lateral meniscus).When a meniscus is torn, it is commonly removed by knee arthroscopy.Some people can still have pain after the meniscus is removed.A meniscus transplant places a new meniscus in the knee where the meniscus is missing.This procedure is only done when meniscus tears are so severe that all or nearly all of the meniscus cartilage is torn or has to be removed.The new meniscus can help with knee pain and possibly prevent future arthritis.Meniscus allograft transplantation may be recommended for knee problems such as: Development of early arthritis Inability to play sports or other activities Knee pain Knee that gives way Unstable knee Persistent knee swelling +You may feel a ""pop"" when a meniscus injury occurs.You also may have: Knee pain inside the joint, which gets worse with pressure on the joint Knee swelling that occurs the next day after injury or after activities Knee joint pain when walking Locking or catching of your knee Difficulty squatting After examining your knee, the doctor may order these imaging tests: X-rays to check for damage to the bones and the presence of arthritis in your knee.An MRI of the knee.An MRI machine takes special pictures of the tissues inside your knee.The pictures will show whether these tissues have been stretched or torn.If you have a meniscus tear, you may need: Crutches to walk until the swelling and pain get better A brace to support and stabilize your knee Physical therapy to help improve joint motion and leg strength Surgery to repair or remove the torn meniscus To avoid squatting or twisting movements Treatment may depend on your age, activity level, and where the tear occurs.For mild tears, you may be able to treat the injury with rest and self-care.For other types of tears, or if you are younger in age, you may need knee arthroscopy (surgery) to repair or trim the meniscus.In this type of surgery, small cuts are made to the knee.A small camera and small surgical tools are inserted to repair the tear.A meniscus transplant may be needed if the meniscus tear is so severe that all or nearly all of the meniscus cartilage is torn or has to be removed.The new meniscus can help with knee pain and possibly prevent future arthritis. +","Self-care and rest might be sufficient for a meniscus tear, depending on your age, physical activity, and the location and severity of the tear.","If you have a meniscus tear, you may need: Crutches to walk until the swelling and pain get better A brace to support and stabilize your knee Physical therapy to help improve joint motion and leg strength Surgery to repair or remove the torn meniscus To avoid squatting or twisting movements Treatment may depend on your age, activity level, and where the tear occurs.For mild tears, you may be able to treat the injury with rest and self-care.For other types of tears, or if you are younger in age, you may need knee arthroscopy (surgery) to repair or trim the meniscus." +31,Could you give me information on sarcoidosis?,"Sarcoidosis is a disease in which small clumps of inflammatory cells form in one or more of your organs.The clumps of cells are called granulomas.They aren't cancerous.When you have sarcoidosis, you also have inflammation throughout your body.Doctors dont know what causes sarcoidosis Granulomas most often form in your lungs and lymph nodes, but they can happen in any organ Granulomas in your lungs can make you cough and feel short of breath Inflammation throughout your body can give you fevers, weight loss, and joint pain To tell if you have sarcoidosis, doctors will do a chest x-ray and look at a sample of your tissue under a microscope (biopsy)There's no cure, but sarcoidosis often goes away on its own Doctors can give you medicine to lessen your symptoms +The skin is frequently affected by sarcoidosis.In people of Scandinavian ancestry, sarcoidosis often starts as a rash with raised, tender, red lumps, usually on the shins (erythema nodosum), often accompanied by a fever and joint pain.The rash tends to resolve within a month or two and is less common in American blacks.Prolonged sarcoidosis may lead to the formation of flat patches, raised patches (plaques), or plaques that discolor the nose, cheeks, lips, and ears (lupus pernio).Lupus pernio is most common in black Americans and Puerto Ricans.People with lupus pernio may also develop granulomas in the nasal passage that cause symptoms similar to those of sinusitis. +Doctors dont treat sarcoidosis unless it's causing symptoms.To lessen your symptoms, doctors may have you take: NSAIDs, such as aspirin or ibuprofen, to lessen pain or fever Corticosteroids, such as prednisone, to treat inflammation If corticosteroids don't help, doctors may use stronger medicines that block your immune system.If you have sarcoidosis in your heart, doctors may put in a pacemaker (a small electrical device that doctors put in your chest to help control unusual heart rhythms).Rarely, if sarcoidosis has severely injured your lungs, heart, or liver, you may need an organ transplant. +Many people with sarcoidosis have no symptoms or only mild symptoms.But a few people become very ill.Symptoms depend on what part of your body is affected.General symptoms of sarcoidosis include: Fever Feeling weak and tired No appetite and losing weight Painful, swollen joints Swollen lymph nodes (small bean-shaped organs in your neck, groin, and armpits)Lung symptoms are the most common and include: Trouble breathing Coughing, sometimes coughing up blood Skin symptoms are common and include: Painful red bumps on your shins (erythema nodosum) Flat or raised patches on your nose, cheeks, lips, and ears Eye symptoms include: Red, painful, watery eyes Decreased vision and rarely blindness Heart symptoms are rare but can be dangerous.You may have: Palpitations from a heart rhythm problem, which can be fatal Trouble breathing from heart failure Many other parts of your body can be affected. +Doctors usually suspect sarcoidosis if you have: A lot of swollen lymph nodes An abnormal chest x-ray To tell for sure, doctors usually: Take a sample of your tissue, usually from your lungs, and look at it under a microscope (biopsy)If you have sarcoidosis, doctors will check how your lungs are working using: Pulmonary function tests You'll also have other tests to see what organs are affected.You may have ECG, CT scan, PET scan, an eye examination by an eye specialist, and blood tests. +Sarcoidosis improves or clears up spontaneously in nearly two thirds of people with lung sarcoidosis.Even enlarged lymph nodes in the chest and extensive lung inflammation may disappear in a few months or years.However, the course can be chronic or progressive in up to 30% of people.Serious involvement outside of the chest (for example, of the heart, nervous system, eyes, or liver) occurs in 4 to 7% of people at the beginning of their illness.People with enlarged lymph nodes in the chest but no sign of lung disease have a very good prognosis.People with Lfgren syndrome often have the best prognosis.About 50% of people who once had sarcoidosis have relapses.About 10 to 20% of people with sarcoidosis develop a serious disability due to damage to the eyes, respiratory system, or elsewhere.Sarcoidosis is fatal in 1 to 5% of affected people.Lung scarring leading to respiratory failure and cor pulmonale is the most common cause of death, followed by bleeding due to lung infection caused by Aspergillus. +The exact cause of sarcoidosis is unknown.What is known is that when a person has the disease, tiny clumps of abnormal tissue (granulomas) form in certain organs of the body.Granulomas are clusters of immune cells.The disease can affect almost any organ.It most commonly affects the lungs.Doctors think that having certain genes makes it more likely for a person to develop sarcoidosis.Things that may trigger the disease include infections with bacteria or viruses.Contact with dust or chemicals may also be triggers.The disease is more common in African Americans and white people of Scandinavian heritage.More women than men have the disease.The disease often begins between ages 20 and 40.Sarcoidosis is rare in young children.A person with a close blood relative who has sarcoidosis is nearly 5 times as likely to develop the condition. +

Summary

Sarcoidosis is a disease that leads to inflammation, usually in your lungs, skin, or lymph nodes.It starts as tiny, grain-like lumps, called granulomas.Sarcoidosis can affect any organ in your body.No one is sure what causes sarcoidosis.It affects men and women of all ages and races.It occurs mostly in people ages 20 to 50, African Americans, especially women, and people of Northern European origin.Many people have no symptoms.If you have symptoms, they may include Cough Shortness of breath Weight loss Night sweats Fatigue Tests to diagnose sarcoidosis include chest x-rays, lung function tests, and a biopsy.Not everyone who has the disease needs treatment.If you do, prednisone, a type of steroid, is the main treatment.NIH: National Heart, Lung, and Blood Institute +The organs most affected by sarcoidosis are the lungs.Enlarged lymph nodes at the place where the lungs meet the heart or to the right of the windpipe (trachea) may be seen on a chest x-ray.Sarcoidosis causes inflammation in the lungs that may eventually lead to scarring and the formation of cysts.Fortunately, such progressive scarring occurs infrequently.Occasionally, the fungus Aspergillus can settle in (colonize) the lung cysts, grow, and cause bleeding.Breathing can become difficult.Severe involvement of the lung by sarcoidosis can eventually strain the right side of the heart, causing right-sided heart failure (cor pulmonale). +","Sarcoidosis starts with small lumps of inflammatory cells (called granulomas) that can form in any organ.It is nor known what causes it.Most frequently, granulomas form in the lungs, skin and lymph nodes of 20-50 year-old people primarily of Northern European and African American origins.Many people have no symptoms and in many people with lung sarcoidosis it clears up on its own.General symptoms of sarcoidosis are fever, weakness, painful swollen lymph nodes and joints, loss of appetite and weight loss.Other symptoms depend on the organs affected by sarcoidosis.Lung symptoms include shortness of breath and cough.Skin symptoms include rash that can lead to flat or raised patches on the nose, cheeks, lips, and ears.Eye symptoms include red, painful, watery eyes and decreased vision. To diagnose sarcoidosis, the doctors could use biopsy, x-rays, and other tests.Doctors may prescribe medicines to treat the symptoms, e.g., prednisone, Rarely, sarcoidosis could lead to death from respiratory failure caused by lung scarring , infection with Aspergillus, or damage to heart.","Sarcoidosis is a disease that leads to inflammation, usually in your lungs, skin, or lymph nodes.It starts as tiny, grain-like lumps, called granulomas.Sarcoidosis can affect any organ in your body.No one is sure what causes sarcoidosis.It affects men and women of all ages and races.It occurs mostly in people ages 20 to 50, African Americans, especially women, and people of Northern European origin. The organs most affected by sarcoidosis are the lungs.In people of Scandinavian ancestry, sarcoidosis often starts as a rash with raised, tender, red lumps, usually on the shins (erythema nodosum), often accompanied by a fever and joint pain. Many people have no symptoms.If you have symptoms, they may include Cough Shortness of breath Weight loss Night sweats Fatigue Tests to diagnose sarcoidosis include chest x-rays, lung function tests, and a biopsy.Not everyone who has the disease needs treatment.If you do, prednisone, a type of steroid, is the main treatment.Sarcoidosis improves or clears up spontaneously in nearly two thirds of people with lung sarcoidosis.Even enlarged lymph nodes in the chest and extensive lung inflammation may disappear in a few months or years.However, the course can be chronic or progressive in up to 30% of people.Serious involvement outside of the chest (for example, of the heart, nervous system, eyes, or liver) occurs in 4 to 7% of people at the beginning of their illness.People with enlarged lymph nodes in the chest but no sign of lung disease have a very good prognosis. About 50% of people who once had sarcoidosis have relapses.About 10 to 20% of people with sarcoidosis develop a serious disability due to damage to the eyes, respiratory system, or elsewhere.Sarcoidosis is fatal in 1 to 5% of affected people.Lung scarring leading to respiratory failure and cor pulmonale is the most common cause of death, followed by bleeding due to lung infection caused by Aspergillus." +33,Which treatment is best for persistent severe diarrhea?,"You should avoid foods that may make your diarrhea worse, such asalcoholic beverages drinks and foods containing caffeine dairy products such as milk, cheese, and ice cream fatty and greasy foods drinks and foods containing fructose fruits such as apples, peaches, and pears spicy foods diet drinks and sugarless gum and candies containing sweeteners such as sorbitol, mannitol, and xylitolResearch shows that following a restricted diet does not help treat diarrhea in most cases.Most experts do not recommend fasting or following a restricted diet when you have diarrhea. +These things may help you feel better if you have diarrhea: - Drink 8 to 10 glasses of clear fluids every day.Water is best.- Drink at least 1 cup of liquid every time you have a loose bowel movement.- Eat small meals throughout the day, instead of 3 big meals.- Eat some salty foods, such as pretzels, soup, and sports drinks.- Eat some high potassium foods, such as bananas, potatoes without the skin, and fruit juices.Ask your doctor if you should take a multivitamin or drink sports drinks to boost your nutrition.Also ask about taking a fiber supplement, such as Metamucil, to add bulk to your stools.Your doctor may also recommend a special medicine for diarrhea.Take this medicine as your doctor told you to take it. +If you have diarrhea, you may lose your appetite for a short time.In most cases, when your appetite returns, you can go back to eating your normal diet.Parents and caretakers should give children with diarrhea their usual age-appropriate diet and give infants breast milk or formula.Your doctor may recommend changing your diet to treat some causes of chronic diarrhea, such as lactose intolerance or celiac disease. +How doctors treat persistent and chronic diarrhea depends on the cause.Doctors may prescribe antibiotics and medicines that target parasites to treat bacterial or parasitic infections.Doctors may also prescribe medicines to treat some of the conditions that cause chronic diarrhea, such as Crohn's disease, irritable bowel syndrome, or ulcerative colitis.How doctors treat chronic diarrhea in children also depends on the cause.Doctors may recommend probiotics.Probiotics are live microorganisms, most often bacteria, that are similar to microorganisms you normally have in your digestive tract.Researchers are still studying the use of probiotics to treat diarrhea.For safety reasons, talk with your doctor before using probiotics or any other complementary or alternative medicines or practices.If your doctor recommends probiotics, talk with him or her about how much probiotics you should take and for how long. +Drugs that relax intestinal muscles and slow intestinal transit (antidiarrheal drugs) can help slow diarrhea.Loperamide is available over the counter.Opioid drugs, such as codeine, diphenoxylate, and paregoric (tincture of opium), are available by prescription and also can help.However, certain bacterial causes of gastroenteritis, particularly Salmonella, Shigella, and Clostridioides difficile, can be worsened by antidiarrheal drugs.Doctors typically recommend antidiarrheal drugs only for people with watery diarrhea and no warning signs because such people are unlikely to have such bacterial infections.Eluxadoline is another drug that may be given to some people who have diarrhea caused by IBS.Over-the-counter drugs include adsorbents (for example, kaolin-pectin), which adhere to chemicals, toxins, and infectious organisms.Some adsorbents also help firm up the stool.Bismuth helps many people with diarrhea.It has a normal side effect of turning the stool black.Bulking agents used for chronic constipation, such as psyllium or methylcellulose, can sometimes help relieve chronic diarrhea as well. +","Chronic and persistent diarrhea is treated depending on its cause.Your doctor might recommend changing your diet and avoid foods that make diarrhea worse, e.g., dairy products, alcohol, greasy or spicy foods and artificial sweeteners.Drugs that slow intestinal muscles, e.g., loperamide, can slow diarrhea.Some of these drugs, r.g., codeine, diphenoxylate, paregoric and eluxadoline, need prescription.Absorbents, such as bismuth may harden the stools.Some of the agents used for constipation could also help, e.g., psyllium or methylcellulose.Some foods also could be considered, e.g., probiotics, salty and high potassium foods, as well as eating small meals often.","How doctors treat persistent and chronic diarrhea depends on the cause.Doctors may prescribe antibiotics and medicines that target parasites to treat bacterial or parasitic infections.Doctors may also prescribe medicines to treat some of the conditions that cause chronic diarrhea, such as Crohn's disease, irritable bowel syndrome, or ulcerative colitis. Drugs that relax intestinal muscles and slow intestinal transit (antidiarrheal drugs) can help slow diarrhea.Loperamide is available over the counter.Opioid drugs, such as codeine, diphenoxylate, and paregoric (tincture of opium), are available by prescription and also can help.Eluxadoline is another drug that may be given to some people who have diarrhea caused by IBS.Over-the-counter drugs include adsorbents (for example, kaolin-pectin), which adhere to chemicals, toxins, and infectious organisms.Some adsorbents also help firm up the stool.Bismuth helps many people with diarrhea. Bulking agents used for chronic constipation, such as psyllium or methylcellulose, can sometimes help relieve chronic diarrhea as well.Researchers are still studying the use of probiotics to treat diarrhea. Your doctor may recommend changing your diet to treat some causes of chronic diarrhea, such as lactose intolerance or celiac disease.You should avoid foods that may make your diarrhea worse, such asalcoholic beverages drinks and foods containing caffeine dairy products such as milk, cheese, and ice cream fatty and greasy foods drinks and foods containing fructose fruits such as apples, peaches, and pears spicy foods diet drinks and sugarless gum and candies containing sweeteners such as sorbitol, mannitol, and xylitol." +36,Are there herbal medicines for rheumatoid arthritis?,"Over the last several decades, research has greatly increased our understanding of the immune system, genetics, and biology.This research is now showing results in several areas important to rheumatoid arthritis.Scientists are thinking about RA in exciting ways that were not possible years ago.

Genetics

NIAMS-supported researchers have identified several genetic factors that may make some people more likely to develop rheumatoid arthritis, as well as factors that affect disease severity.Scientists have learned that dozens of genes determine whether a person develops rheumatoid arthritis and how severe the disease will become.Researchers are studying these findings to help identify new treatment approaches for the disease.Researchers are also investigating the potential connection between health, disease, and the human microbiome, which are microorganisms that inhabit the human body, such as the intestines and the mouth.One study found that the presence of a specific type of gut bacteria correlated with rheumatoid arthritis in newly diagnosed, untreated people.Another study has found that bacteria in the mouth can contribute to the autoimmune RA process, indicating that good dental hygiene is important.More work is being done to understand how bacteria interacts with the immune system in the disease.

The Disease Process

NIAMS intramural researchers are studying the natural history of rheumatoid arthritis in children and adults to understand how the disease progresses and affects patient symptoms and functional status.Investigators are also exploring whether patients with rheumatoid arthritis in remission while taking tumor necrosis factor-alpha (TNF-?)inhibitors can remain in remission after tapering the dose of these medications.Most studies so far suggest that taking them away completely leads to flares.However, researchers are studying and identifying what factors predict who will relapse when treatments are reduced.Scientists are continuing to understand what happens at the molecular level in rheumatoid arthritis and are working to develop tests that could help diagnose RA earlier and identify patients who would benefit most from specific treatments.Joint inflammation. NIAMS-funded researchers have determined that joint inflammation can continue in rheumatoid arthritis even after clinical symptoms have eased.This finding may help doctors determine when a patient is truly in remission and can safely stop treatment.

New Therapies

To date, there is still no cure for RA.Researchers continue to identify turned on genes and molecules that contribute to the development and worsening of rheumatoid arthritis and thus are potential targets for new treatments.The path between identifying the molecule and developing a drug that targets it is long and difficult.Fortunately, several new medications for RA have emerged over the past 20 years that substantially reduce symptoms and damage in rheumatoid arthritis.However, over time, medications may stop working for some people, creating a need for new advanced therapies.Researchers continue to identify more candidate drugs, with hopes that these will have fewer side effects or will cure more patients.National Institutes of Health Accelerating Medicines Partnership.The NIAMS and the National Institute of Allergy and Infectious Diseases are leading the Accelerating Medicines Partnership in Rheumatoid Arthritis and Systemic Lupus Erythematosus (AMP RA/SLE).The AMP RA/SLE consortium is a unique public?private partnership that was created to find new ways to identify and validate promising biological targets for diagnostics and drug development.Over the last several decades, research has greatly increased our understanding of the immune system, genetics, and biology.This research is now showing results in several areas important to rheumatoid arthritis.Scientists are thinking about RA in exciting ways that were not possible years ago.

Genetics

NIAMS-supported researchers have identified several genetic factors that may make some people more likely to develop rheumatoid arthritis, as well as factors that affect disease severity.Scientists have learned that dozens of genes determine whether a person develops rheumatoid arthritis and how severe the disease will become.Researchers are studying these findings to help identify new treatment approaches for the disease.Researchers are also investigating the potential connection between health, disease, and the human microbiome, which are microorganisms that inhabit the human body, such as the intestines and the mouth.One study found that the presence of a specific type of gut bacteria correlated with rheumatoid arthritis in newly diagnosed, untreated people.Another study has found that bacteria in the mouth can contribute to the autoimmune RA process, indicating that good dental hygiene is important.More work is being done to understand how bacteria interacts with the immune system in the disease.

The Disease Process

NIAMS intramural researchers are studying the natural history of rheumatoid arthritis in children and adults to understand how the disease progresses and affects patient symptoms and functional status.Investigators are also exploring whether patients with rheumatoid arthritis in remission while taking tumor necrosis factor-alpha (TNF-?)inhibitors can remain in remission after tapering the dose of these medications.Most studies so far suggest that taking them away completely leads to flares.However, researchers are studying and identifying what factors predict who will relapse when treatments are reduced.Scientists are continuing to understand what happens at the molecular level in rheumatoid arthritis and are working to develop tests that could help diagnose RA earlier and identify patients who would benefit most from specific treatments.Joint inflammation. NIAMS-funded researchers have determined that joint inflammation can continue in rheumatoid arthritis even after clinical symptoms have eased.This finding may help doctors determine when a patient is truly in remission and can safely stop treatment.

New Therapies

To date, there is still no cure for RA.Researchers continue to identify turned on genes and molecules that contribute to the development and worsening of rheumatoid arthritis and thus are potential targets for new treatments.The path between identifying the molecule and developing a drug that targets it is long and difficult.Fortunately, several new medications for RA have emerged over the past 20 years that substantially reduce symptoms and damage in rheumatoid arthritis.However, over time, medications may stop working for some people, creating a need for new advanced therapies.Researchers continue to identify more candidate drugs, with hopes that these will have fewer side effects or will cure more patients.National Institutes of Health Accelerating Medicines Partnership.The NIAMS and the National Institute of Allergy and Infectious Diseases are leading the Accelerating Medicines Partnership in Rheumatoid Arthritis and Systemic Lupus Erythematosus (AMP RA/SLE).The AMP RA/SLE consortium is a unique public?private partnership that was created to find new ways to identify and validate promising biological targets for diagnostics and drug development.Over the last several decades, research has greatly increased our understanding of the immune system, genetics, and biology.This research is now showing results in several areas important to rheumatoid arthritis.Scientists are thinking about RA in exciting ways that were not possible years ago.

Genetics

NIAMS-supported researchers have identified several genetic factors that may make some people more likely to develop rheumatoid arthritis, as well as factors that affect disease severity.Scientists have learned that dozens of genes determine whether a person develops rheumatoid arthritis and how severe the disease will become.Researchers are studying these findings to help identify new treatment approaches for the disease.Researchers are also investigating the potential connection between health, disease, and the human microbiome, which are microorganisms that inhabit the human body, such as the intestines and the mouth.One study found that the presence of a specific type of gut bacteria correlated with rheumatoid arthritis in newly diagnosed, untreated people.Another study has found that bacteria in the mouth can contribute to the autoimmune RA process, indicating that good dental hygiene is important.More work is being done to understand how bacteria interacts with the immune system in the disease.

The Disease Process

NIAMS intramural researchers are studying the natural history of rheumatoid arthritis in children and adults to understand how the disease progresses and affects patient symptoms and functional status.Investigators are also exploring whether patients with rheumatoid arthritis in remission while taking tumor necrosis factor-alpha (TNF-?)inhibitors can remain in remission after tapering the dose of these medications.Most studies so far suggest that taking them away completely leads to flares.However, researchers are studying and identifying what factors predict who will relapse when treatments are reduced.Scientists are continuing to understand what happens at the molecular level in rheumatoid arthritis and are working to develop tests that could help diagnose RA earlier and identify patients who would benefit most from specific treatments.Joint inflammation. NIAMS-funded researchers have determined that joint inflammation can continue in rheumatoid arthritis even after clinical symptoms have eased.This finding may help doctors determine when a patient is truly in remission and can safely stop treatment.

New Therapies

To date, there is still no cure for RA.Researchers continue to identify turned on genes and molecules that contribute to the development and worsening of rheumatoid arthritis and thus are potential targets for new treatments.The path between identifying the molecule and developing a drug that targets it is long and difficult.Fortunately, several new medications for RA have emerged over the past 20 years that substantially reduce symptoms and damage in rheumatoid arthritis.However, over time, medications may stop working for some people, creating a need for new advanced therapies.Researchers continue to identify more candidate drugs, with hopes that these will have fewer side effects or will cure more patients.National Institutes of Health Accelerating Medicines Partnership.The NIAMS and the National Institute of Allergy and Infectious Diseases are leading the Accelerating Medicines Partnership in Rheumatoid Arthritis and Systemic Lupus Erythematosus (AMP RA/SLE).The AMP RA/SLE consortium is a unique public?private partnership that was created to find new ways to identify and validate promising biological targets for diagnostics and drug development. +NSAIDs are commonly used to treat the symptoms of rheumatoid arthritis.They do not prevent the damage caused by rheumatoid arthritis from progressing and thus should not be considered the primary treatment.(See also table Drugs Used to Treat Rheumatoid Arthritis.)NSAIDs can reduce the swelling in affected joints and relieve pain.They can be taken by mouth or applied directly to the skin over painful joints.Rheumatoid arthritis, unlike osteoarthritis, causes considerable inflammation.Thus, drugs that decrease inflammation, including NSAIDs, have an important advantage over drugs such as acetaminophen that reduce pain but not inflammation.However, NSAIDs (except cyclooxygenase inhibitors) should not be taken by people who have active digestive tract (peptic) ulcersincluding stomach ulcers or duodenal ulcersbecause NSAIDs can upset the stomach.Drugs called proton pump inhibitors (such as esomeprazole, lansoprazole, omeprazole, pantoprazole, and rabeprazole) can reduce the risk of stomach or duodenal ulcers (see table Drugs Used to Treat Peptic Ulcer Disease).Other possible side effects of NSAIDs may include headache, confusion, increased blood pressure, worsening of high blood pressure, worsening of kidney function, swelling, and decreased platelet function.People who get hives, inflammation and swelling in the nose, or asthma after they take aspirin may have the same symptoms after taking other NSAIDs.NSAIDs may increase the risk of heart attacks and strokes.The risk appears to be higher if the drug is used at higher doses and for longer periods of time.The risk is higher with certain NSAIDs than others.Aspirin is no longer used to treat rheumatoid arthritis because effective doses are often toxic.The cyclooxygenase (COX-2) inhibitors (coxibs, such as celecoxib) are NSAIDs that act similarly to the other NSAIDs but are slightly less likely to damage the stomach.However, if a person also takes aspirin, stomach damage is almost as likely to occur as with other NSAIDs.Caution should be taken with use of coxibs and probably all NSAIDs for long periods or by people with risk factors for heart attack and stroke. +Treatment of rheumatoid arthritis continues to improve, which can give many people relief from symptoms, improving their quality of life.Doctors may use the following options to treat RA: Medications.Surgery.Routine monitoring and ongoing care.Complementary therapies.Your doctor may recommend a combination of treatments, which may change over time based on your symptoms and the severity of your disease.No matter which treatment plan your doctor recommends, the goals are to help: Relieve pain.Decrease inflammation and swelling.Prevent, slow, or stop joint and organ damage.Improve your ability to participate in daily activities.Rheumatoid arthritis may start causing joint damage during the first year or two that a person has the disease, so early diagnosis and treatment are very important.

Medications

Most people who have RA take medications.Studies show that early treatment with combinations of medications, instead of one medication alone, may be more effective in decreasing or preventing joint damage.Many of the medications that doctors prescribe to treat RA help decrease inflammation and pain, and slow or stop joint damage.They may include: Anti-inflammatory medications to provide pain relief and lower inflammation.Corticosteroids that can help decrease inflammation, provide some pain relief, and slow joint damage.Because they are potent drugs, your doctor will prescribe the lowest dose possible to achieve the desired benefit.Disease-modifying antirheumatic drugs (DMARDs) that can help to slow or change the progression of the disease.Biologic response modifiers if your disease is more severe.These medications target specific immune messages and interrupt the signal, helping to decrease or stop inflammation.Janus kinase (JAK) inhibitors, which send messages to specific cells to stop inflammation from inside the cell.

Surgery

Your doctor may recommend surgery if you have permanent damage or pain that limits your ability to perform day-to-day activities.Surgery is not for everyone.You and your doctor can discuss the options and choose what is right for you.Your doctor will consider the following before recommending surgery: Your overall health.The condition of the affected joint or tendon.The risks and benefits of the surgery.Types of surgery may include joint repairs and joint replacements.Read more in our Joint Replacement Surgery Health Topic.

Routine Monitoring and Ongoing Care

Regular medical care is important because your doctor can: Monitor how the disease is progressing.Determine how well the medications are working.Talk to you about any side the effects from the medications.Adjust your treatment as needed.Monitoring typically includes regular visits to the doctor.It also may include blood and urine tests, and x?rays.Having rheumatoid arthritis increases your risk of developing osteoporosis, particularly if you take corticosteroids.Osteoporosis is a bone disease that causes the bones to weaken and easily break.Talk to your doctor about your risk for the disease and the potential benefits of calcium and vitamin D supplements or other osteoporosis treatments.Treatment of rheumatoid arthritis continues to improve, which can give many people relief from symptoms, improving their quality of life.Doctors may use the following options to treat RA: Medications.Surgery.Routine monitoring and ongoing care.Complementary therapies.Your doctor may recommend a combination of treatments, which may change over time based on your symptoms and the severity of your disease.No matter which treatment plan your doctor recommends, the goals are to help: Relieve pain.Decrease inflammation and swelling.Prevent, slow, or stop joint and organ damage.Improve your ability to participate in daily activities.Rheumatoid arthritis may start causing joint damage during the first year or two that a person has the disease, so early diagnosis and treatment are very important.

Medications

Most people who have RA take medications.Studies show that early treatment with combinations of medications, instead of one medication alone, may be more effective in decreasing or preventing joint damage.Many of the medications that doctors prescribe to treat RA help decrease inflammation and pain, and slow or stop joint damage.They may include: Anti-inflammatory medications to provide pain relief and lower inflammation.Corticosteroids that can help decrease inflammation, provide some pain relief, and slow joint damage.Because they are potent drugs, your doctor will prescribe the lowest dose possible to achieve the desired benefit.Disease-modifying antirheumatic drugs (DMARDs) that can help to slow or change the progression of the disease.Biologic response modifiers if your disease is more severe.These medications target specific immune messages and interrupt the signal, helping to decrease or stop inflammation.Janus kinase (JAK) inhibitors, which send messages to specific cells to stop inflammation from inside the cell.

Surgery

Your doctor may recommend surgery if you have permanent damage or pain that limits your ability to perform day-to-day activities.Surgery is not for everyone.You and your doctor can discuss the options and choose what is right for you.Your doctor will consider the following before recommending surgery: Your overall health.The condition of the affected joint or tendon.The risks and benefits of the surgery.Types of surgery may include joint repairs and joint replacements.Read more in our Joint Replacement Surgery Health Topic.

Routine Monitoring and Ongoing Care

Regular medical care is important because your doctor can: Monitor how the disease is progressing.Determine how well the medications are working.Talk to you about any side the effects from the medications.Adjust your treatment as needed.Monitoring typically includes regular visits to the doctor.It also may include blood and urine tests, and x?rays.Having rheumatoid arthritis increases your risk of developing osteoporosis, particularly if you take corticosteroids.Osteoporosis is a bone disease that causes the bones to weaken and easily break.Talk to your doctor about your risk for the disease and the potential benefits of calcium and vitamin D supplements or other osteoporosis treatments.Treatment of rheumatoid arthritis continues to improve, which can give many people relief from symptoms, improving their quality of life.Doctors may use the following options to treat RA: Medications.Surgery.Routine monitoring and ongoing care.Complementary therapies.Your doctor may recommend a combination of treatments, which may change over time based on your symptoms and the severity of your disease.No matter which treatment plan your doctor recommends, the goals are to help: Relieve pain.Decrease inflammation and swelling.Prevent, slow, or stop joint and organ damage.Improve your ability to participate in daily activities.Rheumatoid arthritis may start causing joint damage during the first year or two that a person has the disease, so early diagnosis and treatment are very important.

Medications

Most people who have RA take medications.Studies show that early treatment with combinations of medications, instead of one medication alone, may be more effective in decreasing or preventing joint damage.Many of the medications that doctors prescribe to treat RA help decrease inflammation and pain, and slow or stop joint damage.They may include: Anti-inflammatory medications to provide pain relief and lower inflammation.Corticosteroids that can help decrease inflammation, provide some pain relief, and slow joint damage.Because they are potent drugs, your doctor will prescribe the lowest dose possible to achieve the desired benefit.Disease-modifying antirheumatic drugs (DMARDs) that can help to slow or change the progression of the disease.Biologic response modifiers if your disease is more severe.These medications target specific immune messages and interrupt the signal, helping to decrease or stop inflammation.Janus kinase (JAK) inhibitors, which send messages to specific cells to stop inflammation from inside the cell.

Surgery

Your doctor may recommend surgery if you have permanent damage or pain that limits your ability to perform day-to-day activities.Surgery is not for everyone.You and your doctor can discuss the options and choose what is right for you.Your doctor will consider the following before recommending surgery: Your overall health.The condition of the affected joint or tendon.The risks and benefits of the surgery.Types of surgery may include joint repairs and joint replacements.Read more in our Joint Replacement Surgery Health Topic.

Routine Monitoring and Ongoing Care

Regular medical care is important because your doctor can: Monitor how the disease is progressing.Determine how well the medications are working.Talk to you about any side the effects from the medications.Adjust your treatment as needed.Monitoring typically includes regular visits to the doctor.It also may include blood and urine tests, and x?rays.Having rheumatoid arthritis increases your risk of developing osteoporosis, particularly if you take corticosteroids.Osteoporosis is a bone disease that causes the bones to weaken and easily break.Talk to your doctor about your risk for the disease and the potential benefits of calcium and vitamin D supplements or other osteoporosis treatments. +Research shows that people who take part in their own care report less pain and make fewer doctor visits.They also enjoy a better quality of life.Self-care can help you play a role in managing your RA and improving your health.You can: Learn about rheumatoid arthritis and its treatments.Use exercises and relaxation techniques to reduce your pain and keeping you active.Communicate well with your health care team so you can have more control over your disease.Reach out for support to help cope with the physical emotional, and mental effects of rheumatoid arthritis.Participating in your care can help build confidence in your ability to perform day-to-day activities, allowing you to lead a full, active, and independent life.

Lifestyle Changes

Certain activities can help improve your ability to function on your own and maintain a positive outlook.Rest and exercise.Balance your rest and exercise, with more rest when your RA is active and more exercise when it is not.Rest helps to decrease active joint inflammation, pain, and fatigue.In general, shorter rest breaks every now and then are more helpful than long times spent in bed.Exercise is important for maintaining healthy and strong muscles, preserving joint mobility, and maintaining flexibility.Exercise can help: Improve your sleep.Decrease pain.Keep a positive attitude.Maintain a healthy weight.Doctors usually recommend low-impact exercises, such as water exercise programs.Talk to your health care providers before beginning any exercise program.Joint care.Some people find wearing a splint for a short time around a painful joint reduces pain and swelling.People use splints mostly on wrists and hands, but also on ankles and feet.Talk to your doctor or a physical or occupational therapist before wearing a splint.Other ways you can protect your joints include: Using self-help devices, such as items with a large grip, zipper pullers, or long-handled shoehorns.Using tools or devices that help with activities of daily living, such as an adaptive toothbrush or silverware.Using devices to help you get on and off chairs, toilet seats, and beds.Choosing activities that put less stress on your joints, such as limiting the use of the stairs or taking rest periods when walking longer distances.Maintaining a healthy weight to help lower the stress on your joints.Monitoring of symptoms.It is important to monitor your symptoms for any changes or the development of new symptoms.Understanding your symptoms and how they may change can help you and your doctor manage your pain when you have a flare.Stress management.The emotions you may feel because of RA fear, anger, and frustration, along with any pain, physical limitations, and the unpredictable nature of flares can increase your stress level.Although there is no evidence that stress plays a role in causing rheumatoid arthritis, it can make living with the disease more difficult.Stress also may affect the amount of pain you feel.Ways to cope with stress can include: Regular rest periods.Relaxation techniques such as deep breathing, meditating, or listening to quiet sounds or music.Movement exercise programs, such as yoga and tai chi.Mental health management.Living with RA can be hard and isolating.If you feel alone, anxious, or depressed about having the disease, talk to your doctor, an RA support social worker, or mental health professional.Keep the lines of communication open.Talk to family and friends about your RA to help them understand the disease.You may find it helpful to join an online or community support group.Healthy diet.A healthy and nutritious diet that includes a balance of calories, protein, and calcium is important for maintaining overall health.Talk to your doctor about drinking alcoholic beverages because they may interact with the medications you take for rheumatoid arthritis.Before making any changes to your diet or activity, talk to your doctor.Research shows that people who take part in their own care report less pain and make fewer doctor visits.They also enjoy a better quality of life.Self-care can help you play a role in managing your RA and improving your health.You can: Learn about rheumatoid arthritis and its treatments.Use exercises and relaxation techniques to reduce your pain and keeping you active.Communicate well with your health care team so you can have more control over your disease.Reach out for support to help cope with the physical emotional, and mental effects of rheumatoid arthritis.Participating in your care can help build confidence in your ability to perform day-to-day activities, allowing you to lead a full, active, and independent life.

Lifestyle Changes

Certain activities can help improve your ability to function on your own and maintain a positive outlook.Rest and exercise.Balance your rest and exercise, with more rest when your RA is active and more exercise when it is not.Rest helps to decrease active joint inflammation, pain, and fatigue.In general, shorter rest breaks every now and then are more helpful than long times spent in bed.Exercise is important for maintaining healthy and strong muscles, preserving joint mobility, and maintaining flexibility.Exercise can help: Improve your sleep.Decrease pain.Keep a positive attitude.Maintain a healthy weight.Doctors usually recommend low-impact exercises, such as water exercise programs.Talk to your health care providers before beginning any exercise program.Joint care.Some people find wearing a splint for a short time around a painful joint reduces pain and swelling.People use splints mostly on wrists and hands, but also on ankles and feet.Talk to your doctor or a physical or occupational therapist before wearing a splint.Other ways you can protect your joints include: Using self-help devices, such as items with a large grip, zipper pullers, or long-handled shoehorns.Using tools or devices that help with activities of daily living, such as an adaptive toothbrush or silverware.Using devices to help you get on and off chairs, toilet seats, and beds.Choosing activities that put less stress on your joints, such as limiting the use of the stairs or taking rest periods when walking longer distances.Maintaining a healthy weight to help lower the stress on your joints.Monitoring of symptoms.It is important to monitor your symptoms for any changes or the development of new symptoms.Understanding your symptoms and how they may change can help you and your doctor manage your pain when you have a flare.Stress management.The emotions you may feel because of RA fear, anger, and frustration, along with any pain, physical limitations, and the unpredictable nature of flares can increase your stress level.Although there is no evidence that stress plays a role in causing rheumatoid arthritis, it can make living with the disease more difficult.Stress also may affect the amount of pain you feel.Ways to cope with stress can include: Regular rest periods.Relaxation techniques such as deep breathing, meditating, or listening to quiet sounds or music.Movement exercise programs, such as yoga and tai chi.Mental health management.Living with RA can be hard and isolating.If you feel alone, anxious, or depressed about having the disease, talk to your doctor, an RA support social worker, or mental health professional.Keep the lines of communication open.Talk to family and friends about your RA to help them understand the disease.You may find it helpful to join an online or community support group.Healthy diet.A healthy and nutritious diet that includes a balance of calories, protein, and calcium is important for maintaining overall health.Talk to your doctor about drinking alcoholic beverages because they may interact with the medications you take for rheumatoid arthritis.Before making any changes to your diet or activity, talk to your doctor. +","Inflammation, pain and damage to the joints caused by rheumatoid arthritis could be reduced by anti-inflammatory drugs, such as NSAIDs, corticosteroids, and Disease-modifying antirheumatic drugs (DMARDs). Self-care can also help.It includes relaxation techniques, such a s deep breathing and meditation, exercises, such as yoga and tai chi, and a balanced diet, which includes protein and calcium, to maintain healthy weight.","several new medications for RA have emerged over the past 20 years that substantially reduce symptoms and damage in rheumatoid arthritis.However, over time, medications may stop working for some people, creating a need for new advanced therapies. Many of the medications that doctors prescribe to treat RA help decrease inflammation and pain, and slow or stop joint damage.They may include: Anti-inflammatory medications to provide pain relief and lower inflammation.Corticosteroids that can help decrease inflammation, provide some pain relief, and slow joint damage.Because they are potent drugs, your doctor will prescribe the lowest dose possible to achieve the desired benefit.Disease-modifying antirheumatic drugs (DMARDs) that can help to slow or change the progression of the disease.Biologic response modifiers if your disease is more severe.Self-care can help you play a role in managing your RA and improving your health.You can: Use exercises and relaxation techniques to reduce your pain and keeping you active. Relaxation techniques such as deep breathing, meditating, or listening to quiet sounds or music.Movement exercise programs, such as yoga and tai chi.Mental health management. Maintaining a healthy weight to help lower the stress on your joints. Healthy diet.A healthy and nutritious diet that includes a balance of calories, protein, and calcium is important for maintaining overall health." +37,How can we help our daughter with Xeroderma Pigmentosum Type C?,"Xeroderma pigmentosum, which is commonly known as XP, is an inherited condition characterized by an extreme sensitivity to ultraviolet (UV) rays from sunlight.This condition mostly affects the eyes and areas of skin exposed to the sun.Some affected individuals also have problems involving the nervous system.The signs of xeroderma pigmentosum usually appear in infancy or early childhood.Many affected children develop a severe sunburn after spending just a few minutes in the sun.The sunburn causes redness and blistering that can last for weeks.Other affected children do not get sunburned with minimal sun exposure, but instead tan normally.By age 2, almost all children with xeroderma pigmentosum develop freckling of the skin in sun-exposed areas (such as the face, arms, and lips); this type of freckling rarely occurs in young children without the disorder.In affected individuals, exposure to sunlight often causes dry skin (xeroderma) and changes in skin coloring (pigmentation).This combination of features gives the condition its name, xeroderma pigmentosum.People with xeroderma pigmentosum have a greatly increased risk of developing skin cancer.Without sun protection, about half of children with this condition develop their first skin cancer by age 10.Most people with xeroderma pigmentosum develop multiple skin cancers during their lifetime.These cancers occur most often on the face, lips, and eyelids.Cancer can also develop on the scalp, in the eyes, and on the tip of the tongue.Studies suggest that people with xeroderma pigmentosum may also have an increased risk of other types of cancer, including brain tumors.Additionally, affected individuals who smoke cigarettes have a significantly increased risk of lung cancer.The eyes of people with xeroderma pigmentosum may be painfully sensitive to UV rays from the sun.If the eyes are not protected from the sun, they may become bloodshot and irritated, and the clear front covering of the eyes (the cornea) may become cloudy.In some people, the eyelashes fall out and the eyelids may be thin and turn abnormally inward or outward.In addition to an increased risk of eye cancer, xeroderma pigmentosum is associated with noncancerous growths on the eye.Many of these eye abnormalities can impair vision.About 30 percent of people with xeroderma pigmentosum develop progressive neurological abnormalities in addition to problems involving the skin and eyes.These abnormalities can include hearing loss, poor coordination, difficulty walking, movement problems, loss of intellectual function, difficulty swallowing and talking, and seizures.When these neurological problems occur, they tend to worsen with time.Researchers have identified at least eight inherited forms of xeroderma pigmentosum: complementation group A (XP-A) through complementation group G (XP-G) plus a variant type (XP-V).The types are distinguished by their genetic cause.All of the types increase skin cancer risk, although some are more likely than others to be associated with neurological abnormalities. +Xeroderma pigmentosum (XP) is a rare condition passed down through families.XP causes the skin and tissue covering the eye to be extremely sensitive to ultraviolet (UV) light.Some people also develop nervous system problems. +People with XP need total protection from sunlight.Even the light coming through windows or from fluorescent bulbs can be dangerous.When out in the sun, protective clothing must be worn.To protect the skin and eyes from the sunlight: Use sunscreen with the highest SPF you can find.Wear long-sleeve shirts and long pants.Wear sunglasses that block UVA and UVB rays.Teach your child to always wear sunglasses when outdoors.To prevent skin cancer, the provider may prescribe medicines, such as a retinoid cream, to apply to the skin.If skin cancer develops, surgery or other methods will be done to remove the cancer. +Xeroderma pigmentosum is caused by mutations in genes that are involved in repairing damaged DNA.DNA can be damaged by UV rays from the sun and by toxic chemicals such as those found in cigarette smoke.Normal cells are usually able to fix DNA damage before it causes problems.However, in people with xeroderma pigmentosum, DNA damage is not repaired normally.As more abnormalities form in DNA, cells malfunction and eventually become cancerous or die.Many of the genes related to xeroderma pigmentosum are part of a DNA-repair process known as nucleotide excision repair (NER).The proteins produced from these genes play a variety of roles in this process.They recognize DNA damage, unwind regions of DNA where the damage has occurred, snip out (excise) the abnormal sections, and replace the damaged areas with the correct DNA.Inherited abnormalities in the NER-related genes prevent cells from carrying out one or more of these steps.The POLH gene also plays a role in protecting cells from UV-induced DNA damage, although it is not involved in NER; mutations in this gene cause the variant type of xeroderma pigmentosum.The major features of xeroderma pigmentosum result from a buildup of unrepaired DNA damage.When UV rays damage genes that control cell growth and division, cells can either die or grow too fast and in an uncontrolled way.Unregulated cell growth can lead to the development of cancerous tumors.Neurological abnormalities are also thought to result from an accumulation of DNA damage, although the brain is not exposed to UV rays.Researchers suspect that other factors damage DNA in nerve cells.It is unclear why some people with xeroderma pigmentosum develop neurological abnormalities and others do not.Inherited mutations in at least eight genes have been found to cause xeroderma pigmentosum.More than half of all cases in the United States result from mutations in the XPC, ERCC2, or POLH genes.Mutations in the other genes generally account for a smaller percentage of cases. +There is no cure for XP, but there are ways to prevent and treat some of the problems associated with it.Some of the strategies employed in the management of XP include:[2][3][4] Protection from ultraviolet light Frequent skin and eye examinations Prompt removal of cancerous tissue Neurological examination Psychosocial care Small, premalignant skin lesions such as actinic keratoses can be frozen with liquid nitrogen.Larger areas of sun-damaged skin can be treated with topical 5-fluorouracil or imiquimod.In rare cases, therapeutic dermatome shaving or dermabrasion is used to remove damaged superficial epidermal layers.Skin cancers can be treated using standard treatment protocols, including electrodesiccation and curettage (scrapes away the lesion and uses electricity to kill any remaining cells ), surgical excision, or chemosurgery.High dose oral isotretinoin or acitretin can be used to prevent new cancers.Cancers of the eyelids, conjunctiva, and cornea are usually treated surgically.Corneal transplantation may be necessary for those with severe keratitis and corneal opacity.[2] More detailed information about the treatment of XP may be accessed through the following online resources: GeneReviews: Management Medscape Reference - Treatment &Medication +Symptoms usually appear by the time a child is 2 years old.Skin symptoms include: Sunburn that does not heal after just a little bit of sun exposure Blistering after just a little bit of sun exposure Spider-like blood vessels under the skin Patches of discolored skin that get worse, resembling severe aging Crusting of the skin Scaling of the skin Oozing raw skin surface Discomfort when being in bright light (photophobia) Skin cancer at a very young age (including melanoma, basal cell carcinoma, squamous cell carcinoma)Eye symptoms include: Dry eye Clouding of the cornea Ulcers of the corneaSwelling or inflammation of the eyelids Cancer of eyelids, cornea or sclera Nervous system (neurologic) symptoms, which develop in some children, include: Intellectual disability Delayed growth Loss of hearing Muscle weakness of the legs and arms +","The most important preventive measure for people with Xeroderma Pigmentosum (XP) is complete protection from ultraviolet (UV) light in sunlight, and even coming through windows and from fluorescent lights.To protect your child from the exposure, always use sunscreen with the highest SPF, long-sleeve shirts and pants.Teach your child to always wear sunglasses when outdoors.Without protection, half of the children with XP develop skin cancer by the age of 10.The doctors could prescribe retinoid creams and other medicines to protect the skin.if skin cancer develops, it could be surgically removed.About 30 percent of people may develop neurological abnormalities, such as hearing loss, poor coordination and difficulty walking, loss of intellectual functions and seizures.It is not clear why some people develop these abnormalities.","XP causes the skin and tissue covering the eye to be extremely sensitive to ultraviolet (UV) light.About 30 percent of people with xeroderma pigmentosum develop progressive neurological abnormalities in addition to problems involving the skin and eyes.These abnormalities can include hearing loss, poor coordination, difficulty walking, movement problems, loss of intellectual function, difficulty swallowing and talking, and seizures.It is unclear why some people with xeroderma pigmentosum develop neurological abnormalities and others do not. People with XP need total protection from sunlight.Even the light coming through windows or from fluorescent bulbs can be dangerous.When out in the sun, protective clothing must be worn.To protect the skin and eyes from the sunlight: Use sunscreen with the highest SPF you can find.Wear long-sleeve shirts and long pants.Wear sunglasses that block UVA and UVB rays.Teach your child to always wear sunglasses when outdoors.To prevent skin cancer, the provider may prescribe medicines, such as a retinoid cream, to apply to the skin.If skin cancer develops, surgery or other methods will be done to remove the cancer.Without sun protection, about half of children with this condition develop their first skin cancer by age 10.Most people with xeroderma pigmentosum develop multiple skin cancers during their lifetime.These cancers occur most often on the face, lips, and eyelids.Cancer can also develop on the scalp, in the eyes, and on the tip of the tongue. There is no cure for XP, but there are ways to prevent and treat some of the problems associated with it. Small, premalignant skin lesions such as actinic keratoses can be frozen with liquid nitrogen.Larger areas of sun-damaged skin can be treated with topical 5-fluorouracil or imiquimod.In rare cases, therapeutic dermatome shaving or dermabrasion is used to remove damaged superficial epidermal layers.Skin cancers can be treated using standard treatment protocols, including electrodesiccation and curettage (scrapes away the lesion and uses electricity to kill any remaining cells ), surgical excision, or chemosurgery.High dose oral isotretinoin or acitretin can be used to prevent new cancers.Cancers of the eyelids, conjunctiva, and cornea are usually treated surgically.Corneal transplantation may be necessary for those with severe keratitis and corneal opacity." +4,How can I find a specialist who will cure my tapeworm infection?,"A single dose of worm medicine usually kills tapeworms in your intestines.If you have tapeworm cysts in your organs, you may need surgery to remove them. +Cysticercosis treatment depends on various factors, such as symptoms and the number and location of cysts in the brain.Cysticercosis is usually not treated unless it involves the brain.Corticosteroids, such as prednisone, are given to people with symptoms due to cysts in the brain.These drugs can reduce inflammation.People who have seizures are given antiseizure drugs.Antiparasitic drugs (such as albendazole or praziquantel) can be used to kill living cysts in the brain, but they are given after symptoms are adequately controlled.Corticosteroids are also given with the antiparasitic drug to minimize inflammation caused by dying cysts.Antiparasitic drugs are not used to treat cysts in the eye or spinal cord because they can trigger severe inflammation that can damage nearby tissues.Occasionally, surgery is necessaryfor example, when cysts are blocking the flow of fluid that surrounds the brain and spinal cord (cerebrospinal fluid) or when cysts are causing problems in the spinal cord or eye. +","Your doctor will prescribe an antiparasitic drug, for example, albendazole or praziquantel, to treat your tapeworm infection.Usually a single dose kills the tapeworms in your intestines.If you have tapeworm cysts, the treatment depends on the location of the cyst and might include corticosteroids and surgery.","A single dose of worm medicine usually kills tapeworms in your intestines.If you have tapeworm cysts in your organs, you may need surgery to remove them.Antiparasitic drugs (such as albendazole or praziquantel) can be used to kill living cysts, but they are given after symptoms are adequately controlled.Corticosteroids are also given with the antiparasitic drug to minimize inflammation caused by dying cysts." +40,What can cure vitiligo?,"Health care providers who treat vitiligo include: Dermatologists, who specialize in diagnosing and treating disorders of the skin, hair, and nails.Primary care physicians, such as a family practitioner or internist.Other specialists, such as ophthalmologists (who treat eye problems) may also provide care.Health care providers who treat vitiligo include: Dermatologists, who specialize in diagnosing and treating disorders of the skin, hair, and nails.Primary care physicians, such as a family practitioner or internist.Other specialists, such as ophthalmologists (who treat eye problems) may also provide care.Health care providers who treat vitiligo include: Dermatologists, who specialize in diagnosing and treating disorders of the skin, hair, and nails.Primary care physicians, such as a family practitioner or internist.Other specialists, such as ophthalmologists (who treat eye problems) may also provide care. +Most treatments for vitiligo focus on stopping the immune system from destroying the melanocytes and improving the skins appearance.In most cases, the goals of your treatment are to: Slow or stop the disease from progressing.Encourage the regrowth of melanocytes.Restore color to the white patches of skin, which can help the skin color look more even.Its important to remember that treatments may take time, and not everyone responds.In addition, the results from treatments can vary from one part of the body to another, and new patches may appear in the meantime.Sometimes, doctors will recommend more than one treatment to get the best results.Treatments can include: Medicines or medicated skin creams, such as corticosteroids or a calcineurin inhibitor, which may be able to return color to the white patches of skin.Use of light (phototherapy) to help return color to the skin.There are several different forms of light therapy.Doctors may use light boxes to treat large areas of vitiligo and use laser treatments on more localized areas.Depigmentation, or removing color from dark areas of the skin so they match the white patches.Doctors usually recommend this treatment for people who have vitiligo on more than half of their bodies.Depigmentation tends to be permanent and can take more than a year to complete.As with other treatments, it is very important to limit exposure to sunlight during and after treatment.Dermatologists may consider surgical techniques for long-standing segmental vitiligo or vitiligo of any type for which other treatments do not work.Skin grafting involves taking pigmented skin from one area of the body and attaching it to an area with a vitiligo patch.Sometimes the area can have a cobblestone appearance, spotty color, or failure to recolor.Blister grafting involves using suction to create a blister on the pigmented skin.The doctor removes the tops of the blisters and grafts or attaches them to the area with the vitiligo.Newer surgical procedures are being studied and may be an option in select cases.Surgery is typically not recommended when vitiligo is spreading or for people who scar easily or develop keloids, which are raised scars that grow larger than the wound that caused the scar.Most treatments for vitiligo focus on stopping the immune system from destroying the melanocytes and improving the skins appearance.In most cases, the goals of your treatment are to: Slow or stop the disease from progressing.Encourage the regrowth of melanocytes.Restore color to the white patches of skin, which can help the skin color look more even.Its important to remember that treatments may take time, and not everyone responds.In addition, the results from treatments can vary from one part of the body to another, and new patches may appear in the meantime.Sometimes, doctors will recommend more than one treatment to get the best results.Treatments can include: Medicines or medicated skin creams, such as corticosteroids or a calcineurin inhibitor, which may be able to return color to the white patches of skin.Use of light (phototherapy) to help return color to the skin.There are several different forms of light therapy.Doctors may use light boxes to treat large areas of vitiligo and use laser treatments on more localized areas.Depigmentation, or removing color from dark areas of the skin so they match the white patches.Doctors usually recommend this treatment for people who have vitiligo on more than half of their bodies.Depigmentation tends to be permanent and can take more than a year to complete.As with other treatments, it is very important to limit exposure to sunlight during and after treatment.Dermatologists may consider surgical techniques for long-standing segmental vitiligo or vitiligo of any type for which other treatments do not work.Skin grafting involves taking pigmented skin from one area of the body and attaching it to an area with a vitiligo patch.Sometimes the area can have a cobblestone appearance, spotty color, or failure to recolor.Blister grafting involves using suction to create a blister on the pigmented skin.The doctor removes the tops of the blisters and grafts or attaches them to the area with the vitiligo.Newer surgical procedures are being studied and may be an option in select cases.Surgery is typically not recommended when vitiligo is spreading or for people who scar easily or develop keloids, which are raised scars that grow larger than the wound that caused the scar.Most treatments for vitiligo focus on stopping the immune system from destroying the melanocytes and improving the skins appearance.In most cases, the goals of your treatment are to: Slow or stop the disease from progressing.Encourage the regrowth of melanocytes.Restore color to the white patches of skin, which can help the skin color look more even.Its important to remember that treatments may take time, and not everyone responds.In addition, the results from treatments can vary from one part of the body to another, and new patches may appear in the meantime.Sometimes, doctors will recommend more than one treatment to get the best results.Treatments can include: Medicines or medicated skin creams, such as corticosteroids or a calcineurin inhibitor, which may be able to return color to the white patches of skin.Use of light (phototherapy) to help return color to the skin.There are several different forms of light therapy.Doctors may use light boxes to treat large areas of vitiligo and use laser treatments on more localized areas.Depigmentation, or removing color from dark areas of the skin so they match the white patches.Doctors usually recommend this treatment for people who have vitiligo on more than half of their bodies.Depigmentation tends to be permanent and can take more than a year to complete.As with other treatments, it is very important to limit exposure to sunlight during and after treatment.Dermatologists may consider surgical techniques for long-standing segmental vitiligo or vitiligo of any type for which other treatments do not work.Skin grafting involves taking pigmented skin from one area of the body and attaching it to an area with a vitiligo patch.Sometimes the area can have a cobblestone appearance, spotty color, or failure to recolor.Blister grafting involves using suction to create a blister on the pigmented skin.The doctor removes the tops of the blisters and grafts or attaches them to the area with the vitiligo.Newer surgical procedures are being studied and may be an option in select cases.Surgery is typically not recommended when vitiligo is spreading or for people who scar easily or develop keloids, which are raised scars that grow larger than the wound that caused the scar. +Vitiligo is a relatively common pigmentation disorder in which the skin's pigment-making cells (melanocytes) are lost or destroyed.As a result, well-defined white patches appear on the skin.Patches may occur on one section or all over the body and may join together (coalesce).[1] Some people also have loss of pigment in patches of hair on the head or body.Vitiligo tends to continue over time, causing larger areas of skin to lose pigment.It may begin at any age but the average age of onset is in the mid-twenties.[2] Vitiligo does not affect physical health, but concerns about appearance and ethnic identity can lead to serious psychological, social, and emotional difficulties, significantly impacting quality of life.[1][3][2] The specific cause of vitiligo is not known.Many people with vitiligo also have a personal or family history of autoimmune disease , suggesting that vitiligo has an autoimmune cause.It sometimes ""runs in families,"" suggesting that genetics may play a role.People with vitiligo often report that its onset was related to a specific triggering event, such as injury, illness, sunburn, emotional stress, or pregnancy.However, there are currently no data supporting that these factors cause vitiligo.[1]There is no cure for vitiligo, but available treatments may stop its progression and induce varying degrees of re-pigmentation.Treatment options vary depending on severity and preference and may include topical, systemic, and/or light-based therapies.A combination of therapies is usually more effective than a single therapy.Despite the availability of treatment, the course of the condition and response to treatment are unpredictable.[3] +Living with vitiligo can be hard.Some people with the disorder feel embarrassed, sad, ashamed, or upset about the changes in their appearance.Sometimes, this can lead to low self-esteem and depression.Seeking advice and help from a mental health professional can help you cope with the disorder and treat depression.In addition to the treatments your doctor recommends, you can help manage the disease by: Protecting your skin from the sun.Use sunscreen and wear clothes to help protect your skin from sunburn and long-term damage.Wearing cosmetics, such as self-tanning lotions or dyes, to cover depigmented patches of skin.Talk to your doctor about which lotion or dye you should use.Finding a doctor who has experience treating people with vitiligo.Learning about the disorder and treatments to help you make decisions about care.Talking with other people who have vitiligo.Consider finding a vitiligo support group in your area or through an online community.Reaching out to family and friends for support.Living with vitiligo can be hard.Some people with the disorder feel embarrassed, sad, ashamed, or upset about the changes in their appearance.Sometimes, this can lead to low self-esteem and depression.Seeking advice and help from a mental health professional can help you cope with the disorder and treat depression.In addition to the treatments your doctor recommends, you can help manage the disease by: Protecting your skin from the sun.Use sunscreen and wear clothes to help protect your skin from sunburn and long-term damage.Wearing cosmetics, such as self-tanning lotions or dyes, to cover depigmented patches of skin.Talk to your doctor about which lotion or dye you should use.Finding a doctor who has experience treating people with vitiligo.Learning about the disorder and treatments to help you make decisions about care.Talking with other people who have vitiligo.Consider finding a vitiligo support group in your area or through an online community.Reaching out to family and friends for support. +Vitiligo is a chronic (long-lasting) disorder that causes patches of skin to lose pigment or color.This happens when melanocytes skin cells that make pigment are attacked and destroyed, causing the skin to turn a milky-white color.There are two types of vitiligo: Nonsegmental or generalized vitiligo is the most common type.It happens when the white patches appear symmetrically on both sides of your body, such as on both hands or both knees.This type of vitiligo can have rapid loss of color or pigment and tends to cover a large area.Segmental vitiligo is much less common and happens when the white patches are only on one segment or side of your body, such as a leg, one side of the face, or arm.This type of vitiligo often begins at an early age and progresses for about 1 to 2 years and then usually stops.The cause of vitiligo is unknown, but research suggests that vitiligo may be an autoimmune disease.The autoimmune system works throughout your body to fight off and defend your body from viruses, bacteria, and infection.In people with autoimmune diseases, the immune cells attack the bodys own healthy tissues by mistake.People with vitiligo may be more likely to develop other autoimmune disorders.A person with vitiligo occasionally may have family members who also have the disease.There is no cure for vitiligo, but treatment may help skin tone appear more even.Vitiligo is a chronic (long-lasting) disorder that causes patches of skin to lose pigment or color.This happens when melanocytes skin cells that make pigment are attacked and destroyed, causing the skin to turn a milky-white color.There are two types of vitiligo: Nonsegmental or generalized vitiligo is the most common type.It happens when the white patches appear symmetrically on both sides of your body, such as on both hands or both knees.This type of vitiligo can have rapid loss of color or pigment and tends to cover a large area.Segmental vitiligo is much less common and happens when the white patches are only on one segment or side of your body, such as a leg, one side of the face, or arm.This type of vitiligo often begins at an early age and progresses for about 1 to 2 years and then usually stops.The cause of vitiligo is unknown, but research suggests that vitiligo may be an autoimmune disease.The autoimmune system works throughout your body to fight off and defend your body from viruses, bacteria, and infection.In people with autoimmune diseases, the immune cells attack the bodys own healthy tissues by mistake.People with vitiligo may be more likely to develop other autoimmune disorders.A person with vitiligo occasionally may have family members who also have the disease.There is no cure for vitiligo, but treatment may help skin tone appear more even. +

Summary

Vitiligo causes white patches on your skin.It can also affect your eyes, mouth, and nose.It occurs when the cells that give your skin its color are destroyed.No one knows what destroys them.It is more common in people with autoimmune diseases, and it might run in families.It usually starts before age 40.The white patches are more common where your skin is exposed to the sun.In some cases, the patches spread.Vitiligo can cause your hair to gray early.If you have dark skin, you may lose color inside your mouth.Using sunscreen will help protect your skin, and cosmetics can cover up the patches.Treatments for vitiligo include medicines, light therapy, and surgery.Not every treatment is right for everyone.Many have side effects.Some take a long time.Some do not always work.NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases +","There is no cure for vitiligo, but sunscreen will help protect the skin.Treatments may prevent new patches and improve the skin appearance.Treatments depend on the severity of the lesions and your preferences.Dermatologists could recommend medications, such as creams containing corticosteroids or a calcineurin inhibitor, which could restore skin color.Phototherapy with light boxes or lasers could also restore the color.Depigmentation, on the other hand, could remove dark spots. Surgery might also be considered.","There is no cure for vitiligo, but available treatments may stop its progression and induce varying degrees of re-pigmentation.Treatment options vary depending on severity and preference and may include topical, systemic, and/or light-based therapies.A combination of therapies is usually more effective than a single therapy. Using sunscreen will help protect your skin, and cosmetics can cover up the patches. Most treatments for vitiligo focus on stopping the immune system from destroying the melanocytes and improving the skins appearance. Not every treatment is right for everyone.Many have side effects.Some take a long time.Some do not always work. Treatments can include: Medicines or medicated skin creams, such as corticosteroids or a calcineurin inhibitor, which may be able to return color to the white patches of skin.Use of light (phototherapy) to help return color to the skin. Depigmentation, or removing color from dark areas of the skin so they match the white patches.Dermatologists may consider surgical techniques for long-standing segmental vitiligo or vitiligo of any type for which other treatments do not work.Surgery is typically not recommended when vitiligo is spreading or for people who scar easily or develop keloids, which are raised scars that grow larger than the wound that caused the scar. Health care providers who treat vitiligo include: Dermatologists, Primary care physicians, Other specialists, such as ophthalmologists (who treat eye problems) may also provide care." +41,What is the long-term effect of heavy metals on the human body and how can it be mitigated?,"Drugs, chemicals, and heavy metals that can cause hyperpigmentation include the following: Amiodarone Hydroquinone Antimalarial drugs Tetracycline antibiotics Phenothiazines Some cancer chemotherapy drugs Some tricyclic antidepressants Some heavy metals (such as silver, gold, and mercury)The areas of hyperpigmentation are usually widespread, but some drugs can specifically affect certain areas.For example, some people develop fixed drug reactions, in which certain drugs (for example, certain antibiotics, nonsteroidal anti-inflammatory drugs [NSAIDs], and barbiturates) cause localized skin eruptions in the same place every time the drug is taken.This eventually leads to hyperpigmentation of the affected skin.Depending on the drug, chemical, or metal and where it is concentrated in the skin, hyperpigmentation may be violet, bluish black, yellow-brown, or shades of blue, silver, and gray (see also Color Changes in the Skin).In addition to the skin, the teeth, nails, white of the eyes (sclera), and lining of the mouth (mucosa) may be discolored.With many of these drugs, the hyperpigmentation often fades after the drug is stopped, but with some of them, the hyperpigmentation can be permanent.Because many drugs that cause skin pigmentation also cause photosensitivity reactions, people should avoid the sun. +Heavy metal poisoning refers to when excessive exposure to a heavy metal affects the normal function of the body.[1] Examples of heavy metals that can cause toxicity include lead, mercury, arsenic, cadmium, and chromium.[1] Exposure may occur through the diet, from medications, from the environment, or in the course of work or play.[2] Heavy metals can enter the body through the skin, or by inhalation or ingestion.[1] Toxicity can result from sudden, severe exposure, or from chronic exposure over time.Symptoms can vary depending on the metal involved, the amount absorbed, and the age of the person exposed.[2] For example, young children are more susceptible to the effects of lead exposure because they absorb more compared with adults and their brains are still developing.[2] Nausea, vomiting, diarrhea, and abdominal pain are common symptoms of acute metal ingestion.Chronic exposure may cause various symptoms resulting from damage to body organs , and may increase the risk of cancer .[2]Treatment depends on the circumstances of the exposure. +Hydrocarbons are the primary poisonous ingredient in oil paints.Some oil paints have heavy metals such as lead, mercury, cobalt, and barium added as pigment.These heavy metals can cause additional poisoning if swallowed in large amounts. +","Heavy metals can cause poisoning that has different symptoms depending on the specific metal, the route and the amount of the exposure and the age of the exposed person.Children are more sensitive to lead exposure because their brain is still developing.Chronic exposure causes different symptoms in different parts of the body, including higher risk of cancer and hyperpigmentation of the skin, teeth, nails, white of the eyes, and lining of the mouth.Treatments depend on the nature of the exposure.","Drugs, chemicals, and heavy metals that can cause hyperpigmentation include the following: Some heavy metals (such as silver, gold, and mercury)The areas of hyperpigmentation are usually widespread, Depending on the drug, chemical, or metal and where it is concentrated in the skin, hyperpigmentation may be violet, bluish black, yellow-brown, or shades of blue, silver, and gray.In addition to the skin, the teeth, nails, white of the eyes (sclera), and lining of the mouth (mucosa) may be discolored. Some oil paints have heavy metals such as lead, mercury, cobalt, and barium added as pigment.These heavy metals can cause additional poisoning if swallowed in large amounts.Heavy metal poisoning refers to when excessive exposure to a heavy metal affects the normal function of the body.Examples of heavy metals that can cause toxicity include lead, mercury, arsenic, cadmium, and chromium.Symptoms can vary depending on the metal involved, the amount absorbed, and the age of the person exposed.For example, young children are more susceptible to the effects of lead exposure because they absorb more compared with adults and their brains are still developing.Nausea, vomiting, diarrhea, and abdominal pain are common symptoms of acute metal ingestion.Chronic exposure may cause various symptoms resulting from damage to body organs , and may increase the risk of cancer.Treatment depends on the circumstances of the exposure." +42,Is there a cure for fish odor syndrome?,"Treatment for trimethylaminuria is focused on removing and preventing the bad odor.Options for treatment include diet modification, vitamin B12 (riboflavin) supplements, antibiotic treatment, and probiotics.Other supplements such as activated charcoal can help remove extra trimethylamine from the body.In addition, some people with trimethylaminuria may benefit from behavioral counseling.[2][3] Specialists involved in the care of someone with trimethylaminuria may include:[1] Nutritionist Medical geneticist Pharmacist Psychologist/ psychiatrist +Trimethylaminuria causes the body to produce a fishy odor that is released in the sweat, urine, breath, and reproductive fluids.People with trimethylaminuria are unable to break down trimethylamine, a chemical found in certain foods.The excess trimethylamine builds up and is the source of the odor.There are no other physical symptoms from trimethylaminuria, but people with this condition may experience serious psychological and social distress.Trimethylaminuria is due to a FMO3 gene that is not working correctly.It is inherited in an autosomal recessive pattern.It is diagnosed based on the symptoms, clinical exam, urine analysis, and can be confirmed by genetic testing .Treatment for trimethylaminuria mainly includes diet modification, acidic soaps and lotions, and vitamin B12 supplements.Other treatment options include antibiotics , activated charcoal, and probiotics. +","Treatment for fish odor syndrome (trimethylaminuria) aim to remove the odor through diet, including probiotics, supplements, e.g., vitamin B12, and skin care with acidic soap and lotions.Activated charcoal can remove extra trimethylamine from the body.","Treatment for trimethylaminuria mainly includes diet modification, acidic soaps and lotions, and vitamin B12 supplements.Other treatment options include antibiotics , activated charcoal, and probiotics.Treatment for trimethylaminuria is focused on removing and preventing the bad odor.Options for treatment include diet modification, vitamin B12 (riboflavin) supplements, antibiotic treatment, and probiotics.Other supplements such as activated charcoal can help remove extra trimethylamine from the body.In addition, some people with trimethylaminuria may benefit from behavioral counseling.Specialists involved in the care of someone with trimethylaminuria may include: Nutritionist Medical geneticist Pharmacist Psychologist/ psychiatrist" +43,How can I get tested and treated for trimethylaminuria?,"Treatment for trimethylaminuria is focused on removing and preventing the bad odor.Options for treatment include diet modification, vitamin B12 (riboflavin) supplements, antibiotic treatment, and probiotics.Other supplements such as activated charcoal can help remove extra trimethylamine from the body.In addition, some people with trimethylaminuria may benefit from behavioral counseling.[2][3] Specialists involved in the care of someone with trimethylaminuria may include:[1] Nutritionist Medical geneticist Pharmacist Psychologist/ psychiatrist +Trimethylaminuria causes the body to produce a fishy odor that is released in the sweat, urine, breath, and reproductive fluids.People with trimethylaminuria are unable to break down trimethylamine, a chemical found in certain foods.The excess trimethylamine builds up and is the source of the odor.There are no other physical symptoms from trimethylaminuria, but people with this condition may experience serious psychological and social distress.Trimethylaminuria is due to a FMO3 gene that is not working correctly.It is inherited in an autosomal recessive pattern.It is diagnosed based on the symptoms, clinical exam, urine analysis, and can be confirmed by genetic testing .Treatment for trimethylaminuria mainly includes diet modification, acidic soaps and lotions, and vitamin B12 supplements.Other treatment options include antibiotics , activated charcoal, and probiotics. +Trimethylaminuria is diagnosed based on the symptoms, a clinical exam, and a test to measure the level of trimethylamine in the urine.Genetic testing can also help confirm the diagnosis.[1][2] Guidelines for diagnosing trimethylaminuria have been published.[4] Testing Resources The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition.The intended audience for the GTR is health care providers and researchers.Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional.The Monell Chemical Senses Center is able to assist in the diagnostic testing of patients who may have trimethylaminuria.Monell is a non-profit, basic scientific research center focused on understanding the senses of taste and smell.They are not a medical clinic.If you are interested in more information, you can send an e-mail to bodyodorinfo@monell.org.The Information Center provides the names of these centers for informational purposes only, not as an endorsement of the institutions' products or services. +","Trimethylaminuria is diagnosed based on the symptoms, a clinical exam, and a test to measure the level of trimethylamine in the urine.Genetic testing and family history can help confirm the diagnosis.Treatments trimethylaminuria aim to remove the odor through diet, including probiotics, supplements, e.g., vitamin B12, and skin care with acidic soap and lotions.Activated charcoal can remove extra trimethylamine from the body.","Trimethylaminuria is diagnosed based on the symptoms, a clinical exam, and a test to measure the level of trimethylamine in the urine.Genetic testing can also help confirm the diagnosis.Treatment for trimethylaminuria mainly includes diet modification, acidic soaps and lotions, and vitamin B12 supplements.Other treatment options include antibiotics , activated charcoal, and probiotics. activated charcoal can help remove extra trimethylamine from the body.In addition, some people with trimethylaminuria may benefit from behavioral counseling.Specialists involved in the care of someone with trimethylaminuria may include: Nutritionist Medical geneticist Pharmacist Psychologist/ psychiatrist" +44,Where can we get information and treatment for collagenous gastritis?,"Because collagenous gastritis is very rare and its cause is unknown, there is currently no established standard therapy for the condition.Various therapies have been attempted with limited success.These have included anti-secretary agents, steroids, iron supplementation, and hypoallergenic diets.Several other therapies have also been tested.A few affected people have shown improvement of symptoms, but no randomized, controlled trials have been performed.More studies are needed to establish a standard treatment strategy.[3] +Collagenous gastritis (CG) is a rare condition that primarily affects the digestive system.People with CG have increased buildup of collagen in the subepithelial layer of the stomach.[1][2] This condition typically affects children and young adults up to 22 years, or older adults over 35 years of age.Signs and symptoms appear to vary depending on the age group.Initial symptoms in children and young adults often include anemia and abdominal pain, whereas older adults often have chronic watery diarrhea associated with collagenous colitis, celiac disease or both.[1][3] Adult collagenous gastritis is also associated with autoimmune diseases such as Sjgren syndrome , lymphocytic gastritis, lymphocytic colitis, and ulcerative colitis.[3] Other signs and symptoms of CG may include nausea and vomiting, weight loss, abdominal distention, and gastrointestinal bleeding.[3] The cause of the condition is unclear.[1] Because of the small number of cases, no standard therapy for CG has been established based on randomized, controlled clinical trials .[3] +The course and long-term outlook ( prognosis ) for people with collagenous gastritis (CG) is unclear.There has not yet been a comprehensive review of outcomes, and large variations in the course of the disease have been reported.[4][5]In the majority of adults, the condition seems to follow a chronic, intermittent course, with no significant mortality risk or severe progression.Diarrhea may resolve with or without treatment, although relapses may occur.[6]In children, a less controllable course has been suspected.[6] However, CG in children seems to follow a generally benign course, with limited long-term morbidity and no increased mortality reported to date.[4] A few reports have documented that the abnormal collagen band in affected people persists (with or without medication) despite symptoms improving.[6] +","Collagenous gastritis is a rare disease for which different treatments were explored.Some people have shown improvements with or without treatments that included anti-secretary agents, steroids, iron supplementation, and hypoallergenic diets.","No standard therapy for CG has been established based on randomized, controlled clinical trials Because collagenous gastritis is very rare and its cause is unknown, there is currently no established standard therapy for the condition.Various therapies have been attempted with limited success.These have included anti-secretary agents, steroids, iron supplementation, and hypoallergenic diets.Several other therapies have also been tested.A few affected people have shown improvement of symptoms.Diarrhea may resolve with or without treatment, A few reports have documented that the abnormal collagen band in affected people persists (with or without medication) despite symptoms improving." +45,Can umbilical cord blood help with ALS?,"No cure has yet been found for ALS.However, the drugs riluzole and edaravone have approved by the Food and Drug Administration (FDA) to treat ALS.Riluzole prolongs life by 2-3 months but does not relieve symptoms.Edaravone can slow the clinical decline in daily functioning of people with ALS.The FDA has also approved the NeuRx Diaphragm Pacing System, which uses implanted electrodes and a battery pack to cause the diaphragm (breathing muscle) to contract, to help certain individuals who have ALS before the onset of severe respiratory failure.Other treatments are desig ned to relieve symptoms and improve the quality of life for people with ALS.Drugs are available to help individuals with spasticity, pain, panic attacks, and depression.Physical therapy, occupational therapy, and rehabilitation may help to prevent joint immobility and slow muscle weakness and atrophy.Individuals with ALS may eventually consider forms of mechanical ventilation (respirators). +There's no cure for ALS or other motor neuron diseases.Doctors treat your symptoms with: Physical therapy to keep your joints flexible and slow muscle wasting Occupational therapy to prevent choking while eating, or a feeding tube into your stomach if you can no longer swallow Medicines to help with muscle twitches or cramps Medicine to help with emotional outbursts or depression Medicine to help with drooling Medicine for pain A ventilator (breathing machine) if you're too weak to breathe on your own Even with feeding tubes and ventilators, about half of people with ALS die within about 3 years.However, some people live over 10 years and very rarely 30 or more.If you have ALS or one of the other dangerous motor neuron diseases, you may want to make an advance directive.An advance directive is a plan to let your loved ones and doctors know what kinds of medical care you want at the end of your life. +Regardless of the part of the body first affected by the disease, muscle weakness and atrophy spread to other parts of the body as the disease progresses.Individuals have increasing problems with moving, swallowing, and speaking or forming words.Eventually people with ALS will not be able to stand or walk, get in or out of bed on their own, or use their hands and arms.In later stages of the disease, individuals have difficulty breathing as the muscles of the respiratory system weaken.Although ventilation support can ease problems with breathing and prolong survival, it does not affect the progression of ALS.Most people with ALS die from respiratory failure, usually within 3 to 5 years from the onset of symptoms.However, about 10 percent of those individuals with ALS survive for 10 or more years. +

Summary

Amyotrophic lateral sclerosis (ALS) is a nervous system disease that attacks nerve cells called neurons in your brain and spinal cord.These neurons transmit messages from your brain and spinal cord to your voluntary muscles - the ones you can control, like in your arms and legs.At first, this causes mild muscle problems.Some people notice Trouble walking or running Trouble writing Speech problems Eventually, you lose your strength and cannot move.When muscles in your chest fail, you cannot breathe.A breathing machine can help, but most people with ALS die from respiratory failure.The disease usually strikes between age 40 and 60.More men than women get it.No one knows what causes ALS.It can run in families, but usually it strikes at random.There is no cure.Medicines can relieve symptoms and, sometimes, prolong survival.NIH: National Institute of Neurological Disorders and Stroke +","There is currently no cure for ALS.Edaravone is a drug for slowing down the decline in body functions and Riluzole may somewhat prolong life.Other drugs are used to relieve symptoms, such as spasticity, pain, panic attacks, and depression.Physical therapy and occupational therapy slow muscle waisting, keep the joints flexible and prevent choking while swallowing food, but a feeding tube might be needed.If people are to weak to breathe, NeuRx Diaphragm Pacing System could stimulate the diaphragm.A ventilator might be used to support breathing and prolong survival.","No one knows what causes ALS.It can run in families, but usually it strikes at random.There is no cure.Medicines can relieve symptoms and, sometimes, prolong survival. The drugs riluzole and edaravone have approved by the Food and Drug Administration (FDA) to treat ALS.Riluzole prolongs life by 2-3 months but does not relieve symptoms.Edaravone can slow the clinical decline in daily functioning of people with ALS.The FDA has also approved the NeuRx Diaphragm Pacing System, which uses implanted electrodes and a battery pack to cause the diaphragm (breathing muscle) to contract, to help certain individuals who have ALS before the onset of severe respiratory failure. Drugs are available to help individuals with spasticity, pain, panic attacks, and depression. Doctors treat your symptoms with: Physical therapy to keep your joints flexible and slow muscle wasting Occupational therapy to prevent choking while eating, or a feeding tube into your stomach if you can no longer swallow A ventilator (breathing machine) if you're too weak to breathe on your own.Although ventilation support can ease problems with breathing and prolong survival, it does not affect the progression of ALS." +46,Is there a registry for children with uncomfortable hair syndrome?,"Uncombable hair syndrome is a condition that is characterized by dry, frizzy hair that cannot be combed flat.This condition develops in childhood, often between infancy and age 3, but can appear as late as age 12.Affected children have light-colored hair, described as blond or silvery with a glistening sheen.The hair does not grow downward but out from the scalp in multiple directions.Despite its appearance, the hair is not fragile or brittle, and it grows at a normal or slightly slower rate.Only scalp hair is affected in uncombable hair syndrome.For unknown reasons, this condition usually improves over time.By adolescence individuals with uncombable hair syndrome have hair that lies flat and has normal or nearly normal texture. +The prevalence of uncombable hair syndrome is unknown; at least 100 cases have been described in the scientific literature.There are likely more people who are undiagnosed because adults who seem unaffected may have had uncombable hair syndrome in childhood. +Uncombable hair syndrome (UHS) usually resolves on its own (spontaneously) by adolescence.[6] Treatment is usually not necessary.[1] In the cases, where UHS is part of syndrome, the prognosis will depend on the specific syndrome and the signs and symptoms present in the person. +There is no definitive treatment for uncombable hair syndrome , but the condition usually improves or resolves on its own with the onset of puberty.Gentle hair care is generally recommended using conditioners and soft brushes, along with avoiding harsh hair treatments such as permanent waves (perms); chemical relaxants; or excessive brushing and blow drying.These strategies may improve the general manageability of the hair, although how well they work is subjective.[6] Another strategy that has been suggested to improve the appearance of the hair is the use of biotin supplements.One case report suggested significant improvement in hair strength and combability, with an increase in rate of growth after 4 months of supplementation.[6] +Uncombable hair syndrome (UHS) is a rare disorder of the hair shaft of the scalp.It is usually characterized by silvery-blond or straw-colored hair that is disorderly; stands out from the scalp; and cannot be combed flat.It may first become apparent from 3 months of age to 12 years of age.[1]Most cases are isolated, but in some cases it he condition often spontaneously regresses in late childhood.[3] Some published studies suggest that biotin may improve the condition.[4] +",At least 100 cases of uncombable hair syndrome have been described in the literature.There might be more cases because the condition is often undiagnosed and resolves on its own in adolescents.Gentle hair care is recommended and biotin might improve the symptoms.,"Uncombable hair syndrome is a condition that is characterized by dry, frizzy hair that cannot be combed flat. Uncombable hair syndrome (UHS) usually resolves on its own (spontaneously) by adolescence.The prevalence of uncombable hair syndrome is unknown; at least 100 cases have been described in the scientific literature.There are likely more people who are undiagnosed because adults who seem unaffected may have had uncombable hair syndrome in childhood.Gentle hair care is generally recommended using conditioners and soft brushes, along with avoiding harsh hair treatments such as permanent waves (perms); chemical relaxants; or excessive brushing and blow drying. Some published studies suggest that biotin may improve the condition." +48,What is the most effective bladder surgery for incontinence and what is its success rate?,"Besides bladder control training, you may want to talk with your doctor about other ways to help manage incontinence:- Medicines can help the bladder empty more fully during urination.Other drugs tighten muscles and can lessen leakage.- Some women find that using an estrogen vaginal cream may help relieve stress or urge incontinence.A low dose of estrogen cream is applied directly to the vaginal walls and urethral tissue.- A doctor may inject a substance that thickens the area around the urethra to help close the bladder opening.This can reduce stress incontinence in women.This treatment may need to be repeated.- Some women may be able to use a medical device, such as a urethral insert, a small disposable device inserted into the urethra.A pessary, a stiff ring inserted into the vagina, may help prevent leaking if you have a prolapsed bladder or vagina.- Nerve stimulation, which sends mild electric current to the nerves around the bladder that help control urination, may be another option.- Surgery can sometimes improve or cure incontinence if it's caused by a change in the position of the bladder or blockage due to an enlarged prostate.Even after treatment, some people still leak urine from time to time.There are bladder control products and other solutions, including adult diapers, furniture pads, urine deodorizing pills, and special skin cleansers that may make leaking urine bother you a little less.Visit the National Institute of Diabetes and Digestive and Kidney Diseases for more information on urinary incontinence in men and urinary incontinence in women.Read about this topic in Spanish.Lea sobre este tema en espanol. +Regardless of the type and cause of incontinence, some general measures are usually helpful.Modifying fluid intake Bladder training Pelvic muscle exercises Fluid intake can be limited at certain times (for example, before going out or 3 to 4 hours before bedtime).Doctors may suggest that people avoid fluids that irritate the bladder (such as caffeine-containing fluids).However, people should drink 48 to 64 oz (1500 to 2000 mL) of fluid a day because concentrated urine irritates the bladder.Bladder training is a technique that involves having the person follow a fixed schedule for urination while awake.The doctor works with the person to establish a schedule of urinating every 2 to 3 hours and suppressing the urge to urinate at other times (for example, by relaxing and breathing deeply).As the person becomes better able to suppress the urge to urinate, the interval is gradually lengthened.A similar technique, called prompted voiding, can be used by people who care for a person with dementia or other cognitive problems.In this, the person is asked whether they need to urinate and whether they are wet or dry at specific intervals.Pelvic muscle exercises (Kegel exercises) are often effective, especially for stress incontinence.People must be certain to exercise the correct muscles, the muscles around the urethra and rectum that stop the flow of urine.The muscles are tightly squeezed for 1 to 2 seconds and then relaxed for about 10 seconds.The exercises are repeated about 10 times three times each day.People are gradually able to increase the time the muscles are tightly squeezed until the contraction is held for about 10 seconds each time.Because it can be difficult to learn to control the correct muscles, doctors may need to provide instruction or recommend the use of biofeedback or electrical stimulation (an electronic version of pelvic floor exercises in which an electric current is used to stimulate the correct muscles).TableSome Drugs Used to Treat Urinary Incontinence Drug How It Works Comments For weakness of the urinary sphincter or pelvic muscles (bladder outlet incompetence) causing stress incontinence Duloxetine Helps strengthen contractions of the urinary sphincter Not as thoroughly studied as many other drugs Not approved for this use in the United States Imipramine (a tricyclic antidepressant)Helps strengthen urinary sphincter contractions and relax an overactive bladder (an anticholinergic effect*) Also used for overactive bladder and urge incontinence FDA approved as temporary therapy for reducing nighttime incontinence (enuresis) in children aged 6 years and older Pseudoephedrine (an alpha-adrenergic stimulant)Helps strengthen urinary sphincter contractions Can cause anxiety, insomnia, and, in men, inability to urinate OTC medication used primarily as a decongestant For bladder outlet obstruction in men causing urge or overflow incontinence Alpha-adrenergic blockers: Alfuzosin Doxazosin Prazosin Silodosin Tamsulosin Terazosin Help relax the urinary sphincter Tend to increase the speed of urine flow and help the bladder empty more completely May decrease blood pressure or cause fatigue 5-Alpha reductase inhibitors: Dutasteride Finasteride Help shrink an enlarged prostate Can take weeks or months to become effective Sometimes decrease sex drive or contribute to erectile dysfunction Phosphodiesterase type 5 (PDE5) inhibitor: Tadalafil Doctors are not certain how this drug affects an enlarged prostate Low dose taken daily (also used to treat erectile dysfunction)For overactive bladder with urge or stress incontinence Darifenacin Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects)Dicyclomine Relaxes involuntary muscles Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects*) Not as thoroughly studied as many other drugs Fesoterodine Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects) Not as thoroughly studied as many other drugs Hyoscyamine Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects*) Not as thoroughly studied as many other drugs Imipramine (a tricyclic antidepressant)Helps strengthen urinary sphincter contractions Increases the bladder's filling capacity and decreases bladder wall muscle spasms (an anticholinergic effect*) Particularly useful for nighttime incontinence Mirabegron (a beta-adrenergic stimulant) Relaxes the bladder wall Not as thoroughly studied as many other drugs May increase blood pressure OnabotulinumtoxinA (a type of botulinum toxin) Blocks the nerve activity in the bladder muscle that causes the bladder to contract involuntarily Injected into the bladder wall through a cystoscope inserted in the bladder Used to treat incontinence in adults with overactive bladder caused by a neurologic disorder (such as multiple sclerosis) when other drugs are ineffective or have too many side effects Oxybutynin Many effects, such as relaxation of involuntary muscles and anticholinergic effects*, which include increasing the bladder's filling capacity and decreasing the bladder wall muscle spasms May be the most effective drug Available as a tablet, skin patch, and gel Solifenacin Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects)Tolterodine Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects)Trospium Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects*)For weak bladder wall muscles with overflow incontinence Bethanechol Helps bladder wall muscles contract Usually ineffective Can cause flushing, abdominal cramps, and an increased heart rate * Anticholinergic effects (such as dry mouth, constipation, and sometimes blurred vision or confusion) can be bothersome, particularly in older people.These drugs have anticholinergic effects that target the urinary system, so they tend to have fewer other anticholinergic side effects than other drugs with anticholinergic effects.FDA =Food and Drug Administration; OTC = over-the-counter. +","Surgery can improve incontinence in some cases, but some leaks can still happen and require additional measures.Measures that generally help include modifying fluid intake, bladder training, pelvic muscle exercises and medications.","Regardless of the type and cause of incontinence, some general measures are usually helpful.Modifying fluid intake Bladder training Pelvic muscle exercises Surgery can sometimes improve or cure incontinence if it's caused by a change in the position of the bladder or blockage due to an enlarged prostate.Even after treatment, some people still leak urine from time to time.There are bladder control products and other solutions, including adult diapers, furniture pads, urine deodorizing pills, and special skin cleansers that may make leaking urine bother you a little less." +49,What are the latest treatments for the stiff-person syndrome?,"Diazepam (a sedative) or another drug to relax the muscles Immune globulinSometimes corticosteroids Sometimes rituximab or plasma exchange Treatment of stiff-person syndrome focuses on relieving symptoms.The sedative diazepam can consistently relieve the muscle stiffness.If diazepam is ineffective, other drugs, such as baclofen (a muscle relaxant), may be tried.Immune globulin (a solution containing many different antibodies collected from a group of donors), given intravenously, may help relieve symptoms for up to a year.Corticosteroids can help but, if taken for a long time, have many side effects.If immune globulin does not help, rituximab (a drug that modifies the immune system's activity) or plasma exchange, which involves filtering toxic substances (including the abnormal antibodies) from the blood, is sometimes tried. +Treatment aims to control symptoms and improve mobility and function.While some people on treatment for SPS may maintain reasonable levels of activity, the majority become increasingly disabled over time.Treatment options depend on the symptoms and severity in each person and may include:[2][3] Benzodiazepines - these are drugs that slow down the nervous system and may relieve muscle spasms and anxiety.They are generally considered the best initial therapy for SPS.Examples include diazepam and clonazepam.Baclofen - this is a muscle relaxant that may be used for people in whom benzodiazepines are not effective or not well-tolerated.Some people benefit from using baclofen in addition to benzodiazepines.Immune modulating therapies - these may be considered in people with severe symptoms who do not experience relief with benzodiazepines and baclofen.Options may include intravenous immune globulin (IVIG) therapy, plasmapheresis (also called plasma exchange), and rituximab.However studies supporting the effectiveness and safety of these therapies for SPS are limited.Physical therapy and occupational therapy are also an important part of management for SPS and may help with side effects of medications (such as weakness) in addition to symptoms of the disease.[3] Management Guidelines Project OrphanAnesthesia is a project whose aim is to create peer-reviewed, readily accessible guidelines for patients with rare diseases and for the anesthesiologists caring for them.The project is a collaborative effort of the German Society of Anesthesiology and Intensive Care, Orphanet, the European Society of Pediatric Anesthesia, anesthetists and rare disease experts with the aim to contribute to patient safety. +","Muscle stiffness in the stiff-person syndrome can be relieved with sedatives diazepam and clonazepam or muscle relaxant baclofen.Immune modulating therapies: intravenous immune globulin, plasma exchange, and rituximab may relieve more severe symptoms.Physical and occupational therapy relieve the symptoms and might help with side effects of the medications.","Treatment of stiff-person syndrome focuses on relieving symptoms.The sedative diazepam can consistently relieve the muscle stiffness.If diazepam is ineffective, other drugs, such as baclofen (a muscle relaxant), may be tried.Immune globulin (a solution containing many different antibodies collected from a group of donors), given intravenously, may help relieve symptoms for up to a year. If immune globulin does not help, rituximab (a drug that modifies the immune system's activity) or plasma exchange, which involves filtering toxic substances (including the abnormal antibodies) from the blood, is sometimes tried. Physical therapy and occupational therapy are also an important part of management for SPS and may help with side effects of medications (such as weakness) in addition to symptoms of the disease." +52,How can we find a specialist or clinical trial for chronic folliculitis?,"Folliculitis is an infection of a hair follicle.It looks like a tiny red or white pimple at the base of a hair.There may be only one infected follicle or many.Each infected follicle is itchy or slightly painful, but the person otherwise does not feel sick.Some people develop folliculitis after exposure to a poorly chlorinated hot tub or whirlpool.This condition, sometimes called hot tub folliculitis or hot tub dermatitis, is caused by the bacteriumPseudomonas aeruginosa.It begins anytime from 6 hours to 5 days after the exposure.Areas of skin covered by a bathing suit, such as the torso and buttocks, are the most common sites.Some people develop mild folliculitis in areas subjected to moisture and friction, such as areas under sports equipment or on the buttocks.Infected hairs easily fall out or may be plucked out, but new pimples tend to develop.Sometimes stiff hairs in the beard area curl and reenter the skin (ingrown hair) after shaving, causing mild irritation and inflammation.However, there is no actual infection.This type of folliculitis is called pseudofolliculitis barbae.Folliculitis is treated with antibacterial cleansers or antibiotics that are applied directly to the skin (topically).Large areas of folliculitis may require antibiotics taken by mouth.Hot tub folliculitis goes away in a week without any treatment.However, adequate chlorination of the hot tub or whirlpool is necessary to prevent recurrences and to protect others from infection.Folliculitis caused by ingrown hairs is treated by a number of methods with varying success.The person may need to temporarily stop shaving.For severe, recurring folliculitis, doctors may take a bacterial culture (a sample of pus is sent to a laboratory and placed in a culture medium that allows microorganisms to grow).The results of the culture are used to guide the choice of antibiotic. +The long-term outlook ( prognosis ) for people with eosinophilic pustular folliculitis (EPF) depends on the type of EPF present (classic, infantile, or immunosuppression-associated).Classic EPF, which occurs mainly in adults, is generally chronic and recurrent but benign.Individual lesions typically last more than 1-2 weeks, and relapse every 3-4 weeks.Except for skin involvement, people with classic EPF are generally in good health with no systemic symptoms.Infantile EPF generally also runs a benign course, and resolves on its own by 3 years of age in over 80% of cases.It is important to recognize that this form is self-limiting so as to avoid unnecessary aggressive treatment in affected infants.Children with this form also generally remain in good health without associated problems, although a possible association with atopy (tendency to develop allergies) has been speculated.The immunosuppression-associated type of EPF is mainly associated with HIV infection, hematological malignancy (blood cancers ), or other cancers, so recognizing that a person has this form of EPF is important.The overall prognosis beyond the skin symptoms largely depends on the prognosis associated with the underlying condition.[7] +Doctors may have you: Wash your body with antibacterial soap Wet a washcloth with warm salt water and apply it to the folliculitis a few times a day Put antibiotic cream on your skin Take antibiotics by mouth, if you have a large area of infected follicles If you regularly get ingrown hairs, doctors may have you: Stop shaving for a while Take antibiotics, if the follicles are infected Hot tub folliculitis will go away on its own.Check and fix the chlorine level of the hot tub to prevent other people from getting folliculitis. +","Folliculitis is usually treated with antibiotics.For chronic recurring type, your doctor will take bacterial cultures to find the best antibiotics.In young children wit eosinophilic pustular folliculitis (EPF) it usually clears on its own by the age of three and does not require treatment.In adults, the underlying condition is treated if EPF is immunosuppression-associated. For folliculitis caused by ingrown hairs , the person might need to temporarily stop shaving.","For severe, recurring folliculitis, doctors may take a bacterial culture (a sample of pus is sent to a laboratory and placed in a culture medium that allows microorganisms to grow).The results of the culture are used to guide the choice of antibiotic.Doctors may have you: Wash your body with antibacterial soap Wet a washcloth with warm salt water and apply it to the folliculitis a few times a day Put antibiotic cream on your skin Take antibiotics by mouth, if you have a large area of infected follicles If you regularly get ingrown hairs, doctors may have you: Stop shaving for a while Take antibiotics, Folliculitis caused by ingrown hairs is treated by a number of methods with varying success.The person may need to temporarily stop shaving.The long-term outlook ( prognosis ) for people with eosinophilic pustular folliculitis (EPF) depends on the type of EPF present (classic, infantile, or immunosuppression-associated).Classic EPF, which occurs mainly in adults, is generally chronic and recurrent but benign.Individual lesions typically last more than 1-2 weeks, and relapse every 3-4 weeks.Infantile EPF generally also runs a benign course, and resolves on its own by 3 years of age in over 80% of cases.It is important to recognize that this form is self-limiting so as to avoid unnecessary aggressive treatment in affected infants.The immunosuppression-associated type of EPF is mainly associated with HIV infection, hematological malignancy (blood cancers ), or other cancers, so recognizing that a person has this form of EPF is important.The overall prognosis beyond the skin symptoms largely depends on the prognosis associated with the underlying condition." +53,Is there a way to improve kidneys in a person on twice-weekly dialysis?,"The abdominal organs, such as the stomach and intestines, are inside a large hollow space called the abdominal cavity.The peritoneum is a membrane that lines the abdominal cavity and covers the abdominal organs.In peritoneal dialysis, that membrane acts as a filter.This membrane has a large surface area and a rich network of blood vessels.Substances from the blood can easily pass through the peritoneum into the abdominal (peritoneal) cavity.A fluid (dialysate) is infused through a catheter inserted through the abdominal wall into the peritoneal space within the abdomen.The dialysate must be left in the abdomen for a sufficient time to allow waste products from the bloodstream to pass slowly into it.Then the dialysate is drained out, discarded, and replaced with fresh dialysate.A soft silicone rubber or porous polyurethane catheter allows the dialysate to flow smoothly and is unlikely to cause damage.A catheter can be put in place temporarily at the persons bedside, or it may be surgically put in place permanently.One type of permanent catheter eventually forms a seal with the skin and can be capped when not in use.Peritoneal dialysis can be done using a machine (called automated peritoneal dialysis) or without one (using manual techniques).Manual peritoneal dialysis techniques are the simplest.No machine is used.There are two types:In manual intermittent peritoneal dialysis, bags containing dialysate are warmed to body temperature and infused into the peritoneal (abdominal) cavity, which takes about 10 minutes.The dialysate is allowed to remain there (dwell time) for 60 to 90 minutes and then is drained out in about 10 to 20 minutes.This process is then repeated.The entire treatment can take 12 to 24 hours.Between periods of dialysis, there is no dialysate in the peritoneal cavity.In continuous ambulatory peritoneal dialysis, the dialysate is usually drained and replenished 4 or 5 times per day.Generally, 3 of these dialysate exchanges are done during the day, with dwell times of 4 hours or longer.An exchange is done at night with a long dwell time of 8 to 12 hours during sleep.Continuous ambulatory peritoneal dialysis differs from intermittent peritoneal dialysis in that there is always dialysate in the peritoneal cavity.Automated peritoneal dialysis techniques are becoming the most commonly used forms of peritoneal dialysis.In automated peritoneal dialysis, an automated device does multiple exchanges during the night while the person sleeps.These techniques minimize the number of exchanges during the day but prevent mobility at night because of cumbersome equipment.Sometimes a daytime exchange time is used.Automated peritoneal dialysis techniques are further divided into three subcategories: Continuous cyclic peritoneal dialysis uses a long (12- to 15-hour) daytime dwell period and 3 to 6 nighttime exchanges done with an automated cycler.Nocturnal intermittent peritoneal dialysis uses exchanges done with a cycler at night while the person's peritoneal cavity is left without dialysate fluid during the day.Tidal peritoneal dialysis is a modification in which some of the dialysate fluid is left in the peritoneal cavity from one exchange to the next.This technique may be more comfortable for the person.Tidal peritoneal dialysis may be done with or without a daytime dwell period.Some people require a combination of continuous ambulatory peritoneal dialysis and continuous cyclic peritoneal dialysis to achieve adequate removal of waste products from their blood.TableSome Common Complications of Peritoneal Dialysis Complication Cause Low blood pressure Loss of too much fluid and salt during dialysis Bleeding Unintentional perforation of an internal organ during placement of the catheter Removal of the catheter from the body Irritation and inflammation of the membrane that lines the abdomen (peritoneum) or the area around the insertion site (when the catheter does not seal to the abdominal wall)Infection Unsterile techniques during dialysis Low level of albumin (a protein) in the blood Loss of protein in fluid removed during dialysis along with inadequate protein in diet Scarring of the peritoneum* Inflammation and infection Electrolytes in the dialysis fluid Use of certain drugsA high sugar (glucose) level in the blood Use of a peritoneal dialysate that has a high concentration of glucose (used to remove water and sodium during dialysis)Hernias in the abdomen or groin Increased pressure within the abdomen caused by continued exposure to high fluid levels, which weaken the barriers that normally prevent excessive movement of organs and other structures Constipation Intake of inadequate fiber or use of calcium salts to treat high phosphate levels in the blood, causing the intestine to widen, which possibly interferes with dialysate flow in and out of the abdomen *The peritoneum acts as a filter in peritoneal dialysis.When the peritoneum is scarred, fluids and waste products can no longer readily pass through it to be removed. +People undergoing dialysis need a special diet.In people undergoing peritoneal dialysis, appetite is generally poor, and protein is lost during dialysis.The diet should have enough calories (about 16 calories per pound of ideal body weight, slightly more in children) and be relatively high in protein (about 1/2 gram of protein per pound of ideal body weight) per day.(The American Association of Kidney Patients has a food guide.)Salt, both the usual table salt, which contains sodium, and the salt containing potassium, is restricted.For people undergoing hemodialysis, daily consumption of sodium and potassium is even more restricted.Foods high in phosphorus also may have to be limited.Daily fluid intake is limited for people who have very little urine output or a persistently low or decreasing sodium concentration in the blood.Daily weighing is important to monitor weight gain.Excessive weight gain between hemodialysis treatments indicates that the person is consuming excessive fluid.Usually, excessive fluid intake is the result of excessive sodium intake, which makes a person thirsty.Multivitamin supplements are needed to replace the nutrients lost through hemodialysis or peritoneal dialysis.Vitamin supplements should be discussed with a doctor or nutritionist. +

Summary

When your kidneys are healthy, they clean your blood.They also make hormones that keep your bones strong and your blood healthy.When your kidneys fail, you need treatment to replace the work your kidneys used to do.Unless you have a kidney transplant, you will need a treatment called dialysis.There are two main types of dialysis.Both types filter your blood to rid your body of harmful wastes, extra salt, and water.Hemodialysis uses a machine.It is sometimes called an artificial kidney.You usually go to a special clinic for treatments several times a week.Peritoneal dialysis uses the lining of your abdomen, called the peritoneal membrane, to filter your blood.NIH: National Institute of Diabetes and Digestive and Kidney Diseases +Many factors, including lifestyle, must be considered in determining which type of dialysis is best for a person.People typically undergo hemodialysis at a dialysis center, usually outside of a hospital.Peritoneal dialysis can be done at home, eliminating the need for travel to a hemodialysis center.Doctors recommend hemodialysis for people with recent abdominal wounds or abdominal surgery or defects in the abdominal wall that make peritoneal dialysis difficult.Peritoneal dialysis is better tolerated than hemodialysis in people whose blood pressure fluctuates frequently between periods of high or normal pressure and periods of low blood pressure.The most common and troublesome complications of peritoneal dialysis are infection of the peritoneal fluid (causing inflammation of the peritoneum, called peritonitis) and infection of the area where the catheter enters the skin (insertion site).Peritonitis may cause constant, sharp, severe pain throughout the abdomen, but sometimes causes little pain.Infection at the insertion site causes redness of the skin and pain at the insertion site.Such infections can be treated with antibiotics and careful wound care.Comparing Hemodialysis With Peritoneal Dialysis When the kidneys fail, waste products and excess water can be removed from the blood by hemodialysis or peritoneal dialysis.In hemodialysis, blood is removed from the body into a dialyzer (called an artificial kidney), which filters the blood.An artificial connection between an artery and a vein (arteriovenous fistula) is made to facilitate the removal of blood.In peritoneal dialysis, the peritoneum is used as a filter.The peritoneum is a membrane that lines the abdomen and covers the abdominal organs, creating a space within the abdomen called the peritoneal space or abdominal cavity.Waste products from the body drain across the peritoneum into the fluid (dialysate) in the abdominal cavity. +","Once kidneys fail, people need dialysis, unless they have kidney transplants.There are two types of dialysis: hemodialysis that is usually done at a dialysis center and peritoneal dialysis, which is becoming most commonly used.It can be done at night when the person sleeps.People on dialysis need a special diet with about 16 calories and 1/2 gram of protein per pound of ideal body weigh a day.Sodium and potassium should be restricted.Your doctor might prescribe some vitamins and supplements.","When your kidneys fail, you need treatment to replace the work your kidneys used to do.Unless you have a kidney transplant, you will need a treatment called dialysis.There are two main types of dialysis. Hemodialysis uses a machine.It is sometimes called an artificial kidney.You usually go to a special clinic for treatments several times a week.Peritoneal dialysis uses the lining of your abdomen, called the peritoneal membrane, to filter your blood. People typically undergo hemodialysis at a dialysis center, usually outside of a hospital.Peritoneal dialysis can be done at home, eliminating the need for travel to a hemodialysis center.Doctors recommend hemodialysis for people with recent abdominal wounds or abdominal surgery or defects in the abdominal wall that make peritoneal dialysis difficult.Peritoneal dialysis is better tolerated than hemodialysis in people whose blood pressure fluctuates frequently between periods of high or normal pressure and periods of low blood pressure.Automated peritoneal dialysis techniques are becoming the most commonly used forms of peritoneal dialysis.In automated peritoneal dialysis, an automated device does multiple exchanges during the night while the person sleeps. People undergoing dialysis need a special diet.The diet should have enough calories (about 16 calories per pound of ideal body weight, slightly more in children) and be relatively high in protein (about 1/2 gram of protein per pound of ideal body weight) per day.Salt, both the usual table salt, which contains sodium, and the salt containing potassium, is restricted.For people undergoing hemodialysis, daily consumption of sodium and potassium is even more restricted.Foods high in phosphorus also may have to be limited. Supplements help provide some of the vitamins and minerals that may be missing from your diet.Peritoneal dialysis also removes some vitamins from your body.Your doctor may prescribe a vitamin and mineral supplement that scientists have designed specifically for people with CKD and kidney failure.Never take vitamin and mineral supplements that you can buy over the counter.They may be harmful to you.Talk with your doctor before taking any medicine, including vitamin and mineral supplements" +54,Could you provide complete information about congenital adrenal hyperplasia?,"Congenital adrenal hyperplasia (CAH) refers to a group of genetic conditions that affect the adrenal glands.These glands sit on top of the kidneys and are responsible for releasing various types of hormones that the body needs to function.Affected people lack an enzyme the adrenal glands need to make one or more of these hormones and often overproduce androgens (male hormones such as testosterone).The signs and symptoms present in each person depend on many factors including the type of CAH, the age of diagnosis, and the sex of the affected person.For example, females with a severe form of the condition may have ambiguous genitalia at birth and if not properly diagnosed, develop dehydration, poor feeding, diarrhea, vomiting and other health problems soon after.People with milder forms may not be diagnosed with the condition until adolescence or adulthood when they experience early signs of puberty or fertility problems.Treatment for CAH varies but may include medication and/or surgery. +The long-term outlook ( prognosis ) for people with congenital adrenal hyperplasia (CAH) is usually good.With lifelong treatment, affected people typically have good health and normal lifespans.[1]However, problems with psychological adjustment are common, particularly in people with genital abnormalities.[4] +Congenital adrenal hyperplasia is the name given toa group of inherited disorders of the adrenal gland. +Congenital adrenal hyperplasia (CAH) is a group of genetic conditions that can be caused by a change ( mutation ) in several different genes :[2] 21-hydroxylase deficiency is caused by mutations in the gene 3-beta-hydroxysteroid dehydrogenase deficiency is caused by mutations in the gene 11-beta-hydroxylase deficiency is caused by mutations in the gene Cytochrome P450 oxidoreductase deficiency is caused by mutations in the gene 17-hydroxylase deficiency is caused by mutations in the CYP17A1 gene Congenital lipoid adrenal hyperplasia is caused by mutations in the STAR gene Most of these genes encode enzymes that the adrenal glands need to make one or more hormones .The adrenal glands are cone-shaped organs that sit on top of the kidneys and are responsible for releasing various types of hormones that the body needs to function.Mutations in these genes lead to deficient levels of enzymes which cause low levels of hormones such as cortisol and/or aldosterone and an overproduction of androgens (male hormones such as testosterone).Cortisol is a hormone that affects energy levels, blood sugar levels, blood pressure, and the body's response to stress, illness, and injury.Aldosterone helps the body maintain the proper level of sodium (salt) and water and helps maintain blood pressure.Irregular levels of these hormones lead to the signs and symptoms of CAH.[3][4] +All forms of congenital adrenal hyperplasia (CAH) are inherited in an autosomal recessive manner.[2] This means that to be affected, a person must have a mutation in both copies of the responsible gene in each cell .The parents of an affected person usually each carry one mutated copy of the gene and are referred to as carriers .Carriers typically do not show signs or symptoms of the condition.When two carriers of an autosomal recessive condition have children, each child has a 25% (1 in 4) risk to have the condition, a 50% (1 in 2) risk to be a carrier like each of the parents, and a 25% chance to not have the condition and not be a carrier. +The best treatment options for congenital adrenal hyperplasia (CAH) depend on many factors including the type of CAH and the signs and symptoms present in each person.Many people with CAH require steroids to replace the low hormones .These medications will need to be taken daily throughout life or the symptoms of CAH may return.It is important that affected people on medications be closely followed by their healthcare provider because their dose may need to be adjusted at different times in life such as periods of high stress or illness.Girls with severe CAH who are born with ambiguous genitalia may undergo surgery to ensure proper function and/or to make the genitals look more female.[2][3][4] For more information on the treatment of CAH, please click here. +The signs and symptoms of congenital adrenal hyperplasia (CAH) vary based on many factors including the type of CAH, the age of diagnosis and the sex of the affected person.For example, girls with the severe form of CAH may be born with ambiguous genitalia, which often allows the condition to be diagnosed before other associated health problems such as poor feeding, vomiting, dehydration, and abnormal heart beat, can develop.Males typically appear unaffected at birth even when they have a severe form of CAH and without proper diagnosis, will develop associated health problems within 2-3 weeks after birth.Both genders can experience other symptoms such as early onset of puberty, fast body growth, and premature completion of growth leading to short stature , if they are not treated in early life.[4][1][2] People affected by milder forms may not have any signs and symptoms of CAH during childhood.In these cases, a diagnosis may not be made until adolescence or adulthood when the affected person experiences early signs of puberty or fertility problems.Females with this type may have excessive facial or body hair; irregular menstrual periods; and/or acne.[4][1][2] There are two main types of CAH: classic CAH, the more severe form, and a milder form called nonclassic CAH.For a detailed description of the signs and symptoms found in each type of CAH, please click here.[3] This table lists symptoms that people with this disease may have.For most diseases, symptoms will vary from person to person.People with the same disease may not have all the symptoms listed.This information comes from a database called the Human Phenotype Ontology (HPO) .The HPO collects information on symptoms that have been described in medical resources.The HPO is updated regularly.Use the HPO ID to access more in-depth information about a symptom.Showing of Medical Terms Other Names Learn More: HPO ID 80%-99% of people have these symptoms Abnormality of metabolism/homeostasis Laboratory abnormality Metabolism abnormality 0001939Accelerated skeletal maturation Advanced bone age Early bone maturation 0005616Cryptorchidism Undescended testes Undescended testis 0000028 Female pseudohermaphroditism 0010458 Hypertension 0000822Hypospadias 0000047 Increased circulating cortisol level 0003118 30%-79% of people have these symptoms Failure to thrive in infancy Faltering weight in infancy Weight faltering in infancy 0001531Feeding difficulties in infancy 0008872 Percent of people who have these symptoms is not available through HPO Abnormality of the thorax Abnormality of the chest 0000765Abnormality of the urinary system Urinary tract abnormalities Urinary tract abnormality Urinary tract anomalies 0000079Absent scrotum 0008707 Adrenal hyperplasia Enlarged adrenal glands 0008221 Adrenogenital syndrome 0000840Ambiguous genitalia Ambiguous external genitalia Ambiguous external genitalia at birth Intersex genitalia 0000062Ambiguous genitalia, female Atypical appearance of female genitals 0000061Autosomal recessive inheritance 0000007 Bifid scrotum Cleft of scrotum 0000048Clitoral hypertrophy Enlarged clitoris 0008665Congenital adrenal hyperplasia 0008258 Decreased circulating aldosterone level Low blood aldosterone level 0004319 Decreased circulating renin level 0003351 Decreased testicular sizeSmall testes Small testis 0008734 Growth abnormality Abnormal growth Growth issue 0001507Gynecomastia Enlarged male breast 0000771 Hyperpigmentation of the skin Patchy darkened skin 0000953Hypoglycemia Low blood sugar 0001943Hypokalemia Low blood potassium levels 0002900Hypokalemic alkalosis 0001949Hypoplasia of the uterus Small uterus Underdeveloped uterus 0000013 Hypoplasia of the vagina Underdeveloped vagina 0008726 Long penis Enlarged penis 0000040 Male pseudohermaphroditism 0000037Micropenis Short penis Small penis 0000054Neonatal onset 0003623Precocious puberty in males Early onset of puberty in males 0008185Premature pubarche Premature pubic hair growth 0012411 Primary amenorrhea 0000786Recurrent fever Episodic fever Increased body temperature, episodic Intermittent fever 0001954Renal salt wasting Loss of salt in urine 0000127 Short stature Decreased body height Small stature 0004322Showing of +Approximately 1 in 10 to 15,000 people in the United States has congenital adrenal hyperplasia due to classic 21-hydroxylase deficiency.[5][4]The prevalence is higher is other parts of the world. +","Congenital adrenal hyperplasia (CAH) affects the adrenal gland. It is inherited, and both parents need to have mutations in their genes for the child to get the disorder.The most common form of CAH is caused by 21-hydroxylase deficiency.that is diagnosed during newborn screening in US. CAH caused by other mutations usually diagnosed when children or young adults start experiencing the symptoms of the condition.The diagnosis is confirmed ,by physical examination; tests for hormone levels in blood and urine; x-rays and genetic testing. The symptoms depend on the sex and age of the person, and type of CAH.Girls may have ambiguous genitalia at birth and develop dehydration, poor feeding, diarrhea, vomiting and other health problems.Milder forms of CAH may be undetected until the early signs of puberty or fertility problems.Treatments include medication , such as steroids to replace the low hormones, or surgery. The outlook for CAH is usually good for people who adhere to lifelong treatment.Some psychological problems are common in people with genital abnormalities.","Congenital adrenal hyperplasia is the name given to a group of inherited disorders of the adrenal gland. Approximately 1 in 10 to 15,000 people in the United States has congenital adrenal hyperplasia due to classic 21-hydroxylase deficiency.The prevalence is higher is other parts of the world.All forms of congenital adrenal hyperplasia (CAH) are inherited in an autosomal recessive manner. Shortly after birth, all newborns in the United States are screened for a variety of conditions, including 21-hydroxylase deficiency.This is the most common cause of congenital adrenal hyperplasia (CAH) and accounts for 95% of classic CAH cases.Nonclassic CAH is not detected through newborn screening and is often not suspected until signs and symptoms of the condition begin to appear later in childhood or early adulthood.In these cases, a diagnosis of CAH is usually based on physical examination; blood and urine tests that measure hormone levels; and/or genetic testing.An X-ray may also be helpful in confirming the diagnosis in children since CAH can cause bones to grow and develop more quickly than usual (advanced bone age) .The signs and symptoms present in each person depend on many factors including the type of CAH, the age of diagnosis, and the sex of the affected person.For example, females with a severe form of the condition may have ambiguous genitalia at birth and if not properly diagnosed, develop dehydration, poor feeding, diarrhea, vomiting and other health problems soon after.People with milder forms may not be diagnosed with the condition until adolescence or adulthood when they experience early signs of puberty or fertility problems.Treatment for CAH varies but may include medication and/or surgery. Many people with CAH require steroids to replace the low hormones . The long-term outlook ( prognosis ) for people with congenital adrenal hyperplasia (CAH) is usually good.With lifelong treatment, affected people typically have good health and normal lifespans.However, problems with psychological adjustment are common, particularly in people with genital abnormalities." +55,Can I have a normal life with rheumatoid arthritis in both knees?,"Treatment of rheumatoid arthritis continues to improve, which can give many people relief from symptoms, improving their quality of life.Doctors may use the following options to treat RA: Medications.Surgery.Routine monitoring and ongoing care.Complementary therapies.Your doctor may recommend a combination of treatments, which may change over time based on your symptoms and the severity of your disease.No matter which treatment plan your doctor recommends, the goals are to help: Relieve pain.Decrease inflammation and swelling.Prevent, slow, or stop joint and organ damage.Improve your ability to participate in daily activities.Rheumatoid arthritis may start causing joint damage during the first year or two that a person has the disease, so early diagnosis and treatment are very important.

Medications

Most people who have RA take medications.Studies show that early treatment with combinations of medications, instead of one medication alone, may be more effective in decreasing or preventing joint damage.Many of the medications that doctors prescribe to treat RA help decrease inflammation and pain, and slow or stop joint damage.They may include: Anti-inflammatory medications to provide pain relief and lower inflammation.Corticosteroids that can help decrease inflammation, provide some pain relief, and slow joint damage.Because they are potent drugs, your doctor will prescribe the lowest dose possible to achieve the desired benefit.Disease-modifying antirheumatic drugs (DMARDs) that can help to slow or change the progression of the disease.Biologic response modifiers if your disease is more severe.These medications target specific immune messages and interrupt the signal, helping to decrease or stop inflammation.Janus kinase (JAK) inhibitors, which send messages to specific cells to stop inflammation from inside the cell.

Surgery

Your doctor may recommend surgery if you have permanent damage or pain that limits your ability to perform day-to-day activities.Surgery is not for everyone.You and your doctor can discuss the options and choose what is right for you.Your doctor will consider the following before recommending surgery: Your overall health.The condition of the affected joint or tendon.The risks and benefits of the surgery.Types of surgery may include joint repairs and joint replacements.Read more in our Joint Replacement Surgery Health Topic.

Routine Monitoring and Ongoing Care

Regular medical care is important because your doctor can: Monitor how the disease is progressing.Determine how well the medications are working.Talk to you about any side the effects from the medications.Adjust your treatment as needed.Monitoring typically includes regular visits to the doctor.It also may include blood and urine tests, and x?rays.Having rheumatoid arthritis increases your risk of developing osteoporosis, particularly if you take corticosteroids.Osteoporosis is a bone disease that causes the bones to weaken and easily break.Talk to your doctor about your risk for the disease and the potential benefits of calcium and vitamin D supplements or other osteoporosis treatments.Treatment of rheumatoid arthritis continues to improve, which can give many people relief from symptoms, improving their quality of life.Doctors may use the following options to treat RA: Medications.Surgery.Routine monitoring and ongoing care.Complementary therapies.Your doctor may recommend a combination of treatments, which may change over time based on your symptoms and the severity of your disease.No matter which treatment plan your doctor recommends, the goals are to help: Relieve pain.Decrease inflammation and swelling.Prevent, slow, or stop joint and organ damage.Improve your ability to participate in daily activities.Rheumatoid arthritis may start causing joint damage during the first year or two that a person has the disease, so early diagnosis and treatment are very important.

Medications

Most people who have RA take medications.Studies show that early treatment with combinations of medications, instead of one medication alone, may be more effective in decreasing or preventing joint damage.Many of the medications that doctors prescribe to treat RA help decrease inflammation and pain, and slow or stop joint damage.They may include: Anti-inflammatory medications to provide pain relief and lower inflammation.Corticosteroids that can help decrease inflammation, provide some pain relief, and slow joint damage.Because they are potent drugs, your doctor will prescribe the lowest dose possible to achieve the desired benefit.Disease-modifying antirheumatic drugs (DMARDs) that can help to slow or change the progression of the disease.Biologic response modifiers if your disease is more severe.These medications target specific immune messages and interrupt the signal, helping to decrease or stop inflammation.Janus kinase (JAK) inhibitors, which send messages to specific cells to stop inflammation from inside the cell.

Surgery

Your doctor may recommend surgery if you have permanent damage or pain that limits your ability to perform day-to-day activities.Surgery is not for everyone.You and your doctor can discuss the options and choose what is right for you.Your doctor will consider the following before recommending surgery: Your overall health.The condition of the affected joint or tendon.The risks and benefits of the surgery.Types of surgery may include joint repairs and joint replacements.Read more in our Joint Replacement Surgery Health Topic.

Routine Monitoring and Ongoing Care

Regular medical care is important because your doctor can: Monitor how the disease is progressing.Determine how well the medications are working.Talk to you about any side the effects from the medications.Adjust your treatment as needed.Monitoring typically includes regular visits to the doctor.It also may include blood and urine tests, and x?rays.Having rheumatoid arthritis increases your risk of developing osteoporosis, particularly if you take corticosteroids.Osteoporosis is a bone disease that causes the bones to weaken and easily break.Talk to your doctor about your risk for the disease and the potential benefits of calcium and vitamin D supplements or other osteoporosis treatments.Treatment of rheumatoid arthritis continues to improve, which can give many people relief from symptoms, improving their quality of life.Doctors may use the following options to treat RA: Medications.Surgery.Routine monitoring and ongoing care.Complementary therapies.Your doctor may recommend a combination of treatments, which may change over time based on your symptoms and the severity of your disease.No matter which treatment plan your doctor recommends, the goals are to help: Relieve pain.Decrease inflammation and swelling.Prevent, slow, or stop joint and organ damage.Improve your ability to participate in daily activities.Rheumatoid arthritis may start causing joint damage during the first year or two that a person has the disease, so early diagnosis and treatment are very important.

Medications

Most people who have RA take medications.Studies show that early treatment with combinations of medications, instead of one medication alone, may be more effective in decreasing or preventing joint damage.Many of the medications that doctors prescribe to treat RA help decrease inflammation and pain, and slow or stop joint damage.They may include: Anti-inflammatory medications to provide pain relief and lower inflammation.Corticosteroids that can help decrease inflammation, provide some pain relief, and slow joint damage.Because they are potent drugs, your doctor will prescribe the lowest dose possible to achieve the desired benefit.Disease-modifying antirheumatic drugs (DMARDs) that can help to slow or change the progression of the disease.Biologic response modifiers if your disease is more severe.These medications target specific immune messages and interrupt the signal, helping to decrease or stop inflammation.Janus kinase (JAK) inhibitors, which send messages to specific cells to stop inflammation from inside the cell.

Surgery

Your doctor may recommend surgery if you have permanent damage or pain that limits your ability to perform day-to-day activities.Surgery is not for everyone.You and your doctor can discuss the options and choose what is right for you.Your doctor will consider the following before recommending surgery: Your overall health.The condition of the affected joint or tendon.The risks and benefits of the surgery.Types of surgery may include joint repairs and joint replacements.Read more in our Joint Replacement Surgery Health Topic.

Routine Monitoring and Ongoing Care

Regular medical care is important because your doctor can: Monitor how the disease is progressing.Determine how well the medications are working.Talk to you about any side the effects from the medications.Adjust your treatment as needed.Monitoring typically includes regular visits to the doctor.It also may include blood and urine tests, and x?rays.Having rheumatoid arthritis increases your risk of developing osteoporosis, particularly if you take corticosteroids.Osteoporosis is a bone disease that causes the bones to weaken and easily break.Talk to your doctor about your risk for the disease and the potential benefits of calcium and vitamin D supplements or other osteoporosis treatments. +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. +Diagnosing and treating rheumatoid arthritis requires a team effort involving you and several types of health care professionals.These may include: Rheumatologists, who specialize in arthritis and other diseases of the bones, joints, and muscles.Primary care providers, such as internists, who specialize in the diagnosis and medical treatment of adults.Orthopaedists, who specialize in the treatment of and surgery for bone and joint diseases or injuries.Physical therapists, who help to improve joint function.Occupational therapists, who teach ways to protect joints, minimize pain, perform activities of daily living, and conserve energy.Dietitians, who teach ways to eat a good diet to improve health and maintain a healthy weight.Nurse educators, who specialize in helping people understand their overall condition and set up their treatment plans.Mental health professionals, who help people cope with difficulties.Diagnosing and treating rheumatoid arthritis requires a team effort involving you and several types of health care professionals.These may include: Rheumatologists, who specialize in arthritis and other diseases of the bones, joints, and muscles.Primary care providers, such as internists, who specialize in the diagnosis and medical treatment of adults.Orthopaedists, who specialize in the treatment of and surgery for bone and joint diseases or injuries.Physical therapists, who help to improve joint function.Occupational therapists, who teach ways to protect joints, minimize pain, perform activities of daily living, and conserve energy.Dietitians, who teach ways to eat a good diet to improve health and maintain a healthy weight.Nurse educators, who specialize in helping people understand their overall condition and set up their treatment plans.Mental health professionals, who help people cope with difficulties.Diagnosing and treating rheumatoid arthritis requires a team effort involving you and several types of health care professionals.These may include: Rheumatologists, who specialize in arthritis and other diseases of the bones, joints, and muscles.Primary care providers, such as internists, who specialize in the diagnosis and medical treatment of adults.Orthopaedists, who specialize in the treatment of and surgery for bone and joint diseases or injuries.Physical therapists, who help to improve joint function.Occupational therapists, who teach ways to protect joints, minimize pain, perform activities of daily living, and conserve energy.Dietitians, who teach ways to eat a good diet to improve health and maintain a healthy weight.Nurse educators, who specialize in helping people understand their overall condition and set up their treatment plans.Mental health professionals, who help people cope with difficulties. +Research shows that people who take part in their own care report less pain and make fewer doctor visits.They also enjoy a better quality of life.Self-care can help you play a role in managing your RA and improving your health.You can: Learn about rheumatoid arthritis and its treatments.Use exercises and relaxation techniques to reduce your pain and keeping you active.Communicate well with your health care team so you can have more control over your disease.Reach out for support to help cope with the physical emotional, and mental effects of rheumatoid arthritis.Participating in your care can help build confidence in your ability to perform day-to-day activities, allowing you to lead a full, active, and independent life.

Lifestyle Changes

Certain activities can help improve your ability to function on your own and maintain a positive outlook.Rest and exercise.Balance your rest and exercise, with more rest when your RA is active and more exercise when it is not.Rest helps to decrease active joint inflammation, pain, and fatigue.In general, shorter rest breaks every now and then are more helpful than long times spent in bed.Exercise is important for maintaining healthy and strong muscles, preserving joint mobility, and maintaining flexibility.Exercise can help: Improve your sleep.Decrease pain.Keep a positive attitude.Maintain a healthy weight.Doctors usually recommend low-impact exercises, such as water exercise programs.Talk to your health care providers before beginning any exercise program.Joint care.Some people find wearing a splint for a short time around a painful joint reduces pain and swelling.People use splints mostly on wrists and hands, but also on ankles and feet.Talk to your doctor or a physical or occupational therapist before wearing a splint.Other ways you can protect your joints include: Using self-help devices, such as items with a large grip, zipper pullers, or long-handled shoehorns.Using tools or devices that help with activities of daily living, such as an adaptive toothbrush or silverware.Using devices to help you get on and off chairs, toilet seats, and beds.Choosing activities that put less stress on your joints, such as limiting the use of the stairs or taking rest periods when walking longer distances.Maintaining a healthy weight to help lower the stress on your joints.Monitoring of symptoms.It is important to monitor your symptoms for any changes or the development of new symptoms.Understanding your symptoms and how they may change can help you and your doctor manage your pain when you have a flare.Stress management.The emotions you may feel because of RA fear, anger, and frustration, along with any pain, physical limitations, and the unpredictable nature of flares can increase your stress level.Although there is no evidence that stress plays a role in causing rheumatoid arthritis, it can make living with the disease more difficult.Stress also may affect the amount of pain you feel.Ways to cope with stress can include: Regular rest periods.Relaxation techniques such as deep breathing, meditating, or listening to quiet sounds or music.Movement exercise programs, such as yoga and tai chi.Mental health management.Living with RA can be hard and isolating.If you feel alone, anxious, or depressed about having the disease, talk to your doctor, an RA support social worker, or mental health professional.Keep the lines of communication open.Talk to family and friends about your RA to help them understand the disease.You may find it helpful to join an online or community support group.Healthy diet.A healthy and nutritious diet that includes a balance of calories, protein, and calcium is important for maintaining overall health.Talk to your doctor about drinking alcoholic beverages because they may interact with the medications you take for rheumatoid arthritis.Before making any changes to your diet or activity, talk to your doctor.Research shows that people who take part in their own care report less pain and make fewer doctor visits.They also enjoy a better quality of life.Self-care can help you play a role in managing your RA and improving your health.You can: Learn about rheumatoid arthritis and its treatments.Use exercises and relaxation techniques to reduce your pain and keeping you active.Communicate well with your health care team so you can have more control over your disease.Reach out for support to help cope with the physical emotional, and mental effects of rheumatoid arthritis.Participating in your care can help build confidence in your ability to perform day-to-day activities, allowing you to lead a full, active, and independent life.

Lifestyle Changes

Certain activities can help improve your ability to function on your own and maintain a positive outlook.Rest and exercise.Balance your rest and exercise, with more rest when your RA is active and more exercise when it is not.Rest helps to decrease active joint inflammation, pain, and fatigue.In general, shorter rest breaks every now and then are more helpful than long times spent in bed.Exercise is important for maintaining healthy and strong muscles, preserving joint mobility, and maintaining flexibility.Exercise can help: Improve your sleep.Decrease pain.Keep a positive attitude.Maintain a healthy weight.Doctors usually recommend low-impact exercises, such as water exercise programs.Talk to your health care providers before beginning any exercise program.Joint care.Some people find wearing a splint for a short time around a painful joint reduces pain and swelling.People use splints mostly on wrists and hands, but also on ankles and feet.Talk to your doctor or a physical or occupational therapist before wearing a splint.Other ways you can protect your joints include: Using self-help devices, such as items with a large grip, zipper pullers, or long-handled shoehorns.Using tools or devices that help with activities of daily living, such as an adaptive toothbrush or silverware.Using devices to help you get on and off chairs, toilet seats, and beds.Choosing activities that put less stress on your joints, such as limiting the use of the stairs or taking rest periods when walking longer distances.Maintaining a healthy weight to help lower the stress on your joints.Monitoring of symptoms.It is important to monitor your symptoms for any changes or the development of new symptoms.Understanding your symptoms and how they may change can help you and your doctor manage your pain when you have a flare.Stress management.The emotions you may feel because of RA fear, anger, and frustration, along with any pain, physical limitations, and the unpredictable nature of flares can increase your stress level.Although there is no evidence that stress plays a role in causing rheumatoid arthritis, it can make living with the disease more difficult.Stress also may affect the amount of pain you feel.Ways to cope with stress can include: Regular rest periods.Relaxation techniques such as deep breathing, meditating, or listening to quiet sounds or music.Movement exercise programs, such as yoga and tai chi.Mental health management.Living with RA can be hard and isolating.If you feel alone, anxious, or depressed about having the disease, talk to your doctor, an RA support social worker, or mental health professional.Keep the lines of communication open.Talk to family and friends about your RA to help them understand the disease.You may find it helpful to join an online or community support group.Healthy diet.A healthy and nutritious diet that includes a balance of calories, protein, and calcium is important for maintaining overall health.Talk to your doctor about drinking alcoholic beverages because they may interact with the medications you take for rheumatoid arthritis.Before making any changes to your diet or activity, talk to your doctor. +","In many people, flares of rheumatoid arthritis are followed by remissions.Treatments are available to relieve pain, reduce inflammation and damage to the joints , and improve ability to perform daily activities.Being actively involved in your care will help leading a normal life.Balance your rest and exercise, resting more during the flares.Short rests are considered more helpful.Exercise will help maintain strong muscles and flexibility.Choose exercised that put less stress on your joints, e.g., limit climbing stairs and stop for rest while walking long distances.Maintain healthy weight.To relax, consider breathing exercises, yoga or tai chi, meditation and relaxing sounds.Physical and occupational therapists could show how to perform daily activities with minimal pain and to protect the joints.","Rheumatoid arthritis is a disease that causes chronic abnormal inflammation, primarily affecting the joints. Many affected people have episodes of symptoms (flares) followed by periods with no symptoms (remissions) for the rest of their lives.Treatment of rheumatoid arthritis continues to improve, which can give many people relief from symptoms, improving their quality of life.Your doctor may recommend a combination of treatments, which may change over time based on your symptoms and the severity of your disease.No matter which treatment plan your doctor recommends, the goals are to help: Relieve pain.Decrease inflammation and swelling.Prevent, slow, or stop joint and organ damage.Improve your ability to participate in daily activities. Participating in your care can help build confidence in your ability to perform day-to-day activities, allowing you to lead a full, active, and independent life.Certain activities can help improve your ability to function on your own and maintain a positive outlook. Balance your rest and exercise, with more rest when your RA is active and more exercise when it is not.Rest helps to decrease active joint inflammation, pain, and fatigue.In general, shorter rest breaks every now and then are more helpful than long times spent in bed.Exercise is important for maintaining healthy and strong muscles, preserving joint mobility, and maintaining flexibility. Choosing activities that put less stress on your joints, such as limiting the use of the stairs or taking rest periods when walking longer distances.Maintaining a healthy weight to help lower the stress on your joints.Stress also may affect the amount of pain you feel.Ways to cope with stress can include: Regular rest periods.Relaxation techniques such as deep breathing, meditating, or listening to quiet sounds or music.Movement exercise programs, such as yoga and tai chi.Physical therapists, who help to improve joint function.Occupational therapists, who teach ways to protect joints, minimize pain, perform activities of daily living, and conserve energy." +56,How can we improve fertility in Klinefelter syndrome karyotype 47 XXY?,"Babies with the 47, XXY form of Klinefelter differ little from healthy children.The results of one study on non-mosaic XXY infants younger than 2 years indicated that most XXY babies had normal external genitalia and facial features with height and weight in the normal range.Genetic testing had been performed due to a delay in walking and/or speech.Early diagnosis of Klinefelter syndrome is shown to be important to monitor potential developmental problems.[4] Boys with the 47, XXY karyotype may struggle through adolescence with academics, various frustrations, and, in a few instances, serious emotional or behavioral difficulties.However, most move toward full independence from their families as they enter adulthood.Some have completed graduate education and have a normal level of functioning.Lifespan is not affected by Klinefelter syndrome.[4] +Most boys with Klinefelter syndrome have normal or slightly decreased intelligence.Many have speech and reading disabilities and difficulties with planning.Most have problems with language skills.Lack of insight, poor judgment, and impaired ability to learn from previous mistakes often cause these children to get into trouble.Although their physical characteristics can vary greatly, most are tall with long arms and legs.They may also have wider hips but otherwise have a relatively normal appearance.Puberty usually occurs at the normal time, but the testes remain small.At puberty, growth of facial hair is often sparse, and the breasts may enlarge somewhat (gynecomastia).Males with the syndrome are usually infertile, but sometimes the testes develop enough to produce sperm.Men with Klinefelter syndrome tend to develop diabetes mellitus, chronic lung disease, varicose veins, hypothyroidism, and breast cancer more often than other men.Some affected boys have 3, 4, and even 5 X chromosomes along with the Y. As the number of X chromosomes increases, the severity of intellectual disability and physical abnormalities also increases.Each extra X is associated with a 15- to 16-point reduction in intelligence quotient (IQ), with language most affected, particularly expressive language skills. +Klinefelter syndrome is a chromosomal condition that affects male physical and cognitive development.Its signs and symptoms vary among affected individuals.Affected individuals typically have small testes that do not produce as much testosterone as usual.Testosterone is the hormone that directs male sexual development before birth and during puberty.A shortage of testosterone can lead to delayed or incomplete puberty, breast enlargement (gynecomastia), reduced facial and body hair, and an inability to have biological children (infertility).Some affected individuals also have genital differences including undescended testes (cryptorchidism), the opening of the urethra on the underside of the penis (hypospadias), or an unusually small penis (micropenis).Older children and adults with Klinefelter syndrome tend to be taller than their peers.Compared with unaffected men, adults with Klinefelter syndrome have an increased risk of developing breast cancer and a chronic inflammatory disease called systemic lupus erythematosus.Their chance of developing these disorders is similar to that of women in the general population.Children with Klinefelter syndrome may have learning disabilities and delayed speech and language development.They tend to be quiet, sensitive, and unassertive, but personality characteristics vary among affected individuals. +For children, speech and language therapy For adolescents, testosterone therapy for life Boys with Klinefelter syndrome usually benefit from speech and language therapy and eventually can do well in school.Males with Klinefelter syndrome may require supplemental testosterone beginning at puberty.The hormone improves bone density, making fractures less likely, and stimulates development of a more masculine appearance.Hormone replacement therapy may help lessen some behavior and developmental problems.More recently, fertility preservation counseling has become an important part of the care of adolescents with Klinefelter syndrome.Obtaining and preserving sperm cells from males who produce them can give them the opportunity to father biological children. +Klinefelter syndrome (KS) is a condition that occurs in males when they have an extra X chromosome .Some males with KS have no obvious signs or symptoms while others may have varying degrees of cognitive, social, behavioral, and learning difficulties.Adults with Klinefelter syndrome may also have primary hypogonadism (decreased testosterone production), small and/or undescendent testes (cryptorchidism), enlarged breast tissue ( gynecomastia ), tall stature, and/or inability to have biological children (infertility), as well as an abnormal opening of the penis (hypospadias), and an small penis (micropenis).KS is not inherited , but usually occurs as a random event during the formation of reproductive cells (eggs and sperm) that results in the presence of one extra copy of the X chromosome in each cell (47,XXY).KS treatment is based on the signs and symptoms present in each person.[1][2][3] Life expectancy is usually normal and many people with KS have normal life.There is a very small risk of developing breast cancer and other conditions such as a chronic inflammatory disease called systemic lupus erythematosus.[3]In some cases, there is more than one X chromosome in each cell (for example, 48,XXXY or 49,XXXXY).These conditions, which are often called ""variants of Klinefelter"" syndrome usually have more serious problems ( intellectual disability , skeletal problems, and poor coordination) than classic Klinefelter syndrome (47,XXY).[3] +","A study of babies with the 47, XXY form of Klinefelter found that most boys had normal external genitalia.Although the majority of XXY males are infertile, sometimes the testes develop enough to produce sperm, which can be preserved for fathering biological children.Fertility preservation counseling for XXY adolescents can help.","Babies with the 47, XXY form of Klinefelter differ little from healthy children.The results of one study on non-mosaic XXY infants younger than 2 years indicated that most XXY babies had normal external genitalia and facial features with height and weight in the normal range.Males with the syndrome are usually infertile, but sometimes the testes develop enough to produce sperm. More recently, fertility preservation counseling has become an important part of the care of adolescents with Klinefelter syndrome.Obtaining and preserving sperm cells from males who produce them can give them the opportunity to father biological children." +57,How can I find a surgeon who will remove abdominal adhesions and mesh from a previous inguinal hernia repair?,"If abdominal adhesions dont cause symptoms or complications, they typically dont need treatment.If abdominal adhesions cause symptoms or complications, doctors can release the adhesions with laparoscopic or open surgery.However, surgery to treat adhesions may cause new adhesions to form.If you have abdominal adhesions, talk with your doctor about the possible benefits and risks of surgery.If abdominal adhesions cause an intestinal obstruction, you will need treatment at a hospital right away.Doctors will examine you and may order tests to find out if you need emergency surgery.If you do, surgeons will release the adhesions, relieving the intestinal obstruction.If you dont need emergency surgery, doctors may try to treat the obstruction without surgery.Health care professionals will give you intravenous (IV) fluids and insert a tube through your nose and into your stomach to remove the contents of your digestive tract above the obstruction.In some cases, the obstruction may go away.If the obstruction does not go away, surgeons will perform surgery to release the adhesions, relieving the intestinal obstruction. +Abdominal adhesions are diffi cult to prevent; however, certain surgical techniques can minimize abdominal adhesions.Laparoscopic surgery decreases the potential for abdominal adhesions because several tiny incisions are made in the lower abdomen instead of one large incision.The surgeon inserts a laparoscopea thin tube with a tiny video camera attachedinto one of the small incisions.The camera sends a magnified image from inside the body to a video monitor.Patients will usually receive general anesthesia during this surgery.If laparoscopic surgery is not possible and a large abdominal incision is required, at the end of surgery a special fi lmlike material can be inserted between organs or between the organs and the abdominal incision.The fi lmlike material, which looks similar to wax paper and is absorbed by the body in about a week, hydrates organs to help prevent abdominal adhesions.Other steps taken during surgery to reduce abdominal adhesions include - using starch- and latex-free gloves - handling tissues and organs gently - shortening surgery time - using moistened drapes and swabs - occasionally applying saline solution +","If abdominal adhesions cause symptoms or complications, the doctors will consider releasing them.Laparoscopic surgery is least likely to cause new adhesions, but new adhesions may still form.Unless you have an intestinal obstruction that requires immediate medical attention, discuss the benefits and risks of removing the abdominal adhesions with your doctor.","Abdominal adhesions are difficult to prevent; however, certain surgical techniques can minimize abdominal adhesions.Laparoscopic surgery decreases the potential for abdominal adhesions because several tiny incisions are made in the lower abdomen instead of one large incision.If abdominal adhesions dont cause symptoms or complications, they typically dont need treatment.If abdominal adhesions cause symptoms or complications, doctors can release the adhesions with laparoscopic or open surgery.However, surgery to treat adhesions may cause new adhesions to form.If you have abdominal adhesions, talk with your doctor about the possible benefits and risks of surgery.If abdominal adhesions cause an intestinal obstruction, you will need treatment at a hospital right away. If the obstruction does not go away, surgeons will perform surgery to release the adhesions, relieving the intestinal obstruction." +61,What can you tell me about 22q12-q13 duplication?,"22q11.2 duplication is a condition caused by an extra copy of a small piece of chromosome 22.The duplication occurs near the middle of the chromosome at a location designated q11.2.The features of this condition vary widely, even among members of the same family.Affected individuals may have developmental delay, intellectual disability, slow growth leading to short stature, and weak muscle tone (hypotonia).Many people with the duplication have no apparent physical or intellectual disabilities. +Chromosome 22q duplication is a chromosome abnormality that occurs when there is an extra copy of genetic material on the long arm (q) of chromosome 22.The severity of the condition and the signs and symptoms depend on the size and location of the duplication and which genes are involved.Features that often occur in people with chromosome 22q duplication include developmental delay , intellectual disability , behavioral problems and distinctive facial features.Chromosome testing of both parents can provide more information on whether or not the duplication was inherited .In most cases, parents do not have any chromosomal anomaly.However, sometimes one parent is found to have a balanced translocation , where a piece of a chromosome has broken off and attached to another one with no gain or loss of genetic material.The balanced translocation normally does not cause any signs or symptoms, but it increases the risk for having an affected child with a chromosomal anomaly like a duplication.Treatment is based on the signs and symptoms present in each person.[1] This page is meant to provide general information about 22q duplications.You can contact GARD if you have questions about a specific duplication on chromosome 22.To learn more about chromosomal anomalies please visit our GARD webpage on FAQs about Chromosome Disorders. +","In general, chromosome 22q duplication refers to an extra copy of genetic material on the long arm (q) of chromosome 22.Depending on the size and location of duplication, an affected person may have developmental delay, intellectual disability, slow growth leading to short stature, weak muscle tone, behavioral problems and distinctive facial features.When a small piece is duplicated, as in 22q11.2 duplication, many people have no signs or symptoms.If needed, the specific signs and symptoms are treated.Affected individuals have a higher risk of having a child with a chromosomal anomaly.","Chromosome 22q duplication is a chromosome abnormality that occurs when there is an extra copy of genetic material on the long arm (q) of chromosome 22.The severity of the condition and the signs and symptoms depend on the size and location of the duplication and which genes are involved.Features that often occur in people with chromosome 22q duplication include developmental delay , intellectual disability , behavioral problems and distinctive facial features.The balanced translocation normally does not cause any signs or symptoms, but it increases the risk for having an affected child with a chromosomal anomaly like a duplication.Treatment is based on the signs and symptoms present in each person.22q11.2 duplication is a condition caused by an extra copy of a small piece of chromosome 22.The duplication occurs near the middle of the chromosome at a location designated q11.2.The features of this condition vary widely, even among members of the same family.Affected individuals may have developmental delay, intellectual disability, slow growth leading to short stature, and weak muscle tone (hypotonia).Many people with the duplication have no apparent physical or intellectual disabilities." +62,"What is the best treatment for lichen sclerosus, including experimental treatments?","Patches on the arms or upper body usually dont need treatment.They will go away over time.Patches of the genital skin should be treated, even if they arent painful or itchy.These patches can scar, causing problems with urination or sex.There is also a very small chance that skin cancer may develop in the patches.You should see your doctor every six to 12 months in order to follow and treat any skin changes.If a young girl gets lichen sclerosus, it may go away at puberty.This means that lifelong treatment may not be necessary, although scarring and changes in skin color may remain.Possible treatments for lichen sclerosus include: Surgery.Circumcision is the most widely used therapy for men with lichen sclerosus, and the disease does not usually come back after this procedure.However, surgery is not a good option for women, as the disease usually comes back after lichen sclerosus patches are removed from their genitals.Medications, including strong cortisone creams or ointments on the skin.These should be applied to skin patches every day for several weeks to stop the itching.Using the cream or ointment two times a week for a long time can keep the disease from coming back.Treatment does not fix the scarring that may have already occurred.See your doctor on a regular basis, since long-term use of these creams and ointments can cause: Thinning and redness of the skin.Stretch marks where the cream is applied.Genital yeast infections.Sometimes, you don't get better when using the cortisone creams.Reasons for this can include Low estrogen levels.Infection.Allergy to the medication.When creams and ointments don't work, your doctor may suggest: Retinoids, or vitamin A-like drugs.Tacrolimus ointment to suppress the bodys misguided immune system.Ultraviolet light treatments (not used on skin of the genitals).If you need medicine, ask your doctor: How does the medicine work?What are its side effects?Why is it the best treatment for my lichen sclerosus?Patches on the arms or upper body usually dont need treatment.They will go away over time.Patches of the genital skin should be treated, even if they arent painful or itchy.These patches can scar, causing problems with urination or sex.There is also a very small chance that skin cancer may develop in the patches.You should see your doctor every six to 12 months in order to follow and treat any skin changes.If a young girl gets lichen sclerosus, it may go away at puberty.This means that lifelong treatment may not be necessary, although scarring and changes in skin color may remain.Possible treatments for lichen sclerosus include: Surgery.Circumcision is the most widely used therapy for men with lichen sclerosus, and the disease does not usually come back after this procedure.However, surgery is not a good option for women, as the disease usually comes back after lichen sclerosus patches are removed from their genitals.Medications, including strong cortisone creams or ointments on the skin.These should be applied to skin patches every day for several weeks to stop the itching.Using the cream or ointment two times a week for a long time can keep the disease from coming back.Treatment does not fix the scarring that may have already occurred.See your doctor on a regular basis, since long-term use of these creams and ointments can cause: Thinning and redness of the skin.Stretch marks where the cream is applied.Genital yeast infections.Sometimes, you don't get better when using the cortisone creams.Reasons for this can include Low estrogen levels.Infection.Allergy to the medication.When creams and ointments don't work, your doctor may suggest: Retinoids, or vitamin A-like drugs.Tacrolimus ointment to suppress the bodys misguided immune system.Ultraviolet light treatments (not used on skin of the genitals).If you need medicine, ask your doctor: How does the medicine work?What are its side effects?Why is it the best treatment for my lichen sclerosus?Patches on the arms or upper body usually dont need treatment.They will go away over time.Patches of the genital skin should be treated, even if they arent painful or itchy.These patches can scar, causing problems with urination or sex.There is also a very small chance that skin cancer may develop in the patches.You should see your doctor every six to 12 months in order to follow and treat any skin changes.If a young girl gets lichen sclerosus, it may go away at puberty.This means that lifelong treatment may not be necessary, although scarring and changes in skin color may remain.Possible treatments for lichen sclerosus include: Surgery.Circumcision is the most widely used therapy for men with lichen sclerosus, and the disease does not usually come back after this procedure.However, surgery is not a good option for women, as the disease usually comes back after lichen sclerosus patches are removed from their genitals.Medications, including strong cortisone creams or ointments on the skin.These should be applied to skin patches every day for several weeks to stop the itching.Using the cream or ointment two times a week for a long time can keep the disease from coming back.Treatment does not fix the scarring that may have already occurred.See your doctor on a regular basis, since long-term use of these creams and ointments can cause: Thinning and redness of the skin.Stretch marks where the cream is applied.Genital yeast infections.Sometimes, you don't get better when using the cortisone creams.Reasons for this can include Low estrogen levels.Infection.Allergy to the medication.When creams and ointments don't work, your doctor may suggest: Retinoids, or vitamin A-like drugs.Tacrolimus ointment to suppress the bodys misguided immune system.Ultraviolet light treatments (not used on skin of the genitals).If you need medicine, ask your doctor: How does the medicine work?What are its side effects?Why is it the best treatment for my lichen sclerosus? +Lichen sclerosus is a long-term problem that usually affects the skin in the genital and anal areas.Sometimes, lichen sclerosus appears on the upper body, breasts, and upper arms.The disease does not cause skin cancer but may increase your likelihood of developing it if your skin is scarred.You should see your doctor every 6 to 12 months in order to follow and treat and skin changes.Lichen sclerosus is a long-term problem that usually affects the skin in the genital and anal areas.Sometimes, lichen sclerosus appears on the upper body, breasts, and upper arms.The disease does not cause skin cancer but may increase your likelihood of developing it if your skin is scarred.You should see your doctor every 6 to 12 months in order to follow and treat and skin changes. +Strong topical steroid creams or ointments reportedly are very helpful for lichen sclerosus, especially when it affects the genital areas.However, the response to this treatment varies.While itching may be relieved within days, it can take weeks or months for the skin's appearance to return to normal.Other treatments that may be used instead of steroid creams, or in combination with steroid creams, include calcipotriol cream, topical and systemic retinoids (acitretin), and/or systemic steroids.If the vaginal opening has narrowed, dilators may be needed.In rare cases, surgery is necessary to allow for sexual intercourse.The condition sometimes causes the vaginal opening to narrow or close again after surgery is initially successful.[1] Additional information about treatment of lichen sclerosus can be viewed on Medscape's Web site. +","Lichen sclerosus patches on the arms and upper body might not need treatment.Patches on genitals may scar causing problems with urination and sex, and increasing the likelihood of cancer.These patches need to be treated, most often with strong cortisone ointments and creams.If topical steroids don't work, your doctor could use topical and systemic retinoids (acitretin), calcipotriol cream, systemic steroids., and tacrolimus ointment.In the areas other than genitals, UV light could be used.Outlook for surgery in men (mostly circumcision) is good, as the disease usually does not come back.In women, however, surgery is not recommended, unless the dilators do not help with vaginal narrowing and surgery is necessary to allow for sexual intercourse.","Lichen sclerosus is a long-term problem that usually affects the skin in the genital and anal areas.Sometimes, lichen sclerosus appears on the upper body, breasts, and upper arms.The disease does not cause skin cancer but may increase your likelihood of developing it if your skin is scarred.You should see your doctor every 6 to 12 months in order to follow and treat and skin changes. Patches on the arms or upper body usually dont need treatment.They will go away over time.Patches of the genital skin should be treated, even if they arent painful or itchy.These patches can scar, causing problems with urination or sex. Possible treatments for lichen sclerosus include: Surgery.Circumcision is the most widely used therapy for men with lichen sclerosus, and the disease does not usually come back after this procedure.However, surgery is not a good option for women, as the disease usually comes back after lichen sclerosus patches are removed from their genitals. If the vaginal opening has narrowed, dilators may be needed.In rare cases, surgery is necessary to allow for sexual intercourse. Medications, including strong cortisone creams or ointments on the skin.Strong topical steroid creams or ointments reportedly are very helpful for lichen sclerosus, especially when it affects the genital areas.However, the response to this treatment varies.While itching may be relieved within days, it can take weeks or months for the skin's appearance to return to normal. Sometimes, you don't get better when using the cortisone creams.Reasons for this can include Low estrogen levels.Infection.Allergy to the medication.When creams and ointments don't work, your doctor may suggest: Retinoids, or vitamin A-like drugs.Tacrolimus ointment to suppress the bodys misguided immune system.Ultraviolet light treatments (not used on skin of the genitals).Other treatments that may be used instead of steroid creams, or in combination with steroid creams, include calcipotriol cream, topical and systemic retinoids (acitretin), and/or systemic steroids." +63,What will stop the progression of Crohn's disease?,"Crohn disease has no known cure and is characterized by intermittent flare-ups of symptoms.Flare-ups may be mild or severe, few or frequent.With proper treatment, most people continue to lead productive lives.However, about 10% of people are disabled by Crohn disease and its complications. +Most people with Crohn disease require surgery at some point during their illness.Surgery is needed when the intestine is obstructed or when abscesses or fistulas do not heal.An operation to remove diseased sections of the intestine may relieve symptoms indefinitely, but it does not cure the disease.Crohn disease tends to recur where the remaining intestine is rejoined, although several drug therapies initiated after surgery reduce this tendency.A second operation is ultimately needed in nearly half of the people.Consequently, surgery is done only if specific complications or the failure of drug treatment makes it necessary.Still, most people who have undergone surgery consider their quality of life to be better than it was before the operation.Because smoking increases the risk of recurrence, especially in women, doctors encourage people to quit smoking. +There's no cure for Crohn disease.Treatments can help reduce the inflammation and relieve symptoms.Medicines may: Help stop diarrhea and belly pain Lessen inflammation in your intestine Change the way your immune system works Doctors may suggest special fluids that have extra nutrients in them, especially for children with slow growth.Doctors will also ask you to: Quit smoking because people who smoke are more likely to have their symptoms come back after treatment Drink plenty of fluids Take nutrients such as iron, calcium, and vitamin D supplements Avoid nuts and raw fruits and vegetables when you have a flare-up Try a dairy-free diet to see if it eases symptoms Not take certain medicines that can cause a flare-up, such as painkillers called NSAIDs Avoid stress Most people with Crohn disease need surgery at some point.In this surgery, doctors remove part of your intestine.This helps with symptoms.Half of the people who have surgery need a second surgery later. +","Treatments help most people with Crohn disease lead normal life.Doctors may prescribe special fluids with extra nutrients and taking supplements such as iron, calcium, and vitamin D. Quit smoking to reduce the likelihood of flare-ups. Avoiding nuts, raw fruit, dairy products and drugs, such as NSAIDs, might ease the symptoms.Surgery for Crohn disease is usually done to treat specific complications. Many people report that their quality of life has improved after surgery.","Crohn disease has no known cure.With proper treatment, most people continue to lead productive lives. Doctors may suggest special fluids that have extra nutrients in them, especially for children with slow growth.Doctors will also ask you to: Quit smoking because people who smoke are more likely to have their symptoms come back after treatment Drink plenty of fluids Take nutrients such as iron, calcium, and vitamin D supplements Avoid nuts and raw fruits and vegetables when you have a flare-up Try a dairy-free diet to see if it eases symptoms Not take certain medicines that can cause a flare-up, such as painkillers called NSAIDs Avoid stress Most people with Crohn disease need surgery at some point.surgery is done only if specific complications or the failure of drug treatment makes it necessary.Still, most people who have undergone surgery consider their quality of life to be better than it was before the operation." +68,Can achondroplasia be treated?,"There is no specific treatment for achondroplasia.Related abnormalities, including spinal stenosis and spinal cord compression, should be treated when they cause problems. +Achondroplasia is a disorder of bone growth that prevents the changing of cartilage (particularly in the long bones of the arms and legs) to bone.It is characterized by dwarfism, limited range of motion at the elbows, large head size, small fingers, and normal intelligence.Achondroplasia can cause health complications such as apnea, obesity, recurrent ear infections, and lordosis of the spine.Achondroplasia is caused by mutations in the FGFR3 gene.It is inherited in an autosomal dominant fashion. +","Achondroplasia is a hereditary disorder of bone growth that causes dwarfism.Achondroplasia cannot be treated.Health complications caused by achondroplasia include apnea, obesity, recurrent ear infections, and lordosis of the spine, spinal stenosis and spinal cord compression.These complications are treated when they cause problems.","Achondroplasia is a disorder of bone growth that prevents the changing of cartilage (particularly in the long bones of the arms and legs) to bone.It is characterized by dwarfism, limited range of motion at the elbows, large head size, small fingers, and normal intelligence.Achondroplasia can cause health complications such as apnea, obesity, recurrent ear infections, and lordosis of the spine. There is no specific treatment for achondroplasia.Related abnormalities, including spinal stenosis and spinal cord compression, should be treated when they cause problems." +72,Does liposuction treat chronic lymphedema?,"At this time, there is no cure for lymphedema.The goal of treatment is to reduce the swelling or keep it from getting worse, and to relieve symptoms.Your doctor can help you figure out which treatments are best for you.Lymphedema can be treated with?Exercise.Moving your swollen arm or leg may help the lymph fluid to drain, thus reducing the swelling.A compression sleeve or stocking.This garment fits tightly on your swollen arm or leg, helping the lymph fluid flow out.Massage therapy.A special kind of massage called manual lymph drainage can help push the lymph fluid out of the swollen part of your body.A pneumatic pump.A machine inflates a sleeve that you place on your swollen arm or leg, helping lymph fluid flow out.Weight loss.In patients who are overweight, lymphedema related to breast cancer may improve with weight loss.Surgery.If your lymphedema is severe, your doctor may suggest that you get an operation.Several options are available.For more information, visit Johns Hopkins Medicine?sCancer treatment.If a cancerous tumor is causing the lymphedema, the cancer is treated. +Lymphedema is the name of a type of swelling.It happens when lymph builds up in your body's soft tissues.Lymph is a fluid that contains white blood cells that defend against germs.It can build up when the lymph system is damaged or blocked.It usually happens in the arms or legs.Causes of lymphedema include - Infection - Cancer - Scar tissue from radiation therapy or surgical removal of lymph nodes - Inherited conditions in which lymph nodes or vessels are absent or abnormal Treatment can help control symptoms.It includes exercise, compression devices, skin care, and massage.NIH: National Cancer Institute +Treatment for lymphedema includes: Compression (usually with wrapping in bandages or stockings) Manual lymph drainage (MLD) Range of motion or resistance exercises Manual lymph drainage is a light massage therapy technique.During massage, the skin is moved in certain directions based on the structure of the lymphatic system.This helps the lymph fluid drain through the proper channels.Treatment also includes skin care to prevent injuries, infection, and skin breakdown.Light exercise and movement programs may also be prescribed.Wearing compression garments on the affected area or using a pneumatic compression pump may be helpful.Your provider and physical therapist will decide which compression methods are best.Surgery is used in some cases, but it has limited success.The surgeon must have a lot of experience with this type of procedure.You will still need physical therapy after surgery to reduce lymphedema.Types of surgery include: Liposuction Removal of abnormal lymphatic tissue Transplant of normal lymphatic tissues to areas with abnormal lymphatic drainage (less common)In rare cases, surgery to bypass abnormal lymph tissue using vein grafts is done.These procedures are most effective for early lymphedema and should be performed by an experienced surgeon. +Lymph is fluid that oozes out of your tiniest blood vessels.The fluid goes between your cells and brings nourishment and carries away damaged cells, cancer cells, and germs.Lymph then travels through tiny tubes called lymphatic vessels.The vessels carry lymph from your tissues to collection points called lymph nodes.Edema means ""swelling.""Lymphedema is swelling of an arm or leg because lymph flow is blocked.Lymphedema usually results from having lymphatic vessels or lymph nodes removed or damaged (such as during surgery or radiation for cancer)It can rarely result from a birth defect Lymphedema has no cure, but special massages along with pressure stockings and bandages can help with the swelling Doctors and nurses avoid drawing blood, taking blood pressure, or starting an IV in an arm or leg with lymphedema +","Although lymphedema has no cure, treatments can control the symptoms.Traditional treatments include compression with wrapping, bandages or a sleeve inflated by a pump that is placed on the swollen limb.Weight loss and light exercise could also help.Manual lymph draining using light massage.Surgery, including liposuction is used with limited success.It is more effective for early lymphedema.The surgeon has to be experienced and physical therapy is needed after the surgery tp reduce lymphedema.In addition to liposuction that removes the abnormal lymphatic tissues, other procedures bypass abnormal tissues or replace them with normal tissues.","Lymphedema has no cure.Treatment can help control symptoms.It includes exercise, compression devices, skin care, and massage. Compression (usually with wrapping in bandages or stockings) Manual lymph drainage (MLD) Range of motion or resistance exercises Manual lymph drainage is a light massage therapy technique.During massage, the skin is moved in certain directions based on the structure of the lymphatic system.This helps the lymph fluid drain through the proper channels.Treatment also includes skin care to prevent injuries, infection, and skin breakdown.Light exercise and movement programs may also be prescribed.Wearing compression garments on the affected area or using a pneumatic compression pump may be helpful.A pneumatic pump.A machine inflates a sleeve that you place on your swollen arm or leg, helping lymph fluid flow out.Weight loss.In patients who are overweight, lymphedema related to breast cancer may improve with weight loss.If your lymphedema is severe, your doctor may suggest that you get an operation.Surgery is used in some cases, but it has limited success.The surgeon must have a lot of experience with this type of procedure.You will still need physical therapy after surgery to reduce lymphedema.Types of surgery include: Liposuction Removal of abnormal lymphatic tissue Transplant of normal lymphatic tissues to areas with abnormal lymphatic drainage (less common)In rare cases, surgery to bypass abnormal lymph tissue using vein grafts is done.These procedures are most effective for early lymphedema and should be performed by an experienced surgeon." +74,Can osteoarthritis of wrist occur in ankylosing spondylitis patients?,"Osteoarthritis is a degenerative joint disease, in which the tissues in the joint break down over time.It is the most common type of arthritis and is more common in older people.People with osteoarthritis usually have joint pain and, after rest or inactivity, stiffness for a short period of time.The most commonly affected joints include the: Hands (ends of the fingers and at the base and ends of the thumbs).Knees.Hips. Neck.Lower back.Osteoarthritis affects each person differently.For some people, osteoarthritis is relatively mild and does not affect day-to-day activities.For others, it causes significant pain and disability.Joint damage usually develops gradually over years, although it could worsen quickly in some people.

What happens in osteoarthritis?

Researchers do not know what triggers or starts the breakdown of the tissues in the joint.However, as osteoarthritis begins to develop, it can damage all the areas of the joint, including: Cartilage, the tissue that covers the ends where two bones meet to form a joint.Tendons and ligaments.Synovium, the lining of the joint.Bone.Meniscus in the knee.As the damage of soft tissues in the joint progresses, pain, swelling, and loss of joint motion develops.If you have joint pain, you may be less active, and this can lead to muscle weakness, which may cause more stress on the joint.Over time, the joint may lose its normal shape.Also, small bone growths, called osteophytes or bone spurs, may grow on the edges of the joint.The shape of the bone may also change.Bits of bone or cartilage can also break off and float inside the joint space.This causes more damage.Researchers continue to study the cause of pain in people who have osteoarthritis.Osteoarthritis is a degenerative joint disease, in which the tissues in the joint break down over time.It is the most common type of arthritis and is more common in older people.People with osteoarthritis usually have joint pain and, after rest or inactivity, stiffness for a short period of time.The most commonly affected joints include the: Hands (ends of the fingers and at the base and ends of the thumbs).Knees.Hips. Neck.Lower back.Osteoarthritis affects each person differently.For some people, osteoarthritis is relatively mild and does not affect day-to-day activities.For others, it causes significant pain and disability.Joint damage usually develops gradually over years, although it could worsen quickly in some people.

What happens in osteoarthritis?

Researchers do not know what triggers or starts the breakdown of the tissues in the joint.However, as osteoarthritis begins to develop, it can damage all the areas of the joint, including: Cartilage, the tissue that covers the ends where two bones meet to form a joint.Tendons and ligaments.Synovium, the lining of the joint.Bone.Meniscus in the knee.As the damage of soft tissues in the joint progresses, pain, swelling, and loss of joint motion develops.If you have joint pain, you may be less active, and this can lead to muscle weakness, which may cause more stress on the joint.Over time, the joint may lose its normal shape.Also, small bone growths, called osteophytes or bone spurs, may grow on the edges of the joint.The shape of the bone may also change.Bits of bone or cartilage can also break off and float inside the joint space.This causes more damage.Researchers continue to study the cause of pain in people who have osteoarthritis. +Ankylosing spondylitis is a form of ongoing joint inflammation (chronic inflammatory arthritis) that primarily affects the spine.This condition is characterized by back pain and stiffness that typically appear in adolescence or early adulthood.Over time, back movement gradually becomes limited as the bones of the spine (vertebrae) fuse together.This progressive bony fusion is called ankylosis.The earliest symptoms of ankylosing spondylitis result from inflammation of the joints between the pelvic bones (the ilia) and the base of the spine (the sacrum).These joints are called sacroiliac joints, and inflammation of these joints is known as sacroiliitis.The inflammation gradually spreads to the joints between the vertebrae, causing a condition called spondylitis.Ankylosing spondylitis can involve other joints as well, including the shoulders, hips, and, less often, the knees.As the disease progresses, it can affect the joints between the spine and ribs, restricting movement of the chest and making it difficult to breathe deeply.People with advanced disease are also more prone to fractures of the vertebrae.Ankylosing spondylitis affects the eyes in up to 40 percent of cases, leading to episodes of eye inflammation called acute iritis.Acute iritis causes eye pain and increased sensitivity to light (photophobia).Rarely, ankylosing spondylitis can also cause serious complications involving the heart, lungs, and nervous system. +Carpal tunnel syndrome: A common cause of wrist pain is carpal tunnel syndrome.You may feel aching, burning, numbness, or tingling in your palm, wrist, thumb, or fingers.The thumb muscle can become weak, making it difficult to grasp things.Pain may go up to your elbow.Carpal tunnel syndrome occurs when the median nerve gets compressed at the wrist because of swelling.This is the nerve in the wrist that allows feeling and movement to parts of the hand.Swelling can occur if you: Do repetitive movements with your wrist, such as typing on a computer keyboard, using a computer mouse, playing racquetball or handball, sewing, painting, writing, or using a vibrating tool Are pregnant, menopausal, or overweight Have diabetes, premenstrual syndrome, an underactive thyroid, or rheumatoid arthritis Injury: Wrist pain with bruising and swelling is often a sign of an injury.Signs of a possible broken bone include deformed joints and inability to move the wrist, hand, or a finger.There can also be cartilage injuries in the wrist.Other common injuries include sprain, strain, tendinitis, and bursitis.Arthritis:Arthritis is another common cause of wrist pain, swelling, and stiffness.There are many types of arthritis:Osteoarthritis occurs with age and overuse.Rheumatoid arthritis generally affects both wrists.Psoriatic arthritis accompanies psoriasis.Infectious arthritis is a medical emergency.Signs of an infection include redness and warmth of the wrist, fever above 100F (37.7C), and recent illness.Other Causes Gout: This occurs when your body produces too much uric acid, a waste product.The uric acid forms crystals in the joints, rather than being excreted in the urine.Pseudogout: This occurs when calcium deposits in the joints, causing pain, redness, and swelling.The wrists and knees are most often affected. +Osteoarthritis is the most common form of arthritis among older people, and it is one of the most frequent causes of physical disability among older adults.The disease affects both men and women.Before age 45, osteoarthritis is more common in men than in women.After age 45, osteoarthritis is more common in women.Osteoarthritis occurs when cartilage, the tissue that cushions the ends of the bones within the joints, breaks down and wears away.In some cases, all of the cartilage may wear away, leaving bones that rub up against each other. +Symptoms range from stiffness and mild pain that comes and goes to severe joint pain.Common signs include joint pain, swelling, and tenderness; stiffness after getting out of bed; and a crunching feeling or sound of bone rubbing on bone.Not everyone with osteoarthritis feels pain.Osteoarthritis most commonly affects the hands, lower back, neck, and weight-bearing joints such as knees, hips, and feet.Osteoarthritis affects just joints, not internal organs.HandsOsteoarthritis of the hands seems to run in families.If your mother or grandmother has or had osteoarthritis in their hands, you're at greater-than-average risk of having it, too.Women are more likely than men to have osteoarthritis in the hands.For most women, it develops after menopause.When osteoarthritis involves the hands, small, bony knobs may appear on the end joints (those closest to the nails) of the fingers.They are called Heberden's (HEBerr-denz) nodes.Similar knobs, called Bouchard's (boo-SHARDZ) nodes, can appear on the middle joints of the fingers.Fingers can become enlarged and gnarled, and they may ache or be stiff and numb.The base of the thumb joint also is commonly affected by osteoarthritis.KneesThe knees are among the joints most commonly affected by osteoarthritis.Symptoms of knee osteoarthritis include stiffness, swelling, and pain, which make it hard to walk, climb, and get in and out of chairs and bathtubs.Osteoarthritis in the knees can lead to disability.HipsThe hips are also common sites of osteoarthritis.As with knee osteoarthritis, symptoms of hip osteoarthritis include pain and stiffness of the joint itself.But sometimes pain is felt in the groin, inner thigh, buttocks, or even the knees.Osteoarthritis of the hip may limit moving and bending, making daily activities such as dressing and putting on shoes a challenge.SpineOsteoarthritis of the spine may show up as stiffness and pain in the neck or lower back.In some cases, arthritis-related changes in the spine can cause pressure on the nerves where they exit the spinal column, resulting in weakness, tingling, or numbness of the arms and legs.In severe cases, this can even affect bladder and bowel function. +Anyone can get osteoarthritis; however, it is more common as people age.Women are more likely than men to have osteoarthritis, especially after age 50.For many women, it develops after menopause.Younger people can also develop osteoarthritis, usually as the result of: Joint injury.Abnormal joint structure.Genetic defect in joint cartilage.Anyone can get osteoarthritis; however, it is more common as people age.Women are more likely than men to have osteoarthritis, especially after age 50.For many women, it develops after menopause.Younger people can also develop osteoarthritis, usually as the result of: Joint injury.Abnormal joint structure.Genetic defect in joint cartilage. +","Ankylosing spondylitis is an inflammation of the spine that starts in adolescence or early adulthood, typically in the joints between the pelvic bones and the base of the spine.Ankylosing spondylitis can involve other joints, including the shoulders, hips, and, less often, the knees. Any person can get osteoarthritis, usually with age and overuse of the joints.The most common arthritis of the wrists is osteoarthritis.Before age 45, osteoarthritis is more common in men than in women.After age 45, osteoarthritis is more common in women.","Anyone can get osteoarthritis; Arthritis is another common cause of wrist pain, swelling, and stiffness.There are many types of arthritis:Osteoarthritis occurs with age and overuse. People with osteoarthritis usually have joint pain and, after rest or inactivity, stiffness for a short period of time.Osteoarthritis most commonly affects the hands, lower back, neck, and weight-bearing joints such as knees, hips, and feet.The disease affects both men and women.Before age 45, osteoarthritis is more common in men than in women.After age 45, osteoarthritis is more common in women.Ankylosing spondylitis is a form of ongoing joint inflammation (chronic inflammatory arthritis) that primarily affects the spine.This condition is characterized by back pain and stiffness that typically appear in adolescence or early adulthood.The earliest symptoms of ankylosing spondylitis result from inflammation of the joints between the pelvic bones (the ilia) and the base of the spine (the sacrum)..The inflammation gradually spreads to the joints between the vertebrae, causing a condition called spondylitis.Ankylosing spondylitis can involve other joints as well, including the shoulders, hips, and, less often, the knees." +76,Can you provide information on familial dysautonomia and support groups for it?,"These organizations can provide support and more information: National Organization for Rare Disorders -- rarediseases.org NLM Genetics Home Reference -- ghr.nlm.nih.gov/condition/familial-dysautonomia +Familial dysautonomia is a genetic disorder that affects the development and survival of certain nerve cells.The disorder disturbs cells in the autonomic nervous system, which controls involuntary actions such as digestion, breathing, production of tears, and the regulation of blood pressure and body temperature.It also affects the sensory nervous system, which controls activities related to the senses, such as taste and the perception of pain, heat, and cold.Familial dysautonomia is also called hereditary sensory and autonomic neuropathy, type III.Problems related to this disorder first appear during infancy.Early signs and symptoms include poor muscle tone (hypotonia), feeding difficulties, poor growth, lack of tears, frequent lung infections, and difficulty maintaining body temperature.Older infants and young children with familial dysautonomia may hold their breath for prolonged periods of time, which may cause a bluish appearance of the skin or lips (cyanosis) or fainting.This breath-holding behavior usually stops by age 6.Developmental milestones, such as walking and speech, are usually delayed, although some affected individuals show no signs of developmental delay.Additional signs and symptoms in school-age children include bed wetting, episodes of vomiting, reduced sensitivity to temperature changes and pain, poor balance, abnormal curvature of the spine (scoliosis), poor bone quality and increased risk of bone fractures, and kidney and heart problems.Affected individuals also have poor regulation of blood pressure.They may experience a sharp drop in blood pressure upon standing (orthostatic hypotension), which can cause dizziness, blurred vision, or fainting.They can also have episodes of high blood pressure when nervous or excited, or during vomiting incidents.About one-third of children with familial dysautonomia have learning disabilities, such as a short attention span, that require special education classes.By adulthood, affected individuals often have increasing difficulties with balance and walking unaided.Other problems that may appear in adolescence or early adulthood include lung damage due to repeated infections, impaired kidney function, and worsening vision due to the shrinking size (atrophy) of optic nerves, which carry information from the eyes to the brain. +Familial dysautonomia (FD) is an inherited disorder that affects nerves throughout the body. +Familial dysautonomia occurs primarily in people of Ashkenazi (central or eastern European) Jewish descent.It affects about 1 in 3,700 individuals in Ashkenazi Jewish populations.Familial dysautonomia is extremely rare in the general population. +Mutations in the ELP1 gene cause familial dysautonomia.The ELP1 gene provides instructions for making a protein that is found in a variety of cells throughout the body, including brain cells.Nearly all individuals with familial dysautonomia have two copies of the same ELP1 gene mutation in each cell.This mutation can disrupt how information in the ELP1 gene is pieced together to make a blueprint for the production of ELP1 protein.As a result of this error, a reduced amount of normal ELP1 protein is produced.This mutation behaves inconsistently, however.Some cells produce near normal amounts of the protein, and other cellsparticularly brain cellshave very little of the protein.Critical activities in brain cells are probably disrupted by reduced amounts or the absence of ELP1 protein, leading to the signs and symptoms of familial dysautonomia. +Familial dysautonomia is caused by the ELP1 gene not working correctly.DNA changes known as pathogenic variants are responsible for making genes work incorrectly or sometimes, not at all.[3] +Treatment for familial dysautonomia (FD) is focused on managing the symptoms.Treatment options include medications to help manage blood pressure, breathing problems, and vomiting episodes.Some people with FD need a feeding tube due to swallowing problems.In addition, in some people, surgery is necessary to correct curvature of the spine.[1][4] Specialists involved in the care of someone with familial dysautonomia may include: Neurologist Gastroenterologist Otolaryngologist (ear, nose, and throat doctor)Pulmonologist Ophthalmologist Sleep specialist Management Guidelines Project OrphanAnesthesia is a project whose aim is to create peer-reviewed, readily accessible guidelines for patients with rare diseases and for the anesthesiologists caring for them.The project is a collaborative effort of the German Society of Anesthesiology and Intensive Care, Orphanet, the European Society of Pediatric Anesthesia, anesthetists and rare disease experts with the aim to contribute to patient safety. +Familial dysautonomia mainly impacts people of eastern European (Ashkenazi) Jewish descent.It has been estimated that FD occurs in about one in 10,000 live births in North America.The incidence of FD has been decreasing over time due to prenatal screening and testing.[1] +Familial dysautonomia is diagnosed based on the symptoms, clinical exam, and confirmed by the results of genetic testing .[2][3]Testing Resources The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition.The intended audience for the GTR is health care providers and researchers.Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional.Orphanet lists international laboratories offering diagnostic testing for this condition. +","Familial dysautonomia is an inherited disorder mainly among people of eastern European (Ashkenazi) Jewish descent.It is diagnosed based on the symptoms, clinical exam, and confirmed by the results of genetic testing that detects mutations in the ELP1 gene.Familial dysautonomia effects autonomic nervous system, which controls digestion, breathing, production of tears, and the regulation of blood pressure and body temperature.It also affects the sensory nervous system that regulates taste and the perception of pain, heat, and cold.The symptoms appear in infancy and include poor muscle tone, feeding difficulties, poor growth, lack of tears, frequent lung infections, and difficulty maintaining body temperature. Walking and speech, are usually delayed, and one-third of children have learning disabilities.Affected adults have difficulties with balance and walking.They may also have lung damage, impaired kidney function, and worsening vision.Treatments for familial dysautonomia symptoms include medications to manage blood pressure, breathing problems, and vomiting episodes.Some people might need a feeding tube due to swallowing problems. Organizations that can provide support and more information about Familial dysautonomia include: National Organization for Rare Disorders -- rarediseases.org and NLM Genetics Home Reference -- ghr.nlm.nih.gov/condition/familial-dysautonomia","Familial dysautonomia (FD) is an inherited disorder that affects nerves throughout the body. Familial dysautonomia mainly impacts people of eastern European (Ashkenazi) Jewish descent.It has been estimated that FD occurs in about one in 10,000 live births in North America. Familial dysautonomia is diagnosed based on the symptoms, clinical exam, and confirmed by the results of genetic testing .Mutations in the ELP1 gene cause familial dysautonomia.This mutation can disrupt how information in the ELP1 gene is pieced together to make a blueprint for the production of ELP1 protein.The disorder disturbs cells in the autonomic nervous system, which controls involuntary actions such as digestion, breathing, production of tears, and the regulation of blood pressure and body temperature.It also affects the sensory nervous system, which controls activities related to the senses, such as taste and the perception of pain, heat, and cold.Problems related to this disorder first appear during infancy.Early signs and symptoms include poor muscle tone (hypotonia), feeding difficulties, poor growth, lack of tears, frequent lung infections, and difficulty maintaining body temperature. Developmental milestones, such as walking and speech, are usually delayed, although some affected individuals show no signs of developmental delay. About one-third of children with familial dysautonomia have learning disabilities, such as a short attention span, that require special education classes.By adulthood, affected individuals often have increasing difficulties with balance and walking unaided.Other problems that may appear in adolescence or early adulthood include lung damage due to repeated infections, impaired kidney function, and worsening vision due to the shrinking size (atrophy) of optic nerves, which carry information from the eyes to the brain.Treatment for familial dysautonomia (FD) is focused on managing the symptoms.Treatment options include medications to help manage blood pressure, breathing problems, and vomiting episodes.Some people with FD need a feeding tube due to swallowing problems.In addition, in some people, surgery is necessary to correct curvature of the spine. These organizations can provide support and more information: National Organization for Rare Disorders -- rarediseases.org NLM Genetics Home Reference -- ghr.nlm.nih.gov/condition/familial-dysautonomia" +77,Are there DNA tests for mental illness?,"In 2008, the former Secretary?s Advisory Committee on Genetics, Health and Society of the U.S. Department of Health and Human Services released a report identifying gaps in the regulation, oversight, and usefulness of genetic testing.They expressed the need for timely, reliable information that health care providers, payers, public health practitioners, policy makers, and consumers could use to make more informed decisions about the appropriate use of these tests in clinical and public health practice.To begin addressing this need for reliable information, CDC?s Office of Genomics and Precision Public Health (OGPPH) established the Evaluation of Genomic Applications in Practice and Prevention (EGAPP?)Initiative project to systematically evaluate genetic tests and other applications of genomic technology that are in transition from research to clinical and public health practice.Since 2005, the independent EGAPP Working Group has released nine recommendations on the validity and utility of specific genetic tests.The U.S. Preventive Services Task Force (USPSTF)external icon has also released recommendations on specific genetic tests used in selected clinical scenarios involving breast cancerexternal icon, colorectal cancer, and hemochromatosisexternal icon.In addition the Genetic Test Registryexternal icon was developed by NCBI.The article ?The NIH genetic testing registry: a new, centralized database of genetic tests to enable access to comprehensive information and improve transparency?external icon in the journal Nucleic Acids Research describes in detail this database. +Alzheimer's disease is an irreversible, progressive brain disease.It is characterized by the development of amyloid plaques and neurofibrillary, or tau, tangles; the loss of connections between nerve cells (neurons) in the brain; and the death of these nerve cells.There are two types of Alzheimer's-early-onset and late-onset.Both types have a genetic component.What Are DNA, Chromosomes, and Genes?The nucleus of almost every human cell contains a ""blueprint"" that carries the instructions a cell needs to do its job.The blueprint is made up of DNA (deoxyribonucleic acid), which is present in long strands that would stretch to nearly 6 feet in length if attached end to end.The DNA is packed tightly together with proteins into compact structures called chromosomes.Normally, each cell has 46 chromosomes in 23 pairs, which are inherited equally from a person's biological parents.The DNA in nearly all cells of an individual is identical.Each chromosome contains many thousands of segments, called genes.People inherit two copies of each gene from their parents, except for genes on the X and Y chromosomes, which, among other functions, determine a person's sex.The genes ""instruct"" the cell to make unique proteins that, in turn, dictate the types of cells made.Genes also direct almost every aspect of the cell's construction, operation, and repair.Even slight changes in a gene can produce a protein that functions abnormally, which may lead to disease.Other changes in genes may increase or decrease a person's risk of developing a particular disease.Early-Onset Alzheimer's DiseaseEarly-onset Alzheimer's disease occurs between a person's 30s to mid-60s and represents less than 10 percent of all people with Alzheimer's.Some cases are caused by an inherited change in one of three genes, resulting in a type known as early-onset familial Alzheimer's disease, or FAD.For other cases of early-onset Alzheimer's, research suggests there may be a genetic component related to factors other than these three genes.A child whose biological mother or father carries a genetic mutation for early-onset FAD has a 50/50 chance of inheriting that mutation.If the mutation is in fact inherited, the child has a very strong probability of developing early-onset FAD.Early-onset FAD is caused by any one of a number of different single-gene mutations on chromosomes 21, 14, and 1.Each of these mutations causes abnormal proteins to be formed.Mutations on chromosome 21 cause the formation of abnormal amyloid precursor protein (APP).A mutation on chromosome 14 causes abnormal presenilin 1 to be made, and a mutation on chromosome 1 leads to abnormal presenilin 2.Each of these mutations plays a role in the breakdown of APP, a protein whose precise function is not yet fully understood.This breakdown is part of a process that generates harmful forms of amyloid plaques, a hallmark of the disease.Critical research findings about early-onset Alzheimer's have helped identify key steps in the formation of brain abnormalities typical of the more common late-onset form of Alzheimer's.Genetics studies have helped explain why the disease develops in people at various ages.NIA-supported scientists are continuing research into early-onset disease through the Dominantly Inherited Alzheimer Network (DIAN), an international partnership to study families with early-onset FAD.By observing the Alzheimer's-related brain changes that occur in these families long before symptoms of memory loss or cognitive issues appear, scientists hope to gain insight into how and why the disease develops in both its early- and late-onset forms.In addition, an NIA-supported clinical trial in Colombia, South America, is testing the effectiveness of an amyloid-clearing drug in symptom-free volunteers at high risk of developing early-onset FAD.For more information, see NIA's Early-Onset Alzheimer's Disease: A Resource List.Late-Onset Alzheimer's DiseaseMost people with Alzheimer's have the late-onset form of the disease, in which symptoms become apparent in the mid-60s and later.The causes of late-onset Alzheimer's are not yet completely understood, but they likely include a combination of genetic, environmental, and lifestyle factors that affect a person's risk for developing the disease.Researchers have not found a specific gene that directly causes the late-onset form of the disease.However, one genetic risk factor-having one form of the apolipoprotein E (APOE) gene on chromosome 19-does increase a person's risk.APOE comes in several different forms, or alleles:- APOE epsilon2 is relatively rare and may provide some protection against the disease.If Alzheimer's disease occurs in a person with this allele, it usually develops later in life than it would in someone with the APOE epsilon4 gene. - APOE epsilon3, the most common allele, is believed to play a neutral role in the disease-neither decreasing nor increasing risk.- APOE epsilon4 increases risk for Alzheimer's disease and is also associated with an earlier age of disease onset.A person has zero, one, or two APOE epsilon4 alleles.Having more APOE epsilon4 alleles increases the risk of developing Alzheimer's.APOE epsilon4 is called a risk-factor gene because it increases a person's risk of developing the disease.However, inheriting an APOE epsilon4 allele does not mean that a person will definitely develop Alzheimer's.Some people with an APOE epsilon4 allele never get the disease, and others who develop Alzheimer's do not have any APOE epsilon4 alleles.Using a relatively new approach called genome-wide association study (GWAS), researchers have identified a number of regions of interest in the genome (an organism's complete set of DNA, including all of its genes) that may increase a person's risk for late-onset Alzheimer's to varying degrees.By 2015, they had confirmed 33 regions of interest in the Alzheimer's genome.A method called whole genome sequencing determines the complete DNA sequence of a person's genome at a single time.Another method called whole exome sequencing looks at the parts of the genome that directly code for the proteins.Using these two approaches, researchers can identify new genes that contribute to or protect against disease risk.Recent discoveries have led to new insights about biological pathways involved in Alzheimer's and may one day lead to effective interventions. +","In general, genetic testing is transitioning from research to clinical practice, which prompted CDC to establish an initiative that evaluates the validity and utility of genetic tests.Researchers use whole genome sequencing, which determines the complete DNA sequence of a person, or sequence parts of DNA to identify genes that predispose a person to have a specific disease.Using genome-wide association study (GWAS), researchers have identified genes that may increase risk for late-onset Alzheimer's disease. The two types of Alzheimer's disease: early-onset and late-onset both have a genetic component. Some cases of the early-onset Alzheimer's disease are caused by one of the single-gene mutations on chromosomes 21, 14, and 1.This form is called familial Alzheimer's disease (FAD.) .One known genetic risk factor for late-onset Alzheimer's disease is having a specific form of the apolipoprotein E (APOE) gene on chromosome 19.","A method called whole genome sequencing determines the complete DNA sequence of a person's genome at a single time.Another method called whole exome sequencing looks at the parts of the genome that directly code for the proteins.Using these two approaches, researchers can identify new genes that contribute to or protect against disease risk.CDC?s Office of Genomics and Precision Public Health (OGPPH) established the Evaluation of Genomic Applications in Practice and Prevention (EGAPP?)Initiative project to systematically evaluate genetic tests and other applications of genomic technology that are in transition from research to clinical and public health practice.Since 2005, the independent EGAPP Working Group has released nine recommendations on the validity and utility of specific genetic tests.Using a relatively new approach called genome-wide association study (GWAS), researchers have identified a number of regions of interest in the genome (an organism's complete set of DNA, including all of its genes) that may increase a person's risk for late-onset Alzheimer's to varying degrees. There are two types of Alzheimer's-early-onset and late-onset.Both types have a genetic component. Early-onset Alzheimer's disease occurs between a person's 30s to mid-60s and represents less than 10 percent of all people with Alzheimer's.Some cases are caused by an inherited change in one of three genes, resulting in a type known as early-onset familial Alzheimer's disease, or FAD. If the mutation is in fact inherited, the child has a very strong probability of developing early-onset FAD.Early-onset FAD is caused by any one of a number of different single-gene mutations on chromosomes 21, 14, and 1. .Researchers have not found a specific gene that directly causes the late-onset form of the disease.However, one genetic risk factor-having one form of the apolipoprotein E (APOE) gene on chromosome 19-does increase a person's risk." +78,Can spinal surgery cause hydrocephalus and blindness in adults?,"Hydrocephalus is a condition in which the primary characteristic is excessive accumulation of cerebrospinal fluid (CSF) -- the clear fluid that surrounds the brain and spinal cord.This excessive accumulation results in an abnormal dilation of the spaces in the brain called ventricles.This dilation causes potentially harmful pressure on the tissues of the brain.Hydrocephalus may be congenital or acquired.Congenital hydrocephalus is present at birth and may be caused by genetic abnormalities or developmental disorders such as spina bifida and encephalocele.Acquired hydrocephalus develops at the time of birth or at some point afterward and can affect individuals of all ages.For example, hydrocephalus ex-vacuo occurs when there is damage to the brain caused by stroke or traumatic injury.Normal pressure hydrocephalus occurs most often among the elderly.It may result from a subarachnoid hemorrhage, head trauma, infection, tumor, or complications of surgery, although many people develop normal pressure hydrocephalus without an obvious cause.Symptoms of hydrocephalus vary with age, disease progression, and individual differences in tolerance to CSF.In infancy, the most obvious indication of hydrocephalus is often the rapid increase in head circumference or an unusually large head size.In older children and adults, symptoms may include headache followed by vomiting, nausea, papilledema (swelling of the optic disk, which is part of the optic nerve), downward deviation of the eyes (called ""sunsetting""), problems with balance, poor coordination, gait disturbance, urinary incontinence, slowing or loss of development (in children), lethargy, drowsiness, irritability, or other changes in personality or cognition, including memory loss.Hydrocephalus is diagnosed through clinical neurological evaluation and by using cranial imaging techniques such as ultrasonography, computer tomography (CT), magnetic resonance imaging (MRI), or pressure-monitoring techniques. +

Summary

Hydrocephalus is the buildup of too much cerebrospinal fluid in the brain.Normally, this fluid cushions your brain.When you have too much, though, it puts harmful pressure on your brain.Hydrocephalus can be congenital, or present at birth.Causes include genetic problems and problems with how the fetus develops.An unusually large head is the main sign of congenital hydrocephalus.Hydrocephalus can also happen after birth.This is called acquired hydrocephalus.It can occur at any age.Causes can include head injuries, strokes, infections, tumors, and bleeding in the brain.Symptoms include Headache Vomiting and nausea Blurry vision Balance problems Bladder control problems Thinking and memory problems Hydrocephalus can permanently damage the brain, causing problems with physical and mental development.If untreated, it is usually fatal.With treatment, many people lead normal lives with few limitations.Treatment usually involves surgery to insert a shunt.A shunt is a flexible but sturdy plastic tube.The shunt moves the cerebrospinal fluid to another area of the body where it can be absorbed.Medicine and rehabilitation therapy can also help.NIH: National Institute of Neurological Disorders and Stroke +Congenital hydrocephalus is when a child is born with an excessive accumulation of cerebrospinal fluid (CSF) in the brain.CSF is a clear fluid that surrounds the brain and spinal cord.This excess fluid causes an abnormal widening of spaces in the brain called ventricles (ventriculomegalia) and can create a harmful pressure on brain tissue .[1]Symptoms of hydrocephalus vary and may include an unusually large head with thin, transparent scalp, bulging forehead with increased spaces between the bones of the skull (fontanelles), and a downward gaze.Other symptoms may include seizures , abnormal reflexes, slow heartbeat and respiratory rate, headaches, vomiting, irritability, weakness, and visual problems.[1][2][3] It is caused by genetic and non-genetic factors.The most common cause of congenital hydrocephalus are variations ( mutations ) in the L1CAM gene , where there is a narrow passageway between the third and fourth ventricles (aqueductal stenosis).Other causes include mutations in many other genes, brain and/or spinal cord malformations, infections, bleeding inside the cavities of the brain (intraventricular hemorrhage), trauma, exposition to certain drugs ( teratogens ) or a congenital tumor of the brain.[1][3] Congenital hydrocephalus can be an isolated malformation or be part of a syndrome where there are other associated malformations.[1]It is most often treated by surgically inserting a shunt system to transport the excess CSF and allow for re-absorption.If left untreated, blindness and continuing mental deterioration may occur.[1][2][3] Hydrocephalus may be subdivided according to the particular defect that exists in the brain and whether the cerebrospinal fluid pressure is high or normal:[1][4] Communicating hydrocephalus is when there is no blockage (obstruction) in the ventricules but the fluid is not absorbed readily, or there is too much fluid to be absorbed.Noncommunicating (obstructive) hydrocephalus is when there is a blockage of the CSF causing widening (dilation) of the pathways that are located upstream of the block, resulting in an increased pressure inside the brain. +The symptoms of hydrocephalus depend on where and how much fluid there is.A baby with hydrocephalus may: Have an abnormally large head Be fussy or show little interest in anything Develop a high-pitched cry Forcefully throw up Have seizures Have bulges in the soft spots of the skull Have one eye that looks in a different direction than the other eye (cross-eyed)Older children may have a headache, vision problems, or both.If not treated, children with hydrocephalus can have learning disabilities or lose vision. +","Acquired hydrocephalus can happen at any age.It could be caused by subarachnoid hemorrhage, head trauma, infection, tumor, or complications of surgery.In many people hydrocephalus develops without an evident cause. Symptoms of hydrocephalus include swelling of the optic disk, which is part of the optic nerve, and blurry vision.If it not treated, hydrocephalus can lead to blindness.","Acquired hydrocephalus develops at the time of birth or at some point afterward and can affect individuals of all ages.For example, hydrocephalus ex-vacuo occurs when there is damage to the brain caused by stroke or traumatic injury.Normal pressure hydrocephalus occurs most often among the elderly.It may result from a subarachnoid hemorrhage, head trauma, infection, tumor, or complications of surgery, although many people develop normal pressure hydrocephalus without an obvious cause.Symptoms of hydrocephalus vary with age, disease progression.In older children and adults, symptoms may include headache followed by vomiting, nausea, papilledema (swelling of the optic disk, which is part of the optic nerve), downward deviation of the eyes (called ""sunsetting""), problems with balance, poor coordination, gait disturbance, urinary incontinence, If left untreated, blindness and continuing mental deterioration may occur." +8,Is there an ayurvedic treatment Acute myeloblastic leukemia with minimal maturation?,"Most cases of APL are treated with an anthracycline chemotherapy drug (daunorubicin or idarubicin) plus the non-chemotherapy drug, all-trans-retinoic acid (ATRA), which is a relative of vitamin A. This treatment leads to remission in 80% to 90% of patients.[6] arsenic trioxide stem cell transplant FDA-Approved Treatments The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition.Learn more orphan products.National Library of Medicine Drug Information Portal Medline Plus Health Information National Library of Medicine Drug Information Portal Medline Plus Health Information +Acute promyelocytic leukemia (APL) is an aggressive type of acute myeloid leukemia in which there are too many immature blood-forming cells (promyelocytes) in the blood and bone marrow.This build up of promyelocytes leads to a shortage of normal white and red blood cells and platelets in the body.The signs and symptoms of APL include an increased risk to both bleed and form blood clots.Individuals may also experience excessive tiredness, pain in affected areas, loss of appetite, and weight loss.[1][2] APL usually occurs in middle-aged adults, but can be diagnosed at any age.It is caused by a mutation that is acquired over a person's lifetime, usually involving a translocation between chromosomes 15 and 17.[2]Treatment may include the use of all-trans retinoic acid (ATRA) and arsenic trioxide or anthracycline-based chemotherapy .[3][4] +",Remission is possible in up to 90% of the patients with acute myeloid leukemia in which there are too many immature myelocytes when they take a drug related to vitamin A and called all-trans-retinoic acid (ATRA).,"Treatment may include the use of all-trans retinoic acid (ATRA) and arsenic trioxide or anthracycline-based chemotherapy.Most cases of APL are treated with an anthracycline chemotherapy drug (daunorubicin or idarubicin) plus the non-chemotherapy drug, all-trans-retinoic acid (ATRA), which is a relative of vitamin A. This treatment leads to remission in 80% to 90% of patients." +81,How can i increase my copper retention while on Vidaza?,"Normally people have enough copper in the foods they eat.Menkes disease (kinky hair syndrome) is a very rare disorder of copper metabolism that is present before birth.It occurs in male infants.Lack of copper may lead to anemia and osteoporosis.In large amounts, copper is poisonous.A rare inherited disorder, Wilson disease, causes deposits of copper in the liver, brain, and other organs.The increased copper in these tissues leads to hepatitis, kidney problems, brain disorders, and other problems. +Oysters and other shellfish, whole grains, beans, nuts, potatoes, and organ meats (kidneys, liver) are good sources of copper.Dark leafy greens, dried fruits such as prunes, cocoa, black pepper, and yeast are also sources of copper in the diet. +","Usually people get enough copper with food.Good sources of copper are: oysters and other shellfish, whole grains, beans, nuts, potatoes, and organ meats (kidneys, liver) , dark leafy greens, dried fruits such as prunes, cocoa, black pepper, and yeast.","Normally people have enough copper in the foods they eat.Oysters and other shellfish, whole grains, beans, nuts, potatoes, and organ meats (kidneys, liver) are good sources of copper.Dark leafy greens, dried fruits such as prunes, cocoa, black pepper, and yeast are also sources of copper in the diet." +82,where can i find information for adults with Hirschsprung's disease?,"The large intestine is lined with muscles that contract to move stool through the intestine.Hirschsprung disease is a birth defect in which part of the colon (large intestine) is missing the nerves that signal the muscles to contract.Stool builds up in the intestine and causes a blockage A child with Hirschsprung disease may throw up, refuse to eat, and have a swollen belly Doctors do surgery to remove the part of the intestine that is missing nerves If not treated, Hirschsprung disease can lead to a fatal infection of the intestines called enterocolitis +Hirschsprung disease is an intestinal disorder characterized by the absence of nerves in parts of the intestine.This condition occurs when the nerves in the intestine (enteric nerves) do not form properly during development before birth (embryonic development).This condition is usually identified in the first two months of life, although less severe cases may be diagnosed later in childhood.Enteric nerves trigger the muscle contractions that move stool through the intestine.Without these nerves in parts of the intestine, the material cannot be pushed through, causing severe constipation or complete blockage of the intestine in people with Hirschsprung disease.Other signs and symptoms of this condition include vomiting, abdominal pain or swelling, diarrhea, poor feeding, malnutrition, and slow growth.People with this disorder are at risk of developing more serious conditions such as inflammation of the intestine (enterocolitis) or a hole in the wall of the intestine (intestinal perforation), which can cause serious infection and may be fatal.There are two main types of Hirschsprung disease, known as short-segment disease and long-segment disease, which are defined by the region of the intestine lacking nerve cells.In short-segment disease, nerve cells are missing from only the last segment of the large intestine.This type is most common, occurring in approximately 80 percent of people with Hirschsprung disease.For unknown reasons, short-segment disease is four times more common in men than in women.Long-segment disease occurs when nerve cells are missing from most of the large intestine and is the more severe type.Long-segment disease is found in approximately 20 percent of people with Hirschsprung disease and affects men and women equally.Very rarely, nerve cells are missing from the entire large intestine and sometimes part of the small intestine (total colonic aganglionosis) or from all of the large and small intestine (total intestinal aganglionosis).Hirschsprung disease can occur in combination with other conditions, such as Waardenburg syndrome, type IV; Mowat-Wilson syndrome; or congenital central hypoventilation syndrome.These cases are described as syndromic.Hirschsprung disease can also occur without other conditions, and these cases are referred to as isolated or nonsyndromic. +Doctors may suspect Hirschsprung disease is if a baby doesn't poop in the first 24 hours after birth.Doctors test for Hirschsprung disease with the following: Barium enema x-ray Rectal biopsy (doctors take out a small piece of the childs rectum to look at under a microscope)Measuring the pressure inside the childs rectum +Doctors treat Hirschsprung disease by: Doing surgery to take out the abnormal section of intestine and reconnect the 2 ends of working intestine Sometimes, if the child is very sick, doctors first do a temporary colostomy.They make a hole in the large intestine and connect it to a hole in the belly.Your baby's poop goes out the hole into a bag until your baby is healthy enough to have another operation.Then doctors do a second surgery to remove the part of the intestine that isnt working, reattach the working intestine, and seal the opening for the colostomy.Doctors treat infection (enterocolitis) with: Fluids and antibiotics in the vein Washing stool out of the intestines with salt water given through a tube in the rectum Surgery +Barium enema Rectal biopsy Measurement of the pressure in the rectum Initially, a barium enema is done to evaluate the defect.During a barium enema, the doctor instills barium and air into the child's rectum and then takes x-rays.Rectal biopsy (removal of a piece of tissue from the rectum for examination under a microscope) and measurement of the pressure inside the rectum (manometry) are the only tests that can be used reliably to diagnose Hirschsprung disease. +Muscle contractions in the gut help digested foods and liquids move through the intestine.This is called peristalsis.Nerves between the muscle layers trigger the contractions.In Hirschsprung disease, the nerves are missing from a part of the bowel.Areas without these nerves cannot push material through.This causes a blockage.Intestinal contents build up behind the blockage.The bowel and abdomen swell as a result.Hirschsprung disease causes about 25% of all newborn intestinal blockages.It occurs 5 times more often in males than in females.Hirschsprung disease is sometimes linked to other inherited or congenital conditions, such as Down syndrome. +Hirschsprung disease is a blockage of the large intestine.It occurs due to poor muscle movement in the bowel.It is a congenital condition, which means it is present from birth. +","Hirschsprung disease is a birth defect that affects the colon (large intestine.)In the two forms of the disease, short-segment disease and long-segment disease, different segments of the colon are missing the nerves that contract the muscles and push the stool through the intestine..If only a small section of the intestine is missing the nerves, the disease is not diagnosed until later in life. Inability to push the stool causes constipation or complete blockage of the intestine..People might develop inflammation of the intestine (enterocolitis) or a hole in the wall of the intestine (intestinal perforation), which can cause serious infection and may be fatal. In short-segment Hirschsprung disease, nerve cells are missing from only the last segment of the large intestine.This type is most common and occurs mostly in men.In the long-segment disease, nerve cells are missing from most of the large intestine.It is fa more severe type that affects about 20 percent of people with Hirschsprung disease.It affects men and women equally. The tests to confirm Hirschsprung disease include barium enema x-ray, rectal biopsy and measurement of the pressure inside the rectum. Hirschsprung disease is treated by surgery that takes out the section of intestine without the nerves.Complications, such as enterocolitis, are treated with fluids and antibiotics.","Hirschsprung disease is a birth defect in which part of the colon (large intestine) is missing the nerves that signal the muscles to contract.If only a small section of the intestine is affected, a child may have milder symptoms and may not be diagnosed until late.Stool builds up in the intestine and causes a blockage. Enteric nerves trigger the muscle contractions that move stool through the intestine.Without these nerves in parts of the intestine, the material cannot be pushed through, causing severe constipation or complete blockage of the intestine in people with Hirschsprung disease..Peoplewith this disorder are at risk of developing more serious conditions such as inflammation of the intestine (enterocolitis) or a hole in the wall of the intestine (intestinal perforation), which can cause serious infection and may be fatal.There are two main types of Hirschsprung disease, known as short-segment disease and long-segment disease, which are defined by the region of the intestine lacking nerve cells.In short-segment disease, nerve cells are missing from only the last segment of the large intestine.This type is most common, occurring in approximately 80 percent of people with Hirschsprung disease.For unknown reasons, short-segment disease is four times more common in men than in women.Long-segment disease occurs when nerve cells are missing from most of the large intestine and is the more severe type.Long-segment disease is found in approximately 20 percent of people with Hirschsprung disease and affects men and women equally.Very rarely, nerve cells are missing from the entire large intestine and sometimes part of the small intestine (total colonic aganglionosis) or from all of the large and small intestine (total intestinal aganglionosis). Doctors test for Hirschsprung disease with the following: Barium enema x-ray.Initially, a barium enema is done to evaluate the defect.Rectal biopsy (removal of a piece of tissue from the rectum for examination under a microscope) and measurement of the pressure inside the rectum (manometry) are the only tests that can be used reliably to diagnose Hirschsprung disease.Doctors treat Hirschsprung disease by: Doing surgery to take out the abnormal section of intestine and reconnect the 2 ends of working intestine.Doctors treat infection (enterocolitis) with: Fluids and antibiotics in the vein Washing stool out of the intestines with salt water given through a tube in the rectum" +83,Can x-rays cause complete hair loss?,"

Summary

X-rays are a type of radiation called electromagnetic waves.X-ray imaging creates pictures of the inside of your body.The images show the parts of your body in different shades of black and white.This is because different tissues absorb different amounts of radiation.Calcium in bones absorbs x-rays the most, so bones look white.Fat and other soft tissues absorb less and look gray.Air absorbs the least, so lungs look black.The most familiar use of x-rays is checking for fractures (broken bones), but x-rays are also used in other ways.For example, chest x-rays can spot pneumonia.Mammograms use x-rays to look for breast cancer.When you have an x-ray, you may wear a lead apron to protect certain parts of your body.The amount of radiation you get from an x-ray is small.For example, a chest x-ray gives out a radiation dose similar to the amount of radiation you're naturally exposed to from the environment over 10 days. +Hair loss from menopause or childbirth often goes away after 6 months to 2 years.For hair loss due to illness (such as fever), radiation therapy, medicine use, or other causes, no treatment is needed.Hair usually grows back when the illness ends or the therapy is finished.You may want to wear a wig, hat, or other covering until the hair grows back.Hair weaves, hair pieces, or changes of hair style may disguise hair loss.This is generally the least expensive and safest approach to hair loss.Hair pieces should not be sutured (sewn) to the scalp because of the risk of scars and infection. +The main risk in getting an x-ray is being exposed to radiation.Doctors try to limit the total amount of radiation you get over your lifetime.Getting too much radiation can raise your chance of getting cancer.Most plain x-rays expose you to a very small amount of radiation If youre pregnant or could be pregnant, doctors will shield your belly from the radiation +","Although getting an x-ray exposes you to some radiation, the dose is usually small.For example, radiation from a chest x-ray equals to 10 days of radiation you get from the environment.The amount of radiation over your lifetime should be monitored and limited.Radiation therapy can cause hair loss.Hair usually grows back after the therapy is finished.","The main risk in getting an x-ray is being exposed to radiation.Doctors try to limit the total amount of radiation you get over your lifetime.Getting too much radiation can raise your chance of getting cancer.Most plain x-rays expose you to a very small amount of radiation.For example, a chest x-ray gives out a radiation dose similar to the amount of radiation you're naturally exposed to from the environment over 10 days.For hair loss due to illness (such as fever), radiation therapy, medicine use, or other causes, no treatment is needed.Hair usually grows back when the illness ends or the therapy is finished." +87,What is the latest research for X-linked congenital stationary night blindness?,"X-linked congenital stationary night blindness is a disorder of the retina, which is the specialized tissue at the back of the eye that detects light and color.People with this condition typically have difficulty seeing in low light (night blindness).They also have other vision problems, including loss of sharpness (reduced acuity), severe nearsightedness (high myopia), involuntary movements of the eyes (nystagmus), and eyes that do not look in the same direction (strabismus).Color vision is typically not affected by this disorder.The vision problems associated with this condition are congenital, which means they are present from birth.They tend to remain stable (stationary) over time.Researchers have identified two major types of X-linked congenital stationary night blindness: the complete form and the incomplete form.The types have very similar signs and symptoms.However, everyone with the complete form has night blindness, while not all people with the incomplete form have night blindness.The types are distinguished by their genetic cause and by the results of a test called an electroretinogram, which measures the function of the retina. +Mutations in the NYX and CACNA1F genes cause the complete and incomplete forms of X-linked congenital stationary night blindness, respectively.The proteins produced from these genes play critical roles in the retina.Within the retina, the NYX and CACNA1F proteins are located on the surface of light-detecting cells called photoreceptors.The retina contains two types of photoreceptor cells: rods and cones.Rods are needed for vision in low light.Cones are needed for vision in bright light, including color vision.The NYX and CACNA1F proteins ensure that visual signals are passed from rods and cones to other retinal cells called bipolar cells, which is an essential step in the transmission of visual information from the eyes to the brain.Mutations in the NYX or CACNA1F gene disrupt the transmission of visual signals between photoreceptors and retinal bipolar cells, which impairs vision.In people with the complete form of X-linked congenital stationary night blindness (resulting from NYX mutations), the function of rods is severely disrupted, while the function of cones is only mildly affected.In people with the incomplete form of the condition (resulting from CACNA1F mutations), rods and cones are both affected, although they retain some ability to detect light. +This condition is inherited in an X-linked recessive pattern.The NYX and CACNA1F genes are located on the X chromosome, which is one of the two sex chromosomes.In males (who have only one X chromosome), one altered copy of the gene in each cell is sufficient to cause the condition.In females (who have two X chromosomes), a mutation would have to occur in both copies of the gene to cause the disorder.Because it is unlikely that females will have two altered copies of this gene, males are affected by X-linked recessive disorders much more frequently than females.A characteristic of X-linked inheritance is that fathers cannot pass X-linked traits to their sons.In X-linked recessive inheritance, a female with one altered copy of the gene in each cell is called a carrier.Carriers of an NYX or CACNA1F mutation can pass on the mutated gene, but most do not develop any of the vision problems associated with X-linked congenital stationary night blindness.However, carriers may have retinal changes that can be detected with an electroretinogram. +Mutations in several genes can cause autosomal recessive congenital stationary night blindness.Each of these genes provide instructions for making proteins that are found in the retina.These proteins are involved in sending (transmitting) visual signals from cells called rods, which are specialized for vision in low light, to cells called bipolar cells, which relay the signals to other retinal cells.This signaling is an essential step in the transmission of visual information from the eyes to the brain.Mutations in two genes, GRM6 and TRPM1, cause most cases of this condition.These genes provide instructions for making proteins that are necessary for bipolar cells to receive and relay signals.Mutations in other genes involved in the same bipolar cell signaling pathway are likely responsible for a small percentage of cases of autosomal recessive congenital stationary night blindness.Gene mutations that cause autosomal recessive congenital stationary night blindness disrupt the transmission of visual signals between rod cells and bipolar cells or interfere with the bipolar cells' ability to pass on these signals.As a result, visual information received by rod cells cannot be effectively transmitted to the brain, leading to difficulty seeing in low light.The cause of the other vision problems associated with this condition is unclear.It has been suggested that the mechanisms that underlie night blindness can interfere with other visual systems, causing myopia, reduced visual acuity, and other impairments.Some people with autosomal recessive congenital stationary night blindness have no identified mutation in any of the known genes.The cause of the disorder in these individuals is unknown. +Autosomal recessive congenital stationary night blindness is likely a rare disease; however, its prevalence is unknown. +","Research shows there are two major types of X-linked congenital stationary night blindness caused by mutations in the NYX or CACNA1F gene.that disrupt visual signals and impair vision.In people with the complete form of X-linked congenital stationary night blindness associated with NYX mutations, the rods are affected severely but the cones are affected mildly.All people with this form have night blindness.People with the incomplete form have CACNA1F mutations that affect functions of both the rods and cones.These people retain some ability to detect light.In addition to genetic cause, the two types could be distinguished with the electroretinogram test that measures the function of the retina. Men have only one copy of the X chromosome that contains the NYX and CACNA1F genes.They, therefore, will have the condition if they get the mutation from their mother.Women would have to inherit the mutation in both the mother's and the father's genes to have the disorder.","Researchers have identified two major types of X-linked congenital stationary night blindness: the complete form and the incomplete form.The types have very similar signs and symptoms.However, everyone with the complete form has night blindness, while not all people with the incomplete form have night blindness.The types are distinguished by their genetic cause and by the results of a test called an electroretinogram, which measures the function of the retina.Mutations in the NYX or CACNA1F gene disrupt the transmission of visual signals between photoreceptors and retinal bipolar cells, which impairs vision.In people with the complete form of X-linked congenital stationary night blindness (resulting from NYX mutations), the function of rods is severely disrupted, while the function of cones is only mildly affected.In people with the incomplete form of the condition (resulting from CACNA1F mutations), rods and cones are both affected, although they retain some ability to detect light. This condition is inherited in an X-linked recessive pattern.The NYX and CACNA1F genes are located on the X chromosome, which is one of the two sex chromosomes.In males (who have only one X chromosome), one altered copy of the gene in each cell is sufficient to cause the condition.In females (who have two X chromosomes), a mutation would have to occur in both copies of the gene to cause the disorder." +88,Can umbilical cord blood cure autism?,"Symptoms are usually lifelong.People with autism with lower intelligence scores are likely to need more support in their adult lives.Autism is treated with: Behavioral therapy to develop social skills Special education at school Sometimes medicine, such as selective serotonin reuptake inhibitors (SSRIs) or other medicine that may help children stop injuring themselves Some families try special diets or alternative therapies.There is no good evidence that these are helpful for children with autism.Talk to your doctor about any therapies you're considering. +Treatment for ASD should begin as soon as possible after diagnosis.Early treatment for ASD is important as proper care can reduce individuals difficulties while helping them learn new skills and make the most of their strengths.The wide range of issues facing people with ASD means that there is no single best treatment for ASD.Working closely with a doctor or health care professional is an important part of finding the right treatment program.

Medication

A doctor may use medication to treat some symptoms that are common with ASD.With medication, a person with ASD may have fewer problems with: Irritability Aggression Repetitive behavior Hyperactivity Attention problems Anxiety and depression Read more about the latest news and information on medication warnings, patient medication guides, or newly approved medications at the Food and Drug Administrations (FDA) website at https://www.fda.gov/.

Behavioral, psychological, and educational therapy

People with ASD may be referred to doctors who specialize in providing behavioral, psychological, educational, or skill-building interventions.These programs are typically highly structured and intensive and may involve parents, siblings, and other family members.Programs may help people with ASD: Learn life-skills necessary to live independently Reduce challenging behaviors Increase or build upon strengths Learn social, communication, and language skills

Other resources

There are many social services programs and other resources that can help people with ASD.Here are some tips for finding these additional services:Contact your doctor, local health department, school, or autism advocacy group to learn about special programs or local resources.Find an autism support group.Sharing information and experiences can help individuals with ASD and/or their caregivers learn about treatment options and ASD-related programs.Record conversations and meetings with health care providers and teachers.This information helps when its time to make decisions about which programs might best meet an individuals needs.Keep copies of doctors' reports and evaluations.This information may help an individual qualify for special programs. +Applied behavior analysis Educational programs Speech and language therapySometimes drug therapy Applied behavior analysis (ABA) is a therapy doctors use to improve, change, or develop specific behaviors in children who have an ASD.These behaviors include social skills, language and communication skills, reading, and academics as well as learned skills such as self-care (for example, showering and grooming), daily-living skills, punctuality, and job competence.This therapy is also used to help children minimize behaviors (for example, aggression) that may interfere with their progress.Applied behavior analysis therapy is tailored to meet the needs of each child and is typically designed and supervised by professionals certified in behavior analysis.Educational programs for school-aged children with an ASD should address social skills development and speech and language delays and help prepare children for education after high school or for employment.The federal Individuals with Disabilities Education Act (IDEA) requires public schools to provide free and appropriate education to children and adolescents with an ASD.Education must be provided in the least restrictive, most inclusive setting possiblethat is, a setting where the children have every opportunity to interact with nondisabled peers and have equal access to community resources.The Americans with Disability Act and Section 504 of the Rehabilitation Act also provide for accommodations in schools and other public settings.Drug therapy cannot change the underlying disorder.However, the selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine, paroxetine, and fluvoxamine, are often effective in reducing ritualistic behaviors of people with an ASD.Antipsychotic drugs, such as risperidone, may be used to reduce self-injurious behavior, although the risk of side effects (such as weight gain and movement disorders) must be considered.Mood stabilizers and psychostimulants may be helpful for people who are inattentive or impulsive or who have hyperactivity.Although some parents try special diets, gastrointestinal therapies, or immunologic therapies, currently there is no good evidence that any of these therapies are helpful in children with an autism spectrum disorder.Other complementary therapies, such as facilitated communication, chelation therapy, auditory integration training, and hyperbaric oxygen therapy, have not been proved effective.In considering such treatments, families should consult with the child's primary care physician regarding benefits and risks. +","Some families try special diets or alternative therapies for autism.Before trying any of the alternative treatments, you should ask your doctor if they have any benefits and if there are any risks.The following alternative and complementary treatments have not been shown effective: gastrointestinal therapies, immunologic therapies, facilitated communication, chelation therapy, auditory integration training, and hyperbaric oxygen therapy.Doctors recommend treating autism with behavioral therapies and educational programs to develop social skills, Medications often reduce ritualistic behavior, self-injurious behavior, hyperactivity and compulsive behavior.","Treatment for ASD should begin as soon as possible after diagnosis.Early treatment for ASD is important as proper care can reduce individuals difficulties while helping them learn new skills and make the most of their strengths.The wide range of issues facing people with ASD means that there is no single best treatment for ASD. Autism is treated with: Behavioral therapy to develop social skills Special education at school Sometimes medicine, such as selective serotonin reuptake inhibitors (SSRIs) or other medicine that may help children stop injuring themselves Some families try special diets or alternative therapies.There is no good evidence that these are helpful for children with autism. Applied behavior analysis (ABA) is a therapy doctors use to improve, change, or develop specific behaviors in children who have an ASD.Educational programs for school-aged children with an ASD should address social skills development and speech and language delays and help prepare children for education after high school or for employment.Drug therapy cannot change the underlying disorder.However, the selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine, paroxetine, and fluvoxamine, are often effective in reducing ritualistic behaviors of people with an ASD.Antipsychotic drugs, such as risperidone, may be used to reduce self-injurious behavior, although the risk of side effects (such as weight gain and movement disorders) must be considered.Mood stabilizers and psychostimulants may be helpful for people who are inattentive or impulsive or who have hyperactivity.Although some parents try special diets, gastrointestinal therapies, or immunologic therapies, currently there is no good evidence that any of these therapies are helpful in children with an autism spectrum disorder.Other complementary therapies, such as facilitated communication, chelation therapy, auditory integration training, and hyperbaric oxygen therapy, have not been proved effective.In considering such treatments, families should consult with the child's primary care physician regarding benefits and risks." +89,Can a cold cause postoperative endophthalmitis?,"Endophthalmitis is caused by infection with bacteria or a fungus.It very often occurs as a rare complication of cataract or other eye surgery. +Antibiotics Sometimes corticosteroids or surgery <i>Endophthalmitis is a medical emergency.Immediate treatment with antibiotics is usually needed to preserve vision and to protect the health of the eye.A delay of even a few hours can result in irreversible vision loss in extreme cases.The choice of antibiotic may be adjusted depending on which organism is found to be causing the endophthalmitis.Antibiotics may be injected into the eye, given by vein (intravenously), or both.People who have very poor vision when they are seen by a doctor may be given corticosteroids or have surgery.Corticosteroids can be given by mouth for a few days after the antibiotic injection, or, less commonly, they can be injected into the eye.Surgery may be needed to remove infected tissue from inside the eye, which may improve the chances of stopping the infection. +

Summary

After any operation, you'll have some side effects.There is usually some pain with surgery.There may also be swelling and soreness around the area that the surgeon cut.Your surgeon can tell you which side effects to expect.There can also be complications.These are unplanned events linked to the operation.Some complications are infection, too much bleeding, reaction to anesthesia, or accidental injury.Some people have a greater risk of complications because of other medical conditions.Your surgeon can tell you how you might feel and what you will be able to do - or not do - the first few days, weeks, or months after surgery.Some other questions to ask are How long you will be in the hospital What kind of supplies, equipment, and help you might need when you go home When you can go back to work When it is ok to start exercising again Are they any other restrictions in your activities Following your surgeon's advice can help you recover as soon as possible.Agency for Healthcare Research and Quality +","Any surgery can have complications that include infections.Doctors tell you how you might feel after the procedure and how to avoid complications.Complications of cataract and other eye surgery include endophthalmitis, which is caused by bacteria or fungus.It is a medical emergency that needs to be treated immediately to preserve vision and avoid irreversible vision loss.","After any operation, you'll have some side effects.There is usually some pain with surgery.There may also be swelling and soreness around the area that the surgeon cut.Your surgeon can tell you which side effects to expect.There can also be complications.These are unplanned events linked to the operation.Some complications are infection, too much bleeding, reaction to anesthesia, or accidental injury.Some people have a greater risk of complications because of other medical conditions.Your surgeon can tell you how you might feel and what you will be able to do - or not do - the first few days, weeks, or months after surgery.Endophthalmitis is caused by infection with bacteria or a fungus.It very often occurs as a rare complication of cataract or other eye surgery.Endophthalmitis is a medical emergency.Immediate treatment with antibiotics is usually needed to preserve vision and to protect the health of the eye.A delay of even a few hours can result in irreversible vision loss in extreme cases." +90,Can you get hives after stopping antibiotics?,"Hives and angioedema are often allergic reactions.Hives may occur when certain chemicals are inhaled, consumed, injected, or touched.These chemicals can be in the environment, foods, drugs, insects, plants, or other sources.They are harmless in most people.But if people are sensitive to them, these chemicals (called triggers or allergens) can cause an allergic reaction.That is, the immune system overreacts to the chemicals.However, hives are not always part of an allergic reaction.For example, they may result from autoimmune disorders.In these disorders, the immune system malfunctions, misinterpreting the body's own tissues as foreign and attacking them.Also, some drugs cause hives directly without triggering an allergic reaction.Emotional stress and some physical conditions (such as heat or light) may cause hives for reasons that are not well understood.Hives usually last less than 6 weeks and are classified as acute.If hives last more than 6 weeks, they are classified as chronic.Acute hives are most commonly caused by Allergic reactions Nonallergic reactions Allergic reactions are often triggered by foods, particularly eggs, fish, shellfish, nuts, and fruits, or by insect stings.Eating even a tiny amount of some foods can suddenly cause hives.But with other foods (such as strawberries), an allergic reaction occurs only after a large amount is eaten.Many drugs, particularly antibiotics, may cause hives.Immediate allergic reactions may also occur when a substance comes into direct contact with the skin (such as latex), after an insect bite, or as a reaction to a substance that is inhaled into the lungs or through the nose.Nonallergic causes of hives include infections, some drugs, some physical stimuli (such as pressure or cold), some emotional stimuli (such as stress), and some food additives.Even though acute hives usually have a specific cause, the cause cannot be identified in about half of cases.Chronic hives are most commonly caused by Unidentified (idiopathic) conditions Autoimmune disordersSometimes the cause is easily overlooked, as when people repeatedly consume a food not known to be a trigger, such as a preservative or dye in foods or penicillin in milk.Often, despite the best efforts, the cause remains unidentified.Chronic hives can last for months or years, then sometimes go away for no apparent reason. +Hives may or may not be an allergic reaction.If hives have lasted less than 6 weeks, the cause is usually an allergic reaction to a specific substance, an acute infection, or a nonallergic reaction to a specific substance.If hives have lasted 6 weeks or more, the cause usually cannot be identified (is idiopathic) or is an autoimmune disorder.People should call an ambulance if they have difficulty breathing or if their throat feels as if it is closing up.People with mild symptoms should avoid any known or suspected triggers and can take antihistamines to relieve symptoms.People who have severe reactions should carry a self-injecting epinephrine pen and, if a reaction occurs, use it immediately. +When you have an allergic reaction to a substance, your body releases histamine and other chemicals into the blood.This causes itching, swelling, and other symptoms.Hives are a common reaction.People with other allergies, such as hay fever, often get hives.Angioedema is swelling of the deeper tissue that sometimes occurs with hives.Like hives, angioedema can occur on any part of the body.When it occurs around the mouth or throat, the symptoms can be severe, including airway blockage.Many substances can trigger hives, including: Animal dander (especially cats) Insect bites Medicines Pollen Shellfish, fish, nuts, eggs, milk, and other foods Hives may also develop as a result of: Emotional stress Extreme cold or sun exposure Excessive perspiration Illness, including lupus, other autoimmune diseases, and leukemia Infections such as mononucleosis Exercise Exposure to water Often, the cause of hives is not known. +Hives are usually caused by an allergic reaction to a: Food Insect sting or bite Chemical Medicine Hives can also be caused by: Stress and other emotional problems Physical factors, such as pressure, cold, heat, and light Autoimmune diseases (diseases that make your immune system attack your own tissues)Sometimes you and your doctor won't be able to figure out what caused your hives. +Doctors first ask questions about the symptoms and medical history.Doctors then do a physical examination.What they find during the history and physical examination often suggests a cause and the tests that may need to be done (see Table: Some Causes and Features of Hives).Doctors ask the person to describe each episode of hives in detail and any other symptoms that occurred (such as itching, difficulty breathing, or swelling of the face and tongue).They ask about the persons activities before and during the episode and about possible exposure to substances that can trigger allergic reactions, including drugs being taken.The person is also asked about specific symptoms that could suggest a cause (see Table: Some Causes and Features of Hives), past allergic reactions, and recent travel.The trigger is not always clear from the history, often because the trigger is something that may have been tolerated previously.During the physical examination, doctors first check to see whether the lips, tongue, throat, or airways are swollen.If there is swelling, they begin treatment right away.Then doctors note how the hives look, determine which parts of the body are affected, and check for other symptoms that may help confirm the diagnosis.Doctors may use various physical stimuli to see whether they can trigger the hives.For example, they may apply light pressure, heat, or cold to the skin or stroke the skin.People themselves should not try to trigger their hives, because a severe reaction could occur.TableSome Causes and Features of Hives Cause Common Features* Tests Acute hives (lasting less than 6 weeks)Drugs such as Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs)Some opioids Vancomycin Succinylcholine (sometimes given before surgery)Contrast agents (used with imaging tests such as computed tomography)Possibly any drug, whether prescription, over-the-counter, or herbal, if people are allergic to it Hives that start within 48 hours after the drug was used A doctor's examination Emotional or physical stimuli Stress or anxiety Cold Exercise Pressure on the skin (dermatographism) Heat Sunlight Sweating as occurs during a warm bath, exercise, or fever For most stimuli, hives that typically start within seconds or minutes of exposure to the stimulus For pressure on the skin, hives that start within 46 hours and affect only the area of the skin pressed For sunlight, hives that affect only the area of the skin exposed to sunlight A doctor's examination Exposure to the suspected physical stimulus to see whether it triggers symptoms Foods that trigger an allergic reaction (food allergens), such as peanuts, nuts, fish, shellfish, wheat, eggs, milk, and soybeans Hives that start within minutes or hours after consumption A doctor's examination, particularly the medical history Sometimes allergy skin prick testing Infections (rare causes)Bacterial, such as some urinary tract, streptococcal, and Helicobacter pylori infections Parasitic, such as Toxocara canis, Giardia intestinalis (lamblia), Schistosoma mansoni, Strongyloides stercoralis, Trichuris trichiura, and Blastocystis hominis infections Viral, such as hepatitis (A, B, or C) and HIV, cytomegalovirus, Epstein-Barr virus, and enterovirus infections Fever, chills, and fatigue Symptoms of the particular infection Particularly for parasitic infections, recent travel to a developing country Tests depending on the suspected infection (suggested by results of the medical history and examination)Diagnosis confirmed if hives disappear after the infection is eliminated Insect bites or stings Hives that start within seconds or minutes after an insect bite or sting A doctor's examination, particularly the medical history Serum sickness Hives that start within 710 days after injection of A blood product (as in a transfusion)A drug derived from animal blood such as horse serum (which is used to treat poisonous snake and spider bites) Possibly another drug May be accompanied by fever, joint pain, swollen lymph nodes, and abdominal painA doctors examination Substances that trigger an allergic reaction through contact (contact allergens), such as latex, animal saliva or dander, dust, pollen, or molds Hives that start within minutes or hours after contact A doctor's examination, particularly the medical historySometimes allergy testing Transfusion reactionsHives that usually start within a few minutes after transfusion of a blood product A doctor's examination, particularly the medical history Chronic hives (lasting more than 6 weeks)Autoimmune disorders Systemic lupus erythematosus (lupus)Sjgren syndrome Urticarial vasculitisVarious symptoms depending on the autoimmune disorder For systemic lupus erythematosus, symptoms may include fever, fatigue, headache, joint pain and swelling, painful breathing, and mouth sores For Sjgren syndrome, dry eyes and dry mouth For urticarial vasculitis, hives that May be painful rather than itchyUsually last more than 24 hours Do not whiten (blanch) when pressure is applied Can be accompanied by small blisters and reddish purple blotches (purpura)For all autoimmune disorders, blood tests to check for abnormal antibodies Sometimes skin biopsy For Sjgren syndrome, a test that estimates the amount of tears people are producing For urticarial vasculitis, skin biopsy Cancer, typically of the digestive organs or lungs, or lymphoma Weight loss, night sweats, abdominal pain, cough (sometimes bringing up blood), jaundice, swollen lymph nodes, or a combination Various tests depending on the cancer suspected Chronic idiopathic hives (diagnosed when no specific cause is identified)Hives that occur daily (or almost daily) and itching that lasts for at least 6 weeks, with no obvious cause A doctors examination Blood and sometimes other tests, such as skin prick tests and exposure to various triggers, to rule out other causes Drugs (same as those for acute hives)Hives that occur in a person who has been taking a prescription, an over-the-counter, or an herbal drug for a long time when there is no other explanation for them A doctor's examinationSometimes allergy testing Trial of avoidance to see whether hives disappear after the drug is stopped Emotional or physical stimuli (same as those for acute hives)For most stimuli, hives that typically occur within seconds or minutes of exposure to the stimulus For pressure on the skin, hives that start within 46 hours and affect only the area of the skin pressed For sunlight, hives that affect only the area of the skin exposed to sunlight A doctor's examination Exposure to the suspected stimulus to see whether it triggers symptoms Endocrine abnormalities such as a thyroid disorder or an elevated level of progesterone (a female hormone)For thyroid disorders, difficulty tolerating heat or cold, a slow or fast heart rate, and shaking (tremor) or sluggishness Occurring in women who take birth control pills (oral contraceptives) or hormone therapy containing progesterone or who have hives appearing just before their menstrual periods start and disappearing when periods stop A doctor's examination If a thyroid disorder is suspected, a blood test to measure thyroid-stimulating hormone Mastocytosis Small red bumps that turn into hives when touched Sometimes abdominal pain, easy flushing, and recurring headaches Skin and sometimes bone marrow biopsySometimes blood tests to measure levels of substances released when certain immune cells (called mast cells) are activated *Features include symptoms and results of the doctor's examination.Features mentioned are typical but not always present.HIV = human immunodeficiency virus. +Hives are red, itchy, raised patches on your skin.Hives usually come and go away completely, but sometimes they last a long time Allergic reactions often cause hives, but there are other causes +","Hives could be caused by an allergic or non-allergic reaction to a specific substance or an an acute infection, stress and other emotional problems, physical factors, such as pressure, cold, heat, and light, and autoimmune diseases.Substances that cause allergic reaction include food, chemicals, and many drugs, particularly antibiotics.Hives start within 48 hours after the drug was used and could last for six weeks or longer.The trigger is not always clear because some substance that was tolerated before can trigger a reaction.","Hives are usually caused by an allergic reaction to a: Food Insect sting or bite Chemical Medicine Hives can also be caused by: Stress and other emotional problems Physical factors, such as pressure, cold, heat, and light Autoimmune diseases (diseases that make your immune system attack your own tissues)Sometimes you and your doctor won't be able to figure out what caused your hives.The trigger is not always clear from the history, often because the trigger is something that may have been tolerated previously.Many drugs, particularly antibiotics, may cause hives.Possibly any drug, whether prescription, over-the-counter, or herbal, if people are allergic to it Hives that start within 48 hours after the drug was used. Hives usually come and go away completely, but sometimes they last a long time." +91,How can I stop being allergic to caffeine?,"Allergen immunotherapy, usually allergy shots (injections), can be given to desensitize people to the allergen when some allergens, especially airborne allergens, cannot be avoided and the drugs used to treat allergic reactions are ineffective.With allergen immunotherapy, allergic reactions can be prevented or reduced in number and/or severity.However, allergen immunotherapy is not always effective.Some people and some allergies tend to respond better than others.Immunotherapy is used most often for allergies to Pollens House dust mites Molds Venom of stinging insects When people are allergic to unavoidable allergens, such as insect venom, immunotherapy helps prevent anaphylactic reactions.Sometimes it is used for allergies to animal dander, but such treatment is unlikely to be useful.Immunotherapy for food allergies is being studied.Immunotherapy is not used when the allergen, such as penicillin and other drugs, can be avoided.However, if people need to take a drug that they are allergic to, immunotherapy, closely monitored by a doctor, can be done to desensitize them.In immunotherapy, tiny amounts of the allergen are usually injected under the skin.The dose is gradually increased until a dose adequate to control symptoms (maintenance dose) is reached.A gradual increase is necessary because exposure to a high dose of the allergen too soon can cause an allergic reaction.Injections are usually given once or twice a week until the maintenance dose is reached.Then injections are usually given every 2 to 4 weeks.The procedure is most effective when maintenance injections are continued throughout the year, even for seasonal allergies.Alternatively, high doses of the allergen may be placed under the tongue (sublingual) and held there for a few minutes, then swallowed.The dose is gradually increased, as for injections.The sublingual technique is relatively new, and how often the dose should be given has not been established.It ranges from every day to 3 times a week.Extracts for grass pollen or house dust mite, placed under the tongue, can be used to help prevent allergic rhinitis.Allergen immunotherapy may take 3 to 4 years to complete.Because immunotherapy injections occasionally cause dangerous allergic reactions, people remain in the doctors office for at least 30 minutes afterward.If they have mild reactions to immunotherapy (such as sneezing, coughing, flushing, tingling sensations, itching, chest tightness, wheezing, and hives), a drugusually an antihistamine, such as diphenhydramine or loratadinemay help.For more severe reactions, epinephrine (adrenaline) is injected. +Leukotriene modifiers, such as montelukast, are anti-inflammatory drugs used to treat the following: Mild persistent asthma Seasonal allergic rhinitis They inhibit leukotrienes, which are released by some white blood cells and mast cells when they are exposed to an allergen.Leukotrienes contribute to inflammation and cause airways to constrict.Omalizumab is a monoclonal antibody (which is a manufactured [synthetic] antibody designed to interact with a specific substance).Omalizumab binds to immunoglobulin E (IgE), an antibody that is produced in large amounts during an allergic reaction, and prevents IgE from binding to mast cells and basophils and triggering an allergic reaction.Omalizumab may be used to treat persistent or severe asthma when other treatments are ineffective.If hives recur frequently and other treatments are ineffective, it may be helpful.When it is used, the dose of a corticosteroid can be reduced.It is given by injection under the skin (subcutaneously). +When antihistamines and mast cell stabilizers cannot control allergic symptoms, a corticosteroid may help.Corticosteroids can be taken as a nasal spray to treat nasal symptoms or through an inhaler, usually to treat asthma.Doctors prescribe a corticosteroid (such as prednisone) to be taken by mouth only when symptoms are very severe or widespread and all other treatments are ineffective.If taken by mouth at high doses and for a long time (for example, for more than 3 to 4 weeks), corticosteroids can have many, sometimes serious side effects.Therefore, corticosteroids taken by mouth are used for as short a time as possible.Creams and ointments that contain corticosteroids can help relieve the itching associated with allergic rashes.One corticosteroid, hydrocortisone, is available OTC. +The drugs most commonly used to relieve the symptoms of allergies are antihistamines.Antihistamines block the effects of histamine (which triggers symptoms).They do not stop the body from producing histamine.Taking antihistamines partially relieves the runny nose, watery eyes, and itching and reduces the swelling due to hives or mild angioedema.But antihistamines do not ease breathing when airways are constricted.Some antihistamines (such as azelastine) are also mast cell stabilizers.Antihistamines are available as Tablets, capsules, or liquid solutions to be taken by mouth Nasal sprays Eye drops Lotions or creams Which is used depends on the type of allergic reaction.Some antihistamines are available without a prescription (over-the-counter, or OTC), and some require a prescription.Some that used to require a prescription are now available OTC.Products that contain an antihistamine and a decongestant (such as pseudoephedrine) are also available OTC.They can be taken by adults and children aged 12 years and older.These products are particularly useful when both an antihistamine and a nasal decongestant are needed.However, some people, such as those who are taking monoamine oxidase inhibitors (a type of antidepressant), cannot take these products.Also, people with high blood pressure should not take a decongestant unless a doctor recommends it and monitors its use.The antihistamine diphenhydramine is available OTC as a lotion, cream, gel, or spray that can be applied to the skin to relieve itching, but it should not be used.Its effectiveness is unproved, and it can cause allergic reactions (such as a rash).It can cause extreme drowsiness in children who are also taking an antihistamine by mouth.Did You Know... Over-the-counter skin products that contain diphenhydramine (an antihistamine) should not be used because their effectiveness is unproved and because allergic reactions and other side effects are possible.Side effects of antihistamines include anticholinergic effects, such as drowsiness, dry mouth, blurred vision, constipation, difficulty with urination, confusion, and light-headedness (particularly after a person stands up), as well as drowsiness.Often, prescription antihistamines have fewer of these effects.Some antihistamines are more likely to cause drowsiness (sedation) than others.Antihistamines that cause drowsiness are widely available OTC.People should not take these antihistamines if they are going to drive, operate heavy equipment, or do other activities that require alertness.Antihistamines that cause drowsiness should not be given to children under 2 years old because they may have serious or life-threatening side effects.These antihistamines are also a particular problem for older people and for people with glaucoma, benign prostatic hyperplasia, constipation, or dementia because of the drugs anticholinergic effects.In general, doctors use antihistamines cautiously in people with cardiovascular disease.Not everyone reacts the same way to antihistamines.For example, Asians seem to be less susceptible to the sedative effects of diphenhydramine than are people of Western European origin.Also, antihistamines cause the opposite (paradoxical) reaction in some people, making them feel nervous, restless, and agitated.TableSome Antihistamines Drug Degree of Anticholinergic Effects* Degree of Drowsiness Nonprescription (over-the-counter) Brompheniramine Moderate Some Cetirizine Few to none Little to none in most people and moderate in some people Chlorpheniramine Moderate Some Clemastine Strong Moderate Desloratadine Few to none Little to none Diphenhydramine Strong Extreme Fexofenadine Few to none Little to none Loratadine Few to none Little to none Prescription Acrivastine Few to none Little to none Azelastine Few to none Some Cyproheptadine Moderate Some Dexchlorpheniramine Moderate Some Hydroxyzine Moderate Extreme Levocetirizine Few to none Little to none Mizolastine Few to none Little to none Promethazine Strong Extreme * Anticholinergic effects include dry mouth, blurred vision, constipation, difficulty with urination, confusion, and light-headedness (particularly after a person stands up).Older people are particularly susceptible to these effects.The degree of drowsiness varies, depending on the dose, other active ingredients in the formulation (as in formulations that contain a decongestant plus an antihistamine), and the person.Acrivastine is available only in combination with pseudoephedrine (a decongestant).The combination is taken by mouth. +","For some allergens, immunotherapy can be used.It is studied for food allergies.During allergen immunotherapy, small portions of the allergens are injected under the skin or placed under the tongue.In both cases, the doses are increased gradually, until the maintenance dose is reached -- a dose that can control the symptoms.Allergen immunotherapy may take 3 to 4 years to complete.Immunotherapy could cause dangerous allergic reactions, therefore it is only done in the doctor's offie under observation, so that the doctor could administer an antihistamine or epinephrine, for more severe reactions.Antihistamines are overall most commonly used to relieve allergy symptoms.If antihistamines and mast cell stabilizers do not help, corticosteroids may be used.","Allergen immunotherapy, usually allergy shots (injections), can be given to desensitize people to the allergen when some allergens, cannot be avoided and the drugs used to treat allergic reactions are ineffective.With allergen immunotherapy, allergic reactions can be prevented or reduced in number and/or severity.However, allergen immunotherapy is not always effective.Some people and some allergies tend to respond better than others.I Immunotherapy for food allergies is being studied.In immunotherapy, tiny amounts of the allergen are usually injected under the skin.The dose is gradually increased until a dose adequate to control symptoms (maintenance dose) is reached.A gradual increase is necessary because exposure to a high dose of the allergen too soon can cause an allergic reaction.Injections are usually given once or twice a week until the maintenance dose is reached.Then injections are usually given every 2 to 4 weeks.The procedure is most effective when maintenance injections are continued throughout the year..Alternatively, doses of the allergen may be placed under the tongue (sublingual) and held there for a few minutes, then swallowed.The dose is gradually increased, as for injections.The sublingual technique is relatively new, and how often the dose should be given has not been established.It ranges from every day to 3 times a week.Allergen immunotherapy may take 3 to 4 years to complete.Because immunotherapy injections occasionally cause dangerous allergic reactions, people remain in the doctors office for at least 30 minutes afterward.If they have mild reactions to immunotherapy (such as sneezing, coughing, flushing, tingling sensations, itching, chest tightness, wheezing, and hives), a drug usually an antihistamine, such as diphenhydramine or loratadine may help.For more severe reactions, epinephrine (adrenaline) is injected.The drugs most commonly used to relieve the symptoms of allergies are antihistamines.Antihistamines block the effects of histamine (which triggers symptoms). When antihistamines and mast cell stabilizers cannot control allergic symptoms, a corticosteroid may help." +92,Can ertapenem cause seizures?,"

Ertapenem injection may cause side effects.Tell your doctor if any of these symptoms are severe or do not go away:

nausea vomiting diarrhea constipation headache dizziness stomach pain fever cough confusion difficulty falling asleep or staying asleep redness or irritation at the injection site swelling, redness, burning, itching, or irritation of the vagina swelling of the hands, feet, ankles, or lower legs

Some side effects can be serious.If you experience any of these symptoms, stop using ertapenem injection and call your doctor immediately or get emergency medical treatment:

severe diarrhea (watery or bloody stools) that may occur with or without fever and stomach cramps (may occur up to 2 months or more after your treatment)hives rash itching difficulty breathing or swallowing seizures unusual tiredness or weakness pale skin fast or irregular heartbeat shortness of breath chest pain Ertapenem injection may cause other side effects.Call your doctor if you have any unusual problems while taking this medication.If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088). +Seizures and other central nervous system (CNS) adverse experiences have been reported during treatment with ertapenem .During clinical investigations in adult patients treated with ertapenem (1 g once a day), seizures, irrespective of drug relationship, occurred in 0.5% of patients during study therapy plus 14-day follow-up period .These experiences have occurred most commonly in patients with CNS disorders (e.g., brain lesions or history of seizures) and/or compromised renal function.Close adherence to the recommended dosage regimen is urged, especially in patients with known factors that predispose to convulsive activity.Anticonvulsant therapy should be continued in patients with known seizure disorders.If focal tremors, myoclonus, or seizures occur, patients should be evaluated neurologically, placed on anticonvulsant therapy if not already instituted, and the dosage of ertapenem re-examined to determine whether it should be decreased or discontinued. +Case reports in the literature have shown that co-administration of carbapenems, including ertapenem, to patients receiving valproic acid or divalproex sodium results in a reduction in valproic acid concentrations.The valproic acid concentrations may drop below the therapeutic range as a result of this interaction, therefore increasing the risk of breakthrough seizures.Increasing the dose of valproic acid or divalproex sodium may not be sufficient to overcome this interaction.The concomitant use of ertapenem and valproic acid/divalproex sodium is generally not recommended.Anti-bacterials other than carbapenems should be considered to treat infections in patients whose seizures are well controlled on valproic acid or divalproex sodium.If administration of ertapenem is necessary, supplemental anti-convulsant therapy should be considered . +","In a study in which adult patients were treated with ertapenem (1 g once a day), 0.5% of patients had seizures during the study and 14-day after the treatment.Other cases are reported in the literature that show ertapenem could cause seizures in people who are taking valproic acid or divalproex sodium.Ertapenem reduces concentration of valproic acid so that it no longer controls breakthrough seizures.Seizures caused by ertapenem are a serious side effect that requires immediate medical attention.","Seizures and other central nervous system (CNS) adverse experiences have been reported during treatment with ertapenem .During clinical investigations in adult patients treated with ertapenem (1 g once a day), seizures, irrespective of drug relationship, occurred in 0.5% of patients during study therapy plus 14-day follow-up period .These experiences have occurred most commonly in patients with CNS disorders (e.g., brain lesions or history of seizures) and/or compromised renal function. Case reports in the literature have shown that co-administration of carbapenems, including ertapenem, to patients receiving valproic acid or divalproex sodium results in a reduction in valproic acid concentrations.The valproic acid concentrations may drop below the therapeutic range as a result of this interaction, therefore increasing the risk of breakthrough seizures.Increasing the dose of valproic acid or divalproex sodium may not be sufficient to overcome this interaction.The concomitant use of ertapenem and valproic acid/divalproex sodium is generally not recommended. If you experience any of these symptoms, stop using ertapenem injection and call your doctor immediately or get emergency medical treatment: severe diarrhea (watery or bloody stools) that may occur with or without fever and stomach cramps (may occur up to 2 months or more after your treatment) hives rash itching difficulty breathing or swallowing seizures unusual tiredness or weakness pale skin fast or irregular heartbeat shortness of breath chest pain Ertapenem injection may cause other side effects." +93,Is there a treatment for Metachromatic leukodystrophy (MLD)?,"Metachromatic leukodystrophy (MLD) is a genetic disorder that affects nerves, muscles, other organs, and behavior.It slowly gets worse over time. +No treatment This disease cannot be cured at the present time.However, bone marrow transplantation or stem cell transplantation may help people who have mild forms of the disease.Enzyme replacement therapy and gene therapy are possible treatment options that are being studied. +There is no cure for MLD.Care focuses on treating the symptoms and preserving the person's quality of life with physical and occupational therapy.Bone marrow transplant may be considered for infantile MLD.Research is studying ways to replace the missing enzyme (arylsulfatase A). +","Although researchers are studying how to cure MLD using bone marrow transplantation or stem cell transplantation, enzyme replacement therapy and gene therapy , there is no cure and no treatments for MLD. Treatments are focusing on alleviating the symptoms, and preserving the person's quality of life with physical and occupational therapy.","Metachromatic leukodystrophy (MLD) is a genetic disorder that affects nerves, muscles, other organs, and behavior.It slowly gets worse over time.There is no cure for MLD.However, bone marrow transplantation or stem cell transplantation may help people who have mild forms of the disease.Enzyme replacement therapy and gene therapy are possible treatment options that are being studied.Bone marrow transplant may be considered for infantile MLD.Research is studying ways to replace the missing enzyme (arylsulfatase A). Care focuses on treating the symptoms and preserving the person's quality of life with physical and occupational therapy."