key,question,text,summ_abs,summ_ext 5,Is there gene therapy for persistent cough?,"The best way to treat a cough is to treat its cause.However, sometimes the cause is unknown.Other treatments, such as medicines and a vaporizer, can help relieve the cough itself.Treating the Cause of a Cough Acute and Subacute Cough An acute cough lasts less than 3 weeks.Common causes of an acute cough are a common cold or other upper respiratory infections.Examples of other upper respiratory infections include the flu, pneumonia, and whooping cough.An acute cough usually goes away after the illness that caused it is over.A subacute cough lasts 3 to 8 weeks.This type of cough remains even after a cold or other respiratory infection is over.Studies show that antibiotics and cold medicines can't cure a cold.However, your doctor may prescribe medicines to treat another cause of an acute or subacute cough.For example, antibiotics may be given for pneumonia.Chronic Cough A chronic cough lasts more than 8 weeks.Common causes of a chronic cough are upper airway cough syndrome (UACS), asthma, and gastroesophageal reflux disease (GERD).""UACS"" is a term used to describe conditions that inflame the upper airways and cause a cough.Examples include sinus infections and allergies.These conditions can cause mucus (a slimy substance) to run down your throat from the back of your nose.This is called postnasal drip.If you have a sinus infection, your doctor may prescribe antibiotics.He or she also may suggest you use a medicine that you spray into your nose.If allergies are causing your cough, your doctor may advise you to avoid the substances that you're allergic to (allergens) if possible.If you have asthma, try to avoid irritants and allergens that make your asthma worse.Take your asthma medicines as your doctor prescribes.GERD occurs if acid from your stomach backs up into your throat.Your doctor may prescribe a medicine to reduce acid in your stomach.You also may be able to relieve GERD symptoms by waiting 3 to 4 hours after a meal before lying down, and by sleeping with your head raised.Smoking also can cause a chronic cough.If you smoke, it's important to quit.Talk with your doctor about programs and products that can help you quit smoking.Also, try to avoid secondhand smoke.Many hospitals have programs that help people quit smoking, or hospital staff can refer you to a program.The Health Topics Smoking and Your Heart article and the National Heart, Lung, and Blood Institute's ""Your Guide to a Healthy Heart"" booklet have more information about how to quit smoking.Other causes of a chronic cough include respiratory infections, chronic bronchitis, bronchiectasis, lung cancer, and heart failure.Treatments for these causes may include medicines, procedures, and other therapies.Treatment also may include avoiding irritants and allergens and quitting smoking.If your chronic cough is due to a medicine you're taking, your doctor may prescribe a different medicine.Treating the Cough Rather Than the Cause Coughing is important because it helps clear your airways of irritants, such as smoke and mucus (a slimy substance).Coughing also helps prevent infections.Cough medicines usually are used only when the cause of the cough is unknown and the cough causes a lot of discomfort.Medicines can help control a cough and make it easier to cough up mucus.Your doctor may recommend medicines such as: Prescription cough suppressants, also called antitussives.These medicines can help relieve a cough.However, they're usually used when nothing else works.No evidence shows that over-the-counter cough suppressants relieve a cough.Expectorants.These medicines may loosen mucus, making it easier to cough up.Bronchodilators.These medicines relax your airways.Other treatments also may relieve an irritated throat and loosen mucus.Examples include using a cool-mist humidifier or steam vaporizer and drinking enough fluids.Examples of fluids are water, soup, and juice.Ask your doctor how much fluid you need.Cough in ChildrenNo evidence shows that cough and cold medicines help children recover more quickly from colds.These medicines can even harm children.Talk with your child's doctor about your child's cough and how to treat it. Determining the cause of chronic cough is crucial to effective treatment.In many cases, more than one underlying condition may be causing your chronic cough. If you are currently smoking, your doctor will discuss with you your readiness to quit and provide assistance to achieve this goal. If you're taking an ACE inhibitor medication, your doctor may switch you to another medicine that doesn't have cough as a side effect. Medications used to treat chronic cough may include: Antihistamines, corticosteroids and decongestants.These drugs are standard treatment for allergies and postnasal drip. Inhaled asthma drugs.The most effective treatments for asthma-related cough are corticosteroids and bronchodilators, which reduce inflammation and open up your airways. Antibiotics.If a bacterial, fungal or mycobacterial infection is causing your chronic cough, your doctor may prescribe medications to address the infection. Acid blockers.When lifestyle changes don't take care of acid reflux, you may be treated with medications that block acid production.Some people need surgery to resolve the problem. ","Chronic persistent cough can be caused by inflammation, allergies and many other diseases. Your doctor will prescribe treatments for the disease.For example, if you have allergies, your doctor may recommend antihistamines, corticosteroids and decongestants.Treatments for cough are used only if the reason is unknown or it causes severe discomfort.","Common causes of a chronic cough are upper airway cough syndrome (UACS), asthma, and gastroesophageal reflux disease (GERD).""UACS"" is a term used to describe conditions that inflame the upper airways and cause a cough.Examples include sinus infections and allergies.If allergies are causing your cough, your doctor may advise you to avoid the substances that you're allergic to (allergens) if possible.Antihistamines, corticosteroids and decongestants.These drugs are standard treatment for allergies and postnasal drip.If you have asthma, try to avoid irritants and allergens that make your asthma worse. The most effective treatments for asthma-related cough are corticosteroids and bronchodilators, which reduce inflammation and open up your airways.If you're taking an ACE inhibitor medication, your doctor may switch you to another medicine that doesn't have cough as a side effect.GERD occurs if acid from your stomach backs up into your throat.Your doctor may prescribe a medicine to reduce acid in your stomach.You also may be able to relieve GERD symptoms by waiting 3 to 4 hours after a meal before lying down, and by sleeping with your head raised.Smoking also can cause a chronic cough.If you smoke, it's important to quit. Other causes of a chronic cough include respiratory infections, chronic bronchitis, bronchiectasis, lung cancer, and heart failure.Treatments for these causes may include medicines, procedures, and other therapies. Cough medicines usually are used only when the cause of the cough is unknown and the cough causes a lot of discomfort." 24,What causes calcification of the basal ganglia and what are the treatments?,"Primary familial brain calcification is caused by mutations in one of several genes.The most commonly mutated gene is called SLC20A2, and accounts for an estimated 40 percent of cases, followed by the PDGFRB gene, which is mutated in about 10 percent of cases.Changes in other genes each account for a small percentage of cases.In about half of individuals with primary familial brain calcification the genetic cause is unknown.These individuals are thought to have mutations in genes that have not yet been linked to the condition. To date, no specific treatment for PFBC is known.Medications can be used to treat symptoms associated with this condition, such as movement disorders, seizures, anxiety, depression, psychosis and urinary incontinence.Off label prescription of biphosphanates have been reported in few patients The diagnosis of PFBC relies upon:[1] 1) visualization of bilateral (on both sides) calcification of the basal ganglia on neuroimaging, 2) presence of progressive neurological dysfunction, 3) absence of a metabolic, infectious, toxic, or traumatic cause, and 4) a family history consistent with autosomal dominant inheritance (a person must inherit one copy of the altered gene from one parent to have the condition).Molecular genetic testing can help confirm the diagnosis.[1] Genetic testing may help to confirm the diagnosis.For individuals in who a diagnosis of PFBC is being considered, other causes of brain calcification should be eliminated prior to pursuing genetic testing, particularly in simplex cases.Testing that might be done includes biochemical analysis of blood and urine, as well as analysis of cerebrospinal fluid.If no other primary cause for brain calcification is detected or if the family history is suggestive of autosomal dominant inheritance, molecular genetic testing should be considered.[1] Sequencing of SLC20A2 should be pursued first.If no mutation is identified, deletion / duplication analysis of SLC20A2 may be considered.If no identifiable mutation or deletion in SLC20A2 is found, sequence analysis of PDGFRB and PDGFB may be considered.[1] 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. ","Causes of brain calcification can be determined using biochemical analysis of blood, urine, or cerebrospinal fluid.One of the causes is a genetic disorder called primary familial brain calcification (PFBC) with characteristic calcium deposits in the basal ganglia.This disorder is frquently caused by mutations in SLC20A2 and PDGFRB genes. If other causes of calcification are eliminated, genetic testing for PFBC is recommended.There are no treatments for PFBC.Medications are used to treat the symptoms, such as movement disorders, seizures, anxiety, depression, psychosis and urinary incontinence.","Primary familial brain calcification is caused by mutations in one of several genes.The most commonly mutated gene is called SLC20A2, and accounts for an estimated 40 percent of cases, followed by the PDGFRB gene, which is mutated in about 10 percent of cases..The diagnosis of PFBC relies upon: 1) visualization of bilateral (on both sides) calcification of the basal ganglia on neuroimaging, 2) presence of progressive neurological dysfunction, 3) absence of a metabolic, infectious, toxic, or traumatic cause, and 4) a family history. For individuals in who a diagnosis of PFBC is being considered, other causes of brain calcification should be eliminated prior to pursuing genetic testing, particularly in simplex cases.Testing that might be done includes biochemical analysis of blood and urine, as well as analysis of cerebrospinal fluid.If no other primary cause for brain calcification is detected or if the family history is suggestive of autosomal dominant inheritance, molecular genetic testing should be considered.To date, no specific treatment for PFBC is known.Medications can be used to treat symptoms associated with this condition, such as movement disorders, seizures, anxiety, depression, psychosis and urinary incontinence." 38,How long does it take to recover from GBS?,"Guillain-Barr√© syndrome can be a devastating disorder because of its sudden and rapid, unexpected onset of weakness‚Äîand usually actual paralysis.Fortunately, 70% of people with GBS eventually experience full recovery.With careful intensive care and successful treatment of infection, autonomic dysfunction and other medical complications, even those individuals with respiratory failure usually survive. Typically, the point of greatest weakness occurs days to at most 4 weeks after the first symptoms occur.Symptoms then stabilize at this level for a period of days, weeks, or, sometimes months.Recovery, however, can be slow or incomplete.The recovery period may be as little as a few weeks up to a few years.Some individuals still report ongoing improvement after 2 years.About 30 percent of those with Guillain-Barr√© have residual weakness after 3 years.About 3 percent may suffer a relapse of muscle weakness and tingling sensations many years after the initial attack.About 15 percent of individuals experience long-term weakness; some may require ongoing use of a walker, wheelchair, or ankle support.Muscle strength may not return uniformly. Recovery can take weeks, months, or years.Most people survive and recover completely.In some people, mild weakness may persist.The outcome is likely to be good when the symptoms go away within 3 weeks after they first started.Possible complications of GBS include: Breathing difficulty (respiratory failure) Shortening of tissues in the joints (contractures) or other deformities Blood clots (deep vein thrombosis) that form when the person with GBS is inactive or has to stay in bed Increased risk of infections Low or unstable blood pressure Paralysis that is permanent Pneumonia Skin damage (ulcers)Breathing food or fluids into the lungs ","Recovery from GBS could take weeks, months, or even years.If the symptoms clear within 3 weeks, the outlook is likely good.Some mild weakness could linger up to three years.In some cases, severe complications, such as respiratory failure or permanent paralysis are possible.","The recovery period may be as little as a few weeks up to a few years. Most people survive and recover completely.In some people, mild weakness may persist.The outcome is likely to be good when the symptoms go away within 3 weeks after they first started.Some individuals still report ongoing improvement after 2 years.About 30 percent of those with Guillain-Barré have residual weakness after 3 years.About 3 percent may suffer a relapse of muscle weakness and tingling sensations many years after the initial attack.About 15 percent of individuals experience long-term weakness; some may require ongoing use of a walker, wheelchair, or ankle support.Muscle strength may not return uniformly." 94,What are the best natural remedies for enlarged prostate?,"The treatment you choose will be based on how bad your symptoms are and how much they bother you.Your provider will also take into account other medical problems you may have.Treatment options include ""watchful waiting,"" lifestyle changes, medicines, or surgery.If you are over 60, you are more likely to have symptoms.But many men with an enlarged prostate have only minor symptoms.Self-care steps are often enough to make you feel better.If you have BPH, you should have a yearly exam to monitor your symptoms and see if you need changes in treatment.SELF-CAREFor mild symptoms: Urinate when you first get the urge.Also, go to the bathroom on a timed schedule, even if you don't feel a need to urinate.Avoid alcohol and caffeine, especially after dinner.DO NOT drink a lot of fluid all at once.Spread out fluids during the day.Avoid drinking fluids within 2 hours of bedtime.Try NOT to take over-the-counter cold and sinus medicines that contain decongestants or antihistamines.These drugs can increase BPH symptoms.Keep warm and exercise regularly.Cold weather and lack of physical activity may worsen symptoms.Reduce stress.Nervousness and tension can lead to more frequent urination.MEDICINESAlpha-1 blockers are a class of drugs that are also used to treat high blood pressure.These medicines relax the muscles of the bladder neck and prostate.This allows easier urination.Most people who take alpha-1 blockers notice improvement in their symptoms, usually within 3 to 7 days after starting the medicine.Finasteride and dutasteride lower levels of hormones produced by the prostate.These drugs also reduce the size of the gland, increase urine flow rate, and decrease symptoms of BPH.You may need to take these medicines for 3 to 6 months before you notice symptoms getting better.Possible side effects include decreased sex drive and impotence.Antibiotics may be prescribed to treat chronic prostatitis (inflammation of the prostate), which may occur with BPH.BPH symptoms improve in some men after a course of antibiotics.Watch out for drugs that may make your symptoms worse:SAW PALMETTOMany herbs have been tried for treating an enlarged prostate.Many men use saw palmetto to ease symptoms.Some studies have shown that it may help with symptoms, but results are mixed, and more research is needed.If you use saw palmetto and think it works, ask your doctor if you should still take it.SURGERYProstate surgery may be recommended if you have: Incontinence Recurrent blood in the urine Inability to fully empty the bladder (urinary retention)Recurrent urinary tract infections Decreasing kidney function Bladder stones Bothersome symptoms not responding to medicinesThe choice of which surgical procedure is recommended is most often based on the severity of your symptoms and the size and shape of your prostate gland.Most men who have prostate surgery have improvement in urine flow rates and symptoms.Transurethral resection of the prostate (TURP):This is the most common and most proven surgical treatment for BPH.TURP is performed by inserting a scope through the penis and removing the prostate piece by piece.Simple prostatectomy: It is a procedure to remove the inside part of the prostate gland.It is done through a surgical cut in your lower belly.This treatment is most often done on men who have very large prostate glands.Other less-invasive procedures use heat or a laser to destroy prostate tissue.Another less-invasive procedure works by ""tacking"" the prostate open without removing or destroying tissues.None have been proven to be better than TURP.People who receive these procedures are more likely to need surgery again after 5 or 10 years.However, these procedures may be a choice for: Younger men (many of the less-invasive procedures carry a lower risk for impotence and incontinence than TURP, although the risk with TURP is not very high)Older people People with severe medical conditions, including uncontrolled diabetes, cirrhosis, alcoholism, psychosis, and serious lung, kidney, or heart disease Men who are taking blood-thinning drugs Men who are otherwise at an increased surgical risk The prostate gland is located underneath the bladder and is about the size of a chestnut.In this cut section, you can see that part of the urethra is encased within the prostate gland.As a man ages, the prostate typically enlarges in size in a process called benign hypertrophy, which means that the gland got larger without becoming cancerous.The enlarged prostate crowds its anatomical neighbors, particularly the urethra, causing it to narrow.The narrowed urethra results in several of the symptoms of benign prostatic hypertrophy, or BPH.Symptoms may include a slowed or delayed start in urination, the need to urinate frequently during the night, difficulty in emptying the bladder, a strong, sudden urge to urinate, and incontinence.Less than half of all men with BPH have symptoms of the disease, or their symptoms are minor and do not restrict their life style.BPH is a normal physiological process of aging and treatment options are available.The choice of the appropriate treatment is based on the severity of the symptoms, the extent to which they affect lifestyle, and the presence of other medical conditions.Men with BPH should consult with their physician yearly to monitor the progression of the symptoms and decide the best course of treatment as needed. ","Treatments depend on the symptoms.If you have only minor symptoms, self-care steps are often enough.A yearly exam is needed to see if you need changes in treatment.SELF-CARE includes urinating on a timed schedule,,avoiding alcohol and caffeine, spreading out small portions of fluids during the day, keeping warm and exercising regularly.Avoid stress and cold and sinus medicines, which contain decongestants or antihistamine that can increase BPH symptoms. Some studies show that saw palmetto may reduce the symptoms.Other herbs have been tried with mixed results.Drug treatments include Alpha-1 blockers that ease urination by relaxing the muscles of the bladder neck and prostate.Finasteride and dutasteride reduce the size of the gland, increase urine flow rate, and decrease symptoms of BPH.","The choice of the appropriate treatment is based on the severity of the symptoms, the extent to which they affect lifestyle, and the presence of other medical conditions.Treatment options include ""watchful waiting,"" lifestyle changes, medicines, or surgery.If you are over 60, you are more likely to have symptoms.But many men with an enlarged prostate have only minor symptoms.Self-care steps are often enough to make you feel better.If you have BPH, you should have a yearly exam to monitor your symptoms and see if you need changes in treatment.SELF-CAREFor mild symptoms: Urinate when you first get the urge.Also, go to the bathroom on a timed schedule, even if you don't feel a need to urinate.Avoid alcohol and caffeine, especially after dinner.DO NOT drink a lot of fluid all at once.Spread out fluids during the day.Avoid drinking fluids within 2 hours of bedtime.Try NOT to take over-the-counter cold and sinus medicines that contain decongestants or antihistamines.These drugs can increase BPH symptoms.Keep warm and exercise regularly.Cold weather and lack of physical activity may worsen symptoms.Reduce stress.Nervousness and tension can lead to more frequent urination.MEDICINESAlpha-1 blockers are a class of drugs that are also used to treat high blood pressure.These medicines relax the muscles of the bladder neck and prostate.This allows easier urination.Most people who take alpha-1 blockers notice improvement in their symptoms, usually within 3 to 7 days after starting the medicine.Finasteride and dutasteride lower levels of hormones produced by the prostate.These drugs also reduce the size of the gland, increase urine flow rate, and decrease symptoms of BPH.You may need to take these medicines for 3 to 6 months before you notice symptoms getting better.Possible side effects include decreased sex drive and impotence.Antibiotics may be prescribed to treat chronic prostatitis (inflammation of the prostate), which may occur with BPH.BPH symptoms improve in some men after a course of antibiotics.Watch out for drugs that may make your symptoms worse:SAW PALMETTOMany herbs have been tried for treating an enlarged prostate.Many men use saw palmetto to ease symptoms.Some studies have shown that it may help with symptoms, but results are mixed, and more research is needed.If you use saw palmetto and think it works, ask your doctor if you should still take it." 95,Can I use a Power Plate machine if I have a pacemaker?,"Most machines and devices will not interfere with your pacemaker.But some with strong magnetic fields may.Always ask your provider about any specific device that you need to avoid.DO NOT put a magnet near your pacemaker.Most appliances in your home are safe to be around.This includes your refrigerator, washer, dryer, toaster, blender, computers and fax machines, hair dryer, stove, CD player, remote controls, and microwaves.You should keep several devices at least 12 inches (30 centimeters) away from the site where the pacemaker is placed under your skin.These include: Battery powered cordless tools (such as screwdrivers and drills)Plug-in power tools (such as drills and table saws) Electric lawnmowers and leaf blowers Slot machines Stereo speakers Tell all providers that you have a pacemaker before any tests are done.Some medical equipment may interfere with your pacemaker.Stay away from large motors, generators, and equipment.DO NOT lean over the open hood of a car that is running.Also stay away from: Radio transmitters and high-voltage power lines Products that use magnetic therapy, such as some mattresses, pillows, and massagers Large electrical- or gasoline-powered appliances If you have a cell phone: DO NOT put it in a pocket on the same side of your body as your pacemaker.When using your cell phone, hold it to your ear on the opposite side of your body.Be careful around metal detectors and security wands.Handheld security wands may interfere with your pacemaker.Show your wallet card and ask to be hand searched.Most security gates at airports and stores are OK.But DO NOT stand near these devices for long periods.Your pacemaker may set off alarms.After any operation, have your provider check your pacemaker. You will probably be able to go home after 1 day or even the same day in some cases.You should be able to return to your normal activity level quickly.Ask your provider how much you can use the arm on the side of your body where the pacemaker was placed.You may be advised not to: Lift anything heavier than 10 to 15 pounds (4.5 to 6.75 kilograms) Push, pull, and twist your arm for 2 to 3 weeks.Raise your arm above your shoulder for several weeks.When you leave the hospital, you will be given a card to keep in your wallet.This card lists the details of your pacemaker and has contact information for emergencies.You should always carry this wallet card with you.You should try to remember the name of the pacemaker manufacturer if you can in case you lose your card. ","Most machines are safe to use with a pacemaker.Some devices should be kept at least 12 inches away.These include battery powered cordless tools (such as screwdrivers and drills)Plug-in power tools (such as drills and table saws) Electric lawnmowers and leaf blowers Slot machinesStereo speakers Some medical equipment may interfere with your pacemaker.Stay away from large motors, generators, and equipment, Radio transmitters and high-voltage power lines Products that use magnetic therapy, such as some mattresses, pillows, and massagers Large electrical- or gasoline-powered appliances.Do not put your cell phone in a pocket or to the ear on the same side as your pacemaker.","Ask your provider how much you can use the arm on the side of your body where the pacemaker was placed.You may be advised not to: Lift anything heavier than 10 to 15 pounds (4.5 to 6.75 kilograms) Push, pull, and twist your arm for 2 to 3 weeks.Raise your arm above your shoulder for several weeks.When you leave the hospital, you will be given a card to keep in your wallet.This card lists the details of your pacemaker and has contact information for emergencies.You should always carry this wallet card with you.You should try to remember the name of the pacemaker manufacturer if you can in case you lose your card Most machines and devices will not interfere with your pacemaker.But some with strong magnetic fields may.Always ask your provider about any specific device that you need to avoid.DO NOT put a magnet near your pacemaker.Most appliances in your home are safe to be around.This includes your refrigerator, washer, dryer, toaster, blender, computers and fax machines, hair dryer, stove, CD player, remote controls, and microwaves.You should keep several devices at least 12 inches (30 centimeters) away from the site where the pacemaker is placed under your skin.These include: Battery powered cordless tools (such as screwdrivers and drills)Plug-in power tools (such as drills and table saws) Electric lawnmowers and leaf blowers Slot machines Stereo speakers Tell all providers that you have a pacemaker before any tests are done.Some medical equipment may interfere with your pacemaker.Stay away from large motors, generators, and equipment.DO NOT lean over the open hood of a car that is running.Also stay away from: Radio transmitters and high-voltage power lines Products that use magnetic therapy, such as some mattresses, pillows, and massagers Large electrical- or gasoline-powered appliances If you have a cell phone: DO NOT put it in a pocket on the same side of your body as your pacemaker.When using your cell phone, hold it to your ear on the opposite side of your body.Be careful around metal detectors and security wands.Handheld security wands may interfere with your pacemaker.Show your wallet card and ask to be hand searched.Most security gates at airports and stores are OK.But DO NOT stand near these devices for long periods.Your pacemaker may set off alarms.After any operation, have your provider check your pacemaker." 97,Is there a cure for sensorineural hearing loss?,"Sensorineural deafness is a type of hearing loss.It occurs from damage to the inner ear, the nerve that runs from the ear to the brain (auditory nerve), or the brain. Over 30 states in the United States require newborn hearing screenings.Treating hearing loss early can allow many infants to develop normal language skills without delay.In infants born with hearing loss, treatments should start as early as age 6 months.Treatment depends on the baby's overall health and the cause of hearing loss.Treatment may include: Speech therapy Learning sign language Cochlear implant (for those with profound sensorineural hearing loss)Treating the cause of hearing loss may include: Medicines for infections Ear tubes for repeated ear infections Surgery to correct structural problems Conductive hearing loss (CHL) occurs because of a mechanical problem in the outer or middle ear.This may be because: The 3 tiny bones of the ear (ossicles) are not conducting sound properly.The eardrum is not vibrating in response to sound.Causes of conductive hearing loss can often be treated.They include: Buildup of wax in the ear canal Damage to the very small bones (ossicles) that are right behind the eardrum Fluid remaining in the ear after an ear infection Foreign object that is stuck in the ear canal Hole in the eardrumScar on the eardrum from repeated infections Sensorineural hearing loss (SNHL) occurs when the tiny hair cells (nerve endings) that detect sound in the ear are injured, diseased, do not work correctly, or have died.This type of hearing loss often cannot be reversed.Sensorineural hearing loss is commonly caused by:Acoustic neuroma Age-related hearing loss Childhood infections, such as meningitis, mumps, scarlet fever, and measles Mnire' disease Regular exposure to loud noises (such as from work or recreation) Use of certain medicines Hearing loss may be present at birth (congenital) and can be due to: Birth defects that cause changes in the ear structures Genetic conditions(more than 400 are known) Infections the mother passes to her baby in the womb (such as toxoplasmosis, rubella, or herpes The ear can also be injured by:Pressure differences between the inside and outside of the eardrum, often from scuba diving Skull fractures (can damage the structures or nerves of the ear) Trauma from explosions, fireworks, gunfire, rock concerts, and earphones Assistive Listening Devices Assistive listening devices devices can help you hear in certain listening environments.These can include telephone and cell phone amplifying devices, smart phone or tablet ""apps,"" and closed circuit systems (induction coil loops) in places of worship, theaters, and auditoriums.TV listening systems help you listen to the television or the radio without being bothered by other noises around you.Some hearing aids can be plugged into televisions or stereos to help you hear better.Cochlear ImplantIf your hearing loss is severe and of a certain type, your doctor may suggest that you talk to an otolaryngologist about a cochlear implant.An otolaryngologist is a surgeon who specializes in ear, nose, and throat diseases.A cochlear implant is a small electronic device that the surgeon places under the skin and behind the ear.The device picks up sounds, changes them to electrical signals, and sends them past the non-working part of the inner ear and on to the brain.Hearing through a cochlear implant sounds different from normal hearing, but it lets many people communicate orally in person and over the telephone, and perceive sounds in the environment. ","Sensorineural deafness is caused by the damage to the inner ear, the auditory nerve or the brain.Although it cannot be reversed, some hearing aids can help you hear better.If the damage is severe, a cochlear implant might be placed under the skin behind the ear.This hearing device converts the sound to electrical signal and sends tit o the brain.The sound is not the same as in normal hearing, but it helps communicating.","Sensorineural hearing loss (SNHL) occurs when the tiny hair cells (nerve endings) that detect sound in the ear are injured, diseased, do not work correctly, or have died.This type of hearing loss often cannot be reversed.If your hearing loss is severe and of a certain type, your doctor may suggest a cochlear implant.A cochlear implant is a small electronic device that the surgeon places under the skin and behind the ear.The device picks up sounds, changes them to electrical signals, and sends them past the non-working part of the inner ear and on to the brain.Hearing through a cochlear implant sounds different from normal hearing, but it lets many people communicate orally in person and over the telephone, and perceive sounds in the environment.Assistive listening devices devices can help you hear in certain listening environment.Some hearing aids can be plugged into televisions or stereos to help you hear better." 102,What is the best treatment for transverse myelitis and who provides it?,"The outlook for people with transverse myelitis varies.Most recovery occurs within 3 months after the condition occurs.For some, healing may take months to years.About a third of people with transverse myelitis recover completely.Some people recover with moderate disabilities, such as bowel problems and trouble walking.Others have permanent disability and need help with daily activities.Those who may have poor chance of recovery are: People who have rapid onset of symptoms People whose symptoms do not improve within the first 3 to 6 months Transverse myelitis usually only occurs once in most people.It may recur in some people with an underlying cause, such as MS.People who have involvement of only on one side of the spinal cord may be more likely to develop MS in the future. As with many disorders of the spinal cord, no effective cure currently exists for people with transverse myelitis.Treatments are designed to manage and alleviate symptoms and largely depend upon the severity of neurological involvement.Therapy generally begins when the patient first experiences symptoms.Physicians often prescribe corticosteroid therapy during the first few weeks of illness to decrease inflammation.Although no clinical trials have investigated whether corticosteroids alter the course of transverse myelitis, these drugs often are prescribed to reduce immune system activity because of the suspected autoimmune mechanisms involved in the disorder.Corticosteroid medications that might be prescribed may include methylprednisone or dexamethasone.[1] Chronic pain is a common complication of transverse myelitis.Nonsteroidal anti-inflammatory drugs such as aspirin, ibuprofen (Advil, Motrin, others) and naproxen (Aleve, Naprosyn, others) can help reduce inflammation and relieve pain.[6] Bed rest is often recommended during the initial days and weeks after onset of the disorder.[1] Based on patient response and test results, additional therapeutic options may be added.Plasma exchange therapy is often used for those with moderate to severe transverse myelitis who dont show much improvement after being treated with intravenous steroids.[4][5] This therapy involves removing the straw-colored fluid in which blood cells are suspended (plasma) and replacing the plasma loss with special fluids.It's not certain how this therapy helps people with transverse myelitis, but it may be that plasma exchange removes antibodies that are involved in inflammation.[5] Some patients respond very well to intravenous cyclophosphamide (a drug often used for lymphomas or leukemia).It is very important that an experienced oncology team be involved in the administration of this drug, and patients should be monitored carefully.Ongoing treatment with chemical agents that modify immune response (such as azathioprine, methotrexate, mycophenolate or oral cyclophosphamide) can be considered for the small subset of patients that experience recurrent transverse myelitis.[4] Individuals with permanent physical disabilities may benefit from physical therapy , occupational therapy and vocational therapy.[1] 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 Transverse myelitis is a neurological disorder caused by inflammation of the spinal cord, which carries nerve signals from the brain to the rest of the body.The segment of the spinal cord that has inflammation or damage determines the symptoms a person has.Generally, inflammation at one segment causes symptoms at that level and below that level.Most commonly, the upper spinal cord is affected, causing impaired leg movement, and problems controlling the bowel and bladder.The onset of symptoms may be acute (sudden, developing over hours or days) or subacute (developing over weeks).[1]The cause of transverse myelitis may be unknown (idiopathic) or it may be associated with a wide variety of underlying health problems, including infections, immune system disorders, and other inflammatory disorders.[1][2] Tests that may be used to diagnose transverse myelitis include MRI to look for compression or inflammation of the spinal cord, and a lumbar puncture (spinal tap) to look for evidence of inflammation in the fluid surrounding the spinal cord (cerebrospinal fluid).Treatment options may include intravenous steroids, pain medicines, plasmapheresis (also called plasma exchange), intravenous immunoglobulin (IVIG), and cyclophosphamide.[1][2] Some people have full or partial recovery from symptoms, while others do not recover any lost function in the affected parts of the body.[3] Most people recover at least partially, although recovery can take up to 2 or 3 years.In general however, if there is no improvement within the first 6 months, a significant recovery is not likely.[1] ","There is no cure for transverse myelitis.Treatments for the symptoms usually start with corticosteroids to reduce inflammation.NSAIDs reduce inflammation and help managing pain.Other treatments include immunoglobulin injections, plasma exchange, cyclophosphamide and other medicines that modify immune response, These drugs should be given by an oncologist.About a third of the people recovers completely.Some could develop long-term bowel problems and permanent disabilities.Physical and occupational therapy could help manage the disabilities.","no effective cure currently exists for people with transverse myelitis.The outlook for people with transverse myelitis varies.Most recovery occurs within 3 months after the condition occurs.For some, healing may take months to years.About a third of people with transverse myelitis recover completely.Some people recover with moderate disabilities, such as bowel problems and trouble walking.Others have permanent disability and need help with daily activities. Treatments are designed to manage and alleviate symptoms and largely depend upon the severity of neurological involvement. Treatment options may include intravenous steroids, pain medicines, plasmapheresis (also called plasma exchange), intravenous immunoglobulin (IVIG), and cyclophosphamide. Therapy generally begins when the patient first experiences symptoms.Physicians often prescribe corticosteroid therapy during the first few weeks of illness to decrease inflammation.Chronic pain is a common complication of transverse myelitis.Nonsteroidal anti-inflammatory drugs such as aspirin, ibuprofen (Advil, Motrin, others) and naproxen (Aleve, Naprosyn, others) can help reduce inflammation and relieve pain.Bed rest is often recommended during the initial days and weeks after onset of the disorder.Plasma exchange therapy is often used for those with moderate to severe transverse myelitis who dont show much improvement after being treated with intravenous steroids.Some patients respond very well to intravenous cyclophosphamide (a drug often used for lymphomas or leukemia).It is very important that an experienced oncology team be involved in the administration of this drug, and patients should be monitored carefully.Ongoing treatment with chemical agents that modify immune response (such as azathioprine, methotrexate, mycophenolate or oral cyclophosphamide) can be considered for the small subset of patients that experience recurrent transverse myelitis.Individuals with permanent physical disabilities may benefit from physical therapy , occupational therapy and vocational therapy." 103,How can I improve my vision with glaucoma?,"If you're at risk for glaucoma, get a full eye exam every 1 to 2 years.That way, if your doctor finds glaucoma, you can start treatment to lower the pressure in your eyes, even if you dont have symptoms yet.Daily treatment will be needed to prevent vision loss. Glaucoma is an eye disease that causes vision loss.It usually happens when pressure from extra fluid within your eyeball damages the nerve in your eye (optic nerve).Vision loss usually happens slowly, so you may not notice it right away Glaucoma gets worse over time It can cause lasting vision loss and blindness if not treated Special eye drops (prescribed by your doctor) can lower the pressure in your eye Get a full eye exam every 1 to 2 years to detect glaucoma early and help prevent vision loss If you have glaucoma, the doctor will need to check the pressure in your eyes often Glaucoma is a group of diseases that can damage the eye's optic nerve and result in vision loss and blindness.While glaucoma can strike anyone, the risk is much greater for people over 60.How Glaucoma Develops There are several different types of glaucoma.Most of these involve the drainage system within the eye.At the front of the eye there is a small space called the anterior chamber.A clear fluid flows through this chamber and bathes and nourishes the nearby tissues.(Watch the video to learn more about glaucoma.To enlarge the video, click the brackets in the lower right-hand corner.To reduce the video, press the Escape (Esc) button on your keyboard.)In glaucoma, for still unknown reasons, the fluid drains too slowly out of the eye.As the fluid builds up, the pressure inside the eye rises.Unless this pressure is controlled, it may cause damage to the optic nerve and other parts of the eye and result in loss of vision.Open-angle GlaucomaThe most common type of glaucoma is called open-angle glaucoma.In the normal eye, the clear fluid leaves the anterior chamber at the open angle where the cornea and iris meet.When fluid reaches the angle, it flows through a spongy meshwork, like a drain, and leaves the eye.Sometimes, when the fluid reaches the angle, it passes too slowly through the meshwork drain, causing the pressure inside the eye to build.If the pressure damages the optic nerve, open-angle glaucoma -- and vision loss -- may result.There is no cure for glaucoma.Vision lost from the disease cannot be restored.However, there are treatments that may save remaining vision.That is why early diagnosis is important.See this graphic for a quick overview of glaucoma, including how many people it affects, whos at risk, what to do if you have it, and how to learn more.See a glossary of glaucoma terms. ","Vision lost due to glaucoma cannot be restored, but the progression of the disease can be prevented by daily treatments with special eye drops that lower the pressure in the eyes.","There is no cure for glaucoma.Vision lost from the disease cannot be restored.However, there are treatments that may save remaining vision. if your doctor finds glaucoma, you can start treatment to lower the pressure in your eyes, even if you dont have symptoms yet.Daily treatment will be needed to prevent vision loss.Special eye drops (prescribed by your doctor) can lower the pressure in your eye" 105,What tests are used to diagnose dementia?,"Dementia is not a specific disease.It is a descriptive term for a collection of symptoms that can be caused by a number of disorders that affect the brain.People with dementia have significantly impaired intellectual functioning that interferes with normal activities and relationships.They also lose their ability to solve problems and maintain emotional control, and they may experience personality changes and behavioral problems, such as agitation, delusions, and hallucinations.While memory loss is a common symptom of dementia, memory loss by itself does not mean that a person has dementia.Doctors diagnose dementia only if two or more brain functions - such as memory and language skills -- are significantly impaired without loss of consciousness.Some of the diseases that can cause symptoms of dementia are Alzheimers disease, vascular dementia, Lewy body dementia, frontotemporal dementia, Huntingtons disease, and Creutzfeldt-Jakob disease.Doctors have identified other conditions that can cause dementia or dementia-like symptoms including reactions to medications, metabolic problems and endocrine abnormalities, nutritional deficiencies, infections, poisoning, brain tumors, anoxia or hypoxia (conditions in which the brains oxygen supply is either reduced or cut off entirely), and heart and lung problems.Although it is common in very elderly individuals, dementia is not a normal part of the aging process. To diagnose dementia, doctors first assess whether a person has an underlying treatable condition such as depression, abnormal thyroid function, normal pressure hydrocephalus, or vitamin B12 deficiency.Early diagnosis is important, as some causes for symptoms can be treated.In many cases, the specific type of dementia a person has may not be confirmed until after the person has died and the brain is examined.A medical assessment for dementia generally includes:- Patient history.Typical questions about a person's medical and family history might include asking about whether dementia runs in the family, how and when symptoms began, changes in behavior and personality, and if the person is taking certain medications that might cause or worsen symptoms.- Physical exam.Measuring blood pressure and other vital signs may help physicians detect conditions that might cause or occur with dementia.Such conditions may be treatable.- Neurological tests.Assessing balance, sensory function, reflexes, vision, eye movements, and other cognitive functions helps identify conditions that may affect the diagnosis or are treatable with drugs. ","Dementia could be caused by many different diseases of the brain.it is diagnosed if at least two brain functions are effected, for example, if people experience memory loss and changes in behavior and personality.Diagnostic tests for dementia include family history, physical examination, and neurological tests to asses balance, sensory functions, reflexes, vision, eye movements, and cognitive functions.In many cases, the type of dementia is confirmed after the person dies.","Dementia is not a specific disease.It is a descriptive term for a collection of symptoms that can be caused by a number of disorders that affect the brain.Doctors diagnose dementia only if two or more brain functions - such as memory and language skills -- are significantly impaired without loss of consciousness.To diagnose dementia, doctors first assess whether a person has an underlying treatable condition such as depression, abnormal thyroid function, normal pressure hydrocephalus, or vitamin B12 deficiency.Early diagnosis is important, as some causes for symptoms can be treated.In many cases, the specific type of dementia a person has may not be confirmed until after the person has died and the brain is examined.A medical assessment for dementia generally includes:- Patient history.Typical questions about a person's medical and family history might include asking about whether dementia runs in the family, how and when symptoms began, changes in behavior and personality, and if the person is taking certain medications that might cause or worsen symptoms.- Physical exam.Measuring blood pressure and other vital signs may help physicians detect conditions that might cause or occur with dementia.Such conditions may be treatable.- Neurological tests.Assessing balance, sensory function, reflexes, vision, eye movements, and other cognitive functions helps identify conditions that may affect the diagnosis or are treatable with drugs." 110,How is acrocallosal syndrome inherited?,"According to many investigators, acrocallosal syndrome, Schinzel type may be inherited as an autosomal recessive trait.Human traits, including the classic genetic diseases, are the product of the interaction of two genes, one received from the father and one from the mother. In recessive disorders, the condition does not appear unless a person inherits the same defective gene for the same trait from each parent.If an individual receives one normal gene and one gene for the disease, the person will be a carrier for the disease but usually will not show symptoms. When acrocallosal syndrome is caused by KIF7 gene mutations, it is inherited in an autosomal recessive pattern, which means both copies of the gene in each cell have mutations.The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition.Acrocallosal syndrome (or severe Greig cephalopolysyndactyly syndrome) resulting from GLI3 gene mutations is considered autosomal dominant , which means one copy of the altered gene in each cell is sufficient to cause the disorder.This condition results from new (de novo) mutations in the gene that occur during the formation of reproductive cells (eggs or sperm) or in early embryonic development.These cases occur in people with no history of the disorder in their family. ","Some forms of acrocallosal syndrome are not inherited, These cases occur due to mutations during early embryo development.The inherited form of acrocallosal syndrome is autosomal recessive, which means both parents have to pass the mutations to the child and both copies of the child's gene in each cell have mutations.","When acrocallosal syndrome is caused by KIF7 gene mutations, it is inherited in an autosomal recessive pattern, which means both copies of the gene in each cell have mutations.The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition.Acrocallosal syndrome (or severe Greig cephalopolysyndactyly syndrome) resulting from GLI3 gene mutations is considered autosomal dominant , which means one copy of the altered gene in each cell is sufficient to cause the disorder.This condition results from new (de novo) mutations in the gene that occur during the formation of reproductive cells (eggs or sperm) or in early embryonic development.These cases occur in people with no history of the disorder in their family." 115,What will show I am no longer contagious after COVID-19?,"Similarities:For both COVID-19 and flu, it?s possible to spread the virus for at least 1 day before experiencing any symptoms.Differences:If a person has COVID-19, they may be contagious for a longer period of time than if they had flu.FluMost people with flu are contagious for about 1 day before they show symptoms.Older children and adults with flu appear to be most contagious during the initial 3-4 days of their illness but many remain contagious for about 7 days.Infants and people with weakened immune systems can be contagious for even longer.COVID-19How long someone can spread the virus that causes COVID-19 is still under investigation.It?s possible for people to spread the virus for about 2 days before experiencing signs or symptoms and remain contagious for at least 10 days after signs or symptoms first appeared.If someone is asymptomatic or their symptoms go away, it?s possible to remain contagious for at least 10 days after testing positive for COVID-19. Duration of isolation and precautions For most adults with COVID-19 illness, isolation and precautions can be discontinued 10 days after symptom onset* and after resolution of fever for at least 24 hours, without the use of fever-reducing medications, and with improvement of other symptoms. Some adults with severe illness may produce replication-competent virus beyond 10 days that may warrant extending duration of isolation and precautions for up to 20 days after symptom onset; severely immunocompromised patients** may produce replication-competent virus beyond 20 days and require additional testing and consultation with infectious diseases specialists and infection control experts. For adults who never develop symptoms, isolation and other precautions can be discontinued 10 days after the date of their first positive RT-PCR test result for SARS-CoV-2 RNA. Role of viral diagnostic testing (RT-PCR or antigen)*** to discontinue isolation or precautions For adults who are severely immunocompromised, a test-based strategy could be considered in consultation with infectious diseases experts. For all others, a test-based strategy is no longer recommended except to discontinue isolation or precautions earlier than would occur under the strategy outlined in Part 1, above. Viral diagnostic testing (RT-PCR or antigen)*** and quarantine after discontinuation of isolation or precautions For adults previously diagnosed with symptomatic laboratory-confirmed COVID-19 who remain asymptomatic after recovery, retesting or quarantine is not recommended if another exposure occurs or might have occurred within 90 days after the date of symptom onset from the initial SARS-CoV-2 infection. ","It is still not clear for how long people can spread COVID-19.It is known that people can start spreading it two days before the symptoms appear and for 10 days after the symptoms start.Alternatively, people can spread the virus for 10 days after testing positive for COVID-19.Viral diagnostic testing (RT-PCR or antigen) is not recommended to stop isolation, unless people are severly immunocompromised.","How long someone can spread the virus that causes COVID-19 is still under investigation.It?s possible for people to spread the virus for about 2 days before experiencing signs or symptoms and remain contagious for at least 10 days after signs or symptoms first appeared.If someone is asymptomatic or their symptoms go away, it?s possible to remain contagious for at least 10 days after testing positive for COVID-19.Some adults with severe illness may produce replication-competent virus beyond 10 days that may warrant extending duration of isolation and precautions for up to 20 days after symptom onset; severely immunocompromised patients may produce replication-competent virus beyond 20 days and require additional testing and consultation with infectious diseases specialists and infection control experts.Role of viral diagnostic testing (RT-PCR or antigen) to discontinue isolation or precautions For adults who are severely immunocompromised, a test-based strategy could be considered in consultation with infectious diseases experts.For all others, a test-based strategy is no longer recommended except to discontinue isolation or precautions earlier than would occur under the strategy outlined above." 116,How to reduce leg swelling caused by steroids?,"Some tips that may help reduce swelling: Put your legs on pillows to raise them above your heart while lying down. Exercise your legs.This helps pump fluid from your legs back to your heart. Follow a low-salt diet, which may reduce fluid buildup and swelling. Wear support stockings (sold at most drugstores and medical supply stores). When traveling, take breaks often to stand up and move around. Avoid wearing tight clothing or garters around your thighs. Lose weight if you need to. Follow your health care provider's treatment recommendations.If you have long-term swelling, ask your provider about options to prevent skin breakdown, such as: - Flotation ring - Lamb's wool pad - Pressure-reducing mattress Continue with your everyday activities.When lying down, keep your arms and legs above your heart level, if possible, so the fluid can drain.DO NOT do this if you get shortness of breath.See your provider instead. ","To reduce swelling, keep your arms and legs above your heart level when you are lying down, so that the swelling can drain.If you are experiencing shortness of breath, call your doctor immediately.Continue with your everyday activities to help draining the fluids.Exercise your legs, reduce salt in your diet to reduce fluid retention, wear support stockings, and void tight clothes.","If you have long-term swelling, ask your provider about options to prevent skin breakdown, such as: - Flotation ring - Lamb's wool pad - Pressure-reducing mattress Continue with your everyday activities.When lying down, keep your arms and legs above your heart level, if possible, so the fluid can drain.DO NOT do this if you get shortness of breath.See your provider instead.Exercise your legs.This helps pump fluid from your legs back to your heart.Follow a low-salt diet, which may reduce fluid buildup and swelling.Wear support stockings (sold at most drugstores and medical supply stores).When traveling, take breaks often to stand up and move around.Avoid wearing tight clothing or garters around your thighs.Lose weight if you need to." 117,Will influenza be the next pandemic?,"Pandemic Influenza outbreaks have been predictably unpredictable in the years since 1918 but always global, and needing a global response.One million people around the world died in a 1957 outbreak which started in China but spread globally.In 1968, another outbreak took 1 to 3 million lives.In 2003, A(H5N1) or so-called Avian Influenza highlighted how the virus could pass from animals to humans, but it did not reach the pandemic stage because it did not pass from human to human.The 2009 Swine flu A(H1N1) pandemic, started in Mexico and spread to over 214 countries and overseas territories or communities.The world was lucky: it turned out to be even milder than some seasonal epidemics.Researchers are always on the lookout, though, because the next outbreak could be far worse.WHO/SEARO/T.Pietrasik WHO is working closely with Ministries of Health, regional and national influenza research and surveillance centres, and other stakeholders to develop a multi-layered approach to preparing for and responding to both seasonal flu outbreaks and pandemics.Specific WHO programmes include the Global Influenza Surveillance and Response System (GISRS), and the Pandemic Influenza Preparedness Framework, which helps developing countries access vaccines, antivirals, and diagnostics to both prepare for and manage pandemics.WHO and partners are developing a Global Influenza Strategy to be launched in 2018.Aligned with the general programme of work 2019-2023 (GPW13), the new strategy will support WHO Member States in developing seasonal influenza prevention and control capacities.These national efforts, in turn, will build greater global preparedness for the next pandemic.Globally, the strategy will focus on research and innovation.This will include improved influenza modelling and forecasting, along with the development of new vaccines, including a possible universal influenza vaccine.This page links all WHO technical and general information on influenza ","It is hard to predict when the next influenza pandemic might occur.Several outbreaks in 1957, 1968 and 2009 effected millions of people.World Health Organization works with the national governments to build preparedness for the next pandemic, including improved modeling and forecasting of influenza and new vaccines.","Pandemic Influenza outbreaks have been predictably unpredictable in the years since 1918 but always global, and needing a global response.One million people around the world died in a 1957 outbreak which started in China but spread globally.In 1968, another outbreak took 1 to 3 million lives.The 2009 Swine flu A(H1N1) pandemic, started in Mexico and spread to over 214 countries and overseas territories or communities.Researchers are always on the lookout, though, because the next outbreak could be far worse.WHO is working closely with Ministries of Health, regional and national influenza research and surveillance centres, and other stakeholders to develop a multi-layered approach to preparing for and responding to both seasonal flu outbreaks and pandemics. the new strategy will support WHO Member States in developing seasonal influenza prevention and control capacities.These national efforts, in turn, will build greater global preparedness for the next pandemic.Globally, the strategy will focus on research and innovation.This will include improved influenza modelling and forecasting, along with the development of new vaccines, including a possible universal influenza vaccine." 119,Can i take zoledronic acid infusion if my mother has scleroderma?,"ZOLEDRONIC ACID INJECTION (ZOE-le-DRON-ik AS-id) Read the Medication Guide that comes with zoledronic acid injection before you start taking it and each time you get a refill.There may be new information.This Medication Guide does not take the place of talking with your doctor about your medical condition or treatment.Talk to your doctor if you have any questions about zoledronic acid¬†injection.What is the most important information I should know about zoledronic acid injection?You should not receive zoledronic acid injection if you are already receiving Zometa.Both zoledronic acid injection and Zometa contain zoledronic acid.Zoledronic acid injection can cause serious side effects including: Low calcium levels in your blood (hypocalcemia) Severe kidney problems Severe jaw bone problems (osteonecrosis) Bone, joint or muscle pain Unusual thigh bone fractures 1.¬†¬†¬†¬†¬† Low calcium levels in your blood (hypocalcemia).Zoledronic acid injection may lower the calcium levels in your blood.If you have low blood calcium before you start taking zoledronic acid injection, it may get worse during treatment.Your low blood calcium must be treated before you take zoledronic acid injection.Most people with low blood calcium levels do not have symptoms, but some people may have symptoms.Call your doctor right away if you have symptoms of low blood calcium such as: Spasms, twitches, or cramps in your muscles Numbness or tingling in your fingers, toes, or around your mouth Your doctor may prescribe calcium and vitamin D to help prevent low calcium levels in your blood, while you take zoledronic acid injection.Take calcium and vitamin D as your doctor tells you to.2.¬†¬†¬†¬†¬†Severe kidney problems.Severe kidney problems may happen when you take zoledronic acid injection.Severe kidney problems may lead to hospitalization or kidney dialysis and can be life-threatening.¬†Your risk of kidney problems is higher if you: already have kidney problems take a diuretic or ""water pill"" do not have enough water in your body (dehydrated) before or after you receive zoledronic acid injection.are of advanced age since the risk increases as you get older take any medicines known to harm your kidneys You should drink at least 2 glasses of fluid within a few hours before receiving zoledronic acid injection to reduce the risk of kidney problems.3.¬†¬†¬†¬†¬†Severe jaw bone problems (osteonecrosis).Severe jaw bone problems may happen when you take zoledronic acid injection.Your doctor should examine your mouth before you start zoledronic acid injection.Your doctor may tell you to see your dentist before you start zoledronic acid injection.It is important for you to practice good mouth care during treatment with zoledronic acid injection.4.¬†¬†¬†¬†¬† Unusual thigh bone fractures.Some people have developed unusual fractures in their thigh bone.Symptoms of a fracture may include new or unusual pain in your hip, groin, or thigh.5.¬†¬†¬†¬†¬† Possible harm to your unborn baby.Zoledronic acid injection should not be used if you are pregnant.Tell your doctor right away if you are pregnant or plan to become pregnant.Zoledronic acid injection may harm your unborn baby.6.¬†¬†¬†¬†¬† Bone, joint, or muscle pain Some people who take bisphosphonates develop severe bone, joint, or muscle pain.Call your doctor right away if you have any of these side effects.What is zoledronic acid injection?Zoledronic acid injection is a prescription medicine used to: Treat certain men and women who have Paget's disease of the bone.Zoledronic acid injection is not for use in children.Who should not take zoledronic acid injection?Do not take zoledronic acid injection if you: Have low levels of calcium in your blood Have kidney problems Are allergic to zoledronic acid or any of its ingredients.A list of ingredients is at the end of this leaflet.What should I tell my doctor before taking zoledronic acid injection?Before you start zoledronic acid injection, be sure to talk to your doctor if you: Have low blood calcium.Have kidney problems.Had parathyroid or thyroid surgery (glands in your neck).Have been told you have trouble absorbing minerals in your stomach or intestines(malabsorption syndrome) or have had parts of your intestine removed.Have asthma (wheezing) from taking aspirin.Plan to have dental surgery or teeth removed.Are pregnant, or plan to become pregnant.Zoledronic acid injection may harm your unborn baby.Zoledronic acid injection should not be used if you are pregnant.Are breastfeeding or plan to breastfeed.It is not known if zoledronic acid injection passes into your milk and may harm your baby.Tell your doctor about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements.Certain medicines may affect how zoledronic acid injection works.Especially tell your doctor if you are taking: An antibiotic.Certain antibiotic medicines called aminoglycosides may increase the effect of zoledronic acid injection in lowering your blood calcium for a long period of time.A diuretic or ""water pill"".Non-steroidal anti-inflammatory medicines (NSAIDS).Ask your doctor or pharmacist for a list of these medicines, if you are not sure.Know the medicines you take.Keep a list of them and show it to your doctor and pharmacist each time you get a new medicine.How will I receive zoledronic acid injection?Your doctor will tell you how often you will receive zoledronic acid injection.Zoledronic acid injection is given by infusion into your vein (intravenously).Your infusion should last at least 15 minutes.Before you receive zoledronic acid injection, drink at least 2 glasses of fluid (such as water) within a few hours as directed by your doctor.You may eat before your treatment with zoledronic acid injection.What are the possible side effects of zoledronic acid injection?Zoledronic acid injection may cause serious side effects.See ""What is the most important information I should know about zoledronic acid injection?""The most common side effects of zoledronic acid injection included: Fever Pain in your bones, joints or muscles Pain in your arms and legs Headache Flu-like illness (fever, chills, bone, joint, or muscle pain, fatigue)Nausea Vomiting Diarrhea Talk to your doctor about things you can do to help decrease some of these side effects that might happen with a zoledronic acid injection infusion.You may get allergic reactions, such as hives, swelling of your face, lips, tongue, or throat.Tell your doctor if you have any side effect that bothers you or that does not go away.These are not all the possible side effects of zoledronic acid injection.For more information, ask your doctor or pharmacist.Call your doctor for medical advice about side effects.You may report side effects to FDA at 1-800-FDA-1088.General information about safe and effective use of zoledronic acid injection.Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide.This Medication Guide summarizes the most important information about zoledronic acid injection.If you would like more information, talk with your doctor.You can ask your doctor or pharmacist for information about zoledronic acid injection that is written for health professionals.For more information, go to: www.heritagepharma.com or call 1-866-901-DRUG (3784) What are the ingredients in zoledronic acid injection?Active ingredient: zoledronic acid monohydrate Inactive ingredients: mannitol, USP; sodium citrate, USP.ZOMETA¬Æ is a registered trademark of Novartis.Manufactured by: Emcure Pharmaceuticals Ltd., Hinjawadi, Pune, India.Manufactured for: Heritage Pharmaceuticals Inc.East Brunswick, NJ 08816 1.866.901.DRUG (3784) Rev. 10/17This Medication Guide has been approved by the U.S. Food and Drug Administration. Scleroderma means hard skin.It is a group of diseases that cause abnormal growth of connective tissue.Connective tissue is the material inside your body that gives your tissues their shape and helps keep them strong.In scleroderma, the tissue gets hard or thick.It can cause swelling or pain in your muscles and joints.Symptoms of scleroderma include - Calcium deposits in connective tissues - Raynaud's phenomenon, a narrowing of blood vessels in the hands or feet - Swelling of the esophagus, the tube between your throat and stomach - Thick, tight skin on your fingers - Red spots on your hands and face No one knows what causes scleroderma.It is more common in women.It can be mild or severe.Doctors diagnose scleroderma using your medical history, a physical exam, lab tests, and a skin biopsy.There is no cure, but various treatments can control symptoms and complications.NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases See FDA-Approved Medication Guide Information for Patients Patients should be made aware that zoledronic acid injection contains the same active ingredient (zoledronic acid) found in Zometa¬Æ , and that patients being treated with Zometa should not be treated with zoledronic acid injection.Zoledronic acid injection is contraindicated in patients with creatinine clearance less than 35 mL/min[see Contraindications (4)].Before being given zoledronic acid injection, patients should tell their doctor if they have kidney problems and what medications they are taking.Zoledronic acid injection should not be given if the patient is pregnant or plans to become pregnant, or if she is breast-feeding [see Warnings and Precautions (5.6)].There have been reports of bronchoconstriction in aspirin-sensitive patients receiving bisphosphonates, including zoledronic acid injection.Before being given zoledronic acid injection, patients should tell their doctor if they are aspirin-sensitive.If the patient had surgery to remove some or all of the parathyroid glands in their neck, or had sections of their intestine removed, or are unable to take calcium supplements they should tell their doctor.Zoledronic acid injection is given as an infusion into a vein by a nurse or a doctor, and the infusion time must not be less than 15 minutes.On the day of treatment the patient should eat and drink normally, which includes drinking at least 2 glasses of fluid such as water within a few hours prior to the infusion, as directed by their doctor, before receiving zoledronic acid injection.After getting zoledronic acid injection it is strongly recommended patients with Paget‚Äôs disease take calcium in divided doses (for example, 2 to 4 times a day) for a total of 1500 mg calcium a day to prevent low blood calcium levels.This is especially important for the two weeks after getting zoledronic acid injection [see Warnings and Precautions (5.2)].Adequate calcium and vitamin D intake is important in patients with osteoporosis and the current recommended daily intake of calcium is 1200 mg and vitamin D is 800 international units ‚Äì 1000 international units daily.All patients should be instructed on the importance of calcium and vitamin D supplementation in maintaining serum calcium levels.Patients should be aware of the most commonly associated side effects of therapy.Patients may experience one or more side effects that could include: fever, flu-like symptoms, myalgia, arthralgia, and headache.Most of these side effects occur within the first 3 days following the dose of zoledronic acid injection.They usually resolve within 3 days of onset but may last for up to 7 to 14 days.Patients should consult their physician if they have questions or if these symptoms persist.The incidence of these symptoms decreased markedly with subsequent doses of zoledronic acid injection.Administration of acetaminophen following zoledronic acid injection administration may reduce the incidence of these symptoms.Physicians should inform their patients that there have been reports of persistent pain and/or a non-healing sore of the mouth or jaw, primarily in patients treated with bisphosphonates for other illnesses.During treatment with zoledronic acid, patients should be instructed to maintain good oral hygiene and undergo routine dental check-ups.¬†If they experience these symptoms, they should inform their physician or dentist.Severe and occasionally incapacitating bone, joint, and/or muscle pain have been infrequently reported in patients taking bisphosphonates, including zoledronic acid injection.Consider withholding future zoledronic acid injection treatment if severe symptoms develop.Atypical femur fractures in patients on bisphosphonate therapy have been reported; patients with thigh or groin pain should be evaluated to rule out a femoral fracture.Zometa is a registered trademark of Novartis Pharmaceuticals Corporation.MEDICATION GUIDE Zoledronic Acid (ZOE-le-DRON-ik AS-id) Injection Read the Medication Guide that comes with zoledronic acid injection before you start taking it and each time you get a refill.There may be new information.This Medication Guide does not take the place of talking with your doctor about your medical condition or treatment.Talk to your doctor if you have any questions about zoledronic acid injection.What is the most important information I should know about zoledronic acid injection?You should not receive zoledronic acid injection if you are already receiving Zometa.Both zoledronic acid injection and Zometa contain zoledronic acid.Zoledronic acid injection can cause serious side effects including: 1.Low calcium levels in your blood (hypocalcemia) 2.Severe kidney problems 3.Severe jaw bone problems (osteonecrosis) 4.Bone, joint or muscle pain 5.Unusual thigh bone fractures 1.Low calcium levels in your blood (hypocalcemia).Zoledronic acid injection may lower the calcium levels in your blood.If you have low blood calcium before you start taking zoledronic acid injection, it may get worse during treatment.Your low blood calcium must be treated before you take zoledronic acid injection.Most people with low blood calcium levels do not have symptoms, but some people may have symptoms.Call your doctor right away if you have symptoms of low blood calcium such as: Spasms, twitches, or cramps in your muscles Numbness or tingling in your fingers, toes, or around your mouth Your doctor may prescribe calcium and vitamin D to help prevent low calcium levels in your blood, while you take zoledronic acid injection.Take calcium and vitamin D as your doctor tells you to.2.Severe kidney problems.Severe kidney problems may happen when you take zoledronic acid injection.Severe kidney problems may lead to hospitalization or kidney dialysis and can be life-threatening.Your risk of kidney problems is higher if you: already have kidney problems take a diuretic or ‚Äúwater pill‚Äù do not have enough water in your body (dehydrated) before or after you receive zoledronic acid injection are of advanced age since the risk increases as you get older take any medicines known to harm your kidneys You should drink at least 2 glasses of fluid within a few hours before receiving zoledronic acid injection to reduce the risk of kidney problems 3.Severe jaw bone problems (osteonecrosis).Severe jaw bone problems may happen when you take zoledronic acid injection.Your doctor should examine your mouth before you start zoledronic acid injection.Your doctor may tell you to see your dentist before you start zoledronic acid injection.It is important for you to practice good mouth care during treatment with zoledronic acid injection.4.Unusual thigh bone fractures.Some people have developed unusual fractures in their thigh bone.Symptoms of a fracture may include new or unusual pain in your hip, groin, or thigh.5.Possible harm to your unborn baby.Zoledronic acid injection should not be used if you are pregnant.Tell your doctor right away if you are pregnant or plan to become pregnant.Zoledronic acid injection may harm your unborn baby.6.Bone, joint, or muscle pain.Some people who take bisphosphonates develop severe bone, joint, or muscle pain.Call your doctor right away if you have any of these side effects.What is zoledronic acid injection ?Zoledronic acid injection is a prescription medicine used to: Treat or prevent osteoporosis in women after menopause.Zoledronic acid injection helps reduce the chance of having a hip or spinal fracture (break).Increase bone mass in men with osteoporosis.Treat or prevent osteoporosis in either men or women who will be taking corticosteroid medicines for at least one year.Treat certain men and women who have Paget‚Äôs disease of the bone.It is not known how long zoledronic acid injection works for the treatment and prevention of osteoporosis.You should see your doctor regularly to determine if zoledronic acid injection is still right for you.Zoledronic acid injection is not for use in children.Who should not take zoledronic acid injection?Do not take zoledronic acid injection if you: Have low levels of calcium in your blood Have kidney problems Are allergic to zoledronic acid or any of its ingredients.A list of ingredients is at the end of this leaflet.What should I tell my doctor before taking zoledronic acid injection?Before you start Zoledronic Acid Injection, be sure to talk to your doctor if you: Have low blood calcium.Have kidney problems.Had parathyroid or thyroid surgery (glands in your neck).Have been told you have trouble absorbing minerals in your stomach or intestines (malabsorption syndrome) or have had parts of your intestine removed.Have asthma (wheezing) from taking aspirin.Plan to have dental surgery or teeth removed.Are pregnant, or plan to become pregnant.Zoledronic acid injection may harm your unborn baby.Zoledronic acid injection should not be used if you are pregnant.Are breastfeeding or plan to breastfeed.It is not known if zoledronic acid injection passes into your milk and may harm your baby.Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.Certain medicines may affect how zoledronic acid injection works.Especially tell your doctor if you are taking: An antibiotic.Certain antibiotic medicines called aminoglycosides may increase the effect of zoledronic acid injection in lowering your blood calcium for a long period of time.A diuretic or ‚Äúwater pill‚Äù.Non-steroidal anti-inflammatory medicines (NSAIDS).Ask your doctor or pharmacist for a list of these medicines, if you are not sure.Know the medicines you take.Keep a list of them and show it to your doctor and pharmacist each time you get a new medicine.How will I receive zoledronic acid injection?Your doctor will tell you how often you will receive zoledronic acid injection.Zoledronic acid injection is given by infusion into your vein (intravenously).Your infusion should last at least 15 minutes.Before you receive zoledronic acid injection, drink at least 2 glasses of fluid (such as water) within a few hours as directed by your doctor.You may eat before your treatment with zoledronic acid injection.If you miss a dose of zoledronic acid injection, call your doctor or healthcare provider to schedule your next dose.What are the possible side effects of zoledronic acid injection?Zoledronic acid injection may cause serious side effects.See ‚ÄúWhat is the most important information I should know about zoledronic acid injection?‚ÄùThe most common side effects of zoledronic acid injection included:‚Ä¢ Fever ‚Ä¢ Pain in your bones, joints or muscles‚Ä¢ Pain in your arms and legs‚Ä¢ Headache‚Ä¢ Flu-like illness (fever, chills, bone, joint, or muscle pain, fatigue)‚Ä¢ Nausea‚Ä¢ Vomiting‚Ä¢ Diarrhea Talk to your doctor about things you can do to help decrease some of these side effects that might happen with a zoledronic acid injection infusion.You may get allergic reactions, such as hives, swelling of your face, lips, tongue, or throat.Tell your doctor if you have any side effect that bothers you or that does not go away.These are not all the possible side effects of zoledronic acid injection.For more information, ask your doctor or pharmacist.Call your doctor for medical advice about side effects.You may report side effects to FDA at 1-800- FDA-1088.General information about safe and effective use of zoledronic acid injection.Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide.This Medication Guide summarizes the most important information about zoledronic acid injection.If you would like more information, talk with your doctor.You can ask your doctor or pharmacist for information about zoledronic acid injection that is written for health professionals.For more information, call 864-879-9994.What are the ingredients in zoledronic acid injection?Active ingredient: zoledronic acid monohydrate.Inactive ingredients: mannitol and sodium citrate.This Medication Guide has been approved by the U.S. Food and Drug Administration.Zometa is a registered trademark of Novartis Pharmaceuticals Corporation.Manufactured for:FRESENIUS KABILake Zurich, IL 60047Made in Indiawww.fresenius-kabi.us451529LEA-019849-00code No.:DRUGS/AP/01/2008Issued: November 2016 ","Your doctor might advise against taking Zoledronic Acid if you havre kidney problems; have trouble absorbing minerals in your stomach; are pregnant or breastfeeding or plan to become pregnant; had surgery that removed your parathyroid or thyroid glands, or part of the intestines; if you are sensitive to aspirin, cannot take calcium supplements, have low blood calcium.People with scleroderma have calcium deposits in their tissues.","Zoledronic acid injection is contraindicated in patients with creatinine clearance less than 35 mL/min.Before being given zoledronic acid injection, patients should tell their doctor if they have kidney problems and what medications they are taking.Zoledronic acid injection should not be given if the patient is pregnant or plans to become pregnant, or if she is breast-feeding.Before being given zoledronic acid injection, patients should tell their doctor if they are aspirin-sensitive. If the patient had surgery to remove some or all of the parathyroid glands in their neck, or had sections of their intestine removed, or are unable to take calcium supplements they should tell their doctor. Before you start Zoledronic Acid Injection, be sure to talk to your doctor if you: Have low blood calcium.Have kidney problems.Had parathyroid or thyroid surgery (glands in your neck).Have been told you have trouble absorbing minerals in your stomach or intestines (malabsorption syndrome) Symptoms of scleroderma include - Calcium deposits in connective tissues" 121,How long should I wait between cefuroxime doses?,"Using multiple doses of cefuroxime axetil tablets, 912 patients were treated with cefuroxime axetil (125 to 500 mg twice daily).There were no deaths or permanent disabilities thought related to drug toxicity.Twenty (2.2%) patients discontinued medication due to adverse events thought by the investigators to be possibly, probably, or almost certainly related to drug toxicity.Seventeen (85%) of the 20 patients who discontinued therapy did so because of gastrointestinal disturbances, including diarrhea, nausea, vomiting, and abdominal pain.The percentage of cefuroxime axetil tablet-treated patients who discontinued study drug because of adverse events was very similar at daily doses of 1,000, 500, and 250 mg (2.3%, 2.1%, and 2.2%, respectively).However, the incidence of gastrointestinal adverse events increased with the higher recommended doses.¬†The following adverse events were thought by the investigators to be possibly, probably, or almost certainly related to cefuroxime axetil tablets in multiple-dose clinical trials (n = 912 cefuroxime axetil-treated patients).¬† Cefuroxime comes as a tablet and a suspension (liquid) to take by mouth.It is usually taken every 12 hours (twice a day) for 7-10 days.To treat gonorrhea, cefuroxime is taken as a single dose, and to treat Lyme disease, cefuroxime is taken twice a day for 20 days.The tablet may be taken with or without food, and the liquid must be taken with food.To help you remember to take cefuroxime, take it around the same time every day.Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.Take cefuroxime exactly as directed.Do not take more or less of it or take it more often than prescribed by your doctor.Shake the liquid well before each use to mix the medication evenly.The tablets should be swallowed whole and taken with a full glass of water.Because the crushed tablet has a strong bitter taste, the tablet should not be crushed.Children who cannot swallow the tablet whole should take the liquid instead.Take cefuroxime until you finish the prescription, even if you feel better.Stopping cefuroxime too soon may cause bacteria to become resistant to antibiotics. ","Usually Cefuroxime is taken twice daily, i.e. every 12 hours.","cefuroxime axetil (125 to 500 mg twice daily).Cefuroxime comes as a tablet and a suspension (liquid) to take by mouth.It is usually taken every 12 hours (twice a day) for 7-10 days.To treat gonorrhea, cefuroxime is taken as a single dose, and to treat Lyme disease, cefuroxime is taken twice a day for 20 days.The tablet may be taken with or without food, and the liquid must be taken with food." 122,What are the risk factors for cancer?,"Each of your body's cells contains genes.Genes are the instructions that tell each of your cells what to do.Genes tell cells when to grow, when to stop growing, and what substances to make.For example, certain genes tell cells in your stomach to make stomach acid.Sometimes one of your genes can go bad in ways that make a cell turn cancerous.A gene can go bad if: The gene was damaged by something you were exposed to (an environmental factor)The gene was copied incorrectly during normal cell growth Less likely, you inherited a cancer gene from one of your parents.Sometimes people in a family are more likely to have a certain cancer.A cancer-causing gene could run in that family.One cancer-causing gene called BRCA increases the risk of breast cancer. Not being physically active.Women who are not physically active have a higher risk of getting breast cancer.Being overweight or obese after menopause.Older women who are overweight or obese have a higher risk of getting breast cancer than those at a normal weight.Taking hormones.Some forms of hormone replacement therapy (those that include both estrogen and progesterone) taken during menopause can raise risk for breast cancer when taken for more than five years.Certain oral contraceptives (birth control pills) also have been found to raise breast cancer risk.Reproductive history.Having the first pregnancy after age 30, not breastfeeding, and never having a full-term pregnancy can raise breast cancer risk.Drinking alcohol.Studies show that a woman?s risk for breast cancer increases with the more alcohol she drinks.Research suggests that other factors such as smoking, being exposed to chemicals that can cause cancer, and changes in other hormones due to night shift working also may increase breast cancer risk. Being around certain things can raise your chances of cancer, including: Tobacco smoke: Lung, mouth, throat, esophagus, kidney, and bladder cancers Asbestos (a mineral fiber used for insulation and other building materials): Lung cancer and mesothelioma (cancer in the tissues that line your lungs)Sunlight: Skin cancer X-rays: Leukemia and cancer in the organ exposed to radiation Radon (a radioactive gas that comes from the ground and can build up to harmful levels in basements): Lung cancer Some chemicals used at work (such as benzene, chromates, nickel, certain pesticides, and vinyl chloride) can cause cancer.Geography (where you live) can affect your chances of getting cancer.One reason is that people in different areas may be exposed to different amounts of carcinogens.Another reason is that people in different areas may have different genetic risk factors. ","Environmental, life-style and hereditary factors can increase the risk of cancer.For some cancers, risk factors are gene damage or cancer genes that run in the family.For many cancers, exposure to chemical s plays a major role.These chemicals include tobacco smoke, asbestos, radon, benzene, chromates, nickel, certain pesticides, and vinyl chloride.Sunlight, alcohol, lack of physical activity, being overweight or obese, and taking hormones are also risk factors for different cancers.For women, never having a full-term pregnancy, having the first pregnancy after 30 and not breastfeeding are risk factors for breast cancer.Geographical location might play a role due to exposure to environmental risks and genetic predisposition.","Sometimes one of your genes can go bad in ways that make a cell turn cancerous.A gene can go bad if: The gene was damaged by something you were exposed to (an environmental factor)The gene was copied incorrectly during normal cell growth Less likely, you inherited a cancer gene from one of your parents.Sometimes people in a family are more likely to have a certain cancer.A cancer-causing gene could run in that family. Being around certain things can raise your chances of cancer, including: Tobacco smoke: Asbestos (a mineral fiber used for insulation and other building materials): Sunlight: X-rays: Radon (a radioactive gas that comes from the ground and can build up to harmful levels in basements)Some chemicals used at work (such as benzene, chromates, nickel, certain pesticides, and vinyl chloride) can cause cancer.Geography (where you live) can affect your chances of getting cancer.One reason is that people in different areas may be exposed to different amounts of carcinogens.Another reason is that people in different areas may have different genetic risk factors.Not being physically active.Women who are not physically active have a higher risk of getting breast cancer.Being overweight or obese after menopause.Taking hormones. Certain oral contraceptives (birth control pills) also have been found to raise breast cancer risk.Reproductive history.Having the first pregnancy after age 30, not breastfeeding, and never having a full-term pregnancy can raise breast cancer risk.Drinking alcohol." 125,What body parts are affected by systemic lupus erythematosus?,"The NIAMS Lupus Clinical Research Program conducts translational and clinical research into the causes, treatment, and prevention of lupus.In addition, the NIAMS funds and supports many researchers at universities and other organizations throughout the country who are studying lupus to better understand the cause, in hopes to prevent and cure the disease.Topics include: Genetics.Several genes associated with lupus risk and severity have been discovered.Sex differences.Researchers are trying to understand the biological bases for sex differences in immune and inflammatory systems to better understand why women are more likely than men to have the disease.Biomarkers.Certain proteins or genes could help doctors predict flares in lupus and, in the future, response to specific treatments.Disease processes.Researchers are exploring possible triggers for lupus.Treatment.Scientists are exploring how lupus develops and how therapies affect the course of the disease.They are also exploring drugs to prevent or delay kidney failure, one of the most serious and life-threatening complications of lupus.Experts are also collaborating to develop registries and working groups, such as: The Lupus Family Registry and Repository, which gathers medical information as well as blood and tissue samples from patients and their relatives.This will help identify genes that make someone more at risk for the disease.Lupus Federal Working Group, which gathers experts across various public health agencies, pharmaceutical companies, and professional organizations.National Institutes of Health (NIH) Accelerating Medicines Partnership, which aims to reduce the time and cost of developing new diagnostics and therapies for diseases, including lupus.The NIAMS Lupus Clinical Research Program conducts translational and clinical research into the causes, treatment, and prevention of lupus.In addition, the NIAMS funds and supports many researchers at universities and other organizations throughout the country who are studying lupus to better understand the cause, in hopes to prevent and cure the disease.Topics include: Genetics.Several genes associated with lupus risk and severity have been discovered.Sex differences.Researchers are trying to understand the biological bases for sex differences in immune and inflammatory systems to better understand why women are more likely than men to have the disease.Biomarkers.Certain proteins or genes could help doctors predict flares in lupus and, in the future, response to specific treatments.Disease processes.Researchers are exploring possible triggers for lupus.Treatment.Scientists are exploring how lupus develops and how therapies affect the course of the disease.They are also exploring drugs to prevent or delay kidney failure, one of the most serious and life-threatening complications of lupus.Experts are also collaborating to develop registries and working groups, such as: The Lupus Family Registry and Repository, which gathers medical information as well as blood and tissue samples from patients and their relatives.This will help identify genes that make someone more at risk for the disease.Lupus Federal Working Group, which gathers experts across various public health agencies, pharmaceutical companies, and professional organizations.National Institutes of Health (NIH) Accelerating Medicines Partnership, which aims to reduce the time and cost of developing new diagnostics and therapies for diseases, including lupus.The NIAMS Lupus Clinical Research Program conducts translational and clinical research into the causes, treatment, and prevention of lupus.In addition, the NIAMS funds and supports many researchers at universities and other organizations throughout the country who are studying lupus to better understand the cause, in hopes to prevent and cure the disease.Topics include: Genetics.Several genes associated with lupus risk and severity have been discovered.Sex differences.Researchers are trying to understand the biological bases for sex differences in immune and inflammatory systems to better understand why women are more likely than men to have the disease.Biomarkers.Certain proteins or genes could help doctors predict flares in lupus and, in the future, response to specific treatments.Disease processes.Researchers are exploring possible triggers for lupus.Treatment.Scientists are exploring how lupus develops and how therapies affect the course of the disease.They are also exploring drugs to prevent or delay kidney failure, one of the most serious and life-threatening complications of lupus.Experts are also collaborating to develop registries and working groups, such as: The Lupus Family Registry and Repository, which gathers medical information as well as blood and tissue samples from patients and their relatives.This will help identify genes that make someone more at risk for the disease.Lupus Federal Working Group, which gathers experts across various public health agencies, pharmaceutical companies, and professional organizations.National Institutes of Health (NIH) Accelerating Medicines Partnership, which aims to reduce the time and cost of developing new diagnostics and therapies for diseases, including lupus. Living with lupus can be physically and emotionally hard.At times, you may think that your friends, family, and coworkers do not understand how you feel.You may experience sadness and anger.A good place to start managing the disease is working with your doctor to determine the best treatment plan and taking your medications as prescribed.But keep in mind, many people with lupus live wonderfully happy lives, and therefore a positive outlook is very important.You can do several things to help you live with lupus: Learn to recognize the warning signs of a flare so that you and your doctor might reduce or prevent them.Warning signs include: Increased tiredness.Joint swelling.Pain.Rash.Fever.Abdominal pain.Headache.Eat a healthy well-balanced diet rich in fruits, vegetables, and whole grains.Exercise to help keep your body strong; however, talk to your doctor before starting an exercise program.If you smoke, quit.This will help lower your risk for heart disease that can be a complication of lupus.Protect yourself from the sun sometimes, exposure to the sun can cause a flare.Wear protective clothing, such as a hat or long-sleeved shirts, and use sunscreen any time you go outside.Reach out to online and community support groups.Keep the lines of communication open.Talk to your family and friends about your lupus to help them understand the disease.Ask for help when you need it.Take a break from focusing on the disease, and spend some time doing activities you enjoy.Lower your stress try meditating, reading, or deep breathing.Remember, stress can trigger a flare.Make changes if you need to in your work environment so you can try to continue to work, such as: Creating a flexible schedule for example, work from home or start the workday later.Working part time.Adjusting your work area so that you are more comfortable.Most people with mild disease or who are in remission can usually participate in the same life activities they did before they were diagnosed.

Pregnancy and Contraception for Women With Lupus

Most women with lupus can have healthy pregnancies if the disease is under control.If you start to plan a pregnancy, talk to your doctor so you can be as healthy as possible before becoming pregnant.Close monitoring during pregnancy is essential, especially if you have low platelets, antiphospholipid antibodies, anti-SSA/Ro antibodies, high blood pressure, lung or heart problems, or kidney disease.It is important to find an obstetrician who manages high-risk pregnancies and has experience working with women who have lupus.Research shows that birth control pills do not increase the risk for severe flares among women with lupus, but estrogen-containing pills are not recommended for women with antiphospholipid antibodies.Talk with your doctor about your antibody test results before starting oral contraceptives.Living with lupus can be physically and emotionally hard.At times, you may think that your friends, family, and coworkers do not understand how you feel.You may experience sadness and anger.A good place to start managing the disease is working with your doctor to determine the best treatment plan and taking your medications as prescribed.But keep in mind, many people with lupus live wonderfully happy lives, and therefore a positive outlook is very important.You can do several things to help you live with lupus: Learn to recognize the warning signs of a flare so that you and your doctor might reduce or prevent them.Warning signs include: Increased tiredness.Joint swelling.Pain.Rash.Fever.Abdominal pain.Headache.Eat a healthy well-balanced diet rich in fruits, vegetables, and whole grains.Exercise to help keep your body strong; however, talk to your doctor before starting an exercise program.If you smoke, quit.This will help lower your risk for heart disease that can be a complication of lupus.Protect yourself from the sun sometimes, exposure to the sun can cause a flare.Wear protective clothing, such as a hat or long-sleeved shirts, and use sunscreen any time you go outside.Reach out to online and community support groups.Keep the lines of communication open.Talk to your family and friends about your lupus to help them understand the disease.Ask for help when you need it.Take a break from focusing on the disease, and spend some time doing activities you enjoy.Lower your stress try meditating, reading, or deep breathing.Remember, stress can trigger a flare.Make changes if you need to in your work environment so you can try to continue to work, such as: Creating a flexible schedule for example, work from home or start the workday later.Working part time.Adjusting your work area so that you are more comfortable.Most people with mild disease or who are in remission can usually participate in the same life activities they did before they were diagnosed.

Pregnancy and Contraception for Women With Lupus

Most women with lupus can have healthy pregnancies if the disease is under control.If you start to plan a pregnancy, talk to your doctor so you can be as healthy as possible before becoming pregnant.Close monitoring during pregnancy is essential, especially if you have low platelets, antiphospholipid antibodies, anti-SSA/Ro antibodies, high blood pressure, lung or heart problems, or kidney disease.It is important to find an obstetrician who manages high-risk pregnancies and has experience working with women who have lupus.Research shows that birth control pills do not increase the risk for severe flares among women with lupus, but estrogen-containing pills are not recommended for women with antiphospholipid antibodies.Talk with your doctor about your antibody test results before starting oral contraceptives. Systemic lupus erythematosus (lupus) is a chronic (long-lasting) autoimmune disease that can affect many parts of the body.Lupus occurs when the immune system, which normally helps protect the body from infection and disease, attacks its own tissues.This attack causes inflammation, and in some cases permanent tissue damage, which can be widespread affecting the skin, joints, heart, lung, kidneys, circulating blood cells, and brain.If you have lupus, you may experience periods of illness (flares) and periods of wellness (remission).Lupus flares can be mild to serious,and they are unpredictable.However, with treatment, many people with lupus can manage the disease.Systemic lupus erythematosus (lupus) is a chronic (long-lasting) autoimmune disease that can affect many parts of the body.Lupus occurs when the immune system, which normally helps protect the body from infection and disease, attacks its own tissues.This attack causes inflammation, and in some cases permanent tissue damage, which can be widespread affecting the skin, joints, heart, lung, kidneys, circulating blood cells, and brain.If you have lupus, you may experience periods of illness (flares) and periods of wellness (remission).Lupus flares can be mild to serious,and they are unpredictable.However, with treatment, many people with lupus can manage the disease. ","Many body parts are effected by systemic lupus erythematosus.It is an autoimmune disease, which means the immune system destroys your own body tissues in the skin, joints, heart, lung, kidneys, circulating blood cells, and brain.Lupus can cause kidney failure and heart disease.","Systemic lupus erythematosus (lupus) is a chronic (long-lasting) autoimmune disease that can affect many parts of the body.Lupus occurs when the immune system, which normally helps protect the body from infection and disease, attacks its own tissues.This attack causes inflammation, and in some cases permanent tissue damage, which can be widespread affecting the skin, joints, heart, lung, kidneys, circulating blood cells, and brain kidney failure, one of the most serious and life-threatening complications of lupus.heart disease can be a complication of lupus." 129,Why is there no urine in my suprapubic catheter bag?,"Summary : A suprapubic catheter (tube) drains urine from your bladder.It is inserted into your bladder through a small hole in your belly.You may need a catheter because you have urinary incontinence (leakage), urinary retention (not being able to urinate), surgery that made a catheter necessary, or another health problem.What to Expect at Home : Your catheter will make it easier for you to drain your bladder and avoid infections.You will need to make sure it is working properly.You will also need to know how to change it.You will need to change it every 4 to 6 weeks.You can learn how to change your catheter in a sterile (very clean) way.After some practice, it will get easier.Your health care provider will change it for you the first time.Sometimes family members, a nurse, or others may be able to help you change your catheter.You will get a prescription to buy special catheters at a medical supply store.Other supplies you will need are sterile gloves, a catheter pack, syringes, sterile solution to clean with, gel such as K-Y Jelly or Surgilube (DO NOT use Vaseline), and a drainage bag.You may also get medicine for your bladder.Drink 8 to 12 glasses of water every day for a few days after you change your catheter.Avoid physical activity for a week or two.It is best to keep the catheter taped to your belly.Once your catheter is in place, you will need to empty your urine bag only a few times a day.Caring for Your Skin Near your Catheter : Follow these guidelines for good health and skin care: - Check the catheter site a few times a day.Check for redness, pain, swelling, or pus. - Wash the area around your catheter every day with mild soap and water.Gently pat it dry.Showers are fine.Ask your providers about bathtubs, swimming pools, and hot tubs.- DO NOT use creams, powders, or sprays near the site.- Apply bandages around the site the way your provider showed you.Make Sure Your Catheter Is Working : You will need to check your catheter and bag throughout the day.- Make sure your bag is always below your waist.This will keep urine from going back into your bladder.- Try not to disconnect the catheter more than you need to.Keeping it connected will make it work better.- Check for kinks, and move the tubing around if it is not draining.Changing Your Catheter : You will need to change the catheter about every 4 to 6 weeks.Always wash your hands with soap and water before changing it.Once you have your sterile supplies ready, lie down on your back.Put on two pairs of sterile gloves, one over the other.Then: - Make sure your new catheter is lubricated on the end you will insert into your belly.-Clean around the site using a sterile solution.- Deflate the balloon with one of the syringes.- Take out the old catheter slowly.- Take off the top pair of gloves.- Insert the new catheter as far in as the other one was placed.- Wait for urine to flow.It may take a few minutes.- Inflate the balloon using 5 to 8 ml of sterile water.- Attach your drainage bag.If you are having trouble changing your catheter, call your doctor right away.Insert a catheter into your urethra through your urinary opening in your labia (women) or penis (men) to pass urine.DO NOT remove the suprapubic catheter because the hole can close up quickly.However, if you have removed the catheter already and cannot get it back in, call your provider or go to the local emergency room.When to Call the Doctor : Call your health care provider if: - You are having trouble changing your catheter or emptying your bag.- Your bag is filling up quickly, and you have an increase in urine.- You are leaking urine.- You notice blood in your urine a few days after you leave the hospital.- You are bleeding at the insertion site after you change your catheter, and it does not stop within 24 hours.- Your catheter seems blocked.- You notice grit or stones in your urine.- Your supplies do not seem to be working (balloon is not inflating or other problems).- You notice a smell or change in color in your urine, or your urine is cloudy.- You have signs of infection (a burning sensation when you urinate, fever, or chills).Alternate Names : SPT You will need to check your catheter and bag throughout the day.Always keep your bag below your waist.Try not to disconnect the catheter more than you need to.Keeping it connected to the bag will make it work better.Check for kinks, and move the tubing around if it is not draining.Drink plenty of water during the day to keep urine flowing. ",Make sure the bag is below your waist so that urine is not going back into the bladder.Keep the catheter connected and check for kinks and move it around if it is not draining.Drink enough water to keep urine flowing.,"You will need to check your catheter and bag throughout the day.Make sure your bag is always below your waist.This will keep urine from going back into your bladder.Try not to disconnect the catheter more than you need to.Keeping it connected will make it work better.- Check for kinks, and move the tubing around if it is not draining.Drink plenty of water during the day to keep urine flowing." 131,Can diabetes cause cold tingling feet?,"Some people with nerve damage have numbness, tingling, or pain, but others have no symptoms.Nerve damage can also lower your ability to feel pain, heat, or cold.Living without pain sounds pretty good, but it comes at a high cost.Pain is the body?s way of telling you something?s wrong so you can take care of yourself.If you don?t feel pain in your feet, you may not notice a cut, blister, sore, or other problem.Small problems can become serious if they aren?t treated early.Preventing Nerve Damage What?s the most important thing you can do to prevent nerve damage or stop it from getting worse?Keep your blood sugar in your target range as much as possible.Other good diabetes management habits can help, too: Don?t smoke.Smoking reduces blood flow to the feet.Follow a healthy eating plan, including eating more fruits and vegetables and less sugar and salt.Get physically active ?10 to 20 minutes a day is better than an hour once a week.Take medicines as prescribed by your doctor. There are many possible causes of numbness and tingling, including: Sitting or standing in the same position for a long time Injuring a nerve (a neck injury may cause you to feel numbness anywhere along your arm or hand, while a low back injury can cause numbness or tingling down the back of your leg)Pressure on the nerves of the spine, such as from a herniated disk Pressure on peripheral nerves from enlarged blood vessels, tumors, scar tissue, or infection Shingles or herpes zoster infectionOther infections such as HIV/AIDS, leprosy, syphilis, or tuberculosis Lack of blood supply to an area, such as from hardening of the arteries, frostbite, or vessel inflammation Abnormal levels of calcium, potassium, or sodium in your body Deficiency of B vitamins such as B1, B6, B12, or folic acid Use of certain medicines Use of certain illicit street drugs Nerve damage due to lead, alcohol, or tobacco, or from chemotherapy drugs Radiation therapy Animal bites Insect, tick, mite, and spider bites Seafood toxins Congenital conditions that affect the nerves Numbness and tingling can be caused by other medical conditions, including: Carpal tunnel syndrome (pressure on a nerve at the wrist) Diabetes Migraines Multiple sclerosis Seizures Stroke Transient ischemic attack (TIA), sometimes called a ""mini-stroke"" Underactive thyroid Raynaud phenomenon (narrowing of the blood vessels, usually in the hands and feet) If you experience any of these symptoms, don?t wait for your next appointment.See your regular doctor or foot doctor right away:Pain in your legs or cramping in your buttocks, thighs, or calves during physical activity.Tingling, burning, or pain in your feet.Loss of sense of touch or ability to feel heat or cold very well.A change in the shape of your feet over time.Loss of hair on your toes, feet, and lower legs.Dry, cracked skin on your feet.A change in the color and temperature of your feet.Thickened, yellow toenails.Fungus infections such as athlete?s foot between your toes.A blister, sore, ulcer, infected corn, or ingrown toenail.Most people with diabetes can prevent serious foot complications.Regular care at home and going to all doctor?s appointments are your best bet for preventing foot problems (and stopping small problems from becoming serious ones).More Information Diabetes and Foot Problemsexternal icon Diabetes Features & Spotlights CDC Diabetes on Facebook @CDCDiabetes on Twitter Numbness and tingling are abnormal sensations that can occur anywhere in your body, but they are often felt in your fingers, hands, feet, arms, or legs. ","Numbness and tingling in the feet could be caused by nerve damage due to diabetes.Nerve damage can also lower your ability fo feel heat or cold, which could lead complications.To prevent complications, keep the blood sugar in the target range.","Numbness and tingling are abnormal sensations that can occur anywhere in your body, but they are often felt in your fingers, hands, feet, arms, or legs.Numbness and tingling can be caused by medical conditions, including Diabetes.to prevent nerve damage or stop it from getting worse Keep your blood sugar in your target range as much as possible.Some people with nerve damage have numbness, tingling, or pain, but others have no symptoms.Nerve damage can also lower your ability to feel pain, heat, or cold. If you don?t feel pain in your feet, you may not notice a cut, blister, sore, or other problem. Pain in your legs or cramping in your buttocks, thighs, or calves during physical activity.Tingling, burning, or pain in your feet.Loss of sense of touch or ability to feel heat or cold very well. Most people with diabetes can prevent serious foot complications." 133,What are the first aid steps for an accidental elbow injury?,"You may need to wear a sling, splint, or cast for about 2 to 3 weeks while your elbow heals.Depending on how badly it is sprained, you may need to work with a physical therapist who will show you stretching and strengthening exercises.Most people recover completely from a simple elbow sprain in about 4 weeks. Your health care provider will likely instruct you to follow RICE to help reduce pain and swelling: Rest your elbow.Avoid lifting anything with your arm and elbow.Don't move the elbow unless you're instructed to do so.Ice your elbow for 15 to 20 minutes at a time, 3 to 4 times a day.Wrap the ice in cloth.DO NOT place ice directly on the skin.Cold from the ice can damage your skin.Compress the area by wrapping it with an elastic bandage or compression wrap.Elevate your elbow by raising it above the level of your heart.You can prop it up with pillows.You can take ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn) to reduce pain and swelling.Acetaminophen (Tylenol) helps with pain, but not swelling.You can buy these pain medicines at the store.Talk with your provider before using these medicines if you have heart disease, high blood pressure, kidney or liver disease, or have had stomach ulcers or internal bleeding in the past.DO NOT take more than the amount recommended on the bottle or by your provider. Steps for first aid treatment of a crush injury are: Stop bleeding by applying direct pressure.Cover the area with a wet cloth or bandage.Then, raise the area above the level of the heart, if possible.If there is suspicion of a head, neck, or spinal injury, immobilize those areas if possible and then limit movement to only the crushed area.Call your local emergency number (such as 911) or local hospital for further advice.Crush injuries most often need to be evaluated in a hospital emergency department.Surgery may be needed. ","If the injury occurred during a crash and if it is bleeding, stop the bleeding first by applying direct pressure, cover the area with a wet cloth and elevate the injured area above the heart level.Call the local emergency number, as the injury should be evaluated in an emergency department, and surgery, sling, splint or cast may be needed.In other cases, you doctor will most likely to follow RICE:Rest you elbow, Ice it for 15-20 minutes.Compress the area with an elastic bandage.Elevate the elbow above the heart level.You might need ibuprofen or naproxen for pain.","Your health care provider will likely instruct you to follow RICE to help reduce pain and swelling: Rest your elbow.Avoid lifting anything with your arm and elbow.Don't move the elbow unless you're instructed to do so.Ice your elbow for 15 to 20 minutes at a time, 3 to 4 times a day.Wrap the ice in cloth. Compress the area by wrapping it with an elastic bandage or compression wrap.Elevate your elbow by raising it above the level of your heart.You can prop it up with pillows.You can take ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn) to reduce pain and swelling.Steps for first aid treatment of a crush injury are: Stop bleeding by applying direct pressure.Cover the area with a wet cloth or bandage.Then, raise the area above the level of the heart, if possible.Call your local emergency number (such as 911) or local hospital for further advice.Crush injuries most often need to be evaluated in a hospital emergency department.Surgery may be needed.You may need to wear a sling, splint, or cast for about 2 to 3 weeks while your elbow heals." 136,Why do I feel pain in the abdomen and while urinating?,"You can try the following home care steps to ease mild abdominal pain: - Sip water or other clear fluids.You may have sports drinks in small amounts.(People with diabetes must check their blood sugar often and adjust their medicines as needed).- Avoid solid food for the first few hours.- If you have been vomiting, wait 6 hours, and then eat small amounts of mild foods such as rice, applesauce, or crackers.Avoid dairy products.- If the pain is high up in your abdomen and occurs after meals, antacids may help, especially if you feel heartburn or indigestion.Avoid citrus, high-fat foods, fried or greasy foods, tomato products, caffeine, alcohol, and carbonated beverages.- Avoid aspirin, ibuprofen or other anti-inflammatory medications, and narcotic pain pills unless your health care provider prescribes them.If you know that your pain is not related to your liver, you can try acetaminophen (Tylenol).These additional steps may help prevent some types of abdominal pain: - Drink plenty of water each day. - Eat small meals more frequently. -Exercise regularly. - Limit foods that produce gas.- Make sure that your meals are well-balanced and high in fiber.Eat plenty of fruits and vegetables. Call your health care provider if: Waking to urinate more often continues over several days.You are bothered by the number of times you must urinate during the night.You have a burning sensation when urinating. Almost everyone has pain in the abdomen at some point.Most of the time, it is not serious.How bad your pain is does not always reflect the seriousness of the condition causing the pain.For example, you might have very bad abdominal pain if you have gas or stomach cramps due to viral gastroenteritis.However, life-threatening conditions, such as colon cancer or early appendicitis, may only cause mild pain or no pain.Other ways to describe pain in your abdomen include: - Generalized pain: This means that you feel it in more than half of your belly.This type of pain is more typical for a stomach virus, indigestion, or gas.If the pain becomes more severe, it may be caused by a blockage of the intestines.- Localized pain: This is pain found in only one area of your belly.It is more likely to be a sign of a problem in an organ, such as the appendix, gallbladder, or stomach. -Cramp-like pain: This type of pain is not serious most of the time.It is likely to be due to gas and bloating, and is often followed by diarrhea.More worrisome signs include pain that occurs more often, lasts than 24 hours, or occurs with a fever.- Colicky pain: This type of pain comes in waves.It very often starts and ends suddenly, and is often severe.Kidney stones and gallstones are common causes of this type of belly pain. Many different conditions can cause abdominal pain.The key is to know when you need to get medical care right away.Sometimes, you may only need to call a health care provider if your symptoms continue.Less serious causes of abdominal pain include: Constipation Irritable bowel syndrome Food allergies or intolerance (such as lactose intolerance)Food poisoning Stomach flu Other possible causes include: Appendicitis Abdominal aortic aneurysm (bulging and weakening of the major artery in the body)Bowel blockage or obstruction Cancer of the stomach, colon (large bowel), and other organs Cholecystitis (inflammation of the gallbladder) with or without gallstones Decreased blood supply to the intestines (ischemic bowel)Diverticulitis (inflammation and infection of the colon) Heartburn, indigestion, or gastroesophageal reflux (GERD)Inflammatory bowel disease (Crohn disease or ulcerative colitis)Kidney stones Pancreatitis (swelling or infection of the pancreas)Ulcers Sometimes, abdominal pain may occur due to a problem somewhere else in your body, such as your chest or pelvic area.For example, you may have abdominal pain if you have: Severe menstrual cramps Endometriosis Muscle strain Pelvic inflammatory disease (PID) Tubal (ectopic) pregnancy Ruptured ovarian cyst Urinary tract infections ","Abdominal pain cam be caused by many conditions.In many cases yo do not need to call your doctor, for example, if the pain is caused by gas.If the symptoms continue, call your doctor.Sometimes abdominal pain is caused by the problems in other areas, for example, urinary tract infection.If you have pain and burning sensation while urinating, call your doctor.","Almost everyone has pain in the abdomen at some point.Most of the time, it is not serious.How bad your pain is does not always reflect the seriousness of the condition causing the pain.For example, you might have very bad abdominal pain if you have gas or stomach cramps due to viral gastroenteritis.Many different conditions can cause abdominal pain.The key is to know when you need to get medical care right away.Sometimes, you may only need to call a health care provider if your symptoms continue.Sometimes, abdominal pain may occur due to a problem somewhere else in your body, such as your chest or pelvic area.For example, you may have abdominal pain if you have Urinary tract infections Call your health care provider if: Waking to urinate more often continues over several days.You are bothered by the number of times you must urinate during the night.You have a burning sensation when urinating." 140,What are the risk factors associated with depression and how is it diagnosed?,"Women are twice as likely as men to be diagnosed with depression.1 It is more than twice as common for African-American, Hispanic, and white women to have depression compared to Asian-American women.Depression is also more common in women whose families live below the federal poverty line.3 Depression (major depressive disorder or clinical depression) is a common but serious mood disorder.It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working.To be diagnosed with depression, the symptoms must be present for at least two weeks.Some forms of depression are slightly different, or they may develop under unique circumstances, such as: Persistent depressive disorder (also called dysthymia) is a depressed mood that lasts for at least two years.A person diagnosed with persistent depressive disorder may have episodes of major depression along with periods of less severe symptoms, but symptoms must last for two years to be considered persistent depressive disorder.Postpartum depression is much more serious than the baby blues (relatively mild depressive and anxiety symptoms that typically clear within two weeks after delivery) that many women experience after giving birth.Women with postpartum depression experience full-blown major depression during pregnancy or after delivery (postpartum depression).The feelings of extreme sadness, anxiety, and exhaustion that accompany postpartum depression may make it difficult for these new mothers to complete daily care activities for themselves and/or for their babies.Psychotic depression occurs when a person has severe depression plus some form of psychosis, such as having disturbing false fixed beliefs (delusions) or hearing or seeing upsetting things that others cannot hear or see (hallucinations).The psychotic symptoms typically have a depressive theme, such as delusions of guilt, poverty, or illness.Seasonal affective disorder is characterized by the onset of depression during the winter months, when there is less natural sunlight.This depression generally lifts during spring and summer.Winter depression, typically accompanied by social withdrawal, increased sleep, and weight gain, predictably returns every year in seasonal affective disorder.Bipolar disorder is different from depression, but it is included in this list is because someone with bipolar disorder experiences episodes of extremely low moods that meet the criteria for major depression (called bipolar depression).But a person with bipolar disorder also experiences extreme high euphoric or irritable moods called mania or a less severe form called hypomania.Examples of other types of depressive disorders newly added to the diagnostic classification of DSM-5 include disruptive mood dysregulation disorder (diagnosed in children and adolescents) and premenstrual dysphoric disorder (PMDD). Depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors.Depression can happen at any age, but often begins in adulthood.Depression is now recognized as occurring in children and adolescents, although it sometimes presents with more prominent irritability than low mood.Many chronic mood and anxiety disorders in adults begin as high levels of anxiety in children.Depression, especially in midlife or older adults, can co-occur with other serious medical illnesses, such as diabetes, cancer, heart disease, and Parkinsons disease.These conditions are often worse when depression is present.Sometimes medications taken for these physical illnesses may cause side effects that contribute to depression.A doctor experienced in treating these complicated illnesses can help work out the best treatment strategy.Risk factors include: Personal or family history of depression Major life changes, trauma, or stress Certain physical illnesses and medications Talk to your doctor or nurse if you have symptoms of depression.Certain medicines and some health problems (such as viruses or a thyroid disorder) can cause the same symptoms as depression.Sometimes depression can be part of another mental health condition.Diagnosis of depression includes a mental health professional asking questions about your life, emotions, struggles, and symptoms.The doctor, nurse, or mental health professional may order lab tests on a sample of your blood or urine and do a regular checkup to rule out other problems that could be causing your symptoms. The risk factors for depression are family history, life experiences, and environment.If you have depression, you may have experienced it when you were younger, and may have a family history of the illness.You may also be going through difficult life events, such as physical or psychological trauma, losing a loved one, a difficult relationship with a family member or friend, or financial troubles.Any of these stressful experiences can lead to depression.For older adults who experience depression for the first time later in life, other factors may be at play.Depression may be related to changes that occur in the brain and body as a person ages.For example, some older adults who are at risk for illnesses such as heart disease or stroke may have hardening and inflammation of the blood vessels, and blood may not be able to flow normally to the body's organs, including the brain.Over time, this blood vessel disease and restricted blood flow can damage nearby brain tissue and harm the nerve connections that help different parts of the brain communicate with each other.If this happens, an older adult with no family history of depression may develop what some doctors call ""vascular depression.""Older adults may also experience depression as a result of brain changes caused by illnesses such as Alzheimers disease or Parkinsons disease.This type of depression can appear in the early stages of these diseases, before many symptoms appear. No test can confirm depression.However, laboratory tests may help a doctor determine whether depression is caused by a hormonal or other physical disorder.For example, blood tests are usually done to detect a thyroid disorder or vitamin deficiency.In younger people, tests may be done to detect drug use.A thorough neurologic examination is done to check for Parkinson disease, which causes some of the same symptoms.People who have severely disturbed sleep may need to have testing (polysomnography) to distinguish sleep disorders from depression. ","The risk factors for depression are genetic (family history), biological, environmental and psychological.Life experiences, such as trauma, loss of a family member or financial problems could cause stress and depression.Changes in the body and brain become a factor as the person ages or experiences onset of an illness, such as Parkinson disease. Women are more likely to have depression, particularly if they are African-American, Hispanic, or white, and if they live below the poverty line.Some forms of depression are caused by specific factors, such as postpartum depression during and after pregnancy, depression with psychosis or other mental illness, seasonal affective disorder due to lack of sunlight during the winter, and some medications or viruses or thyroid disorders. Depression is diagnosed if the systems persist for at least two weeks.The examination by a mental health professional includes questions about the symptoms, life experiences and emotions.Although there are no tests to confirm depression, the doctor may order some tests to determine if the symptoms are caused by a hormonal or other physical disorder.","The risk factors for depression are family history, life experiences, and environment.Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors.If you have depression, you may be going through difficult life events, such as physical or psychological trauma, losing a loved one, a difficult relationship with a family member or friend, or financial troubles.Any of these stressful experiences can lead to depression. Depression may be related to changes that occur in the brain and body as a person ages. Older adults may also experience depression as a result of brain changes caused by illnesses such as Alzheimers disease or Parkinsons disease.This type of depression can appear in the early stages of these diseases, before many symptoms appear.Women are twice as likely as men to be diagnosed with depression.It is more than twice as common for African-American, Hispanic, and white women to have depression compared to Asian-American women.Depression is also more common in women whose families live below the federal poverty line.Some forms of depression are slightly different, or they may develop under unique circumstances, Postpartum depression, full-blown major depression during pregnancy or after delivery. Psychotic depression occurs when a person has severe depression plus some form of psychosis.Seasonal affective disorder is characterized by the onset of depression during the winter months, when there is less natural sunlight. Certain medicines and some health problems (such as viruses or a thyroid disorder) can cause the same symptoms as depression.Sometimes depression can be part of another mental health condition.To be diagnosed with depression, the symptoms must be present for at least two weeks.No test can confirm depression.However, laboratory tests may help a doctor determine whether depression is caused by a hormonal or other physical disorder.Diagnosis of depression includes a mental health professional asking questions about your life, emotions, struggles, and symptoms" 141,Will the strong flu vaccine be better for teachers?,"In addition to FLUAD and FLUAD Quadrivalent, one other flu vaccine is licensed specifically for people 65 years and older.The high-dose flu vaccine (Fluzone High-Dose Quadrivalent) contains four times the amount of antigen as the standard-dose inactivated flu vaccine, and has been associated with a stronger immune response following vaccination and better effectiveness than the regular dose flu vaccine in older people in a two-season randomized trial.People in this age group may also receive standard-dose, flu vaccines without adjuvant or the recombinant flu vaccine.People 65 years and older can get any flu vaccine approved for use in that age group with no preference for any one vaccine over another. In the United States, FLUAD and FLUAD Quadrivalent are licensed only for persons aged 65 years and older.FLUAD and FLUAD Quadrivalent should not be given to people with a history of severe allergic reaction to the any flu vaccine or to vaccine ingredients other than eggs.Information about vaccine ingredients is located in package inserts from each manufacturer.

Summary

Flu is a respiratory infection caused by a number of viruses.Most people with the flu get better on their own.But it can be serious.It can cause complications and sometimes even death.Getting the flu vaccine every year is the best way to lower your chance of getting the flu and spreading it to others.The flu vaccine causes antibodies to develop in your body about two weeks after you get it.These antibodies provide protection against infection with the viruses that are in the vaccine.There are different types of flu shots, including some especially for people 65 and older.Ask your health care provider which one is right for you.Everyone 6 months of age and older should get a flu vaccine every season.People with egg allergies should check with their doctors before getting a vaccine.Other exceptions are people who have Had reactions to flu shots before Guillain-Barre Syndrome A fever Centers for Disease Control and Prevention ","A randomized clinical trial has shown the the high dose flu vaccine that contains four times more antigen than the regular vaccine had better effectiveness in older people.The stronger vaccines FLUAD, FLUAD Quadrivalent and Fluzone High-Dose Quadrivalent are licensed only for peopler 65 and older in the United States.Ask your doctor which vaccine is right for you.","There are different types of flu shots, including some especially for people 65 and older.Ask your health care provider which one is right for you.In the United States, FLUAD and FLUAD Quadrivalent are licensed only for persons aged 65 years and older.In addition to FLUAD and FLUAD Quadrivalent, one other flu vaccine is licensed specifically for people 65 years and older.The high-dose flu vaccine (Fluzone High-Dose Quadrivalent) contains four times the amount of antigen as the standard-dose inactivated flu vaccine, and has been associated with a stronger immune response following vaccination and better effectiveness than the regular dose flu vaccine in older people in a two-season randomized trial." 142,How does managing gestational diabetes affect the baby’s weight?,"Gestational diabetes occurs when your body can't make the extra insulin needed during pregnancy.Insulin, a hormone made in your pancreas, helps your body use glucose for energy and helps control your blood glucose levels.During pregnancy, your body makes special hormones and goes through other changes, such as weight gain.Because of these changes, your body's cells don't use insulin well, a condition called insulin resistance.All pregnant women have some insulin resistance during late pregnancy.Most pregnant women can produce enough insulin to overcome insulin resistance, but some cannot.These women develop gestational diabetes.Being overweight or obese is linked to gestational diabetes.Women who are overweight or obese may already have insulin resistance when they become pregnant.Gaining too much weight during pregnancy may also be a factor.Having a family history of diabetes makes it more likely that a woman will develop gestational diabetes, which suggests that genes play a role. Gestational diabetes is a type of diabetes that develops during pregnancy.Diabetes means your blood glucose, also called blood sugar, is too high.Too much glucose in your blood is not good for you or your baby.Gestational diabetes is usually diagnosed in the 24th to 28th week of pregnancy.Managing your gestational diabetes can help you and your baby stay healthy.You can protect your own and your baby's health by taking action right away to manage your blood glucose levels. ","All pregnant women have some insulin resistance during late pregnancy.If a woman cannot produce enough insulin to offset the resistance, she develops gestational diabetes.The high levels of glucose in the blood caused by this condition are not good for the baby.To protect the baby's health, the blood glucose levels have to be managed immediately.","During pregnancy, your body makes special hormones and goes through other changes, such as weight gain.Because of these changes, your body's cells don't use insulin well, a condition called insulin resistance.All pregnant women have some insulin resistance during late pregnancy.Most pregnant women can produce enough insulin to overcome insulin resistance, but some cannot.These women develop gestational diabetes Too much glucose in your blood is not good for you or your baby.Gestational diabetes is usually diagnosed in the 24th to 28th week of pregnancy.Managing your gestational diabetes can help you and your baby stay healthy.You can protect your own and your baby's health by taking action right away to manage your blood glucose levels." 143,Do side effects of metoprolol include coughing and choking?,"Metoprolol may cause side effects.Tell your doctor if any of these symptoms are severe or do not go away: - dizziness or lightheadedness - tiredness - depression - nausea - dry mouth - stomach pain - vomiting - gas or bloating - heartburn - constipation - rash or itching - cold hands and feet - runny nose Some side effects can be serious.The following symptoms are uncommon, but if you experience any of them, call your doctor immediately: - shortness of breath - wheezing - swelling of the hands, feet, ankles, or lower legs - weight gain - fainting - rapid, pounding, or irregular heartbeat Metoprolol 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).

Summary

Most of the time, medicines make our lives better.They reduce aches and pains, fight infections, and control problems such as high blood pressure or diabetes.But medicines can also cause unwanted reactions.One problem is interactions, which may occur between Two drugs, such as aspirin and blood thinners Drugs and food, such as statins and grapefruit Drugs and supplements, such as ginkgo and blood thinners Drugs and diseases, such as aspirin and peptic ulcers Interactions can change the actions of one or both drugs.The drugs might not work, or you could get side effects.Side effects are unwanted effects caused by the drugs.Most are mild, such as a stomach aches or drowsiness, and go away after you stop taking the drug.Others can be more serious.Drug allergies are another type of reaction.They can be mild or life-threatening.Skin reactions, such as hives and rashes, are the most common type.Anaphylaxis, a serious allergic reaction, is more rare.When you start a new prescription or over-the-counter medication, make sure you understand how to take it correctly.Know which other medications and foods you need to avoid.Ask your health care provider or pharmacist if you have questions. ","Side effects and drug allergies are unwanted reactions to taking drugs.Some of the reactions, e.g., anaphylaxis, are uncommon but could be life-threatening. Metoprolol may cause serious side effects.You have to call your doctor if you experience shortness of breath, wheezing, fainting or rapid, pounding, or irregular heartbeat.","Side effects are unwanted effects caused by the drugs.Most are mild, such as a stomach aches or drowsiness, and go away after you stop taking the drug.Others can be more serious.Drug allergies are another type of reaction.They can be mild or life-threatening.Skin reactions, such as hives and rashes, are the most common type.Anaphylaxis, a serious allergic reaction, is more rare. Metoprolol may cause side effects.The following symptoms are uncommon, but if you experience any of them, call your doctor immediately: - shortness of breath - wheezing - swelling of the hands, feet, ankles, or lower legs - weight gain - fainting - rapid, pounding, or irregular heartbeat Metoprolol may cause other side effects.Call your doctor if you have any unusual problems while taking this medication." 144,What happens in lactic acidosis?,"The main treatment for lactic acidosis is to correct the medical problem that causes the condition. Lactic acidosis refers to lactic acid build up in the bloodstream.Lactic acid is produced when oxygen levels, become low in cells within the areas of the body where metabolism takes place. The most common cause of lactic acidosis is severe medical illness in which blood pressure is low and too little oxygen is reaching the bodys tissues.Intense exercise or convulsions can cause temporary cause lactic acidosis.Certain diseases can also cause the condition including: AIDS Alcoholism Cancer Cirrhosis Cyanide poisoning Kidney failure Respiratory failure Sepsis (severe infection)Some medicines can rarely cause lactic acidosis:Certain inhalers used to treat asthma or COPD Epinephrine An antibiotic called linezolid Metformin, used to treat diabetes (most often when overdosed) One type of medicine used to treat HIV infection Propofol ","Lactic acid builds up in the body when the blood pressure is low and cells do not have enough oxygen for metabolism.Accumulation of lactic acid in the bloodstream causes lactic acidosis.Intense exercise or convulsions can cause temporary lactic acidosis.Other causes include AIDS, alcoholism, cancer, cirrhosis, cyanide poisoning, kidney failure, respiratory failure, and sepsis.Some medications, e.g. Metformin, which is used to treat diabetes, could cause lactic acidosis.Lactic acidosis is treated by addressing the condition that caused it.","Lactic acidosis refers to lactic acid build up in the bloodstream.Lactic acid is produced when oxygen levels, become low in cells within the areas of the body where metabolism takes place.The most common cause of lactic acidosis is severe medical illness.Intense exercise or convulsions can cause temporary cause lactic acidosis.Certain diseases can also cause the condition including: AIDS Alcoholism Cancer Cirrhosis Cyanide poisoning Kidney failure Respiratory failure Sepsis (severe infection)Some medicines can rarely cause lactic acidosis:Certain inhalers used to treat asthma or COPD Epinephrine An antibiotic called linezolid Metformin, used to treat diabetes (most often when overdosed) One type of medicine used to treat HIV infection Propofol The main treatment for lactic acidosis is to correct the medical problem that causes the condition." 145,how does enterohepatic circulation of bile affect cholesterol levels?,"

Summary

What is cholesterol?

Cholesterol is a waxy, fat-like substance that's found in all the cells in your body.Your liver makes cholesterol, and it is also in some foods, such as meat and dairy products.Your body needs some cholesterol to work properly.But if you have too much cholesterol in your blood, you have a higher risk of coronary artery disease.

How do you measure cholesterol levels?

A blood test called a lipoprotein panel can measure your cholesterol levels.Before the test, you'll need to fast (not eat or drink anything but water) for 9 to 12 hours.The test gives information about your Total cholesterol - a measure of the total amount of cholesterol in your blood.It includes both low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol.LDL (bad) cholesterol - the main source of cholesterol buildup and blockage in the arteries HDL (good) cholesterol - HDL helps remove cholesterol from your arteries Non-HDL - this number is your total cholesterol minus your HDL.Your non-HDL includes LDL and other types of cholesterol such as VLDL (very-low-density lipoprotein).Triglycerides - another form of fat in your blood that can raise your risk for heart disease, especially in women

What do my cholesterol numbers mean?

Cholesterol numbers are measured in milligrams per deciliter (mg/dL).Here are the healthy levels of cholesterol, based on your age and gender: Anyone age 19 or younger: Type of Cholesterol Healthy Level Total Cholesterol Less than 170mg/dL Non-HDL Less than 120mg/dL LDL Less than 100mg/dL HDL More than 45mg/dL Men age 20 or older: Type of Cholesterol Healthy Level Total Cholesterol 125 to 200mg/dL Non-HDL Less than 130mg/dL LDL Less than 100mg/dL HDL 40mg/dL or higher Women age 20 or older: Type of Cholesterol Healthy Level Total Cholesterol 125 to 200mg/dL Non-HDL Less than 130mg/dL LDL Less than 100mg/dL HDL 50mg/dL or higher Triglycerides are not a type of cholesterol, but they are part of a lipoprotein panel (the test that measures cholesterol levels).A normal triglyceride level is below 150 mg/dL.You might need treatment if you have triglyceride levels that are borderline high (150-199 mg/dL) or high (200 mg/dL or more).

How often should I get a cholesterol test?

When and how often you should get a cholesterol test depends on your age, risk factors, and family history.The general recommendations are: For people who are age 19 or younger:The first test should be between ages 9 to 11 Children should have the test again every 5 years Some children may have this test starting at age 2 if there is a family history of high blood cholesterol, heart attack, or stroke For people who are age 20 or older: Younger adults should have the test every 5 years Men ages 45 to 65 and women ages 55 to 65 should have it every 1 to 2 years

What affects my cholesterol levels?

A variety of things can affect cholesterol levels.These are some things you can do to lower your cholesterol levels:Diet.Saturated fat and cholesterol in the food you eat make your blood cholesterol level rise.Saturated fat is the main problem, but cholesterol in foods also matters.Reducing the amount of saturated fat in your diet helps lower your blood cholesterol level.Foods that have high levels of saturated fats include some meats, dairy products, chocolate, baked goods, and deep-fried and processed foods.Weight.Being overweight is a risk factor for heart disease.It also tends to increase your cholesterol.Losing weight can help lower your LDL (bad) cholesterol, total cholesterol, and triglyceride levels.It also raises your HDL (good) cholesterol level.Physical Activity.Not being physically active is a risk factor for heart disease.Regular physical activity can help lower LDL (bad) cholesterol and raise HDL (good) cholesterol levels.It also helps you lose weight.You should try to be physically active for 30 minutes on most, if not all, days.Smoking.Cigarette smoking lowers your HDL (good) cholesterol.HDL helps to remove bad cholesterol from your arteries.So a lower HDL can contribute to a higher level of bad cholesterol.Things outside of your control that can also affect cholesterol levels include: Age and Gender.As women and men get older, their cholesterol levels rise.Before the age of menopause, women have lower total cholesterol levels than men of the same age.After the age of menopause, women's LDL (bad) cholesterol levels tend to rise.Heredity.Your genes partly determine how much cholesterol your body makes.High blood cholesterol can run in families.Race.Certain races may have an increased risk of high blood cholesterol.For example, African Americans typically have higher HDL and LDL cholesterol levels than whites.

How can I lower my cholesterol?

There are two main ways to lower your cholesterol: Heart-healthy lifestyle changes, which include:
    Heart-healthy eating.A heart-healthy eating plan limits the amount of saturated and trans fats that you eat.Examples include the Therapeutic Lifestyle Changes diet and the DASH Eating Plan.Weight Management.If you are overweight, losing weight can help lower your LDL (bad) cholesterol.Physical Activity.Everyone should get regular physical activity (30 minutes on most, if not all, days).Managing stress.Research has shown that chronic stress can sometimes raise your LDL cholesterol and lower your HDL cholesterol.Quitting smoking.Quitting smoking can raise your HDL cholesterol.Since HDL helps to remove LDL cholesterol from your arteries, having more HDL can help to lower your LDL cholesterol.
  • Drug Treatment.If lifestyle changes alone do not lower your cholesterol enough, you may also need to take medicines.There are several types of cholesterol medicines available, including statins.The medicines work in different ways and can have different side effects.Talk to your health care provider about which one is right for you.While you are taking medicines to lower your cholesterol, you should continue with the lifestyle changes.
NIH: National Heart, Lung, and Blood Institute

Summary

What is cholesterol?

Your body needs some cholesterol to work properly.But if you have too much in your blood, it can stick to the walls of your arteries and narrow or even block them.This puts you at risk for coronary artery disease and other heart diseases.Cholesterol travels through the blood on proteins called lipoproteins.One type, LDL, is sometimes called the ""bad"" cholesterol.A high LDL level leads to a buildup of cholesterol in your arteries.Another type, HDL, is sometimes called the ""good"" cholesterol.It carries cholesterol from other parts of your body back to your liver.Then your liver removes the cholesterol from your body.

What are the treatments for high cholesterol?

If you have high cholesterol, lifestyle changes can help you to lower your cholesterol level.But sometimes the lifestyle changes are not enough, and you need to take cholesterol medicines.You should still continue with the lifestyle changes even though you are taking medicines.

Who needs cholesterol medicines?

Your health care provider may prescribe medicine if: You have already had a heart attack or stroke, or you have peripheral arterial disease Your LDL (bad) cholesterol level is 190 mg/dL or higher You are 40-75 years old, you have diabetes, and your LDL cholesterol level is 70 mg/dL or higher You are 40-75 years old, you have a high risk of developing heart disease or stroke, and your LDL cholesterol level is 70 mg/dL or higher

What are the different types of medicines for cholesterol?

There are several types of cholesterol-lowering drugs available, including Statins, which block the liver from making cholesterol Bile acid sequestrants, which decrease the amount of fat absorbed from food Cholesterol absorption inhibitors, which decrease the amount of cholesterol absorbed from food and lower triglycerides.Nicotinic acid (niacin), which lowers LDL (bad) cholesterol and triglycerides and raises HDL (good) cholesterol.Even though you can buy niacin without a prescription, you should talk to your health care provider before taking it to lower your cholesterol.High doses of niacin can cause serious side effects.PCSK9 inhibitors, which block a protein called PCSK9.This helps your liver remove and clear LDL cholesterol from your blood.Fibrates, which lower triglycerides.They may also raise HDL (good) cholesterol.If you take them with statins, they may increase the risk of muscle problems.Combination medicines, which include more than one type of cholesterol-lowering medicine There are also a few other cholesterol medicines (lomitapide and mipomersen) that are only for people who have familial hypercholesterolemia (FH).FH is an inherited disorder that causes high LDL cholesterol.

How does my health care provider decide which cholesterol medicine I should take?

When deciding which medicine you should take and which dose you need, your health care provider will consider Your cholesterol levels Your risk for heart disease and stroke Your age Any other health problems you have Possible side effects of the medicines.Higher doses are more likely to cause side effects, especially over time.Medicines can help control your cholesterol, but they don't cure it.You need to keep taking your medicines and get regular cholesterol checks to make sure that you cholesterol levels are in a healthy range. ","Liver and bile effect cholesterol levels.Liver makes cholesterol, whereas bile acids are needed to absorb fat from blood.If the food contains saturated fat and cholesterol, blood cholesterol levels rise.To lower cholesterol levels, your doctor may prescribe statins that block the liver from making cholesterol or bile acid sequestrants that decrease the absorption of fats from food.","A variety of things can affect cholesterol levelsThere are several types of cholesterol-lowering drugs available, including Statins, which block the liver from making cholesterol Saturated fat and cholesterol in the food you eat make your blood cholesterol level rise.Saturated fat is the main problem, but cholesterol in foods also matters.Bile acid sequestrants decrease the amount of fat absorbed from food" 148,What happens if you ignore a heart attack?,"Blood Flow to the Heart Is Blocked The heart works 24 hours a day, pumping oxygen and nutrient-rich blood to the body.Blood is supplied to the heart through its coronary arteries.If a blood clot suddenly blocks a coronary artery, it cuts off most or all blood supply to the heart, and a heart attack results.If blood flow isn't restored quickly, the section of heart muscle begins to die.The more time that passes without treatment to restore blood flow, the greater the damage to the heart.Affects Both Men and Women Heart attacks are a leading killer of both men and women in the United States.Each year, more than one million people in the U.S. have a heart attack and about half of them die.Half of those who die do so within one hour of the start of symptoms and before reaching the hospital.The good news is that excellent treatments are available for heart attacks.These treatments can save lives and prevent disabilities.Prompt Treatment Is Important Heart attack treatment works best when it's given right after symptoms occur.Prompt treatment of a heart attack can help prevent or limit damage to the heart and prevent sudden death.Call 9-1-1 Right Away A heart attack is an emergency.Call 9-1-1 for an ambulance right away -- within 5 minutes -- if you think you or someone else may be having a heart attack.You also should call for help if your chest pain doesn't go away as it usually does when you take medicine prescribed for angina (chest pain).Do not drive to the hospital or let someone else drive you.Emergency personnel in the ambulance can begin life-saving treatment on the way to the emergency room.They carry drugs and equipment that can help your medical condition, including - oxygen - aspirin to prevent further blood clotting - heart medications, such as nitroglycerin - pain relief treatments - defibrillators that can restart the heart if it stops beating.oxygen aspirin to prevent further blood clotting heart medications, such as nitroglycerin pain relief treatments defibrillators that can restart the heart if it stops beating.If blood flow in the blocked artery can be restored quickly, permanent heart damage may be prevented.Yet, many people do not seek medical care for 2 hours or more after symptoms start. A heart attack is when blood flow to part of your heart is suddenly blocked and some of your heart muscle dies.Doctors use the term myocardial infarction to refer to a heart attack.Myocardium is a word for heart muscle, and infarction is a word for blocked blood flow.So a myocardial infarction is a heart attack.Go to an emergency department and chew on an aspirin tablet if you think you're having a heart attack You may have chest pressure, shortness of breath, and a tired feeling if you're having a heart problem Sometimes a heart attack may cause mild symptoms or none at all (silent heart attack)Doctors do blood tests and ECG/EKG if you have symptoms of a heart attack Doctors will give you medicine and do procedures to try to get more blood to the affected area of your heart Having a heart attack increases your chances of having another one.Therefore, it is very important that you and your family know how and when to seek medical attention.Talk to your doctor about making an emergency action plan, and discuss it with your family.The emergency action plan should include - warning signs or symptoms of a heart attack - instructions for accessing emergency medical services in your community, including calling 9-1-1 - steps you can take while waiting for medical help to arrive, such as taking aspirin and nitroglycerin - important information to take along with you to the hospital, such as a list of medications that you take or that you are allergic to, and name and number of whom you should contact if you go to the hospital.warning signs or symptoms of a heart attack instructions for accessing emergency medical services in your community, including calling 9-1-1 steps you can take while waiting for medical help to arrive, such as taking aspirin and nitroglycerin important information to take along with you to the hospital, such as a list of medications that you take or that you are allergic to, and name and number of whom you should contact if you go to the hospital. Angina is a recurring pain or discomfort in the chest that happens when some part of the heart does not receive enough blood.An episode of angina is not a heart attack.However, people with angina may have a hard time telling the difference between angina and heart attack symptoms.Angina is chest pain or discomfort that occurs when your heart muscle does not get enough blood.Angina may feel like pressure or a squeezing pain in your chest.The pain may also occur in your shoulders, arms, neck, jaw, or back.It may also feel like indigestion.It is usually relieved within a few minutes by resting or by taking prescribed angina medicine. ","Heart attack occurs when the blood supply to a section of the heart muscle is blocked.If the blood flow is not restored with treatment, this part of the heart muscle begins to die and more damage occurs over time.People who had a heart attack, may have another one.Sometimes the symptoms of heart attack are mild, and sometimes angina symptoms can be confused with heart attack.Angina is chest pain or discomfort caused by insufficient blood supply to the heart.It can be relieved with rest or angina medications.","If a blood clot suddenly blocks a coronary artery, it cuts off most or all blood supply to the heart, and a heart attack results.If blood flow isn't restored quickly, the section of heart muscle begins to die.The more time that passes without treatment to restore blood flow, the greater the damage to the heart.Having a heart attack increases your chances of having another one.Therefore, it is very important that you and your family know how and when to seek medical attention.Sometimes a heart attack may cause mild symptoms or none at all (silent heart attack) people with angina may have a hard time telling the difference between angina and heart attack symptoms.Angina is chest pain or discomfort that occurs when your heart muscle does not get enough blood.Angina may feel like pressure or a squeezing pain in your chest.The pain may also occur in your shoulders, arms, neck, jaw, or back.It may also feel like indigestion.It is usually relieved within a few minutes by resting or by taking prescribed angina medicine." 151,What are nutritional considerations for vegetarian athletes?,"DIETARY TIPS FOR VEGETARIANSWhen following a vegetarian diet, keep in mind the following: Eat different kinds of foods, including vegetables, fruits, beans, nuts, seeds, whole grains, and low-fat or fat-free dairy and eggs if your diet includes these.Choose fortified foods, such as cereals, breads, soy or almond milk, and fruits juices to get a full range of nutrients.Limit foods that are high in sugar, salt (sodium), and fat.Include a protein source with all meals.If needed, take supplements if your diet lacks certain vitamins and minerals.Learn to read the Nutrition Facts Label on food packages.The label tells you the ingredients and nutrition contents of the food product.If you follow a more restrictive diet, you may want to work with a dietitian to make sure you are getting enough nutrients. A vegetarian diet does not include any meat, poultry, or seafood.It is a meal plan made up of foods that come mostly from plants.These include: Vegetables Fruits Whole grains Legumes Seeds Nuts May include eggs and/or milk if ovo-lacto vegetarianA vegetarian diet contains no animal proteins.A semi-vegetarian diet is a meal plan that contains little animal protein, but mostly plant-based foods.Vegetarians DO NOT eat: Fowl Seafood Beef Pork Lamb Other animal meats, such as bison, or exotic meats like ostrich or alligator Vegetarians also do not eat products containing gelatin or rennin (an enzyme found in calf's stomachs that is used to produce many cheeses).Here are the different types of vegetarian diets: Vegan: Includes only plant-based foods.No animal proteins or animal by-products such as eggs, milk, or honey.Lacto-vegetarian: Includes plant foods plus some or all dairy products.Lacto-ovo vegetarian: Includes plant foods, dairy products, and eggs.Semi- or partial vegetarian: Includes plant foods and may include chicken or fish, dairy products, and eggs.It does not include red meat.Pescatarian: Includes plant foods and seafood.

Summary

A vegetarian diet focuses on plants for food.These include fruits, vegetables, dried beans and peas, grains, seeds and nuts.There is no single type of vegetarian diet.Instead, vegetarian eating patterns usually fall into the following groups:The vegan diet, which excludes all meat and animal products The lacto vegetarian diet, which includes plant foods plus dairy products The lacto-ovo vegetarian diet, which includes both dairy products and eggs People who follow vegetarian diets can get all the nutrients they need.However, they must be careful to eat a wide variety of foods to meet their nutritional needs.Nutrients vegetarians may need to focus on include protein, iron, calcium, zinc and vitamin B12.United States Department of Agriculture ","Proteins in a vegetarian diet come mostly from plants.It is important to eat different foods such as vegetables, fruits, beans, nuts, seeds, whole grains, and, for some people, dairy and eggs.Fortified cereals, breads, soy or almond milk, and fruit juices are recommended to get the necessary nutrients. Foods containing large amounts of sugar and salt are not recommended.Proteins should be included with every meal.You might also need supplements, e.g., iron, calcium, zinc and vitamin B12. Consult a dietitian to make sure you are getting enough nutrients.","A vegetarian diet does not include any meat, poultry, or seafood.It is a meal plan made up of foods that come mostly from plants.A vegetarian diet contains no animal proteins. When following a vegetarian diet, keep in mind the following: Eat different kinds of foods, including vegetables, fruits, beans, nuts, seeds, whole grains, and low-fat or fat-free dairy and eggs if your diet includes these.Choose fortified foods, such as cereals, breads, soy or almond milk, and fruits juices to get a full range of nutrients.Limit foods that are high in sugar, salt (sodium), and fat.Include a protein source with all meals.If needed, take supplements if your diet lacks certain vitamins and minerals.Learn to read the Nutrition Facts Label on food packages.The label tells you the ingredients and nutrition contents of the food product.If you follow a more restrictive diet, you may want to work with a dietitian to make sure you are getting enough nutrients.People who follow vegetarian diets can get all the nutrients they need.However, they must be careful to eat a wide variety of foods to meet their nutritional needs.Nutrients vegetarians may need to focus on include protein, iron, calcium, zinc and vitamin B12." 152,What are the symptoms of cri-du-chat syndrome?,"Symptoms of cri-du-chat syndrome often include a characteristic high-pitched, mewing cry that sounds like a kitten crying.This cry may be heard immediately after birth, lasts several weeks, and then disappears.However, not all affected newborns have this distinct cry.An infant with this syndrome may have a low birth weight and a small head with many abnormal features, including a round face, small jaw, wide nose, widely separated eyes, crossed eyes (strabismus), and abnormally shaped ears set low in the head.Often the infant seems limp.Webbed fingers and toes (syndactyly) and heart defects are common.There are significant limitations in mental and physical development.Many children with cri du chat syndrome survive to adulthood but have substantial disabilities. Most cases of cri-du-chat syndrome are not inherited.The deletion occurs most often as a random event during the formation of reproductive cells (eggs or sperm) or in early fetal development.Affected people typically have no history of the disorder in their family.About 10 percent of people with cri-du-chat syndrome inherit the chromosome abnormality from an unaffected parent.In these cases, the parent carries a chromosomal rearrangement called a balanced translocation, in which no genetic material is gained or lost.Balanced translocations usually do not cause any health problems; however, they can become unbalanced as they are passed to the next generation.Children who inherit an unbalanced translocation can have a chromosomal rearrangement with extra or missing genetic material.Individuals with cri-du-chat syndrome who inherit an unbalanced translocation are missing genetic material from the short arm of chromosome 5, which results in the intellectual disability and health problems characteristic of this disorder. Cri du chat syndrome is rare.It is caused by a missing piece of chromosome 5.Most cases are believed to occur during the development of the egg or sperm.A small number of cases occur when a parent passes a different, rearranged form of the chromosome to their child. ","Cri-du-chat syndrome could be inherited or caused by a random mutation that results in the intellectual disability and health problems.The syndrome is called cri-du-chat because one of the symptoms is a characteristic high-pitched, mewing cry that sounds like a kitten crying.This cry starts after birth and lasts several weeks before disappearing.The symptoms also include a low birth weight and a small head with a round face, small jaw, wide nose, widely separated eyes, crossed eyes, and abnormally shaped ears set low in the head.The infant may seem limp and have webbed fingers and toes and heart defects.","Affected people typically have no history of the disorder in their family. Individuals with cri-du-chat syndrome who inherit an unbalanced translocation are missing genetic material from the short arm of chromosome 5, which results in the intellectual disability and health problems characteristic of this disorder.Symptoms of cri-du-chat syndrome often include a characteristic high-pitched, mewing cry that sounds like a kitten crying.This cry may be heard immediately after birth, lasts several weeks, and then disappears.However, not all affected newborns have this distinct cry.An infant with this syndrome may have a low birth weight and a small head with many abnormal features, including a round face, small jaw, wide nose, widely separated eyes, crossed eyes (strabismus), and abnormally shaped ears set low in the head.Often the infant seems limp.Webbed fingers and toes (syndactyly) and heart defects are common.There are significant limitations in mental and physical development.Many children with cri du chat syndrome survive to adulthood but have substantial disabilities." 153,What are the symptoms of Waldenstrom macroglobulinemia?,"Waldenstrom macroglobulinemia is a chronic, slow-growing lymphoproliferative disorder.[1] It usually affects older adults and is primarily found in the bone marrow, although lymph nodes and the spleen may be involved.Affected individuals have a high level of an antibody called immunoglobulin M (IgM) in their blood, which can cause thickening of the blood (hyperviscosity).[2] Although some individuals initially do not have symptoms and are diagnosed from routine blood work, common symptoms may include weakness, appetite loss and weight loss.Other symptoms may include peripheral neuropathy , fever, Raynaud's phenomenon, and mental status changes.[1] Hyperviscosity of the blood may cause nosebleeds, headaches, dizziness, and blurring or loss of vision.[2] The cause of the condition is not known but environmental, genetic, and viral factors have been suggested.There have been some reports of familial cases suggesting a genetic predisposition .Treatment is often reserved for those with symptoms and may include various medications including corticosteroids , alkylating agents, biologic response modifiers and purine analogues.[1] For individuals who do not have any symptoms, doctors may decide to ""watch and wait"" and not treat the disease right away.This can last many years for some individuals.For individuals requiring treatment, the type and severity of symptoms present, aggressiveness of the disease, and age all play a role in the type of therapy chosen.[2][1]Some affected individuals have a procedure called plasmapheresis, to reverse or prevent the symptoms associated with the thickening of the blood (hyperviscosity).This involves removing the blood, passing it through a machine that removes the part of the blood with the IgM antibody , and returning the blood to the body.This may be combined with other treatments such as various types of chemotherapy .Many different drugs can be used to manage this condition, both alone and/or in various combinations.For many individuals, there is a delayed response to treatment and the best response sometimes occurs several months after the treatment ends.Although the condition is not curable, many individuals do have a long-term response to treatment.Those who relapse after treatment or do not respond to initial treatment may consider secondary therapies.There are also several new drugs and drug combinations that are being studied in clinical trials.[2] More detailed information about the specific medications used to treat Waldenstrom macroglobulinemia can be viewed on Medscape Reference's Web site. Waldenstrm macroglobulinemia is thought to result from a combination of genetic changes.The most common known genetic change associated with this condition is a mutation in the MYD88 gene, which is found in more than 90 percent of affected individuals.Another gene commonly associated with Waldenstrm macroglobulinemia, CXCR4, is mutated in approximately 30 percent of affected individuals (most of whom also have the MYD88 gene mutation).Other genetic changes believed to be involved in Waldenstrm macroglobulinemia have not yet been identified.Studies have found that certain regions of DNA are deleted or added in some people with the condition; however, researchers are unsure which genes in these regions are important for development of the condition.The mutations that cause Waldenstrm macroglobulinemia are acquired during a person's lifetime and are present only in the abnormal blood cells.The proteins produced from the MYD88 and CXCR4 genes are both involved in signaling within cells.The MyD88 protein relays signals that help prevent the self-destruction (apoptosis) of cells, thus aiding in cell survival.The CXCR4 protein stimulates signaling pathways inside the cell that help regulate cell growth and division (proliferation) and cell survival.Mutations in these genes lead to production of proteins that are constantly functioning (overactive).Excessive signaling through these overactive proteins allows survival and proliferation of abnormal cells that should undergo apoptosis, which likely contributes to the accumulation of lymphoplasmacytic cells in Waldenstrm macroglobulinemia. Waldenstrm macroglobulinemia is a rare blood cell cancer characterized by an excess of abnormal white blood cells called lymphoplasmacytic cells in the bone marrow.This condition is classified as a lymphoplasmacytic lymphoma.The abnormal cells have characteristics of both white blood cells (lymphocytes) called B cells and of more mature cells derived from B cells known as plasma cells.These abnormal cells produce excess amounts of IgM, a type of protein known as an immunoglobulin; the overproduction of this large protein is how the condition got its name (""macroglobulinemia"").Waldenstrm macroglobulinemia usually begins in a person's sixties and is a slow-growing (indolent) cancer.Some affected individuals have elevated levels of IgM and lymphoplasmacytic cells but no symptoms of the condition; in these cases, the disease is usually found incidentally by a blood test taken for another reason.These individuals are diagnosed with smoldering (or asymptomatic) Waldenstrm macroglobulinemia.It can be several years before this form of the condition progresses to the symptomatic form.Individuals with symptomatic Waldenstrm macroglobulinemia can experience general symptoms such as fever, night sweats, and weight loss.Several other signs and symptoms of the condition are related to the excess IgM, which can thicken blood and impair circulation, causing a condition known as hyperviscosity syndrome.Features related to hyperviscosity syndrome include bleeding in the nose or mouth, blurring or loss of vision, headache, dizziness, and difficulty coordinating movements (ataxia).In some affected individuals, the IgM proteins clump together in the hands and feet, where the body temperature is cooler than at the center of the body.These proteins are then referred to as cryoglobulins, and their clumping causes a condition known as cryoglobulinemia.Cryoglobulinemia can lead to pain in the hands and feet or episodes of Raynaud phenomenon, in which the fingers and toes turn white or blue in response to cold temperatures.The IgM protein can also build up in organs such as the heart and kidneys, causing a condition called amyloidosis, which can lead to heart and kidney problems.Some people with Waldenstrm macroglobulinemia develop a loss of sensation and weakness in the limbs (peripheral neuropathy).Doctors are unsure why this feature occurs, although they speculate that the IgM protein attaches to the protective covering of nerve cells (myelin) and breaks it down.The damaged nerves cannot carry signals normally, leading to neuropathy.Other features of Waldenstrm macroglobulinemia are due to the accumulation of lymphoplasmacytic cells in different tissues.For example, accumulation of these cells can lead to an enlarged liver (hepatomegaly), spleen (splenomegaly), or lymph nodes (lymphadenopathy).In the bone marrow, the lymphoplasmacytic cells interfere with normal blood cell development, causing a shortage of normal blood cells (pancytopenia).Excessive tiredness (fatigue) due to a reduction in red blood cells (anemia) is common in affected individuals.People with Waldenstrm macroglobulinemia have an increased risk of developing other cancers of the blood or other tissues. Symptoms may include any of the following: - Bleeding of the gums - Blurred or decreased vision - Bluish skin - Dizziness - Easy bruising of the skin - Fatigue - Flank pain - Headache - Mental status changes - Nosebleeds - Numbness, tingling, or burning pain in the hands, feet, fingers, toes, ears, or nose - Rash - Swollen glands - Unintentional weight loss - Vision loss in one eye Blood tests Additional laboratory tests Blood tests are done when macroglobulinemia is suspected.The three most useful tests are serum protein electrophoresis, measurement of immunoglobulins, and immunoelectrophoresis (a process by which proteins are separated out from plasma and identified based on the detectable immunologic reactions they produce).The occurrence of specific mutations in a specific gene, MYD88, commonly occur among patients with macroglobulinemia.Doctors may do other laboratory tests as well.For example, doctors may check a blood sample to determine if the numbers of red and white blood cells and platelets are normal.In addition, serum viscosity, which is a test to check the thickness of the blood, is often done.Blood clotting test results may be abnormal, and other tests may detect cryoglobulins.An examination of a urine sample may show Bence Jones proteins (pieces of abnormal antibodies).A bone marrow biopsy may reveal an increased number of lymphocytes and plasma cells, which helps confirm the diagnosis of macroglobulinemia, and the appearance of these cells helps differentiate this disorder from multiple myeloma.X-rays may show a loss of bone density (osteoporosis).Computed tomography (CT) may reveal an enlarged spleen, liver, or lymph nodes. Many people who have macroglobulinemia have no symptoms, and the disorder is discovered by chance when an elevated level of blood proteins is found during routine blood tests.Other people have symptoms resulting from interference with blood flow to the skin, fingers, toes, nose, and brain that occurs when the large quantity of macroglobulins thickens the blood (hyperviscosity syndrome).These symptoms include bleeding from the skin and mucous membranes (such as the lining of the mouth, nose, and digestive tract), fatigue, weakness, headache, confusion, dizziness, and even coma.The thickened blood also may worsen heart conditions and cause increased pressure in the brain.Tiny blood vessels in the back of the eyes can become filled with blood and may bleed, resulting in damage to the retina and impaired eyesight.People who have macroglobulinemia may also have swollen lymph nodes and an enlarged liver and spleen due to infiltration by cancerous plasma cells.Recurring bacterial infections resulting from inadequate production of normal antibodies may cause fever and chills.Anemia, which may result in weakness and fatigue, occurs when cancerous plasma cells prevent production of normal blood-forming cells in the bone marrow.Infiltration of bones by cancerous plasma cells may cause loss of bone density (osteoporosis), which can weaken bones and increase the risk of fractures.Some people develop a condition called cryoglobulinemia.Cryoglobulinemia involves the development of antibodies that clog up the blood vessels in cold temperatures.What Is Cryoglobulinemia?Cryoglobulins are abnormal antibodies produced by plasma cells and dissolved in the blood.When cooled below normal body temperature, cryoglobulins form large collections of solid particles (precipitates).When warmed to normal body temperature, they re-dissolve.The formation of cryoglobulins (cryoglobulinemia) is uncommon.In most instances, an underlying disorder causes people to form cryoglobulins.These disorders include cancers such as macroglobulinemia and chronic lymphocytic leukemia, autoimmune disorders such as systemic lupus erythematosus (lupus), and infections by such organisms as hepatitis C virus.Rarely, a cause for the formation of cryoglobulins cannot be found.Precipitates of cryoglobulins can trigger inflammation of blood vessels (vasculitis), which causes various symptoms, such as bruises, joint aches, and weakness.The vasculitis may damage the liver and kidneys.In some people, the damage may progress to liver failure and kidney failure and can be fatal.People with cryoglobulinemia may also be very sensitive to cold or develop Raynaud syndrome, in which the hands and feet become very painful and turn white when chilled.Avoiding cold temperatures helps prevent vasculitis.Treating the underlying disorder may reduce the formation of cryoglobulins.For example, using interferon alpha to treat hepatitis C virus infection helps reduce formation of cryoglobulins.Removal of a large amount of plasma (the liquid part of blood) plus plasma transfusions (plasma exchange) may help, especially when combined with interferon. ","Waldenstrom macroglobulinemia is a chronic disorder.that usually affects older adults. Sometimes there are no symptoms.Some of the symptoms related to thickening of the blood (hyperviscosity).are caused by high levels of immunoglobulin M (IgM) in the blood.Hyperviscosity of the blood may cause nosebleeds, headaches, dizziness, and blurring or loss of vision.Other common symptoms include weakness, appetite loss, weight loss, peripheral neuropathy, fever, Raynaud's phenomenon, and mental status changes.Other symptoms of Waldenstrm macroglobulinemia are caused by accumulation of lymphoplasmacytic cells in different tissues, which can lead to an enlarged liver (hepatomegaly), spleen (splenomegaly), or lymph nodes (lymphadenopathy), shortage of normal blood cells (pancytopenia) and reduction in red blood cells (anemia).","Waldenstrm macroglobulinemia usually begins in a person's sixties.Some affected individuals have elevated levels of IgM and lymphoplasmacytic cells but no symptoms.These individuals are diagnosed with smoldering (or asymptomatic) Waldenstrm macroglobulinemia.It can be several years before this form of the condition progresses to the symptomatic form.Individuals with symptomatic Waldenstrm macroglobulinemia can experience general symptoms such as fever, night sweats, and weight loss.Several other signs and symptoms of the condition are related to the excess IgM, which can thicken blood and impair circulation, causing a condition known as hyperviscosity syndrome.Features related to hyperviscosity syndrome include bleeding in the nose or mouth, blurring or loss of vision, headache, dizziness, and difficulty coordinating movements (ataxia).In some affected individuals, the IgM proteins clump together in the hands and feet, where the body temperature is cooler than at the center of the body.These proteins are then referred to as cryoglobulins, and their clumping causes a condition known as cryoglobulinemia.Cryoglobulinemia can lead to pain in the hands and feet or episodes of Raynaud phenomenon, in which the fingers and toes turn white or blue in response to cold temperatures.The IgM protein can also build up in organs such as the heart and kidneys, causing a condition called amyloidosis, which can lead to heart and kidney problems.Some people with Waldenstrm macroglobulinemia develop a loss of sensation and weakness in the limbs (peripheral neuropathy).Other features of Waldenstrm macroglobulinemia are due to the accumulation of lymphoplasmacytic cells in different tissues.For example, accumulation of these cells can lead to an enlarged liver (hepatomegaly), spleen (splenomegaly), or lymph nodes (lymphadenopathy).In the bone marrow, the lymphoplasmacytic cells interfere with normal blood cell development, causing a shortage of normal blood cells (pancytopenia).Excessive tiredness (fatigue) due to a reduction in red blood cells (anemia) is common in affected individuals." 155,How often does dry macular degeneration turn into wet and why?,"Age-related macular degeneration (AMD) is a disease characterized by deterioration or breakdown of the macula, which is responsible for sharp, central vision.In neovascular AMD, also called “wet” AMD, blood vessels begin to grow up from the choroid (the bed of blood vessels below the retina) and into the retina.These new and abnormal blood vessels leak fluid into the macula and cause macular edema. Age-related macular degeneration is an eye disease that is a leading cause of vision loss in older people in developed countries.Subtle abnormalities indicating changes in vision may occur in a person's forties or fifties.Distorted vision and vision loss usually become noticeable in a person's sixties or seventies and tend to worsen over time.Age-related macular degeneration mainly affects central vision, which is needed for detailed tasks such as reading, driving, and recognizing faces.The vision loss in this condition results from a gradual deterioration of light-sensing cells in the tissue at the back of the eye that detects light and color (the retina).Specifically, age-related macular degeneration affects a small area near the center of the retina, called the macula, which is responsible for central vision.Side (peripheral) vision and night vision are generally not affected, but slow adjustment of vision to darkness (dark adaptation) and reduced dim light (scotopic) vision often occur in the early stages of the disease.Researchers have described two major types of age-related macular degeneration, known as the dry form and the wet form.The dry form is much more common, accounting for 85 to 90 percent of all cases of age-related macular degeneration.It is characterized by a buildup of yellowish deposits called drusen beneath the retina and vision loss that worsens slowly over time.The most advanced stage of dry age-related macular degeneration is known as geographic atrophy, in which areas of the macula waste away (atrophy), resulting in severe vision loss.Dry age-related macular degeneration typically affects vision in both eyes, although vision loss often occurs in one eye before the other.In 10 to 15 percent of affected individuals, the dry form progresses to the wet form of age-related macular degeneration.The wet form is characterized by the growth of abnormal, fragile blood vessels underneath the macula.These vessels leak blood and fluid, which damages the macula and makes central vision appear blurry and distorted.The wet form of age-related macular degeneration is associated with severe vision loss that can worsen rapidly.

Summary

Macular degeneration, or age-related macular degeneration (AMD), is a leading cause of vision loss in Americans 60 and older.It is a disease that destroys your sharp, central vision.You need central vision to see objects clearly and to do tasks such as reading and driving.AMD affects the macula, the part of the eye that allows you to see fine detail.It does not hurt, but it causes cells in the macula to die.There are two types: wet and dry.Wet AMD happens when abnormal blood vessels grow under the macula.These new blood vessels often leak blood and fluid.Wet AMD damages the macula quickly.Blurred vision is a common early symptom.Dry AMD happens when the light-sensitive cells in the macula slowly break down.Your gradually lose your central vision.A common early symptom is that straight lines appear crooked.Regular comprehensive eye exams can detect macular degeneration before the disease causes vision loss.Treatment can slow vision loss.It does not restore vision.NIH: National Eye Institute Age-related macular degeneration (AMD) is an eye disease that causes the macula to lose its normal structure (called degeneration).When the macula doesn't work properly, you lose the center part of your vision.The center vision is where you see fine details.AMD is more common in older people In severe cases, it can lead to blindness Certain vitamins may help slow vision loss from AMDSome people need special treatments to slow down vision loss from AMD There are two types of AMD.First you get: Dry AMD, in which cells in the macula die slowly and cause a steady loss of vision After you have had dry AMD for a while, you might get:Wet AMD, in which new abnormal blood vessels grow under the damaged macula and leak blood, causing faster vision loss Viewing the Retina The retina is at the back of the eye.It changes light and images that enter the eye into nerve signals that are sent to the brain.A part of the retina called the macula makes vision sharper and more detailed.It is a yellow spot in the center of the retina.It has a high amount of two natural colors (pigments) called lutein and zeaxanthin.AMD is caused by damage to the blood vessels that supply the macula.This change also harms the macula.There are two types of AMD:Dry AMD occurs when the blood vessels under the macula become thin and brittle.Small yellow deposits, called drusen, form.Almost all people with macular degeneration start with the dry form.Wet AMD occurs in about 10% of people with macular degeneration.New abnormal and very fragile blood vessels grow under the macula.These vessels leak blood and fluid.This type of AMD causes most of the vision loss associated with the condition.Doctors are not sure what causes AMD.The condition is rare before age 55.It occurs most in people 75 years or older.Risk factors for AMD are: Family history of AMD Being White Cigarette smoking High-fat diet Being a woman ","Macular degeneration almost always starts with the dry form.The dry form, which accounts for 85-90% of all cases, occurs due to a deposit of yellowish substance under the retina.In 10-15% of people the dry form progresses to the wet form, which is caused by abnormal fragile blood vessels growing under the macula.These vessels leak blood and fluid causing vision loss.","Researchers have described two major types of age-related macular degeneration, known as the dry form and the wet form.The dry form is much more common, accounting for 85 to 90 percent of all cases of age-related macular degeneration.It is characterized by a buildup of yellowish deposits called drusen beneath the retina and vision loss that worsens slowly over time.The most advanced stage of dry age-related macular degeneration is known as geographic atrophy, in which areas of the macula waste away (atrophy), resulting in severe vision loss.Dry age-related macular degeneration typically affects vision in both eyes, although vision loss often occurs in one eye before the other.Almost all people with macular degeneration start with the dry form.In 10 to 15 percent of affected individuals, the dry form progresses to the wet form of age-related macular degeneration.The wet form is characterized by the growth of abnormal, fragile blood vessels underneath the macula.These vessels leak blood and fluid, which damages the macula and makes central vision appear blurry and distorted.The wet form of age-related macular degeneration is associated with severe vision loss that can worsen rapidly." 158,Why has my ileostomy discharge changed its color to green?,"Call your provider if: Your stoma is swelling and is more than a half inch (1 centimeter) larger than normal.Your stoma is pulling in, below the skin level.Your stoma is bleeding more than normal.Your stoma has turned purple, black, or white.Your stoma is leaking often.Your stoma does not seem to fit as well as it did before.You have a skin rash, or the skin around your stoma is raw.You have a discharge from the stoma that smells bad.Your skin around your stoma is pushing out.You have any kind of sore on the skin around your stoma.You have any signs of being dehydrated (there is not enough water in your body).Some signs are dry mouth, urinating less often, and feeling lightheaded or weak.You have diarrhea that is not going away. Your stoma is made from the lining of your intestine.It will be pink or red, moist, and a little shiny.Stool that comes from your ileostomy is thin or thick liquid, or it may be pasty.It is not solid like the stool that comes from your colon.Foods you eat, medicines you take, and other things may change how thin or thick your stool is.Some amount of gas is normal.You will need to empty the pouch 5 to 8 times a day. Some foods will loosen your stools and can increase output after you eat them.If you believe a certain food has caused a change in your stools, do not eat it for a while, and then try again.These foods may make your stools looser: Milk, fruit juice, and raw fruits and vegetables Prune juice, licorice, large meals, spicy foods, beer, red wine, and chocolate Some foods will make your stool thicker.Some of these are applesauce, baked potatoes, rice, bread, peanut butter, pudding, and baked apples.Drink 8 to 10 glasses of fluid a day.Drink more when it is hot or when you have been very active.If you have diarrhea or your stools are looser or more watery: Drink extra fluids with electrolytes (sodium, potassium).Drinks such as Gatorade, PowerAde, or Pedialyte contain electrolytes.Drinking soda, milk, juice, or tea will help you get enough liquids.Try to eat foods that have potassium and sodium every day to keep your potassium and sodium levels from getting too low.Some examples of foods that contain potassium are bananas.Some high-sodium foods are salted snacks.Pretzels may help reduce water loss in stool.They also have extra sodium.DO NOT wait to get help.Diarrhea can be dangerous.Call your provider if it does not go away. Chew your foods well.This will help keep high-fiber foods from blocking your stoma.Some signs of blockage are sudden cramping in your belly, a swollen stoma, nausea (with or without vomiting), and sudden increase of very watery output.Drinking hot tea and other liquids may flush any foods that are blocking the stoma.There will be times when nothing comes out of your ileostomy for a little while.This is normal.Call your provider right away if your ileostomy bag stays empty longer than 4 to 6 hours.Your intestine may be blocked.DO NOT just take a laxative if this problem happens.Some foods that may block your stoma are raw pineapple, nuts and seeds, celery, popcorn, corn, dried fruits (such as raisins), mushrooms, chunky relishes, coconut, and some Chinese vegetables.Tips for when no stool is coming from your stoma: Try loosening the opening of the pouch if you think it is too tight.Change your position.Try holding your knees up to your chest.Take a warm bath or warm shower. ","Ileostomy stools change depending on the foods you eat.If a certain food causes changes, do not it ir for a while, and then try again.If your discharge smells bad, call you doctor immediately.","Stool that comes from your ileostomy is thin or thick liquid, or it may be pasty.It is not solid like the stool that comes from your colon.Foods you eat, medicines you take, and other things may change how thin or thick your stool is.If you believe a certain food has caused a change in your stools, do not eat it for a while, and then try again.Call your providerif: You have a discharge from the stoma that smells bad." 160,Does too much sugar cause diabetes?,"Diabetes is a disease caused by high levels of blood sugar (glucose) in your body.This can happen when your body does not make insulin or does not use insulin correctly.Insulin is a hormone made in the pancreas, an organ near your stomach.Insulin helps the glucose from food get into your body's cells for energy.If your body does not make enough insulin, or your body does not use the insulin correctly, the glucose stays and builds up in your blood.Over time, this extra glucose can lead to prediabetes or diabetes.Diabetes puts you at risk for other serious and life-threatening health problems, such as heart disease, stroke, blindness, and kidney damage. Insulin is a hormone produced by the pancreas to control blood sugar.Diabetes can be caused by too little insulin, resistance to insulin, or both.To understand diabetes, it is important to first understand the normal process by which food is broken down and used by the body for energy.Several things happen when food is digested and absorbed: A sugar called glucose enters the bloodstream.Glucose is a source of fuel for the body.An organ called the pancreas makes insulin.The role of insulin is to move glucose from the bloodstream into muscle, fat, and other cells, where it can be stored or used as fuel.People with diabetes have high blood sugar because their body cannot move sugar from the blood into muscle and fat cells to be burned or stored for energy, and/or because their liver makes too much glucose and releases it into the blood.This is because either: Their pancreas does not make enough insulin Their cells do not respond to insulin normally Both of the above There are two major types of diabetes.The causes and risk factors are different for each type: Type 1 diabetes is less common.It can occur at any age, but it is most often diagnosed in children, teens, or young adults.In this disease, the body makes little or no insulin.This is because the pancreas cells that make insulin stop working.Daily injections of insulin are needed.The exact cause of the failure to make enough insulin is unknown.Type 2 diabetes is more common.It most often occurs in adulthood, but because of high obesity rates, children and teens are now being diagnosed with this disease.Some people with type 2 diabetes do not know they have it.With type 2 diabetes, the body is resistant to insulin and doesn't use insulin as well as it should.Not all people with type 2 diabetes are overweight or obese.There are other causes of diabetes, and some people cannot be classified as type 1 or type 2.Gestational diabetes is high blood sugar that develops at any time during pregnancy in a woman who does not already have diabetes.If your parent, brother, or sister has diabetes, you may be more likely to develop the disease. Type 1 diabetes is caused by a lack of insulin due to the destruction of insulin-producing beta cells in the pancreas.In type 1 diabetesan autoimmune diseasethe bodys immune system attacks and destroys the beta cells.Normally, the immune system protects the body from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances.But in autoimmune diseases, the immune system attacks the bodys own cells.In type 1 diabetes, beta cell destruction may take place over several years, but symptoms of the disease usually develop over a short period of time.Type 1 diabetes typically occurs in children and young adults, though it can appear at any age.In the past, type 1 diabetes was called juvenile diabetes or insulin-dependent diabetes mellitus.Latent autoimmune diabetes in adults (LADA) may be a slowly developing kind of type 1 diabetes.Diagnosis usually occurs after age 30.In LADA, as in type 1 diabetes, the bodys immune system destroys the beta cells.At the time of diagnosis, people with LADA may still produce their own insulin, but eventually most will need insulin shots or an insulin pump to control blood glucose levels.Genetic Susceptibility Heredity plays an important part in determining who is likely to develop type 1 diabetes.Genes are passed down from biological parent to child.Genes carry instructions for making proteins that are needed for the bodys cells to function.Many genes, as well as interactions among genes, are thought to influence susceptibility to and protection from type 1 diabetes.The key genes may vary in different population groups.Variations in genes that affect more than 1 percent of a population group are called gene variants.Certain gene variants that carry instructions for making proteins called human leukocyte antigens (HLAs) on white blood cells are linked to the risk of developing type 1 diabetes.The proteins produced by HLA genes help determine whether the immune system recognizes a cell as part of the body or as foreign material.Some combinations of HLA gene variants predict that a person will be at higher risk for type 1 diabetes, while other combinations are protective or have no effect on risk.While HLA genes are the major risk genes for type 1 diabetes, many additional risk genes or gene regions have been found.Not only can these genes help identify people at risk for type 1 diabetes, but they also provide important clues to help scientists better understand how the disease develops and identify potential targets for therapy and prevention.Genetic testing can show what types of HLA genes a person carries and can reveal other genes linked to diabetes.However, most genetic testing is done in a research setting and is not yet available to individuals.Scientists are studying how the results of genetic testing can be used to improve type 1 diabetes prevention or treatment.Autoimmune Destruction of Beta Cells In type 1 diabetes, white blood cells called T cells attack and destroy beta cells.The process begins well before diabetes symptoms appear and continues after diagnosis.Often, type 1 diabetes is not diagnosed until most beta cells have already been destroyed.At this point, a person needs daily insulin treatment to survive.Finding ways to modify or stop this autoimmune process and preserve beta cell function is a major focus of current scientific research.Recent research suggests insulin itself may be a key trigger of the immune attack on beta cells.The immune systems of people who are susceptible to developing type 1 diabetes respond to insulin as if it were a foreign substance, or antigen.To combat antigens, the body makes proteins called antibodies.Antibodies to insulin and other proteins produced by beta cells are found in people with type 1 diabetes.Researchers test for these antibodies to help identify people at increased risk of developing the disease.Testing the types and levels of antibodies in the blood can help determine whether a person has type 1 diabetes, LADA, or another type of diabetes.Environmental Factors Environmental factors, such as foods, viruses, and toxins, may play a role in the development of type 1 diabetes, but the exact nature of their role has not been determined.Some theories suggest that environmental factors trigger the autoimmune destruction of beta cells in people with a genetic susceptibility to diabetes.Other theories suggest that environmental factors play an ongoing role in diabetes, even after diagnosis.Viruses and infections.A virus cannot cause diabetes on its own, but people are sometimes diagnosed with type 1 diabetes during or after a viral infection, suggesting a link between the two.Also, the onset of type 1 diabetes occurs more frequently during the winter when viral infections are more common.Viruses possibly associated with type 1 diabetes include coxsackievirus B, cytomegalovirus, adenovirus, rubella, and mumps.Scientists have described several ways these viruses may damage or destroy beta cells or possibly trigger an autoimmune response in susceptible people.For example, anti-islet antibodies have been found in patients with congenital rubella syndrome, and cytomegalovirus has been associated with significant beta cell damage and acute pancreatitisinflammation of the pancreas.Scientists are trying to identify a virus that can cause type 1 diabetes so that a vaccine might be developed to prevent the disease.Infant feeding practices.Some studies have suggested that dietary factors may raise or lower the risk of developing type 1 diabetes.For example, breastfed infants and infants receiving vitamin D supplements may have a reduced risk of developing type 1 diabetes, while early exposure to cows milk and cereal proteins may increase risk.More research is needed to clarify how infant nutrition affects the risk for type 1 diabetes.Read more in the Centers for Disease Control and Preventions (CDCs) publication National Diabetes Statistics Report, 2014 at www.cdc.gov for information about research studies related to type 1 diabetes. Type 1 diabetes can occur at any age.It is most often diagnosed in children, adolescents, or young adults.Insulin is a hormone produced in the pancreas by special cells, called beta cells.The pancreas is below and behind the stomach.Insulin is needed to move blood sugar (glucose) into cells.Inside the cells, glucose is stored and later used for energy.With type 1 diabetes, beta cells produce little or no insulin.Without enough insulin, glucose builds up in the bloodstream instead of going into the cells.This buildup of glucose in the blood is called hyperglycemia.The body is unable to use the glucose for energy.This leads to the symptoms of type 1 diabetes.The exact cause of type 1 diabetes is unknown.Most likely, it is an autoimmune disorder.This is a condition that occurs when the immune system mistakenly attacks and destroys healthy body tissue.With type 1 diabetes, an infection or another trigger causes the body to mistakenly attack the beta cells in the pancreas that make insulin.The tendency to develop autoimmune diseases, including type 1 diabetes, can be inherited from your parents. Researchers do not know the exact causes of type 1 and type 2 diabetes.Researchers do know that inheriting certain genes from your family can raise your risk for developing diabetes.Obesity is also a major risk factor for type 2 diabetes.Smoking can also cause type 2 diabetes.And the more you smoke the higher your risk for type 2 diabetes and other serious health problems if you already have diabetes.16Weight loss can help control type 2 diabetes so that you are healthier.Quitting smoking can also help you control your blood sugar levels.Being a healthy weight and not smoking can help all women be healthier.But, obesity and smoking do not always cause diabetes.Some women who are overweight or obese or smoke never develop diabetes.Also, women who are a normal weight or only slightly overweight can develop diabetes if they have other risk factors, such as a family history of diabetes. Type 2 diabetesthe most common form of diabetesis caused by a combination of factors, including insulin resistance, a condition in which the bodys muscle, fat, and liver cells do not use insulin effectively.Type 2 diabetes develops when the body can no longer produce enough insulin to compensate for the impaired ability to use insulin.Symptoms of type 2 diabetes may develop gradually and can be subtle; some people with type 2 diabetes remain undiagnosed for years.Type 2 diabetes develops most often in middle-aged and older people who are also overweight or obese.The disease, once rare in youth, is becoming more common in overweight and obese children and adolescents.Scientists think genetic susceptibility and environmental factors are the most likely triggers of type 2 diabetes.Genetic Susceptibility Genes play a significant part in susceptibility to type 2 diabetes.Having certain genes or combinations of genes may increase or decrease a persons risk for developing the disease.The role of genes is suggested by the high rate of type 2 diabetes in families and identical twins and wide variations in diabetes prevalence by ethnicity.Type 2 diabetes occurs more frequently in African Americans, Alaska Natives, American Indians, Hispanics/Latinos, and some Asian Americans, Native Hawaiians, and Pacific Islander Americans than it does in non-Hispanic whites.Recent studies have combined genetic data from large numbers of people, accelerating the pace of gene discovery.Though scientists have now identified many gene variants that increase susceptibility to type 2 diabetes, the majority have yet to be discovered.The known genes appear to affect insulin production rather than insulin resistance.Researchers are working to identify additional gene variants and to learn how they interact with one another and with environmental factors to cause diabetes.Studies have shown that variants of the TCF7L2 gene increase susceptibility to type 2 diabetes.For people who inherit two copies of the variants, the risk of developing type 2 diabetes is about 80 percent higher than for those who do not carry the gene variant.1However, even in those with the variant, diet and physical activity leading to weight loss help delay diabetes, according to the Diabetes Prevention Program (DPP), a major clinical trial involving people at high risk.Genes can also increase the risk of diabetes by increasing a persons tendency to become overweight or obese.One theory, known as the thrifty gene hypothesis, suggests certain genes increase the efficiency of metabolism to extract energy from food and store the energy for later use.This survival trait was advantageous for populations whose food supplies were scarce or unpredictable and could help keep people alive during famine.In modern times, however, when high-calorie foods are plentiful, such a trait can promote obesity and type 2 diabetes.Obesity and Physical Inactivity Physical inactivity and obesity are strongly associated with the development of type 2 diabetes.People who are genetically susceptible to type 2 diabetes are more vulnerable when these risk factors are present.An imbalance between caloric intake and physical activity can lead to obesity, which causes insulin resistance and is common in people with type 2 diabetes.Central obesity, in which a person has excess abdominal fat, is a major risk factor not only for insulin resistance and type 2 diabetes but also for heart and blood vessel disease, also called cardiovascular disease (CVD).This excess belly fat produces hormones and other substances that can cause harmful, chronic effects in the body such as damage to blood vessels.The DPP and other studies show that millions of people can lower their risk for type 2 diabetes by making lifestyle changes and losing weight.The DPP proved that people with prediabetesat high risk of developing type 2 diabetescould sharply lower their risk by losing weight through regular physical activity and a diet low in fat and calories.In 2009, a follow-up study of DPP participantsthe Diabetes Prevention Program Outcomes Study (DPPOS)showed that the benefits of weight loss lasted for at least 10 years after the original study began.2 Read more about the DPP, funded under National Institutes of Health (NIH) clinical trial number NCT00004992, and the DPPOS, funded under NIH clinical trial number NCT00038727 in Diabetes Prevention Program.Insulin Resistance Insulin resistance is a common condition in people who are overweight or obese, have excess abdominal fat, and are not physically active.Muscle, fat, and liver cells stop responding properly to insulin, forcing the pancreas to compensate by producing extra insulin.As long as beta cells are able to produce enough insulin, blood glucose levels stay in the normal range.But when insulin production falters because of beta cell dysfunction, glucose levels rise, leading to prediabetes or diabetes.Abnormal Glucose Production by the LiverIn some people with diabetes, an abnormal increase in glucose production by the liver also contributes to high blood glucose levels.Normally, the pancreas releases the hormone glucagon when blood glucose and insulin levels are low.Glucagon stimulates the liver to produce glucose and release it into the bloodstream.But when blood glucose and insulin levels are high after a meal, glucagon levels drop, and the liver stores excess glucose for later, when it is needed.For reasons not completely understood, in many people with diabetes, glucagon levels stay higher than needed.High glucagon levels cause the liver to produce unneeded glucose, which contributes to high blood glucose levels.Metformin, the most commonly used drug to treat type 2 diabetes, reduces glucose production by the liver.The Roles of Insulin and Glucagon in Normal Blood Glucose RegulationA healthy persons body keeps blood glucose levels in a normal range through several complex mechanisms.Insulin and glucagon, two hormones made in the pancreas, help regulate blood glucose levels: - Insulin, made by beta cells, lowers elevated blood glucose levels. - Glucagon, made by alpha cells, raises low blood glucose levels.- Insulin helps muscle, fat, and liver cells absorb glucose from the bloodstream, lowering blood glucose levels.- Insulin stimulates the liver and muscle tissue to store excess glucose.The stored form of glucose is called glycogen.- Insulin also lowers blood glucose levels by reducing glucose production in the liver.- Glucagon signals the liver and muscle tissue to break down glycogen into glucose, which enters the bloodstream and raises blood glucose levels.- If the body needs more glucose, glucagon stimulates the liver to make glucose from amino acids.Metabolic Syndrome Metabolic syndrome, also called insulin resistance syndrome, refers to a group of conditions common in people with insulin resistance, including - higher than normal blood glucose levels - increased waist size due to excess abdominal fat - high blood pressure - abnormal levels of cholesterol and triglycerides in the blood Cell Signaling and Regulation Cells communicate through a complex network of molecular signaling pathways.For example, on cell surfaces, insulin receptor molecules capture, or bind, insulin molecules circulating in the bloodstream.This interaction between insulin and its receptor prompts the biochemical signals that enable the cells to absorb glucose from the blood and use it for energy.Problems in cell signaling systems can set off a chain reaction that leads to diabetes or other diseases.Many studies have focused on how insulin signals cells to communicate and regulate action.Researchers have identified proteins and pathways that transmit the insulin signal and have mapped interactions between insulin and body tissues, including the way insulin helps the liver control blood glucose levels.Researchers have also found that key signals also come from fat cells, which produce substances that cause inflammation and insulin resistance.This work holds the key to combating insulin resistance and diabetes.As scientists learn more about cell signaling systems involved in glucose regulation, they will have more opportunities to develop effective treatments.Beta Cell Dysfunction Scientists think beta cell dysfunction is a key contributor to type 2 diabetes.Beta cell impairment can cause inadequate or abnormal patterns of insulin release.Also, beta cells may be damaged by high blood glucose itself, a condition called glucose toxicity.Scientists have not determined the causes of beta cell dysfunction in most cases.Single gene defects lead to specific forms of diabetes called maturity-onset diabetes of the young (MODY).The genes involved regulate insulin production in the beta cells.Although these forms of diabetes are rare, they provide clues as to how beta cell function may be affected by key regulatory factors.Other gene variants are involved in determining the number and function of beta cells.But these variants account for only a small percentage of type 2 diabetes cases.Malnutrition early in life is also being investigated as a cause of beta cell dysfunction.The metabolic environment of the developing fetus may also create a predisposition for diabetes later in life.Risk Factors for Type 2 Diabetes People who develop type 2 diabetes are more likely to have the following characteristics: - age 45 or older - overweight or obese - physically inactive - parent or sibling with diabetes - family background that is African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, or Pacific Islander American - history of giving birth to a baby weighing more than 9 pounds - history of gestational diabetes - high blood pressure140/90 or aboveor being treated for high blood pressure - high-density lipoprotein (HDL), or good, cholesterol below 35 milligrams per deciliter (mg/dL), or a triglyceride level above 250 mg/dL - polycystic ovary syndrome, also called PCOS - prediabetesan A1C level of 5.7 to 6.4 percent; a fasting plasma glucose test result of 100125 mg/dL, called impaired fasting glucose; or a 2-hour oral glucose tolerance test result of 140199, called impaired glucose tolerance - acanthosis nigricans, a condition associated with insulin resistance, characterized by a dark, velvety rash around the neck or armpits - history of CVD The American Diabetes Association (ADA) recommends that testing to detect prediabetes and type 2 diabetes be considered in adults who are overweight or obese and have one or more additional risk factors for diabetes.In adults without these risk factors, testing should begin at age 45. Other types of diabetes have a variety of possible causes.Genetic Mutations Affecting Beta Cells, Insulin, and Insulin Action Some relatively uncommon forms of diabetes known as monogenic diabetes are caused by mutations, or changes, in a single gene.These mutations are usually inherited, but sometimes the gene mutation occurs spontaneously.Most of these gene mutations cause diabetes by reducing beta cells ability to produce insulin.The most common types of monogenic diabetes are neonatal diabetes mellitus (NDM) and MODY.NDM occurs in the first 6 months of life.MODY is usually found during adolescence or early adulthood but sometimes is not diagnosed until later in life.More information about NDM and MODY is provided in the NIDDK health topic, Monogenic Forms of Diabetes.Other rare genetic mutations can cause diabetes by damaging the quality of insulin the body produces or by causing abnormalities in insulin receptors.Other Genetic Diseases Diabetes occurs in people with Down syndrome, Klinefelter syndrome, and Turner syndrome at higher rates than the general population.Scientists are investigating whether genes that may predispose people to genetic syndromes also predispose them to diabetes.The genetic disorders cystic fibrosis and hemochromatosis are linked to diabetes.Cystic fibrosis produces abnormally thick mucus, which blocks the pancreas.The risk of diabetes increases with age in people with cystic fibrosis.Hemochromatosis causes the body to store too much iron.If the disorder is not treated, iron can build up in and damage the pancreas and other organs.Damage to or Removal of the Pancreas Pancreatitis, cancer, and trauma can all harm the pancreatic beta cells or impair insulin production, thus causing diabetes.If the damaged pancreas is removed, diabetes will occur due to the loss of the beta cells.Endocrine Diseases Endocrine diseases affect organs that produce hormones.Cushings syndrome and acromegaly are examples of hormonal disorders that can cause prediabetes and diabetes by inducing insulin resistance.Cushings syndrome is marked by excessive production of cortisolsometimes called the stress hormone.Acromegaly occurs when the body produces too much growth hormone.Glucagonoma, a rare tumor of the pancreas, can also cause diabetes.The tumor causes the body to produce too much glucagon.Hyperthyroidism, a disorder that occurs when the thyroid gland produces too much thyroid hormone, can also cause elevated blood glucose levels.Autoimmune Disorders Rare disorders characterized by antibodies that disrupt insulin action can lead to diabetes.This kind of diabetes is often associated with other autoimmune disorders such as lupus erythematosus.Another rare autoimmune disorder called stiff-man syndrome is associated with antibodies that attack the beta cells, similar to type 1 diabetes.Medications and Chemical Toxins Some medications, such as nicotinic acid and certain types of diuretics, anti-seizure drugs, psychiatric drugs, and drugs to treat human immunodeficiency virus (HIV), can impair beta cells or disrupt insulin action.Pentamidine, a drug prescribed to treat a type of pneumonia, can increase the risk of pancreatitis, beta cell damage, and diabetes.Also, glucocorticoidssteroid hormones that are chemically similar to naturally produced cortisolmay impair insulin action.Glucocorticoids are used to treat inflammatory illnesses such as rheumatoid arthritis, asthma, lupus, and ulcerative colitis.Many chemical toxins can damage or destroy beta cells in animals, but only a few have been linked to diabetes in humans.For example, dioxina contaminant of the herbicide Agent Orange, used during the Vietnam Warmay be linked to the development of type 2 diabetes.In 2000, based on a report from the Institute of Medicine, the U.S. Department of Veterans Affairs (VA) added diabetes to the list of conditions for which Vietnam veterans are eligible for disability compensation.Also, a chemical in a rat poison no longer in use has been shown to cause diabetes if ingested.Some studies suggest a high intake of nitrogen-containing chemicals such as nitrates and nitrites might increase the risk of diabetes.Arsenic has also been studied for possible links to diabetes.Lipodystrophy Lipodystrophy is a condition in which fat tissue is lost or redistributed in the body.The condition is associated with insulin resistance and type 2 diabetes. ","Diabetes is caused by high levels of blood sugar.The blood sugar levels are high either if your body does not make insulin or it does not use insulin right.Insulin, a hormone produced in the pancreas, helps the glucose from food get into your body's cells for energy.There are two main types of diabetes, each with its own risk factors and potential causes.In diabetes type 1, the body makes little or no insulin. Most likely, the cause is an autoimmune disorder in which the immune system attacks and destroys pancreatic cells that produce insulin.It can be triggered by an infection or some medications.Some foods may raise the risk of developing type 1 diabetes.For example, early exposure to cows milk and cereals in infants may increase risk. In type 2 diabetes, which is more common, the body is resistant to insulin, i.e., it is not used properly and the body can no longer produce enough insulin to compensate for the inability to use insulin.","Insulin is a hormone produced by the pancreas to control blood sugar.Diabetes can be caused by too little insulin, resistance to insulin, or both.To understand diabetes, it is important to first understand the normal process by which food is broken down and used by the body for energy.Several things happen when food is digested and absorbed: A sugar called glucose enters the bloodstream.Glucose is a source of fuel for the body.An organ called the pancreas makes insulin.The role of insulin is to move glucose from the bloodstream into muscle, fat, and other cells, where it can be stored or used as fuel.People with diabetes have high blood sugar because their body cannot move sugar from the blood into muscle and fat cells to be burned or stored for energy, and/or because their liver makes too much glucose and releases it into the blood.This is because either: Their pancreas does not make enough insulin Their cells do not respond to insulin normally.There are two major types of diabetes.The causes and risk factors are different for each type: Type 1 diabetes is less common.It can occur at any age, but it is most often diagnosed in children, teens, or young adults.In this disease, the body makes little or no insulin.This is because the pancreas cells that make insulin stop working. The exact cause of the failure to make enough insulin is unknown. Most likely, it is an autoimmune disorder.This is a condition that occurs when the immune system mistakenly attacks and destroys healthy body tissue.With type 1 diabetes, an infection or another trigger causes the body to mistakenly attack the beta cells in the pancreas that make insulin.Some studies have suggested that dietary factors may raise or lower the risk of developing type 1 diabetes.For example, breastfed infants and infants receiving vitamin D supplements may have a reduced risk of developing type 1 diabetes, while early exposure to cows milk and cereal proteins may increase risk. Some medications, such as nicotinic acid and certain types of diuretics, anti-seizure drugs, psychiatric drugs, and drugs to treat human immunodeficiency virus (HIV), can impair beta cells or disrupt insulin action. Type 2 diabetes is more common. With type 2 diabetes, the body is resistant to insulin and doesn't use insulin as well as it should.Type 2 diabetes develops when the body can no longer produce enough insulin to compensate for the impaired ability to use insulin." 161,What is the life expectancy for non-Hodgkin’s lymphoma?,"Low-grade NHL often cannot be cured by chemotherapy alone.Low-grade NHL progresses slowly and may take many years before the disease gets worse or even requires treatment.The need for treatment is usually determined by symptoms, how fast the disease is progressing, and if blood counts are low.Chemotherapy may cure many types of high-grade lymphomas.If the cancer does not respond to chemotherapy, the disease can cause rapid death. Without timely treatment, BL is rapidly fatal.[1]However, the majority of people treated with aggressive therapy achieve long-term remission .[5]In general, children with BL have better survival rates than adults with BL.The prognosis in children correlates with the extent of disease at the time of diagnosis.Those with limited disease when diagnosed and treated have a survival rate greater than 90%.Children with more extensive disease, especially involving the bone marrow and central nervous system , have long-term survival rates of 50-90%.[2]While the majority of adults with BL also achieve long-term remission with aggressive therapy, adults (particularly those with advanced stage disease) do more poorly than children.[2][7]In addition to the extent of disease at the time of diagnosis, prognosis depends on the age of the adult.In general, survival rates decrease with age and are lowest for elderly patients.[2] Unfortunately, specific statistics regarding the prognosis for adults with BL appear to be more scarce.[8]The outlook is poor for both children and adults if BL returns after improvement (relapses) or does not go into remission as a result of the first cycle of chemotherapy .[9][2]Additional information about the chance to have relapsing BL is available here. Mantle cell lymphoma (MCL) belongs to a group of diseases known as non-Hodgkins lymphomas (NHL).NHL's are cancers that affect the the lymphatic system (part of the immune system ).In MCL, there are cancerous B-cells (a type of immune system cell).The cancerous B-cells are within a region of the lymph node known as the mantle zone.[1] Although MCLs are slow-growing cancers, the cancer is usually widespread by the time it is diagnosed.In these situations, treatment must be intensive since MCL can become life threatening within a short period of time.[2][3] MCL accounts for 6% of all NHL's and is mostly found in males during their early 60s.[4][2][3] More than one half of people with BL can be cured with intensive chemotherapy.The cure rate may be lower if the cancer spreads to the bone marrow or spinal fluid.The outlook is poor if the cancer comes back after a remission or does not go into remission as a result of the first cycle of chemotherapy. The following summary is from Orphanet, a European reference portal for information on rare diseases and orphan drugs.Orpha Number: 545 Definition Follicular lymphoma is a form of non-Hodgkin lymphoma (see this term) characterized by a proliferation of B cells whose nodular structure of follicular architecture is preserved.Epidemiology Prevalence of follicular lymphoma is estimated at about 1/3,000.Clinical descriptionThe median age at diagnosis is 60-65 years.The disease is extremely rare in children.Follicular lymphoma is located primarily in the lymph nodes , but can also involve the spleen, bone marrow, peripheral blood and Waldeyer's ring.The skin and central nervous system are affected in rare cases.Symptoms appear at an advanced stage of the disease and can include fever, night sweats and weight loss.At diagnosis, patients usually present with adenopathy and, in 50% of cases, splenomegaly.EtiologyIn 85% of cases, follicular lymphomas are associated with a translocation t(14;18) (q32;q21), which activates the BCL2 gene encoding the BCL2 protein that is essential for some apoptosis processes.Diagnostic methods Diagnosis is based on histological analysis of the adenopathy, a complete blood count, measurement of lactate dehydrogenase (LDH) and biopsy analysis of a lymph node.Examination using imagery (particularly a chest radiograph) is required.The observation of the translocation t(14;18) by polymerase chain reaction (PCR), in addition to suggested histological results, confirms the diagnosis.Differential diagnosis Differential diagnoses include chronic lymphocytic B cell leukemia, diffuse large B cell lymphoma, mantle cell lymphoma and MALT lymphoma (see these terms).Management and treatment If the lymphoma is localized it should be treated by radiotherapy.In the case of advanced stage lymphoma, chemotherapy with immuno-chemotherapy should be offered (rituximab combined with CHOP).In cases of chemosensitive relapse, treatment can be intensified.PrognosisThe survival rate at five years is 80-90% and medial survival is approximately 10-12 years.Visit the Orphanet disease page for more resources. ","There are many forms of non-Hodgkin?s lymphoma and life expectancy depends on the specific type and response to treatment.Some forms, e.g., BL, are rapidly fatal without treatment or if they don't go into remission.Some forms progress slowly.One of the slow growing forms, Mantle cell lymphoma (MCL) might be widespread before it is detected, in which case the life expectancy could be short. Another slow form is low-grade NHL.It may take many years before it gets worse and needs treatment.For another form, follicular lymphoma, the survival rate at five years is 80-90% and medial survival is approximately 10-12 years.","Without timely treatment, BL is rapidly fatal. However, the majority of people treated with aggressive therapy achieve long-term remission.The outlook is poor if the cancer comes back after a remission or does not go into remission as a result of the first cycle of chemotherapy. Mantle cell lymphoma (MCL) belongs to a group of diseases known as non-Hodgkins lymphomas (NHL).Although MCLs are slow-growing cancers, the cancer is usually widespread by the time it is diagnosed.MCL can become life threatening within a short period of time.Low-grade NHL progresses slowly and may take many years before the disease gets worse or even requires treatment. If the cancer does not respond to chemotherapy, the disease can cause rapid death." 165,What is the best treatment for elbow pain?,"Your health care provider will likely instruct you to follow RICE to help reduce pain and swelling: Rest your elbow.Avoid lifting anything with your arm and elbow.Don't move the elbow unless you're instructed to do so.Ice your elbow for 15 to 20 minutes at a time, 3 to 4 times a day.Wrap the ice in cloth.DO NOT place ice directly on the skin.Cold from the ice can damage your skin.Compress the area by wrapping it with an elastic bandage or compression wrap.Elevate your elbow by raising it above the level of your heart.You can prop it up with pillows.You can take ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn) to reduce pain and swelling.Acetaminophen (Tylenol) helps with pain, but not swelling.You can buy these pain medicines at the store.Talk with your provider before using these medicines if you have heart disease, high blood pressure, kidney or liver disease, or have had stomach ulcers or internal bleeding in the past.DO NOT take more than the amount recommended on the bottle or by your provider. Elbow pain can be caused by many problems.A common cause in adults is tendinitis.This is inflammation and injury to the tendons, which are soft tissues that attach muscle to bone.People who play racquet sports are most likely to injure the tendons on the outside of the elbow.This condition is commonly called tennis elbow.Golfers are more likely to injure the tendons on the inside of the elbow.Other common causes of elbow tendinitis are gardening, playing baseball, using a screwdriver, or overusing your wrist and arm.Young children commonly develop ""nursemaid elbow,"" which often occurs when someone is pulling on their straightened arm.The bones are stretched apart momentarily and a ligament slips in between.It becomes trapped when the bones try to snap back into place.As a result, the child will usually quietly refuse to use the arm, but often cries out when they try to bend or straighten the elbow.This condition is also called an elbow subluxation (a partial dislocation).This often gets better on its own when the ligament slips back into place.Surgery is usually not needed.Other common causes of elbow pain are: Bursitis -- inflammation of a fluid-filled cushion beneath the skin Arthritis -- narrowing of the joint space and loss of cartilage in the elbow Elbow strains Infection of the elbow Tendon tears -- biceps rupture Your provider will examine you and carefully check your elbow.You will be asked about your medical history and symptoms such as: Are both elbows affected?Does the pain shift from the elbow to other joints?Is the pain over the outside bony prominence of the elbow?Did the pain begin suddenly and severely?Did the pain begin slowly and mildly and then get worse?Is the pain getting better on its own?Did the pain begin after an injury?What makes the pain better or worse?Is there pain that goes from the elbow down to the hand?Treatment depends on the cause, but may involve: Antibiotics Corticosteroid shots Manipulation Pain medicine Physical therapy Surgery (last resort) Call your providerif: You have a prolonged case of tendinitis that doesn't improve with home care.The pain is due to a direct elbow injury.There is obvious deformity.You can't use the elbow.You have fever or swelling and redness of your elbow.Your elbow is locked and can't straighten or bend.A child has elbow pain. Gently try to move the elbow and increase your range of motion.If this hurts or you cannot move the elbow, call your health care provider. ","Call your doctor if the elbow is injured or deformed, you cannot use it or bend or dtrighten, it is swollen or you have fever.Your doctor might recommend RICE: rest, ice, compressing the elbow with a bandage and elevating it about your heart level.Ibuprofen or naproxen will reduce pain.Your doctor might recommend antibiotics, corticosteroid injections, physical therapy, manipulation and surgery , as the last resort.","Call your providerif: You have a prolonged case of tendinitis that doesn't improve with home care.The pain is due to a direct elbow injury.There is obvious deformity.You can't use the elbow.You have fever or swelling and redness of your elbow.Your elbow is locked and can't straighten or bend.A child has elbow pain.Treatment depends on the cause, but may involve: Antibiotics Corticosteroid shots Manipulation Pain medicine Physical therapy Surgery (last resort)Your health care provider will likely instruct you to follow RICE to help reduce pain and swelling: Rest your elbow.Avoid lifting anything with your arm and elbow.Don't move the elbow unless you're instructed to do so.Ice your elbow for 15 to 20 minutes at a time, 3 to 4 times a day.Compress the area by wrapping it with an elastic bandage or compression wrap.Elevate your elbow by raising it above the level of your heart. You can take ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn) to reduce pain and swelling.Acetaminophen (Tylenol) helps with pain, but not swelling." 166,What can relieve dry eyes from computer work?,"Diagnosis of dry eye requires a comprehensive eye evaluation.Your eye care professional will ask you about your symptoms, your overall health (conditions for which you are treated, medications that you take), your eye history (use of contact lenses, past refractive or other eye surgery), and aspects of your daily environment (exposure to environmental allergens or occupational hazards).He or she will test your vision, check your eye pressure, examine your eyelids and front eye structures, and if necessary may dilate the pupils to examine the inside of the eye.Your eye care professional may order a tearing test to find out if your eyes are producing enough tears to keep them moist.In one type of test, called a Schirmers test, the doctor may measure your tear production by placing strips of blotting paper under your lower eyelids, usually done after numbing the eye with anesthetic drops.After a few minutes, the doctor removes the strips and measures the amount of tear production. Murine Tears¬Æ For DRY EYES Lubricant Eye Drops Original Natural Tears Formula ?Moisture Enriched ?Eye Doctor Recommended 0.5 fl oz.(15 mL) Clear Eyes¬Æ Pure Relief‚Ñ¢ for DRY EYES Glycerin / Lubricant Eye Drops 0.34 FL OZ (10 mL) for the temporary relief of burning and irritation due to dryness of the eye.¬†¬† for use as a protectant against further¬†irritation or dryness of the eye. ","Your doctors will thoroughly examine your eyes to diagnose dry eye.For temporary relief of irritation caused by dryness, they may recommend artificial tears and lubricants, such as Clear Eyes® or Murine Tears®",Diagnosis of dry eye requires a comprehensive eye evaluation.for the temporary relief of burning and irritation due to dryness of the eye. for use as a protectant against further irritation or dryness of the eye.Clear Eyes® Pure Relief?for DRY EYES Glycerin / Lubricant Eye Drops 0.34 FL OZ (10 mL) Murine Tears® For DRY EYES Lubricant Eye Drops Original Natural Tears Formula ?Moisture Enriched ?Eye Doctor Recommended 0.5 fl oz.(15 mL) 169,Can abdominal aortic aneurysm repair cause testicular pain?,"Testicular torsion causes: Severe pain in one testicle and sometimes in the belly area Sudden swelling of the testicle Feeling sick and throwing up Fever Needing to urinate often There are a number of less common causes.Less common causes include A hernia in the groin (inguinal hernia) Infection of the testis (orchitis), usually caused by mumps or another virusPain from a disorder in the abdomen (such as a kidney stone or appendicitis) Injury Dangerous disorders that sometimes cause scrotal pain include a ruptured abdominal aortic aneurysm and necrotizing infection of the perineumthe area between the genitals and anuscalled Fournier gangrene.Cancer of a testis only rarely causes pain. ","Testicular pain can be caused by testicular torsion, inguinal hernia, Infection of the testis, a disorder in the abdomen, e.g. kidney stone or appendicitis, or Injury.Infrequently, scrotal pain can be caused by testicular cancer, a ruptured abdominal aortic aneurysm and necrotizing infection in the perianal area.","Testicular torsion causes: Severe pain in one testicle and sometimes in the belly area There are a number of less common causes.Less common causes include A hernia in the groin (inguinal hernia) Infection of the testis (orchitis), usually caused by mumps or another virusPain from a disorder in the abdomen (such as a kidney stone or appendicitis) Injury Dangerous disorders that sometimes cause scrotal pain include a ruptured abdominal aortic aneurysm and necrotizing infection of the perineum the area between the genitals and anus called Fournier gangrene.Cancer of a testis only rarely causes pain." 170,What are the symptoms and outlook for Angelman syndrome?,"There is no cure for Angelman syndrome.Treatment helps to manage health and development problems caused by the condition.Anticonvulsant medicines help control seizures Behavior therapy helps manage hyperactivity, sleep problems, and development problems Occupational and speech therapy manage speech problems and teach living skills Physical therapy helps with walking and movement problems Angelman syndrome (AS) is a genetic condition that causes problems with the way a child's body and brain develop.The syndrome is present from birth (congenital).However, it often isn't diagnosed until about 6 to 12 months of age.This is when development problems are first noticed in most cases. Most individuals with Angelman syndrome will have severe developmental delays, speech limitations, and motor difficulties.However, individuals with Angelman syndrome can have normal life spans and generally do not show developmental regression as they age.Early diagnosis and tailored interventions and therapies help improve quality of life. Many of the characteristic features of Angelman syndrome result from the loss of function of a gene called UBE3A. People normally inherit one copy of the UBE3A gene from each parent.Both copies of this gene are turned on (active) in many of the body's tissues.In certain areas of the brain, however, only the copy inherited from a person's mother (the maternal copy) is active.This parent-specific gene activation is caused by a phenomenon called genomic imprinting.If the maternal copy of the UBE3A gene is lost because of a chromosomal change or a gene mutation, a person will have no active copies of the gene in some parts of the brain.Several different genetic mechanisms can inactivate or delete the maternal copy of the UBE3A gene.Most cases of Angelman syndrome (about 70 percent) occur when a segment of the maternal chromosome 15 containing this gene is deleted.In other cases (about 11 percent), Angelman syndrome is caused by a mutation in the maternal copy of the UBE3A gene.In a small percentage of cases, Angelman syndrome results when a person inherits two copies of chromosome 15 from his or her father (paternal copies) instead of one copy from each parent.This phenomenon is called paternal uniparental disomy.Rarely, Angelman syndrome can also be caused by a chromosomal rearrangement called a translocation, or by a mutation or other defect in the region of DNA that controls activation of the UBE3A gene.These genetic changes can abnormally turn off (inactivate) UBE3A or other genes on the maternal copy of chromosome 15.The causes of Angelman syndrome are unknown in 10 to 15 percent of affected individuals.Changes involving other genes or chromosomes may be responsible for the disorder in these cases.In some people who have Angelman syndrome, the loss of a gene called OCA2 is associated with light-colored hair and fair skin.The OCA2 gene is located on the segment of chromosome 15 that is often deleted in people with this disorder.However, loss of the OCA2 gene does not cause the other signs and symptoms of Angelman syndrome.The protein produced from this gene helps determine the coloring (pigmentation) of the skin, hair, and eyes. Angelman syndrome is a complex genetic disorder that primarily affects the nervous system.Characteristic features of this condition include delayed development, intellectual disability, severe speech impairment, and problems with movement and balance (ataxia).Most affected children also have recurrent seizures (epilepsy) and a small head size (microcephaly).Delayed development becomes noticeable by the age of 6 to 12 months, and other common signs and symptoms usually appear in early childhood.Children with Angelman syndrome typically have a happy, excitable demeanor with frequent smiling, laughter, and hand-flapping movements.Hyperactivity, a short attention span, and a fascination with water are common.Most affected children also have difficulty sleeping and need less sleep than usual.With age, people with Angelman syndrome become less excitable, and the sleeping problems tend to improve.However, affected individuals continue to have intellectual disability, severe speech impairment, and seizures throughout their lives.Adults with Angelman syndrome have distinctive facial features that may be described as ""coarse.""Other common features include unusually fair skin with light-colored hair and an abnormal side-to-side curvature of the spine (scoliosis).The life expectancy of people with this condition appears to be nearly normal. ","Angelman syndrome is a genetic disorder in which children have developmental delays, speech impairment, intellectual disability, problems with movement and balance, and seizures.Affected children may have small head size, happy demeanor, hyperactivity, a short attention span, fascination with water, difficulty sleeping, unusually fair skin with light-colored hair, and scoliosis.individuals with Angelman syndrome have nearly normal life spans and do not have developmental regression as they age. Treatment helps managing problems caused by the condition, e.g., physical therapy could help with walking problems.","Angelman syndrome is a complex genetic disorder that primarily affects the nervous system.Characteristic features of this condition include delayed development, intellectual disability, severe speech impairment, and problems with movement and balance (ataxia).Most affected children also have recurrent seizures (epilepsy) and a small head size (microcephaly).Delayed development becomes noticeable by the age of 6 to 12 months, and other common signs and symptoms usually appear in early childhood.Children with Angelman syndrome typically have a happy, excitable demeanor with frequent smiling, laughter, and hand-flapping movements.Hyperactivity, a short attention span, and a fascination with water are common.Most affected children also have difficulty sleeping and need less sleep than usual.With age, people with Angelman syndrome become less excitable, and the sleeping problems tend to improve.However, affected individuals continue to have intellectual disability, severe speech impairment, and seizures throughout their lives.Adults with Angelman syndrome have distinctive facial features that may be described as ""coarse.""Other common features include unusually fair skin with light-colored hair and an abnormal side-to-side curvature of the spine (scoliosis).The life expectancy of people with this condition appears to be nearly normal." 174,Can Norwegian scabies last for 4 years and how can I get rid of it?,"Scabies is an itchy skin condition caused by the microscopic mite Sarcoptes scabei.It is common all over the world, and can affect anyone.Scabies spreads quickly in crowded conditions where there is frequent skin-to-skin contact between people.Hospitals, child-care centers, and nursing homes are examples.Scabies can easily infect sex partners and other household members.Sharing clothes, towels, and bedding can sometimes spread scabies.This can happen much more easily when the infested person has crusted scabies.You cannot get scabies from a pet.Pets get a different mite infection called mange.Symptoms are - Pimple-like irritations or a rash - Intense itching, especially at night - Sores caused by scratching Your health care provider diagnoses scabies by looking at the skin rash and finding burrows in the skin.Several lotions are available to treat scabies.The infected person's clothes, bedding and towels should be washed in hot water and dried in a hot dryer.Treatment is also recommended for household members and sexual partners.Centers for Disease Control and Prevention Crusted scabies may be particularly difficult to treat.Patients with crusted scabies may be instructed by their doctors to remove scaling skin so that topical medications can penetrate the skin more easily.[3] Repeated applications of a topical medication or combined treatment with a topical and an oral medication for several weeks or longer may be necessary.[3][4] Patients who still have signs of infection after one month may need additional treatment.Infants and pregnant women should be treated for scabies only if the benefit is determined to outweigh the risk and if the diagnosis is confirmed by biopsy .[3]A dermatologist or infectious disease physician should be involved in the care of the patient and those with whom they have had close contact.Treatment of crusted scabies should be done in an inpatient or residential setting, with the patient in a private room.Treatment includes oral Ivermectin and topical insecticides. Crusted scabies (also called Norwegian scabies) is an infestation characterized by thick crusts of skin that contain large numbers of scabies mites and eggs.It is a severe form of scabies that occurs most often in people who have a weakened immune system or a neurological disease, the elderly, and the disabled.The symptoms of the more common form of scabies, such as itching and a rash, may be absent.Crusted scabies is very contagious and can spread both by direct skin-to-skin contact and through contaminated items such as clothing, bedding, and furniture.[1][2] It is caused by super-infestation with Sarcoptes scabiei var hominis, a mite that can only reproduce on humans.People with crusted scabies should receive quick and aggressive medical treatment for their infestation to prevent future outbreaks of scabies.[1] Ivermectin, a drug used to treat parasitic infections, is commonly used for treatment.[2] Scabies is an itchy rash.It's caused by tiny insects called mites.The mites get into your skin and lay eggs The mites spread easily to other people through physical contact The rash itches very badly Doctors treat scabies with a medicated cream ","Norwegian scabies, also called crusted scabies, is particularly hard to treat and needs to br treated aggressively, otherwise future re-infections are possible, particularly in crowded conditions, such as nursing homes, or other places where clothes, towels and bedding are shared.Topical insecticides and oral Ivermectin need to be applied repeatedly for several weeks or longer, with the patient in a private room.","Crusted scabies (also called Norwegian scabies) is an infestation characterized by thick crusts of skin that contain large numbers of scabies mites and eggs. Scabies spreads quickly in crowded conditions where there is frequent skin-to-skin contact between people.Hospitals, child-care centers, and nursing homes are examples.Scabies can easily infect sex partners and other household members.Sharing clothes, towels, and bedding can sometimes spread scabies. People with crusted scabies should receive quick and aggressive medical treatment for their infestation to prevent future outbreaks of scabies.Ivermectin, a drug used to treat parasitic infections, is commonly used for treatment.Crusted scabies may be particularly difficult to treat.Patients with crusted scabies may be instructed by their doctors to remove scaling skin so that topical medications can penetrate the skin more easily.Repeated applications of a topical medication or combined treatment with a topical and an oral medication for several weeks or longer may be necessary.Patients who still have signs of infection after one month may need additional treatment.A dermatologist or infectious disease physician should be involved in the care of the patient and those with whom they have had close contact.Treatment of crusted scabies should be done in an inpatient or residential setting, with the patient in a private room.Treatment includes oral Ivermectin and topical insecticides." 175,What treatments are effective for dandruff and hair loss?,"If there's a health problem causing your hair loss, doctors treat that problem.They also treat hair loss with: Medicine for male and female pattern baldness, which can take 8 to 12 months to work Hair transplants to move hair follicles from a hairy area of your scalp to your bald area Wigs Wigs often offer the best treatment for temporary hair loss (for example, that caused by chemotherapy).People undergoing chemotherapy should consult a wig maker even before therapy begins so that an appropriate wig can be ready when needed.When hair regrows, it may be different in color and texture from the original hair.

Summary

You lose up to 100 hairs from your scalp every day.That's normal, and in most people, those hairs grow back.But many men -- and some women -- lose hair as they grow older.You can also lose your hair if you have certain diseases, such as thyroid problems, diabetes, or lupus.If you take certain medicines or have chemotherapy for cancer, you may also lose your hair.Other causes are stress, a low protein diet, a family history, or poor nutrition.Treatment for hair loss depends on the cause.In some cases, treating the underlying cause will correct the problem.Other treatments include medicines and hair restoration. ","In some cases, treating the health problem that causes hair loss treats hair loss too.In other cases, medicine for male or female pattern baldness is needed for about a year.Hair transplants can be used to move hair follicles to the bald area.For temporary hair loss, e.g. due to chemotherapy, wigs could be used.","Treatment for hair loss depends on the cause.In some cases, treating the underlying cause will correct the problem.Other treatments include medicines and hair restoration: Medicine for male and female pattern baldness, which can take 8 to 12 months to work Hair transplants to move hair follicles from a hairy area of your scalp to your bald area.Wigs often offer the best treatment for temporary hair loss (for example, that caused by chemotherapy)." 176,Is there any help for retinitis pigmentosa?,"Retinitis pigmentosa (RP) is a group of rare, genetic disorders that involve a breakdown and loss of cells in the retina—which is the light sensitive tissue that lines the back of the eye.Common symptoms include difficulty seeing at night and a loss of side (peripheral) vision.The retina is the light-sensitive tissue at the back of the eye that contains photoreceptors and other cell types Available treatments aim to slow the progression of the disease and primarily include light avoidance and the use of low-vision aids.Some practitioners also consider vitamin A as a possible treatment option.However, taking too much vitamin A can be toxic and the effects of vitamin A on the disease appear to be relatively weak.[4] Studies have explored potential treatment with DHA, an omega-3 fatty acid naturally found in fish.While DHA is known to play a structural role in retinal cells , more research is needed to determine whether supplements should be recommended.[2] Current research is focused on the development of new treatments including gene therapy , retinal transplantation, and the use of a retinal prosthesis.Stem cell transplantation would involve the injection and integration of stem cells into the retina, in hopes these cells will replace dead cells and provide the missing enzymes and chemicals needed for sight.Gene therapy could potentially be used when the disease-causing mutation is known and would aim to restore production of the missing or abnormal protein .Studies with retinal prosthetics have tested devices that transform light into electrical signals that can be sent directly to the inner retina and brain, avoiding the diseased part of the outer retina.Though challenges remain, preliminary research into these technologies has been promising.[2][3] 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 Retinitis pigmentosa (RP) is a group of inherited eye diseases that affect the light-sensitive part of the eye (retina).RP causes cells in the retina to die, causing progressive vision loss.The first sign of RP usually is night blindness.As the condition progresses, affected individuals develop tunnel vision (loss of peripheral vision), and eventually loss of central vision.RP may be caused by mutations in any of at least 50 genes .Inheritance can be autosomal dominant , autosomal recessive , or X-linked .[1]Treatment options to slow the progression of vision loss include light avoidance, use of low-vision aids, and vitamin A supplementation.Researchers are working to develop new treatment options for the future such as gene therapy , stem cell transplantation and prosthetic implants.[2][3] Vitamin A palmitate Omega-3 fatty acid supplements Lutein plus zeaxanthin supplementsSometimes, drugs called carbonic anhydrase inhibitors Sometimes, surgically implanted computer chips No treatment can reverse the damage caused by retinitis pigmentosa.Vitamin A palmitate may help slow the progression of the disorder in some people.Supplements with an omega-3 fatty acid (for example, docosahexaenoic acid) and a combination of lutein plus zeaxanthin may also slow the rate of vision loss.People who have swelling of the retina (macular edema), drugs called carbonic anhydrase inhibitors (usually acetazolamide or dorzolamide) are given by mouth or as eye drops.A new gene-therapy drug called voretigene neparovovec-ryzl may restore some vision to people with a particular mutation, provided they still have some retinal cells capable of surviving and reproducing.People who have lost all vision or almost all vision can be given a surgically implanted computer chip in the eye, which can restore some perception of light and shapes. ","Retinitis pigmentosa is an inherited eye diseases that destroys cells in the retina, causing progressive vision loss. No treatment can reverse the damage caused by retinitis pigmentosa. The existing treatments aim to slow the progression of disease, whereas some experimental treatments aim to restore the retinal cell function or bypass or replace the retina.Vitamin A is considered as a possible treatment with relatively weak effect, but too much vitamin A can be toxic.Other explored and approved medications include DHA, an omega-3 fatty acid naturally found in fish; lutein plus zeaxanthin supplements; and carbonic anhydrase inhibitor.The latter (usually acetazolamide or dorzolamide) are given by mouth or as eye drops to people who have swelling of the retina.The experimental treatments include gene therapy with voretigene neparovovec-ryzl that might restore some vision loss caused by specific mutations; retinal transplantation, retinal prosthesis, i.e. computer chips that transform light into signals, as retina would do; and injection of stem cells into the retina.For people in whom the disease causes swelling of the retina,","Retinitis pigmentosa (RP) is a group of inherited eye diseases that affect the light-sensitive part of the eye (retina).RP causes cells in the retina to die, causing progressive vision loss. Available treatments aim to slow the progression of the disease and primarily include light avoidance and the use of low-vision aids.Some practitioners also consider vitamin A as a possible treatment option.However, taking too much vitamin A can be toxic and the effects of vitamin A on the disease appear to be relatively weak.Studies have explored potential treatment with DHA, an omega-3 fatty acid naturally found in fish. Current research is focused on the development of new treatments including gene therapy , retinal transplantation, and the use of a retinal prosthesis.Stem cell transplantation would involve the injection and integration of stem cells into the retina, in hopes these cells will replace dead cells and provide the missing enzymes and chemicals needed for sight.Gene therapy could potentially be used when the disease-causing mutation is known and would aim to restore production of the missing or abnormal protein .Studies with retinal prosthetics have tested devices that transform light into electrical signals that can be sent directly to the inner retina and brain, avoiding the diseased part of the outer retina. The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition. Vitamin A palmitate; Omega-3 fatty acid supplements Lutein plus zeaxanthin supplements Sometimes, drugs called carbonic anhydrase inhibitors Sometimes, surgically implanted computer chips No treatment can reverse the damage caused by retinitis pigmentosa. People who have swelling of the retina (macular edema), drugs called carbonic anhydrase inhibitors (usually acetazolamide or dorzolamide) are given by mouth or as eye drops.A new gene-therapy drug called voretigene neparovovec-ryzl may restore some vision to people with a particular mutation, provided they still have some retinal cells capable of surviving and reproducing.People who have lost all vision or almost all vision can be given a surgically implanted computer chip in the eye, which can restore some perception of light and shapes." 178,What can cause night leg cramps in a healthy woman?,"Leg pain can be due to a muscle cramp (also called a charley horse).Common causes of cramps include: Dehydration or low amounts of potassium, sodium, calcium, or magnesium in the blood Medicines (such as diuretics and statins) Muscle fatigue or strain from overuse, too much exercise, or holding a muscle in the same position for a long time An injury can also cause leg pain from: A torn or overstretched muscle (strain) Hairline crack in the bone (stress fracture)Inflamed tendon (tendinitis) Shin splints (pain in the front of the leg from overuse)Other common causes of leg pain include: Peripheral artery disease (PAD), which causes a problem with blood flow in the legs (this type of pain, called claudication, is generally felt when exercising or walking and is relieved by rest)Blood clot (deep vein thrombosis) from long-term bed rest Infection of the bone (osteomyelitis) or skin and soft tissue (cellulitis) Inflammation of the leg joints caused by arthritis or gout Nerve damage common to people with diabetes, smokers, and alcoholics Varicose veins Less common causes include: Cancerous bone tumors (osteosarcoma, Ewing sarcoma) Legg-Calve-Perthes disease: Poor blood flow to the hip that may stop or slow the normal growth of the leg Noncancerous (benign) tumors or cysts of the femur or tibia (osteoid osteoma) Sciatic nerve pain (radiating pain down the leg) caused by a slipped disk in the back Slipped capital femoral epiphysis: Most often seen in boys and overweight children between ages 11 and 15 If you have a muscle cramp, stop your activity and try stretching and massaging the muscle.Heat will relax the muscle when the spasm begins, but ice may be helpful when the pain has improved.If the muscle is still sore, nonsteroidal anti-inflammatory medications can help with pain.If the muscle cramps are severe, your health care provider can prescribe other medicines.The most common cause of muscle cramps during sports activity is not getting enough fluids.Often, drinking water will ease the cramping.However, water alone does not always help.Salt tablets or sports drinks, which also replenish lost minerals, can be helpful.Other tips for relieving muscle cramps: - Change your workouts so that you are exercising within your ability.- Drink plenty of fluids while exercising and increase your potassium intake (orange juice and bananas are great sources of potassium).- Stretch to improve flexibility. Leg cramps are common.The most common causes are benign leg cramps and exercise-associated cramping.Stretching and not consuming caffeine can help prevent muscle cramps.Drug therapy is not usually recommended to prevent muscle cramps. Some disorders cause symptoms that resemble muscle cramps.Dystonias are involuntary muscle contractions, but they usually last longer and occur more often than cramps.Also, they tend to affect other muscles and may affect many other muscles, including any limb muscles as well as those of the back, neck, and voice.In contrast, benign leg cramps and exercise-associated muscle cramping tend to affect the calf muscles.Tetany is continuous or periodic spasms of muscles throughout the body.These spasms usually last much longer than muscle cramps and are more widespread.The muscles may also twitch.Illusory muscle cramps occur in some people.These people feel as if they are having cramps but no muscle contraction occurs.Hardening of the arteries in the legs (peripheral arterial disease) may cause calf pain (claudication) during physical activity such as walking.This pain is due to inadequate blood flow to muscles, not to muscle contraction as occurs with cramps. ","The most common causes of leg cramps are dehydration and low amounts of potassium, sodium, calcium, or magnesium in the blood.Some medications, muscle fatigue due to too much exercise or holding a muscle in the same position for a long time can also cause cramps.Some leg pain can.be confused with cramps, e.g., due to injury, blood clots, varicose veins, peripheral arterial disease, inflammation or nerve damage due to diabetes or smoking.Some disorders cause symptoms that mimic muscle cramps: involuntary muscle contractions; continuous or periodic spasms of muscles, and illusory muscle cramps.These people feel as if they are having cramps but no muscle contraction occurs.","Leg cramps are common. Common causes of cramps include: Dehydration or low amounts of potassium, sodium, calcium, or magnesium in the blood Medicines (such as diuretics and statins) Muscle fatigue or strain from overuse, too much exercise, or holding a muscle in the same position for a long time. Some disorders cause symptoms that resemble muscle cramps.Dystonias are involuntary muscle contractions, but they usually last longer and occur more often than cramps.Also, they tend to affect other muscles and may affect many other muscles, including any limb muscles as well as those of the back, neck, and voice.In contrast, benign leg cramps and exercise-associated muscle cramping tend to affect the calf muscles.Tetany is continuous or periodic spasms of muscles throughout the body.These spasms usually last much longer than muscle cramps and are more widespread.The muscles may also twitch.Illusory muscle cramps occur in some people.These people feel as if they are having cramps but no muscle contraction occurs.Hardening of the arteries in the legs (peripheral arterial disease) may cause calf pain (claudication) during physical activity such as walking.This pain is due to inadequate blood flow to muscles, not to muscle contraction as occurs with cramps.An injury can also cause leg pain from: A torn or overstretched muscle (strain) Hairline crack in the bone (stress fracture)Inflamed tendon (tendinitis) Shin splints (pain in the front of the leg from overuse)Other common causes of leg pain include: Blood clot (deep vein thrombosis) from long-term bed rest Infection of the bone (osteomyelitis) or skin and soft tissue (cellulitis) Inflammation of the leg Nerve damage common to people with diabetes, smokers, and alcoholics Varicose veins" 180,What should I know if I am newly diagnosed with inflammatory colitis?,"The outlook depends on the cause of the problem.Crohn disease is a chronic condition which has no cure but can be controlled.Ulcerative colitis can usually be controlled with medicines.If not controlled, it can be cured by surgically removing the colon.Viral, bacterial and parasitic colitis can be cured with appropriate medicines.Pseudomembranous colitis can usually be cured with appropriate antibiotics. Computed tomography (CT) or sometimes colonoscopy A doctor may suspect ischemic colitis on the basis of the symptoms of pain and bleeding, especially in a person older than 60.It is important for doctors to distinguish ischemic colitis from acute mesenteric ischemia, a more dangerous condition in which blood flow to part of the intestine is completely and irreversibly blocked.Doctors usually do CT or sometimes also colonoscopy (examination of the large intestine with a flexible viewing tube) to distinguish ischemic colitis from other forms of inflammation, such as infection or inflammatory bowel disease. Most of the times, the cause of colitis is not known.Causes of colitis include: Infections caused by a virus or a parasite Food poisoning due to bacteria Crohn disease Ulcerative colitis Lack of blood flow (ischemic colitis)Past radiation to the large bowel (radiation colitis and strictures)Necrotizing enterocolitis in newborns Pseudomembranous colitis caused by Clostridium difficile infection Stool tests A doctor usually suspects hemorrhagic colitis when a person has bloody diarrhea.To make the diagnosis of hemorrhagic colitis, a doctor has stool specimens tested for strains of E. coli or the toxins they produce.Other tests, such as sigmoidoscopy, may be done if a doctor suspects that other diseases may be causing the bloody diarrhea. The health care provider will perform a physical exam.You will also be asked questions about your symptoms, such as: How long have you had the symptoms?How severe is your pain?How often do you have pain and how long does it last?How often do you have diarrhea?Have you been traveling?Have you been taking antibiotics recently?Your provider may recommend a flexible sigmoidoscopy or colonoscopy.During this test, a flexible tube is inserted through the rectum to examine the colon.You may have biopsies taken during this exam.Biopsies may show changes related to inflammation.This can help determine the cause of colitis.Other studies that can identify colitis include: CT scan of the abdomen MRI of the abdomen Barium enema Stool culture Stool examination for ova and parasites A health care provider diagnoses ulcerative colitis with the following:medical and family history physical exam lab tests endoscopies of the large intestineThe health care provider may perform a series of medical tests to rule out other bowel disorders, such as irritable bowel syndrome, Crohn's disease, or celiac disease, that may cause symptoms similar to those of ulcerative colitis.Medical and Family HistoryTaking a medical and family history can help the health care provider diagnose ulcerative colitis and understand a patient's symptoms.The health care provider will also ask the patient about current and past medical conditions and medications.Physical ExamA physical exam may help diagnose ulcerative colitis.During a physical exam, the health care provider most oftenchecks for abdominal distension, or swelling listens to sounds within the abdomen using a stethoscope taps on the abdomen to check for tenderness and painLab TestsA health care provider may order lab tests to help diagnose ulcerative colitis, including blood and stool tests.Blood tests.A blood test involves drawing blood at a health care provider's office or a lab.A lab technologist will analyze the blood sample.A health care provider may use blood tests to look foranemia inflammation or infection somewhere in the body markers that show ongoing inflammation low albumin, or proteincommon in patients with severe ulcerative colitisStool tests.A stool test is the analysis of a sample of stool.A health care provider will give the patient a container for catching and storing the stool at home.The patient returns the sample to the health care provider or to a lab.A lab technologist will analyze the stool sample.Health care providers commonly order stool tests to rule out other causes of GI diseases, such as infection.Endoscopies of the Large IntestineEndoscopies of the large intestine are the most accurate methods for diagnosing ulcerative colitis and ruling out other possible conditions, such as Crohn's disease, diverticular disease, or cancer.Endoscopies of the large intestine includeColonoscopy.Colonoscopy is a test that uses a long, flexible, narrow tube with a light and tiny camera on one end, called a colonoscope or scope, to look inside the rectum and entire colon.In most cases, light anesthesia and pain medication help patients relax for the test.The medical staff will monitor a patient's vital signs and try to make him or her as comfortable as possible.A nurse or technician places an intravenous (IV) needle in a vein in the patient's arm or hand to give anesthesia.For the test, the patient will lie on a table or stretcher while the gastroenterologist inserts a colonoscope into the patient's anus and slowly guides it through the rectum and into the colon.The scope inflates the large intestine with air to give the gastroenterologist a better view.The camera sends a video image of the intestinal lining to a monitor, allowing the gastroenterologist to carefully examine the tissues lining the colon and rectum.The gastroenterologist may move the patient several times and adjust the scope for better viewing.Once the scope has reached the opening to the small intestine, the gastroenterologist slowly withdraws it and examines the lining of the colon and rectum again.A colonoscopy can show irritated and swollen tissue, ulcers, and abnormal growths such as polypsextra pieces of tissue that grow on the inner lining of the intestine.If the gastroenterologist suspects ulcerative colitis, he or she will biopsy the patient's colon and rectum.A biopsy is a procedure that involves taking small pieces of tissue for examination with a microscope.A health care provider will give patients written bowel prep instructions to follow at home before the test.The health care provider will also give patients information about how to care for themselves following the procedure.Flexible sigmoidoscopy.Flexible sigmoidoscopy is a test that uses a flexible, narrow tube with a light and tiny camera on one end, called a sigmoidoscope or scope, to look inside the rectum, the sigmoid colon, and sometimes the descending colon.In most cases, a patient does not need anesthesia.For the test, the patient will lie on a table or stretcher while the health care provider inserts the sigmoidoscope into the patient's anus and slowly guides it through the rectum, the sigmoid colon, and sometimes the descending colon.The scope inflates the large intestine with air to give the health care provider a better view.The camera sends a video image of the intestinal lining to a monitor, allowing the health care provider to examine the tissues lining the sigmoid colon and rectum.The health care provider may ask the patient to move several times and adjust the scope for better viewing.Once the scope reaches the end of the sigmoid colon, the health care provider slowly withdraws it while examining the lining of the colon and rectum again.The health care provider will look for signs of bowel diseases and conditions such as irritated and swollen tissue, ulcers, and polyps.If the health care provider suspects ulcerative colitis, he or she will biopsy the patient's colon and rectum.A health care provider will give patients written bowel prep instructions to follow at home before the test.The health care provider will also give patients information about how to care for themselves following the procedure. Colitis is swelling (inflammation) of the large intestine (colon). People with ulcerative colitis may be more likely to develop colon cancer whenulcerative colitis affects the entire colon a person has ulcerative colitis for at least 8 years inflammation is ongoing people also have primary sclerosing cholangitis, a condition that affects the liver a person is malePeople who receive ongoing treatment and remain in remission may reduce their chances of developing colon cancer.People with ulcerative colitis should talk with their health care provider about how often they should get screened for colon cancer.Screening can include colonoscopy with biopsies or a special dye spray called chromoendoscopy.Health care providers may recommend colonoscopy every 1 to 3 years for people with ulcerative colitis who havethe disease in one-third or more or of their colon had ulcerative colitis for 8 yearsSuch screening does not reduce a person's chances of developing colon cancer.Instead, screening can help diagnose cancer early and improve chances for recovery.Surgery to remove the entire colon eliminates the risk of colon cancer. ","Colitis is an inflammation of the colon.It can be caused by infection due to viruses, bacteria or parasites; or lack of blood flow (ischemic colitis) Crohn's disease, or celiac disease may have symptoms similar to ulcerative colitis.A physical examination, biopsy, colonoscopy, CT scan, MR, and stool tests can help determine the cause of colitis.If you have ulcerative colitis, your doctor will tell you how often you need diagnostic screening for colon cancer.If diagnosed early, colon cancer is curable.The outlook for colitis depends on the cause.Ulcerative colitis can be controlled with medicines or surgery.Viral, bacterial and parasitic colitis can be cured with medicines.","Colitis is swelling (inflammation) of the large intestine (colon).Most of the times, the cause of colitis is not known.Causes of colitis include: Infections caused by a virus or a parasite Food poisoning due to bacteria Lack of blood flow (ischemic colitis) .Crohn's disease, or celiac disease may cause symptoms similar to those of ulcerative colitis.A physical exam may help diagnose ulcerative colitis.Endoscopies of the large intestine are the most accurate methods for diagnosing ulcerative colitis and ruling out other possible conditions, such as Crohn's disease, diverticular disease, or cancer.Biopsies may show changes related to inflammation.This can help determine the cause of colitis.Other studies that can identify colitis include: CT scan of the abdomen MRI of the abdomen Stool examination for ova and parasites People with ulcerative colitis should talk with their health care provider about how often they should get screened for colon cancer.screening can help diagnose cancer early and improve chances for recovery.The outlook depends on the cause of the problem. Ulcerative colitis can usually be controlled with medicines.If not controlled, it can be cured by surgically removing the colon.Viral, bacterial and parasitic colitis can be cured with appropriate medicines.Pseudomembranous colitis can usually be cured with appropriate antibiotics." 181,What causes headache and pain around the right ear and eye?,"The most common type of headache is tension headache.It is likely caused by tight muscles in your shoulders, neck, scalp, and jaw.A tension headache: - May be related to stress, depression, anxiety, a head injury, or holding your head and neck in an abnormal position.- Tends to be on both sides of your head.It often starts at the back of the head and spreads forward.The pain may feel dull or squeezing, like a tight band or vice.Your shoulders, neck, or jaw may feel tight or sore.A migraine headache involves severe pain.It usually occurs with other symptoms, such as vision changes, sensitivity to sound or light, or nausea.With a migraine: - The pain may be throbbing, pounding, or pulsating.It tends to begin on one side of your head.It may spread to both sides. -The headache may be associated with an aura.This is a group of warning symptoms that start before your headache.The pain usually gets worse as you try to move around.- Migraines may be triggered by foods, such as chocolate, certain cheeses, or monosodium glutamate (MSG).Caffeine withdrawal, lack of sleep, and alcohol may also be triggers.Rebound headaches are headaches that keep coming back.They often occur from overuse of pain medicines.For this reason, these headaches are also called medicine overuse headaches.People who take pain medicine more than 3 days a week on a regular basis can develop this type of headache.Other types of headaches: - Cluster headache is a sharp, very painful headache that occurs up to several times a day for months.It then goes away for a similar period of time.The headache usually lasts less than an hour.It tends to occur at the same times every day.- Sinus headache causes pain in the front of the head and face.It is due to swelling in the sinus passages behind the cheeks, nose, and eyes.The pain is worse when you bend forward and when you first wake up in the morning.- Headaches may occur if you have a cold, the flu, a fever, or premenstrual syndrome.- Headache due to a disorder called temporal arteritis.This is a swollen, inflamed artery that supplies blood to part of the head, temple, and neck area.In rare cases, a headache can be a sign of something more serious, such as: - Bleeding in the area between the brain and the thin tissue that covers the brain (subarachnoid hemorrhage) - Blood pressure that is very high - Brain infection, such as meningitis or encephalitis, or abscess - Brain tumor - Buildup of fluid inside the skull that leads to brain swelling (hydrocephalus) -Buildup of pressure inside the skull that appears to be, but is not a tumor (pseudomotor cerebri) - Carbon monoxide poisoning - Lack of oxygen during sleep (sleep apnea) - Problems with the blood vessels and bleeding in the brain, such as arteriovenous malformation (AVM), brain aneurysm, or stroke The eustachian tube runs from the middle part of each ear to the back of the throat.This tube drains fluid that is made in the middle ear.If the eustachian tube becomes blocked, fluid can build up.This may lead to pressure behind the eardrum or an ear infection.Ear pain in adults is less likely to be from an ear infection.Pain that you feel in the ear may be coming from another place, such as your teeth, the joint in your jaw (temporomandibular joint), or your throat.This is called ""referred"" pain.Causes of ear pain may include: Arthritis of the jaw Short-term ear infection Long-term ear infection Ear injury from pressure changes (from high altitudes and other causes) Object stuck in the ear or buildup of ear wax Hole in the eardrum Sinus infection Sore throatTemporomandibular joint syndrome (TMJ) Tooth infection Ear pain in a child or infant may be due to infection.Other causes may include: Ear canal irritation from cotton-tipped swabs Soap or shampoo staying in the ear An earache is a sharp, dull, or burning pain in one or both ears.The pain may last a short time or be ongoing.Related conditions include: Otitis media Swimmer's ear Malignant otitis externa ","Pain in one or both ears in adults may be caused by ear infection, arthritis, injury, ear wax buildup, or be ""referred"" from the teeth, temporomandibular joint, sinuses or the throat.Swelling of i the sinuses behind the cheeks, nose, and eyes could cause sinus headaches. Temporal arteritis due to swollen, inflamed artery that supplies blood to parts of the head, temple, and neck area could also cause headaches.The most common type of headache are tension headaches caused by tightness of the shoulder, neck, or head muscles.Migraine headache may start on one side of the head.Cluster headaches are sharp and occur several times a day for several months.","An earache is a sharp, dull, or burning pain in one or both ears.The pain may last a short time or be ongoing. Ear pain in adults is less likely to be from an ear infection.Pain that you feel in the ear may be coming from another place, such as your teeth, the joint in your jaw (temporomandibular joint), or your throat.This is called ""referred"" pain.Causes of ear pain may include: Arthritis of the jaw Short-term ear infection Long-term ear infection Ear injury from pressure changes (from high altitudes and other causes) Object stuck in the ear or buildup of ear wax Hole in the eardrum Sinus infection Sore throatTemporomandibular joint syndrome (TMJ) Tooth infection The most common type of headache is tension headache.It is likely caused by tight muscles in your shoulders, neck, scalp, and jaw. A migraine headache involves severe pain.The pain may be throbbing, pounding, or pulsating.It tends to begin on one side of your head.Cluster headache is a sharp, very painful headache that occurs up to several times a day for months.Sinus headache causes pain in the front of the head and face.It is due to swelling in the sinus passages behind the cheeks, nose, and eyes. Headache due to a disorder called temporal arteritis.This is a swollen, inflamed artery that supplies blood to part of the head, temple, and neck area." 182,How can I prevent knee arthritis from progressing?,"Simple causes of knee pain often clear up on their own while you take steps to manage your symptoms.If knee pain is caused by an accident or injury, you should contact your health care provider.If your knee pain has just started and is not severe, you can: Rest and avoid activities that cause pain.Avoid putting weight on your knee.Apply ice.First, apply it every hour for up to 15 minutes.After the first day, apply it at least 4 times per day.Cover your knee with a towel before applying ice.DO NOT fall asleep while using ice.You can leave it on too long and get frostbite.Keep your knee raised as much as possible to bring down any swelling.Wear an elastic bandage or elastic sleeve, which you can buy at most pharmacies.This may reduce swelling and provide support.Take ibuprofen (Motrin) or naproxyn (Aleve) for pain and swelling.Acetaminophen (Tylenol) can help relieve pain, but not swelling.Talk to your provider before taking these medicines if you have medical problems, or if you have taken them for more than a day or two.Sleep with a pillow underneath or between your knees.Follow these general tips to help relieve and prevent knee pain: Always warm up before exercising and cool down after exercising.Stretch the muscles in the front of your thigh (quadriceps) and in the back of your thigh (hamstrings).Avoid running down hills -- walk down instead.Bicycle, or better yet, swim instead of run.Reduce the amount of exercise you do.Run on a smooth, soft surface, such as a track, instead of on cement or pavement.Lose weight if you are overweight.Every pound (0.5 kilogram) that you are overweight puts about 5 extra pounds (2.25 kilograms) of pressure on your kneecap when you go up and down stairs.Ask your provider for help losing weight.If you have flat feet, try special shoe inserts and arch supports (orthotics).Make sure your running shoes are well made, fit well, and have good cushioning.Further steps for you to take may depend on the cause of your knee pain. The treatment of knee problems depends on your type of injury or condition.

Arthritis in Knees

The most common type of arthritis of the knee is osteoarthritis.In this disease, the cartilage in your knee gradually wears away.Treatments for osteoarthritis are: Medicines to reduce pain, such as aspirin and acetaminophen.Medicines to reduce swelling and inflammation, such as ibuprofen and nonsteroidal anti-inflammatory drugs (NSAIDs).Injections of corticosteroids medications directly into the knee joint.Exercises to improve movement and strength.Weight loss to relieve the stress on the knee joint.Rheumatoid arthritis is another type of arthritis that affects the knee.In rheumatoid arthritis, your knee becomes inflamed and cartilage may be destroyed.Treatment includes: Physical therapy to strengthen the muscles.Weight loss to relieve the stress on the knee joint.Medicines similar to those prescribed for osteoarthritis.However, you may need additional medicines such as disease-modifying, anti-rheumatic drugs or biologic response modifiers to control the disease.Knee for a seriously knee damage, which can include: Knee replacement.Cartilage replacement.Resurfacing the damaged cartilage.Treatment for other joint diseases is similar to the treatment for rheumatoid arthritis.

Chondromalacia

To treat chondromalacia, many doctors recommend that people with chondromalacia perform low-impact exercises such as: Swimming.Riding a stationary bicycle.Using a cross-country ski machine.These types of exercises strengthen muscles, particularly muscles of the inner part of the quadriceps, without injuring joints.If these treatments dont improve the condition, surgery may be indicated.

Injuries to the Menisci

If the tear is minor and the pain and other symptoms go away, the doctor may recommend a muscle-strengthening program.The following exercises are designed to build up the quadriceps and hamstring muscles and increase flexibility and strength after injury to the meniscus: Warming up the joint by riding a stationary bicycle, then straightening and raising the leg (but not straightening it too much).Extending the leg while sitting (a weight may be worn on the ankle for this exercise).Raising the leg while lying on the stomach.Exercising in a pool (walking as fast as possible in chest-deep water, performing small flutter kicks while holding onto the side of the pool, and raising each leg to 90 degrees in chest-deep water while pressing the back against the side of the pool).Before beginning any type of exercise program, consult your doctor or physical therapist to learn which exercises are appropriate for you and how to do them correctly.If you are doing the wrong exercise or exercising improperly, you can cause problems.A health care professional can also advise you on how to warm up safely and when to avoid exercising a joint affected by arthritis.If your lifestyle is limited by the symptoms or the problem, surgery may be indicated.

Cruciate Ligament Injuries

For an incomplete tear, your doctor may recommend an exercise program to strengthen surrounding muscles.He or she may also prescribe a brace to protect the knee during activity.For a completely torn anterior cruciate ligament in an active athlete and motivated person, your doctor is likely to recommend surgery.

Medial and Lateral Collateral Ligament Injuries

Most sprains of the collateral ligaments will heal if you: Follow a prescribed exercise program.Apply ice packs to reduce pain and swelling.Use a small sleeve-type brace to protect and stabilize the knee.A sprain may take 2 to 4 weeks to heal.A severely sprained or torn collateral ligament may be accompanied by a torn anterior cruciate ligament, which usually requires surgical repair.

Tendon Injuries and Disorders

Treatment for tendon injuries and disorders includes: Rest.Ice.Elevation.Medicines such as aspirin or ibuprofen to relieve pain and reduce swelling.Limiting sports activity.Exercise for stretching and strengthening.A cast, if there is a partial tear.Surgery for complete tears or very severe injuries.The goals of an exercise program for tendon injuries and disorder are: Restore the ability to bend and straighten the knee.Strengthen the knee to prevent repeat injury.

Osgood-Schlatter Disease

Osgood-Schlatter disease is temporary and the pain usually goes away without treatment, which includes: Applying ice to the knee when pain begins to help relieve inflammation.Stretching and strengthening exercises.Limiting participation in vigorous sports.Wearing knee pads for protection and apply ice to the knee after more intense activity.If there is a great deal of pain, sports activities may be limited until the discomfort becomes tolerable.

Iliotibial Band Syndrome

Iliotibial band syndrome usually disappears if you: Reduce your activity.Perform stretching exercises followed by muscle-strengthening exercises.In rare cases when the syndrome doesnt disappear, you may need surgery to split the tendon so it isnt stretched too tightly over the bone.

Osteochondritis Dissecans

Doctors treat osteochondritis dissecans with: Rest and limiting activity.Physical therapy.If conservative measures do not help or the cartilage fragments are loose, surgery may be recommended.Surgery can include: A surgeon placing a pin or screw.This can stimulate new blood flow to the cartilage.A surgeon may scrape the cavity to reach fresh bone and add a bone graft to fix the fragments in position.Research is being done to investigate cartilage and tissue transplants.

Plica Syndrome

The treatments for plica syndrome include: Medicines such as aspirin or ibuprofen to reduce swelling.Rest.Ice.Elastic bandage on the knee.Exercises to strengthen muscles.Cortisone injection into the plicae.You may need surgery to remove the plica if the other treatments do not fix the problem.The treatment of knee problems depends on your type of injury or condition.

Arthritis in Knees

The most common type of arthritis of the knee is osteoarthritis.In this disease, the cartilage in your knee gradually wears away.Treatments for osteoarthritis are: Medicines to reduce pain, such as aspirin and acetaminophen.Medicines to reduce swelling and inflammation, such as ibuprofen and nonsteroidal anti-inflammatory drugs (NSAIDs).Injections of corticosteroids medications directly into the knee joint.Exercises to improve movement and strength.Weight loss to relieve the stress on the knee joint.Rheumatoid arthritis is another type of arthritis that affects the knee.In rheumatoid arthritis, your knee becomes inflamed and cartilage may be destroyed.Treatment includes: Physical therapy to strengthen the muscles.Weight loss to relieve the stress on the knee joint.Medicines similar to those prescribed for osteoarthritis.However, you may need additional medicines such as disease-modifying, anti-rheumatic drugs or biologic response modifiers to control the disease.Knee for a seriously knee damage, which can include: Knee replacement.Cartilage replacement.Resurfacing the damaged cartilage.Treatment for other joint diseases is similar to the treatment for rheumatoid arthritis.

Chondromalacia

To treat chondromalacia, many doctors recommend that people with chondromalacia perform low-impact exercises such as: Swimming.Riding a stationary bicycle.Using a cross-country ski machine.These types of exercises strengthen muscles, particularly muscles of the inner part of the quadriceps, without injuring joints.If these treatments dont improve the condition, surgery may be indicated.

Injuries to the Menisci

If the tear is minor and the pain and other symptoms go away, the doctor may recommend a muscle-strengthening program.The following exercises are designed to build up the quadriceps and hamstring muscles and increase flexibility and strength after injury to the meniscus: Warming up the joint by riding a stationary bicycle, then straightening and raising the leg (but not straightening it too much).Extending the leg while sitting (a weight may be worn on the ankle for this exercise).Raising the leg while lying on the stomach.Exercising in a pool (walking as fast as possible in chest-deep water, performing small flutter kicks while holding onto the side of the pool, and raising each leg to 90 degrees in chest-deep water while pressing the back against the side of the pool).Before beginning any type of exercise program, consult your doctor or physical therapist to learn which exercises are appropriate for you and how to do them correctly.If you are doing the wrong exercise or exercising improperly, you can cause problems.A health care professional can also advise you on how to warm up safely and when to avoid exercising a joint affected by arthritis.If your lifestyle is limited by the symptoms or the problem, surgery may be indicated.

Cruciate Ligament Injuries

For an incomplete tear, your doctor may recommend an exercise program to strengthen surrounding muscles.He or she may also prescribe a brace to protect the knee during activity.For a completely torn anterior cruciate ligament in an active athlete and motivated person, your doctor is likely to recommend surgery.

Medial and Lateral Collateral Ligament Injuries

Most sprains of the collateral ligaments will heal if you: Follow a prescribed exercise program.Apply ice packs to reduce pain and swelling.Use a small sleeve-type brace to protect and stabilize the knee.A sprain may take 2 to 4 weeks to heal.A severely sprained or torn collateral ligament may be accompanied by a torn anterior cruciate ligament, which usually requires surgical repair.

Tendon Injuries and Disorders

Treatment for tendon injuries and disorders includes: Rest.Ice.Elevation.Medicines such as aspirin or ibuprofen to relieve pain and reduce swelling.Limiting sports activity.Exercise for stretching and strengthening.A cast, if there is a partial tear.Surgery for complete tears or very severe injuries.The goals of an exercise program for tendon injuries and disorder are: Restore the ability to bend and straighten the knee.Strengthen the knee to prevent repeat injury.

Osgood-Schlatter Disease

Osgood-Schlatter disease is temporary and the pain usually goes away without treatment, which includes: Applying ice to the knee when pain begins to help relieve inflammation.Stretching and strengthening exercises.Limiting participation in vigorous sports.Wearing knee pads for protection and apply ice to the knee after more intense activity.If there is a great deal of pain, sports activities may be limited until the discomfort becomes tolerable.

Iliotibial Band Syndrome

Iliotibial band syndrome usually disappears if you: Reduce your activity.Perform stretching exercises followed by muscle-strengthening exercises.In rare cases when the syndrome doesnt disappear, you may need surgery to split the tendon so it isnt stretched too tightly over the bone.

Osteochondritis Dissecans

Doctors treat osteochondritis dissecans with: Rest and limiting activity.Physical therapy.If conservative measures do not help or the cartilage fragments are loose, surgery may be recommended.Surgery can include: A surgeon placing a pin or screw.This can stimulate new blood flow to the cartilage.A surgeon may scrape the cavity to reach fresh bone and add a bone graft to fix the fragments in position.Research is being done to investigate cartilage and tissue transplants.

Plica Syndrome

The treatments for plica syndrome include: Medicines such as aspirin or ibuprofen to reduce swelling.Rest.Ice.Elastic bandage on the knee.Exercises to strengthen muscles.Cortisone injection into the plicae.You may need surgery to remove the plica if the other treatments do not fix the problem.The treatment of knee problems depends on your type of injury or condition.

Arthritis in Knees

The most common type of arthritis of the knee is osteoarthritis.In this disease, the cartilage in your knee gradually wears away.Treatments for osteoarthritis are: Medicines to reduce pain, such as aspirin and acetaminophen.Medicines to reduce swelling and inflammation, such as ibuprofen and nonsteroidal anti-inflammatory drugs (NSAIDs).Injections of corticosteroids medications directly into the knee joint.Exercises to improve movement and strength.Weight loss to relieve the stress on the knee joint.Rheumatoid arthritis is another type of arthritis that affects the knee.In rheumatoid arthritis, your knee becomes inflamed and cartilage may be destroyed.Treatment includes: Physical therapy to strengthen the muscles.Weight loss to relieve the stress on the knee joint.Medicines similar to those prescribed for osteoarthritis.However, you may need additional medicines such as disease-modifying, anti-rheumatic drugs or biologic response modifiers to control the disease.Knee for a seriously knee damage, which can include: Knee replacement.Cartilage replacement.Resurfacing the damaged cartilage.Treatment for other joint diseases is similar to the treatment for rheumatoid arthritis.

Chondromalacia

To treat chondromalacia, many doctors recommend that people with chondromalacia perform low-impact exercises such as: Swimming.Riding a stationary bicycle.Using a cross-country ski machine.These types of exercises strengthen muscles, particularly muscles of the inner part of the quadriceps, without injuring joints.If these treatments dont improve the condition, surgery may be indicated.

Injuries to the Menisci

If the tear is minor and the pain and other symptoms go away, the doctor may recommend a muscle-strengthening program.The following exercises are designed to build up the quadriceps and hamstring muscles and increase flexibility and strength after injury to the meniscus: Warming up the joint by riding a stationary bicycle, then straightening and raising the leg (but not straightening it too much).Extending the leg while sitting (a weight may be worn on the ankle for this exercise).Raising the leg while lying on the stomach.Exercising in a pool (walking as fast as possible in chest-deep water, performing small flutter kicks while holding onto the side of the pool, and raising each leg to 90 degrees in chest-deep water while pressing the back against the side of the pool).Before beginning any type of exercise program, consult your doctor or physical therapist to learn which exercises are appropriate for you and how to do them correctly.If you are doing the wrong exercise or exercising improperly, you can cause problems.A health care professional can also advise you on how to warm up safely and when to avoid exercising a joint affected by arthritis.If your lifestyle is limited by the symptoms or the problem, surgery may be indicated.

Cruciate Ligament Injuries

For an incomplete tear, your doctor may recommend an exercise program to strengthen surrounding muscles.He or she may also prescribe a brace to protect the knee during activity.For a completely torn anterior cruciate ligament in an active athlete and motivated person, your doctor is likely to recommend surgery.

Medial and Lateral Collateral Ligament Injuries

Most sprains of the collateral ligaments will heal if you: Follow a prescribed exercise program.Apply ice packs to reduce pain and swelling.Use a small sleeve-type brace to protect and stabilize the knee.A sprain may take 2 to 4 weeks to heal.A severely sprained or torn collateral ligament may be accompanied by a torn anterior cruciate ligament, which usually requires surgical repair.

Tendon Injuries and Disorders

Treatment for tendon injuries and disorders includes: Rest.Ice.Elevation.Medicines such as aspirin or ibuprofen to relieve pain and reduce swelling.Limiting sports activity.Exercise for stretching and strengthening.A cast, if there is a partial tear.Surgery for complete tears or very severe injuries.The goals of an exercise program for tendon injuries and disorder are: Restore the ability to bend and straighten the knee.Strengthen the knee to prevent repeat injury.

Osgood-Schlatter Disease

Osgood-Schlatter disease is temporary and the pain usually goes away without treatment, which includes: Applying ice to the knee when pain begins to help relieve inflammation.Stretching and strengthening exercises.Limiting participation in vigorous sports.Wearing knee pads for protection and apply ice to the knee after more intense activity.If there is a great deal of pain, sports activities may be limited until the discomfort becomes tolerable.

Iliotibial Band Syndrome

Iliotibial band syndrome usually disappears if you: Reduce your activity.Perform stretching exercises followed by muscle-strengthening exercises.In rare cases when the syndrome doesnt disappear, you may need surgery to split the tendon so it isnt stretched too tightly over the bone.

Osteochondritis Dissecans

Doctors treat osteochondritis dissecans with: Rest and limiting activity.Physical therapy.If conservative measures do not help or the cartilage fragments are loose, surgery may be recommended.Surgery can include: A surgeon placing a pin or screw.This can stimulate new blood flow to the cartilage.A surgeon may scrape the cavity to reach fresh bone and add a bone graft to fix the fragments in position.Research is being done to investigate cartilage and tissue transplants.

Plica Syndrome

The treatments for plica syndrome include: Medicines such as aspirin or ibuprofen to reduce swelling.Rest.Ice.Elastic bandage on the knee.Exercises to strengthen muscles.Cortisone injection into the plicae.You may need surgery to remove the plica if the other treatments do not fix the problem. A knee sprain is a tear in one or more of the ligaments that hold your knee in place.Ligaments are short, tough bands of tissue that hold your bones together at a joint.Knee sprains: Usually happen when you twist your leg Can be mild, moderate, or severe depending on whether the ligament is stretched, partly, or fully torn Often involve more than one ligament Cause pain and swelling Don't show up on x-rays, but doctors may do an MRI Are treated by Protecting the area, Rest, Ice, Compression, and Elevation (""PRICE"") Often require a knee brace Sometimes require surgery The cartilage ""shock absorber pads"" inside your knee may also be injured.See a doctor if you're unable to stand or walk.Holding the Knee Together The collateral ligaments, one on either side of the knee, prevent the knee from moving from side to side too much.The cruciate ligaments inside the joint prevent the knee from moving forward or backward too much.The menisci are cartilage ""shock absorber pads"" between the thighbone (femur) and larger lower leg bone (tibia), which form part of the knee joint. Thorough treatment of fungal infections elsewhere in the body may help prevent fungal arthritis. Studies of the various forms of arthritis are helping doctors better understand these diseases and develop treatments to stop or slow their progression and damage to joints, including the knees.Studies are also underway to discover or develop safer and more effective pain relief, particularly for osteoarthritis of the knee.In recent years, the nutritional supplement pair glucosamine and chondroitin has shown some potential for reducing the pain of osteoarthritis, although no conclusive proof has emerged to date.Both of these nutrients are found in small quantities in food and are components of normal cartilage.The Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT), which was cosponsored by the National Center for Complementary and Integrative Health (NCCIH) and the NIAMS, assessed the effectiveness and safety of these supplements, when taken together or separately.The trial found that the combination of glucosamine and chondroitin sulfate did not provide significant relief from osteoarthritis pain among all participants.However, a smaller subgroup of study participants with moderate-to-severe pain showed significant relief with the combined supplements.Studies involving imaging techniques, in combination with measurements of biochemical markers, could result in early identification of diseases affecting the knee.They could also increase the ability to predict disease progression and enable direct monitoring of responses to tissue repair and therapeutic interventions.Other areas of research involve trying to understand better how and why joint injuries occur and the measures that should be taken to prevent them, investigating the role of exercise in protecting the knee, and developing less invasive surgeries and better joint prostheses.Studies of the various forms of arthritis are helping doctors better understand these diseases and develop treatments to stop or slow their progression and damage to joints, including the knees.Studies are also underway to discover or develop safer and more effective pain relief, particularly for osteoarthritis of the knee.In recent years, the nutritional supplement pair glucosamine and chondroitin has shown some potential for reducing the pain of osteoarthritis, although no conclusive proof has emerged to date.Both of these nutrients are found in small quantities in food and are components of normal cartilage.The Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT), which was cosponsored by the National Center for Complementary and Integrative Health (NCCIH) and the NIAMS, assessed the effectiveness and safety of these supplements, when taken together or separately.The trial found that the combination of glucosamine and chondroitin sulfate did not provide significant relief from osteoarthritis pain among all participants.However, a smaller subgroup of study participants with moderate-to-severe pain showed significant relief with the combined supplements.Studies involving imaging techniques, in combination with measurements of biochemical markers, could result in early identification of diseases affecting the knee.They could also increase the ability to predict disease progression and enable direct monitoring of responses to tissue repair and therapeutic interventions.Other areas of research involve trying to understand better how and why joint injuries occur and the measures that should be taken to prevent them, investigating the role of exercise in protecting the knee, and developing less invasive surgeries and better joint prostheses.Studies of the various forms of arthritis are helping doctors better understand these diseases and develop treatments to stop or slow their progression and damage to joints, including the knees.Studies are also underway to discover or develop safer and more effective pain relief, particularly for osteoarthritis of the knee.In recent years, the nutritional supplement pair glucosamine and chondroitin has shown some potential for reducing the pain of osteoarthritis, although no conclusive proof has emerged to date.Both of these nutrients are found in small quantities in food and are components of normal cartilage.The Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT), which was cosponsored by the National Center for Complementary and Integrative Health (NCCIH) and the NIAMS, assessed the effectiveness and safety of these supplements, when taken together or separately.The trial found that the combination of glucosamine and chondroitin sulfate did not provide significant relief from osteoarthritis pain among all participants.However, a smaller subgroup of study participants with moderate-to-severe pain showed significant relief with the combined supplements.Studies involving imaging techniques, in combination with measurements of biochemical markers, could result in early identification of diseases affecting the knee.They could also increase the ability to predict disease progression and enable direct monitoring of responses to tissue repair and therapeutic interventions.Other areas of research involve trying to understand better how and why joint injuries occur and the measures that should be taken to prevent them, investigating the role of exercise in protecting the knee, and developing less invasive surgeries and better joint prostheses. Knee pain can have different causes.Being overweight puts you at greater risk for knee problems.Overusing your knee can trigger knee problems that cause pain.If you have a history of arthritis, it could also cause knee pain.Here are some common causes of knee pain: MEDICAL CONDITIONS Arthritis.Including rheumatoid arthritis, osteoarthritis, lupus, and gout.Baker cyst.A fluid-filled swelling behind the knee that may occur with swelling (inflammation) from other causes, like arthritis.Cancers that either spread to your bones or begin in the bones.Osgood-Schlatter disease.Infection in the bones of the knee.Infection in the knee joint.INJURIES AND OVERUSE Bursitis.Inflammation from repeated pressure on the knee, such as kneeling for a long time, overuse, or injury.Dislocation of the kneecap.Fracture of the kneecap or other bones.Iliotibial band syndrome.Injury to the thick band that runs from your hip to the outside of your knee.Pain in the front of your knee around the kneecap.Torn ligament.An anterior cruciate ligament (ACL) injury, or medial collateral ligament (MCL) injury may cause bleeding into your knee, swelling, or an unstable knee.Torn cartilage (a meniscus tear).Pain felt on the inside or outside of the knee joint.Strain or sprain.Minor injuries to the ligaments caused by sudden or unnatural twisting. You may need this procedure if you have damage to the cartilage: In the knee joint Under the kneecap The goal of this surgery is to prevent or slow further damage to the cartilage.This will help prevent knee arthritis.It can help you delay the need for a partial or total knee replacement.This procedure is also used to treat knee pain due to cartilage injuries.A surgery called autologous chondrocyte implantation or mosaicplasty can also be done for similar problems. Some knee problems, such as those resulting from an accident, can't be prevented.However, people can prevent many knee problems by doing the following: Before exercising or participating in sports, warm up by walking or riding a stationary bicycle, then do stretches.Stretching the muscles in the front of the thigh (quadriceps) and back of the thigh (hamstrings) reduces tension on the tendons and relieves pressure on the knee during activity.Strengthen the leg muscles by doing specific exercises (for example, by walking up stairs or hills or by riding a stationary bicycle).A supervised workout with weights is another way to strengthen the leg muscles that support the knee.Avoid sudden changes in the intensity of exercise.Increase the force or duration of activity gradually.Wear shoes that fit properly and are in good condition.This will help maintain balance and leg alignment when walking or running.Flat feet or over-pronated feet (feet that roll inward) can cause knee problems.People can often reduce some of these problems by wearing special shoe inserts (orthotics).Maintain a healthy weight to reduce stress on the knee.Obesity increases the risk of osteoarthritis of the knee.Some knee problems, such as those resulting from an accident, can't be prevented.However, people can prevent many knee problems by doing the following: Before exercising or participating in sports, warm up by walking or riding a stationary bicycle, then do stretches.Stretching the muscles in the front of the thigh (quadriceps) and back of the thigh (hamstrings) reduces tension on the tendons and relieves pressure on the knee during activity.Strengthen the leg muscles by doing specific exercises (for example, by walking up stairs or hills or by riding a stationary bicycle).A supervised workout with weights is another way to strengthen the leg muscles that support the knee.Avoid sudden changes in the intensity of exercise.Increase the force or duration of activity gradually.Wear shoes that fit properly and are in good condition.This will help maintain balance and leg alignment when walking or running.Flat feet or over-pronated feet (feet that roll inward) can cause knee problems.People can often reduce some of these problems by wearing special shoe inserts (orthotics).Maintain a healthy weight to reduce stress on the knee.Obesity increases the risk of osteoarthritis of the knee.Some knee problems, such as those resulting from an accident, can't be prevented.However, people can prevent many knee problems by doing the following: Before exercising or participating in sports, warm up by walking or riding a stationary bicycle, then do stretches.Stretching the muscles in the front of the thigh (quadriceps) and back of the thigh (hamstrings) reduces tension on the tendons and relieves pressure on the knee during activity.Strengthen the leg muscles by doing specific exercises (for example, by walking up stairs or hills or by riding a stationary bicycle).A supervised workout with weights is another way to strengthen the leg muscles that support the knee.Avoid sudden changes in the intensity of exercise.Increase the force or duration of activity gradually.Wear shoes that fit properly and are in good condition.This will help maintain balance and leg alignment when walking or running.Flat feet or over-pronated feet (feet that roll inward) can cause knee problems.People can often reduce some of these problems by wearing special shoe inserts (orthotics).Maintain a healthy weight to reduce stress on the knee.Obesity increases the risk of osteoarthritis of the knee. Early diagnosis and treatment can help prevent joint damage.If you have a family history of arthritis, tell your doctor, even if you do not have joint pain.Avoiding excessive, repeated motions may help protect you against osteoarthritis. ","Treatments for osteoarthritis, the most common type of knee arthritis, include pain medication, e.g., aspirin and acetaminophen, anti-inflammatory drugs, such as ibuprofen, and injections of corticosteroids into the knee joint.A combination of nutritional supplements glucosamine and chondroitin may help.Another type of knee arthritis, rheumatoid arthritis, might need additional medications such as disease-modifying, anti-rheumatic drugs.General tips for protecting your knees include: avoiding excessive, repeated motions; exercises to improve movement and strengthen the muscles.Weight loss to relieve the stress on the knee joint.Stretching before and after exercising, Wearing properly fitting shoes and replacing running with other exercise, such and cycling or swimming.","The most common type of arthritis of the knee is osteoarthritis.In this disease, the cartilage in your knee gradually wears away.Treatments for osteoarthritis are: Medicines to reduce pain, such as aspirin and acetaminophen.Medicines to reduce swelling and inflammation, such as ibuprofen and nonsteroidal anti-inflammatory drugs (NSAIDs).Injections of corticosteroids medications directly into the knee joint.Exercises to improve movement and strength.Weight loss to relieve the stress on the knee joint.Rheumatoid arthritis is another type of arthritis that affects the knee.In rheumatoid arthritis, your knee becomes inflamed and cartilage may be destroyed.Treatment includes: Physical therapy to strengthen the muscles.Weight loss to relieve the stress on the knee joint.Medicines similar to those prescribed for osteoarthritis.However, you may need additional medicines such as disease-modifying, anti-rheumatic drugs or biologic response modifiers to control the disease. for a seriously knee damage, Knee replacement.Cartilage replacement.Resurfacing the damaged cartilage.Treatment for other joint diseases is similar to the treatment for rheumatoid arthritis. In recent years, the nutritional supplement pair glucosamine and chondroitin has shown some potential for reducing the pain of osteoarthritis, although no conclusive proof has emerged to date. Avoiding excessive, repeated motions may help protect you against osteoarthritis. Follow these general tips to help relieve and prevent knee pain: Always warm up before exercising and cool down after exercising.Stretch the muscles in the front of your thigh (quadriceps) and in the back of your thigh (hamstrings).Avoid running down hills -- walk down instead.Bicycle, or better yet, swim instead of run. Run on a smooth, soft surface, such as a track, instead of on cement or pavement. Wear shoes that fit properly and are in good condition.This will help maintain balance and leg alignment when walking or running.Flat feet or over-pronated feet (feet that roll inward) can cause knee problems.People can often reduce some of these problems by wearing special shoe inserts (orthotics)" 183,How to stop getting Bartholin Abscess?,"A Bartholin abscess forms when a small opening (duct) from the gland gets blocked.Fluid in the gland builds up and may become infected.Fluid may build up over many years before an abscess occurs.Often the abscess appears quickly over several days.The area will become very hot and swollen.Activity that puts pressure on the vulva, and walking and sitting, may cause severe pain. Bartholin abscess is the buildup of pus that forms a lump (swelling) in one of the Bartholin glands.These glands are found on each side of the vaginal opening. SELF-CARE STEPSSoaking in warm water 4 times a day for several days can ease the discomfort.It can also help the abscess open and drain on its own.However, the opening is often very small and closes quickly.Therefore, the abscess often returns.DRAINAGE OF THE ABSCESSA small surgical cut can completely drain the abscess.This relieves symptoms and provides the fastest recovery.The procedure can be done under local anesthesia in a provider's office.A 1 to 2 cm cut is made at the site of abscess.The cavity is irrigated with normal saline.A catheter (tube) may be inserted and left in place for 4 to 6 weeks.This allows continuous drainage while the area heals.Sutures are not required.You should begin soaking in warm water 1 to 2 days afterward.You cannot have sexual intercourse until the catheter is removed.You may be asked to have antibiotics if there is pus or other signs of infection.MARSUPIALIZATIONWomen can also be treated with a minor surgery called marsupialization.The procedure involves creating an elliptical opening along the cyst to help the gland drain.The abscess is removed.The provider places stitches at the edges of the cyst.The procedure can sometimes be done in the clinic with medicine to numb the area.In other cases, it may need to be done in the hospital with general anesthesia so that you are asleep and pain-free.You should begin soaking in warm water 1 to 2 days afterward.You cannot have sexual intercourse for 4 weeks after surgery.You can use oral pain medicines after the procedure.Your provider may prescribe narcotic pain medicines if you need them.Your provider may recommend that the glands be completely removed if abscesses keep coming back. The problem rarely goes away on its own.Antibiotics alone usually cannot treat an abscess.Treatment involves surgery to open and drain the abscess.Surgery is usually done with local numbing medicine, along with medicine to make you sleepy.Sometimes, spinal or general anesthesia is used.Surgery is most often an outpatient procedure, which means that you go home on the same day.The surgeon cuts open the abscess and drains the pus.Sometimes a drain is put in to keep the incision open and draining, and sometimes the abscess cavity is packed with gauze.If the pus collection is deep, you may need to stay in the hospital longer for pain control and nursing care of the abscess drainage site.After surgery, you may need warm sitz baths (sitting in a tub of warm water).This helps relieve pain and reduce swelling.Drained abscesses are usually left open and no stitches are needed.The surgeon may prescribe painkillers and antibiotics.You may need stool softeners.Practice good hygiene.Eat soft or liquid foods until the abscess has healed.Avoiding constipation will help decrease pain.You may need stool softeners.Drinking fluids and eating foods with lots of fiber can also help. The chance of a full recovery is excellent.The abscesses may return in few cases.It is important to treat any vaginal infection that is diagnosed at the same time as the abscess. ","Abscess forms when the duct of Bartholin gland gets blocked. Soaking in warm water 4 times a day for several days can help the abscess drain on its own.The opening might close quickly and the abscess may recur.A minor surgery called marsupialization involves creating an elliptical opening along the cyst to help the gland drain.After the surgery, practice good hygiene and avoid constipation by drinking fluids and eating fiber.It is important to treat vaginal infection.If the obsesses keep coming back, your doctor may recommend removing there glands.","A Bartholin abscess forms when a small opening (duct) from the gland gets blocked.These glands are found on each side of the vaginal opening.Soaking in warm water 4 times a day for several days can ease the discomfort.It can also help the abscess open and drain on its own.However, the opening is often very small and closes quickly.Therefore, the abscess often returns. Women can be treated with a minor surgery called marsupialization.The procedure involves creating an elliptical opening along the cyst to help the gland drain. Practice good hygiene.Eat soft or liquid foods until the abscess has healed.Avoiding constipation will help decrease pain.You may need stool softeners.Drinking fluids and eating foods with lots of fiber can also help.The chance of a full recovery is excellent.The abscesses may return in few cases.It is important to treat any vaginal infection that is diagnosed at the same time as the abscess. Your provider may recommend that the glands be completely removed if abscesses keep coming back." 184,Do silk gastrostomy stitches require removal?,"Gastrostomy feeding tube (G-tube) insertion is done in part using a procedure called endoscopy.This is a way of looking inside the body using a flexible tube with a small camera on the end of it.The endoscope is inserted through the mouth and down the esophagus, which leads to the stomach.After the endoscopy tube is inserted, the skin over the left side of belly (abdomen) area is cleaned and numbed.The doctor makes a small surgical cut in this area.The G-tube is inserted through this cut into the stomach.The tube is small, flexible, and hollow.The doctor uses stitches to close the stomach around the tube. Stitches are special threads that are sewn through the skin at an injury site to bring a wound together.Care for your stitches and wound as follows: Keep the area clean and dry for the first 24 to 48 hours after stitches have been placed.Then, you can start to gently wash around the site 1 to 2 times daily.Wash with cool water and soap.Clean as close to the stitches as you can.Do not wash or rub the stitches directly.Dab the site dry with a clean paper towel.Do not rub the area.Avoid using the towel directly on the stitches.If there was a bandage over the stitches, replace it with a new clean bandage and antibiotic treatment, if instructed to do so.Your provider should also tell you when you need to have a wound checked and the stitches removed.If not, contact your provider for an appointment. A gastrostomy feeding tube insertion is the placement of a feeding tube through the skin and the stomach wall.It goes directly into the stomach. ","A gastrostomy tube is inserted through the skin and the stomach wall.The stomach is closed around the tube with stitches.if your doctor has not told you if you need the stitches removed, contact your doctor.","A gastrostomy feeding tube insertion is the placement of a feeding tube through the skin and the stomach wall.It goes directly into the stomach.The G-tube is inserted through cut into the stomach.The tube is small, flexible, and hollow.The doctor uses stitches to close the stomach around the tube.Your provider should tell you when you need to have a wound checked and the stitches removed.If not, contact your provider for an appointment." 185,Are people who had chickenpox susceptible to shingles and trigeminal neuralgia?,"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 The pain of TN comes from the trigeminal nerve.This nerve carries the sensations of touch and pain from the face, eyes, sinuses, and mouth to the brain.Trigeminal neuralgia may be caused by: Multiple sclerosis (MS) or other diseases that damage the protective covering myelin of the nerves Pressure on the trigeminal nerve from a swollen blood vessel or tumor Injury to the trigeminal nerve, such as from trauma to the face or from oral or sinus surgery Often, no exact cause is found.TN usually affects adults above age 50 years, but it can occur at any age.Women are affected more often than men.When TN affects people younger than 40, it is often due to MS or a tumor. ","It is often not clear what causes trigeminal neuralgia.Some of the known causes include multiple sclerosis and other diseases that damage the protective covering of the nerves, pressure on the trigeminal nerve from a swollen blood vessel, tumor or injury.Trigeminal neuralgia runs in families, maybe because of the way the blood vessels are formed.","Trigeminal neuralgia may be caused by: Multiple sclerosis (MS) or other diseases that damage the protective covering myelin of the nerves Pressure on the trigeminal nerve from a swollen blood vessel or tumor Injury to the trigeminal nerve, such as from trauma to the face or from oral or sinus surgery Often, no exact cause is found.There is some evidence that the disorder runs in families, perhaps because of an inherited pattern of blood vessel formation." 188,What are the recommendations for a girl with hypothyroidism?,"If untreated, hypothyroidism can eventually cause anemia, a low body temperature, and heart failure.This situation may progress to confusion, stupor, or coma (myxedema coma).Myxedema coma is a life-threatening complication in which breathing slows, seizures occur, and blood flow to the brain decreases.Myxedema coma can be triggered in a person with hypothyroidism by physical stresses, such as exposure to the cold, as well as by an infection, injury, surgery, and drugs such as sedatives that depress brain function.Spotlight on Aging: Hypothyroidism in Older People Many older people have some degree of hypothyroidism.About 10% of women and 6% of men are affected.Typical symptoms, such as weight gain, muscle cramps, tingling of the hands, and the inability to tolerate cold, are less common among older people.When such symptoms do occur among older people, they are less obvious.Older people may also have less typical symptoms.For example, they may lose weight, become confused, and have a decreased appetite, joint stiffness, joint and muscle pains, weakness, and a tendency to fall.Because symptoms in older people can be different, are often subtle and vague, and are common among older people who do not have hypothyroidism, doctors may not recognize these symptoms as being caused by hypothyroidism.A screening test, in which blood levels of thyroid-stimulating hormone are measured, is important.The test should be done at age 65 even if people have no symptoms of hypothyroidism. Experts recommend that people eat a balanced diet to obtain most nutrients.More information about diet and nutrition can be found on the National Agricultural Library website at www.nutrition.gov.Dietary Supplements Iodine is an essential mineral for the thyroid.However, people with autoimmune thyroid disease may be sensitive to harmful side effects from iodine.Taking iodine drops or eating foods containing large amounts of iodinesuch as seaweed, dulse, or kelpmay cause or worsen hypothyroidism or hyperthyroidism.More information about iodine can be found in the National Library of Medicine fact sheet Iodine in diet, available at www.nlm.nih.gov/medlineplus/ency/article/002421.htm.Women need more iodine when they are pregnantabout 250 micrograms a day because the baby gets iodine from the mothers diet.In the United States, about 7 percent of pregnant women may not get enough iodine in their diet or through prenatal vitamins.3Choosing iodized salt salt supplemented with iodineover plain salt and prenatal vitamins containing iodine will ensure this need is met.To help ensure coordinated and safe care, people should discuss their use of dietary supplements, such as iodine, with their health care provider.Tips for talking with health care providers are available through the National Center for Complementary and Integrative Health. Doctors treat hypothyroidism with: Thyroid hormone pills After you start the pills, your doctor will gradually adjust the dose based on your TSH level.It's important to talk to your doctor about medicines that interfere with absorbing thyroid hormone.Such medicines include iron, calcium, and some antacids. ","In people with hypothyroidism, the body does not produce enough thyroid hormone.Women are more likely to have hypothyroidism.This disorder can almost always be completely controlled with synthetic thyroxine.It is very important to take these pills as instructed. Your doctor will find the exact dose you need.Tell your doctor about all medications and supplements you are taking, as they may interfere with the levels of thyroid hormone.It is also important to eat a balanced diet.If hypothyroidism is not treated, it can cause anemia, heart failure, confusion, stupor, and coma.","Hypothyroidism is a disorder that occurs when the thyroid gland does not make enough thyroid hormone to meet the needs. Women are much more likely than men to develop hypothyroidism.Hypothyroidism can almost always be completely controlled with synthetic thyroxine, as long as the recommended dose is taken every day as instructed.After you start the pills, your doctor will gradually adjust the dose based on your TSH level.It's important to talk to your doctor about medicines that interfere with absorbing thyroid hormone.Such medicines include iron, calcium, and some antacids.If untreated, hypothyroidism can eventually cause anemia, a low body temperature, and heart failure.This situation may progress to confusion, stupor, or coma. Experts recommend that people eat a balanced diet to obtain most nutrients.To help ensure coordinated and safe care, people should discuss their use of dietary supplements, such as iodine, with their health care provider." 190,How is Usher syndrome diagnosed and treated?,"

Summary

Usher syndrome is an inherited disease that causes serious hearing loss and retinitis pigmentosa, an eye disorder that causes your vision to get worse over time.It is the most common condition that affects both hearing and vision.There are three types of Usher syndrome: People with type I are deaf from birth and have severe balance problems from a young age.Vision problems usually start by age 10 and lead to blindness.People with type II have moderate to severe hearing loss and normal balance.Vision problems start in the early teens and get worse more slowly than in type I. People with type III are born with normal hearing and near-normal balance but develop vision problems and then hearing loss.There is no cure.Tools such as hearing aids or cochlear implants can help some people.Training such as Braille instruction, low-vision services, or auditory training can also help.NIH: National Institute on Deafness and Other Communication Disorders Usher syndrome is a condition characterized by hearing loss or deafness and progressive vision loss.The loss of vision is caused by an eye disease called retinitis pigmentosa (RP), which affects the layer of light-sensitive tissue at the back of the eye (the retina).Vision loss occurs as the light-sensing cells of the retina gradually deteriorate.Night vision loss begins first, followed by blind spots that develop in the side (peripheral) vision.Over time, these blind spots enlarge and merge to produce tunnel vision.In some cases of Usher syndrome, vision is further impaired by clouding of the lens of the eye (cataracts).Many people with retinitis pigmentosa retain some central vision throughout their lives, however.Researchers have identified three major types of Usher syndrome, designated as types I, II, and III.These types are distinguished by their severity and the age when signs and symptoms appear.Type I is further divided into seven distinct subtypes, designated as types IA through IG.Usher syndrome type II has at least three described subtypes, designated as types IIA, IIB, and IIC.Individuals with Usher syndrome type I are typically born completely deaf or lose most of their hearing within the first year of life.Progressive vision loss caused by retinitis pigmentosa becomes apparent in childhood.This type of Usher syndrome also includes problems with the inner ear that affect balance.As a result, children with the condition begin sitting independently and walking later than usual.Usher syndrome type II is characterized by hearing loss from birth and progressive vision loss that begins in adolescence or adulthood.The hearing loss associated with this form of Usher syndrome ranges from mild to severe and mainly affects high tones.Affected children have problems hearing high, soft speech sounds, such as those of the letters d and t. The degree of hearing loss varies within and among families with this condition.Unlike other forms of Usher syndrome, people with type II do not have difficulties with balance caused by inner ear problems.People with Usher syndrome type III experience progressive hearing loss and vision loss beginning in the first few decades of life.Unlike the other forms of Usher syndrome, infants with Usher syndrome type III are usually born with normal hearing.Hearing loss typically begins during late childhood or adolescence, after the development of speech, and progresses over time.By middle age, most affected individuals are profoundly deaf.Vision loss caused by retinitis pigmentosa also develops in late childhood or adolescence.People with Usher syndrome type III may also experience difficulties with balance due to inner ear problems.These problems vary among affected individuals, however. So far, 11 genetic loci (a segment of chromosome on which a certain gene is located) have been found to cause Usher syndrome, and nine genes have been pinpointed that cause the disorder.They are: - Type 1 Usher syndrome: MY07A, USH1C, CDH23, PCHD15, SANS - Type 2 Usher syndrome: USH2A, VLGR1, WHRN - Type 3 Usher syndrome: USH3A With so many possible genes involved in Usher syndrome, genetic tests for the disorder are not conducted on a widespread basis.Diagnosis of Usher syndrome is usually performed through hearing, balance, and vision tests.Genetic testing for a few of the identified genes is clinically available.To learn about laboratories that conduct clinical testing, visit the Web site www.GeneTests.org and search the laboratory directory by typing in the term Usher syndrome.Genetic testing for additional Usher syndrome genes may be available through clinical research studies.To learn about clinical trials that include genetic testing for Usher syndrome, visit the Web site www.clinicaltrials.gov and type in the search term Usher syndrome or Usher genetic testing. Because Usher syndrome affects hearing, balance, and vision, diagnosis of the disorder usually includes the evaluation of all three senses.Evaluation of the eyes may include a visual field test to measure a person’s peripheral vision, an electroretinogram (ERG) to measure the electrical response of the eye’s light-sensitive cells, and a retinal examination to observe the retina and other structures in the back of the eye.A hearing (audiologic) evaluation measures how loud sounds at a range of frequencies need to be before a person can hear them.An electronystagmogram (ENG) measures involuntary eye movements that could signify a balance problem.Early diagnosis of Usher syndrome is very important.The earlier that parents know if their child has Usher syndrome, the sooner that child can begin special educational training programs to manage the loss of hearing and vision. Usher syndrome is inherited, which means that it is passed from parents to their children through genes.Genes are located in almost every cell of the body.Genes contain instructions that tell cells what to do.Each person inherits two copies of each gene, one from each parent.Sometimes genes are altered, or mutated.Mutated genes may cause cells to act differently than expected.Usher syndrome is inherited as an autosomal recessive trait.The term autosomal means that the mutated gene is not located on either of the chromosomes that determine a person’s sex; in other words, both males and females can have the disorder and can pass along the disorder to a child.The word recessive means that to have Usher syndrome, an individual must receive a mutated form of the Usher syndrome gene from each parent.If a child has a mutation in one Usher syndrome gene but the other gene is normal, he or she is predicted to have normal vision and hearing.Individuals with a mutation in a gene that can cause an autosomal recessive disorder are called carriers, because they “carry” the gene with a mutation but show no symptoms of the disorder.If both parents are carriers of a mutated gene for Usher syndrome, they will have a one-in-four chance of having a child with Usher syndrome with each birth.Usually, parents who have normal hearing and vision do not know if they are carriers of an Usher syndrome gene mutation.Currently, it is not possible to determine whether an individual who does not have a family history of Usher syndrome is a carrier.NIDCD scientists are hoping to change this, however, as they learn more about the genes responsible for Usher syndrome. There are three clinical types of Usher syndrome: type 1, type 2, and type 3.In the United States, types 1 and 2 are the most common types.Together, they account for approximately 90-95 percent of all cases of children who have Usher syndrome.Type 1: Children with type 1 Usher syndrome are profoundly deaf at birth and have severe balance problems.Many of these individuals obtain little or no benefit from hearing aids.Parents should consult their doctor and other hearing health professionals as early as possible to determine the best communication method for their child.Intervention should be introduced early, during the first few years of life, so that the child can take advantage of the unique window of time during which the brain is most receptive to learning language, whether spoken or signed.If a child is diagnosed with type 1 Usher syndrome early on, before he or she loses the ability to see, that child is more likely to benefit from the full spectrum of intervention strategies that can help him or her participate more fully in life’s activities.Because of the balance problems associated with type 1 Usher syndrome, children with this disorder are slow to sit without support and typically don’t walk independently before they are 18 months of age.These children usually begin to develop vision problems in early childhood, almost always by the time they reach 10 years of age.Visual problems most often begin with difficulty seeing at night, but tend to progress rapidly until the individual is completely blind.Type 2: Children with type 2Usher syndrome are born with moderate to severe hearing loss and normal balance.Although the severity of hearing loss varies, most of these children can benefit from hearing aids and communicate orally.The visual problems in type 2 Usher syndrome tend to progress more slowly than those in type 1, with the onset of retinitis pigmentosa often not apparent until the teens.Type 3: Children with type 3 Usher syndrome have normal hearing at birth.Although most children with the disorder have normal to near-normal balance, some may develop balance problems later on.Hearing and sight worsen over time, but the rate at which they decline can vary from person to person, even within the same family.A person with type 3 Usher syndrome may develop hearing loss by the teens, and he or she will usually require hearing aids by mid- to late adulthood.Night blindness usually begins sometime during puberty.Blind spots appear by the late teens to early adulthood, and, by mid-adulthood, the individual is usually legally blind. Type 1 Type 2 Type 3 hearing profound deafness in both ears from birth moderate to severe hearing loss from birth normal at birth; progressive loss in childhood or early teens vision decreased night vision before age 10 decreased night vision begins in late childhood or teens varies in severity; night vision problems often begin in teens vestibular function (balance) balance problems from birth normal normal to near-normal, chance of later problems Usher syndrome is the most common condition that affects both hearing and vision.A syndrome is a disease or disorder that has more than one feature or symptom.The major symptoms of Usher syndrome are hearing loss and an eye disorder called retinitis pigmentosa, or RP.Retinitis pigmentosa causes night-blindness and a loss of peripheral vision (side vision) through the progressive degeneration of the retina.The retina is a light-sensitive tissue at the back of the eye and is crucial for vision.As retinitis pigmentosa progresses, the field of vision narrows, a condition known as “tunnel vision,” until only central vision (the ability to see straight ahead) remains.Many people with Usher syndrome also have severe balance problems.Photograph of the retina of a patient with Usher syndrome (left) compared to a normal retina (right).The optic nerve (arrow) looks very pale, the vessels (stars) are very thin and there is characteristic pigment, called bone spicules (double arrows). ","Usher syndrome is an inherited disorder that affects both hearing and vision.Because nine genes may be involved, genetic tests are not routinely conducted. Genetic testing for some of the genes is available; for some other genes there may be clinical research studies. Diagnosis of Usher syndrome includes evaluation of hearing, balance, and vision.Vision tests include a visual field test, an electroretinogram, and a retinal examination.It is important to diagnose Usher syndrome as soon as possible, so that the child can start special educational to prepare for the loss of hearing and vision.There is no cure.Hearing aids or cochlear implants can help some people.Training, such as Braille instruction, low-vision services, sign language, and auditory training, during the first few years of life can take advantage of the time during brain is most receptive to learning.","Usher syndrome is the most common condition that affects both hearing and vision.Usher syndrome is inherited, which means that it is passed from parents to their children through genes.So far, 11 genetic loci (a segment of chromosome on which a certain gene is located) have been found to cause Usher syndrome, and nine genes have been pinpointed that cause the disorder.With so many possible genes involved in Usher syndrome, genetic tests for the disorder are not conducted on a widespread basis. Genetic testing for a few of the identified genes is clinically available.Genetic testing for additional Usher syndrome genes may be available through clinical research studies. Because Usher syndrome affects hearing, balance, and vision, diagnosis of the disorder usually includes the evaluation of all three senses.Evaluation of the eyes may include a visual field test to measure a person?s peripheral vision, an electroretinogram (ERG) to measure the electrical response of the eye?s light-sensitive cells, and a retinal examination to observe the retina and other structures in the back of the eye.A hearing (audiologic) evaluation measures how loud sounds at a range of frequencies need to be before a person can hear them.An electronystagmogram (ENG) measures involuntary eye movements that could signify a balance problem.Early diagnosis of Usher syndrome is very important.The earlier that parents know if their child has Usher syndrome, the sooner that child can begin special educational training programs to manage the loss of hearing and vision.There is no cure.Tools such as hearing aids or cochlear implants can help some people.Training such as Braille instruction, low-vision services, or auditory training can also help.Parents should consult their doctor and other hearing health professionals as early as possible to determine the best communication method for their child.Intervention should be introduced early, during the first few years of life, so that the child can take advantage of the unique window of time during which the brain is most receptive to learning language, whether spoken or signed." 191,How is junctional epidermolysis bullosa treated?,"The goal of treatment is to prevent blisters from forming and avoiding complications.Other treatment will depend on how bad the condition is.HOME CAREFollow these guidelines at home: Take good care of your skin to prevent infections.Follow your provider's advice if blistered areas become crusted or raw.You might need regular whirlpool therapy and to apply antibiotic ointments to wound-like areas.Your provider will let you know if you need a bandage or dressing, and if so, what type to use.You may need to use oral steroid medicines for short periods of time if you have swallowing problems.You may also need to take medicine if you get a candida (yeast) infection in the mouth or throat.Take good care of your oral health and get regular dental check-ups.It is best to see a dentist who has experience treating people with EB.Eat a healthy diet.When you have a lot of skin injury, you may need extra calories and protein to help your skin heal.Choose soft foods and avoid nuts, chips, and other crunchy foods if you have sores in your mouth.A nutritionist can help you with your diet.Do exercises a physical therapist shows you to help keep your joints and muscles mobile.SURGERYSurgery to treat this condition may include: Skin grafting in places where sores are deep Dilation (widening) of the esophagus if there is a narrowing Repair of hand deformities Removal of any squamous cell carcinoma (a type of skin cancer) that develops OTHER TREATMENTSOther treatments for this condition may include: Medicines that suppress the immune system may be used for the autoimmune form of this condition.Protein and gene therapy and the use of the drug interferon are being studied. Epidermolysis bullosa (EB) is a group of disorders in which skin blisters form after a minor injury.It is passed down in families. Junctional epidermolysis bullosa (JEB) is one of the major forms of epidermolysis bullosa, a group of genetic conditions that cause the skin to be very fragile and to blister easily.Blisters and skin erosions form in response to minor injury or friction, such as rubbing or scratching.Researchers classify junctional epidermolysis bullosa into two main types: Herlitz JEB and non-Herlitz JEB.Although the types differ in severity, their features overlap significantly, and they can be caused by mutations in the same genes.Herlitz JEB is the more severe form of the condition.From birth or early infancy, affected individuals have blistering over large regions of the body.Blistering also affects the mucous membranes, such as the moist lining of the mouth and digestive tract, which can make it difficult to eat and digest food.As a result, many affected children have chronic malnutrition and slow growth.The extensive blistering leads to scarring and the formation of red, bumpy patches called granulation tissue.Granulation tissue bleeds easily and profusely, making affected infants susceptible to serious infections and loss of necessary proteins, minerals, and fluids.Additionally, a buildup of granulation tissue in the airway can lead to a weak, hoarse cry and difficulty breathing.Other complications of Herlitz JEB can include fusion of the fingers and toes, abnormalities of the fingernails and toenails, joint deformities (contractures) that restrict movement, and hair loss (alopecia).Because the signs and symptoms of Herlitz JEB are so severe, infants with this condition usually do not survive beyond the first year of life.The milder form of junctional epidermolysis bullosa is called non-Herlitz JEB.The blistering associated with non-Herlitz JEB may be limited to the hands, feet, knees, and elbows, and it often improves after the newborn period.Other characteristic features of this condition include alopecia, malformed fingernails and toenails, and irregular tooth enamel.Most affected individuals do not have extensive scarring or granulation tissue formation, so breathing difficulties and other severe complications are rare.Non-Herlitz JEB is typically associated with a normal lifespan. ","Junctional epidermolysis bullosa causes the skin to blister easily.The treatments with antibiotic ointments are preventing blisters, skin infections, and complications.Sometimes regular whirlpool therapy and oral corticosteroids are needed. Other features of junctional epidermolysis bullosa include alopecia, malformed fingernails and toenails, and irregular tooth enamel. To take care of the teeth, regular dental check-ups are needed.Healthy nutrition is important to help the skin heal.Crunchy foods that can damage oral mucosa should be avoided.Physical therapy can keep the joints and muscles healthy.Sometimes surgery is needed to remove deep sores and other deformities.Researchers are exploring gene therapy and interferon treatments.","Junctional epidermolysis bullosa (JEB) is one of the genetic conditions that cause the skin to be very fragile and to blister easily.Other characteristic features of this condition include alopecia, malformed fingernails and toenails, and irregular tooth enamel.The goal of treatment is to prevent blisters from forming and avoiding complications.Other treatment will depend on how bad the condition is.Take good care of your skin to prevent infections. .You might need regular whirlpool therapy and to apply antibiotic ointments to wound-like areas.Your provider will let you know if you need a bandage or dressing, and if so, what type to use.You may need to use oral steroid medicines for short periods of time if you have swallowing problems.You may also need to take medicine if you get a candida (yeast) infection in the mouth or throat.Take good care of your oral health and get regular dental check-ups.Eat a healthy diet.When you have a lot of skin injury, you may need extra calories and protein to help your skin heal.Choose soft foods and avoid nuts, chips, and other crunchy foods if you have sores in your mouth. .Do exercises a physical therapist shows you to help keep your joints and muscles mobile.Surgery to treat this condition may include: Skin grafting in places where sores are deep Dilation (widening) of the esophagus if there is a narrowing Repair of hand deformities Removal of any squamous cell carcinoma (a type of skin cancer) that develops Medicines that suppress the immune system may be used for the autoimmune form of this condition.Protein and gene therapy and the use of the drug interferon are being studied." 192,Could acupuncture and other treatments help with arthritis?,"Proposed uses include Pain relief, including after surgical or dental procedures Relief of the nausea and vomiting that commonly occur during pregnancy or after surgery or chemotherapy Treatment of addiction, carpal tunnel syndrome, fibromyalgia, headache, low back pain, fatigue, and joint pain Acupuncture research is inherently difficult to conduct.Blinding (preventing research subjects and practitioners from knowing which people were given which treatment) is challenging in acupuncture studies.So-called ""sham"" acupuncture (insertion of needles at points other than those used in acupuncture) often puts pressure on acupressure points, making measuring acupuncture effects difficult.In some regions, particularly in China, published acupuncture studies tend to show a more positive effect.This may reflect bias, but it could also be that these providers are practicing the full schema of traditional Chinese medicine of which acupuncture is only a component.Acupuncture is effective in treating several disorders and symptoms, though further study is needed.Comparing acupuncture to the control practice of sham acupuncture is complicated because the comparison therapy is still a relaxation practice with a provider.The placebo for acupuncture may involve using opaque sheaths containing a blunt needle or toothpick that is pressed against the skin but is not inserted, though this would still put pressure on acupuncture points.Many academic medical centers and healthcare organizations, including the World Health Organization, continue to investigate and explore the efficacy of acupuncture. Side effects of acupuncture are usually mild if the technique is done correctly, but the following should be noted: Temporary worsening of symptoms may occur.Occasionally, needles are mistakenly left in place after acupuncture is completed; equipment counting, similar to that conducted after surgical procedures, makes this less likely.As with any medical treatment involving needles, some people may feel faint and need to lie down.Acupuncture may cause bruising or bleeding in people who have severe bleeding disorders or who take blood-thinning drugs.Rarely, deep needle placement can cause a collapsed lung and internal injury. Doctors who diagnose and treat arthritis and other rheumatic disease include: General practitioners, such as your family doctor.Rheumatologists, who specialize in arthritis and other diseases of the bones, joints, and muscles.Orthopaedists, who specialize in treatment and surgery for bone and joint diseases.Physical therapists, who help improve joint function.Occupational therapists, who teach ways to protect joints, minimize pain, perform activities of daily living, and conserve energy.Dietitians, who teach about good diets and maintaining a healthy weight.Nurse educators, who help you understand your condition and help start treatment plans.Rehabilitation specialists, who help you make the most of your physical potential.Licensed acupuncture therapists, who reduce pain and improve physical functioning by inserting fine needles into the skin at specific points on the body.Psychologists or social workers, who help with social challenges caused by medical conditions.Chiropractors, who focus treatment on the relationship between the body's structuremainly the spineand its functioning.Massage therapists, who press, rub, and otherwise manipulate the muscles and other soft tissues of the body.Doctors who diagnose and treat arthritis and other rheumatic disease include: General practitioners, such as your family doctor.Rheumatologists, who specialize in arthritis and other diseases of the bones, joints, and muscles.Orthopaedists, who specialize in treatment and surgery for bone and joint diseases.Physical therapists, who help improve joint function.Occupational therapists, who teach ways to protect joints, minimize pain, perform activities of daily living, and conserve energy.Dietitians, who teach about good diets and maintaining a healthy weight.Nurse educators, who help you understand your condition and help start treatment plans.Rehabilitation specialists, who help you make the most of your physical potential.Licensed acupuncture therapists, who reduce pain and improve physical functioning by inserting fine needles into the skin at specific points on the body.Psychologists or social workers, who help with social challenges caused by medical conditions.Chiropractors, who focus treatment on the relationship between the body's structuremainly the spineand its functioning.Massage therapists, who press, rub, and otherwise manipulate the muscles and other soft tissues of the body.Doctors who diagnose and treat arthritis and other rheumatic disease include: General practitioners, such as your family doctor.Rheumatologists, who specialize in arthritis and other diseases of the bones, joints, and muscles.Orthopaedists, who specialize in treatment and surgery for bone and joint diseases.Physical therapists, who help improve joint function.Occupational therapists, who teach ways to protect joints, minimize pain, perform activities of daily living, and conserve energy.Dietitians, who teach about good diets and maintaining a healthy weight.Nurse educators, who help you understand your condition and help start treatment plans.Rehabilitation specialists, who help you make the most of your physical potential.Licensed acupuncture therapists, who reduce pain and improve physical functioning by inserting fine needles into the skin at specific points on the body.Psychologists or social workers, who help with social challenges caused by medical conditions.Chiropractors, who focus treatment on the relationship between the body's structuremainly the spineand its functioning.Massage therapists, who press, rub, and otherwise manipulate the muscles and other soft tissues of the body. Your doctor will talk to you about the best way to treat your arthritis, based upon the type you have.Possible treatments include: Medications such as: Pain relievers that are taken by mouth.Creams or ointments that are rubbed into the skin over sore muscles or joints to relieve pain.Medications that may slow the course of the disease and prevent further damage to joints or other parts of the body.Surgery, such as joint replacement.Your doctor will talk to you about the best way to treat your arthritis, based upon the type you have.Possible treatments include: Medications such as: Pain relievers that are taken by mouth.Creams or ointments that are rubbed into the skin over sore muscles or joints to relieve pain.Medications that may slow the course of the disease and prevent further damage to joints or other parts of the body.Surgery, such as joint replacement.Your doctor will talk to you about the best way to treat your arthritis, based upon the type you have.Possible treatments include: Medications such as: Pain relievers that are taken by mouth.Creams or ointments that are rubbed into the skin over sore muscles or joints to relieve pain.Medications that may slow the course of the disease and prevent further damage to joints or other parts of the body.Surgery, such as joint replacement. The main goals of treatment are to: Preserve a high level of physical and social functioning.Maintain a good quality of life.To achieve these goals, doctors recommend treatments that: Reduce swelling.Maintain full movement in the affected joints.Relieve pain.Prevent, identify, and treat complications.Most children with juvenile arthritis need a combination of medication and other treatments to reach these goals.

Medications

/h3>Nonsteroidal anti-inflammatory drugs (NSAIDs).Aspirin, ibuprofen, naproxen, and naproxen sodium are examples of NSAIDs.They are often the first type of medication doctors prescribe for juvenile arthritis.All NSAIDs work similarly by blocking substances called prostaglandins that add to inflammation and pain.However, each NSAID is a different chemical, and each has a slightly different effect on the body.For unknown reasons, some children seem to respond better to one NSAID than another.NSAIDs should only be used at the lowest dose possible for the shortest time needed.You can buy some NSAIDs over the counter, while several others, including a subclass called COX-2 inhibitors, need a prescription.All NSAIDs can have significant side effects, so consult your childs doctor before giving any of them.Your childs doctor should monitor your child if he or she takes NSAIDs regularly to control juvenile arthritis.Side effects of NSAIDs include stomach problems; skin rashes; high blood pressure; fluid retention; and liver, kidney, and heart problems.The longer a person uses NSAIDs, the more likely he or she is to have side effects, ranging from mild to serious.Many other medicines cannot be taken when a person is taking NSAIDs because NSAIDs alter the way the body uses or eliminates these other medicines.Disease-modifying antirheumatic drugs (DMARDs).If NSAIDs do not relieve symptoms of your childs juvenile arthritis, the doctor may prescribe this type of medication.DMARDs slow the progression of juvenile arthritis, but because they may take weeks or months to relieve symptoms, they often are taken with an NSAID.Although there are many different types of DMARDs, many doctors prescribe one called methotrexate.Researchers have learned that methotrexate is safe and effective for some children with juvenile arthritis whose symptoms are not relieved by other medications.Because children only need small doses of methotrexate for relief of arthritis symptoms, potentially dangerous side effects rarely occur.The most serious complication can be liver damage, which a doctor can help prevent with regular blood tests and check-ups.Careful monitoring for side effects is important for people taking methotrexate.When side effects are noticed early, the doctor can reduce the dose and eliminate the side effects.Corticosteroids.If your child has very severe juvenile arthritis, stronger medicines may be needed to stop serious symptoms, such as inflammation of the sac around the heart (pericarditis).Corticosteroids, such as prednisone, may be added to the treatment plan to control severe symptoms.This medication can be given by IV (intravenous), mouth, or injection directly into a joint.Corticosteroids are powerful anti-inflammatory medicines.Corticosteroids can interfere with your childs normal growth and can cause other side effects, such as a round face, weakened bones, and an increased chance of having infections.Once the medication controls severe symptoms, the doctor will reduce the dose gradually and, in time, stop it completely.It can be dangerous to stop taking corticosteroids suddenly.Carefully follow the doctors instructions about how to take or reduce the dose.For inflammation in one or just a few joints, injecting a corticosteroid compound into the affected joint or joints can often bring quick relief without the systemic side effects of oral or IV medication.Biologic agents.If your child has received little relief from other medications, he or she may be given one of a newer class of medications called biologic response modifiers, or biologic agents.These are based on compounds made by living cells.Tumor necrosis factor (TNF) inhibitors are biologic agents that work by blocking the actions of TNF, a naturally occurring protein in the body that helps cause inflammation.Other biologic agents block other inflammatory proteins, such as interleukin-1 or immune cells called T cells.Different biologics tend to work better for the different subtypes of the disease.

Other Treatments

/h3>Physical therapy.A regular, general exercise program is an important part of a childs treatment plan.Exercise can help to maintain muscle tone and preserve and recover the range of motion of the joints.A physiatrist (rehabilitation specialist) or a physical therapist can design an appropriate exercise program for your child.The specialist also may recommend using splints and other devices to help maintain normal bone and joint growth.Complementary and alternative therapies.Many adults seek alternative ways of treating arthritis, such as special diets, supplements, acupuncture, massage, or even magnetic jewelry or mattress pads.Research shows that increasing numbers of children are using alternative and complementary therapies as well.Although there is little research to support many alternative treatments, some people seem to benefit from them.If your childs doctor feels the approach has value and is not harmful, you can incorporate it into the treatment plan.However, do not neglect regular health care or treatment of serious symptoms.The main goals of treatment are to: Preserve a high level of physical and social functioning.Maintain a good quality of life.To achieve these goals, doctors recommend treatments that: Reduce swelling.Maintain full movement in the affected joints.Relieve pain.Prevent, identify, and treat complications.Most children with juvenile arthritis need a combination of medication and other treatments to reach these goals.

Medications

/h3>Nonsteroidal anti-inflammatory drugs (NSAIDs).Aspirin, ibuprofen, naproxen, and naproxen sodium are examples of NSAIDs.They are often the first type of medication doctors prescribe for juvenile arthritis.All NSAIDs work similarly by blocking substances called prostaglandins that add to inflammation and pain.However, each NSAID is a different chemical, and each has a slightly different effect on the body.For unknown reasons, some children seem to respond better to one NSAID than another.NSAIDs should only be used at the lowest dose possible for the shortest time needed.You can buy some NSAIDs over the counter, while several others, including a subclass called COX-2 inhibitors, need a prescription.All NSAIDs can have significant side effects, so consult your childs doctor before giving any of them.Your childs doctor should monitor your child if he or she takes NSAIDs regularly to control juvenile arthritis.Side effects of NSAIDs include stomach problems; skin rashes; high blood pressure; fluid retention; and liver, kidney, and heart problems.The longer a person uses NSAIDs, the more likely he or she is to have side effects, ranging from mild to serious.Many other medicines cannot be taken when a person is taking NSAIDs because NSAIDs alter the way the body uses or eliminates these other medicines.Disease-modifying antirheumatic drugs (DMARDs).If NSAIDs do not relieve symptoms of your childs juvenile arthritis, the doctor may prescribe this type of medication.DMARDs slow the progression of juvenile arthritis, but because they may take weeks or months to relieve symptoms, they often are taken with an NSAID.Although there are many different types of DMARDs, many doctors prescribe one called methotrexate.Researchers have learned that methotrexate is safe and effective for some children with juvenile arthritis whose symptoms are not relieved by other medications.Because children only need small doses of methotrexate for relief of arthritis symptoms, potentially dangerous side effects rarely occur.The most serious complication can be liver damage, which a doctor can help prevent with regular blood tests and check-ups.Careful monitoring for side effects is important for people taking methotrexate.When side effects are noticed early, the doctor can reduce the dose and eliminate the side effects.Corticosteroids.If your child has very severe juvenile arthritis, stronger medicines may be needed to stop serious symptoms, such as inflammation of the sac around the heart (pericarditis).Corticosteroids, such as prednisone, may be added to the treatment plan to control severe symptoms.This medication can be given by IV (intravenous), mouth, or injection directly into a joint.Corticosteroids are powerful anti-inflammatory medicines.Corticosteroids can interfere with your childs normal growth and can cause other side effects, such as a round face, weakened bones, and an increased chance of having infections.Once the medication controls severe symptoms, the doctor will reduce the dose gradually and, in time, stop it completely.It can be dangerous to stop taking corticosteroids suddenly.Carefully follow the doctors instructions about how to take or reduce the dose.For inflammation in one or just a few joints, injecting a corticosteroid compound into the affected joint or joints can often bring quick relief without the systemic side effects of oral or IV medication.Biologic agents.If your child has received little relief from other medications, he or she may be given one of a newer class of medications called biologic response modifiers, or biologic agents.These are based on compounds made by living cells.Tumor necrosis factor (TNF) inhibitors are biologic agents that work by blocking the actions of TNF, a naturally occurring protein in the body that helps cause inflammation.Other biologic agents block other inflammatory proteins, such as interleukin-1 or immune cells called T cells.Different biologics tend to work better for the different subtypes of the disease.

Other Treatments

/h3>Physical therapy.A regular, general exercise program is an important part of a childs treatment plan.Exercise can help to maintain muscle tone and preserve and recover the range of motion of the joints.A physiatrist (rehabilitation specialist) or a physical therapist can design an appropriate exercise program for your child.The specialist also may recommend using splints and other devices to help maintain normal bone and joint growth.Complementary and alternative therapies.Many adults seek alternative ways of treating arthritis, such as special diets, supplements, acupuncture, massage, or even magnetic jewelry or mattress pads.Research shows that increasing numbers of children are using alternative and complementary therapies as well.Although there is little research to support many alternative treatments, some people seem to benefit from them.If your childs doctor feels the approach has value and is not harmful, you can incorporate it into the treatment plan.However, do not neglect regular health care or treatment of serious symptoms.The main goals of treatment are to: Preserve a high level of physical and social functioning.Maintain a good quality of life.To achieve these goals, doctors recommend treatments that: Reduce swelling.Maintain full movement in the affected joints.Relieve pain.Prevent, identify, and treat complications.Most children with juvenile arthritis need a combination of medication and other treatments to reach these goals.

Medications

/h3>Nonsteroidal anti-inflammatory drugs (NSAIDs).Aspirin, ibuprofen, naproxen, and naproxen sodium are examples of NSAIDs.They are often the first type of medication doctors prescribe for juvenile arthritis.All NSAIDs work similarly by blocking substances called prostaglandins that add to inflammation and pain.However, each NSAID is a different chemical, and each has a slightly different effect on the body.For unknown reasons, some children seem to respond better to one NSAID than another.NSAIDs should only be used at the lowest dose possible for the shortest time needed.You can buy some NSAIDs over the counter, while several others, including a subclass called COX-2 inhibitors, need a prescription.All NSAIDs can have significant side effects, so consult your childs doctor before giving any of them.Your childs doctor should monitor your child if he or she takes NSAIDs regularly to control juvenile arthritis.Side effects of NSAIDs include stomach problems; skin rashes; high blood pressure; fluid retention; and liver, kidney, and heart problems.The longer a person uses NSAIDs, the more likely he or she is to have side effects, ranging from mild to serious.Many other medicines cannot be taken when a person is taking NSAIDs because NSAIDs alter the way the body uses or eliminates these other medicines.Disease-modifying antirheumatic drugs (DMARDs).If NSAIDs do not relieve symptoms of your childs juvenile arthritis, the doctor may prescribe this type of medication.DMARDs slow the progression of juvenile arthritis, but because they may take weeks or months to relieve symptoms, they often are taken with an NSAID.Although there are many different types of DMARDs, many doctors prescribe one called methotrexate.Researchers have learned that methotrexate is safe and effective for some children with juvenile arthritis whose symptoms are not relieved by other medications.Because children only need small doses of methotrexate for relief of arthritis symptoms, potentially dangerous side effects rarely occur.The most serious complication can be liver damage, which a doctor can help prevent with regular blood tests and check-ups.Careful monitoring for side effects is important for people taking methotrexate.When side effects are noticed early, the doctor can reduce the dose and eliminate the side effects.Corticosteroids.If your child has very severe juvenile arthritis, stronger medicines may be needed to stop serious symptoms, such as inflammation of the sac around the heart (pericarditis).Corticosteroids, such as prednisone, may be added to the treatment plan to control severe symptoms.This medication can be given by IV (intravenous), mouth, or injection directly into a joint.Corticosteroids are powerful anti-inflammatory medicines.Corticosteroids can interfere with your childs normal growth and can cause other side effects, such as a round face, weakened bones, and an increased chance of having infections.Once the medication controls severe symptoms, the doctor will reduce the dose gradually and, in time, stop it completely.It can be dangerous to stop taking corticosteroids suddenly.Carefully follow the doctors instructions about how to take or reduce the dose.For inflammation in one or just a few joints, injecting a corticosteroid compound into the affected joint or joints can often bring quick relief without the systemic side effects of oral or IV medication.Biologic agents.If your child has received little relief from other medications, he or she may be given one of a newer class of medications called biologic response modifiers, or biologic agents.These are based on compounds made by living cells.Tumor necrosis factor (TNF) inhibitors are biologic agents that work by blocking the actions of TNF, a naturally occurring protein in the body that helps cause inflammation.Other biologic agents block other inflammatory proteins, such as interleukin-1 or immune cells called T cells.Different biologics tend to work better for the different subtypes of the disease.

Other Treatments

/h3>Physical therapy.A regular, general exercise program is an important part of a childs treatment plan.Exercise can help to maintain muscle tone and preserve and recover the range of motion of the joints.A physiatrist (rehabilitation specialist) or a physical therapist can design an appropriate exercise program for your child.The specialist also may recommend using splints and other devices to help maintain normal bone and joint growth.Complementary and alternative therapies.Many adults seek alternative ways of treating arthritis, such as special diets, supplements, acupuncture, massage, or even magnetic jewelry or mattress pads.Research shows that increasing numbers of children are using alternative and complementary therapies as well.Although there is little research to support many alternative treatments, some people seem to benefit from them.If your childs doctor feels the approach has value and is not harmful, you can incorporate it into the treatment plan.However, do not neglect regular health care or treatment of serious symptoms. Treating juvenile arthritis often requires a team approach that involves your child and his or her family and a number of different health professionals.Ideally, your childs care should be managed by a pediatric rheumatologist, who is a doctor who has been specially trained to treat the rheumatic diseases in children.However, many pediatricians and adult rheumatologists also treat children with juvenile arthritis.Because there are relatively few pediatric rheumatologists and they are mainly concentrated at major medical centers in metropolitan areas, children who live in smaller towns and rural areas may benefit from having a doctor in their town coordinate care through a pediatric rheumatologist.Many large medical centers now conduct outreach clinics, in which doctors and a supporting team travel from large cities to smaller towns for one or two days to treat local patients.Other members of your childs health care team may include: Physical therapist.This health professional can work with your child to develop a plan of exercises that will improve joint function and strengthen muscles without causing further harm to affected joints.Occupational therapist.This health professional can teach ways to protect joints, minimize pain, conserve energy, and exercise.Occupational therapists specialize in the upper extremities (hands, wrists, elbows, arms, shoulders, and neck).Counselor or psychologist.Being a child or adolescent with a chronic disease isnt easy, for the child or his or her family.Your child may benefit from sorting out his or her feelings with a psychologist or counselor trained to help children in this situation.Your family members may benefit from counseling as well.Ophthalmologist.If your childs medications or form of arthritis can affect the eyes, catching problems early can help keep them from becoming serious.All children with juvenile arthritis need to have regular exams by an ophthalmologist (eye doctor) to detect eye inflammation.Dentist and orthodontist.Thorough brushing and flossing of the teeth can be difficult if your childs hands are affected by arthritis.If your childs jaw is also affected by arthritis, he or she may have a hard time opening the mouth for proper brushing.Therefore, your child needs regular dental exams.Because juvenile arthritis can also affect the alignment of the jaw, children with this disease should also see an orthodontist.Orthopaedic surgeon.Some children need surgery to help minimize or repair the effects of their disease.Orthopaedic surgeons are doctors who perform surgery on the joints and bones.Dietitian.For children with chronic diseases, good nutrition is particularly important.A dietitian can help design a nutritious diet that will benefit the whole family.Pharmacist.A pharmacist is a good source of information about medications, including possible side effects and other drugs that could interact with them.If your child has trouble swallowing large pills or taking other medication, the pharmacist may be able to suggest different ways to take the medication or may be able to prepare or help you get kid-friendly versions of some medications.Social worker.A social worker can help your child and your family deal with life and lifestyle changes caused by arthritis.A social worker also can help you find helpful resources for your child.Rheumatology nurse.A rheumatology nurse likely will be closely involved in your childs care, serving as the main point of contact with your doctors office about appointments, tests, medications, and instructions.School nurse.For a school-age child, the school nurse also may be part of your health care team, particularly if your child needs to take medications regularly during school hours.Treating juvenile arthritis often requires a team approach that involves your child and his or her family and a number of different health professionals.Ideally, your childs care should be managed by a pediatric rheumatologist, who is a doctor who has been specially trained to treat the rheumatic diseases in children.However, many pediatricians and adult rheumatologists also treat children with juvenile arthritis.Because there are relatively few pediatric rheumatologists and they are mainly concentrated at major medical centers in metropolitan areas, children who live in smaller towns and rural areas may benefit from having a doctor in their town coordinate care through a pediatric rheumatologist.Many large medical centers now conduct outreach clinics, in which doctors and a supporting team travel from large cities to smaller towns for one or two days to treat local patients.Other members of your childs health care team may include: Physical therapist.This health professional can work with your child to develop a plan of exercises that will improve joint function and strengthen muscles without causing further harm to affected joints.Occupational therapist.This health professional can teach ways to protect joints, minimize pain, conserve energy, and exercise.Occupational therapists specialize in the upper extremities (hands, wrists, elbows, arms, shoulders, and neck).Counselor or psychologist.Being a child or adolescent with a chronic disease isnt easy, for the child or his or her family.Your child may benefit from sorting out his or her feelings with a psychologist or counselor trained to help children in this situation.Your family members may benefit from counseling as well.Ophthalmologist.If your childs medications or form of arthritis can affect the eyes, catching problems early can help keep them from becoming serious.All children with juvenile arthritis need to have regular exams by an ophthalmologist (eye doctor) to detect eye inflammation.Dentist and orthodontist.Thorough brushing and flossing of the teeth can be difficult if your childs hands are affected by arthritis.If your childs jaw is also affected by arthritis, he or she may have a hard time opening the mouth for proper brushing.Therefore, your child needs regular dental exams.Because juvenile arthritis can also affect the alignment of the jaw, children with this disease should also see an orthodontist.Orthopaedic surgeon.Some children need surgery to help minimize or repair the effects of their disease.Orthopaedic surgeons are doctors who perform surgery on the joints and bones.Dietitian.For children with chronic diseases, good nutrition is particularly important.A dietitian can help design a nutritious diet that will benefit the whole family.Pharmacist.A pharmacist is a good source of information about medications, including possible side effects and other drugs that could interact with them.If your child has trouble swallowing large pills or taking other medication, the pharmacist may be able to suggest different ways to take the medication or may be able to prepare or help you get kid-friendly versions of some medications.Social worker.A social worker can help your child and your family deal with life and lifestyle changes caused by arthritis.A social worker also can help you find helpful resources for your child.Rheumatology nurse.A rheumatology nurse likely will be closely involved in your childs care, serving as the main point of contact with your doctors office about appointments, tests, medications, and instructions.School nurse.For a school-age child, the school nurse also may be part of your health care team, particularly if your child needs to take medications regularly during school hours.Treating juvenile arthritis often requires a team approach that involves your child and his or her family and a number of different health professionals.Ideally, your childs care should be managed by a pediatric rheumatologist, who is a doctor who has been specially trained to treat the rheumatic diseases in children.However, many pediatricians and adult rheumatologists also treat children with juvenile arthritis.Because there are relatively few pediatric rheumatologists and they are mainly concentrated at major medical centers in metropolitan areas, children who live in smaller towns and rural areas may benefit from having a doctor in their town coordinate care through a pediatric rheumatologist.Many large medical centers now conduct outreach clinics, in which doctors and a supporting team travel from large cities to smaller towns for one or two days to treat local patients.Other members of your childs health care team may include: Physical therapist.This health professional can work with your child to develop a plan of exercises that will improve joint function and strengthen muscles without causing further harm to affected joints.Occupational therapist.This health professional can teach ways to protect joints, minimize pain, conserve energy, and exercise.Occupational therapists specialize in the upper extremities (hands, wrists, elbows, arms, shoulders, and neck).Counselor or psychologist.Being a child or adolescent with a chronic disease isnt easy, for the child or his or her family.Your child may benefit from sorting out his or her feelings with a psychologist or counselor trained to help children in this situation.Your family members may benefit from counseling as well.Ophthalmologist.If your childs medications or form of arthritis can affect the eyes, catching problems early can help keep them from becoming serious.All children with juvenile arthritis need to have regular exams by an ophthalmologist (eye doctor) to detect eye inflammation.Dentist and orthodontist.Thorough brushing and flossing of the teeth can be difficult if your childs hands are affected by arthritis.If your childs jaw is also affected by arthritis, he or she may have a hard time opening the mouth for proper brushing.Therefore, your child needs regular dental exams.Because juvenile arthritis can also affect the alignment of the jaw, children with this disease should also see an orthodontist.Orthopaedic surgeon.Some children need surgery to help minimize or repair the effects of their disease.Orthopaedic surgeons are doctors who perform surgery on the joints and bones.Dietitian.For children with chronic diseases, good nutrition is particularly important.A dietitian can help design a nutritious diet that will benefit the whole family.Pharmacist.A pharmacist is a good source of information about medications, including possible side effects and other drugs that could interact with them.If your child has trouble swallowing large pills or taking other medication, the pharmacist may be able to suggest different ways to take the medication or may be able to prepare or help you get kid-friendly versions of some medications.Social worker.A social worker can help your child and your family deal with life and lifestyle changes caused by arthritis.A social worker also can help you find helpful resources for your child.Rheumatology nurse.A rheumatology nurse likely will be closely involved in your childs care, serving as the main point of contact with your doctors office about appointments, tests, medications, and instructions.School nurse.For a school-age child, the school nurse also may be part of your health care team, particularly if your child needs to take medications regularly during school hours. ","Arthritis treatments aim to reduce swelling, maintain movements in the joints, relieve pain, and prevent complications.Alternative and complementary approached to treatment seem to help some people.These approaches include acupuncture, special diets, supplements, massage, magnetic jewelry or mattress pads.Acupuncture usually has little side effects, but sometimes temporary worsening of symptoms may occur.Traditional treatments include mediations, surgery, physical therapy, occupational therapy, maintaining healthy weight, massage and other muscle and bone manipulation.","Your doctor will talk to you about the best way to treat your arthritis, based upon the type you have.Possible treatments include: Medications such as: Pain relievers that are taken by mouth.Creams or ointments that are rubbed into the skin over sore muscles or joints to relieve pain.Medications that may slow the course of the disease and prevent further damage to joints or other parts of the body.Surgery, such as joint replacement.Doctors who diagnose and treat arthritis and other rheumatic disease include: General practitioners, such as your family doctor.Rheumatologists, who specialize in arthritis and other diseases of the bones, joints, and muscles.Orthopaedists, who specialize in treatment and surgery for bone and joint diseases.Physical therapists, who help improve joint function.Occupational therapists, who teach ways to protect joints, minimize pain, perform activities of daily living, and conserve energy.Dietitians, who teach about good diets and maintaining a healthy weight.Nurse educators, who help you understand your condition and help start treatment plans.Rehabilitation specialists, who help you make the most of your physical potential.Licensed acupuncture therapists, who reduce pain and improve physical functioning by inserting fine needles into the skin at specific points on the body. Chiropractors, who focus treatment on the relationship between the body's structuremainly the spineand its functioning.Massage therapists, who press, rub, and otherwise manipulate the muscles and other soft tissues of the body. doctors recommend treatments that: Reduce swelling.Maintain full movement in the affected joints.Relieve pain.Prevent, identify, and treat complications.Many adults seek alternative ways of treating arthritis, such as special diets, supplements, acupuncture, massage, or even magnetic jewelry or mattress pads.Although there is little research to support many alternative treatments, some people seem to benefit from them.Side effects of acupuncture are usually mild if the technique is done correctly, but the following should be noted: Temporary worsening of symptoms may occur." 194,Can scoliosis cause neck pain and how is it treated?,"How well a person with scoliosis does depends on the type, cause, and severity of the curve.The more severe the curving, the more likely it will get worse after the child stops growing.People with mild scoliosis do well with braces.They usually do not have long-term problems.Back pain may be more likely when the person gets older.Outlook for those with neuromuscular or congenital scoliosis varies.They may have another serious disorder, such as cerebral palsy or muscular dystrophy, so their goals are much different.Often, the goal of surgery is simply to allow a child to be able to sit upright in a wheelchair.Congenital scoliosis is difficult to treat and usually requires many surgeries. Treatment depends on many things: The cause of scoliosis Where the curve is in your spine How big the curve is If your body is still growing Most people with idiopathic scoliosis do not need treatment.But you should still be checked by a doctor about every 6 months.If you are still growing, your doctor might recommend a back brace.A back brace prevents further curving.There are many different types of braces.What kind you get depends on the size and location of your curve.Your provider will pick the best one for you and show you how to use it.Back braces can be adjusted as you grow.Back braces work best in people over age 10.Braces do not work for those with congenital or neuromuscular scoliosis.You may need surgery if the spine curve is severe or getting worse very quickly.Surgery involves correcting the curve as much as possible: Surgery is done with a cut through the back, belly area, or beneath the ribs.The spine bones are held in place with 1 or 2 metal rods.The rods are held down with hooks and screws until the bone heals together.After surgery, you may need to wear a brace for a while to keep the spine still.Scoliosis treatment may also include: Emotional support: Some children, especially teens, may be self-conscious when using a back brace.Physical therapy and other specialists to help explain the treatments and make sure the brace fits correctly. Treatments depend on how severe the curve is.A small curve may not need treatment.But doctors will check it regularly to see if it gets worse.In more severe cases, treatment should be started as early as possible and may include: A brace to try to keep the spine straight Physical therapy to keep scoliosis from getting worse Surgery to join backbones together Your child may feel badly about having scoliosis or be upset about the treatment.Talking to a professional counselor may help your child feel better. A number of factors contribute to the likelihood of scoliosis worsening.The more severe the curve, the greater the likelihood of it worsening, and curves tend to worsen in the early stages of puberty when growth is accelerated.Likewise, the more symptoms that develop, the greater the likelihood that scoliosis will worsen.Worsening scoliosis may eventually cause permanent problems, such as noticeable deformities or chronic pain.Severe scoliosis may even affect internal organsfor example, deforming and damaging the lungs.Sometimes scoliosis can worsen even if symptoms have not developed.In most children who have scoliosis, the curvature does not progress further but rather remains small.However, it needs to be monitored by a doctor regularly.Scoliosis that causes symptoms, is worsening, or is severe may need to be treated.The earlier treatment is begun, the better the chance of preventing a severe deformity. Mild scoliosis usually causes no symptoms.Sometimes the back becomes sore or stiff after the child sits or stands for a long period of time.Mild or more severe pain may eventually follow.Mild scoliosis may be discovered during a routine physical examination.A parent, teacher, or doctor may suspect scoliosis when one of the childs shoulders seems higher than the other or when the childs clothes do not hang straight. Mild scoliosis usually has no symptoms.But sometimes children have: One shoulder higher than the other One hip higher than the other causing an uneven waist Mild to severe back pain Severe scoliosis can cause: Constant pain Difficulty breathing, if the rib cage presses on the lungs Damage to internal organs Scoliosis causes a sideways curve of your backbone, or spine.These curves are often S- or C-shaped.Scoliosis is most common in late childhood and the early teens, when children grow fast.Girls are more likely to have it than boys.It can run in families.Symptoms include leaning to one side and having uneven shoulders and hips.Doctors use your medical and family history, a physical exam, and imaging tests to diagnose scoliosis.Treatment depends on your age, how much more you're likely to grow, how much curving there is, and whether the curve is temporary or permanent.People with mild scoliosis might only need checkups to see if the curve is getting worse.Others might need to wear a brace or have surgery.NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases ","Mild scoliosis may cause back pain if a child sits or stands for a long time.As people with scoliosis grow older, back pain is more likely.If scoliosis is worsening, it can cause chronic pain and noticeable deformities.Treatments depend on the severity of the curve.If it is mild, regular checkups are needed to see if it is progressing.Mild scoliosis is successfully treated with braces.Physical therapy may be needed to prevent scoliosis from worsening.Sometimes surgery is needed to correct the curve.","Mild scoliosis usually causes no symptoms.Sometimes the back becomes sore or stiff after the child sits or stands for a long period of time. People with mild scoliosis do well with braces.They usually do not have long-term problems.Back pain may be more likely when the person gets older.Worsening scoliosis may eventually cause permanent problems, such as noticeable deformities or chronic pain.Treatments depend on how severe the curve is.People with mild scoliosis might only need checkups to see if the curve is getting worse.In more severe cases, treatment should be started as early as possible and may include: A brace to try to keep the spine straight Physical therapy to keep scoliosis from getting worse Surgery to join backbones together" 195,How can I find out if my neck pain is caused by arthritis?,"Arthritis is inflammation of one or more joints.A joint is the area where two bones meet.There are over 100 different types of arthritis. There are several types of arthritis.Common ones include: Ankylosing Spondylitis is arthritis that affects the spine.It often involves redness, heat, swelling, and pain in the spine or in the joint where the bottom of the spine joins the pelvic bone.Gout is caused by crystals that build up in the joints.It usually affects the big toe, but many other joints may be affected.Juvenile Arthritis is the term used to describe arthritis in children.Arthritis is caused by inflammation of the joints.Osteoarthritis usually comes with age and most often affects the fingers, knees, and hips.Sometimes osteoarthritis follows a joint injury.For example, you might have badly injured your knee when young and develop arthritis in your knee joint years later.Psoriatic Arthritis can occur in people who have psoriasis (scaly red and white skin patches).It affects the skin, joints, and areas where tissues attach to bone.Reactive Arthritis is pain or swelling in a joint that is caused by an infection in your body.You may also have red, swollen eyes and a swollen urinary tract.Rheumatoid arthritis happens when the bodys own defense system doesnt work properly.It affects joints and bones (often of the hands and feet), and may also affect internal organs and systems.You may feel sick or tired, and you may have a fever.Arthritis is seen with other conditions.These include: Lupus happens when the bodys defense system harms the joints, heart, skin, kidneys, and other organs.Infection that gets into a joint and destroys the cushion between the bones.There are several types of arthritis.Common ones include: Ankylosing Spondylitis is arthritis that affects the spine.It often involves redness, heat, swelling, and pain in the spine or in the joint where the bottom of the spine joins the pelvic bone.Gout is caused by crystals that build up in the joints.It usually affects the big toe, but many other joints may be affected.Juvenile Arthritis is the term used to describe arthritis in children.Arthritis is caused by inflammation of the joints.Osteoarthritis usually comes with age and most often affects the fingers, knees, and hips.Sometimes osteoarthritis follows a joint injury.For example, you might have badly injured your knee when young and develop arthritis in your knee joint years later.Psoriatic Arthritis can occur in people who have psoriasis (scaly red and white skin patches).It affects the skin, joints, and areas where tissues attach to bone.Reactive Arthritis is pain or swelling in a joint that is caused by an infection in your body.You may also have red, swollen eyes and a swollen urinary tract.Rheumatoid arthritis happens when the bodys own defense system doesnt work properly.It affects joints and bones (often of the hands and feet), and may also affect internal organs and systems.You may feel sick or tired, and you may have a fever.Arthritis is seen with other conditions.These include: Lupus happens when the bodys defense system harms the joints, heart, skin, kidneys, and other organs.Infection that gets into a joint and destroys the cushion between the bones. ",There are over 100 different types of arthritis.Arthritis that affects the spine is called ankylosing spondylitis.It can cause swelling and pain in the spine.,"Arthritis is inflammation of one or more joints.A joint is the area where two bones meet.There are over 100 different types of arthritis.Ankylosing Spondylitis is arthritis that affects the spine.It often involves redness, heat, swelling, and pain in the spine." 197,What is the best treatment for chronic diarrhea caused by malabsorption?,"Treatment depends on the cause and is aimed at relieving symptoms and ensuring the body receives enough nutrients.A high-calorie diet may be tried.It should supply: Key vitamins and minerals, such as iron, folic acid, and vitamin B12 Enough carbohydrates, proteins, and fats If needed, injections of some vitamins and minerals or special growth factors will be given.Those with damage to the pancreas may need to take pancreatic enzymes.Your provider will prescribe these if necessary.Medicines to slow down the normal movement of the intestine can be tried.This may allow food to remain in the intestine longer.If the body is not able to absorb enough nutrients, total parenteral nutrition (TPN) is tried.It will help you or your child get nutrition from a special formula through a vein in the body.Your provider will select the right amount of calories and TPN solution.Sometimes, you can also eat and drink while getting nutrition from TPN. Malabsorption involves problems with the body's ability to take in nutrients from food. Treatment depends on the cause.Some malabsorption diseases have specific treatments.For example, tropical sprue and Whipple disease are treated with antibiotics.In general, if you have trouble with only certain foods, doctors will have you avoid them.If you are missing certain digestive enzymes, sometimes you can take enzyme supplements.If you have a vitamin deficiency, you'll take extra vitamins. You may need to take extra vitamins and nutrients. Mal means bad.So malabsorption means bad absorption.A problem somewhere in your gastrointestinal (GI) tract keeps you from absorbing one or more kinds of nutrients.Malabsorption can be caused by diseases, surgery on your intestines, or intestinal infections You'll usually lose weight and have diarrhea and smelly stool (poop) After a while, you may get vitamin deficiencies, which may give you a low blood count and feel make you feel sick Doctors often have to do stool and blood tests and sometimes look in your stomach and intestines with a flexible scope (endoscopy) Different causes of malabsorption need different treatments, but doctors usually try to adjust your diet to relieve your symptoms Many diseases can cause malabsorption.Most often, malabsorption involves problems absorbing certain sugars, fats, proteins, or vitamins.It can also involve an overall problem with absorbing food.Problems or damage to the small intestine that may lead to problems absorbing important nutrients.These include: Celiac disease Tropical sprue Crohn disease Whipple disease Damage from radiation treatments Overgrowth of bacteria in the small bowel Parasite or tapeworm infection Surgery that removes all or part of the small intestine Enzymes produced by the pancreas help absorb fats and other nutrients.A decrease of these enzymes makes it harder to absorb fats and certain nutrients.Problems with the pancreas may be caused by:Cystic fibrosis Infections or swelling of the pancreas Trauma to the pancreas Surgery to remove part of the pancreas Some of the other causes of malabsorption include: AIDS and HIV Certain medicines (tetracycline, some antacids, some medicines used to treat obesity, colchicine, acarbose, phenytoin, cholestyramine) Gastrectomy and surgical treatments for obesity Cholestasis Chronic liver disease Cow's milk protein intolerance Soy milk protein intolerance ","If diarrhea and smelly stool are caused by malabsorption, the doctors may need to treat the condition that caused malabsorption.For example, infections diseases, such as tropical sprue and Whipple disease are treated with antibiotics.In general, the doctors may recommend to adjust your diet.If only certain foods give you trouble, they may recommend avoiding these foods.If you are missing digestive enzymes, you can take enzyme supplements.Overall, they may try a high-calorie diet that provides key vitamins and minerals, such as iron, folic acid, and vitamin B12, and enough carbohydrates, proteins, and fats.The doctors may also recommend medicines to slow down the bowel movement.","A problem somewhere in your gastrointestinal tract keeps you from absorbing one or more kinds of nutrients.Malabsorption can be caused by diseases, surgery on your intestines, or intestinal infections .These include: Celiac disease Tropical sprue Crohn disease Whipple disease Damage from radiation treatments Overgrowth of bacteria in the small bowel Parasite or tapeworm infection You'll usually lose weight and have diarrhea and smelly stool. Different causes of malabsorption need different treatments. For example, tropical sprue and Whipple disease are treated with antibiotics.In general, if you have trouble with only certain foods, doctors will have you avoid them.If you are missing certain digestive enzymes, sometimes you can take enzyme supplements. doctors usually try to adjust your diet to relieve your symptoms.A high-calorie diet may be tried.It should supply: Key vitamins and minerals, such as iron, folic acid, and vitamin B12 Enough carbohydrates, proteins, and fats Those with damage to the pancreas may need to take pancreatic enzymes.Medicines to slow down the normal movement of the intestine can be tried." 202,What should be done about abdominal aneurysm measuring 3.5 centimeters in 84-year-old?,"The outcome is often good if you have surgery to repair the aneurysm before it ruptures.When an abdominal aortic aneurysm begins to tear or ruptures, it is a medical emergency.Only about 1 in 5 people survive a ruptured abdominal aneurysm. The aorta is the main blood vessel that supplies blood to the abdomen, pelvis, and legs.An abdominal aortic aneurysm occurs when an area of the aorta becomes very large or balloons out. Abdominal aortic aneurysms (AAAs) are aneurysms that occur in the part of the aorta that passes through the abdomen.They may occur at any age, but are most common in men between 50 and 80 years of age.Many people with an AAA have no symptoms, but some people have a pulsing sensation in the abdomen and/or pain in the back.[1] If the aneurysm ruptures, it may cause deep, severe pain; nausea; vomiting; fast heart rate; clammy skin; and/or shock.[1][2] About 20% of AAAs eventually rupture and are often fatal.[1]The condition has multiple genetic and environmental risk factors , and may sometimes occur as part of an inherited syndrome .When more than one family member is affected, it may be considered "" familial abdominal aortic aneurysm.""[3] Treatment depends on the size of the aneurysm and may include blood pressure medications, or surgery to repair the aneurysm.[1] If you have bleeding inside your body from an aortic aneurysm, you will need surgery right away.If the aneurysm is small and there are no symptoms: Surgery is rarely done.You and your provider must decide if the risk of having surgery is smaller than the risk of bleeding if you do not have surgery.Your provider may want to check the size of the aneurysm with ultrasound tests every 6 months.Most of the time, surgery is done if the aneurysm is bigger than 2 inches (5 centimeters) across or growing quickly.The goal is to do surgery before complications develop.There are two types of surgery: Open repair -A large cut is made in your abdomen.The abnormal vessel is replaced with a graft made of man-made material.Endovascular stent grafting - This procedure can be done without making a large cut in your abdomen, so you may recover more quickly.This may be a safer approach if you have certain other medical problems or are an older adult.Endovascular repair can sometimes be done for a leaking or bleeding aneurysm. The exact cause of an aneurysm is unknown.It occurs due to weakness in the wall of the artery.Factors that can increase your risk of having this problem include: Smoking High blood pressure Male gender Genetic factors An abdominal aortic aneurysm is most often seen in males over age 60 who have one or more risk factors.The larger the aneurysm, the more likely it is to break open or tear.This can be life threatening. The aorta is the main blood vessel (artery) that carries blood away from your heart to the rest of your body.An aneurysm is a bulge in an artery wall.An abdominal aortic aneurysm is a bulge in the part of your aorta that passes through your belly.Aneurysms may cause a pulsing feeling in your belly Aneurysms that are large or are growing need surgery to prevent them from bursting If the aneurysm bursts, blood flows out and you have severe pain and low blood pressure If the aneurysm bursts, you'll die if you don't have surgery Doctors often find an aneurysm during a regular exam or from an imaging test (such as an x-ray or CT scan) taken for another problem and found by accident You're more likely to have an abdominal aortic aneurysm if: You're a man You're between the ages of 50 and 80 Someone in your family had one You have high blood pressure You smoke ","Treatment depends on the size of the abdominal aneurysm.It may include blood pressure medications.Surgery is usually done if the aneurysm is bigger than 5 centimeters across or if it is growing quickly.Your doctor may need to monitor the size of the aneurysm with ultrasound every 6 months.Discuss with your doctor if the risk of having surgery is smaller than the risk of aneurism rapture.If you have internal bleeding due to aneurism, you will need surgery immediately.The outcomes are usually better if you have the surgery before the aneurysm raptures.There are two types of surgery: an open repair in which the ballooning portion of the aorta is replaced with a graft, and endovascular stent grafting, which is safer for older adults and people with other medical problems.","Treatment depends on the size of the aneurysm and may include blood pressure medications, or surgery to repair the aneurysm.If you have bleeding inside your body from an aortic aneurysm, you will need surgery right away.If the aneurysm is small and there are no symptoms: Surgery is rarely done.You and your provider must decide if the risk of having surgery is smaller than the risk of bleeding if you do not have surgery.Your provider may want to check the size of the aneurysm with ultrasound tests every 6 months.Most of the time, surgery is done if the aneurysm is bigger than 2 inches (5 centimeters) across or growing quickly.The goal is to do surgery before complications develop.There are two types of surgery: Open repair -A large cut is made in your abdomen.The abnormal vessel is replaced with a graft made of man-made material.Endovascular stent grafting - This procedure can be done without making a large cut in your abdomen, so you may recover more quickly.This may be a safer approach if you have certain other medical problems or are an older adult.Endovascular repair can sometimes be done for a leaking or bleeding aneurysm.The larger the aneurysm, the more likely it is to break open or tear.This can be life threatening.The outcome is often good if you have surgery to repair the aneurysm before it ruptures.When an abdominal aortic aneurysm begins to tear or ruptures, it is a medical emergency.Only about 1 in 5 people survive a ruptured abdominal aneurysm." 203,What is the best treatment for chronic pancreatitis?,"People with severe pain or who are losing weight may need to stay in the hospital for: Pain medicines.Fluids given through a vein (IV).Stopping food or fluid by mouth to limit the activity of the pancreas, and then slowly starting an oral diet.Inserting a tube through the nose or mouth to remove the contents of the stomach (nasogastric suctioning) may sometimes be done.The tube may stay in for 1 to 2 days, or sometimes for 1 to 2 weeks.The right diet is important for people with chronic pancreatitis to keep a healthy weight and get the correct nutrients.A nutritionist can help you create a diet that includes: Drinking plenty of liquids Limiting fats Eating small, frequent meals (this helps reduce digestive symptoms)Getting enough vitamins and calcium in the diet, or as extra supplements Limiting caffeine The health care provider may prescribe pancreatic enzymes.You must take these medicines with every meal, and even with snacks.The enzymes will help you digest food better, gain weight and reduce diarrhea.Avoid smoking and drinking alcoholic beverages, even if your pancreatitis is mild.Other treatments may involve: Pain medicines or a surgical nerve block to relieve pain Taking insulin to control blood sugar (glucose) levelSurgery may be performed if a blockage is found.In severe cases, a part of or the entire pancreas may be removed.

Summary

The pancreas is a large gland behind the stomach and close to the first part of the small intestine.It secretes digestive juices into the small intestine through a tube called the pancreatic duct.The pancreas also releases the hormones insulin and glucagon into the bloodstream.Pancreatitis is inflammation of the pancreas.It happens when digestive enzymes start digesting the pancreas itself.Pancreatitis can be acute or chronic.Either form is serious and can lead to complications.Acute pancreatitis occurs suddenly and usually goes away in a few days with treatment.It is often caused by gallstones.Common symptoms are severe pain in the upper abdomen, nausea, and vomiting.Treatment is usually a few days in the hospital for intravenous (IV) fluids, antibiotics, and medicines to relieve pain.Chronic pancreatitis does not heal or improve.It gets worse over time and leads to permanent damage.The most common cause is heavy alcohol use.Other causes include cystic fibrosis and other inherited disorders, high levels of calcium or fats in the blood, some medicines, and autoimmune conditions.Symptoms include nausea, vomiting, weight loss, and oily stools.Treatment may also be a few days in the hospital for intravenous (IV) fluids, medicines to relieve pain, and nutritional support.After that, you may need to start taking enzymes and eat a special diet.It is also important to not smoke or drink alcohol.NIH: National Institute of Diabetes and Digestive and Kidney Diseases Treatment for acute or chronic pancreatitis may includea hospital stay to treat dehydration with intravenous (IV) fluids and, if you can swallow them, fluids by mouth pain medicine, and antibiotics by mouth or through an IV if you have an infection in your pancreas a low-fat diet, or nutrition by feeding tube or IV if you can't eatYour doctor may send you to a gastroenterologist or surgeon for one of the following treatments, depending on the type of pancreatitis that you have.Mild acute pancreatitis usually goes away in a few days with rest and treatment.If your pancreatitis is more severe, your treatment may also include:Surgery.Your doctor may recommend surgery to remove the gallbladder, called cholecystectomy, if gallstones cause your pancreatitis.Having surgery within a few days after you are admitted to the hospital lowers the chance of complications.If you have severe pancreatitis, your doctor may advise delaying surgery to first treat complications.Procedures.Your doctor or specialist will drain fluid in your abdomen if you have an abscess or infected pseudocyst, or a large pseudocyst causing pain or bleeding.Your doctor may remove damaged tissue from your pancreas.Endoscopic Cholangiopancreatography (ERCP).Doctors use ERCP to treat both acute and chronic pancreatitis.ERCP combines upper gastrointestinal endoscopy and x-rays to treat narrowing or blockage of a bile or pancreatic duct.Your gastroenterologist may use ERCP to remove gallstones blocking the bile or pancreatic ducts.Treatment for chronic pancreatitis may help relieve pain, improve how well the pancreas works, and manage complications.Your doctor may prescribe or provide the following:Medicines and vitamins.Your doctor may give you enzyme pills to help with digestion, or vitamins A, D, E, and K if you have malabsorption.He or she may also give you vitamin B-12 shots if you need them.Treatment for diabetes.Chronic pancreatitis may cause diabetes.If you get diabetes, your doctor and health care team will work with you to create an eating plan and a routine of medicine, blood glucose monitoring, and regular checkups.Surgery.Your doctor may recommend surgery to relieve pressure or blockage in your pancreatic duct, or to remove a damaged or infected part of your pancreas.Surgery is done in a hospital, where you may have to stay a few days.In patients who do not get better with other treatments, surgeons may perform surgery to remove your whole pancreas, followed by islet auto-transplantation.Islets are groups of cells in your pancreas that make hormones, including insulin.After removing your pancreas, doctors will take islets from your pancreas and transplant them into your liver.The islets will begin to make hormones and release them into your bloodstream.Procedures.Your doctor may suggest a nerve block, which is a shot of numbing medicine through your skin and directly into nerves that carry the pain message from your pancreas.If you have stones blocking your pancreatic duct, your doctor may use a procedure to break up and remove the stones. ","Treatments for chronic pancreatitis aim to relieve pain, improve pancreatic functions, and manage complications.Treatments may include a stay in the hospital for intravenous (IV) fluids and nutritional support.If gallstones are blocking pancreatic ducts, they may be removed with cholangiopancreatography (ERCP). It is important to maintain a diet that includes plenty of liquids and limits fats.Eating small, frequent meals helps reduce digestive symptoms.Getting enough vitamins and calcium in the diet, or as extra supplements is also important.Your doctor may give you vitamins A, D, E,, K and B-12 shots. Your doctor may also give you pancreatic enzyme pills that have to be taken with every meal and snack.Doctors recommend avoid smoking and alcoholic beverages, as well as limiting caffeine.","Chronic pancreatitis does not heal or improve.It gets worse over time and leads to permanent damage.Treatment for chronic pancreatitis may help relieve pain, improve how well the pancreas works, and manage complications.Treatment may also be a few days in the hospital for intravenous (IV) fluids and nutritional support. Your gastroenterologist may use ERCP to remove gallstones blocking the bile or pancreatic ducts.Cholangiopancreatography (ERCP).combines upper gastrointestinal endoscopy and x-rays to treat narrowing or blockage of a bile or pancreatic duct. Your doctor may give you enzyme pills to help with digestion, or vitamins A, D, E, and K if you have malabsorption.He or she may also give you vitamin B-12 shots if you need them.The right diet is important for people with chronic pancreatitis to keep a healthy weight and get the correct nutrients.A nutritionist can help you create a diet that includes: Drinking plenty of liquids Limiting fats Eating small, frequent meals (this helps reduce digestive symptoms)Getting enough vitamins and calcium in the diet, or as extra supplements Limiting caffeine The health care provider may prescribe pancreatic enzymes.You must take these medicines with every meal, and even with snacks.The enzymes will help you digest food better, gain weight and reduce diarrhea.Avoid smoking and drinking alcoholic beverages, even if your pancreatitis is mild." 204,How to stop snoring from sleep apnea?,"With treatment, the prognosis is usually excellent.Life span is not affected, and most serious complications can be prevented.Losing weight, quitting smoking, and not using alcohol excessively can help.Nasal infections and allergies should be treated.Hypothyroidism and acromegaly should be treated.Weight loss (bariatric) surgery frequently reduces sleep apnea and reverses symptoms in people who are very overweight (morbidly obese), but even people who lose a lot of weight as a result of surgery may not experience a significant decrease in sleep apnea and the associated symptoms.Heavy snorers and people who often choke in their sleep should not consume alcohol or take sleep aids, sedating antihistamines, or other drugs that cause drowsiness.Sleeping on the side or elevating the head of the bed can help reduce snoring.Special devices strapped on the back help prevent people from sleeping on their back.The various other devices and sprays marketed to reduce snoring may help simple snoring, but they have not been shown to relieve obstructive sleep apnea.There are several surgical procedures marketed for snoring as well, but there is little proof of how well they work and how long they are effective.People with obstructive sleep apnea, particularly those who have excessive daytime sleepiness, benefit most predictably from continuous positive airway pressure (CPAP).With CPAP, people breathe through a face or nose mask connected to a device that provides a slightly higher pressure in the airway.This increased pressure props the throat open as the person breathes in.CPAP can be given with or without humidifying the delivered air.Close follow-up by a health care practitioner is needed during the first 2 weeks of use to ensure proper mask fit and provide appropriate encouragement as the person learns to sleep with the mask.Some people who use CPAP still have excessive daytime sleepiness.These people may benefit from taking modafinil, which is a mild stimulant used to treat daytime sleepiness in people with obstructive sleep apnea.Other drugs are also being tested for people with obstructive sleep apnea.Removable oral appliances, fitted by dentists, can help relieve obstructive sleep apnea (and snoring) in people with mild to moderate sleep apnea.These appliances, which are worn only while sleeping, help keep the airway open.Most appliances separate the jaws and push the lower jaw forward so the tongue cannot move backward to block the throat.Others hold the tongue forward.Upper airway stimulation is a procedure in which an implanted electrical device is used to activate one of the two 12th cranial nerves (hypoglossal nerve).This therapy can be successful in people with moderate to severe obstructive sleep apnea who are unable to tolerate CPAP therapy.Surgery of the head or neck as a treatment for sleep apnea is useful if there are enlarged tonsils or an obvious blockage of the upper airway by another structure.In children, surgery to remove the tonsils and adenoids is the most common treatment.This type of surgery usually relieves sleep apnea, particularly if the tonsils or adenoids are enlarged.Surgery is sometimes used in people without obvious blockage if no other treatments have worked.Another common procedure is a uvulopalatopharyngoplasty, in which tissue from around the upper airways (for example, the tonsils and adenoids) is removed.It is most often helpful in people who have mild sleep apnea.Other surgical procedures are sometimes used, but they have not been studied as thoroughly. Espaol Sleep apnea (AP-ne-ah) is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep.Breathing pauses can last from a few seconds to minutes.They may occur 30times or more an hour.Typically, normal breathing then starts again, sometimes with a loud snort or choking sound.Sleep apnea usually is a chronic (ongoing) condition that disrupts your sleep.When your breathing pauses or becomes shallow, youll often move out of deep sleep and into light sleep.As a result, the quality of your sleep is poor, which makes you tired during the day.Sleep apnea is a leading cause of excessive daytime sleepiness.Overview Sleep apnea often goes undiagnosed.Doctors usually can't detect the condition during routine office visits.Also, no blood test can help diagnose the condition.Most people who have sleep apnea don't know they have it because it only occurs during sleep.A family member or bed partner might be the first to notice signs of sleep apnea.The most common type of sleep apnea is obstructive sleep apnea.In this condition, the airway collapses or becomes blocked during sleep.This causes shallow breathing or breathing pauses.When you try to breathe, any air that squeezes past the blockage can cause loud snoring.Obstructive sleep apnea is more common in people who are overweight, but it can affect anyone.For example, small children who have enlarged tonsil tissues in their throats may have obstructive sleep apnea.The animation below shows how obstructive sleep apnea occurs.Click the ""start"" button to play the animation.Written and spoken explanations are provided with each frame.Use the buttons in the lower right corner to pause, restart, or replay the animation, or use the scroll bar below the buttons to move through the frames.The animation shows how the airway can collapse and block air flow to the lungs, causing sleep apnea.Central sleep apnea is a less common type of sleep apnea.This disorder occurs if the area of your brain that controls your breathing doesn't send the correct signals to your breathing muscles.As a result, you'll make no effort to breathe for brief periods.Central sleep apnea can affect anyone.However, it's more common in people who have certain medical conditions or use certain medicines.Central sleep apnea can occur with obstructive sleep apnea or alone.Snoring typically doesn't happen with central sleep apnea.This article mainly focuses on obstructive sleep apnea.Outlook Untreated sleep apnea can: Increase the risk of high blood pressure, heart attack, stroke, obesity, and diabetes Increase the risk of, or worsen, heart failure Make arrhythmias (ah-RITH-me-ahs), or irregular heartbeats, more likely Increase the chance of having work-related or driving accidents Sleep apnea is a chronic condition that requires long-term management.Lifestyle changes, mouthpieces, surgery, and breathing devices can successfully treat sleep apnea in many people. Apnea is a medical word for ""not breathing.""Sleep apnea is when your breathing slows or stops for a short time while you're sleeping and then restarts.This happens over and over each time you sleep, often many times an hour.You wake up partway when your breathing stops.When you wake up, you start breathing again.Usually you don't remember waking up.However, it still breaks up a good night's sleep.People with sleep apnea usually snore loudly at night and are very tired during the day Doctors usually do a sleep study if they suspect sleep apnea Doctors may treat you with a breathing machine connected to a mask (CPAP machine), with a mouthpiece, or sometimes with surgery If you're not treated, you have an increased risk of high blood pressure, stroke, and heart disease To treat obstructive sleep apnea, your doctor may: Give you a CPAP machine to help you breathe while you sleep Give you a mouthpiece that helps keep your airway open during sleep Sometimes do surgery on the back of your mouth to remove and reshape tissueSurgically place a device to help keep your airway openA CPAP machine pushes air into your throat through a mask.The pressurized air keeps your throat from closing.There are different masks.Some cover your mouth and nose.Others cover only your nose or fit inside your nose (like nose plugs).CPAP works very well, but many people aren't able to sleep well because of the mask.Mouthpieces are plastic devices that fit over your teeth.You wear them at night.They're a little like the mouth guards that some athletes wear for sports.The mouthpieces are adjusted to pull your jaw forward.Pulling your jaw forward helps keep your throat from closing.A dentist makes the mouthpiece specially to fit your mouth.Doctors will also have you do other things:Lose weight if you're overweight or obese Stop smoking Avoid drinking alcoholAvoid medicines that cause drowsiness before bed Sleep on your side or raise the head of your bed Sometimes, take medicine to help you stay awake during the day The underlying disorder is treated if possible.For example, drugs may be given to reduce the severity of heart failure.Otherwise, there are few, well-conducted clinical trials.Oxygen delivered by nasal prongs (not under pressure) may reduce episodes of apnea in people whose levels of blood oxygen become low while sleeping.Some people with central sleep apnea may benefit from CPAP.People with central apnea of the Cheyne-Stokes type have fewer episodes of apnea and a lower severity of heart failure with this treatment but do not survive longer.Acetazolamide can help people who have central sleep apnea caused by high altitude and possibly even people at sea level.Some people benefit from surgery to implant a device that stimulates the diaphragm (a diaphragmatic/phrenic nerve stimulator) to help the person breathe. ","Sleep apnea may be managed with lifestyle changes, mouthpieces that help keep your airway open during sleep, surgery, and breathing devices.To heavy snorers, doctors recommend avoiding alcohol, sleep aids, sedating antihistamines, or other drugs that cause drowsiness.Snoring may be reduced by sleeping on the side or elevating the head of the bed. .Sleeping on their back can be prevented by special devices.It has not been demonstrated that the devices, procedures and drugs marketed for snoring relieve obstructive sleep apnea. Doctors may recommend continuous positive airway pressure (CPAP), which provides a slightly higher pressure in the airway through a face or nose mask. Doctors may also recommend losing excessive weight, stop smoking, treat nasal infections and allergies.","To treat obstructive sleep apnea, your doctor may: Give you a CPAP machine to help you breathe while you sleep Give you a mouthpiece that helps keep your airway open during sleep Sometimes do surgery on the back of your mouth to remove and reshape tissueSurgically place a device to help keep your airway open .Doctors will also have you do other things:Lose weight if you're overweight or obese Stop smoking Avoid drinking alcohol.Nasal infections and allergies should be treated.Hypothyroidism and acromegaly should be treated..Heavysnorers and people who often choke in their sleep should not consume alcohol or take sleep aids, sedating antihistamines, or other drugs that cause drowsiness.Sleeping on the side or elevating the head of the bed can help reduce snoring.Special devices strapped on the back help prevent people from sleeping on their back.The various other devices and sprays marketed to reduce snoring may help simple snoring, but they have not been shown to relieve obstructive sleep apnea.There are several surgical procedures marketed for snoring as well, but there is little proof of how well they work and how long they are effective.People with obstructive sleep apnea, benefit most predictably from continuous positive airway pressure (CPAP).With CPAP, people breathe through a face or nose mask connected to a device that provides a slightly higher pressure in the airway." 205,How can I stop pain in my hand joints?,"Follow your doctor's recommendation for treating the cause of the pain.For nonarthritis joint pain, both rest and exercise are important.Warm baths, massage, and stretching exercises should be used as often as possible.Aceteminophen (Tylenol) may help the soreness feel better.Nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen or naproxen may help relieve pain and swelling.Talk to your health care provider before giving aspirin or NSAIDs such as ibuprofen to children. The causes for pain in many joints usually are different than those for pain in a single joint.Pain in many joints is usually caused by: Arthritis Arthritis is joint inflammation that causes swelling, pain, and stiffness in the joints.The causes of the arthritis are different depending on whether the joints started hurting suddenly (acutely) or have been hurting for a long time (chronic).Sudden (acute) arthritis in more than one joint is most often caused by:Infection from a virus The start of a joint disorder or a flare up of a long-term joint disorder (such as rheumatoid arthritis)Less common causes include: Lyme disease Gonorrhea Streptococcal infections Reactive arthritis Gout Chronic arthritis in more than one joint is caused by: Inflammatory disorders, such as rheumatoid arthritis, psoriatic arthritis, or systemic lupus erythematosus Osteoarthritis, which is the most common cause in older adults Autoimmune disorders Juvenile idiopathic arthritis (in children)The most common disorders outside the joints that cause pain around the joints include: Fibromyalgia Polymyalgia rheumatica Bursitis or tendinitis ","Pain in the joints is usually caused by arthritis, which is an inflammation that causes swelling and stiffness in the joints.Arthritis has many different causes, such as infection, or autoimmune diseases.There are also some disorders outside the joints that may cause pain around the joints, e.g., fibromyalgia or tendinitis.Yup doctor will recommend how to treat the cause of the pain.Pain that is not caused by arthritis may be reduced with rest, stretching exercise, warm baths, massage, aceteminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen or naproxen.","Pain in many joints is usually caused by: Arthritis Arthritis is joint inflammation that causes swelling, pain, and stiffness in the joints.The causes of the arthritis are different depending on whether the joints started hurting suddenly (acutely) or have been hurting for a long time (chronic).Sudden (acute) arthritis in more than one joint is most often caused by:Infection from a virus The start of a joint disorder or a flare up of a long-term joint disorder (such as rheumatoid arthritis) Chronic arthritis in more than one joint is caused by: Inflammatory disorders, such as rheumatoid arthritis, psoriatic arthritis, or systemic lupus erythematosus Osteoarthritis, which is the most common cause in older adults Autoimmune disorders The most common disorders outside the joints that cause pain around the joints include: Fibromyalgia Polymyalgia rheumatica Bursitis or tendinitis Follow your doctor's recommendation for treating the cause of the pain.For nonarthritis joint pain, both rest and exercise are important.Warm baths, massage, and stretching exercises should be used as often as possible.Aceteminophen (Tylenol) may help the soreness feel better.Nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen or naproxen may help relieve pain and swelling." 206,When can I have alcohol after cataract surgery?,"Cataract surgery is an outpatient procedure.This means you likely do not have to stay overnight at a hospital.The surgery is performed by an ophthalmologist.This is a medical doctor who specializes in eye diseases and eye surgery.Adults are usually awake for the procedure.Numbing medicine (local anesthesia) is given using eyedrops or a shot.This blocks pain.You will also get medicine to help you relax.Children usually receive general anesthesia.This is medicine that puts them into a deep sleep so that they are unable to feel pain.The doctor uses a special microscope to view the eye.A small cut (incision) is made in the eye.The lens is removed in one of the following ways, depending on the type of cataract:Phacoemulsification: With this procedure, the doctor uses a tool that produces sound waves to break up the cataract into small pieces.The pieces are then suctioned out.This procedure uses a very small incision.Extracapsular extraction: The doctor uses a small tool to remove the cataract in mostly one piece.This procedure uses a larger incision.Laser surgery: The doctor guides a machine that uses laser energy to make the incisions and soften the cataract.The rest of the surgery is much like phacoemulsification.Using the laser instead of a knife (scalpel) may speed recovery and be more accurate.After the cataract is removed, a manmade lens, called an intraocular lens (IOL), is usually placed into the eye to restore the focusing power of the old lens (cataract).It helps improve your vision.The doctor may close the incision with very small stitches.Usually, a self-sealing (sutureless) method is used.If you have stitches, they may need to be removed later.The surgery lasts less than half an hour.Most times, just one eye is done.If you have cataracts in both eyes, your doctor may suggest waiting at least 1 to 2 weeks between each surgery. Most people do well and recover quickly after cataract surgery.If a person has other eye problems, such as glaucoma or macular degeneration, the surgery may be more difficult or the outcome may not be as good. Before you go home, you may receive the following: A patch to wear over your eye until the follow-up exam Eyedrops to prevent infection, treat inflammation, and help with healing You will need to have someone drive you home after surgery.You will usually have a follow-up exam with your doctor the next day.If you had stitches, you will need to make an appointment to have them removed.Tips for recovering after cataract surgery: Wear dark sunglasses outside after you remove the patch.Wash your hands well before and after using eyedrops and touching your eye.Try not to get soap and water in your eye when you are bathing or showering for the first few days.Light activities are best as you recover.Check with your doctor before doing any strenuous activity, resuming sexual activity, or driving.Recovery takes about 2 weeks.If you need new glasses or contact lenses, you can usually have them fitted at that time.Keep your follow-up visit with your doctor. ","Most people recover quickly after cataract surgery, which is an outpatient procedure.Recovery should take about two weeks.Check with your doctor before doing any strenuous activity, resuming sexual activity, or driving.","Cataract surgery is an outpatient procedure.This means you likely do not have to stay overnight at a hospital.Most people do well and recover quickly after cataract surgery.Check with your doctor before doing any strenuous activity, resuming sexual activity, or driving.Recovery takes about 2 weeks." 207,What is the life expectancy of a person with Wolf Hirschhorn Syndrome?,"Symptoms of Wolf-Hirschhorn syndrome often include profound intellectual disability.Children may also have epilepsy, a broad or beaked nose, scalp defects, drooping upper eyelids (ptosis) and gaps or fissures (colobomas) of the iris, cleft palate, and delayed bone development.Boys may have undescended testes (cryptorchidism) and a misplaced opening of the urethra (hypospadias).Some children have an immune deficiency, which means their body is less able to fight off infections.Many affected children die during infancy. The long-term outlook ( prognosis ) for people with Wolf-Hirschhorn syndrome (WHS) depends on the specific features present and the severity of those features.The average life expectancy is unknown.Muscle weakness may increase the risk of having chest infections and ultimately may reduce the life expectancy.Many people, in the absence of severe heart defects, chest infections, and uncontrollable seizures , survive into adulthood.[3][4] Wolf-Hirschhorn syndrome is a condition that affects many parts of the body.The major features of this disorder include a characteristic facial appearance, delayed growth and development, intellectual disability, and seizures.Almost everyone with this disorder has distinctive facial features, including a broad, flat nasal bridge and a high forehead.This combination is described as a ""Greek warrior helmet"" appearance.The eyes are widely spaced and may be protruding.Other characteristic facial features include a shortened distance between the nose and upper lip (a short philtrum), a downturned mouth, a small chin (micrognathia), and poorly formed ears with small holes (pits) or flaps of skin (tags).Additionally, affected individuals may have asymmetrical facial features and an unusually small head (microcephaly).People with Wolf-Hirschhorn syndrome experience delayed growth and development.Slow growth begins before birth, and affected infants tend to have problems feeding and gaining weight (failure to thrive).They also have weak muscle tone (hypotonia) and underdeveloped muscles.Motor skills such as sitting, standing, and walking are significantly delayed.Most children and adults with this disorder also have short stature.Intellectual disability ranges from mild to severe in people with Wolf-Hirschhorn syndrome.Compared to people with other forms of intellectual disability, their socialization skills are strong, while verbal communication and language skills tend to be weaker.Most affected children also have seizures, which may be resistant to treatment.Seizures tend to disappear with age.Additional features of Wolf-Hirschhorn syndrome include skin changes such as mottled or dry skin, skeletal abnormalities such as abnormal curvature of the spine (scoliosis and kyphosis), dental problems including missing teeth, and an opening in the roof of the mouth (cleft palate) and/or in the lip (cleft lip).Wolf-Hirschhorn syndrome can also cause abnormalities of the eyes, heart, genitourinary tract, and brain.A condition called Pitt-Rogers-Danks syndrome has features that overlap with those of Wolf-Hirschhorn syndrome.Researchers now recognize that these two conditions are actually part of a single syndrome with variable signs and symptoms. ","The average life expectancy for people with Wolf-Hirschhorn syndrome is unknown.The outlook depends on the specific features of the disease and their severity.One of the features of Wolf-Hirschhorn syndrome is slow growth and development that starts before birth.The infants have problems with feeding which could cause failure to thrive and death during infancy.Muscle weakness may also increase the risk of chest infections and reduce life expectancy.If there are no severe heart defects, chest infections, and uncontrollable seizures, children survive into adulthood.","The long-term outlook ( prognosis ) for people with Wolf-Hirschhorn syndrome (WHS) depends on the specific features present and the severity of those features.The average life expectancy is unknown.Muscle weakness may increase the risk of having chest infections and ultimately may reduce the life expectancy.Many people, in the absence of severe heart defects, chest infections, and uncontrollable seizures , survive into adulthood.People with Wolf-Hirschhorn syndrome experience delayed growth and development.Slow growth begins before birth, and affected infants tend to have problems feeding and gaining weight (failure to thrive).Many affected children die during infancy." 210,is it safe for a 4-year-old boy to take adult dietary supplements?,"Because dietary supplements are not regulated as drugs by the FDA, their manufacturers are not required to prove that supplements are safe and effective (although they must have a history of safety).Consequently, few supplements have been studied rigorously for safety and effectiveness.Furthermore, because the need to evaluate supplements in humans has been recognized only recently, much of the available information has not been gathered systematically or scientifically and so is difficult to evaluate.Manufacturers must now report serious adverse events to the FDA through the FDA MedWatch system.However, a few supplements (for example, fish oil, chondroitin, glucosamine, St. John's wort) are proven to be safe and useful additions to standard drugs.Did You Know...Manufacturers are not required to prove that dietary supplements are safe and effective.In contrast, both prescription and nonprescription (over-the-counter) drugs have been extensively and systematically studied by researchers and reviewed for safety and effectiveness by the FDA.These include studies in animals to detect the development of cancer and organ damage and studies in humans to detect any signs of toxicity.The amount and quality of evidence supporting the effectiveness of supplements vary greatly.For some supplements, evidence supporting their effectiveness is convincing.However, for most, scientific studies have not been designed well enough to provide clear, reliable answers.For some supplements, the only evidence suggesting effectiveness is reports about individual people or studies conducted in animals.Evidence about the safety and effectiveness of dietary supplements is increasing rapidly as more and more clinical studies are being done.Information about such studies is available from the National Institutes of Health's National Center for Complementary and Integrative Health (NCCIH). If you are thinking about using dietary supplements:- Learn.Find out as much as you can about any dietary supplement you might take.Talk with your doctor, your pharmacist, or a registered dietitian.A supplement that seemed to help your neighbor might not work for you.If you are reading fact sheets or checking websites, be aware of the source of the information.Could the writer or group profit from the sale of a particular supplement?Read more about choosing reliable health information websites.- Remember.Just because something is said to be ""natural"" doesn't mean it is safe or good for you.It could have side effects.It might make a medicine your doctor prescribed for you either weaker or stronger.It could also be harmful to you if you have certain medical conditions.- Tell your doctor.He or she needs to know if you decide to use a dietary supplement.Do not diagnose or treat any health condition without first checking with your doctor.Learn how medications can interact with dietary supplements.For more information, visit the National Center for Complementary and Integrative Health. - Buy wisely.Choose brands that your doctor, dietitian, or pharmacist recommend.Don't buy dietary supplements with ingredients you don't need.Don't assume that more is better.It is possible to waste money on unneeded supplements.- Check the science.Make sure any claim about a dietary supplement is based on scientific proof.The company making the dietary supplement should be able to send you information on the safety and/or effectiveness of the ingredients in a product, which you can then discuss with your doctor.Remember, if something sounds too good to be true, it probably is. Scientists are still working to answer this question.The U.S. Food and Drug Administration (FDA) checks prescription medicines, such as antibiotics or blood pressure medicines, to make sure they are safe and do what they promise.The same is true for over-the-counter drugs like pain and cold medicines.The FDA does not have authority over dietary supplements in the same way it does prescription medicines.The Federal Government does not regularly test what is in dietary supplements, and companies are not required to share information on the safety of a dietary supplement with the FDA before they sell it.The companies are responsible for making sure the supplement is safe, but the FDA does not evaluate the safety of the product before the supplement is sold.So, just because you see a dietary supplement on a store shelf does not mean it is safe, that it does what the label says it will, or that it contains what the label says it contains.If the FDA receives reports of possible problems with a supplement, it will issue warnings about products that are clearly unsafe.The FDA may also take these supplements off the market.The Federal Trade Commission looks into reports of ads that might misrepresent what dietary supplements do.A few private groups, such as the U.S. Pharmacopeia, NSF International, ConsumerLab.com, and the Natural Products Association, have their own ""seals of approval"" for dietary supplements.To get such a seal, products must be made by following good manufacturing procedures, must contain what is listed on the label, and must not have harmful levels of ingredients that don't belong there, like lead. Eating a variety of healthy foods is the best way to get the nutrients you need.However, some people don't get enough vitamins and minerals from their daily diet, and their doctors may recommend a supplement.Dietary supplements may provide nutrients that might be missing from your daily diet.Talk with your doctor before taking any supplements.Some supplements can change how medicines you may already be taking will work.If your doctor recommends a dietary supplement for you, make sure you're getting the brand recommended by the doctor and that you take it as directed.Do you wonder if you need a dietary supplement?Maybe you do, but usually not.Ask yourself why you think you might want to take a dietary supplement.Are you concerned about getting enough nutrients?Is a friend, a neighbor, or someone on a commercial suggesting you take one?Some ads for dietary supplements in magazines, online, or on TV seem to promise that these supplements will make you feel better, keep you from getting sick, or even help you live longer.Often, there is little, if any, good scientific research supporting these claims.Supplements may cost a lot, could be harmful, or simply might not be helpful.Talk to your doctor or a registered dietitian for advice. ","Dietary supplements are not regulated by FDA.It is therefore hard to judge their safety and effectiveness.The information on the labels and websites does not have to be supported by studies.Supplements may be costly, not always helpful, and sometimes harmful The vest source of nutrients is a healthy diet.Before taking any supplements, talk to your doctor, a pharmacist or a dietitian.","Because dietary supplements are not regulated as drugs by the FDA, their manufacturers are not required to prove that supplements are safe and effective.Consequently, few supplements have been studied rigorously for safety and effectiveness.just because you see a dietary supplement on a store shelf does not mean it is safe, that it does what the label says it will, or that it contains what the label says it contains.Furthermore, because the need to evaluate supplements in humans has been recognized only recently, much of the available information has not been gathered systematically or scientifically and so is difficult to evaluate. Eating a variety of healthy foods is the best way to get the nutrients you need.Supplements may cost a lot, could be harmful, or simply might not be helpful. Talk with your doctor, your pharmacist, or a registered dietitian.A supplement that seemed to help your neighbor might not work for you.If you are reading fact sheets or checking websites, be aware of the source of the information.Remember.Just because something is said to be ""natural"" doesn't mean it is safe or good for you.It could have side effects." 211,What are the chances of getting shingles after vaccine?,"What is shingles?Shingles is a painful skin rash, often with blisters.It is also called Herpes Zoster, or just Zoster.A shingles rash usually appears on one side of the face or body and lasts from 2 to 4 weeks.Its main symptom is pain, which can be quite severe.Other symptoms of shingles can include fever, headache, chills and upset stomach.Very rarely, a shingles infection can lead to pneumonia, hearing problems, blindness, brain inflammation (encephalitits) or death.For about 1 person in 5, severe pain can continue even long after the rash clears up.This is called post-herpetic neuralgia.Shingles is caused by the Varicella Zoster virus, the same virus that causes chickenpox.Only someone who has had chickenpox -- or, rarely, has gotten chickenpox vaccine -- can get shingles.The virus stays in your body, and can cause shingles many years later.You can't catch shingles from another person with shingles.However, a person who has never had chickenpox (or chickenpox vaccine) could get chickenpox from someone with shingles.This is not very common.Shingles is far more common in people 50 years of age and older than in younger people.It is also more common in people whose immune systems are weakened because of a disease such as cancer, or drugs such as steroids or chemotherapy.At least 1 million people a year in the United States get shingles.Shingles vaccine A vaccine for shingles was licensed in 2006.In clinical trials, the vaccine reduced the risk of shingles by 50%.It can also reduce pain in people who still get shingles after being vaccinated.A single dose of shingles vaccine is recommended for adults 60 years of age and older.Some people should not get shingles vaccine or should wait.A person should not get shingles vaccine who: - Has ever had a life-threatening allergic reaction to gelatin, the antibiotic neomycin, or any other component of shingles vaccine.Tell your doctor if you have any severe allergies. -Has a weakened immune system because of current: - AIDS or another disease that affects the immune system, - Treatment with drugs that affect the immune system, such as prolonged use of high-dose steroids, - Cancer treatment such as radiation or chemotherapy, - Cancer affecting the bone marrow or lymphatic system, such as leukemia or lymphoma. -Is pregnant, or might be pregnant.Women should not become pregnant until at least 4 weeks after getting shingles vaccine.Someone with a minor acute illness, such as a cold, may be vaccinated.But anyone with a moderate or severe acute illness should usually wait until they recover before getting the vaccine.This includes anyone with a temperature of 101.3F or higher.What are the risks from shingles vaccine?A vaccine, like any medicine, could possibly cause serious problems, such as severe allergic reactions.However, the risk of a vaccine causing serious harm, or death, is extremely small.No serious problems have been identified with shingles vaccine.Mild problems - Redness, soreness, swelling, or itching at the site of the injection (about 1 person in 3).- Headache (about 1 person in 70).Like all vaccines, shingles vaccine is being closely monitored for unusual or severe problems.What if there is a serious reaction?What should I look for? -Look for anything that concerns you, such as signs of a severe allergic reaction, very high fever, or behavior changes.Signs of a severe allergic reaction can include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, and weakness.These would start a few minutes to a few hours after the vaccination.What should I do? -If you think it is a severe allergic reaction or other emergency that can't wait, call 9-1-1 or get the person to the nearest hospital.Otherwise, call your doctor. -Afterward, the reaction should be reported to the Vaccine Adverse Event Reporting System (VAERS).Your doctor might file this report, or you can do it yourself through the VAERS website or by calling 1-800-822-7967.VAERS is only for reporting reactions.They do not give medical advice.How can I learn more? -Ask your doctor.- Contact your local or state health department.- Contact the Centers for Disease Control and Prevention (CDC): - Call 1-800-232-4636 (1-800-CDC-INFO) - Visit CDC's vaccines website The shingles vaccine is a safe and easy, one-time shot that may keep you from getting shingles.Most people age 60 and older should get vaccinated.You should get the shot even if you have already had shingles or don't remember having chickenpox.However, if you have a weak immune system or allergies to certain medicines, make sure to check with your doctor first.You can get the shingles vaccine at your doctor's office and at some pharmacies.All Medicare Part D plans and most private health insurance plans will cover the cost. Preventing chickenpox by vaccinating children and adults who do not have immunity with the varicella vaccine is recommended.There are two shingles vaccines: a newer recombinant vaccine and an older, weakened live-virus vaccine.Recombinant vaccines contain only pieces of a virus.The recombinant vaccine is preferred and is recommended for healthy people aged 50 or over, regardless of whether they recall having had chickenpox or shingles and regardless of whether they have been vaccinated with the older shingles vaccine.The recombinant herpes zoster vaccine is given in two doses, injected into a muscle.The doses are given 2 to 6 months apart and at least 2 months after the older (weakened live-virus) vaccine for people who have had that vaccine.The recombinant vaccine significantly reduces the chance of getting shingles and postherpetic neuralgia.When shingles occurs, taking antiviral drugs may reduce the risk of developing postherpetic neuralgia. Everyone who has had chickenpox has VZV in their body and is at risk for getting shingles.Right now, there is no way of knowing who will get the disease.But, some things make it more likely:-Advanced age.The risk of getting shingles increases as you age.People may have a harder time fighting off infections as they get older.About half of all shingles cases are in adults age 60 or older.The chance of getting shingles becomes much greater by age 70. - Trouble fighting infections.Your immune system is the part of your body that responds to infections.Age can affect your immune system.So can an HIV infection, cancer, cancer treatments, too much sun, or organ transplant drugs.Even stress or a cold can weaken your immune system for a short time.These all can put you at risk for shingles. Shingles is a disease that affects your nerves.It can cause burning, shooting pain, tingling, and/or itching, as well as a rash and blisters.You may recall having chickenpox as a child.Shingles is caused by the same virus, the varicella-zoster virus (VZV).After you recover from chickenpox, the virus continues to live in some of your nerve cells.It is usually inactive, so you don't even know it's there.In fact, most adults live with VZV in their bodies and never get shingles.But, for about one in three adults, the virus will become active again.Instead of causing another case of chickenpox, it produces shingles.We do not totally understand what makes the virus go from inactive to active.Having shingles doesn't mean you have any other underlying disease. ","Many adults have Varicella Zoster virus that causes shingles.For about one in three of them, the virus will become active.The recombinant vaccine significantly reduces the chances of getting shingles.In a 2006 clinical trial, the vaccine reduced the risk of shingles by 50%.Even if a person gets shingles after vaccination, the pain will likely be reduced due to vaccination.Side effects of the vaccination are infrequent and mostly mild, such as redness, swelling and itching at the site of injection in one in three people; and headaches in one in 70 people.If you have the signs of severe reaction, call your doctor or emergency immediately.these signs can start in a few minutes to several hours after vaccination and include hives, swelling of the face and throat and difficulty breathing, fast heartbeat, dizziness and weakness.","Shingles is caused by the Varicella Zoster virus.most adults live with VZV in their bodies and never get shingles.But, for about one in three adults, the virus will become active again.The recombinant vaccine significantly reduces the chance of getting shingles and postherpetic neuralgia.A vaccine for shingles was licensed in 2006.In clinical trials, the vaccine reduced the risk of shingles by 50%.It can also reduce pain in people who still get shingles after being vaccinated.A vaccine, like any medicine, could possibly cause serious problems, such as severe allergic reactions.However, the risk of a vaccine causing serious harm, or death, is extremely small.No serious problems have been identified with shingles vaccine.Mild problems - Redness, soreness, swelling, or itching at the site of the injection (about 1 person in 3).- Headache (about 1 person in 70). Signs of a severe allergic reaction can include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, and weakness.These would start a few minutes to a few hours after the vaccination." 212,Can chronic granulomatous disease (CGD) be cured?,"Chronic granulomatous disease (CGD) is a rare, inherited immunodeficiency that affects certain white blood cells .People with this condition have immune systems that do not function properly, leaving the body vulnerable to chronic inflammation and frequent bacterial and fungal infections.The features of this condition usually develop in infancy or early childhood; however, milder forms may be diagnosed in the teen years or even in adulthood.[1][2]It is caused by changes ( mutations ) in any one of five different genes and is usually inherited in an autosomal recessive or X-linked recessive manner.[3] Treatment consists of continuous therapy with antibiotic and antifungal medications to treat and prevent infections.[1][4]The only cure for the disease is an allogeneic hematopoietic stem cell transplantation (HSCT).[5] Antibiotics and antifungal drugs to prevent and treat infections Interferon gamma Transfusions of granulocytes Stem cell transplantation Antibiotics, usually trimethoprim/sulfamethoxazole, are given regularly and indefinitely to prevent infection.Antifungal drugs (such as itraconazole) are usually also given regularly to help prevent fungal infections.Interferon gamma (a drug that modifies the immune system), injected 3 times a week, can reduce the number and severity of infections.Transfusions of granulocytes can be lifesaving when the other, usual treatments have been ineffective.Granulocytes are a type of white blood cell that includes some phagocytes.Stem cell transplantation has cured some people with chronic granulomatous disease.Close relatives who have a similar tissue and blood types are the best donors.If they are willing to donate, they can be tested to determine whether their tissue and blood types are compatible with those of the affected person.Before transplantation, the person is given drugs to suppress the immune system (immunosuppressants) and thus help prevent rejection of the transplant. Symptoms of chronic granulomatous disease usually first appear during early childhood but sometimes not until adolescence.Chronic infections occur in the skin, lungs, lymph nodes, mouth, nose, urinary tract, and intestines.People may have a bone infection (osteomyelitis).Pockets of pus (abscesses) can develop around the anus and in the lungs and liver.The lymph nodes tend to fill with bacteria and enlarge.The skin over the lymph nodes may break down and allow pus to drain.The liver and spleen enlarge.Children may grow slowly. Chronic granulomatous disease is a disorder that causes the immune system to malfunction, resulting in a form of immunodeficiency.Immunodeficiencies are conditions in which the immune system is not able to protect the body from foreign invaders such as bacteria and fungi.Individuals with chronic granulomatous disease may have recurrent bacterial and fungal infections.People with this condition may also have areas of inflammation (granulomas) in various tissues that can result in damage to those tissues.The features of chronic granulomatous disease usually first appear in childhood, although some individuals do not show symptoms until later in life.People with chronic granulomatous disease typically have at least one serious bacterial or fungal infection every 3 to 4 years.The lungs are the most frequent area of infection; pneumonia is a common feature of this condition.Individuals with chronic granulomatous disease may develop a type of fungal pneumonia, called mulch pneumonitis, which causes fever and shortness of breath after exposure to decaying organic materials such as mulch, hay, or dead leaves.Exposure to these organic materials and the numerous fungi involved in their decomposition causes people with chronic granulomatous disease to develop fungal infections in their lungs.Other common areas of infection in people with chronic granulomatous disease include the skin, liver, and lymph nodes.Inflammation can occur in many different areas of the body in people with chronic granulomatous disease.Most commonly, granulomas occur in the gastrointestinal tract and the genitourinary tract.In many cases the intestinal wall is inflamed, causing a form of inflammatory bowel disease that varies in severity but can lead to stomach pain, diarrhea, bloody stool, nausea, and vomiting.Other common areas of inflammation in people with chronic granulomatous disease include the stomach, colon, and rectum, as well as the mouth, throat, and skin.Additionally, granulomas within the gastrointestinal tract can lead to tissue breakdown and pus production (abscesses).Inflammation in the stomach can prevent food from passing through to the intestines (gastric outlet obstruction), leading to an inability to digest food.These digestive problems cause vomiting after eating and weight loss.In the genitourinary tract, inflammation can occur in the kidneys and bladder.Inflammation of the lymph nodes (lymphadenitis) and bone marrow (osteomyelitis), which both produce immune cells, can lead to further impairment of the immune system.Rarely, people with chronic granulomatous disease develop autoimmune disorders, which occur when the immune system malfunctions and attacks the body's own tissues and organs.Repeated episodes of infection and inflammation reduce the life expectancy of individuals with chronic granulomatous disease; however, with treatment, most affected individuals live into mid- to late adulthood. ","Immure systems of people with chronic granulomatous disease do not function properly, which leads to frequent infections and chronic inflammation in all body systems.Treatments include antibiotics and anti-fungal medicines to suppress infection, interferon gamma injections to support the immune system, and transfusions of granulocytes if other treatments are not effective. The only cure is an allogeneic hematopoietic stem cell transplantation (HSCT).A close relative whose tissues are compatible with those of the sick person may donate their stem cells.Before transplantation, the immune system of the sick person is suppressed to prevent rejection of the donated cells.","Chronic granulomatous disease (CGD) is a rare, inherited immunodeficiency that affects certain white blood cells .People with this condition have immune systems that do not function properly, leaving the body vulnerable to chronic inflammation and frequent bacterial and fungal infections. Symptoms of chronic granulomatous disease usually first appear during early childhood but sometimes not until adolescence.Chronic infections occur in the skin, lungs, lymph nodes, mouth, nose, urinary tract, and intestines.People may have a bone infection (osteomyelitis).Pockets of pus (abscesses) can develop around the anus and in the lungs and liver.The lymph nodes tend to fill with bacteria and enlarge.The skin over the lymph nodes may break down and allow pus to drain.The liver and spleen enlarge.Treatment consists of continuous therapy with antibiotic and antifungal medications to treat and prevent infections, Interferon gamma Transfusions of granulocytes.The only cure for the disease is an allogeneic hematopoietic stem cell transplantation (HSCT).Antibiotics, usually trimethoprim/sulfamethoxazole, are given regularly and indefinitely to prevent infection.Antifungal drugs (such as itraconazole) are usually also given regularly to help prevent fungal infections.Interferon gamma (a drug that modifies the immune system), injected 3 times a week, can reduce the number and severity of infections.Transfusions of granulocytes can be lifesaving when the other, usual treatments have been ineffective..Stem cell transplantation has cured some people with chronic granulomatous disease.Close relatives who have a similar tissue and blood types are the best donors.If they are willing to donate, they can be tested to determine whether their tissue and blood types are compatible with those of the affected person.Before transplantation, the person is given drugs to suppress the immune system (immunosuppressants) and thus help prevent rejection of the transplant." 213,What can I take for Bell's palsy?,"Bell's palsy is a form of temporary facial paralysis which results from damage or trauma to one of the facial nerves.This disorder is characterized by the sudden onset of facial paralysis that often affects just one side and can cause significant facial distortion.Symptoms vary, but may include twitching, weakness, drooping eyelid or corner of the mouth, drooling, dry eye or mouth, impairment of taste, and excessive tearing in the eye.While the exact cause is unknown, many researchers believe that a virus may lead to swelling of the 7th cranial nerve.Steroids, such as prednisone, may reduce the inflammation and swelling.Other medications used to treat Bell's palsy include acyclovir (to fight viral infections) and aspirin, acetaminophen, or ibuprofen (to relieve pain).Physical therapy, facial massage and acupuncture have also been used. Bell palsy is sudden weakness on one side of your face.It happens when a nerve in your face (called the facial nerve) swells and gets squeezed.Bell palsy affects only one side of your face That side of your face becomes weak and droops Treatment usually involves medicine called corticosteroids Most people with Bell palsy get better within several months, even without treatment Bell's palsy is a disorder of the nerve that controls movement of the muscles in the face.This nerve is called the facial orseventh cranial nerve.Damage to this nerve causes weakness or paralysis of these muscles.Paralysis means that you cannot use the muscles at all. Often, no treatment is needed.Symptoms often begin to improve right away.But, it may take weeks or even months for the muscles to get stronger.Your provider may give you lubricating eye drops or eye ointments to keep the surface of the eye moist if you can't close it completely.You may need to wear an eye patch while you sleep.Sometimes, medicines may be used, but it isn't known how much they help.If medicines are used, they are started right away.Common medicines are: Corticosteroids, which may reduce swelling around the facial nerve Medicines such as valacyclovir to fight the virus that may be causing Bell palsy Surgery to relieve pressure on the nerve (decompression surgery) has not been shown to benefit most people with Bell palsy. Most people who have Bell palsy recover completely, without treatment, in several months Some people who have severe Bell palsy and can't move one side of their face at all may not recover fully If youve had symptoms for less than 48 hours, doctors may give you medicine called a corticosteroid that can make full recovery even more likely If you cannot close your eye all the way, your doctor may give you eye drops or a patch to protect your eye from drying out too much ","Bell palsy is sudden weakness and drooping on one side of the face due to swelling or squeezing of the facial nerve.Often the symptoms begin resolving immediately without any treatment.If you see your doctors within the first 48 hours, they may give you steroids to make full recovery more likely.They may also give you antiviral medications, e.g., acyclovir, and medicines to relieve pain, such as aspirin, acetaminophen, or ibuprofen. PThe doctors may recommend physical therapy, facial massage and acupuncture.If your eye does not close all the way, you may get eye drops and a patch to protect the eye from drying out.Decompression surgery to relieve the nerve did not show benefits in most people.Even without treatment, most people with Bell palsy get better within several months.It may take months for the muscles to get stronger.","Bell palsy is sudden weakness on one side of your face.It happens when a nerve in your face (called the facial nerve) swells and gets squeezed.Bell palsy affects only one side of your face That side of your face becomes weak and droops Often, no treatment is needed.Symptoms often begin to improve right away. If you had symptoms for less than 48 hours, doctors may give you medicine called a corticosteroid that can make full recovery even more likely.Steroids, such as prednisone, may reduce the inflammation and swelling.Other medications used to treat Bell's palsy include acyclovir (to fight viral infections) and aspirin, acetaminophen, or ibuprofen (to relieve pain).Physical therapy, facial massage and acupuncture have also been used.If you cannot close your eye all the way, your doctor may give you eye drops or a patch to protect your eye from drying out too much. Surgery to relieve pressure on the nerve (decompression surgery) has not been shown to benefit most people with Bell palsy.Most people with Bell palsy get better within several months, even without treatment.But, it may take weeks or even months for the muscles to get stronger." 215,What are the long-term effects of Ritalin?,"The effectiveness of Ritalin LA for long-term use, i.e., for more than 2 weeks, has not been systematically evaluated in controlled trials.Therefore, the physician who elects to use Ritalin LA for extended periods should periodically re-evaluate the long-term usefulness of the drug for the individual patient (see DOSAGE AND ADMINISTRATION). RITALIN ¬Æ ¬†(methylphenidate hydrochloride tablets, USP) CII Read the Medication Guide that comes with RITALIN¬Æ before you or your child starts taking it and each time you get a refill.There may be new information.This Medication Guide does not take the place of talking to your doctor about your or your child‚Äôs treatment with RITALIN¬Æ.What Is RITALIN ¬Æ ?RITALIN¬Æ is a central nervous system stimulant prescription medicine.It is used for the treatment of Attention-Deficit Hyperactivity Disorder (ADHD).RITALIN ¬Æ may help increase attention and decrease impulsiveness and hyperactivity in patients with ADHD.RITALIN¬Æ should be used as a part of a total treatment program for ADHD that may include counseling or other therapies.RITALIN ¬Æ is also used in the treatment of a sleep disorder called narcolepsy.Who should not take RITALIN ¬Æ ?RITALIN ¬Æ should not be taken if you or your child: are very anxious, tense, or agitated have an eye problem called glaucoma have tics or Tourette‚Äôs syndrome, or a family history of Tourette‚Äôs syndrome.Tics are hard to control repeated movements or sounds.are taking or have taken within the past 14 days an anti-depression medicine called a monoamine oxidase inhibitor or MAOI.are allergic to anything in RITALIN¬Æ. See the end of this Medication Guide for a complete list of ingredients.RITALIN ¬Æ should not be used in children less than 6 years old because it has not been studied in this age group.RITALIN ¬Æ may not be right for you or your child.Before starting RITALIN ¬Æ tell your or your child‚Äôs doctor about all health conditions (or a family history of) including: heart problems, heart defects, high blood pressure mental problems including psychosis, mania, bipolar illness, or depression tics or Tourette‚Äôs syndrome seizures or have had an abnormal brain wave test (EEG) Tell your doctor if you or your child is pregnant, planning to become pregnant, or breast-feeding.Can RITALIN ¬Æ be taken with other medicines?Tell your doctor about all of the medicines that you or your child take including prescription and nonprescription medicines, vitamins, and herbal supplements.RITALIN ¬Æ and some medicines may interact with each other and cause serious side effects.Sometimes the doses of other medicines will need to be adjusted while taking RITALIN ¬Æ .Your doctor will decide whether RITALIN¬Æ can be taken with other medicines.Especially tell your doctor if you or your child takes: anti-depression medicines including MAOIs seizure medicines blood thinner medicines blood pressure medicines cold or allergy medicines that contain decongestants Know the medicines that you or your child takes.Keep a list of your medicines with you to show your doctor and pharmacist.Do not start any new medicine while taking RITALIN ¬Æ without talking to your doctor first.How should RITALIN ¬Æ be taken?Take RITALIN ¬Æ exactly as prescribed.Your doctor may adjust the dose until it is right for you or your child.Ritalin is usually taken 2 to 3 times a day.Take RITALIN ¬Æ 30 to 45 minutes before a meal.From time to time, your doctor may stop RITALIN ¬Æ treatment for a while to check ADHD symptoms.Your doctor may do regular checks of the blood, heart, and blood pressure while taking RITALIN ¬Æ .Children should have their height and weight checked often while taking RITALIN ¬Æ .RITALIN ¬Æ treatment may be stopped if a problem is found during these check-ups.If you or your child takes too much RITALIN ¬Æ or overdoses, call your doctor or poison control center right away, or get emergency treatment.What are possible side effects of RITALIN ¬Æ ?See ‚ÄúWhat is the most important information I should know about RITALIN ¬Æ ?‚Äù for information on reported heart and mental problems.Other serious side effects include: slowing of growth (height and weight) in children seizures, mainly in patients with a history of seizures eyesight changes or blurred vision Common side effects include: headache ¬†¬†¬†¬†¬† ¬†¬†¬†¬†¬† ‚Ä¢ decreased appetite stomach ache ¬†¬†¬†¬†¬† ‚Ä¢ nervousness trouble sleeping nausea ¬†¬†¬†¬†¬† Talk to your doctor if you or your child has side effects that are bothersome or do not go away.This is not a complete list of possible side effects.Ask your doctor or pharmacist for more information.How should I store RITALIN ¬Æ ?Store RITALIN in a safe place at room temperature, 59 to 86¬∞ F (15 to 30¬∞ C).Protect from light.Keep RITALIN ¬Æ and all medicines out of the reach of children.General information about RITALIN ¬ÆMedicines are sometimes prescribed for purposes other than those listed in a Medication Guide.Do not use RITALIN ¬Æ for a condition for which it was not prescribed.Do not give RITALIN ¬Æ to other people, even if they have the same condition.It may harm them and it is against the law.This Medication Guide summarizes the most important information about RITALIN ¬Æ .If you would like more information, talk with your doctor.You can ask your doctor or pharmacist for information about RITALIN ¬Æ that was written for healthcare professionals.For more information about RITALIN ¬Æ call 1-888-669-6682.What are the ingredients in RITALIN ¬Æ ?Active Ingredient: methylphenidate HCL Inactive Ingredients: D&C Yellow No.10 (5-mg and 20-mg tablets), FD&C Green No.3 (10-mg tablets), lactose, magnesium stearate, polyethylene glycol, starch (5-mg and 10-mg tablets), sucrose, talc, and tragacanth (20-mg tablets).Call your doctor for medical advice about side effects.You may report side effects to FDA at 1-800-FDA-1088.This Medication Guide has been approved by the U.S. Food and Drug Administration. Ritalin should be initiated in small doses, with gradual weekly increments.Daily dosage above 60 mg is not recommended.If improvement is not observed after appropriate dosage adjustment over a one-month period, the drug should be discontinued.Tablets: Start with 5 mg twice daily (before breakfast and lunch) with gradual increments of 5 to 10 mg weekly.SR Tablets: Ritalin-SR tablets have a duration of action of approximately 8 hours.Therefore, Ritalin-SR tablets may be used in place of Ritalin tablets when the 8-hour dosage of Ritalin-SR corresponds to the titrated 8-hour dosage of Ritalin.Ritalin-SR tablets must be swallowed whole and never crushed or chewed.If paradoxical aggravation of symptoms or other adverse effects occur, reduce dosage, or, if necessary, discontinue the drug.Ritalin should be periodically discontinued to assess the child‚Äôs condition.Improvement may be sustained when the drug is either temporarily or permanently discontinued.Drug treatment should not and need not be indefinite and usually may be discontinued after puberty. Pharmacodynamics Ritalin is a mild central nervous system stimulant.The mode of action in man is not completely understood, but Ritalin presumably activates the brain stem arousal system and cortex to produce its stimulant effect.There is neither specific evidence which clearly establishes the mechanism whereby Ritalin produces its mental and behavioral effects in children, nor conclusive evidence regarding how these effects relate to the condition of the central nervous system.Effects on QT Interval The effect of Focalin¬Æ XR (dexmethylphenidate, the pharmacologically active d-enantiomer of Ritalin) on the QT interval was evaluated in a double-blind, placebo- and open label active (moxifloxacin)-controlled study following single doses of Focalin¬Æ XR 40mg in 75 healthy volunteers.ECGs were collected up to 12 h post-dose.Frederica‚Äôs method for heart rate correction was employed to derive the corrected QT interval (QTcF).The maximum mean prolongation of QTcF intervals was <5 ms, and the upper limit of the 90% confidence interval was below 10 ms for all time matched comparisons versus placebo.This was below the threshold of clinical concern and there was no evident-exposure response relationship.Pharmacokinetics Ritalin in the SR tablets is more slowly but as extensively absorbed as in the regular tablets.Relative bioavailability of the SR tablet compared to the Ritalin tablet, measured by the urinary excretion of Ritalin major metabolite (?-phenyl-2-piperidine acetic acid) was 105% (49%-168%) in children and 101% (85%-152%) in adults.The time to peak rate in children was 4.7 hours (1.3-8.2 hours) for the SR tablets and 1.9 hours (0.3-4.4 hours) for the tablets.An average of 67% of SR tablet dose was excreted in children as compared to 86% in adults.In a clinical study involving adult subjects who received SR tablets, plasma concentrations of Ritalin‚Äôs major metabolite appeared to be greater in females than in males.No gender differences were observed for Ritalin plasma concentration in the same subjects. ","It is not clear how Ritalin produces its effect and how these mental and behavioral effects relate to the state of the brain.The effectiveness of the long-term use of Ritalin has not been studied.You doctor may recommend stopping the drug after puberty.Some of the known side-effects are headache, decreased appetite stomach ache, nervousness, trouble sleeping, and nausea. More serious side effects include slowing in gaining height and weigh in children, seizures, and changes in eyesight or blurred vision. A clinical trial studied the effect of Ritalin on the QT interval and found that the prolongation was below the threshold for clinical concerns.Discuss the side effects and long-term effects with your doctor.","There is neither specific evidence which clearly establishes the mechanism whereby Ritalin produces its mental and behavioral effects in children, nor conclusive evidence regarding how these effects relate to the condition of the central nervous system.The effectiveness of Ritalin LA for long-term use, i.e., for more than 2 weeks, has not been systematically evaluated in controlled trials. Drug treatment should not and need not be indefinite and usually may be discontinued after puberty.Common side effects include: headache, decreased appetite stomach ache, nervousness, trouble sleeping, nausea. Other serious side effects include: slowing of growth (height and weight) in children, seizures, mainly in patients with a history of seizures, eyesight changes or blurred vision.Talk to your doctor if you or your child has side effects that are bothersome or do not go away. The effect of Ritalin on the QT interval was evaluated in a double-blind, placebo- and open label active (moxifloxacin)-controlled study.The maximum mean prolongation of QTcF intervals was below the threshold of clinical concern and there was no evident-exposure response relationship." 217,What will help with numbness of the hand that only feels right when it is hanging down?,"Doctors treat the problem that's causing your numbness.Doctors may suggest ways to help ease symptoms and prevent other problems: If your foot is numb, wear shoes and socks that fit well and check for pebbles or other things in your shoes before putting them on Check your numb area for sores, redness, or swelling If your hand is numb, be careful when touching things that may be hot or sharp If you have problems walking, getting physical therapy or using a cane or walker may help you walk safely and prevent falls Talk with your doctor about whether it's safe for you to drive. Your health care provider should find and treat the cause of your numbness or tingling.Treating the condition may make the symptoms go away or stop them from getting worse.For example, if you have carpal tunnel syndrome or low back pain, your doctor may recommend certain exercises.If you have diabetes, your doctor will discuss ways to control your blood sugar levels.Low levels of vitamins will be treated with vitamin supplements.Medicines that cause numbness or tingling may need to be switched or changed.DO NOT change or stop taking any of your medicines or take large doses of any vitamins or supplements until you have talked with your provider.Because numbness can cause a decrease in feeling, you may be more likely to accidentally injure a numb hand or foot.Take care to protect the area from cuts, bumps, bruises, burns, or other injuries. The condition causing numbness is corrected or treated when possible.General measures can help relieve symptoms and prevent additional problems.Precautions to prevent injury are needed because people with numbness are less likely to feel discomfort.If their feet are numb, particularly if circulation is impaired, they should wear socks and shoes that fit well and should check their shoes for pebbles or other foreign material before putting their shoes on.People should inspect their feet frequently for sores and signs of infection, such as redness.If hands or fingers are numb, people should be careful when handling objects that could be hot or sharp.If people are having difficulty walking or have lost their sense of position (where body parts are), physical therapy can help them learn to walk more safely and to prevent falls.People should be aware that they may have problems driving, and if they do, they should talk to their doctor about the problems. Doctors begin by asking which body parts are affected.The pattern of body parts affected by numbness often indicates which part of the nerve pathway is malfunctioning: Part of a limb: Peripheral nerve or sometimes spinal nerve root malfunction Arm and leg on the same side of the body: Brain malfunction Both sides of the body below a specific level of the body: Spinal cord malfunction, as occurs in transverse myelitis (which causes inflammation across the entire width of the spinal cord)Both sides, mainly in the hands and feet: Simultaneous malfunction of many peripheral nerves throughout the body (a polyneuropathy)Then doctors ask about the person's other symptoms and medical history.Doctors also 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 Numbness).Doctors ask the person to describe the numbness.Then doctors may ask specific questions: When numbness began How quickly it began Whether the person also has other symptoms such as abnormal sensations, weakness or paralysis, loss of bowel or bladder control, retention of urine, vision problems, difficulty swallowing, or deterioration of mental function Whether any event, such as pressure on a limb, an injury, sleeping in an awkward position, or an infection, triggered the symptoms Knowing how quickly numbness and other symptoms began helps doctors determine the type of disorder.The person is asked about symptoms that may suggest a cause.For example, back and/or neck pain suggests osteoarthritis, a ruptured disk, or another disorder that puts pressure on the spinal cord.Doctors also ask whether the person has had a disorder that can cause numbness, particularly diabetes, chronic kidney disease, infections (such as HIV infection or Lyme disease), a stroke, or arthritis.Doctors may ask whether any family members have had similar symptoms or have a hereditary disorder that affects the nervous system.They ask the person about use of drugs, including recreational drugs, and about possible exposure to toxins.The physical examination includes a complete evaluation of the nervous system (neurologic examination), focusing on testing sensation (whether the person can feel stimuli, such as touch and temperature, normally), as well as reflexes and muscle function.TableSome Causes and Features of Numbness Cause Common Features* Tests Numbness in both limbs (arm and leg) on one side of the body Disorders that affect the outer layer of the cerebrum (the largest area of the brain), such as Stroke Tumors Multiple sclerosis Degenerative brain disorders Loss of sensation on the same side of the face and body that is affected by the disorder and loss of the ability to recognize items by touch Usually weakness, loss of coordination, and other symptoms indicating malfunction of the nervous system MRI or CT of the brain Disorders that affect the upper part of the brain stem, such as Stroke Tumors Abscesses (pockets of pus) Loss of sensation on the same side of the face and body that is affected by the disorder Often double vision MRI or CT of the brain Disorders that affect the lower part of the brain stem, such as Stroke Tumors Degenerative brain disorders Loss of sensation on one side of the face and on the opposite side of the body affected by the disorder Often vision problems and difficulty chewing, swallowing, and speaking MRI of the brain Numbness in the limbs or torso on both sides Disorders that affect the width of the spinal cord, such as Compression of the spinal cord by injuries, tumors, a ruptured or herniated disk, hematomas (pockets of blood), or abscesses (pockets of pus) Acute transverse myelitis (sudden inflammation of the spinal cord)Loss of sensation and usually weakness below a certain level of the body No loss of sensation in the face Usually retention of urine, loss of bowel and bladder control (incontinence), and/or reduced sexual response, including erectile dysfunction in men MRI of the spinal cord Cauda equina syndrome, caused by pressure, as may result from A ruptured or herniated disk Spread of cancer to the spine Numbness mainly in the thighs, buttocks, bladder, genitals, and the area between them (saddle area)Usually pain in the lower back Often retention of urine, loss of bowel and bladder control, and/or reduced sexual response, including erectile dysfunction in men MRI of the spinal cord Polyneuropathies (simultaneous malfunction of many peripheral nerves throughout the body), as may result from Use of certain drugs Diabetes Chronic kidney disease Metabolic disorders, such as uremia (build up of toxic substances in blood due to kidney failure), and vitamin B12 deficiency Infections, such as HIV infection or Lyme disease Numbness and abnormal sensations in about the same areas on both sides of the body, mainly in the feet and hands Sometimes weakness and loss of reflexes Nerve conduction studies (measuring how fast nerves transmit signals) and electromyography (stimulating muscles and recording their electrical activity)Other tests depending on the disorder suspected Demyelinating disorders (disorders that cause nerves to become inflamed and lose their outer layer, called the myelin sheath), such as Multiple sclerosis Often weakness or clumsiness and abnormal sensations (such as tingling or numbness)Sometimes changes in vision or speech MRI of the brain and spinal cord Spinal tap (lumbar puncture) to examine a sample of cerebrospinal fluid (the fluid that surrounds the brain and spinal cord)Numbness in part of one limb Disorders that affect a spinal nerve root such as A ruptured or herniated disk Collapse of the backbones (vertebrae) due to arthritis or osteoporosis Pain that Sometimes shoots down an arm or a leg May feel like an electric shock May be worsened by moving the spine, coughing, or doing a Valsalva maneuver (forcefully trying to exhale without letting air escape through the nose or mouth)Often weakness and/or reduced or absent reflexes in the area supplied by the nerve root A doctor's examination Sometimes MRI or CT of the spinal cord Sometimes nerve conduction studies and electromyography Disorders that affect a plexus (a network of nerve fibers), such as Thoracic outlet compression syndromeAn injury such as a stabbing Cancer that spreads to organs near a plexus Brachial neuritis (sudden malfunction of the plexus in the neck and shoulder) Numbness, pain, and/or weakness in a relatively large area of a limb Nerve conduction studies and electromyography MRI Mononeuropathy (malfunction of one peripheral nerve), as occurs in Carpal tunnel syndromePeroneal nerve palsy (affecting a nerve near the knee) Numbness with or without pain Often weakness and reduced or absent reflexes in an area supplied by one nerve A doctor's examinationSometimes nerve conduction studies and electromyography *Features include symptoms and results of the doctor's examination.Features mentioned are typical but not always present.CT = computed tomography; MRI = magnetic resonance imaging. Numbness results when one part of the pathway for sensation malfunctions, usually because of a disorder or drug.Many conditions can cause numbness in various ways.For example, they may Reduce or block the blood supply to nerves in the body, as occurs in vasculitis, or in the brain, as results from stroke Damage part of the pathway for sensation, as may result from injuries or from hereditary disorders that affect nerves (neuropathies), such as Friedreich ataxia Put pressure on (compress) part of the pathway Infect a nerve, as occurs in leprosy, HIV infection, or Lyme disease Cause nerves in part of the pathway to become inflamed and lose their outer layer (called demyelination), as occurs in multiple sclerosis or Guillain-Barr syndrome Cause metabolic abnormalities, which may occur in diabetes, vitamin B12 deficiency, or poisoning due to heavy metals (such as lead) or another toxin or when chemotherapy drugs are used Pressure on different parts of the pathway has various causes, depending on which part of the pathway is affected (see table Some Causes and Features of Numbness), as in the following:Pressure on nerves: Repeating specific movements over and over, causing swelling, as occurs in carpal tunnel syndrome, or remaining in one position too long, as when people sit with their legs crossed a long time Pressure on spinal nerve roots: Rupture or herniation of a disk in the spine, osteoarthritis, or narrowing of the passageway for the spinal cord (spinal stenosis)Pressure on the spinal cord: A tumor, an injury, or a pocket of blood (hematoma) or pus (abscess) near the spinal cord Numbness is loss of feeling in part of your body.You may have less feeling than usual or no feeling at all.Numbness can be a sign of a problem with your brain or your spinal cord.With numbness, you may not be able to: Feel a light touch Sense pain Tell hot from cold Sense vibration Know the position of the numb part of your body Along with numbness, you may also have: Tingling or a pins-and-needles feeling Weakness Paralysis (trouble moving part of your body)Numbness can cause problems with balance and coordination.It can affect your ability to walk or drive. When you touch something with your hand, the nerves in your hand send messages to your brain.The messages allow you to feel what you touch.Similar nerves connect all different parts of your body to your brain.Numbness happens when something goes wrong with the path on which those messages travel.Many different disorders and medicines can block or put pressure on this path, such as: Stroke Infection, such as Lyme disease or HIV Multiple sclerosis Diabetes Not having enough vitamin B12 in your body Osteoarthritis that presses on the nerves coming out of the spinal cord Pressure on a nerve from repeated motions or sitting in one position too long Injury to the brain, spinal cord or nerves Some people get numbness and tingling in their hands and around their mouth when they feel anxious and breathe too fast (hyperventilation).This isn't dangerous. Numbness refers to partial or complete loss of sensation and is often accompanied by abnormal sensations, such as tingling.Numbness, which has many causes, occurs when one part of the pathway from sensory receptors in the skin to the brain malfunctions.If people have any warning sign, they should see a doctor immediately.Telling doctors which parts of the body are affected and how quickly symptoms develop helps doctors identify the location and cause of the malfunction.Testing usually starts with nerve conduction studies and electromyography if the sensory nerves, plexuses, or spinal nerve roots are thought to be affected or with MRI if the brain or spinal cord is thought to be affected. ","Part of a limb getting numb may indicate a peripheral nerve or a spinal nerve root malfunction.Your doctor will diagnose the cause and treat numbness when possible. Treatment the cause may help the symptoms.For example, exercise may help with carpal tunnel syndrome, medicines that cause numbness may be changed, and vitamins may be prescribed if the vitamin levels are low.Do not take or change any medications or supplements until you talk to your doctor.Because numbness can cause a decrease in feeling, you may be more likely to accidentally injure a numb hand while handling something hot or sharp.Take care to protect the area from cuts, bumps, bruises, burns, or other injuries.You may also have problems driving.","The pattern of body parts affected by numbness often indicates which part of the nerve pathway is malfunctioning: Part of a limb: Peripheral nerve or sometimes spinal nerve root malfunctionThe condition causing numbness is corrected or treated when possible.General measures can help relieve symptoms and prevent additional problems.Precautions to prevent injury are needed because people with numbness are less likely to feel discomfort.If hands or fingers are numb, people should be careful when handling objects that could be hot or sharp..People should be aware that they may have problems driving, and if they do, they should talk to their doctor about the problems.Your health care provider should find and treat the cause of your numbness or tingling.Treating the condition may make the symptoms go away or stop them from getting worse.For example, if you have carpal tunnel syndrome, your doctor may recommend certain exercises.Low levels of vitamins will be treated with vitamin supplements.Medicines that cause numbness or tingling may need to be switched or changed.DO NOT change or stop taking any of your medicines or take large doses of any vitamins or supplements until you have talked with your provider.Because numbness can cause a decrease in feeling, you may be more likely to accidentally injure a numb hand.Take care to protect the area from cuts, bumps, bruises, burns, or other injuries." 219,How can male incontinence be corrected?,"Bladder control training may help you get better control of your bladder.Your doctor may suggest you try the following: Pelvic muscle exercises (also known as Kegel exercises) work the muscles that you use to stop urinating.Making these muscles stronger helps you hold urine in your bladder longer.Learn more about pelvic floor exercises and how to do them. Biofeedback uses sensors to make you aware of signals from your body.This may help you regain control over the muscles in your bladder and urethra.Biofeedback can be helpful when learning pelvic muscle exercises. Timed voiding may help you control your bladder.In timed voiding, you urinate on a set schedule, for example, every hour.You can slowly extend the time between bathroom trips.When timed voiding is combined with biofeedback and pelvic muscle exercises, you may find it easier to control urge and overflow incontinence. Lifestyle changes may help with incontinence.Losing weight, quitting smoking, saying ‚Äúno‚Äù to alcohol, drinking less caffeine (found in coffee, tea, and many sodas), preventing constipation and avoiding lifting heavy objects may help with incontinence.Choosing water instead of other drinks and limiting drinks before bedtime may also help. 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. ","To manage incontinence, your doctor may recommend bladder control training (lone or in combination with timed voiding and biofedback); life-style changes (such as losing excess weight, avoiding alcohol and caffeine); medicines that fully empty the bladder fully during urination, medicines that tighten the muscles to reduce leakage, controlling nerves around the bladder with mild electric currents.Surgery may help with leakage caused by a change of the bladder position or enlarged prostate.Leakage may still occur after treatment.The bladder control products that can help coping include adult diapers, furniture pads, urine deodorizing pills, and skin cleansers.","Bladder control training may help .Pelvic muscle exercises (also known as Kegel exercises) work the muscles that you use to stop urinating.Making these muscles stronger helps you hold urine in your bladder longer.Biofeedback uses sensors to make you aware of signals from your body.This may help you regain control over the muscles in your bladder and urethra.Timed voiding may help you control your bladder. When timed voiding is combined with biofeedback and pelvic muscle exercises, you may find it easier to control urge and overflow incontinence.Lifestyle changes may help with incontinence.Losing weight, quitting smoking, saying “no” to alcohol, drinking less caffeine (found in coffee, tea, and many sodas), preventing constipation and avoiding lifting heavy objects may help with incontinence.Choosing water instead of other drinks and limiting drinks before bedtime may also help. 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.-- 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." 220,How should the parents boost delayed puberty in a 14-year-old girl?,"Summary : Puberty is when your body changes and you develop from being a girl to a woman.Learn what changes to expect so that you feel more prepared.Expect Changes with Puberty : Know that you are going through a growth spurt.You have not grown this much since you were a baby.You might grow 2 to 4 inches in a year.When you are done going through puberty, you will be almost as tall as you will be when you are a grown up.Your feet may be the first to grow.They seem really big at first, but you will grow into them.Expect to gain weight.This is normal and needed to have healthy menstrual cycles.You will notice that you get curvier, with bigger hips and breasts than when you were a little girl.Expect Lots of Body Changes : Your body makes hormones to get puberty started.Here are some changes you will start seeing.You will: - Sweat more.You may notice that your armpits smell now.Shower every day and use deodorant.- Start developing breasts.They start as small breast buds under your nipples.Eventually your breasts grow more, and you may want to start wearing a bra.Ask your mom or a trusted adult to take you shopping for a bra. - Grow body hair.You will start getting pubic hair.This is hair on and around your private parts (genitals).It starts out light and thin and gets thicker and darker as you get older.You will also grow hair in your armpits.- Get your period.See ""menstrual periods"" below. - Get some pimples or acne.This is caused by the hormones that start in puberty.Keep your face clean and use non-oily face cream or sunscreen.Talk to your health care provider if you are having a lot of problems with pimples.Know When Puberty Happens : Most girls go through puberty somewhere between being 8 to 15 years old.There is a wide age range when puberty starts.That is why some kids in 7th grade still look like young children and others look really grown up.You may wonder when you will get your period.Usually girls get their period about 2 years after their breasts start to grow.Menstrual Periods : Each month, one of your ovaries releases an egg.The egg goes through the fallopian tube into the uterus.Each month, the uterus creates a lining of blood and tissue.If the egg is fertilized by a sperm (this is what could happen with unprotected sex), the egg may plant itself into this uterus lining and result in a pregnancy.If the egg is not fertilized, it just passes through the uterus.The uterus no longer needs the extra blood and tissue.The blood passes through the vagina as your period.The period usually lasts 2 to 7 days and happens about once a month.Be prepared to get your period.Talk to your provider about when you might start getting your period.Your provider may be able to tell you, from other changes in your body, when you should expect your period.Keep supplies for your period in your backpack or purse.You will want some pads or pantiliners.Being prepared for when you get your period keeps you from being too worried.Ask your mother, an older female relative, friend, or someone you trust to help you get supplies.Pads come in all different sizes.They have a sticky side so you can stick them on your underwear.Pantiliners are small, thin pads.Once you have your period, you may want to learn how to use tampons.You insert a tampon into your vagina to absorb the blood.The tampon has a string that you use to pull it out.Have your mother or a trusted female friend teach you how to use tampons.Change tampons every 4 to 8 hours.Be Aware of Mood Swings : You can feel really moody right before you get your period.This is caused by hormones.You might feel: - Irritable - Have trouble sleeping - Sad - Less confident about yourself.You may even have trouble figuring out what you want to wear to school.Luckily, feeling moody should go away once you start your period.Accept Changes in Your Body : Try to be comfortable with your body changing.If you are stressed about changes, talk to your parents or a provider that you trust.Avoid dieting to prevent normal weight gain during puberty.Dieting is really unhealthy when you are growing.When to Call the Doctor : Talk to your health care provider if you have: - Worries about puberty - Really long, heavy periods - Irregular periods that do not seem to get regular - Lots of pain and cramping with your periods - Any itching or odor from your private parts.This could be a sign of a yeast infection or a sexually transmitted disease.- A lot of acne.You may be able to use special soap or medicine to help. Problems with puberty usually involve hormones.There are many different hormone problems that result in too few hormones so that: Puberty is delayed or doesn't start at all Less often, there are too many hormones and the girl has: Early puberty ","Normally, puberty in girls starts when they are between 8 to 15 years old, which explains why children in 7th grade may look as young children or almost grown up. Problems with puberty are caused by hormones.Puberty is delayed or doesn't start at all if there are too few hormones, which could be caused by different problems.",Most girls go through puberty somewhere between being 8 to 15 years old.There is a wide age range when puberty starts.That is why some kids in 7th grade still look like young children and others look really grown up.Problems with puberty usually involve hormones.There are many different hormone problems that result in too few hormones so that: Puberty is delayed or doesn't start at all 226,How can I improve my speech after hurting my head?,"Stroke is the number one cause of serious adult disability in the United States.Stroke disability is devastating to the stroke patient and family, but therapies are available to help rehabilitate patients after stroke.For most stroke patients, rehabilitation mainly involves physical therapy.The aim of physical therapy is to have the stroke patient relearn simple motor activities such as walking, sitting, standing, lying down, and the process of switching from one type of movement to another.Another type of therapy to help patients relearn daily activities is occupational therapy.This type of therapy also involves exercise and training.Its goal is to help the stroke patient relearn everyday activities such as eating, drinking and swallowing, dressing, bathing, cooking, reading and writing, and using the toilet.Occupational therapists seek to help the patient become independent or semi-independent.Speech therapy helps stroke patients relearn language and speaking skills, or learn other forms of communication.Speech therapy is appropriate for patients who have no problems with cognition or thinking, but have problems understanding speech or written words, or problems forming speech.With time and patience, a stroke survivor should be able to regain some, and sometimes all, language and speaking abilities.Learn more about stroke signs, treatment, and prevention from the Centers for Disease Control and Prevention. People cannot articulate words normally because part of the nervous system that controls muscles used in speech is damaged.Rehabilitation goals depend on the cause of the dysarthria.If the cause is a stroke, a head injury, or brain surgery, the goal is to restore and preserve speech.If dysarthria is mild, repetition of words or sentences may enable people to relearn to use facial muscles and the tongue for correct pronunciation.If dysarthria is severe, people may be taught to use a letter or picture board or an electronic communication device with a keyboard and message display (print or screen).If dysarthria is caused by a progressive disorder of the nervous system, such as amyotrophic lateral sclerosis (ALS or Lou Gehrig disease) or multiple sclerosis, the goal of therapy is to maintain speech function for as long as possible.People are taught exercises that increase control of the mouth, tongue, and lips and are taught to speak more slowly and use shorter phrases.Poor control of breathing muscles may force people to take a breath in the middle of a sentence.Planning punctuation in a sentence can help.Doing breathing exercises can also help, sometimes by breathing through handheld assistive devices, which help dislodge mucus in the airways. You may need to be referred to a speech and language therapist for testing and treatment.Special skills you may learn include: Safe chewing or swallowing techniques, if needed To avoid conversations when you are tired To repeat sounds over and over again so you can learn mouth movements To speak slowly, use a louder voice, and pause to make sure other people understand What to do when you feel frustrated while speaking You can use many different devices or techniques to help with speech, such as: Apps that use photos or speech Computers or cell phones to type out words Flip cards with words or symbols Surgery may help people with dysarthria.Things that family and friends can do to communicate better with someone who has dysarthria include: Turn off the radio or TV.Move to a quieter room if needed.Make sure lighting in the room is good.Sit close enough so that you and the person who has dysarthria can use visual cues.Make eye contact with each other.Listen carefully and allow the person to finish.Be patient.Make eye contact with them before speaking.Give positive feedback for their effort. Depending on the cause of dysarthria, symptoms may improve, stay the same, or get worse slowly or quickly.People with ALS eventually lose the ability to speak.Some people with Parkinson disease or multiple sclerosis lose the ability to speak.Dysarthria caused by medicines or poorly fitting dentures can be reversed.Dysarthria caused by a stroke or brain injury will not get worse, and may improve.Dysarthria after surgery to the tongue or voice box should not get worse, and may improve with therapy. Depending on its cause, dysarthria may develop slowly or occur suddenly.People with dysarthria have trouble making certain sounds or words.Their speech is poorly pronounced (such as slurring), and the rhythm or speed of their speech changes.Other symptoms include: Sounding as though they are mumbling Speaking softly or in a whisper Speaking in a nasal or stuffy, hoarse, strained, or breathy voice A person with dysarthria may also drool and have problems chewing or swallowing.It may be hard to move the lips, tongue, or jaw. ","If the cause of dysarthria is a head injury, the goal is to restore and preserve speech. For mild dysarthria, repeating words and sentences helps correcting pronunciation by training facial muscles and tongue. Special exercises may increase control of the mouth, tongue, and lips.Speaking slowly, using louder voice and pauses and shorter phrases should help other people understand you.Other devices that can help include planning punctuation in a sentence; doing breathing exercises, avoiding conversations when you are tired, and surgery. For people who have no cognitive problems but problems from g speech, speech therapy is appropriate.You may need to be referred to a speech and language therapist for testing and treatment.","Depending on the cause of dysarthria, symptoms may improve, stay the same, or get worse slowly or quickly.Rehabilitation goals depend on the cause of the dysarthria.If the cause is a head injury, the goal is to restore and preserve speech. If dysarthria is mild, repetition of words or sentences may enable people to relearn to use facial muscles and the tongue for correct pronunciation. People are taught exercises that increase control of the mouth, tongue, and lips and are taught to speak more slowly and use shorter phrases.Poor control of breathing muscles may force people to take a breath in the middle of a sentence.Planning punctuation in a sentence can help.Doing breathing exercises can also help, sometimes by breathing through handheld assistive devices, which help dislodge mucus in the airways.Speech therapy is appropriate for patients who have no problems with cognition or thinking, but have problems understanding speech or written words, or problems forming speech. You may need to be referred to a speech and language therapist for testing and treatment.Special skills you may learn include:To avoid conversations when you are tired To speak slowly, use a louder voice, and pause to make sure other people understand What to do when you feel frustrated while speaking Surgery may help people with dysarthria." 227,Does someone who already had shingles need the vaccine?,"What is shingles?Shingles is a painful skin rash, often with blisters.It is also called Herpes Zoster, or just Zoster.A shingles rash usually appears on one side of the face or body and lasts from 2 to 4 weeks.Its main symptom is pain, which can be quite severe.Other symptoms of shingles can include fever, headache, chills and upset stomach.Very rarely, a shingles infection can lead to pneumonia, hearing problems, blindness, brain inflammation (encephalitits) or death.For about 1 person in 5, severe pain can continue even long after the rash clears up.This is called post-herpetic neuralgia.Shingles is caused by the Varicella Zoster virus, the same virus that causes chickenpox.Only someone who has had chickenpox -- or, rarely, has gotten chickenpox vaccine -- can get shingles.The virus stays in your body, and can cause shingles many years later.You can't catch shingles from another person with shingles.However, a person who has never had chickenpox (or chickenpox vaccine) could get chickenpox from someone with shingles.This is not very common.Shingles is far more common in people 50 years of age and older than in younger people.It is also more common in people whose immune systems are weakened because of a disease such as cancer, or drugs such as steroids or chemotherapy.At least 1 million people a year in the United States get shingles.Shingles vaccine A vaccine for shingles was licensed in 2006.In clinical trials, the vaccine reduced the risk of shingles by 50%.It can also reduce pain in people who still get shingles after being vaccinated.A single dose of shingles vaccine is recommended for adults 60 years of age and older.Some people should not get shingles vaccine or should wait.A person should not get shingles vaccine who: - Has ever had a life-threatening allergic reaction to gelatin, the antibiotic neomycin, or any other component of shingles vaccine.Tell your doctor if you have any severe allergies. -Has a weakened immune system because of current: - AIDS or another disease that affects the immune system, - Treatment with drugs that affect the immune system, such as prolonged use of high-dose steroids, - Cancer treatment such as radiation or chemotherapy, - Cancer affecting the bone marrow or lymphatic system, such as leukemia or lymphoma. -Is pregnant, or might be pregnant.Women should not become pregnant until at least 4 weeks after getting shingles vaccine.Someone with a minor acute illness, such as a cold, may be vaccinated.But anyone with a moderate or severe acute illness should usually wait until they recover before getting the vaccine.This includes anyone with a temperature of 101.3F or higher.What are the risks from shingles vaccine?A vaccine, like any medicine, could possibly cause serious problems, such as severe allergic reactions.However, the risk of a vaccine causing serious harm, or death, is extremely small.No serious problems have been identified with shingles vaccine.Mild problems - Redness, soreness, swelling, or itching at the site of the injection (about 1 person in 3).- Headache (about 1 person in 70).Like all vaccines, shingles vaccine is being closely monitored for unusual or severe problems.What if there is a serious reaction?What should I look for? -Look for anything that concerns you, such as signs of a severe allergic reaction, very high fever, or behavior changes.Signs of a severe allergic reaction can include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, and weakness.These would start a few minutes to a few hours after the vaccination.What should I do? -If you think it is a severe allergic reaction or other emergency that can't wait, call 9-1-1 or get the person to the nearest hospital.Otherwise, call your doctor. -Afterward, the reaction should be reported to the Vaccine Adverse Event Reporting System (VAERS).Your doctor might file this report, or you can do it yourself through the VAERS website or by calling 1-800-822-7967.VAERS is only for reporting reactions.They do not give medical advice.How can I learn more? -Ask your doctor.- Contact your local or state health department.- Contact the Centers for Disease Control and Prevention (CDC): - Call 1-800-232-4636 (1-800-CDC-INFO) - Visit CDC's vaccines website Live shingles vaccine can provide protection against shingles and PHN.Another type of shingles vaccine, recombinant shingles vaccine, is the preferred vaccine for the prevention of shingles.However, live shingles vaccine may be used in some circumstances (for example if a person is allergic to recombinant shingles vaccine or prefers live shingles vaccine, or if recombinant shingles vaccine is not available).Adults 60 years and older who get live shingles vaccine should receive 1 dose, administered by injection.Shingles vaccine may be given at the same time as other vaccines. The shingles vaccine is a safe and easy, one-time shot that may keep you from getting shingles.Most people age 60 and older should get vaccinated.You should get the shot even if you have already had shingles or don't remember having chickenpox.However, if you have a weak immune system or allergies to certain medicines, make sure to check with your doctor first.You can get the shingles vaccine at your doctor's office and at some pharmacies.All Medicare Part D plans and most private health insurance plans will cover the cost. Shingles is a viral infection that causes a painful rash of fluid-filled blisters.If the chickenpox virus becomes active, it travels to your skin where it causes painful sores Doctors dont know what causes the virus to become active again, but it sometimes happens when medicines or other illnesses weaken your immune system Adults ages 50 and older and people with a weakened immune system are more likely to get shingles You usually get shingles only once Medicines cant cure shingles, but antivirals (medicines that stop viruses) and pain medicine may help you feel better A vaccine can prevent shingles Go to a doctor right away if you think you have shingles, because treatment works best when started early. ","The shingles vaccine is safe and it was shown to reduced the risk of shingles by 50%.in a clinical trial. People who already had shingles or don't remember having chickenpox should still get it, Even if you get shingles again, the vaccine will reduce pain.","At least 1 million people a year in the United States get shingles. A vaccine for shingles was licensed in 2006.In clinical trials, the vaccine reduced the risk of shingles by 50%.It can also reduce pain in people who still get shingles after being vaccinated.The shingles vaccine is a safe and easy shot that may keep you from getting shingles. You should get the shot even if you have already had shingles or don't remember having chickenpox." 228,What causes occipital neuralgia and what are its symptoms?,"Occipital Neuralgia is a condition in which the occipital nerves, the nerves that run through the scalp, are injured or inflamed.This causes headaches that feel like severe piercing, throbbing or shock-like pain in the upper neck, back of the head or behind the ears. Causes Occipital neuralgia can be the result of pinched nerves or muscle tightness in the neck.It can also be caused by a head or neck injury.Occipital neuralgia can either be primary or secondary.A secondary condition is associated with an underlying disease. Although any of the following may be causes of occipital neuralgia, many cases can be attributed to chronic neck tension or unknown origins. Osteoarthritis of the upper cervical spine Trauma to the greater and/or lesser occipital nerves Compression of the greater and/or lesser occipital nerves or C2 and/or C3 nerve roots from degenerative cervical spine changes Cervical disc disease Tumors affecting the C2 and C3 nerve roots Gout Diabetes Blood vessel inflammation Infection Symptoms Symptoms of occipital neuralgia include continuous aching, burning and throbbing, with intermittent shocking or shooting pain that generally starts at the base of the head and goes to the scalp on one or both sides of the head.Patients often have pain behind the eye of the affected side of the head.Additionally, a movement as light as brushing hair may trigger pain.The pain is often described as migraine-like and some patients may also experience symptoms common to migraines and cluster headaches. Occipital Neuralgia is a condition in which the occipital nerves, the nerves that run through the scalp, are injured or inflamed.This causes headaches that feel like severe piercing, throbbing or shock-like pain in the upper neck, back of the head or behind the ears. Causes Occipital neuralgia can be the result of pinched nerves or muscle tightness in the neck.It can also be caused by a head or neck injury.Occipital neuralgia can either be primary or secondary.A secondary condition is associated with an underlying disease. Although any of the following may be causes of occipital neuralgia, many cases can be attributed to chronic neck tension or unknown origins. Osteoarthritis of the upper cervical spine Trauma to the greater and/or lesser occipital nerves Compression of the greater and/or lesser occipital nerves or C2 and/or C3 nerve roots from degenerative cervical spine changes Cervical disc disease Tumors affecting the C2 and C3 nerve roots Gout Diabetes Blood vessel inflammation Infection Symptoms Symptoms of occipital neuralgia include continuous aching, burning and throbbing, with intermittent shocking or shooting pain that generally starts at the base of the head and goes to the scalp on one or both sides of the head.Patients often have pain behind the eye of the affected side of the head.Additionally, a movement as light as brushing hair may trigger pain.The pain is often described as migraine-like and some patients may also experience symptoms common to migraines and cluster headaches. Occipital neuralgia is a distinct type of headache characterized by piercing, throbbing, or electric-shock-like chronic pain in the upper neck, back of the head, and behind the ears, usually on one side of the head.Typically, the pain of occipital neuralgia begins in the neck and then spreads upwards.Some individuals will also experience pain in the scalp, forehead, and behind the eyes.Their scalp may also be tender to the touch, and their eyes especially sensitive to light.The location of pain is related to the areas supplied by the greater and lesser occipital nerves, which run from the area where the spinal column meets the neck, up to the scalp at the back of the head.The pain is caused by irritation or injury to the nerves, which can be the result of trauma to the back of the head, pinching of the nerves by overly tight neck muscles, compression of the nerve as it leaves the spine due to osteoarthritis, or tumors or other types of lesions in the neck.Localized inflammation or infection, gout, diabetes, blood vessel inflammation (vasculitis), and frequent lengthy periods of keeping the head in a downward and forward position are also associated with occipital neuralgia.In many cases, however, no cause can be found.A positive response (relief from pain) after an anesthetic nerve block will confirm the diagnosis. ","Symptoms of occipital neuralgia include piercing, throbbing or stabbing pain in the upper neck, back of the head and ear, usually on one side of the head.The scalp and forehead can be sensitive to touch and the eyes could be sensitive to light.The pain is located in the areas supplied by the occipital nerve and caused by irritation or injury to these nerves.Occipital nerves could be injured due to trauma, tight neck muscles, osteoarthritis, tumors or other lesions in the neck.Other potential causes are inflammation, gout, diabetes, and keeping the head downwards for a long time.Sometimes the causes are not known.The diagnosis is confirmed if pain is relieved after an anesthetic nerve block.","Occipital Neuralgia is a condition in which the occipital nerves, the nerves that run through the scalp, are injured or inflamed.Occipital neuralgia is a distinct type of headache characterized by piercing, throbbing, or electric-shock-like chronic pain in the upper neck, back of the head, and behind the ears, usually on one side of the head.Typically, the pain of occipital neuralgia begins in the neck and then spreads upwards.Some individuals will also experience pain in the scalp, forehead, and behind the eyes.Their scalp may also be tender to the touch, and their eyes especially sensitive to light.The location of pain is related to the areas supplied by the greater and lesser occipital nerves, which run from the area where the spinal column meets the neck, up to the scalp at the back of the head.The pain is caused by irritation or injury to the nerves, which can be the result of trauma to the back of the head, pinching of the nerves by overly tight neck muscles, compression of the nerve as it leaves the spine due to osteoarthritis, or tumors or other types of lesions in the neck.Localized inflammation or infection, gout, diabetes, blood vessel inflammation (vasculitis), and frequent lengthy periods of keeping the head in a downward and forward position are also associated with occipital neuralgia.In many cases, however, no cause can be found.A positive response (relief from pain) after an anesthetic nerve block will confirm the diagnosis." 230,What are the side effects of ropinirole?,"Along with its needed effects, a medicine may cause some unwanted effects.Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur: More common Confusion dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position drowsiness falling nausea seeing, hearing, or feeling things that are not there (hallucinations) sleepiness or unusual drowsiness swelling of the legs twisting, twitching, or other unusual body movements unusual tiredness or weakness worsening of parkinsonism Less common Abdominal or stomach pain bloating or swelling of the face, arms, hands, lower legs, or feet blood in the urine blurred vision burning, pain, or difficulty in urinating chest pain chills cold sweats cough double vision or other eye or vision problems fainting fear or nervousness feeling of constant movement of self or surroundings high or low blood pressure irregular or pounding heartbeat loss of memory mental depression pain pain in the arms or legs pounding in the ears rapid weight gain sensation of spinning slow or fast heartbeat sore throat sweating tightness in chest tingling of the hands or feet tingling, numbness, or prickly feelings trouble in concentrating troubled breathing unusual weight gain or loss vomiting Rare Anxiety buzzing or ringing in the ears changes in vision fever headache joint pain loss of bladder control muscle cramps, pain, or spasms nasal congestion runny nose sneezing trouble with swallowing unusual urges Ropinirole may cause side effects.Tell your doctor if any of these symptoms are severe or do not go away: - nausea - vomiting - stomach pain - heartburn or gas - diarrhea - constipation - decrease in appetite - weight loss - dizziness - drowsiness - tiredness - weakness - headache - sweating or flushing - confusion - difficulty remembering or concentrating - anxiety - uncontrolled, sudden body movements - shaking of a part of your body that you cannot control - decreased sensitivity (response) to touch - frequent or urgent need to urinate - difficulty urinating or pain when urinating - in men, difficulty achieving or maintaining an erection - back, muscle, or joint pain - pain, burning, numbness, or tingling in the hands or feet - swelling of the hands, arms, feet, ankles, or lower legs - dry mouth Some side effects can be serious.If you experience any of the following symptoms, call your doctor immediately: - hallucinations (seeing things or hearing voices that do not exist) - fainting - chest pain - slow, fast, or irregular heartbeat - shortness of breath - difficulty swallowing - double vision or other changes in vision People who have Parkinson's disease may have a greater risk of developing melanoma (a type of skin cancer) than people who do not have Parkinson's disease.There is not enough information to tell whether medications used to treat Parkinson's disease such as ropinirole increase the risk of developing skin cancer.You should have regular skin examinations to check for melanoma while you are taking ropinirole even if you do not have Parkinson's disease.Talk to your doctor about the risk of taking ropinirole.Some people taking ropinirole and other similar medications have developed fibrotic changes (scarring or thickening) in their lungs and heart valves.It is not yet known whether this problem is caused by ropinirole.Talk to your doctor about the risk of taking this medication.Ropinirole may cause other side effects.Call your doctor if you have any unusual problems while you are 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). ","Ropinirole may cause side effects: - nausea - vomiting - stomach pain - heartburn or gas - diarrhea - constipation - decrease in appetite - weight loss - dizziness - drowsiness - tiredness - weakness - headache - sweating or flushing - confusion - difficulty remembering or concentrating - anxiety - uncontrolled, sudden body movements - shaking of a part of your body that you cannot control - decreased sensitivity (response) to touch - frequent or urgent need to urinate - difficulty urinating or pain when urinating - in men, difficulty achieving or maintaining an erection - back, muscle, or joint pain - pain, burning, numbness, or tingling in the hands or feet - swelling of the hands, arms, feet, ankles, or lower legs - dry mouth Some side effects can be serious: - hallucinations (seeing things or hearing voices that do not exist) - fainting - chest pain - slow, fast, or irregular heartbeat - shortness of breath - difficulty swallowing - double vision or other changes in vision","Ropinirole may cause side effects: - nausea - vomiting - stomach pain - heartburn or gas - diarrhea - constipation - decrease in appetite - weight loss - dizziness - drowsiness - tiredness - weakness - headache - sweating or flushing - confusion - difficulty remembering or concentrating - anxiety - uncontrolled, sudden body movements - shaking of a part of your body that you cannot control - decreased sensitivity (response) to touch - frequent or urgent need to urinate - difficulty urinating or pain when urinating - in men, difficulty achieving or maintaining an erection - back, muscle, or joint pain - pain, burning, numbness, or tingling in the hands or feet - swelling of the hands, arms, feet, ankles, or lower legs - dry mouth Some side effects can be serious: - pounding in the ears - rapid weight gain - sensation of spinninghallucinations (seeing things or hearing voices that do not exist) - fainting - chest pain - slow, fast, or irregular heartbeat - shortness of breath - difficulty swallowing - double vision or other changes in vision" 231,Can leg muscle movement lost to Guillain-Barre syndrome be recovered?,"Unfortunately, there is no cure for Guillain-Barr syndrome (GBS).However, symptoms of the syndrome can be improved with treatments including plasma exchange therapy and immunoglobulin therapy.Both of these therapies can help prevent the immune system from continuing to attack the peripheral nervous system.[1][3] In some cases, corticosteroids have been used to try to alleviate symptoms of GBS.However, it has not been proven that steroids can help speed recovery.[3] People who have GBS may be admitted to the hospital for treatment and to reduce the risk of complications.In some cases, other treatments may be necessary to prevent complications of GBS including pain medications and heparin to reduce the risk of blood clots.Some people with GBS may require help breathing with a ventilator.[3] Physical, occupational, and speech therapy may be recommended to help people fully recover from GBS.[3] Damage stops progressing within 8 weeks.Without treatment, most people with Guillain-Barr syndrome improve slowly over several months.However, with early treatment, people can improve very quicklyin days or weeks.About 30% of adults and even more children with the disorder have residual weakness 3 years after the syndrome began.On average, fewer than 2% of people die.After initial improvement, 3 to 10% of people with Guillain-Barr syndrome develop chronic inflammatory demyelinating polyneuropathy. Most people who have Guillain-Barr syndrome (GBS) regain muscle strength within a few months after diagnosis and treatment.However, for some, severe muscle weakness may continue even after treatment.Some people may have a slower recovery from the symptoms of GBS, and they may be in the hospital or on a ventilator for a longer time.For these people, recovery may take a few years.About 30% of people who had GBS continue to have muscle weakness years after the first symptoms of GBS.[3][8][9]In rare cases, people have passed away from complications of GBS.Causes of death may include acute respiratory distress syndrome, sepsis, pulmonary emboli, and unexplained cardiac arrest.[8] Some people with GBS may relapse after an original improvement of symptoms.[10]The risk of relapse appears to be higher in people who have had a later onset of treatment, a longer-lasting disease, and other medical problems occurring at the same time.[3] For many with GBS, suddenly relying on family members and medical professionals to help with tasks required for daily living can be devastating.In some cases, people with GBS may suffer from anxiety or depression.[3] It is important for people with GBS and their family members to tell their doctor about signs and symptoms of depression, especially if the depression is long-lasting and does not improve as the physical symptoms of GBS improve. Guillain-Barr syndrome is an autoimmune disorder that affects the nerves.Autoimmune disorders occur when the immune system malfunctions and attacks the body's own tissues and organs.In Guillain-Barr syndrome, the immune response damages peripheral nerves, which are the nerves that connect the central nervous system (the brain and spinal cord) to the limbs and organs.Specifically, the immune response affects a particular part of peripheral nerves called axons, which are the extensions of nerve cells (neurons) that transmit nerve impulses.Guillain-Barr syndrome can affect the neurons that control muscle movement (motor neurons); the neurons that transmit sensory signals such as pain, temperature, and touch (sensory neurons); or both.As a result, affected individuals can experience muscle weakness or lose the ability to feel certain sensations.Muscle weakness or paralysis are the characteristic features of Guillain-Barr syndrome.The weakness often begins in the legs and spreads to the arms, torso, and face and is commonly accompanied by numbness, tingling, or pain.Additional signs and symptoms of the condition include difficulty swallowing and difficulty breathing.Occasionally, the nerves that control involuntary functions of the body such as blood pressure and heart rate are affected, which can lead to fluctuating blood pressure or an abnormal heartbeat (cardiac arrhythmia).There are several types of Guillain-Barr syndrome, classified by the part of the peripheral nerve involved in the condition.The most common type of Guillain-Barr syndrome is acute inflammatory demyelinating polyradiculoneuropathy (AIDP).In AIDP, the immune response damages myelin, which is the covering that protects axons and promotes the efficient transmission of nerve impulses.In two other types of Guillain-Barr syndrome, acute motor axonal neuropathy (AMAN) and acute motor-sensory axonal neuropathy (AMSAN), the axons themselves are damaged by the immune response.In AMAN, only the axons of motor neurons are damaged.In AMSAN, the axons of sensory neurons are also damaged.Because of sensory nerve damage, affected individuals can lose the ability to sense the position of their limbs and can have abnormal or absent reflexes (areflexia).Miller Fisher syndrome, another type of Guillain-Barr syndrome, involves cranial nerves, which extend from the brain to various areas of the head and neck.Miller Fisher syndrome is characterized by three features: weakness or paralysis of the muscles that move the eyes (ophthalmoplegia), problems with balance and coordination (ataxia), and areflexia.People with this condition can have other signs and symptoms common in Guillain-Barr syndrome, such as muscle weakness.Guillain-Barr syndrome occurs in people of all ages.The development of the condition usually follows a pattern.Prior to developing the condition, most people with Guillain-Barr syndrome have a bacterial or viral infection.The first phase of Guillain-Barr syndrome, during which signs and symptoms of the condition worsen, can last up to four weeks, although the peak of the illness is usually reached in one to two weeks.During the second phase, called the plateau, signs and symptoms of Guillain-Barr syndrome stabilize.This phase can last weeks or months.During the recovery phase, symptoms improve.However, some people with Guillain-Barr syndrome never fully recover and can still experience excessive tiredness (fatigue), muscle weakness, or muscle pain.

Summary

Guillain-Barre syndrome is a rare disorder that causes your immune system to attack your peripheral nervous system (PNS).The PNS nerves connect your brain and spinal cord with the rest of your body.Damage to these nerves makes it hard for them to transmit signals.As a result, your muscles have trouble responding to your brain.No one knows what causes the syndrome.Sometimes it is triggered by an infection, surgery, or a vaccination.The first symptom is usually weakness or a tingling feeling in your legs.The feeling can spread to your upper body.In severe cases, you become almost paralyzed.This is life-threatening.You might need a respirator to breathe.Symptoms usually worsen over a period of weeks and then stabilize.Guillain-Barre can be hard to diagnose.Possible tests include nerve tests and a spinal tap.Most people recover.Recovery can take a few weeks to a few years.Treatment can help symptoms, and may include medicines or a procedure called plasma exchange.NIH: National Institute of Neurological Disorders and Stroke ","Guillain-Barr syndrome (GBS) is an autoimmune disorder..Damageto the nerves caused by GBS stops progressing within 8 weeks.If not treated, the syndrome improves slowly on its own.Early treatment can speed up healing.Treatments include plasma exchange therapy and immunoglobulin therapy that prevent the immune system from continuing to attack the peripheral nervous system.Corticosteroids may help with symptoms.Physical, occupational, and speech therapy may help recovery.In about 30% of people, muscle weakness may continue for several years even after treatment.In some cases, recovery may take a few years.Occasionally, GBS may relapse after an improvement, particularly in people who started treatment late, had a longer-lasting disease, and other medical problems.","Damage stops progressing within 8 weeks.Without treatment, most people with Guillain-Barr syndrome improve slowly over several months.However, with early treatment, people can improve very quicklyin days or weeks.Most people who have Guillain-Barr syndrome (GBS) regain muscle strength within a few months after diagnosis and treatment.However, for some, severe muscle weakness may continue even after treatment.Some people may have a slower recovery from the symptoms of GBS.For these people, recovery may take a few years.About 30% of people who had GBS continue to have muscle weakness years after the first symptoms of GBS.Some people with GBS may relapse after an original improvement of symptoms.The risk of relapse appears to be higher in people who have had a later onset of treatment, a longer-lasting disease, and other medical problems occurring at the same time.Unfortunately, there is no cure for Guillain-Barr syndrome (GBS).However, symptoms of the syndrome can be improved with treatments including plasma exchange therapy and immunoglobulin therapy.Both of these therapies can help prevent the immune system from continuing to attack the peripheral nervous system.In some cases, corticosteroids have been used to try to alleviate symptoms of GBS.Physical, occupational, and speech therapy may be recommended to help people fully recover from GBS." 232,What can cause urinary retention in young men once in a while?,"Causes include: Problems with your bladder muscles Something blocking your bladders opening, such as a kidney stone or enlarged prostate gland Severe constipation (fecal impaction)Nerve problems to your bladder (these can happen in people with health problems such as diabetes or Parkinson disease)Certain medicines Urinary retention is more common in men because growth of the prostate can block the flow of urine. Catheterization Treatment of the cause Surgery, occasionally If people cannot urinate at all, doctors immediately insert a thin rubber tube into the bladder (urinary catheter) to remove the retained urine and provide relief.The cause of urinary retention is treated.Drugs that can cause urinary retention are stopped whenever possible.Men who have an enlarged prostate may need prostate surgery or drugs to shrink the prostate (for example, finasteride or dutasteride) or drugs that relax the muscles at the neck of the bladder (for example, terazosin or tamsulosin).People who have nerve problems that interfere with bladder contractions or function may need to use a catheter themselves periodically or have a catheter permanently placed.Occasionally surgery is needed to direct urine from the bladder away from the urethra and out of the body. If you cant urinate at all, doctors will insert a catheter into your bladder right away to drain the urine.To treat the cause of your urinary retention, doctors may: Have you stop any medicines that may be causing the problem If youre a man with an enlarged prostate, treat it with surgery or medicinesPrescribe medicine to relax the muscles at the opening of your bladder If you have nerve problems, have you put a catheter in your bladder several times a day to drain urine Sometimes, do surgery to pass urine out of your body in a different way Urinary retention is when: You can't urinate (pee) at all or only a little You can urinate but there's still urine in your bladder after you're done With urinary retention: You may also leak urine and urinate without meaning to (urinary incontinence)Doctors will do an ultrasound after you pee to see how much urine is left in your bladder Doctors may use a catheter (thin flexible tube) to empty your bladder ","Urinary retention in men could be caused by problems with bladder muscles, kidney stones or enlarge prostate blocking the bladder opening, severe constipation, bladder nerve problems, and some medications.If you cannot urinate, your doctor will insert a catheter to drain urine from the bladder.The doctor will then treat the cause of retention: stop medicines, relax the muscles or treat the enlarged prostate.","Urinary retention is when: You can't urinate at all or only a little Causes include: Problems with your bladder muscles Something blocking your bladders opening, such as a kidney stone or enlarged prostate gland Severe constipation (fecal impaction)Nerve problems to your bladder (these can happen in people with health problems such as diabetes or Parkinson disease)Certain medicines If you cant urinate at all, doctors will insert a catheter into your bladder right away to drain the urine.To treat the cause of your urinary retention, doctors may: Have you stop any medicines that may be causing the problem If youre a man with an enlarged prostate, treat it with surgery or medicinesPrescribe medicine to relax the muscles at the opening of your bladder If you have nerve problems, have you put a catheter in your bladder several times a day to drain urine" 234,Are there any new treatments for orthostatic tremor?,"For this procedure, tiny electrodes are placed in the area of the brain involved in tremorsthe basal ganglia (collections of nerve cells that help smooth out muscle movements).The electrodes send small amounts of electricity to the specific area of the basal ganglia responsible for the tremors and thus help relieve symptoms.Deep brain stimulation is sometimes done when drugs cannot control a severe, disabling tremor.Sometimes essential tremors or tremors due to Parkinson disease or another disorder require such treatment.Such treatments are used only when drug therapy has been tried and has been not been effective.These treatments are available only at special centers.

Summary

What is a tremor?

A tremor is a rhythmic shaking movement in one or more parts of your body.It is involuntary, meaning that you cannot control it.This shaking happens because of muscle contractions.A tremor is most often in your hands, but it could also affect your arms, head, vocal cords, trunk, and legs.It may come and go, or it may be constant.Tremor can happen on its own or be caused by another disorder.

What are the types of tremor?

There are several types of tremor, including Essential tremor, sometimes called benign essential tremor.This is the most common type.It usually affects your hands, but it can also affect your head, voice, tongue, legs, and trunk.Parkinsonian tremor, which is a common symptom in people who have Parkinson's disease.It is usually affects one or both hands when they are at rest, but it can affect the chin, lips, face, and legs.Dystonic tremor, which happens in people who have dystonia.Dystonia is a movement disorder in which you have involuntary muscle contractions.The contractions cause you to have twisting and repetitive movements.It can affect any muscle in the body.

What causes tremor?

Generally, tremor is caused by a problem in the deep parts of the brain that control movements.For most types, the cause is unknown.Some types are inherited and run in families.There can also be other causes, such as Neurologic disorders, including multiple sclerosis, Parkinson's disease, stroke, and traumatic brain injury Certain medicines, such as asthma medicines, amphetamines, caffeine, corticosteroids, and medicines used for certain psychiatric and neurological disorders Alcohol use disorder or alcohol withdrawal Mercury poisoning Hyperthyroidism (overactive thyroid)Liver or kidney failure Anxiety or panic

Who is at risk for tremor?

Anyone can get tremor, but it is most common in middle-aged and older adults.For certain types, having a family history raises your risk of getting it.

What are the symptoms of tremor?

Symptoms of tremor may include Rhythmic shaking in the hands, arms, head, legs, or torso Shaky voice Difficulty writing or drawing Problems holding and controlling utensils, such as a spoon

How is tremor diagnosed?

To make a diagnosis, your health care provider Will take your medical history Will do a physical exam, which includes checking Whether the tremor happens when the muscles are at rest or in actionThe location of the tremor How often you have the tremor and how strong it is Will do a neurological exam, including checking for Problems with balance Problems with speech Increased muscle stiffness May do blood or urine tests to look for the cause May do imaging tests to help figure out if the cause is damage in your brain May do tests which check your abilities to do daily tasks such as handwriting and holding a fork or cup May do an electromyogram.This is a test which measures involuntary muscle activity and how your muscles respond to nerve stimulation

What are the treatments for tremor?

There is no cure for most forms of tremor, but there are treatments to help manage symptoms.In some cases, the symptoms may be so mild that you do not need treatment.Finding the right treatment depends on getting the right diagnosis of the cause.Tremor caused by another medical condition may get better or go away when you treat that condition.If your tremor is caused by a certain medicine, stopping that medicine usually makes the tremor go away.Treatments for tremor where the cause is not found include Medicines.There are different medicines for the specific types of tremor.Another option is Botox injections, which can treat several different types.Surgery may be used for severe cases that do not get better with medicines.The most common type is deep brain stimulation (DBS).Physical, speech-language, and occupational therapy, which may help to control tremor and deal with the daily challenges caused by the tremor If you find that caffeine and other stimulants trigger your tremors, it may be helpful to cut them from your diet.NIH: National Institute of Neurological Disorders and Stroke Eliminating or minimizing the trigger may lessen the tremor.For example, avoiding caffeine, getting enough sleep, and minimizing stress may help.If many daily activities (such as using utensils and drinking from a glass at mealtime) become difficult or if the person's work requires steady hands, drug therapy may help.People with a physiologic tremor and anxiety may benefit from taking a low dose of a benzodiazepine (a sedative), such as lorazepam.However, these drugs should be taken only occasionally.If a physiologic tremor is worsened by taking prescribed drugs that are necessary or by feeling very anxious, propranolol (a beta-blocker) may help. Primary orthostatic tremor (POT) is a rare, progressive that causes unsteadiness when standing still, due to a rapid affecting the legs and trunk.[1][2] The tremor is sometimes described as having shaky legs, and it improves or disappears when walking, sitting, or lying down.[1][2][3] This may cause people with POT to attempt to sit again or walk immediately after standing, for fear of falling.[2][3] People with POT may also experience tiredness, physical exhaustion, muscle stiffness or weakness, and/or pain.[3][4] Symptoms tend to gradually worsen over time and may lead to the need for a mobility aid such as a cane, scooter, or wheelchair.[1][3][4] The diagnosis of POT relies on a clinical exam as well as a specialized test called a surface electromyogram (EMG), which measures electrical activity in the muscles.[3] The cause of POT is not completely understood, but the disorder is thought to involve dysfunction of the brains ability to regulate nerve signals that control muscle activity.[1][3] Some researchers believe that POT is a type of .[3]Treatment usually involves medications used to control seizures (anticonvulsants) such as clonazepam or gabapentin.In some cases, treatment may include medications used for Parkinsons disease (levodopa or pramipexole), and/or botulinum toxin (Botox) injections in the leg muscles.More than one therapy may be tried before finding one that helps.[3] POT does not appear to alter life expectancy.However, quality of life for people with POT may be severely impaired due to physical symptoms, fear of falling, and uncertainty about the course of the disorder.[1] Doctors will treat the cause of your tremor.If you take medicines that could be causing your tremor, your doctors may be able to adjust your dose.If your tremor is mild, you may not need treatment.Some simple actions may help, including: Grabbing objects tightly and holding them close to your body to avoid dropping them Avoiding uncomfortable positions Using helpful devices, such as Velcro, straws, and spoons or forks with large handles To avoid triggers of your tremor: Avoid caffeine (in coffee, soda, chocolate, tea) Get at least 7 hours of sleep at night Lower your stress as much as possible Talk to your doctor about taking medicines to ease your symptoms, such as beta-blockers, antiseizure medicines, or sedatives.If your tremor happens when you reach for things, you may: Work with a therapist to use weights on your wrists to steady the tremor Hold your arm steady while reaching If your tremor happens when you walk, strapping a weight to your ankle may help steady your leg. ","Primary orthostatic tremor described as shaky legs improves or disappears when walking, sitting, or lying down.Tremors may be avoided if you avoid caffeine, get at least 7 hours of sleep at night and lower your stress.Your doctor may prescribe anticonvulsant medications such as clonazepam or gabapentin, medications used for Parkinson disease (levodopa or pramipexole), and botulinum toxin (Botox) injections in the leg muscles.If medications do not help your doctor may try deep brain stimulation (DBS).","Primary orthostatic tremor causes unsteadiness when standing still.The tremor is sometimes described as having shaky legs, and it improves or disappears when walking, sitting, or lying down.Treatment usually involves medications used to control seizures (anticonvulsants) such as clonazepam or gabapentin.In some cases, treatment may include medications used for Parkinsons disease (levodopa or pramipexole), and/or botulinum toxin (Botox) injections in the leg muscles.More than one therapy may be tried before finding one that helps. Surgery may be used for severe cases that do not get better with medicines.The most common type is deep brain stimulation (DBS).Deep brain stimulation is sometimes done when drugs cannot control a severe, disabling tremor. To avoid triggers of your tremor: Avoid caffeine Get at least 7 hours of sleep at night Lower your stress as much as possible." 235,What are the alternatives to Lipitor for lowering cholesterol in a diabetic?,"All men should have their blood cholesterol levels tested every 5 years, starting at age 35 years.All women should do the same, starting at age 45 years.Many adults should have their blood cholesterol levels tested at a younger age, possibly as early as age 20 years, if they have risk factors for heart disease.Children with risk factors for heart disease should also have their blood cholesterol levels checked.Some expert groups recommend cholesterol testing for all children ages 9 to 11 and again between ages 17 and 21.Have your cholesterol checked more often (probably every year) if you have: Diabetes Heart disease Blood flow problems to your feet or legs A history of stroke A blood cholesterol test measures the level of total cholesterol.This includes HDL (good) cholesterol and LDL (bad) cholesterol.Your LDL level is what health care providers watch most closely.You want it to be low.If it gets too high, you will need to treat it.Treatment includes: Eating a healthy diet Losing weight (if you are overweight)Exercising You may also need medicine to lower your cholesterol.You want your HDL cholesterol to be high.Exercise can help raise it. Some people's body makes too much cholesterol, no matter what they eat.This kind of high cholesterol problem runs in families.High cholesterol can also be caused by:Eating a lot of foods high in fat and cholesterol Having diabetes Not being active Drinking too much alcohol Taking certain medicines You don't have to be fat to have high cholesterol.

Summary

What is cholesterol?

Your body needs some cholesterol to work properly.But if you have too much in your blood, it can stick to the walls of your arteries and narrow or even block them.This puts you at risk for coronary artery disease and other heart diseases.Cholesterol travels through the blood on proteins called lipoproteins.One type, LDL, is sometimes called the ""bad"" cholesterol.A high LDL level leads to a buildup of cholesterol in your arteries.Another type, HDL, is sometimes called the ""good"" cholesterol.It carries cholesterol from other parts of your body back to your liver.Then your liver removes the cholesterol from your body.

What are the treatments for high cholesterol?

If you have high cholesterol, lifestyle changes can help you to lower your cholesterol level.But sometimes the lifestyle changes are not enough, and you need to take cholesterol medicines.You should still continue with the lifestyle changes even though you are taking medicines.

Who needs cholesterol medicines?

Your health care provider may prescribe medicine if: You have already had a heart attack or stroke, or you have peripheral arterial disease Your LDL (bad) cholesterol level is 190 mg/dL or higher You are 40-75 years old, you have diabetes, and your LDL cholesterol level is 70 mg/dL or higher You are 40-75 years old, you have a high risk of developing heart disease or stroke, and your LDL cholesterol level is 70 mg/dL or higher

What are the different types of medicines for cholesterol?

There are several types of cholesterol-lowering drugs available, including Statins, which block the liver from making cholesterol Bile acid sequestrants, which decrease the amount of fat absorbed from food Cholesterol absorption inhibitors, which decrease the amount of cholesterol absorbed from food and lower triglycerides.Nicotinic acid (niacin), which lowers LDL (bad) cholesterol and triglycerides and raises HDL (good) cholesterol.Even though you can buy niacin without a prescription, you should talk to your health care provider before taking it to lower your cholesterol.High doses of niacin can cause serious side effects.PCSK9 inhibitors, which block a protein called PCSK9.This helps your liver remove and clear LDL cholesterol from your blood.Fibrates, which lower triglycerides.They may also raise HDL (good) cholesterol.If you take them with statins, they may increase the risk of muscle problems.Combination medicines, which include more than one type of cholesterol-lowering medicine There are also a few other cholesterol medicines (lomitapide and mipomersen) that are only for people who have familial hypercholesterolemia (FH).FH is an inherited disorder that causes high LDL cholesterol.

How does my health care provider decide which cholesterol medicine I should take?

When deciding which medicine you should take and which dose you need, your health care provider will consider Your cholesterol levels Your risk for heart disease and stroke Your age Any other health problems you have Possible side effects of the medicines.Higher doses are more likely to cause side effects, especially over time.Medicines can help control your cholesterol, but they don't cure it.You need to keep taking your medicines and get regular cholesterol checks to make sure that you cholesterol levels are in a healthy range. Summary : Cholesterol is a waxy, fat-like substance that occurs naturally in all parts of the body.Your body needs some cholesterol to work properly.But if you have too much in your blood, it can combine with other substances in the blood and stick to the walls of your arteries.This is called plaque.Plaque can narrow your arteries or even block them.High levels of cholesterol in the blood can increase your risk of heart disease.Your cholesterol levels tend to rise as you get older.There are usually no signs or symptoms that you have high blood cholesterol, but it can be detected with a blood test.You are likely to have high cholesterol if members of your family have it, if you are overweight or if you eat a lot of fatty foods.You can lower your cholesterol by exercising more and eating more fruits and vegetables.You also may need to take medicine to lower your cholesterol.NIH: National Heart, Lung, and Blood Institute ","Diabetes is a risk factor for having high cholesterol.Treatments include eating healthy, including fruits and vegetables in your diet, exercising to raise HDL (good) cholesterol, and losing weight, if needed.If this is not enough, your doctor has a wide choice of medications.Your doctor will decide which one is better for your cholesterol levels, age and health conditions.In addition to statins that suppress cholesterol production in the liver, the cholesterol-lowering drugs include cholesterol absorption inhibitors, bile acid sequestrants, and PCSK9 inhibitors that help the liver to remove LDL (bad) cholesterol from the blood.Fibrates also lower LDL levels and may raise HDL levels.","High cholesterol can also be caused by:Eating a lot of foods high in fat and cholesterol Having diabetes Not being active Drinking too much alcohol Taking certain medicines Treatment includes: Eating a healthy diet more fruits and vegetables Losing weight (if you are overweight)Exercising You may also need medicine to lower your cholesterol.You want your HDL cholesterol to be high.Exercise can help raise it.There are several types of cholesterol-lowering drugs available, including Statins, which block the liver from making cholesterol Bile acid sequestrants, which decrease the amount of fat absorbed from food Cholesterol absorption inhibitors, which decrease the amount of cholesterol absorbed from food and lower triglycerides..PCSK9 inhibitors, which block a protein called PCSK9.This helps your liver remove and clear LDL cholesterol from your blood.Fibrates, which lower triglycerides.They may also raise HDL (good) cholesterol.If you take them with statins, they may increase the risk of muscle problems.Combination medicines, which include more than one type of cholesterol-lowering medicine When deciding which medicine you should take and which dose you need, your health care provider will consider Your cholesterol levels Your risk for heart disease and stroke Your age Any other health problems you have Possible side effects of the medicines." 238,What can cause poor balance and memory loss in a 65-year-old?,"Doctors can usually determine whether the cause is age-related changes, mild cognitive impairment, or early dementia based on the type of memory loss and the symptoms that accompany it.However, when the diagnosis is unclear, neuropsychologic testing can provide more information.This testing is similar to mental status testing except it is much more detailed.Complete testing may take hours.These tests must be given by a trained, licensed psychologist or psychiatrist with expertise in memory loss.These tests may not be as useful in people over 65.If doctors suspect dementia or find any abnormalities during the neurologic examination, they usually do magnetic resonance imaging (MRI) or computed tomography (CT) to check for abnormalities such as a brain tumor, normal-pressure hydrocephalus, damage due to a head injury, and stroke.Doctors may also do blood tests to measure levels of vitamin B12 and thyroid hormones to determine whether vitamin B12 deficiency or a thyroid disorder could be causing memory loss.If a brain infection is suspected, doctors usually do a spinal tap (lumbar puncture) to obtain samples of the fluid around the brain (cerebrospinal fluid) for analysis. Many disorders can cause a deterioration of mental function that resembles dementia.Some of these disorders can be reversed with treatment.They include the following: Normal-pressure hydrocephalus (due to excess fluid around the brain)Subdural hematomas (pockets of blood under the outer layer of the membranes covering the brain) Hypothyroidism (an underactive thyroid gland)Vitamin B12 deficiency Other disorders are only partially reversible.They include those that interfere with the supply of blood or nutrients to the brain, such as a cardiac arrest and certain types of stroke.They also include unusually long seizures, head injuries, a brain infection, HIV infection, brain tumors, and overuse of certain drugs (including alcohol).In people with these disorders, treatment can sometimes improve memory and mental function.If damage is more extensive, treatment may not improve mental function but can often prevent further deterioration.In delirium, memory is affected, but memory loss is not the most noticeable symptom.Rather, people with delirium are very confused, disoriented, and incoherent.Severe alcohol withdrawal (delirium tremens), a severe bloodstream infection (sepsis), lack of oxygen (as may result from pneumonia), and many other disorders can cause delirium, as can use of illegal drugs. Memory loss is the inability to remember things as well as you used to.Mild memory loss can be a normal part of aging.For example, you may forget where you put your car keys.Memory loss that is more serious may be a warning sign of a brain function problem, such as Alzheimer disease or dementia.Your family members may notice your memory loss before you do Signs of more serious memory loss include forgetting about things that just happened or having problems doing activities you've done many times before Using lists, calendars, and memory aids can help you cope with memory loss Doctors ask about the persons symptoms and medical history.Doctors then do a physical examination.Having a family member present is helpful because people with memory difficulties may not be able to describe their symptoms accurately.What doctors 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 Memory Loss).Doctors often talk to the person and the persons family members separately because family members may not feel free to describe the symptoms candidly with the person listening.Doctors ask specific questions about the memory loss: What types of things the person forgets (for example, whether the person forgets words or names or gets lost) When the memory problems started Whether memory loss is getting worse How the memory loss is affecting the persons ability to function at work and at home Doctors also ask whether the person has other symptoms, such as difficulty using or understanding language and changes in their eating and sleeping habits or mood.They ask about all disorders the person has had and all the drugs the person is taking (including recreational or illegal drugs, over-the counter drugs, and nutritional supplements) to check for possible causes.Information about the persons education, jobs, and social activities can help doctors better assess the person's previous mental function and gauge the severity of the problem.Doctors ask whether any family members have had dementia or early mild cognitive impairment.During the physical examination, doctors evaluate all body systems but focus on the nervous system (neurologic examination), including evaluation of mental function (mental status testing).In mental status testing, doctors ask people to answer questions or do specific tasks to evaluate various aspects of mental function, such as Orientation to time, place, and person:State the current date and place and who they are.Attention: Repeat a short list of words.Concentration: Spell ""world"" backwards or repeat their phone number forward, then backward.Short-term memory: Recall the short list of words after several minutes.Long-term memory:Answer questions about the distant past.Use of language: Name common objects and body parts, and read, write, and repeat certain phrases.Ability to understand spatial relationships: Copy simple and complex structures (for example, using building blocks) and draw an object such as clock, cube, or house.This testing also assesses abstract thinking, comprehension, the ability to follow commands and solve math problems, awareness of the illness, and mood.TableSome Causes and Features of Memory Loss Cause Common Features* Tests Age-related memory changes (age-associated memory impairment)Occasional forgetfulness of such things as names or the location of car keys No effect on thinking, other mental functions, or the ability to do daily activities A doctor's examination (particularly a neurologic examination and mental status testing to assess functions such as attention, orientation, and memory)Mild cognitive impairment Memory loss that is more severe than expected for a person's age, particularly difficulty remembering recent events and conversations (short-term memory loss)No effect on the ability to do daily activities An increased risk of developing dementia A doctor's examination Sometimes formal neuropsychologic testing, which resembles mental status testing but evaluates function in more detail Dementia Memory loss that becomes worse as time passes, eventually with no awareness of the loss Difficulty using and understanding language, doing usual manual tasks, thinking, and planning (for example, planning and shopping for meals), resulting in not being able to function normally Disorientation (for example, not knowing the time or location) Difficulty recognizing faces or common objects Changes in personality or behavior (for example, becoming irritable, agitated, paranoid, inflexible, or disruptive) A doctors examination Usually MRI or CT of the brain Sometimes formal neuropsychologic testing Possibly a spinal tap (lumbar puncture) to measure levels of two abnormal proteins (amyloid and tau) that occur in Alzheimer disease Sometimes blood tests to check for certain causes, such as an underactive thyroid gland (hypothyroidism) or a vitamin deficiency Depression Memory loss and awareness of the loss, usually accompanied by intense sadness, and lack of interest in usual pleasures Sometimes sleep problems (too little or too much), loss of appetite, and slowing of thinking, speech, and general activity Common among people with dementia, mild cognitive impairment, or age-related changes in memory A doctors examination Sometimes use of standardized questionnaires to identify depression Drugs, such as Drugs with anticholinergic effects, including some antidepressants and many antihistamines (used in OTC sleep aids, cold remedies, and allergy drugs)Opioids Drugs that help people sleep (sedatives) Use of a drug that can cause memory loss Often recent use of a new drug, an increase in a drugs dose, or a change in health that prevents the drug from being processed and eliminated from the body normally, as can occur in kidney or liver disorders Typically stopping the drug to see whether memory improves *Features include symptoms and results of the doctor's examination.Features mentioned are typical but not always present.CT = computed tomography; MRI = magnetic resonance imaging; OTC = over-the-counter. Memory loss and fear of dementia are common sources of worry among older people.Usually, memory loss results from normal age-related changes in the brain, which slow mental functions slightly but do not significantly impair them.Memory loss due to dementia usually interferes with the ability to do daily activities and becomes progressively worse.People who are aware of memory loss may not have dementia.Doctors can usually identify the cause based on results of the examination, imaging tests (such as MRI or CT), and other tests, including formal tests of mental function.Having a healthy lifestyle, staying mentally active, and participating in social activities may help maintain mental function or postpone its decline.Using lists and other memory aids, focusing on one thing at a time, and getting organized can help older people compensate for age-related changes in memory.Drugs called cholinesterase inhibitors (such as donepezil) may help with memory, particularly if people have Alzheimer disease or Lewy body dementia, and donepezil may help people with mild cognitive impairment. The most common causes of memory loss are Age-related changes in memory (most common) Mild cognitive impairment Dementia Depression Age-related changes in memory (called age-associated memory impairment) refer to the normal slight decline in brain function that occurs as people age.Most older people have some memory problems.Retrieving memories of new things, such as what is a new neighbor's name or how to use a new computer program, takes longer.Older people also have to rehearse new memories more often for the memories to be stored.People with this type of memory loss occasionally forget things, such as where they left their car keys.But for them, unlike people with dementia, the ability to do daily activities or to think is not impaired.Given enough time, these people usually remember, although sometimes later than is convenient.This type of memory loss is not a sign of dementia or early Alzheimer disease.Mild cognitive impairment is an imprecise term used to describe impairments in mental function that are more severe than normal age-related changes but less severe than those caused by dementia.Memory loss is often the most obvious symptom.People with mild cognitive impairment have trouble remembering recent conversations and may forget important appointments or social events, but they typically remember past events.Attention and the ability to do daily activities are not affected.However, up to half of people with mild cognitive impairment develop dementia within 3 years.Dementia is a much more serious decline in mental function.Memory loss, particularly for recently acquired information, is often the first symptom, and it becomes worse with time.People who have dementia may forget entire events, not just the details.They may do the following: Have difficulty remembering how to do things they have done many times before and how to get to places they have often been to No longer do things that require many steps, such as following a recipe Forget to pay bills or keep appointments Forget to turn off a stove, lock the house when they leave, or take care of a child left in their care Unlike people with age-related changes in memory, people with dementia are unaware of their memory loss and often deny that they have such loss.Finding the right word, naming objects, understanding language, and doing, planning, and organizing daily activities become more and more difficult.People with dementia eventually become disoriented, not knowing what time or even what year it is or where they are.Their personality may change.They may become more irritable, anxious, paranoid, inflexible, or disruptive.There are many forms of dementia.Alzheimer disease is the most common.Most forms of dementia progressively worsen until the person's death.Some conditions that increase the risk of heart and blood vessel disorders (such as high blood pressure, high levels of cholesterol, and diabetes) seem to increase the risk of dementia.Depression can cause a type of memory loss (called pseudodementia) that resembles memory loss due to dementia.Also, dementia commonly causes depression.Thus, determining whether dementia or depression is the cause of memory loss can be difficult.However, people with memory loss due to depression, unlike those with dementia, are aware of their memory loss and complain about it.Also, they rarely forget important current events or personal matters and usually have other symptoms, such as intense sadness, sleeping problems (too little or too much), sluggishness, or loss of appetite.Stress can interfere with forming a memory and with recalling a memory, partly by preoccupying people and thus preventing them from paying attention to other things.However, in certain circumstances, particularly when stress is mild to moderate and does not last long, it can enhance memory. The most common cause of memory loss is: Getting olderminor changes in memory can be normal as you age Other common causes: Mild thinking problems (mild cognitive impairment)about half of the people who have this will get dementia a few years later Dementia (such as Alzheimer disease)Depressionif you have depression, you probably also have other symptoms, such as intense sadness and problems sleeping Some medicines Overusing drugs or alcohol ","Some memory changes, such as forgetting where you put your car keys or occasionally forgetting a name, are considered normal as you age.More severe loss particularly remembering recent events may bee associated with a mild cognitive impairment.Having problems doing activities you've done many times may indicate dementia.Some disorders have symptoms that resemble dementia, for example, excess fluid around the brain, subdural hematomas, hypothyroidism, and Vitamin B12 deficiency.Doctors could usually determine what causes your memory loss based on the symptoms, physical examination, imaging tests (such as MRI or CT), and other tests, including formal tests of mental function.","Causes and Features of Memory Loss Age-related memory changes (age-associated memory impairment) Occasional forgetfulness of such things as names or the location of car keys No effect on thinking, other mental functions, or the ability to do daily activities Mild cognitive impairment Memory loss that is more severe than expected for a person's age, particularly difficulty remembering recent events and conversations (short-term memory loss) Dementia Memory loss that becomes worse as time passes, eventually with no awareness of the loss Many disorders can cause a deterioration of mental function that resembles dementia.They include the following: Normal-pressure hydrocephalus (due to excess fluid around the brain)Subdural hematomas (pockets of blood under the outer layer of the membranes covering the brain) Hypothyroidism (an underactive thyroid gland) Vitamin B12 deficiency Doctors can usually determine whether the cause is age-related changes, mild cognitive impairment, or early dementia based on the type of memory loss and the symptoms that accompany it." 239,How common is mosaic Turner Syndrome?,"This condition occurs in about 1 in 2,500 newborn girls worldwide, but it is much more common among pregnancies that do not survive to term (miscarriages and stillbirths). Turner syndrome is a rare genetic condition in which a female does not have the usual pair of two X chromosomes. Turner syndrome affects about 1 of every 2,500 female live births worldwide. This disorder affects all races and regions of the world equally.There are no known environmental risks for Turner syndrome.Parents who have had many unaffected children can still have a child with Turner syndrome later on. Generally, Turner syndrome is not passed on from mother to child.In most cases, women with Turner syndrome are infertile. ","Turner syndrome is a rare genetic condition tht occurs in about 1 in 2,500 newborn girls worldwide.","Turner syndrome is a rare genetic condition .This condition occurs in about 1 in 2,500 newborn girls worldwide, but it is much more common among pregnancies that do not survive to term (miscarriages and stillbirths)."