Galih Gumelar Health & Therapy

2009-09-08T08:18:00.000-07:00

Galih Gumelar Helath & Therapy - The body has a very good mechanism to notify us if there is an abnormality. It is important to know the symptoms of type 2 diabetes mellitus at an early stage because the earlier the treatment is going to get better results and the less likely the occurrence of complications. Here are some signs - signs / symptoms of diabetes - diabetes we should be cautious.

* Unusual tiredness
The patient will feel weak even though his body was not doing any activities that are not too heavy. So, if you always feel tired and sleepy even before you do not stay up, it helps you see a doctor immediately.
* Losing weight drastically.
If you eat too much food your body will become fat. Excess fat in the body will cause the body to insulin resistance increases. In people who have diabetes, although he ate his food in excess is not to be fat and even take care of it because the muscles are not getting enough energy to grow.
* Disturbance of vision.
High sugar levels in the blood will draw out the liquid in the cell, this will cause the cells become wrinkled. This situation also occurs in the eye lens, so the lens becomes damaged and the patient will experience vision problems. This vision problems would improve if diabetes mellitus successfully handled properly. If not handled, these vision problems can worsen and cause blindness.
* Often when wounds become infected and very difficult to heal.
This situation can occur because the bacteria thrive because of high levels of sugar in the blood. In addition, mushrooms are also really enjoyed growing up in high blood levels glukosanya.

Thus some of the main symptoms that you notice on diabetes - diabetes. Signs - another sign that can be observed among others:

* Frequent urination. Usually waking at night to urinate.
* Itching - itching excessive. This itching usually occurs in About a genitals.
* Easy to hungry and thirsty beyond the habit
* Often good tingling in the feet or other parts
* Lust sex decreases (Melepasmu ...)
* Easy sleepy. This is basically a part of the fatigue.
* For pregnant women may be indicated with the baby weight more than 4 kg.

If you have diabetes and your offspring showed symptoms - even mild symptoms. Immediately take action to do a lot of exercise and consume alternative herbal medicine that has no side effects.

Pengobatan Ustadz Galih Gumelar - Sebagai penyakit serebrovaskuler (pembuluh darah otak), stroke ditandai dengan kematian jaringan otak (infark serebr

2009-09-08T08:16:00.000-07:00

Galih Gumelar Health& Therapi - As serebrovaskuler disease (blood vessels of the brain), stroke is marked by the death of brain tissue (cerebral infarction) occur because of reduced blood flow and oxygen to the brain with various risk factors.

Have two types of stroke; ischemic stroke, blood flow to the brain stops because atherosclerosis (cholesterol buildup in blood vessel walls) or a blood clot that has clogged the blood vessels to the brain. In hemorragik stroke, broken blood vessels that block normal blood flow and blood seeped into an area in the brain and damage it.

Because a stroke can be about any part of the brain, the symptoms were diverse, ranging from mild to severe and even some who until death.

Mild form of stroke known as brain attack first glance (Transient ischemic Attack / TIA). Symptoms sometimes just a sense of weakness on one side of the face, or perhaps a sense of tingling in the arms or legs. Some are complaining about noise from the function of speech.

Mild stroke symptoms will usually return to normal in a quick time, less than an hour. Symptoms of a more severe stroke will generally lead to a more typical symptoms, like paralysis.

In general, symptoms of stroke include:
1. Weakness or paralysis of limbs that are supplied
2. Difficulty swallowing
3. Difficulty speaking
4. Disturbance hold urine
5. Loss of consciousness
6. Headache

Some conditions are at risk for stroke

1. Several different factors increase the risk of stroke, including: high blood pressure (hypertension) which are not controlled. This damage artery walls.
2. Diet. High dietary salt content is associated with high blood pressure, while the diet of many fatty and sweet foods is associated with coarsening the surface and narrowing the arteries.
3. Onset diabetes (Diabetes). Those who have diabetes menghidap more likely to experience high blood pressure and atherosclerosis, and by the greater risk of experiencing a stroke.
4. Atrial fibrillation. Type degupan irregular heart was raising the risk of blood clot formation in the heart, which then may be left behind and taken the blood flow to the brain.
5. Smoking. This has a negative effect on the arteries and causes blood pressure higher.
6. Alcohol drinking, drinking habits, alcohol will boost blood pressure and may cause blood vessels in the brain burst.

Red Onion and Adventurous Fiber Foods - To Lower Blood Sugar levels

2009-09-08T08:07:00.000-07:00

Galih Gumelar Health & Therapi - DIABETES mellitus (DM) is often called the laity "diabetes", is a disorder that has the characteristics of high blood sugar levels. With diabetes means "flowed on" because the sufferer is always drinking and in large quantities, then keep the form of urine flow urine alias. While mellitus means "sweet", because urine contains glucose, aka sufferer's blood sugar that taste sweet.

IN essence, Council of Ministers due to the hormone insulin that people with inadequate or ineffective, so can not work normally. In fact, the normal person, insulin has a major role regulate blood sugar levels; approximately 60-120 mg / dl in the fasting state, and below 140 mg / dl at two hours after eating.

There are two categories of the most common DM, ie diabetes type 1 and type 2 diabetes. Diabetes type 1, DM diidap by 5-10 percent of patients, usually occurs in children or young adults. While type 2 diabetes, DM diidap by 90-95 per cent of all people with diabetes, increase in number, especially in minority populations.

Diabetes is found in all populations and age groups, but the increase in the number of patients in the elderly group (elderly) and people were black, Hispanic, Native American, and Asian people.

The Congressionally-Established Diabetes Research Working Group (1999) reported that although deaths due to diseases of cancer, stroke, and cardiovascular disease tend to decrease since 1988, mortality due to diabetes increased by about 30 percent. The average life expectancy of people with diabetes on average 15 years shorter than those who did not suffer.

In Indonesia, especially in the urban community, diabetes, a disease classified as prominent today.

Waspadji research in 1982 found that 1.7 percent of patients have diabetes in Jakarta, and in 1992 climbed to 5.7 percent. Epidemiological studies in Depok in 2001, cooperation Perkeni (Association endocrinologist Indonesia) and the Ministry of Health, the number of people with diabetes have 6.2 percent. (Kompas, 5 November 2001). Most diabetes cases found in Indonesia in Manado which reached 6.1 percent. (Kompas, May 29, 2002).

Based on 1998 WHO records, the number of diabetics in Indonesia ranked the 6th largest in the world after India, China, Russia, Japan, and Brazil. The number of diabetics in Indonesia is expected to increase to 12 million people in the year 2025. The increase of 250 percent of 5 million people in 1995 took place with increasing elderly population and changing life styles, ranging from the types of food consumed to reduced physical activity.

Over the centuries, more than 400 plants successfully identified as a "drug" diabetes. In Europe, Asia, and the Middle East, raw onion has long become a favorite choice of food to control blood sugar. In Puerto Rico, Cuba, and Santo Domingo, pariah been widely used as a "medicine" for traditional diabetes.

Recent studies show that consumption of foods high in fiber, particularly soluble fiber, may improve control of blood sugar in type 2 diabetes. The study was conducted by Dr. Manisha Chandalia and colleagues from Medicine Section and the Center for Human Nutrition, University of Texas Southwestern Medical Center, Dallas, United States.

Efficacy of tolbutamide in the red onion

Shallots have long occupied an honored place in medicine as "medicine" of diabetes. Modern research shows, red onions have a "power" lowering blood sugar, and power have on levels found in food.

Indian researchers who make gifts of red onion, both in the form of onion juice and "round" alias is still intact, for 25-200 grams of the subjects studied, found that more and more onion given, the greater the blood sugar decreases. There was no difference between raw red onion and red onion that has been boiled.

According to the theory of the research team, red onion affect sugar metabolism in the liver, or the release of insulin metabolism, and / or prevent the destruction of insulin. "Agent" who may have the ability of hypoglycemia, lower blood sugar levels, it is active allyl propyl disulfide and allicin. Experimental and clinical evidence suggests that allyl propyl disulfide lower blood sugar by increasing the "lifetime" (lifespan) of insulin.

In fact, already since the year 1923 scientists detect the presence of depressor blood sugar in the onion, and in the 1960s, researchers managed to isolate compounds of onion antidiabetes which works similarly to the general antidiabetes pharmaceutical drugs, known as tolbutamide, which is often used to reduces blood sugar levels. How it works is that tolbutamide stimulates insulin synthesis and expenses. In guinea pigs, onion extract showed, 77 percent as effective as standard dose of tolbutamide.

Other research results show, red onion have the effect of lowering blood sugar and fat. Therefore, it is recommended to add the red onion into every meal. Shallots can be used after a meal in the amount of free.

Soluble fiber in natural foods

High levels of blood sugar is a major problem in diabetes. Research shows that the fiber has a strong effect on blood sugar control.

In the study conducted Chandalia et al, 13 with type 2 diabetes were asked to follow two diets, each for six weeks. The first diet is a diet that contains moderate amounts of fiber (total fiber, 24 g; 8 g fiber, 16 g of soluble and insoluble fiber), as recommended American Diabetes Association. Meanwhile, the second diet is high fiber diet (50 g total fiber, each 25 g fiber, soluble and insoluble fiber) containing the full composition of natural food fiber.

Both diets, prepared in the kitchen of research, containing macro nutrients and energy are the same (see Table). Chandalia et al then compared the effects of these two diets to control blood sugar and blood fat levels.

The result? Patient-diabetics who consume 50 g total fiber per day, equal to 7 to 8 servings of fruits and vegetables, high fiber diet aliases have blood sugar levels lower and more stable than-diabetic patients who consumed moderate fiber diet. High-fiber diet also lowered blood total cholesterol level of about 7 percent.

How precise mechanisms high-fiber diet can improve blood sugar control, is not clear. However, it is thought to be caused by a type of soluble fiber gum and pectin that can slow gastric emptying, and even slow down or reduce the absorption of blood sugar.

Chandalia et al study also showed that the intake (intake) high soluble fiber may be achieved by eating natural foods which are full of fiber. High-fiber diet and little side effects were well received by the patient. Therefore, to increase consumption of fiber, the people with diabetes are encouraged to eat natural foods full of fiber compared with fiber preparations or supplements.

Laden foods fiber used for high-fiber diet in the study Chandalia and friends is a dish of fruit cocktail, fresh oranges, fresh pineapple, fresh papaya, peaches (peaches) fresh cherries, fresh tomatoes, corn, zucchini, green beans, whole-wheat bread, and oatmeal (oatmeal and oat bran). Fruit, especially citrus and pineapple, green beans, and oatmeal is a source of soluble fiber is good.

Stroke Risk Level in Patients with Hypertension

2009-09-08T07:55:00.000-07:00

The influence of hypertension on Organs

Galih Gumelar Helath & Therapi - Hypertension can cause damage to various target organs such as brain, heart, kidney, aorta, perifir blood vessels, and retina. Some are cross-sectional studies show that the target organ damage more closely associated with blood pressure measured during ambulatory 24-hour or Blood Preasure (ABP) than blood pressure while in the clinic.

In normal people, blood pressure followed the circadian pattern, which decreased blood pressure at night and has increased in the morning. Similarly, the majority of hypertension, which also follows the normal circadian pattern (dippers). However, hypertension in non-dippers did not decrease blood pressure at night. Incidence of cardiovascular disease and stroke occur more frequently in people with hypertension non-dippers than dippers hypertension. Target organ damage more closely related to severe patients with high blood pressure at night (non-dippers) than patients with blood pressure normally decreases at night (dippers) 7. For example, studies of Verdecchia and colleagues in a prospective cohort terhadap1100 hypertension, reported mortality rates average higher, both in non-dippers and reverse dippers Dipper instead. Yamamoto research results prove that high blood pressure on ambulatory measurement (ABP), particularly high blood pressure at night and a decrease in blood pressure is less at night, will cause adverse effects (increasing the extent of the lesion) in the quiet of ischemic lesions (silent ischemic lesions), and stroke in patients with symptomatic myocardial lakuner9.

In the meantime, the results of Chaturvedi and colleagues proved that ischemic stroke is more common in the morning (between 06.00 to 12.00). According to Chaturvedi, there are some acceptable explanation why the ischemic stroke occurred in the morning:

Circadian pattern of blood pressure. The pattern of blood pressure rise in the morning (the highest increase occurred in the mid-morning until noon). Increased blood pressure causes increased intraplaque hemorrhage, which will aggravate the stenosis of blood vessels having atherosclerosis.
Increased platelet aggregation occurred in the morning.
Blood viscosity peak in the morning.
TPA activity (endogenous tissue plasminogen activator) is very low in the morning. This will change the balance between thrombosis and fibrinolysis that thrombosis become more dominant.
Role of Hypertension in Stroke Pathogenesis

Normal people have a system of autoregulation of cerebral arteries. If the systemic blood pressure increases, cerebral vessels become vasospasme (voasokonstriksi). Conversely, when the systemic blood pressure decreases, the cerebral vessels will be vasodilatation. Thus, blood flow to the brain remains constant. Despite a decline in systemic blood pressure by 50 mmHg, autoregulation of cerebral arteries is still able to maintain blood flow to the brain remained normal. Limits on systemic blood pressure which can still be addressed by autoregulation was 200 mm Hg for systolic and 110-120 mm Hg for diastolic pressure.

When systemic blood pressure increases, cerebral vessels to constrict. Depending on the degree of constriction of the blood pressure increase. If the blood pressure rise high enough for months or years, will cause the muscle layer hialinisasi on cerebral vessels. As a result, the lumen diameter of blood vessels will become permanent. This is dangerous because of cerebral vessels can not constrict dilated or freely to cope with fluctuations of systemic blood pressure. When a decline in systemic blood pressure perfusion pressure to the brain tissue is not adequate. This will result in cerebral ischemia. Conversely, when there is an increase in systemic blood pressure perfusion pressure in the capillary walls are high. As a result, there hiperemia, edema, and possible bleeding on otak13.

In chronic hypertension can occur mikroaneurisma in diameter and 1 mm. Is known as Mikroaneurisma aneurysm of Charcot-Bouchard and mainly occurs in arteria lentikulostriata. On systemic blood pressure spikes, as people angry or pushing, aneurysms can rupture. Chronic hypertension is one of the causes of endothelial dysfunction of blood vessels.

In normal circumstances, endothelial show dualistic function. These properties simultaneously express and release vasoconstrictor substances (angiotensin II, endotelin-I, thromboxane A-2, and superoxide radicals) and vasodilator (prostaglandin and nitric oxide). These factors cause and prevent cell proliferation of smooth muscle cells of blood vessels in a balanced way. The balance between these antagonistic systems in an optimal control function of blood vessel walls. As a result of endothelial dysfunction, vasoconstriction occurs, the cell proliferation of smooth muscle cells of blood vessels, platelet aggregation, adhesion lekosit, and increased permeability to macromolecules, such as lipoprotein, fibrinogen, and imunoglobulin14. This condition will accelerate the occurrence of atherosclerosis. Atherosclerosis is an important role for the occurrence of myocardial stroke.

Blood pressure reduction in Stroke Prevention In Primary and Secondary

Primary stroke prevention is intended for individuals at high risk for stroke, namely by controlling the risk factors of stroke. Risk factors of stroke can be treated or controlled and is proven to reduce the occurrence of stroke is well-hypertension, smoking, diabetes, carotid artery stenosis are asymptomatic, Sickle cell disease, hyperlipidemia, and arterial fibrillation. Other risk factors that could potentially be controlled is obesity, less physical activity, alcohol, hiperhomosisteinemia, drug abuse (cocaine, amphetamines, and heroin), nutrition (diet less vegetables and fruits), oral contraceptives, hiperkoagulabilitas, chronic infections Chalmydia pneumoniae, and hormon15 replacement therapy.

Klugel and colleagues reported that uncontrolled hypertension is present in 78% cases of ischemic stroke and 85% in cases of stroke hemoragik16. Uncontrolled hypertension is very strong relation with stroke akut17. Overviews of a prospective randomized 14 shows that the decrease in blood pressure 5 mm Hg to 6 mm Hg can reduce the occurrence of stroke 42% 18. The research results Systolic Hypertension in the Eldery Program (Shep) shows the incidence of stroke decreased 36% with antihypertensive treatment (klortahalidon or atenolol) in elderly patients with isolated systolic hypertension (isolated systolic hypertension) 19. The risk of stroke will increase two times each 7.5 mmHg increase in diastolic pressure. Antihypertensives may lower the risk of stroke 38% 20.

The results of meta-analysis conducted by Gueyffier showed that lowering blood pressure with antihypertensive drugs can reduce the risk of stroke ulang21. While the research results from POGRESS (perindopril Against recurrent Protection Study) showed that treatment with perindopril in stroke patients with hypertension can significantly reduce the occurrence of re sroke (risk reduction = 28%, 95% Cl = 17% to 38%, P <0.0001)> 20-25% of the blood pressure on average. Indications of hypertension therapy in acute stroke:

If the diastolic blood pressure> 140 mmHg on two readings 5-minute intervals, give the IV natriun nitroprusid (very emergency).
If the systolic blood pressure> 230 mmHg and or diastolic blood pressure of l21-140 mm Hg on two readings 20 minutes intervals, giving 20 mg iv labetolol for 1-2 minutes. Labetolol dose may be repeated every 10-20 minutes until a satisfactory reduction in blood. After the initial dose, given every labetolol be 6-8 hours if necessary (emergency).
If the systolic blood pressure 180-230 mmHg or diastolic blood pressure 105-120 mmHg, emergency therapy should be postponed without any evidence of intracerebral hemorrhage or heart failure the left ventricle. If the blood pressure stayed at two times the measurement interval of 60 minutes, then 200-300 mg given 2-3 times daily labetolol. Labetolol alternative treatment is nifedipin oral 10 mg every 6 hours or captopril 6,25-12,5 mg every 8 hours (urgency).
Systolic pressure <180>

Blood pressure in the acute phase should not be lowered more than 20%. Decrease blood tekananan average no more than 25% and arterial blood pressure on average.

If the systolic blood pressure over 230 mmHg or diastolic pressure over 140 mmHg on two measurements of blood pressure hoses 5 minutes, give sodium nitroprusid or nitroglycerin drip.
When the systolic pressure 180-230 mmHg or diastolic pressure of 105-140 mmHg, or arterial blood pressure an average of 130 mmHg on two measurements of blood pressure hoses 20 minutes, give injections or enalapril labetolol.
When the systolic pressure less than 180 mm Hg and diastolic blood pressure less than 105 mmHg, antihypertensive drug treatment delayed.

Hypertension drugs given to stroke patients is a drug that does not affect cerebral blood flow. Dyker and colleagues reported that administration of perindopril effectively lower blood pressure without disturbing the brain's blood flow in patients with ischemic stroke akut31. Meanwhile, Walter and his colleagues reported that administration of perindopril in patients with ischemic stroke who are not acute, with stenosis or occlusion of moderate to severe carotid artery intema, decrease blood pressure without a decrease in cerebral blood flow.

What Are Colds?

2009-02-23T07:43:00.000-08:00

Everyone gets a cold from time to time. Children get more colds than adults.

Colds usually last 1 to 2 weeks. You can catch a cold at any time of year, but they are more common in late winter and early spring.

There is no cure for a cold. Antibiotics will not cure a cold. If you catch a cold, treat the symptoms.

What are the symptoms?

Lots of different viruses cause colds, but the symptoms are usually the same:

Runny nose and sneezing
Red eyes
Sore throat and cough
Headaches and body aches

You will probably feel a cold come on over the course of a couple of days. As the cold gets worse, your nose may get stuffy with thicker mucus.

A cold is not the same as the flu. Flu symptoms are worse and come on faster. If you have the flu, you may feel very tired. You may also have a fever and shaking chills, lots of aches and pains, a headache, and a cough.

If you feel like you have a cold all the time, or if cold symptoms last more than 2 weeks, you may have allergies or sinusitis. Call your doctor.

What can you do for a cold?

Good home treatment of a cold can help you feel better. When you get a cold:

Get extra rest. Slow down just a little from your usual routine. You don't need to stay home in bed, but try not to expose others to your cold.
Drink plenty of fluids. Hot water, herbal tea, or chicken soup will help relieve a stuffy nose and head.
Take aspirin, ibuprofen (such as Advil or Motrin), or acetaminophen (such as Tylenol) to relieve aches. Do not give aspirin to anyone younger than 20. It has been linked to Reye's syndrome, a serious illness.
Use a humidifier in your bedroom and take hot showers to relieve a stuffy nose and head.
If you feel mucus in the back of your throat (postnasal drip), gargle with warm water. This will help make your throat feel better.
Use paper tissues, not handkerchiefs. This will help keep your cold from spreading.
If your nose does get red and raw, put a dab of petroleum jelly on the sore area.

Don't take cold medicine that uses several drugs to treat different symptoms. For example, don't take medicine that contains both a decongestant for a stuffy nose and a cough medicine. Treat each symptom on its own.

A nasal decongestant spray can help your stuffy nose, but make sure you don't use it for more than 3 days in a row. You could get a "rebound" effect, which makes the mucous membranes in your nose swell up even more.

Do not give cough and cold medicines to a child younger than 2 unless you've checked with the doctor first. If your child’s doctor tells you to give a medicine, be sure to follow what he or she tells you to do. Using saline drops or a humidifier may help thick or dried mucus to drain. To remove mucus from your baby’s nose, use a suction bulb to gently suction the mucus out. This is a safer way to treat your baby's stuffy nose.

When should you call a doctor?

Call your doctor if:

You have trouble breathing.
You have a fever of 104 ° F (40 ° C) or higher.
You have a fever of 101 ° F (38.3 ° C) or higher that has not come down after 12 hours of home treatment. Or you have a fever of 100 ° F (37.8 ° C) to 101 ° F (38.3 ° C) that has not come down after 3 days of home treatment.
You have new symptoms that are not part of a cold, like a stiff neck or shortness of breath.
You cough up yellow, green, or bloody mucus.
Mucus from your nose is thick like pus or is bloody.
You have pain in your face, eyes, or teeth that does not get better with home treatment, or you have a red area on your face or around your eyes.
Your cold seemed to be getting better after a few days but is now getting worse with new symptoms.

How can you prevent colds?

There are several things you can do to help prevent colds:

Wash your hands often.
Be extra careful in winter and when you are around people with colds.
Keep your hands away from your face. Your nose, eyes, and mouth are the most likely places for germs to enter your body.
Eat well, and get plenty of sleep and exercise. This keeps your body strong so it can fight colds.
Do not smoke. Smoking makes it easier to get a cold and harder to get rid of one.

Treating Pain When It Becomes a Disease in Its Own Right

2009-02-23T07:42:00.001-08:00

Navigating the path to chronic pain control is tricky. For the patient and the doctor, the challenge is that there is no single drug or therapy. A combination of approaches, often coordinated by a team of pain experts, is best.

Chronic pain can begin with an injury or a problem such as a bulging disk in the spine. It can be associated with complex syndromes such as fibromyalgia. Or you may experience it as headaches, back pain, joint pain, nerve pain, or a myriad of other localized symptoms.

But here's the rub: Whatever its origin, chronic pain can become a disease in its own right, requiring special attention and treatment. Theories about why and how this happens are explained in this Health Journey. The good news is that science understands more about chronic pain than ever and recognizes that alternative therapies such as yoga, meditation, and acupuncture play a healing role.

You're not alone! One study estimated that 30% of Americans have experienced some kind of chronic pain. Among them are people whose stories we explore here—inspiring, instructive, wise.

Chronic Obstructive Pulmonary Disease (COPD)

2009-02-23T07:17:00.000-08:00

What is chronic obstructive pulmonary disease (COPD)?

Chronic obstructive pulmonary disease (COPD) is a lung disease that makes it hard to breathe. It is caused by damage to the lungs over many years, usually from smoking.

COPD is often a mix of two diseases:

Chronic bronchitis (say “bron-KY-tus”). In chronic bronchitis, the airways that carry air to the lungs (bronchial tubes) get inflamed and make a lot of mucus. This can narrow or block the airways, making it hard for you to breathe.
Emphysema (say “em-fuh-ZEE-muh”). In a healthy person, the tiny air sacs in the lungs are like balloons. As you breathe in and out, they get bigger and smaller to move air through your lungs. But with emphysema, these air sacs are damaged and lose their stretch. Less air gets in and out of the lungs, which makes you feel short of breath.

COPD gets worse over time. You can't undo the damage to your lungs. But you can take steps to prevent more damage and to feel better.

What causes COPD?

COPD is almost always caused by smoking. Over time, breathing tobacco smoke irritates the airways and destroys the stretchy fibers in the lungs.

Other things that may put you at risk include breathing chemical fumes, dust, or air pollution over a long period of time. Secondhand smoke is also bad.

It usually takes many years for the lung damage to start causing symptoms, so COPD is most common in people who are older than 60.

You may be more likely to get COPD if you had a lot of serious lung infections when you were a child. People who get emphysema in their 30s or 40s may have a disorder that runs in families, called alpha-1 antitrypsin deficiency. But this is rare.

What are the symptoms?

The main symptoms are:

A long-lasting (chronic) cough.
Mucus that comes up when you cough.
Shortness of breath that gets worse when you exercise.

As COPD gets worse, you may be short of breath even when you do simple things like get dressed or fix a meal. It gets harder to eat or exercise, and breathing takes much more energy. People often lose weight and get weaker.

At times, your symptoms may suddenly flare up and get much worse. This is called a COPD exacerbation (say “egg-ZASS-er-BAY-shun”). An exacerbation can range from mild to life-threatening. The longer you have COPD, the more severe these flare-ups will be.

How is COPD diagnosed?

To find out if you have COPD, a doctor will:

Do a physical exam and listen to your lungs.
Ask you questions about your past health and whether you smoke or have been exposed to other things that can irritate your lungs.
Have you do a simple breathing test called spirometry to find out how well your lungs work.
Do chest X-rays and other tests to help rule out other problems that could be causing your symptoms.

If there is a chance you could have COPD, it is very important to find out as soon as you can. This gives you time to take steps to slow the damage to your lungs.

How is it treated?

The only way to slow COPD is to quit smoking. This is the most important thing you can do. It is never too late to quit. No matter how long you have smoked or how serious your COPD is, quitting smoking can help stop the damage to your lungs.

It’s hard to quit smoking. Talk to your doctor about treatments that can help. Using medicines and support increases the chance that you will quit for good. To learn more about how to quit, go to www.smokefree.gov, or call 1-800-QUITNOW (1-800-784-8669).

Your doctor can prescribe treatments that may help you manage your symptoms and feel better.

Medicines can help you breathe easier. Most of them are inhaled so they go straight to your lungs. If you get an inhaler, it is very important to use it just the way your doctor shows you.
A lung (pulmonary) rehab program can help you learn to manage your disease. A team of health professionals can provide counseling and teach you how to breathe easier, exercise, and eat well.
In time, you may need to use oxygen some or most of the time.

People who have COPD are more likely to get lung infections, so you will need to get a flu shot every year. You should also get the pneumonia vaccine. It may not keep you from getting pneumonia. But if you do get pneumonia, you probably will not be as sick.

There are many things you can do at home to stay as healthy as you can.

Avoid things that can irritate your lungs, such as smoke, pollution, and cold, dry air.
Use an air conditioner or air filter in your home.
Take rest breaks during the day.
Get regular exercise to stay as strong as you can.
Eat well so you can keep your strength up. If you are losing weight, ask your doctor or dietitian about ways to make it easier to get the calories you need.

What else should you think about?

As COPD gets worse, you may have flare-ups when your symptoms suddenly get much worse. It is important to know what to do if this happens. Your doctor can prescribe medicines to help. But if the attack is severe, you may need to go to the emergency room or call 911.

Knowing you have a disease that gets worse over time can be hard. It’s common to feel sad or hopeless sometimes. If these feelings last, be sure to tell your doctor. Counseling and support groups can help you cope.

Be sure to talk to your doctor about what kinds of treatment you want if your breathing problems become life-threatening. You may want to write a living will. You can also choose a health care agent to make decisions in case you are not able to. It can be comforting to know that you will get the type of care you want.

Chronic Fatigue Syndrome

2009-02-23T07:16:00.001-08:00

What is chronic fatigue syndrome (CFS)?

Chronic fatigue syndrome, sometimes called CFS, is a condition that makes you feel so tired that you can't do all of your normal, daily activities. There are other symptoms too, but being very tired for at least 6 months is the main one.

Many people improve in a year or two and do not have a relapse. Some people continue to have severe fatigue and other symptoms for many years.

The disease is not well understood. Most experts now believe that it is a separate illness with its own set of symptoms. But some doctors do not believe this.

There are no tests for CFS. Because of this, many people have trouble accepting their disease or getting their friends and family to do so. Having people who believe your diagnosis and support you is very important. Having a doctor you can trust is critical.

Your tiredness is real. It’s not “in your head.” It is your body's reaction to a combination of emotional and physical factors.

What causes CFS?

Doctors don't know what causes CFS. Sometimes it begins after an illness like the flu, but there is no proof of any connection. It's likely that a number of factors or triggers come together to cause CFS.

What are the symptoms?

Extreme tiredness, or fatigue, is the main symptom. If you have CFS:

You may feel exhausted all or much of the time.
You may have problems sleeping, or you may wake up feeling tired or not rested.
It may be harder for you to think clearly, to concentrate, and to remember things.
You may also have headaches, muscle and joint pain, a sore throat, and tender glands in your neck or armpits.
Your symptoms may flare up after a mental or physical activity that used to be no problem for you.

Depression is common with CFS, and it can make your other symptoms worse. Antidepressant medicines can help you feel better.

How is CFS diagnosed?

There are no tests for CFS. Doctors can diagnose it only by ruling out other possible causes of your fatigue. Many other health problems can cause fatigue, and most people with fatigue have something other than chronic fatigue syndrome.

How is it treated?

There is no treatment for CFS itself, but many of its symptoms can be treated. A good relationship with your doctor is important, because the two of you will need to work together to find a combination of medicines and behavior changes that will help you get better. Some trial and error may be necessary, because no single combination of treatments works for everyone.

Home treatment is very important. You may need to change your daily schedule, learn better sleep habits, and start getting regular gentle exercise.

Counseling and a gradual increase in exercise help people with CFS get better.

Even though it may not be easy, keeping a good attitude really helps. Try not to get caught in a cycle of frustration, anger, and depression. Learning to cope with your symptoms and talking to others who have the same illness can help you keep a good attitude.

What Puts You at Risk for High Cholesterol?

2009-02-23T06:46:00.000-08:00

A bad diet is a sure way to spike your triglyceride reading.

Blood cholesterol is a risk factor for coronary artery disease and heart attack, so reducing your risk of high cholesterol is a worthy goal. However, the next time you brag that your cholesterol is nice and low—or lament that your number is in the mid-200s—know this: "Your total cholesterol is a pretty meaningless number," says Maureen Mays, MD, a preventive cardiologist and lipid specialist at Oregon Health & Science University in Portland. "Not only does the general public not know this, some doctors don't either."

Here's why "the number" is so misleading. Total cholesterol is calculated by adding LDL (bad cholesterol), HDL (good cholesterol), and one-fifth of your triglyceride total. "We have been using this formula of adding a bad thing to a good thing and factoring in one-fifth of a bad thing, and it's not useful," Dr. Mays says.

That's one reason 50% of people who have a heart attack have normal cholesterol readings.

Effects of diet and exercise
A smarter way of looking at cholesterol risk is by component. LDL, or bad cholesterol, is very responsive to good nutrition and exercise. The target number is less than 100 mg/dL. It's not uncommon for LDL to swing up by 40% in response to a sedentary lifestyle and a diet high in saturated and other unhealthy fats, according to Dr. Mays.

It can also drop by up to 40% in response to a heart-healthy diet and regular exercise.

One in 500 people has an inherited risk of extremely high LDL and should be put on statins to control their risk of heart disease.

Asthma in Teens and Adults

2009-02-23T03:20:00.000-08:00

Is this topic for you?

This topic provides information about asthma in teens and adults. If you are looking for information about asthma in children age 12 and younger, see the topic Asthma in Children.

What is asthma?

Asthma causes swelling and inflammation in the airways that lead to your lungs. When asthma flares up, the airways tighten and become narrower. This keeps the air from passing through easily and makes it hard for you to breathe. These flare-ups are also called asthma attacks or exacerbations.

Asthma affects people in different ways. Some people only have asthma attacks during allergy season, or when they breathe in cold air, or when they exercise. Others have many bad attacks that send them to the doctor often.

Even if you have few asthma attacks, you still need to treat your asthma. The swelling and inflammation in your airways can lead to permanent changes in your airways and harm your lungs.

Many people with asthma live active, full lives. Even though asthma is a lifelong disease, treatment can control it and keep you healthy.

What causes asthma?

Experts do not know exactly what causes asthma. But there are some things we do know:

Asthma runs in families.
Asthma is much more common in people with allergies, though not everyone with allergies gets asthma. And not everyone with asthma has allergies.
Pollution may cause asthma or make it worse.

What are the symptoms?

Symptoms of asthma can be mild or severe. You may have mild attacks now and then, or you may have severe symptoms every day, or you may have something in between. How often you have symptoms can also change. When you have asthma, you may:

Wheeze, making a loud or soft whistling noise that occurs when you breathe in and out.
Cough a lot.
Feel tightness in your chest.
Feel short of breath.
Have trouble sleeping because of coughing or having a hard time breathing.
Quickly get tired during exercise.

Your symptoms may be worse at night.

Severe asthma attacks can be life-threatening and need emergency treatment.

How is asthma diagnosed?

Along with doing a physical exam and asking about your health, your doctor may order lung function tests. These tests include:

Spirometry. Doctors use this test to diagnose and keep track of asthma. It measures how quickly you can move air in and out of your lungs and how much air you move.
Peak expiratory flow (PEF). This shows how fast you can breathe out when you try your hardest.
An exercise or inhalation challenge. This test measures how quickly you can breathe after exercise or after taking a medicine.
A chest X-ray, to see if another disease is causing your symptoms.
Allergy tests, if your doctor thinks your symptoms may be caused by allergies.

You will need routine checkups with your doctor to keep track of your asthma and decide on treatment.

How is it treated?

There are two parts to treating asthma. The goals are to:

Control asthma over the long term. To do this, use a daily asthma treatment plan. This is a written plan that tells you which medicine to take. It also helps you track your symptoms and know how well the treatment is working. Many people take controller medicine—usually an inhaled corticosteroid—every day. Taking controller medicine every day helps to reduce the swelling of the airways and prevent attacks. Your doctor will show you how to use your inhaler correctly. This is very important so you get the right amount of medicine to help you breathe better.
Treat asthma attacks when they occur. Use an asthma action plan, which tells you what to do when you have an asthma attack. It helps you identify triggers that can cause your attacks. You use rescue medicine, such as albuterol, during an attack.

If you need to use the rescue inhaler more often than usual, talk to your doctor. This is a sign that your asthma is not controlled and can cause problems.

Asthma attacks can be life-threatening, but you may be able to prevent them if you follow a plan. Your doctor can teach you the skills you need to use your asthma treatment and action plans.

How can you prevent asthma attacks?

You can prevent some asthma attacks by avoiding those things that cause them. These are called triggers. A trigger can be:

Irritants in the air, such as cigarette smoke or other air pollution. Don't smoke, and try to avoid being around others when they smoke.
Things you are allergic to, such as pet dander, dust mites, cockroaches, or pollen. When you can, avoid those things you are allergic to. It may also help to take certain kinds of allergy medicine.
Exercise. Ask your doctor about using an inhaler before you exercise if this is a trigger for you.
Other things like dry, cold air; an infection; or some medicines, such as aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs). Try not to exercise outside when it is cold and dry. Talk to your doctor about vaccines to prevent some infections, and ask about what medicines you should avoid.

Sometimes you don't know what triggers an asthma attack. This is why it is important to have an asthma action plan that tells you what to do during an attack.

Osteoarthritis

2009-02-23T03:11:00.000-08:00

What is osteoarthritis?

Healthy joints help your body move, bend, and twist. Knees glide up and down stairs without creaking or crunching. Hips move you along on a walk without a complaint. But when osteoarthritis affects your joints, such simple, everyday movements can hurt. Taking the stairs can be painful. Walking a few steps, opening a door, and even combing your hair can be hard.

Osteoarthritis is mainly a disease of the hips, knees, hands, neck, and low back. But it can happen in other joints too. A joint is where two bones connect. And you have them all over your body.

Osteoarthritis is most common in older people. Although you cannot cure arthritis, there are many treatments that can help with your pain and make it easier for you to move. And you can do things to keep the damage from getting worse.

What causes osteoarthritis?

The simplest way to describe osteoarthritis is that it is wear and tear on the cartilage of your joints. Your joints have cushioning inside them called cartilage. This tissue is firm, thick, and slippery. It covers and protects the ends of bones where they meet to form a joint.

With osteoarthritis, there are changes in the cartilage that cause it to break down. When it breaks down, the bones rub together and cause damage and pain. Experts do not know why this breakdown in cartilage happens. But aging, joint injury, and genetics may be a part of the reason.

What are the symptoms?

Pain: Your joints may ache, or the pain may feel burning or sharp. For some people, it may get better after a while. Pain while sleeping or constant pain may be a sign that your arthritis is getting worse.
Stiffness: When you have arthritis, getting up in the morning can be hard. Your joints may feel stiff and creaky for a short time, until you get moving. You may also get stiff from sitting.
Muscle weakness: The muscles around the joint may get weaker. This happens a lot with arthritis in the knee.
Swelling: Arthritis can cause swelling in joints, making them feel tender and sore.
Deformed joints: Joints can start to look like they are the wrong shape, especially as arthritis gets worse.
Cracking and creaking: Your joints may make crunching, creaking sounds.

How is osteoarthritis diagnosed?

Your doctor will want to make sure your pain is caused by arthritis and not another problem. So first, you will need to describe your symptoms as best you can. Your doctor will ask you questions about your symptoms. Examples of questions include:

Is the pain burning, aching, or sharp?
Are your joints stiff in the morning? If yes, how long does the stiffness last?
Do you have any joint swelling?

Knowing these things will help your doctor make a diagnosis. If your joints are tender and swollen and the muscles are weak, this will also help your doctor confirm whether you have arthritis. You may also have X-rays to check your joints for damage. Your doctor may want to do blood tests or other tests to see if there are other causes for your pain.

How is it treated?

There are many treatments for arthritis, but what works for someone else may not help you. Work with your doctor to find what is best for you. Often a mix of things helps most.

If your pain is mild, you may only need pain medicines you can buy without a prescription. These include acetaminophen (such as Tylenol), aspirin, ibuprofen, or naproxen (such as Aleve). But if you still have pain, you may need a stronger prescription medicine. Because you will take these medicines for a long time, you will need to have regular checkups from your doctor.

Using ice or heat on the painful joint can help. Heat may help you loosen up before an activity. Ice is a good pain reliever after activity or exercise. Your doctor may give you gels or creams that you can rub on the joint to make it stop hurting. Having shots of medicine in the joint also helps some people.

If you are overweight, losing weight may be one of the best things you can do for your arthritis. It helps take some stress off your joints. Exercise is also good, because it can help make your muscles stronger. Having stronger thigh muscles, for example, can help reduce stress on your knees. Swimming, bicycling, and walking are good activities. But make sure you talk to your doctor about what kind of activity is best for you. You may also get help from a physical therapist.

If your pain gets so bad that you have trouble walking, you may need surgery. Hips and knees that have been severely damaged can be replaced with man-made joints.

Anxiety

2009-02-23T02:53:00.000-08:00

Anxiety

Feeling worried or nervous is a normal part of everyday life. Everyone frets or feels anxious from time to time. Mild to moderate anxiety can help you focus your attention, energy, and motivation. If anxiety is severe, you may have feelings of helplessness, confusion, and extreme worry that are out of proportion with the actual seriousness or likelihood of the feared event. Overwhelming anxiety that interferes with daily life is not normal. This type of anxiety may be a symptom of another problem, such as depression.

Anxiety can cause physical and emotional symptoms. A specific situation or fear can cause some or all of these symptoms for a short time. When the situation passes, the symptoms usually go away.

Physical symptoms of anxiety include:

Trembling, twitching, or shaking.
Feeling of fullness in the throat or chest.
Breathlessness or rapid heartbeat.
Lightheadedness or dizziness.
Sweating or cold, clammy hands.
Feeling jumpy.
Muscle tension, aches, or soreness (myalgias).
Extreme tiredness.
Sleep problems, such as the inability to fall asleep or stay asleep, early waking, or restlessness (not feeling rested when you wake up).

Anxiety affects the part of the brain that helps control how you communicate. This makes it more difficult to express yourself creatively or function effectively in relationships. Emotional symptoms of anxiety include:

Restlessness, irritability, or feeling on edge or keyed up.
Worrying too much.
Fearing that something bad is going to happen; feeling doomed.
Inability to concentrate; feeling like your mind goes blank.

Anxiety disorders

Anxiety disorders occur when people have both physical and emotional symptoms. Anxiety disorders interfere with how a person gets along with others and affect daily activities. Women are twice as likely as men to have problems with anxiety disorders. Examples of anxiety disorders include panic attacks, phobias, obsessive-compulsive disorder, and post-traumatic stress disorder (PTSD).

Often the cause of anxiety disorders is not known. Many people with an anxiety disorder say they have felt nervous and anxious all their lives. This problem can occur at any age. Children who have at least one parent with the diagnosis of depression are more than twice as likely to have an anxiety disorder than other children.

Anxiety disorders often occur with other problems, such as:

Mental health problems, such as depression or substance abuse.
A physical problem, such as heart or lung disease. A complete medical examination may be needed before an anxiety disorder can be diagnosed.

Panic attacks

A panic attack is a sudden feeling of extreme anxiety or intense fear without a clear cause or when there is no danger. Panic attacks are common. They sometimes occur in otherwise normal, healthy people and will usually last for several minutes.

Symptoms include feelings of dying or losing control of yourself, rapid breathing (hyperventilation), and a racing heart. You may feel dizzy, sweaty, or shaky. Other symptoms include trouble breathing, chest pain or tightness, and an irregular heartbeat. These symptoms come on suddenly and without warning.

Sometimes symptoms of a panic attack are so intense that the person fears he or she is having a heart attack. Many of the symptoms of a panic attack can occur with other illnesses, such as hyperthyroidism, coronary artery disease, or chronic obstructive pulmonary disease (COPD). A complete medical examination may be needed before an anxiety disorder can be diagnosed.

People who have repeated unexpected panic attacks and worry about the attacks are said to have a panic disorder.

Phobias

Phobias are extreme and irrational fears that interfere with daily life. People with phobias have fears that are out of proportion to real danger. And although these people are aware that their fears are not rational, they are not able to control them.

Phobias are common and are sometimes present with other conditions, such as panic disorder or Tourette's disorder. Most people deal with phobias by avoiding the situation or object that causes them to feel panic (avoidance behavior).

A phobic disorder occurs when the avoidance behavior becomes so extreme that it interferes with your ability to participate in your daily activities. There are three main types of phobic disorders:

Fear of being alone or in public places where help might not be available or escape is impossible (agoraphobia)
Fear of situations where the individual might be exposed to criticism by others (social phobia)
Fear of specific things (specific phobia)

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a doctor.

Alcohol Abuse and Dependence

2009-02-23T02:52:00.001-08:00

Is this topic for you?

This topic is about alcohol abuse and dependence in adults. For information about alcohol problems in teens or children, see the topic Teen Alcohol and Drug Abuse. For information about drug abuse in adults, see the topic Drug Abuse and Dependence.

What are alcohol abuse and alcohol dependence?

Alcohol abuse means having unhealthy or dangerous drinking habits, such as drinking every day or drinking too much at a time. Alcohol abuse can harm your relationships, cause you to miss work, and lead to legal problems such as driving while drunk (intoxicated). When you abuse alcohol, you continue to drink even though you know your drinking is causing problems.

If you continue to abuse alcohol, it can lead to alcohol dependence. Alcohol dependence is also called alcoholism. You are physically or mentally addicted to alcohol. You have a strong need, or craving, to drink. You feel like you must drink just to get by.

You might be dependent on alcohol if you have three or more of the following problems in a year:

You cannot quit drinking or control how much you drink.
You need to drink more to get the same effect.
You have withdrawal symptoms when you stop drinking. These include feeling sick to your stomach, sweating, shakiness, and anxiety.
You spend a lot of time drinking and recovering from drinking, or you have given up other activities so you can drink.
You have tried to quit drinking or to cut back the amount you drink but haven't been able to.
You continue to drink even though it harms your relationships and causes you to develop physical problems.

Alcoholism is a long-term (chronic) disease. It's not a weakness or a lack of willpower. Like many other diseases, it has a course that can be predicted, has known symptoms, and is influenced by your genes and your life situation.

How much drinking is too much?

Alcohol is part of many people’s lives and may have a place in cultural and family traditions. It can sometimes be hard to know when you begin to drink too much.

You are at risk of drinking too much and should talk to your doctor if you are:¹

A woman who has more than 3 drinks at one time or more than 7 drinks a week. A standard drink is 1 can of beer, 1 glass of wine, or 1 mixed drink.
A man who has more than 4 drinks at one time or more than 14 drinks a week.

If you think you might have a drinking problem, take a short quiz to check your symptoms:

Interactive Tool: Do You Have a Drinking Problem?

What are some signs of alcohol abuse or dependence?

Certain behaviors may mean that you're having trouble with alcohol. These include:

Drinking in the morning, being drunk often for long periods of time, or drinking alone.
Changing what you drink, such as switching from beer to wine because you think it will help you drink less or keep you from getting drunk.
Feeling guilty after drinking.
Making excuses for your drinking or doing things to hide your drinking, such as buying alcohol at different stores.
Not remembering what you did while you were drinking (blackouts).
Worrying that you won't get enough alcohol for an evening or weekend.

How are alcohol problems diagnosed?

Alcohol problems may be diagnosed at a routine doctor visit or when you see your doctor for another problem. If a partner or friend thinks you have an alcohol problem, he or she may urge you to see your doctor.

Your doctor will ask questions about your symptoms and past health, and he or she will do a physical exam and sometimes a mental health assessment. The mental health assessment checks to see whether you may have a mental health problem, such as depression.

Your doctor also may ask questions or do tests to look for health problems linked to alcohol, such as cirrhosis.

How are they treated?

Treatment depends on how bad your alcohol problem is. Some people are able to cut back to a moderate level of drinking with help from a counselor. People who are addicted to alcohol may need medical treatment and may need to stay in a hospital or treatment center.

Your doctor may decide you need detoxification, or detox, before you start treatment. Detox flushes out the alcohol in your body. You need detox when you are physically addicted to alcohol. When you go through detox, you may need medicine to help with withdrawal symptoms.

After detox, you focus on staying alcohol-free, or sober. Most people receive some type of therapy, such as group counseling. You also may need medicine to help you stay sober.

When you are sober, you've taken the first step toward recovery. To gain full recovery, you need to take steps to improve other areas of your life, such as learning to deal with work and family. This makes it easier to stay sober.

You will likely need support to stay sober and in recovery. This can include counseling and support groups like Alcoholics Anonymous. Recovery is a long-term process, not something you can achieve in a few weeks.

Treatment doesn't focus on alcohol use alone. It addresses other parts of your life, like your relationships, work, medical problems, and living situation. Treatment and recovery support you in making positive changes so you can live without alcohol.

What can you do if you or another person has a problem with alcohol?

If you feel you have an alcohol problem, get help. Even if you are successful in other areas of your life, visit a doctor or go to a self-help group. The earlier you get help, the easier it will be to cut back or quit.

Helping someone with an alcohol problem is hard. If you're covering for the person, you need to stop. For example, don't make excuses for the person when he or she misses work.

You may be able to help by talking to the person about what his or her drinking does to you and others. Talk to the person in private, when the person is not using drugs or alcohol and when you are both calm. If the person agrees to get help, call for an appointment right away.

Attention Deficit Hyperactivity Disorder (ADHD)

2009-02-23T02:50:00.000-08:00

What is attention deficit hyperactivity disorder (ADHD)?

Attention deficit hyperactivity disorder (ADHD) is a condition in which a person has trouble paying attention and focusing on tasks, tends to act without thinking, and has trouble sitting still. It may begin in early childhood and can continue into adulthood. Without treatment, ADHD can cause problems at home, school, work, and with relationships. In the past, ADHD was called attention deficit disorder (ADD).

What causes ADHD?

The exact cause is not clear, but ADHD tends to run in families.

What are the symptoms?

The three types of ADHD symptoms include:

Trouble paying attention. People with ADHD are easily distracted and have a hard time focusing on any one task.
Trouble sitting still for even a short time. This is called hyperactivity. Children with ADHD may squirm, fidget, or run around at the wrong times. Teens and adults often feel restless and fidgety and are not able to enjoy reading or other quiet activities.
Acting before thinking. People with ADHD may talk too loud, laugh too loud, or become angrier than the situation calls for. Children may not be able to wait for their turn or to share. This makes it hard for them to play with other children. Teens and adults seem to "leap before they look." They may make quick decisions that have a long-term impact on their lives. They may spend too much money or change jobs often.

How is ADHD diagnosed?

ADHD is often diagnosed when a child is between 6 and 12 years old. Teachers may notice symptoms in children who are in this age group.

First, the child will have a physical exam to make sure that he or she does not have other problems such as learning disabilities, depression, or anxiety disorder. The doctor will use guidelines from the American Psychiatric Association to diagnose ADHD. The doctor may also look at written reports about the child’s behavior. Parents, teachers, and others who have regular contact with the child prepare these reports.

How is it treated?

There is no cure for ADHD, but treatment may help control the symptoms. Treatment may include medicines and behavior therapy. Parents and other adults need to closely watch children after they begin to take medicines for ADHD. The medicines may cause side effects such as loss of appetite, headaches or stomachaches, tics or twitches, and problems sleeping. Side effects usually get better after a few weeks. If they don't, the doctor can lower the dose.

Therapy focuses on making changes in the environment to improve the child’s behavior. Often, counseling and extra support at home and at school help children succeed at school and feel better about themselves.

How does ADHD affect adults?

Many adults don't realize that they have ADHD until their children are diagnosed. Then they begin to notice their own symptoms. Adults with ADHD may find it hard to focus, organize, and finish tasks. They often forget things. But they also often are very creative and curious. They love to ask questions and keep learning. Some adults with ADHD learn to manage their lives and find careers that let them use those strengths.

But many adults have trouble at home and work. As a group, adults with ADHD have higher divorce rates. They also are more likely to smoke and have more substance abuse problems than adults without ADHD. Fewer adults with ADHD enter college, and fewer graduate. Treatment with medicine, counseling, and behavior therapy can help adults with ADHD.

Acne Vulgaris

2009-02-23T02:38:00.000-08:00

What is acne vulgaris?

Acne vulgaris, or acne, is a skin problem that starts when oil and dead skin cells clog up your pores. Some people call it blackheads, blemishes, whiteheads, pimples, or zits. When you have just a few red spots, or pimples, you have a mild form of acne. Severe acne can mean hundreds of pimples that can cover the face, neck, chest, and back. Or, it can be bigger, solid, red lumps that are painful (cysts).

Most young people get at least mild acne. It usually gets better after the teen years. But many adult women do have acne in the days before their menstrual periods.

How you feel about your acne may not be related to how bad it is. Some people with severe acne are not bothered by it. Others are embarrassed or upset even though they have only a few pimples.

The good news is that there are many good treatments that can help you get acne under control.

What causes acne?

Acne starts when oil and dead skin cells clog the skin's pores. If germs get into the pores, the result can be swelling, redness, and pus. See a picture of how pimples form .

For most people, acne starts during the teen years. This is because hormone changes make the skin more oily after puberty starts.

You do not get acne from eating chocolate or greasy foods. But you can make it worse by using oily skin products that clog your pores.

Acne can run in families. If one of your parents had severe acne, you are more likely to have it.

What are the symptoms?

Symptoms of acne include whiteheads, blackheads, and pimples. These can occur on the face, neck, shoulders, back, or chest. Pimples that are large and deep are called cystic lesions. These can be painful if they get infected. They also can scar the skin.

How is acne treated?

To help control acne, keep your skin clean. Avoid skin products that clog your pores. Look for products that say "noncomedogenic" on the label. Wash your skin once or twice a day with a gentle soap or acne wash. Try not to scrub or pick at your pimples. This can make them worse and can cause scars.

If you have just a few pimples to treat, you can get an acne cream without a prescription. Look for one that has benzoyl peroxide or salicylic acid. These work best when used just the way the label says.

It can take time to get acne under control. Keep using the same treatment for 6 to 8 weeks. You may even notice that it gets worse before it gets better. If your skin is not better after 8 weeks, try another product.

If your pimples are really bothering you or are scarring your skin, see your doctor. A prescription gel or cream for your skin may be all you need. Your doctor may also order antibiotic pills. A mix of treatments may work best. If you are female, taking certain birth control pills may help.

If you have acne cysts, talk to your doctor about stronger medicine. Isotretinoin (such as Accutane) works very well, but it can cause birth defects. And using Accutane may be associated with depression. Let your doctor know if you have had depression before taking this medicine. And if you are female, you must protect against pregnancy by using two forms of birth control. Even one dose of this medicine can cause birth defects if a woman takes it while she is pregnant. You cannot take isotretinoin if you are breast-feeding.

What can be done about acne scars?

There are skin treatments that can help acne scars look better and feel smoother. Ask your doctor about them. The best treatment for you depends on how severe the scarring is. You can have scar tissue removed or have a shot of collagen. Collagen smoothes a pitted scar by plumping up the skin underneath. You may get the best results with a combination of treatments.

Skin Cancer, Melanoma

2009-02-23T02:35:00.000-08:00

What is melanoma?

Melanoma is a kind of skin cancer. It is not as common as other types of skin cancer, but it is the most serious.

Melanoma can affect your skin only, or it may spread to your organs and bones. Luckily, it can be cured if it’s found and treated early.

What causes melanoma?

You can get melanoma by spending too much time in the sun. This causes normal skin cells to become abnormal. These abnormal cells quickly grow out of control and attack the tissues around them.

Melanoma tends to run in families. Other things in your family background can increase your chances of getting the disease. For example, you may have abnormal, or atypical, moles. Atypical moles may fade into the skin and have a flat part that is level with the skin. They may be smooth or slightly scaly, or they may look rough and “pebbly.” These moles don't cause cancer by themselves. But having many of them is a sign that melanoma may run in your family.

What are the symptoms?

The main sign of melanoma is a change in a mole or other skin growth, such as a birthmark. Any change in the shape, size, or color of a mole may be a sign of melanoma.

Melanoma may grow in a mole or birthmark that you already have. But melanomas usually grow in unmarked skin. They can be found anywhere on your body. Most of the time, they are on the upper back in men and women and on the legs of women.

Melanoma looks like a flat, brown or black mole that has uneven edges. Melanomas usually have an irregular or asymmetrical shape. This means that one half of the mole doesn't match the other half. Melanoma moles or marks can be 6 mm (0.2 in.) or larger.

Unlike a normal mole or mark, a melanoma can:

Change color.
Be lumpy or rounded.
Become crusty, ooze, or bleed.

How is melanoma diagnosed?

Your doctor will check your skin to look for melanoma. If your doctor thinks you have melanoma, he or she will remove a sample of tissue from the area around the melanoma (biopsy). Another doctor, called a pathologist, will look at the tissue to check for cancer cells.

If your biopsy shows melanoma, you may need to have more tests to find out if it has spread to your lymph nodes.

How is it treated?

The most common treatment is surgery to remove the melanoma. That is all the treatment that you may need for early-stage melanomas that have not spread to other parts of your body.

Depending on where the melanoma is on your body, and how thick it is, the surgery to remove it may leave a scar. You might need another surgery to repair this scar.

After surgery, your doctor will want to see you every 3 to 6 months for the next 5 years. During these visits, your doctor will check to see if the cancer has returned and if you have any new melanomas.

If your melanoma is very deep or has spread to your lymph nodes, you may need medicine called interferon to fight the cancer cells.

Can you prevent melanoma?

The best way to prevent all kinds of skin cancer, including melanoma, is to protect yourself whenever you are out in the sun. It’s important to avoid exposure to the sun’s ultraviolet (UV) rays.

Try to stay out of the sun during the middle of the day (from 10 a.m. to 4 p.m.).
Wear protective clothes when you are outside, such as a hat that shades your face, a long-sleeved shirt, and long pants.
Get in the habit of using sunscreen every day. Your sunscreen should have an SPF of least 15. Look for a sunscreen that protects against both types of UV radiation in the sun's rays—UVA and UVB.
Use a higher SPF when you are at higher elevations.
Avoid sunbathing and tanning salons.

Check your skin every month for odd marks, moles, or sores that will not heal. Pay extra attention to areas that get a lot of sun, such as your hands, arms, and back. Ask your doctor to check your skin during regular physical exams or at least once a year. Even though the biggest cause of melanoma is spending too much time in the sun, it can be found on parts of your body that never see the sun.

Healing Touch

2009-02-23T02:32:00.000-08:00

What is healing touch?

Healing touch influences a person's physical or emotional health without anyone physically touching the person. Healing touch is a common practice. Healing touch is related to spiritual or energy healing, therapeutic touch, and distant healing.

In the 1970s, nurses developed a specific form of healing touch called therapeutic touch to provide a more holistic (viewing the body and mind as a whole, not as individual components), compassionate approach to healing. Many nursing schools in the United States teach therapeutic touch, and it is often used in conventional medical settings (for example, before and after surgery) to help comfort patients.

Central to healing touch is the belief that a vital energy or life force flows freely through space and sustains all living organisms. In a healthy person, this energy is thought to flow in and out of the body in a balanced way. It is believed that illness results when the energy flow is out of balance.

Practitioners of healing touch use their hands in an attempt to change a person's energy flow and restore health. Healing touch does not require contact between the practitioner and the person during treatment. The practitioner moves his or her hands several inches above the person's body.

Like other complementary medicines, healing touch starts with the idea that people are naturally healthy. The way people live and think may disturb their natural energy, and they may become ill. The aim of healing touch is to focus (or channel) healing energy to restore natural health.

What is healing touch used for?

People use healing touch to help treat many diseases. Supporters of healing touch believe it is especially helpful for healing wounds, curing infections, and relieving pain and anxiety. Some research studies have shown that, like yoga and meditation, healing touch reduces anxiety and stress.

Little research has been done on the effects of healing touch, and it is a difficult form of therapy to study using traditional scientific techniques. But some studies on distant healing show benefits.

Is healing touch safe?

You can safely use healing touch along with conventional medical treatments, but it is not considered appropriate or safe for serious, life-threatening situations or to replace other proven treatments that are known to help with a disease. There is no known risk in adding healing touch or distant healing to your medical treatment.

Always tell your doctor if you are using an alternative therapy or if you are thinking about combining an alternative therapy with your conventional medical treatment. It may not be safe to forgo your conventional medical treatment and rely only on an alternative therapy.

Complementary Medicine

2009-02-23T02:29:00.001-08:00

What is complementary medicine?

Complementary medicine is a term used for a wide variety of health care practices that may be used along with standard medical treatment.

People often use yoga, meditation, and other complementary practices to improve wellness and quality of life. But in recent years, more people in the United States have been turning to complementary medicine to help treat a wide range of conditions from hot flashes to high blood pressure. Other examples of complementary medicine include acupuncture, herbal remedies, naturopathic medicine, massage therapy, and light therapy.

Is research being done on complementary medicine?

Even though most complementary therapies and medicines have been in use for hundreds or even thousands of years, many have not been subject to the same rigorous scientific testing for safety and effectiveness that standard medical treatments go through before they are approved in the United States. In many cases, the very nature of a complementary therapy, such as music therapy or prayer, can make it difficult or impossible to evaluate by the same scientific methods or criteria.

But more research is being done on complementary therapies. The National Center for Complementary and Alternative Medicine (NCCAM) and other offices of the National Institutes of Health provide information to the public and to health professionals on the use and effectiveness of complementary medicine therapies. NCCAM's goal is to develop guidelines to help people choose safe and appropriate alternative and complementary therapies.

Should I use complementary medicine?

Before you use complementary medicine, think about what motivates you. Why are you considering complementary medicine? Are you looking for a cure? Or are you looking for greater comfort and improved quality of life? Seeking a "cure" through complementary medicine alone can be disappointing. Set realistic expectations, and beware of false or exaggerated claims. Many complementary therapies can improve health and quality of life, but if a medicine or therapy sounds too good to be true, it probably is.

Choose a primary doctor who is open-minded about using complementary medicine. Consult your primary doctor for help in making decisions about using complementary therapies.

What are the risks of complementary medicine?

Even though facilities, medicines, and practitioners of conventional medicine are closely monitored and regulated in the United States, complementary medicines and therapies may be subject to less testing and regulation. Many practitioners of complementary therapies are extensively educated in their field, but depending on where they practice, it may be difficult to know whether practitioners are experts in their fields.

One risk involved with using alternative medicine is that you might miss a necessary or possibly lifesaving treatment. For example, you might try to treat cancer with an unproven complementary therapy instead of using a conventional treatment such as surgery or chemotherapy that is known to help. It is always best to get as much information as possible—on both complementary and conventional treatments—and then discuss your options with a doctor who is open to discussing them.

It is also important to remember that just because a product is natural does not mean it is harmless. There have been a few serious problems—and, in some cases, deaths—resulting from taking complementary medicines. Also, some complementary therapies have the potential for dangerous interactions with conventional therapies. Be sure to tell your doctor about any complementary therapies you are using or are thinking of using.

What are the benefits of complementary medicine?

Some complementary therapies work as well as conventional therapies. They often cost less and have fewer side effects. For example, acupuncture can reduce arthritis pain with fewer side effects than medicines, and St. John's wort has recently been shown to treat mild to moderate depression as well as a commonly prescribed antidepressant medicine while causing fewer side effects.

Another benefit of complementary medicine is in the more holistic, "whole person" approach of many of its practitioners. Most complementary medicine practitioners and many medical doctors use this approach, which considers your lifestyle, background, and habits, in addition to your physical health. It provides a more complete health picture and more effective way to treat many diseases. This personal approach makes many people feel better about their practitioner, their treatment, and their medical condition.

A person who uses a complementary therapy often benefits from a sense of empowerment. In seeking care outside conventional medicine, you are taking a more active role in your health care that can make you feel more in control of your health.

Science has shown that your emotional state can affect your health. Many people respond well to complementary treatments because they often address your sense of well-being as well as the condition itself.

Chinese Medicine

2009-02-23T02:26:00.001-08:00

What is Chinese medicine?

Chinese medicine is a system of medicine partly based on the idea that an energy, called qi (pronounced "chee"), flows along pathways in the body called meridians. In this belief, if the flow of qi along these meridians is blocked or unbalanced, illness can occur. In China, doctors have practiced Chinese medicine for thousands of years, and it is gaining in popularity in many Western countries.

Causes of qi imbalance are thought to involve:

External forces, such as wind, cold, or heat.
Internal forces, such as emotions of joy, anger, or fear.
Lifestyle factors, such as poor diet, too little sleep, or too much alcohol.

Another important concept in Chinese medicine is the concept of yin and yang. In this approach, all things, including the body, are composed of opposing forces called yin and yang. Health is said to depend on the balance of these forces. Chinese medicine focuses on maintaining the yin-yang balance to maintain health and prevent illness.

Chinese medicine doctors look at the balance of body, mind, and spirit to determine how to restore qi, the yin-yang balance, and good health.

What is Chinese medicine used for?

People use Chinese medicine to treat many illnesses from asthma and allergies to cancer and infertility. Chinese doctors may use several types of treatment to restore qi balance.

Chinese medicine therapies include:

Acupuncture, which uses thin metal needles placed along the body's meridians.
Acupressure, which uses the hands or fingers to apply direct pressure to points along the body's meridians.
Chinese herbs, combinations of herbs, roots, powders, or animal substances to help restore balance in the body.
Cupping, which uses warm air in glass jars to create suction placed on areas of the body to help stimulate qi.
Diet. Yin and yang foods can help restore the yin-yang balance in the body.
Massage (tui na) on specific areas of the body or along the body's meridians.
Moxibustion, which uses small amounts of heated plant fiber (moxa, or Chinese mugwort) on specific areas of the body.
Qi gong, which uses movement, breathing techniques, and meditation.

Is Chinese medicine safe?

Research in China and worldwide has shown Chinese medicine to be helpful for many types of illness. Because Chinese medicine differs from Western medical practice in diagnosis and treatment methods, it is difficult to apply Western scientific standards to it.

For example, in Western medical practice, any two people with a similar infection (such as an sinusitis) may be treated with a standard course of antibiotics. In Chinese medicine, each person might receive a different treatment for the same illness depending on the person's own qi and yin-yang balance.

The United States accredits schools in Chinese medicine, so a practitioner certified by an accredited school has had extensive training in Chinese medicine.

The National Institutes of Health, through the National Center for Complementary and Alternative Medicine (NCCAM) and other institutes, funds ongoing research of many complementary therapies to determine their benefits and risks. Acupuncture has been the most studied of Chinese medicine treatments and has become accepted as a therapy for certain conditions in the United States. Promising results have been found for the use of acupuncture in treating nausea and vomiting related to chemotherapy, postsurgery pain, and pregnancy. Acupuncture also may be useful for other conditions such as addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma. In general, acupuncture is safe when done by a certified acupuncturist, but the treatment can be expensive and time-consuming.

Like conventional medications, Chinese herbal medications may also cause side effects, trigger allergic reactions, or interact with other prescription and nonprescription medications or herbs. Before you use any Chinese therapies, be sure to tell your health professional about any prescription, nonprescription, or other natural supplements you are taking.

Aromatherapy (Essential Oils Therapy)

2009-02-23T02:16:00.000-08:00

What is aromatherapy?

Aromatherapy, or essential oils therapy, is using a plant's aroma-producing oils (essential oils) to treat disease. Essential oils are taken from a plant's flowers, leaves, stalks, bark, rind, or roots. The oils are mixed with another substance (such as oil, alcohol, or lotion) and then put on the skin, sprayed in the air, or inhaled. You can also massage the oils into the skin or pour them into bath water. Aromatherapy as used today originated in Europe and has been practiced there since the early 1900s.

Practitioners of aromatherapy believe that fragrances in the oils stimulate nerves in the nose. Those nerves send impulses to the part of the brain that controls memory and emotion. Depending on the type of oil, the result on the body may be calming or stimulating.

The oils are thought to interact with the body's hormones and enzymes to cause changes in blood pressure, pulse, and other body functions. Another theory suggests that the fragrance of certain oils may stimulate the body to produce pain-fighting substances.

What is aromatherapy used for?

Aromatherapy may promote relaxation and help relieve stress. It has also been used to help treat a wide range of physical and mental conditions, including burns, infections, depression, insomnia, and high blood pressure. But so far there is limited scientific evidence to support claims that aromatherapy effectively prevents or cures illness.

Is aromatherapy safe?

Practitioners of aromatherapy are not specially licensed in the United States. A wide range of licensed health professionals (such as massage therapists, nurses, and counselors) may have experience and training in aromatherapy. It is important to talk with your medical doctor to see whether aromatherapy may be helpful and safe for your specific health condition.

Do not swallow the oils used in aromatherapy. Many of the oils are potent and can be dangerous if taken internally (swallowed).

Children younger than age 5 should not use aromatherapy, because they can be very sensitive to the oil. Nor should anyone use oils near the eyes or mouth, because irritation of the skin and membranes may occur.

People with certain chronic illnesses or conditions should not use aromatherapy without first consulting a doctor. These illnesses and conditions include:

Lung conditions such as asthma, respiratory allergies, or chronic lung disease. Oils may cause airway spasms.
Skin allergies. Some oils may cause skin irritation, especially in the membranes of the eyes, nose, and mouth.
Pregnancy. Pregnant women should not use aromatherapy. Some oils (such as juniper, rosemary, and sage) may cause uterine contractions.

Ayurveda

2009-02-23T02:12:00.000-08:00

What is ayurveda?

Ayurveda, or ayurvedic medicine, is a healthy-lifestyle system that people in India have used for more than 5,000 years. Ayurveda emphasizes good health and prevention of illness through lifestyle practices (such as massage, meditation, yoga, and dietary changes) and the use of herbal remedies.

Ayurvedic medicine is holistic, which means viewing the body and mind as a whole. Ayurveda not only treats a person's physical complaints, but it also changes lifestyle practices to help maintain or improve health.

According to ayurveda, the five elements of nature (space, air, fire, water, earth) combine in the body as three components (doshas) known as Vatta, Pitta, and Kapha. These doshas relate closely to the basic elements of nature and to specific functions of the body. A balance of these doshas is thought to be required for optimal health.

Air and space represent Vatta. Vatta controls muscle and joint movement, breathing, and heartbeat. Also, Vatta controls anxiety, fear, pain, and other functions of the nervous system.
Fire and water represent Pitta, which is thought to control such bodily functions as digestion, metabolism, intelligence, and skin color. Pitta governs the emotions of anger, hate, and jealousy.
Earth and water represent Kapha. The physical structure of the body and the immune system are governed by Kapha. Emotional responses thought to be controlled by Kapha include calmness, forgiveness, love, and greed.

The doshas, which are determined at the time of conception, also relate to an individual's physical makeup and personality. A person with a Vatta makeup tends to have a small, thin build. The Pitta body style is more of a medium, muscular build. The Kapha appearance is usually bigger and well-developed. Most people are considered to have a combination of doshas, with one type usually being predominant.

In ayurvedic medicine, it is thought that if an imbalance occurs in any of the three doshas, illness results. Ayurvedic medicine treats illness through a variety of means, including dietary changes, herbal remedies, and exercise. According to the ayurvedic philosophy, you can also use yoga, meditation, or counseling to treat disease.

What is ayurveda used for?

People use ayurvedic practices to maintain health, reduce stress, and improve flexibility, strength, and stamina. Researchers have found that yoga and meditation can be effective ways to treat diseases such as asthma, high blood pressure, and arthritis.

Ayurveda stresses proper diet for maintaining good health and treating disease. Herbal medicines are prescribed based on the person's dosha type.

Researchers are studying the effects of ayurvedic herbal medicines on various long-term (chronic) illnesses.

Is ayurveda safe?

Ayurvedic practices such as yoga and meditation can be safe ways to promote health. If you have a long-term illness, you may be able to combine ayurveda with conventional medical treatment.

Ayurvedic herbal medications, like conventional medications, may cause side effects, trigger allergic reactions, or interact with other medications or herbs you are taking. Some ayurvedic medications may contain high levels of heavy metals. A study found that about 1 in 5 ayurvedic medicine products available in grocery stores in the Boston area contained potentially harmful levels of lead and other heavy metals.¹ Be sure to tell your doctor about all herbs and natural supplements that you are taking. If you have taken ayurvedic medicine products, ask your doctor about screening for heavy metals.

Naturopathic Medicine

2009-02-23T02:11:00.000-08:00

What is naturopathic medicine?

Naturopathic medicine (or naturopathy) is based on the belief that the body can heal itself naturally. Naturopathic medicine attempts to improve health, prevent disease, and treat illness by promoting the use of organic foods and exercise; encouraging a healthy, balanced lifestyle; and applying concepts and treatments from other areas of complementary medicine (such as ayurveda, homeopathy, and herbal therapies).

Naturopathy was developed in the late 1800s in the United States. Today, a licensed naturopathic doctor (ND) attends a 4-year, graduate-level naturopathic medical school and studies the same basic sciences as a medical doctor (MD). However, the ND also studies alternative approaches to therapy, such as herbal medicine, acupuncture, and bodywork.

Most traditional naturopathic physicians (naturopaths) believe in natural therapies, such as nutritional and lifestyle counseling. They generally avoid prescribing medicines or performing surgery. Some naturopaths prescribe herbal medicines, homeopathic dilutions, nutritional supplements, or perform minor surgeries. The disagreement over specific practice guidelines and licensing requirements in different states has led to some public confusion about the role of the naturopath.

What is naturopathy used for?

People use naturopathic medicine for promoting good health, preventing disease, and treating illness. Most naturopaths can treat earaches, allergies, and other common medical problems. Naturopathic medicine tries to find the underlying cause of the condition rather than focusing solely on treating symptoms. A properly trained naturopathic physician works with other health professionals, referring people to other practitioners for diagnosis or treatment when appropriate.

Is naturopathy safe?

Two common concerns about naturopathic medicine are the use of dietary fasting and a bias against immunization (vaccinations).

Talk with your medical doctor before fasting (not eating or drinking, or consuming only liquids for a period of time). Fasting can be dangerous, especially if you have a disease such as diabetes.
Some naturopaths do not believe that immunization is necessary. Before immunizations became available, childhood illnesses caused large numbers of deaths and long-term health problems but provided survivors with natural immunity. The benefits of immunization greatly outweigh the risks.¹

Naturopathy licensing varies from state to state. Not all states require naturopaths to be licensed. Also, not all naturopathic educational programs are the same. Some schools grant degrees that are not accepted by state licensing boards. In the United States, the Council on Naturopathic Medical Education (CNME) is the only agency recognized by the U.S. Department of Education to accredit naturopathic programs and colleges.

Before you choose a naturopath, find out whether the person graduated from an accredited college. Also check to see whether your state has licensing laws that govern the practice of NDs. If your state licenses NDs, ask your prospective ND whether he or she is licensed.

Allergy medications

2009-02-23T02:08:00.000-08:00

Because you can't always avoid allergy triggers, you may need medication to help alleviate allergy symptoms.

Allergy medications are available in pill, liquid, nasal spray, eyedrop and skin cream (topical) forms. Some are available over-the-counter while others are available by prescription only.

The best medication or combination of medications for you depends on your symptoms, what other health conditions you have and what other medications you take. Certain allergy medications work better for some people than others. You may need to try a few different medications to determine which ones are most effective and have the least bothersome side effects.

To choose the best allergy medications for you, learn what's available to treat your symptoms — and work with your doctor to figure out what medications is best for you.

Options for allergy medications

There are several types of medications used to treat and prevent allergy symptoms. Medications are available in pill and liquid forms, nasal sprays, eyedrops and skin creams.

Corticosteroids help prevent and treat the inflammation associated with allergic conditions.
Antihistamines block histamine, an inflammatory chemical released by your immune system during an allergic reaction.
Decongestants relieve nasal and sinus congestion.
Leukotriene modifiers block the effects of leukotrienes, inflammatory chemicals released by your immune system during an allergic reaction.
Cromolyn sodium prevents the release of histamine, an inflammatory chemical released by your immune system during an allergic reaction.

Corticosteroids

Type	Purpose	Side effects
Nasal sprays Examples include: Beclomethasone (Beconase) Fluticasone (Flonase) Triamcinolone (Nasacort) Budesonide (Rhinocort) Flunisolide (Nasarel) Mometasone (Nasonex)	These prescription medications prevent and relieve allergy symptoms such as nasal stuffiness, sneezing, and itchy, runny nose. For many people, these nasal sprays are the most effective treatment for allergy symptoms caused by hay fever or pets. It may take a few days or longer of regular use before your symptoms improve. Nasal corticosteroids are generally safe for extended use.	Mild side effects can include: Unpleasant smell or taste Irritation, especially during the winter Crusting and nosebleeds, especially in the winter
Eyedrops Examples include: Dexamethasone (Decadron, Maxidex, others) Fluorometholone (FML, Fluor-Op, others) Prednisolone (Pred Forte, Econopred, others)	Corticosteroid eyedrops are prescription medications used to treat severe allergy symptoms such as red, watery and itchy eyes caused by hay fever and allergic conjunctivitis. They are used for only a short period of time when other types of eyedrops don't work. You may be advised to avoid these medications if you are pregnant or plan to become pregnant.	These medications can cause: Blurred vision and other mild side effects Increased risk of eye infections, glaucoma and cataracts with prolonged use
Skin creams Examples include: Hydrocortisone (Cortaid, Ala-cort, others) Triamcinolone (Triderm, Kenalog, others)	These medications relieve the scaling and itching caused by eczema (atopic dermatitis). Some low-potency corticosteroid creams are available without a prescription, but you should always talk to your doctor before using any topical corticosteroid.	Side effects can include: Skin irritation Skin discoloration
Pills and liquids Examples include: Prednisone (Prednisone, Prednisone Intensol, others) Prednisolone (Prednisolone, Prelone, others)	Oral corticosteroids are sometimes used to treat severe allergy symptoms. Because they can cause serious side effects, they're usually prescribed for only short periods of time.	Long-term use of these medications can cause serious side effects such as: Cataracts Osteoporosis Muscle weakness

Type

Purpose

Side effects

Nasal sprays

Examples include:

Beclomethasone (Beconase)
Fluticasone (Flonase)
Triamcinolone (Nasacort)
Budesonide (Rhinocort)
Flunisolide (Nasarel)
Mometasone (Nasonex)

These prescription medications prevent and relieve allergy symptoms such as nasal stuffiness, sneezing, and itchy, runny nose. For many people, these nasal sprays are the most effective treatment for allergy symptoms caused by hay fever or pets.

It may take a few days or longer of regular use before your symptoms improve. Nasal corticosteroids are generally safe for extended use.

Mild side effects can include:

Unpleasant smell or taste
Irritation, especially during the winter
Crusting and nosebleeds, especially in the winter

Eyedrops

Examples include:

Dexamethasone (Decadron, Maxidex, others)
Fluorometholone (FML, Fluor-Op, others)
Prednisolone (Pred Forte, Econopred, others)

Corticosteroid eyedrops are prescription medications used to treat severe allergy symptoms such as red, watery and itchy eyes caused by hay fever and allergic conjunctivitis. They are used for only a short period of time when other types of eyedrops don't work.

You may be advised to avoid these medications if you are pregnant or plan to become pregnant.

These medications can cause:

Blurred vision and other mild side effects
Increased risk of eye infections, glaucoma and cataracts with prolonged use

Skin creams

Examples include:

Hydrocortisone (Cortaid, Ala-cort, others)
Triamcinolone (Triderm, Kenalog, others)

These medications relieve the scaling and itching caused by eczema (atopic dermatitis). Some low-potency corticosteroid creams are available without a prescription, but you should always talk to your doctor before using any topical corticosteroid.

Side effects can include:

Skin irritation
Skin discoloration

Pills and liquids

Examples include:

Prednisone (Prednisone, Prednisone Intensol, others)
Prednisolone (Prednisolone, Prelone, others)

Oral corticosteroids are sometimes used to treat severe allergy symptoms. Because they can cause serious side effects, they're usually prescribed for only short periods of time.

Long-term use of these medications can cause serious side effects such as:

Cataracts
Osteoporosis
Muscle weakness

Antihistamines

Type	Purpose	Side effects
Oral Over-the-counter examples include: Loratadine (Claritin) Diphenhydramine (Benadryl) Chlorpheniramine (Chlor-Trimeton) Clemastine (Tavist) Prescription examples include: Fexofenadine (Allegra) Cetirizine (Zyrtec)	Antihistamines block the action of histamine, an inflammatory chemical released by your immune system during an allergic reaction. Blocking histamine reduces such symptoms as redness, swelling, runny nose, itchy, watery eyes, and hives (urticaria).	Older, first-generation antihistamines such as diphenhydramine (Benadryl), chlorpheniramine (Chlor-Trimeton) and clemastine (Tavist) may make you sleepy. Avoid using them before driving or operating heavy machinery. Cetirizine (Zyrtec) may cause drowsiness in some people.
Nasal spray Examples include: Azelastine (Astelin)	This prescription medication helps relieve allergy symptoms such as sneezing, itchy or runny nose, sinus congestion, and postnasal drip.	Side effects of this medication can include: Bitter taste Dizziness, drowsiness or fatigue Dry mouth Headache Nasal burning or nosebleed Nausea Runny nose or sore throat Sneezing
Eyedrops Over-the-counter examples include: Naphazoline (Visine-A, Opcon-A, others) Prescription examples include: Naphazoline (Albalon, others) Emedastine (Emadine) Olopatadine (Patanol, others)	Antihistamine eyedrops can reduce itching, redness and swelling associated with allergies. You may need to use these medications several times a day, as the effects may last only a few hours.	Side effects of these medications can include: Red eyes Watering eyes Headache Mild stinging or burning Antihistamine eyedrops increase the risk of eye inflammation for contact lens wearers, so you're safer wearing glasses during treatment.

Type

Purpose

Side effects

Oral

Over-the-counter examples include:

Loratadine (Claritin)
Diphenhydramine (Benadryl)
Chlorpheniramine (Chlor-Trimeton)
Clemastine (Tavist)

Prescription examples include:

Fexofenadine (Allegra)
Cetirizine (Zyrtec)

Antihistamines block the action of histamine, an inflammatory chemical released by your immune system during an allergic reaction.

Blocking histamine reduces such symptoms as redness, swelling, runny nose, itchy, watery eyes, and hives (urticaria).

Older, first-generation antihistamines such as diphenhydramine (Benadryl), chlorpheniramine (Chlor-Trimeton) and clemastine (Tavist) may make you sleepy. Avoid using them before driving or operating heavy machinery.

Cetirizine (Zyrtec) may cause drowsiness in some people.

Nasal spray

Examples include:

Azelastine (Astelin)

This prescription medication helps relieve allergy symptoms such as sneezing, itchy or runny nose, sinus congestion, and postnasal drip.

Side effects of this medication can include:

Bitter taste
Dizziness, drowsiness or fatigue
Dry mouth
Headache
Nasal burning or nosebleed
Nausea
Runny nose or sore throat
Sneezing

Eyedrops

Over-the-counter examples include:

Naphazoline (Visine-A, Opcon-A, others)

Prescription examples include:

Naphazoline (Albalon, others)
Emedastine (Emadine)
Olopatadine (Patanol, others)

Antihistamine eyedrops can reduce itching, redness and swelling associated with allergies. You may need to use these medications several times a day, as the effects may last only a few hours.

Side effects of these medications can include:

Red eyes
Watering eyes
Headache
Mild stinging or burning

Antihistamine eyedrops increase the risk of eye inflammation for contact lens wearers, so you're safer wearing glasses during treatment.

Decongestants

Type	Purpose	Side effects
Pills and liquids Examples include: Pseudoephedrine (Sudafed, others) Promethazine (Phenergan, others) Many medications contain a decongestant such as pseudoephedrine combined with other medications. Claritin-D, for example, contains pseudoephedrine and an antihistamine.	Decongestants relieve nasal and sinus congestion caused by hay fever, as well as eye congestion caused by allergic conjunctivitis. Most decongestants are available over-the-counter. You should not use these medications if you have high blood pressure (hypertension).	Side effects of these medications can include: Lightheadedness Insomnia Nervousness Increased blood pressure Increased heart rate Irregular heart beat Worsening of prostate enlargement symptoms
Nasal sprays Examples include: Phenylephrine (Neo-Synephrine, others) Oxymetazoline (Afrin, others)	Decongestant sprays relieve nasal, sinus and eye congestion. Don't use a decongestant nasal spray for more than two or three days at a time. After longer use, you may develop severe congestion as soon as you stop (rebound congestion).	Nasal decongestants can cause: Dryness Burning or stinging inside the nose Runny nose Sneezing Taking too much of a nasal decongestant may cause: Blurred vision Fast, irregular or pounding heartbeat Headache Dizziness or drowsiness Lightheadedness High blood pressure Nervousness Trembling or muscle weakness Insomnia
Eyedrops Examples include: Tetrahydrozoline (Visine, Murine Plus, others)	Over-the-counter decongestant eyedrops or combined decongestant-antihistamine eyedrops can temporarily alleviate symptoms such as redness and itchiness of the eye.	Side effects include: Persistent eye redness with overuse Damage to blood vessels in the eye when overused A type of sudden (acute) glaucoma (rare)

Type

Purpose

Side effects

Pills and liquids

Examples include:

Pseudoephedrine (Sudafed, others)
Promethazine (Phenergan, others)

Many medications contain a decongestant such as pseudoephedrine combined with other medications. Claritin-D, for example, contains pseudoephedrine and an antihistamine.

Decongestants relieve nasal and sinus congestion caused by hay fever, as well as eye congestion caused by allergic conjunctivitis. Most decongestants are available over-the-counter.

You should not use these medications if you have high blood pressure (hypertension).

Side effects of these medications can include:

Lightheadedness
Insomnia
Nervousness
Increased blood pressure
Increased heart rate
Irregular heart beat
Worsening of prostate enlargement symptoms

Nasal sprays

Examples include:

Phenylephrine (Neo-Synephrine, others)
Oxymetazoline (Afrin, others)

Decongestant sprays relieve nasal, sinus and eye congestion.

Don't use a decongestant nasal spray for more than two or three days at a time. After longer use, you may develop severe congestion as soon as you stop (rebound congestion).

Nasal decongestants can cause:

Dryness
Burning or stinging inside the nose
Runny nose
Sneezing

Taking too much of a nasal decongestant may cause:

Blurred vision
Fast, irregular or pounding heartbeat
Headache
Dizziness or drowsiness
Lightheadedness
High blood pressure
Nervousness
Trembling or muscle weakness
Insomnia

Eyedrops

Examples include:

Tetrahydrozoline (Visine, Murine Plus, others)

Over-the-counter decongestant eyedrops or combined decongestant-antihistamine eyedrops can temporarily alleviate symptoms such as redness and itchiness of the eye.

Side effects include:

Persistent eye redness with overuse
Damage to blood vessels in the eye when overused
A type of sudden (acute) glaucoma (rare)

Leukotriene modifiers

Type	Purpose	Side effects
Pills and tablets Leukotriene modifiers are available only by prescription. They're produced in pill and chewable tablet form. Examples include: Montelukast (Singulair) Zileuton (Zyflo) Zafirlukast (Accolate)	These drugs block the effects of leukotrienes, inflammatory chemicals released by your immune system during an allergic reaction. Such medications have proved most effective in treating asthma, but montelukast also relieves hay fever symptoms.	Side effects differ for each type of leukotriene inhibitor, but can include: Cough Dizziness Headache Stomach upset or pain Stuffy nose Tiredness Insomnia Muscle weakness Liver damage (zileuton)

Type

Purpose

Side effects

Pills and tablets

Leukotriene modifiers are available only by prescription. They're produced in pill and chewable tablet form.

Examples include:

Montelukast (Singulair)
Zileuton (Zyflo)
Zafirlukast (Accolate)

These drugs block the effects of leukotrienes, inflammatory chemicals released by your immune system during an allergic reaction. Such medications have proved most effective in treating asthma, but montelukast also relieves hay fever symptoms.

Side effects differ for each type of leukotriene inhibitor, but can include:

Cough
Dizziness
Headache
Stomach upset or pain
Stuffy nose
Tiredness
Insomnia
Muscle weakness
Liver damage (zileuton)

Cromolyn and mast cell stabilizers

Type	Purpose	Side effects
Nasal spray Available over-the-counter, the nasal spray cromolyn sodium (examples include NasalCrom, Children's NasalCrom) works best when you take it before your symptoms develop. Some people need to use the spray three or four times a day.	Mast cell stabilizer nasal sprays prevent the release of the symptom-triggering chemical histamine. They reduce symptoms associated with hay fever and allergic conjunctivitis.	This medication can cause minor side effects, which include: Unpleasant taste Drowsiness Headache Nasal irritation Sneezing
Eyedrops Several different mast cell stabilizer eyedrops are available by prescription. None are sold over-the-counter. Examples include: Cromolyn sodium (Crolom) Lodoxamide (Alomide) Pemirolast (Alamast) Nedocromil (Alocril)	Mast cell stabilizer eyedrops prevent the release of the symptom-triggering chemical histamine. They reduce symptoms associated with hay fever and allergic conjunctivitis.	Cromolyn sodium and lodoxamide can cause: Burning or stinging eyes Rarely, other side effects Pemirolast may cause: Chills Coughing and sneezing Sore throat Nedocromil may cause side effects including: Blurred vision Changes in color vision Breathing problems or wheezing Insomnia Eye irritation or swelling Headache Increased sensitivity of eyes to sunlight Nasal congestion

Type

Purpose

Side effects

Nasal spray

Available over-the-counter, the nasal spray cromolyn sodium (examples include NasalCrom, Children's NasalCrom) works best when you take it before your symptoms develop. Some people need to use the spray three or four times a day.

Mast cell stabilizer nasal sprays prevent the release of the symptom-triggering chemical histamine. They reduce symptoms associated with hay fever and allergic conjunctivitis.

This medication can cause minor side effects, which include:

Unpleasant taste
Drowsiness
Headache
Nasal irritation
Sneezing

Eyedrops

Several different mast cell stabilizer eyedrops are available by prescription. None are sold over-the-counter.

Examples include:

Cromolyn sodium (Crolom)
Lodoxamide (Alomide)
Pemirolast (Alamast)
Nedocromil (Alocril)

Mast cell stabilizer eyedrops prevent the release of the symptom-triggering chemical histamine. They reduce symptoms associated with hay fever and allergic conjunctivitis.

Cromolyn sodium and lodoxamide can cause:

Burning or stinging eyes
Rarely, other side effects

Pemirolast may cause:

Chills
Coughing and sneezing
Sore throat

Nedocromil may cause side effects including:

Blurred vision
Changes in color vision
Breathing problems or wheezing
Insomnia
Eye irritation or swelling
Headache
Increased sensitivity of eyes to sunlight
Nasal congestion

When allergies trigger asthma

If you have the type of asthma triggered by allergies, your doctor may recommend medications such as:

Inhaled corticosteroids
Leukotriene modifiers
Bronchodilators
Allergy desensitization shots (immunotherapy)

Omalizumab (Xolair), an anti-IgE monoclonal antibody, may help you if you have severe allergic asthma. Administered by injection every two to four weeks, omalizumab blocks the IgE antibodies that your immune system produces as a reaction to allergens such as pollen, dust mites or pet dander.

Immunotherapy: An option if medications are ineffective

If you have hay fever symptoms or allergic asthma that doesn't improve with medications or if you aren't able to take allergy medications without side effects, your doctor may recommend allergy shots (immunotherapy). Over a period of three to five years, you receive regular injections containing allergen extracts. The goal is to desensitize you to specific allergens and decrease or eliminate your need for medications.

Immunotherapy may be especially effective if you're allergic to cat dander, dust mites or pollen produced by trees, grass and weeds. In children with allergic rhinitis, immunotherapy may help prevent the development of asthma. Rarely, immunotherapy injections can cause a severe allergic reaction (anaphylaxis).

Injectable epinephrine: First aid for severe allergic reactions

If you're highly allergic to certain foods, such as peanuts, or to bee or wasp venom, you may be at risk of anaphylactic shock — a sudden, life-threatening allergic reaction. To be on the safe side, your doctor may suggest that you carry an injectable dose of epinephrine (adrenaline). Epinephrine can help slow the reaction while you seek emergency medical treatment. You may be able to administer the drug by yourself, after being taught how to use a self-injecting syringe and needle. A friend, family member or medical professional called in response to a severe anaphylactic reaction also may administer the medication.

Work with your doctor

By understanding how allergy medications work, you can work with your doctor to develop a treatment plan that's best for you. Before taking any medication — prescription or over-the-counter — be sure to tell your doctor if you are pregnant or breast-feeding, if you have any chronic health problems such as diabetes, glaucoma or high blood pressure, or if you're taking any other medications. This will help you avoid a drug interaction or other adverse effect.

Keep track of your symptoms, when you use your medications, and how much you use — that way you and your doctor can figure out what works best. It may not be possible for you to avoid allergy symptoms altogether — but working with your doctor to find the right medications can help.

Vaginal Yeast Infections

2009-02-23T01:59:00.001-08:00

Other problems (like bacterial vaginosis and trichomoniasis) can cause vaginal symptoms that may seem like a yeast infection. If you need help finding out which problem you have, see the Check Your Symptoms section of the topic Vaginal Problems.

What is a vaginal yeast infection?

Yeast is a fungus that normally lives in the vagina in small numbers. A vaginal yeast infection means that too many yeast cells are growing in the vagina. These infections are very common. Although they can bother you a lot, they are not usually serious. And treatment is simple.

What causes a vaginal yeast infection?

Most yeast infections are caused by a type of yeast called Candida albicans.

A healthy vagina has many bacteria and a small number of yeast cells. The most common bacteria, Lactobacillus acidophilus, help keep other organisms—like the yeast—under control.

When something happens to change the balance of these organisms, yeast can grow too much and cause symptoms. Taking antibiotics sometimes causes this imbalance. The high estrogen levels caused by pregnancy or hormone replacement therapy can also cause it. So can certain health problems, like diabetes or HIV infection.

What are the symptoms?

A yeast infection causes itching or soreness in the vagina and sometimes causes pain or burning when you urinate or have sex. Some women also have a thick, clumpy, white discharge that has no odor and looks a little like cottage cheese.

These symptoms are more likely to occur during the week before your menstrual period.

How is a vaginal yeast infection diagnosed?

It’s easy to guess wrong about a vaginal infection. See your doctor if you aren't sure what you have or if this is the first time you have had these symptoms. Also see your doctor if you are pregnant. Your doctor may want to do a vaginal exam.

How is it treated?

If you have had a yeast infection before and can recognize the symptoms, and you aren't pregnant, you can treat yourself at home with medicines you can buy without a prescription. You can use an antifungal cream, or a suppository that you put into your vagina, or antifungal tablets that you swallow.

If your symptoms are mild, you may want to wait to see if they clear up on their own.

Yeast infections are common during pregnancy. If you are pregnant, don't use medicine for a yeast infection without talking to your doctor first.

If you use a cream or suppository to treat the infection, don't depend on a condom or diaphragm for birth control. The oil in some medicines weakens latex, the material often used to make these devices.

Many women have infections that come back. If you have more than four yeast infections in a year, see your doctor. He or she may do some tests to see if your yeast infections are being caused by another health problem, such as diabetes.

Can vaginal yeast infections be prevented?

You can prevent yeast infections by making sure that your genital area stays as dry as possible and can “breathe.” For example:

Wear cotton, not nylon, underwear, and avoid tight-fitting pants and panty hose.
Change out of a wet swimsuit right away.
Avoid douches and feminine sprays, scented toilet paper, and deodorant tampons.

Alzheimer's Disease

2009-02-23T01:55:00.000-08:00

Alzheimer’s disease is the most common cause of mental decline, or dementia. But dementia also has many other causes. For more information, see the topic Dementia.

What is Alzheimer's disease?

Alzheimer's disease damages the brain. It causes a steady loss of memory and how well you can speak, think, and carry on daily activities.

Alzheimer's disease always gets worse over time, but how quickly this happens varies. Some people lose the ability to do daily activities early on. Others may still do fairly well until much later in the disease.

Mild memory loss is common in people older than 60. It may not mean that you have Alzheimer’s disease. But if your memory is getting worse, see your doctor. If it is Alzheimer’s, treatment may help.

What causes Alzheimer's disease?

Alzheimer’s disease happens because of changes in the brain. These include lower levels of chemical messengers (neurotransmitters) that help brain cells work properly. What causes these changes is not clear.

The risk of getting Alzheimer’s disease increases as you get older. But this does not mean that everyone will get it. By age 85, about 35 out of 100 of people have some form of dementia¹. That means 65 out 100 don't have it. Dementia is rare before age 60.

Having a relative with Alzheimer’s raises your risk of getting it, but most people with Alzheimer's disease do not have a family history of it.

What are the symptoms?

For most people, the first symptom of Alzheimer's disease is memory loss. Often the person who has a memory problem does not notice it, but family and friends do. But the person with the disease may also know that something is wrong.

As the disease gets worse, the person may:

Have trouble making decisions.
Be confused about what time and day it is.
Get lost in places he or she knows well.
Have trouble learning and remembering new information.
Have trouble finding the right words to say what he or she wants to say.
Have more trouble doing daily tasks like cooking a meal or paying bills.

The symptoms of Alzheimer’s get worse slowly over time. A person who gets these symptoms over a few hours or days or whose symptoms suddenly get worse needs to see a doctor right away, because there may be another problem.

As people with Alzheimer’s get worse, they may get restless and wander, especially in late afternoon and at night. This is called sundowning. Over time, they may also start to act very different. They may withdraw from family and friends. They may see or hear things that are not really there. They may falsely believe that others are lying, cheating, using them, or trying to harm them. They may strike out at others.

Later, they may not be able to take care of themselves. They may not know their loved ones when they see them. They may forget how to eat, dress, bathe, use the toilet, or get up from a bed or a chair and walk.

How is Alzheimer's disease diagnosed?

To check for the disease, your doctor will ask about your past health and do a physical exam. He or she may ask you to do some simple things that test your memory and other mental skills. Your doctor may also check how well you can do daily tasks.

The exam usually includes blood tests to look for another cause of your problems. You may have tests to look at a picture of your brain, such as CT and MRI scans. By themselves, these tests can't show for sure whether you have Alzheimer’s. But they may find small changes in the brain related to the disease.

How is it treated?

There is no cure for Alzheimer's disease, but there are medicines that may slow it down for a while and make it easier to live with. Drugs that may be prescribed include:

Medicines to help with memory and thinking problems, such as donepezil (Aricept).
Medicines to help with help with moderate to severe confusion and memory loss, such as memantine (Namenda).

These medicines may not work for everyone or have a big effect, but most experts think they are worth a try.

As the disease gets worse, the person may get depressed or angry and upset. The doctor may also prescribe medicines to help with these problems.

How can you help your loved one with Alzheimer's disease?

If you are or will be taking care of a loved one with Alzheimer’s, start learning what you can expect. This can help you make the most of the person's abilities as they change, and it can help you deal with new problems as they arise.

Work with your loved one to make decisions about the future before the disease gets worse. It is important to write a living will and a durable power of attorney. A living will states the types of medical care your loved one wants. A durable power of attorney lets your loved one pick someone to be his or her health care agent. This person makes care decisions when your loved one cannot.

Your loved one will need more and more care as the disease gets worse. In time, he or she may need help to eat, get dressed, or use the bathroom. You may be able to give this care at home, or you may want to think about using a nursing home. A nursing home can give this kind of care 24 hours a day. The time may come when a nursing home is the best choice.

Because people are living longer than they used to, Alzheimer's disease is becoming a more common problem. Ask your doctor about local resources such as support groups or other organizations that can help as you care for your loved one. You can also search the Internet for online support groups. Help is available.

Asthma

2009-01-25T21:21:00.001-08:00

What is asthma?

People with asthma have sensitive airways in their lungs. When exposed to certain triggers their airways narrow, making it hard for them to breathe.

Three main factors cause the airways to become narrow:

The inside lining of the airways becomes red and swollen (inflammation)
Extra mucous (sticky fluid) may be produced
The muscle around the airways tightens (bronchoconstriction)

Why do people get asthma in the first place?

The causes of asthma are not really understood but there is often a family history of asthma, eczema or hayfever. Asthma can begin at any age and change over time. Unborn babies whose mothers smoke during pregnancy, and children exposed to smoke in early childhood, have a higher risk of developing childhood asthma.

How do you recognise asthma?

A dry, irritating, persistent cough, particularly at night, early morning, with exercise or activity
Chest tightness
Shortness of breath
Wheeze

Asthma triggers

Colds and flu
Exposure to cigarette smoke
Exercise/activity
Inhaled allergens (e.g. pollens, moulds, animal dander and dust mites)
Environmental (e.g. dust, pollution, wood smoke, bush fires)
Changes in temperature and weather
Certain medications (e.g. aspirin)
Chemicals and strong smells (e.g. perfumes, cleaners)
Emotional factors (e.g. laughter, stress)
Some foods and food preservatives, flavourings and colourings (uncommon)

Figures

Today we live in a community where:

Over 2 million Australians have asthma.
Approximately 15% of children have currently diagnosed asthma (or one in six children have currently diagnosed asthma).
Approximately 11% of adults have currently diagnosed asthma (or one in ten adults have currently diagnosed asthma).
Indigenous Australians have more problems with asthma than other Australians.
The majority of people with asthma do not have a written asthma action plan.
Many people with asthma who could benefit by using regular preventer medication are not using it.
Asthma is one of the most common reasons for hospital admissions in children.
397 people died due to asthma in 2002.

Every person’s asthma is different. Not all people will have the same triggers, nor will they react to every trigger listed above. You may not always know what triggers your asthma. It is helpful to identify triggers in order to avoid them however this is not always possible (e.g. colds and flu).

Acupuncture Treatment

Acupuncture and Traditional Chinese Medicine can be very effective for respiratory disorders including Asthma. There are many studies relating to the success of acupuncture treatment for asthma which have been reported in the medical journals. (1)

In 1979 the World health Organisation listed 40 diseases for which acupuncture was considered to be beneficial and diseases of the respiratory tract including asthma and bronchitis were included in that list (2).

In a study conducted at the Department of Anaesthesia and Intensive Care in the University Hospital of Vienna revealed that over 70% of patients with long-standing asthma reported a significant improvement of their ailments after ten weeks of acupuncture treatment. (3)

Traditional Chinese Herbal Treatment

18/10/2005 - An oral combination of three Chinese herbal extracts: Ling-Zhi (Ganoderma lucidum), Ku-Shen (Radix Sophora flavescentis) and Gan-Cao (Radix Glycyrrhiza uralensis) could be as effective as conventional medicines at alleviating asthma symptoms but without such severe side effects, report Chinese and American researchers.

1990 - There has been one positive study involving a Chinese herb called Xifukang (a compound preparation of Chinese herbs) which was published in 1990. The results of treatment of 53 patients indicated that the clinical symptoms including cough, sputum production, chest pain, weakness, etc. were markedly improved and measurements of pulmonary function significantly enhanced . The researchers concluded that the therapeutic mechanism of Xifukang included promoting blood circulation to eliminate blood stasis, increasing ventilation, protecting dust-cells, resisting fibrosis, regulating immune function, enhancing lung clearance, and postponing and preventing development of silicosis. (4)

Green Tea May Help Protect Against Rheumatoid Arthritis

2009-01-25T21:18:00.001-08:00

Rheumatoid arthritis (RA) is an autoimmune disease that affects more than 2.1 million Americans. It is characterized by joint pain, stiffness, inflammation, swelling, and sometimes joint destruction. Nonsteroidal anti-inflammatory drugs are the standard treatment for RA, but their prolonged use is associated with adverse effects and discomfort. Natural plant alternatives like green tea are being investigated for the management of RA. Green tea is the most widely consumed beverage in the world, and its polyphenols (substances rich in antioxidants) possess anti-inflammatory properties.

NCCAM-funded investigators at the University of Maryland and Rutgers University examined the effects of green tea polyphenols on RA by using an animal model in rats. The animals consumed green tea in their drinking water (controls drank water only) for 1 to 3 weeks before being injected with heat-killed Mycobacterium tuberculosis H37Ra to induce arthritis. The researchers found that green tea significantly reduced the severity of arthritis.

The researchers suggest that green tea affects arthritis by causing changes in various arthritis-related immune responses—it suppresses both cytokine IL-17 (an inflammatory substance) and antibodies to Bhsp65 (a disease-related antigen), and increases cytokine IL-10 (an anti-inflammatory substance). Therefore, they recommend that green tea be further explored as a dietary therapy for use together with conventional treatment for managing RA.

Acupuncture Shows Promise in Improving Rates of Pregnancy Following IVF

2009-01-25T21:16:00.001-08:00

A review of seven clinical trials of acupuncture given with embryo transfer in women undergoing in vitro fertilization (IVF) suggests that acupuncture may improve rates of pregnancy. An estimated 10 to 15 percent of couples experience reproductive difficulty and seek specialist fertility treatments, such as IVF. IVF, which involves retrieving a woman's egg, fertilizing it in the laboratory, and then transferring the embryo back into the woman's womb is an expensive, lengthy, and stressful process. Identifying a complementary approach that can improve success would be welcome to patients and providers.

According to Eric Manheimer of the University of Maryland School of Medicine's Center for Integrative Medicine and colleagues who conducted the systematic review, acupuncture has been used in China for centuries to regulate the female reproductive system. With this in mind, the reviewers analyzed results from seven clinical trials of acupuncture in women who underwent IVF to see if rates of pregnancy were improved with acupuncture. The studies encompassed data on over 1366 women and compared acupuncture, given within one day of embryo transfer, with sham acupuncture, or no additional treatment.

The reviewers found that acupuncture given as a complement to IVF increased the odds of achieving pregnancy. According to the researchers, the results indicate that 10 women undergoing IVF would need to be treated with acupuncture to bring about one additional pregnancy. The results, considered preliminary, point to a potential complementary treatment that may improve the success of IVF and the need to conduct additional clinical trials to confirm these findings.

Acupuncture May Help Symptoms of Posttraumatic Stress Disorder

2009-01-25T21:15:00.001-08:00

A pilot study shows that acupuncture may help people with posttraumatic stress disorder. Posttraumatic stress disorder (PTSD) is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat.

Michael Hollifield, M.D., and colleagues conducted a clinical trial examining the effect of acupuncture on the symptoms of PTSD. The researchers analyzed depression, anxiety, and impairment in 73 people with a diagnosis of PTSD. The participants were assigned to receive either acupuncture or group cognitive-behavioral therapy over 12 weeks, or were assigned to a wait-list as part of the control group. The people in the control group were offered treatment or referral for treatment at the end of their participation.

The researchers found that acupuncture provided treatment effects similar to group cognitive-behavioral therapy; both interventions were superior to the control group. Additionally, treatment effects of both the acupuncture and the group therapy were maintained for 3 months after the end of treatment.

The limitations of the study are consistent with preliminary research. For example, this study had a small group of participants that lacked diversity, and the results do not account for outside factors that may have affected the treatments' results.

Cut The Sugar

2009-01-25T20:54:00.000-08:00

Each time you eat a snack containing sugar or starch (carbohydrates), the resulting acid attack on your teeth can last up to 20 minutes, and a lot of snacks and drinks contain sugar. How much sugar? A single can of pop contains up to 10 teaspoons of sugar, and if you think that natural sugar (like the sugar in raisins or other fruit) is better for your teeth it’s not. Sugar is sugar, and the average Canadian consumes over 40 kilograms of sugar each year! Click here for a list of how much sugar your favorite snack might contain.

Beat the Clock - foods that are eaten during a meal usually pose less of a threat to teeth because of the additional saliva produced during mealtime eating. Saliva helps to wash food particles from your mouth and lessen the damage from acid.

Brush & floss those teeth - toothbrushing is important, and you should brush twice a day. Did you know that if you don’t floss, you miss cleaning up to 35% of each tooth? If you’re not sure how to floss, just ask your dentist.

Stock up on Dairy Products - yogurt and cheese, milk and milk products contain things that are good for your teeth. Everything that’s made from milk is a good source of calcium - an essential nutrient for the development of bones and teeth. Some scientific studies have shown that eating cheese might actually help to protect your teeth from cavities by preventing something called demineralization (the loss of important calcium in your teeth).

BRACES

2009-01-25T20:51:00.000-08:00

Having straight teeth is important. Teeth that are crooked or out of place (misaligned) affect the way a person chews and talks and how their smile looks. Because they have unnatural spaces, crooked teeth are harder to clean and are more likely to have cavities.

In some cases, crooked teeth can affect the way the jaws line up and can cause pain and discomfort.

Severe Malocclusion

One method to correct this is to have Orthodontic treatment (or braces and retainers as they are sometimes called). Orthodontic treatment works by exerting a gentle pressure over time to straighten teeth that are growing, or have already grown, out of place.

Braces have three basic parts:
1) Brackets - brackets that are attached to each tooth
2) Bonding or band - the material that attaches the bracket to the tooth
3) Arch Wire - a thin metal wire that runs from bracket to bracket

Braces have come a long way from the "train track" look of years ago. Today, many orthodontic patients can get braces that attach to the backs of the teeth, or use transparent brackets.

A retainer is a custom-made, removable appliance that helps keep teeth in their new, straightened position after braces have been removed. Retainers can also be used to treat more minor orthodontic problems.

Do Allergies Cause Asthma?

2009-01-25T20:49:00.000-08:00

People who have certain kinds of allergies are more likely to have asthma. Do you have allergies that affect your nose and eyes, causing stuff like a runny nose or red, itchy eyes? If so, you're more likely to have asthma, too. Whatever causes the allergic reaction, such as pollen or dust, can also trigger asthma symptoms.

But not everyone who has allergies gets asthma, and not all asthma happens because of allergies. Huh? Allergies and asthma can be a little confusing, so let's find out more.

About 9 million kids in the United States have been diagnosed with asthma. Of these, about three out of four have asthma symptoms that are triggered by an allergy to something (called an allergen). In these people, the symptoms of asthma like wheezing, coughing, or trouble breathing are often brought on by being around allergens.

Allergies have a lot to do with your immune (say: ih-myoon) system. Most of the time your immune system fights germs and bacteria to help you stay healthy. But in a kid with allergies, the immune system treats allergens (such as pollen) as if they're invading the body, like a bad germ.

When the immune system reacts to an invading allergen, the body releases substances that cause allergy symptoms, such as a runny nose or red, itchy eyes. Some kids can also get asthma symptoms, like coughing, wheezing, or a tight feeling in the chest.

If you have asthma, it is a good idea to find out whether allergies may be causing your asthma symptoms. To figure out what they're allergic to, sometimes kids will visit a special doctor called an allergist (say: ah-lur-jist).

If the allergist finds out that you are allergic to certain things, the best way to prevent allergic reactions (and to help stop asthma symptoms from bugging you) is to avoid being around the allergens. The doctor may also prescribe medicine for your allergies, if you can't completely avoid what's causing them.

heart attack

2009-01-24T01:13:00.000-08:00

What happens during a heart attack?

The heart muscle requires a constant supply of oxygen-rich blood. The coronary arteries provide the heart with blood. If you have coronary artery disease, the inside of your coronary arteries may look like this:

Plaques (made of fatty matter, calcium, and stray cells) of different sizes attach to the walls of the arteries. Many of the plaques are hard on the outside and soft and mushy on the inside. The plaque builds up and narrows the artery.

When the plaque's hard, outer shell ruptures (cracks or tears), platelets (disc-shaped particles in the blood that aid clotting) come to the area, and blood clots form around the plaque.

If a blood clot totally blocks the artery, the heart muscle becomes "starved" for oxygen and nutrients (called ischemia) in the region below the blockage. Within a short time, death of heart muscle cells occur, causing permanent damage. This is called a myocardial infarction (MI) or heart attack.

A heart attack can also occur less frequently by a spasm of a coronary artery. During coronary spasm, the coronary arteries constrict or spasm on and off, causing lack of blood supply to the heart muscle (ischemia). It may occur at rest and can even occur in people without significant coronary artery disease. If coronary artery spasm occurs for a long period of time, a heart attack can occur.

What are the symptoms of a heart attack?

Ask your doctor about your risk of heart attack and how to reduce this risk.

Share this information with your family members and caregivers so they learn to recognize the symptoms of a heart attack and when to help you seek emergency treatment.

If you are having any one of the symptoms described below that lasts for more than 5 minutes, SEEK EMERGENCY TREATMENT WITHOUT DELAY. These symptoms could be the signs of a heart attack and immediate treatment is essential.

Symptoms of a heart attack include:

	Chest pain or discomfort in the center of the chest; a “squeezing,” “heaviness” or “crushing” feeling that lasts for more than a few minutes or goes away and comes back

	Pain or discomfort in other areas of the upper body including the arms, back, neck, jaw, or stomach

	Difficulty breathing, shortness of breath

	Sweating or “cold sweat”

	Fullness, indigestion, or choking feeling (may feel like “heartburn”)

	Nausea or vomiting

	Extreme weakness or anxiety

	Rapid or irregular heart beats

Do not wait for your symptoms to “go away.” Early recognition and treatment of heart attack symptoms can reduce the risk of heart damage and allow treatment to be started immediately. Even if you’re not sure your symptoms are those of a heart attack, you should still be evaluated.

Some people have a heart attack without having any symptoms (a "silent" myocardial infarction). A silent MI can occur among all patients, though it is more common among diabetics. If you have a silent MI, your heart attack may be diagnosed during a routine doctor’s exam.

The first symptoms start the clock

At the first signs of a heart attack, call for emergency treatment.

The best time to treat a heart attack is within the first one to two hours from the first onset of symptoms. Studies show that the people who have symptoms of a heart attack often delay, or wait to seek treatment, for longer than seven hours.

People who delay tend to be older, female and to have a history of angina, high blood pressure or diabetes.

Do not wait :
Fast action can save lives - including your own

Reasons people delay

	They are young and cannot believe it is happening to them

	Symptoms are not what they expected

	They may deny the symptoms are serious and wait until they go away

	They may ask the advice of others, especially family members

	They may first try to treat the symptoms themselves, using aspirin or antacids

	They may think the symptoms are related to other health problems (upset stomach, arthritis)

	They may put the care of others first (first take care of children or other family members) and not want to worry them.

Waiting just a couple hours for medical help may limit your treatment options, increase the amount of damage to your heart muscle, and reduce your chance of survival.

Know in advance:

	The symptoms of a heart attack.

	Who to call for emergency help. Do not call a friend or family member. Call for an ambulance to take you to the nearest A&E.

Treat all chest discomfort as angina or a heart attack unless your doctor has told you otherwise.

Treatments (medications, open heart surgery and interventional procedures) do not cure coronary artery disease. Having had a heart attack or treatment does not mean you will never have another heart attack; It CAN happen again.

Understand Cholesterol

2009-01-24T01:09:00.000-08:00

Cholesterol is a waxy substance produced by the body and found in foods that come from animals. Cholesterol is needed by your body to make hormones, skin oils digestive juices and vitamin D. You could not live without some cholesterol in your body.

However, too much cholesterol is a major risk factor for heart disease, particularly LDL (low density lipoprotein) cholesterol. LDL causes the build-up of fatty deposits within your arteries, reducing or blocking the flow of blood and oxygen to your heart.

Why Is Cholesterol Important?

Your blood cholesterol level has a lot to do with your chances of getting heart disease. High blood cholesterol is one of the major risk factors for heart disease. A risk factor is a condition that increases your chance of getting a disease. In fact, the higher your blood cholesterol level, the greater your risk for developing heart disease or having a heart attack.

How Does Cholesterol Cause Heart Disease?

When there is too much cholesterol (a fat-like substance) in your blood, it builds up in the walls of your arteries. Over time, this buildup causes "hardening of the arteries" so that arteries become narrowed and blood flow to the heart is slowed down or blocked. The blood carries oxygen to the heart, and if enough blood and oxygen cannot reach your heart, you may suffer chest pain. If the blood supply to a portion of the heart is completely cut off by a blockage, the result is a heart attack.

High blood cholesterol itself does not cause symptoms, so many people are unaware that their cholesterol level is too high. It is important to find out what your cholesterol numbers are because lowering cholesterol levels that are too high lessens the risk for developing heart disease and reduces the chance of a heart attack or dying of heart disease, even if you already have it. Cholesterol lowering is important for everyone--younger, middle age, and older adults; women and men; and people with or without heart disease

What Affects Cholesterol Levels?

A variety of things can affect cholesterol levels. These are things you can do something about:

Diet: Saturated fat and cholesterol in the food you eat make your blood cholesterol level go up. Saturated fat is the main culprit, but cholesterol in foods also matters. Reducing the amount of saturated fat and cholesterol in your diet helps lower your blood cholesterol level.

Weight: Being overweight is a risk factor for heart disease. It also tends to increase your cholesterol. Losing weight can help lower your LDL and total cholesterol levels, as well as raise your HDL and lower your triglyceride levels.

Exercise: Regular exercise can help lower LDL (bad) cholesterol and raise HDL (good) cholesterol levels. It also helps you lose weight. You should try to exercise for 30 minutes on most, if not all, days.

However, there are things you cannot do anything about also can affect cholesterol levels. These 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 levels tend to rise.

Heredity: Your genes partly determine how much cholesterol your body makes. High blood cholesterol can run in families.

2009-01-24T01:08:00.001-08:00

Angina Useful Info



Angina (angina pectoris - Latin for squeezing of the chest) is the chest discomfort that occurs when the blood oxygen supply to an area of the heart muscle does not meet the demand. In most cases, the lack of blood supply is due to a narrowing of the coronary arteries as a result of arteriosclerosis (see below). Angina is usually felt as a squeezing, pressure, heaviness, tightening, or aching across the chest, particularly behind the breastbone. This pain often radiates to the neck, jaw, arms, back, or even the teeth. Patients may also complain of indigestion, heartburn, weakness, sweating, nausea, cramping, and shortness of breath. Angina usually occurs during exertion, severe emotional stress, or after a heavy meal. During these periods, the heart muscle demands more blood oxygen than the narrowed coronary arteries can deliver. Angina typically lasts from 1 to 15 minutes and is relieved by rest or by placing a nitroglycerin tablet under the tongue. Nitroglycerin relaxes the blood vessels and lowers blood pressure. Both resting and nitroglycerin decrease the heart muscles demand for oxygen, thus relieving angina. Causes The most common cause of angina is coronary artery disease. A less common cause of angina is spasm of the coronary arteries. Coronary arteries supply oxygenated blood to the heart muscle. Coronary artery disease develops as cholesterol is deposited in the artery wall, causing the formation of a hard, thick substance called cholesterol plaque. The accumulation of cholesterol plaque over time causes narrowing of the coronary arteries, a process called arteriosclerosis. Arteriosclerosis can be accelerated by smoking, high blood pressure, elevated cholesterol, and diabetes. When coronary arteries become narrowed by more than 50% to 70%, they can no longer meet the increased blood oxygen demand by the heart muscle during exercise or stress. Lack of oxygen to the heart muscle causes chest pain (angina). The walls of the arteries are surrounded by muscle fibers. Rapid contraction of these muscle fibers causes a sudden narrowing (spasm) of the arteries. A spasm of the coronary arteries reduces blood to the heart muscle and causes angina. Angina is usually a warning sign of the presence of significant coronary artery disease. Patients with angina are at risk of developing a heart attack (myocardial infarction). A heart attack is the death of heart muscle precipitated by the complete blockage of a diseased coronary artery by a blood clot. During angina, the lack of oxygen (ischemia) to the heart muscle is temporary and reversible. The lack of oxygen to the heart muscle resolves and the chest pain disappears when the patient rests. The muscle damage in a heart attack is permanent. The dead muscle turns into scar tissue with healing. A scarred heart cannot pump blood as efficiently as a normal heart, and can lead to heart failure. Up to 25% of patients with significant coronary artery disease have no symptoms at all, even though they clearly lack adequate blood and oxygen supply to the heart muscle. These patients have "silent" angina. They have the same risk of heart attack as those with symptoms of angina. Diagnosis The resting electrocardiogram (EKG) is a recording of the electrical activity of the heart muscle, and can detect heart muscle which is in need of oxygen. The resting EKG is useful in showing the changes which are caused by a heart attack. It is less useful in patients with angina, since the chest pain and lack of oxygen supply to the heart only become evident during exertion or excitement.

Tooth Anatomy

2009-01-23T23:46:00.000-08:00

People use their teeth to bite and chew food - they are the first step in the digestion of food. The long, sharp canine teeth tear up food (like meat). The wide, flat molars grind and mash up food. While we chew food, the tongue pushes the food to the teeth and saliva helps digestion and wets the food. Teeth also help us say certain sounds.

People have two sets of teeth in their lives, the primary teeth (also called the baby, milk or deciduous teeth) and the permanent teeth (also called the adult or secondary teeth). Children have 20 primary teeth; they are replaced by the permanent teeth by about age 13. Adults have 32 permanent teeth.

Primary Teeth:
Most babies are born with no visible teeth -- the teeth are forming inside the gums. The 20 primary teeth (also called baby teeth or first teeth) erupt (poke through the gums) over the time from when a baby is from about 6 months to a year old.

Permanent Teeth:
Primary teeth fall out and are replaced by 32 permanent teeth (also called the adult teeth). This happens over the time from when a child is from about 6 to 14 years old.

As a permanent tooth forms under the gums and in the jawbone, the roots of the primary tooth it is replacing dissolve. Then the primary tooth becomes loose and falls out. The permanent tooth will fill the space.

Wisdom Teeth:

Wisdom teeth (also called the third molars) are molars that usually erupt from the ages of 17 to 21.

Tooth Glossary:

Cementum - a layer of tough, yellowish, bone-like tissue that covers the root of a tooth. It helps hold the tooth in the socket. The cementum contains the periodontal membrane.

Crown - the visible part of a tooth.

Dentin - the hard but porous tissue located under both the enamel and cementum of the tooth. Dentin is harder than bone.

Enamel - the tough, shiny, white outer surface of the tooth.

Gums - the soft tissue that surrounds the base of the teeth.

Nerves - nerves transmit signals (conveying messages like hot, cold, or pain) to and from the brain.

Periodontal membrane/ligament - the fleshy tissue between tooth and the tooth socket; it holds the tooth in place. The fibers of the periodontal membrane are embedded within the cementum.

Pulp - the soft center of the tooth. The pulp contains blood vessels and nerves; it nourishes the dentin.

Root - the anchor of a tooth that extends into the jawbone. The number of roots ranges from one to four.

Malaria

2009-01-23T22:43:00.001-08:00

Plasmodium is a group of one-celled animal parasites that lives on the red cells in the blood of many birds, reptiles and mammals. There are four human malaria species - P. falciparum, P. ovale, P. vivax and P. malariae. P. falciparum is by far the most dangerous. Unfortunately, it is also the most common in Africa. Malaria is transmitted by certain Anopheles mosquitoes. The parasite has to undergo a crucial development process in the mosquito, and this can only happen in certain mosquitos.

Malaria kills over one million people each year, most of whom are children under 5, and almost 90% of whom live in Africa, south of the Sahara. Each year there are over 300 million clinical cases of malaria, that is five times as many as combined cases of TB, AIDS, measles and leprosy. Malaria is responsible for one out of every four childhood deaths in Africa.

Women are four times more likely to get sick, and twice as likely to die from malaria if they are pregnant. Malaria-afflicted families are able to harvest only 40% of their crops, compared with healthy families, suggesting a link between malaria and poverty. The direct and indirect costs of malaria in Africa are estimated to exceed $2 billion per year. It is believed that it could be controlled with a budget amounting to one-tenth of this amount. Malaria slows economic growth in African countries by an estimated 1.3% each year.

The cheapest and safest malaria drug - chloroquine - is rapidly losing its effectiveness. In some parts of the world, malaria is resistant to the four leading front-line drugs. Malaria quickly rebounded from the mass insecticide spraying campaigns in the 1950's and 1960's. It then eluded mass treatment strategies based on a single drug, such as chloroquine. Malaria can quickly adapt and rebound when efforts are fragmented and uncoordinated. Yet it has been shown that malaria deaths could be reduced with coordinated intervention.

Malaria life cycle

2009-01-23T22:40:00.001-08:00

The malaria parasite life cycle involves two hosts. During a blood meal, a malaria-infected female Anopheles mosquito inoculates sporozoites into the human host (1). Sporozoites infect liver cells (2) and mature into schizonts (3), which rupture and release merozoites (4). (Of note, in Plasmodium vivax and P. ovale a dormant stage [hypnozoites] can persist in the liver and cause relapses by invading the bloodstream weeks, or even years later.) After this initial replication in the liver (exo-erythrocytic schizogony [A]), the parasites undergo asexual multiplication in the erythrocytes (erythrocytic schizogony [B]). Merozoites infect red blood cells (5). The ring stage trophozoites mature into schizonts, which rupture releasing merozoites (6). Some parasites differentiate into sexual erythrocytic stages (gametocytes) (7). Blood stage parasites are responsible for the clinical manifestations of the disease.
The gametocytes, male (microgametocytes) and female (macrogametocytes), are ingested by an Anopheles mosquito during a blood meal (8). The parasites' multiplication in the mosquito is known as the sporogonic cycle [C]. While in the mosquito's stomach, the microgametes penetrate the macrogametes generating zygotes (9). The zygotes in turn become motile and elongated (ookinetes) (10) which invade the midgut wall of the mosquito where they develop into oocysts (11). The oocysts grow, rupture, and release sporozoites (12), which make their way to the mosquito's salivary glands. Inoculation of the sporozoites into a new human host perpetuates the malaria life cycle (1). (The above graph and description were copied from the Parasite Image Library)