Posted by: wortix | August 31, 2009

Preventing Heart and Blood Vessel Problems

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Cardiovascular disease is the term used to describe problems involving the heart (cardio) or blood vessels (vascular). The most devastating complications of cardiovascular disease are stroke and heart attack; these can often be fatal. In fact, cardiovascular disease is the number one cause of death overall in the United States; the statistics that one in five Americans has cardiovascular disease includes women.

Active, exercising women already have lowered their risk of cardiovascular disease, as exercise affords the best heart protection. The recommendation by the American Heart Association is 30 minutes of moderate to intense physical activity 5 days a week. Aerobic exercise, which raises heart rate and uses up oxygen, improves cholesterol levels and maintains the peak functioning efficiency of heart and blood vessels. It also trains the cells to carry oxygen more efficiently and improves the rate of oxygen uptake in breathing.

High blood pressure is a precursor to heart and blood vessel disease. Blood pressure is necessary to promote exchange of nutrients from the blood into the capillaries and into the body. If there are problems such as hardened arteries, slow or inefficient heart functioning, or increased body demands due to poorly trained muscles, blood pressure rises. Because regular exercisers do not usually have these problems, blood pressure remains low. This reduces the occurrence of bad side effects of blood pressure such as heart attack and stroke. Studies have recently shown that regular exercise of moderate intensity for one hour five days a week is as effective as medication in managing high blood pressure.

The unmodifiable factors that can also increase your risk of cardiovascular disease are family history of stroke or heart attack, especially in family members under the age of 50; high cholesterol or triglycerides; and diabetes. Modifiable factors include smoking, obesity, and inactivity. Less clear but risky lifestyle behaviors are high stress and poor diet (high sugar and saturated fat/high cholesterol/low fiber). If you have any of these increased risks, you should see your doctor to discuss prevention methods in addition to exercise. These may include an aspirin a day, a low-cholesterol, unsaturated fat, high-fiber diet, and medications.

Factors That Increase Risk of Cardiovascular Disease

  • High LDL cholesterol
  • Obesity
  • High triglycerides
  • Inactivity
  • Diabetes
  • Stress
  • Family history
  • Poor diet
  • Smoking
  • Older age

Because women who have been through menopause are at an increased risk of heart disease and stroke, and women taking oral contraceptives or hormone replacement can be at an increased risk of stroke and blood clots, if you are in these categories and have the risk factors mentioned above, consult with your doctor for the best prevention strategies. Other heart-protective dietary behaviors can include a high-fiber, low glycemic index diet, increasing amount of omega-3 fatty acids, adding soy products, and having (only) one alcoholic drink per day.


Health Benefits of Aerobic Exercise

  • Prevents heart disease
  • Decreases osteoporosis risk
  • Lowers blood pressure
  • Reduces depression
  • Reduces strokes
  • Reduces cancer
  • Prevents obesity
  • Reduces stress
  • Prevents diabetes
  • Improves sleep
  • Reduces cholesterol

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Posted by: wortix | August 27, 2009

Pituitary Disorders Overview

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The pituitary gland is a tiny organ, the size of a pea, found at the base of the brain. As the master gland of the body, it produces and secretes many hormones that travel throughout the body, directing certain processes stimulating other glands to produce different types of hormones. The pituitary gland controls biochemical processes important to our well-being.


The pituitary gland makes these types of hormones:

  • Prolactin – Prolactin stimulates milk production from the breasts after childbirth to enable nursing. It also affects sex hormone levels from ovaries in women and from testes in men.
  • Growth hormone (GH) – GH stimulates growth in childhood and is important for maintaining a healthy body composition and well-being in adults. In adults it is important for maintaining muscle mass as well as bone mass. It also affects fat distribution in the body.
  • Adrenocorticotropin (ACTH) – ACTH stimulates the production of cortisol by the adrenal glands. Cortisol, a so-called “stress hormone” is vital to our survival. It helps to maintain blood pressure and blood glucose levels.
  • Thyroid-stimulating hormone (TSH) – TSH stimulates the thyroid gland, which regulates the body’s metabolism, energy, growth, and nervous system activity. This hormone is also vital to our survival.
  • Antidiuretic hormone (ADH) – ADH, also called vasopressin, regulates water balance. If this hormone is not released properly, it can lead to too little hormone (called diabetes insipidus), or too much hormone (called syndrome of inappropriate ADH). Both of these conditions affect the kidneys. Diabetes insipidus is different from the more well-known diabetes mellitus (or type II diabetes), which affects the levels of glucose in our bodies.
  • Luteinizing hormone (LH) – LH regulates testosterone in men and estrogen in women.
  • Follicle-stimulating hormone (FSH) – FSH promotes sperm production in men and stimulates the ovaries to enable ovulation in women. Luteinizing hormone and follicle-stimulating hormone work together to cause normal function of the ovaries and testes.

Pituitary Tumors

The most frequent cause of pituitary disorders is pituitary gland tumors. The pituitary gland is made of several cell types. Sometimes these cells grow too much or produce small growths.

These growths are called pituitary tumors, and they are fairly common in adults. These are not brain tumors and are not a form of cancer. In fact, cancerous tumors of this sort are extremely rare. Pituitary tumors, however, can interfere with the normal formation and release of hormones.

Two types of tumors exist – secretory and non-secretory. Secretory tumors produce too much of a hormone, creating an imbalance of proper hormones in the body. Non-secretory tumors cause problems because of their large size or because they interfere with normal function of the pituitary gland.

The problems caused by pituitary tumors fall into three general categories:

  1. Hypersecretion – Too much of any hormone secreted into the body is usually caused by a secretory pituitary gland tumor. Many secretory tumors make too much prolactin, the hormone that triggers milk production in new mothers. Other tumors may affect the adrenal glands, making too much of the hormones that stimulate them and causing a hormone imbalance. Tumors also can make excess growth hormone or too much of the hormone that stimulates the thyroid gland leading to overproduction of thyroid hormones.
  2. Hyposecretion – Too little of any hormone secreted into the body is usually caused by a non-secretory pituitary gland tumor, which interferes with the ability of the normal pituitary gland to create hormones. It can, however, also be caused by a large secretory tumor. Hyposecretion can also happen with surgery or the radiation of a pituitary gland tumor.
  3. Tumor mass effects – As a pituitary gland tumor grows and presses against the normal pituitary gland or other areas in the brain, it may cause headaches, vision problems, or other health effects related to hyposecretion. Tumor mass effects can be seen in any type of pituitary tumor that grows large enough. Injuries, certain medications, and other conditions can also affect the pituitary gland. Loss of normal pituitary function also has been reported after major head trauma.

NOTE: If you think you have a problem with your pituitary gland, it is important that you see a pituitary specialist who can determine whether you have a pituitary gland tumor or another endocrine system disease. An endocrinologist is an expert in hormone-related conditions and some endocrinologists make the pituitary gland their specialty. You may be referred to other doctors if you need surgery or radiation treatments.

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Posted by: wortix | August 19, 2009

What Is a Growth Disorder?

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Lately, it seems as though your child is looking up to classmates — literally. The other kids in the class have been getting taller and developing into young adults, but your child’s growth seems to be lagging behind. Classmates now tower over your child.

Is something wrong? Maybe, maybe not. Some kids just grow more slowly than others because their parents did, too. But others may have an actual growth disorder, which is any type of problem that prevents kids from meeting realistic expectations ofgrowth, from failure to gain height and weight in young children to short stature or delayed sexual development in teens.

Variations of Normal Growth Patterns

A couple of differences seen in the growth patterns of normal children include these common conditions, which are not growth disorders:

Constitutional growth delay: This condition describes children who are small for their ages but who are growing at a normal rate. They usually have a delayed “bone age,” which means that their skeletal maturation is younger than their age in years. (Bone age is measured by taking an X-ray of the hand and wrist and comparing it with standard X-ray findings seen in kids the same age.) These children don’t have any signs or symptoms of diseases that affect growth. They tend to reach puberty later than their peers do, with delay in the onset of sexual development and the pubertal growth spurt. But because they continue to grow until an older age, they tend to catch up to their peers when they reach adult height. One or both parents or other close relatives often had a similar “late-bloomer” growth pattern.

Familial (or genetic) short stature: This is a condition in which shorter parents tend to have shorter children. This term applies to short children who don’t have any symptoms of diseases that affect their growth. Kids with familial short stature still have growth spurts and enter puberty at normal ages, but they usually will only reach a height similar to that of their parents.

With both constitutional growth delay and familial short stature, kids and families need to be reassured that the child does nothave a disease or medical condition that poses a threat to health or that requires treatment. However, because they may be short or may not enter puberty when their classmates do, some may need extra help coping with teasing or they may need reassurance that they will go through full sexual development eventually. In a few normal children who are very short or very late entering puberty, hormone treatment may be helpful.

Growth Disorders

Diseases of the kidneys, heart, gastrointestinal tract, lungs, bones, or other body systems may affect growth. Other symptoms or physical signs in kids with these illnesses usually give clues as to the disease causing the growth delay. However, poor growth can be the first sign of a problem in some.

Growth disorders include:

Failure to thrive, which isn’t a specific growth disorder itself, but can be a sign of an underlying condition causing growth problems. Although it’s common for newborns to lose a little weight in the first few days, failure to thrive is a condition in which some infants continue to show slower-than-expected weight gain and growth. Usually caused by inadequate nutrition or a feeding problem, it’s most common in kids younger than age 3. It may also be a symptom of another problem, such as an infection, a digestive problem, child neglect, or abuse.

Endocrine diseases (diseases involving hormones, the chemical messengers of the body) involve a deficiency or excess of hormones and can be responsible for growth failure during childhood and adolescence. Growth hormone deficiency is a disorder that involves the pituitary gland (the small gland at the base of the brain that secretes several hormones, including growth hormone). A damaged or malfunctioning pituitary gland may not produce enough hormones for normal growth.Hypothyroidism is a condition in which the thyroid gland fails to make enough thyroid hormone, which is essential for normal bone growth.

Turner syndrome, one of the most common genetic growth disorders, occurs in girls and is a syndrome in which there’s a missing or abnormal X chromosome. In addition to short stature, girls with Turner syndrome usually don’t undergo normal sexual development because their ovaries (the sex organs that produce eggs and female hormones) fail to mature and function normally.

Diagnosing a Growth Disorder

The tests a doctor may recommend to detect a growth disorder depend on the findings at each step of evaluation. A short child who’s healthy and growing at a normal rate may just be observed throughout childhood, but a child who has stopped growing or is growing more slowly than expected will often need additional testing.

Your doctor or an endocrinologist will look for signs of the many possible causes of short stature and growth failure. Blood tests may be done to look for hormone and chromosome abnormalities and to rule out other diseases associated with growth failure. A bone age X-ray might be done and special scans (such as an MRI) can check the pituitary gland for abnormalities.

To measure the ability of the pituitary gland to produce growth hormone, the doctor (usually a pediatric endocrinologist) may do a growth hormone stimulation test. This involves giving the child medications that cause the pituitary gland to secrete growth hormone, then drawing several small blood samples over time to check growth hormone levels.

Treating a Growth Disorder

Although the treatment of a growth problem usually isn’t urgent, earlier diagnosis and treatment of can help some kids catch up with peers and increase their final height.

If an underlying medical condition is identified, specific treatment may result in improved growth. Growth failure due to hypothyroidism, for example, is usually treated with thyroid hormone replacement pills.

Growth hormone injections for children with growth hormone deficiency, Turner syndrome, and chronic kidney failure may help kids reach a more normal height. Human growth hormone is generally considered safe and effective, although full treatment may take many years and not all kids will have a good response. And the treatment can be costly (about $20,000 to $30,000 per year), although many health insurance plans cover it.

What about growth hormone treatment for short children who aren’t growth hormone deficient when tested? The U.S. Food and Drug Administration (FDA) has approved its use in such children if they’re predicted to reach a very short final height (under 4 feet 11 inches [150 centimeters] for a girl or 5 feet 4 inches [163 centimeters] for a boy).

Talk with your doctor for more information about treatment options if you’re concerned.

Helping Your Child

You can boost your child’s self-esteem by providing positive reinforcement and emphasizing other characteristics, like intelligence, personality, and talents. Try to take the focus off of height as a measure of social acceptance.

Kids who are very self-conscious about their size may need some additional help in coping. In some cases, evaluation and treatment by a mental health professional may be needed.

If You Suspect a Problem

If you’re concerned about your child’s growth, speak with your doctor, who may refer you to a pediatric endocrinologist, who can help diagnose and treat specific growth disorders.

It’s also important to watch for the social and emotional problems that kids with growth disorders face. It’s not easy being the shortest kid in the class and it’s never any fun being teased. Helping your child build self-esteem and emphasizing strengths — regardless of how tall he or she may grow — might be just what the doctor ordered.

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Posted by: wortix | August 12, 2009

Eye Injuries

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You can treat many minor eye irritations by flushing the eye with water, but more serious injuries require medical attention.


Injuries to the eye are the most common preventable cause of blindness, so when in doubt, err on the side of caution and call your doctor for help.

What to Do:

Routine Irritations
(sand, dirt, and other foreign bodies on the eye surface)

  • Wash your hands thoroughly before touching the eyelids to examine or flush the eye.
  • Do not touch, press, or rub the eye itself, and do whatever you can to keep your child from touching it (a baby can be swaddled as a preventive measure).
  • Do not try to remove any foreign body except by flushing, because of the risk of scratching the surface of the eye, especially the cornea.
  • Tilt the child’s head over a basin or sink with the affected eye down and gently pull down the lower lid, encouraging the child to open his or her eyes as wide as possible. For an infant or small child, it’s helpful to have a second person hold the child’s eyes open while you flush.
  • Gently pour a steady stream of lukewarm water (do not heat the water) from a pitcher or faucet over the eye.
  • Flush for up to 15 minutes, checking the eye every 5 minutes to see if the foreign body has been flushed out.
  • Because a particle can scratch the cornea and cause an infection, the eye should be examined by a doctor if there continues to be any irritation afterward.
  • If a foreign body is not dislodged by flushing, it will probably be necessary for a trained medical professional to flush the eye.

Embedded Foreign Body
(an object penetrates or enters the globe of the eye)

If an object, such as a piece of glass or metal, is sticking out of the eye, take the following steps:

  • Call for emergency medical help.
  • Cover the affected eye with a small cup taped in place. The point is to keep all pressure off the globe of the eye.
  • Keep your child (and yourself) as calm and comfortable as possible until help arrives.

Chemical Exposure

  • Many chemicals, even those found around the house, can damage an eye. If your child gets a chemical in the eye and you know what it is, look on the product’s container for an emergency number to call for instructions.
  • Flush the eye (see above) with lukewarm water for 15 to 30 minutes. If both eyes are affected, flush them in the shower.
  • Call for emergency medical help.

Call your local poison control center for specific instructions. Be prepared to give the exact name of the chemical, if you have it. However, do not delay flushing the eye first.

Black Eye, Blunt Injury, or Contusion

A black eye is often a minor injury, but it can also appear when there is significant eye injury or head trauma. A visit to the doctor or an eye specialist may be required to rule out serious injury, particularly if you’re not certain of the cause of the black eye.

For a black eye:

  • Apply cold compresses intermittently: 5 to 10 minutes on, 10 to 15 minutes off. If you use ice, make sure it’s covered with a towel or sock to protect the delicate skin on the eyelid.
  • Use cold compresses for 24 to 48 hours, then switch to applying warm compresses intermittently. This will help the body reabsorb the leakage of blood and may help reduce discoloration.
  • If the child is in pain, give acetaminophen — not aspirin or ibuprofen, which can increase bleeding.
  • Prop the child’s head with an extra pillow at night, and encourage him or her to sleep on the uninjured side of the face (pressure can increase swelling).
  • Call your doctor, who may recommend an in-depth evaluation to rule out damage to the eye. Call immediately if any of the following symptoms are noted:
    • increased redness
    • drainage from the eye
    • persistent eye pain
    • any changes in vision
    • any visible abnormality of the eyeball
    • visible bleeding on the white part (sclera) of the eye, especially near the cornea

If the injury occurred during one of your child’s routine activities, such as a sport, follow up by investing in an ounce of prevention — protective goggles or unbreakable glasses are vitally important.

Reviewed by: Sharon Lehman, MD

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Posted by: wortix | August 5, 2009

What Is Bronchitis?

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What Is Bronchitis?

Bronchitis (bron-KI-tis) is a condition in which the bronchial tubes, the tubes that carry air to your lungs, become inflamed.

People who have bronchitis often have a cough that brings up mucus. Mucus is a slimy substance made by the lining of the bronchial tubes. Bronchitis also may cause wheezing (a whistling or squeaky sound when you breathe), chest pain or discomfort, a low fever, and shortness of breath.


There are two main types of bronchitis: acute (short term) and chronic (ongoing).

Acute Bronchitis

Infections or other factors that irritate the lungs cause acute bronchitis. The same viruses that cause colds and the flu often cause acute bronchitis. These viruses are spread through the air when people cough. They also are spread through physical contact (for example, on hands that have not been washed). Sometimes bacteria cause acute bronchitis.

Acute bronchitis lasts from a few days to 10 days. However, the cough that occurs may last for several weeks after the infection is gone.

Several factors increase the risk for acute bronchitis. Examples include tobacco smoke (including secondhand smoke), air pollution, dust, and fumes. Avoiding these lung irritants as much as possible can help lower your risk for acute bronchitis.

Most cases of acute bronchitis go away within a few days. If you think you have acute bronchitis, see your doctor. He or she will want to rule out other, more serious health conditions that need medical care.

Chronic Bronchitis

Chronic bronchitis is an ongoing, serious condition. It occurs when the lining of the bronchial tubes is constantly irritated and inflamed.

Bronchitis is “chronic” if you have a cough with mucus on most days for at least 3 months a year and 2 years in a row (without another apparent cause). Smoking is the main cause of chronic bronchitis.

Viruses or bacteria can easily infect the irritated bronchial tubes. When this happens, the condition worsens and lasts longer. As a result, people who have chronic bronchitis also have periods when symptoms get much worse than usual.

Chronic bronchitis is a serious, long-term medical condition. Early diagnosis and treatment, combined with quitting cigarette smoking and avoiding secondhand cigarette smoke, can help people live better with this condition. The chance of complete recovery is low for people who have severe chronic bronchitis.

What Causes Bronchitis?

Acute Bronchitis

Infections or other factors that irritate your lungs cause acute bronchitis. The same viruses that cause colds and the flu are the most common cause of acute bronchitis. Sometimes bacteria can cause the condition.

Certain substances can irritate your lungs and airways and raise your risk for acute bronchitis. For example, inhaling or being exposed to cigarette or cigar smoke, air pollution, dusts, vapors, or fumes raises your risk. These lung irritants also can make symptoms worse.

Being exposed to a high level of dust or fumes, such as from an explosion or a big fire, also may lead to acute bronchitis.

Chronic Bronchitis

Repeatedly breathing in fumes that irritate and damage lung and airway tissues causes chronic bronchitis. Smoking is the major cause of this condition.

Breathing in air pollution and dust or fumes from the environment or the workplace also can lead to chronic bronchitis.

People who have chronic bronchitis go through periods when symptoms become much worse than usual. During these times, they also may have acute viral or bacterial bronchitis.

Who Is At Risk for Bronchitis?

Bronchitis is a very common condition. Millions of cases occur every year.

Elderly people, infants, and young children are at higher risk for acute bronchitis than people in other age groups. People of all ages can get chronic bronchitis, but it occurs more often in people who are older than 45. Women are more than twice as likely to be diagnosed with chronic bronchitis as men.

Smoking and having an existing lung disease greatly increase your risk for bronchitis. Contact with chemical fumes, vapors, and dusts from certain jobs—such as those in coal mining, textile manufacturing, and grain handling—also increases your risk for the condition.

Air pollution, infections, and allergies can worsen the symptoms of chronic bronchitis, especially if you smoke.

What Are the Signs and Symptoms of Bronchitis?

Acute Bronchitis

Acute bronchitis caused by an infection usually develops after you already have a cold or the flu. Symptoms of a cold or the flu include sore throat, fatigue (tiredness), fever, body aches, stuffy or runny nose, vomiting, and diarrhea.

The main symptom of acute bronchitis is a cough. The cough may produce clear mucus (a slimy substance). If the mucus is yellow or green, you may have a bacterial infection as well. Even after the infection clears up, you may still have a dry cough for days or weeks.

Other symptoms of acute bronchitis include wheezing (a whistling or squeaky sound when you breathe), low fever, and chest tightness or pain.

If your acute bronchitis is severe, you also may have shortness of breath, especially with physical activity.

Chronic Bronchitis

The signs and symptoms of chronic bronchitis include coughing, wheezing, and chest discomfort. The coughing may produce large amounts of mucus. This type of cough is often called “smoker’s cough.”

How Is Bronchitis Diagnosed?

Your doctor usually will diagnose bronchitis based on your signs and symptoms. He or she may ask questions about your cough, such as how long you’ve had it, what you’re coughing up, and how much you cough.

Your doctor also will likely ask:

  • About your medical history
  • Whether you’ve recently had a cold or the flu
  • Whether you smoke or spend time around others who smoke
  • Whether you’ve been exposed to air pollution, dust, or fumes

Your doctor will use a stethoscope to listen for wheezing (a whistling or squeaky sound when you breathe) or other abnormal sounds in your lungs. He or she also may:

  • Look at your mucus to see whether you have a bacterial infection
  • Test the oxygen levels in your blood using a sensor attached to your fingertip or toe
  • Order a chest x ray, lung function tests, or blood tests

How Is Bronchitis Treated?

The main goals of treating acute and chronic bronchitis are to relieve symptoms and help make breathing easier.

If you have acute bronchitis, your doctor may recommend rest, plenty of fluids, and aspirin (for adults) or acetaminophen to treat fever.

Antibiotics usually aren’t prescribed for acute bronchitis. This is because they don’t work against viruses—the most common cause of acute bronchitis. However, if your doctor thinks you have a bacterial infection, he or she may prescribe antibiotics.

A humidifier or steam can help loosen mucus and relieve wheezing and limited air flow. If your bronchitis causes wheezing, you may need an inhaled medicine to open your airways. You take this medicine using an inhaler. This device allows the medicine to go right to your lungs.

Your doctor also may prescribe medicines to relieve or reduce your cough and treat your inflamed airways (especially if your cough persists).

To lower your risk of getting bronchitis, your doctor also may suggest a flu shot and/or a pneumonia vaccine (if you’re aged 60 or older).

If you have chronic bronchitis and have also been diagnosed with COPD (chronic obstructive pulmonary disease), you may need medicines to open your airways and help clear away mucus. These medicines include bronchodilators (inhaled) and steroids (inhaled or pill form).

Sometimes people who have chronic bronchitis need oxygen therapy to help them breathe better and get enough oxygen to their bodies.

One of the best ways to treat acute and chronic bronchitis is to remove the source of irritation and damage to the lungs. If you smoke cigarettes, it’s very important to quit. Talk to your doctor about programs and products that can help you quit smoking. Try to avoid secondhand smoke. Also, try to avoid places with a lot of dusts, fumes, vapors, or air pollutants.

How Can Bronchitis Be Prevented?

You can’t always prevent acute or chronic bronchitis. However, you can take steps to lower your risk for both types of the condition. The most important step is to quit smoking or not start smoking.

Try to avoid other lung irritants, such as secondhand smoke, fumes, air pollution, and dust. For example, wear a mask over your mouth and nose when you use paint, paint remover, varnish, or other things with strong fumes. This will help protect your lungs.

Wash your hands often to reduce exposure to germs and bacteria. Get a flu shot every year, especially if you have lung problems. Get a pneumonia vaccine as your doctor advises if you’re aged 60 or older.

Living With Chronic Bronchitis

If you have chronic bronchitis, you can take steps to control your symptoms. Lifestyle changes and ongoing care can help you manage the condition.

Lifestyle Changes

The most important step is to quit smoking or not start smoking. Avoid other lung irritants, such as secondhand smoke, fumes, air pollution, and dust. This will help keep your lungs healthy.

Wash your hands often to lower your risk for a viral or bacterial infection. Also, try to stay away from people who have colds or the flu. See your doctor right away if you have signs or symptoms of a cold or the flu.

Follow a healthy diet and be as physically active as you can. A healthy diet includes a variety of fruits, vegetables, and whole grains. It also includes lean meats, poultry, fish, and fat-free or low-fat milk or milk products. A healthy diet also is low in saturated fat, trans fat, cholesterol, sodium (salt), and added sugar.

For more information on following a healthy diet, see the National Heart, Lung, and Blood Institute’s Aim for a Healthy Weight Web site, “Your Guide to a Healthy Heart,” and “Your Guide to Lowering Your Blood Pressure With DASH.” All of these resources include general advice about healthy eating.

Ongoing Care

See your doctor regularly and take all your medicines as prescribed. Also, talk to your doctor about getting a yearly flu shot and/or a pneumonia vaccine.

If you have chronic bronchitis, pulmonary rehabilitation (rehab) may help improve your breathing. Pulmonary rehab is a breathing exercise program that’s supervised by a respiratory therapist. This is a health care worker who knows about lung treatments. Talk to your doctor about whether rehab may benefit you.

People who have chronic bronchitis often breathe fast. Talk to your doctor about a breathing method called pursed-lip breathing. This breathing method may help you feel better because it slows down your breathing. To do pursed-lip breathing, take a deep breath. Then, slowly breathe out through your mouth. At the same time, hold your lips as if you’re going to kiss someone.

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Posted by: wortix | July 30, 2009


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What is dysphagia?

People with dysphagia have difficulty swallowing and may also experience pain while swallowing. Some people may be completely unable to swallow or may have trouble swallowing liquids, foods, or saliva. Eating then becomes a challenge. Often, dysphagia makes it difficult to take in enough calories and fluids to nourish the body.

Illustration: Profile showing location of Pharynx, palate, esophagus, tongue, larynx, trachea, lungs, and stomach


How do we swallow?

Swallowing is a complex process. Some 50 pairs of muscles and many nerves work to move food from the mouth to the stomach. This happens in three stages. First, the tongue moves the food around in the mouth for chewing. Chewing makes the food the right size to swallow and helps mix the food with saliva. Saliva softens and moistens the food to make swallowing easier. During this first stage, the tongue collects the prepared food or liquid, making it ready for swallowing.

The second stage begins when the tongue pushes the food or liquid to the back of the mouth, which triggers a swallowing reflex that passes the food through the pharynx (the canal that connects the mouth with the esophagus). During this stage, the larynx (voice box) closes tightly and breathing stops to prevent food or liquid from entering the lungs.

The third stage begins when food or liquid enters the esophagus, the canal that carries food and liquid to the stomach. This passage through the esophagus usually occurs in about 3 seconds, depending on the texture or consistency of the food.


How does dysphagia occur?

Dysphagia occurs when there is a problem with any part of the swallowing process. Weak tongue or cheek muscles may make it hard to move food around in the mouth for chewing. Food pieces that are too large for swallowing may enter the throat and block the passage of air.

Other problems include not being able to start the swallowing reflex (a stimulus that allows food and liquids to move safely through the pharynx) because of a stroke or other nervous system disorder. People with these kinds of problems are unable to begin the muscle movements that allow food to move from the mouth to the stomach. Another difficulty can occur when weak throat muscles cannot move all of the food toward the stomach. Bits of food can fall or be pulled into the windpipe (trachea), which may result in lung infection.


What are some problems caused by dysphagia?

Dysphagia can be serious. Someone who cannot swallow well may not be able to eat enough of the right foods to stay healthy or maintain an ideal weight.

Sometimes, when foods or liquids enter the windpipe of a person who has dysphagia, coughing or throat clearing cannot remove it. Food or liquid that stays in the windpipe may enter the lungs and create a chance for harmful bacteria to grow. A serious infection (aspiration pneumonia) can result.

Swallowing disorders may also include the development of a pocket outside the esophagus caused by weakness in the esophageal wall. This abnormal pocket traps some food being swallowed. While lying down or sleeping, a person with this problem may draw undigested food into the pharynx. The esophagus may be too narrow, causing food to stick. This food may prevent other food or even liquids from entering the stomach.


What causes dysphagia?

Dysphagia has many causes. Any condition that weakens or damages the muscles and nerves used for swallowing may cause dysphagia. For example, people with diseases of the nervous system, such as cerebral palsy or Parkinson’s disease, often have problems swallowing. Additionally, stroke or head injury may affect the coordination of the swallowing muscles or limit sensation in the mouth and throat. An infection or irritation can cause narrowing of the esophagus. People born with abnormalities of the swallowing mechanism may not be able to swallow normally. Infants who are born with a hole in the roof of the mouth (cleft palate) are unable to suck properly, which complicates nursing and drinking from a regular baby bottle.

In addition, cancer of the head, neck, or esophagus may cause swallowing problems. Sometimes the treatment for these types of cancers can cause dysphagia. Injuries of the head, neck, and chest may also create swallowing problems.


How is dysphagia treated?

There are different treatments for various types of dysphagia. First, doctors and speech-language pathologists who test for and treat swallowing disorders use a variety of tests that allow them to look at the parts of the swallowing mechanism. One test, called a fiber optic laryngoscopy, allows the doctor to look down the throat with a lighted tube. Other tests, including video fluoroscopy, which takes videotapes of a patient swallowing, and ultrasound, which produces images of internal body organs, can painlessly take pictures of various stages of swallowing.

Once the cause of the dysphagia is found, surgery or medication may help. If treating the cause of the dysphagia does not help, the doctor may have the patient see a speech-language pathologist who is trained in testing and treating swallowing disorders. The speech-language pathologist will test the person’s ability to eat and drink and may teach the person new ways to swallow.

Treatment may involve muscle exercises to strengthen weak facial muscles or to improve coordination. For others, treatment may involve learning to eat in a special way. For example, some people may have to eat with their head turned to one side or looking straight ahead. Preparing food in a certain way or avoiding certain foods may help other people. For instance, those who cannot swallow liquids may need to add special thickeners to their drinks. Other people may have to avoid hot or cold foods or drinks.

For some, however, consuming foods and liquids by mouth may no longer be possible. These individuals must use other methods to nourish their bodies. Usually this involves a feeding system, such as a feeding tube, that bypasses the part of the swallowing mechanism that is not working normally.


What research is being done on dysphagia?

Scientists are conducting research that will improve the ability of physicians and speech-language pathologists to evaluate and treat swallowing disorders. All aspects of the swallowing process are being studied in people of all ages, including those who do and do not have dysphagia. For example, scientists have found that there is great variation in tongue movement during swallowing. Knowing which tongue movements cause problems will help physicians and speech-language pathologists evaluate swallowing.

Research has also led to new, safe ways to study tongue and throat movements during the swallowing process. These methods will help physician and speech pathologists safely reevaluate a patient’s progress during treatment. Studies of treatment methods are helping scientists discover why some forms of treatment work with some people and not with others. For example, research has shown that, in most cases, a patient who has had a stroke should not drink with his or her head tipped back. Other research has shown that some patients with cancer who have had part or all of their tongue removed should drink with their head tipped back. This knowledge will help some patients avoid serious lung infections and help others avoid tube feedings.


Where can I get help?

If you have a swallowing problem, you may need to consult with an otolaryngologist (physician with special training in disorders of the ear, nose, and throat) or a speech-language pathologist trained in dysphagia. You may need to consult with a neurologist if a stroke or other neurologic disorder causes the swallowing problem. Other trained professionals who may provide treatment are occupational therapists and physical therapists.

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What is good emotional health?

People with good emotional health are aware of their thoughts, feelings and behaviors. They have learned healthy ways to cope with the stress and problems that are a normal part of life. They feel good about themselves and have healthy relationships.

However, many things that happen in your life can disrupt your emotional health and lead to strong feelings of sadness, stress or anxiety. These things include:

  • Being laid off from your job
  • Having a child leave or return home
  • Dealing with the death of a loved one
  • Getting divorced or married
  • Suffering an illness or an injury
  • Getting a job promotion
  • Experiencing money problems
  • Moving to a new home
  • Having a baby.
“Good” changes can be just as stressful as “bad” changes.

How can my emotions affect my health?

Your body responds to the way you think, feel and act. This is often called the “mind/body connection.” When you are stressed, anxious or upset, your body tries to tell you that something isn’t right. For example, high blood pressure or a stomach ulcer might develop after a particularly stressful event, such as the death of a loved one. The following can be physical signs that your emotional health is out of balance:
  • Back pain
  • Change in appetite
  • Chest pain
  • Constipation or diarrhea
  • Dry mouth
  • Extreme tiredness
  • General aches and pains
  • Headaches
  • High blood pressure
  • Insomnia (trouble sleeping)
  • Lightheadedness
  • Palpitations (the feeling that your heart is racing)
  • Sexual problems
  • Shortness of breath
  • Stiff neck
  • Sweating
  • Upset stomach
  • Weight gain or loss
Poor emotional health can weaken your body’s immune system, making you more likely to get colds and other infections during emotionally difficult times. Also, when you are feeling stressed, anxious or upset, you may not take care of your health as well as you should. You may not feel like exercising, eating nutritious foods or taking medicine that your doctor prescribes. Abuse of alcohol, tobacco or other drugs may also be a sign of poor emotional health.

Why does my doctor need to know about my emotions?

You may not be used to talking to your doctor about your feelings or problems in your personal life. But remember, he or she can’t always tell that you’re feeling stressed, anxious or upset just by looking at you. It’s important to be honest with your doctor if you are having these feelings.

First, he or she will need to make sure that other health problems aren’t causing your physical symptoms. If your symptoms aren’t caused by other health problems, you and your doctor can address the emotional causes of your symptoms. Your doctor may suggest ways to treat your physical symptoms while you work together to improve your emotional health.

If your negative feelings don’t go away and are so strong that they keep you from enjoying life, it’s especially important for you to talk to your doctor. You may have what doctors call “major depression.” Depression is a medical illness that can be treated with individualized counseling, medicine or with both.

How can I improve my emotional health?

First, try to recognize your emotions and understand why you are having them. Sorting out the causes of sadness, stress and anxiety in your life can help you manage your emotional health. The following are some other helpful tips.

Express your feelings in appropriate ways. If feelings of stress, sadness or anxiety are causing physical problems, keeping these feelings inside can make you feel worse. It’s OK to let your loved ones know when something is bothering you. However, keep in mind that your family and friends may not be able to help you deal with your feelings appropriately. At these times, ask someone outside the situation–such as your family doctor, a counselor or a religious advisor–for advice and support to help you improve your emotional health.

Live a balanced life. Try not to obsess about the problems at work, school or home that lead to negative feelings. This doesn’t mean you have to pretend to be happy when you feel stressed, anxious or upset. It’s important to deal with these negative feelings, but try to focus on the positive things in your life too. You may want to use a journal to keep track of things that make you feel happy or peaceful. Some research has shown that having a positive outlook can improve your quality of life and give your health a boost. You may also need to find ways to let go of some things in your life that make you feel stressed and overwhelmed. Make time for things you enjoy.

Develop resilience. People with resilience are able to cope with stress in a healthy way. Resilience can be learned and strengthened with different strategies. These include having social support, keeping a positive view of yourself, accepting change, and keeping things in perspective.

Calm your mind and body. Relaxation methods, such as meditation, are useful ways to bring your emotions into balance. Meditation is a form of guided thought. It can take many forms. For example, you may do it by exercising, stretching or breathing deeply. Ask your family doctor for advice about relaxation methods.

Take care of yourself. To have good emotional health, it’s important to take care of your body by having a regular routine for eating healthy meals, getting enough sleep and exercising to relieve pent-up tension. Avoid overeating and don’t abuse drugs or alcohol. Using drugs or alcohol just causes other problems, such as family and health problems.

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Posted by: wortix | July 23, 2009

Neck Pain

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Most people will experience neck pain at some point in their lives. Neck pain can be acute, meaning it lasts a few hours to a few weeks, or it can be chronic. Neck pain that lasts several weeks or longer is considered chronic neck pain.


Most causes of neck pain aren’t serious. Poor posture at work, such as leaning into your computer, and during hobbies, such as hunching over your workbench, are common causes of neck pain.

But sometimes neck pain can signify something more serious. If your neck pain is so severe that you can’t touch your chin to your chest despite a few days of self-care, seek immediate medical attention.


Neck pain takes many forms. Signs and symptoms of neck pain may include:

  • Pain in your neck that may feel sharp or dull
  • Stiffness in your neck
  • Difficulty going about your daily tasks because of pain or stiffness in your neck
  • Shoulder pain in addition to neck pain, in some cases
  • Back pain in addition to neck pain, in some cases


  • Muscle strains. Overuse, such as too much time spent hunched over a steering wheel, often triggers muscle strains. Neck muscles, particularly those in the back of your neck, become fatigued and eventually strained. When you overuse your neck muscles repeatedly, chronic pain can develop. Even such minor things as reading in bed or gritting your teeth can strain neck muscles.
  • Worn joints. Like the other joints in your body, your neck joints experience wear and tear with age, which can cause osteoarthritis in your neck. Neck (cervical) osteoarthritis can cause pain and stiffness in your neck.
  • Disk disorders. As you age, the cushioning disks between your vertebrae become dry and stiff, narrowing the spaces in your spinal column where the nerves come out. The disks in your neck also can herniate. This means the inner gelatinous cartilage material of a disk protrudes through the disk’s tougher cartilage covering. Neck pain may occur or nearby nerves can be irritated. Other tissues and bony growths (spurs) also can press on your nerves as they exit your spinal cord, causing pain.
  • Injuries. Rear-end collisions often result in whiplash injuries, which occur when the head is jerked forward and back, stretching the soft tissues of the neck beyond their limits.

When to seek medical advice

Neck pain doesn’t always require medical care. Rarely, it can be a sign of an emergency.

When to try home care
Neck pain caused by muscle irritations is usually easy to self-diagnose, and it usually gets better on its own within a few of days. This type of neck pain typically develops after excessive activity, a period of overuse or prolonged postures that put excessive strain on your neck muscles. If your neck pain doesn’t let up within a week or two, see your doctor.

When to seek immediate medical care
See your doctor if the following signs and symptoms occur in conjunction with neck pain:

  • Severe pain from an injury. After head or neck trauma, such as whiplash or a blow to your head, see your doctor immediately. Severe pain over a bone might indicate a fracture or an injury to a ligament.
  • Shooting pain. Pain radiating to your shoulder, through your shoulder blades or down your arm, with or without numbness or tingling in your fingers, may indicate nerve irritation. Neck pain from nerve irritation can last from weeks to six months or longer. More sophisticated tests and treatments are available for this type of continued nerve irritation, so see your doctor.
  • Loss of strength. Weakness in an arm or a leg, walking with a stiff leg, or shuffling your feet indicates a possible neurological problem and needs immediate evaluation.
  • Change in bladder or bowel habits. Any significant change, especially a sudden onset of incontinence, could indicate a neurological problem.

Tests and diagnosis

Your doctor often will be able to diagnose the cause of your neck pain and recommend treatment just by asking questions about the type, location and onset of your pain.

In less clear-cut cases, your doctor may use imaging techniques or other tests such as:

  • X-rays
  • Magnetic resonance imaging (MRI)
  • Computerized tomography (CT) scans
  • Electromyography (EMG)

Treatments and drugs

Most neck pain responds well to home care. If neck pain persists, your doctor may recommend other treatments.

Self-care for neck pain
Self-care measures you can try at home to relieve neck pain include:

  • Over-the-counter pain relievers. Try over-the-counter pain relievers, such as aspirin, ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) and acetaminophen (Tylenol, others).
  • Alternate heat and cold. Reduce inflammation by applying cold, such as an ice pack or ice wrapped in a towel, for up to 20 minutes several times a day. Alternate the cold treatment with heat. Try taking a warm shower or using a heating pad on the low setting. Heat can help relax sore muscles, but it sometimes aggravates inflammation, so use it with caution.
  • Rest. Lie down from time to time during the day to give your neck a rest from holding up your head. Avoid prolonged rest, since too much inactivity can cause increased stiffness in your neck muscles.
  • Gentle stretching. Gently move your neck to one side and hold it for 30 seconds. Stretch your neck in as many directions as your pain allows. This may help alleviate some of the pain.
  • Over-the-counter pain creams. Creams and gels made to relieve muscle and joint pain may provide some temporary relief from neck pain. Look for products with ingredients such as menthol and camphor.

Treatment for persistent neck pain
For pain that doesn’t get better with simple home-care measures, your doctor may recommend one or more treatments, such as:

  • Neck exercises and stretching. Your doctor may recommend that you work with a physical therapist to learn neck exercises and stretches. A physical therapist can guide you through these exercises and stretches, so that you can do them on your own at home. Exercises may improve pain by restoring muscle function and increasing the strength and endurance of your neck muscles.
  • Transcutaneous electrical nerve stimulation (TENS).Electrodes placed on your skin near the painful areas deliver tiny electrical impulses that may relieve pain.
  • Injections of medication. Injections of medications into your neck may help relieve pain. Your doctor may inject corticosteroid medications near the nerve roots, near the small neck joints or into the muscles in your neck to help with pain. Numbing medications, such as lidocaine, also can be injected to numb your neck pain.
  • Pain medications. Your doctor may prescribe stronger pain medicine than what you can get over-the-counter. Opioid analgesics are sometimes used briefly to treat acute neck pain. Muscle relaxants, tramadol (Ultram) or tricyclic antidepressant medications used for pain also may be prescribed.
  • Traction. Traction uses weights and pulleys to gently stretch your neck and keep it immobilized. This therapy, under supervision of a medical professional and physical therapist, may provide relatively fast relief of some neck pain, especially pain related to nerve root irritation. Relief may last for hours or even days.
  • Short-term immobilization. A soft collar that supports your neck may help relieve pain by taking pressure off the structures in your neck.
  • Surgery. Surgery is rarely needed for neck pain. However, it may be an option for relieving nerve root or spinal cord compression.


Most neck pain is associated with poor posture on top of age-related wear and tear. To help prevent neck pain, keep your head centered over your spine, so gravity works with your neck instead of against it. Some simple changes in your daily routine may help. Consider trying to:

  • Take frequent breaks if you drive long distances or work long hours at your computer. Keep your head back, over your spine, to reduce neck strain. Try to avoid clenching your teeth.
  • Adjust your desk, chair and computer so the monitor is at eye level. Knees should be slightly lower than hips. Use your chair’s armrests.
  • Avoid tucking the phone between your ear and shoulder when you talk. If you use the phone a lot, get a headset.
  • Stretch frequently if you work at a desk. Shrug your shoulders up and down. Pull your shoulder blades together and then relax. Pull your shoulders down while leaning your head to each side to stretch your neck muscles.
  • Balance your base. Stretching the front chest wall muscles and strengthening the muscles around the shoulder blade and back of the shoulder can promote a balanced base of support for the neck.
  • Avoid sleeping on your stomach. This position puts stress on your neck. Choose a pillow that supports the natural curve of your neck.

Alternative medicine

Talk to your doctor if you’re interested in trying complementary and alternative neck pain treatments. Your doctor can discuss the benefits and risks of various alternative neck pain treatments.

Alternative neck pain treatments include:

  • Acupuncture. Acupuncture involves the insertion of thin needles into various points on your body. Studies have found that acupuncture may be helpful for many types of pain. But studies in neck pain have been mixed. For results, you may need to undergo several acupuncture sessions. Acupuncture is generally considered safe when performed by a certified practitioner using sterile needles. But don’t undergo acupuncture treatment if you’re taking blood thinners.
  • Massage. During a massage, a trained practitioner manipulates the muscles in your neck. Little scientific evidence exists to support massage in people with neck pain, though it may provide relief when combined with your doctor’s recommended treatments. Massage is generally safe for most people with minor neck strains, as long as it’s performed by a trained massage therapist. If you have chronic neck pain or neck pain that’s caused by injury or arthritis, ask your doctor if massage would be safe for you.

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Posted by: wortix | July 16, 2009

Calcium and Bone Health

Bones play many roles in the body. They provide structure, protect organs, anchor muscles, and store calcium. Adequate calcium consumption and weight bearing physical activity build strong bones, optimizes bone mass, and may reduce the risk of osteoporosis later in life.

For more information on bone health and osteoporosis please visit the National Osteoporosis Foundation.

Peak Bone Mass

Peak bone mass refers to the genetic potential for bone density. By the age of 20, the average woman has acquired most of her skeletal mass. A large decline in bone mass occurs in older adults, increasing the risk of osteoporosis. For women this occurs around the time of menopause.

It is important for young girls to reach their peak bone mass in order to maintain bone health throughout life. A person with high bone mass as a young adult will be more likely to have a higher bone mass later in life. Inadequate calcium consumption and physical activity early on could result in a failure to achieve peak bone mass in adulthood.


Osteoporosis or “porous bone” is a disease of the skeletal system characterized by low bone mass and deterioration of bone tissue. Osteoporosis leads to an increase risk of bone fractures typically in the wrist, hip, and spine.


While men and women of all ages and ethnicities can develop osteoporosis, some of the risk factors for osteoporosis include those who are

  • Female
  • White/Caucasian
  • Post menopausal women
  • Older adults
  • Small in body size
  • Eating a diet low in calcium
  • Physically inactive

To find out more about the prevalence and risk factors associated with osteoporosis, please visit the National Osteoporosis Foundation.*


Calcium is a mineral needed by the body for healthy bones, teeth, and proper function of the heart, muscles, and nerves. The body cannot produce calcium; therefore, it must be absorbed through food. Good sources of calcium include

  • Dairy products—low fat or nonfat milk, cheese, and yogurt
  • Dark green leafy vegetables—bok choy and broccoli
  • Calcium fortified foods—orange juice, cereal, bread, soy beverages, and tofu products
  • Nuts—almonds

Recommended amount of calcium vary for individuals. Below is a table of adequate intakes as outlined by the National Academy of Science.

Recommended Calcium Intakes

Ages Amount mg/day
Birth–6 months 210
6 months–1 year 270
1–3 500
4–8 800
9–13 1300
14–18 1300
19–30 1000
31–50 1000
51–70 1200
70 or older 1200
Pregnant & Lactating 1000
14–18 1300
19–50 1000

Source: Dietary Reference Intakes for Calcium, National Academy of Sciences, 1997

Vitamin D also plays an important role in healthy bone development. Vitamin D helps in the absorption of calcium (this is why milk is fortified with vitamin D).

For more information on calcium and children visit the National Institute of Child Health and Human Development (NICHD).

Weight-Bearing Physical Activity

Regular physical activity has been associated with many positive health benefits including strong bones. Like proper calcium consumption, adequate weight-bearing physical activity early in life is important in reaching peak bone mass. Weight-bearing physical activities cause muscles and bones to work against gravity. Some examples of weight bearing physical activities include

  • Walking, Jogging, or running
  • Tennis or Racquetball
  • Field Hockey
  • Stair climbing
  • Jumping rope
  • Basketball
  • Dancing
  • Hiking
  • Soccer
  • Weight lifting

Incorporating weight-bearing physical activity into an exercise plan is a great way to keep bones healthy and meet physical activity recommendations set forth in the Dietary Guidelines for Americans.

Adults: Engage in at least 30 minutes of moderate physical activity [on] most, preferably all, days of the week

Children: Engage in at least 60 minutes of moderate physical activity [on] most, preferably all, days of the week

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1. What is causing my back pain?
2. What can I do to prevent my back pain from getting worse?
3. Why is my back vulnerable to pain and injury?
4. Could stress be a contributing factor, and what can I do about it?
5. What are my treatment options?
6. If surgery is recommended, is it really necessary and what are the risks?
7. What are the potential risks and benefits of other available treatments?
8. What lifestyle changes do I need to make to keep my back healthy?
9. How can I be sure that my work does not negatively affect my back?
10. What are the chances that my back pain will result in permanent disability?

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