medical-direct

Eczema - Atopic Dermatitis

2007-09-09T17:50:00.000Z

Eczema, also known as atopic dermatitis (or inflammation of the skin), is a chronic skin condition commonly characterized by dry, red, swollen, patches of skin that itch relentlessly. For many individuals who have eczema, frequent scratching of the affected area only makes the condition more bothersome and uncomfortable. Repeated scratching also may cause the skin to become red or swollen, which can then cause the area to crack, ooze clear liquid and become crusty. Eczema occurs most often in the folds of the elbows or behind the knees, but it can appear anywhere on the surface of the body. In children, eczema often occurs on the scalp and face as well. An eczema outbreak can last from a few days to a few weeks or more. And whereas some individuals experience a single outbreak, many experience frequent flare-ups, usually as a result of exposure to one or more triggers or irritants.

The itching and scratching caused by eczema can lead to breaks or cracks in the skin. Often, bacteria can infect the open skin wounds and cause an infection. These skin infections, also called cellulitis, can cause the skin to appear red and swollen and may be warm to the touch. These skin infections can spread to other areas of the body, therefore, it is important to contact a doctor if cellulitis is suspected.

What causes it?

Medical researchers believe that eczema may be an abnormal response of the immune system to various environmental or emotional triggers. When the body comes into contact with one or more of these triggers, the immune system senses the trigger and reacts to dispel it. The immune system's reaction is thought to be the cause of the symptoms that are associated with eczema outbreaks.

Triggers for eczema can include skin irritants, such as chemicals; emotional stress; allergies, for example, to food and airborne allergens; and extreme changes in temperature. Paint thinners and pesticides, alcohol-containing products, astringents, and fragrances are chemicals that can trigger eczema in some individuals. Although paint thinners and pesticides can be avoided fairly easily, it is harder to avoid alcohol, astringents, and fragrances, which are ingredients in most cosmetics and household cleaners. If you believe any of these types of products contribute to your eczema, it is a good idea to check the ingredient list on the label before purchasing one of these products.

Heightened emotional states, for example, feelings of extreme anxiety, anger, or aggression, can also trigger eczema outbreaks. Understanding and trying to avoid situations that lead to these stresses may be beneficial in preventing eczema outbreaks. Approaches to avoiding stress include getting plenty of sleep, exercising regularly, and avoiding alcohol or illegal drugs.

Certain foods, for example, milk, eggs, soy, or peanuts, trigger eczema outbreaks for some individuals. Reading the ingredient list before purchasing food products that you suspect may contain ingredients you are allergic to is a wise step to take.

Airborne allergens such as pollens, mould spores, and animal dander as well as extreme changes in temperature can also lead to an outbreak of eczema for some individuals. During the heat of summer, remaining indoors where air conditioning is available is a good preventive measure. In the winter months, using a humidifier to add moisture to the air inside your home may help prevent dry skin, thus preventing an eczema outbreak.

Hormonal Contraception - Birth Control

2007-09-05T12:05:00.001Z

Contraception (preventing pregnancy) has been attempted for thousands of years. Over the centuries, contraceptive methods have varied greatly from ways we would consider bizarre to methods quite similar to what we use today. For example, in ancient Egypt, crocodile dung and honey were put in the vagina to prevent conception. In some African countries, women used okra pods as vaginal pouches – similar to the female condoms now in use. From dung to seedpods, the effectiveness of traditional contraceptive methods is quite questionable. Although today's methods of birth control can be more complicated to use, they are undeniably more reliable and certainly more appealing.

Over the next 25 years, the world's population is estimated to exceed 8 billion individuals. At more than 40%, this increase represents the largest population growth ever seen over such a short time period. Governments as well as individuals are taking action to keep a huge growth in population from overwhelming resources. Without using some form of family planning, however, approximately 80% of women age 35 to 39 and 91% of women age 20 to 24 would become pregnant at least once during a 5-year period. Even more significant to overall population growth, one out of ten women age 15 to 19 will become pregnant each year, despite a consistent decline in the teen birth rate. Far more likely to live in poverty, babies born to teen-aged mothers are often low in birth weight, which contributes not only to higher infant death rates, but also to greater risk of lifelong health problems. Although estimates vary over a large range, as many as 60% of all pregnancies are believed to be unplanned. Worldwide, unplanned children are more likely to die before the age of one year.

Efforts to control population growth take many forms – from governmental limits on the number of children per family to individual decisions about contraceptive methods. Hormonal contraception is just one method of birth control now used to help keep population growth in check and minimize the number of unwanted pregnancies. By far, the most popular method of limiting family size in the United States is oral hormonal contraception taken by the female partner. Since the U.S. Food and Drug Administration (FDA) approved the first “modern” contraceptive, Enovid 10, in 1960, major advances have been made in hormonal contraception. Available in several different dosage forms, today’s hormonal contraceptives are formulated to reduce side effects and increase convenience while maintaining effectiveness.

Important Note: Hormonal contraceptives, in any form, do not provide protection against the spread of sexually transmitted infections (STIs), such as AIDS, gonorrhea, or syphilis (just to name a few).

Hypertension - High Blood Pressure

2007-09-01T10:07:00.000Z

What is High Blood Pressure?

In hypertension, also known as high blood pressure, blood is forced through the heart and vessels throughout the body with a greater force than is necessary. Over time, hypertension damages the heart and blood vessels. Eventually, untreated hypertension can lead to life-threatening health problems such as heart disease and strokes.

When your blood pressure is checked, two measurements--systolic and diastolic--are taken.

Systolic blood pressure represents the peak pumping pressure of your heart when it is fully contracted during a heartbeat.

Diastolic blood pressure represents the pressure in the heart when it is at rest between heartbeats. You may be diagnosed with hypertension if your systolic pressure is 140 or higher, and your diastolic is 90 or higher.

Normal blood pressure is defined as a systolic less than 120 and a diastolic less than 80 (or "less than 120 over 80"). "Pre-hypertension" is a new classification that impacts approximately 45 million American adults and is defined as a systolic of 120 to 139 and a diastolic of 80 to 89. Individuals who have pre-hypertension are on the brink of developing full blown hypertension.

Hypertension is defined as a systolic pressure of 140 or higher and/or a diastolic of 90 or higher. Hypertension is further classified by stages - stage 1 and stage 2 - depending on the systolic and diastolic pressure readings (see table below).

Hypertension is diagnosed when either the systolic or diastolic pressure is high or if both the systolic and diastolic pressures are high. To be diagnosed with hypertension, two or more properly measured blood pressure readings must be taken on each of two or more doctor's office visits and then the readings are averaged. This means it takes more than just one elevated blood pressure reading to be diagnosed with hypertension.

When the two blood pressure measurements fall into separate stages--for example a Stage 2 systolic reading, but a diastolic pressure in the normal range, the higher of the two is used for the classification. The higher part of the blood pressure measurement along with your personal risk for hypertension and other health conditions you may have, help your doctor determine the best treatment options for you. The table below lists the stages or classifications of hypertension.

	Systolic	Diastolic
Normal	Less than 120	Less than 80
Pre-hypertension	120 to 139	80 to 89
Stage 1	140 to 159	90 to 99
Stage 2	160 or higher	100 or higher

The higher the blood pressure, the more likely you are to experience a heart attack, stroke, heart failure or kidney disease.

Hypertension - What causes it?

2007-08-18T12:11:00.000Z

What causes Hypertension (High Blood Pressure)

Two main types of hypertension are recognized. By far the most common is Essential Hypertension, sometimes called Primary Hypertension. This is hypertension in which there is no identifiable cause. Ninety five percent of all persons living with hypertension have essential hypertension. Although researchers have been unable to pinpoint its specific causes, several risk factors definitely increase an individual's chance of developing essential hypertension. Some of these risk factors are controllable. They include:

Obesity
High Salt Intake
Smoking
Lack of Exercise
Emotional and/or Physical Stress

Risk factors that cannot be controlled are:

Gender--Males are at a higher risk for hypertension at earlier ages than females.
Age--The risk goes up for older women; more than half of women over the age of 60 have high blood pressure.
Race--Hypertension and its complications are more common among people of African ancestry than among members of other ethnic groups. Not only does hypertension typically begin earlier among African-Americans; its complications are more frequent, and it leads to death more often.
Family History of Hypertension--Risk is higher in people whose parents also have high blood pressure.

The other major type of hypertension, termed Secondary Hypertension, has an identifiable cause. It is due to disease. For example, kidney (renal) hypertension is due to high blood pressure within the arteries that supply blood to the kidneys. The underlying cause is kidney disease or conditions like atherosclerosis, which narrow or block the renal arteries. Secondary hypertension may also result from hormonal imbalances, particularly in the kidney's adrenal glands. Cushing's syndrome and pheochromocytoma (pronounced: “fee–oh–chrome–oh–sigh–toe–ma”), which is a tumor of the adrenal glands, are two of the conditions that can disrupt adrenal hormones and lead to secondary hypertension. Other causes of secondary hypertension include pregnancy, thyroid disease, and the use of some medications such as oral contraceptives and non-steroidal anti-inflammatory medications (NSAIDs).

Treatments for Heart Failure

2007-08-12T17:42:00.000Z

How is Heart Failure treated?

The management of heart failure (HF) depends on its cause and clinical course. Since high blood pressure, coronary artery disease, high cholesterol, and valvular heart disease are common causes of HF, aggressive management of these conditions is essential. Treatment goals include:

Improve the individual’s quality of life and symptoms
Prevent the heart failure from worsening
Prolong the individual’s life span
Treat the underlying cause of the heart failure.
When a person is diagnosed with HF, both non-drug (described in "Helping Yourself") and drug therapy is recommended. All patients with chronic HF due to left ventricle systolic dysfunction (means the heart muscle itself is weakened and not able to pump blood out of the heart as effectively as before) should receive an angiotensin-converting enzyme inhibitor (ACE-Inhibitor), unless the person is intolerant to or has a contraindication to the use of this class of drugs. ACE-Inhibitors are "vasodilators," which cause the peripheral blood vessels to dilate, or open up. This reduces the work of the heart by making it easier for blood to flow.

ACE-Inhibitors should even be used in HF patients who do not yet have symptoms of HF because these drugs have been shown in clinical studies to reduce the risk of disease progression and improve patient survival. In patients with fluid retention, ACE-Inhibitors are typically combined with diuretics.

Diuretics (aka, “water pills”), available since the 1950s, are used to help the kidneys get rid of excess water and sodium, thereby reducing blood volume and the heart's workload. These drugs can help alleviate HF symptoms like shortness of breath and lower extremity edema (fluid collection in the feet, ankles, & lower legs).

Patients who cannot tolerate ACE-Inhibitors should be treated with angiotensin II receptor blockers (ARBs). ARBs have been shown to improve survival in persons who have HF.

There may be special situations when a combination of an ACE-Inhibitor and ARB may be used. However, the role of this combination is not well-defined and is somewhat controversial.

Other "vasodilators" such as a combination of hydralazine plus nitrate therapy may be used if patients cannot tolerate either ACE-Inhibitors or ARBs. The hydralazine and nitrate combination is considered a second-line therapy and should not be used for the treatment of HF in patients who have not been previously treated with an ACE-Inhibitor. A new drug called BiDil combines hydralazine and isosorbide dinitrate into one tablet. BiDil was shown in one study to improve survival in African American persons who have HF.

Beta-blockers are also a first-line recommendation for HF patients. These drugs decrease the heart rate as well as the overall work of the heart through vasodilation. Certain beta-blockers have been shown in clinical studies to reduce the risk of death associated with HF. All persons with stable, mild-to-moderate or moderate-to-severe HF due to left ventricular dysfunction (who do not have intolerance or contraindications) should have a beta-blocker (either bisoprolol, carvedilol, or metoprolol succinate) added to a regimen of an ACE-Inhibitor and a diuretic as early as possible.

Some clinicians recommend using digitalis (digoxin), a drug that has been used since the 18th century, to strengthen the heart's pumping action. Other clinicians contend that digitalis has not been shown to affect the normal course of HF. They recommend that it should be reserved for patients who still have symptoms of HF after being treated with an ACE-Inhibitor, diuretic, and a beta-blocker or for those patients who also have atrial fibrillation. While digoxin has not been adequately shown in clinical studies to reduce death from HF, it has been shown to improve HF symptoms and patient quality of life. Patients taking both diuretics and digitalis may need to supplement their levels of potassium.

In patients with severe heart failure, another type of diuretic can be added to treatment regimens consisting of an ACE-Inhibitor, diuretic, beta-blocker, and digoxin. Spironolactone (brand name: Aldactone), a potassium-sparing diuretic, has been shown in clinical studies to reduce mortality in patients with severe heart failure and thus, may be considered for use in these patients. Spironolactone blocks the action of aldosterone, a hormone that may exert adverse effects on the heart muscle and peripheral blood vessels. Spironolactone not only may improve fluid balance but may also decrease the risk of progression of HF. For patients with more severe forms of HF, spironolactone has been shown in clinical studies to reduce hospitalizations and death from heart failure. Spironolactone's efficacy and safety in patients with mild to moderate HF remains unknown.

Most recently, eplerenone (Inspra) received FDA approval for the treatment of heart failure that occurs following a heart attack. Eplerenone is a selective aldosterone receptor blocker, the first drug in this class. Individuals may be candidates for eplerenone therapy if they have documented heart failure proceeding a heart attack. For more information on the use of eplerenone following a heart attack, talk to your doctor or primary health care provider.

Sometimes, surgery proves effective. When HF is due to disease of the heart valves, surgery to repair the valve or implant an artificial heart valve may be helpful. Surgery is also used to correct congenital heart defects that can lead to HF. When HF is caused by partial or complete blockage of the coronary arteries, coronary bypass surgery or angioplasty may be used.

Heart transplants are a last resort in treating severe HF caused by diseased heart muscle. Although the success rate of heart transplants has significantly improved, the cost of the operation and shortage of donor organs makes it impractical except as a last resort.

Drug classes used to treat Heart Failure
ACE-Inhibitors
Aldosterone Receptor Blockers
Angiotensin II Receptor Blockers
Beta Blockers
Cardiac Glycosides
Diuretics
Selective Aldosterone Receptor Antagonist

Who is at risk of heart disease

2007-07-30T17:36:00.000Z

Nearly five million Americans have chronic Heart Failure, with 550,000 new cases occurring each year. Heart failure results in almost 1 million hospital admissions each year and is the most common diagnosis among patients between the ages of 55 to 65 years discharged from hospitals.

Forty four percent of patients with HF have diabetes, 30% have kidney problems, 52% are women, and atrial fibrillation (irregular heart rhythm) accounts for approximately 31% of heart failure patients. These numbers are expected to continue to increase as the population of elderly Americans rises.

What are the symptoms?

Due to the complexity of trying to determine whether or not a symptom is caused by the inadequate “forward flow” of blood or the “backward buildup” of blood, the following list of symptoms are all attributed to heart failure.

Common symptoms include:

Exercise intolerance (diminished ability to perform physical tasks)
Cough
Fatigue
Nocturia (having to go to the bathroom frequently during the night)
Abdominal pain
Loss of appetite
Nausea
Bloating
Mental status change such as confusion
Shortness of breath (that may even occur at rest)
Cool or pale extremities (legs, feet, hands, fingers)
Edema (or swelling), particularly in the lower legs, ankles, and feet
Chest pain

High Blood Pressure - are you at risk?

2007-07-16T12:12:00.000Z

What are the risk factors for Hypertension (High Blood Pressure)

Risk factors are characteristics that may increase your chance for developing a condition. The more risk factors you have, the more likely you are to develop the condition. You are at increased risk for developing hypertension if you:

Are 60 years of age or older
Have a family history of hypertension
Are of African-American descent
Are overweight or obese
Are a smoker
Lack exercise or don't get enough physical activity
Consume excessive amounts of alcohol (on a regular basis - defined as 3 or more drinks/day for a man or 2 or more drinks/day for a woman)
Use oral contraceptives (birth control)
Have a high salt intake and low potassium intake in your diet

Atrial Fibrillation - cause and treatment

2007-06-11T12:21:00.000Z

Atrial Fibrillation

What is it?

Atrial fibrillation (AF) is a condition in which the heart beats with an abnormal or irregular rhythm. When the heart beats rapidly and irregularly, serious problems can occur such as blood clotting. The abnormal rhythm can come and go (called paroxysmal atrial fibrillation), persist for longer than 7 days (persistent atrial fibrillation), or persist despite treatment (permanent atrial fibrillation).

Atrial Fibrillation

What causes it?

The heart muscle has four chambers or compartments. The two upper chambers are called the right and left atria. Within the right atria, is a small mass of tissue - known as the sinoatrial node (SA node). This SA node triggers an electrical - like impulse that stimulates the heart muscle to beat and pump blood in and out of the heart. The SA node is like a “pacemaker” for the heart. It controls how fast the heart beats and keeps the rhythm of the heart regular.

For most individuals, when the heart beats at a normal rate and rhythm, it pumps about 60 to 100 times per minute. Atrial Fibrillation (AF) can cause the heart to beat 120 to 180 times per minute, or faster. When AF occurs, electrical impulses originate from many areas in the atrium instead of from the SA node - as many as 350 different impulses per minute, all trying to cause the heart to beat. Unfortunately, the heart cannot respond to the overload of electrical - like impulses and thus it begins to beat rapidly and irregularly - almost like a quiver instead of a beat. The fast and irregular beating of the heart can cause the feeling of heart fluttering or palpitations. Additionally, blood is not pumped effectively and may pool in the atria. When blood pools, it is more likely to clot. If a clot develops and breaks loose it can clog a blood vessel in the brain, causing a stroke.

The two lower chambers - the right and left ventricles - of the heart are also affected by AF. Rapid and irregular beating does not allow sufficient time for the ventricles to adequately fill with blood before being stimulated to pump the blood out of the heart again. As a result, less blood is pumped out of the heart and the body’s tissues--which are dependent on the heart for oxygen-rich blood--are provided with a smaller supply, causing symptoms like shortness-of-breath, dizziness and fatigue or tiredness.

Heart Failure Heart Disease

2007-06-09T17:47:00.000Z

Heart Failure

What is it?

Heart failure, also called left ventricular dysfunction, is a condition in which the heart muscle does not pump adequately. As a result, blood is not dispersed adequately to the body and fluid backs up into the lungs, causing "congestion."

In some patients, heart failure occurs suddenly, while in other cases it develops gradually. As heart function deteriorates over the years, the strength of muscle contractions may be reduced. In other cases, mechanical problems may affect the ability of heart chambers to fill with blood, so that less blood is pumped out to tissues in the body. In other cases, the pumping chambers enlarge and fill with too much blood. The weakened heart muscle may not be strong enough to pump out all of the blood it receives. There are also cases where the heart enlargement affects the functioning of the valves that usually stop blood from flowing backwards into the heart chamber it just left. This condition, called regurgitation, may make the heart failure even worse.

When the heart cannot efficiently pump blood into the arteries, the blood backs up into the lungs and the resulting fluid collection is responsible for the congestion and breathing difficulties. Blood may also collect in veins, especially in the lower extremities, and cannot circulate into tissues.

In most patients, heart failure is controllable. With appropriate care, people may live for many years after the diagnosis is made.

What causes it?

Heart failure (HF) is often the direct result of the heart muscle's inability to contract with enough force to pump blood efficiently. Among the causes of HF are heart valve disease, scar tissue left from a previous heart attack, and high blood pressure which has been uncontrolled for long periods.

Coronary artery disease, in which the coronary arteries supplying the heart muscle are narrowed by plaques (usually from high cholesterol), is the most common cause of HF accounting for 60% of people with the disease. Although coronary artery disease often starts at an early age, HF occurs most often in the elderly. The majority of these patients are women. Researchers theorize that this is probably because men are more likely to die from coronary artery disease before it progresses to HF.

HF is also associated with alcohol abuse, and drug abuse, particularly cocaine and amphetamines, which affect heart rate. Among other disorders that can cause HF are hyperthyroidism -- or an overactive thyroid-- and various abnormalities of the heart valves. In addition, viral infection or inflammation of the heart, known as myocarditis, or a heart muscle disease called cardiomyopathy can cause HF. There are also rare cases where HF is caused by extreme vitamin deficiencies.

What are the risk factors?

Risk factors are characteristics that may increase your chance for developing a condition. If you have conditions such as coronary artery disease, valvular heart disease or high blood pressure, then you are at risk for developing heart failure (HF). Other factors that increase your chance of having or developing HF include:

Age - Older people are more likely to develop HF than younger people.
Male gender - Before age 60 or 70, men are more likely than women to develop coronary disease.
Family history of heart disease
Cigarette smoking
High blood pressure
Diabetes
Alcohol abuse
Coronary artery disease
Chronic kidney disease
Atrial fibrillation
High cholesterol
COPD (lung disease) or asthma

How is Hypertension (High Blood Pressure) treated

2007-05-30T12:17:00.000Z

How is Hypertension (High Blood Pressure) treated?

The overall goal in treating hypertension is to prevent other health related complications and death from hypertension related complications. Treating and controlling your hypertension can help prevent damage to your heart, brain, kidneys, blood vessels, and eyes. For individuals who don't have other medical or health conditions such as diabetes or heart failure, typically the goal is to lower systolic blood pressure to less than 140 and the diastolic blood pressure to less than 90 ("less than 140 over 90"). For individuals with other medical conditions, blood pressure goals are lower and are determined by your doctor. For instance, the blood pressure goal for most people with diabetes is a systolic less than 130 and a diastolic less than 80 (“less than 130 over 80”).

For individuals who have pre-hypertension, it is critical to adopt a healthy lifestyle to prevent high blood pressure. These lifestyle modifications include weight reduction, eating a healthy diet (called the “DASH" eating plan), increasing your amount of physical activity, and limiting alcoholic beverages. You can get more information about lifestyle modifications in the Helping Yourself section above.

For individuals with hypertension, lifestyle modifications as mentioned above are important but many times, medications will also be needed to adequately manage blood pressure. Many types of drugs are used to lower blood pressure. The initial drug choice is determined by your stage of hypertension (or how high your blood pressure is) and whether you have other health conditions that would affect the drug choice. (See the table below titled “Options for Individualizing Antihypertensive Therapy”for more information.)

Options for Individualizing Antihypertensive Drug Therapy
If you have:	Then your doctor may prescribe one of the following:
Diabetes mellitus	ACE Inhibitors, ARBs, Diuretics, Beta Blockers, Calcium Channel Blockers
Heart failure	Diuretics, Beta Blockers, ACE Inhibitors, ARBs, spironolactone
Heart attack	Beta Blockers, ACE Inhibitors, spironolactone
Isolated systolic hypertension (elevated systolic only)	Diuretics, certain Long-acting Calcium Channel Blockers
Kidney Disease	ACE Inhibitors, ARBs
Recurrent Stroke Prevention	Diuretics, ACE Inhibitors

* You can learn more about the drug classes listed in the above table by clicking on the drug class links at the bottom of the page.

For hypertension that isn't controlled by diet and exercise, new treatment guidelines for hypertension recommend that most patients be started on a thiazide-type diuretic, unless there is a compelling need for a different class of medications (for example, if another health condition is present, that would affect drug choice as listed above).

Thiazide diuretics are useful in achieving blood pressure control. They have been proven to enhance effectiveness of other antihypertensive medications when used in combination, and are typically more affordable than other antihypertensive medications.

Patients with Stage 1 hypertension are generally started on a thiazide-type diuretic, but ACE Inhibitors, angiotensin II receptor blockers (ARBs), beta blockers, calcium channel blockers, or combinations of different classes can also be considered. Patients diagnosed with Stage 2 hypertension typically need a combination of two drugs usually consisting of a thiazide diuretic along with an ACE Inhibitor, an ARB, a beta blocker or a calcium channel blocker to adequately lower their blood pressure. However, the treatment guidelines are meant only to be a guide. Your healthcare provider is in the best position to design a drug therapy regimen to manage your hypertension.

If the initial drug regimen does not achieve the goal blood pressure, your healthcare provider may change your regimen by increasing your dosage or by adding additional antihypertensive medications until your goal blood pressure is achieved. Many patients eventually require two or more drugs to effectively control their blood pressure. Some patients may even require four or five medications to control their blood pressure.

It is important to remember that everyone can respond to antihypertensive medications differently. What works for others may not work for you and vice versa. It is sometimes necessary for a doctor to prescribe different antihypertensive medications until the best regimen for you is found.

More severe hypertension may require the use of drugs called "vasodilators", which widen arteries, allowing blood to flow more easily and thus, lowering blood pressure. Oral vasodilators, such as hydralazine and minoxidil, are often used together with diuretics and other drugs that reduce fluid retention. Clonidine, another type of antihypertensive, may also be utilized.

Hypertension is typically a lifelong condition. However, in some patients-- especially those who have made lifestyle modifications such as losing weight-- may be able to modify their antihypertensive medication regimen after hypertension has been controlled for at least one year. In so-called "Step-Down" therapy the number of drugs being used, their dosages, or both are gradually reduced to see if blood pressure can remain controlled. The goal is to maintain blood pressure control using the lowest dosage of the least number of medications possible. The key though is to keep blood pressure at or under goal. Not all patients are able to "Step Down" from their antihypertensive therapy. Making lifestyle changes (see "Helping Yourself" above) may help increase the likelihood of successful "Step Down" therapy.

Drug classes used to treat Hypertension (High Blood Pressure)

ACE-Inhibitor and Calcium Channel Blocker Combination

ACE-Inhibitor and Diuretic Combination

ACE-Inhibitors

Alpha Blockers

Alpha-2 Agonists

Angiotensin II Receptor Blocker and Diuretic Combinations

Angiotensin II Receptor Blockers

Beta Blockers

Calcium Channel Blockers

Combined Alpha and Beta Blockers

Diuretics

Who gets High Blood Pressure?

2007-05-15T12:16:00.000Z

Hypertension (High Blood Pressure)

Who has it?

According to estimates based on the Third National Health and Nutrition Examination Survey and on U.S. Census information, one-fourth of the general adult population in America has some degree of high blood pressure--a total of about 50 million people. Approximately 1 billion people worldwide have hypertension. Today it's estimated that there is a 19.3% prevalence of hypertension among white women, 24.4% among white men, 34.2% among black women, 35% among black men, 22% among Mexican-American women, and 25.2% among Mexican-American men.

Older persons also develop hypertension more often than younger individuals. Today it's estimated that in the older population (greater than 60 years of age), the prevalence of hypertension is 60%. As the population continues to age, it is expected that these numbers will also continue to increase. For unexplained reasons, people who live in the Southeastern part of the U.S. also seem to have higher rates of hypertension.

Approximately 45 million Americans have "prehypertension." These individuals are at increased risk for going on to develop hypertension.

Cholesterol - what is it?

2007-05-06T21:35:00.000Z

Cholesterol is a soft, waxy, fat-like substance the body needs for cells to grow and regenerate. Cholesterol comes from two sources: your body and the foods you eat. The body manufactures its own cholesterol in the liver, and it only takes a small amount of cholesterol in the blood to meet its needs. However, because cholesterol can be found in foods such as red meats, whole milk dairy foods, and egg yolks, eating too much dietary cholesterol can make your blood cholesterol levels increase. Too much cholesterol circulating in the bloodstream is known as hypercholesterolemia.

Hypercholesterolemia increases the risk of heart disease because it can lead to atherosclerosis, a condition in which fat and cholesterol are deposited on the walls of the arteries. Atherosclerosis can occur in arteries throughout the body, including the coronary arteries feeding the heart. In time, narrowing of the coronary arteries by atherosclerosis can produce the signs and symptoms of heart disease, including angina (chest pain) and heart attacks.

Hepatitis C What it is

2007-05-04T19:28:00.000Z

Hepatitis C

The word "hepatitis" means inflammation of the liver. The usual cause of hepatitis is infection by a virus. At least six viruses, usually identified by the letters A through G, are known to cause hepatitis. In the United States, hepatitis A, hepatitis B, and hepatitis C are the most common types. Rarely, some kinds of hepatitis are not caused by infection. These non-contagious types of hepatitis can result from alcohol abuse, certain drugs, ingestion of toxic substances, or autoimmune disease (the body's own immune system attacks the liver).

Typically, hepatitis B and hepatitis C infections have distinct phases. The first, or acute phase, occurs soon after infection with the hepatitis virus and lasts for 6 months or less. Many individuals recover from acute hepatitis, and their livers return to normal within a few months. Depending on the type of hepatitis, however, some of the individuals who contract acute hepatitis infections may not be able to eliminate the virus. For these individuals, the acute infection may be followed by a chronic phase. Usually, chronic hepatitis involves a prolonged latent or inactive period. During this time, which may last 20 years or longer, individuals with hepatitis probably do not experience symptoms or feel ill. Generally, however, the virus continues to multiply, gradually causing liver damage. Typically, symptoms do not become apparent until liver damage is extensive. However, abnormal levels of liver enzymes such as alanine aminotransferase (ALT) and aspartate aminotransferase (AST) may show if liver tests are done.

Hepatitis - Risk Factors and Symptoms

2007-04-30T19:24:00.000Z

What are the risk factors?

Risk factors are circumstances or conditions that can increase the chances of developing a condition. Some of these behaviors can be changed and taking special precautions may be helpful for limiting others. Risk factors for hepatitis B include:

Being tattooed or having body or ear piercing with contaminated instruments
Immigration from areas where the disease is common, especially among children
Injectable drug use
Poor socioeconomic conditions
Sexual activity with homosexual or bisexual men
Sexual activity with more than one partner in 6 months
Travel to high-risk countries in Africa, Asia, South America, and Eastern and Mediterranean parts of Europe

Other individuals who may be at greater risk are:

Dialysis patients
Health care workers
Individuals who received a blood transfusion prior to July 1992
Individuals with hemophilia, especially those who used blood-derived clotting factors before 1987
Infants born to infected mothers
Sexual or household contacts of infected individuals

What are the symptoms?

Many individuals who contract HBV are not even aware that they have hepatitis because the symptoms may be so mild. The most common symptoms of hepatitis B are often mistaken for the flu and they may not be recognized because they may not appear until one to 6 months after becoming infected. Some of these symptoms may be:

Fatigue
Loss of appetite
Mild fever
Muscle or joint aches

Additional symptoms that may appear a few days after the initial symptoms include:

Bitter taste in the mouth or bad breath
Clay-colored (light) stools
Confusion
Dark urine
Nausea and vomiting
Pain on the right side below the ribs
Widespread itching
Yellow colored skin or white areas of eyes (jaundice)

The following symptoms of more serious liver damage may occur months to years later in individuals with chronic hepatitis B:

Bruising easily or the appearance of “spider veins” broken blood vessels that form a tangled, spiderlike appearance under the skin
Changes in personality or behavior (encephalopathy)
Pain on the upper left side of stomach (due to an enlarged spleen)
Red coloration of the palms of the hands
Swelling of the legs and stomach (ascites)
Vomiting bright red blood or dark, grainy "coffee ground" material (as a result of bleeding from enlarged blood vessels in the oesophagus and stomach)

Hepatitis B - Who gets it, What causes it?

2007-04-25T19:23:00.000Z

Hepatitis B

What causes it?

HBV is transmitted from individual to individual through contact with infected bodily fluids, such as blood. Because chronic carriers of HBV are often unaware that they have the virus, they may transmit the disease to others unknowingly. Injecting illegal drugs with contaminated needles or having sex with an infected individual are common ways to become infected. Sharing and reusing diabetes blood testing supplies with any infected individual may also cause an individual to become infected. In addition, instruments such as those used for tattooing and body piercing can spread hepatitis if they are not properly sterilized between uses. A mother who is infected can transmit HBV to her baby during childbirth. However, it is not transmitted through breast-feeding.

Once HBV makes its way to the liver, it multiplies. Symptoms usually develop within one to 6 months. Exactly how liver cells are damaged or why some individuals acquire chronic infection or liver cancer is unknown.

Who has it?

Of all the serious transmittable diseases, hepatitis is the most common. Up to 100,000 new cases of hepatitis B are reported each year in the United States, and the Centers for Disease Control and Prevention (CDC) estimates that 1.25 million Americans are infected with chronic hepatitis B.

Hepatitis B affects individuals of both sexes and all ages, ethnic groups, and sexual orientations. About one-fifth of the world’s population will have hepatitis B at sometime in their lives. It is more common in males, with the highest occurrence between the ages of 20 and 49 years. Individuals with hemophilia may be slightly more at risk, if they use clotting factors that are made from human blood.

In the United States, the acute form of hepatitis has been declining due to the availability of an effective vaccine and the aggressive promotion of vaccination among children and teenagers. Changes in high-risk behavior may also contribute to the decrease. In 1990, approximately 21,000 Americans were believed to have acute hepatitis B. By 2002, that number had dropped to approximately 8,000.

Chronic hepatitis B affects an estimated 1.25 million Americans and about 400 million chronic carriers are believed to exist in the world population. As the number of acute cases goes down, the number of chronic carriers of hepatitis B is also expected to decline. However, increases in occurrence have been observed among the major risk groups: individuals with compromised immune systems, sexually active individuals, and injectable drug users.

Benign Prostate Hyperplasia

2007-04-15T13:29:00.000Z

Benign prostatic hyperplasia (BPH) is enlargement of the prostate gland - a gland found only in men, which produces the milky fluid in which sperm are ejaculated. The enlargement results from uncontrolled growth of the gland. As the prostate gland progressively becomes larger, the urethra - a tube through which urine is passed out of the body - may become constricted because it is surrounded by the prostate gland. This constriction can obstruct the flow of urine out of the bladder and this constriction and/or obstruction is thought to cause the urinary symptoms characteristic of BPH.

The exact cause of benign prostatic hyperplasia (BPH) is unclear, although researchers believe it may be caused by hormonal changes that occur during the aging process. One theory is that as a man ages, the amount of testosterone in his blood decreases, leaving a higher proportion of oestrogen (estrogen) in his blood. The disproportion of estrogen may contribute to cell growth within the prostate gland. Another possible hormonal change involves dihydrotestosterone (DHT), a by-product of testosterone. If levels of DHT accumulate in the prostate, overgrowth of cells in the prostate can occur.

Breast Cancer

2007-03-25T13:32:00.000Z

Breast cancer is now the most common cancer affecting women. It is also the second most frequent cause of cancer death.

Causes of breast cancer - hypersensitivity of estrogen and/or progesterone-specific receptors within breast tissue are responsible for the majority of breast cancer cases. It is believed that these two hormones may be responsible for proliferation of breast cells and resultant tumor formation. Additionally the mutations of two abnormal genes, BRCA1 and BRCA, have been found to play an important role in the development of breast cancer.
The incidence of breast cancer begins in early adulthood, with a sharp rise in incidence to the time of menopause. After menopause, the incidence of cancer decreases significantly.

Breast cancer does not affect women exclusively: one percent of all breast cancers occur in men.

Haemophilia, Hemophilia

2007-02-28T19:17:00.000Z

Hemophilia is a bleeding disorder that occurs almost exclusively among boys and men. Currently hemophilia is not curable, but most cases of it can now be treated effectively. Although it is an inherited condition that can be detected before a child is born, hemophilia is usually discovered when a small child who is beginning to crawl suffers exaggerated bruising from what ordinarily would be minor injuries. While most people think of bleeding from open wounds when they think of hemophilia, external injuries do not usually present the most serious problem. Uncontrolled internal bleeding is much more dangerous. Internal bleeding close to the skin surface causes bruises; bleeding into deeper tissues may result in a hematoma, which is a pocket of blood inside a muscle or organ. Individuals with hemophilia not only tend to have more bruises than other individuals, their bruises are usually more severe. Something as simple as a shot that is injected into muscle tissue may cause a large bruise that lasts for several weeks.

In the late 1800s and early 1900s, hemophilia was sometimes called "The Royal Disease", because many members of the English, German, Russian and Spanish royal families either had it or carried it. Until the 1960's, when clotting factors were identified, the only treatment for hemophilia was blood transfusions. Unfortunately, not enough of the needed clotting factors are present in whole blood or blood plasma to stop serious internal bleeding, so most individuals with severe hemophilia died before reaching adulthood. Others suffered painful and disabling joint damage. Today, because hemophilia can be controlled with clotting factor products, most individuals who have it lead nearly normal lives. Excellent resources, including support groups, are available for individuals with hemophilia and their families. Research, especially in the field of gene therapy, offers hope for better treatment and even a cure in the not-too-distant future.

What is it?

Hemophilia is a disorder of the blood clotting system. Normally, an injury to a blood vessel activates certain blood components known as “clotting factors”. A series of 12 natural clotting factors helps to change ordinary blood components into sticky clumps. Platelets, tiny cell particles that circulate in blood, begin attaching to each other and to protein fibers that are also in the blood. Ordinarily, a soft mass of platelets and fibers (a blood clot) forms quickly, bleeding stops, and the wound begins to heal. This process is known as coagulation. Hemophilia results when one or more clotting factors are absent or insufficient. As a result, either blood clots break apart because they are too fragile to withstand blood flow or clots do not form, at all.

Although a deficiency of any of the 12 clotting factors is possible, the two that appear to be most essential to forming blood clots are factor 8 (designated by the Roman numeral VIII) and factor 9 (IX). A deficiency of factor VIII is also called hemophilia A or classic hemophilia. Approximately 80% of individuals with hemophilia have hemophilia A. Abnormal production of factor IX is called hemophilia B or Christmas Disease (because the first person diagnosed with it was named Stephen Christmas). About 10% to 15% of individuals with hemophilia have hemophilia B. Other inherited bleeding disorders, including deficiencies of other clotting factors and von Willebrand's disease, are very rare.

Both hemophilia A and hemophilia B are classified by the estimated percentage of natural clotting factor that is produced by the individual.

Mild hemophilia is considered to be 5% of normal production

Moderate hemophilia is 1% to 5% of normal production

Severe hemophilia is 1% or less

About two-thirds of individuals with hemophilia A and about half with hemophilia B have severe cases. The severity of an individual’s condition often corresponds to the likelihood of physical problems. It may also predict how serious those problems might be and suggest which treatments may be most effective.

Although most bleeding episodes in mild to moderate hemophilia usually result from an injury, individuals with severe hemophilia may experience bleeding with no apparent cause. In severe hemophilia, most bleeding is internal. Bleeding may occur inside joints and muscles, or more seriously, in organs such as the stomach or brain. However, if the appropriate clotting factor is given as quickly as possible following injury, individuals with hemophilia may not have either visible evidence of bleeding or interference with everyday life.

The physical damage that can result from untreated serious bleeding depends on where the bleeding occurs.

Serious bleeding into muscle tissue: Areas of muscle cells around the bleeding may die. The resulting scar tissue contracts as it is formed, potentially leading to decreased ability to bend joints. The scar tissue may also squeeze nerves, causing numbness and tingling.
Serious bleeding into joints: Knees, elbows, ankles, shoulders, hips, and wrists, are usually affected in that order. Joint bleeding may cause multilayered damage that may result in severe, painful arthritis. Commonly, damage progresses as follows:
- Blood flows into the joint until pressure in the joint space increases significantly, shutting off the flow of blood.
- Bone ends in the joint are forced apart by the extra blood, causing pain and swelling,
- Red blood cells release iron and other compounds as they break down within the joint space. Both the resulting debris and the scavenger cells that enter the joint to remove it, attack the smooth cartilage at the ends of the bones.
- Eventually, patches of cartilage erode away, softened areas of bone splay out, and small areas of dead bone form cysts. Ligaments stretch and slacken, allowing bones to shift into unnatural positions. Chronic handicaps may develop. Hemophilic arthritis can lead to muscle wasting. Weakened bones also increase the risk of fractures.
Bleeding into the skull or brain: Because bleeding can press on the brain, drowsiness, extreme headaches, nausea, vomiting, and sensitivity to light may result. Scar tissue, which can also be caused by bleeding into the brain, occasionally leads to epilepsy.

Gastroesophageal Reflux Disease (GERD) -

2007-02-28T18:04:00.000Z

Commonly called heartburn or indigestion, GERD is a sense of burning and discomfort between the ribs just below the sternum (breastbone). Sometimes people with GERD experience a sour or bitter taste in the back of their mouth or throat

What causes it?

The esophagus is the passageway ("food pipe") that carries swallowed food to the stomach. GERD occurs when the muscular valve between the esophagus and the stomach does not function properly, causing acid to back up into the esophagus. The acid can then cause inflammation of the esophagus (esophagitis). GERD can cause internal bleeding or esophageal ulcers.

Chronic GERD can result in:

narrowing of the esophagus from chronic scarring, making it difficult to completely swallow
a condition known as Barrett's esophagus, which is sometimes a precursor to esophageal cancer
Mechanism of GERD

Who has it?
Heartburn, the primary symptom of GERD, affects about seven per cent each day. The prevalence increased in adults older than 40 years of age. In addition, up to 25 percent of pregnant women have heartburn on a daily basis because of increased pressure from the uterus pushing up on the stomach. Since other disorders can cause heartburn (e.g., peptic ulcer disease), less people are found to actually have GERD. It is estimated that approximately 10% of Americans suffer from heartburn daily and more than one-third have occasional symptoms.

Because most patients with GERD require chronic therapy, costs associated with diagnosis and treatment are estimated to be $9.3 billion.

Hepatitis C - Causes

2007-02-27T19:31:00.000Z

What causes it?

Why HCV attacks liver cells is not well understood, but liver damage may be caused in at least three possible ways:

Direct cell damage. Viral cells are parasites that depend on normal cells to multiply. Once a virus enters a normal cell, the virus uses the cell’s DNA to make more virus, which is released when the normal cell dies. While other viruses are more likely to infect other body cells, HCV affects liver cells.
The development of immune complexes in the liver. Proteins that are formed by the body’s immune system to get rid of the virus, immune complexes may also cause damage to liver cells.
The action of T-cells. Specialized white blood cells that attack and kill substances identified by the body as invaders, T-cells may destroy liver cells instead of HCV because the virus is changing so quickly.

Headaches - Types of Headache

2007-02-23T19:13:00.000Z

Tension Headache

The most common type of headache, tension headache pain is usually described as feeling like a tight band that puts constant pressure on both sides of the head. Pain may extend into the neck or shoulders. Generally, tension headaches are mild to moderate in severity and they do not usually interfere with routine activity. An occasional inconvenience for most individuals, tension headaches often have a specific cause such as fatigue or stress. However, some individuals may have frequent or even daily tension headaches that may be severe enough to limit regular activity. Chronic tension headaches may have no apparent cause or they may be associated with other conditions such as anxiety, depression, or insomnia. About equal numbers of men and women have tension headaches and individuals of any age may experience them, although they most commonly occur between the ages of 20 and 40 years.

Migraine Headache

Migraine headaches are often described as intense throbbing or pounding pain on one or both sides of the head. Nausea and the inability to tolerate light, smells, or sounds may accompany the pain of a migraine. Up to a third of individuals who have migraines may have a warning that a migraine is about to start. These individuals may experience an aura that may include visual changes (such as dimmed or blinking lights) or unusual sensations (such as tingling in their hands, feet, or face). Generally, migraines are infrequent, although they may be chronic for some individuals. Migraines can last for days, often leaving patients feeling exhausted and lethargic. While the exact causes of migraine headaches are unknown, individuals who have recurring migraines may be able to identify physical factors that “trigger” their migraines. For example, some migraines are attributed to stress; others may occur in response to environmental changes, such as very cold weather; certain foods may contribute to other migraines. About three times as many women as men suffer from migraines, with many women experiencing migraines around their menstrual periods.

Cluster Headache

Much less common than migraines or tension headaches, cluster headaches usually occur in groups (clusters) that may continue for a few days up to several weeks. Most often cluster headaches involve sudden attacks of extreme pain lasting from a few minutes to several hours and often involving only one side of the head. Affecting many more men than women, cluster headaches may be associated with irritation of the eye and nose. Individuals who smoke and drink alcohol may be more prone to having cluster headaches. This type of headaches are more prone in people who have the following: people with eye problem, runny noses, facial sweating.

Other Types of Headaches

Organic Headache

Organic headaches are relatively rare, but they need immediate medical attention because they have serious physical causes such as blood clots, brain tumors, brain infections, or bleeding into the brain. Sometimes becoming intensely severe over a few hours or days, they may be associated with weakness, confusion, or unconsciousness.

Sinus Headache

Usually, sinus headache pain is due to swelling in the sinus cavities around the nose and eyes. Often caused by allergies or infections, sinus headaches may be accompanied by fever, a stuffy nose, or toothaches. Leaning forward or lying down may increase sinus headache pain.

Rebound Headache

Ironically, rebound headaches result from overuse of headache medications. Individuals who take more headache medication than recommended, take it continually for long periods of time, or consume large amounts of caffeine may need more and more medication to control headache pain. When the effects of the medication start to decrease, the headache is even worse and more medication is needed. Eventually, the medication doesn’t work anymore. Individuals who have ten or more headaches a month may be experiencing rebound headaches.

Hormonal Headache

Headaches of the hormonal type often result from fluctuation of hormones in the female body.

Hepatitis

2007-02-22T19:20:00.000Z

Introduction

The word "hepatitis" means inflammation of the liver. Rarely, some kinds of hepatitis are not caused by infection. These non-contagious types of hepatitis can result from alcohol abuse, certain drugs, ingestion of toxic substances, or autoimmune disease (the body's own immune system attacks the liver). The usual cause of hepatitis, however, is infection by a virus. At least six viruses, usually identified by the letters A through G, are known to cause hepatitis. In the United States, hepatitis A, hepatitis B, and hepatitis C are the most common.

What is it?

Hepatitis B is a specific type of hepatitis caused by the virus that has been designated as hepatitis B virus (abbreviated as HBV), which causes inflammation and damage to the liver. As the virus infects more liver cells, inflammation and destruction of liver cells can interfere with the functions of the liver.

Normal Liver Functions That May Be Affected by Liver Damage
Breakdown of harmful substances to keep them from building up in the bloodstream
Production of bile to help digest food
Production of cholesterol and protein
Regulation of blood clotting
Storage and release of energy in the form of sugar

Most individuals are able to fight off (or clear) infection with HBV and they recover in 2 to 4 months. Ordinarily individuals only get hepatitis B once and after the HBV infection has been cleared, the individual has lifelong immunity . Up to 10% of adults, 50% of children under the age of 5, and 90% of infants who contract hepatitis B will not be able to eliminate the virus in 6 months. These individuals are considered to be chronic carriers of HBV.

It is estimated that chronic hepatitis B affects 1.25 million people in the United States and leads to 5,000 U.S. deaths per year. Chronic hepatitis puts individuals at a greater risk of developing cirrhosis or liver cancer. Cirrhosis is a condition that gradually replaces active liver cells with inactive scar tissue. Slowly, liver function is lost and liver failure may result. However, individuals who are chronic carriers of HBV but who have no symptoms are much less likely to develop cirrhosis than individuals who have chronic symptoms of hepatitis B.

Hepatitis C - Risk Factors - Who gets Hepatitis C?

2007-02-21T19:33:00.000Z

Who has it?

The World Health Organization estimates that 180 million people around the world (about 3% of the population) are infected with HCV. Although it affects members of all ethnic groups, hepatitis C appears to be more common in less industrialized areas of the world, with estimates as high as 20% of the population in some countries.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), 4.1 million Americans (about 1.6% of the population) show evidence of having had an infection with HCV. Only about 25% of those individuals experienced symptoms that were attributed to hepatitis C, but 55% to 85% of them went on to the chronic phase. The Center for Disease Control estimates that there are 26,000 new infections each year, a decrease from the average of 240,000 per year in the 1980s. Most will develop chronic liver disease, which may progress to cirrhosis or liver cancer. In the 1970s and 1980s, a number of individuals got hepatitis C from donated blood that was contaminated with HCV, Today, the risk of transfusion-associated hepatitis C is very low (approximately one chance for every 100,000 units that are transfused). Approximately 25% of people who have HIV/AIDS will develop hepatitis C. Persons with HIV are more prone to get hepatitis C through sexual exposure.

What are the risk factors?

Mainly, HCV is passed from one individual to another through blood and blood products. A much smaller chance exists that it may also be transferred in bodily secretions, such as semen. The risk for infection with HCV is increased for individuals who:

are born to mothers who have HCV
had contact with high-risk individuals more than 6 months before the onset of symptoms
have ever injected street drugs (even only once or many years ago)
have HIV or AIDS
have sexual contact with an infected individual
live in poor socioeconomic conditions
received transfusions of blood or blood products (especially before July 1992)
require long-term kidney dialysis
used blood-derived clotting factors before 1987
work in health care facilities where they may be exposed to blood
have liver disease

Illegal injection drug use accounts for about 60% of new HCV infections in the United States. In approximately 10% of infections, the source of exposure is unknown.

High Cholesterol - what does it mean?

2007-02-20T20:33:00.000Z

With cholesterol testing at health fairs and drug stores, and with a breakdown of fat and cholesterol counts on all the packaged food we eat, you are probably well aware of the relationship between high cholesterol and heart disease. Yet, heart disease remains the leading cause of death in the United States; and you may not always eat the healthy, low-cholesterol diet that you should.

Because of the important relationship between high cholesterol and heart disease, all adults over the age of 20 years should have a fasting lipoprotein profile [a complete cholesterol profile--includes measuring total cholesterol, triglycerides, low-density lipoprotein(LDL) and high-density lipoprotein (HDL)] checked at least every 5 years. This should occur more often if a family history of coronary heart disease exists. Most children do not need to have their blood cholesterol level checked.

Hepatitis - Treatments

2007-02-15T19:26:00.000Z

How is it treated?

Hepatitis B that lasts beyond 6 months or becomes serious may be treated with several different medications, but not every case needs to be treated. Whether or not an individual with hepatitis B is taking medication, regular visits to a doctor who specializes in liver diseases are very important. Laboratory tests that measure liver function, need to be performed regularly to track disease progression and to determine possible complications. Because no cure has been found for hepatitis B, treatment is aimed at decreasing the ability of the virus to multiply, decreasing inflammation and damage to the liver, and increasing the immune system’s ability to fight the virus.

Currently, drug treatments seem to be most helpful for individuals who have liver disease caused by hepatitis B. Unfortunately, there is no drug treatment for the acute phase of hepatitis B. Nausea and vomiting often seen with early infection is treated with fluid replacement. In the United States, the four drugs that have been approved by the Food and Drug Administration (FDA) for treating chronic hepatitis B are:

Interferon-alpha (Intron A and Pegasys) A synthetic version of antiviral proteins produced by the immune system, artificial interferon is used to treat a number of conditions. Although it may cause side effects such as depression, headache and flu-like symptoms, interferon is approved for both children and adults with hepatitis B. It is given by injection several times a week. There is also a modified form of interferon known as peginterferon that has been approved for the treatment of Hepatitis B and C. It has a similar but larger chemical structure than interferon-alpha that improves how the drug works and only needs to be injected once weekly.

Lamivudine (Epivir-HBV) Taken orally once a day for at least a year, lamivudine is approved for use by both children and adults with chronic hepatitis B. It has very few side effects, but long term use of lamivudine is likely to cause the hepatitis virus to become resistant to the effects of this medicine. Because of this, combination therapy and the use of other medicines to treat hepatitis B are areas of intense study.

Adefovir dipivoxil (Hepsera) Approved only for adults with chronic hepatitis B, adefovir is taken once a day as an oral tablet. Studies have shown that use of adefovir has been beneficial in reducing the amount of virus in the body without causing as much resistance as lamivudine. The most common side effects experienced by patients taking this medicine are headache, throat pain, and stomach pain.

Entecavir (Baraclude) Approved by the FDA March 30,2005, entecavir resembles a product needed by viral DNA to continue growing. It has been approved for chronic hepatitis B patients in whom the virus is active and replicating. Entecavir can also be used in patients with a resistant virus who have failed lamivudine therapy. Entecavir, taken as an oral tablet or solution once daily, is tolerated as well as lamivudine. The hepatitis B virus is much less likely to develop resistance to entecavir, representing a convenient treatment option for chronically infected patients.

Therapy with one drug is still considered to be the first line treatment approach and the choice of drug is specific to each patient with chronic hepatitis B. Combination therapy with interferon alpha and a nucleoside analog (like lamivudine or entecavir) may be used to prevent viral resistance and has shown promising results in reducing viral replication. However, further studies are needed to fully evaluate the benefit of combination therapy over treatment with one drug. Your doctor may run tests to check the health of your liver if you are on medicines like adefovir, lamivudine, or entecavir. If you are on any of these medicines, tell your doctor if you experience abdominal pain, skin discoloration, orange or dark urine, and frequent diarrhea or constipation.

Prevention of hepatitis B

Hepatitis B cannot be cured, but it can be prevented relatively easily.

Before exposure to HBV

The hepatitis B vaccine (Engerix-B, Recombivax HB) is a safe and effective protection from hepatitis B. Given as three injections during a 6-month period, it generally produces immunity for 15 years or longer. Generally, the injections are given in a doctor’s office or clinic.

Currently, hepatitis B vaccination is required by many school districts before a student is admitted. It is recommended for all individuals under the age of 19 years and for individuals who:

are homosexual men
have kidney dialysis
have liver diseases (including other types of hepatitis)
have multiple sex partners
have or ever have had a sexually transmitted disease (for example, gonorrhea or syphilis)
have sex with a partner who has hepatitis B
have sex with multiple partners
live in or travel to countries where hepatitis B is common
live in the same home as an individual who has chronic hepatitis B
may be exposed to HVB in blood

After exposure to the virus

Individuals who know or believe that they have been exposed to HBV, including babies born to mothers who test positive for HBV, should receive the three hepatitis B vaccine injections. They should also get one injection of hepatitis B immune globulin (BayHep B, Nabi-HB). Abbreviated as HBIG, this medication is made up of immune system proteins that specifically help to fight HBV.

Drug classes used to treat Hepatitis B

Interferons

Nucleoside Reverse Transcriptase Inhibitors

Celiac Disease

2007-02-15T03:35:00.000Z

Celiac (coeliac) disease is a chronic condition where the body reacts to a protein — called gluten — and loses its ability to absorb necessary nutrients. Gluten is most commonly found in wheat, barley, rye, and oats. Celiac disease is considered an auto immune disorder because with consumption of gluten, the immune system actually attacks the body’s own cells in the small intestine.

The exact cause of celiac disease is unknown. Research has shown that it may have a genetic link, and the disease usually appears after some distress to the body such as pregnancy, childbirth, illness, severe emotional stress, physical injury, or surgery.

The effects of celiac disease appear when a protein, called gluten, is consumed. The small intestines are responsible for proper absorption of nutrients needed for energy and building of body tissues. Tiny projections, called villa, line the small intestines to allow greater absorption of food and nutrients. When gluten enters the small intestine, a reaction occurs and the body attacks the villa, leaving small lesions. Upon damage to the villa, the small intestine is then unable to absorb nutrients properly leading to symptoms of malnourishment.

Gout

2007-02-02T18:13:00.000Z

Gout is a type of arthritis (inflammation of the joints) that mostly arises in men age 40 years and older. Women can also develop gout, although it is more likely to occur after menopause. Gout is caused by a buildup of needlelike uric acid crystals in the joints. Uric acid is a waste product in your body that comes from two sources:

1. Normal cell metabolism
2. Digestion of the food you eat

Under normal conditions, most uric acid is passed through the kidneys and is eventually excreted in the urine. There is a small amount of uric acid in your blood at all times, which does not cause problems. However, in patients with gout, the amount of uric acid in the blood is higher than normal, either because their body produces too much uric acid or because their kidneys are unable remove uric acid from the blood. The excess amount of uric acid in individuals with gout is stored in the joints and over a period of time may result in crystal formation. The uric acid crystals deposited in the joints are responsible for the excruciating pain of gout.

There are two types of gout, primary and secondary, depending on the cause of high uric acid in the blood.

Primary Gout: Primary gout is the most common. In primary gout the cause of excess uric acid is usually not known. Most scientists believe that primary gout is caused by genetics, which means that patients probably inherited this condition from someone in their family. The basic defect is either an impaired clearance of uric acid by the kidneys (also termed "underexcreter"), an increase in production of uric acid (termed "overproducer"), or a combination of both defects.

Secondary Gout: In secondary gout, the cause of excess uric acid is usually known. Most commonly, secondary gout is caused by certain medications or health conditions.

Medications that may cause secondary gout include:

Diuretics ("water pills"), such as chlorothiazide (Diuril), chlorthalidone (Hygroton), hydrochlorothiazide (Esidrix, HCTZ, HydroDIURIL, Oretic), metolazone (Mykrox, Zaroxolyn), bumetanide (Bumex, Edecrin), ethacrynic acid, furosemide (Lasix), torsemide (Demadex)
Pyrazinamide (PZA)
Cyclosporine (Sandimmune, Neoral)
Aspirin
Nicotinic acid (Niacin)
Levodopa

Health conditions that may cause secondary gout include:

Alcoholism
Leukemia
Lymphoma
Lung cancer
Smoking
Psoriasis
Obesity
Kidney dysfunction
Congestive heart failure
Starvation
Anemia
Untreated high blood pressure
Diabetes
Severe illness or injury
Immobility due to bed rest
Down's syndrome
Thyroid disorders

Glaucoma

2007-02-02T17:12:00.000Z

Glaucoma is an eye disease that is caused by an increase in intraocular pressure (IOP) -- this pressure gives the eyeball its round shape. The increase in IOP results from a change in the eye's ability to drain aqueous humor, the fluid circulating inside the eye.

There are two general types of glaucoma: -open-angle and closed-angle (the angle refers to the point where the muscles that keep open the pores that drain the fluid meet.)

The most common type is open-angle glaucoma (accounts for 90% of glaucoma cases); it is the leading cause of blindness in people of African American descent. Normally, open-angle glaucoma is a slowly progressive (or chronic) disease that produces no obvious symptoms until its late stages and occurs in both eyes, although one eye may have a faster progression of the disease than the other. A smaller percentage of people develop closed-angle glaucoma, which is typically acute (occurs more suddenly) and associated with a red, swollen, and painful eye. It is usually the result of a blockage of the pores that drain eye fluid and should be treated urgently to remove the blockage to help avoid permanent vision loss.

Fibromyalgia

2007-02-01T17:03:00.000Z

Fibromyalgia (FM) is a chronic pain disorder that affects the muscles and the soft fibrous tissues of the body (the ligaments, tendons, and soft tissue in between joints). The word 'fibromyalgia' comes from the Latin words for fibrous tissue (fibro), muscle (myo), and pain (algia). Unlike other chronic painful diseases (e.g. multiple sclerosis), FM is a syndrome. A syndrome is a loose collection of signs and symptoms that characterize a condition. Unlike a disease, the exact cause of FM is still unknown. People with fibromyalgia have 'tender points' on the body. Tender points are specific places on the body especially the neck, shoulders, back, hips, arms, and legs. These points hurt when pressure is put on them. Too much exercise or overexertion of muscles can make FM symptoms worse, as can physical inactivity. FM is very hard to diagnose. Patients often experience many signs and symptoms that vary in amount and intensity and can be easily confused with other conditions. This confusion can increase the pain and frustration often felt by a patient with FM.

Erectile Dysfunction - Health Conditions - Conditions & Treatments - DrugDigest

2007-01-31T17:00:00.000Z

In the past few years, there has been an increase in the number of advertisements regarding erectile dysfunction. You've probably seen former Presidential candidate Bob Dole or Baltimore Oriole Rafael Palmeiro in television commercials informing viewers of erectile dysfunction and the use of Viagra. Former professional football player and coach Mike Ditka has also been seen educating viewers about the once taboo subject of erectile dysfunction. With heightened awareness of this disorder, the attitudes of the public and healthcare professionals are changing with more individuals seeking help with the disorder.

Erectile dysfunction (ED), sometimes called "impotence", is the inability to achieve or maintain an erection for sexual intercourse. Impotence can involve three aspects of erection development: the time to develop an erection, the strength of the erection, or the amount of stimulation needed to achieve an erection. Erectile dysfunction may be a result of a variety of factors, ranging from chronic diseases, medications, to psychological factors.

What causes it?
Before discussing the causes of erectile dysfunction, it is important to understand how an erection develops and how an erection is sustained. The penis is made of a mass of tissue composed of several structures of spongy networks that contain blood vessels and smooth muscle tissue. Normal nerve function and blood supply to these areas is essential to experience and maintain an erection. When sexual arousal takes place (whether it be a result of visual stimuli, touches, smells, or thoughts), the brain responds by communicating the arousal to the body's nervous system, which activates blood flow to the penis. As blood flow increases in the penile area, blood vessels supplying the penis dilate so the body of erectile tissue becomes engorged. When the erectile tissue engorges, an erection develops.

If something affects any of the factors responsible for an erection, erectile dysfunction may result. Psychological factors or nonphysical factors may also contribute to erectile dysfunction. Such factors may include depression, stress, anxiety, negative feelings toward a sexual partner, or even feelings of dissatisfaction with sexual function.

Although psychological and nonphysical causes are possible, there are several physical causes that may contribute to erectile dysfunction. Common diseases such as diabetes, high blood pressure, atherosclerosis (hardening of the arteries), thyroid problems, and alcoholism may also cause erectile dysfunction. Spinal cord injury, multiple sclerosis, or other diseases that may affect nerve conduction to the penile area can decrease the likelihood of achieving or maintaining an erection. Low hormone levels (for example, low levels of testosterone or prolactin) may also be a cause of erectile dysfunction, although the incidence of these causes is thought to be much less than the common diseases such as diabetes. Studies have even shown that the pressure obtained from riding a bike, which comes from sitting on a bicycle seat with a nose extension, restricts blood flow to the penis.

Certain prescription medications and illicit drugs may cause erectile dysfunction. Up to 25% of cases of erectile dysfunction result from medication side effects. Examples of prescription medications that may lead to erectile dysfunction include certain antidepressants, medications for high blood pressure, antipsychotics, medications used for anxiety disorders, anticholinergics (e.g. diphenhydramine, benztropine, and atropine), cimetidine, digoxin, and substances of abuse (e.g. alcohol, cocaine, and marijuana). Check with your doctor or pharmacist if you suspect that a medication you are taking may be the cause of erectile dysfunction

Endometriosis

2007-01-31T11:58:00.000Z

Endometriosis is a disorder in women that can cause painful menstruation, chronic pelvic pain, painful intercourse, and possible infertility. The disorder may worsen over time, resulting in scarring to the ovaries and fallopian tubes and leading to decreased ability to get pregnant. In fact, 30% to 40% of patients with endometriosis are infertile. This is two to three times the rate of infertility in the general population.

What causes it?
No single theory seems to explain all cases of endometriosis. Several theories, however, have been suggested:

The endometrial cells, which line the uterus, migrate from the uterus through the fallopian tubes into the pelvis. These cells implant on other pelvic organs and are stimulated by hormones released during menstruation. This can cause bleeding at these locations. Surrounding organs may then absorb the blood, leading to pain and inflammation. This theory fails to explain why women still have endometriosis after sterilization (sometimes called 'having their tubes tied') or after hysterectomy (removal of the uterus). It is possible that the endometrial tissue spreads from the uterus to the abdominal cavity through the lymphatic system or bloodstream instead of through the fallopian tubes.
The cause may stem from an abnormality in the immune system that allows normally shed endometrial cells to attach and grow in other areas.
The disease may be caused by a genetic birth defect as evidenced by its tendency to run in families.
Tissue in the abdominal cavity may change into endometrial tissue as a result of repeated inflammation.

Attention Deficit- Hyperactivity Disorder (ADHD)

2007-01-30T14:01:00.000Z

At some point, everyone has experienced having trouble concentrating on the task at hand. Especially as children, most of us probably would have rather been outside on a nice day instead of sitting in a classroom concentrating on schoolwork. Even so, most of us could focus if we needed to. Now, imagine being a child or an adult who is not able to focus on or complete any task, no matter how hard he or she tries. Or imagine being hyperactive all the time and not having the ability to control it...this is what life is like for a person with attention deficit-hyperactivity disorder (ADHD).
Documented cases of ADHD can be found as early as the 1930s, but it wasn't until the 1990s that ADHD gained notice as a true psychiatric condition. ADHD, or ADD as it is sometimes called, is defined as "a disorder of inattention, hyperactivity, and impulsivity that presents early in life." This condition is thought to be predominately genetic in nature. Most of the patients that are diagnosed with ADHD will have a family history of ADHD or another psychiatric condition. Risk factors play an important role in how this condition develops. Currently there is no cure, but treatment is available to help patients function better in society and in their daily lives.

Conjunctivitis

2007-01-30T07:38:00.000Z

Conjunctivitis, often referred to as “pink eye”, is a general term used to describe irritation of the conjunctiva. The conjunctiva is a thin, colorless membrane that lines the eyelid and a portion of the eyeball. There are several types and causes of conjunctivitis, but most involve first an irritant and then resulting inflammation of the conjunctiva.

Conjunctivitis may result from allergic, bacterial, and viral irritants.

Seasonal allergic conjunctivitis usually stems from an air-born irritant such as ragweed, pollen, or mold. When the conjunctiva is exposed to the irritant, a chain of events leads to the swelling, itching, and redness often associated with this form of conjunctivitis. First, the irritant is detected and marked by the body’s immune system as foreign and unlike other cells. Then the target is marked for elimination. Combatant cells, called mast cells, arrive on the scene to remove the foreign attacker.

A similar chain of events occur when the conjunctiva is exposed to bacterial or viral irritants.

Diabetes Conditions & Treatments

2007-01-29T16:48:00.000Z

Diabetes, also known as diabetes mellitus, is a chronic disease characterized by high glucose (sugar) levels in the blood. Your body produces a hormone called insulin to regulate the amount of sugar in the blood. If you have diabetes, your body either doesn't produce enough insulin (Type 1) or does not adequately respond to the insulin it is producing (Type 2).

There are three major types of diabetes:
1. Type 1: In type 1 diabetes, the body loses its ability to produce insulin. Insulin is necessary for the body to be able to use sugar. Sugar is the basic fuel for the cells in the body, and insulin takes the sugar from the blood and helps transport it into the cells. In people with Type 1 diabetes, the immune system mistakenly attacks the insulin-producing cells in the pancreas. When this happens, beta cells in the Islets of Langerhans, which are tiny clusters of cells in the pancreas that manufacture insulin and glucagon, are attacked and destroyed by the body's own immune system in an autoimmune reaction. This is called an autoimmune response. Type 1 diabetes typically affects younger people, and symptoms may appear suddenly. This type of diabetes accounts for about 5 percent to 10 percent of all diagnosed cases of diabetes.

2. Type 2: In type 2 diabetes, the body either becomes less responsive to the insulin it produces or does not produce enough insulin. Insulin helps the body use sugar, which is necessary for the cells in the body to live. Insulin takes the sugar from the blood and helps transport it into cells. The body can become resistant to insulin because of obesity, sedentary lifestyles, aging, certain drugs, or high glucose levels. Type 2 diabetes, which usually has its onset in adulthood after the age of 30, is much more common than type 1 diabetes. At least 90 percent to 95 percent of all people who have diabetes are classified as having type 2.

Pre-diabetes : A person is said to have pre-diabetes (also known as Impaired Glucose Tolerance - IGT) when his/her fasting blood glucose level is higher than normal but not high enough to be diagnosed with type 2 diabetes. For example, it is considered normal if your fasting blood sugar level is less than 100 mg/dL. However, you’re considered to have pre-diabetes if your fasting blood sugar levels are between 100-125 mg/dL. It is estimated that 17 million Americans have pre-diabetes.
3. Gestational diabetes: This form of diabetes is diagnosed in pregnant women who have never had diabetes before, but who have high blood sugar levels during pregnancy. High blood sugar levels occur in pregnancy and usually disappear after the mother gives birth. This type of diabetes occurs about 4 percent of all pregnant women - about 135,000 cases in the United States. In 40 percent of all cases, gestational diabetes leads to type 2 diabetes later in life.

Secondary diabetes: High blood sugar levels result from specific genetic syndromes, surgery, drugs, malnutrition, infections, and other damage to or diseases of the pancreas. This type of diabetes may account for 1 percent to 2 percent of all cases of diabetes.

What causes it?

The cause of type 1 diabetes is unclear; however, it is thought that autoimmune, genetic, and environmental factors are involved in the development of this type of diabetes. The appearance of type 1 diabetes is suspected to follow an exposure to some type of "environmental trigger" - for example, a virus. It is thought that this stimulates an immune attack against the beta cells of the pancreas in genetically predisposed people.

There are two important causes of type 2 diabetes:

Heredity: Type 2 diabetes often runs in the family, but the onset of the illness doesn't occur until adulthood.
Obesity: If you are overweight, your body may become less responsive to the insulin you have, resulting in type 2 diabetes.

Deep Vein Thrombosis - Health Conditions - Conditions & Treatments

2007-01-28T16:39:00.000Z

Deep vein thrombosis (DVT) is the term used to describe blood clots (also called thrombi) that form in the veins, usually in the lower legs. These clots can grow in size and interfere with blood flow in the legs; and sometimes the clots break loose and travel to the lungs, brain, heart, or other areas of the body. When the clots lodge in other organs or tissues, they can block blood flow, and cause serious damage to these organs. As many as 50% of patients with DVT experience damage to their lungs caused by a clot. This condition is commonly known as a pulmonary embolism (PE).

What are the symptoms?

While it is common to not experience any symptoms at all, some people may experience any of the following symptoms of a DVT:

* Leg pain, usually in only one leg
* Leg tenderness, usually in only one leg
* Swelling (edema), usually in only one leg
* Increased warmth, usually in only one leg
* Changes in skin color (red or bluish), usually in only one leg
* Joint pain
* Sharp pain when the foot is bent upward

Laboratory tests:

The following lab tests are commonly performed to help diagnose a DVT:

* Ultrasound (used to detect DVT)
* Chest X-ray (used to detect clots in lungs)
* Antiphospholipid antibodies (indicators in the blood that a person has an increased risk of DVT)
* Venography (the most accurate test for detecting a clot in the leg)"

Coronary Heart Disease

2007-01-26T11:41:00.000Z

Coronary heart disease, also termed coronary artery disease or ischaemic (ischemic) heart disease, is the most common form of heart disease and the most common cause of death in the western world. The coronary arteries are large blood vessels in the surface of the heart that deliver blood to the heart muscle. Fatty plaques can build up in the arteries and block blood flow - a process called atherosclerosis. If the arteries become blocked, the heart muscle does not get enough oxygen, bringing on a variety of symptoms such as chest pain and shortness of breath, as well as heart muscle damage and even death.

The main mechanisms of angina (chest pain) are conditions that either decrease the supply of blood, or increase the demand for blood. Decreased supply is most commonly due to atherosclerosis (a build up of fatty deposits), or spasms in the arteries, which can limit the space through which blood flows to the heart.

An increase in demand takes place during exercise or exertion. The heart beats faster to supply the muscles and other organs with more oxygen in response to the increased demand. Chronic stable angina results when this increased demand for blood exceeds the supply to the coronary arteries. This can also occur during periods of stress, or extreme temperatures. Although spasms of the coronary arteries are the main cause of Prinzmetal's angina, approximately two thirds of people with this type of angina also have atherosclerosis in at least one vessel.

Coronary heart disease can result in:
* Angina pectoris
* Unstable Angina
* Acute myocardial infarction, or heart attack

There is no exact single cause of coronary heart disease but rather numerous factors that can contribute to or increase the risk of developing the condition. These factors can include lifestyle, heredity, age, and gender.

Asthma

2007-01-06T13:36:00.000Z

Asthma is a chronic lung disease. Although everyone's airways react to irritants, the overly sensitive airways of the asthma patient exhibit an exaggerated response. This exaggerated response ultimately leads to inflammation, irritation, and swelling of the airways that causes limited airflow. The result is periodic attacks of coughing, wheezing-high pitched, whistle-like breathing noises that signify tight airways-and other breathing difficulties. Asthma can range from a mildly bothersome annoyance to a life-threatening medical emergency.

Bacteria and Bacterial Infection

2006-12-30T14:02:00.000Z

While children's recurring ear infections used to be easily treated, lately they have become a parent's nightmare. In the old days, you would simply call the pediatrician, make a quick trip to the pharmacy for the "pink stuff" - shake well, keep in the refrigerator, finish all - and in a week you had a happy, healthy child again. But now, infections seem more difficult to treat in both children and adults. What's changed?

Bacteria are simple one-celled organisms. We share our world with countless different species of bacteria, many of which have not yet been identified. Most are harmless, and many are helpful -- even vital to our existence. For example, the bacteria that live in the roots of plants like beans and peas, help extract nitrogen from the atmosphere to enrich the soil.

Bacteria can be found, by the billions, all around us: on furniture and counter-tops, in the soil, and on plants and animals. They are a natural and needed part of life. In fact, they often protect us by competing with more dangerous bacteria for food and space. Bacteria cause disease and infection when they are able to gain access to more vulnerable parts of our bodies and multiply rapidly. Bacteria can infect many parts of the body, including:

* eyes
* ears
* throat
* sinuses
* lungs
* airways
* skin
* kidneys
* bladder
* stomach
* colon
* brain
* heart
* bones
* genitals
* blood

Arthritis

2006-12-28T11:32:00.000Z

The Tin Man was lucky. Just a squirt of oil on his stiff joints and he was dancing down the yellow brick road with Dorothy. But for the 70 million Americans who have arthritis, managing the condition is not as simple.

Arthritis is the general term for at least 100 rheumatic diseases that painfully affect joints, muscles, and connective tissues throughout the body. More than just a physical disease, arthritis drains patients emotionally and financially. It is the number one cause of disability in the United States. For millions of Americans with severe arthritis, pain and deformity limit such everyday activities as getting out of bed, climbing stairs, dressing, or simply walking. And, because it is a chronic disease, it is fertile ground for hundreds of alternative and unproven therapies.

Acne

2006-12-15T11:30:00.000Z

Acne, also called acne vulgaris, is a common inflammatory skin condition that is characterized by pimples, blackheads, and red, swollen bumps on the skin (usually the face, neck, shoulders, or back). The term acne is used to describe the condition when a person has between 5 to 10 pimples, blackheads, or red and swollen bumps on his or her body at the same time. Acne is typically thought to occur in adolescence, but it can also occur in adulthood. While not a life-threatening condition, acne can have a significant psychological and physical impact on a person's life, causing poor self-image, anxiety, depression, and permanent scarring of the skin.

Allergies

2006-12-05T11:31:00.001Z

An allergy is your body's reaction to a foreign substance--such as pollen or pet dander--that enters, or comes in contact with the body. It may be that pollen never bothered you before but over time, and with repeated exposures, your body grew overly sensitive to it, resulting in allergy symptoms such as sneezing and watery eyes. When foreign substances such as pollen cause allergic reactions, they are called allergens.

Allergens cause cells in your body to release chemicals known as mediators, which trigger allergy symptoms. These mediators include histamine and prostaglandins.

Histamine is the mediator that stimulates mucus production and causes redness, swelling and inflammation.
Prostaglandins are mediators that constrict airways and enlarge blood vessels.

The Mechanism of an Allergic Reaction

Drug Medication and Interaction Advice

2006-11-29T11:27:00.000Z

Whether it's Prozac or aspirin, Pepcid or echinacea, DrugDigest reviews drugs, vitamins, and herbs to tell you how to take medicine appropriately, what the product should and shouldn't do for you, and the scientific evidence that advises physicians and pharmacists on when to recommend these products.

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