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safegen-blog · 7 years ago

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https://safegenericpharmacy.com/blog/diabetes/

Overview

Diabetes is a chronic condition in which the body produces too little insulin or can’t use available insulin efficiently. Insulin is ahormonevital to helping the body use digested food for growth and energy.

An estimated 25.8 million people in the United States, or approximately 8.3% of the population, have diabetes. In 2010, about 1.9 million people age 20 or older were diagnosed, according to the American Diabetes Association (ADA).

You are at higher risk for developing type 2 diabetes if you are overweight, don’t exercise, are over 45, or have close relatives with diabetes, especially type 2 diabetes. Higher-risk ethnic groups include African American, Latino/Hispanic, Native American, Alaska Native, Asians and Pacific Islanders. Native Americans and Alaska Natives are at more than twice the risk of Caucasians for developing type 2 diabetes.

Although diabetes is a potentially life-threatening condition, people with well-managed diabetes can expect to live healthy lives.

How Diabetes Develops

Much of the food we eat is broken down by digestive juices into a simple sugar calledglucose, which is the body’s main source of energy. Glucose passes into the bloodstream and, from there, into cells, which use it for energy.

However, most cells require the hormone insulin to “unlock” them so glucose can enter. Insulin is normally produced by beta cells in the pancreas (a large gland behind the stomach). In healthy people, the process of eating signals the pancreas to produce the right amount of insulin to enable the glucose from the food to get into cells. If this process fails or doesn’t work properly, diabetes develops.

In people with diabetes, the pancreas produces little or no insulin, or the body’s cells do not respond to the insulin that is produced. As a result, glucose builds up in the blood, overflows into the urine and passes out of the body. Thus, the body loses its main source of fuel even though the blood contains large amounts of glucose.

Types of Diabetes

There are several types of diabetes:

In type 1 diabetes, the pancreas makes little or no insulin because the insulin-producing beta cells have been destroyed. Type 1 diabetes is less common than type 2 diabetes, accounting for about 5 to 10 percent of diabetes cases. Formerly known as “juvenile diabetes,” type 1 typically develops during childhood or young adulthood but can appear at any age.Type 1 diabetes is classified as an autoimmune disease—a condition that results when the immune system turns against a specific part or system of the body. In diabetes, the immune system attacks and destroys the insulin-producing beta cells in the pancreas. Scientists do not know exactly what causes the body’s immune system to attack the beta cells, but they believe that both genetic and environmental factors are involved.

In type 2 diabetes, the pancreas makes insulin but the body does not respond to it properly (insulin resistance). In time, the pancreas can fail to produce enough of its own insulin and requires insulin replacement. Type 2 diabetes most often occurs in overweight or obese adults after the age of 30, but may also develop in children. Factors that contribute to insulin resistance and type 2 diabetes are genetics,obesity, physical inactivity and advancing age.Type 2 diabetes is on the rise in the United States, and rates are expected to continue increasing for several reasons. The increasing prevalence of obesity among Americans is a major contributor to the rise in type 2 diabetes. According to the Centers for Disease Control and Prevention (CDC), 34 percent of adults are obese and 34 percent are overweight (and not obese), for a total of 68 percent of adults who are over their ideal weight. And adults aren’t the only ones struggling with their weight. The CDC reports that 17 percent of children age 12 to 19, 20 percent of children age 6 to 11 and 10 percent of children age 2 to 5 are obese. Another reason is related to the relatively low levels of physical activity among American adults. (At least 50 percent of American adults don’t get enough physical activity.)Other factors contributing to the rise of type 2 diabetes include:

A third type of diabetes, gestational diabetes, is one of the most common problems of pregnancy. Left uncontrolled, it can be dangerous for both baby and mother.During normal pregnancy, hormones produced by the placenta increase the mother’s resistance to insulin. Gestational diabetes results when the insulin resistance exceeds the body’s capacity to make additional insulin to overcome it. This resistance usually disappears when the pregnancy ends, but women who have had gestational diabetes have a 35 to 60 percent chance of developing diabetes during the 10 to 20 years after their pregnancy, according to the CDC. All pregnant women are routinely screened for gestational diabetes between their 24th and 28th weeks.

A new term, “pre-diabetes,” describes an increasingly common condition in whichblood glucose levels are higher than normal, but not high enough for a diagnosis of diabetes. About 57 million people in the United States have prediabetes.Those with prediabetes have impaired fasting glucose (between 100 and 126 mg/dL after an overnight fast), or they have impaired glucose tolerance as indicated by one or more simple tests used to measure glucose levels. The ADA reports that in one study, about 11 percent of people with prediabetes developed type 2 diabetes each year during the average three years of follow-up. Other research shows that most people with this condition go on to develop type 2 diabetes within 10 years unless they make modest changes in their diet and level of physical activity.Some long-term damaging effects to the body, particularly the heart and circulatory system, may start during the prediabetes phase of the disease.

The increasing age of the population

The fast growth rate of certain ethnic populations at high risk for developing the condition, including Latino and Hispanic Americans

Women and Diabetes: Special Concerns

In the United States, 11.5 million women age 20 and older (10.2 percent) have diabetes. Women with diabetes develop heart disease more often than other women, and their heart disease is more severe. In fact, approximately two-thirds of women with diabetes die from cardiovascular disease, and they die younger than women without diabetes. Women under age 50 with diabetes are more vulnerable to heart attacks and strokes than those without diabetes because the disease seems to cancel the protective effects of estrogen on a woman’s heart before menopause. Women with diabetes are also at even greater risk for developing heart disease after menopause.

Women with diabetes have lower levels of high-density lipoproteins (HDL) cholesterol(the good cholesterol) and higher levels of triglycerides, or fats, in the blood. Elevated low-density lipoproteins (LDL) cholesterol is a major cause of coronary heart diseaseand should be treated aggressively. Although LDL cholesterol (the type of cholesterol that contributes to plaque buildup in your arteries) levels are not higher in women with diabetes, studies find that reducing LDL levels to less than 100 mg/dL can help prevent heart attacks and strokes in women with diabetes.

High cholesterol is typically treated with specially designed diets low in saturated fat, weight loss, exercise and, if necessary, medication.

For more information on the link between diabetes and heart disease, check out the National Heart, Lung and Blood Institute’s web site at www.safegenericpharmacy.com.

For more Information visit us our website: safegenericpharmacy.com

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safegen-blog · 7 years ago

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https://safegenericpharmacy.com/blog/diabetes/

Overview

Although diabetes is a potentially life-threatening condition, people with well-managed diabetes can expect to live healthy lives.

How Diabetes Develops

Types of Diabetes

There are several types of diabetes:

The increasing age of the population

The fast growth rate of certain ethnic populations at high risk for developing the condition, including Latino and Hispanic Americans

Women and Diabetes: Special Concerns

High cholesterol is typically treated with specially designed diets low in saturated fat, weight loss, exercise and, if necessary, medication.

For more information on the link between diabetes and heart disease, check out the National Heart, Lung and Blood Institute’s web site at www.safegenericpharmacy.com.

Other health issues of concern to women with diabetes include:

High blood pressure. The goal for blood pressure among those with diabetes is less than 130/80 mm Hg, according to the American Diabetes Association.

Urinary tract and vaginal infections. Urinary tract infections and vaginal yeast infections are more common in women with diabetes. The fungi and bacteria that cause these infections thrive in a high-sugar environment, and the body’s immune system can’t fight them as effectively when blood glucose levels are too high.

Menstrual problems. Irregular menstrual periods are common in women with diabetes, especially if their blood glucose isn’t well controlled. Blood glucose levels may rise, and insulin needs may increase before a woman’s period and fall once it begins.

Adverse reactions to hormonal birth control methods. Contraceptives containing hormones (such as birth control pills), IUDs that contain progesterone and long-lasting progestin implants and injections may alter blood glucose levels. Birth control pills may increase insulin resistance in some women with diabetes. Women with type 2 diabetes may find it harder to manage their blood glucose while taking birth control pills. Although rare in healthy individuals, the risk of complications from birth control pills, such as high blood pressure and stroke, are greater for women with diabetes. However, the American Diabetes Association says most birth control methods are safe for women with diabetes—talk to your health care professional about any potential risks.

Management is Key to Living Well with Diabetes

Although diabetes is a chronic and potentially life-threatening condition, it can be effectively controlled and managed once it has been accurately diagnosed. The goal of diabetes management is to prevent short-term and long-term complications from developing, according to the American Association of Clinical Endocrinologists.

Without proper management, individuals with either type 1 or type 2 diabetes can develop serious or deadly complications from high glucose levels, including blindness, kidney disease and nerve damage, as well as vascular disease that can lead to amputations, heart disease and strokes. Uncontrolled diabetes can complicate pregnancy; birth defects also are more common in babies born to women with uncontrolled diabetes.

For women with type 1 diabetes, controlling blood glucose (blood sugar) levels may mean three to four (and sometimes more) shots of insulin a day, adjusting insulin doses to food and exercise, checking blood glucose up to eight times a day depending on their health care providers’ recommendations and adhering to a planned diet.

Type 2 diabetes may be controlled initially by a planned diet, exercise and daily monitoring of glucose levels. Frequently, oral drugs that lower blood glucose levels or insulin injections need to be added to this regimen.

Treating diabetes comprehensively—that is, managing not only blood glucose, but also blood pressure and cholesterol—is crucial to helping prevent heart attacks and stroke. The good news is that women with diabetes who maintain lower blood glucose, blood pressure and cholesterol levels can lower their risk of cardiovascular disease. To reduce your risk, follow the “ABC” approach recommended by the National Diabetes Education Program, National Institute of Health and the American Diabetes Association. The ABCs are easy to remember:

A stands for the A1C, or hemoglobin A1C test, which measures average blood glucose over the previous two to three months.

B is for blood pressure.

C is for cholesterol.

Diabetes treatment guidelines issued by the American College of Physicians (ACP) and published in the April 2003 issue of the Annals of Internal Medicine emphasize the importance of aggressive blood pressure control in lowering the risk for heart disease, stroke and early death in type 2 diabetes patients. Until these guidelines were released, the focus in diabetes care has been on tightly controlling blood glucose, but new evidence suggests that both blood glucose and blood pressure are very important in managing the disease.

The ACP recommends that patients with diabetes and high blood pressure strive for blood pressure levels of less than 130/80 mm Hg, and that thiazide diuretics andangiotensin-converting enzyme (ACE) inhibitors be used as first-line agents to control blood pressure in most patients with diabetes.

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safegen-blog · 7 years ago

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https://safegenericpharmacy.com/blog/eating-disorders/

Overview

Eating disorders are devastating mental illnesses that affect an estimated 20 million American women and 10 million American men sometime during their life. Approximately 85 percent to 95 percent of the people who suffer from the eating disorders anorexia nervosa and bulimia nervosa are women.

Although eating disorders revolve around eating and body weight, they are often more about control, feelings and self-expression than they are about food. Women with eating disorders often use food and dieting as ways of coping with life’s stresses. For some, food becomes a source of comfort and nurturing, or a way to control or release stress. For others, losing weight may start as a way to gain the approval of friends and family. Eating disorders are not diets, signs of personal weakness or problems that simply will go away without proper treatment.

Eating disorders occur in all socioeconomic and ethnic groups. They usually develop in girls between ages 12 and 25. Because of the shame associated with this complex illness, many women don’t seek treatment or get help until years later. Eating disorders also occur in young children, older women and men, but much less frequently.

There are four official eating disorders diagnoses: anorexia nervosa, bulimia nervosa,binge eating disorder and eating disorder not otherwise specified (EDNOS). Anorexia is a disorder in which preoccupation with dieting and thinness leads to excessive weight loss. If you suffer from this disease, you may not acknowledge that weight loss or restricted eating is a problem, and you may “feel fat” even when you’re emaciated. Women with anorexia intentionally starve themselves or exercise excessively in a relentless pursuit to be thin, losing more than 15 percent of their normal body weight. Roughly half of all women suffering from anorexia never return to their pre-anorexic health, and about 20 percent remain chronically ill. The death rate for anorexia is among the highest of any psychiatric illness. The deaths are about evenly divided between suicide and medical complications related to starvation. Women with bulimia regularly and sometimes secretly binge on large quantities of food—often between 2,000 and 5,000 calories at a time and, on rare occasions, even up to 20,000 calories at a time—then experience intense feelings of guilt or shame and try to compensate by getting rid of the excess calories. Some people purge by inducing vomiting, abusing laxatives and diuretics, or taking enemas. Others fast or exercise to extremes. If you suffer from this disease, you feel out of control and recognize that your behavior is not normal but often deny to others that you have a problem. Women struggling with bulimia can be normal weight or overweight and may experience weight fluctuations. Women with binge eating disorder (BED) also binge on large quantities of food in short periods, but unlike women with bulimia, they do not use weight control behaviors such as fasting or purging in an attempt to lose weight or compensate for a binging session. When the binge is over, an individual with BED will often feel disgusted, guilty and depressed about overeating. A fourth type of eating disorder, eating disorder not otherwise specified, refers to symptoms that don’t fit into the other three eating disorders diagnoses. Individuals struggling with EDNOS, may have elements of BED, or be close to a diagnosis of anorexia or bulimia, but don’t quite meet full diagnostic criteria. EDNOS is simply a catchall term for anyone with significant eating problems who doesn’t meet the criteria for the other diagnoses. The majority of those who seek treatment for eating disorders fall into this category.

Although it has become synonymous with eating disorders, anorexia is relatively rare, affecting between 0.5 percent and 1 percent of women in their lifetimes, according to the National Alliance on Mental Illness. Another 2 percent to 3 percent develop bulimia and 3.5 percent develop binge eating disorder.

Yet, statistics don’t tell the whole story. Many more women who don’t necessarily meet all the criteria for an eating disorder are preoccupied with their bodies and are caught in destructive patterns of dieting and overeating that can seriously affect their health and well being.

There is no single cause of eating disorders. Biological, social and psychological factors all play a role. Evidence suggesting a genetic predisposition reveals that anorexia may be more common between sisters and in identical twins. Therefore, a woman with a mother or sister who has anorexia is 12 times more likely than the general public to develop that disorder and four times more likely to develop bulimia. Furthermore, among identical twins, whose genetic makeup is 100 percent the same, there is a 59 percent chance that if one twin has anorexia, then the other twin will also develop an eating disorder. For fraternal twins sharing only 50 percent of their siblings’ genes, there is an 11 percent chance that the other twin will have an eating disorder.

Other research points to hormonal disturbances and to an imbalance of neurotransmitters, chemicals in the brain that, among other things, regulate mood and appetite.

In some women, an event or series of events triggers the eating disorder and allows it to take root and thrive. Triggers can be as subtle as a degrading comment or as traumatic as rape or incest. Times of transition, such as puberty, divorce, marriage or starting college, can also provoke disordered eating behaviors. Parents who are preoccupied with eating and overly concerned about or critical of a daughter’s weight, and coaches who relentlessly insist on weigh-ins or a certain body image from their athletes, especially in weight-conscious sports such as ballet, cheerleading, diving, wrestling and gymnastics, may also unintentionally encourage an eating disorder. Additionally, the pressure of living in a culture where self-worth is equated with unattainable standards of slimness and beauty can also perpetuate body image and/or eating issues.

Furthermore, the discrepancy between our society’s concept of the “ideal” body size for women and the size of the average American woman has never been greater—leading many women to unrealistic goals where weight is concerned.

Diagnosis

Because the consequences of eating disorders can be so severe, early diagnosis is crucial for lasting recovery. Eating disorders in general can disrupt physical and emotional growth in teenagers and can lead to premature osteoporosis, a condition where bones become weak and more susceptible to fracture. Additionally, the triad of osteoporosis, amenorrhea and disordered eating behaviors has the risk of leading to hormonal imbalances, which could also contribute to increased infertility and a higher risk of miscarriages.

Anorexia nervosa

Anorexia nervosa, a serious, potentially life-threatening disease characterized by self-starvation and excessive weight loss, has the highest mortality rate of any mental illness. Its onset is typically in early to mid-adolescence, and it is one of the most common psychiatric diagnoses in young women seeking treatment. Among the physical effects of anorexia are:

anemia, often caused by iron deficiency, which reduces the blood’s ability to carry oxygen and causes fatigue, difficulty breathing, dizziness, headache, insomnia, pale skin, loss of hunger and irregular heartbeat

elevated cholesterol, which occurs because eating disorders affect liver function, reducing bile acid secretions that contain cholesterol and enabling more cholesterol to remain in the body rather than being secreted

low body temperature and cold hands and feet

constipation and bloating

shrunken organs

low blood pressure

slowed metabolism and reflexes

slowed heart rate, which can be mistaken as a sign of physical fitness

irregular heartbeat, which can lead to cardiac arrest

slowed thinking and cognitive and mood changes secondary to long-term starvation

Women with anorexia have an intense fear of becoming fat and, therefore, are obsessed with food, body shape and size. It is common for women with anorexia, for example, to collect recipes and prepare gourmet meals for family and friends, but not eat any of the food themselves. Instead, they allow their bodies to wither away and “disappear,” gauging their hunger as a measure of their self-control. Women struggling with anorexia diet because they want to improve their feelings of self-esteem and love, not to lose a few pounds. Depression and insomnia often occur with eating disorders.

Women struggling with anorexia may tend to keep their feelings to themselves, seldom disobey authority and are often described as perfectionists. These individuals are often good students and excellent athletes. Anorexia is common in dancers and competitive athletes in sports such as gymnastics and figure skating, where success is measured not only on athletic performance, but also on having the “ideal” body.

Symptoms of anorexia nervosa can include:

distorted body image and intense persistent fear of gaining weight

excessive weight loss

menstrual irregularities

excessive body/facial hair

compulsive exercise

Bulimia nervosa

Bulimia nervosa involves using food and eating for emotional calming or soothing. Bingeing becomes a way to relieve stress, anxiety or depression. Purging the calories, through self-induced vomiting, laxative or diuretic abuse or over-exercising, relieves the guilt of overeating and may also be a way of releasing emotional tension or stress until the binge-purge cycle becomes a habit. Women struggling with bulimia are usually more impulsive, more socially outgoing and exhibit less self-control than those struggling with anorexia. They are also more likely to abuse alcohol and other substances.

For more Information visit us our website: safegenericpharmacy.com

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safegen-blog · 7 years ago

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Overview In a healthy brain, nerve cells communicate with each other through electrical impulses that work together to control the body. But when those cells, called neurons, misfire or signal abnormally, a person can experience a number of sensations, emotions, behaviors, convulsions, muscle spasms and even loss of consciousness. Any or all of those symptoms may be seizures. If a person has more than one unprovoked seizure, she may be suffering from epilepsy. An individual is considered to have epilepsy when seizures recur over a period of time without an obvious provoking reason, such as alcohol withdrawal, low blood sugar or electrolyte imbalances in the blood. Epilepsy can be successfully treated with antiepileptic medication or, in selected cases, surgical removal of the brain region that generates seizures. In some patients it can spontaneously disappear. The symptoms of epilepsy are complex. A seizure can be as subtle as staring off into space for a few moments, as if daydreaming. Other types of seizures cause more dramatic symptoms, including uncontrollable movements, loss of consciousness, stiffening, jerking and loss of some bodily functions, among other symptoms. These symptoms can be as brief as a few seconds or as long as several minutes. According to the Epilepsy Foundation and the U.S. Centers for Disease Control and Prevention (CDC), about 200,000 Americans will learn that they have epilepsy this year, and more than 3 million are currently living with the disorder. About one in 100 adults have active epilepsy, and more than one-third are not getting sufficient treatment. Men are at a slightly higher risk to develop epilepsy in childhood, but in adulthood the incidence of epilepsy is equal among men and women. The CDC estimates that this neurological disease costs approximately $15.5 billion annually in medical costs and lost or reduced earnings and production. Epilepsy is not contagious and is not caused by mental illness or retardation. But for most people who suffer from this chronic condition, the stigma associated with it is enormous and affects just about every aspect of life. Family life, driving, employment, social interactions and self-image are just a few lifestyle considerations that confront people with epilepsy. Just the fear of having a seizure produces tremendous ongoinganxiety for some people—a burden for even those whose seizures are generally well controlled with medication. There is no single cause of epilepsy, and in many cases, no known cause is ever found. Conditions that can lead to epilepsy include: injury to the brain before, during or after birth or in adulthood infections that damage the brain toxic substances that affect the brain injury and lack of oxygen to the brain disturbance in blood circulation to the brain (stroke and other vascular problems) metabolism or nutritional imbalance tumors of the brain genetic or hereditary abnormalities high fever (known as febrile seizures) other degenerative diseases such as dementia malformation of the brain Seizures can be triggered by a variety of things, such as failure to take seizure-controlling medication as prescribed, lack of sleep, alcohol consumption or hormonal changes associated with the menstrual cycle. Failure to take medication (called noncompliance by physicians) is the most common trigger. Epilepsy and Reproductive Health Issues Epilepsy is associated with many reproductive health issues for women. Although it is not well understood, researchers know that the female hormones estrogen andprogesterone act on certain brain cells, including those in a part of the brain called the temporal lobe, where partial seizures often begin. Therefore, estrogen and progesterone can affect the frequency and severity of seizures. Some women experience changes in their seizure patterns at times of hormonal fluctuations such aspuberty, ovulation, the beginning of menstruation, pregnancy and even at menopause. This hormone-seizure interaction makes each life stage—and sometimes each menstrual period—a unique challenge. Because seizures disrupt regions of the brain that regulate reproductive hormones, women who have seizures also are more likely to have reproductive problems such as polycystic ovarian disease, early menopause and irregular ovulation leading to infertility. In addition, studies have shown that certain antiepileptic drugs may cause reproductive problems. Women should discuss this with their physicians. Even birth control choices are affected by epilepsy. Certain antiepileptic medications (medications that control seizures) make hormonal birth control less effective in preventing pregnancy. Hormonal birth control includes oral contraceptives (birth control pills), long-acting progestin shots and implants and intrauterine devices that release hormones. While most women with epilepsy can have healthy babies, they are advised to work with health care professionals knowledgeable about seizure disorders to guard against increased risks for malformations to the baby or complications during pregnancy. Why Epilepsy Happens Epilepsy was one of the first brain disorders described, dating back to ancient Babylon more than 3,000 years ago. The word “epilepsy” comes from a Greek work that means to “attack” or “seize.” Over the years, many misconceptions have ensued. Epilepsy is a disorder in which the normal pattern of brain activity becomes disturbed. During a seizure, neurons fire as many as 500 times a second, far exceeding the normal rate of about 80 times a second. The resulting seizure can occur at any time of day or night with little or no warning. Attacks can occur frequently or rarely. Genetic abnormalities may be a significant factor contributing to epilepsy. The condition may run in some families, and some researchers say that more than 500 genes could be linked to the disorder. For many people, epilepsy is the result of brain injury from other conditions or disorders. Heart attacks and strokes, for example, deprive the brain of oxygen and can cause damage that produces epilepsy. Conditions that affect the brain’s normal functions such as brain tumors and degenerative conditions such Alzheimer’s disease also may trigger it. Metabolic disorders such as pyruvate deficiency and other brain disorders such as cerebral palsy, neurofibromatosis and autism are all associated with an increased risk of epilepsy, as well. Virtually any sort of injury to the brain, from head trauma to poisoning (such as from carbon monoxide or even illegal drug use) to infections can lead to seizures and epilepsy. Toxic substances such as alcohol may also trigger it. Cases that do not involve brain damage, injury, known genetic factors or any other known cause are known as idiopathic epilepsy. Research continues on the cause of epilepsy. Types of Seizure and Epilepsy: Many and Varied To date, researchers have identified more than 20 kinds of seizures and numerous syndromes and other conditions that include recurring seizures. People can have one or more than one type of seizure. In general, there are two kinds of seizures: Partial seizures. Partial seizures are the most common type of seizure in people with epilepsy; about 60 percent of people with epilepsy have partial seizures, which occur in just one part of the brain and affect the physical and mental activity controlled by that area of the brain. Also called focal seizures, partial seizures may be simple or complex. During a simple partial seizure, you remain conscious and may experience numbness, weakness, inability to speak and jerking of the arm or leg. Another term that physicians use is “auras,” which refers to unexplained feelings such as joy, sadness, anger or nausea or altered sensations (déjà vu, jamais vu and often-unpleasant smells). In a complex partial seizure (also called a psychomotor or temporal lobe seizure), you experience an altered consciousness, display repetitious behavior or movements and are not able to interact with others until the seizure subsides. Emotional changes may also occur during the seizure. Complex partial seizures occur in adults, although the condition typically begins in childhood. Repeated seizures in the temporal lobe of the brain can, over a long period of time, affect memory and learning. Generalized seizures. There are many types of generalized seizures, which result from abnormal neuronal activity on both sides of the brain. Generalized seizures involve bursts of electrical energy that sweep through the whole brain at once, causing loss of consciousness for seconds or minutes, falls or muscle spasms that lead to convulsions. Absence seizures. Formerly called petit mal seizures, partial seizures are a common type of generalized seizure that typically starts in childhood and typically stops when the child reaches puberty. During an absence seizure, a child may experience temporary lapses of consciousness that look like blank staring. When seizures occur, a health care professional will determine if they are associated with epilepsy or another condition. Determining the underlying cause is critical to effective and appropriate treatment. The many types of epilepsy are usually described by a specific group of symptoms. Some of the more common types include: Frontal lobe epilepsy. Sudden onset and termination of a cluster of very short seizures are the hallmarks of this type of epilepsy. Occipital lobe epilepsy. This type usually begins with visual hallucinations, rapid eye blinking or other eye-related symptoms. After that, it resembles temporal or frontal lobe epilepsy. Temporal lobe epilepsy. This type typically has a “warning” or aura of altered perceptions (déjà vu, jamais vu, epigastric sensations, foul taste or odor) followed by altered awareness, confusion and responsiveness and other unusual behaviors and patterns of cognition. Diagnosis When health care professionals use the term “epilepsy,” they are referring to a medical condition that involves two or more spontaneously recurrent seizures. The term “seizure” refers to the event. In other words, not all seizures are epilepsy. Accurate diagnosis of epilepsy requires a detailed medical history and a battery of tests that provide a comprehensive picture of the brain. Developmental, neurological and behavioral assessments are performed. To assist the health care team in making a diagnosis, you may be asked to keep a detailed seizure diary. This type of record keeping also may be recommended as a lifelong management strategy to help record how medication and other factors affect seizure activity. A seizure diary could include the following information (some of which may need to be recorded by a family member or partner): Date and time the seizure occurred. A detailed description of the seizure, including length of the seizure and your symptoms. Be specific. Note what you were doing when the seizure occurred. Record all medications taken, including both over-the-counter and prescribed, as well as the dose and time taken. Be sure to include a note about your last dose of antiepileptic medication (if you are currently taking any). Record if you skipped or changed your dosage, whether by accident or with the guidance of your health care professional. Describe the food and beverages you consumed within the 24 hours prior to the seizure, as well as the times you ate or drank. Record information about your menstrual period. Describe how you were feeling and the events or situations that you experienced within the two to three days before your seizure. (Be sure to note your sleeping habits, daily activities and general health.) In addition to taking a detailed medical history, your health care professional may order blood tests to check on your general health and to determine if you have an infection, genetic disorder or vitamin deficiency or if you’ve been exposed to any poisons, such as lead. If your health care professional suspects your seizure may be caused by an infection or bleeding in the brain, he or she may perform brain imaging or a spinal tap, in which a small amount of fluid is taken from your spinal canal to be tested. Other important tests involve recording your brain’s activity: Electroencephalogram (EEG). This painless test records the electrical activity in your brain to see if there are any irregularities. Small electrodes are pasted to your head and connected to a computer to record the electrical activity. Abnormal brain activity patterns may indicate epilepsy. You may have the test, which lasts for about one to two hours or longer if your doctor recommends, at a hospital or doctor’s office. A normal EEG doesn’t rule out epilepsy, and you may need to have an EEG more than once before a diagnosis is made. Sometimes, the health care professional may ask that you do not sleep the night before the test or awaken early to enhance the chance of seeing an abnormality. Brain imaging. There are a variety of tests, similar to X-rays, that help your health care professional examine your brain. Magnetic resonance imaging (MRI) scans, computed tomography (CT) scans, single photon emission tomography (SPECT) and positron emission tomography (PET) scans are three imaging techniques used to view the brain. All three types of imaging may or may not be necessary in the evaluation of your epilepsy. Typically, you’ll be asked to lie on a table and the MRI, CT, SPECT or PET machine will be moved over your head to scan your brain. These procedures are painless. You may have an injection of a substance that makes the scan easier to read. After the injection, some people say they experience a metallic taste in the mouth, feel flushed or have brief nausea. Treatment Accurate diagnosis of the type of epilepsy a person has is critical to determining the right treatment. It’s also important to begin treatment as quickly as possible to avoid any harm that can be caused by recurrent seizures. The standard treatment for epilepsy is medication, called antiepileptic drugs (AEDs) or antiseizure medication. Although antiepileptic medications don’t cure epilepsy, they help prevent seizures in about 70 percent of people who take them. Other treatment approaches include the ketogenic diet, vagus nerve stimulation and surgery. More than 20 medicines are available to treat epilepsy. You and your health care professional will decide which one is right for you based on the type of seizures you have, your lifestyle and age and, for women, how likely you are to become pregnant. Some of the more common drugs used to prevent seizures include:

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safegen-blog · 7 years ago

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https://safegenericpharmacy.com/blog/chronic-dry-eye/

Overview

Chronic dry eye is an inflammatory disorder of tears and the surface of the eye, also called the ocular surface. It encompasses a group of disorders, which typically cause symptoms of dryness and overall eye discomfort. It may also cause stinging, burning, a gritty feeling or episodes of blurred vision.

The condition affects an estimated 5 percent to 30 percent of the population age 50 and older in the United States. In addition, tens of millions of Americans experience less severe symptoms of the disorder.

Chronic dry eye is one of the most common reasons people visit an eye health professional. It occurs most often in the elderly.

The exact cause of chronic dry eye is unknown. External factors may aggravate dry eye symptoms, including conditions common in many workplaces such as prolonged computer use and exposure to air conditioning, heating, dust and allergens.

But chronic dry eye should not be confused with eye allergies, an even more pervasive problem. Eye allergies are reactions to substances in the environment that can result in some of the same types of discomforts associated with eye dryness.

There are two major types of chronic dry eye: aqueous tear-deficient and evaporative. Both can cause your eyes to sting or burn, feel scratchy, become irritated and tear excessively.

Chronic dry eye most commonly occurs in both eyes but may affect one eye more than the other. People with dry eyes have difficulty wearing contact lenses. They also may develop mucus in or around their eyes. There can be pain and redness in the eye, a feeling of heavy eyelids or blurred, changing or decreased vision. People with more severe cases of dry eye often are also sensitive to light.

Although eye infections are more common in people with chronic dry eye, irreversible vision is rare. More commonly, people with dry eye have fluctuating vision and experience problems with tasks requiring visual concentration such as reading, using a computer and driving. Most people with dry eye find the condition to be an uncomfortable nuisance, with many characteristics of other “chronic pain” types of syndromes.

Understanding the Role of Tear Film

The tear film on your eyes actually consists of the following three major components:

Lipid. The outer layer of the tear film is covered by an oily layer produced bymeibomian glands in the lower and upper eyelids. This layer smoothes the eye’s surface and keeps tears from evaporating too fast and helps them stay on the eye.

Aqueous. The aqueous component is a watery layer that is produced by the lacrimal glands. This layer makes up most of what we normally consider tears. It nourishes the cornea (the clear tissue of the outer protective layer of the eye that transmits light) and the conjunctiva (a thin, clear layer of tissue that covers the white outer surface of the eye). This tear layer also cleanses the eye and washes away foreign particles or irritants that are wrapped up by the other major component—mucin.

Mucin. The goblet cells of the conjunctiva, as well as the surface cells of the cornea and the conjunctiva, produce this protective lubricant of tears. It helps spread the watery layer of tears across the eye to keep the eye wet, and it traps and wraps up foreign pathogens and debris so they do not damage the ocular surface.

As we age, the eyes naturally produce fewer tears. However, sometimes the lipid and mucin layers produced by the eye are so unstable that tears can’t remain on the eye long enough to keep it lubricated. Chronic dry eye—also called dry eye disease, dry eye syndrome, keratoconjunctivitis sicca or simply dry eye—is the result.

Chronic dry eye occurs most often in older women. Information gathered from the Women’s Health Study, a large cohort study in which 25,665 postmenopausal women provided information about the use of hormone replacement therapy, suggests that those who use hormone replacement therapy, particularly estrogen alone, are at increased risk of chronic dry eye. A relatively uncommon but often more serious form of the disorder is associated with rheumatoid arthritis or dry mouth and is calledSjögren’s syndrome. Sjögren’s syndrome is an autoimmune disease that attacks the body’s lubricating glands, such as the tear and salivary glands.

Recent research suggests that contact lenses, refractive surgery (such as LASIK), and use of computers and smartphones are also risk factors for chronic dry eye. Allergies can also contribute to eye dryness, causing additional eye discomforts such as itchiness, redness, swelling and wateriness.

Although chronic dry eye has no cure, its symptoms can be managed. Over-the-counter artificial tears that lubricate the eye are the most common treatment. Other treatments include eye ointments, antibiotics (both oral and drops) and avoiding environmental triggers such as hair dryers and rooms with low humidity. A prescription medication, cyclosporine ophthalmic emulsion 0.05% (Restasis), works to increase the body’s ability to produce its own tears.

In cases of moderate to severe dry eye, tears can be conserved by placement of a temporary or permanent punctal plug into the channel at the inner corner of the eyelid where tears drain into the nose and the back of the throat. And in some cases, a surgical procedure to close the tear ducts is needed.

Diagnosis

Your ophthalmologist or optometrist can diagnose chronic dry eye during an eye examination. A complete physical examination and blood tests may be necessary to diagnose any underlying diseases, such as Sjögren’s syndrome. Make sure you tell your eye care professional what medications you are taking because many drugs can aggravate dryness of the eyes. Among those that can contribute to chronic dry eye are:

some high blood pressure medications, including diuretics

certain antidepressants

some heart medications

antihistamines

decongestants

Parkinson disease medications

sleeping pills

birth control pills

some pain relievers

The early symptoms of chronic dry eye may include:

eye redness

burning, stinging or scratchy sensation in the eye, especially in an environment with low humidity

a feeling that something is in the eye

trouble wearing contact lenses

a gritty feeling that may be persistent and painful

eye dryness

excessive tearing

blurry vision

In mild cases, these symptoms may come and go. An individual may have some or all of these symptoms. As the condition worsens, the symptoms tend to become more persistent. People who have severe cases of chronic dry eye may find little or no relief for these symptoms from artificial tears, have eyes that are unusually sensitive to light and may experience severe eye pain or notice changing vision.

Because many people are unable to tolerate contact lenses, they may desire corrective surgery such as laser-assisted in situ keratomileusis (LASIK). But according to the U.S. Food and Drug Administration, LASIK eye surgery may lead to temporary or permanent chronic dry eye, requiring intensive drop therapy or use of plugs or other procedures.

During your eye examination, your eye care professional may look at your eyes with a slit lamp, a lighted, microscope-like instrument that illuminates the eyes. Your eye care professional will focus on the front of your eye and check whether it remains moist or quickly develops dry spots. If the eye is deficient in tears, particularly in mucin or lipid parts of tears, dry spots appear quickly.

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safegen-blog · 7 years ago

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https://safegenericpharmacy.com/blog/chronic-fatigue-syndrome/

Overview

Chronic fatigue syndrome (CFS) is an illness characterized by prolonged, debilitating fatigue that does not improve with rest and worsens with physical or mental activity. It is also characterized by multiple nonspecific symptoms such as headaches, recurrent sore throats, muscle and joint pains, and memory and concentration difficulties.

CFS can be hard to diagnose, and its cause or causes are unknown. Even its name can be confusing: CFS is also known as myalgic encephalomyelitis (ME or ME/CFS or CFS/ME), as well as chronic fatigue and immune dysfunction syndrome (CFIDS).

Profound fatigue, the hallmark of the disorder, can come on suddenly or gradually and persists or recurs throughout the period of illness. Unlike the short-term disability of an illness such as the flu, by definition CFS symptoms must have lasted for at least six months. They often linger for years.

CFS affects women at about four times the rate that it affects men, and the illness is diagnosed more often in people in their 40s and 50s. It can affect any sex, race or socioeconomic class. Research shows that it is at least as common in Hispanics and African Americans as it is in Caucasians. And although CFS is less common in children than in adults, children can develop the illness, particularly during the teen years. It can be as disabling as multiple sclerosis and chronic obstructive pulmonary disease.

The prevalence of CFS is difficult to measure because the illness can be difficult to diagnose, but, in general, it is estimated that at least 1 million people in the United States have CFS, according to the CDC. CFS is sometimes seen in members of the same family, suggesting there may be a genetic link; more research is needed to prove this link.

CFS does not appear to be a new illness, although it only recently was assigned a name. Relatively small outbreaks of similar disorders have been described in medical literature since the 1930s. Furthermore, case reports of comparable illnesses date back several centuries.

Interest in CFS was renewed in the mid-1980s after several studies found slightly higher levels of antibodies to the Epstein-Barr virus(EBV) in people with CFS-like symptoms than in healthy individuals. Most of these people had experienced an episode of infectious mononucleosis (sometimes called mono or the “kissing disease”) a few years before they began to experience the chronic, incapacitating symptoms of CFS. As a result, for a time, the CFS-like illness became popularly termed “chronic EBV.”

Further investigation revealed that elevated EBV antibodies were not indicative of CFS, since healthy people have EBV antibodies and some people with CFS don’t have elevated levels of EBV antibodies.

The international group organized by the CDC named the illness chronic fatigue syndrome because the name reflects the most common symptom: long-term, persistent fatigue. It is important to note, however, that the word “fatigue” may be extremely misleading. Fatigue is but one symptom among many that make up this illness, and it doesn’t reflect the significance of other disabling symptoms. The word also adds to generalized misunderstanding and trivialization of the illness. Use of the name ME/CFS is becoming more common.

There are no indications that CFS is contagious or that it can be transmitted through intimate or casual contact. Research continues to determine the safety of blood donation by people with CFS. The AABB, an organization representing blood banking centers in the United States and around the world, has recommended the indefinite deferral of potential blood donors with a past or current history of CFS. This recommendation has been adopted by the American Red Cross and America’s Blood Centers, the two largest blood collectors in the United States.

CFS may begin suddenly or come on gradually. The sudden onset frequently follows a respiratory, gastrointestinal or other acuteinfection, including mononucleosis. Other cases develop after emotional or physical traumas such as serious accidents,bereavement or surgery.

Although CFS can persist for many years, long-term studies indicate that CFS generally is not a progressive illness. Symptoms are usually most severe in the first year or two. Thereafter, the symptoms typically stabilize, then persist chronically, wax and wane, or improve. For some people with CFS, however, symptoms can get worse over time.

It appears that while the majority of people with CFS partially recover, only a few fully recover, while others experience a cycle of recovery and relapse. There’s no way to predict which category you might fall into. There is some evidence that the sooner a person is diagnosed with CFS and symptoms are managed and treated, the better the chances of improvement, which illustrates the importance of early diagnosis and treatment.

Diagnosis

Chronic fatigue syndrome (CFS) is diagnosed by excluding known medical and psychiatric illnesses that also exhibit fatigue and similar symptoms. It is important to diagnose these conditions because treatments may be available. Diseases that also have fatigue include:

hypothyroidism

sleep apnea

narcolepsy

alcohol or substance abuse

severe obesity

lupus

multiple sclerosis

cancer

depression

anorexia nervosa

bulimia nervosa

schizophrenia

bipolar disorder

dementia

Thus, the diagnosis of CFS is one of exclusion—excluding other possible causes of the symptoms. Some diseases eliminate a diagnosis of CFS, such as multiple sclerosis, lupus or a severe psychiatric disorder such as schizophrenia. It would not provide any benefits in these cases to have a second diagnosis.

The current diagnostic criteria for CFS specify unexplained, persistent fatigue that’s not due to ongoing exertion, isn’t substantially relieved by rest, started recently and leads to significant reduction in previous activity levels. They also require the presence of at least four of the following symptoms:

sleep problems

impairment in short-term memory or concentration

post-exertional malaise occurring within 12 to 24 hours of exertion and lasting 24 hours or more

joint pain without joint swelling or redness

muscle discomfort or pain

headaches of a new type or severity

recurrent sore throat

tender lymph nodes in the neck and underarms

Multiple subjective symptoms are also reported, and although these are not included in the current diagnostic criteria, they are reported with relative frequency. These include:

irritable bowel syndrome and other gastrointestinal complaints

allergy-like symptoms

skin rashes

visual disturbances

dizziness

numbness and tingling in arms and legs

sensitivities to various chemicals

dry eyes

chills

night sweats

alcohol and medication intolerances

Some CFS patients also report mild to moderate symptoms of anxiety or depression. However, many people with CFS don’t have depression or any other psychiatric illness. Depression may be a secondary effect of CFS, not necessarily a primary condition, as people attempt to cope with the changes in lifestyle that living with a chronic illness dictates.

Whether anxiety or depression occurs before or during the illness is not the significant factor; getting help for these distressing conditions is what is essential.

Allergies also tend to be more common in CFS patients than in the general population. Many CFS patients have a history of allergies years before the onset of the syndrome. Sometimes patients report a worsening of allergic symptoms or the onset of new allergies after becoming ill with CFS. Because allergies are so common in people with CFS, it is important to identify symptoms caused by allergies so they can be treated independently.

Your health care professional should take a thorough medical history and conduct extensive physical and mental status examinations, including laboratory tests.

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safegen-blog · 7 years ago

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https://safegenericpharmacy.com/blog/estrogen/

Overview

Estrogen is probably the most widely known and discussed of all hormones. The term “estrogen” actually refers to any of a group of chemically similar hormones; estrogenic hormones are sometimes mistakenly referred to as exclusively female hormones when in fact both men and women produce them. However, the role estrogen plays in men is not entirely clear.

To understand the roles estrogens play in women, it is important to understand something about hormones in general. Hormones are vital chemical substances in humans and animals. Often referred to as “chemical messengers,” hormones carry information and instructions from one group of cells to another. In the human body, hormones influence almost every cell, organ and function. They regulate our growth, development, metabolism, tissue function, sexual function, reproduction, the way our bodies use food, the reaction of our bodies to emergencies and even our moods.

The Role of Estrogen in Women The estrogenic hormones are uniquely responsible for the growth and development of female sexual characteristics and reproduction in both humans and animals. The term “estrogen” includes a group of chemically similar hormones: estrone, estradiol (the most abundant in women of reproductive age) and estriol. Overall, estrogen is produced in the ovaries, adrenal glands and fat tissues. More specifically, the estradiol and estrone forms are produced primarily in the ovaries in premenopausal women, while estriol is produced by the placentaduring pregnancy.

In women, estrogen circulates in the bloodstream and binds to estrogen receptors on cells in targeted tissues, affecting not only the breasts and uterus, but also the brain, bone, liver, heart and other tissues.

Estrogen controls growth of the uterine lining during the first part of the menstrual cycle, causes changes in the breasts during adolescence and pregnancy and regulates various other metabolic processes, including bone growth and cholesterollevels.

Estrogen & Pregnancy During the reproductive years, the pituitary gland in the brain generates hormones that cause a new egg to be released from its follicleeach month. As the follicle develops, it produces estrogen, which causes the lining of the uterus to thicken.

Progesterone production increases after ovulation in the middle of a woman’s cycle to prepare the lining to receive and nourish a fertilized egg so it can develop into a fetus. If fertilization does not occur, estrogen and progesterone levels drop sharply, the lining of the uterus breaks down and menstruation occurs.

If fertilization does occur, estrogen and progesterone work together to prevent additional ovulation during pregnancy. Birth control pills (oral contraceptives) take advantage of this effect by regulating hormone levels. They also result in the production of a very thin uterine lining, called the endometrium, which is unreceptive to a fertilized egg. Plus, they thicken the cervical mucus to prevent sperm from entering the cervix and fertilizing an egg.

Oral contraceptives containing estrogen may also relieve menstrual cramps and some perimenopausal symptoms and regulate menstrual cycles in women with polycystic ovarian syndrome (PCOS). Furthermore, research indicates that birth control pills may reduce the risk of ovarian, uterine and colorectal cancer.

Other Roles of Estrogen

Bone

Estrogen produced by the ovaries helps prevent bone loss and works together with calcium, vitamin D and other hormones and minerals to build bones. Osteoporosisoccurs when bones become too weak and brittle to support normal activities.

Your body constantly builds and remodels bone through a process called resorptionand deposition. Up until around age 30, your body makes more new bone than it breaks down. But once estrogen levels start to decline, this process slows.

Thus, after menopause your body breaks down more bone than it rebuilds. In the years immediately after menopause, women may lose as much as 20 percent of their bone mass. Although the rate of bone loss eventually levels off after menopause, keeping bone structures strong and healthy to prevent osteoporosis becomes more of a challenge.

Vagina and Urinary Tract

When estrogen levels are low, as in menopause, the vagina can become drier and the vaginal walls thinner, making sex painful.

Additionally, the lining of the urethra, the tube that brings urine from the bladder to the outside of the body, thins. A small number of women may experience an increase in urinary tract infections (UTIs) that can be improved with the use of vaginal estrogen therapy.

Perimenopause: The Menopause Transition

Other physical and emotional changes are associated with fluctuating estrogen levels during the transition to menopause, called perimenopause. This phase typically lasts two to eight years. Estrogen levels may continue to fluctuate in the year after menopause. Symptoms include:

Hot flashes—a sudden sensation of heat in your face, neck and chest that may cause you to sweat profusely, increase your pulse rate and make you feel dizzy or nauseous. A hot flash typically lasts about three to six minutes, although the sensation can last longer and may disrupt sleep when it occurs at night.

Irregular menstrual cycles

Breast tenderness

Exacerbation of migraines

Mood swings

Estrogen Therapy

Estrogen therapy is used to treat certain conditions, such as delayed onset of pubertyand menopausal symptoms such as hot flashes and symptomatic vaginal atrophy. Vaginal atrophy is a condition in which low estrogen levels cause a woman’s vagina to narrow, lose flexibility and take longer to lubricate. Female hypogonadism, a condition in which the ovaries produce little or no hormones, as well as premature ovarian failure, can also cause vaginal dryness, breast atrophy and lower sex drive and is also treated with estrogen.

For many years, estrogen therapy and estrogen-progestin therapy were prescribed to treat menopausal symptoms, to prevent osteoporosis and to improve women’s overall health. However, after publication of results from the Women’s Health Initiative (WHI) in 2002 and March 2004, the U.S. Food and Drug Administration (FDA) now advises health care professionals to prescribe menopausal hormone therapies at the lowest possible dose and for the shortest possible length of time to achieve treatment goals. Treatment is generally reserved for management of menopausal symptoms rather than prevention of chronic disease.

The WHI was a study of 27,347 women aged 50 to 79 (mean age, 63) taking estrogen therapy or estrogen/progestin therapy. They were followed for an average of five and a half to seven years. The study was unable to document that benefits outweighed risks when hormone therapy was used as preventive therapy, and it found that risk due to hormones may differ depending on a woman”s age or years since menopause.

The National Cancer Institute found a very significant drop in the rate of hormone-dependent breast cancers among women, the most common breast cancer, in 2003. In a study published in the New England Journal of Medicine in April 2007, researchers speculated that the drop was directly related to the fact that millions of women stopped taking hormone therapy in 2002 after the results of a major government study found the treatment slightly increased a woman’s risk for breast cancer, heart disease and stroke. The researchers found that the decrease in breast cancer began in mid-2002 and leveled off after 2003. The decrease occurred in women over 50 and was marked in women with tumors that were estrogen receptor (ER) positive—cancers that require estrogen to grow. The researchers speculate that stopping the treatment prevented very tiny ER positive cancers from growing (and in some cases, possibly helped them to regress) because they didn’t have the additional estrogen required to fuel their growth.

However, for symptomatic menopausal women or for women with premature menopause, hormone therapy remains the most effective therapy for hot flashes. For more on the WHI study, guidelines for considering menopausal hormone therapy and its potential risks and benefits, visit the National Institutes of Health.

In addition to treating menopause-related symptoms, estrogen and other hormones are prescribed to treat reproductive health and endocrine disorders (the endocrine system is the system in the body that regulates hormone production and function).

Some uses of hormone therapy include the following situations:

delayed puberty

contraception

irregular menstrual cycles

symptomatic menopause

Diagnosis

Because hormone disorders can cause a wide variety of symptoms that also are associated with other conditions, a careful evaluation of your symptoms and general health is recommended, especially if you experience any unusual symptoms. To arrive at a diagnosis, your health care professional will want to rule out certain conditions.

Your assessment will include a thorough personal medical history, a family medical history and a physical examination. Blood and other laboratory tests may be ordered to measure hormone levels. Brain scans are sometimes ordered to identify abnormalities that may be affecting the endocrine system, and DNA testing can detect genetic abnormalities.

Estradiol or other hormone levels may be tested in the evaluation of precocious puberty in girls (the onset of signs of puberty before age seven), delayed puberty and in assisted reproductive technology (ART) to monitor ovarian follicle development in the days prior to in-vitro fertilization. Hormone levels are also sometimes used to monitor HT.

Estrone and/or estradiol levels may be tested if you are having hot flashes, night sweats, insomnia and/or amenorrhea (the absence of periods for extended periods of time). However, due to the day-to-day and even hour-to-hour fluctuations in estradiol levels, they are less helpful than follicle stimulating hormone levels (FSH) for these evaluations. Salivary estradiol testing is less reliable still and of no value in diagnosing or treating symptoms. In most cases, a woman’s age, symptoms and menstrual irregularity is sufficient for making the diagnosis.

Accurate diagnosis of hormonal disorders is important to determining appropriate treatment, which often includes estrogen therapy.

The following are common reasons estrogen therapy is prescribed:

Delayed puberty. Delayed puberty can result from a variety of disruptions to normal hormone production, including central nervous system lesions, pituitary disorders, autoimmune processes involving the ovaries or other endocrine glands, metabolic and infectious diseases, anorexia or malnutrition, exposure to environmental toxins and over-intensive athletic training.Signs of delayed puberty include:

Irregular menstrual periods. Once a medical evaluation finds that there is no other serious cause of your irregular cycles, oral contraceptives or cyclic progesterone may be used to regulate your cycle, assuming there is no reason you can’t use them. Polycystic ovarian syndrome is a common cause of irregular menstrual cycles.

Lack of breast tissue development by the age of 13

No menstrual periods for five years following initial breast growth or by age 16

Estrogen treatment for girls with delayed puberty is somewhat controversial; some health care professionals advise treatment, while others prefer close monitoring.

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safegen-blog · 7 years ago

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https://safegenericpharmacy.com/blog/chronic-obstructive-pulmonary-disease-copd/

Overview

Chronic obstructive pulmonary disease (COPD) is a lung disorder that typically occurs in older adults with a history of smoking. It kills one person every four minutes in the United States and is one of the few causes of death that continues to increase. Today, more women than men have COPD, with an estimated 7 million women diagnosed with the disease. The prevalence of COPD is increasing among women while decreasing among men. Plus, more women than men die every year from the disease.

When you have COPD, your airways and the tiny air sacs in the lung (alveoli) are damaged by smoking or other inhaled particles and gases, which cause swelling, or inflammation. Eventually, this damages the lungs making it hard to breathe in and out and difficult for oxygen and carbon dioxide to pass through the air sacs.

Chronic obstructive pulmonary disease used to be described as chronic bronchitis oremphysema, but today we know that both conditions are forms of COPD. Asthma is a separate conditions that also involves airflow limitation but affects people of all ages and typically affects those 40 and older. In addition, breathing issues in asthma can often be resolved with bronchodilator medication, while the airways with COPD may be only partially opened with medication.

It is possible, however, to have emphysema, bronchitis and asthma all at the same time.

An estimated 14.8 million Americans have been diagnosed with COPD. Although more adults are aware of the disease today than a few years ago (71 percent compared to 65 percent in 2008), a substantial number of people still do not know about the disease, its symptoms and how it is managed. In fact, an estimated 12 million people may have COPD and remain undiagnosed.

Although the primary cause of COPD is cigarette smoking, about 10 to 20 percent of those diagnosed—one out of six people with the disease—have never smoked. Instead, they developed the condition from environmental exposures such as air pollution or work-related fumes, exhaust or dust. Other possible causes include low birth weight, fetal developmental issues, early childhood infections and genetic factors. Further, close to 100,000 Americans have a genetic condition known as alpha-1 antitrypsin, or AAT deficiency, that has been linked to COPD.

Diagnosis

It is important that you get diagnosed as early in the disease as possible. While there is no cure for COPD, early and long-term treatment may improve symptoms, help you breathe better and reduce the risk of exacerbations (sudden worsening of your symptoms).

Unfortunately, studies find that doctors are not very good at diagnosing COPD in women because they have long considered it a “man’s disease.” If you think you might have COPD, ask your health care professional to test your lung function with spirometry.

Symptoms of COPD may include shortness of breath, particularly in the morning but eventually throughout the day. You may also have a cough and mucus production. Over time, your symptoms may worsen, particularly when exercising or climbing stairs, for example. You may notice that you’ve cut back on certain activities, because they make you too tired or cause shortness of breath or chest tightness. As the disease gets worse, these symptoms occur even when you’re resting. Other symptoms may include fatigue and morning headaches.

COPD is marked by hyperinflation of the lungs, meaning you can’t exhale all the air you’ve inhaled, so your lungs remain inflated like a balloon. This also interferes with how much air you can inhale, leading to the shortness of breath that is a primary symptom of the disease.

To diagnose COPD, your doctor will take a complete medical history and listen carefully to your lungs before ordering certain tests. These may include:

Spirometry. This simple test uses a spirometer, which is a machine that checks how well your lungs function and displays the results on a graph. It measures two things:

Other pulmonary tests. You may undergo other pulmonary tests, including one that measures your lung volume, and oximetry, in which a small sensor is clipped to your finger to measure the oxygen level in your blood.

X-ray. Your doctor may order an X-ray to examine your lungs. However, X-rays are not very good at detecting COPD, so if your doctor does order one, ask why.

CT scan. Although not required for a diagnosis, your doctor may order a CT scan, particularly to see if you have emphysema.

Arterial blood gases. This test measures the amount of oxygen and carbon dioxide in your blood, as well as the acidity (pH) of your blood. As your COPD worsens, carbon dioxide builds up because you have a hard time exhaling.

Forced vital capacity (FVC), how much air you can exhale after taking in a deep breath.

Forced expiratory volume (FEV1), how much air you can exhale in one second.

Your doctor will read the results, assess how well your lungs are working and determine if you have COPD. You are typically diagnosed with COPD if you have an FEV1/FVC ratio less than 70 percent and an FEV1 less than 80 percent of what would be “predicted” based on your age, gender, weight and other parameters.

Spirometry is used not only to confirm your diagnosis, but also to track the progression of your disease over time.

Once you are diagnosed, your doctor will classify your disease into one of four grades: mild (GOLD 1), moderate (GOLD 2), severe (GOLD 3), very severe (GOLD 4). The grade helps determine the best treatment regimen.

Exacerbations. Exacerbations are periodic flare-ups of COPD symptoms, such as cough, mucus production and shortness of breath. Although they tend to occur more frequently in patients with more severe disease, they can occur at any stage of the disease. They are marked by increased shortness of breath, greater difficulty trying to breathe out and higher levels of carbon dioxide because of reduced lung function. They typically lead to a change in your medication and may require hospitalization. A major goal of treatment is to reduce the risk of exacerbations.

Comorbidities. COPD doesn’t just affect your lungs. The inflammation that accompanies the disease, coupled with the chronic, or long-term, oxygen deficiency, can contribute to numerous health problems that are more prevalent in people with COPD than in those without the disease. Among them are:

depression

diabetes

heart disease

high blood pressure

infections

lung cancer

osteoporosis

Two of the most common comorbidities are depression, which affects 28 to 42 percent of those with COPD, and osteoporosis, which is three to five times more common in those with COPD than in those without it. One study found that 68 percent of those aged 50 to 70 with COPD had osteoporosis.

Treatment

The goals of treating COPD are to reduce your symptoms and risk of exacerbations, and improve your overall health and exercise tolerance.

COPD is treated with a combination of medication and nonmedical approaches. An important part of managing COPD, however, includes a good relationship and open communication with your doctor, and following your doctor’s instructions.

Nonmedical treatments

Smoking cessation. If you smoke, you must stop. Continuing to smoke will increase damage to your lungs and worsen your symptoms. Your best chance at success in quitting smoking is to enlist the help of your doctor and to find a support system, either in person, by phone or online. You may also need medication or a nicotine replacement product, like gum or a patch.You may experience some nicotine withdrawal symptoms, because nicotine can be quite addictive. These include sleeplessness, irritability, dizziness, headaches, increased appetite and weight gain. Be patient; symptoms usually peak within two to three days and disappear between a few days to several weeks after quitting.

Pulmonary rehabilitation. This includes exercises to strengthen the muscles that help you breathe (your diaphragm), as well as regular exercise, such as walking. If there is no formal pulmonary rehabilitation program near you, you should try to walk at least 20 minutes a day or until you feel any breathlessness or other symptoms. Studies find that pulmonary rehabilitation programs can improve your ability to exercise, reduce shortness of breath, improve your quality of life and reduce the amount of medical services you use.

Nutrition. About a third of people with severe COPD eat too little protein and develop protein-related malnutrition. This may make your COPD worse and increase your risk of death. Talk to your doctor about whether you should take high-calorie nutritional supplements and, if needed, appetite stimulants. You also might consider:

Education. The more you know about your COPD, the better you may be able to manage it. It is important that you understand what triggers exacerbations, what medications you need and how to use them, how to reduce shortness of breath and how to recognize and treat complications. Education allows you to take a larger role in managing your COPD.

Eating small, frequent meals with high-protein foods that are easy to fix, such as hard-boiled eggs, peanut butter, chicken breasts, cubes of cheese, cottage cheese and yogurt.

Resting before meals.

Taking vitamins (check with your doctor on the best options).

Types of Medications

Several types of medication are used to treat COPD symptoms. In some instances, you may be placed on more than one medication to control your symptoms.

The most commonly used medications are:

Bronchodilators. Bronchodilators work by relaxing your airways so you can breathe easier. They improve both lung function (which spirometry measures) and symptoms, can increase your exercise ability and can improve airflow. They may also reduce your risk of exacerbations and hospitalization.

This is important because the more exacerbations you have, the higher your risk of future exacerbations. They may also hasten disease progression, leading to worse lung function more quickly. Thus, bronchodilators are a standard type of COPD treatment. All are inhaled, although they may be delivered via different types of inhalers. Long-acting bronchodilators are convenient and more effective at maintaining symptom relief than short-acting therapies.

Inhaled glucocorticoids (also known as inhaled corticosteroids, or ICS)

These drugs may help reduce inflammation from COPD and may reduce exacerbations. They are never used as solo therapy for COPD and are always prescribed in conjunction with a long-acting bronchodilator, sometimes two, in people with more severe COPD, significant symptoms or repeated exacerbations. They are used to treat asthma. Potential side effects of ICS include thrush, hoarse voice and bruising.

Phosphodiesterase-4 (PDE-4) inhibitor

This class of drug reduces inflammation and may increase airway relaxation. It is generally reserved for those with severe or very severe COPD, particularly those experiencing frequent exacerbations, severely limited airflow and chronic bronchitis.

Inhalers. Most medications for COPD are delivered via inhalers. There are four main types of inhalers:

Metered dose inhaler (MDI). With these inhalers, you insert an aerosol canister of medication at the end of a small tube, press down on the canister and breathe in deeply. MDI requires coordination between your hand and breath, and you must be able to take a deep breath. There are breath-activated MDIs, which are triggered when you breathe in and may be easier to use. Still, studies find that up to 67 percent of people do not use MDIs properly.

Dry powder inhaler. With these inhalers, you insert a specific dose of the medication into the device, put the mouthpiece between your lips and breathe in deeply. They are portable and easy to use, but any exposure to moisture can ruin the medicine because it’s a dry powder. You also have to be able to breathe in deeply to get the right dose of medicine.

Nebulizer. With a nebulizer, the medicine is automatically sent through a mouthpiece. You breathe in through the mouthpiece to get the medicine into your lungs, and out through your nose. For some people, a nebulizer may be the easiest delivery system to use, but it is bulky and requires more time than other types of inhalers.

It is important that you work with your health care professional to find the right inhaler for you and to become comfortable with how it works. If you don’t like the one you’re using, ask about switching. Many inhalers are very effective, but the key is to find one that works for you and that you can use properly. Things such as your age, eyesight and other medical conditions can all affect your ability to use the medicine. Remember: the medication only works if it gets into your lungs.

Vaccinations. Any kind of lung infection, including a cold, can lead to a COPD exacerbation. You can’t prevent all such infections, but you can protect yourself against pneumococcal pneumonia and the flu with vaccines. So make sure you get a flu vaccine every year. If you are 65 or older, or you have an FEV1 less than 40 percent, you should consider getting a pneumococcal polysaccharide (pneumonia) vaccine.

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safegen-blog · 7 years ago

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https://safegenericpharmacy.com/blog/endometriosis/

Overview

Endometriosis is a noncancerous condition in which tissue similar to theendometrium (uterine lining) grows outside your uterus and adheres to other structures, most commonly in the pelvis, such as on the ovaries, bowel, fallopian tubes or bladder. Rarely it implants in other places, such as the liver, lungs, diaphragmand surgical sites.

It is a common cause of pelvic pain and infertility. It affects about 5 million women in the United States.

Historically thought of as a disease that affects adult women, endometriosis is increasingly being diagnosed in adolescents, as well.

The most common symptoms are painful menstrual periods and/or chronic pelvic pain.

Others include:

Diarrhea and painful bowel movements, especially during menstruation

Intestinal pain

Painful intercourse

Abdominal tenderness

Backache

Severe menstrual cramps

Excessive menstrual bleeding

Painful urination

Pain in the pelvic region with exercise

Painful pelvic examinations

Infertility

It is important to understand that other conditions aside from endometriosis can cause any or all of these symptoms and other causes may need to be ruled out. These include, but are not limited to, interstitial cystitis, irritable bowel syndrome, inflammatory bowel disease, pelvic adhesions (scar tissue), ovarian masses, uterine abnormalities, fibromyalgia, malabsorption syndromes and, very rarely, malignancies.

When endometriosis tissue grows outside of the uterus, it continues to respond to hormonal signals—specifically estrogen—from the ovaries telling it to grow. Estrogen is the hormone that causes your uterine lining to thicken each month. When estrogen levels drop, the lining is expelled from the uterus, resulting in menstrual flow (you get your period). But unlike the tissue lining the uterus, which leaves your body during menstruation, endometriosis tissue is essentially trapped.

With no place to go, the tissue bleeds internally. Your body reacts to the internal bleeding with inflammation, a process that can lead to the formation of scar tissue, also called adhesions. This inflammation and the resulting scar tissue may cause pain and other symptoms.

Recent research also finds that this misplaced endometrial tissue may develop its own blood supply to help it proliferate and nerve supply to communicate with the brain, one reason for the condition’s severe pain and the other chronic pain conditions so many women with endometriosis suffer from.

The type and intensity of symptoms range from completely disabling to mild. Sometimes, there aren’t any symptoms at all, particularly in women with so-called “unexplained infertility.”

If your endometriosis results in scarring of the reproductive organs, it may affect your ability to get pregnant. In fact, 30 to 40 percent of women with endometriosis are infertile. Even mild endometriosis can result in infertility.

Researchers don’t know what causes endometriosis, but many theories exist. One suggests that retrograde menstruation—or “reverse menstruation”—may be the main cause. In this condition, menstrual blood doesn’t flow out of the cervix (the opening of the uterus to the vagina), but, instead, is pushed backward out of the uterus through the fallopian tubes into the pelvic cavity.

But because most women experience some amount of retrograde menstruationwithout developing endometriosis, researchers believe something else may contribute to its development.

For example, endometriosis could be an immune system problem or local hormonal imbalance that enables the endometrial tissue to take root and grow after it is pushed out of the uterus.

Other researchers believe that in some women, certain abdominal cells mistakenly turn into endometrial cells. These same cells are the ones responsible for the growth of a woman’s reproductive organs in the embryonic stage. It’s believed that something in the woman’s genetic makeup or something she’s exposed to in the environment in later life changes those cells so they turn into endometrial tissue outside the uterus. There’s also some thinking that damage to cells that line the pelvis from a previous infection can lead to endometriosis.

Some studies show that environmental factors may play a role in the development of endometriosis. Toxins in the environment such as dioxin seem to affect reproductivehormones and immune system responses, but this theory has not been proven and is controversial in the medical community.

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safegen-blog · 7 years ago

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https://safegenericpharmacy.com/blog/clinical-trials/

Overview

A clinical trial uses human volunteers in planned research to increase medical knowledge. A trial look at an “intervention,” such as a drug, medical device, procedure or participants’ behavior (such as diet and exercise), to assess its merit. The researchers measure the effects of the intervention on the participants. The goal is to see if a new drug, device, procedure or behavioral modification is effective and safe.

For example, a clinical trial might look at the effects of a new drug on participants to see if it effectively and safely lowers highblood pressure.

There is another kind of clinical study, called an observational study, in which participants are also observed to assess health outcomes, but they are not assigned specific interventions, such as a drug or procedure. For example, researchers conducting an observational study might observe a group of older adults to see how exercise affects their cardiac health. (Find out more about observational studies.)

In the United States, research usually starts with lab experiments and sometimes with animal testing or computer modeling. This may be followed by clinical trials in humans.

Currently, more than 150,000 studies of drugs and other treatments are in active clinical trials in 185 countries. They may be done in cities and towns of any size and can be conducted at universities, community clinics, hospitals and doctors’ offices.

The federal government maintains a website called ClinicalTrials.gov that provides information on publicly and privately funded clinical studies of drugs, diseases and conditions. The site has information about what trials are being conducted or coming up and which ones are seeking participants.

All clinical trials must have a study design plan called a protocol. This plan is presented to the U.S. Food and Drug Administration (FDA) as part of the Investigational New Drug (IND) application. The FDA and a research ethical review board or an institutional review board (IRB) must approve a protocol for each study site. After the study begins, the review board advocates for the volunteers. Anyone who volunteers to participate in a study must first sign a written informed consent, which says that you have been given information about the study and understand it. (Find out more about oversight of clinical trials and informed consent.)

Once a trial is completed, the results are examined by the FDA. Before approval is given, the clinical trial results of safety and effectiveness must be “statistically significant.” That means the results are analyzed to show that they are highly likely to be “true” and not the result of chance.

The process can take more than 10 years, and many new products and procedures never make it through the process and never reach the market.

Pharmaceutical companies also test drugs that have been approved to continue checking long-term safety and effectiveness. If the company wants to market the drug for new uses or add labeling claims, more clinical trials are required.

Reasons for Conducting Clinical Trials

Any question a health care professional might have about how best to diagnose, treat or prevent a medical condition may be addressed scientifically by a clinical trial. For example, a study might ask whether using a particular drug in addition to surgery is better than surgery alone or whether earlier, more aggressive treatment of a condition produces a better outcome. Trials are often used to compare a new drug’s safety and effectiveness to a placebo or to existing drugs used for the same purpose.

While some may have goals of testing potential cures for diseases or ways to prevent them, others may be aimed at improving quality of life for those living with a disease or condition.

Here are a few reasons for conducting clinical trials:

Evaluating a way to treat or manage a disease or a condition, such as drugs, medical devices or approaches to surgery or treatment

Finding ways to prevent development or recurrence of a disease or condition, such as testing new medicines, vaccines or lifestyle changes

Evaluating ways to identify or diagnose a disease or condition

Examining ways to identify a condition or the risk factors for that condition

Looking for ways to improve the comfort and quality of life of people with a chronicillness and measuring the success of those methods

How a Clinical Trial Is Set Up

When a company or agency proposes a new drug or medical device, it usually conducts some trials using animals or computer models. If those results prove promising, it submits an Investigational New Drug (IND) application to the FDA asking to begin testing with humans in a clinical trial.

The IND includes a design plan called a protocol. This includes, for example, study locations; how long the study will last; how many people will participate; eligibility requirements; and a schedule of tests, procedures, medications and dosages.

Before the clinical trial can begin, the FDA and a research ethical review board or an institutional review board (IRB) must approve a protocol for each study site. The review board will advocate for the volunteers. Its job is to be sure that the clinical trial is designed to answer the scientific question and to assure participants’ safety.

Many trials include multiple “arms,” or groups of participants who are given different treatments for the purposes of comparison. One group might receive an experimental drug, while another receives a standard treatment or a placebo.

Some words you may hear used to describe clinical trials include:

Open-label: A drug trial in which both the researchers and the volunteers know what drug is being administered and at what dose. It is also called a non-blinded trial. Sometimes such studies are conducted while a drug is awaiting review; during that period, participants or insurers may be required to pay the wholesale cost of the medication.

Placebo-controlled: A trial in which some participants are given the drug that’s being tested and others are given a placebo, or inactive compound. A placebo can have many forms. In addition to the familiar pills, a placebo may be an injected saline (inactive) solution in the case of an injected or infused drug or an inactive cream or nasal spray. The placebo will look exactly like the experimental medication.

Double-blinded or double-masked: Usually participants don’t know if they’re receiving the treatment being tested or not. Such studies are termed single-blinded. But in some cases, health care providers also don’t know which group is receiving the drug and which a placebo. These studies are called “double-blinded.”

Randomized: A randomized trial is one in which participants are randomly selected for either the experimental group or the control group. Often, researchers use a computer program to determine who goes into which group. Neither the researcher nor the volunteer has any input or control into which group you enter.

Phases of Clinical Trials

Clinical trials have several phases. The initial trials, usually small (20 to 80 volunteers), are called Phase I trials. Some Phase I trials use the same dose of a drug throughout the trial, but others may increase the dose to determine the maximum safe dosage and to discover what, if any, side effects result as the dose is increased. Additionally, researchers sometimes take note of effectiveness data gathered during Phase I trials: Did participants stabilize or get better? The primary purpose of these studies is to measure the drug’s safety.

In Phase II trials, researchers again look at safety, but also gather data on effectiveness. Some Phase II trials compare the drug to existing treatments, others to a placebo. Phase II trials target volunteers with a specific disease to evaluate the potential benefits of the new drug in this select population. Phase II trials are usually larger than Phase I studies and may include up to several hundred participants.

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safegen-blog · 7 years ago

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https://safegenericpharmacy.com/blog/fitness/

Overview

If a friend told you that delaying the aging process, controlling your weight, feeling happier and less anxious, sleeping better and warding off illnesses like heart disease, some forms of cancer, high blood pressure and diabetes was as easy as walking briskly for 30 minutes each day, would you believe her?

It’s true. You can receive all these benefits simply by taking that 30-minute daily walk. According to the Centers for Disease Control and Prevention, inactive nonsmoking women have an estimated 12.7 years of active life expectancy at age 65, compared with 18.4 years for highly active, nonsmoking women. The American Heart Association reports that a sedentary lifestyle is a major risk factor for heart disease and stroke. Studies find that people who start a regular physical exercise program after a heart attack have better rates of survival and an improved quality of life compared with those who remain sedentary. And people who do not exercise have a risk of coronary heart disease double that of people who exercise regularly—an increased risk similar to that caused by high cholesterol, high blood pressure and cigarette smoking.

In addition, being sedentary has several negative health consequences. Your muscles, including your heart and lungs, become weak; your joints become stiff and easily injured; and you can develop high blood pressure, fatigue, obesity andosteoporosis. Lack of physical activity can also contribute to anxiety and depression. Being physically fit, on the other hand, reduces the risk of heart disease, some forms of cancer, high blood pressure, diabetes and other diseases. Exercise may also reduce bone loss after menopause.

What’s missing in this age of modern conveniences and desk jobs are reasons to get our bodies up and moving regularly.

That’s why the U.S. Department of Health and Human Services’ National Center for Health Statistics reports that about 40 percent of American adults report no leisure-time physical activity, and only 31 percent of adults say they engage in regular leisure-time activity (defined as either three sessions per week of vigorous physical activity lasting 20 minutes or more, or five sessions per week of light-to-moderate physical activity lasting 30 minutes or more).

The good news is that it’s never too late to take up exercise. At any age, at any level of health, even if you already suffer from a chronicdisease, you can improve your level of fitness. Plus, if walking isn’t your cup of tea, there are endless options, all with similar results.

What, exactly, is fitness? Physical fitness has the following components:

Cardiovascular fitness. Your level of cardiovascular fitness determines your body’s ability to use oxygen to help provide energy. It provides the stamina or endurance to be active without gasping for breath.

Muscular strength. Muscular strength is the ability of your muscles to exert force during an activity.

Muscular endurance. Muscular endurance is the ability of the muscle to continue to perform without fatigue.

Flexibility. Flexibility refers to maintaining an optimal range of motion in the joint areas, making bending and stretching easy.

Body composition. Body compositi

Treatment

The first and easiest change to make on your journey to fitness is to add “lifestyle physical activity” to your day. This means being more physically active during your usual daily activities. You can:

park in a far-away spot and briskly walk to your destination

take the stairs instead of an elevator

rake leaves instead of using the blower

play tag with the kids instead of computer games

go golfing, bowling or dancing for fun

walk down the hall instead of using the phone or e-mail

take a walk during a morning or afternoon break.

do indoor chores such as window washing, tub scrubbing or reorganizing your closet

do active outdoor chores, such as mowing the grass, gardening or washing the car

Making these changes is an easy way to improve mood, heart and respiratory function and muscular fitness, as well as to reduce body fat.

However, for women who need to make more dramatic gains in fitness or need to lose weight, a more formal exercise program, in addition to lifestyle physical activity, may be necessary. Your program should address the five components of fitness by including:

Aerobic activities, which involve using the large muscles of your body in a rhythmical, continuous activity, improving cardiovascular conditioning and helping reduce body fat. Aerobic exercises include walking, jogging, bicycling and swimming, as well as aerobics or other exercise classes or videos.

Strength training, such as weight lifting. This improves muscular strength and endurance and helps maintain bone density. It also raises metabolism, helping you burn more calories.

Stretching exercises, which include slow, gentle movements that elongate your muscles and improve flexibility. These are often part of exercise classes or videos, as well as yoga and Pilates.

How Much Is Enough?

One of the most common questions is, “How much do I need to exercise?” The Centers for Disease Control and Prevention’s 2010 Physical Activity Guidelines for Americans recommend that adults do both aerobic and strength training. Specifically, the guidelines recommend the following:

A total of at least 150 minutes of moderate-intensity aerobic activity (such as brisk walking) per week, which translates to about 30 minutes per day, five days a week, coupled with muscle-strengthening activities that work all major muscle groups on two or more days a week or

A total of at least 75 minutes of vigorous-intensity aerobic activity (jogging or running) every week and muscle-strengthening activities that work all major muscle groups on two or more days a week or

An equivalent mix of moderate- and vigorous-intensity aerobic activity and muscle-strengthening activities that work all major muscle groups on two or more days a week.

The guidelines also recommend that adults perform muscle-strengthening activities that involve all major muscle groups at least two days a week.

The new guidelines note that adults can achieve additional health benefits, including the promotion of greater weight loss or the prevention of weight regain, by increasing to five hours (300 minutes) a week of moderate-intensity aerobic physical activity or two hours and 30 minutes a week of vigorous-intensity physical activity or an equivalent combination of both.

These minutes can be accumulated in increments of 10. For instance, 10 minutes of an aerobics video in the morning, 10 minutes of brisk walking at lunch and 10 minutes of brisk walking in the evening. Intermittent exercise (intermittently increasing the heart rate) can be part of a good weight-loss strategy because your metabolism is elevated following each bout of exercise.

If you have been inactive, you need to work up slowly to this amount. Start with five or 10 minutes—whatever you’re comfortable with—every other day and add one minute every other session. If you do too much too soon, you can become injured, fatigued and discouraged. You can know that you are not pushing yourself too hard if you feel recovered by the next day.

Similarly, don’t overdo strength training. Start slowly, with lighter weights, and work up to heavier weights. You don’t need to strength train more than a couple times per week. Finally, always wait at least 48 hours before exercising the same muscle group to give those muscles adequate time to recover between sessions.

Ideally, you should warm up the muscles that you plan to use for the activity. This can be done by starting your walk or activity slowly for two to three minutes and then increasing to a brisk walk or increasing the intensity of the activity. It is also helpful to stretch any muscles and joints that you routinely use at work or play a couple of times per week. Hold each stretch for about 30 seconds. Some lighter stretches can even be done at your desk or while you watch TV. Examples of stretching exercises include shoulder or arm circles. There are also a number of stretches specifically targeted to arm, back, chest, thigh and calf muscles.

How Hard Should You Work?

The second question is, “How hard do I need to exercise?”

As you work on increasing the length of your exercise sessions, you also need to work on increasing their intensity. Low-intensity aerobic exercise, like housework, gardening and walking the dog, provide many general health benefits, but to truly enhance fitness, especially if weight loss is one of your goals, you need to up the ante and exercise at a moderate or higher intensity with vigorous activities like brisk walking or jogging, singles tennis, aerobics classes or cycling.

In fact, results from a University of Pittsburgh study published in the Journal of the American Medical Association found that women trying to lose weight can benefit as much from moderate-intensity physical activity as from an intense workout. The exercise duration and intensity trial involved 201 overweight, healthy women ages 21 to 45 years. All received reduced-calorie meals and were assigned to one of four physical activity regimens.

The regimens consisted of either a moderate or vigorous-intensity physical activity performed for either a shorter (2.5 to 3.5 hours per week) or longer (3.5 to 5 hours per week) duration. The physical activity consisted primarily of brisk walking that burned between 1,000 and 2,000 calories a week.

Women in all four groups lost between 13 and 20 pounds, or 8 percent to 10 percent of their body weight, and maintained that weight loss for a year. They also improved their cardiorespiratory fitness. But, most importantly, the amount of weight lost and fitness improvement was essentially the same among the four groups.

The author concluded that an intervention program should initially target the adoption and maintenance of at least 150 minutes a week of moderate-intensity exercise, and, when appropriate, eventually progress to exercise levels of 60 minutes per day, most days of the week. This upper level is consistent with the Centers for Disease Control and Prevention’s 2010 Physical Activity Guidelines for Americans’ recommendation of a total of 300 minutes per week (60 minutes per day, most days of the week) for greater weight loss and the prevention of weight regain.

Because the goal of aerobic exercise is to work your heart, your exercise needs to increase your heart rate. One way to determine if you are exercising intensely enough is to measure your heart rate. Your heart rate should be about 50 percent to 85 percent of its maximum. Maximum heart rate for one minute is your age subtracted from 220.

After warming up and then sustaining an aerobic activity for about five minutes, take your pulse by placing two fingers on the radial artery on your wrist (it will be toward the thumb side of your wrist). Count the beats for 10 seconds. The number of beats you count should fall between the two numbers listed beside your age in the chart below. The following chart illustrates recommended 10-second heart rate counts.

AgeNumber of beats in 10 seconds

2017 to 28

3016 to 30

4015 to 26

5014 to 24

6013 to 23

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safegen-blog · 7 years ago

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https://safegenericpharmacy.com/blog/colon-cancer/

Overview

Colorectal cancer is one of the most common cancers in the United States. About one in 20 people will develop cancer of the colon or rectum in their lifetimes. It also is the second leading cause of cancer deaths when men and women are considered together and is the third leading cause of cancer death among women.

There are regional differences in colorectal cancer’s incidence and mortality throughout the country, with the lowest rates occurring among those living in Western states, and survival rates lowest among African Americans.

The good news is that the disease is not only highly beatable and treatable, but also highly preventable. Regular screening and removal of polyps can reduce colorectal cancer risk by up to 90 percent. But unfortunately, fear, denial and embarrassment keep many people from being screened.

When colon cancer is caught and treated in stage I, there is a 74 percent chance of survival at five years. Once the cancer is larger and has spread to the lymph nodes, however, the five-year survival rate drops to 46 percent. If the cancer has already spread to distant parts of the body such as the liver or lungs, the five-year survival rate goes down to 6 percent.

The large intestine is the last section of the digestive tract and consists of the colon and rectum. The colon is four to six feet long, and the last seven to nine inches of it is called the rectum. After food is digested in the stomach and nutrients are absorbed in the small intestine, waste from this process moves into the colon, where it solidifies and remains for one or two days until it passes out of the body.

Sometimes the body produces too much tissue, ultimately forming a tumor. These tumors can be benign (not cancerous) or malignant(cancerous). In the large intestine, these tumors are called polyps. Polyps are found in about 30 percent to 50 percent of adults. People with polyps in their colon tend to continue producing new polyps even after existing polyps are removed.

There are several types of polyps, the most common being hyperplastic polyps, adenomatous polyps, sessile serrated polyps and malignant polyps. Hyperplastic polyps are typically not precancerous. Adenomatous polyps (also called “adenomas”) and sessile serrated polyps may undergo cancerous changes, becoming adenocarcinomas. Malignant polyps are already cancerous.

Colon cancers develop from precancerous polyps that grow larger and eventually transform into cancer. It is believed to take about 10 years for a small precancerous polyp to grow into cancer. Therefore, if appropriate colorectal cancer screening is performed, most of these polyps can be removed before they turn into cancer, effectively preventing the development of colon cancer.

Besides adenocarcinomas, there are other rare types of cancers of the large intestine, including carcinoid tumors typically found in the appendix and rectum; gastrointestinalstromal tumors found in the connective tissue of the colonic or rectal wall; and lymphomas, which are malignancies of immune cells that can involve the colon, rectum and lymph nodes.

Risk Factors

The exact cause of colon cancer is unknown, but it appears to be influenced both by hereditary and environmental factors. People at an increased risk of colon cancer include those with either a personal or family history of colorectal cancer or polyps, individuals with a long-standing history of inflammatory bowel disease and people with familial colorectal cancer syndromes. Some of those at high risk may have a 100 percent chance of developing colorectal cancer.

Specific risk factors include:

Personal History: A personal history of colorectal cancer, benign colorectal polyps which are adenomas or sessile serrated polyps, or chronic inflammatory bowel disease (e.g., ulcerative colitis and Crohn’s disease) puts you at increased risk for colorectal cancer. In fact, people who have had colorectal cancer are more likely to develop new cancers in other areas of the colon and rectum, despite previous removal of cancer.

Heredity: If one of your parents, siblings or children has had colorectal cancer or a benign adenoma, you have a higher risk of developing colorectal cancer. If two or more close relatives have had the disease, you also have an increased risk; approximately 20 percent of all people with colorectal cancer fall into this category. Your risk is even greater if your relatives were affected before age 60 or if more than one close relative is affected.Additionally, there are two genetic conditions—familial adenomatous polyposis (FAP) and hereditary nonpolyposis colorectal cancer (HNPCC)—that lead to colorectal cancer in about 5 percent of patients.

Familial adenomatous polyposis (FAP). People who have inherited the FAP syndrome may develop hundreds to thousands of polyps in their colon and rectum at a young age, usually in their teens or early adulthood. These polyps are all adenomas. By age 40, almost all patients with FAP will develop colon cancer if they don’t have preventive surgery. Most people who have this syndrome begin annual colon examinations while in elementary school, and many choose to have their colon and rectum removed before cancer develops. FAP is rare, accounting for about 1 percent of all cases of colorectal cancer.

Hereditary non-polyposis colon cancer (HNPCC). Also known as Lynch Syndrome, HNPCC is a more common form of inherited colon cancer, accounting for about 3 percent to 5 percent of all colorectal cancer cases. While it is not associated with thousands of polyps, polyps are present and grow more quickly into cancer than in patients without HNPCC. Colon cancer in people with HNPCC also develops at a younger age than sporadic colon cancer, although not as young as in those with FAP.Cancers in patients with HNPCC tend to be fast growing and respond less to chemotherapy. The lifetime risk of colon cancer in people with HNPCC may be as high as 80 percent. People with HNPCC are also at an increased risk for other types of cancer, including cancer of the ovary, uterus, stomach, kidney andbladder.

MUTYH-associated polyposis (MAP): People with this syndrome, which is caused by mutations in the gene MUTYH, develop colon polyps that are destined to become cancerous if they are not removed. Their colonoscopyfindings may be similar to FAP with hundreds to thousands of polyps or not. People with MUTYH are also at increased risk of cancers of the small intestine, skin, ovary and bladder.

There are some additional rare genetic mutations associated with colon cancer. These include Turcot syndrome, an inherited condition in which people are at an increased risk of adenomatous polyps (and thus, colon cancer) and brain tumors, and Peutz-Jeghers syndrome, a condition that leads to freckles around the mouth and sometimes on the hands and feet, as well as large polyps in the digestive tract and an increased risk of colon and other cancers at a young age.

In addition, there are several gene mutations found in Jews of Eastern European descent (Ashkenazi Jews) that increase colon cancer risk. The most common mutation, which is called the I1307K APC mutation, is found in 6 percent of American Jews.

If you have a history of adenomas or colon cancer or suspect you have a family history of the disease, you should discuss this with your health care professional because you may need to begin screening for the disease at a relatively young age. In some cases, you may wish to undergo genetic testing.

Age: The risk of colorectal cancer increases with age. Ninety percent of new cases of colorectal cancer in the United States are in people over 50. Clinical studies indicate that when screened for the disease, African Americans tend to be diagnosed with colorectal cancer at a younger age than Caucasians.

Race: African Americans are more likely to get colorectal cancer than any other ethnic group. Compared to Caucasians, African Americans are about 10 percent more likely to develop colorectal cancer. Unfortunately, they also are more likely to be diagnosed in advanced stages. As a result, African Americans are more likely to die from colon cancer than Caucasians. In 2007, the rate of death from colon cancer among African Americans was 44 percent greater than that among whites.

Diet: Eating a diet high in processed meats (hot dogs and some lunch meats) and red meats (lamb, beef or liver) may increase your risk of developing the disease. Avoiding red meat and eating a low-fat diet rich in vegetables, fruit and fiber (e.g., broccoli, whole grains and beans) may reduce your risk of developing colorectal cancer. Some studies suggest that boosting calcium intake helps prevent colon cancer. Until further studies are done, men should keep their intake below 1,500 milligrams because of the increased risk of prostate cancer associated with high levels of calcium. Some research has also shown that vitamin D, which you can get from foods, sun exposure or a pill, can help lower colon cancer risk, but because of the increased risk of skin cancer with sun exposure, most health care professionals don’t advocate getting more sun to reduce colorectal cancer at this time. Other studies suggest that taking a multivitamin that contains folic acid may lower colon cancer risk, but more study is needed in this area. There is some research suggesting that a diet high in magnesium may decrease colon cancer risk, especially in women. More research is necessary to find out if this link exists.

Lifestyle: Regular exercise is a key weapon in the fight against colorectal cancer. Another significant risk factor in colorectal cancer is smoking. Get help quitting if you can’t do it on your own. And keep your alcohol intake to one drink a day or less (two drinks a day or less for men).

Obesity: Obesity is an epidemic in the United States and has been associated with many types of cancers, including colorectal cancer. There is a strong link between higher BMI (body mass index) and waist circumference and colon cancer risk in men and a weaker association seen in women. High levels of insulin and insulin-like growth factor may play a role in development of colon cancer in obese people. Weight loss has been shown to reduce the risk of colon cancer.

Screening Tests

The American Cancer Society recommends all women and men over the age of 50 who are at average risk of colorectal cancer undergo one of the following:

A fecal occult blood test once a year. This test detects microscopic amounts of blood in the stool and only detects tumors that are bleeding. This must be performed on three separate bowel movements, and you should avoid nonsteroidal anti-inflammatory medications (NSAIDS) for seven days and vitamin C and red meat for three days before collecting the stool samples. Your health care professional provides the necessary materials to collect the stool specimens for simple testing at home or in the office. The stool should be collected before it is in the toilet water. A wooden stick is used to smear a small sample of stool onto the slots in the test card. You will get three test cards, which, when completed, you return to your health care professional. Your health care professional may recommend this test earlier than age 50 or more frequently if you are at high risk for colon cancer and/or polyps.

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safegen-blog · 7 years ago

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https://safegenericpharmacy.com/blog/flucolds/

Overview

The flu, or influenza, is a viral disease of the respiratory tract—the nose, throat, bronchial tubes and lungs—and is highly contagious. It is spread though airborne droplets of moisture produced by coughs or sneezes. When you breathe these germs in through your nose or mouth, you may come down with the flu, generally within one to four days of exposure.

The flu is a potentially serious disease that can lead to hospitalization, or, in severe cases, death. Even healthy people can become very sick from the flu. Death rates from the flu vary from season to season. Flu-related deaths have ranged from a low of 3,000 to a high of 49,000 between 1976 and 2007, according to the U.S. Centers for Disease Control and Prevention (CDC). Outbreaks frequently start in school-age children, who carry the virus home and spread it to other groups.

And, beginning with the 2009-2010 flu season, there was a new flu to contend with—H1N1 flu (“swine flu”), which caused the first flu pandemic in more than 40 years. Since this outbreak, the seasonal flu vaccines have included coverage for the 2009 H1N1 flu. The seasonal trivalent flu vaccine usually contains one of each of the three kinds of influenza viruses that most commonly circulate among people today: influenza A (H1N1), influenza A (H3N2) and influenza B viruses. For the 2013-14 season, there are more flu vaccine options available than ever before. See thePrevention section for more information.

Flu seasons are unpredictable. The 2011-2012 flu season affected a record low number of people, but the 2012-2013 flu season was moderately severe. The flu season in the United States commonly peaks in January or February, but it can begin as early as October and continue into May.

Because flu can be so serious and can spread so rapidly, the CDC recommends that everyone age 6 months and older get vaccinated every year. A yearly flu vaccine is the first and most important step in protecting against flu, according to the CDC.

Vaccines are especially important to those most susceptible to flu complications, including older people, children, pregnant women, people who are morbidly obese, people with compromised immune systems and those with chronic illnesses such as heart disease, kidney disease, asthma, COPD and diabetes. The most serious, often life-threatening complication of the flu is pneumonia. Other complications include ear infection, bronchitis, dehydration and worsening of chronic conditions, such ascongestive heart failure, asthma or diabetes. Croup and a lung disease called bronchiolitis can also arise as complications in infants and young children.

In addition, the severity of illness is increased by exposure to cigarette smoke, which can injure airways and damage the cilia, the tiny hair-like structures that help keep airways clear. Toxic fumes, industrial smoke and other air pollutants are also risk factors.

There is also evidence that influenza can be more dangerous for women in their second or third trimester of pregnancy. The strain and stress of pregnancy on a woman’s lungs, combined with the type of influenza, can lead to pulmonary problems, although there doesn’t appear to be any danger to the fetus from the influenza virus itself.

There are three strains of the flu virus:

Type A results in severe illness that easily spreads throughout a population, even globally, affecting a large number of people at the same time.

Type B is a generally less severe strain that tends to affect fewer people.

Type C causes very mild symptoms, so mild that many people don’t even realize they’re sick.

The influenza virus changes its genetic makeup every year. That’s why you can get the flu every year and why a flu vaccine containing the new virus is recommended annually for everyone 6 months and older.

This constantly changing virus presents a particular challenge to medical science, making it impossible to create a single vaccine to prevent the disease. Instead, the World Health Organization (WHO) and the CDC monitor each new strain of influenza virus as it appears, assessing which may be the predominant virus in the following year’s flu season. Scientists use this data, collected by a surveillance network, to develop a vaccine each year against the specific virus they predict will predominate. For the 2013-2014 season, the standard trivalent flu vaccine contains one influenza A (H3N2) virus, one influenza A (H1N1) virus and one influenza B virus. Starting this year, there is also a quadrivalent vaccine available that contains a fourth strain, a different B virus.

Ask your health care professional for more information about restrictions and availability of flu vaccine or visit the CDC’s website: www.safegenericpharmacy.com.

In terms of prevention and treatment, drugs called neuraminidase inhibitors (NAI)—also referred to as antivirals—attack influenza viruses, at the cellular level and block the viruses’ ability to escape from cells already infected, thus preventing the infections from spreading.

These antiviral medications can also prevent the flu, which can help contain the virus in certain settings, such as family members passing the flu to one another in a household or coworkers spreading it in the workplace.

Diagnosis

Many people confuse the terms “cold” and “flu” because the illnesses share some of the same features. Both are caused by viruses that infect the respiratory tract, mainly during the winter, and both can cause symptoms such as coughing and sore throat. A cold is a minor viral infection of the nose and throat and can occur in any season. More than 200 viruses are known to cause the common cold.

It’s important to know the difference between the cold and flu because each illness is treated differently. You know you have the flu when you feel as though you’ve been hit by a truck and experience symptoms such as high fever, severe headache, muscle and body aches and extreme tiredness, along with coughing and nasal symptoms. A cold is less severe and often includes a runny nose, sneezing and coughing. Unlike flu, colds typically don’t cause fever.

Flu Symptoms

The flu causes muscle and joint pain, high fever, a deep cough, chills, fatigue and weakness that usually send you straight to bed for three to five days or longer. Afterward, cough and tiredness may persist for days or even weeks. Other symptoms include headache, eye pain and sometimes a stuffy nose and sore throat. Some strains of the flu also produce vomiting and diarrhea. Symptoms usually come on suddenly once you’ve been exposed to the virus.

While there is such a thing as “stomach flu,” it is not caused by the influenza virus. Most people with stomach flu are infected with one of the many gastroenteritis viruses that cause temporary nausea and vomiting.

If you’ve been in contact with someone who has the flu and you begin to experience flu-like symptoms, chances are you have the virus. Only your health care professional can diagnose your symptoms accurately, so it’s important to call for an appointment as soon as your symptoms develop to see if you’re a candidate for prescription antiviral medication.

If you think you’ve been exposed to someone who has the flu and you begin to experience symptoms, the CDC currently recommends you stay home and keep away from others as much as possible and avoid travel, work, school or public places for at least 24 hours after your fever is gone (without the use of fever-reducing medication) except to get medical care or for other necessities.

If you become severely ill or you are in one of the groups at high risk for complications, (children younger than five, pregnant women, people of any age with certain chronic medical conditions like asthma, COPD, diabetes or heart disease, people who are immunosuppressed due to HIV infection or because they are taking immunosuppressive medications, and people over age 65), call your health care professional or seek medical treatment.

In children, warning signs necessitating emergency medical care include fast breathing or trouble breathing; bluish or gray skin color; not drinking enough fluids; severe or persistent vomiting; not waking up or not interacting; being so irritable that the child does not want to be held; and flu-like symptoms that improve but then return with fever and worsening cough.

In adults, warning signs necessitating emergency medical care include difficulty breathing or shortness of breath; pain or pressure in the chest or abdomen; sudden dizziness; confusion; severe or persistent vomiting; and flu-like symptoms that improve but then return with fever and worsening cough.

Antiviral medications can be used to treat people who are severely ill with flu. To be effective, antiviral medications should be taken within 12 to 48 hours of the onset of symptoms.

Flu Complications

Flu often develops into acute bronchitis—an inflammation of the bronchi, the air passages or tubes to the lungs. Symptoms include:

A fever, 100 to 102 degrees Fahrenheit.

An irritating, dry, painful cough that starts to produce small amounts of white or light yellow sputum after two or three days; at this stage the fever often recedes, and the pain from coughing diminishes. If your sputum is yellow-green or green in color, you may have a bacterial infection.

Even after the condition improves, a slight cough commonly remains for another week or two. Most cases of acute bronchitis simply represent continued inflammation from viral infection, rather than a bacterial complication. Many people benefit from short-term use of an inhaled bronchodilator such as albuterol (Accuneb, Proventil, Ventolin or ProAir).

You usually don’t need antibiotics, regardless of how long your cough has lasted. However, if you have a cough for three weeks or more, you should be carefully evaluated to rule out pneumonia or bacterial bronchitis. If you are producing green secretions when you cough, you may have a bacterial infection and need antibiotics.

Pneumonia symptoms typically appear after you feel like you’ve just about recovered from the flu. Symptoms include:

high fever

shaking chills

chest pain with each breath

continuous hacking cough that produces thick, yellow-greenish-colored phlegm, or sputum, or sputum with blood in it

extreme weakness and fatigue

The Flu in Children

Children are both highly likely to get the flu and the most likely to transmit it to others. In fact, studies find that:

Children are more likely than adults to get the flu and to have complications with the illness. The flu is most serious in children under age 2.

Families with school-age children experience more flu infections than those without because schools are ideal locations for viruses to attack and spread. On average, about one-third of family members of school-aged children are infected with the flu each year.

Children do not have as much natural immunity to influenza as adults because they have had less lifetime exposure. Also, close contact with other children in school, home and day-care settings increases a child’s risk of getting and spreading the virus.

Treatment

When you have the flu, the most important thing is rest. Plus, if you stay home, there’s less risk that you’ll spread the flu to other people. Flu can continue to be contagious for up to five to seven days after symptoms appear.

The following may help with flu symptoms:

Ask your health care professional about the prescription antiviral drugs oseltamivir (Tamiflu) or zanamivir (Relenza). Antivirals attack the virus at the source and should be started within 12 to 48 hours from the time the first symptoms appear to be effective. If taken within the proper timeframe, antivirals can help you feel better faster. Tamiflu, an oral medication available in capsule or liquid form, is approved for people one year and older. Relenza, an inhaled medication, is approved for people seven years and older. Side effects are mild and may include nausea and, less commonly, vomiting. Relenza may cause some nasal irritation.

Drink plenty of fluids. Hot liquids may relieve the feeling of congestion and loosen phlegm.

Take a pain reliever like acetaminophen for aches and fever. However, don’t use aspirin or products containing aspirin on anyone under 19 years of age, because there is a strong link between aspirin and Reye’s Syndrome, a disease that affects all body organs, particularly the brain and liver, in children.

Take a cough suppressant for relief from a dry, hacking cough when trying to sleep. A cough that produces mucus or phlegm is not necessarily a symptom of flu, but it can be a symptom of a cold or other illness. If you are coughing up phlegm, you may have developed a secondary bacterial infection that needs to be treated by a health care professional. Don’t use a suppressant if you are coughing up mucus; it’s important that you get those substances out of your lungs.

Use a humidifier, respirator or steamer in the bedroom to help ease congestion.

Because the flu is a viral infection, it cannot be treated with antibiotics. Antibiotics only kill bacteria and thus are useless against the flu. Taking antibiotics when you don’t need them contributes to an important public health problem—antibiotic resistance. Some diseases that were once easily cured by antibiotics have become resistant to treatment. For example, earlier this century, antibiotics nearly eliminated dreaded bacterial diseases like tuberculosis and gonorrhea. However, years of widespread misuse have allowed “antibiotic-resistant” forms of these illnesses to become more common.

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safegen-blog · 7 years ago

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https://safegenericpharmacy.com/blog/contraception/

Overview

Choosing a birth control method is one of the most personal health care decisions a woman makes. In nearly four decades of childbearing years, your need for birth control will most likely change many times. But at each life stage, you can make informed decisions by learning about all your contraceptive options and selecting one or more that best fits your reproductive health needs.

Many women are not adequately protected from an unwanted pregnancy by their choice of birth control method. In fact, according to the Guttmacher Institute, about one-half of all pregnancies in the United States are unplanned.

There are several reasons for failure of contraception, including inappropriate use (for example, not inserting a diaphragm the right way or not using enough spermicide); failure to continue use of the method (for example, forgetting to take your birth control pills or not using a condom every time you have sex); and failure of the contraceptive method itself.

Of the women who experience unplanned pregnancies each year in the United States, 41 percent use birth control, but these women use birth control inconsistently. Of women who use birth control consistently, only 5 percent become pregnant per year. This illustrates the importance of consistent birth control use.

Myths or personal concerns about the risks and safety of certain birth control options also contribute to incorrect use of birth control. Women may use a particular method only occasionally, for example, thinking that less frequent use is safer than continuous use. Or they may stop using a particular method because of bothersome side effects.

Age-related changes can lead women to believe they no longer need to use contraception. For example, women nearing menopausemay mistakenly think they are no longer fertile because their menstrual cycles are no longer regular. However, according to the American Congress of Obstetricians and Gynecologists (ACOG), about 75 percent of pregnancies in women over 40 are unintended. Although menopause does mark the end of a woman’s childbearing years, you have not gone through menopause until 12 consecutive months without a period. You can get pregnant even if your periods are irregular.

Today, American women have more contraceptive options to choose from than ever before. So you should be able to find one that works well for you and fits your lifestyle.

Other things to consider before making a contraception choice:

Find out how much the contraceptive costs. Most oral contraceptives and some other contraceptives are now free under the Affordable Care Act, but check with your insurance provider to be sure.

Ask yourself if you can realistically use this method. Are you sure you understand how to use it properly? Will this method embarrass you or your partner? Does it fit with your lifestyle?

Find out how to use the method correctly and what to do if you forget to use it occasionally.

Ask your health care professional about side effects. What should you expect? What should you do about them if they occur, and when should you expect them to stop?

Will this method cause any unacceptable weight gain?

You can probably think of many more questions about birth control. Learn as much as you can about your options and make an informed decision about which method is the best and safest for you. Consider your needs and discuss them with your health care professional during your next medical appointment.

To get you started, here is some basic information about contraceptive options approved by the U.S. Food and Drug Administration (FDA), and resources you can use for more in-depth research.

For a comparison of how effective each type of contraception is for preventing pregnancy, please see the chart, “Contraceptive Failure Rates” at the end of this entry.

Contraceptive Options The contraceptive options women may choose are:

Birth control pills, also called oral contraceptives

Hormonal contraceptive patches

Hormonal contraceptive vaginal rings

Long-acting hormonal methods, such as shots and implants

Intrauterine devices (IUDs)

Barrier methods such as condoms, diaphragms, contraceptive sponges and cervical caps

Spermicides

Natural family planning (also called fertility awareness or the “rhythm” method)

Permanent contraception (sterilization)

Emergency contraception

Remember that most methods of birth control do not protect against sexually transmitted diseases (STDs) such as HIV, gonorrhea, chlamydia, genital herpes and human papillomavirus (HPV). Latex condoms, when used consistently and correctly, provide the best available means of reducing the risk of many STDs, according to the United States Centers for Disease Control and Prevention. If you are not in an exclusive relationship with someone who has been tested for STDs, you should use condoms along with any other form of birth control.

Birth Control Pills There are three types of BCPs on the market today: the combination pill, the mini-pilland the emergency contraceptive pill. The combination pill is the most widely prescribed. It contains two hormones: estrogen and progestin. It works by suppressingovulation each month. Learn more: Birth Control Pills

Long-Acting Hormonal Methods Several options are available to women who want long-term, but not permanent, protection against pregnancy, including intrauterine devices, hormonal patches and vaginal rings. These options rely on estrogen-progestin or progestin alone to prevent ovulation. Learn more: Long-Acting Hormonal Methods

Barrier Methods Barrier methods are less effective than hormonal methods but cause fewer side effects and are associated with less risk. They include condoms, diaphragms, the contraceptive sponge and cervical caps Learn more: Barrier Methods

Natural Family Planning A calendar, body temperature and physical symptoms, such as the consistency of cervical mucus, are used to determine when ovulation is likely, and you avoid intercourse during this time. Learn More: Natural Family Planning

Permanent Contraception Female sterilization closes a woman’s fallopian tubes by blocking, tying or cutting them so an egg cannot travel to the uterus.

Birth Control Pills (BCPs)

There are three types of birth control pills on the market today: the combination pill, the mini-pill and the emergency contraceptive pill.

Combination Pill

The combination pill is the most widely prescribed. It contains two hormones: estrogen and progestin. It works by suppressing ovulation each month, thinning the uterine lining and changing the consistency of the mucus in a woman’s cervix, making it harder for sperm to move into contact with an egg.

Low-dose combination birth control pills contain 10 to 50 mcg of estrogen, a lower dose (one-fourth or less) than the birth control pills marketed 30 to 50 years ago. They come in different formulations. Some require taking a constant dose of both medications for 21 days followed by one week of placebo tablets. Others vary the dose of estrogen and/or progestin that a woman gets throughout her cycle (multiphasic) or add additional days (tablets) of estrogen at the end of the 21- or 24-day cycle.

The FDA also has approved continuous-use birth control pills that contain ethinyl estradiol and levonorgestrel. Brand names include Lybrel, Alesse, Lessina, Nordette and others. It is a monophasic pill (containing the same levels of estrogen and progestin throughout the entire pill-taking schedule) that comes in a 28- or 21-day pack and is designed to be taken continuously, with no break between pill packets. That means you won’t have a period. You may have some spotting or breakthrough bleeding, particularly when you first start using continuous birth control pills. But most women will have no bleeding (or hardly any) by the end of a year.

Seasonale is a 91-day oral contraceptive regimen also designed to reduce the number of months you have a menstrual cycle. Tablets containing progestin and estrogen are taken for 12 weeks (84 days), followed by one week of placebo tablets. Therefore, the number of expected menstrual periods is reduced from once a month to about once every three months, or four times a year. Seasonique is the same as Seasonale except with Seasonale, women take inactive pills during their four yearly periods and with Seasonique, they take a low dose of estrogen during their periods. Recently, Lo-Seasonique was approved by the FDA as well. It is similar to Seasonique but with lower doses of hormones.

If and when you decide to get pregnant and stop taking birth control pills, you may get pregnant immediately—there are no long-term effects on your fertility from birth control pills.

Benefits. Birth control pills are now also prescribed by health care professionals because of their long- and short-term health benefits for women. Birth control pills can help:

Regulate, shorten or eliminate a woman’s menstrual cycle

Decrease severe cramping and heavy bleeding

Reduce anemia

Reduce ovarian cancer risk. According to the American Cancer Society, women who have taken birth control pills for five years or more have about half the risk of ovarian cancer compared to women who have never taken the pill.

May reduce colorectal cancer risk.

Reduce the development of ovarian cysts

Decrease benign breast disease

Provide reliable birth control without affecting future ability to become pregnant

Reduce the severity and incidence of pelvic inflammatory disease (PID)—infection primarily of the fallopian tubes and/or the female reproductive tract

Protect against ectopic pregnancy (pregnancy outside the uterus, in the fallopian tubes)

Reduce the risk of uterine (endometrial) cancer. Studies find that oral contraceptives protect against this disease by providing the progestins needed to oppose the stimulation of the uterine lining caused by estrogen. The risk is lowest in women who have taken the pill for a long time, and it appears to continue for at least 10 years after a woman has stopped taking the pill.

Minimize perimenopausal symptoms, such as irregular menstrual bleeding

Reduce acne

Treat the emotional and physical symptoms of premenstrual dysphoric disorder (PMDD), a severe form of PMS. Two combination oral contraceptives—called Yaz and Beyaz—have been approved by the FDA for use as an oral contraceptive and as a treatment for the emotional and physical symptoms of PMDD. Both Yaz and Beyaz contain the progestin drospirenone and ethinyl estradiol, a form of estrogen. Beyaz also contains folic acid.

Risks. Women with certain health conditions may not be able to use birth control pills. These include:

Heart disease or stroke

Liver disease

Blood clots in the deep veins or lung (risk may vary by formulation so check with your provider)

Breast cancer

Severe or uncontrolled diabetes. The estrogen in birth control pills may increase glucose levels and decrease the body’s insulin response, while the progestin in the pills may encourage overproduction of insulin. Use of birth control pills by diabetic women should be limited to those who do not smoke, are younger than 35 and are otherwise healthy with no evidence of persistent high blood pressure, kidney disease, vision problems or other vascular disease.

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safegen-blog · 7 years ago

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https://safegenericpharmacy.com/blog/cosmetic-skin-procedures/

Overview

Today women can reduce, prevent or even erase the signs of aging without resorting to surgery. Nonsurgical aesthetic treatments, also known as cosmetic skin procedures, can reduce the appearance of wrinkles, facial lines, unwanted hair, broken blood vessels, large pores and acne scars.

Women—and men—are embracing these procedures, which range from injections and microdermabrasion to laser and hair removal treatments. Plastic surgeons perform an estimated 8.5 million minimally invasive aesthetic treatments annually, while dermatologists, otolaryngologists, ophthalmologists and other medical specialists perform millions more.

The increased acceptance of aesthetic cosmetic procedures—both surgical and nonsurgical—is partially due to the decreased stigma attached to them. According to the American Society for Aesthetic Plastic Surgery, nonsurgical procedures make up nearly two-thirds of aesthetic treatments performed by plastic surgeons today.

Despite the growing popularity of these procedures, it is important for consumers to do their homework. Even something as simple as a chemical peel carries potential risks, particularly when performed by someone who is not properly trained in the procedure.

The most important things to remember about nonsurgical aesthetic treatments are:

You will likely have to bear the entire cost; insurance rarely covers cosmetic treatments.

Few treatments are permanent. Most will need to be repeated within a few months or a few years.

Just because a health care provider offers a treatment doesn’t mean that person is qualified to perform the treatment. Ask for references, talk to patients and confirm certifications.

Plastic surgeons and dermatologists are the most qualified professionals available to provide most nonsurgical aesthetic treatments.

Diagnosis

Unlike a health problem or medical condition, nonsurgical aesthetic treatments are entirely optional. You don’t have to fill in those wrinkles, erase those broken blood vessels or minimize that redness. You do it because you want to.

It is important, however, that you have realistic expectations about the treatment you choose. Ask your aesthetic specialty physician to show you before and after photos of treatments he or she has performed. Also ask how long the effects will last, what the estimated cost will be and how many treatments you may require if undergoing a treatment that requires several sessions, such as laser treatments.

Treatment

The first step is determining the right treatment for your aesthetic concern. You have numerous options. The most commonly performed treatments follow.

OnabotulinumtoxinA (Botox Cosmetic)

OnabotulinumtoxinA, often referred to by the brand name, Botox, is a purified protein derived from the bacterium Clostridium botulinum. It reduces muscle activity by blocking the nerve impulses that cause the squinting or frowning muscles to contract. OnabotulinumtoxinA is approved for the temporary treatment of frown lines and brow furrows.

Only licensed health care professionals can purchase onabotulinumtoxinA. Plastic surgeons or dermatologists routinely administer onabotulinumtoxinA , although any physician with special training in facial anatomy may perform the injections. Some states also allow nonphysicians such as registered nurses or physician assistants to administer the drug if they are directly supervised by a physician. Regardless of who administers your injection, always ask to see the vial and look for the manufacturer’s safety hologram to ensure you are treated with authentic product.

It only takes a few minutes to be treated with onabotulinumtoxinA, and the effects last up to four months. Botox Cosmetic costs an average of $350 to $500 per area of treatment, and costs vary across the country based on a number of factors. Some aesthetic specialty physicians charge by the unit of product. This allows them to charge more or less depending upon the specific patient’s need. Be sure to ask your physician the estimated total cost of your treatment.

Potential risks include allergic reaction, headache, bruising (if injections occur while taking aspirin or anti-inflammatory medications or if you’ve had alcohol within the previous week), redness and numbness at the injection site. There is a slight risk of paralysis of nerves adjacent to the injection site. If you are pregnant, nursing or have a medical condition, make sure you discuss the possible risks with your physician. OnabotulinumtoxinA is not recommended for pregnant or nursing women.

Dermal Fillers

These injectable products fill fine lines and plump up wrinkles to provide a natural and smooth look. They are among the most popular nonsurgical cosmetic treatments. According to the American Society for Plastic Surgery, hyaluronic acid dermal filler procedures—one category of soft tissue fillers—are the second most popular aesthetic injectable treatment behind onabotulinumtoxinA.

Dermal fillers work differently than onabotulinumtoxinA. Fillers are injected directly into wrinkles and lines, instantly adding volume. There are many dermal fillers to choose from, so make sure to ask your aesthetic specialty physician which type of filler will help you achieve your desired results. Certain dermal fillers may work better in different people and for different areas, so you may need to try more than one before finding the best product for you. Physicians may use multiple products, depending on your needs, to obtain your desired result. You pay by the syringe, and several syringes may be required, so ask your physician for an estimated total cost before beginning your treatment. Costs vary based on geographic region and type of filler, but the average cost for treatment with injectable fillers is $1,000.

FDA-approved dermal fillers include:

Hyaluronic acid fillers (Elevess, Hylaform, Juvéderm, Voluma, Perlane, Restylane and others). Hyaluronic acid is a natural substance found throughout all living animals. It absorbs more than 1,000 times its weight in water, thus adding volume to the skin’s surface. With age, however, hyaluronic acid concentrations drop, causing wrinkles and folds. These fillers are used to temporarily replace lost hyaluronic acid and restore skin volume.Hyaluronic acid dermal filler injections typically take less than 30 minutes to perform. Hyaluronic acid injections last between three and five months, depending on your body chemistry, lifestyle and the rate at which you are aging. Most people receive new injections two to three times a year.

Collagen fillers (CosmoPlast, CosmoDerm, Zyderm, Zyplast and others). Collagen is a protein substance found in all human and animal tissue. It makes your skin, bones and ligaments tough while providing structure. Collagen is often used for filling wrinkles and lines and scars on your face, neck and back. Zyderm and Zyplast cosmetic injections use collagen from cattle, called “bovine collagen.” CosmoPlast and CosmoDerm injections use highly purified human collagen, a natural protein that supports the skin and helps replenish collagen lost with time, exposure to sunlight and other factors. Other collagens used in cosmetic procedures include collagen from human cadaver skin that has been sterilized, purified and processed into a liquid form. Brand names of this form include Cymetra, Dermalogen and Fascian. These fillers are rarely used anymore.Collagen injections typically take less than an hour, and for best results, should be repeated every one to two months. Plastic surgeons and dermatologists are best suited for providing collagen injections. Rare side effects include the formation of small, temporary bumps beneath the skin, infection and scarring.

Fat fillers. Your aesthetic specialty physician may suggest afat filler, in which fat is removed from another part of your body and injected into the wrinkle/line. Since the fat is of your own body, the risk of complications is very low.

Synthetic fillers (polymethyl methacrylate, hydoxylapatite and polylactic acid).Synthetic fillers are used for filling facial wrinkles and folds. It takes less than an hour for synthetic filler injections, and the results can last anywhere from six months to five or more years, depending on the filler product. Synthetic fillers should be administered by plastic surgeons or dermatologists. Synthetic fillers differ depending on the brand:

Polymethyl methacrylate (PMMA) contains 20 percent PMMA beads suspended in 80 percent collagen. A few months after injection, the collagen breaks down, sparking your body to produce its own natural collagen to fill in the space. Unlike other fillers, it is not absorbed by the body. Brand names include Articol, Artefill and Metacrill.

Hydroxylapatite is an injectable gel. Calcium hydroxylapatite is a substance found in teeth and bones and is used for numerous medical applications including cheek, jaw, skull and chin implants. Brand names of the injectable form include Radiesse and Radiance.

Polylactic acid is a compound used in numerous medical products, such as stitches and screws used to repair broken bones. Although Polylactic acid has only been approved to restore shape and contour to the faces of those with AIDS, it is often used “off label” for cosmetic treatments. Polylactic acid treatments do not produce immediate results because they stimulate college production, so it may take up to a few months the full effect. Although polylactic acid is considered semipermanent, you may need an occasional touch-up treatment. Brand names include Sculptra and New-Fill.

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safegen-blog · 7 years ago

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https://safegenericpharmacy.com/blog/fibromyalgia/

Overview

Fibromyalgia is a chronic disorder characterized by widespread pain and reduced pressure pain threshold (tender points). People with fibromyalgia may also experience fatigue, sleep disturbances, stiffness, deep tenderness, soreness and achiness, increased headaches or facial pain, difficulty concentrating, forgetfulness and problems multitasking. Patients with fibromyalgia frequently report functional impairment and diminished quality of life.

The cause of fibromyalgia is unknown, but recent evidence suggests it is associated with abnormalities in the central nervous systemprocessing of pain. Fibromyalgia patients develop an increased response to painful stimuli and experience pain from non-painful stimuli such as touch. This is thought to reflect enhanced pain processing that is characteristic of central pain sensitization.

Patients with fibromyalgia have been found to have elevated levels of substance P in their spinal fluid, a chemical that helps transmit pain signals from the brain. Fibromyalgia patients also have been found to have reduced spinal fluid levels of neurotransmitters such as norepinephrine and serotohttps://www.safegenericpharmacy.comnin that are involved in the pain inhibitory pathways in the central nervous system. Scientists are investigating how the brain and spinal cord process pain and how substance P and other neurotransmitters fit into the process.

Recent studies have found that fibromyalgia runs in families, suggesting a genetic predisposition to the disorder.

Diagnosing fibromyalgia has been controversial because there are no specific laboratory tests to identify the disorder. Until recently, many health care professionals thought fibromyalgia was primarily caused by psychological factors. In recent years, however, health care professionals have come to understand that psychological factors do not necessarily cause fibromyalgia but rather may contribute to an increased risk for disability associated with fibromyalgia. Furthermore, depression andanxiety disorders may share some of the same chemical imbalances that are associated with fibromyalgia. For example, low levels of certain chemicals in the brain, including serotonin and norepinephrine, are linked not only to depression, but also to pain and fatigue.

It is estimated that at least 2 percent of the U.S. adult population has fibromyalgia. This condition occurs more commonly in women of childbearing age (as many as 80 to 90 percent of those diagnosed with fibromyalgia are women), but children, postmenopausal women, the elderly and men can also be affected. Because diagnosis can be difficult, it may take several years to correctly diagnose. Fortunately, with increased awareness of the disorder, many patients are getting diagnosed earlier than in the past, which may improve long-term outcomes.

The severity of fibromyalgia symptoms varies. For some women, pain or other symptoms can be so intense that they interfere with daily activities. For others, symptoms may cause discomfort but are not incapacitating. However, fibromyalgia can be quite disabling. Many people with the condition report that it interferes with their lives at home and work and gets in the way of their personal relationships. Plus, dealing with a disorder that is so often misunderstood can be extremely frustrating.

Treating fibromyalgia requires a comprehensive approach, encompassing symptom management and lifestyle adaptation. It also requires a team approach with the patient and health care professionals, including physicians, physical therapists and cognitive therapists.

Diagnosis

Fibromyalgia is defined by the American College of Rheumatology as chronic (three months or more) widespread pain and pain on palpation of 11 of 18 tender points. Common associated symptoms include sleep problems, fatigue, cognitive impairment and mood disturbances. Even though it is recognized as a legitimate clinical entity, experts think it continues to be underdiagnosed or misdiagnosed.

If you suspect you may have this condition, discuss your symptoms with your primary care physician. Your primary physician may refer you to other medical professionals for further evaluation. For example, you may be referred to a rheumatologist, who specializes in disorders affecting the joints, muscles, tendons, ligaments and bones.

Even with the right doctor, fibromyalgia can be difficult to diagnose. Many of its symptoms are variable, so they’re not always there, and many are common across numerous medical conditions. There is no specific medical test for fibromyalgia.

The American College of Rheumatology criteria for fibromyalgia require that a person has had widespread pain above and below the waist, on both sides of the body and in the axial skeleton, for at least three months, as well as pain on palpation of at least 11 of 18 specific tender point sites. You can view an illustration of common tender points in fibromyalgia at www.safegenericpharmacy.com.

These criteria were designed to standardize classification for participants in clinical trials, and some health care providers find them difficult to understand and use. The American College of Rheumatology has also developed preliminary diagnostic criteria for diagnosing fibromyalgia that do not require tender point exams. Instead, these criteria involve using combined numerical scores that reflect severity of pain and other symptoms. These criteria may include a combination of chronic, widespread pain and other commonly associated symptoms such as fatigue and sleep disturbance.

Your health care provider will diagnose you based on your symptoms, a complete medical history, physical exam and tests to rule out other conditions such as lupus, rheumatoid arthritis or hypothyroidism.

In addition to the pain, sleep problems and fatigue are common in patients with fibromyalgia. Other associated symptoms may include the following:

Cognitive disorders, most often short-term memory lapses and difficulty concentrating

Unusual sensitivity to cold, especially in the hands and feet, often accompanied by color changes, numbness and tingling; this condition is known as Raynaud’s phenomenon (also called Raynaud’s syndrome)

Urinary complaints, including a strong urge to urinate, frequent urination and pain in the bladder

Painful menstrual periods

Heightened sensitivity to noises, bright lights, odors and touch

Painful sexual intercourse

Stiffness, particularly in the early morning, after prolonged sitting or standing, or with changes in temperature or relative humidity

Light-headedness and/or balance problems.

Abdominal discomfort

Paresthesia (numbness or tingling), often in the hands or feet

Fibromyalgia also may coexist with other chronic painful conditions such as osteoarthritis, rheumatoid arthritis or low back pain. It frequently is accompanied by central sensitivity syndromes, including irritable bowel syndrome, interstitial cystitis, restless leg syndrome, temporomandibular disorder (TMD), tension-type headaches or migraines, chronic pelvic pain, endometriosis and chronic prostatitis. There also appears to be a link between fibromyalgia and chronic fatigue syndrome (CFS). Up to 70 percent of people with fibromyalgia fit the criteria for CFS.

Fibromyalgia can affect mood and cause psychological distress, and research has shown that a lifetime history of mood or anxiety disorders is common in people with fibromyalgia. When depression or anxiety is present, treatment is important because they can make fibromyalgia symptoms worse and can interfere with successful management. Even if you don’t have depression, antidepressants may be prescribed for pain relief and to help you sleep.

Recent studies suggest that depression and fibromyalgia may share a biological link. Low levels of certain chemicals in the brain, including serotonin and norepinephrine, are associated not only with depression, but also with pain and fatigue. Still, not everyone with fibromyalgia will experience depression or anxiety. Up to 74 percent of people with fibromyalgia experience depression and an estimated 60 percent experience anxiety at some point in their lives.

Treatment

Treating fibromyalgia requires a comprehensive, multidisciplinary approach. Among the most effective treatments are medications, exercise, sleep management and cognitive behavioral therapy.

Treatment centers on managing the symptoms of fibromyalgia; there is no cure. Since symptoms vary, so does treatment.

Exercise

Exercise may seem an impossibly tall order—after all, if you’re in pain, how can you work out? But if you don’t get regular aerobic exercise, your muscles become weaker, making them even more susceptible to pain during everyday tasks. In fact, studies find that aerobic exercise such as swimming and walking improves muscle fitness and reduces muscle pain and tenderness in people with fibromyalgia. Stick with a low-impact exercise program such as walking, swimming or water aerobics, and be sure to discuss any new exercise program with your health care professional if you’ve been inactive.

Exercise can also help you sleep better, improve your mood, reduce pain, increase flexibility, improve blood flow, help you manage your weight and promote general physical fitness. It is inexpensive and, if done correctly, has few negative side effects.

When you exercise, listen to your body and know when to stop or slow down to prevent pain caused by over-exercising. Talk to your health care professional about how to introduce exercise into your life in a way that is tolerable and safe. In some situations, your health care professional may recommend physical therapy with therapists knowledgeable in fibromyalgia management, who can help you with a physical rehabilitation program.

Attitude Can Improve Symptoms

Your psychological outlook is important, with studies finding benefits from cognitive therapy for women with fibromyalgia. Specifically, studies find, negative thinking increases stress and affects your perception of pain, so learning to minimize and control these thoughts can improve your symptoms.

The key is not so much to “think positively,” but to “think non-negatively.” So when negative thoughts occur, ask yourself: “Does this thought benefit me in any way—does it improve the way I feel, advance my goals or improve a relationship?”

Strategies for dealing with negative thoughts include:

Alternative interpretation. You might start with a fairly neutral thought such as “I’m tired today.” From there, it’s easy to go negative—”I feel lousy. I won’t get anything done today.” An alternative, non-negative interpretation could be: “What strategies can I try to sleep better so I won’t feel so tired?”

Anti-catastrophic reappraisal. This technique consists of challenging negative thoughts. You might have a catastrophic thought such as, “This fatigue is never going to get better. I’ll never wake up with any energy.” When you have such thoughts, ask yourself: How likely is it really that the fatigue will never get better? Have you ever been more fatigued than you are today?

Coping statements. In these statements, you tell yourself that you can handle these symptoms, and remind yourself of strategies you’ve used in the past to cope with or alleviate symptoms.

Label shifting. How we describe things influences our overall mood and physical sense of well-being. So instead of viewing your pain as excruciating, try describing it as uncomfortable, or view it as a warning that maybe you’ve been overdoing it.

Medications

Pregabalin (Lyrica), previously approved by the U.S. Food and Drug Administration for adjunctive treatment of partial onset seizures and certain types of neuropathic pain, was the first medication to be approved for treating fibromyalgia. Common side effects may include dizziness, sleepiness, dry mouth, swelling, blurred vision, weight gain and difficulty with concentration and attention.

Duloxetine (Cymbalta), previously approved for the treatment of major depression, generalized anxiety disorder and diabetic peripheral neuropathic pain, is also approved for treating fibromyalgia and for treatment of chronic musculoskeletal pain due to chronic osteoarthritis pain and chronic low back pain. Common side effects of duloxetine may include nausea, dry mouth, constipation, sleepiness, increased sweating and decreased appetite. And the third medication approved for the treatment of fibromyalgia is milnacipran (Savella). Common side effects of milnacipran may include nausea, constipation, hot flush, increased sweating, vomiting, palpitations, increased heart rate, dry mouth and hypertension.

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safegen-blog · 7 years ago

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https://safegenericpharmacy.com/blog/crohns-disease/

Overview

Crohn’s disease is a chronic inflammatory bowel disease that can affect any part of your digestive system, even your mouth.

The disease is typically diagnosed in adolescence and young adulthood, but it is becoming more common in children. Overall, about 700,000 people in the United States may have Crohn’s disease, though some of those cases are undiagnosed. While there is no cure for Crohn’s, it can be managed with medication, although surgery is often required.

Symptoms of Crohn’s include diarrhea, sometimes at night; abdominal pain; bowel obstruction (when something partially or fully blocks the intestines); weight loss; fever; night sweats; and fatigue. The pain tends to occur in the lower right part of yourabdomen or near your belly button. The pain might improve with a bowel movement. You may also see blood in your stool.

Many people live with Crohn’s for years before receiving the correct diagnosis.

Crohn’s can affect every part of the digestive system and can affect more than one part at the same time. Specifically:

Ileocolitis. This is the most common form of the disease. It affects the ileum (the last part of the small intestine) and some portion of the large intestine, or colon, which goes from the end of the ileum to the anus. About half of people with Crohn’s will have disease in these parts of their digestive system.

Crohn’s disease of the small intestine. The small intestine is affected in about 80 percent of people with Crohn’s. Sometimes this coexists with colon involvement (see above) or it can be the small intestine alone. The primary symptoms are weight loss and nutritional deficiencies because your intestine doesn’t absorb nutrients from food. Other symptoms include diarrhea, abdominal pain, lack of appetite and sometimes nausea and vomiting.

Colonic Crohn’s disease. This form of the disease affects about 20 percent of patients and is limited to the colon. It is often confused with ulcerative colitis, another inflammatory bowel disease. Symptoms include bloody diarrhea with mucus; cramping abdominal pain; and an urgent need to have a bowel movement.

Perianal disease. About a third of people with Crohn’s will develop perianal disease, in which the disease affects the anus and surrounding area. You may have abscesses or fistula on this part of your body, as well as skin tags, hemorrhoids, painful ulcers in the anus or rectum, and strictures, an abnormal narrowing of the rectum or anus. Symptoms include bright red blood in your stool or bleeding from your rectum, and pain, redness and/or discharge in the anal area. In some women, the fistulas may affect the vagina, and they could have the sensation of air or liquid coming out of the vagina.

Other less common manifestations of Crohn’s disease include symptoms in their mouth, esophagus or other digestive areas.

A major complication of Crohn’s is an obstruction in your small intestine or colon that prevents digested material from passing through. Symptoms of an obstruction include bloating after meals, cramping pain and loud growling from your stomach.

Another common complication is development of a fistula, literally a hole between two organs. Symptoms depend on where the fistula forms, but include vomiting, gas when you urinate (you’ll see bubbles in your urine), a grainy vaginal discharge and recurrenturinary tractinfections. Fistulas can be managed with medication but sometimes require surgery to repair.

Sometimes the inflammation that underlies Crohn’s can affect other parts of your body, causing painful joints; ulcers in your mouth or on your skin; a tender, red rash on your shins; and eye inflammation. You also have a higher risk of blood clots, kidney stones, loss of bone density, anemia and vitamin B12 deficiency.

People with Crohn’s also have a higher risk of developing colon cancer and liver disease.

No one knows what causes Crohn’s, but experts suspect it is related to a combination of abnormalities, environmental factors, genetic causes and intestinal bacteria or viruses in the system. Researchers have identified several genes connected with the disease and know that it tends to run in families. The disease is most prevalent in people with Eastern European heritage, and there have been recently been an increased number of cases in African Americans.

The goal of treatment for Crohn’s is to prevent acute flares or exacerbations and keep you in remission. About 10 percent to 20 percent of people with Crohn’s have a remission after the initial diagnosis.

Diagnosis

To diagnose Crohn’s disease, your doctor will order a series of tests, ask you a lot of questions about your symptoms and examine you thoroughly. You should share any family history of gastrointestinal problems or inflammatory bowel diseases, including Crohn’s and ulcerative colitis, because Crohn’s is often hereditary.

Tests used to diagnose Crohn’s disease include:

Blood tests. The doctor will likely order a complete blood count to check for anemia and high levels of white blood cells, which could signify infection and/or inflammation. Blood tests can also evaluate the health of your kidneys and liver and assess levels of inflammation.

Colonoscopy. This procedure lets your doctor perform a detailed examination of the inside of your entire colon, including your rectum. A thin, lighted flexible tube with a small camera attached to the end is inserted through your anus to look for ulcerations and inflammation. If needed, the doctor can take tissue samples and correct certain problems using the same tube. You need to fast for at least 24 hours before a colonoscopy and take a special liquid to completely empty your bowel. The procedure is typically performed under sedation or anesthesia.

Endoscopy. This procedure enables the doctor to see the upper digestive tract, including your esophagus, stomach and upper part of the small intestine (duodenum). The doctor inserts a small, flexible tube with a light and a lens on the end through your mouth. During the procedure, the doctor can take tissue samples and pictures. The procedure is done while you are anesthetized or heavily sedated, so you shouldn’t feel any pain or discomfort.

Ultrasound. An ultrasound uses sound waves to provide an image of the inside of your abdominal area. You may have an external ultrasound or an endoscopic ultrasound, in which the ultrasound wand is inserted through the rectum, to look for any strictures. This may be used to look at the gall bladder, kidneys and pancreas.

Imaging tests. In some instances, your doctor may order an MRI or a CT scan to look at the intestine and the complications such as abscesses or fistulas. An MRI uses magnets and a CT scan uses radiation to provide a three-dimensional image of your organs.

Antibody tests. Because some immune system dysfunction is involved with Crohn’s, your doctor may order antibody tests to differentiate your disease from ulcerative colitis, another inflammatory bowel disease.

Barium enema. In this procedure, a tube is inserted into your rectum and air and barium, a radio opaque liquid, are inserted into your bowel. X-rays are then taken to identify any abnormalities.

Upper gastrointestinal series. An upper GI series requires you to drink a contrast agent. Then fluoroscopic imaging is used to examine your esophagus, stomach and duodenum.

Small bowel follow-through. A small bowel follow looks at the distal portions of the small bowel, the jejunum and ileum. It helps evaluate abdominal pain and diarrhea. The small bowel series often is done immediately after an upper GI exam, though it may also be done separately. You will drink some contrast, and radiographs of you abdomen will be obtained every 20 or 30 minutes. The test can take several hours

Capsule endoscopy. This procedure, also known as wireless capsule endoscopy or small bowel endoscopy, uses a tiny wireless camera to take pictures that help doctors see inside your small intestine. The camera fits inside a vitamin-sized capsule that you swallow. As the camera travels through your digestive tract, it takes pictures that are transmitted to a recorder. These pictures can reveal areas of inflammation in the small intestine that can help your doctor Crohn’s.

After diagnosing you, your doctor will stage your disease as a way of assessing its severity. Staging provides important information for developing a treatment plan.

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