Input: How to prevent Alzheimer's Disease ?

Output: Currently, no medicines or other treatments are known to prevent Alzheimers disease, but scientists are studying many possibilities. These possibilities include lifestyle factors such as exercise and physical activity, a healthy diet, and mentally stimulating activities. In addition to lifestyle factors, scientists have found clues that some long-term health conditions, like heart disease, high blood pressure, and diabetes, are related to Alzheimer's disease. Its possible that controlling these conditions will reduce the risk of developing Alzheimers. Exercise and Physical Activity Studies show that exercise and other types of physical activity are good for our hearts, waistlines, and ability to carry out everyday activities. Research suggests that exercise may also play a role in reducing risk for Alzheimers disease. Animal studies show that exercise increases both the number of small blood vessels that supply blood to the brain and the number of connections between nerve cells in older rats and mice. In addition, researchers have found that exercise raises the level of a nerve growth factor (a protein key to brain health) in an area of the brain that is important to memory and learning.  See suggestions for ways older adults can start or continue to exercise. Diet and Dietary Supplements A number of studies suggest that eating certain foods may help keep the brain healthyand that others can be harmful. A diet that includes lots of fruits, vegetables, and whole grains and is low in fat and added sugar can reduce the risk of heart disease and diabetes. Researchers are looking at whether a healthy diet also can help prevent Alzheimers. One study reported that people who ate a Mediterranean diet had a 28 percent lower risk of developing MCI (mild cognitive impairment) and a 48 percent lower risk of progressing from MCI to Alzheimers disease. (MCI often, but not always, leads to Alzheimers dementia.) A Mediterranean diet includes vegetables, legumes, fruits, cereals, fish, olive oil, and low amounts of saturated fats, dairy products, meat, and poultry. For more about healthy eating as you age , see  Eating Well As You Get Older. Other research has looked at the effect on brain health of several different vitamins and dietary supplements. One area of research focuses on antioxidants, natural substances that appear to fight damage caused by molecules called free radicals. Other studies are looking at resveratrol, a compound found in red grapes and red wine, as well as vitamins and other substances found in food. Chronic Diseases Age-related diseases and conditionssuch as vascular disease, high blood pressure, heart disease, and diabetesmay increase the risk of Alzheimers. Many studies are looking at whether this risk can be reduced by preventing or controlling these diseases and conditions. For example, one clinical trial is looking at how lowering blood pressure to or below current recommended levels may affect cognitive decline and the development of MCI and Alzheimers disease. Participants are older adults with high systolic (upper number) blood pressure who have a history of heart disease or stroke, or are at risk for those conditions. Diabetes is another disease that has been linked to Alzheimers. Past research suggests that abnormal insulin production contributes to Alzheimers-related brain changes. (Insulin is the hormone involved in diabetes.) Diabetes treatments have been tested in people with Alzheimers, but the results have not been conclusive. Keeping the Brain Active Keeping the mind sharpthrough social engagement or intellectual stimulationis associated with a lower risk of Alzheimers disease. Activities like working, volunteering, reading, going to lectures, and playing computer and other games are being studied to see if they might help prevent Alzheimers. One clinical trial is testing the impact of formal cognitive training, with and without physical exercise, in people with MCI to see if it can prevent or delay Alzheimers disease. Other trials are underway in healthy older adults to see if exercise and/or cognitive training (for example, a demanding video game) can delay or prevent age-related cognitive decline. Find out about things you can do that may keep your brain healthy. </s>


Input: What are the treatments for Alzheimer's Disease ?

Output: Medications Can Treat Symptoms There is no known cure for Alzheimer's disease, but there are medicines that can treat symptoms of the disease. Most Alzheimers medicines work best for people in the mild or moderate stages of the disease. For example, they can keep memory loss from getting worse for a time. Other medicines may help behavioral symptoms, such as trouble sleeping or feeling worried or depressed. All of these medicines may have side effects and may not work for everyone. A person with Alzheimer's should be under a doctor's care. He or she may see a primary care doctor or a specialist, such as a neurologist, geriatric psychiatrist, or geriatrician. The doctor can treat the person's physical and behavioral problems, answer questions, and refer the patient and caregiver to other sources of help. Medications for Alzheimers Currently, no treatment can stop Alzheimer's disease. However, four medications are used to treat its symptoms. These medicines may help maintain thinking, memory, and speaking skills for a limited time. They work by regulating certain chemicals in the brain. Most of these medicines work best for people in the early or middle stages of the disease. For people with mild to moderate Alzheimers, donepezil (Aricept), rivastigmine (Exelon), or galantamine (Razadyne) may help. Donepezil is also approved to treat symptoms of moderate to severe Alzheimer's. Another drug, memantine (Namenda), is used to treat symptoms of moderate to severe Alzheimers, although it also has limited effects. All of these medicines have possible side effects, including nausea, vomiting, diarrhea, and loss of appetite. You should report any unusual symptoms to a doctor right away. It is important to follow a doctor's instructions when taking any medication. Scientists are testing many new drugs and other treatments to see if they can help slow, delay, or prevent Alzheimers disease. Learn how Alzheimers medications work, how to take them, and where to find more information.  Managing Behavioral Symptoms Certain medicines and other approaches can help control the behavioral symptoms of Alzheimer's disease. These symptoms include sleeplessness, agitation, wandering, anxiety, anger, and depression. Treating these symptoms often makes people with Alzheimers disease more comfortable and makes their care easier for caregivers. See more about medications used to treat behavioral symptoms. Some medicines must be used with caution. Memory Aids Memory aids may help some people who have mild Alzheimers disease with day-to-day living. A calendar, list of daily plans, notes about simple safety measures, and written directions describing how to use common household items can be useful. Help for Caregivers Caring for a person with Alzheimers can have high physical, emotional, and financial costs. The demands of day-to-day care, changing family roles, and difficult decisions about placement in a care facility can be difficult. Sometimes, taking care of the person with Alzheimers makes caregivers feel good because they are providing love and comfort. At other times, it can be overwhelming. Changes in the person can be hard to understand and cope with. Here are some ways for caregivers of people with Alzheimers to get help. - Ask family and friends to help out in specific ways, like making a meal or visiting the person while they take a break.  - Join a caregivers support group.  - Use home health care, adult day care, and respite services. Ask family and friends to help out in specific ways, like making a meal or visiting the person while they take a break. Join a caregivers support group. Use home health care, adult day care, and respite services. For more information about caring for someone with Alzheimers disease, see  Alzheimer's Caregiving. </s>


Input: what research (or clinical trials) is being done for Alzheimer's Disease ?

Output: Research supported by the National Institutes of Health (NIH) and other organizations has expanded knowledge of brain function in healthy older people, identified ways that may lessen age-related cognitive decline, and deepened our understanding of Alzheimers. Many scientists and physicians are working together to untangle the genetic, biological, and environmental factors that might cause Alzheimers disease. This effort is bringing us closer to better managing and, ultimately, better treating and preventing this devastating disease. Types of Research Different types of researchbasic, translational, and clinical researchare conducted to better understand Alzheimers and find ways to treat, delay, or prevent the disease. - Basic research helps scientists gain new knowledge about a disease process, including how and why it starts and progresses.   - Translational research grows out of basic research. It creates new medicines, devices, or behavioral interventions aimed at preventing, diagnosing, or treating a disease.  - Clinical research is medical research involving people. It includes clinical studies, which observe and gather information about large groups of people. It also includes clinical trials, which test a medicine, therapy, medical device, or other intervention in people to see if it is safe and effective. Basic research helps scientists gain new knowledge about a disease process, including how and why it starts and progresses. Translational research grows out of basic research. It creates new medicines, devices, or behavioral interventions aimed at preventing, diagnosing, or treating a disease. Clinical research is medical research involving people. It includes clinical studies, which observe and gather information about large groups of people. It also includes clinical trials, which test a medicine, therapy, medical device, or other intervention in people to see if it is safe and effective.  See the latest Alzheimers Disease Progress Report to read about results of NIA-supported Alzheimers research. Basic Research Basic research seeks to identify the cellular, molecular, and genetic processes that lead to Alzheimers disease. Basic research has focused on two of the main signs of Alzheimers disease in the brain: plaques and tangles. Plaques are made of a protein called beta-amyloid and form abnormal clumps outside nerve cells in the brain. Tangles are made from a protein called tau and form twisted bundles of fibers within nerve cells in the brain. Scientists are studying how plaques and tangles damage nerve cells in the brain. They can see beta-amyloid plaques and tau tangles by making images of the brains of living people. Such imaging has led to clinical trials that are looking at ways to remove beta-amyloid from the human brain or halt its production before more brain damage occurs. Scientists are also exploring the very earliest brain changes in the disease process. Findings will help them better understand the causes of Alzheimers. As they learn more, they are likely to come up with better targets for further research. Over time, this might lead to more effective therapies to delay or prevent the disease. Genetics is another important area of basic research. Discovering more about the role of genes that increase or decrease the risk of developing Alzheimers will help researchers answers questions such as What makes the disease process begin? and Why do some people with memory and other thinking problems develop Alzheimers disease while others do not? Genetics research helps scientists learn how risk-factor genes interact with other genes and lifestyle or environmental factors to affect Alzheimers risk. This research also helps identify people who are at high risk for developing Alzheimers and can participate in clinical research on new prevention and treatment approaches. Translational Research Translational research allows new knowledge from basic research to be applied to a clinical research setting. An important goal of Alzheimers translational research is to increase the number and variety of potential new medicines and other interventions that are approved for testing in humans. Scientists also examine medicines approved to treat other diseases to see they might be effective in people with Alzheimers. The most promising interventions are tested in test-tube and animal studies to make sure they are safe and effective. Currently, a number of different substances are under development that may one day be used to treat or prevent the symptoms of Alzheimers disease and mild cognitive impairment. Clinical Research Clinical research is medical research involving people. It includes clinical studies, which observe and gather information about large groups of people. It also includes clinical trials, which test medicines, therapies, medical devices, or other interventions in people to see if they are safe and effective. Clinical trials are the best way to find out whether a particular intervention actually slows, delays, or prevents Alzheimers disease. Trials may compare a potential new treatment with a standard treatment or placebo (mock treatment). Or, they may study whether a certain behavior or condition affects the progress of Alzheimers or the chances of developing it. NIH, drug companies, and other research organizations are conducting many clinical trials to test possible new treatments that may - improve memory, thinking, and reasoning skills in people with Alzheimers or mild cognitive impairment  - relieve the behavior problems of Alzheimers, such as aggression and agitation  - delay the progression from mild cognitive impairment (MCI) to Alzheimers   - prevent Alzheimers disease. improve memory, thinking, and reasoning skills in people with Alzheimers or mild cognitive impairment relieve the behavior problems of Alzheimers, such as aggression and agitation delay the progression from mild cognitive impairment (MCI) to Alzheimers prevent Alzheimers disease. A wide variety of interventions are being tested in clinical trials. They include experimental drugs as well as non-drug approaches. </s>


Input: what research (or clinical trials) is being done for Alzheimer's Disease ?

Output: All types of people are needed to volunteer for Alzheimers research. People with Alzheimer's disease or MCI, those with a family history of Alzheimers, and healthy people with no memory problems and no family history of Alzheimers may be able to take part in clinical trials. Participants in clinical trials help scientists learn about the brain in healthy aging and in Alzheimers. Results of these trials are used to improve prevention and treatment methods. The Alzheimers Disease Education and Referral (ADEAR) Centers clinical trials finder makes it easy for people to find out about studies that are sponsored by the federal government and private companies, universities, and other organizations. It includes studies testing new ways to detect, treat, delay, and prevent Alzheimers disease, other dementias, and MCI. You can search for studies about a certain topic or in a certain geographic area by going to www.nia.nih.gov/alzheimers/clinical-trials. To find out more about Alzheimers clinical trials, talk to your health care provider or contact the ADEAR Center at 1-800-438-4380 or adear@nia.nih.gov. Also, visit its website at  www.nia.nih.gov/alzheimers/volunteer. </s>


Input: What is (are) Alzheimer's Disease ?

Output: Alzheimers disease is a brain disease that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks. It begins slowly and gets worse over time. Currently, it has no cure. Alzheimers disease is the most common cause of dementia in older people.  Get more details about Alzheimer's disease. </s>


Input: What is (are) Alzheimer's Disease ?

Output: Dementia is a loss of thinking, remembering, and reasoning skills that interferes with a persons daily life and activities. Alzheimers disease is the most common cause of dementia among older people. Dementia ranges in severity from the mild stage, when it is just beginning to affect a persons functioning, to the severe stage, when the person must depend completely on others for care. </s>


Input: What is (are) Alzheimer's Disease ?

Output: Mild cognitive impairment, or MCI, is a condition that can be an early sign of Alzheimers diseasebut not everyone with MCI will develop Alzheimers. People with MCI can still take care of themselves and do their normal activities. Signs of MCI may include - losing things often  - forgetting to go to events and appointments  - having more trouble coming up with words than other people the same age. losing things often forgetting to go to events and appointments having more trouble coming up with words than other people the same age. </s>


Input: What is (are) Alzheimer's Disease ?

Output: Memory problems are typically one of the first signs of Alzheimers disease, though different people may have different initial symptoms. A decline in other aspects of thinking, such as finding the right words, vision/spatial issues, and impaired reasoning or judgment, may also signal the very early stages of Alzheimers disease. </s>


Input: What is (are) Alzheimer's Disease ?

Output: Alzheimer's disease has three stages: early (also called mild), middle (moderate), and late (severe). A person in the early stage of Alzheimers may - find it hard to remember things  -  ask the same questions over and over  -  get lost in familiar places  -  lose things or put them in odd places  - have trouble handling money and paying bills  - take longer than normal to finish daily tasks. find it hard to remember things ask the same questions over and over get lost in familiar places lose things or put them in odd places have trouble handling money and paying bills take longer than normal to finish daily tasks. As Alzheimers disease progresses to the middle stage, memory loss and confusion grow worse, and people may have problems recognizing family and friends. Other symptoms are this stage include -  difficulty learning new things and coping with new situations  - trouble carrying out tasks that involve multiple steps, like getting dressed  -  impulsive behavior  - forgetting the names of common things  - hallucinations, delusions, or paranoia  - wandering away from home. difficulty learning new things and coping with new situations trouble carrying out tasks that involve multiple steps, like getting dressed impulsive behavior forgetting the names of common things hallucinations, delusions, or paranoia wandering away from home. As Alzheimers disease becomes more severe, people lose the ability to communicate. They may sleep more, lose weight, and have trouble swallowing. Often they are incontinentthey cannot control their bladder and/or bowels. Eventually, they need total care. </s>


Input: What causes Alzheimer's Disease ?

Output: Scientists do not yet fully understand what causes Alzheimer's disease in most people. In early-onset Alzheimers, which occurs in people between the ages of 30 and 60, a genetic mutation is usually the cause. Late-onset Alzheimers, which usually develops after age 60, arises from a complex series of brain changes that occur over decades. The causes probably include a mix of genetic, environmental, and lifestyle factors. These factors affect each person differently. Learn more about the genetics of Alzheimers disease.  Increasing age is the most important known risk factor for Alzheimer's disease. Lifestyle factors, such as diet and physical exercise, and long-term health conditions, like high blood pressure and diabetes, might also play a role in the risk of developing Alzheimers disease. </s>


Input: How to diagnose Alzheimer's Disease ?

Output: The only definitive way to diagnose Alzheimer's disease is to find out whether plaques and tangles exist in brain tissue. To look at brain tissue, doctors perform a brain autopsy, an examination of the brain done after a person dies. Doctors can only make a diagnosis of "possible" or probable Alzheimers disease while a person is alive. Doctors with special training can diagnose Alzheimer's disease correctly up to 90 percent of the time. Doctors who can diagnose Alzheimers include geriatricians, geriatric psychiatrists, and neurologists. A geriatrician specializes in the treatment of older adults. A geriatric psychiatrist specializes in mental problems in older adults. A neurologist specializes in brain and nervous system disorders. To diagnose Alzheimer's disease, doctors may - ask questions about overall health, past medical problems, ability to carry out daily activities, and changes in behavior and personality  - conduct tests to measure memory, problem solving, attention, counting, and language skills   - carry out standard medical tests, such as blood and urine tests  - perform brain scans to look for anything in the brain that does not look normal. ask questions about overall health, past medical problems, ability to carry out daily activities, and changes in behavior and personality conduct tests to measure memory, problem solving, attention, counting, and language skills carry out standard medical tests, such as blood and urine tests perform brain scans to look for anything in the brain that does not look normal. </s>


Input: How to diagnose Alzheimer's Disease ?

Output: An early, accurate diagnosis of Alzheimer's disease helps people and their families plan for the future. It gives them time to discuss care options, find support, and make legal and financial arrangements while the person with Alzheimers can still take part in making decisions. Also, even though no medicine or other treatment can stop or slow the disease, early diagnosis offers the best chance to treat the symptoms. </s>


Input: How to diagnose Alzheimer's Disease ?

Output: The time from diagnosis of Alzheimers disease to death varies. It can be as little as 3 or 4 years if the person is over 80 years old when diagnosed or as long as 10 years or more if the person is younger. </s>


Input: What are the treatments for Alzheimer's Disease ?

Output: Currently, no treatment can stop Alzheimer's disease. However, four medications are used to treat its symptoms. These medicines may help maintain thinking, memory, and speaking skills for a limited time. They work by regulating certain chemicals in the brain. Most of these medicines work best for people in the early or middle stages of the disease. For people with mild or moderate Alzheimer's, donepezil (Aricept), rivastigmine (Exelon), or galantamine (Razadyne) may help. Donepezil is also approved to treat symptoms of moderate to severe Alzheimer's. Another drug, memantine (Namenda), is used to treat symptoms of moderate to severe Alzheimer's, although it also has limited effects. All of these medicines have possible side effects. Learn how Alzheimers medications work, how to take them, and where to find more information. Certain medicines and other approaches can help control the behavioral symptoms of Alzheimer's disease. These symptoms include sleeplessness, agitation, wandering, anxiety, anger, and depression. See more about medications used to treat behavioral symptoms. Some medicines must be used with caution. </s>


Input: How to prevent Alzheimer's Disease ?

Output: Currently, no medicines or treatments are known to prevent Alzheimer's disease, but scientists are studying many possibilities. These possibilities include lifestyle factors such as exercise and physical activity, a healthy diet, and mentally stimulating activities. In addition to lifestyle factors, scientists have found clues that some long-term health conditions, like heart disease, high blood pressure, and diabetes, are related to Alzheimer's disease. Its possible that controlling these conditions will reduce the risk of developing Alzheimers. </s>


Input: How to prevent Alzheimer's Disease ?

Output: Research suggests that exercise may play a role in reducing risk for Alzheimers disease. Animal studies show that exercise increases both the number of small blood vessels that supply blood to the brain and the number of connections between nerve cells in older rats and mice. In addition, researchers have found that exercise raises the level of a nerve growth factor (a protein key to brain health) in an area of the brain that is important to memory and learning.  Learn more about the benefits of exercise for older adults. For more on specific exercises geared to the needs of older adults, visit Go4Life, the exercise and physical activity campaign from the National Institute on Aging. </s>


Input: How to prevent Alzheimer's Disease ?

Output: A number of studies suggest that eating certain foods may help keep the brain healthyand that others can be harmful. Researchers are looking at whether a healthy dietone that includes lots of fruits, vegetables, and whole grains and is low in fat and added sugarcan help prevent Alzheimers. For more information about healthy eating as you age, see  Eating Well As You Get Older. </s>


Input: How to prevent Alzheimer's Disease ?

Output: Keeping the mind sharpthrough social engagement or intellectual stimulationis associated with a lower risk of Alzheimers disease. Activities like working, volunteering, reading, going to lectures, and playing computer and other games are being studied to see if they might help prevent Alzheimers. But we do not know with certainty whether these activities can actually prevent Alzheimers.  Find out about things you can do that may keep your brain healthy. </s>


Input: what research (or clinical trials) is being done for Alzheimer's Disease ?

Output: Basic research helps scientists gain new knowledge about a disease process, including how and why it starts and progresses. In Alzheimers disease, basic research seeks to identify the cellular, molecular, and genetic processes that lead to the disease. For example, scientists are studying - the ways in which plaques and tangles damage nerve cells in the brain  - the very earliest brain changes in the disease process  - the role of Alzheimers risk-factor genes in the development of the disease  - how risk-factor genes interact with other genes and lifestyle or environmental factors to affect Alzheimers risk. the ways in which plaques and tangles damage nerve cells in the brain the very earliest brain changes in the disease process the role of Alzheimers risk-factor genes in the development of the disease how risk-factor genes interact with other genes and lifestyle or environmental factors to affect Alzheimers risk. See the latest Alzheimers Disease Progress Report to read about results of NIA-supported Alzheimers research. </s>


Input: what research (or clinical trials) is being done for Alzheimer's Disease ?

Output: Translational research grows out of basic research. It creates new medicines, devices, or behavioral interventions aimed at preventing, diagnosing, or treating a disease. An important goal of Alzheimers translational research is to increase the number and variety of potential new medicines and other interventions that are approved for testing in humans. Scientists also examine medicines approved to treat other diseases to see they might be effective in people with Alzheimers. The most promising interventions are tested in test-tube and animal studies to make sure they are safe and effective. Currently, a number of different substances are under development that may one day be used to treat the symptoms of Alzheimers disease or mild cognitive impairment. See the latest Alzheimers Disease Progress Report to read about results of NIA-supported Alzheimers research. </s>


Input: what research (or clinical trials) is being done for Alzheimer's Disease ?

Output: Clinical research is medical research involving people. It includes clinical studies, which observe and gather information about large groups of people. It also includes clinical trials, which test a medicine, therapy, medical device, or intervention in people to see if it is safe and effective. Clinical trials are the best way to find out whether a particular intervention actually slows, delays, or prevents Alzheimers disease. Trials may compare a potential new treatment with a standard treatment or placebo (mock treatment). Or, they may study whether a certain behavior or condition affects the progress of Alzheimers or the chances of developing it. See the latest Alzheimers Disease Progress Report to read about results of NIA-supported Alzheimers research. </s>


Input: What are the treatments for Alzheimer's Disease ?

Output: People with Alzheimer's disease, those with mild cognitive impairment, those with a family history of Alzheimers, and healthy people with no memory problems who want to help scientists test new treatments may be able to take part in clinical trials. Participants in clinical trials help scientists learn about the brain in healthy aging as well as what happens in Alzheimers. Results of these trials are used to improve prevention and treatment methods. To find out more about Alzheimers clinical trials, talk to your health care provider or contact the Alzheimers Disease Education and Referral (ADEAR) Center at 1-800-438-4380. You can search for studies about a certain topic or in a certain geographic area by going to www.nia.nih.gov/alzheimers/clinical-trials. </s>


Input: What is (are) Shingles ?

Output: Shingles is a painful rash that develops on one side of the face or body. The rash forms blisters that typically scab over in 7 to 10 days and clear up within 2 to 4 weeks. Most commonly, the rash occurs in a single stripe around either the left or the right side of the body. In other cases, the rash occurs on one side of the face. In rare cases (usually among people with weakened immune systems), the rash may be more widespread and look similar to a chickenpox rash. Shingles is very common. Fifty percent of all Americans will have had shingles by the time they are 80. While shingles occurs in people of all ages, it is most common in 60- to 80-year-olds. In fact, one out of every three people 60 years or older will get shingles. (Watch the video to learn more about shingles. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) What Causes Shingles? Shingles is caused by a reactivation of the chickenpox virus. It is distinctive because it affects only one side of the body. The early signs of shingles usually develop in three stages: severe pain or tingling, possibly itchy rash, and blisters that look like chickenpox. The virus that causes shingles is a herpes virus, (Another name for shingles is herpes zoster.) Once you are infected with this kind of virus, it remains in your body for life. It stays inactive until a period when your immunity is down. Shingles and Pain The most common complication of shingles is pain -- a condition called post-herpetic neuralgia (PHN). People with PHN have severe pain in the areas where they had the shingles rash, even after the rash clears up. In most patients, the pain usually clears up in a few weeks or months, but some people can have pain from PHN for years. Persistent pain from shingles is a common symptom in people over 60. In fact, one out of six people older than 60 years who get shingles will have severe pain. As people get older, they are more likely to develop long-term pain as a complication of shingles and the pain is likely to be more severe. Other Complications Shingles may also lead to other serious complications. - Outbreaks that start on the face or eyes can cause vision or hearing problems. Even permanent blindness can result if the cornea of the eye is affected.  -  Bacterial infection of the open sores can lead to scarring.  Outbreaks that start on the face or eyes can cause vision or hearing problems. Even permanent blindness can result if the cornea of the eye is affected. Bacterial infection of the open sores can lead to scarring. - In a very small number of cases, bacteria can cause more serious conditions, including toxic shock syndrome and necrotizing fasciitis, a severe infection that destroys the soft tissue under the skin.  - The burning waves of pain, loss of sleep, and interference with even basic life activities can cause serious depression.  - In patients with immune deficiency, the rash can be much more extensive than usual and the illness can be complicated by pneumonia. These cases are more serious, but they are rarely fatal.  - Very rarely, shingles can also lead to pneumonia, brain inflammation (encephalitis), or death.  In a very small number of cases, bacteria can cause more serious conditions, including toxic shock syndrome and necrotizing fasciitis, a severe infection that destroys the soft tissue under the skin. The burning waves of pain, loss of sleep, and interference with even basic life activities can cause serious depression. In patients with immune deficiency, the rash can be much more extensive than usual and the illness can be complicated by pneumonia. These cases are more serious, but they are rarely fatal. Very rarely, shingles can also lead to pneumonia, brain inflammation (encephalitis), or death. Shingles Usually Does Not Return People who develop shingles usually have only one episode in their lifetime. However, a person can have a second or even a third episode. The Shingles Vaccine Adults 60 years old or older should talk to their healthcare professional about getting a one-time dose of the shingles vaccine. The vaccine can reduce your risk of shingles and the long-term pain it can cause. If you have already had shingles or you have a chronic medical condition, you can receive the shingles vaccine. (See more about the shingles vaccine in the chapter Prevention.) Is Shingles Contagious? Shingles cannot be passed from one person to another. However, the virus that causes shingles, the varicella zoster virus, can be spread from a person with active shingles to another person who has never had chickenpox. In such cases, the person exposed to the virus might develop chickenpox, but they would not develop shingles. The virus is spread through direct contact with fluid from the rash blisters caused by shingles. A person with active shingles can spread the virus when the rash is in the blister phase. A person is not infectious before the blisters appear. Once the rash has developed crusts, the person is no longer contagious. Shingles is less contagious than chickenpox and the risk of a person with shingles spreading the virus is low if the rash is covered. If You Have Shingles If you have shingles, - keep the rash covered  - avoid touching or scratching the rash  - wash your hands often to prevent the spread of varicella zoster virus.  keep the rash covered avoid touching or scratching the rash wash your hands often to prevent the spread of varicella zoster virus. Until your rash has developed crusts, avoid contact with - pregnant women who have never had chickenpox or the chickenpox vaccine  - premature or low birth weight infants  - people with weakened immune systems, such as people receiving immunosuppressive medications or undergoing chemotherapy, organ transplant recipients, and people with human immunodeficiency virus (HIV) infection. pregnant women who have never had chickenpox or the chickenpox vaccine premature or low birth weight infants people with weakened immune systems, such as people receiving immunosuppressive medications or undergoing chemotherapy, organ transplant recipients, and people with human immunodeficiency virus (HIV) infection. If you have not had chickenpox and you come into contact with someone who has shingles, ask your healthcare provider whether you should get a chickenpox vaccination.  To learn more, see "What You Need to Know about Shingles and the Shingles Vaccine." </s>


Input: What causes Shingles ?

Output: Caused By A Virus Shingles is caused by a virus called varicella-zoster virus -- the one that gave you chickenpox when you were a child. As you recovered from chickenpox, the sores healed and the other symptoms went away, but the virus remained. It is with you for life. The virus hides out in nerve cells, usually in the spine. But it can become active again. Somehow, the virus gets a signal that your immunity has become weakened. This triggers the reactivation. When the virus becomes active again, it follows a nerve path called a dermatome. The nerve path begins at specific points in the spine, continues around one side of the body, and surfaces at the nerve endings in the skin. The pattern of the rash reflects the location of that nerve path. Risk Factors The leading risk factor for shingles is a history of having had chickenpox. One out of every five people who have had chickenpox is likely to get shingles. Another risk factor is aging. As we age, our natural immunity gradually loses its ability to protect against infection. The shingles virus can take advantage of this and become active again. Conditions that weaken the immune system can also put people at risk for shingles. Shingles is especially dangerous for anyone who has had cancer, radiation treatments for cancer, HIV/AIDS, or a transplant operation. Stress is another factor that may contribute to outbreaks. While stress alone does not cause the outbreaks, shingles often occurs in people who have recently had a stressful event in their lives. Most cases of shingles occur in adults. Only about 5 percent of cases occur in children. With children, immune deficiency is the primary risk factor, but children who had chickenpox before they were one year old may also get shingles before they become adults. There have been studies of adults who had chickenpox as children and were later exposed to children who had chickenpox. Interestingly, that exposure apparently boosted the adult's immunity, which actually helped them avoid getting shingles later in life. </s>


Input: How to prevent Shingles ?

Output: A Vaccine for Adults 60 and Older In May 2006, the U.S. Food and Drug Administration approved a vaccine (Zostavax) to prevent shingles in people age 60 and older. The vaccine is designed to boost the immune system and protect older adults from getting shingles later on. Even if you have had shingles, you can still get the shingles vaccine to help prevent future occurrences of the disease. There is no maximum age for getting the vaccine, and only a single dose is recommended. In a clinical trial involving thousands of adults 60 years old or older, the vaccine reduced the risk of shingles by about half. A One-time Dose To reduce the risk of shingles, adults 60 years old or older should talk to their healthcare professional about getting a one-time dose of the shingles vaccine. Even if the shingles vaccine doesnt prevent you from getting shingles, it can still reduce the chance of having long-term pain. If you have had shingles before, you can still get the shingles vaccine to help prevent future occurrences of the disease. There is no maximum age for getting the vaccine. Side Effects Vaccine side effects are usually mild and temporary. In most cases, shingles vaccine causes no serious side effects. Some people experience mild reactions that last up to a few days, such as headache or redness, soreness, swelling, or itching where the shot was given. When To Get the Vaccine The decision on when to get vaccinated should be made with your health care provider. The shingles vaccine is not recommended if you have active shingles or pain that continues after the rash is gone. Although there is no specific time that you must wait after having shingles before receiving the shingles vaccine, you should generally make sure that the shingles rash has disappeared before getting vaccinated. Where To Get the Vaccine The shingles vaccine is available in doctors offices, pharmacies, workplaces, community health clinics, and health departments. Most private health insurance plans cover recommended vaccines. Check with your insurance provider for details and for a list of vaccine providers. Medicare Part D plans cover shingles vaccine, but there may be costs to you depending on your specific plan. If you do not have health insurance, visit www.healthcare.gov  to learn more about health insurance options. Who Should Not Get the Vaccine? You should NOT get the shingles vaccine if you - have an active case of shingles or have pain that continues after the rash is gone  - have ever had a life-threatening or severe allergic reaction to gelatin, the antibiotic neomycin, or any other component of the shingles vaccine. Tell your doctor if you have any severe allergies.  - have a weakened immune system because of:  -- HIV/AIDS or another disease that affects the immune system   -- treatment with drugs that affect the immune system, such as steroids   -- cancer treatment such as radiation or chemotherapy   -- cancer affecting the bone marrow or lymphatic system, such as leukemia or lymphoma.  have an active case of shingles or have pain that continues after the rash is gone have ever had a life-threatening or severe allergic reaction to gelatin, the antibiotic neomycin, or any other component of the shingles vaccine. Tell your doctor if you have any severe allergies. have a weakened immune system because of:  -- HIV/AIDS or another disease that affects the immune system   -- treatment with drugs that affect the immune system, such as steroids   -- cancer treatment such as radiation or chemotherapy   -- cancer affecting the bone marrow or lymphatic system, such as leukemia or lymphoma. - are pregnant or might be pregnant. are pregnant or might be pregnant. To learn more about the vaccine, see Zostavax: Questions and Answers.  Could Vaccines Make Shingles a Rare Disease? The shingles vaccine is basically a stronger version of the chickenpox vaccine, which became available in 1995. The chickenpox shot prevents chickenpox in 70 to 90 percent of those vaccinated, and 95 percent of the rest have only mild symptoms. Millions of children and adults have already received the chickenpox shot. Interestingly, the chickenpox vaccine may reduce the shingles problem. Widespread use of the chickenpox vaccine means that fewer people will get chickenpox in the future. And if people do not get chickenpox, they cannot get shingles. Use of the shingles and chickenpox vaccines may one day make shingles a rare disease. To find out more, visit Shingles Vaccination: What You Need to Know or  Shingles Vaccine) </s>


Input: What are the symptoms of Shingles ?

Output: Burning, Itching, Tingling, Then a Rash  An outbreak of shingles usually begins with a burning, itching, or tingling sensation on the back, chest, or around the rib cage or waist. It is also common for the face or eye area to be affected. (Watch the video to learn more about one woman's experience with shingles. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) Some people report feeling feverish and weak during the early stages. Usually within 48 to 72 hours, a red, blotchy rash develops on the affected area. The rash erupts into small blisters that look like chickenpox. The blisters seem to arrive in waves over a period of three to five days. Blisters The blisters tend to be clustered in one specific area, rather than being scattered all over the body like chickenpox. The torso or face are the parts most likely to be affected, but on occasion, shingles breaks out in the lower body. The burning sensation in the rash area is often accompanied by shooting pains. After the blisters erupt, the open sores take a week or two to crust over. The sores are usually gone within another two weeks. The pain may diminish somewhat, but it often continues for months -- and can go on for years. Pain Shingles can be quite painful. Many shingles patients say that it was the intense pain that ultimately sent them to their healthcare provider. They often report that the sensation of anything brushing across the inflamed nerve endings on the skin is almost unbearable. Diagnosis is Usually Easy for Healthcare Providers A typical shingles case is easy to diagnose. A healthcare provider might suspect shingles if - the rash is only on one side of the body   - the rash erupts along one of the many nerve paths, called dermatomes, that stem from the spine. the rash is only on one side of the body the rash erupts along one of the many nerve paths, called dermatomes, that stem from the spine. A healthcare provider usually confirms a diagnosis of shingles if the person also - reports a sharp, burning pain   - has had chickenpox   - has blisters that look like chickenpox   - is elderly. reports a sharp, burning pain has had chickenpox has blisters that look like chickenpox is elderly. If the Diagnosis Is Unclear Some people go to their healthcare provider because of burning, painful, itchy sensations on one area of skin, but they don't get a rash. If there is no rash, the symptoms can be difficult to diagnose because they can be mistaken for numerous other diseases. In cases where there is no rash or the diagnosis is questionable, healthcare providers can do a blood test. If there is a rash, but it does not resemble the usual shingles outbreak, a healthcare provider can examine skin scrapings from the sores. </s>


Input: What are the treatments for Shingles ?

Output: If You Suspect Shingles  If you suspect you have shingles, see your healthcare provider within 72 hours of the first sign of the rash.Treatment with antiviral medications can reduce the severity of the nerve damage and speed healing. But to be effective, they must be started as soon as possible after the rash appears. (Watch the video to learn more about shingles treatments. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) Antivirals and Other Treatments At the early stage of shingles, a healthcare provider will usually prescribe antiviral pills. These antiviral medicines include acyclovir, valacyclovir, or famcyclovir, Your healthcare provider, may also prescribe drugs to relieve pain. Wet compresses, calamine lotion, and colloidal oatmeal baths may help relieve some of the itching. Patients with long-term pain may also be treated with numbing patches, tricyclic antidepressants, and gabapentin, an anti-seizure medication. While these treatments can reduce the symptoms of shingles, they are not a cure. The antivirals do weaken the virus and its effects, but the outbreak still tends to run its course. Good hygiene, including daily bathing, can help prevent bacterial infections. It is a good idea to keep fingernails clean and well-trimmed to reduce scratching. Shingles Vaccine The shingles vaccine is NOT recommended if you have active shingles or pain that continues after the rash is gone. To learn more about the shingles vaccine, see the chapter on "Prevention." </s>


Input: What is (are) Shingles ?

Output: Shingles -- also called varicella-zoster -- is a painful skin disease caused by a reactivation of the chickenpox virus. It is distinctive because it affects only one side of the body. The early signs of shingles usually develop in three stages: severe pain or tingling, possibly itchy rash, and blisters that look like chickenpox. (Watch the video to learn more about shingles. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) </s>


Input: Who is at risk for Shingles? ?

Output: Shingles is very common. Fifty percent of all Americans will have had shingles by the time they are 80. While shingles occurs in people of all ages, it is most common in 60-to 80-year-olds. In fact, one out of every three people 60 years or older will get shingles. </s>


Input: What are the symptoms of Shingles ?

Output: The first symptoms usually include burning, itching, or tingling sensations on the back, chest, or around the rib cage or waist. In other cases, it can be the face or eye area that is involved. The affected area can become extremely painful. This is when most people go to a healthcare provider to find out what is causing the pain. Some people report feeling feverish and weak during the early stages. Usually within 48 to 72 hours, a red, blotchy rash develops on the affected area. The rash erupts into small blisters that look like chickenpox. The blisters tend to be clustered in one specific area, rather than being scattered all over the body like chickenpox. The torso or face are the parts most likely to be affected, but on occasion, shingles breaks out in the lower body. The burning sensation in the rash area is often accompanied by shooting pains. After the blisters erupt, the open sores take a week or two to crust over. The sores are usually gone within another two weeks. The pain may diminish somewhat, but it often continues for months -- and can go on for years. </s>


Input: How to diagnose Shingles ?

Output: A typical shingles case is easy to diagnose. A healthcare provider might suspect shingles if - the rash is only on one side of the body   - the rash erupts along one of the many nerve paths, called dermatomes, that stem from the spine. the rash is only on one side of the body the rash erupts along one of the many nerve paths, called dermatomes, that stem from the spine. A healthcare provider usually confirms a diagnosis of shingles if the person also - reports a sharp, burning pain   - has had chickenpox   - has blisters that look like chickenpox   - is elderly. reports a sharp, burning pain has had chickenpox has blisters that look like chickenpox is elderly. Other symptoms of shingles can include -  fever  -  headache  -  chills  -  upset stomach.  fever headache chills upset stomach. Some people go to their healthcare provider because of burning, painful, itchy sensations on one area of skin, but they don't get a rash. If there is no rash, the symptoms can be difficult to diagnose because they can be mistaken for numerous other diseases. In cases where there is no rash or the diagnosis is questionable, healthcare providers can do a blood test. If there is a rash, but it does not resemble the usual shingles outbreak, a healthcare provider can examine skin scrapings from the sores. </s>


Input: What are the complications of Shingles ?

Output: The most common complication of shingles is pain -- a condition called post-herpetic neuralgia (PHN). People with PHN have severe pain in the areas where they had the shingles rash, even after the rash clears up. In most patients, the pain usually clears up in a few weeks or months, but some people can have pain from PHN for years. Shingles may also lead to other serious complications. - Outbreaks that start on the face or eyes can cause vision or hearing problems. Even permanent blindness can result if the cornea of the eye is affected.  -  Bacterial infection of the open sores can lead to scarring.   - In a very small number of cases, bacteria can cause more serious conditions, including toxic shock syndrome and necrotizing fasciitis, a severe infection that destroys the soft tissue under the skin.  - The burning waves of pain, loss of sleep, and interference with even basic life activities can cause serious depression.  - In patients with immune deficiency, the rash can be much more extensive than usual and the illness can be complicated by pneumonia. These cases are more serious, but they are rarely fatal.  - Very rarely, shingles can also lead to pneumonia, brain inflammation (encephalitis), or death.  Outbreaks that start on the face or eyes can cause vision or hearing problems. Even permanent blindness can result if the cornea of the eye is affected. Bacterial infection of the open sores can lead to scarring. In a very small number of cases, bacteria can cause more serious conditions, including toxic shock syndrome and necrotizing fasciitis, a severe infection that destroys the soft tissue under the skin. The burning waves of pain, loss of sleep, and interference with even basic life activities can cause serious depression. In patients with immune deficiency, the rash can be much more extensive than usual and the illness can be complicated by pneumonia. These cases are more serious, but they are rarely fatal. Very rarely, shingles can also lead to pneumonia, brain inflammation (encephalitis), or death. </s>


Input: What causes Shingles ?

Output: Shingles is caused by a virus called the varicella-zoster virus -- the one that gave you chickenpox when you were a child. As you recovered from chickenpox, the sores and other symptoms healed, but the virus remained. It is with you for life. Researchers know that the varicella-zoster virus behaves differently from other viruses, such as the flu virus. Our immune system usually kills off invading germs, but it cannot completely knock out this type of virus. The virus just becomes inactive. The virus can become active again, especially in the later years of your life when your immune system doesn't protect you as well from infections. The virus travels from the spinal nerve cells and follows a nerve path out to the skin. Nerve endings in the skin become inflamed and erupt in a very painful rash. Healthcare providers cannot always be sure what the trigger is in each case. They don't know why the virus reactivates in one person with these risk factors, while in another person with the same risk factors, it does not. </s>


Input: Who is at risk for Shingles? ?

Output: The leading risk factor for shingles is a history of having had chickenpox. One out of every five people who have had chickenpox is likely to get shingles. Another risk factor is aging. As we age, our natural immunity gradually loses its ability to protect against infection. The shingles virus can take advantage of this and become active again. Conditions that weaken the immune system can also put people at risk for shingles. Shingles is especially dangerous for anyone who has had cancer, radiation treatments for cancer, HIV/AIDS, or a transplant operation. Our immune system gradually loses strength as we mature. After people reach 50, the body is not able to fight off infections as easily as it once did. </s>


Input: What is (are) Shingles ?

Output: "A burning, tingly feeling is what I noticed first," said an elderly woman describing her symptoms. "I looked in the mirror, and there was a rash on just one side of my back. Then the shooting pains started. Days later, I could hardly stand to have my clothes touching me. I thought maybe I had hives or poison ivy," she said, "until I went to the doctor." </s>


Input: What are the symptoms of Shingles ?

Output: A week or two after the blisters erupt, the oozing sores will begin to crust over. The sores are usually gone after another two weeks. The pain usually decreases over the next few weeks, but some patients may have pain for months -- sometimes, for years. </s>


Input: How to prevent Shingles ?

Output: Yes. In May 2006, the U.S. Food and Drug Administration approved a vaccine to prevent shingles in people age 60 and older. The vaccine, called Zostavax, is designed to boost the immune system and protect older adults from getting shingles later on. Even if you have had shingles, you can still get the shingles vaccine to help prevent future occurrences of the disease. There is no maximum age for getting the vaccine, and only a single dose is recommended. The shingles vaccine is NOT recommended if you have active shingles or pain that continues after the rash is gone. (Watch the video to learn more about shingles treatments. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) The shingles vaccine is available in pharmacies and doctor's offices. Talk with your healthcare professional if you have questions about the vaccine. To learn more about the vaccine,  see "Zostavax: Questions and Answers." </s>


Input: What are the treatments for Shingles ?

Output: Treatment with antiviral medications can reduce the severity of the nerve damage and speed healing. But to be effective, they must be started as soon as possible after the rash appears. If you suspect you have shingles, see your healthcare provider within 72 hours of the first sign of the rash. At the early stage of shingles, a healthcare provider will usually prescribe antiviral pills. These antiviral medicines include acyclovir, valacyclovir, or famcyclovir, Your healthcare provider, may also prescribe drugs to relieve pain. Wet compresses, calamine lotion, and colloidal oatmeal baths may help relieve some of the itching. Patients with long-term pain may also be treated with numbing patches, tricyclic antidepressants, and gabapentin, an anti-seizure medication. The shingles vaccine is not recommended if you have active shingles or pain that continues after the rash is gone. While these treatments can reduce the symptoms of shingles, they are not a cure. The antivirals do weaken the virus and its effects, but the outbreak still tends to run its course. Good hygiene, including daily bathing, can help prevent bacterial infections. It is a good idea to keep fingernails clean and well-trimmed to reduce scratching. </s>


Input: What is (are) Psoriasis ?

Output: Psoriasis (sow RYE uh sis) is a chronic skin disease. Chronic means that it lasts a long time, often a lifetime. Psoriasis affects more than 5 million adults in the United States. It appears about equally in males and females. Psoriasis occurs when the skin cells grow too quickly. The body does not shed these excess cells and they build up on the surface of the skin, forming thick, scaly patches.   Types of Psoriasis Psoriasis occurs in five different forms that affect both men and women. Most people have only one type of psoriasis at a time. Sometimes, one type of psoriasis will disappear and another will appear. Here is a brief overview of the different forms of psoriasis. - Is the most common form  - appears as raised red patches covered in silvery white scales   - usually shows up on the scalp, knees, elbows and lower back   - patches may itch or be painful and can also crack and bleed.  Is the most common form appears as raised red patches covered in silvery white scales usually shows up on the scalp, knees, elbows and lower back patches may itch or be painful and can also crack and bleed. - is the second most common form of psoriasis  - usually begins in childhood or early adulthood   - appears as small red spots on the skin.  is the second most common form of psoriasis usually begins in childhood or early adulthood appears as small red spots on the skin. - appears as red sores in body folds, such as the groin and under the breasts  - is more common in people who are overweight   - often occurs along with another form of psoriasis.  appears as red sores in body folds, such as the groin and under the breasts is more common in people who are overweight often occurs along with another form of psoriasis. - features white blisters surrounded by red skin  - mainly affects adults  - may occur all over the body, but usually affects one area.  features white blisters surrounded by red skin mainly affects adults may occur all over the body, but usually affects one area. - is the rarest and most dangerous form of psoriasis   - is characterized by inflammation  - usually affects most of the body.  is the rarest and most dangerous form of psoriasis is characterized by inflammation usually affects most of the body. </s>


Input: What causes Psoriasis ?

Output: Although the cause of psoriasis is not completely understood, scientists believe it is related to a problem with a type of blood cells called T cells. These cells normally travel through the bloodstream to help fight an infection, but in people with psoriasis, they attack the bodys skin cells by mistake. Genes Play a Role No one knows what causes T cells to go wrong, but certain genes have been linked to psoriasis. People who have these genes are more likely to develop psoriasis than people without the genes. However, genes alone do not cause psoriasis. Scientists believe psoriasis occurs when something in the environment triggers the disease in someone who has one or more of these genes.  Psoriasis Triggers These so-called triggers may be different for different people. Different triggers may start the disease or make it worse in different people. Factors that may trigger psoriasis or make it worse include - physical and emotional stress  - injury to the skin such as cuts or burns  - infections, particularly strep throat  - cold weather   - smoking or heavy alcohol use  - certain medications such as     - lithium, a psychiatric drug   - antimalarials such as hydroxychloroquine and chloroquine    - inderal, a high blood pressure medicine   - quinidine, a heart medication   - indomethacin, a nonsteroidal anti-inflammatory drug often used to treat arthritis.   physical and emotional stress injury to the skin such as cuts or burns infections, particularly strep throat cold weather smoking or heavy alcohol use certain medications such as - lithium, a psychiatric drug  - antimalarials such as hydroxychloroquine and chloroquine   - inderal, a high blood pressure medicine  - quinidine, a heart medication  - indomethacin, a nonsteroidal anti-inflammatory drug often used to treat arthritis. lithium, a psychiatric drug antimalarials such as hydroxychloroquine and chloroquine inderal, a high blood pressure medicine quinidine, a heart medication indomethacin, a nonsteroidal anti-inflammatory drug often used to treat arthritis. </s>


Input: What are the symptoms of Psoriasis ?

Output: Different forms of psoriasis have different symptoms. In many cases your doctor can diagnose psoriasis based on the signs seen in the physical exam as well as the symptoms you describe. Symptoms The most common symptoms of psoriasis are - patches of thick, red skin   - skin inflammation  - silvery scales  - itching  - pain. patches of thick, red skin skin inflammation silvery scales itching pain. Psoriasis most commonly affects the elbows, knees, scalp, lower back, face, palms, soles of the feet, nails, and soft tissues. Making a Diagnosis In most cases, your primary care provider can diagnose psoriasis simply by examining your skin. Because the symptoms of psoriasis may be similar to those of other skin diseases, however, sometimes the diagnosis is more difficult. You may need to see a dermatologist, a doctor who specializes in diagnosing and treating skin diseases. If your doctor isn't sure if you have psoriasis, he or she may order a biopsy. This involves removing a small sample of skin and looking at it under a microscope. </s>


Input: What are the treatments for Psoriasis ?

Output: The goals of psoriasis treatment are to change the course of the disease by interfering with the increased production of skin cells, and to remove scales and smooth rough skin. There are many types of treatments. Many are medicines and other treatments your doctor will have to prescribe. But there are other types of treatments you can buy without a prescription or try on your own. Some treatments for psoriasis are applied directly to the skin. Some use light to treat skin lesions. Others are taken by mouth or injected. This chapter focuses on treatments that are applied directly to the skin -- also called topical treatments or light therapy.  Topical Treatments Here are some different types of topical treatments for psoriasis. - helps soften and loosen skin scales  - comes as a cream, lotion, liquid, gel, ointment or shampoo. helps soften and loosen skin scales comes as a cream, lotion, liquid, gel, ointment or shampoo. - reduce inflammation and slow the growth and build-up of skin cells   - are used in different strengths for different parts of the body.  reduce inflammation and slow the growth and build-up of skin cells are used in different strengths for different parts of the body. - works by slowing the production of skin cells   - is often combined with a steroid for added effects   - may be used with UVB light.  works by slowing the production of skin cells is often combined with a steroid for added effects may be used with UVB light. - is used to treat long-term psoriasis and hard-to-treat plaques  - reduces inflammation   - slows down the growth of skin cells. is used to treat long-term psoriasis and hard-to-treat plaques reduces inflammation slows down the growth of skin cells. - cause the skin to shed dead cells  - slow the growth of skin cells   - decrease itching.  cause the skin to shed dead cells slow the growth of skin cells decrease itching. - are believed to work by reducing skin cell overgrowth  - decrease inflammation  - are often used with other treatments.  are believed to work by reducing skin cell overgrowth decrease inflammation are often used with other treatments. - slow down the growth of skin cells   - may be used with steroid creams for added effects.  slow down the growth of skin cells may be used with steroid creams for added effects. Regardless of the topical medication your doctor prescribes, it is important to follow directions carefully. Some can be messy and stain your clothing and bedding. Others can have potentially dangerous side effects. Light Therapy Light therapy, also called phototherapy, uses ultraviolet light to treat skin lesions. Laser therapy delivers intense, focused doses of light to specific areas of the skin to clear lesions without harming surrounding tissues. Here are some different kinds of light therapy. UVB phototherapy - penetrates the skin to slow the growth of affected cells   - is given at home or at the doctors office   - may be combined with topical treatments or injected or oral medicines to increase effectiveness. penetrates the skin to slow the growth of affected cells is given at home or at the doctors office may be combined with topical treatments or injected or oral medicines to increase effectiveness. Excimer laser - targets select areas of skin with a beam of high-intensity UVB light   - is used to treat chronic, localized psoriasis plaques  - may take 4 to 10 sessions to see results . targets select areas of skin with a beam of high-intensity UVB light is used to treat chronic, localized psoriasis plaques may take 4 to 10 sessions to see results . Pulsed dye laser - uses a dye and different wavelength of light from other skin treatments  - destroys tiny blood vessels that help psoriasis lesions form  - may take 4 to 6 sessions to clear treated lesions.  uses a dye and different wavelength of light from other skin treatments destroys tiny blood vessels that help psoriasis lesions form may take 4 to 6 sessions to clear treated lesions. </s>


Input: What are the treatments for Psoriasis ?

Output: While many psoriasis treatments are applied directly to the skin, your doctor may prescribe others that must be taken by mouth or injected. There are also some natural treatments, taken by mouth or applied to the skin, that you can try on your own. Systemic Therapies These therapies, prescribed by your doctor, work in different ways to help control the underlying disease process. It is important to learn as much as you can about these medications and to take them exactly as prescribed by your doctor. Oral or injected medications for psoriasis include the following. - is used to treat severe psoriasis (meaning more than 20 percent of skin is affected)  - slows the rapid growth of skin cells  - is taken by mouth or injected.  is used to treat severe psoriasis (meaning more than 20 percent of skin is affected) slows the rapid growth of skin cells is taken by mouth or injected. - may be used for severe psoriasis not controlled by methotrexate  - suppresses overactive T cells that play a role in psoriasis  - is taken by mouth or injected. may be used for severe psoriasis not controlled by methotrexate suppresses overactive T cells that play a role in psoriasis is taken by mouth or injected. - are man-made drugs related to vitamin A   - help slow the production of skin cells  - reduce inflammation. are man-made drugs related to vitamin A help slow the production of skin cells reduce inflammation. - are made from living cells grown in a laboratory  - block the action of specific cells and proteins that play a role in psoriasis  - must be injected beneath the skin or given intravenously (by IV). are made from living cells grown in a laboratory block the action of specific cells and proteins that play a role in psoriasis must be injected beneath the skin or given intravenously (by IV). Natural Treatments For many people, natural treatments can help relieve the symptoms of psoriasis. There are many natural treatments you can try on your own, but you should never use them to replace the treatment your doctor prescribes. Here are some natural treatments you may want to try. Spending a few minutes in the summer sun can help your psoriasis, but be sure to use sun block and increase time spent in the sun gradually. Applying cream from the aloe vera plant improves symptoms for some people. You should avoid aloe vera tablets. Taking fish oil orally helps some people with psoriasis. If you want to try fish oil, first speak with your doctor, as it may interact with other medications you are taking. Soaking in a solution of Dead Sea salts may improve scaling and itching. Be sure to apply moisturizer when you get out of the tub. Capsaicin, the ingredient that makes cayenne peppers hot, is the active ingredient in some topical pain-relievers. Some people find they relieve pain and itching. </s>


Input: what research (or clinical trials) is being done for Psoriasis ?

Output: Scientists who are working to better understand and treat psoriasis are making headway in several different areas. The Role of T Cells Scientists believe that psoriasis occurs when white blood cells called T cells, which normally help fight infections, attack the bodys skin cells by mistake. Scientists are working to understand what causes these cells to go awry in people with psoriasis. Their hope is that by better understanding why T cells attack the bodys healthy skin tissue, they can develop better treatments to stop or prevent that damaging process. New Treatments Since discovering that T cells attack skin cells in psoriasis, researchers have been studying new treatments that quiet immune system reactions in the skin. Among these are treatments that block the activity of T cells or block cytokines (proteins that promote inflammation). If researchers find a way to target only the disease-causing immune reactions while leaving the rest of the immune system alone, resulting treatments could benefit psoriasis patients as well as those with other autoimmune diseases (when the immune system attacks the bodys own tissues). Currently there are a number of potential psoriasis treatments in clinical trials, including injections, pills, and topical ointments. Clinical trials are research studies with volunteers in which drugs are tested for the effectiveness and safety. All drugs must complete and pass this process before they can be approved by the FDA. Psoriasis Genes Because psoriasis is more common among people who have one or more family members with the disease, scientists have long suspected that genes are involved. A number of genetic loci  specific locations on the genes  have been associated with the development of psoriasis or the severity or progression of the disease. In 2012, scientists discovered the first gene to be directly linked to development of plaque psoriasis. Researchers continue to study the genetic aspects of psoriasis, and some studies are looking at the nervous system to determine the genes responsible for the circuitry that causes itching. Psoriasis-related Conditions Research in recent years has shown that people with psoriasis are more likely to develop other health problems, including problems with the heart and blood vessels. Research is continuing to examine links between psoriasis and other health problems. Scientists are working to understand how and why these diseases occur in people with psoriasis, with the hope that this understanding will lead to better treatments for both psoriasis and the related diseases. Stress Reduction Treatment For many people with psoriasis, life stresses cause the disease to worsen or become more active. Research suggests that stress is associated with the increased production of chemicals by the immune system that promote inflammation. The same chemicals may play a role in the anxiety and depression that is common in people with psoriasis. Researchers are studying the use of stress reduction techniques, along with medical treatment, in the hope that reducing stress will both lower anxiety and improve the skin lesions of psoriasis. Where to Find More Information More information on research is available from the following websites. - NIH Clinical Research Trials and You helps people learn more about clinical trials, why they matter, and how to participate. Visitors to the website will find information about the basics of participating in a clinical trial, first-hand stories from actual clinical trial volunteers, explanations from researchers, and links to help you search for a trial or enroll in a research-matching program.  - ClinicalTrials.gov offers up-to-date information for locating federally and privately supported clinical trials for a wide range of diseases and conditions.  - NIH RePORTER is an electronic tool that allows users to search a repository of both intramural and extramural NIH-funded research projects from the past 25 years and access publications (since 1985) and patents resulting from NIH funding.  - PubMed is a free service of the U.S. National Library of Medicine that lets you search millions of journal citations and abstracts in the fields of medicine, nursing, dentistry, veterinary medicine, the health care system, and preclinical sciences.  NIH Clinical Research Trials and You helps people learn more about clinical trials, why they matter, and how to participate. Visitors to the website will find information about the basics of participating in a clinical trial, first-hand stories from actual clinical trial volunteers, explanations from researchers, and links to help you search for a trial or enroll in a research-matching program. ClinicalTrials.gov offers up-to-date information for locating federally and privately supported clinical trials for a wide range of diseases and conditions. NIH RePORTER is an electronic tool that allows users to search a repository of both intramural and extramural NIH-funded research projects from the past 25 years and access publications (since 1985) and patents resulting from NIH funding. PubMed is a free service of the U.S. National Library of Medicine that lets you search millions of journal citations and abstracts in the fields of medicine, nursing, dentistry, veterinary medicine, the health care system, and preclinical sciences. </s>


Input: What is (are) Psoriasis ?

Output: Psoriasis is a chronic skin disease. Chronic means that it lasts a long time, often a lifetime. Psoriasis affects more than 5 million adults in the United States. It appears about equally in males and females. Psoriasis occurs when the skin cells grow too quickly. The body does not shed these excess cells and they build up on the surface of the skin, forming thick, scaly patches. </s>


Input: What is (are) Psoriasis ?

Output: The most common form of psoriasis is called plaque psoriasis. It appears as raised red patches covered in silvery white scales. Plaque psoriasis usually shows up on the scalp, knees, elbows, and lower back. The patches may itch or be painful. They can also crack and bleed. </s>


Input: What causes Psoriasis ?

Output: Although the cause of psoriasis is not completely understood, scientists believe it is related to a problem with a type of blood cells called T cells. These cells normally travel through the bloodstream to help fight an infection, but in people with psoriasis, they attack the bodys skin cells by mistake. </s>


Input: How to diagnose Psoriasis ?

Output: In most cases, your primary care doctor can diagnose psoriasis simply by examining your skin. If your doctor isn't sure if you have psoriasis, he or she may order a biopsy. This involves removing a small sample of skin and looking at it under a microscope. </s>


Input: What are the treatments for Psoriasis ?

Output: The goals of psoriasis treatment are to change the course of the disease by interfering with the increased production of skin cells, and to remove scales and smooth rough skin. </s>


Input: What are the treatments for Psoriasis ?

Output: There are many types of treatments. Many are medicines and other treatments your doctor will have to prescribe. But there are other types of treatments you can buy without a prescription or try on your own. Some treatments for psoriasis are applied to the directly to the skin. Some use light to treat skin lesions. Others are taken by mouth or injected. </s>


Input: What are the treatments for Psoriasis ?

Output: Topical treatments are those that are applied directly to the skin. Topical treatments for psoriasis include - salicylic acid,  - steroid-based creams  - calcipotriene-containing ointment  - anthralin  - coal-tar ointments and shampoos  - and vitamin D analogues.  salicylic acid, steroid-based creams calcipotriene-containing ointment anthralin coal-tar ointments and shampoos and vitamin D analogues. </s>


Input: What is (are) Psoriasis ?

Output: Oral or injected medications for psoriasis include methotrexate, cycloclosporine, oral retinoids, and biologics. These therapies, prescribed by your doctor, work in different ways to help control the underlying disease process. </s>


Input: What is (are) Psoriasis ?

Output: Light therapy, also called phototherapy, uses ultraviolet light to treat skin lesions. Laser therapy delivers intense, focused doses of light to specific areas of the skin to clear lesions without harming surrounding tissues. </s>


Input: What are the treatments for Psoriasis ?

Output: For many people, natural treatments can help relieve the symptoms of psoriasis. There are many natural treatments you can try on your own, but you should never use them to replace the treatment your doctor prescribes. Some natural treatments you may want to try are - sunlight  - aloe  - fish oil  - Dead Sea salts  - cayenne. sunlight aloe fish oil Dead Sea salts cayenne. </s>


Input: What is (are) Psoriasis ?

Output: Having psoriasis may cause you to feel self-conscious, particularly if it affects a part of the body that others can see. Some people plan their clothing  such as long skirts vs. knee-length or long-sleeve instead of short-sleeve shirts  to hide affected skin. Others withdraw from sports and other activities where affected skin would show. Pain, itching, and other symptoms can lead to frustration. Uncertainty over the course of the disease or the need for ongoing treatment may cause you to feel anxious or depressed. In some cases psoriasis symptoms make it difficult or impossible for people keep up with their jobs, household chores, or favorite activities. Having to give up a job or favorite hobby can further increase the risk of emotional problems. </s>


Input: what research (or clinical trials) is being done for Psoriasis ?

Output: Scientists who are working to better understand and treat psoriasis are making headway in several different areas, including the role of T cells, new treatments, psoriasis genes, psoriasis-related conditions, and stress-reduction treatment. </s>


Input: What is (are) Heart Attack ?

Output: Blood Flow to the Heart Is Blocked The heart works 24 hours a day, pumping oxygen and nutrient-rich blood to the body. Blood is supplied to the heart through its coronary arteries. If a blood clot suddenly blocks a coronary artery, it cuts off most or all blood supply to the heart, and a heart attack results. If blood flow isn't restored quickly, the section of heart muscle begins to die. The more time that passes without treatment to restore blood flow, the greater the damage to the heart. Affects Both Men and Women Heart attacks are a leading killer of both men and women in the United States. Each year, more than one million people in the U.S. have a heart attack and about half of them die. Half of those who die do so within one hour of the start of symptoms and before reaching the hospital. The good news is that excellent treatments are available for heart attacks. These treatments can save lives and prevent disabilities. Prompt Treatment Is Important Heart attack treatment works best when it's given right after symptoms occur. Prompt treatment of a heart attack can help prevent or limit damage to the heart and prevent sudden death. Call 9-1-1 Right Away A heart attack is an emergency. Call 9-1-1 for an ambulance right away -- within 5 minutes -- if you think you or someone else may be having a heart attack. You also should call for help if your chest pain doesn't go away as it usually does when you take medicine prescribed for angina (chest pain). Do not drive to the hospital or let someone else drive you. Emergency personnel in the ambulance can begin life-saving treatment on the way to the emergency room. They carry drugs and equipment that can help your medical condition, including - oxygen   - aspirin to prevent further blood clotting   - heart medications, such as nitroglycerin   - pain relief treatments  - defibrillators that can restart the heart if it stops beating.  oxygen aspirin to prevent further blood clotting heart medications, such as nitroglycerin pain relief treatments defibrillators that can restart the heart if it stops beating. If blood flow in the blocked artery can be restored quickly, permanent heart damage may be prevented. Yet, many people do not seek medical care for 2 hours or more after symptoms start. </s>


Input: What are the symptoms of Heart Attack ?

Output: Symptoms Can Vary Not all heart attacks begin with the sudden, crushing chest pain that often is shown on TV or in the movies. The warning signs and symptoms of a heart attack aren't the same for everyone. Many heart attacks start slowly as mild pain or discomfort. Some people don't have symptoms at all. Heart attacks that occur without any symptoms or very mild symptoms are called silent heart attacks. However, some people may have a pattern of symptoms that recur. The more signs and symptoms you have, the more likely it is that you're having a heart attack If you have a second heart attack, your symptoms may not be the same as the first heart attack. Here are common signs and symptoms of a heart attack. Chest Pain or Discomfort The most common symptom of heart attack is chest pain or discomfort. Chest pain or discomfort that doesn't go away or changes from its usual pattern (for example, occurs more often or while you're resting) can be a sign of a heart attack. Most heart attacks involve discomfort in the center of the chest that lasts for more than a few minutes or goes away and comes back. The discomfort can feel like uncomfortable pressure, squeezing, fullness, or pain. It can be mild or severe. Heart attack pain can sometimes feel like indigestion or heartburn. All chest pain should be checked by a doctor. Other Upper Body Discomfort Discomfort can also occur in other areas of the upper body, including pain or numbness in one or both arms, the back, neck, jaw or stomach. Shortness of Breath Shortness of breath often happens along with, or before chest discomfort. Other Symptoms Other symptoms may include - breaking out in a cold sweat   - having nausea and vomiting   - feeling light-headed or dizzy   - fainting   - sleep problems   - fatigue   - lack of energy.  breaking out in a cold sweat having nausea and vomiting feeling light-headed or dizzy fainting sleep problems fatigue lack of energy. Angina or a Heart Attack? Angina is chest pain or discomfort that occurs if an area of your heart muscle doesn't get enough oxygen-rich blood. Angina occurs in people who have coronary heart disease, usually when they're active. Angina symptoms can be very similar to heart attack symptoms. Angina pain usually lasts for only a few minutes and goes away with rest. If you think you may be having a heart attack, or if your angina pain does not go away as usual when you take your angina medication as directed, call 9-1-1 for help. You can begin to receive life saving treatment in the ambulance on the way to the emergency room. </s>


Input: What causes Heart Attack ?

Output: Most heart attacks are caused by a blood clot that blocks one of the coronary arteries, the blood vessels that bring blood and oxygen to the heart muscle. When blood cannot reach part of your heart, that area starves for oxygen. If the blockage continues long enough, cells in the affected area die. The Most Common Cause Coronary heart disease (CHD)is the most common underlying cause of a heart attack. CHD, also called coronary artery disease, is the hardening and narrowing of the coronary arteries caused by the buildup of plaque inside the walls of the arteries. When plaque builds up in the arteries, the condition is called atherosclerosis (ath-er-o-skler-O-sis). The buildup of plaque occurs over many years. Over time, an area of plaque can rupture (break open) inside of an artery. This causes a blood clot to form on the plaque's surface. If the clot becomes large enough, it can mostly or completely block blood flow through a coronary artery. If the blockage isn't treated quickly, the portion of heart muscle fed by the artery begins to die. Healthy heart tissue is replaced with scar tissue. This heart damage may not be obvious, or it may cause severe or long-lasting problems. Other Causes Heart attack also can occur due to problems with the very small, microscopic blood vessels of the heart. This condition is called microvascular disease. It's believed to be more common in women than in men. A less common cause of heart attacks is a severe spasm or tightening of the coronary artery that cuts off blood flow to the heart. These spasms can occur in persons with or without coronary artery disease. What causes a coronary artery to spasm isn't always clear. A spasm may be related to emotional stress or pain, exposure to extreme cold, cigarette smoking, or by taking certain drugs like cocaine. Risk Factors You Cannot Change Certain factors make it more likely that you will develop coronary artery disease and have a heart attack. These risk factors include some things you cannot change. If you are a man over age 45 or a woman over age 55, you are at greater risk. Having a family history of early heart disease, diagnosed in a father or brother before age 55 or in a mother or sister before age 65, is another risk factor. You are also at risk if you have a personal history of angina or previous heart attack, or if you have had a heart procedure such as percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG). Risk Factors You Can Change Importantly, there are many risk factors that you can change. These include - smoking  - being overweight or obese  - physical inactivity  - high blood pressure  - high blood cholesterol  - high blood sugar due to insulin resistance or diabetes   - an unhealthy diet (for example, a diet high in saturated fat, trans fat, cholesterol, and sodium). smoking being overweight or obese physical inactivity high blood pressure high blood cholesterol high blood sugar due to insulin resistance or diabetes an unhealthy diet (for example, a diet high in saturated fat, trans fat, cholesterol, and sodium). Metabolic Syndrome Some of these risk factorssuch as obesity, high blood pressure, and high blood sugartend to occur together. When they do, it's called metabolic syndrome. In general, a person with metabolic syndrome is twice as likely to develop heart disease and five times as likely to develop diabetes as someone without metabolic syndrome. </s>


Input: Who is at risk for Heart Attack? ?

Output: Lowering your risk factors for coronary heart disease (CHD) can help you prevent a heart attack. Even if you already have CHD or have already had a heart attack, you can still take steps to lower your risk. These steps involve following a heart healthy lifestyle and getting ongoing care for conditions that raise your risk. Heart Healthy Lifestyle Changes You can make these lifestyle changes to lower your risk of having a heart attack. - If you smoke, quit.  - Maintain a healthy weight.  - Be as physically active as you can.  - Follow a heart healthy diet. If you smoke, quit. Maintain a healthy weight. Be as physically active as you can. Follow a heart healthy diet. If you smoke, quit.  Smoking can raise your risk of CHD and heart attack. Talk with your doctor about programs and products that can help you quit. Also, try to avoid secondhand smoke. Maintain a healthy weight.  If you're overweight or obese, work with your doctor to create a reasonable weight-loss plan that involves diet and physical activity. Controlling your weight helps you control risk factors for coronary heart disease (CHD) and heart attack. Be as physically active as you can. Physical activity can improve your fitness level and your health. Talk with your doctor about what types of activity are safe for you. Follow a heart healthy diet.  Following a healthy diet is an important part of a heart healthy lifestyle. Eat a healthy diet to prevent or reduce high blood pressure and high blood cholesterol, and to maintain a healthy weight. A healthy diet includes a variety of fruits, vegetables, and whole grains. It also includes lean meats, poultry, fish, beans, and fat-free or low-fat milk or milk products. A healthy diet is low in saturated fat, trans fat, cholesterol, sodium (salt), and added sugars. For More Information About Healthy Eating For more information about following a healthy diet, go to the National Heart, Lung, and Blood Institute's (NHLBI's) Aim for a Healthy Weight Web site,  Your Guide to a Healthy Heart, and  Your Guide to Lowering Your Blood Pressure With DASH. In addition, a variety of heart healthy recipes to help you plan meals is available at  Aim for a Healthy Weight. All of these resources provide general information about healthy eating. Treatment for Related Conditions Get treatment for related conditions that make having a heart attack more likely. - If you have high blood cholesterol, follow your doctor's advice about lowering it. Take medications to lower your cholesterol as directed if diet and exercise aren't enough.   -  If you have high blood pressure, follow your doctor's advice about keeping it under control. Take blood pressure medications as directed.   - If you have diabetes, sometimes called high blood sugar, try to control your blood sugar level through diet and physical activity (as your doctor recommends). If needed, take medicine as prescribed. If you have high blood cholesterol, follow your doctor's advice about lowering it. Take medications to lower your cholesterol as directed if diet and exercise aren't enough. If you have high blood pressure, follow your doctor's advice about keeping it under control. Take blood pressure medications as directed. If you have diabetes, sometimes called high blood sugar, try to control your blood sugar level through diet and physical activity (as your doctor recommends). If needed, take medicine as prescribed. </s>


Input: How to diagnose Heart Attack ?

Output: If You Have Symptoms, Call 9-1-1 Diagnosis and treatment of a heart attack can begin when emergency personnel arrive after you call 9-1-1. Do not put off calling 9-1-1 because you are not sure that you are having a heart attack. Call within 5 minutes of the start of symptoms. At the hospital emergency room, doctors will work fast to find out if you are having or have had a heart attack. They will consider your symptoms, medical and family history, and test results. Initial tests will be quickly followed by treatment if you are having a heart attack. Diagnostic Tests - an electrocardiogram  - blood tests  - nuclear heart scan  - cardiac catheterization  - and coronary angiography. an electrocardiogram blood tests nuclear heart scan cardiac catheterization and coronary angiography. The electrocardiogram, also known as ECG or EKG, is used to measure the rate and regularity of your heartbeat. Blood tests are also used in diagnosing a heart attack. When cells in the heart die, they release enzymes into the blood. They are called markers or biomarkers. Measuring the amount of these markers in the blood can show how much damage was done to your heart. Doctors often repeat these tests to check for changes. The nuclear heart scan uses radioactive tracers to outline the heart chambers and major blood vessels leading to and from the heart. A nuclear heart scan shows any damage to your heart muscle as well as how well blood flows to and from the heart. In cardiac catheterization, a thin, flexible tube is passed through an artery in your groin or arm to reach the coronary arteries. This test allows your doctor to - determine blood pressure and flow in the heart's chambers  - collect blood samples from the heart, and  - examine the arteries of the heart by x-ray. determine blood pressure and flow in the heart's chambers collect blood samples from the heart, and examine the arteries of the heart by x-ray. Coronary angiography is usually done with the cardiac catheterization. A dye that can be seen on an x-ray is injected through the catheter into the coronary arteries. It shows where there are blockages and how severe they are. </s>