MONALISA HEALTH

About your BMI

2009-12-20T08:11:00.000+07:00

For years, you've used 2 numbers to manage your weight — the fluctuating one on your bathroom scale and the one on the tag of your favorite pair of jeans.

And then there's the body mass index (BMI). Although much emphasis has been put on this number, the question is: How meaningful is it, really?

The truth is, BMI — a statistical measure of the relationship between a person's weight and height — is useful when generalizing about groups of people. It has been used to classify people as underweight, normal weight, overweight and obese.

An adult with a BMI between 18.5 and 24.9 is considered within the normal range, according to the National Institutes of Health (NIH) in Bethesda, Md.

The NIH says a BMI between 25 and 29.9 is considered overweight, and a BMI of 30 and above is considered obese. (Calculate your BMI here. You'll need to know your height and weight.)

Generally speaking, groups of people with BMIs of 25 and above face a higher risk of serious health problems such as type 2 diabetes, cardiovascular disease, certain cancers and many other conditions. Risks are compounded as BMI increases.

But this number is not always accurate when applied to individuals, especially athletes, children, people who have lost muscle mass and the elderly. The biggest criticism of BMI is this: It fails to distinguish between muscle and fat. What's more, it doesn't measure body fat.

"BMI is a way of estimating your density," but it doesn't consider how your body's put together," says Stephen G. Rice, M.D., Ph.D., director of the Jersey Shore Sports Medicine Center in Neptune, N.J. "If you had huge muscles, you'd weigh more since muscles are dense," he says. Therefore, it's important to look at a person rather than just at his or her BMI number.

"Muscle is 15% heavier than fat," says Robert Girandola, Ph.D., an associate professor of kinesiology at the University of Southern California (USC) and a nutrition and obesity expert. "So if you do resistance training and are very active in sports, it's possible your BMI may be high while your body fat is low."

Therefore, based solely on his BMI, a muscular athlete like Arnold Schwarzenegger in his prime would be defined as obese.

Looking just at BMI is problematic for another group as well — postmenopausal women who lose muscle mass as they age. In those cases, a low BMI may underestimate a woman's body fat. "I have a patient whose BMI is 23" — well within the normal range, says Zhaoping Li, M.D., an associate professor of clinical medicine at the University of California, Los Angeles Center for Human Nutrition and its director for clinical research.

"But her body fat may be 39 [%]. She has no muscle." For women, the average body-fat percentage — remember, that's a different measure from BMI — is 25% to 31%. Thirty-two percent and higher is considered obese.

BMI also fails to consider where fat is deposited, which determines whether someone's body shape is identified as an apple or a pear. Generally, apples — those with excess abdominal fat — are more at risk for obesity- and heart-related health problems than those who are pear-shaped. Conversely, people who carry their fat on their thighs and buttocks have a lower incidence of health risks.

Ethnicity also must be taken into account. For instance, when compared with whites, Asians have lower BMIs but higher percentages of body fat, according to The American Journal of Clinical Nutrition. This means that Asians may be considered overweight with a BMI over 22.9

A better measure of fat

"We need some way of measuring body fat independent of BMI," Rice says. "The number alone without context is just a number." He points to more accurate tests of body composition like being weighed underwater and using calipers to measure skin fold thickness on various parts of the body.

Rather than simply estimating health risks related to body weight and shape, there is a simpler calculation that combines 2 easy-to-get numbers.

"For adults, a better tool is a combination of BMI and waist circumference," says Michael L.Goran, Ph.D., a professor of preventive medicine, physiology and biophysics at USC's Keck School of Medicine and associate director at its Institute for Health Promotion and Disease Prevention Research.

According to the Mayo Clinic's guidelines, women's waist measurements should be less than 35 inches, while men's should be less than 40 inches. If these figures are combined with BMI, together they can be a more accurate predictor of disease risk.

Taking action

To get a more accurate picture of your disease risk than BMI alone, follow these steps:

Measure the circumference of your waist at its widest part with your belly relaxed.

Use the 2 figures of BMI and waist circumference to find a more accurate estimation of your disease risk by consulting the chart created by the National Heart, Lung and Blood Institute, a part of NIH. According to the chart, a man considered "overweight" by virtue of a BMI between 25 and 29.9 and a waist size of 38 inches is at "increased" risk of disease. But if the same man's waist is 40 inches, he moves into the "high" risk group.

Go to the National Heart, Lung and Blood Institute website to evaluate the disease risk associated with your BMI and waist circumference.

Reviwed by: Stacy Beller Stryer, M.D.

Breast Cancer, Metastatic or Recurrent

2009-11-25T18:55:00.001+07:00

What are metastatic and recurrent breast cancer?

Monalisa Health-Breast cancer occurs when abnormal cells grow out of control in one or both breasts. Treatment often cures breast cancer if it is found before it has spread.

But even after treatment that seemed to work, cancer can come back (recur) or spread (metastasize) to other parts of the body. Cancer that comes back in or near the original site is called locally recurrent breast cancer. Cancer that spreads to other parts of the body is called metastatic breast cancer.

For most women who have had breast cancer, their greatest fear is that the cancer will come back or spread. Finding out this has happened can turn your world upside down. But there is hope. Treatment can often cure recurrent breast cancer. Although metastatic breast cancer usually cannot be cured, treatment can help you manage the disease and live longer. Some women live for many years, managing their cancer like a long-term health problem.

Why does breast cancer come back after treatment?

Even with the best treatment, cancer can come back. If just a small cluster of cancer cells remains in your body, those cells can spread through the blood or lymph system and grow. This may happen from a few months to many years after the first diagnosis.

If your breast cancer has come back, you may be tempted to second-guess your previous treatment choices. But the fact is, there is no guarantee with any treatment.

The treatment decisions you and your doctor made in the past were the right ones at that time. But now it is time to make new decisions and explore other treatment options.

What are the symptoms?

The symptoms depend on where the cancer is and how large it is. The most common places for breast cancer to spread are within the breast or to the nearby chest wall or to the liver, lungs, or bones. Common symptoms include a lump in your breast or on your chest wall, bone pain, or shortness of breath.

You may not have any symptoms. Sometimes recurrent or metastatic breast cancer is found with an X-ray or lab test.

How is it treated?

To plan your treatment, your doctor will consider where the cancer is and what type of treatment you had in the past. Your wishes and quality of life are also important factors. Treatment choices may include surgery, medicines like chemotherapy or hormone therapy, and radiation. Sometimes a mix of these treatments is used.

Treatments for breast cancer can cause side effects. Your doctor can tell you what problems to expect and help you find ways to manage them.

Clinical trials to test new cancer treatments are going on all the time. Ask your doctor if it would be a good idea to take part in one of these studies.

If treatments have not worked, a time may come when your goal shifts from curing the disease to staying as comfortable as you can. Palliative care can provide symptom relief and support for you and your loved ones so you can make the most of the time you have left.

How can you handle your feelings about having breast cancer again?

It is common to have a wide range of emotions. It may be hard to stay hopeful when you are fighting cancer for the second or third time. These ideas may help.

Get the support you need. Spend time with people who care about you, and let them help you. Talk to your hospital social worker if you need help with bills or other worries. Your local American Cancer Society may also be helpful.
Take good care of yourself. Get plenty of rest. Eat healthy meals. Get regular exercise. Try meditation or guided imagery to help you relax. These steps can help you feel as well and stay as healthy as you can.
Talk about your feelings. Find a support group. Talking with other people who have breast cancer can be a big help. Sharing your experience can help others too.
Do everything you can to stay positive. Set a goal each day to do something special for yourself or someone else.

If your emotions are too much to handle, be sure to tell your doctor. You may be able to get counseling or other types of help.

You may want to think about planning for the future. A living will lets doctors know what type of life-support measures you want if your health gets much worse. You can also choose a health care agent to make decisions in case you are not able to. It can be comforting to know that you will get the type of care you want.

Symptoms of pregnancy

2009-04-24T13:18:00.001+07:00

Monalisa Health-You may be pregnant if you:

Have had sexual intercourse and you have not used any method of birth control.
Have missed one or more periods.
Have your period, but there is a lot less bleeding than usual.
Take birth control pills, but you missed a pill. It is especially risky to miss a pill early in the cycle or pack or to start your new pack a day or two late.
Have other symptoms of early pregnancy. Symptoms include:
- Fatigue.
- Breast tenderness or enlargement.
- Nausea or vomiting.
- Increased urination.
Have done a home pregnancy test, and the result was positive.

If you have regular menstrual periods and are sexually active, you can become pregnant, even if you use birth control.

If you think you might be pregnant, do a home pregnancy test. If the result is positive, practice the following good health habits until you see your doctor:

Eat a balanced diet.
Do not smoke.
Do not use alcohol or drugs.
Avoid caffeine, or limit your intake to about 1 cup of coffee or tea each day.
Do not clean a cat litter box to avoid the risk of toxoplasmosis.
Avoid people who are ill.
Take a vitamin supplement that contains folic acid or a prenatal vitamin.

Even if the pregnancy test is negative, if you continue to have pregnancy symptoms, it is a good idea to see your doctor to confirm the results. Practice good health habits until you see your doctor.

Traditional massage therapist finds a place with doctors

2009-03-15T07:00:00.000+07:00

Matheos Viktor Messakh

monalisa Health-Ten-year-old Bowo was playing with his friends in the schoolyard in East Jakarta when he felt a pain in the lower part of his stomach and could barely move his feet. His parents were called to the school and the boy was taken to hospital.

The doctor could do nothing for the boy other than diagnose a hernia. However, the hospital knew of a health clinic that had a Cimande massage therapist. The desperate parents and grimacing boy saw no other option; they headed straight to the clinic.

"After less than one hour of massage and with pain relief medication, my boy was able to go out and play again," the boy's father, Rasyid, told The Jakarta Post on Tuesday.

Like many forms of traditional massage in Indonesia, Cimande massage has developed a reputation for its ability to cure bone-, joint- and muscle-related complaints.

The type of massage is named after the village in Bogor, West Java, where many of the massage therapists come from. The skills have been handed down from generation to generation, a tradition accompanied by a kind of mystic aura.

Muhammad Si In, a 48-year-old massage therapist from Cimande, said he had received training in the technique from his grandfather, Abah Emang, from when he was 20 years old, but he was not allowed to practice it until he had his own family in 1987.

"We promised him that we would only practice it when we got married and had children of our own. I don't know why, but I obeyed."

Si In, who is popularly known as Bang Mamat, said that he received the training together with 12 other children, but he was the only one who passed the test allowing him to treat the public.

The preparation his grandfather gave him, Si In said, went for nearly a year and involved numerous rituals, prohibitions and taboos, including 40 days of fasting and not being allowed to eat rice or any vine fruit.

He has since come to be the therapist at a certified health clinic in East Jakarta, after beginning in 1987 practicing at his own house in Bogor, before becoming a therapist in Indramayu, West Java, for one year. From 2000, he was the therapist for the Bogor regent.

Since 2006 he has been working for a Gran Ananda clinic in East Jakarta, where he works alongside doctors helping treat complaints ranging from sore muscles and stiff tendons to more serious bone and muscle problems such as fractures, sprains and hernias. He treats patients in a simple room, with nothing but a thin mat and pillow.

Si In said between five and 10 patients visit the clinic for massage therapy during the week, and 10 to 15 during the weekend. The clinic also gets some patients from abroad.

Adi, the coordinator of Gran Ananda clinic, said that initially doctors at the clinic were reluctant to work with Si In, but after he succeeded with several patients, they started to cooperate with him.

After all, Si In does also hold a license from the East Jakarta health service agency permitting him to practice his traditional skill.

The therapist, who never finished high school, said he had no interest in learning about muscles, bones or human anatomy or to enrich his skills from books or other modern sources - he believes the knowledge gained during that year of training with his grandfather is enough.

"I just have to learn from the patients that come to me," said Si In, who has been part of the health team for Bogor municipality's regional sports week (Porda) contingent since 2000.

Even professional massage therapist Sugiat Mulyosudarmo admires the Cimande traditional therapists. He said he often visits them to "steal" their skills.

"They have the talent, even though they might know nothing about muscles or bones. I always learn from them and never underestimate them," said Sugiat, who holds several licenses for sports massage, including from the International Olympics Commission in 1998 and 2002.

Sugiat, who has been a massage therapist for the Indonesian badminton team for many national and international events since 1987, said that if traditional massage therapists had their own institution to update their skills and promote them, they would be as widely accepted as professional therapists.

"They have the knowledge; they just don't know how to explain it. They are smart because they never stop learning."

This lack of knowledge about human anatomy, said Sugiat, is the traditional therapists' only Achilles heel.

"Sometimes, they treat different illnesses with the same treatment. We can feel pain in the same part of our body but the cause could be different so the treatment should be different."

However, Si In said that passing his grandfather's rigorous selection process was enough for him to become a therapist.

"We can feel it in our hand if we have the skills and in time we can also know the problem just by looking at the patient," he said. "Even if someone had done something with it already, we will know if it is totally fixed.

10 Risk Factors for Heart Disease

2009-01-25T06:04:00.000+07:00

Monalisa health-Heart disease risk factors are more controllable than you think.

(MICHAEL FLIPPO/FOTOLIA)

Some risk factors for heart disease can be controlled, and some can't. According to the American Heart Association, these are the leading factors that put you at risk for coronary artery disease or a heart attack.

Age: More than 83% of people who die from coronary heart disease are 65 or older. Older women are more likely to die of heart attacks within a few weeks of the attack than older men.
Being male: Men have a greater risk of heart attack than women do, and they have attacks earlier in life. Even after menopause, when women's death rate from heart disease increases, it's not as great as men's.
Family history. Those with parents or close relatives with heart disease are more likely to develop it themselves.
Race: Heart disease risk is higher among African Americans, Mexican Americans, American Indians, native Hawaiians, and some Asian Americans compared to Caucasians.
Smoking: Cigarette smoking increases your risk of developing heart disease by two to four times.
High cholesterol: As blood cholesterol rises, so does risk of coronary heart disease.
High blood pressure: High blood pressure increases the heart's workload, causing the heart to thicken and become stiffer. It also increases your risk of stroke, heart attack, kidney failure, and congestive heart failure. When high blood pressure exists with obesity, smoking, high blood cholesterol levels, or diabetes, the risk of heart attack or stroke increases several times. 
Sedentary lifestyle. Inactivity is a risk factor for coronary heart disease.
Excess weight: People who have excess body fat—especially if a lot of it is at the waist—are more likely to develop heart disease and stroke even if they have no other risk factors.
Diabetes: Having diabetes seriously increases your risk of developing cardiovascular disease. About three-quarters of people with diabetes die from some form of heart or blood vessel disease.

How to Quit Smoking:97 Reasons to Quit

2009-01-23T15:07:00.001+07:00

monalisa health-(FOTOLIA/ISTOCKPHOTO)

1. You won't have to pay more and more and more and more each year.
Yup, taxes will almost certainly continue to go up. New Jersey, Vermont, and Connecticut are among the states leaning harder on smokers for revenue, but even some tobacco-growing states are beginning to milk the coffin-nail cash cow. Lawmakers' reasoning: There is evidence that price increases cause smokers to reduce consumption. And the medical costs of smoking are astronomical—a huge burden to the states.

2. Really, if you think cigarette prices can't go up much more, you've got Wall Street against you as well as the government.
Addiction—to oil, tobacco, etc.—is a very good thing to bank on. Many on Wall Street remain bullish about Big Tobacco's ability to jack up prices, even if sales drop because of tax increases.

3. You'll be smarter than Goofy.
"No Smoking" is a superb 1951 Disney cartoon depicting the history of tobacco use and, in modern times, Goofy's addiction and attempt to quit (there's a hilarious Mad Men-ish scene of an office full of smokers). It ends with him smoking an exploding cigar as the narrator concludes: "Give the smoker enough rope and he'll hang on to his habit."

(YOUTUBE.COM)

4. Once you quit, you'll find it more amusing that tobacco soup smells like s**t.
Or at least that's what kids at a Washington state elementary school said when Teens Against Tobacco Use visited their class recently and mixed up a concoction of cigarette ingredients.

(SMOKE-FREE.CA)

5. Smoking can cramp your style in the bedroom.
Smoking can affect circulation; with less blood flow to your genitals, arousal for both men and women can be more difficult.

6. Sever yourself from the sordid history of animal testing in smoking research.
Smoking-related cancer researchers have long used animals as test subjects, producing the famous smoking beagles photos from the 1970s, which are still used by antivivisection sites today.

(VIOLENCEFREESCIENCE.ORG)

7. You'll sleep better.
Smokers are four times as likely to report feeling unrested after a night's sleep, a Johns Hopkins study found; it seems going through nicotine withdrawal each night can contribute to sleep disturbances.

8. Cool bonuses at work may be in your future.
Employers are increasingly offering incentives—such as gift cards, premium discounts, or cash—to employees who participate in smoking cessation programs.

9. Quitting is a plausible excuse to play computer games.
A recent survey commissioned by online game maker RealNetworks suggests that playing games online can help distract people from smoking.

10. Nonsmokers have stronger bones than smokers.
Women smokers have been found to lose 2.3% to 3.3% of bone mineral density for every 10 pack-years of tobacco use. The effects are even worse in postmenopausal women.

Vicks VapoRub Linked to Infant Breathing Problems

2009-01-18T17:04:00.000+07:00

Monalisa health-The popular cold remedy Vicks VapoRub may cause airway inflammation that can restrict breathing in infants and toddlers, a new study says.

Doctors at Wake Forest University started their study after treating an 18-month-old girl who had developed severe respiratory distress after the salve had been put directly under her nose to relieve cold symptoms.

“The company is really clear that you don’t put it in the nose, and you never use it in kids under 2,” said lead researcher Dr. Bruce K. Rubin, professor and vice chair for research at Wake Forest’s Department of Pediatrics. “Sure enough, when we stopped all the medicine, the child got much better very quickly.”

Rubin’s experience prompted him to see if there had been other similar cases. “We encountered a few others that appeared to develop problems after using Vicks VapoRub. Parents never volunteered it, because they always thought it is just something you buy over-the-counter, and it’s not a real medicine, because you just rub it on, after all,” he said.

Rubin said Vicks VapoRub can make some adults feel better without really making them better. “For kids, because it can induce some inflammation, even a little bit, that little bit might be enough to tip over a child to having problems,” he said.

The findings were published in the January issue of the journal Chest.

To test whether Vicks VapoRub could cause respiratory distress, the researchers conducted experiments with ferrets. The animals were chosen because they have airways similar to human airways, Rubin said.

The researchers found that Vicks VapoRub increased mucus production by up to 59 percent; the ability to clear mucus was reduced by 36 percent.

David Bernens, a spokesman for Proctor & Gamble, the makers of Vicks VapoRub, doesn’t think one incident involving one child means that the product is unsafe.

“The product is safe and effective when used as directed,” he said. “To say it was the Vicks VapoRub that caused the respiratory distress — I’m not sure we have made that link yet.”

Dr. James A. L. Mathers Jr., president of the American College of Chest Physicians, said in an association news release: “Parents should consult with a physician before administering any over-the-counter medicine to infants and young children. Furthermore, the American College of Chest Physicians and several other health-care organizations have concluded that over-the-counter cough and cold medicines can be harmful for infants and young children and are, therefore, not recommended.”

In October, major manufacturers and the U.S. Food and Drug Administration announced that over-the-counter cough and cold medicines should not be used by children younger than 4 years old.

Dr. Daniel Craven, a pediatric pulmonologist at University Hospitals Rainbow Babies and Children’s Hospital in Cleveland, said parents shouldn’t use Vicks VapoRub, because it has no medicinal value and may even be dangerous.

“Previous research has failed to demonstrate any respiratory benefits of VapoRub, and conscientious pediatricians have thus usually tried to dissuade families from spending money on this and similarly ineffective therapies,” Craven said. “Although the findings are someone limited, this study raises the possibility that this product may not just be ineffective, but possibly might have adverse respiratory consequences — particularly if there is an intense exposure — as when it is applied directly under the nostrils.”

More information

For more on children and colds, visit the American Academy of Family Physicians.

SOURCES: Bruce K. Rubin, M.D., professor, vice chair, research, department of pediatrics, Wake Forest University School of Medicine, Winston-Salem, N.C.; Daniel Craven, M.D., pediatric pulmonologist, University Hospitals Case Medical Center’s Rainbow Babies and Children’s Hospital, Cleveland; David Bernens, spokesman, Proctor & Gamble, Cincinnati; January 2009 Chest

By Steven Reinberg

Fertility Problems

2009-01-08T19:36:00.000+07:00

Monalisa Health-You may have fertility problems if you have not been able to get pregnant after trying for at least 1 year. Another word for this is infertility. Infertility may not mean that it is impossible to get pregnant. Often, couples conceive without help in their second year of trying. Some do not succeed, but medical treatments help many couples.

Age is an important factor if you are trying to decide whether to get testing and treatment for fertility problems. A woman is most fertile in her late 20s. After age 35, fertility decreases and the risk of miscarriage goes up.

If you are younger than 35, you may want to give yourself more time to get pregnant.
If you are 35 or older, you may want to get help soon.

What causes fertility problems?

Fertility problems can have many causes. In cases of infertility:¹

About 50 out of 100 are caused by a problem with the woman’s reproductive system . These may be problems with her fallopian tubes or uterus or her ability to release an egg (ovulate).
About 35 out of 100 are caused by a problem with the man's reproductive system . The most common is low sperm count.
About 5 out of 100 are caused by an uncommon problem, such as the man or woman having been exposed to a medicine called DES before birth.
In about 10 out of 100, no cause can be found in spite of testing.

Should you be tested for fertility problems?

Before you have fertility tests, try fertility awareness. A woman can learn when she is likely to ovulate and be fertile by charting her basal body temperature and using home tests. Some couples find that they simply have been missing their most fertile days when trying to conceive.

If you are not sure when you ovulate, try this Interactive Tool: When Are You Most Fertile?.

If these methods don't help, the first step is for both partners to have some simple tests. A doctor can:

Do a physical exam of both of you.
Ask questions about your past health to look for clues, such as a history of miscarriages or pelvic inflammatory disease.
Ask about your lifestyle habits, such as how often you exercise and whether you drink alcohol or use drugs.
Do tests that check semen quality and both partners' hormone levels in the blood. Hormone imbalances can be a sign of ovulation problems or sperm problems that can be treated.

Your family doctor can do these tests. For more complete testing, you may need to see a fertility specialist.

How are fertility problems treated?

A wide range of treatments is available. Depending on what is causing the problem, you may be able to:

Take a medicine that helps the woman ovulate.
Have a procedure that puts sperm directly inside the woman (insemination).
Have a surgery that corrects a problem caused by endometriosis or blocked fallopian tubes.
Have a procedure that might increase the man’s sperm count.

If these options are not possible or don't work for you, you may want to consider in vitro fertilization (IVF). During an IVF, eggs and sperm are mixed in a lab so the sperm can fertilize the eggs. Then the doctor puts one or more fertilized eggs into the woman’s uterus. Many couples try IVF more than once.

Treatment for fertility problems can be stressful, costly, and hard on your body. Before you start testing, make some decisions about what you want to do. You may change your mind later, but it’s a good idea to start with a plan.

Learn all you can about the tests and treatments, and decide which you want to try. For example, some couples agree to try medicines but don't want surgery or other treatments.
Find out how much treatments cost and whether your insurance will cover them. If you don't have insurance coverage, decide what you can afford.

Treatments for infertility can increase your chances of getting pregnant. But they also increase your chance of having more than one baby at a time (multiple pregnancy). Be sure to discuss the risks with your doctor.

Fertility problems can put a lot of strain on a couple. It may help to see a counselor with experience in infertility. Think about joining an infertility support group. Talking with other people with the same issue can help you feel less alone.

How can you get ready for pregnancy?

2009-01-02T09:46:00.000+07:00

Monalisa Health-If you're planning to get pregnant, you might already be thinking about which room to turn into the baby’s room and how to decorate it. And you might be thinking about all the baby clothes and gear like car seats that you'll need.

But you also can start to think about how to help yourself have a happy pregnancy and a healthy baby.

Even before you get pregnant, take these steps to make your pregnancy as healthy as possible:

See a doctor or certified nurse-midwife for an exam. Talk about the medicines and dietary supplements you take. Ask if you need any immunizations. Talk about any health problems or other concerns you have.
Do not take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin. These may raise your risk of miscarriage, especially around the time you conceive or if you use them for more than a week.¹
Take a daily multivitamin or prenatal vitamin with 0.4 mg (400 mcg) of folic acid. This B vitamin lowers the chance of having a baby with a birth defect.
See your dentist. Take care of any dental work you may need.
Keep track of your menstrual cycle. This helps you know the best time to try to get pregnant. And after you are pregnant, you will be better able to help your doctor or midwife figure out when your baby is due and how it is growing.
Make healthy lifestyle choices. Eat a healthy diet. Avoid caffeine, or don't have more than 1 cup of coffee or tea each day. Avoid alcoholic drinks, cigarettes, and illegal drugs. Take only the medicines your doctor or midwife says are okay.
Exercise regularly. A strong body helps you handle the demands of pregnancy, childbirth, and recovery. Exercise also helps improve your mood.

If you are not sure when you are most likely to get pregnant (when you are fertile), use the Interactive Tool: When Are You Most Fertile?

You're pregnant! What can you do to have a healthy pregnancy?

Now that you're pregnant, you may be happy and excited. You may be a little nervous or worried. If this will be your first child, you may even feel overwhelmed by all of the things you need to know about having a baby. There is a lot to learn. But you don't have to know everything right away. You can read all about pregnancy now, or you can learn about each stage as your pregnancy goes on.

During your pregnancy, you'll have tests to watch for certain problems that could occur. With all the tests you'll have, you may worry that something will go wrong. But most women have healthy pregnancies. If there is a problem, these tests can find it early so that you and your doctor or midwife can treat it or watch it to help improve your chance of having a healthy baby.

Taking great care of yourself is the best thing you can do for yourself and your baby. Everything healthy that you do for your body helps your growing baby. Rest when you need it, eat well, drink plenty of water, and exercise regularly.

You'll need to have regular checkups. At every visit, your doctor or midwife will weigh you and measure your belly to check your baby's growth. You'll also get blood and urine tests and have your blood pressure checked.

It’s important to avoid tobacco smoke, alcohol and drugs, chemicals, and radiation (like X-rays). These can harm you and the baby.

Try to keep your body temperature from getting too high [over 100.4 ° F (38 ° C) ]. Treat a fever with acetaminophen (such as Tylenol). Don't get too hot when you exercise. And don't get in a high-temperature hot tub or sauna.

What kinds of exams and tests will you have?

Your first prenatal exam gives your doctor or midwife important information for planning your care. You'll have a pelvic exam and urine and blood tests. You'll also have your blood pressure and weight checked. The urine and blood tests are used for a pregnancy test and to tell whether you have low iron levels (are anemic) or have signs of infection.

At each prenatal visit you'll be weighed, have your belly measured, and have your blood pressure and urine checked. Go to all your appointments. Although these quick office visits may seem simple and routine, your doctor is watching for signs of possible problems like high blood pressure.

In some medical centers, you can have screening in your first trimester to see if your baby has a chance of having Down syndrome or another genetic problem. The test usually includes a blood test and an ultrasound.

During your second trimester, you can have a blood test (triple or quadruple screen test) to see if you have a higher-than-normal chance of having a baby with birth defects. Based on the results of the tests, you may be referred to a geneticist for further discussion. Or you may have other tests to find out for sure if your baby has a birth defect.

Late in your second trimester, your blood sugar will be checked for diabetes during pregnancy (gestational diabetes). Near the end of your pregnancy, you will have tests to look for infections that could harm your newborn.

What warning signs should you look for during your pregnancy?

Call your doctor or midwife right away if you have:

Cramping.
Blood or other fluid from your vagina.
Belly pain.
An ache in your low back that doesn't go away.
Burning or pain when you urinate.
A bad headache.
Blurred vision.
A fever.
Sudden severe swelling of your feet, ankles, or hands.

Cervical Cancer

2008-12-30T06:38:00.001+07:00

What is cervical cancer?

Monalisa Health-Cervical cancer occurs when abnormal cells on the cervix grow out of control. The cervix is the lower part of the uterus that opens into the vagina. Cervical cancer can often be cured when it’s found early. It is usually found at a very early stage through a Pap test.

What causes cervical cancer?

Most cervical cancer is caused by a virus called human papillomavirus, or HPV. You get HPV by having sex with someone who has it. There are many types of the HPV virus. Not all types of HPV cause cervical cancer. Some of them cause genital warts, but other types may not cause any symptoms.

You can have HPV for years and not know it. It stays in your body and can lead to cervical cancer years after you were infected. This is why it is important for you to have regular Pap tests. A Pap test can find changes in cervical cells before they turn into cancer. If you treat these cell changes, you may prevent cervical cancer.

What are the symptoms?

Abnormal cervical cell changes rarely cause symptoms. But you may have symptoms if those cell changes grow into cervical cancer. Symptoms of cervical cancer may include:

Bleeding from the vagina that is not normal, or a change in your menstrual cycle that you can't explain.
Bleeding when something comes in contact with your cervix, such as during sex or when you put in a diaphragm.
Pain during sex.
Vaginal discharge that is tinged with blood.

How is cervical cancer diagnosed?

As part of your regular pelvic exam, you should have a Pap test. During a Pap test the doctor scrapes a small sample of cells from the surface of the cervix to look for cell changes. If a Pap test shows abnormal cell changes, your doctor may do other tests to look for precancerous or cancer cells on your cervix.

Your doctor may also do a Pap test and take a sample of tissue (biopsy) if you have symptoms of cervical cancer, such as bleeding after sex.

How is it treated?

Cervical cancer that is caught early can usually be cured. If the cancer is caught very early, you still may be able to have children after treatment.

The treatment for most stages of cervical cancer removes the cancer and makes you unable to have children. These treatments include:

A hysterectomy and removal of pelvic lymph nodes with or without removal of both ovaries and fallopian tubes.
Radiation therapy.
Chemotherapy.

Depending on how much the cancer has grown, you may have one or more treatments. And you may have a combination of treatments.

It’s common to feel scared, sad, or angry after finding out that you have cervical cancer. Talking to others who have had the disease may help you feel better. Ask your doctor about support groups in your area. You can also find people online who will share their experiences with you.

Can cervical cancer be prevented?

The Pap test is the best way to find cervical cell changes that can lead to cervical cancer. Regular Pap tests almost always show these cell changes before they turn into cancer. It is important to follow up with your doctor after any abnormal Pap test result to treat abnormal cell changes. This may help prevent cervical cancer.

A new vaccine called Gardasil protects against four types of HPV, which together cause most cases of cervical cancer and genital warts. You get three shots over 6 months. The vaccine is recommended for girls 11 to 12 years old. It is also recommended for females 13 to 26 years old who did not get the vaccine when they were younger.

The virus that causes cervical cancer is spread through sexual contact. The best way to avoid getting a sexually transmitted disease is to not have sex. If you do have sex, practice safer sex, such as using condoms and limiting the number of sex partners you have.

Alzheimer's Disease

2008-12-26T15:33:00.000+07:00

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

What is Alzheimer's disease?

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

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

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

What causes Alzheimer's disease?

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

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

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

What are the symptoms?

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

As the disease gets worse, the person may:

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

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

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

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

How is Alzheimer's disease diagnosed?

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

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

How is it treated?

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

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

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

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

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

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

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

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

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

Sinusitis

2008-12-20T16:16:00.000+07:00

Monalisa health-Sinusitis is an infection or inflammation of the mucous membranes that line the inside of the nose and facial sinuses. Facial sinuses are hollow spaces, or cavities, located in the skull around the eyes, cheeks, and nose.

When a mucous membrane becomes inflamed, it swells, blocking the drainage from the sinuses into the nose and throat and causing pressure and pain in the sinuses. Bacteria are more likely to grow in sinuses that are unable to drain properly. Symptoms may include pain and pressure in the face, yellow or greenish discharge from the nose, nasal congestion, and sometimes a fever, a chronic cough that produces mucus, and a reduced sense of taste or smell.

Sinusitis often improves on its own, but it may need to be treated with antibiotics or other medications if symptoms are severe or last longer than 4 weeks.

What Is Osteoarthritis?

2008-12-20T16:08:00.000+07:00

Monalisa Health-To learn the difference between osteoarthritis and rheumatoid arthritis, visit our A-Z Health Library.

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

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

Tackling Everday Life With Arthritis

Patients share their struggles and strategies

More about arthritis

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

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

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

Asthma in Teens and Adults

2008-12-17T19:09:00.000+07:00

Overview

Is this topic for you?

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

What is asthma?

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

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

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

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

What causes asthma?

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

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

What are the symptoms?

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

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

Your symptoms may be worse at night.

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

How is asthma diagnosed?

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

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

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

How is it treated?

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

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

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

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

How can you prevent asthma attacks?

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

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

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

Radioactive ‘Seed’ Rx Helps Women With Implants Fight Breast Cancer

2008-12-15T21:38:00.000+07:00

Monalisa Health-MONDAY, (HealthDay News) — Women who have had their breasts augmented with implants and are later diagnosed with early-stage breast cancer may be treated successfully with a partial-breast radiation treatment known as brachytherapy, according to an Arizona physician and researcher.

“It’s such a challenge to take care of these augmented women,” said Dr. Robert Kuske Jr., a Scottsdale radiation oncologist and clinical professor of radiation oncology at the University of Arizona Health Sciences Center, Tucson.

Kuske was expected to present the study Monday at the Radiological Society of North America’s annual meeting, in Chicago.

In brachytherapy, the physician watches via a computer as tiny radioactive “seeds” are guided into place in the breast through small plastic tubes. Once they are in place, the seeds emit high doses of radiation in short bursts. The treatment takes five days.

As Kuske explained, other therapies such as external beam radiation can be performed on women with augmented breasts who first undergo a lumpectomy. However, beam radiation carries a risk of scar tissue forming around the implant. This complication, called capsular contracture, can be both painful and disfiguring.

So, Kuske offered brachytherapy instead to 69 women who had had their breasts augmented before their cancer diagnosis. These women also did not want to undergo a mastectomy and breast reconstruction, preferring lumpectomy instead. Brachytherapy can be given in higher doses to a small, targeted area of the breast after a lumpectomy to remove the tumor.

None of the 69 patients have had a recurrence of the cancer during a follow-up that ranged from a half a year to 5.5 years, with a median follow-up of 16 months, Kuske said.

Regarding the women’s post-treatment appearance, “95 percent had excellent results,” according to Kuske. “You can’t even tell the breast has been treated.” Five percent got “good” results. None of the patients developed capsular contracture, he said.

Seed therapy has been used for years to treat prostate cancer successfully, Kuske noted, and was even used years ago to treat breast cancer. But the technology has improved greatly, said Kuske, who also serves as a consultant for Nucletron, a radiotherapy company, and Cianna Medical, which makes a breast brachytherapy device.

The treatment may appeal to women who don’t want to have their augmented breast removed, said Dr. Christy Russell, associate professor of medicine at the University of Southern California’s Norris Cancer Center in Los Angeles and chair of the American Cancer Society’s Breast Cancer Advisory Committee.

Women with augmented breasts who develop breast cancer can undergo mastectomy and reconstruction, she said, but some women want to keep the augmented breast instead.

“It’s a fine study,” Russell said. “But his follow-up is too short, and there are too few patients.” More study is needed, she said.

Longer follow-up is definitely needed, agreed Dr. Nayana Vora, professor of radiation oncology, City of Hope Comprehensive Cancer Center, Duarte, Calif. “Most capsular contracture happens within two years after radiation therapy,” she noted.

Many women, she said, will still opt for mastectomy and reconstruction. But the brachytherapy option may be an alternative for those who don’t want to give up their augmented breasts.

But, Vora stressed, this is only for women with small tumors, probably less than 3 centimeters in diameter. “I would not offer this to the patient with a larger tumor,” she said, because the radiation oncologist would need to treat more of the breast, thus increasing the risk of capsular contracture.

More information

To learn more about brachytherapy, visit the American Cancer Society.

SOURCES: Robert Kuske Jr., M.D., clinical professor, radiation oncology, University of Arizona Health Sciences Center, Tucson, and Scottsdale radiation oncologist; Christy Russell, M.D., associate professor, medicine, University of Southern California’s Norris Cancer Center, Los Angeles, and chair, American Cancer Society Breast Cancer Advisory Committee; Nayana L. Vora, M.D., professor, radiation oncology, City of Hope Comprehensive Cancer Center, Duarte, Calif.; Dec. 1, 2008, presentation, Radiological Society of North America, Chicago

By Kathleen Doheny
HealthDay Reporter

Psychological Issues Can Fuel a Low Libido

2008-12-09T08:08:00.000+07:00

Monalisa Health-Sex drive problems are so often a product of how you feel and what you've experienced that there is something to that "headache" saying after all. It's said that the brain is the most powerful sexual organ, and that goes for both men and women.

The most common psychological reasons for disinterest in sex include:

Cultural factors, such as the way you were raised to think about sex
Low self-esteem
Depression
Conflict with your partner
A history of sexual trauma such as abuse or assault
Stress and psychological health

Stress also has physiological effects. "Chronic stress changes hormones," says Michael Krychman, MD, executive director of the Southern California Center for Sexual Health and Survivorship Medicine in Newport Beach, Calif. "And hormones affect sex drive."

Either way, treatment of psychologically based sex drive problems can be very effective.

Talk therapy
A certified sex therapist can sit down with you (and your partner, if you have one) and work at finding hidden issues that may be affecting your sex drive.

"Some people have trauma they don’t even realize they’ve had," says Marjorie Green, MD, director of the Mount Auburn Female Sexual Medicine Center in Cambridge, Mass., and a clinical instructor at Harvard Medical School. "And sometimes people think that there isn’t a problem in a relationship and there is."

Medication
In addition to individual and couples counseling and any nonmedical therapeutic techniques, antidepressant medication may be prescribed. Some antidepressants may add to sex drive difficulties, so it’s important to work closely with your doctor so that the prescription can be tailored to your needs.

3 Kinds of Drugs That Can Kill Your Sex Drive

2008-12-09T08:06:00.000+07:00

Monalisa Health-Birth control pills and other medications can dampen desire.

(BEATHAN/CORBIS/VEER)

If you're having sex drive issues, check your medicine cabinet. Several varieties of prescription medication can dampen desire.

Birth control
Some hormonal birth control methods such as pills and patches can increase women's levels of sex-hormone-binding globulin (SHBG), which drops the amount of testosterone that's floating around freely in the bloodstream.

A small but alarming 2006 Boston University study, authored by Irwin Goldstein, MD, director of San Diego Sexual Medicine and editor in chief of The Journal of Sexual Medicine, found the Pill to have a long-term effect on libido in some women. The level of SHBG was twice as high in women who had taken the Pill—four months after they'd stopped taking the medication—as those who never had.

That kind of long-term effect is pretty rare, however, according to Hilda Hutcherson, MD, an ob-gyn professor at Columbia University. She finds that birth-control-related sex drive problems usually go away when her patients switch pill formulations. "It's the progestin that seems to affect libido," Dr. Hutcherson says. "Some progestins have an androgen [male hormone] effect, and those tend to have less effect on libido."

Or try another form of birth control completely. With most women Dr. Hutcherson has seen in practice, she says she's found that "if you take them off the Pill, their sex drive comes back."

Antidepressants
Selective serotonin-reuptake inhibitors (SSRIs) such as Prozac are supposed to cheer you up, but they can interfere with one potential source of happiness: sexual pleasure. Some doctors will keep the SSRI but add Wellbutrin, which increases dopamine and acts as an "antidote to the SSRIs," according to Dr. Goldstein. For others, a doctor might switch the patient to Wellbutrin and cut the SSRI.

Everyone's body reacts differently to drugs, however, and for some, depression itself is more of a sex drive dampener than the SSRIs are. For still another set of patients, notes Marjorie Green, MD, director of the Mount Auburn Female Sexual Medicine Center in Cambridge, Mass., and a clinical instructor at Harvard Medical School, "When you give them SSRIs, they get a libido and can be sexually functional when they weren't able to be before."

Complete Blood Count (CBC)

2008-12-09T08:03:00.000+07:00

Monalisa Health-
White blood cell (WBC, leukocyte) count. White blood cells protect the body against infection. If an infection develops, white blood cells attack and destroy the bacteria, virus, or other organism causing it. White blood cells are bigger than red blood cells but fewer in number. When a person has a bacterial infection, the number of white cells rises very quickly. The number of white blood cells is sometimes used to find an infection or to see how the body is dealing with cancer treatment.

White blood cell types (WBC differential). The major types of white blood cells are neutrophils, lymphocytes, monocytes, eosinophils, and basophils. Immature neutrophils, called band neutrophils, are also part of this test. Each type of cell plays a different role in protecting the body. The numbers of each one of these types of white blood cells give important information about the immune system. Too many or too few of the different types of white blood cells can help find an infection, an allergic or toxic reaction to medicines or chemicals, and many conditions, such as leukemia.
Red blood cell (RBC) count. Red blood cells carry oxygen from the lungs to the rest of the body. They also carry carbon dioxide back to the lungs so it can be exhaled. If the RBC count is low (anemia), the body may not be getting the oxygen it needs. If the count is too high (a condition called polycythemia), there is a chance that the red blood cells will clump together and block tiny blood vessels (capillaries). This also makes it hard for your red blood cells to carry oxygen.
Hematocrit (HCT, packed cell volume, PCV). This test measures the amount of space (volume) red blood cells take up in the blood. The value is given as a percentage of red blood cells in a volume of blood. For example, a hematocrit of 38 means that 38% of the blood's volume is made of red blood cells. Hematocrit and hemoglobin values are the two major tests that show if anemia or polycythemia is present.
Hemoglobin (Hgb). The hemoglobin molecule fills up the red blood cells. It carries oxygen and gives the blood cell its red color. The hemoglobin test measures the amount of hemoglobin in blood and is a good measure of the blood's ability to carry oxygen throughout the body.
Red blood cell indices. There are three red blood cell indices: mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC). They are measured by a machine and their values come from other measurements in a CBC. The MCV shows the size of the red blood cells. The MCH value is the amount of hemoglobin in an average red blood cell. The MCHC measures the concentration of hemoglobin in an average red blood cell. These numbers help in the diagnosis of different types of anemia. Red cell distribution width (RDW) can also be measured which shows if the cells are all the same or different sizes or shapes.
Platelet (thrombocyte) count. Platelets (thrombocytes) are the smallest type of blood cell. They are important in blood clotting. When bleeding occurs, the platelets swell, clump together, and form a sticky plug that helps stop the bleeding. If there are too few platelets, uncontrolled bleeding may be a problem. If there are too many platelets, there is a chance of a blood clot forming in a blood vessel. Also, platelets may be involved in hardening of the arteries (atherosclerosis).

Your doctor may order a blood smear test to be done at the same time as a CBC but it is not part of the regular CBC test. In this test, a drop of blood is spread (smeared) on a slide and stained with a special dye. The slide is looked at under a microscope. The number, size, and shape of red blood cells, white blood cells, and platelets are recorded. Blood cells with different shapes or sizes can help diagnose many blood diseases, such as leukemia, malaria, or sickle cell anemia.

What is cervical cancer?

2008-12-09T08:00:00.000+07:00

What causes cervical cancer?

What are the symptoms?

Abnormal cervical cell changes rarely cause symptoms. But you may have symptoms if those cell changes grow into cervical cancer. Symptoms of cervical cancer may include:

Bleeding from the vagina that is not normal, or a change in your menstrual cycle that you can't explain.
Bleeding when something comes in contact with your cervix, such as during sex or when you put in a diaphragm.
Pain during sex.
Vaginal discharge that is tinged with blood.

How is cervical cancer diagnosed?

Your doctor may also do a Pap test and take a sample of tissue (biopsy) if you have symptoms of cervical cancer, such as bleeding after sex.

How is it treated?

Cervical cancer that is caught early can usually be cured. If the cancer is caught very early, you still may be able to have children after treatment.

The treatment for most stages of cervical cancer removes the cancer and makes you unable to have children. These treatments include:

A hysterectomy and removal of pelvic lymph nodes with or without removal of both ovaries and fallopian tubes.
Radiation therapy.
Chemotherapy.

Depending on how much the cancer has grown, you may have one or more treatments. And you may have a combination of treatments.

Can cervical cancer be prevented?

Do Vaccines Really Cause Autism?

2008-12-09T07:29:00.000+07:00

Monalisa Health-To say there’s a big debate over autism is an understatement. More than 5,000 families have filed court claims blaming vaccine makers for their children’s autism symptoms—including serious language delays, poor social skills, and repetitive movements—yet the research to date repeatedly shows no connection between vaccines and autism. A recent court decision added fuel to the fire by awarding compensation to the family of a young girl who developed autism symptoms after being vaccinated. What’s the real story? Health asked leading autism researchers to help us figure it out.

Q: Why does there seem to be a sudden epidemic of autism?
A: Epidemic may be the wrong word. In the mid-1970s the reported rate of autism was 21 in 10,000 children, or 1 in 470. Today it’s 65 to 67 per 10,000, or 1 in 150—about a threefold increase in 30 years. While any uptick in these numbers is worrisome, scientists aren’t calling that an epidemic. Many experts believe the actual rise in autism cases (additions to the amount typically seen in the general population) is quite small. The surge in diagnoses, they say, is largely due to a broader understanding of what qualifies as autism, greater awareness of the disorder, and the increased availability of services for children with autism symptoms.

To better understand that argument, consider this: Many children who are classified as autistic today would have been diagnosed with speech disorders or mental retardation 30 years ago. Indeed, as the number of children with autism has climbed, the number diagnosed with mental retardation has dropped. “These factors could explain all of the increase in autism cases,” says autism expert Eric Fombonne, MD, head of the department of psychiatry at Montreal Children’s Hospital./By Laurie Tarkan

Can Some Breast Cancer Tumors Regress if Left Untreated?

2008-12-09T07:26:00.000+07:00

Monalisa Health-Little is known about how untreated breast cancer grows, because it would be considered unethical to not treat women with breast tumors. However, some types of cancer, such as metastatic melanoma, have been known to spontaneously regress or shrink on their own. And there have been about 32 reported cases of invasive breast cancer that have spontaneously regressed.

Could there be some type of breast tumor, as yet unknown, that’s unlikely to grow rapidly and threaten a patient’s life? Maybe, but many doctors remain skeptical.

There are reasons the study numbers don’t match, they say, including that women in the second group only had one mammogram, and there may have been more cases of cancer than were detected. Or use of hormone therapy may have differed between the two groups.

“The authors try to dismiss some of the reasons why those two numbers might not be equal and they latch on to what I think is one of the more far-fetched explanations—that a large fraction of these tumors have regressed,” says Chris Kagay, MD, a clinical fellow at Harvard School of Medicine. “The authors are making a bold proposition about the natural history of breast cancer based on pretty limited evidence.”

There’s little scientific evidence that breast cancers can regress, adds Robert A. Smith, PhD, director of Cancer Screening at the American Cancer Society. “The conclusion that more than 1 in 5 invasive breast cancers is destined to regress without incident if not detected by mammography is nothing more than an overreaching leap in logic.”

The study is also missing some important information—mortality data. Women who have routine mammograms should be less likely to die of breast cancer than women who do not have them. A follow-up study examining death rates could either confirm or dismiss the study, experts say.

“Now we’re left in this odd position of having this intriguing finding but not knowing where to go with it,” says Kaplan. “It’s important to understand that this is a pretty preliminary finding. It’s at odds with what most people believe.”

Cancer specialists worry that this type of research can be dangerous if it discourages women from having mammograms.

“It’s important to remember that mammography saves lives,” says Dr. Kagay. “Suggesting that screening is not valuable or that these cancers detected will spontaneously regress is quite frankly dangerous if it convinces women that they don’t need to be screened.”

Can Some Breast Cancer Tumors Regress if Left Untreated?

2008-12-09T07:25:00.000+07:00

Istockphoto

By Kate Stinchfield

Monalisa Health-Do more frequent mammograms pick up some breast cancer tumors that might have gone away without treatment? Possibly, according to a controversial study published this week in Archives of Internal Medicine. However, experts caution that the research raises an interesting question, but can’t definitively answer it.

In the study, a research team led by Per-Henrik Zahl, MD, of the Norwegian Institute of Public Health, looked at two groups of women from before and after Norway stepped up its mammogram screening program in 1996.

One group of 119,000 women ages 50 to 64 had mammograms every two years, for a total of three mammograms between 1996 and 2001. The researchers compared them to a second group of nearly 110,000 women who were ages 50 to 64 in 1992 but didn’t have routine mammograms. Those women had a single mammogram in 1997.

Not surprisingly, the women who had more mammograms had more cases of invasive breast cancer—if you look for cancer, you tend to find it. However, at the end of the six-year period, cases of invasive breast cancer were still 22% higher among regularly screened women, although the researchers expected the same number of cases in both groups.

They suggest that some of the tumors detected by mammography would have spontaneously regressed had they not been caught and treated.

It’s a controversial idea, but one worth considering, says Robert M. Kaplan, PhD, the chairman at UCLA’s Department of Health Services, who cowrote an editorial accompanying the study. “Our tendency was to dismiss it when we first read it, but the more we looked at it, the more we thought that maybe there is something to this.”

First Things First: Depression Is Not Your Fault and It Can Be Treated

2008-12-09T07:14:00.000+07:00

Monalisa Health-The first step to overcoming the devastating effects of depression is to see it as a disease, not a personal failing. Like other chronic diseases, depression wreaks havoc on the person who suffers as well as on her or his friends and family. The social costs are also huge: Depression is a leading cause of disability worldwide.

However, there is a lot of positive news about depression treatment: New approaches to psychotherapy and antidepressant medications help millions live with or recover from depression. And a growing network of support groups and online resources are helping to break the stigma of mental illness.

As you'll discover on this Health Journey, successful treatment is best achieved with a patient who is involved, resourceful, questioning—at precisely a time when you probably don't feel like being any of those things. Take comfort in the stories of patients who have found their way out of mental illness and be inspired by the therapists, doctors, and caregivers who have helped.

Our Depression Health Journey team includes editorial adviser Kenneth Robbins, MD, MPH; editor Amy O'Connor; research editor Michael Gollust; lead writer Mary Pinkowish; and many contributing journalists.

Low-Calorie Restaurant Meals Busted

2008-12-09T07:12:00.000+07:00

From Health magazine

Monalisa health-In a scary bit of diet detective work, a group of television stations across the country ordered “healthy” entrées from a number of chain restaurants, sent them to a lab for nutritional testing, and found out that the meals may actually contain more fat and calories than menus indicate—in some cases, two or three times more! Chili’s Guiltless Grill Salmon should have 480 calories and 14 grams of fat, for instance, but the salmon tested had 664 calories and 35 grams of fat. So how can you be sure you’re getting the diet-friendly lunch you ordered? Here, three tips from Phil Lempert, editor of SupermarketGuru.com and a food-industry expert.

Ask about oil. Chinese restaurants may use cooking oil plus sesame oil for flavor—and just one extra teaspoon will add 40 calories and 4.5 grams of fat. Ask the server to tell the chef to ditch the extra oil and substitute an extra sprinkle of herbs.

Go naked. If you order grilled fish, ask for it to be prepared without butter. Be just as specific with steamed veggies and other healthy picks.

Bring the dressing. Love salads? Bring your favorite low-cal dressing from home. Restaurant dressings on the side are OK, but use them sparingly unless you’re sure of their fat content.

(PHOTO: ISTOCKPHOTO)

Managing Bipolar Disorder's Highs and Lows

2008-12-09T07:10:00.000+07:00

Monalisa Health-Mania, the up side of bipolar disorder, is as destructive as the ensuing depression.

(HUBER-STARKE/RADIUS/MASTERFILE)

Bipolar disorder, sometimes called manic depression, affects nearly six million American adults, or about 2.5% of the adult population, according to the National Institute of Mental Health. Some patients who eventually get diagnosed spend years, even decades, cycling through institutions and switching therapists before they get the correct treatment.

Mary, a mental health advocate who lives in western Massachusetts, is one of these people. She had episodes of mild depression starting when she was in her late teens.

When these came on, a quick call to her primary care physician got her a prescription for Prozac. Each time she took antidepressants, the medications kicked her into a slightly manic state during which she was often pretty effective in her many roles at work, home, and community. "I survived that way for 20 years," she says.

Then in 2002, her world crumbled when her son, who had been diagnosed with bipolar disease at age 7, spent more than four months in a hospital while awaiting transfer to a residential mental health facility. Mary became suicidally depressed. This time her doctors reached the conclusion that she, too, had bipolar disorder.

How to Diagnose Bipolar Disorder

2008-12-09T07:09:00.000+07:00

Monalisa Health-Bipolar patients can spend one-third of their lives in a manic state.

(MIKA/ZEFA/CORBIS)

To understand bipolar disorder, think of a pendulum. People with this disease swing between episodes of depression and periods of mania.

Glenn Koons, 50, of Reading, Penn., says when he was depressed, "I totally turned inward." But when he swung into a manic phase, "You start thinking you are invincible. And in the work world, it can have a positive side, but then it spins out of control."

Steven D. Hollon, PhD, professor of psychology at Vanderbilt University in Nashville, says that manic bipolar patients can destroy their own families. "Manias are like a mildly controlled cocaine high," he says.

In full-blown mania, people may hallucinate or lose touch with reality.

Three categories of bipolar disorder exist.

Bipolar disorder I is the classic type. People have depression, get better for a time, then go into a manic episode.
Bipolar disorder II is similar. People have episodes of depression, but the manic phases aren't as serious or destructive as in bipolar I. For example, instead of being grandiose or delusional, the person may be extremely self-confident, cocky, or ambitious. These milder manic episodes are also called hypomania. In addition, people with bipolar II tend to have fewer manic episodes than people with bipolar I.
The third type of bipolar disorder is called the rapid-cycling form. People with this type have four or more episodes of depression and/or mania in a 12-month period. They may be healthy between episodes of depression and mania, or they may go directly from depression to a manic episode.

What Is Bipolar Disorder?

2008-12-09T07:08:00.000+07:00

Monalisa Health-What is bipolar disorder?
Bipolar disorder is an illness that causes extreme mood changes from manic episodes of very high energy to the extreme lows of depression. It is also called manic-depressive disorder.

This illness can cause behavior so extreme that you cannot function at work, in family or social situations, or in relationships with others. Some people with bipolar disorder become suicidal.

Having this disorder can make you feel helpless and hopeless. But you are not alone. Talking with others who suffer from it may help you learn that there is hope for a better life. And treatment can help you get back in control.

Family members often feel helpless when a loved one is depressed or manic. If your loved one has bipolar disorder, you may want to get counseling for yourself. Therapy can also help a child who has a bipolar parent.

What causes bipolar disorder?
The cause of bipolar disorder is not completely understood. We know that it runs in families. It may also be affected by your living environment or family situation. One possible cause is an imbalance of chemicals in the brain.