Astigmatism

Astigmatism

Definition  :

Astigmatism (uh-STIG-muh-tiz-um) is a common, mild and generally easily treatable imperfection in the curvature of your eye. The condition can cause blurred vision.

Astigmatism occurs when the front surface of your eye (cornea) or the lens, inside your eye, has a slightly different surface curvature in one direction from the other. Instead of being even and smooth in all directions, the surface may have some areas that are flatter or steeper.

Astigmatism blurs your vision at all distances. Astigmatism is often present at birth and may occur in combination with nearsightedness or farsightedness. Often it's not pronounced enough to require corrective action. When it is, your treatment options include corrective lenses and surgery.


Symptoms:

Signs and symptoms of astigmatism may include:

• Blurred or distorted vision
• Eyestrain
• Headaches

When to see a doctor
If your quality of vision detracts from your enjoyment of activities or interferes with your ability to perform everyday tasks, see an eye doctor. An eye doctor can determine whether you have astigmatism, and if so, to what degree. He or she can then advise you of your options to correct your vision.

If you're a healthy adult older than 40, have your eyes examined about every two to four years until age 55. After age 55, have them checked every one to three years for signs of eye disease or problems, and then every one to two years after age 65. If you have eye problems, such as astigmatism, you may need to have your eyes checked more frequently. If you're at risk of certain eye diseases, such as glaucoma, or you have diabetes, check with your doctor to see how often you need to have your eyes examined.


Causes:

Your eye has two parts that focus images — the cornea and the lens. In a perfectly shaped eye, each of these focusing elements has a perfectly smooth curvature, like the surface of a smooth ball. A cornea or lens with such a surface curvature bends (refracts) all incoming light the same way and makes a sharply focused image on the back of your eye (retina).

However, if your cornea or lens isn't evenly and smoothly curved, the light rays aren't refracted properly. This causes a refractive error. Astigmatism is one type of refractive error. In astigmatism, your cornea or lens is curved more steeply in one direction than in another. When the cornea has a distorted shape, you have corneal astigmatism. When the lens is distorted, you have lenticular astigmatism. Either type of astigmatism can cause blurred vision. Blurred vision may occur more in one direction — either horizontally, vertically or diagonally.

Astigmatism may occur in combination with other refractive errors, which include:

• Nearsightedness (myopia). This occurs when your cornea is curved too much or your eye is longer than normal. Instead of being focused precisely on your retina, light is focused in front of your retina, resulting in a blurry appearance for distant objects.
  
• Farsightedness (hyperopia). This occurs when your cornea is curved too little or your eye is shorter than normal. The effect is the opposite of nearsightedness. When your eye is in a relaxed state, light is focused behind the back of your eye, making nearby objects blurry.

Astigmatism may be present from birth, or it may develop after an eye injury, disease or surgery. Astigmatism isn't caused or made worse by reading in poor light, sitting too close to the television or squinting.


Treatments and drugs:

The goal of treating astigmatism is to address the uneven curvature that's causing your blurred vision. Treatments include wearing corrective lenses and undergoing refractive surgery.

Corrective lenses
Wearing corrective lenses treats astigmatism by counteracting the uneven curvature of your cornea. Types of corrective lenses are:

• Eyeglasses. Eyeglasses can be made with special lenses that help compensate for the uneven shape of your eye. In addition to correcting astigmatism, eyeglasses can also correct for other refractive errors, such as nearsightedness or farsightedness.
  
• Contact lenses. Like eyeglasses, contact lenses can correct astigmatism. A wide variety of contact lenses are available — hard, soft, extended wear, disposable, rigid gas permeable and bifocal. Ask your eye doctor about the pros and cons of each and which contact lenses might be best for you.
  
  Contact lenses are also used in a procedure called orthokeratology, or Ortho-K. In orthokeratology, you wear rigid contact lenses for several hours a day until the curvature of your eye improves. Then, you wear the lenses less frequently to maintain the new shape. If you discontinue this treatment, your eyes return to their former shape. Wearing contact lenses for extended periods of time increases the risk of infection in the eye.
  

Refractive surgery
This astigmatism treatment method corrects the problem by reshaping the surface of your eye. Refractive surgery methods include:

• LASIK surgery. Laser-assisted in-situ keratomileusis (LASIK) is a procedure in which a doctor uses an instrument called a keratome to make a thin, circular hinged cut into your cornea. Alternatively, this same cut can be made with a special cutting laser. The surgeon lifts the flap and then uses an excimer laser to sculpt the shape of the cornea under the flap. An excimer laser differs from other lasers in that it doesn't produce heat.
  
• Photorefractive keratectomy (PRK). In PRK, your surgeon removes the outer protective layer of the cornea before using an excimer laser to change the curvature of the cornea.
  
• Laser-assisted subepithelial keratomileusis (LASEK). In this procedure, a much thinner layer of cornea is folded back, which makes your eye less vulnerable to damage should an injury occur. LASEK may be a better option if you have a thin cornea or if you're at high risk of an eye injury at work or from playing sports.

Radial keratotomy is a procedure that was used in the past to correct astigmatism. However, it's not commonly performed anymore.

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Asthma

Asthma

Definition:

Asthma is a condition in which your airways narrow and swell and produce extra mucus. This can make breathing difficult and trigger coughing, wheezing and shortness of breath.

For some people, asthma is a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack.

Asthma can't be cured, but its symptoms can be controlled. Because asthma often changes over time, it's important that you work with your doctor to track your signs and symptoms and adjust treatment as needed

Symptoms:

Asthma symptoms range from minor to severe and vary from person to person. You may have infrequent asthma attacks, have symptoms only at certain times — such as when exercising — or have symptoms all the time.
Asthma signs and symptoms include:

• Shortness of breath
• Chest tightness or pain
• Trouble sleeping caused by shortness of breath, coughing or wheezing
• A whistling or wheezing sound when exhaling (wheezing is a common sign of asthma in children)
• Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu

Signs that your asthma is probably worsening include:

• Asthma signs and symptoms that are more frequent and bothersome
• Increasing difficulty breathing (measurable with a peak flow meter, a device used to check how well your lungs are working)
• The need to use a quick-relief inhaler more often

For some people, asthma symptoms flare up in certain situations:

• Exercise-induced asthma, which may be worse when the air is cold and dry
• Occupational asthma, triggered by workplace irritants such as chemical fumes, gases or dust
• Allergy-induced asthma, triggered by particular allergens, such as pet dander, cockroaches or pollen

When to see a doctor
Seek emergency treatment
Severe asthma attacks can be life-threatening. Work with your doctor ahead of time to determine what to do when your signs and symptoms worsen — and when you need emergency treatment. Signs of an asthma emergency include:

• Rapid worsening of shortness of breath or wheezing
• No improvement even after using a quick-relief inhaler, such as albuterol
• Shortness of breath when you are doing minimal physical activity

Contact your doctor

• If you think you have asthma. If you have frequent coughing or wheezing that lasts more than a few days or any other signs or symptoms of asthma, see your doctor. Treating asthma early may prevent long-term lung damage and help keep the condition from worsening over time.
  
• To monitor your asthma after diagnosis. If you know you have asthma, work with your doctor to keep it under control. Good long-term control helps you feel better on a daily basis and can prevent a life-threatening asthma attack.
  
• If your asthma symptoms get worse. Contact your doctor right away if your medication doesn't seem to ease your symptoms or if you need to use your quick-relief inhaler more often. Don't try to solve the problem by taking more medication without consulting your doctor. Overusing asthma medication can cause side effects and may make your asthma worse.
  
• To review your treatment. Asthma often changes over time. Meet with your doctor on a regular basis to discuss your symptoms and make any needed treatment adjustments.

Causes:

It isn't clear why some people get asthma and others don't, but it's probably due to a combination of environmental and genetic (inherited) factors.

Asthma triggers
Exposure to various substances that trigger allergies (allergens) and irritants can trigger signs and symptoms of asthma. Asthma triggers are different from person to person and can include:

• Airborne allergens, such as pollen, animal dander, mold, cockroaches and dust mites
• Allergic reactions to some foods, such as peanuts or shellfish
• Respiratory infections, such as the common cold
• Physical activity (exercise-induced asthma)
• Cold air
• Air pollutants and irritants, such as smoke
• Certain medications, including beta blockers, aspirin, ibuprofen (Advil, Motrin, others) and naproxen (Aleve)
• Strong emotions and stress
• Sulfites and preservatives added to some types of foods and beverages
• Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat
• Menstrual cycle in some women

Complications:

Asthma complications include:

• Symptoms that interfere with sleep, work or recreational activities
• Sick days from work or school during asthma flare-ups
• Permanent narrowing of the bronchial tubes (airway remodeling) that affects how well you can breathe
• Emergency room visits and hospitalizations for severe asthma attacks
• Side effects from long-term use of some medications used to stabilize severe asthma

Proper treatment makes a big difference in preventing both short-term and long-term complications caused by asthma.

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Aspergillosis

Aspergillosis

Definition:

Aspergillosis is a group of illnesses caused by a certain type of mold. These illnesses usually affect the respiratory system. The mold that triggers the illnesses, aspergillus, occurs widely indoors and outdoors. Most strains of this mold are harmless. But a few can cause serious illnesses when their

spores are inhaled by people with a weakened immune system, underlying lung disease or asthma.

In some people, the spores trigger an allergic reaction. Other people develop mild to serious lung infections. The most serious form of aspergillosis — invasive aspergillosis — occurs when the infection spreads to blood vessels and beyond.

Depending on the type of aspergillosis, treatment may involve observation, antifungal medications or, in rare cases, surgery.

Symptoms:

The signs and symptoms of aspergillosis vary with the type of illness you develop:

Allergic reaction
Some people with asthma or cystic fibrosis have an allergic reaction to aspergillus mold. Signs and symptoms of this condition, known as allergic bronchopulmonary aspergillosis, include:

• Fever
• A cough that may bring up blood or plugs of mucus
• Worsening asthma

Fungal mass
A growth of tangled fungus fibers (fungus ball) may develop if there are air spaces (cavities) in the lungs. This type of aspergillosis is called aspergilloma. Lung cavities may develop in people with pre-existing lung conditions, such as emphysema, tuberculosis or advanced sarcoidosis. Aspergilloma is a benign condition that may not initially produce symptoms, but over time it can cause:

• A cough that often brings up blood (hemoptysis), sometimes large amounts
• Wheezing
• Shortness of breath
• Unintentional weight loss
• Fatigue

Infection
The most severe form of aspergillosis, invasive pulmonary aspergillosis, occurs when the infection spreads rapidly from the lungs through your bloodstream to your brain, heart, kidneys or skin. This occurs only in people whose immune system is weakened, commonly from chemotherapy. Signs and symptoms depend on which organs are affected, but in general, invasive aspergillosis can cause:

• Fever and chills
• Cough that brings up blood-streaked sputum (hemoptysis)
• Severe bleeding from your lungs
• Shortness of breath
• Chest or joint pain
• Nosebleed
• Facial swelling on one side
• Skin lesions

Other types of aspergillosis
In addition to your lungs, aspergillus can invade other areas of the body, such as your sinuses. In your sinuses, it can cause a stuffy nose, drainage (possibly bloody), inflammation, fever, facial pain and headache.

When to see a doctor
If you have asthma or cystic fibrosis, see your doctor whenever you notice a change in your symptoms. Although aspergillosis may not be the cause, it's important to have any problems evaluated. If you have a weakened immune system and develop an unexplained fever, shortness of breath or a cough that brings up blood, get immediate medical care. In the case of invasive aspergillosis, prompt treatment is so crucial that treatment is often started before the infection is diagnosed.

Causes:


Aspergillus mold is virtually unavoidable. Outdoors, it's found in decaying leaves and compost and on plants, trees and grain crops. Inside, the spores — the reproductive parts of mold — thrive in air conditioning and heating ducts, insulation, and some food and spices. Aspergillus is so common in old buildings, even in older hospitals, that small epidemics have occurred among people with weakened immune systems when nearby buildings have been torn down.

Everyday exposure to aspergillus is rarely a problem for people with healthy immune systems. When mold spores are inhaled, immune system cells simply surround and destroy them. But people who have a weakened immune system from illness or immunosuppressant medications have fewer infection-fighting cells. This allows aspergillus to take hold, invading the lungs and, in the most serious cases, other parts of the body.

Aspergillosis is not contagious from person to person.

Complications:

Depending on the type of infection, aspergillosis can cause a variety of serious complications:

• Bone destruction and spread of infection. An aspergillus infection in your sinuses can destroy facial bones. It can also spread beyond your sinuses and may be life-threatening if you have a weakened immune system.
  
• Bleeding. Both aspergillomas and invasive aspergillosis can cause severe, and sometimes fatal, bleeding in your lungs.
  
• Systemic infection. The most serious complication of invasive aspergillosis is the spread of the infection to other parts of your body, especially your brain, heart and kidneys. Invasive aspergillosis spreads rapidly and is often fatal in spite of early treatment.

Treatments and drugs:

Aspergillosis treatments vary with the type of disease. Possible treatments include:

• Observation. Aspergillomas often don't need treatment, and medications aren't usually effective in treating these fungal masses. Instead, aspergillomas that don't cause symptoms may simply be closely monitored by chest X-ray.
  
• Oral corticosteroids. The goal in treating allergic bronchopulmonary aspergillosis is to prevent existing asthma or cystic fibrosis from becoming worse. The best way to do this is with oral corticosteroids. Antifungal medications by themselves aren't helpful for allergic bronchopulmonary aspergillosis, but they may be used in combination with corticosteroids to reduce the dose of steroids and improve lung function.
  
• Antifungal medications. These drugs are the standard treatment for invasive pulmonary aspergillosis. Historically, the drug of choice has been amphotericin B, but the newer medication voriconazole (Vfend) is now preferred because it appears more effective and may have fewer side effects. All antifungals can cause serious problems, however, including kidney and liver damage, and they frequently interact with other medications given to people who have weakened immune systems.
  
• Surgery. Because antifungal medications don't penetrate aspergillomas very well, surgery to remove the fungal mass is the first-choice treatment when bleeding from the mass in the lungs occurs. But the surgery is risky, and your doctor may instead suggest embolization. In this procedure, your doctor, usually a radiologist, threads a small catheter into the artery that supplies blood to the cavity containing the fungus ball, and injects a special material that clogs the artery. Though this procedure can stop massive bleeding, it doesn't prevent it from recurring, so it's generally considered a temporary treatment.

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Asperger's syndrome

Asperger's syndrome

Definition:

Asperger's syndrome is a developmental disorder that affects a person's ability to socialize and communicate effectively with others. Children with Asperger's syndrome typically exhibit social awkwardness and an all-absorbing interest in specific topics.

Doctors group Asperger's syndrome with other conditions that are called autistic spectrum disorders or pervasive developmental disorders. These disorders all involve problems with social skills and communication. Asperger's syndrome is generally thought to be at the milder end of this spectrum.
While there's no cure for Asperger's syndrome, if your child has the condition treatment can help him or her learn how to interact more successfully in social situations

Symptoms:

Asperger's syndrome symptoms include:

• Engaging in one-sided, long-winded conversations, without noticing if the listener is listening or trying to change the subject
• Displaying unusual nonverbal communication, such as lack of eye contact, few facial expressions, or awkward body postures and gestures
• Showing an intense obsession with one or two specific, narrow subjects, such as baseball statistics, train schedules, weather or snakes
• Appearing not to understand, empathize with or be sensitive to others' feelings
• Having a hard time "reading" other people or understanding humor
• Speaking in a voice that is monotonous, rigid or unusually fast
• Moving clumsily, with poor coordination

Unlike children with more-severe forms of autism spectrum disorders, those with Asperger's syndrome usually don't have delays in the development of language skills. That means your child will use single words by the age of 2 and phrases by the time he or she is 3 years old. But, children with Asperger's syndrome may have difficulties holding normal conversations. Conversations may feel awkward and lack the usual give and take of normal social interactions.

Toddlers and school-age children with Asperger's syndrome may not show an interest in friendships. Youngsters with Asperger's often have developmental delays in their motor skills, such as walking, catching a ball or playing on playground equipment.

In early childhood, kids with Asperger's may be quite active. By young adulthood, people with Asperger's syndrome may experience depression or anxiety.

When to see a doctor
All kids have their quirks, and many toddlers show a sign or symptom of Asperger's syndrome at some point. It's natural for small children to be egocentric, and many children show a strong interest in a particular topic, such as dinosaurs or a favorite fictional character. These generally aren't reasons to be alarmed.

However, if your elementary schoolchild has frequent problems in school or seems unable to make friends, it's time to talk with your child's doctor. These difficulties have many possible causes, but developmental disorders such as Asperger's syndrome need to be considered. Children who have behaviors that interfere with learning and social development should have a comprehensive evaluation.


Causes:

It's not clear what causes Asperger's syndrome, although changes in certain genes may be involved. The disorder also seems to be linked to changes in the structure of the brain.
One factor that isn't associated with the development of Asperger's syndrome or other autism spectrum disorders is childhood immunizations.


Treatments and drugs:

The core signs of Asperger's syndrome can't be cured. However, many children with Asperger's syndrome grow into happy and well-adjusted adults.
Most children benefit from early specialized interventions that focus on behavior management and social skills training. Your doctor can help identify resources in your area that may work for your child.

Asperger's syndrome treatment options may include:


Communication and social skills training
Children with Asperger's syndrome may be able to learn the unwritten rules of socialization and communication when taught in an explicit and rote fashion, much like the way students learn foreign languages. Children with Asperger's syndrome may also learn how to speak in a more natural rhythm, as well as how to interpret communication techniques, such as gestures, eye contact, tone of voice, humor and sarcasm.

Cognitive behavioral therapy
This general term encompasses many techniques aimed at curbing problem behaviors, such as interrupting, obsessions, meltdowns or angry outbursts, as well as developing skills such as recognizing feelings and coping with anxiety. Cognitive behavioral therapy usually focuses on training a child to recognize a troublesome situation — such as a new place or an event with lots of social demands — and then select a specific learned strategy to cope with the situation.

Medication
There are no medications that specifically treat Asperger's syndrome. But some medications may improve specific symptoms — such as anxiety, depression or hyperactivity — that can occur in many children with Asperger's syndrome. Examples include:

• Aripiprazole (Abilify). This drug may be effective for treating irritability related to Asperger's syndrome. Side effects may include weight gain and an increase in blood sugar levels.
  
• Guanfacine (Intuniv). This medication may be helpful for the problems of hyperactivity and inattention in children with Asperger's syndrome. Side effects may include drowsiness, irritability, headache, constipation and bedwetting.
  
• Selective serotonin reuptake inhibitors (SSRIs). Drugs such as fluvoxamine (Luvox) may be used to treat depression or to help control repetitive behaviors. Possible side effects include restlessness and agitation.
  
• Risperidone (Risperdal). This medication may be prescribed for agitation and irritability. It may cause trouble sleeping, a runny nose and an increased appetite. This drug has also been associated with an increase in cholesterol and blood sugar levels.
  
• Olanzapine (Zyprexa). Olanzapine is sometimes prescribed to reduce repetitive behaviors. Possible side effects include increased appetite, drowsiness, weight gain, and increased blood sugar and cholesterol levels.
  
• Naltrexone (Revia). This medication, which is sometimes used to help alcoholics stop drinking, may help reduce some of the repetitive behaviors associated with Asperger's syndrome. However, the use of low-dose naltrexone — in doses as low as two to four mg a day — has been gaining favor recently. But, there's no good evidence that such low doses have any effect on Asperger's syndrome.

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Ascariasis

Ascariasis

Definition  :

Ascariasis (as-kuh-RIE-uh-sis) is a type of roundworm infection. These worms are parasites that use your body as a host to mature from larvae or eggs to adult worms and reproduce. Adult worms can be more than a foot (30 centimeters) long.

Ascariasis is one of the most common human worm infections worldwide, although it's uncommon in the United States. Because most people have such mild cases of ascariasis, they have no symptoms. But when your body is infested with hundreds of worms, serious symptoms and complications can occur.

Ascariasis occurs most often in young children and is most prevalent in tropical and subtropical regions of the world — especially in areas where sanitation and hygiene are poor. In the United States, ascariasis is most likely to occur in rural areas of the Southeast.


Symptoms:

Most people infected with ascariasis have no symptoms. Moderate to heavy infestations cause symptoms that may vary, depending on which part of your body is affected.

In the lungs
After you ingest the microscopic ascariasis eggs, they hatch in your small intestine and the larvae migrate through your bloodstream or lymphatic system into your lungs. At this stage, you may experience signs and symptoms similar to asthma or pneumonia, including:

• Persistent cough
• Shortness of breath
• Wheezing

After spending six to 10 days in the lungs, the larvae travel to your throat, where you cough them up and then swallow them.

In the intestines
The larvae mature into adult worms in your small intestine, and the adult worms typically live in the intestines until they die. In mild or moderate ascariasis, the intestinal infestation can cause:

• Vague abdominal pain
• Nausea and vomiting
• Diarrhea or bloody stools

If you have a heavy intestinal infestation — a large number of worms — you may experience:

• Severe abdominal pain
• Fatigue
• Vomiting
• Weight loss
• A worm in vomit or stool

When to see a doctor
Consult your doctor if you have persistent abdominal pain, diarrhea or nausea.


Causes:

Ascariasis isn't spread directly from person to person. Instead, a person has to come into contact with soil mixed with human feces that contain ascaris eggs. In many developing countries, human feces are used for fertilizer or poor sanitary facilities allow human waste to mix with local soil in yards, ditches and fields.

Because small children often play in dirt, infection can occur if they put their dirty fingers in their mouths. Unwashed fruits or vegetables grown in contaminated soil also can transmit the microscopic eggs that cause ascariasis.
Life cycle of a worm

• Ingestion. The microscopic ascariasis eggs can't become infective without coming into contact with soil. People can accidentally ingest contaminated soil through hand-to-mouth contact or by eating uncooked fruits or vegetables that have been grown in contaminated soil.
  
• Migration. Larvae hatch from the eggs in your small intestine and then penetrate the intestinal wall to travel to your lungs via your bloodstream or lymphatic system. After maturing for about a week in your lungs, the larvae break into your airway and travel up your throat, where they're coughed up and swallowed.
  
• Maturation. Once back in the intestines, the parasites grow into male or female worms. Female worms can be more than 15 inches (40 centimeters) long and a little less than a quarter inch (6 millimeters) in diameter. Male worms are generally smaller.
  
• Reproduction. Male and female worms mate in the small intestine. Female worms can produce 200,000 eggs a day. You expel the eggs in your feces. The fertilized eggs must be in soil for at least 18 days before they become infective.

The whole process — from egg ingestion to egg deposits — takes about two or three months. Ascariasis worms can live inside you for a year or two.


Complications:

Mild cases of ascariasis usually don't cause complications. If you have a heavy infestation, potentially dangerous complications may include:

• Nutritional deficiencies. Children with ascariasis are especially at risk of nutritional deficiencies. Loss of appetite and insufficient absorption of digested foods can occur. 
  
• Intestinal blockage and perforation. In heavy ascariasis infestation, a mass of worms can block a portion of your intestine, causing severe abdominal cramping and vomiting. The blockage can even perforate the intestinal wall or appendix, causing internal bleeding (hemorrhage ) or appendicitis.
  
• Duct blockages. In some cases, worms may block the narrow ducts of your liver or pancreas, causing severe pain. 

Treatments and drugs:

While symptomatic infections usually warrant treatment, infections with no symptoms typically don't need to be treated. In some cases, ascariasis will resolve on its own. This occurs when there are no male worms to mate with females, and the females eventually die.

Medications
Anti-parasite medications are the first line of treatment against ascariasis. The most common are:

• Albendazole (Albenza)
• Ivermectin (Stromectol)
• Mebendazole

These medications work by killing the adult worms. Each medication can be taken as a single dose. Side effects include mild abdominal pain or diarrhea.

Surgery
In cases of heavy infestation, surgery may be necessary to repair damage the worms have caused and to remove worms. Intestinal obstruction or perforation, bile duct obstruction, and appendicitis are complications that may require surgery.

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Asbestosis

Asbestosis

Definition:

Asbestosis (as-bes-TOE-sis) is a breathing disorder caused by inhaling asbestos fibers. Prolonged accumulation of these fibers in your lungs can cause scarring of lung tissue and shortness of breath. Asbestosis symptoms can range from mild to severe, and usually don't appear until many years after exposure.

Asbestos is a natural mineral product that's resistant to heat and corrosion. It was used extensively in the past in products such as insulation, fire-retardant materials, cement, and some vinyl floor tiles.
Most people with asbestosis acquired it on the job before the federal government began regulating the use of asbestos and asbestos products in the mid-1970s. Today, its handling is strictly regulated. Acquiring asbestosis is extremely unlikely if you follow your employer's safety procedures. Treatment focuses on relieving your symptoms.

Symptoms:

The effects of long-term exposure to asbestos typically don't show up for at least 20 to 30 years after initial exposure. Asbestosis signs and symptoms include:

• Shortness of breath. The main symptom of asbestosis is shortness of breath. Initially, the shortness of breath occurs only with exertion, but eventually it will happen even while you're resting.
  
• Coughing and chest pain. As the disease progresses, you may experience a persistent dry cough and intermittent chest pain.
  
• Finger deformity. Advanced cases of asbestosis sometimes result in a finger deformity called clubbing, where the tips of the fingers spread out and become rounder. Many other types of health problems also can cause clubbing.

When to see a doctor
If you have a history of exposure to asbestos and you're experiencing increasing shortness of breath, talk to your doctor about the possibility of asbestosis.

Causes:

If you are exposed to high levels of asbestos dust over a long period of time, some of the airborne fibers can become lodged within your alveoli — the tiny sacs inside your lungs where oxygen is exchanged for carbon dioxide in your blood. The asbestos fibers irritate and scar lung tissue, interfering with its ability to deliver oxygen to your blood.

As asbestosis progresses, more and more lung tissue becomes scarred. Eventually, your lung tissue becomes so stiff that it can't contract and expand normally.

Smoking cigarettes appears to increase the retention of asbestos fibers in the lungs, and often results in a faster progression of the disease.

Complications:

If you smoke and have asbestosis, your chance of developing lung cancer increases greatly. Tobacco smoke and asbestos both appear to contribute to each other's cancer-causing effects.

Treatments and drugs:

There's no treatment to reverse the effects of asbestos on the alveoli. Treatment focuses on preventing progression of the disease and relieving symptoms.

Medications
People who have asbestosis-related breathing problems are sometimes helped by the use of prescription inhalers more commonly used by people who have asthma.

Therapy
To ease difficulty breathing, your doctor may prescribe supplemental oxygen, which is delivered by thin plastic tubing that has two prongs that fit into your nostrils.

Surgery
If your symptoms are severe, you may be a candidate for a lung transplant.

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Arthritis

Arthritis

Definition:

Arthritis is inflammation of one or more of your joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. The two most common types of arthritis are osteoarthritis and rheumatoid arthritis.

Osteoarthritis is usually caused by normal wear and tear, while rheumatoid arthritis is an autoimmune disorder. Other types of arthritis can be caused by uric acid crystals, infections or even an underlying disease — such as psoriasis or lupus.

Treatments vary, depending on the type of arthritis. The main goals of arthritis treatments are to reduce symptoms and improve quality of life.

Symptoms:

The most common signs and symptoms of arthritis involve the joints. Depending on the type of arthritis you have, your signs and symptoms may include:

• Pain
• Stiffness
• Swelling
• Redness
• Decreased range of motion

Causes:

The pain associated with arthritis is caused by joint damage. Joints are made up of the following parts:

• Cartilage. A hard, but slick, coating on the ends of bones, cartilage allows bones of the joint to slide smoothly over each other.
  
• Joint capsule. This tough membrane encloses all the joint parts.
  
• Synovium. This thin membrane lines the joint capsule and secretes synovial fluid, which lubricates the joint and nourishes the cartilage.

How arthritis damages joints
The two main types of arthritis damage joints in different ways.

• Osteoarthritis. In osteoarthritis, wear-and-tear damage to cartilage can result in bone grinding directly on bone, which causes pain and restricts movement. This wear and tear can occur over many years, or it can be hastened by a joint injury or infection.
  
• Rheumatoid arthritis. In rheumatoid arthritis, the body's immune system attacks joints and inflames the synovium, causing swelling, redness and pain. The disease can eventually destroy cartilage and bone within the joint.

Complications:
 Severe arthritis, particularly if it affects your hands or arms, can make it difficult for you to take care of daily tasks. Arthritis of weight-bearing joints can keep you from walking comfortably or sitting up straight. In some cases, joints may become twisted and deformed.


Treatments and drugs:

Arthritis treatment focuses on relieving symptoms and improving joint function. You may need to try several different treatments, or combinations of treatments, before you determine what works best for you.

Medications
The medications used to treat arthritis vary, depending on the type of arthritis. Commonly used arthritis medications include:

• Analgesics. These types of medications help reduce pain, but have no effect on inflammation. Examples include acetaminophen (Tylenol, others), tramadol (Ultram, Ryzolt) and narcotics containing oxycodone (Percocet, Oxycontin, others) or hydrocodone (Vicodin, Lortab, others).
  
• Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs reduce both pain and inflammation. Over-the-counter NSAIDs include ibuprofen (Advil, Motrin, others) and naproxen (Aleve). Some types of NSAIDs are available only by prescription. Oral NSAIDs can cause stomach irritation, and some may increase your risk of heart attack or stroke. Some NSAIDs are also available as creams or gels, which can be rubbed on joints.
  
• Counterirritants. Some varieties of creams and ointments contain menthol or capsaicin, the ingredient that makes hot peppers spicy. Rubbing these preparations on the skin over your aching joint may interfere with the transmission of pain signals from the joint itself.
  
• Disease-modifying antirheumatic drugs (DMARDs). Often used to treat rheumatoid arthritis, DMARDs slow or stop your immune system from attacking your joints. Examples include methotrexate (Trexall) and hydroxychloroquine (Plaquenil).
  
• Biologics. Typically used in conjunction with DMARDs, biologic response modifiers are genetically engineered drugs that target various protein molecules that are involved in the immune response. Examples include etanercept (Enbrel) and infliximab (Remicade).
  
• Corticosteroids. This class of drug, which includes prednisone and cortisone, reduces inflammation and suppresses the immune system. Corticosteroids can be taken orally or be injected directly into the painful joint.

Therapy
Physical therapy can be helpful for some types of arthritis. Exercises can improve range of motion and strengthen the muscles surrounding joints. In some cases, splints or braces may be warranted.

Surgery
If conservative measures don't help, your doctor may suggest surgery, such as:

• Joint replacement. This procedure removes your damaged joint and replaces it with an artificial one. Joints most commonly replaced are hips and knees.
• Joint fusion. This procedure is more often used for smaller joints, such as those in the wrist, ankle and fingers. It removes the ends of the two bones in the joint and then locks those ends together until they heal into one rigid unit.

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