Osteoporosis Causes

Osteoporosis occurs when there is an imbalance between new bone formation and old bone resorption. The body may fail to form enough new bone, or too much old bone may be reabsorbed, or both. Two essential minerals for normal bone formation are calcium and phosphate. Throughout youth, the body uses these minerals to produce bones. Calcium is essential for proper functioning of the heart, brain, and other organs. To keep those critical organs functioning, the body reabsorbs calcium that is stored in the bones to maintain blood calcium levels. If calcium intake is not sufficient or if the body does not absorb enough calcium from the diet, bone production and bone tissue may suffer. Thus, the bones may become weaker, resulting in brittle and fragile bones that can break easily. Usually, the loss of bone occurs over an extended period of years. Often, a person will sustain a fracture before becoming aware that the disease is present. By then, the disease may be in its advanced stages and damage may be serious. The leading cause of osteoporosis is a lack of certain hormones, particularly estrogen in women and androgen in men. Women, especially those older than 60 years of age, are frequently diagnosed with the disease. Menopause is accompanied by lower estrogen levels and increases a woman's risk for osteoporosis. Other factors that may contribute to bone loss in this age group include inadequate intake of calcium and vitamin D, lack of weight-bearing exercise, and other age-related changes in endocrine functions (in addition to lack of estrogen). Other conditions that may lead to osteoporosis include overuse of corticosteroids (Cushing syndrome), thyroid problems, lack of muscle use, bone cancer, certaingenetic disorders, use of certain medications, and problems such as low calcium in the diet.

The following are risk factors for osteoporosis:

Women are at a greater risk than men, especially women who are thin or have a small frame, as are those of advanced age.
o

Women who are white or Asian, especially those with a family member with osteoporosis, have a greater risk of developing osteoporosis than other women.
o

Women who are postmenopausal, including those who have had early or surgically induced menopause, or abnormal or absence of menstrualperiods are at greater risk.
o

Cigarette smoking, eating disorders such as anorexia nervosa or bulimia, low amounts of calcium in the diet, heavy alcohol consumption, inactive lifestyle, and use of certain medications, such as corticosteroids and anticonvulsants, are also risk factors.
o o

Rheumatoid arthritis itself is a risk factor for osteoporosis. Having a parent that has/had osteoporosis is a risk factor for the

offspring.

Osteoporosis Symptoms
Early in the course of the disease, osteoporosis may cause no symptoms. Later, it may cause dull pain in the bones or muscles, particularly low back pain or neck pain. Later in the course of the disease, sharp pains may come on suddenly. The pain may not radiate (spread to other areas); it may be made worse by activity that puts weight on the area, may be accompanied by tenderness, and generally begins to subside in one week. Pain may linger more than three months. People with osteoporosis may not even recall a fall or other trauma that might cause a broken bone, such as in the spine or foot. Spinal compression fractures may result in loss of height with a stooped posture (called adowager's hump). Fractures at other sites, commonly the hip or bones of the wrist, usually result from a fall.

Prevention
Building strong bones during childhood and adolescence can be the best defense against developing osteoporosis later. The average woman has acquired 98% of her skeletal mass by 30 years of age. There are four steps to prevent osteoporosis. No one step alone is enough to prevent osteoporosis.

Eat a balanced diet rich in calcium and vitamin D.

Engage in weight-bearing exercise.

Adopt a healthy lifestyle with no smoking or excessive alcohol intake.

Take medication to improve bone density when appropriate.

HIV/AIDS Symptoms and Signs

Many people with HIV do not know they are infected. In the United States, it is likely that 20% of HIV-positive individuals are unaware of their infection.

Many people do not develop symptoms after they first get infected with HIV. Others have a history of a flu-like illness within several days to weeks after exposure to the virus. Early HIV symptoms also includefever, headache, tiredness, and enlarged lymph nodes in the neck. These symptoms usually disappear on their own within a few weeks. After that, the person feels normal and has no symptoms. This asymptomatic phase often lasts for years. The progression of disease varies widely among individuals. This state may last from a few months to more than 10 years. During this period, the virus continues to multiply actively and infects and kills the cells of the immune system. o The virus destroys the cells that are the primary infection fighters, a type of white blood cell called CD4 cells. o Even though the person has no symptoms, he or she is contagious and can pass HIV to others through the routes listed above.

AIDS is the later stage of HIV infection, when the body begins losing its ability to fight infections. Once the CD4 cell count falls low enough, an infected person is said to have AIDS. Sometimes, the diagnosis of AIDS is made because the person has unusual infections or cancers that show how weak the immune system is. The infections that happen with AIDS are called opportunistic infections because they take advantage of the opportunity to infect a weakened host. The infections include (but are not limited to) o pneumonia caused by Pneumocystis, which causes wheezing; o brain infection with toxoplasmosis which can cause trouble thinking or symptoms that mimic a stroke; o widespread infection with a bacteria called MAC (mycobacterium avium complex) which can cause fever and weight loss; o yeast infection of the swallowing tube (esophagus) which causes pain with swallowing; o widespread diseases with certain fungi like histoplasmosis, which can cause fever, cough, anemia, and other problems. A weakened immune system can also lead to other unusual conditions: o lymphoma in (a form of cancer of the lymphoid tissue) in the brain, which can cause fever and trouble thinking; o a cancer of the soft tissues called Kaposi's sarcoma, which causes brown, reddish, or purple spots that develop on the skin or in the mouth.

HIV Prevention
Despite significant efforts, there is no effective vaccine against HIV. The only way to prevent infection by the virus is to avoid behaviors that put you at risk, such as sharing needles or having unprotected sex. In this context, unprotected sex means sex without a barrier such as a condom. Because condoms break, even they are not perfect protection. Many people infected with HIV don't have any symptoms. There is no way to know with certainty whether a sexual partner is infected. Here are some prevention strategies: Abstain from sex. This obviously has limited appeal, but it absolutely protects against HIV transmission by this route. Have sex with a single partner who is uninfected. Mutual monogamy between uninfected partners eliminates the risk of sexual transmission of HIV. Use a condom in other situations. Condoms offer some protection if used properly and consistently. Occasionally, they may break or leak. Only condoms made of latex should be used. Only water-based lubricants should be used with latex condoms. Do not share needles or inject illicit drugs. If you work in a health-care field, follow recommended guidelines for Protecting yourself against needle sticks and exposure to contaminated fluids. If you have engaged in risky behaviors, get tested to see if you have HIV. The risk of HIV transmission from a pregnant woman to her baby is significantly reduced if the mother takes medications during pregnancy, labor, and delivery and her baby takes medications for the first six weeks of life. Even shorter courses of treatment are effective, though not as optimal. The key is to get tested for HIV as early as possible in pregnancy. In consultation with their physician, many women opt to avoid breastfeeding to minimize the risk of transmission after the baby is born.

Human Immunodeficiency Virus (HIV) Infection Causes

The infection is caused by the human immunodeficiency virus (HIV). After HIV is in the body, it attacks and destroys CD4+ cells, which are the part of the body's immune system that fights infection and disease. When HIV weakens or destroys the immune cells, it may lead to certain illnesses or diseases, such as some types of pneumonia or cancer that are more likely to develop in someone who has a weakened immune system. These conditions are a sign that HIV has progressed to AIDS. HIV is spread when blood, semen, or vaginal fluids from an infected person enter another person's body, usually through sexual contact, from sharing needles when injecting drugs, or from mother to baby during birth. HIV is rarely spread by blood transfusions or organ transplants in the United States because of improved screening procedures.

HIV: Skin Effects Several of the main skin conditions that affect people with HIV are caused by viruses most people already have in their bodies. However, these viruses typically do not cause disease in people whose immune systems are healthy. Some of the more common dermatological, or skin, effects of HIV include: Varicella zoster virus (VZV) infection. VZV is a herpes virus which causes both chicken pox (varicella) and shingles (herpes zoster). Most adults have already been exposed to this virus. HIV-infected individuals may develop new skin sores from either of these diseases. HIV patients who didnt have chicken pox earlier in their life may develop the condition, which in some cases can affect their organs and become life-threatening. Shingles can be localized to one area or it can spread over large areas of the skin. Shingles lesions can become infected and even lead to the development of encephalitis (brain inflammation) in people with HIV.

Herpes simplex virus (HSV). HSV was one of the first diseases identified in people with advanced HIV disease and is now considered one of the AIDSdefining diseases by the U.S. Centers for Disease Control and Prevention. HSV causes open sores that may look like a cluster of blisters. They pop and crust over before healing completely; this process takes about 7 to 10 days in otherwise healthy individuals, but in people with advanced HIV disease, the sores may enlarge to 2 to 10 centimeters in diameter, becoming crusted and painful.

Kaposis sarcoma (KS). Kaposis sarcoma is a cancer caused by a herpes virus called Kaposi sarcoma herpes virus. Healthy individuals may be infected with Kaposi sarcoma herpes virus without developing the cancer. However, as HIV-infected people become sicker, KS may develop. KS tumors grow from cells which line blood vessels and lymph nodes. The cells form tumors on the skin that appear as brown, purple, or red splotches, called lesions. In some cases, the lesions look worse than they are, as they may cause no other symptoms. Other people with KS may experience painful swelling, particularly around the eyes, in the legs, or in the groin. Although less common, KS lesions can also form in organs, like the liver, digestive system, or the lungs, which could be deadly.

What are glaucoma symptoms and signs?

Patients with open-angle glaucoma and chronic angle-closure glaucoma in general have no symptoms early in the course of the disease. Visual field loss (side vision loss) is not a symptom until late in the course of the disease. Rarely patients with fluctuating levels of intra-ocular pressure may have haziness of vision and see haloes around lights, especially in the morning. On the other hand, the symptoms of acute angle-closure are often extremely dramatic with the rapid onset of severe eye pain,headache, nausea and vomiting, and visual blurring. Occasionally, the nausea and vomiting exceed the ocular symptoms to the extent that an ocular cause is not contemplated. The eyes of patients with open-angle glaucoma or chronic angle-closure glaucoma may appear normal in the mirror or to family or friends. Some patients get slightly red eyes from the chronic use of eyedrops. The ophthalmologist, on examining the patient, may find elevated intraocular pressure, optic-nerve abnormalities, or visual field loss in addition to other less common signs. The eyes of patients with acute angle-closure glaucoma will appear red, and the pupil of the eye may be large and nonreactive to light. The cornea may appear cloudy to the naked eye. The ophthalmologist will typically find decreased visual acuity, corneal swelling, highly elevated intraocular pressure, and a closed drainage angle.

What causes glaucoma?

Elevated pressure in the eye is the main factor leading to glaucomatous damage to the eye (optic) nerve. Glaucoma with normal intraocular pressure is discussed below in the section on the different types of glaucoma. The optic nerve, which is located in back of the eye, is the main visual nerve for the eye. This nerve transmits the images we see back to the brain for interpretation. The eye is firm and round, like a basketball. Its tone and shape are maintained by a pressure within the eye (the intraocular pressure), which normally ranges between 8 mm and 22 mm (millimeters) of mercury. When the pressure is too low, the eye becomes softer, while an elevated pressure causes the eye to become harder. The optic nerve is the most susceptible part of the eye to high pressure because the delicate fibers in this nerve are easily damaged. The front of the eye is filled with a clear fluid called the aqueous humor, which provides nourishment to the structures in the front of the eye. This fluid is produced constantly by the ciliary body, which surrounds the lens of the eye. The aqueous humor then flows through the pupil and leaves the eye through tiny channels called the trabecular meshwork. These channels are located at what is called the drainage angle of the eye. This angle is where the clear cornea, which covers the front of the eye, attaches to the base (root or periphery) of the iris, which is the colored part of the eye. The cornea covers the iris and the pupil, which are in front of the lens. The pupil is the small, round, black-appearing opening in the center of the iris. Light passes through the pupil, on through the lens, and to the retina at the back of the eye. Please see the figure, which is a diagram that shows the drainage angle of the eye.

Legend for figure: This diagram of the front part of the eye is in cross section to show the filtering, or drainage, angle. This angle is between the cornea and the iris, which join each other right where the drainage channels (trabecular meshwork) are located. The arrow shows the flow of the aqueous fluid from the ciliary body, through the pupil, and into the drainage channels. This figure is recreated from Understanding and Treating Glaucoma, a human anatomy board book by Tim Peters and Company Inc., Gladstone N.J. In most people, the drainage angles are wide open, although in some individuals, they can be narrow. For example, the usual angle is about 45 degrees, whereas a narrow angle is about 25 degrees or less. After exiting through the trabecular meshwork in the drainage angle, the aqueous fluid then drains into tiny blood vessels (capillaries) into the main bloodstream. The aqueous humor should not be confused with tears, which are produced by a gland outside of the eyeball itself. This process of producing and removing the fluid from the eye is similar to that of a sink with the faucet always turned on, producing and draining the water. If the sink's drain becomes clogged, the water may overflow. If this sink were a closed system, as is the eye, and unable to overflow, the pressure in the sink would rise. Likewise, if the eye's trabecular meshwork becomes clogged or blocked, the intraocular pressure may become elevated. Also, if the sink's faucet is on too high, the water may overflow. Again, if this sink were a closed system, the pressure within the sink would increase. Likewise, if too much fluid is being produced within the eye, the intraocular pressure may become too high. In either event, since the eye is a closed system, if it cannot remove the increased fluid, the pressure builds up and optic-nerve damage may result.

Can glaucoma be prevented?

Primary open-angle glaucoma cannot be prevented, given our current state of knowledge. However the optic-nerve damage and visual loss resulting from glaucoma can be prevented by earlier diagnosis, effective treatment, and compliance with treatment. Secondary types of glaucoma can often be prevented by avoidance of trauma to the eye and prompt treatment of eye inflammation and other diseases of the eye or body that may cause secondary forms of glaucoma. Most cases of visual loss from angle-closure glaucomas can be prevented by the appropriate use of laser iridotomy in eyes at risk for the development of acute or chronic angle-closure glaucoma.

THE EFFECTS OF GLAUCOMA

Glaucoma is an eye disease characterized by dysfunction of the ocular drainage system. While the exact cause of glaucoma remains unclear, fluid inside the eye builds up because of the diminished draining rate. As the eye's internal pressure increases without control, the optic nerve becomes damaged, leading to irreversible vision deficit and loss. Glaucoma falls into several different types, including openangle glaucoma, which is the most common. According to the National Eye Institute, no cure exists for glaucoma; treatment aims at saving the remaining vision. TUNNEL VISION If glaucoma is not diagnosed and treated early, an individual starts to lose peripheral vision, or the area of vision outside the central field of sight. People who have glaucoma experience tunnel vision and cannot see objects to the side, near the head or by their feet. When you drive and change lanes, you risk hitting the car in your blind spot if you did not look ahead of time. Similarly, loss of peripheral vision predisposes you to accidents and risks of tripping, falling, hitting your head or bumping into objects. unique stem cell therpy for post stroke, patients will have obvious improvement in 5 weeks. BLINDNESS According to the All Eyes on Glaucoma Campaign, glaucoma is the world's leading cause of preventable blindness. As the disease progresses, following the loss of peripheral vision, gradually the central field of vision starts to decrease until no vision remains. After depending on your sight for all of your life, blindness presents an overwhelming life change and requires adaptation to overcome changes and challenges associated with vision loss.

Diabetes Causes
Type 1 diabetes: Type 1 diabetes is believed to be an autoimmune disease. The body's immune system specifically attacks the cells in the pancreas that produce insulin. A predisposition to develop type 1 diabetes may run in families, but genetic causes (a postitive family history) are much more common for type 2 diabetes. Environmental factors, including common unavoidable viral infections, may also contribute to type 1 diabetes. Type 1 diabetes is most common in people of non-Hispanic, Northern European descent (especially Finland and Sardinia), followed by African Americans, and Hispanic Americans. It is relatively rare in those of Asian descent. Type 1 diabetes is slightly more common in men than in women.

Type 2 diabetes: Type 2 diabetes has strong genetic links, meaning that type 2 diabetes tends to run in families. Several genes have been identified, and more are under study which may relate to the causes of type 2 diabetes. Risk factors for developing type 2 diabetes include the following: High blood pressure High blood triglyceride (fat) levels Gestational diabetes or giving birth to a baby weighing more than 9 pounds High-fat diet High alcohol intake Sedentary lifestyle Obesity or being overweight Ethnicity, particularly when a close relative had type 2 diabetes or gestational diabetes: certain groups, such as African Americans, Native Americans, Hispanic Americans, and Japanese Americans, have a greater risk of developing type 2 diabetes than non-Hispanic whites. Aging: Increasing age is a significant risk factor for type 2 diabetes. Risk begins to rise significantly at about age 45 years, and rises considerably after age 65 years.

Diabetes Prevention
It is not yet known how to prevent type 1 diabetes. Type 2 diabetes, however, can be prevented in some cases.

Control weight to normal or near-normal levels by eating a healthy low-fat, highfiber diet. Regular exercise is crucial to the prevention of type 2 diabetes. Keep alcohol consumption low. Quit smoking. If a person has high blood fat levels (such as high cholesterol) or high blood pressure, take all medications as directed. Lifestyle modifications and/or certain medications can be used in people with prediabetes to prevent progression to diabetes. Prediabetes can be diagnosed by checking fasting glucose and 2 hours after ingesting up to 75 grams of glucose (dosing is based on the weight of the patient). If you or someone you know already has diabetes, the focus should be on preventing the complications, which can cause serious disabilities such as blindness, kidney failure requiring dialysis, amputation, or even death.

Tight glucose control: The single best thing a person with diabetes can do is to keep their blood sugar level within the suggested range every day. The only way to do this is through a combination of regular blood sugar checks; a balanced diet low in simple sugars and fat, and high in complex carbohydrates and fiber; a high degree of personal motivation; and appropriate medical treatment. Consult a nutritionist or check with a doctor with questions in regard to diet. Quit smoking Maintain a healthy weight Increase physical activity levels. Aim for moderately vigorous physical activity for at least 30 minutes every day. Drink an adequate amount of water and avoid consuming too much salt. The skin should be taken care of; keep it supple and hydrated to avoid sores and cracks that can become severely infected. Brush and floss the teeth every day. See a dentist regularly to prevent gum disease. The feet should be washed and examined daily, looking for small cuts, sores, or blisters that may cause problems later. The toenails should be filed rather than cut to avoid damaging the surrounding skin. A specialist in foot care (podiatrist) may be necessary to help care for the feet.

The Effects of Diabetes

Diabetes is being a huge health problem. Many people suffer from diabetes and the other medical side effects it cause. An early diagnosis of diabetes can help a person to avoid serious related diseases. The earlier diabetes is caught the easy it is for doctors to monitor the patients overall health, thus preventing any further medical problems. Diabetes is when the pancreas does not function properly and glucose levels fall outside the normal range. A normal glucose reading is lower than 110 mg/dL upon waking in the morning and lower than 140 mg/dL two hours after eating. There are simple blood tests that are used to diagnose diabetes. Once diagnosed a person will work with their doctor to determine a treatment. Treatments can include diet changes, pills, or injections. Any history, family history and people in certain ethnic groups may be at elevated risk for developing diabetes. There are different types of diabetes. Some start in childhood, some start in adulthood and another form occurs during pregnancy. All can cause harmful effects on the body if not taken care of. Long term effects of diabetes are usually due to a patient letting their glucose levels remain elevated for long periods of time. That is why early detection is important. Excess blood sugar levels have a horrible effect on the body. Some common effects from diabetes include vision problems, kidney damage, nerve damage, heart and circulation problems. A person with diabetes is at a higher risk for these types of conditions, but a person who does not control their diabetes is even more likely to develop one of these conditions. Diabetes is a disease that does not have a cure. Diagnosing and treating diabetes have evolved into easier processes. A person with diabetes can normally live life as they did before their diagnosis. Living with diabetes is a matter of taking control over the disease and preventing complications.

Diabetes Symptoms
Symptoms of type 1 diabetes are often dramatic and come on very suddenly.

Type 1 diabetes is usually recognized in childhood or early adolescence, often in association with an illness (such as a virus or urinary tract infection) or injury. The extra stress can cause diabetic ketoacidosis. o Symptoms of ketoacidosis includenausea and vomiting. Dehydration and often-serious disturbances in blood levels of potassium follow. o Without treatment, ketoacidosis can lead to coma and death. Symptoms of type 2 diabetes are often subtle and may be attributed to aging or obesity.
A

person may have type 2 diabetes for many years without knowing it. People with type 2 diabetes can develop hyperglycemic hyperosmolar nonketotic syndrome. Type 2 diabetes can be precipitated by steroids and stress. If not properly treated, type 2 diabetes can lead to complications such as blindness,kidney failure, heart disease, and nerve damage. Common symptoms of both type 1 and type 2 diabetes include: Fatigue, constantly tired: In diabetes, the body is inefficient and sometimes unable to use glucose for fuel. The body switches over to metabolizing fat, partially or completely, as a fuel source. This process requires the body to use more energy. The end result is feeling fatigued or constantly tired. Unexplained weight loss: People with diabetes are unable to process many of the calories in the foods they eat. Thus, they may lose weight even though they eat an apparently appropriate or even an excessive amount of food. Losing sugar and water in the urine and the accompanying dehydration also contributes to weight loss. Excessive thirst (polydipsia): A person with diabetes develops high blood sugar levels, which overwhelms the kidney's ability to reabsorb the sugar as the blood is filtered to make urine. Excessive urine is made as the kidney spills the excess sugar. The body tries to counteract this by sending a signal to the brain to dilute the blood, which translates into thirst. The body encourages more water consumption to dilute the high blood sugar back to normal levels and to compensate for the water lost by excessive urination. Excessive urination (polyuria): Another way the body tries to rid the body of the extra sugar in the blood is to excrete it in the urine. This can also lead to dehydration because a large amount of water is necessary to excrete the sugar.

Excessive eating (polyphagia): If the body is able, it will secrete more insulin in order to try to manage the excessive blood sugar levels. Moreover, the body is resistant to the action of insulin in type 2 diabetes. One of the functions of insulin is to stimulate hunger. Therefore, higher insulin levels lead to increased hunger. Despite increased caloric intake, the person may gain very little weight and may even lose weight. Poor wound healing: High blood sugar levels prevent white blood cells, which are important in defending the body against bacteria and also in cleaning up dead tissue and cells, from functioning normally. When these cells do not function properly, wounds take much longer to heal and become infected more frequently. Long-standing diabetes also is associated with thickening of blood vessels, which prevents good circulation, including the delivery of enough oxygen and other nutrients to body tissues. Infections: Certain infections, such as frequent yeast infections of the genitals, skin infections, and frequent urinary tract infections, may result from suppression of the immune system by diabetes and by the presence of glucose in the tissues, which allows bacteria to grow. These infections can also be an indicator of poor blood sugar control in a person known to have diabetes. Altered mental status: Agitation, unexplained irritability, inattention, extreme lethargy, or confusion can all be signs of very high blood sugar, ketoacidosis, hyperosmolar hyperglycemia nonketotic syndrome, or hypoglycemia (low sugar). Thus, any of these merit the immediate attention of a medical professional. Call your health care professional or 911. Blurry vision: Blurry vision is not specific for diabetes but is frequently present with high blood sugar levels.

Influenza A (H1N1)
What are the causes of the flu?
The flu (influenza) viruses Influenza viruses cause the flu and are divided into three types, designated A, B, and C. Influenza types A and B are responsible for epidemics of respiratory illness that occur almost every winter and are often associated with increased rates of hospitalization and death. Influenza type C differs from types A and B in some important ways. Type C infection usually causes either a very mild respiratory illness or no symptoms at all; it does not cause epidemics and does not have the severe public-health impact of influenza types A and B. Efforts to control the impact of influenza are aimed at types A and B, and the remainder of this discussion will be devoted only to these two types. Influenza viruses continually change over time, usually by mutation (change in the viral RNA). This constant changing often enables the virus to evade the immune system of the host (humans, birds, and other animals) so that the host is susceptible to changing influenza virus infections throughout life. This process works as follows: a host infected with influenza virus develops antibodies against that virus; as the virus changes, the "first" antibody no longer recognizes the "newer" virus and infection can occur because the host does not recognize the new flu virus as a problem until the infection is well under way. The first antibody developed may, in some instances, provide partial protection against infection with a new influenza virus. In 2009, almost all individuals had no antibodies that could recognize the novel H1N1 virus immediately. Type A viruses are divided into subtypes or strains based on differences in two viral surface proteins called the hemagglutinin (H) and the neuraminidase (N). There are at least 16 known H subtypes and nine known N subtypes. These surface proteins can occur in many combinations. When spread by droplets or direct contact, the virus, if not killed by the host's immune system, replicates in the respiratory tract and damages host cells. In people who are immune compromised (for example, pregnant individuals,infants, cancer patients, asthma patients, people with pulmonary disease and many others), the virus can cause viral pneumonia or stress the individual's system to make them more susceptible to bacterial infections, especially bacterial pneumonia. Both pneumonia types, viral and bacterial, can cause severe disease and sometimes death.

Antigenic shift and drift Influenza type A viruses undergo two kinds of changes. One is a series of mutations that occurs over time and causes a gradual evolution of the virus. This is called antigenic "drift." The other kind of change is an abrupt change in the hemagglutinin and/or the neuraminidase proteins. This is calledantigenic "shift." In this case, a new subtype of the virus suddenly emerges. Type A viruses undergo both kinds of changes; influenza type B viruses change only by the more gradual process of antigenic drift and therefore do not cause pandemics. The 2009 pandemic-causing H1N1 virus is a classic example of antigenic shift. The U.S. Centers for Disease Control and Prevention (CDC) has indicated that novel H1N1 swine flu has an RNA genome that contains five RNA strands derived from various swine flu strains, two RNA strands frombird flu (also termed avian flu) strains, and only one RNA strand from human flu strains. They suggest mainly antigenic shifts over about 20 years have led to the development of novel H1N1 flu virus. A diagram that illustrates both antigenic shift and drift can be found below (see Figure 2) and features influenza A types H1N1 and bird flu, but almost every influenza A viral strain can go through these processes that changes the viral RNA.

What is the key to flu prevention?

Flu vaccine Most of the illness and death caused by influenza can be prevented by annual influenza vaccination. The CDC's current Advisory Committee on Immunization Practices (ACIP) issued recommendations for everyone 6 months of age and older, who do not have any contraindications to vaccination, to receive a flu vaccine each year. Flu vaccine (influenza vaccine made from inactivated and sometimes attenuated [noninfective] virus) is specifically recommended for those who are at high risk for developing serious complications as a result of influenza infection. A new vaccine type, Fluzone Intradermal, was approved by the FDA in 2011 (for adults 18-64 years of age). This injection goes only into the intradermal area of the skin, not into the muscle (IM) like most conventional flu shots and uses a much smaller needle than the conventional shots. This killed viral preparation is supposed to be about as effective as the IM shot but claims to produce less pain and fewer side effects (see section below).

What are the symptoms of swine flu (H1N1)?

Symptoms of swine flu are similar to most influenza infections: fever (100 F or greater), cough, nasal secretions, fatigue, and headache, with fatigue being reported in most infected individuals. Some patients also get nausea, vomiting, and diarrhea. In Mexico, many of the initial patients infected with H1N1 influenza were young adults, which made some investigators speculate that a strong immune response, as seen in young people, may cause some collateral tissue damage. Some patients develop severe respiratory symptoms and need respiratory support (such as a ventilator to breathe for the patient). Patients can get pneumonia(bacterial secondary infection) if the viral infection persists, and some can developseizures. Death often occurs from secondary bacterial infection of the lungs; appropriate antibiotics need to be used in these patients. The usual mortality (death) rate for typical influenza A is about 0.1%, while the 1918 "Spanish flu" epidemic had an estimated mortality rate ranging from 2%-20%. Swine (H1N1) flu in Mexico had about 160 deaths and about 2,500 confirmed cases, which would correspond to a mortality rate of about 6%, but these initial data have been revised and the mortality rate currently worldwide is estimated to be much lower. By June 2009, the virus had reached 74 different countries on every continent except Antarctica, and by September 2009, the virus had been reported in most countries (over 200) in the world. Fortunately, the mortality rate as of H1N1 has remained low and similar to that of the conventional flu (average conventional flu mortality rate is about 36,000 per year; projected H1N1 flu mortality rate was 90,000 per year in the U.S. as determined by the president's advisory committee, but it never approached that high number). Fortunately, although H1N1 developed into a pandemic (worldwide) flu strain, the mortality rate in the U.S. and many other countries only approximated the usual numbers of flu deaths worldwide. Speculation about why the mortality rate remained much lower than predicted includes increased public awareness and action that produced an increase in hygiene (especially hand washing), a fairly rapid development of a new vaccine, and patient self-isolation if symptoms developed. Research is ongoing to develop data-based answers to such questions

The Effects of Influenza

High Fever

The World Health Organization (WHO) reports that the first noticeable side effect that is associated with an influenza infection is a sudden, high fever. Body temperature is considered normal at 98.6 degrees F, and a fever becomes suspect when the temperature rises one degree above the norm. A fever is considered high when it reaches or exceeds 103 degrees F. Muscle pain and weakness due to inflammation are a common occurrence with influenza. According to Merck, the pain and weakness that are associated with influenza are often centered on the legs. Dangerous complications that require immediate medical attention can arise during a bout of influenza that involves further inflammation of the muscle surrounding the heart and lungs, but the scenario is quite rare. The development of a headache is also common in patients who are diagnosed with influenza. The U.S. National Library of Medicine reports that the cough that accompanies influenza often starts out dry in nature. Unfortunately for some, a dry cough can quickly change to a persistent cough that involves a runny nose and thick mucus. Bronchitis or pneumonia can also become a factor as the influenza virus progresses and more mucus forms. In some cases, shortness of breath can result. A change in cough symptoms requires a trip to a physician's office for further treatment that can clear the mucus and prevent a dangerous lung infection. A patient suffering from influenza will often experience profuse sweating accompanied by chills. The University of Illinois Medical Center explains that chills are a result of muscle contractions that occur when the body faces a sudden rise in temperature due to an infection. As the body begins to defend itself against the influenza infection, profuse sweating can occur. Sweating is the body's way of cooling itself down and lowering body temperature The Centers for Disease Control and Prevention reports that there are two types of vaccinations that can guard against influenza---flu shot and nasal spray. The flu shot is recommended for people ages 6 months and older. The nasal spray version is suitable for ages 2 and older. Antibodies to fight an influenza infection begin to develop within two weeks of inoculation and can help to reduce the risks of contracting influenza or at least minimize the symptoms in those who become infected.

Muscle Pain, Weakness and Headache

Cough and Runny Nose

Sweating and Chills

The Vaccine

CRONIC DISEASES

SPREADABL E DISEASES

GENETIC DISEASES

OSTEOPOROSIS GLAUCOMA HIV (AIDS) INFLUENZA DIABETES