What is Tuberculosis?

Tuberculosis (TB) is a disease that can damage a person's lungs or other parts of the body and cause serious illness.

How is TB spread?

TB is spread when people who have active untreated TB germs in their lungs or throat cough, sneeze or speak, and send their germs into the air. People who breathe these germs into their lungs can become infected.

People who breathe in TB germs usually have had very close, day-to-day, contact with someone who has the disease. That's why most people get TB germs from someone they spend a lot of time with, like a family member, friend or close co-worker.

TB germs spread through the air

What does having "TB infection" mean?

Having TB infections means that the TB germs are in the body but they are in an "inactive" state.

After TB germs enter the body, in most cases, body defenses control the germs by building a wall around them the way a scab forms over a cut. The germs can stay alive inside these walls for years in an inactive state. While TB germs are inactive, they can't do damage, and they can't spread to other people. The person is infected, but not sick. He/she probably won't even know that he/she is infected.

Millions of Americans have TB infection. For most of them, the germs will always be inactive.

Inactive TB germs can't hurt you now ...

What is TB disease?

Tuberculosis disease is a serious illness caused by active TB germs.

It is possible to get TB disease shortly after the germs enter the body if body defenses are weak.

It is also possible, even after many years, for inactive TB germs to become active when body defenses are weakened. This may be due to aging, a serious illness, drug or alcohol abuse, or HIV infection (the virus that causes AIDS).

When defenses are weakened and inactive TB germs become active, the germs can then break out of the walls, begin multiplying and damage the lungs or other organs.

If people with TB disease do not take their medication, they can become seriously ill, and may even die. But people with TB can be cured, if they have proper medical treatment and take their medication as prescribed.

when body defenses are weakened, inactive TB germs become active and break out

What is Drug Resistant TB?

Sometimes, TB germs are "resistant" to one or more of the TB medicines most often prescribed by doctors. When this happens combinations of other TB medicines are given to the patient. Drug resistant TB can take longer to cure than regular TB, but most patients can be cured.

Drug resistant TB develops when a person with active TB stops taking their medicine too soon, or if they have not been given the right TB medicine. A person with untreated drug resistant TB of the lungs or throat can transmit these resistant germs.

What are the signs of TB?

TB can attack any part of the body, but the lungs are the most common target. People with tuberculosis disease may have some or all of the following symptoms:

Sometimes, a person with advanced TB will cough up blood streaked sputum.

People with active TB disease may have only mild symptoms. They may be spreading their germs to others without even knowing that they have TB.

What are the tests for TB?

Who should get tested for TB?

Common Sites for Tuberculosis

Can TB patients infect other people?

Usually, after a week or more of taking effective medication, most patients with TB disease will stop spreading germs. A doctor will test the patient and then decide when the patient is no longer contagious. Most TB patients live at home and can continue their normal activities as long as they are taking their TB medicine.

If you or anyone you know has questions about TB, you can call one of for more information.

How can we fight TB?

The best way to fight TB is to make sure that people who need medicine take it regularly. They include:

What is Diabetes?

Diabetes mellitus is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. Diabetes can be associated with serious complications and premature death, but people with diabetes can take steps to control the disease and lower the risk of complications.

Types of diabetes

Type 1

Type 1 diabetes was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes. Type 1 diabetes develops when the body's immune system destroys pancreatic beta cells, the only cells in the body that make the hormone insulin that regulates blood glucose. This form of diabetes usually strikes children and young adults, who need several insulin injections a day or an insulin pump to survive. Type 1 diabetes may account for 5% to 10% of all diagnosed cases of diabetes. Risk factors for type 1 diabetes include autoimmune, genetic, and environmental factors.

Type 2

Type 2 diabetes was previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. Type 2 diabetes may account for about 90% to 95% of all diagnosed cases of diabetes. It usually begins as insulin resistance, a disorder in which the cells do not use insulin properly. As the need for insulin rises, the pancreas gradually loses its ability to produce insulin. Type 2 diabetes is associated with older age, obesity, family history of diabetes, prior history of gestational diabetes, impaired glucose tolerance, physical inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Pacific Islanders are at particularly high risk for type 2 diabetes. Type 2 diabetes is increasingly being diagnosed in children and adolescents.

Gestational diabetes

Gestational diabetes is a form of glucose intolerance that is diagnosed in some women during pregnancy. Gestational diabetes occurs more frequently among African Americans, Hispanic/Latino Americans, and American Indians. It is also more common among obese women and women with a family history of diabetes. During pregnancy, gestational diabetes requires treatment to normalize maternal blood glucose levels to avoid complications in the infant. After pregnancy, 5% to 10% of women with gestational diabetes are found to have type 2 diabetes. Women who have had gestational diabetes have a 20% to 50% chance of developing diabetes in the next 5-10 years.

Other

Other specific types of diabetes result from specific genetic conditions (such as maturity-onset diabetes of youth), surgery, drugs, malnutrition, infections, and other illnesses. Such types of diabetes may account for 1% to 5% of all diagnosed cases of diabetes.

Treating Diabetes

In order to survive, people with type 1 diabetes must have insulin delivered by injections or a pump.
Many people with type 2 diabetes can control their blood glucose by following a careful diet and exercise program, losing excess weight, and taking oral medication.
Many people with diabetes also need to take medications to control their cholesterol and blood pressure.
Among adults with diagnosed diabetes, about 11% take both insulin and oral medications, 22% take insulin only, 49% take oral medications only, and 17% do not take either insulin or oral medications.

Preventing Diabetes

Research studies in the United States and abroad have found that lifestyle changes can prevent or delay the onset of type 2 diabetes among high-risk adults. These studies included people with IGT and other high-risk characteristics for developing diabetes. Lifestyle interventions included diet and moderate-intensity physical activity (such as walking for 2 1/2 hours each week). For both sexes and all age and racial and ethnic groups, the development of diabetes was reduced 40% to 60% during these studies that lasted 3 to 6 years.

Studies have also shown that medications have been successful in preventing diabetes in some population groups. In the Diabetes Prevention Program, a large prevention study of people at high risk for diabetes, people treated with the drug metformin reduced their risk of developing diabetes by 31%. Treatment with metformin was most effective among younger, heavier people (those 25-40 years of age who were 50 to 80 pounds overweight) and less effective among older people and people who were not as overweight.

There are no known methods to prevent type 1 diabetes. Several clinical trials are currently in progress.

Preventing diabetes complications

Glucose control

Research studies in the United States and abroad have found that improved glycemic control benefits people with either type 1 or type 2 diabetes. In general, for every 1% reduction in results of A1C blood tests, the risk of developing micro vascular diabetic complications (eye, kidney, and nerve disease) is reduced by 40%.

Blood pressure control

Blood pressure control can reduce cardiovascular disease (heart disease and stroke) by approximately 33% to 50% and can reduce micro vascular disease (eye, kidney, and nerve disease) by approximately 33%.
In general, for every 10 millimeters of mercury (mm Hg) reduction in systolic blood pressure, the risk for any complication related to diabetes is reduced by 12%.

Control of blood lipids

Improved control of cholesterol and lipids (for example, HDL, LDL, and triglycerides) can reduce cardiovascular complications by 20% to 50%.
Preventive care practices for eyes, kidneys, and feet
Detecting and treating diabetic eye disease with laser therapy can reduce the development of severe vision loss by an estimated 50% to 60%.
Comprehensive foot care programs can reduce amputation rates by 45% to 85%.
Detecting and treating early diabetic kidney disease can reduce the development of kidney failure by 30% to 70%

What is hypertension?

Hypertension is the name of a condition in which blood pressure is persistently elevated (it stays high for a long period of time). Blood pressure is a measure of the pressure of the blood against the blood vessel walls. Persistent high blood pressure puts undue stress on the heart, blood vessels and other organs.

The Causes of High Blood Pressure

The causes of high blood pressure are a bit of a mystery. About 5% of patients requiring hypertension treatment can trace their high blood pressure to a physical cause such as kidney disease. Treatment of the disease reduces the symptoms of high blood pressure.

But for 95% of patients who undergo hypertension treatment, the causes of high blood pressure are unknown. Diet and stress are suspected as prime contributors to hypertension, but medical experts aren't exactly certain of all the mechanisms involved.

Symptoms of High Blood Pressure

As if it wasn't bad enough that the causes of high blood pressure are unknown, recognizable physical symptoms of high blood pressure are almost non-existent. Although some patients complain of dizziness, headaches or blurred vision, most patients only discover they need hypertension treatment when their blood pressure is taken.

Why is hypertension dangerous?

High blood pressure is a serious health risk for many people. Hypertension can cause hardening of the arteries, heart attacks and strokes. Heart and kidney disease, as well as hardening of the arteries, have been attributed to hypertension. Fortunately, hypertension treatment is well researched and readily available.

Who is at risk?

The short answer to this question is "everyone;" 25% of adult Americans suffer from hypertension. It's not alarmist to call it a national epidemic. Some people are at greater risk than others. Men are more likely to have high blood pressure than women.

For reasons as yet unknown, Americans of African descent have a much greater incidence rate of hypertension than any other racial group. Heart problems, strokes and diseases associated with hypertension show up in alarming numbers amongst the male African American population.

What are the Risks?

Physicians call hypertension the silent killer. Due to the lack of hypertension symptoms, often organ damage is the first indication of high blood pressure. This can take the form of kidney disease, stroke or changes in the retina of the eyes. Heart problems are very common with hypertension because high blood pressure forces the heart to work harder than it should.

What is AIDS?

AIDS

Acquired Immune Deficiency Syndrome is the final and most serious stage of HIV disease, which causes severe damage to the immune system.

The Centers for Disease Control has defined AIDS as beginning when a person with HIV infection has a CD4 cell (also called "t-cell", a type of immune cell) count below 200. It is also defined by numerous opportunistic infections and cancers that occur in the presence of HIV infection.

Alternative Names :-

Acquired immune deficiency syndrome

Causes, incidence, and risk factors

AIDS is the fifth leading cause of death among persons between ages 25 and 44 in the United States. About 47 million people worldwide have been infected with HIV since the start of the epidemic.
The Human Immunodeficiency Virus (HIV) causes AIDS. The virus attacks the immune system and leaves the body vulnerable to a variety of life-threatening illnesses and cancers.

Common bacteria, yeast, parasites, and viruses that ordinarily do not cause serious disease in people with fully functional immune systems can cause fatal illnesses in people with AIDS.

HIV has been found in saliva, tears, nervous system tissue, blood, semen (including pre-seminal fluid, or "pre-cum"), vaginal fluid, and breast milk. However, only blood, semen, vaginal secretions, and breast milk have been proven to transmit infection to others.

Transmission of the virus occurs:

HIV infection is not spread by casual contact (such as hugging and touching), by touching dishes, doorknobs, or toilet seats previously touched by a person infected with the virus, during participation in sports, or by mosquitoes.

It is not transmitted to a person who DONATES blood or organs in the U.S. because hospitals do not re-use syringes and sterilize all devices involved in such procedures.

However, HIV can be transmitted to the person RECEIVING blood or organs from an infected donor. This is why blood banks and organ donor programs screen donors, blood, and tissues thoroughly.

Those at highest risk include homosexual or bisexual men engaging in unprotected sex, intravenous drug users who share needles, the sexual partners of those who participate in high-risk activities, infants born to mothers with HIV, and people who received blood transfusions or clotting products between 1977 and 1985 (prior to standard screening for the virus in the blood).

AIDS begins with HIV infection. People infected with HIV may have no symptoms for ten years or longer, but they can still transmit the infection to others during this symptom-free period. Meanwhile, their immune system gradually weakens until they develop AIDS.

Acute HIV infection progresses over time to asymptomatic HIV infection and then to early symptomatic HIV infection. Later, it progresses to AIDS (very advanced HIV infection with T-cell count below 200).

Most individuals infected with HIV will progress to AIDS, if not treated. However, there is a tiny group of patients who develop AIDS very slowly or never at all. These patients are called non-progressors and many seem to have a genetic difference which prevents the virus from attaching to certain immune receptors.

Symptoms

The symptoms of AIDS are primarily the result of infections that do not normally develop in individuals with healthy immune systems. These are called "opportunistic infections."

Patients with AIDS have had their immune system depleted by HIV and are very susceptible to such opportunistic infections. Common symptoms are fevers, sweats (particularly at night), swollen glands, chills, weakness, and weight loss.

Treatment

There is no cure for AIDS at this time. However, several treatments are available that can delay the progression of disease for many years and improve the quality of life of those who have developed symptoms.

Antiviral therapy suppresses the replication of the HIV virus in the body. A combination of several antiretroviral agents, termed Highly Active Anti-Retroviral Therapy (HAART), has been highly effective in reducing the number of HIV particles in the blood stream (as measured by a blood test called the viral load). This can help the immune system bounce back for a while and improve T-cell counts.

Although this is not a cure for HIV, and people on HAART with suppressed levels of HIV can still transmit the virus to others through sex or sharing of needles, the treatment shows great promise.

There is good evidence that if the levels of HIV remain suppressed and the CD4 count remains high (>200), that life and quality of life can be significantly prolonged and improved. However, HIV tends to become resistant in patients who do not take their medications every day. Also, certain strains of HIV mutate easily and may become resistant to HAART especially quickly.

Genetic tests are now available to determine whether the virus is resistant to a particular drug -- these may be useful in determining the best drug combination and adjusting it if it starts to fail.

When HIV becomes resistant to HAART, salvage therapy is required to try to suppress the resistant strain of HIV. Different combinations of medications are tried to attempt to reduce viral load. This is often not successful, unfortunately, and the patient will usually develop AIDS and its complications.

Treatment with HAART is not without complications. HAART is a collection of different medications, each with its own side effect profile. Some common side effects are nausea, headache, weakness, malaise, and fat accumulation on your back and abdomen ("buffalo hump," lipodystrophy). When used long-term, these medications may increase the risk of heart attack by affecting fat metabolism.

Any doctor prescribing HAART should be carefully following the patient for possible side effects associated with the combination of medications being taken. In addition, routine blood tests measuring CD4 counts and HIV viral load (a blood test that measures how much virus is in the blood) should be taken every three to four months. The goal is to get the CD4 count as close to normal as possible, and to suppress the HIV viral load to an undetectable level.

Other antiviral agents are in investigational stages and many new drugs are in the pipeline. Growth factors that stimulate cell growth, such as Epogen (erthythropoetin) and G-CSF are sometimes used to treat anemia and low white blood cell counts associated with AIDS.

Medications are also used to prevent opportunistic infections (such as Pneumocystis carinii pneumonia) and can keep AIDS patients healthier for longer periods of time. Opportunistic infections are treated as they occur.

Prevention

Prevention of AIDS requires foresight and self-discipline. The requirements often seem personally restrictive, but they are effective and can save your life.