Bøger af National Institutes of Health

This book by the National Institutes of Health (Publication 11-7629) and the National Heart, Lung, and Blood Institute provides an overview of anemia. You've probably picked up this book because you've read about anemia and are curious to learn more. Perhaps you've just been diagnosed, or a family member has been. Or, you've had anemia for a while, and you want to learn more about it. People of all ages, races, and ethnicities can develop anemia at some point in their lives. There are many types of anemia, and they are linked to a variety of diseases and conditions. Some types of anemia are very common, and some are very rare. Some are very mild and have little or no impact on a person's life. Some are severe and can even be life-threatening if not treated aggressively. All anemias have one thing in common, though: They all affect your blood, and that affects your overall health. The good news is that anemia often can be successfully treated or even prevented. It starts with general information-what causes anemia, who is at risk, how it's diagnosed, and how it's treated. Then, the book goes into more detail about major types of anemia: iron-deficiency, pernicious, aplastic, and hemolytic. The book wraps up with some closing thoughts about leading a healthy lifestyle, working with your doctor, and talking with your family. These are important things to think about when it comes to anemia. The book doesn't provide detailed information about all types of anemia.

The National Institutes of Health Publication 02-5050, Cancer Clinical Trials: The Basic Workbook, features information about and different aspects of clinical trials. The self-modulated workbook, with its accompanying activities, will help readers understand why cancer clinical trials are important, how they work, how participant safety is protected, as well as some of the reasons so few adults participate in these trials. It is designed for individuals who want to develop a basic understanding of clinical trials. Scientific discoveries are providing more and more insights into the causes of cancer. Many of these successes are limited to the laboratory and have yet to be translated into improved care for people with cancer. Clinical trials are a critical part of the research process. Clinical trials help to move basic scientific research from the laboratory into treatments for people. By evaluating the results of these trials, we can find better treatments and ways to prevent, detect, and treat cancer. But very few adults with cancer-only 3 percent-participate in clinical trials. We need to test the best cancer prevention, detection, and treatment ideas in the shortest time possible, and this can only happen if more people participate in clinical trials. We know that most people understand very little about clinical trials. National Cancer Institute (NCI) research has shown that the general public is either unaware of clinical trials as a treatment/ prevention option or misinformed about the clinical trial process. The reasons for this lack of understanding are complex, and there is no simple solution. We do know, however, that there are many barriers that discourage both physicians and potential participants from taking part in clinical trials. By reading this workbook, you are already helping to overcome some of these barriers. Whether you are a cancer survivor, someone who works with people with cancer, or someone who is touched by cancer in another way-this workbook can help answer your questions about clinical trials. It will help you understand why cancer clinical trials are important, how they work, how the participants' safety is protected, and some of the reasons why more adults don't participate in trials. With this information, you can help people in your community make informed decisions about their cancer treatment and prevention options, including the option of participating in a clinical trial.

The National Institutes of Health Publication 12-4280, "Prevent Diabetes Problems: Keep Your Mouth Healthy," addresses diabetes and how you can prevent or slow down related health problems. Too much glucose in the blood for a long time can cause diabetes problems. This high blood glucose, also called blood sugar, can damage many parts of the body, such as the heart, blood vessels, eyes, and kidneys. Heart and blood vessel disease can lead to heart attacks and strokes. You can do a lot to prevent or slow down diabetes problems. This booklet is about mouth problems that can be caused by diabetes. Too much glucose in your blood from diabetes can cause pain, infection, and other problems in your mouth. Your mouth includes: your teeth, your gums, your jaw, and tissues such as your tongue, the roof and bottom of your mouth, and the inside of your cheeks. Glucose is present in your saliva-the liquid in your mouth that makes it wet. When diabetes is not controlled, high glucose levels in your saliva help harmful germs, called plaque, grow. Plaque also comes from eating foods that contain sugars or starches. Some types of plaque cause tooth decay or cavities. Other types of plaque cause gum disease. Gum disease can happen more often, be more severe, and take longer to heal if you have diabetes. In turn, having gum disease can make your blood glucose hard to control. Some studies show that treating your gum disease makes it easier to control your blood glucose. You will learn the things you can do each day and during each year to stay healthy and prevent diabetes problems. This Publication is one of seven in a series that can help you learn more about how to prevent diabetes problems. These include: "Keep Your Diabetes Under Control," "Keep Your Heart and Blood Vessels Healthy," "Keep Your Kidneys Healthy," "Keep Your Eyes Healthy," "Keep Your Feet and Skin Healthy," "Keep Your Nervous System Healthy," and "Keep Your Mouth Healthy."

Food gives you energy and helps your body repair itself. Food is broken down in your stomach and intestines. Your blood picks up nutrients from the digested food and carries them to all your body cells. These cells take nutrients from your blood and put waste products back into the bloodstream. When your kidneys were healthy, they worked around the clock to remove wastes from your blood. The wastes left your body when you urinated. Other wastes are removed in bowel movements. Now that your kidneys have stopped working, hemodialysis removes wastes from your blood. But between dialysis sessions, wastes can build up in your blood and make you sick. You can reduce the amount of wastes by watching what you eat and drink. A good meal plan can improve your dialysis and your health. Your clinic has a dietitian to help you plan meals. A dietitian specializes in food and nutrition. A dietitian with special training in care for kidney health is called a renal dietitian. When you start hemodialysis, you must make many changes in your life. Watching the foods you eat will make you healthier. This publication by the National Institutes of Health (Publication No. 08-4274) will help you choose the right foods. Use this with a dietitian to help you learn how to eat right to feel right on hemodialysis.

The National Institutes of Health Publication 12-4222, "What I Need to Know About Diabetes Medicines," provides information about diabetes and the medicines that may be need to help you prevent some of the health problems that diabetes may cause. Over time, high levels of blood glucose, also called blood sugar, can cause health problems. These problems include heart disease, heart attacks, strokes, kidney disease, nerve damage, digestive problems, eye disease, and tooth and gum problems. You can help prevent health problems by keeping your blood glucose levels on target. Everyone with diabetes needs to choose foods wisely and be physically active. If you can't reach your target blood glucose levels with wise food choices and physical activity, you may need diabetes medicines. The kind of medicine you take depends on your type of diabetes, your schedule, and your other health conditions. Diabetes medicines help keep your blood glucose in your target range. The target range is suggested by diabetes experts and your doctor or diabetes educator.

Many cancer survivors indicate that while they felt they had lots of information and support during their illness, once treatment stopped, they entered a whole new world-one filled with new questions. Facing Forward: Life After Cancer Treatment, National Institutes of Health Publication 10-2424, covers posttreatment issues such as follow-up medical care, physical and emotional changes, and changes in social and work relationships. This book was written to share common feelings and reactions that many people just like you have had after treatment ended. It also offers some practical tips to help you through this time. Use this book in whatever way works best for you. You can read it from beginning to end. Or you can just refer to the section you need. This book shares what we have learned from other survivors about life after cancer: practical ways of dealing with common problems and guidelines for managing your physical, social, and emotional health. When possible, specific information from research with cancer survivors has been included. While cancer is a major event for all who are diagnosed, it brings with it the chance for growth. As hard as treatment can be, many cancer survivors have indicated that the experience led them to make important changes in their lives. Many say they now take time to appreciate each new day. They also have learned how to take better care of themselves and value how others care for them. Others draw from their experience to become advocates to improve cancer research, treatment, and care. We hope that this book will serve as a resource and inspiration to you as face forward with life after cancer.

The National Institutes of Health Publication 02-5053, Cancer Clinical Trials: A Resource Guide for Outreach, Education, and Advocacy, helps individuals and organizations find ways to participate and engage their community in clinical trials outreach and education activities. This publication includes worksheets and a Plan for Action to plan outreach efforts. Whether you are a health care professional who wants to find ways to reach your community, a member of a patient group who wants to educate its members, or someone who want to engage your group or organization to initiate clinical trial outreach activities. This guide is not designed to be a comprehensive overview; rather, it gives some examples of activities others have engaged in, and provides tools and suggestions for implantation in your community. By informing your community about clinical trials, you can help people make informed decisions about their cancer treatment or prevention options, including the option of participation in a clinical trial. The more people that participate in clinical trials, the faster we can answer the critical research questions that will lead us to better treatment and prevention options for all cancers. This workbook is designed to complement the other materials in the National Cancer Institute Clinical Trials Education Series, described at the beginning of this book.

The National Institutes of Health Publication 11-5337, "I Can Lower My Risk for Type 2 Diabetes: A Guide for American Indians," provides information on diabetes - how to prevent it, how to learn how to take care of yourself if you have diabetes, and how to prevent some of the serious problems that can diabetes can cause. Type 2 diabetes is the most common type in American Indians. This type of diabetes can occur at any age, even during childhood. People develop type 2 diabetes because the cells in the muscles, liver, and fat do not use insulin properly. Eventually, the body cannot make enough insulin. As a result, the amount of glucose in the blood increases while the cells are starved of energy. Over time, high blood glucose damages nerves and blood vessels, leading to problems such as heart disease, stroke, blindness, kidney failure, and amputation. Although people with diabetes can prevent or delay complications by keeping blood glucose (also called blood sugar) levels close to normal, preventing or delaying the development of type 2 diabetes in the first place is even better. The results of a major federally funded study, the Diabetes Prevention Program (DPP), prove that we can prevent or delay the disease. This study of 3,234 people at high risk for diabetes showed that moderate diet and exercise, resulting in a 5- to 7-percent weight loss, can delay and possibly prevent type 2 diabetes. More than 170 American Indians participated in the DPP. The DPP tested three approaches to preventing diabetes: making lifestyle changes, taking a diabetes pill, or following the standard diabetes education approach. People in the lifestyle change group exercised about 30 minutes a day, 5 days a week, usually by walking, and they lowered their intake of fat and calories. Those who took the diabetes pill metformin received standard information on exercise and diet, as is done in an Indian Health Service clinic or tribal physician's office. These approaches were compared with the third group who only received the standard information on exercise and diet and took a placebo-a pill without medicine in it. The DPP results showed that people in the lifestyle change group reduced their risk of getting type 2 diabetes by 58 percent. Average weight loss in the first year of the study was 15 pounds. Lifestyle change was even more effective in those 60 years and older. They reduced their risk by 71 percent. People who took metformin and received standard information on exercise and diet reduced their risk by 31 percent. The Diabetes Prevention Program Outcomes Study (DPPOS) has continued to follow most DPP participants since the DPP ended in 2001. The DPPOS has shown that the benefits of weight loss and metformin last for at least 10 years. Ten years after they enrolled in the DPP, people in the lifestyle change group had reduced their risk for developing diabetes by 34 percent. Those in the lifestyle change group age 60 or older had reduced their risk of developing diabetes by 49 percent. Participants in the lifestyle change group also had fewer heart and blood vessel disease risk factors, including lower blood pressure and triglyceride levels, even though they took fewer drugs to control their heart disease risk. The metformin group had reduced their risk of developing diabetes by 18 percent. Even though controlling your weight with lifestyle changes is challenging, it produces long-term health rewards by lowering your risk for type 2 diabetes, lowering your blood glucose levels, and reducing other risk factors for heart disease.

Violence or natural disasters can cause trauma in young people. Trauma is hurt or harm. It can be hurt to a person's body. It can be harm to a person's mind. Community members play important roles. They help children who experience violence or disaster. They help children cope with trauma. They help protect children from further trauma. They also help young people avoid or overcome emotional problems. These problems can result from trauma. There are two types of trauma - physical and mental. Physical trauma includes the body's response to serious injury and threat. Mental trauma includes frightening thoughts and painful feelings. They are the mind's response to serious injury. Mental trauma can produce strong feelings. It can also produce extreme behavior; such as intense fear or helplessness, withdrawal or detachment, lack of concentration, irritability, sleep disturbance, aggression, hyper vigilance (intensely watching for more distressing events), or flashbacks (sense that event is reoccurring).

The National Institutes of Health Publication 06-5129, "What I Need to Know About Gestational Diabetes," is for women with gestational diabetes. Gestational (jes-TAY-shun-ul) diabetes is diabetes that is found for the first time when a woman is pregnant. Out of every 100 pregnant women in the United States, three to eight get gestational diabetes. Diabetes means that your blood glucose (also called blood sugar) is too high. Your body uses glucose for energy. But too much glucose in your blood can be harmful. When you are pregnant, too much glucose is not good for your baby. This high blood glucose can damage many parts of your body, such as the heart, blood vessels, eyes, and kidneys. Heart and blood vessel disease can lead to heart attacks and strokes. You can do a lot to prevent or slow down diabetes problems.

The decline in U.S. smoking prevalence since the publication of the first Surgeon General's Report in 1964 has been hailed as one of the greatest public health accomplishments of the past century. Forty four million Americans-almost half of those who ever smoked-have quit, and lung cancer death rates have decreased greatly as a result. As a nation, we've launched wide-reaching tobacco control programs in worksites, schools, communities, and all 50 states, and we've witnessed enormous shifts in social norms, policies, and public attitudes. Growth in clean indoor-air laws and smoking restrictions have made quit-smoking cues "persistent and inescapable", and new data shows that tobacco price increases and mass media cessation campaigns can significantly increase population quit rates. Over the last three decades, we have developed effective clinical treatments-psychosocial and pharmacological-and seen the publication and update of authoritative practice guidelines recommending evidence based treatments that, if universally applied, could double our national annual quit rate in a highly cost-effective way. Prospects for preventing and treating tobacco use and addiction have never been better. Yet the papers in this monograph, Those Who Continue to Smoke: Is Achieving Abstinence Harder and Do We Need to Change Our Interventions?, raise important questions about what it will take to build on the successes of the last century and, in particular, on the last few decades of research and practice. While efforts to promote tobacco cessation need to be part of a much broader national tobacco control strategy that emphasizes prevention, it is clear that the greatest gains in reducing tobacco-caused morbidity, mortality, and health care costs in the next 30 to 40 years will come from helping addicted smokers quit. Further declines in adult smoking are likely to strengthen prevention efforts as well, since adult smoking is a critical determinant of social norms and a vector for youth initiation. In this context, the findings presented in this monograph have important implications for the next generation of research and practice to help addicted smokers quit. Specifically, these papers and the findings they present indicate that helping more smokers quit will require: (1) developing more powerful treatments that can break through the 25% to 30% quit-rate ceiling achieved with our best existing treatments; (2) refining, targeting and tailoring treatments for high-risk populations; (3) greatly improving surveillance of quitting patterns and determinants; (4) developing combined clinical-public health approaches that harness synergies between evidence based clinical treatments, and macro-level policy and environmental cessation strategies; and (5) improving the use of and demand for treatments that work.

Erection problems can be a difficult topic to discuss, but if you have problems getting or keeping an erection, you have good reasons to talk with a doctor: Erection problems not only interfere with your sex life, they can be a sign of other health problems. Erection problems can be a sign of blocked blood vessels or nerve damage from diabetes. If you don't see your doctor, these problems will go untreated and can harm your body. Erection problems used to be called impotence. Now the term erectile dysfunction is more common. Sometimes people just use the initials ED. Your doctor can offer several ED treatments. For many men, the answer is as simple as taking a pill. Other men have to try two or three options before they find a treatment that works for them. Don't give up if the first treatment doesn't work. Finding the right treatment can take time. This publication by the National Institutes of Health (Publication No. 09-5483) provides information on the causes, diagnosis, and treatment of erection problems.

Diseases and conditions affecting the bladder and associated structures of the lower urinary tract are a leading cause of urinary incontinence, pelvic pain, and kidney failure, and they often contribute to poor quality of life. It has been estimated that 35 million Americans suffer from bladder disease and most have chronic conditions.Benjamin Franklin documented the poor quality of life for people with bladder problems in 1752. He invented the first flexible urethral catheter, made of silver and covered with gut, to help his brother empty his bladder. Franklin's brother suffered from bladder outlet obstruction caused by bladder stones. Years later, Franklin, who suffered from the same problem, was forced to catheterize himself intermittently with his own invention. Although technology now provides better instrumentation, medical science has not solved many cases of urinary retention-or other problems related to the bladder-and intermittent catheterization much as Franklin described is still used. Bladder diseases and problems affect people of all ages, races, and ethnic groups. Strides have been taken to improve diagnosis, management, and treatment of bladder diseases, but many primary questions about bladder formation, function, and disease remain. The Bladder Research Progress Review Group (BRPRG) was formed by the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) of the National Institutes of Health (NIH) to examine the state of bladder research in the United States and to develop a plan for future research in this area. The members of the BRPRG are a multidisciplinary group of recognized experts in bladder research. Their task was a complex one because many diseases and conditions of the urinary tract such as incontinence, obstruction, interstitial cystitis, and spina bifida affect the bladder's structure and function. Bladder diseases such as bladder cancer or urinary tract infections affect specific tissues such as bladder epithelium; thus, research on these tissues will contribute directly to overall progress in cancer and infectious diseases research and not to research on bladder alone. From early 2000 to July 2001, members of the BRPRG had discussions and intensive meetings to examine all areas of bladder-related problems categorized by diseases and by organ or tissue in an attempt to develop a strategic bladder research plan. This plan is provided in this document. Overwhelmingly, the BRPRG has concluded that bladder research in the United States is inadequate, fraught with a number of impediments, and lags behind research in other areas that affect the health of Americans to a similar degree. The extent of health problems associated with the bladder emphasizes the urgent need to expand rapidly bladder health-related research not only to diagnose, manage, and treat bladder diseases, but also to discover the risk and preventive factors that will ultimately improve overall health. Recent discoveries and technological advances in biomedical science have provided a unique opportunity to make rapid and important advances in bladder research that might improve diagnosis, management, and prevention of bladder problems. This report outlines future critical research on the basic science of the lower urinary tract and clinical studies of bladder diseases and conditions. It also makes specific recommendations for focused inclusion of biotechnologies that offer opportunities for bladder research. In addition, the report describes the kinds of programs that will provide a pipeline of new researchers through training, new collaborations, and infrastructure to support this work. The potential consequences of rapid progress in bladder research could save many children, women, and men from the physical and emotional consequences of bladder diseases and conditions.

The National Institutes of Health Publication 10-6287, Pain Control: Support for People With Cancer, discusses pain control medicines and other methods to help manage pain, and addresses the physical and emotional effects of pain. Having cancer doesn't mean that you will have pain. But if you do, you can manage most of your pain with medicine and other treatments. This book discusses how to work with your health care team and others to find the best way to control your pain.

Exposure to environmental tobacco smoke (ETS) has been linked to a variety of adverse health outcomes. Many Californians are exposed at home, at work, and in public places. In the comprehensive reviews published as Reports of the Surgeon General and by the U.S. Environmental Protection Agency (U.S. EPA) and the National Research Council (NRC), ETS exposure has been found to be causally associated with respiratory illnesses-including lung cancer, childhood asthma, and lower respiratory tract infections. Scientific knowledge about ETS-related effects has expanded considerably since the release of the above-mentioned reviews. The state of California has therefore undertaken a broad review of ETS covering the major health endpoints potentially associated with ETS exposure: perinatal and postnatal manifestations of developmental toxicity, adverse impacts on male and female reproduction, respiratory disease, cancer, and cardiovascular disease. A "weight of evidence" approach has been used, in which the body of evidence is examined to determine whether or not it can be concluded that ETS exposure is causally associated with a particular effect. Because the epidemiological data are extensive, they serve as the primary basis for assessment of ETS-related effects in humans. The report also presents an overview on measurements of ETS exposure (particularly as they relate to characterizations of exposure in epidemiological investigations) and on the prevalence of ETS exposure in California and nationally. ETS, or "secondhand smoke," is the complex mixture formed from the escaping smoke of a burning tobacco product and smoke exhaled by the smoker. The characteristics of ETS change as it ages and combines with other constituents in the ambient air. Exposure to ETS is also frequently referred to as "passive smoking," or "involuntary tobacco smoke" exposure. Although all exposures of the fetus are "passive" and "involuntary," for the purposes of this review, in utero exposure resulting from maternal smoking during pregnancy is not considered to be ETS exposure.

Enclosed is the fourth edition of a book that is dedicated to the medical and social issues of individuals with sickle cell disease. This publication, which was developed by physicians, nurses, psychologists, and social workers who specialize in the care of children and adults with sickle cell disease, describes the current approach to counseling and also to management of many of the medical complications of sickle cell disease. Each chapter was prepared by one or more experts and then reviewed by several others in the field. Additional experts reviewed the entire volume. This book is not the result of a formalized consensus process but rather represents the efforts of those who have dedicated their professional careers to the care of individuals with sickle cell disease. The names of the authors, their affiliations, and their e-mail addresses are listed in the front of the book.

The makings of future news headlines about tomorrow's life saving therapies starts in the biomedical research laboratory. Ideas abound; early successes and later failures and knowledge gained from both; the rare lightning bolt of an unexpected breakthrough discovery --- this is a glimpse of the behind the scenes action of some of the world's most acclaimed stem cell scientists' quest to solve some of the human body's most challenging mysteries.Stem cells --- what lies ahead? The following chapters explore some of the cutting edge research featuring stem cells. Disease and disorders with no therapies or at best, partially effective ones, are the lure of the pursuit of stem cell research. Described here are examples of significant progress that is a prologue to an era of medical discovery of cell-based therapies that will one day restore function to those whose lives are now challenged every day --- but perhaps in the future, no longer.