Presentation is loading. Please wait.

Presentation is loading. Please wait.

Diseases and conditions In this presentation I will get to talk and explore different kinds of disease and conditions.

Similar presentations


Presentation on theme: "Diseases and conditions In this presentation I will get to talk and explore different kinds of disease and conditions."— Presentation transcript:

1 Diseases and conditions In this presentation I will get to talk and explore different kinds of disease and conditions

2 Anemia What Is Anemia? What Is Anemia? Maybe your day is so packed with things to do that you hardly have time to grab breakfast, let alone make sure you're eating right the rest of the day. Perhaps you're staying up late to get your homework finished and missing out on the sleep you need. The fact is, lots of teens are tired. And with all the demands of school and other activities, it's easy to understand why. Maybe your day is so packed with things to do that you hardly have time to grab breakfast, let alone make sure you're eating right the rest of the day. Perhaps you're staying up late to get your homework finished and missing out on the sleep you need. The fact is, lots of teens are tired. And with all the demands of school and other activities, it's easy to understand why. For some people, though, there may be another explanation for why they feel so exhausted: anemia. For some people, though, there may be another explanation for why they feel so exhausted: anemia. To understand anemia, it helps to start with breathing. The oxygen we inhale doesn't just stop in our lungs. It's needed throughout our bodies to fuel the brain and all our other organs and tissues that allow us to function. Oxygen travels to these organs through the bloodstream — specifically in the red blood cells. To understand anemia, it helps to start with breathing. The oxygen we inhale doesn't just stop in our lungs. It's needed throughout our bodies to fuel the brain and all our other organs and tissues that allow us to function. Oxygen travels to these organs through the bloodstream — specifically in the red blood cells. Red blood cells, or RBCs, are manufactured in the body's bone morrowand act like boats, ferrying oxygen throughout the rivers of the bloodstream. RBCs contain hemoglobin, a protein that holds onto oxygen. To make enough hemoglobin, the body needs to have plenty of iron. We get this iron, along with the other nutrients necessary to make red blood cells, from food. Red blood cells, or RBCs, are manufactured in the body's bone morrowand act like boats, ferrying oxygen throughout the rivers of the bloodstream. RBCs contain hemoglobin, a protein that holds onto oxygen. To make enough hemoglobin, the body needs to have plenty of iron. We get this iron, along with the other nutrients necessary to make red blood cells, from food. Anemia occurs when a person has fewer RBCs than normal. This can happen for three main reasons: Anemia occurs when a person has fewer RBCs than normal. This can happen for three main reasons: Red blood cells are being lost. Red blood cells are being lost. The body is producing RBCs slower than it should. The body is producing RBCs slower than it should. RBCs are being destroyed by the body. RBCs are being destroyed by the body.

3 Anemia Blood Loss Blood Loss When a small amount of blood is lost, the bone marrow is able to replace it without a person becoming anemic. But if a large amount of blood is lost over a short period of time, which can happen if someone has a serious accident or injury, for example, the bone marrow may not be able to replace the red blood cells quickly enough. When a small amount of blood is lost, the bone marrow is able to replace it without a person becoming anemic. But if a large amount of blood is lost over a short period of time, which can happen if someone has a serious accident or injury, for example, the bone marrow may not be able to replace the red blood cells quickly enough. Losing a little blood over a long period of time also might lead to anemia. This can happen in girls who have heavy menstrual periods, especially if they don't get enough iron in their diets Losing a little blood over a long period of time also might lead to anemia. This can happen in girls who have heavy menstrual periods, especially if they don't get enough iron in their diets

4 Anemia Iron Deficiency Anemia Iron Deficiency Anemia Iron deficiency anemia is the most common type of anemia in U.S. teens. It occurs when a person's diet is lacking in iron. Iron deficiency — when the body's stores of iron are reduced — is the first step toward anemia. If the body's iron stores aren't replenished at this point, continuing iron deficiency can cause the body's normal hemoglobin production to slow down. When hemoglobin levels and red blood cell production drop below normal, a person is said to have anemia. Someone with anemia may appear pale and may be tired all the time. Iron deficiency anemia is the most common type of anemia in U.S. teens. It occurs when a person's diet is lacking in iron. Iron deficiency — when the body's stores of iron are reduced — is the first step toward anemia. If the body's iron stores aren't replenished at this point, continuing iron deficiency can cause the body's normal hemoglobin production to slow down. When hemoglobin levels and red blood cell production drop below normal, a person is said to have anemia. Someone with anemia may appear pale and may be tired all the time. There are other nutritional reasons why someone's body may not make enough RBCs. Vitamin B12 and folic acid are also needed to make red blood cells, so it's important to get enough of these nutrients in your diet. If the bone marrow is not working properly because of an infection, chronic illness, or certain medications like chemotherapy, anemia can develop. There are other nutritional reasons why someone's body may not make enough RBCs. Vitamin B12 and folic acid are also needed to make red blood cells, so it's important to get enough of these nutrients in your diet. If the bone marrow is not working properly because of an infection, chronic illness, or certain medications like chemotherapy, anemia can develop.

5 Anemia Hemolytic Anemia Hemolytic Anemia In a person with hemolytic (pronounced: hee-muh-lih- tik) anemia, the normal lifespan of the red blood cells is shorter than normal. When blood cells die off early, the bone marrow is unable to keep up with production. This can happen for a variety of reasons. A person may have a disorder like sickle cell anemia or sphenocytosis. In other cases, the body's own immune system can cause destruction of RBCs. Antibodies can be formed as a reaction to certain infections or drugs that attack the RBCs by mistake. In a person with hemolytic (pronounced: hee-muh-lih- tik) anemia, the normal lifespan of the red blood cells is shorter than normal. When blood cells die off early, the bone marrow is unable to keep up with production. This can happen for a variety of reasons. A person may have a disorder like sickle cell anemia or sphenocytosis. In other cases, the body's own immune system can cause destruction of RBCs. Antibodies can be formed as a reaction to certain infections or drugs that attack the RBCs by mistake.sickle cell anemiasickle cell anemia

6 Anemia Why Do Teens Get Anemia? Why Do Teens Get Anemia? Because teens go through rapid growth spurts, they can be at risk for iron deficiency anemia. During a growth spurt, the body has a greater need for all types of nutrients, including iron, which we need to get in the foods we eat. Because teens go through rapid growth spurts, they can be at risk for iron deficiency anemia. During a growth spurt, the body has a greater need for all types of nutrients, including iron, which we need to get in the foods we eat. After puberty, girls are at more risk of iron deficiency anemia than guys are. That's because a girl needs more iron to compensate for the blood lost during her menstrual periods. Pregnancy can also cause a girl to develop anemia. And a teen on a diet to lose weight may be getting even less iron. After puberty, girls are at more risk of iron deficiency anemia than guys are. That's because a girl needs more iron to compensate for the blood lost during her menstrual periods. Pregnancy can also cause a girl to develop anemia. And a teen on a diet to lose weight may be getting even less iron. Vegetarians are more at risk of iron deficiency anemia than people who eat meat are. Red meat is the richest and best-absorbed source of iron. Although there is some iron in grains, vegetables, and some fruits and beans, there's less of it. And the iron in these food sources is not absorbed by the body as readily as the iron in meat. Vegetarians are more at risk of iron deficiency anemia than people who eat meat are. Red meat is the richest and best-absorbed source of iron. Although there is some iron in grains, vegetables, and some fruits and beans, there's less of it. And the iron in these food sources is not absorbed by the body as readily as the iron in meat.

7 Anemia What Are the Symptoms? What Are the Symptoms? It's easy for people to overlook the symptoms of anemia because it often happens gradually over time. Looking pale can be a sign of anemia because fewer red blood cells are flowing through the blood vessels. The heart will beat faster in an effort to pump the same amount of blood and oxygen to the body, so the pulse may be faster than normal. It's easy for people to overlook the symptoms of anemia because it often happens gradually over time. Looking pale can be a sign of anemia because fewer red blood cells are flowing through the blood vessels. The heart will beat faster in an effort to pump the same amount of blood and oxygen to the body, so the pulse may be faster than normal. As anemia progresses, a person may feel tired and short of breath, especially when climbing stairs or working out. They may develop headaches. Iron deficiency, which occurs before iron deficiency anemia develops, may affect a person's ability to concentrate, learn, and remember. As anemia progresses, a person may feel tired and short of breath, especially when climbing stairs or working out. They may develop headaches. Iron deficiency, which occurs before iron deficiency anemia develops, may affect a person's ability to concentrate, learn, and remember. Anemia is not contagious, so you cannot catch it from someone who has it. Anemia is not contagious, so you cannot catch it from someone who has it.

8 Anemia How Is Anemia Treated? How Is Anemia Treated? The treatment of anemia depends on what's causing it. If the anemia is caused by iron deficiency, your doctor will probably prescribe an iron supplement to be taken several times a day. Your doctor may do a blood test after you have been on the iron supplement. Even if the tests show that the anemia has improved, you may have to continue taking iron for several months to replenish your body's total iron stores. The treatment of anemia depends on what's causing it. If the anemia is caused by iron deficiency, your doctor will probably prescribe an iron supplement to be taken several times a day. Your doctor may do a blood test after you have been on the iron supplement. Even if the tests show that the anemia has improved, you may have to continue taking iron for several months to replenish your body's total iron stores. Because some people become nauseated if they take an iron supplement on an empty stomach, it can help to take it with food. Vitamin C boosts iron absorption, so drink a glass of orange or grapefruit juice when you take your iron. You can increase the chances that the iron you get from food will be absorbed by your body in other ways, too. For example, avoid drinking tea with food because a substance in tea called tannin reduces the body's ability to absorb iron found in the food or iron supplement. Milk can also interfere with iron absorption, so don't pair milk with iron- rich foods if you are concerned about getting enough iron. Because some people become nauseated if they take an iron supplement on an empty stomach, it can help to take it with food. Vitamin C boosts iron absorption, so drink a glass of orange or grapefruit juice when you take your iron. You can increase the chances that the iron you get from food will be absorbed by your body in other ways, too. For example, avoid drinking tea with food because a substance in tea called tannin reduces the body's ability to absorb iron found in the food or iron supplement. Milk can also interfere with iron absorption, so don't pair milk with iron- rich foods if you are concerned about getting enough iron. Some people need more iron than others: Girls need more than guys, for example. And a girl who has heavy periods has a greater need for iron than a girl who has a light flow. Some people need more iron than others: Girls need more than guys, for example. And a girl who has heavy periods has a greater need for iron than a girl who has a light flow. To make sure you get enough iron, eat a balanced diet every day, starting with a breakfast that includes an iron source, such as an iron-fortified cereal or bread. Lean meat, raisins, spinach, eggs, dried beans, and molasses are also good sources of iron. To make sure you get enough iron, eat a balanced diet every day, starting with a breakfast that includes an iron source, such as an iron-fortified cereal or bread. Lean meat, raisins, spinach, eggs, dried beans, and molasses are also good sources of iron. If someone's anemia is caused by another medical condition, doctors will work to treat the cause. People with some types of anemia will need to see a specialist, called a hematologist, who can provide the right medical care for their needs. If someone's anemia is caused by another medical condition, doctors will work to treat the cause. People with some types of anemia will need to see a specialist, called a hematologist, who can provide the right medical care for their needs. The good news is that for most people anemia is easily treated. And in a few weeks you'll have your energy back! The good news is that for most people anemia is easily treated. And in a few weeks you'll have your energy back!

9 Asthma What Is Asthma? What Is Asthma? Asthma is a lung condition that causes a person to have difficulty breathing. Asthma is a common condition: More than 6 million kids and teens have it. Asthma is a lung condition that causes a person to have difficulty breathing. Asthma is a common condition: More than 6 million kids and teens have it. Asthma affects a person's bronchial tubes, also known as airways. When a person breathes normally, air is taken in through the nose or mouth and then goes into the trachea (windpipe), passing through the bronchial tubes, into the lungs, and finally back out again. But people with asthma have airways that are inflamed. This means that they swell and produce lots of thick mucus. They are also overly sensitive, or hyperreactive, to certain things, like exercise, dust, or cigarette smoke. This hyperreactivity causes the smooth muscle that surrounds the airways to tighten up. The combination of airway inflammation and muscle tightening narrows the airways and makes it difficult for air to move through. Asthma affects a person's bronchial tubes, also known as airways. When a person breathes normally, air is taken in through the nose or mouth and then goes into the trachea (windpipe), passing through the bronchial tubes, into the lungs, and finally back out again. But people with asthma have airways that are inflamed. This means that they swell and produce lots of thick mucus. They are also overly sensitive, or hyperreactive, to certain things, like exercise, dust, or cigarette smoke. This hyperreactivity causes the smooth muscle that surrounds the airways to tighten up. The combination of airway inflammation and muscle tightening narrows the airways and makes it difficult for air to move through.bronchialtubesbronchialtubes In most people with asthma, the difficulty breathing happens periodically. When it does happen, it is known as an asthma flare-up also known as an asthma attack, flare, episode, or exacerbation. In most people with asthma, the difficulty breathing happens periodically. When it does happen, it is known as an asthma flare-up also known as an asthma attack, flare, episode, or exacerbation.asthma flare-upasthma flare-up

10 Asthma Asthma Flare-Ups Asthma Flare-Ups A person having an asthma flare-up may cough, wheeze (make a whistling sound while breathing), be short of breath, and feel an intense tightness in the chest. Many people with asthma compare a flare-up to the sensation of trying to breathe through a straw - it feels extremely hard to get air in and out of their lungs. An asthma flare-up can last for several hours or longer if a person doesn't use asthma medication. When an asthma flare-up is over, the person usually feels better. A person having an asthma flare-up may cough, wheeze (make a whistling sound while breathing), be short of breath, and feel an intense tightness in the chest. Many people with asthma compare a flare-up to the sensation of trying to breathe through a straw - it feels extremely hard to get air in and out of their lungs. An asthma flare-up can last for several hours or longer if a person doesn't use asthma medication. When an asthma flare-up is over, the person usually feels better. Between flare-ups, a person's breathing can seem completely normal, or a person may continue to have some symptoms, such as coughing. Some people with asthma feel as if they are always short of breath. Other people with the condition may only cough at night or while exercising and they may never have a noticeable flare-up. Between flare-ups, a person's breathing can seem completely normal, or a person may continue to have some symptoms, such as coughing. Some people with asthma feel as if they are always short of breath. Other people with the condition may only cough at night or while exercising and they may never have a noticeable flare-up.

11 Asthma What Causes It? What Causes It? No one knows exactly what causes asthma. It's thought to be a combination of environmental and genetic (hereditary) factors. A teen with asthma may have a parent or other close relative who has asthma or had it as a child. Teens who are overweight may be more likely to have asthma, although a person doesn't have to be overweight to have it. No one knows exactly what causes asthma. It's thought to be a combination of environmental and genetic (hereditary) factors. A teen with asthma may have a parent or other close relative who has asthma or had it as a child. Teens who are overweight may be more likely to have asthma, although a person doesn't have to be overweight to have it. Asthma isn't contagious, so you can't catch it from someone who has it. Asthma isn't contagious, so you can't catch it from someone who has it. Asthma symptoms can be brought on by dozens of different things, and what causes asthma flare-ups in one person might not bother another at all. The things that set off asthma symptoms are called triggers. The following are some of the common triggers: Asthma symptoms can be brought on by dozens of different things, and what causes asthma flare-ups in one person might not bother another at all. The things that set off asthma symptoms are called triggers. The following are some of the common triggers:triggers Allergens. Some people with asthma find that allergens - certain substances that cause an allergic reaction in some people - can be a major trigger. Common allergens are dust mites (microscopic bugs that live in dust), molds, pollen, animal dander, and cockroaches. Allergens. Some people with asthma find that allergens - certain substances that cause an allergic reaction in some people - can be a major trigger. Common allergens are dust mites (microscopic bugs that live in dust), molds, pollen, animal dander, and cockroaches.allergensallergic reactionallergensallergic reaction Airborne irritants and pollutants. Certain substances in the air, such as chalk dust or smoke, can trigger asthma because they irritate the airways. Cigarette smoke is a major cause of asthma symptoms, and not just for smokers - secondhand smoke can trigger asthma symptoms in people who are around smokers. Scented products such as perfumes, cosmetics, and cleaning solutions can trigger symptoms, as can strong odors from fresh paint or gasoline fumes. And some research studies have found that high levels of air pollutants such as ozone may irritate the sensitive tissues in the bronchial tubes and can possibly aggravate the symptoms of asthma in some people with the condition. Airborne irritants and pollutants. Certain substances in the air, such as chalk dust or smoke, can trigger asthma because they irritate the airways. Cigarette smoke is a major cause of asthma symptoms, and not just for smokers - secondhand smoke can trigger asthma symptoms in people who are around smokers. Scented products such as perfumes, cosmetics, and cleaning solutions can trigger symptoms, as can strong odors from fresh paint or gasoline fumes. And some research studies have found that high levels of air pollutants such as ozone may irritate the sensitive tissues in the bronchial tubes and can possibly aggravate the symptoms of asthma in some people with the condition. Exercise. Some people have what's called exercise-induced asthma, which is triggered by physical activity. Although it can be especially frustrating, most cases of exercise-induced asthma can be treated so that people can still enjoy the sports they love. Exercise. Some people have what's called exercise-induced asthma, which is triggered by physical activity. Although it can be especially frustrating, most cases of exercise-induced asthma can be treated so that people can still enjoy the sports they love. Weather. Cold or dry air can sometimes trigger asthma symptoms in certain people, as can extreme heat or humidity. Weather. Cold or dry air can sometimes trigger asthma symptoms in certain people, as can extreme heat or humidity. Respiratory tract infections. Colds, flu, and other viral infections can trigger asthma in some people. Respiratory tract infections. Colds, flu, and other viral infections can trigger asthma in some people.

12 Asthma How Do Doctors Diagnose Asthma? How Do Doctors Diagnose Asthma? Many people with asthma are diagnosed with the condition when they're kids, but some don't find out that they have it until their teen years or even later. In diagnosing asthma, a doctor will ask about any concerns and symptoms you have, your past health, your family's health, any medications you're taking, any allergies you may have, and other issues. This is called the medical history. Many people with asthma are diagnosed with the condition when they're kids, but some don't find out that they have it until their teen years or even later. In diagnosing asthma, a doctor will ask about any concerns and symptoms you have, your past health, your family's health, any medications you're taking, any allergies you may have, and other issues. This is called the medical history. The doctor will also perform a physical exam. He or she may recommend that you take some tests. Tests that doctors use to diagnose asthma include spirometry (pronounced: spye-rah-muh- tree) and peak flow meter tests, which involve blowing into devices that can measure how well your lungs are performing. Your doctor may also recommend allergy tests to see if allergies are causing your symptoms, or special exercise tests to see whether your asthma symptoms may be brought on by physical activity. Doctors occasionally use X-rays in diagnosing asthma, but these are usually only to rule out other possible problems. The doctor will also perform a physical exam. He or she may recommend that you take some tests. Tests that doctors use to diagnose asthma include spirometry (pronounced: spye-rah-muh- tree) and peak flow meter tests, which involve blowing into devices that can measure how well your lungs are performing. Your doctor may also recommend allergy tests to see if allergies are causing your symptoms, or special exercise tests to see whether your asthma symptoms may be brought on by physical activity. Doctors occasionally use X-rays in diagnosing asthma, but these are usually only to rule out other possible problems.

13 Asthma How Is It Treated? How Is It Treated? There's no cure for asthma, but the condition can usually be managed and flare-ups can be prevented. Asthma is treated in two ways: by avoiding potential triggers and with medication. There's no cure for asthma, but the condition can usually be managed and flare-ups can be prevented. Asthma is treated in two ways: by avoiding potential triggers and with medication. Teens who have asthma need to avoid the things that can cause their symptoms. Of course, some things that can cause symptoms can't be completely avoided (like catching a cold!), but people can control their exposure to some triggers, such as pet dander, for example. Teens who have asthma need to avoid the things that can cause their symptoms. Of course, some things that can cause symptoms can't be completely avoided (like catching a cold!), but people can control their exposure to some triggers, such as pet dander, for example. In the case of exercise-induced asthma, the trigger (physical activity) needs to be managed rather than avoided. Exercise can help a person stay healthier overall, and doctors can help athletes find treatments that allow them to them participate in their sports. In the case of exercise-induced asthma, the trigger (physical activity) needs to be managed rather than avoided. Exercise can help a person stay healthier overall, and doctors can help athletes find treatments that allow them to them participate in their sports. Doctors treat every asthma case individually because the severity of each person's asthma and what triggers the symptoms are different. For this reason, doctors have a variety of treatment medications at their disposal. Most asthma medications are inhaled (which means that a person takes the medication by breathing it into the lungs), but asthma medications can also take the form of pills or liquids. They fall into two categories: Doctors treat every asthma case individually because the severity of each person's asthma and what triggers the symptoms are different. For this reason, doctors have a variety of treatment medications at their disposal. Most asthma medications are inhaled (which means that a person takes the medication by breathing it into the lungs), but asthma medications can also take the form of pills or liquids. They fall into two categories: Rescue medications that act quickly to halt asthma symptoms once they start. Some medications can be used as needed to stop asthma symptoms (such as wheezing, coughing, and shortness of breath) when a person first notices them. These medications act fast to stop the symptoms, but they're not long lasting. They are also known as "reliever," "quick-relief, " or "fast-acting" medications. Rescue medications that act quickly to halt asthma symptoms once they start. Some medications can be used as needed to stop asthma symptoms (such as wheezing, coughing, and shortness of breath) when a person first notices them. These medications act fast to stop the symptoms, but they're not long lasting. They are also known as "reliever," "quick-relief, " or "fast-acting" medications. Rescue medications Rescue medications Controller medications to manage asthma and prevent symptoms from occurring in the first place. Many people with asthma need to take medication every day to control the condition overall. Controller medications (also called "preventive" or "maintenance" medications) work differently from rescue medications. They treat the problem of airway inflammation instead of the symptoms (coughing, wheezing, etc.) that it causes. Controller medications are slow acting and can take days or even weeks to begin working. Although you may not notice them working in the same way as rescue medications, regular use of controller medications should lessen your need for the rescue medications. Doctors also prescribe controller medications as a way to minimize any permanent lung changes that may be associated with having asthma. Controller medications to manage asthma and prevent symptoms from occurring in the first place. Many people with asthma need to take medication every day to control the condition overall. Controller medications (also called "preventive" or "maintenance" medications) work differently from rescue medications. They treat the problem of airway inflammation instead of the symptoms (coughing, wheezing, etc.) that it causes. Controller medications are slow acting and can take days or even weeks to begin working. Although you may not notice them working in the same way as rescue medications, regular use of controller medications should lessen your need for the rescue medications. Doctors also prescribe controller medications as a way to minimize any permanent lung changes that may be associated with having asthma. Controller medications Controller medications Some people with asthma rely only on rescue medications; others use rescue medications together with controller medications to keep their asthma in check overall. Each person needs to work closely with a doctor to create an asthma action plan that's right for them. Some people with asthma rely only on rescue medications; others use rescue medications together with controller medications to keep their asthma in check overall. Each person needs to work closely with a doctor to create an asthma action plan that's right for them. asthma action plan asthma action plan

14 Asthma Dealing With Asthma Dealing With Asthma The best way to control asthma is prevention. Although medications can play an essential role in preventing flare- ups, environmental control is also very important. Here are some things you can do to help prevent coming into contact with the allergens or irritants that cause your asthma flare-ups: The best way to control asthma is prevention. Although medications can play an essential role in preventing flare- ups, environmental control is also very important. Here are some things you can do to help prevent coming into contact with the allergens or irritants that cause your asthma flare-ups: Keep your environment clear of potential allergens. For example, if dust is a trigger for you, vacuum (or remove) rugs and drapes where dust mites can hide. Placing pillows and mattresses in dust-proof covers can help. If pets trigger your symptoms, keep a pet-free household. If you can't part with Fido or Fluffy, keep certain rooms pet free and bathe your pet frequently to get rid of dander. Keep your environment clear of potential allergens. For example, if dust is a trigger for you, vacuum (or remove) rugs and drapes where dust mites can hide. Placing pillows and mattresses in dust-proof covers can help. If pets trigger your symptoms, keep a pet-free household. If you can't part with Fido or Fluffy, keep certain rooms pet free and bathe your pet frequently to get rid of dander. Pay attention to the weather and take precautions when you know weather or air pollution conditions may affect you. You may need to stay indoors or limit your exercise to indoor activities. Pay attention to the weather and take precautions when you know weather or air pollution conditions may affect you. You may need to stay indoors or limit your exercise to indoor activities. Don't smoke (or, if you're a smoker, quit). Smoking is always a bad idea for the lungs, but it's especially bad for someone who has asthma. Don't smoke (or, if you're a smoker, quit). Smoking is always a bad idea for the lungs, but it's especially bad for someone who has asthma.Smoking Be smart about exercise. It's a great way to keep the body and mind healthy, so if you're prone to exercise- induced asthma flare-ups, talk to your doctor about how to manage your symptoms. If you get flare-ups during a game or workout, stop what you're doing until the flare-up has cleared or you've taken rescue medication. When the symptoms have gone, you can start exercising again. Be smart about exercise. It's a great way to keep the body and mind healthy, so if you're prone to exercise- induced asthma flare-ups, talk to your doctor about how to manage your symptoms. If you get flare-ups during a game or workout, stop what you're doing until the flare-up has cleared or you've taken rescue medication. When the symptoms have gone, you can start exercising again. Asthma doesn't have to prevent you from doing what you love! Sure, it takes a bit of work (and remembering!) but if you follow your asthma action plan, take your medications properly, recognize your symptoms and triggers, and check in with your doctor regularly, you can do anything that other teens do. That includes any sports activity, even cross-country skiing, swimming, or playing basketball. Asthma doesn't have to prevent you from doing what you love! Sure, it takes a bit of work (and remembering!) but if you follow your asthma action plan, take your medications properly, recognize your symptoms and triggers, and check in with your doctor regularly, you can do anything that other teens do. That includes any sports activity, even cross-country skiing, swimming, or playing basketball.

15 Epilepsy What Is Epilepsy? What Is Epilepsy? Epilepsy is a condition of the nervous system that affects 2.5 million Americans. More than 180,000 people are diagnosed with epilepsy every year. Epilepsy is a condition of the nervous system that affects 2.5 million Americans. More than 180,000 people are diagnosed with epilepsy every year. It can be scary watching someone have an epileptic seizure. The person may lose consciousness or seem unaware of what's going on, make involuntary motions (movements the person has no control over, such as jerking or thrashing one or more parts of the body), or experience unusual feelings or sensations (such as unexplained fear). After a seizure, he or she may feel tired, weak, or confused. It can be scary watching someone have an epileptic seizure. The person may lose consciousness or seem unaware of what's going on, make involuntary motions (movements the person has no control over, such as jerking or thrashing one or more parts of the body), or experience unusual feelings or sensations (such as unexplained fear). After a seizure, he or she may feel tired, weak, or confused. People have seizures when the electrical signals in the brain misfire. The brain's normal electrical activity is disrupted by these overactive electrical discharges, causing a temporary communication problem between nerve cells. People have seizures when the electrical signals in the brain misfire. The brain's normal electrical activity is disrupted by these overactive electrical discharges, causing a temporary communication problem between nerve cells. Just because someone has a seizure does not necessarily mean that person has epilepsy, though. Seizures can be triggered in anyone under certain conditions, such as life-threatening dehydration or high temperature. But when a person experiences repeated seizures for no obvious reason, that person is said to have epilepsy. Just because someone has a seizure does not necessarily mean that person has epilepsy, though. Seizures can be triggered in anyone under certain conditions, such as life-threatening dehydration or high temperature. But when a person experiences repeated seizures for no obvious reason, that person is said to have epilepsy.dehydration Many people develop epilepsy as children or teens. Others develop it later in life. For some people with epilepsy (particularly kids), the seizures eventually become less frequent or disappear altogether. Many people develop epilepsy as children or teens. Others develop it later in life. For some people with epilepsy (particularly kids), the seizures eventually become less frequent or disappear altogether.

16 Epilepsy What Causes Epilepsy? What Causes Epilepsy? This is a tricky question with no clear-cut answer. Often doctors can't pinpoint exactly what causes epilepsy in a particular individual. But scientists do know that these are some of the things that can make a person more likely to develop epilepsy: This is a tricky question with no clear-cut answer. Often doctors can't pinpoint exactly what causes epilepsy in a particular individual. But scientists do know that these are some of the things that can make a person more likely to develop epilepsy: a brain injury, such as from a car crash or bike accident a brain injury, such as from a car crash or bike accident an infection or illness that affected the developing brain of a fetus during pregnancy an infection or illness that affected the developing brain of a fetus during pregnancy lack of oxygen to an infant's brain during childbirth lack of oxygen to an infant's brain during childbirth meningitis, encephalitis, or any other type of infection that affects the brain meningitis, encephalitis, or any other type of infection that affects the brain brain tumors or strokes brain tumors or strokes brain tumors brain tumors poisoning, such as lead or alcohol poisoning poisoning, such as lead or alcohol poisoningalcohol Epilepsy is not contagious. You can't catch it from someone who has it. Epilepsy is not passed down through families (inherited) in the same way that blue eyes or brown hair are. But a person who has a close relative with epilepsy has a slightly higher risk for epilepsy than somebody with no family history of seizures. Epilepsy is not contagious. You can't catch it from someone who has it. Epilepsy is not passed down through families (inherited) in the same way that blue eyes or brown hair are. But a person who has a close relative with epilepsy has a slightly higher risk for epilepsy than somebody with no family history of seizures.

17 Epilepsy Understanding Seizures Seizures may look frightening, but they're not painful. They affect different people in different ways. Epileptic seizures fall into two main categories: partial and generalized. Seizures may look frightening, but they're not painful. They affect different people in different ways. Epileptic seizures fall into two main categories: partial and generalized. Partial seizures start in one part of the brain. The electrical disturbances may then move to other parts of the brain or they may stay in one area until the seizure is over. A person having a partial seizure may lose consciousness. There may be twitching of a finger or several fingers, a hand or arm, or a leg or foot. Certain facial muscles might twitch. Speech might become slurred, unclear, or unusual during the seizure. The person's vision might be affected temporarily. He or she might feel tingling throughout one side of the body. It all depends on where in the brain the abnormal electrical activity is taking place. Partial seizures start in one part of the brain. The electrical disturbances may then move to other parts of the brain or they may stay in one area until the seizure is over. A person having a partial seizure may lose consciousness. There may be twitching of a finger or several fingers, a hand or arm, or a leg or foot. Certain facial muscles might twitch. Speech might become slurred, unclear, or unusual during the seizure. The person's vision might be affected temporarily. He or she might feel tingling throughout one side of the body. It all depends on where in the brain the abnormal electrical activity is taking place. Generalized seizures involve electrical disturbances that occur all over the brain at the same time. The person may appear to be daydreaming, may stare off into space, or may pass out. The muscles may stiffen and the person might make sudden jerking motions, such as flinging the arms outward. He or she may suddenly go limp and slump down or fall over. Generalized seizures involve electrical disturbances that occur all over the brain at the same time. The person may appear to be daydreaming, may stare off into space, or may pass out. The muscles may stiffen and the person might make sudden jerking motions, such as flinging the arms outward. He or she may suddenly go limp and slump down or fall over. Most seizures last only a few seconds or minutes. After a seizure is over, the person might feel sleepy or confused for a few minutes or even an hour or more. People who've had seizures may not remember the seizure or what happened immediately before the event. They may be alert and ready to resume whatever they were doing before the seizure happened. It varies from person to person. Most seizures last only a few seconds or minutes. After a seizure is over, the person might feel sleepy or confused for a few minutes or even an hour or more. People who've had seizures may not remember the seizure or what happened immediately before the event. They may be alert and ready to resume whatever they were doing before the seizure happened. It varies from person to person. Certain things can sometimes trigger seizures in people with epilepsy. They include: Certain things can sometimes trigger seizures in people with epilepsy. They include: flashing or bright lights flashing or bright lights a lack of sleep a lack of sleepsleep stress stress stress overstimulation (like staring at a computer screen or playing video games for too long) overstimulation (like staring at a computer screen or playing video games for too long) fever fever certain medications certain medications hyperventilation (breathing too fast or too deeply) hyperventilation (breathing too fast or too deeply)

18 Epilepsy ) Living With Epilepsy Living With Epilepsy People with epilepsy can and do live normal lives. Many athletes, authors, politicians, entrepreneurs, doctors, parents, and artists have epilepsy. People with epilepsy can and do live normal lives. Many athletes, authors, politicians, entrepreneurs, doctors, parents, and artists have epilepsy. If you have epilepsy, you can still become involved in extracurricular activities, go on dates, and get a job. Your doctor will give you instructions about taking precautions to protect yourself in various situations. For example, teens with epilepsy can enjoy swimming, but should always swim with other people to be safe. Aside from some minor safety precautions, though, you can enjoy all the stuff your friends and classmates do. As long as epilepsy is under medical control, people with epilepsy are able to drive. If you have epilepsy, you can still become involved in extracurricular activities, go on dates, and get a job. Your doctor will give you instructions about taking precautions to protect yourself in various situations. For example, teens with epilepsy can enjoy swimming, but should always swim with other people to be safe. Aside from some minor safety precautions, though, you can enjoy all the stuff your friends and classmates do. As long as epilepsy is under medical control, people with epilepsy are able to drive. Tell the people close to you — friends, relatives, teachers, coaches — about your epilepsy and teach them what to do in case you have a seizure when they're with you. Some of the things friends can do to help someone who's having a seizure are: Tell the people close to you — friends, relatives, teachers, coaches — about your epilepsy and teach them what to do in case you have a seizure when they're with you. Some of the things friends can do to help someone who's having a seizure are: Stay calm. Stay calm. Help, but don't force, the person to lie down on his or her side, preferably on a soft surface, and place something soft under the person's head. Help, but don't force, the person to lie down on his or her side, preferably on a soft surface, and place something soft under the person's head. Take the person's glasses or backpack off and loosen any tight clothing near the neck. Take the person's glasses or backpack off and loosen any tight clothing near the neck. Don't restrain or hold the person. Don't restrain or hold the person. Move objects, especially sharp or hard ones, away from the person. Move objects, especially sharp or hard ones, away from the person. Stay with the person or make sure another friend or trusted person stays with him or her. Stay with the person or make sure another friend or trusted person stays with him or her. Talk with the person in a calm, reassuring way after the seizure is over. Talk with the person in a calm, reassuring way after the seizure is over. Observe the event and be able to describe what happened before, during, and after the seizure. Observe the event and be able to describe what happened before, during, and after the seizure. Do not place an object into the person's mouth during a seizure. Do not place an object into the person's mouth during a seizure. There's usually no need to call 911 if the person having a seizure is known to have epilepsy. However, if the person is injured, has another medical condition like diabetes, or has a long seizure or multiple seizures, he or she may need medical attention. There's usually no need to call 911 if the person having a seizure is known to have epilepsy. However, if the person is injured, has another medical condition like diabetes, or has a long seizure or multiple seizures, he or she may need medical attention. Epilepsy sounds frightening, but managing it can be simple. If you have epilepsy, follow your treatment plan. Get plenty of sleep. Eat right. And exercise to reduce stress and stay in shape. Epilepsy sounds frightening, but managing it can be simple. If you have epilepsy, follow your treatment plan. Get plenty of sleep. Eat right. And exercise to reduce stress and stay in shape.

19 Lupus What Is Lupus? What Is Lupus? Lupus is a disease that involves the immune system and affects about 1.5 million Americans; nearly 90% of those diagnosed with the disease are female. Normally, a person's immune system works by producing immunity cells and antibodies, special substances that fight germs and infections. Lupus is a disease that involves the immune system and affects about 1.5 million Americans; nearly 90% of those diagnosed with the disease are female. Normally, a person's immune system works by producing immunity cells and antibodies, special substances that fight germs and infections. But when a person has lupus, the immune system goes into overdrive and can't tell the difference between some of the body's normal, healthy cells and germs that can cause infection. So the immune system responds by making autoantibodies that attack the body's normal cells. But when a person has lupus, the immune system goes into overdrive and can't tell the difference between some of the body's normal, healthy cells and germs that can cause infection. So the immune system responds by making autoantibodies that attack the body's normal cells. The three types of lupus are: The three types of lupus are: 1. Systemic Lupus Erythematosus 1. Systemic Lupus Erythematosus Also called SLE, this is the type of lupus that most people mean when they talk about the disease. It was given its name by a 19th century French doctor who thought that the facial rash of some people with lupus looked like the bite or scratch of a wolf ("lupus" is Latin for wolf and "erythematosus" is Latin for red). Also called SLE, this is the type of lupus that most people mean when they talk about the disease. It was given its name by a 19th century French doctor who thought that the facial rash of some people with lupus looked like the bite or scratch of a wolf ("lupus" is Latin for wolf and "erythematosus" is Latin for red). SLE is the most serious form of lupus. Like Chantelle, about 15% of the people who have SLE first start to feel sick when they are teens. SLE can affect the skin, joints, and tendons. It may also affect organs like the brain, heart, lungs, and kidneys. SLE is the most serious form of lupus. Like Chantelle, about 15% of the people who have SLE first start to feel sick when they are teens. SLE can affect the skin, joints, and tendons. It may also affect organs like the brain, heart, lungs, and kidneys. 2. Discoid Lupus 2. Discoid Lupus This type of lupus is a skin disease that causes a rash on the face, neck, scalp, and ears. It is a much more rare form of lupus than SLE, although about 10% of people with discoid lupus will develop a mild form of SLE. It doesn't affect other body organs the way that SLE can. The rash of discoid lupus can cause scarring, though. This type of lupus is a skin disease that causes a rash on the face, neck, scalp, and ears. It is a much more rare form of lupus than SLE, although about 10% of people with discoid lupus will develop a mild form of SLE. It doesn't affect other body organs the way that SLE can. The rash of discoid lupus can cause scarring, though. 3. Drug-Induced Lupus 3. Drug-Induced Lupus This type of lupus is caused by a reaction to certain kinds of medicines. For example, some types of antiseizure medicines and acne medicines can cause this kind of lupus in teens. Drug-induced lupus is similar to SLE in the ways it affects the body, but once a person stops taking the medicine, the symptoms usually go away. This type of lupus is caused by a reaction to certain kinds of medicines. For example, some types of antiseizure medicines and acne medicines can cause this kind of lupus in teens. Drug-induced lupus is similar to SLE in the ways it affects the body, but once a person stops taking the medicine, the symptoms usually go away.

20 Lupus What Causes Lupus? What Causes Lupus? No one really knows what causes lupus. Researchers think that some people may be more likely to get it due to things that are out of their control, like: No one really knows what causes lupus. Researchers think that some people may be more likely to get it due to things that are out of their control, like: gender: Many more women get lupus than men; there are 10 women to every one man with lupus. gender: Many more women get lupus than men; there are 10 women to every one man with lupus. estrogen: This female hormone may be a factor in lupus — almost all women who get lupus are of childbearing age. estrogen: This female hormone may be a factor in lupus — almost all women who get lupus are of childbearing age.hormone race/ethnicity: Lupus occurs more often in African-American, Asian-American, Latin-American, and Native-American women than in non-Hispanic Caucasian women. race/ethnicity: Lupus occurs more often in African-American, Asian-American, Latin-American, and Native-American women than in non-Hispanic Caucasian women. family history/genetics: About 10% of people with lupus have a family member with lupus. family history/genetics: About 10% of people with lupus have a family member with lupus. major stress or infection: If people have the genetic tendency to get lupus, extreme stress or an infection may trigger the disease — but the blueprint for lupus has to already be there. One thing researchers know about lupus is that it is not contagious. You can't catch any of the three types of lupus from another person. And although lupus involves the immune system, it is not the same as other diseases that involve the immune system, like AIDS. major stress or infection: If people have the genetic tendency to get lupus, extreme stress or an infection may trigger the disease — but the blueprint for lupus has to already be there. One thing researchers know about lupus is that it is not contagious. You can't catch any of the three types of lupus from another person. And although lupus involves the immune system, it is not the same as other diseases that involve the immune system, like AIDS.stressAIDSstressAIDS

21 Lupus Symptoms of Lupus and How It Is Diagnosed Symptoms of Lupus and How It Is Diagnosed Lupus can be hard to diagnose because its symptoms can vary from one person to the next. The symptoms can also make lupus look like certain other diseases. For example, like Chantelle, people with lupus may feel weak and fatigued. They may have muscle aches, loss of appetite, swollen glands, and hair loss. Sometimes they have abdominal pain, nausea, diarrhea, and vomiting. Lupus can be hard to diagnose because its symptoms can vary from one person to the next. The symptoms can also make lupus look like certain other diseases. For example, like Chantelle, people with lupus may feel weak and fatigued. They may have muscle aches, loss of appetite, swollen glands, and hair loss. Sometimes they have abdominal pain, nausea, diarrhea, and vomiting. The doctor may perform certain blood tests when lupus is suspected and will probably send the person to a rheumatologist (pronounced: roo-muh-tol-uh-jist). Rheumatologists are doctors who have special training in diagnosing and treating autoimmune diseases like lupus. The doctor may perform certain blood tests when lupus is suspected and will probably send the person to a rheumatologist (pronounced: roo-muh-tol-uh-jist). Rheumatologists are doctors who have special training in diagnosing and treating autoimmune diseases like lupus. Because signs and symptoms of SLE can be so varied, a rheumatologist will look for 11 specific signs: Because signs and symptoms of SLE can be so varied, a rheumatologist will look for 11 specific signs: malar rash: A malar (pronounced: may-lur) rash appears across the nose and cheeks in the shape of a butterfly. malar rash: A malar (pronounced: may-lur) rash appears across the nose and cheeks in the shape of a butterfly. discoid rash: This rash features round, red, scaly patches that can appear on the face, arms, scalp, or ears. discoid rash: This rash features round, red, scaly patches that can appear on the face, arms, scalp, or ears. photosensitivity: This means sensitivity to ultraviolet rays, like the ones that come from the sun or from fluorescent lights. Most people with SLE are photosensitive and find that the sun worsens their lupus. photosensitivity: This means sensitivity to ultraviolet rays, like the ones that come from the sun or from fluorescent lights. Most people with SLE are photosensitive and find that the sun worsens their lupus. ulcers in the nose or mouth: These usually don't hurt and many people with SLE don't even know they are there. ulcers in the nose or mouth: These usually don't hurt and many people with SLE don't even know they are there. arthritis: This makes joints hurt, especially in hands and feet. Unlike the kind of arthritis that older people sometimes get, this arthritis doesn't damage the bones. Most people with SLE have some degree of arthritis. arthritis: This makes joints hurt, especially in hands and feet. Unlike the kind of arthritis that older people sometimes get, this arthritis doesn't damage the bones. Most people with SLE have some degree of arthritis. serositis (pronounced: sir-o-syte-us): This is the collection of fluid near the linings covering the heart, lungs, or abdomen. serositis (pronounced: sir-o-syte-us): This is the collection of fluid near the linings covering the heart, lungs, or abdomen. kidney problems: These can be mild or severe. Most people with SLE will have kidney problems, but only about half of them will have permanent kidney damage. kidney problems: These can be mild or severe. Most people with SLE will have kidney problems, but only about half of them will have permanent kidney damage. neurologic problems: This refers to problems with the brain and nervous system, like seizures. neurologic problems: This refers to problems with the brain and nervous system, like seizures. blood problems: SLE can cause a lower than normal number of red blood cells (anemia), white blood cells, or platelets. blood problems: SLE can cause a lower than normal number of red blood cells (anemia), white blood cells, or platelets. immune system problems: Blood tests may show that the immune system isn't functioning properly. immune system problems: Blood tests may show that the immune system isn't functioning properly. positive ANA test: This is a blood test that shows a certain type of antibody. About 95% of people with SLE have a positive ANA test. positive ANA test: This is a blood test that shows a certain type of antibody. About 95% of people with SLE have a positive ANA test. Someone with four or more of these signs or symptoms is likely to have SLE. Most patients don't develop all 11 of them Someone with four or more of these signs or symptoms is likely to have SLE. Most patients don't develop all 11 of them

22 Lupus Treating Lupus Treating Lupus The type of treatment someone gets often depends on how severe the lupus is and which body systems are affected. Almost all people with SLE take some kind of medicine to help control their lupus. Patients whose joints hurt often take acetaminophen (such as Tylenol) or ibuprofen (such as Advil or Motrin) to help with the pain. The type of treatment someone gets often depends on how severe the lupus is and which body systems are affected. Almost all people with SLE take some kind of medicine to help control their lupus. Patients whose joints hurt often take acetaminophen (such as Tylenol) or ibuprofen (such as Advil or Motrin) to help with the pain. Others take antimalarial drugs (medicines first developed to prevent and treat malaria, but that have also been found to help treat lupus). Antimalarial drugs often help treat skin rashes and joint pain. Others take antimalarial drugs (medicines first developed to prevent and treat malaria, but that have also been found to help treat lupus). Antimalarial drugs often help treat skin rashes and joint pain. Some rheumatologists prescribe anti-inflammatory steroids, medicines that help fight the fatigue and fever that can affect people with SLE. People with lupus that affects important body organs may be given other immunosuppressive drugs. These drugs help stop the immune system from producing the autoantibodies that destroy healthy cells. These drugs are very strong, though, and can have side effects. So they are used only when it's really necessary. Some rheumatologists prescribe anti-inflammatory steroids, medicines that help fight the fatigue and fever that can affect people with SLE. People with lupus that affects important body organs may be given other immunosuppressive drugs. These drugs help stop the immune system from producing the autoantibodies that destroy healthy cells. These drugs are very strong, though, and can have side effects. So they are used only when it's really necessary.

23 Lupus Living With Lupus Living With Lupus In addition to taking medicine, a big part of treating lupus may involve lifestyle changes. For a lot of people with lupus, paying close attention to certain health habits can help prevent their symptoms from flaring up. Getting enough rest and avoiding becoming too busy or overly stressed are helpful. Eating well and exercising regularly can also help a person avoid a flare. In addition to taking medicine, a big part of treating lupus may involve lifestyle changes. For a lot of people with lupus, paying close attention to certain health habits can help prevent their symptoms from flaring up. Getting enough rest and avoiding becoming too busy or overly stressed are helpful. Eating well and exercising regularly can also help a person avoid a flare. People with lupus can learn to manage the disease to minimize its impact on their lives. Some teens work with a health care team, getting help from a rheumatologist, a nephrologist (a doctor who specializes in kidney problems), a nurse practitioner, and a social worker. Because lupus can differ from one person to another, the team will create a special treatment plan based on the person's individual needs. People with lupus can learn to manage the disease to minimize its impact on their lives. Some teens work with a health care team, getting help from a rheumatologist, a nephrologist (a doctor who specializes in kidney problems), a nurse practitioner, and a social worker. Because lupus can differ from one person to another, the team will create a special treatment plan based on the person's individual needs. Part of managing lupus is controlling the symptoms and preventing flares. A flare is a period of time when the disease gets worse. During a flare, a person feels much more tired, sick, feverish, and achy than usual, and it can also harm important body organs. Part of managing lupus is controlling the symptoms and preventing flares. A flare is a period of time when the disease gets worse. During a flare, a person feels much more tired, sick, feverish, and achy than usual, and it can also harm important body organs. When it comes to staying healthy, sometimes the things a person with lupus doesn't do can be just as important as those they do. Rheumatologists recommend that people with lupus don't spend time in the sun unless they wear lots of sunscreen and protective clothing because ultraviolet rays can bring on a flare. When it comes to staying healthy, sometimes the things a person with lupus doesn't do can be just as important as those they do. Rheumatologists recommend that people with lupus don't spend time in the sun unless they wear lots of sunscreen and protective clothing because ultraviolet rays can bring on a flare. Smoking, drinking, and drugs are also a bad idea for teens with lupus. Alcohol can throw off the balance of certain medications, a dangerous situation for someone with lupus. Tattooing and body piercing are also off limits because of an increased risk of infection. Infection can be a risk because some of the medications doctors prescribe for lupus suppress the immune system and don't allow the body to fight infections as it usually would. Smoking, drinking, and drugs are also a bad idea for teens with lupus. Alcohol can throw off the balance of certain medications, a dangerous situation for someone with lupus. Tattooing and body piercing are also off limits because of an increased risk of infection. Infection can be a risk because some of the medications doctors prescribe for lupus suppress the immune system and don't allow the body to fight infections as it usually would. Doctors also advise that teen girls with lupus stay away from birth control pills containing the hormone estrogen; researchers believe that the extra estrogen in the pills can make symptoms worse. Doctors suggest that teens who are sexually active use other types of contraception instead. Doctors also advise that teen girls with lupus stay away from birth control pills containing the hormone estrogen; researchers believe that the extra estrogen in the pills can make symptoms worse. Doctors suggest that teens who are sexually active use other types of contraception instead.contraception With the right medicines and by paying attention to their health habits, most teens with lupus can go to school, enjoy many activities, play sports, and hang out with their friends. If you have a friend or classmate who has lupus, ask how you can help and offer your support. For example, if your friend is sick, keeping him or her up to date on what's going on in school by bringing notes and homework home is always a big help With the right medicines and by paying attention to their health habits, most teens with lupus can go to school, enjoy many activities, play sports, and hang out with their friends. If you have a friend or classmate who has lupus, ask how you can help and offer your support. For example, if your friend is sick, keeping him or her up to date on what's going on in school by bringing notes and homework home is always a big help


Download ppt "Diseases and conditions In this presentation I will get to talk and explore different kinds of disease and conditions."

Similar presentations


Ads by Google