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What To Do When Every Moment Counts

You might know the most common symptoms of heart attack: sustained, crushing chest pain and difficulty breathing. A heart attack might also cause cold sweats, a racing heart, pain down the left arm, jaw stiffness, or shoulder pain.

Many don’t know that women often have different heart attack symptoms than men. For instance, instead of having chest pain during a heart attack, women may feel extremely exhausted and fatigued or have indigestion and nausea.

“Many women have a vague sense of gloom and doom, a sense of ‘I just don’t feel quite right and don’t know why,’ ” says Dr. Patrice Desvigne-Nickens, an NIH expert in heart health.

The symptoms of stroke include sudden difficulty seeing, speaking, or walking, and feelings of weakness, numbness, dizziness, and confusion. “Some people get a severe headache that’s immediate and strong, different from any kind you’ve ever had,” says Dr. Salina Waddy, an NIH stroke expert.

At the first sign of any of these symptoms, fast action by you, someone you know, or a passerby can make a huge difference. NIH-funded research has helped ensure that more people survive heart attacks and strokes every year. We now have medicines, procedures, and devices that can help limit heart and brain damage following an attack, as long as medical help arrives quickly.

If the heart is starved for blood for too long—generally more than 20 minutes—heart muscle can be irreversibly damaged, Desvigne-Nickens says. “You need to be in the hospital because there’s a risk of cardiac arrest [your heart stopping],” which could be deadly. At the hospital, doctors can administer clot-busting drugs and other emergency procedures.

With stroke, Waddy says, “The longer you wait, the more brain cells are dying,” and the greater the chance for permanent damage or disability.

Emergency treatment for stroke depends on the kind of stroke. The most common type, ischemic stroke, is caused by a clot that clogs a blood vessel in the brain. The clot-dissolving drug tPA works best when given soon after symptoms begin. NIH research shows that patients who received tPA within 3 hours of stroke onset were more likely to recover fully.

Other strokes are caused by a hemorrhage—when a blood vessel breaks and bleeds into the brain. “The patient can have a larger hemorrhage within the first 3 hours,” Waddy says. A hospital medical team can help contain the bleeding, so every moment counts.

Even if you’re unsure, don’t feel embarrassed or hesitate to call 9-1-1 if you suspect a heart attack or stroke. “You should not go get your car keys. Your spouse shouldn’t be driving you to the hospital,” advises Desvigne-Nickens. “The emergency crew is trained to treat these symptoms, and it could mean the difference between life and death.”

Heart attack or stroke can happen to anyone, but your risk increases with age. A family or personal history of heart attack or stroke also raises your risk. But some risk factors for heart attack and stroke are within your control. Treating them can dramatically reduce your risk.

“If you have high blood pressure, high cholesterol, or diabetes, work with your doctor to get these conditions under control,” Waddy says. “Know your numbers [blood pressure, blood sugar, and cholesterol] and what they mean.”

You can also prepare for a medical emergency, to some degree. A hospital may not have access to your medical records when you arrive. Keep important health information handy, such as the medicines you’re taking, allergies, and emergency contacts. It would be important for the medical team to know, for example, if you’ve been taking anticoagulants to help prevent blood clots; these blood thinners put you at increased risk of bleeding. You might consider carrying an NIH wallet card that lists heart attack symptoms and has room for your personal medical information.

NIH researchers are studying new drugs and procedures to help the heart and brain repair themselves and improve organ function. “But there is absolutely nothing that will save both your time and health as well as prevention,” says Dr. Jeremy Brown, director of NIH’s Office of Emergency Care Research. Studies show that making healthy lifestyle choices can help prevent these medical emergencies from happening in the first place. Eat a healthy diet rich in protein, whole grains, and fruits and vegetables, and low in saturated fat. Get regular physical activity and don’t smoke.

“I think one of the most important things we can do is to take a basic CPR and first aid course,” recommends Brown. “We know the majority of cardiac arrests happen outside of hospitals and of that many, many can be saved if we get people with basic training on the scene quickly. An ambulance can never get there as quickly as a citizen passing by.” Whether or not you’re trained to offer help, if you see someone having symptoms of a heart attack or stroke, call for help immediately. “If you’re even thinking about calling 9-1-1, you should call,” Desvigne-Nickens says. “Yes other conditions can mimic the signs and symptoms of a heart attack or stroke, but let the emergency physician figure that out in the emergency room.

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Covid vs Flu vs Cold vs Allergy - Health Information

Staying Healthy This Winter

Feeling sick can be especially concerning these days. Could your sniffles be caused by COVID-19? Or the flu? A cold? Or maybe allergies?

Determining the cause of an illness can be tricky because many share some symptoms. They can leave you sniffling, coughing, and feeling tired. But there are important differences.

Figuring out what’s making you sick can help you recover and prevent spreading sickness to others.

Flu vs COVID-19

“Distinguishing COVID from flu can be difficult because the symptoms overlap so much,” explains Dr. Brooke Bozick, an NIH expert on respiratory diseases that affect the lungs.

Flu and COVID-19 are caused by different viruses that can be spread among people. Flu is caused by the influenza virus. COVID-19 is caused by SARS-CoV-2. Both can give you a fever, cough, headaches, and body aches.

Flu and COVID-19 also spread similarly. They’re transmitted by small particles that come from your nose and mouth when you sneeze, cough, sing, or talk, raising the possibility of infecting people who are nearby. Infected people may not have symptoms, but can still pass along either virus.

“Both influenza and COVID can be spread to other people before individuals develop symptoms,” notes Dr. Aubree Gordon, an infectious disease expert at the University of Michigan.

COVID-19 symptoms can take longer than flu symptoms to develop, she explains. Someone with flu usually has symptoms 1 to 4 days after being infected. A person with COVID-19 typically shows symptoms about 5 days after infection, although this can range from 2 to 14 days.

One telling sign of COVID-19 in some cases is loss of smell or taste. But because of other similar symptoms, there’s really only one way to be certain if you have COVID-19 or flu: Get tested.

“You can go and get a COVID test at many pharmacies, and your doctor can administer tests for flu,” Bozick says. COVID-19 tests are also available at many health centers. And you can buy testing kits approved for use at home.

Could It Be a Cold? Or Allergies?

Like flu and COVID-19, colds are also caused by viruses and can be passed to others.

Symptoms of a cold tend to be mild. You may have a runny nose, cough, congestion, and sore throat. But you won’t usually have the aches and fever that are common with COVID-19 and flu. Often, you’ll feel better in a couple of days.

There’s no cure for the common cold. Typical treatments include rest, fluids, and over-the-counter medicines. Some complementary treatments may help with cold symptoms, too. Taking honey may help with nighttime cough for children over 1 year old. Rinsing your nose and sinuses can help with congestion. You can use a neti pot or other nasal rinsing device. Be sure to only use water that’s been properly processed, such as distilled or boiled water, not tap water. Nasal rinses can bring relief for both cold and allergies.

Allergies can cause a runny nose and sneezing. But they’re not contagious. If your eyes, nose, or ears itch, that also could be an allergy.

Exposure to things like dust, pets, and tree or grass pollen can trigger allergies, which are caused by the immune system overreacting.

Allergy symptoms tend to stop when you’re no longer exposed to the cause. Unless you have asthma, allergies typically do not cause breathing problems. Allergies can be treated with drugs like antihistamines, decongestants, and nasal steroids.

Wintery Mix of Viruses

Winter is the prime cold and flu season. You’re more likely to be indoors and closer to others when it’s colder outside. Weather also plays a role in the spread of viruses.

“Cold and flu viruses survive better and are more transmissible if it’s cooler and if there’s lower humidity,” Gordon explains.

Experts are concerned that flu and COVID-19 cases may increase and overlap in the winter. Flu cases usually start to increase around October and peak between December and February. Being infected with flu and SARS-CoV-2 at the same time is possible, as is showing symptoms of both.

If you’re sick with the flu, your doctor may prescribe antiviral drugs. Such drugs can make your flu milder and shorten the time you are sick. They work best if they’re used early in your illness.

The FDA has also approved one antiviral drug, called remdesivir, to treat COVID-19. Other treatments are in development and under review. No complementary approaches have been shown to be helpful for fighting off flu or COVID-19.

Fortunately, strategies to prevent the spread of COVID-19 also prevent the spread of flu and cold. “Measures like masking and social distancing work for other respiratory viruses, as well as COVID-19,” says Dr. Chip Walter, who studies vaccine development at Duke University.

Staying Well

There’s another really important way to fight viruses. “Get your flu shot and COVID-19 vaccine,” Walter advises. They are safe and effective ways to protect yourself and those around you.

Don’t forget to vaccinate your children, too. That is the best way to protect their health. COVID-19 vaccines are now recommended for everyone age 5 years and older. Flu vaccines are recommended for everyone 6 months and older.

Flu vaccines are designed to protect against the four types of flu viruses that scientists expect to circulate that year.

Researchers like Walter and others are working to develop flu vaccines that last longer and offer broader protection against many flu strains.

Masks continue to be an important tool for stopping the spread of respiratory viruses, such as COVID-19. “With the pandemic still ongoing, it’s going to be really important that people wear masks,” Gordon says. Try to avoid crowded indoor situations when possible, too.

For more tips on guarding against getting sick this winter, see the Wise Choices box. 

Protecting Yourself and Others

To fight the spread of COVID-19, many places now require people to wear face masks. But the advice on wearing them has changed over the course of the pandemic. This has led some people to question: Do face masks even protect against COVID-19?

“Yes, absolutely,” says Dr. Adriaan Bax, a biophysicist at NIH. He has been testing how well different types of masks work. Masks, he explains, can help stop the spread of COVID-19 for a few reasons.

First, masks can trap fluid droplets that exit the mouth while you’re speaking. If you have COVID-19, these droplets contain virus that can be inhaled by others.

Bax and his colleagues have shown that just by talking, a person produces thousands of these little droplets every second. Speaking loudly or singing produces even more droplets.

Stopping droplets at the source is the easiest way to prevent the virus from spreading through the air. Wearing a mask can play a crucial role. Bax and colleagues have found that even a simple cloth mask can stop nearly all droplets produced during speech.

After droplets leave someone’s mouth, the water in them quickly evaporates. This causes the droplets to shrink. These shrunken droplets are called aerosols. They can float in the air for anywhere from minutes to hours. Once the virus is carried in such tiny aerosols, it becomes more difficult to stop.

Masks can also help protect the people wearing them. Studies have found that NIOSH-approved N95 respirators and KN95 masks block aerosols from entering the airway very effectively.* Surgical and cloth masks are less effective, but they still provide some protection. How well they work depends on the number of layers, choice of materials, and whether they’re worn properly.

Even if a mask doesn’t block all of the aerosols, it may still protect the wearer against severe disease. Severe COVID-19 tends to occur when virus gets into the lower airway and the lungs.

Wearing a mask may help the body clear out virus from the lower airway before it reaches the lungs. This is because, as Bax’s team has shown, wearing a mask traps the moisture that would otherwise escape when you exhale. This raises the amount of moisture in your airways (or the humidity).

Moisture is essential to promote the natural clearance process of the airways. This helps keep the lungs free of contamination by dust, pollutants, and viruses. Masks may aid this process by raising the humidity.

“Some may find wearing a mask uncomfortable, especially on hot and humid days. This is largely because of the humidifying effect. But this drawback is very minor compared to the benefit that masks offer,” says Bax.

For most people, cloth masks and surgical masks don’t interfere with normal breathing. Oxygen and carbon dioxide are much smaller than the respiratory droplets that carry the virus and pass easily through masks.

Masks work best when we all wear them. But with any mask, not all virus particles are blocked. That’s why it’s still important to stay a distance from others, generally about six feet. For tips on wearing masks, see the Wise Choices box.

And remember: Getting a COVID-19 vaccine is the best way to protect yourself and others from the virus.

Treatments Work, but Prevention Is Key 

It’s been more than 30 years since a disease now called AIDS was first recognized in the United States. Back then, it was considered a death sentence. No treatments were available, its cause was unknown, and people often died within a few months after being diagnosed. Today, people infected with HIV—the virus that causes AIDS—can live full, healthy lives, in large part because of medicines and other discoveries made with NIH support.

The terms HIV and AIDS can be confusing, because they’re related but different. HIV is a virus that harms your immune system by invading and then destroying your infection-fighting white blood cells. AIDS is the final stage of an untreated HIV infection. People with AIDS can have a range of symptoms, because their weakened immune systems put them at risk for life-threatening infections and cancers.

HIV virus passes from one person to another through certain body fluids, such as blood and semen. About 90% of new HIV infections in the U.S. occur during sex. Shared needles and injection drug use is the second most common route of infection. HIV can also spread from an infected mother to her newborn. HIV isn’t spread through casual contact, such as shaking hands, hugging, sneezing, sharing utensils, or using bathrooms.

Today, by taking a combination of HIV-fighting medicines (called antiretroviral therapy), fewer Americans with HIV are developing AIDS. And some HIV infections can now be prevented by taking daily medications (called PrEP).

Because of these advances, some people may think that there’s little need to be concerned about HIV and AIDS. But nothing could be further from the truth. Nationwide, more than 1 million people are infected with HIV, and each year over 50,000 more become newly infected. About 1 in 7 Americans who have HIV don’t even realize they’re infected, so they may be unknowingly spreading the virus to others. The problem is even more severe in developing nations, especially in parts of Africa.

Even though treatments and prevention strategies can keep HIV in check, there’s still no cure and no vaccine to prevent HIV infections. That’s why NIH-funded scientists continue to search for new, more effective ways to halt HIV infections.

“If you get a diagnosis of HIV infection, and you begin antiretroviral therapy in a timely fashion, before your immune system becomes substantially compromised, your prognosis is excellent,” says Dr. Anthony S. Fauci, NIH’s infectious disease chief, who first began treating AIDS patients in the early 1980s. Studies show that with early treatment, HIV levels may become so low that the virus becomes undetectable in the blood. That lengthens life and reduces the risk of spreading HIV to others. “If those who are infected stay on therapy, they can save their own lives and also help keep HIV from infecting their sexual partners,” Fauci says.

Keeping HIV infections in check requires early diagnosis and taking daily HIV medications for life. Even if it’s undetectable in the blood, once a person’s been infected with HIV, it remains forever hidden in the body. “HIV has the ability to integrate itself into your cells and hide in an inactive form, called a reservoir,” says Fauci. Although medicines can keep virus levels low, they don’t clear out the viral reservoir. So if treatment lapses, HIV comes out of hiding and rushes back into the bloodstream.

For some people, keeping up with this daily health regimen can be a challenge. Nationwide, fewer than 1 in 3 people with HIV takes antiretroviral medicines regularly enough to reduce the virus to undetectable levels. That’s why ongoing NIH-funded studies are creating and evaluating medications that might be taken less often, such as once a month. This approach will be tested in a large clinical trial expected to begin in Africa later this year. Other approaches that don’t depend on daily anti-HIV drugs are also being tested.

Research over the past few decades has identified preventive strategies that work: limit your number of sexual partners, never share needles, and use condoms correctly and regularly. NIH is also exploring new ways to prevent HIV infections, including experimental vaccines.

One preventive approach for people at increased risk for HIV infection involves taking a daily dose of an antiretroviral drug. “In terms of prevention, a game-changer that we’ve got right now is pre-exposure prophylaxis, or PrEP,” says Dr. Carl W. Dieffenbach, who heads NIH’s global research efforts in HIV/AIDS. “This strategy protects you from getting infected with HIV if you take the medication daily.”

A pill form of PrEP (called Truvada) is approved by the U.S. Food and Drug Administration for people at high risk of getting HIV. Truvada combines 2 antiretroviral drugs already used to treat HIV infections.

When it comes to treatment and prevention, Dieffenbach says, “the most important activity that you can engage in is first getting an HIV test.” Your health care provider, community health clinic, and others may offer quick HIV tests, often at no cost to you. The U.S. Centers for Disease Control and Prevention recommends at least a yearly HIV screening for people considered at high risk for infection. Testing is especially important for young people from ages 13 to 24, because more than half in that age group who tested positive for HIV didn’t know they’d been infected.

Some people avoid getting tested because they’re afraid of the possibility of being HIV-positive. Others may feel embarrassed or uncomfortable talking about sexual issues, and so they don’t get tested. But the earlier HIV is diagnosed and treated, the better the outcome.

“The stigma associated with HIV infection makes it difficult for some people who are at risk to come forward and either be counseled about how to avoid infection, or if they are infected, to get into a health care system and stay in the health care system,” Fauci says. But studies show that open communication can help people treat and prevent HIV.

“The stigma problem can only be solved one person or one family at a time, because each person’s situation is unique,” Dieffenbach says. “It’s about continuing a conversation with openness and acceptance in communities. As hard as that is, it does really matter."

Genital Herpes Often Unrecognized

It’s an uncomfortable topic, but it’s a health issue you should know about. Nationwide, about 1 out of 6 people between ages 14 and 49 is infected with the herpes simplex virus type 2—the main cause of genital herpes. Surprisingly, most people don’t know they’re infected. Even if you have no symptoms, or only mild ones, you can still transmit the virus to others.

Herpes simplex virus (HSV) comes in 2 forms. The most common, HSV-1, is best known for causing cold sores or fever blisters on the face, especially on the lips and mouth. But HSV-1 can also cause genital herpes. HSV-2 usually affects the genitals, but can also infect the mouth. Both types of HSV can pass from one person to another through sexual or other skin-to-skin contact.

“Once people are infected with herpes simplex, the virus stays in the body for the rest of their lives,” says Dr. Carolyn Deal, who heads the sexually transmitted diseases branch at NIH. Symptoms may first appear about 2 weeks after infection. After that, the herpes virus goes into hiding in your nerve cells. It may re-emerge several times a year. Over time, reappearances occur less often.

The first outbreak is usually the most severe and lasts the longest, sometimes 2 to 4 weeks. During an outbreak, you might notice tingling or sores (lesions) near the area where HSV first entered your body. Small red bumps are the first to appear. They change into small blisters, and then become itchy, painful sores that might develop a crust. The sores eventually heal without leaving a scar.

Often, though, people don’t recognize their first genital herpes outbreak or later recurrences. A study by the U.S. Centers for Disease Control and Prevention found that more than 80% of people with HSV-2 infections have not been diagnosed with the disease.

Your health care provider can sometimes diagnose genital herpes by looking at the sores or testing a sample from infected skin. Between outbreaks, a blood test can detect evidence of HSV-1 or HSV-2.

Although there’s no cure for herpes, prescription medicines can help calm symptoms and prevent future outbreaks. Taken regularly, these medications can also reduce the risk of passing herpes to sexual partners.

“For prevention, the recommendations for genital herpes are similar to many other sexually transmitted diseases,” says Deal. The most reliable way to prevent infection is to abstain from sex or to be in a long-term monogamous relationship with an uninfected partner. Condoms can also reduce the risk of transmission, but are not a reliable solution, as they may not cover all infected areas. Infected people should avoid having sex with uninfected partners during an outbreak.

Although herpes infections generally don’t cause serious medical problems alone, they can cause complications. Genital herpes can increase your chances of becoming infected with HIV, the virus that causes AIDS. In rare cases, herpes outbreaks during pregnancy can put the newborn child at risk for serious or even deadly infections.

Although genital herpes is a lifelong disease, there are many options for managing the condition and preventing its spread. Talk to your health care 

Herpes infections are caused by herpes simplex virus (HSV) types 1 and 2. These viruses are contagious and transmitted from one person to another through skin-to-skin contact. Kissing or touching is the main cause of HSV-1 transmission, and sexual contact is the main cause of HSV-2 transmission Genital herpes is a common sexually transmitted disease (STD) that any sexually active person can get. Most people with the virus don't have symptoms. Even without signs of the disease, herpes can still be spread to sex partners.

Genital herpes cannot be cured, but outbreaks can be treated. Your doctor can give you medicines to make the sores go away more quickly and to reduce the number of outbreaks. When you have herpes sores, you should wear loose clothing and keep the genital area clean and dry. Try not to touch the sores. If you do touch them, wash your hands with soap and water right away because the virus can be passed with your fingers.People who have herpes can pass the virus from oral or genital contact even when they do not have sores. Males should use latex condoms every time they have sex to lower the risk of getting genital herpes. However, it does not completely remove the risk. You should not have sex with someone who has active sores, even with a condom. Ask your partner if he or she has ever had a herpes infection. If your partner has had herpes, you should see your doctor for information to help prevent you from getting it. Do not have oral sex, kiss, or share cups, glasses, or lip balm with someone who currently has, or has recently had, cold sores.

Las infecciones por herpes son causadas por el virus del herpes simple (HSV) tipos 1 y 2. Estos virus son contagiosos y se transmiten de una persona a otra a través del contacto de piel a piel. Besar o tocar es la principal causa de transmisión de HSV-1, y el contacto sexual es la principal causa de transmisión de HSV-2 El herpes genital es una enfermedad de transmisión sexual (ETS) común que puede contraer cualquier persona sexualmente activa. La mayoría de las personas con el virus no presentan síntomas. Incluso sin signos de la enfermedad, el herpes se puede transmitir a las parejas sexuales. El herpes genital no se puede curar, pero los brotes se pueden tratar. Su médico puede darle medicamentos para que las llagas desaparezcan más rápidamente y para reducir la cantidad de brotes. Cuando tenga llagas de herpes, debe usar ropa holgada y mantener el área genital limpia y seca. Trate de no tocar las llagas. Si los toca, lávese las manos con agua y jabón de inmediato porque el virus se puede transmitir con los dedos. Las personas que tienen herpes pueden transmitir el virus por contacto oral o genital incluso cuando no tienen llagas. Los hombres deben usar condones de látex cada vez que tengan relaciones sexuales para reducir el riesgo de contraer herpes genital. Sin embargo, no elimina completamente el riesgo. No debe tener relaciones sexuales con alguien que tenga llagas activas, ni siquiera con condón. Pregúntele a su pareja si alguna vez ha tenido una infección por herpes. Si su pareja ha tenido herpes, debe consultar a su médico para obtener información que ayude a prevenir que lo contraiga. No tenga sexo oral, no bese ni comparta tazas, vasos o bálsamo labial con alguien que actualmente tenga, o haya tenido recientemente, herpes labial.

Influenza, or flu, can knock you off your feet and leave you miserable for nearly a week. It can cause fever, aches and pains, coughing, and exhaustion.

The best way to avoid this fate is to get a flu vaccine each year as early as possible, before or even during flu season, which usually lasts from October to as late as May. The vaccine is available as either a shot or a nasal spray.

Flu is highly contagious. When infected people cough or sneeze, the flu virus can spread to others up to 6 feet away. As many as 1 in 5 Americans come down with the flu each year, and kids are 2 to 3 times more likely than adults to get sick with the flu. Most cases are mild, but flu can also be serious, leading to hospitalization and even death.

Flu vaccines can reduce illness, doctors’ visits, and missed work and school. Vaccines can also prevent flu-related hospitalizations and deaths. When more people get vaccinated, it’s harder for the flu virus to spread.

Experts recommend that everyone 6 months and older get the annual flu vaccine, with rare exceptions. Talk to your doctor if you have questions about which vaccine options are best for you and your family. Learn more at www.flu.gov

Living With Chronic Obstructive Pulmonary Disease

Maybe you’ve noticed that you get out of breath doing light activities lately. Or have a cough that won’t go away. You might think it’s temporary, or just part of getting older.

But these issues can also be signs of chronic obstructive pulmonary disease, more commonly called COPD. With COPD, your lungs can no longer take in all the air you need.

More than 16 million people in the U.S. are living with COPD. Millions more likely have the disease but don’t know it. Symptoms can be mild at first and get worse over time.

“Some people with COPD get very short of breath when they try to walk, or do any kind of physical activity,” says Dr. Janet Larson, who studies COPD at the University of Michigan. “Some are bothered by persistent coughing.”

People may also feel tightness in their chest, experience wheezing, or a whistling or squeaky sound when breathing. They can also feel extremely tired, or fatigued.

“But many people don’t recognize the symptoms, or don’t know they can be from a disease,” says Dr. Prescott Woodruff, a lung specialist at the University of California, San Francisco.

COPD includes two main conditions. In one, called emphysema, tissue inside the lungs breaks down. In the other, called chronic bronchitis, the airways are irritated and show signs of inflammation. Many people with COPD have both.

“There are many things we can do for COPD,” Woodruff says. “Most of them can improve your quality of life. And some of them can improve life expectancy. So we want people to recognize the symptoms and seek help.”

Lessening Lung Irritation

Smoking is the main risk factor for the disease. But up to a quarter of people who develop COPD have never smoked.

The number of people in the U.S. who smoke has dropped over the last few decades. “But the amount of chronic lung disease has not declined as fast as we would have expected, given the decrease in smoking,” says Dr. Joel Kaufman, who studies how the environment impacts chronic diseases at the University of Washington.

Other factors can also play a role. Second-hand smoke—smoke in the air from other people smoking—is a risk factor. Others include your age, gender, and where you live and work.

COPD is more common in women and in people over the age of 40. People with a rare genetic disorder, called AAT deficiency, are also at increased risk.

COPD is also about twice as common in rural communities compared with urban ones. That’s largely because these communities have higher smoking rates.

Long-term exposures to other substances, including some types of chemical fumes and dust, may also increase the risk of COPD.

In a recent study, Kaufman and his team found that people who lived in areas with high air pollution had more emphysema-like changes in their lungs over time. This highlights additional risk factors that can potentially be lowered for whole communities, Kaufman explains.

“The more we understand about these risks, the more we can effectively target air quality improvements going forward,” says Kaufman.

Boosting Quality of Life

People who currently smoke or smoked in the past may feel stigmatized and embarrassed to talk with their doctor, when they shouldn’t, Woodruff says. “That’s a huge population that may not be getting the attention they need,” he says.

If you have symptoms of COPD, talk with your health care provider. They can refer you for testing. The main test used to diagnose COPD is called spirometry. In this test, you blow into a tube connected to a small machine. The machine measures how well your lungs are working.

Some people may also need imaging or blood tests. These tests can help determine whether their COPD is severe. They may also rule out other possible causes of symptoms.

Treatments for COPD can’t yet cure the disease. But they can slow the rate at which it gets worse, and make you feel better. Medications can help some people breathe more easily. These include drugs that help open the airways or reduce inflammation.

People with severe COPD may need oxygen therapy. Some may eventually have surgery. But usually only as a last resort if they don’t improve from taking medicines.

Pulmonary rehabilitation can also be used to treat the condition. These programs help you learn new breathing strategies, improve your body’s endurance and strength, and move in ways that preserve your energy. They may also include mental health care and nutrition counseling.

“People with COPD tend to be some of the least physically active people,” says Larson. Many feel embarrassed that they can’t keep up with other people, she explains. This can lead them to avoid activities they used to enjoy.

Larson and her team are testing a program to build light physical activity into the daily lives of people with COPD. Light physical activity—such as walking and using bands for strength exercises—can improve their health and energy levels, she explains.

By making exercise more accessible, “we hope that if they have a flare-up of their disease, and have to quit being active for a while, that they’ll be able to get right back to it on their own,” Larson says.

In an early study of the program, people with COPD increased their activity levels by more than half an hour a day. Talk with your health care provider to learn more about rehab programs.

Personalizing Treatments

Better treatments are still needed for COPD. Scientists first need to learn more about how the disease differs between people.

“By identifying the different subtypes of COPD, we can then target the specific underlying problems with new therapies,” Woodruff says.

In a recent study, Woodruff’s team identified one such subtype. They found that many current or former smokers had normal results on a spirometry test, but still had other symptoms of COPD, like a chronic cough or trouble breathing.

The researchers are now testing whether COPD drugs can help people with this subtype feel better and prevent them from developing full-blown COPD.

The team also found that some people with COPD have a type of inflammation in their lungs that looks like asthma. This may be another subtype of COPD. Now they’re testing whether asthma medications can help reduce symptoms in these patients.

For now, lifestyle changes and medications can help people with COPD manage symptoms. See the Wise Choices box for tips to help you breathe better

Healthy Start for Mom and Baby

Life is busy before a baby arrives. There are many things to do to prepare. One of the most important is to visit your health care provider regularly.

Check-ups before your baby is born are called prenatal visits. They help make sure you and your baby are healthy. Your health care provider will look for certain problems that can happen during pregnancy. Some issues are best treated early. Others can be prevented before they start.

“Prenatal care is fundamental for shaping the lives of women and their children,” says Dr. Monica Longo, an NIH expert on prenatal health. Longo cares for women with high-risk pregnancies. Such women have a higher chance of complications.

If you think you may be pregnant, schedule a visit with your provider. If you’re pregnant, you’ll need to start regular prenatal visits. Most women have check-ups about once a month in the beginning. Then, they go more often later in the pregnancy.

During a prenatal visit, your provider will ask about your health history. They will also perform a physical exam and weight check. They’ll let you know how much weight gain is healthy for your body and help track your progress.

You’ll also be asked to provide a urine sample. Urinary tract infections (UTIs) are common during pregnancy. UTIs and other infections increase the risk of having a preterm birth. This is when you give birth at 37 weeks or earlier.

“One of the primary purposes of prenatal care is actually prevention,” says Longo. “We screen women to find potential health problems before those issues can worsen.”

During certain stages of pregnancy, your provider will perform blood tests and imaging tests. These include ultrasound exams to look at the baby’s growth and development. Visits are also an opportunity to talk with your provider about how to give your baby a healthy start.

“During prenatal visits, we educ-ate and counsel moms about healthy habits, healthy food choices, and exercise,” Longo says. “We also address any concerns a new mom-to-be might have.”

Taking a prenatal vitamin is also key. Folic acid is included in most prenatal vitamins. It reduces the risk of severe birth defects that affect the developing brain and spine.

It’s important to stay away from things that could harm your baby. These include certain medications, smoking, and alcoholic drinks. Also, talk with your provider about any health conditions. Conditions like diabetes (a disease that causes high blood sugar) and high blood pressure need to be brought under control.

Some women choose to talk with their provider before becoming pregnant. This is called a preconception visit. It can help you plan for a safer pregnancy.

Early and regular care for you and your developing baby is important. Studies show that prenatal care reduces the risk of having a low-birth weight baby. Low birth weight can cause health problems. Even during the pandemic, it’s essential to keep up with regular prenatal care.

“Providers around the globe have adapted prenatal care to fit the current challenges,” says Longo. That means using telehealth for visits that don’t have to be done in person.

Health care providers are also seeing fewer patients and extending the time between them. This reduces possible exposure in waiting rooms

Learn To Breathe Easier

Most people have little trouble climbing a flight of stairs or taking a brisk walk, but these simple activities can be tough for someone with asthma. Although there’s no cure, you can breathe easier by knowing how to keep the condition under control.

Asthma is a common, long-lasting disease that affects the lungs. It can begin in childhood or adulthood. More than 25 million Americans have asthma, including 7 million children. Without proper care, asthma can become serious, even deadly. But most people with asthma learn to manage the disease so they have few symptoms or none at all.

Major symptoms of asthma include wheezing (a whistling sound when breathing), shortness of breath, coughing that’s worse at night and early morning, and chest tightness. These symptoms arise from reactions that narrow the airways, the tubes that carry air into and out of your lungs. When symptoms flare up, it’s called an asthma attack.

The airways of people with asthma are prone to inflammation, which causes the airways to swell and narrow. They become extra sensitive to certain substances that are breathed in. These are called “triggers.”

Asthma triggers can worsen inflammation and cause the muscles around the airways to tighten, further shrinking air passages and making it harder to breathe. Cells in the airways might also produce excess mucus (a sticky, thick liquid), making the airways even narrower.

Common asthma triggers include cigarette smoke, air pollution, mold, house dust mites, and furry animal dander. Other asthma triggers include weather changes, exercise, stress, and respiratory infections like common colds.

“Preventing such infections is important,” stresses Dr. Stewart Levine, an asthma expert at NIH. “People who have asthma should also obtain a flu shot, as they may be at higher risk for flu-related complications.”

Asthma is one of the most common causes of chronic (long-term) illness in children—and some symptoms appear more often in children than in adults. “Children have smaller airways, so if they have asthma, they tend to wheeze more often, particularly during the night,” says Dr. Robert Lemanske, Jr., a pediatric asthma expert at the University of Wisconsin.

Some preschool age children frequently wheeze when they get colds but don’t go on to develop chronic asthma. “But some kids start wheezing at age 3, and the problem continues,” says Lemanske. “These kids also tend to be more allergic.”

A doctor will test for asthma by doing a physical exam and asking about your medical history to learn when and how often your symptoms occur. Your doctor may also ask you to breathe in and blow out into the tube of a spirometer. This device measures how much air you can breathe out and how fast you can do it.

“It’s sometimes tough to do a spirometry test on young children,” says Dr. Michelle Freemer, an NIH asthma expert. For youngsters, a doctor will do a physical exam and may perform other tests to identify possible asthma triggers.

Whether you’re young or older, it’s important to know how to manage your asthma. Work with your doctor to develop a written asthma action plan. (Here’s a sample asthma action plan from NIH). Your action plan should spell out the daily treatment plan to help control your asthma. This may include recommendations for medications and for avoiding exposure to your triggers. The action plan should also give specific instructions for what to do when asthma symptoms start and what actions to take if symptoms worsen, including when to seek medical attention, go to the hospital, or call an ambulance.

“Patients with asthma should have an action plan, so they know if they’re getting into trouble and what to do about it,” Freemer says.

For some patients, Freemer notes that a hand-held device called a peak flow meter can help you monitor your asthma. You blow into the device to measure how strongly your lungs can force air out. If the meter shows that your air flow is lower than normal, you can use your action plan to adjust your treatment.

“There are 2 main types of medicines for managing asthma: quick-relief and long-term controllers,” says Levine. Quick-relief medicines—such as short-acting bronchodilator inhalers—are used to relax the muscles in the airways to make it easier to breathe within a few minutes. If exercise is an asthma trigger, doctors may recommend taking this medicine 5 to 15 minutes before exercise or strenuous activity.

Long-term control medicines—such as inhaled corticosteroids—are used every day to help control symptoms and prevent asthma attacks. “Inhaled corticosteroids are recommended as the preferred long-term control medications for most children and adults,” says Freemer. “Taken daily, they help reduce inflammation to control the disease.”

If young children have trouble taking inhaled medications, there are masks and other devices that can help. Some kids are given a nebulizer, a portable machine that releases medicine in a mist.

A small percentage of people with asthma have a hard time controlling their symptoms even when they take their medicines regularly. Their airways become extremely inflamed and particularly sensitive to asthma triggers. They wheeze more, wake more throughout the night, and are at greater risk for breathing failure and trips to urgent care. If your asthma is severe, see a specialist to identify the most appropriate, personalized treatment.

The underlying causes of asthma are still unclear. Researchers believe asthma is caused by a combination of your genes and environmental factors. If you have allergies or a parent who has asthma, you’re at increased risk for the disease. Obesity and exposure to cigarette smoke may also raise the risk of developing asthma. NIH scientists are continuing to investigate the causes of this disease.

Researchers are also working to develop new approaches to help prevent and treat asthma. Levine’s team is studying the effects of house dust mites inside the home. While exposing mice to dust mites, the researchers identified a protein in the lung that blocked the development of asthma. With further research, the finding may eventually lead to new approaches for preventing or controlling asthma symptoms in people.

If you or your loved ones have asthma, identify your triggers and try to avoid them. Monitor your symptoms, and take prescribed medications regularly.

“For most people with asthma, if you take your prescribed medicines and stay away from the triggers, you’ll do well,” Levine says. Keep your asthma under control so you can keep living life to the fullest.

Asthma is a common, long-lasting disease that affects the lungs.

Without proper care, asthma can become serious, even deadly. But most people with asthma learn to manage the disease so they have few symptoms or none at all.

Asthma signs and symptoms include:

● Shortness of breath.

● Chest tightness or pain.

● Wheezing when exhaling, which is a common sign of asthma in children.

● Trouble sleeping caused by shortness of breath, coughing or wheezing.

● Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu. Asthma Causes and Triggers

● Infections like sinusitis, colds, and the flu.

● Allergens such as pollens, mold, pet dander, and dust mites.

● Irritants like strong odors from perfumes or cleaning solutions.

● Air pollution.

● Tobacco smoke.

● Exercise.

● Cold air or changes in the weather, such as temperature or humidity.

Take your asthma medicines as prescribed.

Asthma medicines are usually inhaled through a machine called a nebulizer, through a small device called a metered dose inhaler (also called an inhaler, puffer or MDI) or through a dry powder inhaler (DPI). For inhalers to work well, you must use them correctly. But more than half of all people who use inhalers don’t use them properly. Ask your doctor or pharmacist to watch you and check your technique. Discuss each of your asthma medications with your doctor or pharmacist.

How to use Metered Dose Inhaler (MDI)

https://youtu.be/fHYTz-ZoRLw

Nebulizers are especially good for infants' or small children's asthma medications. They can also be used for longer periods, making a potentially life-saving devices for someone suffering from a severe asthma attack.

https://www.aafa.org/asthma-prevention, NIH

Is It COVID-19, the Flu, a Cold, Allergies or Asthma? (printable PDF)

Smoking tobacco can cause many health problems. Did you know that it can harm your heart and blood vessels? Smoking is a risk factor for heart disease, which can lead to heart attack, heart failure, and death. About one of every three people in the U.S. dies from heart disease.

Tobacco smoke contains many toxic chemicals. Once those chemicals get inside your body, they travel around in your blood. They can damage your heart and blood vessels. They also affect the cholesterol and fats in your blood.

All this damage can help fats and other debris build up on blood vessels. The blood vessels can become narrower. That prevents blood from flowing through as easily. Not as much oxygen and nutrients can get to the heart. That’s how heart disease develops.

Those narrow blood vessels also raise your blood pressure. That pressure puts stress on your heart.

You can reduce your risk of heart disease by not smoking. Avoiding secondhand smoke also reduces your risk

●Develop regular sleep habits; this means keeping a regular sleep and wake time, sleeping as much as needed to feel refreshed the following day, but not spending more time in bed than needed

● Avoid staying in bed in the morning to catch up on sleep

● Avoid daytime naps; if a nap is necessary, keep it short (less than 1 hour) and avoid napping after 3 pm

● Keep a regular daytime schedule; regular times for meals, medications, chores, and other activities helps keep the inner body clock running smoothly

● Do not read, write, eat, watch TV, talk on the phone, or play cards in bed

● Avoid caffeine after lunch; avoid alcohol within 6 hours of bedtime; avoid nicotine before bedtime

● Do not go to bed hungry, but do not eat a big meal near bedtime either

● Avoid sleeping pills, particularly over-the-counter remedies

● Slow down and unwind before bed (beginning at least 30 minutes before bedtime (a light snack may be helpful); create a bedtime ritual such as getting ready for bed, wearing night clothes, listening to relaxing music, or reading a magazine, newspaper, or book

● Avoid watching TV in the bedroom or sleeping on the sofa and then going to bed later in the night

● Avoid stimulating activities prior to bedtime (eg, vigorous exercise, discussing or reviewing finances, or discussing stressful issues with a spouse or partner or ruminating about them with oneself)

● Keep the bedroom dark, quiet, and at a comfortable temperature

● Exercise daily; this is best performed in the late afternoon or early evening (but not later than 6-7 pm)

● Do not force yourself to sleep; if you are unable to fall asleep within 15-30 minutes, get up and do something relaxing until sleepy (eg, read a book in a dimly lit room, watch a non-stimulating TV program); avoid watching the clock or worrying about the perceived consequences of not getting enough sleep

Desarrollar hábitos de sueño regulares; Esto significa mantener un horario regular para dormir y despertarse, dormir tanto como sea necesario para sentirse renovado al día siguiente, pero no pasar más tiempo en la cama del necesario. Evite quedarse en la cama por la mañana para recuperar el sueño. Evite las siestas durante el día; si es necesaria una siesta, hágalo breve (menos de 1 hora) y evite tomar una siesta después de las 3 pm Mantenga un horario diurno regular; horarios regulares para las comidas, medicamentos, quehaceres y otras actividades ayudan a mantener el reloj interno del cuerpo funcionando sin problemas No lea, escriba, coma, vea televisión, hable por teléfono ni juegue cartas en la cama Evite la cafeína después del almuerzo; evite el alcohol dentro de las 6 horas antes de acostarse; evitar la nicotina antes de acostarse No se vaya a la cama con hambre, pero tampoco coma una comida abundante cerca de la hora de acostarse Evite las pastillas para dormir, especialmente los remedios de venta libre Disminuya la velocidad y relájese antes de acostarse (comenzando al menos 30 minutos antes de acostarse (un refrigerio ligero puede ser útil); cree un ritual a la hora de acostarse, como prepararse para acostarse, ponerse ropa de dormir, escuchar música relajante o leer una revista, un periódico, o reservar Evite ver televisión en el dormitorio o dormir en el sofá y luego acostarse más tarde en la noche. Evite actividades estimulantes antes de acostarse (p. Ej., Ejercicio vigoroso, discutir o revisar las finanzas, discutir mas estresantes con su cónyuge o pareja o reflexionar sobre ellos con uno mismo) Mantenga el dormitorio oscuro, silencioso y a una temperatura agradable Ejercitarte diariamente; Esto se realiza mejor al final de la tarde o temprano en la noche (pero no más tarde de las 6 a las 7 pm) No se obligue a dormir; si no puede conciliar el sueño en 15-30 minutos, levántese y haga algo relajante hasta que enga sueño (por ejemplo, lea un libro en una habitación con poca luz, mire un programa de televisión que no sea estimulante); Evite mirar el reloj o preocuparse por las consecuencias percibidas de no dormir lo suficient

Prevent another UTI:

● Empty your bladder often. Urinate and empty your bladder as soon as you feel the need. Do not hold your urine for long periods of time.

● Wipe from front to back after you urinate or have a bowel movement. This will help prevent germs from getting into your urinary tract through your urethra.

● Drink liquids as directed. Ask how much liquid to drink each day and which liquids are best for you. You may need to drink more liquids than usual to help flush out the bacteria. Do not drink alcohol, caffeine, or citrus juices. These can irritate your bladder and increase your symptoms. Your healthcare provider may recommend cranberry juice to help prevent a UTI.

● Urinate after you have sex. This can help flush out bacteria passed during sex.

● Do not douche or use feminine deodorants. These can change the chemical balance in your vagina.

● Change sanitary pads or tampons often. This will help prevent germs from getting into your urinary tract.

● Do pelvic muscle exercises often. Pelvic muscle exercises may help you start and stop urinating. Strong pelvic muscles may help you empty your bladder easier. Squeeze these muscles tightly for 5 seconds like you are trying to hold back urine. Then relax for 5 seconds. Gradually work up to squeezing for 10 seconds. Do 3 sets of 15 repetitions a

Prevenir otra ITU: Vacíe su vejiga a menudo. Orine y vacíe su vejiga tan pronto como sienta la necesidad. No retenga la orina durante largos períodos de tiempo. Limpie de adelante hacia atrás después de orinar o evacuar. Esto ayudará a evitar que los gérmenes entren a su tracto urinario a través de la uretra. Beba líquidos según las indicaciones. Pregunte cuánto líquido debe beber cada día y qué líquidos son mejores para usted. Es posible que deba beber más líquidos de lo habitual para ayudar a eliminar la bacteria. No tome alcohol, cafeína o jugos cítricos. Estos pueden irritar su vejiga y aumentar sus síntomas. Su proveedor de atención médica puede recomendar el jugo de arándano para ayudar a prevenir una ITU. Orina después de tener relaciones sexuales. Esto puede ayudar a eliminar las bacterias que pasan durante el sexo. No se douche o use desodorantes femeninos. Estos pueden cambiar el equilibrio químico en su vagina. Cambie las toallas sanitarias o los tampones a menudo. Esto ayudará a evitar que los gérmenes entren a su tracto urinario. Haga ejercicios musculares pélvicos a menudo. Los ejercicios de los músculos pélvicos pueden ayudarlo a comenzar y dejar de orinar. Los músculos pélvicos fuertes pueden ayudarlo a vaciar su vejiga más fácilmente. Aprieta estos músculos con fuerza durante 5 segundos como si estuvieras intentando retener la orina. Luego relájate durante 5 segundos. Poco a poco trabajar hasta apretar durante 10 segundos. Haga 3 series de 15 repeticiones al día, o según las indicaciones

Some signs of TB disease are: • A bad cough that lasts 3 weeks or longer. • Pain in the chest. • Coughing up blood or phlegm from deep inside the lungs. • Weakness or feeling very tired. • Losing weight without trying. • Having no appetite. • Chills and fever. • Sweating at night or when you are sleeping

TB germs can sometimes stay alive in the air for a few hours, especially in small places with no fresh air. Fresh air and sunlight make it harder for TB germs to stay alive. The fresh air scatters the germs and the sunlight kills them

You will probably start off with several TB medicines. • You will need to take your medicines the right way, just as your doctor or healthcare provider tells you. • You will need to stay on TB medicines for at least 6 months.

Take isoniazid on an empty stomach, at least 1 hour before or 2 hours after a meal. Use this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics.

Take INH at night before bedtime (1 hour before or 2 hours after eating). 9 If the medication upsets your stomach, you may take it with a snack. 9 If you have diabetes, your blood sugars may change. DO NOT: 9 consume alcohol while taking INH. 9 use Tylenol (acetaminophen) or any medications containing this drug while you are on INH. AVOID: 9 taking aluminum-based antacids (Maalox or Mylanta, for example).

Algunos signos de la enfermedad de la tuberculosis son: • Una tos fuerte que dura 3 semanas o más. • Dolor en el pecho. • Toser sangre o flema desde el interior de los pulmones. • Debilidad o sentirse muy cansado. • Bajar de peso sin intentarlo. • Falta de apetito. • Escalofríos y fiebre. • Sudar por la noche o cuando duerme.

Los gérmenes de la tuberculosis a veces pueden permanecer vivos en el aire durante algunas horas, especialmente en lugares pequeños sin aire fresco. El aire fresco y la luz solar dificultan la vida de los gérmenes de la tuberculosis. El aire fresco esparce los gérmenes y la luz del sol los mata.

Probablemente comenzará con varios medicamentos para la tuberculosis. • Deberá tomar sus medicamentos de la manera correcta, tal como le indique su médico o proveedor de atención médica. • Deberá seguir tomando los medicamentos para la tuberculosis durante al menos 6 meses. Tome isoniazid con el estómago vacío, al menos 1 hora antes o 2 horas después de una comida. Use este medicamento durante todo el tiempo prescrito. Sus síntomas pueden mejorar antes de que la infección desaparezca por completo. Omitir dosis también puede aumentar el riesgo de una mayor infección que sea resistente a los antibióticos.

Tome INH por la noche antes de acostarse (1 hora antes o 2 horas después de comer). 9 Si el medicamento le produce malestar estomacal, puede tomarlo con un refrigerio. 9 Si tiene diabetes, sus niveles de azúcar en sangre pueden cambiar. NO DEBE: 9 consumir alcohol mientras toma INH. 9 use Tylenol (acetaminofén) o cualquier medicamento que contenga este

Keep your nails short to limit any damage done to your skin by scratching. As much as possible try not to scratch. It is thought that scratching can make itch worse and you may get into an 'itch-scratch' vicious cycle. (That is, you itch more because you scratch, so you scratch more because you itch more ... and so on.)

Keep cool as much as possible. Some people find having cool (or lukewarm) baths or showers soothing. Avoid irritants such as soaps, bubble bath and detergents. Cotton clothes are usually preferable to woollen clothes.

Moisturisers (emollients). Dry skin may be making the itch worse. Moisturisers are useful to keep the skin supple and moist. They can be applied once a day or several times a day if your skin becomes very dry. Water and soap dry out the skin as they wash away the natural skin oils. Therefore, the most important time to use moisturisers is after a bath or shower. Moisturisers work by providing a replacement for these body oils and keeping the skin moist. Numerous moisturisers are available as creams, ointments and bath/shower additives, and also to use instead of soap. It may be worth trying out a few to see which is the most suitable. These can be bought over-the-counter or different ones are available on prescription from your doctor. Use them liberally, as often as needed.

Mantenga sus uñas cortas para limitar cualquier daño causado a su piel al rascarse. En la medida de lo posible, trate de no rayar. Se cree que rascarse puede empeorar la picazón y puede entrar en un círculo vicioso de "picazón-rascado". (Es decir, te pica más porque te rascas, entonces te rascas más porque te pica más ... y así sucesivamente). Manténgase fresco tanto como sea posible. Algunas personas encuentran reconfortante tomar baños o duchas fríos (o tibios). Evite irritantes como jabones, baños de burbujas y detergentes. La ropa de algodón suele ser preferible a la ropa de lana. Hidratantes (emolientes). La piel seca puede empeorar la picazón. Los humectantes son útiles para mantener la piel tersa y húmeda. Se pueden aplicar una vez al día o varias veces al día si tu piel se vuelve muy seca. El agua y el jabón secan la piel mientras eliminan los aceites naturales de la piel. Por lo tanto, el momento más importante para usar humectantes es después del baño o la ducha. Los humectantes actúan reemplazando estos aceites corporales y manteniendo la piel húmeda. Numerosos humectantes están disponibles como cremas, ungüentos y aditivos para el baño / ducha, y también para usar en lugar de jabón. Puede valer la pena probar algunos para ver cuál es el más adecuado. Estos se pueden comprar sin receta o hay diferentes disponibles con receta de su médico. Úselos generosamente, tantas veces como sea necesario.Moisturisers (emollients): These should be applied several times every day to help the outer layer of skin to function better as a barrier to the environment. The drier the skin, the more frequently moisturiser should be applied. Many different moisturisers are available, varying in their degree of greasiness, and it is important to choose the most suitable to use Topical steroid creams or ointments: Apply twice daily. These will usually improve the redness and itching. Avoidance of Allergens: Atopic people often have allergies: Air borne allergens from cats, dogs, pollen, grass or the house dustmite, can cause flare-ups of atopic eczema for some patients. Latex (rubber) allergy is more common in people who have atopic eczema. The symptoms may, consist only of itching of the skin after contact with rubber products. Contact allergy to creams and ointments used to treat atopic eczema can rarely occur. It is advisable to inform the doctor know if treatments seem to be making the skin worse (see Patient Information Leaflet on Contact Dermatitis)