PNEUMONIA

Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs
may fill with fluid or pus (purulent material), causing cough with phlegm or pus,
fever, chills, and difficulty breathing. A variety of organisms, including bacteria,
viruses and fungi, can cause pneumonia.

Pneumonia can range in seriousness from mild to life-threatening. It is most serious

for infants and young children, people older than age 65, and people with health
problems or weakened immune systems.

Risk factors

Pneumonia can affect anyone. But the two age groups at highest risk are:

Children who are 2 years old or younger

People who are age 65 or older

Other risk factors include:

Being hospitalized. You're at greater risk of pneumonia if you're in a hospital

intensive care unit, especially if you're on a machine that helps you breathe (a
ventilator).

Chronic disease. You're more likely to get pneumonia if you have asthma, chronic
obstructive pulmonary disease (COPD) or heart disease.

Smoking. Smoking damages your body's natural defenses against the bacteria and
viruses that cause pneumonia.

Weakened or suppressed immune system. People who have HIV/AIDS, who've had

an organ transplant, or who receive chemotherapy or long-term steroids are at risk.

Complications

Even with treatment, some people with pneumonia, especially those in high-risk
groups, may experience complications, including:

 Bacteria in the bloodstream (bacteremia). Bacteria that enter the bloodstream

from your lungs can spread the infection to other organs, potentially causing
organ failure.
  Difficulty breathing. If your pneumonia is severe or you have chronic
underlying lung diseases, you may have trouble breathing in enough oxygen.
You may need to be hospitalized and use a breathing machine (ventilator) while
your lung heals.
 Fluid accumulation around the lungs (pleural effusion). Pneumonia may cause
fluid to build up in the thin space between layers of tissue that line the lungs and
chest cavity (pleura). If the fluid becomes infected, you may need to have it
drained through a chest tube or removed with surgery.
 Lung abscess. An abscess occurs if pus forms in a cavity in the lung. An
abscess is usually treated with antibiotics. Sometimes, surgery or drainage with
a long needle or tube placed into the abscess is needed to remove the pus.
Prevention

To help prevent pneumonia:

 Get vaccinated. Vaccines are available to prevent some types of pneumonia

and the flu. Talk with your doctor about getting these shots. The vaccination
guidelines have changed over time so make sure to review your vaccination
status with your doctor even if you recall previously receiving a pneumonia
vaccine.
 Make sure children get vaccinated. Doctors recommend a different pneumonia
vaccine for children younger than age 2 and for children ages 2 to 5 years who
are at particular risk of pneumococcal disease. Children who attend a group
child care center should also get the vaccine. Doctors also recommend flu shots
for children older than 6 months.
 Practice good hygiene. To protect yourself against respiratory infections that
sometimes lead to pneumonia, wash your hands regularly or use an alcohol-
based hand sanitizer.
 Don't smoke. Smoking damages your lungs' natural defenses against
respiratory infections.
 Keep your immune system strong. Get enough sleep, exercise regularly and
eat a healthy diet.

GESTATIONAL DIABETES

Gestational diabetes is diabetes diagnosed for the first time during pregnancy
(gestation). Like other types of diabetes, gestational diabetes affects how your cells
use sugar (glucose). Gestational diabetes causes high blood sugar that can affect your
pregnancy and your baby's health.

While any pregnancy complication is concerning, there's good news. Expectant

mothers can help control gestational diabetes by eating healthy foods, exercising and,
if necessary, taking medication. Controlling blood sugar can keep you and your baby
healthy and prevent a difficult delivery.
In women with gestational diabetes, blood sugar usually returns to normal soon after
delivery. But if you've had gestational diabetes, you have a higher risk of getting type
2 diabetes. You'll need to be tested for changes in blood sugar more often.

Risk factors

Some women have a greater risk of gestational diabetes. Risk factors for gestational
diabetes include the following:

 Overweight and obesity.

 A lack of physical activity.
 Previous gestational diabetes or prediabetes.
 Polycystic ovary syndrome.
 Diabetes in an immediate family member.
 Previously delivering a baby weighing more than 9 pounds (4.1 kilograms).
 Race — Women who are Black, Hispanic, American Indian and Asian
American have a higher risk of developing gestational diabetes.
Complications

Gestational diabetes that's not carefully managed can lead to high blood sugar levels.
High blood sugar can cause problems for you and your baby, including an increased
likelihood of needing a C-section to deliver.

Complications that may affect your baby

If you have gestational diabetes, your baby may be at increased risk of:

 Excessive birth weight. Higher than normal blood sugar in mothers can cause
their babies to grow too large. Very large babies — those who weigh 9 pounds
or more — are more likely to become wedged in the birth canal, have birth
injuries or need a C-section birth.
 Early (preterm) birth. High blood sugar may increase women's risk of early
labor and delivery before the due date. Or early delivery may be recommended
because the baby is large.
 Serious breathing difficulties. Babies born early to mothers with gestational
diabetes may experience respiratory distress syndrome — a condition that
makes breathing difficult.
 Low blood sugar (hypoglycemia). Sometimes babies of mothers with
gestational diabetes have low blood sugar (hypoglycemia) shortly after birth.
Severe episodes of hypoglycemia may cause seizures in the baby. Prompt
feedings and sometimes an intravenous glucose solution can return the baby's
blood sugar level to normal.
  Obesity and type 2 diabetes later in life. Babies of mothers who have
gestational diabetes have a higher risk of developing obesity and type 2 diabetes
later in life.
 Stillbirth. Untreated gestational diabetes can result in a baby's death either
before or shortly after birth.
 Prevention
 There are no guarantees when it comes to preventing gestational diabetes —
but the more healthy habits you can adopt before pregnancy, the better. If you've
had gestational diabetes, these healthy choices may also reduce your risk of
having it again in future pregnancies or developing type 2 diabetes in the future.
 Eat healthy foods. Choose foods high in fiber and low in fat and calories.
Focus on fruits, vegetables and whole grains. Strive for variety to help you
achieve your goals without compromising taste or nutrition. Watch portion
sizes.
 Keep active. Exercising before and during pregnancy can help protect you
from developing gestational diabetes. Aim for 30 minutes of moderate activity
on most days of the week. Take a brisk daily walk. Ride your bike. Swim laps.
Short bursts of activity — such as parking further away from the store when you
run errands or taking a short walk break — all add up too.
 Start pregnancy at a healthy weight. If you're planning to get pregnant, losing
extra weight beforehand may help you have a healthier pregnancy. Focus on
making lasting changes to your eating habits that can help you through
pregnancy, such as eating more vegetables and fruits.
 Don't gain more weight than recommended. Gaining some weight during
pregnancy is normal and healthy. But gaining too much weight too quickly can
up your risk of gestational diabetes. Ask your doctor what a reasonable amount
of weight gain is for you.

VIRAL GASTROENTERITIS

Viral gastroenteritis is an intestinal infection marked by watery diarrhea, abdominal

cramps, nausea or vomiting, and sometimes fever.

The most common way to develop viral gastroenteritis — often called stomach flu —
is through contact with an infected person or by ingesting contaminated food or water.
If you're otherwise healthy, you'll likely recover without complications. But for
infants, older adults and people with compromised immune systems, viral
gastroenteritis can be deadly.

There's no effective treatment for viral gastroenteritis, so prevention is key. In

addition to avoiding food and water that may be contaminated, thorough and frequent
hand-washings are your best defense.

Risk factors
Gastroenteritis occurs all over the world, affecting people of every age, race and
background.

People who may be more susceptible to gastroenteritis include:

Young children. Children in child care centers or elementary schools may be

especially vulnerable because it takes time for a child's immune system to mature.

Older adults. Adult immune systems tend to become less efficient later in life. Older
adults in nursing homes, in particular, are vulnerable because their immune systems
weaken and they live in close contact with others who may pass along germs.

Schoolchildren, churchgoers or dormitory residents. Anywhere that groups of people

come together in close quarters can be an environment for an intestinal infection to
get passed.

Anyone with a weakened immune system. If your resistance to infection is low — for
instance, if your immune system is compromised by HIV/AIDS, chemotherapy or
another medical condition — you may be especially at risk.

Each gastrointestinal virus has a season when it's most active. If you live in the
Northern Hemisphere, for instance, you're more likely to have rotavirus or norovirus
infections between October and April.

Complications

The main complication of viral gastroenteritis is dehydration — a severe loss of water

and essential salts and minerals. If you're healthy and drink enough to replace fluids
you lose from vomiting and diarrhea, dehydration shouldn't be a problem.

Infants, older adults and people with suppressed immune systems may become
severely dehydrated when they lose more fluids than they can replace. Hospitalization
might be needed so that lost fluids can be replaced intravenously. Dehydration can be
fatal, but rarely.

Prevention

The best way to prevent the spread of intestinal infections is to follow these
precautions:

 Get your child vaccinated. A vaccine against gastroenteritis caused by the

rotavirus is available in some countries, including the United States. Given to
 children in the first year of life, the vaccine appears to be effective in preventing
severe symptoms of this illness.
 Wash your hands thoroughly. And make sure your children do, too. If your
children are older, teach them to wash their hands, especially after using the
toilet. It's best to use warm water and soap and to rub hands vigorously for at
least 20 seconds, remembering to wash around cuticles, beneath fingernails and
in the creases of the hands. Then rinse thoroughly. Carry sanitizing wipes and
hand sanitizer for times when soap and water aren't available.
 Use separate personal items around your home. Avoid sharing eating utensils,
drinking glasses and plates. Use separate towels in the bathroom.
 Keep your distance. Avoid close contact with anyone who has the virus, if
possible.
 Disinfect hard surfaces. If someone in your home has viral gastroenteritis,
disinfect hard surfaces, such as counters, faucets and doorknobs, with a mixture
of 2 cups (0.47 liters) of bleach to 1 gallon (3.8 liters) of water.
 Check out your child care center. Make sure the center has separate rooms for
changing diapers and preparing or serving food. The room with the diaper-
changing table should have a sink as well as a sanitary way to dispose of
diapers.
Take precautions when traveling

When you're traveling in other countries, you can become sick from contaminated
food or water. You may be able to reduce your risk by following these tips:

 Drink only well-sealed bottled or carbonated water.

 Avoid ice cubes, because they may be made from contaminated water.
 Use bottled water to brush your teeth.
 Avoid raw food — including peeled fruits, raw vegetables and salads — that
has been touched by human hands.
 Avoid undercooked meat and fish.