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Q: When someone hasn't had their period since march 21st and it's April 30th and there is still no period.And they get dizzy and feel tired and sick or stressed all the time.Are they pregnant?
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What are some pick up lines?

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Genital warts?

DefinitionGenital warts are soft, wart-like growths on the genitals caused by a virus. Genital warts are a type of sexually transmitted infection (STI).Alternative NamesCondylomata acuminata; Penile warts; Human papilloma virus (HPV); Venereal warts; Condyloma; HPV DNA test; Sexually transmitted disease (STD)Causes, incidence, and risk factorsThe virus responsible for genital warts is called human papilloma virus (HPV). More than 70 different types of HPV exist. Several types cause genital warts.Genital warts may be found on the penis, vulva, urethra, vagina, cervix, larynx, and around and in the anus.Other types of HPV are associated with common or flat warts found on other parts of the skin, such as the hands. However, people will not get genital warts from contact with warts on the hands or other parts of the body.HPV infection around the genitals is common, although most people have no symptoms. Even if you do NOT have symptoms, however, you must be treated to prevent complications and spreading the condition to others.In women, HPV can invade the walls of the vagina and cervix. These warts are flat and not easy to see without special procedures.Certain types of HPV can lead to precancerous changes in the cervix, cervical cancer, or anal cancer. These are called high-risk types of HPV.The following are important facts about how HPV and genital warts can be spread:HPV infection is passed from one person to another through sexual contact involving the anal, oral, or vaginal skin or mucus membrane. It is possible for genital warts and HPV to be spread, even when no warts are visible.You may not see warts for at least 6 weeks to 6 months after becoming infected with HPV. It may also take longer, even years. Because of this, when you first notice genital warts, it does not mean that you or your partner has had sexual contact with someone outside of your relationship.Not everyone who has been exposed to the HPV virus and genital warts wil develop them.The following factors put you at higher risk for getting genital warts, having them spread more quickly, having them return, or having other complications of HPV:Having multiple sexual partnersNot knowing whether someone you had sex with had STIsBecoming sexually active at an early ageUsing tobacco and alcoholHaving stress and other viral infections (such as herpes) at the same timeBeing pregnantHaving an immune system that does not work well, such as during cancer treatment or AIDSIf a child has genital warts, you should suspect sexual abuse as a possible cause.SymptomsGenital warts can be raised or flat, and are usually flesh-colored. They may appear as cauliflower-like growths. Sometimes they are so small and flat that they cannot be seen with the naked eye.Common places to find genital warts:Females most often have warts inside or around the vagina or anus, on the skin around these areas, or on the cervix.Males most often have warts on the penis, scrotum, groin area, or thighs, as well as inside or around the anus in those who have anal intercourse.Both males and females may have warts on the lips, mouth, tongue, palate, or throat (larynx)Other symptoms are rare, but may include:Increased dampness or moisture in the area of the growthsIncreased vaginal dischargeItching of the penis, scrotum, anal area, or vulvaVaginal bleeding, with or after sexual intercourseHowever, many people with HPV infection often have no symptoms.Signs and testsA genital examination reveals flesh-colored to white, flat or raised, single or clustered lesions anywhere on the genitalia.In women, a pelvic examination may reveal growths on the vaginal walls or cervix. Magnification (colposcopy) may be used to see lesions that are invisible to the naked eye. The tissue of the vagina and cervix may be treated with acetic acid (dilute vinegar) to make the warts visible.A Pap smear may note changes caused by HPV. Women with these types of changes often need more frequent Pap smears for a period of time.An HPV DNA test can identify the high-risk types of HPV that are known to cause cervical cancer. It may be done as a screening test for women over age 30, or for women of any age who have a slightly abnormal Pap test result.TreatmentGenital warts must be treated by a doctor. Do NOT use over-the-counter remedies meant for other kinds of warts.Your doctor may treat genital warts by applying a skin treatment in the office. Or, the doctor may prescribe a medication that you apply at home several times per week. These treatments include:Imiquimod (Aldara)Podophyllin and podofilox (Condylox)Trichloroacetic acid (TCA)Surgical treatments include:CryosurgeryElectrocauterizationLaser therapySurgical excision (cutting them out)If you develop genital warts, all of your sexual partners must be examined by a health care provider and treated if genital warts are found.After your first treatment, your doctor will schedule follow-up examinations to see if the warts have returned.Women who have had genital warts, and women whose partners have ever had genital warts, should have Pap smears at least once a year. For warts on the cervix, women may be advised to have Pap smears every 3 to 6 months after initial treatment.Women with precancerous changes caused by HPV infection may need further treatment.Young women and girls ages 9 - 26 shoul be vaccinated against HPV.Expectations (prognosis)Most sexually active young women become infected with HPV, but very few remain infected for more than 5 years. In many cases, HPV goes away on its own.Most men who become infected with HPV never develop any symptoms or problems from the infection. However, they can pass it on to current and sometimes future sexual partners.Even after you have been treated for genital warts, you may still infect others.Certain types of genital warts increase a woman's risk for cancer of the cervix and vulva.ComplicationsSome types of HPV have been found to cause cancer of the cervix and vulva. They are the main cause of cervical cancer.The types of HPV that can cause genital warts are not the same as the types that can cause penile or anal cancer.The warts may become numerous and quite large, requiring more extensive treatment and follow-up procedures.Calling your health care providerCall your doctor if a current or past sexual partner is found to have genital warts. Call if you have visible warts on your external genitals, itching, discharge, or abnormal vaginal bleeding. Keep in mind that genital warts may not appear for months to years after having sexual contact with an infected person.Call your doctor if a young child is thought to possibly have genital warts.Women should begin to have Pap smears at age 21.PreventionTotal abstinence is the only foolproof way of avoiding genital warts and other STIs. You can also avoid STIs by having a sexual relationship with only one partner who is known to be disease-free.Skin near the warts and around the genitals, anus, and other areas can pass the virus from one person to the next. Therefore, male and female condoms cannot fully protect you. Nonetheless, condoms reduce risk and should still be used. They reduce your chances of getting or spreading STIs. These precautions must be taken at all times. HPV can be passed from person to person even when there are no visible warts or other symptoms. See: Safe sexStop smoking.Two vaccines are available that prevent infection against four of the HPV strains responsible for the majority of cervical cancer in women. The vaccine is given as a series of three shots. It is recommended for girls and women ages 9 to 26. See: HPV vaccine for more detailed information.ReferencesDiaz ML. Human papilloma virus: prevention and treatment.Obstet Gynecol Clin North Am.2008;35(2):199-217.Mayrand MH, Duarte-Franco E, Rodrigues I, Walter SD, Hanley J, Ferenczy A, et al. Human papillomavirus DNA versus Papanicolaou screening tests for cervical cancer. N Engl J Med. 2007;357:1579-1588.Kahn JA. HPV vaccination for the prevention of cervical intraepithelial neoplasia. N Engl J Med. 2009;361:271-278.HPV and Men - CDC Fact Sheet. April 3, 2008. Accessed December 20, 2009.


Pressure ulcer?

DefinitionA pressure ulcer is an area of skin that breaks down when you stay in one position for too long without shifting your weight. This often happens if you use a wheelchair or you are bedridden, even for a short period of time (for example, after surgery or an injury). The constant pressure against the skin reduces the blood supply to that area, and the affected tissue dies.A pressure ulcer starts as reddened skin but gets progressively worse, forming a blister, then an open sore, and finally a crater. The most common places for pressure ulcers are over bony prominences (bones close to the skin) like the elbow, heels, hips, ankles, shoulders, back, and the back of the head.Alternative NamesBedsore; Decubitus ulcerCausesThese factors increase the risk for pressure ulcers:Being bedridden or in a wheelchairFragile skinHaving a chronic condition, such as diabetes or vascular disease, that prevents areas of the body from receiving proper blood flowInability to move certain parts of your body without assistance, such as after spinal or brain injury or if you have a neuromuscular disease (like multiple sclerosis)MalnourishmentMental disability from conditions such as Alzheimer's disease -- the patient may not be able to properly prevent or treat pressure ulcersOlder ageUrinary incontinence or bowel incontinenceSymptomsPressure sores are categorized by severity, from Stage I (earliest signs) to Stage IV (worst):Stage I: A reddened area on the skin that, when pressed, is "nonblanchable" (does not turn white). This indicates that a pressure ulcer is starting to develop.Stage II: The skin blisters or forms an open sore. The area around the sore may be red and irritated.Stage III: The skin breakdown now looks like a crater where there is damage to the tissue below the skin.Stage IV: The pressure ulcer has become so deep that there is damage to the muscle and bone, and sometimes tendons and joints.First AidAny new or changing pressure sore should be discussed with your doctor or nurse. Once a pressure ulcer is identified, steps must be taken immediately:Relieve the pressure on that area. Use pillows, special foam cushions, and sheepskin to reduce the pressure.Treat the sore based on the stage of the ulcer. Your health care provider will give you specific treatment and care instructions.Avoid further trauma or friction. Powder the sheets lightly to decrease friction in bed. (There are many items made specifically for this purpose -- check a medical supplies store.)Improve nutrition and other underlying problems that may affect the healing process.If the pressure ulcer is at Stage II or worse, your health care provider will give you specific instructions on how to clean and care for open ulcers. It is very important to do this properly to prevent infection.Keep the area clean and free of dead tissue. Your health care provider will give you specific care directions. Generally, pressure ulcers are rinsed with a salt-water rinse to remove loose, dead tissue. The sore should be covered with special gauze dressing made for pressure ulcers.New medicines that promote skin healing are now available and may be prescribed by your doctor.Do NotDo NOT massage the area of the ulcer. Massage can damage tissue under the skin.Donut-shaped or ring-shaped cushions are NOT recommended. They interfere with blood flow to that area and cause complications.Call immediately for emergency medical assistance ifContact your health care provider if an area of the skin blisters or forms an open sore. Contact the provider immediately if there are any signs of an infection. An infection can spread to the rest of the body and cause serious problems. Signs of an infected ulcer include:A foul odor from the ulcerRedness and tenderness around the ulcerSkin close to the ulcer is warm and swollenFever, weakness, and confusion are signs that the infection may have spread to the blood or elsewhere in the body.PreventionIf bedridden or immobile due to diabetes, circulation problems, incontinence, or mental disabilities, you should be checked for pressure sores every day. You, or your caregiver, need to check your body from head to toe. Pay special attention to the areas where pressure ulcers often form. Look for reddened areas that, when pressed, do not turn white. Also look for blisters, sores, or craters. In addition, take the following steps:Change position at least every 2 hours to relieve pressure.Use items that can help reduce pressure -- pillows, sheepskin, foam padding, and powders from medical supply stores.Eat healthy, well-balanced meals that contain enough calories to keep you healthy.Drink plenty of water (8 to 10 cups) every day.Exercise daily, including range-of-motion exercises for immobile patients.Keep skin clean and dry.After urinating or having a bowel movement, clean the area and dry it well. A doctor can recommend creams to help protect the skin.ReferencesFonder MA, Lazarus GS, Cowan DA, Aronson-Cook B, Kohli AR, Mamelak AJ. Treating the chronic wound: a practical approach to the care of nonhealing wounds and wound care dressings. J Am Acad Dermatol. 2008;58(2):185-206.Bluestein D, Javaheri A. Pressure ulcers: prevention, evaluation, and management. Am Fam Physician. 2008;78(10):1186-1194.