Antioxidant
Antioxidant vitamins -- E, C and beta carotene (a form of vitamin A) -- have potential health-promoting properties. Much research has recently focused on how antioxidant vitamins may reduce cardiovascular disease risk. Oxidation of low- density lipoprotein (LDL or "bad") cholesterol is important in the development of fatty buildups in the arteries. This process, called atherosclerosis can lead to heart attacks and strokes. Increasing evidence suggests that LDL cholesterol lipoprotein oxidation and its biological effects can be prevented by using antioxidants-both in the diet and in supplements. These data are from various sources: basic science, epidemiology, experiments in animals and clinical investigations, including limited clinical trials. The strongest evidence for using naturally occurring antioxidants to protect against the development of cardiovascular disease is for vitamin E. It's weakest for vitamin C. Data on the role of beta carotene are limited. High intakes of vitamin E have been associated with a lower risk of coronary artery disease (CAD) incidence, based on epidemiological studies. Animal studies also suggest that vitamin E can slow the development of atherosclerosis. Further, vitamin E inhibits LDL cholesterol oxidation in test tube experiments and in human studies. Some epidemiological studies suggest that vitamin C, which also inhibits lipoprotein oxidation, is associated with reduced rates of clinical CAD. Beta carotene doesn't seem to inhibit LDL cholesterol oxidation, but early data suggest that it may reduce further clinical events in people who have CAD. One should not recommend using dietary supplements of antioxidants to prevent cardiovascular disease until their effect is proved in clinical trials that directly test their impact on CVD end points. This caution is because the doses of these antioxidants that inhibited LDL cholesterol oxidation in some studies are much larger than can be achieved by diet alone. Beneficial effects must be demonstrated in randomized, placebo-controlled clinical trials before recommending widespread use to prevent cardiovascular disease.

Bicycle Safety
Bicycle Safety-wear a bike helmet. 1 out of 7 children under age 15 suffers a head injury in a bike crash. Bike helmets can prevent head injuries. Make sure that your bike and your children's bikes are the right size. Your child should be able to straddle the bike with both feet on the ground. Young children should use bikes with coaster brakes- -the kind that brake when you pedal backwards. Before using hand brakes, a child's hands should be large enough and strong enough to use the levers. Avoid riding at night if at all possible. Make sure your bike has reflectors. Obey all traffic laws. Stop at stop signs, check for traffic before turning, and ride on the same side of the road as the automobiles do. Be predictable and ride defensively. Try to ride where drivers of cars can see you. Bicycles are frequently involved in car accidents because the driver of the car did not even know the bike was there. Often, accidents occur when drivers don't pay enough attention to bikers. Many accidents have been avoided because the biker was paying attention to the car. Never ride out into a street without stopping first. Use the proper hand signals for turning or stopping. Yield the right of way to pedestrians. Wear brightly colored clothing so that motorists can easily see you. Use bike paths at all times if possible.

Bike Helmet Safety
Bike Helmet Safety-Kids, especially 11- to 14- year-olds, are sometimes reluctant to wear helmets. They may insist they're good riders who don't need helmets anymore, complain that helmets are uncomfortable, or - an old favorite - point out that none of their friends wear them. Your child may be especially mature for her age; she may be a particularly skilled rider; or it just might feel easier to give in. But we urge you to resist that temptation. Requiring your children to wear a helmet every time, everywhere they go, is the best thing you can do to protect them. If your child rides a bike, then she probably also enjoys skateboards, scooters or inline skates! Make sure that whenever she "wheels" around, she's wearing the right gear. Helmet Tips * Don't negotiate. It's estimated that 75 percent of bicycle-related deaths among children could be prevented with a bicycle helmet. * Buy a helmet that meets or exceeds current safety standards developed by the U.S. Consumer Product Safety Commission. * Correct fit is essential. Helmets should be comfortable and snug, but not too tight. They shouldn't rock back and forth or side to side. * Make sure your child wears her helmet correctly - centered on top of her head and always with the straps buckled. Children who wear their helmets tipped back have a 52 percent greater risk of head injury than those who wear their helmets properly. * If your child is reluctant to wear her helmet, try letting her choose her own. Helmets come in many colors and styles - allowing children to choose a helmet that's "cool" may make them less likely to take it off when you're not around. * Talk to other parents and encourage them to have their kids wear helmets. Let your children see that you wear a helmet, too. Children are more likely to wear helmets when riding with others who wear them.

Caffeine
Substance that exists naturally in plants. It can also be produced synthetically and used as an additive in certain food products. It is a central nervous system stimulant and a diuretic. Caffeine is absorbed and distributed very quickly. After absorption, it passes into the central nervous system, or the brain. "Caffeine sensitivity" refers to the amount of caffeine that will produce negative side effects. This amount will vary from person to person. Caffeine does not accumulate in the bloodstream nor is it stored in the body. It is excreted in the urine many hours after it has been consumed. Caffeine will not reduce the effects of alcohol, although many people still believe a cup of coffee will "sober up" an intoxicated person. Caffeine may be used as a treatment for migraine headaches and in relieving, for a short time, fatigue or drowsiness. Caffeine is widely consumed. It is found naturally in the leaves, seeds, and fruits of more than 60 plants, including tea leaves, kola nuts, coffee, and cocoa beans. It is in coffee, tea, chocolate, cocoa and many carbonated beverages such as colas. Caffeine is frequently added to over-the-counter medications such as pain relievers, appetite suppressants, and cold medicines. Caffeine has no flavor and can be removed from a food by a chemical process called decaffeination. Excessive caffeine intake can lead to a fast heart rate, diuresis (excessive urination), nausea and vomiting, restlessness, anxiety, depression, tremors, and difficulty sleeping. Abrupt withdrawal of caffeine may cause headaches, drowsiness, irritability, nausea, vomiting, and other symptoms. Reduce caffeine intake gradually to prevent any symptoms of withdrawal.

Calcium
The NICHD recommends milk and other dairy products as a primary source of calcium. In addition, a variety of other foods are excellent sources of calcium as well. Dark green, leafy vegetables and foods with added calcium can be healthy ways to get enough calcium. By eating a wide variety of foods with calcium, you can help make sure to get the calcium you need each day.

Camping and Hiking Safety
Camping and Hiking Safety-Always bring a first aid kit when camping. Know how to use the contents of the kit. Some situations can be made worse by using first aid supplies incorrectly. Use the buddy-system. It is never a good idea to camp or hike alone. If you were to become immobile because you broke a leg, or you were to fall and get stuck, a partner could go for help. Make sure someone knows where you plan to camp or hike. ( Teach children and remind adults to pick out landmarks at the campsite, and when on hikes to help recognize locations.) Be careful when exploring (always take a compass and map). Take whistles in case you. Whistles can be heard further than your voice will carry. Use caution when chopping wood or building fires. Dress appropriately. Wear long-sleeved shirts and long pants to avoid bites from ticks and other insects. In cold conditions, wear many layers of thin clothing, along with a hat, boots and gloves. When hiking, consider tucking your pants into your socks and boots to help protect against ticks. Take a supply of clean drinking water and drink it. People can become dehydrated very quickly in warm, dry, or windy conditions. Dehydration can lead to other serious complications and should be avoided. Don't drink water unless you know it is clean. Avoid alcoholic beverages which tend to cause dehydration. Don't touch animals out in the wild. Don't eat wild berries and plants. Don't over-do-it when hiking. Never leave a campfire unattended. Before leaving a campsite to return home, make sure all fires are out and the ashes are cold. A single burning ember in a seemingly smothered fire is enough to initiate another full blown fire.

Child Dental Health
The care of the child's teeth and gums, including hygiene (brushing and rinsing), examinations by dentists (assessing the current condition of teeth and gums), and treatments (use of fluoride, extractions, fillings, or orthodontics). Healthy teeth and gums are essential to overall good health. Poor dental development, dental disease, and dental trauma can result in poor nutrition, painful and dangerous infections, problems with speech development, and problems with self-image. Current recommendations for dental care during childhood include: Even though newborns and infants do not have teeth, care of the mouth and gums is important, ask your pediatrician if and when your infant needs fluoride added to his diet. Use a damp washcloth to wipe your infant's gums after each meal. Do not put your infant or young child to bed with a bottle of milk, juice, or sugar water. Use only water for bedtime bottles. Begin using a soft toothbrush instead of the washcloth to clean your child's teeth as soon as his first tooth shows (usually between 5-8 months of age). Your child's first visit to the dentist should be between the time his first tooth appears (5-8 months) and the time when all his primary teeth are visible (before 2 1/2 years). Many dentists will recommend a "trial" visit to expose the child to the sights, sounds, smells, and feel of the office before the actual examination. Children who are accustomed to having their gums wipes and teeth brushed will have fewer problems to having the dentist look inside their mouths. Your child should brush his teeth and gums at least twice each day and especially before bed. When permanent teeth are established, flossing his teeth each evening before bed should be encouraged. Additional dental treatments (such as braces or extractions) may be needed during adolescence to prevent long-term problems. Prevent tooth damage by teaching your child to use appropriate protective gear, safe play practices, and actions to take in case of injuries to teeth, gums, or mouth. Regular visits to your dentist (at least every 6 months) will ensure early recognition and treatment of problems. Proper care will give your child healthy teeth and gums for a lifetime. As your child becomes more active, trauma to his teeth may occur. Lost or damaged teeth (chips, change in position) or gums should be treated as a medical emergency to prevent infection, tooth loss, or damage to tooth, root, gums, or mouth. Even damage to primary (first) teeth should be treated to prevent future problems with tooth or gum development. If your child loses a GROWN-UP tooth during a fall or other injury, you should: find the tooth, avoid touching the root, and carefully rinse the tooth in running water (use stopper or strainer to avoid losing the tooth down the drain). Place the clean tooth back into its hole in your child's mouth and have your child hold the tooth in place with his fingers, if you or your child are unable to do this, place the tooth either in saliva (under your tongue), cold milk or saline (such as contact lens solution). Take your child and his tooth for immediate medical or dental assistance.

Child Safety
Child Safety-the space between crib bars should be no more than 2 1/2 inches. A crib or playpen should have no sharp edges. The distance from the mattress to the top of the rail should be over 2 feet. Use bumper pads on the inside of the crib. Keep plastic wrap or bags away from children. Keep stuffed animals with buttons that can be swallowed away from small children. Avoid putting extra blankets and stuffed animals in a crib with a baby. Child-proof your home: * Place gates at the top and bottom of each stairway. * Cover unused electrical sockets. * Keep toxic substances (such as cleaning fluids, bug poisons, and other chemicals) well out of a child's reach. * Avoid storing toxic substances in unmarked and inappropriate containers (such as food containers). * Keep knives out of reach. * Buy medicines with child-resistant caps. Place all medications out of the reach of children. * Put safety latches on cabinets that a child should not open. * Keep matches out of reach. * Set the hot water heater thermostat to no more than 125 degrees F. * When cooking on the stove, make sure that pot and pan handles are turned to the middle of the stove top. Handles that hang over the edge of the stove top may be reached by a curious toddler. * Keep toys with small parts (and other small objects) out of the reach of toddlers. * In the bathroom, avoid putting dangerous items (such as razor blades) in a waste basket where a young child might have access. * Keep toilet lids down. Never leave an infant unattended in the bathtub. Keep children away from hot beverages and stove tops. Don't leave small children alone in the kitchen. Establish sensible rules for outdoor play and supervise young children constantly. When heating a baby bottle in the microwave oven or on the stove, always test the milk temperature to prevent burning your baby's mouth.

Children
Children need to eat a wide variety of foods for good health. Use the Food Guide Pyramid on page 5 as a starting point for planning family meals and snacks. The Food Guide Pyramid applies to healthy people age 2 years and older. The smaller number of servings in the range is for children age 6 years and under. For 2- to 3-year-old children, the serving size should be smaller, about two- thirds the size of a regular serving (except for milk). When you help children build healthy eating habits early, they will approach eating with a positive attitude-that food is something to enjoy, help them grow, and give them energy. Give your child a snack or two in addition to his or her three daily meals. Offer your child a wide variety of foods, such as grains, vegetables and fruits, low-fat dairy products, and lean meat or beans. Serve snacks like dried fruit, low-fat yogurt, and air-popped popcorn. Let your child decide whether and how much to eat. Keep serving new foods even if your child does not eat them at first. Cook with less fat-bake, roast, or poach foods instead of frying. Limit the amount of added sugar in your child's diet. Choose cereals with low or no added sugar. Serve water or low-fat milk more often than sugar-sweetened sodas and fruit-flavored drinks. Choose and prepare foods with less salt. Keep the saltshaker off the table. Have fruits and vegetables on hand for snacks instead of salty snack foods. Involve your child in planning and preparing meals. Children may be more willing to eat the dishes they help fix. Have family meals together and serve everyone the same thing. Do not be too strict. In small amounts, sweets or food from fast-food restaurants can still have a place in a healthy diet. Make sure your child eats breakfast. Breakfast provides children with the energy they need to listen and learn in school.

Children and Exercise
Children should exercise to stay healthy. For children older than 6 years, 20 minutes a day of aerobic exercise at least 3 days a week should be adequate. Encourage your child to build strength, flexibility and aerobic capacity (for example, through running).

Cholesterol
A soft, waxy substance that is present in all parts of the body including the nervous system, skin, muscle, liver, intestines, and heart. It is made by the body and obtained from animal products in the diet. Cholesterol is manufactured in the liver for normal body functions including the production of hormones, bile acid, and Vitamin D. It is transported in the blood to be used by all parts of the body. Dietary cholesterol is present only in foods of animal origin (not in foods of plant origin). Cholesterol is found in eggs, dairy products, meat, poultry, fish, and shellfish. Egg yolks and organ meats (liver, kidney, sweetbread, and brain) are high in dietary cholesterol. Fish generally contains less cholesterol than other meats, but some shellfish is high in cholesterol content. Foods of plant origin (vegetables, fruits, grains, cereals, nuts, and seeds) contain no cholesterol. Fat content is not a good measurement of cholesterol content. For example, liver and other organ meats are low in fat but very high in cholesterol. Excessive cholesterol contributes to atherosclerosis and subsequent heart disease. The risk of developing heart disease or atherosclerosis increases as the level of blood cholesterol increases. Approximately 25% of the adult population in the U.S. has elevated blood cholesterol levels. More than half of the adult population has blood cholesterol levels that are higher than the "desirable" range, as specified by the medical community. Elevated cholesterol levels often begin in childhood. Some children may be at higher risk than others secondary to family history. The level for total cholesterol has been lowered in the past few years. Depending on the laboratory levels either less than 200 or 190 milligrams per deciliter (mg/dl) are considered "desirable" because they carry the least risk of heart disease. When the level is above 200 mg/dl the risk for coronary heart disease increases. It is also important to know the levels for High Density Lipoprotein (HDL, also known as the "good cholesterol") and Low Density Lipoprotein (LDL, or "bad cholesterol"). You must consult your health care provider to measure and discuss your cholesterol profile. To lower high cholesterol levels, eat less than 30% of the total daily calories from fat. Of that 30%, less than one-third should be from saturated fat and not more than one-third should be from polyunsaturated fat. At least one-third of the total fat calories should be from monounsaturated fat. Less than 300 milligrams (mg) of dietary cholesterol per day should be consumed.

Cold Sores
Cold Sores or Herpes labialis is an infection caused by the herpes simplex virus, characterized by an eruption of small and usually painful blisters on the skin of the lips, mouth, gums or the skin around the mouth. These blisters are commonly called cold sores or fever blisters. Most Americans are infected with the type 1 virus by the age of 20. The initial infection may cause no symptoms or mouth ulcers. The virus remains in the nerve tissue of the face. In some people, the virus reactivates and produces recurrent cold sores that are usually in the same area, but are not serious. Herpes virus type 2 usually causes genital herpes and infection of babies at birth but can also cause herpes labialis. Herpes viruses are contagious. Contact can occur directly, or through contact with infected razors, towels, dishes, etc. Occasionally, oral/genital contact can spread oral herpes to the genitals (and vice versa), so people with active herpes lesions on or around their mouths or on their genitals should avoid oral sex. The first symptoms usually appear within 1 or 2 weeks, and as late as 3 weeks, after contact with an infected person. The lesions of herpes labialis usually last for 7 to 10 days, then begin to resolve. The virus may become latent, residing in the nerve cells, with recurrence at or near the original site. Recurrence is usually milder. It may be triggered by menstruation, sun exposure, illness with fever, stress, or other unknown causes. Warning symptoms of itching, burning, increased sensitivity, or tingling sensation may occur about 2 days before lesions appear. They include: Skin lesion/rash located around the lips, mouth, and gums; Small blisters (vesicles), filled with clear yellowish fluid, blisters appear on a raised, red, painful skin area. Blisters form, break, and ooze, yellow crusts slough to reveal pink, healing skin, several smaller blisters may merge to form a larger blister, and a mild fever (may occur). Untreated, the symptoms will generally subside in 1 to 2 weeks. Antiviral medications may be given by mouth to may shorten the course of the symptoms and decrease pain. Wash blisters gently with soap and water to minimize the spread of the virus to other areas of skin. An antiseptic soap may be recommended. Applying ice or warmth to the area may reduce pain. Take precautions to avoid infecting others. Prevention methods include avoid direct contact with cold sores or other herpes lesions. Minimize the risk of indirect spread by thoroughly washing items in hot (preferably boiling) water before re-use. Do not share items with an infected person, especially when herpes lesions are active. Avoid precipitating causes (especially sun exposure) if prone to oral herpes. Avoid performing oral sex when you have active herpes lesions on or near your mouth and avoid passive oral sex with someone who has active oral or genital herpes lesions. Condoms can help reduce, but do not entirely eliminate, the risk of transmission via oral or genital sex with an infected person. Unfortunately, both oral and genital herpes viruses can sometimes be transmitted even when the person does not have active lesions.

Diabetes
Diabetes is a life-long disease marked by elevated levels of sugar in the blood. It can be caused by too little insulin (a chemical produced by the pancreas to regulate blood sugar), resistance to insulin, or both. People with diabetes have high blood glucose. This is because their pancreas does not make enough insulin or their muscle, fat, and liver cells do not respond to insulin normally, or both. There are three major types of diabetes: * Type 1 diabetes is usually diagnosed in childhood. The body makes little or no insulin, and daily injections of insulin are required to sustain life. Without proper daily management, medical emergencies can arise. * Type 2 diabetes is far more common than type 1 and makes up about 90% of all cases of diabetes. It usually occurs in adulthood. Here, the pancreas does not make enough insulin to keep blood glucose levels normal, often because the body does not respond well to the insulin. Many people with type 2 diabetes do not know they have it, although it is a serious condition. Type 2 diabetes is becoming more common due to the growing number of older Americans, increasing obesity levels, and widespread failure to exercise. * Gestational diabetes is high blood glucose that develops at any time during pregnancy in a person who does not have diabetes. High blood levels of glucose can cause several problems, including frequent urination, excessive thirst, hunger, fatigue, weight loss and blurry vision. However, because type 2 diabetes develops slowly, some people with high blood sugar experience no symptoms at all. About 40% of type 2 diabetics have no symptoms of the condition.

Dietary Fiber
Dietary fiber is found in plant foods and humans cannot digest it. It has no calories because the body cannot absorb it. Dietary fiber provides a feeling of fullness and adds bulk in the diet. This assists digestion and elimination. Including fiber in your daily diet helps prevent many problems and brings many benefits. It may be helpful in controlling weight by making you feel full sooner. It helps prevent constipation. It may be helpful in the prevention or treatment of diverticulosis, diabetes, and heart disease (ask your health care provider or registered dietician about recommendations for these conditions). There are two forms of fiber: soluble and insoluble. Soluble fiber attracts water and turns to gel during digestion. This slows digestion and the rate of nutrient absorption from the stomach and intestine. It is found in oat bran, barley, nuts, seeds, beans, lentils, peas, and some fruits and vegetables. Insoluble fiber is found in foods such as wheat bran, vegetables and whole grains. It appears to speed the passage of foods through the stomach and intestines and adds bulk to the stool. The recommendation for older children, adolescents and adults is 20 to 35 grams per day. Younger children will not be able to eat enough calories to achieve this, but introducing whole grains, fresh fruits and other high fiber foods is suggested. To ensure an adequate fiber intake, eat a variety of foods, including more fruits, vegetables, whole grains, cereals, and dried beans and peas.

Fire Safety
Fire Safety-In the event of a fire, remember time is the biggest enemy and every second counts! Escape first, then call for help. Develop a home fire escape plan and designate a meeting place outside. Make sure everyone in the family knows two ways to escape from every room. Practice feeling your way out with your eyes closed. Never stand up in a fire, always crawl low under the smoke and try to keep your mouth covered. Never return to a burning building for any reason; it may cost you your life. Finally, having a working smoke alarm dramatically increases your chances of surviving a fire. And remember to practice a home escape plan frequently with your family. In less than 30 seconds a small flame can get completely out of control and turn into a major fire. It only takes minutes for thick black smoke to fill a house. In minutes, a house can be engulfed in flames. Most fires occur in the home when people are asleep. If you wake up to a fire, you won't have time to grab valuables because fire spreads too quickly and the smoke is too thick. There is only time to escape. A fire's heat alone can kill. Room temperatures in a fire can be 100 degrees at floor level and rise to 600 degrees at eye level. Inhaling this super hot air will scorch your lungs. This heat can melt clothes to your skin. In five minutes a room can get so hot that everything in it ignites at once: this is called flashover. Fire starts bright, but quickly produces black smoke and complete darkness. If you wake up to a fire you may be blinded, disoriented and unable to find your way around the home you've lived in for years. Fire uses up the oxygen you need and produces smoke and poisonous gases that kill. Breathing even small amounts of smoke and toxic gases can make you drowsy, disoriented and short of breath. The odorless, colorless fumes can lull you into a deep sleep before the flames reach your door. You may not wake up in time to escape.

First Aid
First Aid-Know CPR and/or first aid techniques. Post emergency numbers near the telephone. Know how and when to call 911 or other emergency numbers. Keep a first aid kit available.

Folic Acid
Folic Acid is a water-soluble vitamin of the B-complex group (B9). Folic acid acts as a coenzyme (with vitamin B-12 and vitamin C) in the breakdown (metabolism) of proteins and in the synthesis of new proteins. It is necessary for the production of red blood cells and the synthesis of DNA (which controls heredity), as well as tissue growth and cell function. It also increases the appetite and stimulates the formation of digestive acids. Synthetic folic acid supplements may be used in the treatment of disorders associated with folic acid deficiency, and may also be part of the recommended treatment for certain menstrual problems and leg ulcers. Food sources of folic acid include: beans and legumes, citrus fruits and juices, wheat bran and other whole grains, dark green leafy vegetables, poultry, pork, shellfish, and liver.

Food Safety
Refers to the conditions and practices that preserve the quality of food to prevent contamination and food-borne illnesses. Proper handling and preparation of food greatly reduces the risks of getting foodborne illnesses. Food can be contaminated in many different ways -- during the packaging process, by inadequate cooking or storage. Different food products may already have different microorganisms such as bacteria or parasites which may be allowed to multiply and cause disease if food is not appropriately handled. Higher risk foods include red meats and poultry; eggs; cheese and dairy products; raw sprouts; and raw fish or shellfish. The main consequence of improper handling and inadequate food safety is infection (foodborne illness) which may be severe and life-threatening especially in young children, older adults, pregnant women, and persons with weakened immune systems. To safetly handle food wash your hands thoroughly before and after handling any food, and after using the bathroom, changing diapers or after coming into contact with animals; Wash all cutting boards and utensils with hot water and soap after preparing each food item and prior to moving on to the next food item. Wear gloves or avoid preparation if your hands have any cuts or sores; Avoid cross-contaminating food items -- separate meat, poultry and seafood from other food and always wash hands, utensils and boards after coming into contact with these products; Cook to proper temperatures. Cook eggs until both the white and yolk are firm. Fish should be opaque and flake easily. Red meats and poultry should reach an internal temperature of 160 and 180 degrees, respectively. Leftovers must be reheated thoroughly to at least 165 degrees Fahrenheit; Refrigerate promptly -- some items such as meat and poultry must be frozen if not to be used within 1-2 days. Leftovers should be refrigerated within two hours. Keep frozen foods in the freezer until they are ready to be thawed and cooked; Foods can also be contaminated before they are purchased. Watch for and do not use outdated food, packaged food with the seal broken, and cans that have a bulge. Do not use foods that have an unusual odor or a spoiled taste; Prepare home- canned foods in nearly sterile conditions and with extreme caution. Home-canned food is the most common cause of botulism.

Gonorrhea
A sexually transmitted disease (commonly known as "the clap") caused by the bacterium Neisseria gonorrhea. Gonorrhea is one of the most common infectious bacterial diseases and is most frequently transmitted during sexual activity, including vaginal intercourse and both oral and anal sex. Gonorrhea is a reportable disease and all state governments require that cases of diagnosed gonorrhea be reported to the health authorities (State Board of Health). This allows for adequate follow-up and testing of sexual contacts. Gonorrhea is easily transmitted during oral, vaginal, or anal sex. The bacteria can infect the throat, producing a severe sore throat (gonococcal pharyngitis). It can infect the vagina, causing irritation with drainage (vaginitis), or the anus and rectum, producing a condition called proctitis. In addition, the organisms may spread up the female reproductive tract, through the cervix and uterus, into the fallopian tubes (the tubes that carry the egg from the ovaries to the uterus). On rare occasions gonorrhea can spread through non-sexual contact. An infected woman may transmit the infection to her newborn during childbirth. Infection of the newborn's eyes is called ophthalmia neonatorum (gonococcal conjunctivitis). Young girls who contract gonorrhea either from sexual abuse or intimate contact with recently contaminated objects (such as a damp towel) develop a severe infection called vulvovaginitis. Symptoms in women include: vaginal discharge, pain or burning on urination, urinary hesitancy, sore throat, painful sexual intercourse, and/or mouth sores. Symptoms in men include: increased irinary frequency or urgency, incontinence, urethral dischard, pain on urination, red or sowllen opening of penis, and/or tender testicles. There are two important steps to treating a sexually transmitted disease, especially one as easily spread as gonorrhea. The first is to cure the infected person. The second is to locate and test all of the person's other sexual contacts and to treat them to prevent further spread of the disease. That is why mandatory reporting has been instituted and has, until recently, held the number of cases of gonorrhea at a low level. However, the incidence is once again rising. Even though penicillin is effective against gonorrhea, there have been increasing numbers of strains that are resistant to penicillin (they don't respond to penicillin treatment). Because of this, gonorrhea is now treated by a large number of new and very potent antibiotics.

Gum Disease
Gum Disease or Periodintis is a dental disorder that results from progression of gingivitis, involving inflammation and infection of the ligaments and bones that support the teeth. Periodontitis is caused when inflammation or infection of the gums (gingivitis) is untreated or treatment is delayed. Infection and inflammation spreads from the gums (gingiva) to the ligaments and bone that support the teeth. Loss of support causes the teeth to become loose and eventually fall out. Periodontitis is the primary cause of tooth loss in adults. This disorder is uncommon in childhood but increases during adolescence. Plaque and tartar (calculus) accumulate at the base of the teeth. Inflammation causes a pocket to develop between the gums and the teeth, which fills with plaque and tartar. Soft tissue swelling traps the plaque in the pocket. Continued inflammation eventually causes destruction of the tissues and bone surrounding the tooth. Because plaque contains bacteria, infection is likely and a tooth abscess may also develop, which increases the rate of bone destruction. Symptoms include: swollen gums, gums appear bright red or red-purple, gums appear shiny, gums bleed easily, gums may be tender when touched but are painless otherwise, breath odor and/or loose teeth. The goal of treatment is to reduce inflammation, and to correct causative conditions. Dental irritants such as rough surfaces of teeth or dental appliances should be repaired. It is important to have the teeth cleaned thoroughly. This may involve use of various instruments or devices to loosen and remove deposits from the teeth (scaling). Meticulous home oral hygiene is necessary after professional tooth cleaning to limit further destruction. The dentist or hygienist will demonstrate brushing and flossing techniques. With periodontitis, professional tooth cleaning is often recommended more frequently than the standard twice a year.

HIV
HIV infection is a viral infection caused by the human immunodeficiency virus (HIV) that gradually destroys the immune system, resulting in infections that are hard for the body to fight. Acute HIV infection may be associated with symptoms resembling mononucleosis or the flu within 2 to 4 weeks of exposure. HIV seroconversion (converting from HIV negative to HIV positive) usually occurs within 3 months of exposure. People who become infected with HIV may have no symptoms for up to 10 years, but they can still transmit the infection to others. Meanwhile, their immune system gradually weakens until they are diagnosed with AIDS. Acute HIV infection progresses over time to asymptomatic HIV infection and then to early symptomatic HIV infection and later, to AIDS (advanced HIV infection): HIV Infection (acute HIV infection) -->early asymptomatic HIV infection -->early symptomatic HIV infection -->AIDS. Most individuals infected with HIV will progress to AIDS if not treated. However, there is a tiny subset of patients who develop AIDS very slowly, or never at all. These patients are called non- progressors. HIV has spread throughout the United States. Higher concentrations of the disease are found in inner city areas. Any symptoms of illness may occur, since infections can occur throughout the body. Special symptoms relating to HIV infection include: sore throat, mouth sores, including candidal infection, muscular stiffness or aching, headache, diarrhea, swollen lymph glands, fever, fatigue, rash of various types, including seborrheic dermatitis, and/or frequent vaginal yeast infections. Drug therapy is often recommended for patients who are committed to taking all their medications and have a CD4 count less than 500 (indicating immune system suppression) or a high viral load (amount of HIV virus in the bloodstream). It is extremely important that patients take all doses of their medications, otherwise the virus will rapidly become resistant to the medications. Therapy is always given with a combination of antiviral drugs. People with HIV infection need to receive education about the disease and treatment so that they can be active partners in decision making with their health care provider.

Household Safety
Household Safety-wear protective footwear and eye wear when mowing the lawn, operating power tools, working with a chisel and hammer or hammering metal on metal. Don't allow children to handle tools until they are old enough to understand and obey instructions regarding their proper use. All stairways should have a sturdy hand rail. All entryways should have lighting that is bright enough to read by. Don't leave objects on stairways and make sure that carpet on stairways is securely fastened. Unplug appliances (such as heating pads and electric blankets) when they are not in use. In the bathroom, use floor mats that don't slip. Put non-slip appliques on the bathtub. Don't use any electrical appliances when you are wet or in the bathtub, shower or pool. Make sure that each fireplace has a fire screen. Keep a fire extinguisher in the kitchen and at least one on every level. Know how to use the extinguishers. Keep the kitchen floor clean from spills that might cause someone to slip and fall. Position pot and pan handles toward the back of the stove or counter. Keep any guns in a locked cabinet and make sure they are unloaded. Firearms and ammunition should be stored separately.

HPV (human papilloma virus)
HPV (human papilloma virus) or genital warts is a viral skin disease characterized by a soft wart-like growth on the genitals. In adults, the disorder is considered a sexually- transmitted disease. Genital warts are caused by the human papilloma virus (HPV). Papilloma viruses cause small growths (warts) on the skin and mucous membranes. Infection of the genital and anal regions with HPV can cause warts (anogenital condyloma) on the penis, vulva, urethra, vagina, cervix, and around the anus (perianal). More than 70 different types of HPV have been classified. Several types, including 6, 11, and 42, are associated with raised, rough, easily visible genital warts (especially in women). Other types are associated with flat warts. More importantly, several types are associated with pre-malignant and malignant changes in the cervix (abnormal Pap smears). These include types 16, 18, 31, 33, 35, 39, 45, 51, and 52. Research also shows that the presence of both HPV and herpes virus together is a good predictor of cervical cancer. Lesions on the external genitalia are easily recognized. On the penis, genital warts tend to be drier and more limited than on the female genitalia or around the anus of either sex. They grow best in the moist genital area. They are raised, rough, flesh-colored "warty" appearing tumors that may occur singly or in clusters. Left untreated, warts around the anus and vulva may rapidly enlarge, taking on a "cauliflower-like" appearance. Keeping the infected area dry may be a problem because the warts are usually damp. In women, HPV can invade the vagina and cervix. These warts are flat and not easily visible without special procedures. Because HPV can lead to premalignant changes in the cervix (cervical dysplasia), it is important that this condition be diagnosed and treated. Regular Pap smears are important for detecting HPV. Infection with HPV is very common, although the majority of people have no symptoms (asymptomatic). In several studies done on college women, nearly half were positive for HPV; although only 1 to 2% had visible warts and less than 10% had ever had any visible genital warts. The incidence of genital warts appears to be increasing rapidly, although this may be a result of increased diagnostic ability and awareness. Risk factors for genital warts include multiple sexual partners, unknown partners, early onset of sexual activity, tobacco use, nutritional status, hormonal conditions, age, stress and concurrent viral infections (such as flu, HIV, Epstein-Barr and herpes). Symptoms include: raised "warty" appearing tumors on the genitals; raised, flesh colored lesions; genital lesions; cauliflower-like appearing growths around the anus or female genitalia; increased dampness or moisture in the area of the growths; itching of the penis, scrotum, anal area, or a vulvar itch; increased vaginal discharge; and/or abnormal vaginal bleeding (not associated with a menstrual period) after sexual intercourse (postcoital).

Hypoglycemia
Hypoglycemia occurs when your body's blood sugar, or glucose, is abnormally low. The term insulin shock is used to describe severe hypoglycemia that results in unconsciousness. Hypoglycemia results when your body's glucose is used up too rapidly, when glucose is released into the bloodstream more slowly than is needed by your body, or when excessive insulin is released into the bloodstream. Insulin is a hormone produced by the pancreas in response to increased glucose levels in the blood, which then reduces blood glucose. Hypoglycemia is relatively common in diabetics. It occurs when too much insulin or oral antidiabetic medication is taken, not enough food is eaten, or from a sudden increase in the amount of exercise without an increase in food intake. Relative hypoglycemia, where a newborn's blood glucose is low, is a fairly common occurrence. Severe hypoglycemia may occur in an infant born to a gestational diabetic or a diabetic mother. In these cases the child is referred to as an IDM for "infant of diabetic mother." If, during the pregnancy, the mother's blood sugar is persistently high, the fetus' pancreas assists in controlling the excess blood sugar by producing extra insulin. When the infant is born, it no longer gets the mother's glucose, but still produces increased insulin, and the increased insulin drives the infant's blood sugar down to dangerous levels. This is a medical emergency that may result in seizures and damage to the baby's nervous system if not treated. Sometimes the cause of hypoglycemia is unknown, or idiopathic. In this case, people who are not diabetic and who do not have another known causes of hypoglycemia experience these symptoms. Hypoglycemia can occur because of an insulin-secreting tumor of the pancreas, liver disease, or as a response to the ingestion of alcohol. It can occur in adults, infants, and children. The incidence is approximately 1 out of 1000 people. Symptoms include: fatigue, general discomfort, uneasiness, or ill feeling (malaise), nervousness, Irritability, or even aggression, trembling, headache, hunger, cold sweats, rapid heart rate, blurry or double vision, confusion, convulsions and/or coma.

Impotence
The inability to achieve and maintain penile erection sufficient to complete satisfactory intercourse. Between 2 and 30 million men in the United States are affected by impotence problems, according to recent estimates. About 52% of men between 40 and 70 years-old have some degree of erectile dysfunction (ED). Approximately 90% of ED is caused by physical, not psychological, problems. Risk factors for ED include: hypertension (high blood pressure), hyperlipidemia (high cholesterol), diabetes, coronary artery disease, peripheral vascular disease, anemia, medications, smoking, alcohol abuse, surgical procedures (vascular surgeries, abdomino- perineal resection, radical prostatectomy, other pelvic surgeries, etc.), neurological conditions, depression, endocrine disorgers (low testosterone, thyroid disease, hyperprolactinemia, etc.), and/or trauma. Impotence can be classified as primary or secondary. A man with primary impotence has never had an erection sufficient for intercourse. This is rare. The more common condition, secondary impotence, is the loss of erectile function after a period of normal function. Except for impotence caused by injury or sudden illness, secondary impotence usually comes on gradually. Treatment of secondary impotence is usually more successful than that for primary impotence because it is easier to restore function that has been lost than it is to discover why function has never occurred in the first place.

Laryngitis
An inflammation of the larynx generally associated with hoarseness or loss of voice. The voice box (larynx) is located at the top of the airway to the lungs (windpipe, trachea) and contains the vocal cords. When they become inflamed or infected, they swell. This can cause hoarseness, and may occasionally cause obstruction of the airway. The most common form of laryngitis is an infectious illness usually caused by a virus which results in hoarseness. It may also be part of a bacterial infection or part of a common cold, bronchitis, flu, or pneumonia. Laryngitis often follows or occurs during an upper respiratory infection and is a self- limiting condition. Common laryngitis is not normally associated with any breathing difficulty (respiratory distress). Several forms of laryngitis occur in children and can lead to significant or fatal respiratory obstruction. These are croup and epiglottitis (discussed under their respective headings). Other causes of laryngitis include laryngeal polyps, laryngeal paralysis (such as Horner syndrome), premalignant changes of the vocal mucosa, malignant tumors, allergies, and trauma. Symptoms include: recent or current upper respiratory infection, hoarseness, fever, swollen lymph nodes or glands in the neck and/or drooping eyelid on one side (Horner syndrome). Since most common laryngitis is viral, treatment with antibiotics is generally not indicated. Your health care provider will make this decision. Voice rest helps both the voice and to reduce inflammation of the vocal cords. A humidifier may provide comfort for the scratchy feeling sometimes associated with laryngitis. Decongestants and analgesics may provide some symptomatic relief from the accompanying upper respiratory infection.

Motor Vehicle
Motor Vehicle-more than 41,000 people lose their lives in motor vehicle crashes each year and over two million more suffer disabling injuries, according to the National Safety Council. The triple threat of high speeds, impaired or careless driving and not using occupant restraints threatens every driver -- regardless of how careful or how skilled. Driving defensively means not only taking responsibility for yourself and your actions but also keeping an eye on "the other guy." The National Safety Council suggests the following guidelines to help reduce your risks on the road: Don't start the engine without securing each passenger in the car, including children and pets. Safety belts save thousands of lives each year! Lock all doors. Remember that driving too fast or too slow can increase the likelihood of collisions. Don't kid yourself. If you plan to drink, designate a driver who won't drink. Alcohol is a factor in almost half of all fatal motor vehicle crashes. Be alert! If you notice that a car is straddling the center line, weaving, making wide turns, stopping abruptly or responding slowly to traffic signals, the driver may be impaired. Avoid an impaired driver by turning right at the nearest corner or exiting at the nearest exit. If it appears that an oncoming car is crossing into your lane, pull over to the roadside, sound the horn and flash your lights. Notify the police immediately after seeing a motorist who is driving suspiciously. Follow the rules of the road. Don't contest the "right of way" or try to race another car during a merge. Be respectful of other motorists. While driving, be cautious, aware and responsible.

Nutrition for Seniors
Nutrition for Seniors-As you grow older, you may need less energy from what you eat. But, you still need just as many of the nutrients in food. Nutrition experts can recommend what the average older person needs to eat, but you should also check with your doctor or a registered dietitian, a specialist trained in nutrition. This is especially true if you have a health problem that limits what you should eat. They can help you plan meals that will include the healthy foods you need without the foods you should avoid. Choose many different healthy foods. Pick those that are lower in fat, especially saturated fat (mostly in foods that come from animals), and cholesterol. Eat or drink only small amounts of sugary or salty foods, and alcoholic drinks, if you drink them at all. Avoid "empty calories" as much as you can. These are foods like sodas, potato chips, and cookies that have a lot of calories, but not many nutrients. The U.S. Department of Agriculture (USDA) has developed the Food Guide Pyramid to help you make healthy food choices. There are five major food groups. Every day you should try to eat the suggested number of servings from each group. If you can't do that, at least try to eat something from each group each day. Lower fat choices are best. Make sure you eat vegetables, fruits, and whole-grain foods.

Obesity
Obesity is defined as a BMI (body mass index) over 30 kg/m2. Patients with a BMI between 25 and 29.9 are considered overweight, but not obese. An individual is considered obese when weight is 20% (25% in women) or more over the maximum desirable for their height. When an adult is more than 100 pounds overweight, it is considered morbid obesity. More than half of the U.S. population is overweight. But being obese is different from being overweight. Obesity increases a person's risk of illness and death due to diabetes, stroke, coronary artery disease, hypertension, high cholesterol, and kidney and gallbladder disorders. Obesity may increase the risk for some types of cancer. It is also a risk factor for the development of osteoarthritis and sleep apnea. Genetic factors play some part in the development of obesity -- children of obese parents are 10 times more likely to be obese than children with parents of normal weight. To help prevent an increase in weight: Avoid excess alcohol consumption; Stress; Depression; Boredom and frustration; Poor eating habits; and avoid a sedentary lifestyle. Perform aerobic exercise for at least 30 minutes a day, 3 times a week and try to increase physical activity in general by walking rather than driving, and climbing stairs rather than using an elevator or escalator. In addition reduce consumption of food that is high in fat and sugar.

Occupational Illness
Occupational illness is any abnormal condition or disorder, other than one resulting from an occupational injury, caused by exposure to factors associated with employment. It includes acute and chronic illnesses or disease which may be caused by inhalation, absorption, ingestion, or direct contact.

Occupational Injury
Occupational injury is any injury such as a cut, fracture, sprain, amputation, etc., which results from a work-related event or from a single instantaneous exposure in the work environment.

Outbreaks
Information on outbreaks of concern to international travelers.

Physical Activity
Physical activity is defined as the state of being active, or as energetic action or movement. Physical activity can increase the basal metabolic rate by approximately 10%. This increase can last for up to 48 hours after the completion of the activity. Physical activity helps in the utilization of calories. The number of calories used is dependent on the type and intensity of the activity, and on the body weight of the person performing the physical activity. Physical activity assists in reducing the appetite. For the purpose of weight loss, physical activity can reduce body fat and is more beneficial in combination with reduced intake of calories. Physical activity also helps in the maintenance and control of weight. Physical activity contributes to health by reducing the heart rate, decreasing the risk for cardiovascular disease, and reducing the amount of bone loss that is associated with age and osteoporosis. Physical activity also helps the body use calories more efficiently, thereby helping in weight loss and maintenance. It can increase basal metabolic rate, reduces appetite, and helps in the reduction of body fat.

Proteins
Proteins are complex organic compounds. The basic structure of protein is a chain of amino acids that contain carbon, hydrogen, oxygen, and nitrogen. The presence of nitrogen differentiates protein from carbohydrate and fat. Protein is the main component of muscles, organs, and glands. Every living cell and all body fluids, except bile and urine, contain protein. The cells of muscles, tendons, and ligaments are maintained with protein. Children and adolescents require protein for growth and development. Proteins are described as essential and nonessential proteins or amino acids. The human body requires approximately 20 amino acids for the synthesis of its proteins. The body can make only 13 of the amino acids -- these are known as the nonessential amino acids. They are called non- essential because the body can make them and does not need to get them from the diet. There are 9 essential amino acids that are obtained only from food, and not made in the body. If the protein in a food supplies enough of the essential amino acids, it is called a complete protein. If the protein of a food does not supply all the essential amino acids, it is called an incomplete protein. All meat and other animal products are sources of complete proteins. These include beef, lamb, pork, poultry, fish, shellfish, eggs, milk, and milk products. Protein in foods (such as grains, fruits, and vegetables) are either low, incomplete protein or lack one of the essential amino acids. These food sources are considered incomplete proteins. Plant proteins can be combined to include all of the essential amino acids and form a complete protein. Examples of combined, complete plant proteins are rice and beans, milk and wheat cereal, and corn and beans.

Reproductive Health
Reproductive Health is the many factors can contribute to producing healthy children. It is well known that the health of an unborn child can suffer if a woman fails to eat right, smokes, or drinks alcohol during pregnancy. It is not well known, however, that a man's exposure to substances in the workplace can affect his ability to have healthy children. Radiation, many chemicals, drugs (legal and illegal), cigarettes, and heat are examples of reproductive hazards.

Sexually transmitted diseases (STDs)
Sexually transmitted diseases (STDs), once called venereal diseases, are among the most common infectious diseases in the U.S. today. More than 20 STDs have now been identified and they affect more than 13 million men and women in this country each year. The annual comprehensive cost of STDs in the United States is estimated to be well in excess of $10 billion. STDs affect men and women of all backgrounds and economic levels. They are most prevalent among teenagers and young adults. Nearly two-thirds of all STDs occur in people younger than 25 years of age. The incidence of STDs is rising, in part because in the last few decades, young people have become sexually active earlier yet are marrying later. In addition, divorce is more common. The net result is that sexually active people today are more likely to have multiple sex partners during their lives and are potentially at risk for developing STDs. Most of the time, STDs cause no symptoms, particularly in women. When and if symptoms develop, they may be confused with those of other diseases not transmitted through sexual contact. Even when an STD causes no symptoms, however, a person who is infected may be able to pass the disease on to a sex partner. That is why many doctors recommend periodic testing or screening for people who have more than one sex partner. Health problems caused by STDs tend to be more severe and more frequent for women than for men, in part because the frequency of asymptomatic infection means that many women do not seek care until serious problems have developed. * Some STDs can spread into the uterus (womb) and fallopian tubes to cause pelvic inflammatory disease (PID), which in turn is a major cause of both infertility and ectopic (tubal) pregnancy. The latter can be fatal. * STDs in women also may be associated with cervical cancer. One STD, human papillomavirus infection (HPV), causes genital warts and cervical and other genital cancers. * STDs can be passed from a mother to her baby before, during, or immediately after birth; some of these infections of the newborn can be cured easily, but others may cause a baby to be permanently disabled or even die. When diagnosed and treated early, many STDs can be treated effectively. Some infections have become resistant to the drugs used to treat them and now require newer types of antibiotics. Experts believe that having STDs other than AIDS increases one's risk for becoming infected with the AIDS virus.

Sports injuries
Sports injuries like Raoul's may be inevitable, but there are some things you can do to help prevent them: Enroll your child in organized sports through schools, community clubs, and recreation areas where there may be adults who are certified athletic trainers (ATC). An ATC is also trained in the prevention, recognition and immediate care of athletic injuries. Make sure your child uses the proper protective gear for a particular sport. This may lessen the chances of being injured. Warmup exercises, such as stretching and light jogging, can help minimize the chance of muscle strain or other soft tissue injury during sports. Warmup exercises make the body's tissues warmer and more flexible. Cooling down exercises loosen the body's muscles that have tightened during exercise. Make warmups and cool downs part of your child's routine before and after sports participation. And don't forget to include sunscreen and a hat (where possible) to reduce the chance of sunburn, which is actually an injury to the skin. Sun protection may also decrease the chances of malignant melanoma--a potentially deadly skin cancer--or other skin cancers that can occur later in life. It is also very important that your child has access to water or a sports drink to stay properly hydrated while playing. Treat Injuries With "RICE" If your child receives a soft tissue injury, commonly known as a sprain or a strain, or a bone injury, the best immediate treatment is easy to remember. "RICE" (Rest, Ice, Compression, and Elevation) the injury. Get professional treatment if any injury is severe. A severe injury means having an obvious fracture or dislocation of a joint, prolonged swelling, or prolonged or severe pain. RICE: * Rest: Reduce or stop using the injured area for 48 hours. If you have a leg injury, you may need to stay off of it completely. * Ice: Put an ice pack on the injured area for 20 minutes at a time, 4 to 8 times per day. Use a cold pack, ice bag, or a plastic bag filled with crushed ice that has been wrapped in a towel. * Compression: Compression of an injured ankle, knee, or wrist may help reduce the swelling. These include bandages such as elastic wraps, special boots, air casts and splints. Ask your doctor which one is best. * Elevation: Keep the injured area elevated above the level of the heart. Use a pillow to help elevate an injured limb.

Syphilis
A sexually transmitted or congenital infection caused by the bacterium Treponema pallidum. Syphilis is an infectious disease caused by the spirochete Treponema pallidum, which penetrates broken skin or mucous membranes. Transmission occurs most frequently by sexual contact. Syphilis can also be transmitted to the fetus during any stage in pregnancy. Syphilis is widespread in the United States and primarily involves sexually active adults between 20-29 years of age. Syphilis has several stages. In the primary stage, painless sores, called chancres, appear approximately 2-3 weeks after initial exposure. Some individuals with primary syphilis may not notice chancres nor have symptoms associated with them, in particular if the chancres are located in the rectum or cervix. In about 4 to 6 weeks chancres will usually disappear. Approximately one-third of untreated individuals will progress to the second stage: secondary syphilis. This usually occurs at about 2 to 8 weeks after the appearance of the original chancre in some cases the chancre may still be present. Secondary syphilis is the stage where the bacteria have spread in the bloodstream and have reached their highest numbers. The most common symptoms include: skin rash which can be varied in appearance, yet frequently involves the palms and soles, in addition to lesions in the mouth, vagina, penis (mucous patches), swollen lymph nodes, and fever. This stage is the most contagious stage of syphilis. It usually resolves within weeks to a year. A latent phase follows, which may last for years and is characterized by the absence of symptoms. The final stage of syphilis is called tertiary syphilis (syphilis; tertiary) and is characterized by brain or central nervous system involvement (neurosyphilis), cardiovascular involvement with inflammation of the aorta (aortitis or aneurysms), and gummatous syphilis (destructive lesions of the skin and bones). The symptoms of syphilis depend on the stage of the disease. In addition, a significant proportion of individuals may remain without symptoms. Symptoms include: Syphilis; primary: chancres -- (usually single yet may be multiple) painless sores on genitals, rectum, or mouth and/or enlarged lymph nodes in the area adjacent to the chancre. Syphilis; secondary: skin rash -- usually throughout the body with both flat and raised patches which may involve the palms and soles of the feet; extensive lymph node enlargement; mucous patches (painless silvery ulcerations of mucous membranes -- seen mostly in the mouth and on the genitals); condyloma lata: coalescing papules which form a grey-white plaque frequently in folds such as groin, genital areas, axilla, and under the breasts; hair loss (alopecia); general symptoms such as fever, fatigue, loss of appetite, and aches and pains in bones. Syphilis; tertiary: infiltrative, destructive lesions of skin, bones, or liver (gummatous syphilis); cardiovascular syphilis, which leads to inflammation of the aorta (aortitis) and can be associated with aortic aneurysms; central nervous system disorders with involvement of the meninges, brain, spinal cord, eye, or auditory system.

Tonsil
Tonsil glands serve as agents against infections. However, in some people, particularly in children with larger tonsils, these glands can perform less efficiently and cause frequent throat and ear infections or obstruct breathing. In these cases, surgery to remove the tonsils is of benefit. Under general anesthesia, the ear-nose-throat (ENT) surgeon holds the mouth open using a mouth gag to expose the tonsils. The tonsils are then removed by being cut away with an instrument or a cautery (burning instrument). Bleeding is controlled, and the cut heals naturally without stitches. Tonsillectomy is advisable when tonsillitis attacks are so frequent or severe that they affect a child's general health or interfere with school, hearing, or breathing. However, some physicians believe tonsillectomies are done more often than necessary, so a second opinion should be obtained when there is any doubt. Specifically, the guidelines for surgery are: * 7 or more episodes of tonsillitis in one year * 5 or more episodes per year over a 2- year period * Severe tonsillitis * Tonsillitis that is not responding to antibiotics * An abscess in the tonsils * Grossly asymmetric tonsils Tonsillectomy is advised if the tonsils are enlarged and obstructing access to the adenoid during an adenoidectomy operation, or the physician suspects the presence of a tonsil tumor. Tonsillectomy is usually done on an outpatient basis, with the patient returning home the same day as the surgery. Only rarely are patients observed overnight in the hospital and return home the day after the surgery. Complete recovery can take 2 weeks. Expect some throat and ear pain in the first days following surgery. The use of ice packs to relieve pain may be used, although sucking on an ice cube or ice cream may provide adequate comfort. In addition, pain- relief medication may be prescribed. During recovery, it is recommended to eat soft, easy- to-swallow food and to drink a lot of cold fluids. The use of humidifier at home can also bring some comfort. Your child may experience alternating "good and bad" days for 2 weeks after surgery. It is a good idea to keep your child away from crowds or ill people for 7 days, since the throat is highly susceptible to infections during this period.

Vegetarian
Vegetarian diets excluding all or some animal products. Vegan is a diet that consists of only foods of plant origin. Lacto-vegetarian is a diet that consists of plant foods plus some or all dairy products. Lacto- ovovegetarian is a diet that consists of plant foods, milk, dairy products and eggs. Semi or Partial Vegetarian is a diet that consists individuals that do not eat red meat, but may eat chicken or fish with plant foods, dairy products, and eggs. The diet may be adopted for a variety of reasons, including religious or political beliefs, economics, or the desire to consume a more healthful diet. The American Dietetic Association states that a well-planned vegetarian diet can be consistent with good nutritional intake. Dietary recommendations vary with the type of vegetarian diet. For children and adolescents these diets require special planning, because it may be difficult to obtain all the nutrients required for growth and development. Nutrients that may be lacking in a vegetarian's diet are Protein, Vitamin B12, Vitamin D, Riboflavin, Calcium, Zinc, and Iron. Eating protein, which is made up of smaller chemicals called amino acids, is necessary for good health. You don't have to eat animal products to get complete proteins in the diet. Integrating the vegetarian style of eating into a non- vegetarian diet is recommended for individuals wishing to choose a healthier diet. For example, a person may choose to eat meat once a day or as little as twice a week.

Vitamin Supplements
The Dietary Supplement Health and Education Act defines dietary supplements as a: product (other than tobacco) intended to supplement the diet that bears or contains one or more of the following dietary ingredients: a vitamin, mineral, amino acid, herb or other botanical; a dietary substance for use to supplement the diet by increasing the total dietary intake; a concentrate, metabolite, constituent, extract, or combination of any ingredient described above; intended for ingestion in the form of a capsule, powder, softgel, or gelcap, and not represented as a conventional food or as a sole item of a meal or the diet. Dietary supplements are available widely through many commercial sources including health food stores, grocery stores, pharmacies, and by mail.

Water
A combination of hydrogen and oxygen; it is the basis for the fluids of the body. Water makes up more than two thirds of the weight of the human body. Without water, humans would die in a few days. All the cell and organ functions depend on water for functioning. It serves as a lubricant and forms the base for saliva and the fluids that surround the joints. Water regulates the body temperature, as the cooling and heating is distributed through perspiration. Water helps to alleviate constipation by moving food through the intestinal tract and thereby eliminating waste. Water is obtained from some of the foods we eat. These are foods that are 85 to 95% water. Some water is obtained from the by-products of metabolism. But our main source of water is our drinking water, which is the best source. Water is also obtained from soup, milk, and juices. Alcoholic beverages and beverages with caffeine (such as coffee, tea, and colas) are not the best choices because they have a diuretic (water-excreting) effect. Six to eight 8-ounce glasses of water, or half of the body weight in ounces, are recommended on a daily basis. For example, if you weight 140 lbs, you will need 70 ounces of water. Milk, juice, and soup can not be substituted for the entire water requirement. Caffeinated and alcoholic beverages (due to their diuretic effect) would not be appropriate substitutes at all. Carrying a water bottle and drinking at regular intervals will help you to obtain the required amount of water your body needs.

Water Safety
Learn to swim. The best thing anyone can do to stay safe in and around the water is to learn to swim. Always swim with a buddy; never swim alone. The American Red Cross has swimming courses for people of any age and swimming ability. Swim in supervised areas only. Obey all rules and posted signs. Watch out for the "dangerous too's"--too tired, too cold, too far from safety, too much sun, too much strenuous activity. Don't mix alcohol and swimming. Alcohol impairs your judgement, balance, and coordination, affects your swimming and diving skills, and reduces your body's ability to stay warm. Pay attention to local weather conditions and forecasts. Stop swimming at the first indication of bad weather. Know how to prevent, recognize, and respond to emergencies.