biologicals

A bioterrorism attack is the deliberate release of viruses, bacteria, or other germs to cause illness or death. These germs are often found in nature. But they can sometimes be made more harmful by increasing their ability to cause disease, spread, or resist medical treatment.

Biological agents spread through the air, water, or in food. Some can also spread from person to person. They can be very hard to detect. They don't cause illness for several hours or days. Scientists worry that anthrax, botulism, Ebola and other hemorrhagic fever viruses, plague, or smallpox could be used as biological agents.

Biodefense uses medical measures to protect people against bioterrorism. This includes medicines and vaccinations. It also includes medical research and preparations to defend against bioterrorist attacks.

Centers for Disease Control and Prevention

Immunotherapy is a cancer treatment that helps your immune system fight cancer. It is a type of biological therapy. Biological therapy uses substances made from living organisms or versions of these substances made in a lab. Immunotherapy isn't used for all cancers, and the response to treatment varies. If you're getting immunotherapy, your health care provider will monitor your treatment closely.

Immunotherapy isn't used as often as other cancer treatments, such as surgery, chemotherapy, and radiation therapy. But immunotherapy is used for some types of cancer, and researchers are doing clinical trials to see whether it also works for other types.

Cancer begins in your cells, which are the building blocks of your body. Usually, your body forms new cells as needed, replacing old cells that die. Sometimes, this process goes wrong. When you have cancer, some of your cells begin to multiply without stopping, and old cells don't die when they should. They spread into the surrounding tissues.

One reason cancer cells can keep growing and spreading is that they can hide from your immune system. Some immunotherapies can "mark" your cancer cells. This makes it easier for your immune system to find and destroy the cells. It is a type of targeted therapy that uses medicines or other substances that attack specific cancer cells with less harm to normal cells. Other types of immunotherapies work by boosting your immune system to work better against cancer.

There are different forms of immunotherapy, so how they are given varies. You could get immunotherapy intravenously (by IV), in pills or capsules, or cream for your skin. For bladder cancer, they might place it directly into your bladder.

How often and how long you get immunotherapy also varies. It depends on your type of cancer, how advanced it is, the type of immunotherapy you get, and how well it is working. You may have treatment every day, week, or month. Some immunotherapies are given in cycles, so your body has time to rest and recover.

You may have side effects. The most common side effects are skin reactions at the needle site if you get it by IV. Other side effects may include flu-like symptoms or, rarely, severe reactions.

NIH: National Cancer Institute

Anatomy is the science that studies the structure of the body. On this page, you'll find links to descriptions and pictures of the human body's parts and organ systems from head to toe.

Cancer is not just one disease but many diseases. Cancer begins in your cells, which are the building blocks of your body. Usually, your body forms new cells as needed, replacing old cells that die. Sometimes this process goes wrong. New cells grow even when you don't need them, and old cells don't die when they should. These extra cells can form a mass called a tumor.

Tumors can be benign or malignant. Benign tumors aren't cancer, while malignant ones are. Cells from malignant tumors can invade nearby tissues. They can also break away and spread to other parts of your body. The spread of cancer from one part of the body to another is called metastasis. Symptoms and treatment depend on the type of cancer and how advanced it is.

There are more than 100 different types of cancer. Cancer can start almost anywhere in your body. Most cancers are named for where they start. For example, lung cancer starts in the lung, and breast cancer starts in the breast.

Cancer may also be described by the type of cell that formed it, such as sarcoma if cancer begins in your bone and soft tissue. Carcinoma is the most common type of cancer. It is formed by epithelial cells, the cells that cover the inside and outside surfaces of your body.

Cancer is a genetic disease. That means changes in your genes cause it. Changes in your genes are also called gene variants or mutations. Genes are parts of DNA in your cells that you inherit from your parents. However, only some cancers are caused by genes passed down from your parents.

Genetic changes can occur to your genes over your lifetime that affect how your cells function. Usually, your body gets rid of damaged cells before they turn cancerous, but this ability goes down as you age. Other factors that may affect your risk of developing cancer can include:

• Exposure to ultraviolet (UV) rays from the sun
• Smoking
• Your diet
• Physical inactivity

Cancer symptoms depend on the type of cancer. For example, some of the symptoms that cancer may cause can include:

• A lump in your breast
• Blood in your urine (pee) or stool (poop)
• Bleeding or bruising for no known reason
• A sore that doesn't heal
• Trouble swallowing
• A new mole or a change to a mole you already have

Cancer may cause various symptoms but often doesn't cause pain. Don't wait until you're having pain before seeing your health care provider. See your provider if you have symptoms that don't get better in a few weeks.

There is no single test that can diagnose cancer. The tests ordered are usually based on your symptoms. Your provider may:

• Ask about your medical history
• Ask about your family health history, including relatives who have had cancer
• Do a physical exam
• Do a screening test such as a mammogram, colonoscopy, or a Pap test
• Order blood tests or imaging tests

To find out if you have cancer, your provider may order a biopsy. A biopsy is the procedure of removing and examining tissue, cells, or fluids from your body.

Treatment depends on the type of cancer and how advanced it is. Most treatment plans may include surgery, radiation, and/or chemotherapy. Some may involve hormone therapy, immunotherapy or other types of biological therapy, or stem cell transplantation.

It's usually not possible to know exactly why cancer develops in some people but not others. There are some things that you can't control which may increase or decrease your risk of getting cancer, such as inheriting certain genes or your age. But some lifestyle habits may increase your risk of certain types of cancer. Avoid or reduce lifestyle habits such as:

• Smoking and tobacco use
• Having too much sun exposure
• Drinking too much alcohol
• Not getting enough physical activity
• Having obesity

NIH: National Cancer Institute

Clinical trials are research studies that test how well new medical approaches work in people. Each study answers scientific questions and tries to find better ways to prevent, screen for, diagnose, or treat a disease. Clinical trials may also compare a new treatment to a treatment that is already available.

Every clinical trial has a protocol, or action plan, for conducting the trial. The plan describes what will be done in the study, how it will be conducted, and why each part of the study is necessary. Each study has its own rules about who can take part. Some studies need volunteers with a certain disease. Some need healthy people. Others want just men or just women.

An Institutional Review Board (IRB) reviews, monitors, and approves many clinical trials. It is an independent committee of physicians, statisticians, and members of the community. Its role is to:

• Make sure that the study is ethical
• Protect the rights and welfare of the participants
• Make sure that the risks are reasonable when compared to the potential benefits

In the United States, a clinical trial must have an IRB if it is studying a drug, biological product, or medical device that the Food and Drug Administration (FDA) regulates, or it is funded or carried out by the federal government.

NIH: National Institutes of Health

Depression is more than a feeling of being sad or irritable for a few days. It's a serious mood disorder. As one of the most common mental disorders in the United States, depression can affect how you think, feel, and your everyday life. You may not know why you feel this way, but even basic daily activities such as sleeping, eating, or working may become difficult. Depression often needs long-term treatment but getting help at the earliest sign of a problem can help manage your symptoms.

The most common types of depression are major depression and persistent depressive disorder.

• Major depression symptoms include a depressed mood or a loss of interest. Symptoms affect your daily activities and last for at least two weeks.
• Persistent depressive disorder (also called dysthymia or dysthymic disorder) has less severe depressive symptoms, but they last longer, usually for at least two years.

Other types of depression can include:

• Seasonal affective disorder comes and goes with the seasons. It usually starts in late fall and early winter and goes away during the spring and summer.
• Bipolar disorder is sometimes called manic depression. This mood disorder can cause intense mood swings.
• Depression with symptoms of psychosis is a severe form of depression that also has delusions (false beliefs) or hallucinations (seeing, hearing, or feeling something that isn't there).

There are a variety of things that may cause depression, including genetic, biological, environmental, and psychological factors. Depression can happen at any age and can affect anyone, but it's more common in women. This is often due to the physical and hormonal changes that women have during menstruation, pregnancy, the postpartum period, and menopause. Other mental disorders or chronic medical conditions such as diabetes, cancer, or heart disease may occur with depression. This may make the chronic condition or depression worse.

In some cases, there is no clear cause for depression.

You may be at a higher risk of depression if you have a close relative who has it or another mental health disorder. Going through trauma or stressful life events may raise your risk even more.

Depression doesn't look the same on everyone. The type and number of symptoms of depression can vary and don't always appear like sadness. Depression may affect you differently based on your:

• Age. The symptoms of depression may be different in a child, who may appear more irritable than sad. Teens may act out or have excessive sleepiness. The symptoms for an older adult may not be as obvious as other age groups.
• Sex. Men often show symptoms and coping behaviors differently than women. Rather than sad, men may appear angry or irritable.
• Medical conditions. Some medicines and medical conditions may cause symptoms that look like depression. Chronic conditions may make depression worse.

Symptoms of depression are ongoing and affect your day-to-day life. They can include:

• Feeling sad or "empty"
• Losing interest in favorite activities
• Overeating, or not wanting to eat at all
• Sleeping too much, or not enough
• Feeling very tired
• Feeling hopeless, irritable, anxious, or guilty
• Having aches and pains, headaches, cramps, or digestive problems
• Having thoughts of death or suicide
• Changing moods or behaviors
• Increasing use of alcohol or drugs
• Isolating from family and friends

If you think you have depression, talk to your health care provider or a mental health provider. To be diagnosed with depression, your provider may use many tools:

• A medical history will include asking about your symptoms and family history. To be diagnosed with depression, your symptoms must occur most of the day, nearly every day, for at least two weeks. One of the symptoms must be a depressed mood or a loss of interest in most activities.
• Medical tests may be done to rule out other medical conditions. Certain medicines and medical conditions (such as viruses or thyroid disorders) may cause symptoms like depression.
• A physical exam to make sure another issue isn't causing your symptoms.
• A mental health evaluation by your provider or a mental health provider.

Depression may need long-term treatment. Most treatments include medicines and/or psychotherapy (talk therapy):

• Medicines such as antidepressants may help control your symptoms. You may need to try several medicines to find which works best for you. Medicine may take time to work and can have side effects. Don't stop taking your medicine without first talking with your provider. Contact your provider if you have any concerns about side effects from the medicine.
• Psychotherapy (talk therapy) under the care of a mental health provider can help you recognize and change troubling emotions, thoughts, and behaviors. This may be done one-on-one or in a group setting. It can give you and your family support, education, skills, and coping strategies.
• Light therapy has been shown to be effective for seasonal affective disorder (SAD).
• Other treatments options may be considered if treatment isn't working or if depression is severe. These may include:
  • Electroconvulsive therapy (ECT) is a brain stimulation procedure that uses a mild electric current when you are under general anesthesia. ECT is most often used for severe depression that is not getting better with other treatments.
  • Repetitive transcranial magnetic stimulation (rTMS) is a brain stimulation procedure that uses magnetic waves to relieve depression. It's not as powerful as ECT, but with rTMS, you don't need anesthesia. It also has a low risk of negative effects on your memory and thinking.

Most cases of depression can't be prevented, but healthy lifestyle changes can have long-term benefits for your mental health. These can include:

• Getting regular exercise
• Having a consistent sleep schedule
• Controlling stress

If you, or someone you love is depressed, see your provider or a mental health provider. It's important to get treatment at the earliest sign of a problem.

If you or someone you know has thoughts of hurting themselves or attempting suicide, get help right away. If it is an emergency, dial 911.

NIH: National Institute of Mental Health

Eating disorders are serious mental health disorders. They involve severe problems with your thoughts about food and your eating behaviors. You may eat much less or much more than you need.

Eating disorders are medical conditions; they are not a lifestyle choice. They affect your body's ability to get proper nutrition. This can lead to health issues, such as heart and kidney problems, or sometimes even death. But there are treatments that can help.

Common types of eating disorders include:

• Binge-eating, which is out-of-control eating. People with binge-eating disorder keep eating even after they are full. They often eat until they feel very uncomfortable. Afterward, they usually have feelings of guilt, shame, and distress. Eating too much too often can lead to weight gain and obesity. Binge-eating disorder is the most common eating disorder in the U.S.
• Bulimia nervosa. People with bulimia nervosa also have periods of binge-eating. But afterwards, they purge, by making themselves throw up or using laxatives. They may also over-exercise or fast. People with bulimia nervosa may be slightly underweight, normal weight, or overweight.
• Anorexia nervosa. People with anorexia nervosa avoid food, severely restrict food, or eat very small quantities of only certain foods. They may see themselves as overweight, even when they are dangerously underweight. Anorexia nervosa is the least common of the three eating disorders, but it is often the most serious. It has the highest death rate of any mental disorder.

The exact cause of eating disorders is unknown. Researchers believe that eating disorders are caused by a complex interaction of factors. These include genetic, biological, behavioral, psychological, and social factors.

Anyone can develop an eating disorder, but they are more common in women. Eating disorders frequently appear during the teen years or young adulthood. But people can also develop them during childhood or later in life.

The symptoms of eating disorders vary, depending on the disorder:

The symptoms of binge-eating include:

• Eating unusually large amounts of food in a specific amount of time, such as a 2-hour period
• Eating even when you're full or not hungry
• Eating fast during binge episodes
• Eating until you're uncomfortably full
• Eating alone or in secret to avoid embarrassment
• Feeling distressed, ashamed, or guilty about your eating
• Frequently dieting, possibly without weight loss

The symptoms of bulimia nervosa include the same symptoms as binge-eating, plus trying to get rid of the food or weight after binging by:

• Purging, making yourself throw up or using laxatives or enemas to speed up the movement of food through your body
• Doing intensive and excessive exercise
• Fasting

Over time, bulimia nervosa can cause health problems such as:

• Chronically inflamed and sore throat
• Swollen salivary glands in the neck and jaw area
• Worn tooth enamel and increasingly sensitive and decaying teeth. This is caused by the exposure to stomach acid every time you throw up.
• GERD (acid reflux) and other gastrointestinal problems
• Severe dehydration from purging
• Electrolyte imbalance, which could be too low or too high levels of sodium, calcium, potassium and other minerals. This can lead to a stroke or heart attack.

The symptoms of anorexia nervosa include:

• Eating very little, to the point of starving yourself
• Intensive and excessive exercise
• Extreme thinness
• Intense fear of gaining weight
• Distorted body image - seeing yourself as overweight even when you are severely underweight

Over time, anorexia nervosa can cause health problems such as:

• Thinning of the bones (osteopenia or osteoporosis)
• Mild anemia
• Muscle wasting and weakness
• Thin, brittle hair and nails
• Dry, blotchy, or yellowish skin
• Growth of fine hair all over the body
• Severe constipation
• Low blood pressure
• Slowed breathing and pulse
• Feeling cold all the time because of a drop in internal body temperature
• Feeling faint, dizzy, or weak
• Feeling tired all the time
• Infertility
• Damage to the structure and function of the heart
• Brain damage
• Multiorgan failure

Anorexia nervosa can be fatal. Some people with this disorder die of complications from starvation, and others die of suicide.

Some people with eating disorders may also have other mental disorders (such as depression or anxiety) or problems with substance use.

Because eating disorders can be so serious, it is important to seek help if you or a loved one thinks that you might have a problem. Your health care provider may use many tools to make a diagnosis:

• A medical history, which includes asking about your symptoms. It is important to be honest about your eating and exercise behaviors so your provider can help you.
• A physical exam
• Blood or urine tests to rule out other possible causes of your symptoms
• Other tests to see whether you have any other health problems caused by the eating disorder. These can include kidney function tests and an electrocardiogram (EKG or ECG).

Treatment plans for eating disorders are tailored to individual needs. You will likely have a team of providers helping you, including doctors, nutritionists, nurses, and therapists. The treatments may include:

• Individual, group, and/or family psychotherapy. Individual therapy may include cognitive behavioral approaches, which help you to identify and change negative and unhelpful thoughts. It also helps you build coping skills and change behavioral patterns.
• Medical care and monitoring, including care for the complications that eating disorders can cause
• Nutrition counseling. Doctors, nurses, and counselors will help you eat healthy to reach and maintain a healthy weight.
• Medicines, such as antidepressants, antipsychotics, or mood stabilizers, may help treat some eating disorders. The medicines can also help with the depression and anxiety symptoms that often go along with eating disorders.

Some people with serious eating disorders may need to be in a hospital or in a residential treatment program. Residential treatment programs combine housing and treatment services.

NIH: National Institute of Mental Health

Genes are sections of DNA in your cells that are passed down (inherited) from your parents. You inherit two copies of each gene, one from each parent. Genes carry information that controls what you look like and how your body works.

There are about 20,000 genes that provide instructions for making proteins, which your body needs to work correctly.

Some genes don't make proteins themselves but instead help control how other genes work. They act like switches, turning other genes on or off. This means they help decide when, where, and how much of a protein is made in your body.

Changes in your genes are also called gene variants or mutations. These changes can be inherited, occur as you age, or result from environmental factors such as chemicals or radiation. Often, these changes have no effect, but sometimes, even a small change in the DNA can alter the instructions for making proteins. If genes don't make the right proteins, or don't make them correctly, this can cause a genetic disorder.

Gene therapy uses genes to treat or prevent disease by correcting genetic problems. It works by changing your genetic material, rather than relying on traditional treatments like medicine or surgery.

New genetic material can be delivered into cells in two main ways:

• ex-vivo treatment. Cells are removed from your body, modified by adding genetic material, and then placed back into your body.
• in-vivo treatment. Genetic material is delivered directly into your body, often through an injection.

A common form of gene therapy involves inserting a normal gene to replace an abnormal gene. Other approaches include:

• Repairing an abnormal gene
• Altering the degree to which a gene is turned on or off

Newer techniques offer different ways to correct genetic problems:

• Genome editing (also called gene editing). Instead of adding new genetic material into cells, this approach changes the DNA that's already in your cells. A well-known example is CRISPR-Cas9. This promising technique is still being studied and may soon be used to treat genetic disorders.
• Cell-based gene therapy combines gene therapy and cell therapy. An example of this would be CAR T cell therapy. Cells, which are often immune system cells, are genetically altered to help treat a disease and then introduced into the body.

Gene therapies are currently only approved to treat a small number of diseases, such as:

• Leber congenital amaurosis, an inherited eye disorder.
• Spinal muscular atrophy, a genetic muscle disorder.

While gene therapy holds great promise, it comes with risks and challenges. Studies are still ongoing to ensure these treatments are safe and effective. Some challenges include:

• Immune system reactions. Your body may see the new material as a threat and react to it.
• Unintended effects. Changes to DNA could affect other genes in harmful ways.
• High costs. Gene therapies are often expensive and are not widely accessible.

Genetic testing is a type of medical test that looks for changes, sometimes called variants or mutations, in your DNA. DNA contains the genetic instructions in all living things. Often, these changes have no effect, but sometimes, even a small change in DNA can cause disease or other health conditions.

Genetic tests take a sample of your blood or tissues and check your cells to look for any changes in:

• Genes are parts of DNA found in your cells that carry information that controls what you look like and how your body works. Many genes tell your body how to make proteins, which are needed for your body to work correctly.
  • Genome sequencing is a process that checks all your DNA.
  • Exome sequencing is a process that only checks the parts of your DNA that provide instructions to make proteins.
• Proteins do most of the work in your cells. If there are changes in the amount and activity level of proteins, they might be due to changes in the genes that produce those proteins.
• Chromosomes are thread-like structures in your cells. Each chromosome is made up of DNA tightly packaged around proteins. People usually have 23 pairs of chromosomes that contain all their DNA.

Most of the time, genetic testing is done through your health care provider. This is called clinical testing. It is done to find out about an inherited disorder (passed down through families) and to help make decisions about your care.

Other ways to get genetic testing include:

• Research-based testing is a genetic test done as part of a research study (clinical trial).
• Direct-to-consumer (DTC) testing is a genetic test that allows you to send a DNA sample and get the results. You may do this to learn about your ancestry or your risk for certain diseases.

Genetic testing may be done for many different reasons, including to:

• Find genetic diseases in a fetus. This is a type of prenatal testing.
• Screen newborn babies for certain treatable conditions.
• Lower the risk of genetic diseases in embryos that were created using assisted reproductive technology.
• Find out if you carry a gene for a certain disease that could be passed on to your children. This is called carrier testing.
• See whether you are at an increased risk of getting a specific disease. This may be done for a disease that runs in your family.
• Diagnose certain diseases.
• Identify genetic changes that may be causing or contributing to a disease that you were already diagnosed with.
• Help guide your provider in deciding the best medicine and dosage for you. This is called pharmacogenomic testing.
• To check for, monitor, or manage a disease. This is sometimes used to help find the best cancer treatment.
• To confirm the biological father (paternity) of a child, or how much genetic information is shared with other relatives.
• To explore the likelihood of having or developing certain physical traits, such as hair color or facial dimples, or to learn about your ancestry.
• To help advance our understanding of genetic conditions, learn how genes work, and find unknown genes.

Genetic tests are often done on a blood or cheek swab sample. But they may also be done on samples of hair, saliva, skin, amniotic fluid (the fluid that surrounds a fetus during pregnancy), or other tissue. The sample is sent to a laboratory. There, a lab technician will use one of several different techniques to look for genetic changes.

The benefits of genetic testing include:

• Helping your provider make recommendations for the management or monitoring of a genetic condition.
• Giving you more information for making decisions about your health and your family's health:
  • If you find out that you are at risk for a certain disease, you might take steps to lower that risk. For example, you may find out that you should be screened for a disease earlier and more often. Or you might decide to make healthy lifestyle changes.
  • If you find out that you are not at risk for a certain disease, then you can talk to your provider about when it would be appropriate to schedule checkups or screenings.
  • A test could give you information that helps you make decisions about having children.
• Identifying genetic disorders early in life so that treatment can start as soon as possible.

The physical risks of the different types of genetic testing are small. But there can be emotional, social, or financial drawbacks:

• Depending on the results, you may feel angry, depressed, anxious, or guilty. This can be especially true if you are diagnosed with a disease that does not have effective treatments.
• Despite the protections that are in place, you may be worried about genetic discrimination in employment or insurance.
• Genetic testing may give you limited information about a genetic disease. For example, it cannot tell you whether you will have symptoms, how severe a disease might be, or whether a disease will get worse over time.
• Genetic testing results might be inconclusive. For example, you might keep getting negative results or not get an answer at all.
• Some genetic tests may give you results that you didn't expect. For example, if you are tested to check for the cause of a rare disease, and a different variant is found that puts you at increased risk for something else that was previously unknown.
• Some genetic tests are expensive, and health insurance might only cover part of the cost. Or they may not cover it at all.

The decision about whether to have genetic testing is complex. In addition to discussing the test with your provider, you can meet with a genetic counselor. Genetic counselors have specialized degrees and experience in genetics and counseling. They can help you understand the tests and weigh the risks and benefits. If you do take a test, they can explain the results and make sure that you have the support that you need.

Every day, around the clock, people who work in the health care industry provide care for millions of people, from newborns to the very ill. In fact, the health care industry is one of largest providers of jobs in the United States. Many health jobs are in hospitals. Others are in nursing homes, doctors' offices, dentists' offices, outpatient clinics and laboratories.

To work in a health occupation, you often must have special training. Some, like doctors, must have more than 4 years of college.

Bureau of Labor Statistics