About all

Dehydration hives: Living With Chronic Hives: Sierra’s Story


Living With Chronic Hives: Sierra’s Story

The teen years are notoriously awkward, and for Sierra Ehrliech, dealing with chronic hives didn’t help. “They just started happening,” she says. “Sometimes my hives were stress-induced, but often I would just get itchy for no reason and freak out when I saw these big red welts on my skin.”

Ehrliech’s experience of living with chronic hives isn’t unique. Chronic idiopathic urticaria, the medical term for hives with no known cause that last for six weeks or longer, affects about 1.5 million people in the United States, according to the Asthma and Allergy Foundation of America.

Women are twice as likely as men to develop chronic idiopathic urticaria, and most cases appear between the ages of 20 and 40. Hives tend to begin with an itchy patch of skin and turn into swollen red welts, according to the American College of Allergy, Asthma & Immunology.

Gaining Control of Chronic Hives

Now 29, Ehrliech, a medical assistant at Mount Sinai Hospital in New York, has her chronic hives pretty much under control with a regular regimen of oral antihistamines, but this didn’t happen overnight. “I take an antihistamine every day at the same time, and I have been hive-free for a few months,” she says. Histamine is a chemical released in the skin that can cause itching and welts. Antihistamines block the effects of histamine.

Before this reprieve, Ehrliech says, “I was constantly itchy, and not scratching was a daily fight for me.” Scratching can make the hives more likely to spread. “Instead, I used a lotion or an antihistamine cream whenever the itch was overwhelming,” she says. “That helped a lot. I always make sure I have some type of cream close by, just in case.”

Ehrliech also learned what makes her hives worse and how to avoid those triggers. “I’m very sensitive to heat, so when I take a hot shower, my skin reacts,” she says. Now Ehrliech knows that she can only tolerate short, lukewarm showers. “I use an unscented soap for sensitive skin,” she says.

“Placing cool cotton cloths on the hives or taking cool showers can relieve the itching,” says Gary Goldenberg, MD, an assistant clinical professor of dermatology at the Icahn School of Medicine at Mount Sinai in New York. Each person’s hives can have different triggers or aggravating factors, he says. “Even if your allergy testing comes back negative, keep a journal and see if any patterns emerge,” he says.

For Ehrliech, the only trigger for her chronic hives seems to be stress. “If I get stressed out at work because I have too much on my plate, a flare will happen,” she says. In these instances, she stops, takes a deep breath, and tries to calm down. “It’s mind over matter.”

“Stress can make everything worse,” Dr. Goldenberg says. “Find something that helps you reduce stress in your life and do it on a regular basis, because this will likely help improve all aspects of your life — including hives.”

What Is H. Pylori? Symptoms, Causes, Diagnosis, Treatment, and Prevention

It’s a good idea to visit your doctor any time you have unusual stomach pains or complaints, especially if they are persistent or recurrent.

See a healthcare provider right away if you experience the following symptoms:

  • Severe stomach or other abdominal pain
  • Stomach or abdominal pain that doesn’t go away
  • Difficulty swallowing
  • Bloody, black, or tarry stools
  • Vomit that’s bloody or looks like coffee grounds

There are different ways to test for H. pylori.

First, your doctor will probably perform a physical exam and ask about your medical history. Then they might recommend one or more of these tests to identify the bacteria.

Blood Test

A blood draw may be done to look for H. pylori antibodies in your body. Although blood tests are easy to perform, they’re often not as accurate as other diagnostic approaches.

Breath Test

A breath test involves swallowing a pill, liquid, or pudding that contains carbon. If you have an H. pylori infection, your doctor will be able to detect carbon molecules when you exhale into a bag.

Breath tests are often difficult to do in young kids, and you can’t take certain medicines, such as proton pump inhibitors, antibiotics, or Pepto-Bismol (bismuth subsalicylate), for a week or two prior to having the test.

Stool Test

A stool sample can help doctors detect proteins that are associated with H. pylori. You’ll need to stop taking medicines such as proton pump inhibitors, antibiotics, or bismuth subsalicylate before having this test.

Upper Endoscopy

During an upper endoscopy, your doctor will first give you a light sedative, then thread a long tube with a tiny camera on the end down your throat, past your esophagus, and into your stomach. This will allow your physician to see inside your digestive track and remove small pieces of tissue (known as biopsy samples) if necessary.

If samples of tissue are removed, they can be analyzed for an H. pylori infection. An endoscopy is considered more invasive than other methods, such as a stool sample or breath test.

Should You Get Screened for H. Pylori?

In places where the risk of getting H. pylori is high, doctors test healthy people for the bacteria even if they have no signs or symptoms, which is known as medical screening. But there’s a debate in the medical community over whether this degree of screening is beneficial.

It might be a good idea to get tested for H. pylori if you’re at a high risk for stomach cancer.

Prognosis of H. Pylori

Many people with H. pylori don’t experience any symptoms of the illness and never even know they have the infection.

If you do have symptoms or develop complications, treatment is usually successful. H. pylori infection can often be cured with treatment consisting of antibiotics and acid-reducing medications.

6 Under-the-Radar Causes of Hives

For some people just the word “hives” is enough to conjure an itchy welt or red splotch. FYI, I may or may not be one of these people.

But in all seriousness, if you’ve ever experienced a bout of hives so much as once (and up to 20 percent of the population has) then you know firsthand they’re nothing to take lightly. In fact, you’d probably do just about anything to keep them from appearing again. It can start and end with just a few — if you’re lucky, that is — or it can turn into a full-fledged welt party spanning multiple limbs. Both cases are far from fun, but the most infuriating situation, no questions asked, is when you can’t for the life of you figure out what’s causing them.

Most of us (myself included) tend to equate hives with food allergies such as nuts or shellfish. But in some cases — namely in what are called “chronic hives” — food allergens are rarely the cause, which makes it all the more difficult to determine the real underlying issue. You see, after speaking with two allergists, I learned there are actually several factors that could be behind a hive breakout, some of which you definitely wouldn’t expect.

Without further ado, read on to learn more about urticaria (the fancy medical term for hives) and their causes from the very experts who treat them for a living.

Acute vs. Chronic

The first order of business is understanding the difference between acute and chronic hives. The latter kind occur several days per week for at least six weeks and are rarely caused by allergies, according to Paula Busse, an associate professor of clinical immunology at Icahn School of Medicine at Mount Sinai. On the other hand, Busse explains that acute hives happen for less than six weeks (or even in a single event) and are often triggered by allergies to certain foods or drugs. Acute hives can also occur after a viral infection, Busse notes.

Chronic Spontaneous vs. Chronic Induced

The next thing you need to know (unless that is you’ve already figured out your hives are acute!) is that there are two different types of chronic hives. Chronic Spontaneous don’t have any identifiable trigger, Busse explains. “What we think happens in this case is that people make antibodies against their mast cells (cells that release histamine), [which is] similar to an autoimmune type disease,” she said. “The antibodies which are made are very specific to the mast cell and not other white blood cells that help with infection,” she added. As for Chronic Induced, those can be caused by a variety of factors, including tight clothes, drastic temperature change, or even exercise. “What happens in these cases, or at least we think, is that these triggers cause the mast cells to pop and release their histamine,” she said, adding that this is why anti-histamines are used to treat hives.

Skin Reactions – Managing Side Effects

What Are Skin Reactions?

Includes: dry
skin, flushing,
nail changes, photosensitivity,
radiation recall,

Skin reactions to drug therapy are extremely common. All drugs may induce
skin reactions, although if they do occur they are usually mild, however, some skin
reactions are serious and potentially life-threatening. Because of this, all
drug-associated rashes should be reported to your health care professional for evaluation.

The cause of skin reactions is often unknown although many have an allergic or toxic

Skin reactions can be independent of dose and can persist long after the drug causing
the allergic reaction has been discontinued. For example, with a hypersensitivity
reaction to penicillin, the skin condition may worsen for seven to ten days after
the drug has been stopped. It is especially important that allergic skin reactions
are correctly identified, since future exposure to the same drug could cause much
more severe skin reactions.

Toxic reactions, in contrast, are dose-dependent and skin reactions generally
resolve fairly soon after the drug causing the reaction is stopped.

There are factors that may increase the risk of developing skin reactions, which

  • Liver disease
  • Kidney disease
  • Systemic lupus erythematosus (lupus)
  • AIDS

Drug allergies are more common in the elderly and may be related to development
of an immune response or to an increased exposure to drugs. The way drugs
are given can influence drug allergy; in general, topical application (applied directly
on the skin) has the greatest likelihood to induce skin reactions, followed by intravenous
(IV) then medications given by mouth.

Types of Skin Reactions:

Dry Skin

What is dry skin?

Dry skin is characterized by mild scaling, roughness, feeling of tightness, and possibly
itching. With dry skin reactions, the skin cells at the lower layer of
the epidermis (top layer of skin) are dry and flat, with no moisture. Factors
that contribute to dry skin reactions include:

  • Dehydration
  • Extreme weather conditions
  • Perfumed products
  • Allergy

When a moisturizer is used on the surface of the skin, the product penetrates and
restores moisture to the skin cells. Creams and lotions are effective ways
of restoring moisture following dry skin reactions. Ointments are designed
to be a barrier and stay on the surface of the skin for protection against harsh

Things you can do to manage dry skin reactions:


  • Perfumed products
  • Bubble bath
  • Soap, particularly perfumed soaps.
  • Soap-free cleansing bars, these can be drying and potentially irritating.
  • Lanolin-based creams, lotions, ointments etc.
  • Anything that you think you might be allergic to. (common allergy-causing agents;
    detergents, plants, pets, harsh chemicals in household cleaning products, rubber
    gloves, jewelry, feathers, grass and pollen, artificial fingernails and adhesive).

Personal Hygiene:

  • Dry yourself by patting your skin with a soft towel, rather than rubbing vigorously.
  • Use mild, non-perfumed, non-deodorant soaps such as Dove, Basis, Aveeno
    or Neutrogena
    dry skin soaps. Or low allergy soap of soap substitute
    – cream, cleaning gels.
  • Take showers or short, cool baths instead of long, hot baths.
  • Shaving for men – if dry skin reactions occurs on your face, skip a couple of days
    (over a weekend?) to give your face a rest. Do not use perfumed after-shave.
  • Shaving for women – if after shaving your legs a rash appears do not shave again
    until the skin has completely healed.


  • Wear cotton clothes where possible next to the skin, rather than wool, synthetic
    fibers or rough clothing.
  • Wash clothes in mild detergent.


  • Extreme weather conditions can worsen and cause dry skin reactions (hot and
    sunny, cold and windy).
  • Wear gloves in cold weather.
  • Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.


  • Drink plenty of fluids keep your body well hydrated. You should drink 2-3
    quarts of non-alcoholic, non-caffeinated beverages daily, unless you are instructed
    to restrict your fluid intake.

Lotions and creams:

  • Use moisturizers regularly. Moisturizers prevent water loss by layering an oily
    substance over the skin to keep water in or by attracting water to the outer skin
    layer from the inner skin layer. Substances that stop water loss include petroleum,
    mineral oil, lanolin and silicone products. Substances that attract water to the
    skin include glycerin, propylene glycol, proteins and some vitamins.
  • Bath oils such as baby oil, mineral oil, Herbal Bath Oil, Lubriderm Bath Oil, or
    Neutrogena Body Oil can be applied to your wet skin after you emerge from the bath
    or shower.

Protect hands:

  • Always rinse and dry hands carefully, particularly after contact with cleaning products.
  • Wear rubber or vinyl gloves to protect hands, underneath wear thin cotton gloves.
    Do not wear for long periods of time. (Wash the cotton gloves frequently).

Note: We strongly encourage you to talk with your health care professional
about your specific medical condition and treatments. The information contained
in this website about skin reactions and other medical conditions is meant to be
helpful and educational, but is not a substitute for medical advice.


What is flushing?

Flushing Is a temporary redness of the face and neck caused by dilation of the blood
capillaries. Flushing is due to a variety of causes such as certain chemotherapy
drugs. Carcinoid tumors can also cause flushing as part of carcinoid syndrome.
Other causes are alcohol and other drugs.

  • Several chemotherapy drugs are associated with this flushing such as: asparaginase,
    bleomycin, carboplatin, carmustine, cisplatin, cyclophosphamide, dacarbazine, diethylstilbestrol,
    docetaxel, doxorubicin, fluorouracil, lomustine, paclitaxel, plicamycin, procarbazine,
    and teniposide.
  • Biologic therapies associated with flushing include interleukin-2.

Note: We strongly encourage you to talk with your health care professional
about your specific medical condition and treatments. The information contained
in this website is meant to be helpful and educational, but is not a substitute
for medical advice.


What is hyperpigmentation?

Hyperpigmentation is a darkening of the skin. This can occur as an overall darkening
of the skin, or it can be localized. This may be connected to phototoxic reaction
where the areas exposed to light may have a golden-brown or slate-grey
color change. Some drugs will cause changes in the nails, darkening of the tongue,
gums, and over finger joints. Most skin reactions occur within two to three weeks
of initiation of chemotherapy and resolve 10 to 12 weeks after stopping treatment.

  • Hyperpigmentation most commonly accompanies use of alkylating agents and antitumor
  • Methotrexate may produce a characteristic “flag sign” on the hair – horizontal hyperpigmented
    bands alternating with normal hair color in light-haired individuals.
  • Discoloration can occur in areas of pressure, such as under tape or dressings.
    This has been reported with busulfan, cyclophosphamide, cisplatin, ifosfamide, thiotepa,
    docetaxel, and etoposide.
  • Serpentine hyperpigmentation: Some chemotherapy drugs (fluorouracil, vinorelbine,
    and some combination regimens) given intravenously (IV) can cause a darkening of
    the venous pathways up the arm. This darkening over the veins will eventually fade.

    • The cause of these skin reactions is currently unknown, but may involve direct toxicity,
      stimulation of melanocytes (cells in skin responsible for skin color), and postinflammatory
      changes. Although skin reactions may occasionally be permanent,
      in most cases, discoloration will gradually resolve after chemotherapy is stopped.

Note: We strongly encourage you to talk with your health care professional
about your specific medical condition and treatments. The information contained
in this website about skin reactions and other medical conditions is meant to be
helpful and educational, but is not a substitute for medical advice.

Nail Changes

What are nail changes?

There are several types of nail changes which may occur in patients receiving
chemotherapy. The most common of these skin reactions seen, particularly in
dark-skinned persons, is hyperpigmentation (darkening). Vertical or horizontal
bands, or general darkening. Drugs in which these skin reactions been known
to occur include:

  • Bleomycin, cyclophosphamide, daunorubicin, doxorubicin, fluorouracil, hydroxyurea,
    aminoglutethimide, busulfan, cisplatin, dacarbazine, docetaxel, idarubicin, ifosfamide,
    melphalan, methotrexate, mitomycin and mitoxantrone.
  • This hyperpigmentation generally grows out with the nail.

Other nail changes include:

  • Beau’s lines (horizontal depressions of the nail plate). These skin reactions
    can occur a few weeks after a course of chemotherapy.
  • Mees’ lines (white horizontal discoloration of the nail plate involving the entire
    nail width).
  • Leukonychia (white horizontal discoloration involving partial nail width).
  • Onycholysis (The separation or loosening of a fingernail or toenail from its nail
  • Onychodystrophy (A malformation of the nail).

All of these skin reactions are temporary and eventually resolve once
the drug causing the change is stopped and the affected nails grow out (this may
take weeks to months).

Things you can do to manage nail changes:

  • Nails should be trimmed and kept clean.
  • Gloves should be worn for housecleaning and gardening to minimize damage and prevent
  • Nail polish and imitation fingernails should not be worn until the nails have grown
    out and returned to normal.

Drugs that may be prescribed by your doctor for skin reactions:

  • Antibiotics may be necessary to treat infections in the nail beds.

Notify your doctor or health care provider if:

  • You suspect an infection of the nails.

Note: We strongly encourage you to talk with your health care professional
about your specific medical condition and treatments. The information contained
in this website about skin reactions and other medical conditions is meant to be
helpful and educational, but is not a substitute for medical advice.


What is photosensitivity?

Photosensitivity is an enhanced skin response to ultraviolet radiation
(sunlight). There are three types of photosensitivity reactions phototoxic,
photoallergic and UV recall reaction.

  • Phototoxic reactions are common photosensitivity reactions
    and can be produced in most individuals given a high enough dose of drug and sufficient
    light exposure. These photosensitivity reactions are usually evident
    within 5-20 hours of exposure and resembles an exaggerated sunburn (redness, swelling,
    blistering, weeping and peeling). The rash is confined to areas exposed to
  • Drugs associated with these photosensitivity reactions are dacarbazine, fluorouracil,
    methotrexate and vinblastine.
  • Photoallergic reactions are less common than phototoxic
    reactions. A photoallergic reaction is similar to a phototoxic reaction but
    the reaction may spread beyond areas exposed to light. A drug that may
    have this photosensitivity reaction is flutamide.
  • UV recall reaction causes a sunburn reactivation if the
    drugs are administered within 1 week of obtaining a sunburn. This reactivation
    may actually be more severe than the primary sunburn.

Things you can do to manage photosensitivity:


  • Use sunscreen or protective clothing when out in the sun, even on cloudy days.
  • Sunblock with physical barrier such as zinc oxide, may be needed.
  • Avoid tanning booths.
  • Being able to tan previously without damaging burns or skin reactions to sunlight
    does not mean that skin will respond the same way while on chemotherapy or radiation.

Reduce inflammation:

  • Use cool wet dressings.
  • Apply lotions.

Drugs or treatments your doctor may recommend or prescribe for photosensitivity

  • Topical creams containing corticosteroids and/or anti-itching properties.
  • If a reaction is severe systemic corticosteroids may be prescribed.

Note: We strongly encourage you to talk with your health care professional
about your specific medical condition and treatments. The information contained
in this website about skin reactions and other medical conditions is meant to be
helpful and educational, but is not a substitute for medical advice.

Radiation Recall

What is radiation recall?

Radiation Recall is a redness that can occur at the site of previous radiation
when certain chemotherapy drugs are given. Radiation recall resembles severe sunburn
in the area of the previous radiation.

  • This effect of radiation recall can occur from 8 days to 15 years after radiation
  • These skin reactions are most commonly associated with antitumor antibiotics such
    as dactinomycin and doxorubicin.
  • Treatment of radiation recall is symptomatic with an effort to avoid or treat secondary
    infections that may occur. Sometimes corticosteroids may be used in order
    to allow continuation of offending drug without further radiation recall effects.

Things you can do to manage radiation recall:

  • Stay out of the sun and avoid tanning beds.
  • If you must be out of the sun, use protective clothing and sunscreen with SPF 30
    or higher over previously radiated skin.

Note: We strongly encourage you to talk with your health care professional
about your specific medical condition and treatments. The information contained
in this website about skin reactions and other medical conditions is meant
to be helpful and educational, but is not a substitute for medical advice.


What is a rash?

A rash is a general term for skin reactions, some more specific terms are
used to describe what the rash looks like such as:

  • Erythematous – redness.
  • Macular – small, distinct, flat areas.
  • Papular – small raised lesions.
  • A macularpapular rash is the most common type of drug-induced skin reaction.
    These skin reactions usually start on the trunk. The arms and legs are often
    involved but the face may be spared. The rash is usually bright red in color
    and the skin may feel hot, burning or itchy. This rash can occur with almost
    any drug at any time up to two to three weeks after the drug has been given, but
    are most common within the first 10 days.
  • A severe form of this type of rash would be a wide spread, red rash that blends
    together. Often associated with peeling of the skin, and desquamation (areas
    of wet or dry open sores). There may be other symptoms such as fever, lymph
    node enlargement, and loss of appetite.

Hives: raised, itchy, red blotches or wheals which
may be pale in the center and red around the outside. This is also a common
drug reaction usually occurring within 36 hours of drug exposure. The lesions
rarely last for more than 24 hours. However on giving the drug again the skin
reactions may develop within minutes.

  • Management of hives involves stopping the causative agent and treatment with antihistamines.
  • Swelling or edema may also occur with hives as part of an allergic reaction.
    It is a vascular reaction resulting in an increased ability for fluid in the cells
    to “leak” into the layers of the skin causing swelling. These skin reactions
    happen much less often than hives alone. The tongue, lips, or eyelids are
    generally affected. Swelling of the airways can result in difficulty
    breathing, closing off of the airway and death. If swelling is happening and
    any sign of breathing difficulty seek help immediately.

Acne: Some drugs can cause or make acne worse.
The lesions in acne like rashes are papular and pus filled but blackheads are usually

  • Drugs commonly associated with this type of rash are corticosteroids, androgens
    (in females), dactinomycin, vinblastin, oral contraceptives.

Psoriasis: Typically described as reddish patches
covered with large dry silvery scales.

  • Some drugs are associated with psoriasis in persons with no prior history of this
    skin condition (interferon alfa) or occasionally can worsen pre-existing psoriasis
    (interferon alfa and interleukin-2).

Purpura: A condition characterized by bleeding under
the skin or mucous membranes. This results in the appearance of purplish
spots or patches.

  • The main cause of these skin reactions is thrombocytopenia (very low platelet

Steven-Johnson syndrome (SJS): A very severe, uncommon
skin reaction that includes flu-like symptoms (fever, chills, generalized aches,
fatigue) and extensive skin reaction with a variety of patterns. Skin
reactions may include skin blistering and erosions.

  • This syndrome is frequently drug induced.
  • A large number of drugs have been implicated as a cause of SJS, most common are
    penicillins, tetracyclines, sulphonamides and NSAID’s (non-steroidal anti-inflammatory
  • Drugs that may be responsible for these skin reactions should be stopped immediately.
  • Patients are usually hospitalized to receive IV corticosteroids, fluid replacement
    and antibiotics, if needed.
  • Drug re-challenge is never justified.

Things you can do to manage rashes:

  • Wear loose non-irritating clothing.
  • When bathing use a mild soap without perfumes.
  • When washing and drying the skin gently pat the area instead of rubbing with the
    towel or washcloth.
  • Use sunscreen or protective clothing when out in the sun, even on cloudy days.
  • Avoid tanning booths.
  • Previous history of skin tanning without damaging burns or skin reactions to sunlight
    does not indicate that skin will respond the same way while on chemotherapy or radiation.

Drugs that may be prescribed by your doctor:

  • Corticosteroid creams
  • Sunscreens
  • Calamine lotion for itching
  • Antihistamines to treat an allergic response.
  • Analgesics (pain medications) if a painful rash is present.

When to call your doctor or health care professional about skin reactions:

  • Swelling, chest pain or difficulty breathing (signs of an allergic reaction).
    Seek help immediately and notify your health care professional.
  • Fever of 100.5° F (38° C) or higher, chills (possible signs of infection).
  • Unexplained or worsening skin rash.
  • Itching, pain or other troubling symptoms accompanying a rash.
  • Rash affecting the mucous membranes in the mouth or nose.
  • Any blistering, peeling, open areas in the skin.
  • If you suspect an infection in the skin or nails.

Note: We strongly encourage you to talk with your health care professional
about your specific medical condition and treatments. The information contained
in this website about skin reactions and other medical conditions is meant to be
helpful and educational, but is not a substitute for medical advice.

Hand-Foot-and-Mouth Disease-Viral Rash

Is this your child’s symptom?

  • Tiny red spots and water blisters on the hands and feet caused by a virus
  • Rash is seen on the palms, fingers, soles and toes
  • The diagnosis cannot be made without these
  • Also can cause small mouth ulcers (sores)

Symptoms of Hand-Foot-and-Mouth Disease (HFMD)

  • Small red spots and tiny water blisters on the hands and feet. Seen on the palms, fingers, soles and toes.
  • The diagnosis cannot be made without these.
  • Small painful ulcers (sores) in the mouth. Look for them on the tongue and sides of mouth. Most children with HFMD have these, but they can be hard to see.
  • Also, small blisters or red spots on the buttocks (30%)
  • Low-grade fever less than 102° F (39° C)
  • Mainly occurs in children age 6 months to 4 years

Cause of HFMD

  • Coxsackie A-16 virus and other enteroviruses
  • Not related to any animal disease

Severe Form of HFMD

  • Since 2012, a severe form of HFMD has occurred in much of the world. It’s caused by a new Coxsackie A6 virus.
  • The rash spreads to the arms, legs and face. The rash is made up of many small blisters.
  • Children with such a severe rash may need to be seen. Reason: to confirm the diagnosis. Exception: close contact with HFMD within the last 7 days.
  • Treatment is the same. Drink enough fluids to prevent dehydration.
  • Peeling of the fingers and toes is common. It looks bad but is harmless. It happens at 1 to 2 weeks. Use a moisturizing cream on the raw skin.
  • Some fingernails and toenails may fall off. It occurs in 4% of severe cases. It happens at 3 to 6 weeks out. Trim them if they catch on things.
  • Fingernails grow back by 3 to 6 months and toenails by 9 to 12 months. They will look normal.

When to Call for Hand-Foot-and-Mouth Disease-Viral Rash

Call Doctor or Seek Care Now

  • Dehydration suspected. No urine in more than 8 hours, dark urine, very dry mouth and no tears.
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Red, swollen and tender gums
  • Ulcers and sores also on the outer lip
  • Rash spreads to the arms and legs (severe form of HFMD)
  • Fever lasts more than 3 days
  • You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Fingernails or toenails fall off
  • You have other questions or concerns

Self Care at Home

  • Hand-foot-mouth disease and no other problems

Seattle Children’s Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

Care Advice for Hand-Foot-and-Mouth Disease (HFMD)

  1. What You Should Know About HFM Disease:
    • Most often, hand-foot-and-mouth disease (HFMD) is a harmless rash.
    • It is caused by a virus called Coxsackie.
    • Here is some care advice that should help.
  2. Liquid Antacid for Mouth Pain (Age 1 Year and Older):
    • For mouth pain, use a liquid antacid (such as Mylanta or the store brand). Give 4 times per day as needed. After meals often is a good time.
    • Age 1 to 6 years. Put a few drops in the mouth. Can also put it on the mouth sores with a cotton swab.
    • Age over 6 years. Use 1 teaspoon (5 mL) as a mouth wash. Keep it on the ulcers as long as possible. Then can spit it out or swallow it.
    • Caution: Do not use regular mouth washes, because they sting.
  3. Fluids and Soft Diet:
    • Try to get your child to drink adequate fluids.
    • Goal: Keep your child well hydrated.
    • Cold drinks, milk shakes, popsicles, slushes, and sherbet are good choices.
    • Solid Foods. Offer a soft diet. Good ones are mac and cheese, mashed potatoes, cereals with milk and ice cream. Also, avoid foods that need much chewing. Do not give citrus, salty, or spicy foods. Note: Fluid intake is more important than eating any solids.
    • For babies, you may need to stop the bottle. Give fluids by cup, spoon or syringe instead. Reason: The nipple can increase the pain.
  4. Pain Medicine:
    • Mouth sores are painful.
    • Blisters also may be painful, especially on the feet.
    • To help with the pain, give an acetaminophen product (such as Tylenol).
    • Another choice is an ibuprofen product (such as Advil).
    • Use as needed.
  5. Fever Medicine:
    • For fevers above 102° F (39° C), give an acetaminophen product (such as Tylenol).
    • Another choice is an ibuprofen product (such as Advil).
    • Note: Fevers less than 102° F (39° C) are important for fighting infections.
    • For all fevers: Keep your child well hydrated. Give lots of cold fluids.
  6. Blisters on the Skin
    • Blisters don’t need any special treatment. You can wash them like normal skin.
    • Blisters on the palms and soles do not open.
    • Those on arms and elsewhere sometimes open. The fluid is contagious to other people. Open blisters do not need to be covered. They quickly dry over.
  7. Return to School:
    • HFMD is easily spread to others.
    • However, most often, it’s a mild and harmless illness.
    • After contact with HFMD, children come down with symptoms in 3-6 days.
    • Can return to child care or school after the fever is gone. Most often, this takes 2 to 3 days.
    • Children with widespread blisters may need to stay home until the blisters dry up. That takes about 7 days.
  8. What to Expect:
    • Fever lasts 2 or 3 days.
    • Mouth sores should go away by 7 days.
    • Rash on the hands and feet lasts 10 days. The rash on the hands and feet may then peel.
  9. Call Your Doctor If:
    • Signs of dehydration occur
    • Fever lasts more than 3 days
    • You think your child needs to be seen
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the ‘Call Your Doctor’ symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 11/12/2021

Last Revised: 10/21/2021

Copyright 2000-2021. Schmitt Pediatric Guidelines LLC.

Hereditary Angioedema: Causes, Symptoms, and Treatment

What Is Hereditary Angioedema?

Hereditary angioedema is a rare genetic condition that causes swelling under the skin and lining of the gut and lungs. It can happen in different parts of your body.

You are born with hereditary angioedema (HAE). Although you’ll always have it, treatment helps you manage it.

There have been big improvements in treatment, and researchers continue to look for new solutions.

Symptoms most often initially show up in childhood and get worse during the teen years. Many people don’t know HAE is causing their swelling until they’re adults. Where you have it on your body, how often the bouts happen, and how strong they are different for everyone. The attacks can come and go as well as move to different spots during the same bout. The swelling typically goes away on its own but can also occur as a life-threatening event.

Your throat can swell. That can cut off your airways and could be deadly. So if you know you have HAE and you feel any change like that, call 911 right away.

The frequency of attacks can vary. You can have attacks as often as every 1 to 2 weeks or 1 to 2 per year, and they can be hard to manage.


With this disease, a certain protein in your body is not in balance. This causes tiny blood vessels to push fluid into nearby areas of your body. That leads to sudden swelling.

A problem with a gene that makes a blood protein called C1 inhibitor often causes HAE. In most cases, you don’t have enough of this protein. In others, you have normal levels but it doesn’t work right.

For the most common form of HAE, if one of your parents has HAE, you have a 50% change of having it, too. But sometimes the gene change happens for unknown reasons. If you have the broken gene, you can pass it on to your children.


The main symptom is swelling. You won’t have the itching or hives that people often get with allergic reactions. A bout may last 2 to 5 days.

It can happen in different parts of the body:

  • Mouth or throat
  • Hands
  • Feet
  • Face
  • Genitals
  • Belly

Swelling in the throat is the most dangerous symptom.

Puffiness in the feet and hands can be painful and make it hard to go about your daily life.

Swelling in your belly can cause:

  • Extreme pain
  • Nausea
  • Vomiting
  • Diarrhea

You may notice warning signs before swelling begins. These may include:

  • Extreme fatigue
  • Muscle ache
  • Tingling
  • Headache
  • Belly pain
  • Hoarseness
  • Mood changes


Although you may not be able to tell what your triggers are, common ones include:

  • Stress or anxiety
  • Minor injury or surgery
  • Illnesses such as colds or flu
  • Physical activities such as typing, hammering, or pushing a lawn mower
  • Medications, including some used for high blood pressure and congestive heart failure

Women may notice a difference in the number or sharpness of attacks when they:

  • Have their period
  • Are pregnant. For some women, it doesn’t happen as often when they’re pregnant, but then the attacks come back after they give birth.
  • Use birth control or hormone replacement therapy containing estrogen. Women usually say they have more and worse attacks while on these medicines.

Getting a Diagnosis

If you’ve had symptoms of HAE, your doctor may ask:

  • What changes have you noticed?
  • Where have you had swelling? How often?
  • Have you had any in your face, neck, tongue, or throat?
  • Have you noticed any changes that happen before swelling begins?
  • Have you had any stomach problems or stomach surgery?
  • Does anyone in your family have a problem with swelling?
  • Have you or anyone in your family been treated for allergies?

The right diagnosis is key. Sometimes people are treated for allergies when it’s really HAE that causes their swelling. Antihistamines and corticosteroids that treat allergies don’t work well for this disease.

You can have severe stomach swelling, pain, and diarrhea and severe dehydration and if misdiagnosed, it can lead to surgery you don’t need.

Your doctor will do a physical exam. You’ll need blood tests, too, to confirm that it’s HAE.

If you do have it, ask your doctor to refer you to a specialist familiar with the condition. You should also ask your doctor about having other members of your family tested, even if no one has symptoms.

Questions for Your Doctor

  • Do I need more tests?
  • What can I expect from this condition?
  • Which treatments do you recommend? What are their side effects?
  • What should I do if my throat swells? How likely is that?
  • How can I find out what triggers my attacks?
  • Will I pass this condition on to my children?
  • Should my family get tested for HAE?
  • Will this affect my plans to have a family?


Doctors can use medications to treat or prevent attacks:

You may also need oxygen or IV fluids to ease your symptoms.

Your doctor will make recommendations for what you need.

Taking Care of Yourself

Learn as much as you can about HAE so you can make informed decisions about your treatment and medications that you should be cautious with.

If you can figure out your triggers, you can better avoid them. It helps to track your attacks and symptoms in a journal and look for patterns.

Talk to your doctor before you have any dental work. They may want you to take medication to avoid a flare. Also talk with your doctor before you take any new prescription medicines. There is a chance they could trigger an attack.

Carry your medical information with you at all times.

If your child has HAE, note any changes in behavior that you see before an attack. As they get older, they’ll need to learn their triggers and treatment needs.

Make sure all caregivers and family members know about the condition and what to do if an attack happens.

Remember: Any swelling in the throat is an emergency. Take your medication for attacks and call 911.

Connect with others who are living with HAE. They can share their insights and tips to help you manage your symptoms.

What to Expect

There’s no cure for HAE, but new treatments have made it possible for people to manage their symptoms and enjoy active lives.

Getting Support

To learn more about HAE and to find the support of others who have it, visit the website of the U.S. Hereditary Angioedema Association at www.haea.org.

FAQ: Methotrexate | Patient Education

Why is this medication being recommended?

Methotrexate is part of a class of drugs called immunosuppressants. It suppresses the body’s immune response and reduces inflammation in your lungs. Because inflammation is the precursor to fibrosis (scarring), we hope methotrexate will prevent the formation of lung fibrosis and allow the inflamed lung to return to normal.

What special precautions should I follow?

Before taking methotrexate:

Tell your doctor and pharmacist if you are allergic to methotrexate, any other medications or any of the inactive ingredients in methotrexate tablets. Ask your pharmacist for a list of the inactive ingredients.

Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements and herbal products you are taking or plan to take. Be sure to mention those listed in the important warning section of the medication insert, as well as any of the following:

  • Certain antibiotics such as chloramphenicol (Chloramycetin), penicillins, and tetracycyline (Bristacycline, Sumycin)
  • Folic acid
  • Rheumatoid arthritis medications
  • Phenytoin (Dilantin)
  • Probenecid (Benemid)
  • Sulfonamides such as co-trimoxazole (Bactrim, Septra), sulfadiazine, sulfamethizole (Urobiotic), and sulfisoxazole (Gantrisin)
  • Theopylline (Theochron, Theolair)

Your doctor may need to change the doses of your medication or monitor you more carefully for side effects.

Methotrexate may cause liver damage. Tell your doctor if you drink or have ever drunk large amounts of alcohol, or if you have or have ever had liver disease. Do not drink alcohol while you are taking methotrexate. Call your doctor immediately if you experience any of the following symptoms: nausea, extreme tiredness, lack of energy, loss of appetite, pain in the upper right part of the stomach, flu-like symptoms or yellowing of the skin or eyes.

Methotrexate may cause kidney damage. Be sure to drink plenty of fluids during your treatment with methotrexate, especially if you exercise or are physically active. Call your doctor if you think you might be dehydrated. You may become dehydrated if you sweat excessively or if you vomit, have diarrhea or have a fever.

Methotrexate may cause a decrease in the number of blood cells made by your bone marrow. Tell your doctor if you have, or have ever had, a low blood count (decrease in the number of blood cells in your body), anemia (red blood cells do not bring enough oxygen to all parts of the body), or any other problem with your blood cells.

Call your doctor immediately if you experience any of the following symptoms:

  • Confusion
  • Difficulty falling asleep or staying asleep
  • Dizziness
  • Excessive tiredness
  • Fast heartbeat
  • Pale skin
  • Shortness of breath
  • Sore throat, chills, fever or other signs of infection
  • Unusual bruising or bleeding
  • Weakness

Methotrexate may cause a severe rash that can be life-threatening. If you develop a rash, blisters or a fever, call your doctor immediately.

Methotrexate may cause damage to your intestines. Tell your doctor if you have or have ever had stomach ulcers or ulcerative colitis, a condition in which part or all of the lining of the intestine is swollen or worn away. If you develop sores in your mouth or diarrhea, stop taking methotrexate and call your doctor immediately.

Tell your doctor if you are breast-feeding. You should not breast-feed during your treatment with methotrexate.

Before having surgery, including dental surgery, tell the doctor or dentist that you are taking methotrexate.

Methotrexate may make your skin sensitive to real or artificial sunlight. Avoid unnecessary or prolonged exposure to sunlight and wear protective clothing, sunglasses and sunscreen. Do not use sunlamps during your treatment with methotrexate. If you have psoriasis, your sores may get worse if you expose them to sunlight while taking methotrexate.

What side effects can this medication cause?

Methotrexate may cause side effects. Tell your doctor if any of the following symptoms are severe or do not go away:

  • Acne
  • Changes in skin color
  • Hair loss
  • Headache
  • Irregular menstrual periods
  • Swollen, tender gums

Some side effects can be serious. If you experience any of the following symptoms or any symptoms listed in the important warning section of the medication insert, call your doctor immediately:

  • Blood in urine
  • Blurred vision
  • Chest pain
  • Difficulty moving one or both sides of the body
  • Difficulty speaking or slurred speech
  • Fainting
  • Pain or redness of one leg only
  • Seizures
  • Sudden loss of vision
  • Urgent or frequent need to urinate
  • Weakness or numbness of an arm or leg

Methotrexate may cause other side effects. Tell your doctor if you have any unusual problems while you are taking this medication.

What monitoring will I need?

Your doctor will order regular lab tests to check your response to methotrexate and monitor for toxicity. You will need to have your blood counts — white blood cells, red blood cells and platelets — and liver function checked regularly. Your doctor may order additional tests depending on the results.

For additional information on methotrexate, please visit MedlinePlus.gov.

90,000 Bee keeping in the apartment? Roger Delon’s hive

The wintering of bees in the observation hives in the apartment, as well as the maintenance itself, in the summer in the apiary in them, was considered (and is still considered) as fun necessary to study the biology of the bee colony.

We have to state that the wish of the famous beekeeper N. Vitvitsky in 1843 “to have in Russia many hunters for such a useful and sublime pleasure as keeping bees in observation glass hives on the windowsills” unfortunately did not come true.

The culture of keeping bees in a person’s apartment has now been lost, and no book on beekeeping can find guidelines in this area … than get it by consuming honey. The loss of moisture through the entrance-tunnel in the window frame is created due to “freezing” from the large temperature difference in the hive and outside (approximately the same way as in the refrigerator from fresh bread is obtained rusk).But the difference between the temperature in the refrigerator and the ambient temperature is only about 10 ° C, and when a bee colony hibernates at the window, this difference can be 30 ° C or more, that is, the dehydration of the bee colony occurs very quickly, and this leads to her death during wintering. Therefore, during the wintering of bees in the apartment, for every hive, a gravitational drinker for bees should be installed above the club.

And, as noted, the consumption of water from drinking bowls by bees does not cause their noticeable revival, and they completely maintain a state of dormancy.

The hive in the apartment must be airtight for the winter. Otherwise, the bees will not sit still and begin to crumble from the honeycomb. That is, a beekeeper should have made a tight cap with glass in advance for observing the bees on Roger Delon’s 2-hive hive and installed a drinking bowl, into which water is poured in advance, overturned and changed to empty in 2 – 3 seconds, so as not to depressurize the hive … Through a window tunnel under a 4×4 cm frame in cross-section, the hive is connected to the outside environment, from where cold air enters the bottom of the hive, and the bees have a choice of temperature conditions.In severe frosts, the club rises up the honeycomb, and in the thaw it goes down, and the bees hang with their “beard” in the cool zone of the lower part of the hive. At the same time, it is necessary to avoid knocking on the hive, since otherwise the bees get excited, go outside and die.

It is necessary to make a dark curtain on the window so that during the spring inspection of summer and autumn work in the hive not to attract bees with too bright light, and if any one flew out of the hive, it will fly out into the window, against which you need to make a hole in the curtain in advance. The underframe space in the winter should be at least 10 cm. At each entrance-tunnel, outside, an arrival board the size of a book should be reinforced and painted in different colors. Accommodation of apartment hives is carried out in summer, at the latest – at the end of August. That is, they prepare one or two empty hives at the window, bring them with the bees, rearrange the frames from field to apartment, and with the arrival of winter they install an airtight observation cap on the hive. Under these conditions, you can count on a good wintering of bees in the apartment.“My two beehives in an apartment with a temperature of 20-25 ° C gave phenomenal results: at the end of March they already had 3-4 frames with a worm, and masses of bees rushed for a bribe under the windows, in the gardens and squares of the townspeople to the flowering of the gardens” , – a colleague from Primorye told me …

You will learn all the other information about the year-round keeping of bees in the apartment yourself, having started the practical realization of your dream of having winged friends by your side.

Installation diagram of Delon’s hive for year-round keeping of bees in an apartment:

  1. – polyethylene film for sealing;
  2. – gravity drinking bowl with water;
  3. – cap with glass;
  4. – rubber band for sealing;
  5. – second hive body;
  6. – main hive body;
  7. frames of the Delon hive;
  8. frames of Delon’s hive;
  9. underframe space – 10 cm;
  10. – garbage pallet;
  11. – adjustable tunnel shutter;
  12. – tap-hole tunnel;
  13. – hive supports;
  14. – window sill frame or building wall;
  15. – arrival board.

Note: Two Delon hives for year-round keeping of bees in an apartment can be placed in the walls to the right and left of the window, and the entrance tunnels can be made in the form of the letter “L” laid on its side. Attach one end of such a recumbent “G” to the hive, and take the other under the frame in the corner to the street. The window will be free for its intended purpose.


“Apiary of Russia” newspaper.

Obtaining royal jelly Technology

Not every apiary is engaged in obtaining royal jelly for the purpose of sale, since this is a very laborious process that requires a number of work related to obtaining this most valuable product.The laboriousness of obtaining royal jelly explains its high cost in the market.

Before describing the process of obtaining royal jelly in an apiary, it is necessary to explain what royal jelly is. Royal jelly is a paste-like substance of white-yellow color with a slightly specific sour taste, produced by the maxillary glands of nursing bees, and used by them to feed the larvae of future queens. Its constituent amino acids, vitamins, minerals, microelements, as well as substances that destroy and suppress the growth of pathogenic bacteria and microbes, endow royal jelly with the most powerful bioenergetic force. Therefore, royal jelly has found wide application in medicine and cosmetology all over the world.

For rearing queen larvae, bees build up cells of queen cells, from which later beekeepers can receive royal jelly.

If the apiary is focused on obtaining royal jelly, then when working with families-educators in the spring during the month it is necessary to feed the bees of the families-educators with sugar syrup 0.5 liters every other day. After that, the work is carried out exactly as described in the article (read in detail in “Working with families-educators”), but when preparing the vaccination frames for families-educators, we attach up to 120 cells of the mother cells to them, without pushing the extra cells, because the goal in this case is is not the receipt of the most powerful queens, but the receipt of royal jelly.After that, the grafting frames are installed in the hives of the families-educators and after 4 days are removed from there to remove the royal jelly from the cells.

Obtaining royal jelly is carried out in laboratory conditions, subject to sterility in the room, temperature regime within 25-30 degrees Celsius and humidity not more than 70%. With a spatula, the larvae of the queens are taken from the bowls, and the remaining royal jelly is sucked out with a special pump. Then the process of obtaining queen cells is repeated, after which the cells of the queen cells are again attached to the grafting frames and placed in the hives of the families-educators.When removing royal jelly, it is assumed that the laboratory has all the necessary tools for replanting larvae and removing royal jelly from the cells, as well as refrigeration equipment for storing and transferring the resulting product.

Sometimes, to obtain royal jelly in apiaries focused on obtaining such a product, the cells of the queen cells are not used directly to obtain queens, but the larvae are transplanted from unsealed cells of the mother liquor into specially prepared wax bowls for the withdrawal of queens. For the manufacture of bowls, light yellow wax and a special template of five sticks with rounded and carefully polished ends with a diameter of 8-9 mm are used. The sticks are first immersed in cold water and then in melted wax to a depth of about 10-12 mm, after which, after waiting for the wax to cool on the sticks, they are again immersed in the wax, but to a shallower depth, and so on several times.

As a result, artificial bowls are obtained, which are removed from the template and attached to the grafting frame, after which the grafting frames are placed in the hive of the educator family by the diaphragm so that they can take the smell of the family and be sanded by the bees.This must be done with the expectation that by the time the queen larvae need to be transplanted from the cells of the queen cells into the bowls, the bowls will be completely ready for this, that is, they will be saturated with the smell of the family and will be polished by the bees. First, a drop of royal jelly is added to the bowls, after which the larva of the uterus is transferred from the unsealed cells of the mother liquor to the bowls with a spatula. As a result, up to 120 bowls can be added to one vaccination frame (this is provided that the goal is not to remove strong queens, but to obtain royal jelly) and the vaccination frames are installed in the families of the teacher between the frames with brood, and after four days, including the day of vaccination, they are removed grafting frames, the larvae are removed with a spatula, after which the royal jelly in them is pumped out with a pump, and royal jelly is again added dropwise to the bowls and a new batch of larvae is transplanted from unprintable mother liquors.You can get about 20 grams of milk from each grafting frame.

Royal jelly has the peculiarity of very quickly losing its useful properties, therefore, within 10 minutes from the moment it is received from the cells of the mother liquor or from the bowls, it is urgently necessary to place it in the refrigerator. Then, subject to the temperature regime in the region of -2-5 degrees Celsius, it can be stored for up to six months, and at a temperature of -20 degrees – up to eighteen months.

Enterprises use such methods of preserving royal jelly as its dehydration and adsorption.These are different methods, but the result is a dry powder, which is slightly inferior in properties to native (freshly harvested) royal jelly.

Related articles:

Share with friends:

work in the apiary in September

The September work of the beekeeper is mainly aimed at preparing families for wintering: at this time, suitable food supplies are selected, nests are treated from parasites, and also work with families. The well-being of bees in winter largely depends on the quality of the manipulations carried out in September.

Read about what needs to be done at the beginning of autumn in the new review.

The beginning of cold weather: how to understand that it is time to prepare an apiary for winter

Even domestic bees are part of nature, and therefore various signs are associated with their behavior:

  • September 22, or Pasikov day, is the date with which the end of Indian summer is associated: at this time, nests are removed to winter houses and the apiaries begin to prepare for sub-zero temperatures, and bees for wintering.

  • If the bees carefully seal the cracks in the hive with propolis, the winter promises to be cold.

  • The sooner the bees drive the drones out of the hive, the earlier one should wait for the onset of cold weather.

You can act with an eye on the signs, but you should not blindly trust them. Experienced beekeepers rely primarily on their own observations, the characteristics of the region and the experience of colleagues in the shop.

Preparing top dressing for wintering

We select honey for the winter

In the first half of September, they finish feeding the bees with sugar syrup: if this is not done, the inhabitants of the hive reduce the release of enzymes, and the harvested honey crystallizes faster. Lack of food and increased energy consumption of bees can lead to sad results of wintering – up to the death of the family.

The ideal winter top dressing is light flower honey. Bees should not be given varieties that crystallize and contain honeydew.Honeydew honey is especially dangerous because it causes bees to develop toxicosis, which leads to dehydration and the death of families. Such honey has a dark, sometimes greenish color.

To distinguish honeydew honey and remove it from the nest, a test is carried out. The components – honey (1 part), water (1 part) and lime water (2 parts) – are mixed in a test tube and brought to a boil. If honey is honeydew, a precipitate falls out in the form of flakes. Honey, which gave a clear solution, can be put to bees for the winter.

Selecting unsuitable cells

Light frames conduct heat, so they should not be installed for wintering. If such combs are already in the nest, the bees will transfer the honey from them to the darker ones, and the empty frame will act as a diaphragm, and it will be difficult for the separated family to overwinter. In spring, the queen does not worm into light combs, because the brood sown in them requires more heating and, accordingly, more energy consumption.

You should also select frames with bee bread: bees do not feed on it in winter, so there is no point in leaving such honeycombs in the hive.

Uniting families

Before wintering, small families of 3-5 streets are united so that they spend the winter normally. If this is not done, the bees will spend more energy on heating the club and will crumble ahead of time. The more individuals die, the less likely the family will survive until spring.

How to choose the right time

The association is held in the evening in non-flying weather. To make the resettlement go smoothly, you can act at a negative air temperature, when the bees have already gathered in the club.

If the procedure is carried out in a warmer time, there is a risk of an attack on the nest, and cases of theft are also possible. In addition, there is a possibility that in summer weather the bees will fly off to the old place, where the nest no longer exists, and scatter to other hives.

How the merger is carried out in September

In order for families to unite without problems, you need to give the frames the same scent. To do this, the night before, parts of one bulb are placed in the hives under the canvas: overnight the nests will be saturated with the same smell, and the bees will calmly endure the procedure.If in a warmer season, frames with syrup can be used for this purpose, in September the night temperature drops, and there is a risk of cooling the nest, therefore it is undesirable to resort to this method.

What about the queens?

Each family has its own queen, and bees from different nests attack other people’s queens to protect their own. To avoid conflicts within a new family, one of them must be resettled in an incubator or nucleus.

Treatment for diseases

All preventive procedures are carried out after the release of the last brood, because it is in it that most of the ticks and pathogens of various diseases are contained.

Braulose treatment

The causative agent of the disease is bee louse, or braula. In summer and autumn, they lay the larvae in bee brood, on the edges of empty cells and in honey lids. The period of incubation of the larva is on average 21 days, the lifespan of an adult insect is 2-3 days.

The larvae gnaw the way out of the egg, feed on wax. During this period, one braula can take food from 7–8 inhabitants of the family. Adult insects parasitize bees: on one working individual there are from 2 to 8 lice, on queens there can be up to 25 of them.

You cannot leave the frames in which the braul passages are found – holes of 0.2–0.3 mm – because the affected family will crumble until spring.

If traces of braulosis are found, the hives are treated with special preparations or tobacco smoke. Before the start of treatment, paper is laid on the bottom of the nest; during fumigation, dead lice fall on it. After finishing the processing, paper with parasites is carefully removed from the hive and burned.

Treatment for varroatosis

The disease is caused by Varroa mites.The parasites feed on the bees’ hemolymph, the affected colonies weaken and die. The brood that appears in the infected hive comes out underdeveloped, adult bees throw it out of the nest. The infected colony is irritated and restless; during the wintering period, the bees often crumble before they even live to the middle of the cold weather.

In the early stages, the lesion is asymptomatic, so it is important to regularly clean the nests. In large apiaries, treatment is carried out with the help of smoke cannons: bees are fumigated with special preparations.In other cases, acid evaporators, thermal strips and other processing means are used. Evaporation of drugs provokes a steady positive trend, but this factor does not negate the obligation of regular treatment.

In the spring, the family is treated with thymol acids and essential oils, because these components do not affect the quality of spring development and do not threaten the health of the uterus. In autumn, beekeepers use stronger drugs – Amitraz, Taufluvalinat and others.Do not use the same product for more than 4 consecutive times due to the risk that the treatment will no longer work on the mites. Ideally, funds are changed every 1.5-2 years.

Instead of a conclusion

September work significantly affects the quality of wintering and the condition of families in the spring, so beekeepers take this stage responsibly. Timely treatment for diseases and preparation of winter feed is the key to the health of bees and a good harvest in the season.


The review was prepared by the specialists of the online store “
Health from nature “.

We offer to order goods for the apiary. We accept orders online and by phone. We will deliver goods in Moscow, send to any region of the Russian Federation.

Empirical, Metagenomic, and Computational Techniques Illuminate the Mechanisms by which Fungicides Compromise Bee Health

Investigating the effects of fungicides on bee health remains an under-researched aspect of pest management strategies. Our research seeks to bridge this knowledge gap by using a set of complementary techniques that explicitly isolate the potential decline factors of the bee. The planning, justification and visualization of these experiments is described below.

It is important to prevent bees from avoiding gridded cage experiments as this will undermine the demographics of the analysis. It is also important that artificial nests have sufficient insulation to protect them from rain and direct sunlight. So that the fungicide is not sprayed directly onto the nests, care should be taken.Colonies should be provided with sugar water reservoirs to supplement the collected nectar and prevent dehydration.

Laboratory established on the basis of fattening trials, strict aseptic conditions should be maintained to prevent contamination when cooking pollen. Commercially purchased pollen must be powdered and UV sterilized before use. Bush hygiene must be maintained to prevent infestation from extraneous parasites such as pantry butterflies and roach. Fluid cylinders should be supplemented with a sterilized sugar solution to prevent dehydration. For pre-processing of the census, care should be taken not to stress the bees, over-processing and keep them hived out for a long period.

As DNA yield depends on age and type of starting material, only well frozen or fresh samples should be used in DNA extraction and amplification. The sample mass for DNA extraction should not exceed 0.25 GM, as this will reduce the yield of DNA.DNA yields must be quantified using gel electrophoresis. Upfront electrophoretic quantification of isolated DNA is important before PCR reactions to ensure effective amplification of 47 .

For metagenomic analysis, it is possible to obtain a more complete analysis of microbial dynamic, limiting the number of annotated sequences (by relaxing the fraction of tolerable differences between sequences) and reducing the number of taxonomic groups, as well as fusion of those for which the relative abundance is significantly low (<2%).


conservative sample size ( N = 5 for both fungicide-treated and cell-treated hives) can inflate data discrepancies that will collapse in future studies using more replication. To add greater resolution and statistical power to the results, bee colonies will be fused and weighed before and after exposure to the fungicide. Running the cell experiment for longer periods will allow the production of a new queen that can serve as additional abscission.With these changes to the current Protocol, future research will provide more detailed information on hive population dynamics.

The hydrophobic nature of the pollen keeps it from mixing effectively with water. Grinding and sifting the pollen granules into a fine powder, helps in the mixing process. The amount of pollen powder can be adjusted to achieve the desired consistency. Care should be taken to mix the liquid (water or fungicide) thoroughly to achieve an even distribution of the active ingredients and even delivery to the forage harvesters.

As excess DNA can inhibit PCR reactions, it is recommended that the sample should not weigh more than 0.25 g. Excessive vortexing should be avoided as it scissors DNA, reducing yield. Low yield DNA can also result from prolonged exposure to the lytic buffer. Bacterial primers should be selected preferably from the V7-V9 region of 16S rRNA to minimize nonspecific amplification of chloroplast DNA 48 . In addition, the sequence of genes such as 18S ribosomal RNA genes can provide a better understanding of microbial diversity in pollen as well as changes in population after fungicide use.

Considering the number of libraries to process with Mothur, the calculation time can be significantly high. Removing Singletons when comparing sequences against each other (if computational resources are limited, remove them before filtering Chimera) can significantly reduce the time required to compute operational taxonomic units.

Cage experiments restrict the range of natural flight of bees (as opposed to allowing them to feed widely across the landscape), and it is unclear to what extent such restrictions might affect response variables.Although control and treatment of cells experience the same range of biotic and abiotic variables, it is technically impossible to control the microenvironment in every cell.

The true meaning of microbial interactions within a community is too complex and confusing to replicate through experimental trials. While our data most likely document a subset of total microbial diversity within pollen provisions, this is the first insight into the interactive effects that can prevail between bacteria and fungi in the presence / absence of fungicides.

Using alternative databases to align sequences 49 or predict functional metabolic states based on pollen bacterial diversity 50 may provide a broader pollen microflora. In the end, it is better to characterize the metabolic and functional dynamics of microbial communities after the application of fungicides, it is necessary to the entire genome of the pollen microflora.

Cage experiments using commercially purchased hives provide one of the best structures for measuring response variables under semi-controlled conditions.Causing minimal changes to the natural ecology of bees (feeding efficiency, social structure, offspring care), Cage experiments minimize adaptation and stress presented in the built environment and manual processing during laboratory experiments.

To the best of our knowledge, no study has yet been conducted to evaluate the effects of fungicides on microbial dynamics in pollen-providing bumblebees. Exposure Fungicides can exclude one or more susceptible species, disrupting the ecological truce between fungi and bacteria.By using field and laboratory-based tests of how crucible play these interactions, this study aims to demonstrate that extermination of resident microbial species can distort the ecological balance of pollen microflora, which in turn can compromise bee health.

Culture dependent techniques such as dilution and coating on standard media recorded only a small portion of the microflora from a given media. This can lead to gross underrepresentation of microbial diversity and unculturable microbes can go undetected 51 .To study the spectrum of microorganisms, scientists must rely on culture-independent methods that are broader and more comprehensive, such as metagenomic analysis and next-generation sequencing. Drawing heavily from these powerful molecular techniques, this study seeks to obtain greater resolution in pollen microflora than in traditional culture-based methods alone.

The results of this study revealed deep losses in the number of workers within the limits of bumblebee bees exposed to the fungicide.For the bumblebee bee colony to be successful, workers must provide sufficient resources and care for the queen’s mother and especially for the developing larvae. Ultimately, the goal of the colony is to maximize capture resources (pollen and nectar) so that as many Queens’ daughter as possible can be produced at the end of summer. A healthy daughter of Korolev is an indicator of suitability for the colony. Then, large cuts in workers effectively undermined the colony’s ability to produce Queens the next year.In this study, not only had worker numbers significantly decreased, but the Queen’s mothers treated a rash with lower biomass, presumably as a result of malnutrition, from forage harvesters with a fungicide. Given the complexity of microbial interactions within pollen positions, it is difficult to discern the exact interactive effects between fungi and bacteria, contributing to these patterns. However, the results obtained from replication and repeated experiments as described here will provide vital insights into the transference of symbiosis between these two groups of microbes (whether competitive, hairless, or synanthropic) in response to xenobiotic stress, and its downstream effects of pollen microflora.

With powerful tools, the molecular ecological complexity of pollen microflora can be better addressed. Preliminary insights uncover a multitude of naturally occurring bacteria and fungi, helping to collectively maintain colony fitness. In particular, yeasts that have been isolated from pollen provisions are known to carry bactericidal and enzymatic properties, both of which are critical for the development of bee larvae. Such ecological associations are indicative of a high degree of symbiosis between bees and their pollen microflora.Pollen positions, therefore, represent an emergent diversity effect, resulting in the cultivation of the microbial community composed of key functional roles. In the absence of these key symbionts, the pollen position appears to be disturbed to an unknown extent. Continuing work in this direction will likely explain the functional diversity of these microbes and expose their role as symbionts as bees.

Recent studies debunked the notion of fungicides as safe for bees 19 , 24 , 52 , , 53 54 .The aim of this study is to isolate the mechanisms of fungicide driving effects on bees, thereby illuminating the causal relationship between fungicide use and bee decline. The hypothesis center around the concept that Bi Microbe symbioses are mutable significantly from fungicide residues in the pollen. Ultimately this work will be re-framed as fungicides viewed and used in agriculture and urban settings. In light of the current global pollinator crisis, the proposed study generates new knowledge on the ecology of native bees as it relates to agricultural production practices.Fungicides remain the last group of agrochemicals to be effectively freed from the norm, limiting crop applications during flowering. As a result, both managed and wild bees are consistently exposed to fungicides. A growing body of literature suggests that although fungicides are not fatal to bees on contact, at higher doses, exposure is quite harmful, resulting in higher larval mortality 21 and altered hunter behavior. This work is expected to highlight the mechanism (s) by which fungicides harm pollinators.In addition, this study will form the basis of Wiser Pest management policies and inform farmers of best management practices. This work will also be instrumental in providing guidelines for improving pesticide spraying, which can affect pesticide laws and regulations. More broadly, these findings will be relevant to any managed ecosystem in which flowering plants are visited to collect insect pollen. With global estimates of bi-specific, extremely high 55 , 56 , if this work can mitigate the decline in bee pollination, the potential impact would be substantial.

Subscription Required. Please recommend JoVE to your librarian.

Flower pollen, bee bread, honey. what to choose?

Bee products and their positive effects on human health are widely recognized throughout the world. Since the time of Hippocrates, the forefather of medicine, various ways of integrating bee products into medicine have been frequently mentioned in the literature.

Today this science has not disappeared either. Vice versa. As interest in healthy living grows, bee products are becoming an increasingly popular part of the daily diet.

But how to integrate bee products into your daily life and what benefits do they bring? You will learn the answer to this question by continuing to read.


When we talk about bee products, the first thing that comes to mind is honey.

Honey is the most popular bee product all over the world. It is a sweet substance that bees make from flower nectar. The honey making process begins with a bee that collects nectar from flowers and delivers it to the hive.Further, the collected nectar goes through the process of dehydration and splitting into simple sugars, mainly glucose and fructose. Depending on which flowers were used to collect the nectar, the color, smell, taste and composition of honey change.

Why is honey so useful?

Under natural conditions, honey is intended to be a backup source of food for bees during the colder months of the year. Therefore, it has a high nutritional value and is saturated with enzymes, minerals, trace elements, vitamins and biologically active substances.The combination of these substances provides the bees with everything they need for optimal body function.

This also explains why honey has potential in medical applications. The substances that make up honey can not only supplement our diet, but also heal. Speaking about the composition of honey, it should be added that it can be very different. It is influenced by the breed of bees, climatic conditions and the type of collected nectar.

Despite the differences in composition, each variant has antibacterial and anti-inflammatory properties.The antioxidants it contains make honey a very healthy product.

Composition of honey

Honey is rich in various substances that strengthen the immune system. For example, many minerals are found in honey. Most of all honey contains potassium, phosphorus, sodium and magnesium.

In turn, trace elements are represented by iron, manganese, copper and cobalt.

Of course, we must not forget that 100 grams of honey contains about 82 grams of sugar. Do not consume more than 25 grams, or 5-6 teaspoons, of sugar per day.

It is therefore important to remember that honey is primarily a source of sugar.

If you put honey in tea or heat it, then remember that at temperatures above 60 degrees, some of the active substances die.

The use of honey

In ancient Greece, China, Rome and Egypt, honey was traditionally used for treating wounds and treating stomach ailments.

Honey is also used to treat insect bites, burns, coughs, sore throats and ears. Thanks to its antibacterial properties, honey is a versatile treatment that promotes the healing process and reduces inflammation.

In addition to external use, honey is also used as a food additive. It has a high energy value, and is also able to provide the body with the necessary minerals, vitamins and antioxidants.

Due to its composition, saturated with various substances necessary for the body, honey reduces the symptoms of various diseases, and is also able to prevent their occurrence.

For example, if you eat honey, you can lower your blood pressure.This property owes honey to its specific antioxidants. Thus, in the long term, the risk of developing heart disease is reduced.

Honey also helps maintain normal blood cholesterol levels. It reduces the amount of low-density (“bad”) cholesterol and increases the level of high-density (“good”) cholesterol.

Flower pollen

Flower pollen is a product created by bees, consisting of pollen, flower nectar and bee saliva.

During the flight of the bee, the hairs on its abdomen and legs attract pollen from the flowers. When enough of it is collected, the bee delivers pollen to the hive. In the hive, pollen is mixed with nectar, honey and bee saliva. As a result of fermentation of this mixture, bee bread is obtained.

The composition of pollen

Pollen is a high-quality, biologically active bee product, which contains about 50 different components, that is, almost all substances necessary for the human body: complete proteins containing more than 20 amino acids, phospholipids, which contribute to the permeability of the cell membrane and playing an important role in metabolic processes.

Pollen contains many carotenoids, which are involved in the synthesis of vitamin A, as well as vitamins P, PP, D, E, K and B vitamins, carbohydrates (mainly glucose and fructose), minerals, some fatty substances, enzymes and hormones.

Unlike honey, pollen contains much less sugar. 100 grams of pollen contains about 26 grams of sugar.

Pollen Applications

Pollen is used to reduce chronic inflammation, detoxify the body, and lower cholesterol levels.It can reduce the number of unwanted bacteria in the body and help fight the formation of abscesses.

In turn, the high concentration of antioxidants in the pollen provides protection against free radicals. Thus, by consuming pollen in food, we reduce the risk of developing chronic diseases such as cancer and diabetes.

Daily consumption of pollen also lowers blood lipids and decreases the amount of bad cholesterol in the body.So pollen reduces the risk of developing heart disease.

The special value of pollen is due to the fact that half of all its constituent amino acids are unsaturated amino acids (linoleic acid, linolenic acid, etc.). They are part of prostaglandins, which in turn act as hormonal regulators.

In addition, the composition also contains carotenoids, which are important for the synthesis of vitamin A, as well as vitamins E, C, P, PP, D, K and B vitamins.

Bee bread (bee bread)

Bee bread is another bee product that is gaining popularity all over the world.

70% Perga consists of pollen, nectar and bee saliva. Due to the high concentration of biologically active substances and the amount of protein, bees are an excellent source of vitamins, minerals, antioxidants and other substances necessary for the body.

Bee bread is much healthier than pollen.

Why choose bee bread?

The main difference between bee bread and pollen is its bioavailability.

In nature, bees cannot fully process the useful substances in pollen. The cellulose shell of pollen prevents both the bee and the human body from efficiently receiving and processing nutrients.

Therefore, bees ferment pollen and turn it into bee bread.

Honey, nectar and saliva, which are part of the bee bread, naturally supplement this product with probiotic bacteria and yeast.Thus, the fermentation process begins, lasting a couple of months, during which the bee bread is formed.

In the form of bee bread, it becomes much easier for the body to process the beneficial substances that are part of the pollen, such as amino acids.

During this process, many proteins are broken down into amino acids, which the body absorbs much better.

During fermentation, bee bread increases the amount of vitamins, antioxidants and enzymes.It is especially interesting that after fermentation, vitamin K appears in bee bread, and the number of lactic acid bacteria increases sixfold.

Bioavailability of zinc, magnesium and silicon dioxide in bee bread is also higher than in pollen. These substances are closely related to the cellulose shell of pollen, which is processed during the fermentation process.

From a practical point of view, pollen in the form of bee bread can be stored for a longer time.

Eating bee bread

Bee bread, like pollen, has a wide range of health benefits.

Due to the improved bioavailability during fermentation, the human body better absorbs the substances contained in bee bread, thus enhancing the medical effect.

It is known that many people do not like the taste of natural bee bread. Therefore, it is often consumed mixed with honey. Those who do not like the taste of bee bread can try the Bee Bite bee bread made in Latvia, which contains not only bee bread, but also berries, apples, cinnamon and hemp protein.

Bee Bite are the only 100% natural bee bread lozenges in Latvia approved by the Food and Veterinary Service.

Which bee product is better to choose?

Bees provide us with a wide range of bee products with high added value. What is the most beneficial product to supplement your daily diet?

The answer is simple: any bee product adds added value to human health.All bee products have the potential for both solving medical problems and for prophylactic body care.

But if we had to choose one of the bee products, we would definitely choose bee bread. Due to the bioavailability of bee bread and the concentration of substances necessary for the body, the substances included in its composition have a greater effect than pollen or honey.

It is also important that by using bee products to enrich your diet, you will definitely feel better than using products obtained from an industrial method.

90,000 Vomiting and diarrhea in children

What causes vomiting and diarrhea?
Vomiting and diarrhea (frequent watery stools) are often caused by viruses, bacteria or parasites. Hard-to-digest foods or undercooked meat or fish can also cause them.
These symptoms are dangerous to the baby as they cause dehydration. And this happens when the body loses too much fluid.

Signs of dehydration

  • Urination occurs less frequently than usual
  • Dark urine
  • Thirst
  • Irritability
  • Slimming
  • Dry mouth

Prevention of dehydration in a child?
If your child has had multiple bouts of vomiting or diarrhea, his body will need to replace the lost fluids and electrolytes.
In case of hepatitis B breastfeeding should not be interrupted, as it contains substances necessary for the child’s body, which prevent dehydration. In some cases, a solution for oral dehydration is indicated (rehydron, gastrolitis).
For toddlers and young children, use an oral dehydration solution that contains the optimal combination of salts, glucose, potassium, sodium, and other nutrients to help the body compensate for lost fluids.
These products are usually sold in pharmacies, but you can make a homemade oral dehydration solution by mixing 8 teaspoons of sugar and 1 teaspoon of salt per 800 ml.boiled water. This mixture does not contain enough potassium, so it is recommended that you drink a glass of orange juice or eat a banana after taking it.
For children over 1 year old, it is recommended to eat fat-free broths, cereals on water, decoctions of rose hips, black currants, tea or juice diluted with water. Juices with a high sugar content (grape, apricot, plum) are excluded, which enhance the fermentation processes in the intestine.
Avoid foods high in sugar, spicy and fatty foods, as well as dairy products, with the exception of freshly prepared cottage cheese.
Most children can return to normal meals 3 days after the diarrhea ends.

Should my child be given medications to stop diarrhea?
In any case, you will need to contact your pediatrician. Perhaps the above recommendations will be sufficient for treatment. In cases of severe dehydration, urgent hospitalization and subsequent antibiotic treatment will be required.

Calling a doctor in case of vomiting and diarrhea is necessary in the following cases:

  • If the child is less than 6 months old
  • Body temperature 38 and above
  • There are signs of dehydration (see Ref.above)
  • There was repeated vomiting
  • There is blood in the stool
  • Persistent abdominal pain
  • Do you suspect that the child has eaten a poisonous substance

Is it possible to prevent vomiting and diarrhea in a child?
Vomiting and diarrhea are caused by foods that are difficult for children to digest. Make sure your child is eating healthy foods.
Most infections that cause diarrhea are caused by viruses and bacteria found in feces.Make sure your child washes their hands, especially after using the toilet.


Smooth leather is the general name for all leathers with a smooth natural grain surface.

Aniline leather – leather dyed with organic dyes with minimal processing.

Laika – leather made from sheepskin, goat skins, dog skins, has high ductility and softness.It is used for sewing gloves, top of model shoes.

Nappa – extra thin leather of increased elasticity, made from cattle hides.

Suede – rough oil-tanned leather. The peculiarity of making suede consists in removing the front layer and finishing both the front and the bakhtarmya side.

Velor – chrome-tanned leather, with the front or fringe side treated by sanding.Has a soft short velvety bristle.

Nubuck – chrome-tanned fleecy leather with a brushed front surface.

Patent leather – chrome tanned leather with lacquer coating or film.

Fatty leather – smooth or rough leather with a surface treated with a special fatty compound.

Beeswax – Natural wax is obtained directly from bees’ hives.It is well absorbed into the skin, contributes to the formation of a protective layer on the skin surface, preventing its dehydration, makes the skin soft, velvety and lasting shine.

Carnauba wax – stands out from the leaves of the carnauba palm. It is the hardest natural wax in the world. Creates a protective layer, preventing the skin from scratching, imparts a deep, noble shine.

Lanolin – wool fat obtained by processing sheep wool.In terms of its indicator, it is close to the fat produced by human skin. Well-regenerates dry and chapped skin.