Druvith/medqa huggingface dataset:
Who is at risk for Am I at Risk for Type 2 Diabetes? Taking Steps to Lower Your Risk of Getting Diabetes? ? 

To find out your risk for type 2 diabetes, check each item that applies to you.
                
- I am age 45 or older.  - I am overweight or obese.  - I have a parent, brother, or sister with diabetes.  - My family background is African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, or Pacific Islander American.  - I have had gestational diabetes.  - I gave birth to at least one baby weighing more than 9 pounds.  - My blood pressure is 140/90 or higher, or I have been told that I have high blood pressure.  - My cholesterol levels are higher than normal. My HDL, or good, cholesterol is below 35, or my triglyceride level is above 250.  - I am fairly inactive.  - I have polycystic ovary syndrome, also called PCOS.  - On previous testing, I had prediabetesan A1C level of 5.7 to 6.4 percent, impaired fasting glucose (IFG), or impaired glucose tolerance (IGT).  - I have other clinical conditions associated with insulin resistance, such as a condition called acanthosis nigricans, characterized by a dark, velvety rash around my neck or armpits.  - I have a history of cardiovascular disease.
                
The more items you checked, the higher your risk.
                

                
Does sleep matter?   Yes. Studies show that untreated sleep problems, especially sleep apnea, can increase the risk of type 2 diabetes. Sleep apnea is a common disorder in which you have pauses in breathing or shallow breaths while you sleep. Most people who have sleep apnea dont know they have it and it often goes undiagnosed. Night shift workers who have problems with sleepiness may also be at increased risk for obesity and type 2 diabetes.   If you think you might have sleep problems, ask your doctor for help. More information about sleep problems is available from the National Heart Lung and Blood Institute at http://www.nhlbi.nih.gov/health/resources/sleep.
Who is at risk for Am I at Risk for Type 2 Diabetes? Taking Steps to Lower Your Risk of Getting Diabetes? ? 

You can do a lot to reduce your risk of getting type 2 diabetes. Being more physically active, reducing fat and calorie intake, and losing a little weight can help you lower your chances of developing type 2 diabetes. Taking the diabetes medicine metformin can also reduce risk, particularly in younger and heavier people with prediabetes and women who have had gestational diabetes. Lowering blood pressure and cholesterol levels also helps you stay healthy.
                
If you are overweight, then take these steps:
                
- Reach and maintain a reasonable body weight. Even a 10 or 15 pound weight loss makes a big difference.  - Make wise food choices most of the time.  - Be physically active every day.
                
If you are fairly inactive, then take this step:
                
- Be physically active every day.
                
If your blood pressure is too high, then take these steps:
                
- Reach and maintain a reasonable body weight.  - Make wise food choices most of the time.  - Reduce your sodium and alcohol intake.  - Be physically active every day.  - Talk with your doctor about whether you need medicine to control your blood pressure.
                
If your cholesterol or triglyceride levels are too high, then take these steps:
                
- Make wise food choices most of the time.  - Be physically active every day.  - Talk with your doctor about whether you need medicine to control your cholesterol levels.
What to do for Am I at Risk for Type 2 Diabetes? Taking Steps to Lower Your Risk of Getting Diabetes ? 

Your eating, diet, and nutrition choices play an important role in preventing or delaying diabetes. Follow the suggestions below to reach and maintain a reasonable weight and make wise food choices most of the time. Remember that it can take time to change your habits and be patient with yourself. You can also get help from a dietitian or join a weight-loss program to support you while you reach your goals.
                

                
Reach and Maintain a Reasonable Body Weight
                
Your weight affects your health in many ways. Being overweight can keep your body from making and using insulin properly. Excess body weight can also cause high blood pressure. Every pound you lose lowers your risk of getting diabetes.
                
In addition to weight, the location of excess fat on the body can be important. A waist measurement of 40 inches or more for men and 35 inches or more for women is linked to insulin resistance and increases a persons risk for type 2 diabetes. This is true even if your BMI falls within the normal range.
                

                
Find Your BMI
                
The BMI is a measure of body weight relative to height. The BMI can help you find out whether you are normal weight, overweight, or obese. Use the table on pages 24 and 25 to find your BMI.
                
- Find your height in the left-hand column.  - Move across in the same row to the number closest to your weight.  - The number at the top of that column is your BMI. Check the word above your BMI to see whether you are normal weight, overweight, or obese.
                
The BMI has certain limitations. The BMI may overestimate body fat in athletes and others who have a muscular build and underestimate body fat in older adults and others who have lost muscle.
                
The BMI for children and teens must be determined based on age, height, weight, and sex. The Centers for Disease Control and Prevention (CDC) has information about BMI in children and teens, including a BMI calculator, at www.cdc.gov/nccdphp/dnpa/bmi. The CDC website also has a BMI calculator for adults. A BMI calculator from the NIH is available at www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm.
                
The NIH also has a free smartphone app for calculating BMI. You can search My BMI Calculator on your phone to find the app. The app also provides links to information about steps you can take to bring your BMI into a healthy range.
What is (are) Medullary Sponge Kidney ? 

Medullary sponge kidney, also known as Cacchi-Ricci disease, is a birth defect where changes occur in the tubules, or tiny tubes, inside a fetus kidneys.
                
In a normal kidney, urine flows through these tubules as the kidney is being formed during a fetus growth. In medullary sponge kidney, tiny, fluid-filled sacs called cysts form in the tubules within the medullathe inner part of the kidneycreating a spongelike appearance. The cysts keep urine from flowing freely through the tubules.
                
Symptoms of medullary sponge kidney do not usually appear until the teenage years or the 20s. Medullary sponge kidney can affect one or both kidneys.
What are the complications of Medullary Sponge Kidney ? 

Complications of medullary sponge kidney include
                
- hematuria, or blood in the urine  - kidney stones  - urinary tract infections (UTIs)
                
Medullary sponge kidney rarely leads to more serious problems, such as chronic kidney disease or kidney failure.
What causes Medullary Sponge Kidney ? 

Scientists do not fully understand the cause of medullary sponge kidney or why cysts form in the tubules during fetal development. Even though medullary sponge kidney is present at birth, most cases do not appear to be inherited.
How many people are affected by Medullary Sponge Kidney ? 

Medullary sponge kidney affects about one person per 5,000 people in the United States. Researchers have reported that 12 to 20 percent of people who develop calcium-based kidney stones have medullary sponge kidney1.
What are the symptoms of Medullary Sponge Kidney ? 

Many people with medullary sponge kidney have no symptoms. The first sign that a person has medullary sponge kidney is usually a UTI or a kidney stone. UTIs and kidney stones share many of the same signs and symptoms:
                
- burning or painful urination  - pain in the back, lower abdomen, or groin  - cloudy, dark, or bloody urine  - foul-smelling urine  - fever and chills  - vomiting
                
People who experience these symptoms should see or call a health care provider as soon as possible.
How to diagnose Medullary Sponge Kidney ? 

A health care provider diagnoses medullary sponge kidney based on
                
- a medical and family history  - a physical exam  - imaging studies
                
Medical and Family History
                
Taking a medical and family history can help diagnose medullary sponge kidney. A health care provider will suspect medullary sponge kidney when a person has repeated UTIs or kidney stones.
                
Physical Exam
                
No physical signs are usually present in a patient with medullary sponge kidney, except for blood in the urine. Health care providers usually confirm a diagnosis of medullary sponge kidney with imaging studies.
                
Imaging Studies
                
Imaging is the medical term for tests that use different methods to see bones, tissues, and organs inside the body. Health care providers commonly choose one or more of three imaging techniques to diagnose medullary sponge kidney:
                
- intravenous pyelogram  - computerized tomography (CT) scan  - ultrasound
                
A radiologista doctor who specializes in medical imaginginterprets the images from these studies, and patients do not need anesthesia.
                
Intravenous Pyelogram
                
In an intravenous pyelogram, a health care provider injects a special dye, called contrast medium, into a vein in the patients arm. The contrast medium travels through the body to the kidneys. The kidneys excrete the contrast medium into urine, which makes the urine visible on an x-ray. An x-ray technician performs this procedure at a health care providers office, an outpatient center, or a hospital. An intravenous pyelogram can show any blockage in the urinary tract, and the cysts show up as clusters of light.
                
Computerized Tomography Scans
                
Computerized tomography scans use a combination of x-rays and computer technology to create images. For a CT scan, a health care provider may give the patient a solution to drink and an injection of contrast medium. CT scans require the patient to lie on a table that slides into a tunnel-shaped device where the x-rays are taken. An x-ray technician performs the procedure in an outpatient center or a hospital. CT scans can show expanded or stretched tubules.
                
Ultrasound
                
Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. A specially trained technician performs the procedure in a health care providers office, an outpatient center, or a hospital. Ultrasound can show kidney stones and calcium deposits within the kidney.
What are the treatments for Medullary Sponge Kidney ? 

Scientists have not discovered a way to reverse medullary sponge kidney. Once a health care provider is sure a person has medullary sponge kidney, treatment focuses on
                
- curing an existing UTI  - removing any kidney stones
                
Curing an Existing Urinary Tract Infection
                
To treat a UTI, the health care provider may prescribe a medication called an antibiotic that kills bacteria. The choice of medication and length of treatment depend on the persons medical history and the type of bacteria causing the infection. More information is provided in the NIDDK health topic, Urinary Tract Infections in Adults.
                
Removing Kidney Stones
                
Treatment for kidney stones usually depends on their size and what they are made of, as well as whether they are causing pain or obstructing the urinary tract. Kidney stones may be treated by a general practitioner or by a urologista doctor who specializes in the urinary tract.
                
Small stones usually pass through the urinary tract without treatment. Still, the person may need pain medication and should drink lots of liquids to help move the stone along. Pain control may consist of oral or intravenous (IV) medication, depending on the duration and severity of the pain. People may need IV fluids if they become dehydrated from vomiting or an inability to drink.
                
A person with a larger stone, or one that blocks urine flow and causes great pain, may need more urgent treatment, such as
                
- shock wave lithotripsy. A machine called a lithotripter is used to break up the kidney stone into smaller pieces to pass more easily through the urinary tract. The patient may need local or general anesthesia.  - ureteroscopy. A ureteroscopea long, tubelike instrument with an eyepieceis used to find and retrieve the stone with a small basket or to break the stone up with laser energy. Local or general anesthesia may be required.  - percutaneous nephrolithotomy. In this procedure, a wire-thin viewing instrument, called a nephroscope, is used to locate and remove the stones. During the procedure, which requires general anesthesia, a tube is inserted directly into the kidney through a small incision in the patients back.
                
More information is provided in the NIDDK health topic, Kidney Stones in Adults.
How to prevent Medullary Sponge Kidney ? 

Scientists have not yet found a way to prevent medullary sponge kidney. However, health care providers can recommend medications and dietary changes to prevent future UTIs and kidney stones.
How to prevent Medullary Sponge Kidney ? 

Health care providers may prescribe certain medications to prevent UTIs and kidney stones:
                
- A person with medullary sponge kidney may need to continue taking a low-dose antibiotic to prevent recurrent infections.  - Medications that reduce calcium in the urine may help prevent calcium kidney stones. These medications may include      - potassium citrate    - thiazide
What to do for Medullary Sponge Kidney ? 

The following changes in diet may help prevent UTIs and kidney stone formation:
                
- Drinking plenty of water and other liquids can help flush bacteria from the urinary tract and dilute urine so kidney stones cannot form. A person should drink enough liquid to produce about 2 to 2.5 quarts of urine every day.3  - Reducing sodium intake, mostly from salt, may help prevent kidney stones. Diets high in sodium can increase the excretion of calcium into the urine and thus increase the chance of calciumcontaining kidney stones forming.  - Foods rich in animal proteins such as meat, eggs, and fish can increase the chance of uric acid stones and calcium stones forming. People who form stones should limit their meat consumption to 6 to 8 ounces a day.4  - People who are more likely to develop calcium oxalate stones should include 1,000 milligrams of calcium in their diet every day. Adults older than 50 years should consume 1,200 milligrams of calcium daily.3 Calcium in the digestive tract binds to oxalate from food and keeps it from entering the blood and the urinary tract, where it can form stones.
                
People with medullary sponge kidney should talk with their health care provider or a dietitian before making any dietary changes. A dietitian can help a person plan healthy meals.
What to do for Medullary Sponge Kidney ? 

- Medullary sponge kidney, also known as Cacchi-Ricci disease, is a birth defect where changes occur in the tubules, or tiny tubes, inside a fetus kidneys.  - Symptoms of medullary sponge kidney do not usually appear until the teenage years or the 20s. Medullary sponge kidney can affect one or both kidneys.  - Complications of medullary sponge kidney include      - hematuria, or blood in the urine    - kidney stones    - urinary tract infections (UTIs)    - Many people with medullary sponge kidney have no symptoms. The first sign that a person has medullary sponge kidney is usually a UTI or a kidney stone. UTIs and kidney stones share many of the same signs and symptoms:      - burning or painful urination    - pain in the back, lower abdomen, or groin    - cloudy, dark, or bloody urine    - foul-smelling urine    - fever and chills    - vomiting    - Health care providers commonly choose one or more of three imaging techniques to diagnose medullary sponge kidney:      - intravenous pyelogram    - computerized tomography (CT) scan    - ultrasound    - Scientists have not discovered a way to reverse medullary sponge kidney. Once a health care provider is sure a person has medullary sponge kidney, treatment focuses on      - curing an existing UTI    - removing any kidney stones    - Scientists have not yet found a way to prevent medullary sponge kidney. However, health care providers can recommend medications and dietary changes to prevent future UTIs and kidney stones.
What is (are) Vesicoureteral Reflux ? 

Vesicoureteral reflux is the abnormal flow of urine from the bladder to the upper urinary tract. The urinary tract is the bodys drainage system for removing wastes and extra water. The urinary tract includes two kidneys, two ureters, a bladder, and a urethra. Blood flows through the kidneys, and the kidneys filter out wastes and extra water, making urine. The urine travels down two narrow tubes called the ureters. The urine is then stored in a balloonlike organ called the bladder. When the bladder empties, urine flows out of the body through a tube called the urethra at the bottom of the bladder.
                
In VUR, urine may flow backrefluxinto one or both ureters and, in some cases, to one or both kidneys. VUR that affects only one ureter and kidney is called unilateral reflux, and VUR that affects both ureters and kidneys is called bilateral reflux.
Who is at risk for Vesicoureteral Reflux? ? 

Vesicoureteral reflux is more common in infants and young children, but older children and even adults can be affected. About 10 percent of children have VUR.1 Studies estimate that VUR occurs in about 32 percent of siblings of an affected child. This rate may be as low as 7 percent in older siblings and as high as 100 percent in identical twins. These findings indicate that VUR is an inherited condition.2
What is (are) Vesicoureteral Reflux ? 

The two types of VUR are primary and secondary. Most cases of VUR are primary and typically affect only one ureter and kidney. With primary VUR, a child is born with a ureter that did not grow long enough during the childs development in the womb. The valve formed by the ureter pressing against the bladder wall does not close properly, so urine refluxes from the bladder to the ureter and eventually to the kidney. This type of VUR can get better or disappear as a child gets older. As a child grows, the ureter gets longer and function of the valve improves.
                
Secondary VUR occurs when a blockage in the urinary tract causes an increase in pressure and pushes urine back up into the ureters. Children with secondary VUR often have bilateral reflux. VUR caused by a physical defect typically results from an abnormal fold of tissue in the urethra that keeps urine from flowing freely out of the bladder.
                
VUR is usually classified as grade I through V, with grade I being the least severe and grade V being the most severe.
What are the symptoms of Vesicoureteral Reflux ? 

In many cases, a child with VUR has no symptoms. When symptoms are present, the most common is a urinary tract infection (UTI). VUR can lead to infection because urine that remains in the childs urinary tract provides a place for bacteria to grow. Studies estimate that 30 percent of children and up to 70 percent of infants with a UTI have VUR.2
What are the complications of Vesicoureteral Reflux ? 

When a child with VUR gets a UTI, bacteria can move into the kidney and lead to scarring. Scarring of the kidney can be associated with high blood pressure and kidney failure. However, most children with VUR who get a UTI recover without long-term complications.
How to diagnose Vesicoureteral Reflux ? 

The most common tests used to diagnose VUR include
                
- Voiding cystourethrogram (VCUG). VCUG is an x-ray image of the bladder and urethra taken during urination, also called voiding. The bladder and urethra are filled with a special dye, called contrast medium, to make the urethra clearly visible. The x-ray machine captures a video of the contrast medium when the child urinates. The procedure is performed in a health care providers office, outpatient center, or hospital by an x-ray technician supervised by a radiologista doctor who specializes in medical imagingwho then interprets the images. Anesthesia is not needed, but sedation may be used for some children. This test can show abnormalities of the inside of the urethra and bladder.  - Radionuclide cystogram (RNC). RNC is a type of nuclear scan that involves placing radioactive material into the bladder. A scanner then detects the radioactive material as the child urinates or after the bladder is empty. The procedure is performed in a health care providers office, outpatient center, or hospital by a specially trained technician, and the images are interpreted by a radiologist. Anesthesia is not needed, but sedation may be used for some children. RNC is more sensitive than VCUG but does not provide as much detail of the bladder anatomy.  - Abdominal ultrasound. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. An abdominal ultrasound can create images of the entire urinary tract, including the kidneys and bladder. The procedure is performed in a health care providers office, outpatient center, or hospital by a specially trained technician, and the images are interpreted by a radiologist; anesthesia is not needed. Ultrasound may be used before VCUG or RNC if the childs family or health care provider wants to avoid exposure to x-ray radiation or radioactive material.
                
Testing is usually done on
                
- infants diagnosed during pregnancy with urine blockage affecting the kidneys  - children younger than 5 years of age with a UTI  - children with a UTI and fever, called febrile UTI, regardless of age  - males with a UTI who are not sexually active, regardless of age or fever  - children with a family history of VUR, including an affected sibling
                
More information about urine blockage in infants is provided in the NIDDK health topic, Urine Blockage in Newborns.
                
VUR is an unlikely cause of UTI in some children, so these tests are not done until other causes of UTI are ruled out for
                
- children 5 years of age and older with a UTI  - children with a UTI but no fever  - sexually active males with a UTI
How to diagnose Vesicoureteral Reflux ? 

Following diagnosis, children with VUR should have a general medical evaluation that includes blood pressure measurement, as high blood pressure is an indicator of kidney damage. If both kidneys are affected, a childs blood should be tested for creatininea waste product of normal muscle breakdown. Healthy kidneys remove creatinine from the blood; when the kidneys are damaged, creatinine builds up in the blood. The urine may be tested for the presence of protein and bacteria. Protein in the urine is another indication of damaged kidneys.
                
- having to urinate often or suddenly  - long periods of time between bathroom visits  - daytime wetting  - pain in the penis or perineumthe area between the anus and genitals  - posturing to prevent wetting  - constipationa condition in which a child has fewer than two bowel movements in a week; the bowel movements may be painful  - fecal incontinenceinability to hold stool in the colon and rectum, which are parts of the large intestine