Druvith/medqa1 huggingface dataset:
Question:  What is (are) Thalassemias ?
Answer: Thalassemias (thal-a-SE-me-ahs) are inherited blood disorders. "Inherited" means that the disorder is passed from parents to children through genes.
                
Thalassemias cause the body to make fewer healthy red blood cells and less hemoglobin (HEE-muh-glow-bin) than normal. Hemoglobin is an iron-rich protein in red blood cells. It carries oxygen to all parts of the body. Hemoglobin also carries carbon dioxide (a waste gas) from the body to the lungs, where it's exhaled.
                
People who have thalassemias can have mild or severe anemia (uh-NEE-me-uh). Anemia is caused by a lower than normal number of red blood cells or not enough hemoglobin in the red blood cells.
                
Overview
                
Normal hemoglobin, also called hemoglobin A, has four protein chainstwo alpha globin and two beta globin. The two major types of thalassemia, alpha and beta, are named after defects in these protein chains.
                
Four genes (two from each parent) are needed to make enough alpha globin protein chains. Alpha thalassemia trait occurs if one or two of the four genes are missing. If more than two genes are missing, moderate to severe anemia occurs.
                
The most severe form of alpha thalassemia is called alpha thalassemia major or hydrops fetalis. Babies who have this disorder usually die before or shortly after birth.
                
Two genes (one from each parent) are needed to make enough beta globin protein chains. Beta thalassemia occurs if one or both genes are altered.
                
The severity of beta thalassemia depends on how much one or both genes are affected. If both genes are affected, the result is moderate to severe anemia. The severe form of beta thalassemia is known as thalassemia major or Cooley's anemia.
                
Thalassemias affect males and females. The disorders occur most often among people of Italian, Greek, Middle Eastern, Southern Asian, and African descent. Severe forms usually are diagnosed in early childhood and are lifelong conditions.
                
Doctors diagnose thalassemias using blood tests. The disorders are treated with blood transfusions, medicines, and other procedures.
                
Outlook
                
Treatments for thalassemias have improved over the years. People who have moderate or severe thalassemias are now living longer and have better quality of life.
                
However, complications from thalassemias and their treatments are frequent. People who have moderate or severe thalassemias must closely follow their treatment plans. They need to take care of themselves to remain as healthy as possible.
Question:  What causes Thalassemias ?
Answer: Your body makes three types of blood cells: red blood cells, white blood cells, and platelets (PLATE-lets). Red blood cells contain hemoglobin, an iron-rich protein that carries oxygen from your lungs to all parts of your body. Hemoglobin also carries carbon dioxide (a waste gas) from your body to your lungs, where it's exhaled.
                
Hemoglobin has two kinds of protein chains: alpha globin and beta globin. If your body doesn't make enough of these protein chains or they're abnormal, red blood cells won't form correctly or carry enough oxygen. Your body won't work well if your red blood cells don't make enough healthy hemoglobin.
                
Genes control how the body makes hemoglobin protein chains. When these genes are missing or altered, thalassemias occur.
                
Thalassemias are inherited disordersthat is, they're passed from parents to children through genes. People who inherit faulty hemoglobin genes from one parent but normal genes from the other are called carriers. Carriers often have no signs of illness other than mild anemia. However, they can pass the faulty genes on to their children.
                
People who have moderate to severe forms of thalassemia have inherited faulty genes from both parents.
                
Alpha Thalassemias
                
You need four genes (two from each parent) to make enough alpha globin protein chains. If one or more of the genes is missing, you'll have alpha thalassemia trait or disease. This means that your body doesn't make enough alpha globin protein.
                
If you're only missing one gene, you're a "silent" carrier. This means you won't have any signs of illness.
                
If you're missing two genes, you have alpha thalassemia trait (also called alpha thalassemia minor). You may have mild anemia.
                
If you're missing three genes, you likely have hemoglobin H disease (which a blood test can detect). This form of thalassemia causes moderate to severe anemia.
                
Very rarely, a baby is missing all four genes. This condition is called alpha thalassemia major or hydrops fetalis. Babies who have hydrops fetalis usually die before or shortly after birth.
                
Example of an Inheritance Pattern for Alpha Thalassemia
                

                
Beta Thalassemias
                
You need two genes (one from each parent) to make enough beta globin protein chains. If one or both of these genes are altered, you'll have beta thalassemia. This means that your body wont make enough beta globin protein.
                
If you have one altered gene, you're a carrier. This condition is called beta thalassemia trait or beta thalassemia minor. It causes mild anemia.
                
If both genes are altered, you'll have beta thalassemia intermedia or beta thalassemia major (also called Cooley's anemia). The intermedia form of the disorder causes moderate anemia. The major form causes severe anemia.
                
Example of an Inheritance Pattern for Beta Thalassemia
Question:  Who is at risk for Thalassemias? ?
Answer: Family history and ancestry are the two risk factors for thalassemias.
                
Family History
                
Thalassemias are inheritedthat is, the genes for the disorders are passed from parents to their children. If your parents have missing or altered hemoglobin-making genes, you may have thalassemia.
                
Ancestry
                
Thalassemias occur most often among people of Italian, Greek, Middle Eastern, Southern Asian, and African descent.
Question:  How to diagnose Thalassemias ?
Answer: Doctors diagnose thalassemias using blood tests, including a complete blood count (CBC) and special hemoglobin tests.
                
A CBC measures the amount of hemoglobin and the different kinds of blood cells, such as red blood cells, in a sample of blood. People who have thalassemias have fewer healthy red blood cells and less hemoglobin than normal in their blood. People who have alpha or beta thalassemia trait may have red blood cells that are smaller than normal.
                
Hemoglobin tests measure the types of hemoglobin in a blood sample. People who have thalassemias have problems with the alpha or beta globin protein chains of hemoglobin.
                
Moderate and severe thalassemias usually are diagnosed in early childhood. This is because signs and symptoms, including severe anemia, often occur within the first 2years of life.
                
People who have milder forms of thalassemia might be diagnosed after a routine blood test shows they have anemia. Doctors might suspect thalassemia if a person has anemia and is a member of an ethnic group that's at increased risk for thalassemias. (For more information, go to "Who Is at Risk for Thalassemias?")
                
Doctors also test the amount of iron in the blood to find out whether the anemia is due to iron deficiency or thalassemia. Iron-deficiency anemia occurs if the body doesn't have enough iron to make hemoglobin. The anemia in thalassemia occurs because of a problem with either the alpha globin or beta globin chains of hemoglobin, not because of a lack of iron.
                
Because thalassemias are passed from parents to children through genes, family genetic studies also can help diagnose the disorder. These studies involve taking a family medical history and doing blood tests on family members. The tests will show whether any family members have missing or altered hemoglobin genes.
                
If you know of family members who have thalassemias and you're thinking of having children, consider talking with your doctor and a genetic counselor. They can help determine your risk for passing the disorder to your children.
                
If you're expecting a baby and you and your partner are thalassemia carriers, you may want to consider prenatal testing.
                
Prenatal testing involves taking a sample of amniotic fluid or tissue from the placenta. (Amniotic fluid is the fluid in the sac surrounding a growing embryo. The placenta is the organ that attaches the umbilical cord to the mother's womb.) Tests done on the fluid or tissue can show whether your baby has thalassemia and how severe it might be.
Question:  How to prevent Thalassemias ?
Answer: You cant prevent thalassemias because theyre inherited (passed from parents to children through genes). However, prenatal tests can detect these blood disorders before birth.
                
Family genetic studies may help find out whether people have missing or altered hemoglobin genes that cause thalassemias. (For more information, go to "How Are Thalassemias Diagnosed?")
                
If you know of family members who have thalassemias and you're thinking of having children, consider talking with your doctor and a genetic counselor. They can help determine your risk for passing the disorder to your children.
Question:  What causes Fanconi Anemia ?
Answer: Fanconi anemia (FA) is an inherited disease. The term inherited means that the disease is passed from parents to children through genes. At least 13 faulty genes are associated with FA. FA occurs when both parents pass the same faulty FA gene to their child.
                
People who have only one faulty FA gene are FA "carriers." Carriers don't have FA, but they can pass the faulty gene to their children.
                
If both of your parents have a faulty FA gene, you have:
                
A 25 percent chance of having FA
                
A 25 percent chance of not having FA
                
A 50 percent chance of being an FA carrier and passing the gene to any children you have
                
If only one of your parents has a faulty FA gene, you won't have the disorder. However, you have a 50 percent chance of being an FA carrier and passing the gene to any children you have.
Question:  Who is at risk for Fanconi Anemia? ?
Answer: Fanconi anemia (FA) occurs in all racial and ethnic groups and affects men and women equally.
                
In the United States, about 1 out of every 181 people is an FA carrier. This carrier rate leads to about 1 in 130,000 people being born with FA.
                
Two ethnic groups, Ashkenazi Jews and Afrikaners, are more likely than other groups to have FA or be FA carriers.
                
Ashkenazi Jews are people who are descended from the Jewish population of Eastern Europe. Afrikaners are White natives of South Africa who speak a language called Afrikaans. This ethnic group is descended from early Dutch, French, and German settlers.
                
In the United States, 1 out of 90 Ashkenazi Jews is an FA carrier, and 1 out of 30,000 is born with FA.
                
Major Risk Factors
                
FA is an inherited diseasethat is, it's passed from parents to children through genes. At least 13 faulty genes are associated with FA. FA occurs if both parents pass the same faulty FA gene to their child.
                
Children born into families with histories of FA are at risk of inheriting the disorder. Children whose mothers and fathers both have family histories of FA are at even greater risk. A family history of FA means that it's possible that a parent carries a faulty gene associated with the disorder.
                
Children whose parents both carry the same faulty gene are at greatest risk of inheriting FA. Even if these children aren't born with FA, they're still at risk of being FA carriers.
                
Children who have only one parent who carries a faulty FA gene also are at risk of being carriers. However, they're not at risk of having FA.
Question:  How to prevent Fanconi Anemia ?
Answer: ou can't prevent Fanconi anemia (FA) because it's an inherited disease. If a child gets two copies of the same faulty FA gene, he or she will have the disease.
                
If you're at high risk for FA and are planning to have children, you may want to consider genetic counseling. A counselor can help you understand your risk of having a child who has FA. He or she also can explain the choices that are available to you.
                
If you're already pregnant, genetic testing can show whether your child has FA. For more information on genetic testing, go to "How Is Fanconi Anemia Diagnosed?"
                
In the United States, Ashkenazi Jews (Jews of Eastern European descent) are at higher risk for FA than other ethnic groups. For Ashkenazi Jews, it's recommended that prospective parents get tested for FA-related gene mutations before getting pregnant.
                
Preventing Complications
                
If you or your child has FA, you can prevent some health problems related to the disorder. Pneumonia, hepatitis, and chicken pox can occur more often and more severely in people who have FA compared with those who don't. Ask your doctor about vaccines for these conditions.
                
People who have FA also are at higher risk than other people for some cancers. These cancers include leukemia (a type of blood cancer), myelodysplastic syndrome (abnormal levels of all three types of blood cells), and liver cancer. Screening and early detection can help manage these life-threatening diseases.
Question:  What causes Atrial Fibrillation ?
Answer: Atrial fibrillation (AF) occurs if the heart's electrical signals don't travel through the heart in a normal way. Instead, they become very rapid and disorganized.
                
Damage to the heart's electrical system causes AF. The damage most often is the result of other conditions that affect the health of the heart, such as high blood pressure and coronary heart disease.
                
The risk of AF increases as you age. Inflammation also is thought to play a role in causing AF.
                
Sometimes, the cause of AF is unknown.
Question:  Who is at risk for Atrial Fibrillation? ?
Answer: Atrial fibrillation (AF) affects millions of people, and the number is rising. Men are more likely than women to have the condition. In the United States, AF is more common among Whites than African Americans or Hispanic Americans.
                
The risk of AF increases as you age. This is mostly because your risk for heart disease and other conditions that can cause AF also increases as you age. However, about half of the people who have AF are younger than 75.
                
AF is uncommon in children.
                
Major Risk Factors
                
AF is more common in people who have:
                
High blood pressure
                
Coronary heart disease (CHD)
                
Heart failure
                
Rheumatic (ru-MAT-ik) heart disease
                
Structural heart defects, such as mitral valve prolapse
                
Pericarditis (PER-i-kar-DI-tis; a condition in which the membrane, or sac, around your heart is inflamed)
                
Congenital heart defects
                
Sick sinus syndrome (a condition in which the heart's electrical signals don't fire properly and the heart rate slows down; sometimes the heart will switch back and forth between a slow rate and a fast rate)
                
AF also is more common in people who are having heart attacks or who have just had surgery.
                
Other Risk Factors
                
Other conditions that raise your risk for AF include hyperthyroidism (too much thyroid hormone), obesity, diabetes, and lung disease.
                
Certain factors also can raise your risk for AF. For example, drinking large amounts of alcohol, especially binge drinking, raises your risk. Even modest amounts of alcohol can trigger AF in some people. Caffeine or psychological stress also may trigger AF in some people.
                
Some data suggest that people who have sleep apnea are at greater risk for AF. Sleep apnea is a common disorder that causes one or more pauses in breathing or shallow breaths while you sleep.
                
Metabolic syndrome also raises your risk for AF. Metabolic syndrome is the name for a group of risk factors that raises your risk for CHD and other health problems, such as diabetes and stroke.
                
Research suggests that people who receive high-dose steroid therapy are at increased risk for AF. This therapy is used for asthma and some inflammatory conditions. It may act as a trigger in people who have other AF risk factors.
                
Genetic factors also may play a role in causing AF. However, their role isn't fully known.
Question:  What are the symptoms of Atrial Fibrillation ?
Answer: Atrial fibrillation (AF) usually causes the heart's lower chambers, the ventricles, to contract faster than normal.
                
When this happens, the ventricles can't completely fill with blood. Thus, they may not be able to pump enough blood to the lungs and body. This can lead to signs and symptoms, such as:
                
Palpitations (feelings that your heart is skipping a beat, fluttering, or beating too hard or fast)
                
Shortness of breath
                
Weakness or problems exercising
                
Chest pain
                
Dizziness or fainting
                
Fatigue (tiredness)
                
Confusion
                
Atrial Fibrillation Complications
                
AF has two major complicationsstroke and heart failure.
                
Stroke
                
During AF, the heart's upper chambers, the atria, don't pump all of their blood to the ventricles. Some blood pools in the atria. When this happens, a blood clot (also called a thrombus) can form.
                
If the clot breaks off and travels to the brain, it can cause a stroke. (A clot that forms in one part of the body and travels in the bloodstream to another part of the body is called an embolus.)
                
Blood-thinning medicines that reduce the risk of stroke are an important part of treatment for people who have AF.
                
Atrial Fibrillation and Stroke
                

                
Heart Failure
                
Heart failure occurs if the heart can't pump enough blood to meet the body's needs. AF can lead to heart failure because the ventricles are beating very fast and can't completely fill with blood. Thus, they may not be able to pump enough blood to the lungs and body.
                
Fatigue and shortness of breath are common symptoms of heart failure. A buildup of fluid in the lungs causes these symptoms. Fluid also can build up in the feet, ankles, and legs, causing weight gain.
                
Lifestyle changes, medicines, and procedures or surgery (rarely, a mechanical heart pump or heart transplant) are the main treatments for heart failure.
Question:  How to prevent Atrial Fibrillation ?
Answer: Following a healthy lifestyle and taking steps to lower your risk for heart disease may help you prevent atrial fibrillation (AF). These steps include:
                
Following a heart healthy diet that's low in saturated fat, trans fat, and cholesterol. A healthy diet includes a variety of whole grains, fruits, and vegetables daily.
                
Not smoking.
                
Being physically active.
                
Maintaining a healthy weight.
                
If you already have heart disease or other AF risk factors, work with your doctor to manage your condition. In addition to adopting the healthy habits above, which can help control heart disease, your doctor may advise you to: 
                
Follow the DASH eating plan to help lower your blood pressure.
                
Keep your cholesterol and triglycerides at healthy levels with dietary changes and medicines (if prescribed).
                
Limit or avoid alcohol.
                
Control your blood sugar level if you have diabetes.
                
Get ongoing medical care and take your medicines as prescribed.
                
For more information about following a healthy lifestyle, visit the National Heart, Lung, and Blood Institute's Aim for a Healthy Weight Web site, "Your Guide to a Healthy Heart," "Your Guide to Lowering Your Blood Pressure With DASH," and "Your Guide to Physical Activity and Your Heart."
Question:  Who is at risk for Angina? ?
Answer: Angina is a symptom of an underlying heart problem. Its usually a symptom of coronary heart disease (CHD), but it also can be a symptom of coronary microvascular disease (MVD). So, if youre at risk for CHD or coronary MVD, youre also at risk for angina.
                
The major risk factors for CHD and coronary MVD include:
                
Unhealthy cholesterol levels.
                
High blood pressure.
                
Smoking.
                
Insulin resistance or diabetes.
                
Overweight or obesity.
                
Metabolic syndrome.
                
Lack of physical activity.
                
Unhealthy diet.
                
Older age. (The risk increases for men after 45 years of age and for women after 55 years of age.)
                
Family history of early heart disease.
                
For more detailed information about CHD and coronary MVD risk factors, visit the Diseases and Conditions Index Coronary Heart Disease, Coronary Heart Disease Risk Factors, and Coronary Microvascular Disease articles.
                
People sometimes think that because men have more heart attacks than women, men also suffer from angina more often. In fact, overall, angina occurs equally among men and women.
                
Microvascular angina, however, occurs more often in women. About 70 percent of the cases of microvascular angina occur in women around the time of menopause.
                
Unstable angina occurs more often in older adults. Variant angina is rare; it accounts for only about 2 out of 100 cases of angina. People who have variant angina often are younger than those who have other forms of angina.