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AISC Team D2 6

[ { "ANSWER": "Noonan's syndrome is an eponymic designation that has been used during the last 8 years to describe a variable constellation of somatic and visceral congenital anomalies, which includes groups of patients previously referred to as male Turner's, female pseudo-Turner's and\n\t\t\t\t\tBonnevie-Ullrich syndromes. It is now recognized that both sexes may show the stigmas of this condition and, unlike Turner's syndrome, there is no karyotype abnormality although there is often a familial pattern. The most commonly observed anomalies include webbing of the neck, hypertelorism, a\n\t\t\t\t\tshield-shaped chest and short stature. Congenital heart disease, principally pulmonary stenosis, and sexual infantilism often with cryptorchidism in the male subject are additional associated anomalies in this syndrome. Renal anomalies have been described rarely and usually consist of\n\t\t\t\t\trotational errors, duplications and hydronephrosis. We report the first case of an infant who displayed many of the stigmas of Noonan's syndrome and also showed early evidence of frank renal failure secondary to renal dysplasia with cystic disease.", "AnswerURL": "https://www.ncbi.nlm.nih.gov/pubmed/765504", "COMMENT": "This article is from 1976, and is a case report.", "_aid": "TQ1A1" }, { "ANSWER": "10% of patients with Noonan syndrome have renal abnormalities but most do not need treatment.", "AnswerURL": "http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61023-X/fulltext", "COMMENT": "Often, the questions are about the associations that do not exist, as is in this case: there is one patient with both disorders. Answers about the lack of association or one of the conditions and more general disorders (as renal disease in this case) are relevant.", "_aid": "TQ1A2" }, { "ANSWER": "Genitourinary. Renal abnormalities, generally mild, are present in 11% of individuals with NS. Dilatation of the renal pelvis is most common. Duplex collecting systems, minor rotational anomalies, distal ureteric stenosis, renal hypoplasia, unilateral renal agenesis, unilateral renal\n\t\t\t\t\tectopia, and bilateral cysts with scarring are reported less commonly.", "AnswerURL": "https://www.ncbi.nlm.nih.gov/books/NBK1124/", "COMMENT": "This answer does not specifically address polycystic renal disease but implicitly establishes the lack of association.", "_aid": "TQ1A3" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "noonan syndrome" }, { "_fid": "F2", "_fcategory": "Problem", "__text": "polycystic renal disease" } ]

[ { "_tid": "T1", "_hasFocus": "F1,F2", "__text": "EFFECT", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "Zolmitriptan tablets are available as 2.5 mg (yellow and functionally-scored) and 5 mg (pink, not scored) film coated tablets for oral administration. The film coated tablets contain anhydrous lactose NF, microcrystalline cellulose NF, sodium starch glycolate NF, magnesium stearate NF,\n\t\t\t\t\thydroxypropyl methylcellulose USP, titanium dioxide USP, polyethylene glycol 400 NF, yellow iron oxide NF (2.5 mg tablet), red iron oxide NF (5 mg tablet), and polyethylene glycol 8000 NF.\n\t\t\t\t\tZolmitriptan orally disintegrating tablets are available as 2.5 mg and 5 mg white uncoated tablets. The orally disintegrating tablets contain mannitol USP, microcrystalline cellulose NF, crospovidone NF, aspartame NF [see WARNINGS AND PRECAUTIONS (5.9)], sodium bicarbonate USP, citric acid anhydrous USP,\n\t\t\t\t\tcolloidal silicon dioxide NF, magnesium stearate NF and orange flavor SN 027512.", "AnswerURL": "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=350eb39e-6072-4467-8f57-ed6edcdbccd8", "COMMENT": "A list of ingredients is a relevant answer.", "_aid": "TQ2A1" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "Zolmitriptan" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "INGREDIENT", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "Substance", "__text": "gluten" } ]

[ { "ANSWER": "Active Ingredients\n\t\t\t\t\tAmphetamine Aspartate\n\t\t\t\t\tAmphetamine Sulfate\n\t\t\t\t\tDextroamphetamine Saccharate\n\t\t\t\t\tDextroamphetamine Sulfate\n\t\t\t\t\tInactive Ingredients\n\t\t\t\t\tFD&C Blue No. 1\n\t\t\t\t\tFD&C Yellow No. 6\n\t\t\t\t\tSilicon Dioxide (Colloidal)\n\t\t\t\t\tMicrocrystalline Cellulose\n\t\t\t\t\tSucrose\n\t\t\t\t\tMagnesium Stearate\n\t\t\t\t\tPregelatinized Corn Starch", "AnswerURL": "https://www.cvs.com/drug/amphetamine-salts/oral-tablet/20mg#detailSpInfo", "COMMENT": "A list of ingredients is relevant", "_aid": "TQ3A1" }, { "ANSWER": "A single entity amphetamine product combining the neutral sulfate salts of dextroamphetamine and amphetamine, with the dextro isomer of amphetamine saccharate and d, l-amphetamine aspartate. In addition, each tablet contains the following inactive ingredients: colloidal silicon dioxide,\n\t\t\t\t\tcompressible sugar, corn starch, magnesium stearate, microcrystalline cellulose and saccharin sodium. The 12.5, 15, 20 and 30 mg also contain FD&C yellow no. 6 aluminum lake.", "AnswerURL": "https://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=58963", "COMMENT": "", "_aid": "TQ3A2" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "amphetamine salts" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "INGREDIENT", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "Substance", "__text": "gluten" } ]

[ { "ANSWER": "Syphilis\n\t\t\t\t\tIf the RPR, VDRL, or TRUST tests are positive, one of the following tests will be needed to confirm the diagnosis: FTA-ABS (fluorescent treponemal antibody test); MHA-TP; TP-EIA; TP-PA.\n\t\t\t\t\tSyphilis can be treated with antibiotics, such as: Doxycycline (type of tetracycline given to people who are allergic to penicillin); Penicillin G benzathine.\n\t\t\t\t\tLength of treatment depends on how severe the syphilis is, and factors such as the person's overall health.\n\t\t\t\t\tSeveral hours after getting treatment for the early stages of syphilis, people may experience the Jarisch-Herxheimer reaction. This process is caused by an immune reaction to the breakdown products of the infection.\n\t\t\t\t\tFollow-up blood tests must be done at 3, 6, 12, and 24 months to ensure that the infection is gone. Avoid sexual contact when the chancre is present. Use condoms until two follow-up tests have shown that the infection has been cured, to reduce the chance of transmitting the infection.\n\t\t\t\t\tAll sexual partners of the person with syphilis should also be treated. Syphilis can spread very easily in the primary and secondary stages.", "AnswerURL": "https://medlineplus.gov/ency/article/000861.htm", "COMMENT": "Answers about diagnostic methods after a positive VDRL test, as well as treatment and prevention of the disease and its dissemination are relevant.", "_aid": "TQ4A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "vdrl positive" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "TREATMENT", "_hasKeyword": null }, { "_tid": "T2", "_hasFocus": "F1", "__text": "DIAGNOSIS", "_hasKeyword": null }, { "_tid": "T3", "_hasFocus": "F1", "__text": "PREVENTION", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "GLUCAGEN\n\t\t\t\t\tglucagon hydrochloride injection, powder, for solution\n\t\t\t\t\tIngredient Name: GLUCAGON HYDROCHLORIDE (UNII: 1H87NVF4DB) (GLUCAGON - UNII:76LA80IG2G) Basis of Strength: GLUCAGON Strength:1 mg in 1 mL", "AnswerURL": "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f09feb8e-6651-4708-a811-bb5264712059", "COMMENT": "Answers about the amount of glucagon in the drug dose are relevant", "_aid": "TQ5A1" }, { "ANSWER": "DOSAGE FORMS AND STRENGTHS GlucaGen is supplied in a vial, alone, or accompanied by Sterile Water for Reconstitution (1 mL) also in a vial (10 pack or diagnostic kit). It is also supplied as GlucaGen HypoKit, a presentation with a disposable prefilled syringe containing 1 mL Sterile\n\t\t\t\t\tWater for Reconstitution. When the glucagon powder is reconstituted with Sterile Water for Reconstitution (if supplied) or with Sterile Water for Injection, USP, it forms a solution of 1 mg/mL (1 unit/mL) glucagon for subcutaneous, intramuscular, or intravenous injection (appearance of the\n\t\t\t\t\tpowder may vary, and occasionally the powder may appear compacted).", "AnswerURL": "http://www.novo-pi.com/glucagenhypokit.pdf", "COMMENT": "", "_aid": "TQ5A2" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "GlucaGen HypoKit" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "INGREDIENT", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "Substance", "__text": "glucose" } ]

[ { "ANSWER": "Likewise, we don't know whether other developmental processes, or environmental factors, affect the expression of FXTAS. For example, although it hasn't been rigorously studied, investigators at UC Davis are interested in the possibility that surgery under a general anesthetic may\n\t\t\t\t\taffect the progression of FXTAS.", "AnswerURL": "https://fragilex.org/2013/fxtas/what-do-we-know-about-cognitive-functioning-in-fxtas/", "COMMENT": "National Fragile X Foundation", "_aid": "TQ6A1" }, { "ANSWER": "Typically patients with FXTAS do not tolerate surgery with general anesthesia well and further deterioration in both motor and cognitive abilities is typically seen (Jacquemont et al 2004). Therefore, surgery should be avoided if at all possible.", "AnswerURL": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2546470/", "COMMENT": "Treatment of fragile X-associated tremor ataxia syndrome (FXTAS) and related neurological problems. Clin Interv Aging. 2008 Jun; 3(2): 251-262. Published online 2008 Jun.", "_aid": "TQ6A2" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "ANESTHESIA" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "CONTRAINDICATION", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "Problem", "__text": "FXTAS" } ]

[ { "ANSWER": "Some studies show that women who take oral contraceptives that contain drosperinone (Beyaz, Gianvi, Loryna, Ocella, Safyral, Syeda, Yasmin, Yaz, and Zarah) may be more likely to develop deep vein thrombosis (a serious or life-threatening condition in which blood clots that form in the\n\t\t\t\t\tveins, usually in the legs and may move through the body to the lungs) than women who take oral contraceptives that do not contain drosperinone. However, other studies do not show this increased risk. Before you begin taking oral contraceptives, talk to your doctor about the risk that you will\n\t\t\t\t\tdevelop blood clots and about which oral contraceptive or other method of birth control may be the best choice for you.Oral contraceptives may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.", "AnswerURL": "https://medlineplus.gov/druginfo/meds/a601050.html", "COMMENT": "Pages on lawsuits are not relevant.", "_aid": "TQ7A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "DVT" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "CAUSE", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "DrugSupplement", "__text": "Ocella" } ]

[ { "ANSWER": "Antibiotic Regimen. Oral antibiotic treatment cures nearly all uncomplicated urinary tract infections, although the rate of recurrence remains high. The following antibiotics are commonly used for uncomplicated UTIs:\n\t\t\t\t\t* The standard regimen is a 3-day course of trimethoprim-sulfamethoxazole, commonly called TMP-SMX (Bactrim, Septra, generic). TMP-SMX combines an antibiotic with a sulfa drug. A single dose of TMP-SMX is sometimes prescribed in mild cases, but cure rates are generally lower than with 3-day\n\t\t\t\t\tregimens. Allergies to sulfa are common and may be serious.\n\t\t\t\t\t* Nitrofurantoin (Furadantin, Macrobid, Macrodantin, generic) is another first-line option. It is usually taken daily for 5 days.\n\t\t\t\t\t* Fosfomycin (Monurol) is not as effective as other antibiotics but may be used during pregnancy. Resistance rates to this drug are very low.\n\t\t\t\t\t* Fluoroquinolone antibiotics, also called quinolones, are only recommended for UTIs when other antibiotics cannot be used. Ciprofloxacin (Cipro, generic) is the quinolone antibiotic most commonly prescribed. Quinolones are usually given over a 3-day period. Pregnant women should not take these\n\t\t\t\t\tdrugs.\n\t\t\t\t\t* Other antibiotics may also be used, including amoxicillin-clavulanate cefdinir, cefaclor, and cefpodoxime-proxetil. These drugs may be prescribed when other antibiotics are not appropriate. They are usually given in 3 - 7 day regimens.\n\t\t\t\t\tAntibiotic Regimen. Oral antibiotic treatment cures nearly all uncomplicated urinary tract infections, although the rate of recurrence remains high. The following antibiotics are commonly used for uncomplicated UTIs: The standard regimen is a 3-day course of trimethoprim-sulfamethoxazole, commonly called\n\t\t\t\t\tTMP-SMX (Bactrim, Septra, generic). TMP-SMX combines an antibiotic with a sulfa drug. A single dose of TMP-SMX is sometimes prescribed in mild cases, but cure rates are generally lower than with 3-day regimens. Allergies to sulfa are common and may be serious. Nitrofurantoin (Furadantin,\n\t\t\t\t\tMacrobid, Macrodantin, generic) is another first-line option. It is usually taken daily for 5 days. Fosfomycin (Monurol) is not as effective as other antibiotics but may be used during pregnancy. Resistance rates to this drug are very low. Fluoroquinolone antibiotics, also called quinolones,\n\t\t\t\t\tare only recommended for UTIs when other antibiotics cannot be used. Ciprofloxacin (Cipro, generic) is the quinolone antibiotic most commonly prescribed. Quinolones are usually given over a 3-day period. Pregnant women should not take these drugs. Other antibiotics may also be used, including\n\t\t\t\t\tamoxicillin-clavulanate cefdinir, cefaclor, and cefpodoxime-proxetil. These drugs may be prescribed when other antibiotics are not appropriate. They are usually given in 3 - 7 day regimens.", "AnswerURL": "http://www.umm.edu/health/medical/reports/articles/urinary-tract-infection", "COMMENT": "", "_aid": "TQ8A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "UTI" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "TREATMENT", "_hasKeyword": "K1,K2" } ]

[ { "_kid": "K1", "_kcategory": "Problem", "__text": "allergic to penicillin" }, { "_kid": "K2", "_kcategory": "Problem", "__text": "allergic to dairy products" } ]

[ { "ANSWER": "Granulomatosis with polyangiitis (GPA), previously known as Wegener's granulomatosis, is a rare disease. The cause of GPA is unknown. It can affect people at any age. Men and women are equally affected. It is more common in whites. Symptoms may include joint pain, weakness, tiredness,\n\t\t\t\t\tand cold symptoms such as a runny nose that doesn't get better. Doctors use blood tests, chest X-rays, and biopsies to diagnose GPA and rule out other causes of the symptoms.", "AnswerURL": "https://medlineplus.gov/granulomatosiswithpolyangiitis.html", "COMMENT": "Cause of Wegners answer", "_aid": "TQ9A1" }, { "ANSWER": "Granulomatosis with polyangiitis (Wegener's) - GPA - is serious but treatable. * The cause of GPA is unknown.\n\t\t\t\t\t* GPA often affects the sinuses, lungs, and kidneys. It can lead to kidney failure if not treated.The cause of GPA is unknown. GPA often affects the sinuses, lungs, and kidneys. It can lead to kidney failure if not treated.", "AnswerURL": "https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Granulomatosis-with-Polyangitis-Wegners", "COMMENT": "Cause of Wegners answer", "_aid": "TQ9A2" }, { "ANSWER": "Wegener's granulomatosis triggered by infection?\n\t\t\t\t\tWegener's granulomatosis is a systemic disease of unknown origin, although recent studies suggest that auto-immune mechanisms and infection play a role in the pathogenesis of this disease. During follow-up, nasal carriage of Staphyloccocus Aureus could be documented. An overview of Wegener's\n\t\t\t\t\tgranulomatosis will be provided with emphasis on the potential role of acute infections as a trigger for Wegener's granulomatosis and the head and neck manifestations.", "AnswerURL": "https://www.ncbi.nlm.nih.gov/pubmed/11256193", "COMMENT": "A case report. Acta Otorhinolaryngol Belg. 2001;55(1):57-63.", "_aid": "TQ9A3" }, { "ANSWER": "Types of Group A Streptococcal Infections\n\t\t\t\t\tCellulitis and Erysipelas\n\n\t\t\t\t\tCellulitis is inflammation of the skin and deep underlying tissues. Erysipelas is an inflammatory disease of the upper layers of the skin. Group A strep (streptococcal) bacteria are the most common cause of cellulitis and erysipelas. To learn more visit the Medline Plus cellulitis site (link is external)\n\t\t\t\t\tor visit the MedlinePlus erysipelas site (link is external).\n\n\t\t\t\t\tImpetigo\n\n\t\t\t\t\tImpetigo is an infection of the top layers of the skin and is most common among children ages 2 to 6 years. It usually starts when bacteria get into a cut, scratch, or insect bite. To learn more visit the MedlinePlus impetigo site (link is external).\n\n\t\t\t\t\tScarlet Fever\n\n\t\t\t\t\tScarlet fever - or scarlatina - is a bacterial infection caused by group A Streptococcus or \"group A strep.\" This illness affects a small percentage of people who have strep throat or, less commonly, streptococcal skin infections. To learn more visit the MedlinePlus scarlet fever site (link is\n\t\t\t\t\texternal).\n\n\t\t\t\t\tSevere Strep Infections\n\n\t\t\t\t\tSome types of group A strep bacteria cause severe infections, such as\n\n\t\t\t\t\tBacteremia (bloodstream infections) - To learn more visit visit the MedlinePlus sepsis site (link is external).\n\t\t\t\t\tToxic shock syndrome (multi-organ infection) - To learn more visit the MedlinePlus toxic shock syndrome site (link is external).\n\t\t\t\t\tNecrotizing fasciitis (flesh-eating disease) - To learn more visit the Centers for Disease Control and Prevention necrotizing fasciitis site (link is external).\n\t\t\t\t\tStrep Throat\n\n\t\t\t\t\tMany things can cause that unpleasant, scratchy, and sometimes painful condition known as a sore throat. Viruses, bacteria, allergens, environmental irritants (such as cigarette smoke), chronic postnasal drip, and fungi can all cause a sore throat. While many sore throats will get better without\n\t\t\t\t\ttreatment, some throat infections - including strep throat - may need antibiotic treatment. To learn more visit the MedlinePlus strep throat site (link is external).", "AnswerURL": "https://www.niaid.nih.gov/diseases-conditions/group-strep-types", "COMMENT": "Articles about diseases caused by stretococcus infection are also relevant", "_aid": "TQ9A4" }, { "ANSWER": "The sources of disease caused by group B strep bacteria are unknown. Group B strep bacteria are common in the gastrointestinal tract (the part of your body that digests food, including the stomach and intestines) of men and women and may be a source of some infection.\n\n\t\t\t\t\tTypes of Infection and Symptoms\n\t\t\t\t\tSymptoms depend on the part of the body that is infected. Below are common diseases caused by group B strep bacteria in adults and their symptoms.\n\n\t\t\t\t\tBacteremia and sepsis (blood infections) symptoms include:\n\n\t\t\t\t\tFever\n\t\t\t\t\tChills\n\t\t\t\t\tLow alertness\n\t\t\t\t\tPneumonia (lung infection) symptoms include:\n\n\t\t\t\t\tFever and chills\n\t\t\t\t\tCough\n\t\t\t\t\tRapid breathing or difficulty breathing\n\t\t\t\t\tChest pain\n\t\t\t\t\tSkin and soft-tissue infections often appear as a bump or infected area on the skin that may be:\n\n\t\t\t\t\tRed\n\t\t\t\t\tSwollen or painful\n\t\t\t\t\tWarm to the touch\n\t\t\t\t\tFull of pus or other drainage\n\t\t\t\t\tThese skin infections may also be accompanied by a fever.\n\n\t\t\t\t\tBone and joint infections often appear as pain in the infected area and might also include:\n\n\t\t\t\t\tFever\n\t\t\t\t\tChills\n\t\t\t\t\tSwelling\n\t\t\t\t\tStiffness or inability to use affected limb or joint\n\t\t\t\t\tRarely in adults, group B strep bacteria can cause meningitis (infection of the fluid and lining surrounding the brain and spinal cord).", "AnswerURL": "https://www.cdc.gov/groupbstrep/about/adults.html", "COMMENT": "", "_aid": "TQ9A5" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "wegeners" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "CAUSE", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "Problem", "__text": "streptococcus infection" } ]

[ { "ANSWER": "Diabetes and Sick Days: What Meds are OK\n\t\t\t\t\tPain and fever reducers\n\t\t\t\t\tExamples: Tylenol, Aspirin\n\t\t\t\t\tEffect on diabetes: No effect. Use cautiously if you have renal disease.\n\t\t\t\t\tAnti-inflammatory\n\t\t\t\t\tExamples: Ibuprofen, such as Advil, Motrin, Nuprin\n\t\t\t\t\tEffect on diabetes: No effect. Also should be used carefully if you have renal disease.", "AnswerURL": "http://www.joslin.org/info/diabetes_and_sick_days_what_meds_are_ok.html", "COMMENT": "OTC medications", "_aid": "TQ10A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "pain(joint)" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "TREATMENT", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "Problem", "__text": "diabetes type 2" } ]

[ { "ANSWER": "Smoking increases a person's chances of developing AMD by two to five fold. Because the retina has a high rate of oxygen consumption, anything that affects oxygen delivery to the retina may affect vision. Smoking causes oxidative damage, which may contribute to the development and\n\t\t\t\t\tprogression of this disease.\n\t\t\t\t\tLearn more about why smoking damages the retina, and explore a number of steps you can take to protect your vision.", "AnswerURL": "http://www.brightfocus.org/macular/prevention-and-risk-factors", "COMMENT": "Smoking is a definite risk factor, but second hand smoke is less clear. Answers about risk factors and causes of AMD are relevant.", "_aid": "TQ11A1" }, { "ANSWER": "AIM:\n\t\t\t\t\tTo undertake a systematic review of the literature on the effect of environmental tobacco smoke (ETS) and eye disease.\n\t\t\t\t\tRESULTS:\n\t\t\t\t\tSeven studies evaluated the possible relationship between ETS and an eye disease. These studies referred to refractive errors in children (n = 2), cataract (n = 1), age-related macular degeneration (n = 3) and Grave ophthalmopathy (n = 1). The data available were insufficient to establish conclusive\n\t\t\t\t\trelationships between ETS and these eye diseases.\n\t\t\t\t\tCONCLUSION:\n\t\t\t\t\tVery scarce data exist in the literature on the effect of ETS on diseases of the eye. It seems appropriate that ETS should be included in future studies addressing the effect of smoking on eye disease.", "AnswerURL": "https://www.ncbi.nlm.nih.gov/pubmed/18658170", "COMMENT": "Br J Ophthalmol. 2008 Oct;92(10):1304-10. doi: 10.1136/bjo.2008.141168. Epub 2008 Jul 25.\n\t\t\t\t\tEnvironmental tobacco smoke exposure and eye disease. This answer is more specific and definitely relevant.", "_aid": "TQ11A2" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "Early AMD" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "CAUSE", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "Substance", "__text": "second hand smoke" } ]

[ { "ANSWER": "Hydatidiform mole (HM) is a rare mass or growth that forms inside the womb (uterus) at the beginning of a pregnancy. It is a type of gestational trophoblastic disease (GTD). HM, or molar pregnancy, results from abnormal fertilization of the oocyte (egg). It results in an abnormal fetus.\n\t\t\t\t\tThe placenta grows normally with little or no growth of the fetal tissue. The placental tissue forms a mass in the uterus. On ultrasound this mass often has a grape-like appearance, as it contains many small cysts.", "AnswerURL": "https://medlineplus.gov/ency/article/000909.htm", "COMMENT": "", "_aid": "TQ12A1" }, { "ANSWER": "A molar pregnancy is caused by an abnormally fertilized egg. Human cells normally contain 23 pairs of chromosomes. One chromosome in each pair comes from the father, the other from the mother. In a complete molar pregnancy, all of the fertilized egg's chromosomes come from the father. Shortly\n\t\t\t\t\tafter fertilization, the chromosomes from the mother's egg are lost or inactivated and the father's chromosomes are duplicated. The egg may have had an inactive nucleus or no nucleus.\n\n\t\t\t\t\tIn a partial or incomplete molar pregnancy, the mother's chromosomes remain but the father provides two sets of chromosomes. As a result, the embryo has 69 chromosomes instead of 46. This can happen when the father's chromosomes are duplicated or if two sperm fertilize a single egg.", "AnswerURL": "http://www.mayoclinic.org/diseases-conditions/molar-pregnancy/basics/causes/con-20034413", "COMMENT": "Answer to the first sub-question: Conception is a requirement", "_aid": "TQ12A2" }, { "ANSWER": "An ultrasound of a complete molar pregnancy - which can be detected as early as eight or nine weeks of pregnancy - may show:\n\n\t\t\t\t\tNo embryo or fetus\n\t\t\t\t\tNo amniotic fluid\n\t\t\t\t\tA thick cystic placenta nearly filling the uterus\n\t\t\t\t\tOvarian cysts\n\t\t\t\t\tAn ultrasound of a partial molar pregnancy may show:\n\n\t\t\t\t\tA growth-restricted fetus\n\t\t\t\t\tLow amniotic fluid\n\t\t\t\t\tA thick cystic placenta", "AnswerURL": "http://www.mayoclinic.org/diseases-conditions/molar-pregnancy/basics/tests-diagnosis/con-20034413", "COMMENT": "Answer to the second sub-question. Estimates the earliest time for when the pregnancy was conceived as 8-9 weeks prior to diagnosis", "_aid": "TQ12A3" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "molar pregnancy" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "INFORMATION", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "OTHER", "__text": "conception" } ]

[ { "ANSWER": "Hereditary neuropathy with liability to pressure palsies is characterized by recurrent episodes of numbness, tingling, and loss of muscle function (palsy) in the region associated with the affected nerve, usually an arm, hand, leg, or foot. An episode can last from several minutes to\n\t\t\t\t\tseveral months, but recovery is usually complete. Repeated incidents, however, can cause permanent muscle weakness or loss of sensation. This disorder is also associated with pain in the limbs, especially the hands.", "AnswerURL": "https://ghr.nlm.nih.gov/condition/hereditary-neuropathy-with-liability-to-pressure-palsies", "COMMENT": "Symptoms of HNPP", "_aid": "TQ13A1" }, { "ANSWER": "The pattern and location of symptoms can vary depending on the type of arthritis. Generally, people with arthritis feel pain and stiffness in and around one or more joints. The onset of arthritis symptoms can develop gradually or suddenly. Arthritis is most often a chronic disease, so\n\t\t\t\t\tsymptoms may come and go, or persist over time.", "AnswerURL": "https://www.cdc.gov/arthritis/basics/faqs.htm", "COMMENT": "Symptoms of arthritis, do not seem to be equivalent symptoms. As in other questions that ask about associations that don't exist, providing information about both disorders is relevant", "_aid": "TQ13A2" }, { "ANSWER": "Pressure palsies are most commonly the result of environmentally acquired physical compression of peripheral nerves. The most common are carpal tunnel syndrome with compression of the median nerve at the wrist, peroneal pressure palsy with compression of the superficial peroneal nerve at the fibular\n\t\t\t\t\thead, and ulnar nerve compression at the elbow. The signs and symptoms of compression neuropathy in hereditary neuropathy with liability to pressure palsies (HNPP) are the same as those of the acquired type. Thus, HNPP is part of the broad differential diagnosis of both compression neuropathies\n\t\t\t\t\tand general peripheral neuropathies, including the hereditary neuropathies and Charcot-Marie-Tooth (CMT) syndrome (see CMT Overview).", "AnswerURL": "https://www.ncbi.nlm.nih.gov/books/NBK1392/", "COMMENT": "Answers on symptoms of HNPP and differential diagnosis (lists of other diseases that have the same symptoms) are relevant", "_aid": "TQ13A3" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "hnpp" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "SYMPTOM", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "Problem", "__text": "arthritis" } ]

[ { "ANSWER": "Giant cell arteritis can be difficult to diagnose because its early symptoms resemble those of many common conditions. For this reason, your doctor will try to rule out other possible causes of your problem.\n\n\t\t\t\t\tTo help diagnose giant cell arteritis, you may have some or all of the following tests and procedures:\n\n\t\t\t\t\tPhysical exam. In addition to asking about your symptoms and medical history, your doctor is likely to perform a thorough physical exam, paying particular attention to your temporal arteries. Often, one or both of these arteries are tender with a reduced pulse and a hard, cord-like feel and appearance.\n\t\t\t\t\tBlood tests. If your doctor thinks you might have giant cell arteritis, you're likely to have a blood test that checks your erythrocyte sedimentation rate - commonly referred to as the sed rate. This test measures how quickly red blood cells fall to the bottom of a tube of blood. Red cells that\n\t\t\t\t\tdrop rapidly may indicate inflammation in your body.\n\n\t\t\t\t\tYou may also have a test that measures C-reactive protein (CRP), a substance your liver produces when inflammation is present. The same tests may be used to follow your progress during treatment.\n\n\t\t\t\t\tBiopsy. The best way to confirm a diagnosis of giant cell arteritis is by taking a small sample (biopsy) of the temporal artery. The procedure is performed on an outpatient basis during local anesthesia, usually with little discomfort or scarring. The sample is examined under a microscope in a\n\t\t\t\t\tlaboratory.\n\n\t\t\t\t\tIf you have giant cell arteritis, the artery will often show inflammation that includes abnormally large cells, called giant cells, which give the disease its name. It's possible to have giant cell arteritis and still have a negative biopsy result. If the results aren't clear, your doctor may\n\t\t\t\t\tadvise another temporal artery biopsy on the other side of your head.\n\n\t\t\t\t\tImaging tests may be used for diagnosing giant cell arteritis and for monitoring your response to treatment. Possible tests include:\n\n\t\t\t\t\tMagnetic resonance angiography (MRA). This test combines the use of magnetic resonance imaging (MRI) with the use of a contrast material that produces detailed images of your blood vessels. Let your doctor know ahead of time if you're uncomfortable being confined in a small space because the test is\n\t\t\t\t\tconducted in a tube-shaped machine.\n\t\t\t\t\tDoppler ultrasound. This test uses sound waves to produce images of blood flowing through your blood vessels.\n\t\t\t\t\tPositron emission tomography (PET). Using an intravenous tracer solution that contains a tiny amount of radioactive material, a PET scan can produce detailed images of your blood vessels and highlight areas of inflammation.", "AnswerURL": "http://www.mayoclinic.org/diseases-conditions/giant-cell-arteritis/basics/tests-diagnosis/con-20023109", "COMMENT": "Asking for help is usually interpreted as asking about treatments, but in this case, answers about confirming the diagnosis are also relevant.", "_aid": "TQ14A1" }, { "ANSWER": "GCA treatment usually involves high doses of corticosteroids. Typically, the dose is 40-60 milligrams (mg) per day of prednisone (Deltasone, Orasone, etc.). Headaches and other symptoms quickly decrease with treatment, and the sedimentation rate declines to a normal range.\n\n\t\t\t\t\tThe high dose of corticosteroids usually continues for a month, and then the dose is slowly decreased. The speed at which your doctor lowers the dose may change if you have recurring symptoms of GCA or large increases in the sedimentation rate. In most cases, though, the prednisone dose can be\n\t\t\t\t\treduced to about 5 - 10 mg per day over a few months. Patients are usually tapered off this medicine by one to two years. GCA rarely returns after treatment.\n\n\t\t\t\t\tActemra (tocilizumab) was approved May 2017 by the FDA to treat adults with giant cell arteritis.", "AnswerURL": "https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Giant-Cell-Arteritis", "COMMENT": "", "_aid": "TQ14A2" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "giant cell vasculitis" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "TREATMENT", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "Is fibromyalgia hereditary?\n\t\t\t\t\tAnswers from Kevin C. Fleming, M.D.\n\t\t\t\t\tFibromyalgia isn't passed directly from parents to children, but the disorder does appear to cluster within families.\n\t\t\t\t\tThe odds of developing fibromyalgia are several times higher in the immediate families of people with fibromyalgia than in families in which no one has fibromyalgia.\n\t\t\t\t\tIn fact, studies of DNA from family members of people with fibromyalgia and other chronic pain syndromes have turned up a number of genes that could help explain why these disorders seem to run in families.\n\t\t\t\t\tEach of these genes plays a role in your nervous system's response to pain. Some of the same genes are also associated with depression and anxiety, which may be the reason why certain antidepressant medications help reduce fibromyalgia symptoms.", "AnswerURL": "http://www.mayoclinic.org/diseases-conditions/fibromyalgia/expert-answers/is-fibromyalgia-hereditary/faq-20058091", "COMMENT": "", "_aid": "TQ15A1" }, { "ANSWER": "Although the etiology of FM remains unknown, it is thought to involve some combination of genetic susceptibility and environmental exposure that triggers further alterations in gene expression. Because FM shows marked familial aggregation, most previous research has focused on genetic\n\t\t\t\t\tpredisposition to FM and has revealed associations between genetic factors and the development of FM, including specific gene polymorphisms involved in the serotonergic, dopaminergic, and catecholaminergic pathways. The aim of this review was to discuss the current evidence regarding genetic\n\t\t\t\t\tfactors that may play a role in the development and symptom severity of FM.", "AnswerURL": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4543151/", "COMMENT": "These answers address hereditary factors but not a genetic test.", "_aid": "TQ15A2" }, { "ANSWER": "That's why it can take a long time to go from fibromyalgia symptoms to a fibromyalgia diagnosis.\n\t\t\t\t\tFibromyalgia can't be easily confirmed or ruled out through a simple laboratory test. Your doctor can't detect it in your blood or see it on an X-ray. Instead, fibromyalgia appears to be linked to changes in how the brain and spinal cord process pain signals.\n\t\t\t\t\tBecause there is no test for fibromyalgia, your doctor must rely solely on your group of symptoms to make a diagnosis. Because a genetic factor appears to be involved in fibromyalgia, your doctor may also want to know if any other members of your immediate family have experienced similar symptoms.", "AnswerURL": "http://www.mayoclinic.org/diseases-conditions/fibromyalgia/in-depth/fibromyalgia-symptoms/ART-20045401?p=1", "COMMENT": "General information on diagnosis of fibromyalgia.", "_aid": "TQ15A3" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "Fibromyalgia" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "DIAGNOSIS", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "OTHER", "__text": "genetic" } ]

[ { "ANSWER": "BMS is hard to diagnose. One reason is that people with BMS often don't have a mouth problem that the doctor or dentist can see during an exam. Your dentist or doctor may refer you to a specialist. Specialists who diagnose BMS include dentists who specialize in oral medicine or oral\n\t\t\t\t\tsurgery. Other specialists include doctors who are ear, nose, and throat specialists; gastroenterologists; or dermatologists.", "AnswerURL": "https://nidcr.nih.gov/oralhealth/Topics/Burning/BurningMouthSyndrome.htm", "COMMENT": "", "_aid": "TQ16A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "burning mouth syndrome" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "PERSON_ORGANIZATION", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "Climara (Estradiol Transdermal System) Patients should be started at the lowest dose. Six (6.5, 9.375, 12.5, 15, 18.75 and 25 cm2 ) Climara systems are available. For the treatment of vasomotor symptoms, treatment should be initiated with the 6.5 cm2 (0.025 mg/day) Climara system\n\t\t\t\t\tapplied to the skin once weekly. The dose should be adjusted as necessary to control symptoms. Clinical responses (relief of symptoms) at the lowest effective dose should be the guide for establishing administration of the Climara system, especially in women with an intact uterus. Attempts to\n\t\t\t\t\ttaper or discontinue the medication should be made at 3- to 6-month intervals.", "AnswerURL": "https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/020375s026lbl.pdf", "COMMENT": "does not specifically address 4.5 months, but 4.5 falls within the recommended discontinuation period.", "_aid": "TQ17A1" }, { "ANSWER": "How Do I Stop Therapy? If you are on menopausal hormone therapy, talk with your health care provider about whether or not to stop it.Also ask about the best way to discontinue the treatment.You can stop abruptly or by gradually reducing the dose over several months.With either method of\n\t\t\t\t\tstopping the medication, you may have menopause-like symptoms.", "AnswerURL": "https://www.nhlbi.nih.gov/files/docs/pht_facts.pdf", "COMMENT": "does not specifically address 4.5 months, but it is an acceptable answer as it describes how to stop and warns about the symptoms.", "_aid": "TQ17A2" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "estradiol 75g patch" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "TAPERING", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "To clean the ears, wash the external ear with a cloth, but do not insert anything into the ear canal.\n\t\t\t\t\tMost cases of ear wax blockage respond to home treatments used to soften wax. Patients can try placing a few drops of mineral oil, baby oil, glycerin, or commercial drops in the ear. Detergent drops such as hydrogen peroxide or carbamide peroxide (available in most pharmacies) may also aid in the\n\t\t\t\t\tremoval of wax.\n\t\t\t\t\tIrrigation or ear syringing is commonly used for cleaning and can be performed by a physician or at home using a commercially available irrigation kit. Common solutions used for syringing include water and saline, which should be warmed to body temperature to prevent dizziness. Ear syringing is most\n\t\t\t\t\teffective when water, saline, or wax dissolving drops are put in the ear canal 15 to 30 minutes before treatment.", "AnswerURL": "http://www.entnet.org/content/earwax-and-care", "COMMENT": "Pages describing how to clean ears that list peroxide are relevant", "_aid": "TQ18A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "ear wax" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "TREATMENT", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "DrugSupplement", "__text": "Peroxide" } ]

[ { "ANSWER": "We prepared a 20% sevoflurane lipid emulsion using caprylic triglyceride (i.e., medium-chain triglyceride). In rats, this emulsion was an effective anesthetic and was not associated with adverse events. The emulsion was stable after consecutive evaluation for 365 days and for 180\n\t\t\t\t\tminutes after the vial was opened.", "AnswerURL": "https://www.ncbi.nlm.nih.gov/pubmed/26716717", "COMMENT": "provides information on stability after opening the vial", "_aid": "TQ19A1" }, { "ANSWER": "Sevoflurane is stable when stored under normal room lighting conditions. No discernible degradation of sevoflurane occurs in the presence of strong acids or heat. Sevoflurane is not corrosive to stainless steel, brass, aluminum nickel-plated brass, chrome-plated brass or copper beryllium\n\t\t\t\t\talloy.", "AnswerURL": "https://www.medicines.org.uk/emc/medicine/49", "COMMENT": "Provides information about stability of the substance in general. This information is also relevant.", "_aid": "TQ19A2" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "Sevoflurane" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "USAGE", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "Oppositional defiant disorder is a pattern of disobedient, hostile, and defiant behavior toward authority figures. This disorder is more common in boys than in girls. Some studies have shown that it affects 20% of school-age children. However, most experts believe this figure is high due\n\t\t\t\t\tto changing definitions of normal childhood behavior. It may also possibly have racial, cultural, and gender biases.\n\n\t\t\t\t\tThis behavior typically starts by age 8. However, it may start as early as the preschool years. This disorder is thought to be caused by a combination of biological, psychological, and social factors.\n\t\t\t\t\tSymptoms include: Actively does not follow adults' requests; Angry and resentful of others; Argues with adults; Blames others for own mistakes; Has few or no friends or has lost friends; Is in constant trouble in school; Loses temper; Is spiteful or seeks revenge; Is touchy or easily annoyed.\n\t\t\t\t\tTo fit this diagnosis, the pattern must last for at least 6 months and must be more than normal childhood misbehavior.\n\n\t\t\t\t\tThe pattern of behaviors must be different from those of other children around the same age and developmental level. The behavior must lead to significant problems in school or social activities.\n\t\t\t\t\tChildren with symptoms of this disorder should be evaluated by a psychiatrist or psychologist.\n\t\t\t\t\tThe best treatment for the child is to talk with a mental health professional in individual and possibly family therapy. The parents should also learn how to manage the child's behavior.\n\n\t\t\t\t\tMedicines may also be helpful, especially if the behaviors occur as part of another condition (such as depression, childhood psychosis, or ADHD).\n\t\t\t\t\tSome children respond well to treatment, while others do not.", "AnswerURL": "https://medlineplus.gov/ency/article/001537.htm", "COMMENT": "there is more information on this page.", "_aid": "TQ20A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "ODD" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "INFORMATION", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "Beckwith-Wiedemann syndrome is a condition that affects many parts of the body. It is classified as an overgrowth syndrome, which means that affected infants are considerably larger than normal (macrosomia) and tend to be taller than their peers during childhood. Growth begins to slow\n\t\t\t\t\tby about age 8, and adults with this condition are not unusually tall. In some children with Beckwith-Wiedemann syndrome, specific parts of the body on one side or the other may grow abnormally large, leading to an asymmetric or uneven appearance. This unusual growth pattern, which is known as\n\t\t\t\t\themihyperplasia, usually becomes less apparent over time.\n\t\t\t\t\tThe signs and symptoms of Beckwith-Wiedemann syndrome vary among affected individuals. Some children with this condition are born with an opening in the wall of the abdomen (an omphalocele) that allows the abdominal organs to protrude through the belly-button. Other abdominal wall defects, such as\n\t\t\t\t\ta soft out-pouching around the belly-button (an umbilical hernia), are also common. Some infants with Beckwith-Wiedemann syndrome have an abnormally large tongue (macroglossia), which may interfere with breathing, swallowing, and speaking. Other major features of this condition include\n\t\t\t\t\tabnormally large abdominal organs (visceromegaly), creases or pits in the skin near the ears, low blood sugar (hypoglycemia) in infancy, and kidney abnormalities.\n\t\t\t\t\tChildren with Beckwith-Wiedemann syndrome are at an increased risk of developing several types of cancerous and noncancerous tumors, particularly a form of kidney cancer called Wilms tumorand a form of liver cancer called hepatoblastoma. Tumors develop in about 10 percent of people with this condition\n\t\t\t\t\tand almost always appear in childhood.\n\t\t\t\t\tMost children and adults with Beckwith-Wiedemann syndrome do not have serious medical problems associated with the condition. Their life expectancy is usually normal.", "AnswerURL": "https://ghr.nlm.nih.gov/condition/beckwith-wiedemann-syndrome", "COMMENT": "", "_aid": "TQ21A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "Beckwith-Wieddeman Syndrome" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "INFORMATION", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "There are no comparative studies of antibiotic therapy for Citrobacter infections. Thus, treatment of Citrobacter infections follows the principles for treatment of other Enterobacteriaceae infections. Based on the in vitro antimicrobial susceptibilities described above,\n\t\t\t\t\taminoglycosides, fluoroquinolones, carbapenems, and the fourth-generation cephems, such as cefepime and cefpirome, would appear to be preferred therapeutic agents for C. freundii infections.", "AnswerURL": "http://www.antimicrobe.org/b93.asp", "COMMENT": "General discussion not specific to ciprofaxin", "_aid": "TQ22A1" }, { "ANSWER": "Citrobacter species are a common cause of nosocomial infections associated with patients that are undergoing prolonged hospital treatments. C. freundii has recently been reported to express resistance to broad-spectrum antibiotincs including piperacillin, piperacillintazobactam,\n\t\t\t\t\tvancomycin and cephalosporins. Isolation of ceftriaxone-resistant Citrobacter freundii (CRCF) has been associated with the overprescribed broad spectrum antibiotics.", "AnswerURL": "https://microbewiki.kenyon.edu/index.php/Citrobacter_freundii", "COMMENT": "General discussion not specific to ciprofaxin", "_aid": "TQ22A2" }, { "ANSWER": "The resistance of C. freundii to antibiotics in 1999 (n = 10), compared with the period from 1996 through 1998 (n = 26), increased 66% for ciprofloxacin, 36% for ticarcillin/clavulanate, 70% for piperacillin/tazobactam, and 62.8% for piperacillin, but remained uniformly susceptible to\n\t\t\t\t\timipenem/cilastatin and the new fluoroquinolone (levofloxacin). This increase in resistance was attributable to the use of third-generation cephalosporin instead of first-generation cephalosporins.", "AnswerURL": "https://www.ncbi.nlm.nih.gov/pubmed/12099331", "COMMENT": "Pages describing resistance to ciprofloxacin and pages listing preferred treatments are relevant", "_aid": "TQ22A3" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "CITROBACTOR FREUNDII" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "TREATMENT", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "DrugSupplement", "__text": "ciprofaxin" } ]

[ { "ANSWER": "The history and physical exam will help determine the severity and acuity of the patient's back pain. If there are no red flag issues, send the patient to be evaluated by a physical therapist who provides care for children and follow up with the patient in clinic. If the history and\n\t\t\t\t\tphysical uncover red flag issues, request appropriate radiographs and lab tests. See Page 2 for a guide to imaging studies. If screening radiographs point to a serious orthopedic condition, request an MRI or refer the patient to an orthopedic specialist who will get the necessary MRI.", "AnswerURL": "https://www.gillettechildrens.org/assets/uploads/general/Newsletter_PDFs/Vol21No1.pdf", "COMMENT": "Gillette Children's Specialty Healthcare", "_aid": "TQ23A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "damage to his back" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "DIAGNOSIS", "_hasKeyword": null }, { "_tid": "T2", "_hasFocus": "F1", "__text": "PERSON_ORGANIZATION", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "With a severe ear infection, pressure may build up and cause the eardrum to rupture. Pus and blood may drain out. This usually relieves pain and pressure, and in most cases the eardrum heals on its own.", "AnswerURL": "http://www.umm.edu/health/medical/altmed/condition/otitis-media", "COMMENT": "University of Maryland Medical Center", "_aid": "TQ24A1" }, { "ANSWER": "Middle ear infections may cause pain, hearing loss, and spontaneous rupture of the eardrum, resulting in a perforation. In this case,there may be infected or bloody drainage from the ear. Infections can cause a hole in the eardrum as a side effect of otitis media.", "AnswerURL": "http://www.entnet.org/content/perforated-eardrum", "COMMENT": "American Academy of Otolaryngology; Head and Neck Surgery", "_aid": "TQ24A2" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "otitis media" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "COMPLICATION", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "Problem", "__text": "blood drainage" } ]

[ { "ANSWER": "In addition, carvedilol produced a slight but significant inhibition of the pressor responses to serotonin (5-hydroxytryptamine), which was nearly identical in magnitude to that seen with hydralazine.", "AnswerURL": "https://www.ncbi.nlm.nih.gov/pubmed/2908302", "COMMENT": "Pages about similarities of the two drugs or their interactions are relevant", "_aid": "TQ25A1" }, { "ANSWER": "Interaction between Coreg and Hydralazine: There is no known interaction between Coreg and Hydralazine in our records. However, an interaction may still exist. Always consult your doctor before taking these medications together. Do not stop taking the medications without a physician's advice.", "AnswerURL": "https://treato.com/Coreg,Hydralazine/?a=s#dndInteraction", "COMMENT": "", "_aid": "TQ25A2" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "Carvedilol" }, { "_fid": "F2", "_fcategory": "DrugSupplement", "__text": "Hydrslazine" } ]

[ { "_tid": "T1", "_hasFocus": "F1,F2", "__text": "INTERACTION", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "There is no drug interactions reported by people who take Phentermine hydrochloride and Dicyclomine hydrochloride together yet. This review analyzes the effectiveness and drug interactions between Phentermine hydrochloride and Dicyclomine hydrochloride. It is created by eHealthMe based\n\t\t\t\t\ton reports from FDA, and is updated regularly.", "AnswerURL": "http://www.ehealthme.com/drug-interaction/phentermine-hydrochloride/dicyclomine-hydrochloride/", "COMMENT": "Not a great source. I did not find any drug interactions in DailyMed.", "_aid": "TQ26A1" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "phentermine" }, { "_fid": "F2", "_fcategory": "DrugSupplement", "__text": "Dicyclomine" } ]

[ { "_tid": "T1", "_hasFocus": "F1,F2", "__text": "INTERACTION", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "Scientists know genes are involved in Alzheimer's. Two categories of genes influence whether a person develops a disease: risk genes and deterministic genes. Alzheimer's genes have been found in both categories.\n\n\t\t\t\t\t1. Risk genes increase the likelihood of developing a disease, but do not guarantee it will happen. Researchers have found several genes that increase the risk of Alzheimer's. apolipoprotein E-e4, or APOE-e4, is the first risk gene identified and remains the one with strongest impact.\n\t\t\t\t\t2. Deterministic genes directly cause a disease, guaranteeing that anyone who inherits one will develop the disorder. Scientists have discovered variations that directly cause Alzheimer's disease in the genes coding three proteins: amyloid precursor protein (APP), presenilin-1 (PS-1) and\n\t\t\t\t\tpresenilin-2 (PS-2).", "AnswerURL": "http://www.alz.org/alzheimers_disease_causes_risk_factors.asp", "COMMENT": "The answer is for Alzheimers, but not the broader term dementia.", "_aid": "TQ27A1" }, { "ANSWER": "The majority of dementia is not inherited, but this depends very much on the particular cause of dementia. Some (rare) causes of dementia are very clearly 'inherited', for example, Huntington's disease. This is an 'autosomal dominant' disease which means that only one faulty copy of the\n\t\t\t\t\tgene is needed in order to inherit the disease.\n\n\t\t\t\t\tIf you have inherited the gene you will get the disease if you live long enough. It does not skip a generation. Some other dementias have both inherited and non-inherited forms. In the case of fronto-temporal dementias, 30 to 50 per cent of cases are inherited. Most cases of Alzheimer's disease\n\t\t\t\t\tare not inherited.", "AnswerURL": "https://www.alzheimers.org.uk/info/20010/risk_factors_and_prevention/117/genetics_of_dementia/8", "COMMENT": "A broader answer from the UK. Both the broader answers about dementia in general and answers for specific types are relevant.", "_aid": "TQ27A2" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "dementia" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "INHERITANCE", "_hasKeyword": null }, { "_tid": "T2", "_hasFocus": "F1", "__text": "SUSCEPTIBILITY", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "Surgery is an effective and safe treatment option for many patients with snoring and sleep apnea, particularly those who are unable to use or tolerate CPAP. Proper patient and procedure selection is critical to successful surgical management of obstructive sleep apnea. Talk to your Ear,\n\t\t\t\t\tNose and Throat doctor for a complete evaluation and to learn what treatment may be best for you.", "AnswerURL": "http://www.entnet.org/content/surgery-obstructive-sleep-apnea", "COMMENT": "Answering as organization/doctor that does surgery", "_aid": "TQ28A1" }, { "ANSWER": "Some people who have sleep apnea might benefit from surgery. The type of surgery and how well it works depend on the cause of the sleep apnea.\n\t\t\t\t\tSurgery is done to widen breathing passages. It usually involves shrinking, stiffening, or removing excess tissue in the mouth and throat or resetting the lower jaw.\n\t\t\t\t\tSurgery to shrink or stiffen excess tissue is done in a doctor's office or a hospital. Shrinking tissue may involve small shots or other treatments to the tissue. You may need a series of treatments to shrink the excess tissue. To stiffen excess tissue, the doctor makes a small cut in the tissue and\n\t\t\t\t\tinserts a piece of stiff plastic.\n\t\t\t\t\tSurgery to remove excess tissue is done in a hospital. You're given medicine to help you sleep during the surgery. After surgery, you may have throat pain that lasts for 1 to 2 weeks.", "AnswerURL": "https://www.nhlbi.nih.gov/health/health-topics/topics/sleepapnea/treatment", "COMMENT": "Answering as a treatment question", "_aid": "TQ28A2" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "sleep apnea" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "TREATMENT", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "ProcedureDevice", "__text": "surgery" } ]

[ { "ANSWER": "IMODIUM - loperamide hydrochloride capsule\n\t\t\t\t\tChronic Diarrhea\n\t\t\t\t\tAdults: The recommended initial dose is 4 mg (two capsules) followed by 2 mg (one capsule) after each unformed stool until diarrhea is controlled, after which the dosage of IMODIUM should be reduced to meet individual requirements. When the optimal daily dosage has been established, this amount may\n\t\t\t\t\tthen be administered as a single dose or in divided doses.\n\t\t\t\t\tThe average daily maintenance dosage in clinical trials was 4 to 8 mg (two to four capsules). A dosage of 16 mg (eight capsules) was rarely exceeded. If clinical improvement is not observed after treatment with 16 mg per day for at least 10 days, symptoms are unlikely to be controlled by further\n\t\t\t\t\tadministration. IMODIUM administration may be continued if diarrhea cannot be adequately controlled with diet or specific treatment.", "AnswerURL": "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=871e2a73-a1e9-4952-8cf2-15da430117ce", "COMMENT": "Dosage schedule", "_aid": "TQ29A1" }, { "ANSWER": "A focused workup of chronic diarrhea may yield a specific diagnosis, including diarrhea-predominant IBS (dIBS), functional diarrhea, diabetic diarrhea, bile acid-induced diarrhea, and microscopic colitis. Ideally, therapeutic decisions are specifically tailored to target the underlying\n\t\t\t\t\tpathophysiology, including, for example, gluten restriction for celiac disease, rotating antibiotics for small bowel bacterial overgrowth, budesonide therapy for collagenous colitis, and loperamide for treatment of functional diarrhea. It is also important to assess the role of diet and\n\t\t\t\t\tmedications in chronic diarrhea. However, if no specific causes are identified following workup, empiric therapy with simple opiate antidiarrheals such as loperamide may be effective. If this proves unsuccessful, the use of more potent agents, including codeine and opium, may be considered.", "AnswerURL": "https://www.ncbi.nlm.nih.gov/pubmed/18192962", "COMMENT": "information about tailored treatments and alternatives to loperamide is relevant", "_aid": "TQ29A2" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "chronic diahrrea" }, { "_fid": "F2", "_fcategory": "DrugSupplement", "__text": "Loperamide" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "TREATMENT", "_hasKeyword": null }, { "_tid": "T2", "_hasFocus": "F2", "__text": "ALTERNATIVE", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "Problem", "__text": "chronic diahrrea" } ]

[ { "ANSWER": "Uveitis is swelling and irritation of the uvea. The uvea is the middle layer of the eye. The uvea provides most of the blood supply to the retina. Uveitis can be caused by autoimmune disorders. These diseases occur when the body's immune system attacks and destroys healthy body tissue\n\t\t\t\t\tby mistake. Examples are: Ankylosing spondylitis; Psoriasis; Reactive arthritis; Rheumatoid arthritis; Sarcoidosis.\n\n\t\t\t\t\tUlcerative colitis Uveitis can also be caused by infections such as:\n\t\t\t\t\tAIDS; Cytomegalovirus (CMV) retinitis; Herpes zoster infection; Histoplasmosis; Kawasaki disease; Syphilis; Toxoplasmosis; Tuberculosis.\n\n\t\t\t\t\tExposure to toxins or injury can also cause uveitis. In many cases, the cause is unknown.", "AnswerURL": "https://medlineplus.gov/ency/article/001005.htm", "COMMENT": "Categorized as information", "_aid": "TQ30A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "UVEITIS" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "INFORMATION", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "Problem", "__text": "AUTOIMMUNE DISEASE" } ]

[ { "ANSWER": "Normal functional bladder capacity in adults ranges from approximately 300 to 400 ml (58,59).", "AnswerURL": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206217/", "COMMENT": "A healthy bladder: a consensus statement\n\t\t\t\t\tInt J Clin Pract. 2011 Oct; 65(10): 1026-1036.", "_aid": "TQ31A1" }, { "ANSWER": "A healthy bladder can hold one and a half to two cups (300-400mls) of urine during the day and about four cups (800mls) at night. It is normal to pass urine five or six times a day if you drink between 6-8 glasses of fluid. It is usual to empty your bladder when you get out of bed in the\n\t\t\t\t\tmorning, three times during the day, and before you go to bed at night. As we age this pattern may change, as older people tend to make more urine at night.", "AnswerURL": "https://www.continence.org.au/pages/bladder-training.html", "COMMENT": "A different opinion. In cups, not ounces.", "_aid": "TQ31A2" } ]

[ { "_fid": "F1", "_fcategory": "Substance", "__text": "urine" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "INFORMATION", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "Anatomy", "__text": "bladder" } ]

[ { "ANSWER": "Abrupt cessation may precipitate angina, MI, arrhythmias, or rebound HTN; discontinue by tapering over 1-2 weeks. Do not abruptly discontinue without physician's advice.", "AnswerURL": "https://www.acc.org/tools-and-practice-support/clinical-toolkits/atrial-fibrillation-afib/rate-rhythm-dosing-table/atenolol", "COMMENT": "General answer", "_aid": "TQ32A1" }, { "ANSWER": "If you have been using this medicine regularly for several weeks, do not suddenly stop using it. Stopping suddenly may cause your chest pain or high blood pressure to come back or get worse. Check with your doctor for the best way to reduce gradually the amount you are taking before\n\t\t\t\t\tstopping completely.", "AnswerURL": "http://www.mayoclinic.org/drugs-supplements/amlodipine-oral-route/precautions/drg-20061784", "COMMENT": "General answer", "_aid": "TQ32A2" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "Amlodipine" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "TAPERING", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "A single dose of shingles vaccine is recommended for\n\t\t\t\t\tadults 60 years of age and older.", "AnswerURL": "https://www.cdc.gov/vaccines/hcp/vis/vis-statements/shingles.pdf", "COMMENT": "", "_aid": "TQ33A1" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "Shingles shot" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "INDICATION", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "OTHER", "__text": "age" } ]

[ { "ANSWER": "You can get or transmit HIV only through specific activities. Most commonly, people get or transmit HIV through sexual behaviors and needle or syringe use.\n\t\t\t\t\tOnly certain body fluids-blood, semen (cum), pre-seminal fluid (pre-cum), rectal fluids, vaginal fluids, and breast milk-from a person who has HIV can transmit HIV. These fluids must come in contact with a mucous membrane or damaged tissue or be directly injected into the bloodstream (from a needle\n\t\t\t\t\tor syringe) for transmission to occur. Mucous membranes are found inside the rectum, vagina, penis, and mouth.\n\t\t\t\t\tIn extremely rare cases, HIV has been transmitted by Contact between broken skin, wounds, or mucous membranes and HIV-infected blood or blood-contaminated body fluids.", "AnswerURL": "https://www.cdc.gov/hiv/basics/transmission.html", "COMMENT": "CDC", "_aid": "TQ34A1" }, { "ANSWER": "Non-sexual Transmission\n\t\t\t\t\tHIV can be transmitted by contact between infectious fluids and bleeding cuts or open sores in the skin. However, healthy intact skin does not allow HIV to enter the body and provides an excellent barrier against the virus.\n\t\t\t\t\tNon-sexual transmission is rare. The rare circumstances where non-sexual transmission has occurred typically involve medical settings or accident scenes where there is a very large volume of blood exposure or a needle stick.", "AnswerURL": "https://www.mnaidsproject.org/learn/hiv-basics/hiv-transmission", "COMMENT": "Minnesota Aids Project", "_aid": "TQ34A2" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "hiv" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "SUSCEPTIBILITY", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "Hydrogen peroxide solutions can be disposed of with no special treatment. You can safely pour them down the drain of a sink or into a toilet.", "AnswerURL": "http://en.hesperian.org/hhg/A_Community_Guide_to_Environmental_Health:Safe_Disposal_of_Chemical_Waste", "COMMENT": "", "_aid": "TQ35A1" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "Hydrogen Peroxide" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "STORAGE_DISPOSAL", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "Congenital diaphragmatic hernia (CDH) can occur as an isolated finding, as part of a genetic syndrome or chromosome abnormality, or with additional birth defects of unknown cause.[5] Some cases have been linked to in utero exposures.[6] In the majority of cases, the cause is not\n\t\t\t\t\tknown.[5]", "AnswerURL": "https://rarediseases.info.nih.gov/diseases/1481/congenital-diaphragmatic-hernia", "COMMENT": "Causes", "_aid": "TQ36A1" }, { "ANSWER": "Isolated congenital diaphragmatic hernia is rarely inherited. In almost all cases, there is only one affected individual in a family.\n\n\t\t\t\t\tWhen congenital diaphragmatic hernia occurs as a feature of a genetic syndrome or chromosomal abnormality, it may cluster in families according to the inheritance pattern for that condition.", "AnswerURL": "https://ghr.nlm.nih.gov/condition/congenital-diaphragmatic-hernia#inheritance", "COMMENT": "Causes", "_aid": "TQ36A2" }, { "ANSWER": "The contents of your child's abdomen, including the stomach, intestines, liver and spleen may go through the hole and into his chest.\n\t\t\t\t\tThis prevents the normal development of the lung on that side, and may also affect the growth of the other lung. And when your child's lungs don't fully develop, he will have trouble breathing after he is born. Complications of a CDH may include: Chronic lung disease: This serious condition can\n\t\t\t\t\trequire your child to have oxygen or medications after being discharged from the hospital.", "AnswerURL": "http://www.childrenshospital.org/conditions-and-treatments/conditions/c/congenital-diaphragmatic-hernia/symptoms-and-causes", "COMMENT": "Life-long lung diseases", "_aid": "TQ36A3" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "congenital diaphragmatic hernia" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "CAUSE", "_hasKeyword": "K1" }, { "_tid": "T2", "_hasFocus": "F1", "__text": "EFFECT", "_hasKeyword": "K2" } ]

[ { "_kid": "K1", "_kcategory": "OTHER", "__text": "cousin marriage" }, { "_kid": "K2", "_kcategory": "Problem", "__text": "lung disease" } ]

[ { "ANSWER": "Shingles cannot be passed from one person to another. However, the virus that causes shingles, the varicella zoster virus, can be spread from a person with active shingles to another person who has never had chickenpox. In such cases, the person exposed to the virus might develop\n\t\t\t\t\tchickenpox, but they would not develop shingles. The virus is spread through direct contact with fluid from the rash blisters caused by shingles. A person with active shingles can spread the virus when the rash is in the blister-phase. A person is not infectious before the blisters appear. Once\n\t\t\t\t\tthe rash has developed crusts, the person is no longer contagious.\n\t\t\t\t\tShingles is less contagious than chickenpox and the risk of a person with shingles spreading the virus is low if the rash is covered.", "AnswerURL": "https://www.cdc.gov/shingles/about/transmission.html", "COMMENT": "", "_aid": "TQ37A1" }, { "ANSWER": "A person can not get shingles from a person that has it. However, the virus that causes chickenpox and shingles can be spread from a person with active shingles to a person who has never had chickenpox or been vaccinated through direct contact with the rash. The person exposed would\n\t\t\t\t\tdevelop chickenpox, not shingles. The virus is not spread through sneezing, coughing or casual contact. A person with shingles can spread the disease when the rash is in the blister-phase. Once the rash has developed crusts, the person is no longer contagious. A person is not infectious before\n\t\t\t\t\tblisters appear or if pain persists after the rash is gone (post-herpetic neuralgia). The risk of spreading shingles is low if the rash is covered. People with shingles should keep the rash covered, not touch or scratch the rash, and wash their hands often to prevent the spread of shingles.\n\t\t\t\t\tOnce the rash has developed crusts, the person is no longer contagious.", "AnswerURL": "https://www.health.ny.gov/diseases/communicable/shingles/fact_sheet.htm", "COMMENT": "New York Department of Health", "_aid": "TQ37A2" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "shingles" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "INFORMATION", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "OTHER", "__text": "handling food" } ]

[ { "ANSWER": "Antiphospholipid syndrome can be caused by an underlying condition, such as an autoimmune disorder, infection or certain medications, or you can develop the syndrome without an underlying cause.", "AnswerURL": "http://www.mayoclinic.org/diseases-conditions/antiphospholipid-syndrome/symptoms-causes/dxc-20307662", "COMMENT": "causes", "_aid": "TQ38A1" }, { "ANSWER": "Doctors generally use medications that reduce your blood's tendency to clot to help prevent complications of antiphospholipid syndrome. If you have thrombosis, standard initial treatment involves a combination of blood-thinning (anticoagulant) medications.", "AnswerURL": "http://www.mayoclinic.org/diseases-conditions/antiphospholipid-syndrome/diagnosis-treatment/treatment/txc-20307675", "COMMENT": "treatment", "_aid": "TQ38A2" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "Antiphosoholipid Syndrome" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "TREATMENT", "_hasKeyword": null }, { "_tid": "T2", "_hasFocus": "F1", "__text": "CAUSE", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "The major hazards of methadone are respiratory depression and, to a lesser degree, systemic hypotension. Respiratory arrest, shock, cardiac arrest, and death have occurred.\n\n\t\t\t\t\tThe most frequently observed adverse reactions include lightheadedness, dizziness, sedation, nausea, vomiting, and sweating. These effects seem to be more prominent in ambulatory patients and in those who are not suffering severe pain. In such individuals, lower doses are advisable.\n\n\t\t\t\t\tOther adverse reactions include the following: (listed alphabetically under each subsection)\n\n\t\t\t\t\tBody as a Whole\n\t\t\t\t\tasthenia (weakness), edema, headache\n\n\t\t\t\t\tCardiovascular\n\t\t\t\t\t(also see WARNINGS: CARDIAC CONDUCTION EFFECTS) - arrhythmias, bigeminal rhythms, bradycardia, cardiomyopathy, ECG abnormalities, extrasystoles, flushing, heart failure, hypotension, palpitations, phlebitis, QT interval prolongation, syncope, T-wave inversion, tachycardia, torsade de pointes,\n\t\t\t\t\tventricular fibrillation, ventricular tachycardia\n\n\t\t\t\t\tDigestive\n\t\t\t\t\tabdominal pain, anorexia, biliary tract spasm, constipation, dry mouth, glossitis\n\n\t\t\t\t\tHematologic and Lymphatic\n\t\t\t\t\treversible thrombocytopenia has been described in opioid addicts with chronic hepatitis\n\n\t\t\t\t\tMetabolic and Nutritional\n\t\t\t\t\thypokalemia, hypomagnesemia, weight gain\n\n\t\t\t\t\tNervous\n\t\t\t\t\tagitation, confusion, disorientation, dysphoria, euphoria, insomnia, seizures\n\n\t\t\t\t\tRespiratory\n\t\t\t\t\tpulmonary edema, respiratory depression (see WARNINGS: RESPIRATORY DEPRESSION)\n\n\t\t\t\t\tSkin and Appendages\n\t\t\t\t\tpruritis, urticaria, other skin rashes, and rarely, hemorrhagic urticaria\n\n\t\t\t\t\tSpecial Senses\n\t\t\t\t\thallucinations, visual disturbances\n\n\t\t\t\t\tUrogenital\n\t\t\t\t\tamenorrhea, antidiuretic effect, reduced libido and/or potency, urinary retention or hesitancy\n\n\t\t\t\t\tMaintenance on a Stabilized Dose\n\t\t\t\t\tDuring prolonged administration of methadone, as in a methadone maintenance treatment program, there is usually a gradual, yet progressive, disappearance of side effects over a period of several weeks. However, constipation and sweating often persist.", "AnswerURL": "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=552751f7-42ff-40c7-8495-a6aa306d5c23", "COMMENT": "confusion is under \"Nervous\" and pruritis (itchy skin) is under \"Skin and Appendages\".", "_aid": "TQ39A1" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "methadone" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "SIDE_EFFECT", "_hasKeyword": "K1,K2" } ]

[ { "_kid": "K1", "_kcategory": "Problem", "__text": "confusion" }, { "_kid": "K2", "_kcategory": "Problem", "__text": "face itches" } ]

[ { "ANSWER": "Methylprednisolone, a corticosteroid, is similar to a natural hormone produced by your adrenal glands. It is often used to replace this chemical when your body does not make enough of it. It relieves inflammation (swelling, heat, redness, and pain) and is used to treat certain forms of\n\t\t\t\t\tarthritis; skin, blood, kidney, eye, thyroid, and intestinal disorders (e.g., colitis); severe allergies; and asthma. Methylprednisolone is also used to treat certain types of cancer.\n\t\t\t\t\tThis medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.", "AnswerURL": "https://medlineplus.gov/druginfo/meds/a682795.html", "COMMENT": "", "_aid": "TQ40A1" }, { "ANSWER": "Methylprednisolone (By mouth) meth-il-pred-NIS-oh-lone\n\t\t\t\t\tTreats many diseases and conditions, including problems related to inflammation. This medicine is a corticosteroid.\n\n\t\t\t\t\tDrug classes: Endocrine-Metabolic Agent, Immune Suppressant\n\n\t\t\t\t\tUses of This Medicine: Methylprednisolone provides relief for inflamed areas of the body. It is used to treat a number of different conditions, such as inflammation (swelling), severe allergies, adrenal problems, arthritis, asthma, blood or bone marrow problems, eye or vision problems, lupus, skin\n\t\t\t\t\tconditions, kidney problems, ulcerative colitis, and flare-ups of multiple sclerosis. Methylprednisolone is a corticosteroid (cortisone-like medicine or steroid). It works on the immune system to help relieve swelling, redness, itching, and allergic reactions.\n\n\t\t\t\t\tThis medicine is available only with your doctor's prescription.", "AnswerURL": "https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0011173/?report=details", "COMMENT": "I initially went to https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0001175/ and expanded the two descriptions", "_aid": "TQ40A2" }, { "ANSWER": "Methylprednisolone (By injection) meth-il-pred-NIS-oh-lone\n\t\t\t\t\tTreats inflammation, severe allergies, flare-ups of ongoing illnesses, and many other medical problems. May also be used to decrease some symptoms of cancer. This medicine is a corticosteroid (cortisone-like medicine or steroid).\n\n\t\t\t\t\tDrug classes: Endocrine-Metabolic Agent, Immune Suppressant\n\n\t\t\t\t\tUses of This Medicine: Methylprednisolone injection provides relief for inflamed areas of the body. It is used to treat a number of different conditions, such as inflammation (swelling), severe allergies, adrenal problems, arthritis, asthma, blood or bone marrow problems, eye or vision problems,\n\t\t\t\t\tlupus, skin conditions, kidney problems, ulcerative colitis, and flare-ups of multiple sclerosis. Methylprednisolone is a corticosteroid (cortisone-like medicine or steroid). It works on the immune system to help relieve swelling, redness, itching, and allergic reactions.\n\n\t\t\t\t\tThis medicine is available only with your doctor's prescription.", "AnswerURL": "https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0011175/?report=details", "COMMENT": "I initially went to https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0001175/ and expanded the two descriptions", "_aid": "TQ40A3" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "methylprednisolole" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "INFORMATION", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "Simvastatin comes as a tablet to take by mouth. It usually is taken once a day in the evening. Take simvastatin at around the same time every day.", "AnswerURL": "https://medlineplus.gov/druginfo/meds/a692030.html#how", "COMMENT": "general answer that does not specifically address morning. The answer is somewhat relevant as it provides information about taking the drug at the same time", "_aid": "TQ41A1" }, { "ANSWER": "Most manufacturers of statins recommend that they are taken at night, on the basis of physiological studies which show that most cholesterol is synthesised when dietary intake is at its lowest. Simvastatin is probably best taken at night because concentrations of total cholesterol and of\n\t\t\t\t\tlow density lipoprotein are significantly greater when it is taken in the morning.", "AnswerURL": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC214096/", "COMMENT": "PMC Article addresses morning versus evening and specifically answers the both subquestions", "_aid": "TQ41A2" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "Simvastatin" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "USAGE", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "If you abruptly stop taking prednisone or taper off too quickly, you might experience prednisone withdrawal symptoms:\n\n\t\t\t\t\tSevere fatigue\n\t\t\t\t\tWeakness\n\t\t\t\t\tBody aches\n\t\t\t\t\tJoint pain\n\t\t\t\t\tPrednisone is similar to cortisol, a hormone naturally made by your adrenal glands. If you take prednisone for more than a few weeks, your adrenal glands decrease cortisol production. A gradual reduction in prednisone dosage gives your adrenal glands time to resume their normal function.\n\n\t\t\t\t\tThe amount of time it takes to taper off prednisone depends on the disease being treated, the dose and duration of use, and other medical considerations. A full recovery can take anywhere from a week to several months. Contact your doctor if you experience prednisone withdrawal symptoms as you are\n\t\t\t\t\ttapering off the drug", "AnswerURL": "http://www.mayoclinic.org/prednisone-withdrawal/expert-answers/faq-20057923", "COMMENT": "", "_aid": "TQ42A1" }, { "ANSWER": "If you are taking prednisone to treat a long-lasting disease, the medication may help control your condition but will not cure it. Continue to take prednisone even if you feel well. Do not stop taking prednisone without talking to your doctor. If you suddenly stop taking prednisone, your\n\t\t\t\t\tbody may not have enough natural steroids to function normally. This may cause symptoms such as extreme tiredness, weakness, slowed movements, upset stomach, weight loss, changes in skin color, sores in the mouth, and craving for salt. Call your doctor if you experience these or other unusual\n\t\t\t\t\tsymptoms while you are taking decreasing doses of prednisone or after you stop taking the medication.", "AnswerURL": "https://medlineplus.gov/druginfo/meds/a601102.html", "COMMENT": "", "_aid": "TQ42A2" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "prednisone" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "TAPERING", "_hasKeyword": "K1,K2,K3" } ]

[ { "_kid": "K1", "_kcategory": "Problem", "__text": "chills" }, { "_kid": "K2", "_kcategory": "Problem", "__text": "fever" }, { "_kid": "K3", "_kcategory": "Problem", "__text": "abdominal pain" } ]

[ { "ANSWER": "An electrical injury is damage to the skin or internal organs when a person comes into direct contact with an electrical current. Symptoms may include:\n\t\t\t\t\tChanges in alertness (consciousness)\n\t\t\t\t\tBroken bones\n\t\t\t\t\tHeart attack (chest, arm, neck, jaw, or back pain)\n\t\t\t\t\tHeadache\n\t\t\t\t\tProblems with swallowing, vision, or hearing\n\t\t\t\t\tIrregular heartbeat\n\t\t\t\t\tMuscle spasms and pain\n\t\t\t\t\tNumbness or tingling\n\t\t\t\t\tBreathing problems or lung failure\n\t\t\t\t\tSeizures\n\t\t\t\t\tSkin burns", "AnswerURL": "http://www.nytimes.com/health/guides/injury/electrical-injury/overview.html", "COMMENT": "New York Times Health Guide", "_aid": "TQ43A1" }, { "ANSWER": "An electrical injury is damage to the skin or internal organs when a person comes into direct contact with an electrical current.\n\t\t\t\t\tSymptoms may include:\n\n\t\t\t\t\tChanges in alertness (consciousness)\n\t\t\t\t\tBroken bones\n\t\t\t\t\tHeart attack (chest, arm, neck, jaw, or back pain)\n\t\t\t\t\tHeadache\n\t\t\t\t\tProblems with swallowing, vision, or hearing\n\t\t\t\t\tIrregular heartbeat\n\t\t\t\t\tMuscle spasms and pain\n\t\t\t\t\tNumbness or tingling\n\t\t\t\t\tBreathing problems or lung failure\n\t\t\t\t\tSeizures\n\t\t\t\t\tSkin burns", "AnswerURL": "https://medlineplus.gov/ency/article/000053.htm", "COMMENT": "almost identical answers", "_aid": "TQ43A2" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "electrical high voltage shock" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "COMPLICATION", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "Problem", "__text": "swallowing problems" } ]

[ { "ANSWER": "Store unopened bottle in refrigerator between 2 degrees to 8 degrees C (36 degrees to 46 degrees F). Protect from freezing.\n\n\t\t\t\t\tStore bottle in use at room temperature between 20 degrees to 25 degrees C (68 degrees to 77 degrees F) in an upright position, for up to 30 days (2 mL fill) or 35 days (3.7 mL fill).", "AnswerURL": "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c82eb602-12e1-692b-d660-f8d5b5736b54", "COMMENT": "Storage instructions", "_aid": "TQ44A1" }, { "ANSWER": "Calcitonin salmon remained stable in nasal spray after being stored for three days at 25 or 40 degrees C", "AnswerURL": "https://www.ncbi.nlm.nih.gov/pubmed/11977855", "COMMENT": "Both storage instructions and studies of stability at room temperature are relevant. Either answer is acceptable", "_aid": "TQ44A2" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "calcitonin salmon nasal spray" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "STORAGE_DISPOSAL", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "Schmorl nodes, also referred as intravertebral disc herniations, refer to protrusions of the cartilage of the intervertebral disc through the vertebral body endplate and into the adjacent vertebra. The protrusions may contact the marrow of the vertebra, leading to inflammation.", "AnswerURL": "https://radiopaedia.org/articles/schmorl-nodes-1", "COMMENT": "", "_aid": "TQ45A1" }, { "ANSWER": "First described in 1927, a Schmorl's node (SN) is the herniation of nucleus pulposus (NP) through the cartilaginous and bony end plate into the body of the adjacent vertebra. SNs are common findings on imaging, and although most SNs are asymptomatic, some have been shown to become\n\t\t\t\t\tpainful lesions. In this manuscript, we review the literature regarding the epidemiology, clinical presentation, pathogenesis, imaging, and management of SNs.", "AnswerURL": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3481099/", "COMMENT": "Schmorl's nodes Eur Spine J. 2012 Nov; 21(11): 2115-2121.", "_aid": "TQ45A2" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "Schmorl's Nodes" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "INFORMATION", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "Sleep Paralysis\n\n\t\t\t\t\tThis condition prevents you from moving or speaking while falling asleep or waking up. However, you're fully conscious (aware) during this time. Sleep paralysis usually lasts just a few seconds or minutes, but it can be scary.", "AnswerURL": "https://www.nhlbi.nih.gov/health/health-topics/topics/nar/signs", "COMMENT": "A short answer", "_aid": "TQ46A1" }, { "ANSWER": "Isolated sleep paralysis is a type of paralysis that occurs when a person just goes to sleep or upon waking from sleep. It is not associated with another sleep disorder. Episodes of isolated sleep paralysis last from a few seconds to 1 or 2 minutes. During these episodes the person is\n\t\t\t\t\tunable to move or speak. Breathing is not affected. These spells end on their own or when the person is touched or moved. In rare cases, the person may have dream-like sensations or hallucinations, which may be scary to them.", "AnswerURL": "https://medlineplus.gov/ency/article/000801.htm", "COMMENT": "A longer explanation", "_aid": "TQ46A2" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "sleep paralysis" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "INFORMATION", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "Exercise-induced bronchoconstriction (EIB), also called exercise-induced asthma, is a narrowing of the airways in the lungs that is triggered by physical activity.\n\n\t\t\t\t\tEIB is common in patients with chronic asthma, who frequently experience flare-ups while exercising. But it can also occur in otherwise healthy individuals who experience asthma symptoms only when they exercise.\n\n\t\t\t\t\tSymptoms of Exercise-Induced Asthma\n\t\t\t\t\tIf you have EIB, you may have problems breathing within five to 20 minutes after exercise. Symptoms of EIB are similar to those of chronic asthma, but the timing of the symptoms is closely linked with physical activity.\n\n\t\t\t\t\tYour symptoms may include:\n\t\t\t\t\t* Wheezing\n\t\t\t\t\t* Tight chest\n\t\t\t\t\t* Cough\n\t\t\t\t\t* Shortness of breath\n\t\t\t\t\t* Chest pain (rarely)\n\n\t\t\t\t\tTriggers\n\t\t\t\t\tPeople with EIB are typically very sensitive to both low temperatures and dry air. Air is usually warmed and humidified by the nose, but during demanding activity people breathe more through their mouths. This allows cold, dry air to reach your lower airways and your lungs without passing through\n\t\t\t\t\tyour nose, triggering asthma symptoms.\n\n\t\t\t\t\tAir pollutants, high pollen levels and viral respiratory infections may also be triggers. Other causes of symptoms while exercising include being out of shape, poorly controlled nasal allergies or vocal cord issues.\n\t\t\t\t\tEven the sport you choose can affect your symptoms. Swimming is considered less likely to cause asthma symptoms because the warm, humid environment of the pool does not aggravate the airways. Warm-weather activities and those requiring only short bursts of energy are also recommended. These\n\t\t\t\t\tinclude:\n\t\t\t\t\t* Hiking\n\t\t\t\t\t* Baseball\n\t\t\t\t\t* Golf\n\t\t\t\t\t* Walking\n\t\t\t\t\t* Leisure biking\n\n\t\t\t\t\tBecause cold, dry air can make symptoms worse, as can activities that require continuous exertion, it is recommended that individuals with EIB avoid sports like:\n\t\t\t\t\t* Cross-country skiing\n\t\t\t\t\t* Running\n\t\t\t\t\t* Soccer\n\t\t\t\t\t* Basketball\n\t\t\t\t\t* Hockey", "AnswerURL": "http://www.aaaai.org/conditions-and-treatments/library/asthma-library/exercise-and-asthma", "COMMENT": "An answer from the American Academy of Allergy, Asthma & Immunology adds some information on the types of exercise to avoid.", "_aid": "TQ47A1" }, { "ANSWER": "Fortunately, having asthma, even exercise-induced asthma, doesn't have to keep you out of the game. In fact, as many as one in 12 Olympic athletes take asthma medication.\n\n\t\t\t\t\tThe trick is to make sure asthma is well controlled with medication and to choose your activity carefully. Some are good choices, others may be more of a challenge. ...\n\t\t\t\t\tOne recent study found that adults who walked three times a week for 12 weeks actually improved asthma control and fitness levels without provoking an attack. ...\n\t\t\t\t\tOne study found that people who practiced Hatha yoga two-and-a-half hours a week for 10 weeks were able to cut down on their asthma medication. The same benefit would probably result from Tai Chi, a martial art that also emphasizes breathing, says Dr. Graham. ...", "AnswerURL": "http://www.health.com/asthma/14-best-and-worst-exercises-for-asthma", "COMMENT": "Pages with specific exercises for asthmatics are relevant", "_aid": "TQ47A2" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "asthma" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "LIFESTYLE_DIET", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "Lifestyle", "__text": "exercises" } ]

[ { "ANSWER": "If you are taking the tablets, extended-release tablets, sublingual tablets (Edluar), or oral spray, you will take the medication as needed, not more than one time a day, immediately before bedtime. You will probably become very sleepy soon after you take zolpidem and will remain sleepy\n\t\t\t\t\tfor some time after you take the medication. Plan to go to bed right after you take zolpidem tablets, extended-release tablets, sublingual tablets (Edluar), and oral spray and to stay in bed for 7 to 8 hours.", "AnswerURL": "https://medlineplus.gov/druginfo/meds/a693025.html", "COMMENT": "", "_aid": "TQ48A1" }, { "ANSWER": "Administration Instructions\n\t\t\t\t\tPatients should be counseled to take AMBIEN right before they get into bed and only when they are able to stay in bed a full night (7-8 hours) before being active again. AMBIEN tablets should not be taken with or immediately after a meal. Advise patients NOT to take AMBIEN if they drank alcohol that\n\t\t\t\t\tevening.", "AnswerURL": "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c36cadf4-65a4-4466-b409-c82020b42452", "COMMENT": "DailyMed PATIENT COUNSELING INFORMATION", "_aid": "TQ48A2" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "Ambien" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "USAGE", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "Bundle branch block is a condition in which there's a delay or obstruction along the pathway that electrical impulses travel to make your heart beat. The delay or blockage may occur on the pathway that sends electrical impulses to the left or the right side of the bottom chambers\n\t\t\t\t\t(ventricles) of your heart.\n\n\t\t\t\t\tBundle branch block sometimes makes it harder for your heart to pump blood efficiently through your circulatory system.\n\n\t\t\t\t\tThere's no specific treatment for bundle branch block itself. However, any underlying health condition that caused bundle branch block, such as heart disease, will need to be treated.\n\n\t\t\t\t\tIn most people, bundle branch block doesn't cause any symptoms. Sometimes, people with the condition don't even know they have a bundle branch block.\n\n\t\t\t\t\tFor those people who do have signs and symptoms, they may include: Fainting (syncope); Feeling as if you're going to faint (presyncope)", "AnswerURL": "http://www.mayoclinic.org/diseases-conditions/bundle-branch-block/basics/definition/CON-20027273?p=1", "COMMENT": "Answers containing general information, symptoms, and treatment are relevant.", "_aid": "TQ49A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "bundle blockage" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "INFORMATION", "_hasKeyword": null }, { "_tid": "T2", "_hasFocus": "F1", "__text": "SYMPTOM", "_hasKeyword": null }, { "_tid": "T3", "_hasFocus": "F1", "__text": "TREATMENT", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "Administration of cephalothin, cephalexin, cefadroxil, and cefazolin in penicillin-allergic patients is associated with a significant increase in the rate of allergic reactions; whereas administration of cefprozil, cefuroxime, cefpodoxime, ceftazidime, and ceftriaxone is not.", "AnswerURL": "http://www.mdedge.com/jfponline/article/62044/cephalosporins-can-be-prescribed-safely-penicillin-allergic-patients", "COMMENT": "Cephalosporins can be prescribed safely for penicillin-allergic patients\n\t\t\t\t\tJ Fam Pract. 2006 February;55(2):106-112", "_aid": "TQ50A1" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "Cephalexin" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "CONTRAINDICATION", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "Problem", "__text": "ALLERGIC TO PENICILLAN" } ]

[ { "ANSWER": "Cardiac ablation carries a risk of complications, including:\n\n\t\t\t\t\tBleeding or infection at the site where your catheter was inserted\n\t\t\t\t\tDamage to your blood vessels where the catheter may have scraped as it traveled to your heart\n\t\t\t\t\tPuncture of your heart\n\t\t\t\t\tDamage to your heart valves\n\t\t\t\t\tDamage to your heart's electrical system, which could worsen your arrhythmia and require a pacemaker to correct\n\t\t\t\t\tBlood clots in your legs or lungs (venous thromboembolism)\n\t\t\t\t\tStroke or heart attack\n\t\t\t\t\tNarrowing of the veins that carry blood between your lungs and heart (pulmonary vein stenosis)\n\t\t\t\t\tDamage to your kidneys from dye used during the procedure\n\t\t\t\t\tDeath in rare cases", "AnswerURL": "http://www.mayoclinic.org/tests-procedures/cardiac-ablation/details/risks/cmc-20268874", "COMMENT": "complications that include worsening of arrhythmia are relevant", "_aid": "TQ51A1" }, { "ANSWER": "Catheter ablation is a procedure that uses radiofrequency energy (similar to microwave heat) to destroy a small area of heart tissue that is causing rapid and irregular heartbeats. Destroying this tissue helps restore your heart's regular rhythm. The procedure is also called\n\t\t\t\t\tradiofrequency ablation. Catheter ablation is a low-risk procedure that is successful in most people who have it.", "AnswerURL": "http://www.heart.org/HEARTORG/Conditions/Arrhythmia/PreventionTreatmentofArrhythmia/Ablation-for-Arrhythmias_UCM_301991_Article.jsp#.WWAS-vnytaQ", "COMMENT": "general success rate", "_aid": "TQ51A2" }, { "ANSWER": "Success Rates for Catheter Ablation at the University of Michigan\n\t\t\t\t\tParoxysmal atrial fibrillation can be eliminated in 70-75 percent of patients with a single procedure. When the procedure is repeated in patients who still have atrial fibrillation after the first procedure, the overall success rate is approximately 85-90 percent.\n\t\t\t\t\tPersistent atrial fibrillation can be eliminated in approximately 50 percent of patients with a single procedure. In about 30 percent of patients who undergo ablation of chronic atrial fibrillation, the atrial fibrillation is replaced by a different kind of short circuit referred to as \"left atrial\n\t\t\t\t\tflutter.\" These patients are treated temporarily with medications and the left atrial flutter sometimes goes away on its own within a few months. If it does not, you may need a second catheter ablation procedure to eliminate the flutter. In these cases, the overall success rate is approximately\n\t\t\t\t\t75-85 percent. If the atrial fibrillation has been persistent for more than 1-2 years, almost all patients will require more than one ablation procedure before a normal heart rhythm is restored.", "AnswerURL": "http://www.umcvc.org/conditions-treatments/catheter-ablation", "COMMENT": "success rates from one hospital", "_aid": "TQ51A3" }, { "ANSWER": "Do you need treatment?\n\n\t\t\t\t\tMost arrhythmias are considered harmless and are left untreated. Once your doctor has documented that you have an arrhythmia, he or she will need to find out whether it's abnormal or merely reflects the heart's normal processes. He or she will also determine whether your arrhythmia is clinically\n\t\t\t\t\tsignificant - that is, whether it causes symptoms or puts you at risk for more serious arrhythmias or complications of arrhythmias in the future. If your arrhythmia is abnormal and clinically significant, your doctor will set a treatment plan.", "AnswerURL": "http://www.heart.org/HEARTORG/Conditions/Arrhythmia/PreventionTreatmentofArrhythmia/Prevention-Treatment-of-Arrhythmia_UCM_002026_Article.jsp#.WWdrHvnytaQ", "COMMENT": "pages discussing when treatment is needed are releant", "_aid": "TQ51A4" } ]

[ { "_fid": "F1", "_fcategory": "ProcedureDevice", "__text": "Heart ablation" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "OTHER_QUESTION", "_hasKeyword": null }, { "_tid": "T2", "_hasFocus": "F1", "__text": "COMPLICATION", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "Problem", "__text": "arrhythmia" } ]

[ { "ANSWER": "Erectile dysfunction: Viagra and other oral medications\n\t\t\t\t\tSildenafil (Viagra), vardenafil (Levitra, Staxyn), tadalafil (Cialis) and avanafil (Stendra) are oral medications that reverse erectile dysfunction by enhancing the effects of nitric oxide, a natural chemical your body produces that relaxes muscles in the penis. This increases blood flow and allows you\n\t\t\t\t\tto get an erection in response to sexual stimulation.", "AnswerURL": "http://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/in-depth/erectile-dysfunction/ART-20047821?p=1", "COMMENT": "medications for erectile dysfunction", "_aid": "TQ52A1" }, { "ANSWER": "Fildena contains Sildenafil Citrate, a common ingredient used in various leading branded ED pills like kamagra etc. and which are available over the counter. Sildenafil Citrate was originally developed by British scientists and then brought to market by the US-based pharma. Sildenafil\n\t\t\t\t\tCitrate helps treat erectile dysfunction (trouble having an erection). Helps a man have an erection or have a better erection with his penis during sex. It also treats pulmonary arterial hypertension (high blood pressure in the lungs) in both men and women.\n\n\t\t\t\t\tFildena is the latest ED pill launched by Fortune Healthcare which has more than two decade's experience in producing ED pills. Fildena has the same trust and guarantee of millions of worldwide patients who have earlier used other ED pills like Filagra, Filitra and Tadalista all manufactured by\n\t\t\t\t\tFortune Healthcare.", "AnswerURL": "http://fildena.bz/", "COMMENT": "Fildena might be generic form of Viagra", "_aid": "TQ52A2" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "fildena" }, { "_fid": "F2", "_fcategory": "DrugSupplement", "__text": "viagra" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "INFORMATION", "_hasKeyword": null }, { "_tid": "T2", "_hasFocus": "F1,F2", "__text": "COMPARISON", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "Management of NPH\n\n\t\t\t\t\tDiagnosing normal pressure hydrocephalus (NPH) can be frustrating. Symptoms of gait disturbance, mild dementia and poor bladder control occur with other health conditions that affect people over 60. These conditions may also coexist with hydrocephalus, creating a challenge to clear and accurate diagnosis\n\t\t\t\t\tand making treatment difficult.\n\t\t\t\t\tVisit our community portals for age and life stage specific resources.\n\t\t\t\t\tBe informed and current about normal pressure hydrocephalus by tuning into interactive, free webinars on a variety of topics.", "AnswerURL": "http://www.hydroassoc.org/management-of-nph/", "COMMENT": "Hydrocephalus Association offers online resources, webinars, and online networks through Facebook", "_aid": "TQ53A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "Nph" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "INFORMATION", "_hasKeyword": "K1" }, { "_tid": "T2", "_hasFocus": "F1", "__text": "PERSON_ORGANIZATION", "_hasKeyword": null } ]

[ { "_kid": "K1", "_kcategory": "Lifestyle", "__text": "exercise" } ]

[ { "ANSWER": "The purpose of this pilot study is to determine if taking a low dose of naltrexone in addition to an antidepressant medication can help treat relapse or recurrence in people with Major Depressive Disorder (MDD). The U.S. Food and Drug Administration (FDA) has approved naltrexone for the\n\t\t\t\t\ttreatment of alcohol dependence and opioid dependence, but the FDA has not approved naltrexone to treat depression. The investigators hypothesize that patients with breakthrough depression on an antidepressant regimen containing a pro-dopaminergic agent assigned to treatment with low dose\n\t\t\t\t\tnaltrexone will demonstrate higher rates of response compared to those patients taking placebo.", "AnswerURL": "https://clinicaltrials.gov/ct2/show/NCT01874951", "COMMENT": "This topic is under investigation.", "_aid": "TQ54A1" }, { "ANSWER": "LDN augmentation showed some benefit for MDD relapse on dopaminergic agents. Confirmation in larger studies is needed.", "AnswerURL": "https://www.ncbi.nlm.nih.gov/pubmed/27736689", "COMMENT": "Psychiatrist's presentations and patients testimonials for or against LDN are relevant. E.g., https://www.patientslikeme.com/treatment_evaluations/browse/64-low-dose-naltrexone-ldn-side-effects-and-efficacy?brand=t&page=3 .", "_aid": "TQ54A2" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "severe depression" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "TREATMENT", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "DrugSupplement", "__text": "naltrexone" } ]

[ { "ANSWER": "Scientists have identified 5 unique hepatitis viruses, identified by the letters A, B, C, D, and E. While all cause liver disease, they vary in important ways.\n\n\t\t\t\t\tHepatitis A virus (HAV) is present in the faeces of infected persons and is most often transmitted through consumption of contaminated water or food. Certain sex practices can also spread HAV. Infections are in many cases mild, with most people making a full recovery and remaining immune from further\n\t\t\t\t\tHAV infections. However, HAV infections can also be severe and life threatening. Most people in areas of the world with poor sanitation have been infected with this virus. Safe and effective vaccines are available to prevent HAV.\n\n\t\t\t\t\tHepatitis B virus (HBV) is transmitted through exposure to infective blood, semen, and other body fluids. HBV can be transmitted from infected mothers to infants at the time of birth or from family member to infant in early childhood. Transmission may also occur through transfusions of HBV-contaminated\n\t\t\t\t\tblood and blood products, contaminated injections during medical procedures, and through injection drug use. HBV also poses a risk to healthcare workers who sustain accidental needle stick injuries while caring for infected-HBV patients. Safe and effective vaccines are available to prevent HBV.\n\n\t\t\t\t\tHepatitis C virus (HCV) is mostly transmitted through exposure to infective blood. This may happen through transfusions of HCV-contaminated blood and blood products, contaminated injections during medical procedures, and through injection drug use. Sexual transmission is also possible, but is\n\t\t\t\t\tmuch less common. There is no vaccine for HCV.\n\n\t\t\t\t\tHepatitis D virus (HDV) infections occur only in those who are infected with HBV. The dual infection of HDV and HBV can result in a more serious disease and worse outcome. Hepatitis B vaccines provide protection from HDV infection.\n\n\t\t\t\t\tHepatitis E virus (HEV) is mostly transmitted through consumption of contaminated water or food. HEV is a common cause of hepatitis outbreaks in developing parts of the world and is increasingly recognized as an important cause of disease in developed countries. Safe and effective vaccines to prevent\n\t\t\t\t\tHEV infection have been developed but are not widely available.", "AnswerURL": "http://www.who.int/features/qa/76/en/", "COMMENT": "", "_aid": "TQ55A1" }, { "ANSWER": "HEPATITIS A is caused by the Hepatitis A virus (HAV)\n\t\t\t\t\tRoutes of Transmission\n\t\t\t\t\tIngestion of fecal matter, even in\n\t\t\t\t\tmicroscopic amounts, from:\n\t\t\t\t\t* Close person-to-person contact\n\t\t\t\t\twith an infected person\n\t\t\t\t\t* Sexual contact with an infected\n\t\t\t\t\tperson\n\t\t\t\t\t* Ingestion of contaminated food\n\t\t\t\t\tor drinks\n\n\t\t\t\t\tHEPATITIS B is caused by the Hepatitis B virus (HBV)\n\t\t\t\t\tRoutes of Transmission\n\t\t\t\t\tContact with infectious blood, semen, and other body\n\t\t\t\t\tfluids primarily through:\n\t\t\t\t\t* Birth to an infected mother\n\t\t\t\t\t* Sexual contact with an infected person\n\t\t\t\t\t* Sharing of contaminated needles, syringes, or other\n\t\t\t\t\tinjection drug equipment\n\t\t\t\t\t* Needlesticks or other sharp instrument injuries\n\n\t\t\t\t\tHEPATITIS C is caused by the Hepatitis C virus (HCV)\n\t\t\t\t\tRoutes of Transmission\n\t\t\t\t\tContact with blood of an infected person\n\t\t\t\t\tprimarily through:\n\t\t\t\t\t* Sharing of contaminated needles, syringes,\n\t\t\t\t\tor other injection drug equipment\n\t\t\t\t\tLess commonly through:\n\t\t\t\t\t* Sexual contact with an infected person\n\t\t\t\t\t* Birth to an infected mother\n\t\t\t\t\t* Needlestick or other sharp instrument injuries", "AnswerURL": "https://www.cdc.gov/hepatitis/resources/professionals/pdfs/abctable.pdf", "COMMENT": "", "_aid": "TQ55A2" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "hepatitis" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "SUSCEPTIBILITY", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "Jock itch usually stays around the creases of the upper thigh and does not involve the scrotum or penis. Jock itch may spread to the anus, causing anal itching and discomfort. Symptoms include:\n\t\t\t\t\tRed, raised, scaly patches that may blister and ooze; patches often have sharply-defined edges with scale at the edges.\n\t\t\t\t\tPatches are often redder around the outside with normal skin tone in the center.\n\t\t\t\t\tAbnormally dark or light skin. Sometimes, these changes are permanent.", "AnswerURL": "https://medlineplus.gov/ency/article/000876.htm", "COMMENT": "", "_aid": "TQ56A1" }, { "ANSWER": "Itchy Crotch Cause: Fungal Infections\n\t\t\t\t\tHow you know you have it: You'll likely develop a rash along with the itching, though its appearance varies depending on the type of fungus causing it. For instance, if a yeast infection is responsible, you may notice moist, shiny areas of skin on your penis, and possibly some white stuff in the\n\t\t\t\t\tskin folds, along with the red, itchy rash, according to the Mayo Clinic.\n\n\t\t\t\t\tYeast is normally present in small amounts on your skin, but an overgrowth of it can cause an infection. This tends to occur in moist places that don't get much light, says Jason Reichenberg, M.D., director of dermatology at the University of Texas Austin. So it usually shows up on the sides of your\n\t\t\t\t\tgroin, between your genitals and thighs.\n\n\t\t\t\t\tOther fungal infections look a little different: They appear dry and flaky, and usually crop up on your thighs, Dr. Reichenberg says.\n\n\t\t\t\t\tHow to treat it: Whatever the type of fungus responsible for your itching, an antifungal cream like Lotrimin AF should do the trick. The cream attacks the fungal cells that cause the infection, while leaving your healthy skin cells unscathed.\n\n\t\t\t\t\tPat the region dry before rubbing on the cream. That will help get rid moisture, keeping the fungus from growing and allowing the cream to work better, Dr. Reichenberg says.\n\n\t\t\t\t\tItchy Crotch Cause: Chafing\n\t\t\t\t\tHow you know you have it: Chafing occurs when your skin rubs together-commonly your thighs. It usually develops when you're doing an activity that involves a lot of friction, like running.\n\n\t\t\t\t\tThe rubbing can disturb your skin barrier, causing tiny cracks and inflammation on your outer layers of skin. This causes a red, irritated rash that burns and itches. Your skin can also grow scaly, too, Dr. Zeichner says.\n\n\t\t\t\t\tHow to treat it: Your goal is to protect your irritated skin and prevent any additional rubbing. A moisturizer like Aveeno Skin Relief Moisturizing Cream will help repair the skin. It also contains colloidal oatmeal, which works to soothe irritation, Dr. Zeichner says.\n\n\t\t\t\t\tPair that with a zinc cream, like Destin, which protects your skin from future rubbing by adding a protective barrier. And then use a cream that contains petroleum, like CeraVe Healing Ointment, which helps hydrate and restore your skin.\n\n\t\t\t\t\tItchy Crotch Cause: Intertrigo\n\t\t\t\t\tHow you know you have it: You'll develop a raw, red rash that itches and stings, usually in areas that contain lots of moisture from sweating, Dr. Zeichner says-so, like your groin, between the folds of your stomach, under your arms, or between your toes, according to the Mayo Clinic. That\n\t\t\t\t\tmoisture can spur an overgrowth of bacteria and fungus.\n\n\t\t\t\t\tHow to treat it: Antibacterial creams like Neosporin and antifungal creams, like Lotrimin, can take care of the bacteria and fungus. And a zinc cream, like Destin, shields your skin from more rubbing.\n\n\t\t\t\t\tIf the rash persists for one to two weeks, head to your dermatologist. He or she will likely prescribe stronger versions of these medications to smooth over the irritation, Dr. Zeichner says.\n\n\t\t\t\t\tItchy Crotch Cause: Contact Dermatitis\n\t\t\t\t\tHow you know you have it: Contact dermatitis occurs when your skin comes in contact with something it's allergic to. You'll likely develop a super itchy, red rash that looks bumpy. It might even ooze a clear or yellowish fluid, which shows that the top layer of your skin has been disrupted, says\n\t\t\t\t\tDr. Reichenberg.\n\n\t\t\t\t\tContact dermatitis is likely the cause if you notice that itchy rash and you've recently changed something in your routine-say, you tried a new laundry detergent or fabric softener, or even bought a new couch made of a different material-right before you noticed it, says Dr. Reichenberg. You'll\n\t\t\t\t\tusually start to notice a reaction hours or even a few days later.\n\n\t\t\t\t\tYou'll also probably experience itching on other body parts that were exposed to the allergen, too, he says. Your itchy balls will likely bother you more, though, since their thin skin is more sensitive to allergens.\n\n\t\t\t\t\tHow to treat it: Stop using the chemical or material you think may be responsible. If it's clothing washed in a new detergent, rewash it a few times with your previous brand, says Dr. Reichenberg.\n\n\t\t\t\t\tIf contact dermatitis was responsible, the reaction should disappear in about two weeks.\n\n\t\t\t\t\tItchy Crotch Cause: Pubic lice\n\t\t\t\t\tHow you know you have it: If you start to notice intense itching, irritation, and tiny specks in your pubic hair, you might have contracted a type of parasite called pubic lice, also known as crabs.\n\n\t\t\t\t\tYou may see tiny white or yellowish specks near the roots of your pubic hair. Those are the lice eggs, says Dennis Fortenberry, M.D., a professor of adolescent medicine at Indiana University. You might also spot the lice themselves crawling-they're tan or grayish-white, and if you're brave enough\n\t\t\t\t\tto look at one through a magnifying glass, it'd resemble a mini crab, reports the Centers for Disease Control and Prevention.\n\n\t\t\t\t\tHow to treat it: Head to your doctor-he or she will confirm that your problem actually is lice, and send you home with a shampoo or lotion containing either permethrin or pyrethrins with piperonyl butoxide, which will kill the lice Dr. Fortenberry says.\n\n\t\t\t\t\tItchy Crotch Cause: Herpes\n\t\t\t\t\tHow you know you have it: For some guys, itching can be the first symptom of this sexually transmitted infection (STI), which is caused by the herpes virus, Dr. Fortenberry says. That itch will usually turn to burning, and within about a day, a blister or cluster of blisters can form. Then, the\n\t\t\t\t\tblisters can break, leading to painful sores.\n\n\t\t\t\t\tIf you've experienced those symptoms in the past and they keep cropping back up, that might point to herpes, since the infection usually causes recurrent outbreaks.\n\n\t\t\t\t\tHow to treat it: This is another case where you'll head to your doctor. He or she will diagnose you, either by simply looking at the appearance of your blisters or by performing a blood test or culture of the lesion, reports the CDC.\n\n\t\t\t\t\tThere's no cure for herpes, but your doctor can provide some treatment. Antiviral meds, like Valtrex, Zovirax, or Famvir, can shorten the outbreak or prevent one from occurring. They also may reduce the chances of passing on the virus to your partner.\n\n\t\t\t\t\tItchy Crotch Cause: Genital Warts\n\t\t\t\t\tHow you know you have it: Genital warts are a common symptom of the STI human papillomavirus (HPV). They are typically soft to the touch and skin colored, and some may even resemble a cauliflower. You might notice just one, or they could crop up in a cluster, Dr. Fortenberry says. But other than\n\t\t\t\t\tsome itching, the warts don't feel like anything.\n\n\t\t\t\t\tHow to treat it: If you think you have genital warts, check in with your doctor, Dr. Fortenberry says. He or she will likely prescribe a medication that contains Imiquimod, Podofilox, or Sinecatechins, which will stimulate your body's immune system to clear up the warts.\n\n\t\t\t\t\tOr, she may apply liquid nitrogen to the growth, which will freeze it off.\n\n\t\t\t\t\tHowever, even though you can get rid of the wart, you can't eliminate the virus from your system-meaning more warts could crop up down the road, and you can still spread it to others if you don't have a visible wart.\n\n\t\t\t\t\tThis article originally appeared on MensHealth.com.", "AnswerURL": "http://www.foxnews.com/health/2017/02/01/7-reasons-your-groin-is-so-itchy.html", "COMMENT": "Alternative causes of itching and bumps in scrotal area are relevant", "_aid": "TQ56A2" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "Jock itch" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "SYMPTOM", "_hasKeyword": "K1,K2" } ]

[ { "_kid": "K1", "_kcategory": "Problem", "__text": "small lumps" }, { "_kid": "K1", "_kcategory": "Anatomy", "__text": "scrotum" } ]

[ { "ANSWER": "Ribcage pain may be caused by any of the following:\n\t\t\t\t\tBruised, cracked, or fractured rib\n\t\t\t\t\tInflammation of cartilage near the breastbone (costochondritis)\n\t\t\t\t\tOsteoporosis\n\t\t\t\t\tPleurisy (the pain is worse when breathing deeply)\n\t\t\t\t\tRest and not moving the area (immobilization) are the best cures for a ribcage fracture.\n\n\t\t\t\t\tFollow your health care provider's instructions for treating the cause of ribcage pain.", "AnswerURL": "https://medlineplus.gov/ency/article/003109.htm", "COMMENT": "the answer includes causes and limited information on remedies.", "_aid": "TQ57A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "rib cage pain" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "CAUSE", "_hasKeyword": null }, { "_tid": "T2", "_hasFocus": "F1", "__text": "TREATMENT", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "Hantavirus is a serious infection that gets worse quickly. Lung failure can occur and may lead to death. Even with aggressive treatment, more than one half of people who have this disease in their lungs die.", "AnswerURL": "https://medlineplus.gov/ency/article/001382.htm", "COMMENT": "", "_aid": "TQ58A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "hantavirus" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "PROGNOSIS", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "Problem", "__text": "death" } ]

[ { "ANSWER": "A blockage inside of the appendix causes appendicitis. The blockage leads to increased pressure, problems with blood flow, and inflammation. If the blockage is not treated, the appendix can burst and spread infection into the abdomen. This causes a condition called peritonitis. The main\n\t\t\t\t\tsymptom is pain in the abdomen, often on the right side. It is usually sudden and gets worse over time. Other symptoms may include\n\t\t\t\t\tSwelling in the abdomen\n\t\t\t\t\tLoss of appetite\n\t\t\t\t\tNausea and vomiting\n\t\t\t\t\tConstipation or diarrhea\n\t\t\t\t\tInability to pass gas\n\t\t\t\t\tLow fever\n\t\t\t\t\tNot everyone with appendicitis has all these symptoms.", "AnswerURL": "https://medlineplus.gov/appendicitis.html", "COMMENT": "", "_aid": "TQ59A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "appendicitis" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "SYMPTOM", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "Problem", "__text": "elevated temperature" } ]

[ { "ANSWER": "Adults\n\t\t\t\t\tThe usual dose is one 5-mg tablet two to three times a day. The maximum recommended dose is one 5-mg tablet four times a day. A lower starting dose of 2.5 mg two or three times a day is recommended for the frail elderly.", "AnswerURL": "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=98526d8f-9f39-d138-1cf9-fa5335bf2ba5", "COMMENT": "", "_aid": "TQ60A1" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "Oxybutinin" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "DOSAGE", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "Measurement", "__text": "5 mg" } ]

[ { "ANSWER": "1. Coadministration of NEURONTIN with hydrocodone decreases hydrocodone exposure [see CLINICAL PHARMACOLOGY (12.3)]. The potential for alteration in hydrocodone exposure and effect should be considered when NEURONTIN is started or discontinued in a patient taking hydrocodone.\n\t\t\t\t\t2. Coadministration of NEURONTIN (125 to 500 mg; N=48) decreases hydrocodone (10 mg; N=50) C max and AUC values in a dose-dependent manner relative to administration of hydrocodone alone; C max and AUC values are 3% to 4% lower, respectively, after administration of 125 mg NEURONTIN and 21% to\n\t\t\t\t\t22% lower, respectively, after administration of 500 mg NEURONTIN. The mechanism for this interaction is unknown. Hydrocodone increases gabapentin AUC values by 14%. The magnitude of interaction at other doses is not known.", "AnswerURL": "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee9ad9ed-6d9f-4ee1-9d7f-cfad438df388", "COMMENT": "Part 1 of the answer is from section 7, drug interactions and part 2 is from clinical pharmacology, section 12.3", "_aid": "TQ61A1" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "Gabamentine" }, { "_fid": "F2", "_fcategory": "DrugSupplement", "__text": "hydrocodene" } ]

[ { "_tid": "T1", "_hasFocus": "F1,F2", "__text": "INTERACTION", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "Avoid Concomitant Use of NSAIDs\n\n\t\t\t\t\tInform patients that the concomitant use of diclofenac sodium extended-release tablets with other NSAIDs or salicylates (e.g., diflunisal, salsalate) is not recommended due to the increased risk of gastrointestinal toxicity, and little or no increase in efficacy (see WARNINGS: GASTROINTESTINAL\n\t\t\t\t\tBLEEDING, ULCERATION, PERFORATION and DRUG INTERACTIONS). Alert patients that NSAIDs may be present in \"over the counter\" medications for treatment of colds, fever, or insomnia.", "AnswerURL": "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ffbf7573-c726-42f6-bbd5-5d2533d8288f", "COMMENT": "Partial Answer for NSAIDS", "_aid": "TQ62A1" }, { "ANSWER": "Some foods and medicines may affect how lisinopril works. Tell your doctor if you are using any of the following:\n\n\t\t\t\t\tAliskiren, everolimus, lithium, sirolimus, temsirolimus\n\t\t\t\t\tAnother blood pressure medicine, including an angiotensin receptor blocker (ARB)\n\t\t\t\t\tDiuretic (water pill, including amiloride, spironolactone, triamterene)\n\t\t\t\t\tInsulin or diabetes medicine\n\t\t\t\t\tNSAID pain or arthritis medicine (including aspirin, celecoxib, diclofenac, ibuprofen, naproxen)", "AnswerURL": "https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0010968/?report=details", "COMMENT": "Non-definitieve answer about lisinopril and diclofenac", "_aid": "TQ62A2" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "diclofenac" }, { "_fid": "F2", "_fcategory": "DrugSupplement", "__text": "lisinopril" }, { "_fid": "F3", "_fcategory": "DrugSupplement", "__text": "aleve" }, { "_fid": "F4", "_fcategory": "DrugSupplement", "__text": "extra-strength Tylenol" } ]

[ { "_tid": "T1", "_hasFocus": "F1,F2", "__text": "INTERACTION", "_hasKeyword": null }, { "_tid": "T2", "_hasFocus": "F1,F3", "__text": "INTERACTION", "_hasKeyword": null }, { "_tid": "T3", "_hasFocus": "F1,F4", "__text": "INTERACTION", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "Trisomy 13, also called Patau syndrome, is a chromosomal condition associated with severe intellectual disability and physical abnormalities in many parts of the body. Individuals with trisomy 13 often have heart defects, brain or spinal cord abnormalities, very small or poorly developed\n\t\t\t\t\teyes (microphthalmia), extra fingers or toes, an opening in the lip (a cleft lip) with or without an opening in the roof of the mouth (a cleft palate), and weak muscle tone (hypotonia). Due to the presence of several life-threatening medical problems, many infants with trisomy 13 die within\n\t\t\t\t\ttheir first days or weeks of life. Only five percent to 10 percent of children with this condition live past their first year.", "AnswerURL": "https://ghr.nlm.nih.gov/condition/trisomy-13", "COMMENT": "Answers addressing the progression are relevant", "_aid": "TQ63A1" }, { "ANSWER": "Clinical tests (28 available)\n\n\t\t\t\t\tCytogenetics Tests\n\n\t\t\t\t\tFISH-metaphase (3)\n\t\t\t\t\tFluorescence in situ hybridization (FISH) (2)\n\t\t\t\t\tFISH-interphase (8)\n\t\t\t\t\tKaryotyping (9)\n\t\t\t\t\tMolecular Genetics Tests\n\n\t\t\t\t\tDetection of homozygosity (2)\n\t\t\t\t\tSequence analysis of the entire coding region (2)\n\t\t\t\t\tTargeted variant analysis (5)\n\t\t\t\t\tDetection of homozygosity (2)\n\t\t\t\t\tDeletion/duplication analysis (3)\n\t\t\t\t\tUniparental disomy study (UPD) (1)", "AnswerURL": "https://www.ncbi.nlm.nih.gov/gtr/conditions/C0152095/", "COMMENT": ", links to the available over the countered genetic tests or pages on individual tests are relevant.", "_aid": "TQ63A2" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "trisomy 13" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "PROGNOSIS", "_hasKeyword": null }, { "_tid": "T2", "_hasFocus": "F1", "__text": "DIAGNOSIS", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "Muscle cramps can occur anywhere and in anyone; however, leg cramps are especially common in older people. Quinine is a medicine which has been used to treat cramps for many years. There is conflicting evidence for its ability to reduce cramps. Quinine can cause serious, even fatal adverse events,\n\t\t\t\t\tespecially in overdosage.\n\n\t\t\t\t\tThere is low quality evidence that quinine (200 mg to 500 mg daily) significantly reduces cramp number and cramp days and moderate quality evidence that quinine reduces cramp intensity. There is moderate quality evidence that there are more minor adverse events with quinine compared to placebo but\n\t\t\t\t\tno increase in major adverse events. However, there are reliable reports from other sources that an overdose of quinine can cause serious harm including death.\n\t\t\t\t\tMore research is needed to clarify the best dose and duration of treatment, as well as alternatives to quinine for cramps.\n\n\t\t\t\t\tThe evidence is current to October 2014.", "AnswerURL": "https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0013201/", "COMMENT": "Some information about dosage is relevant", "_aid": "TQ64A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "leg cramps" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "TREATMENT", "_hasKeyword": "K1,K2" } ]

[ { "_kid": "K1", "_kcategory": "DrugSupplement", "__text": "quinine" }, { "_kid": "K2", "_kcategory": "Food", "__text": "seltzer water" } ]

[ { "ANSWER": "When a person is infested with scabies mites the first time, symptoms may not appear for up to two months after being infested. However, an infested person can transmit scabies, even if they do not have symptoms. Scabies usually is passed by direct, prolonged skin-to-skin contact with an\n\t\t\t\t\tinfested person. However, a person with crusted (Norwegian) scabies can spread the infestation by brief skin-to-skin contact or by exposure to bedding, clothing, or even furniture that he/she has used.\n\n\t\t\t\t\tScabies is prevented by avoiding direct skin-to-skin contact with an infested person or with items such as clothing or bedding used by an infested person. Scabies treatment usually is recommended for members of the same household, particularly for those who have had prolonged skin-to-skin contact. All\n\t\t\t\t\thousehold members and other potentially exposed persons should be treated at the same time as the infested person to prevent possible reexposure and reinfestation. Bedding and clothing worn or used next to the skin anytime during the 3 days before treatment should be machine washed and dried\n\t\t\t\t\tusing the hot water and hot dryer cycles or be dry-cleaned. Items that cannot be dry-cleaned or laundered can be disinfested by storing in a closed plastic bag for several days to a week. Scabies mites generally do not survive more than 2 to 3 days away from human skin. Children and adults\n\t\t\t\t\tusually can return to child care, school, or work the day after treatment.\n\n\t\t\t\t\tPersons with crusted scabies and their close contacts, including household members, should be treated rapidly and aggressively to avoid outbreaks. Institutional outbreaks can be difficult to control and require a rapid, aggressive, and sustained response.\n\n\t\t\t\t\tRooms used by a patient with crusted scabies should be thoroughly cleaned and vacuumed after use.", "AnswerURL": "https://www.cdc.gov/parasites/scabies/prevent.html", "COMMENT": "Prevention", "_aid": "TQ65A1" }, { "ANSWER": "Products used to treat scabies are called scabicides because they kill scabies mites; some also kill mite eggs. Scabicides used to treat human scabies are available only with a doctor's prescription. No \"over-the-counter\" (non-prescription) products have been tested and approved to treat\n\t\t\t\t\tscabies.\n\t\t\t\t\tScabicide lotion or cream should be applied to all areas of the body from the neck down to the feet and toes. In addition, when treating infants and young children, scabicide lotion or cream also should be applied to their entire head and neck because scabies can affect their face, scalp, and neck, as\n\t\t\t\t\twell as the rest of their body. Only permethrin or sulfur ointment may be used in infants. The lotion or cream should be applied to a clean body and left on for the recommended time before washing it off. Clean clothing should be worn after treatment. Both sexual and close personal contacts who\n\t\t\t\t\thave had direct prolonged skin-to-skin contact with an infested person within the preceding month should be examined and treated. All persons should be treated at the same time to prevent reinfestation.", "AnswerURL": "https://www.cdc.gov/parasites/scabies/treatment.html", "COMMENT": "Treatment", "_aid": "TQ65A2" }, { "ANSWER": "Scabies treatment involves eliminating the infestation with medications. Several creams and lotions are available with a doctor's prescription. You usually apply the medication over all your body, from your neck down, and leave the medication on for at least eight hours. A second treatment is needed\n\t\t\t\t\tif new burrows and rash appear.\n\n\t\t\t\t\tBecause scabies spreads so easily, your doctor will likely recommend treatment for all household members and other close contacts, even if they show no signs of scabies infestation.\n\n\t\t\t\t\tMedications commonly prescribed for scabies include:\n\n\t\t\t\t\tPermethrin cream, 5 percent (Elimite). Permethrin is a topical cream that contains chemicals that kill scabies mites and their eggs. It is generally considered safe for adults, pregnant women, and children ages 2 months and older. This medicine is not recommended for nursing mothers.\n\t\t\t\t\tLindane lotion. This medication - also a chemical treatment - is recommended only for people who can't tolerate other approved treatments, or for whom other treatments didn't work. This medication isn't safe for children younger than age 2 years, women who are pregnant or nursing, the elderly, or\n\t\t\t\t\tanyone who weighs less than 110 pounds (50 kilograms).\n\t\t\t\t\tCrotamiton (Eurax). This medication is available as a cream or a lotion. It's applied once a day for two days. This medication isn't recommended for children or for women who are pregnant or nursing. Frequent treatment failure has been reported with crotamiton.\n\t\t\t\t\tIvermectin (Stromectol). Doctors may prescribe this oral medication for people with altered immune systems, for people who have crusted scabies, or for people who don't respond to the prescription lotions and creams. Ivermectin isn't recommended for women who are pregnant or nursing, or for children who\n\t\t\t\t\tweigh less than 33 pounds (15 kg).\n\t\t\t\t\tAlthough these medications kill the mites promptly, you may find that the itching doesn't stop entirely for several weeks.\n\n\t\t\t\t\tDoctors may prescribe other topical medications, such as sulfur compounded in petrolatum, for people who don't respond to or can't use these medications.", "AnswerURL": "http://www.mayoclinic.org/diseases-conditions/scabies/basics/treatment/con-20023488", "COMMENT": "treatment", "_aid": "TQ65A3" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "mite infestation" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "TREATMENT", "_hasKeyword": null }, { "_tid": "T2", "_hasFocus": "F1", "__text": "PREVENTION", "_hasKeyword": null } ]

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[ { "ANSWER": "Mixing alcohol and medicines can be harmful. Alcohol, like some medicines, can make you sleepy, drowsy,or lightheaded. Drinking alcohol while taking medicines can intensify these effects. You may have trouble concentrating or performing mechanical skills. Small amounts of alcohol can\n\t\t\t\t\tmake it dangerous to drive, and when you mix alcohol with certain medicines you put yourself at even greater risk. Combining alcohol with some medicines can lead to falls and serious injuries, especially among older people.", "AnswerURL": "https://pubs.niaaa.nih.gov/publications/medicine/harmful_interactions.pdf", "COMMENT": "The answer provided is a summary. The entire pamphlet is useful and provides a list of drugs that interact with alcohol.", "_aid": "TQ66A1" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "meds" }, { "_fid": "F2", "_fcategory": "Food", "__text": "wine" } ]

[ { "_tid": "T1", "_hasFocus": "F1,F2", "__text": "INTERACTION", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "Calves (milk replacer): For Calves (up to 250 lb): For treatment of bacterial enteritis caused by Escheria coli susceptible to oxytetracycline; treatment and control of colibacillosis (bacterial enteritis) caused by Escheria coli susceptible by neomycin. Feed continuously for 7-14 days\n\t\t\t\t\tin milk replacer or starter feed. Treatment should continue 24 to 48 hours beyond remission of disease symptoms.\n\t\t\t\t\tCalves, Beef Cattle, and Nonlactating Dairy Cattle: For treatment of bacterial enteritis caused by Escheria coli and bacterial pneumonia (shipping fever complex) caused by Pasteurella multocide susceptible to oxytetracycline; treatment and control of colibacillosis (bacterial enteritis) caused by\n\t\t\t\t\tEscheria coli susceptible by neomycin. Feed continuously for 7-14 days in feed or milk replacersTreatment should continue 24 to 48 hours beyond remission of disease symptoms.\n\t\t\t\t\tMix Neo-Oxy 100/100 MR with non-medicated milk replacer to provide the following concentrations:Use Level of Oxytetracycline and Neomycin: 10 mg/lb body weight/day", "AnswerURL": "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=2f768604-3ba4-40da-b9b8-ee6f395f4f5d", "COMMENT": "This infromation is in a table in DailyMed.This drug is for veterinary use, not human use.", "_aid": "TQ67A1" }, { "ANSWER": "MIXING AND USE DIRECTIONS\n\n\t\t\t\t\tMix Neo-Oxy 100/100 MR with nonmedicated milk replacer to provide the following concentrations:\n\n\t\t\t\t\tCALVES (milk replacer) - For calves (up to 250 lb) for increased rate of weight gain and improved feed efficiency.\n\n\t\t\t\t\tOxytetracycline and Neomycin Amount: 0.05-0.1 mg/lb of body weight daily. Feed continuously; in milk replacers or starter feed.\n\n\t\t\t\t\tLb of Neo-Oxy 100/100 MR per ton of Type C Medicated Feed (1): 0.1-0.2 (2)\n\n\n\n\t\t\t\t\tRESIDUE WARNING: Zero day withdrawal. Use of more than one product containing neomycin or failure to follow withdrawal times may result in illegal drug residues.\n\n\t\t\t\t\tFor calves (up to 250 lb) for treatment of bacterial enteritis caused by E. coli susceptible to oxytetracycline; treatment and control of colibacillosis (bacterial enteritis) caused by E. coli susceptible to neomycin.\n\n\t\t\t\t\tOxytetracycline and Neomycin Amount: 10 mg/lb of body weight daily. Feed continuously for 7-14 days in milk replaces or starter feed. If symptoms persist after using 2 or 3 days, consult a veterinarian. Treatment should continue 24 to 48 hours beyond remission of disease symptoms.\n\n\t\t\t\t\tLb of Neo-Oxy 100/100 MR per ton of Type C Medicated Feed (1): 20 (2)\n\n\t\t\t\t\tRESIDUE WARNING: A withdrawal period has not been established for use in preruminating calves. Do not use in calves to be processed for veal. A milk discard time has not been established for use in lactating dairy cattle. Do not use in female dairy cattle 20 months or older. Withdraw 5 days before\n\t\t\t\t\tslaughter. Use of more than one product containing neomycin or failure to follow withdrawal times may result in illegal drug residues.\n\n\t\t\t\t\tCALVES, BEEF CATTLE, AND NONLACTATING DAIRY CATTLE\n\n\t\t\t\t\tFor treatment of bacterial enteritis caused by E. coli and bacterial pneumonia (shipping fever complex) caused by Pasteurella multocide susceptible to oxytetracycline; treatment and control of colibacillosis (bacterial enteritis) caused by E. coli susceptible to neomycin.\n\n\t\t\t\t\tOxytetracycline and Neomycin Amount: 10 mg/lb of body weight daily. Feed continuously for 7-14days in feed or milk replaces. If symptoms persist after using 2 or 3 days, consult a veterinarian. Treatment should continue 24 to 48 hours beyond remission of disease symptoms.\n\n\t\t\t\t\tLb of Neo-Oxy 100/100 MR per ton of Type C Medicated Feed (1): 20 (2)\n\n\t\t\t\t\tRESIDUE WARNING: A withdrawal period has not been established for use in preruminating calves. Do not use in calves to be processed for veal. A milk discard time has not been established for use in lactating dairy cattle. Do not use in female dairy cattle 20 months or older. Withdraw 5 days before\n\t\t\t\t\tslaughter. Use of more than one product containing neomycin or failure to follow withdrawal times may result in illegal drug residues.\n\n\t\t\t\t\t(1) Mixing directions are for example only and are based on mixing 1 lb of dry milk with 1 gallon of water.\n\n\t\t\t\t\t(2) If calf weighs 100 lb, consuming 1 gallon of milk replaced per day.\n\n\n\t\t\t\t\tFOR USE IN DRY FEEDS ONLY. NOT FOR USE IN LIQUID FEED SUPPLEMENTS.", "AnswerURL": "https://www.drugs.com/pro/neo-oxy-100-100-mr.html", "COMMENT": "", "_aid": "TQ67A2" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "NEO-OXY 100/100 MR" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "INDICATION", "_hasKeyword": null }, { "_tid": "T2", "_hasFocus": "F1", "__text": "USAGE", "_hasKeyword": null } ]

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[ { "ANSWER": "Babies need blood sugar (glucose) for energy. Most of that glucose is used by the brain.\n\n\t\t\t\t\tThe baby gets glucose from the mother through the placenta before birth. After birth, the baby gets glucose from the mother through her milk or from formula, and the baby also produces it in the liver.\n\n\t\t\t\t\tGlucose level can drop if:\n\n\t\t\t\t\tThere is too much insulin in the blood. Insulin is a hormone that pulls glucose from the blood.\n\t\t\t\t\tThe baby is not producing enough glucose.\n\t\t\t\t\tThe baby's body is using more glucose than is being produced.\n\t\t\t\t\tThe baby is not able to feed enough to keep the glucose level up.\n\t\t\t\t\tNeonatal hypoglycemia occurs when the newborn's glucose level causes symptoms or is below the level considered safe for the baby's age. It occurs in about 1 to 3 out of every 1,000 births.\n\n\t\t\t\t\tLow blood sugar level is more likely in infants with one or more of these risk factors:\n\n\t\t\t\t\tBorn early, has a serious infection, or needed oxygen right after delivery\n\t\t\t\t\tMother has diabetes (these infants are often larger than normal)\n\t\t\t\t\tHave slower than usual growth in the womb during pregnancy\n\t\t\t\t\tAre smaller in size than normal for their gestational age\n\n\t\t\t\t\tIf you have diabetes during pregnancy, work with your health care provider to control your blood sugar level. Be sure that your newborn's blood sugar level is monitored after birth.", "AnswerURL": "https://medlineplus.gov/ency/article/007306.htm", "COMMENT": "Causes and some prevention", "_aid": "TQ68A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "Hypoglycemia" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "CAUSE", "_hasKeyword": "K1" }, { "_tid": "T2", "_hasFocus": "F1", "__text": "PREVENTION", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "PersonPopulation", "__text": "newborns" } ]

[ { "ANSWER": "CT scan: This radiology test takes multiple cross-sectional pictures of the body. It is not generally performed to make a diagnosis of diverticulosis, but this type of exam, when done for other reasons, may identify diverticula.", "AnswerURL": "http://patients.gi.org/topics/diverticulosis-and-diverticulitis/", "COMMENT": "American College of Gastroenterology patient center", "_aid": "TQ69A1" }, { "ANSWER": "What tests do doctors use to diagnose diverticulosis and diverticulitis?\n\n\t\t\t\t\tYour doctor may use the following tests to help diagnose diverticulosis and diverticulitis:CT scan\n\n\t\t\t\t\tA computerized tomography (CT) scan uses a combination of x-rays and computer technology to create images of your gastrointestinal (GI) tract.\n\n\t\t\t\t\tAn x-ray technician performs the procedure in an outpatient center or a hospital. A radiologist reads and reports on the images. You don't need anesthesia for this procedure.\n\n\t\t\t\t\tFor a CT scan, a health care professional may give you a solution to drink and an injection of a special dye, called contrast medium. Contrast medium makes the structures inside your body easier to see during the procedure. You'll lie on a table that slides into a tunnel-shaped device that takes\n\t\t\t\t\tthe x-rays. A CT scan of your colon is the most common test doctors use to diagnose diverticulosis and diverticulitis.", "AnswerURL": "https://www.niddk.nih.gov/health-information/digestive-diseases/diverticulosis-diverticulitis/diagnosis", "COMMENT": "A different answer from above. Answers about tests to diagnose diverticulosis-diverticulitis are relevant.", "_aid": "TQ69A2" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "diverticulosis" }, { "_fid": "F2", "_fcategory": "Problem", "__text": "diverticulitis" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "DIAGNOSIS", "_hasKeyword": "K1" }, { "_tid": "T2", "_hasFocus": "F2", "__text": "DIAGNOSIS", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "DiagnosticProcedure", "__text": "cat scan" } ]

[ { "ANSWER": "Common cold\n\t\t\t\t\tPrevention\n\t\t\t\t\tTo lower your chances of getting sick:\n\n\t\t\t\t\tAlways wash your hands. Children and adults should wash hands after nose-wiping, diapering, and using the bathroom, and before eating and preparing food.\n\t\t\t\t\tDisinfect your environment. Clean commonly touched surfaces (such as sink handles, door knobs, and sleeping mats) with an EPA-approved disinfectant.\n\t\t\t\t\tChoose smaller daycare classes for your children.\n\t\t\t\t\tUse instant hand sanitizers to stop the spread of germs.\n\t\t\t\t\tUse paper towels instead of sharing cloth towels.\n\t\t\t\t\tThe immune system helps your body fight off infection. Here are ways to support the immune system:\n\n\t\t\t\t\tAvoid secondhand smoke. It is responsible for many health problems, including colds.\n\t\t\t\t\tDO NOT use antibiotics if they are not needed.\n\t\t\t\t\tBreastfeed infants if possible. Breast milk is known to protect against respiratory tract infections in children, even years after you stop breastfeeding.\n\t\t\t\t\tDrink plenty of fluids to help your immune system work properly.\n\t\t\t\t\tEat yogurt that contains \"active cultures.\" These may help prevent colds. Probiotics may help prevent colds in children.\n\t\t\t\t\tGet enough sleep.", "AnswerURL": "https://medlineplus.gov/ency/article/000678.htm", "COMMENT": "considered as prevention question. It can also be seen as a question about risk factors / susceptibility, which are listed as things to avoid, such as smoking", "_aid": "TQ70A1" }, { "ANSWER": "Why Some People Are More Likely to Catch a Cold\n\t\t\t\t\tThe answer may be in your DNA structures", "AnswerURL": "http://healthland.time.com/2013/02/22/why-some-people-are-more-likely-to-catch-a-cold/", "COMMENT": "considered as susceptibility question. Both prevention and susceptibility answers are relevant.", "_aid": "TQ70A2" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "COLD" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "SUSCEPTIBILITY", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "The maximum recommended daily dose of metformin hydrochloride tablets are 2550 mg in adults and 2000 mg in pediatric patients (10-16 years of age).", "AnswerURL": "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=56d13a1c-b289-4528-b23c-60f5427b4552", "COMMENT": "", "_aid": "TQ71A1" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "Metformin" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "DOSAGE", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "Very few cases are seen in the U.S. since the nationwide measles vaccination program. SSPE tends to occur several years after a person has measles, even though the person seems to have fully recovered from the illness. Males are more often affected than females. The disease generally\n\t\t\t\t\toccurs in children and adolescents.", "AnswerURL": "https://medlineplus.gov/ency/article/001419.htm", "COMMENT": "Answers about SSPE onset age are relevant", "_aid": "TQ72A1" }, { "ANSWER": "Subacute sclerosing panencephalitis (SSPE) is a very rare, but fatal disease of the central nervous system that results from a measles virus infection acquired earlier in life. SSPE generally develops 7 to 10 years after a person has measles, even though the person seems to have fully\n\t\t\t\t\trecovered from the illness. Since measles was eliminated in 2000, SSPE is rarely reported in the United States.\n\n\t\t\t\t\tAmong people who contracted measles during the resurgence in the United States in 1989 to 1991, 4 to 11 out of every 100,000 were estimated to be at risk for developing SSPE. The risk of developing SSPE may be higher for a person who gets measles before they are two years of age.", "AnswerURL": "https://www.cdc.gov/measles/about/complications.html", "COMMENT": "", "_aid": "TQ72A2" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "SSPE" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "SUSCEPTIBILITY", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "ProcedureDevice", "__text": "measles vaccination" } ]

[ { "ANSWER": "Supportive care for Klippel-Trenaunay syndrome\n\n\t\t\t\t\tCompression garments-Your doctor may recommend that your child wear tight-fitting pieces of clothing on the affected limb to reduce pain and swelling. They can also help protect your child's limb from bumps and scrapes, which can cause bleeding.\n\t\t\t\t\tHeel inserts-If your child's legs are slightly different lengths (less than one inch difference), a heel insert can help your child walk normally.\n\t\t\t\t\tAnticoagulant therapy-One of the biggest potential risks of KTS is that a blood clot formed in the abnormal blood vessels may break off and make its way to your child's heart or lungs. Your doctor may recommend medications that thin your child's blood to help prevent blood clots from forming.\n\t\t\t\t\tOther medications-Your doctor may also recommend various pain medications and antibiotic medications for your child.\n\t\t\t\t\tSurgical care for Klippel-Trenaunay syndrome\n\n\t\t\t\t\tOrthopedic Center-KTS can cause your child's foot or leg to become excessively large; in some cases your doctor may recommend an operation.\n\t\t\t\t\tAn orthopedic surgeon can reshape your child's foot to help him fit it into a shoe.\n\t\t\t\t\tAn orthopedic surgeon can perform a procedure called epiphysiodesis, which interrupts the growth plate and stops the leg from growing when it's reached a certain length.\n\t\t\t\t\tOther surgeries-Your doctor may recommend one of these other surgical procedures if your child's symptoms call for it.\n\t\t\t\t\tA surgeon can remove some of your child's excessive problematic veins.\n\t\t\t\t\tA surgeon can also help reduce the size of your child's affected limb with a debulking procedure, in which many of the abnormal vessels and some of the overgrown tissue is removed.\n\t\t\t\t\tSclerotherapy -To help shrink and eliminate your child's abnormal veins in the affected area, your doctor may propose the injection of an irritating solution, which causes the veins to collapse. One of our experienced interventional radiologists can perform this procedure.\n\t\t\t\t\tLaser therapy-Pulsed dye laser treatments can help lighten your child's capillary malformation (port wine stain). Laser treatment can also speed healing if your child's lesion begins to bleed.", "AnswerURL": "http://www.childrenshospital.org/conditions-and-treatments/conditions/k/klippel-trenaunay-syndrome/treatments", "COMMENT": "Boston Childrens Hospital", "_aid": "TQ73A1" }, { "ANSWER": "There are many different treatment options for patients with KTS depending on your child's symptoms:\n\n\t\t\t\t\tCompression garments, like tight-fitting, elastic sleeves, supply blood flow back to the heart (chronic vein insufficiency). They prevent lymphedema and recurrent bleeding from capillary or venous malformations of the limb. They also protect the limb from trauma. Learn more about compression garments\n\t\t\t\t\t(PDF).\n\t\t\t\t\tPain medicine, antibiotics and elevating the limb to manage swelling.\n\t\t\t\t\tMedicines to prevent blood clotting (anticoagulant therapy).\n\t\t\t\t\tHeel inserts or surgery may be considered when one leg is longer than another.\n\t\t\t\t\tYour child may be referred to an orthopedic specialist to help develop a treatment plan.\n\t\t\t\t\tLaser therapy to lighten the color of the port wine stain, treat pain or help ulcers or open sores heal.\n\t\t\t\t\tSclerotherapy (SCLAIR-oh-THAIR-uh-pee) to block unneeded veins.\n\t\t\t\t\tSome patients with KTS need surgery. This includes:\n\n\t\t\t\t\tVein ligation: Clamping off a section of veins to prevent blood flow through a damaged section. It promotes blood flow through veins that are not damaged.\n\t\t\t\t\tVein stripping: Using a metal wire to remove swelling inside a damaged vein.\n\t\t\t\t\tVein resection: Removing a section of veins from the body.", "AnswerURL": "http://www.seattlechildrens.org/medical-conditions/common-childhood-conditions/klippel-trenaunay-syndrome-KTS/", "COMMENT": "Seattle Children's Hospital", "_aid": "TQ73A2" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "Klippel-Tranaunay Syndrome" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "INFORMATION", "_hasKeyword": null }, { "_tid": "T2", "_hasFocus": "F1", "__text": "TREATMENT", "_hasKeyword": "K1,K2" } ]

[ { "_kid": "K1", "_kcategory": "Anatomy", "__text": "leg" }, { "_kid": "K2", "_kcategory": "PersonPopulation", "__text": "5 months old" } ]

[ { "ANSWER": "Iron is a mineral found in many over-the-counter supplements. Iron overdose occurs when someone takes more than the normal or recommended amount of this mineral. This can be by accident or on purpose.\n\n\t\t\t\t\tIron overdose is especially dangerous for children. A severe overdose can happen if a child eats adult multivitamins, such as prenatal vitamins. If the child eats too many pediatric multivitamins, the effect is usually minor.\n\n\t\t\t\t\tThis is for information only and not for use in the treatment or management of an actual overdose. DO NOT use it to treat or manage an actual overdose. If you or someone you are with overdoses, call your local emergency number (such as 911), or your local poison center can be reached directly by\n\t\t\t\t\tcalling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.\n\n\t\t\t\t\tYour local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.\n\n\t\t\t\t\tBefore Calling Emergency\n\t\t\t\t\tHave this information ready:\n\n\t\t\t\t\tPerson's age, weight, and condition\n\t\t\t\t\tName of the product (ingredients and strength, if known)\n\t\t\t\t\tTime it was swallowed\n\t\t\t\t\tAmount swallowed\n\t\t\t\t\tIf the medicine was prescribed for the person", "AnswerURL": "https://medlineplus.gov/ency/article/002659.htm", "COMMENT": "", "_aid": "TQ74A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "Iron Overdose" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "TREATMENT", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "Hereditary hypophosphatemic rickets can have several patterns of inheritance. When the condition results from mutations in the PHEX gene, it is inherited in an X-linked dominant pattern. The PHEX gene is located on the X chromosome, which is one of the two sex chromosomes. In females\n\t\t\t\t\t(who have two X chromosomes), a mutation in one of the two copies of the gene in each cell is sufficient to cause the disorder. In males (who have only one X chromosome), a mutation in the only copy of the gene in each cell causes the disorder.\n\t\t\t\t\tLess commonly, hereditary hypophosphatemic rickets can have an X-linked recessive pattern of inheritance. This form of the condition is often called Dent disease. Like the PHEX gene, the gene associated with Dent disease is located on the X chromosome. In males, one altered copy of the gene in each\n\t\t\t\t\tcell is sufficient to cause the condition. In females, a mutation would have to occur in both copies of the gene to cause the disorder. Because it is unlikely that females will have two altered copies of this gene, males are affected by X-linked recessive disorders much more frequently than\n\t\t\t\t\tfemales.\n\t\t\t\t\tIn a few families, hereditary hypophosphatemic rickets has had an autosomal dominant inheritance pattern, which means one copy of an altered gene in each cell is sufficient to cause the disorder. The rare condition HHRH has an autosomal recessive pattern of inheritance, which means both copies of\n\t\t\t\t\ta gene in each cell have mutations.", "AnswerURL": "https://ghr.nlm.nih.gov/condition/hereditary-hypophosphatemic-rickets#inheritance", "COMMENT": "", "_aid": "TQ75A1" }, { "ANSWER": "Hypophosphatemic rickets is most often inherited in an X-linked dominant manner. This means that the gene responsible for the condition is located on the X chromosome, and having only one mutated copy of the gene is enough to cause the condition.\n\n\t\t\t\t\tBecause males have only one X chromosome (and one Y chromosome) and females have two X chromosomes, X-linked dominant conditions affect males and females differently. Both males and females can have an X-linked dominant condition. However, because males don't have a second, working copy of the gene\n\t\t\t\t\t(as females do), they usually have more severe disease than females.\n\n\t\t\t\t\tIf a father has the mutated X-linked gene:\n\t\t\t\t\tall of his daughters will inherit the mutated gene (they will all receive his X chromosome)\n\t\t\t\t\tnone of his sons will inherit the mutated gene (they only inherit his Y chromosome)\n\t\t\t\t\tIf a mother has the mutated X-linked gene, each of her children (both male and female) has a 50% chance to inherit the mutated gene.\n\n\t\t\t\t\tLess commonly, hypophosphatemic rickets is inherited in an X-linked recessive, autosomal dominant, or autosomal recessive manner.", "AnswerURL": "https://rarediseases.info.nih.gov/diseases/6735/hypophosphatemic-rickets", "COMMENT": "Answers describing inheritance are relevant", "_aid": "TQ75A2" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "Inherited Ricketts" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "SUSCEPTIBILITY", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "What do we know about the effectiveness of complementary health approaches for fibromyalgia?\n\t\t\t\t\tAlthough some studies of tai chi, yoga, mindfulness meditation, and biofeedback for fibromyalgia have had promising results, the evidence is too limited to allow definite conclusions to be reached about whether these approaches are helpful.\n\t\t\t\t\tIt's uncertain whether acupuncture is helpful for fibromyalgia pain.\n\t\t\t\t\tVitamin D supplements may reduce pain in people with fibromyalgia who are deficient in this vitamin.\n\t\t\t\t\tSome preliminary research on transcranial magnetic stimulation (TMS) for fibromyalgia symptoms has had promising results.", "AnswerURL": "https://nccih.nih.gov/health/pain/fibromyalgia.htm", "COMMENT": "Alternatrive treatments", "_aid": "TQ76A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "acute fibromyalgia" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "TREATMENT", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "MTHFR gene mutation is a genetic change that affects an enzyme involved in breaking down the amino acid homocysteine.[1][2][3] C677T and A1298C are two very common MTHFR gene changes.\n\n\t\t\t\t\tPeople with MTHFR gene mutations may develop elevated levels of homocysteine in their blood (homocysteinemia) or urine (homocystinuria). Risks for health effects vary depending on the levels of homocysteine.[5]\n\n\t\t\t\t\tHigh homocysteine levels in the body may occur if the MTHFR enzyme is not functioning normally due to MTHFR mutations such as C677T and A1298C. Elevated levels of homocysteine can also occur if there is a lack of folate or B vitamins. Homocysteine levels also tend to rise with age, smoking, and use\n\t\t\t\t\tof certain drugs (such as carbamazepine, methotrexate, and phenytoin).[13][14]\n\n\t\t\t\t\tIt is important to ensure that people with and without MTHFR gene mutations receive adequate amounts of folate, choline, and B vitamins (B12, B6, and riboflavin) to mitigate health risks. If adequate nutrition cannot be attained through diet alone, supplementation with folate (e.g., levomefolate\n\t\t\t\t\t(5-methyl THF) or folinic acid) and B vitamins is considered.[3][13] Speak to a healthcare professional if you have questions about your nutrition or need for vitamin supplementation.", "AnswerURL": "https://rarediseases.info.nih.gov/diseases/10953/mthfr-gene-mutation", "COMMENT": "Covers health issues", "_aid": "TQ77A1" }, { "ANSWER": "Outlook (Prognosis)\n\t\t\t\t\tAlthough no cure exists for homocystinuria, vitamin B therapy can help about half of people affected by the condition.\n\n\t\t\t\t\tIf the diagnosis is made in childhood, starting a low-methionine diet quickly may prevent some intellectual disability and other complications of the disease. For this reason, some states screen for homocystinuria in all newborns.\n\n\t\t\t\t\tPeople whose blood homocysteine levels continue to rise are at increased risk for blood clots. Clots can cause serious medical problems and shorten lifespan.\n\n\t\t\t\t\tPossible Complications\n\t\t\t\t\tMost serious complications result from blood clots. These episodes can be life-threatening.\n\n\t\t\t\t\tDislocated lenses of the eyes can seriously damage vision. Lens replacement surgery may be needed.\n\n\t\t\t\t\tIntellectual disability is a serious consequence of the disease. But, it can be reduced if diagnosed early.", "AnswerURL": "https://medlineplus.gov/ency/article/001199.htm", "COMMENT": "Covers prognosis for those who develop homocystinuria", "_aid": "TQ77A2" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "Homozygout MTHFR A1298C Health Issues" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "INFORMATION", "_hasKeyword": null }, { "_tid": "T2", "_hasFocus": "F1", "__text": "PROGNOSIS", "_hasKeyword": null } ]

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[ { "ANSWER": "Can vitamin D be harmful?\n\t\t\t\t\tYes, when amounts in the blood become too high. Signs of toxicity include nausea, vomiting, poor appetite, constipation, weakness, and weight loss. And by raising blood levels of calcium, too much vitamin D can cause confusion, disorientation, and problems with heart rhythm. Excess vitamin D can\n\t\t\t\t\talso damage the kidneys.The upper limit for vitamin D is 1,000 to 1,500 IU/day for infants, 2,500 to 3,000 IU/day for children 1-8 years, and 4,000 IU/day for children 9 years and older, adults, and pregnant and lactating teens and women. Vitamin D toxicity almost always occurs from overuse of\n\t\t\t\t\tsupplements. Excessive sun exposure doesn't cause vitamin D poisoning because the body limits the amount of this vitamin it produces.", "AnswerURL": "https://ods.od.nih.gov/factsheets/VitaminD-Consumer/", "COMMENT": "some websites report flatulence caused by constipation, which is caused by vitamin d. The answer is mostly about other effects and safe doses, but getting the flatulence part only answers the first subquestion", "_aid": "TQ78A1" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "Vitamin D" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "SIDE_EFFECT", "_hasKeyword": "K1" }, { "_tid": "T2", "_hasFocus": "F1", "__text": "DOSAGE", "_hasKeyword": "K2" } ]

[ { "_kid": "K1", "_kcategory": "Problem", "__text": "flatulence" }, { "_kid": "K2", "_kcategory": "Measurement", "__text": "50,000 IUs" } ]

[ { "ANSWER": "How Can You Reduce Your Risk of Getting Shingles?\n\t\t\t\t\tVaccination is the only way to reduce your risk of shingles and PHN. CDC recommends adults age 60 years or older receive a single dose of shingles vaccine. Zostavax'ae is the only shingles vaccine currently available. It is available by prescription from a healthcare professional. Talk with your doctor or\n\t\t\t\t\tpharmacist if you have questions about the shingles vaccine.", "AnswerURL": "https://www.cdc.gov/Features/Shingles/", "COMMENT": "it is OK if an answer mentions asking or visiting a doctor, but only in addition to specific information that directly answers the question. Just answering go see your doctor is not very useful -- it is our standard disclaimer. in this task, we aim to provide information that will\n\t\t\t\t\tallow better communicate with the doctor", "_aid": "TQ79A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "shingles outbreak" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "PREVENTION", "_hasKeyword": null } ]

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[ { "ANSWER": "Take over-the-counter pain medicines like acetaminophen or ibuprofen.\n\t\t\t\t\t2. Try over-the-counter pain relievers such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve)", "AnswerURL": "https://medlineplus.gov/ency/article/003182.htm\n\t\t\t\t\t2. http://www.mayoclinic.org/symptoms/leg-pain/basics/when-to-see-doctor/sym-20050784", "COMMENT": "The question is underspecified as the cause is not given. Any answers listing over the counter pain killers generally acceptable for long-term use are fine.", "_aid": "TQ80A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "leg pain" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "TREATMENT", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "PersonPopulation", "__text": "age 65" } ]

[ { "ANSWER": "1. The long-term outlook (prognosis) and life expectancy for people with common variable immunodeficiency (CVID) varies. The prognosis largely depends on whether there is severe autoimmune disease; whether there are recurrent infections that cause structural lung damage; and the development of a\n\t\t\t\t\tmalignancy (cancer). Other major factors that influence prognosis include the extent of organ damage and how successfully infections can be prevented.\n\t\t\t\t\tAffected people who have only bacterial infections have a better prognosis than those with additional complications and can have nearly normal life expectancy. This is especially the case if they are diagnosed early and begin treatment soon after the onset of symptoms.\n\n\t\t\t\t\t2. In some cases, abnormal growth of small nodules of lymphoid tissue in the gastrointestinal tract (nodular lymphoid hyperplasia) may occur. In addition, an increased percent of individuals with CVID are more prone to developing certain forms of cancer than the general population such as\n\t\t\t\t\tmalignancies of lymphatic tissue (lymphoma) and possibly stomach cancer). The risk of gastric carcinoma is almost 50 times greater in patients with CVID than in other individuals.\n\n\t\t\t\t\tIn addition, some individuals with CVID may develop granular, inflammatory nodules (noncaseating granulomas) within tissue of the skin, lungs, spleen, and/or liver.\n\n\t\t\t\t\t3. Of the 411 subjects with known follow-up (87% of the cohort), 93 patients (19.6%) had died.\n\t\t\t\t\tThe median age at death was 44 years for females (range 10-90 years) and 42 years for\n\t\t\t\t\tmales (range 9-79 years), not significantly different. The predominant causes of death\n\t\t\t\t\tincluded respiratory failure from chronic lung disease, lymphoid or other malignancy, or\n\t\t\t\t\toverwhelming infections (TABLE 6). To further examine the mortality of this cohort, we\n\t\t\t\t\tcompared those with known long term follow-up, 226 females (48%) and 185 males (39%)\n\t\t\t\t\tto age-matched population controls. The survival of both male (p=0.0001) and female\n\t\t\t\t\t(p=0.0001) CVID subjects was significantly reduced as compared to 1994 United States\n\t\t\t\t\treference information.34 (FIGURE 1) The risk of death in this interval was nearly 11 times\n\t\t\t\t\thigher for CVID patients with one or more of the non-infectious complications, than for\n\t\t\t\t\tsubjects who had infections only (HR=10.96; p=0.0001) (TABLE 7). Kaplan-Meier Analysis\n\t\t\t\t\tconfirmed this observation, with a long term survival of 95% for patients without versus 42%\n\t\t\t\t\tfor those with non-infectious complications (FIGURE 2). These data agree with a previous\n\t\t\t\t\tstudy on CVID subjects from the ESID registry.7\n\t\t\t\t\tHowever, we found here that not all complications were associated with reduced survival. Patients with gastrointestinal disease\n\t\t\t\t\t(HR 2.78; p=0.0004), liver disease/hepatitis (HR 2.48; p=0.0003), lymphoma (HR 2.44;\n\t\t\t\t\tp=0.001), chronic lung disease including radiological and/or functional lung disease as\n\t\t\t\t\tdescribed above (HR 2.06; p=0.001), or malabsorption (HR 2.06; p=0.022) had reduced\n\t\t\t\t\tsurvival in this interval, as compared to CVID patients without these particular complications.\n\t\t\t\t\tIn contrast, patients with any of the autoimmune conditions, cancers other\n\t\t\t\t\tthan lymphoma, history of splenectomy, presence of granulomatous disease, or the\n\t\t\t\t\tdevelopment of bronchiectasis alone, did not have significantly reduced survival over the 4\n\t\t\t\t\tdecades of study.", "AnswerURL": "1. https://rarediseases.info.nih.gov/diseases/6140/common-variable-immunodeficiency\n\t\t\t\t\t2. https://rarediseases.org/rare-diseases/common-variable-immune-deficiency/\n\t\t\t\t\t3. http://www.bloodjournal.org/content/bloodjournal/early/2011/12/16/blood-2011-09-377945.full.pdf?sso-checked=true", "COMMENT": "", "_aid": "TQ81A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "CVID" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "EFFECT", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "Problem", "__text": "cancer" } ]

[ { "ANSWER": "Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. Insulin is a hormone that helps the glucose get into your cells to give them energy. With type 1 diabetes, your body does not make insulin. With type 2 diabetes, the more common\n\t\t\t\t\ttype, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood. You can also have prediabetes. This means that your blood sugar is higher than normal but not high enough to be called diabetes. Having prediabetes puts you at a higher risk of getting\n\t\t\t\t\ttype 2 diabetes. Over time, having too much glucose in your blood can cause serious problems. It can damage your eyes, kidneys, and nerves. Diabetes can also cause heart disease, stroke and even the need to remove a limb. Pregnant women can also get diabetes, called gestational diabetes.", "AnswerURL": "https://medlineplus.gov/diabetes.html", "COMMENT": "", "_aid": "TQ82A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "diabete" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "INFORMATION", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "1. he tapered off bupropion SR, taking 150 mg/day for 4 days followed by 150 mg every other day for 8 days (4 total doses) and 150 mg every third day for 6 days (2 total doses) without further complications.\n\t\t\t\t\t2. For patients taking 300 mg/day during the autumn-winter season, the dose should be tapered to 150 mg/day for 2 weeks prior to discontinuation.\n\t\t\t\t\tAdverse events with onset during the 2 weeks following down-titration of WELLBUTRIN XL from 300 mg/day to 150 mg/day were reported by 14% of patients compared to 18% of patients who continued on placebo.\n\n\t\t\t\t\tAdverse events with onset during the 2 weeks following discontinuation of WELLBUTRIN XL were reported by 9% of patients compared with 12% of patients following discontinuation of placebo.", "AnswerURL": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC181057/\n\t\t\t\t\t2. https://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=8985", "COMMENT": "any site that provides a schedule for tapering is fine, e.g., http://survivingantidepressants.org/index.php?/topic/877-tips-for-tapering-off-wellbutrin-ir-sr-xr-xl-bupropion/", "_aid": "TQ83A1" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "wellbutrin xl 150" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "TAPERING", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "prospective monitoring of serum enzymes upon initiating atorvastatin therapy is no longer recommended. Clinically apparent liver injury attributed to atorvastatin is usually self-limited and recovery is complete within 1 to 4 months.", "AnswerURL": "https://livertox.nih.gov/Atorvastatin.htm", "COMMENT": "lipitor is atorvastatin", "_aid": "TQ84A1" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "Lipitor" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "SIDE_EFFECT", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "Problem", "__text": "liver damage" } ]

[ { "ANSWER": "1. It's also a good idea to take your calcium supplements at a different time from your multivitamin or an iron-rich meal. Calcium may not be absorbed as well if it's taken at the same time as iron, zinc or magnesium.\n\t\t\t\t\t2. Vitamin D intake: this nutrient, obtained from food and produced by skin when exposed to sunlight of sufficient intensity, improves calcium absorption.\n\t\t\t\t\t3. In 1993, the U.S. Food and Drug Administration authorized a health claim related to calcium and osteoporosis for foods and supplements [58]. In January 2010, this health claim was expanded to include vitamin D. Model health claims include the following: \"Adequate calcium throughout life, as\n\t\t\t\t\tpart of a well-balanced diet, may reduce the risk of osteoporosis\" and \"Adequate calcium and vitamin D as part of a healthful diet, along with physical activity, may reduce the risk of osteoporosis in later life\"", "AnswerURL": "http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/calcium-supplements/faq-20058238\n\t\t\t\t\t2. https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/\n\t\t\t\t\t3. https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/", "COMMENT": "calcium with magnesium is wrong; they shouldn't be taken together. It's not necessary to take vitamin D with calcium but it doesn't hurt.", "_aid": "TQ85A1" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "calcium" }, { "_fid": "F2", "_fcategory": "Problem", "__text": "osteoporosis" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "ACTION", "_hasKeyword": "K1" }, { "_tid": "T2", "_hasFocus": "F2", "__text": "TREATMENT", "_hasKeyword": "K2" } ]

[ { "_kid": "K1", "_kcategory": "DrugSupplement", "__text": "Magnesium" }, { "_kid": "K2", "_kcategory": "DrugSupplement", "__text": "Calcium Castco ( Kirkland ) brand with D" } ]

[ { "ANSWER": "1. Invitae Ehlers-Danlos Syndrome Panel\n\t\t\t\t\tLaboratory contact: 1400 16th Street, San Francisco, California 94103, United States\n\t\t\t\t\t2. Invitae Osteogenesis Imperfecta Panel\n\n\t\t\t\t\t3. The milder forms of osteogenesis imperfecta, including type I, are characterized by bone fractures during childhood and adolescence that often result from minor trauma. Fractures occur less frequently in adulthood. People with mild forms of the condition typically have a blue or grey tint to\n\t\t\t\t\tthe part of the eye that is usually white (the sclera), and may develop hearing loss in adulthood. Affected individuals are usually of normal or near normal height.\n\n\t\t\t\t\tOther types of osteogenesis imperfecta are more severe, causing frequent bone fractures that may begin before birth and result from little or no trauma. Additional features of these conditions can include blue sclerae, short stature, hearing loss, respiratory problems, and a disorder of tooth\n\t\t\t\t\tdevelopment called dentinogenesis imperfecta. The most severe forms of osteogenesis imperfecta, particularly type II, can include an abnormally small, fragile rib cage and underdeveloped lungs. Infants with these abnormalities have life-threatening problems with breathing and often die shortly\n\t\t\t\t\tafter birth.\n\n\t\t\t\t\t4. Symptoms of EDS include:\n\n\t\t\t\t\tBack pain\n\t\t\t\t\tDouble-jointedness\n\t\t\t\t\tEasily damaged, bruised, and stretchy skin\n\t\t\t\t\tEasy scarring and poor wound healing\n\t\t\t\t\tFlat feet\n\t\t\t\t\tIncreased joint mobility, joints popping, early arthritis\n\t\t\t\t\tJoint dislocation\n\t\t\t\t\tJoint pain\n\t\t\t\t\tPremature rupture of membranes during pregnancy\n\t\t\t\t\tVery soft and velvety skin\n\t\t\t\t\tVision problems", "AnswerURL": "1. https://www.ncbi.nlm.nih.gov/gtr/tests/553788/laboratory/\n\t\t\t\t\t2. https://www.ncbi.nlm.nih.gov/gtr/tests/551762/\n\t\t\t\t\t3. https://ghr.nlm.nih.gov/condition/osteogenesis-imperfecta\n\t\t\t\t\t4. https://medlineplus.gov/ency/article/001468.htm", "COMMENT": "providing only a link to https://www.ncbi.nlm.nih.gov/gtr/ is fine, it's also fine to provide http://www.oif.org/site/DocServer/Fact_Sheet_Testing_Labs.pdf?docID=17844\n\t\t\t\t\tthe disorders don't have common symptoms; returning symptoms of each is fine", "_aid": "TQ86A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "EDS" }, { "_fid": "F2", "_fcategory": "Problem", "__text": "Osteogenesis Imperfecta" } ]

[ { "_tid": "T1", "_hasFocus": "F1,F2", "__text": "COMPARISON", "_hasKeyword": null }, { "_tid": "T2", "_hasFocus": "F1", "__text": "DIAGNOSIS", "_hasKeyword": null }, { "_tid": "T3", "_hasFocus": "F1", "__text": "PERSON_ORGANIZATION", "_hasKeyword": "K1" }, { "_tid": "T4", "_hasFocus": "F2", "__text": "DIAGNOSIS", "_hasKeyword": null }, { "_tid": "T5", "_hasFocus": "F2", "__text": "PERSON_ORGANIZATION", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "GeographicLocation", "__text": "Southern California" } ]

[ { "ANSWER": "1. Cervicitis will go away within a few days to a week after you start taking antibiotics. If you have pelvic inflammatory disease, it may take a few weeks to treat the infection completely. Pelvic inflammatory disease can cause more serious problems, such as infertility or pain from\n\t\t\t\t\tscar tissue.\n\t\t\t\t\t2. Cervicitis may last for months to years. Cervicitis may lead to pain with intercourse (dyspareunia).", "AnswerURL": "1. http://www.health.harvard.edu/womens-health/cervicitis\n\t\t\t\t\t2. https://medlineplus.gov/ency/article/001495.htm", "COMMENT": "", "_aid": "TQ87A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "inflammation" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "CAUSE", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "ProcedureDevice", "__text": "tampon" } ]

[ { "ANSWER": "1. Trisomy 7 is extremely rare at birth and is generally considered lethal in embryogenesis. All surviving children are mosaics with variable and nonspecific clinical features. Chromosomal mosaicism may be suggested by body asymmetry and/or Blaschkolinear skin pigmentary dysplasia\n\t\t\t\t\tassociated with developmental delay. Cultured skin fibroblasts cytogenetic analysis confirms mosaicism and identifies its chromosomal origin. In amniocytes, trisomy 7 is frequently a cell culture artifact leading to single- or multiple-cell pseudomosaicism with normal fetal outcome.\n\n\n\t\t\t\t\t2. 7q11.23 duplication syndrome is considered to be an autosomal dominant condition, which means one copy of chromosome 7 with the duplication in each cell is sufficient to cause the disorder. Most cases result from a duplication that occurs during the formation of reproductive cells (eggs and\n\t\t\t\t\tsperm) or in early fetal development. These cases occur in people with no history of the disorder in their family. Less commonly, an affected person inherits the chromosome with a duplicated segment from a parent.\n\n\n\n\t\t\t\t\t3. Rearrangements of chromosomes include deletions of DNA sequences and duplications of segments, both of which can encompass thousands to hundreds of thousands of bases. Why do these large rearrangements occur? For one, certain structural features of the genome, also referred to as genome\n\t\t\t\t\tarchitecture, can render various regions fragile and thus prone to events such as chromosome breakage, which often result in translocations, deletions, and duplications. Often, these alterations happen due to errors during cell division when chromosomes align (Figure 1). Homologous\n\t\t\t\t\trecombination between areas of concentrated repeated sequences frequently creates deletions and duplications. Because they commonly involve more than one gene, the disorders caused by these large deletion and duplication mutations are often severe.", "AnswerURL": "1. http://www.nature.com/ejhg/journal/v13/n9/full/5201442a.html\n\n\t\t\t\t\t2. https://ghr.nlm.nih.gov/condition/7q1123-duplication-syndrome#inheritance\n\n\t\t\t\t\t3. https://www.nature.com/scitable/topicpage/dna-deletion-and-duplication-and-the-associated-331", "COMMENT": "there is no specific information for Trisomy 7 causes -- general information on causes of duplication is relevant.", "_aid": "TQ88A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "trisomy 7" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "INFORMATION", "_hasKeyword": null }, { "_tid": "T2", "_hasFocus": "F1", "__text": "INHERITANCE", "_hasKeyword": null }, { "_tid": "T3", "_hasFocus": "F1", "__text": "CAUSE", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "1. This meta-analysis suggested that metformin could effectively lower SBP in nondiabetic patients, especially in those with impaired glucose tolerance or obesity.", "AnswerURL": "https://www.ncbi.nlm.nih.gov/pubmed/27607453", "COMMENT": "", "_aid": "TQ89A1" }, { "ANSWER": "2. Metformin does not significantly affect BP in patients with Type 2 diabetes intensively treated with insulin.", "AnswerURL": "1. http://journals.lww.com/jhypertension/Abstract/2017/01000/Effects_of_metformin_on_blood_pressure_in.4.aspx\n\t\t\t\t\t2. https://www.ncbi.nlm.nih.gov/pubmed/15975107", "COMMENT": "pages with patients' discussions about metformin that contain answers are also relevant, so are the lists of metformin side effects", "_aid": "TQ89A2" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "metformin" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "SIDE_EFFECT", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "Problem", "__text": "high blood pressure" } ]

[ { "ANSWER": "1. Aclidinium is in a class of medications called bronchodilators. It works by relaxing and opening the air passages to the lungs to make breathing easier.\n\n\t\t\t\t\t2. There are currently six muscarinic receptor antagonists licenced for use in the treatment of COPD, the short-acting muscarinic receptor antagonists (SAMAs) ipratropium bromide and oxitropium bromide and the long-acting muscarinic receptor antagonists (LAMAs) aclidinium bromide, tiotropium\n\t\t\t\t\tbromide, glycopyrronium bromide and umeclidinium bromide. Concerns have been raised about possible associations of muscarinic receptor antagonists with cardiovascular safety, but the most advanced compounds seem to have an improved safety profile.\n\n\t\t\t\t\t3. The use of TUDORZA PRESSAIR is contraindicated in the following conditions:\n\t\t\t\t\t*Severe hypersensitivity to milk proteins [see WARNINGS AND PRECAUTIONS (5.5)] *Hypersensitivity to aclidinium bromide or any of the excipients [see Warnings and Precautions (5.5)]", "AnswerURL": "1. https://medlineplus.gov/druginfo/meds/a613001.html\n\t\t\t\t\t2. https://www.ncbi.nlm.nih.gov/pubmed/27787709\n\t\t\t\t\t3. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=acdd5932-375b-4966-8a06-3806ab74c36d#section-4", "COMMENT": "for the cataract surgery sub-question, providing the contraindications is relevant", "_aid": "TQ90A1" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "aclinidium" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "INFORMATION", "_hasKeyword": "K1" }, { "_tid": "T2", "_hasFocus": "F1", "__text": "CONTRAINDICATION", "_hasKeyword": "K2" } ]

[ { "_kid": "K1", "_kcategory": "DrugSupplement", "__text": "steroid" }, { "_kid": "K2", "_kcategory": "ProcedureDevice", "__text": "cataract surgery" } ]

[ { "ANSWER": "1. Smoking has been found to increase the risk of cancers of the mouth, esophagus, stomach, and pancreas. Research suggests that smoking may also increase the risk of cancers of the liver, colon, and rectum.\n\t\t\t\t\tSmoking increases the risk of heartburn and gastroesophageal reflux disease (GERD).\n\t\t\t\t\tSmoking increases the risk of peptic ulcers.\n\t\t\t\t\tSmoking may worsen some liver diseases, including primary biliary cirrhosis and nonalcoholic fatty liver disease (NAFLD).\n\t\t\t\t\tCurrent and former smokers have a higher risk of developing Crohn's disease than people who have never smoked.\n\t\t\t\t\tPeople who smoke are more likely to develop colon polyps.\n\t\t\t\t\tSmoking increases the risk of developing pancreatitis.\n\t\t\t\t\tSome studies have shown that smoking may increase the risk of developing gallstones.\n\n\t\t\t\t\t2. Epidemiological and experimental evidence have shown that nicotine has harmful effects on the gastric mucosa. The mechanisms by which cigarette smoking or nicotine adversely affect the gastric mucosa have not been fully elucidated. In this report, clinical and experimental data are reviewed.\n\t\t\t\t\tThe effects of nicotine from smoking on gastric aggressive or defensive factors are discussed. Nicotine potentiates gastric aggressive factors and attenuates defensive factors; it also increases acid and pepsin secretions, gastric motility, duodenogastric reflux of bile salts, the risk of\n\t\t\t\t\tHelicobacter pylori infection, levels of free radicals, and platelet-activating factor, endothelin generation, and vasopressin secretion. Additionally, nicotine impairs the therapeutic effect of H2-receptor antagonists and decreases prostaglandin synthesis, gastric mucosal blood flow, mucus\n\t\t\t\t\tsecretion, and epidermal growth factor secretion. Although many of the studies provide conflicting results, the bulk of the evidence supports the hypothesis that nicotine is harmful to the gastric mucosa.", "AnswerURL": "1. https://www.niddk.nih.gov/health-information/digestive-diseases/smoking-digestive-system\n\t\t\t\t\t2. https://www.ncbi.nlm.nih.gov/pubmed/7915701", "COMMENT": "information about smoking or nicotine effects is relevant", "_aid": "TQ91A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "smoking" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "EFFECT", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "OTHER", "__text": "digestion" } ]

[ { "ANSWER": "1. Fibromyalgia is a disorder that causes muscle pain and fatigue. People with fibromyalgia have \"tender points\" on the body. Tender points are specific places on the neck, shoulders, back, hips, arms, and legs. These points hurt when pressure is put on them.\n\n\t\t\t\t\tPeople with fibromyalgia may also have other symptoms, such as\n\n\t\t\t\t\tTrouble sleeping\n\t\t\t\t\tMorning stiffness\n\t\t\t\t\tHeadaches\n\t\t\t\t\tPainful menstrual periods\n\t\t\t\t\tTingling or numbness in hands and feet\n\t\t\t\t\tProblems with thinking and memory (sometimes called \"fibro fog\")\n\n\t\t\t\t\t2. Foot, leg, and ankle swelling is common when the person also:\n\n\t\t\t\t\tIs overweight\n\t\t\t\t\tHas a blood clot in the leg\n\t\t\t\t\tIs older\n\t\t\t\t\tHas a leg infection\n\t\t\t\t\tHas veins in the legs that cannot properly pump blood back to the heart\n\t\t\t\t\tInjury or surgery involving the leg, ankle, or foot can also cause swelling. Swelling may also occur after pelvic surgery, especially for cancer.\n\n\t\t\t\t\tLong airplane flights or car rides, as well as standing for long periods of time, often lead to some swelling in the feet and ankles.\n\n\t\t\t\t\tSwelling may occur in women who take estrogen, or during parts of the menstrual cycle. Most women have some swelling during pregnancy. More severe swelling during pregnancy may be a sign of preeclampsia, a serious condition that includes high blood pressure and swelling.\n\n\t\t\t\t\tSwollen legs may be a sign of heart failure, kidney failure, or liver failure. In these conditions, there is too much fluid in the body.\n\n\t\t\t\t\tCertain medicines may also cause your legs to swell. Some of these are:\n\n\t\t\t\t\tAntidepressants, including MAO inhibitors and tricyclics\n\t\t\t\t\tBlood pressure medicines called calcium channel blockers\n\t\t\t\t\tHormones, such as estrogen (in birth control pills or hormone replacement therapy) and testosterone\n\t\t\t\t\tSteroids", "AnswerURL": "1. https://medlineplus.gov/fibromyalgia.html\n\t\t\t\t\t2. https://medlineplus.gov/ency/article/003104.htm", "COMMENT": "both the answers about Fibromyalgia symptoms and causes of swelling are relevant", "_aid": "TQ92A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "fibromyalgia" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "EFFECT", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "Problem", "__text": "swollen" } ]

[ { "ANSWER": "A healthy person cannot \"catch\" cancer from someone who has it. There is no evidence that close contact or things like sex, kissing, touching, sharing meals, or breathing the same air can spread cancer from one person to another.\n\n\t\t\t\t\tCancer cells from one person are generally unable to live in the body of another healthy person. A healthy person's immune system recognizes foreign cells and destroys them, including cancer cells from another person.", "AnswerURL": "https://www.cancer.org/cancer/cancer-basics/is-cancer-contagious.html", "COMMENT": "", "_aid": "TQ93A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "cancer" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "SUSCEPTIBILITY", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "Problem", "__text": "blood contact" } ]

[ { "ANSWER": "You are more likely to get plantar fasciitis if you:\n\n\t\t\t\t\tHave foot arch problems (both flat feet and high arches)\n\t\t\t\t\tRun long distances, downhill or on uneven surfaces\n\t\t\t\t\tAre obese or gain weight suddenly\n\t\t\t\t\tHave a tight Achilles tendon (the tendon connecting the calf muscles to the heel)\n\t\t\t\t\tWear shoes with poor arch support or soft soles\n\t\t\t\t\tChange your activities", "AnswerURL": "https://medlineplus.gov/ency/article/007021.htm", "COMMENT": "", "_aid": "TQ94A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "Plantar fasiciitis" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "SUSCEPTIBILITY", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "Problem", "__text": "weight bearing" } ]

[ { "ANSWER": "1. Upper GI endoscopy can identify many different diseases\n\n\t\t\t\t\tanemia\n\t\t\t\t\tgastroesophageal reflux disease\n\t\t\t\t\tulcers\n\t\t\t\t\tcancer\n\t\t\t\t\tinflammation, or swelling\n\t\t\t\t\tprecancerous abnormalities\n\t\t\t\t\tceliac disease\n\n\t\t\t\t\t2. Tests for Liver Cancer\n\n\t\t\t\t\tIf you have some of the signs and symptoms of liver cancer, your doctor will try to find if they are caused by liver cancer or something else.\n\n\t\t\t\t\tMedical history and physical exam\n\t\t\t\t\tImaging tests: Ultrasound, Computed tomography (CT), Magnetic resonance imaging (MRI), Angiography\n\n\t\t\t\t\tNeedle biopsy: A hollow needle is placed through the skin in the abdomen and into the liver. The skin is first numbed with local anesthesia before the needle is placed. Different-sized needles may be used.\n\n\t\t\t\t\tLaparoscopic biopsy: Biopsy specimens can also be taken during laparoscopy. This lets the doctor see the surface of the liver and take samples of abnormal-appearing areas.\n\n\t\t\t\t\tSurgical biopsy: An incisional biopsy (removing a piece of the tumor) or an excisional biopsy (removing the entire tumor and some surrounding normal liver tissue) can be done during an operation.\n\n\t\t\t\t\tLab tests", "AnswerURL": "1. https://www.niddk.nih.gov/health-information/diagnostic-tests/upper-gi-endoscopy\n\t\t\t\t\t2. https://www.cancer.org/cancer/liver-cancer/detection-diagnosis-staging/how-diagnosed.html", "COMMENT": "any pages on diagnostic procedures for liver cancer are relevant. Pages on diseases identified using upper gi endoscopy are also relevant", "_aid": "TQ95A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "LIVER CANCER" }, { "_fid": "F2", "_fcategory": "Problem", "__text": "Lipnodes CANCER" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "DIAGNOSIS", "_hasKeyword": "K1" }, { "_tid": "T2", "_hasFocus": "F2", "__text": "DIAGNOSIS", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "DiagnosticProcedure", "__text": "UPPER GI" } ]

[ { "ANSWER": "1. A heart attack happens if the flow of oxygen-rich blood to a section of heart muscle suddenly becomes blocked and the heart can't get oxygen. Most heart attacks occur as a result of coronary heart disease (CHD).\n\n\t\t\t\t\t2. Endocarditis (EN-do-kar-DI-tis) is an infection of the inner lining of the heart chambers and valves. This lining is called the endocardium (en-do-KAR-de-um). The condition also is called infective endocarditis (IE).\n\n\t\t\t\t\tThe term \"endocarditis\" also is used to describe an inflammation of the endocardium due to other conditions. This article only discusses endocarditis related to infection.\n\n\t\t\t\t\tIE occurs if bacteria, fungi, or other germs invade your bloodstream and attach to abnormal areas of your heart. The infection can damage your heart and cause serious and sometimes fatal complications.\n\n\t\t\t\t\tIE can develop quickly or slowly; it depends on what type of germ is causing it and whether you have an underlying heart problem. When IE develops quickly, it's called acute infective endocarditis. When it develops slowly, it's called subacute infective endocarditis.\n\n\t\t\t\t\tOverview\n\n\t\t\t\t\tIE mainly affects people who have:\n\n\t\t\t\t\tDamaged or artificial (man-made) heart valves\n\t\t\t\t\tCongenital heart defects (defects present at birth)\n\t\t\t\t\tImplanted medical devices in the heart or blood vessels\n\t\t\t\t\tPeople who have normal heart valves also can have IE. However, the condition is much more common in people who have abnormal hearts.\n\n\t\t\t\t\tCertain factors make it easier for bacteria to enter your bloodstream. These factors put you at higher risk for IE. For example, poor dental hygiene and unhealthy teeth and gums increase your risk for the infection.", "AnswerURL": "1. https://www.nhlbi.nih.gov/health/health-topics/topics/heartattack/causes\n\t\t\t\t\t2. https://www.nhlbi.nih.gov/health/health-topics/topics/endo", "COMMENT": "both answers on causes of heart attack and the connection between oral infection and heart disease are relevant", "_aid": "TQ96A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "heart attack" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "CAUSE", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "Problem", "__text": "abscess teeth" } ]

[ { "ANSWER": "1. The defining characteristics of syncope include rapid onset with transient loss of consciousness usually accompanied by falling, followed by spontaneous, complete, and usually prompt recovery without intervention. Because some patients use the term dizziness to describe syncopal\n\t\t\t\t\tevents, it is important to ask patients exactly what they mean by dizziness and whether loss of consciousness occurred.\n\n\t\t\t\t\tSyncope must be differentiated from vertigo, coma, drop attacks, dizziness, sudden cardiac death, and seizures. Vertigo (i.e., sensation of movement) does not include loss of consciousness. Coma involves loss of consciousness without spontaneous recovery. Drop attacks involve sudden falls without loss\n\t\t\t\t\tof consciousness or warning and with immediate recovery. Drop attacks may be idiopathic but also have several specific causes (e.g., underlying cardiovascular disease, spondylotic osteophytes or colloidal cysts that transiently block the vertebral arteries or cerebral aqueduct, vertebrobasilar\n\t\t\t\t\tstroke). The typical signs of epileptic seizures include dejavu, tongue lacerations, limb jerking, and postictal confusion but not common signs of syncope, such as prodromal diaphoresis, palpitations, or provocation by prolonged sitting or standing. Although limb jerking is noted in 15 percent\n\t\t\t\t\tof syncopal patients, the other typical signs of seizures are absent.\n\n\t\t\t\t\t2. Correct and early diagnosis of TIA versus mimics is critical because early interventions (e.g., antiplatelet agents, statin therapy, blood pressure-lowering therapy, anticoagulation when appropriate) can lead to an 80 percent reduction in risk of recurrent ischemic events. The most common TIA\n\t\t\t\t\tmimics are seizures, migraines, metabolic disturbances, and syncope. Mimics are more likely with gradual onset of symptoms and with nonspecific symptoms (Table 113), such as memory loss or headache.", "AnswerURL": "1. http://www.aafp.org/afp/2005/1015/p1492.html\n\t\t\t\t\t2. http://www.aafp.org/afp/2012/0915/p521.html", "COMMENT": "", "_aid": "TQ97A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "stroke ischemic" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "DIAGNOSIS", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "1. GNC Preventive Nutrition CoQ-10 100 mg Coenzyme Q-10 100 mg; Other Ingredients: Soybean oil, Gelatin, Glycerin, Chlorophyll, Titanium Dioxide (Natural Mineral Whitener). No Sugar, No Starch, No Artificial Colors, No Artificial Flavors, No preservatives, No Wheat, No Gluten, No Corn,\n\t\t\t\t\tNo Dairy, Yeast Free.\n\n\t\t\t\t\t2. Metabolic Maintenance CoQ10 (Veggie Capsules) Vitamin C (as Ascorbic Acid), CoEnzyme Q10 (Ubiquinone), vegetarian capsule, l-leucine.", "AnswerURL": "1. http://www.consumerlab.com/ingredients/Coenzyme_Q10%20/coq10_old/\n\t\t\t\t\t2. https://www.toxinless.com/coenzyme-q10", "COMMENT": "", "_aid": "TQ98A1" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "COENZYME Q10" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "INGREDIENT", "_hasKeyword": "K1" }, { "_tid": "T2", "_hasFocus": "F1", "__text": "INDICATION", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "PersonPopulation", "__text": "MUSLIMS" } ]

[ { "ANSWER": "Since autoimmune diseases vary greatly in presentation, many different physician specialists care for patients with these disorders. The specialist is usually skilled in treating diseases of a particular system. For example: rheumatologists tend to treat diseases affecting the joints\n\t\t\t\t\tand connective tissue; neurologists, autoimmune diseases of the central and/or peripheral nervous system; dermatologists; diseases of the skin; gastroenterologists, diseases of the intestinal tract; and endocrinologists, diseases of endocrine organs. It can be truly said that physicians of any\n\t\t\t\t\tspecialty may encounter patients with autoimmune disease.", "AnswerURL": "http://autoimmune.pathology.jhmi.edu/faqs.cfm", "COMMENT": "", "_aid": "TQ99A1" } ]

[ { "_fid": "F1", "_fcategory": "Problem", "__text": "autoimmune illness" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "PERSON_ORGANIZATION", "_hasKeyword": null } ]

[ null ]

[ { "ANSWER": "The recommended starting dose for Effexor is 75 mg/day, administered in two or three divided doses, taken with food. Depending on tolerability and the need for further clinical effect, the dose may be increased to 150 mg/day. If needed, the dose should be further increased up to 225\n\t\t\t\t\tmg/day. When increasing the dose, increments of up to 75 mg/day should be made at intervals of no less than 4 days. In outpatient settings there was no evidence of usefulness of doses greater than 225 mg/day for moderately depressed patients, but more severely depressed inpatients responded to\n\t\t\t\t\ta mean dose of 350 mg/day. Certain patients, including more severely depressed patients, may therefore respond more to higher doses, up to a maximum of 375 mg/day, generally in three divided doses", "AnswerURL": "https://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=9595#s84", "COMMENT": "recommended doses of effexor are relevant", "_aid": "TQ100A1" }, { "ANSWER": "Antidepressants most likely to cause sexual side effects include:\n\n\t\t\t\t\tSelective serotonin reuptake inhibitors (SSRIs), which include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Selfemra), paroxetine (Paxil, Pexeva) and sertraline (Zoloft).\n\t\t\t\t\tSerotonin and norepinephrine reuptake inhibitors (SNRIs), which include venlafaxine (Effexor XR), desvenlafaxine (Pristiq, Khedezla) and duloxetine (Cymbalta).\n\t\t\t\t\tTricyclic and tetracyclic antidepressants, such as amitriptyline, nortriptyline (Pamelor) and clomipramine (Anafranil).\n\t\t\t\t\tMonoamine oxidase inhibitors (MAOIs), such as isocarboxazid (Marplan), phenelzine (Nardil) and tranylcypromine (Parnate). However, selegiline (Emsam), a newer MAOI that you stick on your skin as a patch, has a low risk of sexual side effects.\n\t\t\t\t\tIf you're taking an antidepressant that causes sexual side effects, your doctor may recommend one of these strategies:\n\n\t\t\t\t\tWaiting several weeks to see whether sexual side effects get better.\n\t\t\t\t\tEngaging in sexual activity before taking an antidepressant if your antidepressant requires a once-a-day dose.\n\t\t\t\t\tAdjusting the dose of your antidepressant to reduce the risk of sexual side effects. But always talk with your doctor before changing your dose.\n\t\t\t\t\tSwitching to another antidepressant that may be less likely to cause sexual side effects.\n\t\t\t\t\tAdding a second antidepressant or another type of medication to counter sexual side effects. For example, the addition of the antidepressant bupropion or the anti-anxiety medication buspirone may ease sexual side effects caused by an antidepressant.\n\t\t\t\t\tAdding a medication to improve sexual function, such as sildenafil (Viagra, Revatio), tadalafil (Adcirca, Cialis) or vardenafil (Levitra, Staxyn). Although these medications are used to treat sexual problems in men, initial research suggests sildenafil may also improve sexual problems caused by\n\t\t\t\t\tantidepressants in some women.", "AnswerURL": "http://www.mayoclinic.org/diseases-conditions/depression/expert-answers/antidepressants/faq-20058104", "COMMENT": "answers about mitigating the ED effects of effexor are relevant, e.g., http://www.pharmatherapist.com/articles/8-tips-for-managing-antidepressant-induced-sexual-dysfunction", "_aid": "TQ100A2" } ]

[ { "_fid": "F1", "_fcategory": "DrugSupplement", "__text": "effextor" } ]

[ { "_tid": "T1", "_hasFocus": "F1", "__text": "SIDE_EFFECT", "_hasKeyword": "K1" } ]

[ { "_kid": "K1", "_kcategory": "Problem", "__text": "ED" } ]