bowang0911/MedQuAD huggingface dataset:
Inguinal hernias can cause the following complications:
                
- Incarceration. An incarcerated hernia happens when part of the fat or small intestine from inside the abdomen becomes stuck in the groin or scrotum and cannot go back into the abdomen. A health care provider is unable to massage the hernia back into the abdomen.  - Strangulation. When an incarcerated hernia is not treated, the blood supply to the small intestine may become obstructed, causing strangulation of the small intestine. This lack of blood supply is an emergency situation and can cause the section of the intestine to die.
                

                
Seek Immediate Care   People who have symptoms of an incarcerated or a strangulated hernia should seek emergency medical help immediately. A strangulated hernia is a life-threatening condition. Symptoms of an incarcerated or a strangulated hernia include   - extreme tenderness or painful redness in the area of the bulge in the groin   - sudden pain that worsens quickly and does not go away   - the inability to have a bowel movement and pass gas   - nausea and vomiting   - fever
A health care provider diagnoses an inguinal hernia with
                
- a medical and family history  - a physical exam  - imaging tests, including x rays
                
Medical and family history. Taking a medical and family history may help a health care provider diagnose an inguinal hernia. Often the symptoms that the patient describes will be signs of an inguinal hernia.
                
Physical exam. A physical exam may help diagnose an inguinal hernia. During a physical exam, a health care provider usually examines the patients body. The health care provider may ask the patient to stand and cough or strain so the health care provider can feel for a bulge caused by the hernia as it moves into the groin or scrotum. The health care provider may gently try to massage the hernia back into its proper position in the abdomen.
                
Imaging tests. A health care provider does not usually use imaging tests, including x rays, to diagnose an inguinal hernia unless he or she
                
- is trying to diagnose a strangulation or an incarceration  - cannot feel the inguinal hernia during a physical exam, especially in patients who are overweight  - is uncertain if the hernia or another condition is causing the swelling in the groin or other symptoms
                
Specially trained technicians perform imaging tests at a health care providers office, an outpatient center, or a hospital.
                
A radiologista doctor who specializes in medical imaginginterprets the images. A patient does not usually need anesthesia.
                
Tests may include the following:
                
- Abdominal x ray. An x ray is a picture recorded on film or on a computer using a small amount of radiation. The patient will lie on a table or stand during the x ray. The technician positions the x-ray machine over the abdominal area. The patient will hold his or her breath as the technician takes the picture so that the picture will not be blurry. The technician may ask the patient to change position for additional pictures.  - Computerized tomography (CT) scan. CT scans use a combination of x rays and computer technology to create images. For a CT scan, the technician may give the patient a solution to drink and an injection of a special dye, called contrast medium. A health care provider injects the contrast medium into a vein, and the injection will make the patient feel warm all over for a minute or two. The contrast medium allows the health care provider to see the blood vessels and blood flow on the x rays. CT scans require the patient to lie on a table that slides into a tunnel-shaped device where the technician takes the x rays. A health care provider may give children a sedative to help them fall asleep for the test.  - Abdominal ultrasound. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure.
People cannot prevent the weakness in the abdominal wall that causes indirect inguinal hernias. However, people may be able to prevent direct inguinal hernias by maintaining a healthy weight and not smoking.
                
People can keep inguinal hernias from getting worse or keep inguinal hernias from recurring after surgery by
                
- avoiding heavy lifting  - using the legs, not the back, when lifting objects  - preventing constipation and straining during bowel movements  - maintaining a healthy weight  - not smoking
Researchers have not found that eating, diet, and nutrition play a role in causing inguinal hernias. A person with an inguinal hernia may be able to prevent symptoms by eating high-fiber foods. Fresh fruits, vegetables, and whole grains are high in fiber and may help prevent the constipation and straining that cause some of the painful symptoms of a hernia.
                
The surgeon will provide instructions on eating, diet, and nutrition after inguinal hernia surgery. Most people drink liquids and eat a light diet the day of the operation and then resume their usual diet the next day.
- An inguinal hernia happens when contents of the abdomenusually fat or part of the small intestinebulge through a weak area in the lower abdominal wall.  - A defect in the abdominal wall that is present at birth causes an indirect inguinal hernia.  - Direct inguinal hernias usually occur only in male adults as aging and stress or strain weaken the abdominal muscles around the inguinal canal. Females rarely form this type of inguinal hernia.  - The first sign of an inguinal hernia is a small bulge on one or, rarely, on both sides of the grointhe area just above the groin crease between the lower abdomen and the thigh.  - An incarcerated hernia happens when part of the fat or small intestine from inside the abdomen becomes stuck in the groin or scrotum and cannot go back into the abdomen.  - When an incarcerated hernia is not treated, the blood supply to the small intestine may become obstructed, causing strangulation of the small intestine.  - People who have symptoms of an incarcerated or a strangulated hernia should seek emergency medical help immediately. A strangulated hernia is a life-threatening condition.  - Repair of an inguinal hernia via surgery is the only treatment for inguinal hernias and can prevent incarceration and strangulation.
Test      Instructions      Results or Dates           A1C test             - Have this blood test at least twice a year. Your result will tell you what your average blood glucose level was for the past 2 to 3 months.         Date: __________  A1C: __________  Next test: __________          Blood lipid (fats) lab tests             - Get a blood test to check your             - total cholesterolaim for below 200        - LDL, or bad, cholesterolaim for below 100        - HDL, or good, cholesterolmen: aim for above 40; women: aim for above 50        - triglyceridesaim for below 150               Date: __________  Total cholesterol: __________  LDL: __________  HDL: __________  Triglycerides: __________  Next test: __________          Kidney function tests             - Once a year, get a urine test to check for protein.      - At least once a year, get a blood test to check for creatinine.         Date: __________  Urine protein: __________  Creatinine: __________  Next test: __________          Dilated eye exam             - See an eye doctor once a year for a complete eye exam that includes using drops in your eyes to dilate your pupils.      - If you are pregnant, have a complete eye exam in your first 3 months of pregnancy. Have another complete eye exam 1 year after your baby is born.         Date: __________  Result: __________  Next test: __________          Dental exam             - See your dentist twice a year for a cleaning and checkup.         Date: __________  Result: __________  Next test: __________           Pneumonia vaccine (recommended by the Centers for Disease Control and Prevention [CDC])              - Get the vaccine if you are younger than 64.      - If youre older than 64 and your shot was more than 5 years ago, get another vaccine.        Date received: __________         Flu vaccine (recommended by the CDC)              - Get a flu shot each year.         Date received: __________         Hepatitis B vaccine (recommended by the CDC)             - Get this vaccine if you are age 19 to 59 and have not had this vaccine.      - Consider getting this vaccine if you are 60 or older and have not had this vaccine.         Date of 1st dose: __________  Date of 2nd dose: __________  Date of 3rd dose: __________
                
PDF Version (PDF, 40 KB)
Diabetes causes blood glucose levels to be above normal. People with diabetes have problems converting food to energy. After food is eaten, it is broken down into a sugar called glucose. Glucose is then carried by the blood to cells throughout the body. The hormone insulin, made in the pancreas, helps the body change blood glucose into energy. People with diabetes, however, either no longer make enough insulin, or their insulin doesn't work properly, or both.
                
Type 2 diabetes
                
Type 2 diabetes is the most common type in American Indians. This type of diabetes can occur at any age, even during childhood. People develop type 2 diabetes because the cells in the muscles, liver, and fat do not use insulin properly. Eventually, the body cannot make enough insulin. As a result, the amount of glucose in the blood increases while the cells are starved of energy. Over time, high blood glucose damages nerves and blood vessels, leading to problems such as heart disease, stroke, blindness, kidney failure, and amputation.
                
Other kinds of diabetes
                
Type 1 diabetes
                
Type 1 diabetes is rare in American Indians. People develop type 1 diabetes when their bodies no longer make any insulin. Type 1 is usually first diagnosed in children or young adults but can develop at any age.
                
Gestational diabetes
                
Gestational diabetes is first diagnosed during pregnancy. It occurs when the body doesn't use insulin properly. Having an American Indian family background raises the risk of developing gestational diabetes. Although this form of diabetes usually goes away after the baby is born, a woman who has had it is more likely to develop type 2 diabetes later in life.
- My mother had diabetes when I was born.   - I am overweight.  - I have a parent, brother, or sister with diabetes.  - My family background is American Indian.  - I have had gestational diabetes, or I gave birth to at least one baby weighing more than 9 pounds.  - My blood pressure is 140/90 mmHg or higher, or I have been told that I have high blood pressure.  - My cholesterol levels are higher than normal. My HDL cholesterol"good" cholesterolis below 35 mg/dL, or my triglyceride level is above 250 mg/dL.  - I am fairly inactive. I exercise fewer than three times a week.
Insulin is a hormone made in the pancreas, an organ located behind the stomach. The pancreas contains clusters of cells called islets. Beta cells within the islets make insulin and release it into the blood.
                
Insulin plays a major role in metabolismthe way the body uses digested food for energy. The digestive tract breaks down carbohydratessugars and starches found in many foodsinto glucose. Glucose is a form of sugar that enters the bloodstream. With the help of insulin, cells throughout the body absorb glucose and use it for energy.
                
Insulin's Role in Blood Glucose Control
                
When blood glucose levels rise after a meal, the pancreas releases insulin into the blood. Insulin and glucose then travel in the blood to cells throughout the body.
                
- Insulin helps muscle, fat, and liver cells absorb glucose from the bloodstream, lowering blood glucose levels.  - Insulin stimulates the liver and muscle tissue to store excess glucose. The stored form of glucose is called glycogen.  - Insulin also lowers blood glucose levels by reducing glucose production in the liver.
                
In a healthy person, these functions allow blood glucose and insulin levels to remain in the normal range.
Insulin resistance is a condition in which the body produces insulin but does not use it effectively. When people have insulin resistance, glucose builds up in the blood instead of being absorbed by the cells, leading to type 2 diabetes or prediabetes.
                
Most people with insulin resistance don't know they have it for many yearsuntil they develop type 2 diabetes, a serious, lifelong disease. The good news is that if people learn they have insulin resistance early on, they can often prevent or delay diabetes by making changes to their lifestyle.
                
Insulin resistance can lead to a variety of serious health disorders. The section "What is metabolic syndrome?" provides more information about other health disorders linked to insulin resistance.
Although the exact causes of insulin resistance are not completely understood, scientists think the major contributors to insulin resistance are excess weight and physical inactivity.
                
Excess Weight
                
Some experts believe obesity, especially excess fat around the waist, is a primary cause of insulin resistance. Scientists used to think that fat tissue functioned solely as energy storage. However, studies have shown that belly fat produces hormones and other substances that can cause serious health problems such as insulin resistance, high blood pressure, imbalanced cholesterol, and cardiovascular disease (CVD).
                
Belly fat plays a part in developing chronic, or long-lasting, inflammation in the body. Chronic inflammation can damage the body over time, without any signs or symptoms. Scientists have found that complex interactions in fat tissue draw immune cells to the area and trigger low-level chronic inflammation. This inflammation can contribute to the development of insulin resistance, type 2 diabetes, and CVD. Studies show that losing the weight can reduce insulin resistance and prevent or delay type 2 diabetes.
                
Physical Inactivity
                
Many studies have shown that physical inactivity is associated with insulin resistance, often leading to type 2 diabetes. In the body, more glucose is used by muscle than other tissues. Normally, active muscles burn their stored glucose for energy and refill their reserves with glucose taken from the bloodstream, keeping blood glucose levels in balance.
                
Studies show that after exercising, muscles become more sensitive to insulin, reversing insulin resistance and lowering blood glucose levels. Exercise also helps muscles absorb more glucose without the need for insulin. The more muscle a body has, the more glucose it can burn to control blood glucose levels.
                
Other Causes
                
Other causes of insulin resistance may include ethnicity; certain diseases; hormones; steroid use; some medications; older age; sleep problems, especially sleep apnea; and cigarette smoking.
                

                
Does sleep matter?   Yes. Studies show that untreated sleep problems, especially sleep apnea, can increase the risk of obesity, insulin resistance, and type 2 diabetes. Night shift workers may also be at increased risk for these problems. Sleep apnea is a common disorder in which a person's breathing is interrupted during sleep. People may often move out of deep sleep and into light sleep when their breathing pauses or becomes shallow. This results in poor sleep quality that causes problem sleepiness, or excessive tiredness, during the day.   Many people aren't aware of their symptoms and aren't diagnosed. People who think they might have sleep problems should talk with their health care provider.   More information about sleep problems is available from the National Heart, Lung, and Blood Institute at http://www.nhlbi.nih.gov/health/resources/sleep.
Prediabetes is a condition in which blood glucose or A1C levelswhich reflect average blood glucose levelsare higher than normal but not high enough for a diagnosis of diabetes. Prediabetes is becoming more common in the United States. The U.S. Department of Health and Human Services estimates that at least 86 million U.S. adults ages 20 or older had prediabetes in 2012.1 People with prediabetes are at increased risk of developing type 2 diabetes and CVD, which can lead to heart attack or stroke.
Insulin resistance and prediabetes usually have no symptoms. People may have one or both conditions for several years without knowing they have them. Even without symptoms, health care providers can identify people at high risk by their physical characteristics, also known as risk factors. The section "Who should be tested for prediabetes?" lists these risk factors.
                
People with a severe form of insulin resistance may have dark patches of skin, usually on the back of the neck. Sometimes people have a dark ring around their neck. Dark patches may also appear on elbows, knees, knuckles, and armpits. This condition is called acanthosis nigricans.
Metabolic syndrome, also called insulin resistance syndrome, is a group of traits and medical conditions linked to overweight and obesity that puts people at risk for both CVD and type 2 diabetes. Metabolic syndrome is defined* as the presence of any three of the following2:
                
- large waist sizewaist measurement of 40 inches or more for men and 35 inches or more for women  - high triglycerides in the bloodtriglyceride level of 150 milligrams per deciliter (mg/dL) or above, or taking medication for elevated triglyceride level  - abnormal levels of cholesterol in the bloodHDL, or good, cholesterol level below 40 mg/dL for men and below 50 mg/dL for women, or taking medication for low HDL  - high blood pressureblood pressure level of 130/85 or above, or taking medication for elevated blood pressure  - higher than normal blood glucose levelsfasting blood glucose level of 100 mg/dL or above, or taking medication for elevated blood glucose
                
In addition to type 2 diabetes, metabolic syndrome has been linked to the following health disorders:
                
- obesity  - CVD  - PCOS  - nonalcoholic fatty liver disease  - chronic kidney disease
                
However, not everyone with these disorders has insulin resistance, and some people may have insulin resistance without getting these disorders.
                
People who are obese or who have metabolic syndrome, insulin resistance, type 2 diabetes, or prediabetes often also have low-level inflammation throughout the body and blood clotting defects that increase the risk of developing blood clots in the arteries. These conditions contribute to increased risk for CVD.
                
*Similar definitions have been developed by the World Health Organization and the American Association of Clinical Endocrinologists.
- Insulin is a hormone that helps cells throughout the body absorb glucose and use it for energy. Insulin resistance is a condition in which the body produces insulin but does not use it effectively.  - Insulin resistance increases the risk of developing type 2 diabetes and prediabetes.  - The major contributors to insulin resistance are excess weight, especially around the waist, and physical inactivity.  - Prediabetes is a condition in which blood glucose or A1C levelswhich reflect average blood glucose levelsare higher than normal but not high enough for a diagnosis of diabetes.  - The Diabetes Prevention Program (DPP) study and its follow-up study, the Diabetes Prevention Program Outcomes Study (DPPOS), confirmed that people with prediabetes can often prevent or delay diabetes if they lose a modest amount of weight by cutting fat and calorie intake and increasing physical activity.  - By losing weight and being more physically active, people can reverse insulin resistance and prediabetes, thus preventing or delaying type 2 diabetes.  - People with insulin resistance and prediabetes can decrease their risk for diabetes by eating a healthy diet and reaching and maintaining a healthy weight, increasing physical activity, not smoking, and taking medication.  - The DPP showed the diabetes medication metformin to be most effective in preventing or delaying the development of type 2 diabetes in younger and heavier people with prediabetes and women who have had gestational diabetes.
Amyloidosis is a rare disease that occurs when amyloid proteins are deposited in tissues and organs. Amyloid proteins are abnormal proteins that the body cannot break down and recycle, as it does with normal proteins. When amyloid proteins clump together, they form amyloid deposits. The buildup of these deposits damages a persons organs and tissues. Amyloidosis can affect different organs and tissues in different people and can affect more than one organ at the same time. Amyloidosis most frequently affects the kidneys, heart, nervous system, liver, and digestive tract. The symptoms and severity of amyloidosis depend on the organs and tissues affected.
The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the two kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra fluid. The urine flows from the kidneys to the bladder through tubes called ureters. The bladder stores urine. When the bladder empties, urine flows out of the body through a tube called the urethra, located at the bottom of the bladder. In men, the urethra is long, while in women it is short.
Primary amyloidosis and dialysis-related amyloidosis are the types of amyloidosis that can affect the kidneys.
                
Primary Amyloidosis of the Kidneys
                
The kidneys are the organs most commonly affected by primary amyloidosis. Amyloid deposits damage the kidneys and make it harder for them to filter wastes and break down proteins. When the kidneys become too damaged, they may no longer be able to function well enough to maintain health, resulting in kidney failure. Kidney failure can lead to problems such as high blood pressure, bone disease, and anemiaa condition in which the body has fewer red blood cells than normal.
                
Dialysis-related Amyloidosis
                
People who suffer from kidney failure and have been on long-term dialysis may develop dialysis-related amyloidosis. This type of amyloidosis occurs when a certain protein, called beta-2 microglobulin, builds up in the blood because dialysis does not remove it completely. The two types of dialysis are
                
- hemodialysis. Hemodialysis uses a special filter called a dialyzer to remove wastes and extra fluid from the blood.  - peritoneal dialysis. Peritoneal dialysis uses the lining of the abdominal cavitythe space in the body that holds organs such as the stomach, intestines, and liverto filter the blood.
                
Dialysis-related amyloidosis is a complication of kidney failure because neither hemodialysis nor peritoneal dialysis effectively filters beta-2 microglobulin from the blood. As a result, elevated amounts of beta-2 microglobulin remain in the blood. Dialysis-related amyloidosis is relatively common in people with kidney failure, especially adults older than 60 years of age, who have been on dialysis for more than 5 years.1
                
More information is provided in the NIDDK health topics:
                
- Treatment Methods for Kidney Failure: Hemodialysis  - Treatment Methods for Kidney Failure: Peritoneal Dialysis