bowang0911/MedQuAD huggingface dataset:
Secondary Insomnia
                
Secondary insomnia is the symptom or side effect of another problem. This type of insomnia often is a symptom of an emotional, neurological, or other medical or sleep disorder.
                
Emotional disorders that can cause insomnia include depression, anxiety, and posttraumatic stress disorder. Alzheimer's disease and Parkinson's disease are examples of neurological disorders that can cause insomnia.
                
Many other disorders or factors also can cause insomnia, such as:
                
Conditions that cause chronic (ongoing) pain, such as arthritis and headache disorders
                
Conditions that make it hard to breathe, such as asthma and heart failure
                
An overactive thyroid
                
Gastrointestinal disorders, such as heartburn
                
Stroke
                
Sleep disorders, such as restless legs syndrome and sleep-related breathing problems
                
Menopause and hot flashes
                
Secondary insomnia also can be a side effect of some medicines. For example, certain asthma medicines, such as theophylline, and some allergy and cold medicines can cause insomnia. Beta blockers also can cause the condition. These medicines are used to treat heart conditions.
                
Commonly used substances also can cause insomnia. Examples include caffeine and other stimulants, tobacco and other nicotine products, and alcohol and other sedatives.
                
Primary Insomnia
                
Primary insomnia isn't a symptom or side effect of another medical condition. It is its own distinct disorder, and its cause isnt well understood. Primary insomnia usually lasts for at least 1 month.
                
Many life changes can trigger primary insomnia. It may be due to major or long-lasting stress or emotional upset. Travel or other factors, such as work schedules that disrupt your sleep routine, also may trigger primary insomnia.
                
Even if these issues are resolved, the insomnia may not go away. Trouble sleeping can persist because of habits formed to deal with the lack of sleep. These habits might include taking naps, worrying about sleep, and going to bed early.
                
Researchers continue to try to find out whether some people are born with an increased risk for primary insomnia.
Insomnia is a common disorder. It affects women more often than men. The disorder can occur at any age. However, older adults are more likely to have insomnia than younger people.
                
People who might be at increased risk for insomnia include those who:
                
Have a lot of stress.
                
Are depressed or have other emotional distress, such as divorce or death of a spouse.
                
Have lower incomes.
                
Work at night or have frequent major shifts in their work hours.
                
Travel long distances with time changes.
                
Have certain medical conditions or sleep disorders that can disrupt sleep. For more information, go to "What Causes Insomnia?"
                
Have an inactive lifestyle.
                
Young and middle-aged African Americans also might be at increased risk for insomnia. Research shows that, compared with Caucasian Americans, it takes African Americans longer to fall asleep. They also have lighter sleep, don't sleep as well, and take more naps. Sleep-related breathing problems also are more common among African Americans.
The main symptom of insomnia is trouble falling or staying asleep, which leads to lack of sleep. If you have insomnia, you may:
                
Lie awake for a long time before you fall asleep
                
Sleep for only short periods
                
Be awake for much of the night
                
Feel as if you haven't slept at all
                
Wake up too early
                
The lack of sleep can cause other symptoms. You may wake up feeling tired or not well-rested, and you may feel tired during the day. You also may have trouble focusing on tasks. Insomnia can cause you to feel anxious, depressed, or irritable.
                
Insomnia also can affect your daily activities and cause serious problems. For example, you may feel drowsy while driving. Driver sleepiness (not related to alcohol) is responsible for almost 20 percent of all serious car crash injuries. Research also shows that insomnia raises older womens risk of falling.
                
If insomnia is affecting your daily activities, talk with your doctor. Treatment may help you avoid symptoms and problems related to the disorder. Also, poor sleep may be a sign of other health problems. Finding and treating those problems could improve your overall health and sleep.
Some diseases and conditions can disrupt the body's normal blood clotting process and lead to disseminated intravascular coagulation (DIC). These diseases and conditions include:
                
Sepsis (an infection in the bloodstream)
                
Surgery and trauma
                
Cancer
                
Serious complications of pregnancy and childbirth
                
Examples of less common causes of DIC are bites from poisonous snakes (such as rattlesnakes and other vipers), frostbite, and burns.
                
The two types of DIC are acute and chronic. Acute DIC begins with clotting in the small blood vessels and quickly leads to serious bleeding. Chronic DIC causes blood clotting, but it usually doesn't lead to bleeding. Cancer is the most common cause of chronic DIC.
                
Similar Clotting Conditions
                
Two other conditions cause blood clotting in the small blood vessels. However, their causes and treatments differ from those of DIC.
                
These conditions are thrombotic thrombocytopenic purpura (throm-BOT-ik throm-bo-cy-toe-PEE-nick PURR-purr-ah), or TTP, and hemolytic-uremic syndrome (HUS). HUS is more common in children than adults. It's also more likely to cause kidney damage than TTP.
Disseminated intravascular coagulation (DIC) is the result of an underlying disease or condition. People who have one or more of the following conditions are most likely to develop DIC:
                
Sepsis (an infection in the bloodstream)
                
Surgery and trauma
                
Cancer
                
Serious complications of pregnancy and childbirth
                
People who are bitten by poisonous snakes (such as rattlesnakes and other vipers), or those who have frostbite or burns, also are at risk for DIC.
Your doctor will diagnose disseminated intravascular coagulation (DIC) based on your medical history, a physical exam, and test results. Your doctor also will look for the cause of DIC.
                
Acute DIC requires emergency treatment. The condition can be life threatening if it's not treated right away. If you have signs or symptoms of severe bleeding or blood clots, call 911 right away.
                
Medical History and Physical Exam
                
Your doctor will ask whether you have or have had any diseases or conditions that can trigger DIC. For more information about these diseases and conditions, go to "What Causes Disseminated Intravascular Coagulation?"
                
Your doctor will ask about signs and symptoms of blood clots and bleeding. He or she also will do a physical exam to look for signs and symptoms of blood clots and internal and external bleeding. For example, your doctor may look for bleeding from your gums.
                
Diagnostic Tests
                
To diagnose DIC, your doctor may recommend blood tests to look at your blood cells and the clotting process. For these tests, a small amount of blood is drawn from a blood vessel, usually in your arm.
                
Complete Blood Count and Blood Smear
                
A complete blood count (CBC) measures the number of red blood cells, white blood cells, and platelets in your blood.
                
Platelets are blood cell fragments that help with blood clotting. Abnormal platelet numbers may be a sign of a bleeding disorder (not enough clotting) or a thrombotic disorder (too much clotting).
                
A blood smear is a test that may reveal whether your red blood cells are damaged.
                
Tests for Clotting Factors and Clotting Time
                
The following tests examine the proteins active in the blood clotting process and how long it takes them to form a blood clot.
                
PT and PTT tests. These tests measure how long it takes blood clots to form.
                
Serum fibrinogen. Fibrinogen is a protein that helps the blood clot. This test measures how much fibrinogen is in your blood.
                
Fibrin degradation. After blood clots dissolve, substances called fibrin degradation products are left behind in the blood. This test measures the amount of these substances in the blood.
Treatment for disseminated intravascular coagulation (DIC) depends on its severity and cause. The main goals of treating DIC are to control bleeding and clotting problems and treat the underlying cause.
                
Acute Disseminated Intravascular Coagulation
                
People who have acute DIC may have severe bleeding that requires emergency treatment in a hospital. Treatment may include blood transfusions, medicines, and oxygen therapy. (Oxygen is given through nasal prongs, a mask, or a breathing tube.)
                
A blood transfusion is a safe, common procedure. You receive blood through an intravenous (IV) line in one of your blood vessels. Blood transfusions are done to replace blood loss due to an injury, surgery, or illness.
                
Blood is made up of various parts, including red blood cells, white blood cells, platelets, and plasma. Some blood transfusions involve whole blood (blood with all of its parts). More often though, only some parts of blood are transfused.
                
If you have DIC, you may be given platelets and clotting factors, red blood cells, and plasma (the liquid part of blood).
                
Chronic Disseminated Intravascular Coagulation
                
People who have chronic DIC are more likely to have blood clotting problems than bleeding. If you have chronic DIC, your doctor may treat you with medicines called anticoagulants, or blood thinners.
                
Blood thinners help prevent blood clots from forming. They also keep existing blood clots from getting larger.
Espaol
                
Coronary heart disease (CHD) is a disease in which a waxy substance called plaque builds up inside the coronary arteries. These arteries supply oxygen-rich blood to your heart muscle.
                
When plaque builds up in the arteries, the condition is called atherosclerosis. The buildup of plaque occurs over many years.
                
Atherosclerosis
                

                
Over time, plaque can harden or rupture (break open). Hardened plaque narrows the coronary arteries and reduces the flow of oxygen-rich blood to the heart.
                
If the plaque ruptures, a blood clot can form on its surface. A large blood clot can mostly or completely block blood flow through a coronary artery. Over time, ruptured plaque also hardens and narrows the coronary arteries.
                
Overview
                
If the flow of oxygen-rich blood to your heart muscle is reduced or blocked, angina or a heart attack can occur.
                
Angina is chest pain or discomfort. It may feel like pressure or squeezing in your chest. The pain also can occur in your shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion.
                
A heart attack occurs if the flow of oxygen-rich blood to a section of heart muscle is cut off. If blood flow isnt restored quickly, the section of heart muscle begins to die. Without quick treatment, a heart attack can lead to serious health problems or death.
                
Over time, CHD can weaken the heart muscle and lead to heart failure and arrhythmias. Heart failure is a condition in which your heart can't pump enough blood to meet your bodys needs. Arrhythmias are problems with the rate or rhythm of the heartbeat.
                
Outlook
                
Lifestyle changes, medicines, and medical procedures can help prevent or treat coronary heart disease. These treatments may reduce the risk of related health problems.
Research suggests that coronary heart disease (CHD) starts when certain factors damage the inner layers of the coronary arteries. These factors include:
                
Smoking
                
High levels of certain fats and cholesterol in the blood
                
High blood pressure
                
High levels of sugar in the blood due to insulin resistance or diabetes
                
Blood vessel inflammation
                
Plaque might begin to build up where the arteries are damaged. The buildup of plaque in the coronary arteries may start in childhood.
                
Over time, plaque can harden or rupture (break open). Hardened plaque narrows the coronary arteries and reduces the flow of oxygen-rich blood to the heart. This can cause angina (chest pain or discomfort).
                
If the plaque ruptures, blood cell fragments called platelets (PLATE-lets) stick to the site of the injury. They may clump together to form blood clots.
                
Blood clots can further narrow the coronary arteries and worsen angina. If a clot becomes large enough, it can mostly or completely block a coronary artery and cause a heart attack.
You can prevent and control coronary heart disease (CHD)by taking action to control your risk factors with heart-healthy lifestyle changes and medicines. Examples of risk factors you can control include high blood cholesterol, high blood pressure, and overweight and obesity. Only a few risk factorssuch as age, gender, and family historycant be controlled.
                
Your risk for CHD increases with the number of risk factors you have. To reduce your risk of CHD and heart attack, try to control each risk factor you have by adopting the following heart-healthy lifestyles:
                
Heart-healthy eating
                
Maintaining a healthy weight
                
Managing stress
                
Physical activity
                
Quitting smoking
                
Know your family history of health problems related to CHD. If you or someone in your family has CHD, be sure to tell your doctor. If lifestyle changes aren't enough, you also may need medicines to control your CHD risk factors.
Vasculitis (vas-kyu-LI-tis) is a condition that involves inflammation in the blood vessels. The condition occurs if your immune system attacks your blood vessels by mistake. This may happen as the result of an infection, a medicine, or another disease or condition.
                
Inflammation refers to the bodys response to injury, including injury to the blood vessels. Inflammation may involve pain, redness, warmth, swelling, and loss of function in the affected tissues.
                
In vasculitis, inflammation can lead to serious problems. Complications depend on which blood vessels, organs, or other body systems are affected.
                
Overview
                
Vasculitis can affect any of the body's blood vessels. These include arteries, veins, and capillaries. Arteries carry blood from your heart to your body's organs. Veins carry blood from your organs and limbs back to your heart. Capillaries connect the small arteries and veins.
                
If a blood vessel is inflamed, it can narrow or close off. This limits or prevents blood flow through the vessel. Rarely, the blood vessel will stretch and weaken, causing it to bulge. This bulge is known as an aneurysm (AN-u-rism).
                
Vasculitis
                

                
The disruption in blood flow caused by inflammation can damage the body's organs. Signs and symptoms depend on which organs have been damaged and the extent of the damage.
                
Typical symptoms of inflammation, such as fever and general aches and pains, are common among people who have vasculitis.
                
Outlook
                
There are many types of vasculitis, but overall the condition is rare. If you have vasculitis, the outlook depends on:
                
The type of vasculitis you have
                
Which organs are affected
                
How quickly the condition worsens
                
The severity of the condition
                
Treatment often works well if its started early. In some cases, vasculitis may go into remission. "Remission" means the condition isn't active, but it can come back, or "flare," at any time.
                
Sometimes vasculitis is chronic (ongoing) and never goes into remission. Long-term treatment with medicines often can control the signs and symptoms of chronic vasculitis.
                
Rarely, vasculitis doesn't respond well to treatment. This can lead to disability and even death.
                
Much is still unknown about vasculitis. However, researchers continue to learn more about the condition and its various types, causes, and treatments.
Vasculitis occurs if your immune system attacks your blood vessels by mistake. What causes this to happen isn't fully known.
                
A recent or chronic (ongoing) infection may prompt the attack. Your body also may attack its own blood vessels in reaction to a medicine.
                
Sometimes an autoimmune disorder triggers vasculitis. Autoimmune disorders occur if the immune system makes antibodies (proteins) that attack and damage the body's own tissues or cells. Examples of these disorders include lupus, rheumatoid arthritis, and scleroderma. You can have these disorders for years before developing vasculitis.
                
Vasculitis also may be linked to certain blood cancers, such as leukemia and lymphoma.
The signs and symptoms of vasculitis vary. They depend on the type of vasculitis you have, the organs involved, and the severity of the condition. Some people may have few signs and symptoms. Other people may become very sick.
                
Sometimes the signs and symptoms develop slowly, over months. Other times, the signs and symptoms develop quickly, over days or weeks.
                
Systemic Signs and Symptoms
                
Systemic signs and symptoms are those that affect you in a general or overall way. Common systemic signs and symptoms of vasculitis are:
                
Fever
                
Loss of appetite
                
Weight loss
                
Fatigue (tiredness)
                
General aches and pains
                
Organ- or Body System-Specific Signs and Symptoms
                
Vasculitis can affect specific organs and body systems, causing a range of signs and symptoms.
                
Skin
                
If vasculitis affects your skin, you may notice skin changes. For example, you may have purple or red spots or bumps, clusters of small dots, splotches, bruises, or hives. Your skin also may itch.
                
Joints
                
If vasculitis affects your joints, you may ache or develop arthritis in one or more joints.
                
Lungs
                
If vasculitis affects your lungs, you may feel short of breath. You may even cough up blood. The results from a chest x ray may show signs that suggest pneumonia, even though that may not be what you have.
                
Gastrointestinal Tract
                
If vasculitis affects your gastrointestinal tract, you may get ulcers (sores) in your mouth or have stomach pain.
                
In severe cases, blood flow to the intestines can be blocked. This can cause the wall of the intestines to weaken and possibly rupture (burst). A rupture can lead to serious problems or even death.
                
Sinuses, Nose, Throat, and Ears
                
If vasculitis affects your sinuses, nose, throat, and ears, you may have sinus or chronic (ongoing) middle ear infections. Other symptoms include ulcers in the nose and, in some cases, hearing loss.
                
Eyes
                
If vasculitis affects your eyes, you may develop red, itchy, burning eyes. Your eyes also may become sensitive to light, and your vision may blur. Rarely, certain types of vasculitis may cause blindness.
                
Brain
                
If vasculitis affects your brain, symptoms may include headaches, problems thinking clearly, changes in mental function, or stroke-like symptoms, such as muscle weakness and paralysis (an inability to move).
                
Nerves
                
If vasculitis affects your nerves, you may have numbness, tingling, and weakness in various parts of your body. You also may have a loss of feeling or strength in your hands and feet and shooting pains in your arms and legs.
Treatment for vasculitis will depend on the type of vasculitis you have, which organs are affected, and the severity of the condition.
                
People who have severe vasculitis are treated with prescription medicines. Rarely, surgery may be done. People who have mild vasculitis may find relief with over-the-counter pain medicines, such as acetaminophen, aspirin, ibuprofen, or naproxen.
                
The main goal of treating vasculitis is to reduce inflammation in the affected blood vessels. This usually is done by reducing or stopping the immune response that caused the inflammation.
                
Types of Treatment
                
Common prescription medicines used to treat vasculitis include corticosteroids and cytotoxic medicines.
                
Corticosteroids help reduce inflammation in your blood vessels. Examples of corticosteroids are prednisone, prednisolone, and methylprednisolone.
                
Doctors may prescribe cytotoxic medicines if vasculitis is severe or if corticosteroids don't work well. Cytotoxic medicines kill the cells that are causing the inflammation. Examples of these medicines are azathioprine, methotrexate, and cyclophosphamide.
                
Your doctor may prescribe both corticosteroids and cytotoxic medicines.
                
Other treatments may be used for certain types of vasculitis. For example, the standard treatment for Kawasaki disease is high-dose aspirin and immune globulin. Immune globulin is a medicine thats injected into a vein.
                
Certain types of vasculitis may require surgery to remove aneurysms that have formed as a result of the condition. (An aneurysm is an abnormal bulge in the wall of a blood vessel.)
You can't prevent vasculitis. However, treatment can help prevent or delay the complications of vasculitis.
                
People who have severe vasculitis are treated with prescription medicines. Rarely, surgery may be done. People who have mild vasculitis may find relief with over-the-counter pain medicines, such as acetaminophen, aspirin, ibuprofen, or naproxen.
                
For more information about vasculitis treatments, go to "How Is Vasculitis Treated?"