bowang0911/MedQuAD huggingface dataset:
Sudden, Intense Joint Pain Gout is a form of arthritis that causes the sudden onset of intense pain and swelling in the joints, which also may be warm and red. Attacks frequently occur at night and can be triggered by stressful events, alcohol or drugs, or the presence of another illness. Early attacks usually subside within 3 to 10 days, even without treatment, and the next attack may not occur for months or even years. Where Gout Usually Occurs Sometime during the course of the disease, many patients will develop gout in the big toe. Gout frequently affects joints in the lower part of the body such as the ankles, heels, knees, or toes. Who is at Risk? Adult men, particularly those between the ages of 40 and 50, are more likely to develop gout than women, who rarely develop the disease before menstruation ends. A Buildup of Uric Acid Before an attack, needle-like crystals of uric acid build up in connective tissue, in the joint space between two bones, or in both. Uric acid is a substance that results from the breakdown of purines, which are part of all human tissue and are found in many foods. Normally, uric acid is dissolved in the blood and passed through the kidneys into the urine, where it is eliminated. If there is an increase in the production of uric acid or if the kidneys do not eliminate enough uric acid from the body, levels of it build up in the blood (a condition called hyperuricemia). Hyperuricemia also may result when a person eats too many high-purine foods, such as liver, dried beans and peas, anchovies, and gravies. Hyperuricemia is not a disease, and by itself it is not dangerous. However, if too many uric acid crystals form as a result of hyperuricemia, gout can develop. The crystals form and build up in the joint, causing inflammation. Stages of Gout Gout can progress through four stages. Asymptomatic (without symptoms) hyperuricemia. In this stage, a person has elevated levels of uric acid in the blood (hyperuricemia), but no other symptoms. Treatment is usually not required. Acute gout, or acute gouty arthritis. In this stage, hyperuricemia has caused uric acid crystals to build up in joint spaces. This leads to a sudden onset of intense pain and swelling in the joints, which also may be warm and very tender. An acute (sudden) attack commonly occurs at night and can be triggered by stressful events, alcohol or drugs, or the presence of another illness. Attacks usually subside within 3 to 10 days, even without treatment, and the next attack may not occur for months or even years. Over time, however, attacks can last longer and occur more frequently. Interval or intercritical gout. This is the period between acute attacks. In this stage, a person does not have any symptoms. Chronic tophaceous (toe FAY shus) gout. This is the most disabling stage of gout. It usually develops over a long period, such as 10 years. In this stage, the disease may have caused permanent damage to the affected joints and sometimes to the kidneys. With proper treatment, most people with gout do not progress to this advanced stage.
Attacks Usually Start at Night Gout is a form of arthritis that causes sudden onset of intense pain and swelling in the joints, which also may be warm and red. Gout typically attacks one joint at a time, and the attacks usually begin at night. Where Gout Usually Occurs Gout normally attacks joints in the lower part of the body, such as the knee, ankle or big toe. For many people, the joints in the big toe are the first to be attacked. In fact, sometime during the course of the disease, many people will develop gout in the big toe. Other Signs and Symptoms These can include - hyperuricemia -- high levels of uric acid in the body  hyperuricemia -- high levels of uric acid in the body -  the presence of uric acid crystals in joint fluid  the presence of uric acid crystals in joint fluid -  more than one attack of acute arthritis more than one attack of acute arthritis -  arthritis that develops in a day, producing a swollen, red, and warm joint  arthritis that develops in a day, producing a swollen, red, and warm joint -  an attack of arthritis in only one joint, often the toe, ankle, or knee. an attack of arthritis in only one joint, often the toe, ankle, or knee. Diagnosis May Be Difficult Gout may be difficult for doctors to diagnose because the symptoms can be vague, and gout often mimics other conditions. Although most people with gout have hyperuricemia at some time during the course of their disease, it may not be present during an acute attack. In addition, having hyperuricemia alone does not mean that a person will get gout. In fact, most people with hyperuricemia do not develop the disease. Testing for Gout To confirm a diagnosis of gout, the doctor inserts a needle into the inflamed joint and draws a sample of synovial fluid, the substance that lubricates a joint. A laboratory technician places some of the fluid on a slide and looks for monosodium urate crystals under a microscope. If crystals are found in the joint fluid, the person usually has gout.
Symptoms Can Be Controlled With proper treatment, most people with gout are able to control their symptoms and live productive lives. The goals for treatment are to ease the pain that comes from sudden attacks, prevent future attacks, stop uric acid buildup in the tissues and joint space between two bones, and prevent kidney stones from forming. Common Treatments The most common treatments for an attack of gout are high doses of non-steroidal anti-inflammatory drugs (NSAIDs) which are taken by mouth, or corticosteroids, which are taken by mouth or injected into the affected joint. Patients often begin to improve within a few hours of treatment. The attack usually goes away completely within a week or so. Several NSAIDs are available over the counter. It is important to check with your doctor concerning the safety of using these drugs and to verify the proper dosage. When NSAIDs or corticosteroids fail to control pain and swelling, the doctor may use another drug, colchicine. This drug is most effective when taken within the first 12 hours of an acute attack. For patients who have repeated gout attacks, the doctor may prescribe medicine such as allupurinol, febuxostat, or probenecid to lower uric acid levels. In severe cases of gout that do not respond to other treatments, pegloticase, a medicine administered by intravenous infusion, may be prescribed to reduce levels of uric acid.
Gout is a form of arthritis that causes sudden onset of intense pain and swelling in the joints, which also may be warm and red. Attacks frequently occur at night and can be triggered by stressful events, alcohol or drugs, or the presence of another illness. Sometime during the course of the disease, many people will develop gout in the big toe. Gout frequently affects joints in the lower part of the body such as the knees, ankles, or toes.
Most people with gout have too much uric acid in their blood, a condition called hyperuricemia. Uric acid is a substance that results from the breakdown of purines, which are part of all human tissue and are found in many foods, especially those high in protein. Needle-like crystals of uric acid can build up in the connective tissue, in the joint space between two bones, or both. If too many uric acid crystals form as a result of hyperuricemia, gout can develop.
These risk factors are associated with gout. - Genetics. Many people with gout have a family history of the disease.   -  Gender and age. Gout is more common in men than in women and more common in adults than in children.  -  Weight. Being overweight increases the risk of developing gout because there is more tissue available for turnover or breakdown, which leads to excess uric acid production. (High levels of uric acid in the blood can lead to gout.)  - Alcohol consumption. Drinking too much alcohol can lead to a buildup of uric acid because alcohol interferes with the removal of uric acid from the body.  - Diet. Eating too many foods that are rich in purines such as liver, dried beans and peas, anchovies and gravies, can cause or aggravate gout in some people.   - Lead exposure. In some cases, exposure to lead in the environment can cause gout. Genetics. Many people with gout have a family history of the disease.  Gender and age. Gout is more common in men than in women and more common in adults than in children. Weight. Being overweight increases the risk of developing gout because there is more tissue available for turnover or breakdown, which leads to excess uric acid production. (High levels of uric acid in the blood can lead to gout.) Alcohol consumption. Drinking too much alcohol can lead to a buildup of uric acid because alcohol interferes with the removal of uric acid from the body. Diet. Eating too many foods that are rich in purines such as liver, dried beans and peas, anchovies and gravies, can cause or aggravate gout in some people. Lead exposure. In some cases, exposure to lead in the environment can cause gout.
Renal insufficiency, or the inability of the kidneys to eliminate waste products, is a common cause of gout in older people. Here are other medical problems that contribute to high blood levels of uric acid and can put people at risk for gout. - high blood pressure  - hypothyroidism (underactive thyroid gland)  - conditions that cause an excessively rapid turnover of cells, such as psoriasis, hemolytic anemia, or some cancers  - Kelley-Seegmiller syndrome or Lesch-Nyhan syndrome, two rare conditions in which the enzyme that helps control uric acid levels either is not present or is found in insufficient quantities.  high blood pressure hypothyroidism (underactive thyroid gland) conditions that cause an excessively rapid turnover of cells, such as psoriasis, hemolytic anemia, or some cancers Kelley-Seegmiller syndrome or Lesch-Nyhan syndrome, two rare conditions in which the enzyme that helps control uric acid levels either is not present or is found in insufficient quantities.
Yes. A number of medications may put people at risk for developing hyperuricemia and gout. They include - diuretics, which are taken to eliminate excess fluid from the body in conditions like hypertension, edema, and heart disease, and which decrease the amount of uric acid passed in the urine. (High levels of uric acid in the blood can lead to gout.)  - salicylate-containing drugs, such as aspirin  - niacin,  a vitamin also known as nicotinic acid  - cyclosporine, a medication that suppresses the bodys immune system (the system that protects the body from infection and disease). This medication is used in the treatment of some autoimmune diseases and to prevent the bodys rejection of transplanted organs.  -   levodopa, a medicine used in the treatment of Parkinsons disease.  diuretics, which are taken to eliminate excess fluid from the body in conditions like hypertension, edema, and heart disease, and which decrease the amount of uric acid passed in the urine. (High levels of uric acid in the blood can lead to gout.) salicylate-containing drugs, such as aspirin niacin,  a vitamin also known as nicotinic acid cyclosporine, a medication that suppresses the bodys immune system (the system that protects the body from infection and disease). This medication is used in the treatment of some autoimmune diseases and to prevent the bodys rejection of transplanted organs.  levodopa, a medicine used in the treatment of Parkinsons disease.
Gout is a form of arthritis that frequently affects joints in the lower part of the body such as the knees, ankles, or toes. The affected joint may become swollen, red, or warm. Attacks usually occur at night. Sometime during the course of the disease, many patients will develop gout in the big toe. Other signs and symptoms of gout include - hyperuricemia -- high levels of uric acid in the body   - the presence of uric acid crystals in joint fluid   - more than one attack of acute arthritis  - arthritis that develops in a day, producing a swollen, red, and warm joint  - attack of arthritis in only one joint, often the toe, ankle, or knee. hyperuricemia -- high levels of uric acid in the body the presence of uric acid crystals in joint fluid more than one attack of acute arthritis arthritis that develops in a day, producing a swollen, red, and warm joint attack of arthritis in only one joint, often the toe, ankle, or knee.
Physicians often prescribe high doses of non-steroidal anti-inflammatory drugs (NSAIDs) or steroids for a sudden attack of gout. NSAIDs are taken by mouth and corticosteroids are either taken by mouth or injected into the affected joint. Patients often begin to improve within a few hours of treatment, and the attack usually goes away completely within a week or so. When NSAIDs or corticosteroids fail to control pain and swelling, the doctor may use another drug, colchicine. This drug is most effective when taken within the first 12 hours of an acute attack. For patients who have repeated gout attacks, the doctor may prescribe medicine such as allupurinol, febuxostat, or probenecid to lower uric acid levels. In severe cases of gout that do not respond to other treatments, pegloticase, a medicine administered by intravenous infusion, may be prescribed to reduce levels of uric acid.
Yes. Smoking is the leading cause of cancer in the United States, and it increases the risk of many types of cancer, including -  lung cancer  - throat cancer  -  mouth cancer  -  nasal cavity cancer (cancer in the airways of the nose)  - esophageal cancer (cancer of the esophagus)  - stomach cancer  -  pancreatic cancer (cancer of the pancreas)  -  kidney cancer   - bladder cancer  -  cervical cancer (cancer of the cervix)  -  acute myeloid leukemia (blood cancer).  lung cancer throat cancer  mouth cancer  nasal cavity cancer (cancer in the airways of the nose) esophageal cancer (cancer of the esophagus) stomach cancer  pancreatic cancer (cancer of the pancreas)  kidney cancer  bladder cancer  cervical cancer (cancer of the cervix)  acute myeloid leukemia (blood cancer). If you smoke, you are up to 10 times more likely to get cancer than a person who has never smoked. This depends on how much and how long you smoked.
One of the keys to successfully quitting is preparation. A great way to prepare to quit smoking is to create a quit plan. Quit plans - keep you focused on quit smoking strategies that can help you be confident and motivated to quit   - help you identify challenges you will face as you quit and ways to overcome them   -  can improve your chances of quitting smoking for good.  keep you focused on quit smoking strategies that can help you be confident and motivated to quit help you identify challenges you will face as you quit and ways to overcome them can improve your chances of quitting smoking for good. Use these steps to create your own customized quit plan. Pick a Quit Date. Make a list of reasons to quit. Decide where you will get support. Decide on your Quit methods. Plan how to avoid your triggers. Plan how to overcome cravings and urges. Decide how to reward yourself after certain milestones. Plan what to do the day before your Quit Date. Here are some quit plan resources. -  Check out  Worksheets for Your Quit Plan on this website.   -  See "Start Your Quit Plan Online Today" at  SmokeFree 60Plus, a quit-smoking website from the National Cancer Institute.  -  Learn about the  Quit Guide from the Centers from Disease Control and Prevention (CDC).  Check out  Worksheets for Your Quit Plan on this website. See "Start Your Quit Plan Online Today" at  SmokeFree 60Plus, a quit-smoking website from the National Cancer Institute. Learn about the  Quit Guide from the Centers from Disease Control and Prevention (CDC).
Quitlines are free, anonymous telephone counseling services. These programs have helped more than 3 million smokers. When you call a quitline, you talk to a trained counselor who can help you develop a strategy for quitting or help you stay on track. The counselor can provide material that could improve your chances of quitting. - You can call the National Cancer Institutes Smoking Quitline at (877) 44U-QUIT or (877) 448-7848 between 8:00 a.m. and 8:00 p.m. Eastern Time.  You can call the National Cancer Institutes Smoking Quitline at (877) 44U-QUIT or (877) 448-7848 between 8:00 a.m. and 8:00 p.m. Eastern Time. - You can also call your states quitline. Call (800) QUIT-NOW or (800) 784-8669 to be connected with free resources about quitting and counseling information in your state.  You can also call your states quitline. Call (800) QUIT-NOW or (800) 784-8669 to be connected with free resources about quitting and counseling information in your state. - If you are a veteran, you can call (855)-QUIT VET or (855) 784-8838 between 8:00 a.m. and 8:00 p.m. Eastern Time on Mondays through Fridays.  If you are a veteran, you can call (855)-QUIT VET or (855) 784-8838 between 8:00 a.m. and 8:00 p.m. Eastern Time on Mondays through Fridays. You can also check out SmokeFree 60Plus. a quit-smoking website for older adults developed by the National Cancer Institute.
These quit smoking websites offer you free, accurate information and professional assistance to help support the immediate and long-term needs of people trying to quit smoking. The National Cancer Institute sponsors - Smokefree 60+.gov, a quit-smoking website for older adults  - Smokefree.gov   - SmokefreeWomen   - SmokefreeEspanol    -   SmokefreeVET  Smokefree 60+.gov, a quit-smoking website for older adults Smokefree.gov SmokefreeWomen SmokefreeEspanol   SmokefreeVET Other online resources are -   Be Tobacco Free , a website from the U.S. Department of Health and Human Services  -  A  Quit Guide from the Centers from Disease Control and Prevention (CDC).   Be Tobacco Free , a website from the U.S. Department of Health and Human Services A  Quit Guide from the Centers from Disease Control and Prevention (CDC). Most states also have quit-smoking websites that have resources, such as free supplies of nicotine replacement therapy, informational mailings, and more. Mobile tools can also help, especially when you're on the go. These include text messaging services and free apps. -  See SmokefreeTXT, a text messaging service   -  See QuitSTART and QuitGuide, free quit smoking apps  See SmokefreeTXT, a text messaging service  See QuitSTART and QuitGuide, free quit smoking apps
Blood alcohol concentration (BAC) measures the percentage of ethanolthe chemical name for alcohol in alcoholic beveragesin a persons blood. As you drink, you increase your blood alcohol concentration (BAC) level. The higher the BAC, the more impaired a person is. In all states, it is against the law for people to drive if their blood alcohol concentration is above .08. The effects of increased blood alcohol levels can include -  reduced inhibitions   -  slurred speech   - motor impairment   - confusion   -  memory problems   - concentration problems   - coma   - breathing problems   - death.  reduced inhibitions slurred speech motor impairment confusion memory problems concentration problems coma breathing problems death. Learn more about the risks of alcohol overdose.
Its not always obvious that someone drinks too much. For older adults, clues to a possible alcohol problem include memory loss, depression, anxiety, poor appetite, unexplained bruises, falls, sleeping problems, and inattention to cleanliness or appearance. Answering "yes" to at least one of the following questions is also a sign of a possible drinking problem: - Have you ever felt you should cut down on your drinking?  - Have people annoyed you by criticizing your drinking?  - Have you ever felt bad or guilty about your drinking?  - Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover? Have you ever felt you should cut down on your drinking? Have people annoyed you by criticizing your drinking? Have you ever felt bad or guilty about your drinking? Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover? If you answered yes to any of these questions, talk with your health care provider. Also seek help if you feel you are having drinking-related problems with your health, relationships, or work.
If a person drinks too much or too often he or she may develop an alcohol use disorder (AUD). An AUD can range in severity from mild to severe. On one end of this spectrum, drinking might cause sickness, depression, or sleeping problems. More severe symptoms include drinking more than intended or craving alcohol once youve stopped drinking. AUD can be a lifelong disease in which people have a strong need to drink, cannot control their drinking once they start, and over time need to drink greater and greater amounts of alcohol to get high. Older adults who develop a severe AUD become physically dependent on alcohol. When they stop drinking, they can get nauseated, sweaty, shaky, and restless. These withdrawal symptoms can cause them to start drinking again to feel better, even though doing so can lead to physical or psychological problems.  Learn more about alcohol use disorder.
There is not one right treatment for everyone with alcohol problems. In general, many people need more than one kind of treatment. Medicines can help people with alcohol use disorder quit drinking. Meeting with a therapist or substance-abuse counselor or with a support group may also help. Support from family and friends is important, too. A doctor can help a person decide on the best treatment. Making a change sooner rather than later makes treatment more likely to succeed. Learn more about treatment options for alcohol problems.  Learn more about available types of alcohol treatment.  (Watch the video to learn more about getting help for alcohol use disorder (AUD). To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.)
Prescription medicines can help people with alcohol use disorder reduce their drinking, avoid going back to heavy drinking, and get sober. None of them works in every person. There are three medications approved by the U.S. Food and Drug Administration for the treatment of alcohol use disorder. - Naltrexone (Depade, ReVia, Vivitrol) acts in the brain to reduce craving for alcohol  -  Acamprosate (Campral) helps manage withdrawal symptoms such as anxiety, nausea, and sweating that may lead to a drinking relapse   - Disulfiram (Antabuse) makes a person feel sick after drinking alcohol.  Naltrexone (Depade, ReVia, Vivitrol) acts in the brain to reduce craving for alcohol Acamprosate (Campral) helps manage withdrawal symptoms such as anxiety, nausea, and sweating that may lead to a drinking relapse Disulfiram (Antabuse) makes a person feel sick after drinking alcohol.
Talking about alcohol use with a professional is beneficial to many people. Counseling  either one-on-one or in groups  can help develop skills to stop or reduce drinking, develop reachable goals, manage the triggers that lead to alcohol misuse and build a strong social support system that supports healthy habits. There are many kinds of counseling approaches. - cognitive behavior therapy   - motivational enhancement therapy  - marital and family counseling  - brief interventions cognitive behavior therapy motivational enhancement therapy marital and family counseling brief interventions Learn more about each type of behavioral therapy.  Counseling can be provided by - primary care doctors   - psychiatrists  -  psychologists  -  social workers  - certified alcohol counselors.  primary care doctors psychiatrists psychologists social workers certified alcohol counselors.
Many people with alcohol problems find it helpful to talk with others who have faced similar problems. Mutual help groups, such as Alcoholics Anonymous (AA) 12-step programs, help people recover from alcohol use disorder. AA meetings are open to anyone who wants to stop drinking. Attending mutual-help groups is beneficial for many people who want to stop drinking. Many people continue to go to support/mutual help groups even after medical treatment for their alcohol problems ends. There are other mutual help groups available such as Smart Recovery, Life Ring, and Moderation Management.  Learn more about available types of treatment for alcohol problems.