fenil210/Med-Lamma huggingface dataset:
What are the symptoms of Nonalcoholic Steatohepatitis ?
NASH is usually a silent disease with few or no symptoms. Patients generally feel well in the early stages and only begin to have symptomssuch as fatigue, weight loss, and weaknessonce the disease is more advanced or cirrhosis develops. The progression of NASH can take years, even decades. The process can stop and, in some cases, reverse on its own without specific therapy. Or NASH can slowly worsen, causing scarring or fibrosis to appear and accumulate in the liver. As fibrosis worsens, cirrhosis develops; the liver becomes seriously scarred, hardened, and unable to function normally. Not every person with NASH develops cirrhosis, but once serious scarring or cirrhosis is present, few treatments can halt the progression. A person with cirrhosis experiences fluid retention, muscle wasting, bleeding from the intestines, and liver failure. Liver transplantation is the only treatment for advanced cirrhosis with liver failure, and transplantation is increasingly performed in people with NASH. NASH ranks as one of the major causes of cirrhosis in America, behind hepatitis C and alcoholic liver disease. + NIDDK + Nonalcoholic Steatohepatitis
What causes Nonalcoholic Steatohepatitis ?
Although NASH has become more common, its underlying cause is still not clear. It most often occurs in persons who are middle-aged and overweight or obese. Many patients with NASH have elevated blood lipids, such as cholesterol and triglycerides, and many have diabetes or prediabetes, but not every obese person or every patient with diabetes has NASH. Furthermore, some patients with NASH are not obese, do not have diabetes, and have normal blood cholesterol and lipids. NASH can occur without any apparent risk factor and can even occur in children. Thus, NASH is not simply obesity that affects the liver.
                
While the underlying reason for the liver injury that causes NASH is not known, several factors are possible candidates:
                
- insulin resistance  - release of toxic inflammatory proteins by fat cells (cytokines)  - oxidative stress (deterioration of cells) inside liver cells + NIDDK + Nonalcoholic Steatohepatitis
What are the treatments for Nonalcoholic Steatohepatitis ?
Currently, no specific therapies for NASH exist. The most important recommendations given to persons with this disease are to
                
- reduce their weight (if obese or overweight)  - follow a balanced and healthy diet  - increase physical activity  - avoid alcohol  - avoid unnecessary medications
                
These are standard recommendations, but they can make a difference. They are also helpful for other conditions, such as heart disease, diabetes, and high cholesterol.
                
A major attempt should be made to lower body weight into the healthy range. Weight loss can improve liver tests in patients with NASH and may reverse the disease to some extent. Research at present is focusing on how much weight loss improves the liver in patients with NASH and whether this improvement lasts over a period of time.
                
People with NASH often have other medical conditions, such as diabetes, high blood pressure, or elevated cholesterol. These conditions should be treated with medication and adequately controlled; having NASH or elevated liver enzymes should not lead people to avoid treating these other conditions.
                
Experimental approaches under evaluation in patients with NASH include antioxidants, such as vitamin E, selenium, and betaine. These medications act by reducing the oxidative stress that appears to increase inside the liver in patients with NASH. Whether these substances actually help treat the disease is not known, but the results of clinical trials should become available in the next few years.
                
Another experimental approach to treating NASH is the use of newer antidiabetic medicationseven in persons without diabetes. Most patients with NASH have insulin resistance, meaning that the insulin normally present in the bloodstream is less effective for them in controlling blood glucose and fatty acids in the blood than it is for people who do not have NASH. The newer antidiabetic medications make the body more sensitive to insulin and may help reduce liver injury in patients with NASH. Studies of these medicationsincluding metformin, rosiglitazone, and pioglitazoneare being sponsored by the National Institutes of Health and should answer the question of whether these medications are beneficial in NASH. + NIDDK + Nonalcoholic Steatohepatitis
What to do for Nonalcoholic Steatohepatitis ?
- Nonalcoholic steatohepatitis (NASH) is fat in the liver, with inflammation and damage.  - NASH occurs in people who drink little or no alcohol and affects 2 to 5 percent of Americans, especially people who are middle-aged and overweight or obese.  - NASH can occur in children.  - People who have NASH may feel well and may not know that they have a liver disease.  - NASH can lead to cirrhosis, a condition in which the liver is permanently damaged and cannot work properly.  - Fatigue can occur at any stage of NASH.  - Weight loss and weakness may begin once the disease is advanced or cirrhosis is present.  - NASH may be suspected if blood tests show high levels of liver enzymes or if scans show fatty liver.  - NASH is diagnosed by examining a small piece of the liver taken through a needle, a procedure called biopsy.  - People who have NASH should reduce their weight, eat a balanced diet, engage in physical activity, and avoid alcohol and unnecessary medications.  - No specific therapies for NASH exist. Experimental therapies being studied include antioxidants and antidiabetes medications. + NIDDK + Nonalcoholic Steatohepatitis
How to diagnose Your Diabetes Care Records ?
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) + NIDDK + Your Diabetes Care Records
What is (are) Henoch-Schnlein Purpura ?
Henoch-Schnlein purpura is a disease that causes small blood vessels in the body to become inflamed and leak. The primary symptom is a rash that looks like many small raised bruises. HSP can also affect the kidneys, digestive tract, and joints. HSP can occur any time in life, but it is most common in children between 2 and 6 years of age.1 Most people recover from HSP completely, though kidney damage is the most likely long-term complication. In adults, HSP can lead to chronic kidney disease (CKD) and kidney failure, described as end-stage renal disease when treated with blood-filtering treatments called dialysis or a kidney transplant. + NIDDK + Henoch-Schnlein Purpura
What causes Henoch-Schnlein Purpura ?
Henoch-Schnlein purpura is caused by an abnormal immune system response in which the bodys immune system attacks the bodys own cells and organs. Usually, the immune system makes antibodies, or proteins, to protect the body from foreign substances such as bacteria or viruses. In HSP, these antibodies attack the blood vessels. The factors that cause this immune system response are not known. However, in 30 to 50 percent of cases, people have an upper respiratory tract infection, such as a cold, before getting HSP.2 HSP has also been associated with
                
- infectious agents such as chickenpox, measles, hepatitis, and HIV viruses  - medications  - foods  - insect bites  - exposure to cold weather  - trauma
                
Genetics may increase the risk of HSP, as it has occurred in different members of the same family, including in twins. + NIDDK + Henoch-Schnlein Purpura
What are the symptoms of Henoch-Schnlein Purpura ?
The symptoms of HSP include the following:
                
- Rash. Leaking blood vessels in the skin cause a rash that looks like bruises or small red dots on the legs, arms, and buttocks. The rash may first look like hives and then change to look like bruises, and it may spread to the chest, back, and face. The rash does not disappear or turn pale when pressed.  - Digestive tract problems. HSP can cause vomiting and abdominal pain, which can range from mild to severe. Blood may also appear in the stool, though severe bleeding is rare.  - Arthritis. Pain and swelling can occur in the joints, usually in the knees and ankles and less frequently in the elbows and wrists.  - Kidney involvement. Hematuria blood in the urineis a common sign that HSP has affected the kidneys. Proteinurialarge amounts of protein in the urineor development of high blood pressure suggests more severe kidney problems.  - Other symptoms. In some cases, boys with HSP develop swelling of the testicles. Symptoms affecting the central nervous system, such as seizures, and lungs, such as pneumonia, have been seen in rare cases.
                
Though the rash affects all people with HSP, pain in the joints or abdomen precedes the rash in about one-third of cases by as many as 14 days.1 + NIDDK + Henoch-Schnlein Purpura
What are the complications of Henoch-Schnlein Purpura ?
In children, the risk of kidney damage leading to long-term problems may be as high as 15 percent, but kidney failure affects only about 1 percent of children with HSP.1 Up to 40 percent of adults with HSP will have CKD or kidney failure within 15 years after diagnosis.3
                
A rare complication of HSP is intussusception of the bowel, which includes the small and large intestines. With this condition, a section of the bowel folds into itself like a telescope, causing the bowel to become blocked.
                
Women with a history of HSP who become pregnant are at higher risk for high blood pressure and proteinuria during pregnancy. + NIDDK + Henoch-Schnlein Purpura
How to diagnose Henoch-Schnlein Purpura ?
A diagnosis of HSP is suspected when a person has the characteristic rash and one of the following:
                
- abdominal pain  - joint pain  - antibody deposits on the skin  - hematuria or proteinuria
                
Antibody deposits on the skin can confirm the diagnosis of HSP. These deposits can be detected using a skin biopsy, a procedure that involves taking a piece of skin tissue for examination with a microscope. A skin biopsy is performed by a health care provider in a hospital with little or no sedation and local anesthetic. The skin tissue is examined in a lab by a pathologista doctor who specializes in diagnosing diseases.
                
A kidney biopsy may also be needed. A kidney biopsy is performed by a health care provider in a hospital with light sedation and local anesthetic. The health care provider uses imaging techniques such as ultrasound or a computerized tomography scan to guide the biopsy needle into the organ. The kidney tissue is examined in a lab by a pathologist. The test can confirm diagnosis and be used to determine the extent of kidney involvement, which will help guide treatment decisions.
                
Hematuria and proteinuria are detected using urinalysis, which is testing of a urine sample. The urine sample is collected in a special container in a health care providers office or commercial facility and can be tested in the same location or sent to a lab for analysis. For the test, a nurse or technician places a strip of chemically treated paper, called a dipstick, into the urine sample. Patches on the dipstick change color when blood or protein are present in urine. + NIDDK + Henoch-Schnlein Purpura
What are the treatments for Henoch-Schnlein Purpura ?
No specific treatment for HSP exists. The main goal of treatment is to relieve symptoms such as joint pain, abdominal pain, and swelling. People with kidney involvement may receive treatment aimed at preventing long-term kidney disease.
                
Treatment is rarely required for the rash. Joint pain is often treated with nonsteroidal anti-inflammatory medications, such as aspirin or ibuprofen. Recent research has shown corticosteroidsmedications that decrease swelling and reduce the activity of the immune systemto be even more effective in treating joint pain. Corticosteroids are also used to treat abdominal pain.
                
Though rare, surgery may be needed to treat intussusception or to determine the cause of swollen testicles.
                
HSP that affects the kidneys may be treated with corticosteroid and immunosuppressive medications. Immunosuppressive medications prevent the body from making antibodies. Adults with severe, acute kidney failure are treated with high-dose corticosteroids and the immunosuppressive cyclophosphamide (Cytoxan).
                
People with HSP that is causing high blood pressure may need to take medications thatwhen taken as prescribed by their health care providerlower their blood pressure and can also significantly slow the progression of kidney disease. Two types of blood pressure lowering medications, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), have proven effective in slowing the progression of kidney disease. Many people require two or more medications to control their blood pressure. In addition to an ACE inhibitor or an ARB, a diuretica medication that helps the kidneys remove fluid from the bloodmay be prescribed. Beta blockers, calcium channel blockers, and other blood pressure medications may also be needed.
                
Blood and urine tests are used to check the kidney function of people with HSP for at least 6 months after the main symptoms disappear. + NIDDK + Henoch-Schnlein Purpura
What to do for Henoch-Schnlein Purpura ?
Eating, diet, and nutrition have not been shown to play a role in causing or preventing HSP. + NIDDK + Henoch-Schnlein Purpura
What to do for Henoch-Schnlein Purpura ?
- Henoch-Schnlein purpura (HSP) is a disease that causes small blood vessels in the body to become inflamed and leak.  - HSP is caused by an abnormal immune system response in which the bodys immune system attacks the bodys own cells and organs. The factors that cause this immune system response are not known.  - The symptoms of HSP include the following:      - rash    - digestive tract problems    - arthritis    - kidney involvement    - In children, the risk of kidney damage leading to long-term problems may be as high as 15 percent, but kidney failure affects only about 1 percent of children with HSP. Up to 40 percent of adults with HSP will have CKD or kidney failure within 15 years after diagnosis.  - A diagnosis of HSP is suspected when a person has the characteristic rash and one of the following:      - abdominal pain    - joint pain    - antibody deposits on the skin    - hematuria or proteinuria    - Antibody deposits on the skin can confirm the diagnosis of HSP.  - No specific treatment for HSP exists. The main goal of treatment is to relieve symptoms such as joint pain, abdominal pain, and swelling. People with kidney involvement may receive treatment aimed at preventing long-term kidney disease. + NIDDK + Henoch-Schnlein Purpura
What is (are) Childhood Nephrotic Syndrome ?
Childhood nephrotic syndrome is not a disease in itself; rather, it is a group of symptoms that
                
- indicate kidney damageparticularly damage to the glomeruli, the tiny units within the kidney where blood is filtered  - result in the release of too much protein from the body into the urine
                
When the kidneys are damaged, the protein albumin, normally found in the blood, will leak into the urine. Proteins are large, complex molecules that perform a number of important functions in the body.
                
The two types of childhood nephrotic syndrome are
                
- primarythe most common type of childhood nephrotic syndrome, which begins in the kidneys and affects only the kidneys  - secondarythe syndrome is caused by other diseases
                
A health care provider may refer a child with nephrotic syndrome to a nephrologista doctor who specializes in treating kidney disease. A child should see a pediatric nephrologist, who has special training to take care of kidney problems in children, if possible. However, in many parts of the country, pediatric nephrologists are in short supply, so the child may need to travel. If traveling is not possible, some nephrologists who treat adults can also treat children. + NIDDK + Childhood Nephrotic Syndrome
What is (are) Childhood Nephrotic Syndrome ?
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 kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra fluid. Children produce less urine than adults and the amount produced depends on their age. 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.
                
Kidneys work at the microscopic level. The kidney is not one large filter. Each kidney is made up of about a million filtering units called nephrons. Each nephron filters a small amount of blood. The nephron includes a filter, called the glomerulus, and a tubule. The nephrons work through a two-step process. The glomerulus lets fluid and waste products pass through it; however, it prevents blood cells and large molecules, mostly proteins, from passing. The filtered fluid then passes through the tubule, which sends needed minerals back to the bloodstream and removes wastes. + NIDDK + Childhood Nephrotic Syndrome
What are the symptoms of Childhood Nephrotic Syndrome ?
The signs and symptoms of childhood nephrotic syndrome may include
                
- edemaswelling, most often in the legs, feet, or ankles and less often in the hands or face  - albuminuriawhen a childs urine has high levels of albumin  - hypoalbuminemiawhen a childs blood has low levels of albumin  - hyperlipidemiawhen a childs blood cholesterol and fat levels are higher than normal
                
In addition, some children with nephrotic syndrome may have
                
- blood in their urine  - symptoms of infection, such as fever, lethargy, irritability, or abdominal pain  - loss of appetite  - diarrhea  - high blood pressure + NIDDK + Childhood Nephrotic Syndrome
What are the complications of Childhood Nephrotic Syndrome ?
The complications of childhood nephrotic syndrome may include
                
- infection. When the kidneys are damaged, a child is more likely to develop infections because the body loses proteins that normally protect against infection. Health care providers will prescribe medications to treat infections. Children with childhood nephrotic syndrome should receive the pneumococcal vaccine and yearly flu shots to prevent those infections. Children should also receive age-appropriate vaccinations, although a health care provider may delay certain live vaccines while a child is taking certain medications.  - blood clots. Blood clots can block the flow of blood and oxygen through a blood vessel anywhere in the body. A child is more likely to develop clots when he or she loses proteins through the urine. The health care provider will treat blood clots with blood-thinning medications.  - high blood cholesterol. When albumin leaks into the urine, the albumin levels in the blood drop. The liver makes more albumin to make up for the low levels in the blood. At the same time, the liver makes more cholesterol. Sometimes children may need treatment with medications to lower blood cholesterol levels. + NIDDK + Childhood Nephrotic Syndrome
How to prevent Childhood Nephrotic Syndrome ?
Researchers have not found a way to prevent childhood nephrotic syndrome when the cause is idiopathic or congenital. + NIDDK + Childhood Nephrotic Syndrome
What to do for Childhood Nephrotic Syndrome ?
Children who have nephrotic syndrome may need to make changes to their diet, such as
                
- limiting the amount of sodium, often from salt, they take in each day  - reducing the amount of liquids they drink each day  - eating a diet low in saturated fat and cholesterol to help control elevated cholesterol levels
                
Parents or caretakers should talk with the childs health care provider before making any changes to the childs diet.
                
More information is provided in the NIDDK health topic, Nutrition for Chronic Kidney Disease in Children. + NIDDK + Childhood Nephrotic Syndrome
What to do for Childhood Nephrotic Syndrome ?
- Childhood nephrotic syndrome is not a disease in itself; rather, it is a group of symptoms that      - indicate kidney damageparticularly damage to the glomeruli, the tiny units within the kidney where blood is filtered    - result in the release of too much protein from the body into the urine    - The two types of childhood nephrotic syndrome are      - primarythe most common type of childhood nephrotic syndrome, which begins in the kidneys and affects only the kidneys    - secondarythe syndrome is caused by other diseases    - The signs and symptoms of childhood nephrotic syndrome may include      - edemaswelling, most often in the legs, feet, or ankles and less often in the hands or face    - albuminuriawhen a childs urine has high levels of albumin    - hypoalbuminemiawhen a childs blood has low levels of albumin    - hyperlipidemiawhen a childs blood cholesterol and fat levels are higher than normal    - A health care provider may order urine tests to help determine if a child has kidney damage from childhood nephrotic syndrome.  - Health care providers will decide how to treat childhood nephrotic syndrome based on the type:      - primary childhood nephrotic syndrome: medications    - secondary childhood nephrotic syndrome: treat the underlying illness or disease    - congenital nephrotic syndrome: medications, surgery to remove one or both kidneys, or transplantation + NIDDK + Childhood Nephrotic Syndrome