laomobai/llama3-1 huggingface dataset:
system: How is treatment-resistant depression diagnosed?
output: Sometimes, other conditions or problems can cause similar symptoms. So when you meet with your doctor, he or she will want to: Confirm the diagnosis. Some people who apparently have treatment-resistant depression were misdiagnosed. They never had only depression in the first place. Instead, they have conditions like bipolar disorder (where antidepressants may be less effective than in unipolar depression), or problems with drugs or alcohol that can cause or worsen depression, or a medical condition (such as hypothyroidism) that can cause symptoms of depression, and may have been getting the wrong treatment. When major depressive disorder is accompanied by other medical or psychiatric disorders (such as anxiety disorders, eating disorders, or personality disorders), the depression often is harder to treat, particularly if the additional disorders that are present don't receive their own independent treatment. Make sure you've been using your medicine correctly. Up to half of all people who get prescribed drugs for depression don't take them as recommended. They miss doses or stop taking them because of side effects. Some give up too soon - it can take 4-12 weeks for a medicine to take effect. Sometimes taking a medicine at too low a dose also explains an inadequate response. Check for other causes. Other issues - ranging from thyroid problems to substance abuse - can worsen or cause depression. So can many medicines used to treat common medical problems. Sometimes, switching medicines or treating an underlying condition can resolve a hard-to-treat depression. Life with depression is hard, but treatment-resistant depression can be especially brutal.
system: What are the symptoms of ankylosing spondylitis?
output: Symptoms: Gradual pain in the lower back and buttocks Lower back pain that worsens and works its way up the spine Pain felt between the shoulder blades and in the neck Pain and stiffness in the back, especially at rest and when getting up Pain and stiffness that get better after activity Pain in the middle back and then upper back and neck (after 5-10 years) If the condition worsens, your spine may become stiffer. It may become hard to bend for everyday activities.
system: What doctors treat rheumatic diseases?
output: If your regular doctor thinks you have a rheumatic disease, he'll probably send you to a rheumatologist -- a doctor who's specially trained to treat them.
system: What are the symptoms of lupus?
output: Symptoms: Joint pain Fatigue Joint stiffness Rashes, including a "butterfly" rash across the cheeks Sun sensitivity Hair loss Blue or white fingers or toes when exposed to cold (called Raynaud's phenomenon) Problems in other organs such as the kidneys Blood disorders, such as anemia and low levels of white blood cells or platelets Chest pain from inflammation of the lining of the heart or lungs Seizures or strokes Diagnosis: Your doctor will ask about your medical history, do a physical exam, and order lab tests of blood and urine samples.
system: Are there distinct rheumatic diseases?
output: Years ago, conditions like this fell under the broad heading of rheumatism. Now there are more than 200 distinct rheumatic diseases. Among the most common ones are: Osteoarthritis Rheumatoid arthritis ( RA) Lupus Spondyloarthropathies -- ankylosing spondylitis ( AS) and psoriatic arthritis ( Ps A) Sjogren's syndrome Gout Scleroderma Infectious arthritis Juvenile idiopathic arthritis Polymyalgia rheumatica Most of these conditions happen when your immune system goes awry and attacks your own tissues.
system: What are the symptoms of Sjorgen's syndrome?
output: Symptoms: Dry eyes (the glands in your eyes don't make enough tears) Eye irritation and burning Dry mouth (the glands in your mouth don't make enough saliva) Tooth decay, gum disease, or thrush Swollen glands on the sides of your face Joint pain and stiffness (rarely) Internal organ diseases (rarely) Diagnosis: Your doctor will do a physical exam and ask about your medical history.
system: What are symptoms of lupus?
output: Symptoms: Joint pain Fatigue Joint stiffness Rashes, including a "butterfly" rash across the cheeks Sun sensitivity Hair loss Blue or white fingers or toes when exposed to cold (called Raynaud's phenomenon) Problems in other organs such as the kidneys Blood disorders, such as anemia and low levels of white blood cells or platelets Chest pain from inflammation of the lining of the heart or lungs Seizures or strokes Diagnosis: Your doctor will ask about your medical history, do a physical exam, and order lab tests of blood and urine samples.
system: What is osteoarthritis (OA)?
output: It results from damage to cartilage, the cushiony material on the end of your bones. As it wears down, your joints hurt and become harder to move. It usually affects the knees, hips, lower back, neck, fingers, and feet.
system: What is ankylosing spondylitis?
output: Anti-double stranded DNA antibody ( Anti-ds DNA) Anti- Smith antibody ( Anti- Sm) â¢ Ankylosing Spondylitis What it is: Ankylosing spondylitis usually starts gradually as lower back pain. It usually involves the joints where the spine attaches to the pelvis, known as the sacroiliac joints. Ankylosing spondylitis is more common in young men, especially from the teenage years to age 30.
system: What is the diagnosis for ankylosing spondylitis?
output: Diagnosis: Your doctor will give you a physical exam and ask you about your medical history. You may get X-rays of your back, looking at the sacroiliac joints. A blood test for a protein called HLA- B27 may help confirm a diagnosis.
system: What is SjÃ¶gren's syndrome?
output: â¢ Sjogren's Syndrome What it is: Sjogren's syndrome causes parts of your body to dry out, like the eyes or mouth. Some people also have RA and lupus. Others just have Sjogren's. The cause is unknown, but it happens when your immune system attacks those body parts. It's more common in women than men.
system: What is the treatment plan for rheumatic diseases?
output: Your rheumatologist will examine you to diagnose your condition, then oversee a treatment plan for you that will likely include medications, regular exercise, a healthy diet, stress management, and rest.
system: How is osteoarthritis (OA) diagnosed?
output: Diagnosis: Your doctor will ask about your medical history and symptoms. You'll also get a physical exam. You may also need to get blood tests or let your doctor take a sample of fluid from an affected joint. Usually by the time someone with OA seeks treatment, there are changes visible on an X-ray of the joint. The X-ray may show narrowing of the joint space or the presence of bone spurs. In some cases, your doctor might request an MRI (magnetic resonance imaging) to provide a picture of the inside of your joint.
system: What is the diagnosis for rheumatoid arthritis?
output: Symptoms: Pain and swelling in multiple joints (usually the same joints on both sides of your body, like both wrists or both ankles) Problems in other organs such as the eyes and lungs Joint stiffness, especially in the morning Fatigue Lumps called rheumatoid nodules Diagnosis: You'll get a checkup and tell your doctor about your health history. The doctor may take X-rays and samples of your joint fluid.
system: How is SjÃ¶gren's syndrome diagnosed?
output: You may also get other tests. To confirm the diagnosis, the doctor may do a biopsy, taking tissue from your inner lip to check in a lab. The doctor will ask about medical history and do a physical exam.
system: How is lupus diagnosed?
output: Blood tests for lupus include: Antinuclear antibody test ( ANA). Most people with lupus have a positive ANA blood test. The doctor will ask about medical history and do a physical exam.
system: How do you treat Bell's palsy?
output: There's no test that can tell you for sure if you have Bell's palsy. If your doctor suggests your symptoms might be triggered by the herpes virus (herpes simplex 1) or by shingles (herpes zoster), he may give you an antiviral medication, like acyclovir. Your doctor may also give you a short course of corticosteroids (like prednisone). In the meantime, your doctor will tell you to take extra care to protect your eye on the affected side. He may suggest you wear an eye patch, since you won't be able to blink. In very rare cases -- where symptoms don't improve after some time -- he may suggest surgery to reduce pressure on your facial nerve.
system: How can you tell if you have Bell's palsy?
output: That means in most cases, they determine you have Bell's palsy only after other conditions have been ruled out. Your doctor will start by doing a complete and careful physical exam. If he suspects you have Bell's palsy, he'll try to close your eyelid on the affected side of your face. If it doesn't close, it'll signal that you have what doctors call âthe Bell phenomenon.â With this condition, your eye rolls upward and outward when you try to close it. He'll probably test your hearing and sense of balance. It may also help him predict how fast and fully you'll recover. There aren't any that can stop it.
system: How often should you have a clinical breast exam?
output: You should have a clinical breast exam every one to three years starting at age 20 and every year starting at age 40. A clinical breast exam may be recommended more frequently if you have a strong family history of breast cancer.
system: What is important for early breast cancer detection?
output: Clinical exams and breast self-awareness are important methods of early breast cancer detection and should be performed along with mammography. All three of these methods provide complete breast cancer screening.
system: What happens during a breast exam?
output: Before your breast exam, your health care provider will ask you detailed questions about your health history, including your menstrual and pregnancy history. Questions might include what age you started menstruating, if you have children, and how old you were when your first child was born. A thorough breast exam will be performed. For the exam, you undress from the waist up. Your health care provider will look at your breasts for changes in size, shape, or symmetry. Your provider may ask you to lift your arms over your head, put your hands on your hips or lean forward. He or she will examine your breasts for any skin changes including rashes, dimpling, or redness. This is a good time to learn how to do a breast self-exam if you don't already know how. As you lay on your back with your arms behind your head, your health care provider will examine your breasts with the pads of the fingers to detect lumps or other changes. The area under both arms will also be examined. Your health care provider will gently press around your nipple to check for any discharge. If there is discharge, a sample may be collected for examination under a microscope.
system: What are some tips to keep in mind when screening your moles for skin cancer?
output: Keep these tips in mind when screening your moles for skin cancer: Use a full-length mirror if you have one. Start at your head and work your way down, looking at all the areas of your body (including the front, backs, and sides of each area, and your fingernails and toenails). Also be sure to check the "hidden" areas: between your fingers and toes, the groin, the soles of your feet, and the backs of your knees. Don't forget to thoroughly check your scalp and neck for moles. Use a handheld mirror or ask a family member to help you look at these areas. Keep track of all the moles on your body and what they look like. Take a photo and date it to help you monitor them. This way, you'll notice if the moles change. If they do change in any way (in color, shape, size, border, etc.) or exhibit other ABCDE features, see your doctor. Also, if you have any new moles that you think look suspicious, see your doctor.
system: How is acupuncture used to treat headaches?
output: Studies have shown that this practice of placing thin needles at specific points on the body may help relieve tension and migraine headaches.
system: What is the treatment for sinus headaches?
output: Sinus headaches: Decongestants and antibiotics usually help if you have a bacterial infection.
system: What is the treatment for cluster headaches?
output: Cluster headaches : Simple pain relievers do little for these, because they don't work fast enough. But doctors have found that inhaling high doses of pure oxygen can bring relief. Pain medicine such as lidocaine that goes inside the nose helps some people. Triptans such as ergotamine or sumatriptan ( Imitrex), given as shots, also might help if you take them at the first sign of a cluster headache. Preventive medicines often work when you take them at the first sign of a new cluster of headaches. Choices include the blood pressure medicine verapamil or a short course of a steroid like prednisone.
system: What can help treat my headache?
output: When it comes to headache remedies, medications can ease your pain, but they aren't the only option. Changing your lifestyle to control stress or avoid triggers may work well, too. These tactics may even prevent you from getting headaches. What works for one person may not work for another, so talk to your doctor to figure out the best remedy for you.
system: What medicines will my doctor suggest for a prolonged migraine?
output: These could include: Blood pressure drugs like propranolol ( Inderal), verapamil ( Calan SR, Isoptin SR), and others Antidepressants Anti-seizure drugs like topiramate ( Topamax) Calcitonin gene-related peptide ( CGRP) inhibitors like erenumab ( Aimovig), galcanezumab-gnlm ( Emgality),and fremanezumab ( Ajovy) Muscle relaxants Relaxation and biofeedback techniques Avoiding foods that trigger your migraines Devices to prevent migraines include: Cefaly: This small headband device sends electrical pulses through your forehead to stimulate a nerve linked with migraines Spring TMS or e Neura s TMS: This device gives off a magnetic pulse that stimulates part of your brain. You hold it against the back of your head at the first sign of a headache.
system: What preventive medicines can I take for my cluster headache?
output: Preventive medicines often work when you take them at the first sign of a new cluster of headaches. Choices include the blood pressure medicine verapamil or a short course of a steroid like prednisone.
system: Can therapy help treat my headaches?
output: CBT mixes meditation and relaxation with education in motivation, behavior, and how to handle emotions. With the help of a psychotherapist, you can learn to change negative thoughts and attitudes and the way you respond to stress. Those skills may help you avoid tension-type and migraine headaches.
system: How is biofeedback and relaxation used to treat headaches?
output: Biofeedback helps you control how muscle groups react to stress. This may help prevent or relieve tension headaches.
system: How is mind-body medicine used to treat headaches?
output: It may be especially helpful for tension headaches. Hypnosis also may lower your perception of pain. Cognitive behavioral therapy. CBT mixes meditation and relaxation with education in motivation, behavior, and how to handle emotions. With the help of a psychotherapist, you can learn to change negative thoughts and attitudes and the way you respond to stress. Those skills may help you avoid tension-type and migraine headaches.
system: What medicine can help relieve a sinus headache?
output: Sinus headaches: Decongestants and antibiotics usually help if you have a bacterial infection.
system: What medicine should I take to relieve a migraine headache?
output: Migraine headaches : One class of drug, called triptans, is the mainstay of migraine treatment. They include eletriptan ( Relpax), naratriptan ( Amerge), rizatriptan ( Maxalt), sumatriptan ( Imitrex), zolmitriptan ( Zomig), and others. You can take them as pills, shots, or nasal spray. A form of ergotamine, called dihydroergotamine ( DHE), also treats migraine headaches. You can get it as a shot or as a nasal spray.
system: How can biofeedback and relaxation treat my headaches?
output: Biofeedback helps you control how muscle groups react to stress. This may help prevent or relieve tension headaches.
system: What is the treatment for migraine headaches?
output: Migraine headaches : One class of drug, called triptans, is the mainstay of migraine treatment. They include eletriptan ( Relpax), naratriptan ( Amerge), rizatriptan ( Maxalt), sumatriptan ( Imitrex), zolmitriptan ( Zomig), and others. You can take them as pills, shots, or nasal spray. A form of ergotamine, called dihydroergotamine ( DHE), also treats migraine headaches. You can get it as a shot or as a nasal spray. Aspirin and other nonsteroidal anti-inflammatory drugs ( NSAIDs) also can help if you take them at the first sign of a migraine attack. NSAIDs also include ibuprofen and naproxen.
system: What questions should I include in my headache diary?
output: To learn more about what brings on your attacks, keep a headache diary that includes answers to these questions: When did your headaches first start? How often do you have them? Do you have any symptoms before the headache starts? Where is the pain? How long does it last? At what time of day do the headaches happen? Do you seem to get them after you eat certain types of food? For women, at what time in your monthly cycle do they happen? Are the headaches triggered by something in your environment, such as smells, noise, or some kinds of weather? How would you describe the pain: throbbing, stabbing, blinding, or piercing, for example?
system: Can Botox help treat my headaches?
output: Best known as Botox, a treatment for wrinkles, the FDA has approved it to prevent chronic migraine headaches in adults. If you have a migraine 15 or more days per month, you can get Botox shots in your head and neck about every 3 months.
system: What medicine should I take to relieve a tension-type headache?
output: Tension headaches: Pain relievers like acetaminophen, aspirin, ibuprofen, or naproxen usually help. But be careful. Taking too many of these pills can cause hard-to-treat rebound headaches. If you need to take these drugs often, see your doctor. Don't give aspirin to anyone under age 19 -- it raises their chance of having a serious condition called Reye's syndrome.
system: Are there certain therapies that can bring relief or prevent headache attacks?
output: Other treatments can bring you relief or even prevent attacks.
system: How is Botox used to treat headaches?
output: Best known as Botox, a treatment for wrinkles, the FDA has approved it to prevent chronic migraine headaches in adults. If you have a migraine 15 or more days per month, you can get Botox shots in your head and neck about every 3 months.
system: How can I learn about what triggers my headache?
output: If you have four or more severe, prolonged migraine headache days each month, your doctor may suggest you try medicine and other things to prevent your attacks. How often do you have them? Do you have any symptoms before the headache starts? Where is the pain? How long does it last? At what time of day do the headaches happen? Do you seem to get them after you eat certain types of food? For women, at what time in your monthly cycle do they happen? Are the headaches triggered by something in your environment, such as smells, noise, or some kinds of weather? How would you describe the pain: throbbing, stabbing, blinding, or piercing, for example?
system: Can chiropractic and osteopathy therapy help relieve my headaches?
output: Osteopaths also can use manipulation and soft tissue techniques on the head, neck, and upper back. It may be especially helpful for tension headaches.
system: What is the treatment for hemiplegic migraines?
output: Doctors disagree over how to treat hemiplegic migraines. Your doctor might prescribe drugs to prevent hemiplegic migraine, to stop them once they've started, and to relieve your symptoms. Your doctor will discuss the best options for you.
system: What medical tests can diagnose hemiplegic migraine?
output: See your doctor for a full exam to figure out what's going on. A CT scan or an MRI of your head can show signs of a stroke. Tests of your heart and the blood vessels in your neck can rule out symptoms caused by blood clots.
system: What are symptoms of hemiplegic migraine headaches?
output: Sometimes, before the actual headache pain, you'll get other symptoms that it's coming. These early symptoms, called auras, can include short-term trouble with muscle control and sensation: Severe, throbbing pain, often on one side of your head A pins-and-needles feeling, often moving from your hand up your arm Numbness on one side of your body, which can include your arm, leg, and half of your face Weakness or paralysis on one side of your body Loss of balance and coordination Dizziness or vertigo Nausea and vomiting You may also have problems with your senses, communication, and drowsiness: Seeing zigzag lines, double vision, or blind spots Extreme sensitivity to light, sound, and smell Language difficulties, such as mixing words or trouble remembering a word Slurred speech Confusion Loss of consciousness or coma (rare) Auras usually come on gradually over a half hour and then can last for hours to slowly resolve.
system: What tests are used to diagnose hemiplegic migraine headaches?
output: See your doctor for a full exam to figure out what's going on. A CT scan or an MRI of your head can show signs of a stroke. Tests of your heart and the blood vessels in your neck can rule out symptoms caused by blood clots. If you have a family member with similar symptoms, your doctor may want to do genetic testing. Familial hemiplegic migraine ( FHM) means it runs in your family, and you could pass it on to your children. People who don't have problems with those three genes have sporadic hemiplegic migraine ( SHM).
system: Do hemiplegic migraines follow a particular pattern?
output: There's not a predictable pattern with this type of migraine. Usually pain follows the paralysis, but it might come before, or you might not get a headache at all. You may hurt a lot and feel only a little weak; then the next attack might bring severe paralysis without much pain.
system: What is the pattern of hemiplegic migraine headaches?
output: There's not a predictable pattern with this type of migraine. Usually pain follows the paralysis, but it might come before, or you might not get a headache at all. You may hurt a lot and feel only a little weak; then the next attack might bring severe paralysis without much pain. It's uncommon, but over time, some people can have long-lasting trouble with movement and coordination.
system: How are hemiplegic migraine headaches treated?
output: Doctors disagree over how to treat hemiplegic migraines. Your doctor might prescribe drugs to prevent hemiplegic migraine, to stop them once they've started, and to relieve your symptoms. Your doctor will discuss the best options for you. Some doctors are feeling more comfortable that drugs called triptans, which are used for migraine headaches, are safe and effective for relieving hemiplegic migraine when you get them, too. Still, they are contraindicated based on package labelling. There is anecdotal evidence that triptans, beta blockers, and ergotamine derivatives may lead to ischemia in patients to treat patients with hemiplegic migraine. CGRP inhibitors are a new class of preventive medicine for treating most common migraines, but indications suggest this treatment would not be effective for hemiplegic migraines.