open-index/open-wikipedia-markdown huggingface dataset:
Fluoxetine

**Fluoxetine**, dem sell under de brand name **Prozac**, among odas, be an antidepressant medication of de selective serotonin reuptake inhibitor (SSRI) class dem use for de treatment of major depressive disorder, anxiety, obsessive–compulsive disorder (OCD), panic disorder, premenstrual dysphoric disorder, den bulimia nervosa. Dem sanso approve am for treatment of major depressive disorder insyd adolescents den kiddies 8 years of age den over. Na dem sanso use am to treat premature ejaculation. Fluoxetine be taken by mouth.

Common side effects dey include loss of appetite, nausea, diarrhea, headache, trouble sleeping, dry mouth, den sexual dysfunction. Serious side effects dey include serotonin syndrome, mania, seizures, an increased risk of suicidal behavior, den an increased risk of bleeding. Antidepressant discontinuation syndrome be less likely to occur plus fluoxetine dan plus oda antidepressants. Fluoxetine wey dem take during pregnancy be associated plus a significant increase insyd congenital heart defects insyd newborns. Na dem suggest say fluoxetine therapy fi be continued during breastfeeding if na dem use am during pregnancy anaa if na oda antidepressants be ineffective.

Na Eli Lilly and Company invent fluoxetine insyd 1972 wey e enter medical use insyd 1986. E dey on de World Health Organization's List of Essential Medicines wey e be available as a generic medication. Insyd 2023, na e be de eighteenth most commonly prescribed medication insyd de United States den de fourth most common antidepressant, plus more dan 27million prescriptions.

Eli Lilly sanso dey market fluoxetine insyd a fixed-dose combination plus olanzapine as olanzapine/fluoxetine (Symbyax), wich na e be approved by de US Food and Drug Administration (FDA) for de treatment of depressive episodes of bipolar I disorder insyd 2003 den for treatment-resistant depression insyd 2009.

## References


## External links
Metformin

**Metformin**, dem sell under de brand name **Glucophage**, among odas, be de main first-line medication give de treatment of type2 diabetes, particularly insyd people wey be overweight. Dem sanso dey use am insyd de treatment of polycystic ovary syndrome, wey dem sam times dey use am as an off-label adjunct to lessen de risk of metabolic syndrome insyd people wey dey take antipsychotic medication. Na e show to inhibit inflammation, wey e no be associated plus weight gain. Dem dey take metformin by mouth.

Metformin generally be well tolerated. Common adverse effects dey include diarrhea, nausea, den abdominal pain. E get a small risk of e dey cause low blood sugar. High blood lactic acid level (acidosis) be a concern if dem use de medication in overly large doses anaa dem prescribe insyd people plus severe kidney problems.

Metformin be a biguanide anti-hyperglycemic agent. E dey work by decreasing glucose production insyd de liver, wey dey increase de insulin sensitivity of body tissues, den dey increase GDF15 secretion, wich dey reduce appetite den caloric intake.

Na dem first describe metformin insyd de scientific literature insyd 1922 by Emil Werner den James Bell. Na French physician Jean Sterne begin de study insyd humans insyd de 1950s. Na dem introduce am as a medication insyd France insyd 1957. E dey on de World Health Organization's List of Essential Medicines. E be available as a generic medication. Insyd 2023,na e be de second most commonly prescribed medication insyd de United States, plus more dan 85million prescriptions. Insyd Australia,na e be one of de top 10 most prescribed medications between 2017 den 2023.

## References


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Botulism

**Botulism** be a rare den potentially fatal illness wey be caused by botulinum toxin, wich be produced by de bacterium *Clostridium botulinum*. De disease dey begin plus weakness, blurred vision, feeling tired, den trouble speaking. Dis then fi be followed by weakness of de arms, chest muscles, den legs. Vomiting, swelling of de abdomen, den diarrhea sanso fi occur. De disease no dey usually affect consciousness anaa cause a fever.

Botulism fi occur insyd several ways. De bacterial spores wich fi cause am be common insyd both soil den water wey be very resistant. Dem dey produce de botulinum toxin wen dem expose am to low oxygen levels den certain temperatures. Foodborne botulism dey happen wen dem chop chow wey dey contain de toxin. Infant botulism instead dey happen wen de bacterium develop insyd de intestines den dey release de toxin. Dis typically dey occur insyd kiddies per less dan one year old, as protective mechanisms against development of de bacterium develop after dat age. Dem dey find wound botulism most often among those wey inject street drugs. Insyd dis situation, spores enter a wound, den insyd de absence of oxygen, release de toxin. De disease no be passed directly between people. Dem confirm ein diagnosis by finding de toxin anaa bacteria insyd de person in question.

Prevention be primarily by proper food preparation. De toxin, though no be de spores, be destroyed by heating am to more dan  for longer dan five minutes. De clostridial spores fi be destroyed insyd an autoclave plus moist heat (120°C/ 250°F for at least 15 minutes) anaa dry heat (160°C/ 320°F for 2 hours) anaa by irradiation. De spores of group I strains be inactivated by heating at 121°C (250°F) for 3 minutes during commercial canning. Spores of group II strains be less heat-resistant, wey dem be often damaged by 90°C (194°F) for 10 minutes, 85°C for 52 minutes, anaa 80°C for 270 minutes; however, dese treatments no fi be sufficient insyd sam chows. Honey fi contain de organism, den for dis reason, honey for no be fed to kiddies under 12 months. Treatment be plus an antitoxin. Insyd those wey loose dema ability to breathe on dema own, mechanical ventilation fi be necessary for months. Dem fi use antibiotics for wound botulism. Death dey occur insyd 5 to 10% of people. Botulism sanso dey affect chaw oda animals. De word be from Latin , wey dey mean 'sausage'.

## References


## Read further

* 

## External links

* WHO fact sheet on botulism
* Botulism in the United States, 1889–1996. Handbook for Epidemiologists, Clinicians and Laboratory Technicians. Centers for Disease Control and Prevention. National Center for Infectious Diseases, Division of Bacterial and Mycotic Diseases 1998.
* NHS choices 
* CDC Botulism: Control Measures Overview for Clinicians
* University of California, Santa Cruz Environmental toxicology – Botulism 
* CDC Botulism FAQ
Sarcoidosis

**Sarcoidosis**, dem sanso know as **Besnier–Boeck–Schaumann disease**, be a non-infectious granulomatous disease wey dey involve abnormal collections of inflammatory cells wey dey form lump dem know as granulomata. De disease usually dey begin insyd de lungs, skin, anaa lymph nodes. Less commonly affected be de eyes, liver, heart, den brain, though any organ fi be affected. De signs den symptoms dey depend on de organ involved. Often, no symptoms anaa mild symptoms per be seen. Wen e affect de lungs, wheezing, coughing, shortness of breath, anaa chest pain fi occur. Sam fi get Löfgren syndrome, plus fever, enlarged hilar lymph nodes, arthritis, den a rash dem know as erythema nodosum.

De cause of sarcoidosis be unknown. Sam believe e fi be secof an immune reaction to a trigger such as an infection anaa chemicals insyd those wey be genetically predisposed. Those plus affected family members be at greater risk. Diagnosis partly be based on signs den symptoms, wich fi be supported by biopsy. Findings wey dey make am likely dey include large lymph nodes at de root of de lung on both sides, high blood calcium plus a normal parathyroid hormone level, anaa elevated levels of angiotensin-converting enzyme insyd de blood. Dem for make de diagnosis only after dem exclude oda possible causes of similar symptoms such as tuberculosis.

Sarcoidosis fi resolve widout any treatment within a few years. However, sam people fi get long-term anaa severe disease. Sam symptoms fi be improved plus de use of anti-inflammatory drugs such as ibuprofen. Insyd cases wer de condition dey cause significant health problems, steroids such as prednisone be indicated. Medications such as methotrexate, chloroquine, anaa azathioprine occasionally fi be used in an effort to decrease de side effects of steroids. De risk of death be 1–7%. De chance of de disease returning insyd sam bro wey na dem previously get am be less dan 5%.

Insyd 2015, na pulmonary sarcoidosis den interstitial lung disease affect 1.9 million people globally wey na e result in 122,000 deaths. E be most common insyd Scandinavians, buh dey occur insyd all parts of de world. Insyd de United States, risk be greater among black dan white people. E usually dey begin between de ages of 20 den 50. E dey occur more often insyd women dan men. Na de English doctor Jonathan Hutchinson first describe sarcoidosis insyd 1877 as a non-painful skin disease.

## References


## External links

* Sarcoidosis UK Information Hub
*
Mirtazapine

**Mirtazapine**, dem sell under de brand name **Remeron** among odas, be an atypical tetracyclic antidepressant, den as such dem dey use am primarily to treat depression. Ein effects fi take up to four weeks buh sanso fi manifest as early as one to two weeks. Dem often dey use am insyd cases of depression wey be complicated by anxiety anaa insomnia. De effectiveness of mirtazapine be comparable to oda commonly prescribed antidepressants. Dem dey take am by mouth.

Common side effects dey include sleepiness, dizziness, increased appetite, den weight gain. Serious side effects fi include mania, low white blood cell count, den increased suicide among kiddies. Withdrawal symptoms fi occur wen stopping. Dem no dey recommend am togeda plus a monoamine oxidase inhibitor, although evidence wey dey support de danger of dis combination be challenged. E be unclear if use during pregnancy be safe. How e dey work no be clear, buh e fi involve blocking certain adrenergic den serotonin receptors. Chemically, e be a tetracyclic antidepressant, wey e be closely related to mianserin. E sanso get strong antihistaminergic effects.

Mirtazapine cam into medical use insyd de United States insyd 1996. Na de patent expire insyd 2004, wey generic versions be available. Insyd 2023, na e be de 99th most commonly prescribed medication insyd de United States, plus more dan 6million prescriptions.

## References


## External links
Marfan syndrome

**Marfan syndrome** (**MFS**) be a multi-systemic genetic disorder wey dey affect de connective tissue. People plus de condition often be tall den thin, plus long arms, legs, fingers, den toes. Dem sanso typically get exceptionally flexible joints den abnormally curved spines. De most serious complications dey involve de heart den aorta, plus an increased risk of mitral valve prolapse den aortic aneurysm. De lungs, eyes, bones, den de covering of de spinal cord sanso be commonly affected. De severity of de symptoms be variable.

MFS be caused by a mutation insyd *FBN1*, one of de genes wey dey make fibrillin, wich dey result in abnormal connective tissue. E be an autosomal dominant disorder. Insyd about 75% of cases, e be inherited from a parent plus de condition, while insyd about 25% e be a new mutation. Diagnosis often be based on de Ghent criteria, family history den genetic testing (DNA analysis).

Der be no known cure for MFS. Chaw of those plus de disorder get a normal life expectancy plus proper treatment. Management often dey include de use of beta blockers such as propranolol anaa atenolol, calcium channel blockers, ACE inhibitors, den/anaa angiotensin receptor blockers ("ARBs"). Surgery fi be required to repair de aorta anaa replace a heart valve. Avoiding strenuous exercise be recommended for those plus de condition.

About 1 insyd 5,000 to 1 insyd 10,000 people get MFS. Rates of de condition be similar insyd different regions of de world. Dem name am after French pediatrician Antoine Marfan, wey first describe am insyd 1896.

## References


## External links

* Orphanet's disease page on Marfan syndrome
Ankylosing spondylitis

**Ankylosing spondylitis** (**AS**) be a type of arthritis from de disease spectrum of axial spondyloarthritis. De term dey cam from de Greek *ankylos* wey dey mean crooked, curved anaa rounded, *spondylos* dey mean vertebra, den *-itis* wey dey mean inflammation. E be characterized by long-term inflammation of de joints of de spine, typically wer de spine join de pelvis. Lower back pain be a hallmark, buh eye den gastrointestinal problems den arthritis of oda joints sanso fi occur. Joint mobility insyd de affected areas often dey worsen over time, though de progression of symptoms dey vary significantly.

Dem dey believe ankylosing spondylitis to involve a combination of genetic den environmental factors. More dan 90% of people affected insyd de UK get a specific human leukocyte antigen dem know as de HLA-B27 antigen, though de genetic correlation dey vary across populations (e.g., 70% of AS patients per insyd Turkey be HLA-B27 positive). De underlying mechanism dem believe e be autoimmune anaa autoinflammatory. Diagnosis be based on symptoms plus support from medical imaging den blood tests. AS be a type of seronegative spondyloarthropathy, wey dey mean say tests dey show no presence of rheumatoid factor (RF) antibodies.

Der currently be no cure give AS. Treatments fi include medication, physical therapy, den surgery. Medication therapy dey focus on relieving de pain den oda symptoms of AS, as well as stopping disease progression by counteracting long-term inflammatory processes. Commonly used medications dey include NSAIDs, TNF inhibitors, IL-17 antagonists, den DMARDs. Glucocorticoid injections often be used for acute den localized flare-ups.

About 0.1% to 0.8% of de population be affected, plus onset typically dey occur insyd young adults. While men den women equally be affected plus AS, women be more likely to experience inflammation rather dan fusion.

## References


## External links

* Questions and Answers about Ankylosing Spondylitis&nbsp;- US National Institute of Arthritis and Musculoskeletal and Skin Diseases
Amitriptyline

**Amitriptyline**, dem sell under de brand name **Elavil** among odas, be a tricyclic antidepressant dem primarily use to treat major depressive disorder, den a variety of pain syndromes such as neuropathic pain, fibromyalgia, migraine den tension headaches. Secof de frequency den prominence of side effects, amitriptyline be generally considered a second-line therapy for dese indications.

De most common side effects be dry mouth, drowsiness, dizziness, constipation, den weight gain. Glaucoma, liver toxicity den abnormal heart rhythms be rare buh serious side effects. Blood levels of amitriptyline de vary significantly from one person to anoda, den amitriptyline interacts plus chaw oda medications potentially dey aggravate ein side effects.

Na dem discover amitriptyline insyd de late 1950s by scientists at Merck wey dem approve by de US Food and Drug Administration (FDA) insyd 1961. E dey on de World Health Organization's List of Essential Medicines. E be available as a generic medication. Insyd 2023, na e be de 90th most commonly prescribed medication insyd de United States, plus more dan 7million prescriptions.

## References


## Read further
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## External links
Ebola

**Ebola**, dem sanso know as **Ebola virus disease** (**EVD**) den **Ebola hemorrhagic fever** (**EHF**), be a viral hemorrhagic fever insyd humans den oda primates, wey ebolaviruses cause. Symptoms typically dey start anywer between two days den three weeks after infection. De first symptoms usually be fever, sore throat, muscle pain, den headaches. Dese usually be followed by vomiting, diarrhoea, rash den decreased liver den kidney function, at wich point sam people begin to bleed both internally den externally. Ebola get a mortality rate of 25–90% wey dey depend on treatment, den averages a mortality rate of approximately 50%. Death often be secof shock from fluid loss, den typically dey occur between 6 den 16 days after de first symptoms appear. Early treatment of symptoms dey increase de survival rate considerably dem compare to late start. Na dem approve an Ebola vaccine by de US FDA insyd December 2019.

De virus dey spread thru direct contact plus body fluids, such as blood from infected humans anaa oda animals, anaa from contact plus items wey recently dem be contaminated plus infected body fluids. Der be no documented cases, either insyd nature anaa under laboratory conditions, of spread thru de air between humans anaa oda primates. After recovering from Ebola, semen anaa breast milk fi continue to carry de virus for anywer between several weeks to several months. Dem dey believe fruit bats to be de natural host of de virus; dem be able to spread de virus widout dem be affected by am. De symptoms of Ebola fi resemble those of several oda diseases, wey dey include malaria, cholera, typhoid fever, meningitis den oda viral hemorrhagic fevers. Diagnosis be confirmed by testing blood samples for de presence of viral RNA, viral antibodies anaa de virus einself.

Control of outbreaks dey require coordinated medical services den community engagement, wey dey include rapid detection, contact tracing of those wey be exposed, quick access to laboratory services, care for those infected, den proper disposal of de dead thru cremation anaa burial. Prevention measures dey involve wearing proper protective clothing den washing hands wen in close proximity to patients den while handling potentially infected bushmeat, as well as thoroughly cooking bushmeat. Two treatments (atoltivimab/maftivimab/odesivimab den ansuvimab) be associated plus improved outcomes. Supportive efforts sanso improve outcomes. Dese dey include oral rehydration therapy (drinking slightly sweetened den salty water) anaa giving intravenous fluids, den treating symptoms. Insyd October 2020, na dem approve atoltivimab/maftivimab/odesivimab (Inmazeb) for medical use insyd de United States to treat de disease caused by *Zaire ebolavirus*.

## References


## External links

* WHO fact sheet on Ebola
* Ebola (Ebola Virus Disease)&nbsp;– Centers for Disease Control and Prevention, Viral Special Pathogens Branch.
* Videos: Ebola outbreak response&nbsp;– World Health Organization.
* 
* Ebola: What You Need to Know&nbsp;– *[[Scientific American]]* articles related to Ebola; note these are general reading articles, they are not scientific peer-reviewed research articles.
Meningitis

**Meningitis** be acute anaa chronic inflammation of de protective membranes wey dey cover de brain den spinal cord, dem collectively call de meninges. De most common symptoms be fever, intense headache, vomiting den neck stiffness den occasionally photophobia. Oda symptoms dey include confusion anaa altered consciousness, nausea, den an inability to tolerate loud noises. Young kiddies often dey exhibit nonspecific symptoms per, such as irritability, drowsiness, anaa poor feeding. A non-blanching rash (a rash wey no dey fade wen dem roll a glass over am) sanso fi be present.

De inflammation fi be caused by infection plus viruses, bacteria, fungi anaa parasites. Non-infectious causes dey include malignancy (cancer), subarachnoid hemorrhage, chronic inflammatory disease (sarcoidosis) den certain drugs. Meningitis fi be life-threatening secof de inflammation ein proximity to de brain den spinal cord; therefore, de condition be classified as a medical emergency. A lumbar puncture, insyd wich dem insert a needle into de spinal canal to collect a sample of cerebrospinal fluid (CSF), fi diagnose anaa exclude meningitis.

Sam forms of meningitis be preventable by immunization plus de meningococcal, mumps, pneumococcal, den Hib vaccines. Giving antibiotics to people plus significant exposure to certain types of meningitis sanso fi be useful for preventing transmission. De first treatment insyd acute meningitis dey consist of promptly giving antibiotics den sam times antiviral drugs. Corticosteroids fi be used to prevent complications from excessive inflammation. Meningitis fi lead to serious long-term consequences such as deafness, epilepsy, hydrocephalus, anaa cognitive deficits, especially if dem no treat am quickly.

Insyd 2019, na dem diagnose meningitis insyd about 7.7 million people worldwide, of whom na 236,000 die, down from 433,000 deaths insyd 1990. Plus appropriate treatment, de risk of death insyd bacterial meningitis be less dan 15%. Outbreaks of bacterial meningitis dey occur between December den June each year insyd an area of sub-Saharan Africa dem know as de meningitis belt. Smaller outbreaks sanso dey occur insyd oda areas of de world. De word *meningitis* dey cam from de Greek  , 'membrane', den de medical suffix *-itis*, 'inflammation'.

## References


## External links

* Meningitis U.S. Centers for Disease Control and Prevention (CDC)
Neurosis

**Neurosis** (pl. **neuroses**) be a term dem mainly use today by followers of Freudian psychoanalytic theory to describe mental disorders wey be caused by past anxiety, often anxieties wey undergo repression. Insyd recent history, na dem use de term to refer to anxiety-related conditions more generally.

Dem no longer dey use de term "neurosis" insyd psychological disorder names anaa categories by de World Health Organization ein *International Classification of Diseases* (ICD) anaa de American Psychiatric Association ein *Diagnostic and Statistical Manual of Mental Disorders* (DSM). According to de *American Heritage Medical Dictionary* of 2007, de term be "no longer used in psychiatric diagnosis".

Neurosis be distinguished from *[[psychosis]]*, wich dey refer to a loss of touch plus reality. Ein descendant term, *neuroticism*, dey refer to a personality trait of being prone to anxiousness den mental collapse. De term "neuroticism" sanso no longer be used for DSM anaa ICD conditions; however, e be a common name for one of de Big Five personality traits. Dem include a similar concept insyd de ICD-11 as de condition "negative affectivity".

## References


## External links

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Pulmonary embolism

**Pulmonary embolism** (**PE**) be a blockage of an artery insyd de lungs by a substance wey move from elsewer insyd de body thru de bloodstream (embolism). Symptoms of a PE fi include shortness of breath, chest pain particularly upon breathing in, den coughing up blood. Symptoms of a blood clot insyd de leg sanso fi be present, such as a red, warm, swollen, den painful leg. Signs of a PE dey include low blood oxygen levels, rapid breathing, rapid heart rate, den sam times a mild fever. Severe cases fi lead to passing out, abnormally low blood pressure, obstructive shock, den sudden death.

PE usually dey result from a blood clot insyd de leg wey travel to de lung. De risk of blood clots be increased by advanced age, cancer, prolonged bed rest den immobilization, smoking, stroke, long-haul travel over 4 hours, certain genetic conditions, estrogen-based medication, pregnancy, obesity, trauma anaa bone fracture, den after sam types of surgery. A small proportion of cases be secof de embolization of air, fat, anaa amniotic fluid. Diagnosis be based on signs den symptoms in combination plus test results. If de risk be low, a blood test dem know as a D-dimer fi rule out de condition. Oda wise, a CT pulmonary angiography, lung ventilation/perfusion scan, anaa ultrasound of de legs fi confirm de diagnosis. Togeda, deep vein thrombosis den PE be known as venous thromboembolism (VTE).

Efforts to prevent PE dey include beginning to move as soon as possible after surgery, lower leg exercises during periods of sitting, den de use of blood thinners after sam types of surgery. Treatment be plus anticoagulant medications such as heparin, warfarin, anaa one of de direct-acting oral anticoagulants (DOACs). Dem dey recommend dese to be taken for at least three months. However, treatment dey use low-molecular-weight heparin no be recommended for those at high risk of bleeding anaa those plus renal failure. Severe cases fi require thrombolysis using medication such as tissue plasminogen activator (tPA) given intravenously anaa thru a catheter, wey sam fi require surgery (a pulmonary thrombectomy). If blood thinners no be appropriate anaa safe to use, a temporary vena cava filter fi be used.

Pulmonary emboli dey affect about 430,000 people each year insyd Europe. Insyd de United States, between 300,000 den 600,000 cases dey occur each year, wich dey contribute to at least 40,000 deaths. Rates be similar insyd males den females. Dem cam be more common as people get older.

## References


## External links

* Wells criteria for pulmonary embolism online calculator 
* Clinical prediction website – Wells criteria for pulmonary embolism 
*
Edema

**Edema** (American English), dem sanso spell am **oedema** (Commonwealth English), wey dem sanso know am as **fluid retention**, **swelling**, **dropsy** den **hydropsy**, be de build-up of fluid insyd de body ein tissue. Most commonly, de legs anaa arms be affected. Symptoms fi include skin wey dey feel tight, de area dey feel heavy, den joint stiffness. Oda symptoms dey depend on de underlying cause.

Causes fi include venous insufficiency, heart failure, kidney problems, low protein levels, liver problems, deep vein thrombosis, infections, kwashiorkor, angioedema, certain medications, den lymphedema. E sanso fi occur insyd immobile patients (stroke, spinal cord injury, aging), anaa plus temporary immobility such as prolonged sitting anaa standing, den during menstruation anaa pregnancy. De condition be more concerning if e start suddenly, anaa pain anaa shortness of breath be present.

Treatment dey depend on de underlying cause. If de underlying mechanism dey involve sodium retention, decreased salt intake den a diuretic fi be used. Elevating de legs den support stockings fi be useful for edema of de legs. Older people be more commonly affected. De word be from de Ancient Greek  *oídēma* wey dey mean 'swelling'.

## References


## External links
Aspirin

**Aspirin** (/ˈæsp(ə)rɪn/) be de genericized trademark give **acetylsalicylic acid** (**ASA**), a nonsteroidal anti-inflammatory drug (NSAID) dem use to reduce pain, fever, den inflammation, den as an antithrombotic. Dem dey use aspirin to treat inflammatory conditions wey dey include Kawasaki disease, pericarditis, den rheumatic fever.

Dem sanso dey use aspirin long-term to help prevent further heart attacks, ischaemic strokes, den blood clots insyd people at high risk. For pain anaa fever, effects typically dey begin within 30 minutes. Aspirin dey work similarly to oda NSAIDs buh sanso dey suppress de normal functioning of platelets.

One common adverse effect be an upset stomach. More significant side effects dey include stomach ulcers, stomach bleeding, den worsening asthma. Bleeding risk be greater among those wey be older, suck alcohol, take oda NSAIDs, anaa be on oda blood thinners. Dem no dey recommend aspirin insyd de last part of pregnancy. Dem generally no dey recommend insyd kiddies plus viral infections secof de risk of Reye syndrome. High doses fi result in ringing insyd de ears.

A precursor to aspirin dem find insyd de bark of de willow tree (genus *Salix*), salicin, be metabolized insyd de human gut into de medicinally active compound salicylic acid wey na dem use am for ein health effects for at least 2,400 years. Na pharmacology seek a synthetic alternative. Insyd 1853, na de chemist Charles Frédéric Gerhardt treat de medicine sodium salicylate plus acetyl chloride to produce acetylsalicylic acid for de first time. Over de next 50 years, na oda chemists, mostly of de German company Bayer, establish de chemical structure wey dem devise more efficient production methods. Na Felix Hoffmann (anaa perhaps Arthur Eichengrün) of Bayer be de first to produce acetylsalicylic acid insyd a pure, stable form insyd 1897. By 1899, na Bayer dub dis drug Aspirin wey na dem dey sell am globally.

Aspirin be available widout medical prescription as a proprietary anaa generic medication insyd most jurisdictions. E be one of de most widely used medications globally, plus an estimated  (50 to 120 billion pills) consumed each year, wey e dey on de World Health Organization's List of Essential Medicines. Insyd 2023, e be de 46th most commonly prescribed medication insyd de United States, plus more dan 14million prescriptions.

## References


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## External links
Aortic dissection

**Aortic dissection** (**AD**) dey occur wen an injury to de innermost layer of de aorta dey allow blood to flow between de layers of de aortic wall, wey dey force de layers apart. Insyd chaw cases, dis be associated plus a sudden onset of agonizing chest anaa back pain, dem often describe as "tearing" insyd character. Vomiting, sweating, den lightheadedness sanso fi occur. Damage to oda organs fi result from de decreased blood supply, such as stroke, lower extremity ischemia, anaa mesenteric ischemia. Aortic dissection quickly fi lead to death from insufficient blood flow to de heart anaa complete rupture of de aorta.

AD be more common insyd those plus a history of high blood pressure; a number of connective tissue diseases wey dey affect blood vessel wall strength wey dey include Marfan syndrome den Ehlers–Danlos syndrome; a bicuspid aortic valve; den previous heart surgery. Major trauma, smoking, cocaine use, pregnancy, a thoracic aortic aneurysm, inflammation of arteries, den abnormal lipid levels sanso be associated plus an increased risk. De diagnosis be suspected based on symptoms plus medical imaging, such as CT scan, MRI, anaa ultrasound dem use to confirm den further evaluate de dissection. De two main types be Stanford type A, wich dey involve de first part of de aorta, den type B, wich no dey do.

Prevention be by blood pressure control den smoking cessation. Management of AD dey depend on de part of de aorta involve. Dissections wey dey involve de first part of de aorta (adjacent to de heart) usually dey require surgery. Dem fi do surgery either by opening de chest anaa from insyd de blood vessel. Dissections wey dey involve de second part of de aorta per typically fi be treated plus medications wey dey lower blood pressure den heart rate, unless der be complications wich then dey require surgical correction. Complications wey dey require surgical correction dey include blood leaking outsyd of de aorta, anaa reduced blood flow to organs secof de dissection wey dey cause a blockage of blood vessels wey dey branch from de aorta.

AD be relatively rare, wey dey occur at an estimated rate of three per 100,000 people per year. E be more common insyd men dan women. De typical age at diagnosis be 63, plus about 10% of cases dey occur before de age of 40. Widout treatment, about half of people plus Stanford type A dissections die within three days den about 10% of people plus Stanford type B dissections die within one month. Na dem describe de first case of AD insyd de examination of King George II of Great Britain dey follow ein death insyd 1760. Na dem introduce surgery give AD insyd de 1950s by Michael E. DeBakey.

## Notable cases

* Muhammad, founder of Islam.
* Lucille Ball
* Playwright Jonathan Larson
* Actor John Ritter
* *Days of Our Lives* den *Babylon 5* actor Richard Biggs

## References


## External links

*
Stress (biology)

**Stress**, whether physiological, biological anaa psychological, be an organism ein response to a stressor, such as an environmental condition anaa change insyd life circumstances. Wen stressed by stimuli wey dey alter an organism ein environment, multiple systems respond across de body. Insyd humans den chaw mammals, de autonomic nervous system den hypothalamic-pituitary-adrenal (HPA) axis be de two major systems wey dey respond to stress. Two well-known hormones wey humans produce during stressful situations be adrenaline den cortisol.

De sympathoadrenal medullary axis (SAM) fi activate de fight-or-flight response thru de sympathetic nervous system, wich dey dedicate energy to more relevant bodily systems to acute adaptation to stress, while de parasympathetic nervous system dey return de body to homeostasis.

De second major physiological stress-response center, de HPA axis, wey dey regulate de release of cortisol, wich dey influence chaw bodily functions, such as metabolic, psychological den immunological functions. De SAM den HPA axes be regulated by several brain regions, wey dey include de limbic system, prefrontal cortex, amygdala, hypothalamus, den stria terminalis. Thru these mechanisms, stress fi alter memory functions, reward, immune function, metabolism, den susceptibility to diseases.

Disease risk be particularly pertinent to mental illnesses, wer by chronic anaa severe stress dey remain a common risk factor for several mental illnesses.

## References



## External links

*The American Institute of Stress
*I'm so stressed out! Fact sheet, 2025, National Institute of Mental Health, US National Institutes of Health
*Caring for your mental health, December 2024, National Institute of Mental Health, US National Institutes of Health
Somatic symptom disorder

**Somatic symptom disorder** (**SSD**) be a mental health condition wey be characterised by an excessive focus on physical symptoms—such as pain anaa shortness of breath—wey dey cause significant distress anaa impairment. Individuals plus SSD dey experience disproportionate thoughts, emotions, den behaviors wey be related to dema symptoms. De symptoms demselves no be deliberately produced anaa feigned (as dem dey insyd malingering den factitious disorders), den dema underlying cause—whether organic, psychogenic anaa unexplained—be irrelevant to de diagnosis.

Manifestations of somatic symptom disorder be variable; symptoms fi be widespread, specific, den often fluctuate. Somatic symptom disorder dey correspond to how an individual dey view den react to symptoms rather dan de symptoms demselves, wey e fi develop insyd de setting of existing chronic illness anaa newly onset conditions.

Na several studies find a high frequency of comorbidity plus major depressive disorder, generalized anxiety disorder, den phobias. Somatic symptom disorder frequently be associated plus functional pain syndromes, such as fibromyalgia den irritable bowel syndrome (IBS). Somatic symptom disorder typically dey lead to poor overall functioning, interpersonal issues, unemployment anaa problems at work, den financial strain as a result of frequent healthcare visits.

De etiology of somatic symptom disorder be unknown. Symptoms fi result from a heightened awareness of specific physical sensations alongside health anxiety. Der be sam controversy wey dey surround de diagnosis, since symptom perception den response be inherently subjective, wey fi depend on de clinician ein interpretation. Additionally, people plus known physical illnesses sam times fi be misdiagnosed plus am.

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Ménière's disease

**Ménière's disease** (**MD**) be a disease of de inner ear wey be characterized by potentially severe den incapacitating episodes of vertigo, tinnitus, hearing loss, den a feeling of fullness insyd de ear. Typically, one ear per be affected initially, buh over time, both ears cam fi be involved. Episodes generally dey last from 20 minutes to a few hours, plus varying time between episodes. De hearing loss den ringing insyd de ears fi cam be constant over time. Na dem identify Ménière's disease insyd de early 1800s by Prosper Menière.

De cause of Ménière's disease be unclear, buh likely dey involve both genetic den environmental factors. A number of theories exist for why e dey occur, wey dey include constrictions insyd blood vessels, viral infections, den autoimmune reactions. About 10% of cases run insyd families. Dem dey believe symptoms to occur as de result of increased fluid buildup insyd de labyrinth of de inner ear. Diagnosis be based on de symptoms den a hearing test. Oda conditions wey fi produce similar symptoms dey include vestibular migraine den transient ischemic attack.

No cure be known. Attacks often be treated plus medications to help plus de nausea den anxiety. Measures to prevent attacks overall be poorly supported by de evidence. A low-salt diet, diuretics, den corticosteroids fi be tried. Physical therapy fi help plus balance den counselling fi help plus anxiety. Injections into de ear anaa surgery sanso fi be tried if oda measures no be effective, buh dem be associated plus risks. De use of tympanostomy tubes (ventilation tubes) to improve vertigo den hearing insyd people plus Ménière's disease no be supported by definitive evidence.

De disease dey affect between 0.3 den 1.9 per 1,000 people. De onset of Ménière's disease usually be around 40 to 60 years old. Females be more commonly affected dan males. After 5–15 years of symptoms, episodes wey dey include dizziness anaa a sensation of spinning sam times stop den de person be left plus loss of balance, poor hearing insyd de affected ear, den ringing anaa oda sounds insyd de affected ear anaa ears.

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* Menière's Disease, Stanford Ear Institute.
Coeliac disease

**Coeliac disease** (Commonwealth English) anaa **celiac disease** (American English) be a chronic autoimmune disease, mainly wey dey affect de small intestine, wey be caused by de consumption of gluten. Coeliac disease dey cause a wide range of symptoms den complications wey fi affect multiple organs outsyd of de gastrointestinal tract.

Symptoms fi be divided into two subtypes, classic den non-classic. De classic form of de disease fi affect any age group, buh be usually diagnosed insyd early childhood den dey cause symptoms of malabsorption such as weight loss, diarrhoea, den stunted growth. Non-classic coeliac disease be more commonly dem see insyd adults wey e be characterized by vague abdominal symptoms den complications insyd organs outsyd of de gastrointestinal tract, such as bone disease, anemia, den oda consequences of nutritional deficiencies.

Coeliac disease be caused by an abnormal immune system response to gluten, dem find insyd wheat den oda grains such as barley den rye. Wen an individual plus a genetic predisposition to de condition dey consume gluten, e dey trigger an inflammatory response insyd de small intestine, wey dey damage de intestinal lining, wey dey lead to malabsorption. Dem dey believe de development of coeliac disease to be influenced by oda environmental factors, such as infections.

Coeliac disease be diagnosed base on symptoms, blood tests, den biopsies of de small intestine while consuming a diet wey dey contain gluten. Insyd those wey already reduce dema gluten intake, reintroducing gluten fi be required to reach an accurate diagnosis. De diagnosis often be complicated by de diverse symptoms, overlap plus oda disorders, den lack of awareness, wey dey lead to a delay insyd diagnosis. Current research dey indicate say der no be enough evidence to advocate for mass screening for coeliac disease insyd those widout symptoms.

De treatment for coeliac disease per be a lifelong gluten-free diet (GFD). A GFD dey involve removing all chow den drink wich dey contain wheat, rye, barley den gluten derivatives. Symptoms fi improve within days of adopting a GFD den de diet dey improve quality of life, dey prevent further complications den dey normalize sam effects of de disease such as stunted growth.

Approximately 1 insyd 200 to 1 insyd 50 people get coeliac disease. Na diagnoses of coeliac disease increase in recently secof increased awareness den availability of blood testing. However, de disease still be thought to be underdiagnosed, plus a significant number of people plus de condition wey dey remain undiagnosed den untreated. Chaw people develop de disease before de age of 10 wey e be slightly more common insyd women dan insyd men.

## Terminology den classification
"Coeliac disease" be de preferred spelling insyd Commonwealth English, while "celiac disease" be typically used insyd North American English.

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Cetirizine

**Cetirizine** be a second-generation peripherally selective antihistamine dem use to treat allergic rhinitis (hay fever), dermatitis, den urticaria (hives). Dem dey take by mouth. Effects generally dey begin within thirty minutes den last for about a day. De degree of benefit be similar to oda antihistamines such as diphenhydramine, wich be a first-generation antihistamine.

Common side effects dey include sleepiness, dry mouth, headache, den abdominal pain. De degree of sleepiness wey dey occur generally be less dan plus first-generation antihistamines secof second-generation antihistamines be more selective for de H1 receptor. Dem compare to oda second-generation antihistamines, cetirizine fi cause drowsiness. Among second-generation antihistamines, cetirizine be more likely dan fexofenadine den loratadine to cause drowsiness.

Ein use insyd pregnancy dey appear safe, buh ein use during breastfeeding no be recommended. De medication dey work by blocking histamine H1 receptors, mostly outsyd de brain.

Dem fi use cetirizine for paediatric patients. De main side effect to be cautious about be somnolence.

Na dem patent am insyd 1983 wey e cam into medical use insyd 1987. Cetirizine be a therapeutic alternative on de World Health Organization's List of Essential Medicines. E be available as a generic medication. Insyd 2023, na e be de 55th most commonly prescribed medication insyd de United States, plus more dan 11million prescriptions.

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Atopic dermatitis

**Atopic dermatitis** (**AD**), dem sanso know as **atopic eczema**, be a long-term type of inflammation of de skin. Atopic dermatitis dem sanso often call simply **eczema**, buh "eczema" sanso be used to refer to dermatitis, de larger group of skin conditions. Atopic dermatitis dey result in itchy, red, swollen, den cracked skin. Clear fluid fi cam from de affected areas, wich fi thicken over time.

Atopic dermatitis dey affect about 20% of people at sam point insyd dema lives. E be more common insyd younger kiddies. Females be affected slightly more often dan males. Chaw people outgrow de condition.

While de condition fi occur at any age, e typically dey begin insyd childhood, plus varying severity over de years. Insyd kiddies under one year of age, de face den limbs den much of de body fi be affected. As kiddie get older, de areas on de insides of de knees den folds of de elbows den around de neck be most commonly affected. Insyd adults, de hands den feet be commonly affected. Scratching de affected areas dey worsen de eczema den dey increase de risk of skin infections. Chaw people plus atopic dermatitis develop hay fever anaa asthma.

De cause be unknown buh dem believe to involve genetics, immune system dysfunction, environmental exposures, den difficulties plus de permeability of de skin. If one identical twin be affected, de oda get an 85% chance of having de condition. Those wey dey live insyd cities den dry climates be more commonly affected. Exposure to certain chemicals anaa frequent hand washing dey make symptoms worse. While emotional stress fi make de symptoms worse, e no be a cause. De disorder no be contagious. A diagnosis typically be based on de signs, symptoms, den family history.

Treatment dey involve avoiding things wey dey make de condition worse, enhancing de skin barrier thru skin care, den treating de underlying skin inflammation. Dem dey use moisturising creams to make de skin less dry den prevent AD flare-ups. Dem dey use anti-inflammatory corticosteroid creams to control flare-ups. Creams based on calcineurin inhibitors (tacrolimus anaa pimecrolimus) sanso fi be used to control flares if oda measures no be effective. Certain antihistamine pills fi help plus itchiness. Things wey commonly make am worse dey include house dust mite, stress, den seasonal factors. Phototherapy fi be useful insyd sam people. Antibiotics (either by mouth anaa topically) usually no be helpful unless der be secondary bacterial infection anaa de person be unwell. Dietary exclusion no dey benefit chaw people, wey e no need if food allergies be suspected. More severe AD cases fi need systemic medicines such as cyclosporin, methotrexate, dupilumab, anaa baricitinib.

Oda names of de condition dey include "infantile eczema", "flexural eczema", "prurigo Besnier", "allergic eczema", den "neurodermatitis".

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Doxycycline

**Doxycycline** be a broad-spectrum antibiotic of de tetracycline class dem use insyd de treatment of infections wey be caused by bacteria den certain parasites. Dem dey use to treat bacterial pneumonia, acne, chlamydia infections, Lyme disease, cholera, typhus, den syphilis. Dem sanso dey use am to prevent malaria. Dem fi take doxycycline by mouth anaa intravenously.

Common side effects dey include diarrhea, nausea, vomiting, abdominal pain, den an increased risk of sunburn. Ein use during pregnancy no be recommended. Like oda agents of de tetracycline class, e either dey slow anaa dey kill bacteria by inhibiting protein production. E dey kill *Plasmodium*—microorganisms wey be associated plus malaria—by targeting a plastid organelle, de apicoplast.

Dem sanso dey use doxycycline as prophylaxis against sexually transmitted infections, particularly insyd men wey dey have sex plus men. E be used for post-exposure prophylaxis (PEP) to reduce de incidence of sexually transmitted bacterial infections (STIs), wey be supported by guidelines from de US Centers for Disease Control and Prevention (CDC) den de Australasian Society for HIV Medicine.

According to NHS guidance, de use of Doxy-PEP be associated plus reductions in risk of chlamydia by 70–89%, syphilis by 73–87%, den gonorrhoea by 51–57%.

Na dem patent doxycycline insyd 1957 wey e cam into commercial use insyd 1967. E dey on de World Health Organization's List of Essential Medicines. Doxycycline be available as a generic medicine. Insyd 2023, na e be de 77th most commonly prescribed medication insyd de United States, plus more dan 8million prescriptions.

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