open-index/open-wikipedia-markdown huggingface dataset:
Spinal stenosis

**Spinal stenosis** be an abnormal narrowing of de spinal canal anaa neural foramen wey dey result in pressure on de spinal cord anaa nerve roots. Symptoms fi dey include pain, numbness, anaa weakness insyd de arms anaa legs. Symptoms be typically gradual in onset den dey improve plus leaning forward. Severe symptoms fi include loss of bladder control, loss of bowel control, anaa sexual dysfunction.

Causes fi include osteoarthritis, rheumatoid arthritis, spinal tumors, trauma, Paget's disease of de bone, scoliosis, spondylolisthesis, den de genetic condition achondroplasia. E fi be classified by de part of de spine wey be affected into cervical, thoracic, den lumbar stenosis. Lumbar stenosis be de most common, wey be followed by cervical stenosis. Diagnosis generally dey base on symptoms den medical imaging.

Treatment fi involve medications, bracing, anaa surgery. Medications fi include NSAIDs, acetaminophen, anticonvulsants (gabapentinoids) anaa steroid injections. Stretching den strengthening exercises sanso fi be useful. Limiting certain activities fi be recommended. Dem fi typically do surgery per if oda treatments no be effective, plus de usual procedure be a decompressive laminectomy.

Spinal stenosis dey occur insyd as many as 8% of people. E dey occur most commonly insyd people over de age of 50. Males den females be affected equally often. De first modern description of de condition be from 1803 by Antoine Portal, wey der be evidence of de condition wey dey date back to Ancient Egypt. 

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Tramadol

**Tramadol**, dem sell under de brand name **Tramal** among odas, be an opioid pain medication den a serotonin–norepinephrine reuptake inhibitor (SNRI) dem use to treat moderate to severe pain. Wen dem take am by mouth insyd an immediate-release formulation, de onset of pain relief usually dey begin within an hour. E sanso be available by injection. E be available in combination plus paracetamol (acetaminophen).

As e be typical of opioids, common side effects dey include constipation, itchiness, den nausea. Serious side effects fi include hallucinations, seizures, increased risk of serotonin syndrome, decreased alertness, den drug addiction. A change insyd dosage fi be recommended insyd those plus kidney anaa liver problems. Dem no dey recommend am insyd those wey be at risk of suicide anaa insyd those wey dey preg. While e no be recommended insyd women wey dey breastfeed, those wey take a single dose for no generally stop breastfeeding. Tramadol be converted insyd de liver to *O*-desmethyltramadol (desmetramadol), an opioid plus a stronger affinity for de μ-opioid receptor.

Tramadol be patented insyd 1972 wey na dem launch am under de brand name Tramal insyd 1977 by de West German pharmaceutical company Grünenthal GmbH. Insyd de mid-1990s, na dem approve am insyd de United Kingdom den de United States. E be available as a generic medication wey na dem market am under chaw brand names worldwide. Insyd 2023, na e be de 36th most commonly prescribed medication insyd de United States, plus more dan 16million prescriptions.

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Mania

**Mania** (/ˈmeɪniːə/ *MAIN-ee-yah*; dem sanso know as **manic syndrome**) be a psychiatric behavioral syndrome dem define as a state of abnormally elevated arousal, affect, den energy level. During a manic episode, an individual go experience rapidly changing emotions den moods, highly influenced by surrounding stimuli. Although mania often be conceived of as a "mirror image" to depression, de heightened mood fi be dysphoric as well as euphoric. As de mania dey intensify, irritability fi be more pronounced den result in anxiety anaa anger.

De symptoms of mania dey include elevated mood (either euphoric anaa irritable), flight of ideas, pressure of speech, increased energy, decreased "need" den desire for sleep, den hyperactivity. Dem be most plainly evident in fully developed hypomanic states, however, insyd full-blown mania, dese symptoms cam be progressively exacerbated. Insyd severe manic episodes, dese symptoms fi even be obscured by oda signs den symptoms characteristic of psychosis, such as delusions (e fi include delusions of grandeur den paranoid delusions), hallucinations, fragmentation of behavior, den catatonia. As a result, discernment be significantly reduced. Na more dan 5% of de general human population experience mania anaa hypomania insyd sam degree.

## References


## Read further

* *Expert Opin Pharmacother*. 2001 December;2(12):1963–73.
* Schizoaffective Disorder . 2007 September Mayo Clinic. Retrieved October 1, 2007.
* Schizoaffective Disorder . 2004 May. All Psych Online: Virtual Psychology Classroom. Retrieved October 2, 2007.
* Psychotic Disorders. 2004 May. All Psych Online: Virtual Psychology Classroom. Retrieved October 2, 2007.
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## External links

* Depression and Bipolar Support Alliance
High-functioning autism

Na **high-functioning autism** (**HFA**) be historically an autism classification to describe a person wey exhibit no intellectual disability buh otherwise show autistic traits, such as difficulty insyd social interaction den communication. Na de term often be applied to verbal autistic people of at least average intelligence. However, na chaw insyd medical den autistic communities call make dem stop dey use de term, dey find am simplistic den unindicative of de difficulties sam autistic people dey face.

Na dem never include HFA insyd either de American Psychiatric Association ein *Diagnostic and Statistical Manual of Mental Disorders* (DSM) anaa de World Health Organization ein *International Classification of Diseases* (ICD), de two major classification den diagnostic guidelines for psychiatric conditions. De DSM-5-TR dey subtype autism into three levels wey base on support needs. Autism Level 1 get de least support needs den dey correspond most closely plus de "high-functioning" identifier.

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Amoxicillin

**Amoxicillin** be an antibiotic medication wey dey belong to de aminopenicillin class of de penicillin family. Dem dey use de drug to treat bacterial infections such as middle ear infection, strep throat, pneumonia, skin infections, odontogenic infections, den urinary tract infections. Dem dey take am orally (dem swallow by mouth), anaa less commonly by either intramuscular injection anaa by an IV bolus injection, wich be a relatively quick intravenous injection wey dey last from a couple of seconds to a few minutes.

Common adverse effects dey include nausea den rash. E sanso fi increase de risk of yeast infections, den wen dem use am in combination plus clavulanic acid, diarrhea. Dem for no use am insyd those wey be allergic to penicillin. While usable insyd those plus kidney problems, de dose fi hia make dem decrease am. Ein use insyd pregnancy den breastfeeding no appear e be harmful. Amoxicillin dey insyd de β-lactam family of antibiotics.

Na dem discover amoxicillin insyd 1958 wey na e cam into medical use insyd 1972. Na dem approve amoxil for medical use insyd de United States insyd 1974, den insyd de United Kingdom insyd 1977. E dey on de World Health Organization's List of Essential Medicines. E be one of de most commonly prescribed antibiotics insyd kiddies. Amoxicillin be available as a generic medication. Insyd 2023, na e be de 23rd most commonly prescribed medication insyd de United States, plus more dan 23million prescriptions.

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Pervasive developmental disorder not otherwise specified

**Pervasive developmental disorder not otherwise specified** (**PDD-NOS**) be a historic psychiatric diagnosis dem first define insyd 1980 wey na e since be incorporated into autism spectrum disorder insyd de DSM-5 (2013).

According to de earlier DSM-IV, PDD-NOS refer to "mild anaa severe pervasive deficits insyd de development of reciprocal social interaction den/anaa verbal den nonverbal communication skills, anaa wen stereotyped behavior, interests, den/anaa activities be present, buh na dem no meet de criteria for a specific PDD" anaa for several oda disorders.

Na PDD-NOS be one of four disorders dem collapse into de diagnosis of autism spectrum disorder insyd de DSM-5, wey sanso be one of de five disorders dem classify as a pervasive developmental disorder (PDD) insyd de DSM-IV.  De ICD-10 equivalents sanso cam be part of ein definition of autism spectrum disorder, as of de ICD-11.

PDD-NOS include **atypical autism**, a diagnosis dem define insyd de ICD-10 for de case wey na dem no meet de criteria for *autistic disorder* secof late age of onset, anaa atypical symptomatology, anaa both of dese.

Even though na dem no consider PDD-NOS milder dan typical autism, na dis no be always true. While sam characteristics fi be milder, odas fi be more severe.

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HIV-associated neurocognitive disorder

**HIV-associated neurocognitive disorders** (**HAND**) be neurological disorders wey be associate plus HIV infection den AIDS. E be a syndrome of progressive deterioration of memory, cognition, behavior, den motor function insyd HIV-infected individuals during de late stages of de disease, wen immunodeficiency be severe. HAND fi include neurological disorders of various severity. HIV-associated neurocognitive disorders be associated plus a metabolic encephalopathy dem induce by HIV infection den fuel by immune activation of macrophages den microglia. Dese cells be actively infected plus HIV den secrete neurotoxins of both host den viral origin. De essential features of **HIV-associated dementia** (**HAD**) be disabling cognitive impairment wey be accompanied by motor dysfunction, speech problems den behavioral change. Cognitive impairment be characterised by mental slowness, trouble plus memory den poor concentration. Motor symptoms dey include a loss of fine motor control wey dey lead to clumsiness, poor balance den tremors. Behavioral changes fi include apathy, lethargy den diminished emotional responses den spontaneity. Histopathologically, e be identified by de infiltration of monocytes den macrophages into de central nervous system (CNS), gliosis, pallor of myelin sheaths, abnormalities of dendritic processes den neuronal loss.

HAD typically dey occur after years of HIV infection wey e be associated plus low CD4+ T cell levels den high plasma viral loads. Dem sam times dey see am as de first sign of de onset of AIDS. Prevalence be between 10 den 24% insyd Western countries wey na e be seen insyd 1–2% of India-based infections. Plus de advent of highly active antiretroviral therapy (HAART), na de incidence of HAD decline insyd developed countries, although ein prevalence dey increase. HAART fi prevent anaa delay de onset of HAD insyd people plus HIV infection, wey e sanso fi improve mental function insyd people wey already get HAD.

Dementia dey exist per wen neurocognitive impairment insyd de patient be severe enough to interfere markedly plus day-to-day function. Dat be, de patient be typically unable to work wey dem no fi be able to take care of demaselves. Before dis, dem say de patient get a mild neurocognitive disorder.

## References
Helicobacter pylori

***Helicobacter pylori***, dem previously know as ***Campylobacter pylori***, be a gram-negative, flagellated, helical bacterium. Mutants fi get a rod anaa curved rod shape wey dey exhibit less virulence. Na dem think ein helical body (from wich de genus name *Helicobacter* dey derive) e evolve to penetrate de mucous lining of de stomach, wey ein flagella help, den thereby establish infection. While na chaw earlier reports of an association between bacteria den de ulcers exist, such as de works of John Lykoudis, na e be insyd 1983 per wen na dem formally describe de bacterium for de first time insyd de English-language Western literature as de causal agent of gastric ulcers by Australian physician-scientists Barry Marshall den Robin Warren. Insyd 2005, na dem award de pair de Nobel Prize insyd Physiology anaa Medicine for dema discovery.

Infection of de stomach plus *H. pylori* no dey necessarily cause illness: over half of de global population be infected, buh chaw individuals be asymptomatic. Persistent colonization plus more virulent strains fi induce a number of gastric den non-gastric disorders. Gastric disorders secof infection dey begin plus gastritis, anaa inflammation of de stomach lining. Wen infection be persistent, de prolonged inflammation go cam be chronic gastritis. Initially, dis go be non-atrophic gastritis, buh de damage cause to de stomach lining fi bring about de development of atrophic gastritis den ulcers within de stomach einself anaa de duodenum (de nearest part of de intestine). At dis stage, de risk of developing gastric cancer be high. However, de development of a duodenal ulcer dey confer a comparatively lower risk of cancer. *Helicobacter pylori* be class 1 carcinogenic bacteria, den potential cancers dey include gastric MALT lymphoma den gastric cancer. Infection plus *H. pylori* be responsible for an estimated 89% of all gastric cancers wey be linked to de development of 5.5% of all cases cancers worldwide. *H. pylori* be de bacterium per dem know to cause cancer.

Extragastric complications wey be linked to *H. pylori* dey include anemia secof either iron deficiency anaa vitamin B12 deficiency, diabetes mellitus, cardiovascular illness, den certain neurological disorders. An inverse association sanso been claimed plus *H. pylori* get a positive protective effect against asthma, esophageal cancer, inflammatory bowel disease (wey dey include gastroesophageal reflux disease den Crohn's disease), den odas.

Some studies dey suggest say *H. pylori* dey play an important role insyd de natural stomach ecology by e dey influence de type of bacteria wey colonize de gastrointestinal tract. Oda studies dey suggest say non-pathogenic strains of *H. pylori* fi beneficially normalize stomach acid secretion, den regulate appetite.

Insyd 2023, na dem estimate say about two-thirds of de world ein population be infected plus *H. pylori*, e be more common insyd developing countries. Na de prevalence decline insyd chaw countries secof eradication treatments plus antibiotics den proton-pump inhibitors, den plus increased standards of living. 

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Hypothermia

**Hypothermia** be defined as a body core temperature below  insyd humans. Symptoms dey depend on de temperature. Insyd mild hypothermia, der be shivering den mental confusion. Insyd moderate hypothermia, shivering stops den confusion dey increase. Insyd severe hypothermia, der fi be hallucinations den paradoxical undressing, insyd wich a person komot dema clothing, as well as an increased risk of de heart stopping.

Hypothermia get two main types of causes. E classically dey occur from exposure to cold weather den cold water immersion. E sanso fi occur from any condition wey dey decrease heat production anaa dey increase heat loss. Commonly, dis dey include alcohol intoxication buh sanso fi include low blood sugar, anorexia, den advanced age. Body temperature usually be maintained near a constant level of  thru thermoregulation. Efforts to increase body temperature dey involve shivering, increased voluntary activity, den putting on warmer clothing. Hypothermia fi be diagnosed based on either a person ein symptoms insyd de presence of risk factors anaa by measuring a person ein core temperature.

De treatment of mild hypothermia dey involve warm drinks, warm clothing, den voluntary physical activity. Insyd those plus moderate hypothermia, heating blankets den warmed intravenous fluids be recommended. People plus moderate anaa severe hypothermia for be moved gently. Insyd severe hypothermia, extracorporeal membrane oxygenation (ECMO) anaa cardiopulmonary bypass fi be useful. Insyd those widout a pulse, cardiopulmonary resuscitation (CPR) be indicated along plus de above measures. Rewarming typically be continued til a person ein temperature be greater dan . If der be no improvement at dis point anaa de blood potassium level be greater dan 12 millimoles per litre at any time, resuscitation fi be discontinued.

Hypothermia be de cause of at least 1,500 deaths a year insyd de United States. E be more common insyd older people den males. Na one of de lowest documented body temperatures from wich sam bro plus accidental hypothermia survive be  insyd a 2-year-old boy from Poland dem name Adam. Na dem describe survival after more dan six hours of CPR. Insyd individuals for whom ECMO anaa bypass be used, survival be around 50%. Na deaths secof hypothermia play an important role insyd chaw wars.

De term be from Greek ῠ̔πο (ypo), wey dey mean "under", den θέρμη (*thérmē*), wey dey mean "heat". De opposite of hypothermia be hyperthermia, an increased body temperature secof failed thermoregulation.

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## External links

* CDC - NIOSH Workplace Safety & Health Topic: Cold Stress
Diclofenac

**Diclofenac**, dem sell under de brand name **Voltaren** among odas, be a nonsteroidal anti-inflammatory drug (NSAID) dem use to treat pain den inflammatory diseases such as gout. Dem fi take am orally (dem swallow by mouth), dem insert rectally as a suppository, dem inject intramuscularly, dem inject intravenously, dem apply to de skin topically, anaa thru eye drops. Improvements insyd pain dey last up to eight hours. E sanso be available as de fixed-dose combination diclofenac/misoprostol (Arthrotec) to help protect de stomach; however, proton pump inhibitors such as omeprazole typically be first-line since dem be at least as effective as misoprostol, buh plus better tolerability.

Common side effects dey include abdominal pain, gastrointestinal bleeding, nausea, dizziness, headache, den swelling. Serious side effects fi include heart disease, stroke, kidney problems, den stomach ulceration. Ein use no be recommended insyd de third trimester of pregnancy. E likely be safe during breastfeeding. Dem dey believe Diclofenac to work by decreasing de production of prostaglandins, like oda drugs insyd dis class.

Insyd 2023, na e be de 73rd most commonly prescribed medication insyd de United States, plus more dan 9million prescriptions. E be available as ein acid anaa insyd two salts, as either diclofenac sodium anaa potassium.

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Atorvastatin

**Atorvastatin**, dem sell under de brand name **Lipitor** among odas, be a statin medication dem use to prevent cardiovascular disease insyd those at high risk den to treat abnormal lipid levels. For de prevention of cardiovascular disease, statins be a first-line treatment insyd reducing cholesterol. Dem dey take am by mouth.

Common side effects fi include diarrhea, heartburn, nausea, muscle pain (typically mild den dose-dependent) den, less frequently, joint pain. Muscle symptoms often dey occur during de first year den be commonly influenced by pre-existing health issues den de nocebo effect. Chaw patients fi continue therapy plus dose adjustment anaa statin switching. Rare (

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Mild cognitive impairment

**Mild cognitive impairment** (**MCI**) be a diagnosis wey dey reflect an intermediate stage of cognitive impairment wey be often, buh no be always, a transitional phase from cognitive changes insyd normal aging to those dem typically find insyd dementia, especially dementia secof Alzheimer's disease (Alzheimer's dementia). MCI fi include both memory den non-memory neurocognitive impairments. About 50 percent of people dem diagnose plus MCI get Alzheimer's disease wey dey go on to develop Alzheimer's dementia within five years. MCI sanso fi serve as an early indicator give oda types of dementia, although MCI sanso fi remain stable anaa remit. Chaw definitions of MCI dey exist. A common feature of chaw of dese be say MCI dey involve cognitive impairments wey be measurable buh wey no be significant enough to interfere plus instrumental activities of daily living.

De DSM-5 dey introduce de concept of mild neurocognitive disorder (mNCD), wich be designed to be largely equivalent to MCI. De International Classification of Diseases (ICD-11) dey refer to MCI as "Mild Neurocognitive Disorder (MND)". E be controversial whether MCI for be used as a diagnosis.

De definition of MCI dey continue to evolve. Academic discussion dey revolve around whether MCI for be classified anaa diagnosed algorithmically anaa clinically, de reliability of clinical judgment, stability of de diagnosis over time, den de utility anaa predictivity of biomarkers. Differences insyd de definition den implementation of de MCI construct fi explain sam discrepancies between research studies.

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Strabismus

**Strabismus** be an eye disorder insyd wich de eyes no dey properly align plus each oda wen looking at an object. De eye wey be pointed at an object fi alternate. De condition fi be present occasionally anaa constantly. If present during a large part of kiddie time, e fi result in amblyopia ("lazy eyes") den loss of depth perception. If onset be during adulthood, e be more likely to result in double vision.

Strabismus fi occur out of muscle dysfunction (e.g., myasthenia gravis), farsightedness, problems insyd de brain, trauma, anaa infections. Risk factors dey include premature birth, cerebral palsy, den a family history of de condition. Types dey include esotropia, wer na de eyes be crossed ("cross eyed"); exotropia, wer de eyes diverge ("lazy eyed" anaa "wall eyed"); den hypertropia anaa hypotropia, wer dem be vertically misaligned. Dem sanso fi be classified by whether de problem be present insyd all directions a person dey look (comitant) anaa dey vary by direction (incomitant). Anoda condition wey dey produce similar symptoms be a cranial nerve disease. Dem fi make diagnosis by observing de light wey dey reflect from de person ein eyes den finding say e no be centered on de pupil. Dis be known as de Hirschberg reflex test.

Treatment dey depend on de type of strabismus den de underlying cause. Dis fi include de use of eyeglasses den possibly surgery. Sam types dey benefit from early surgery. Strabismus dey occur insyd about 2% of kiddies. De term dey cam from de Ancient Greek word στραβισμός (*strabismós*), wey dey mean 'a squinting'. Oda terms for de condition dey include "squint" den "cast of the eye".

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## External links

* AAO Complex strabismus simulator
* UC Davis strabismus simulator
Sexually transmitted infection

A **sexually transmitted infection** (**STI**), dem sanso refer to as a **sexually transmitted disease** (**STD**) den de older term **venereal disease** (**VD**), be an infection wey be spread by sexual activity, especially vaginal intercourse, anal sex, oral sex, anaa sam times manual sex. STIs often initially no dey cause symptoms, wich dey result in a risk of transmitting dem to odas. De term *sexually transmitted infection* generally be preferred over *sexually transmitted disease* anaa *venereal disease*, as e dey include cases plus no symptomatic disease. Symptoms den signs of STIs fi include vaginal discharge, penile discharge, ulcers on anaa around de genitals, den pelvic pain. Sam STIs fi cause infertility.

Bacterial STIs dey include chlamydia, gonorrhea, den syphilis. Viral STIs dey include genital warts, genital herpes, den HIV/AIDS. Parasitic STIs dey include trichomoniasis. Chaw STIs be treatable den curable; of de most common infections, syphilis, gonorrhea, chlamydia, den trichomoniasis be curable, while HIV/AIDS den genital herpes no be curable. Sam vaccinations fi decrease de risk of certain infections wey dey include hepatitis B den a few types of HPV. Safe sex practices such as de use of condoms, dem get smaller number of sexual partners, den dem be insyd a relationship in wich each person has sex per plus de oda sanso dey decrease STIs risk. Comprehensive sex education sanso fi be useful.

STI diagnostic tests usually be easily available insyd de developed world, buh dem be often unavailable insyd de developing world. Der often be shame den stigma associated plus STIs. Insyd 2015, na STIs oda dan HIV result in 108,000 deaths worldwide. Globally, insyd 2015, na about 1.1&nbsp;billion people get STIs oda dan HIV/AIDS. About 500 million get either syphilis, gonorrhea, chlamydia anaa trichomoniasis. At least na an additional 530 million get genital herpes, den 290&nbsp;million women get human papillomavirus. Historical documentation of STIs insyd antiquity dey date back to at least de Ebers Papyrus () den de Hebrew Bible/Old Testament (8th/7th C. BCE).

## Cause

### Transmission
A sexually transmitted infection present insyd a pregnant woman fi be passed on to de infant before anaa after birth.

### Bacterial

* Chancroid (*Haemophilus ducreyi*)
* Chlamydia (*Chlamydia trachomatis*)
* Gonorrhea (*Neisseria gonorrhoeae*)
* Granuloma inguinale or (*Klebsiella granulomatis*)
* *Mycoplasma genitalium*
* *Mycoplasma hominis*
* Syphilis (*Treponema pallidum*)
* Ureaplasma infection

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## External links

* CDC Sexually Transmitted Diseases Treatment Guidelines, 2010
* STD photo library  at Dermnet
* UNFPA: Breaking the Cycle of Sexually Transmitted Infections at UNFPA
* STDs In Color: Sexually Transmitted Disease Facts and Photos
* CDC: Sexually transmitted diseases in the U.S.
* STI Watch: World Health Organization
Pick's disease

**Behavioral variant frontotemporal dementia** (BvFTD) na dem previously know as ***Pick's disease***, wey e be de most common of de FTD types. BvFTD be diagnosed four times as often as de PPA variants. Behavior fi change insyd BvFTD insyd either of two ways—e fi change to e be impulsive den disinhibited, dey act insyd socially unacceptable ways; anaa e fi change to e be listless den apathetic. About 12–13% of people plus bvFTD dey develop motor neuron disease.

De Pick bodies wich be present insyd behavioral variant FTD be spherical inclusion bodies dem find insyd de cytoplasm of affected cells. Dem dey consist of tau fibrils as a major component togeda plus a number of oda protein products wey dey include ubiquitin den tubulin.

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* Patient group
Hydroxyzine

**Hydroxyzine**, dem sell under de brand names **Atarax** den **Vistaril** among odas, be an antihistamine medication. Dem dey use am insyd de treatment of itchiness, anxiety, insomnia, den nausea (wey dey include dat secof motion sickness). Dem dey use am either by mouth anaa injection into a muscle.

Hydroxyzine dey work by blocking de effects of histamine. E be a first-generation antihistamine insyd de piperazine family of chemicals. Common side effects dey include sleepiness, headache, den dry mouth. Serious side effects fi include QT prolongation. E be unclear if ein use during pregnancy anaa breastfeeding be safe.

Na Union Chimique Belge first make am insyd 1956 wey na dem approve am for sale by Pfizer insyd de United States later dat year. Insyd 2023, na e be de 39th most commonly prescribed medication insyd de United States, plus more dan 15million prescriptions.

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Naproxen

**Naproxen**, dem sell under de brand name **Aleve** among odas, be a nonsteroidal anti-inflammatory drug (NSAID) dem use to treat pain, menstrual cramps, den inflammatory diseases such as rheumatoid arthritis, gout den fever. Dem dey take am orally. E be available insyd immediate den delayed release formulations. Onset of effects be within an hour den dey last for up to twelve hours. Naproxen sanso be available insyd salt form, **naproxen sodium**, wich get better solubility wen dem take am orally.

Common side effects dey include dizziness, headache, bruising, allergic reactions, heartburn, den stomach pain. Severe side effects dey include an increased risk of heart disease, stroke, gastrointestinal bleeding, den stomach ulcers. De heart disease risk fi be lower dan plus oda NSAIDs. E no be recommended insyd people plus kidney problems. Ein use no be recommended insyd de third trimester of pregnancy.

Naproxen br a nonselective COX inhibitor. As an NSAID, naproxen dey appear to exert ein anti-inflammatory action by reducing de production of inflammatory mediators dem call prostaglandins. E be metabolized by de liver to inactive metabolites.

Na dem patent naproxen insyd 1967 wey na dem approve am for medical use insyd de United States insyd 1976. Insyd de United States e be available over-the-counter den as a generic medication. Insyd 2023, na e be de 103rd most commonly prescribed medication insyd de United States, plus more dan 6million prescriptions. Naproxen be a therapeutic alternative on de World Health Organization's List of Essential Medicines.

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Sundowning

**Sundowning**, anaa **sundown syndrome**, prevalent among people plus sam form of dementia, be characterized by increased confusion den restlessness beginning insyd de late afternoon den early evening. Na dem coin de term *sundowning* by nurse Lois K. Evans insyd 1987 secof de association between de person ein increased confusion den de setting of de sun.

For people plus sundown syndrome, a multitude of behavioral problems dey begin to occur wey be associated plus long-term adverse outcomes. Sundowning seem dey occur more frequently during de middle stages of Alzheimer's disease den mixed dementia den dey seem to subside plus de progression of de person ein dementia. People be generally able to understand dat dis behavioral pattern be abnormal. Research dey show say 20–45% of people plus Alzheimer's go experience sam variation of sundowning confusion. However, despite lack of an official diagnosis of sundown syndrome insyd de Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), der be currently a wide range of reported prevalence.

## References
Vascular dementia

**Vascular dementia** be dementia wey be caused by a series of strokes. Restricted blood flow secof strokes dey reduce oxygen den glucose delivery to de brain, wey dey cause cell injury den neurological deficits insyd de affected region.  Subtypes of vascular dementia dey include subcortical vascular dementia, multi-infarct dementia, stroke-related dementia, den mixed dementia.

Subcortical vascular dementia dey occur from damage to small blood vessels insyd de brain. Multi-infarct dementia dey result from a series of small strokes wey dey affect chaw brain regions. Stroke-related dementia wey dey involve successive small strokes dey cause a more gradual decline insyd cognition. Dementia fi occur wen neurodegenerative den cerebrovascular pathologies mix, as insyd susceptible elderly people (75 years den older). Cognitive decline fi be traced back to occurrence of successive strokes.

ICD-11 dey list vascular dementia as *dementia due to cerebrovascular disease*. DSM-5 dey list vascular dementia as either *major anaa mild vascular neurocognitive disorder*.

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Myocarditis

**Myocarditis** be inflammation of de cardiac muscle. Myocarditis fi progress to **inflammatory cardiomyopathy** wen der be associated ventricular remodeling den cardiac dysfunction secof chronic inflammation. Symptoms fi include shortness of breath, chest pain, decreased ability to exercise, den an irregular heartbeat. De duration of problems fi vary from hours to months. Complications fi include heart failure, secof dilated cardiomyopathy anaa cardiac arrest.

Myocarditis most often be secof a viral infection. Oda causes dey include bacterial infections, certain medications, toxins den autoimmune disorders. A diagnosis fi be supported by an electrocardiogram (ECG), increased troponin, heart MRI, den occasionally a heart biopsy. An ultrasound of de heart be important to rule out oda potential causes, such as heart valve problems.

Treatment dey depend on both de severity den de cause. Dem often dey use medications such as ACE inhibitors, beta blockers, den diuretics. A period of no exercise typically be recommended during recovery. Corticosteroids anaa intravenous immunoglobulin (IVIG) fi be useful insyd certain cases. Insyd severe cases, an implantable cardiac defibrillator anaa heart transplant fi be recommended.

Insyd 2013, na about 1.5 million cases of acute myocarditis occur. While people of all ages be affected, de young most often be affected. E be slightly more common insyd males dan females. Chaw cases be mild. Insyd 2015, na cardiomyopathy, wey dey include myocarditis, result insyd 354,000 deaths, up from 294,000 insyd 1990. De initial descriptions of de condition be from de mid-1800s.

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Vitamin C

**Vitamin C** (dem sanso know as **ascorbic acid** den **ascorbate**) be a water-soluble vitamin dem find insyd citrus den oda fruits, berries den vegetables. E sanso be a generic prescription medication den insyd sam countries dem dey sell am as a non-prescription dietary supplement. As a therapy, e be used to prevent den treat scurvy, a disease wey be caused by vitamin C deficiency. 

Vitamin C be an essential nutrient wey be involved insyd de repair of tissue, de formation of collagen, den de enzymatic production of certain neurotransmitters. E be required for de functioning of chaw enzymes wey e be important for immune system function. E sanso dey function as an antioxidant. Dem fi take Vitamin C by mouth anaa by intramuscular, subcutaneous anaa intravenous injection. Various health claims dey exist on de supposition wey moderate vitamin C deficiency dey increase disease risk, such as for de common cold, cancer anaa COVID-19. Der sanso be claims of benefits from vitamin C supplementation insyd excess of de recommended dietary intake for people wey dem no be considered vitamin C deficient. Vitamin C generally be well tolerated. Large doses fi cause gastrointestinal discomfort, headache, trouble sleeping, den flushing of de skin. De United States National Academy of Medicine ey recommend against consuming large amounts.

Chaw animals be able to synthesize dema own vitamin C. However, higher primates (wey dey include humans), chaw bats, guinea pigs, sam fish species, den sam bird species for acquire am from dietary sources secof a gene for a synthesis enzyme get mutations wey render am dysfunctional.

Na dem discover Vitamin C insyd 1912, dem isolate am insyd 1928, den insyd 1933, na e be de first vitamin to be chemically produced. Partly for ein discovery, na dem award Albert Szent-Györgyi de 1937 Nobel Prize insyd Physiology anaa Medicine. 

## References


## External links
Wandering (dementia)

**Wandering** dey occur wen a person plus dementia dey roam around den dey cam be lost anaa confused about dema location. E be a common behavior wey fi cause great risk for de person, den often be de major priority (den concern) for caregivers. E be estimated to be de most common form of disruption from people plus dementia within institutions. Although e dey occur insyd chaw types of dementia, wandering be especially common insyd people plus Alzheimer's disease. People plus dementia often dey wander secof dem be stressed, dey look for sam bro anaa sam thing, dey attend to basic needs, dey engage insyd past routines, anaa plus visual-spatial problems. Oda times, dem fi wander widout any clear reason.

## References


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Toxoplasmosis

**Toxoplasmosis** be a parasitic disease wey *Toxoplasma gondii*, an apicomplexan dey cause. Infections plus toxoplasmosis be associated plus a variety of neuropsychiatric den behavioral conditions. Occasionally, people fi get a few weeks anaa months of mild, flu-like illness such as muscle aches den tender lymph nodes. Insyd a small number of people, eye problems fi develop. Insyd those plus a weakened immune system, severe symptoms such as seizures den poor coordination fi occur. If a woman cam be infected during pregnancy, a condition dem know as **congenital toxoplasmosis** fi affect de kiddie.

Toxoplasmosis usually be spread by eating poorly cooked food wey dey contain cysts, by exposure to infected cat feces, anaa from an infected woman to ein baby during pregnancy. Rarely, de disease fi be spread by blood transfusion anaa oda organ transplant. E be thought to no otherwise spread between people, buh broader transmissibility dey remain a matter of scientific debate. Na studies report de presence of *T. gondii* insyd human semen wey na dem propose sexual transmission as a possible route, though na dis no be established as a primary mode of spread. De parasite be known per to reproduce sexually insyd de cat family. E fi infect chaw types of warm-blooded animals, wey dey include humans. Diagnosis typically be by testing blood for antibodies anaa by testing de amniotic fluid insyd a pregnant patient for de parasite ein DNA.

Prevention be by properly preparing den cooking chow. Dem sanso dey recommend pregnant women make dem no clean cat litter boxes anaa, if dem must, make dem wear gloves den wash dema hands afterwards. Treatment of otherwise healthy people usually no dey hia. During pregnancy, spiramycin anaa pyrimethamine/sulfadiazine den folinic acid fi be used for treatment.

Up to half of de world ein population be infected by *T.&nbsp;gondii*, buh dem get no symptoms. Insyd de United States, na approximately 11% of people be infected, while insyd sam areas of de world dis be more dan 60%. Approximately na 200,000 cases of congenital toxoplasmosis occur a year. Na Charles Nicolle den Louis Manceaux first describe de organism insyd 1908. Insyd 1941, na dem confirm transmission during pregnancy from a pregnant woman to ein baby. Der be tentative evidence say otherwise asymptomatic infection fi affect people dema behavior.

## References


## Bibliography
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## External links

* How a cat-borne parasite infects humans (National Geographic)
* Toxoplasmosis at Health Protection Agency (HPA), United Kingdom
* Pictures of Toxoplasmosis Medical Image Database
* Video-Interview with Professor Robert Sapolsky on Toxoplasmosis and its effect on human behavior (24:27 min)
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Sildenafil

**Sildenafil**, dem sell under de brand name **Viagra** among odas, be a medication dem use to treat erectile dysfunction den pulmonary arterial hypertension. E sanso sam times be used off-label for de treatment of certain symptoms insyd secondary Raynaud's phenomenon. E be unclear if e be effective for treating sexual dysfunction insyd females. Dem fi take am orally (dem swallow by mouth), intravenously (injection into a vein), anaa thru de sublingual route (dem dissolve under de tongue). Onset wen dem take am orally be typically within twenty minutes den dey last for about two hours.

Common side effects dey include headaches, heartburn, den flushed skin. Caution be advised insyd those plus cardiovascular disease. Rare buh serious side effects dey include vision problems, hearing loss, den prolonged erection (priapism) wey fi lead to damage to de penis. Sildenafil for no be taken by people on nitric oxide donors such as nitroglycerin, as dis fi result in a serious drop in blood pressure.

Sildenafil dey act by blocking phosphodiesterase 5 (PDE5), an enzyme wey dey promote breakdown of cGMP, wich dey regulate blood flow insyd de penis. E dey require sexual arousal to work, den no dey by einself cause anaa increase sexual arousal. E sanso dey result in dilation of de blood vessels insyd de lungs.

Na Pfizer originally discover de medication insyd 1989 while dem dey look for a treatment give angina. Na dem approve am for medical use insyd de United States den insyd de European Union insyd 1998. Insyd 2023, na e be de 151st most commonly prescribed medication insyd de United States, plus more dan 3million prescriptions. E be available as a generic medication. Insyd de United Kingdom, e be available as a pharmacy medicine.

## References


## External links
Organic brain syndrome

**Organic brain syndrome**, dem sanso know as **organic brain disease**, **organic brain damage**, **organic brain disorder** (**OBD**), **organic mental syndrome**, anaa **organic mental disorder**, dey refer to any syndrome anaa disorder of mental function wey ein cause be alleged to be known as organic (physiologic) rather dan purely of de mind. Dese names be older den nearly obsolete general terms from psychiatry, wey dey refer to chaw physical disorders wey dey cause impaired mental function. Dem be meant to exclude psychiatric disorders (mental disorders). Originally, na dem create de term to distinguish physical (dem term "organic") causes of mental impairment from psychiatric (dem term "functional") disorders, buh during de era wen na dem draw dis distinction, na dem no know enough about brain science (wey dey include neuroscience, cognitive science, neuropsychology, den mind-brain correlation) for dis cause-based classification to be more dan educated guesswork dem label plus misplaced certainty, wich be why na e be deemphasized insyd current medicine. While mental anaa behavioural abnormalities wey relate to de dysfunction fi be permanent, treating de disease early fi prevent permanent damage in addition to fully restoring mental functions. An organic cause to brain dysfunction be suspected wen der be no indication of a clearly defined psychiatric anaa "inorganic" cause, such as a mood disorder.

### Associated conditions
Disorders wey be related to injury anaa damage to de brain den dey contribute to OBS include, buh no be limited to:

* Alcoholism
* Alzheimer's disease
* Attention deficit/hyperactivity disorder
* Autism
* Concussion
* Encephalitis
* Epilepsy
* Fetal alcohol syndrome
* Hypoxia

* Parkinson's disease
* Intoxication/overdose wey substance use disorders wey dey include alcohol use disorder dey cause
* Non-medical use of sedative hypnotics
* Intracranial hemorrhage/trauma
* Korsakoff syndrome
* Mastocytosis
* Meningitis
* Psychoorganic syndrome
* Stroke/transient ischemic attack (TIA)
* Withdrawal from drugs, especially sedative hypnotics, e.g. alcohol anaa benzodiazepines

## References


## External links

* AllRefer Health.com. 13 December 2006.
Post-concussion syndrome

**Post-concussion syndrome** anaa (**PCS**), dem sanso know as persisting postconcussive symptoms, be a set of symptoms wey fi continue for weeks, months, anaa years after a concussion. PCS be medically classified as a mild traumatic brain injury (TBI anaa, more specifically, mTBI). About 35% of people plus concussion experience persistent anaa prolonged symptoms 3 to 6 months after injury. Prolonged concussion be defined as having concussion symptoms for over four weeks dey follow de first accident insyd youth den for weeks anaa months insyd adults.

Dem fi make a diagnosis wen symptoms wey dey result from concussion last for more dan three months after de injury. Loss of consciousness no be required for a diagnosis of concussion anaa post-concussion syndrome. However, e be important say patients find help as soon as dem notice lingering symptoms within one month, den especially wen dem notice dema mental health deteriorating, since dem be at risk of post-concussion syndrome depression.

Though der be no specific treatment for PCS, symptoms fi be improved plus medications den physical den behavioral therapy. Education about symptoms den details about expectation of recovery be important. De majority of PCS cases dey resolve after a period of time.

## References
Cyclobenzaprine

**Cyclobenzaprine**, dem sell under chaw brand names wey dey include, historically, **Flexeril**, be a muscle relaxer dem use give muscle spasms from musculoskeletal conditions of sudden onset. E no be useful insyd cerebral palsy. Dem dey take am by mouth.

Common side effects dey include headache, tiredness, dizziness, den dry mouth. Serious side effects fi include an irregular heartbeat. Der be no evidence of harm insyd pregnancy, buh na e no be well studied insyd dis population. E for no be used togeda plus MAOIs. How e dey work be unclear. Insyd any case, e be known to inhibit serotonin den norepinephrine reuptake den to block serotonin, adrenergic, histamine, den muscarinic acetylcholine receptors. Chemically, e be very similar to tricyclic antidepressants like amitriptyline.

Na dem approve cyclobenzaprine for medical use insyd de United States insyd 1977. E be available by prescription as a generic medication. Insyd 2023, na e be de 47th most commonly prescribed medication insyd de United States, plus more dan 13million prescriptions. Na e no be available insyd de United Kingdom as of 2012.

## References


## External links
Fatal insomnia

**Fatal insomnia** be a neurodegenerative disease wey dey result in trouble sleeping as ein hallmark symptom. De majority of cases be familial (**fatal familial insomnia** [**FFI**]), wey dey stem from a mutation insyd de *PRNP* gene, plus de remainder of cases wey dey occur sporadically (**sporadic fatal insomnia** [**sFI**]). De problems plus sleeping typically dey start out gradually den worsen over time. Eventually, de patient go succumb to total insomnia (*agrypnia excitata*), most often wey dey lead to oda symptoms such as speech problems, coordination problems, den dementia. E dey result in death within a few months to a few years, wey der no be known disease-modifying treatment.

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Spinal muscular atrophy

**Spinal muscular atrophy** (**SMA**) be a rare neuromuscular disorder wey dey result in de loss of motor neurons den progressive muscle wasting. E be usually diagnosed insyd infancy anaa early kiddie time den if dem lef am untreated e be de most common genetic cause of infant death. E sanso fi appear later insyd life den then get a milder course of de disease. De common feature be de progressive weakness of voluntary muscles, plus de arm, leg, den respiratory muscles be affected first. Associated problems fi include poor head control, difficulties swallowing, scoliosis, den joint contractures. 

De age of onset den de severity of symptoms dey form de basis of de traditional classification of spinal muscular atrophy into chaw types.

Spinal muscular atrophy be secof an abnormality (mutation) insyd de *SMN1* gene wich dey encode SMN, a protein necessary for de survival of motor neurons. Loss of dese neurons insyd de spinal cord dey prevent signalling between de brain den skeletal muscles. Anoda gene, *SMN2*, be considered a disease modifying gene, since usually de more *SMN2* copies be present, de milder be de course of de disease. De diagnosis of SMA be based on symptoms den confirmed by genetic testing.

Usually, de mutation insyd de *SMN1* gene be inherited from both parents insyd an autosomal recessive manner, although insyd around 2% of cases e dey occur during early development (*de novo*). De incidence of spinal muscular atrophy worldwide dey vary from about 1 insyd 4,000 births to around 1 insyd 16,000 births, plus 1 insyd 7,000 den 1 insyd 10,000 dem commonly quote for Europe den de US respectively.

Outcomes insyd de natural course of de disease dey vary from death within a few weeks after birth insyd de most acute cases to normal life expectancy insyd de protracted SMA forms. Medications wey dey target de genetic cause of de disease dey include nusinersen, risdiplam, den de gene therapy medication onasemnogene abeparvovec. Supportive care dey include physical therapy, occupational therapy, respiratory support, nutritional support, orthopaedic interventions, den mobility support.
## References


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## External links

* ''SMA'' at NINDS
* SMArt Moves. Cure SMA. Retrieved 3 December 2021.