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<s>[INST]Answer this question truthfully: What is the condition Hyperlipoproteinemia type 5?[/INST] A reduced HDL-C level is associate with ASCVD</s>

<s>[INST]Answer this question truthfully: What is a cataract, and what type of information is available regarding it?[/INST] A standard eye exam and slit lamp examination are used to diagnose cataracts. Other diagnostic tests are rarely needed. A comprehensive eye exam includes: Visual acuity test: This eye chart test measures how well you see at various distances. Dilated eye exam: Drops are placed in your eyes to widen, or dilate, the pupils. Your eye care professional uses a special magnifying lens to examine your retina and optic nerve for signs of damage and other eye problems. After the exam, your close-up vision may remain blurred for several hours. Tonometry: An instrument measures the pressure inside the eye. Numbing drops may be applied to your eye for this test.</s>

<s>[INST]Answer this question truthfully: Can you provide a summary of Mycoplasma pneumonia?[/INST] Antimicrobial therapy is the mainstay of therapy for atypical pneumonia caused by Mycoplasma. Pharmacologic therapies for Mycoplasma pneumonia include either a macrolide (e.g. azithromycin) for 2-5 days, doxycycline for 14 days, or a fluoroquinolone for 14 days. Supportive therapy includes rest, adequate fluid intake, and administration of either non-steroidal anti-inflammatory drugs (NSAIDS) or acetaminophen if needed. Aspirin should be avoided among children. There is no vaccine against Mycoplasma. There are no preventive measures against Mycoplasma pneumonia. However, avoiding infected individuals helps reduce risk of infection.</s>

<s>[INST]Answer this question truthfully: What is the history and what are the symptoms of truncus arteriosus?[/INST] Bluish skin (cyanosis) Delayed growth or growth failure Fatigue Lethargy Poor feeding Rapid breathing (tachypnea) Shortness of breath (dyspnea)</s>

<s>[INST]Answer this question truthfully: What are the historical background and symptoms associated with tricuspid stenosis?[/INST] Tricuspid stenosis is mostly associated with mitral valve abnormalities. Common symptoms include dyspnea, peripheral edema, and fatigue. Tricuspid stenosis (TS) is the narrowing of the tricuspid orifice that obstructs blood flow from the right atrium to the right ventricle. Almost all cases result from rheumatic fever. Symptoms include a fluttering discomfort in the neck, fatigue, cold skin, and right upper quadrant abdominal discomfort. Jugular pulsations are prominent, and a presystolic murmur is often heard at the left sternal edge in the 4th intercostal space and is increased during inspiration. The diagnosis is by echocardiography. TS is usually benign, requiring no specific treatment, but symptomatic patients may benefit from surgery.</s>

<s>[INST]Answer this question truthfully: What is the recommended medical treatment for cellulitis?[/INST] Appropriate wound care is essential for the management of all diabetic foot ulcers. Uninfected diabetic ulcers do not require antibiotic therapy. For acutely infected wounds, empiric antibiotic with efficacy against Gram-positive cocci should be initiated after obtaining a post- debridement specimen for aerobic and anaerobic culture. Infections with antibiotic-resistant organisms and those that are chronic, previously treated, or severe usually require broader spectrum regimens. Click on the following categories to expand treatment regimens. Uninfected (Grade 1) No Evidence of Infection Mild (Grade 2) Acute Infection Without Recent Antibiotic Use High Risk for MRSA Moderate to Severe (Grade 34) Chronic Infection or Recent Antibiotic Use High Risk for MRSA High Risk for Pseudomonas aureuginosa Polymicrobial Infection Uninfected Wound, No Evidence of Infection Uninfected wounds should be managed with appropriate wound care. Antibiotic therapy is not recommended. Mild DFI, Acute Infection Without Recent Antibiotic Use Preferred Regimen Dicloxacillin 125250 mg PO qid OR Clindamycin 150300 mg PO qid OR Cephalexin 500 mg PO qid OR Levofloxacin 750 mg PO qd OR Amoxicillin-Clavulanate 500 mg PO bid (or 250 mg PO tid) Usually active against community-associated MRSA, but check macrolide sensitivity and consider ordering a D-test before using for MRSA. Relatively broad-spectrum oral agent that includes anaerobic coverage. Mild DFI, High Risk for MRSA Preferred Regimen Doxycycline 100 mg PO q12h OR TMPSMX 80-160 mg/400-800 mg PO q12h Active against many MRSA & some gram-negatives; uncertain against streptococci. Moderate to Severe DFI, Chronic Infection or Recent Antibiotic Use Preferred Regimen Levofloxacin 750 mg IV/PO q24h OR Cefoxitin 1 g IV q4h (or 2 g IV q68h) OR Ceftriaxone 12 g/day IV/IM q1224h OR AmpicillinSulbactam 1.53 g IV/IM q6h OR Moxifloxacin 400 mg IV/PO q24h OR Ertapenem 1 g IV/IM q24h OR Tigecycline 100 mg IV, then 50 mg IV q12h OR ImipenemCilastatin 0.51 g IV q68h Alternative Regimen Levofloxacin 750 mg IV/PO q24h OR Ciprofloxacin 6001200 mg/day IV q612h OR Ciprofloxacin 12002700 mg IV q612h (for more severe cases) PLUS Clindamycin 150300 mg PO qid Active against MRSA. Not active against MRSA; consider when ESBL-producing pathogens suspected. Moderate to Severe DFI, High Risk for MRSA Preferred Regimen Linezolid 600 mg IV/PO q12h OR Daptomycin 4 mg/kg IV q24h OR Vancomycin 1520 mg/kg IV q812h (trough: 1020 mg/L) Moderate to Severe DFI, High Risk for Pseudomonas aeruginosa Preferred Regimen PiperacillinTazobactam 3.375 g IV q68h Moderate to Severe DFI, Polymicrobial Infection Preferred Regimen Vancomycin 1520 mg/kg IV q812h (trough: 1020 mg/L) OR Linezolid 600 mg IV/PO q12h OR Daptomycin 4 mg/kg IV q24h PLUS PiperacillinTazobactam 3.375 g IV q68h OR ImipenemCilastatin 0.51 g IV q68h OR Ertapenem 1 g IV/IM q24h OR Meropenem 1 g IV q8h Alternative Regimen Vancomycin 1520 mg/kg IV q812h (trough: 1020 mg/L) OR Linezolid 600 mg IV/PO q12h OR Daptomycin 4 mg/kg IV q24h PLUS Ceftazidime 2 g IV q8h OR Cefepime 2 g IV q8h OR Aztreonam 2 g IV q68h PLUS Metronidazole 15 mg/kg IV, then 7.5 mg/kg IV q6h</s>

<s>[INST]Answer this question truthfully: What is the underlying mechanism or cause of aplastic anemia?[/INST] Genes involved in the pathogenesis of aplastic anemia include: HLA-DR15 CD4+ CD25+ FOXP3+ regulatory T cells STAT3 TERT TERC</s>

<s>[INST]Answer this question truthfully: Could you explain the meaning of ejection fraction, please?[/INST] In cardiovascular physiology, ejection fraction (E f) is the fraction of blood pumped out of a ventricle with each heart beat. The term ejection fraction applies to both the right and left ventricles; one can speak equally of the left ventricular ejection fraction (LVEF) and the right ventricular ejection fraction (RVEF). Without a qualifier, the term ejection fraction refers specifically to that of the left ventricle. By definition, the volume of blood within a ventricle immediately before a contraction is known as the end-diastolic volume. Similarly, the volume of blood left in a ventricle at the end of contraction is end-systolic volume. The difference between end-diastolic and end-systolic volumes is the stroke volume, the volume of blood ejected with each beat. Ejection fraction (E f) is the fraction of the end-diastolic volume that is ejected with each beat; that is, it is stroke volume (SV) divided by end-diastolic volume (EDV): <math>E_f = \frac{SV}{EDV} = \frac{EDV - ESV}{EDV}</math></s>

<s>[INST]Answer this question truthfully: What is the meaning of periventricular leukomalacia?[/INST] The prognosis for individuals with PVL depends upon the severity of the brain damage. Some children exhibit fairly mild symptoms, while others have significant deficits and disabilities. Template:Disease-stub Template:Certain conditions originating in the perinatal period de:Periventrikulre Leukomalazie</s>

<s>[INST]Answer this question truthfully: What does drug-induced pulmonary toxicity mean?[/INST] Careful and extensive investigations in multiple visits to ensure the idiopathic interstitial pneumonia is accurately diagnosed.:*10 to 20% of patients with IPF have positive rheumatoid factor or positive circulating anti-nuclear antibodies (ANAs), but rarely are titers high. However only the presence of high titers (> 1:160) would suggest the presence of a connective tissue disease. *</s>

<s>[INST]Answer this question truthfully: What is the history and what are the symptoms of ST elevation myocardial infarction?[/INST] The onset of symptoms in myocardial infarction (MI) is usually gradual, over several minutes, and rarely instantaneous.</s>

<s>[INST]Answer this question truthfully: Dehydroepiandrosterone is a compound, what are its effects and what are its uses?[/INST] Studies have shown that DHEA is useful in patients with systemic lupus erythematosus. An application of the evidence was reviewed by the U.S. Food and Drug Administration in 2001 and is available online. This review also shows that cholesterol and other serum lipids decrease with the use of DHEA (mainly a decrease in HDL-C and triglycerides can be expected in women, p110). DHEA supplementation has been studied as a treatment for Alzheimer's disease, but was found to be ineffective. Some small placebo-controlled randomized clinical trial studies have found long-term supplementation to improve mood and relieve depression or to decrease insulin resistance. However, a larger placebo-controlled randomized clinical trial reported in the New England Journal of Medicine in 2006 found that DHEA supplementation in elderly men and women had no beneficial effects on body composition, physical performance, insulin sensitivity, or quality of life. DHEA supplements are sometimes used as muscle-building or performance-enhancing drugs by athletes. However, a randomized placebo-controlled trial found that DHEA supplementation had no effect on lean body mass, strength, or testosterone levels. A 1986 study found that a higher level of endogenous DHEA, as determined by a single measurement, correlated with a lower risk of death or cardiovascular disease. However, a more recent 2006 study found no correlation between DHEA levels and risk of cardiovascular disease or death in men. Some in vitro studies have found DHEA to have an anti-proliferative or apoptotic effect on cancer cell lines. The clinical significance of these findings, if any, is unknown. Higher levels of DHEA, in fact, have been correlated with an increased risk of developing breast cancer in both pre- and postmenopausal women. A 2002 review found that DHEA was difficult to study in an animal model. The authors concluded that there was no evidence that DHEA was beneficial for any of the conditions for which it had been studied to that point, that it was associated with significant side effects, and that based on these findings, "there is currently no scientific reason to prescribe DHEA for any purpose whatsoever." In the United States, dietary supplements containing DHEA or DHEAS have been advertised with claims that they may be beneficial for a wide variety of ailments. DHEA and DHEAS are readily available in the United States, where they are regulated as foods rather than as medications. Given the lack of any proven benefit from DHEA supplementation, a 2004 review in the American Journal of Sports Medicine concluded that "The marketing of this supplement's effectiveness far exceeds its science."</s>

<s>[INST]Answer this question truthfully: What are some other diagnostic tests used for identifying diffuse large B cell lymphoma?[/INST] Other diagnostic studies for diffuse large B cell lymphoma include: Laparoscopy (rarely performed) Laparotomy (rarely performed) Bone marrow aspiration and biopsy</s>

<s>[INST]Answer this question truthfully: Can you provide any information about fleas?[/INST] The goal of treatment is to get rid of the fleas by treating the home, pets, and outside areas with insecticide. Small children should not be in the home when insecticides are being used. Birds and fish must be protected during spraying. Home foggers and flea collars do not always work. If home treatments do not work, professional extermination may be needed. If flea bites occur, an over-the-counter 1% hydrocortisone cream can help relieve itching.</s>

<s>[INST]Answer this question truthfully: What is the likelihood of developing an infection after undergoing a stent placement procedure?[/INST] Coronary artery stent infection has occured in approximately 2 dozen cases as of 2012.</s>

<s>[INST]Answer this question truthfully: What are the symptoms and history of malaise?[/INST] It is not possible to easily determine the cause of the malaise, and thus whether it is slight or not, and whether it is an emergency or not (for example, a cancer is very serious, possibly deadly, but it is usually not an absolute emergency as the life is not likely to be threatened in the next hours). The first response is: To keep the person safe, protected from the external dangers and weather (cover with a jacket or a blanket in cold conditions); To place the person to rest, possibly in a calm place: to propose the recumbent position, but to let the person adopt the most comfortable position; the aim is to prevent from falling down, and to make the blood circulation easier; To ask questions: How does the person feel, When did it start, If it is the first time it has happened, If the person has a known disease, known health problems, If the person had a recent accident, If the person is under medical treatment, If the person was already hospitalized; Talk to the person to calm him or her down.</s>

<s>[INST]Answer this question truthfully: What does mass imaging of the lung mean?[/INST] The evaluation of lung mass depends on the following 5 characteristics: Calcification: Calcification patterns are commonly seen in granulomatous disease and hamartomas. They are normally a sign of benign lung mass. The characteristic benign calcification patterns of lung mass include: Diffuse Central Laminated Popcorn Size: Any area of pulmonary opacification that measures more than 30 mm (3 cm) has to be evaluated to determine the histology of the tissue. Location: Common locations of lung mass are pleural, endobronchial, and parenchymal. Margins: The different types of margins for lung mass include lobulated or scalloped margins and smooth margins. The lobulated or scalloped margins are associated with intermediate malignancy probability whereas smooth margins are associated with benign nature of lung mass. Attenuation: Lung mass may have different types of attenuation. Common types of attenuation are solid (malignancy rate of only 7%), calcified, partly solid (malignancy rate of 63%), and ground glass (malignancy rate of 18%).</s>

<s>[INST]Answer this question truthfully: What does junctional bradycardia mean?[/INST] Junctional bradycardia is a slow (40 to 60 beats per minute) narrow complex escape rhythm that originates in the atrioventricular node to compensate for slow or impaired conduction of pacemaker activity in the atrium.</s>

<s>[INST]Answer this question truthfully: What are the possible diagnoses that could be considered for type 1 diabetes mellitus?[/INST] Diabetes mellitus type 2 Diabetes insipidus Gestational diabetes</s>

<s>[INST]Answer this question truthfully: What are the epidemiological and demographic characteristics of membranoproliferative glomerulonephritis?[/INST] Membranoproliferative glomerulonephritis Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Membranoproliferative glomerulonephritis from other Diseases Epidemiology and Demographics Risk Factors Screening Natural History, Complications and Prognosis Diagnosis Diagnostic Study of Choice History and Symptoms Physical Examination Laboratory Findings Electrocardiogram Chest X Ray CT MRI Echocardiography or Ultrasound Other Imaging Findings Other Diagnostic Studies Treatment Medical Therapy Surgery Primary Prevention Secondary Prevention Cost-Effectiveness of Therapy Future or Investigational Therapies Case Studies Case #1 Membranoproliferative glomerulonephritis epidemiology and demographics On the Web Most recent articles Most cited articles Review articles CME Programs Powerpoint slides Images American Roentgen Ray Society Images of Membranoproliferative glomerulonephritis epidemiology and demographics All Images X-rays Echo & Ultrasound CT Images MRI Ongoing Trials at Clinical Trials.gov US National Guidelines Clearinghouse NICE Guidance FDA on Membranoproliferative glomerulonephritis epidemiology and demographics CDC on Membranoproliferative glomerulonephritis epidemiology and demographics Membranoproliferative glomerulonephritis epidemiology and demographics in the news Blogs on Membranoproliferative glomerulonephritis epidemiology and demographics Directions to Hospitals Treating Membranoproliferative glomerulonephritis Risk calculators and risk factors for Membranoproliferative glomerulonephritis epidemiology and demographics Membranoproliferative glomerulonephritis (MPGN) is observed in 6-12% of US patients receiving renal biopsies. This entity accounts for 7% of children and 12% of adults with idiopathic nephrotic syndrome. MPGN causes significant proportion of the cases of nephritis among patients in nonindustrialized countries. For example, in Mexico, MPGN accounts for 40% of all patients with nephritis. Most of these patients have type I disease; MPGN type II is uncommon. However, the incidence of MPGN type I is decreasing progressively in developed countries, which may be explained by a change in environmental factors, especially a decline in infections. In an investigation of the changing patterns of adult primary glomerular disease occurrence in a single region of the United Kingdom, Hanko analyzed the results of 1844 native renal biopsies taken between 1976 and 2005 (inclusive) and found the presence of primary glomerulonephritis was revealed in 49% of the biopsies, with the most common forms being immunoglobulin A (IgA) nephropathy (38.8%). Other common forms were membranous nephropathy (29.4%), minimal-change disease (MCD) (9.8%), MPGN type 1 (9.6%), and focal segmental glomerulosclerosis (FSGS) (5.7%). The incidence of IgA nephropathy increased significantly over the study period, whereas the occurrence of membranous nephropathy decreased. In the United States, MPGN predominantly affects the white population. Type I disease affects women more often than men, whereas a nearly equal sex distribution is seen in MPGN type II. The idiopathic forms of MPGN are more common in children and young adults (range, 6-30 y). Isolated reports of involvement in patients as young as 2 years and as old as 80 years are noted in the literature. Secondary types of MPGN predominate among adults. By dividing glomerular diseases into two subtypes, which are Nephrotic or Nephritic, subdividing into several specific disease will be much more easier .The incidence of MPGN (as a lesion in renal biopsies) ranges from 1.4 to 9.3 cases per million population (pmp) per year and with few exceptions, the incidence has decreased over time.</s>

<s>[INST]Answer this question truthfully: What classification does Toxoplasmosis belong to?[/INST] Acute: If the duration of symptoms is less than 4-6 weeks Chronic: If the symptoms persist for more than 6 weeks. Neurotoxoplasmosis (cerebral toxoplasmosis) Pulmonary toxoplasmosis Occular toxoplasmosis Congenital toxoplasmosis</s>

<s>[INST]Answer this question truthfully: What information does an MRI provide for someone with acute viral nasopharyngitis?[/INST] There are no MRI findings associated with acute viral nasopharyngitis.</s>

<s>[INST]Answer this question truthfully: What is meant by blood type?[/INST] Transfusion medicine is a specialized branch of hematology that is concerned with the study of blood groups, along with the work of a blood bank to provide a transfusion service for blood and other blood products. Across the world, blood products must be prescribed by a medical doctor (licensed physician or surgeon) in a similar way as medicines. In the USA, blood products are tightly regulated by the Food and Drug Administration. Much of the routine work of a blood bank involves testing blood from both donors and recipients to ensure that every individual recipient is given blood that is compatible and is as safe as possible. If a unit of incompatible blood is transfused between a donor and recipient, a severe acute immunological reaction, hemolysis (RBC destruction), renal failure and shock are likely to occur, and death is a possibility. Antibodies can be highly active and can attack RBCs and bind components of the complement system to cause massive hemolysis of the transfused blood. Patients should ideally receive their own blood or type-specific blood products to minimize the chance of a transfusion reaction. Risks can be further reduced by cross-matching blood, but this may be skipped when blood is required for an emergency. Cross-matching involves mixing a sample of the recipient's blood with a sample of the donor's blood and checking to see if the mixture agglutinates, or forms clumps. If agglutination is not obvious by direct vision, blood bank technicians usually check for agglutination with a microscope. If agglutination occurs, that particular donor's blood cannot be transfused to that particular recipient. In a blood bank it is vital that all blood specimens are correctly identified, so labeling has been standardized using a barcode system known as ISBT 128. The blood group may be included on identification tags or on tattoos worn by military personnel, in case they should need an emergency blood transfusion. Frontline German Waffen-SS had such tattoos during World War II. Ironically, this was an easy form of SS identification. Rare blood types can cause supply problems for blood banks and hospitals. For example Duffy -negative blood occurs much more frequently in people of African origin, and the rarity of this blood type in the rest of the population can result in a shortage of Duffy-negative blood for patients of African ethnicity. Similarly for RhD negative people, there is a risk associated with travelling to parts of the world where supplies of RhD negative blood are rare, particularly East Asia, where blood services may endeavor to encourage Westerners to donate blood. A pregnant woman can make IgG blood group antibodies if her fetus has a blood group antigen that she does not have. This can happen if some of the fetus' blood cells pass into the mother's blood circulation (e.g. a small fetomaternal hemorrhage at the time of childbirth or obstetric intervention), or sometimes after a therapeutic blood transfusion. This can cause Rh disease or other forms of hemolytic disease of the newborn (HDN) in the current pregnancy and/or subsequent pregnancies. If a pregnant woman is known to have anti-RhD antibodies, the RhD blood type of a fetus can be tested by analysis of fetal DNA in maternal plasma to assess the risk to the fetus of Rh disease. Antibodies associated with some blood groups can cause severe HDN, others can only cause mild HDN and others are not known to cause HDN.</s>

<s>[INST]Answer this question truthfully: What is the significance of MRI in the diagnosis of dermatomyositis?[/INST] Utilizing an MRI for the diagnosis of dermatomyositis is useful because it can detect subtle muscle inflammation and swelling in early stages of the disease.</s>

<s>[INST]Answer this question truthfully: Could you give me an overview of Papillorenal syndrome, please?[/INST] The renal coloboma syndrome differentials include most of the disease with renal and ocular anomalies. The numerous important differentials are CHARGE Syndrome that includes characteristic five features of the disease including Coloboma, Heart Abnormalities, Choanal Atresia, Growth and development Retardation, Genital Anomalies, Ear and hearing abnormalities. A lot of patients studied under Renal-coloboma syndrome do not have any sort of craniofacial anomalies that are typical of CHARGE Syndrome. Branchio-oto-renal syndrome - Renal hypoplasia in these patients makes this an important differential. Pt with PAX6 Mutations - significant overlap with eye findings in patients with PAX6 gene mutation make it an important differential but the renal anomalies that are typical for RCS are absent in these patients. COACH Syndrome or Joubert - Important differential due to the presence of both renal abnormalities and coloboma in these patients. However, patients with Renal-coloboma syndrome does not have any developmental abnormality, cerebellar abnormalities, and/or hepatic dysfunction. Cat Eye Syndrome - This genetic abnormality is having symptomatic overlap with Renal-coloboma syndrome but the Iris coloboma that is typical for RCS is usually not observed in this disorder.</s>

<s>[INST]Answer this question truthfully: What do molecular genetic studies entail regarding 21-Hydroxylase deficiency?[/INST] The CYP21 gene for the P450c21 enzyme (also known as 21-hydroxylase) is at 6p21.3, amid genes HLA B and HLA DR coding for the major human histocompatibility loci (HLA). CYP21 is paired with a nonfunctional pseudogene CYP21A. Scores of abnormal alleles of CYP21 have been documented, most arising from recombinations of homologous regions of CYP21 and CYP21A. Differences in residual enzyme activity of the various alleles account for the various degrees of severity of the disease. Inheritance of all forms of 21-hydroxylase CAH is autosomal recessive. Persons affected by any forms of the disease have two abnormal alleles, and both parents are usually carriers (heterozygotes). When parents both carry an abnormal allele, each child has a 25% chance of having the disease, a 50% chance of being an asymptomatic carrier like parents, and a 25% chance of having two normal genes. It is now possible to test for heterozygosity by measuring 17-hydroxyprogesterone elevation after ACTH stimulation, or more recently by direct gene sequencing.</s>

<s>[INST]Answer this question truthfully: Could you provide more context or is that the complete sentence? If it's complete the phrasing is grammatically correct.[/INST] Moderately impaired mental ability Problems with swallowing. The Other symptoms may include Vomiting Arthritis Hoarseness Breathing difficulty Xanthemas which thicken around joints as the disease progresses Lipogranulomas - small lumps of fat in the skin Swollen lymph nodes Hepatosplenomegaly Swollen joints Joint contractures (chronic shortening of muscles or tendons around joints) Impaired intellectual ability</s>

<s>[INST]Answer this question truthfully: What is the importance of performing HLA analysis in cases of Transfusion-associated Graft versus Host Disease?[/INST] TA-GvHD can be suspected from a biopsy of the affected skin, and established by HLA analysis of the circulating lymphocytes. This testing can identify circulating lymphocytes with a different HLA type than the tissue cells of the host.</s>

<s>[INST]Answer this question truthfully: What is Beriberi, and how is screening utilized to detect it?[/INST] There is insufficient evidence to recommend routine screening for beriberi.</s>

<s>[INST]Answer this question truthfully: What is the medical treatment for Roseola?[/INST] The mainstay of therapy for roseola is supportive as HHV 6 typically causes a benign, self limited illness in infants and antiviral therapy is not indicated. Supportive therapy for roseola includes antipyretics such as acetaminophen if associated with discomfort. Intravenous foscarnet and ganciclovir are proposed as first line treatment for HHV 6 encephalitis for 3 to 4 weeks.</s>

<s>[INST]Answer this question truthfully: What is the history of Blastomycosis and what are its symptoms?[/INST] Clinical manifestations of Blastomycosis range from subclinical infection to fatal disseminated disease. Symptoms are based on the involvement of organ systems: Presents clinically as acute and chronic. The symptoms often mimic with bacterial pneumonia presentation. Most common symptoms include: Fever with chills Productive cough Hemoptysis. Weight loss Night sweats chest pain ARDS can develop as a result of endo-bronchial spread of infection which is dreadful complication with high mortality rate. The most common extra pulmonary sites involved in blastomycosis are skin, bone, genitourinary and CNS. Skin is involved in 40-80% of the cases. The cutaneous manifestations of blastomycosis comes in two forms verrucous and ulcerative. Cutaneous blastomycosis is often confused with basal cell or squamous cell carcinomas or pyoderma gangrenosum. Verrucous Ulcerative Location Above the subcutaneous abscess Drain-out from subcutaneous abscess through skin Morphology Irregularly shaped lesions with raised and crusted borders Heaped up borders with or without exudative base Microscopic findings Papillomatosis Pseudo epitheliomatous hyperplasia Acanthosis (hyperplasia and diffuse thickening of the stratum spinosum of the epidermis) Micro-abscesses About 25% of the blastomycosis involve bone. Osteomyelitis is the most common presentation of oseous blastomycosis. Most commonly involved bones include vertebrae, ribs, skull and long bones. Infection can spread from the involved bone to surrounding joints (purulent arthritis) or soft tissue (subcutaneous abscess with draining sinus which can lead to the formation of an ulcer. The most common complication of vertebral osteomyelitis is extension of infection from the spine, resulting para-vertebral or psoas abscess. About 10 % of the blastomycosis involves genitourinary system. In men the most commonly involved organs include prostate, testicles and epididymis. Epididymo-orchitis causes swelling and pain, and prostatitis is associated with dysuria and symptoms of obstruction. Involvement of female genitourinary system is rare but if involved it causes endometrial infection or tubo-ovarian abscess. About 5-10 % of blastomycosis involve CNS. It presents as meningitis or mass lesion. CSF analysis of WBC reveals neutrophilic predominance. Laryngea l involvement causes hoarseness. Blastomycosis can disseminate almost to any other site such as liver, spleen, breast, lymph nodes etc.</s>

<s>[INST]Answer this question truthfully: How is CT utilized in diagnosing or treating meningioma?[/INST] Head CT scan may be diagnostic of meningioma. Some of the findings on CT scan suggestive of meningioma include edema, CSF attenuation cleft, round/elongated extraaxial mass, and hyperostosis of the adjacent skull. Although MRI is the diagnostic study of choice, CT is easier to use and may be used in cases where there is a contraindication to the use of an MRI.</s>

<s>[INST]Answer this question truthfully: What does the term "esophageal candidiasis" refer to?[/INST] Esophageal candidiasis is classified according to the severity of lesions seen during endoscopy.</s>

<s>[INST]Answer this question truthfully: What is the secondary prevention method for external otitis?[/INST] Preventing recurrence of otitis externa revolves around effectively diagnosing infectious or dermatologic etiologies and ensuring appropriate topical or systemic therapy is administered.</s>

<s>[INST]Answer this question truthfully: Can you provide a summary of what hemorrhoids are?[/INST] There is no medical treatment for hemorrhoids. Medical therapy aims to provide symptomatic relief from constipation. Local treatments such as warm sitz baths, cold compress, and topical analgesic (such as nupercainal) can provide temporary relief. Surgery is not the first-line treatment option for patients with hemorrhoids. Surgical intervention is usually reserved for patients with either complicated or large hemorrhoids (beyond grade III). Primary prevention of hemorrhoids may include drinking excessive fluids, regular exercise, practicing better posture, and reduction of bowel movement straining and time. Eating a high-fiber diet can make stools softer and easier to pass, reducing the pressure on hemorrhoids caused by straining. The secondary preventive measures for hemorrhoids are similar to primary preventive measures.</s>

<s>[INST]Answer this question truthfully: Can you explain what a sebaceous cyst is?[/INST] A sebaceous cyst (a form of trichilemmal cyst) is a closed sac or cyst below the surface of the skin that has a lining that resembles the uppermost part (infundibulum) of a hair follicle and fills with a fatty white, semi-solid material called sebum. Sebum is produced by sebaceous glands of the epidermis.</s>

<s>[INST]Answer this question truthfully: Can you provide an explanation or summary of portal hypertension?[/INST] Based on the etiology, portal hypertension may be classified as pre- hepatic, intra- hepatic, and post- hepatic. Intra- hepatic portal hypertension classified into pre- sinusoidal, sinusoidal, and post- sinusoidal disorders. Based on the function impairment in the liver, portal hypertension may be classified as cirrhotic and non- cirrhotic.</s>

<s>[INST]Answer this question truthfully: How is echocardiography utilized for the diagnosis of congestive heart failure?[/INST] Echocardiography is commonly used to diagnose and monitor the progression of heart failure. This modality uses ultrasound to determine the stroke volume (SV, the amount of blood in the heart that exits the ventricles with each beat), the end-diastolic volume (EDV, the total amount of blood at the end of diastole), and the SV divided by the EDV, a value known as the ejection fraction (EF). In pediatrics, the shortening fraction is the preferred measure of systolic function.</s>

<s>[INST]Answer this question truthfully: What is the connection between Colitis and Secondary Prevention?[/INST] Effective measures for the secondary prevention of proctocolitis include: Abstinence from sexual activity until the patient and their partners are successfully treated (i.e., completion of a 7-day regimen and resolution of symptoms) Sexual partners with individuals treated for chlamydia or gonorrhea <60 days before the onset of symptoms should receive evaluation and empiric treatment of the causative infection Testing for other sexually-transmitted diseases In case of proctocolitis caused by chlamydia or Neisseria gonorrhea, retesting for the causative organism is recommended 3 months after completion of treatment.</s>

<s>[INST]Answer this question truthfully: Could you provide me with the context in which you want the sentence to be rephrased, so that I can provide the most accurate rephrasing possible?[/INST] Rh disease is one of the causes of hemolytic disease of the newborn (also known as HDN). The disease ranges from mild to severe. When the disease is mild the fetus may have mild anaemia with reticulocytosis. When the disease is moderate or severe the fetus can have a more marked anaemia and erythroblastosis (erythroblastosis fetalis). When the disease is very severe it can cause morbus haemolyticus neonatorum, hydrops fetalis, or stillbirth.</s>

<s>[INST]Answer this question truthfully: What is the historical background of low-density lipoprotein?[/INST] In 1949, a new method for quantitative measurement of LDL and other lipoproteins using ultracentrifuge was developed. In 1950, LDL was first isolated. In 1963, another lipoprotein, Lp(a), was discovered as a complex particle in human plasma in an immunochemical study. In 1973, Myant first hypothesized the role of LDL in the metabolism of cholesterol. In 1979, the Lipid Research Clinics Coronary Primary Prevention Trial (LRC-CPPT) demonstrated that reductions in total cholesterol and LDL were associated with reduction in coronary heart disease risk. It was reported that a 25% reduction in cholesterol or a 35% reduction in LDL cholesterol resulted in a 49% decrease in coronary heart disease risk.</s>

<s>[INST]Answer this question truthfully: What are the factors that lead to echinococcosis?[/INST] Scolex of Echinococcus granulosus from hydatid cyst. From Public Health Image Library (PHIL). Photomicrograph reveals some of the ultrastructural morphology exhibited by an adult cestode, Echinococcus granulosus, found in a dog. E. granulosus causes cystic echinococcosis. From Public Health Image Library (PHIL).</s>

<s>[INST]Answer this question truthfully: Which laboratory tests are utilized to diagnose Scarlet Fever?[/INST] Diagnosis of scarlet fever is clinical. The blood tests shows marked leukocytosis with neutrophilia and conservated or increased eosinophils, high ESR and CRP, and elevation of antistreptolysin O titer. Blood culture is rarely positive, but the streptococci can usually be demonstrated in throat culture.</s>

<s>[INST]Answer this question truthfully: Could you provide me with the target audience for the rephrased sentence for me to provide you with a contextually appropriate response?[/INST] It was first described in 1969.</s>

<s>[INST]Answer this question truthfully: Could you explain the meaning of "idiopathic sclerosing mesenteritis"?[/INST] Sclerosing mesenteritis may present with no or nearly no signs or symptoms, but many people have chronic and severe pain in the abdomen as the most common chief complaint. Other people have chronic problems with bowel movements, resulting in diarrhea, bloating, gas, and cramping which can range from severe to mild. The disorder is identified by histopathology showing fat necrosis, fibrosis and chronic inflammation of the small intestine. Examination of the mesentery may indicate a solitary mass, but diffuse mesentery thickening is common.</s>

<s>[INST]Answer this question truthfully: What are the potential risks linked to cardiac disease and acute myocardial infarction during pregnancy?[/INST] The following should be considered in diagnosis and treatment of this condition: Criteria for diagnosis of AMI in pregnant women are in general the same as in non pregnant patients (symptoms, exam, ECG, biomarkers, +/- imaging/angiography). 37% of patients undergoing elective C-section have EKG changes suggestive of MI or ischemia. Echocardiography to assess regional wall motion abnormalities can be useful. Note that creatine kinase and its MB fraction can increase nearly 2-fold within 30 minutes after delivery, as can troponin levels. If exercise stress testing is indicated, a submaximal protocol (<70% of maximal predicted heart rate) with fetal monitoring is preferred. Radionuclide imaging using 99m technetium-labeled sestamibi or 201 thallium, as well as cardiac catheterization or interventional procedure, are expected to yield<11 rad of radiation to the conceptus, which is generally considered safe; termination of pregnancy is generally recommended at a level of 10 rads.</s>

<s>[INST]Answer this question truthfully: Could you provide me with an overview of eclampsia, please?[/INST] Detection and management of preeclampsia is critical to reduce the risk of eclampsia. Appropriate management of patients with preeclampsia generally involves the use of magnesium sulfate as an agent to prevent convulsions, and thus preventing eclampsia.</s>

<s>[INST]Answer this question truthfully: What are the standard guidelines for creating chapters and sub-chapters?[/INST] Goal: To summarize all applicable chest x ray findings related to the condition. Appropriate content: Indications and contraindications Advantages and disadvantages Characteristics of chest x rays with the condition Chest x ray copyleft image examples Remember: You cannot take copyright images and post them to WikiDoc. All images posted as examples must be from a copyleft source such as National Library of Medicine, RadsWiki, Radiopedia. If there is any doubt as to whether an image is copyleft, please consult with Dr. Gibson . There should be no information that could identify a patient on any image.</s>

<s>[INST]Answer this question truthfully: What information is available regarding reserpine, hydralazine, and hydrochlorothiazide?[/INST] Before taking reserpine, hydralazine, and hydrochlorothiazide: tell your doctor and pharmacist if you are allergic to reserpine, hydralazine, hydrochlorothiazide, sulfa drugs, tartrazine (a yellow dye in some medications and processed foods), or any other drugs. tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially amitriptyline (Elavil), aspirin, clomipramine (Anafranil), desipramine (Norpramin), digoxin (Lanoxin), doxepin (Adepin, Sinequan), ephedrine, epinephrine, imipramine (Tofranil), indomethacin (Indocin), MAO inhibitors phenelzine (Nardil) and tranylcypromine (Parnate), methylphenidate (Ritalin), metoprolol (Lopressor), nortriptyline (Aventyl, Pamelor), phenylephrine, propranolol (Inderal), protriptyline (Vivactil), quindine (Quinaglute), trimipramine (Surmontil), and vitamins. tell your doctor if you have or have ever had liver or kidney disease, asthma, lupus, gallstones, diabetes, a heart attack, coronary artery disease, rheumatic heart disease, a history of depression, an ulcer, ulcerative colitis, or electric shock therapy. tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking reserpine, hydralazine, and hydrochlorothiazide, call your doctor. if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking this medication. you should know that this medication may make you drowsy or dizzy. Do not drive a car or operate machinery until you know how it affects you. ask your doctor about the safe use of alcohol while you are taking reserpine, hydralazine, and hydrochlorothiazide. Alcohol can make the side effects from this medication worse.</s>

<s>[INST]Answer this question truthfully: What is the historical background or context of primary hyperaldosteronism?[/INST] Primary hyperaldosteronism (Conn's syndrome) was described for the first time by the Polish internist, Micha Lityski. In 1955, Dr Jerome W. Conn, the American endocrinologist, first described the condition and named it Conn's syndrome. Over the last few decades other more rare type of primary hyperaldosteronism have also been described. From 1960s to early 1970s, techniques of diagnosis and treatment were greatly improved by the availability of spironolactone, realization of the renin-angiotensin-aldosterone system, and progress in laboratory tests and adrenal venous sampling.</s>

<s>[INST]Answer this question truthfully: What information exists regarding congenital herpes?[/INST] http://www.nlm.nih.gov/medlineplus/ency/article/001368.htm Template:WH Template:WS</s>

<s>[INST]Answer this question truthfully: What is the underlying biological mechanism of osteoporosis?[/INST] On gross pathology, decreased bone density and small pores in diaphysis of bones are characteristic findings of osteoporosis. In advanced forms of the disease some pathological fractures may be seen. Gross pathology of osteoporotic bone in contrast with normal bone, showing the decrease in trabecular bone mineral density (BMD) - By Turner Biomechanics Laboratory, via Wikimedia.org</s>

<s>[INST]Answer this question truthfully: What does a Subarachnoid hemorrhage CT refer to?[/INST] The modality of choice for diagnosis of subarachnoid hemorrhage is noncontrast head computed tomography (CT), with or without lumbar puncture The sensitivity of CT to the presence of subarachnoid blood is strongly influenced by both the amount of blood and the time since the hemorrhage</s>

<s>[INST]Answer this question truthfully: What are the names of antacids and drugs, and could you provide an explanation for each one?[/INST] Examples of antacids (brand names may vary in different countries). Aluminum hydroxide (Amphojel , AlternaGEL ) Magnesium hydroxide (Phillips Milk of Magnesia) Aluminum hydroxide and magnesium hydroxide (Maalox , Mylanta ) Aluminum carbonate gel (Basaljel ) Calcium carbonate (Alcalak , TUMS , Quick-Eze , Rennie , Titralac , Rolaids ) Sodium bicarbonate (Bicarbonate of soda, Alka-Seltzer ) Hydrotalcite (Mg 6 Al 2 (CO 3)(OH) 16 4(H 2 O); Talcid ) Bismuth subsalicylate (Pepto-Bismol) Magaldrate + Simethicone (Pepsil) Template:Major Drug Groups Template:Antacids Template:WikiDoc Sources ca:Anticid de:Antazidum hr:Antacidi nl:Antacidum sk:Antacidum sl:Antacid sr: sh:Antacid fi:Antasidi sv:Antacida th:</s>

<s>[INST]Answer this question truthfully: What is the "Resident Survival Guide for Acetaminophen Overdose"?[/INST] Acetaminophen overdose is the intentional or accidental ingestion of a high dose of acetaminophen. Acute acetaminophen overdose occurs 8 hours before presentation, while chronic acetaminophen overdose occurs following the repeated supratherapeutic ingestion of acetaminophen. Acetaminophen is available in the U.S. market under the following brand names: Tylenol Anacin-3 Liquiprin Percocet Tempra Cold and flu medicines Aceta Actimin Apacet Aspirin Free Anacin Atasol Banesin Dapa Datril Extra-Strength Feverall Fibi Genapap Genebs Panadol</s>

<s>[INST]Answer this question truthfully: What is the cause of paroxysmal supraventricular tachycardia?[/INST] Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. There are no life-threatening causes of disease name, however complications resulting from untreated disease name is common. Life-threatening causes of symptom/manifestation include cause1, cause2, and cause3. Cause is a life-threatening cause of disease. Common causes of disease name may include: Cause1 Cause2 Cause3 OR Disease name is caused by an infection with pathogen name. Pathogen name is caused by pathogen name. Less common causes of disease name include: Cause1 Cause2 Cause3 Disease name is caused by a mutation in the gene name gene. List the causes of the disease in alphabetical order: Cause 1 Cause 2 Cause 3 Cause 4 Cause 5 Cause 6 Cause 7 Cause 8 Cause 9 Cause 10</s>

<s>[INST]Answer this question truthfully: What are the historical background and symptoms associated with Escherichia coli enteritis?[/INST] History-taking for patients with E. coli enteritis should focus on risk factors for the transmission of pathogenic E. coli and development of enteritis: Immunocompromised status Pregnancy Recent ingestion of uncooked or poorly handled vegetables, meat, poultry, raw milk, or poorly stored foods that require refrigeration (e.g. mayonnaise) Enterohemorrhagic E. coli O157:H7 is commonly associated with ingestion of ground beef (e.g. in hamburgers) or alfalfa sprouts Recent drinking from untreated water (e.g. stream or well) Recent travel to developing countries Enterotoxigenic E. coli is the most common cause of traveler's diarrhea Exposure to daycare Exposure to healthcare settings (e.g. nursing homes or hospitals) Exposure to contacts with similar symptoms Recent history of receptive anal or oral - anal contact</s>

<s>[INST]Answer this question truthfully: What is the underlying disease process involved in the development of urethral cancer?[/INST] In end stage type, they may appear as an exophytic mass.</s>

<s>[INST]Answer this question truthfully: Could you please provide me the text you want me to rephrase?[/INST] The term anorexia is of Greek origin: an (privation or lack of) and orexis (appetite) thus meaning a lack of desire to eat. A person who is diagnosed with anorexia nervosa is most commonly referred to with the adjectival form anorexic. The noun form, as in'he is an anorectic', is used less commonly. The term " anorectic " can also refer to any drug that suppresses appetite. "Anorexia nervosa" is frequently shortened to " anorexia " in both the popular media and scientific literature. This is technically incorrect, as strictly speaking "anorexia" refers to the medical symptom of reduced appetite. In popular culture, and especially with anorectics themselves, the term is often shortened to "ana" to avoid sounding clinical and impersonal. " Pro-ana " groups often use the terms "ana" and "mia" (referring to bulimia nervosa) to describe their conditions, as it has less negative connotations than the full medical term. Some pro-ana groups discourage or deride the use of colloquial abbreviations. The history of anorexia nervosa begins with the first recognition and description of anorexia as a disease in the late 19th century. It became widely known, particularly in the United States, in the 1980s. In the late 19th century, the public attention drawn to " fasting girls " provoked conflict between religion and science. Such cases as Sarah Jacob (the "Welsh Fasting Girl") and Mollie Fancher (the "Brooklyn Enigma") stimulated controversy as experts weighed the claims of complete abstinence from food. Believers referenced the duality of mind and body, while skeptics insisted on the laws of science and material facts of life. Critics accused the fasting girls of hysteria, superstition, and deceit. The progress of secularization and medicalization passed cultural authority from clergy to physicians, transforming anorexia nervosa from revered to repulsed. During the period when this disease was first named "anorexia nervosa", in the early to mid 19th century, as opposed to its original title that assumed it was a type of hysteria, doctors began to emphasize and isolate what procedures and techniques contributed to the most successful recoveries in the young women afflicted. One of the most commonly shared opinions in treatment was the isolation of the patient from family, friends, loved ones, and any social connections which in technical terms is termed as a parentectomy. Theories of the reasons for the development and spread of the disease in Victorian society is rooted in the idea of a close-knit and involved family, and especially mothers in their young privileged daughter's life. Women were expected to behave eloquently and were controlled and under constant supervision. It is hypothesized that this was a daughter's way of controlling her life and of trying to look better in society; having control of what was going into her body was the one aspect in her life she fully dominated. It was documented by many physicians that most often as soon as girls were isolated from their social pressures they made quick and successful recoveries from the diseases. Also it was stated that it was the professional and moral authority of doctors and nurses that forced anoretics to begin eating again, and that they did so out of fear of the doctors. Early treatment of anorexia nervosa is illustrated in the novel Second Star to the Right by Deborah Hautzig. In the story, an anorexic girl named Leslie is placed in the behavior-modification ward in a hospital. She is required to drink at least of liquid food per day, or else she is involuntarily force fed by hospital wardens. While the story does fall short in depicting the harsh reality of hospitalized anorexic, it does provide an accurate description of one of the first medical procedures against anorexia nervosa - Force feeding. Other forms of early treatment included "drug therapy, psychoanalysis, dynamic psychotherapy, family therapy, behavior modification, peer counseling and support groups social skills training, assertiveness training, projective art therapy, hypnosis, relaxation techniques, movement therapy,nutritional education, and even sex education." Early treatment was usually a combination of a monitored eating program and psychological instruction which aimed to raise the patients awareness of the disorder and also to promote psychological growth. However, treatments varied on the amount of emphasis placed on the eating program or the psychological instruction. Some programs regarded immediate weight gain as the first step in recovery and psychological growth second, while others emphasized the psychological treatment of the patient over the weight gaining program. Forced feeding was reserved for the most dangerous cases of anorexia nervosa, where a patient becomes so emaciated that his/her life may be in jeopardy. A patient undergoing forced feeding would have invasive tubes placed in his/her nose where food would pass into the body, or could undergo a relatively new process called total parenteral nutrition (TNP). TNP is best described as the process where "an intravenous catheter is inserted so that the tip lies in a large vein near the heart, where blood flow is relatively rapid. Then a concentrated fluid containing a balance of nutrition is infused at a steady rate." The cost of these medical procedures is very high, their success or effectiveness is not guaranteed, and the procedures can vary greatly from doctor to doctor, making anorexia nervosa one of the more difficult disorders to treat. Anorexia nervosa is thought to be a new disease by most people of todays society. This disease, however, is known to have existed since the late 19th century. Today anorexia nervosa is classified as a disease. During the Victorian Era, the disorder was thought to be a form of hysteria that affected mainly women of the middle and upper classes. Obesity during this era was thought to be a characteristic of poverty. In general however, the ideal womans body type during the Victorian era was one that was curvy and full- figured. Many women attempted to achieve this body type through the use of corsets. The role of restrictive corsets during the Victorian era shows the early focus on body type and exemplifies how women, as early as the late 18th century, have been taking extreme measures to achieve the believed ideal body type. (Brumberg, "Fasting Girls"), (Carol Lawson, "Anorexia: It's Not a New Disease") Although the medical facts of anorexia nervosa have been documented since the 1870s, personal details of anorexics' lives are more publicized today than ever before. Since Karen Carpenter's death in 1983, which resulted from complications of the disorder, people recognize and casually label overly thin women as anorexics. Since the late 1980s, many special eating disorder clinics have opened, but it may be difficult to change the eating behavior and mindset of an anorexia victim, especially when they are surrounded by numerous other thin women who have similar eating behaviors. Today, many young women are obsessed with dieting as a form of cultural expression and a way to look as thin as models and celebrities. Anorexia nervosa seems to be more prevalent as the ideal female body image becomes thinner; however, the disorder may have always been this widespread but just less publicized. In the 1980s, slimness embodied the ideal of feminine beauty. It is this that caused many women to incessantly diet in order to keep up with the demands of modern fashion. In a 1984 survey carried out by Glamor magazine of thirty-three thousand women between the ages of eighteen and thirty-five, 75 percent believed they were fat, although only 25 percent were actually overweight (Palm Beach Post, December 26, 1985). Indications of being thin was important to women of the upper class, and this class specific cultural model was pervasive throughout the media including television, film, magazines, and advertising After Growing Pains actress Tracey Gold nearly died from severe complications caused by self-starvation, anorexia in children and adolescents became a more serious issue than in adults. Various pediatric organizations now focus on this issue with methods of counseling designed for the under-18 age groups.</s>

<s>[INST]Answer this question truthfully: What exactly is primary central nervous system lymphoma?[/INST] There are no known direct causes for primary central nervous system lymphoma. To view a comprehensive list of risk factors that increase the risk of primary nervous system lymphoma, click here.</s>

<s>[INST]Answer this question truthfully: Could you explain what angioimmunoblastic T-cell lymphoma is?[/INST] There are no established causes for angioimmunoblastic T-cell lymphoma.</s>

<s>[INST]Answer this question truthfully: What are the other diagnostic tests for Upper Airway Resistance Syndrome?[/INST] It is difficult to confirm diagnosis, as few sleep testing centers have the proper test equipment to recognize the illness. Polysomnography (sleep study) with the use of a probe to measure Pes (esophageal pressure) is the gold standard diagnostic test for UARS. Apneas and hypopneas are absent or present in low numbers. Multiple snore arousals may be seen, and if an esophageal probe (Pes) is used, progressive elevation of esophageal pressure fluctuations terminating in arousals is noted. UARS can also be diagnosed using a nasal cannula/pressure transducer to measure the inspiratory airflow vs time signal.</s>

<s>[INST]Answer this question truthfully: What is the information regarding epithelioid sarcoma?[/INST] Tissue biopsy may be helpful in the diagnosis of epithelioid sarcoma.</s>

<s>[INST]Answer this question truthfully: Could you provide more context or information about the term "ichthyosis" or the sentence where it is used?[/INST] Dry skin Scaly skin Thick skin Dry, scaly skin Icthyosis vulgaris. Adapted from Dermatology Atlas. Icthyosis vulgaris. Adapted from Dermatology Atlas. Icthyosis vulgaris. Adapted from Dermatology Atlas. Icthyosis vulgaris. Adapted from Dermatology Atlas. Icthyosis vulgaris. Adapted from Dermatology Atlas. Icthyosis vulgaris. Adapted from Dermatology Atlas. Icthyosis vulgaris. Adapted from Dermatology Atlas. Icthyosis vulgaris. Adapted from Dermatology Atlas. Icthyosis vulgaris. Adapted from Dermatology Atlas. Icthyosis vulgaris. Adapted from Dermatology Atlas. Skin biopsy</s>

<s>[INST]Answer this question truthfully: What is the main way to prevent gestational trophoblastic neoplasia?[/INST] There are no established measures for primary prevention of gestational trophoblastic neoplasia.</s>

<s>[INST]Answer this question truthfully: Could you please provide the original sentence that needs to be rephrased?[/INST] Currently there is no cure for lichen planus but there are certain types of medicines used to reduce the effects of the inflammation. Lichen planus may go into a dormant state after treatment. There are also reports that lichen planus can flare up years after it is considered cured. Oral and topical steroids. Hydroxychloroquine Tacrolimus Dapsone Oral retinoids Immunosuppressant medications</s>

<s>[INST]Answer this question truthfully: Could you explain the meaning of acne vulgaris?[/INST] There are multiple grading scales for rating the severity of acne vulgaris. Three techniques include the Leeds acne grading technique, which counts and categorizes lesions into inflammatory and non-inflammatory (ranges from 0 to 10.0), Cook's acne grading scale, which uses photographs to rate severity from 0 to 8 (0 being the mildest or least severe and 8 being the most severe), and the Pillsbury scale, which classifies the severity of the acne from 1 (least severe) to 4 (most severe).</s>

<s>[INST]Answer this question truthfully: What are the epidemiological and demographic characteristics of individuals who experience failure to thrive?[/INST] A study in India found that 40% of the population were affected by mild to moderate malnutrition whereas western literature suggests a prevalence of 8% in the pediatric population. Failure to thrive is seen more in children < 2 years of age and during their teenage years when the growth rate of the child is at its highest. The incidence of non-organic failure to thrive has been reported to be somewhere between 30%-50% in the failure to thrive patients. There is no gender or race predisposition. It is found in those families who suffer from a lack of financial resources/education and are burdened with additional stressors like family discord, infidelity, psychiatric conditions, alcohol or drug abuse, etcetera. "Failure to Thrive: A Practical Guide - American Family Physician". Gretchen Homan et al reported that failure to thrive is prevalent in up to 10% of children in primary care and approximately 5% of those who are hospitalized. Another study suggested that failure to thrive accounts for up to 5% of the pediatric admissions for children less than 2 years of age. 15-30% of children seen by acute care services suffer from growth deficits. "Failure To Thrive - StatPearls - NCBI Bookshelf".</s>

<s>[INST]Answer this question truthfully: What is the historical background or context of the patent foramen ovale?[/INST] In 1513, Leonardo da Vinci made the first anatomic description of patent foramen ovale. He wrote this in his notes: "I found from the left chamber to the right chamber a perforating channel, which I note here to see whether this occurs in other auricle (atria) of other hearts". In 1564, the presence of foramen ovale at birth was first described by an Italian surgeon named Leonardi Botali. In 1877, Julius Friedrich Cohnheim, a German pathologist, first described the association between patent foramen ovale and stroke. This was based on a report he made from an autopsy he performed on a 35-year old woman who had a fatal stroke. He found a long thrombus in the lower extremity and a foramen ovale. He wrote in his report "I found a very large foramen ovale through which I could pass three fingers with ease. Now I could no longer ignore the fact that a torn-off piece of thrombus arising from the V. curalis, while traveling through the heart, passed out of the right atrium into the left atrium and to the A. Foss. Sylvii."</s>

<s>[INST]Answer this question truthfully: What is the underlying mechanism of the formation of breast lumps?[/INST] Pathologic findings Microscopic image Phyllodes tumor is a tumor of the intralobular breast stroma and it may be benign or malignant with large slit-like spaces. It is a type of fibroepithelial tumor. Histopathologic image of Phyllodes tumor Source: Nephron, from Wikimedia Commons Sclerosing adenosis microscopic pathology has increased numbers of small breast acini with collapsed lumens, fibrosis surrounds the acini, considered as benign lesion with increased risk of breast cancer. Histopathologic image of sclerosing adenosis Source: Nephron, from Wikimedia Commons ADH, based on a molecular basis, is a low-grade DCIS with localized proliferation. Histopathologic image of atypical ductal hyperplasia Source: Nephron, from Wikimedia Commons</s>

<s>[INST]Answer this question truthfully: What is stent thrombosis and how does it occur?[/INST] Over the years stent thrombosis of bare metal stents (BMS) has been minimized by refining stent design, adopting optimal stenting strategies and improved antiplatelet medication usage from early rates of 24% to a rare and acceptable 0.5-1.5% in the current environment. Following the approval by the FDA, the drug eluting stents (DES) largely replaced BMS, driven solely by the reduced revascularization with relatively little attention paid to the issue of stent thrombosis. Increased usage of DES and continued presentation of patients with ST beyond the first few months of implantation, coupled with the widespread awareness of ST, have led to a steady and increased stream of reporting of ST in DES. Recent description of frequent subclinical insitu thrombus formation within DES in the coronaries by Katani et al , not only took the medical community by surprise but afforded a first hand in-vivo glimpse at the stent site itself.</s>

<s>[INST]Answer this question truthfully: What information is available concerning depression in older people?[/INST] To better manage depression at home, elderly people should: Exercise regularly, seek out pleasurable activities, and maintain good sleep habits. Learn to watch for the early signs of depression, and know how to react if it gets worse. Minimize alcohol use and avoid illegal drugs. These substances can make depression worse over time, and they may also impair judgment about suicide. Surround themselves with people who are caring and positive. Talk about their feelings to someone they trust. Take medications correctly and learn how to manage side effects.</s>

<s>[INST]Answer this question truthfully: What are the reasons for developing epithelial ovarian tumors?[/INST] Ovarian cancer etiology is not completely understood but there are multiple risk factors that can play a role in its occurrence such as: Follicle stimulation or fertility drugs as Clomiphene Based on multiple studies, the following are theories of the etiology of ovarian cancer: Theory 1: Repeated ovulations lead to injury of the ovarian epithelium and subsequent exposure to the inflammatory cytokine, transformation of the mesenchymal epithelium, alteration of the genes and hence cancer. With increased age, cortical inclusion cysts develop and its ovarian surface epithelium become metaplastic or neoplastic under the effect of accumulated inflammatory cytokines or stromal factors stimulation Theory 2: Ovarian cancer originates from the fallopian tube. This theory evidenced by the presence of dysplastic changes in the fallopian tubes of women who underwent prophylactic removal of their ovaries. Theory 3: Persistent Gonadotrophin release from the pituitary gland has a direct effect on the ovarian epithelium and is considered carcinogenic Ovarian cancer Microchapters Home Patient Information Overview Historical Perspective Classifications Pathophysiology Causes of Ovarian cancer Differentiating Ovarian cancer from other Diseases Epidemiology & Demographics Risk Factors Screening Natural History, Complications & Prognosis Diagnosis History & Symptoms Physical Examination Staging Laboratory Findings Chest X Ray CT MRI Echocardiography or Ultrasound Other Imaging Findings Other Diagnostic Studies Treatment Medical Therapy Surgery Primary Prevention Secondary Prevention Cost-Effectiveness of Therapy Future or Investigational Therapies Case Studies Case #1 Epithelial ovarian tumors causes On the Web Most recent articles Most cited articles Review articles CME Programs Powerpoint slides Images American Roentgen Ray Society Images of Epithelial ovarian tumors causes All Images X-rays Echo & Ultrasound CT Images MRI Ongoing Trials at Clinical Trials.gov US National Guidelines Clearinghouse NICE Guidance FDA on Epithelial ovarian tumors causes CDC on Epithelial ovarian tumors causes Epithelial ovarian tumors causes in the news Blogs on Epithelial ovarian tumors causes Directions to Hospitals Treating Ovarian cancer Risk calculators and risk factors for Epithelial ovarian tumors causes Desogestrel and Ethinyl Estradiol Estropipate Medroxyprogesterone</s>

<s>[INST]Answer this question truthfully: What is the role of biochemistry in relation to triglycerides?[/INST] The chemical formula is RCOO- CH 2 CH (-OOCR') CH 2 -OOCR", where R, R', and R" are longer alkyl chains. The three fatty acids RCOOH, R'COOH and R"COOH can be all different, all the same, or only two the same. Chain lengths of the fatty acids in naturally occurring triglycerides can be of varying lengths but 16, 18 and 20 carbons are the most common. Natural fatty acids found in plants and animals are typically composed only of even numbers of carbon atoms due to the way they are bio-synthesised from acetyl CoA. Bacteria, however, possess the ability to synthesise odd- and branched-chain fatty acids. Consequently, ruminant animal fat contains odd numbered fatty acids, such as 15, due to the action of bacteria in the rumen. Most natural fats contain a complex mixture of individual triglycerides; because of this, they melt over a broad range of temperatures. Cocoa butter is unusual in that it is composed of only a few triglycerides, one of which contains palmitic, oleic and stearic acids in that order. This gives rise to a fairly sharp melting point, causing chocolate to melt in the mouth without feeling greasy. General structure of a triglyceride Example of an unsaturated fat triglyceride. Left part: glycerol, right part from top to bottom: palmitic acid, oleic acid, alpha-linolenic acid, chemical formula: C 55 H 98 O 6 Triglycerides are also split into their components via transesterification during the manufacture of biodiesel. The fatty acid mono alkyl ester can be used as fuel in diesel engines. The glycerin has many uses, such as in the manufacture of food and in the production of pharmaceuticals. Other examples are the Triglyceride process in the decaffeination of coffee beans.</s>

<s>[INST]Answer this question truthfully: Can you provide an overview of paraphimosis, please?[/INST] Paraphimosis can often be reduced by manipulation. This involves compression of the glans, then movement of the foreskin to its normal position, perhaps with the aid of a lubricant. If this fails, the foreskin may need to be cut (dorsal slit procedure) or removed by circumcision. An alternate method, the Dundee technique, entails placing multiple punctures in the swollen foreskin with a fine needle, and then expressing the edema fluid by manual pressure. Prevention of recurrence is through education of the patient and his care givers on the need to pull back the foreskin over the glans after it has been retracted (for example, when cleaning the glans or passing a foley catheter), or through elective circumcision or preputioplasty.</s>

<s>[INST]Answer this question truthfully: What does Kimura disease mean?[/INST] The cause of Kimura disease remains unknown. Allergic reaction or an alteration of immune regulation or persistent antigenic stimulation following arthropod bites and parasitic or candidal infection have been postulated. However, none of these theories have been substantiated till date.</s>

<s>[INST]Answer this question truthfully: What is Enterobiasis, and what information is currently known about it?[/INST] Identifying the adult worms around the anus during the physical examination. Adhesive tape test; this is done by firmly pressing the adhesive side of clear, transparent cellophane tape to the skin around the anus. The eggs stick to the tape and the tape can be placed on a slide and looked at under a microscope.</s>

<s>[INST]Answer this question truthfully: What exactly is smallpox? Is it a virus?[/INST] Viruses; dsDNA; Poxviridae; Chordopoxvirinae; Orthopoxvirus; Variola vera</s>

<s>[INST]Answer this question truthfully: What are the other imaging findings associated with spontaneous coronary artery dissection?[/INST] When the diagnosis of spontaneous coronary artery dissection (SCAD) cannot be ascertained by the standard coronary angiography, intracoronary imaging such as intravascular ultrasound (IVUS) or optical coherence tomography (OCT) may provide complementary information for establishing a definitive diagnosis. Coronary computed tomography angiography (CCTA) may be useful for non-invasive follow-up of SCAD involving proximal or large-caliber coronary arteries. OCT findings suggestive of SCAD may include the presence of two lumens and intramural hematoma.</s>

<s>[INST]Answer this question truthfully: What is Actinic Keratosis?[/INST] Reduce sun exposure and protect your skin from the sun: Wear protective clothing such as hats, long-sleeved shirts, long skirts, or pants. Try to avoid sun exposure during midday, when ultraviolet light is most intense. Use high-quality sunscreens, preferably with a sun protection factor (SPF) rating of at least 15. Pick a sunscreen that blocks both UVA and UVB light. Apply sunscreen before going out into the sun, and reapply often. Use sunscreen year-round, including in the winter. Avoid sun lamps, tanning beds, and tanning salons. Other important sun safety facts to keep in mind: Sun exposure is stronger in or near surfaces that reflect light, such as water, sand, concrete, and areas painted white. Sun exposure is more intense at the beginning of the summer. Skin burns faster at higher altitudes.</s>

<s>[INST]Answer this question truthfully: Can you provide an overview of Glanzmann's thrombasthenia?[/INST] The treatment of bleeding episodes in patients with glanzmann's thrombasthenia includes local measures with or without anti-fibrinolytic therapy first, followed by platelet transfusion, and rFVIIa if bleeding persists. However, the majority of cases of glanzmann's thrombasthenia are self-limited and only require supportive care. Other options include desmopressin (DDAVP) which increases in plasma, the tissue plasminogen activator (TPA), FVIII and VWF, but it has no significant effect on platelet disorders, rFVIIa: Manages bleeding in most patients with glanzmann's thrombasthenia, rituximab, bevacizumab, hematopoietic stem cell transplantation and gene therapy. Surgical intervention is not recommended for the management of glanzmann's thrombasthenia DDAVP prevents bleeding after dental extraction and minor surgery in patients with milder platelet defects. Glanzmann's thrombasthenia patients need regular dental visits and must maintain good oral hygiene because the recurrence of gingival bleeding is more in them. These patient should avoid contact sports. Estrogens, platelet transfusion, antifibrinolytic agents, and recombinant human factor VIIa are some other therapies used for treatment/prevention.</s>

<s>[INST]Answer this question truthfully: What is the secondary prevention of cystic fibrosis?[/INST] Effective measures for secondary prevention of cystic fibrosis include: Airway clearance techniques Dornase alpha Hypertonic saline Antibiotics for prevention of airway infection with resistant bacterial pathogens (especially P. aeruginosa) Immunizations including anti-RSV monoclonal antibody Physical activity to maintain bone health and improve airway clearance Nutritional support for pancreatic insufficiency Extra salt and water Hot and dry climates</s>

<s>[INST]Answer this question truthfully: Could you provide a proper English version of the given sentence? It already seems grammatically correct.[/INST] The incidence of polycythemia is approximately 0.7 to 2.6 per 100,000 individuals in the US.</s>

<s>[INST]Answer this question truthfully: What is the Sandbox: Ammu Endocrine?[/INST] These disorders greatly increase the risk of developing multiple cancerous and noncancerous tumors in glands such as the parathyroid, pituitary, and pancreas. Multiple endocrine neoplasia occurs when tumors are found in at least two endocrine glands. Tumors can also develop in organs and tissues other than endocrine glands. If the tumors become cancerous, some cases can be life-threatening. The disorder affects 1 in 30,000 people. Although many different types of hormone-producing tumors are associated with multiple endocrine neoplasia, tumors of the parathyroid gland, pituitary gland, and pancreas are most frequent in multiple endocrine neoplasia type 1. Tumors cause an overactivation of these hormone-producing glands, leading to serious health problems such as severe ulcers. Overactivity of the parathyroid gland (hyperparathyroidism) is the most common sign of this disorder. Hyperparathyroidism disrupts the normal balance of calcium in the blood, which can lead to kidney stones, thinning of bones, weakness, and fatigue. Neoplasia in the pituitary gland can manifest as prolactinomas whereby too much prolactin is secreted, suppressing the release of gonadotropins, causing a decrease in sex hormones such as testosterone. Pancreatic tumors usually form in the islet cells, which over-secrete insulin, causing a decrease in blood glucose levels.</s>

<s>[INST]Answer this question truthfully: What other imaging findings are typically associated with gallbladder cancer?[/INST] Given the rate of high incidence of metastases in gallbladder cancer, FDG(fluorodeoxyglucose), PET (positron emission tomography) scan is particularly useful in identifying metastases. PET scan is useful in diagnosing abnormal lesions and detecting residual disease after cholecystectomy. PET scan has the ability to detect occult metastasis in patients with potentially resectable tumors and changes the management in almost 25% of the patients. Percutaneous transhepatic cholecystoscopy and Percutaneous transhepatic fine needle aspiration are helpful in the evaluation of gallbladder polyps.</s>

<s>[INST]Answer this question truthfully: Could you please provide me with information on Bloody?[/INST] Your doctor may recommend: For an infection of the vagina or cervix: antibiotics that are safe for the baby. For bleeding caused by an ectopic pregnancy: surgery or medical treatment to remove the growing embryo and control or prevent internal bleeding. For a miscarriage: antibiotics to fight infection blood transfusions for severe blood loss possible dilation and curettage or medication may be needed to help complete the miscarriage and stop bleeding. For vaginal bleeding caused by placenta previa: bed rest in the hospital, at least until the bleeding stops. cesarean section if it is close to the delivery date, or if the bleeding is severe. if the baby is premature when bleeding occurs, steroids may be recommended to help speed fetal lung maturity. Home care: Avoid sexual intercourse until you know the cause of the bleeding. Drink only fluids if the bleeding and cramping are severe. If a miscarriage occurs, expect a small amount of vaginal bleeding for up to 10 days after. Avoid using tampons for bleeding during pregnancy and for 2 to 4 weeks after miscarriage. Medication is usually not necessary. Don't take any medication without talking to your doctor.</s>

<s>[INST]Answer this question truthfully: What is a perinatal infection?[/INST] In the scale of optimal virulence, vertical transmission tends to progress benign symbiosis, so is a critical idea for evolutionary medicine. Because the ability of reproducibility of pathogen in the host is the leading cause of pathogen to pass from mother to child, Its transmissibility tends to be inversely related to their virulence. Although HIV is transmitted through perinatal transmission, it is vertical transmission is not the primary mode of transmission. in addition to the new medicine decreased the frequency of vertical transmission of HIV. The incidence of perinatal HIV cases in the United States has decreased as a result of the implementation of recommendations on HIV counselling and voluntary testing practices and the use of zidovudine therapy to reduce perinatal HIV transmission. In dual inheritance theory, vertical transmission refers to the passing of cultural traits from parents to children.</s>

<s>[INST]Answer this question truthfully: What are the conditions that make pregnancy in women with cardiac disease not recommended?[/INST] Absolute and relative contraindications to pregnancy include severe pulmonary arterial hypertension; severe fixed valve stenoses (AS, MS, PS, HOCM, coarctation; Class III or IV congestive heart failure with a left ventricular ejection fraction of < 40%; a history of peripartum cardiomyopathy; a dilated aorta such as in Marfan's syndrome with an aortic arch >40-45 mm; and severe cyanosis.</s>

<s>[INST]Answer this question truthfully: What is the importance of a chest X-ray in connection to Toxoplasmosis?[/INST] There are no specific chest x ray findings associated with toxoplasmosis.</s>

<s>[INST]Answer this question truthfully: What information is available on coronary heart disease?[/INST] http://www.nlm.nih.gov/medlineplus/ency/article/007115.htm Template:WH Template:WS</s>

<s>[INST]Answer this question truthfully: What information is currently available on Tay-Sachs disease?[/INST] Development of improved testing methods has allowed neurologists to diagnose Tay-Sachs and other neurological diseases with greater precision. But Tay-Sachs disease is sometimes misdiagnosed at first, because clinicians are not aware that it is not exclusively a Jewish disease. All patients with Tay-Sachs disease have a "cherry-red" spot, easily observable by a physician using an ophthalmoscope, in the back of their eyes (the retina). This red spot is the area of the retina which is accentuated because of gangliosides in the surrounding retinal ganglion cells (which are neurons of the central nervous system). The choroidal circulation is showing through "red" in this region of the fovea where all of the retinal ganglion cells are normally pushed aside to increase visual acuity. Thus, the cherry-red spot is the only normal part of the retina seen. Microscopic analysis of neurons shows that they are distended from excess storage of gangliosides. Without molecular diagnostic methods, only the cherry red spot, characteristic of all GM2 gangliosidosis disorders, provides a definitive diagnostic sign.</s>

<s>[INST]Answer this question truthfully: What is the name of the surgical procedure used to remove colon polyps?[/INST] Surgery is the mainstay of treatment for colon polyps. Surgery is indicated for all colon polyps that are detected during screening for colorectal cancer. There are different surgical treatments for colon polyps including polypectomy, laparoscopic surgery and total proctocolectomy. All polyps must be sent to pathology laboratory for the biopsy.</s>

<s>[INST]Answer this question truthfully: What is the connection between cancer and a CT scan of the vulvar area?[/INST] A CT scan for vulvar cancer may be helpful in determination of tumor size, tumor shape, and to detect metastasis of vulvar cancer.</s>

<s>[INST]Answer this question truthfully: What measures can be taken to prevent HIV-associated nephropathy?[/INST] HIV -positive patients should be screened for chronic kidney disease (CKD). Interventions in HIV-positive patients with renal disease should be done in order to slow the progress and prevent end stage renal disease (ESRD) and they should be referred to a nephrologist.</s>

<s>[INST]Answer this question truthfully: What does systolic heart murmur mean?[/INST] Class I " 1. Echocardiography is recommended for asymptomatic patients with diastolic murmurs, continuous murmurs, holo- systolic murmurs, late systolic murmurs, murmurs associated with ejection clicks or murmurs that radiate to the neck or back. (Level of Evidence: C) " " 2. Echocardiography is recommended for asymptomatic patients who have grade 3 or louder midpeaking systolic murmurs. (Level of Evidence: C) "</s>

<s>[INST]Answer this question truthfully: Could you explain what is meant by a semicircular canal?[/INST] Transverse section of a human semicircular canal and duct Illustration of otolith organs Template:WikiDoc Sources</s>

<s>[INST]Answer this question truthfully: What is the history and what are the symptoms associated with renal papillary necrosis?[/INST] The most common symptoms of renal papillary necrosis include back pain, fever and urinary symptoms. History of medical conditions such as diabetes and sickle cell disease and long term analgesics use such as acetaminophen and NSAIDS should be considered.</s>

<s>[INST]Answer this question truthfully: What precautions should be taken for aortic regurgitation?[/INST] Aortic regurgitation of any etiology is associated with a higher rate of infection of the valve, i.e. infective endocarditis. The American Heart Association recommended that prophylaxis against infective endocarditis be limited only to patients with either prosthetic heart valves, previous episode(s) of endocarditis, or with certain types of congenital heart disease. Patients with severe aortic regurgitation should avoid strenuous exercise and any exercise that greatly increases afterload such as weight lifting.</s>

<s>[INST]Answer this question truthfully: Could you explain what X-linked severe combined immunodeficiency is?[/INST] Diagnosis of X-SCID is possible through observation and investigation of the immune system. A healthy immune system should contain large amounts of lymphocytes, but individuals with X-SCID will contain unusually small amounts of T-cells, non-functional B-cells, and no natural killer cells. There are also tests of lymphocyte function. These tests introduce agents to the immune system and observation, one can see how the lymphocytes react. Antibody responses to introduced vaccines and infections are absent, and T-cell responses to mitogens, substances that stimulate lymphocyte transformation, are deficient. Immunoglobulins, substances that aid in fighting off infections, are very low. Also, the thymic shadow is absent on chest X-rays. Since the mutation in X-SCID is X-linked, there are genetic tests for detecting carriers in XSCID pedigrees. One method is to look for family-specific IL2RG mutations. Finally, if none of those options are available, there is an unusual pattern of nonrandom X-chromosome inactivation on lymphocytes in carriers, thus looking for such inactivation would prove useful.</s>

<s>[INST]Answer this question truthfully: What information is available about Pentoxifylline?[/INST] Keep all appointments with your doctor and the laboratory. Your blood pressure may need to be checked regularly, especially if you are taking other heart medications. Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.</s>