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The United States Preventive Services Task Force (USPSTF) recommends screening for gonorrhea in women at increased risk of infection, which includes all sexually active women younger than 25 years. Extragenital gonorrhea and chlamydia are highest in men who have sex with men (MSM). Additionally, the USPSTF also recommends routine screening in people who have previously tested positive for gonorrhea or have multiple sexual partners and individuals who use condoms inconsistently, provide sexual favors for money, or have sex while under the influence of alcohol or drugs. Screening for gonorrhea in women who are (or intend to become) pregnant, and who are found to be at high risk for sexually transmitted<unk> s, is recommended as part of prenatal care in the United States. | risks of Pelvic inflammatory disease | causes of Endometritis | risks of Appendix cancer | symptom of Pelvic inflammatory disease | complications of Pelvic inflammatory disease | risks of Erectile dysfunction | risks of Vaginal yeast infection | medical cause of Dysmenorrhea | 00
| 50,481 |
<unk> develops when damage to the DNA of endothelial cells causes them to divide uncontrollably and prevents programmed death. This allows them to grow into a mass invading other parts of the body and consuming its resources. If part of the mass breaks off and enters the circulatory or lymphatic system (which is very common due to<unk> s arising from the lining of said systems) it allows them to lodge elsewhere in the body. This process is called metastasis and is a negative prognostic factor. The underlying causes of DNA damage is not understood but several risk factors are widely accepted. Accepted risk factors include lymphedema, radiation therapy, neurofibromatosis, Maffucci syndrome, Klippel-Trenaunay syndrome and chemicals such as arsenic, thorotrast and vinyl chloride. A 2020 study analyzing the genome of cutaneous<unk> s suggests that ultraviolet radiation may be a causative agent of<unk> s. Immunosuppression may play a role in the pathogenesis of<unk> . There have been reports of<unk> in immunosuppressed individuals following kidney transplantation. The association between lymphedema and<unk> may be due to localized immunodeficiency, however this hypothesis has not been confirmed. Some studies suggest a link between AIDS and<unk> though this may be due to misdiagnosed Kaposi's sarcoma. | Angiosarcoma | Hemangiosarcoma | Glomangiosarcoma | Hemangioma | Angiokeratoma | Lymphangiosarcoma | Sarcoma | Lymphangioma | 00
| 20,156 |
Any approach to<unk> risks causing a pneumothorax. Careful technique can limit this risk, which ranges from less than 1% to about 10%. The precise risk of pneumothorax depends on technique and on underlying<unk> disease, as certain<unk> diseases such as COPD can increase the risk of pneumothorax. Pneumothorax sometimes requires treatment with a chest tube. Bleeding can be life-threatening and can occur in 1 to 4%. Rarely, intercostal artery can be injured when<unk> needle is punctured through the back, due to variations in the course of the artery during its first 6 cm from the spine when emerged from the midline vessels such as costocervical trunk of subclavian artery and descending thoracic aorta. There is a higher chance of the artery deviated from its usual course of groove below the ribs (subcostal groove), for the ribs that are nearer to the head. Therefore, target lesions near the back of the<unk> s are usually avoided if possible, and the puncture should be as near to the superior margin of the ribs as possible during<unk> . | Lung biopsy | Bronchial brushing | Bronchoscopy | Bronchoalveolar lavage | Bronchography | Bronchial challenge test | Thoracoscopy | Mediastinoscopy | 00
| 68,459 |
<unk> (also spelled "Kohler" and referred to in some texts as<unk> I) is a rare bone disorder of the foot found in children between six and nine years of age. The disease typically affects boys, but it can also affect girls. It was first described in 1908 by Alban<unk> (1874–1947), a German radiologist. Dr. A.<unk> noted that children with foot pain displayed characteristics, within their x-rays, of irregularity in growth and development of the tarsal navicular bone in the foot. Furthermore,<unk> is known to affect five times more boys than girls and typically, only one foot is affected. The disease was then found to belong to a group of conditions called osteochondroses, which disturb bone growth at ossification centres which occurs during bone development. It is caused when the navicular bone temporarily loses its blood supply. As a result, tissue in the bone dies and the bone collapses. When treated, it causes no long term problems in most cases although rarely can return in adults. As the navicular bone gets back to normal, symptoms typically abate. In February 2010, the Journal of the American Medical Association reported that the 19-year-old king Tutankhamun may well have died of complications from malaria combined with<unk> II. | Köhler disease | Haff disease | Cyberchondria | Chandler's disease | Upington disease | Gingival cyst | Bartholin's cyst | Bornholm disease | 00
| 29,765 |
<unk> varies widely by geographic location around the world. In 2010, there was an estimated 48.5 million infertile couples worldwide, and from 1990 to 2010 there was little change in levels of infertility in most of the world. In 2010, the countries with the lowest rates of<unk> included the South American countries of Peru, Ecuador and Bolivia, as well as in Poland, Kenya, and Republic of Korea. The highest rate regions included Eastern Europe, North Africa, the Middle East, Oceania, and Sub-Saharan Africa. The prevalence of primary infertility has increased since 1990, but secondary infertility has decreased overall. Rates decreased (although not prevalence) of<unk> in high-income, Central/Eastern Europe, and Central Asia regions. Africa Sub-Saharan Africa has had decreasing levels of primary infertility from 1990 to 2010. Within the Sub-Saharan region, rates were lowest in Kenya, Zimbabwe, and Rwanda, while the highest rates were in Guinea, Mozambique, Angola, Gabon, and Cameroon along with Northern Africa near the Middle East. According to a 2004 DHS report, rates in Africa were highest in Middle and Sub-Saharan Africa, with East Africa’s rates close behind. Asia In Asia, the highest rates of combined secondary and primary infertility was in the South Central region, and then in the Southeast region, with the lowest rates in the Western areas. Latin America and Caribbean The prevalence of<unk> in the Latin America/Caribbean region is typically lower than the global prevalence. However, the greatest rates occurred in Jamaica, Suriname, Haiti, and Trinidad and Tobago. Central and Western Latin America has some of the lowest rates of prevalence. The highest regions in Latin America and the Caribbean was in the Caribbean Islands and in less developed countries. | Female infertility | Male infertility | Oncofertility | Infertility | Ovarian disease | Tubal factor infertility | Male infertility crisis | Chronic testicular pain | 00
| 31,541 |
Chemokine (C-C motif) ligand 1 <unk> is also known as small inducible cytokine A1 and I-309 in humans.<unk> is a small glycoprotein that belongs to the CC chemokine family. | CCL1 | IFL | OPCS-4 | ANGPTL8 | Major basic protein | STAT protein | Rho | NLRP3 | 00
| 42,299 |
The United States Centers for Disease Control and Prevention (CDC) recommends several measures for the prevention of infection with HCoV-NL63 including: washing hands often with soap and water, avoiding close contact with sick individuals, and not touching the eyes, mouth, or nose. | Human coronavirus NL63 | SARS-CoV-2 Beta variant | Human coronavirus OC43 | SARS-CoV-2 Gamma variant | Human coronavirus HKU1 | SARS-CoV-2 Iota variant | SARS-CoV-2 Alpha variant | Influenza D virus | 00
| 33,270 |
Age of onset is variable. The term<unk> ' in the title of<unk> refers to the histological type of the polyps rather than the age of onset. Affected individuals may present with rectal bleeding, abdominal pain, diarrhea or anemia. On colonoscopy or sigmoidoscopy polyps that vary in shape or size are present. The polyps can be sessile or pedunculated hamartomatous polyps. | Juvenile polyposis syndrome | Familial adenomatous polyposis | Serrated polyposis syndrome | Hereditary diffuse gastric cancer | Hereditary nonpolyposis colorectal cancer | MUTYH-associated polyposis | Peutz–Jeghers syndrome | Ogden syndrome | 00
| 42,036 |
The<unk> should be cleaned and any debris removed. A topical antibiotic (such as neomycin or bacitracin) should be applied to prevent infection and to keep the wound moist. Dressing the wound is beneficial because it helps keep the wound from drying out, providing a moist environment conducive for healing. If the<unk> is painful, a topical analgesic (such as lidocaine or benzocaine) can be applied, but for large<unk> , a systemic analgesic may be necessary. Avoid exposing abraded skin to the sun as permanent hyperpigmentation can develop. | Abrasion | Elscint | Skin fissure | Overbite | Hobcart | Veinoplus | Flat wart | Skin tag | 00
| 19,464 |
Injection site erythema, peripheral edema, injection site pruritus and diarrhea. | Tesamorelin | Macimorelin | Liraglutide | Protollin | Exenatide | Glimepiride | Insulin degludec | Nafarelin | 00
| 64,094 |
In industrialized nations,<unk> is relatively uncommon and is primarily associated with specific medications, occupational exposures, or tobacco and alcohol use disorder. However, in developing nations,<unk> optic neuropathy is much more common, especially in regions afflicted by famine. All genders and all races are equally affected, and all ages are susceptible. | Toxic and nutritional optic neuropathy | Chronic relapsing inflammatory optic neuropathy | Autoimmune optic neuropathy | Arteritic anterior ischemic optic neuropathy | Ischemic optic neuropathy | Posterior ischemic optic neuropathy | Kjer's optic neuropathy | Late congenital syphilitic oculopathy | 00
| 37,763 |
<unk> is a deficit in memory caused by brain damage or disease, but it can also be caused temporarily by the use of various sedatives and hypnotic drugs. The memory can be either wholly or partially lost due to the extent of damage that was caused. There are two main types of<unk> : retrograde<unk> and anterograde<unk> . Retrograde<unk> is the inability to retrieve information that was acquired before a particular date, usually the date of an accident or operation. In some cases the memory loss can extend back decades, while in others the person may lose only a few months of memory. Anterograde<unk> is the inability to transfer new information from the short-term store into the long-term store. People with anterograde<unk> cannot remember things for long periods of time. These two types are not mutually exclusive; both can occur simultaneously. Case studies also show that<unk> is typically associated with damage to the medial temporal lobe. In addition, specific areas of the hippocampus (the CA1 region) are involved with memory. Research has also shown that when areas of the diencephalon are damaged,<unk> can occur. Recent studies have shown a correlation between deficiency of RbAp48 protein and memory loss. Scientists were able to find that mice with damaged memory have a lower level of RbAp48 protein compared to normal, healthy mice. In people suffering with<unk> , the ability to recall immediate information is still retained, and they may still be able to form new memories. However, a severe reduction in the ability to learn new material and retrieve old information can be observed. People can learn new procedural knowledge. In addition, priming (both perceptual and conceptual) can assist<unk> cs in the learning of fresh non-declarative knowledge. Individuals with<unk> also retain substantial intellectual, linguistic, and social skill despite profound impairments in the ability to recall specific information encountered in prior learning episodes. The term is ; . | Amnesia | Snatiation | Paranoia | Anhedonia | Allomnesia | Sexual anhedonia | Dyssomnia | Alexithymia | 00
| 53,934 |
The prevalence of the disease is currently unknown, largely owing to its recent description and delineation from other forms of autosomal recessive cerebellar<unk> . | Cerebellar ataxia, neuropathy, vestibular areflexia syndrome | symptom of Amyotrophic lateral sclerosis | Bickerstaff brainstem encephalitis | Barré–Liéou syndrome | Post viral cerebellar ataxia | Cerebellar cognitive affective syndrome | Facial onset sensory and motor neuropathy | Marburg acute multiple sclerosis | 00
| 74,621 |
<unk> is a neurological condition characterized by weakness or paralysis and reduced muscle tone without other obvious cause (e.g., trauma). This abnormal condition may be caused by disease or by trauma affecting the nerves associated with the involved muscles. For example, if the somatic nerves to a skeletal muscle are severed, then the muscle will exhibit<unk> . When muscles enter this state, they become limp and cannot contract. This condition can become fatal if it affects the respiratory muscles, posing the threat of suffocation. It also occur in spinal shock stage in complete transection of spinal cord occurred in injuries like gunshots injuries. | Flaccid paralysis | Monoplegia | Triplegia | Tick paralysis | Hemiparesis | Triparesis | Paraplegia | Synesthesia | 00
| 44,518 |
alt=Artistic rendering of DVT Traditionally, the three factors of Virchow's triad—venous stasis, hypercoagulability, and changes in the endothelial blood vessel lining—contribute to VTE and were used to explain its formation. More recently, inflammation has been identified as playing a clear causal role. Other related causes include activation of immune system components, the state of microparticles in the blood, the concentration of oxygen, and possible platelet activation. Various risk factors contribute to VTE, including genetic and environmental factors, though many with multiple risk factors never develop it. Acquired risk factors include the strong risk factor of older age, which alters blood composition to favor clotting. Previous VTE, particularly unprovoked VTE, is a strong risk factor. A leftover clot from a prior DVT increases the risk of a subsequent DVT. Major surgery and trauma increase risk because of tissue factor from outside the vascular system entering the blood. Minor injuries, lower limb amputation, hip fracture, and long bone fractures are also risks. In orthopedic surgery, venous stasis can be temporarily provoked by a cessation of blood flow as part of the procedure. Inactivity and immobilization contribute to venous stasis, as with orthopedic casts, paralysis, sitting, long-haul travel, bed rest, hospitalization, catatonia, and in survivors of acute stroke. Conditions that involve compromised blood flow in the veins are May–Thurner syndrome, where a vein of the pelvis is compressed, and venous thoracic outlet syndrome, which includes Paget–Schroetter syndrome, where compression occurs near the base of the neck. Infections, including sepsis, COVID-19, HIV, and active tuberculosis, increase risk. Chronic inflammatory diseases and some autoimmune diseases, such as inflammatory bowel disease, systemic sclerosis, Behçet's syndrome, primary antiphospholipid syndrome, and systemic lupus erythematosus (SLE) increase risk. SLE itself is frequently associated with secondary antiphospholipid syndrome. Cancer can grow in and around veins, causing venous stasis, and can also stimulate increased levels of tissue factor. Cancers of the blood, lung, pancreas, brain, stomach, and bowel are associated with high VTE risk. Solid tumors such as adenocarcinomas can contribute to both VTE and disseminated intravascular coagulation. In severe cases, this can lead to simultaneous clotting and bleeding. Chemotherapy treatment also increases risk. Obesity increases the potential of blood to clot, as does pregnancy. In the postpartum, placental tearing releases substances that favor clotting. Oral contraceptives and hormonal replacement therapy increase the risk through a variety of mechanisms, including altered blood coagulation protein levels and reduced fibrinolysis. The coagulation system, often described as a "cascade", includes a group of proteins that regulate clotting. DVT risk can be altered by abnormalities in the cascade. The regulators, antithrombin (ᾳTHR) and activated protein C (APC), are shown in green above the clotting factors they affect.|alt=Imagine showing the coagulation, which includes a group of proteins that regulate clots. DVT risk can be altered by abnormalities in the cascade. Dozens of genetic risk factors have been identified, and they account for approximately 50 to 60% of the variability in VTE rates. As such, family history of VTE is a risk factor for a first VTE. Factor V Leiden, which makes factor V resistant to inactivation by activated protein C, mildly increases VTE risk by about three times. Deficiencies of three proteins that normally prevent blood from clotting—protein C, protein S, and antithrombin—contribute to VTE. These deficiencies in antithrombin, protein C, and protein S are rare but strong, or moderately strong, risk factors. They increase risk by about 10 times. Having a non-O blood type roughly doubles VTE risk. Non-O blood type is common globally, making it an important risk factor. Individuals without O blood type have higher blood levels of von Willebrand factor and factor VIII than those with O blood type, increasing the likelihood of clotting. Those homozygous for the common fibrinogen gamma gene variant rs2066865 have about a 1.6 times higher risk of VTE. The genetic variant prothrombin G20210A, which increases prothrombin levels, increases risk by about 2.5 times. Additionally, approximately 5% of people have been identified with a background genetic risk comparable to the factor V Leiden and prothrombin G20210A mutations. Blood alterations including dysfibrinogenemia, low free protein S, activated protein C resistance, homocystinuria, hyperhomocysteinemia, high fibrinogen levels, high factor IX levels, and high factor XI levels are associated with increased risk. Other associated conditions include heparin-induced thrombocytopenia, catastrophic antiphospholipid syndrome, paroxysmal nocturnal hemoglobinuria, nephrotic syndrome, chronic kidney disease, polycythemia vera, essential thrombocythemia, intravenous drug use, and smoking. Some risk factors influence the location of DVT within the body. In isolated distal DVT, the profile of risk factors appears distinct from proximal DVT. Transient factors, such as surgery and immobilization, appear to dominate, whereas thrombophilias and age do not seem to increase risk. Common risk factors for having an upper extremity DVT include having an existing foreign body (such as a central venous catheter, a pacemaker, or a triple-lumen PICC line), cancer, and recent surgery. | complications of Baker's cyst | complications of Testicular torsion | complications of Cystocele | medical cause of Vaginitis | complications of Epididymitis | medical cause of Epididymitis | complications of Bladder stone | medical cause of Phimosis | 00
| 14,439 |
Mechanical stimulation The most common<unk> s are pressure<unk> s, caused by rubbing or applying pressure on or near the closed eyes. They have been known since antiquity, and described by the Greeks. The pressure mechanically stimulates the cells of the retina. Experiences include a darkening of the visual field that moves against the rubbing, a diffuse colored patch that also moves against the rubbing, well defined shapes such as bright circles that exist near or opposite to where pressure is being applied, a scintillating and ever-changing and deforming light grid with occasional dark spots (like a crumpling fly-spotted flyscreen), and a sparse field of intense blue points of light. Pressure<unk> s can persist briefly after the rubbing stops and the eyes are opened, allowing the<unk> s to be seen on the visual scene. Hermann von Helmholtz and others have published drawings of their pressure<unk> s. One example of a pressure<unk> is demonstrated by gently pressing the side of one's eye and observing a colored ring of light on the opposite side, as detailed by Isaac Newton. Another common<unk> is "seeing stars" from a sneeze, laughter, a heavy and deep cough, blowing of the nose, a blow on the head or low blood pressure (such as on standing up too quickly or prior to fainting). It is possible these involve some mechanical stimulation of the retina, but they may also involve mechanical and metabolic (such as from low oxygenation or lack of glucose) stimulation of neurons of the visual cortex or of other parts of the visual system. Less commonly,<unk> s can also be caused by some diseases of the retina and nerves, such as multiple sclerosis. The British National Formulary lists<unk> s as an occasional side effect of at least one anti-anginal medication. The name<unk> " was coined by J. B. H. Savigny, better known as the ship's surgeon of the wrecked French frigate Méduse. It was first employed by Serre d'Uzes to test retinal function prior to cataract surgery. Electrical stimulation<unk> s have been created by electrical stimulation of the brain, reported by neurologist Otfrid Foerster as early as 1929. Brindley and Lewin (1968) inserted a matrix of stimulating electrodes directly into the visual cortex of a 52-year-old blind female, using small pulses of electricity to create<unk> s. These<unk> s were points, spots, and bars of colorless or colored light. Brindley and Rushton (1974) used the<unk> s to create a visual prosthesis, in this case by using the<unk> s to depict Braille spots. In recent years, researchers have successfully developed experimental brain–computer interfaces or neuroprostheses that stimulate<unk> s to restore vision to people blinded through accidents. Notable successes include the human experiments by William H. Dobelle and Mark Humayun and animal research by Dick Normann. A noninvasive technique that uses electrodes on the scalp, transcranial magnetic stimulation, has also been shown to produce<unk> s. Experiments with humans have shown that when the visual cortex is stimulated above the calcarine fissure,<unk> s are produced in the lower part of the visual field, and vice versa. Others<unk> s have been produced by intense, changing magnetic fields, such as with transcranial magnetic stimulation (TMS). These fields can be positioned on different parts of the head to stimulate cells in different parts of the visual system. They also can be induced by alternating currents that entrain neural oscillation as with transcranial alternating current stimulation. In this case they appear in the peripheral visual field. This claim has been disputed. The alternative hypothesis is that current spread from the occipital electrode evokes<unk> s in the retina.<unk> s created by magnetic fields are known as magnetophosphenes. Astronauts exposed to radiation in space have reported seeing<unk> s. Patients undergoing radiotherapy have reported seeing blue flashes of light during treatment; the underlying phenomenon has been shown to resemble Cherenkov radiation.<unk> s can be caused by some medications, such as Ivabradine. | Phosphene | Magnetophosphene | Theobromine | Toxaphene | Desmethylchlorotrianisene | Chlorotrianisene | Menthol | Esthiomene | 00
| 17,165 |
Diagnosis of<unk> is possible (with microscopy) after removal of the worm. The primary form of diagnosis of<unk> is the identification of larva in the tissue. Serological testing such as enzyme-linked immunosorbent assay (ELISA) or the Western blot are also reliable but may not be easily accessible in endemic areas. CT scanning or MRI can be used to help identify a soft tissue worm and when looking at CNS disease it can be used to reveal the presence of the worm. The presence of haemorrhagic tracks on gradient-echo T2-weighted MRI is characteristic and possibly diagnostic. | Gnathostomiasis | Naegleriasis | Ancylostomiasis | Dracunculiasis | Scarabiasis | Trichuriasis | Trichomoniasis | Trichiasis | 00
| 20,054 |
<unk> affects between 5% and 66% of people, with about 20% of individuals in most populations having the condition to some degree. This makes it the most common disease of the oral mucosa.<unk> occurs worldwide, but is more common in developed countries. Within nations, it is more common in higher socioeconomic groups. Males and females are affected in an equal ratio, and the peak age of onset between 10 and 19 years. About 80% of people with<unk> first developed the condition before the age of 30. There have been reports of ethnic variation. For example, in the United States,<unk> may be three times more common in white-skinned people than black-skinned people. | Aphthous stomatitis | Herpes labialis | Contact stomatitis | Denture-related stomatitis | Bovine papular stomatitis | Oral candidiasis | Adenoviral keratoconjunctivitis | Dermatophagia | 00
| 24,154 |
<unk> can develop in several different ways depending on the underlying cause of the disease. Eosinophils play a central role in defending the body against infection by parasites. Many diseases, such as asthma and eczema, are caused when eosinophils overreact to environmental triggers and release an excess of chemicals, e.g., cytokines and histamine. The common characteristic among different causes of<unk> is eosinophil overreaction or dysfunction in the lungs. Medications and environmental exposures Medications, substance abuse, and environmental exposures may all trigger eosinophil dysfunction. Medications such as nonsteroidal anti-inflammatory drugs (e.g., ibuprofen), nitrofurantoin, phenytoin, L-tryptophan, daptomycin and ampicillin, and drugs of abuse such as inhaled heroin and cocaine may trigger an allergic response which results in<unk> . Chemicals such as sulfites, aluminum silicate, and cigarette smoke can cause<unk> when inhaled. A New York City firefighter developed<unk> after inhalation of dust from the World Trade Center on September 11, 2001. Parasitic infections Parasites cause<unk> in three different ways. Parasites can either invade the lungs, live in the lungs as part of their life cycle, or be spread to the lungs by the bloodstream. Eosinophils then migrate to the lungs in order to fight the parasites, and cause<unk> when they release their contents. Important parasites that invade the lungs include Paragonimus lung flukes and the tapeworms Echinococcus and Taenia solium. Important parasites which inhabit the lungs as part of their normal life cycle include the worms (helminths) Ascaris lumbricoides, Strongyloides stercoralis and the hookworms Ancylostoma duodenale and Necator americanus. When<unk> is caused by helminths, it is often called "Löffler's syndrome". The final group of parasites cause<unk> when their eggs are carried into the lungs by the bloodstream. This can include Trichinella spiralis, Strongyloides stercoralis, Ascaris lumbricoides, the hookworms, and the schistosomes. Acute and Chronic<unk> The causes for both acute and chronic<unk> are unknown as of 2005. There is some suspicion that at least the acute form is the result of the body's response to some unidentified environmental agent. | Eosinophilic pneumonia | Atypical pneumonia | Acute eosinophilic pneumonia | Lipid pneumonia | Cryptogenic organizing pneumonia | Lobar pneumonia | Parasitic pneumonia | Fungal pneumonia | 00
| 30,285 |
Jankovic and Mejia's 2006 review indicated that autopsies of victims of the 1917 to 1926 encephalitis lethargica pandemic revealed "neurofibrillary tangles and neuronal loss in the globus pallidus, hypothalamus, midbrain tegmentum, periaqueductal gray matter, striatum, and the substantia nigra". Wohlfart et al hypothesized that<unk> originates in the periaqueductal gray matter in the mesencephalon. The vocalizing center in animals is located in the periaqueductal gray matter and a<unk> -like episode involving grunts and animal sounds can be evoked by electrical stimulation of this region. Wohlfart and colleagues hypothesized that the stimulation of the autonomic nervous system by the posterior hypothalamus is involved in<unk> , adding that<unk> resembles sham rage in animals, which is controlled by stimulation of the sympathetic nervous system. During<unk> , a person may experience pupil dilation, tachycardia, salivation, increased blood pressure, retraction of lips, barking, grunting, and rage just as an animal would if presenting sham rage. Bates and colleagues (1996) say that neuroimaging and pathology results do not support evidence of hypothalamic involvement similar to that found in sham rage. | Klazomania | Potomania | Graphomania | Amenomania | Distichia | Hypomania | Strephosymbolia | Unhappy triad | 00
| 41,476 |
<unk> is the third full-length album released by Cephalic Carnage. It was released in 2002 via Relapse Records. The album was reissued by Relapse Records with a bonus track on September 13, 2011. | Lucid Interval | Lucid interval | Eloquent cortex | Hyperfocus | Haybittle–Peto boundary | Endaural phenomena | Microsleep | Pocock boundary | 00
| 41,632 |
Its primary use in medicine is to reduce pain, cramping, numbness, or weakness in the arms or legs which occurs due to intermittent claudication, a form of muscle pain resulting from peripheral artery diseases. This is its only FDA, MHRA and TGA-labelled indication. However,<unk> is also recommended for off-label use as an adjunct to compression bandaging for the treatment of chronic venous leg ulcers by the Scottish Intercollegiate Guidelines Network (SIGN) as this has been shown to improve healing rates.<unk> has been tested for use in sarcoidosis patients as an alternative or compliment to prednisone and other steroids, as the drug can inhibit excess levels of TNF-a, which is associated with granuloma formation.<unk> has also been used to treat immunologic reactions to leprosy with some success.<unk> has also been shown to be of benefit in alcoholic hepatitis, with some studies demonstrating a reduction in risk of hepatorenal syndrome. An interesting off-label indication of<unk> is the supportive treatment of distal diabetic neuropathy, where it can be added, for example, to thioctic acid or gabapentin. Theoretically, it can (among other things) act prophylactically against ulcerative changes of the lower limbs associated with chronically decompensated diabetes. Patients with measurable impairment in arterial supply are more likely to benefit from adjunctive treatment with<unk> . The administration of higher doses of<unk> in hospitalization for complications of distal diabetic neuropathy is usually conditioned by the joint agreement of the neurologist with the physicians of internal medicine (diabetology and angiology). | Pentoxifylline | Enoxaparin sodium | Apixaban | Elinogrel | Cilostazol | Epitiostanol | Endarterectomy | Palladin | 00
| 26,707 |
Efforts to prevent<unk> include hand washing and food safety measures while traveling in areas of high risk. Vaccine Although there is currently no vaccine that protects against Shigella infection, several are in development. Vaccination may eventually become a part of the strategy to reduce the incidence and severity of diarrhea, particularly among children in low-resource settings. For example, Shigella is a longstanding World Health Organization (WHO) target for vaccine development, and sharp declines in age-specific diarrhea/dysentery attack rates for this pathogen indicate that natural immunity does develop following exposure; thus, vaccination to prevent this disease should be feasible. The development of vaccines against these types of infection has been hampered by technical constraints, insufficient support for coordination, and a lack of market forces for research and development. Most vaccine development efforts are taking place in the public sector or as research programs within biotechnology companies. | symptoms of Dysentery | symptom of Dysentery | symptom of Gastroenteritis | symptom of Campylobacteriosis | symptom of Listeriosis | symptom of Cholera | symptom of Giardiasis | symptom of Shigellosis | 00
| 4,576 |
<unk> appears to occur randomly and for unknown reasons. Prevalence is higher in females than males, with a ratio of roughly 3:2. The condition is observed on the left side of the face about as often as on the right side. | Parry–Romberg syndrome | Smith–Fineman–Myers syndrome | MORM syndrome | Sly syndrome | Imerslund–Gräsbeck syndrome | WHIM syndrome | Lujan–Fryns syndrome | Senior–Løken syndrome | 00
| 41,679 |
<unk> is a biographical docuseries about YouTube star<unk> <unk> , produced by Shots Studios, directed by Emmy-award winner Alicia Zubikowski. The first episode was released on<unk> ' YouTube channel on May 19, 2020. | The Secret Life of Lele Pons | Multiple chemical sensitivity | Neurodiversity | Old person smell | Role of microglia in disease | Tissue tropism | Acute to chronic ratio | Neuroscience of multilingualism | 00
| 73,455 |
Diagram of discomfort caused by coronary artery disease. Pressure, fullness, squeezing or pain in the center of the chest. Can also feel discomfort in the neck, jaw, shoulders, back or arms.<unk> pectoris can be quite painful, but many patients with<unk> complain of chest discomfort rather than actual pain: the discomfort is usually described as a pressure, heaviness, tightness, squeezing, burning, or choking sensation. Apart from chest discomfort,<unk> l pains may also be experienced in the epigastrium (upper central abdomen), back, neck area, jaw, or shoulders. This is explained by the concept of referred pain and is because the spinal level that receives visceral sensation from the heart simultaneously receives cutaneous sensation from parts of the skin specified by that spinal nerve's dermatome, without an ability to discriminate the two. Typical locations for referred pain are arms (often inner left arm), shoulders, and neck into the jaw.<unk> is typically precipitated by exertion or emotional stress. It is exacerbated by having a full stomach and by cold temperatures. Pain may be accompanied by breathlessness, sweating, and nausea in some cases. In this case, the pulse rate and the blood pressure increases. Chest pain lasting only a few seconds is normally not<unk> (such as precordial catch syndrome). Myocardial ischemia comes about when the myocardium (the heart muscle) receives insufficient blood and oxygen to function normally either because of increased oxygen demand by the myocardium or because of decreased supply to the myocardium. This inadequate perfusion of blood and the resulting reduced delivery of oxygen and nutrients are directly correlated to blocked or narrowed blood vessels. Some experience "autonomic symptoms" (related to increased activity of the autonomic nervous system) such as nausea, vomiting, and pallor. Major risk factors for<unk> include cigarette smoking, diabetes, high cholesterol, high blood pressure, sedentary lifestyle, and family history of premature heart disease. A variant form of<unk> —Prinzmetal's<unk> —occurs in patients with normal coronary arteries or insignificant atherosclerosis. It is believed caused by spasms of the artery. It occurs more in younger women. Coital<unk> , also known as<unk> d'amour, is<unk> subsequent to sexual intercourse. It is generally rare, except in patients with severe coronary artery disease. | Angina | Gastroesophageal reflux disease | Chest pain | Heartburn | Carditis | Shingles | Abdominal angina | Cholecystitis | 00
| 4,722 |
Differential diagnosis The implementation and application of existing collaborative care models, such as DICE, can aid in avoiding misdiagnosis. Comorbidities (such as vascular, infectious, traumatic, autoimmune, idiopathic, or even becoming malnourished) have the potential to mimic symptoms of dementia. For instance, studies have also shown a relationship between depression and its cognitive effects on everyday functioning and distortions of memory. Investigations such as PET and SPECT imaging of the brain show reduced blood flow in areas of the brain in people with Alzheimer's disease (AD) compared with a more normal blood flow in those with<unk> , and the MRI shows medial temporal lobe atrophy in people with AD.<unk> vs. dementia<unk> symptoms can appear similar to dementia. Due to the similar side effects to dementia, this can result in a misdiagnosis of depression, or the adverse effects of medications being taken. This form of dementia is not the original form and does not result from the same cognitive changes. Once the depression is properly treated or the medication therapy is changed, the cognitive impairment can be effectively reversed. Generally, dementia involves a steady and irreversible cognitive decline but in some cases there may be different outcomes. In addition, diminished mental capacity and social withdrawal are commonly identified as symptoms in the elderly but oftentimes is due to symptoms of depression. As a result, elderly patients are often misdiagnosed especially when healthcare professionals do not make an accurate assessment. Older people with predominantly cognitive symptoms such as loss of memory, and vagueness, as well as prominent slowing of movement and reduced or slowed speech, were sometimes misdiagnosed as having dementia when further investigation showed they were suffering from a major depressive episode. This was an important distinction as the former was untreatable and progressive and the latter treatable with antidepressant therapy, electroconvulsive therapy, or both. In contrast to major depression, dementia is a progressive neurodegenerative syndrome involving a pervasive impairment of higher cortical functions resulting from widespread brain pathology. A significant overlap in cognitive and neuropsychological dysfunction in Dementia and<unk> patients increases the difficulty in diagnosis. Differences in the severity of impairment and quality of patients' responses can be observed, and a test of antisaccadic movements may be used to differentiate the two, as<unk> patients have poorer performance on this test. Individuals with<unk> present considerable cognitive deficits, including disorders in learning, memory and psychomotor performance. Substantial evidences from brain imaging such as CT scanning and positron emission tomography (PET) have also revealed abnormalities in brain structure and function. A comparison between dementia and<unk> is shown below. Variable<unk> Dementia Onset More precise, usually in terms of days or weeks Subtle Course Rapid, uneven Slow, worse at night Past history Depression or mania frequently Uncertain relation Family history Depression or mania Positive family history for dementia in approximately 50% DAT Mood Depressed; little or no response to sad or funny situations; behavior and affect inconsistent with degree of cognitive deficit Shallow or labile; normal or exaggerated response to sad or funny situations; consistent with degree of cognitive impairment Cooperation Poor; little effort to perform well; responds often with "I don't know"; apathetic, emphasizes failure Good; frustrated by inability to do well; response to queries approximate con fabricated or perseverated; emphasizes trivial accomplishment Memory Highlight memory loss; greater impairment of personality features (e.g. confidence, drive, interests, and attention) Denies or minimizes impairments; greater impairment in cognitive features (recent memory and orientation to time and date) Mini-Mental State Exam (MMSE). Changeable on repeated tests Stable on repeated tests Symptoms Increased psychologic symptoms: sadness, anxiety, somatic symptoms Increased neurologic symptoms: dysphasia, dyspraxia, agnosia, incontinence Computed Tomography (CT) and Electroencephalogram (EEG) Normal for age Abnormal | Pseudodementia | Procidentia | Subcortical dementia | Semantic dementia | Dementia | Vascular dementia | Early-onset Alzheimer's disease | Alcohol-related dementia | 00
| 47,850 |
<unk> can be present at birth. If the condition develops after birth, it is usually the result of injury or diseases. If due to injury, about half the time it is caused by vehicle or bicycle accidents; 25% of the time by falls and 10% of the time by recreational activities such as diving accidents. It also occurs in patients with bone diseases, such as osteomalacia, rheumatoid arthritis, Paget's disease, Ehlers-Danlos syndrome, Marfan syndrome, and osteogenesis imperfecta. | Basilar invagination | Nasal glial heterotopia | Microlissencephaly | Lissencephaly | Schizencephaly | Hemihydranencephaly | Exencephaly | Microhydranencephaly | 00
| 55,264 |
The<unk> (CANFAR) is the only national charitable<unk> that raises awareness to generate funds for<unk> into all aspects of HIV infection and AIDS. Since inception in 1987, CANFAR has invested more than $21 million in<unk> initiatives across Canada, and supported more than 400 distinct<unk> initiatives. CANFAR is funded solely through the generosity of corporations, groups, and individuals across Canada. Each year it is the responsibility of CANFAR's Scientific Advisory Committee (SAC) to evaluate which<unk> proposals seem most promising and likely to make a worthwhile contribution to the international body of HIV and AIDS<unk> . CANFAR is dedicated to funding all aspects of<unk> , including: fundamental and applied<unk> ; educational and prevention; care; psychosocial initiatives; and community<unk> . __TOC__ | Canadian Foundation for AIDS Research | AIDS Services of Austin | Office of AIDS Research | San Francisco AIDS Foundation | President's Commission on the HIV Epidemic | HIV/AIDS Bureau | Uganda AIDS Commission | Harvard AIDS Initiative | 00
| 38,034 |
<unk> is adaptation of an organism to less demanding environment, or, alternatively, the decrease of physiological adaptation to normal conditions. Decondition may result from decreased physical activity, prescribed bed rest, orthopedic casting, paralysis, aging, etc. A particular interest in the study of<unk> is in aerospace medicine, to diagnose, fight, and prevent adverse effects of the conditions of space flight.<unk> due to decreased physical effort results in muscle loss, including heart muscles.<unk> due to lack of gravity or non-standard gravity action (e.g., during bed rest) results in abnormal distribution of body fluids. | Deconditioning | Preconditioning | Overtraining | Ischemic preconditioning | Neuraxial blockade | Neural adaptation | Allostatic load | Myocardial stunning | 00
| 48,094 |
A number of preventative measures are recommended, including avoiding straining while attempting to defecate, avoiding constipation and diarrhea either by eating a high-fiber diet and drinking plenty of fluid or by taking fiber supplements, and getting sufficient exercise. Spending less time attempting to defecate, avoiding reading while on the toilet, and losing weight for overweight persons and avoiding heavy lifting are also recommended. | medical cause of Hematochezia | medical cause of Gastrointestinal bleeding | symptom of Vitamin K deficiency | medical cause of Hematuria | symptom of Diverticulitis | medical cause of Abdominal pain | symptom of Protein S deficiency | medical cause of Vaginitis | 00
| 7,032 |
Symptoms of intoxication from overdose include drowsiness, insomnia, stupor, agitation, coma, transient confusion, increased anxiety, ataxia, convulsions, oliguria, anuria, tachycardia or bradycardia, arrhythmia, AV block, hypotension, shock, respiratory depression, and, rarely, cardiac arrest. Since no antidote for tricyclic antidepressant overdose is known, its treatment remains largely supportive. Removal of the drug should be facilitated by vomiting or gastric lavage. Cardiovascular function should be monitored continuously for at least 48 hours. Arrhythmias should be treated on a case-by-case basis with an appropriate pacemaker and correction of metabolic irregularities, particularly electrolyte imbalances. Respiratory failure should be managed by intubation and artificial respiration. Convulsions should be managed with anticonvulsants (typically diazepam), while monitoring for any worsening in CNS depression. Hypotension can be treated by assuming the corresponding recovery position, by increasing plasma volume with saline infusions, or by pressors, such as adrenaline or dobutamine. | Opipramol | Stiripentol | Fenproporex | Mitapivat | Florbetapir | Avacopan | Vigabatrin | Piritramide | 00
| 38,619 |
Disability-adjusted life year for alcohol use disorders per million inhabitants in 2012. Alcohol consumption per person 2016. The World Health Organization estimates that as of 2016 there are 380 million people with alcoholism worldwide (5.1% of the population over 15 years of age). Substance use disorders are a major public health problem facing many countries. "The most common substance of abuse/dependence in patients presenting for treatment is alcohol." In the United Kingdom, the number of 'dependent drinkers' was calculated as over 2.8 million in 2001. About 12% of American adults have had an alcohol dependence problem at some time in their life. In the United States and Western Europe, 10 to 20 percent of men and 5 to 10 percent of women at some point in their lives will meet criteria for alcoholism. Estonia had the highest death rate from alcohol in Europe in 2015 at 8.8 per 100,000 population. In the United States, 30% of people admitted to hospital have a problem related to alcohol. Within the medical and scientific communities, there is a broad consensus regarding alcoholism as a disease state. For example, the American Medical Association considers alcohol a drug and states that "drug addiction is a chronic, relapsing brain disease characterized by compulsive drug seeking and use despite often devastating consequences. It results from a complex interplay of biological vulnerability, environmental exposure, and developmental factors (e.g., stage of brain maturity)." Alcoholism has a higher prevalence among men, though, in recent decades, the proportion of female alcoholics has increased. Current evidence indicates that in both men and women, alcoholism is 50–60 percent genetically determined, leaving 40–50 percent for environmental influences. Most alcoholics develop alcoholism during adolescence or young adulthood. | risks of Subarachnoid hemorrhage | risks of Hypertriglyceridemia | risks of Panic attack | risks of Atrial fibrillation | risks of Myocardial infarction | risks of Alzheimer's disease | risks of Coronary artery disease | risks of Peripheral artery disease | 00
| 329 |
<unk> is an aminoglycoside antibiotic that displays bactericidal activity against gram-negative aerobic bacilli and some anaerobic bacilli where resistance has not yet arisen. It is generally not effective against gram-positive bacilli and anaerobic gram-negative bacilli.<unk> comes in oral and topical formulations, including creams, ointments, and eyedrops.<unk> belongs to the aminoglycoside class of antibiotics that contain two or more amino sugars connected by glycosidic bonds.<unk> was discovered in 1949 by microbiologist Selman Waksman and his student Hubert Lechevalier at Rutgers University.<unk> received approval for medical use in 1952. Rutgers University was granted the patent for<unk> in 1957. | Neomycin | Dactinomycin | Anisomycin | Paromomycin | Capreomycin | Boromycin | Bicyclomycin | Valrubicin | 00
| 9,628 |
The exact cause of<unk> is not known, and it is unlikely that a single underlying cause exists. Several contributing factors have been identified, which vary widely among<unk> patients with different medical histories. Physical exercise (including, but not limited to, competitive athletics) is one of the major triggers for<unk> episodes, leading to its frequent misdiagnosis as exercise-induced asthma. Other triggers include airborne pollutants and irritants such as smoke, dust, gases, soldering fumes, cleaning chemicals such as ammonia, perfumes, and other odours. Gastroesophageal reflux disease (GERD) and rhinosinusitis (inflammation of the paranasal sinuses and nasal cavity) may also play a role in inflaming the airway and leading to symptoms of<unk> as discussed below. Laryngeal hyperresponsiveness is considered the most likely physiologic cause of<unk> , brought on by a range of different triggers that cause inflammation and/or irritation of the larynx (voice box). The glottic closure reflex (or laryngeal adductor reflex) serves to protect the airway, and it is possible that this reflex becomes hyperactive in some individuals, resulting in the paradoxical vocal fold closure seen in<unk> . Two major causes of laryngeal inflammation and hyperresponsiveness are gastroesophageal reflux disease (GERD) and postnasal drip (associated with rhinosinusitis, allergic or nonallergic rhinitis, or a viral upper respiratory tract infection (URI)). Rhinosinusitis is very common among patients with<unk> and for many patients,<unk> symptoms are ameliorated when the rhinosinusitis is treated. GERD is also common among<unk> patients, but only some experience an improvement in<unk> symptoms when GERD is treated. Other causes of laryngeal hyperresponsiveness include inhalation of toxins and irritants, cold and dry air, episodic croup and laryngopharyngeal reflux (LPR). | Vocal cord dysfunction | Vocal cord paresis | Velopharyngeal insufficiency | Laryngotracheal stenosis | Pulmonary hypoplasia | Tracheomalacia | Congenital limb deformities | Tracheal agenesis | 00
| 50,624 |
<unk> obacilli are homofermentative, i.e. hexoses are metabolised by glycolysis to<unk> ate as major end product, or heterofermentative, i.e. hexoses are metabolised by the Phosphoketolase pathway to<unk> ate, CO2 and acetate or ethanol as major end products. Most<unk> obacilli are aerotolerant and some species respire if heme and menaquinone are present in the growth medium. Aerotolerance of<unk> obacilli is manganese-dependent and has been explored (and explained) in<unk> iplantibacillus plantarum (previously<unk> plantarum).<unk> obacilli generally do not require iron for growth. The<unk> obacillaceae are the only family of the<unk> ic acid bacteria (LAB) that includes homofermentative and heterofermentative organisms; in the<unk> obacillaceae, homofermentative or heterofermentative metabolism is shared by all strains of a genus.<unk> species are all homofermentative, do not express pyruvate formate lyase, and most species do not ferment pentoses. In L. crispatus, pentose metabolism is strain specific and acquired by lateral gene transfer. | Lactobacillus | Streptococcus | Enterococcus | Actinobacillus | Clostridium | Escherichia coli | Salmonella | Caulobacter | 00
| 7,498 |
<unk> , also known as<unk> force trauma or non-penetrating trauma, is physical trauma or impactful force to a body part, often occurring with road traffic collisions, direct blows, assaults, injuries during sports, and particularly in the elderly who fall. It is contrasted with penetrating trauma which occurs when an object pierces the skin and enters a tissue of the body, creating an open wound and bruise.<unk> can result in contusions, abrasions, lacerations, internal hemorrhages, bone fractures, as well as death. Worldwide, a significant cause of disability and death in people under the age of 35 years is trauma, of which most are due to<unk> . | Blunt trauma | Blast injury | Penetrating trauma | Avulsion injury | Barotrauma | Running injuries | Polytrauma | Lightning injury | 00
| 33,617 |
Various<unk> es with nomenclature. Not every<unk> contains a Q wave, an R wave, and an S wave. By convention, any combination of these waves can be referred to as a<unk> . However, correct interpretation of difficult ECGs requires exact labeling of the various waves. Some authors use lowercase and capital letters, depending on the relative size of each wave. For example, an<unk> would be positively deflected, while an<unk> would be negatively deflected. If both<unk> es were labeled RS, it would be impossible to appreciate this distinction without viewing the actual ECG. Monomorphic or polymorphic Monomorphic refers to all<unk> waves in a single lead being similar in shape. Polymorphic means that the<unk> change from<unk> to<unk> . These terms are used in the description of ventricular tachycardia. | QRS complex | J wave | U wave | P wave | Delta wave | T wave | ST segment | Plateau potentials | 00
| 25,117 |
Genetic diagnosis Early in pregnancy,<unk> is used for diagnosis of chromosomal, genetic, and other fetal problems such as: * Down syndrome, also known as Trisomy 21 * Trisomy 13 * Trisomy 18 * Sex chromosome aneuploidies, also known as sex chromosome anomalies * Fragile X * Neural tube defects (anencephaly and spina bifida) by alpha-fetoprotein levels. * Rare, inherited metabolic disorders Lung development<unk> can be used to test fetal lung development. Problems with lung development can increase the risk of infant respiratory distress syndrome. Fetal lung development can be tested by sampling the amount of surfactant in the<unk> iotic fluid in pregnancies greater than 30 weeks. Several tests are available, including the lecithin-sphingomyelin ratio ("L/S ratio"), the presence of phosphatidylglycerol (PG), or the surfactant/albumin (S/A) ratio. * For the L/S ratio, if the result is less than 2:1, the fetal lungs may be surfactant deficient. * The presence of PG usually indicates fetal lung maturity. * For the S/A ratio, the result is given as mg of surfactant per gm of protein. An S/A ratio 55 indicates mature surfactant production. Infection<unk> can detect infections via decreased glucose level, a Gram stain showing bacteria, or abnormal differential count of white blood cells. Rh Incompatibility<unk> can be used to diagnose Rh incompatibility, a condition when the mother has Rh-negative blood and the fetus has Rh-positive blood. Early detection is important to treat the mother with Rh immune globulin and to treat her baby for hemolytic anemia. Decompression of polyhydramnios Polyhydramnios, or the<unk> cumulation of<unk> iotic fluids which leads to increase risk of cesarean section, can be relieved via decompression<unk> .<unk> can also be used to diagnose potential causes of polyhydramnios. Preterm rupture of membranes An emerging indication for<unk> is in the management of preterm rupture of membranes where measurement of certain<unk> iotic fluid inflammatory markers may be helpful. If<unk> iotic fluid IL-6, a marker of inflammation, is elevated, the fetus is at high risk and delivery should be considered. | Amniocentesis | Magnetogenetics | Fetal echocardiography | Fetal scalp blood testing | Chorionic villus sampling | Prenatal testing | Preimplantation genetic diagnosis | Obstetric ultrasonography | 00
| 7,399 |
<unk> is a recombinant RBD protein subunit vaccine. | Noora | Protruding ear | Acalvaria | Achiria | Eye drop | Trachoma | Tympanites | Morel's ear | 00
| 74,736 |
<unk> is similar to the process of scarring, in that both involve stimulated fibroblasts laying down connective tissue, including collagen and glycosaminoglycans. The process is initiated when immune cells such as macrophages release soluble factors that stimulate fibroblasts. The most well characterized pro-fibrotic mediator is TGF beta, which is released by macrophages as well as any damaged tissue between surfaces called interstitium. Other soluble mediators of<unk> include CTGF, platelet-derived growth factor (PDGF), and interleukin 10 (IL-10). These initiate signal transduction pathways such as the AKT/mTOR and SMAD pathways that ultimately lead to the proliferation and activation of fibroblasts, which deposit extracellular matrix into the surrounding connective tissue. This process of tissue repair is a complex one, with tight regulation of extracellular matrix (ECM) synthesis and degradation ensuring maintenance of normal tissue architecture. However, the entire process, although necessary, can lead to a progressive irreversible fibrotic response if tissue injury is severe or repetitive, or if the wound healing response itself becomes deregulated. | Fibrosis | Infibulation | Sclerosis | Steatosis | Calcification | Neovascularization | Hydrodilatation | Transflammation | 00
| 18,594 |
X-ray of 29-year-old person with H1N1 Diagnosis based on symptoms is fairly accurate in otherwise healthy people during seasonal epidemics and should be suspected in cases of pneumonia, acute respiratory distress syndrome (ARDS), sepsis, or if encephalitis, myocarditis, or breaking down of muscle tissue occur. Because influenza is similar to other viral respiratory tract illnesses, laboratory diagnosis is necessary for confirmation. Common ways of collecting samples for testing include nasal and throat swabs. Samples may be taken from the lower respiratory tract if infection has cleared the upper but not lower respiratory tract. Influenza testing is recommended for anyone hospitalized with symptoms resembling influenza during flu season or who is connected to an influenza case. For severe cases, earlier diagnosis improves patient outcome. Diagnostic methods that can identify influenza include viral cultures, antibody- and antigen-detecting tests, and nucleic acid-based tests. Viruses can be grown in a culture of mammalian cells or embryonated eggs for 3–10 days to monitor cytopathic effect. Final confirmation can then be done via antibody staining, hemadsorption using red blood cells, or immunofluorescence microscopy. Shell vial cultures, which can identify infection via immunostaining before a cytopathic effect appears, are more sensitive than traditional cultures with results in 1–3 days. Cultures can be used to characterize novel viruses, observe sensitivity to antiviral drugs, and monitor antigenic drift, but they are relatively slow and require specialized skills and equipment. Serological assays can be used to detect an antibody response to influenza after natural infection or vaccination. Common serological assays include hemagglutination inhibition assays that detect HA-specific antibodies, virus neutralization assays that check whether antibodies have neutralized the virus, and enzyme-linked immunoabsorbant assays. These methods tend to be relatively inexpensive and fast but are less reliable than nucleic-acid based tests. Direct fluorescent or immunofluorescent antibody (DFA/IFA) tests involve staining respiratory epithelial cells in samples with fluorescently-labeled influenza-specific antibodies, followed by examination under a fluorescent microscope. They can differentiate between IAV and IBV but can't subtype IAV. Rapid influenza diagnostic tests (RIDTs) are a simple way of obtaining assay results, are low cost, and produce results quickly, at less than 30 minutes, so they are commonly used, but they can't distinguish between IAV and IBV or between IAV subtypes and are not as sensitive as nucleic-acid based tests. Nucleic acid-based tests (NATs) amplify and detect viral nucleic acid. Most of these tests take a few hours, but rapid molecular assays are as fast as RIDTs. Among NATs, reverse transcription polymerase chain reaction (RT-PCR) is the most traditional and considered the gold standard for diagnosing influenza because it is fast and can subtype IAV, but it is relatively expensive and more prone to false-positives than cultures. Other NATs that have been used include loop-mediated isothermal amplification-based assays, simple amplification-based assays, and nucleic acid sequence-based amplification. Nucleic acid sequencing methods can identify infection by obtaining the nucleic acid sequence of viral samples to identify the virus and antiviral drug resistance. The traditional method is Sanger sequencing, but it has been largely replaced by next-generation methods that have greater sequencing speed and throughput. | picture of Opportunistic infection | medical cause of Infection | Canga's bead symptom | symptom of Leishmaniasis | field of Fungal infection | symptom of Cryptococcosis | symptom of Abscess | symptom of Buruli ulcer | 00
| 51,939 |
<unk> is a rare, genetic birth defect affecting about 1 in 40,000 births. About 97% of those affected are male.<unk> is a congenital disorder of the urinary system, characterized by a triad of symptoms. The syndrome is named for the mass of wrinkled skin that is often (but not always) present on the abdomen of those with the disorder. | Prune belly syndrome | Gastroschisis | Koolen–De Vries syndrome | Cooks syndrome | Cowden syndrome | Bruck syndrome | Van Wyk and Grumbach syndrome | Flynn–Aird syndrome | 00
| 5,607 |
Diagram labeling<unk> in green. The<unk> is the cortical area just posterior to the auditory cortex (Heschl's gyrus) within the Sylvian fissure. It is a triangular region which forms the heart of Wernicke's area, one of the most important functional areas for language. Original studies on this area found that the<unk> was one of the most asymmetric regions in the brain, with this area being up to ten times larger in the left cerebral hemisphere than the right. | Planum temporale | Ligamenta flava | Frenulum breve | Sinus pericranii | Vesical tenesmus | Caput Medusae | Collateral eminence | Stratum spinosum | 00
| 19,977 |
It appears to affect both males and females equally. As of 2020, it is unclear exactly how many people have<unk> . However, the CDC says less than 25 cases have been reported, the National Organization for Rare Disorders says about 18 cases have been reported, while the National Center for Advancing Translational Sciences says 30 cases have been reported in literature. Orphanet says it occurs in 1 in one million people. | Filippi Syndrome | Sanfilippo syndrome | Alder–Reilly anomaly | Pelger–Huët anomaly | Tietz syndrome | Treacher Collins syndrome | DeSanto-Shinawi syndrome | Klippel–Feil syndrome | 00
| 74,898 |
Health advocacy messages such as this one encourage patients to talk with their doctor<unk> out safety in using<unk> s.<unk> s are screened for any negative effects before their approval for clinical use, and are usually considered safe and well tolerated. However, some<unk> s have been associated with a wide extent of adverse side effects ranging from mild to very severe depending on the type of<unk> used, the microbes targeted, and the individual patient. Side effects may reflect the pharmacological or toxicological properties of the<unk> or may involve hypersensitivity or allergic reactions. Adverse effects range from fever and nausea to major allergic reactions, including photodermatitis and anaphylaxis. Common side effects of oral<unk> s include diarrhea, resulting from disruption of the species composition in the intestinal flora, resulting, for example, in overgrowth of pathogenic bacteria, such as Clostridium difficile. Taking probiotics during the course of<unk> treatment can help prevent<unk> -associated diarrhea. Antibacterials can also affect the vaginal flora, and may lead to overgrowth of yeast species of the genus Candida in the vulvo-vaginal area. Additional side effects can result from interaction with other drugs, such as the possibility of tendon damage from the administration of a quinolone<unk> with a systemic corticosteroid. Some<unk> s may also damage the mitochondrion, a bacteria-derived organelle found in eukaryotic, including human, cells. Mitochondrial damage cause oxidative stress in cells and has been suggested as a mechanism for side effects from fluoroquinolones. They are also known to affect chloroplasts. | Antibiotic | Steroid | Antimicrobial | Antiseptic | Broad-spectrum antibiotic | Antiemetic | Analgesic | Antiviral drug | 00
| 209 |
Inflatable vaginal expander ZSI 200 NS ZSI 200 NS vaginal expander stretching the female vagina In order to facilitate sexual intercourse, the main treatments are self-dilation methods (using intra-vaginal cylinders or inflatable expanders (vaginal stents) of increasing size) and surgical vaginoplasty to lengthen the vagina. Self-dilation has a high success rate, estimated at 75%, and is usually the first-line treatment due to low surgical invasiveness. Overall, the complication rates are significantly lower with dilation than with vaginoplasty. Surgery is indicated when there is inability or reluctance to perform self-dilation, or where it is performed but with failed result. The vaginoplasty is performed around the inflatable expander which maintains the neovagina against the pelvic wall after the surgery and favors the process of microscopic neovascularization while reducing the risks for hematoma. One appropriate surgical variant is the Vecchietti technique. In this procedure, an olive-shaped pressure device is pressed towards the potential vaginal space by a thread that goes through the skin, behind the urinary bladder and pubic bone and exits the skin in the hypogastrium, where it is attached to a plate that provides counter-traction. Vaginoplasty can also be performed using a skin graft or an intestinal graft. Traction vaginoplasty such as the Vecchietti technique seems to have the highest success rates both anatomically (99%) and functionally (96%), whereas skin graft procedures and intestinal procedures have the lowest successful outcomes (83–95%). After vaginoplasty, available evidence suggests that continued self-dilation is needed to maintain the patency in periods of coital inactivity. A vaginal expander can be used regularly to prevent post-operative vaginal retraction. | Vaginal hypoplasia | Uterine hypoplasia | Vaginal atresia | Blighted ovum | Boggy uterus | Cervical agenesis | Elongated labia | Prostate hypoplasia | 00
| 45,482 |
Dissection of a cadaver, 15th-century painting The<unk> extends from the earliest examinations of sacrificial victims to the sophisticated analyses of the body performed by modern<unk> sts and scientists. Written descriptions of human organs and parts can be traced back thousands of years to ancient Egyptian papyri, where attention to the body was necessitated by their highly elaborate burial practices. Theoretical considerations of the structure and function of the human body did not develop until far later, in Ancient Greece. Ancient Greek philosophers, like Alcmaeon and Empedocles, and ancient Greek doctors, like Hipprocrates and his school, paid attention to the causes of life, disease, and different functions of the body. Aristotle advocated dissection of animals as part of his program for understanding the causes of biological forms. During the Hellenistic Age, dissection and vivesection of human beings took place for the first time in the work of Herophilos and Erasistratus.<unk> cal knowledge in antiquity would reach its apex in the person of Galen, who made important discoveries through his medical practice and his dissections of monkeys, oxen, and other animals. The development of the study of<unk> gradually built upon concepts that were present in Galen's work, which was a part of the traditional medical curriculum in the Middle Ages. The Renaissance brought a reconsideration of classical medical texts, and<unk> cal dissections became once again fashionable for the first time since Galen. Important<unk> cal work was carried out by Mondino de Luzzi, Berengario da Carpi, and Jacques Dubois, culminating in Andreas Vesalius's seminal work De Humani Corporis Fabrica (1543). An understanding of the structures and functions of organs in the body has been an integral part of medical practice and a source for scientific investigations ever since. | History of anatomy | History of medicine | Topographical code | Anatomical model | History of Stanford Medicine | Concussion grading systems | Clinical associates | Tile classification | 00
| 3,271 |
Top view of a modern<unk> A<unk> is a small jar, traditionally of glazed earthenware, used by apothecaries for holding ointment or medicine. In the 21st century<unk> s are available in plastic: a sales catalogue describes one with a 60ml capacity as "For general use, surgical procedures, and other medical uses; Useful for holding medicines or ointments". Another supplier offers both single-use and reusable<unk> s of 60ml and 280ml. The term, recorded from the 15th century, may derive from the idea of pots originally imported in galleys, and has also been used for small pots used for other purposes - such as preparing an individual portion of custard or melting wax while making fishing flies. The<unk> Inn The 16th-century<unk> Inn in Hartfield, Sussex, England, is said to take its name "from the small glazed earthenware pots made to contain medicines and ointments that were once produced on-site".<unk> s in a variety of shapes are held in several museums. File:Gallipot, England, probably London, c. 1760, tin-glazed earthenware, HD 91.150 - Flynt Center of Early New England Life - Deerfield, Massachusetts - DSC04326.c. 1760, English tin-glazed earthenware in the Flynt Center of Early New England Life - Deerfield, Massachusetts File:MET 24 80 157 56685.Kangxi period (1662–1722) Chinese porcelain in the Metropolitan Museum of Art File:MET 65 86 119 O1.18th-century Chinese ivory in the Metropolitan Museum of Art | Gallipot | OHVIRA | SimThyr | FCM | DRACO | Paro | Exisulind | NLM | 00
| 66,540 |
The first symptoms typically include fever, intermittent abdominal pain, and an enlarged liver. Occasionally, yellow discoloration of the skin occurs.<unk> usually occurs in the presence of other diseases, such as autosomal recessive polycystic kidney disease, cholangitis, gallstones, biliary abscess, sepsis, liver cirrhosis, kidney failure, and cholangiocarcinoma (7% affected). People with<unk> are 100 times more at risk for cholangiocarcinoma than the general population. After recognizing symptoms of related diseases,<unk> can be diagnosed. Morbidity is common and is caused by complications of cholangitis, sepsis, choledocholithiasis, and cholangiocarcinoma. These morbid conditions often prompt the diagnosis. Portal hypertension may be present, resulting in other conditions including enlarged spleen, hematemesis, and melena. These problems can severely affect the patient's quality of life. In a 10-year period between 1995 and 2005, only 10 patients were surgically treated for<unk> , with an average patient age of 45.8 years. After reviewing 46 cases of<unk> before 1990, 21.7% of the cases were the result of an intraheptic cyst or nonobstructive biliary tree dilation, 34.7% were linked with congenital hepatic fibrosis, 13% were isolated choledochal cystic dilation, and the remaining 24.6% had a combination of all three. | Caroli disease | Haff disease | Darier's disease | Lev's disease | Machado–Joseph disease | Kyrle disease | Tornwaldt's disease | Chandler's disease | 00
| 10,532 |
At the beginning, people show pin-sized dots with white plaque on them which constantly grow into flat, red areas hardly surrounded by white plaque. Despite the visible symptoms, patients in nearly all cases do not suffer from burning or itching, nor does it smell strange. Due to its analogy to a fungal skin infection,<unk> is often misdiagnosed as mycosis – especially in cases where patients have no other symptoms of reactive arthritis. | Balanitis circinata | Dens evaginatus | Mania errabunda | Tinea imbricata | Chirurgia magna | Pachyonychia congenita | Lichen striatus | Corona phlebectatica | 00
| 44,239 |
<unk> <unk> is a very rare, chronic photodermatitis-type skin condition with usual onset in childhood. It was first described in 1862 by Bazin. It is sometimes called "Bazin's<unk> ". A study published in Scotland in 2000 reviewed the cases of 17 patients and estimated a prevalence of 0.34 cases per 100,000 population. In this study they reported an average age of onset of 7.9 years. Frequently the rash first appeared in the spring or summer months and involved sun-exposed skin. The rash starts as a vesicular eruption, later becoming umbilicated, and resulted in<unk> scarring. It is most frequently found on the nose, cheeks, ears, dorsum of the hand, and arms (places that are most exposed to light). | Hydroa vacciniforme | Tinea imbricata | Trichostasis spinulosa | Telogen effluvium | Melanosis coli | Bradyphrenia | Ichthyosis bullosa of Siemens | Tinea manuum | 00
| 55,186 |
<unk> (TP/TE/TUe), sold under the brand name Durasteron, is an injectable combination medication of testosterone propionate (TP), testosterone valerate (TV), and testosterone<unk> (TUe), all of which are androgens/anabolic steroids. It contains 20 mg TP, 80 mg TE, and 150 mg TUe (for a total of 250 mg testosterone ester and 169.5 mg free testosterone) in oil solution and is administered by intramuscular injection at regular intervals, for instance once every 3 or 4 weeks. Use of Durasteron by bodybuilders has been reported. | Testosterone propionate/testosterone enanthate/testosterone undecylenate | Testosterone propionate/testosterone valerate/testosterone undecylenate | Testosterone propionate/testosterone cypionate/prasterone | Testosterone acetate/testosterone undecanoate/testosterone valerate | Estradiol benzoate/estradiol dienanthate/testosterone enanthate benzilic acid hydrazone | Estradiol benzoate/estradiol phenylpropionate/testosterone propionate/testosterone phenylpropionate/testosterone isocaproate | Testosterone propionate/testosterone ketolaurate | Estradiol benzoate/estradiol valerate/norethisterone acetate/testosterone enanthate | 00
| 72,458 |
Bleeding, also known as a hemorrhage, haemorrhage, or simply blood loss, is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethra, vagina or anus, or through a wound in the skin. Hypovolemia is a massive decrease in blood volume, and death by excessive loss of blood is referred to as exsanguination. Typically, a healthy person can endure a loss of 10–15% of the total blood volume without serious medical difficulties (by comparison, blood donation typically takes 8–10% of the donor's blood volume). The stopping or controlling of bleeding is called hemostasis and is an important part of both first aid and surgery. The use of cyanoacrylate glue to prevent bleeding and seal battle wounds was designed and first used in the Vietnam War. Today many medical treatments use a medical version of "super glue" instead of using traditional stitches used for small wounds that need to be closed at the skin level. | symptom of Lassa fever | symptom of Trench fever | symptom of Paratyphoid fever | symptom of Rocky Mountain spotted fever | symptom of Chikungunya | symptom of West Nile fever | symptom of Rift Valley fever | symptom of Leishmaniasis | 00
| 6,212 |
A challenging feature of MeN is that, because the pathophysiology of disease remains relatively poorly understood, the case definition remains broad and likely will include many cases of undiagnosed kidney diseases that ultimately prove to be unrelated to MeN. Recent efforts to provide a case definition have focused on the following features: * Suspected disease: * Estimated GFR (eGFR) 2 * Absence of diabetes, hypertension, autoimmune disease, glomerular disease, congenital kidney disease, obstructive kidney disease as a clear cause of kidney disease (these comorbidities may be present but cannot account for disease development) * Residing in a hotspot region * Proteinuria 2 on 3 month or longer repeat measurement * Relative hypokalemia and/or hyperuricemia * Kidney ultrasound with loss of corticomedullary differentiation or bilateral small kidney size, without cystic disease or large stone burden * Kidney biopsy showing primary tubulointerstitial disease without alternative cause of kidney disease in evidence This case definition may not be as useful for disease outside of<unk> while there are many similarities between clinical aspects of CKDu in India, Sri Lanka, and MeN in<unk> there are some important differences as well. Individuals affected in<unk> are younger (aged 20–40 as opposed to 20-60 at the age of onset of CKD). Both regions demonstrate a high male-to-female ratio and significant familial concordance, but the degree of male predominance appears to be greater in<unk> Most affected individuals in both regions live in rural poverty and work in occupations involving physical labor, including agriculture, fishing, and aquaculture. Hypokalemia, hyponatremia, minimal proteinuria, and sterile pyuria are highly prevalent. Individuals in<unk> often have hyperuricemia and urate crystalluria, but this is observed less frequently India or Sri Lanka, . Kidney biopsy in individuals with MeN demonstrates some consistent features across regions. Biopsies are generally chronic glomerular and tubulointerstitial damage with glomerulosclerosis and chronic glomerular ischemia, without positive findings on immunofluorescence or definitive evidence of primary glomerular lesions. Glomerular enlargement may be observed. Ultrastructural changes evaluated with electron microscopy were mostly consistent with the light microscopic observations. Large dysmorphic lysosomes within tubular epithelial cells have been proposed as a distinctive feature but at present are not considered pathognomonic. In kidney biopsies from individuals with acute kidney injury (AKI) among high-risk patients for MeN, considered possibly a contributing stage to disease, the main findings were described as tubulointerstitial nephritis with varying degrees of acute inflammation and chronic tubulointerstitial changes. In some cases, neutrophils have been found in the tubular lumen of both chronic and acute MeN/CKDu patients, but urine cultures from these patients have been negative. | Mesoamerican nephropathy | IgA nephropathy | Malarial nephropathy | Balkan endemic nephropathy | Sickle cell nephropathy | Uddanam nephropathy | HIV-associated nephropathy | Analgesic nephropathy | 00
| 65,092 |
<unk> s vary considerably in length and design, as do peptide hormones, but their base structure is the same. They consist of one or more inactive peptide hormones or hormone chains attached to each other in a way that prevents hormone expression, often by making the chains’ binding ends inaccessible via folding and binding of other chains to said ends. For hormonal expression to be induced, the binding ends of hormones but either bind to receptors in the cell membrane, or in the case of steroids, bind to steroid receptor proteins in the cell, both of which mediate hormone expression. Proinsulin molecule; schematic, topological drawing. B chain (orange), C-peptide (gray), and A chain (green). The C-peptide is seen to bind to the B and A chains and suppress hormonal expression. When cleavage occurs to produce insulin, the B and A chain are connected by disulfide bonds, while the C-peptide is cut out and discarded. Some<unk> s contain structures other than inactive peptide hormones for the purpose of keeping hormone expression suppressed. For example, proinsulin contains an extra non-hormonal chain called C-peptide that binds two insulin peptide chains together, designed to keep both chains inactive by binding to their ends, specifically, their C-domain junctions, which have been proposed to be their site of binding to hormone-expression receptors in the cell. Despite the restrictions it enables, the C-peptide folds the proinsulin chains to make their junction ends accessible to be cleaved by<unk> convertases later, making the folding of the proinsulin chain containing C-peptide essential for the proper cleavage of proinsulin to successfully produce insulin. | Prohormone | Xenohormone | Neurohormone | Hormone | Local hormone | Gastrointestinal hormone | Sex hormone | Neuropeptide | 00
| 69,217 |
Symptoms are typically vague and non-specific, such as fatigue or headaches. These symptoms, although they can be disabling, are called non-specific because they are not associated with any single specific medical condition. A 2010 review of<unk> literature said that the following symptoms, in this order, were the most reported in the condition: headache, fatigue, confusion, depression, shortness of breath, arthralgia, myalgia, nausea, dizziness, memory problems, gastrointestinal symptoms, respiratory symptoms. Symptoms mainly arise from the autonomic nervous system (such as nausea or dizziness) or have psychiatric or psychological aspects (such as difficulty concentrating). | Multiple chemical sensitivity | Acute to chronic ratio | Cold sensitivity | Hypoallergenic | Oat sensitivity | Acid-fastness | Vangent | Depurative | 00
| 4,102 |
No symptoms Recommended treatment of asymptomatic<unk> depends in part on the expectations of developing bleeding and/or thrombotic complications as indicated by the personal history of the afflicted individual and family members. Where possible, determination of the exact mutation causing the disorder and the propensity of this mutation type to develop these complications may be helpful. Individuals with fibrinogen levels >1.0 gram/liter typically do not develop bleeding or thrombosis episodes. Individuals with fibrinogen levels of 0.5-1.0 grams/liter require fibrinogen supplementation preferably with a plasma-derived fibrinogen concentrate to maintain fibrinogen levels of >1 gram/liter prior to major surgery. Individuals with fibrinogen levels of 1 to 2 gram/liter at the end of pregnancy and during the postpartum period; b) > 1 gram/liter prior to major surgery; c) > 0.5 to 1 gram/liter during the first two trimesters of pregnancy; and d) >0.5 gram/liter prior to minor surgery. Tranexamic acid may be used in place of fibrinogen supplementation as prophylactic treatment prior to minor surgery and to treat minor bleeding episodes. Symptoms Individuals with<unk> who have a history of excessive bleeding should be treated at a center specialized in treating hemophilia and avoid all medications that interfere with normal platelet function. During bleeding episodes, treatment with fibrinogen concentrates or, if unavailable infusion of fresh frozen plasma and/or cryoprecipitate (a fibrinogen-rich plasma fraction) to maintain fibrinogen activity levels >1 gram/liter. Individuals with<unk> who experience episodic thrombosis should also be treated at a center specialized in treating hemophilia. Standard recommendations for these individuals are that they use antithrombotic agents and be instructed on antithrombotic behavioral methods in high risk situations (e.g. long car rides and air flights. Acute venous thrombosis episodes should be treated with low molecular weight heparin for a time that depends on personal and family history of thrombosis events. Prophylactic treatment prior to minor surgery should avoid fibrinogen supplementation and use anticoagulation measures; prior to major surgery, fibrinogen supplementation should be used only if serious bleeding occurs; otherwise, prophylactic anticoagulation measures are recommended. Fibrin storage disease There are too few cases of fibrinogen storage disease to establish optimal treatments for the liver diseases. Management of the disorder has been based on general recommendations for patients with liver disease, particularly Alpha 1 antitrypsin deficiency-associated liver disease. In the latter disease, autophagy, the pathway that cells use to dispose of dysfunctional or excessively stored components including proteins, has been targeted using autophagy-enhancing drugs, e.g. carbamazepine, vitamin E, and ursodeoxycholic acid. These drugs have been tested in individual patients with fibrin storage disease with some success in reducing evidence of liver injure, i.e. reduction in blood liver enzyme levels. These and other autophagy-enhancing drugs are suggested to be further studied in fibrinogen storage disease. | Congenital hypofibrinogenemia | Factor VII deficiency | Harris platelet syndrome | Acquired haemophilia | Congenital afibrinogenemia | Gray platelet syndrome | Von Willebrand disease | Dysfibrinogenemia | 00
| 70,486 |
An<unk> is a sore on the skin or a mucous membrane, accompanied by the disintegration of tissue.<unk> can result in complete loss of the epidermis and often portions of the dermis and even subcutaneous fat.<unk> are most common on the skin of the lower extremities and in the gastrointestinal tract. An<unk> that appears on the skin is often visible as an inflamed tissue with an area of reddened skin. A skin<unk> is often visible in the event of exposure to heat or cold, irritation, or a problem with blood circulation. They can also be caused due to a lack of mobility, which causes prolonged pressure on the tissues. This stress in the blood circulation is transformed to a skin<unk> commonly known as bedsores or decubitus<unk> .<unk> often become infected, and pus forms. | Ulcer | Clinic | Papule | Dermal patch | Nail | Syringe | Periwound | Crown | 00
| 9,340 |
Gastrointestinal bleeding can range from small non-visible amounts, which are only detected by laboratory testing, to massive bleeding where bright red blood is passed and shock develops. Rapid bleeding may cause syncope. The presence of bright red blood in stool, known as hematochezia, typically indicates lower gastrointestinal bleeding. Digested blood from the upper gastrointestinal tract may appear black rather than red, resulting in "coffee ground" vomit or melena. Other signs and symptoms include feeling tired, dizziness, and pale skin color. A number of foods and medications can turn the stool either red or black in the absence of bleeding. Bismuth found in many antacids may turn stools black as may activated charcoal. Blood from the vagina or urinary tract may also be confused with blood in the stool. | symptom of Hereditary hemorrhagic telangiectasia | symptoms of Hereditary hemorrhagic telangiectasia | symptom of Chilaiditi syndrome | symptom of Neurofibromatosis | symptom of Scurvy | symptom of Kabuki syndrome | symptom of Giant cell arteritis | symptom of Hereditary angioedema | 00
| 18,526 |
<unk><unk> Medications<unk> occurs in about 30% of women who are taking a course of antibiotics by mouth. Broad-spectrum antibiotics kill healthy bacteria in the<unk> such as Lactobacillus. These bacteria normally help to limit<unk> colonization. Oral contraceptive use is also associated with increased risk of<unk> thrush. Pregnancy In pregnancy, higher levels of estrogen make a woman more likely to develop a<unk><unk> . During pregnancy, the Candida fungus is more common, and recurrent<unk> is also more likely. There is tentative evidence that treatment of asymptomatic candidal vulvovaginitis in pregnancy reduces the risk of preterm birth. Lifestyle While<unk> s may occur without sex, a high frequency of intercourse increases the risk. Personal hygiene methods or tight-fitting clothing, such as tights and thong underwear, do not appear to increase the risk. Diseases Those with poorly controlled diabetes have increased rates of<unk> while those with well controlled diabetes do not. The risk of developing thrush is also increased when there is poor immune function, as with HIV/AIDS, or in those receiving chemotherapy. Diet A diet high in sugar may increase the risk of<unk> thrush; in some women, reducing sugar intake seems to reduce the risk of reoccurring<unk> thrush. | Vaginal yeast infection | Bacterial vaginosis | Chlamydia | Atrophic vaginitis | Gonorrhea | Aerobic vaginitis | Vaginal intraepithelial neoplasia | Puberty menorrhagia | 00
| 55,244 |
<unk> , also known as wolf's bane, leopard's bane, mountain tobacco and mountain<unk> , is a moderately toxic European flowering plant in the daisy family Asteraceae. It is noted for its large yellow flower head. The names "wolf's bane" and "leopard's bane" are also used for another plant, aconitum, which is extremely poisonous.<unk> is used as an herbal medicine for analgesic and anti-inflammatory purposes, but there is insufficient high-quality clinical evidence for such effects, and it is toxic when taken internally or applied to injured skin. | Arnica montana | Cerbera odollam | Arcanum joviale | Hirudo orientalis | Mitragyna speciosa | Ephedra distachya | Capillaria philippinensis | Gonyaulax | 00
| 15,732 |
The autonomic nervous system is a component of the peripheral nervous system and comprises two branches: the sympathetic nervous system (SNS) and the parasympathetic nervous system (PSNS). The SNS controls the more active responses such as increasing heart rate and blood pressure. The PSNS slows down the heart rate and aids in digestion, for example. Symptoms typically arise from abnormal responses of either the sympathetic or parasympathetic systems based on situation or environment. | symptom of Mitral valve prolapse | symptom of Mitral valve stenosis | symptom of Pulmonary valve stenosis | symptom of Tricuspid insufficiency | symptom of Pericarditis | symptom of Hypertrophic cardiomyopathy | symptom of Atrial fibrillation | symptom of Myocarditis | 00
| 12,043 |
<unk> is a demyelinating disease, in which the myelin sheath covering the axons of nerve cells is gradually destroyed, impairing the transmission of nerve impulses. It affects the subcortical white matter, particularly that of the parietal and occipital lobes.<unk> destroys oligodendrocytes and produces intranuclear inclusions. It is similar to another demyelinating disease, MS, but progresses much more quickly. The breakdown of myelin is proportional to the degree of immunocompromise. | Progressive multifocal leukoencephalopathy | Toxic leukoencephalopathy | Tuberculous meningitis | Granulomatous meningoencephalitis | Herpesviral encephalitis | Malignant multiple sclerosis | Drug-induced aseptic meningitis | Polioencephalitis | 00
| 1,868 |
Spinal muscular atrophy is caused by loss-of-function mutations in the SMN1 gene which codes for survival motor neuron (SMN) protein. People survive owing to low amounts of the SMN protein produced from the SMN2 gene.<unk> modulates alternative splicing of the SMN2 gene, functionally converting it into SMN1 gene, thus increasing the level of SMN protein in the CNS. The drug distributes to CNS and peripheral tissues. The half-life is estimated to be 135 to 177 days in cerebrospinal fluid (CSF) and 63 to 87 days in blood plasma. The drug is metabolized via exonuclease (3′- and 5′)-mediated hydrolysis and does not interact with CYP450 enzymes. The primary route of elimination is likely by urinary excretion for<unk> and its metabolites. | Nusinersen | Inotersen | Belinostat | Memantine | Glybuzole | Glysobuzole | Ozanimod | Siponimod | 00
| 68,786 |
The<unk> of a medication is an assessment of the risk of fetal injury due to the pharmaceutical, if it is used as directed by the mother during<unk> . It does not include any risks conferred by pharmaceutical agents or their metabolites in breast milk. Every drug has specific information listed in its product literature. The British National Formulary used to provide a table of drugs to be avoided or used with caution in<unk> , and did so using a limited number of key phrases, but now Appendix 4 (which was the<unk> table) has been removed. Appendix 4 is now titled "Intravenous Additives". However, information that was previously available in the former Appendix 4<unk> and Appendix 5 (breast feeding) is now available in the individual drug monographs. | Pregnancy category | Childbirth positions | Prevalence of birth control | Deemed status | Child development stages | Natural history of disease | Risk factor | Timeline of sexual orientation and medicine | 00
| 14,677 |
Genotype and QT interval duration are the strongest predictors of outcome for patients with LQTS. These have been combined to create an externally validated risk score calculator, estimating a 5 year risk for each individual patient, which can help physicians to identify patients at the highest risk of life-threatening arrhythmic events. For people who experience cardiac arrest or fainting<unk> d by LQTS and who are untreated, the risk of death within 15 years is around 50%. With careful treatment this decreases to less than 1% over 20 years. Those who exhibit symptoms before the age of 18 are more likely to experience a cardiac arrest. | medical cause of Ventricular fibrillation | medical cause of Ventricular tachycardia | medical cause of Supraventricular tachycardia | complications of Atrial fibrillation | medical cause of Myocardial infarction | symptoms of Brugada syndrome | complications of Ventricular tachycardia | medical cause of Coronary artery disease | 00
| 11,441 |
The various interventions recommended for<unk> fall into three categories: family counseling, prevention of the disease's many complications, and bone marrow transplantation in an effort to restore<unk> -sufficient stem cells. However, due to the uncommonness of, and only recent appreciation for, the disease, standard phase 2 clinical trials to establish the efficacy of a , and/or non-drug treatment regiments against an appropriate placebo treatment regimen have not been reported. Family counseling Family members of an diagnosed with an inactivating<unk> gene mutation should be told of their chances of having this mutation, advised of the consequences of this mutation, recommended to be tested for the mutation, warned that they are not suitable donors for any<unk> deficient individual, and offered long term follow up of their mutation. Prevention of complications Recommendations for individuals exhibiting susceptibility to the infectious complications of<unk> (e.g. MonoMAC-afflicted individuals) include: early vaccination for papillomavirus, early vaccination or prophylaxis drug treatment for nontuberculosus mycobacteria, and, perhaps, prophylaxis drug treatment (e.g. Azithromycin) for bacteria. Standard methods are recommended for the prevention of deep vein thrombosis and/or the embolism that occur in lymphedema of the lower extremities and for the blood hypercoagulability state complicating<unk> insufficiency presentations such as the Emberger syndrome.<unk> deficient individuals should be routinely monitored by: a) frequent complete blood counts and when indicated bone marrow examinations to detect progression of their disorder to more MDS or leukemia; b) and clinical evaluation of respiratory function and when indicated lung function tests to detect deterioration of lung function; and c) clinical evaluation analyses to determine the infection susceptibility, tumor formation, and the worsening function of other organs. Bone marrow transplantation Many authorities currently recommend<unk> be treated by a moderately but not maximally aggressive myeloablative conditioning regimen to remove native bone marrow stem/progenitor cells followed by hematopoietic stem cell transplantation to repopulate the bone marrow with<unk> sufficient stem cells. The use of this procedure should be anticipatory and occur before the development of a hyperellular bone marrow or a bone marrow or blood populated by an excess of progenitor cells (i.e. blast cells >2% to 5%). These developments are often followed by transformation of the disorder to a leukemia. This regiment should also be performed before the development of severe systemic infections, tumors, or deterioration in lung function. disease. While it takes up to 3.5 years for this regiment to fully re-institute good immune function, it significantly reduces susceptibility to infections and infection-induced tumor formation. The regimen also improves or normalizes lung function in cases of pulmonary alveolar proteinosis and pulmonary artery hypertension and may halt the progression or improve the function of other organs directly injured by<unk> . Clinical trials Many reports on the recommended treatment of<unk> follow an NIH clinical trial termed "A Pilot and Feasibility Study of Reduced-Intensity Hematopoietic Stem Cell Transplant regimen for Patients With<unk> Mutations". This trial used a regimen of medication (cyclophosphamide, fludarabine) and total body irradiation conditioning followed by allogenic hematopoietic Stem Cell Transplant on 10 patients. The trial had 8 disease-free survivors and obtained an overall survival 76 months with a range of 18 to 95 months. An NIH intervention study is in the process of recruiting and treating 144 individuals with<unk> to determine the success of a treatment regimen consisting of medication (fludarabine, busulfan, cyclophosphamide) and total body irradiation conditioning followed by allogenic hematopoietic stem cell transplantation. | GATA2 deficiency | WNT4 deficiency | Janus kinase 3 deficiency | ZC4H2 deficiency | CDK13-related disorder | LRBA deficiency | ZAP70 deficiency | 1p36 deletion syndrome | 00
| 71,374 |
Laboratory studies suggest that<unk> can aid with stroke recovery by improving neuroprotection, neurogenesis, and neuroplasticity by amplifying endogenous processes of self-protection and self-repair of the brain. MLC901 can activate KATP channels, which has a neuroprotective effect against brain ischemia. | NeuroAiD | OHVIRA | ICPC-2 PLUS | ScotSTAR | DCAP-BTLS | Pro-ana | HeRAMS | PATH | 00
| 47,361 |
<unk> refers to the mixture of medical<unk> es and volatile anaesthetic agents which is produced by an anaesthetic machine. The<unk> rate and composition of the<unk> is determined by the anaesthetist. Typically the<unk> emerges from the common<unk> outlet, a specific outlet on the anaesthetic machine to which the breathing attachment is then connected. Some older forms of breathing attachment, such as the Magill attachment, require high<unk> s (e.g. 7 litres/min) to prevent the patient from rebreathing their own expired carbon dioxide. More modern systems, e.g. the circle breathing attachment, use soda lime to absorb carbon dioxide, so that expired<unk> becomes suitable to re-use. With a very efficient circle system, the<unk> may be reduced to the patient's minimum oxygen requirements (e.g. 250ml/min), plus a little volatile. | Fresh gas flow | Gas exchange | Mechanical properties of biomaterials | Wound ballistics | Airway resistance | Breathing circuit | Biot's respiration | Wound healing | 00
| 40,136 |
<unk> <unk> , or<unk> salt) is a metal halide salt composed of<unk> and chlorine. It is odorless and has a white or colorless vitreous crystal appearance. The solid dissolves readily in water, and its solutions have a salt-like taste.<unk> can be obtained from ancient dried lake deposits.<unk> is used as a fertilizer, in medicine, in scientific applications, and in food processing, where it may be known as E number additive E508. It occurs naturally as the mineral sylvite, and in combination with sodium chloride as sylvinite. | Potassium chloride | Calcium chloride | Sodium bicarbonate | Potassium canrenoate | Ringer's lactate solution | Calcium gluconate | Potassium bromide | Mannitol | 00
| 6,704 |
Note that this description is focused on<unk> of childhood. Similar syndromes may develop following a brainstem infarction. The cause of<unk> of childhood is the mutation of ATP1A3 gene. In a study of fifteen females and nine males’ patient with<unk> , a mutation in ATP1A3 gene was present. Three patients showed heterozygous de-novo missense mutation. Six patients were found with de-novo missense mutation and one patient was identified with de-novo splice site mutation. De novo mutation is a mutation that occurs in the germ cell of one parent. Neither parent has the mutation, but it is passed to the child through the sperm or egg. | Alternating hemiplegia | Spastic diplegia | Spastic hemiplegia | Triplegia | Harding ataxia | Dissociated sensory loss | Tetraplegia | Paraplegia | 00
| 64,373 |
<unk> uses<unk><unk><unk> (MRI) to produce high quality two-dimensional or three-dimensional images of the brain and brainstem without the use of ionizing radiation (X-rays) or radioactive tracers. | Magnetic resonance imaging of the brain | Brain biopsy | Hemoencephalography | Cranial ultrasound | Carotid ultrasonography | Stereoelectroencephalography | Pneumoencephalography | Transcranial pulsed ultrasound | 00
| 61,142 |
TCC of the<unk> is diagnosed by examination of the tissue by a pathologist. It has a characteristic appearance under the microscope and distinctive pattern of immunostaining. Pathology It is not related urothelial<unk> . It is in the<unk> cell category of<unk> an tumours which also includes malignant Brenner tumour and benign Brenner tumour. Image:<unk> - low mag. Low mag. Image:<unk> - very high mag. Very high mag. | Transitional cell carcinoma of the ovary | Tubular carcinoma | Clear-cell ovarian carcinoma | Papillary serous cystadenocarcinoma | Adrenocortical carcinoma | Follicular cyst of ovary | Ovarian serous cystadenoma | Serous cystadenocarcinoma | 00
| 64,085 |
Right<unk> in patient with Right femoral enchondroma The<unk> , also known as the Throckmorton sign, is a slang or joke term used in the field of radiology. It refers to the position of a penis as it relates to pathology on an X-ray of a pelvis. When the penis (visible on the X-ray as a shadow) points towards the same side as a unilateral medical condition such as a broken bone, this is considered a "positive<unk> ", and if the shadow points to the other side, it is a "negative<unk> ." Studies have shown that the "sign" is no better than chance at identifying the location of a hip fracture. In those cases where the<unk> is positive, it has been proposed that a person with a displaced hip fracture may try to lie on the injured side to immobilize the fracture and reduce pain; the penis then inclines toward the downward (injured) side. Andy Murray, British professional tennis player, released a picture of his pelvic X-ray following his hip resurfacing surgery on January 29, 2019 clearly demonstrating an example of a negative<unk> Thomas or Throckmorton sign where his penis pointed away from the site of injury. The release of the X-ray image with visible genitalia was discussed by Piers Morgan on Good Morning Britain prompting Murray, who was watching at the time, to message the show, stating, "Please can you stop discussing my genitals on national TV, I was heavily medicated at the time of posting." | John Thomas sign | Terry Thomas sign | Bing's sign | Markle sign | Claybrook sign | Boas' sign | Lincoln sign | Halo sign | 00
| 67,406 |
Common side effects include abdominal pain, loss of appetite, nausea, feeling tired, and dizziness. Serious side effects may include angioedema, liver problems, stroke, psychosis, heart problems, suicide, and aggression. A 2020 meta-analysis found that<unk> was associated with anorexia, weight loss, and hypertension, rating it as a "potentially least preferred agent based on safety" for treating ADHD. As of 2019, safety in pregnancy and breastfeeding is not clear; a 2018 review stated that, "because of lack of data, the treating physician should consider stopping<unk> treatment in women with ADHD during pregnancy." The U.S. Food and Drug Administration (FDA) has issued a black box warning for suicidal behavior/ideation. Similar warnings have been issued in Australia. Unlike stimulant medications,<unk> does not have abuse liability or the potential to cause withdrawal effects on abrupt discontinuation. Incidence of adverse effects Very common (>10% incidence) adverse effects include: * Nausea (26%) * Xerostomia (Dry mouth) (20%) * Appetite loss (16%) * Insomnia (15%) * Fatigue (10%) * Headache * Cough * Vomiting (in children and adolescents) Common (1–10% incidence) adverse effects include: Uncommon (0.1–1% incidence) adverse effects include: Rare (0.01–0.1% incidence) adverse effects including: * Raynaud's phenomenon * Abnormal/increased liver function tests * Jaundice * Hepatitis * Liver injury * Acute liver failure * Urinary retention * Priapism * Male genital pain | Atomoxetine | Guanfacine | Dapoxetine | Vortioxetine | Edivoxetine | Duloxetine | Fluoxetine | Fluparoxan | 00
| 15,588 |
<unk> is a fungal infection due to any type of Candida (a type of yeast). When it affects the mouth, in some countries it is commonly called thrush. Signs and symptoms include white patches on the tongue or other areas of the mouth and throat. Other symptoms may include soreness and problems swallowing. When it affects the vagina, it may be referred to as a yeast infection or thrush. Signs and symptoms include genital itching, burning, and sometimes a white "cottage cheese-like" discharge from the vagina. Yeast infections of the penis are less common and typically present with an itchy rash. Very rarely, yeast infections may become invasive, spreading to other parts of the body. This may result in fevers along with other symptoms depending on the parts involved. More than 20 types of Candida can cause infection with Candida albicans being the most common. Infections of the mouth are most common among children less than one month old, the elderly, and those with weak immune systems. Conditions that result in a weak immune system include HIV/AIDS, the medications used after organ transplantation, diabetes, and the use of corticosteroids. Other risks include dentures, following antibiotic therapy, and breastfeeding. Vaginal infections occur more commonly during pregnancy, in those with weak immune systems, and following antibiotic use. Individuals at risk for invasive<unk> include low birth weight babies, people recovering from surgery, people admitted to intensive care units, and those with an otherwise compromised immune system. Efforts to prevent infections of the mouth include the use of chlorhexidine mouthwash in those with poor immune function and washing out the mouth following the use of inhaled steroids. Little evidence supports probiotics for either prevention or treatment, even among those with frequent vaginal infections. For infections of the mouth, treatment with topical clotrimazole or nystatin is usually effective. Oral or intravenous fluconazole, itraconazole, or amphotericin B may be used if these do not work. A number of topical antifungal medications may be used for vaginal infections, including clotrimazole. In those with widespread disease, an echinocandin such as caspofungin or micafungin is used. A number of weeks of intravenous amphotericin B may be used as an alternative. In certain groups at very high risk, antifungal medications may be used preventatively. Infections of the mouth occur in about 6% of babies less than a month old. About 20% of those receiving chemotherapy for cancer and 20% of those with AIDS also develop the disease. About three-quarters of women have at least one yeast infection at some time during their lives. Widespread disease is rare except in those who have risk factors. | Candidiasis | Lobomycosis | Phycomycosis | Dermatomycosis | Otomycosis | Zygomycosis | Botryomycosis | Chromoblastomycosis | 00
| 694 |
In human, the F9 gene is located on the X chromosome at position q27.1. The gene for<unk> is located on the X chromosome (Xq27.1-q27.2) and is therefore X-linked recessive: mutations in this gene affect males much more frequently than females. At least 534 disease-causing mutations in this gene have been discovered. The F9 gene was first cloned in 1982 by Kotoku Kurachi and Earl Davie. Polly, a transgenic cloned Poll Dorset sheep carrying the gene for<unk> , was produced by Dr Ian Wilmut at the Roslin Institute in 1997. | Factor IX | Factor VIII | Factor VIII | Factor XI | Fibrinogen | Thrombin | Prothrombinase | Β-Thromboglobulin | 00
| 22,113 |
The cause of 48,XXXY can be from non-disjunction in the paternal sperm or non-disjunction in the maternal oocyte. The most likely scenario for the existence of this aneuploidy is that each party (maternal and paternal) equally contributed to it, by the egg giving an XX and the sperm giving an XY. In the case where the sperm is the genetic cause of 48,XXXY<unk> , the sperm would have to contain two X chromosomes and one Y chromosome. This would be caused by two nondisjunction events in spermatogenesis, both meiosis I and meiosis II. The duplicated X chromosome in the sperm would have to fail to separate in both meiosis I and meiosis II for a sperm as well as the X and Y chromosomes would have to be in the same sperm. Then the XXY sperm would fertilize a normal oocyte to make a<unk> zygote. In the case where the oocyte is the genetic cause of 48,XXXY<unk> the oocyte would contain three X chromosome. This would be caused by two nondisjunction events during oogenesis. In meiosis I both sets of duplicated X chromosomes would have to be not separated. Then in meiosis II one set of X chromosomes would have to not separate and the other set would separate resulting in one oocyte with three X chromosomes. A normal sperm containing a Y chromosome would have to fertilize the XXX oocyte to make a<unk> zygote. Mechanism The additional X chromosomes that are characteristic of this condition are associated with an androgen deficiency. This causes reduced or absent feedback inhibition of the pituitary gland, by elevating the gonadotropin levels. | XXXY syndrome | XYY syndrome | XX male syndrome | XYYY syndrome | Turner syndrome | XXYY syndrome | XYYYY syndrome | Klinefelter syndrome | 00
| 63,308 |
<unk> is a syndrome characterized by more than one<unk> . It is sometimes equated with Cowden syndrome. However, MeSH also includes Bannayan–Zonana syndrome (that is, Bannayan–Riley–Ruvalcaba syndrome) and Lhermitte–Duclos disease under this description. Some articles include Cowden syndrome, Bannayan–Riley–Ruvalcaba syndrome, and at least some forms of Proteus syndrome and Proteus-like syndrome under the umbrella term PTEN<unk> tumor syndromes (PHTS). | Multiple hamartoma syndrome | Hemihyperplasia–multiple lipomatosis syndrome | Laron syndrome | Noonan syndrome with multiple lentigines | Nevoid basal-cell carcinoma syndrome | Kapur–Toriello syndrome | Schinzel–Giedion syndrome | Goldenhar syndrome | 00
| 51,672 |
The causes of<unk> ing are many and can be either serious or non-serious. It usually results from pain, weakness, neuromuscular imbalance, or a skeletal deformity. In 30% of cases, the underlying cause remains unknown after appropriate investigations. The most common underlying cause of<unk> ing in children is minor physical trauma. In those with no history of trauma, 40% are due to transient synovitis and 2% are from Legg–Calvé–Perthes syndrome. Other important causes are infectious arthritis, osteomyelitis, and slipped capital femoral epiphysis in children. Infection Septic arthritis Septic arthritis can be difficult to separate from less serious conditions such as transient synovitis. Factors that can help indicate septic arthritis rather than synovitis include a WBC count greater than 12×109/l, fever greater than , ESR greater than 40 mm/h, CRP greater than 2.0 mg/dL, and refusal to walk. People with septic arthritis usually look clinically toxic or sick. Even in the absence of any of these factors, however, septic arthritis may be present. Joint aspiration is required to confirm the diagnosis. Other Other infections that classically lead to a<unk> include Lyme disease (a bacterial infection spread by deer ticks) and osteomyelitis (an infection of the bone). Mechanical Trauma Accidental or deliberate physical trauma may result in either a fracture, muscle bruising, or a contusion. It is the leading cause of a<unk> . Deliberate abuse is important to consider. Slipped capital femoral epiphysis Slipped capital femoral epiphysis (SCFE) is a condition in which the growth plate of the head of the femur slips over the underlying bone. It most commonly presents with hip pain in males during puberty and is associated with obesity. The majority of people affected have a painful<unk> and in half of cases both hips are affected. Nearly a quarter of people present with only knee pain. Treatment involves non-weight-bearing movement and surgery. If not identified early, osteonecrosis or death of the head of the femur may occur. Other A non-painful<unk> may be due to a number of mechanical conditions including hip dysplasia and leg length differences. Inflammatory Transient synovitis Transient synovitis is a reactive arthritis of the hip of unknown cause. People are usually able to walk and may have a low grade fever. They usually look clinically nontoxic or otherwise healthy. It may only be diagnosed once all other potential serious causes are excluded. With symptomatic care it usually resolves over one week. Juvenile rheumatoid arthritis Juvenile rheumatoid arthritis presents gradually with early morning stiffness, fatigue, and weight loss. Vascular Legg–Calvé–Perthes syndrome Legg–Calvé–Perthes syndrome is a degenerative disease of the head of the femur which results in bone loss and deformity. It usually presents as a chronic condition. Neoplastic Cancers including acute lymphocytic leukemia, osteosarcoma, and Ewing’s sarcoma may result in a gradual onset of<unk> ing in children. It is often associated with night sweating, easy bruising, weight loss, and pain most prominent at night. | Limp | IPrEx | Cll1 | SCALPEL | Sparx | Basigin | CoWIN | Clathrin | 00
| 22,257 |
No direct determinant of<unk> s has been discovered; however, factors that put one at a higher risk of developing them include; smoking, exposure to asbestos and other chemical carcinogens, being obese and/or consuming an unhealthy diet, having a family history of cancer, and alcohol and coffee consumption. The incidence rate of<unk> s is greater in men than in women. The incidence of<unk> s is more greatly distributed in North America and Europe than in Asia and South America. The incidence of small renal<unk> s (masses under 4 cm long) has been increasing since the 1980s. Because<unk> s are often difficult to detect, the advancement of diagnostic imaging has inherently been correlated with the incidence rate. Although new diagnostic techniques are being utilized and<unk> s have been diagnosed more often at a lower stage, the mortality rate of the<unk> s have not fluctuated accordingly. Score Component 1 point 2 points 3 points R (radius, maximal diameter) ≤ 4 cm > 4 and 4 and entirely above upper polar line Mass crosses polar line 50% of the mass is across polar line, or mass is entirely between polar lines, or mass crosses axial midline A higher score indicates a higher difficulty in removing the<unk> surgically, potentially making radical (total) nephrectomy necessary. Specific guidelines vary internationally, but in Hong Kong data, patients that underwent partial nephrectomy had scores averaging 7, and those with radical nephrectomy had scores averaging 9. | Kidney tumour | Renal cyst | Kidney cancer | Liver tumor | Ureteral cancer | Pyonephrosis | Hydronephrosis | Kidney stone disease | 00
| 56,516 |
There are no known risk factors that have been identified specific to the disease. The tumor appears to arise from the primitive cells of childhood, and is considered a childhood cancer. Research has indicated that there is a chimeric relationship between<unk> and Wilms' tumor and Ewing sarcoma. Together with neuroblastoma and non-Hodgkin's lymphoma, they form the small-cell tumors.<unk> is associated with a unique chromosomal translocation (notated as t(11;22)(p13:q12)) that merges the EWSR1 FET family gene normally located on band 12 of the long (or "q") arm of chromosome 22 with part of the WT1 transcription factor gene normally located on band 13 of the short arm of chromosome 11. The resulting EWSR1-WT1 fusion gene is converted to a fusion transcript that directs the formation of an EWSR1-WT1 chimeric protein. The EWSR1-WT1 chimeric protein contains the N-terminal transactivation domain of EWSR1 and the DNA-binding domain of WT1. This translocation is seen in virtually all cases of<unk> . The EWS/WT1 translocation product targets ENT4. ENT4 is also known as PMAT. | Desmoplastic small-round-cell tumor | Plexiform angiomyxoid myofibroblastic tumor | Perivascular epithelioid cell tumour | Adenomatoid tumor | Solid pseudopapillary tumour | Sclerosing epithelioid fibrosarcoma | Small-blue-round-cell tumor | Multinucleate cell angiohistiocytoma | 00
| 27,703 |
<unk> s can be congenital or acquired, with the majority being congenital. Congenital<unk> s happen due to an abnormality in the development of the<unk> sac that creates a bulge which is walled off to form a<unk> . Acquired<unk> s can be caused by inflammation from surgery, pericarditis, trauma, echinococcosis, tuberculosis, metastasis, or hemodialysis. The inflammation can lead to a walled-off pocket of fluid that is a<unk> . | Pericardial cyst | Cardiac myxoma | Annuloaortic ectasia | Crisscross heart | Overriding aorta | Cardiac fibroma | Pulmonary artery sling | Aortoesophageal fistula | 00
| 73,769 |
<unk> <unk> is characterized by persistent<unk> and often a general lack of energy, even during the day after apparently adequate or even prolonged nighttime sleep.<unk> can be considered as a broad condition encompassing several sleep disorders where increased sleep is a symptom, or as a symptom of another underlying disorder like narcolepsy, circadian rhythm sleep disorder, sleep apnea or idiopathic hypersomnia. Some persons with<unk> , including those with hypersomnias like narcolepsy and idiopathic hypersomnia, are compelled to nap repeatedly during the day; fighting off increasingly strong urges to sleep during inappropriate times such as while driving, while at work, during a meal, or in conversations. As the compulsion to sleep intensifies, the ability to complete tasks sharply diminishes, often mimicking the appearance of intoxication. During occasional unique and/or stimulating circumstances, a person with<unk> can sometimes remain animated, awake and alert, for brief or extended periods of time.<unk> can affect the ability to function in family, social, occupational, or other settings. A proper diagnosis of the underlying cause and ultimately treatment of symptoms and/or the underlying cause can help mitigate such complications. According to the National Sleep Foundation, around 20 percent of people experience<unk> . | Excessive daytime sleepiness | Hypersomnia | Irregular sleep–wake rhythm | Dyssomnia | Orthosomnia | Sleepwalking | Fidgeting | Parasomnia | 00
| 40,794 |
<unk> or<unk> s (; from Greek χυμός khymos, "juice") is the semi-fluid mass of partly digested food that is expelled by a person's stomach, through the pyloric valve, into the duodenum (the beginning of the small intestine).<unk> results from the mechanical and chemical breakdown of a bolus and consists of partially digested food, water, hydrochloric acid, and various digestive enzymes.<unk> slowly passes through the pyloric sphincter and into the duodenum, where the extraction of nutrients begins. Depending on the quantity and contents of the meal, the stomach will digest the food into<unk> in some time from 40 minutes to 3 hours. With a pH of approximately 2,<unk> emerging from the stomach is very acidic. The duodenum secretes a hormone, cholecystokinin (CCK), which causes the gall bladder to contract, releasing alkaline bile into the duodenum. CCK also causes the release of digestive enzymes from the pancreas. The duodenum is a short section of the small intestine located between the stomach and the rest of the small intestine. The duodenum also produces the hormone secretin to stimulate the pancreatic secretion of large amounts of sodium bicarbonate, which then raises pH of the<unk> to 7. The<unk> then moves through the jejunum and the ileum, where digestion progresses, and the nonuseful portion continues onward into the large intestine. The duodenum is protected by a thick layer of mucus and the neutralizing actions of the sodium bicarbonate and bile. At a pH of 7, the enzymes that were present from the stomach are no longer active. This then leads into the further breakdown of the nutrients still present by anaerobic bacteria, which at the same time help to package the remains. These bacteria also help synthesize vitamin B and vitamin K, which will be absorbed along with other nutrients. | Chyme | Stye | Snake | Milk Teeth | Mold | Straw | Boil | Floater | 00
| 11,292 |
The<unk> ,<unk> T-cell<unk> virus, or<unk> T-cell leukemia-lymphoma virus <unk> family of viruses are a group of<unk> retroviruses that are known to cause a type of cancer called adult T-cell leukemia/lymphoma and a demyelinating disease called<unk> -1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). The<unk> s belong to a larger group of primate T-lymphotropic viruses (PTLVs). Members of this family that infect<unk> s are called<unk> s, and the ones that infect Old World monkeys are called Simian T-lymphotropic viruses (STLVs). To date, four types of<unk> s <unk> -1,<unk> -2,<unk> -3, and<unk> -4) and four types of STLVs (STLV-1, STLV-2, STLV-3, and STLV-5) have been identified.<unk> types<unk> -1 and<unk> -2 viruses are the first retroviruses discovered. Both belong to the oncovirus subfamily of retroviruses and can transform<unk> lymphocytes so that they are self-sustaining in vitro. The<unk> s are believed to originate from interspecies transmission of STLVs. The<unk> -1 genome is diploid, composed of two copies of a single-stranded RNA virus whose genome is copied into a double-stranded DNA form that integrates into the host cell genome, at which point the virus is referred to as a provirus. A closely related virus is bovine leukemia virus BLV. The original name for HIV, the virus that causes AIDS, was<unk> -3. | Human T-lymphotropic virus | Kaposi's sarcoma-associated herpesvirus | Oncolytic adenovirus | Trichodysplasia spinulosa polyomavirus | Oncovirus | Human betaherpesvirus 7 | Human betaherpesvirus 5 | Xenotropic murine leukemia virus–related virus | 00
| 53,969 |
<unk> hepatomyoencephalopathy <unk> syndrome is the name given to a multi-system disease affecting the liver, muscle and brain which is now known to be caused by phytotoxins. After extensive investigation the culprit has been found to be the beans of a common herb in India, Cassia occidentalis. In many districts of western Uttar Pradesh, Uttarakhand, Odisha and Haryana, India, outbreaks of an<unk> “encephalopathy” syndrome, dubbed as a “mysterious disease”, have been an annual feature for many years. At least 500-700 young previously healthy children had been losing their lives every year in this region. The disease affected rural young children during the winter months of September to December, with fatality rates around 75-80%. It was first assumed it to be a kind of viral encephalitis. Many national investigating agencies failed to diagnose the entity for many years. | Acute HME syndrome | Decompression sickness | Aseptic meningitis | Brain fag syndrome | Austrian syndrome | Viral meningitis | Oculo-respiratory syndrome | Brain fever | 00
| 68,052 |
Prognosis is dependent on the severity of symptoms and the patient's overall health. | Felty's syndrome | SUNCT syndrome | Crome syndrome | Eosinophilia–myalgia syndrome | Michels Caskey syndrome | Roemheld syndrome | Mendelson's syndrome | MASA syndrome | 00
| 36,331 |
This not known with certainty but is estimated to be about one per million. It appears to be more common in females than males. | Familial partial lipodystrophy | Congenital generalized lipodystrophy | Familial multiple lipomatosis | Sugarman syndrome | Acquired generalized lipodystrophy | Dunnigan familial partial lipodystrophy | Meige disease | Lipoatrophic diabetes | 00
| 54,711 |
<unk> ,<unk> -Luc operation, also known as<unk> -Luc antrostomy, and Radical antrostomy, is an operation to remove irreversibly damaged mucosa of the maxillary sinus. It is done when maxillary sinusitis is not cured by medication or other non-invasive technique. The approach is mainly from the anterior wall of the maxilla bone. It was introduced by George<unk> (1893)and Henry<unk> (1897). The maxillary sinus is entered from two separate openings, one in the canine fossa to gain access to the antrum and other in the naso antral wall for drainage. | Caldwell-Luc surgery | Mohs surgery | Radiosurgery | SADI-S surgery | Smile surgery | Prison plastic surgery | Forensic facial reconstruction | Prostate steam treatment | 00
| 67,870 |
Triplet expansion is caused by slippage during DNA replication or during DNA repair synthesis. Because the tandem repeats have identical sequence to one another, base pairing between two DNA strands can take place at multiple points along the sequence. This may lead to the formation of 'loop out' structures during DNA replication or DNA repair synthesis. This may lead to repeated copying of the repeated sequence, expanding the number of repeats. Additional mechanisms involving hybrid RNA:DNA intermediates have been proposed. | Trinucleotide repeat disorder | Lysosomal storage disease | Ribosomopathy | Lipid storage disorder | Trinucleotide repeat expansion | Creatine transporter defect | Cerebral creatine deficiency | Peroxisomal disorder | 00
| 29,048 |
This condition is considered premalignant because it may lead to squamous cell carcinoma in about 10% of all cases. It is not possible to predict which cases will progress into SCC, so the current consensus is that all lesions should be treated. Treatment options include 5-fluorouracil, imiquimod, scalpel vermillionectomy, chemical peel, electrosurgery, and carbon dioxide laser vaporization. These curative treatments attempt to destroy or remove the damaged epithelium. All methods are associated with some degree of pain, edema, and a relatively low rate of recurrence. Medication Topical 5-fluorouracil (5-FU, Efudex, Carac) has been shown to be an effective therapy for diffuse, but minor<unk> . 5-fluorouracil works by blocking DNA synthesis. Cells that are rapidly growing need more DNA, so they accumulate more 5-fluorouracil, resulting in their death. Normal skin is much less affected. The treatment usually takes 2–4 weeks depending on the response. The typical response includes an inflammatory phase, followed by redness, burning, oozing, and finally erosion. Treatment is stopped when ulceration and crusting appear. There is minimal scarring. Complete clearance has been reported in about 50% of patients. Imiquimod (Aldara) is an immune response modifier that has been studied for the treatment of<unk> . It promotes an immune response in the skin leading to apoptosis (death) of the tumor cells. It causes the epidermis to be invaded by macrophages, which leads to epidermal erosion. T-cells are also activated as a result of imiquimod treatment. Imiquimod appears to promote an “immune memory” that reduces the recurrence of lesions. There is minimal scarring. Complete clearance has been demonstrated in up to 45% of patients with<unk> keratoses. However, the dose and duration of therapy, as well as the long-term efficacy, still need to be established in the treatment of<unk> . Procedures Both cryosurgery and electrosurgery are effective choices for small areas of<unk> . Cryosurgery is accomplished by applying liquid nitrogen in an open spraying technique. Local anesthesia is not required, but treatment of the entire lip can be quite painful. Cure rates in excess of 96% have been reported. Cryosurgery is the treatment of choice for focal areas of<unk> . Electrosurgery is an alternate treatment, but local anesthesia is required, making it less practical than cryosurgery. With both techniques, adjacent tissue damage can delay healing and promote scar formation. More extensive or recurring areas of<unk> may be treated with either a shave vermillionectomy or a carbon dioxide laser. The shave vemillionectomy removes a portion of the vermillion border but leaves the underlying muscle intact. Considerable bleeding can occur during the procedure due to the vascular nature of the lip. A linear scar may also form after treatment, but this can usually be minimized with massage and steroids. Healing time is short, and effectiveness is very high. A newer procedure uses a carbon dioxide laser to ablate the vermillion border. This treatment is relatively quick and easy to perform, but it requires a skilled operator. Anesthesia is usually required. Secondary infection and scarring can occur with laser ablation. In most cases, the scar is minimal, and responds well to steroids. Pain can be a progressive problem during the healing phase, which can last three weeks or more. However, the carbon dioxide laser also offers a very high success rate, with very few recurrences. Chemical peeling with 50% trichloroacetic acid has also been evaluated, but results have been poor. Healing usually takes 7–10 days with very few side effects. However, limited studies show that the success rate may be lower than 30%. | Actinic cheilitis | Angular cheilitis | Linitis plastica | Tinea capitis | Dermatochalasis | Tinea imbricata | Ankyloblepharon | Capillaritis | 00
| 42,722 |
A<unk><unk> from 1970, with Ovrette brand contraception pills A<unk><unk> is a document included in the<unk> of a<unk> that provides information about that drug and its use. For prescription<unk> s, the<unk> is technical, providing information for medical professionals about how to prescribe the drug.<unk><unk> s for prescription drugs often include a separate document called a "patient<unk><unk> " with information written in plain language intended for the end-user—the person who will take the drug or give the drug to another person, such as a minor.<unk> s for over-the-counter<unk> s are also written plainly. In the United States, labelling for the healthcare practitioner is called "Prescribing Information" (PI), and labelling for patients and/or caregivers includes<unk> Guides", "Patient<unk><unk> s", and "Instructions for Use". In Europe, the technical document is called the "summary of product characteristics" (SmPC), and the document for end-users is called the "patient information leaflet" (PIL) or<unk> leaflet". Similar documents attached to the outside of a<unk> are sometimes called outserts. | Medication package insert | Incident report | Drug labelling | Drug packaging | FDA warning letter | Drug coupon | Sentinel event | Procedure code | 00
| 39,080 |
<unk> <unk> is not necessarily a mode of mechanical ventilation though it may be referred to as such.<unk> is a strategy (method or style) of ventilating the lungs in such a way that the amount of time the lungs are in inhalation is greater than the amount of time they are in exhalation, allowing for a constant inflation of the lungs, ensuring they remain "recruited" (meaning they participate in gas exchange and are not allowed to deflate to get stuck together or tighten up). The primary goal for<unk> is improved oxygenation by forcing inspiratory time to be greater than expiratory time (example: inhale is 3 seconds and exhalation is 1 second, a 3:1 I:E<unk> increasing the mean airway pressure and potentially improving oxygenation. Normal I:E<unk> is 5:6, so forcing the I:E to be 2:1, 3:1, 4:1, (or even as high as 20:1) is the source of the term for the strategy.<unk> has not often been shown to improve important clinical outcomes, such as mortality, duration of mechanical ventilation, or duration of ICU stay. This may be due to the fact that<unk> is not considered as a mode early enough once ARDS is diagnosed. The preponderance of evidence suggests that<unk> improves oxygenation, although the evidence is weak and characterized by low quality, conflicting studies. | Inverse ratio ventilation | Collateral ventilation | High-frequency ventilation | Open lung ventilation | Volume-controlled ventilation | Pressure support ventilation | Prone ventilation | Pressure-controlled ventilation | 00
| 61,707 |
The etiology of<unk> has many explanations which differ from case to case. Many<unk> cal disorders in children involve genetic and physiological mechanisms, though there are still many without any physical grounds. It is absolutely imperative that multiple sources of data be gathered. Diagnosing the<unk> of children is daunting. It is influenced by development and contest, in addition to the traditional sources. Interviews with parents about school, etc., are inadequate. Either reports from teachers or direct observation by the professional are critical. (author, Robert B. Bloom, Ph.D.) The disorders with physical or biological mechanisms are easier to diagnose in children and are often diagnosed earlier in childhood. However, there are some disorders, no matter the mechanisms, that are not identified until adulthood. There is also reason to believe that there is co-morbidity of disorders, in that if one disorder is present, there is often another. | Child psychopathology | Child bereavement | Infant mental health | Child development | Developmental disability | Prenatal development | Learning problems in childhood cancer | Adolescent health | 00
| 26,372 |
Pharmacodynamics (+)-Desmetramadol is a G-protein biased μ-opioid receptor full agonist. It shows comparatively far lower affinity for the δ- and κ-opioid receptors. The two enantiomers of<unk> show quite distinct pharmacological profiles; both (+) and (−)-desmetramadol are inactive as serotonin reuptake inhibitors, but (−)-desmetramadol retains activity as a norepinephrine reuptake inhibitor, and so the mix of both the parent compound and metabolites contributes significantly to the complex pharmacological profile of tramadol. While the multiple receptor targets can be beneficial in the treatment of pain (especially complex pain syndromes such as neuropathic pain), it increases the potential for drug interactions compared to other opioids, and may also contribute to side effects.<unk> is also an antagonist of the serotonin 5-HT2C receptor, at pharmacologically relevant concentrations, via competitive inhibition. This suggests that the apparent anti-depressant properties of tramadol may be at least partially mediated by<unk> , thus prolonging the duration of therapeutic benefit. Inhibition of the 5-HT2C receptor is a suggested factor in the mechanism of anti-depressant effects of agomelatine and maprotiline. The potential selectivity and favorable side effect profile of<unk> compared to its prodrug, tramadol, makes it more suitable for clinical use, although no such large scale controlled trials have been conducted with patients. Upon inhibition of the receptor, downstream signaling causes dopamine and norepinephrine release, and the receptor is thought to significantly regulate mood, anxiety, feeding, and reproductive behavior. 5-HT2C receptors regulate dopamine release in the striatum, prefrontal cortex, nucleus accumbens, hippocampus, hypothalamus, and amygdala, among others. Research indicates that some suicide victims have an abnormally high number of 5-HT2C receptors in the prefrontal cortex. There is some mixed evidence that agomelatine, a 5-HT2C antagonist, is an effective antidepressant. Antagonism of 5-HT2C receptors by agomelatine results in an increase of dopamine and norepinephrine activity in the frontal cortex. Pharmacokinetics Metabolites<unk> is metabolized in the liver into the active metabolite N,O-didesmethyltramadol via CYP3A4 and CYP2B6. The inactive tramadol metabolite N-desmethyltramadol is metabolized into the active metabolite N,O-didesmethyltramadol by CYP2D6. | Desmetramadol | Tramadol | Tapentadol | Acetylmethadol | Etodolac | Ketorolac | Hydrocodone | Pafolacianine | 00
| 44,871 |
The vitreous (Latin for "glassy") humor is a gel which fills the eye behind the lens. Between it and the retina is the vitreous membrane. With age the vitreous humor changes, shrinking and developing pockets of liquefaction, similar to the way a gelatin dessert shrinks and detaches from the edge of a pan. At some stage the vitreous membrane may peel away from the retina. This is usually a sudden event, but it may also occur slowly over months. Age and refractive error play a role in determining the onset of<unk> in a healthy person.<unk> is rare in emmetropic people under the age of 40 years, and increases with age to 86% in the 90s. Several studies have found a broad range of incidence of<unk> , from 20% of autopsy cases to 57% in a more elderly population of patients (average age was 83.4 years). People with myopia (nearsightedness) greater than 6 diopters are at higher risk of<unk> at all ages.<unk> does not directly threaten vision. Even so, it is of increasing interest because the interaction between the vitreous body and the retina might play a decisive role in the development of major pathologic vitreoretinal conditions, such as epiretinal membrane.<unk> may also occur in cases of cataract surgery, within weeks or months of the surgery. The vitreous membrane is more firmly attached to the retina anteriorly, at a structure called the vitreous base. The membrane does not normally detach from the vitreous base, although it can be detached with extreme trauma. However, the vitreous base may have an irregular posterior edge. When the edge is irregular, the forces of the vitreous membrane peeling off the retina can become concentrated at small posterior extensions of the vitreous base. Similarly, in some people with retinal lesions such as lattice retinal degeneration or chorio-retinal scars, the vitreous membrane may be abnormally adherent to the retina. If enough traction occurs the retina may tear at these points. If there are only small point tears, these can allow glial cells to enter the vitreous humor and proliferate to create a thin epiretinal membrane that distorts vision. In more severe cases, vitreous fluid may seep under the tear, separating the retina from the back of the eye, creating a retinal<unk> . Trauma can be any form from a blunt force trauma to the face such as a boxer's punch or even in some cases has been known to be from extremely vigorous coughing or blowing of the nose. | Posterior vitreous detachment | Ischemic optic neuropathy | Vitreous hemorrhage | Posterior ischemic optic neuropathy | Anterior ischemic optic neuropathy | Arteritic anterior ischemic optic neuropathy | Acute retinal necrosis | Optic neuritis | 00
| 27,916 |
A study by You et al. was only able to evaluate the 47 documented cases that have been made to date. According to this study,<unk> s are more prevalent in females as compared to males with a ratio of 3:1. Additionally, individuals are more likely to present with<unk> s at a younger age than with uveal melanomas, the most common intraocular tumor. According to the participants evaluated in this study, the average age of occurrence was 37 years old, however, it is important to note that the age range documented represented individuals 9–76 years old. | Intraocular schwannoma | Optic nerve sheath meningioma | Optic nerve glioma | Optic nerve tumor | Intraocular lymphoma | Vestibular schwannoma | Orbital lymphoma | Coloboma of optic nerve | 00
| 63,832 |
Removing avian proteins The only recommended long-term treatment is avoidance of the avian proteins that trigger<unk> . This can stop the underlying inflammatory response, although symptoms may continue depending on existing damage. It is advisable to remove all<unk> s, and bedding and pillows containing feathers, from the patient's home, as well as any down-filled outerwear and sleeping bags. It is also advisable to wash all soft furnishings, walls, ceilings and furniture, and to avoid future exposure to<unk> s,<unk> droppings, or any items containing feathers, such as pillows in many hotels. In extreme cases, patients may be advised to evacuate their homes permanently and to dispose of all possessions that have been exposed to avian proteins if they cannot be cleaned thoroughly inside and out. (This includes books, beds, and upholstered furniture.) The patient should not attempt to clean any contaminated items. Anyone who comes in contact with items that have been near<unk> s should change clothes and wash their hair before coming in contact with the patient. Steroids Corticosteroids, such as prednisone, often suppresses symptoms temporarily, especially in the early stages of the disease. However, corticosteroids tend not to have a long-term effect if avian protein is not also removed from the environment. Dosage is chosen specific to each patient. By reducing inflammation, corticosteroids might also delay fibrosis in the<unk> s. | Bird fancier's lung | Farmer's lung | Metsovo lung | Underwood's septa | Saber-sheath trachea | Surfer's knots | World Trade Center lung | Fiddler's neck | 00
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