text
stringlengths 3
11.6k
| option_0
stringlengths 2
124
| option_1
stringlengths 3
101
| option_2
stringlengths 3
124
| option_3
stringlengths 3
124
| option_4
stringlengths 3
87
| option_5
stringlengths 3
124
| option_6
stringlengths 3
124
| option_7
stringlengths 2
124
| label
class label 1
class | idx
int32 0
75.1k
|
|---|---|---|---|---|---|---|---|---|---|---|
Coronary angiography of an MI patient Clinical signs of MI or angina if coronary thrombus is symptomatic: Imaging modalities used to evaluate the presence of coronary thrombi: * angioscopy * endocoronary ultrasound * coronary angiography * magnetic resonance imaging (MRI) Postmortem examiners may look for Lines of Zahn, to determine whether blood clotted in the heart vessels before or after death. | Coronary thrombosis | Coronary occlusion | Coronary artery ectasia | Coronary artery aneurysm | Coronary ischemia | Cholesterol embolism | Vasculitis | Embolism | 00
| 17,040 |
<unk> is a tick-borne bacterial infection, caused by bacteria of the family Anaplasmataceae, genera Ehrlichia and Anaplasma. These obligate intracellular bacteria infect and kill white blood cells. The average reported annual incidence is on the order of 2.3 cases per million people. | Ehrlichiosis | Toxoplasmosis | Malaria | Anthrax | Freshers' flu | Bird Flu | Spanish flu | Rickettsiosis | 00
| 43,151 |
The prevalence is not known but this is considered to be a rare disease. About fifty cases have bene described in the literature up to 2019. | Hereditary fibrosing poikiloderma with tendon contractures, myopathy, and pulmonary fibrosis | Camptodactyly-arthropathy-coxa vara-pericarditis syndrome | Hypotrichosis–lymphedema–telangiectasia syndrome | Hereditary sclerosing poikiloderma | Cerebral dysgenesis–neuropathy–ichthyosis–keratoderma syndrome | Undifferentiated connective tissue disease | Chronic multifocal Langerhans cell histiocytosis | X-linked recessive chondrodysplasia punctata | 00
| 72,301 |
<unk> is a speciality dealing with the functional troubles of the three axes (urological, gynaecological and coloproctological) of the female perineum. The<unk> st takes a holistic approach, using defect-specific and mini-invasive treatments. | Perineology | Andrology | Hematology | Thanatology | Endocrinology | Cytotechnology | Immunohaematology | Hemorheology | 00
| 40,954 |
Causes of<unk> are: * Rheumatic disease * Carcinoid syndrome * Pacemaker leads (complication) | Tricuspid valve stenosis | Pulmonary valve stenosis | Tricuspid regurgitation | Mitral stenosis | Pulmonary vein stenosis | Supravalvular aortic stenosis | Aortic regurgitation | Pulmonic stenosis | 00
| 40,597 |
<unk> <unk> is a method of corneal transplantation. The<unk> technique involves the removal of a very thin sheet of tissue from the posterior side of a person's cornea, replacing it with the two innermost layers of corneal tissue from a donor's eyeball. The two corneal layers which are exchanged are the<unk> 's<unk> and the corneal endothelium. The person's corneal tissue is gently excised and replaced with the donor tissue via small 'clear corneal incisions' (small corneal incisions just anterior to the corneal limbus. The donor tissue is tamponaded against the person's exposed posterior corneal stroma by injecting a small air bubble into the anterior chamber. To ensure the air tamponade is effective, it is necessary for people to strictly posture so that they are looking up at the ceiling during the recovery period and until the air bubble has fully resorbed. | Descemet membrane endothelial keratoplasty | Conductive keratoplasty | Laser thermal keratoplasty | Boston keratoprosthesis | Corneal transplantation | Automated lamellar keratoplasty | Minimally invasive glaucoma surgery | Excimer laser trabeculostomy | 00
| 72,638 |
A<unk> ,<unk><unk> notice,<unk><unk> warning,<unk><unk> order, or<unk> order is a public-health<unk> or directive issued by governmental or other health authorities to consumers when a community's drinking<unk> is or could be contaminated by pathogens. Under a<unk> (BWA), the Centers for Disease Control and Prevention recommends that<unk> be brought to a rolling<unk> for one minute before it is consumed in order to kill protozoa, bacteria, and viruses. At altitudes above ,<unk> ing should be extended to 3 minutes, as the lower<unk> ing point at high altitudes requires more time to kill such organisms. BWAs are typically issued when monitoring of<unk> being served to consumers detects E. coli or other microbiological indicators of sewage contamination. Another reason for a BWA is a failure of distribution system integrity evidenced by a loss of system pressure. While loss of pressure does not necessarily mean the<unk> has been contaminated, it does mean that pathogens may be able to enter the piped-water system and thus be carried to consumers. In the United States, this has been defined as a drop below . | Boil-water advisory | Tao brush | Kambo cleanse | Oral hygiene | Feminine hygiene | Dry toilet | Assisted feeding | Sanitation | 00
| 34,622 |
One explanation is that in left ventricular dysfunction, the ejection fraction will decrease significantly, causing reduction in stroke volume, hence causing an increase in end-diastolic volume. As a result, during the next cycle of systolic phase, the myocardial muscle will be stretched more than usual and as a result there will be an increase in myocardial contraction, related to the Frank–Starling physiology of the heart. This results, in turn, in a stronger systolic pulse. There may initially be a tachycardia as a compensatory mechanism to try to maintain cardiac output. Other explanation is due to the heterogeneity of the refractory period between the healthy and diseased myocardial cells. | Pulsus alternans | Pulsus paradoxus | Right axis deviation | Heart click | Third heart sound | Pulsus bigeminus | Precordial thump | Electrical alternans | 00
| 45,802 |
Hippolyte<unk> (1840-1919)<unk> is a presumed disorder whereby the right ventricle is severely compressed due to a shift in the ventricular septal wall of the heart leading to heart failure. It was first described by Hippolyte<unk> in 1910. Today it is questioned whether or not<unk> is its own<unk> or a side effect of other cardiac conditions such as left ventricular heart failure whereby the left ventricle is substantially enlarged which encroaches on the space of the right ventricle. | Bernheim syndrome | Patau syndrome | Weaver syndrome | Feingold syndrome | Patterson syndrome | Larsen syndrome | Takayasu's arteritis | Sotos syndrome | 00
| 72,632 |
More than one kind of treatment is often used, depending on the stage of the cancer, the individual's overall health, age, response to chemotherapy, and other factors such as the likely side effects of the treatment. After full staging, the<unk> patient can typically be classified in one of three different categories: patients with early,<unk> metastatic disease (stages I and II, and select type III tumors), patients with locally advanced disease confined to the thoracic cavity (e.g., large tumors, tumors involving critical chest structures, or patients with positive mediastinal lymph nodes), or patients with distant metastasis outside of the thoracic cavity. Early/nonmetastatic<unk> <unk> s are usually not very sensitive to chemotherapy and/or radiation, so surgery (lung resection to remove the tumor) remains the treatment of choice if patients are diagnosed at an early stage. If the persons have a<unk> , but inoperable tumor, they may undergo highly targeted, high-intensity radiation therapy. New methods of giving radiation treatment allow doctors to be more accurate in treating lung cancers. This means less radiation affects nearby healthy tissues. New methods include cyberknife and stereotactic body radiation therapy. Certain people who are deemed to be higher risk may also receive adjuvant (ancillary) chemotherapy after initial surgery or radiation therapy. A number of possible chemotherapy agents can be selected, but most involve the platinum-based chemotherapy drug called cisplatin. Other treatments include percutaneous ablation and chemoembolization. The most widely used ablation techniques for lung cancer are radiofrequency ablation (RFA), cryoablation, and microwave ablation. Ablation may be an option for patients whose tumors are near the outer edge of the lungs. Nodules less than 1 cm from the trachea, main bronchi, oesophagus, and central vessels should be excluded from RFA given high risk of complications and frequent incomplete ablation. Additionally, lesions greater than 5 cm should be excluded and lesions 3 to 5 cm should be considered with caution given high risk of recurrence. As a minimally invasive procedure, it can be a safer alternative for patients who are poor candidates for surgery due to comorbidities or limited lung function. A study comparing thermal ablation to sublobar resection as treatment for early stage<unk> in older people found no difference in overall survival of the patients. It is possible that RFA followed by radiation therapy has a survival benefit due to synergism of the two mechanisms of cell destruction. Advanced/metastatic<unk> The treatment approach for people who have advanced<unk> is first aimed at relieving pain and distress (palliative), but a wide variety of chemotherapy options exists. These agents include both traditional chemotherapies, such as cisplatin, which indiscriminately target all rapidly dividing cells, and newer targeted agents, which are more tailored to specific genetic aberrations found within a person's tumor. When choosing an appropriate chemotherapy approach, the toxicity profile (side effects of the drug) should be taken into account and balanced with the person's comorbidities (other conditions or side effects that the person is experiencing). Carboplatin is a chemotherapy agent that has a similar effect on a person's survival when compared to cisplatin, and has a different toxicity profile from cisplatin. At present, two genetic markers are routinely profiled in<unk> tumors to guide further treatment decision-making - mutations within epidermal growth factor (EGFR) and anaplastic lymphoma kinase. Also, a number of additional genetic markers are known to be mutated within<unk> and may impact treatment in the future, including BRAF, HER2/neu, and KRAS. For advanced<unk> , a combined chemotherapy treatment approach that includes cetuximab, an antibody that targets the EGFR signalling pathway, is more effective at improving a person's overall survival when compared to standard chemotherapy alone. Thermal ablations, i.e. RFA, cryoablation, and microwave ablation, are appropriate for palliative treatment of tumor-related symptoms or recurrences within treatment fields. People with severe pulmonary fibrosis and severe emphysema with a life expectancy less than a year should be considered poor candidates for this treatment. EGFR mutations Roughly 10–35% of people who have<unk> will have drug-sensitizing mutations of the EGFR. The distribution of these mutations has been found to be race-dependent, with one study estimating that 10% of Caucasians, but 50% of Asians, will be found to have such tumor markers. A number of different EGFR mutations have been discovered, but certain aberrations result in hyperactive forms of the protein. People with these mutations are more likely to have adenocarcinoma histology and be<unk> smokers or light smokers. These people have been shown to be sensitized to certain medications that block the EGFR protein known as tyrosine kinase inhibitors specifically, erlotinib, gefitinib, afatinib, or osimertinib. Reliable identification of mutations in lung cancer needs careful consideration due to the variable sensitivity of diagnostic techniques. ALK gene rearrangements Up to 7% of<unk> patients have EML4-ALK translocations or mutations in the ROS1 gene; these patients may benefit from ALK inhibitors, which are now approved for this subset of patients. Crizotinib, which gained FDA approval in August 2011, is an inhibitor of several kinases, specifically ALK, ROS1, and MET. Crizotinib has been shown in clinical studies to have response rates around 60% if patients are shown to have ALK-positive disease. Several studies have also shown that ALK mutations and EGFR activating mutations are typically mutually exclusive. Thus, patients who fail crizotinib are not recommended to be switched to an EGFR-targeted drug such as erlotinib. Other treatment options Micrograph showing a PD-L1-positive<unk> , PD-L1 immunostain<unk> patients with advanced disease who are not found to have either EGFR or ALK mutations may receive bevacizumab, which is a monoclonal antibody medication targeted against the vascular endothelial growth factor (VEGF). This is based on an Eastern Cooperative Oncology Group study that found that adding bevacizumab to carboplatin and paclitaxel chemotherapy for certain patients with recurrent or advanced<unk> (stage IIIB or IV) may increase both overall survival and progression-free survival. 50px Text was copied from this source, which is available under a Creative Commons Attribution 4.0 International License. programmed death receptor 1 (PD-1) expressed on the surface of T cells, and result in decreased tumor cell kill by the immune system. Atezolizumab is an anti PD-L1 monoclonal antibody. Nivolumab and Pembrolizumab are anti PD-1 monoclonal antibodies. Ipilimumab is a monoclonal antibody that targets Cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) on the surface of T cells. Bevacizumab is a monoclonal antibody that targets Vascular Endothelial Growth Factor (VEGF) in the circulation and functions as an angiogenesis inhibitor.<unk> cells expressing programmed death-ligand 1 (PD-L1) could interact with programmed death receptor 1 (PD-1) expressed on the surface of T cells, and result in decreased tumor cell kill by the immune system. Atezolizumab is an anti PD-L1 monoclonal antibody. Nivolumab and Pembrolizumab are anti PD-1 monoclonal antibodies. Ipilimumab is a monoclonal antibody that targets Cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) on the surface of T cells. Bevacizumab is a monoclonal antibody that targets Vascular Endothelial Growth Factor (VEGF) in the circulation and functions as an angiogenesis inhibitor. Multiple phase 3 clinical trials utilizing immunotherapy in the first line for treatment of<unk> were published, including Pembrolizumab in KEYNOTE-024, KEYNOTE-042, KEYNOTE-189 and KEYNOTE-407; Nivolumab and Ipilimumab in CHECKMATE-227 and CHECKMATE 9LA; and Atezolizumab in IMpower110, IMpower130 and IMpower150. In 2015, the US Food and Drug Administration (FDA) approved the anti-PD-1 agent nivolumab for advanced or metastatic SCC. In 2015, FDA also approved the anti-EGFR drug necitumumab for metastatic SCC. 2 October 2015, the FDA approved pembrolizumab for the treatment of metastatic<unk> in patients whose tumors express PD-L1 and who have failed treatment with other chemotherapeutic agents. October 2016, pembrolizumab became the first immunotherapy to be used first line in the treatment of<unk> if the cancer overexpresses PDL1 and the cancer has no mutations in EGFR or in ALK; if chemotherapy has already been administered, then pembrolizumab can be used as a second-line treatment, but if the cancer has EGFR or ALK mutations, agents targeting those mutations should be used first. Assessment of PDL1 must be conducted with a validated and approved companion diagnostic. Overall survival in<unk><unk> cell lung cancer patients treated with protocols incorporating immunotherapy in the first line for advanced or metastatic disease. Nasser NJ, Gorenberg M, Agbarya A. Pharmaceuticals2020, 13(11), 373; https://doi.org/10.3390/ph13110373 The prognosis of patients with<unk><unk> -cell lung cancer improved significantly with the introduction of immunotherapy. People with tumor PDL-1 expressed over half or more of the tumor cells achieved a median overall survival of 30 months with pembrolizumab. Mobocertinib (Exkivity) was approved for medical use in the United States in September 2021, and it is indicated for adults with locally advanced or metastatic<unk><unk> cell lung cancer<unk> with epidermal growth factor receptor (EGFR) exon 20 insertion mutations, as detected by an FDA-approved test, whose disease has progressed on or after platinum-based chemotherapy. | Non-small-cell lung carcinoma | Large-cell lung carcinoma | Adenocarcinoma of the lung | Giant-cell carcinoma of the lung | Sarcomatoid carcinoma of the lung | Squamous-cell carcinoma of the lung | Mesothelioma | Pulmonary sclerosing pneumocytoma | 00
| 38,735 |
A rheumatologist will aim to diagnose the cause of the patient’s pain by first determining whether it is inside the joint itself, meaning true<unk> , or if it is actually caused by an inflammation of the tendons, referred to as tendonitis. Imaging, such as an MRI or musculoskeletal ultrasound is often required to make a firm diagnosis. | Synovitis | Facet joint arthrosis | Bursitis | Acroosteolysis | Glossitis | Osteoradionecrosis | Joint dislocation | Enthesitis | 00
| 29,455 |
The substance is an ester of the diterpene<unk> and angelic acid. A 3-step semisynthesis of<unk> starting from<unk> was described by a chemical research group in Denmark in 2012. A 14-step synthesis of (+)-ingenol from (+)-3-carene, which is a relatively inexpensive constituent of turpentine, was published in July 2013. | Ingenol mebutate | Nandrolone furylpropionate | Gestonorone caproate | Quingestanol acetate | Segesterone acetate | Dienogest | Degarelix | Bisoctrizole | 00
| 62,694 |
<unk> (also known as a "recurrent melanocytic nevus", and "recurrent nevus") is a cutaneous condition in which melanotic skin lesions clinically resemble a superficial spreading melanoma at the site of a recent shave removal of a melanocytic nevus. | Pseudomelanoma | Melanoma | Angiokeratoma | Nodular melanoma | Lentigo maligna melanoma | Polypoid melanoma | Desmoplastic melanoma | Cherry angioma | 00
| 55,918 |
A medical professional applies nose drops. Pressure is applied to a<unk> spray container. Ketamine prepared in a spiral for "snorting." a common technique for self-administration of some recreational drugs.<unk> , popularly known as snorting, is a route of<unk> in which drugs are insufflated through the nose. It can be a form of either topical<unk> or systemic<unk> , as the drugs thus locally delivered can go on to have either purely local or systemic effects.<unk> sprays are locally acting drugs such as decongestants for cold and allergy treatment, whose systemic effects are usually minimal. Examples of systemically active drugs available as<unk> sprays are migraine drugs, rescue medications for overdose and seizure emergencies, nicotine replacement, and hormone treatments. | Nasal administration | Oral administration | Subcutaneous injection | Subcutaneous infusion | Intraperitoneal injection | Intramuscular injection | Transdermal spray | Intravaginal administration | 00
| 54,816 |
Main symptoms of aspirin overdose<unk> toxicity has potentially serious consequences, sometimes leading to significant morbidity and death. Patients with mild intoxication frequently have nausea and vomiting, abdominal pain, lethargy, ringing in the ears, and dizziness. More significant signs and symptoms occur in more severe poisonings and include high body temperature, fast breathing rate, respiratory alkalosis, metabolic acidosis, low blood potassium, low blood glucose, hallucinations, confusion, seizure, cerebral edema, and coma. The most common cause of death following an aspirin overdose is cardiopulmonary arrest usually due to pulmonary edema. High doses of<unk> can cause<unk> -induced tinnitus. Severity The severity of toxicity depends on the amount of aspirin taken. Severity Mild (150 mg/kg) Moderate (150–300 mg/kg) Severe (300–500 mg/kg) Toxicity No toxicity expected Mild to moderate toxicity expected Life-threatening toxicity expected Symptoms Nausea, vomiting, dizziness Nausea, vomiting, ringing in the ears, headache, confusion, hyperventilation, tachycardia, fever Delirium, hallucinations, seizures, coma, respiratory arrest | Salicylate poisoning | Sepsis | Tin poisoning | Myocardial infarction | Thallium poisoning | Psychomotor agitation | Sulfuric acid poisoning | Diabetic ketoacidosis | 00
| 56,414 |
There is no single test to diagnose<unk> . It is typically diagnosed by age 2, though milder cases may go undetected for a longer time. A doctor will typically use a series of tests to assess developmental progress in growth, muscle control, coordination, vision, hearing, and posture. Continuous loss of motor skills likely indicates a condition other than<unk> CP such as a genetic muscle disease Some metabolic disorders mimic<unk> and can be ruled out using a Magnetic resonance imaging test (MRI). Some tests to assess a child suspected to have<unk> are: * Cranial ultrasound * CT scan * Magnetic resonance imaging These tests are imaging techniques used to produce pictures of the brain and to examine them for areas of damage that indicate a diagnosis of<unk> . A child with a<unk> CP diagnosis will likely be referred to screening for other conditions associated with<unk> such as epilepsy (seizure disorder), intellectual disability, and visual impairment. Types Scientific classifications The types of<unk> are generally distinguished by the primary areas of the body that are affected. *<unk> hemiplegia Hemiplegia is a type of cerebral palsy affecting one vertical half of the body (such as one arm and one leg). The affected side of the body is opposite the affected area of the brain in hemiplegia. For example, if the right side of the brain is damaged, the person will have weakness or paralysis on the left side of the body. People with hemiplegia typically favor an arm or hand and may keep the weaker hand in a fist. Typically, people that have<unk> hemiplegia are the most ambulatory of all the forms, although they generally have dynamic equinus (a limping instability) on the affected side and are primarily prescribed ankle-foot orthoses to prevent said equinus. *<unk> diplegia describes<unk> CP in which muscle tightness predominantly occurs in the legs. The arms may be somewhat affected or not affected at all. *<unk> monoplegia is one single limb being affected. *<unk> triplegia is three limbs being affected. *<unk> quadriplegia is all four limbs more or less equally affected. People with<unk> quadriplegia are rarely able to ambulate without assistance and may not stand at all. Among the forms of<unk> CP, quad CP is more likely to co-occur with seizures and mild to moderate intellectual disability. In<unk> in children with low birth weights, 25% of children had hemiplegia, 37.5% had quadriplegia, and 37.5% had diplegia. No one person with a particular type of<unk> CP presents in exactly the same way. | Spastic cerebral palsy | Athetoid cerebral palsy | Dyskinetic cerebral palsy | Ataxic cerebral palsy | Cerebral palsy | Klumpke paralysis | Infantile progressive bulbar palsy | Oculopharyngeal muscular dystrophy | 00
| 61,394 |
<unk> <unk> , also known as keratomileusis in situ, is a non-laser<unk> refractive procedure used to correct high degree refractive errors. This procedure can correct large amounts of myopia and hyperopia. However, the resultant change is not as predictable as with other procedures. | Automated lamellar keratoplasty | Conductive keratoplasty | Laser thermal keratoplasty | Descemet membrane endothelial keratoplasty | Corneal transplantation | Phototherapeutic keratectomy | Boston keratoprosthesis | Photorefractive keratectomy | 00
| 42,678 |
The prognosis is worse when there are more areas of pain reported. Treatment may include psychotherapy (with cognitive-behavioral therapy or operant conditioning), medication (often with antidepressants but also with pain medications), and sleep therapy. According to a study performed at the Leonard M. Miller School of Medicine, antidepressants have an analgesic effect on patients suffering from<unk> . In a randomized, placebo-controlled antidepressant treatment study, researchers found that "antidepressants decreased pain intensity in patients with psychogenic pain or somatoform<unk> significantly more than placebo". Prescription and nonprescription pain medications do not help and can actually hurt if the patient suffers side effects or develops an addiction. Instead, antidepressants and talk therapy are recommended. CBT helps patients learn what worsens the pain, how to cope, and how to function in their life while handling the pain. Antidepressants work against the pain and worry. Unfortunately, many people do not believe the pain "is all in their head," so they refuse such treatments. Other techniques used in the management of chronic pain may also be of use; these include massage, transcutaneous electrical nerve stimulation, trigger point injections, surgical ablation, and non-interventional therapies such as meditation, yoga, and music and art therapy. There are also interventions known as pain control programs that involve the removal of patients from their usual settings to a clinic or facility that provides inpatient or outpatient treatments. These include multidisciplinary or multimodal approaches, which use combinations of cognitive, behavior, and group therapies. Before treating a patient, a psychologist must learn as many facts as possible about the patient and the situation. A history of physical symptoms and a psychosocial history help narrow down possible correlations and causes. Psychosocial history covers the family history of<unk> s and worries about illnesses, chronically ill parents, stress and negative life events, problems with family functioning, and school difficulties (academic and social). These indicators may reveal whether there is a connection between stress-inducing events and an onset or increase in pain, and the removal in one leading to the removal in the other. They also may show if the patient gains something from being ill and how their reported pain matches medical records. Physicians may refer a patient to a psychologist after conducting medical evaluations, learning about any psychosocial problems in the family, discussing possible connections of pain with stress, and assuring the patient that the treatment will be a combination between medical and psychological care. Psychologists must then do their best to find a way to measure the pain, perhaps by asking the patient to put it on a number scale. Pain questionnaires, screening instruments, interviews, and inventories may be conducted to discover the possibility of somatoform<unk> s. Projective tests may also be used. | Pain disorder | Physical disorder | Cognitive disorder | Chronic pain | Cancer pain | Body image disturbance | Stroke recovery | Mental disorder | 00
| 30,020 |
Fever, headache, and neurological problems, while classic, only occur in 20% of people with<unk> . The famous triad of fever, headache and focal neurologic findings are highly suggestive of<unk> . These symptoms are caused by a combination of increased intracranial pressure due to a space-occupying lesion (headache, vomiting, confusion, coma), infection (fever, fatigue etc.) and focal neurologic brain tissue damage (hemiparesis, aphasia etc.). The most frequent presenting symptoms are headache, drowsiness, confusion, seizures, hemiparesis or speech difficulties together with fever with a rapidly progressive course. Headache is characteristically worse at night and in the morning, as the intracranial pressure naturally increases when in the supine position. This elevation similarly stimulates the medullary vomiting center and area postrema, leading to morning vomiting. Other symptoms and findings depend largely on the specific location of the abscess in the brain. An abscess in the cerebellum, for instance, may cause additional complaints as a result of brain stem compression and hydrocephalus. Neurological examination may reveal a stiff neck in occasional cases (erroneously suggesting meningitis). | Brain abscess | Epidural hematoma | Brain metastasis | Subdural empyema | Amoebic brain abscess | Leptomeningeal cancer | Meninges | Coma | 00
| 386 |
<unk> is a form of vampirism that refers to drinking one's own blood, typically as a form of sexual gratification. As a mental disorder, this is also called as autohemophagia, which is derived from three Greek words: auto, which means "self"; hemo, for "blood"; and, phag, meaning "to eat". Although closely related to vampirism, the two differ in that vampirism is a sadistic act while<unk> is on the side of masochism. Along with drinking their own blood, most practitioners of<unk> also engage in self-harm in order to obtain the blood. | Autovampirism | Anticipatory grief | Homicidal ideation | Self-disorder | Obsessive love | Morbid love | Self-cannibalism | Insanity | 00
| 33,927 |
There are many symptoms that could possibly occur before the hallucinations begin. Symptoms include headache, dizziness, irritability, insomnia, and indisposition. Typically,<unk> has a sudden onset. | Alcoholic hallucinosis | Stimulant psychosis | Benzodiazepine withdrawal syndrome | Myxedema psychosis | Alcohol withdrawal syndrome | Substance-induced psychosis | Dancing mania | Benzodiazepine overdose | 00
| 50,613 |
<unk> near Chennai, India<unk> s are medical clinics that assist couples, and sometimes individuals, who want to become parents but for medical reasons have been unable to achieve this goal via the natural course. Clinics apply a number of diagnosis tests and sometimes very advanced medical treatments to achieve conceptions and pregnancies. | Fertility clinic | Abortion clinic | Pregnancy options counseling | Prenatal and perinatal psychology | LGBT reproduction | Birth control | Birth control | Sperm bank | 00
| 41,792 |
Child When treated with GH, a severely deficient child will begin to grow faster within months. In the first year of treatment, the rate of<unk> may increase from half as fast as other children are growing to twice as fast (e.g., from 1 inch a year to 4 inches, or 2.5 cm to 10).<unk> typically slows in subsequent years, but usually remains above normal so that over several years a child who had fallen far behind in his height may grow into the normal height range. Excess adipose tissue may be reduced. Adults GH treatment can confer a number of measurable benefits to severely GH-deficient adults, such as enhanced energy and strength, and improved bone density. Muscle mass may increase at the expense of adipose tissue. Although adults with hypopituitarism have been shown to have a reduced life expectancy, and a cardiovascular mortality rate of more than double controls, treatment has not been shown to improve mortality, although blood lipid levels do improve. Similarly, although measurements of bone density improve with treatment, rates of fractures have not been shown to improve. Effects on quality of life are unproven, with a number of studies finding that adults with<unk> had near-normal indicators of QoL at baseline (giving little scope for improvement), and many using outdated dosing strategies. However, it may be that those adults with poor QoL at the start of treatment do benefit. | Growth hormone deficiency | Prader–Willi syndrome | Isolated growth hormone deficiency | Turner syndrome | Thyroid dysgenesis | Noonan syndrome | Congenital hypothyroidism | Small for gestational age | 00
| 15,185 |
<unk> (PIA), also known as 4-iodoamphetamine (4-IA), is a research chemical of the phenethylamine and amphetamine chemical classes. It acts as a selective serotonin releasing agent and is also a MAOI. PIA is rumored to be a serotonergic neurotoxin on the account of that being reported to be the case for para-chloroamphetamine. However, PIA is a much weaker 5-HT neurotoxin than is the case for PCA. | Para-Iodoamphetamine | Levoamphetamine | Para-Methoxyphenylpiperazine | Methylbenzylpiperazine | Meta-Chlorophenylpiperazine | Propylamphetamine | Methamphetamine | Benzyl alcohol | 00
| 56,911 |
Anticoagulant therapy is the mainstay of treatment. Acutely, supportive treatments, such as oxygen or analgesia, may be required.<unk> ople are often admitted to hospital in the early stages of treatment, and tend to remain under inpatient care until the INR has reached therapeutic levels (if warfarin is used). Increasingly, however, low-risk cases are managed at home in a fashion already common in the treatment of DVT. Evidence to support one approach versus the other is weak. Anticoagulation Anticoagulant therapy is the mainstay of treatment. For many years, vitamin K antagonists (warfarin or less commonly acenocoumarol or phenprocoumon) have been the cornerstone. As vitamin K antagonists do not act immediately, initial treatment is with rapidly acting injectable anticoagulants: unfractionated heparin (UFH), low molecular weight heparin (LMWH), or fondaparinux, while oral vitamin K antagonists are initiated and titrated (usually as part of inpatient hospital care) to the international normalized ratio, a test that determines the dose. In terms of injectable treatments, LMWH may reduce bleeding among<unk> ople with<unk> as compared to UFH. According to the same review, LMWH reduced the incidence of recurrent thrombotic complications and reduced thrombus size when compared to heparin. There was no difference in overall mortality between participants treated with LMWH and those treated with unfractionated heparin. Vitamin K antagonists require frequent dose adjustment and monitoring of the international normalized ratio (INR). In<unk> , INRs between 2.0 and 3.0 are generally considered ideal. If another episode of<unk> occurs under warfarin treatment, the INR window may be increased to e.g. 2.5–3.5 (unless there are contraindications) or anticoagulation may be changed to a different anticoagulant e.g. LMWH. In recent years, many anticoagulants have been introduced that offer similar to warfarin but without a need for titration to the INR. Known as the directly acting oral anticoagulants, these treatments are now preferred over vitamin K antagonists by American professional guidelines. Two of these (rivaroxaban and apixaban) do not require initial heparin or fondaparinux treatment, whereas dabigatran and edoxaban do. A Cochrane review found that there is no evidence of a difference between oral DTIs (dabigatran, rivaroxaban, edoxaban, apixaban) and standard anticoagulation in the prevention of recurrent<unk> . In<unk> ople with cancer who develop<unk> , therapy with a course of LMWH is favored over warfarin or other oral anticoagulants. Similarly, pregnant women are treated with low molecular weight heparin until after delivery to avoid the known teratogenic effects of warfarin, especially in the early stages of pregnancy, but it can be used while breastfeeding. Anticoagulation therapy is usually continued for 3–6 months, or "lifelong" if there have been previous DVTs or<unk> s, or none of the usual transient risk factors is present. In those without a known cause that can be reversed 2 years of treatment may be better than 6 months. For those with small<unk> s (known as subsegmental<unk> s) the effects of anticoagulation is unknown as it has not been properly studied as of 2020. Thrombolysis Massive<unk> causing hemodynamic instability (shock and/or low blood pressure, defined as a systolic blood pressure 15 min if not caused by new-onset arrhythmia, hypovolemia or sepsis) is an indication for thrombolysis, the enzymatic destruction of the clot with medication. In this situation, it is the best available treatment in those without contraindications and is supported by clinical guidelines. It is also recommended in those in cardiac arrest with a known<unk> . Catheter-directed thrombolysis (CDT) is a new technique found to be relatively safe and effective for massive<unk> s. This involves accessing the venous system by placing a catheter into a vein in the groin and guiding it through the veins by using fluoroscopic imaging until it is located next to the<unk> in the lung circulation. Medication that breaks up blood clots is released through the catheter so that its highest concentration is directly next to the pulmonary embolus. CDT is<unk> rformed by interventional radiologists or vascular surgeons, and in medical centers that offer CDT, it may be offered as a first-line treatment. Catheter-based ultrasound-assisted thrombolysis is being investigated. The use of thrombolysis in non-massive<unk> s is still debated. Some have found that the treatment decreases the risk of death and increases the risk of bleeding including intracranial hemorrhage. Others have found no decrease in the risk of death. Inferior vena cava filter Used inferior vena cava filter. There are two situations when an inferior vena cava filter is considered advantageous, and those are if anticoagulant therapy is contraindicated (e.g. shortly after a major operation), or a<unk> rson has a pulmonary embolus in spite of being anticoagulated. In these instances, it may be implanted to prevent new or existing DVTs from entering the pulmonary artery and combining with an existing blockage. In spite of the device's theoretical advantage of preventing pulmonary emboli, there is a lack of evidence supporting its effectiveness. Inferior vena cava filters should be removed as soon as it becomes safe to start using anticoagulation. Although modern filters are meant to be retrievable, complications may prevent some from being removed. The long-term safety profile of<unk> rmanently leaving a filter inside the body is not known. Surgery Surgical management of acute<unk> (pulmonary thrombectomy) is uncommon and has largely been abandoned because of poor long-term outcomes. However, recently, it has gone through a resurgence with the revision of the surgical technique and is thought to benefit certain<unk> ople. Chronic<unk> leading to pulmonary hypertension (known as chronic thromboembolic hypertension) is treated with a surgical procedure known as a pulmonary thromboendarterectomy. | Pulmonary embolism | Dilated cardiomyopathy | Pulmonary hemorrhage | Pneumonia | Pleural effusion | Costochondritis | Lung infarction | Myocardial stunning | 00
| 8,118 |
<unk> (from Greek σκληρός sklērós, "hard") is the stiffening of a tissue or anatomical feature, usually caused by a replacement of the normal organ-specific tissue with connective tissue. The structure may be said to have undergone sclerotic changes or display sclerotic lesions, which refers to the process of<unk> Common medical conditions whose pathology involves<unk> include: * Amyotrophic lateral<unk> also known as Lou Gehrig's disease or Motor neurone disease—a progressive, incurable, usually fatal disease of motor neurons. * Atherosclerosis, a deposit of fatty materials, such as cholesterol, in the arteries which causes hardening. * Focal segmental glomerulosclerosis is a disease that attacks the kidney's filtering system (glomeruli) causing serious scarring and thus a cause of nephrotic syndrome in children and adolescents, as well as an important cause of kidney failure in adults. * Hippocampal<unk> a brain damage often seen in individuals with temporal lobe epilepsy. * Lichen<unk> , an autoimmune disease that hardens the connective tissues of the vagina and the penis. * Multiple<unk> or focal<unk> is a central nervous system disease which affects coordination. * Osteosclerosis, a condition where the bone density is significantly increased, resulting in decreased lucency on radiographs. * Otosclerosis, a disease of the ears. * Primary lateral<unk> progressive muscle weakness in the voluntary muscles. * Primary<unk> g cholangitis, a hardening of the bile duct by scarring and repeated inflammation. * Systemic<unk> (progressive systemic scleroderma), a rare, chronic disease which affects the skin, and in some cases also blood vessels and internal organs. * Tuberous<unk> a rare genetic disease which affects multiple systems. | Sclerosis | Scalding | Hyperpigmentation | Calcification | Steatosis | Moist desquamation | Granulation | Neovascularization | 00
| 54,304 |
Signs and symptoms are as for kidney cancer. | Collecting duct carcinoma | Transitional cell carcinoma | Tubular carcinoma | Renal medullary carcinoma | Hyalinizing clear cell carcinoma | Renal anaplastic sarcoma | Renal medullary fibroma | Medullary carcinoma | 00
| 50,298 |
A bottle of sifted<unk> flakes from a local vendor in the United Arab Emirates<unk> (, "dizziness" or "vertigo") is an Arabian tobacco product, consisting of dried and finely shredded tobacco flakes mixed with herbs and spices. It originated in Iran during the 15th century. Unlike hookah tobacco (also called "shisha" or "mu'assel"),<unk> is not cured with molasses. Users smoke the tobacco blend in small quantities using a pipe called a midwakh. Because the midwakh pipe is used almost exclusively for smoking<unk> , the terms are often used interchangeably.<unk> has a higher concentration of nicotine compared to other forms of tobacco, and can cause brief periods of euphoria, relaxation or lightheadedness in some users. As using the midwakh also reportedly leaves fewer lingering smells, and requires less tobacco to be used at a time, it can be used discreetly, which has made it popular among student populations and young adults. The product is popular in the United Arab Emirates (UAE), Oman, Qatar, Saudi Arabia, Yemen, Bahrain, Jordan, and other Middle Eastern countries. It has reportedly spread to Europe, Bhatkal in India and other regions via immigration, tourism and trade. Scientific research on the health effects of<unk> use is lacking, but officials have concerns over the use of the product as a touted cigarette alternative, and preliminary studies have quantified<unk> 's high nicotine and tar concentration, as well as toxins present in its smoke. Notable concern in the UAE over the spreading popularity of<unk> among teenagers and young adults has led to multiple tobacco control efforts to curb its use. | Dokha | Karoshi | Latah | Medgadget | Riken | Tabun | Kuru | Kuru | 00
| 46,716 |
Mechanism of action<unk> is lethal to P. vivax and P. ovale in the liver stage, and also to P. vivax in the blood stage through its ability to do oxidative damage to the cell. However, the exact mechanism of action is not fully understood. Pharmacokinetics<unk> is well-absorbed in the gut and extensively distributed in the body without accumulating in red blood cells. Administration of<unk> with food or grapefruit juice increases its oral bioavailibity. In blood, about 20% of circulating<unk> is protein-bound, with preferential binding to the acute phase protein orosomucoid. With a half-life on the order of 6 hours, it is quickly metabolized by liver enzymes to carboxyprimaquine, which does not have anti-malarial activity. Renal excretion of the parent drug is less than 4%. | Primaquine | Tafenoquine | Amodiaquine | Artemether | Piperaquine | Mefloquine | Chloroquine | Delamanid | 00
| 24,783 |
<unk> or the itch mite is a parasitic mite (an arthropod) that burrows into skin and causes<unk> . The mite is found in all parts of the world. Humans are not the only mammals that can become infected. Other mammals, such as wild and domesticated dogs and cats (in which it is one cause of mange) as well as ungulates, wild boars, bovids, wombats, koalas, and great apes are affected. Human<unk> mite seen under an optical microscope (x20) The Italian biologists Giovanni Cosimo Bonomo and Diacinto Cestoni showed in the 17th century that<unk> is caused by<unk> ; this discovery of the itch mite in 1687 marked<unk> as the first disease of humans with a known microscopic causative agent. The disease produces intense, itchy skin rashes when the impregnated female tunnels into the stratum corneum of the skin and deposits eggs in the burrow. The larvae, which hatch in three to 10 days, move about on the skin, moult into a nymphal stage, and then mature into adult mites. The adult mites live three to four weeks in the host's skin. | Sarcoptes scabiei | Herpes gladiatorum | Malum perforans | Lawsonia inermis | Lichen ruber moniliformis | Aedes epactius | Trichorrhexis invaginata | Brugia timori | 00
| 12,076 |
stitches The overall treatment depends on the type, cause, and depth of the<unk> , and<unk> hether other structures beyond the skin (dermis) are involved. Treatment of recent lacerations involves examining, cleaning, and closing the<unk> . Minor<unk> s, like bruises,<unk> ill heal on their own,<unk> ith skin discoloration usually disappearing in 1–2<unk> eeks. Abrasions,<unk> hich are<unk> s<unk> ith intact skin (non-penetration through dermis to subcutaneous fat), usually require no active treatment except keeping the area clean, initially<unk> ith soap and<unk> ater. Puncture<unk> s may be prone to infection depending on the depth of penetration. The entry of puncture<unk> is left open to allow for bacteria or debris to be removed from inside. Cleaning Evidence to support the cleaning of<unk> s before closure is scant. For simple lacerations, cleaning can be accomplished using a number of different solutions, including tap<unk> ater and sterile saline solution. Infection rates may be lower<unk> ith the use of tap<unk> ater in regions<unk> here<unk> ater quality is high. Cleaning of a<unk> is also known as<unk> toilet'. It is not clear if delaying a shower following a surgery helps reduce complications related to<unk> healing.<unk> cleansing solutions Evidence is insufficient to conclude<unk> hether cleaning<unk> s is beneficial or<unk> hether<unk> cleaning solutions (polyhexamethylene biguanide, aqueous oxygen peroxide, etc.) are better than sterile<unk> ater or saline solutions to help venous leg ulcers heal. It is also uncertain<unk> hether the choice of cleaning solution or method of application makes any difference to venous leg ulcer healing. Closure A surgeon placing a suture If a person presents to a healthcare center<unk> ithin 6 hours of a laceration they are typically closed immediately after evaluating and cleaning the<unk> . After this point in time, however, there is a theoretical concern of increased risks of infection if closed immediately. Thus some healthcare providers may delay closure<unk> hile others may be<unk> illing to immediately close up to 24 hours after the injury. Using clean non-sterile gloves is equivalent to using sterile gloves during<unk> closure. If closure of a<unk> is decided upon a number of techniques can be used. These include bandages, a cyanoacrylate glue, staples, and sutures. Absorbable sutures have the benefit over non absorbable sutures of not requiring removal. They are often preferred in children. Buffering the pH of lidocaine makes the injection less painful. Adhesive glue and sutures have comparable cosmetic outcomes for minor lacerations <5 cm in adults and children. The use of adhesive glue involves considerably less time for the doctor and less pain for the person. The<unk> opens at a slightly higher rate but there is less redness. The risk for infections (1.1%) is the same for both. Adhesive glue should not be used in areas of high tension or repetitive movements, such as joints or the posterior trunk. Split-thickness skin grafting (STSG) is also a surgical technique that features rapid<unk> closure, multiple possible donor sites<unk> ith minimal morbidity. Dressings In the case of clean surgical<unk> s, there is no evidence that the use of topical antibiotics reduces infection rates in comparison<unk> ith non-antibiotic ointment or no ointment at all. Antibiotic ointments can irritate the skin, slow healing, and greatly increase the risk of developing contact dermatitis and antibiotic resistance. Because of this, they should only be used<unk> hen a person shows signs of infection and not as a preventative. The effectiveness of dressings and creams containing silver to prevent infection or improve healing is not currently supported by evidence. Alternative medicine There is moderate evidence that honey is more effective than antiseptic followed by gauze for healing<unk> s infected after surgical operations. There is a lack of quality evidence relating to the use of honey on other types of<unk> s, such as minor acute<unk> s, mixed acute and chronic<unk> s, pressure ulcers, Fournier's gangrene, venous leg ulcers, diabetic foot ulcers and Leishmaniasis. There is no good evidence that therapeutic touch is useful in healing. More than 400 species of plants are identified as potentially useful for<unk> healing. Only three randomized controlled trials, however, have been done for the treatment of burns. | Wound | Soft tissue | Injection port | Coagulation | Body fluid | Biomedical tissue | Surgical instrument | Fluid compartments | 00
| 11,179 |
There are no currently known causes of this disease. There are studies currently proposing several theories of the causes which include inflammation of the adipose tissue, nervous system malfunction and endocrine malfunction. None of the theories that are currently proposed have been found viable. Since little is known about<unk> , there are currently no known modes of prevention. | Dercum's disease | Freiberg disease | Butcher's wart | Martorell's ulcer | Marjolin's ulcer | Coats' disease | Swaim's Panacea | Dieulafoy's lesion | 00
| 37,136 |
Cancers are classified by the type of cell that the tumor cells resemble and is therefore presumed to be the origin of the tumor. These types include: * Carcinoma: Cancers derived from epithelial cells. This group includes many of the most common cancers and include nearly all those in the breast, prostate, lung, pancreas and colon. * Sarcoma: Cancers arising from connective tissue (i.e. bone, cartilage, fat, nerve), each of which develops from cells originating in mesenchymal cells outside the bone marrow. * Lymphoma and leukemia: These two classes arise from hematopoietic (blood-forming) cells that leave the marrow and tend to mature in the lymph nodes and blood, respectively. * Germ cell tumor: Cancers derived from pluripotent cells, most often presenting in the testicle or the ovary (seminoma and dysgerminoma, respectively). * Blastoma: Cancers derived from immature "precursor" cells or embryonic tissue. Cancers are usually named using -carcinoma, -sarcoma or -blastoma as a suffix, with the Latin or Greek word for the organ or tissue of origin as the root. For example, cancers of the liver parenchyma arising from malignant epithelial cells is called hepatocarcinoma, while a malignancy arising from primitive liver precursor cells is called a hepatoblastoma and a cancer arising from fat cells is called a liposarcoma. For some common cancers, the English organ name is used. For example, the most common type of breast cancer is called ductal carcinoma of the breast. Here, the adjective ductal refers to the appearance of cancer under the microscope, which suggests that it has originated in the milk ducts. Benign tumors (which are not cancers) are named using -oma as a suffix with the organ name as the root. For example, a benign tumor of smooth muscle cells is called a leiomyoma (the common name of this frequently occurring benign tumor in the uterus is fibroid). Confusingly, some types of cancer use the -noma suffix, examples including melanoma and seminoma. Some types of cancer are named for the size and shape of the cells under a microscope, such as giant cell carcinoma, spindle cell carcinoma and small-cell carcinoma. File:Breast cancer gross appearance.An invasive ductal carcinoma of the breast (pale area at the center) surrounded by spikes of whitish scar tissue and yellow fatty tissue File:Colon cancer 2.An invasive colorectal carcinoma (top center) in a colectomy specimen File:Lung cancer.A squamous-cell carcinoma (the whitish tumor) near the bronchi in a lung specimen File:BreastCancer.A large invasive ductal carcinoma in a mastectomy specimen | complications of Alcoholism | complications of Alcohol intoxication | complications of Botulism | complications of Progeria | complications of Substance use disorder | complications of Substance abuse | medical cause of Drug overdose | complications of Lead poisoning | 00
| 5,914 |
corneal scar in his left eye, 1972 The mortality rate from variola minor is approximately 1%, while the mortality rate from variola major is approximately 30%. Ordinary type-confluent is fatal about 50–75% of the time, ordinary-type semi-confluent about 25–50% of the time, in cases where the rash is discrete the case-fatality rate is less than 10%. The overall fatality rate for children younger than 1 year of age is 40–50%. Hemorrhagic and flat types have the highest fatality rates. The fatality rate for flat or late hemorrhagic type<unk> is 90% or greater and nearly 100% is observed in cases of early hemorrhagic<unk> . The case-fatality rate for variola minor is 1% or less. There is no evidence of chronic or recurrent infection with Variola virus. In cases of flat<unk> in vaccinated people, the condition was extremely rare but less lethal, with one case series showing a 66.7% death rate. In fatal cases of ordinary<unk> , death usually occurs between days 10-16 of the illness. The cause of death from<unk> is not clear, but the infection is now known to involve multiple organs. Circulating immune complexes, overwhelming viremia, or an uncontrolled immune response may be contributing factors. In early hemorrhagic<unk> , death occurs suddenly about six days after the fever develops. The cause of death in early hemorrhagic cases is commonly due to heart failure and pulmonary edema. In late hemorrhagic cases, high and sustained viremia, severe platelet loss and poor immune response were often cited as causes of death. In flat<unk> modes of death are similar to those in burns, with loss of fluid, protein and electrolytes, and fulminating sepsis. Complications Complications of<unk> arise most commonly in the respiratory system and range from simple bronchitis to fatal pneumonia. Respiratory complications tend to develop on about the eighth day of the illness and can be either viral or bacterial in origin. Secondary bacterial infection of the skin is a relatively uncommon complication of<unk> . When this occurs, the fever usually remains elevated. Other complications include encephalitis (1 in 500 patients), which is more common in adults and may cause temporary disability; permanent pitted scars, most notably on the face; and complications involving the eyes (2% of all cases). Pustules can form on the eyelid, conjunctiva, and cornea, leading to complications such as conjunctivitis, keratitis, corneal ulcer, iritis, iridocyclitis, and atrophy of the optic nerve. Blindness results in approximately 35-40% of eyes affected with keratitis and corneal ulcer. Hemorrhagic<unk> can cause subconjunctival and retinal hemorrhages. In 2-5% of young children with<unk> , virions reach the joints and bone, causing osteomyelitis variolosa. Bony lesions are symmetrical, most common in the elbows, legs, and characteristically cause separation of the epiphysis and marked periosteal reactions. Swollen joints limit movement, and arthritis may lead to limb deformities, ankylosis, malformed bones, flail joints, and stubby fingers. Between 65 and 80% of survivors are marked with deep pitted scars (pockmarks), most prominent on the face. | Smallpox | Monkeypox | Cowpox | Impetigo | Chickenpox | Sealpox | Molluscum contagiosum | Mumps | 00
| 49,608 |
The risk of contracting<unk> from STIs can be reduced by using condoms during every sexual encounter. Condoms are effective against the spread of STIs like chlamydia and gonorrhea that cause<unk> . Also, being in a long-term monogamous relationship with an uninfected partner can lower the risk of an STI. Ensuring that foreign objects like tampons are properly placed in the vagina and following instructions how long to leave it inside, how often to change it, and/or how often to clean it can reduce the risk of<unk> . In addition, avoiding potential irritants like douches and deodorant tampons can prevent<unk> . | Cervicitis | Vaginitis | Appendicitis | Leukorrhea | Chondritis | Creatorrhea | Oophoritis | Gonorrhea | 00
| 11,528 |
<unk> (HE) is general brain dysfunction due to significantly high blood pressure. Symptoms may include headache, vomiting, trouble with balance, and confusion. Onset is generally sudden. Complications can include seizures, posterior reversible encephalopathy syndrome, and bleeding in the back of the eye. In<unk> , generally the blood pressure is greater than 200/130 mmHg. Occasionally it can occur at a BP as low as 160/100 mmHg. This can occur in kidney failure, those who rapidly stop blood pressure medication, pheochromocytoma, and people on a monoamine oxidase inhibitor (MAOI) who eat foods with tyramine. When it occurs in pregnancy it is known as eclampsia. The diagnosis requires ruling out other possible causes. The condition is generally treated with medications to relatively rapidly lower the blood pressure. This may be done with labetalol or sodium nitroprusside given by injection into a vein. In those who are pregnant, magnesium sulfate may be used. Other treatments may include anti-seizure medications.<unk> is uncommon. It is believed to occur more often in those without easy access to health care. The term was first used by Oppenheimer and Fishberg in 1928. It is classified as a type of<unk> emergency. | Hypertensive encephalopathy | Hydrocephalus | Hypertensive leukoencephalopathy | Cocaine intoxication | Posterior reversible encephalopathy syndrome | Stroke | Idiopathic intracranial hypertension | Uremia | 00
| 38,165 |
It is a physiological phenomenon that requires no treatment. | Bier spots | Forchheimer spots | Elschnig spots | Bitot's spots | Koplik's spots | Fuchs spot | Fordyce spots | Brushfield spots | 00
| 53,010 |
<unk> , also known as scopolamine<unk> and sold under the brandname<unk> among others, is an anticholinergic medication used to treat crampy abdominal pain, esophageal spasms, renal colic, and bladder spasms. It is also used to improve respiratory secretions at the end of life.<unk> can be taken by mouth, injection into a muscle, or into a vein. Side effects may include sleepiness, vision changes, dry mouth, rapid heart rate, triggering of glaucoma, and severe allergies. Sleepiness is uncommon. It is unclear if it is safe in pregnancy. It appears safe in breastfeeding. Greater care is recommended in those with heart problems. It is an anticholinergic agent, which does not have much effect on the brain.<unk> was patented in 1950, and approved for medical use in 1951. It is on the World Health Organization's List of Essential Medicines. It is not available in the United States, and a similar compound methscopolamine may be used instead. It is manufactured from<unk> , which occurs naturally in the plant deadly nightshade. It is available in the United States only for the medical treatment of horses. | Hyoscine butylbromide | Halofantrine | Terbutaline | Bromethalin | Acetomepregenol | Oxymetazoline | Levomepromazine | Pilocarpine | 00
| 27,050 |
Overall, according to a study in British Columbia, approximately 2.3 children per 100,000 births (1 in 43,000) have some form of glycogen storage disease. In the United States, they are estimated to occur in 1 per 20,000–25,000 births. Dutch incidence rate is estimated to be 1 per 40,000 births. While a Mexican incidence showed 6.78:1000 male newborns. | medical cause of Neutropenia | symptoms of Biphenotypic acute leukaemia | symptom of Biphenotypic acute leukaemia | symptom of Acute myeloid leukemia | symptom of Aplastic anemia | symptom of Myelodysplastic syndrome | symptoms of Aplastic anemia | complications of Acute lymphoblastic leukemia | 00
| 6,780 |
inheritance.<unk> is an autosomal recessive disorder, which means the defective gene is located on an autosome, and two copies of the defective gene - one from each parent - are required to inherit the disorder. The parents of an individual with an autosomal recessive disorder both carry one copy of the defective gene, but usually do not experience any signs or symptoms of the disorder. Genetic basis Various human GALE mutations resulting in Type III<unk> mia have been identified. Functional analysis of these mutant GALE isoforms suggests that reduced catalytic efficiency and increased likelihood of proteolytic digestion act causatively in Type III<unk> mia. Mutated Residue Biochemical Effect Clinical Manifestation V94M, K257R, L313M, R335H Strongly impaired turnover number and specificity constant Severe generalized<unk> mia. S81R, T150M, P293L Mild turnover number impairment Intermediate<unk> mia. L183P, D103G, G90E, N34S Strongly impaired turnover number and specificity constant; increased proteolytic digestion. Severe generalized<unk> mia. Biochemical basis Pathways, intermediates, and enzymes involved in<unk> metabolism. GALE deficiency inhibits UDP-glucose regeneration, preventing the formation of glucose-1-phosphate and leading to the accumulation of<unk> and<unk> -1-phosphate. High<unk> -1-phosphate levels have been shown to interfere with phosphoglucomutase, glycogen phosphorylase, UDP-glycopyrophosphorylase, activity in bacterial models and in vitro, yet in vivo mechanisms toxicity have yet to be confirmed. Regardless, median<unk> -1-phosphate levels act as the most accurate predictors of the severity of symptoms associated with Type III<unk> mia. Blockage of the Leloir pathway by GALE deficiency or dysfunction activates alternate pathways of glucose metabolism and leads to galactitol and galactonate formation. Galactonate is metabolized by the pentose phosphate pathway, and is not considered toxic. Galactitol, however, may accumulate in lens fibers, perturbing lens epithelial cell permeability and leading to cell death and cataract formation. GALE deficiency also perturbs glycolipid and glycoprotein biosynthesis due to decreased production of UDP-GalNAc from UDP-GlcNAc. | Galactose epimerase deficiency | Malonyl-CoA decarboxylase deficiency | Galactose-1-phosphate uridylyltransferase deficiency | Ornithine aminotransferase deficiency | Enolase deficiency | Glutaminase deficiency | Pyruvate kinase deficiency | Holocarboxylase synthetase deficiency | 00
| 44,891 |
Good hygiene, public health and sanitation programs, and elimination of infected rats help to prevent the spread of<unk> . Preventing fecal contamination of food and water in institutions and crowded areas is of primary importance. General sanitation and rodent and insect control (especially control of fleas and grain insects) are also essential for prevention of H. nana infection. | Hymenolepiasis | Trichinosis | Opisthorchiasis | Trichuriasis | Trichomoniasis | Taeniasis | Trichiasis | Clonorchiasis | 00
| 20,047 |
<unk> is a vasopressor/antihypotensive agent (it raises the blood pressure).<unk> was approved in the United States by the Food and Drug Administration (FDA) in 1996 for the treatment of dysautonomia and orthostatic hypotension. In August 2010, the FDA proposed withdrawing this approval because the manufacturer, Shire plc, failed to complete required studies after the medicine reached the market. In September 2010, the FDA reversed its decision to remove<unk> from the market and allowed it to remain available to patients while Shire plc collected further data regarding the efficacy and safety of the drug. Shire announced on September 22, 2011 that it was withdrawing completely from supplying<unk> and leaving it to several generics to supply the drug. | Midodrine | Ritodrine | Minaprine | Erythrocrine | Amixetrine | Testosterone ketolaurate | Carbetocin | Halofantrine | 00
| 27,657 |
<unk> 100-mg capsules manufactured by Ranbaxy Pharmaceuticals Acne<unk> and doxycycline are frequently used for the treatment of acne vulgaris. Both of these closely related antibiotics have similar levels of efficacy, although doxycycline has a slightly lower risk of adverse side effects. Historically,<unk> has been an effective treatment for acne vulgaris. However, acne that is caused by antibiotic-resistant bacteria is a growing problem in many countries. In Europe and North America, a number of people with acne no longer respond well to treatment with tetracycline family antibiotics because their acne symptoms are caused by bacteria (primarily Cutibacterium acnes) that are resistant to these antibiotics. In order to reduce resistance rates as well as increase the effectiveness of treatment, oral antibiotics should be generally combined with topical acne creams such as benzoyl peroxide or a retinoid (tretinoin, adapalene, etc.).<unk> itself is used both orally and topically in the treatment of acne. Infections<unk> is also used for other skin infections such as methicillin-resistant Staphylococcus aureus. Although<unk> 's broader spectrum of activity, compared with other members of the group, includes activity against Neisseria meningitidis, its use for prophylaxis is no longer recommended because of side effects (dizziness and vertigo). It may be used to treat certain strains of methicillin-resistant S. aureus infection and a disease caused by drug-resistant Acinetobacter spp. A list of uses includes: * Amoebic dysentery * Anthrax * Bubonic plague * Cholera * Ehrlichiosis * Gonorrhea (when penicillin cannot be given) * Gougerot-Carteaud syndrome (confluent and reticulated papillomatosis) * Hidradenitis suppurativa * For use as an adjuvant to HAART * Leprosy * Periodontal disease * Perioral dermatitis * Respiratory infections such as pneumonia * Rocky Mountain spotted fever * Rosacea * Syphilis (when penicillin cannot be given) * Urinary tract infections, rectal infections, and infections of the cervix caused by certain<unk> robes Other Both<unk> and doxycycline have shown effectiveness in asthma due to immune-suppressing effects.<unk> and doxycycline have modest effectiveness in treating rheumatoid arthritis. However, the 2015 American College of Rheumatology guideline for the treatment of rheumatoid arthritis does not include<unk> . Recent research indicate that centrally infused<unk> attenuates brain<unk> roglial activation, neuroinflammation and sympathetic activation during pulmonary hypertension | Minocycline | Tetracycline | Extended-spectrum penicillin | Sarecycline | Cephalosporin | Oxytetracycline | Teicoplanin | Doxycycline | 00
| 9,399 |
<unk> or De<unk> may refer to: | Rosa | Gumma | Globe | DermAtlas | Epicles | Aura | Aura | Locura | 00
| 11,219 |
Mutations in the PLA2G6 gene have been identified in most individuals with<unk> . The PLA2G6 gene provides instructions for making an enzyme called an A2 phospholipase. This enzyme family is involved in metabolizing phospholipids. Phospholipid metabolism is important for many body processes, including helping to keep the cell membrane intact and functioning properly. Specifically, the A2 phospholipase produced from the PLA2G6 gene, sometimes called PLA2 group VI, helps to regulate the levels of a compound called phosphatidylcholine, which is abundant in the cell membrane. Mutations in the PLA2G6 gene impair the function of the PLA2 group VI enzyme. This impairment of enzyme function may disrupt cell membrane maintenance and contribute to the development of spheroid bodies in the nerve axons. Although it is unknown how changes in this enzyme's function lead to the signs and symptoms of<unk> , phospholipid metabolism problems have been seen in both this disorder and a related disorder called pantothenate kinase-associated neurodegeneration. These disorders, as well as the more common Alzheimer disease and Parkinson disease, also are associated with changes in brain iron metabolism. Researchers are studying the links between phospholipid defects, brain iron, and damage to nerve cells, but have not determined how the iron accumulation that occurs in some individuals with<unk> may contribute to the features of this disorder. A few individuals with<unk> have not been found to have mutations in the PLA2G6 gene. The genetic cause of the condition in these cases is unknown; there is evidence that at least one other gene may be involved. Mutations in the NAGA gene, resulting in alpha-N-acetylgalactosaminidase deficiency, cause an<unk> known as Schindler disease. | Infantile neuroaxonal dystrophy | Ullrich congenital muscular dystrophy | Congenital muscular dystrophy | Spinal muscular atrophy | Myotonic dystrophy | Madras motor neuron disease | Distal spinal muscular atrophy type 1 | Distal spinal muscular atrophy type 2 | 00
| 46,707 |
<unk> may be divided into the following clinical types: * Plaque-type<unk> (also known as "Classic<unk> " and<unk> of Mibelli") is characterized by skin lesions that start as small, brownish papules that slowly enlarge to form irregular, annular, hyperkeratotic or verrucous plaques. Sometimes they may show gross overgrowth and even horn-like structures may develop. Skin malignancy, although rare, is reported from all types of<unk> . Squamous cell carcinomas have been reported to develop in Mibelli's type<unk> over partianal areas involving anal mucosa. This was the first report mentioning mucosal malignancy in any form of<unk> . * Disseminated superficial<unk> is a more generalized processes and involves mainly the extremities in a bilateral, symmetric fashion. In about 50% of cases, skin lesions only develop in sun-exposed areas, and this is referred to as disseminated superficial actinic<unk> *<unk> palmaris et plantaris disseminata is characterized by skin lesions that are superficial, small, relatively uniform, and demarcated by a distinct peripheral ridge of no more than 1mm in height. * Linear<unk> is characterized clinically skin lesions are identical to those of classic<unk> , including lichenoid papules, annular lesions, hyperkeratotic plaques with central atrophy, and the characteristic peripheral ridge. * Punctate<unk> is a skin condition associated with either classic<unk> or linear<unk> types of<unk> , and is characterized by multiple, minute, and discrete punctate, hyperkeratotic, seed-like skin lesions surrounded by a thin, raised margin on the palms and soles. *<unk> plantaris discreta is a skin condition that occurs in adults, with a 4:1 female preponderance, characterized by a sharply marginated, rubbery, wide-based papules. It is also known as "Steinberg's lesion". It was characterized in 1970. | Porokeratosis | Hyperkeratosis | Hypodermyasis | Granulomatous slack skin | Arsenical keratosis | Reactional keratosis | Dysplastic nevus | Epidermolytic hyperkeratosis | 00
| 54,290 |
In the United States each year approximately 1,000,000 individuals develop herpes zoster. Of those individuals, approximately 10–18% develop<unk> . Fewer than 10 percent of people younger than 60 develop<unk> after a bout of herpes zoster, while about 40 percent of people older than 60 do. | Postherpetic neuralgia | Trigeminal neuralgia | Atypical trigeminal neuralgia | Occipital neuralgia | Erythromelalgia | Morning sickness | Cold-stimulus headache | Cerebritis | 00
| 19,937 |
Tuberculosis exists in all countries in the world. Some countries have a larger number of people infected with tuberculosis than others. For each 100,000 people, Swaziland has the greatest number (627) of tuberculosis cases in the world. Second is Cambodia (560), followed in third position by Zambia (445), fourth is Djibouti (382), fifth is Indonesia (321), sixth is Mali (295), seventh is Zimbabwe (291), eighth is Kenya (291), ninth is Papua New Guinea (283) and tenth is Gambia (283). The United States, Sweden and Iceland have one of the lowest populations of tuberculosis at 2 per 100,000. with Canada, Netherlands, Jamaica, Norway, Malta, Granada and Antigua and Barbuda with 3 per 100,000. In North America, countries over 10:100,000 are Mexico (14), Belize (18), Bahamas (19), Panama (28), El Salvador (36), Nicaragua (35), Honduras (46), Guatemala (48), and the worst is the Dominican Republic (88). Most Western European countries have less than 10 per 100,000 except Spain (14), Portugal (16), Estonia (27), Latvia (43), Lithuania (48), while Eastern and Southern European countries have a greater number with Romania (94) being the highest. In South America, the greatest number of cases of tuberculosis are in Bolivia (30) with Guyana (18) and Honduras (15) following with the remaining countries having less than 10:100,000. "One-third of the world’s burden of tuberculosis (TB), or about 4.9 million prevalent cases, is found in the World Health Organization (WHO) South-East Asia Region." "About one-third of the world's population has<unk> TB, which means people have been infected by TB bacteria but are not (yet) ill with disease and cannot transmit the disease," and most of those cases are in developing countries. "In the US, over half of all active TB cases occur in immigrants. The reported cases of active TB in foreign-born persons has remained at 7000–8000 per year, while the number of cases in US-born people has dropped from 17,000 in 1993 to 6,500 in 2005. As a result, the percentage of active TB cases in immigrants has increased steadily (from 29% of all cases in 1993 to 54% in 2005)." and most of those cases are in developing countries. | Latent tuberculosis | Primary inoculation tuberculosis | Extensively drug-resistant tuberculosis | Totally drug-resistant tuberculosis | Tuberculosis in relation to HIV | Multidrug-resistant tuberculosis | Tuberculosis | Vietnamese tuberculosis | 00
| 35,157 |
<unk> , also known as acetorphan, is an antidiarrheal medication which acts as a peripheral enkephalinase inhibitor. Unlike other opioid medications used to treat diarrhea, which reduce intestinal motility,<unk> has an antisecretory effect — it reduces the secretion of water and electrolytes into the intestine. It is available in France (where it was first introduced in ~1990) and other European countries (including Germany, Italy, the United Kingdom, Spain, Portugal, Poland, Finland, Russia and the Czech Republic) as well as most of South America and some South East Asian countries (including China, India and Thailand), but not in the United States. It is sold under the tradename Hidrasec, among others. Thiorphan is the active metabolite of<unk> , which exerts the bulk of its inhibitory actions on enkephalinases. | Racecadotril | Moexipril | Spirapril | Ramipril | Macitentan | Methallenestril | Ambrisentan | Oprelvekin | 00
| 48,671 |
The<unk> (PSI) was a proposed classification scale for reporting the<unk> of influenza<unk> s in the United States. The PSI was accompanied by a set of guidelines intended to help communicate appropriate actions for communities to follow in potential<unk> situations. Released by the United States Department of Health and Human Services (HHS) on February 1, 2007, the PSI was designed to resemble the Saffir-Simpson Hurricane Scale classification scheme. The<unk> was replaced by the<unk><unk> Assessment Framework in 2014, which uses quadrants based on transmissibility and clinical<unk> rather than a linear scale. | Pandemic severity index | Test panel | Epidemic curve | Fractional kill | Global Influenza Surveillance and Response System | Apparent infection rate | Case fatality rate | Early warning score | 00
| 43,351 |
<unk> (MD) is a familial disease characterized by lymphedema, commonly in the legs, caused by congenital abnormalities in the lymphatic system. Disruption of the normal drainage of lymph leads to fluid accumulation and hypertrophy of soft tissues. It was named by Sir William Osler for William<unk> , a Canadian physician, who described a case in 1892, though it was first described by Rudolf Virchow in 1863. | Milroy's disease | Tornwaldt's disease | Dieterich's disease | Majocchi's disease | Gorham's disease | Palm Island mystery disease | Mortimer's disease | Kimura's disease | 00
| 52,234 |
<unk> , or simply<unk> , is the process of seeking<unk> utic benefits from hanging by the legs, ankles, or feet in an inverted angle or entirely upside down. It is a form of spinal traction. Gravity boots are ankle supports designed for<unk> . Some people use gravity boots to add an extra challenge to workouts, doing inverted crunches or squats. People who have heart disease, high blood pressure, eye diseases (such as glaucoma), or are pregnant are at higher risk for the dangers related to<unk> and should consult their doctors about it first. The first time anyone tries<unk> with gravity, they should be sure to have someone standing by, in case assistance is required to get out of the apparatus, or if health problems are experienced. During an episode of acid reflux, small amounts of stomach acid may manage to escape from the stomach and into the oesophagus. Gravity typically minimises this upward leakage, but an<unk> table and acid reflux can be a painful, nauseating, and potentially dangerous combination. | Inversion therapy | Aversion therapy | Sonodynamic therapy | Selective reduction | Weaver–Dunn procedure | Distal Revascularization and Interval Ligation | Microwave ablation | Ballottement | 00
| 41,340 |
<unk> or<unk> is a level of uric acid in blood serum that is below normal. In humans, the normal range of this blood component has a lower threshold set variously in the range of 2 mg/dL to 4 mg/dL, while the upper threshold is 530 μmol/L (6 mg/dL) for women and 619 μmol/L (7 mg/dL) for men.<unk> usually is benign and sometimes is a sign of a medical condition. | Hypouricemia | Hyperaemia | Hyperammonemia | Algaemia | Alkalosis | Lactic acidosis | Hypermethioninemia | Hypervalinemia | 00
| 33,822 |
The prognosis of<unk> depends on magnesium values and on the clinical condition that induced<unk> . Values that are not excessively high (mild<unk> and in the absence of triggering and aggravating conditions (e.g., chronic kidney disease) are benign conditions. On the contrary, high values (severe<unk> expose the patient to high risks and high mortality. | Hypermagnesemia | Rhabdomyolysis | Hyponatremia | Hypercalcaemia | Lithium toxicity | Hypophosphatemia | Hyperkalemia | Hypernatremia | 00
| 20,256 |
Worldwide roughly 20 million people are infected with<unk> . Human infections are most common in regions with many human and animal reservoir hosts plus an abundance of intermediate hosts, such as snails, crabs, or crayfish, and where in addition consumption of raw or undercooked seafood is common. Consumption of insufficiently cooked meat from infected land animal hosts, such as wild boar, commonly transmits the infection. The domestic cat is a reservoir for a variety of lung flatworms and can transmit the infection to humans. | Paragonimus | Echinostoma | Anorchia | Trichostrongylus | Mammomonogamus | Trichinella | Anisakis | Fasciola | 00
| 27,206 |
A<unk> is a<unk> emergency that takes place in a<unk> or remote setting affinitive care (hospital, clinic, etc.). Such an emergency can require specialized skills, treatment techniques, and knowledge in order to manage the patient for an extended period of time before and during evacuation. | Wilderness medical emergency | George H. W. Bush vomiting incident | Hi-wa itck | Alder Hey organs scandal | Wilderness emergency medical technician | medical diagnosis of Diabetic ketoacidosis | medical cause of Neonatal jaundice | diagnosis of Diabetic ketoacidosis | 00
| 61,407 |
<unk> is a 1973 book by Flora Rheta Schreiber about the treatment of<unk> Dorsett (a pseudonym for Shirley Ardell Mason) for dissociative identity disorder (then referred to as multiple personality disorder) by her psychoanalyst, Cornelia B. Wilbur. The book was made into two television movies of the same name, once in 1976 and again in 2007. There have also been books published after the fact, challenging the facts of<unk> s therapy sessions. A few examples of these are<unk> in her own words,<unk> Exposed, and After<unk> | Sybil | Lewis lead | Basilicon | Cerate | Vinyl chloride | Cyanide | Metaldehyde | Pubmeth | 00
| 16,226 |
In medicine and medical anthropology, a<unk> ,<unk> -specific syndrome, or folk illness is a combination of psychiatric and somatic symptoms that are considered to be a recognizable disease only within a specific society or<unk> . There are no objective biochemical or structural alterations of body organs or functions, and the disease is not recognized in other<unk> s. The term<unk> was included in the fourth version of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) which also includes a list of the most common<unk><unk> conditions (DSM-IV: Appendix I). Counterpart within the framework of ICD-10 (Chapter V) are the<unk> -specific disorders defined in Annex 2 of the Diagnostic criteria for research. More broadly, an endemic that can be attributed to certain behavior patterns within a specific<unk> by suggestion may be referred to as a potential behavioral epidemic. As in the cases of drug use, or alcohol and smoking abuses, transmission can be determined by communal reinforcement and person-to-person interactions. On etiological grounds, it can be difficult to distinguish the causal contribution of<unk> upon disease from other environmental factors such as toxicity. | Culture-bound syndrome | Macrophage activation syndrome | Multiple organ dysfunction syndrome | Systemic inflammatory response syndrome | Tertiary peritonitis | Hemolytic–uremic syndrome | Tumor lysis syndrome | Gulf War syndrome | 00
| 27,757 |
<unk> , sold under the brand name Revcovi, is a medication for the treatment of the rare disease adenosine deaminase deficiency-SCID in children and adults. It is a recombinant enzyme that is administered weekly by intramuscular injection.<unk> may interact with PEGylated drugs.<unk> -lvlr was approved by the U.S. Food and Drug Administration (FDA) in 2018. Leadiant Biosciences was awarded a priority review voucher for its development under the pediatric rare diseases program. | Elapegademase | Pegaspargase | Bovhyaluronidase azoximer | Mucrocetin | Apetamin | Angiozyme | Streptokinase | Velmanase alfa | 00
| 72,221 |
Common side effects (in more than 10% of patients) include low blood cell counts (pancytopenia, thrombocytopenia, anaemia, leucopenia, neutropenia, lymphopenia), airway infections, as well as unspecific reactions such as fatigue, diarrhoea, nausea, headache, and sleeping problems. | Panobinostat | Martinostat | Olaparib | Rucaparib | Teprotumumab | Vorinostat | Palbociclib | Dabrafenib | 00
| 53,251 |
<unk> in, swelling, or stiffness in one or more joints is commonly present in<unk> .<unk> is inflammatory, and affected joints are generally red or warm to the touch. Asymmetrical oligoarthritis, defined as inflammation affecting two to four joints during the first six months of disease, is present in 70% of cases. However, in 15% of cases, the arthritis is symmetrical. The joints of the hand that is involved in psoriasis are the proximal interphalangeal (PIP), the distal interphalangeal (DIP), the metacarpophalangeal (MCP), and the wrist. Involvement of the distal interphalangeal joints (DIP) is a characteristic feature and is present in 15% of cases. In addition to affecting the joints of the hands and wrists,<unk> may affect the fingers, nails, and skin. Sausage-like swelling in the fingers or toes, known as dactylitis, may occur. Psoriasis can also cause changes to the nails, such as pitting or separation from the nail bed, onycholysis, hyperkeratosis under the nails, and horizontal ridging. Psoriasis classically presents with scaly skin lesions, which are most commonly seen over extensor surfaces such as the scalp, natal cleft and umbilicus. In<unk> ,<unk> in can occur in the area of the sacrum (the lower back, above the tailbone), as a result of sacroiliitis or spondylitis, which is present in 40% of cases.<unk> in can occur in and around the feet and ankles, especially enthesitis in the Achilles tendon (inflammation of the Achilles tendon where it inserts into the bone) or plantar fasciitis in the sole of the foot. Along with the above-noted<unk> in and inflammation, there is extreme exhaustion that does not go away with adequate rest. The exhaustion may last for days or weeks without abatement.<unk> may remain mild or may progress to more destructive joint disease. Periods of active disease, or flares, will typically alternate with periods of remission. In severe forms,<unk> may progress to arthritis mutilans which on X-ray gives a "pencil-in-cup" appearance. Because prolonged inflammation can lead to joint damage, early diagnosis and treatment to slow or prevent joint damage is recommended. | Psoriatic arthritis | Rheumatoid arthritis | Reactive arthritis | Inflammatory arthritis | Juvenile idiopathic arthritis | Post-traumatic arthritis | Enteropathic arthropathy | Oligoarthritis | 00
| 14,746 |
Medications that aim to lower the uric acid concentration Medications used to treat hyperuricemia are divided into two categories: xanthine oxidase inhibitors and uricosurics. For people who have recurring attacks of gout, one of these two categories of drugs is recommended. The evidence for people with asymptomatic hyperuricaemia to take these medications is not clear. Xanthine oxidase inhibitors Xanthine oxidase inhibitors, including allopurinol, febuxostat and topiroxostat, decrease the production of uric acid, by interfering with xanthine oxidase. Uricosurics Uricosuric agents (benzbromarone, benziodarone, probenecid, lesinurad, sulfinpyrazone, ethebencid, zoxazolamine, and ticrynafen) increase the excretion of uric acid, by reducing the reabsorption of uric acid once it has been filtered out of the blood by the kidneys. Some of these medications are used as indicated, others are used off-label. In people receiving hemodialysis, sevelamer can significantly reduce serum uric acid, apparently by adsorbing urate in the gut. In women, use of combined oral contraceptive pills is significantly associated with lower serum uric acid. Following<unk> atelier's principle, lowering the blood concentration of uric acid may permit any existing crystals of uric acid to gradually dissolve into the blood, whence the dissolved uric acid can be excreted. Maintaining a lower blood concentration of uric acid similarly should reduce the formation of new crystals. If the person has chronic gout or known tophi, then large quantities of uric acid crystals may have accumulated in joints and other tissues, and aggressive and/or long duration use of medications may be needed. Precipitation of uric acid crystals, and conversely their dissolution, is known to be dependent on the concentration of uric acid in solution, pH, sodium concentration, and temperature. Non-medication treatments for hyperuricemia include a low purine diet (see Gout) and a variety of dietary supplements. Treatment with lithium salts has been used as lithium improves uric acid solubility. pH Serum pH is neither safely nor easily altered. Therapies that alter pH principally alter the pH of urine, to discourage a possible complication of uricosuric therapy: formation of uric acid kidney stones due to increased uric acid in the urine (see Nephrolithiasis). Medications that have a similar effect include acetazolamide. Temperature Low temperature is a reported trigger of acute gout. An example would be a day spent standing in cold water, followed by an attack of gout the next morning. This is believed to be due to temperature-dependent precipitation of uric acid crystals in tissues at below normal temperature. Thus, one aim of prevention is to keep the hands and feet warm, and soaking in hot water may be therapeutic. | symptom of Lesch–Nyhan syndrome | symptom of Tay–Sachs disease | symptom of Maroteaux–Lamy syndrome | symptom of Myotonic dystrophy | symptom of Bannayan–Riley–Ruvalcaba syndrome | symptom of Fragile X syndrome | symptom of Neurofibromatosis | symptom of Rotor syndrome | 00
| 13,280 |
<unk> happens because of individuals bringing<unk> s into a<unk> environment and spreading<unk> s agents within that environment, which children then contact and become at risk for<unk> . Increased risk of<unk> is related to practices of those in the<unk> environment, and<unk> risk can be reduced by taking precautions. Practices which reduce the likelihood of spreading<unk> include encouraging hand washing in all present, providing facial tissue to cover sneezes, doing food preparation in a place separate from other activity, cleaning and using a disinfectant on surfaces people touch, and among groups using diapers, having good practices to change and dispose of diapers while cleaning children and the changing area. There are some alternetives to prevent diseases through physical contact with objects. Most of the objects in child center like toys, chairs, tables, and everything that can be touch by anyone can be what causes<unk> s or a disease. There is some disinfectant that has studies report of their effectiveness against "Salmonella Typhimurium" and "Staphylococcus aureus" on a chair and a toy. They can be used to prevent these<unk> s. First, we have Clorox Anywhere (CA) that has achieved the greatest results of reducing "Staphylococcus aureus" and "Salmonella Typhimurium". Clorox Green Works (GCW) is the second to show reduction but not more than Clorox Anywhere. The one that has shown less reduction but still shows effectiveness is CITRUS Farm Edition (CFE). | Infection in childcare | Maternal healthcare in Texas | Antibiotic use in livestock | Bad trip | Rape during the Kashmir conflict | Breastfeeding in public | Illness and injuries during spaceflight | Rape during the Rwandan genocide | 00
| 66,168 |
There is no single strategy for treatment of facial<unk> s, because of the large amount of variation in these<unk> s. Which kind of surgery is used depends on the type of<unk> ing and which structures are involved. There is much discussion about the timing of reconstruction of bone and soft tissue. The problem with early reconstruction is the recurrence of the deformity due to the intrinsic restricted growth. This requires additional operations at a later age to make sure all parts of the face are in proportion. A disadvantage of early bone reconstruction is the chance to damage the tooth germs, which are located in the maxilla, just under the orbit. The soft tissue reconstruction can be done at an early age, but only if the used skin flap can be used again during a second operation. The timing of the operation depends on the urgency of the underlying condition. If the operation is necessary to function properly, it should be done at early age. The best aesthetic result is achieved when the incisions are positioned in areas which attract the least attention (they cover up the scars). If, however, the function of a part of the face isn’t damaged, the operation depends on psychological factors and the facial area of reconstruction. The treatment plan of a facial<unk> is planned right after diagnosis. This plan includes every operation needed in the first 18 years of the patients life to reconstruct the face fully. In this plan, a difference is made between problems that need to be solved to improve the health of the patient (coloboma) and problems that need to be solved for a better cosmetic result (hypertelorism). The treatment of the facial<unk> s can be divided in different areas of the face: the cranial anomalies, the orbital and eye anomalies, the nose anomalies, the midface anomalies and the mouth anomalies. Treatment of the cranial anomalies The most common cranial anomaly seen in combination with facial<unk> s is encephalocele. Encephalocele The treatment of encephalocele is based on surgery to repair the bony gap and provide adequate protection of the underlying brain. The question remains if the external brain tissue should be put back into the skull or if it is possible to cut off that piece of brain tissue, because its claimed that the external piece of brain tissue often isn’t functional, with the exception of a basal encephalocele, in which the pituitary gland can be found in the mouth. Treatment of orbital / eye anomalies The most common orbital /eye anomalies seen in children with facial<unk> s are colobomas and vertical dystopia. Coloboma The coloboma which occurs often in facial<unk> s is a<unk> in the lower or upper eyelid. This should be closed as soon as possible, to prevent drought of the eye and a consecutive loss of vision. Vertical orbital dystopia Vertical orbital dystopia can occur in facial<unk> s when the orbital floor and/or the maxilla is involved in the<unk> . Vertical orbital dystopia means that the eyes do not lay on the same horizontal line in the face (one eye is positioned lower than the other). The treatment is based on the reconstruction of this orbital floor, by either closing the boney<unk> or reconstructing the orbital floor using a bone graft. Hypertelorism There are many types of operations which can be performed to treat a hypertelorism. 2 options are: box osteotomy and facial bipartition (also referred to as a median fasciotomy). The goal of the box osteotomy is to bring the orbits closer together by removing a part of the bone between the orbits, to detach both orbits from the surrounding bone structures and move both orbits more to the centre of the face. The goal of the facial bipartition is not only to bring the orbits closer together, but also to create more space in the maxilla. This can be done by splitting the maxilla and the frontal bone, remove a triangular shaped piece of bone from the forehead and nasal bones and pulling the two pieces of forehead together. Not only will the hypertelorism be solved by pulling the frontal bone closer together, but because of this pulling, the space between the both parts of the maxilla will become wider. File: Picture_box_osteotomy.Box Osteotomy File: Picture_median_fasciotomy.Facial Bipartition Treatment of nose anomalies The nose anomalies found in facial<unk> s vary. The main goal of the treatment is to reconstruct the nose to get a functional and esthetic acceptable result. A few possible treatment options are to reconstruct the nose with a forehead flap or reconstruct the nasal dorsum with a bone graft, for example a rib graft. The nasal reconstruction with a forehead flap is based on the repositioning of a skin flap from the forehead to the nose. A possible downside of this reconstruction is that once you performed it at a younger age, you can’t lengthen the flap at a later stage. A second operation is often needed if the operation is done on early age, because the nose has a restricted growth in the<unk> area. Repair of the ala (wing of the nose) often requires the inset of cartilage graft, commonly taken from the ear. Treatment of midface anomalies The treatment of soft tissue parts of midface anomalies is often a reconstruction from a skin flap of the cheek. This skinflap can be used for other operations in the further, as it can be raised again and transposed again. In the treatment of midface anomalies there are generally more operations needed. Bone tissue reconstruction of the midface often occurs later than the soft tissue reconstruction. The most common method to reconstruct the midface is by using the fracture/ incision lines described by René Le Fort. When the<unk> involves the maxilla, it is likely that the impaired growth will result in a smaller maxillary bone in all 3 dimensions (height, projection, width). Treatment of mouth anomalies There are several options for treatment of mouth anomalies like Tessier<unk> number 2-3-7 . These<unk> s are also seen in various syndromes like Treacher Collins syndrome and hemifacial microsomia, which makes the treatment much more complicated. In this case, treatment of mouth anomalies is a part of the treatment of the syndrome. | Craniofacial cleft | Hemifacial microsomia | Oxycephaly | Scaphocephaly | Trigonocephaly | Cranioschisis | Otocephaly | Cleft Lip and Palate Association | 00
| 59,884 |
<unk> , with the amino acid sequence ADVPGNYPLDKDGNTYTCLELGENKDCQKVCKLHGVQYGYCYAFFCWCKELDDKDVSV, is 58 amino acid residues long and has a molecular mass of 6598 Da; it has 3 disulfide bridges (Cys18-Cys41, Cys27-Cys46, and Cys31-Cys48). It has large homology to other toxins from the venom of Parabuthus transvaalicus, including bestoxin, birtoxin, ikitoxin and dortoxin. | Altitoxin | Antivenom | Cephem | Antitoxin | Anti-tetanus immunoglobulin | Diphtheria antitoxin | Immunoisolate | Iotroxic acid | 00
| 59,812 |
Advertised as an "analytics tool and care management platform", the<unk> software allows doctors to view data about a patient including how many pharmacies they have visited and the combinations of medication they are prescribed. It combines data from the prescription registries of various U.S. states, making the registries interoperable nationally. It additionally uses machine learning to generate various three-digit "risk scores" and an overall "Overdose Risk Score", collectively referred to as Narx Scores, in a process that potentially includes EMS and criminal justice data as well as court records. | NarxCare | PharMed | Lipotuck | Medgadget | TennCare | VirtaMed | Pharmasave | Aneugen | 00
| 74,808 |
<unk> <unk> ,<unk><unk> and<unk><unk> or<unk><unk><unk> (CVT), is the presence of a blood clot in the dural<unk><unk> es (which drain blood from the brain), the<unk> veins, or both. Symptoms may include severe headache, visual symptoms, any of the symptoms of stroke such as weakness of the face and limbs on one side of the body, and seizures. The diagnosis is usually by computed tomography (CT scan) or magnetic resonance imaging (MRI) to demonstrate obstruction of the<unk><unk> es. After confirmation of the diagnosis, investigations may be performed to determine the underlying cause, especially if one is not readily apparent. Treatment is typically with anticoagulants (medications that suppress blood clotting) such as low molecular weight heparin. Rarely, thrombolysis (enzymatic destruction of the blood clot) is used. The disease may be complicated by raised intracranial pressure, which may warrant surgical intervention such as the placement of a shunt. | Cerebral venous sinus thrombosis | Subarachnoid hemorrhage | Brain abscess | Cavernous sinus thrombosis | Amoebic brain abscess | Subdural empyema | Arachnoiditis | Pseudosubarachnoid hemorrhage | 00
| 47,367 |
Currently malignant mixed tumours do not have a definitive predisposing factor; however, prior physical injury has been proposed as a potential risk for the emergence of these tumours.<unk><unk> less than three centimetres are shown to have a heightened risk of malignancy. Other critical indicators include excessive mucoid matrix, – a connective tissue tumour with a myxoid background that is composed of "clear, mucoid substance – numerous mitoses, and poorly differentiated<unk> components." (Metzler, Schaumburg-Lever, Hornstein, and Rassner, 1996) | Malignant chondroid syringoma | Neural fibrolipoma | Aggressive angiomyxoma | Malignant acrospiroma | Chondroid syringoma | Peripheral ossifying fibroma | Malignant ectomesenchymoma | Ganglion cyst | 00
| 56,035 |
The treatment of pancreatitis is supportive and depends on severity. Morphine generally is suitable for<unk> control. There are no clinical studies to suggest that morphine can aggravate or<unk> pancreatitis or cholecystitis. The treatment for acute pancreatitis will depend on whether the diagnosis is for the mild form of the condition, which<unk> s no complications, or the severe form, which can<unk> serious complications. Mild acute pancreatitis The treatment of mild acute pancreatitis is successfully carried out by admission to a general hospital ward. Traditionally, people were not allowed to eat until the inflammation resolved but more recent evidence suggests early feeding is safe and improves outcomes, and may result in an ability to leave the hospital sooner. Due to inflammation occurring in pancreatitis, proinflammatory cytokines secreted into the bloodstream can<unk> inflammation throughout the body, including the lungs and can manifest as ARDS. Because pancreatitis can<unk> lung injury and affect normal lung function, supplemental oxygen is occasionally delivered through breathing tubes that are connected via the nose (e.g., nasal cannulae) or via a mask. The tubes can then be removed after a few days once it is clear that the condition is improving. Dehydration may result during an episode of acute pancreatitis, so fluids will be provided intravenously. Opioids may be used for the<unk> . When the pancreatitis is due to gallstones, early gallbladder removal also appears to improve outcomes. Severe acute pancreatitis Severe pancreatitis can<unk> organ failure, necrosis, infected necrosis, pseudocyst, and abscess. If diagnosed with severe acute pancreatitis, people will need to be admitted to a high-dependency unit or intensive care unit. It is likely that the levels of fluids inside the body will have dropped significantly as it diverts bodily fluids and nutrients in an attempt to repair the pancreas. The drop in fluid levels can lead to a reduction in the volume of blood within the body, which is known as hypovolemic shock. Hypovolemic shock can be life-threatening as it can very quickly starve the body of the oxygen-rich blood that it needs to survive. To avoid going into hypovolemic shock, fluids will be administered intravenously. Oxygen will be supplied through tubes attached to the nose and ventilation equipment may be used to assist with breathing. Feeding tubes may be used to provide nutrients, combined with appropriate analgesia. As with mild acute pancreatitis, it will be necessary to treat the underlying<unk> —gallstones, discontinuing medications, cessation of alcohol, etc. If the<unk> is gallstones, it is likely that an ERCP procedure or removal of the gallbladder will be recommended. The gallbladder should be removed during the same hospital admission or within two weeks of pancreatitis onset so as to limit the risk of recurrent pancreatitis. If the<unk> of pancreatitis is alcohol, cessation of alcohol consumption and treatment for alcohol dependency may improve pancreatitis. Even if the underlying<unk> is not related to alcohol consumption, doctors recommend avoiding it for at least six months as this can<unk> further damage to the pancreas during the recovery process. Oral intake, especially fats, is generally restricted initially but early enteral feeding within 48 hours has been shown to improve clinical outcomes. Fluids and electrolytes are replaced intravenously. Nutritional support is initiated via tube feeding to surpass the portion of the digestive tract most affected by secreted pancreatic enzymes if there is no improvement in the first 72–96 hours of treatment. | medical cause of Abdominal pain | medical cause of Bowel obstruction | symptom of Diverticulitis | symptom of Gallbladder cancer | symptoms of Diverticulitis | medical cause of Constipation | symptom of Small intestine cancer | symptom of Cholecystitis | 00
| 4,535 |
The lesion is associated with anterior shoulder dislocation. When the humerus is driven from the glenoid cavity, its relatively soft head impacts against the anterior edge of the glenoid. The result is a divot or flattening in the posterolateral aspect of the humeral head, usually opposite the coracoid process. The mechanism which leads to shoulder dislocation is usually traumatic but can vary, especially if there is history of previous dislocations. Sports, falls, seizures, assaults, throwing, reaching, pulling on the arm, or turning over in bed can all be causes of anterior dislocation. | Hill–Sachs lesion | Olney's lesions | Janeway lesion | Bankart lesion | Rokitansky nodule | Elschnig spots | Cameron lesions | Butcher's wart | 00
| 43,094 |
Childhood (or paediatric) acquired<unk> injury (ABI) is the term given to any injury to the<unk> that occurs during childhood but after birth and the immediate neonatal period. It excludes injuries sustained as a result of genetic or congenital disorder. It also excludes those resulting from birth traumas such as hypoxia or conditions such as foetal alcohol syndrome. It encompasses both traumatic and non-traumatic (or atraumatic) injuries. Pediatric acquired<unk> injury (PABI) is the number one cause of death and disability for children and young adults in the United States." and affects mostly children ages (6-10) and adolescent ages (11-17) around the world. The injury can be traumatic or non-traumatic in nature, and most patients never return to normal after suffering from the injury.There are many different symptoms such as amnesia, anhedonia, and apraxia. Currently there isn’t a cure for the injury. PABI effects the family of the patient also, because the families of the patient will need to adapt to the new changes they will experience in their child. It is recommended that the families decide to gain as much information as they can about the injury and what to expect by going to different program events and meetings. Traumatic injuries could include a blow to the head; gunshot; stabbing; crushing and excessive vibration / oscillation. This can be caused by shaking or sudden deceleration. Traumatic injuries might but do not necessarily have to involve an open wound or penetration of the skull or of the meninges - an 'open head’ injury. Non-traumatic injuries could include those caused by illnesses, such as tumours, encephalitis, meningitis and sinusitis. They could also be caused by infections such as septicaemia; events such as anoxia and hypoxia occasioned by strangulation or near drowning, lead toxicity, and substance misuse. | Childhood acquired brain injury | Pediatric stroke | Acquired brain injury | Childhood cancer | Traumatic brain injury | Trauma in children | Pediatric concussion | Primary and secondary brain injury | 00
| 64,595 |
<unk> (or<unk> are small particles of lipids formed by fragmentation of the stroma of erythrocytes (red-blood cells). They are ingested by phagocytes within the blood.<unk> were first discovered in 1896 by HF Müller. They are minute bits of disintegrated red blood corpuscles. Also in resting and slow flowing blood the RBC form piles called Roulaux by sticking together by the force of surface tension | Haemoconia | Edwardsiella | Shigella | Salmonella | Enteroaggregative Escherichia coli | Kingella kingae | Vancomycin-resistant Enterococcus | Methicillin-resistant Staphylococcus aureus | 00
| 58,051 |
Social and environmental Social circumstances appear to be highly influential in<unk> beliefs. Based on data collected by means of a mental health survey distributed to residents of Ciudad Juárez, Chihuahua (in Mexico) and El<unk> so, Texas (in the United States),<unk> beliefs seem to be associated with feelings of powerlessness and victimization, enhanced by social situations. Potential causes of these effects included a sense of believing in external control, and mistrust which can be strengthened by lower socioeconomic status. Those living in a lower socioeconomic status may feel less in control of their own lives. In addition, this study explains that females have the tendency to believe in external control at a higher rate than males, potentially making females more susceptible to mistrust and the effects of socioeconomic status on<unk> . Emanuel Messinger reports that surveys have revealed that<unk> can develop from<unk> rental relationships and untrustworthy environments. These environments could include being very disciplinary, stringent, and unstable. It was even noted that, "indulging and<unk> mpering (thereby impressing the child that they are something special and warrants special privileges)," can be contributing backgrounds. Experiences likely to enhance or manifest the symptoms of<unk> include increased rates of disappointment, stress, and a hopeless state of mind. Discrimination has also been reported as a potential predictor of<unk> delusions. Such reports that<unk> seemed to appear more in older<unk> tients who had experienced higher levels of discrimination throughout their lives. In addition to this it has been noted that immigrants are quite susceptible to forms of psychosis. This could be due to the aforementioned effects of discriminatory events and humiliation. Psychological Many more mood-based symptoms, grandiosity and guilt, may underlie functional<unk> . Colby (1981) defined<unk> cognition in terms of persecutory delusions and false beliefs whose propositional content clusters around ideas of being harassed, threatened, harmed, subjugated, persecuted, accused, mistreated, wronged, tormented, disparaged, vilified, and so on, by malevolent others, either specific individuals or groups (p. 518). Three components of<unk> cognition have been identified by Robins & Post: a) suspicions without enough basis that others are exploiting, harming, or deceiving them; b) preoccupation with unjustified doubts about the loyalty, or trustworthiness, of friends or associates; c) reluctance to confide in others because of unwarranted fear that the information will be used maliciously against them (1997, p. 3).<unk> cognition has been conceptualized by clinical psychology almost exclusively in terms of psychodynamic constructs and dispositional variables. From this point of view,<unk> cognition is a manifestation of an intra-psychic conflict or disturbance. For instance, Colby (1981) suggested that the biases of blaming others for one's problems serve to alleviate the distress produced by the feeling of being humiliated, and helps to repudiate the belief that the self is to blame for such incompetence. This intra-psychic perspective emphasizes that the cause of<unk> cognitions are inside the head of the people (social perceiver), and dismiss the fact that<unk> cognition may be related with the social context in which such cognitions are embedded. This point is extremely relevant because when origins of distrust and suspicion (two components of<unk> cognition) are studied many researchers have accentuated the importance of social interaction,<unk> rticularly when social interaction has gone awry. Even more, a model of trust development pointed out that trust increases or decreases as a function of the cumulative history of interaction between two or more persons. Another relevant difference can be discerned among "pathological and non-pathological forms of trust and distrust". According to Deutsch, the main difference is that non-pathological forms are flexible and responsive to changing circumstances.<unk> thological forms reflect exaggerated perceptual biases and judgmental predispositions that can arise and perpetuate them, are reflexively caused errors similar to a self-fulfilling prophecy. It has been suggested that a "hierarchy" of<unk> exists, extending from mild social evaluative concerns, through ideas of social reference, to persecutory beliefs concerning mild, moderate, and severe threats. Physical A<unk> reaction may be caused from a decline in brain circulation as a result of high blood pressure or hardening of the arterial walls. Drug-induced<unk> , associated with cannabis, amphetamines, methamphetamine and similar stimulants has much in common with schizophrenic<unk> ; the relationship has been under investigation since 2012. Drug-induced<unk> has a better prognosis than schizophrenic<unk> once the drug has been removed. For further information, see stimulant psychosis and substance-induced psychosis. Based on data obtained by the Dutch NEMESIS project in 2005, there was an association between impaired hearing and the onset of symptoms of psychosis, which was based on a five-year follow up. Some older studies have actually declared that a state of<unk> can be produced in<unk> tients that were under a hypnotic state of deafness. This idea however generated much skepticism during its time. | Paranoia | Snatiation | Hypersomnia | Allomnesia | Amnesia | Anhedonia | Dyssomnia | Pain asymbolia | 00
| 1,756 |
<unk> (or obstetric violence) is the violation of pregnant women during<unk> in the form(s) of neglect, physical<unk> and/or lack of respect. This treatment is regarded as a form of violence against women and a violation of women's rights. It is a recurring issue in facilities around the globe per World Health Organization studies, and can have serious consequences for mother and child. Namely,<unk> may prevent women from seeking pre-natal care and using other health care services in the future. Further examples of<unk> include non-consented care, non-confidential care, non-dignified care, discrimination, abandonment of care and detention in facilities. Adolescents, women who are unmarried, women of low socioeconomic status, migrant women, women infected with HIV, and ethnic minority women are at a greater risk of experiencing<unk> . | Abuse during childbirth | Concussions in sport | Cannabis in pregnancy | History of psychosurgery | History of depression | History of herbalism | History of chemical warfare | Pregnancy from rape | 00
| 70,378 |
variants of concern of SARS-CoV-2 depicted in a tree scaled radially by genetic distance, derived from Nextstrain on 1 December 2021 Nomenclature On 26 November, the WHO's Technical Advisory Group on SARS-CoV-2 Virus Evolution declared PANGO lineage B.1.1.529 a variant of concern and designated it with the Greek letter<unk> . Greek letters are used to identify variants of SARS-CoV-2. The WHO skipped the preceding letters nu and xi in the Greek alphabet to avoid confusion with the similarities of the English word "new" and the Chinese surname Xi. The previous designation was for the "variant of interest" Mu. Possibly due to a lack of familiarity with the Greek alphabet among some English speakers and the relative frequency of the Latin prefix "omni" in other common speech, the name of the variant has also occasionally been mispronounced and misspelled as "Omnicron". The GISAID project has assigned it the clade identifier GR/484A, and the Nextstrain project has assigned it the clade identifiers 21K and 21L, both belonging to a larger<unk> group 21M. Mutations File:SARS-CoV-2<unk> (BA.1) variant.The genomic sequence of the<unk> variant is pictured above. + Gene Amino acid ORF1ab nsp3: K38R nsp3: V1069I nsp3: Δ1265 nsp3: L1266I nsp3: A1892T nsp4: T492I nsp5: P132H nsp6: Δ105-107 nsp6: A189V nsp12: P323L nsp14: I42V Spike A67V Δ69-70 T95I G142D, Δ143-145 Δ211 L212I ins214EPE G339D S371L S373P S375F K417N N440K G446S S477N T478K E484A Q493R G496S Q498R N501Y Y505H T547K D614G H655Y N679K P681H N764K D796Y N856K Q954H N969K L981F E T9I M D3G Q19E A63T N P13L Δ31-33 R203K G204R Sources: UK Health Security Agency CoVariants The variant has many mutations, some of which have concerned scientists. The<unk> variant has a total of 60 mutations compared to the reference / ancestral variant: 50 nonsynonymous mutations, 8 synonymous mutations, and 2 non-coding mutations. Thirty-two mutations affect the spike protein, the main antigenic target of antibodies generated by infections and of many vaccines widely administered. Many of those mutations had not been observed in other strains. The variant is characterised by 30 amino acid changes, three small deletions, and one small insertion in the spike protein compared with the original virus, of which 15 are located in the receptor-binding domain (residues 319–541). It also carries a number of changes and deletions in other genomic regions. Additionally, the variant has three mutations at the furin cleavage site. The furin cleavage site increases SARS-CoV-2 infectivity. The mutations by genomic region are the following: * Spike protein: A67V, Δ69-70, T95I, G142D, Δ143-145, Δ211, L212I, ins214EPE, G339D, S371L, S373P, S375F, K417N, N440K, G446S, S477N, T478K, E484A, Q493R, G496S, Q498R, N501Y, Y505H, T547K, D614G, H655Y, N679K, P681H, N764K, D796Y, N856K, Q954H, N969K, L981F * Half (15) of these 30 changes are located in the receptor binding domain-RBD (residues 319–541) * ORF1ab * nsp3: K38R, V1069I, Δ1265, L1266I, A1892T * nsp4: T492I * nsp5: P132H * nsp6: Δ105-107, A189V * nsp12: P323L * nsp14: I42V * Envelope protein: T9I * Membrane protein: D3G, Q19E, A63T * Nucleocapsid protein: P13L, Δ31-33, R203K, G204R A link with HIV infection may explain a large number of mutations in the sequence of the<unk> variant. Indeed, in order to be affected by such a high number of mutations, the virus must have been able to evolve a long time without killing its host, nor being eliminated. One such situation occurs in people with a weakened immune system but receiving enough medical care to survive. This is the case in HIV patients in South Africa, who represent more than 20% of the population. Due to lack of access to clinics, fear of stigmatisation and disrupted healthcare, millions living with HIV in the region are not on effective HIV therapy. HIV prevention could be key to reducing the risk of uncontrolled HIV driving the emergence of Covid variants. In addition, it is believed that one of these many mutations, comprising a 9-nucleotide sequence, may have been acquired from another coronavirus (known as HCoV-229E), responsible for the common cold. This is not entirely at times, viruses within the body acquire and swap segments of genetic material from each other, and this is one common means of mutation. One hypothesis to explain the novel mutations is that SARS-CoV-2 was transmitted from humans to mice and mutated in a population of mice sometime between mid-2020 and late 2021 before reinfecting humans. Sublineages and BA.2 subvariant Researchers have established the existence of three sublineages of<unk> . The 'standard' sublineage is now referred to as BA.1 (or B.1.1.529.1), and the two other sublineages are known as BA.2 (or B.1.1.529.2) and BA.3 (or B.1.1.529.3). They share many mutations, but also significantly differ. In general, BA.1 and BA.2 share 32 mutations, but differ by 28. This makes them as different as some other major variants, and it has been suggested that BA.2 should receive its own Greek-letter name. BA.1 has itself been divided in two, the original BA.1 and BA.1.1, where the main difference is that the latter has a R346K mutation. A laboratory study on hamsters and mice in Japan published as a non-peer-reviewed preprint in mid-February 2022 suggested that BA.2, is not only more transmissible than BA.1, but may cause more severe disease. Therapeutic monoclonal antibodies used to treat people infected with COVID did not have much effect on BA.2, which was "almost completely resistant" to casirivimab and imdevimab, and 35 times more resistant to sotrovimab than the original B.1.1 virus. The researchers proposed that BA.2 should be recognised as a unique variant of concern, which would be given its own Greek letter. Detection Ordinary COVID-19 tests, both PCR and rapid, can detect all<unk> subvariants as COVID-19, but further tests are necessary to distinguish the subvariants from each other and from other COVID-19 variants. A notable difference between the 'standard'<unk> subvariant and BA.2 is that the latter lacks the characteristic S-gene target failure (SGTF)-causing deletion (Δ69-70) by which many qPCR tests are able to rapidly detect a case as an<unk> (or Alpha) variant, from the previously dominant Delta variant. Thus, countries that primarily rely on SGTF for detection may overlook BA.2, and British authorities consider SGTF alone as insufficient for monitoring the spread of<unk> . This has resulted in it having been nicknamed 'Stealth<unk> '. Because BA.2 still can be separated from other variants through normal full sequencing, or checks of certain other mutations, the nickname is however inaccurate. Some countries, such as Denmark and Japan, use a variant qPCR that tests for several mutations, including L452R. It can also distinguish Delta, which has L452R, and all<unk> sublineages, which do not have L452R. As<unk> became dominant and the Delta variant became rare, the SGTF mutation that had made Delta and BA.2 similar in qPCR tests could now be used for easily separating BA.1 and BA.2 from each other. As a consequence, BA.2 could now be regarded as decidedly un-stealthy. The third<unk> sublineage, BA.3, is very rare. It has the same SGTF deletion (Δ69-70) as BA.1. In April 2022 the WHO announced it was tracking BA.4 and BA.5 subvariants with BA.4 having been detected in South Africa, Botswana, Denmark, Scotland and England.Early indications from data collected in South Africa suggested BA.4 and BA.5 have a significant growth advantage over BA.2. In addition, there were two new subvariants detected in New York State, USA, which are BA.2.12 and BA.2.12.1, both of which have a significant growth advantage of 23-27% over BA.2 and contributing to a rise in infections in central New York State, centred on Syracruse and Lake Ontario. Affected countries and transmissibility According to early research, BA.2 is roughly 30% to 60% more transmissible than BA.1. As a consequence, it may prolong a COVID-19 wave when it overtakes BA.1, although it is difficult to assess what part is caused by the higher transmissibility of BA.2 in countries that simultaneously reduce restrictions (allowing easier transmission than in earlier periods with more restrictions). A new BA.1–BA.2 recombinant isolated from the UK in January 2022, dubbed the "XE" recombinant, was found by the WHO to be potentially 10% more transmissible than BA.2, making it about 43% to 76% to more transmissible than BA.1, and making the XE recombinant the most contagious variant identified. On 7 April 2022 Brazilian authorities announced the first detected case of a person infected with<unk> XE. The first known sequence of BA.2 was in a sample from 15 November 2021. In mid-December 2021, BA.2 still appeared to be rare with relatively few sequences from half a dozen countries having been uploaded to GISAID, but subsequently numbers rapidly increased. As of 17 January 2022, BA.2 had been detected in at least 40 countries and in all continents except Antarctica. By 31 January, it had been detected in at least 57 countries. In global samples collected from 4 February to 5 March and uploaded to GISAID, BA.2 accounted for c. 34%, compared to 41% for BA.1.1, 25% for BA.1 and less than 1% for BA.3. In a review two weeks later, covering 16 February to | SARS-CoV-2 Omicron variant | SARS-CoV-2 Delta variant | SARS-CoV-2 Epsilon variant | SARS-CoV-2 Alpha variant | SARS-CoV-2 Gamma variant | SARS-CoV-2 Eta variant | SARS-CoV-2 Lambda variant | SARS-CoV-2 Mu variant | 00
| 74,925 |
<unk> (, , "ear" + , , "to shape") denotes the surgical and non-surgical procedures for correcting the deformities and defects of the pinna (external ear), and for reconstructing a defective, or deformed, or absent external ear, consequent to congenital conditions (e.g. microtia, anotia, etc.) and trauma (blunt, penetrating, or blast). The<unk> c surgeon corrects the defect or deformity by creating an external ear that is of natural proportions, contour, and appearance, usually achieved by the reshaping, the moving, and the augmenting of the cartilaginous support framework of the pinna. Moreover, the occurrence of congenital ear deformities occasionally overlaps with other medical conditions (e.g. Treacher Collins syndrome and hemifacial microsomia). | Otoplasty | Omentopexy | Genitoplasty | Metoidioplasty | Cheiloplasty | Acromioplasty | Crown lengthening | Latarjet procedure | 00
| 22,024 |
Feeding and nutrition Developing<unk> worms that have infected their definitive hosts, prior to the sexual pairing of males and females, require a nutrient source in order to properly develop from cercariae to adults. The developing parasites lyse host red blood cells to gain access to nutrients and also makes its own fungi from its waste it is hard to detect; the hemoglobin and amino acids the blood cells contain can be used by the worm to form proteins. While hemoglobin is digested intracellularly, initiated by salivary gland enzymes, iron waste products cannot be used by the worms, and are typically discarded via regurgitation. Kasschau et al. (1995) tested the effect of temperature and pH on the ability of developing<unk> to lyse red blood cells. The researchers found that the parasites were best able to destroy red blood cells for their nutrients at a pH of 5.1 and a temperature of 37 °C. Locomotion<unk> is locomotive in primarily two stages of its life cycle: as cercariae swimming freely through a body of freshwater to locate the epidermis of their human hosts, and as developing and fully-fledged adults, migrating throughout their primary host upon infection. Cercariae are attracted to the presence of fatty acids on the skin of their definitive host, and the parasite responds to changes in light and temperature in their freshwater medium to navigate towards the skin. Ressurreicao et al. (2015) tested the roles of various protein kinases in the ability of the parasite to navigate its medium and locate a penetrable host surface. Extracellular signal-regulated kinase and protein kinase C both respond to changes in medium temperature and light levels, and the stimulation of p38 mitogen-activated protein kinase, associated with recognition of parasite host surface, results in a glandular secretion that deteriorates the host epidermis, and allows the parasite to burrow into its host. The parasite's nervous system contains bilobed ganglia and several nerve cords which splay out to every surface of the body; serotonin is a transmitter distributed widely throughout the nervous system and plays an important role in nervous reception, and stimulating mobility. | Schistosoma mansoni | Schistosoma japonicum | Taenia asiatica | Schistosoma haematobium | Taenia solium | Echinostoma cinetorchis | Taenia saginata | Trichuris trichiura | 00
| 27,007 |
<unk> <unk> is a rare disease in which amoebae of the genus<unk> invade the clear portion of the front (cornea) of the eye. It affects roughly 100 people in the United States each year.<unk> are protozoa found nearly ubiquitously in soil and water and can cause infections of the skin, eyes, and central nervous system. Infection of the cornea by<unk> is difficult to treat with conventional medications, and<unk> may cause permanent visual impairment or blindness, due to damage to the cornea or through damage to other structures important to vision. Recently,<unk> has been recognized as an orphan disease and a funded project, orphan diseases<unk> (ODAK), has tested the effects of a diverse range drugs and biocides on<unk> . | Acanthamoeba keratitis | Herpes simplex keratitis | Fungal keratitis | Nummular keratitis | Neurotrophic keratitis | Diffuse lamellar keratitis | Peripheral ulcerative keratitis | Interstitial keratitis | 00
| 37,030 |
Uterine atony is the failure of the uterus to contract adequately following delivery. Contraction of the uterine muscles during labor compresses the blood vessels and slows flow, which helps prevent hemorrhage and facilitates coagulation. Therefore, a lack of uterine muscle contraction can lead to an acute hemorrhage, as the vasculature is not being sufficiently compressed. Uterine atony is the most common cause of postpartum hemorrhage, which is an emergency and potential cause of fatality. Across the globe, postpartum hemorrhage is a top 5 causes of maternal death. Recognition of the warning signs of uterine atony in the setting of extensive postpartum bleeding should initiate interventions aimed at regaining stable uterine contraction. | medical cause of Postpartum bleeding | medical cause of Abnormal uterine bleeding | symptom of Postpartum infections | symptom of Postpartum bleeding | complications of Heavy menstrual bleeding | complications of Abnormal uterine bleeding | complications of Mastitis | symptom of Eclampsia | 00
| 36,948 |
<unk> (compound of Latin amoenus, "cheerful"; and Greek μανία, "madness") is a disused psychiatric diagnosis that originally designated patients with delusional disorders which do not paralyse them, but who may have fixed bizarre delusions. In some cases, religious delusion might accompany, causing individuals to believe to have peculiar spiritual powers, or even being God, often characterising outlines which might be diagnosed by modern psychiatry as paranoid schizophrenia or bipolar disorder. According to Benjamin Rush,<unk> would be a higher form of hypochondriasis, in which the patient, instead of having anxiety upon non-existent diseases, would deny any imperfection in his health, being not melancholic about his mental abnormalities, but rather cheerful (hence the name of the condition). | Amenomania | Potomania | Klazomania | Hypomania | Graphomania | Dipsomania | Mania | Erotomania | 00
| 71,016 |
<unk> <unk> is an intermediate form of diabetes that has some characteristics of type 1 and some of type 2 diabetes. Type 1 diabetes involves autoimmune destruction of pancreatic beta cells which create insulin. This occurs earlier in a person's life, leading to patients being insulin dependent, and the lack of natural insulin makes patients<unk> to a condition called diabetic ketoacidosis (DKA). Type 2 diabetes is different in that it is usually caused by insulin resistance in the body in older patients leading to beta cell burnout over time, and is not<unk> to DKA.<unk> is a condition that involves DKA like type 1, but occurs later in life and can regain beta cell function like type 2 diabetes. However, it is distinct from latent autoimmune diabetes of adults (LADA), a form of type 1 sometimes referred to as type 1.5 that does not occur with DKA. There are also distinctions to be made between<unk> and LADA as patients who exhibit<unk> symptoms can regain beta cell function similar to type 2 diabetics whereas LADA will not exhibit this reclamation of beta cell function.<unk> is readily diagnosible because it presents a single characteristic, ketoacidosis, which confirms it as<unk> .<unk> comes in four forms depending upon the presence or absence of β-cell autoantibodies (A+ or A−) and β-cell functional reserve (β+ or β−). Other styles of classification have been used for<unk> , including styles incorporating BMI, but the Aβ system has been found to have the highest accuracy and predictive value of all the systems utilized. The autoantibodies used to diagnose the A+ subtypes of<unk> include the autoantibodies detected in patients with type 1 diabetes, including Glutamic Acid Decarboxylase 65 (GAD65), Zinc Transporter T8 (ZnT8), Islet Antigen-2 (IA-2), and HLA class II type 1 diabetes susceptibility alleles. | Ketosis-prone diabetes | Diabetic hypoglycemia | Lifestyle causes of type 2 diabetes | Idiopathic hypoglycemia | Steroid diabetes | Lipoatrophic diabetes | Non-islet cell tumor hypoglycemia | Reactive hypoglycemia | 00
| 63,690 |
Most optic nerve melanocytomas are small, black, and do not grow. | Optic nerve tumor | Optic nerve glioma | Autoimmune optic neuropathy | Optic neuritis | Ischemic optic neuropathy | Optic nerve sheath meningioma | Labyrinthine fistula | Posterior ischemic optic neuropathy | 00
| 54,165 |
In medicine, a<unk> (American English) or<unk> (British English) is a drug delivery device used to administer medication in the form of a mist inhaled into the lungs.<unk> s are commonly used for the treatment of asthma, cystic fibrosis, COPD and other respiratory diseases or disorders. They use oxygen, compressed air or ultrasonic power to break up solutions and suspensions into small aerosol droplets that are inhaled from the mouthpiece of the device. An aerosol is a mixture of gas and solid or liquid particles. | Nebulizer | Air purifier | Inhaler | Caphosol | Metered-dose inhaler | Asthma spacer | Deodorant | Mouthwash | 00
| 15,150 |
Protein GNAS A male with Pseudohypoparathyroidism has a 50% chance of passing on the defective GNAS gene to his children, although in an imprinted, inactive form. Any of his children receiving this gene will have<unk> . Any of his daughters that have<unk> may in turn pass along Pseudohypoparathyroidism 1A to her children as the imprinting pattern on the inherited paternal gene will be changed to the maternal pattern in the mother's ovum during meiosis. The gene will be reactivated in any children who inherit it.<unk> and pseudohypoparathyroidism both involve the same GNAS gene, but<unk> has normal calcium homeostasis because of the normal maternal allele in the kidney. | Pseudopseudohypoparathyroidism | Hypoparathyroidism | Pseudohypoparathyroidism | Tertiary hyperparathyroidism | Albright's hereditary osteodystrophy | Secondary hyperparathyroidism | Primary hyperparathyroidism | X-linked recessive hypoparathyroidism | 00
| 38,546 |
<unk> is classified as an NK1 antagonist because it blocks signals given off by NK1 receptors. This, therefore, decreases the likelihood of vomiting in patients. NK1 is a G protein-coupled receptor located in the central and peripheral nervous system. This receptor has a dominant ligand known as Substance P (SP). SP is a neuropeptide, composed of 11 amino acids, which sends impulses and messages from the brain. It is found in high concentrations in the vomiting center of the brain, and, when activated, it results in a vomiting reflex. In addition to this it also plays a key part in the transmission of pain impulses from the peripheral receptors to the central nervous system.<unk> has been shown to inhibit both the acute and delayed emesis induced by cytotoxic chemotherapeutic drugs by blocking substance P landing on receptors in the brain's neurons. Positron emission tomography (PET) studies, have demonstrated that<unk> can cross the blood brain barrier and bind to NK1 receptors in the human brain. It has also been shown to increase the activity of the 5-HT3 receptor antagonists ondansetron and the corticosteroid dexamethasone, which are also used to prevent nausea and vomiting caused by chemotherapy.<unk> is taken orally in the form of a capsule. Before clinical testing, a new class of therapeutic agent has to be characterized in terms of preclinical metabolism and excretion studies. Average bioavailability is found to be around 60-65%.<unk> is metabolized primarily by CYP3A4 with minor metabolism by CYP1A2 and CYP2C19. Seven metabolites of<unk> , which are only weakly active, have been identified in human plasma. As a moderate inhibitor of CYP3A4,<unk> can increase plasma concentrations of co-administered medicinal products that are metabolized through CYP3A4. Specific interaction has been demonstrated with oxycodone, where<unk> both increased the efficacy and worsened the side effects of oxycodone; however it is unclear whether this is due to CPY3A4 inhibition or through its NK-1 antagonist action. Following IV administration of a 14C-labeled prodrug of<unk> (L-758298), which is converted rapidly and completely to<unk> , approximately 57% of the total radioactivity is excreted in the urine and 45% in feces. No unchanged substance is excreted in urine. | Aprepitant | Eptifibatide | Oprelvekin | Netupitant | Prasugrel | Defibrotide | Elinogrel | Ambrisentan | 00
| 23,572 |
Because symptoms are non-specific, diagnosis is often delayed. Measurement of hormones including pancreatic polypeptide, gastrin, proinsulin, insulin, glucagon, and vasoactive intestinal peptide can determine if a tumor is causing hypersecretion. Multiphase CT and MRI are the primary modalities for morphologic imaging of<unk> s. While MRI is superior to CT for imaging, both of the primary tumor and evaluation of metastases, CT is more readily available. Notably, while many malignant lesions are hypodense in contrast-enhanced studies, the liver metastases of<unk> s are hypervascular and readily visualized in the late arterial phase of the post-contrast CT study. However, morphological imaging alone is not sufficient for a definite diagnosis On biopsy, immunohistochemistry is generally positive for chromogranin and synaptophysin. Genetic testing thereof typically shows altered MEN1 and DAXX/ATRX. | Pancreatic neuroendocrine tumor | Small intestine neuroendocrine tumor | Metastatic insulinoma | Acinar cell carcinoma of the pancreas | Glucagonoma | Pancreatic mucinous cystic neoplasm | Insulinoma | Goblet cell carcinoid | 00
| 66,433 |
The condition resembles Begger syndrome and Refsum disease. | Familial Danish dementia | Familial British dementia | CADASIL | Canavan disease | Synucleinopathy | Menkes disease | Familial amyloid polyneuropathy | Sandhoff disease | 00
| 74,627 |
Classification<unk> may be divided into multiple types: Type Locus & Gene OMIM<unk> with migratory circinate erythema 12q13 (KRT5)<unk> with mottled pigmentation. :Associated with a recurrent mutation in KRT14. 12q13 (KRT5)<unk> , autosomal recessive 17q12-q21 (KRT14) Generalized<unk> : Also known as "Koebner variant of generalized<unk> ", presents at birth to early infancy with a predilection for the hands, feet, and extremities, and palmar-plantar hyperkeratosis and erosions may be present. 17q12-q21 (KRT5), 12q13 (KRT14) Localized<unk> : Also known as "Weber–Cockayne syndrome" and "Weber–Cockayne variant of generalized<unk> ", is characterized by onset in childhood or later in life, and is the most common variant of<unk> . 17q12-q21 (KRT5), 17q11-qter, 12q13 (KRT14)<unk><unk> herpetiformis : Also known as "Dowling-Meara<unk> ", presents at birth with a generalized distribution, often with oral mucosa involvement and variable lesions in infancy. 17q12-q21 (KRT5), 12q13 (KRT14)<unk> with muscular dystrophy : A rare clinical entity, and is the only epidermolytic<unk><unk> described that is not caused by a keratin mutation, presenting as a generalized intraepidermal blistering similar to the Koebner variant of generalized<unk> , but also associated with adult onset muscular dystrophy. 8q24 (PLEC1)<unk> with pyloric atresia 8q24 (PLEC1)<unk> of Ogna : Has onset in infancy, presenting with seasonal blistering on acral areas during summer months. 8q24 (PLEC1) | Epidermolysis bullosa simplex | Epidermolysis bullosa acquisita | Ichthyosis bullosa of Siemens | Ichthyosis acquisita | Tinea imbricata | Urticaria pigmentosa | Poikiloderma of Civatte | Tinea capitis | 00
| 37,271 |
Due to its mechanism of action,<unk> increases blood potassium levels. Combination with potassium preparations or potassium-sparing diuretics could cause hyperkalaemia (excessive potassium levels). Combination with NSAIDs, especially in patients with impaired kidney function, has a risk of causing (usually reversible) kidney failure. | Telmisartan | Losartan | Olmesartan | Cyclothiazide | Valsartan | Azilsartan | Irbesartan | Chlorothiazide | 00
| 25,825 |
<unk> is a cutaneous condition and refers to reticulated red to red-brown skin patches with telangiectasias. It is identifiable as a reddish-brown discoloration on the side of the neck, usually on both sides. It is more common in lighter-skinned individuals, in females rather than in males and more often affects middle-aged to elderly women. This disease is basically a change of the skin due to dilation of the blood vessels in the neck.<unk> " was the French dermatologist who first identified it in the 1920s. | Poikiloderma of Civatte | Papuloerythroderma of Ofuji | Ichthyosis bullosa of Siemens | Dermatopathia pigmentosa reticularis | Ichthyosis acquisita | Keratoderma blennorrhagicum | Poikiloderma vasculare atrophicans | Phytophotodermatitis | 00
| 57,730 |
Extraesophageal symptoms result from exposure of the upper aerodigestive tract to gastric contents. This causes a variety of symptoms, including hoarseness, postnasal drip, sore throat, difficulty swallowing, indigestion, wheezing, globus pharyngeus, and chronic throat-clearing. Some people with<unk> have heartburn, while others have little to no heartburn as<unk> ed stomach contents do not remain in the esophagus long enough to irritate the surrounding tissue. Individuals with more severe forms of<unk> may experience abrasion of tooth enamel due to intermittent presence of gastric contents in the oral cavity. Additionally,<unk> can cause inflammation in the vocal tract which results in the symptom of dysphonia or hoarseness. Hoarseness is considered to be one of the primary symptoms of<unk> and is associated with complaints such as strain, vocal fatigue, musculoskeletal tension, and hard glottal attacks, all of which can reduce a person's ability to communicate effectively. Moreover,<unk> patients may try to compensate for their hoarseness by increasing muscular tension in their vocal tract. This hyper-functional technique adopted in response to the inflammation caused by<unk> can lead to a condition called muscle tension dysphonia and may persist even after the hoarseness and inflammation has disappeared. A speech-language pathologist will often need to be involved to help resolve this maladaptive, compensatory pattern through the implementation of voice therapy.<unk> presents as a chronic and intermittent disease in children.<unk> in children and infants tends to manifest with a unique set of symptoms. Symptoms seen in children with<unk> include a cough, hoarseness, stridor, sore throat, asthma, vomiting, globus sensation, wheezing, aspiration and recurrent pneumonia. Common symptoms of<unk> in infants include wheezing, stridor, persistent or recurrent cough, apnea, feeding difficulties, aspiration, regurgitation, and failure to thrive. Moreover,<unk> in children is commonly concomitant with laryngeal disorders such as laryngomalacia, subglottic stenosis, and laryngeal papillomatosis. Relationship to GERD Illustration of the superior view of the larynx. Tissues lining laryngeal structures, including the vocal folds, may be damaged in<unk> .<unk> is often regarded as a subtype of GERD that occurs when stomach contents flow upward through the esophagus and reach the level of the larynx and pharynx. However,<unk> is associated with a distinct presentation of symptoms.<unk> and GERD frequently differ in the relative prevalence of heartburn and throat clearing. While heartburn is present in over 80% of GERD cases, it occurs in only 20% of<unk> cases. Throat clearing shows the opposite prevalence pattern, occurring in approximately 87% of<unk> cases and in fewer than 5% of GERD cases. Unlike GERD,<unk> also poses a risk for bronchitis or pneumonitis as<unk> of stomach acid to the level of the larynx can result in aspiration.<unk> is also commonly associated with erythema, or redness, as well as edema in the tissues of the larynx that are exposed to gastric contents. In contrast, most cases of GERD are nonerosive, with no apparent injury to the mucosal lining of the esophageal tissue exposed to the<unk> ed material. Differences in the molecular structure of the epithelial tissue lining the<unk> region may be partly responsible for the different symptomatic manifestations of<unk> in comparison to GERD. In contrast to the resistant stratified squamous epithelium lining the esophagus, the larynx is lined by ciliated respiratory epithelium, which is more fragile and susceptible to damage. While the epithelium lining the esophagus is capable of withstanding as many as 50 instances of exposure to gastric contents each day, which is the uppermost estimate considered to be within the range of normal physiologic functioning, injury to laryngeal epithelium can occur following exposure to only small amounts of acidic gastric contents. | Laryngopharyngeal reflux | Subglottic stenosis | Laryngomalacia | Velopharyngeal insufficiency | Laryngotracheal stenosis | Post-nasal drip | Exercise-induced laryngeal obstruction | Nasal septum deviation | 00
| 50,044 |
Chest injuries can be classified as blunt or penetrating. Blunt and penetrating injuries have different pathophysiologies and clinical courses. Specific types of injuries include: * Injuries to the chest wall * Chest wall contusions or hematomas. * Rib fractures * Flail chest * Sternal fractures * Fractures of the shoulder girdle * Pulmonary injury (injury to the lung) and injuries involving the pleural space * Pulmonary contusion * Pulmonary laceration * Pneumothorax * Hemothorax * Hemopneumothorax * Injury to the airways * Tracheobronchial tear * Cardiac injury * Pericardial tamponade * Myocardial contusion * Traumatic arrest * Hemopericardium * Blood vessel injuries * Traumatic aortic rupture * Thoracic aorta injury * Aortic dissection * And injuries to other structures within the torso * Esophageal injury (Boerhaave syndrome) * Diaphragm injury | causes of Rib fracture | causes of Pleurisy | causes of Fat embolism syndrome | complications of Hemothorax | causes of Cardiac tamponade | complications of Rib fracture | medical cause of Hemothorax | causes of Mandibular fracture | 00
| 34,263 |
Left sided<unk> in a person with an atrophic right kidney. Stent is also present (image below). Left sided<unk> , coronal view. Stent is also present. Treatment of<unk> focuses upon the removal of the obstruction and drainage of the urine that has accumulated behind the obstruction. Therefore, the specific treatment depends upon where the obstruction lies. Acute obstruction of the upper urinary tract is usually treated by the insertion of a nephrostomy tube. Chronic upper urinary tract obstruction is treated by the insertion of a ureteric stent or a pyeloplasty. Lower urinary tract obstruction (such as that caused by bladder outflow obstruction secondary to prostatic hypertrophy) is usually treated by insertion of a urinary catheter or a suprapubic catheter. Surgery is not required in all prenatally detected cases. | Hydronephrosis | Pyonephrosis | Glomerulonephrosis | Pyelonephritis | Ureteric stricture | Ureteral cancer | Salpingitis | Obstructive uropathy | 00
| 25,103 |
Prevention is that of any tick bite, avoid excessive foliage and bushy areas. If you do come in contact with these areas, wear long sleeves and pants to cover as much skin as possible. Be specifically careful in areas used to graze or feed goats or sheep. | Bhanja virus | Limestone Canyon virus | Playa de Oro virus | Amur virus | Alkhurma virus | Slow virus | Ngari virus | Magboi virus | 00
| 66,226 |
<unk> also known as a<unk> in the singular, and sometimes more formally termed a<unk> telescope, is a term for a pair of vision-enhancement lenses. They magnify between two and six times, and are used to improve distance vision for those with severely impaired eyesight, especially those with albinism. They can either be a combination of head-mounted eyeglasses (termed the "carrier") and binoculars, or be designed to attach to existing glasses. Some use monoculars which have small telescopes mounted on, in, or behind their regular lenses, so that they can look through either the regular lens or the telescope. Newer designs use smaller lightweight mini telescopes magnifying up to six times, which can be embedded into the spectacle glass and improve aesthetic appearance. The mini telescopic eyeglasses have been shown to be used in the treatment of nystagmus. In some jurisdictions, those with low vision may be permitted to drive automobiles when using<unk> | Bioptics | Cryonics | GeroScience | Medicine | Biomedicine | Medic | Medicen | Biopharmaceutical | 00
| 55,401 |
<unk> <unk> is a rapid-onset muscle weakness caused by the immune system damaging the peripheral nervous system. Typically, both sides of the body are involved, and the initial symptoms are changes in sensation or pain often in the back along with muscle weakness, beginning in the feet and hands, often spreading to the arms and upper body. The symptoms may develop over hours to a few weeks. During the acute phase, the disorder can be life-threatening, with about 15% of people developing weakness of the breathing muscles and, therefore, requiring mechanical ventilation. Some are affected by changes in the function of the autonomic nervous system, which can lead to dangerous abnormalities in heart rate and blood pressure. Although the cause is unknown, the underlying mechanism involves an autoimmune disorder in which the body's immune system mistakenly attacks the peripheral nerves and damages their myelin insulation. Sometimes this immune dysfunction is triggered by an infection or, less commonly, by surgery, and rarely, by vaccination. The diagnosis is usually based on the signs and symptoms through the exclusion of alternative causes and supported by tests such as nerve conduction studies and examination of the cerebrospinal fluid. There are a number of subtypes based on the areas of weakness, results of nerve conduction studies, and the presence of certain antibodies. It is classified as an acute polyneuropathy. In those with severe weakness, prompt treatment with intravenous immunoglobulins or plasmapheresis, together with supportive care, will lead to good recovery in the majority of cases. Recovery may take weeks to years, with about a third having some permanent weakness. Globally, death occurs in approximately 7.5% of those affected.<unk> is rare, at 1 or 2 cases per 100,000 people every year. Both sexes and all parts of the world have similar rates of disease. The syndrome is named after the French neurologists Georges<unk> and Jean Alexandre<unk> , who, together with French physician André Strohl, described the condition in 1916. | Guillain–Barré syndrome | Myasthenia gravis | Tension myositis syndrome | Botulism | Lambert–Eaton myasthenic syndrome | Acute flaccid myelitis | FACES syndrome | CMV polyradiculomyelopathy | 00
| 46,728 |
A<unk> is a medical condition due to reduced functionality of<unk><unk> .<unk><unk> defects can cause an accelerated aging disease or an increased risk of cancer, or sometimes both. | DNA repair-deficiency disorder | Radiation damage | Ribosomopathy | Chromosome instability | Vitamin deficiency | Congenital vertebral anomaly | Mineral deficiency | Environmental disease | 00
| 37,696 |
A<unk> (also known as a release of frenulum) is a<unk> of the frenulum of<unk> of penis. An abnormally short or sensitive frenulum of the penis can make some types of sexual activity uncomfortable or even painful. This may be a complication of circumcision or a naturally occurring event. When it is a naturally occurring event, a short frenulum can restrict normal retraction of the foreskin during erection (a condition known as frenulum breve). The goal of treatment is to allow normal retraction of the foreskin. Circumcision may relieve this condition but is not indicated solely for treating frenulum breve. | Frenuloplasty of prepuce of penis | Frenulectomy of the penis | Penoscrotal transposition | Prostatic urethral lift | Genitoplasty | Penile subincision | Penile implant | Urethroplasty | 00
| 61,451 |
Only a few treatments can give any improvements. Sulindac has been used experimentally in some<unk> , lowering the amount of amniotic fluid and thereby inhibiting fetal movement. This is believed to lower the risk of cord entanglement and compression. However, the potential side effects of the drug have been insufficiently investigated. Regular and aggressive fetal monitoring is recommended for cases of<unk> to look for cord entanglement beginning after viability. Many women enter inpatient care, with continuous monitoring, preferably in the care of a perinatologist, an obstetrician that specialises in high-risk pregnancies. However RCOG's guidelines cite Dias et al. in observing that cord entanglement is nearly always found in<unk> pregnancies and it is not clearly associated with poor outcomes, with most fetal deaths instead arising from twin reversed arterial perfusion or fetal anomaly. The clinical guidelines of ACOG and RCOG both recommend premature delivery by cesarean section between 32 and 34 weeks. A retrospective study in 2016 argued that there is evidence vaginal delivery can be equally safe and reduce complications for some<unk> but this finding has not been incorporated into clinical guidelines. | Monoamniotic twins | Monochorionic twins | Locked twins | Conjoined twins | Parasitic twin | Craniopagus twins | Vanishing twin | Vestigial twin | 00
| 56,361 |
UGT1A1 gene mutations causes the condition. As a result, there can be reduced functionality of the bilirubin-UGT enzyme. Eventually it causes unconjugated<unk> and jaundice as substance accumulates in the body due to the reduced ability of the enzyme. | Hereditary hyperbilirubinemia | Neonatal cholestasis | Neonatal hemochromatosis | Hemolytic jaundice | Congenital hepatic fibrosis | Dubin–Johnson syndrome | Progressive familial intrahepatic cholestasis | Intrahepatic cholestasis of pregnancy | 00
| 49,950 |