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A<unk> is a surgical procedure that creates a stoma (artificial opening) for the urinary system. A<unk> is made to avail for urinary diversion in cases where drainage of urine through the bladder and urethra is not possible, e.g. after extensive surgery or in case of obstruction. | Urostomy | Nephrostomy | Percutaneous nephrostomy | Ureteric balloon catheter | Ureterostomy | Penrose drain | Ureterocutaneostomy | Cystogastrostomy | 00
| 26,855 |
An agar plate streaked with microorganisms<unk> (from Greek , mīkros, "small"; , bios, "life"; and , -logia) is the scientific study of microorganisms, those being unicellular (single cell), multicellular (cell colony), or acellular (lacking cells).<unk> encompasses numerous sub-disciplines including virology, bacteriology, protistology, mycology, immunology and parasitology. Eukaryotic microorganisms possess membrane-bound organelles and include fungi and protists, whereas prokaryotic organisms—all of which are microorganisms—are conventionally classified as lacking membrane-bound organelles and include Bacteria and Archaea.<unk> sts traditionally relied on culture, staining, and microscopy. However, less than 1% of the microorganisms present in common environments can be cultured in isolation using current means.<unk> sts often rely on molecular biology tools such as DNA sequence based identification, for example the 16S rRNA gene sequence used for bacteria identification. Viruses have been variably classified as organisms, as they have been considered either as very simple microorganisms or very complex molecules. Prions, never considered as microorganisms, have been investigated by virologists, however, as the clinical effects traced to them were originally presumed due to chronic viral infections, and virologists took search—discovering "infectious proteins". The existence of microorganisms was predicted many centuries before they were first observed, for example by the Jains in India and by Marcus Terentius Varro in ancient Rome. The first recorded microscope observation was of the fruiting bodies of moulds, by Robert Hooke in 1666, but the Jesuit priest Athanasius Kircher was likely the first to see microbes, which he mentioned observing in milk and putrid material in 1658. Antonie van Leeuwenhoek is considered a father of<unk> as he observed and experimented with microscopic organisms in the 1670s, using simple microscopes of his own design. Scientific<unk> developed in the 19th century through the work of Louis Pasteur and in medical<unk> Robert Koch. | Microbiology | Bacteriology | Clinical chemistry | Virology | Radiochemistry | Laboratory specimen | Biomarker | Biomarker | 00
| 54,079 |
AOS was initially described as having autosomal dominant inheritance due to the reports of families with multiple affected family members in more than one generation. The severity of the condition can vary between family members, suggestive of variable expressivity and reduced penetrance of the disease-causing allele. Subsequently, it was reported that some cases of AOS appear to have autosomal recessive inheritance, perhaps with somewhat more severe phenotypic effects. Six AOS genes have been identified: ARHGAP31, DOCK6, RBPJ, EOGT, NOTCH1, and DLL4. ARHGAP31 and DOCK6 are both regulatory proteins that control members of the Rho family of GTPases and specifically regulate the activity of Cdc42 and Rac1. Autosomal dominant mutations in ARHGAP31 (a GTPase-activating protein) and autosomal recessive mutations in DOCK6 (a guanine nucleotide exchange factor) cause an accumulation of the inactive GTPase and lead to defects of the cytoskeleton. RBPJ, EOGT, NOTCH1 and DLL4 are all involved in the Notch signalling pathway. Mutations in EOGT are found in AOS with autosomal recessive inheritance; the other three genes account for cases with autosomal dominant inheritance. | Adams–Oliver syndrome | Wilson's temperature syndrome | Wilson–Mikity syndrome | Gianotti–Crosti syndrome | Toriello–Carey syndrome | Schwartz–Matsuo syndrome | Pellegrini–Stieda syndrome | Gilbert's syndrome | 00
| 33,545 |
Perioperative<unk> of steroids to mitigate this rare but potentially fatal complications of perioperative use of steroid such as full-blown adrenal crisis in the perioperative period due to the secondary adrenal insufficiency. Various exogenous steroid preparations are used for a wide range of indications. __TOC__ | Stress dose | Absorptive state | Stress concentration | Eating recovery | Neutral stimulus | Alcohol flush reaction | Allostatic load | Hormesis | 00
| 73,156 |
The display of a<unk> The fetal heartbeat is shown in orange, uterine contractions are shown in green, and the small green numbers (lower right) show the mother's heartbeat.<unk> sound Schematic explanation of<unk> : heart rate (A) is calculated from fetal heart motion determined by ultrasound, and uterine contractions are measured by a tocodynamometer (B). These numbers are represented on a time scale with the help of a running piece of paper, producing a graphical representation. External<unk> can be used for continuous or intermittent monitoring. The fetal heart rate and the activity of the uterine muscle are detected by two transducers placed on the mother's abdomen, with one above the fetal heart to monitor heart rate, and the other at the fundus of the uterus to measure frequency of contractions. Doppler ultrasound provides the information, which is recorded on a paper strip known as a<unk> <unk> . External to cometry is useful for showing the beginning and end of contractions as well as their frequency, but not the strength of the contractions. The absolute values of pressure readings on an external to cometer are dependent on position and are not sensitive in people who are obese. In cases where information on the strength or precise timing of contractions is needed, an internal to cometer is more appropriate. Internal<unk> uses an electronic transducer connected directly to the fetus. A wire electrode, sometimes called a spiral or scalp electrode, is attached to the fetal scalp through the cervical opening and is connected to the monitor. Internal monitoring provides a more accurate and consistent transmission of the fetal heart rate, as unlike external monitoring, it is not affected by factors such as movement. Internal monitoring may be used when external monitoring is inadequate, or if closer surveillance is needed. Internal to cometry can only be used if the amniotic sac is ruptured (either spontaneously or artificially) and the cervix is open. To gauge the strength of contractions, a small catheter (called an intrauterine pressure catheter or IUPC) is passed into the uterus past the fetus. Combined with an internal fetal monitor, an IUPC may give a more precise reading of the baby's heart rate and the strength of contractions. A typical<unk> reading is printed on paper and may be stored on a computer for later reference. A variety of systems for centralized viewing of<unk> have been installed in maternity hospitals in industrialised countries, allowing simultaneous monitoring of multiple tracings in one or more locations. Display of maternal vital signs, ST signals and an electronic partogram are available in the majority of these systems. A few of them have incorporated computer analysis of<unk> c signals or combined<unk> c and ST data analysis. | Cardiotocography | Vectorcardiography | Electrical cardiometry | Holter monitor | Electrocardiography | Sphygmograph | Magnetocardiography | Electrocochleography | 00
| 14,635 |
The<unk> (or medical<unk> is an academic discipline concerning language and symbols in health and<unk> .<unk> most commonly refers to the persuasive element in human interactions and is often best studied in the specific situations in which it occurs. As a subfield of<unk> , medical<unk> specifically analyzes and evaluates the structure, delivery, and intention of communications messages in<unk> - and health-related contexts. Primary topics of focus includes patient-physician communication, health literacy, language that constructs disease knowledge, and pharmaceutical advertising (including both direct-to-consumer and direct-to-physician advertising). The general research areas are described below. Medical<unk> is a more focused subfield of the<unk> of science. Practitioners from the medical<unk> field hail from a variety of disciplines, including English studies, communication studies, and health humanities. Through methods such as content analysis, survey methodology, and usability testing, researchers in this sphere recognize the importance of communication to successful healthcare. Several communication journals, including Communication Design Quarterly, Journal of Business and Technical Communication, Technical Communication Quarterly, and Present Tense, have published special issues on themes related to medical<unk> . The majority of research in the field is indexed in the academic database EBSCO Communication & Mass Media Complete. In 2013, scholars in the field also began a biennial symposium, Discourses of Health and<unk> . | Rhetoric of health and medicine | Outline of medicine | Outline of public health | International health | Drug policy | Regulatory science | Community health | Volunteers in Medicine | 00
| 65,532 |
An enlargement of the aorta may occur; an increased risk of abnormality is seen in babies of women taking lithium during the first trimester of pregnancy (though some have questioned this) and in those with Wolff-Parkinson-White syndrome. | Ebstein's anomaly | Tetralogy of Fallot Tetralogy of Fallot 1 | Jordans' anomaly | First arch syndrome | Choanal atresia | Double aortic arch | Pulmonary atresia | May–Hegglin anomaly | 00
| 19,522 |
<unk> (also known as "Fibromatosis<unk> ca multiplex<unk> s," "Murray–Puretic–Drescher syndrome") is a very rare, autosomal recessive disease due to mutations in capillary morphogenesis protein-2 (CMG-2 gene). It occurs from early childhood to adulthood, and presents as slow-growing, pearly white or skin-colored dermal or subcutaneous papules or nodules on the face, scalp, and back, which may be confused clinically with neurofibromatosis. The World Health Organization, 2020, reclassified the papules and nodules that occur in<unk> as one of the specific benign types of tumors in the category of fibroblastic and myofibroblastic tumors. | Juvenile hyaline fibromatosis | Diffuse infantile fibromatosis | Aggressive fibromatosis | Aggressive infantile fibromatosis | Cellular angiofibroma | Desmoplastic fibroma | Ameloblastic fibroma | Myxoid cyst | 00
| 53,171 |
Fundoscopy and patients history. Differential Diagnoses Several other diseases can result in<unk> that can be confused with<unk> . These include diabetic<unk> ,<unk> due to autoimmune disease, anemia, radiation<unk> , and central retinal vein occlusion. Keith Wagener Barker (KWB) Grades ;Grade 1 :Vascular Attenuation ;Grade 2 :As grade 1 + Irregularly located, tight constrictions – Known as "AV nicking" or "AV nipping" – Salus's sign ;Grade 3 :As grade 2 + Retinal edema, cotton wool spots and flame-hemorrhages "Copper Wiring" + Bonnet's Sign + Gunn's Sign ;Grade 4 :As grade 3 + optic disc edema + macular star "Silver Wiring" There is an association between the grade of<unk> and mortality. In a classic study in 1939 Keith and colleagues described the prognosis of people with differing severity of<unk> . They showed 70% of those with grade 1<unk> were alive after 3 years whereas only 6% of those with grade 4 survived. The most widely used modern classification system bears their name. The role of<unk> grading in risk stratification is debated, but it has been proposed that individuals with signs of<unk> signs, especially retinal hemorrhages, microaneurysms and cotton-wool spots, should be assessed carefully. | Hypertensive retinopathy | Diabetic retinopathy | Autoimmune retinopathy | Radiation retinopathy | Photic retinopathy | Retinal vasculitis | Diabetic papillopathy | Branch retinal artery occlusion | 00
| 9,386 |
A structural feature common to all IAP family proteins is that they all contain at least one baculoviral IAP repeat (BIR) domain characterized by a conserved zinc-coordinating Cys/His motif at the N-terminal half of the protein.<unk> is distinguished from other IAP family members in that it has only one BIR domain. The mice and human BIR domain of<unk> are very similar structurally except for two differences that may affect function variability. The human<unk> also contains an elongated C-terminal helix comprising 42 amino acids.<unk> is 16.5 kDa large and is the smallest member of the IAP family. X-ray crystallography has shown two molecules of human<unk> g coming together to form a bowtie-shape dimer through a hydrophobic interface. This interface includes N-terminal residues 6-10 just before the BIR domain region and the 10 residue region connecting the BIR domain to the C-terminal helix. The structural integrity of the determined crystal structure of<unk> is quite reliable, as physiological conditions were used to obtain the images. | Survivin | Tetherin | Perospirone | Adhyperforin | Diamphotoxin | Lectin | Suramin | Visine | 00
| 42,321 |
<unk> is metabolized by CYP3A4 in vitro.<unk> is likely to interact with substrates of CYP3A4, like rifampicin, phenytoin, St John's wort, carbamazepine or ritonavir, therefore concomitant use with these agents is not recommended. It might also interact with hormonal contraceptives and progestogens such as levonorgestrel and other substrates of the progesterone receptor, as well as with glucocorticoids. | Ulipristal acetate | Macimorelin | Linagliptin | Saxagliptin | Sitagliptin | Liraglutide | Vildagliptin | Lumacaftor | 00
| 57,395 |
Figures for incidences of cancers of the brain show a significant difference between more- and less-developed countries (the less-developed countries have lower incidences of tumors of the brain). This could be explained by undiagnosed tumor-related deaths (patients in extremely poor situations do not get diagnosed, simply because they do not have access to the modern diagnostic facilities required to diagnose a<unk> and by deaths caused by other poverty-related causes that preempt a patient's life before tumors develop or tumors become life-threatening. Nevertheless, statistics suggest that certain forms of primary<unk> s are more common among certain populations. The incidence of low-grade astrocytoma has not been shown to vary significantly with nationality. However, studies examining the incidence of malignant central nervous system (CNS) tumors have shown some variation with national origin. Since some high-grade lesions arise from low-grade tumors, these trends are worth mentioning. Specifically, the incidence of CNS tumors in the United States, Israel, and the Nordic countries is relatively high, while Japan and Asian countries have a lower incidence. These differences probably reflect some biological differences as well as differences in pathologic diagnosis and reporting. Worldwide data on incidence of cancer can be found at the WHO (World Health Organisation) and is handled by the IARC (International Agency for Research on Cancer) located in France. United States In the United States in 2015, approximately 166,039 people were living with brain or other central nervous system tumors. Over 2018, it was projected that there would be 23,880 new cases of<unk> s and 16,830 deaths in 2018 as a result, accounting for 1.4 percent of all cancers and 2.8 percent of all cancer deaths. Median age of diagnosis was 58 years old, while median age of death was 65. Diagnosis was slightly more common in males, at approximately 7.5 cases per 100 000 people, while females saw 2 fewer at 5.4. Deaths as a result of brain cancer were 5.3 per 100 000 for males, and 3.6 per 100 000 for females, making brain cancer the 10th leading cause of cancer death in the United States. Overall lifetime risk of developing brain cancer is approximated at 0.6 percent for men and women. UK Brain, other CNS or intracranial tumors are the ninth most common cancer in the UK (around 10,600 people were diagnosed in 2013), and it is the eighth most common cause of cancer death (around 5,200 people died in 2012). White British patients with<unk> r are 30% more likely to die within a year of diagnosis than patients from other ethnicities. The reason for this is unknown. Children In the United States more than 28,000 people under 20 are estimated to have a<unk> . About 3,720 new cases of<unk> s are expected to be diagnosed in those under 15 in 2019. Higher rates were reported in 1985–1994 than in 1975–1983. There is some debate as to the reasons; one theory is that the trend is the result of improved diagnosis and reporting, since the jump occurred at the same time that MRIs became available widely, and there was no coincident jump in mortality. Central nervous system tumors make up 20–25 percent of cancers in children. The average survival rate for all primary brain cancers in children is 74%. Brain cancers are the most common cancer in children under 19, are result in more death in this group than leukemia. Younger people do less well. The most common<unk> types in children (0-14) are: pilocytic astrocytoma, malignant glioma, medulloblastoma, neuronal and mixed neuronal-glial tumors, and ependymoma. In children under 2, about 70% of<unk> s are medulloblastomas, ependymomas, and low-grade gliomas. Less commonly, and seen usually in infants, are teratomas and atypical teratoid rhabdoid tumors. Germ cell tumors, including teratomas, make up just 3% of pediatric primary<unk> s, but the worldwide incidence varies significantly. In the UK, 429 children aged 14 and under are diagnosed with a<unk> r on average each year, and 563 children and young people under the age of 19 are diagnosed. | Brain tumor | Bell's palsy | Central nervous system tumor | Idiopathic intracranial hypertension | Brain metastasis | Migraine | Brain stem tumor | Epidural hematoma | 00
| 2,580 |
<unk> is a serotonin 5-HT3 receptor antagonist used as an antiemetic to treat nausea and vomiting following chemotherapy and radiotherapy. Its main effect is to reduce the activity of the vagus nerve, which is a nerve that activates the vomiting center in the medulla oblongata. It does not have much effect on vomiting due to motion sickness. This drug does not have any effect on dopamine receptors or muscarinic receptors.<unk> was developed by chemists working at the British drug company Beecham around 1985 and is available as a generic. It is produced by Roche Laboratories under the trade name Kytril. The drug was approved in the United Kingdom in 1991 and in United States in 1994 by the FDA. A<unk> transdermal patch with the trade name Sancuso was approved by the US FDA on September 12, 2008. Sancuso is manufactured by 3M Drug Delivery Systems for Kyowa Kirin, Inc. It was patented in 1985 and approved for medical use in 1991. It is on the World Health Organization's List of Essential Medicines. | Granisetron | Tropisetron | Alosetron | Cilansetron | Palonosetron | Avacopan | Agomelatine | Bocasan | 00
| 12,598 |
<unk> is a<unk> or tumor of the thyroid. It can be a benign tumor such as thyroid adenoma, or it can be a malignant<unk> (thyroid cancer), such as papillary, follicular, medullary or anaplastic thyroid cancer. Most patients are 25 to 65 years of age when first diagnosed; women are more affected than men. The estimated number of new cases of thyroid cancer in the United States in 2010 is 44,670 compared to only 1,690 deaths. Of all thyroid nodules discovered, only about 5 percent are cancerous, and under 3 percent of those result in fatalities. | Thyroid neoplasm | Thyroid adenoma | Thyroid lymphoma | Thyroid nodule | Thyroid cancer | Papillary thyroid cancer | Follicular thyroid cancer | Medullary thyroid cancer | 00
| 6,083 |
Like all fractures, consideration has to be given to other illnesses that might jeopardize the patient, then to reduction and fixation of the fracture itself. Except in avulsive type injuries, or those where there might be airway compromise, a several day delay in the treatment of mandible fractures seems to have little impact on the outcome or complication rates. General considerations Since mandible fractures are usually the result of blunt force trauma to the head and face, other injuries need to be considered before the mandible fracture. First and foremost is compromise of the airway. While rare, bilateral mandible fractures that are unstable can cause the tongue to fall back and block the airway. Fractures such as a symphyseal or bilateral parasymphyseal may lead to mobility of the central portion of the mandible where genioglossus attaches, and allow the tongue to fall backwards and block the airway. In larger fractures, or those from high velocity injuries, soft tissue swelling can block the airway. In addition to the potential for airway compromise, the force delivered to break the jaw can be great enough to either fracture the cervical spine or cause intra-cranial injury (head injury). It is common for both to be assessed with facial fractures. Finally, vascular injury can result (with particular attention to the internal carotid and jugular) from high velocity injuries or severely displaced mandible fractures. Loss of consciousness combined with aspiration of tooth fragments, blood and possibly dentures mean that the airway may be threatened. Reduction Reduction refers to approximating the ends of the bones edges that are broken. This is done with either an open technique, where an incision is made, the fracture is found and is physically manipulated into place, or closed technique where no incision is made. The mouth is unique, in that the teeth are well secured to the bone ends but come through epithelium (mucosa). A leg or wrist, for instance, has no such structure to help with a closed reduction. In addition, when the fracture happens to be in a tooth bearing area of the jaws, aligning the teeth well usually results in alignment of the fracture segments. To align the teeth, circumdental wiring is often used where wire strands (typically 24 gauge or 26 gauge) are wrapped around each tooth then attached to a stainless steel arch bar. When the maxillary (top) and<unk> (bottom) teeth are aligned together, this brings the fracture segments into place. Higher tech solutions are also available, to help reduce the segments with arch bars using bonding technology. Fixation Simple fractures are usually treated with closed reduction and indirect skeletal fixation, more commonly referred to as maxillo-mandibular fixation (MMF). The closed reduction is explained above. The indirect skeletal fixation is accomplished by placing an arch bar, secured to the teeth on the maxillary and<unk> dentition, then securing the top and bottom arch bars with wire loops. Many alternatives exist to secure the maxillary and<unk> dentition including resin bonded arch bars, Ivy loops (small eyelets of wires), orthodontic bands and MMF bone screws where titanium screws with holes in the head of them are screwed into the basal bone of the jaws then secured with wire. Closed reduction with direct skeletal fixation follows the same premise as MMF except that wires are passed through the skin and around the bottom jaw in the mandibule and through the piriform rim or zygomatic buttresses of the maxilla then joined together to secure the jaws. The option is sometimes used when a patient is edentulous (has no teeth) and rigid internal fixation cannot be used. Open reduction with direct skeletal fixation allows the bones to be directly<unk> ed through an incision so that the fractured ends meet, then they can be secured together either rigidly (with screws or plates and screws) or non-rigidly (with transosseous wires). There are a multitude of various plate and screw combinations including compression plates, non-compression plates, lag-screws, mini-plates and biodegradable plates. External fixation, which can be used with either open or closed reduction uses a pin system, where long screws are passed through the skin and into either side of a fracture segment (typically 2 pins per side) then secured in place using an external fixator. This is a more common approach when the bone is heavily comminuted (shattered into small pieces, for instance in a bullet wound) and when the bone is infected (osteomyelitis). Regardless of the method of fixation, the bone need to remain relatively stable for a period of 3–6 weeks. On average, the bone gains 80% of its strength by 3 weeks and 90% of it by 4 weeks. There is great variation depending on the severity of injury, health of the wound, and age of the patient. File:Maxillomandibularfixation.Maxillomandibular fixation with circumdental wires, archbars and elastics for a condyle fracture File:Rigid Internal fixation mandible.Rigid internal fixation of parasymphysis fracture of the mandible. White arrow marks fracture, black arrow marks arch bar on lower teeth File:Rigid Internal fixation mandible condyle.Rigid internal fixation of right condyle fracture with mini-plate on the neck of the condyle. Black arrow marks right earlobe, white arrow marks head of the condyle File:External fixation mandible.External fixation of left mandible fracture Current clinical evidence A 2013 Cochrane review assessed clinical studies on surgical (open reduction) and non-surgical (closed reduction) management of mandible fractures that do not involve the condyle. The review found insufficient evidence to recommend the effectiveness of any single intervention. Special considerations Condyle The best treatment for condylar fractures is controversial. There are two main options, namely closed reduction or open reduction and fixation. Closed reduction may involve intermaxillary fixation, where the jaws are splinted together in the correct position for a period of weeks. Open reduction involves surgical exposure of the fracture site, which can be carried out via incisions within the mouth or incisions outside the mouth over the area of the condyle. Open reduction is sometimes combined with use of an endoscope to aid visualization of fracture site. Although closed reduction carries a risk of the bone healing out of position, with consequent alteration of the bite or the creation of facial asymmetry, it does not risk temporary damage to the facial nerve or result in any facial scar that accompanies open reduction. A systematic review was unable to find sufficient evidence of the superiority of one method over another in the management of condylar fractures. Paediatric condylar fractures are especially problematic, owing to the remaining growth potential and possibility of ankylosis of the joint. Early mobilization is often recommended as in the Walker protocol. Edentulous mandible A broken jaw that has no teeth in it faces two additional issues. First, the lack of teeth makes reduction and fixation using MMF difficult. Instead of placing circumdental wires around the teeth, existing dentures can be left in (or Gunning splints, a type of temporary denture) and the mandible fixated to the maxilla using skeletal fixation (circummandibular and circumzygomatic wires) or using MMF bone screws. More commonly, open reduction and rigid internal fixation is placed. When the width of the mandible is less than 1 cm, the jaw loses its endosteal blood supply. Instead, the blood supply comes largely from the periosteum. Open reduction (which normally strips the periosteum during the dissection) can lead to avascular necrosis. In these cases, oral surgeons sometimes opt for external fixation, closed reduction, supraperiosteal dissection or other techniques to maintain the periosteal blood flow. High velocity injuries In high velocity injuries, the soft tissue can be severely damaged far from the bullet wound itself due to hydrostatic shock. Because of this the airway must be carefully managed and vessels well examined. Because the jaw can be highly comminuted, MMF and rigid internal fixation can be difficult. Instead, external fixation is often used,. Pathologic fracture Fractures where large cysts or tumours are in the area (and weaken the jaw), where there is an area of osteomyelitis or where osteonecrosis exist cause special challenges to fixation and healing. Cysts and tumours can limit effective bone to bone contact and osteomyelitis or osteonecrosis compromise blood supply to the bone. In all of the situations, healing will be delayed and sometimes, resection is the only alternative to treatment. | Mandibular fracture | Nasal fracture | Skull fracture | Cervical fracture | Glossoptosis | Le Fort fracture of skull | Zygoma fracture | Zygomaticomaxillary complex fracture | 00
| 52,134 |
<unk> therapy uses machines specifically designed to deliver a flow of air at a constant pressure.<unk> machines possess a motor that pressurizes room temperature air and delivers it through a hose connected to a mask or tube worn by the patient. This constant stream of air opens and keeps the upper airway unobstructed during inhalation and exhalation. Some<unk> machines have other features as well, such as heated humidifiers. The therapy is an alternative to<unk> end-expiratory pressure (PEEP). Both modalities stent open the alveoli in the lungs and thus, recruit more of the lung surface area for ventilation, but, while PEEP refers to devices that impose<unk> pressure only at the end of the exhalation,<unk> devices apply<unk> throughout the breathing cycle. Thus, the ventilator does not cycle during<unk> , no additional pressure greater than the level of<unk> is provided, and patients must initiate all of their breaths.An example of a nasal mask for<unk> <unk> setup for adults in a low resource setting Method of delivery of<unk> Nasal<unk> Nasal prongs or a nasal mask is the most common modality of treatment. Nasal prongs are placed directly in the person's nostrils. A nasal mask is a small mask that covers the nose. There are also nasal pillow masks which have a cushion at the base of the nostrils, and are considered the least invasive option.Frequently, nasal<unk> is used for infants, although this use is controversial. Studies have shown nasal<unk> reduces ventilator time, but an increased occurrence of pneumothorax also was prevalent. Nasopharyngeal<unk> Nasopharyngeal<unk> is administered by a tube that is placed through the person's nose and ends in the nasopharynx. This tube bypasses the nasal cavity in order to deliver the<unk> farther down in the upper respiratory system. Face mask A full face mask over the mouth and nose is another approach for people who breathe out of their mouths when they sleep. Often, oral masks and naso-oral masks are used when nasal congestion or obstruction is an issue. Devices that combine nasal pressure with mandibular advancement devices (MAD) also exist. Example of a full face mask<unk> Compliance A large portion of people do not adhere to the recommended method of<unk> therapy, with more than 50% of people discontinuing use in the first year. A significant change in behaviour is required in order to commit to long-term use of<unk> therapy and this can be difficult for many people. In addition, people with moderate to severe obstructive sleep apnea have a higher risk of concomitant symptoms such as anxiety and depression, which can make it more difficult to change their sleep habits and to use<unk> on a regular basis. Educational and supportive approaches have been shown to help motivate people who need<unk> therapy to use their devices more often. | Continuous positive airway pressure | Positive airway pressure | Airway clearance therapy | Oxygen therapy | Hyperinflation therapy | Mechanical ventilation | Intermittent positive pressure breathing | Pulmonary hygiene | 00
| 41,616 |
While there is no corrective cure for the disease, some symptoms can be managed therapeutically and/or monitored. Therapeutic treatment options include physical therapy to improve muscular development while patient growth and osteoporosis can be monitored via developmental assessments and bone density scans, respectively. | Wrinkly skin syndrome | Peeling skin syndrome | Gradenigo's syndrome | Swimmer's itch | Heat urticaria | Pressure urticaria | Intertrigo | Sunburn | 00
| 56,888 |
<unk> , Trichocephalus<unk> or whipworm, is a parasitic roundworm (a type of helminth) that causes<unk> sis (a type of helminthiasis which is one of the neglected tropical diseases) when it infects a human large intestine. It is commonly known as the whipworm which refers to the shape of the worm; it looks like a whip with wider "handles" at the posterior end. | Trichuris trichiura | Taenia saginata | Taenia asiatica | Ascaris lumbricoides | Trichinella britovi | Taenia solium | Schistosoma mansoni | Onchocerca volvulus | 00
| 4,311 |
Mouth mirror, a commonly used<unk> <unk> s are tools that<unk> professionals use to provide<unk> treatment. They include tools to examine, manipulate, treat, restore, and remove teeth and surrounding oral structures. | Dental instrument | Dental aerosol | Surgical instrument | Dental surgery | Electronic cigarette | Cigarette | Ultra-processed food | Drug injection | 00
| 38,773 |
Though the<unk> system has traditionally been used, there is little value in its use because it does not help direct treatment. The classification is as follows: Radius Fracture Ulna Fracture Absent Present Extra articular I II Intra-articular involving radiocarpal joint III IV Intra articular involving distal radio-ulnar joint V VI Intra articular involving both radiocarpal & distal radioulnar joints VII VIII | Frykman classification | Wassel classification | Gartland classification | Nissen-Lie classification | Herbert classification | Pipkin classification | Ruedi–Allgower classification | Herscovici classification | 00
| 66,101 |
Hazard pictogram for carcinogenic substances Share of cancer deaths attributed to tobacco in 2016. The majority of cancers, some 90–95% of<unk> s, are due to genetic mutations from environmental and lifestyle factors. The remaining 5–10% are due to inherited genetics. Environmental refers to any<unk> that is not inherited, such as lifestyle, economic, and behavioral factors and not merely pollution. Common environmental factors that contribute to cancer death include tobacco use (25–30%), diet and obesity (30–35%), infections (15–20%), radiation (both ionizing and non-ionizing, up to 10%), lack of physical activity, and pollution. Psychological stress does not appear to be a risk factor for the onset of cancer, though it may worsen outcomes in those who already have cancer. It is not generally possible to prove what<unk> d a particular cancer because the various<unk> s do not have specific fingerprints. For example, if a person who uses tobacco heavily develops lung cancer, then it was probably<unk> d by the tobacco use, but since everyone has a small chance of developing lung cancer as a result of air pollution or radiation, the cancer may have developed for one of those reasons. Excepting the rare transmissions that occur with pregnancies and occasional organ donors, cancer is generally not a transmissible disease, however factors that may have contributed to the development of cancer can be transmissible; such as oncoviruses like hepatitis B, Epstein-Barr virus and HIV. Chemicals The incidence of lung cancer is highly correlated with smoking. Exposure to particular substances have been linked to specific types of cancer. These substances are called carcinogens. Tobacco smoke, for example,<unk> s 90% of lung cancer. It also<unk> s cancer in the larynx, head, neck, stomach, bladder, kidney, esophagus and pancreas. Tobacco smoke contains over fifty known carcinogens, including nitrosamines and polycyclic aromatic hydrocarbons. Tobacco is responsible for about one in five cancer deaths worldwide and about one in three in the developed world. Lung cancer death rates in the United States have mirrored smoking patterns, with increases in smoking followed by dramatic increases in lung cancer death rates and, more recently, decreases in smoking rates since the 1950s followed by decreases in lung cancer death rates in men since 1990. In Western Europe, 10% of cancers in males and 3% of cancers in females are attributed to alcohol exposure, especially liver and digestive tract cancers. Cancer from work-related substance exposures may<unk> between 2 and 20% of<unk> s,<unk> ng at least 200,000 deaths. Cancers such as lung cancer and mesothelioma can come from inhaling tobacco smoke or asbestos fibers, or leukemia from exposure to benzene. Exposure to perfluorooctanoic acid (PFOA), which is predominantly used in the production of Teflon, is known to<unk> two kinds of cancer. Diet and exercise Diet, physical inactivity and obesity are related to up to 30–35% of cancer deaths. In the United States, excess body weight is associated with the development of many types of cancer and is a factor in 14–20% of cancer deaths. A UK study including data on over 5 million people showed higher body mass index to be related to at least 10 types of cancer and responsible for around 12,000<unk> s each year in that country. Physical inactivity is believed to contribute to cancer risk, not only through its effect on body weight but also through negative effects on the immune system and endocrine system. More than half of the effect from diet is due to overnutrition (eating too much), rather than from eating too few vegetables or other healthful foods. Some specific foods are linked to specific cancers. A high-salt diet is linked to gastric cancer. Aflatoxin B1, a frequent food contaminant,<unk> s liver cancer. Betel nut chewing can<unk> oral cancer. National differences in dietary practices may partly explain differences in cancer incidence. For example, gastric cancer is more common in Japan due to its high-salt diet while colon cancer is more common in the United States. Immigrant cancer profiles mirror those of their new country, often within one generation. Infection Worldwide approximately 18% of cancer deaths are related to infectious diseases. This proportion ranges from a high of 25% in Africa to less than 10% in the developed world. Viruses are the usual infectious agents that<unk> cancer but cancer bacteria and parasites may also play a role. Oncoviruses (viruses that can<unk> cancer) include human papillomavirus (cervical cancer), Epstein–Barr virus (B-cell lymphoproliferative disease and nasopharyngeal carcinoma), Kaposi's sarcoma herpesvirus (Kaposi's sarcoma and primary effusion lymphomas), hepatitis B and hepatitis C viruses (hepatocellular carcinoma) and human T-cell leukemia virus-1 (T-cell leukemias). Bacterial infection may also increase the risk of cancer, as seen in Helicobacter pylori-induced gastric carcinoma. Parasitic infections associated with cancer include Schistosoma haematobium (squamous cell carcinoma of the bladder) and the liver flukes, Opisthorchis viverrini and Clonorchis sinensis (cholangiocarcinoma). Radiation Radiation exposure such as ultraviolet radiation and radioactive material is a risk factor for cancer. Many non-melanoma skin cancers are due to ultraviolet radiation, mostly from sunlight. Sources of ionizing radiation include medical imaging and radon gas. Ionizing radiation is not a particularly strong mutagen. Residential exposure to radon gas, for example, has similar cancer risks as passive smoking. Radiation is a more potent source of cancer when combined with other cancer-causing agents, such as radon plus tobacco smoke. Radiation can<unk> cancer in most parts of the body, in all animals and at any age. Children are twice as likely to develop radiation-induced leukemia as adults; radiation exposure before birth has ten times the effect. Medical use of ionizing radiation is a small but growing source of radiation-induced cancers. Ionizing radiation may be used to treat other cancers, but this may, in some<unk> s, induce a second form of cancer. It is also used in some kinds of medical imaging. Prolonged exposure to ultraviolet radiation from the sun can lead to melanoma and other skin malignancies. Clear evidence establishes ultraviolet radiation, especially the non-ionizing medium wave UVB, as the<unk> of most non-melanoma skin cancers, which are the most common forms of cancer in the world. Non-ionizing radio frequency radiation from mobile phones, electric power transmission and other similar sources has been described as a possible carcinogen by the World Health Organization's International Agency for Research on Cancer. Evidence, however, has not supported a concern. This includes that studies have not found a consistent link between mobile phone radiation and cancer risk. Heredity The vast majority of cancers are non-hereditary (sporadic). Hereditary cancers are primarily<unk> d by an inherited genetic defect. Less than 0.3% of the population are carriers of a genetic mutation that has a large effect on cancer risk and these<unk> less than 3–10% of cancer. Some of these syndromes include: certain inherited mutations in the genes BRCA1 and BRCA2 with a more than 75% risk of breast cancer and ovarian cancer, and hereditary nonpolyposis colorectal cancer (HNPCC or Lynch syndrome), which is present in about 3% of people with colorectal cancer, among others. Statistically for cancers<unk> ng most mortality, the relative risk of developing colorectal cancer when a first-degree relative (parent, sibling or child) has been diagnosed with it is about 2. The corresponding relative risk is 1.5 for lung cancer, and 1.9 for prostate cancer. For breast cancer, the relative risk is 1.8 with a first-degree relative having developed it at 50 years of age or older, and 3.3 when the relative developed it when being younger than 50 years of age. Taller people have an increased risk of cancer because they have more cells than shorter people. Since height is genetically determined to a large extent, taller people have a heritable increase of cancer risk. Physical agents Some substances<unk> cancer primarily through their physical, rather than chemical, effects. A prominent example of this is prolonged exposure to asbestos, naturally occurring mineral fibers that are a major<unk> of mesothelioma (cancer of the serous membrane) usually the serous membrane surrounding the lungs. Other substances in this category, including both naturally occurring and synthetic asbestos-like fibers, such as wollastonite, attapulgite, glass wool and rock wool, are believed to have similar effects. Non-fibrous particulate materials that<unk> cancer include powdered metallic cobalt and nickel and crystalline silica (quartz, cristobalite and tridymite). Usually, physical carcinogens must get inside the body (such as through inhalation) and require years of exposure to produce cancer. Physical trauma resulting in cancer is relatively rare. Claims that breaking bones resulted in bone cancer, for example, have not been proven. Similarly, physical trauma is not accepted as a<unk> for cervical cancer, breast cancer or brain cancer. One accepted source is frequent, long-term application of hot objects to the body. It is possible that repeated burns on the same part of the body, such as those produced by kanger and kairo heaters (charcoal hand warmers), may produce skin cancer, especially if carcinogenic chemicals are also present. Frequent consumption of scalding hot tea may produce esophageal cancer. Generally, it is believed that cancer arises, or a pre-existing cancer is encouraged, during the process of | medical cause of Gastrointestinal bleeding | medical cause of Hematochezia | symptom of Vitamin K deficiency | symptom of Ascariasis | medical cause of Peptic ulcer disease | medical cause of Gastritis | symptom of Gallbladder cancer | medical cause of Abdominal pain | 00
| 5,899 |
Valbenazine was approved by the FDA for<unk> in April 2017. Tetrabenazine, which is a dopamine depleting drug, is sometimes used to treat<unk> and other movement disorders (e.g. Huntington's chorea). Deutetrabenazine, an isotopic isomer of tetrabenazine, was approved by the FDA for<unk> in August 2017. Vitamin B6 has been reported to be an effective treatment for<unk> in two randomised double-blind placebo-controlled trials, but the overall evidence for its effectiveness is considered "weak." Clonidine may also be useful in the treatment of<unk> , although dose-limiting hypotension and sedation may hinder its usage. Botox injections are used for minor focal dystonia, but not in more advanced<unk> . As of 2018 evidence is insufficient to support the use of benzodiazepines, baclofen, progabide, sodium valproate, gaboxadol, or calcium channel blockers (e.g. diltiazem). | Tardive dyskinesia | Akathisia | Focal dystonia | Torsion dystonia | Myoclonic dystonia | Paroxysmal dyskinesia | Pseudoathetosis | Dopamine-responsive dystonia | 00
| 10,846 |
<unk> s are a group of differences and disorders that affect the development of the nervous system, leading to slightly different brain function which may affect emotion, learning ability, self-control, and memory. The effects of<unk> s tend to last for a person's lifetime. | Neurodevelopmental disorder | Developmental disorder | Specific developmental disorder | Developmental disability | Multiple complex developmental disorder | Frontal lobe disorder | Pervasive developmental disorder | Developmental coordination disorder | 00
| 31,568 |
Studies have shown that 80% of those with a first<unk><unk> episode will have at least one more depression during their life, with a lifetime average of four episodes. Other general population studies indicate that around half those who have an episode recover (whether treated or not) and remain well, while the other half will have at least one more, and around 15% of those experience chronic recurrence. Studies recruiting from selective inpatient sources suggest lower recovery and higher chronicity, while studies of mostly outpatients show that nearly all recover, with a median episode duration of 11 months. Around 90% of those with severe or psychotic depression, most of whom also meet criteria for other mental<unk> s, experience recurrence. Cases when outcome is poor are associated with inappropriate treatment, severe initial symptoms including psychosis, early age of onset, previous episodes, incomplete recovery after one year of treatment, pre-existing severe mental or medical<unk> , and family dysfunction. A high proportion of people who experience full symptomatic remission still have at least one not fully resolved symptom after treatment. Recurrence or chronicity is more likely if symptoms have not fully resolved with treatment. Current guidelines recommend continuing antidepressants for four to six months after remission to prevent relapse. Evidence from many randomized controlled trials indicates continuing antidepressant medications after recovery can reduce the chance of relapse by 70% (41% on placebo vs. 18% on antidepressant). The preventive effect probably lasts for at least the first 36 months of use.<unk><unk> episodes often resolve over time whether or not they are treated. Outpatients on a waiting list show a 10–15% reduction in symptoms within a few months, with approximately 20% no longer meeting the full criteria for a<unk><unk> . The median duration of an episode has been estimated to be 23 weeks, with the highest rate of recovery in the first three months. According to a 2013 review, 23% of untreated adults with mild to moderate depression will remit within 3 months, 32% within 6 months and 53% within 12 months. Ability to work Depression may affect people's ability to work. The combination of usual clinical care and support with return to work (like working less hours or changing tasks) probably reduces sick leave by 15%, and leads to fewer<unk> symptoms and improved work capacity, reducing sick leave by an annual average of 25 days per year. Helping depressed people return to work without a connection to clinical care has not been shown to have an effect on sick leave days. Additional psychological interventions (such as online cognitive behavioral therapy) lead to fewer sick days compared to standard management only. Streamlining care or adding specific providers for depression care may help to reduce sick leave. Life expectancy and the risk of suicide Depressed individuals have a shorter life expectancy than those without depression, in part because people who are depressed are at risk of dying of suicide. Up to 60% of people who die of suicide have a mood<unk> such as<unk> depression, and the risk is especially high if a person has a marked sense of hopelessness or has both depression and borderline personality<unk> . About 2–8% of adults with<unk> depression die by suicide, and about 50% of people who die by suicide had depression or another mood<unk> . The lifetime risk of suicide associated with a diagnosis of<unk> depression in the US is estimated at 3.4%, which averages two highly disparate figures of almost 7% for men and 1% for women (although suicide attempts are more frequent in women). The estimate is substantially lower than a previously accepted figure of 15%, which had been derived from older studies of people who were hospitalized. Depressed people have a higher rate of dying from other causes. There is a 1.5- to 2-fold increased risk of cardiovascular disease, independent of other known risk factors, and is itself linked directly or indirectly to risk factors such as smoking and obesity. People with<unk> depression are less likely to follow medical recommendations for treating and preventing cardiovascular<unk> s, further increasing their risk of medical complications. Cardiologists may not recognize underlying depression that complicates a cardiovascular problem under their care. | Major depressive disorder | Hodophobia | Depression | Dissociative identity disorder | Major depressive episode | Agoraphobia | Late life depression | Narcolepsy | 00
| 840 |
The science of epidemiology has matured significantly from the times of Hippocrates, Semmelweis and John Snow. The techniques for gathering and analyzing<unk> data vary depending on the type of disease being monitored but each study will have overarching similarities. | Epidemiological method | Epidemiology in Country Practice | Real world data | Diagnosis-related group | Comparison of birth control methods | Phases of clinical research | Patient-reported outcome | Clinical endpoint | 00
| 9,834 |
A<unk> is a predetermined group of medical<unk> s used in the diagnosis and treatment of disease.<unk> s (sometimes called profiles) are typically composed of individual laboratory<unk> s which are related in some way: by the medical condition they are intended to help diagnose (cardiac risk panel), by the specimen type (complete blood count, CBC), by the<unk> s most frequently requested by users (comprehensive chemistry profile), by the methodology employed in the<unk> (viral panel by polymerase chain reaction), or by the types of components included (urine drug screen). | Test panel | Risk panel | Bioanalysis | Death panel | QTY Code | Community rating | EFAR System Model | Toxicity category rating | 00
| 40,409 |
There are no known prevention methods for<unk> , but it is predicted that it could be due to infection by Treponema pallidum, Toxoplasma gondi, and cytomegalovirus. | Villitis of unknown etiology | Rhinitis medicamentosa | Mouth and genital ulcers with inflamed cartilage syndrome | Pyostomatitis vegetans | Tick-borne lymphadenopathy | Lymphedema–distichiasis syndrome | Treponematosis | Staphylococcal infection | 00
| 61,562 |
A woman placed in the<unk> (in this case, 45 degrees) In medicine,<unk> is a standard patient<unk> in which the patient is seated in a semi-sitting<unk> (45-60 degrees) and may have knees either bent or straight. Variations in the angle are denoted by high<unk> , indicating an upright<unk> at approximately 90 degrees and semi-Fowler, 30 to 45 degrees; and low<unk> , where the head is slightly elevated." It is an intervention used to promote oxygenation via maximum chest expansion and is implemented during events of respiratory distress.<unk> facilitates the relaxing of tension of the abdominal muscles, allowing for improved breathing. In immobile patients and infants, the<unk> alleviates compression of the chest that occurs due to gravity.<unk> increases comfort during eating and other activities, is used in postpartum women to improve uterine drainage, and in infants when signs of respiratory distress are present.<unk> is also used when oral or nasal gastric feeding tubes have been implemented as it minimizes the risk of aspiration. Peristalsis and swallowing are aided by the effect of gravitational pull. It is named for George Ryerson<unk> , who saw it as a way to decrease the mortality of peritonitis: Accumulation of purulent material under the diaphragm led to rapid systemic sepsis and septic shock, whereas pelvic abscesses could be drained through the rectum. | Fowler's position | Waters' view | Keen's point | Breslow's depth | Stenvers projection | Schuller's view | Dandy's point | Talairach coordinates | 00
| 38,736 |
The presentation of patient with SPCD can be incredibly varied, from asymptomatic to lethal cardiac manifestations. Early cases were reported with liver dysfunction, muscular findings (weakness and underdevelopment), hypoketotic hypoglycemia, cardiomegaly, cardiomyopathy and marked carnitine<unk> in plasma and tissues, combined with increased excretion in urine. Patients who present clinically with SPCD fall into two categories, a metabolic presentation with hypoglycemia and a cardiac presentation characterized by cardiomyopathy. Muscle weakness can be found with either presentation. In countries with expanded newborn screening, SPCD can be identified shortly after birth. Affected infants show low levels of free carnitine and all other acylcarnitine species by tandem mass spectrometry. Not all infants with low free carnitine are affected with SPCD. Some may have carnitine<unk> secondary to another metabolic condition or due to maternal carnitine<unk> . Proper follow-up of newborn screening results for low free carnitine includes studies of the mother to determine whether her carnitine<unk> is due to SPCD or secondary to a metabolic disease or diet. Maternal cases of SPCD have been identified at a higher than expected rate, often in women who are asymptomatic. Some mothers have also been identified through newborn screening with cardiomyopathy that had not been previously diagnosed. The identification and treatment of these asymptomatic individuals is still developing, as it is not clear whether they require the same levels of intervention as patients identified with SPCD early in life based on clinical presentation. | Systemic primary carnitine deficiency | Short-chain acyl-coenzyme A dehydrogenase deficiency | Medium-chain acyl-coenzyme A dehydrogenase deficiency | Very long-chain acyl-coenzyme A dehydrogenase deficiency | Long-chain 3-hydroxyacyl-coenzyme A dehydrogenase deficiency | Carnitine-acylcarnitine translocase deficiency | Multiple carboxylase deficiency | Carnitine palmitoyltransferase II deficiency | 00
| 26,548 |
<unk> <unk> , also spelled<unk> , is a steroid, a weak<unk> n, and a minor female sex hormone. It is one of three major endogenous<unk> ns, the others being estradiol and estriol.<unk> , as well as the other<unk> ns, are synthesized from cholesterol and secreted mainly from the gonads, though they can also be formed from adrenal androgens in adipose tissue. Relative to estradiol, both<unk> and estriol have far weaker activity as<unk> ns.<unk> can be converted into estradiol, and serves mainly as a precursor or metabolic intermediate of estradiol. It is both a precursor and metabolite of estradiol. In addition to its role as a natural hormone,<unk> has been used as a medication, for instance in menopausal hormone therapy; for information on<unk> as a medication, see the<unk> (medication) article. | Estrone | Methyltestosterone | Allyltestosterone | Androgen | Estradiol | Estradiol | Dihydrotestosterone | 2-Hydroxyestradiol | 00
| 12,975 |
Since<unk> tends to coincide with a mixture of other mental disorders such as generalised anxiety disorder, therapists endorse an extensive and multi-pronged treatment scheme. Such programs address the psychological issues related to<unk> first, which make the choking phobia easier to oppose later on with retraining schemes and talk therapy which centre on helping the sufferer learn to relax whilst eating. Proposed treatments include hypnotherapy, cognitive behavioural therapy and Eye Movement desensitisation and reprocessing. Aversion relief therapy is a commonly used treatment which has been proven to be effective in the field of choking phobias. In this case, the sufferer is given a small shock to their fingers until they swallow (Whitehead and Schuster 1985). In order to get relief, the sufferer will have no other option but to swallow the food since the shock only stops once the action of swallowing occurs. Another possible treatment for<unk> includes tongue depressors placed on the back of the throat in order for the sufferer to defeat the anxiety associated with swallowing (Whitehead and Schuster 1958). Lastly, relaxation sessions can take place before meals. Such treatments include positive visualisation, deep breathing, and guided meditation. Although pharmacotherapy such as low doses of selective serotonin reuptake inhibitors have been used for treatment, it is more common for behavioural approaches to be used. Additionally, before<unk> can be diagnosed, it is of the utmost importance to remove any other potential natural conditions which may be actually causing choking symptoms. In this case, Dysphagia may be a real health problem that could be causing constriction of the oesophagus during swallowing, meaning that sufferers with this condition are legitimately not imagining the symptoms that they outline. Furthermore, Omophydroid Muscle Syndrome- a rare muscle condition which causes chronic soreness and pain swallowing, may be the cause of falsely diagnosed<unk> . It is also not uncommon for<unk> to be misdiagnosed with conversion disorder (Globus Pharyngeus) and eating disorders. Treatment studies Di Scipio et al (1978) medicated three children under the age of 2- with the inability to swallow. Two of the children had earlier undergone oropharyngeal surgery whilst the other child had an uncertain diagnosis however the strain was examined to be a congenital neurological disorder and possibly pseudobulbar palsy. Those children were fed by a gastrostomy. The phobia was unexplained but may have accumulated after a traumatic incident of a barium swallow. The treatment in these three cases comprised: # positive reinforcement of the psychomotor constituent of oral consumption; # tube feeding made dependent on oral feeding (the children were fed through a tube once the child attempted swallowing); # introduction of massed learning tests over 72 hour periods. This treatment took place between 1 and 2 years. | Pseudodysphagia | Presbyphagia | Dysphagia | Dysphagia lusoria | Hypnagogia | Coccydynia | Aphagia | Spasmodic dysphonia | 00
| 36,860 |
<unk> is a disease that was identified in a report, released on January 31, 2008, by the Centers for Disease Control and Prevention. The first known outbreak of this neuropathy occurred in southeastern Minnesota in the United States. The disease was reported among pig slaughterhouse workers who appeared at various care facilities in the area reporting similar neurological symptoms. The disease was later identified at pork processing plants in Indiana and Nebraska as well. The condition is characterized by acute paralysis, pain, fatigue, numbness, and weakness, especially in extremities. It was initially believed that workers might have contracted the disease through inhaling aerosols from pig brains blown through a compressed-air hose and that this exposure to pig neural tissue induced an autoimmune response that might have produced their mysterious peripheral neuropathy. These suspicions were confirmed in reports and investigations conducted at the Mayo Clinic in Rochester, Minnesota. | Progressive inflammatory neuropathy | Chemotherapy-induced peripheral neuropathy | Acute motor axonal neuropathy | Diabetic neuropathy | Small fiber peripheral neuropathy | Vasculitic neuropathy | Alcoholic polyneuropathy | Proximal diabetic neuropathy | 00
| 48,926 |
The cause is a genetic mutation in the MAPKinase pathway that occurs during early development. The origin is a dendritic<unk> , although previously thought to be a histiocyte, a term still used. The mutations causes white blood<unk> s (lymphocytes, macrophages, and eosinophils) to move towards dendritic<unk> s, resulting in damage in any organ except the heart and kidneys. The disease was once thought to be a lipid storage disease as the lesions have a high cholesterol content, but the blood cholesterol is usually normal. Some sources such as the National Cancer Institute describe it as a type of cancer, while other sources specifically state it is not a type of cancer. | Chronic multifocal Langerhans cell histiocytosis | Progressive nodular histiocytoma | Progressive nodular histiocytosis | Thymoma-associated multiorgan autoimmunity | Skin manifestations of sarcoidosis | Acrokeratoelastoidosis of Costa | AIDS-related lymphoma | Inflammatory myofibroblastic tumour | 00
| 45,439 |
<unk> , also known as alcohol poisoning, commonly described as drunkenness or inebriation, is the negative behavior and physical effects caused by a recent consumption of alcohol. In addition to the toxicity of ethanol, the main psychoactive component of alcoholic beverages, other physiological symptoms may arise from the activity of acetaldehyde, a metabolite of alcohol. These effects may not arise until hours after ingestion and may contribute to the condition colloquially known as a hangover. Symptoms of<unk> at lower doses may include mild sedation and poor coordination. At higher doses, there may be slurred speech, trouble walking, and vomiting. Extreme doses may result in a respiratory depression, coma, or death. Complications may include seizures, aspiration pneumonia, injuries including suicide, and low blood sugar.<unk> can lead to alcohol-related crime with perpetrators more likely to be intoxicated than victims.<unk> typically begins after two or more alcoholic drinks. Risk factors include a social situation where heavy drinking is common and a person having an impulsive personality. Diagnosis is usually based on the history of events and physical examination. Verification of events by witnesses may be useful. Legally,<unk> is often defined as a blood alcohol concentration (BAC) of greater than 5.4–17.4 mmol/L (25–80 mg/dL or 0.025–0.080%). This can be measured by blood or breath testing. Alcohol is broken down in the human body at a rate of about 3.3 mmol/L (15 mg/dL) per hour, depending on an individual's metabolic rate (metabolism). Management of<unk> involves supportive care. Typically this includes putting the person in the recovery position, keeping the person warm, and making sure breathing is sufficient. Gastric lavage and activated charcoal have not been found to be useful. Repeated assessments may be required to rule out other potential causes of a person's symptoms. Acute<unk> has been documented throughout history, and alcohol remains one of the world's most widespread recreational drugs. Some religions consider<unk> to be a sin. | Alcohol intoxication | Hepatic encephalopathy | Drug withdrawal | Traumatic brain injury | Nicotine withdrawal | Wernicke encephalopathy | Alcohol withdrawal syndrome | Meningitis | 00
| 765 |
<unk> location The vast majority of<unk> s are asymptomatic. However, as the<unk> aorta expands and/or ruptures, the<unk> may become painful and lead to pulsating sensations in the abdomen or pain in the chest, lower back, legs, or scrotum. Complications The complications include rupture, peripheral embolization, acute<unk> occlusion, and<unk> aval (between the aorta and inferior vena cava) or aortoduodenal (between the aorta and the duodenum) fistulae. On physical examination, a palpable and pulsatile<unk> mass can be noted. Bruits can be present in case of renal or visceral arterial stenosis. The signs and symptoms of a ruptured<unk> may include severe pain in the lower back, flank, abdomen or groin. A mass that pulses with the heart beat may also be felt. The bleeding can lead to a hypovolemic shock with low blood pressure and a fast heart rate. This may lead to brief passing out. The mortality of<unk> rupture is as high as 90 percent. 65 to 75 percent of patients die before they arrive at the hospital and up to 90 percent die before they reach the operating room. The bleeding can be retroperitoneal or into the<unk> cavity. Rupture can also create a connection between the aorta and intestine or inferior vena cava. Flank ecchymosis (appearance of a bruise) is a sign of retroperitoneal bleeding, and is also called Grey Turner's sign. | Abdominal aortic aneurysm | Appendicitis | Superior mesenteric artery syndrome | Splenic infarction | Aortoenteric fistula | Postcholecystectomy syndrome | Renal vein thrombosis | Spontaneous bacterial peritonitis | 00
| 17,824 |
The<unk> <unk> is a gene<unk> comprising over fifty genes encoding proteins involved in the terminal<unk> and cornification of keratinocytes, the primary cell type of the epidermis. In humans, the<unk> is located on a 1.9 Mbp stretch within chromosome 1q21. The proteins encoded by<unk> genes are closely related in terms of function, and evolutionarily they belong to three distinct gene families: the cornified envelope precursor family, the S100 protein family and the S100 fused type protein (SFTP) family. It has been hypothesized that the clustering of<unk> genes occurred due to duplication events which were evolutionarily favored during the adaptation to terrestrial environments.<unk> proteins have been involved in a variety of skin disorders including ichthyosis vulgaris, atopic dermatitis and psoriasis. | Epidermal differentiation complex | Dermoepidermal junction | Neuromatrix | Growth cone | Germinal matrix | Chemosensory clusters | Inner enamel epithelium | Microkeratome | 00
| 68,542 |
There is basically one symptom of<unk> : bleeding from the area where the stomach lesion is. Bowel movements may contain blood. Vomit may be bloody as well, but a<unk> may not cause vomiting. Blood may be black because it will be partially digested. Loss of blood may cause one to develop anemia. | Gastric erosion | Gastric volvulus | Perforated ulcer | Evisceration | Atrophic gastritis | Tropical ulcer | Black stomach | Gastric lymphoma | 00
| 44,111 |
<unk> caused by<unk> -reacting antibodies. Autoantibodies that bind to the erythrocyte membrane leading to premature erythrocyte destruction (hemolysis) characterize autoimmune hemolytic anemia. | Cold autoimmune hemolytic anemia | Warm antibody autoimmune hemolytic anemia | Acquired hemolytic anemia | Mixed autoimmune hemolytic anemia | Contaminated haemophilia blood products | Donath–Landsteiner hemolytic anemia | Drug-induced autoimmune hemolytic anemia | Drug-induced nonautoimmune hemolytic anemia | 00
| 68,310 |
<unk> is a peptide consisting of 645 proteinogenic amino acids with 17 disulfide bridges. Amino acids 1–30 and 31–60 constitute two copies of modified human GLP-1, the alanine at position 2 having been exchanged for a glycine for better DPP-4 resistance. The remaining sequence is human albumin. The complete sequence is HGEGTFTSDV SSYLEGQAAK EFIAWLVKGR HGEGTFTSDV SSYLEGQAAK EFIAWLVKGR (2 copies of modified GLP-1, modifications underlined) DAHKSEVAHR FKDLGEENFK ALVLIAFAQY LQQCPFEDHV KLVNEVTEFA KTCVADESAE (albumin starts at the beginning of this line) NCDKSLHTLF GDKLCTVATL RETYGEMADC CAKQEPERNE CFLQHKDDNP NLPRLVRPEV DVMCTAFHDN EETFLKKYLY EIARRHPYFY APELLFFAKR YKAAFTECCQ AADKAACLLP KLDELRDEGK ASSAKQRLKC ASLQKFGERA FKAWAVARLS QRFPKAEFAE VSKLVTDLTK VHTECCHGDL LECADDRADL AKYICENQDS ISSKLKECCE KPLLEKSHCI AEVENDEMPA DLPSLAADFV ESKDVCKNYA EAKDVFLGMF LYEYARRHPD YSVVLLLRLA KTYETTLEKC CAAADPHECY AKVFDEFKPL VEEPQNLIKQ NCELFEQLGE YKFQNALLVR YTKKVPQVST PTLVEVSRNL GKVGSKCCKH PEAKRMPCAE DYLSVVLNQL CVLHEKTPVS DRVTKCCTES LVNRRPCFSA LEVDETYVPK EFNAETFTFH ADICTLSEKE RQIKKQTALV ELVKHKPKAT KEQLKAVMDD FAAFVEKCCK ADDKETCFAE EGKKLVAASQ AALGL with disulfide bridges linking amino acids 113-122, 135-151, 150-161, 184-229, 228-237, 260-306, 305-313, 325-339, 338-349, 376-421, 420-429, 452-498, 497-508, 521-537, 536-547, 574-619, 618-627. Synthesis It is bioengineered in the yeast Saccharomyces cerevisiae using recombinant DNA technology. | Albiglutide | Semaglutide | Teduglutide | Dulaglutide | Liraglutide | Linagliptin | Saxagliptin | Exenatide | 00
| 53,024 |
<unk> (HCA) is a derivative of citric acid that is found in a variety of tropical plants including Garcinia cambogia and Hibiscus sabdariffa. There are four isomers, (+)- and (-)-hydroxycitric acid, and (+)- and (-)-allo-hydroxycitric acid. The (-)-hydroxycitric acid isomer is the one found in Garcinia. | Hydroxycitric acid | Dichloroacetic acid | Orthosilicic acid | Orellanine | Sodium glycerophosphate | Epoetin beta | Kaurenoic acid | Selenous acid | 00
| 40,138 |
Chemically,<unk> F 18 is 7-(6-F-18fluoropyridin-3-yl)-5H-pyrido4,3 bindole. | Flortaucipir | Liraglutide | Linagliptin | Ulipristal acetate | Glimepiride | Lobeglitazone | Saxagliptin | Exenatide | 00
| 73,514 |
Initial treatment in<unk> is one or two days of bedrest (although growing number of studies shows that it makes little difference) and pain relieving medications. In cases with ongoing pain despite conservative treatments, a surgical operation that will remove the compressing disc material, a microdiscectomy or discectomy may be recommended to treat a lumbar disc herniation. | Lumbar disc disease | Degenerative disc disease | Spinal disease | Spinal disc herniation | Spinal stenosis | Lumbar spinal stenosis | Spinal tumor | Discitis | 00
| 2,620 |
<unk> is a medical condition illustrated by a variance in size (anisocytosis) and shape (poikilocytosis) of a red blood cell. The underlying cause can be attributed to various anemias, most often; beta thalassemia major, a form of microcytic anemia. In β thalassemia major the beta hemoglobin chain is completely absent, rendering an increase in fetal hemoglobin (HbF). | Anisopoikilocytosis | Macrocytosis | Neuroacanthocytosis | Spherocytosis | Poikilocytosis | Binucleated cells | Pyknocytosis | Anisocytosis | 00
| 69,938 |
<unk> , also known as Hutchinson fracture, is a type of oblique fracture of the radial styloid process in the forearm. The injury is typically caused by compression of the scaphoid bone of the hand against the styloid process of the distal radius. It can be caused by falling onto an outstretched hand. Treatment is often open reduction and internal fixation, which is surgical realignment of the bone fragments and fixation with pins, screws, or plates. __TOC__ | Chauffeur's fracture | Pott's fracture | Smith's fracture | Bennett's fracture | Malgaigne's fracture | Boxer's fracture | Hangman's fracture | Barton's fracture | 00
| 53,863 |
Types (old nomenclature) Several genetic causes of<unk> have been identified. A de novo mutation in TGFB3, a ligand of the TGF β pathway, was identified in an individual with a syndrome presenting partially overlapping symptoms with Marfan Syndrome and<unk> . Type Gene Locus OMIM Description 1A TGFBR1 9q22 Also known as Furlong disease 1B TGFBR2 3p22 2A TGFBR1 9q22 2B TGFBR2 3p22 Previously known as Marfan syndrome type 2 3 SMAD3 Also known as Aneurysms-osteoarthritis syndrome 4 TGFB2 5 TGFB3 | Loeys–Dietz syndrome | Ehlers–Danlos syndromes | Tietz syndrome | Marfan syndrome | Frank–Ter Haar syndrome | Crigler–Najjar syndrome | Letterer–Siwe disease | Wilson–Mikity syndrome | 00
| 39,477 |
<unk> , sold under the brand name Reyvow, is a medication used for the acute (active but short-term) treatment of migraine with or without aura (a sensory phenomenon or visual disturbance) in adults. It is not useful for prevention. It is taken by mouth. Common side effects include sleepiness, dizziness, tiredness, and numbness.<unk> was approved in the United States in October 2019 and became available in February 2020. It was developed by Eli Lilly. The U.S. Food and Drug Administration (FDA) considers it to be a first-in-class medication. | Lasmiditan | Dietitian | Serenic | Gutter oil | Riken | Pedestrian | Balm in Gilead | Cochrane | 00
| 59,372 |
<unk> is used to lower prolactin and, in low doses, to prevent migraine attacks. The use of<unk> as initial antiparkinsonian medication for Parkinson's disease has been advocated, delaying the need for levodopa until<unk> becomes insufficient for controlling the parkinsonian symptoms. Evidence is insufficient to support<unk> in the treatment of advanced Parkinson's disease as an alternative to levodopa or bromocriptine. | Lisuride | Miglitol | Geritol | Paricalcitol | Glibenclamide | Canagliflozin | Rosiglitazone | Glucuronide | 00
| 35,794 |
<unk> is an antifungal medication used for a number of fungal infections. This includes candidiasis, blastomycosis, coccidiodomycosis, cryptococcosis, histoplasmosis, dermatophytosis, and pityriasis versicolor. It is also used to prevent candidiasis in those who are at high risk such as following organ transplantation, low birth weight babies, and those with low blood neutrophil counts. It is given either by mouth or by injection into a vein. Common side effects include vomiting, diarrhea, rash, and increased liver enzymes. Serious side effects may include liver problems, QT prolongation, and seizures. During pregnancy it may increase the risk of miscarriage while large doses may cause birth defects.<unk> is in the azole antifungal family of medication. It is believed to work by affecting the fungal cellular membrane.<unk> was patented in 1981 and came into commercial use in 1988. It is on the World Health Organization's List of Essential Medicines.<unk> is available as a generic medication. In 2019, it was the 133rd most commonly prescribed medication in the United States, with more than 5million prescriptions. | Fluconazole | Itraconazole | Miconazole | Terbinafine | Posaconazole | Micafungin | Sertaconazole | Fosravuconazole | 00
| 17,682 |
There are several approaches to treat this infectious disease. One approach involves shaving the affected areas. Another approach involves the use of antifungal medication. | White piedra | Grisi siknis | Paraphrenia | Cebocephaly | Oneirophrenia | Incontinentia pigmenti achromians | Ethmocephaly | Commotio cordis | 00
| 45,708 |
The prognosis is usually poor. Mortality rate is high during<unk> infancy and almost half of the children die by 2 years of age. Most of the survivors suffer from psychomotor impairment. In the patient with severe phenotype, even when optimal treatment is initiated promptly the prognosis remains poor. | Early myoclonic encephalopathy | Wernicke encephalopathy | Post-encephalitic parkinsonism | Powassan encephalitis | Ethylmalonic encephalopathy | Camel spongiform encephalopathy | Glycine encephalopathy | Autoimmune encephalitis | 00
| 62,451 |
<unk> are small blood vessels that comprise a vascular network supplying the walls of large blood vessels, such as elastic arteries (e.g., the aorta) and large veins (e.g., the venae cavae). The name derives . Occasionally two different singular forms are seen:<unk> vasis () and vas vasis (). | Vasa vasorum | Lymphatic endothelium | Fovea centralis | Node of Ranvier | Corpora quadrigemina | Caliber persistent artery | Neurilemma | Postganglionic nerve fibers | 00
| 20,125 |
Ultrasound imaging of the thyroid gland (right lobe longitudinal) in a person with Hashimoto thyroiditis Diagnosis is usually made by detecting elevated levels of antithyroid peroxidase antibodies in the serum, but seronegative (without circulating autoantibodies) thyroiditis is also possible. Given the relatively nonspecific symptoms of initial hypothyroidism, Hashimoto's thyroiditis is often misdiagnosed as depression, cyclothymia, premenstrual syndrome, chronic fatigue syndrome, fibromyalgia, and less frequently, as erectile dysfunction or an anxiety disorder. On gross examination, a hard goiter that is not painful to the touch often presents; other symptoms seen with hypothyroidism, such as periorbital myxedema, depend on the current state of progression of the response, especially given the usually gradual development of clinically relevant hypothyroidism. Testing for thyroid-stimulating hormone (TSH), free T3, free T4, and the antithyroglobulin antibodies (anti-Tg), antithyroid peroxidase antibodies (anti-TPO, or TPOAb) and antimicrosomal antibodies can help obtain an accurate diagnosis. Earlier assessment of the person may present with elevated levels of thyroglobulin owing to transient thyrotoxicosis, as inflammation within the thyroid causes damage to the integrity of thyroid follicle storage of thyroglobulin; TSH secretion from the anterior pituitary increases in response to a decrease in negative feedback inhibition secondary to decreased serum thyroid hormones. Typically, T4 is the preferred thyroid hormone test for hypothyroidism. This exposure of the body to substantial amounts of previously isolated thyroid enzymes is thought to contribute to the exacerbation of tolerance breakdown, giving rise to the more pronounced symptoms seen later in the disease. Lymphocytic infiltration of the thyrocyte-associated tissues often leads to the histologically significant finding of germinal center development within the thyroid gland. Hashimoto's when presenting as mania is known as Prasad's syndrome after Ashok Prasad, the psychiatrist who first described it. | medical cause of Hypothyroidism | medical cause of Hyperthyroidism | medical cause of Precocious puberty | medical diagnosis of Hyperparathyroidism | symptom of Hypothyroidism | onset of Kallmann syndrome | medical cause of Hyperdontia | symptoms of Congenital adrenal hyperplasia | 00
| 15,831 |
<unk> s (TAARs), sometimes referred to as<unk><unk> receptors (TAs or TARs), are a class of G protein-coupled receptors that were discovered in 2001. TAAR1, the first of six functional human TAARs, has gained considerable interest in academic and proprietary pharmaceutical research due to its role as the endogenous receptor for the<unk><unk> s phenylethylamine, tyramine, and tryptamine – metabolic derivatives of the<unk> acids phenylalanine, tyrosine and tryptophan, respectively – ephedrine, as well as the synthetic psychostimulants, amphetamine, methamphetamine and methylenedioxymethamphetamine (MDMA, ecstasy). In 2004, it was shown that mammalian TAAR1 is also a receptor for thyronamines, decarboxylated and deiodinated relatives of thyroid hormones. TAAR2–TAAR9 function as olfactory receptors for volatile<unk> odorants in vertebrates. Figure 2: Table of ligands, expression patterns, and species-specific behavioral responses for each TAAR | Trace amine-associated receptor | Prolactin-releasing peptide receptor | Baroreceptor | Norepinephrine transporter | 5-HT3 receptor | Glutamate transporter | Mechanosensitive channels | Gluten exorphin | 00
| 38,314 |
<unk> is used in the European Union to treat people with Duchenne muscular dystrophy who have a nonsense mutation in the dystrophin gene, can walk, and are more than five years old. | Ataluren | SimThyr | Cevira | MedMagLabs | StomaphyX | Konzo | Gutka | Krebiozen | 00
| 47,482 |
<unk> , or BA20, is part of the temporal cortex in the human brain. The region encompasses most of the ventral temporal cortex, a region believed to play a part in high-level visual processing and recognition memory. This area is also known as inferior temporal area<unk> , and it refers to a subdivision of the cytoarchitecturally defined temporal region of cerebral cortex. In the human it corresponds approximately to the inferior temporal gyrus. Cytoarchitecturally it is bounded medially by the ectorhinal area 36 (H), laterally by the middle temporal area 21, rostrally by the temporopolar area 38 (H) and caudally by the occipitotemporal area 37 (H) (Brodmann-1909). | Brodmann area 20 | Brodmann area 25 | Brodmann area 24 | Brodmann area 32 | Brodmann area 26 | Brodmann area 22 | Brodmann area 23 | Brodmann area 29 | 00
| 13,908 |
<unk> is an autosomal recessive metabolic disorder associated with a mutation in the enzyme<unk><unk> . | Adenine phosphoribosyltransferase deficiency | Methylenetetrahydrofolate reductase deficiency | Purine nucleoside phosphorylase deficiency | Dihydropyrimidine dehydrogenase deficiency | Adenosine deaminase deficiency | Adenosine deaminase 2 deficiency | Ribose-5-phosphate isomerase deficiency | Dihydrofolate reductase deficiency | 00
| 33,957 |
<unk> (INN) is an HIV fusion inhibitor, the first of a class of antiretroviral drugs used in combination therapy for the treatment of HIV-1 infection. It is marketed under the trade name Fuzeon (Roche). | Enfuvirtide | Saquinavir | Coronavir | Abacavir | Indinavir | Fosamprenavir | Entecavir | Amprenavir | 00
| 8,080 |
<unk> (Surital) is a barbiturate derivative invented in the 1950s. It has sedative, anticonvulsant, and hypnotic effects, and is used as a strong but short acting sedative.<unk> is still in current use, primarily for induction in surgical anaesthesia or as an anticonvulsant to counteract side effects from other anaesthetics. It is the thiobarbiturate analogue of secobarbital. | Thiamylal | Corn starch | Iron sucrose | High-fructose corn syrup | Tuaminoheptane | Lactose | Phospho soda | Diatrizoate | 00
| 44,458 |
<unk> is an ultra-long-acting beta-adrenoceptor agonist developed by Novartis. It needs to be taken only once a day, unlike the related drugs formoterol and salmeterol. It is licensed only for the treatment of chronic obstructive pulmonary disease (COPD) (long-term data in patients with asthma are thus far lacking). It is delivered as an aerosol formulation through a dry powder inhaler. | Indacaterol | Abiraterone acetate | Olodaterol | Ingenol mebutate | Semagacestat | Quingestanol acetate | Dienogest | Bisoctrizole | 00
| 49,819 |
In in vivo systems it is often used to quantify the binding of a test molecule to the binding site of radioligand. The higher the affinity of the molecule the more radioligand is displaced from the binding site and the increasing radioactive decay can be measured by scintillography. This assay is commonly used to calculate binding constant of molecules to receptors. Due to the probable injuries of<unk> s, they could not be administrated in the normal doses of the medications. Therefore, the binding affinity (PKD) of the<unk> -tracers must be high. In addition, since via the<unk> imaging technique is desired to investigate a function accurately, the selectivity of bindings to the specific targets is very important. | PET radiotracer | Imaging biomarker | Nuclear medicine | Radiomics | Radioactive tracer | Molecular imaging | Tumor marker | Radiochemistry | 00
| 68,320 |
A unique reported symptom of the<unk> variant is night sweats. Also, loss of taste and smell seem to be uncommon compared to other strains. A study performed between 1 and 7 December by the Center for Disease Control found that: "The most commonly reported symptoms were cough, fatigue, and congestion or runny nose" making it difficult to distinguish from a less damaging variant or other virus. Research published in London on 25 December 2021 suggested the most frequent symptoms stated by users of the Zoe Covid app were "a running nose, headaches, fatigue, sneezing and sore throats." | 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
| 74,926 |
<unk> is a low level of potassium (K+) in the blood serum. Mild low potassium does not typically cause symptoms. Symptoms may include feeling tired, leg cramps, weakness, and constipation. Low potassium also increases the risk of an abnormal heart rhythm, which is often too slow and can cause cardiac arrest. Causes of<unk> include vomiting, diarrhea, medications like furosemide and steroids, dialysis, diabetes insipidus, hyperaldosteronism, hypomagnesemia, and not enough intake in the diet. Normal potassium levels are between 3.5 and 5.0 mmol/L (3.5 and 5.0 mEq/L) with levels below 3.5 mmol/L defined as<unk> . It is classified as severe when levels are less than 2.5 mmol/L. Low levels may also be suspected based on an electrocardiogram (ECG). Hyperkalemia is a high level of potassium in the blood serum. The speed at which potassium should be replaced depends on whether or not there are symptoms or abnormalities on an electrocardiogram. Potassium levels that are only slightly below the normal range can be managed with changes in the diet. Lower levels of potassium require replacement with supplements either taken by mouth or given intravenously. If given intravenously, potassium is generally replaced at rates of less than 20 mmol/hour. Solutions containing high concentrations of potassium (>40 mmol/L) should generally be given using a central venous catheter. Magnesium replacement may also be required.<unk> is one of the most common water–electrolyte imbalances. It affects about 20% of people admitted to hospital. The word<unk> comes from hypo- 'under' + kalium 'potassium' + -emia 'blood condition'. | Hypokalemia | Hyponatremia | Hypernatremia | Alkalosis | Hypercalcaemia | Hyperkalemia | Hypocalcemia | Hypermagnesemia | 00
| 19,116 |
The most common etiology of piriformis syndrome is that resulting from a specific previous injury due to trauma. Large injuries include trauma to the buttocks while "micro traumas" result from small repeated bouts of stress on the piriformis muscle itself. To the extent that piriformis syndrome is the result of some type of trauma and not neuropathy, such secondary causes are considered preventable, especially those occurring in daily activities: according to this theory, periods of prolonged sitting, especially on hard surfaces, produce minor stress that can be relieved with bouts of standing. An individual's environment, including lifestyle factors and physical activity, determine susceptibility to trauma of any given type. Although empirical research findings on the subject have never been published, many believe that taking sensible precautions during high-impact sports and when working in physically demanding conditions may decrease the risk of experiencing piriformis syndrome, either by forestalling injury to the muscle itself or injury to the nerve root that causes it to spasm. In this vein, proper safety and padded equipment should be worn for protection during any type of regular, firm contact (i.e., American football, etc.). In the workplace, individuals are encouraged to make regular assessments of their surroundings and attempt to recognize those things in one's routine that might produce micro or macro traumas. No research has substantiated the effectiveness of any such routine, however, and participation in one may do nothing but heighten an individual's sense of worry over physical minutiae while have no effect in reducing the likeliness of experiencing or re-experiencing piriformis syndrome. Other suggestions from some researchers and physical therapists have included prevention strategies include warming up before physical activity, practicing correct exercise form, stretching, and doing strength training, though these are often suggested for helping treat or prevent any physical injury and are not piriformis-specific in their approach As with any type of exercise, it is thought that warmups will decrease the risk of injury during flexion or rotation of the hip. Stretching increases range of motion, while strengthening hip adductors and abductors theoretically allows the piriformis to tolerate trauma more readily. However, to the extent that piriformis syndrome is actually related to sciatic nerve pain based in the spine, physically "warming up" the hip muscles will have no effect in preventing disc herniation and subsequent experience of pain along the sciatic pathway. Hip adduction is a strengthening exercise for the piriformis muscle. A cable attached at the ankle can be used to adduct the hip, bringing the leg in toward the opposite side of the body. The same equipment can also be used for hip abduction, where the leg starts beside the opposing leg and moves out to the side, away from the body. | medical cause of Sciatica | medical cause of Piriformis syndrome | symptom of Sciatica | causes of Sciatica | symptom of Legius syndrome | symptom of Carpal tunnel syndrome | symptom of Ankylosing spondylitis | complications of Patellar dislocation | 00
| 20,601 |
Prognosis for patients with<unk> is quite varied, owed to the spectrum of clinical manifestations. Infants who experience severe cyanosis at birth may die within hours of delivery if medical intervention is not immediate. Alternatively, longevity of neonates with mild cardiac lesions is unaffected. Ten percent of patients born with right atrial isomerism die by the age of 5 without intervention. Improvements in therapies has increased the 5-year survival to 30-74% for right atrial isomeric patients and 65-84% for left atrial isomeric patients based on the cause of their disease. | Situs ambiguus | Situs inversus | Pulmonary agenesis | Double aortic arch | Pulmonary atresia | Gastroschisis | Diaschisis | Cranioschisis | 00
| 20,344 |
<unk> , sold under the brand name Diovan HCT among others, is an medication used to treat high blood pressure when<unk> is not sufficient. It is a combination of<unk> , an angiotensin receptor blocker with hydrochlorothiazide, a diuretic. It is taken by mouth. Common side effects include dizziness and headaches. Serious side effects may include allergic reactions, electrolyte abnormalities, and glaucoma. Use in pregnancy is not recommended. The combination was approved for medical use in the United States in 1998. It is available as a generic medication. In 2018, it was the 182nd most commonly prescribed medication in the United States, with more than 3million prescriptions. | Valsartan/hydrochlorothiazide | Losartan/hydrochlorothiazide | Olmesartan/hydrochlorothiazide | Atenolol/chlorthalidone | Enalapril/hydrochlorothiazide | Telmisartan/hydrochlorothiazide | Lisinopril/hydrochlorothiazide | Hydrochlorothiazide/triamterene | 00
| 60,313 |
<unk> is an autoimmune synaptopathy. The disorder occurs when the immune system malfunctions and generates antibodies that attack the body's tissues. The antibodies in<unk> attack a normal human protein, the nicotinic acetylcholine receptor, or a related protein called MuSK, a muscle-specific kinase. Other, less frequent antibodies are found against LRP4, agrin, and titin proteins. Human leukocyte antigen haplotypes are associated with increased susceptibility to<unk> and other autoimmune disorders. Relatives of people with<unk> have a higher percentage of other immune disorders. The thymus gland cells form part of the body's immune system. In those with<unk> , the thymus gland is large and abnormal. It sometimes contains clusters of immune cells that indicate lymphoid hyperplasia, and the thymus gland may give wrong instructions to immune cells. File:Synapse diag4.Neuromuscular junction: 1. Axon 2. Muscle cell membrane 3. Synaptic vesicle 4. Nicotinic acetylcholine receptor 5. Mitochondrion File:Gray1178.A juvenile thymus shrinks with age. File:Nicotinic Acetylcholine receptor.The nicotinic acetylcholine receptor In pregnancy For women who are pregnant and already have<unk> , in a third of cases, they have been known to experience an exacerbation of their symptoms, and in those cases, it usually occurs in the first trimester of pregnancy. Signs and symptoms in pregnant mothers tend to improve during the second and third trimesters. Complete remission can occur in some mothers. Immunosuppressive therapy should be maintained throughout pregnancy, as this reduces the chance of neonatal muscle weakness, and controls the mother's<unk> . About 10–20% of infants with mothers affected by the condition are born with transient neonatal<unk> (TNM), which generally produces feeding and respiratory difficulties that develop about 12 hours to several days after birth. A child with TNM typically responds very well to acetylcholinesterase inhibitors, and the condition generally resolves over a period of three weeks, as the antibodies diminish, and generally does not result in any complications. Very rarely, an infant can be born with arthrogryposis multiplex congenita, secondary to profound intrauterine weakness. This is due to maternal antibodies that target an infant's acetylcholine receptors. In some cases, the mother remains asymptomatic. | Myasthenia gravis | Guillain–Barré syndrome | Congenital myasthenic syndrome | Botulism | Neurasthenia | Organophosphate poisoning | Polymyositis | Brainstem stroke syndrome | 00
| 1,359 |
<unk> makes use of heavily T2-weighted MRI pulse sequences. These sequences show high signal in static or slow moving fluids within the gallbladder, biliary ducts and pancreatic duct, with low signal of surrounding tissue. Secretin is also given to a patient to increase ductal compliance, making imaging easier. Comparison to other techniques In the diagnosis of pancreatic disorders,<unk> is a much less invasive investigation when compared to endoscopic retrograde<unk> (ERCP). Although both techniques can image the ductal system in detail,<unk> also allows imaging of the surrounding parenchyma. In a study from 2008, 269 patients undergoing both ERCP and<unk> showed comparable results between the two techniques. | Magnetic resonance cholangiopancreatography | Percutaneous transhepatic cholangiography | Splenic aspiration | Cholecystography | Intravenous cholangiography | Cholangiography | Hyperpolarized carbon-13 MRI | Endoscopic retrograde cholangiopancreatography | 00
| 31,533 |
The onset of puberty is characterized by increased levels of hypothalamic gonadotropin releasing hormone (GnRH). GnRH triggers the secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) from the anterior pituitary gland, which in turn causes the ovaries to respond and secrete estradiol. Increases in gonadal estrogen promote breast development, female fat distribution and skeletal growth. Adrenal androgen and gonadal androgen result in pubic and axillary hair. Peripheral precocious puberty caused by exogenous estrogens is evaluated by assessing decreased levels of gonadotrophins.<unk> s in plastics, packaged food, drink trays and containers, (more so, when they've been heated in the Sun, or an oven), may interfere with pubertal development by actions at different levels – hypothalamic-pituitary axis, gonads, peripheral target organs such as the breast, hair follicles and genitals. Exogenous chemicals that mimic estrogen can alter the functions of the endocrine system and cause various health defects by interfering with synthesis, metabolism, binding or cellular responses of natural estrogens. Although the physiology of the reproductive system is complex, the action of environmental exogenous estrogens is hypothesized to occur by two possible mechanisms.<unk> s may temporarily or permanently alter the feedback loops in the brain, pituitary, gonads, and thyroid by mimicking the effects of estrogen and triggering their specific receptors or they may bind to hormone receptors and block the action of natural hormones. Thus it is plausible that environmental estrogens can accelerate sexual development if present in a sufficient concentration or with chronic exposure. The similarity in the structure of exogenous estrogens and the estrogens has changed the hormone balance within the body and resulted in various reproductive problems in females. The overall mechanism of action is binding of the exogenous compounds that mimic estrogen to the estrogen binding receptors and cause the determined action in the target organs. | Xenoestrogen | Phytoestrogen | Antiestrogen | Conjugated estrogens | Tissue-selective estrogen complex | Estrogen conjugate | Antiandrogen | Phytoprogestogen | 00
| 26,148 |
Parisian Communards A<unk> or corpse is a dead human body that is used by medical students, physicians and other scientists to study anatomy, identify disease sites, determine causes of death, and provide tissue to repair a defect in a living human being. Students in medical school study and dissect<unk> s as a part of their education. Others who study<unk> s include archaeologists and arts students. The term<unk> is used in courts of law to refer to a dead body, as well as by recovery teams searching for bodies in natural disasters. The word comes from the Latin word<unk> ere ("to fall"). Related terms include<unk> ous (resembling a<unk> and<unk> ic spasm (a muscle spasm causing a dead body to twitch or jerk). A<unk> graft (also called “postmortem graft”) is the grafting of tissue from a dead body onto a living human to repair a defect or disfigurement.<unk> s can be observed for their stages of decomposition, helping to determine how long a body has been dead.<unk> s have been used in art to depict the human body in paintings and drawings more accurately. | Cadaver | Creosote | Pharmasave | Dollond | Street medic | Veterinarian | Accident | Transfer board | 00
| 46,874 |
The course of treatment and the success rate is dependent on the type of<unk> A. Some patients with atypical HUS and TTP have responded to plasma infusions or exchanges, a procedure which replaces proteins necessary for the complement cascade that the patient does not have; however, this is not a permanent solution or treatment, especially for patients with congenital predispositions. Monoclonal antibodies like eculizumab and caplacizumab can assist with atypical hemolytic uremic syndrome and acquired<unk> thrombocytopenic purpura respectively whilst dexamethasone can help with immune<unk> thrombocytopenic purpura and low molecular weight heparin can help with disseminated intravascular coagulation. | Thrombotic microangiopathy | Systemic vasculitis | Cryoglobulinemic vasculitis | Lupus vasculitis | Venom-induced consumption coagulopathy | Cerebral vasculitis | Primary fibrinogenolysis | Amyloid purpura | 00
| 34,346 |
<unk> typically presents with self-limited, recurrent severe headache associated with autonomic symptoms. About 15–30% of people living with<unk> experience episodes with aura, and they also frequently experience episodes without aura. The severity of the pain, duration of the headache, and frequency of attacks are variable. A<unk> lasting longer than 72 hours is termed status<unk> sus. There are four possible phases to a<unk> , although not all the phases are necessarily experienced: * The prodrome, which occurs hours or days before the headache * The aura, which immediately precedes the headache * The pain phase, also known as headache phase * The postdrome, the effects experienced following the end of a<unk> attack<unk> is associated with major depression, bipolar disorder, anxiety disorders, and obsessive–compulsive disorder. These psychiatric disorders are approximately 2–5 times more common in people without aura, and 3–10 times more common in people with aura. Prodrome phase Prodromal or premonitory symptoms occur in about 60% of those with<unk> s, with an onset that can range from two hours to two days before the start of pain or the aura. These symptoms may include a wide variety of phenomena, including altered mood, irritability, depression or euphoria, fatigue, craving for certain food(s), stiff muscles (especially in the neck), constipation or diarrhea, and sensitivity to smells or noise. This may occur in those with either<unk> with aura or<unk> without aura. Neuroimaging indicates the limbic system and hypothalamus as the origin of prodromal symptoms in<unk> . Aura phase Enhancements reminiscent of a zigzag fort structure Negative scotoma, loss of awareness of local structures Positive scotoma, local perception of additional structures Mostly one-sided loss of perception Aura is a transient focal neurological phenomenon that occurs before or during the headache. Aura appears gradually over a number of minutes (usually occurring over 5–60 minutes) and generally lasts less than 60 minutes. Symptoms can be visual, sensory or motoric in nature, and many people experience more than one. Visual effects occur most frequently: they occur in up to 99% of cases and in more than 50% of cases are not accompanied by sensory or motor effects. Visual disturbances often consist of a scintillating scotoma (an area of partial alteration in the field of vision which flickers and may interfere with a person's ability to read or drive). These typically start near the center of vision and then spread out to the sides with zigzagging lines which have been described as looking like fortifications or walls of a castle. Usually the lines are in black and white but some people also see colored lines. Some people lose part of their field of vision known as hemianopsia while others experience blurring. Sensory aura are the second most common type; they occur in 30–40% of people with auras. Often a feeling of pins-and-needles begins on one side in the hand and arm and spreads to the nose–mouth area on the same side. Numbness usually occurs after the tingling has passed with a loss of position sense. Other symptoms of the aura phase can include speech or language disturbances, world spinning, and less commonly motor problems. Motor symptoms indicate that this is a hemiplegic<unk> , and weakness often lasts longer than one hour unlike other auras. Auditory hallucinations or delusions have also been described. Pain phase Classically the headache is unilateral, throbbing, and moderate to severe in intensity. It usually comes on gradually and is aggravated by physical activity. However, the effects of physical activity on<unk> are complex and some researchers have concluded that, while exercise can trigger<unk> attacks, regular exercise may have a prophylactic effect and decrease frequency of attacks. The feeling of pulsating pain is not in phase with the pulse. In more than 40% of cases, however, the pain may be bilateral and neck pain is commonly associated with it. Bilateral pain is particularly common in those who have<unk> without aura. Less commonly pain may occur primarily in the back or top of the head. The pain usually lasts 4 to 72 hours in adults, however in young children frequently lasts less than 1 hour. The frequency of attacks is variable, from a few in a lifetime to several a week, with the average being about one a month. The pain is frequently accompanied by nausea, vomiting, sensitivity to light, sensitivity to sound, sensitivity to smells, fatigue and irritability. Many thus seek a dark and quiet room. In a basilar<unk> , a<unk> with neurological symptoms related to the brain stem or with neurological symptoms on both sides of the body, common effects include a sense of the world spinning, light-headedness, and confusion. Nausea occurs in almost 90% of people, and vomiting occurs in about one-third. Other symptoms may include blurred vision, nasal stuffiness, diarrhea, frequent urination, pallor, or sweating. Swelling or tenderness of the scalp may occur as can neck stiffness. Associated symptoms are less common in the elderly. Silent<unk> Sometimes, aura occurs without a subsequent headache. This is known in modern classification as a typical aura without headache, or acephalgic<unk> in previous classification, or commonly as a silent<unk> . However, silent<unk> can still produce debilitating symptoms, with visual disturbance, vision loss in half of both eyes, alterations in color perception, and other sensory problems, like sensitivity to light, sound, and odors, and aura sudden outbreak without headache can be scary. It can last from 15 to 30 minutes, usually no longer than 60 minutes, and it can recur or appear as an isolated event. Postdrome The<unk> postdrome could be defined as that constellation of symptoms occurring once the acute headache has settled. Many report a sore feeling in the area where the<unk> was, and some report impaired thinking for a few days after the headache has passed. The person may feel tired or "hung over" and have head pain, cognitive difficulties, gastrointestinal symptoms, mood changes, and weakness. According to one summary, "Some people feel unusually refreshed or euphoric after an attack, whereas others note depression and malaise." For some individuals this can vary each time. | Migraine | Cluster headache | Lupus headache | Subarachnoid hemorrhage | Tension headache | Sinusitis | External compression headache | Brain tumor | 00
| 1,509 |
<unk> is a trend that arose in answer to medical paternalism. However, only rarely can unchecked physician paternalism be justified, and unlimited patient autonomy would presumably be equally abhorrent. Informed consent is a process where patients make decisions informed by the advice of medical professionals. In recent years, the term<unk> " has been used in many different contexts. These include, for example: shared decision making, participatory medicine, health consumerism, and patient-centered care. For the latter context, i.e. patient-centered care, a more nuanced definition was proposed in 2009 by the president of the Institute for Healthcare Improvement Donald Berwick: "The experience (to the extent the informed, individual patient desires it) of transparency, individualization, recognition, respect, dignity, and choice in all matters, without exception, related to one's person, circumstances, and relationships in health care" are concepts closely related to<unk> . In the UK over the course of 2016 two new relevant terms have expanded in usage: Patient and Public Involvement (PPI) and Engagement (PPIE) in the sense of the older term coproduction (public services). In 2019 a collection of papers on this research topic was published with newer information. With regard to participatory medicine, it has proven difficult to ensure the representativeness of patients. Researchers warn that there are "three different types of representation" which have "possible applications in the context of patient engagement: democratic, statistical, and symbolic."<unk> is a generic term, and thus no list can be exhaustive; nonetheless, the following description shall subdivide it into several areas where patients and/or their advocates have a role. | Patient participation | Patient group directions | Patient trade-off | Good clinical practice | Patient safety | Criticism of patents | Clinical research ethics | Patient experience | 00
| 56,221 |
The disorder is progressive, with the ultimate severity of symptoms often depending on age of onset. In severe cases amputation has been performed when conservative measures such as physical therapy and regional anesthetics have been ineffective. | Melorheostosis | Buccal exostosis | Acrodysostosis | Pachydermoperiostosis | Craniosynostosis | Hyperostosis frontalis interna | Pycnodysostosis | Paraphrenia | 00
| 48,458 |
The prognosis associated with myocarditis is stratified by the severity and time course along which symptoms develop. In addition to symptom severity, there are also several indicators of heart function that can be used to predict patient outcomes, many of which are part of the standard evaluation of patients presenting with cardiovascular dysfunction. An electrocardiogram is one of the most common screening tools used in cases of suspected cardiac pathology, such as myocarditis. The findings that correlate with poorer outcomes are non-specific and include widened QRS complexes and QT intervals, partial or complete atrial-ventricular heart block, and malignant ventricular arrhythmias like sustained ventricular tachycardia or ventricular fibrillation. Electrocardiogram findings of ST elevations with upward concavity and an early repolarization pattern, however, were associated with a better cardiovascular prognosis in general. In cases of acute myocarditis, cardiac magnetic resonance imaging can reveal several prognostic indicators that, similar to ECGs, are non-specific and reflect poorer cardiac physiology. Late gadolinium enhancement on cardiac MRI demonstrates perturbations in extracellular volume as a result of cell necrosis or edema, and is significantly associated with increases in all-cause mortality, cardiovascular mortality, and major adverse cardiovascular events. The association was strongest with any late gadolinium enhancement, but remained true for findings of anterolateral-specific enhancement. A similar relationship was found between a left ventricular ejection fraction < 50%, increased mortality, and increased major adverse cardiovascular events. Myocarditis has been reported to be a major cause of sudden cardiac death (SCD) in infants, adolescents, and young adults, but the reported rates show wide variation (1 to 14 percent) among young people depending on differences in SCD definition and classification/ definition of myocarditis post-mortem as well as inhomogeneity in the study populations. And one has also to distinguish between studies about myocarditis in general and fulminant myocarditis. | complications of Pericarditis | complications of Dilated cardiomyopathy | complications of Myocardial stunning | complications of Angina | medical cause of Constrictive pericarditis | complications of Atrial fibrillation | complications of Myocardial infarction | medical cause of Pericarditis | 00
| 12,780 |
The<unk> , or AAPP, is an organization of psychiatrists and<unk> rs who share an interest in the interface of their two fields. It publishes a quarterly journal and holds annual meetings in conjunction with the annual meeting of the American Psychiatric Association. __NOTOC__ | Association for the Advancement of Philosophy and Psychiatry | Maia Chung Autism and Disabilities Foundation | World Network of Users and Survivors of Psychiatry | Projects for Assistance in Transition from Homelessness | Commissioners in Lunacy | British Association for Behavioural and Cognitive Psychotherapies | Current Approaches in Psychiatry | Self-help groups for mental health | 00
| 69,953 |
A<unk> is a record of an individual's<unk> ing and waking times with related information, usually over a period of several weeks. It is self-reported or can be recorded by a care-giver. The<unk> , or<unk> log, is a tool used by doctors and patients. It is a useful resource in the diagnosis and treatment of especially circadian rhythm<unk> disorders, and in monitoring whether treatment of those and other<unk> disorders is successful.<unk> es may be used in conjunction with actigraphy. In addition to being a useful tool for medical professionals in the diagnosis of<unk> problems, a<unk> can help make individuals more aware of the parameters affecting their<unk> . This data alone can help people self-diagnose what helps them get a good<unk> . | Sleep diary | Sleep study | Somnology | Actigraphy | Personality test | Polysomnography | Rating scales for depression | Optometry | 00
| 46,710 |
There are two main types of intraocular<unk> s: primary central nervous system involvement (PCNSL) and primary central nervous system with ocular involvement (PCNSLO). The difference between PCNSL and PCNSLO is that PNSCL involves the central nervous system, while PCNSLO does not. 56-86% of<unk> s are classified PCNSL and 15-25% are classified PCNSLO. PCNSLO is common in people who are severely immunosuppressed. Symptoms of this form of ocular<unk> include painless decreased vision, sensitivity to light, a red eye, and floaters. Diagnosis is difficult due to its gradual onset and the fact that the symptoms are the same as other diseases. PCNSLO is usually bilateral, but sometimes grows unevenly. Like other metastatic tumors of the eye, it is usually confined to the choroid. | Orbital lymphoma | Orbital cellulitis | Intraocular lymphoma | Periorbital cellulitis | Labyrinthitis | Optic papillitis | Idiopathic orbital inflammatory disease | Vestibular adenitis | 00
| 61,365 |
<unk> , the artificial replacement of organic limbs or organs, often play a role in<unk> , particularly science<unk> , as either plot points or to give a character a beyond normal appearance. Numerous works of literature, television, and films feature characters who have<unk> attached.<unk> are used, in a narrative sense, to either, provide a plot point in the characters back-story, a plot point to give to character a disability (or more often in Science<unk> , an advantage), or just to distinguish the character in some way. Having a character in a story with a prostheses, can sometimes be the whole point of the story (e.g. Robocop is a full-body cyborg of police officer Alex Murphy, in essence he is a human/robot police officer, which is the basic premise for the film). | Prosthetics in fiction | Single-use medical devices | Stafford Hospital scandal | Furness General Hospital scandal | Personal medicine | Nursing in Islam | Pastoral care | Living medicine | 00
| 27,939 |
Mutations in the SLC16A2 gene cause<unk> . The SLC16A2 gene, also known as MCT8, provides instructions for making a protein that plays a critical role in the development of the nervous system. This protein transports a particular hormone into nerve cells in the developing brain. This hormone, called triiodothyronine or T3, is produced by the thyroid. T3 appears to be critical for the normal formation and growth of nerve cells, as well as the development of junctions between nerve cells (synapses) where cell-to-cell communication occurs. T3 and other forms of thyroid hormone also help regulate the development of other organs and control the rate of chemical reactions in the body. Gene mutations alter the structure and function of the SLC16A2 protein. As a result, this protein is unable to transport T3 into nerve cells effectively. A lack of this critical hormone in certain parts of the brain disrupts normal brain development, resulting in intellectual disability and problems with movement. Excess amounts of T3 circulate in the bloodstream. It is unclear if this is a consequence of compensatory hyperdeiodination or if it results from impaired uptake by certain cell types. Increased T3 levels in the blood may be toxic to some organs and contribute to the signs and symptoms of<unk> . Several studies have documented the potentially dangerous effects of the silymarin mixture on the MCT8 transporter. All of the flavonolignan compounds found in the silymarin mixture seem to block the uptake of thyroid hormones into the cells by selectively blocking the MCT8 transmembrane transporter. The authors of several studies noted that especially silychristin, one of the compounds of the silymarin mixture seems to be perhaps the most powerful and selective inhibitor for the MCT8 transporter. Due to the essential role played by the thyroid hormone in human metabolism in general it is believed that the intake of silymarin can lead to disruptions of the thyroid system. Because the thyroid hormones and the MCT8 as well are known to play a critical role during early and fetal development, the administration of silymarin during pregnancy is especially thought to be dangerous, potentially leading to the<unk> . | Allan–Herndon–Dudley syndrome | Townes–Brocks syndrome | Fryns-Aftimos syndrome | Flynn–Aird syndrome | Kearns–Sayre syndrome | Grisel's syndrome | Dennie–Marfan syndrome | Lujan–Fryns syndrome | 00
| 45,167 |
Treatment of<unk> has been with interferon and ribavirin. The response to treatment is similar to that in adults. It shows a similar dependence on the genotype. Recurrence after transplant is universal and the outcomes after transplant are usually poor. In<unk> treatment should be initiated within 12 weeks of the detection of the viral RNA if viral clearance has not occurred within this time. Given the difficulties with establishing a diagnosis of hepatitis C infection in infancy, this recommendation does not apply to infants. Both pegylated interferon and ribavirin are unsuitable for use in<unk> and infancy: newer methods of treatment are urgently required. | HCV in children and pregnancy | FACE AIDS | HIV-tainted blood scandal | Tuberculosis in relation to HIV | HIV/AIDS in Laos | field of Hepatitis D | HIV/AIDS in Vietnam | Breastfeeding and HIV | 00
| 65,226 |
Summary Fetal age Management Term > 37 weeks * Induction of labor * Antibiotics if needed to prevent group B streptococcus (GBS) transmission Late pre-term 34–36 weeks * Same as for term Preterm 24–33 weeks * * Watchful waiting (expectant management) * Tocolytics to prevent the beginning of labor * Magnesium sulfate infusion for 24–48 hours to allow maximum efficacy of corticosteroids for fetal lungs and also confer benefit to fetal brain and gut before delivery * One time dose of corticosteroids (two separate administrations, 12–24 hours apart) before 34 weeks * Antibiotics if needed to prevent GBS transmission Pre-viable < 24 weeks * Discussion of watchful waiting or induction of labor * No antibiotics, corticosteroids, tocolysis, or magnesium sulfate The management of PROM remains controversial, and depends largely on the gestational age of the fetus and other complicating factors. The risks of quick delivery (induction of labor) vs. watchful waiting in each case is carefully considered before deciding on a course of action. As of 2012, the Royal College of Obstetricians and Gynaecologists advised, based on expert opinion and not clinical evidence, that attempted delivery during maternal instability increases the rates of both fetal death and maternal death, unless the source of instability is an intrauterine infection. In all women with PROM, the age of the fetus, its position in the uterus, and its well being should be evaluated. This can be done with ultrasound, Doppler fetal heart rate monitoring, and uterine activity monitoring. This will also show whether or not uterine contractions are happening which may be a sign that labor is starting. Signs and symptoms of infection should be closely monitored, and, if not already done, a group B streptococcus (GBS) culture should be collected. At any age, if the fetal well-being appears to be compromised, or if intrauterine infection is suspected, the baby should be delivered quickly by induction of labour. Term Both expectant management (watchful waiting) and an induction of labor (artificially stimulating labor) are considered in this case. 90% of women start labor on their own within 24 hours, and therefore it is reasonable to wait for 12–24 hours as long as there is no risk of infection. However, if labor does not begin soon after the PROM, an induction of labor is recommended because it reduces rates of infections, decreases the chances that the baby will require a stay in the neonatal intensive care unit (NICU), and does not increase the rate of caesarean sections. If a woman strongly does not want to be induced, watchful waiting is an acceptable option as long as there is no sign of infection, the fetus is not in distress, and she is aware and accepts the risks of PPROM. There is not enough data to show that the use of prophylactic antibiotics (to prevent infection) is beneficial for mothers or babies at or near term because of the potential side effects and development of antibiotic resistance. 34 to 37 weeks When the fetus is 34 to 37 weeks gestation, the risk of being born prematurely must be weighed against the risk of PROM. Previously it was recommended that delivery be carried out as if the baby was term. A 2017 Cochrane review however found waiting resulted in better outcomes when pregnancy is before 37 weeks. 24 to 34 weeks Before 34 weeks, the fetus is at a much higher risk of the complications of prematurity. Therefore, as long as the fetus is doing well, and there are no signs of infection or placental abruption, watchful waiting (expectant management) is recommended. The younger the fetus, the longer it takes for labor to start on its own, but most women will deliver within a week. Waiting usually requires a woman to stay in the hospital so that health care providers can watch her carefully for infection, placental abruption, umbilical cord compression, or any other fetal emergency that would require quick delivery by induction of labor. In 2017, a review of watchful waiting vs the early birth strategy was conducted to ascertain which was associated with a lower overall risk. Focusing on the 24–37-week range, the review analysed twelve randomised controlled trials from the "Cochrane Pregnancy and Childbirth's Trials Register", concluding that "In women with PPROM before 37 weeks' gestation with no contraindications to continuing the pregnancy, a policy of expectant management with careful monitoring was associated with better outcomes for the mother and baby." There is believed to be a correlation between volume of amniotic fluid retained and neonatal outcomes before 26 weeks' gestation. Amniotic fluid levels are an important consideration when debating expectant management vs clinical intervention, as low levels, or oligohydramnios, can result in lung and limb abnormalities. Additionally, labor and infection are less likely to occur when there are sufficient levels of amniotic fluid remaining in the uterus. Serial amnioinfusion in pregnancies with PPROM-related oligohydramnios at less than 26 weeks gestation, successfully alleviates oligohydramnios, with perinatal outcomes that are significantly better than the outcome in those with the persistent condition and is comparable with gestations with PPROM in which oligohydramnios never develops. Recommended * Monitoring for infection: signs of infection include a fever in the mother, fetal tachycardia (fast heart rate of the fetus, more than160 beats per minute), or tachycardia in the mother (more than 100 beats per minute). White blood cell (WBC) counts are not helpful in this case because WBC's are normally high in late pregnancy. * Steroids before birth: corticosteroids (betamethasone) given to the mother of a baby at risk of being born prematurely can speed up fetal lung development and reduce the risk of death of the infant, respiratory distress syndrome, brain bleeds, and bowel necrosis. It is recommended that mothers receive one course of corticosteroids between 24 and 34 weeks when there is a risk of preterm delivery. In cases of PPROM these medications do not increase the risk of infection even though steroids are known to suppress the immune system. More than two courses is not recommended because three or more can lead to small birth weight and small head circumference. In pregnancies between 32 and 34 weeks (right around the time that fetal lungs mature) vaginal fluid can be tested to determine fetal lung maturity using chemical markers which can help to decide if corticosteroids should be given. * Magnesium sulfate: Intravenous magnesium sulfate is given to the mother in cases when there is a risk of preterm birth before 32 weeks. This has been shown to protect the fetal brain and reduce the risk of cerebral palsy. * Latency antibiotics: The time from PROM to labor is termed the latency period, and there is an inverse relationship between gestational age and the length of latency, meaning that the earlier the rupture, the longer it will take for labor to begin naturally. As expected, antibiotics given to mothers that experience PPROM serve to protect against infections during this lengthened latency period. Additionally, antibiotics increase the time that babies stay in the womb. Antibiotics don't seem to prevent death or make a difference in the long-term (years after the baby is born). But, because of the short-term benefits, routine use of antibiotics in PPROM is still recommended. The American Congress of Obstetricians and Gynecologists (ACOG) recommends a seven-day course of intravenous ampicillin and erythromycin followed by oral amoxicillin and erythromycin if watchful waiting is attempted before 34 weeks. Amoxicillin/clavulanic acid increases the risk of fetal bowel death<unk><unk> and should be avoided in pregnancy. * Prophylactic antibiotics: If a woman is colonized with GBS, than the typical use of antibiotics during labor is recommended to prevent transmission of this bacteria to the fetus, regardless of earlier treatments. Controversial or not recommended * Preventative tocolysis (medications to prevent contractions): the use of tocolytic medications to prevent labor contractions is controversial. On the one hand, this can delay delivery and allow the fetus more time to develop and benefit from antenatal corticosteroid medication, on the other hand it increases the risk of infection or chorioamnionitis. The use of tocolysis has not shown to benefit mom or baby and currently there is not enough data to recommend or discourage its use in the case of preterm PROM. * Therapeutic tocolysis (medications to stop contractions): Once labor has started, using tocolysis to stop labor has not been shown to help, and is not recommended. * Amnioinfusion: This treatment attempts to replace the lost amniotic fluid from the uterus by infusing normal saline fluid into the uterine cavity. This can be done through the vagina and cervix (transcervical amnioinfusion) or by passing a needle through the abdominal wall (transabdominal amnioinfusion). Current data suggests that this treatment prevents infection, lung problems, and fetal death. However, there have not been enough trials to recommend its routine use in all cases of PPROM. * Home care: Typically women with PPROM are managed in the hospital, but, occasionally they opt to go home if watchful waiting is attempted. Since labor usually starts soon after PPROM, and | risks of Necrotizing enterocolitis | risks of Giardiasis | risks of Short bowel syndrome | risks of Refeeding syndrome | causes of Fecal incontinence | risks of Peritonitis | risks of Postpartum infections | risks of Myocardial infarction | 00
| 27,610 |
<unk> , La(C O3)3, is the salt formed by<unk> (III) cations and<unk> anions. It is an ore of<unk> metal (bastnäsite), along with monazite. | Lanthanum carbonate | Strontium ranelate | Calcium carbonate | Potassium fluoride | Sodium fluoride | Amine fluoride | Tricresyl phosphate | Ferrous tartrate | 00
| 29,318 |
<unk> <unk> is a form of<unk><unk> in which the<unk><unk> – the percentage of the volume of blood ejected from the left ventricle with each<unk> beat divided by the volume of blood when the left ventricle is maximally filled – is normal, defined as greater than 50%; this may be measured by echocardiography or cardiac catheterization. Approximately half of people with<unk><unk> have<unk><unk><unk> , while the other half have a reduction in<unk><unk> , called<unk><unk> with reduced<unk><unk> <unk> . Risk factors for<unk> include hypertension, hyperlipidemia, diabetes, smoking, and obstructive sleep apnea.<unk> is characterized by abnormal diastolic function: there is an increase in the stiffness of the left ventricle, which causes a decrease in left ventricular relaxation during diastole, with resultant increased pressure and/or impaired filling. There is an increased risk for atrial fibrillation and pulmonary hypertension. There is controversy regarding the relationship between diastolic<unk><unk> and<unk> . | Heart failure with preserved ejection fraction | Ischemic cardiomyopathy | Diabetic cardiomyopathy | Hypertrophic cardiomyopathy | Dilated cardiomyopathy | Restrictive cardiomyopathy | Alcoholic cardiomyopathy | Amyloid cardiomyopathy | 00
| 62,543 |
In 2016 the United States Preventive Services Task Force concluded that testing the general population under the age of 40 without symptoms is of unclear benefit. | Hypertriglyceridemia | Hyperlipidemia | Hypolipoproteinemia | Dyslipidemia | Glycemia | Dysglycemia | Hyperinsulinemia | Hypocholesterolemia | 00
| 15,700 |
<unk><unk> health problems can be an umbrella term for the various problems a<unk> user can develop from extended and incorrect<unk> use. A<unk> user may experience many physical health problems from using<unk> s extensively over a prolonged period of time in an inefficient manner. The<unk> user may have poor etiquette when using peripherals, for example incorrect posture. Reportedly, excessive use of electronic screen media can have ill effects on mental health related to mood, cognition, and behavior, even to the point of hallucination. | Computer-induced medical problems | Religious response to assisted reproductive technology | Illness and injuries during spaceflight | Doping in sport | Video game–related health problems | Mass-casualty incident | At risk mental state | Immigration health surcharge | 00
| 59,949 |
Dominant genetic disorders can be caused by just a single copy of an abnormal gene. This abnormal gene can be the result of being inherited from either parent or be a new mutation. Most cases are caused by a de novo (new) mutation in the gene that occurs during the formation of the egg or sperm. These cases occur when there is no history of the disorder in the family. The COL11A2 gene is responsible for providing instructions on making one component of the type XI collagen. Type XI collagen is a complex molecule that helps give structure and strength to the connective tissues. Collagen is found in bone. It is also found in cartilage that makes up most of the skeleton during early development. The mutation of COL11A2 in<unk> disrupts the assembly of the type XI collagen molecules. The malfunctioning collagen weakens the connective tissue causing impaired bone development. COL11A2 is also associated with autosomal dominant non-syndromic hearing loss (ADNSHL). All mutations of COL11A2 in ADNSHL are missense mutations. | Weissenbacher–Zweymüller syndrome | Smith–Magenis syndrome | Schinzel–Giedion syndrome | Marshall–Smith syndrome | Smith–Lemli–Opitz syndrome | Goldberg–Shprintzen syndrome | Bardet–Biedl syndrome | Kapur–Toriello syndrome | 00
| 12,002 |
Humans with Swyer syndrome develop with external phenotypes typical of females and nonfunctional gonads instead of ovaries or testes. Individuals are most commonly diagnosed during puberty after menstruation fails to occur (primary amenorrhea). The consequences of Swyer syndrome without treatment: * Gonads cannot make estrogen, so the breasts will not develop and the uterus will not grow and menstruate until estrogen is administered. This is often given transdermally. * Gonads cannot make progesterone, so menstrual periods will not be predictable until progestin is administered, usually as a pill. * Gonads cannot produce eggs, so conceiving children is not possible without embryo transfer. There has been a case of unassisted pregnancy in one woman with<unk> , who had a predominantly 46,XY karyotype – a 46,XY karyotype in peripheral lymphocytes, mosaicism in cultured skin fibroblasts (80% 46,XY and 20% 45,X), and a predominantly 46,XY karyotype in the ovary (93% 46,XY and 6% 45,X) – who gave birth to a 46,XY female with complete gonadal dysgenesis. * Streak gonads with Y chromosome-containing cells have a high likelihood of developing cancer, especially gonadoblastoma. Streak gonads are usually removed within a year or so of diagnosis, since the cancer can begin during infancy. * Osteopenia is often present. | XY gonadal dysgenesis | XX gonadal dysgenesis | Thyroid dysgenesis | Complete androgen insensitivity syndrome | Mild androgen insensitivity syndrome | Gonadotropin-releasing hormone insensitivity | Gonadal dysgenesis | Müllerian agenesis | 00
| 14,367 |
Treatment is based on lab investigation report. | Parotitis | Proctitis | Appendicitis | Urethritis | Rectitis | Prostatitis | Vaginitis | Cervicitis | 00
| 23,341 |
A<unk> is a prosthesis used to change the size, shape, and contour of a person's breast. In reconstructive plastic surgery,<unk> s can be placed to restore a natural looking breast following a mastectomy, to correct congenital defects and deformities of the chest wall or, cosmetically, to enlarge the appearance of the breast through breast augmentation surgery. Complications of<unk> s may include breast pain, skin changes, infection, rupture, and a fluid collection around the breast. There are four general types of<unk> s, defined by their filler material: saline solution, silicone gel, structured and composite filler. The saline<unk> has an elastomer silicone shell filled with sterile saline solution during surgery; the silicone<unk> has an elastomer silicone shell pre-filled with viscous silicone gel; structured<unk> s use nested elastomer silicone shells and two saline filled lumen; and the alternative composition<unk> s featured miscellaneous fillers, such as soy oil or polypropylene string. In surgical practice, for the reconstruction of a breast, the tissue expander device is a temporary breast prosthesis used to form and establish an<unk> pocket for the future permanent<unk> . For the correction of male breast defects and deformities, the pectoral<unk> is the breast prosthesis used for the reconstruction and the aesthetic repair of a man's chest wall (see: gynecomastia and mastopexy). | Breast implant | Breast prostheses | Polypropylene breast implant | Breast surgery | Breast augmentation | Myfreeimplants | Breast reconstruction | Medarex | 00
| 36,382 |
Screening individuals for certain predisposing gene variants before initiating treatment with particular<unk> -, TEN/SJS-, or TEN-inducing drugs is recommended or under study. These recommendations are typically limited to specific populations that show a significant chance of having the indicated gene variant since screening of populations with extremely low incidences of expressing the variant is considered cost-ineffective. Individuals expressing the HLA allele associated with sensitivity to an indicated drug should not be treated with the drug. These recommendations include the following. Before treatment with carbamazepine, the Taiwan and USA Food and Drug Administrations recommend screening for HLA-B*15:02 in certain Asian groups. This has been implemented in Taiwan, Hong Kong, Singapore, and many medical centers in Thailand and Mainland China. Before treatment with allopurinol, the American College of Rheumatology guidelines for managing gout recommend HLA-B*58:01 screening. This is provided in many medical centers in Taiwan, Hong Kong, Thailand, and Mainland China. Before treatment with abacavir, the USA Food and Drug Administration recommends screening for HLA-B*57:01 in Caucasian populations. This screening is widely implemented. It has also been suggested that all individuals found to express this HLA serotype avoid treatment with abacovir. Current trials are underway in Taiwan to define the cost-effectiveness of avoiding phenytoin in<unk> ,<unk> /TEN, and TEN for individuals expressing the CYP2C9*3 allele of CYP2C9. | Stevens–Johnson syndrome | Staphylococcal scalded skin syndrome | Chickenpox | Streptococcal intertrigo | Skin condition | Johnson–Munson syndrome | Staphylococcal infection | Acute cutaneous lupus erythematosus | 00
| 2,108 |
A variety of over-the-counter and prescription anti-itch drugs are available. Some plant products have been found to be effective anti-pruritics, others not. Non-chemical remedies include cooling, warming, soft stimulation. Topical antipruritics in the form of creams and sprays are often available over-the-counter. Oral anti-itch drugs also exist and are usually prescription drugs. The active ingredients usually belong to the following classes: * Antihistamines, such as diphenhydramine (Benadryl) * Corticosteroids, such as hydrocortisone topical cream; see topical steroid * Counterirritants, such as mint oil, menthol, or camphor * Crotamiton (trade name Eurax) is an antipruritic agent available as a cream or lotion, often used to treat scabies. Its mechanism of action remains unknown. * Local anesthetics, such as benzocaine topical cream (Lanacane) Phototherapy is helpful for severe itching, especially if caused by kidney failure. The common type of light used is UVB. Sometimes scratching relieves isolated itches, hence the existence of devices such as the back scratcher. Often, however, scratching only offers temporary relief and can intensify itching, even causing further damage to the skin, dubbed the "itch-scratch cycle". The mainstay of therapy for dry skin is maintaining adequate skin moisture and topical emollients. No studies have been conducted to investigate the effectiveness of emollient creams, cooling lotions, topical corticosteroids, topical antidepressants, systemic antihistamines, systemic antidepressants, systemic anticonvulsants, and phototherapy on chronic itchiness of unknown origin. The effectiveness of therapeutic options for people who are terminally ill with malignant cancer is not known. | symptoms of Primary biliary cholangitis | symptom of Primary biliary cholangitis | medical cause of Pancreatitis | symptom of Autoimmune hepatitis | symptom of Liver cancer | symptom of Gallbladder cancer | symptoms of Amoebiasis | symptom of Hepatic veno-occlusive disease | 00
| 12,501 |
The cause of<unk> is unknown. However, several risk factors, genetic and environmental, have been identified. Genetics Genetics play a major role in<unk> , and may explain up to 50% of the disease susceptibility.<unk> is potentially associated with polymorphisms of genes in the serotoninergic, dopaminergic and catecholaminergic systems. Several genes have been suggested as candidates for susceptibility to<unk> . These include SLC64A4, TRPV2, MYT1L, NRXN3, and the 5-HT2A receptor 102T/C polymorphism. The heritability of<unk> is estimated to be higher in patients younger than 50. Neuropathic pain and major depressive disorder often co-occur with<unk> – the reason for this comorbidity appears to be due to shared genetic abnormalities, which leads to impairments in monoaminergic, glutamatergic, neurotrophic, opioid and proinflammatory cytokine signaling. In these vulnerable individuals, psychological stress or illness can cause abnormalities in inflammatory and stress pathways that regulate mood and pain. Eventually, a sensitization and kindling effect occurs in certain neurons leading to the establishment of<unk> and sometimes a mood disorder. Nervous system Stress Woman feeling emotional stressStress may be an important precipitating factor in the development of<unk> . A 2021 meta-analysis found psychological trauma to be strongly associated with<unk> . People who suffered abuse in their lifetime were three times more likely to suffer from<unk> , people who suffered medical trauma or other stressors in their lifetime were about twice as likely. Some authors have proposed that, because exposure to stressful conditions can alter the function of the hypothalamic-pituitary-adrenal (HPA) axis, the development of<unk> may stem from stress-induced disruption of the HPA axis. Several studies have linked<unk> with a previous "hyperactive" lifestyle, where a person goes beyond his or her limits and neglects basic bodily needs such as food and rest. This lifestyle has been hypothesized to increase the allostatic load and contribute to a state of physical deconditioning.<unk> is frequently comorbid with stress-related disorders such as chronic fatigue syndrome, posttraumatic stress disorder, irritable bowel syndrome and depression. Personality Although some have suggested that<unk> patients are more likely to have specific personality traits, when depression is statistically controlled for, it appears that their personality is no different than that of people in the general population. Lifestyle Poor lifestyles including being a smoker, obesity and inactivity may increase the risk of an individual developing<unk> . Sleep disturbances Impaired sleep is a risk factor for<unk> . In 1975, Moldofsky and colleagues reported the presence of anomalous alpha wave activity (typically associated with arousal states) measured by electroencephalogram (EEG) during non-rapid eye movement sleep of "fibrositis syndrome". By disrupting stage IV sleep consistently in young, healthy subjects, the researchers reproduced a significant increase in muscle tenderness similar to that experienced in "neurasthenic musculoskeletal pain syndrome" but which resolved when the subjects were able to resume their normal sleep patterns. Mork and Nielsen used prospective data and identified a dose-dependent association between sleep problems and risk of<unk> . Improving sleep quality can help<unk> sufferers minimize pain. Non-celiac gluten sensitivity Non-celiac gluten sensitivity (NCGS) may be an underlying cause of<unk> -like symptoms but further research is needed. Other risk markers Other risk markers for<unk> include premature birth, female sex, cognitive influences, primary pain disorders, multiregional pain, infectious illness, hypermobility of joints, iron deficiency and small-fiber polyneuropathy. | Fibromyalgia | Osteoarthritis | Polymyalgia rheumatica | Rheumatoid arthritis | Complex regional pain syndrome | Myofascial pain syndrome | Thyroid disease | Calpainopathy | 00
| 10,778 |
Treatment and intervention for<unk> can be classified into a unique paradigm based on disease prevention. Primary prevention Primary prevention aims to reduce the risk factors before a disease or condition occurs. Sun protection is the most effective form of primary prevention of<unk> . The major methods of sun protection are sunscreen products, sun protective clothing, and reducing exposure to the sun, especially during peak sun hours (10 AM-4PM in the spring and summer seasons). Broad-spectrum sunscreen products provide optimal coverage for protection against UV damage because they protect against both types of UVA rays (UVA1 and UVA2) along with UVB rays. Proper application methods and timing are important factors in proper sunscreen use. This includes using a proper quantity of sunscreen, applying sunscreen prior to sun exposure, and consistent reapplication (especially after exposure to water or sweat). Secondary protection Secondary protection refers to early detection of disease, potentially while still asymptomatic, to allow positive interference to prevent, delay, or attenuate the symptomatic clinical condition. This includes the following: retinoids (e.g. tretinoin), antioxidants (e.g. topical vitamin C, oral supplements, CoQ10, Lipoic acid), estrogens, growth factors and cytokines. There are various forms of topical retinoids. Tretinoin, a retinoid, is widely considered to be the most efficacious treatment for<unk> by dermatologists due to consistent evidence from several randomized clinical trials. Retinoids are vitamin A derivatives that bind to retinoic acid receptors (RARs) and retinoid X receptors (RXRs). Binding to these receptors induces a cascade of cellular processes that ultimately lead to increased collagen production and epidermal thickening, reducing the appearance of skin sagging and wrinkling. Tretinoin is also efficacious for the treatment of acne. Adapalene and tazarotene are also third-generation synthetic retinoids that are used for the treatment for acne. Adapalene has not been widely studied or proven for use in<unk> . However, it has been used off-label for that purpose. Tazarotene has been proven to be efficacious in the treatment of<unk> . Retinoid derivatives, known as retinol and retinal, are often used in over the counter cosmeceutical products for anti-aging purposes. The form of retinol and retinal are metabolized in the skin to retinoic acid, which can then act on the RARs and RXRs. These products are considered cosmeceuticals rather than drugs due to their lack of regulation, and they have not been widely studied. Furthermore, tretinoin is the most well studied and consistent in its efficacy in the treatment of<unk> . Tertiary prevention Lastly, tertiary prevention is the treatment of an existing symptomatic disease process to ameliorate its effects or delay its progress. Such tertiary prevention includes the use of chemical peels, resurfacing techniques (e.g. micro-dermabrasion), ablative or non-ablative laser resurfacing, radio-frequency technology, soft tissue augmentation (also known as fillers), and botulinum toxins. Photorejuvenation procedures are performed by dermatologists to reduce the visible symptoms. Each of these treatment modalities have primary concerns that they address. For example, botulinum injections paralyze facial muscles. This prevents muscle contraction and subsequent wrinkle formation. Injectable fillers are often used in the nasolabial fold to increase volume and minimize the appearance of sagging or wrinkling. | Photoaging | Photorejuvenation | Laser coagulation | Irradiation | Laser hair removal | Ultraviolet light therapy | Facial rejuvenation | Geroprotector | 00
| 55,184 |
<unk> <unk> occurs when a person receives two copies of a chromosome, or of part of a chromosome, from one parent and no copy from the other parent.<unk> can be the result of heterodisomy, in which a pair of non-identical chromosomes are inherited from one parent (an earlier stage meiosis I error) or isodisomy, in which a single chromosome from one parent is duplicated (a later stage meiosis II error).<unk> may have clinical relevance for several reasons. For example, either isodisomy or heterodisomy can disrupt parent-specific genomic imprinting, resulting in imprinting disorders. Additionally, isodisomy leads to large blocks of homozygosity, which may lead to the uncovering of recessive genes, a similar phenomenon seen in inbred children of consanguineous partners.<unk> has been found to occur in about 1 in 2,000 births. | Uniparental disomy | Genomic imprinting | Germline mosaicism | Structural inheritance | Postzygotic mutation | Robertsonian translocation | Caudal duplication | Non-Mendelian inheritance | 00
| 11,351 |
The conjunctiva provides lining for the inside of the eyelid as well as a coating for the sclera, the white portion of the eyeball. It typically serves to provide lubrication for the eye through the production of mucus and tears. When infected with<unk> , patients will experience painful, red eyes, swelling of the conjunctival tissue, and frequent mucus discharge from the eyes accompanied by excessive tearing and subconjunctival<unk> g. This<unk> g is caused by the rupture of blood vessels beneath the conjunctiva giving the eyes a bright red appearance. Some patients also experience blurry vision and fever in addition to the common symptoms and one in every ten thousand cases exhibits paralysis similar to that of polio. | Acute hemorrhagic conjunctivitis | Allergic conjunctivitis | Ocular larva migrans | Sympathetic ophthalmia | Ligneous conjunctivitis | Periorbital cellulitis | Actinic conjunctivitis | Orbital cellulitis | 00
| 64,591 |
<unk> <unk> , also known as<unk> c age-related macular degeneration (AMD) or advanced dry AMD, is an advanced form of age-related macular degeneration that can result in the progressive and irreversible loss of retinal tissue (photoreceptors, retinal pigment epithelium, choriocappillaris) which can lead to a loss of visual function over time. It is estimated that<unk> affects >5 million people worldwide and approximately 1 million patients in the US, which is similar to the prevalence of neovascular (wet) AMD, the other advanced form of the disease. The incidence of advanced AMD, both<unk> and neovascular AMD, increases exponentially with age and while there are therapies for wet AMD,<unk> currently has no approved treatment options. The aim of most current clinical trials is to reduce the progression of<unk> lesion enlargement. | Geographic atrophy | Posterior cortical atrophy | Neurofibrillary tangle | Hippocampal sclerosis | Central chromatolysis | Amyloid plaques | Pellucid marginal degeneration | Superficial siderosis | 00
| 69,917 |
Overdose of<unk> may result in reversible renal toxicity. Treatment of overdose includes emptying of the stomach by induced vomiting or gastric lavage, as well as administration of antacids containing magnesium, aluminium, or calcium to reduce drug absorption. Renal function and urinary pH should be monitored. Important support includes adequate hydration and urine acidification if necessary to prevent crystalluria. Hemodialysis or peritoneal dialysis can only remove less than 10% of<unk> .<unk> may be quantified in plasma or serum to monitor for drug accumulation in patients with hepatic dysfunction or to confirm a diagnosis of poisoning in acute overdose victims. | Ciprofloxacin | Norfloxacin | Meropenem | Sparfloxacin | Colistin | Ofloxacin | Cethromycin | Metronidazole | 00
| 636 |
culture of Bacillus anthracis, the causative<unk> of anthrax A<unk> (also called bio-agent,<unk> threat<unk> ,<unk> warfare<unk> ,<unk> weapon, or bioweapon) is a bacterium, virus, protozoan, parasite, fungus, chemical, or toxin that can be used purposefully as a weapon in bioterrorism or<unk> warfare (BW). In addition to these living or replicating pathogens, toxins and biotoxins are also included among the bio-agents. More than 1,200 different kinds of potentially weaponizable bio-agents have been described and studied to date.<unk> s have the ability to adversely affect human health in a variety of ways, ranging from relatively mild allergic reactions to serious medical conditions, including serious injury, as well as serious or permanent disability or even death. Many of these organisms are ubiquitous in the natural environment where they are found in water, soil, plants, or animals. Bio-agents may be amenable to "weaponization" to render them easier to deploy or disseminate. Genetic modification may enhance their incapacitating or lethal properties, or render them impervious to conventional treatments or preventives. Since many bio-agents reproduce rapidly and require minimal resources for propagation, they are also a potential danger in a wide variety of occupational settings. The 1972<unk> Weapons Convention (BWC) is an international treaty banning the development, use or stockpiling of<unk> weapons; as of March 2021, there were 183 States Parties to the BWC. Bio-agents are, however, widely studied for both defensive and medical research purposes under various biosafety levels and within biocontainment facilities throughout the world. | Biological agent | Drug | Drug | Biomaterial | Prebiotic | Pesticide | Botanical drug | Pollutant | 00
| 16,630 |
<unk> is a set of symptoms similar to those of meningitis but not caused by meningitis. Whereas meningitis is inflammation of the meninges (membranes that cover the central nervous system),<unk> is caused by nonmeningitic irritation of the meninges, usually associated with acute febrile illness, especially in children and adolescents.<unk> involves the triad (3-symptom syndrome) of nuchal rigidity (neck stiffness), photophobia (intolerance of bright light) and headache. It therefore requires differentiating from other CNS problems with similar symptoms, including meningitis and some types of intracranial hemorrhage. Related clinical signs include Kernig's sign and three signs all named Brudzinski's sign. Although nosologic coding systems, such as ICD-10 and MeSH, define<unk><unk> us as meningitis-like but in fact not meningitis, many physicians use the term<unk> in a loose sense clinically to refer to any meningitis-like set of symptoms before the cause is definitively known. In this sense, the word implies "suspected meningitis". The words meningeal symptoms can be used instead to avoid ambiguity, thus reserving the term<unk> for its strict sense. | Meningism | Meningitis | Meninges | Meningohydroencephalocoele | Seroma | Encephalitis | Leptomeningeal cancer | Cerebral vasculitis | 00
| 22,666 |
Together with Crohn's disease, about 11.2 million people were affected . Each year, ulcerative colitis newly occurs in 1 to 20 per 100,000 people (incidence), and there are a total of 5-500 per 100,000 individuals with the disease (prevalence). In 2015, a worldwide total of 47,400 people died due to inflammatory bowel disease (UC and Crohn's disease). The peak onset is between 30 and 40 years of age, with a second peak of onset occurring in the 6th decade of life. Ulcerative colitis is equally common among men and women. With appropriate treatment the risk of death appears the similar as that of the general population. UC has become more common since the 1950s. The geographic distribution of UC and Crohn's disease is similar worldwide, with the highest number of new cases a year of UC found in Canada, New Zealand and the United Kingdom. The disease is more common in North America and Europe than other regions. In general, higher rates are seen in northern locations compared to southern locations in Europe and the United States. UC is more common in western Europe compared with eastern Europe. Worldwide, the prevalence of UC varies from 2 - 299 per 100,000 people. Together, ulcerative colitis and Crohn's disease affect about a million people in the United States. As with Crohn's disease, the rates of UC are greater among Ashkenazi Jews and decreases progressively in other persons of Jewish descent, non-Jewish Caucasians, Africans, Hispanics, and Asians. Appendectomy prior to age 20 for appendicitis and current tobacco use are protective against development of UC. However, former tobacco use is associated with a higher risk of developing the disease. United States , the number of new cases of UC in the United States was between 2.2 and 14.3 per 100,000 per year. The number of people affected in the United States in 2004 was between 37 and 246 per 100,000. Canada In Canada, between 1998 and 2000, the number of new cases per year was 12.9 per 100,000 population or 4,500 new cases. The number of people affected was estimated to be 211 per 100,000 or 104,000. United Kingdom In the United Kingdom 10 per 100,000 people newly develop the condition a year while the number of people affected is 243 per 100,000. Approximately 146,000 people in the United Kingdom have been diagnosed with UC. | causes of Fecal incontinence | causes of Hematochezia | medical cause of Fecal incontinence | risks of Necrotizing enterocolitis | symptom of Hirschsprung's disease | risks of Short bowel syndrome | medical cause of Constipation | causes of Peritonitis | 00
| 4,512 |