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Abscess originating from a tooth, that has spread to the buccal space. Above: deformation of the cheek on the second day. Below: deformation on the third day. CEJ, which is the line separating the crown (in this case, heavily decayed) and the roots. The double headed arrow (bottom right) shows the extent of the abscess that surrounds the apex of the palatal root. The pain is continuous and may be described as extreme, growing, sharp, shooting, or throbbing. Putting pressure or warmth on the tooth may induce extreme pain. The area may be sensitive to touch and possibly swollen as well. This swelling may be present at either the base of the tooth, the gum, and/or the cheek, and sometimes can be reduced by applying ice packs. An acute abscess may be painless but still have a swelling present on the gum. It is important to get anything that presents like this checked by a<unk> professional as it may become chronic later. In some cases, a tooth abscess may perforate bone and start draining into the surrounding tissues creating local facial swelling. In some cases, the lymph glands in the neck will become swollen and tender in response to the infection. It may even feel like a migraine as the pain can transfer from the infected area. The pain does not normally transfer across the face, only upwards or downwards as the nerves that serve each side of the face are separate. Severe aching and discomfort on the side of the face where the tooth is infected is also fairly common, with the tooth itself becoming unbearable to touch due to extreme amounts of pain. | Dental abscess | Periodontal abscess | Gingival cyst | Salivary gland fistula | Posthitis | Median mandibular cyst | Nasal fracture | Cuffitis | 00
| 43,013 |
<unk> looks different depending on how early it enters the digestive tract—and thus how much digestive action it has been exposed to—and how much there is. The term can refer either to melena, with a black appearance, typically originating from upper gastrointestinal bleeding; or to hematochezia, with a red color, typically originating from lower gastrointestinal bleeding. Evaluation of the<unk> found in<unk> depends on its characteristics, in terms of color, quantity and other features, which can point to its source, however, more serious conditions can present with a mixed picture, or with the form of bleeding that is found in another section of the tract. The term<unk> " is usually only used to describe visible<unk> , and not fecal occult<unk> , which is found only after physical examination and chemical laboratory testing. In infants, the Apt test can be used to distinguish fetal hemoglobin from maternal<unk> based on the differences in composition of fetal hemoglobin as compared to the hemoglobin found in adults. | Blood in stool | Fecal vomiting | Nipple discharge | Bloating | Rectal bleeding | Rectal discharge | Abdominal pain | Rectal pain | 00
| 30,177 |
<unk> is the maximum level of pain that a person is able to tolerate.<unk> is distinct from pain threshold (the point at which pain begins to be felt). The perception of pain that goes in to<unk> has two major components. First is the biological component—the headache or skin prickling that activates pain receptors. Second is the brain’s perception of pain—how much focus is spent paying attention to or ignoring the pain. The brain’s perception of pain is a response to signals from pain receptors that sensed the pain in the first place. | Pain tolerance | Threshold of pain | Referred pain | Sense of balance | Affective sensation | Physical strength | Pain and pleasure | Anesthesia awareness | 00
| 45,798 |
<unk> consist of three components (1) ganglion cells, (2) epithelioid cells (neuroendocrine-like), and (3) spindle cells (schwannoma-like). The microscopic differential diagnosis includes poorly differentiated carcinoma, neuroendocrine tumour and<unk> .<unk> s may be sporadic or arise in the context neurofibromatosis type 1. Image:<unk> - intermed mag. Intermed. mag. Image:<unk> - 2 - intermed mag. Intermed. mag. Image:<unk> - very high mag. Very high mag. Image:<unk> - 2 - very high mag. Very high mag. | Gangliocytic paraganglioma | Glomus tumor | Pineocytoma | Pheochromocytoma | Paraganglioma | Somatostatinoma | Gastrinoma | Oncocytoma | 00
| 63,155 |
Diet plays an important role in the genesis of<unk> . Personal choices, food advertising, social customs and cultural influences, as well as food availability and pricing all play a role in determining what and how much an individual eats. | Diet and obesity | Alcohol and sex | Alcohol and weight | Smoking and pregnancy | Obesity and the environment | Diet and cancer | Alcohol use and sleep | Diet and attention deficit hyperactivity disorder | 00
| 55,006 |
Model of a normal heart (left); and a weakened heart, with over-stretched muscle and dilation of left ventricle (right); both during diastole Heart failure is caused by any condition that reduces the efficiency of the heart muscle, through damage or overloading. Over time, these increases in workload, which are mediated by long-term activation of neurohormonal systems such as the renin–angiotensin system, lead to fibrosis, dilation, and structural changes in the shape of the left ventricle from elliptical to spherical. The heart of a person with heart failure may have a reduced force of contraction due to overloading of the ventricle. In a normal heart, increased filling of the ventricle results in increased contraction force by the Frank–Starling law of the heart, and thus a rise in cardiac output. In heart failure, this mechanism fails, as the ventricle is loaded with blood to the point where heart muscle contraction becomes less efficient. This is due to reduced ability to cross-link actin and myosin filaments in over-stretched heart muscle. | complications of Idiopathic pulmonary fibrosis | complications of Bronchiolitis | complications of Alpha-1 antitrypsin deficiency | complications of Melioidosis | medical cause of Bronchiolitis obliterans | symptom of Idiopathic pulmonary fibrosis | medical cause of Bronchiolitis | complications of Asbestosis | 00
| 9,476 |
<unk> () (brand names Colpotrofin, Colpotrophine, Delipoderm), also known as estradiol 3-propyl 17β-methyl diether, is a synthetic estrogen which is used topically in a 1% cream formulation for the treatment of vaginal atrophy in women. It is the 3-propyl and 17β-methyl diether of estradiol and does not appear to convert into estradiol in the body.<unk> is minimally absorbed and appears to have negligible systemic estrogenic effect. The drug has been described as a tropic agent and antiseborrheic. It has not been found to be effective in the treatment of pattern hair loss or other conditions of cutaneous androgenization.<unk> was first introduced in France in 1974 and has been marketed in 34 countries worldwide. It has been used in millions of women. | Promestriene | Dienogest | Estropipate | Gestodene | Hexestrol | Progabide | Bisoctrizole | Lapisteride | 00
| 58,706 |
Hydroyapatite crystal deposition in the joint causes the release of collagenases, serine proteases, elastases, and interleukin-1. This leads to acute and rapid decline in joint function and degradation of joint anatomy. Subsequently, disruption of the rotator cuff ensues. | Milwaukee shoulder syndrome | Facet syndrome | Anterior interosseous syndrome | Medial knee injuries | Iliocostal friction syndrome | Heel pad syndrome | Iliotibial band syndrome | Back strain | 00
| 59,056 |
Hypertension As with other angiotensin II receptor antagonists,<unk> is indicated for the treatment of hypertension.<unk> has an additive antihypertensive effect when combined with a diuretic, such as chlorthalidone. It is available in a fixed-combination formulation with a low dose of the thiazide diuretic hydrochlorothiazide.<unk> /hydrochlorothiazide combination preparations are marketed under various trade names including Atacand Plus, Hytacand, Blopress Plus, Advantec and Ratacand Plus. Congestive heart failure Angiotensin receptor blockers such as<unk> and valsartan have been demonstrated in randomised controlled trials to reduce heart failure hospitalisations and cardiovascular deaths for chronic heart failure patients with reduced left ventricular ejection fraction (LVEF ≤40%) and are intolerant to angiotensin-converting enzyme inhibitors. Prehypertension In a four-year randomized controlled trial,<unk> was compared to placebo to see whether it could prevent or postpone the development of full-blown hypertension in people with so-called prehypertension. During the first two years of the trial, half of participants were given<unk> while the other half received placebo;<unk> reduced the risk of developing hypertension by nearly two-thirds during this period. In the last two years of the study, all participants were switched to placebo. By the end of the study,<unk> had significantly reduced the risk of hypertension, by more than 15%. Serious adverse effects were more common among participants receiving placebo than in those given<unk> . Prevention of atrial fibrillation Results from a meta-analysis completed in 2005 demonstrated a reduction in atrial fibrillation in patients with systolic left ventricular dysfunction treated with<unk> , another angiotensin receptor blocker or an angiotensin converting enzyme inhibitor. Evidence for the use of<unk> specifically is also supported by an analysis of the CHARM study which demonstrated a reduction in atrial fibrillation in patients with systolic left ventricular dysfunction. While these studies have demonstrated a potential additional benefit for<unk> when used in patients with systolic left ventricular dysfunction, additional studies are required to further elucidate the role of<unk> in the prevention of atrial fibrillation in other population groups. Diabetic retinopathy Use of antihypertensive drugs has been demonstrated to slow the progression of diabetic retinopathy; the role of<unk> specifically in reducing progression in type 1 and type 2 diabetes is still up for debate. Results from a 2008 study on patients with type 1 diabetes showed there was no benefit in using<unk> to reduce progression of diabetic retinopathy when compared to placebo.<unk> has been demonstrated to reverse the severity (cause regression) of mild to moderate diabetic retinopathy in patients with type 2 diabetes. The patient populations investigated in these studies were limited to mostly Caucasians and those younger than 75 years of age, so generalization of these findings to other population groups should be done with caution. Migraine prophylaxis In two small randomised, controlled cross-over studies,<unk> was shown to be effective for the prophylaxis of migraine, however, further studies would enhance confidence in its use for this indication. | Candesartan | Olmesartan | Irbesartan | Valsartan | Losartan | Azilsartan | Cyclothiazide | Telmisartan | 00
| 22,117 |
As recognition of<unk> is relatively recent, there are limited studies on its epidemiology. It is therefore difficult to make an accurate estimation of prevalence. Furthermore, age of onset is almost impossible to estimate; age at diagnosis is frequently misused as the age of onset. A 2011 study estimated the incidence of<unk> in Japan at 2.8–10.8/million population, with a median age of onset of 58 years. | IgG4-related disease | IgG4-related skin disease | Anti-IgLON5 disease | IgA vasculitis | Isolated primary immunoglobulin M deficiency | Antisynthetase syndrome | Undifferentiated connective tissue disease | Leukotriene receptor antagonist-associated Churg–Strauss syndrome | 00
| 61,358 |
They commonly infect the skin, eyes, and viscera in humans. * Ancylostoma brasiliensis causes cutaneous larva migrans. * Toxocara causes visceral larva migrans. | Ancylostomiasis | Gnathostomiasis | Naegleriasis | Dracunculiasis | Scarabiasis | Necatoriasis | Mansonelliasis | Trichuriasis | 00
| 46,193 |
<unk> (brand names Imiprex, Elepsin), or imipramine N-oxide, is a tricyclic antidepressant (TCA) that was introduced in Europe in the 1960s for the treatment of depression.<unk> is both an analogue and a metabolite of imipramine, and has similar effects. However, in clinical trials,<unk> was found to have a faster onset of action, slightly higher efficacy, and fewer and less marked side effects, including diminished orthostatic hypotension and anticholinergic effects like dry mouth, sweating, dizziness, and fatigue.<unk> 's pharmacology has not been well elucidated, but based on its very close relationship with imipramine, it likely acts as a serotonin and norepinephrine reuptake inhibitor and serotonin, adrenenaline, histamine, and muscarinic acetylcholine receptor antagonist, though with weaker antiadrenergic and anticholinergic actions.<unk> has been said to be a prodrug of imipramine. | Imipraminoxide | Toremifene | Tasimelteon | Pulmocide | Co-dydramol | Plerixafor | Deflazacort | Mitapivat | 00
| 57,893 |
<unk> is<unk> of the abdominal aorta and inferior vena cava by the gravid uterus when a pregnant woman lies on her back, i.e. in the supine position. It is a frequent cause of low maternal blood pressure (hypotension), which can result in loss of consciousness and in extreme circumstances fetal demise.<unk><unk> is thought to be the cause of supine hypotensive syndrome. Supine hypotensive syndrome is characterized by pallor, tachycardia, sweating, nausea, hypotension and dizziness and occurs when a pregnant woman lies on her back and resolves when she is turned on her side. Medical management of supine hypotensive syndrome can include turning the patient to the left recumbent position (so the uterus is not sitting on the IVC) and administering IV fluids. The aorta and inferior vena cava are central vessels, the largest artery and vein. They supply blood to the heart, and the rest of the body. Thus, when there is<unk> due to the weight of the fetus, signs of shock (sweating, pallor, fast and weak pulse) may be experienced. Patients should be placed in a left lateral recumbent position and emergency help summoned immediately. | Aortocaval compression syndrome | Inferior vena cava syndrome | Superior vena cava syndrome | Thoracic aortic aneurysm | Aortic dissection | Inflammatory aortic aneurysm | Acute aortic syndrome | Aortic rupture | 00
| 42,503 |
<unk> is used in form of the acetate. It is a prodrug that is converted to active metabolite<unk> and inactive metabolite<unk> -M1. Initial in vitro and in vivo animal studies referred to<unk> acetate as PPI-0903. Characteristic of cephalosporins,<unk> has a bicyclic ring with four-member β-lactam ring fused to a six-member cephem ring.<unk> is thought to have activity against MRSA with its 1,3-thiazole ring. | Ceftaroline fosamil | Imipenem | Amikacin | Imipenem/cilastatin/relebactam | Rifampicin | Secnidazole | Doxycycline | Doripenem | 00
| 57,138 |
CT scan of a<unk> in a patient with COPD A<unk> also known as scabbard<unk> is a<unk> that has an abnormal shape. The posterior area of the<unk> increases in diameter while the lateral measurement decreases. | Saber-sheath trachea | Bird fancier's lung | Bio-secure bubble | Metsovo lung | Farmer's lung | Tracheoinnominate fistula | Subglottic stenosis | Cramp-ring | 00
| 47,780 |
The<unk> (also VATER association, and less accurately<unk> syndrome) refers to a recognized group of birth defects which tend to co-occur (see below). This pattern is a recognized association, as opposed to a syndrome, because there is no known pathogenetic cause to explain the grouped incidence. Each child with this condition can be unique. At present this condition is treated after birth with issues being approached one at a time. Some infants are born with symptoms that cannot be treated and they do not survive. Also,<unk> can be linked to other similar conditions such as Klippel Feil and Goldenhar syndrome including crossovers of conditions. No specific genetic or chromosome problem has been identified with<unk> .<unk> can be seen with some chromosomal defects such as Trisomy 18 and is more frequently seen in babies of diabetic mothers.<unk> , however, is most likely caused by multiple factors.<unk> specifically refers to the abnormalities in structures derived from the embryonic mesoderm. | VACTERL association | DiGeorge syndrome | Independent SAGE | Head injury criterion | Disease cluster | MURCS association | Clichy criteria | Injured reserve list | 00
| 29,480 |
Symptoms of<unk> include but are not limited to pain, dysesthesias (uncomfortable sensations), and complete loss of sensory and motor function of the affected nerve. | Neurotmesis | Axonotmesis | Hutchinson's mask | Laryngeal mask airway | Electrolarynx | Cragie tube | Surgical mask | Schimmelbusch mask | 00
| 22,211 |
<unk> (also known as "lamellar dyshidrosis", "recurrent focal palmar peeling", "recurrent palmar peeling") is a sometimes harmless, sometimes painful skin condition that can affect the focal surface of the fingers and/or the palm or soles of the feet. It is often misdiagnosed as chronic contact dermatitis or psoriasis. It is characterized by dry skin and superficial, air-filled blisters. These blisters can be peeled off very easily and will leave reddish, tender areas. The loss of this corneal layer of the skin, which protects the underlying layers, leaves the skin more vulnerable to dryness and cracking. | Keratolysis exfoliativa | Tinea versicolor | Tinea faciei | Keratoderma blennorrhagicum | Granuloma faciale | Lentigo simplex | Herpes labialis | Streptococcal intertrigo | 00
| 52,726 |
The most accepted way to treat GP is with the use of corticosteroids, i.e. prednisone; and/or topical steroids, i.e. clobetasol and betamethasone. Suppressing the immune system with corticosteroids helps by decreasing the number of antibodies attacking the skin. Treating GP can be difficult and can take several months. Some cases of GP persist for many years. In the post partum period, if necessary, the full range of immunosuppressive treatment may be administered for cases unresponsive to corticosteroid treatments, such as tetracyclines, nicotinamide, cyclophosphamide, ciclosporin, goserelin, azathioprine, dapsone, rituximumab, or plasmaphoresis, or intravenous immunoglobulin may sometimes be considered when the symptoms are severe. There is no cure for GP. Women who have GP are considered in remission if they are no longer blistering. Remission can last indefinitely, or until a subsequent pregnancy. GP usually occurs in subsequent pregnancies; however, it often seems more manageable because it is anticipated. | Gestational pemphigoid | Eczema vaccinatum | Alopecia mucinosa | Poikiloderma vasculare atrophicans | Vulvar childhood pemphigoid | Vesicular pemphigoid | Steroid rosacea | Paraneoplastic pemphigus | 00
| 45,312 |
<unk> is a topical steroid that comes in the form of a cream. It is manufactured by E. Fougera & Co. and is used as an anti-inflammatory and anti-itching agent, like other topical corticosteroids. It is prescribed for psoriasis and atopic dermatitis, among other conditions. With respect to potency, it is regarded as a Class I corticosteroid of classes I – VII in the United States. No long-term animal studies have been done to determine whether<unk> could have carcinogenic properties. Little data is available regarding whether<unk> would be present in great enough quantities to cause harm to a infant. | Diflorasone diacetate | Fluticasone furoate | Fluticasone propionate | Flumetasone | Clobetasone | Fluticasone | Betamethasone dipropionate | Fluticasone/salmeterol | 00
| 40,081 |
Various studies have shown that insertion and use of the standard tracheal<unk> is easy, providing a clear airway in the majority of cases. Comparative studies indicate that the standard<unk> is generally as effective as the<unk> mask airway, while some studies indicate that the Pro-seal<unk> mask may be more effective than the standard<unk> under controlled ventilation conditions in general anaesthesia. The indications and contraindications for use of the<unk> are similar to those of the<unk> mask airway and include the use in general anaesthesia for minor surgical operations. Several studies describe the usefulness of the device in securing a difficult airway, even in cases where insertion of the<unk> mask had failed. The double-lumen<unk> -Suction II, with the possibility of placing a gastric<unk> , has been found to have distinct advantages over the standard<unk> and has been recommended as a first-line device to secure the airway in emergency situations when direct laryngoscopy fails in neonates and infants. The<unk> is also recommended for medical personnel not experienced in tracheal intubation, and as a rescue device when intubation has failed in adults. According to the manufacturer the use of<unk> s is contraindicated in people with an intact gag reflex, known oesophageal disease, and people who have ingested caustic substances. | Laryngeal tube | Electrolarynx | Cragie tube | Combitube | Laryngeal mask airway | Nasal cannula | Tracheal tube | Tympanostomy tube | 00
| 64,610 |
<unk> has an autosomal recessive pattern of inheritance. Mutations in the following genes cause<unk> : * BCKDHA () * BCKDHB () * DBT () * DLD () These four genes produce proteins that work together as the branched-chain alpha-keto acid dehydrogenase complex. The complex is essential for breaking down the amino acids leucine, isoleucine, and valine. These are present in some quantity in almost all kinds of food, but in particular, protein-rich foods such as dairy products, meat, fish, soy, gluten, eggs, nuts, whole grains, seeds, avocados, algae, edible seaweed, beans, and pulses. Mutation in any of these genes reduces or eliminates the function of the enzyme complex, preventing the normal breakdown of isoleucine, leucine, and valine. As a result, these amino acids and their by-products build up in the body. Because high levels of these substances are toxic to the brain and other organs, this accumulation leads to the serious medical problems associated with<unk> . This condition has an autosomal recessive inheritance pattern, which means the defective gene is located on an autosome, and two copies of the gene – one from each parent – must be inherited to be affected by the disorder. The parents of a child with an autosomal recessive disorder are carriers of one copy of the defective gene, but are usually not affected by the disorder. | Maple syrup urine disease | Urocanic aciduria | Alpha-aminoadipic and alpha-ketoadipic aciduria | Hawkinsinuria | 3-Methylglutaconic aciduria | Homocystinuria | Alkaptonuria | 2-Hydroxyglutaric aciduria | 00
| 25,287 |
A<unk> is an infection caused by pathogens (such as bacteria and viruses) that use mother-to-child transmission, that is, transmission directly from the mother to an embryo, fetus, or baby during pregnancy or childbirth. It can occur when the mother has a pre-existing disease or becomes infected during pregnancy. Nutritional deficiencies may exacerbate the risks of perinatal infections. | Vertically transmitted infection | Intentional contagion of infection | Blood-borne disease | Opportunistic infection | Environmental disease | Laboratory-acquired infection | Sexually transmitted infection | Clonally transmissible cancer | 00
| 29,381 |
Screening for cancer is controversial in cases when it is not yet known if the test actually saves lives. Screening can lead to substantial false positive result and subsequent invasive procedures. The controversy arises when it is not clear if the benefits of screening outweigh the risks of follow-up diagnostic tests and cancer treatments.<unk> is not indicated unless life expectancy is greater than five years and the benefit is uncertain over the age of 70. Several factors are considered to determine whether the benefits of screening outweigh the risks and the costs of screening. These factors include: *Possible harms from the screening test: Some types of screening tests, such as X-ray images, expose the body to potentially harmful ionizing radiation. There is a small chance that the radiation in the test could cause a new cancer in a healthy person. Screening mammography, used to detect breast cancer, is not recommended to men or to young women because they are more likely to be harmed by the test than to benefit from it. Other tests, such as a skin check for skin cancer, have no significant risk of harm to the patient. A test that has high potential harms is only recommended when the benefits are also high. *The likelihood of the test correctly identifying cancer: If the test is not sensitive, then it may miss cancers. If the test is not specific, then it may wrongly indicate cancer in a healthy person. All<unk> tests produce both false positives and false negatives, and most produce more false positives. Experts consider the rate of errors when making recommendations about which test, if any, to use. A test may work better in some populations than others. The positive predictive value is a calculation of the likelihood that a positive test result actually represents cancer in a given individual, based on the results of people with similar risk factors. *The likelihood of cancer being present: Screening is not normally useful for rare cancers. It is rarely done for young people, since cancer is largely a disease found in people over the age of 50. Countries often focus their screening recommendations on the major forms of treatable cancer found in their population. For example, the United States recommends universal screening for colon cancer, which is common in the US, but not for stomach cancer, which is less common; by contrast, Japan recommends screening for stomach cancer, but not colon cancer, which is rarer in Japan. Screening recommendations depend on the individual's risk, with high-risk people receiving earlier and more frequent screening than low-risk people. *Possible harms from follow-up procedures: If the screening test is positive, further diagnostic testing is normally done, such as a biopsy of the tissue. If the test produces many false positives, then many people will undergo needless medical procedures, some of which may be dangerous. *Whether suitable treatment is available and appropriate: Screening is discouraged if no effective treatment is available. When effective and suitable treatment is not available, then diagnosis of a fatal disease produces significant mental and emotional harms. For example, routine screening for cancer is typically not appropriate in a very frail elderly person, because the treatment for any cancer that is detected might kill the patient. *Whether early detection improves treatment outcomes: Even when treatment is available, sometimes early detection does not improve the outcome. If the treatment result is the same as if the screening had not been done, then the only screening program does is increase the length of time the person lived with the knowledge that he had cancer. This phenomenon is called lead-time bias. A useful screening program reduces the number of years of potential life lost (longer lives) and disability-adjusted life years lost (longer healthy lives). *Whether the cancer will ever need treatment: Diagnosis of a cancer in a person who will never be harmed by the cancer is called overdiagnosis. Overdiagnosis is most common among older people with slow-growing cancers. Concerns about overdiagnosis are common for breast and prostate cancer. *Whether the test is acceptable to the patients:If a screening test is too burdensome, such as requiring too much time, too much pain, or culturally unacceptable behaviors, then people will refuse to participate. *Cost of the test: Some expert bodies, such as the United States Preventive Services Task Force, completely ignore the question of money. Most, however, include a cost-effectiveness analysis that, all else being equal, favors less expensive tests over more expensive tests, and attempt to balance the cost of the screening program against the benefits of using those funds for other health programs. These analyses usually include the total cost of the screening program to the healthcare system, such as ordering the test, performing the test, reporting the results, and biopsies for suspicious results, but not usually the costs to the individual, such as for time taken away from employment. *The extent to which a cancer is treatable: if a person has a low life expectancy or otherwise is in the end stages of a chronic condition, then such a patient may have a better life by ignoring the cancer even if one were found. If the diagnosis of cancer would not result in a change in care then<unk> would not likely result in a positive outcome. Overdiagnosis in this case occurs, for example, in patients with end-stage renal disease and organizations recommend against<unk> for such patients. | Cancer screening | Breast cancer screening | Lung cancer screening | Prostate cancer screening | Cervical screening | Cardiology diagnostic tests and procedures | Cancer staging | Newborn screening | 00
| 55,728 |
Illustration showing a heart with a<unk> Sketch showing heart with<unk> . A:<unk> rctation (narrowing) of the<unk> . 1:Inferior vena<unk> va, 2:Right pulmonary veins, 3: Right pulmonary artery, 4:Superior vena<unk> va, 5:Left pulmonary artery, 6:Left pulmonary veins, 7:Right ventricle, 8:Left ventricle, 9:Pulmonary artery, 10:Aorta Schematic drawing of alternative locations of<unk> , relative to the ductus arteriosus. A: Ductal<unk> rctation, B: Preductal<unk> rctation, C: Postductal<unk> rctation. 1:<unk> ascendens, 2: Arteria pulmonalis, 3: Ductus arteriosus, 4:<unk> descendens, 5: Truncus brachiocephalicus, 6: Arteria<unk> rotis communis sinistra, 7: Arteria subclavia sinistra 3D model of<unk> rctation of<unk> There are three types of<unk> c<unk> rctations: # Preductal<unk> rctation: The narrowing is proximal to the ductus arteriosus. Blood flow to the<unk> that is distal to the narrowing is dependent on the ductus arteriosus; therefore severe<unk> rctation<unk> n be life-threatening. Preductal<unk> rctation results when an intracardiac anomaly during fetal life decreases blood flow through the left side of the heart, leading to hypoplastic development of the<unk> . This is the type seen in approximately 5% of infants with Turner syndrome. # Ductal<unk> rctation: The narrowing occurs at the insertion of the ductus arteriosus. This kind usually appears when the ductus arteriosus closes. # Postductal<unk> rctation: The narrowing is distal to the insertion of the ductus arteriosus. Even with an open ductus arteriosus, blood flow to the lower body<unk> n be impaired. This type is most common in adults. It is associated with notching of the ribs (because of collateral circulation), hypertension in the upper extremities, and weak pulses in the lower extremities. Postductal<unk> rctation is most likely the result of the extension of a muscular artery (ductus arteriosus) into an elastic artery<unk> during fetal life, where the contraction and fibrosis of the ductus arteriosus upon birth subsequently narrows the<unk> c lumen.<unk> c<unk> rctation and<unk> c stenosis are both forms of<unk> c narrowing. In terms of word root meanings, the names are not different, but a conventional distinction in their usage allows differentiation of clinical aspects. This spectrum is dichotomized by the idea that<unk> c<unk> rctation occurs in the<unk> c arch, at or near the ductus arteriosus, whereas<unk> c stenosis occurs in the<unk> c root, at or near the<unk> c valve. This naturally could present the question of the dividing line between a post valvular stenosis and a preductal<unk> rctation; nonetheless, the dichotomy has a practical use, as most defects are either one or the other. | Coarctation of the aorta | Familial thoracic aortic aneurysm | Annuloaortic ectasia | Double aortic arch | Interrupted aortic arch | Aortic stenosis | Pulmonary vein stenosis | Pulmonic stenosis | 00
| 19,544 |
<unk> is used for the treatment of moderate to severe pain for both acute (following injury, surgery, etc.) and chronic musculoskeletal pain. It is also specifically indicated for controlling the pain of diabetic neuropathy when around-the-clock opioid medication is required. Extended-release formulations of<unk> are not indicated for use in the management of acute pain.<unk> is Pregnancy Category C. There are no adequate and well-controlled studies of<unk> in pregnant women, and<unk> is not recommended for use in women during and immediately prior to labor and delivery. There are no adequate and well-controlled studies of<unk> in children. | Tapentadol | Tramadol | Desmetramadol | Acetylmethadol | Hydrocodone | Etodolac | Ketorolac | Noroxycodone | 00
| 47,096 |
The pathogenesis of infectious/inflammatory disease in the<unk> s most likely has its basis in their anatomic location and their inherent function as organ of immunity, processing infectious material, and other antigens and then becoming, paradoxically, a focus of infection/inflammation. No single theory of pathogenesis has yet been accepted, however. Viral infection with secondary bacterial invasion may be one mechanism of the initiation of chronic disease, but the effects of the environment, host factors, the widespread use of antibiotics, ecological considerations, and diet all may play a role. A recent cross-sectional study revealed a high rate of prevalent virus infections in non-acutely ill patients undergoing routine<unk> lectomy. However, none of the 27 detected viruses showed positive association to the<unk> lar disease. In children, the<unk> s are common sites of infections that may give rise to acute or chronic<unk> litis. However, it is still an open question whether<unk> lar hypertrophy is also caused by a persistent infection.<unk> lectomy is one of the most common major operations performed on children. The indications for the operation have been complicated by the controversy over the benefits of removing a chronically infected tissue and the possible harm caused by eliminating an important immune inductive tissue. The information that is necessary to make a rational decision to resolve this controversy can be obtained by understanding the immunological potential of the normal<unk> s and comparing these functions with the changes that occur in the chronically diseased counterparts. Acute<unk> litis A medical animation still that shows<unk> litis.<unk> litis is the inflammation of<unk> s. Acute<unk> litis is the most common manifestation of<unk> lar disease. It is associated with sore throat, fever and difficulty swallowing. The<unk> s may appear normal sized or enlarged but are usually erythematous. Often, but not always, exudates can be seen. Not all these signs and symptoms are present in every patient. Recurrent<unk> litis Recurrent infection has been variably defined as from four to seven episodes of acute<unk> litis in one year, five episodes for two consecutive years or three episodes per year for 3 consecutive years.<unk> lar hypertrophy<unk> lar hypertrophy is the enlargement of the<unk> s, but without the history of inflammation. Obstructive<unk> lar hypertrophy is currently the most common reason for<unk> lectomy. These patients present with varying degrees of disturbed sleep which may include symptoms of loud snoring, irregular breathing, nocturnal choking and coughing, frequent awakenings, sleep apnea, dysphagia and/or daytime hypersomnolence. These may lead to behavioral/mood changes in patients and facilitate the need for a polysomnography in order to determine the degree to which these symptoms are disrupting their sleep. | Palatine tonsil | Cauliflower ear | Oral torus | Periorbita | Symphytum | Adina | Danger triangle of the face | Clitoral hood | 00
| 11,009 |
<unk> is characterized by sacralization of the lowest lumbar vertebral body and lumbarization of the uppermost sacral segment. It involves a total or partial unilateral or bilateral fusion of the transverse process of the lowest lumbar vertebra to the sacrum, leading to the formation of a transitional 5th lumbar vertebra. Of importance is that this syndrome will result in a pain generating 4th lumbar disc resulting in a "sciatic" type of a pain correlating to the 5th lumbar nerve root. Usually the transitional vertebra will have a "spatulated" transverse process on one side resulting in articulation or partial articulation with the sacrum or at time the ilium and in some cases with both. This results in limited / altered motion at the lumbo-sacral articulation. This loss of motion will then be compensated for at segments superior to the transitional vertebra resulting in accelerated degeneration and strain through the L4 disc level which can become symptomatic and inflame the adjacent L5 nerve root resulting in "sciatic" or radicular pain patterns. Scoliosis is frequently found to be associated. | Bertolotti's syndrome | Renpenning's syndrome | Liddle's syndrome | Banti's syndrome | Grisel's syndrome | Wilkinson's syndrome | Bálint's syndrome | Susac's syndrome | 00
| 35,950 |
An<unk> (EGCT) occurs in the abnormal growth of<unk> <unk> s in the gonads (testes or ovaries) and the areas other than the brain via tissue, lymphatic system, or circulatory system. The<unk> can be benign or malignant (cancerous) by its growth rate. According to the National Cancer Institute and St. Jude Children's Research Hospital, the chance of children who are under 15 years old having EGCTs is 3%, in comparison to adolescents, a possibility of 14% with aged 15 to 19 can have EGCTs. There is no obvious cut point in between children and adolescents. However, common cut points in researches are 11 years old and 15 years old. The signs and symptoms are varied according to the location of the EGCTs. Common symptoms are fever, constipation, abdomen mass with or without pain, backache, bumps in testicles for male, abnormal bleeding in vagina or miss menses for female. The cause of EGCTs has not been found. Some potential risk factors include smoking, alcohol consumption, specific genetic syndromes, congenital abnormalities, and more. Among these risk factors, specifically, the Klinefelter syndrome (KS) and cryptorchidism increase the possibility for males having testicular<unk> s and the Turner syndrome (TS) affects the risk of having ovarian cysts in females. Swyer syndrome and other syndromes may increase the risk of having EGCTs in the gonads. The diagnosis is made by a combination of picture-taking testaments, physical examinations, and the investigation of samples from blood, urine, and tissue by using microscope. By collecting the data from the testaments, clinicians use the classifications of EGCTs to assist diagnosing the type of<unk> . Due to the probability of having EGCTs among pediatric, several treatments had been used to remove the<unk> or kill the cancer<unk> s. The treatments include surgery, chemotherapy, radiation therapy, targeted therapy, salvage therapy, and clinical trials. Among the treatments, the BEP combination (bleomycin, etoposide, cisplatin) is the standard chemotherapy treatment method for EGCTs by increasing the survival rate. The prognosis of EGCTs are varied after a series of treatments and follow-up testaments which include factors of age, gender, type of EGCT, location the cyst, treatment method, response, and symptoms are presented after a period of time. __TOC__ | Extracranial germ cell tumor | Glial tumor | Central nervous system cyst | Dysembryoplastic neuroepithelial tumour | Neuroectodermal neoplasm | Central nervous system primitive neuroectodermal tumor | Primary central nervous system lymphoma | Primitive neuroectodermal tumor | 00
| 72,170 |
Diagnosis of<unk> can be difficult, since the symptoms are hard to separate from complications due to the original<unk> infection, and from the normal infirmities of aging. No laboratory test for<unk> is known, nor are any other specific diagnostic criteria. Three important criteria are recognized, including previous diagnosis of<unk> , long interval after recovery, and gradual onset of weakness. In general,<unk> is a diagnosis of exclusion whereby other possible causes of the symptoms are eliminated. Neurological examination aided by other laboratory studies can help to determine what component of a neuromuscular deficit occurred with<unk> and what components are new and to exclude all other possible diagnoses. Objective assessment of muscle strength in<unk> patients may not be easy. Changes in muscle strength are determined in specific muscle groups using various muscle scales that quantify strength, such as the Medical Research Council (MRC) scale. magnetic resonance imaging, neuroimaging, and electrophysiological studies, muscle biopsies, or spinal fluid analysis may also be useful in establishing a<unk> diagnosis. | Post-polio syndrome | Leukomyelitis | Guillain–Barré syndrome | FACES syndrome | Acute disseminated encephalomyelitis | Eastern equine encephalitis | Tension myositis syndrome | Postvaccinal encephalitis | 00
| 11,672 |
It has received regulatory approval for use as a treatment for non-small cell lung cancer, although there is emerging evidence to support its use in other cancers such as breast cancer. | Afatinib | Imatinib | Neratinib | Dasatinib | Capmatinib | Tucatinib | Ponatinib | Lapatinib | 00
| 51,529 |
Diagnosis of<unk> can be difficult and can require multiple examinations and histories provided by the patient. The<unk> history is essential and will indicate any further examinations required. The correct diagnosis of<unk> requires an in-depth<unk> history which will include: * Location of the<unk> * Timing * Duration * Associated symptoms * Exacerbating and alleviating factors * Description of the type of<unk> experienced e.g. dull, aching, throbbing, burning, tingling or pulsating. Other information and examinations include: * Full medical history * Full dental history * Full social history * Clinical examination * Radiographic examination | Orofacial pain | Periocular injection | Periorbital hyperpigmentation | Tinnitus | Gastroptosis | Enophthalmos | Ear pain | Subconjunctival injection | 00
| 64,860 |
<unk> is a surgical procedure that is sometimes used to treat gastroesophageal reflux, mainly in neurologically impaired children. It has been suggested as an alternative to Nissen fundoplication for these cases. Preliminary studies have shown it may have a lower failure rate and a lower incidence of recurrent reflux. | Esophagogastric dissociation | Esophageal dysphagia | Peripolesis | Esophageal spasm | Inspissation | Esophageal food bolus obstruction | Visakhapatnam gas leak | Odontoma dysphagia syndrome | 00
| 52,204 |
A<unk> is an exam offered to<unk> to review elements of their reproductive health. The exam includes a breast<unk> , a pelvic<unk> and a Pap smear but may also include other procedures. Hospitals employ strict policies relating to the provision of consent by the patient, the availability of chaperones at the<unk> , and the absence of other parties. | Well-woman examination | Birth control | Birth control | Clinical associates | HeartRhythm Case Reports | Independent medical examination | Injured reserve list | Timeline of psychology | 00
| 64,555 |
The symptoms can be roughly divided into convulsive symptoms and gangrenous symptoms. Convulsive Convulsive symptoms of<unk> Convulsive symptoms include painful seizures and spasms, diarrhea, paresthesias, itching, mental effects including mania or psychosis, headaches, nausea and vomiting. Usually the gastrointestinal effects precede central nervous system effects. Gangrenous The dry gangrene is a result of vasoconstriction induced by the ergotamine-ergocristine alkaloids of the fungus. It affects the more poorly vascularized distal structures, such as the fingers and toes. Symptoms include desquamation or peeling, weak peripheral pulses, loss of peripheral sensation, edema and ultimately the death and loss of affected tissues. Vasoconstriction is treated with vasodilators. | Ergotism | Dyssomnia | Aspermia | Orthosomnia | Somnophilia | Amnesia | Mania | Hypersomnia | 00
| 9,795 |
Although DNA analysis techniques such as polymerase chain reaction can be used to look for DNA of herpesviruses in spinal fluid or blood, the results may be negative, even in cases where other definitive symptoms exist. | Herpesviral meningitis | Fungal meningitis | Herpesviral encephalitis | Viral meningitis | Eastern equine encephalitis | Aseptic meningitis | Tick-borne encephalitis | Japanese encephalitis | 00
| 54,544 |
According to the Dietary Reference Intake review, neither plasma nor urine concentrations can serve as useful clinical indicators of<unk> status. Before<unk> became a standard ingredient in total parenteral nutrition (TPN), people getting TPN as their sole source of nutrition developed symptoms that were reversed within two-week after<unk> was added. | Chromium deficiency | Fluorine deficiency | Boron deficiency | Biotin deficiency | Metal toxicity | Lead poisoning | Fluoride toxicity | Selenium deficiency | 00
| 30,697 |
Treatment for gastroenteritis due to Y. enterocolitica is not needed in the majority of cases. Severe infections with systemic involvement (sepsis or bacteremia) often requires aggressive antibiotic therapy; the drugs of choice are doxycycline and an aminoglycoside. Alternatives include cefotaxime, fluoroquinolones, and co-trimoxazole. | Yersiniosis | Shigellosis | Bartonellosis | Rhinosporidiosis | Salmonellosis | Brucellosis | Rotaviral gastroenteritis | Cryptosporidiosis | 00
| 31,075 |
The most commonly reported side effects were: oral thrush, nausea, headache, and pain in the pharynx or larynx. More rarely reported side effects (occurring in <1% of patients during the clinical trial) include: tachycardia, palpitations, dry mouth, allergic reaction (bronchospasm, dermatitis, hives), pharyngitis, muscle spasms, tremor, dizziness, insomnia, nervousness, and hypertension. Patients experiencing an allergic reaction or increase in difficulty breathing while using this medication should immediately discontinue its use and contact their physician. | Mometasone/formoterol | Beclometasone/formoterol | Fluticasone/salmeterol | Budesonide/formoterol | Beclometasone/formoterol/glycopyrronium bromide | Fluticasone propionate | Arformoterol | Aclidinium bromide/formoterol | 00
| 61,521 |
<unk> <unk> is a progressively worsening condition where muscles in the extremities gradually weaken. The disorder, a pure<unk> neuropathy syndrome, is sometimes mistaken for amyotrophic lateral sclerosis (ALS) because of the similarity in the clinical picture, especially if muscle fasciculations are present.<unk> is thought to be autoimmune. It was first described in the mid-1980s. Unlike ALS, which affects both upper and lower<unk> neuron pathways,<unk> involves only the lower<unk> neuron pathway, specifically, the peripheral nerves emanating from the lower<unk> neurons. Definitive diagnosis is often difficult, and many<unk> patients labor for months or years under an ALS diagnosis before finally getting a determination of<unk> .<unk> usually involves very little pain; however, muscle cramps, spasms and twitches can cause pain for some sufferers.<unk> is not fatal, and does not diminish life expectancy. Many patients, once undergoing treatment, only experience mild symptoms over prolonged periods, though the condition remains slowly progressive.<unk> can however, lead to significant disability, with loss of function in hands affecting ability to work and perform everyday tasks, and "foot drop" leading to inability to stand and walk; some patients end up using aids like canes, splints and walkers. | Multifocal motor neuropathy | Progressive bulbar palsy | Small fiber peripheral neuropathy | Peripheral mononeuropathy | Progressive muscular atrophy | Facial onset sensory and motor neuropathy | Dissociated sensory loss | Proximal diabetic neuropathy | 00
| 60,653 |
<unk> may be avoided by using proper hygiene and sanitation with food preparation. This includes thoroughly cooking all meats. If food is to be stored longer than two hours, keep hot foods hot (over 140 °F) and cold foods cold (40 °F or under). Ensure to refrigerate leftovers promptly and store cooked food in a wide, shallow container and refrigerate as soon as possible. Sanitation is very important. Keep kitchens and food-serving areas clean and sanitized. Finally, as most<unk> food poisoning are the result of food handling, hand washing is critical. Food handlers should use hand sanitizers with alcohol or thorough hand washing with soap and water. Tips for hand washing: 1. Wash hands with warm, soapy water before and after handling raw foods. :a. First, wet your hands. : :b. Add soap to your hands. : :c. Rub both sides for at least 20 seconds. : :d. Rinse thoroughly. : :e. Air dry, or dry your hands with a clean towel or paper towel. 2. Always wash your hands after using the bathroom, after changing a baby's diaper, after touching pets or other animals, and after sneezing or coughing 3. Properly dress or glove. | Staphylococcal enteritis | Antibiotic-associated diarrhea | Clostridial necrotizing enteritis | Food protein-induced enterocolitis syndrome | Wilderness-acquired diarrhea | Porcine epidemic diarrhoea | Tropical sprue | Rotaviral gastroenteritis | 00
| 20,140 |
<unk> is used at a low dose in combination with ethinylestradiol (EE), an estrogen, in combined birth control pills. It has also been used in the treatment of gynecological conditions including vaginal bleeding, oligomenorrhea, polymenorrhea, hypermenorrhea, dysmenorrhea, secondary amenorrhea, and endometriosis and in France (under the brand name Lutéran) in menopausal hormone therapy in combination with an estrogen.<unk> is used at dosages of 1 to 2 mg/day in combined birth control pills and at dosages of 2 to 10 mg/day in the treatment of gynecological disorders. Combined birth control pills containing EE and<unk> have been found to be useful in reducing androgen-dependent symptoms such as skin and hair conditions. Dosages of<unk> of 15 to 20 mg/day have been found to improve hot flashes. High-dose<unk> -only tablets are used as a form of progestogen-only birth control, although they are not specifically licensed as such.<unk> has been widely used as a means of androgen deprivation therapy in the treatment of prostate cancer and benign prostatic hyperplasia (BPH) in Japan and South Korea, but has seen little use for these indications elsewhere in the world. It is used at dosages of 50 to 100 mg/day in the treatment of prostate diseases. Similarly to cyproterone<unk> (CPA),<unk> shows a lower risk of hot flashes than gonadotropin-releasing hormone analogues (GnRH analogues). The medication is the only other steroidal antiandrogen besides CPA that has been approved and used for the treatment of prostate cancer; megestrol<unk> has also been researched, but has not been approved.<unk> has also been found to be effective in the treatment of other androgen-dependent conditions such as acne, seborrhea, hirsutism, and pattern hair loss in women, similarly to CPA. It has been studied at moderate dosages of 4 to 12 mg/day in the treatment of precocious puberty in girls. It showed similar benefits as those of medroxyprogesterone<unk> in these girls and was found to reduce, but not abolish premature development such as breast growth and menstruation. Only slight or no axillary hair growth was observed in the girls.<unk> has also been used as a component of hormone therapy for transgender women, similarly to CPA and spironolactone, albeit mostly only in Japan.<unk> has been used to prevent the testosterone flare at the start of gonadotropin-releasing hormone agonist therapy in men with prostate cancer. Available forms<unk> is available in the form of oral tablets at low doses (2 mg) in combination with EE in birth control pills (e.g., as Belara in Germany), at low to moderate doses (2, 5, 10, 25 mg) alone (e.g., as Lutéran in France and Lutoral in Mexico), and at high doses (50 mg) alone (e.g., as Prostal in Japan and Prostal-L in South Korea). | Chlormadinone acetate | Methenmadinone acetate | Chlormethenmadinone acetate | Bolandiol dipropionate | Hydroxyprogesterone heptanoate | Ethinylestradiol sulfate | Ethinylestradiol sulfonate | Androstenediol dipropionate | 00
| 55,833 |
Being naturally present in the human body, CO2 is the only 100% biocompatible contrast agent, meaning no adverse reactions, such as allergy, nephrotoxicity, and hepatotoxicity.<unk><unk> is a negative contrast medium and it has a low radiopacity (while iodinated contrast media are defined as positive contrast media due to their high radiopacity). Contrast is caused by the different X-ray absorption coefficients between the tissue and the contrast agent. In the vascular imaging results produced using CO2, vessels look brighter rather than the surrounding tissues, because the contrast medium absorbs less X-ray radiations rather an iodine-based contrast medium, where the vessel are displayed in black. The CO2 does not mix with blood. At atmospheric pressure CO2 is in gaseous form and, when it comes out from the catheter, it forms a train of bubbles which displaces blood, causing a transient ischemia, in relation to the bloodstream (systolic pressure). When added together by DSA “stacking” software, the result is a composite diagnostic image of the frames.<unk><unk> is highly soluble, allowing multiple injections without a maximum dosage (per procedure, while it is 100 mL per injection by the literature), but, in case of multiple injections, should be considered and adequate time interval between them, so to allow the gas to be expelled from the body. Compared with the oxygen, the most present gaseous substance in the body, CO2 is more than 20 times more soluble, meaning the possibility of injecting high quantities in the body. High compressibility and explosive delivery. More pressure is exerted to the gas, more its density increases, resulting in a decrease in gas volume and an increase in gas pressure. The effusion of the gas from the catheter orifice into a state of lower pressure, such as a blood vessel, leads to a sudden increase in the volume of the gas - the “explosive delivery” or “jet effect” - which could lead to an excessive stress in vessels walls. To avoid this, immediately prior to the injection of CO2, a flush is performed, injecting small amounts of CO2 to reduce gas compression and guarantee gas delivery at a steady flow rate. CO2 is 400 times less viscous than iodinated contrast medium, allowing its injection through devices with a very little inner lumen, as microcatheters, or, even, with other devices inserted in the catheter, as guidewires, balloons or as in atherectomy procedures. The low viscosity of CO2 makes it easy to pass through small vessels, visualizing tight stenosis, collaterals, small bleedings and endoleaks in AAA procedures. Expulsion: Once dissolved in the plasma, CO2 is transported to the lungs and removed in a single pass by the alveoli, favoring the possibility of performing multiple injections without complications (in healthy patients, meaning no severe COPD or significative POF, especially in presence of pulmonary embolism). Buoyancy is defined as the tendency of a body to float when submerged into a fluid. CO2 is lighter than blood and, therefore, floats above the bloodstream. The main advantage is represented by the simplicity of filling the more superficial (in transverse plane) vessels of the body, conversely the main disadvantage consists in a less ease of filling the deeper ones. | Carbon dioxide angiography | Intravascular fluorescence | Xenon gas MRI | Thorpe tube flowmeter | Radionuclide angiography | Indocyanine green angiography | Intravascular imaging | Perfusion scanning | 00
| 73,619 |
A common symptom of<unk> is the attribution bias. These individuals typically have a biased perception of reality, often exhibiting more hostile beliefs. A<unk> person may view someone else's accidental behavior as though it is with intent or threatening. An investigation of a non-clinical<unk> population found that feeling powerless and depressed, isolating oneself, and relinquishing activities are characteristics that could be associated with those exhibiting more frequent<unk> . Some scientists have created different subtypes for the various symptoms of<unk> including erotic, persecutory, litigious, and exalted. Due to the suspicious and troublesome personality traits of<unk> , it is unlikely that someone with<unk> will thrive in interpersonal relationships. Most commonly<unk> individuals tend to be of a single status. According to some research there is a hierarchy for<unk> . The least common types of<unk> at the very top of the hierarchy would be those involving more serious threats. Social anxiety is at the bottom of this hierarchy as the most frequently exhibited level of<unk> . | Paranoia | Snatiation | Hypersomnia | Allomnesia | Amnesia | Anhedonia | Dyssomnia | Pain asymbolia | 00
| 1,754 |
<unk> affects 3.5 to 6.1 percent of the global population. | Arachnophobia | Phonophobia | Thermophobia | Neophobia | Phagophobia | Nosophobia | Mysophobia | Pseudophobia | 00
| 148 |
A<unk> (also gastroprokinetic agent, gastrokinetic agent or propulsive) is a type of drug which enhances gastrointestinal motility by increasing the frequency or strength of contractions, but without disrupting their rhythm. They are used to treat certain gastrointestinal symptoms, including abdominal discomfort, bloating, constipation, heart burn, nausea, and vomiting; and certain gastrointestinal disorders, including irritable bowel syndrome, gastritis, gastroparesis, and functional dyspepsia. Most<unk> s are grouped under the Anatomical Therapeutic Chemical Classification System (a World Health Organization drug classification system), as ATC code A03F. | Prokinetic agent | Proton-pump inhibitor | Mucoactive agent | Galactagogue | Monoamine releasing agent | Antimotility agent | Cholagogue | Antisialagogue | 00
| 58,418 |
<unk> is a disease of birds in which kidney failure causes a build-up of urates in the internal organs, leaving a chalky white coating on them. Symptoms include anorexia and emaciation. It is a problem common to caged birds. Vultures are particularly sensitive to poisoning by diclofenac, which leads to kidney failure,<unk> , and death. | Visceral gout | Glossitis | Septic arthritis | Osteochondropathy | Facet joint arthrosis | Inflammatory arthritis | Post-traumatic arthritis | Bursitis | 00
| 43,306 |
<unk> is a branch of<unk> concerned with the study of neurons at a<unk> level. This includes morphology and physiological properties of single neurons. Several techniques such as intracellular recording, patch-clamp, and voltage-clamp technique, pharmacology, confocal imaging, molecular biology, two photon laser scanning microscopy and Ca2+ imaging have been used to study activity at the<unk> level.<unk> examines the various types of neurons, the functions of different neurons, the influence of neurons upon each other, and how neurons work together. | Cellular neuroscience | Molecular neuroscience | Clinical neuroscience | Social neuroscience | Social Neuroscience | Nuclear technology | Biomedicine | Cancer research | 00
| 53,260 |
<unk> (), also known as hydrocortisone hydrogen succinate () or simply hydrocortisone succinate and sold under the brand name Solu-Cortel among many others, is a synthetic glucocorticoid corticosteroid and a corticosteroid ester which is used for antiinflammatory and antiallergic indications. | Hydrocortisone hemisuccinate | Hydrocortisone aceponate | Cortisone acetate | Methandriol propionate | Calcipotriol | Methandriol | Testosterone enanthate | Norethisterone acetate oxime | 00
| 71,140 |
Vocal<unk> When a person speaks, the vocal cords create vibrations (vocal<unk> in the tracheobronchial tree and through the lungs and chest wall, where they can be felt (tactile<unk> . This is usually assessed with the healthcare provider placing the flat of their palms on the chest wall and then asking a patient to repeat a phrase containing low-frequency vowels such as "blue balloons" or "toys for tots" (the original diphthong used was the German word neunundneunzig but the translation to the English 'ninety-nine' was a higher-frequency diphthong and thus not as effective in eliciting<unk> . An increase in tactile<unk> indicates denser or inflamed lung tissue, which can be caused by diseases such as pneumonia. A decrease suggests air or fluid in the pleural spaces or a decrease in lung tissue density, which can be caused by diseases such as chronic obstructive pulmonary disease or asthma. Pleural<unk> Pleural<unk> is a palpable vibration of the wall of the thorax caused by friction between the parietal and visceral pleura of the lungs. See pleural friction rub for the auditory analog of this sign. Dental<unk> <unk> appears when teeth move. This can be assessed by feeling and looking at teeth when the mouth is opened and closed. Periodontal<unk> Periodontal<unk> occurs in either of the alveolar bones when an individual sustains trauma from occlusion. It is a result of teeth exhibiting at least slight mobility rubbing against the adjacent walls of their sockets, the volume of which has been expanded ever so slightly by inflammatory responses, bone resorption or both. As a test to determine the severity of periodontal disease, a patient is told to close his or her mouth into maximum intercuspation and is asked to grind his or her teeth ever so slightly. Fingers placed in the labial vestibule against the alveolar bone can detect<unk> . Rhonchal<unk> Rhonchal<unk> , also known as bronchial<unk> , is a palpable vibration produced during breathing caused by partial airway obstruction. The obstruction can be due to mucus or other secretions in the airway, bronchial hyperreactivity, or tumors. See rhonchus (rhonchi) for the auditory analog of this sign. Tactile<unk> Tactile<unk> , known by many other names including pectoral<unk> , tactile vocal<unk> , or just vocal<unk> , is a vibration felt on the patient's chest during low frequency vocalization. Commonly, the patient is asked to repeat a phrase while the examiner feels for vibrations by placing a hand over the patient's chest or back. Phrases commonly used in English include, 'boy oh boy' and 'toy boat' (diphthong phrases), as well as 'blue balloons' and 'Scooby-Doo'. 'Ninety-nine' is classically included, however, this is a misinterpretation of the original German report, in which "neunundneunzig" was the low-frequency diphthong of choice. Tactile<unk> is normally more intense in the right second intercostal space, as well as in the interscapular region, as these areas are closest to the bronchial trifurcation (right side) or bifurcation (left side). Tactile<unk> is pathologically increased over areas of consolidation and decreased or absent over areas of pleural effusion or pneumothorax (when there is air outside the lung in the chest cavity, preventing lung expansion). The reason for increased<unk> in a consolidated lung is the fact that the sound waves are transmitted with less decay in a solid or fluid medium (the consolidation) than in a gaseous medium (aerated lung). Conversely, the reason for decreased<unk> in a pleural effusion or pneumothorax (or any pathology separating the lung tissue itself from the body wall) is that this increased space diminishes or prevents entirely sound transmission. It has recently been suggested that the artifacts caused by eliciting tactile<unk> during breast ultrasonography can be used to differentiate between benign and malignant tumors. Tussive<unk> Tussive<unk> is a vibration felt on the chest when the patient coughs. Pericardial<unk> Pericardial<unk> is a vibration felt on the chest wall due to the friction of the surfaces of the pericardium over each other. See pericardial friction rub for the auditory analog of this sign. Hydatid<unk> Hydatid<unk> is a vibratory sensation felt on palpating a hydatid cyst. | Fremitus | Magpas | Debra | Ergoloid | Morgue | Acria | Mollipect | Philotimus | 00
| 34,381 |
Lifestyle changes Apart from treating underlying reversible causes (e.g., stopping or reducing certain medications, treating autoimmune causes), several measures can improve the symptoms of orthostatic hypotension and prevent episodes of syncope (fainting). Even small increases in the blood pressure may be sufficient to maintain blood flow to the brain on standing. In dysautonomic patients who do not have a diagnosis of high blood pressure, drinking 2–3 liters of fluid a day and taking 10 g of salt can improve symptoms, by maximizing the amount of fluid in the bloodstream. Another strategy is keeping the head of the bed slightly elevated. This reduces the return of fluid from the limbs to the kidneys at night, thereby reducing nighttime urine production and maintaining fluid in the circulation. Various measures can be used to improve the return of blood to the heart; the wearing of compression stockings and exercises ("physical counterpressure maneuvers" or PCMs) can be undertaken just before standing up (e.g., leg crossing and squatting). Medications The medication midodrine can benefit people with orthostatic hypotension, The main side effect is piloerection ("goose bumps"). Fludrocortisone is also used, although based on more limited evidence. Droxidopa has been shown to be effective as well, with few, mostly mild side effects reported. A number of other measures have slight evidence to support their use - indomethacin, fluoxetine, dopamine antagonists, metoclopramide, domperidone, monoamine oxidase inhibitors with tyramine (can produce severe hypertension), oxilofrine, potassium chloride, and yohimbine. Other Robotic devices, such as the ERIGO machine, has been proven to help orthostatic hypotension in some patients. These machines adjust a patient's position from 0 degrees to 90 degrees in progressive increments, allowing the blood pressure to adjust more slowly. | symptom of Pure autonomic failure | symptom of Channelopathy | symptom of Dysautonomia | symptom of Myasthenia gravis | symptom of Avascular necrosis | symptom of Long QT syndrome | symptom of Polyneuropathy | symptom of Chronic kidney disease | 00
| 5,829 |
<unk> is an infection of the lungs by parasites. It is a rare cause of pneumonia, occurring almost exclusively in immunocompromised persons (persons with a weakened or absent immune system). This is a respiratory infection that may or may not be serious. There is a variety of parasites that can affect the lungs. In general, these parasites enter the body through the skin or by being swallowed. Once inside the body, these parasites travel to the lungs, most often through the blood. There, a similar combination of cellular destruction and immune response causes disruption of oxygen transportation. Depending on the type of parasite, antihelmynthic drugs can be prescribed. The most common parasites involved: *Ascaris *Schistosoma *Toxoplasma gondii | Parasitic pneumonia | Lipid pneumonia | Fungal pneumonia | Dust pneumonia | Viral pneumonia | Atypical pneumonia | Bacterial pneumonia | Lobar pneumonia | 00
| 28,343 |
Following a first seizure, the risk of more seizures in the next two years is 40–50%. The greatest predictors of more seizures are problems either on the electroencephalogram or on imaging of the brain. In adults, after 6 months of being seizure-free after a first seizure, the risk of a subsequent seizure in the next year is less than 20% regardless of treatment. Up to 7% of seizures that present to the emergency department (ER) are in status epilepticus. In those with a status epilepticus, mortality is between 10% and 40%. Those who have a seizure that is provoked (occurring close in time to an acute brain event or toxic exposure) have a low risk of re-occurrence, but have a higher risk of death compared to those with epilepsy. | symptom of Japanese encephalitis | symptom of Eastern equine encephalitis | symptom of Rabies | medical cause of Japanese encephalitis | symptom of West Nile fever | symptoms of Rabies | symptom of Neuroleptic malignant syndrome | symptoms of Mulibrey nanism | 00
| 2,015 |
An early stage of<unk> can be "heat exhaustion" (or "heat prostration" or "heat stress"), whose symptoms can include heavy sweating, rapid breathing and a fast, weak pulse. If the condition progresses to heat stroke, then hot, dry skin is typical as blood vessels dilate in an attempt to increase heat loss. An inability to cool the body through perspiration may cause dry skin.<unk> from neurological disease may include little or no sweating, cardiovascular problems, and confusion or delirium. Other signs and symptoms vary. Accompanying dehydration can produce nausea, vomiting, headaches, and low blood pressure and the latter can lead to fainting or dizziness, especially if the standing position is assumed quickly. In severe heat stroke, confusion and aggressive behavior may be observed. Heart rate and respiration rate will increase (tachycardia and tachypnea) as blood pressure drops and the heart attempts to maintain adequate circulation. The decrease in blood pressure can then cause blood vessels to contract reflexively, resulting in a pale or bluish skin color in advanced cases. Young children, in particular, may have seizures. Eventually, organ failure, unconsciousness and death will result. | symptom of Malignant hyperthermia | symptom of Cardiogenic shock | symptom of Diabetic ketoacidosis | symptom of Toxic shock syndrome | symptoms of Cardiogenic shock | symptom of Hypothermia | symptoms of Toxic shock syndrome | symptom of Altitude sickness | 00
| 5,192 |
A<unk> (also vesicourachal<unk> is a congenital disorder caused by the partial persistence of the allantois. The allantois, which later becomes the urachus, connects an embryo's bladder to the yolk sac. Normally, the urachus closes off to become the median umbilical ligament; however, if it does not seal close to the bladder, a blind pouch connected to the bladder remains. This is usually asymptomatic but can lead to recurrent urinary tract infections. If the urachus is wholly patent, urine can drain from the bladder to an opening by the umbilicus, a condition known as urachal fistula. | Urachal diverticulum | Cimino fistula | Urachal cyst | Collaural fistula | Urachal fistula | Urachal cancer | Anal fissure | Galactocele | 00
| 74,264 |
<unk> is a condition in which<unk> cells, otherwise known as neurons, become damaged and progressively weaken in the cerebellum. There are two types of<unk> ; paraneoplastic<unk> , and alcoholic or nutritional<unk> . As the cerebellum contributes to the coordination and regulation of motor activities, as well as controlling equilibrium of the human body, any<unk> to this part of the organ can be life-threatening.<unk> can result in disorders in fine movement, posture, and motor learning in humans, due to a disturbance of the vestibular system. This condition may not only cause<unk> damage on a temporary or permanent basis, but can also affect other tissues of the central nervous system, those including the cerebral cortex, spinal cord and the brainstem (made up of the medulla oblongata, midbrain, and pons).<unk> can be attributed to a plethora of hereditary and non-hereditary conditions. More commonly,<unk> can also be classified according to conditions that an individual may acquire during their lifetime, including infectious, metabolic, autoimmune, paraneoplastic, nutritional or toxic triggers. | Cerebellar degeneration | Cerebral atrophy | Leukoencephalopathy | Corticobasal degeneration | Cerebellar abiotrophy | Central chromatolysis | Synaptopathy | White dot syndromes | 00
| 71,715 |
<unk> <unk> , also known as stagnant<unk> syndrome, is a state that occurs when the normal bacterial flora of the small intestine proliferates to numbers that cause significant derangement to the normal physiological processes of digestion and absorption. In some cases of<unk> , overgrowth of pathogenic non-commensal bacteria has also been noted. It has long been understood that from birth, and throughout life, large amounts of bacteria reside symbiotically within animal gastrointestinal tracts such as the human gastrointestinal tract. The understanding of this gut flora has even led to novel treatments for bowel irregularity that utilize so called "probiotics" or good bacteria that aid in normal digestion. The problem of<unk> arises when the bacterial colonies residing in the upper gastrointestinal tract begin to grow out of control or are altered in their makeup thereby creating a burden on the normal physiological processes occurring in the small intestine. This results in problems, among others, of: vitamin B12 deficiency, fat malabsorption and steatorrhea, fat-soluble vitamin deficiencies and intestinal wall injury. | Blind loop syndrome | Saal Greenstein syndrome | Cooks syndrome | Ramos-Arroyo syndrome | Shrunken pore syndrome | Constriction ring syndrome | Arts syndrome | Familial dysautonomia | 00
| 33,371 |
SMAD4, also called SMAD family member 4,<unk> , or DPC4 (Deleted in Pancreatic Cancer-4) is a highly conserved protein present in all metazoans. It belongs to the SMAD family of transcription factor proteins, which act as mediators of TGF-β signal transduction. The TGFβ family of cytokines regulates critical processes during the lifecycle of metazoans, with important roles during embryo development, tissue homeostasis, regeneration, and immune regulation. SMAD 4 belongs to the co-SMAD group (common mediator SMAD), the second class of the SMAD family. SMAD4 is the only known co-SMAD in most metazoans. It also belongs to the Darwin family of proteins that modulate members of the TGFβ protein superfamily, a family of proteins that all play a role in the regulation of cellular responses. Mammalian SMAD4 is a<unk> of the Drosophila protein<unk> against<unk> " named Medea. SMAD4 interacts with R-Smads, such as SMAD2, SMAD3, SMAD1, SMAD5 and SMAD8 (also called SMAD9) to form heterotrimeric complexes. Once in the nucleus, the complex of SMAD4 and two R-SMADS binds to DNA and regulates the expression of different genes depending on the cellular context. Intracellular reactions involving SMAD4 are triggered by the binding, on the surface of the cells, of growth factors from the TGFβ family. The sequence of intracellular reactions involving SMADS is called the SMAD pathway or the transforming growth factor beta (TGF-β) pathway since the sequence starts with the recognition of TGF-β by cells. | Mothers against decapentaplegic homolog 4 | Merosome | Mir-3180 microRNA precursor family | Mir-590 microRNA precursor family | BGR-34 | Mir-625 microRNA precursor family | Mir-636 microRNA precursor family | Mir-618 microRNA precursor family | 00
| 38,097 |
Mechanism of action Insulin is a protein normally produced in the pancreas which regulates metabolic processes throughout the body. The primary role of insulin is to increase the metabolism of glucose, storage of energy in adipose tissue, and decrease the body's own production of glucose. Pharmacokinetics The half life of endogenous insulin once it<unk> rs the bloodstream is 4 to 6 minutes. This allows the endocrine system to rapidly adapt to changing conditions within the body. Exogenous insulin, however, would not be effective with a short half life, as it would require continuous injection or infusion to have the desired effect. While it is difficult to change the rate at which the protein is metabolized in the bloodstream, it is possible to alter how fast the protein is absorbed from the site of injection in various ways.<unk> was formulated by the addition of zinc to the crude porcine and bovine insulin extracts, which causes the insulin protein to form larger crystals which dissolve into the body slower upon injection. This means that while the insulin in the bloodstream is still metabolized in 4–6 minutes, more insulin is continually being absorbed from the dose injected for hours after administration. Compared to NPH insulin, another intermediate acting insulin, up to 40% of the dose of<unk> may remain unabsorbed for over 24 hours after administration. The variation in absorption between doses in the same patient of<unk> is comparable to that of insulin NPH. The distribution of insulin is not well understood, but it is known that it is heavily bound to receptors throughout the body (approximately 80% to receptors on liver cells) and metabolized in large part by phase one processes in the liver. Of the approximately 71-minute estimated lifetime of an insulin molecule, over 60 minutes is spent attached to a liver receptor. In addition, circulating unbound insulin is excreted and reabsorbed by the kidneys and broken down in the lysosomes. The remainder of metabolism of insulin molecules is via intracellular proteolysis via insulysin and related enzymes. | Lente insulin | Insulin aspart | Regular insulin | Insulin detemir | Insulin glulisine | Ultralente insulin | Insulin glargine | Insulin degludec | 00
| 58,905 |
Minor complications include nose bleeds, sinusitis, and a sore throat. Sometimes more significant complications occur including erosion of the nose where the tube is anchored, esophageal perforation, damage to a surgical anastomosis, pulmonary aspiration, a collapsed lung, or intracranial placement of the tube. | Nasogastric intubation | Tracheal intubation | Basic airway management | Advanced airway management | Surgical airway management | Blind insertion airway device | Tracheotomy | Laryngeal mask airway | 00
| 11,173 |
Major<unk> s The human<unk> consists of several<unk> s that operate via feedback loops. Several important feedback<unk> s are mediated via the hypothalamus and pituitary. * TRH – TSH – T3/T4 * GnRH – LH/FSH – sex hormones * CRH – ACTH – cortisol * Renin – angiotensin – aldosterone * leptin vs. Ghrelin Glands<unk> glands are glands of the<unk> that secrete their products, hormones, directly into interstitial spaces where they are absorbed into blood rather than through a duct. The major glands of the<unk> include the pineal gland, pituitary gland, pancreas, ovaries, testes, thyroid gland, parathyroid gland, hypothalamus and adrenal glands. The hypothalamus and pituitary gland are neuroendocrine organs. The hypothalamus and the anterior pituitary are two out of the three<unk> glands that are important in cell signaling. They are both part of the HPA axis which is known to play a role in cell signaling in the nervous<unk> . Hypothalamus: The hypothalamus is a key regulator of the autonomic nervous<unk> . The<unk> has three sets of<unk> outputs which include the magnocellular<unk> , the parvocellular<unk> , and autonomic intervention. The magnocellular is involved in the expression of oxytocin or vasopressin. The parvocellular is involved in controlling the secretion of hormones from the anterior pituitary. Anterior Pituitary: The main role of the anterior pituitary gland is to produce and secrete tropic hormones. Some examples of tropic hormones secreted by the anterior pituitary gland include TSH, ACTH, GH, LH, and FSH. Cells There are many types of cells that make up the<unk> and these cells typically make up larger tissues and organs that function within and outside of the<unk> . * Hypothalamus * Anterior pituitary gland * Pineal gland * Posterior pituitary gland * The posterior pituitary gland is a section of the pituitary gland. This organ does not produce any hormone but stores and secretes hormones such as antidiuretic hormone (ADH) which is synthesized by supraoptic nucleus of hypothalamus and oxytocin which is synthesized by paraventricular nucleus of hypothalamus. ADH functions to help the body to retain water; this is important in maintaining a homeostatic balance between blood solutions and water. Oxytocin functions to induce uterine contractions, stimulate lactation, and allows for ejaculation. * Thyroid gland * follicular cells of the thyroid gland produce and secrete T3 and T4 in response to elevated levels of TRH, produced by the hypothalamus, and subsequent elevated levels of TSH, produced by the anterior pituitary gland, which further regulates the metabolic activity and rate of all cells, including cell growth and tissue differentiation. * Parathyroid gland * Epithelial cells of the parathyroid glands are richly supplied with blood from the inferior and superior thyroid arteries and secrete parathyroid hormone (PTH). PTH acts on bone, the kidneys, and the GI tract to increase calcium reabsorption and phosphate excretion. In addition, PTH stimulates the conversion of Vitamin D to its most active variant, 1,25-dihydroxyvitamin D3, which further stimulates calcium absorption in the GI tract. * Adrenal glands * Adrenal cortex * Adrenal medulla * Pancreas * Pancreas contain nearly 1 to 2 million islets of Langerhans (a tissue which consists cells that secrete hormones) and acini. Acini secretes digestive enzymes. * Alpha cells * The alpha cells of the pancreas secrete hormones to maintain homeostatic blood sugar. Insulin is produced and excreted to lower blood sugar to normal levels. Glucagon, another hormone produced by alpha cells, is secreted in response to low blood sugar levels; glucagon stimulates glycogen stores in the liver to release sugar into the bloodstream to raise blood sugar to normal levels. * Beta cells * 60% of the cells present in islet of Langerhans are beta cells. Beta cells secrete insulin. Along with glucagon, insulin helps in maintaining glucose levels in our body. Insulin decreases blood glucose level ( a hypoglycemic hormone) whereas glucagon increases blood glucose level. * Delta cells * F Cells * Ovaries * Granulosa cells * Testis * Leydig cells | Endocrine system | Reproductive system | Autonomic nervous system | Somatosensory system | Integumentary system | Immune system | Immune cycle | Female reproductive system | 00
| 865 |
<unk> or arteriography is a medical imaging technique used to visualize the inside, or lumen, of blood vessels and organs of the body, with particular interest in the arteries, veins, and the heart chambers. This is traditionally done by injecting a radio-opaque contrast agent into the blood vessel and imaging using X-ray based techniques such as fluoroscopy. The word itself comes from the Greek words ἀγγεῖον<unk> n 'vessel' and γράφειν graphein 'to write, record'. The film or image of the blood vessels is called an<unk> or more commonly an<unk> gram. Though the word can describe both an arteriogram and a venogram, in everyday usage the terms<unk> gram and arteriogram are often used synonymously, whereas the term venogram is used more precisely. The term<unk> has been applied to radionuclide<unk> and newer vascular imaging techniques such as CO2<unk> , CT<unk> and MR<unk> . The term isotope<unk> has also been used, although this more correctly is referred to as isotope perfusion scanning. | Angiography | Angiology | Magnetic resonance angiography | Radionuclide angiography | Microangiography | Radiochemistry | Synthetic MRI | Biomedical spectroscopy | 00
| 12,755 |
The<unk> <unk> , also known as the central<unk> is a brain region that plays a critical role in autonomic function, motivated behavior and behavioural responses to threatening stimuli.<unk> is also the primary control center for descending pain modulation. It has enkephalin-producing cells that suppress pain. The<unk> is the<unk> matter located around the cerebral aqueduct within the tegmentum of the midbrain. It projects to the nucleus raphe magnus, and also contains descending autonomic tracts. The ascending pain and temperature fibers of the spinothalamic tract send information to the<unk> via the spinomesencephalic tract (so-named because the fibers originate in the spine and terminate in the<unk> , in the mesencephalon or midbrain). This region has been used as the target for brain-stimulating implants in patients with chronic pain. | Periaqueductal gray | Barrel cortex | Fusiform body area | Watershed area | Piriform cortex | Midbrain tegmentum | Fields of Forel | Postcentral sulcus | 00
| 23,396 |
<unk> (INN), often used as the disodium salt (trade name Lusedra) is an intravenous sedative-hypnotic agent. It is currently approved for use in sedation of adult patients undergoing diagnostic or therapeutic procedures such as endoscopy. | Fospropofol | Ufufunyane | Bremazocine | Dezocine | Desomorphine | Propofol | Tirapazamine | Clobazam | 00
| 49,395 |
The<unk> (formerly the<unk> Hospital NHS Foundation Trust) is an NHS foundation trust based in Cambridge, United Kingdom. It runs the<unk><unk> Hospital on the Cambridge Biomedical Campus. The Trust achieved foundation status on 1 July 2004. | Royal Papworth Hospital NHS Foundation Trust | Tavistock and Portman NHS Foundation Trust | Ms B v An NHS Hospital Trust | Isle of Wight Primary Care Trust | Helen's Trust | Devon Partnership NHS Trust | Sandwell and West Birmingham Hospitals NHS Trust | Surrey and Borders Partnership NHS Foundation Trust | 00
| 73,615 |
<unk> is a vaccine used to treat cancer, specifically non-small-cell lung carcinoma (NSCLC).<unk> is composed of recombinant human epidermal growth factor <unk> conjugated to a protein carrier. The vaccine was developed by the Center of Molecular Immunology, Havana, Cuba. There are agreements in place to test it in the United States, Japan, and some European countries. It is currently available in Cuba, Colombia, Bosnia and Herzegovina, Peru and Paraguay. In October 2015 Serbia's Institute of Virology, Vaccines and Sera (AKA Torlak Institute) signed a memorandum for use in 30 patients as part of a study.<unk> is relatively cheap to produce and store, and has low toxicity. Side effects of the vaccine appear to be mild, and include chills, fever, and feeling sick. | CimaVax-EGF | Biocitech | ScotSTAR | Alloplant | Poly-MVA | Elastix | Trafermin | Metab-L | 00
| 62,222 |
Coeliac disease appears to be multifactorial, both in that more than one genetic factor can cause the disease and in that more than one factor is necessary for the disease to manifest in a person. Almost all people (95%) with coeliac disease have either the variant HLA-DQ2 allele or (less commonly) the HLA-DQ8 allele. However, about 20–30% of people without coeliac disease have also inherited either of these alleles. This suggests that additional factors are needed for coeliac disease to develop; that is, the predisposing HLA risk allele is necessary but not sufficient to develop coeliac disease. Furthermore, around 5% of those people who do develop coeliac disease do not have typical HLA-DQ2 or HLA-DQ8 alleles (see below). Genetics DQ α5-β2 -binding cleft with a deamidated gliadin peptide (yellow), modified from The vast majority of people with coeliac have one of two types (out of seven) of the HLA-DQ protein. HLA-DQ is part of the MHC class II antigen-presenting receptor (also called the human leukocyte antigen) system and distinguishes cells between self and non-self for the purposes of the immune system. The two subunits of the HLA-DQ protein are encoded by the HLA-DQA1 and HLA-DQB1 genes, located on the short arm of chromosome 6. There are seven HLA-DQ variants (DQ2 and DQ4–DQ9). Over 95% of people with coeliac have the isoform of DQ2 or DQ8, which is inherited in families. The reason these genes produce an increase in the risk of coeliac disease is that the receptors formed by these genes bind to gliadin peptides more tightly than other forms of the antigen-presenting receptor. Therefore, these forms of the receptor are more likely to activate T lymphocytes and initiate the autoimmune process. HLA region of chromosome 6 Most people with coeliac bear a two-gene HLA-DQ2 haplotype referred to as DQ2.5 haplotype. This haplotype is composed of two adjacent gene alleles, DQA1*0501 and DQB1*0201, which encode the two subunits, DQ α5 and DQ β2. In most individuals, this DQ2.5 isoform is encoded by one of two chromosomes 6 inherited from parents (DQ2.5cis). Most coeliacs inherit only one copy of this DQ2.5 haplotype, while some inherit it from both parents; the latter are especially at risk for coeliac disease as well as being more susceptible to severe complications. Some individuals inherit DQ2.5 from one parent and an additional portion of the haplotype (either DQB1*02 or DQA1*05) from the other parent, increasing risk. Less commonly, some individuals inherit the DQA1*05 allele from one parent and the DQB1*02 from the other parent (DQ2.5trans) (called a trans-haplotype association), and these individuals are at similar risk for coeliac disease as those with a single DQ2.5-bearing chromosome 6, but in this instance, the disease tends not to be familial. Among the 6% of European coeliacs that do not have DQ2.5 (cis or trans) or DQ8 (encoded by the haplotype DQA1*03:DQB1*0302), 4% have the DQ2.2 isoform, and the remaining 2% lack DQ2 or DQ8. The frequency of these genes varies geographically. DQ2.5 has high frequency in peoples of North and Western Europe (Basque Country and Ireland with highest frequencies) and portions of Africa and is associated with disease in India, but it is not found along portions of the West Pacific rim. DQ8 has a wider global distribution than DQ2.5 and is particularly common in South and Central America; up to 90% of individuals in certain Amerindian populations carry DQ8 and thus may display the coeliac phenotype. Other genetic factors have been repeatedly reported in coeliac disease; however, involvement in disease has variable geographic recognition. Only the HLA-DQ loci show a consistent involvement over the global population. Many of the loci detected have been found in association with other autoimmune diseases. One locus, the LPP or lipoma-preferred partner gene, is involved in the adhesion of extracellular matrix to the cell surface, and a minor variant (SNP = rs1464510) increases the risk of disease by approximately 30%. This gene strongly associates with coeliac disease (p −39) in samples taken from a broad area of Europe and the US. The prevalence of coeliac disease genotypes in the modern population is not completely understood. Given the characteristics of the disease and its apparent strong heritability, it would normally be expected that the genotypes would undergo negative selection and to be absent in societies where agriculture has been practised the longest (compare with a similar condition, Lactose intolerance, which has been negatively selected so strongly that its prevalence went from ~100% in ancestral populations to less than 5% in some European countries). This expectation was first proposed by Simoons (1981). By now, however, it is apparent that this is not the case; on the contrary, there is evidence of positive selection in coeliac disease genotypes. It is suspected that some of them may have been beneficial by providing protection against bacterial infections. Prolamins The majority of the proteins in food responsible for the immune reaction in coeliac disease are the prolamins. These are storage proteins rich in proline (prol-) and glutamine (-amin) that dissolve in alcohols and are resistant to proteases and peptidases of the gut. Prolamins are found in cereal grains with different grains having different but related prolamins: wheat (gliadin), barley (hordein), rye (secalin) and oats (avenin). One region of α-gliadin stimulates membrane cells, enterocytes, of the intestine to allow larger molecules around the sealant between cells. Disruption of tight junctions allow peptides larger than three amino acids to enter the intestinal lining. Illustration of deamidated α-2 gliadin's 33mer, amino acids 56–88, showing the overlapping of three varieties of T-cell epitope Membrane leaking permits peptides of gliadin that stimulate two levels of the immune response: the innate response, and the adaptive (T-helper cell-mediated) response. One protease-resistant peptide from α-gliadin contains a region that stimulates lymphocytes and results in the release of interleukin-15. This innate response to gliadin results in immune-system signalling that attracts inflammatory cells and increases the release of inflammatory chemicals. The strongest and most common adaptive response to gliadin is directed toward an α2-gliadin fragment of 33 amino acids in length. The response to the 33mer occurs in most coeliacs who have a DQ2 isoform. This peptide, when altered by intestinal transglutaminase, has a high density of overlapping T-cell epitopes. This increases the likelihood that the DQ2 isoform will bind, and stay bound to, peptide when recognised by T-cells. Gliadin in wheat is the best-understood member of this family, but other prolamins exist, and hordein (from barley), secalin (from rye), and avenin (from oats) may contribute to coeliac disease. Avenins toxicity in people with coeliac disease depends on the oat cultivar consumed because of prolamin genes, protein amino acid sequences, and the immunoreactivities of toxic prolamins, which vary among oat varieties. Tissue transglutaminase The active form of tissue transglutaminase (green) bound to a gluten peptide mimic (blue). Anti-transglutaminase antibodies to the enzyme tissue transglutaminase (tTG) are found in the blood of the majority of people with classic symptoms and complete villous atrophy, but only in 70% of the cases with partial villous atrophy and 30% of the cases with minor mucosal lesions. Tissue transglutaminase modifies gluten peptides into a form that may stimulate the immune system more effectively. These peptides are modified by tTG in two ways, deamidation or transamidation. Deamidation is the reaction by which a glutamate residue is formed by cleavage of the epsilon-amino group of a glutamine side chain. Transamidation, which occurs three times more often than deamidation, is the cross-linking of a glutamine residue from the gliadin peptide to a lysine residue of tTg in a reaction that is catalysed by the transglutaminase. Crosslinking may occur either within or outside the active site of the enzyme. The latter case yields a permanently covalently linked complex between the gliadin and the tTg. This results in the formation of new epitopes believed to trigger the primary immune response by which the autoantibodies against tTg develop. Stored biopsies from people with suspected coeliac disease have revealed that autoantibody deposits in the subclinical coeliacs are detected prior to clinical disease. These deposits are also found in people who present with other autoimmune diseases, anaemia, or<unk> phenomena at a much increased rate over the normal population. Endomysial components of antibodies (EMA) to tTG are believed to be directed toward cell-surface transglutaminase, and these antibodies are still used in confirming a coeliac disease diagnosis. However, a 2006 study showed that EMA-negative people with coeliac tend to be older males with more severe abdominal symptoms and a lower frequency of "atypical" symptoms, including autoimmune disease. In this study, the anti-tTG antibody deposits did not correlate with the severity of villous destruction. These findings, coupled with recent work showing that gliadin has an innate response component, suggest that gliadin may be more responsible for the primary manifestations of coeliac disease, whereas tTG is a bigger factor in secondary effects such as allergic responses and secondary autoimmune diseases. In a large percentage of people with coeliac, the anti-tTG antibodies also recognise a rotavirus protein called VP7. These antibodies stimulate monocyte proliferation, and | medical cause of Malabsorption | medical cause of Protein losing enteropathy | medical cause of Bowel obstruction | complications of Malabsorption | medical cause of Malnutrition | medical cause of Abdominal pain | medical cause of Intestinal pseudo-obstruction | medical cause of Constipation | 00
| 4,477 |
Normally, no yeast or trichomonas are found on the slide. White blood cells and clue cells are normally absent or very low in number. Symptoms of infections able to be diagnosed by<unk><unk> : * A vaginal yeast infection often causes a white, lumpy discharge that looks like cottage cheese. :*diagnosis is made if pseudohyphae or yeast buds are present (these are visible only 50% of the time) * Trichomoniasis causes a vaginal discharge that is yellow-green, foamy, and bad-smelling. :*Diagnosis is made if mobile trichomonads are visible on the slide A<unk> with a clue cell at bottom left, indicating bacterial vaginosis. * Bacterial vaginosis generally produces a vaginal discharge that is thin and milky with a fishy odor. :*Diagnosis is made using Amsel Criteria - three of the four following criteria must be met: ::*>20% of the epithelial cells are clue cells (the single most reliable predictor) ::*Discharge is thin and homogeneous ::*Sample smells fishy when mixed with potassium hydroxide ("whiff test") ::*Vaginal pH is >4.5 Furthermore, presence of white blood cells is a general sign of infection. | Vaginal wet mount | High vaginal swab | Postcoital test | Vaginal ultrasonography | Sperm–cervical mucus contact test | Vaginal photoplethysmograph | Triple smear | Obstetric ultrasonography | 00
| 57,450 |
Location of the IGHMBP2 gene on chromosome<unk> 1, locus<unk> 1q13.3 DSMA1 is caused by a genetic mutation in the IGHMBP2 gene (located on chromosome<unk> 1, locus<unk> 1q13.3), which codes the immunoglobulin helicase μ-binding protein 2. The role of the IGHMBP2 protein is not fully understood, but it is known to affect mRNA processing. The cellular mechanisms of the mutation, as well as the protein mechanisms disrupted by the mutation, are unknown. IGHMBP2 mutations are usually random mutations which are normally not passed down through generations. | Distal spinal muscular atrophy type 1 | Distal spinal muscular atrophy type 2 | Jokela type spinal muscular atrophy | Spinal muscular atrophy | X-linked spinal muscular atrophy type 2 | Fukuyama congenital muscular dystrophy | Becker muscular dystrophy | Ullrich congenital muscular dystrophy | 00
| 55,954 |
<unk> (SFOT) is a group of<unk> procedures; they can be broadly divided into two main categories. | Surgically facilitated orthodontic therapy | Goeckerman therapy | Pulsed electromagnetic field therapy | Intermittent vacuum therapy | Removable partial denture | Craniosacral therapy | Online speech therapy | Psychiatric somatotherapy | 00
| 73,350 |
<unk> is a rare complication of pelvic inflammatory disease (PID) involving liver capsule inflammation leading to the creation of adhesions. The condition is named after the two physicians, Thomas<unk> -Hugh, Jr and Arthur Hale<unk> who first reported this condition in 1934 and 1930 respectively. | Fitz-Hugh–Curtis syndrome | Michels Caskey syndrome | Bogart–Bacall syndrome | Gómez–López-Hernández syndrome | Pascual-Castroviejo syndrome type 1 | Riga–Fede disease | Ogilvie syndrome | Howel–Evans syndrome | 00
| 16,865 |
<unk> s are<unk> trials conducted directly through doctors and clinics rather than academic research facilities. They are designed to be administered through primary care physicians,<unk> health centers and local outpatient facilities. In 1986, the<unk> Consortium held the first such trials in the United States to determine the efficiency of preventive treatments after the onset of Pneumocystis pneumonia. The trials give patients access to new medications and keep doctors involved with new developments in research. However, critics state that drug company payments to doctors for patients enrolled in such studies present a conflict of interest and potential for abuse.<unk><unk> trials are becoming prevalent in human-testing stage pharmaceutical research. | Community-based clinical trial | Academic clinical trial | Natural history study | Multicenter trial | Pragmatic clinical trial | Retrospective cohort study | Prospective cohort study | Placebo-controlled study | 00
| 43,988 |
Poor prognostic factors include: age < 40 years upon diagnosis, extensive colitis, severe colitis on endoscopy, prior hospitalization, elevated CRP and low serum albumin. Progression or remission People with<unk> usually have an intermittent course, with periods of disease inactivity alternating with "flares" of disease. People with proctitis or left-sided colitis usually have a more benign course: only 15% progress proximally with their disease, and up to 20% can have sustained remission in the absence of any therapy. A subset of people experience a course of disease progress rapidly. In these cases, there is usually a failure to respond to medication and surgery often is performed within the first few years of disease onset. People with more extensive disease are less likely to sustain remission, but the rate of remission is independent of the severity of the disease. Several risk factors are associated with eventual need for colectomy, including: prior hospitalization for<unk> , extensive colitis, need for systemic steroids, young age at diagnosis, low serum albumin, elevated inflammatory markers (CRP & ESR), and severe inflammation seen during colonoscopy. Surgical removal of the large intestine is necessary in some cases. Colorectal cancer The risk of colorectal cancer is significantly increased in people with<unk> after ten years if involvement is beyond the splenic flexure. People with backwash ileitis might have an increased risk for colorectal carcinoma. Those people with only proctitis usually have no increased risk. It is recommended that people have screening colonoscopies with random biopsies to look for dysplasia after eight years of disease activity, at one to two year intervals. Mortality People with<unk> are at similar or perhaps slightly increased overall risk of death compared with the background population. However, the distribution of causes-of-death differs from the general population. Specific risk factors may predict worse outcomes and a higher risk of mortality in people with<unk> , including: C. difficile infection and cytomegalovirus infection (due to reactivation). | Ulcerative colitis | Crohn's disease | Diversion colitis | Dysentery | Collagenous colitis | Ischemic colitis | Microscopic colitis | Chemical colitis | 00
| 4,507 |
Pericoronitis (green arrow) in lower right<unk> tooth<unk> without communication to the mouth, that have no pathology associated with the tooth, and have not caused tooth resorption on the blocking tooth, rarely have symptoms. The chances of developing pathology on an<unk><unk> tooth that is not communicating with the mouth is approximately 12%. However, when<unk> communicate with the mouth, food and bacteria penetrate to the space around the tooth and cause symptoms such as localized pain, swelling and bleeding of the tissue overlying the tooth. The tissue overlying the tooth is called the operculum, and the disorder is called pericoronitis which means inflammation around the crown of the tooth. Low grade chronic periodontitis commonly occurs on either the<unk> tooth or the second molar, causing less obvious symptoms such as bad breath and bleeding from the gums. The<unk> can also remain asymptomatic (pain free), even with disease. The term asymptomatic means that the person has no symptoms. The term asymptomatic should not be equated with absence of disease. Most diseases have no symptoms early in the disease process. A pain-free or asymptomatic tooth can still be infected for many years before pain symptoms develop. | Impacted wisdom teeth | Toothache | Chattering teeth | Temporomandibular joint dysfunction | Melanocytic oral lesion | Facial trauma | Perforated eardrum | Enamel hypoplasia | 00
| 64,947 |
Little is known about the causes of<unk> s, although some evidence has shown that ultraviolet light, radiation, and genes may be causation factors. A genetic role might also be plausible, according to some studies. In several cases, patients developed a<unk> after immunosuppression. | Microcystic adnexal carcinoma | Eccrine carcinoma | Hidradenocarcinoma | Apocrine gland carcinoma | Tubular carcinoma | Trichoadenoma | Adenoacanthoma | Papillary serous cystadenocarcinoma | 00
| 56,095 |
A<unk> or hepatic<unk> is a benign tumor of the<unk> composed of hepatic endothelial cells. It is the most common benign<unk> tumour, and is usually asymptomatic and diagnosed incidentally on radiological imaging.<unk><unk> s are thought to be congenital in origin. Several subtypes exist, including the giant hepatic<unk> , which can cause significant complications. | Cavernous liver hemangioma | Hepatoid tumor | Liver angiosarcoma | Pancreatoblastoma | Hepatoblastoma | Hepatocellular adenoma | Pancreatic serous cystadenoma | Cholangiocarcinoma | 00
| 65,888 |
<unk> was a British charity that provided financial assistance during the AIDs epidemic to institutions and to people suffering from HIV/AIDs. In 1996, the charity had close to £11million in assets Founded in Chelsea in 1986,<unk> was absorbed into the Terrence Higgins Trust in 2011.<unk> supporters included the Princess Alexandra, the Duchess of York, Princess Margaret and Diana, Princess of Wales.<unk> managed many high profile performance events in London that included prominent actors, musicians, dancers and theatre producers.<unk> also started charitable walks and other events throughout the country for the general population. __TOC__ | Crusaid | Splinter | Pharmasave | Splint | Earwax | Souvenaid | Winpepi | Liftware | 00
| 45,565 |
<unk> () refers to the earliest gonadal changes of puberty. In response to pituitary gonadotropins, the ovaries in girls and the testes in boys begin to grow and increase the production of the sex steroids, especially estradiol and testosterone. * In boys, testicular enlargement is the first physical sign of<unk> , and usually of puberty. * In girls, ovarian growth cannot be directly seen, so thelarche and growth acceleration are usually the first evidence of<unk> .<unk> should be contrasted with adrenarche.<unk> indicates that true central puberty has begun, while adrenarche is an independent maturational process only loosely associated with complete puberty. | Gonadarche | Thelarche | Menarche | Spermarche | Pubarche | Adrenarche | Sunovion | Premature thelarche | 00
| 17,157 |
Optimal treatment for this condition is not known. Surgery to remove the lesion is the usual form of treatment. Whether radiotherapy or chemotherapy can offer any advantage is not known. | Pulmonary enteric adenocarcinoma | Large cell neuroendocrine carcinoma of the lung | Atypical pulmonary carcinoid tumour | Salivary gland–like carcinoma of the lung | Mucinous cystadenocarcinoma of the lung | Epithelial-myoepithelial carcinoma of the lung | Goblet cell carcinoid | Oesophagogastric junctional adenocarcinoma | 00
| 65,715 |
Some of the fundamental components of<unk> include recurring intrusive thoughts, impotence to resist the compulsion to engage in stealing, and the release of internal pressure following the act. These symptoms suggest that<unk> could be regarded as an obsessive-compulsive type of disorder. People diagnosed with<unk> often have other types of disorders involving mood, anxiety, eating, impulse control, and drug use. They also have great levels of stress, guilt, and remorse, and privacy issues accompanying the act of stealing. These signs are considered to either cause or intensify general comorbid disorders. The characteristics of the behaviors associated with stealing could result in other problems as well, which include social segregation and substance use. The many types of other disorders frequently occurring along with<unk> usually make clinical diagnosis uncertain. There is a difference between ordinary theft and<unk> : "ordinary theft (whether planned or impulsive) is deliberate and motivated by the usefulness of the object or its monetary worth," whereas with<unk> , there "is the recurrent failure to resist impulses to steal items even though the items are not needed for personal use or for their monetary value." | Kleptomania | Alexithymia | Coprophobia | Acrophobia | Agoraphobia | Cephalalgiaphobia | Psychopathy | Aquaphobia | 00
| 12,638 |
<unk> are very small, with an extremely sharp and fine tip. Some<unk> have curved blades for certain types of precision tasks, while others may have straight blades. | Iris scissors | Eye dropper | Metzenbaum scissors | Pupilometer | Mayo scissors | Goggles | Eyepatch | Corneal inlay | 00
| 63,295 |
<unk> has not been commonly used in diagnosing Lyme disease because in vitro cell culturing now serves the purpose, however the process is commonly used to diagnose infections involving microorganisms such as trypanosomiasis. | Xenodiagnosis | Toxgnostics | Vaccine vial monitor | Virology | Wastewater surveillance | Isolation tank | Animal testing on invertebrates | Molecular diagnostics | 00
| 60,180 |
<unk> is a medical specialty within primary care that provides continuing and comprehensive health care for the individual and<unk> across all ages, genders, diseases, and parts of the body. The specialist, who is usually a primary care physician, is named a<unk> physician. It is often referred to as general practice and a practitioner as a general practitioner. Historically, their role was once performed by any doctor with qualifications from a medical school and who works in the community. However, since the 1950s,<unk> / general practice has become a specialty in its own right, with specific training requirements tailored to each country. The names of the specialty emphasize its holistic nature and/or its roots in the<unk> . It is based on knowledge of the patient in the context of the<unk> and the community, centering on disease prevention and health promotion. According to the World Organization of<unk> Doctors (WONCA), the aim of<unk> is "promoting personal, comprehensive and continuing care for the individual in the context of the<unk> and the community". The issues of values underlying this practice are usually known as primary care ethics. | Family medicine | Social medicine | Psychosomatic medicine | Sports medicine | Sexual medicine | Neuroesthetics | Allopathic medicine | Pharmacy | 00
| 24,544 |
Early treatment options include pain medication using nonsteroidal anti-inflammatory drugs, and suppression of ovarian function. More advanced treatment includes a minimally invasive procedure performed by an Interventional Radiologist. This minimally invasive procedure involves stopping blood within the pelvic varicose veins using a minimally invasive procedure called a catheter directed embolization. The procedure rarely requires an overnight stay in hospital and is usually performed as an outpatient procedure, and is done using local anesthetic and moderate sedation. Patients report an 80% success rate, as measured by the amount of pain reduction experienced. | Pelvic congestion syndrome | Urethral syndrome | Pelvic inflammatory disease | Pelvic organ prolapse | PELVIS syndrome | Prostatitis | Hydrocele | Ovarian vein syndrome | 00
| 60,194 |
<unk> <unk> is characterized by an excess amount of mucus produced by the mucous membranes that line the nasal cavities. The membranes create mucus faster than it can be processed, causing a backup of mucus in the nasal cavities. As the cavity fills up, it blocks off the air passageway, causing difficulty breathing through the nose. Air caught in nasal cavities, namely the sinus cavities, cannot be released and the resulting pressure may cause a headache or facial pain. If the sinus passage remains blocked, there is a chance that sinusitis may result. If the mucus backs up through the Eustachian tube, it may result in ear pain or an ear infection. Excess mucus accumulating in the throat or back of the nose may cause a post-nasal drip, resulting in a sore throat or coughing. Additional symptoms include sneezing, nosebleeds, and nasal discharge. | Rhinorrhea | Cerebrospinal fluid rhinorrhoea | Creatorrhea | Logorrhea | Leukorrhea | Gonorrhea | Blennorrhea | Aerobic vaginitis | 00
| 26,754 |
Episodes of<unk> or<unk> occur in 9% of adolescents. 10-35% of migraine sufferers experience auras, with 88% of these patients experiencing both visual auras (which include<unk> and neurological auras.<unk> seems to be slightly more common in boys than in girls among children who experience migraines. Approximately 80% of temporal lobe seizures produce auras that may lead to<unk> or<unk> . They are a common feature of simple partial seizures and usually precede complex partial seizures of temporal lobe origin. Central Serous Chorioretinopathy (CSCR) which can produce<unk> predominantly affects persons between the ages of 20 and 50. Women appear to be affected more than men by a factor of almost 3 to 1. | Micropsia | Palinopsia | Photopsia | Dysmorphopsia | Pelopsia | Cerebral polyopia | Akinetopsia | Ocular dysmetria | 00
| 7,436 |
<unk> (BRRS) is a rare overgrowth syndrome and hamartomatous disorder with occurrence of multiple subcutaneous lipomas, macrocephaly and hemangiomas. The disease is inherited in an autosomal dominant manner. The disease belongs to a family of hamartomatous polyposis syndromes, which also includes Peutz–Jeghers syndrome, juvenile polyposis and Cowden syndrome. Mutation of the PTEN gene underlies this syndrome, as well as Cowden syndrome, Proteus syndrome, and Proteus-like syndrome, these four syndromes are referred to as PTEN Hamartoma-Tumor Syndromes. | Bannayan–Riley–Ruvalcaba syndrome | Wilson–Mikity syndrome | Wilson's temperature syndrome | Maroteaux–Lamy syndrome | Barakat-Perenthaler syndrome | Mowat–Wilson syndrome | Schwartz–Matsuo syndrome | Berk–Tabatznik syndrome | 00
| 34,568 |
Symptoms of AVM vary according to the location of the malformation. Roughly 88% of people with an AVM are asymptomatic; often the malformation is discovered as part of an autopsy or during treatment of an unrelated disorder (called in medicine an "incidental finding"); in rare cases, its expansion or a micro-bleed from an AVM in the brain can cause epilepsy, neurological deficit, or pain. The most general symptoms of a cerebral AVM include headaches and epileptic seizures, with more specific symptoms occurring that normally depend on the location of the malformation and the individual. Such possible symptoms include: * Difficulties with movement coordination, including muscle weakness and even paralysis; * Vertigo (dizziness); * Difficulties of speech (dysarthria) and communication, such as aphasia; * Difficulties with everyday activities, such as apraxia; * Abnormal sensations (numbness, tingling, or spontaneous pain); * Memory and thought-related problems, such as confusion, dementia or hallucinations. Cerebral AVMs may present themselves in a number of different ways: * Bleeding (45% of cases) * Acute onset of severe headache. May be described as the worst headache of the patient's life. Depending on the location of bleeding, may be associated with new fixed neurologic deficit. In unruptured brain AVMs, the<unk> of spontaneous bleeding may be as low as 1% per year. After a first rupture, the annual bleeding<unk> may increase to more than 5%. * Seizure or brain seizure (46%) Depending on the place of the AVM, it can cause loss of vision in one place. * Headache (34%) * Progressive neurologic deficit (21%) * May be caused by mass effect or venous dilatations. Presence and nature of the deficit depend on location of lesion and the draining veins. * Pediatric patients * Heart failure * Macrocephaly * Prominent scalp veins Pulmonary arteriovenous malformations Pulmonary arteriovenous malformations are abnormal communications between the veins and arteries of the pulmonary circulation, leading to a right-to-left blood shunt. They have no symptoms in up to 29% of all cases, however they can give rise to serious complications including hemorrhage, and infection. They are most commonly associated with hereditary hemorrhagic telangiectasia. | risks of Sulfhemoglobinemia | causes of Hemolytic anemia | risks of Hypoxia | risks of Peritonitis | risks of Stevens–Johnson syndrome | risks of Refeeding syndrome | risks of Myocardial infarction | risks of Hypertriglyceridemia | 00
| 364 |
Posterior abdominal wall, after removal of the peritoneum, showing kidneys, suprarenal capsules, and great vessels. (Hepatic veins labeled at center top.) Any obstruction of the venous vasculature of the liver is referred to as<unk> , from the venules to the right atrium. This leads to increased portal vein and hepatic sinusoid pressures as the blood flow stagnates. The increased portal pressure causes increased filtration of vascular fluid with the formation of ascites in the abdomen and collateral venous flow through alternative veins leading to esophageal, gastric and rectal varices. Obstruction also causes centrilobular necrosis and peripheral lobule fatty change due to ischemia. If this condition persists chronically what is known as nutmeg liver will develop. Kidney failure may occur, perhaps due to the body sensing an "underfill" state and subsequent activation of the renin-angiotensin pathways and excess sodium retention. | Budd–Chiari syndrome | Hepatic veno-occlusive disease | Liver cancer | Nephrotic syndrome | Alcoholic liver disease | Fatty liver disease | Adams–Oliver syndrome | Hepatopulmonary syndrome | 00
| 14,648 |
In spite of Crohn's and UC being very different<unk> s, both may present with any of the following symptoms: abdominal pain, diarrhea, rectal bleeding, severe internal cramps/muscle spasms in the region of the pelvis and weight loss. Anemia is the most prevalent extraintestinal complication of<unk> . Associated complaints or<unk> s include arthritis, pyoderma gangrenosum, primary sclerosing cholangitis, and non-thyroidal illness syndrome (NTIS). Associations with deep vein thrombosis (DVT) and bronchiolitis obliterans organizing pneumonia (BOOP) have also been reported. Diagnosis is generally by assessment of<unk> markers in stool followed by colonoscopy with biopsy of pathological lesions. | Inflammatory bowel disease | Coeliac disease | Crohn's disease | Irritable bowel syndrome | Gastroenteritis | Ulcerative colitis | Anorexia nervosa | Chemical colitis | 00
| 15,082 |
The majority of people with<unk> are not symptomatic, and the findings are an incidental imaging abnormality. In some, the x-ray findings may correspond to symptoms of back stiffness with flexion/extension or with mild back pain. Back pain or stiffness may be worse in the morning. Rarely, large anterior cervical spine osteophytes may affect the esophagus or the larynx and cause pain, difficulty swallowing or even dyspnea. Similar calcification and ossification may be seen at peripheral entheseal sites, including the shoulder, iliac crest, ischial tuberosity, trochanters of the hip, tibial tuberosities, patellae, and bones of the hands and/or feet. | Diffuse idiopathic skeletal hyperostosis | Hereditary multiple exostoses | Giant-cell tumor of bone | Fibrous dysplasia of bone | Gerodermia osteodysplastica | Paget's disease of bone | Malignant infantile osteopetrosis | Pycnodysostosis | 00
| 58,601 |
The treatment of KTs has varied depending on their size, numbers, locations, symptoms, damage to tissues, and disfiguring effects. Excision may be the treatment of choice for surgically accessible lesions. However, following surgical removal, KTs have a high rate of local recurrence, particularly in cases where the lesions are not completely removed. Other treatment methods, which may be used in combination with surgical removal and/or with each other include: carbon dioxide-based laser vaporization; electrocauterization; shave excision of the tumor with phenolization (i.e. excision of the tumor’s protruding portion followed by treatment of the proximal perionych i.e., skin around a nail with phenol to eradicate the root of the tumor); and in individuals with tuberous sclerosis, topical application of sirolimus, i.e. rapamycin, (1% solution). Some of the latter methods have been used in order to preserve the nail matrix and nailplate and may be ideal for younger patients with few tumors since they may leave a normal appearing nail. | Koenen's tumor | Askin's tumor | Baker's cyst | Tarlov cyst | Krukenberg tumor | Bartholin's cyst | Tornwaldt cyst | Klatskin tumor | 00
| 55,381 |
<unk> is a cutaneous condition resulting from<unk> that may result in various skin lesions.<unk> strains can also infect human eyes causing<unk> keratitis. | Acanthamoeba infection | Soil-transmitted helminthiasis | Trichiasis | Hookworm infection | Pinworm infection | Trichuriasis | Ectoparasitic infestation | Helminthiasis | 00
| 55,654 |
Equipment<unk> s: a<unk> (also called a papillotome) is a catheter with a cutting wire at its far end. They have various configurations based on cutting wire length, outer diameter, number of lumens, and presence of other features such as the ability to rotate. The<unk> is connected to an electrosurgical generator, allowing the cutting wire to function as a knife when an electrical current is applied. Additional lumens allow the addition of a guidewire and injection of radio-opaque contrast. They can be broadly categorized as pull-type, push-type, or needle-knife. Pull-type: pull-type<unk> s consist of a steel cutting wire within a Teflon catheter. The wire exits the catheter approximately 3 cm before its distal end and re-enters the catheter approximately 3 mm from its tip. When tension is applied to the wire, the distal portion of the catheter becomes curved so that the exposed wire is brought upwards into contact with the<unk> sphincter and papilla, away from the catheter. Push-type: push-type<unk> s have a similar design to pull-type, but instead tightening the wire pushes it out to form a bow oriented downwards. This is useful for patients with Billroth II anatomy. Needle-knife: a needle-knife<unk> has a retractable cutting wire of 3 to 5 mm with a Teflon sheath. They are most often used for a pre-cut<unk> when standard methods of cannulation fail. Technique Standard<unk> : the<unk> is inserted into the bile duct. A cholangiogram is then used to evaluate any<unk> abnormalities requiring further intervention. The papilla is then incised with the cutting wire by applying electrocautery. Pre-cut<unk> : pre-cut<unk> refers to the techniques used to cut the papillary mucosa and<unk> sphincter in order to expose the underlying bile duct and gain access to it when standard cannulation fails. Transpancreatic<unk><unk> (septotomy): when the guidewire is unintentionally inserted into the main pancreatic duct the<unk> is then placed in the pancreatic duct and used to cut the septum between the pancreatic duct and bile duct. It is then withdrawn and re-directed through the incision site into the bile duct with the guidewire. Needle knife papillotomy: a needle knife<unk> is placed en face to the<unk> papilla. An incision is then made stepwise, starting at the upper margin of the papillary orifice and extending towards the<unk> sphincter, creating an incision to allow the bile duct to be cannulated. Needle knife fistulotomy: a needle knife fistulotomy has two different technique which are used. For the first technique an incision is made a few millimeters above the opening to the duct and then extended upwards. The other option is to make an incision in the roof of the papilla and then extend it either up or down without cutting the papillary orifice itself. The rate of pancreatitis after ERCP was significantly lower after fistulotomy, compared to other precut techniques. Modifications for anatomic variations Periampullary diverticulum: periampullary diverticulum makes the procedure more difficult because it becomes harder to assess the incision. Needle-knife fistulotomy or pancreatic stent placement followed by precut<unk> are two of several techniques that have been used to account for the increased difficulty. Surgically altered anatomy (Billroth II): if a patient has undergone a partial gastrectomy with Billroth II anastomosis, the papilla may appear to be upside down from the perspective of the endoscope compared to normal. Cannulation may need to be performed in a reverse position with the bile duct oriented downwards. | Biliary endoscopic sphincterotomy | Endoscopic retrograde cholangiopancreatography | Cholecystectomy | Hepatic artery embolization | Percutaneous ethanol injection | Percutaneous hepatic perfusion | Hepatoportoenterostomy | Cholecystenterostomy | 00
| 74,422 |
Risk factors The number of associated risk factors for dementia was increased from nine to twelve in 2020. The three newly added risks are over-indulgence in alcohol, traumatic brain injury, and air pollution. The other nine risk factors are: lower levels of education; high blood pressure; hearing<unk> ; smoking; obesity; depression; inactivity; diabetes, and low social contact. Many of these identified risk factors including, the lower level of education, smoking, physical inactivity and diabetes, are modifiable. Several of the group are known vascular risk factors that may be able to be reduced or eliminated. Managing these risk factors can reduce the risk of dementia in individuals in their late midlife or older age. A reduction in a number of these risk factors can give a positive outcome. The decreased risk achieved by adopting a healthy lifestyle is seen even in those with a high genetic risk. Based on the English Longitudinal Study of Ageing (ELSA), research found that loneliness in older people increased the risk of dementia by one-third. Not having a partner (being single, divorced, or widowed) doubled the risk of dementia. However, having two or three closer relationships reduced the risk by three-fifths. The two most modifiable risk factors for dementia are physical inactivity and lack of cognitive stimulation. Physical activity, in particular aerobic exercise, is associated with a reduction in age-related brain tissue<unk> , and neurotoxic factors thereby preserving brain volume and neuronal integrity. Cognitive activity strengthens neural plasticity and together they help to support cognitive reserve. The neglect of these risk factors diminishes this reserve. Studies suggest that sensory impairments of vision and hearing are modifiable risk factors for dementia. These impairments may precede the cognitive symptoms of Alzheimer's disease for example, by many years. Hearing<unk> may lead to social isolation which negatively affects cognition. Social isolation is also identified as a modifiable risk factor. Age-related hearing<unk> in midlife is linked to cognitive impairment in late life, and is seen as a risk factor for the development of Alzheimer's disease and dementia. Such hearing<unk> may be caused by a central auditory processing disorder that makes the understanding of speech against background noise difficult. Age-related hearing<unk> is characterised by slowed central processing of auditory information. Worldwide, mid-life hearing<unk> may account for around 9% of dementia cases. Evidence suggests that frailty may increase the risk of cognitive decline, and dementia, and that the inverse also holds of cognitive impairment increasing the risk of frailty. Prevention of frailty may help to prevent cognitive decline. A 2018 review however concluded that no medications have good evidence of a preventive effect, including blood pressure medications. A 2020 review found a decrease in the risk of dementia or cognitive problems from 7.5% to 7.0% with blood pressure lowering medications. Economic disadvantage has been shown to have a strong link to higher dementia prevalence, which cannot yet be fully explained by other risk factors. Dental health Limited evidence links poor oral health to cognitive decline. However, failure to perform tooth brushing and gingival inflammation can be used as dementia risk predictors. Oral bacteria The link between Alzheimer's and gum disease is oral bacteria. In the oral cavity, bacterial species include P. gingivalis, F. nucleatum, P. intermedia, and T. forsythia. Six oral treponema spirochetes have been examined in the brains of Alzheimer's patients. Spirochetes are neurotropic in nature, meaning they act to destroy nerve tissue and create inflammation. Inflammatory pathogens are an indicator of Alzheimer's disease and bacteria related to gum disease have been found in the brains of Alzheimer's disease sufferers. The bacteria invade nerve tissue in the brain, increasing the permeability of the blood-brain barrier and promoting the onset of Alzheimer's. Individuals with a plethora of tooth plaque risk cognitive decline. Poor oral hygiene can have an adverse effect on speech and nutrition, causing general and cognitive health decline. Oral viruses Herpes simplex virus (HSV) has been found in more than 70% of those aged over 50. HSV persists in the peripheral nervous system and can be triggered by stress, illness or fatigue. High proportions of viral-associated proteins in amyloid plaques or neurofibrillary tangles (NFTs) confirm the involvement of HSV-1 in Alzheimer's disease pathology. NFTs are known as the primary marker of Alzheimer's disease. HSV-1 produces the main components of NFTs. Diet Diet is seen to be a modifiable risk factor for the development of dementia. Thiamine deficiency is identified to increase the risk of Alzheimer's disease in adults. The role of thiamine in brain physiology is unique and essential for the normal cognitive function of older people. Many dietary choices of the elderly population including, the higher intake of gluten-free products, compromise the intake of thiamine as these products are not fortified with thiamine. The Mediterranean and DASH diets are both associated with less cognitive decline. A different approach has been to incorporate elements of both of these diets into one known as the MIND diet. These diets are generally low in saturated fats while providing a good source of carbohydrates, mainly those that help stabilize blood sugar and insulin levels. Raised blood sugar levels over a long time, can damage nerves and cause memory problems if they are not managed. Nutritional factors associated with the proposed diets for reducing dementia risk, include unsaturated fatty acids, antioxidants vitamin E vitamin C and flavonoids, vitamin B, and vitamin D. The MIND diet may be more protective but further studies are needed. The Mediterranean diet seems to be more protective against Alzheimer's than DASH but there are no consistent findings against dementia in general. The role of olive oil needs further study as it may be one of the most important components in reducing the risk of cognitive decline and dementia. In those with celiac disease or non-celiac gluten sensitivity, a strict gluten-free diet may relieve the symptoms given a mild cognitive impairment. Once dementia is advanced no evidence suggests that a gluten free diet is useful. Omega-3 fatty acid supplements do not appear to benefit or harm people with mild to moderate symptoms. However, there is good evidence that omega-3 incorporation into the diet is of benefit in treating depression, a common symptom, and potentially modifiable risk factor for dementia. | complications of Hearing loss | medical cause of Hearing loss | complications of Concussion | complications of Strabismus | symptom of Pierre Robin sequence | complications of Congenital heart defect | complications of Chiari malformation | symptom of Congenital heart defect | 00
| 2,801 |
Broad classification of arrhythmias according to region of heart required to sustain the rhythm Arrhythmia may be classified by rate (tachycardia, bradycardia), mechanism (automaticity, re-entry, triggered) or duration (isolated premature beats; couplets; runs, that is 3 or more beats; non-sustained = less than 30 seconds or sustained= over 30 seconds). Arrhythmias are also classified by site of origin: Atrial arrhythmia *Sinus bradycardia *Sinus arrhythmia *Sinus tachycardia *Premature atrial contractions (PACs) *Wandering atrial pacemaker *Atrial tachycardia *Multifocal atrial tachycardia *Supraventricular tachycardia (SVT) *Atrial flutter *Atrial fibrillation (Afib) *AV nodal reentrant tachycardia Junctional arrhythmia *AV nodal reentrant tachycardia *Junctional rhythm *Junctional tachycardia *Premature junctional contraction Ventricular arrhythmia=== *Premature ventricular contractions (PVCs), sometimes called ventricular extra beats (VEBs) *Premature ventricular beats occurring after every normal beat are termed ventricular bigeminy *PVCs that occur at intervals of 2 normal beats to 1 PVC, or 1 normal beat to 2 PVCs, are termed "PVCs in trigeminy" *Groups of three premature ventricular beats are called triplets and are considered a brief run of non-sustained ventricular tachycardia (NSVT); if the grouping lasts for more than 30 seconds, it is considered sustained ventricular tachycardia (VT). *Accelerated idioventricular rhythm *Monomorphic ventricular tachycardia *Polymorphic ventricular tachycardia *Ventricular fibrillation *Torsades de pointes *Arrhythmogenic right ventricular dysplasia *Re-entry ventricular arrhythmia Heart blocks These are also known as AV blocks, because the vast majority of them arise from pathology at the atrioventricular node. They are the most common causes of bradycardia: *First-degree heart block, which manifests as PR prolongation *Second-degree heart block *Type 1 Second degree heart block, also known as Mobitz I or Wenckebach *Type 2 Second degree heart block, also known as Mobitz II *Third-degree heart block, also known as complete heart block. First, second, and third-degree blocks also can occur at the level of the sinoatrial junction. This is referred to as sinoatrial block typically manifesting with various degrees and patterns of sinus bradycardia. Sudden arrhythmic death syndrome Sudden arrhythmic death syndrome (SADS), is a term used as part of sudden unexpected death syndrome to describe sudden death because of cardiac arrest occasioned by an arrhythmia in the presence or absence of any structural heart disease on autopsy. The most common cause of sudden death in the US is coronary artery disease specifically because of poor oxygenation of the heart muscle, that is myocardial ischemia or a heart attack Approximately 180,000 to 250,000 people die suddenly of this cause every year in the US. SADS may occur from other causes. There are many inherited conditions and heart diseases that can affect young people which can subsequently cause sudden death without advance symptoms. Causes of SADS in young people include viral myocarditis, long QT syndrome, Brugada syndrome, Catecholaminergic polymorphic ventricular tachycardia,<unk> cardiomyopathy and arrhythmogenic right ventricular dysplasia. Fetal arrhythmia Arrhythmias may also occur in the fetus. The normal heart rate of the fetus is between 110 and 160 beats per minute. Any rhythm beyond these limits is abnormal and classed as a fetal arrhythmia. These are mainly the result of premature atrial contractions, usually give no symptoms, and have little consequence. However, around one percent of these will be the result of significant structural damage to the heart. | complications of Hypertrophic cardiomyopathy | complications of Dilated cardiomyopathy | complications of Long QT syndrome | complications of Left ventricular hypertrophy | medical cause of Hypertrophic cardiomyopathy | medical cause of Dilated cardiomyopathy | complications of Atrial fibrillation | medical cause of Ventricular tachycardia | 00
| 58,182 |
Histopathology of<unk> types in a distal pancreatectomy specimen from a 60-year-old man, by gross pathology (center image), microscopy and immunohistochemistry: The resected specimen (c) revealed that the mural nodule in the MPD consisted of PB-type<unk> with high-grade dysplasia (adenocarcinoma) (a) with a diffuse positivity of p53 immunostaining (an insert) and KRAS mutation (G12V). The BD-IPMN of the body was lined by gastric mucinous epithelium showing low<unk> configuration with mild epithelial stratification with the same KRAS mutation (d), and the proliferation of similar gastric<unk> components sequentially involved the bottom of the mural nodule and the wall of the surrounding dilated MPD (indicated by red arrowheads) (b). The BD-IPMN of the tail was lined by flat, monolayer gastric mucinous epithelium lacking cellular atypia and KRAS mutation (e). In most cases,<unk> s are diagnosed based on clinical and radiographic criteria. If fluid from the cyst is aspirated, the CEA level is typically elevated. Confirmation of the diagnosis with tissue is rarely necessary. By histopathology,<unk> is characterized on light microscopy by Mucinous epithelial cells, and growth within the pancreatic ducts. Mucin 5AC is a useful immunohistochemistry marker. Characteristic genetic alterations are those of KRAS and GNAS. Further subtyping of<unk> can be done as either: *Gross pathology: Main duct, branch duct, and mixed duct lesions, which determines surgical management. Main duct lesion is the segmental or diffuse dilatation of main pancreatic duct greater than 5 mm without other causes of obstruction. Meanwhile, branch duct lesion is the pancreatic cyst more than 5 mm that communicates with the main duct. The mixed duct lesions fulfills both criteria above. *By light microscopy and immunohistochemistry: Gastric, intestinal, pancreaticbiliary, and oncocytic. | Intraductal papillary mucinous neoplasm | Pancreatic mucinous cystic neoplasm | Pancreatic serous cystadenoma | Pancreatic pseudocyst | Bile duct hamartoma | Pancreatic mucinous cystadenoma | Collecting duct carcinoma | Phyllodes tumor | 00
| 56,893 |
Although the convulsions caused by central nervous system<unk> may lead to incidental injury to the victim, it remained uncertain for many years whether damage to the nervous system following the seizure could occur and several studies searched for evidence of such damage. An overview of these studies by Bitterman in 2004 concluded that following removal of breathing gas containing high fractions of<unk> , no long-term neurological damage from the seizure remains. The majority of infants who have survived following an incidence of bronchopulmonary dysplasia will eventually recover near-normal lung function, since lungs continue to grow during the first 5–7 years and the damage caused by bronchopulmonary dysplasia is to some extent reversible (even in adults). However, they are likely to be more susceptible to respiratory infections for the rest of their lives and the severity of later infections is often greater than that in their peers. Retinopathy of prematurity (ROP) in infants frequently regresses without intervention and eyesight may be normal in later years. Where the disease has progressed to the stages requiring surgery, the outcomes are generally good for the treatment of stage 3 ROP, but are much worse for the later stages. Although surgery is usually successful in restoring the anatomy of the eye, damage to the nervous system by the progression of the disease leads to comparatively poorer results in restoring vision. The presence of other complicating diseases also reduces the likelihood of a favourable outcome. | Oxygen toxicity | Cerebral hypoxia | Nitrogen dioxide poisoning | Chromium toxicity | Histotoxic hypoxia | Fluoride toxicity | Chlorine gas poisoning | Silent hypoxia | 00
| 12,856 |
Histopathology of<unk> (or cartwheel)<unk> . This is a case of dermatofibrosarcoma protuberans. HE stain. plant whorl for comparison. A<unk> , cartwheel or whorled<unk> is a sign in histopathology which consists of spindle cells with elongated nuclei radiating from a center point. The name<unk> " originates from Latin storea (woven), as<unk> tissue tends to resemble woven fabric on microscopy. Skin tumors that can be classified as<unk> " are mainly: *Fibrous histiocytoma (dermatofibroma) *Soft tissue perineurioma *Dermatofibrosarcoma protuberans A collagenoma, having a cartwheel or woven appearance. | Storiform pattern | Mulibrey nanism | Cyclic alternating pattern | Homogeneously staining region | Vertical auto profile | Tunnel cluster | Zoobiquity | Lancefield grouping | 00
| 74,206 |
They can be divided into short-acting, long-acting, and ultra-long-acting<unk> adrenoreceptor agonists: Generic name—Trade name Short-acting β2 agonists (SABAs) * bitolterol—Tornalate * fenoterol—Berotec * isoprenaline (INN) or isoproterenol (USAN)—Isuprel * levosalbutamol (INN) or levalbuterol (USAN)—Xopenex * orciprenaline (INN) or metaproterenol (USAN)—Alupent * pirbuterol—Maxair * procaterol * ritodrine—Yutopar * salbutamol (INN) or albuterol (USAN)—Ventolin * terbutaline—Bricanyl Long-acting β2 agonists (LABAs) * arformoterol—Brovana (some consider it to be an ultra-LABA) * bambuterol—Bambec, Oxeol * clenbuterol—Dilaterol, Spiropent * formoterol—Foradil, Oxis, Perforomist * salmeterol—Serevent Ultra-long-acting β2 agonists * abediterol * carmoterol * indacaterol—Arcapta Neohaler (U.S.), Onbrez Breezhaler (EU, RU) * olodaterol—Striverdi Respimat * vilanterol * with umeclidinium bromide—Anoro Ellipta * with fluticasone furoate—Breo Ellipta (U.S.), Relvar Ellipta (EU, RU) * with fluticasone furoate and umeclidinium bromide—Trelegy Ellipta Unknown duration of action * isoxsuprine * mabuterol * zilpaterol—Zilmax | Beta2-adrenergic agonist | Beta-adrenergic agonist | Alpha-adrenergic agonist | Muscarinic antagonist | Norepinephrine–dopamine disinhibitor | Dopamine agonist | Adrenergic release inhibitor | Adenosine receptor antagonist | 00
| 24,853 |