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<unk> s range in size from microscopic diode<unk> s (top) with numerous applications, to football field sized neodymium glass<unk> s (bottom) used for inertial confinement fusion, nuclear weapons research and other high energy density physics experiments. When<unk> s were invented in 1960, they were called "a solution looking for a problem". Since then, they have become ubiquitous, finding utility in thousands of highly varied applications in every section of modern society, including consumer electronics, information technology, science, medicine, industry, law enforcement, entertainment, and the military. Fiber-optic communication using<unk> s is a key technology in modern communications, allowing services such as the Internet. The first widely noticeable use of<unk> s was the supermarket barcode scanner, introduced in 1974. The<unk> disc player, introduced in 1978, was the first successful consumer product to include a<unk> but the compact disc player was the first<unk> -equipped device to become common, beginning in 1982 followed shortly by<unk> printers. Some other uses are: * Communications: besides fiber-optic communication,<unk> s are used for free-space optical communication, including<unk> communication in space. * Medicine: see below. * Industry: cutting including converting thin materials, welding, material heat treatment, marking parts (engraving and bonding), additive manufacturing or 3D printing processes such as selective<unk> sintering and selective<unk> melting, non-contact measurement of parts and 3D scanning, and<unk> cleaning. * Military: marking targets, guiding munitions, missile defense, electro-optical countermeasures (EOCM), lidar, blinding troops, firearms sight. See below * Law enforcement: LIDAR traffic enforcement.<unk> s are used for latent fingerprint detection in the forensic identification field * Research: spectroscopy,<unk> ablation,<unk> annealing,<unk> scattering,<unk> interferometry, lidar,<unk> capture microdissection, fluorescence microscopy, metrology,<unk> cooling. * Commercial products:<unk> printers, barcode scanners, thermometers,<unk> pointers, holograms, bubblegrams. * Entertainment: optical discs,<unk> lighting displays,<unk> turntables In 2004, excluding diode<unk> s, approximately 131,000<unk> s were sold with a value of US$2.19 billion. In the same year, approximately 733 million diode<unk> s, valued at $3.20 billion, were sold. In medicine<unk> s have many uses in medicine, including<unk> surgery (particularly eye surgery),<unk> healing, kidney stone treatment, ophthalmoscopy, and cosmetic skin treatments such as acne treatment, cellulite and striae reduction, and hair removal.<unk> s are used to treat cancer by shrinking or destroying tumors or precancerous growths. They are most commonly used to treat superficial cancers that are on the surface of the body or the lining of internal organs. They are used to treat basal cell skin cancer and the very early stages of others like cervical, penile, vaginal, vulvar, and non-small cell lung cancer.<unk> therapy is often combined with other treatments, such as surgery, chemotherapy, or radiation therapy.<unk> -induced interstitial thermotherapy (LITT), or interstitial<unk> photocoagulation, uses<unk> s to treat some cancers using hyperthermia, which uses heat to shrink tumors by damaging or killing cancer cells.<unk> s are more precise than traditional surgery methods and cause less damage, pain, bleeding, swelling, and scarring. A disadvantage is that surgeons must have specialized training. It may be more expensive than other treatments. As weapons A<unk> weapon is a<unk> that is used as a directed-energy weapon. Tactical High Energy weapon has been used to shoot down rockets and artillery shells. Hobbies In recent years, some hobbyists have taken interests in<unk> s.<unk> s used by hobbyists are generally of class IIIa or IIIb (see Safety), although some have made their own class IV types. However, compared to other hobbyists,<unk> hobbyists are far less common, due to the cost and potential dangers involved. Due to the cost of<unk> s, some hobbyists use inexpensive means to obtain<unk> s, such as salvaging<unk> diodes from broken DVD players (red), Blu-ray players (violet), or even higher power<unk> diodes from CD or DVD burners. Hobbyists also have been taking surplus pulsed<unk> s from retired military applications and modifying them for pulsed holography. Pulsed Ruby and pulsed YAG<unk> s have been used. Examples by power<unk> application in astronomical adaptive optics imaging Different applications need<unk> s with different output powers.<unk> s that produce a continuous beam or a series of short pulses can be compared on the basis of their average power.<unk> s that produce pulses can also be characterized based on the peak power of each pulse. The peak power of a pulsed<unk> is many orders of magnitude greater than its average power. The average output power is always less than the power consumed. + The continuous or average power required for some uses: Power Use<unk> pointers CD-ROM drive DVD player or DVD-ROM drive High-speed CD-RW burner Consumer 16× DVD-R burner DVD 24× dual-layer recording Green<unk> in Holographic Versatile Disc prototype development Output of the majority of commercially available solid-state<unk> s used for micro machining Typical sealed CO2 surgical<unk> s Typical sealed CO2<unk> s used in industrial<unk> cutting Examples of pulsed systems with high peak power: * 700 TW (700×1012 W) – National Ignition Facility, a 192-beam, 1.8-megajoule<unk> system adjoining a 10-meter-diameter target chamber * 10 PW (10×1015 W) – world's most powerful<unk> as of 2019, located at the ELI-NP facility in Măgurele, Romania. | Laser | Nd:YAG laser | Comedo extraction | Whitfield's ointment | Oculoplastics | Crusaid | Eyepatch | Contact lens | 00
| 1,245 |
The root cause of the condition is not entirely clear, and it appears to have multiple causes, including iatrogenic cause from misplaced epidural steroid injection therapy when accidentally administered intrathecally (inside the dura mater, the sac enveloping the arachnoid mater), or from contrast media used in myelography prior to the development of metrizamide and other water-soluble contrast agents. Other noninfectious inflammatory processes include surgery, intrathecal hemorrhage, and the administration of anesthetics (e.g. chloroprocaine), and steroids (e.g. prednisolone, triamcinolone acetonide). A variety of other causes exist, including infectious, inflammatory, and neoplastic processes. Infectious causes include bacterial, viral, fungal, and parasitic agents. Prior spinal surgery has been documented as a cause of<unk> ossificans, as well as for the adhesive form. It can also be caused by long term pressure from either a severe disc herniation or spinal stenosis. | Arachnoiditis | Idiopathic intracranial hypertension | Subdural empyema | Brain abscess | Cavernous sinus thrombosis | Subdural hematoma | Labyrinthitis | Pseudosubarachnoid hemorrhage | 00
| 22,745 |
<unk> , sold under the brand name Remeron among others, is an atypical antidepressant, and as such is used primarily to treat depression. Its effects may take up to four weeks, but can also manifest as early as one to two weeks. It is often used in cases of depression complicated by anxiety or insomnia. The effectiveness of<unk> is comparable to other commonly prescribed antidepressants. It is taken by mouth. Common side effects include sleepiness, dizziness, increased appetite and weight gain. Serious side effects may include mania, low white blood cell count, and increased suicide among children. Withdrawal symptoms may occur with stopping. It is not recommended together with an MAO inhibitor, although evidence supporting the danger of this combination has been refuted. It is unclear if use during pregnancy is safe. How it works is not clear, but it may involve blocking certain adrenergic and serotonin receptors. Chemically, it is a tetracyclic antidepressant (TeCA), and is closely related to mianserin. It also has strong antihistaminergic effects.<unk> came into medical use in the United States in 1996. The patent expired in 2004, and generic versions are available. In 2019, it was the 106th most commonly prescribed medication in the United States, with more than 6million prescriptions. | Mirtazapine | Sertraline | Citalopram | Fluparoxan | Quetiapine | Asenapine | Loxapine | Escitalopram | 00
| 13,746 |
<unk> s, also known as<unk> ors, are substances (drugs and nutrients) that stimulate the immune system by inducing activation or increasing activity of any of its components. One notable example is the granulocyte macrophage colony-stimulating factor. | Immunostimulant | Antiseptic | Antimicrobial | Antiviral drug | Antifungal | Antiparasitic | Prebiotic | Analgesic | 00
| 30,615 |
Management of<unk> , particularly in severe cases, can be complex and require the joint effort of multiple subspecialists. This is a rare disease with no consensus treatment guidelines or large randomized controlled trials to guide therapy. Supportive care Patient with<unk> can be extremely ill and may need intensive care. They are at risk of bleeding complications including intracranial hemorrhage. The thrombocytopenia and coagulopathy are managed with platelet transfusions and fresh frozen plasma, although caution is needed due to the risk of fluid overload and heart failure from multiple transfusions. The possibility of disseminated intravascular coagulation, a dangerous and difficult-to-manage condition, is concerning. Anticoagulant and antiplatelet medications can be used after careful assessment of the risks and benefits. Definitive treatment Generally, treatment of the underlying vascular tumor results in resolution of<unk> . If complete surgical resection is feasible, it provides a good opportunity for cure (although it can be dangerous to operate on a vascular tumor in a patient prone to bleeding, even with appropriate surgical subspecialists involved). If surgery is not possible, various other techniques can be used to control the tumor: :*embolization (by interventional radiology) can limit the tumor's blood supply :*external compression bandages can have similar effects :*certain medications, including: :**corticosteroids :**alpha-interferon :**chemotherapy (e.g. vincristine) :*radiation therapy has been used, often successfully, but now is avoided whenever possible due to the risk of long-term adverse effects (e.g. risk for future cancer). | Kasabach–Merritt syndrome | Rapp–Hodgkin syndrome | Bare lymphocyte syndrome type II | Pitt–Hopkins syndrome | Schwartz–Jampel syndrome | Hypotrichosis–lymphedema–telangiectasia syndrome | Schwartz–Matsuo syndrome | Bare lymphocyte syndrome | 00
| 36,821 |
<unk> typically requires no treatment. In those who do need treatment, metroplasty is the surgical correction of choice. Women who have recurrent miscarriage with no other explanation may benefit from surgery. | Bicornuate uterus | Unicornuate uterus | Arcuate uterus | Couvelaire uterus | T-shaped uterus | Retroverted uterus | Ectopic decidua | Peritoneal inclusion cyst | 00
| 38,699 |
The<unk> is a national<unk><unk> network sponsored by the National Cancer Institute (NCI) that consists of about 10,000 cancer specialists at hospitals, medical centers, and community clinics across the United States and Canada. The<unk> develops and conducts<unk><unk> with promising new cancer therapies, and utilizes scientific research to develop treatment and prevention strategies for cancer, as well as researching methods to alleviate side effects of cancer and cancer treatments. The<unk> seeks to reduce the impact of cancer on people by uniting a broad community of scientists and clinicians from many disciplines, committed to discovering, validating and disseminating effective strategies for the prevention and treatment of cancer. The<unk> conducts<unk> in the following disease and modality areas: breast, gastrointestinal (GI), genitourinary (GU), leukemia, lymphoma, myeloma, neuro-oncology, respiratory, experimental therapeutics (rare cancers), cancer control and transplant. The<unk> was formed by the merger of three legacy<unk><unk> groups: the American College of Surgeons<unk> Group (ACOSOG), the Cancer and Leukemia Group B (CALGB), and the North Central Cancer Treatment Group (NCCTG). The merger was completed in 2014. | Alliance for Clinical Trials in Oncology | NCI-designated Cancer Center | European Organisation for Research and Treatment of Cancer | Cancer Research UK | American Association for Cancer Research | Personalized onco-genomics | Molecular tumor board | Comparative oncology | 00
| 61,756 |
In particular, a few limitations of PC-MRI are of importance for the measured velocities: * Partial volume effects (when a voxel contains the boundary between static and moving materials) can overestimate<unk> leading to inaccurate velocities at the interface between materials or tissues. * Intravoxel<unk> dispersion (when velocities within a pixel are heterogeneous or in areas of turbulent flow) can produce a resultant<unk> that does not resolve the flow features accurately. * Assuming that acceleration and higher orders of motion are negligible can be inaccurate depending on the flow field. * Displacement artifacts (also known as misregistration and oblique flow artifacts) occur when there is a time difference between the<unk> and frequency encoding. These artifacts are highest when the flow direction is within the slice plane (most prominent in the heart and aorta for biological flows) | Phase contrast magnetic resonance imaging | Contrast-enhanced ultrasound | Magnetic field imaging | Radionuclide angiography | Synthetic MRI | Magnetic resonance angiography | Amplified magnetic resonance imaging | Contrast CT | 00
| 68,759 |
Deaths due to<unk> per million persons in 2012 Disability-adjusted life year for<unk> per 100,000 inhabitants in 2004. A moderate degree of<unk> affects approximately 610 million people worldwide or 8.8% of the population. It is slightly more common in females (9.9%) than males (7.8%). Up to 15% of children ages 1–3 years have<unk> . Mild<unk> affects another 375 million.<unk><unk> affects up to 52% of pregnant women worldwide. The prevalence of<unk><unk> as a cause of<unk> varies among countries; in the groups in which<unk> is most common, including young children and a subset of non-pregnant women,<unk><unk> accounts for a fraction of<unk> cases in these groups (25% and 37%, respectively).<unk><unk> is common in pregnant women. Within the United States,<unk> affects about 2% of adult males, 10.5% of Caucasian women, and 20% of African-American and Mexican-American women. A map provides a country-by-country listing of what nutrients are fortified into specified foods. Some of the Sub-Saharan countries shown in the deaths from<unk> map from 2012 are as of 2018 fortifying foods with<unk> . | Iron-deficiency anemia | Lead poisoning | Iatrogenic anemia | Megaloblastic anemia | Hemoglobinemia | Nutritional anemia | Sideroblastic anemia | Myelophthisic anemia | 00
| 14,728 |
There are many causes of back pain, including blood vessels, internal organs, infections, mechanical, and autoimmune causes. Approximately 90 percent of people with back pain are diagnosed with nonspecific acute back pain in which there is no identifiable underlying pathology. In approximately 10 percent of people, a cause can be identified through diagnostic imaging. Less than 2 percent of cases are attributed to secondary factors, with metastatic cancers and serious infections, such as spinal osteomyelitis and epidural abscesses, accounting for around 1 percent. +Common causes Cause % of people with back pain Nonspecific 90% Vertebral compression fracture 4% Metastatic cancer 0.7% Infection 0.01% Cauda equina 0.04% Nonspecific In as many as 90 percent of cases, no physiological causes or abnormalities on diagnostic tests can be found. Nonspecific back pain can be due to back strain/sprain. The cause is peripheral injury to muscle or ligaments. The patient may or may not recall the cause. The pain can present acutely but in some cases can persist, leading to chronic pain. Chronic back pain in people with otherwise normal scans can result from central sensitization, where an initial injury causes a longer-lasting state of heightened sensitivity to pain. This persistent state maintains pain even after the initial injury has healed. Treatment of sensitization may involve low doses of anti-depressants and directed rehabilitation such as physical therapy. Spinal disc disease Spinal disc disease occurs when the nucleus pulposus, a gel-like material in the inner core of the vertebral disc, ruptures. Rupturing of the nucleus pulposus can lead to compression of nerve roots. Symptoms may be unilateral or bilateral, and correlate to the region of the spine affected. The most common region for spinal disk disease is at L4–L5 or L5–S1. The risk for lumbar disc disease is increased in overweight individuals due to the increased compressive force on the nucleus pulposus, and is twice as likely to occur in men. A 2002 study found that lifestyle factors such as night shift work and lack of sporting activity can also increase the risk of lumbar disk disease. Lumbar disc herniation Severe spinal cord compression is considered a surgical emergency and requires decompression to preserve motor and sensory function. Cauda equina syndrome refers to severe compression of the cauda equina and presents initially with pain followed by motor and sensory. Bladder incontinence is seen in later stages of the cauda equina syndrome. Degenerative disease Spondylosis, or degenerative arthritis of the spine, occurs when the intervertebral disc undergoes degenerative changes, causing the disc to fail at cushioning the vertebrae. There is an association between intervertebral disc space narrowing and lumbar spine pain. The space between the vertebrae becomes more narrow, resulting in compression and irritation of the nerves. Spondylolithesis is the anterior shift of one vertebra compared to the neighboring vertebra. It is associated with age-related degenerative changes as well as trauma and congenital anomalies. Spinal stenosis can occur in cases of severe spondylosis, spondylotheisis and age associated thickening of the ligamentum flavum. Spinal stenosis involves narrowing of the spinal canal and typically presents in patients greater than 60 years of age. Neurogenic claudication can occur in cases of severe lumbar spinal stenosis and presents with symptoms of pain in the lower back, buttock or leg that is worsened by standing and relieved by sitting. Vertebral compression fractures occurs in 4 percent of patients presenting to primary care with low back pain. Risk factors include age, female gender, history of osteoporosis, and chronic glucocorticoid use. Fractures can occur due to trauma but in many cases can be asymptomatic. Infection Common infectious causes of back pain include osteomyelitis, septic diskitis, paraspinal abscess, and epidural abscess. Infectious causes that lead to back pain involve various structures surrounding the spine. Osteomyelitis is the bacterial infection of the bone. Vertebral osteomyelitis is most commonly caused by staphylococci. Risk factors include skin infection, urinary tract infection, IV catheter use, IV drug use, previous endocarditis, and lung disease. Spinal epidural abscess is also commonly caused by severe infection with bacteremia. Risk factors include recent epidural, IV drug use, or recent infection. Cancer Spread of cancer to the bone or spinal cord can lead to back pain. Bone is one of the most common sites of metastatic lesions. Patients typically have a history of malignancy. Common types of cancer that present with back pain include multiple myeloma, lymphoma, leukemia, spinal cord tumors, primary vertebral tumors, and prostate cancer. Back pain is present in 29% of patients with systemic cancer. Unlike other causes of back pain which commonly affect the lumbar spine, the thoracic spine is most commonly affected. The pain can be associated with systemic symptoms such as weight loss, chills, fever, nausea and vomiting. Unlike other causes of back pain, neoplasm-associated back pain is constant, dull, poorly localized, and worst with rest. Metastasis to the bone also increases the risk of spinal cord compression or vertebral fractures which requires emergent surgical treatment. Autoimmune Back pain can be caused by the vertebrae compressing the intervertebral discs. Inflammatory arthritides such as ankylosing spondylitis, psoriatic arthritis, rheumatoid arthritis, and systemic lupus erythematosus can all cause varying levels of joint destruction. Among the inflammatory arthritides, ankylosing spondylitis is most closely associated with back pain due to the inflammatory destruction of the bony components of the spine. Ankylosing spondylitis is common in young men and presents with a range of possible symptoms such as uveitis, psoriasis, and inflammatory bowel disease. Referred pain Back pain can also be due to referred pain from another source. Referred pain occurs when pain is felt at a location different from the source of the pain. Disease processes that can present with back pain include pancreatitis, kidney stones, severe urinary tract infections, and abdominal aortic aneurysms. Risk factors Heavy lifting, obesity, sedentary lifestyle, and lack of exercise can increase a person's risk of back pain. People who smoke are more likely to experience back pain than others. Poor posture and weight gain in pregnancy are also risk factors for back pain. In general, fatigue can worsen pain. A few studies suggest that psychosocial factors such as on-the-job stress and dysfunctional family relationships may correlate more closely with back pain than structural abnormalities revealed in X-rays and other medical imaging scans. | complications of Achondroplasia | complications of Prader–Willi syndrome | complications of Noonan syndrome | complications of Treacher Collins syndrome | complications of Kallmann syndrome | complications of Nuchal cord | symptom of Achondroplasia | onset of Klippel–Feil syndrome | 00
| 6,475 |
According to UNFPA, there are four essential elements for prevention of<unk> . These include, prenatal care, assistance with birth, access to emergency obstetric care and adequate postnatal care. It is recommended that expectant mothers receive at least four antenatal visits to check and monitor the health of mother and fetus. Second, skilled birth attendance with emergency backup such as doctors, nurses and midwives who have the skills to manage normal deliveries and recognize the onset of complications. Third, emergency obstetric care to address the major causes of<unk> which are hemorrhage, sepsis, unsafe abortion, hypertensive disorders and obstructed labor. Lastly, postnatal care which is the six weeks following delivery. During this time, bleeding, sepsis and hypertensive disorders can occur, and newborns are extremely vulnerable in the immediate aftermath of birth. Therefore, follow-up visits by a health worker to assess the health of both mother and child in the postnatal period is strongly recommended. Additionally, reliable access to information, compassionate counseling and quality services for the management of any issues that arise from abortions (whether safe or unsafe) can be beneficial in reducing the number of<unk> s. In regions where abortion is legal, abortion practices need to be safe in order to effectively reduce the number of<unk> s related to abortion.<unk> Surveillance and Response is another strategy that has been used to prevent<unk> . This is one of the interventions proposed to reduce<unk> mortality where<unk> s are continuously reviewed to learn the causes and factors that led to the<unk> . The information from the reviews is used to make recommendations for action to prevent future similar<unk> s.<unk> and perinatal<unk> reviews have been in practice for a long time worldwide, and the World Health Organization (WHO) introduced the<unk> and Perinatal<unk> Surveillance and Response (MPDSR) with a guideline in 2013. Studies have shown that acting on recommendations from MPDSR can reduce<unk> and perinatal mortality by improving quality of care in the community and health facilities. Prenatal Care It was estimated that in 2015, a total of 303,000 women died due to causes related to pregnancy or childbirth. The majority of these were due to severe bleeding, sepsis or infections, eclampsia, obstructed labor, and consequences from unsafe abortions. Most of these causes are either preventable or have highly effective interventions. An important factor that contributes to the<unk> mortality rate is access and opportunity to receive prenatal care. Women who do not receive prenatal care are between three and four times more likely to die from complications resulting from pregnancy or delivery than those who receive prenatal care. Even in high-resource countries, many women do not receive the appropriate preventative or prenatal care. For example, 25% of women in the United States do not receive the recommended number of prenatal visits. This number increases for women among traditionally marginalized populations—32% of African American women and 41% for American Indian and Alaska Native women do not receive the recommended preventative health services prior to delivery. Medical technologies The decline in<unk> s has been due largely to improved aseptic techniques, better fluid management and quicker access to blood transfusions, and better prenatal care. Technologies have been designed for resource poor settings that have been effective in reducing<unk> s as well. The non-pneumatic anti-shock garment is a low-technology pressure device that decreases blood loss, restores vital signs and helps buy time in delay of women receiving adequate emergency care during obstetric hemorrhage. It has proven to be a valuable resource. Condoms used as uterine tamponades have also been effective in stopping post-partum hemorrhage. Medications and Surgical Management Some<unk> s can be prevented through medication use. Injectable oxytocin can be used to prevent<unk> due to postpartum bleeding. Additionally, postpartum infections can be treated using antibiotics. In fact, the use of broad-spectrum antibiotics both for the prevention and treatment of<unk> infection is common in low-income countries.<unk> due to eclampsia can also be prevented through the use of medications such as magnesium sulfate. Many complications can be managed with procedures and/or surgery if there is access to a qualified surgeon and appropriate facilities and supplies. For example, the contents of the uterus can be cleaned if there is concern for remaining pregnancy tissue or infection. If there is concern for excess bleeding, special ties, stitches or tools (Bakri Balloon) can be placed if there is concern for excess bleeding. Public health In April 2010 Sierra Leone launched free healthcare for pregnant and breastfeeding women. A public health approach to addressing<unk> mortality includes gathering information on the scope of the problem, identifying key causes, and implementing interventions, both prior to pregnancy and during pregnancy, to combat those causes and prevent<unk> mortality. Public health has a role to play in the analysis of<unk> . One important aspect in the review of<unk> and its causes are<unk> Mortality Review Committees or Boards. The goal of these review committees are to analyze each<unk> and determine its cause. After this analysis, the information can be combined in order to determine specific interventions that could lead to preventing future<unk> s. These review boards are generally comprehensive in their analysis of<unk> s, examining details that include mental health factors, public transportation, chronic illnesses, and substance use disorders. All of this information can be combined to give a detailed picture of what is causing<unk> mortality and help to determine recommendations to reduce their impact. Many states within the US are taking<unk> Mortality Review Committees a step further and are collaborating with various professional organizations to improve quality of perinatal care. These teams of organizations form a "perinatal quality collaborative" (PQC) and include state health departments, the state hospital association and clinical professionals such as doctors and nurses. These PQCs can also involve community health organizations, Medicaid representatives,<unk> Mortality Review Committees and patient advocacy groups. By involving all of these major players within<unk> health, the goal is to collaborate and determine opportunities to improve quality of care. Through this collaborative effort, PQCs can aim to make impacts on quality both at the direct patient care level and through larger system devices like policy. It is thought that the institution of PQCs in California was the main contributor to the<unk> mortality rate decreasing by 50% in the years following. The PQC developed review guides and quality improvement initiatives aimed at the most preventable and prevalent<unk> s: those due to bleeding and high blood pressure. Success has also been observed with PQCs in Illinois and Florida. Several interventions prior to pregnancy have been recommended in efforts to reduce<unk> mortality. Increasing access to reproductive healthcare services, such as family planning services and safe abortion practices, is recommended in order to prevent unintended pregnancies. Several countries, including India, Brazil, and Mexico, have seen some success in efforts to promote the use of reproductive healthcare services. Other interventions include high quality sex education, which includes pregnancy prevention and sexually transmitted infection (STI) prevention and treatment. By addressing STIs, this not only reduces perinatal infections, but can also help reduce ectopic pregnancy caused by STIs. Adolescents are between two and five times more likely to suffer from<unk> mortality than a female twenty years or older. Access to reproductive services and sex education could make a large impact, specifically on adolescents, who are generally uneducated in regards to carrying a healthy pregnancy. Education level is a strong predictor of<unk> health as it gives women the knowledge to seek care when it is needed. Public health efforts can also intervene during pregnancy to improve<unk> outcomes. Areas for intervention have been identified in access to care, public knowledge, awareness about signs and symptoms of pregnancy complications, and improving relationships between healthcare professionals and expecting mothers. Access to care during pregnancy is a significant issue in the face of<unk> mortality. "Access" encompasses a wide range of potential difficulties including costs, location of healthcare services, availability of appointments, availability of trained health care workers, transportation services, and cultural or language barriers that could inhibit a woman from receiving proper care. For women carrying a pregnancy to term, access to necessary antenatal (prior to delivery) healthcare visits is crucial to ensuring healthy outcomes. These antenatal visits allow for early recognition and treatment of complications, treatment of infections and the opportunity to educate the expecting mother on how to manage her current pregnancy and the health advantages of spacing pregnancies apart. Access to birth at a facility with a skilled healthcare provider present has been associated with safer deliveries and better outcomes. The two areas bearing the largest burden of<unk> mortality, Sub-Saharan Africa and South Asia, also had the lowest percentage of births attended by a skilled provider, at just 45% and 41% respectively. Emergency obstetric care is also crucial in preventing<unk> mortality by offering services like emergency cesarean sections, blood transfusions, antibiotics for infections and assisted vaginal delivery | Maternal death | Stillbirth | Maternal near miss | Fetal-maternal haemorrhage | After-birth abortion | Unsafe abortion | Maternal-fetal conflict | Forced pregnancy | 00
| 11,319 |
They are members of the<unk> workforce trained in the technical aspects of the supply of medicines and medical devices to patients. They may have a high level of expertise and ability to tackle difficult situations. Some<unk> s are experts in their fields; for example, medicines management, clinical trials and aseptically compounding sterile and non-sterile medicines.<unk> s work in a variety of locations (usually in community, retail, and hospital<unk> es), but can also work for long-term care facilities,<unk> utical manufacturers, third-party insurance companies, computer software companies, in government, or in teaching. Job responsibilities often include dispensing prescription drugs and other medical devices to patients and instructing patients on their use. They may also perform administrative duties in<unk> utical practice, such as reviewing prescription requests with doctor's offices and insurance companies to ensure correct medications are provided and payment is received. Additionally,<unk> s handle inventory related tasks such as cycle counts and returning expired and damaged medications back to the manufacturers.<unk> s may take on the role of Compounding Supervisor, overseeing day to day sterile and non-sterile medicines preparation while meeting standards required by regulatory bodies. In recent times,<unk> s also speak directly with the patients on the phone to aid in the awareness of taking medications on time. In many countries, both developed and developing, the relative importance of<unk> s within the<unk> workforce has been amplified in recent years, largely as a reaction to<unk> st shortages, resulting in an increase in their numbers and responsibilities; alternative medicine,<unk> therapeutics, customer care, retail and hospital software systems, inventory management, and infection control. Practical training, such as completing an internship in a<unk> , is required as part of training for licensing and employment as a<unk> . Many employers favour<unk> s to be certified by a national and/or local<unk> boards by passing standard written and practical examinations, including paying licensing fees and obtaining liability insurance. In the United States, voluntary certification is available through many private organizations. Elsewhere, such as in Canada, Tanzania and the United Kingdom,<unk> s are required to be registered with a provincial or a national regulatory body or council. | Pharmacy technician | Pharmacist | Biological pharmacist | Clinician | Biomedical scientist | Clinical biologist | Mental health professional | Biomedical equipment technician | 00
| 22,228 |
<unk> is useful for diagnosing vesicovaginal or ureterovaginal fistulae. For this test, the patient takes oral phenazopyridine (Pyridium) 200 mg three times a day, and indigo carmine or methylene blue is filled into the empty urinary bladder via a urethral catheter. Pyridium turns urine orange in the kidneys, and methylene blue (or indigo carmine) turns urine blue in the bladder. A tampon is placed into the vagina. If the tampon turns blue, vesicovaginal fistula is suspected. If the tampon turns orange, ureterovaginal fistula is suspected. If the tampon turns blue and orange, suspect a combination of vesicovaginal and ureterovaginal fistulae. It is important to be alert for leakage around the catheter, which may spill back into the vagina creating the false impression of a fistula. It is also important to ensure that adequate distension of the bladder occurs as some fistulae do not leak at small volumes; conversely, some fistulae with an oblique track through the bladder wall may leak at small volumes, but not at capacity. Direct inspection of leaking<unk> in vagina in lithotomy position is better than the traditional 'three swab test' as multiple fistulae may be located in this way. | Double dye test | Dye tracing | Lancaster red-green test | Lateral flow test | Laser Doppler imaging | Intravascular fluorescence | Acid perfusion test | Peritoneal equilibration test | 00
| 47,734 |
The FDA label includes a boxed warning about the risk of potential heart failure, fetal harm, and lung toxicity. | Pertuzumab/trastuzumab/hyaluronidase | Trastuzumab/hyaluronidase | Daratumumab/hyaluronidase | Bortezomib/dexamethasone | Loncastuximab tesirine | Decitabine/cedazuridine | Trastuzumab emtansine | Trifluridine/tipiracil | 00
| 73,608 |
There is no cure for<unk> ; the goals of treatment are to reduce symptoms and slow the progression of disease. Although the evidence that stopping exposure to beryllium decreases progression of the disease is limited, it is still considered to be an accepted approach to treatment in any stage of disease. People with early stages of disease, without lung function abnormalities or clinical symptoms, are periodically monitored with physical exams, pulmonary function testing and radiography. Once clinical symptoms or significant abnormalities in pulmonary function testing appear, treatments include oxygen and oral corticosteroids and whatever supportive therapy is required. | Berylliosis | Baritosis | Metastrongylosis | Tungiasis | Acanthocheilonemiasis | Naegleriasis | Necatoriasis | Sulfatidosis | 00
| 7,689 |
At present there is no specific treatment. Many patients with haemolytic anaemia take folic acid (vitamin B9) since the greater turnover of cells consumes this vitamin. During crises transfusion may be required. Clotting problems can occur for which anticoagulation may be needed. Unlike hereditary spherocytosis, splenectomy is contraindicated. | Hereditary stomatocytosis | Hereditary sclerosing poikiloderma | Hypohidrotic ectodermal dysplasia | Hereditary angioedema | Nickel allergy | Rapunzel syndrome | Hereditary mucoepithelial dysplasia | Griscelli syndrome | 00
| 32,872 |
The average life expectancy of an individual with any type of<unk> and no neurological symptoms is approximately 37 years, and 29 years if neurological symptoms are present. In the United States, the probability for individuals with the disorder to survive until 40 years of age may be as high as 70% if they have never been exposed to sunlight in their life. In India, many patients with<unk> die at an early age from skin cancers. However, if a person is diagnosed early, does not have severe neurological symptoms, and takes precautionary measures to completely avoid any exposure to UV light and sunlight, they may be able to survive until middle age. | Xeroderma pigmentosum | Cockayne syndrome | Iododerma | Erythropoietic protoporphyria | Chyloderma | Trichothiodystrophy | Keratoderma | Poikiloderma | 00
| 21,534 |
The<unk> is an orthopedic<unk> to alleviate the symptoms of trapezius palsy when more conservative measures, such as spontaneous resolution and surgical nerve repair are not promising. The rhomboid major, rhomboid minor, and levator scapulae muscles are transferred laterally along the scapula to replace the functions of the lower, middle, and upper fibers of the trapezius, respectively. The transferred muscles hold the scapula in a more medial and upwardly rotated position, without winging. | Eden-Lange procedure | Hughes procedure | Ross procedure | Mustard procedure | Damus–Kaye–Stansel procedure | Manchester operation | Joel-Cohen incision | Krukenberg procedure | 00
| 72,574 |
<unk> is a condition consisting of abnormal expansion or dilatation of one or more paranasal sinuses. It most often affects the frontal sinus, and can cause damage to vision due to pressure on the nearby optic nerve. The preferred treatment is endoscopic surgery to deflate the sinus. | Pneumosinus dilatans | Peritonsillar abscess | Bronchocele | Epiglottitis | Adenoiditis | Retropharyngeal abscess | Globus pharyngis | Parapharyngeal abscess | 00
| 38,262 |
The<unk> is a very fine, slightly<unk> ic film on the surface of human skin acting as a barrier to bacteria, viruses and other potential contaminants that might penetrate the skin. Sebum is secreted by the sebaceous gland and when mixed with sweat becomes the<unk> . Unlike the<unk> on the skin’s surface, the viable epidermis (ie., layers below the stratum corneum) has a neutral pH around 7.0. The general assumption is that skin surface pH is on average between 5.0 and 6.0. However the pH of the skin’s<unk> is a broad range that depends on the condition of the skin and other estimates deem the range to be between 4.5 and 6.5 as slightly<unk> ic. More recent research has challenged the proposed ranges. When healthy human skin has not had contact with skin products or water for extended periods it has been found to naturally return to<unk> ity levels below that of 5.0. A value of 4.7 was considered to be the natural average and ideal. Some subjects within the standard deviation reached values as low as 4.3. The study subjects with a skin pH below 5.0 showed statistically significant less scaling, higher hydration levels, and had better resident flora presence than subjects with skin pH above 5.0; concluding that people with a natural pH below 5.0 have a better condition than individuals with skin at a naturally higher pH. The<unk> ic surface pH is an important determinant for the growth conditions of resident microflora (i.e. normally found on the skin). Human skin has a mutualistic symbiotic relationship with its microflora. The skin provides the right environmental condition for the resident flora and the resident flora in turn strengthen skin’s defence by prevention of the colonization of harmful bacteria as well as playing a role in the<unk> ification of the skin. Using skincare products to alter the skin pH down to 4.0-4.5 kept the resident bacterial flora attached to the skin while using alkaline personal care products on the skin promoted their dispersal from the skin. Since blood is slightly alkaline (7.4), pathogenic bacteria that become adapted to the pH of the skin and are able to reach internal tissues will encounter an environment to which they are less well adapted. This combination of<unk> ic exterior and alkaline interior is one of the body's non-specific host defenses against bacterial pathogens. | Acid mantle | Wart | Crusaid | Tar water | BufferGel | Syringe | Veneer | Splinter | 00
| 39,851 |
The CDC gives specific recommendations for prescribers regarding initiation of<unk> s, clinically appropriate<unk> of<unk> s, and assessing possible risks associated with<unk> therapy. Large retail pharmacy chains in the US are implementing protocols, guidelines, and initiatives to take back unused<unk> s, providing naloxone kits, and being vigilant for suspicious prescriptions. Insurance programs can help limit<unk> <unk> by setting quantity limits on prescriptions or requiring prior authorizations for certain medications.<unk> related deaths Naloxone is<unk> d for the emergency treatment of an overdose. It can be given by many routes (e.g., intramuscular, intravenous, subcutaneous, intranasal, and inhalation) and acts quickly by displacing<unk> s from<unk> receptors and preventing activation of these receptors by<unk> s. Naloxone kits are recommended for laypersons who may witness an<unk> overdose, for individuals with large prescriptions for<unk> s, those in substance<unk> treatment programs, or who have been recently released from incarceration. Since this is a life-saving medication, many areas of the United States have implemented standing orders for law enforcement to carry and give naloxone as needed. In addition, naloxone could be<unk> d to challenge a person's<unk> abstinence status prior to starting a medication such as naltrexone, which is<unk> d in the management of<unk> addiction. Good Samaritan laws typically protect bystanders that administer naloxone. In the United States, at least 40 states have Good Samaritan laws to encourage bystanders to take action without fear of prosecution. As of 2019, 48 states allow for a pharmacist to have the authority to distribute naloxone without an individual prescription. Homicide, suicide, accidents and liver disease are also<unk> related causes of death for those suffering from OUD. Many of these<unk> related causes of death are unnoticed due to the often limited information provided on death certificates. | treatment of Opioid use disorder | treatment of Depression | treatment of Bipolar disorder | treatment of Panic disorder | treatment of Eating disorder | treatment of Obsessive–compulsive personality disorder | treatment of Body image disturbance | treatment of Avoidant personality disorder | 00
| 17,357 |
High grade anal<unk> .<unk> <unk> is the development of a benign<unk> or high-grade dysplasia in an epithelium. The exact dividing<unk> e between dysplasia and<unk> has been very difficult to draw throughout the era of medical science. It varies between persons. In the localizations shown below, the term<unk> is used to describe more accurately what was historically referred to as epithelial dysplasia.<unk> is not cancer, but it is associated with higher risk for developing cancer in future. It is thus sometimes a precancerous condition. | Intraepithelial neoplasia | Epithelial dysplasia | Squamous intraepithelial lesion | Hyperplastic polyp | In situ lymphoid neoplasia | Inflammatory fibroid polyp | Carcinoma in situ | Cryptitis | 00
| 58,420 |
LMS is inherited in an autosomal recessive manner. This means the defective gene responsible for the disorder is located on an autosome, and two copies of the defective gene (one inherited from each parent) are required in order to be born with the disorder. The parents of an individual with an autosomal recessive disorder both carry one copy of the defective gene, but usually do not experience any signs or symptoms of the disorder. | Laurence–Moon syndrome | Coffin–Siris syndrome | Beckwith–Wiedemann syndrome | Maroteaux–Lamy syndrome | Griscelli syndrome type 2 | GRACILE syndrome | Klüver–Bucy syndrome | Wiedemann–Steiner syndrome | 00
| 37,067 |
<unk> is a species of medicinal leech. It has been confused with<unk> medicinalis, but has recently been recognized as a different species. This Asian species is associated with mountainous areas in the subboreal eremial zone and occurs in Azerbaijan, Iran, Uzbekistan and Kazakhstan. It occurs also in Georgia, and probably in Armenia. | Hirudo orientalis | Arcanum joviale | Peganum harmala | Mitragyna speciosa | Craniopagus parasiticus | Dracunculus medinensis | Ephedra distachya | Cerbera odollam | 00
| 67,660 |
<unk> is the presence of air or gas within the cranial cavity. It is usually associated with disruption of the skull: after head and facial trauma, tumors of the skull base, after neurosurgery or otorhinolaryngology, and rarely, spontaneously.<unk> can occur in scuba diving, but is very rare in this context. If there is a valve mechanism which allows air to enter the skull but prevents it from escaping, a tension<unk> can occur (similar to what can happen in a tension pneumothorax). CT scans of patients with a tension<unk> typically show air that compresses the frontal lobes of the brain, which results in a tented appearance of the brain in the skull known as the Mount Fuji sign. The name is derived from the resemblance of the brain to Mount Fuji in Japan, a volcano known for its symmetrical cone. In typical cases, there is a symmetrical depression near the midline (such as the crater of a volcano), due to intact bridging veins. Its occurrence seems to be limited to tension<unk> (not occurring in<unk> without tension). The sign was first described by a team of Japanese neurosurgeons.<unk> has also been shown to follow neurosurgical procedures such as deep brain stimulation, where while seemingly innocuous to the patient, may cause brain shift and subsequent stereotactic inaccuracy. Efforts are made by neurosurgeons to reduce<unk> volume during surgery, and thus, subsequent brain shift. | Pneumocephalus | Hydrocephalus | Cerebrospinal fluid leak | Intraventricular hemorrhage | Acephaly | Pachygyria | Vocal cord hemorrhage | Hemicrania continua | 00
| 38,640 |
Methods for estimating<unk> and<unk> use a sequence alignment of two or more nucleotide sequences of homologous genes that code for proteins (rather than being genetic switches, controlling development or the rate of activity of other genes). Methods can be classified into three groups: approximate methods, maximum-likelihood methods, and counting methods. However, unless the sequences to be compared are distantly related (in which case maximum-likelihood methods prevail), the class of method used makes a minimal impact on the results obtained; more important are the assumptions implicit in the chosen method. Approximate methods Approximate methods involve three basic steps: (1) counting the number of synonymous and nonsynonymous sites in the two sequences, or estimating this number by multiplying the sequence length by the proportion of each class of substitution; (2) counting the number of synonymous and nonsynonymous substitutions; and (3) correcting for multiple substitutions. These steps, particularly the latter, require simplistic assumptions to be made if they are to be achieved computationally; for reasons discussed later, it is impossible to exactly determine the number of multiple substitutions. Maximum-likelihood methods The maximum-likelihood approach uses probability theory to complete all three steps simultaneously. It estimates critical parameters, including the divergence between sequences and the transition/transversion ratio, by deducing the most likely values to produce the input data. Counting methods In order to quantify the number of substitutions, one may reconstruct the ancestral sequence and record the inferred changes at sites (straight counting – likely to provide an underestimate); fitting the substitution rates at sites into predetermined categories (Bayesian approach; poor for small data sets); and generating an individual substitution rate for each codon (computationally expensive). Given enough data, all three of these approaches will tend to the same result. | Ka/Ks ratio | E/A ratio | NC ratio | Rate pressure product | Extraction ratio | QT interval | QRS complex | PR interval | 00
| 37,606 |
Type Glandular tissue Nipple Areola Fat tissue Hair patch 1 yes yes yes yes 2 yes yes 3 yes yes 4 yes 5 ("pseudomamma") yes yes yes 6 ("polythelia") yes 7 ("polythelia areolaris") yes 8 ("polythelia pilosa") yes Polythelia refers to the presence of an additional nipple alone while polymastia denotes the much rarer presence of additional mammary glands. Although usually presenting on the milk line, pseudomamma can appear as far away as the foot. A possible relationship with mitral valve prolapse has been proposed. | Supernumerary nipple | Inverted nipple | Cracked nipple | Accessory breast | Bifid penis | Genital wart | Genu recurvatum | Webbed penis | 00
| 19,420 |
Globally about 106 million cases of chlamydia and 106 million cases of gonorrhea occurred in 2008. The number of cases of PID; however, is not clear. It is estimated to affect about 1.5 percent of young women yearly. In the United States PID is estimated to affect about one million people yearly. Rates are highest with teenagers and first time mothers. PID causes over 100,000 women to become infertile in the US each year. | causes of Peritonitis | causes of Ascites | causes of Hematuria | causes of Hematochezia | risks of Peritonitis | causes of Wandering spleen | medical cause of Peritonitis | complications of Peritonitis | 00
| 1,789 |
<unk> is a<unk> in epidural anaesthesia first described by Professor Achille Mario<unk> in 1933. It is a method for the identification of the epidural space, a potential space. As a needle is advanced through the ligamentum flavum, to the epidural space, with constant pressure applied to the piston of a syringe, loss of resistance occurs once the needle enters the epidural space due to the change in pressure. The identification of this space, allows subsequent administration of epidural anaesthesia, a technique used primarily for analgesia during childbirth. This technique remains in use at , and is commonly referred to the loss of resistance to saline technique (LORS) or its variation, the loss of resistance to air technique (LORA). These use, respectively, saline or air to identify the epidural space. The LORS technique is generally favoured due to the increased complication risk with the LORA technique such as pneumocephalus or air embolism. | Dogliotti's principle | Bell–Magendie law | McNeill's law | Lightwood's law | Hickam's dictum | Clark's rule | Eichler's rule | Ribot's law | 00
| 48,356 |
<unk> are a type of<unk> with short blades that was originally developed for ophthalmic surgery. They are alternatively referred to as<unk> forceps in the United Kingdom and Asia.<unk> are also available in the crafting market and are sometimes used for the production of fabric-related goods. Both closed and open shank versions are available. | Iris scissors | Eye dropper | Metzenbaum scissors | Pupilometer | Mayo scissors | Goggles | Eyepatch | Corneal inlay | 00
| 63,294 |
There are hospital protocols for prevention, supplementing with thiamine in the presence of: history of alcohol misuse or related seizures, requirement for IV glucose, signs of malnutrition, poor diet, recent diarrhea or vomiting, peripheral neuropathy, intercurrent illness, delirium tremens or treatment for DTs, and others. Some experts advise parenteral thiamine should be given to all at-risk patients in the emergency department. In the clinical diagnosis should be remembered that early symptoms are nonspecific, and it has been stated that WE may present nonspecific findings. There is consensus to provide water-soluble vitamins and minerals after gastric operations. In some countries certain foods have been supplemented with thiamine, and have reduced WE cases. Improvement is difficult to quantify because they applied several different actions. Avoiding or moderating alcohol consumption and having adequate nutrition reduces one of the main risk factors in developing<unk> -Korsakoff syndrome. | Wernicke encephalopathy | Alcohol intoxication | Powassan encephalitis | Anti-Hu associated encephalitis | Glycine encephalopathy | Toxic encephalopathy | Early myoclonic encephalopathy | Ethylmalonic encephalopathy | 00
| 13,739 |
<unk> is a cutaneous condition reported in infants exposed to blue lights for the treatment of indirect hyperbilirubinemia characterized by marked purpura in skin exposed to the UV light. | Transient erythroporphyria of infancy | Congenital malaria | Neonatal alloimmune thrombocytopenia | Neonatal toxic shock-like exanthematous disease | Neonatal lupus erythematosus | Neonatal hepatitis | Leukemia cutis | Meningohydroencephalocoele | 00
| 55,872 |
Hypersalivation is optimally treated by treating or avoiding the underlying cause. Mouthwash and tooth brushing may have drying effects. In the palliative care setting, anticholinergics and similar drugs that would normally reduce the production of saliva causing a dry mouth could be considered for symptom management: scopolamine, atropine, propantheline, hyoscine, amitriptyline, glycopyrrolate. As of 2008, it is unclear if medication for people who have too much saliva due to clozapine treatment is useful. | symptom of Rabies | symptom of Japanese encephalitis | symptoms of Rabies | symptom of West Nile fever | symptom of Eastern equine encephalitis | symptom of Scabies | symptom of Chikungunya | symptom of Trench fever | 00
| 39,963 |
The<unk> lies in front of the neck of the first rib, and posterior to the common carotid artery. The vertebral artery lies anterior to the ganglion as it has just originated from the subclavian artery. After passing over the ganglion, the artery enters the vertebral foramen and lies posterior to the anterior tubercle of C6 (Chassaignac's tubercle). | Stellate ganglion | Ciliary ganglion | Olfactory trigone | Middle cervical ganglion | Medulla | Medulla | Subfornical organ | Cortical minicolumn | 00
| 25,651 |
<unk> , sold under brand names such as Finajet and Finaplix among others, is an androgen and anabolic steroid (AAS) medication which is used in veterinary medicine, specifically to increase the profitability of livestock by promoting muscle growth in cattle. It is given by injection into muscle. Side effects of<unk> include symptoms of masculinization like acne, increased body hair growth, scalp hair loss, voice changes, and increased sexual desire. The drug is a synthetic androgen and anabolic steroid and hence is an agonist of the androgen receptor (AR), the biological target of androgens like testosterone and dihydrotestosterone (DHT). It has strong anabolic effects and highly androgenic effects, as well as potent progestogenic effects, and weak glucocorticoid effects.<unk> is an androgen ester and a long-lasting prodrug of<unk> in the body.<unk> was discovered in 1963 and was introduced for veterinary use in the early 1970s. In addition to its veterinary use,<unk> is used to improve physique and performance, and is purchased from black market suppliers. The drug is a controlled substance in many countries and so non-veterinary use is generally illicit. | Trenbolone acetate | Stenbolone acetate | Metenolone acetate | Metenolone | Prebediolone acetate | Trenbolone enanthate | Trestolone | Cortisone acetate | 00
| 40,232 |
Some of the listed side effects include dizziness, nausea, sleepiness, dry mouth, pain in neck, throat or jaw, numbness or tingling. | Sumatriptan/naproxen sodium | Naproxen/diphenhydramine | Phenylephrine/ketorolac | Hydrocodone/aspirin | Celecoxib/tramadol | Butalbital/acetaminophen | Amlodipine/celecoxib | Ibuprofen/paracetamol | 00
| 51,977 |
Friction<unk> s Friction<unk> s are caused by excess shear stress between the bottom and surface of the skin and the body. The strata of skin around the stratum spinosum are most susceptible to shear. As the stratum spinosum tears away from the connecting tissues below, plasma from the cells diffuses out. This plasma solution helps new cells divide and grow into new connective tissues and epidermal layers. The clear fluid will be reabsorbed as new cells develop and the swollen appearance will subside. Painful<unk> s located on hands (palmar surface) and feet (plantar surface) are due to tissue shearing deeper in the epidermis, near nerve endings. Lower tissues are more susceptible to infection. | Blister | Oscar | Saddle sore | Sequela | Pouchitis | Phlegmon | Chilblains | Eschar | 00
| 9,230 |
Even though<unk> often goes away on its own over time, there are both medical and surgical treatments for<unk> for patients who want immediate relief. Medical treatments include the use of topical nasal drops and oxymetazoline HCL, which give an upper nasal block so that the air flow can't reach the olfactory cleft. Other medications suggested include sedatives, anti-depressants, and anti-epileptic drugs. The medications may or may not work and for some patients, and side effects may not be tolerable. Most patients benefit from medical treatment, but for some, surgical treatment is required. Options include a bifrontal craniotomy and excision of the olfactory epithelium, which cuts all of the fila olfactoria. According to some studies, transnasal endoscopic excision of the olfactory epithelium has been described as a safe and effective phantosmia treatment. The Bifrontal craniotomy results in permanent anosmia, and both surgeries are accompanied with the risks associated with general surgery. | Dysosmia | Anosmia | Aspermia | Dysmelia | Phantosmia | Hyperhidrosis | Dysacusis | Cynanthropy | 00
| 47,829 |
<unk> () is a traditional Chinese medicinal term in which the individual suffers withdrawal like symptoms including painful brainfog, chills, nausea, and even flu like symptoms with anxiety, believed to be caused by a loss of semen and orgasm. The symptoms can last weeks to months after a single orgasm. And in Traditional Chinese Medicine, shen (kidney) is the reservoir of vital essence in semen (ching) and k’uei signifies deficiency.<unk> or shen-k'uei is one of several Chinese culture-bound syndromes locally ascribed to getting stuck in yang and the needing of yin to rebalance Yang (Chinese: 陽). Semen is believed to be "lost" through sexual activity or masturbation, nocturnal emissions, "white urine" which is believed to contain semen, or other mechanisms. Symptoms within the Chinese diagnostic system include painful brain fog, chills, dizziness, backache, tiredness, weakness, insomnia, frequent dreams, and complaints of sexual dysfunction (such as premature ejaculation or impotence). From an ethnopsychiatric perspective, additional symptoms are preoccupation with sexual performance, potential semen loss, and bodily complaints. | Shenkui | Hwabyeong | Ysguborwen | Shin-bang | Evenor | Yinshu | Sumpong | Ya mong | 00
| 65,546 |
Congenital anomalies deaths per million persons in 2012 Disability-adjusted life year for congenital anomalies per 100,000 inhabitants in 2004. Congenital anomalies resulted in about 632,000 deaths per year in 2013 down from 751,000 in 1990. The types with the greatest death are congenital heart defects (323,000), followed by neural tube defects (69,000). Many studies have found that the frequency of occurrence of certain congenital malformations depends on the sex of the child (table). For example, pyloric stenosis occurs more often in males while congenital hip dislocation is four to five times more likely to occur in females. Among children with one kidney, there are approximately twice as many males, whereas among children with three kidneys there are approximately 2.5 times more females. The same pattern is observed among infants with excessive number of ribs, vertebrae, teeth and other organs which in a process of evolution have undergone reduction—among them there are more females. Contrarily, among the infants with their scarcity, there are more males. Anencephaly is shown to occur approximately twice as frequently in females. The number of boys born with 6 fingers is two times higher than the number of girls. Now various techniques are available to detect congenital anomalies in fetus before birth. About 3% of newborns have a "major physical anomaly", meaning a physical anomaly that has cosmetic or functional significance. Physical congenital abnormalities are the leading cause of infant mortality in the United States, accounting for more than 20% of all infant deaths. Seven to ten percent of all children will require extensive medical care to diagnose or treat a birth defect. : + The sex ratio of patients with congenital malformations Congenital anomaly Sex ratio, ♂♂:♀♀ Defects with female predominance Congenital hip dislocation 1 : 5.2; 1 : 5; 1 : 8; 1 : 3.7 Cleft palate 1 : 3 Anencephaly 1 : 1.9; 1 : 2 Craniocele 1 : 1.8 Aplasia of lung 1 : 1.51 Spinal herniation 1 : 1.4 Diverticulum of the esophagus 1 : 1.4 Stomach 1 : 1.4 Neutral defects Hypoplasia of the tibia and femur 1 : 1.2 Spina bifida 1 : 1.2 Atresia of small intestine 1 : 1 Microcephaly 1.2 : 1 Esophageal atresia 1.3 : 1; 1.5 : 1 Hydrocephalus 1.3 : 1 Defects with male predominance Diverticula of the colon 1.5 : 1 Atresia of the rectum 1.5 : 1; 2 : 1 Unilateral renal agenesis 2 : 1; 2.1 : 1 Schistocystis 2 : 1 Cleft lip and palate 2 : 1; 1.47 : 1 Bilateral renal agenesis 2.6 : 1 Congenital anomalies of the genitourinary system 2.7 : 1 Pyloric stenosis, congenital 5 : 1; 5.4 : 1 Meckel's diverticulum More common in boys Congenital megacolon More common in boys All defects 1.22 : 1; 1.29 : 1 * Data obtained on opposite-sex twins. ** — Data were obtained in the period 1983–1994. P. M. Rajewski and A. L. Sherman (1976) have analyzed the frequency of congenital anomalies in relation to the system of the organism. Prevalence of men was recorded for the anomalies of phylogenetically younger organs and systems. In respect of an etiology, sexual distinctions can be divided on appearing before and after differentiation of male's gonads during embryonic development, which begins from the eighteenth week. The testosterone level in male embryos thus raises considerably. The subsequent hormonal and physiological distinctions of male and female embryos can explain some sexual differences in frequency of congenital defects. It is difficult to explain the observed differences in the frequency of birth defects between the sexes by the details of the reproductive functions or the influence of environmental and social factors. United States The CDC and National Birth Defect Project studied the incidence of birth defects in the US. Key findings include: * Down syndrome was the most common condition with an estimated prevalence of 14.47 per 10,000 live births, implying about 6,000 diagnoses each year. * About 7,000 babies are born with a cleft palate, cleft lip or both. +Adjusted National Prevalence Estimates and Estimated Number of Cases in the United States, 2004–2006 Birth Defects Cases per Births Estimated Annual Number of Cases Estimated National Prevalence per 10,000 Live Births (Adjusted for maternal race/ethnicity) Central nervous system defects Anencephaly 1 in 4,859 859 2.06 Spina bifida without anencephaly 1 in 2,858 1460 3.50 Encephalocele 1 in 12,235 341 0.82 Eye defects Anophthalmia/ microphthalmia 1 in 5,349 780 1.87 Cardiovascular defects Common truncus 1 in 13,876 301 0.72 Transposition of great arteries 1 in 3,333 1252 3.00 Tetralogy of Fallot 1 in 2,518 1657 3.97 Atrioventricular septal defect 1 in 2,122 1966 4.71 Hypoplastic left heart syndrome 1 in 4,344 960 2.30 Orofacial defects Cleft palate without cleft lip 1 in 1,574 2651 6.35 Cleft lip with and without cleft palate 1 in 940 4437 10.63 Gastrointestinal defects Esophageal atresia/tracheoeophageal fistula 1 in 4,608 905 2.17 Rectal and large intestinalatresia/stenosis 1 in 2,138 1952 4.68 Musculoskeletal defects Clubfoot, lower limbs 1 in 250 ~ 1000 ... ... Reduction deformity, upper limbs 1 in 2,869 1454 3.49 Reduction deformity, lower limbs 1 in 5,949 701 1.68 Gastroschisis 1 in 2,229 1871 4.49 Omphalocele 1 in 5,386 775 1.86 Diaphragmatic hernia 1 in 3,836 1088 2.61 Chromosomal anomalies Trisomy 13 1 in 7,906 528 1.26 Trisomy 21 (Down syndrome) 1 in 691 6037 14.47 Trisomy 18 1 in 3,762 1109 2.66 | medical cause of Paraplegia | medical cause of Hemiparesis | symptom of Cerebral palsy | symptom of Amyotrophic lateral sclerosis | medical cause of Dystonia | medical cause of Parkinsonism | picture of Acrocallosal syndrome | medical cause of Polyneuropathy | 00
| 10,839 |
The deeper the<unk> , the more complications that can arise. Professional strength<unk> s are typically administered by certified dermatologists or licensed estheticians. Professional<unk> s and lower-concentration DIY home<unk> kits can pose health risks, including injury and scarring of the skin. Possible complications include photosensitivity, prolonged erythema, pigmentary changes, milia, skin atrophy, and textural changes. Many individuals report professional<unk> s leave a minor yellowish tinge on their skin due to the retinol elements in the<unk> . This is expected to last 2–3 hours maximum. Varying mild to moderate redness after the procedure is expected. | Chemical peel | Dermal adhesive | Surgical tape | Gauze sponge | Surgical lubricant | Crusaid | Splint | Ligature | 00
| 38,636 |
A<unk> is an area of the cerebral cortex that includes only four cortical layers instead of six. Microgyria are believed by some to be part of the genetic lack of prenatal development which is a cause of, or one of the causes of, dyslexia. Albert Galaburda of Harvard Medical School noticed that language centers in dyslexic brains showed microscopic flaws known as ectopias and microgyria (Galaburda et al., 2006, Nature Neuroscience 9(10): 1213-1217). Both affect the normal six-layer structure of the cortex. These flaws affect connectivity and functionality of the cortex in critical areas related to sound and visual processing. These and similar structural abnormalities may be the basis of the inevitable and hard to overcome difficulty in reading. | Microgyrus | Choroid | Ateronon | Ranula | Gyrus | Pinguecula | Syrinx | Tophus | 00
| 1,403 |
<unk> is a one-hour Technicolor made-for-television educational film, released in 1957 by Bell Laboratories and directed by Frank Capra, and first telecast by CBS. It details the workings of the circulatory system. | Hemo the Magnificent | Patched | Beauty Mark | Singe | Complex of Sultan Bayezid II | Sultiame | Hovid | Essure | 00
| 44,225 |
<unk> is a chemical compound of<unk> and fluorine. It is a toxic, colorless gas. The oxidation state of<unk> is +5. | Arsenic pentafluoride | Arsenic trioxide | Arsenic trichloride | Chlorofluorocarbon | Carbon tetrachloride | Butylated hydroxytoluene | Diquafosol | Dibenzofuran | 00
| 49,932 |
Photographs which purportedly depicted ghosts or spirits were popular during the 19th century.<unk> is the study of alleged psychic phenomena (extrasensory perception, telepathy, precognition, clairvoyance, psychokinesis, a.k.a. telekinesis, and psychometry) and other paranormal claims, for example, those related to near-death experiences, synchronicity, apparitional experiences, etc. Criticized as being a pseudoscience, the majority of mainstream scientists reject it.<unk> has also been criticised by mainstream critics for many of its practitioners claiming that their studies are plausible in spite of there being no convincing evidence for the existence of any psychic phenomena after more than a century of research.<unk> research rarely appears in mainstream scientific journals; instead, most papers about<unk> are published in a small number of niche journals. | Parapsychology | Orthomolecular psychiatry | Counseling psychology | Biological psychiatry | Psychoanalytic theory | Social cognitive theory | Social narrative | Cross-cultural psychiatry | 00
| 1,695 |
The<unk> ing procedure is the principal stain in histology in part because it can be done quickly, is not expensive, and stains tissues in such a way that a considerable amount of microscopic anatomy is revealed, and can be used to diagnose a wide range of histopathologic conditions. The results from<unk> ing are not overly dependent on the chemical used to fix the tissue or slight inconsistencies in laboratory protocol, and these factors contribute to its routine use in histology.<unk> ing does not always provide enough contrast to differentiate all tissues, cellular structures, or the distribution of chemical substances, and in these cases more specific stains and methods are used. | H&E stain | HPS stain | Giemsa stain | PAS diastase stain | Leishman stain | Phosphotungstic acid-haematoxylin stain | Mucicarmine stain | Auramine phenol stain | 00
| 31,958 |
For last several decades of the 20th century, all histological variants of NSCLC were generally treated identically. In the last decade, it has become apparent that different variants of malignant tumors generally exhibit diverse genetic, biological, and clinical properties, including response to treatment. As patients with uncommon lung tumor variants, including tumors composed of mixtures of histological subtypes, tend to be excluded from clinical trials, the most efficacious treatment regimen(s) for<unk> squamous<unk> carcinoma remain unknown. In general, these variants appear to be treated according to standard protocols in place for squamous<unk> carcinoma. | Basaloid squamous cell lung carcinoma | Salivary gland–like carcinoma of the lung | Adenosquamous lung carcinoma | Epithelial-myoepithelial carcinoma of the lung | Sarcomatoid carcinoma of the lung | Basaloid large cell carcinoma of the lung | Mucinous cystadenocarcinoma of the lung | Giant-cell carcinoma of the lung | 00
| 61,264 |
<unk> is a non-peptide, small-molecule compound, and is structurally distinct from GnRH analogues. It is an N-phenylurea derivative. | Relugolix | Elagolix | Lifitegrast | Deflazacort | Maralixibat chloride | Sufugolix | Seratrodast | Naloxegol | 00
| 68,035 |
<unk> is a peer-reviewed academic journal that publishes papers four times a year in the field of Otorhinolaryngology. The journal's editor is Charles J Limb. It has been in publication since 1996 and is currently published by SAGE Publications. According to the Journal Citation Reports, the journal has a 2015 impact factor of 2.500. | Trends in Amplification | Threshold expression | Acute to chronic ratio | Form constant | Cold sensitivity | Skew deviation | Clinical significance | Cryptocurrency | 00
| 62,175 |
<unk> is a viral disease of typically short duration. In most cases, symptoms include fever, chills, loss of appetite, nausea, muscle pains – particularly in the back – and headaches. Symptoms typically improve within five days. In about 15% of people, within a day of improving the fever comes back, abdominal pain occurs, and liver damage begins causing<unk> skin. If this occurs, the risk of bleeding and kidney problems is increased. The disease is caused by the<unk> virus and is spread by the bite of an infected mosquito. It infects only humans, other primates, and several types of mosquitoes. In cities, it is spread primarily by Aedes aegypti, a type of mosquito found throughout the tropics and subtropics. The virus is an RNA virus of the genus Flavivirus. The disease may be difficult to tell apart from other illnesses, especially in the early stages. To confirm a suspected case, blood-sample testing with polymerase chain reaction is required. A safe and effective vaccine against<unk> exists, and some countries require vaccinations for travelers. Other efforts to prevent infection include reducing the population of the transmitting mosquitoes. In areas where<unk> is common, early diagnosis of cases and immunization of large parts of the population are important to prevent outbreaks. Once a person is infected, management is symptomatic; no specific measures are effective against the virus. Death occurs in up to half of those who get severe disease. In 2013,<unk> resulted in about 127,050 severe infections and 45,000 deaths worldwide, with nearly 90 percent of these occurring in Africa. Nearly a billion people live in an area of the world where the disease is common. It is common in tropical areas of the continents of South America and Africa, but not in Asia. Since the 1980s, the number of cases of<unk> has been increasing. This is believed to be due to fewer people being immune, more people living in cities, people moving frequently, and changing climate increasing the habitat for mosquitoes. The disease originated in Africa and spread to the Americas starting in the 15th century with the European trafficking of enslaved Africans from sub-Saharan Africa. Since the 17th century, several major outbreaks of the disease have occurred in the Americas, Africa, and Europe. In the 18th and 19th centuries,<unk> was considered one of the most dangerous infectious diseases; numerous epidemics swept through major cities of the US and in other parts of the world. In 1927,<unk> virus was the first human virus to be isolated. | Yellow fever | Dengue fever | Tomato fever | Chikungunya | Ross River fever | Trench fever | Haverhill fever | Blackwater fever | 00
| 2,431 |
BCl3 is an aggressive reagent that can form hydrogen chloride upon exposure to moisture or alcohols. The dimethyl sulfide adduct (BCl3SMe2), which is a solid, is much safer to use, when possible, but H2O will destroy the BCl3 portion while leaving dimethyl sulfide in solution. | Boron trichloride | Silver diammine fluoride | Diisopropyl fluorophosphate | Trenbolone hexahydrobenzylcarbonate | Perchloryl fluoride | Zinc pyrithione | Methenmadinone acetate | Zinc sulfate | 00
| 34,112 |
These<unk> s are packaged for single use, without preservatives<unk> s or<unk> s are liquid<unk> s applied directly to the surface of the eye, particularly the human eye, usually in small amounts such as a single<unk> or a few<unk> s.<unk> s usually contain saline to match the salinity of the<unk> s containing only saline and sometimes a lubricant are often used as artificial tears to treat dry eyes or simple eye irritation such as itching or redness.<unk> s may also contain one or more medications to treat a wide variety of eye diseases. Depending on the condition being treated, they may contain steroids, antihistamines, sympathomimetics, beta receptor blockers, parasympathomimetics, parasympatholytics, prostaglandins, nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics, antifungals, or topical anesthetics.<unk> s have less of a risk of side effects than do oral medicines, and such risk can be minimized by occluding the lacrimal punctum (i.e. pressing on the inner corner of the eye) for a short while after instilling<unk> s. Prior to the development of single-use pre-loaded sterile plastic applicators,<unk> s were administered using an<unk> per, a glass pipette with a rubber bulb. | Eye drop | Ear drop | Protruding ear | Red eye | Enophthalmos | Christmas eye | Lagophthalmos | Cryptophthalmos | 00
| 22,620 |
It affects males and females equally. Fewer than 50 cases have been reported worldwide. | Gordon syndrome | McKittrick-Wheelock syndrome | Laron syndrome | Dennie–Marfan syndrome | Flynn–Aird syndrome | Sly syndrome | Marfan syndrome | MEDNIK syndrome | 00
| 65,908 |
Mechanism of action<unk> displays bacteriostatic activity or inhibits growth of bacteria, especially at higher concentrations. By binding to the 50s subunit of the bacterial rRNA complex, protein synthesis and subsequent structure and function processes critical for life or replication are inhibited.<unk> interferes with aminoacyl translocation, preventing the transfer of the tRNA bound at the A site of the rRNA complex to the P site of the rRNA complex. Without this translocation, the A site remains occupied, thus the addition of an incoming tRNA and its attached amino acid to the nascent polypeptide chain is inhibited. This interferes with the production of functionally useful proteins, which is the basis of this antimicrobial action.<unk> increases gut motility by binding to Motillin receptor, thus it is a Motillin receptor agonist in addition to its antimicrobial properties. Pharmacokinetics<unk> is easily inactivated by gastric acid; therefore, all orally administered formulations are given as either enteric-coated or more-stable salts or esters, such as<unk> ethylsuccinate.<unk> is very rapidly absorbed, and diffuses into most tissues and phagocytes. Due to the high concentration in phagocytes,<unk> is actively transported to the site of infection, where, during active phagocytosis, large concentrations of<unk> are released. Metabolism Most of<unk> is metabolised by demethylation in the liver by the hepatic enzyme CYP3A4. Its main elimination route is in the bile with little renal excretion, 2%-15% unchanged drug.<unk> 's elimination half-life ranges between 1.5 and 2.0 hours and is between 5 and 6 hours in patients with end-stage renal disease.<unk> levels peak in the serum 4 hours after dosing; ethylsuccinate peaks 0.5-2.5 hours after dosing, but can be delayed if digested with food.<unk> crosses the placenta and enters breast milk. The American Association of Pediatrics determined<unk> is safe to take while breastfeeding. Absorption in pregnant patients has been shown to be variable, frequently resulting in levels lower than in nonpregnant patients. | Erythromycin | Cethromycin | Methicillin | Ampicillin | Meropenem | Clarithromycin | Natamycin | Cefotaxime | 00
| 909 |
The cause of HCM is variable. Many people are asymptomatic or mildly symptomatic, and many of those carrying disease genes for HCM do not have clinically detectable disease. The symptoms of HCM include shortness of breath due to stiffening and decreased blood filling of the ventricles, exertional chest pain (sometimes known as angina) due to reduced blood flow to the coronary arteries, uncomfortable awareness of the heart beat (palpitations), as well as disruption of the electrical system running through the abnormal heart muscle, lightheadedness, weakness, fainting and sudden cardiac death. Shortness of breath is largely due to increased stiffness of the left ventricle (LV), which impairs filling of the ventricles, but also leads to elevated pressure in the left ventricle and left atrium, causing back pressure and interstitial congestion in the lungs. Symptoms are not closely related to the presence or severity of an outflow tract gradient. Often, symptoms mimic those of congestive heart failure (esp. activity intolerance and dyspnea), but treatment of each is different. Beta blockers are used in both cases, but treatment with diuretics, a mainstay of CHF treatment, will exacerbate symptoms in hypertrophic obstructive cardiomyopathy by decreasing ventricular preload volume and thereby increasing outflow resistance (less blood to push aside the thickened obstructing tissue). Major risk factors for sudden death in individuals with HCM include prior history of cardiac arrest or ventricular fibrillation, spontaneous sustained ventricular tachycardia, abnormal exercise blood pressure and non-sustained ventricular tachycardia, unexplained syncope, family history of premature sudden death, and LVW thickness greater than 15 mm to 30 mm, on echocardiogram. "Spike and dome" pulse and "triple ripple apical impulse" are two other signs that can be discovered in physical examination. | causes of Cardiomegaly | causes of Cardiac tamponade | types of Cardiomegaly | causes of Ventricular tachycardia | causes of Hyperthermia | causes of Mitral insufficiency | causes of Fat embolism syndrome | causes of Mitral valve stenosis | 00
| 14,915 |
The bacteria are originally found in mice and cause mites feeding on the mice (usually the house mouse) to become infected. Humans will get<unk> when receiving a bite from an infected mite, not from the mice themselves. The mite is Liponyssoides sanguineus, which was previously known as Allodermanyssus sanguineus. | Rickettsialpox | Rocky Mountain spotted fever | Chickenpox | Pacific Coast tick fever | Smallpox | Cowpox | Sealpox | Mumps | 00
| 28,182 |
<unk> (aEEG) or cerebral function monitoring (CFM) is a technique for monitoring brain function in intensive care settings over longer periods of time than the traditional electroencephalogram (EEG), typically hours to days. By placing electrodes on the scalp of the patient, a trace of electrical activity is produced which is then displayed on a semilogarithmic graph of peak-to-peak<unk> over time;<unk> is logarithmic and time is linear. In this way, trends in electrical activity in the cerebral cortex can be interpreted to inform on events such as seizures or suppressed brain activity. aEEG is useful especially in neonatology where it can be used to aid in diagnosis of hypoxic ischemic encephalopathy (HIE), and to monitor and diagnose seizure activity. | Amplitude integrated electroencephalography | Quantitative electroencephalography | Steady state visually evoked potential | Stent-electrode recording array | Event-related functional magnetic resonance imaging | Spike-triggered average | Brainstem auditory evoked potential | EEG analysis | 00
| 68,640 |
<unk> s, also called<unk> s, are organic<unk> s that contain carbon bonded to bromine. The most pervasive is the naturally produced bromomethane. One prominent application of synthetic<unk> s is the use of polybrominated diphenyl ethers as fire-retardants, and in fact fire-retardant manufacture is currently the major industrial use of the element bromine. A variety of minor<unk> s are found in nature, but none are biosynthesized or required by mammals.<unk> s have fallen under increased scrutiny for their environmental impact. | Organobromine compound | Organochlorine compound | Loline alkaloid | Dioxins and dioxin-like compounds | Polycyclic aromatic hydrocarbon | Polychlorinated dibenzodioxins | Corrosive substance | Polychlorinated naphthalene | 00
| 52,551 |
<unk> is a hereditary condition characterized by muscle wasting<unk> , particularly of<unk> muscles in legs and hands, and by early-onset contractures (permanent shortening of a muscle or joint) of the hip, knee, and ankle. Affected individuals often have shorter lower limbs relative to the trunk and upper limbs. The condition is a result of a loss of anterior horn cells localized to lumbar and cervical regions of the spinal cord early in infancy, which in turn is caused by a mutation of the TRPV4 gene. The disorder is inherited in an autosomal dominant manner. Arm muscle and function, as well as cardiac and respiratory functions are typically well preserved. | Congenital distal spinal muscular atrophy | Congenital muscular dystrophy | Spinal muscular atrophies | Distal hereditary motor neuronopathies | Spinal muscular atrophy | Jokela type spinal muscular atrophy | Spinal muscular atrophy with lower extremity predominance 1 | Monomelic amyotrophy | 00
| 63,190 |
Slit lamp photograph showing retinal detachment in<unk> Signs and symptoms associated with<unk><unk> include headaches, problems with balance and walking, dizziness, weakness of the limbs, vision problems, and high blood pressure. Conditions associated with<unk><unk> include angiomatosis, hemangioblastomas, pheochromocytoma, renal cell carcinoma, pancreatic cysts (pancreatic serous cystadenoma), endolymphatic sac tumor, and bilateral papillary cystadenomas of the epididymis (men) or broad ligament of the uterus (women). Angiomatosis occurs in 37.2% of patients presenting with<unk><unk> and usually occurs in the retina. As a result, loss of vision is very common. However, other organs can be affected: strokes, heart attacks, and cardiovascular<unk> are common additional symptoms. Approximately 40% of<unk><unk> presents with CNS hemangioblastomas and they are present in around 60-80%. Spinal hemangioblastomas are found in 13-59% of<unk><unk> and are specific because 80% are found in<unk><unk> . Although all of these tumours are common in<unk><unk> , around half of cases present with only one tumour type. | Von Hippel–Lindau disease | Mowat–Wilson syndrome | Neurofibromatosis type 4 | Hurler–Scheie syndrome | Lesch–Nyhan syndrome | Neurofibromatosis type II | Neurofibromatosis type I | Stratton Parker syndrome | 00
| 2,402 |
Individuals with<unk><unk> may be assisted by occupational therapy, physical or speech therapy. Anti-seizure medications such as carbamazepine, phenobarbital, and clobazam can be used to manage seizures—the medication used often is influenced by the type of seizure. Bone density can be determined via a DXA scan and may be improved with calcium supplements. In 2014, several parents of individuals with SRS founded the<unk><unk> Foundation, a 501(c)(3) non-profit based in the US. It is a member of the National Organization for Rare Disorders. | Snyder–Robinson syndrome | Cerebral palsy | Nance–Horan syndrome | Prader–Willi syndrome | Shapiro syndrome | Rett syndrome | Zadik–Barak–Levin syndrome | Urban–Rogers–Meyer syndrome | 00
| 72,501 |
Acute toxicity studies have not indicated a risk of acute side effects with overdose of<unk> . The median lethal dose (LD50) of<unk> in mice is approximately 700 mg/kg.<unk> has been administered in total amounts of 2,000 to 3,000 mg over several months in patients with cancer without toxicity observed. The most likely sign of overdose is reversible feminization, namely gynecomastia. Other symptoms of estrogen overdosage may include nausea, vomiting, bloating, increased weight, water retention, breast tenderness, vaginal discharge, heavy legs, and leg cramps. These side effects can be diminished by reducing the estrogen dosage. There is no specific antidote for overdose of<unk> . Treatment of<unk> overdose should be based on symptoms. | Polyestradiol phosphate | Polyestriol phosphate | Progestogen ester | Androgen ester | Progestogen | Progestogen | Estradiol sulfate | Estrogen ester | 00
| 32,161 |
4-day-old infant latched and<unk> with<unk> Video showing how a<unk> is used A<unk> (SNS), also known as a lactation aid, is a device that consists of a container and a capillary tube. It is used to provide additional nutrients to a baby whose mother has low milk supply. During breastfeeding, the end of the tube is placed alongside the mother's nipple so that both the tube and the breast are in the infant's mouth. The SNS container can be filled with pumped breastmilk, donor milk, or with infant formula. The tubing is usually attached with removable tape. When the newborn infant suckles on the breast, the infant is nourished both by fluid from the capillary tube and by the mother's breastmilk from the nipple. The mother's milk supply is stimulated by the infant suckling, and in most cases the use of the SNS can be discontinued in a few days or weeks when the mother's milk supply has risen to meet the infant's needs. Mothers usually obtain SNS supplies from a lactation consultant. | Supplemental nursing system | Barrier nursing | Direct care | Single-use medical devices | Pharmacy management system | Notes on Nursing | Adaptive equipment | Admission, discharge, and transfer system | 00
| 28,743 |
Deficiency of vitamin B12 can occur in<unk><unk> Symptoms traditionally linked to<unk> include bloating, diarrhea, and abdominal pain/discomfort. Steatorrhea may be seen in more severe cases.<unk><unk> can cause a variety of symptoms, many of which are also found in other conditions, making the diagnosis challenging at times. Many of the symptoms are due to malabsorption of nutrients due to the effects of<unk> which either metabolize nutrients or cause inflammation of the<unk> bowel, impairing absorption. The symptoms of<unk><unk> include nausea, flatus, constipation, bloating, abdominal distension, abdominal pain or discomfort, diarrhea, fatigue, and weakness.<unk> also causes an increased permeability of the<unk> intestine. Some patients may lose weight. Children with<unk><unk> may develop malnutrition and have difficulty attaining proper growth. Steatorrhea, a sticky type of diarrhea where fats are not properly absorbed and spill into the stool, may also occur. Patients with<unk><unk> that is longstanding can develop complications of their illness as a result of malabsorption of nutrients. Laboratory test results may include elevated folate, and, less commonly, vitamin B12 deficiency or other nutritional deficiencies. Anemia may occur from a variety of mechanisms, as many of the nutrients involved in production of red blood cells are absorbed in the affected<unk> bowel. Iron is absorbed in the more proximal parts of the<unk> bowel, the duodenum and jejunum, and patients with malabsorption of iron can develop a microcytic anemia, with<unk> red blood cells. Vitamin B12 is absorbed in the last part of the<unk> bowel, the ileum, and patients who malabsorb vitamin B12 can develop a megaloblastic anemia with large red blood cells. Related conditions In recent years, several proposed links between<unk> and other disorders have been made. However, the usual methodology of these studies involves the use of breath testing as an indirect investigation for<unk> . Breath testing has been criticized by some authors for being an imperfect test for<unk> , with multiple known false positives. Irritable bowel syndrome Some studies reported up to 80% of patients with irritable bowel syndrome (IBS) have<unk> (using the hydrogen breath test). IBS-D is associated with elevated hydrogen numbers on breath tests while IBS-C is associated with elevated methane numbers on breath tests. Subsequent studies demonstrated statistically significant reduction in IBS symptoms following therapy for<unk> . Various mechanisms are involved in the development of diarrhea and IBS-D in<unk><unk> . First, the excessive<unk> concentrations can cause direct inflammation of the<unk> bowel cells, leading to an inflammatory diarrhea. The malabsorption of lipids, proteins and carbohydrates may cause poorly digestible products to enter into the colon. This can cause diarrhea by the osmotic drive of these molecules, but can also stimulate the secretory mechanisms of colonic cells, leading to a secretory diarrhea. There is a lack of consensus however, regarding the suggested link between IBS and<unk> . Other authors concluded that the abnormal breath results so common in IBS patients do not suggest<unk> , and state that "abnormal fermentation timing and dynamics of the breath test findings support a role for abnormal intestinal<unk> distribution in IBS." There is general consensus that breath tests are abnormal in IBS; however, the disagreement lies in whether this is representative of<unk> . | Small intestinal bacterial overgrowth | Autoimmune gastrointestinal dysmotility | Intestinal neuronal dysplasia | Foreign body in alimentary tract | Exocrine pancreatic insufficiency | Glucose-galactose malabsorption | Fructose malabsorption | Food protein-induced enterocolitis syndrome | 00
| 21,686 |
<unk> is metabolized in the liver by the cytochrome P450 enzyme CYP3A4. When administered concomitantly with drugs that inhibit CYP3A4, such as ketoconazole, the metabolism of<unk> is impaired, leading to an increase in its concentration in the body and a reduction in its excretion. As stated above,<unk> may also prolong the QT interval. Therefore, administering it concomitantly with drugs which also have this effect, such as moxifloxacin or pimozide, can theoretically increase the risk of arrhythmia. | Solifenacin | Zoliflodacin | Proglumetacin | Revefenacin | Darifenacin | Tofenacin | Arbekacin | Sakacin | 00
| 39,534 |
<unk> carries certain risks that may be serious or life-threatening. When making the decision to undergo such a procedure it is recommended to compare the benefits with the potential risks and complications. Hence, all patients must be informed on all the risks they are exposing themselves to. Severe complications occur however in rare cases and these include blood clots, thrombosis, cardiac and pulmonary complications or infection. Infection and blood clots are a serious potential risk after<unk> , but which occur rarely. Infection is usually treated with antibiotics and drainage. Patients are recommended to move around as soon as possible after surgery to minimize their risks of developing blood clots. Pulmonary embolism, heart attack or stroke are very rare complications that may result after any type of surgery due to immobility after surgery which results in blood clots that may travel to the heart, lung or brain. Thus, pulmonary embolism is a serious risk after "tummy tuck" procedure and if they occur, they commonly happen within three weeks of the surgery, but more commonly within the first 72 hours after the procedure has been performed. If complications occur, they usually delay the healing process. In rare cases, another surgery is needed to fix a potential complication. Skin necrosis is one of the complications that may require another procedure as the dead skin must be replaced by a skin graft. Although necrosis is extremely rare, smokers have an increased risk to develop skin necrosis. Stopping nicotine use and smoking several weeks before and several weeks after surgery cleans the body and improves the chance of an uneventful recovery. One of the more common problems after an<unk> is collection of fluid under the skin after the drains have been removed. A surgeon can aspirate the fluid with a needle. The drainage stops within a month and does not affect the final results. The scars resulting from<unk> are long, large in appearance, and permanent. The size of the scar depends on the amount of skin that has been cut off, the techniques used for the surgery, the surgeon's skills, and the body's ability to recover. Although this scar will never become invisible, it is usually placed under the swimsuit line so it is covered by clothes. It normally takes nine months to a year before scars flatten out and lighten in color. Possible risks of<unk> include: * Bleeding * Fluid accumulation * Poor wound healing * Skin loss * Numbness or other changes in skin sensation * Anesthesia complications * Skin discoloration and/or prolonged swelling * Fatty tissue found deep in the skin might die (fat necrosis) * Major wound separation * Asymmetry * Recurrent looseness of skin * Pain, which may persist * Persistent swelling in the legs * Nerve damage * Possibility of revisional surgery * Hematoma (may occur in 3 to 4% of cases) * Keloid (heavy scar) * Seroma * Suture rupture * Swelling * Visible scar * Death | Abdominoplasty | Pull-through procedure | Fistulotomy | Fistulectomy | Perineoplasty | Coloanal anastomosis | Ostectomy | Anal sphincterotomy | 00
| 11,415 |
* Damage to local organs (e.g., bowel, bladder, uterus and neurovascular structures in the retroperitoneum and lateral pelvic sidewalls from<unk> l implantation and its removal; * Postoperative bleeding requiring repeated surgery; * Amniotic fluid embolism; * Complications (such as dilutional coagulopathy, consumptive coagulopathy, acute transfusion reactions, transfusion-associated lung injury, acute respiratory distress syndrome, and electrolyte abnormalities) caused by transfusion of large volumes of blood products, crystalloids, and other volume expanders; * Postoperative thromboembolism, infection, multisystem organ failure, and maternal death. The exact incidence of maternal mortality related to<unk><unk> and its complications is unknown, but it is significant, especially if the urinary bladder is involved | Placenta accreta spectrum | After-birth abortion | Instillation abortion | Septic abortion | Toxic abortion | Puppy pregnancy syndrome | complications of Mastitis | complications of Pregnancy | 00
| 34,012 |
The NICE clinical guideline on chronic obstructive<unk> disease states that<unk> should be offered to all patients who consider themselves functionally disabled by COPD (usually MRC Medical Research Council grade 3 and above)”. It is indicated not only in patients with COPD, but also for the following conditions: * Cystic fibrosis * Bronchitis * Sarcoidosis * Idiopathic<unk> fibrosis * Before and after lung surgery * Interstitial lung disease:<unk> may be safe and may help improve functional exercise capacity, a person's short-term quality of life, and improve shortness of breath (dyspnoea). | Pulmonary rehabilitation | Asthma spacer | Hyperinflation therapy | Airway clearance therapy | Balneotherapy | Oxygen therapy | Bronchial thermoplasty | Aspiration therapy | 00
| 53,517 |
* Brain: the pituitary stalk, also known as the<unk> and<unk> undibular stalk, is the connection between the hypothalamus and the posterior pituitary. * Hair follicle: the<unk> is the cup or funnel in which a hair follicle grows. *<unk> (heart): The<unk> of the heart, or conus arteriosus, is the outflow portion of the right ventricle. * Lung: The alveolar sacs of the lungs, from which the air chambers (alveoli) open, are also called<unk> undibula. * Sinus (anatomy): The ethmoidal<unk> is the most important of three<unk> undibula of the nose: the frontal<unk> and the maxillary<unk> flow into it. *<unk> of uterine tube: the funnel-like end of the mammal oviduct nearest to the ovary. * Gallbladder: The<unk> of the gallbladder (also known as the "neck" of the gallbladder) is the end of nearest to the cystic duct, which is often dilated relative to the body of the gallbladder, and is a common site for gallstones. * Renal pelvis, sometimes called the renal<unk> | Infundibulum | Inoculum | Otic vesicle | Epicles | Concha bullosa | Nodule of vermis | Root sheath | Reticular membrane | 00
| 1,195 |
A Necator americanus larva.<unk> , an experimental type of immunotherapy, is the treatment of autoimmune diseases and immune disorders by means of deliberate infestation with a helminth or with the eggs of a helminth. Helminths are parasitic worms such as hookworms, whipworms, and threadworms that have evolved to live within a host organism on which they rely for nutrients. These worms are members of two phyla: nematodes, which are primarily used in human<unk> , and flat worms (trematodes).<unk> consists of the inoculation of the patient with specific parasitic intestinal nematodes (or other helminths). A number of such organisms are currently being investigated for their use as treatment including: Trichuris suis ova, commonly known as pig whipworm eggs; Necator americanus, commonly known as hookworms; Trichuris trichiura ova, commonly referred to as human whipworm eggs; and Hymenolepis diminuta, commonly known as rat tapeworm cysticerci. While the latter four species may be considered to be mutualists – providing benefit to their host without causing longterm harm – there are other helminth species that have demonstrated therapeutic effects but which also have a potential to cause less desirable or even harmful effects and therefore do not share the ideal characteristics for a therapeutic helminth. These include Ascaris lumbricoides, commonly known as human giant roundworm; Strongyloides stercoralis, commonly known as human roundworm; Enterobius vermicularis, commonly known as pinworm or threadworm; and Hymenolepis nana, also known as dwarf tapeworm. Current research targets Crohn's disease, ulcerative colitis, inflammatory bowel disease, coeliac disease, multiple sclerosis and asthma. Helminth infection has emerged as one possible explanation for the low incidence of autoimmune diseases and allergies in less developed countries, while reduced infection rates have been linked with the significant and sustained increase in autoimmune diseases seen in industrialized countries. | Helminthic therapy | Maggot therapy | Anthrax weaponization | Bridge therapy | Aerosol-generating procedure | Stamina therapy | Ozone therapy | Psychedelic therapy | 00
| 29,902 |
<unk> (brand name Vitespen), also known as cancer vaccine heat shock protein peptide complex-96 and cancer vaccine HSPPC-96, is a personalized cancer vaccine developed by the American biopharmaceutical company Antigenics Inc. (now Agenus) that is evaluated in multiple clinical trials. It has been granted fast track and orphan drug designations from the US Food and Drug Administration for kidney cancer, metastatic melanoma, and glioma. The investigational agent is not yet approved in the US but was approved in Russia in April 2008 for patients who have earlier-stage kidney cancer. The European Medicines Agency is evaluating conditional approval for<unk> .<unk> is one of a group of new drugs called cancer vaccines that intend to train the body's immune system to fight the cancer. While chemotherapy is often accompanied by severe side effects, cancer vaccines tend to have only minimal ones (often only inflammations of the injection site). In April 2009, the World Vaccine Congress named<unk> as the best therapeutic vaccine. However, after a negative opinion from the Committee for Medicinal Products for Human Use (CHMP) on 19 November 2009, Antigenics Inc. decided to withdraw their application for approval by the European Medicines Agency shortly after on 23 November 2009. | Oncophage | Lentivirus | Oncovirus | Oncolytic virus | Passenger virus | Pandemrix | Oncolytic adenovirus | Arbovirus | 00
| 50,575 |
Hereditary factors are the most common cause. A diet high in saturated fat and cholesterol increases blood cholesterol and triglyceride levels. Other disorders, such as diabetes mellitus, kidney disease, and hypothyroidism, may promote hypertriglyceridemia. Certain drugs, such as estrogen, corticosteroids, retinoids, protease inhibitors, thiazide diuretics, and beta-blockers, may cause hypertriglyceridemia. Obesity increases the risk of hyperlipidemia. Chronic, excessive alcohol use increases the risk of hypertriglyceridemia. Smoking and not exercising may lead to hyperlipidemia. Steroid uses, alcoholism, hypothyroidism, oral contraceptives, chronic kidney failure, hypopituitarism, and nephritic syndrome are other contributors to hyperlipidemia. | Combined hyperlipidemia | Familial hypertriglyceridemia | Familial hypercholesterolemia | types of Dyslipidemia | Hypolipoproteinemia | Hyper-CVAD | Dyslipidemia | Hyperlipidemia | 00
| 15,704 |
Advocates for this technique claim that it can improve breathing mechanics, including diaphragmatic function. They use the term "zone of apposition" to describe where the diaphragm attaches to the rib cage. The diaphragm's mechanical action and respiratory advantage depends on its relationship and anatomical arrangement with the rib cage. | Postural restoration | Nerve induction | Autogenic training | Lateral release | Continuous passive motion | Eyebrow restoration | Pressure control | Harm reduction | 00
| 64,857 |
Patella, its tendon and tibial tuberosity The condition is usually seen in athletic individuals typically between 10–14 years of age. Following a strain or partial rupture of patellar ligament the patient develops a traction ‘tendinitis’ characterized by pain and point tenderness at the inferior (lower) pole of the patella associated with focal swelling. Children with cerebral palsy are particularly prone to SLJ 4. | Sinding-Larsen and Johansson syndrome | Dahlberg Borer Newcomer syndrome | Alice in Wonderland syndrome | Smith–Fineman–Myers syndrome | Naegeli–Franceschetti–Jadassohn syndrome | Grisel's syndrome | Wallis–Zieff–Goldblatt syndrome | caption of Plummer–Vinson syndrome | 00
| 65,792 |
<unk> s resulting from chronic rhinosinusitis affect approximately 4.3% of the population.<unk> s occur more frequently in men than women and are more common as people get older, increasing drastically after the age of 40. Of people with chronic rhinosinusitis, 10% to 54% also have allergies. An estimated 40% to 80% of people with sensitivity to aspirin will develop<unk> osis. In people with cystic fibrosis,<unk> s are noted in 37% to 48%. | Nasal polyp | Nasal septal abscess | Nasal vestibulitis | Trachoma | Nasal septum perforation | Aerosinusitis | Adenoiditis | Rhinosinusitis | 00
| 16,365 |
<unk> is the sampling of a<unk> <unk> of an oocyte. It was first applied clinically in humans in 1987 after extensive animal studies. A<unk> <unk> is a small haploid cell that is formed concomitantly as an egg cell during oogenesis, but which generally does not have the ability to be fertilized. After sampling of a<unk> <unk> , subsequent analysis can be used to predict viability and pregnancy chance of the oocyte, as well as the future health of a person resulting from such a pregnancy. The latter use makes it a form of preimplantation genetic screening (PGS). Compared to a blastocyst biopsy, a<unk> can potentially be of lower costs, less harmful side-effects, and more sensitive in detecting abnormalities. | Polar body biopsy | Needle-localized biopsy | Vitreology | Open biopsy | Dermatopathology | DNA profiling | Tissue typing | Lymph node biopsy | 00
| 66,945 |
<unk> or California pseudotyphus is a condition characterized by a rash of maculopapules or furuncles. It is caused by Rickettsia felis. | Flea-borne spotted fever | Flinders Island spotted fever | Japanese spotted fever | African tick bite fever | Blackwater fever | Rocky Mountain spotted fever | Spondweni fever | American tick bite fever | 00
| 57,632 |
Major risk factors Routine counseling of adults to advise them to improve their diet and increase their physical activity has not been found to significantly alter behavior and thus is not recommended. ; Conditions that exacerbate or provoke<unk> One study found that smokers with coronary artery disease had a significantly increased level of sympathetic nerve activity when compared to those without. This is in addition to increases in blood pressure, heart rate, and peripheral vascular resistance associated with nicotine, which may lead to recurrent<unk> attacks. In addition, the Centers for Disease Control and Prevention (CDC) reports that the risk of CHD (Coronary heart disease), stroke, and PVD (Peripheral vascular disease) is reduced within 1–2 years of smoking cessation. In another study, it was found that, after one year, the prevalence of<unk> in smoking men under 60 after an initial attack was 40% less in those having quit smoking compared to those that continued. Studies have found that there are short-term and long-term benefits to smoking cessation. Other medical problems * Esophageal disorders * Gastroesophageal reflux disease (GERD) * Hyperthyroidism * Hypoxemia * Profound anemia * Uncontrolled hypertension Other cardiac problems * Bradyarrhythmia * Hypertrophic cardiomyopathy * Tachyarrhythmia * Valvular heart disease Myocardial ischemia can result from: # a reduction of blood flow to the heart that can be caused by stenosis, spasm, or acute occlusion (by an embolus) of the heart's arteries. # resistance of the blood vessels. This can be caused by narrowing of the blood vessels; a decrease in radius. Blood flow is proportional to the radius of the artery to the fourth power. # reduced oxygen-carrying capacity of the blood, due to several factors such as a decrease in oxygen tension and hemoglobin concentration. This decreases the ability of hemoglobin to carry oxygen to myocardial tissue. Atherosclerosis is the most common cause of stenosis (narrowing of the blood vessels) of the heart's arteries and, hence,<unk> pectoris. Some people with chest pain have normal or minimal narrowing of heart arteries; in these patients, vasospasm is a more likely cause for the pain, sometimes in the context of Prinzmetal's<unk> and syndrome X. Myocardial ischemia also can be the result of factors affecting blood composition, such as the reduced oxygen-carrying capacity of blood, as seen with severe anemia (low number of red blood cells), or long-term smoking. | Angina | Gastroesophageal reflux disease | Chest pain | Heartburn | Carditis | Shingles | Abdominal angina | Cholecystitis | 00
| 4,725 |
Notable<unk> types and associated diseases Over 170 types of<unk> have been identified, and they are designated by numbers. They may be divided into "low-risk" and "high-risk" types. Low-risk types cause warts and high-risk types can cause lesions or cancer. Cervical testing Guidelines from the American Cancer Society recommend different screening strategies for cervical cancer based on a woman's age, screening history, risk factors and choice of tests. Because of the link between<unk> and cervical cancer, the ACS currently recommends early detection of cervical cancer in average-risk asymptomatic adults primarily with cervical cytology by Pap smear, regardless of<unk> vaccination status. Women aged 30–65 should preferably be tested every 5 years with both the<unk> test and the Pap test. In other age groups, a Pap test alone can suffice unless they have been diagnosed with atypical squamous cells of undetermined significance (ASC-US). Co-testing with a Pap test and<unk> test is recommended because it decreases the rate of false-negatives. According to the National Cancer Institute, "The most common test detects DNA from several high-risk<unk> types, but it cannot identify the types that are present. Another test is specific for DNA from<unk> types 16 and 18, the two types that cause most<unk> -associated cancers. A third test can detect DNA from several high-risk<unk> types and can indicate whether<unk> -16 or<unk> -18 is present. A fourth test detects RNA from the most common high-risk<unk> types. These tests can detect<unk><unk> s before cell abnormalities are evident. "Theoretically, the<unk> DNA and RNA tests could be used to identify<unk><unk> s in cells taken from any part of the body. However, the tests are approved by the FDA for only two indications: for follow-up testing of women who seem to have abnormal Pap test results and for cervical cancer screening in combination with a Pap test among women over age 30." Mouth testing Guidelines for oropharyngeal cancer screening by the Preventive Services Task Force and American Dental Association in the U.S. suggest conventional visual examination, but because some parts of the oropharynx are hard to see, this cancer is often only detected in later stages. The diagnosis of oropharyngeal cancer occurs by biopsy of exfoliated cells or tissues. The National Comprehensive Cancer Network and College of American Pathologists recommend testing for<unk> in oropharyngeal cancer. However, while testing is recommended, there is no specific type of test used to detect<unk> from oral tumors that is currently recommended by the FDA in the United States. Because<unk> type 16 is the most common type found in oropharyngeal cancer, p16 immunohistochemistry is one test option used to determine if<unk> is present, which can help determine course of treatment since tumors that are negative for p16 have better outcomes. Another option that has emerged as a reliable option is<unk> DNA in situ hybridization (ISH) which allows for visualization of the<unk> . Testing men There is not a wide range of tests available even though<unk> is common; most studies of<unk> used tools and custom analysis not available to the general public. Clinicians often depend on the vaccine among young people and high clearance rates (see Clearance subsection in Virology) to create a low risk of disease and mortality, and treat the cancers when they appear. Others believe that reducing<unk><unk> in more men and women, even when it has no symptoms, is important (herd immunity) to prevent more cancers rather than just treating them. Where tests are used, negative test results show safety from transmission, and positive test results show where shielding (condoms, gloves) is needed to prevent transmission until the<unk> clears. Studies have tested for and found<unk> in men, including high-risk types (i.e. the types found in cancers), on fingers, mouth, saliva, anus, urethra, urine, semen, blood, scrotum and penis. The Qiagen/Digene kit mentioned in the previous section was used successfully off label to test the penis, scrotum and anus of men in long-term relationships with women who were positive for high-risk<unk> . 60% of them were found to carry the virus, primarily on the penis. Other studies used cytobrushes and custom analysis. In one study researchers sampled subjects' urethra, scrotum and penis. Samples taken from the urethra added less than 1% to the<unk> rate. Studies like this led Giuliano to recommend sampling the glans, shaft and crease between them, along with the scrotum, since sampling the urethra or anus added very little to the diagnosis. Dunne recommends the glans, shaft, their crease, and the foreskin. In one study the subjects were asked not to wash their genitals for 12 hours before sampling, including the urethra as well as the scrotum and the penis. Other studies are silent on washing - a particular gap in studies of the hands. One small study used wet cytobrushes, rather than wet the skin. It found a higher proportion of men to be<unk> -positive when the skin was rubbed with a 600 grit emery paper before being swabbed with the brush, rather than swabbed with no preparation. It's unclear whether the emery paper collected the virions or simply loosened them for the swab to collect. Studies have found self-collection (with emery paper and Dacron swabs) as effective as collection done by a clinician, and sometimes more so, since patients were more willing than a clinician to scrape vigorously. Women had similar success in self-sampling using tampons, swabs, cytobrushes and lavage. Several studies used cytobrushes to sample fingertips and under fingernails, without wetting the area or the brush. Other studies analyzed urine, semen, and blood and found varying amounts of<unk> , but there is not a publicly available test for those yet. Other testing Although it is possible to test for<unk> DNA in other kinds of<unk> s, there are no FDA-approved tests for general screening in the United States or tests approved by the Canadian government, since the testing is inconclusive and considered medically unnecessary. Genital warts are the only visible sign of low-risk genital<unk> and can be identified with a visual check. These visible growths, however, are the result of non-carcinogenic<unk> types. Five percent acetic acid (vinegar) is used to identify both warts and squamous intraepithelial neoplasia (SIL) lesions with limited success by causing abnormal tissue to appear white, but most doctors have found this technique helpful only in moist areas, such as the female genital tract. At this time,<unk> tests for males are used only in research. Research into testing for<unk> by antibody presence has been done. The approach is looking for an immune response in blood, which would contain antibodies for<unk> if the patient is<unk> positive. The reliability of such tests has not been proven, as there has not been a FDA approved product as of August 2018; testing by blood would be a less invasive test for screening purposes. | Human papillomavirus infection | Circumcision | Radiation exposure | Dry sex | Tobacco smoking | Vaginal yeast infection | Risky sexual behavior | Vaginal intraepithelial neoplasia | 00
| 7,446 |
The back of an East Asian man showing<unk> . Individuals who experience the alcohol<unk> ing<unk> may be less prone to alcoholism. Disulfiram, a drug sometimes given as treatment for alcoholism, works by inhibiting acetaldehyde dehydrogenase, causing a five to tenfold increase in the concentration of acetaldehyde in the body. The resulting irritating<unk> ing<unk> tends to discourage affected individuals from drinking. The most obvious symptom is<unk> ing on a person's face and body after drinking alcohol. Other effects include "nausea, headache and general physical discomfort". Many cases of alcohol-induced respiratory<unk> s, which involve rhinitis and worsening of asthma, develop within 1–60 minutes of drinking alcohol and are due to the same causes as<unk><unk> s. | Alcohol flush reaction | Cannabinoid hyperemesis syndrome | Alcohol withdrawal syndrome | Post-acute-withdrawal syndrome | Nicotine withdrawal | Drug withdrawal | Poison ivy | Opioid withdrawal | 00
| 24,722 |
The beginning of pregnancy may be detected either based on symptoms by the woman herself, or by using pregnancy tests. However, an important condition with serious health implications that is quite common is the denial of pregnancy by the pregnant woman. About one in 475 denials will last until around the 20th week of pregnancy. The proportion of cases of denial, persisting until delivery is about 1 in 2500. Conversely, some non-pregnant women have a very strong belief that they are pregnant along with some of the physical changes. This condition is known as a false pregnancy. Physical signs Linea nigra in a woman at 22 weeks pregnant. Most pregnant women experience a number of symptoms, which can signify pregnancy. A number of early medical signs are associated with pregnancy. These signs include: * the presence of human chorionic gonadotropin (hCG) in the blood and urine * missed menstrual period * implantation bleeding that occurs at implantation of the embryo in the uterus during the third or fourth week after last menstrual period * increased basal body temperature sustained for over 2 weeks after ovulation * Chadwick's sign (darkening of the cervix, vagina, and vulva) * Goodell's sign (softening of the vaginal portion of the cervix) * Hegar's sign (softening of the uterus isthmus) * Pigmentation of the linea alba – linea nigra, (darkening of the skin in a midline of the abdomen, caused by hyperpigmentation resulting from hormonal changes, usually appearing around the middle of pregnancy). * Darkening of the nipples and areolas due to an increase in hormones. Biomarkers Pregnancy detection can be accomplished using one or more various pregnancy tests, which detect hormones generated by the newly formed placenta, serving as biomarkers of pregnancy. Blood and urine tests can detect pregnancy 12 days after implantation. Blood pregnancy tests are more sensitive than urine tests (giving fewer false negatives). Home pregnancy tests are urine tests, and normally detect a pregnancy 12 to 15 days after fertilization. A quantitative blood test can determine approximately the date the embryo was conceived because hCG doubles every 36 to 48 hours. A single test of progesterone levels can also help determine how likely a fetus will survive in those with a threatened miscarriage (bleeding in early pregnancy). Ultrasound Obstetric ultrasonography can detect fetal abnormalities, detect multiple pregnancies, and improve gestational dating at 24 weeks. The resultant estimated gestational age and due date of the fetus are slightly more accurate than methods based on last menstrual period. Ultrasound is used to measure the nuchal fold in order to screen for Down syndrome. | risks of Vaginal yeast infection | risks of Postpartum infections | risks of Pelvic inflammatory disease | risks of Appendix cancer | causes of Cervical cancer | symptom of Vaginal yeast infection | causes of Endometritis | risks of Necrotizing enterocolitis | 00
| 25,192 |
Hair cells Hair cells and supporting cells are both located in the cochlea inside the<unk> <unk> . In mammals, hair cells are located in the Organ of Corti and convert energy from sound waves and physical movement into electrical signals. This is accomplished through integrating neurons with hair cells that transmit signals to the auditory nerve. There are three rows of outer hair cells and one row of<unk> hair cells on the Organ of Corti. 95% of neurons that transmit signals to the auditory nerve are connected to<unk> hair cells, making<unk> hair cells mainly responsible for auditory sensory input. While<unk> hair cells are the sensory receptors, outer hair cells are the efferent receptors and are important in fine-tuning sensory input by contracting and relaxing to alter the tectorial membrane on the surface of the hair cells. Uncoiled cochlea with basilar membrane Supporting cells Supporting cells are critical for maintaining<unk> <unk> sensory cells. They reside both on the surface and throughout the epithelium of the<unk> <unk> , communicating through gap junctions. Supporting cells are critical for maintaining the physical structure of the<unk> <unk> , as well as maintaining the environment of the sensory epithelium of the<unk> <unk> . Maintaining appropriate ion concentrations and pH in the<unk> <unk> epithelium is important for hair cells to initiate action potentials to transmit signals to the brain. Supporting cells are also responsible for removing damaged hair cells from the<unk> <unk> . Outer hair cell and Deiter's cell Hair cells and most supporting cells are ectoderm-derived. The main types of supporting cells are Hensen’s cells, Deiters’ cells, Claudius cells,<unk> phalangeal cells, and<unk> and outer pillar cells. Hensen’s cells, Deiter’s cells, and outer hair cells make up the outer tunnel and are mainly responsible for allowing hair cells to function. Hensen’s cells are columnar in shape, have many phagosomes in their cytoplasm and contain lipid droplets that correlate with the extent of their<unk> vation. Deiters’ cells are attached to outer hair cells. They have phalanges that extend to create tight junctions with nearby outer hair cells. Because Deiters’ cells<unk> act with outer hair cells, they play a key role in coordinating shifts and mechanical force between outer hair cells. | Inner ear regeneration | Lens regeneration | Nasolacrimal duct obstruction | Tooth gemination | Vitreomacular adhesion | Ophthalmic drug administration | Protruding ear | Tooth regeneration | 00
| 73,907 |
The IUPAC name of<unk> is 1-2-(dimethylamino)-1-(4 methoxyphenyl)ethylcyclohexanol, though it is sometimes referred to as (±)-1-a-a-(dimethylamino)methyl-p-methoxybenzylcyclohexanol. It consists of two enantiomers present in equal quantities (termed a racemic mixture), both of which have the empirical formula of C17H27NO2. It is usually sold as a mixture of the respective hydrochloride salts, (R/S)-1-2-(dimethylamino)-1-(4 methoxyphenyl)ethylcyclohexanol hydrochloride, C17H28ClNO2, which is a white to off-white crystalline solid.<unk> is structurally and pharmacologically related to the atypical opioid analgesic tramadol, and more distantly to the newly released opioid tapentadol, but not to any of the conventional antidepressant drugs, including tricyclic antidepressants, SSRIs, MAOIs, or RIMAs.<unk> extended release is chemically the same as normal<unk> . The extended release (controlled release) version distributes the release of the drug into the gastrointestinal tract over a longer period than normal<unk> . This results in a lower peak plasma concentration. Studies have shown that the extended release formula has a lower incidence of nausea as a side effect, resulting in better compliance. | Venlafaxine | Desvenlafaxine | Nortriptyline | Atomoxetine | Fluoxetine | Amitriptyline | Citalopram | Imipramine | 00
| 13,663 |
In general, the prognosis of<unk> is quite poor, because most patients present with advanced disease. By the time the first symptoms (such as difficulty swallowing) appear, the disease has already progressed. The overall five-year survival rate (5YSR) in the United States is around 15%, with most people dying within the first year of diagnosis. The latest survival data for England and Wales (patients diagnosed during 2007) show that only one in ten people survives<unk> for at least ten years. Individualized prognosis depends largely on stage. Those with cancer restricted entirely to the esophageal mucosa have about an 80% 5YSR, but submucosal involvement brings this down to less than 50%. Extension into the muscularis propria (muscle layer of the esophagus) suggests a 20% 5YSR, and extension to the structures adjacent to the esophagus predict a 7% 5YSR. Patients with distant metastases (who are not candidates for curative surgery) have a less than 3% 5YSR. | Esophageal cancer | Gastroesophageal reflux disease | Hypopharyngeal cancer | Esophageal spasm | Laryngeal cancer | Oropharyngeal cancer | Esophageal disease | Esophageal candidiasis | 00
| 9,304 |
Nociceptive Mechanism of nociceptive<unk> . Nociceptive<unk> is caused by stimulation of sensory nerve fibers that respond to stimuli approaching or exceeding harmful intensity (nociceptors), and may be classified according to the mode of noxious stimulation. The most common categories are "thermal" (e.g. heat or cold), "mechanical" (e.g. crushing, tearing, shearing, etc.) and "chemical" (e.g. iodine in a cut or chemicals released during inflammation). Some nociceptors respond to more than one of these modalities and are consequently designated polymodal. Nociceptive<unk> may also be classed according to the site of origin and divided into "visceral", "deep somatic" and "superficial somatic"<unk> . Visceral structures (e.g., the heart, liver and intestines) are highly sensitive to stretch, ischemia and inflammation, but relatively insensitive to other stimuli that normally evoke<unk> in other structures, such as burning and cutting. Visceral<unk> is diffuse, difficult to locate and often referred to a distant, usually superficial, structure. It may be accompanied by nausea and vomiting and may be described as sickening, deep, squeezing, and dull. Deep somatic<unk> is initiated by stimulation of nociceptors in ligaments, tendons, bones, blood vessels, fasciae and muscles, and is dull, aching, poorly-localized<unk> . Examples include sprains and broken bones. Superficial somatic<unk> is initiated by activation of nociceptors in the skin or other superficial tissue, and is sharp, well-defined and clearly located. Examples of injuries that produce superficial somatic<unk> include minor wounds and minor (first degree) burns. Neuropathic Neuropathic<unk> is caused by damage or disease affecting any part of the nervous system involved in bodily feelings (the somatosensory system). Neuropathic<unk> may be divided into peripheral, central, or mixed (peripheral and central) neuropathic<unk> . Peripheral neuropathic<unk> is often described as "burning", "tingling", "electrical", "stabbing", or "pins and needles". Bumping the "funny bone" elicits acute peripheral neuropathic<unk> . Some manifestations of neuropathic<unk> include: traumatic neuropathy, tic douloureux,<unk> ful diabetic neuropathy, and postherpetic neuralgia. Nociplastic Nociplastic<unk> is<unk> characterized by a changed nociception (but without evidence of real or threatened tissue damage, or without disease or damage in the somatosensory system). In some debates regarding physician-assisted suicide or euthanasia,<unk> has been used as an argument to permit people who are terminally ill to end their lives. This applies, for example, to fibromyalgia patients. Psychogenic Psychogenic<unk> , also called psychalgia or somatoform<unk> , is<unk> caused, increased or prolonged by mental, emotional or behavioral factors. Headache, back<unk> and stomach<unk> are sometimes diagnosed as psychogenic. Sufferers are often stigmatized, because both medical professionals and the general public tend to think that<unk> from a psychological source is not "real". However, specialists consider that it is no less actual or hurtful than<unk> from any other source. People with long-term<unk> frequently display psychological disturbance, with elevated scores on the Minnesota Multiphasic Personality Inventory scales of hysteria, depression and hypochondriasis (the "neurotic triad"). Some investigators have argued that it is this neuroticism that causes acute<unk> to turn chronic, but clinical evidence points the other direction, to chronic<unk> causing neuroticism. When long-term<unk> is relieved by therapeutic intervention, scores on the neurotic triad and anxiety fall, often to normal levels. Self-esteem, often low in chronic<unk> patients, also shows improvement once<unk> has resolved. | symptom of Chest pain | symptom of Pericarditis | symptom of Mouth breathing | symptom of Air embolism | symptom of Hypoxia | symptom of Lipedema | symptom of Constrictive pericarditis | symptom of Pulmonary embolism | 00
| 1,725 |
Surgical management options include extensive cervical laminectomy with or without an additional<unk> arthrodesis, anterior decompression and arthrodesis, and<unk> cervical laminoplasty. Treatment decisions can be made based on a grading systems devised by Hirabayashi et al., supplemented by the Nurick myelopathy classification system. | Ossification of the posterior longitudinal ligament | Ischemia-reperfusion injury of the appendicular musculoskeletal system | Humeral avulsion of the glenohumeral ligament | Protrusio acetabuli | Anterior vertebral body tethering | Discoid meniscus | Fibroma of tendon sheath | Posselt's envelope of motion | 00
| 69,902 |
Contraindications include: * Epilepsy as it can lower the seizure threshold * TCAs should not be used concomitantly or within 14 days of treatment with monoamine oxidase inhibitors due to the risk for serotonin syndrome * Acute recovery phase following myocardial infarction as TCAs may produce conduction defects and arrhythmias * Liver failure * Hypersensitivity to<unk> | Dosulepin | Pretomanid | Covaxin | Mucrocetin | Itruvone | Crotamiton | Celadrin | Co-codaprin | 00
| 28,797 |
The<unk> (LSYPE), also known as "Next Steps", is a large-scale panel study collecting information about<unk><unk> in<unk> aged 13 to 14 in 2004. | Longitudinal Study of Young People in England | European Prospective Investigation into Cancer and Nutrition | British birth cohort studies | Harvard alumni health study | West of Scotland Coronary Prevention Study | Cohorts for Heart and Aging Research in Genomic Epidemiology | Lothian birth-cohort studies | Avon Longitudinal Study of Parents and Children | 00
| 57,032 |
<unk> , a sulfanilamide, is a structural analog of para-aminobenzoic acid (PABA). They compete with PABA to bind to dihydropteroate synthetase and inhibit conversion of PABA and dihydropteroate diphosphate to dihydrofolic acid, or dihydrofolate. Inhibiting the production of dihydrofolate intermediate interferes with the normal bacterial synthesis of folic acid (folate). Folate is an essential metabolite for bacterial growth and replication because it is used in DNA synthesis, primarily at thymidylate and purine biosynthesis, and amino acids synthesis, including serine, glycine and methionine. Hence, blockage of folate production inhibits the folate-dependent metabolic processes for bacterial growth. Since it inhibits bacterial growth,<unk> is considered a bacteriostatic antibiotic. Tetrahydrofolate synthesis pathwaySulfonamides are selective against bacteria because they interfere with the synthesis of folate, a process which does not occur in humans. Humans do not synthesize folate, and must acquire it through diet. | Sulfamethoxazole | Trimethoprim | Moxifloxacin | Phenoxymethylpenicillin | Penicillin | Streptomycin | Enrofloxacin | Minocycline | 00
| 21,514 |
Cancers are classified by the type of cell that the tumor cells resemble and is therefore presumed to be the origin of the tumor. These types include: * Carcinoma: Cancers derived from epithelial cells. This group includes many of the most common cancers and include nearly all those in the breast, prostate, lung, pancreas and colon. * Sarcoma: Cancers arising from connective tissue (i.e. bone, cartilage, fat, nerve), each of which develops from cells originating in mesenchymal cells outside the bone marrow. * Lymphoma and leukemia: These two classes arise from hematopoietic (blood-forming) cells that leave the marrow and tend to mature in the lymph nodes and blood, respectively. * Germ cell tumor: Cancers derived from pluripotent cells, most often presenting in the testicle or the ovary (seminoma and dysgerminoma, respectively). * Blastoma: Cancers derived from immature "precursor" cells or embryonic tissue. Cancers are usually named using -carcinoma, -sarcoma or -blastoma as a suffix, with the Latin or Greek word for the organ or tissue of origin as the root. For example, cancers of the liver parenchyma arising from malignant epithelial cells is called hepatocarcinoma, while a malignancy arising from primitive liver precursor cells is called a hepatoblastoma and a cancer arising from fat cells is called a liposarcoma. For some common cancers, the English organ name is used. For example, the most common type of breast cancer is called ductal carcinoma of the breast. Here, the adjective ductal refers to the appearance of cancer under the microscope, which suggests that it has originated in the milk ducts. Benign tumors (which are not cancers) are named using -oma as a suffix with the organ name as the root. For example, a benign tumor of smooth muscle cells is called a leiomyoma (the common name of this frequently occurring benign tumor in the uterus is fibroid). Confusingly, some types of cancer use the -noma suffix, examples including melanoma and seminoma. Some types of cancer are named for the size and shape of the cells under a microscope, such as giant cell carcinoma, spindle cell carcinoma and small-cell carcinoma. File:Breast cancer gross appearance.An invasive ductal carcinoma of the breast (pale area at the center) surrounded by spikes of whitish scar tissue and yellow fatty tissue File:Colon cancer 2.An invasive colorectal carcinoma (top center) in a colectomy specimen File:Lung cancer.A squamous-cell carcinoma (the whitish tumor) near the bronchi in a lung specimen File:BreastCancer.A large invasive ductal carcinoma in a mastectomy specimen | medical cause of Hypercalcaemia | medical cause of Hyperphosphatemia | medical cause of Hyperkalemia | complications of Hypercalcaemia | medical cause of Hypophosphatemia | medical cause of Hyperthermia | medical diagnosis of Hyperparathyroidism | medical cause of Chronic kidney disease | 00
| 5,912 |
<unk> does not improve mortality in severe sepsis or septic shock but does increase bleeding risks. Therefore, a 2012 Cochrane review recommended that clinicians and policymakers not recommend its use and Eli Lilly has announced the discontinuation of all clinical trials. | Drotrecogin alfa | Efmoroctocog alfa | Vonicog alfa | Etelcalcetide | Susoctocog alfa | Moroctocog alfa | Sulfatide | Velmanase alfa | 00
| 24,843 |
Muscle cells work by detecting a flow of electrical impulses from the brain, which signals them to contract through the release of calcium by the sarcoplasmic reticulum. Fatigue (reduced ability to generate force) may occur due to the nerve, or within the muscle cells themselves. New research from scientists at Columbia University suggests that muscle fatigue is caused by calcium leaking out of the muscle cell. This makes less calcium available for the muscle cell. In addition, the Columbia researchers propose that an enzyme activated by this released calcium eats away at muscle fibers. Substrates within the muscle generally serve to power muscular contractions. They include molecules such as adenosine triphosphate (ATP), glycogen and creatine phosphate. ATP binds to the myosin head and causes the ‘ratchetting’ that results in contraction according to the sliding filament model. Creatine phosphate stores energy so ATP can be rapidly regenerated within the muscle cells from adenosine diphosphate (ADP) and inorganic phosphate ions, allowing for sustained powerful contractions that last between 5–7 seconds. Glycogen is the intramuscular storage form of glucose, used to generate energy quickly once intramuscular creatine stores are exhausted, producing lactic acid as a metabolic byproduct. Contrary to common belief, lactic acid accumulation doesn't actually cause the burning sensation felt when people exhaust their oxygen and oxidative metabolism, but in actuality, lactic acid in presence of oxygen recycles to produce pyruvate in the liver, which is known as the Cori cycle. Substrates produce metabolic fatigue by being depleted during exercise, resulting in a lack of intracellular energy sources to fuel contractions. In essence, the muscle stops contracting because it lacks the energy to do so. | symptom of Subacute bacterial endocarditis | symptom of Myocarditis | symptom of Atrial fibrillation | symptom of Pericarditis | symptoms of Brugada syndrome | symptom of Kawasaki disease | symptom of Dilated cardiomyopathy | symptom of Constrictive pericarditis | 00
| 12,516 |
<unk> <unk> ,<unk> o known as motor neurone disease (MND) or Lou Gehrig's disease, is a neurodegenerative disease that results in the progressive loss of motor neurons that control voluntary muscles.<unk> is the most common type of motor neuron disease. Early symptoms of<unk> include stiff muscles, muscle twitches, and gradual increasing weakness and muscle wasting. Limb-onset<unk> begins with weakness in the arms or legs, while bulbar-onset<unk> begins with difficulty speaking or swallowing. Half of the people with<unk> develop at least mild difficulties with thinking and behavior, and about 15% develop frontotemporal dementia. Most people experience pain. The affected muscles are responsible for chewing food, speaking, and walking. Motor neuron loss continues until the ability to eat, speak, move, and finally the ability to breathe is lost.<unk> eventually causes paralysis and early death, usually from respiratory failure. Most cases of<unk> (about 90% to 95%) have no known cause, and are known as sporadic<unk> . However, both genetic and environmental factors are believed to be involved. The remaining 5% to 10% of cases have a genetic cause linked to a history of the disease in the family, and these are known as familial<unk> . About half of these genetic cases are due to one of two specific genes.<unk> and frontotemporal dementia (FTD) are considered to be part of a common disease spectrum <unk> -FTD) because of genetic, clinical, and pathological similarities. The underlying mechanism involves damage to both upper and lower motor neurons; in<unk> -FTD, neurons in the frontal and temporal lobes of the brain die as well. The diagnosis is based on a person's signs and symptoms, with testing done to rule out other potential causes. There is no known cure for<unk> . The goal of treatment is to improve symptoms. A medication called riluzole may extend life by about two to three months. Non-invasive ventilation may result in both improved quality and length of life. Mechanical ventilation can prolong survival but does not stop disease progression. A feeding tube may help. The disease can affect people of any age, but usually starts around the age of 60 and in inherited cases around the age of 50. The average survival from onset to death is two to four years, though this can vary, and about 10% survive longer than 10 years, and death is usually due to respiratory failure. In Europe, the disease affects about two to three people per 100,000 per year. Rates in much of the world are unclear. In the United States, it is more common in white people than in black people. Descriptions of the disease date back to at least 1824 by Charles Bell. In 1869, the connection between the symptoms and the underlying neurological problems was first described by French neurologist Jean-Martin Charcot, who in 1874 began using the term<unk> . It became well known in the United States in the 20th century when in 1939 it affected baseball player Lou Gehrig (leading to his death two years later), and later worldwide, following the 1963 diagnosis of then 21 year old cosmologist Stephen Hawking. However, unlike most<unk> sufferers, Hawking managed to survive his illness for another 55 years. The first<unk> gene was discovered in 1993 while the first animal model was developed in 1994. In 2014, videos of the Ice Bucket Challenge went viral on the Internet and increased public awareness of the condition. | Amyotrophic lateral sclerosis | Botulism | Tropical ataxic neuropathy | Juvenile primary lateral sclerosis | Vascular myelopathy | Multiple system atrophy | Surfer's myelopathy | Lambert–Eaton myasthenic syndrome | 00
| 51,805 |
The coronary arteries originate off of the ascending aorta and continue onto the surface of the heart (the epicardium). When the heart contracts during systole, the contraction compresses the coronary arteries which prevents<unk> . Therefore, it is only when the heart relaxes, during diastole, that the coronary vessels open up and allow for<unk> ; thus<unk> is highest during diastole, unlike most other arteries which experience higher<unk><unk> s under systole.<unk> can be measured by calculating the difference between the aortic<unk> and the left ventricular end diastolic<unk> :<unk> <unk> = Aortic Diastolic<unk> – Left Ventricular end-diastolic<unk> (LVEDP) In the research setting, the absolute<unk> can be measured using coronary and aortic<unk> transducers, however,<unk> is not regularly measured in human clinical practice. During cardiac surgery, when a patient is placed on cardiopulmonary bypass, and blood is passed through the coronary vessels in a retrograde direction,<unk> can be approximated by using the measured right atrial<unk> in place of LVEDP because the coronary sinus drains into the right atrium.<unk> is not the sole determinant of Coronary Blood Flow (CBF). CBF is also determined mainly by metabolic autoregulation; sympathetic regulation plays some role in coronary dilation/constriction but less so than in other vascular systems. That is, when the ventricular myocardium is working, it extracts oxygen from the coronary blood and produces adenosine as a by product of ATP use. Hypoxia and adenosine both contribute to coronary vasodilation, which increase CBF. Both higher<unk> and greater vasodilation will result in higher CBF. | Coronary perfusion pressure | Mean systemic pressure | Cardiac output | Mean arterial pressure | Coronary flow reserve | Vagal tone | Cerebral perfusion pressure | Central venous pressure | 00
| 57,745 |
Kidneys Individuals with<unk> are usually born with hydronephrosis, or dilation of the internal structures of the kidneys, due to narrowing (stenosis) of the passage between the kidneys and the ureters (the ureteropelvic junction), leading to a build-up of urine. There is also often vesicoureteral reflux, in which urine passes backwards from the bladder to the ureters, and frequent urinary tract infections. Heart Individuals with<unk> are typically born with heart defects, which can include aortic valve stenosis, atrial or ventricular septal defect, bicuspid aortic valve or patent ductus arteriosus. Physical features The syndrome has a characteristic facial appearance which is similar to that of Kabuki syndrome, including prominent, downward-displaced ears that are underdeveloped, long eyelids, epicanthic folds, a short, broad nose, an open, downturned mouth and a deep groove in the midline of the tongue. Cleft palate occurs in about half of those affected. There is sometimes webbing of the neck or bulging eyes, and less commonly there is excessive hair on the forehead or other parts of the body or a unibrow. Individuals with the syndrome may also have a broad first toe and crowding of the toes, and at least two affected individuals have had polydactyly of the fifth digit (postaxial polydactyly). Some of those affected have had undescended testicles (cryptorchidism). A small minority of those affected have had congenital joint contractures such as club foot. Neurological Those with<unk> typically have severe mental disability and are usually born with microcephaly. There are typically language and walking delays, and those affected have very low muscle tone and decreased reflexes. They may have neural tube defects such as lipomyelomeningocele (a form of spina bifida) or may have syringomyelia (a cyst in the spinal cord). Those with the syndrome may also have symptoms of dysautonomia (impairments in the autonomic nervous system), including gastrointestinal dysmotility, contributing to gastroesophageal reflux disease, or neurogenic bladder dysfunction, in which bladder control is limited. Dysautonomia has also led to high pain tolerance and reduced sweating in some patients. Some of those with the syndrome have been found to have an underdeveloped corpus callosum, the main band of white matter that connects the two cerebral hemispheres. Skeletal<unk> patients often have skeletal problems such as scoliosis or hip dysplasia, which can lead to hip dislocation. They may be born with congenital vertebral anomalies; parts of the spine may be fused and fail to segment. There may also be extra vertebrae in the lower back. Some of those affected have been reported to have premature fusion of the skull bones (craniosynostosis), particularly those across the midline and at the front of the skull. This has led to an elongated skull shape known as scaphocephaly as well as a ridge on the forehead known as a metopic ridge. Growth Those affected may be born with low weight and size and may display stunted growth in childhood, although this symptom has been variable and not in every individual with<unk> . Hearing and eyesight A minority of those with<unk> have had hearing loss of both sensorineural and conductive types, and a smaller minority have had optic nerve abnormalities. | Okamoto syndrome | Yushō disease | Sanjad-Sakati syndrome | Satoyoshi syndrome | Mungan syndrome | Pashayan syndrome | Nakajo syndrome | Abruzzo–Erickson syndrome | 00
| 72,782 |
The predominant view as of 2018 is that genetic, psychological, and environmental factors all contribute to the development or progression of mental<unk> s. Different risk factors may be present at different ages, with risk occurring as early as during prenatal period. Genetics A number of psychiatric<unk> s are linked to a family history (including depression, narcissistic personality<unk> and anxiety). Twin studies have also revealed a very high heritability for many mental<unk> s (especially autism and schizophrenia). Although researchers have been looking for decades for clear linkages between genetics and mental<unk> s, that work has not yielded specific genetic biomarkers yet that might lead to better diagnosis and better treatments. Statistical research looking at eleven<unk> s found widespread assortative mating between people with mental illness. That means that individuals with one of these<unk> s were two to three times more likely than the general population to have a partner with a mental<unk> . Sometimes people seemed to have preferred partners with the same mental illness. Thus, people with schizophrenia or ADHD are seven times more likely to have affected partners with the same<unk> . This is even more pronounced for people with Autism spectrum<unk> s who are 10 times more likely to have a spouse with the same<unk> . Environment economically unequal countries During the prenatal stage, factors like unwanted pregnancy, lack of adaptation to pregnancy or substance use during pregnancy increases the risk of developing a mental<unk> . Maternal<unk> and birth complications including prematurity and infections have also been implicated in increasing susceptibility for mental illness. Infants neglected or not provided optimal nutrition have a higher risk of developing cognitive impairment. Social influences have also been found to be important, including abuse, neglect, bullying, social<unk> ,<unk> events, and other negative or overwhelming life experiences. Aspects of the wider community have also been implicated, including employment problems, socioeconomic inequality, lack of social cohesion, problems linked to migration, and features of particular societies and cultures. The specific risks and pathways to particular<unk> s are less clear, however. Nutrition also plays a role in mental<unk> s. In schizophrenia and psychosis, risk factors include migration and discrimination, childhood trauma, bereavement or separation in families, recreational use of drugs, and urbanicity. In anxiety, risk factors may include parenting factors including parental rejection, lack of parental warmth, high hostility, harsh discipline, high maternal negative affect, anxious childrearing, modelling of dysfunctional and drug-abusing behaviour, and child abuse (emotional, physical and sexual). Adults with imbalance work to life are at higher risk for developing anxiety. For bipolar<unk> ,<unk> (such as childhood adversity) is not a specific cause, but does place genetically and biologically vulnerable individuals at risk for a more severe course of illness. Drug use Mental<unk> s are associated with drug use including: cannabis, alcohol and caffeine, use of which appears to promote anxiety. For psychosis and schizophrenia, usage of a number of drugs has been associated with development of the<unk> , including cannabis, cocaine, and amphetamines. There has been debate regarding the relationship between usage of cannabis and bipolar<unk> . Cannabis has also been associated with depression. Adolescents are at increased risk for tobacco, alcohol and drug use; Peer pressure is the main reason why adolescents start using substances. At this age, the use of substances could be detrimental to the development of the brain and place them at higher risk of developing a mental<unk> . Chronic disease People living with chronic conditions like HIV and diabetes are at higher risk of developing a mental<unk> . People living with diabetes experience significant<unk> from biological impact of the disease, which places them at risk for developing anxiety and depression. Diabetic patients also have to deal with emotional<unk> trying to manage the disease. Conditions like heart disease, stroke, respiratory conditions, cancer, and arthritis increase the risk of developing a mental<unk> when compared to the general population. Personality traits Risk factors for mental illness include a propensity for high neuroticism or "emotional instability". In anxiety, risk factors may include temperament and attitudes (e.g. pessimism). Causal models Mental<unk> s can arise from multiple sources, and in many cases there is no single accepted or consistent cause currently established. An eclectic or pluralistic mix of models may be used to explain particular<unk> s. The primary paradigm of contemporary mainstream Western psychiatry is said to be the biopsychosocial model which incorporates biological, psychological and social factors, although this may not always be applied in practice. Biological psychiatry follows a biomedical model where many mental<unk> s are conceptualized as<unk> s of brain circuits likely caused by developmental processes shaped by a complex interplay of genetics and experience. A common assumption is that<unk> s may have resulted from genetic and developmental vulnerabilities, exposed by<unk> in life (for example in a diathesis–stress model), although there are various views on what causes differences between individuals. Some types of mental<unk> s may be viewed as primarily neurodevelopmental<unk> s. Evolutionary psychology may be used as an overall explanatory theory, while attachment theory is another kind of evolutionary-psychological approach sometimes applied in the context of mental<unk> s. Psychoanalytic theories have continued to evolve alongside and cognitive-behavioral and systemic-family approaches. A distinction is sometimes made between a "medical model" or a "social model" of<unk> and disability. | symptom of Post-traumatic stress disorder | symptom of Somatization disorder | symptom of Conversion disorder | symptom of Bipolar disorder | symptom of Anxiety disorder | symptom of Progeria | symptom of Opioid use disorder | symptom of Delirium | 00
| 1,379 |
Side effects for any psychoactive drug are difficult to predict, though<unk> is usually well tolerated. Commonly reported side effects for<unk> , some of which tend to subside with continued use, include: *Dizziness *Respiratory depression (impaired breathing) *Drowsiness *Intoxicated feeling *Light-headedness *Nausea *Sedation *Euphoria *Severe impairment of judgment *Diarrhea *Memory Loss *Constipation Fioricet (50/40/325) Rare side-effects include Stevens–Johnson syndrome, an adverse reaction to barbiturates, and anaphylaxis. The risk and severity of all side effects is greatly increased when<unk> (or<unk> -containing medications) are combined with other sedatives (ex. ethanol, opiates, benzodiazepines, antihistamines). In particular,<unk> , especially when combined with other sedatives (e.g. opioids), can cause life-threatening respiratory depression and death. Inhibitors of the hepatic enzyme CYP3A4 may also increase the risk, severity, and duration of side effects, many drugs inhibit this enzyme as do some foods such as grapefruit and the blood orange. Taking<unk> -based medications with some other drugs may also increase the side effects of the other medication. | Butalbital | Ephedrine | Theobromine | Butabarbital | Pseudoephedrine | Bethanechol | Clopenthixol | Guaifenesin | 00
| 28,067 |
<unk> responds excellently to low dose corticosteroids, with sustained and often complete remission. Non-steroidal anti-inflammatory drugs (NSAIDs) have also been used. Hydroxychloroquine has proven effective in some cases. | Remitting seronegative symmetrical synovitis with pitting edema | Interstitial granulomatous dermatitis with arthritis | Proliferative fasciitis and proliferative myositis | Chronic recurrent multifocal osteomyelitis | Photosensitivity with HIV infection | Blistering distal dactylitis | Pruritic papular eruption of HIV disease | Neuralgia-inducing cavitational osteonecrosis | 00
| 53,911 |
<unk> often has a poor prognosis. Typical survival despite surgery is between 12 and 21 months depending on the stage of disease at diagnosis with about 7.5% of people surviving for 5 years. Women, young people, people with low-stage cancers, and people with epithelioid cancers have better prognoses. Negative prognostic factors include sarcomatoid or biphasic histology, high platelet counts (above 400,000), age over 50 years, white blood cell counts above 15.5, low glucose levels in the pleural fluid, low albumin levels, and high fibrinogen levels. Several markers are under investigation as prognostic factors, including nuclear grade, and serum c-reactive protein. Long-term survival is rare. Pericardial<unk> has a 10-month median survival time. In peritoneal<unk> , high expression of WT-1 protein indicates a worse prognosis. | Mesothelioma | Hemangioendothelioma | Epithelioid hemangioendothelioma | Pulmonary sclerosing pneumocytoma | Large-cell lung carcinoma | Giant-cell carcinoma of the lung | Sarcomatoid carcinoma of the lung | Sarcoma | 00
| 10,435 |
<unk> are named after Henri<unk> , who discovered these brainstem lesions in dogs with increased intracranial pressure. They are small linear areas of bleeding in the midbrain and upper pons of the brainstem. They are caused by a traumatic downward displacement of the brainstem with parahippocampal gyrus herniation through the tentorial notch. or acute hematoma, edema following trauma, abscess, or tumor. | Duret haemorrhages | Splinter hemorrhage | Cavernous sinus thrombosis | Pseudoaneurysm | Cerebral venous sinus thrombosis | Pseudosubarachnoid hemorrhage | Vitreous hemorrhage | Cirsoid aneurysm | 00
| 34,413 |