vania-janet/multiturn-rag-retrieval-data huggingface dataset:
Myocardial infarction
Treatment of an MI is time - critical . Aspirin is an appropriate immediate treatment for a suspected MI . Nitroglycerin or opioids may be used to help with chest pain ; however , they do not improve overall outcomes . Supplemental oxygen should be used in those with low oxygen levels or shortness of breath . In a STEMI , treatments attempt to restore blood flow to the heart , and include percutaneous coronary intervention ( PCI ) , where the arteries are pushed open and may be stented , or thrombolysis , where the blockage is removed using medications . People who have a non-ST elevation myocardial infarction ( NSTEMI ) are often managed with the blood thinner heparin , with the additional use of PCI in those at high risk . In people with blockages of multiple coronary arteries and diabetes , coronary artery bypass surgery ( CABG ) may be recommended rather than angioplasty . After an MI , lifestyle modifications , along with long term treatment with aspirin , beta blockers , and statins , are typically recommended .
Vitiligo
Phototherapy is considered a second - line treatment for vitiligo . Exposing the skin to light from UVB lamps is the most common treatment for vitiligo . The treatments can be done at home with an UVB lamp or in a clinic . The exposure time is managed so that the skin does not suffer overexposure . Treatment can take a few weeks if the spots are on the neck and face and if they existed not more than 3 years . If the spots are on the hands and legs and have been there more than 3 years , it can take a few months . Phototherapy sessions are done 2 -- 3 times a week . Spots on a large area of the body may require full body treatment in a clinic or hospital . UVB broadband and narrowband lamps can be used , but narrowband ultraviolet picked around 311 nm is the choice . It has been constitutively reported that a combination of UVB phototherapy with other topical treatments improves re-pigmentation . However , some vitiligo patients may not see any changes to skin or re-pigmentation occurring . A serious potential side effect involves the risk of developing skin cancer , the same risk as an over-exposure to natural sunlight .
Huntington's disease
Several clinical trials of new experimental treatments are underway and planned in Huntington 's disease .
Toxic shock syndrome
Treatment includes antibiotics , incision and drainage of any abscesses , and possibly intravenous immunoglobulin . The need for rapid removal of infected tissue via surgery in those with a streptococcal cause , while commonly recommended , is poorly supported by the evidence . Some recommend delaying surgical debridement . The overall risk of death in streptococcal disease is about 50 % while in staphylococcal disease it is around 5 % . Death may occur within 2 days .
Vitiligo
There is no cure for vitiligo but several treatment options are available . The best evidence is for applied steroids and the combination of ultraviolet light in combination with creams . Due to the higher risks of skin cancer , the United Kingdom 's National Health Service suggests phototherapy only be used if primary treatments are ineffective . Lesions located on the hands , feet , and joints are the most difficult to repigment ; those on the face are easiest to return to the natural skin color as the skin is thinner in nature .
Telangiectasia
In some cases stroke and transient ischemic attacks have occurred after sclerotherapy . Varicose veins and reticular veins are often treated before treating telangiectasia , although treatment of these larger veins in advance of sclerotherapy for telangiectasia may not guarantee better results . Varicose veins can be treated with foam sclerotherapy , endovenous laser treatment , radiofrequency ablation , or open surgery . The biggest risk , however , seems to occur with sclerotherapy , especially in terms of systemic risk of DVT , pulmonary embolism , and stroke .
Vitiligo
A medication for rheumatoid arthritis , tofacitinib , has been tested for the treatment of vitiligo .
Anemia
Treatment of exceptional blood loss ( anemia ) is recognized as an indication for hyperbaric oxygen ( HBO ) by the Undersea and Hyperbaric Medical Society . The use of HBO is indicated when oxygen delivery to tissue is not sufficient in patients who can not be given blood transfusions for medical or religious reasons . HBO may be used for medical reasons when threat of blood product incompatibility or concern for transmissible disease are factors . The beliefs of some religions ( ex : Jehovah 's Witnesses ) may require they use the HBO method . A 2005 review of the use of HBO in severe anemia found all publications reported positive results .
Technological and industrial history of the United States
Research conducted by universities , hospitals , and corporations also contributes to improvement in diagnosis and treatment of disease . NIH funded the basic research on Acquired Immune Deficiency Syndrome ( HIV / AIDS ) , for example . Many of the drugs used to treat this disease have emerged from the laboratories of the American pharmaceutical industry .
Telangiectasia
Sclerotherapy is the `` gold standard '' and is preferred over laser for eliminating telangiectasiae and smaller varicose leg veins . A sclerosant medication is injected into the diseased vein so it hardens and eventually shrinks away . Recent evidence with foam sclerotherapy shows that the foam containing the irritating sclerosant quickly appears in the patient 's heart and lungs , and then in some cases travels through a patent foramen ovale to the brain . This has led to concerns about the safety of sclerotherapy for telangectasias and spider veins .
Pleurisy
Treatment depends on the underlying cause . Paracetamol ( acetaminophen ) and ibuprofen may be used to decrease pain . Incentive spirometry may be recommended to encourage larger breaths . About one million people are affected in the United States each year . Descriptions of the condition date from at least as early as 400 BC by Hippocrates .
Lyme disease
For early cases , prompt treatment is usually curative . However , the severity and treatment of Lyme disease may be complicated due to late diagnosis , failure of antibiotic treatment , and simultaneous infection with other tick - borne diseases ( coinfections ) , including ehrlichiosis , babesiosis , and immune suppression in the patient .
Thalidomide
After further work was done by Celgene and others , in 2006 the U.S. Food and Drug Administration granted accelerated approval for thalidomide in combination with dexamethasone for the treatment of newly diagnosed multiple myeloma patients .
Vitiligo
There is no known cure for vitiligo . For those with light skin , sunscreen and makeup are all that is typically recommended . Other treatment options may include steroid creams or phototherapy to darken the light patches . Alternatively , efforts to lighten the unaffected skin , such as with hydroquinone , may be tried . A number of surgical options are available for those who do not improve with other measures . A combination of treatments generally has better outcomes . Counselling to provide emotional support may be useful .
Pleurisy
The treatment for pleurisy depends on its origin and is prescribed by a physician on a base of an individual assessment . Paracetamol ( acetaminophen ) and amoxicillin , or other antibiotics in case of bacterial infections , are common remedies dispensed by doctors to relieve the initial symptoms and pain in the chest , while viral infections are self - limited . Non-steroidal anti-inflammatory drugs ( NSAIDs ) , preferably indometacin , are usually employed as pain control agents .
Heart
As well as addressing the underlying cause for a patient 's heart failure ( most commonly ischaemic heart disease or hypertension ) , the mainstay of heart failure treatment is with medication . These include drugs to prevent fluid from accumulating in the lungs by increasing the amount of urine a patient produces ( diuretics ) , and drugs that attempt to preserve the pumping function of the heart ( beta blockers , ACE inhibitors and mineralocorticoid receptor antagonists ) .
Pleurisy
Relief of symptoms Removal of the fluid , air , or blood from the pleural space Treatment of the underlying condition
Streptococcal pharyngitis
Prevention is by washing hands and not sharing eating utensils . There is no vaccine for the disease . Treatment with antibiotics is only recommended in those with a confirmed diagnosis . Those infected should stay away from other people for at least 24 hours after starting treatment . Pain can be treated with paracetamol ( acetaminophen ) and nonsteroidal anti-inflammatory drugs ( NSAIDS ) such as ibuprofen .
Thalidomide
Thalidomide was studied in a Phase II trial for Kaposi 's sarcoma , a rare soft - tissue cancer most commonly seen in the immunocompromised , that is caused by the Kaposi 's sarcoma - associated herpesvirus ( KSHV ) .
Human rights and development
In 2008 , reports appeared that malaria parasites in Cambodia and Thailand were resisting artemisinin , the most effective single drug to treat malaria . The countries launched a joint monitoring , prevention and treatment project in seven provinces along their shared border , with support from WHO . In Thailand more than 300 volunteer village malaria health workers were trained to provide free services to test for malaria and directly observe the treatment of patients . Use of a smart phone to capture data on patients and to monitor treatment has accelerated progress . An electronic malaria information system ( e-MIS ) uploaded on the health workers ' mobile devices shows malaria volunteers where to find patients , the status of their treatment , the situation and trends . In Ethiopia a programme , supported by UNICEF and its partners , is preventing transmission of the virus from HIV - positive mothers to their children , a critical measure in ensuring an AIDS - free generation .
Human rights and development
This sixth MDG is to combat HIV / AIDS , malaria and other diseases . The goal has three targets 1 ) to halt and reverse HIV / AIDS , 2 ) to achieve universal treatment for HIV / AIDs 3 ) to halt and reverse Malaria and other Diseases unquestionably reflecting the Right to health . To date 2.3 million people are newly infected by HIV each year , with 1.6 million in sub-Saharan Africa . Tuberculosis ( TB ) mortality rate decreased 41 % between 1991 and 2011 , yet TB killed 1.4 million people in 2011 , including 430,000 among people who were HIV - positive . Multidrug - resistant TB is a major global challenge and the rate of people accessing treatment is slow .
Thalidomide
Thalidomide , sold under the brand name Immunoprin , among others , is an immunomodulatory drug and the prototype of the thalidomide class of drugs . Today , thalidomide is used mainly as a treatment of certain cancers ( multiple myeloma ) and of a complication of leprosy .
Pleurisy
There may be a role for the use of corticosteroids ( for tuberculous pleurisy ) , tacrolimus ( Prograf ) and methotrexate ( Trexall , Rheumatrex ) in the treatment of pleurisy . Further studies are needed .
Myocardial infarction
Statin therapy has been shown to reduce mortality and subsequent cardiac events , and should be commenced with the aim of lowering LDL cholesterol . Other medications , such as ezetimibe , may also be added with this goal in mind .
Heart
Abnormal heart rhythms ( arrhythmias ) can be treated using antiarrhythmic drugs . These may work by manipulating the flow of electrolytes across the cell membrane ( such as calcium channel blockers , sodium channel blockers , amiodarone , or digoxin ) , or modify the autonomic nervous system 's effect on the heart ( beta blockers and atropine ) . In some arrhythmias such as atrial fibrillation which increase the risk of stroke , this risk can be reduced using anticoagulants such as warfarin or novel oral anticoagualants .
Anemia
The motive for the administration of an erythropoiesis - stimulating agent ( ESA ) is to maintain hemoglobin at the lowest level that both minimizes transfusions and meets the individual person 's needs . They should not be used for mild or moderate anemia . They are not recommended in people with chronic kidney disease unless hemoglobin levels are less than 10 g / dL or they have symptoms of anemia . Their use should be along with parenteral iron .
Carbon monoxide poisoning
Further treatment for other complications such as seizure , hypotension , cardiac abnormalities , pulmonary edema , and acidosis may be required . Increased muscle activity and seizures should be treated with dantrolene or diazepam ; diazepam should only be given with appropriate respiratory support . Hypotension requires treatment with intravenous fluids ; vasopressors may be required to treat myocardial depression . Cardiac dysrhythmias are treated with standard advanced cardiac life support protocols . If severe , metabolic acidosis is treated with sodium bicarbonate . Treatment with sodium bicarbonate is controversial as acidosis may increase tissue oxygen availability . Treatment of acidosis may only need to consist of oxygen therapy . The delayed development of neuropsychiatric impairment is one of the most serious complications of carbon monoxide poisoning . Brain damage is confirmed following MRI or CAT scans . Extensive follow up and supportive treatment is often required for delayed neurological damage . Outcomes are often difficult to predict following poisoning , especially people who have symptoms of cardiac arrest , coma , metabolic acidosis , or have high carboxyhemoglobin levels . One study reported that approximately 30 % of people with severe carbon monoxide poisoning will have a fatal outcome . It has been reported that electroconvulsive therapy ( ECT ) may increase the likelihood of delayed neuropsychiatric sequelae ( DNS ) after carbon monoxide ( CO ) poisoning .
Streptococcal pharyngitis
Pain medication such as NSAIDs and paracetamol ( acetaminophen ) helps in the management of pain associated with strep throat . Viscous lidocaine may also be useful . While steroids may help with the pain , they are not routinely recommended . Aspirin may be used in adults but is not recommended in children due to the risk of Reye syndrome .
Medicare (United States)
Part B coverage includes chiropractic care , out patient physician services , visiting nurse , and other services such as x-rays , laboratory and diagnostic tests , influenza and pneumonia vaccinations , blood transfusions , renal dialysis , outpatient hospital procedures , limited ambulance transportation , immunosuppressive drugs for organ transplant recipients , chemotherapy , hormonal treatments such as Lupron , and other outpatient medical treatments administered in a doctor 's office . Medication administration is covered under Part B if it is administered by the physician during an office visit .
Telangiectasia
Telangiectasias on the face are often treated with a laser . Laser therapy uses a light beam that is pulsed onto the veins in order to seal them off , causing them to dissolve . These light - based treatments require adequate heating of the veins . These treatments can result in the destruction of sweat glands , and the risk increases with the number of treatments .
Bubonic plague
Several classes of antibiotics are effective in treating bubonic plague . These include aminoglycosides such as streptomycin and gentamicin , tetracyclines ( especially doxycycline ) , and the fluoroquinolone ciprofloxacin . Mortality associated with treated cases of bubonic plague is about 1 -- 15 % , compared to a mortality of 40 -- 60 % in untreated cases .
Telangiectasia
Other issues which arise with the use of sclerotherapy to treat spider veins are staining , shadowing , telangetatic matting , and ulceration . In addition , incompleteness of therapy is common , requiring multiple treatment sessions .
Huntington's disease
Tetrabenazine was approved in 2008 for treatment of chorea in Huntington 's disease in the US . Other drugs that help to reduce chorea include neuroleptics and benzodiazepines . Compounds such as amantadine or remacemide are still under investigation but have shown preliminary positive results . Hypokinesia and rigidity , especially in juvenile cases , can be treated with antiparkinsonian drugs , and myoclonic hyperkinesia can be treated with valproic acid .
Freedmen's Bureau
Despite the good intentions , efforts , and limited success of the Bureau , medical treatment of the freedmen was severely deficient . Most southern white doctors and nurses would not treat freedmen , infrastructure had been destroyed by the war , and people had few means of improving sanitation . Blacks had not had much opportunity to develop their own medical personnel . In this period epidemics of cholera and yellow fever were carried along the river corridors , breaking out across the South .
Myocardial infarction
The pain associated with myocardial infarction may be treated with nitroglycerin or morphine . Nitroglycerin ( given under the tongue or intravenously ) may improve the blood supply to the heart , and decrease the work the heart must do . It is an important part of therapy for its pain relief , despite there being no benefit to overall mortality . Morphine may also be used , and is effective for the pain associated with STEMI . The evidence for benefit from morphine on overall outcomes , however , is poor and there is some evidence of potential harm .
Huntington's disease
There is no cure for HD . Full - time care is required in the later stages of the disease . Treatments can relieve some symptoms and in some improve quality of life . The best evidence for treatment of the movement problems is with tetrabenazine . HD affects about 4 to 15 in 100,000 people of European descent . It is rare among Japanese , while the occurrence rate in Africa is unknown . The disease affects men and women equally . Complications such as pneumonia , heart disease , and physical injury from falls reduce life expectancy . Suicide is the cause of death in about 9 % of cases . Death typically occurs fifteen to twenty years from when the disease was first detected .
Huntington's disease
Research is being conducted on many different approaches to prevent Huntington 's disease or slow its progression . Disease - modifying strategies can be broadly grouped into three categories : reducing the level of the mutant huntingtin protein ( including gene splicing and gene silencing ) ; approaches aimed at improving neuronal survival by reducing the harm caused by the protein to specific cellular pathways and mechanisms ( including protein homeostasis and histone deacetylase inhibition ) ; and strategies to replace lost neurons . In addition , novel therapies to improve brain functioning are under development ; these seek to produce symptomatic rather than disease - modifying therapies , and include phosphodiesterase inhibitors .
Anemia
Nutritional iron deficiency is common in developing nations . An estimated two - thirds of children and of women of childbearing age in most developing nations are estimated to suffer from iron deficiency ; one - third of them have the more severe form of the disorder , anemia . Iron deficiency from nutritional causes is rare in men and postmenopausal women . The diagnosis of iron deficiency mandates a search for potential sources of loss , such as gastrointestinal bleeding from ulcers or colon cancer . Mild to moderate iron - deficiency anemia is treated by oral iron supplementation with ferrous sulfate , ferrous fumarate , or ferrous gluconate . When taking iron supplements , stomach upset or darkening of the feces are commonly experienced . The stomach upset can be alleviated by taking the iron with food ; however , this decreases the amount of iron absorbed . Vitamin C aids in the body 's ability to absorb iron , so taking oral iron supplements with orange juice is of benefit . In anemias of chronic disease , associated with chemotherapy , or associated with renal disease , some clinicians prescribe recombinant erythropoietin or epoetin alfa , to stimulate RBC production , although since there is also concurrent iron deficiency and inflammation present , parenteral iron is advised to be taken concurrently .
Statin
Statins , also known as HMG - CoA reductase inhibitors , are a class of lipid - lowering medications . Statins have been found to reduce cardiovascular disease ( CVD ) and mortality in those who are at high risk of cardiovascular disease . The evidence is strong that statins are effective for treating CVD in the early stages of the disease ( secondary prevention ) and in those at elevated risk but without CVD ( primary prevention ) .
Heart
In addition to using medications , narrowed heart arteries can be treated by expanding the narrowings or redirecting the flow of blood to bypass an obstruction . This may be performed using a percutaneous coronary intervention , during which narrowings can be expanded by passing small balloon - tipped wires into the coronary arteries , inflating the balloon to expand the narrowing , and sometimes leaving behind a metal scaffold known as a stent to keep the artery open .
Blood plasma
Plasmapheresis is a medical therapy that involves blood plasma extraction , treatment , and reintegration .
History of West Africa
Disease has been a hindrance to human development in West Africa throughout history . The environment , especially the tropical rain - forests , allow many single cell organisms , parasites , and bacteria to thrive and prosper . Prior to the slave trade , West Africans strived to maintain ecological balance , controlling vegetation and game , and thereby minimising the prevalence of local diseases . The increased amount and intensity of warfare due to the slave trade meant that the ecological balance could not be sustained . Endemic diseases became epidemic in scale . Genetic mutations developed that provided increased resistance to disease , such as sickle cell , evident in the Kwa forest agriculturalists from c. 700 C.E. , providing some protection from malaria . HIV
Angular cheilitis
Finally , if the condition appears resistant to treatment , investigations for underlying causes such as anemia or nutrient deficiencies or HIV infection . Identification of the underlying cause is essential for treating chronic cases . The lesions may resolve when the underlying disease is treated , e.g. with a course of oral iron or B vitamin supplements . Patch testing is recommended by some in cases which are resistant to treatment and where allergic contact dermatitis is suspected .
Glycolysis
There is ongoing research to affect mitochondrial metabolism and treat cancer by reducing glycolysis and thus starving cancerous cells in various new ways , including a ketogenic diet .
Human brain
Having experienced a stroke , a person may be admitted to a stroke unit , and treatments may be directed as preventing future strokes , including ongoing anticoagulation ( such as aspirin or clopidogrel ) , antihypertensives , and lipid - lowering drugs . A multidisciplinary team including speech pathologists , physiotherapists , occupational therapists , and psychologists plays a large role in supporting a person affected by a stroke and their rehabilitation .
Huntington's disease
Among the approaches aimed at improving cell survival in the presence of mutant huntingtin are correction of transcriptional regulation using histone deacetylase inhibitors , modulating aggregation of huntingtin , improving metabolism and mitochondrial function and restoring function of synapses .
Vitiligo
Segmental vitiligo ( SV ) differs in appearance , cause , and frequency of associated illnesses . Its treatment is different from that of NSV . It tends to affect areas of skin that are associated with dorsal roots from the spinal cord and is most often unilateral . It is much more stable / static in course and its association with autoimmune diseases appears to be weaker than that of generalized vitiligo . SV does not improve with topical therapies or UV light , however surgical treatments such as cellular grafting can be effective .