vania-janet/multiturn-rag-retrieval-data huggingface dataset:
Mechanism of action of aspirin
Early diagnosis is vital ; while most children recover with supportive therapy , severe brain injury or death are potential complications .
Vitamin A deficiency
The major cause is roughage which include few animal sources of pre-formed vitamin A . In addition to dietary problems , there are other causes of VAD . Iron deficiency can affect vitamin A uptake . Excess alcohol consumption can deplete vitamin A , and a stressed liver may be more susceptible to vitamin A toxicity . People who consume large amounts of alcohol should seek medical advice before taking vitamin A supplements . In general , people should also seek medical advice before taking vitamin A supplements if they have any condition associated with fat malabsorption such as pancreatitis , cystic fibrosis , tropical sprue and biliary obstruction . Other causes of Vitamin A deficiency are inadequate intake , fat malabsorption , or liver disorders . Deficiency impairs immunity and hematopoiesis and causes rashes and typical ocular effects ( e.g. , xerophthalmia , night blindness ) .
BRCA1
DNA damage appears to be the primary underlying cause of cancer , and deficiencies in DNA repair appears to underlie many forms of cancer . If DNA repair is deficient , DNA damage tends to accumulate . Such excess DNA damage may increase mutational errors during DNA replication due to error - prone translesion synthesis . Excess DNA damage may also increase epigenetic alterations due to errors during DNA repair . Such mutations and epigenetic alterations may give rise to cancer . The frequent microRNA - induced deficiency of BRCA1 in breast and ovarian cancers likely contribute to the progression of those cancers .
Sickle cell disease
Psychological therapies such as patient education , cognitive therapy , behavioural therapy and psychodynamic psychotherapy , that aim to complement current medical treatments , require further research to determine their effectiveness .
Sickle cell disease
The first approved drug for the causative treatment of sickle cell anaemia , hydroxyurea , was shown to decrease the number and severity of attacks in a study in 1995 and shown to possibly increase survival time in a study in 2003 . This is achieved , in part , by reactivating fetal haemoglobin production in place of the haemoglobin S that causes sickle cell anaemia . Hydroxyurea had previously been used as a chemotherapy agent , and there is some concern that long - term use may be harmful , but this risk has been shown to be either absent or very small and it is likely that the benefits outweigh the risks .
Sickle cell disease
Most people with sickle cell disease have intensely painful episodes called vaso - occlusive crises . However , the frequency , severity , and duration of these crises vary tremendously . Painful crises are treated symptomatically with pain medications ; pain management requires opioid administration at regular intervals until the crisis has settled . For milder crises , a subgroup of patients manage on NSAIDs ( such as diclofenac or naproxen ) . For more severe crises , most patients require inpatient management for intravenous opioids ; patient - controlled analgesia ( PCA ) devices are commonly used in this setting . Diphenhydramine is also an effective agent that doctors frequently prescribe to help control itching associated with the use of opioids .
Sickle cell disease
Treatment involves a number of measures . L - glutamine use was supported by the FDA starting at the age of 5 as it decreases complications .
Sickle cell disease
Management is similar to vaso - occlusive crisis , with the addition of antibiotics ( usually a quinolone or macrolide , since cell wall - deficient ( `` atypical '' ) bacteria are thought to contribute to the syndrome ) , oxygen supplementation for hypoxia , and close observation . Should the pulmonary infiltrate worsen or the oxygen requirements increase , simple blood transfusion or exchange transfusion is indicated . The latter involves the exchange of a significant portion of the person 's red cell mass for normal red cells , which decreases the percent of haemoglobin S in the patient 's blood . The patient with suspected acute chest syndrome should be admitted to the hospital with worsening A-a gradient an indication for ICU admission .
Sickle cell disease
Large scale natural history studies and further intervention studies were introduced in the 1970s and 1980s , leading to widespread use of prophylaxis against pneumococcal infections amongst other interventions . Bill Cosby 's Emmy - winning 1972 TV movie , To All My Friends on Shore , depicted the story of the parents of a child suffering from sickle cell disease . The 1990s saw the development of hydroxycarbamide , and reports of cure through bone marrow transplantation appeared in 2007 .
Sickle cell disease
The number of people with the disease in the United States is approximately 1 in 5,000 , mostly affecting Americans of sub-Saharan African descent , according to the National Institutes of Health . In the United States , about one out of 500 African - American children and one in every 36,000 Hispanic - American children have sickle cell anaemia . It is estimated that sickle cell disease affects 90,000 Americans . Most infants with SCD born in the United States are now identified by routine neonatal screening . As of 2016 all 50 states include screening for sickle cell disease as part of their newborn screen . Patient advocates for sickle cell disease have complained that it gets less government and private research funding than similar rare diseases like cystic fibrosis , with researcher Elliott Vichinsky saying this shows racial discrimination or the role of wealth in health care advocacy .
Sickle cell disease
The highest frequency of sickle cell disease is found in tropical regions , particularly sub-Saharan Africa , tribal regions of India and the Middle East . Migration of substantial populations from these high prevalence areas to low prevalence countries in Europe has dramatically increased in recent decades and in some European countries sickle cell disease has now overtaken more familiar genetic conditions such as haemophilia and cystic fibrosis . In 2015 , it resulted in about 114,800 deaths .
Sickle cell disease
About 90 % of people survive to age 20 , and close to 50 % survive beyond age 50 . In 2001 , according to one study performed in Jamaica , the estimated mean survival for people with sickle cell was 53 years old for men and 58 years old for women with homozygous SCD . The specific life expectancy in much of the developing world is unknown .
Sickle cell disease
Abnormal haemoglobin forms can be detected on haemoglobin electrophoresis , a form of gel electrophoresis on which the various types of haemoglobin move at varying speeds . Sickle cell haemoglobin ( HgbS ) and haemoglobin C with sickling ( HgbSC ) -- the two most common forms -- can be identified from there . The diagnosis can be confirmed with high - performance liquid chromatography . Genetic testing is rarely performed , as other investigations are highly specific for HbS and HbC .
Sickle cell disease
As of 2015 , about 4.4 million people have sickle cell disease , while an additional 43 million have sickle cell trait . About 80 % of sickle cell disease cases are believed to occur in Sub-Saharan Africa . It also occurs relatively frequently in parts of India , the Arabian Peninsula and among people of African origin living in other parts of the world . In 2015 , it resulted in about 114,800 deaths . The condition was first described in the medical literature by the American physician James B. Herrick in 1910 . In 1949 , the genetic transmission was determined by E.A. Beet and J.V. Neel . In 1954 , the protective effect against malaria of sickle cell trait was described .
Sickle cell disease
In Jamaica , 10 % of the population carries the sickle cell gene , making it the most prevalent genetic disorder in the country .
Sickle cell disease
People who are known carriers of the disease often undergo genetic counseling before they have a child . A test to see if an unborn child has the disease takes either a blood sample from the fetus or a sample of amniotic fluid . Since taking a blood sample from a fetus has greater risks , the latter test is usually used . Neonatal screening provides not only a method of early detection for individuals with sickle cell disease , but also allows for identification of the groups of people that carry the sickle cell trait .
Sickle cell disease
As a result of population growth in African - Caribbean regions of overseas France and immigration from North and sub-Saharan Africa to mainland France , sickle cell disease has become a major health problem in France . SCD has become the most common genetic disease in the country , with an overall birth prevalence of 1 / 2,415 in Metropolitan France , ahead of phenylketonuria ( 1 / 10,862 ) , congenital hypothyroidism ( 1 / 3,132 ) , congenital adrenal hyperplasia ( 1 / 19,008 ) and cystic fibrosis ( 1 / 5,014 ) for the same reference period .
Sickle cell disease
Normally , humans have haemoglobin A , which consists of two alpha and two beta chains , haemoglobin A2 , which consists of two alpha and two delta chains , and haemoglobin F , consisting of two alpha and two gamma chains in their bodies . Out of these three types , haemoglobin F dominates until about 6 weeks of age . Afterwards , haemoglobin A dominates throughout life . In people diagnosed with sickle cell disease , at least one of the β - globin subunits in haemoglobin A is replaced with what 's known as haemoglobin S. In sickle cell anaemia , a common form of sickle cell disease , haemoglobin S replaces both β - globin subunits in the haemoglobin .
Sickle cell disease
The Memphis physician Lemuel Diggs , a prolific researcher into sickle cell disease , first introduced the distinction between sickle cell disease and trait in 1933 , although it took until 1949 until the genetic characteristics were elucidated by James V. Neel and E.A. Beet. 1949 was the year when Linus Pauling described the unusual chemical behaviour of haemoglobin S , and attributed this to an abnormality in the molecule itself . The actual molecular change in HbS was described in the late 1950s by Vernon Ingram . The late 1940s and early 1950s saw further understanding in the link between malaria and sickle cell disease . In 1954 , the introduction of haemoglobin electrophoresis allowed the discovery of particular subtypes , such as HbSC disease .
Sickle cell disease
Sickling of the red blood cells , on a blood film , can be induced by the addition of sodium metabisulfite . The presence of sickle haemoglobin can also be demonstrated with the `` sickle solubility test '' . A mixture of haemoglobin S ( Hb S ) in a reducing solution ( such as sodium dithionite ) gives a turbid appearance , whereas normal Hb gives a clear solution .
Sickle cell disease
Sickle cell gene mutation probably arose spontaneously in different geographic areas , as suggested by restriction endonuclease analysis . These variants are known as Cameroon , Senegal , Benin , Bantu , and Saudi - Asian . Their clinical importance is because some are associated with higher HbF levels , e.g. , Senegal and Saudi - Asian variants , and tend to have milder disease .
Sickle cell disease
Sickle cell disease occurs more commonly among people whose ancestors lived in tropical and sub-tropical sub-Saharan regions where malaria is or was common . Where malaria is common , carrying a single sickle cell allele ( trait ) confers a heterozygote advantage : humans with one of the two alleles of sickle cell disease show less severe symptoms when infected with malaria .
Sickle cell disease
In Saudi Arabia , about 4.2 % of the population carry the sickle cell trait and 0.26 % have sickle cell disease . The highest prevalence is in the Eastern province where approximately 17 % of the population carry the gene and 1.2 % have sickle cell disease . In 2005 , Saudi Arabia introduced a mandatory pre-marital test including HB electrophoresis which aimed to decrease the incidence of SCD and thalassemia .
Sickle cell disease
The allele responsible for sickle cell anaemia can be found on the short arm of chromosome 11 , more specifically 11p15. 5 . A person who receives the defective gene from both father and mother develops the disease ; a person who receives one defective and one healthy allele remains healthy , but can pass on the disease and is known as a carrier or heterozygote . Heterozygotes are still able to contract malaria , but their symptoms are generally less severe .
Sickle cell disease
Sickle cell disease is common in ethnic groups of central India who share a genetic linkage with African communities , where the prevalence has ranged from 9.4 to 22.2 % in endemic areas of Madhya Pradesh , Rajasthan and Chhattisgarh . It is also endemic among Tharu people of Nepal and India ; however , they have a sevenfold lower incidence of malaria despite living in a malaria infested zone .
Sickle cell disease
This condition is inherited in an autosomal recessive pattern , which means both copies of the gene in each cell have mutations . The parents each carry one copy of the mutated gene , but they typically do not show signs and symptoms of the condition .
Sickle cell disease
In the United Kingdom , it is thought that between 12,000 and 15,000 people have sickle cell disease with an estimate of 250,000 carriers of the condition in England alone . As the number of carriers is only estimated , all newborn babies in the UK receive a routine blood test to screen for the condition . Due to many adults in high - risk groups not knowing if they are carriers , pregnant women and both partners in a couple are offered screening so they can get counselling if they have the sickle cell trait . In addition blood donors from those in high - risk groups are also screened to confirm whether they are carriers and whether their blood filters properly . Donors who are found to be carriers are then informed and their blood , while often used for those of the same ethnic group , is not used for those with sickle cell disease who require a blood transfusion .
Sickle cell disease
Three - quarters of sickle cell cases occur in Africa . A recent WHO report estimated that around 2 % of newborns in Nigeria were affected by sickle cell anaemia , giving a total of 150,000 affected children born every year in Nigeria alone . The carrier frequency ranges between 10 % and 40 % across equatorial Africa , decreasing to 1 -- 2 % on the north African coast and < 1 % in South Africa . There have been studies in Africa that show a significant decrease in infant mortality rate , ages 2 -- 16 months , because of the sickle cell trait . This happened in predominant areas of malarial cases .
Sickle cell disease
Sickle cell conditions have an autosomal recessive pattern of inheritance from parents . The types of haemoglobin a person makes in the red blood cells depend on what haemoglobin genes are inherited from her or his parents . If one parent has sickle cell anaemia and the other has sickle cell trait , then the child has a 50 % chance of having sickle cell disease and a 50 % chance of having sickle cell trait . When both parents have sickle cell trait , a child has a 25 % chance of sickle cell disease , 25 % do not carry any sickle cell alleles , and 50 % have the heterozygous condition .
Sickle cell disease
In the United States , with no endemic malaria , the prevalence of sickle cell anaemia among African Americans is lower ( about 0.25 % ) than in West Africa ( about 4.0 % ) and is falling . Without endemic malaria , the sickle cell mutation is purely disadvantageous and tends to decline in the affected population by natural selection , and now artificially through prenatal genetic screening . However , the African American community descends from a significant admixture of several African and non-African ethnic groups and also represents the descendants of survivors of slavery and the slave trade . Thus , a lower degree of endogamy and , particularly , abnormally high health - selective pressure through slavery may be the most plausible explanations for the lower prevalence of sickle cell anaemia ( and , possibly , other genetic diseases ) among African Americans compared to West Africans . Another factor that limits the spread of sickle cell genes in North America is the absence of cultural proclivities to polygamy , which allows affected males to continue to seek unaffected children with multiple partners .
Sickle cell disease
In Bahrain a study published in 1998 that covered about 56,000 people in hospitals in Bahrain found that 2 % of newborns have sickle cell disease , 18 % of the surveyed people have the sickle cell trait , and 24 % were carriers of the gene mutation causing the disease . The country began screening of all pregnant women in 1992 and newborns started being tested if the mother was a carrier . In 2004 , a law was passed requiring couples planning to get married to undergo free premarital counseling . These programs were accompanied by public education campaigns .
Sickle cell disease
Due to the adaptive advantage of the heterozygote , the disease is still prevalent , especially among people with recent ancestry in malaria - stricken areas , such as Africa , the Mediterranean , India , and the Middle East . Malaria was historically endemic to southern Europe , but it was declared eradicated in the mid-20th century , with the exception of rare sporadic cases .
Sickle cell disease
The first modern report of sickle cell disease may have been in 1846 , where the autopsy of an executed runaway slave was discussed ; the key findings was the absence of the spleen . There were also reports amongst African slaves in the United States exhibiting resistance to malaria but being prone to leg ulcers . The abnormal characteristics of the red blood cells , which later lent their name to the condition , was first described by Ernest E. Irons ( 1877 -- 1959 ) , intern to the Chicago cardiologist and professor of medicine James B. Herrick ( 1861 -- 1954 ) , in 1910 . Irons saw `` peculiar elongated and sickle - shaped '' cells in the blood of a man named Walter Clement Noel , a 20 - year - old first - year dental student from Grenada . Noel had been admitted to the Chicago Presbyterian Hospital in December 1904 suffering from anaemia . Noel was readmitted several times over the next three years for `` muscular rheumatism '' and `` bilious attacks '' but completed his studies and returned to the capital of Grenada ( St. George 's ) to practice dentistry . He died of pneumonia in 1916 and is buried in the Catholic cemetery at Sauteurs in the north of Grenada . Shortly after the report by Herrick , another case appeared in the Virginia Medical Semi-Monthly with the same title , `` Peculiar Elongated and Sickle - Shaped Red Blood Corpuscles in a Case of Severe Anemia . '' This article is based on a patient admitted to the University of Virginia Hospital on November 15 , 1910 . In the later description by Verne Mason in 1922 , the name `` sickle cell anemia '' is first used . Childhood problems related to sickle cells disease were not reported until the 1930s , despite the fact that this can not have been uncommon in African - American populations .
Ultraviolet
UV rays also treat certain skin conditions . Modern phototherapy has been used to successfully treat psoriasis , eczema , jaundice , vitiligo , atopic dermatitis , and localized scleroderma . In addition , UV light , in particular UVB radiation , has been shown to induce cell cycle arrest in keratinocytes , the most common type of skin cell . As such , sunlight therapy can be a candidate for treatment of conditions such as psoriasis and exfoliative cheilitis , conditions in which skin cells divide more rapidly than usual or necessary .
Heart
Diseases affecting the heart can be treated by a variety of methods including lifestyle modification , drug treatment , and surgery . Ischaemic
Thalidomide
It is used as a second - line treatment to manage graft versus host disease and aphthous stomatitis in children and has been prescribed for other conditions in children including actinic prurigo and epidermolysis bullosa ; the evidence for these uses is weak . It is recommended only as a third line treatment in graft versus host disease in adults , based on lack of efficacy and side effects observed in clinical trials .
West African Ebola virus epidemic
There is as yet no known confirmed medication or treatment for Ebola virus disease . The director of the US National Institute of Allergy and Infectious Diseases has stated that the scientific community is still in the early stages of understanding how infection with the Ebola virus can be treated and prevented . A number of experimental treatments are undergoing clinical trials . During the epidemic some patients received experimental blood transfusions from Ebola survivors , but a later study found that the treatment did not provide significant benefit .
Thalidomide
Thalidomide is used as a first - line treatment in multiple myeloma in combination with dexamethasone or with melphalan and prednisone , to treat acute episodes of erythema nodosum leprosum and for maintenance therapy .
Apoptosis
The main method of treatment for death from signaling - related diseases involves either increasing or decreasing the susceptibility of apoptosis in diseased cells , depending on whether the disease is caused by either the inhibition of or excess apoptosis . For instance , treatments aim to restore apoptosis to treat diseases with deficient cell death , and to increase the apoptotic threshold to treat diseases involved with excessive cell death . To stimulate apoptosis , one can increase the number of death receptor ligands ( such as TNF or TRAIL ) , antagonize the anti-apoptotic Bcl - 2 pathway , or introduce Smac mimetics to inhibit the inhibitor ( IAPs ) . The addition of agents such as Herceptin , Iressa , or Gleevec works to stop cells from cycling and causes apoptosis activation by blocking growth and survival signaling further upstream . Finally , adding p53 - MDM2 complexes displaces p53 and activates the p53 pathway , leading to cell cycle arrest and apoptosis . Many different methods can be used either to stimulate or to inhibit apoptosis in various places along the death signaling pathway .
Sickle cell disease
Since 2000 , neonatal screening of SCD has been performed at national level for all newborns defined as being `` at risk '' for SCD based on ethnic origin ( defined as those born to parents originating from sub-Saharan Africa , North Africa , the Mediterranean area ( South Italy , Greece and Turkey ) , the Arabic peninsula , the French overseas islands and the Indian subcontinent ) .
Medical diagnosis
A treatment plan is proposed which may include therapy and follow - up consultations and tests to monitor the condition and the progress of the treatment , if needed , usually according to the medical guidelines provided by the medical field on the treatment of the particular illness .
Pleurisy
Ideally , the treatment of pleurisy is aimed at eliminating the underlying cause of the disease .
Naegleria fowleri
The core antimicrobial treatment consists of antifungal drug amphotericin B , but the fatality rate even with this treatment is greater than 95 % . New treatments are being sought . Miltefosine , an antiparasitic , has been used in a few cases with mixed results .