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[ { "from": "human", "value": "How to do Exposure Therapy?" }, { "from": "gpt", "value": "Some of the rules for constructing a good program of Exposure Therapy are:\nThe subject should have a final goal which should represent non-phobic behavior. This might be (for example) to hold a large snake and rub it against their cheek for several minutes. They should also have in mind a series of intermediate steps such that once they have partially habituated to one step the next is close enough to it that they can readily move on. Such a sequence is called a hierarchy. It may be explicit, in the form of a list of increasingly challenging tasks, or implicit, in the form of a set of principles for escalating the exposure. The therapist will decide which of these will be more useful for the subject. (A useful way of constructing such a hierarchy is the Method of Factors. At every stage the subjects self-exposure should be completely voluntary - a criterion that may be derived from the theory of cognitive dissonance. One important corollary of this principle is that, at every moment, the subject must have an easy way of terminating the exposure. By choosing not to escape - and therefore practising a competing response - the subject thereby weakens the arousal-escape connection. The arousal experienced at any point should be the maximum that the subject is prepared to accept (this is the main difference between Exposure Therapy and Systematic desensitization). It's useful if at each stage the subject asks themselves \"is there anything more I could do?\" By considering which factors they can manipulate they should be able to keep moving smoothly up their hierarchy. Research by Marks and Rachmann citation needed demonstrated that optimum results are obtained with daily practice lasting at least an hour; and that the daily session should be ended by allowing the level of arousal to fall off to around half its peak value. For this reason it's useful for the subject to keep a note of their arousal level on a 0-8 scale (where 0=no arousal and 8=intolerable arousal). Before this fall-off phase the level of arousal should be maintained at an uncomfortable but tolerable level." } ]

[ { "from": "human", "value": "What are the symptoms of Fibromyalgia?" }, { "from": "gpt", "value": "Pain in the main symptom of fibromyalgia. It may be mild to severe.\nPainful areas are called tender points. Tender points are found in the soft tissue on the back of the neck, shoulders, chest, lower back, hips, shins, elbows, and knees. The pain then spreads out from these areas. The pain may feel like a deep ache, or a shooting, burning pain. The joints are not affected, although the pain may feel like it is coming from the joints.\nPeople with fibromyalgia tend to wake up with body aches and stiffness. For some patients, pain improves during the day and gets worse at night. Some patients have pain all day long.\nPain may get worse with activity, cold or damp weather, anxiety, and stress.\nFatigue, depressed mood, and sleep problems are seen in almost all patients with fibromyalgia. Many say that they can't get to sleep or stay asleep, and they feel tired when they wake up.\nOther symptoms of fibromyalgia may include:\nIrritable bowel syndrome (IBS) Memory and concentration problems Numbness and tingling in hands and feet Palpitations Reduced ability to exercise Tension or migraine headaches" } ]

[ { "from": "human", "value": "What causes Fibromyalgia?" }, { "from": "gpt", "value": "The cause is unknown. Possible causes or triggers of fibromyalgia include:\nPhysical or emotional trauma Abnormal pain response - areas in the brain that are responsible for pain may react differently in fibromyalgia patients Sleep disturbances Infection, such as a virus, although none has been identified" } ]

[ { "from": "human", "value": "Who is at highest risk for Fibromyalgia ?" }, { "from": "gpt", "value": "Fibromyalgia is most common among women aged 20 to 50.\nThe following conditions may be seen with fibromyalgia or mimic its symptoms:\nChronic neck or back pain Chronic fatigue syndrome Depression Hypothyroidism (underactive thyroid) Lyme disease Sleep disorders" } ]

[ { "from": "human", "value": "When to seek urgent medical care when I have Fibromyalgia ?" }, { "from": "gpt", "value": "Call your health-care provider if you have symptoms of fibromyalgia." } ]

[ { "from": "human", "value": "What to expect if I have Fibromyalgia (Outlook/Prognosis)?" }, { "from": "gpt", "value": "Fibromyalgia is a long-term disorder. Sometimes, the symptoms improve. Other times, the pain may get worse and continue for months or years." } ]

[ { "from": "human", "value": "What are the symptoms of Grief?" }, { "from": "gpt", "value": "There can be five stages of grief. These reactions might not occur in a specific order, and can (at times) occur together. Not everyone experiences all of these emotions:\nDenial, disbelief, numbness Anger, blaming others Bargaining (for instance \"If I am cured of this cancer, I will never smoke again.\") Depressed mood, sadness, and crying Acceptance, coming to terms\nPeople who are grieving may have crying spells, some trouble sleeping, and lack of productivity at work." } ]

[ { "from": "human", "value": "What causes Grief?" }, { "from": "gpt", "value": "Grief may be triggered by the death of a loved one. People also can experience grief if they have an illness for which there is no cure, or a chronic condition that affects their quality of life. The end of a significant relationship may also cause a grieving process.\nEveryone feels grief in their own way. However, there are common stages to the process of mourning. It starts with recognizing a loss and continues until a person eventually accepts that loss. People's responses to grief will be different, depending on the circumstances of the death.\nFor example, if the person who died had a chronic illness, the death may have been expected. The end of the person's suffering might even have come as a relief. If the death was accidental or violent, coming to a stage of acceptance might take longer." } ]

[ { "from": "human", "value": "When to seek urgent medical care when I have Grief ?" }, { "from": "gpt", "value": "Call your health care provider if:\nYou can't deal with grief You are using excessive amounts of drugs or alcohol You become very depressed You have prolonged depression that interferes with your daily life" } ]

[ { "from": "human", "value": "What to expect if I have Grief (Outlook/Prognosis)?" }, { "from": "gpt", "value": "It may take a year or longer to overcome strong feelings of grief, and to accept the loss." } ]

[ { "from": "human", "value": "What are the symptoms of Hyperventilation syndrome?" }, { "from": "gpt", "value": "Patients with hyperventilation syndrome, might not be aware that they are breathing fast. However, they will be aware of having many of the other symptoms, including:\nBelching Bloating Chest pain Confusion Dizziness Dry mouth Lightheadedness Muscle spasms in hands and feet Numbness and tingling in the arms or around the mouth Palpitations Shortness of breath Sleep disturbances Weakness" } ]

[ { "from": "human", "value": "What causes Hyperventilation syndrome?" }, { "from": "gpt", "value": "Anxiety and nervousness Bleeding Cardiac disease, such as congestive heart failure or heart attack Drugs (such as an aspirin overdose) Infection such as pneumonia or sepsis Ketoacidosis and similar medical conditions Lung disease such as asthma, chronic obstructive pulmonary disease (COPD), or pulmonary embolism Panic attack Pregnancy Severe pain Situations where there is a psychological advantage in having a sudden, dramatic illness (for example, somatization disorder) Stimulant use Stress" } ]

[ { "from": "human", "value": "Who is at highest risk for Hyperventilation syndrome ?" }, { "from": "gpt", "value": "Hyperventilation syndrome can be triggered by emotions of stress, anxiety, depression, or anger. Occasional hyperventilation from panic is generally related to a specific fear or phobia, such as a fear of heights, dying, or closed-in spaces (claustrophobia)." } ]

[ { "from": "human", "value": "When to seek urgent medical care when I have Hyperventilation syndrome ?" }, { "from": "gpt", "value": "Rapid breathing for the first time. (This is a medical emergency and you should be taken to the emergency room right away.) Severe pain, having a fever, or noticed any bleeding. Worsening of symptoms." } ]

[ { "from": "human", "value": "What are the symptoms of Marijuana intoxication?" }, { "from": "gpt", "value": "The intoxicating effects of marijuana include relaxation, sleepiness, and mild euphoria (getting high).\nSmoking marijuana leads to fast and predictable signs and symptoms. Eating marijuana can cause slower, and sometimes less predictable effects.\nMarijuana can cause undesirable side effects, which increase with higher doses. These side effects include:\nDecreased short-term memory Dry mouth Impaired perception and motor skills Red eyes\nMore serious side effects include panic, paranoia, or acute psychosis, which may be more common with new users or in those who already have a psychiatric disease.\nThe amount and effect of these side effects varies from person to person, as well as with the amount of marijuana used.\nMarijuana is often cut with hallucinogens and other, more dangerous drugs that have more serious side effects than marijuana. These side effects may include:\nAcute high blood pressure with headache Chest pain and heart rhythm disturbances Extreme hyperactivity and physical violence Heart attack Seizures Stroke Sudden collapse (cardiac arrest)" } ]

[ { "from": "human", "value": "When to seek urgent medical care when I have Marijuana intoxication ?" }, { "from": "gpt", "value": "If someone who has been using marijuana develops any of the symptoms of intoxication, has trouble breathing, or cannot be awakened, call 911 or your local emergency number.\nIf the person has stopped breathing or has no pulse, begin CPR and continue it until help arrives." } ]

[ { "from": "human", "value": "What to expect if I have Marijuana intoxication (Outlook/Prognosis)?" }, { "from": "gpt", "value": "People who have seizures, cardiac arrest, or a heart attack may not survive. However, these reactions are rare." } ]

[ { "from": "human", "value": "What are the symptoms of Night terror?" }, { "from": "gpt", "value": "Night terrors are most common during the first third of the night, often between midnight and 2 a.m.\nChildren often scream and are very frightened and confused. They thrash around violently and are often not aware of their surroundings. You may be unable to talk to, comfort, or fully wake up a child who is having a night terror. The child may be sweating, breathing very fast (hyperventilating), have a fast heart rate (palpitations), and widened (dilated) pupils. The spell may last 10 - 20 minutes, then the child goes back to sleep.\nMost children are unable to explain what happened the next morning. They often have no memory of the event when they wake up the next day.\nChildren with night terrors may also sleep walk.\nIn contrast, nightmares are more common in the early morning. They may occur after someone watches frightening movies or TV shows, or has an emotional experience. A person may remember the details of a dream when he or she wakes up, and will not be disoriented after the episode." } ]

[ { "from": "human", "value": "What causes Night terror?" }, { "from": "gpt", "value": "The cause is unknown, but night terrors may be triggered by:\nFever Lack of sleep Periods of emotional tension, stress, or conflict\nNight terrors are most common in boys ages 5 - 7, although they also can occur in girls. They are fairly common in children ages 3 - 7, and much less common after that.\nNight terrors may run in families. They can occur in adults, especially when there is emotional tension or the use of alcohol." } ]

[ { "from": "human", "value": "When to seek urgent medical care when I have Night terror ?" }, { "from": "gpt", "value": "Call for an appointment with your health care provider if:\nThe night terrors occur often They disrupt sleep on a regular basis Other symptoms occur with the night terror The night terror causes, or almost causes, injuries" } ]

[ { "from": "human", "value": "What to expect if I have Night terror (Outlook/Prognosis)?" }, { "from": "gpt", "value": "Most children outgrow night terrors in a short period of time. The number of episodes usually decreases after age 10. Rarely, children will have problems falling asleep or staying asleep." } ]

[ { "from": "human", "value": "What causes Nightmare?" }, { "from": "gpt", "value": "Anxiety and stress are the most common causes of nightmares.\nA major life event occurs before the nightmare in some cases.\nOther causes of nightmares include:\nAbrupt alcohol withdrawal Breathing disorder in sleep (sleep apnea) Death of a loved one (bereavement) Excessive alcohol consumption Illness with a fever Recent withdrawal from a drug, such as sleeping pills Side effect of a drug Sleep disorder (for example, narcolepsy or sleep terror disorder) Eating just before going to bed, which raises the body's metabolism and brain activity" } ]

[ { "from": "human", "value": "When to seek urgent medical care when I have Nightmare ?" }, { "from": "gpt", "value": "Contact your health care provider if:\nYou have nightmares more than once a week Nightmares stop you from getting a good night's rest, or from keeping up with your daily activities for a long period of time" } ]

[ { "from": "human", "value": "What are the symptoms of Opiate withdrawal?" }, { "from": "gpt", "value": "Early symptoms of withdrawal include:\nAgitation Anxiety Muscle aches Increased tearing Insomnia Runny nose Sweating Yawning\nLate symptoms of withdrawal include:\nAbdominal cramping Diarrhea Dilated pupils Goose bumps Nausea Vomiting\nOpioid withdrawal reactions are very uncomfortable but are not life threatening.\nSymptoms usually start within 12 hours of last heroin usage and within 30 hours of last methadone exposure." } ]

[ { "from": "human", "value": "What causes Opiate withdrawal?" }, { "from": "gpt", "value": "About 9% of the population is believed to misuse opiates over the course of their lifetime, including illegal drugs like heroin and prescribed pain medications such as Oxycontin.\nThese drugs can cause physical dependence. This means that a person relies on the drug to prevent symptoms of withdrawal. Over time, greater amounts of the drug become necessary to produce the same effect.\nThe time it takes to become physically dependent varies with each individual.\nWhen the drugs are stopped, the body needs time to recover, and withdrawal symptoms result. Withdrawal from opiates can occur whenever any chronic use is discontinued or reduced.\nSome people even withdraw from opiates after being given such drugs for pain while in the hospital without realizing what is happening to them. They think they have the flu, and because they don't know that opiates would fix the problem, they don't crave the drugs." } ]

[ { "from": "human", "value": "When to seek urgent medical care when I have Opiate withdrawal ?" }, { "from": "gpt", "value": "Call your doctor if you are using or withdrawing from opiates." } ]

[ { "from": "human", "value": "What to expect if I have Opiate withdrawal (Outlook/Prognosis)?" }, { "from": "gpt", "value": "Withdrawal from opiates is painful, but not life threatening." } ]

[ { "from": "human", "value": "What are the symptoms of Personality disorder?" }, { "from": "gpt", "value": "Symptoms vary widely depending on the type of personality disorder.\nIn general, personality disorders involve feelings, thoughts, and behaviors that do not adapt to a wide range of settings.\nThese patterns usually begin in adolescence and may lead to problems in social and work situations.\nThe severity of these conditions ranges from mild to severe." } ]

[ { "from": "human", "value": "What causes Personality disorder?" }, { "from": "gpt", "value": "The causes of personality disorders are unknown. However, many genetic and environmental factors are thought to play a role.\nMental health professionals categorize these disorders into the following types:\nAntisocial personality disorder Avoidant personality disorder Borderline personality disorder Dependent personality disorder Histrionic personality disorder Narcissistic personality disorder Obsessive compulsive personality disorder Paranoid personality disorder Schizoid personality disorder Schizotypal personality disorder" } ]

[ { "from": "human", "value": "When to seek urgent medical care when I have Personality disorder ?" }, { "from": "gpt", "value": "Call for an appointment with your health care provider or mental health professional if you or someone close to you has symptoms of a personality disorder." } ]

[ { "from": "human", "value": "What to expect if I have Personality disorder (Outlook/Prognosis)?" }, { "from": "gpt", "value": "The outlook varies. Some personality disorders go away during middle age without any treatment, while others only improve slowly throughout life, even with treatment." } ]

[ { "from": "human", "value": "What are the symptoms of Sleep walking?" }, { "from": "gpt", "value": "When people sleepwalk, they may sit up and look as though they are awake when they are actually asleep. They may get up and walk around, or do complex activities such as moving furniture, going to the bathroom, and dressing or undressing. Some people even drive a car while they are asleep.\nThe episode can be very brief (a few seconds or minutes) or it can last for 30 minutes or longer, but most episodes last for less than 10 minutes. If they are not disturbed, sleepwalkers will go back to sleep. However, they may fall asleep in a different or even unusual place.\nSymptoms of sleepwalking include:\nActing confused or disoriented when they wake up Having blank look on face Opening eyes during sleep Not remembering the sleep walking episode when they wake up Performing detailed activity of any type during sleep Rarely, showing aggressive behavior when they are woken up by someone else Sitting up and appearing awake during sleep Taking in sleep and saying things that do not make sense Walking during sleep Taking in sleep and saying things that do not make sense" } ]

[ { "from": "human", "value": "What causes Sleep walking?" }, { "from": "gpt", "value": "The normal sleep cycle has distinct stages, from light drowsiness to deep sleep. During rapid eye movement (REM) sleep, the eyes move quickly and vivid dreaming is most common.\nEach night people go through several cycles of non-REM and REM sleep. S leepwalking (somnambulism) most often occurs during deep, non-REM sleep (stage 3 or stage 4 sleep) early in the night. If it occurs during REM sleep, it is part of REM behavior disorder and tends to happen near morning.\nThe cause of sleepwalking in children is usually unknown. Fatigue, lack of sleep, and anxiety are all associated with sleepwalking.\nIn adults, sleepwalking may occur with:\nAlcohol, sedatives, or other medication Medical conditions, such as partial complex seizures Mental disorders\nIn the elderly, sleepwalking may be a symptom of an organic brain syndrome or REM behavior disorders.\nSleepwalking can occur at any age, but it happens most often in children ages 5 - 12. It appears to run in families." } ]

[ { "from": "human", "value": "When to seek urgent medical care when I have Sleepwalking ?" }, { "from": "gpt", "value": "You probably won't need to visit your health care provider if you are sleepwalking. However, discuss the condition with your doctor if:\nYou also have other symptoms Sleepwalking is frequent or persistent You perform potentially dangerous activities (such as driving) while sleepwalking" } ]

[ { "from": "human", "value": "What to expect if I have Sleepwalking (Outlook/Prognosis)?" }, { "from": "gpt", "value": "Sleepwalking usually decreases as children get older.\nIt usually does not indicate a serious disorder, although it can be a symptom of other disorders.\nIt is unusual for sleepwalkers to perform activities that are dangerous. However, you may need to take care to prevent injuries such as falling down stairs or climbing out of a window." } ]

[ { "from": "human", "value": "Could SCT be an instance of childhood-onset dysexecutive syndrome?" }, { "from": "gpt", "value": "The Executive system of the human brain coordinates actions and strategies for everyday tasks. Dysexecutive syndrome is defined as \"cluster of impairments generally associated with damage to the frontal lobes of the brain\" which includes \"difficulties with high-level tasks such as planning, organising, initiating, monitoring and adapting behaviour.\" \nAdele Diamond has recently postulated that the core cognitive deficit of those with ADHD-PI (ADD), is working memory, or, as she coined in her recent paper on the subject, \"childhood-onset dysexecutive syndrome\". She states:\n\"Instructional methods that place heavy demands on working memory will disproportionately disadvantage individuals with ADD\". \"language problems often co-occur with ADD, and it is suggested that part of the reason might be that linguistic tasks, especially verbal ones, tax working memory so heavily. Spatial and artistic skills, however, are often preserved or superior in individuals with ADD.\" \"The working memory deficit in many children with ADD is accompanied by markedly slowed reaction times, a characteristic that covaries with poorer working memory in general\". \"Individuals with ADD have difficulty maintaining a sufficiently high level of motivation to complete a task...They go looking for something else to do or think about because they are bored...to remedy a general lower arousal level..\"" } ]

[ { "from": "human", "value": "What are the symptoms of Stress?" }, { "from": "gpt", "value": "Stress is a normal feeling. In small doses, stress can help you get things done. Stress does not affect everyone the same way.\nMany people feel stress symptoms in their body. You may be having pain in your abdomen, headaches, and muscle tightness or pain.\nWhen you are very stressed, you may notice:\nA faster heart rate (palpitations) Skipped heartbeats Rapid breathing Sweating Trembling Dizziness\nOther symptoms include:\nLoose stools Frequent need to pee Dry mouth Problems swallowing\nYou may have a harder time focusing, feel tired most of the time, or lose your temper more often. Stress may also cause sexual problems. It can also cause problems with falling or staying asleep and nightmares" } ]

[ { "from": "human", "value": "What causes Stress?" }, { "from": "gpt", "value": "Many people have stress when they need to adapt or change. Examples are:\nStarting a new job or school Moving to a new home Getting married Having a child Breaking up with someone\nAn injury or illness to you, a friend, or a loved one is a common cause of stress. Feelings of stress and anxiety are common in people who feel depressed and sad.\nSome drugs may cause or worsen symptoms of stress. These can include:\nSome inhaler medicines used to treat asthma Thyroid drugs Some diet pills Some cold remedies Caffeine, cocaine, alcohol, and tobacco products may also cause or make symptoms of stress or anxiety worse.\nWhen these feelings happen often, a person may have an anxiety disorder. Other problems where stress may be present are:\nObsessive-compulsive disorder Panic disorder Post-traumatic stress disorder (PTSD)" } ]

[ { "from": "human", "value": "When to seek urgent medical care when I have Stress ?" }, { "from": "gpt", "value": "Call a suicide hotline if you have thoughts of suicide.\nReasons you may want to seek more help are:\nYou have feelings of panic, such as dizziness, rapid breathing, or a racing heartbeat. You are unable to work or function at home or at your job. You have fears that you cannot control. You are having memories of a traumatic event.\nDo not stop taking any prescribed medicines without talking to your doctor." } ]

[ { "from": "human", "value": "When to seek urgent medical care when I have Substance abuse ?" }, { "from": "gpt", "value": "If you are concerned about the possibility of getting addicted to any prescribed medications If you are concerned about possible drug abuse by yourself or a family member If you are interested in getting more information on drug abuse If you are seeking treatment of drug abuse for yourself or a family member" } ]

[ { "from": "human", "value": "What are the symptoms of Suicide?" }, { "from": "gpt", "value": "Often, but not always, a person may show certain symptoms or behaviors before a suicide attempt, including:\nHaving trouble concentrating or thinking clearly Giving away belongings Talking about going away or the need to get my affairs in order Suddenly changing behavior, especially calmness after a period of anxiety Losing interest in activities that they used to enjoy Performing self-destructive behaviors, such as heavily drinking alcohol, using illegal drugs, or cutting their body Pulling away from friends or not wanting to go out Suddenly having trouble in school or work Talking about death or suicide, or even saying that they want to hurt themselves Talking about feeling hopeless or guilty Changing sleep or eating habits" } ]

[ { "from": "human", "value": "What causes Suicide?" }, { "from": "gpt", "value": "Suicide and suicidal behaviors usually occur in people with:\nBipolar disorder Borderline personality disorder Depression Drug or alcohol dependence Schizophrenia\nPeople who try to commit suicide are often trying to get away from a life situation that seems impossible to deal with. Many who make a suicide attempt are seeking relief from:\nFeeling ashamed, guilty, or like a burden to others Feeling like a victim Feelings of rejection, loss, or loneliness\nSuicidal behaviors may be caused by a situation or event that the person views as overwhelming, such as:\nAging (the elderly have the highest rate of suicide) Death of a loved one Dependence on drugs or alcohol Emotional trauma Serious physical illness Unemployment or money problems\nMost suicide attempts do not result in death. Many of these attempts are done in a way that makes rescue possible. These attempts are often a cry for help.\nSome people attempt suicide in a way that is somewhat non-violent, such as poisoning or overdose. Males, especially elderly men, are more likely to choose violent methods, such as shooting themselves. As a result, suicide attempts by males are more likely to be completed.\nRelatives of people who attempt or commit suicide often blame themselves or become very angry. They may see the suicide attempt as selfish. However, people who try to commit suicide often mistakenly believe that they are doing their friends and relatives a favor by taking themselves out of the world." } ]

[ { "from": "human", "value": "Who is at highest risk for Suicide ?" }, { "from": "gpt", "value": "Risk factors for suicide in teenagers include:\nAccess to guns Family member who committed suicide History of hurting themselves on purpose History of being neglected or abused Living in communities where there have been recent outbreaks of suicide in young people Romantic breakup" } ]

[ { "from": "human", "value": "When to seek urgent medical care when I have Suicide ?" }, { "from": "gpt", "value": "Call a health care provider right away if you or someone you know is having thoughts of suicide." } ]

[ { "from": "human", "value": "What to expect if I have Suicide (Outlook/Prognosis)?" }, { "from": "gpt", "value": "Always take suicide attempts and threats seriously.\nAbout one-third of people who try to commit suicide will try again within 1 year.\nAbout 10% of people who threaten or try to commit suicide will eventually kill themselves.\nThe person needs mental health care right away. Do not dismiss the person as just trying to get attention." } ]

[ { "from": "human", "value": "How is a toxicology screen performed?" }, { "from": "gpt", "value": "Toxicology screening is most often done using a blood or urine sample. However, it may be done soon after swallowing the medication, using stomach contents that are obtained through gastric lavage or after vomiting." } ]

[ { "from": "human", "value": "How to prepare for a toxicology screen?" }, { "from": "gpt", "value": "No special preparation is needed.\nIf able, tell your health care provider what drugs (including over-the-counter medications) you have taken, including when and how much.\nThis test is sometimes part of an investigation for drug use or abuse. Special consents, handling and labeling of specimens, or other special procedures may be required." } ]

[ { "from": "human", "value": "How will a toxicology screen feel?" }, { "from": "gpt", "value": "Blood test: When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.\nUrine test: A urine test involves normal urination. There is no discomfort." } ]

[ { "from": "human", "value": "Why is a toxicology screen performed?" }, { "from": "gpt", "value": "This test is often done in emergency medical situations.\nIt can be used to evaluate possible accidental or intentional overdose or poisoning.\nIt may help determine the cause of acute drug toxicity, to monitor drug dependency, and to determine the presence of substances in the body for medical or legal purposes.\nAdditional reasons the test may be performed:\nAlcoholism Alcohol withdrawal state Altered mental state Analgesic nephropathy (kidney poisoning) Complicated alcohol abstinence (Delirium tremens (patient information)|delirium tremens) Delirium Dementia Drug abuse monitoring Fetal alcohol syndrome Intentional overdose Seizures Stroke secondary to cocaine Suspected sexual assault Unconsciousness\nIf the test is used as a drug screen, it must be done during a certain time period after the drug has been taken or while forms of the drug can still be detected in the body. Examples are below:\nAlcohol: 3 to 10 hours Amphetamines: 24 to 48 hours Barbiturates: up to 6 weeks Benzodiazepines: up to 6 weeks with high level use Cocaine: 2 to 4 days; up to 10 to 22 days with heavy use Codeine: 1 to 2 days Heroin: 1 to 2 days Hydromorphone: 1 to 2 days Methadone: 2 to 3 days Morphine: 1 to 2 days Phencyclidine (PCP): 1 to 8 days Propoxyphene: 6 to 48 hours Tetrahydrocannabinol (THC): 6 to 11 weeks with heavy use" } ]

[ { "from": "human", "value": "What are normal results?" }, { "from": "gpt", "value": "Normal value ranges for over-the-counter or prescription medications may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.\nA negative value usually means that alcohol, prescription medications that have not been prescribed, and illegal drugs have not been detected.\nA blood toxicology screen can determine the presence and level (amount) of a drug in your body.\nUrine sample results are usually reported as positive (substance is found) or negative (no substance is found)." } ]

[ { "from": "human", "value": "What do abnormal results mean?" }, { "from": "gpt", "value": "Elevated levels of alcohol or prescription drugs can be a sign of intentional or accidental intoxication or overdose.\nThe presence of illegal drugs or drugs not prescribed for the person indicates illicit drug use." } ]

[ { "from": "human", "value": "What are the symptoms of Acute respiratory distress syndrome?" }, { "from": "gpt", "value": "Labored, rapid breathing Low blood pressure and organ failure Shortness of breath\nSymptoms usually develop within 24 to 48 hours of the original injury or illness. Often, people with ARDS are so sick they are unable to complain of symptoms." } ]

[ { "from": "human", "value": "What causes Acute respiratory distress syndrome?" }, { "from": "gpt", "value": "ARDS can be caused by any major swelling (inflammation) or injury to the lung. Some common causes include:\nBreathing vomit into the lungs (aspiration) Inhaling chemicals Pneumonia Septic shock Trauma\nARDS leads to a buildup of fluid in the air sacs. This fluid prevents enough oxygen from passing into the bloodstream.\nThe fluid buildup also makes the lungs heavy and stiff, and decreases the lungs' ability to expand. The level of oxygen in the blood can stay dangerously low, even if the person receives oxygen from a breathing machine (mechanical ventilator) through a breathing tube (endotracheal tube). ARDS often occurs along with the failure of other organ systems, such as the liver or the kidneys. Cigarette smoking and heavy alcohol use may be risk factors." } ]

[ { "from": "human", "value": "When to seek urgent medical care when I have Acute respiratory distress syndrome ?" }, { "from": "gpt", "value": "Usually, ARDS occurs during another illness, for which the patient is already in the hospital. Occasionally, a healthy person may develop severe pneumonia that gets worse and becomes ARDS. If you have trouble breathing, call your local emergency number (such as 911) or go to the emergency room." } ]

[ { "from": "human", "value": "What to expect if I have Acute respiratory distress syndrome (Outlook/Prognosis)?" }, { "from": "gpt", "value": "About a third of people with ARDS die from the disease. Survivors usually get back normal lung function, but many people have permanent, usually mild, lung damage. Many people who survive ARDS have memory loss or other problems with thinking after they recover. This is due to brain damage that occurred when the lungs weren't working properly and the brain wasn't getting enough oxygen." } ]

[ { "from": "human", "value": "What are the symptoms of Asbestosis?" }, { "from": "gpt", "value": "Chest pain Cough Shortness of breath with exertion (slowly gets worse over time) Tightness in the chest\nPossible other symptoms include:\nClubbing of fingers Nail abnormalities" } ]

[ { "from": "human", "value": "What causes Asbestosis?" }, { "from": "gpt", "value": "Breathing in asbestos fibers can cause scar tissue (fibrosis) to form inside the lung. Scarred lung tissue does not expand and contract normally.\nHow severe the disease is depends on how long the person was exposed to asbestos and the amount he or she breathed in. Often, people do not notice symptoms for 20 years or more after the asbestos exposure.\nAsbestos fibers were commonly used in construction before 1975. Asbestos exposure occured in asbestos mining and milling, construction, fireproofing, and other industries. Families of asbestos workers can also be exposed from particles brought home on the worker's clothing.\nOther asbestos-related diseases include:\nPleural plaques (calcification) Malignant mesothelioma -- can develop 20-40 years after exposure Pleural effusion -- a collection that develops around the lung a few years after asbestos exposure\nWorkers today are less likely to get asbestos-related diseases because of government regulations.\nCigarette smoking increases the risk of getting asbestos-related diseases." } ]

[ { "from": "human", "value": "When to seek urgent medical care when I have Asbestosis ?" }, { "from": "gpt", "value": "Call for an appointment with your health care provider if you suspect that you've been exposed to asbestos or if you have unexplained symptoms." } ]

[ { "from": "human", "value": "What to expect if I have Asbestosis (Outlook/Prognosis)?" }, { "from": "gpt", "value": "The outcome depends on the amount of asbestos you were exposed to, and for how long. This condition tends to get worse more slowly than idiopathic pulmonary fibrosis if you stop being exposed to asbestos.\nPatients who develop malignant mesothelioma tend to have a poor outcome. About 75% of those who are affected die within 1 year." } ]

[ { "from": "human", "value": "What are the symptoms of Aspiration pneumonia ?" }, { "from": "gpt", "value": "Bluish discoloration of the skin caused by lack of oxygen Chest pain Cough with Foul-smelling phlegm (sputum) Pus Blood Greenish sputum\nFatigue Fever Shortness of breath Wheezing\nOther symptoms that can occur with this disease:\nBreath odor Excessive sweating Swallowing difficulty" } ]

[ { "from": "human", "value": "What causes Aspiration pneumonia?" }, { "from": "gpt", "value": "Risk factors for aspiration or breathing in of foreign material into the lungs are:\nBeing less alert due to medicines, illness, or other reasons Coma Disorders of the esophagus, the tube that moves food from the mouth to the stomach (esophageal stricture, gastroesophageal reflux) Drinking large amounts of alcohol Medicine to put you into a deep sleep for surgery (general anesthesia) Old age Poor gag reflex in people who are not alert (unconscious or semi-conscious) after a stroke or brain injury Problems with swallowing\nAcidic material that is breathed into the lungs can cause severe lung injury. However, it may not necessarily lead to pneumonia." } ]

[ { "from": "human", "value": "Who is at highest risk for Aspiration pneumonia ?" }, { "from": "gpt", "value": "Patients with decreased immunity Bed-ridden patients" } ]

[ { "from": "human", "value": "When to seek urgent medical care when I have Aspiration pneumonia ?" }, { "from": "gpt", "value": "Call your health care provider, go to the emergency room, or call the local emergency number (such as 911) if you have:\nChest pain Chills Fever Shortness of breath Wheezing" } ]

[ { "from": "human", "value": "What to expect if I have Aspiration pneumonia (Outlook/Prognosis)?" }, { "from": "gpt", "value": "The outcome depends on:\nThe severity of the pneumonia The type of bacteria causing the pneumonia How much of the lungs are involved\nIf acute respiratory failure develops, the patient may have a long-term illness or die. Many people who have aspiration pneumonia have other serious health problems, which may affect the outlook for recovery." } ]

[ { "from": "human", "value": "What are the symptoms of Atelectasis?" }, { "from": "gpt", "value": "Chest pain Cough Breathing difficulty" } ]

[ { "from": "human", "value": "What causes Atelectasis?" }, { "from": "gpt", "value": "Atelectasis is caused by a blockage of the air passages (bronchus or bronchioles) or by pressure on the outside of the lung. It is common after surgery, or in patients who were in the hospital.\nRisk factors for developing atelectasis include:\nAnesthesia Foreign object in the airway (most common in children) Lung diseases Mucus that plugs the airway Pressure on the lung caused by a buildup of fluid between the ribs and the lungs (called a pleural effusion) Prolonged bed rest with few changes in position Shallow breathing (may be caused by painful breathing) Tumors that block an airway" } ]

[ { "from": "human", "value": "When to seek urgent medical care when I have Atelectasis ?" }, { "from": "gpt", "value": "Call your health care provider if you develop symptoms of atelectasis." } ]

[ { "from": "human", "value": "What to expect if I have Atelectasis (Outlook/Prognosis)?" }, { "from": "gpt", "value": "In an adult, atelectasis in a small area of the lung is usually not life threatening. The rest of the lung can make up for the collapsed area, bringing in enough oxygen for the body to function. Large areas of atelectases may be life threatening, especially in a baby or small child, or someone who has another lung disease or illness. The collapsed lung usually reinflates slowly if the blockage of the airway has been removed. However, some scarring or damage may remain." } ]

[ { "from": "human", "value": "What are the symptoms of Atypical pneumonia?" }, { "from": "gpt", "value": "Pneumonia due to mycoplasma and chlamydophila bacteria is usually mild.\nPneumonia due to Legionella pneumophila gets worse during the first 4 - 6 days, and then improves over 4 - 5 days. Even though symptoms will improve, it may take a while for them to go away completely.\nThe most common symptoms of pneumonia are:\nChills. Cough (with Legionella pneumonia, you may cough up bloody mucus). Fever, which may be mild or high. Shortness of breath (may only occur when you climb stairs).\nOther symptoms include:\nChest pain that gets worse when you breathe deeply or cough. Confusion, especially in older people or those with Legionella pneumonia. Headache. Loss of appetite, low energy, and fatigue. Muscle aches and joint stiffness. Sweating and clammy skin.\nLess common symptoms include:\nDiarrhea (especially with Legionella pneumonia). Ear pain (with mycoplasma pneumonia). Eye pain or soreness (with mycoplasma pneumonia). Neck lump (with mycoplasma pneumonia). Rash (with mycoplasma pneumonia). Sore throat (with mycoplasma pneumonia)." } ]

[ { "from": "human", "value": "What causes Atypical pneumonia?" }, { "from": "gpt", "value": "Mycoplasma pneumonia is a type of atypical pneumonia. It is caused by the bacteria M. pneumoniae. It typically affects people younger than age 40. Pneumonia due to chlamydia-related bacteria occurs year round and accounts for 5 - 15% of all pneumonias. It is usually mild. Pneumonia due to Legionella is seen more often in middle-aged and older adults, smokers, and those with chronic illnesses or a weak immune system." } ]

[ { "from": "human", "value": "When to seek urgent medical care when I have Atypical pneumonia ?" }, { "from": "gpt", "value": "Contact your health care provider if you develop fever, cough, or shortness of breath. There are numerous causes for these symptoms. The doctor will need to rule out pneumonia." } ]

[ { "from": "human", "value": "What to expect if I have Atypical pneumonia (Outlook/Prognosis)?" }, { "from": "gpt", "value": "Most patients with pneumonia due to mycoplasma or chlamydophila do well with the right antibiotic therapy. P.Legionella can be severe, leading to problems such as kidney failure, diabetes, COPD, a weak immune system, and death." } ]

[ { "from": "human", "value": "What are the symptoms of Bronchiectasis?" }, { "from": "gpt", "value": "Symptoms often develop gradually, and may occur months or years after the event that causes the bronchiectasis.\nThey may include:\nBluish skin color Breath odor Chronic cough with large amounts of foul-smelling sputum Clubbing of fingers Coughing up blood Cough that gets worse when lying on one side Fatigue Paleness Shortness of breath that gets worse with exercise Weight loss Wheezing" } ]

[ { "from": "human", "value": "What causes Bronchiectasis?" }, { "from": "gpt", "value": "Bronchiectasis is often caused by recurrent inflammation or infection of the airways. It most often begins in childhood as a complication from infection or inhaling a foreign object.\nCystic fibrosis causes about half of all bronchiectasis in the United States.\nThe condition can also be caused by routinely breathing in food particles while eating." } ]

[ { "from": "human", "value": "Who is at highest risk for Bronchiectasis ?" }, { "from": "gpt", "value": "Recurrent, severe lung infections (pneumonia, tuberculosis, fungal infections), abnormal lung defenses, and obstruction of the airways by a foreign body or tumor are some of the risk factors." } ]

[ { "from": "human", "value": "When to seek urgent medical care when I have Bronchiectasis ?" }, { "from": "gpt", "value": "Call your health care provider if:\nChest pain or shortness of breath gets worse There is a change in color or amount of the phlegm you cough up, or if it is bloody Other symptoms get worse or do not improve with treatment" } ]

[ { "from": "human", "value": "What to expect if I have Bronchiectasis (Outlook/Prognosis)?" }, { "from": "gpt", "value": "With treatment, most people can lead normal lives without major disability." } ]

[ { "from": "human", "value": "What are the symptoms of Bronchitis?" }, { "from": "gpt", "value": "The symptoms of either type of bronchitis may include:\nChest discomfort Cough that produces mucus; if it's yellow-green, you are more likely to have a bacterial infection Fatigue Fever -- usually low Shortness of breath worsened by exertion or mild activity Wheezing\nEven after acute bronchitis has cleared, you may have a dry, nagging cough that lingers for several weeks.\nAdditional symptoms of chronic bronchitis include:\nAnkle, feet, and leg swelling Blue-colored lips from low levels of oxygen Frequent respiratory infections (such as colds or the flu)" } ]

[ { "from": "human", "value": "What causes Bronchitis?" }, { "from": "gpt", "value": "Acute bronchitis generally follows a viral respiratory infection. At first, it affects your nose, sinuses, and throat and then spreads to the lungs. Sometimes, you may get another (secondary) bacterial infection in the airways. This means that bacteria infect the airways, in addition to the virus.\nChronic bronchitis is a long-term condition. People have a cough that produces excessive mucus. To be diagnosed with chronic bronchitis, you must have a cough with mucus most days of the month for at least 3 months.\nChronic bronchitis is one type of chronic obstructive pulmonary disease, or COPD for short. (Emphysema is another type of COPD.)\nThe following things can make bronchitis worse:\nAir pollution Allergies Certain occupations (such as coal mining, textile manufacturing, or grain handling) Infections" } ]

[ { "from": "human", "value": "Who is at highest risk for Bronchitis ?" }, { "from": "gpt", "value": "People at risk for acute bronchitis include:\nThe elderly, infants, and young children Persons with heart or lung disease Smokers" } ]

[ { "from": "human", "value": "When to seek urgent medical care when I have Bronchitis ?" }, { "from": "gpt", "value": "Call your doctor if:\nYou have a cough most days or you have a cough that returns frequently You are coughing up blood You have a high fever or shaking chills You have a low-grade fever for 3 or more days You have thick, greenish mucus, especially if it has a bad smell You feel short of breath or have chest pain You have an underlying chronic illness, like heart or lung disease" } ]

[ { "from": "human", "value": "What to expect if I have Bronchitis (Outlook/Prognosis)?" }, { "from": "gpt", "value": "For acute bronchitis, symptoms usually go away within 7 to 10 days if you do not have an underlying lung disorder. However, a dry, hacking cough can linger for a number of months.\nThe chance for recovery is poor for persons with advanced chronic bronchitis. Early recognition and treatment, combined with smoking cessation, significantly improve the chance of a good outcome." } ]

[ { "from": "human", "value": "How is the Chest tube insertion done?" }, { "from": "gpt", "value": "Chest tubes are inserted to drain blood, fluid, or air and to allow the lungs to fully expand. The tube is placed between the ribs and into the space between the inner lining and the outer lining of the lung (pleural space).\nThe area where the tube will be inserted is numbed (local anesthesia). Sometimes you will be given medication to make you relaxed and sleepy (sedation) through a vein (intravenously).\nThe chest tube is inserted through a one-inch cut in the skin between the ribs into the chest. It is connected to a bottle or canister that contains sterile water. Suction is attached to the system for drainage. A stitch (suture) and adhesive tape keep the tube in place. After every chest tube insertion, a chest x-ray is done to make sure it is in the right place.\nThe chest tube usually stays in place until x-rays show that all the blood, fluid, or air has drained from the chest and the lung has fully re-expanded. When the chest tube is no longer needed, it can be easily removed. Most people don't need medications to sedate or numb them while the chest tube is removed. Antibiotics may be used to prevent or treat infection.\nIn certain people, the chest tube may be inserted using a minimally invasive technique guided by x-ray or ultrasound. Chest tubes are usually placed during major lung or heart surgery while the person is under general anesthesia." } ]

[ { "from": "human", "value": "Who needs Chest tube insertion?" }, { "from": "gpt", "value": "Chest tubes are used to treat conditions that can cause the lung to collapse, such as:\nAfter surgery or trauma in the chest (pneumothorax or hemothorax). Air leaks from the lung into the chest (pneumothorax). Bleeding into the chest (hemothorax). Collection of fat in the chest (chylothorax). Lung abscesses or pus in the chest (empyema)." } ]

[ { "from": "human", "value": "Where to find centers that perform Chest tube insertion?" }, { "from": "gpt", "value": "Directions to Hospitals Performing Chest tube insertion" } ]

[ { "from": "human", "value": "What to expect if I have Chest tube insertion (Outlook/Prognosis)?" }, { "from": "gpt", "value": "You will stay in the hospital until the chest tube is removed. While the chest tube is in place, the nursing staff will carefully check for possible air leaks, breathing difficulties, and the need for oxygen. You'll need to breathe deeply and cough often to help re-expand the lung, help with drainage, and prevent fluids from collecting in the lungs. Chest x-rays are done often while a chest tube is in place to make sure that all of the air, blood, and other fluids are being removed." } ]

[ { "from": "human", "value": "What are the symptoms of CMV pneumonitis?" }, { "from": "gpt", "value": "Cough. Fatigue. Fever. General discomfort, uneasiness, or ill feeling (malaise). Loss of appetite. Muscle aches or joint pains. Shortness of breath. Shortness of breath on exertion. Sweating, excessive (night sweats).\nLow oxygen levels in the blood (hypoxemia) with CMV pneumonia often predicts death, especially in patients who need mechanical ventilation." } ]

[ { "from": "human", "value": "What causes CMV pneumonitis?" }, { "from": "gpt", "value": "CMV pneumonia is caused by a member of a group of herpes-type viruses. Infection with CMV is very common. Most humans are exposed to CMV in their lifetime, but typically only individuals with weakened immune systems become ill from CMV infection\nUsually CMV produces no symptoms, but serious CMV infections can occur in people with weakened immune systems from conditions such as:\nAIDS. Bone marrow transplant. Organ transplant. Chemotherapy or other treatments that suppress the immune system.\nIn people who have had organ and bone marrow transplants, the risk of infection is greatest 5 - 13 weeks after the transplant." } ]

[ { "from": "human", "value": "When to seek urgent medical care when I have CMV pneumonitis ?" }, { "from": "gpt", "value": "Call your health care provider if you have symptoms of CMV pneumonia." } ]

[ { "from": "human", "value": "What to expect if I have CMV pneumonitis (Outlook/Prognosis)?" }, { "from": "gpt", "value": "Antiviral medications stop the virus from copying itself, but do not destroy it. CMV itself suppresses the immune system, and may increase the risk of other infections due to the additional immunosuppression." } ]

[ { "from": "human", "value": "What are the symptoms of cryptogenic organizing pneumonia?" }, { "from": "gpt", "value": "Patients with cryptogenic organizing pneumonia may have a positive history of connective tissue diseases, drug intake, malignancy and other interstitial lung disease. Common symptoms are dry cough, shortness of breath, fever, fatigue and weight loss. Less common symptoms are hemoptysis, chest pain and night sweats." } ]

[ { "from": "human", "value": "What causes of cryptogenic organizing pneumonia?" }, { "from": "gpt", "value": "Some of the causes of organizing pneumonia include infectious agents, drugs, inflammatory diseases, and toxic exposures." } ]

[ { "from": "human", "value": "Who is at highest risk for Cryptogenic organizing pneumonia ?" }, { "from": "gpt", "value": "Cryptogenic organizing pneumonia affects men and women equally, usually beginning between the ages of 40 and 60." } ]

[ { "from": "human", "value": "When to seek urgent medical care when I have Cryptogenic organizing pneumonia ?" }, { "from": "gpt", "value": "When there is worsening shortness of breath, dry cough changed to a productive cough." } ]

[ { "from": "human", "value": "What to expect if I have Cryptogenic organizing pneumonia (Outlook/Prognosis)?" }, { "from": "gpt", "value": "The overall prognosis for cryptogenic organizing pneumonia is significantly better than that of other interstitial lung diseases. Recovery occurs in approximately 2/3 of patients treated with steroids, with symptoms generally clearing over several months." } ]

[ { "from": "human", "value": "When does an inhaler need to be replaced?" }, { "from": "gpt", "value": "A metered dose inhaler contains enough medication for a certain number of puffs which is printed on the canister. Even though the inhaler may continue to work beyond that number of uses, the amount of medication delivered may not be correct. It is important to keep track of the number of times an inhaler was used, so that it can be replaced after its recommended number of uses. The manufacturer of Ventolin has addressed this issue by adding in a counter to the mouthpiece, as has the manufacturer of Advair. Also, depending on the manufacturer, inhalers are sold as a complete unit or the individual canister as a refill prescription." } ]

[ { "from": "human", "value": "How Does Tobacco Deliver its Effects?" }, { "from": "gpt", "value": "There are more than 4,000 chemicals found in the smoke of tobacco products. Of these, nicotine, first identified in the early 1800s, is the primary reinforcing component of tobacco that acts on the brain.\nCigarette smoking is the most popular method of using tobacco; however, there has also been a recent increase in the sale and consumption of smokeless tobacco products, such as snuff and chewing tobacco. These smokeless products also contain nicotine, as well as many toxic chemicals.\nThe cigarette is a very efficient and highly engineered drug delivery system. By inhaling tobacco smoke, the average smoker takes in 1 to 2 mg of nicotine per cigarette8. When tobacco is smoked, nicotine rapidly reaches peak levels in the bloodstream and enters the brain. A typical smoker will take 10 puffs on a cigarette over a period of 5 minutes that the cigarette is lit. Thus, a person who smokes about 1-1/2 packs (30 cigarettes) daily gets 300 “hits” of nicotine to the brain each day. In those who typically do not inhale the smoke—such as cigar and pipe smokers and smokeless tobacco users – nicotine is absorbed through the mucosal membranes and reaches peak blood levels and the brain more slowly.\nImmediately after exposure to nicotine, there is a “kick” caused in part by the drug’s stimulation of the adrenal glands and resulting discharge of epinephrine (adrenaline). The rush of adrenaline stimulates the body and causes a sudden release of glucose, as well as an increase in blood pressure, respiration, and heart rate9. Nicotine also suppresses insulin output from the pancreas, which means that smokers are always slightly hyperglycemic (i.e., they have elevated blood sugar levels10). The calming effect of nicotine reported by many users is usually associated with a decline in withdrawal effects rather than direct effects of nicotine." } ]

[ { "from": "human", "value": "Is Nicotine Addictive?" }, { "from": "gpt", "value": "Yes. Most smokers use tobacco regularly because they are addicted to nicotine. Addiction is characterized by compulsive drug seeking and use, even in the face of negative health consequences. It is well documented that most smokers identify tobacco use as harmful and express a desire to reduce or stop using it, and nearly 35 million of them want to quit each year7. Unfortunately, only about 6 percent of people who try to quit are successful for more than a month.\nResearch has shown how nicotine acts on the brain to produce a number of effects. Of primary importance to its addictive nature are findings that nicotine activates reward pathways—the brain circuitry that regulates feelings of pleasure. A key brain chemical involved in mediating the desire to consume drugs is the neurotransmitter dopamine, and research has shown that nicotine increases levels of dopamine in the reward circuits. This reaction is similar to that seen with other drugs of abuse, and is thought to underlie the pleasurable sensations experienced by many smokers9. Nicotine’s pharmacokinetic properties also enhance its abuse potential. Cigarette smoking produces a rapid distribution of nicotine to the brain, with drug levels peaking within 10 seconds of inhalation9. However, the acute effects of nicotine dissipate in a few minutes, as do the associated feelings of reward, which causes the smoker to continue dosing to maintain the drug’s pleasurable effects and prevent withdrawal.\nNicotine withdrawal symptoms include irritability, craving, cognitive and attentional deficits, sleep disturbances, and increased appetite. These symptoms may begin within a few hours after the last cigarette, quickly driving people back to tobacco use. Symptoms peak within the first few days of smoking cessation and may subside within a few weeks. For some people, however, symptoms may persist for months.\nWhile withdrawal is related to the pharmacological effects of nicotine, many behavioral factors can also affect the severity of withdrawal symptoms. For some people, the feel, smell, and sight of a cigarette and the ritual of obtaining, handling, lighting, and smoking the cigarette are all associated with the pleasurable effects of smoking and can make withdrawal or craving worse. While nicotine gum and patches may alleviate the pharmacological aspects of withdrawal, cravings often persist. Other forms of nicotine replacement, such as inhalers, attempt to address some of these other issues, while behavioral therapies can help smokers identify environmental triggers of withdrawal and craving so they can employ strategies to prevent or circumvent these symptoms and urges." } ]

[ { "from": "human", "value": "What are the symptoms of Obesity hypoventilation syndrome?" }, { "from": "gpt", "value": "The main symptoms of OHS are due to lack of sleep and include:\nExcessive daytime sleepiness. Falling asleep during the day. Increased risk for accidents or mistakes at work. Depression.\nSymptoms of low blood oxygen level (chronic hypoxia) can also occur, such as shortness of breath or feeling tired after very little effort." } ]

[ { "from": "human", "value": "What causes Obesity hypoventilation syndrome?" }, { "from": "gpt", "value": "The exact cause of OHS in unknown. Most (but not all) patients with the syndrome have a form of sleep apnea.\nOHS is believed to result from both a defect in the brain's control over breathing, and excessive weight (due to obesity) against the chest wall, which makes it hard for a person to take a deep breath. As a result, the blood has too much carbon dioxide and not enough oxygen. People with OHS are often tired due to sleep loss, poor sleep quality, and chronic hypoxia.\nExcess (morbid) obesity is the main risk factor." } ]