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A<unk> is a protein found on the surface of certain cells – including, among others, B lymphocytes, follicular dendritic cells, natural killer cells, macrophages, neutrophils, eosinophils, basophils, human platelets, and mast cells – that contribute to the protective functions of the immune system. Its name is derived from its binding specificity for a part of an antibody known as the<unk> (fragment crystallizable) region.<unk> s bind to antibodies that are attached to infected cells or invading pathogens. Their activity stimulates phagocytic or cytotoxic cells to destroy microbes, or infected cells by antibody-mediated phagocytosis or antibody-dependent cell-mediated cytotoxicity. Some viruses such as flaviviruses use<unk> s to help them infect cells, by a mechanism known as antibody-dependent enhancement of infection. | Fc receptor | Thromboxane receptor | Co-receptor | Interleukin-3 receptor | IL-2 receptor | Type I cytokine receptor | Complement receptor 1 | Interleukin-7 receptor | 00
| 31,336 |
<unk> is the discernment of an infant's<unk> at birth. Terms that may be related to<unk> are: Assigned male at birth (AMAB): a person of any age and irrespective of current gender whose<unk> at birth resulted in a declaration of "male". Synonyms: male assigned at birth (MAAB) and designated male at birth (DMAB). Assigned female at birth (AFAB): a person of any age and irrespective of current gender whose<unk> at birth resulted in a declaration of "female". Synonyms: female assigned at birth (FAAB) and designated female at birth (DFAB). Intersex, in humans and other animals, describes variations in<unk> characteristics including chromosomes, gonads,<unk> hormones, or genitals that, according to the UN Office of the High Commissioner for Human Rights, "do not fit typical binary notions of male or female bodies". These may complicate the<unk> of a newborn and can result a phenotypical<unk> that is inconsistent with normal genotype. Transgender people have a gender identity, or gender expression, that differs from their assigned<unk> . Transgender people are sometimes called transsexual if they desire medical assistance to transition from one<unk> to another.<unk> reassignment: a treatment program consisting of a combination of psychological, medical, and surgical methods intended to physically change a person's<unk> ual characteristics. | Sex assignment | Manning criteria | Partner notification | Impairment rating | Race for Life | Injured reserve list | Patient-reported outcome | Underprivileged area score | 00
| 17,240 |
Before inserting or removing a<unk> one's hands should be washed to avoid introducing harmful bacteria into the vaginal canal. The rim of a<unk> is squeezed into an oval or arc shape for insertion. A water-based lubricant (usually spermicide) may be applied to the rim of the<unk> to aid insertion. One teaspoon (5 mL) of spermicide may be placed in the dome of the<unk> before insertion, or with an applicator after insertion. The<unk> must be inserted sometime before sexual intercourse, and remain in the vagina for 6 to 8 hours after a man's last ejaculation. For multiple acts of intercourse, it is recommended that an additional 5 mL of spermicide be inserted into the vagina (not into the dome—the seal of the<unk> should not be broken) before each act. Upon removal, a<unk> should be cleansed with mild soap and warm water before storage. The<unk> must be removed for cleaning at least once every 24 hours and can be re-inserted immediately. Oil-based products should not be used with latex<unk> . Lubricants or vaginal medications that contain oil will cause the latex to rapidly degrade and greatly increases the chances of the<unk> breaking or tearing. Natural latex rubber will degrade over time. Depending on usage and storage conditions, a latex<unk> should be replaced every one to three years. Silicone<unk> may last much longer—up to ten years. Effectiveness The effectiveness of<unk> , as of most forms of contraception, can be assessed two ways: method effectiveness and actual effectiveness. The method effectiveness is the proportion of couples correctly and consistently using the method who do not become pregnant. Actual effectiveness is the proportion of couples who intended that method as their sole form of birth control and do not become pregnant; it includes couples who sometimes use the method incorrectly, or sometimes not at all. Rates are generally presented for the first year of use. Most commonly the Pearl Index is used to calculate effectiveness rates, but some studies use decrement tables. For all forms of contraception, actual effectiveness is lower than method effectiveness, due to several factors: * mistakes on the part of those providing instructions on how to use the method * mistakes on the part of the method's users * conscious user non-compliance with method For instance, someone using a<unk> might be fitted incorrectly by a health care provider, or by mistake remove the<unk> too soon after intercourse, or simply choose to have intercourse without placing the<unk> Contraceptive Technology reports that the method failure rate of the<unk> with spermicide is 6% per year. The actual pregnancy rates among<unk> users vary depending on the population being studied, with yearly rates of 10% to 39% being reported. Unlike some other cervical barriers, the effectiveness of the<unk> is the same for women who have given birth as for those who have not. Advantages The<unk> does not interfere with a woman's menstrual cycle, therefore, no reversal or wait time is necessary if contraception is no longer wanted or needed. The<unk> only has to be used during intercourse. Many women, especially those who have sex less frequently, prefer barrier contraception such as the<unk> over methods that require some action every day. Like all cervical barriers,<unk> may be inserted several hours before use, allowing uninterrupted foreplay and intercourse. Most couples find that neither partner can feel the<unk> during intercourse. The<unk> is less expensive than many other methods of contraception. Sexually transmitted infections There is some evidence that the cells in the cervix are particularly susceptible to certain sexually transmitted infections (STIs). Cervical barriers such as<unk> may offer some protection against these infections. However, research conducted to test whether the<unk> offers protection from HIV found that women provided with both male condoms and a<unk> experienced the same rate of HIV infection as women provided with male condoms alone. Because pelvic inflammatory disease (PID) is caused by certain STIs,<unk> may lower the risk of PID. Cervical barriers may also protect against human papillomavirus (HPV), the virus that causes cervical cancer, although the protection appears to be due to the spermicide used with<unk> and not the barrier itself.<unk> are also considered a good candidate as a delivery method for microbicides (preparations that, used vaginally, protect against STIs) that are currently in development. | Diaphragm | Epigastrium | Thoracic diaphragm | Airtraq | Gumma | Ainhum | Azasteroid | Hippus | 00
| 11,181 |
External<unk> are commonly used in women who have undergone surgical treatment for breast cancer such as a mastectomy or lumpectomy. They have a variety of physical benefits including improved symmetry and balance, as well as psychological benefits such as improved self-confidence. Outside of post-surgical uses, prosthetics are also used by individuals to create the illusion of breasts. Mastectomy<unk> are most commonly used after a mastectomy, usually a consequence of cancer. They are often molded to mimic the natural shape of a woman's breast and can either be used temporarily or for long-term use as an alternative to, or prior to surgical breast reconstruction. Depending on the type of mastectomy performed, progress of post-operative healing, and other various factors, surgeons will determine the time when a woman can start to use a<unk> . A prescription may be required for<unk> and mastectomy bras for insurance purposes. Up to 90% of women use a prosthetic after surgery, temporarily or permanently. Over half of these women choose full weight options, while others will opt for more lightweight prosthetic devices. Some choose to make homemade<unk> , using materials such as rice and cotton. Post-mastectomy bras Post-mastectomy bras are similar to regular bras with the exception of containing spandex stretch pockets on the inside that help keep the<unk> in place. Post-mastectomy bras can be found at specialty shops or mastectomy boutiques and some shops are also willing to stitch pockets into regular bras and swimsuits.to hold<unk> . Post-surgical camisoles Post-surgical camisoles are convenient for women to be used immediately after their breast surgery, especially if their breasts feel sore or sensitive. They are often made with soft cotton fabric and are designed to avoid rubbing or causing irritation to the skin. The camisoles have pockets for draining and similar to post-mastectomy bras, they have stitching to help hold fiber<unk> in place. Right after breast surgery, women are advised to avoid or limit their arm and shoulder movement; camisoles are ideal for this reasons because they are pulled over the hip. Attachable<unk> Attachable<unk> can be used as an alternative to post-mastectomy bras. Attachable<unk> can be attached directly to the skin via adhesives and can also be worn with a regular bra. Homemade<unk> Some women may choose to re-purpose the supplies found in their homes to create homemade<unk> . For example, shoulder pads or nylons may be used as fillers for their bras. Homemade versions can be ideal for those who prefer loose-fitting clothes where the breast shape is not as defined. Lumpectomy After a lumpectomy or a quadrantectomy individuals may be left with an asymmetrical silhouette.<unk> can help to act as an equalizer to accommodate for the missing tissue. Examples of<unk> after small but not total breast tissue removal include partial<unk> , and attachable<unk> (also known as a contact<unk> . Partial<unk> are available in a variety of materials such as silicone, foam, or fiber. These inserts are able to discretely fit into a regular bra or into the insert of a mastectomy bra. Attachable<unk> anchor directly onto your body and are secured using adhesive or Velcro. Attachable<unk> can be custom made as a partial breast shape, as well as coming readily available in full sizes. These<unk> , unlike the partial<unk> , move independent of a bra and can be worn along with a regular bra. For those who do not want a bra specially designed for<unk> , an attachable option may be a consideration. Breast enhancement Transgender Many pre or non-hormonal trans women and men who cross-dress as women use<unk> in order to create the illusion of feminine breasts. They are sometimes combined with cleavage enhancement techniques when used with clothing with low necklines. Example of a man wearing a cleavage top Full frontal cleavage tops are also available, mainly marketed to the transgender community. They incorporate a pair of<unk> in a one-piece skin coloured garment that is designed to provide the illusion of natural cleavage. Such garments have the disadvantage of having a visible top edge at the neck, which requires the wearing of a choker or similar necklace to hide the top edge of the garment. The edges of the<unk> are often distinguishable through the thin outer cover. Psychosocial considerations After a lumpectomy or mastectomy, both physical and psychological health of women can be affected as an outcome of tissue removal. A<unk> is an alternative post-surgical option to breast reconstruction to aid with these consequences. Breast tissue removal can leave women with an altered center of gravity, and could have negative impacts on posture as well as balance. A<unk> may help to correct balance and posture deficiencies caused by tissue removal. Additionally, partial or full loss of a breast can result in loss of self-esteem for some women. As a result, they may have feelings of introversion, shyness, or insecurity about their new appearance.<unk> may not only add to physical appearance, it may also have psychological benefits by providing a sense of femininity for women. | Breast prostheses | Breast implant | Breast surgery | Breast augmentation | Myfreeimplants | Breast reconstruction | Implant | Breast reduction | 00
| 40,666 |
<unk> s are a family of tryptamine-based drugs used as abortive medication in the treatment of migraines and cluster headaches. This drug class was first introduced in the 1990s. While effective at treating individual headaches, they do not provide preventive treatment and are not considered a cure. They are not effective for the treatment of tension–type headache, except in persons who also experience migraines.<unk> s do not relieve other kinds of pain. The drugs of this class act as agonists for serotonin 5-HT1B and 5-HT1D receptors at blood vessels and nerve endings in the brain. The first clinically available<unk> was sumatriptan, which has been marketed since 1991.<unk> s have largely replaced ergotamines, an older class of medications used to relieve migraine and cluster headaches. | Triptan | Sumatriptan | Frovatriptan | Rizatriptan | Eletriptan | Almotriptan | Zolmitriptan | Naratriptan | 00
| 17,860 |
<unk> is a form of<unk> appearing after birth, leading to a reduction in the level of IgG, and also sometimes IgA and IgM. (The ratios of immunoglobulins vary rapidly in all infants, and the term dysgammaglobulinemia, although theoretically applicable, is not usually used in<unk> s context.) It can result in increased infections, but it can also present without symptoms. | Transient hypogammaglobulinemia of infancy | Selective immunoglobulin A deficiency | Adult-onset immunodeficiency syndrome | X-linked agammaglobulinemia | Primary immunodeficiency | Isolated primary immunoglobulin M deficiency | Combined immunodeficiencies | Severe combined immunodeficiency | 00
| 49,194 |
<unk> is a rare genetic disease characterized by a mutation in the MYH9 gene in nonmuscle myosin. This disease affects the patient's renal system and can result in kidney failure.<unk> was first discovered in 1972 when two families had similar symptoms to Alport syndrome.<unk> and other Alport-like disorders were seen to be caused by mutations in the MYH9 (myosin heavy chain 9) gene, however,<unk> differs as it was more specifically linked to a mutation on the R702 codon on the MYH9 gene. Diseases with mutations on the MYH9 gene also include May–Hegglin anomaly, Sebastian syndrome and Fechtner syndrome. | Epstein syndrome | Cortes Lacassie syndrome | Nezelof syndrome | Van Gogh syndrome | Townes–Brocks syndrome | Van Den Bosch syndrome | Heerfordt syndrome | Koolen–De Vries syndrome | 00
| 72,384 |
Because admission of<unk> use during pregnancy can stigmatize birth mothers, many are reluctant to admit to drinking or to provide an accurate report of the quantity they drank. This complicates diagnosis and treatment of the syndrome. As a result, diagnosis of the severity of<unk> relies on protocols of observation of the child's physiology and behavior rather than maternal self-reporting. Presently, four<unk> diagnostic systems that diagnose FAS and other<unk> conditions have been developed in North America: * The Institute of Medicine's guidelines for FAS, the first system to standardize diagnoses of individuals with prenatal<unk> exposure; * The University of Washington's "The 4-Digit Diagnostic Code", which ranks the four key features of<unk> on a Likert scale of one to four and yields 256 descriptive codes that can be categorized into 22 distinct clinical categories, ranging from FAS to no findings; * The Centers for Disease Control's<unk><unk> Syndrome: Guidelines for Referral and Diagnosis", which established consensus on the diagnosis FAS in the U.S. but deferred addressing other<unk> conditions; and * Canadian guidelines for<unk> diagnoses, which established criteria for diagnosing<unk> in Canada and harmonized most differences between the IOM and University of Washington's systems. Each diagnostic system requires that a complete<unk> evaluation includes an assessment of the four key features of<unk> , described below. A positive finding on all four features is required for a diagnosis of FAS. However, prenatal<unk> exposure and central nervous system damage are the critical elements of the<unk> of<unk> , and a positive finding in these two features is sufficient for an<unk> diagnosis that is not "full-blown FAS". While the four diagnostic systems essentially agree on criteria for<unk><unk> syndrome (FAS), there are still differences when full criteria for FAS are not met. This has resulted in differing and evolving nomenclature for other conditions across the<unk> of<unk> , which may account for such a wide variety of terminology. Most individuals with deficits resulting from prenatal<unk> exposure do not express all features of FAS and fall into other<unk> conditions. The Canadian guidelines recommend the assessment and descriptive approach of the "4-Digit Diagnostic Code" for each key feature of<unk> and the terminology of the IOM in diagnostic categories, excepting ARBD. Thus, other<unk> conditions are partial expressions of FAS. However, these other<unk> conditions may create disabilities similar to FAS if the key area of central nervous system damage shows clinical deficits in two or more of ten domains of brain functioning. Essentially, even though growth deficiency and/or FAS facial features may be mild or nonexistent in other<unk> conditions, yet clinically significant brain damage of the central nervous system is present. In these other<unk> conditions, an individual may be at greater risk for adverse outcomes because brain damage is present without associated visual cues of poor growth or the "FAS face" that might ordinarily trigger an<unk> evaluation. Such individuals may be misdiagnosed with primary mental health disorders such as ADHD or oppositional defiance disorder without appreciation that brain damage is the underlying cause of these disorders, which requires a different treatment paradigm than typical mental health disorders. While other<unk> conditions may not yet be included as an ICD or DSM-IV-TR diagnosis, they nonetheless pose significant impairment in functional behavior because of underlying brain damage.<unk><unk> syndrome The following criteria must be fully met for an FAS diagnosis: # Growth deficiency: Prenatal or postnatal height or weight (or both) at or below the 10th percentile # FAS facial features: All three FAS facial features present # Central nervous system damage: Clinically significant structural neurological, or functional impairment # Prenatal<unk> exposure: Confirmed or Unknown prenatal<unk> exposure<unk><unk> syndrome (FAS) is the first diagnosable condition of<unk> that was discovered. FAS is the only expression of<unk> that has garnered consensus among experts to become an official ICD-9 and ICD-10 diagnosis. To make this diagnosis or determine any<unk> condition, a multi-disciplinary evaluation is necessary to assess each of the four key features for assessment. Generally, a trained physician will determine growth deficiency and FAS facial features. While a qualified physician may also assess central nervous system structural abnormalities and/or neurological problems, usually central nervous system damage is determined through psychological, speech-language, and occupational therapy assessments to ascertain clinically significant impairments in three or more of the Ten Brain Domains. Prenatal<unk> exposure risk may be assessed by a qualified physician, psychologist, social worker, or chemical health counselor. These professionals work together as a team to assess and interpret data of each key feature for assessment and develop an integrative, multi-disciplinary report to diagnose FAS (or other<unk> conditions) in an individual. Partial FAS Partial FAS (pFAS) was previously known as atypical FAS in the 1997 edition of the "4-Digit Diagnostic Code". People with pFAS have a confirmed history of prenatal<unk> exposure, but may lack growth deficiency or the complete facial stigmata. Central nervous system damage is present at the same level as FAS. These individuals have the same functional disabilities but "look" less like FAS. The following criteria must be fully met for a diagnosis of Partial FAS: # Growth deficiency: Growth or height may range from normal to deficient # FAS facial features: Two or three FAS facial features present # Central nervous system damage: Clinically significant structural, neurological, or functional impairment in three or more of the Ten Brain Domains # Prenatal<unk> exposure: Confirmed prenatal<unk> exposure<unk><unk> effects<unk><unk> effects (FAE) is a previous term for<unk> -related neurodevelopmental disorder and<unk> -related birth defects. It was initially used in research studies to describe humans and animals in whom teratogenic effects were seen after confirmed prenatal<unk> exposure (or unknown exposure for humans), but without obvious physical anomalies. Smith (1981) described FAE as an "extremely important concept" to highlight the debilitating effects of brain damage, regardless of the growth or facial features. This term has fallen out of favor with clinicians because it was often regarded by the public as a less severe disability than FAS, when in fact its effects can be just as detrimental.<unk> -related neurodevelopmental disorder<unk> -related neurodevelopmental disorder (ARND) was initially suggested by the Institute of Medicine to replace the term FAE and focus on central nervous system damage, rather than growth deficiency or FAS facial features. The Canadian guidelines also use this diagnosis and the same criteria. While the "4-Digit Diagnostic Code" includes these criteria for three of its diagnostic categories, it refers to this condition as static encephalopathy. The behavioral effects of ARND are not necessarily unique to<unk> however, so use of the term must be within the context of confirmed prenatal<unk> exposure. ARND may be gaining acceptance over the terms FAE and ARBD to describe<unk> conditions with central nervous system abnormalities or behavioral or cognitive abnormalities or both due to prenatal<unk> exposure without regard to growth deficiency or FAS facial features. The following criteria must be fully met for a diagnosis of ARND or static encephalopathy: # Growth deficiency: Growth or height may range from normal to minimally deficient # FAS facial features: Minimal or no FAS facial features present # Central nervous system damage: Clinically significant structural, neurological, or functional impairment in three or more of the Ten Brain Domains # Prenatal<unk> exposure: Confirmed prenatal<unk> exposure;0<unk> -related birth defects<unk> -related birth defects (ARBD), formerly known as possible<unk><unk> effect (PFAE), was a term proposed as an alternative to FAE and PFAE. The IOM presents ARBD as a list of congenital anomalies that are linked to maternal<unk> use but have no key features of<unk> . PFAE and ARBD have fallen out of favor because these anomalies are not necessarily specific to maternal<unk> consumption and are not criteria for diagnosis of<unk> . The Canadian guidelines recommend that ARBD should not be used as an umbrella term or diagnostic category for<unk> . Exposure Prenatal<unk> exposure is determined by interview of the biological mother or other family members knowledgeable of the mother's<unk> use during the pregnancy (if available), prenatal health records (if available), and review of available birth records, court records (if applicable), chemical dependency treatment records (if applicable), chemical biomarkers, or other reliable sources. Exposure level is assessed as confirmed exposure, unknown exposure, and confirmed absence of exposure by the IOM, CDC and Canadian diagnostic systems. The "4-Digit Diagnostic Code" further distinguishes confirmed exposure as High Risk and Some Risk: * High Risk: Confirmed use of<unk> during pregnancy known to be at high blood<unk> levels (100 mg/dL or greater) delivered at least weekly in early pregnancy. * Some Risk: Confirmed use of<unk> during pregnancy with use less than High Risk or unknown usage patterns. * Unknown Risk: Unknown use of<unk> during pregnancy. * No Risk: Confirmed absence of prenatal<unk> exposure. Confirmed exposure Amount, frequency, and timing of prenatal<unk> use can dramatically impact the other three key features of<unk> . | Fetal alcohol spectrum disorder | Attention deficit hyperactivity disorder | Fetal hydantoin syndrome | Williams syndrome | Congenital rubella syndrome | Neonatal encephalopathy | Fetal trimethadione syndrome | Fetal warfarin syndrome | 00
| 21,911 |
Frontal lobe ataxia is often associated with damage to the frontopontocerebellar tract (Arnold's bundle) that connects the frontal lobe to the cerebellum. This pathway normally sends information from the cortical regions to the cerebellum, particularly information used to initiate planned movement. Many neurologists describe frontal lobe ataxia as really an apraxia, in which voluntary control of initiating movement is greatly hindered, but normal movement is present when elicited involuntarily or reflexively. This indicates that cerebellar function is intact and that the presented symptoms of<unk> are due to damage located within frontal lobe regions and pathways leading from there to the cerebellum. | Bruns apraxia | Ideomotor apraxia | Hemispatial neglect | Finger agnosia | Copropraxia | Visuospatial dysgnosia | Misophonia | Constructional apraxia | 00
| 54,877 |
The symptoms to<unk> are often overlooked or attributed to the student being lazy, unmotivated, careless or anxious. The condition may also be dismissed as simply being an expression of attention deficiency or having delayed visual-motor processing. In order to be diagnosed with<unk> , one must have a cluster, but not necessarily all, of the following symptoms: The symptoms of<unk> can change as one ages.<unk> may cause students emotional trauma often due to the fact that no one can read their writing, and they are aware that they are not performing to the same level as their peers. Emotional problems that may occur alongside<unk> include impaired self-esteem, lowered self-efficacy, reduced motivation, poorer social functioning, heightened anxiety, and depression. They may put in extra efforts in order to have the same achievements as their peers, but often get frustrated because they feel that their hard work does not pay off.<unk> is a hard disorder to detect as it does not affect specific ages, gender, or intelligence. The main concern in trying to detect<unk> is that people hide their disability behind their verbal fluency/comprehension and strong syntax coding because they are ashamed that they cannot achieve the same goals as their peers. Having<unk> is not related to a lack of cognitive ability, and it is not uncommon in intellectually gifted individuals, but due to<unk> their intellectual abilities are often not identified. Associated conditions There are some common problems not related to<unk> but often associated with<unk> , the most common of which is stress. Developing an aversion to writing is another common issue. Often children (and adults) with<unk> will become extremely frustrated with the task of writing specially on plain paper (and spelling); younger children may cry, pout, or refuse to complete written assignments. This frustration can cause the student a great deal of stress and can lead to stress-related illnesses. This can be a result of any symptom of<unk> . | Dysgraphia | Dyslexia | Hypersexuality | Developmental coordination disorder | Musical anhedonia | Paraphilia | Acrodynia | Misophonia | 00
| 20,743 |
Up to 90% of cardiovascular disease may be preventable if established risk factors are avoided. Currently practiced measures to prevent cardiovascular disease include: * Maintaining a healthy diet, such as the Mediterranean diet, a vegetarian, vegan or another plant-based diet. *Replacing saturated fat with healthier choices: Clinical trials show that replacing saturated fat with polyunsaturated vegetable oil reduced CVD by 30%. Prospective observational studies show that in many populations lower intake of saturated fat coupled with higher intake of polyunsaturated and monounsaturated fat is associated with lower rates of CVD. *Decrease body fat if overweight or obese. The effect of weight loss is often difficult to distinguish from dietary change, and evidence on weight reducing diets is limited. In observational studies of people with severe obesity, weight loss following bariatric surgery is associated with a 46% reduction in cardiovascular risk. *Limit alcohol consumption to the recommended daily limits; People who moderately consume alcoholic drinks have a 25–30% lower risk of cardiovascular disease. However, people who are genetically predisposed to consume less alcohol have lower rates of cardiovascular disease suggesting that alcohol itself may not be protective. Excessive alcohol intake increases the risk of cardiovascular disease and consumption of alcohol is associated with increased risk of a cardiovascular event in the day following consumption. *Decrease non-HDL cholesterol. Statin treatment reduces cardiovascular mortality by about 31%. * Stopping smoking and avoidance of second-hand smoke. Stopping smoking reduces risk by about 35%. * At least 150 minutes (2 hours and 30 minutes) of moderate exercise per week. * Lower blood pressure, if elevated. A 10 mmHg reduction in blood pressure reduces risk by about 20%. Lowering blood pressure appears to be effective even at normal blood pressure ranges. * Decrease psychosocial stress. This measure may be complicated by imprecise definitions of what constitute psychosocial interventions. Mental stress–induced myocardial ischemia is associated with an increased risk of heart problems in those with previous heart disease. Severe emotional and physical stress leads to a form of heart<unk> known as Takotsubo syndrome in some people. Stress, however, plays a relatively minor role in hypertension. Specific relaxation therapies are of unclear benefit. * Not enough sleep also raises the risk of high blood pressure. Adults need about 7–9 hours of sleep. Sleep apnea is also a major risk as it causes one to stop breathing which can put stress on your body which can raise your risk of heart disease. Most guidelines recommend combining preventive strategies. There is some evidence that interventions aiming to reduce more than one cardiovascular risk factor may have beneficial effects on blood pressure, body mass index and waist circumference; however, evidence was limited and the authors were unable to draw firm conclusions on the effects on cardiovascular events and mortality. There is additional evidence to suggest that simply providing people with a cardiovascular disease risk score may reduce cardiovascular disease risk factors by a small amount compared to usual care. However, there was some uncertainty as to whether providing these scores had any effect on cardiovascular disease events. It is unclear whether or not dental care in those with periodontitis affects their risk of cardiovascular disease. Diet A diet high in fruits and vegetables decreases the risk of cardiovascular disease and death. A 2021 review found that plant-based diets can provide a risk reduction for CVD if a healthy plant-based diet is consumed. Unhealthy plant-based diets do not provide benefits over regular diets including meat. A similar meta-analysis and systematic review also looked into dietary patterns and found "that diets lower in animal foods and unhealthy plant foods, and higher in healthy plant foods are beneficial for CVD prevention". A 2018 meta-analysis of observational studies concluded that "In most countries, a vegan diet is associated with a more favourable cardio-metabolic profile compared to an omnivorous diet." Evidence suggests that the Mediterranean diet may improve cardiovascular outcomes. There is also evidence that a Mediterranean diet may be more effective than a low-fat diet in bringing about long-term changes to cardiovascular risk factors (e.g., lower cholesterol level and blood pressure). The DASH diet (high in nuts, fish, fruits and vegetables, and low in sweets, red meat and fat) has been shown to reduce blood pressure, lower total and low density lipoprotein cholesterol and improve metabolic syndrome; but the long-term benefits have been questioned. A high fiber diet is associated with lower risks of cardiovascular disease. Worldwide, dietary guidelines recommend a reduction in saturated fat, and although the role of dietary fat in cardiovascular disease is complex and controversial there is a long-standing consensus that replacing saturated fat with unsaturated fat in the diet is sound medical advice. Total fat intake has not been found to be associated with cardiovascular risk. A 2020 systematic review found moderate quality evidence that reducing saturated fat intake for at least 2 years caused a reduction in cardiovascular events. A 2015 meta-analysis of observational studies however did not find a convincing association between saturated fat intake and cardiovascular disease. Variation in what is used as a substitute for saturated fat may explain some differences in findings. The benefit from replacement with polyunsaturated fats appears greatest, while replacement of saturated fats with carbohydrates does not appear to have a beneficial effect. A diet high in trans fatty acids is associated with higher rates of cardiovascular disease, and in 2015 the Food and Drug Administration (FDA) determined that there was 'no longer a consensus among qualified experts that partially hydrogenated oils (PHOs), which are the primary dietary source of industrially produced trans fatty acids (IP-TFA), are generally recognized as safe (GRAS) for any use in human food'. There is conflicting evidence concerning dietary supplements of omega-3 fatty acids (a type of polysaturated fat in oily fish) added to diet improve cardiovascular risk. The benefits of recommending a low-salt diet in people with high or normal blood pressure are not clear. In those with heart failure, after one study was left out, the rest of the trials show a trend to benefit. Another review of dietary salt concluded that there is strong evidence that high dietary salt intake increases blood pressure and worsens hypertension, and that it increases the number of cardiovascular disease events; both as a result of the increased blood pressure and, quite likely, through other mechanisms. Moderate evidence was found that high salt intake increases cardiovascular mortality; and some evidence was found for an increase in overall mortality, strokes, and left ventricular hypertrophy. Intermittent fasting Overall, the current body of scientific evidence is uncertain on whether intermittent fasting could prevent cardiovascular disease. Intermittent fasting may help people lose more weight than regular eating patterns, but was not different than energy restriction diets. Medication Blood pressure medication reduces cardiovascular disease in people at risk, irrespective of age, the baseline level of cardiovascular risk, or baseline blood pressure. The commonly-used drug regimens have similar efficacy in reducing the risk of all major cardiovascular events, although there may be differences between drugs in their ability to prevent specific outcomes. Larger reductions in blood pressure produce larger reductions in risk, and most people with high blood pressure require more than one drug to achieve adequate reduction in blood pressure. Adherence to medications is often poor and while mobile phone text messaging has been tried to improve adherence, there is insufficient evidence that it alters secondary prevention of cardiovascular disease. Statins are effective in preventing further cardiovascular disease in people with a history of cardiovascular disease. As the event rate is higher in men than in women, the decrease in events is more easily seen in men than women. In those at risk, but without a history of cardiovascular disease (primary prevention), statins decrease the risk of death and combined fatal and non-fatal cardiovascular disease. The benefit, however, is small. A United States guideline recommends statins in those who have a 12% or greater risk of cardiovascular disease over the next ten years. Niacin, fibrates and CETP Inhibitors, while they may increase HDL cholesterol do not affect the risk of cardiovascular disease in those who are already on statins. Fibrates lower the risk of cardiovascular and coronary events, but there is no evidence to suggest that they reduce all-cause mortality. Anti-diabetic medication may reduce cardiovascular risk in people with Type 2 Diabetes, although evidence is not conclusive. A meta-analysis in 2009 including 27,049 participants and 2,370 major vascular events showed a 15% relative risk reduction in cardiovascular disease with more-intensive glucose lowering over an average follow-up period of 4.4 years, but an increased risk of major hypoglycemia. Aspirin has been found to be of only modest benefit in those at low risk of heart disease as the risk of serious bleeding is almost equal to the benefit with respect to cardiovascular problems. In those at very low risk, including those over the age of 70, it is not recommended. The United States Preventive Services Task Force recommends against use of aspirin for prevention in women less than 55 and men less than 45 | risks of Erectile dysfunction | risks of Hypertriglyceridemia | risks of Stevens–Johnson syndrome | risks of Myocardial infarction | risks of Subarachnoid hemorrhage | risks of Pelvic inflammatory disease | risks of Coronary artery disease | risks of Toxic epidermal necrolysis | 00
| 13,542 |
A<unk> is a coronary artery stent that combines the technology of an antibody-coated stent and a drug-eluting stent. Currently, second-generation drug-eluting stents require long-term use of<unk> -antiplatelet<unk> , which increases the risk of major bleeding occurrences in patients. Compared to drug-eluting stents,<unk> s have improved vessel regeneration and cell proliferation capabilities. As a result,<unk> s were developed to reduce the long-term need for<unk> -antiplatelet<unk> . The COMBO stent is the first and only<unk> that addresses the challenges of vessel healing in drug-eluting stents. This stent is an anti-CD34 antibody-coated and sirolimus-eluting bioresorbable stent. The COMBO stent combines the Genous stent's endothelial cell capture technology with an antiproliferative, biodegradable sirolimus drug elution. The COMBO stent has received CE Mark approval. | Dual therapy stent | Cypher stent | Bare-metal stent | Bypass surgery | Distal Revascularization and Interval Ligation | Endoscopic vessel harvesting | Embolization | Mustard procedure | 00
| 65,810 |
Produced mainly in the liver,<unk> sminogen is the inactive zymogen form of<unk> smin, and circulates in<unk> sma in a closed conformation that cannot be activated. Binding clots or cell surface causes its conformation to change, allowing it to be activated by<unk> s.<unk> s do so by cleaving the R561/V562 peptide bond, producing the active protein<unk> smin, which catalyzes the degradation of fibrin polymers that make up the structure of blood clots. 3-dimensional structure of tPA 3-dimensional structure of uPA | Plasminogen activator | Endopeptidase inhibitor | Tissue factor pathway inhibitor | Fibrinolysis | Thrombolysis | Exopeptidase inhibitor | Anticoagulant | Anistreplase | 00
| 28,580 |
A container with cream<unk> is an emulsion semisolid dosage form that is used for skin external application. Most of the<unk> s contain more than 20 per cent of water and volatiles and/or less than 50 per cent of hydrocarbons, waxes, or polyethylene glycols as the vehicle for external skin application. In a<unk> , ingredients are dissolved or dispersed in either a water-in-oil (W/O) emulsion or an oil-in-water (O/W) emulsion. The<unk> has a higher content of oily substance than gel, but a lower content of oily ingredient than ointment. Therefore, the viscosity of<unk> lies between gel and ointment. The pharmacological effect of the<unk> is confined to the skin surface or within the skin.<unk> penetrates through the skin by transcellular route, intercellular route, or trans-appendageal route.<unk> is used for a wide range of diseases and conditions, including atopic dermatitis (eczema), psoriasis, skin infection, acne, and wart. Excipients found in a<unk> include thickeners, emulsifying agents, preservatives, antioxidants, and buffer agents. Steps required to manufacture a<unk> include excipient dissolution, phase mixing, introduction of active substances, and homogenization of the product mixture. | Topical cream formulation | Topical drug delivery system | Topical medication | Polyherbal formulation | Barrier cream | Injectable filler | Topical tobacco paste | Aqueous cream | 00
| 74,484 |
Patients with TAMA present with variable combinations of a morbilliform skin eruption, chronic diarrhea, and abnormal liver enzymes. The histopathology of the skin, liver, or bowel mucosa resembles GVHD. | Thymoma-associated multiorgan autoimmunity | Chronic multifocal Langerhans cell histiocytosis | Nodal marginal zone B cell lymphoma | Thymic carcinoma | Thymoma with immunodeficiency | Radiation-induced thyroiditis | Primary mediastinal B-cell lymphoma | Critical illness–related corticosteroid insufficiency | 00
| 70,214 |
<unk> is a cutaneous condition caused by a mutation in the<unk><unk> gene. It is also known as Congenital disorder of glycosylation 1m. | Dolichol kinase deficiency | Triosephosphate isomerase deficiency | Enolase deficiency | Aminoacylase 1 deficiency | Mevalonate kinase deficiency | Glycerol kinase deficiency | Galactose epimerase deficiency | Ornithine translocase deficiency | 00
| 57,776 |
Most adverse health effects of exposure to<unk> may be grouped in two general categories: *deterministic effects (harmful tissue reactions) due in large part to killing or malfunction of cells following high doses from<unk> burns. *stochastic effects, i.e., cancer and heritable effects involving either cancer development in exposed individuals owing to mutation of somatic cells or heritable disease in their offspring owing to mutation of reproductive (germ) cells. The most common impact is stochastic induction of cancer with a latent period of years or decades after exposure. For example,<unk> is one cause of chronic myelogenous leukemia, although most people with CML have not been exposed to<unk> . The mechanism by which this occurs is well understood, but quantitative models predicting the level of risk remain controversial. The most widely accepted model the Linear no-threshold model (LNT) holds that the incidence of cancers due to<unk> increases linearly with effective<unk> dose at a rate of 5.5% per sievert. If this is correct, then natural background<unk> is the most hazardous source of<unk> to general public health, followed by medical imaging as a close second. Other stochastic effects of<unk> are teratogenesis, cognitive decline, and heart disease. Although DNA is always susceptible to damage by<unk> , the DNA molecule may also be damaged by<unk> with enough energy to excite certain molecular bonds to form pyrimidine dimers. This energy may be less than<unk> , but near to it. A good example is ultraviolet spectrum energy which begins at about 3.1 eV (400 nm) at close to the same energy level which can cause sunburn to unprotected skin, as a result of photoreactions in collagen and (in the UV-B range) also damage in DNA (for example, pyrimidine dimers). Thus, the mid and lower ultraviolet electromagnetic spectrum is damaging to biological tissues as a result of electronic excitation in molecules which falls short of ionization, but produces similar non-thermal effects. To some extent, visible light and also ultraviolet A (UVA) which is closest to visible energies, have been proven to result in formation of reactive oxygen species in skin, which cause indirect damage since these are electronically excited molecules which can inflict reactive damage, although they do not cause sunburn (erythema). Like ionization-damage, all these effects in skin are beyond those produced by simple thermal effects. | Ionizing radiation | Irradiation | Radiation | Co-carcinogen | Immunologic adjuvant | Food irradiation | Carcinogen | Radiosensitizer | 00
| 8,042 |
<unk> is sometimes used as a method of suicide. It has a similar fatality index to that of benzodiazepine drugs, apart from temazepam, which is particularly toxic in overdose. Deaths have occurred from<unk> overdose, alone or in combination with other drugs. Overdose of<unk> may present with excessive sedation and depressed respiratory function that may progress to coma and possibly death.<unk> combined with alcohol, opiates, or other central nervous system depressants may be even more likely to lead to fatal overdoses.<unk> overdosage can be treated with the GABAA receptor benzodiazepine site antagonist flumazenil, which displaces<unk> from its binding site, thereby rapidly reversing its effects. Serious effects on the heart may also occur from a<unk> overdose when combined with piperazine. Death certificates show the number of<unk> -related deaths is on the rise. When taken alone, it usually is not fatal, but when mixed with alcohol or other drugs such as opioids, or in patients with respiratory, or hepatic disorders, the risk of a serious and fatal overdose increases. | Zopiclone | Eszopiclone | Chloropicrin | Flumetasone | Budesonide | Clobetasone | Mibolerone | Fluticasone furoate | 00
| 20,560 |
<unk> deficiency is one of the most common nutritional deficiencies affecting up to two billion people worldwide.<unk> deficiency commonly occurs in patients suffering chronic infection.<unk> s are used to treat patients with<unk> deficiency,<unk> -deficiency anaemia and chronic kidney disease. IV<unk><unk> s are administered to patients who cannot use oral supplementation to treat their deficiency, or if oral treatment has proven ineffective. Oral<unk> supplementations are the first line of care for<unk> deficiency and<unk> deficiency anaemia. Anaemic patients are treated with<unk> tablets containing 100 mg to 200 mg of<unk> . Oral<unk> tablets are not easily tolerated and may cause nausea, vomiting, abdominal pain, constipation and diarrhoea. The oxidative properties of<unk> conflict with the gastrointestinal tract prohibiting proper absorption of<unk> into the blood. Disorders affecting the gut lead to resistance against oral supplements. Side effects of constipation or diarrhoea are more common with the use of oral<unk> than<unk> <unk> . The adverse effects associated with oral<unk> supplements prohibit patients from completing the full course of medication.<unk> s are prescribed when gastrointestinal absorption is poor or when an urgent increase in haemoglobin levels is required for severely anaemic patients, such as women in their second and third trimester of pregnancy.<unk> deficiency anaemia effects forty-two percent of pregnant women.<unk> s are a form of treatment for pregnant women that ensures a fast and early recovery. Pregnant women are more likely to successfully replenish<unk> stores and increase their haemoglobin levels with<unk> <unk> compared to oral<unk> supplements. Recovery is reached faster and with fewer side effects than oral<unk> .<unk> <unk> is proven to be very effective for pregnant women with<unk> deficiency anaemia but not necessarily more effective than oral supplements for those with<unk> deficiency alone. The type of<unk> supplement used depends on the patient's specific condition. The degree and severity of anaemia, tolerability to previous treatment and history of allergy must all be considered before<unk> <unk> is administered. Correction of<unk> deficiency with oral<unk> supplements is particularly ineffective when a patient suffers from a coexisting medical condition.<unk> <unk> therapy has an established role in the treatment of<unk> deficiency anaemia when oral supplements are ineffective or cannot be used. IV<unk><unk> s can administer the exact dose of<unk> to normalise levels in the blood. Pre-operative anaemia is associated with high risk of death.<unk> s can optimise haemoglobin levels, significantly reducing mortality rates. IV<unk> is found to be highly effective for patients with chronic kidney disease when combined with erythropoiesis stimulating agents. Recent studies of<unk> and its associated with red blood cells has increased interest in the use and development of<unk> <unk> therapy to reduce the requirement for allogenic red blood cell transfusions. These findings show that<unk> <unk> has a broad use to many patients where anaemia is an underlying issue. | Intravenous iron infusion | Intravenous ascorbic acid | Activated charcoal cleanse | Iron preparation | Granulocyte transfusion | Phlebotomy | Hemotherapy | Autologous blood therapy | 00
| 72,344 |
Fibrinous pericarditis is an exudative inflammation. The pericardium is infiltrated by the fibrinous exudate. This consists of fibrin strands and leukocytes. Fibrin describes an amorphous, eosinophilic (pink) network. Leukocytes (white blood cells; mainly neutrophils) are found within the fibrin deposits and intrapericardic. Vascular congestion is also present. Inflammatory cells do not penetrate the myocardium (as is seen with other presentations of pericarditis), and as a result, this particular variant does not present with diffuse ST elevation on ECG (a classic sign of pericarditis known as stage I ECG changes which are seen with other causes) because the inflammatory cells do not penetrate the myocardium. To naked eye examination, this pathology is referred to as having a "Bread and Butter Appearance". | Uremic pericarditis | Acute pericarditis | Constrictive pericarditis | Tachycardia-induced cardiomyopathy | Ischemic cardiomyopathy | Tamponade | Myopericarditis | Tuberculous pericarditis | 00
| 54,770 |
Many different treatments exist for<unk> . These include alpha hydroxy acid, anti-androgen medications, antibiotics, antiseborrheic medications, azelaic acid, benzoyl peroxide, hormonal treatments, keratolytic soaps, nicotinamide, retinoids, and salicylic acid.<unk> treatments work in at least four different ways, including the following: reducing inflammation, hormonal manipulation, killing C.<unk> s, and normalizing skin cell shedding and sebum production in the pore to prevent blockage. Typical treatments include topical therapies such as antibiotics, benzoyl peroxide, and retinoids, and systemic therapies, including antibiotics, hormonal agents, and oral retinoids. Recommended therapies for first-line use in<unk> vulgaris treatment include topical retinoids, benzoyl peroxide, and topical or oral antibiotics. Procedures such as light therapy and laser therapy are not first-line treatments and typically have only an add on role due to their high cost and limited evidence. Blue light therapy is of unclear benefit. Medications for<unk> target the early stages of comedo formation and are generally ineffective for visible skin lesions;<unk> generally improves between eight and twelve weeks after starting therapy. Skin care In general, it is recommended that people with<unk> do not wash affected skin more than twice daily. The application of a fragrance-free moisturizer to sensitive and<unk> -prone skin may reduce irritation. Skin irritation from<unk> medications typically peaks at two weeks after onset of use and tends to improve with continued use. Dermatologists recommend using cosmetic products that specifically say non-comedogenic, oil-free, and won't clog pores.<unk> vulgaris patients, even those with oily skin, should moisturize in order to support the skins moisture barrier since skin barrier dysfunction may contribute to<unk> . Moisturizers, especially ceramide-containing moisturizers, as an adjunct therapy are particularly helpful for the dry skin and irritation that commonly results from topical<unk> treatment. Studies show that ceramide-containing moisturizers are important for optimal skin care; they enhance<unk> therapy adherence and complement existing<unk> therapies. In a study where<unk> patients used 1.2% clindamycin phosphate / 2.5% benzoyl peroxide gel in the morning and applied a micronized 0.05% tretinoin gel in the evening the overwhelming majority of patients experienced no cutaneous adverse events throughout the study. It was concluded that using ceramide cleanser and ceramide moisturizing cream caused the favorable tolerability, did not interfere with the treatment efficacy, and improved adherence to the regimen. The importance of preserving the acidic mantle and its barrier functions is widely accepted in the scientific community. Thus, maintaining a pH in the range 4.5 - 5.5 is essential in order to keep the skin surface in its optimal, healthy conditions. Diet Causal relationship is rarely observed with diet/nutrition and dermatologic conditions. Rather, associations — some of them compelling — have been found between diet and outcomes including disease severity and the number of conditions experienced by a patient. Evidence is emerging in support of medical nutrition therapy as a way of reducing the severity and incidence of dermatologic diseases, including<unk> . Researchers observed a link between high glycemic index diets and<unk> . Dermatologists also recommend a diet low in simple sugars as a method of improving<unk> . As of 2014, the available evidence is insufficient to use milk restriction for this purpose. Medications Benzoyl peroxide alt=A tube of benzoyl peroxide gel Benzoyl peroxide (BPO) is a first-line treatment for mild and moderate<unk> due to its effectiveness and mild side-effects (mainly skin irritation). In the skin follicle, benzoyl peroxide kills C.<unk> s by oxidizing its proteins through the formation of oxygen free radicals and benzoic acid. These free radicals likely interfere with the bacterium's metabolism and ability to make proteins. Additionally, benzoyl peroxide is mildly effective at breaking down comedones and inhibiting inflammation. Combination products use benzoyl peroxide with a topical antibiotic or retinoid, such as benzoyl peroxide/clindamycin and benzoyl peroxide/adapalene, respectively. Topical benzoyl peroxide is effective at treating<unk> . Side effects include increased skin photosensitivity, dryness, redness, and occasional peeling. Sunscreen use is often advised during treatment, to prevent sunburn. Lower concentrations of benzoyl peroxide are just as effective as higher concentrations in treating<unk> but are associated with fewer side effects. Unlike antibiotics, benzoyl peroxide does not appear to generate bacterial antibiotic resistance. Retinoids Retinoids are medications that reduce inflammation, normalize the follicle cell life cycle, and reduce sebum production. They are structurally related to vitamin A. Studies show dermatologists and primary care doctors underprescribe them for<unk> . The retinoids appear to influence the cell life cycle in the follicle lining. This helps prevent the accumulation of skin cells within the hair follicle that can create a blockage. They are a first-line<unk> treatment, especially for people with dark-colored skin. Retinoids are known to lead to faster improvement of postinflammatory hyperpigmentation. Topical retinoids include adapalene, retinol, retinaldehyde, isotretinoin, tazarotene, trifarotene, and tretinoin. They often cause an initial flare-up of<unk> and facial flushing and can cause significant skin irritation. Generally speaking, retinoids increase the skin's sensitivity to sunlight and are therefore recommended for use at night. Tretinoin is the least expensive of the topical retinoids and is the most irritating to the skin, whereas adapalene is the least irritating but costs significantly more. Most formulations of tretinoin are incompatible for use with benzoyl peroxide. Tazarotene is the most effective and expensive topical retinoid but is usually not as well tolerated. In 2019 a tazarotene lotion formulation, marketed to be a less irritating option, was approved by the FDA. Retinol is a form of vitamin A that has similar but milder effects and is present in many over-the-counter moisturizers and other topical products. Isotretinoin is an oral retinoid that is very effective for severe nodular<unk> , and moderate<unk> that is stubborn to other treatments. One to two months of use is typically adequate to see improvement.<unk> often resolves completely or is much milder after a 4–6 month course of oral isotretinoin. After a single round of treatment, about 80% of people report an improvement, with more than 50% reporting complete remission. About 20% of people require a second course, but 80% of those report improvement, resulting in a cumulative 96% efficacy rate. There are concerns that isotretinoin is linked to adverse effects, like depression, suicidality, and anemia. There is no clear evidence to support some of these claims. Isotretinoin has been found in some studies to be superior to antibiotics or placebo in reducing<unk> lesions. However, a 2018 review comparing inflammatory lesions after treatment with antibiotics or isotretinoin found no difference. The frequency of adverse events was about twice as high with isotretinoin use, although these were mostly dryness-related events. No increased risk of suicide or depression was conclusively found. Medical authorities strictly regulate isotretinoin use in women of childbearing age due to its known harmful effects in pregnancy. For such a woman to be considered a candidate for isotretinoin, she must have a confirmed negative pregnancy test and use an effective form of birth control. In 2008, the United States started the iPLEDGE program to prevent isotretinoin use during pregnancy. iPledge requires the woman to have two negative pregnancy tests and to use two types of birth control for at least one month before isotretinoin therapy begins and one month afterward. The effectiveness of the iPledge program is controversial due to continued instances of contraception nonadherence. Antibiotics People may apply antibiotics to the skin or take them orally to treat<unk> . They work by killing C.<unk> s and reducing inflammation. Although multiple guidelines call for healthcare providers to reduce the rates of prescribed oral antibiotics, many providers do not follow this guidance. Oral antibiotics remain the most commonly prescribed systemic therapy for<unk> . Widespread broad-spectrum antibiotic overuse for<unk> has led to higher rates of antibiotic-resistant C.<unk> s strains worldwide, especially to the commonly used tetracycline (e.g., doxycycline) and macrolide antibiotics (e.g., topical erythromycin). Therefore, dermatologists prefer antibiotics as part of combination therapy and not for use alone. Commonly used antibiotics, either applied to the skin or taken orally, include clindamycin, erythromycin, metronidazole, sulfacetamide, and tetracyclines (e.g., doxycycline or minocycline). Doxycycline 40 milligrams daily (low-dose) appears to have similar efficacy to 100 milligrams daily and has fewer gastrointestinal side effects. However, low-dose doxycycline is not FDA-approved for the treatment of<unk> . Antibiotics applied to the skin are typically used for mild to moderately severe<unk> . Oral antibiotics are generally more effective than topical antibiotics and produce faster resolution of inflammatory<unk> lesions than topical applications. Topical and oral antibiotics are not recommended for use together. Oral antibiotics are recommended for no longer than three months as antibiotic courses exceeding this duration are associated with the development of antibiotic resistance and show no clear benefit over shorter durations. If long-term oral antibiotics beyond three months are used, then it is recommended that benzoyl peroxide or a retinoid be used at the same time to limit the risk of C.<unk> s developing antibiotic resistance. The antibiotic dapsone is effective against inflammatory<unk> when applied to the skin. It is generally not a first-line choice due to its higher cost and a lack of clear superiority over other antibiotics. Topical | Acne | Hidradenitis suppurativa | Oscar | Miliaria | Sunburn | Rosacea | Scar | Folliculitis | 00
| 5,146 |
A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists in growing abnormally, even if the original trigger is removed. This abnormal growth usually forms a mass, when it may be called a tumor. ICD-10 classifies neoplasms into four main groups: benign neoplasms, in situ neoplasms, malignant neoplasms, and neoplasms of uncertain or unknown behavior. Malignant neoplasms are also simply known as cancers and are the focus of oncology. Prior to the abnormal growth of tissue, as neoplasia, cells often undergo an abnormal pattern of growth, such as metaplasia or dysplasia. However, metaplasia or dysplasia does not always progress to neoplasia and can occur in other conditions as well. The word is from Ancient Greek νέος- neo 'new' and πλάσμα plasma 'formation, creation'. | medical cause of Mandibular fracture | symptom of Mandibular fracture | complications of Frostbite | causes of Mandibular fracture | symptom of Bone tumor | complications of Strabismus | symptom of Carpal tunnel syndrome | types of Hair loss | 00
| 21,809 |
<unk> is a connective tissue disorder involving the growth of fibrous plaques in the soft tissue of the penis. Specifically, scar tissue forms in the tunica albuginea, the thick sheath of tissue surrounding the corpora cavernosa, causing pain, abnormal curvature, erectile dysfunction, indentation, loss of girth and shortening. It is estimated to affect about 10% of men. The condition becomes more common with age. | Peyronie's disease | Blount's disease | Minor's disease | Reis–Bucklers corneal dystrophy | Darier's disease | Sorsby's fundus dystrophy | Meesmann corneal dystrophy | Fundic gland polyposis | 00
| 6,284 |
While the cause of<unk> remains unclear, current theory suggests that there may be a genetic predisposition as case reports have identified clusters of the disease and prevalence among twins. In fact, according to the Cleveland Clinic approximately 10% of cases appear to be inherited and often coexists with other genetic abnormalities that affect the blood vessels. Approximately 10% of patients with<unk> have an affected family member. A study conducted from the patient registry at Michigan Cardiovascular Outcomes Research and Reporting Program (MCORRP) at the University of Michigan Health System reported a high prevalence of a family history of stroke (53.5%), aneurysm (23.5%), and sudden death (19.8%). Even though<unk> is a non-atherosclerotic disease family histories of hypertension and hyperlipidemia were also common among those diagnosed with<unk> . It is believed that the cause of<unk> is not a single identifier such as genetics but has multiple underlying factors. Theories of hormonal influence, mechanical stress from trauma and stress to the artery walls, and also the effect of loss of oxygen supply to the blood vessel wall caused by fibrous lesions. It has been suggested that environmental factors, such as smoking and estrogen, may play a role in addition to genetic factors, however concerns for safety associated with exogenous female hormones in<unk> remain theorectical. | Fibromuscular dysplasia | Arteriosclerosis obliterans | Familial myxovascular fibromas | Endocardial fibroelastosis | Fibromatosis | Familial thoracic aortic aneurysm | Actinic elastosis | Collagen disease | 00
| 35,347 |
According to one review published in 2003, reduction of the blood pressure by 5 mmHg can decrease the risk of stroke by 34%, of ischemic heart disease by 21%, and reduce the likelihood of dementia, heart failure, and mortality from cardiovascular disease. Target blood pressure Various expert groups have produced guidelines regarding how low the blood pressure target should be when a person is treated for hypertension. These groups recommend a target below the range 140–160 / 90–100 mmHg for the general population. Cochrane reviews recommend similar targets for subgroups such as people with diabetes and people with prior cardiovascular disease. Additionally, Cochrane reviews have found that for older individuals with moderate to high cardiovascular risk, the benefits of trying to achieve a lower than standard blood pressure target (at or below 140/90 mmHg) are outweighed by the risk associated with the intervention. These findings may not be applicable to other populations. Many expert groups recommend a slightly higher target of 150/90 mmHg for those over somewhere between 60 and 80 years of age. The JNC-8 and American College of Physicians recommend the target of 150/90 mmHg for those over 60 years of age, but some experts within these groups disagree with this recommendation. Some expert groups have also recommended slightly lower targets in those with diabetes or<unk> kidney disease with protein loss in the urine, but others recommend the same target as for the general population. The issue of what is the best target and whether targets should differ for high risk individuals is unresolved, although some experts propose more intensive blood pressure lowering than advocated in some guidelines. For people who have never experienced cardiovascular disease who are at a 10-year risk of cardiovascular disease of less than 10%, the 2017 American Heart Association guidelines recommend medications if the systolic blood pressure is >140 mmHg or if the diastolic BP is >90 mmHg. For people who have experienced cardiovascular disease or those who are at a 10-year risk of cardiovascular disease of greater than 10%, it recommends medications if the systolic blood pressure is >130 mmHg or if the diastolic BP is >80 mmHg. Lifestyle modifications The first line of treatment for hypertension is lifestyle changes, including dietary changes, physical exercise, and weight loss. Though these have all been recommended in scientific advisories, a Cochrane systematic review found no evidence for effects of weight loss diets on death, long-term complications or adverse events in persons with hypertension. The review did find a decrease in body weight and blood pressure. Their potential effectiveness is similar to and at times exceeds a single medication. If hypertension is high enough to justify immediate use of medications, lifestyle changes are still recommended in conjunction with medication. Dietary changes shown to reduce blood pressure include diets with low sodium, the DASH diet (Dietary Approaches to Stop Hypertension), and plant-based diets. There is some evidence green tea consumption may help lower blood pressure, but this is insufficient for it to be recommended as a treatment. There is evidence from randomized, double-blind, placebo-controlled clinical trials that Hibiscus tea consumption significantly reduces systolic blood pressure (−4.71 mmHg, 95% CI −7.87, −1.55) and diastolic blood pressure (−4.08 mmHg, 95% CI −6.48, −1.67). Beetroot juice consumption also significantly lowers the blood pressure of people with high blood pressure. Increasing dietary potassium has a potential benefit for lowering the risk of hypertension. The 2015 Dietary Guidelines Advisory Committee (DGAC) stated that potassium is one of the shortfall nutrients which is under-consumed in the United States. However, people who take certain antihypertensive medications (such as ACE-inhibitors or ARBs) should not take potassium supplements or potassium-enriched salts due to the risk of high levels of potassium. Physical exercise regimens which are shown to reduce blood pressure include isometric resistance exercise, aerobic exercise, resistance exercise, and device-guided breathing. Stress reduction techniques such as biofeedback or transcendental meditation may be considered as an add-on to other treatments to reduce hypertension, but do not have evidence for preventing cardiovascular disease on their own. Self-monitoring and appointment reminders might support the use of other strategies to improve blood pressure control, but need further evaluation. Medications Several classes of medications, collectively referred to as antihypertensive medications, are available for treating hypertension. First-line medications for hypertension include thiazide-diuretics, calcium channel blockers, angiotensin converting enzyme inhibitors (ACE inhibitors), and angiotensin receptor blockers (ARBs). These medications may be used alone or in combination (ACE inhibitors and ARBs are not recommended for use in combination); the latter option may serve to minimize counter-regulatory mechanisms that act to restore blood pressure values to pre-treatment levels. Most people require more than one medication to control their hypertension. Medications for blood pressure control should be implemented by a stepped care approach when target levels are not reached. Previously beta-blockers such as atenolol were thought to have similar beneficial effects when used as first-line therapy for hypertension. However, a Cochrane review that included 13 trials found that the effects of beta-blockers are inferior to that of other antihypertensive medications in preventing cardiovascular disease. Resistant hypertension Resistant hypertension is defined as high blood pressure that remains above a target level, in spite of being prescribed three or more antihypertensive drugs simultaneously with different mechanisms of action. Failing to take prescribed medications as directed is an important cause of resistant hypertension. Resistant hypertension may also result from<unk> ally high activity of the autonomic nervous system, an effect known as "neurogenic hypertension". Electrical therapies that stimulate the baroreflex are being studied as an option for lowering blood pressure in people in this situation. Some common secondary causes of resistant hypertension include obstructive sleep apnea, pheochromocytoma, renal artery stenosis, coarctation of the aorta, and primary aldosteronism. Refractory hypertension Refractory hypertension is characterized by uncontrolled elevated blood pressure unmitigated by five or more antihypertensive agents of different classes, including a long-acting thiazide-like diuretic, a calcium channel blocker, and a blocker of the renin-angiotensin system. People with refractory hypertension typically have increased sympathetic nervous system activity, and are at high risk for more severe cardiovascular diseases and all-cause mortality. Non-modulating Non-modulating essential hypertension is a form of salt-sensitive hypertension, where sodium intake does not modulate either adrenal or renal vascular responses to angiotensin II. Individuals with this subset have been termed non-modulators. They make up 25-30% of the hypertensive population. | medical cause of Chronic kidney disease | symptom of Kidney cancer | complications of Kidney disease | symptom of Renal papillary necrosis | medical cause of Pyelonephritis | medical cause of Polyuria | complications of Acute liver failure | medical cause of Hematuria | 00
| 5,262 |
An<unk> is caused by one or more emboli getting stuck in an artery and blocking blood flow, causing ischemia, possibly resulting in infarction with tissue death (necrosis). Individuals with<unk> thrombosis or embolism often develop collateral circulation to compensate for the loss of<unk> flow. However, it takes time for sufficient collateral circulation to develop, making affected areas more vulnerable for sudden occlusion by embolisation than for e.g. gradual occlusion as in atherosclerosis. Materials<unk> s can consist of various materials, including: * Thromboembolism – embolism of thrombus or blood clot. * Cholesterol embolism - embolism of cholesterol, often from atherosclerotic plaque inside a vessel. * Fat embolism – embolism of bone fracture or fat droplets. * Air embolism (also known as a gas embolism) – embolism of air bubbles. * Septic embolism – embolism of pus containing bacteria. * Cancer embolism In contrast, amniotic fluid embolism almost exclusively affects the venous side. | Arterial embolism | Paradoxical embolism | Cholesterol embolism | Septic embolism | Carotid artery dissection | Embolism | Coronary thrombosis | Post-thrombotic syndrome | 00
| 58,982 |
<unk> <unk> is a rare form of<unk><unk> with symptoms generally starting when an individual is 40 to 50 years old. It can be autosomal dominant neuromuscular disease or autosomal recessive. The most common inheritance of<unk> is autosomal dominant, which means only one copy of the mutated gene needs to be present in each cell. Children of an affected parent have a 50% chance of inheriting the mutant gene. Autosomal dominant inheritance is the most common form of inheritance. Less commonly,<unk> can be inherited in an autosomal recessive pattern, which means that two copies of the mutated gene need to be present in each cell, both parents need to be carriers of the mutated gene, and usually show no signs or symptoms. The PABPN1 mutation contains a GCG trinucleotide repeat at the 5' end of the coding region, and expansion of this repeat which then leads to autosomal dominant<unk> <unk> disease. | Oculopharyngeal muscular dystrophy | Ataxic cerebral palsy | Athetoid cerebral palsy | Infantile progressive bulbar palsy | Skoptic syndrome | Dyskinetic cerebral palsy | Spastic cerebral palsy | Spinal and bulbar muscular atrophy | 00
| 19,994 |
There is much debate about the true cause and mechanism of the<unk> ng fits brought about by the<unk> .<unk> ng occurs in response to irritation in the nasal cavity, which results in an afferent nerve fiber signal propagating through the ophthalmic and maxillary branches of the trigeminal nerve to the trigeminal nerve nuclei in the brainstem. The signal is interpreted in the trigeminal nerve nuclei, and an efferent nerve fiber signal goes to different parts of the body, such as mucous glands and the thoracic diaphragm, thus producing a<unk> . The most obvious difference between a normal<unk> and a<unk><unk> is the stimulus: normal<unk> s occur due to irritation in the nasal cavity, while the<unk><unk> can result from a wide variety of stimuli. Some theories are below. There is also a genetic factor that increases the probability of<unk> . The C allele on the rs10427255 SNP is particularly implicated in this although the mechanism is unknown by which this gene increases the probability of this response. Optic-trigeminal summation Stimulation of the ophthalmic branch of the trigeminal nerve may enhance the irritability of the maxillary branch, resulting in an increased probability of<unk> ng. This is similar to the mechanism by which photophobia develops by persistent light exposure relaying signals through the optic nerve and trigeminal nerve to produce increased sensitivity in the ophthalmic branch. If this increased sensitivity occurred in the maxillary branch instead of the ophthalmic branch, a<unk> could result instead of photophobia. Parasympathetic generalization The parasympathetic nervous system has many neighboring fibers that respond to different stimuli. When one stimulus activates multiple nerve fibers of the parasympathetic nervous system, parasympathetic generalization is occurring. There is a possibility that sensory input from the eyes could travel to the neurons in the cortex that interpret such signals, but neighboring neurons which are involved in<unk> ng are also activated, due to the generalization. This could lead to a<unk> in response to a stimulus other than nasal irritation. Increased light sensitivity When the trigeminal nerve is directly stimulated, there is the possibility that increased light sensitivity in the ocular nerve could result. An example of directly stimulating would be plucking an eyebrow or pulling hair. In many people who show the<unk> , even this direct stimulation can lead to a<unk><unk> which is why we find it easier to<unk> while looking at a bright light. Propofol-induced inhibitory suppression Uncontrollable<unk> ng during a periocular injection while sedated by propofol is likely caused by the drug. Propofol has been shown to temporarily suppress inhibitory neurons in the brainstem, which is also where the trigeminal nucleus – the<unk> center" of the brain – lies. This chain of events leads to increased sensitivity to stimulation and reduced threshold for involuntary responses. In this hypersensitive state, the periocular injection stimulates the ophthalmic and/or maxillary branch of the trigeminal nerve, which results in summation in the trigeminal nuclei. This summation can lead to a<unk> in the unconscious patient. | Photic sneeze reflex | Pharyngeal reflex | Snout reflex | Pressure of speech | Alaryngeal speech | Palmomental reflex | Tonic labyrinthine reflex | Chaddock reflex | 00
| 34,962 |
A<unk> or copay is a fixed amount for a covered service, paid by a patient to the provider of service before receiving the service. It may be defined in an insurance policy and paid by an insured person each time a medical service is accessed. It is technically a form of coinsurance, but is defined differently in health insurance where a coinsurance is a percentage payment after the deductible up to a certain limit. It must be paid before any policy benefit is payable by an insurance company.<unk> s do not usually contribute towards any policy out-of-pocket maximum, whereas coinsurance payments do. Insurance companies use<unk> s to share health care costs to prevent moral hazard. It may be a small portion of the actual cost of the medical service but is meant to deter people from seeking medical care that may not be necessary, e.g., an infection by the common cold. In health systems with prices below the market clearing level in which waiting lists act as rationing tools,<unk> can serve to reduce the welfare cost of waiting lists. However, a copay may also discourage people from seeking necessary medical care, and higher copays may result in non-use of essential medical services and prescriptions, thus rendering someone who is insured effectively uninsured because they are unable to pay higher copays. | Copayment | Money worship | Pay for performance | Comstock laws | Bundled payment | Fee-for-service | Stop-loss insurance | Professional courtesy | 00
| 26,776 |
Diagnosis can be difficult as symptoms may be nonspecific. A CT scan of the head is typically recommended if a concern is present. It is unclear how useful subdural haematoma, retinal hemorrhages, and encephalopathy are alone at making the diagnosis. File:AbusiveheadtraumaBonewindowsNo.A skull fracture from abusive head trauma in an infant File:SkullFracAHTLtMark2.3D CT reconstruction showing a skull fracture in an infant File:SkullFracAHTMark.3D CT reconstruction showing a skull fracture in an infant Triad While the findings of<unk> are complex and many, they are often incorrectly referred to as a "triad" for legal proceedings; distilled down to retinal hemorrhages, subdural hematomas, and encephalopathy.<unk> may be misdiagnosed, underdiagnosed, and overdiagnosed, and caregivers may lie or be unaware of the mechanism of injury. Commonly, there are no externally visible signs of the condition. Examination by an experienced ophthalmologist is critical in diagnosing<unk> , as particular forms of ocular bleeding are strongly associated with AHT. Magnetic resonance imaging may also depict retinal hemorrhaging but is much less sensitive than an eye exam. Conditions that are often excluded by clinicians include hydrocephalus, sudden infant death syndrome (SIDS), seizure disorders, and infectious or congenital diseases like meningitis and metabolic disorders. CT scanning and magnetic resonance imaging are used to diagnose the condition. Conditions that often accompany<unk> /AHT include classic patterns of skeletal fracturing (rib fractures, corner fractures), injury to the cervical spine (in the neck), retinal hemorrhage, cerebral bleed or atrophy, hydrocephalus, and papilledema (swelling of the optic disc). The terms non-accidental head injury or inflicted traumatic brain injury have been used in place of "abusive head trauma" or "SBS". Classification The term abusive head trauma (AHT) is preferred as it better represents the broader potential causes. The US Centers for Disease Control and Prevention identifies<unk> as "an injury to the skull or intracranial contents of an infant or young child (< 5 years of age) due to inflicted blunt impact and/or violent<unk> g". In 2009, the American Academy of Pediatrics recommended the use of the term AHT to replace<unk> , in part to differentiate injuries arising solely from<unk> g and injuries arising from<unk> g as well as trauma to the head. The Crown Prosecution Service for England and Wales recommended in 2011 that the term<unk> be avoided and the term non accidental head injury (NAHI) be used instead. Controversy Efforts to create doubt about AHT include the mischaracterization and replacement of the complex diagnostic process by a near mechanical determination based on the “triad” — the findings of subdural hemorrhage, retinal hemorrhage and encephalopathy. This critique has been sensationalized in the mass media in an attempt to create the appearance of a “medical controversy” where there is none. The straw man “triad” argument ignores the fact that the AHT diagnosis typically is made only after careful consideration of all historical, clinical and laboratory findings as well as radiologic investigations by the collaboration of a multidisciplinary team. Differential diagnosis Vitamin C deficiency Some authors have suggested that certain cases of suspected<unk> may result from vitamin C deficiency. This contested hypothesis is based upon a speculated marginal, near scorbutic condition or lack of essential nutrient(s) repletion and a potential elevated histamine level. However, symptoms consistent with increased histamine levels, such as low blood pressure and allergic symptoms, are not commonly associated with scurvy as clinically significant vitamin C deficiency. A literature review of this hypothesis in the journal Pediatrics International concluded the following: "From the available information in the literature, concluded that there was no convincing evidence to conclude that vitamin C deficiency can be considered to be a cause of<unk> ." The proponents of such hypotheses often question the adequacy of nutrient tissue levels, especially vitamin C, for those children currently or recently ill, bacterial infections, those with higher individual requirements, those suffering from environmental challenges (e.g. allergies), and perhaps transient vaccination-related stresses. At the time of this writing, infantile scurvy in the United States is practically nonexistent. No cases of scurvy mimicking<unk> or sudden infant death syndrome have been reported, and scurvy typically occurs later in infancy, rarely causes death or intracranial bleeding, and is accompanied by other changes of the bones and skin and invariably an unusually deficient dietary history. In one study vaccination was shown not associated with retinal hemorrhages. Gestational problems Gestational problems affecting both mother and fetus, the birthing process, prematurity and nutritional deficits can accelerate skeletal and hemorrhagic pathologies that can also mimic<unk> , even before birth. | Shaken baby syndrome | Neonatal meningitis | Michelin tire baby syndrome | Blue baby syndrome | Neonatal stroke | Omphalitis of newborn | Gray baby syndrome | Neonatal diabetes | 00
| 11,894 |
<unk> is an imaging modality that uses<unk><unk> . | Visible light imaging | Diffuse optical imaging | Optical tomography | Iatrochemistry | Ultrasound biomicroscopy | OCT Biomicroscopy | Spectral imaging | Roentgen stereophotogrammetry | 00
| 70,637 |
Slotted<unk> forceps A<unk> is a surgical clamp with a round eyelet. Also known as a sponge clamp, or sponge stick. Used for atraumatically grasping lung tissue in thoracic surgery. When grasping a surgical sponge in the jaws,<unk> s are commonly used for removing small amounts of fluids from the operative area and applying pressure to sites of bleeding. May also be used for tissue dissection. Invented by David William<unk> of Oklahoma City, Oklahoma, who pioneered sex change operations in the United States. | Foerster clamp | Allis clamp | Pennington clamp | Zavanelli maneuver | Dye tracing | Leopold's maneuvers | Pringle manoeuvre | Tourniquet | 00
| 24,266 |
Malnutrition occurs when an individual gets too few or too many nutrients, resulting in health problems. Specifically, it is "a deficiency, excess, or imbalance of energy, protein and other nutrients" which adversely affects the body's tissues and form. Malnutrition is a category of diseases that includes undernutrition and overnutrition. Undernutrition is a lack of nutrients, which can result in stunted growth, wasting, and underweight. A surplus of nutrients causes overnutrition, which can result in obesity. In some developing countries, overnutrition in the form of obesity is beginning to appear within the same communities as undernutrition. Most clinical studies use the term 'malnutrition' to refer to undernutrition. However, the use of 'malnutrition' instead of 'undernutrition' makes it impossible to distinguish between undernutrition and overnutrition, a less acknowledged form of malnutrition. Accordingly, a 2019 report by The Lancet Commission suggested expanding the definition of malnutrition to include "all its forms, including obesity, undernutrition, and other dietary risks." The World Health Organization and The Lancet Commission have also identified "the double burden of malnutrition," which occurs from "the coexistence of overnutrition (overweight and obesity) alongside undernutrition (stunted growth and wasting)." | complications of Gastroparesis | caption of Plummer–Vinson syndrome | complications of Pyloric stenosis | medical cause of Dysphagia | complications of Peptic ulcer disease | complications of Dysphagia | medical cause of Heartburn | complications of Crohn's disease | 00
| 9,697 |
<unk> (ROB) is a chromosomal abnormality wherein a certain type of a chromosome becomes attached to another. It is the most common form of chromosomal translocation in humans, affecting 1 out of every 1,000 babies born. It does not usually cause health difficulties, but can in some cases result in genetic disorders such as Down syndrome and Patau syndrome.<unk> s result in a reduction in the number of chromosomes. | Robertsonian translocation | Caudal duplication | Trisomy | Germline mosaicism | Postzygotic mutation | Uniparental disomy | Isodisomy | Chromosomal translocation | 00
| 20,290 |
<unk> is a rare inherited condition that has close resemblance clinically to Dowling-Degos' disease, but is histologically distinct, characterized by skin lesions that are 1- to 2-mm slightly keratotic red to dark brown papules which are focally confluent in a reticulate pattern. The disease is also characterized by slowly progressive and disfiguring reticulate hyperpigmentation of the flexures, clinically and histopathologically diagnostic for Dowling-Degos disease but also associated with suprabasal, nondyskeratotic acantholysis. | Galli–Galli disease | Ollier disease | Vogt–Koyanagi–Harada disease | Akureyri disease | TRIANGLE disease | Gaucher's disease | BENTA disease | Hailey–Hailey disease | 00
| 53,770 |
<unk> is a condition characterized by inflammation of the stomach, small intestines, and colon. | Gastroenterocolitis | Enterocolitis | Proctocolitis | Gastroenteritis | Ischemic colitis | Ileitis | Colitis | Enteritis | 00
| 49,951 |
The terms<unk><unk> and<unk><unk> can refer to permanent or temporary changes to human sex organs. Some forms of<unk> alteration are performed on adults with their informed consent at their own behest, usually for aesthetic reasons or to enhance stimulation. However, other forms are performed on people who do not give informed consent, including infants or children. Any of these procedures may be considered<unk> s or<unk> s in different cultural contexts and by different groups of people. | Genital modification and mutilation | Debulking | Hospitalism | Pastoral care | Female infanticide | Cheesewiring | Moulage | Feminization | 00
| 4,878 |
A<unk> is a type of intravenous therapy that has the function of providing<unk> for the circulatory system. It may be used for fluid replacement or during surgery to prevent nausea and vomiting after surgery. | Volume expander | Osmotic dilator | Catheter lock solution | Saline flush | Contrast agent | Diuresis | Iodixanol | Uterotonic | 00
| 49,514 |
Jaundice in adults is rare. Under the five year DISCOVERY programme in the UK, annual incidence of jaundice was 0.74 per 1000 individuals over age 45, although this rate may be slightly inflated due to the main goal of the programme collecting and analyzing cancer data in the population. Jaundice is commonly associated with severity of disease with an incidence of up to 40% of patients requiring intensive care in ICU experiencing jaundice. The causes of jaundice in the intensive care setting is both due to jaundice as the primary reason for ICU stay or as a morbidity to an underlying disease (i.e. sepsis). In the developed world, the most common causes of jaundice are blockage of the bile duct or medication-induced. In the developing world, the most common cause of jaundice is infectious such as viral hepatitis, leptospirosis, schistosomiasis, or malaria. Risk factors Risk factors associated with high serum bilirubin levels include male gender, white ethnicities, and active smoking. Mean serum total bilirubin levels in adults were found to be higher in men (0.72 ± 0.004 mg/dl) than women (0.52 ± 0.003 mg/dl). Higher bilirubin levels in adults are found also in non-Hispanic white population (0.63 ± 0.004 mg/dl) and Mexican American population (0.61 ± 0.005 mg/dl) while lower in non-Hispanic black population (0.55 ± 0.005 mg/dl). Bilirubin levels are higher in active smokers. | symptom of Rotor syndrome | symptoms of Rotor syndrome | symptom of Scheuermann's disease | symptom of Maroteaux–Lamy syndrome | symptom of Prader–Willi syndrome | symptom of Buschke–Ollendorff syndrome | symptom of Andersen–Tawil syndrome | symptom of Williams syndrome | 00
| 4,801 |
A<unk> is a microbicide for<unk> use. Most commonly such a product would be a topical gel inserted into the anus so that it make act as protection against the contract of a sexually transmitted infection during anal sex. Along with vaginal microbicides,<unk> s are currently the subject of medical research on microbicides for sexually transmitted diseases to determine the circumstances under which and the extent to which they provide protection against infection. Less commonly,<unk> s can have other purposes also; for example, they could be used to treat certain medical conditions as a suppository would. | Rectal microbicide | Vaginal microbicide | Heat-based contraception | Contraceptive patch | Long-acting reversible contraception | Contraceptive sponge | Female condom | Flavored condom | 00
| 62,029 |
<unk> , or simply<unk><unk> dysgenesis (ASD), is a failure of the normal development of the tissues of the<unk><unk> of the eye. It leads to anomalies in the structure of the mature<unk><unk> , associated with an increased risk of glaucoma and corneal opacity. Peters (frequently misspelled as Peter's) anomaly is a specific type of<unk> <unk><unk> dysgenesis, in which there is central corneal leukoma, adhesions of the iris and cornea and abnormalities of the posterior corneal stroma, Descemet's membrane, corneal endothelium, lens and<unk> chamber. | Anterior segment mesenchymal dysgenesis | Nasal glial heterotopia | Thyroid dysgenesis | Patulous Eustachian tube | Congenital fourth nerve palsy | Regional odontodysplasia | Persistent thyroglossal duct | Gonadal dysgenesis | 00
| 56,937 |
Stroke is the most common source of<unk> for a<unk><unk><unk> . The stroke for this disorder occurs in the<unk><unk> of the brain. Other etiologies that cause<unk><unk><unk> include: trauma (traumatic brain injury), disease, seizures disorders, and infections. Depending on the etiology that causes the<unk><unk><unk> , different deficits can be accounted for. "The level of deficit or disorder an individual with<unk><unk><unk> displays depends on the location and extent of the<unk> . A small focal<unk><unk> stroke can produce a very specific deficit and leave most other cognitive and perceptual processes intact, whereas a very large stroke in the<unk><unk> more than likely results in multiple profound deficits." Adults with<unk><unk><unk> may exhibit behavior that can be characterized by insensitivity to others and preoccupation with self; unawareness of the social context of conversations; and verbose, rambling and tangential speech. | Right hemisphere brain damage | Frontal lobe injury | symptom of Intracerebral hemorrhage | symptom of Epidural hematoma | Cervical spinal stenosis | symptom of Brain tumor | Basal ganglia disease | symptom of Vertebral artery dissection | 00
| 60,678 |
Screening for an<unk> so that it may be detected and treated prior to rupture is the best way to reduce the overall mortality of the disease. The most cost-efficient screening test is an abdominal aortic ultrasound study. Noting the results of several large, population-based screening trials, the US Centers for Medicare and Medicaid Services (CMS) now provides payment for one ultrasound study in male or female smokers aged 65 years or older ("SAAAVE Act"). | Aortic aneurysm | Thoracic aortic aneurysm | Inflammatory aortic aneurysm | Aortic dissection | Coronary artery aneurysm | Mycotic aneurysm | Aortic rupture | Intracranial aneurysm | 00
| 17,395 |
<unk> can affect males and females as early as 3 years of age. In many cases, the cause is unknown. Some dental professionals believe the inflammation is due to chronic irritation from teeth, fillings, or dental appliances. Stress, poor nutrition, smoking, and alcohol use may also be initiating factors. | Transient lingual papillitis | Vestibular adenitis | Rectovestibular fistula | Nasal vestibulitis | Ophthalmodynia periodica | Vulvar vestibulitis | Vestibular papillomatosis | Salivary gland fistula | 00
| 43,170 |
A<unk> is an antibody which can precipitate out of a solution upon antigen binding. | Precipitin | Antigen | Microantibody | Niquitin | Isoantibodies | M protein | Ferritin | Antibody | 00
| 43,630 |
<unk> (EAC) is a system in orthopaedic trauma surgery aiming to identify serious major trauma patients and treat the most time-critical injuries without adding to their physiological burden. | Early appropriate care | Maximum medical improvement | Barrier nursing | Coordinated diagnostics | Acute Care of at-Risk Newborns | Basic life support | Early goal-directed therapy | Supplemental nursing system | 00
| 66,393 |
<unk> (the human Ether-à-go-go-Related Gene) is a gene () that codes for a protein known as Kv11.1, the alpha subunit of a potassium ion channel. This ion channel (sometimes simply denoted as 'hERG') is best known for its contribution to the electrical activity of the heart: the<unk> channel mediates the repolarizing IKr current in the cardiac action potential, which helps coordinate the heart's beating. When this channel's ability to conduct electrical current across the cell membrane is inhibited or compromised, either by application of drugs or by rare mutations in some families, it can result in a potentially fatal disorder called long QT syndrome. Conversely, genetic mutations that increase the current through these channels can lead to the related inherited heart rhythm disorder Short QT syndrome. A number of clinically successful drugs in the market have had the tendency to inhibit<unk> , lengthening the QT and potentially leading to a fatal irregularity of the heartbeat (a ventricular tachyarrhythmia called torsades de pointes). This has made<unk> inhibition an important antitarget that must be avoided during drug development.<unk> has also been associated with modulating the functions of some cells of the nervous system and with establishing and maintaining cancer-like features in leukemic cells. | HERG | MCN | HER2/neu | MECACAR | AEMT-CC | EPERC | BIM-1 | CoWIN | 00
| 25,881 |
<unk> is a condition defined as a confluence of the breast tissue of both breasts across the intermammary cleft that normally divides them. It can be surgically corrected by a plastic surgeon through<unk> revision.<unk> can either be a congenital anomaly or iatrogenic. Congenital<unk> is a rare condition with few published cases. Iatrogenic<unk> may occur following breast augmentation, forming what is also colloquially referred to as a "uniboob" or "breadloafing" as a result of the release of skin and muscle tissue around the sternum due to over-dissection. | Symmastia | Saddle nose | Pellagra | Hamartia | Anotia | Aspermia | Melanonychia | Focal hyperhidrosis | 00
| 51,629 |
The dose-limiting side effects include tingling or numbness, difficulty sleeping, fatigue, and loss of muscle strength.<unk> can cause seizures, especially but not exclusively when given at high doses and/or in particularly vulnerable individuals who have a history of seizures. | Amifampridine | Secnidazole | Rifampicin | Miproxifene phosphate | Tinidazole | Rifabutin | Azficel-T | Piretanide | 00
| 42,232 |
The exact prevalence of<unk> is unknown. But, about 50 to 80 cases have been reported in literature. Although the occurrence of this disorder is thought to be higher. According to Orphanet, the condition occurs in 1 in 1 million people. The condition affects both males and females equally. | Schinzel–Giedion syndrome | Bardet–Biedl syndrome | Langer–Giedion syndrome | Daentl Townsend Siegel syndrome | Beckwith–Wiedemann syndrome | Letterer–Siwe disease | Prader–Willi syndrome | Weismann-Netter–Stuhl syndrome | 00
| 48,746 |
15% of lung cancers in the US are of this type.<unk> cell lung cancer occurs almost exclusively in smokers – most commonly in heavy smokers and rarely in non-smokers. | Small-cell carcinoma | Adenomatoid tumor | Mucinous carcinoma | Sarcomatoid carcinoma | Spindle cell carcinoma | Signet ring cell carcinoma | Adenosarcoma | Adenocarcinoma | 00
| 19,808 |
An injury to the urethra leaving Buck's fascia intact results in a collection of<unk> <unk> limited to the penis, deep to Buck's fascia. However, if the injury to the bulb of the penis results in urethral injury accompanying a tear of the Buck's fascia, then extravasated blood and<unk> would accumulate in the superficial perineal space, passing into the penis (outer to Buck's fascia) as well as the scrotum and lower anterior abdominal wall.<unk> involving a compromised Buck's fascia can be appreciated clinically by blood collecting in the superficial pouch, resulting in a 'butterfly'-shaped region around the penis. | Extravasation of urine | Bladder outlet obstruction | Ureteral neoplasm | Urinary tract obstruction | Obstructive uropathy | Ureteric stricture | Catheter-associated urinary tract infection | Urethral stricture | 00
| 47,991 |
<unk> is a bariatric surgery performed on patients with morbid obesity to create an irreversible weight loss, when implementing harsh restrictions on the diets have failed. Jejunocolic anastomosis was firstly employed. Nonetheless, it led to some unexpected complications such as severe electrolyte imbalance and liver failure. It was then modified to jejunoileal techniques. Viewed as a novel form of treatment for obesity, many<unk> operations were carried out in the 1960s and 1980s. Significant weight loss was observed in patients, but this surgery also resulted in several complications, for instance, nutritional deficiencies and metabolic problems. Due to the presence of surgical alternatives and anti-obesity medications,<unk> is now rarely used. | Intestinal bypass | Jejunoileal bypass | Ileojejunal bypass | Longitudinal intestinal lengthening and tailoring | Ileal interposition | Partial ileal bypass surgery | Duodenal-jejunal bypass liner | Jejunojejunostomy | 00
| 72,064 |
The overall reaction for the breakdown of glycogen to glucose-1-phosphate is: : glycogen(n residues) + Pi glycogen(n-1 residues) + glucose-1-phosphate Here, glycogen phosphorylase cleaves the bond linking a terminal glucose residue to a glycogen branch by substitution of a phosphoryl group for the α1→4 linkage. Glucose-1-phosphate is converted to glucose-6-phosphate (which often ends up in glycolysis) by the enzyme phosphoglucomutase. Glucose residues are phosphorolysed from branches of glycogen until four residues before a glucose that is branched with a α1→6 linkage. Glycogen debranching enzyme then transfers three of the remaining four glucose units to the end of another glycogen branch. This exposes the α1→6 branching point,α1→6 glucosidase, removing the final glucose residue of the branch as a molecule of glucose and eliminating the branch. This is the only case in which a glycogen metabolite is not glucose-1-phosphate. The glucose is subsequently phosphorylated to glucose-6-phosphate by hexokinase. | Glycogenolysis | Gluconeogenesis | Glyceroneogenesis | Glucose uptake | Proteolysis | Ethanol metabolism | Purine metabolism | Fatty acid metabolism | 00
| 11,313 |
<unk> <unk> , sold under the brand name Estradurin, is an estrogen medication which is used primarily in the treatment of prostate cancer in men. It is also used in women to treat breast cancer, as a component of hormone therapy to treat low estrogen levels and menopausal symptoms, and as a component of feminizing hormone therapy for transgender women. It is given by injection into muscle once every four weeks. Common side effects of<unk> include headache, breast tenderness, breast development, feminization, sexual dysfunction, infertility, and vaginal bleeding.<unk> is a synthetic estrogen and hence is an agonist of the estrogen receptor, the biological target of estrogens like estradiol. It is an estrogen ester in the form of a polymer and is an extremely long-lasting prodrug of estradiol in the body. The time it takes for 50% of a dose of<unk> to be eliminated from the body is more than two months. Because<unk> works by being converted into estradiol, it is considered to be a natural and bioidentical form of estrogen. The safety profile of parenteral estradiol esters like<unk> is greatly improved relative to synthetic oral estrogens like ethinylestradiol and diethylstilbestrol.<unk> was discovered around 1953 and was introduced for medical use in the United States in 1957. Along with estradiol undecylate and estradiol valerate, it has been frequently used in the United States and Europe as a parenteral form of estrogen to treat men with prostate cancer. However, it is no longer available in the United States. | Polyestradiol phosphate | Polyestriol phosphate | Progestogen ester | Androgen ester | Progestogen | Progestogen | Estradiol sulfate | Estrogen ester | 00
| 32,157 |
<unk> refers to the<unk> pertaining to all aspects of<unk> s. The issues examined in the field of<unk> are special cases of clinical research<unk> . | Biobank ethics | Clinical research ethics | Candidate of Medicine | Clinical research associate | Outline of public health | Outline of clinical research | Glossary of clinical research | Patient group directions | 00
| 62,181 |
The exact pathogenesis is not fully elucidated. The hallmark feature is the formation of polyclonal IgG autoantibody against the P antigen, which is a polysaccharide surface antigen on red cells in most humans. As a weak, biphasic antibody, it absorbs to the P antigen in the<unk> temperature as in the periphery in the primary phase, and fixes complement on recirculation to the core temperature in the secondary phase, resulting in intravascular hemolysis. | Paroxysmal cold hemoglobinuria | Paroxysmal nocturnal hemoglobinuria | Hereditary spherocytosis | Mixed autoimmune hemolytic anemia | Congenital hemolytic anemia | Trimethylaminuria | Hemoglobin Lepore syndrome | Hereditary persistence of fetal hemoglobin | 00
| 35,630 |
<unk> s are used in electroretinogram and visual evoked potential recordings to separate the responses originating from the stimulation of different locations in the visual field (and thus different retinal locations). The concept is as follows: Each visual field location is stimulated with a stimulus sequence that is uncorrelated to the sequences used for the other locations. All visual field locations are stimulated in parallel with their individual stimulus sequence. The retinal or cortical activity, which is a mixture of the responses from all visual field locations, is recorded with usual electroretinographic or visual evoked potential methods, respectively. Due to the independence of the stimulus sequences, the responses for each visual field location can be extracted using mathematical algorithms.<unk> s, in particular the<unk> ERG, are used in the diagnosis of ophthalmological diseases. The<unk> was developed in the early 1990s in the laboratory of Erich Sutter at the Smith-Kettlewell Eye Research Institute | Multifocal technique | Computer-assisted surgery | Circumcision surgical procedure | Converse technique | Skin window technique | Seldinger technique | Ashby technique | Up-and-down procedure | 00
| 28,630 |
<unk> , or ptyalism, also known as sialorrhea or hypersialosis is the excessive production of saliva. It has also been defined as increased amount of saliva in the mouth, which may also be caused by decreased clearance of saliva.<unk> can contribute to drooling if there is an inability to keep the mouth closed or difficulty in swallowing (dysphagia) the excess saliva, which can lead to excessive spitting.<unk> also often precedes emesis (vomiting), where it accompanies nausea (a feeling of needing to vomit). | Hypersalivation | Neglect | Counterregulatory eating | Hedonic hunger | Metopism | Accommodative excess | Accommodative insufficiency | Raw foodism | 00
| 39,960 |
<unk> is most likely to occur in adults around 50 years of age. There is a predilection for gender with 60–80% being female. The gland affected has a diffuse swelling. The swelling can be asymptomatic, but mild pain can also be associated. There is a preponderance of this disease in those who suffer from HIV infection. Most cases of<unk> s appear in conjunction with Sjögren's syndrome. When Sjögren's syndrome is present, the swelling is usually bilateral. Otherwise, the affected glands are usually only on one side of the body. In many cases, a biopsy is needed to distinguish<unk> s from sialadenosis (sialosis). | Benign lymphoepithelial lesion | In situ lymphoid neoplasia | Lymphoepithelial lesion | Ectopic salivary gland tissue | Cutaneous sinus of dental origin | Proliferating epidermoid cyst | Melanocytic oral lesion | Fibroepithelial neoplasm | 00
| 33,918 |
Most<unk> s have a reservoir tip or teat end, making it easier to accommodate the man's ejaculate.<unk> s come in different sizes and shapes. They also come in a variety of surfaces intended to stimulate the user's partner.<unk> s are usually supplied with a lubricant coating to facilitate penetration, while flavored<unk> s are principally used for oral sex. As mentioned above, most<unk> s are made of latex, but polyurethane and lambskin<unk> s also exist. Female<unk> A female<unk> Male<unk> s have a tight ring to form a seal around the penis while female<unk> s usually have a large stiff ring to prevent them from slipping into the body orifice. The Female Health Company produced a female<unk> that was initially made of polyurethane, but newer versions are made of nitrile. Medtech Products produces a female<unk> made of latex. Materials Natural latex An unrolled latex<unk> Latex has outstanding elastic properties: Its tensile strength exceeds 30 MPa, and latex<unk> s may be stretched in excess of 800% before breaking. In 1990 the ISO set standards for<unk> production (ISO 4074, Natural latex rubber<unk> s), and the EU followed suit with its CEN standard (Directive 93/42/EEC concerning medical devices). Every latex<unk> is tested for holes with an electric current. If the<unk> passes, it is rolled and packaged. In addition, a portion of each batch of<unk> s is subject to water leak and air burst testing. While the advantages of latex have made it the most popular<unk> material, it does have some drawbacks. Latex<unk> s are damaged when used with oil-based substances as lubricants, such as petroleum jelly, cooking oil, baby oil, mineral oil, skin lotions, suntan lotions, cold creams, butter or margarine. Contact with oil makes latex<unk> s more likely to break or slip off due to loss of elasticity caused by the oils. Additionally, latex allergy precludes use of latex<unk> s and is one of the principal reasons for the use of other materials. In May 2009, the U.S. Food and Drug Administration (FDA) granted approval for the production of<unk> s composed of Vytex, latex that has been treated to remove 90% of the proteins responsible for allergic reactions. An allergen-free<unk> made of synthetic latex (polyisoprene) is also available. Synthetic The most common non-latex<unk> s are made from polyurethane.<unk> s may also be made from other synthetic materials, such as AT-10 resin, and most polyisoprene. Polyurethane<unk> s tend to be the same width and thickness as latex<unk> s, with most polyurethane<unk> s between 0.04 mm and 0.07 mm thick. Polyurethane can be considered better than latex in several ways: it conducts heat better than latex, is not as sensitive to temperature and ultraviolet light (and so has less rigid storage requirements and a longer shelf life), can be used with oil-based lubricants, is less allergenic than latex, and does not have an odor. Polyurethane<unk> s have gained FDA approval for sale in the United States as an effective method of contraception and HIV prevention, and under laboratory conditions have been shown to be just as effective as latex for these purposes. However, polyurethane<unk> s are less elastic than latex ones, and may be more likely to slip or break than latex, lose their shape or bunch up more than latex, and are more expensive. Polyisoprene is a synthetic version of natural rubber latex. While significantly more expensive, it has the advantages of latex (such as being softer and more elastic than polyurethane<unk> s) without the protein which is responsible for latex allergies. Unlike polyurethane<unk> s, they cannot be used with an oil-based lubricant. Lambskin<unk> s made from sheep intestines, labeled "lambskin", are also available. Although they are generally effective as a contraceptive by blocking sperm, it is presumed that they are likely less effective than latex in preventing the transmission of sexually transmitted infections, because of pores in the material. This is based on the idea that intestines, by their nature, are porous, permeable membranes, and while sperm are too large to pass through the pores, viruses — such as HIV, herpes, and genital warts — are small enough to pass. However, there are to date no clinical data confirming or denying this theory. As a result of laboratory data on<unk> porosity, in 1989 the FDA began requiring lambskin<unk> manufacturers to indicate that the products were not to be used for the prevention of sexually transmitted infections. This was based on the presumption that lambskin<unk> s would be less effective than latex in preventing HIV transmission, rather than a conclusion that lambskin<unk> s lack efficacy in STI prevention altogether. An FDA publication in 1992 states that lambskin<unk> s "provide good birth control and a varying degree of protection against some, but not all, sexually transmitted diseases", and that the labelling requirement was decided upon because the FDA "cannot expect people to know which STDs they need to be protected against", and since "the reality is that you don't know what your partner has, we wanted natural-membrane<unk> s to have labels that don't allow the user to assume they're effective against the small viral STDs." Some believe that lambskin<unk> s provide a more "natural" sensation, and they lack the allergens that are inherent to latex, but because of their lesser protection against infection, other hypoallergenic materials such as polyurethane are recommended for latex-allergic users and/or partners. Lambskin<unk> s are also significantly more expensive than other types and as slaughter by-products they are also not vegetarian. Spermicide Some latex<unk> s are lubricated at the manufacturer with a small amount of a nonoxynol-9, a spermicidal chemical. According to Consumer Reports,<unk> s lubricated with spermicide have no additional benefit in preventing pregnancy, have a shorter shelf life, and may cause urinary tract infections in women. In contrast, application of separately packaged spermicide is believed to increase the contraceptive efficacy of<unk> s. Nonoxynol-9 was once believed to offer additional protection against STDs (including HIV) but recent studies have shown that, with frequent use, nonoxynol-9 may increase the risk of HIV transmission. The World Health Organization says that spermicidally lubricated<unk> s should no longer be promoted. However, it recommends using a nonoxynol-9 lubricated<unk> over no<unk> at all. , nine<unk> manufacturers have stopped manufacturing<unk> s with nonoxynol-9 and Planned Parenthood has discontinued the distribution of<unk> s so lubricated. Ribbed and studded A ribbed<unk> Textured<unk> s include studded and ribbed<unk> s which can provide extra sensations to both partners. The studs or ribs can be located on the inside, outside, or both; alternatively, they are located in specific sections to provide directed stimulation to either the G-spot or frenulum. Many textured<unk> s which advertise "mutual pleasure" also are bulb-shaped at the top, to provide extra stimulation to the penis. Some women experience irritation during vaginal intercourse with studded<unk> s. Other The anti-rape<unk> is another variation designed to be worn by women. It is designed to cause pain to the attacker, hopefully allowing the victim a chance to escape. A collection<unk> is used to collect semen for fertility treatments or sperm analysis. These<unk> s are designed to maximize sperm life. Some<unk> -like devices are intended for entertainment only, such as glow-in-the dark<unk> s. These novelty<unk> s may not provide protection against pregnancy and STDs. In February 2022, the U.S. Food and Drug Administration (FDA) approved the first<unk> s specifically indicated to help reduce transmission of sexually transmitted infections (STIs) during anal intercourse. | Condom | Vaginal syringe | Vaginal ring | Macy catheter | Dental dam | Word catheter | Hot water bottle | Antimonial cup | 00
| 476 |
<unk> is the use of osmotically active substances to reduce the volume of intracranial contents.<unk> serves as the primary medical treatment for cerebral edema. The primary purpose of<unk> is to improve elasticity and decrease intracranial volume by removing free water, accumulated as a result of cerebral edema, from brain's extracellular and intracellular space into vascular compartment by creating an osmotic gradient between the blood and brain. Normal serum osmolality ranges from 280-290 mOsm/kg and serum osmolality to cause water removal from brain without much side effects ranges from 300-320 mOsm/kg. Usually, 90 mL of space is created in the intracranial vault by 1.6% reduction in brain water content.<unk> has cerebral dehydrating effects. The main goal of<unk> is to decrease intracranial pressure (ICP) by shifting excess fluid from brain. This is accomplished by intravenous administration of osmotic agents which increase serum osmolality in order to shift excess fluid from intracellular or extracellular space of the brain to intravascular compartment. The resulting brain shrinkage effectively reduces intracranial volume and decreases ICP. | Osmotherapy | Endoscopic third ventriculostomy | Cerebrospinal fluid diversion | Dialysis | Osmotic dilator | Ventriculostomy | Iridodialysis | Acetazolamide | 00
| 39,342 |
Down<unk> is the most common genetic cause of intellectual disability. Among children, the cause of intellectual disability is unknown for one-third to one-half of cases. About 5% of cases are inherited from a person's parents. Genetic defects that cause intellectual disability, but are not inherited, can be caused by accidents or mutations in genetic development. Examples of such accidents are development of an extra chromosome 18 (trisomy 18) and Down<unk> , which is the most common genetic cause. Velocardiofacial<unk> and fetal alcohol spectrum disorders are the two next most common causes. However, there are many other causes. The most common are: * Genetic conditions. Sometimes disability is caused by abnormal genes inherited from parents, errors when genes combine, or other reasons. The most prevalent genetic conditions include Down<unk> , Klinefelter<unk> , Fragile X<unk> (common among boys), neurofibromatosis, congenital hypothyroidism,<unk><unk> , phenylketonuria (PKU), and Prader–Willi<unk> . Other genetic conditions include Phelan-McDermid<unk> (22q13del), Mowat–Wilson<unk> , genetic ciliopathy, and Siderius type X-linked intellectual disability () as caused by mutations in the PHF8 gene (). In the rarest of cases, abnormalities with the X or Y chromosome may also cause disability. Tetrasomy X and pentasomy X<unk> affect a small number of girls worldwide, while boys may be affected by 49, XXXXY, or 49, XYYYY. 47, XYY is not associated with significantly lowered IQ though affected individuals may have slightly lower IQs than non-affected siblings on average. * Problems during pregnancy. Intellectual disability can result when the fetus does not develop properly. For example, there may be a problem with the way the fetus's cells divide as it grows. A pregnant woman who drinks alcohol (see fetal alcohol spectrum disorder) or gets an infection like rubella during pregnancy may also have a baby with an intellectual disability. * Problems at birth. If a baby has problems during labor and birth, such as not getting enough oxygen, he or she may have a developmental disability due to brain damage. * Exposure to certain types of disease or toxins. Diseases like whooping cough, measles, or meningitis can cause intellectual disability if medical care is delayed or inadequate. Exposure to poisons like lead or mercury may also affect mental ability. * Iodine deficiency, affecting approximately 2 billion people worldwide, is the leading preventable cause of intellectual disability in areas of the developing world where iodine deficiency is endemic. Iodine deficiency also causes goiter, an enlargement of the thyroid gland. More common than full-fledged cretinism, as intellectual disability caused by severe iodine deficiency is called, is mild impairment of intelligence. Residents of certain areas of the world, due to natural deficiency and governmental inaction, are severely affected by iodine deficiency. India has 500 million suffering from deficiency, 54 million from goiter, and 2 million from cretinism. Among other nations affected by iodine deficiency, China and Kazakhstan have instituted widespread salt iodization programs. But, as of 2006, Russia had not. * Malnutrition is a common cause of reduced intelligence in parts of the world affected by famine, such as Ethiopia and nations struggling with extended periods of warfare that disrupt agriculture production and distribution. * Absence of the arcuate fasciculus. | symptom of Williams syndrome | symptom of Angelman syndrome | symptom of Rotor syndrome | symptom of Fragile X syndrome | symptom of Buschke–Ollendorff syndrome | symptom of Kallmann syndrome | symptom of Botulism | symptom of Spinocerebellar ataxia type 1 | 00
| 50,930 |
<unk> is the common name of autosomal recessive oral-facial-digital syndrome type III, one of ten distinct genetic disorders that involve developmental defects to the mouth. Alternative names for this condition include: Brachydactyly of the hands and feet with duplication of the first toes,<unk> brachydactyly and Brachydactyly with major proximal phalangeal shortening. | Sugarman syndrome | Mungan syndrome | Noonan syndrome | Christianson syndrome | Galloway Mowat syndrome | Avellis syndrome | Griscelli syndrome | Leschke syndrome | 00
| 31,249 |
Alveoli are the primary structure affected by<unk> . Any particles that are smaller than 5 microns can enter the alveoli of the lungs. These tiny air sacs facilitate the passage of oxygen from inhaled air to the bloodstream. In the case of<unk> , it is more difficult for this exchange of oxygen to occur since irritants have caused inflammation of the alveoli. Due to the lack of a definitive determination of a single irritant causing<unk> , there are several possible causes. *Viral infection. Measles can cause severe<unk> , and ribavirin has been proposed as a possible treatment. CMV is another cause. *Pneumonia * Radiation therapy * Inhaling chemicals, such as sodium hydroxide *Interstitial lung disease *Sepsis * Adverse reaction to medications * Hypersensitivity to inhaled agents * Inhalation of spores of some species of mushroom (bronchoalveolar allergic syndrome) *Mercury exposure *Smoking * Overexposure to chlorine *Bronchial obstruction (obstructive<unk> or post-obstructive<unk> *Ascariasis (during parasite migration) * Aspirin overdose, some antibiotics, and chemotherapy drugs * “Farmer’s lung” and “hot tub lung” are common names for types of hypersensitivity<unk> that result from exposure to some types of thermophilic actinomyces, mycobacteria and molds. * Avian proteins in bird feces and feathers * Whole body or chest radiation therapy used for cancer treatment | Pneumonitis | Bronchitis | Pneumonia | Croup | Hydrothorax | Bronchopneumonia | Bronchorrhea | Tracheitis | 00
| 29,017 |
Visible light can be seen by the naked eye (and thus forms images that people can look at), but it does not penetrate most objects (only translucent ones). In contrast, X-rays can penetrate a wider variety of objects (such as the human body), but they are invisible to the naked eye. To take advantage of the penetration for image-forming purposes, one must somehow convert the X-rays' intensity variations (which correspond to material contrast and thus image contrast) into a form that is visible. Classic film-based radiography achieves this by the variable chemical changes that the X-rays induce in the film, and classic<unk> achieves it by<unk> scence, in which certain materials convert X-ray energy (or other parts of the spectrum) into visible light. This use of<unk> scent materials to make a viewing scope is how<unk> got its name. As the X-rays pass through the patient, they are attenuated by varying amounts as they pass through or reflect off the different tissues of the body, casting an X-ray shadow of the radiopaque tissues (such as bone tissue) on the<unk> scent screen. Images on the screen are produced as the unattenuated or mildly attenuated X-rays from radiolucent tissues interact with atoms in the screen through the photoelectric effect, giving their energy to the electrons. While much of the energy given to the electrons is dissipated as heat, a fraction of it is given off as visible light. Early radiologists would adapt their eyes to view the dim<unk> c images by sitting in darkened rooms, or by wearing red adaptation goggles. After the development of X-ray image intensifiers, the images were bright enough to see without goggles under normal ambient light. Nowadays, in all forms of digital X-ray imaging (radiography,<unk> , and CT) the conversion of X-ray energy into visible light can be achieved by the same types of electronic sensors, such as flat panel detectors, which convert the X-ray energy into electrical signals, small bursts of current that convey information that a computer can analyze, store, and output as images. As<unk> scence is a special case of luminescence, digital X-ray imaging is conceptually similar to digital gamma ray imaging (scintigraphy, SPECT, and PET) in that in both of these imaging mode families, the information conveyed by the variable attenuation of invisible electromagnetic radiation as it passes through tissues with various radiodensities is converted by an electronic sensor into an electric signal that is processed by a computer and made output as a visible-light image. | Fluoroscopy | Frozen pelvis | Radiography | Scintigraphy | Palpation | Exploratory surgery | Contrast CT | Volume CT | 00
| 12,418 |
<unk> is an antiseizure drug chemically classified as a sulfonamide and unrelated to other antiseizure agents. The precise mechanism by which<unk> exerts its antiseizure effect is unknown, although it is believed that the drug blocks sodium and T-type calcium channels, which leads to the suppression of neuronal hypersynchronization (that is, seizure-form activity). It is also known to be a weak carbonic anhydrase inhibitor (similarly to the anticonvulsant topiramate). It is also known to modulate GABAergic and glutamatergic neurotransmission. | Zonisamide | Galantamine | Mesuximide | Ethosuximide | Phenytoin | Propazepine | Levetiracetam | Carbamazepine | 00
| 27,507 |
Of all breast tissue samples taken,<unk> s comprise about 50%, and this rate rises to 75% for tissue sample in women under the age of 20 years.<unk> s are more frequent among women in higher socioeconomic classes and darker-skinned people. Body mass index and the number of full-term pregnancies were found to have a negative correlation with the risk of<unk> s. There are no known genetic<unk> ctors that influence the rate of<unk> s. The rate of occurrence of<unk> s in women have been reported in literature to range from 7% to 13%. | Fibroadenoma | Phyllodes tumor | Intraductal papilloma | Ductal carcinoma in situ | Carcinoma ex pleomorphic adenoma | Invasive lobular carcinoma | Atypical ductal hyperplasia | Lobular carcinoma in situ | 00
| 24,628 |
The<unk> <unk> is the volume in the lungs at which its smallest airways, the respiratory bronchioles, collapse. It is defined mathematically as the sum of the<unk> volume and the residual volume. The alveoli lack supporting cartilage and so depend on other factors to keep them open. The<unk> is less than the Functional Residual<unk> , the amount of gas that normally remains in the lungs during respiration This means that there is normally enough air within the lungs to keep these airways open throughout both inhalation and exhalation. As the lungs age, there is a gradual increase in the<unk> (i.e. The small airways begin to collapse at a higher volume/before expiration is complete). This also occurs with certain disease processes, such as asthma, chronic obstructive pulmonary disease, and pulmonary edema. Any process that increases the<unk> by increasing the<unk> volume (CV) can increase an individual's risk of hypoxemia, as the small airways may collapse during exhalation, leading to air trapping and atelectasis. A mnemonic for factors increasing<unk> is ACLS-S: Age, Chronic bronchitis, LV failure, Smoking, Surgery. Alternatively, CLOSE: Cigarettes, LV failure, Old age, Surgery, Emphysema (& asthma). Often supine positioning will decrease functional residual<unk> (FRC) but has no effect on<unk> . | Closing capacity | Contrast resolution | Parafunctional activity | Diffusing capacity | Efficiency of food conversion | Pain tolerance | Mechanical properties of biomaterials | Diastolic function | 00
| 46,765 |
Signs and symptoms of hypovolemia progress with increased loss of fluid volume. Early symptoms of hypovolemia include headache, fatigue, weakness, thirst, and dizziness. The more severe signs and symptoms are often associated with hypovolemic shock. These include oliguria, cyanosis, abdominal and chest pain, hypotension, tachycardia, cold hands and feet, and progressively altering mental status. | complications of Hypoalbuminemia | complications of Acute liver failure | complications of Kidney disease | complications of Hemolytic–uremic syndrome | complications of HELLP syndrome | medical cause of Hyperphosphatemia | complications of Rhabdomyolysis | complications of Vasculitis | 00
| 13,345 |
<unk> is a public health term which refers to the health intervention given to a client's intimate<unk> s when a client goes to a health care provider requesting health care.<unk> notification is a type of<unk> wherein if someone has a contagious disease, the health care provider finding the problem will try to notify that person's<unk> s that they have been exposed to infection. It is a form of contact tracing.<unk> are important because in some cases a person's health problems are partially caused or sustained by other people. A common example would be that a person visits a doctor because he has an infectious disease. If that disease is also contagious, then that person's close associates may also have the disease. If a physician were to only treat the person who initially requests treatment, then the disease may remain in the community. Instead, principles of<unk> dictate that health care should treat all members of a group which transmits infection. | Partner services | Pharmacare | Charity care | Cancer insurance | Personal medicine | Pharmacy | Pharmacy | Outline of medicine | 00
| 61,319 |
<unk> refers to a congenital<unk> defect of one of the septa of the<unk> . * Atrial septal defect * Atrioventricular septal defect * Ventricular septal defect Although aortopulmonary septal defects are defects of the aorticopulmonary septum, which is not technically part of the<unk> , they are sometimes grouped with the<unk> s. | Heart septal defect | Aortopulmonary septal defect | Atrial septal defect | Ventricular septal defect | Pulmonary atresia | Pulmonary artery sling | Double aortic arch | Atrioventricular septal defect | 00
| 53,565 |
Cancer-associated retinopathy A division of AIR, cancer-associated retinopathy is a paraneoplastic syndrome, which is a disorder caused by an immune system response to an abnormality. Autoimmune antibodies target proteins in retinal photoreceptor cells. The proteins targeted as antigenic are recoverin, α‐enolase and transducin. This autoimmune response leads to photoreceptor cell death. It causes progressive vision loss that can lead to blindness. CAR is typically associated with the anti-recoverin antibody. Melanoma-associated retinopathy Retinal bipolar cells (cells in retina that transmit signals) react with the antibodies, leading to cell death. Although it is less prevalent than CAR, diagnosed cases of MAR continue to increase while CAR numbers decrease. | Autoimmune retinopathy | Diabetic retinopathy | Autoimmune optic neuropathy | Hypertensive retinopathy | Retinal vasculitis | Toxic and nutritional optic neuropathy | Radiation retinopathy | Photic retinopathy | 00
| 66,910 |
<unk> (from , , ; and , , ), also known as scribomania, is an obsessive impulse to write. When used in a specific psychiatric context, it labels a morbid mental condition which results in writing rambling and confused statements, often degenerating into a meaningless succession of words or even nonsense then called graphorrhea (see hypergraphia). The term<unk> " was used in the early 19th century by Esquirol and later by Eugen Bleuler, becoming more or less common.<unk> is related to typomania, which is obsessiveness with seeing one's name in publication or with writing for being published, excessive symbolism or typology. Outside the psychiatric definitions of<unk> and related conditions, the word is used more broadly to label the urge and need to write excessively, professionally or not. Max Nordau, in his attack of what he saw as degenerate art, frequently used the term<unk> " to label the production of the artists he condemned (most notably Richard Wagner or the French symbolist poets). Milan Kundera, in The Book of Laughter and Forgetting (1979), explains proliferation of non-professional writing as follows: Czesław Miłosz--winner of the Nobel Prize for Literature in 1980--used the term<unk> " in a context much different than Kundera's. In The Captive Mind (1951), Miłosz wrote that the typical writer in the Eastern Bloc who accepted socialist realism "believes that the by-ways of 'philosophizing' lead to a greater or lesser degree of<unk> . Anyone gripped in the claws of dialectics the philosophy of dialectical materialism is forced to admit that the thinking of private philosophers, unsupported by citations failing to regurgigate Stalinist propaganda, is sheer nonsense." | Graphomania | Distichia | Klazomania | Onychotillomania | Potomania | Amenomania | Amaurosis | Machiavellianism | 00
| 44,694 |
Most people with this condition die when they reach their fifties or sixties, with the median age of death being 58. They usually die due to complications from pneumonia, diarrhea, and strokes. | Familial Danish dementia | Familial British dementia | CADASIL | Canavan disease | Synucleinopathy | Menkes disease | Familial amyloid polyneuropathy | Sandhoff disease | 00
| 74,626 |
Although there are no specific symptoms for this condition, common complains include progressively increasing pelvic pain during menstruation and hematocolpos due to the buildup of blood in the body. Other symptoms may include swelling of the abdomen, nausea and vomiting during menstruation, and pelvic pain. Fertility may also be affected. The condition often leads to an increased need for C-sections due to the smaller uteruses. | OHVIRA | DRACO | PATH | IOMAI | TOFI | DKMS | CAPOX | MOSQUITO | 00
| 69,690 |
Diagnosis of an IgE-mediated<unk> is based on the person's history of allergic reactions, skin prick test (SPT), patch test and measurement of<unk> protein specific serum immunoglobulin E (IgE or sIgE). A negative IgE test does not rule out non-IgE mediated allergy, which is also described as cell-mediated allergy. SPT and sIgE have sensitivities of 55% and 83%, respectively, and specificities of 68% and 38%. These numbers mean that either test may miss diagnosing an existing<unk> , that both could be positive for other food allergens, and that the tests have wide variability leading to a false-positive outcome of 30%. Confirmation is by double-blind, placebo-controlled food challenges, conducted by an allergy specialist. A diagnostic laboratory test is not available for non-IgE-mediated allergies, reflecting the obscure pathophysiology of these conditions. Instead, a person's history of symptoms is studied, and if the symptoms cease with the removal of<unk> , the diagnosis is made. | Soy allergy | Milk allergy | Peanut allergy | Corn allergy | Egg allergy | Poultry allergy | Fruit allergy | Sesame allergy | 00
| 32,054 |
There is no specific treatment for infectious mononucleosis, other than treating the symptoms. In severe cases, steroids such as corticosteroids may be used to control the swelling of the throat and tonsils. Currently, there are no antiviral drugs or vaccines available. It is important to note that symptoms related to infectious mononucleosis caused by EBV infection seldom last for more than 4 months. When such an illness lasts more than 6 months, it is frequently called chronic EBV infection. However, valid laboratory evidence for continued active EBV infection is seldom found in these patients. The illness should be investigated further to determine if it meets the criteria for chronic fatigue syndrome, or CFS. This process includes ruling out other causes of chronic illness or fatigue. | Epstein–Barr virus infection | Human papillomavirus infection | HIV superinfection | Social history of viruses | Tobacco smoking | Living with COVID-19 | Hepatitis C and HIV coinfection | Nipah virus infection | 00
| 54,047 |
A typical case of<unk> ; absence of lactobacilli, presence of para basal epithelial cells, and pus cells. Gram-positive cocci and Gram-negative bacilli are also present. (Gram stain) The diagnosis is based on microscopic criteria. Ideally, phase-contrast microscopy is used with a magnification of 400x (high-power field) or by Gram stain. For scoring purposes, along with relative number of leucocytes, percentage of toxic leucocytes, background flora and proportion of epitheliocytes, lactobacillary grade must be evaluated: ;grade I :numerous pleiomorphic lactobacilli; no other bacteria ;grade IIa :mixed flora, but predominantly lactobacilli ;grade IIb :mixed flora, but proportion of lactobacilli severely decreased because of an increased number of other bacteria ;grade III :lactobacilli severely depressed or absent because of overgrowth of other bacteria AV score Lactobacillary grades Number of leukocytes Proportion of toxic leucocytes Background flora Proportion of parabasal epitheliocytes 0 I and IIa 10/hpf and; 10/epithelial cell >50% of leukocytes Cocci or chains >10% The "AV score" is calculated according to what is described in the table. * AV score <3: no signs of AV * AV score 3 or 4: light AV * AV score 5 or 6: moderate AV * AV score ≥7:severe AV. pH measurement alone is not enough for the diagnosis. | Aerobic vaginitis | Atrophic vaginitis | Rhinorrhea | Logorrhea | Bacterial vaginosis | Creatorrhea | Leukorrhea | Gonorrhea | 00
| 68,710 |
The diagnosis is based on symptoms. Other conditions that may present similarly include vestibular disorders such as benign paroxysmal positional vertigo and vestibular migraine and stroke. | Motion sickness | Stroke | Sweating sickness | Benign paroxysmal positional vertigo | Ski sickness | Migraine-associated vertigo | Foreign accent syndrome | Morning sickness | 00
| 4,422 |
<unk> <unk> is an inflammatory disease that can involve the heart, joints, skin, and brain. The disease typically develops two to four weeks after a streptococcal throat infection. Signs and symptoms include fever, multiple painful joints, involuntary muscle movements, and occasionally a characteristic non-itchy rash known as erythema marginatum. The heart is involved in about half of the cases. Damage to the heart valves, known as<unk> heart disease (RHD), usually occurs after repeated attacks but can sometimes occur after one. The damaged valves may result in heart failure, atrial fibrillation and infection of the valves.<unk> may occur following an infection of the throat by the bacterium Streptococcus pyogenes. If the infection is left untreated,<unk> occurs in up to three percent of people. The underlying mechanism is believed to involve the production of antibodies against a person's own tissues. Due to their genetics, some people are more likely to get the disease when exposed to the bacteria than others. Other risk factors include malnutrition and poverty. Diagnosis of<unk> is often based on the presence of signs and symptoms in combination with evidence of a recent streptococcal infection. Treating people who have strep throat with antibiotics, such as penicillin, decreases the risk of developing<unk> . In order to avoid antibiotic misuse this often involves testing people with sore throats for the infection; however, testing might not be available in the developing world. Other preventive measures include improved sanitation. In those with<unk> and<unk> heart disease, prolonged periods of antibiotics are sometimes recommended. Gradual return to normal activities may occur following an attack. Once RHD develops, treatment is more difficult. Occasionally valve replacement surgery or valve repair is required. Otherwise complications are treated as usual.<unk> occurs in about 325,000 children each year and about 33.4 million people currently have<unk> heart disease. Those who develop<unk> are most often between the ages of 5 and 14, with 20% of first-time attacks occurring in adults. The disease is most common in the developing world and among indigenous peoples in the developed world. In 2015 it resulted in 319,400 deaths down from 374,000 deaths in 1990. Most deaths occur in the developing world where as many as 12.5% of people affected may die each year. Descriptions of the condition are believed to date back to at least the 5th century BCE in the writings of Hippocrates. The disease is so named because its symptoms are similar to those of some<unk> disorders. | Rheumatic fever | Quartan fever | Lyme disease | Pontiac fever | Haverhill fever | Cotton fever | Typhoid fever | Scarlet fever | 00
| 12,143 |
<unk> is the congenital absence or complete closure of a portion of the lumen of the duodenum. It causes increased levels of amniotic fluid during pregnancy (polyhydramnios) and intestinal obstruction in newborn babies. Newborns present with bilious or non-bilous vomiting (depending on where in the duodenum the obstruction is) within the first 24 to 48 hours after birth, typically after their first oral feeding. Radiography shows a distended stomach and distended duodenum, which are separated by the pyloric valve, a finding described as the double-bubble sign. Treatment includes suctioning out any fluid that is trapped in the stomach, providing fluids intravenously, and surgical repair of the intestinal closure. | Duodenal atresia | Annular pancreas | Intestinal atresia | Gastric atresia | Choanal atresia | Familial multiple intestinal atresia | Gastroschisis | Situs inversus | 00
| 43,676 |
<unk> are the mixture of stem<unk> that can be obtained from the<unk> fluid as well as the<unk> membrane. They can develop into various tissue types including skin, cartilage, cardiac tissue, nerves, muscle, and bone. The<unk> also have potential medical applications, especially in organ regeneration. The stem<unk> are usually extracted from the<unk> sac by amniocentesis which occurs without harming the embryos. The use of<unk> fluid stem<unk> is therefore generally considered to lack the ethical problems associated with the use of<unk> from embryos. In 2009, the first US<unk> bank was opened in Medford, MA, by Biocell Center, an international company specializing in the cryopreservation and private banking of<unk> fluid stem<unk> . | Amniotic stem cells | Neural stem cell | Embryoid body | Progenitor cell | Extravillous trophoblast | Syncytiotrophoblast | Cytotrophoblast | Hemangioblast | 00
| 55,594 |
A flow chart of two theories of self-harm Self-harm is not typically suicidal behavior, although there is the possibility that a self-inflicted injury may result in life-threatening damage. Although the person may not recognise the connection, self-harm often becomes a response to profound and overwhelming emotional pain that cannot be resolved in a more functional way. The motivations for self-harm vary, as it may be used to fulfill a number of different functions. These functions include self-harm being used as a coping mechanism which provides temporary relief of intense feelings such as anxiety, depression, stress, emotional numbness and a sense of failure or self-loathing. There is also a positive statistical correlation between self-harm and emotional abuse. Self-harm may become a means of managing and controlling pain, in contrast to the pain experienced earlier in the person's life over which they had no control (e.g., through abuse). Other motives for self-harm do not fit into medicalized models of behavior and may seem incomprehensible to others, as demonstrated by this quotation: "My motivations for self-harming were diverse, but included examining the interior of my arms for hydraulic lines. This may sound strange." Assessment of motives in a medical setting is usually based on precursors to the incident, circumstances, and information from the patient. However, limited studies show that professional assessments tend to suggest more manipulative or punitive motives than personal assessments. A UK Office for National Statistics study reported only two motives: "to draw attention" and "because of anger". For some people, harming themselves can be a means of drawing attention to the need for help and to ask for assistance in an indirect way. It may also be an attempt to affect others and to manipulate them in some way emotionally. However, those with chronic, repetitive self-harm often do not want attention and hide their scars carefully. Many people who self-harm state that it allows them to "go away" or dissociate, separating the mind from feelings that are causing anguish. This may be achieved by tricking the mind into believing that the present suffering being felt is caused by the self-harm instead of the issues they were facing previously: the physical pain therefore acts as a distraction from the original emotional pain. To complement this theory, one can consider the need to "stop" feeling emotional pain and mental agitation. "A person may be hyper-sensitive and overwhelmed; a great many thoughts may be revolving within their mind, and they may either become triggered or could make a decision to stop the overwhelming feelings." Alternatively, self-harm may be a means of feeling something, even if the sensation is unpleasant and painful. Those who self-harm sometimes describe feelings of emptiness or numbness (anhedonia), and physical pain may be a relief from these feelings. "A person may be detached from themselves, detached from life, numb and unfeeling. They may then recognise the need to function more, or have a desire to feel real again, and a decision is made to create sensation and 'wake up'." Those who engage in self-harm face the contradictory reality of harming themselves while at the same time obtaining relief from this act. It may even be hard for some to actually initiate cutting, but they often do because they know the relief that will follow. For some self-harmers this relief is primarily psychological while for others this feeling of relief comes from the beta endorphins released in the brain. Endorphins are endogenous opioids that are released in response to physical injury, acting as natural painkillers and inducing pleasant feelings, and in response to self-harm would act to reduce tension and emotional distress. Many self-harmers report feeling very little to no pain while self-harming and, for some, deliberate self-harm may become a means of seeking pleasure. As a coping mechanism, self-harm can become psychologically addictive because, to the self-harmer, it works; it enables them to deal with intense stress in the current moment. The patterns sometimes created by it, such as specific time intervals between acts of self-harm, can also create a behavioral pattern that can result in a wanting or craving to fulfill thoughts of self-harm. Autonomic nervous system Emotional pain activates the same regions of the brain as physical pain, so emotional stress can be a significantly intolerable state for some people. Some of this is environmental and some of this is due to physiological differences in responding. The autonomic nervous system is composed of two components: the sympathetic nervous system controls arousal and physical activation (e.g., the fight-or-flight response) and the parasympathetic nervous system controls physical processes that are automatic (e.g., saliva production). The sympathetic nervous system innervates (e.g., is physically connected to and regulates) many parts of the body involved in stress responses. Studies of adolescents have shown that adolescents who self-injure have greater physiological reactivity (e.g., skin conductance) to stress than adolescents who do not self-injure. This stress response persists over time, staying constant or even increasing in self-injuring adolescents, but gradually decreases in adolescents who do not self-injure. | complications of Panic attack | medical cause of Panic attack | medical cause of Insomnia | symptom of Panic attack | complications of Heat stroke | medical cause of Lightheadedness | symptom of Delirium tremens | complications of Trigeminal neuralgia | 00
| 6,404 |
<unk> (RALD) is a rare genetic<unk> of the immune system. RALD is characterized by lymphadenopathy, splenomegaly,<unk> ty, and elevation in granulocytes and monocytes. It shares many features with<unk> lymphoproliferative syndrome and is caused by somatic mutations in NRAS or KRAS. This was first described by investigators João Oliveira and Michael Lenardo from the National Institutes of Health. | RAS-associated autoimmune leukoproliferative disorder | Thymoma-associated multiorgan autoimmunity | Fibrin-associated diffuse large B-cell lymphoma | ALK+ large B-cell lymphoma | Autoimmune lymphoproliferative syndrome | Epstein–Barr virus–associated lymphoproliferative diseases | X-linked lymphoproliferative disease | Nodal marginal zone B cell lymphoma | 00
| 65,890 |
<unk> refers to an alteration of the color of the skin or nails. "Hyperchromia" can refer to hyperpigmentation, and "hypochromia" can refer to hypopigmentation. "Dyschromatoses" involve both hyperpigmented and hypopigmented macules. __TOC__ | Dyschromia | Hyperpigmentation | Hypopigmentation | Xanthosis | Polychromasia | Hyperkeratinization | Xanthochromia | Hypertrichosis | 00
| 55,177 |
<unk> s typically last from 5 to 12 days and may be treated in the same way as other bruises. Ways to reduce the appearance of<unk> s include icing recent<unk> s to reduce swelling, rubbing them with a chilled spoon to remove the bruise, and applying a warm compress to older<unk> s to dilate vessels and promote blood flow. They can be covered with a concealer or powder corresponding to the sufferer's skin tone, or a fake tan. Alternatively, articles of clothing such as scarves, snoods, turtle necks, or sleeves may be used to conceal<unk> s. | Hickey | Litter | Juice | Sniffle | Tick | Mulberry molar | Word salad | Tablet | 00
| 60,003 |
<unk> or preseptal cellulitis (not to be confused with orbital cellulitis, which is posterior to the orbital septum), is an inflammation and infection of the eyelid and portions of skin around the eye anterior to the orbital septum. It may be caused by breaks in the skin around the eye, and subsequent spread to the eyelid; infection of the sinuses around the nose (sinusitis); or from spread of an infection elsewhere through the blood. | Periorbital cellulitis | Chalazion | Orbital cellulitis | Sympathetic ophthalmia | Blepharitis | Corneal ulcer | Periorbital dermatitis | Orbital lymphoma | 00
| 40,183 |
<unk> is a COVID-19 candidate nanoparticle vaccine under development by Icosavax currently undergoing a Phase I/II clinical trial in Australia. It was originally developed at the Institute of Protein Design (IPD) and the University of Washington School of Medicine, both based at the University of Washington. | IVX-411 | VIR-576 | VISTA | MPI-CDG | TA-CD | OSU-6162 | STAR*D | Pro-ana | 00
| 74,713 |
<unk> is essential for all animal life, with each cell capable of synthesizing it by way of a complex 37-step process. This begins with the mevalonate or HMG-CoA reductase pathway, the target of statin drugs, which encompasses the first 18 steps. This is followed by 19 additional steps to convert the resulting lanosterol into<unk> . A human male weighing 68 kg (150 lb) normally synthesizes about 1 gram (1,000 mg) of<unk> per day, and his body contains about 35 g, mostly contained within the cell membranes. Typical daily<unk> dietary intake for a man in the United States is 307 mg. Most ingested<unk> is esterified, which causes it to be poorly absorbed by the gut. The body also compensates for absorption of ingested<unk> by reducing its own<unk> synthesis. For these reasons,<unk> in food, seven to ten hours after ingestion, has little, if any effect on concentrations of<unk> in the blood. However, during the first seven hours after ingestion of<unk> , as absorbed fats are being distributed around the body within extracellular water by the various lipoproteins (which transport all fats in the water outside cells), the concentrations increase. Plants make<unk> in very small amounts. In larger quantities they produce phytosterols, chemically similar substances which can compete with<unk> for reabsorption in the intestinal tract, thus potentially reducing<unk> reabsorption. When intestinal lining cells absorb phytosterols, in place of<unk> , they usually excrete the phytosterol molecules back into the GI tract, an important protective mechanism. The intake of naturally occurring phytosterols, which encompass plant sterols and stanols, ranges between ≈200–300 mg/day depending on eating habits. Specially designed vegetarian experimental diets have been produced yielding upwards of 700 mg/day. Function in cells Membranes<unk> composes about 30% of all animal cell membranes. It is required to build and maintain membranes and modulates membrane fluidity over the range of physiological temperatures. The hydroxyl group of each<unk> molecule interacts with water molecules surrounding the membrane, as do the polar heads of the membrane phospholipids and sphingolipids, while the bulky steroid and the hydrocarbon chain are embedded in the membrane, alongside the nonpolar fatty-acid chain of the other lipids. Through the interaction with the phospholipid fatty-acid chains,<unk> increases membrane packing, which both alters membrane fluidity and maintains membrane integrity so that animal cells do not need to build cell walls (like plants and most bacteria). The membrane remains stable and durable without being rigid, allowing animal cells to change shape and animals to move. The structure of the tetracyclic ring of<unk> contributes to the fluidity of the cell membrane, as the molecule is in a trans conformation making all but the side chain of<unk> rigid and planar. In this structural role,<unk> also reduces the permeability of the plasma membrane to neutral solutes, hydrogen ions, and sodium ions. Substrate presentation<unk> regulates the biological process of substrate presentation and the enzymes that use substrate presentation as a mechanism of their activation. (PLD2) is a well-defined example of an enzyme activated by substrate presentation. The enzyme is palmitoylated causing the enzyme to traffic to<unk> dependent lipid domains sometimes called "lipid rafts". The substrate of phospholipase D is phosphatidylcholine <unk> which is unsaturated and is of low abundance in lipid rafts.<unk> localizes to the disordered region of the cell along with the polyunsaturated lipid phosphatidylinositol 4,5-bisphosphate (PIP2). PLD2 has a PIP2 binding domain. When PIP2 concentration in the membrane increases, PLD2 leaves the<unk> dependent domains and binds to PIP2 where it then gains access to its substrate<unk> and commences catalysis based on substrate presentation. Substrate presentation; PLD (blue oval) is sequestered into<unk> -dependent lipid domains (green lipids) by palmitoylation. PLD also binds PIP2(red hexagon) domains (grey shading) located in the disordered region of the cell with phosphatidylcholine <unk> . When<unk> decreases or PIP2 increases in the cell, PLD translocates to PIP2 where it is exposed to and hydrolizes<unk> to phosphatidic acid (red spherical lipid). Signaling<unk> is also implicated in cell signaling processes, assisting in the formation of lipid rafts in the plasma membrane, which brings receptor proteins in<unk> ose proximity with high concentrations of second messenger molecules. In multiple layers,<unk> and phospholipids, both electrical insulators, can facilitate speed of transmission of electrical impulses along nerve tissue. For many neuron fibers, a myelin sheath, rich in<unk> since it is derived from compacted layers of Schwann cell membrane, provides insulation for more efficient conduction of impulses. Demyelination (loss of some of these Schwann cells) is believed to be part of the basis for multiple sclerosis.<unk> binds to and affects the gating of a number of ion channels such as the nicotinic acetylcholine receptor, GABAA receptor, and the inward-rectifier potassium channel.<unk> also activates the estrogen-related receptor alpha (ERRα), and may be the endogenous ligand for the receptor. The constitutively active nature of the receptor may be explained by the fact that<unk> is ubiquitous in the body. Inhibition of ERRα signaling by reduction of<unk> production has been identified as a key mediator of the effects of statins and bisphosphonates on bone, muscle, and macrophages. On the basis of these findings, it has been suggested that the ERRα should be de-orphanized and<unk> assified as a receptor for<unk> . Chemical precursor Within cells,<unk> is also a precursor molecule for several biochemical pathways. For example, it is the precursor molecule for the synthesis of vitamin D in the calcium metabolism and all steroid hormones, including the adrenal gland hormones cortisol and aldosterone, as well as the sex hormones progesterone, estrogens, and testosterone, and their derivatives. Metabolism<unk> is recycled in the body. The liver excretes<unk> into biliary fluids, which are then stored in the gallbladder, which then excretes them in a non-esterified form (via bile) into the digestive tract. Typically, about 50% of the excreted<unk> is reabsorbed by the small intestine back into the bloodstream. | Cholesterol | Lipoprotein | Oxycholesterol | Glycogen | Phytosterol | Saturated fat | Protein | Medium-chain triglyceride | 00
| 627 |
<unk> is an inflammation of one or both parotid glands, the major salivary glands located on either side of the face, in humans. The parotid gland is the salivary gland most commonly affected by inflammation. | Parotitis | Proctitis | Appendicitis | Urethritis | Rectitis | Prostatitis | Vaginitis | Cervicitis | 00
| 23,338 |
<unk> (pronounced "Homes") is the medical acronym for "Higher-Order HistoMolecular Stratification", a term and concept which was first applied to lung cancer research and treatment theory. The<unk> Paradigm postulates that lung cancer cases can be more effectively treated if different tumors can be rationally classified into more homogeneous groups (or "strata"). These could then be used in randomized clinical trials with maximized potential for detecting significant differences in treatment regimens and other characteristics of the differing variants. Rational stratification under the<unk> paradigm uses a combination of histological criteria and molecular characteristics of the tumor. | HOHMS | DKMS | IOMAI | SFHAM | PATH | CAPOX | DESMOND | NLM | 00
| 58,728 |
<unk> is due to insufficient insulin production from beta cells in the setting of insulin resistance. Insulin resistance, which is the inability of cells to respond adequately to normal levels of insulin, occurs primarily within the muscles, liver, and fat tissue. In the liver, insulin normally suppresses glucose release. However, in the setting of insulin resistance, the liver inappropriately releases glucose into the blood. The proportion of insulin resistance versus beta cell dysfunction differs among individuals, with some having primarily insulin resistance and only a minor defect in insulin secretion and others with slight insulin resistance and primarily a lack of insulin secretion. Other potentially important mechanisms associated with<unk> and insulin resistance include: increased breakdown of lipids within fat cells, resistance to and lack of incretin, high glucagon levels in the blood, increased retention of salt and water by the kidneys, and inappropriate regulation of metabolism by the central nervous system. However, not all people with insulin resistance develop<unk> since an impairment of insulin secretion by pancreatic beta cells is also required. In the early stages of insulin resistance, the mass of beta cells expands, increasing the output of insulin to compensate for the insulin insensitivity. But when<unk> has become manifest, a<unk> <unk> diabetic will have lost about half of their beta cells. Fatty acids in the beta cells activate FOXO1, resulting in apoptosis of the beta cells. The causes of the aging-related insulin resistance seen in obesity and in<unk> are uncertain. Effects of intracellular lipid metabolism and ATP production in liver and muscle cells may contribute to insulin resistance. New evidence also points to a role of a brain region called the hypothalamus in the development of insulin resistance. For one thing, a gene called Dusp8 is linked with an increased risk for<unk> . This gene codes for a protein that regulates neuronal signaling in the hypothalamus. Also, infusions into the hypothalamus of a hormone called leptin normalize blood glucose and diminish insulin resistance in diabetic animals. Activation of hypothalamic cells by leptin has an important role in maintaining normal levels of blood glucose. Thus, both the endocrine cells of the pancreas AND cells in the hypothalamus may have a role in the etiology of<unk> . Hypothalamic cells regulate blood glucose via projections to the autonomic nervous system. Autonomic innervation of liver and muscle cells stimulates an increased uptake of glucose. In diabetic humans, the control of blood glucose by the autonomic nervous system is abnormal. Leptin-sensitive, glucose regulating neurons become resistant to leptin during aging or during exposure to a high-fat diet. These leptin resistant neurons fail to restrain food intake, obesity, and blood glucose. The reasons for this lowered responsiveness to leptin are uncertain and are part of the puzzle of the causes of<unk> . Blood glucose levels can also be normalized in diabetic rodents by a single intrahypothalamic infusion of Fibroblast Growth Factor 1 (FGF1), an effect that persists for months even in severely diabetic animals. This remarkable cure of<unk> is accomplished by a stimulation of accessory brain cells called astrocytes. Hypothalamic astrocytes that produce Fatty Acid Binding Protein 7 (FABP7) are targets of FGF1; these cells are also in close contact with leptin-sensitive neurons, influence their function, and regulate leptin sensitivity. An abnormal function of FABP7+ astrocytes thus may contribute to the resistance to leptin and insulin that appear during aging and during exposure to high-fat diets. During aging, FABP7+ astrocytes develop cytoplasmic granules derived from degenerating mitochondria. This mitochondrial degeneration is partly due to the oxidative stress of the heightened amounts of fatty acids that are taken up by these cells and oxidized within mitochondria. A pathological degeneration of mitochondria in these cells may compromise their normal functions and contribute to abnormalities in the control of blood glucose by the hypothalamus. | Type 2 diabetes | Type 3 diabetes | Type 3c diabetes | Prediabetes | Type 1 diabetes | Diabetes | Prehypertension | Metabolic syndrome | 00
| 6,501 |
Tracking the change in contraception use of<unk> n women from 2008-2012 Use of modern birth<unk> methods has been shown to decrease female fertility rate in Sub-Saharan<unk> . Health<unk> has the highest maternal death rate, which measures the death rate of women due to pregnancy and childbirth. The maternal mortality ratio in Sub Saharan<unk> is 1,006 maternal deaths per 100,000 live births. An article by Baggaley et al. suggests that increasing access to safe abortion would reduce maternal mortality due to unsafe abortions in Ethiopia and Tanzania. Alvergne et al. argue in “Fertility, parental investment, and the early adoption of modern contraception in rural Ethiopia” that an increase in usage of family planning increases birth spacing which consequently decreases infant mortality, although it had no observed effect on overall child mortality, possibly due to a recent overall decrease childhood death rates among both contraception users and nonusers. Additionally, increasing condom use in<unk> would decrease rates of HIV transmission. Social According to Gyimah, women who have their first child at a younger age are less likely to finish school and will be more limited to low-paying career options. Research suggests that desire to continue with their education is one of the largest reasons that women use birth<unk> and terminate pregnancies. Since birth<unk> is not widely available, beginning a family at a young age is additionally correlated with a higher overall fertility rate. Alvergne suggests that another benefit of longer birth intervals due to contraception use is an increase in parental investment and proportion of resources dedicated to each child. Two of the most prevalent reasons for married women to use birth<unk> are to plan birth spacing and postpone pregnancies to achieve their desired family size. According to Gyimah, fertility rates are declining in some<unk> n countries, particularly Kenya, Botswana, Zimbabwe, and Ghana. The decrease in fertility rates in Ghana is largely attributed to investment in education that has caused an increase in age at first birth and improved job opportunities for women. Economic Increased use of family planning leads to economic development because women are more likely to work and their children are more likely to be healthy and educated. There is an estimated 140%-600% return on investment in family planning methods due to health care savings and economic development. "The Economic Case for Birth<unk> ," published in 1967, argues that decreasing the birth rate in countries with high fertility levels is crucial to economic growth and that "one dollar used to slow population growth can be 100 times more effective in raising income per head than one dollar to expand output." Since the majority of<unk> n countries have high fertility rates relative to the rest of the world, it is clear that most<unk> n countries have not undergone a demographic transition. In other parts of the world, there is evidence that economic growth increases after a country undergoes demographic transition. This is due to more women working, greater parental investment in children in terms of education and attention, and longer, more productive working life due to health improvements. Although other improvements in public health are necessary to fully undergo a demographic transition, it can not occur without family planning. It is unclear, however, how exactly the demographic transition will affect society in sub-Saharan<unk> . An economic downside to using birth<unk> to limit fertility is the possibility that parents will not having enough successful, living offspring to support them financially in old age. This is a significant concern among parents. | Birth control in Africa | Nutrition in Clinical Practice | Vaccines for Children Program | African Americans and birth control | Preventive healthcare | Animal vaccination | Human nutrition | Vaccination policy | 00
| 64,339 |
Concerning more serious afflictions, the complex origins of<unk> may be treated with multiple drugs, which have a limited effect individually, but greater when combined with others that act on different brain pathways or mechanisms. Treatment is most effective when the underlying cause is known, and can be treated as such. Some drugs being studied in different combinations include clonazepam, sodium valproate, piracetam, and primidone. Hormonal therapy may improve responses to antimyoclonic drugs in some people. Some studies have shown that doses of 5-hydroxytryptophan (5-HTP) leads to improvement in patients with some types of action<unk> and PME. These differences in the effect of 5-HTP on patients with<unk> have not yet been explained. Many of the drugs used for<unk> , such as barbiturates, phenytoin and primidone, are also used to treat epilepsy. Barbiturates slow down the central nervous system and cause tranquilizing or antiseizure effects. Phenytoin and primidone are effective antiepileptics drugs, although phenytoin can cause liver failure or have other harmful long-term effects in patients with PME. Sodium valproate is an alternative therapy for<unk> and can be used either alone or in combination with clonazepam. Some people have adverse reactions to clonazepam and/or sodium valproate. When patients are taking multiple medications, the discontinuation of drugs suspected of causing<unk> and treatment of metabolic derangements may resolve some cases of<unk> . When pharmacological treatment is indicated anticonvulsants are the main line of treatment. Paradoxical reactions to treatment are notable. Drugs which most people respond to may in other individuals worsen their symptoms. Sometimes this leads to the mistake of increasing the dose, rather than decreasing or stopping the drug. Treatment of<unk> focuses on medications that may help reduce symptoms. Drugs used include sodium valproate, clonazepam, the anticonvulsant levetiracetam, and piracetam. Dosages of clonazepam usually are increased gradually until the patient improves or side effects become harmful. Drowsiness and loss of coordination are common side effects. The beneficial effects of clonazepam may diminish over time if the patient develops a tolerance to the drug. In forms of<unk> where only a single area is affected, and even in a few other various forms, Botox injections (OnabotulinumtoxinA) may be helpful. The chemical messenger responsible for triggering the involuntary muscle contractions is blocked by the Botulinum toxins of the Botox. Surgery is also a viable option for treatment if the symptoms are caused by a tumor or lesion in the brain or spinal cord. Surgery may also correct symptoms in those where<unk> affects parts of the face or ear. While DBS is still being studied for use with<unk> , Deep Brain Stimulation has also been tried in those with this and other movement disorders. | Myoclonus | Chorea | Chorea | Clonus | Opisthotonus | Opsoclonus | Synkinesis | Paratonia | 00
| 15,663 |
MST is performed with the use of a modified rTMS device that delivers a higher output. Similar to ECT, because MST induces<unk> s, general anesthesia is used to relax the muscles. However, because there is not an electric current that may stimulate the jaw muscles, a bite block is not necessary. Coils are placed over the frontal cortex (usually bilaterally) and the treatment dosage is usually determined via titration with a preset dosing schedule. The treatment dosage is determined once the<unk> threshold has been met and a sufficient<unk> is produced. Various coil designs have been tested, such as the figure 8 coil, double cone coil, and cap coil. The latter two are the ones that have been most reliable in<unk> induction. | Magnetic seizure therapy | Cranial electrotherapy stimulation | Deep brain stimulation | Electrical brain stimulation | Kinesiotherapy | NeuroIntegration Therapy | Transcranial direct-current stimulation | Ablative brain surgery | 00
| 57,093 |
Children are much more prone to exhibit these<unk> s than adults. The mean age of onset of seizures for children with<unk> s is 8.1 years old. Few other neurological deficits are associated with<unk> s, so that earlier detection of the<unk> before seizure symptoms are rare.<unk> s are found in the temporal lobe in 84% of reported cases. In children,<unk> s account for 0.6% of diagnosed central nervous system<unk> s. It has been found that males have a slightly higher risk of having these<unk> s. Some familial accounts of<unk> s have been documented, though the genetic ties have not yet been fully confirmed. | Dysembryoplastic neuroepithelial tumour | Neurothekeoma | Primitive neuroectodermal tumor | Extracranial germ cell tumor | Glial tumor | Sialoblastoma | Central neurocytoma | Pediatric ependymoma | 00
| 44,471 |
The<unk> (CVMP) is the European Medicines Agency's committee responsible for elaborating the agency's opinions on all issues regarding<unk> medicines. | Committee for Medicinal Products for Veterinary Use | Task Force on Prescription Drugs | Armed Forces DNA Identification Laboratory | Outline of public health | Biological and Pharmaceutical Bulletin | Scientific Advisory Group for Origins of Novel Pathogens | Committee on Toxicity | Biological pharmacist | 00
| 73,685 |
<unk> is poisoning due to exposure to<unk> s.<unk> s are typically used as pesticides; however, some also have medical uses. Symptoms may be similar to organophosphate poisoning. | Carbamate poisoning | Salicylate poisoning | Nicotine poisoning | Strychnine poisoning | Theobromine poisoning | Organophosphate poisoning | Paracetamol poisoning | Ethylene glycol poisoning | 00
| 69,408 |
<unk> (from the Greek πλάσμα, plasma, something molded, and ἀφαίρεσις aphairesis, taking away) is the removal, treatment, and return or exchange of blood plasma or components thereof from and to the blood circulation. It is thus an extracorporeal therapy (a medical procedure performed outside the body). Three general types of<unk> can be distinguished: * Autologuous, removing blood plasma, treating it in some way, and returning it to the same person, as a therapy. * Exchange, removing blood plasma and exchanging it with blood products to be donated to the recipient. This type is called plasma exchange (PE, PLEX, or PEX) or plasma exchange therapy (PET). The removed plasma is discarded and the<unk> tient receives replacement donor plasma, albumin, or a combination of albumin and saline (usually 70% albumin and 30% saline). * Donation, removing blood plasma, separating its components, and returning some of them to the same person while holding out others to become blood products donated by the donor. In such a plasma donation procedure, blood is removed from the body, blood cells and plasma are separated, and the blood cells are returned while the plasma is collected and frozen to preserve it for eventual use as fresh frozen plasma or as an ingredient in the manufacture of a variety of medications.<unk> of the autologous and exchange types is used to treat a variety of disorders, including those of the immune system, such as Goodpasture's syndrome, Guillain–Barré syndrome, lupus, myasthenia gravis, and thrombotic thrombocytopenic purpura. | Plasmapheresis | Autosplenectomy | Leukapheresis | Apheresis | Splenectomy | Exchange transfusion | Erythrocytapheresis | Photopheresis | 00
| 19,461 |
Subsets and Splits