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Human food additive<unk> is a food additive used as an emulsifier and thickener with the E number E425(ii).<unk> -rich salep powder is responsible for the unique textural properties of salep dondurma, a mastic-flavored stretchable and chewy ice cream of Turkish origin. Konjac, also rich in<unk> , is widely used for its jelly-like texture. It found use in shirataki noodles, in fruit jellies snacks (with choking risk), and as a substitute for gelatin. Human dietary supplement<unk> is an ingredient in a variety of dietary supplement products marketed with claims that they aid in weight loss, but medical research has found no good evidence to support its use for this purpose. The claim is that it makes a gel when mixed with water, which can take up space in the stomach and linger there longer than water alone would, inducing a person to feel full after having eaten a smaller amount of food. In Europe and Canada,<unk> dietary supplements can be marketed with claims to lower cholesterol levels and to relieve constipation. Data from a randomized controlled clinical trial suggests that<unk> dietary supplements help regulate the hormone ghrelin and might help control appetite in people with Type II Diabetes. Health risks A health advisory was released by Health Canada stating the following: "Natural health products containing the ingredient<unk> in tablet, capsule or powder form, which are currently on the Canadian market, have a potential for harm if taken without at least 250 ml or 8 ounces of water or other fluid. The risk includes choking and/or blockage of the throat, esophagus or intestine, according to international adverse reaction case reports. It is also important to note that these products should not be taken immediately before going to bed." Other adverse effects include diarrhea, belching, and bloating; in one study people taking<unk> s had higher triglyceride levels. Consumer issues Several companies have been determined by the Federal Trade Commission (FTC) or the Food and Drug Administration (FDA) to have, at some time, violated the Federal Food, Drug, and Cosmetic Act. The companies include Vitacost, PediaLean, Herbal Worldwide Holdings, BioTrim, and others. The company Obesity Research Institute, the marketer of FiberThin, Zylotrim, Propolene and Lipozene, settled FTC charges that their misleading weight-loss claims violated federal laws by agreeing to pay $1.5 million in consumer redress. In 2001, a number of jelly-type candy products containing konjac-derived<unk> were barred from import by the U.S. Food and Drug Administration due to choking hazards. Dietary supplements for animals It is also used as dietary supplement for farmed animals in order to help them gain more weight from food, called the feed conversion ratio. The effect of mannan oligosaccharides on animal performance was analysed in meta-analyses for poultry, pigs, and calves. | Glucomannan | Lipoarabinomannan | Mirificin | Lecithin | Cerebroside | Methyl cellulose | Titratable acid | Niquitin | 00
| 26,920 |
The exact prevalence of the syndrome is unknown, because both aortic stenosis and angiodysplasia are common diseases in the elderly. A retrospective chart review of 3.8 million people in Northern Ireland found that the incidence of gastrointestinal bleeding in people with any diagnosis of aortic stenosis (they did not subgroup people by severity) was just 0.9%. They also found that the reverse correlation—the incidence of aortic stenosis in people with gastrointestinal bleeding—was 1.5%. However, in 2003 a study of 50 people with aortic stenosis severe enough to warrant immediate valve replacement found GI bleeding in 21% of people, and another study done in the USA looking at angiodysplasia rather than GI bleeding found that the prevalence of aortic stenosis was 31% compared to 14% in the control group. It is a disease mainly found in older adults but a rare case of<unk> has been reported in children. | Heyde's syndrome | Tornwaldt's disease | Waltman Walter syndrome | TRIANGLE disease | Dieterich's disease | Bright's disease | Darier's disease | Camisa disease | 00
| 14,883 |
S. pneumoniae is normally found in the nose and throat of 5–10% of healthy adults and 20–40% of healthy children. It can be found in higher amounts in certain environments, especially those where people are spending a great deal of time in close proximity to each other (day-care centers, military barracks). It attaches to nasopharyngeal cells through interaction of bacterial surface adhesins. This normal colonization can become infectious if the organisms are carried into areas such as the Eustachian tube or nasal sinuses where it can cause otitis media and sinusitis, respectively. Pneumonia occurs if the organisms are inhaled into the lungs and not cleared (again, viral infection, or smoking-induced ciliary paralysis might be contributing factors). The organism's polysaccharide capsule makes it resistant to phagocytosis and if there is no pre-existing anticapsular antibody alveolar macrophages cannot adequately kill the pneumococci. The organism spreads to the blood stream (where it can cause bacteremia) and is carried to the meninges, joint spaces, bones, and peritoneal cavity, and may result in meningitis, brain abscess, septic arthritis, or osteomyelitis. S. pneumoniae has several virulence factors, including the polysaccharide capsule mentioned earlier, that help it evade a host's immune system. It has<unk> surface proteins that inhibit complement-mediated opsonization, and it secretes IgA1 protease that will destroy secretory IgA produced by the body and mediates its attachment to respiratory mucosa. The risk of<unk> is much increased in persons with impaired IgG synthesis, impaired phagocytosis, or defective clearance of pneumococci. In particular, the absence of a functional spleen, through congenital asplenia, surgical removal of the spleen, or sickle-cell disease predisposes one to a more severe course of infection (overwhelming post-splenectomy infection) and prevention measures are indicated (see asplenia). People with a compromised immune system, such as those living with HIV, are also at higher risk of<unk> disease. In HIV patients with access to treatment, the risk of invasive pneumoccal disease is 0.2–1% per year and has a fatality rate of 8%. There is an association between<unk> pneumonia and influenza. Damage to the lining of the airways (respiratory epithelium) and upper respiratory system caused by influenza may facilitate<unk> entry and infection. Other risk factors include smoking, injection drug use, Hepatitis C, and COPD. Virulence factors S. pneumoniae expresses different virulence factors on its cell surface and inside the organism. These virulence factors contribute to some of the clinical manifestations during infection with S. pneumoniae. * Polysaccharide capsule—prevents phagocytosis by host immune cells by inhibiting C3b opsonization of the bacterial cells * Pneumolysin (Ply)—a 53-kDa pore-forming protein that can cause lysis of host cells and activate complement * Autolysin (LytA)—activation of this protein lyses the bacteria releasing its internal contents (i.e., pneumolysin) * Hydrogen peroxide—causes damage to host cells (can cause apoptosis in neuronal cells during meningitis) and has bactericidal effects against competing bacteria (Haemophilus influenzae, Neisseria meningitidis, Staphylococcus aureus) * Pili—hair-like structures that extend from the surface of many strains of S. pneumoniae. They contribute to colonization of upper respiratory tract and increase the formation of large amounts of TNF by the immune system during sepsis, raising the possibility of septic shock * Choline binding protein A/Pneumococcal surface protein A (CbpA/PspA)—an adhesin that can interact with carbohydrates on the cell surface of pulmonary epithelial cells and can inhibit complement-mediated opsonization of pneumococci * Competence for genetic transformation likely plays an important role in nasal colonization fitness and virulence (lung infectivity) | Pneumococcal infection | Group A streptococcal infection | Group B streptococcal infection | Side effects of penicillin | Arcanobacterium haemolyticum infection | Staphylococcal infection | Influenza | Influenza | 00
| 52,396 |
<unk> is a term for weak cartilage in the walls of the bronchial tubes, often occurring in children under a day.<unk> means 'floppiness' of some part of the bronchi. Patients present with noisy breathing and/or wheezing. There is collapse of a main stem bronchus on exhalation. If the trachea is also involved the term tracheobronchomalacia (TBM) is used. If only the upper airway the trachea is involved it is called tracheomalacia (TM). There are two types of<unk> . Primary<unk> is due to a deficiency in the cartilaginous rings. Secondary<unk> may occur by extrinsic compression from an enlarged vessel, a vascular ring or a bronchogenic cyst. Though uncommon, idiopathic (of unknown cause) tracheobronchomalacia has been described in older adults. | Bronchomalacia | Tracheobronchomalacia | Malacia | Tracheomalacia | Tracheal tumor | Laryngomalacia | Bronchitis kettle | Croup | 00
| 50,039 |
<unk> is a rule of thumb that a patient is at high risk of a fatal drug-induced liver injury (DILI) if given a medication that causes hepatocellular injury (not Hepatobiliary injury) with jaundice. The law is based on observations by<unk> Zimmerman, a major scholar of drug-induced liver injury. Some have suggested the principle be called a<unk> pothesis or observation.<unk> cases have three components: * The drug causes hepatocellular injury, generally defined as an elevated ALT or AST by 3-fold or greater above the upper limit of normal. Often with aminotransferases much greater (5-10x) the upper limit of normal. * Among subjects showing such aminotransferase elevations, they also have elevation of their serum total bilirubin of greater than 2× the upper limit of normal, without findings of cholestasis (defined as serum alkaline phosphatase activity less than 2× the upper limit of normal). * No other reason can be found to explain the combination of increased aminotransferase and serum total bilirubin, such as viral hepatitis, alcohol abuse, ischemia, preexisting liver disease, or another drug capable of causing the observed injury. In Zimmerman's analysis of 116 patients with hepatocellular injury and jaundice due to drug exposure, 76% went on to either require a liver transplant or died. Other studies have reported a lower but still significant mortality of 10%. | Hy's law | Lightwood's law | Farr's laws | McNeill's law | Ribot's law | Davis's law | Laura's Law | Sutton's law | 00
| 44,962 |
<unk> was filed as Investigational New Drug (IND) number 76431. Initial Phase I studies with<unk> involved determination of pharmacokinetic parameters following a single dose in healthy volunteers. Next, safety and tolerability were investigated in a Phase I trial involving 30 volunteers with advanced solid tumors or lymphoma. Although there were no notable tumor responses, a strong correlation was noted between dose and adverse events, with the primary adverse event reported being gastrointestinal reaction. A Phase II study in 18 patients with pancreatic cancer was initiated for combination treatment with<unk> and gemcitabine, but efficacy of<unk> was not observed. In 2004, a Phase I/II study involved 17 patients at 2 locations with relapsed, refractory poor-risk AML with FLT3 mutations; this study demonstrated effective FLT3 inhibition by<unk> . A multi-center Phase II study of 29 patients above the age of 60 was initiated for treatment with<unk> alone; the results, reported in 2006, indicated that the primary endpoint of complete remission was not achieved in any participants. Despite this failure, another multi-center Phase II trial involving 42 patients combined<unk> with conventional chemotherapy; the results, reported in 2005, indicated that twice as many patients showed a clinical response when treated with<unk> as compared to those not treated. Consequently, a Phase III trial was initiated with 224 patients for<unk> following chemotherapy; no significant difference in cancer remission was seen between patients treated with chemotherapy alone and with<unk> and chemotherapy, according to results in a 2011 report. Additional clinical trials have been initiated since this Phase III trial. These include a multi-center Phase II trial involving 37 patients with V617F JAK2 positive polycythemia vera and essential thrombocytosis; results published in 2014 indicate that the trial did not achieve the endpoint of 15% reduction of V617F JAK2 allele burden in 15% of patients. A Phase I study of 47 patients reported in 2010 that treatment of refractory neuroblastoma was well tolerated at the recommended doses, and an additional Phase I study in children with refractory neuroblastoma was completed in 2011. Phase I results were reported in 2015 for a<unk> trial involving patients with V617F JAK2 positive myelofibrosis. | Lestaurtinib | Mobocertinib | Osimertinib | Selpercatinib | Upadacitinib | Brigatinib | Baricitinib | Axitinib | 00
| 49,566 |
The<unk> (or supraclavicular triangle, omoclavicular triangle, Ho's triangle), the smaller division of the posterior triangle, is bounded, above, by the inferior belly of the omohyoideus; below, by the clavicle; its base is formed by the posterior border of the sternocleidomastoideus. Its floor is formed by the first rib with the first digitation of the serratus anterior. The size of the<unk> varies with the extent of attachment of the clavicular portions of the Sternocleidomastoideus and Trapezius, and also with the height at which the Omohyoideus crosses the neck. Its height also varies according to the position of the arm, being diminished by raising the limb, on account of the ascent of the clavicle, and increased by drawing the arm downward, when that bone is depressed. This space is covered by the integument, the superficial and deep fasciæ and the platysma, and crossed by the supraclavicular nerves. Just above the level of the clavicle, the third portion of the<unk> artery curves lateralward and downward from the lateral margin of the scalenus anterior, across the first rib, to the axilla, and this is the situation most commonly chosen for ligaturing the vessel. Sometimes this vessel rises as high as 4 cm. above the clavicle; occasionally, it passes in front of the Scalenus anterior, or pierces the fibers of that muscle. The<unk> vein lies behind the clavicle, and is not usually seen in this space; but in some cases it rises as high as the artery, and has even been seen to pass with that vessel behind the Scalenus anterior. The brachial plexus of nerves lies above the artery, and in close contact with it. Passing transversely behind the clavicle are the transverse scapular vessels; and traversing its upper angle in the same direction, the transverse cervical artery and vein. The external jugular vein runs vertically downward behind the posterior border of the Sternocleidomastoideus, to terminate in the<unk> vein; it receives the transverse cervical and transverse scapular veins, which form a plexus in front of the artery, and occasionally a small vein which crosses the clavicle from the cephalic. The small nerve to the subclavius also crosses this triangle about its middle, and some lymph glands are usually found in the space. Enlarged nodes in this triangle irrespective of size are categorized at N3 in the TNM classification for nasopharyngeal carcinoma. | Subclavian triangle | Posterior triangle of the neck | Subclavian loop | Muscular triangle | Anterior triangle of the neck | Submandibular triangle | Supracristal plane | Thoracic inlet | 00
| 39,078 |
The type of<unk> dictates the treatment; however, surgery is a common treatment. Most traumatic<unk> warrant an emergency repairing surgery to prevent complications and maintain functionality of the penis sexually and urologically. Catheterization is usually a part of treatment for penis<unk> es; when the urethra is intact, urethral catheterization may be used, but if it has been<unk> d, suprapubic catheterization is used. Some<unk> es, including animal bites, are also treated with antibiotics, irrigation, and rabies prophylaxis. | Penile injury | Penile fracture | Bulbar urethral necrosis | Penile torsion | Ureterovaginal fistula | Urethral syndrome | Urethrovaginal fistula | Urogenital fistula | 00
| 68,539 |
<unk> is the contraction of the ciliary muscle in the eye, in the accommodation of focus for near vision.<unk> may also exert tensions on the trabecular meshwork, opening the pores and facilitating outflow of the aqueous humour into the canal of Schlemm. The increase in aqueous humour outflow is desirable for patients with glaucoma. | Cyclospasm | Laryngospasm | Vasospasm | Bronchospasm | Eupnea | Cardiovascular drift | Mydriasis | Venospasm | 00
| 24,380 |
The<unk> is a type of melanocytic nevus (or mole) found in infants at birth. This type of birthmark occurs in an estimated 1% of infants worldwide; it is located in the area of the head and neck 15% of the time. | Congenital melanocytic nevus | Connective tissue nevus | Eccrine nevus | Benign melanocytic nevus | Adenoma sebaceum | Melanocytic nevus | Linear verrucous epidermal nevus | Pigmented spindle cell nevus | 00
| 32,200 |
Eating<unk> The cause is typically the eating of foods containing<unk> seeds or<unk> seed oil. Briefly, the immune system overreacts to proteins found in<unk> -containing foods. Once an allergic reaction has occurred, it remains a lifelong sensitivity for 70-80% of people. Cross-contact Cross-contact, also referred to as cross-contamination, occurs when foods are being processed in factories or at food markets, or are being prepared for cooking in restaurants and home kitchens. The allergenic proteins are transferred from one food to another. Bakeries are mentioned as a possible site of cross-contact because<unk> seeds are used as ingredients in various baked goods. Assessment of food products purchased from Middle Eastern grocery stores and bakeries in Montreal, Canada found that 16% of packaged products with Precautionary Allergen Labelling may contain<unk> ; the finding indicates that products had measurable<unk> content, causing inadvertent cross-contamination. Occupational exposure Exposure of inhaled<unk> dust has occurred at bakeries. Cross-reactivity to other plant foods The 2S albumins in<unk> seeds partially share amino acid sequence and structure with 2S albumins from other plants, and are likely the proteins responsible for cross-reactive allergic reactions to peanuts, almonds, and hazelnuts. Allergic reactions to oleosins from hazelnut and peanut oils have been confirmed as cross-reactive to<unk> oil. Protein analysis suggests allergy to chia seeds may cross-react with<unk> . | Sesame allergy | Tree nut allergy | Sweat allergy | Nickel allergy | Peanut allergy | Corn allergy | Insect sting allergy | Rice allergy | 00
| 75,056 |
Symptoms include a blueish or greenish coloration of the blood (cyanosis), skin, and mucous membranes, even though a blood count test may not show any abnormalities in the blood. This discoloration is caused by greater than 5 grams per cent of deoxyhemoglobin, or 1.5 grams per cent of methemoglobin, or 0.5 grams per cent of sulfhemoglobin, all serious medical abnormalities. | Sulfhemoglobinemia | Methemoglobinemia | Organic acidemia | Cyanide poisoning | Hyperaemia | Isovaleric acidemia | Propionic acidemia | Algaemia | 00
| 45,623 |
100mg generic<unk> capsules Cough<unk> is a prescription non-opioid alternative for the symptomatic relief of cough. It has been shown to improve cough associated with a variety of respiratory conditions including asthma, bronchitis, pneumonia, tuberculosis, pneumothorax, opiate-resistant cough in lung cancer, and emphysema.<unk> also reduces the consistency and volume of sputum production associated with cough in those with chronic obstructive pulmonary disorder (COPD). Compared to codeine,<unk> has been shown to be more effective in reducing the frequency of induced cough in experiments.<unk> does not treat the underlying cause of the cough. Hiccups<unk> has been shown to have use in the suppression of hiccups. Intubation<unk> acts as a local anesthetic and the liquid inside the capsule can be applied in the mouth to numb the oropharynx for awake intubation. However, there can be life-threatening adverse effects when the medication is absorbed by the oral mucosa, including choking, hypersensitivity reactions, and circulatory collapse. | Benzonatate | Galantamine | Retigabine | Phenylpiracetam | Tianeptine | Ethosuximide | Chlordiazepoxide | Levetiracetam | 00
| 25,248 |
<unk> , also called pigeon chest, is a malformation of the chest characterized by a protrusion of the sternum and ribs. It is distinct from the related malformation<unk> excavatum. | Pectus carinatum | Pes cavus | Pectus excavatum | Omphalolith | Fissured tongue | Visceroptosis | Cephalohematoma | Subungual hematoma | 00
| 24,577 |
The highest-velocity<unk> es tend to have the worst associated damage. A study published in 1991, which documented 314 individuals who had suffered<unk> cranial<unk> es caused by gunshot wounds, found that 73% succumbed to their<unk> es at the scene of the incident, and a further 19% ultimately died later, thus indicating a total mortality rate of 92%. Perforating<unk> es have an even worse prognosis.<unk> <unk> trauma can cause impairment or loss of abilities controlled by parts of the brain that are damaged. A famous example is Phineas Gage, whose personality appears to have changed (though not as dramatically as usually described) after a perforating<unk> to his frontal lobe(s). People with subarachnoid hemorrhage, a blown pupil, respiratory distress, hypotension, or cerebral vasospasm are more likely to have worse outcomes. People with<unk> <unk> trauma may have complications such as acute respiratory distress syndrome, disseminated intravascular coagulation, and neurogenic pulmonary edema. Up to 50% of patients with<unk> brain<unk> es get late-onset post-traumatic epilepsy. | Penetrating head injury | Closed-head injury | Traumatic brain injury | Acquired brain injury | Cerebral contusion | Traumatic asphyxia | Polytrauma | Pediatric concussion | 00
| 20,248 |
<unk> or<unk> is defined as the occurrence of blood or red blood cells in the urine. The word<unk> is derived from Greek haima (αἷμα) "blood" and ouron (οὖρον) "urine".<unk> can be visible to the naked eye (termed "gross<unk> ") and may appear red or brown (sometimes referred to as tea-colored), or it can be microscopic (i.e. not visible to the eye but detected with a microscope or laboratory test). The origin of the blood that enters and mixes with the urine can arise from any anatomical site within the urinary system, including the kidney, ureter, urinary bladder, and urethra, and in men, the prostate. Common causes of<unk> include urinary tract infection (UTI), kidney stones, viral illness, trauma, bladder cancer, and exercise. The underlying causes of<unk> can be divided into glomerular and non-glomerular causes, referring to the involvement of the glomerulus of the kidney. Notably, not all red urine is<unk> . Other substances such as certain medications and foods (e.g. blackberries, beets, food dyes) can cause urine to appear red. Menstruation in women may also cause the appearance of<unk> and may result in a positive urine dipstick test for<unk> . Additionally, a urine dipstick test may be falsely positive for<unk> due to other substances in the urine such as myoglobin during rhabdomyolysis. A positive urine dipstick test should be confirmed with microscopy, where<unk> is defined by three of more red blood cells per high power field. When<unk> is detected, a thorough history and physical examination with appropriate further evaluation (e.g. laboratory testing) can help determine the underlying cause. | Hematuria | Pyuria | Anuria | Oliguria | Polyuria | Crystalluria | Dysuria | Microhematuria | 00
| 14,594 |
Ballantyne syndrome has several characteristics: * edema, always a key feature * albuminuria of the mother, usually mild * preeclampsia, unusual The fetal symptoms are related to fluid retention, including ascites and polyhydramnios. Fetal hydrops suggests the presence of an important and probably fatal fetal pathology. It can be associated with parvovirus B19 infection and with twin-to-twin transfusion syndrome. | Mirror syndrome | Rape trauma syndrome | Otodental syndrome | Diencephalic syndrome | Virtual reality sickness | Disconnection syndrome | Daughter from California syndrome | Religious trauma syndrome | 00
| 44,423 |
<unk> (MTS) is thought to represent between two and five percent of lower-extremity venous disorders.<unk> is often unrecognized; however, current estimates are that this condition is three times more common in women than in men. The classic syndrome typically presents in the second to fourth decades of life. In the 21st century in a broader disease profile, the syndrome acts as a permissive lesion and becomes symptomatic when something else happens such as, following trauma, a change in functional status such as swelling following orthopaedic joint replacement. | May–Thurner syndrome | Van Wyk and Grumbach syndrome | Helsmoortel-Van der Aa syndrome | Wells-Jankovic syndrome | Jeavons syndrome | Crome syndrome | Bogart–Bacall syndrome | Keutel syndrome | 00
| 34,502 |
Pharmacokinetics Metabolic pathway for<unk> <unk> . Active metabolites are highlighted.<unk> is absorbed from the gut to about 88%. Bioavailability varies greatly between individual patients, between 30 and 90%, because the drug is partly inactivated in the liver. Highest blood plasma concentrations, counting not only the drug itself, but also its metabolites, are reached after 1–2 hours, and the average plasma half-life is 26 to 80 minutes for<unk> and 3–5 hours for drug plus metabolites. 20 to 30% are bound to plasma proteins while circulating in the bloodstream.<unk> is a prodrug, a substance that is not an active drug itself, but is activated in the body. This happens in several steps; at first, it is slowly and almost completely converted to 6-mercaptopurine (6-MP) by reductive cleavage of the thioether (–S–). This is mediated by glutathione and similar compounds in the intestinal wall, the liver, and on red blood cells, without the aid of enzymes. 6-MP is metabolized analogously to natural purines, giving thioguanosine triphosphate (TGTP) and thiodeoxyguanosine triphosphate (TdGTP) via thioinosine monophosphate (TIMP) and several further intermediates. On a second path, the sulfur atom of 6-MP and TIMP is methylated. The end products of<unk> metabolism are thiouric acid (38%) and various methylated and hydroxylated purines, which are excreted via the urine. Mechanism of action<unk> inhibits purine synthesis. Purines are needed to produce DNA and RNA. By inhibiting purine synthesis, less DNA and RNA are produced for the synthesis of white blood cells, thus causing immunosuppression.<unk> is converted within tissues to 6-MP, some of which is converted, in turn, to 6-thioguanine by the addition of an amino group. Both 6-MP and 6-thioguanine are conjugated with ribose, and then phosphorylated to form the nucleotides thioinosinic acid and thioguanylic acid, respectively. These nucleotides masquerade, respectively, as inosinic acid and guanylic acid; the former is the starting point for purine nucleotide biosynthesis, while the latter is one of the building blocks of DNA and RNA. * The nucleotides are incorporated into newly synthesized (but nonfunctional) DNA, halting replication. * The nucleotides act to inhibit glutamine-phosphoribosyl pyrophosphate amidotransferase (GPAT), one of the enzymes involved in purine biosynthesis, one of the earlier steps in the synthesis of DNA and RNA. They achieve GPAT inhibition through a form of negative feedback called product inhibition. Because actively replicating cells (such as cancer cells and the T cells and B cells of the immune system) are most active in synthesizing purine, making new DNA, these cells are most strongly affected. * A portion of the nucleotides is additionally phosphorylated to the triphosphate forms. These bind to GTP-binding protein Rac1, blocking synthesis of the protein Bcl-xL, thus sending activated T cells and mononuclear cells into apoptosis (programmed cell death). Increased apoptosis of mononuclear cells is seen in inflammatory bowel disease patients treated with<unk> . | Azathioprine | Hydroxychloroquine | Etanercept | Aminophenazone | Tofacitinib | Teriflunomide | Leflunomide | Sirolimus | 00
| 13,400 |
In human, the<unk> gene is located on the X chromosome at position q28.<unk> was first characterized in 1984 by scientists at Genentech. The gene for<unk> is located on the X chromosome (Xq28). The gene for<unk> presents an interesting primary structure, as another gene <unk> A1) is embedded in one of its introns. | Factor VIII | Factor IX | Factor XI | Thrombin | Prothrombinase | Von Willebrand factor | Fibrinogen | Platelet-activating factor | 00
| 14,127 |
<unk> of the parotid gland accounts for a much larger percentage of hospital admissions than<unk> of the submandibular gland. Submandibular<unk> has been said to only account for 10% of all cases diagnosed as<unk> . Chronic<unk> has been classified as a relatively common presentation, whereas bacterial<unk> and sclerosing polycystic<unk> are defined as rare. Chronic sclerosing<unk> has been shown to affect predominantly males who are over the age of 50, with 40% of cases having an allergic disease, such as chronic sinusitis or bronchial asthma. One study found that 112 patients from England and Wales ranging from 12 to 81 years of age complained of symptoms from their diagnosed<unk> , with the group having a mean age of 39 and a standard deviation of 16 years. The study also found that more patients underwent surgery to treat their<unk> between the ages of 20 and 69 years but that there were many more patients who complained of symptoms between the ages of 20 and 49, and then went on to be diagnosed with<unk> . In each group studied, most patients suffered from<unk> in their twenties but there was also found to be a significant number of females whose symptoms started in their thirties and forties. More women reported symptoms that were confirmed to be<unk> than men in this study, which may suggest that females are more likely to be affected but more research would need to be done to be sure of this. A study done on the epidemiology of<unk> in the United States of America found that acute suppurative parotitis is responsible for 0.01-0.02% of hospital admissions, with the submandibular gland accounting for 10% of cases of<unk> in the major salivary glands in this population. This study found that there was no predilection to any race, sex or age, although it was noted that<unk> in general tended to occur in people who are debilitated, dehydrated or older. Bacterial<unk> is uncommon nowadays and is usually associated with sialoliths. A study involving hospitals in the United Kingdom found that the incidence of admissions for<unk> is 27.5 per million of the population, with the most common cause being mumps which causes a viral infection in the salivary gland. Ascending acute bacterial parotitis used to be a common perimortal event but today this is no longer the case due to antibiotics and basic modern care which means that patients will be much less likely to become dehydrated. | Sialadenitis | Laryngitis | Phlegmon | Tonsillitis | Pharyngitis | Posthitis | Sinusitis | Placentitis | 00
| 37,796 |
Incorrect application (e.g. into the lungs) results in pulmonary aspiration which can sometimes be fatal if immediate medical treatment is not initiated. The use of<unk> carbon is contraindicated when the ingested substance is an acid, an alkali, or a petroleum product. | Activated charcoal | Drotaverine | Sodium thiosulfate | Secobarbital | Fomepizole | Ethallobarbital | Acetylcysteine | Pivhydrazine | 00
| 65,952 |
Adverse effects of<unk> include dependency, both physical and psychological; reduced sleep quality resulting in somnolence; and overdose, resulting in excessive sedation, impairment of balance and speech, respiratory depression or coma, and possibly death. Because of the latter,<unk> is commonly used in suicide. When used in late pregnancy, it might cause hypotonia of the fetus. Dependence<unk> , as with other benzodiazepines, can lead to drug dependence. Discontinuation may result in benzodiazepine withdrawal syndrome, characterised by seizures, psychosis, insomnia, and anxiety. Rebound insomnia, worse than baseline insomnia, typically occurs after discontinuation of<unk> even from short-term single nightly dose therapy. Paradoxical effects<unk> may cause a paradoxical reaction in some individuals, including anxiety, aggressiveness, agitation, confusion, disinhibition, loss of impulse control, talkativeness, violent behavior, and even convulsions. Paradoxical adverse effects may even lead to criminal behaviour. Hypotonia Benzodiazepines such as<unk> are lipophilic and rapidly penetrate membranes and, therefore, rapidly cross over into the placenta with significant uptake of the drug. Use of benzodiazepines including<unk> in late pregnancy, especially high doses, may result in hypotonia, also known as floppy baby syndrome. Other<unk> impairs cognitive functions. This may appear as lack of concentration, confusion and anterograde amnesia—the inability to create memories while under the influence. It can be described as a hangover-like effect which can persist to the next day. It also impairs psychomotor functions similar to other benzodiazepines and nonbenzodiazepine hypnotic drugs; falls and hip fractures were frequently reported. The combination with alcohol increases these impairments. Partial, but incomplete tolerance develops to these impairments. Other adverse effects include: * Slurred speech * Gastrointestinal disturbances, lasting 12 or more hours * Vomiting * Respiratory depression in higher doses Special precautions Benzodiazepines require special precaution if used in the elderly, during pregnancy, in children, in alcohol- or drug-dependent individuals, and in individuals with comorbid psychiatric disorders. Impairment of driving skills with a resultant increased risk of road traffic accidents is probably the most important adverse effect. This side-effect is not unique to<unk> but also occurs with other hypnotic drugs.<unk> seems to have a particularly high risk of road traffic accidents compared to other hypnotic drugs. Extreme caution should be exercised by drivers after taking<unk> . | Flunitrazepam | Flutoprazepam | Halazepam | Triazolam | Medazepam | Remimazolam | Amfepramone | Estazolam | 00
| 967 |
Scar remained from a<unk> Before the operation, CT scans and MRIs are taken to study the cranial defect. The patient is given antibiotics to prevent bacterial infection. The patient is situated on a foam donut or a horseshoe head holder for the operation. The patient is then anaesthetised and an incision is made following the incision of the previous operation. The scalp and the temporalis muscle is reflected to completely reveal the cranial defect. Significant blood loss is observed as new blood vessels formed in scar tissues are damaged by incision. Any soft tissues at the edge of the defect are removed and the defect is cleaned. The<unk> material is placed on the defect and is fixed to the surrounding skull with standard titanium plate and screws. CSF may be drained from the brain to reduce herniation. Small holes may be drilled on the bone graft or the prosthesis to prevent the accumulation of fluid under the repaired defect. Soft tissues, temporalis, and the scalp are then fixed back in place. Subgaleal drain and dressing are applied to control facial swelling. After the operation, a CT scan is taken and patients may stay in intensive care for at least a night for better neurological status observation, or be placed in a regular care unit. The subgaleal drain and dressing are removed before the patient is dispatched. Children Special considerations to children undergoing<unk> are made to accommodate for their growing cranium. Certain materials are more favoured when compared to adult<unk> . Autologous bone grafts are the most preferred materials for paediatric<unk> , as they are accepted by the host and the bone flap can be integrated into the body of the host. However, autologous bone pieces may be unavailable or unsuitable in certain occasions. The body size of children may be not enough to have bone flaps to be stored in their subcutaneous spaces, while cryopreservation facilities for bone grafts are not widely available. The use of autograft is also associated with a high rate of bone resorption. Synthetic materials are used for paediatric<unk> when the use of autografts is not available or not recommended. Hydroxyapatite is another option for children<unk> as it allows the expansion of cranium for children and its ability to be moulded smoothly. It is less commonly used than autografts due to its brittle nature, high infection rate, and poor ability to integrate with the human cranium. Bilateral<unk> es are more prone to complications compared to unilateral<unk> es in children. This may be explained by its larger scalp wound area, a higher volume of blood loss, and the higher complexity and duration of the operation. | Cranioplasty | Astragalectomy | Craniotomy | Cerebrospinal fluid diversion | Decompressive craniectomy | Minimal-access cranial suspension | Head transplant | Lumbar–peritoneal shunt | 00
| 36,280 |
Nitroglycerin can be used immediately to dilate the venous system and reduce the circulating blood volume, therefore reducing the work and oxygen demand of the heart. In addition, nitroglycerin causes peripheral venous and artery dilation reducing cardiac preload and afterload. These reductions allow for decreased stress on the heart and therefore lower the oxygen demand of the heart's muscle cells. Antiplatelet drugs such as aspirin and clopidogrel can reduce platelet aggregation at the unstable atherosclerotic plaque, as well as combining these with an anticoagulant such as a low molecular weight heparin, can reduce clot formation. | complications of Angina | complications of Myocardial infarction | medical cause of Myocardial infarction | medical cause of Chest pain | complications of Arrhythmia | complications of Ventricular tachycardia | symptom of Myocardial infarction | complications of Coronary thrombosis | 00
| 32,570 |
The presentation of<unk> varies depending on the cause. The genetic conditions such as Liddle's syndrome and Congenital adrenal hyperplasia present in childhood or earlier in life than the acquired causes which can present at any age. Adult patients present with clinical history of resistant hypertension despite typical medical therapy and lifestyle changes. Hypertension may be asymptomatic or may lead to symptoms such as headache, dizziness, vision changes, or kidney disease. Symptoms of hypokalemia include fatigue, muscular weakness, and increased urine production. | Pseudohyperaldosteronism | Familial hyperaldosteronism | Primary aldosteronism | Pseudohypoaldosteronism | Hyperaldosteronism | Glucocorticoid remediable aldosteronism | Apparent mineralocorticoid excess syndrome | Hypoaldosteronism | 00
| 37,698 |
Laboratory tests may reveal an increased sedimentation rate, elevated CRP, anemia and elevated creatinine due to kidney impairment. An important diagnostic test is the presence of perinuclear antineutrophil cytoplasmic antibodies (p-ANCA) with myeloperoxidase specificity (a constituent of neutrophil granules), and protein and red blood cells in the urine. In patients with neuropathy, electromyography may reveal a sensorimotor peripheral neuropathy. Differential diagnosis The signs and symptoms of<unk> may resemble those of granulomatosis with<unk> (GPA) (another form of small-vessel vasculitis) but typically lacks the significant upper respiratory tract involvement (e.g., sinusitis) frequently seen in people affected by GPA. | Microscopic polyangiitis | Granulomatosis with polyangiitis | Polyarteritis nodosa | Lupus vasculitis | Eosinophilic granulomatosis with polyangiitis | Thromboangiitis obliterans | Transplant glomerulopathy | Thin basement membrane disease | 00
| 27,699 |
Skin showing sunburn below the shorts line Differential diagnosis The differential diagnosis of sunburn includes other skin pathology induced by UV radiation including photoallergic reactions, phototoxic reactions to topical or systemic medications, and other dermatologic disorders that are aggravated by exposure to sunlight. Considerations for diagnosis include duration and intensity of UV exposure, use of topical or systemic medications, history of dermatologic disease, and nutritional status. * Phototoxic reactions: Non-immunological response to sunlight interacting with certain drugs and chemicals in the skin which resembles an exaggerated sunburn. Common drugs that may cause a phototoxic reaction include amiodarone, dacarbazine, fluoroquinolones, 5-fluorouracil, furosemide, nalidixic acid, phenothiazines, psoralens, retinoids, sulfonamides, sulfonylureas, tetracyclines, thiazides, and vinblastine. * Photoallergic reactions: Uncommon immunological response to sunlight interacting with certain drugs and chemicals in the skin. When in excited state by UVR, these drugs and chemicals form free radicals that react to form functional antigens and induce a Type IV hypersensitivity reaction. These drugs include 6-methylcoumarin, aminobenzoic acid and esters, chlorpromazine, promethazine, diclofenac, sulfonamides, and sulfonylureas. Unlike phototoxic reactions which resemble exaggerated sunburns, photoallergic reactions can cause intense itching and can lead to thickening of the skin. * Phytophotodermatitis: UV radiation induces inflammation of the skin after contact with certain plants (including limes, celery, and meadow grass). Causes pain, redness, and blistering of the skin in the distribution of plant exposure. * Polymorphic light eruption: Recurrent abnormal reaction to UVR. It can present in various ways including pink-to-red bumps, blisters, plaques and urticaria. * Solar urticaria: UVR-induced wheals that occurs within minutes of exposure and fades within hours. * Other skin diseases exacerbated by sunlight: Several dermatologic conditions can increase in severity with exposure to UVR. These include systemic lupus erythematosus (SLE), dermatomyositis, acne, atopic dermatitis, and rosacea. Additionally, since sunburn is a type of radiation burn, it can initially hide a severe exposure to radioactivity resulting in acute radiation syndrome or other radiation-induced illnesses, especially if the exposure occurred under sunny conditions. For instance, the difference between the erythema caused by sunburn and other radiation burns is not immediately obvious. Symptoms common to heat illness and the prodromic stage of acute radiation syndrome like nausea, vomiting, fever, weakness/fatigue, dizziness or seizure can add to further diagnostic confusion. | symptom of Xeroderma pigmentosum | symptom of Japanese encephalitis | symptom of Chilaiditi syndrome | symptom of Dermatomyositis | symptom of Maroteaux–Lamy syndrome | symptom of Stevens–Johnson syndrome | symptom of Rotor syndrome | symptom of Bannayan–Riley–Ruvalcaba syndrome | 00
| 52,861 |
<unk> is a parasitic protozoan that causes<unk> in humans. It is one of several species of Plasmodium parasites that infect other organisms as pathogens, also including Plasmodium falciparum and Plasmodium vivax, responsible for most<unk> infection. Found worldwide, it causes a so-called "benign<unk> , not nearly as dangerous as that produced by P. falciparum or P. vivax. The signs include fevers that recur at approximately three-day intervals – a quartan fever or quartan<unk> – longer than the two-day (tertian) intervals of the other<unk> parasites. | Plasmodium malariae | Plasmodium vivax | Plasmodium ovale | Plasmodium chabaudi | Plasmodium knowlesi | Plasmodium unalis | Plasmodium yoelii | Leishmania infantum | 00
| 27,029 |
<unk> s work the same way that viral vaccines work, by training the immune system to attack cells that contain the<unk> s in the vaccine. The difference is that the<unk> s for viral vaccines are derived from viruses or cells infected with virus, while the<unk> s for<unk> s are derived from cancer cells. Since<unk><unk> s are<unk> s found in cancer cells but not normal cells, vaccinations containing<unk><unk> s should train the immune system to target cancer cells not healthy cells. Cancer-specific<unk><unk> s include peptides from proteins that are not typically found in normal cells but are activated in cancer cells or peptides containing cancer-specific mutations.<unk> -presenting cells (APCs) such as dendritic cells take up<unk> s from the vaccine, process them into epitopes, and present the epitopes to T-cells via Major Histocompatibility Complex proteins. If T-cells recognize the epitope as foreign, the adaptive immune system is activated and target cells that express the<unk> s. | Tumor antigen vaccine | Dendritic cell-based cancer vaccine | Cancer vaccine | Antigen-presenting cell vaccine | Therapeutic vaccines | T-cell vaccination | Cancer immunotherapy | Vaccine therapy | 00
| 48,229 |
The variation in pressure in the left ventricle (blue line) and the aorta (red line) over two cardiac cycles ("heart beats"), showing the definitions of systolic and diastolic pressure. A recent classification recommends blood pressure criteria for defining normal blood pressure, prehypertension,<unk> (stages I and II), and isolated systolic<unk> , which is a common occurrence among the elderly. These readings are based on the average of seated blood pressure readings that were properly measured during 2 or more office visits. In individuals older than 50 years,<unk> is considered to be present when a person's blood pressure is consistently at least 140 mmHg systolic or 90 mmHg diastolic. Patients with blood pressures over 130/80 mmHg along with Type 1 or Type 2 diabetes, or kidney disease require further treatment. Classification Systolic pressure Diastolic pressure mmHg kPa (kN/m2) mmHg kPa (kN/m2) Normal 90–119 12–15.9 60–79 8.0–10.5 Prehypertension 120–139 16.1–18.5 80–89 10.8–11.9 Stage 1 140–159 18.7–21.2 90–99 12.0–13.2 Stage 2 ≥160 ≥21.3 ≥100 ≥13.3 Isolated systolichypertension ≥140 ≥18.7 <90 <12.0 Source: American Heart Association (2003). Resistant<unk> is defined as the failure to reduce blood pressure to the appropriate level after taking a three-drug regimen. Guidelines for treating resistant<unk> have been published in the UK, and US. | Essential hypertension | Benign hypertension | Secondary hypertension | Paroxysmal hypertension | Renovascular hypertension | White coat hypertension | Labile hypertension | Systolic hypertension | 00
| 17,819 |
A<unk> is a type of burn caused by exposure to the combustion gases which are expelled from the muzzle of a firearm as it is fired.<unk> s only occur when the individual is in close proximity to the discharging firearm, as the gases quickly dissipate. This can be an indicator on a corpse of whether the person was shot at point-blank range or not. | Powder burn | Aerosol burn | Electrical burn | Chemical burn | Hydrofluoric acid burn | Flash burn | Cigarette burns | Friction burn | 00
| 62,803 |
The aims of treatment are to limit the severity and duration of pain, shorten the duration of a<unk> episode, and reduce complications. Symptomatic treatment is often needed for the complication of postherpetic neuralgia. However, a study on untreated<unk> shows that, once the rash has cleared, postherpetic neuralgia is very rare in people under 50 and wears off in time; in older people, the pain wore off more slowly, but even in people over 70, 85% were free from pain a year after their<unk> outbreak. Analgesics People with mild to moderate pain can be treated with over-the-counter pain medications. Topical lotions containing calamine can be used on the rash or blisters and may be soothing. Occasionally, severe pain may require an opioid medication, such as morphine. Once the lesions have crusted over, capsaicin cream (Zostrix) can be used. Topical lidocaine and nerve blocks may also reduce pain. Administering gabapentin along with antivirals may offer relief of postherpetic neuralgia. Antivirals Antiviral drugs may reduce the severity and duration of<unk> ; however, they do not prevent postherpetic neuralgia. Of these drugs, aciclovir has been the standard treatment, but the newer drugs valaciclovir and famciclovir demonstrate similar or superior efficacy and good safety and tolerability. The drugs are used both for prevention (for example in people with HIV/AIDS) and as therapy during the acute phase. Complications in immunocompromised individuals with<unk> may be reduced with intravenous aciclovir. In people who are at a high risk for repeated attacks of<unk> , five daily oral doses of aciclovir are usually effective. Steroids Corticosteroids do not appear to decrease the risk of long-term pain. Side effects however appear to be minimal. Their use in Ramsay Hunt syndrome had not been properly studied as of 2008. Zoster ophthalmicus Zoster ophthalmicus Treatment for zoster ophthalmicus is similar to standard treatment for<unk> at other sites. A trial comparing acyclovir with its prodrug, valacyclovir, demonstrated similar efficacies in treating this form of the disease. The significant advantage of valacyclovir over acyclovir is its dosing of only three times/day (compared with acyclovir's five times/day dosing), which could make it more convenient for people and improve adherence with therapy. | Shingles | Insect bites and stings | Sealpox | Angina | Farmyard pox | Herpes simplex | Streptococcal intertrigo | Sciatica | 00
| 12,694 |
Asthma is the result of chronic inflammation of the conducting zone of the airways (most especially the bronchi and bronchioles), which subsequently results in increased contractability of the surrounding smooth muscles. This among other factors leads to bouts of narrowing of the airway and the classic symptoms of wheezing. The narrowing is typically reversible with or without treatment. Occasionally the airways themselves change. Typical changes in the airways include an increase in eosinophils and thickening of the lamina reticularis. Chronically the airways' smooth muscle may increase in size along with an increase in the numbers of mucous glands. Other cell types involved include T lymphocytes, macrophages, and neutrophils. There may also be involvement of other components of the immune system, including cytokines, chemokines, histamine, and leukotrienes among others. File:Asthma attack-illustration NIH.Figure A shows the location of the lungs and airways in the body. Figure B shows a cross-section of a normal airway. Figure C shows a cross-section of an airway during asthma symptoms. File:Asthma .alt=Obstruction of the lumen of a bronchiole by mucoid exudate, goblet cell metaplasia, and epithelial basement membrane thickening in a person with asthma. File:Asthma (Lungs).Diagram of asthma | risks of Allergic rhinitis | risks of Sinusitis | causes of Peanut allergy | risks of Stevens–Johnson syndrome | risks of Pneumocystis pneumonia | causes of Tonsillitis | risks of Melioidosis | risks of Toxic epidermal necrolysis | 00
| 3,031 |
<unk> injections were proposed over a century ago however the number performed remained relatively low until the mid 2000s. Until 2001,<unk> injections were mainly used to treat end-ophthalmitis. The number of<unk> injections stayed fairly constant, around 4,500 injections per year in the US. The number of injections tripled to 15,000 in 2002 when triamcinolone injections were first used to treat diabetic macular oedema. This use continued to drive an increase to 83,000 injections in 2004. In 2005 bevacizumab and ranibizumab<unk> injections for the treatment of wet-AMD caused a rise in injections to 252,000. In 2008, over 1 million<unk> injections were performed. This doubled to 2 million just 3 years later in 2011 when another anti-VEGF<unk> injection aflibercept became available for the treatment of wet AMD.<unk> injections hit an all-time high in 2016 reaching over 5.9 million injections in the US. | Intravitreal administration | Intravitreal injection | Intracameral injection | Intracerebroventricular injection | Subcutaneous injection | Subcutaneous infusion | Intraperitoneal injection | Intramuscular injection | 00
| 37,560 |
<unk> is used by physicians to diagnose scapholunate instability. This test has a low specificity and sometimes is positive for capito-lunate instability. As many as 20% of normal wrists will also have a 'clunk'. | Watson's test | Clarke's test | Schwatrz's test | Monoyer chart | Sereny test | Golovin–Sivtsev table | Jaeger chart | Ogden tables | 00
| 57,366 |
Diagnosis is made by carefully looking at the pubic hair for nits, young lice and adult lice. Lice and nits can be removed either with forceps or by cutting the infested hair with scissors (with the exception of an infestation of the eye area). A magnifying glass, dermatoscope or a stereo-microscope can be used for identification. Testing for other sexually transmitted infections is recommended in those who are infested with pubic lice. | Pediculosis pubis | Calcaneal spur | Osteitis pubis | Pediculosis corporis | Protrusio acetabuli | Pectus excavatum | Sacral dimple | Carpal coalition | 00
| 59,535 |
Pathophysiology of the<unk> An<unk> <unk> is a very uncommon childbirth (obstetric) emergency in which<unk><unk> enters the blood stream of the mother to trigger a serious reaction. This reaction then results in cardiorespiratory (heart and lung) collapse and massive bleeding (coagulopathy). The rate at which it occurs is 1 instance per 20,000 births and it comprises 10% of all maternal deaths. This condition is unpredictable and no risk factors have been verified. | Amniotic fluid embolism | Traumatic asphyxia | Artificial rupture of membranes | Cerebrospinal fluid leak | Foetal cerebral redistribution | Neonatal meningitis | Rupture of membranes | Fetal-maternal haemorrhage | 00
| 42,892 |
Bloating is not life-threatening. In most cases, bloating can be handled with simple home remedies and changes in lifestyle. Foods Certain foods have been known to worsen bloating. Poorly digested components of many foods are excreted into the large intestine where they are degraded by bacteria, producing excess gas. Depending on the undigested component, this may affect the odor and the volume of gas created. Excess dietary fiber intake is a known cause of belching, gas and bloating. Many vegetables are known to cause bloating due to high levels of fiber and undigestible sugars such as raffinose (e.g., beans, cabbage, broccoli). There are many individuals who are unable to tolerate dairy products because of lactose intolerance. Such foods should be eliminated from the diet if symptoms develop. Medications For some people, recurrent<unk> symptoms worsen their quality of life and thus many resort to health supplements or medications. Dietary supplements containing various enzymes, for example Beano, are formulated to help break down complex carbohydrates and vegetables in order to reduce substances in the gut that cause bacterial overgrowth and subsequent bloating. Though these enzymes can help reduce gas and belching, they may not always reduce bloating. Other-over-the-counter formulas recommended for bloating include simethicone and activated charcoal. Probiotics are also used to treat bloating based on the theory that improved gut flora will improve digestion and lessen gas generation. | Abdominal distension | Gallbladder flush | Blood in stool | Abdominal pain | Abdominal guarding | Rectal discharge | Nipple discharge | Fecal vomiting | 00
| 32,832 |
<unk> consists of placing a rigid covered dome around the abdomen, with the inside being decompressed to -50 to -100 mmHg for 15 to 30 seconds out of each minute for 30 minutes, one to three times daily, or continuously during labour.<unk> has been known to treat<unk> compartment syndrome (ACS) helping patients who suffer from intra-abdominal pressure (IAP) and organ dysfunction. | Abdominal decompression | Preperitoneal packing | Whole bowel irrigation | Gastroenterostomy | Perihepatic packing | Colostomy reversal | Cholecystenterostomy | Ileostomy | 00
| 60,991 |
Prevention of<unk> is difficult as there are no reliable markers for the later development of the disorder. There is tentative though inconclusive evidence for the effectiveness of early intervention to prevent<unk> in the prodrome phase. There is some evidence that early intervention in those with first-episode psychosis may improve short-term outcomes, but there is little benefit from these measures after five years. Cognitive behavioral therapy may reduce the risk of psychosis in those at high risk after a year and is recommended in this group, by the National Institute for Health and Care Excellence (NICE). Another preventive measure is to avoid drugs that have been associated with development of the disorder, including cannabis, cocaine, and amphetamines. Antipsychotics are prescribed following a first-episode psychosis, and following remission a preventive maintenance use is continued to avoid relapse. However, it is recognised that some people do recover following a single episode and that long-term use of antipsychotics will not be needed but there is no way of identifying this group. | Schizophrenia | Delusional disorder | Disorganized schizophrenia | Schizoaffective disorder | Simple-type schizophrenia | Autism | Schizophreniform disorder | Bipolar disorder | 00
| 2,038 |
The<unk> include axons of type GSE, general somatic efferent, which innervate skeletal muscle of the levator palpebrae superioris, superior rectus, medial rectus, inferior rectus, and inferior oblique muscles.(innervates all the extrinsic muscles except superior oblique and lateral rectus.) The<unk> also includes axons of type GVE, general visceral efferent, which provide preganglionic parasympathetics to the ciliary ganglion. From the ciliary ganglion post ganglionic fibers pass through the short ciliary<unk> to the constrictor pupillae of the iris and the cilliary muscles. | Oculomotor nerve | Supratrochlear nerve | Olfactory nerve | Buccal branches of the facial nerve | Auriculotemporal nerve | Olfactory trigone | Nerve of pterygoid canal | Optician | 00
| 9,289 |
<unk> is the act of performing a surgical procedure on oneself. It can be an act taken in extreme circumstances out of necessity, an attempt to avoid embarrassment, legal action, or financial costs, or a rare manifestation of a psychological disorder. | Self-surgery | Self-Surgery | Circumcision surgical procedure | Virgin cleansing myth | Pastoral care | Implant | Foreskin restoration | Clitoral enlargement methods | 00
| 20,430 |
<unk> is a fluorescence in situ hybridization assay that was developed for the detection of bladder cancer in urine specimens. It consists of fluorescently labeled DNA probes to the pericentromeric regions of chromosomes 3 (red), 7 (green), and 17 (aqua) and to the 9p21 band (gold) location of the P16 tumor suppressor gene. | UroVysion | Petrissage | Organ gifting | Adhesion | Denudation | Encopresis | Labial fusion | Hydrodissection | 00
| 66,956 |
<unk> is not exclusive for insulinoma, and other conditions will also be considered. The same signs may be caused by hyperinsulinism not caused by insulinoma. | Whipple's triad | Charcot's cholangitis triad | picture of Diverticulitis | Prehn's sign | Friedreich's sign | Ballance's sign | Oliver's sign | Carvallo's sign | 00
| 20,506 |
This mass can be detected and removed before transformation and metastasis. The tumor is often detected by imaging such as ultrasound. The location and size of the tumor may cause pressure and pain to the patient. But often the tumor goes undetected. After detection, the mass is tested using an invasive fine-needle aspiration biopsy.<unk> is the benign analogue of<unk> cell carcinoma. This adenoma is extremely rare; when it occurs, it usually occurs in women. Often the adenoma is harmless but is removed after detection because its future course cannot be trusted. | Hürthle cell adenoma | Metanephric adenoma | Nephrogenic adenoma | Pleomorphic adenoma | Pituitary adenoma | Adrenocortical adenoma | Granular cell tumor | Primary pigmented nodular adrenocortical disease | 00
| 31,402 |
<unk> (also known as stress eating) is defined as the "propensity to eat in response to positive and negative emotions". While the term often refers to eating as a means of coping with negative emotions, it also includes eating for positive emotions, such as eating foods when celebrating an event or eating to enhance an already good mood. In these situations, emotions are still driving the eating but not in a negative way. | Emotional eating | Counterregulatory eating | Kinking hair | Sleep-talking | Soiling | Food craving | Binge eating | Eating recovery | 00
| 65,939 |
<unk> s are a class of drugs that activate<unk> -HT2C<unk> s. They have been investigated for the treatment of a number of conditions including obesity, psychiatric disorders, sexual dysfunction and urinary incontinence. The<unk> -HT2C<unk> s are one of three subtypes that belong to the serotonin<unk> -HT2<unk> subfamily along with<unk> -HT2A and<unk> -HT2B<unk> s. The development of<unk> -HT2C agonists has been a major obstacle, because of severe side effects due to a lack of selectivity over<unk> -HT2A and<unk> -HT2B<unk> s. Activation of<unk> -HT2A<unk> s can induce hallucinations, and the activation of<unk> -HT2B<unk> s has been implicated in cardiac valvular insufficiency and possibly in pulmonary hypertension. | 5-HT2C receptor agonist | Serotonin receptor agonist | Glycine receptor antagonist | Adenosine reuptake inhibitor | Dopamine agonist | Muscarinic antagonist | 5-HT3 antagonist | Dopamine antagonist | 00
| 63,584 |
Renal ultrasonography of<unk> renal disease caused by glomerulonephritis with increased echogenicity and reduced cortical thickness. Measurement of<unk> length on the US image is illustrated by '+' and a dashed line. Some forms of glomerulonephritis are diagnosed clinically, based on findings on history and examination. Other tests may include: * Urine examination * Blood tests investigating the cause, including FBC, inflammatory markers, and special tests (including ASLO, ANCA, Anti-GBM, Complement levels, Anti-nuclear antibodies) * Biopsy of the<unk> * Renal ultrasonography is useful for prognostic purposes in finding signs of<unk><unk> disease, which however may be caused by many other diseases than glomerulonephritis. | causes of Chronic kidney disease | causes of Nephrotic syndrome | causes of Hypercalcaemia | causes of Hyperphosphatemia | causes of Pyelonephritis | causes of Peripheral artery disease | risks of Peripheral artery disease | risks of Myocardial infarction | 00
| 21,445 |
<unk> is not significantly absorbed from the gut, and therefore does not have much significant interactions with other drugs in people with normal liver function. | Rifaximin | Ursodeoxycholic acid | Chenodeoxycholic acid | Lactulose | Piretanide | Sucralfate | Cefiderocol | Rifapentine | 00
| 34,538 |
Absolute contraindications for the procedure are metastatic disease in the abdominal cavity or nearby organs. These are found most often on the peritoneum, in the liver, and in the omentum. In order to determine if there are metastases, surgeons will inspect the abdomen at the beginning of the procedure after gaining access. Alternatively, they may perform a separate procedure called a diagnostic laparoscopy which involves insertion of a small camera through a small incision to look inside the abdomen. This may spare the patient the large abdominal incision that would occur if they were to undergo the initial part of a<unk> that was cancelled due to metastatic disease. Further contraindications include encasement of major vessels (such as celiac artery, inferior vena cava, or superior mesenteric artery) as mentioned above. | Pancreaticoduodenectomy | Segmental resection | Pancreatectomy | Transcatheter arterial chemoembolization | Hepatectomy | Gastrectomy | Jejunoileal bypass | Sleeve gastrectomy | 00
| 21,771 |
<unk> , also known as amidotrizoate, is a contrast agent used during X-ray imaging. This includes visualizing veins, the urinary system, spleen, and joints, as well as computer tomography (CT scan). It is given by mouth, injection into a vein, injection into the bladder, through a nasogastric tube, or rectally. Relatively common side effects include vomiting, diarrhea, and skin redness. Other side effects include itchiness, kidney problems, low blood pressure, and allergic reactions. It is not recommended in people who have an iodine allergy.<unk> is an iodinated ionic radiocontrast agent with high osmolality.<unk> was approved for medical use in the United States in 1954. It is on the World Health Organization's List of Essential Medicines. | Diatrizoate | Dichloroacetic acid | Orthosilicic acid | Phospho soda | Triheptanoin | Hermaphrodite | Thiamylal | Lactitol | 00
| 30,713 |
A<unk> is a yellow, perifollicular, saucerlike or cup-shaped crust with a cheesy odor, composed of dense mats of mycelia and epithelial debris. Scutula often occur on the scalp and are characteristic of favus. | Scutulum | Vesical tenesmus | Symphytum | Inoculum | Pinguecula | Genu varum | Periorbita | Cutaneous horn | 00
| 36,738 |
If<unk> injury is not diagnosed promptly, a worse outcome is associated. Delayed treatment is associated with an especially high morbidity and mortality if perforation of the gastrointestinal tract is involved. | Abdominal trauma | Post-vagotomy diarrhea | Splenic injury | Pancreatic injury | Intra-abdominal infection | Major trauma | Biliary injury | Postoperative fever | 00
| 50,466 |
<unk> is an antiemetic drug. In the United States, the combination drug<unk> /palonosetron (trade name Akynzeo) is approved by the Food and Drug Administration for prevention of acute and delayed chemotherapy-induced nausea and vomiting, including highly emetogenic chemotherapy such as with cisplatin. In Europe, it is approved by the European Medicines Agency (EMA) for the same indication. | Netupitant | Oprelvekin | Aprepitant | Bosentan | Macitentan | Ezlopitant | Eptifibatide | Tafamidis | 00
| 66,800 |
<unk> is an antibacterial medicated<unk> owned by Godrej Consumer Products.<unk> was originally manufactured in Boston, Massachusetts by Potter Drug and Chemical Company. Noted Boston philanthropist George Robert White (1847-1922) was once the president and owner of Potter Drug and Chemical Company.<unk> has been in use, and is relatively unchanged, since 1865. | Cuticura soap | Winpepi | Pit latrine | Crusaid | Haidinger's brush | Tao brush | Antimonial cup | Tar water | 00
| 43,551 |
Treatment of THB deficiencies consists of THB supplementation (2–20 mg/kg per day) or diet to control blood phenylalanine concentration and replacement therapy with neurotransmitters precursors (L-DOPA and 5-HTP) and supplements of folinic acid in DHPR deficiency.<unk> is available as a tablet for oral administration in the form of<unk> dihydrochloride (BH4*2HCL). BH4*2HCL is FDA approved under the trade name Kuvan. The typical cost of treating a patient with Kuvan is $100,000 per year. BioMarin holds the patent for Kuvan until at least 2024, but Par Pharmaceutical has a right to produce a generic version by 2020. BH4*2HCL is indicated at least in<unk> caused by GTPCH deficiency or PTPS deficiency. | Tetrahydrobiopterin deficiency | Cerebral folate deficiency | Cytochrome b5 deficiency | Adenine phosphoribosyltransferase deficiency | Molybdenum cofactor deficiency | Methylenetetrahydrofolate reductase deficiency | Dihydropyrimidine dehydrogenase deficiency | Biotin deficiency | 00
| 32,652 |
<unk> refers to a high or low<unk><unk> <unk> (BMR). It has numerous causes, both physiological (part of the body's normal function) and pathological (associated with disease). | Abnormal basal metabolic rate | Thyroid hormone resistance | Insulin resistance | Pituitary ACTH hypersecretion | Adrenocortical hyperfunction | Problematic social media use | Chronic stress | Problematic smartphone use | 00
| 31,534 |
The Javits Center in New York City has been used as an ACS during the COVID-19 pandemic. An<unk> (ACS) is a medical treatment facility established in a non-traditional setting during a public-health crisis (or other event causing strain on local medical resources) as a means of providing additional capacity to deliver medical<unk> within a given area. The term encompasses both civilian-operated medical facilities established in non-traditional places such as hotels, gymnasiums, and convention centers, or other "structures of opportunity," as well as military field medical units being used for public-health purposes. Usually, the option of establishing an ACS becomes relevant once the scale of an emergency extends beyond a single metropolitan area. Though commonly established (or, at a minimum, overseen) by public-health authorities, ACSes can also be established by private entities, such as large employers. ACSes have been widely used as part of the response to the COVID-19 pandemic, and in other recent crises such as the Western African Ebola virus epidemic. | Alternate care site | Injection port | Patient gown | Biological specimen | Drug packaging | Surgical instrument | Durable medical equipment | Trocar | 00
| 73,971 |
<unk> , also known as agenesis of corpus callosum with neuronopathy (ACCPN) and Charlevoix disease, among other names, is a very rare neurodegenerative genetic disorder that damages the nerves used to control muscles and related to sensation and is often associated with agenesis of the corpus collosum. It was first described by Eva<unk> et al. in 1972. | Andermann syndrome | Zimmermann–Laband syndrome | Scheuermann's disease | Ackerman syndrome | Hallermann–Streiff syndrome | Conradi–Hünermann syndrome | Omenn syndrome | Binder's syndrome | 00
| 69,760 |
The following revised diagnostic criteria for<unk> were proposed in 2005. The diagnosis requires the presence of both A criteria together with B3 to B6, or of criterion A1 together with B1 to B6. The criteria are as follows: * A1. Platelet count > 400 × 103/µL for at least 2 months. * A2. Acquired V617F JAK2 mutation present * B1. No cause for a reactive thrombocytosis * normal inflammatory indices * B2. No evidence of iron deficiency * stainable iron in the bone marrow or normal red cell mean corpuscular volume * B3. No evidence of polycythemia vera * hematocrit < midpoint of normal range or normal red cell mass in presence of normal iron stores * B4. No evidence of chronic myeloid leukemia * But the Philadelphia chromosome may be present in up to 10% of cases. Patients with the Philadelphia chromosome have a potential for the development of acute leukemia, especially acute lymphocytic leukemia. * B5. No evidence of myelofibrosis * no collagen fibrosis and ≤ grade 2 reticulin fibrosis (using 0–4 scale) * B6. No evidence of a myelodysplastic syndrome * no significant dysplasia * no cytogenetic abnormalities suggestive of myelodysplasia | Essential thrombocythemia | Refractory cytopenia of childhood | Polycythemia vera | Transient erythroblastopenia of childhood | Primary myelofibrosis | Chronic neutrophilic leukemia | Drug-induced thrombocytopenic purpura | Aplastic anemia | 00
| 18,396 |
An eating disorder is a mental disorder defined by abnormal eating behaviors that negatively affect a person's physical or mental health. Only one eating disorder can be diagnosed at a given time. Types of eating disorders include binge eating disorder, where the afflicted eats a large amount in a short period of time; anorexia nervosa, where the person afflicted has an intense fear of gaining weight and restricts food or overexercises to manage this fear; bulimia nervosa, where afflicted individuals eat a large quantity (binging) then try to rid themselves of the food (purging); pica, where the afflicted eats non-food items; rumination syndrome, where the afflicted regurgitates undigested or minimally digested food; avoidant/restrictive food intake disorder (ARFID), where people have a reduced or selective food intake due to some psychological reasons (see below); and a group of other specified feeding or eating disorders. Anxiety disorders, depression and substance abuse are common among people with eating disorders. These disorders do not include obesity. The causes of eating disorders are not clear, although both biological and environmental factors appear to play a role. Cultural idealization of thinness is believed to contribute to some eating disorders. Individuals who have experienced sexual abuse are also more likely to develop eating disorders. Some disorders such as pica and rumination disorder occur more often in people with intellectual disabilities. Treatment can be effective for many eating disorders. Treatment varies by disorder and may involve counseling, dietary advice, reducing excessive exercise, and the reduction of efforts to eliminate food. Medications may be used to help with some of the associated symptoms. Hospitalization may be needed in more serious cases. About 70% of people with anorexia and 50% of people with bulimia recover within five years. Only 10% of people with eating disorders receive treatment, and of those, approximately 80% do not receive the proper care. Many are sent home weeks earlier than the recommended stay and are not provided with the necessary treatment. Recovery from binge eating disorder is less clear and estimated at 20% to 60%. Both anorexia and bulimia increase the risk of death. Estimates of the prevalence of eating disorders vary widely, reflecting differences in gender, age, and culture as well as methods used for diagnosis and measurement. In the developed world, anorexia affects about 0.4% and bulimia affects about 1.3% of young women in a given year. Binge eating disorder affects about 1.6% of women and 0.8% of men in a given year. According to one analysis, the percent of women who will have anorexia at some point in their lives may be up to 4%, or up to 2% for bulimia and binge eating disorders. Rates of eating disorders appear to be lower in less developed countries. Anorexia and bulimia occur nearly ten times more often in females than males. The typical onset of eating disorders in late childhood to early adulthood. Rates of other eating disorders are not clear. | complications of Body image disturbance | treatment of Gender dysphoria | treatment of Body image disturbance | treatment of Eating disorder | risks of Erectile dysfunction | risks of Somatization disorder | complications of Eating disorder | symptom of Chronic fatigue syndrome | 00
| 4,066 |
Food from<unk> s A<unk> is a diet consisting mostly or entirely of<unk><unk> foods.<unk> s encompass a wide range of dietary patterns that contain low amounts of animal products and high amounts of<unk> products such as vegetables, fruits, whole cereals, legumes, nuts and seeds. They do not need to be vegan or vegetarian but are defined in terms of low frequency of animal food consumption. | Plant-based diet | Feingold diet | Low-fiber/low-residue diet | Low-FODMAP diet | Stillman diet | Rice diet | Specific carbohydrate diet | Cotton ball diet | 00
| 17,890 |
Due to the rarity of this disease, there is a lack of comprehensive and high quality research about the different treatment options, and therefore, no specific treatment plan is followed globally. However, some studies have attempted to outline the most widely accepted approaches in dealing with<unk> . Fluorinated steroids There is no agreement on using fluorinated steroids in treating<unk> , and the results of the different studies are contradictory. These steroids (such as dexamethasone) are used when the disease is diagnosed in utero as they can cross the placenta without being deactivated. The main goal of using corticosteroids is to mitigate the inflammation by decreasing the amount of anti Ro/La autoantibodies in the fetal serum. Therefore, they are used in the autoimmune-mediated<unk> . Both the mother and the fetus might suffer from their side effects which can include growth problems and adrenal insufficiency. Beta-adrenergic agonist Trebutaline and Sulbutamol are among the medications that have been used to treat<unk> . They are used mainly to increase the heart rate in fetuses suffering from bradycardia. Although they showed positive results, some patients showed intolerance to their side effects. Plasmapheresis Plasma exchange in women positive to anti Ro/La autoantibodies has not been studied thoroughly, but it is suggested to have and effect on the titer of the antibodies in the mother's serum and therefore might have a preventive role. Intravenous immunoglobulin Using intravenous immunoglobulin showed some promising results in decreasing the possibility of having<unk> 's complications such as EFE and cardiomyopathy. Hydroxychloroquine Hydroxychloroquine is relatively new approach, but it showed promising results in preventing the inflammation and other injuries result from it such as fibrosis. Apart from these medications, a pace maker might be needed in around two thirds of the cases, and a procedure might be required when the heart has structural abnormalities. | Congenital heart block | Ectopic pacemaker | Cyanotic heart defect | Acyanotic heart defect | Cardiac myxoma | Heart valve dysplasia | Primary tumors of the heart | Broken Heart | 00
| 73,018 |
Type 1 and Type 2 FAD call for the same treatment: immediate surgery to replace the aorta. Surgery is required due to the high risk of mortality. Type 3 is less severe and requires the maintenance of blood pressure through diet and exercise. Upon diagnosing someone with FAD intravenous antihypertensive treatment is frequently used. Often intravenous sodium nitroprusside is used for its efficiency in lessening the pulsatile load thus reducing blood pressure. Reducing this force slows the progression of the<unk> . Surgical success depends on age, severity of symptoms, postoperative organ dysfunction and stroke. Surgical intervention is always indicated in Type 1 cases. Aortic surgery is palliative, not curative. The goal is to merely to prevent rupture, restore blood flow, and fix any aortic valve dysfunction. Post operative protocols include frequent monitoring of the aorta diameter. Statins and beta blockers are also popular treatments used to reduce future plaque build up and blockage of epinephrine receptors as a way to control heart rate and blood pressure. Long term treatment should also include regular check ups every 3 to 6 months. A CT scan or MRI is recommended, along with required chest x-rays. Antihypertensive therapy with beta adrenergic antagonists is required regardless of medical versus surgical treatment. Ten to twenty percent of those who choose surgical intervention are re-operated on due to compression, aneurysm development or blood leakage. | Familial aortic dissection | Familial thoracic aortic aneurysm | Familial atrial fibrillation | Takayasu's arteritis | Arterial tortuosity syndrome | Inflammatory aortic aneurysm | Monckeberg's arteriosclerosis | Coronary artery aneurysm | 00
| 54,647 |
<unk> , also known as 2-hydroxymethylene-17α-methyl-4,5α-dihydrotestosterone (2-hydroxymethylene-17α-methyl-DHT) or as 2-hydroxymethylene-17α-methyl-5α-androstan-17β-ol-3-one, is a synthetic androstane steroid and a 17α-alkylated derivative of DHT. | Oxymetholone | Metenolone | Oxendolone | Trestolone | Fluocinonide | Methylstenbolone | Mometasone | Trenbolone acetate | 00
| 29,939 |
Surgery is the only cure for parathyroid adenomas. It is successful about 95% of the time. Parathyroidectomy is the removal of the affected gland(s). The standard of treatment of primary hyperparathyroidism was formerly a surgical technique called bilateral neck exploration, in which the neck was opened on both sides, the parathyroids were identified, and the affected tissue was removed. By the 1980s, unilateral exploration became more common. Parathyroidectomy can now be performed in a minimally invasive fashion, mainly because imaging techniques can pinpoint the location of the tissue. Minimally invasive techniques include smaller open procedures, radio-guided and video-assisted procedures, and totally endoscopic surgery. Before surgery is attempted, the affected glandular tissue must be located. Though the parathyroid glands are usually located on the back of the thyroid, their position is variable. Some people have one or more parathyroid glands elsewhere in the neck anatomy or in the chest. About 10% of parathyroid adenomas are ectopic, located not along the back of the thyroid but elsewhere in the body, sometimes in the mediastinum of the chest. This can make them difficult to locate, so various imaging techniques are used, such as the sestamibi scan, single-photon emission computed tomography (SPECT), ultrasound, MRI, and CT scans. sometimes parathyroid adenomas can be ablated by ethanol injection, laser or radiofrequency guided by ultrasound. | medical cause of Hyperparathyroidism | medical diagnosis of Hyperparathyroidism | medical cause of Hyperphosphatemia | medical cause of Hypophosphatemia | complications of Hyperparathyroidism | symptom of Hyperparathyroidism | medical cause of Hyperthyroidism | medical cause of Hypothyroidism | 00
| 50,879 |
<unk> (USAN), trade name Ravicti, is a medication used in the treatment of certain inborn urea cycle disorders. The medication works by preventing the harmful buildup of ammonia in the body. It is an FDA-approved prescription drug in the US. It is approved for anyone over 2 months of age. It was developed by Hyperion Therapeutics based on the existing drug Buphenyl, and received approval on February 1, 2013. Hyperion has been criticized for setting a high price for the drug. The price was set at US$250,000–290,000. In 2014, the drug generated $30.8 million in net sales, far behind the older and less expensive Buphenyl ($113.6 million in sales). In March 2015, Horizon Pharma acquired Hyperion Therapeutics and thus Raviciti. | Glycerol phenylbutyrate | Indoxyl sulfate | Beta-Hydroxy beta-methylbutyric acid | Homotaurine | Doisynolic acid | Oxycholesterol | 3-Indolepropionic acid | Phenylacetic acid | 00
| 64,405 |
Unlike diagnostic efforts prompted by symptoms and<unk> signs, cancer screening involves efforts to detect cancer after it has formed, but before any noticeable symptoms appear. This may involve physical examination, blood or urine tests or<unk> imaging. Cancer screening is not available for many types of cancers. Even when tests are available, they may not be recommended for everyone. Universal screening or mass screening involves screening everyone. Selective screening identifies people who are at higher risk, such as people with a family history. Several factors are considered to determine whether the benefits of screening outweigh the risks and the costs of screening. These factors include: * Possible harms from the screening test: for example, X-ray images involve exposure to potentially harmful ionizing radiation * The likelihood of the test correctly identifying cancer * The likelihood that cancer is present: Screening is not normally useful for rare cancers. * Possible harms from follow-up procedures * Whether suitable treatment is available * Whether early detection improves treatment outcomes * Whether the cancer will ever need treatment * Whether the test is acceptable to the people: If a screening test is too burdensome (for example, extremely painful), then people will refuse to participate. * Cost Recommendations U.S. Preventive Services Task Force The U.S. Preventive Services Task Force (USPSTF) issues recommendations for various cancers: * Strongly recommends cervical cancer screening in women who are sexually active and have a cervix at least until the age of 65. * Recommend that Americans be screened for colorectal cancer via fecal occult blood testing, sigmoidoscopy, or colonoscopy starting at age 50 until age 75. * Evidence is insufficient to recommend for or against screening for skin cancer, oral cancer, lung cancer, or prostate cancer in men under 75. * Routine screening is not recommended for bladder cancer, testicular cancer, ovarian cancer, pancreatic cancer, or prostate cancer. * Recommends mammography for breast cancer screening every two years from ages 50–74, but does not recommend either breast self-examination or clinical breast examination. A 2013 Cochrane review concluded that breast cancer screening by mammography had no effect in reducing mortality because of overdiagnosis and overtreatment. Japan Screens for gastric cancer using photofluorography due to the high incidence there. Genetic testing Gene Cancer types BRCA1, BRCA2 Breast, ovarian, pancreatic HNPCC, MLH1, MSH2, MSH6, PMS1, PMS2 Colon,<unk> , small bowel, stomach, urinary tract Genetic testing for individuals at high-risk of certain cancers is recommended by unofficial groups. Carriers of these mutations may then undergo enhanced surveillance, chemoprevention, or preventative surgery to reduce their subsequent risk. | medical cause of Abnormal uterine bleeding | symptom of Postpartum infections | medical cause of Postpartum bleeding | symptom of Postpartum bleeding | symptoms of Endometriosis | symptom of Endometriosis | symptom of Ectopic pregnancy | symptom of Ovarian cancer | 00
| 5,928 |
<unk> (TVOR), also referred to as<unk> retrieval (OCR), is a technique used in in vitro fertilization (IVF) in order to remove<unk> s from the ovary of a woman, enabling fertilization outside the body.<unk> is more properly referred to as<unk> ovum retrieval when the<unk> s have matured into ova, as is normally the case in IVF. It can be also done for egg donation,<unk> cryopreservation and other assisted reproduction technology such as ICSI | Transvaginal oocyte retrieval | Posthumous sperm retrieval | Menstrual extraction | Ovarian tissue cryopreservation | Ovarian drilling | Ovarian stimulation | Artificial insemination | Embryo transfer | 00
| 45,762 |
Some of the possible complications associated with<unk> include: * Risks of anaesthesia, including allergic reaction * Surgical risks such as bleeding or infection * Blood clots that may cause potentially fatal cardiovascular complications, such as heart attack, deep vein thrombosis or stroke * Collapsed lung * Fluid build-up under the wound * Tissue death along the wound, or skin loss * Sensory nerve damage, which may cause prolonged or permanent numbness in the upper arm or even in the forearm * Prolonged swelling * Damage to underlying tissues such as muscles * Asymmetry (unevenness) of the skin * Unsightly, inflamed or itchy scarring * Further surgery to treat complications. | Brachioplasty | Phalloplasty | Chondrolaryngoplasty | Non-surgical rhinoplasty | Trabeculoplasty | Gingivoplasty | Rhinoplasty | Cricopharyngeal myotomy | 00
| 47,687 |
<unk> (born 1939) is an American molecular geneticist who pioneered the development of mouse models to understand the molecular basis of diseases due to mutations of thyroid hormone receptors.<unk> is a senior investigator at the National Cancer Institute and chief of the gene regulation section. | Sheue-yann Cheng | Shenkui | Patient portal | Prego v. City of New York | London medical students at Belsen | Hospital corpsman | Clinical research associate | Jeremy Kyle's Emergency Room | 00
| 73,728 |
<unk> is a group of blood and lymph tumors that develop from lymphocytes (a type of white blood cell). In current usage the name usually refers to just the cancerous versions rather than all such tumours. Signs and symptoms may include enlarged lymph nodes, fever, drenching sweats, unintended weight loss, itching, and constantly feeling tired. The enlarged lymph nodes are usually painless. The sweats are most common at night. Many subtypes of<unk> s are known. The<unk> main categories of<unk> s are the non-Hodgkin<unk> (NHL) (90% of cases) and Hodgkin<unk> (HL) (10%). The World Health Organization (WHO) includes<unk> other categories as types of<unk> – multiple myeloma and immunoproliferative diseases.<unk> s and leukemias are a part of the broader group of tumors of the hematopoietic and lymphoid tissues. Risk factors for Hodgkin<unk> include infection with Epstein–Barr virus and a history of the disease in the family. Risk factors for common types of non-Hodgkin<unk> s include autoimmune diseases, HIV/AIDS, infection with human T-lymphotropic virus, immunosuppressant medications, and some pesticides. Eating large amounts of red meat and tobacco smoking may also increase the risk. Diagnosis, if enlarged lymph nodes are present, is usually by lymph node biopsy. Blood, urine, and bone marrow testing may also be useful in the diagnosis. Medical imaging may then be done to determine if and where the cancer has spread.<unk> most often spreads to the lungs, liver, and brain. Treatment may involve<unk> or more of the following: chemotherapy, radiation therapy, proton therapy, targeted therapy, and surgery. In some non-Hodgkin<unk> s, an increased amount of protein produced by the<unk> cells causes the blood to become so thick that plasmapheresis is performed to remove the protein. Watchful waiting may be appropriate for certain types. The outcome depends on the subtype with some being curable and treatment prolonging survival in most. The five-year survival rate in the United States for all Hodgkin<unk> subtypes is 85%, while that for non-Hodgkin<unk> s is 69%. Worldwide,<unk> s developed in 566,000 people in 2012 and caused 305,000 deaths. They make up 3–4% of all cancers, making them as a group the seventh-most common form. In children, they are the third-most common cancer. They occur more often in the developed world than the developing world. | Lymphoma | Cat-scratch disease | Thymoma | Paracoccidioidomycosis | Thyroid nodule | Meningioma | Myoma | Branchial cleft cyst | 00
| 5,070 |
Urine may contain pus (a condition known as pyuria) as seen from a person with sepsis due to a urinary tract infection. Lower urinary tract infection is also referred to as a bladder infection. The most common symptoms are burning with urination and having to urinate frequently (or an urge to urinate) in the absence of vaginal discharge and significant pain. These symptoms may vary from mild to severe and in healthy women last an average of sixdays. Some pain above the pubic bone or in the lower back may be present. People experiencing an upper urinary tract infection, or pyelonephritis, may experience flank pain, fever, or nausea and vomiting in addition to the classic symptoms of a lower urinary tract infection. Rarely, the urine may appear bloody or contain visible pus in the urine. Children In young children, the only symptom of a urinary tract infection (UTI) may be a fever. Because of the lack of more obvious symptoms, when females under the age of two or uncircumcised males less than a year exhibit a fever, a culture of the urine is recommended by many medical associations. Infants may feed poorly, vomit, sleep more, or show signs of jaundice. In older children, new onset urinary incontinence (loss of bladder control) may occur. About 1 in 400 infants of 1 to 3 months of age with a UTI also have bacterial meningitis. Elderly Urinary tract symptoms are frequently lacking in the elderly. The presentations may be vague with incontinence, a change in mental status, or fatigue as the only symptoms, while some present to a health care provider with sepsis, an infection of the blood, as the first symptoms. Diagnosis can be complicated by the fact that many elderly people have preexisting incontinence or dementia. It is reasonable to obtain a urine culture in those with signs of systemic infection that may be unable to report urinary symptoms, such as when advanced dementia is present. Systemic signs of infection include a fever or increase in temperature of more than from usual, chills, and an increased white blood cell count. | causes of Hematuria | causes of Pyelonephritis | medical cause of Hematuria | causes of Hematochezia | causes of Peritonitis | symptom of Pyelonephritis | causes of Ascites | medical cause of Pyelonephritis | 00
| 2,329 |
<unk> or<unk> MRI <unk> measures brain activity by detecting changes associated with blood flow. This technique relies on the fact that cerebral blood flow and neuronal activation are coupled. When an area of the brain is in use, blood flow to that region also increases. The primary form of<unk> uses the blood-oxygen-level dependent (BOLD) contrast, discovered by Seiji Ogawa in 1990. This is a type of specialized brain and body scan used to map neural activity in the brain or spinal cord of humans or other animals by imaging the change in blood flow (hemodynamic response) related to energy use by brain cells. Since the early 1990s,<unk> has come to dominate brain mapping research because it does not involve the use of injections, surgery, the ingestion of substances, or exposure to ionizing radiation. This measure is frequently corrupted by noise from various sources; hence, statistical procedures are used to extract the underlying signal. The resulting brain activation can be graphically represented by color-coding the strength of activation across the brain or the specific region studied. The technique can localize activity to within millimeters but, using standard techniques, no better than within a window of a few seconds. Other methods of obtaining contrast are arterial spin labeling and diffusion MRI. Diffusion MRI is similar to BOLD<unk> but provides contrast based on the magnitude of diffusion of water molecules in the brain. In addition to detecting BOLD responses from activity due to tasks or stimuli,<unk> can measure resting state, or negative-task state, which shows the subjects' baseline BOLD variance. Since about 1998 studies have shown the existence and properties of the default mode network, a<unk> ly connected neural network of apparent resting brain states.<unk> is used in research, and to a lesser extent, in clinical work. It can complement other measures of brain physiology such as electroencephalography (EEG), and near-infrared spectroscopy (NIRS). Newer methods which improve both spatial and time resolution are being researched, and these largely use biomarkers other than the BOLD signal. Some companies have developed commercial products such as lie detectors based on<unk> techniques, but the research is not believed to be developed enough for widespread commercial use. | Functional magnetic resonance imaging | Functional imaging | Magnetic resonance spectroscopic imaging | Kinetic imaging | Electromagnetic source imaging | Functional near-infrared spectroscopy | Gated SPECT | Current density imaging | 00
| 8,441 |
<unk> (Photodyn, Sensibion) is a porphyrin prepared from hemin. It is a derivative of protoporphyrin IX, where the two vinyl groups have been hydrated (converted to alcohols). It is a deeply colored solid that is usually encountered as a solution. Its chemical structure was determined in 1900. It is used as a photosensitizer in photodynamic therapy. Acetylation of<unk> followed by hydrolysis of the product of that reaction affords a mixture called<unk> derivative <unk> D), which is also used in photodynamic therapy.<unk> has also been used as an antidepressant and antipsychotic since the 1920s. | Hematoporphyrin | Hemichrome | Fosdenopterin | Neurite | Hemoglobin | Melanin | Cellulite | Lipochrome | 00
| 58,416 |
Hazardous noise causes injury to the hearing mechanisms in the inner ear.<unk> may result in sensorineural HL (SNHL) that is either temporary (temporary threshold shift, TTS) or permanent (permanent threshold shift, PTS). A TTS will resolve with time, while the time frame for hearing recovery is unique in every case, any SNHL that persists beyond eight weeks after injury is most likely permanent and should be considered PTS. * Hearing loss * Tinnitus (ringing in the ear) * Aural fullness (ear fullness) * Recruitment (ear pain with loud noise) * Difficulty localizing sounds * Difficult in hearing a noisy background * Vertigo | Acoustic trauma | Facial trauma | Barotrauma | Penetrating trauma | Traumatic asphyxia | Closed-head injury | Trauma | Blast injury | 00
| 68,263 |
The etymology of English<unk> derives from Medieval Latin<unk> , from Arabic إكسير (al-ʾiksīr), probably from Ancient Greek ξήριον (xḗrion "a desiccative powder for wounds").<unk> originated in medieval European alchemy meaning "A preparation by the use of which it was sought to change metals into gold"<unk> stone or philosopher's stone) or "A supposed drug or essence with the property of indefinitely prolonging life"<unk> of life). The word was figuratively extended to mean "A sovereign remedy for disease. Hence adopted as a name for quack medicines" (e.g., Daffy's<unk> and "The quintessence or soul of a thing; its kernel or secret principle". In modern usage,<unk> is a pharmaceutical term for "A sweetened aromatic solution of alcohol and water, serving as a vehicle for medicine". Outside of<unk> cultural contexts, English<unk> poisoning usually refers to accidental contamination, such as the 1937<unk> sulfanilamide mass poisoning in the United States. Dān 丹 "cinnabar; vermillion;<unk> ; alchemy" is the keyword for<unk> immortality<unk> s. The red mineral cinnabar (dānshā 丹砂 lit. "cinnabar sand") was anciently used to produce the pigment vermilion (zhūhóng 朱紅) and the element mercury (shuǐyín 水銀 "watery silver" or gǒng 汞). According to the ABC Etymological Dictionary of Old<unk> , the etymology of Modern Standard<unk> dān from Old<unk> *tān (< *tlan ?) 丹 "red; vermillion; cinnabar", gān 矸 in dāngān 丹矸 from *tân-kân (< *tlan-klan ?) "cinnabar; vermillion ore", and zhān from *tan 旃 "a red flag" derive from Proto-Kam-Sui *h-lan "red" or Proto-Sino-Tibetan *tja-n or *tya-n "red". The *t- initial and *t- or *k- doublets indicate that Old<unk> borrowed this item. Oracle script for 丹 "cinnabar" Although the word dan 丹 "cinnabar; red" frequently occurs in oracle script from the late Shang Dynasty (c. 1600–1046 BCE) and bronzeware script and seal script from the Zhou Dynasty (1045–256 BCE), paleographers disagree about the graphic origins of the logograph 丹 and its ancient variants 𠁿 and 𠕑. Early scripts combine a 丶 dot or ⼀ stroke (depicting a piece of cinnabar) in the middle of a surrounding frame, which is said to represent: *jǐng 井 "well" represents the mine from which the cinnabar is taken" (Shuowen Jiezi) *"the crucible of the Taoist alchemists" (Léon Wieger) *"the contents of a square receptacle" (Bernhard Karlgren) *"placed in a tray or palette to be used as red pigment" (Wang Hongyuan 王宏源) *"mineral powder on a stretched filter-cloth" (Needham and Lu). Many<unk><unk> names are compounds of dan, such as jīndān 金丹 (with "gold") meaning "golden<unk> ;<unk> of immortality; potable gold" and xiāndān 仙丹 (with "Daoist immortal")<unk> of immortality; panacea", and shéndān 神丹 (with "spirit; god") "divine<unk> ". Bùsǐ zhī yào 不死之藥 "drug of deathlessness" was another early name for the<unk> of immortality.<unk> alchemists would liàndān 煉丹 (with "smelt; refine") "concoct pills of immortality" using a dāndǐng 丹鼎 (with "tripod cooking vessel; cauldron") "furnace for concocting pills of immortality". In addition, the ancient<unk> believed that other substances provided longevity and immortality, notably the língzhī 靈芝 "Ganoderma mushroom". The transformation from chemistry-based waidan 外丹 "external<unk> /alchemy" to physiology-based neidan 內丹 "internal<unk> /alchemy" gave new analogous meanings to old terms. The human body metaphorically becomes a ding "cauldron" in which the adept forges the Three Treasures (essence, life-force, and spirit) within the jindan Golden<unk> within the dāntián 丹田 (with "field") "lower part of the abdomen". In early China, alchemists and pharmacists were one and the same. Traditional<unk> medicine also used less concentrated cinnabar and mercury preparations, and dan means "pill; medicine" in general, for example, dānfāng 丹方 semantically changed from "prescription for<unk> of immortality" to "medical prescription". Dan was lexicalized into medical terms such as dānjì 丹劑 "pill preparation" and dānyào 丹藥 "pill medicine". The<unk> names for immortality<unk> s have parallels in other cultures and languages, for example, Indo-Iranian soma or haoma, Sanskrit amrita, and Greek ambrosia. | Chinese alchemical elixir poisoning | Scombroid food poisoning | Tin poisoning | Loch Maree Hotel botulism poisoning | Mozambique funeral beer poisoning | Mushroom poisoning | Ciguatera fish poisoning | Chlorine gas poisoning | 00
| 69,743 |
If the Hirschsprung's disease is treated in time,<unk> patients live otherwise healthy lives. If it is not found soon enough, death often occurs in infancy. Digestive problems from the colostomy and reattachment may exist, but most cases can be treated with laxatives. The hearing loss, which is usually degenerative, can only be treated with surgery or hearing aids. However, leaving hearing loss untreated may not reduce quality of life . | ABCD syndrome | EAST syndrome | TEMPI syndrome | HAIR-AN syndrome | RIDDLE syndrome | IPEX syndrome | CLOVES syndrome | MELAS syndrome | 00
| 30,915 |
Vaccination with live-attenuated or live vaccines is not recommended during treatment and should be administered at least four weeks before starting<unk> . | Satralizumab | Caplacizumab | Brolucizumab | Natalizumab | Ixekizumab | Tocilizumab | Benralizumab | Ravulizumab | 00
| 71,724 |
<unk> or scratchy<unk> can temporarily be relieved with 1/4 to 1/2 teaspoon salt dissolved in an 8 ounces or 230 ml glass of warm water. Pain medications such as non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol (acetaminophen) help in the management of pain. The use of corticosteroids seems to increase slightly the likelihood of resolution and the reduction of pain, but more analysis is necessary to ensure that this minimal benefit outweighs the risks. Antibiotics probably reduce pain, diminish headaches and could prevent some<unk> complications; but, since these effects are small, they must be balanced with the<unk> of antimicrobial resistance. It is not known whether antibiotics are effective for preventing recurrent<unk> . There is an old wives tale that having a hot drink can help with common cold and influenza symptoms, including<unk> , but there is only limited evidence to support this idea. If the<unk> is unrelated to a cold and is caused by for example tonsillitis, a cold drink may be helpful. There are also other medications like lozenges which can help people to cope with a<unk> . Without active treatment, symptoms usually last two to seven days. | Sore throat | Nasal congestion | Cough | Headache | Neck spasm | Catarrh | Vomiting | Nausea | 00
| 10,585 |
Side view of the skull with anterior<unk> . Side view of the skull with posterior<unk> . Side view of the skull with superior<unk> . Front view of the skull with lateral<unk> . There are four different positions of<unk> <unk> : posterior, anterior, superior and lateral. The most common position is anterior, while the other types are rare. Anterior<unk> shifts the lower<unk> forward if the mouth excessively opens. This type of<unk> may happen bilaterally or unilaterally after yawning. The muscles that are affected during anterior<unk> <unk> are the masseter and temporalis which pull up on the mandible and the lateral pterygoid which relaxes the mandibular condyle. The condyle can get locked in front of the articular eminence. Posterior<unk> is possible for people who get injured by being punched in the chin. This<unk> will push the<unk> back affecting the alignment of the mandibular condyle and mastoid. The external auditory canal may be fractured. Superior<unk> s occur after being punched below the mandibular ramus as the mouth remains half-open. Since great force occurs in a punch, the angle of the<unk> will be forced upward moving towards the condylar head. This can result in a fracture of the glenoid fossa and displacement of the condyle into the middle cranial fossa, potentially injuring the facial and vestibulocochlear nerves and the temporal lobe. Lateral<unk> s move the mandibular condyle away from the skull and are likely to happen together with<unk> fractures. Posterior, superior and lateral<unk> s are uncommon injuries and usually result from high-energy trauma to the chin. By contrast, anterior<unk> s are more often the result of low-energy trauma (e.g. tooth extraction) or secondary to a medical condition that affects the stability of the joint (e.g. seizures, ligamentous laxity, degeneration of joint capsule). | Dislocation of jaw | Overbite | Mandibular fracture | Phossy jaw | Fissured tongue | Anismus | Crenated tongue | Stridor | 00
| 59,017 |
If the femur head is dislocated, it should be reduced as soon as possible, to prevent damage to its blood supply. This is preferably done under anaesthesia, following which, leg is kept pulled by applying traction to prevent joint from dislocating. The final management depends on the size of the fragment(s), stability and congruence of the joint. In some cases traction for six to eight weeks may be the only treatment required; however, surgical fixation using screw(s) and plate(s) may be required if the injury is more complex. The latter treatment will be called for if bone fragments do not fall into place, or if they are found in the joint, or if the joint itself is unstable. Post-surgery Depending on the stability achieved via initial treatment, the patient may be allowed to stand and walk with help of support within about six to eight weeks. Full function may return in about three months. Principles of management At the site of injury: After stabilizing an injured person and resuscitation, quick examination is done to check injury to vital organs. If one suspects injury to the hip, it is imperative to immobilise the limb using some kind of support to prevent movements of the injured limb to prevent further damage A trained paramedic may be able to diagnose hip dislocation by noticing the position of the injured limb. It is essential to document status of nerves and vessels before starting any treatment to protect oneself from litigation On arrival at the hospital, trained trauma surgeon will assess the patient and prescribe necessary tests including x-rays as described earlier. Non-surgical management consists of reducing the dislocated joint by maneuver under anaesthesia and applying traction to the limb to maintain position of joint and fractured bones. If non surgical management is preferred it may require six weeks to 3 months for recovery. Surgical management The surgical management requires high degree of training and well equipped centre. It should be carried out by experienced surgical team to get best results. The principles laid down for management are; * Anatomic reduction of the fractured fragments * Stable fixation * Congruent joint * Early mobilization * Delayed weight bearing Innominate bone is a flat bone with many curves. In most part the bone is thick enough and has broad surfaces that are amenable to primary fixation using lag screw(s) and to neutralize forces across the bone one needs to add plate(s) on the surface of the fractured fragments for it to heal without deformity. Before surgery, patient needs tests to check fitness for surgery Anaesthesia : the surgery may be performed either under regional anaesthesia or general anaesthesia Surgical approaches. Following are the common approaches; * Kocher Langenbeck approach for posterior injuries * Ili inguinal, Ilio femoral of modified stoppa’s approach for anterior or combined injuries Implants : normally lag screws and reconstruction plates are preferred implants Post operative management: would involve initial period or bed rest, followed by mobilisation by trained therapist Total time to recover may be up to 3 months | Acetabular fracture | Sacral fracture | Hip dislocation | Hip fracture | Knee dislocation | Femoral fracture | Humerus fracture | Jefferson fracture | 00
| 61,423 |
Cancer can be considered a very large and exceptionally heterogeneous family of malignant diseases, with<unk> <unk><unk> s comprising one of the largest subsets. Terminology All<unk> <unk><unk> lesions are thought to begin via the repeated, uncontrolled division of cancer stem<unk> s of epithelial lineage or characteristics. Accumulation of these cancer<unk> s causes a microscopic focus of abnormal<unk> s that are, at least initially, locally confined within the specific tissue in which the progenitor<unk> resided. This condition is called<unk> <unk><unk> in situ, and it is diagnosed when the tumor has not yet penetrated the basement membrane or other delimiting structure to invade adjacent tissues. Once the lesion has grown and progressed to the point where it has breached, penetrated, and infiltrated adjacent structures, it is referred to as "invasive"<unk> <unk><unk> . Once a<unk> becomes invasive, it is able to spread to other organs and cause a metastasis, or "secondary tumor", to form. | Conjunctival squamous cell carcinoma | Pseudolymphoma | Rhinoscleroma | Odontogenic keratocyst | Fundic gland polyp | Aquarium granuloma | Idiopathic facial aseptic granuloma | Chorangioma | 00
| 64,179 |
Immunodysregulation polyendocrinopathy enteropathy X-linked (or<unk> is a rare disease linked to the dysfunction of the gene encoding transcription factor forkhead box P3 (FOXP3), widely considered to be the master regulator of the regulatory T cell lineage. It leads to the dysfunction of CD4+ regulatory T-cells and the subsequent autoimmunity. The disorder is one of the autoimmune polyendocrine syndromes and manifests with autoimmune enteropathy, psoriasiform or eczematous dermatitis, nail dystrophy, autoimmune endocrinopathies, and autoimmune skin conditions such as alopecia universalis and bullous pemphigoid. Management for<unk> has seen limited success in treating the syndrome by bone marrow transplantation. | IPEX syndrome | EAST syndrome | TAN syndrome | TEMPI syndrome | SUNCT syndrome | VEXAS syndrome | 3C syndrome | RIDDLE syndrome | 00
| 34,790 |
Direct-to-consumer options for monitoring heart rate and heart rate variability have become increasingly prevalent using smartphones and smartwatches. These monitoring systems have become increasingly validated and may help provide early identification for those at risk for a serious arrhythmia such as atrial fibrillation.<unk> can be a very concerning symptom for people. The etiology of the<unk> in most patients is benign. Therefore, comprehensive workups are not indicated. However appropriate follow up with the primary care provider can provide the ability to monitor symptoms over time and determine if consultation with cardiologist is required. People who are determined to be at high risk for<unk> of serious or life-threatening etiologies require a more extensive workup and comprehensive management. Once a cause is determined, the recommendations for treatment are quite strong with moderate to high quality therapies studied. Partnership with the people who have the chief complaint of<unk> using a shared decision-making model and involving an interprofessional team including a nurse, nurse practitioner, physician assistant, and physician can help best direct therapy and provide good followup. | Palpitations | Tachycardia | Bradycardia | Hyperthymesia | Orthopnea | Chest pain | Apnea | Bigeminy | 00
| 12,724 |
The pediatric<unk> undergoes dramatic changes and significant pruning of neural networks throughout development. Whereby the areas for primary senses and motor skills are mostly developed by age 4, other areas, like the frontal cortices involved in higher level reasoning, decision-making, emotion, and impulsivity continue to develop well into the late teens to early 20s. Therefore, the patient's age and<unk> developmental state influence what neuronal systems become most affected post-injury. Key structural features of the pediatric<unk> make the<unk> tissue more susceptible to the mechanical<unk> during TBI than the adult<unk> : a larger water content in the<unk> tissue and reduced myelination results in diminished shear resistance after<unk> . It has also been shown that more immature<unk> s have an enlarged extracellular space volume and a decreased expression of glial aquaporin 4 leading to an increased incidence of<unk> swelling after TBI. Along with a delayed decrease in cerebral blood flow, these unique features of the developing<unk> can mediate further secondary damage, through hypoxia, excitotoxicity, free radical damage, and neuroinflammation after the primary<unk> . Even properties of these secondary events differ between the developing<unk> and the adult<unk> : (1) in the developing<unk> , the overexpression and activation of the N-methyl-D-aspartate receptor (NMDA-R) leads to an increased calcium influx and an increased capacity for excitoxicity when compared to the adult<unk> and (2) the developing<unk> has lower glutathione peroxidase activity and a decreased ability to maintain stores of glutathione peroxidase, therefore the developing<unk> is more vulnerable to oxidative stress than the adult<unk> . Damage to the developing<unk> , by any of the above mechanisms, can disturb neuronal maturation, leading to neuronal loss, axonal destruction, and demyelination. | Childhood acquired brain injury | Pediatric stroke | Acquired brain injury | Childhood cancer | Traumatic brain injury | Trauma in children | Pediatric concussion | Primary and secondary brain injury | 00
| 64,596 |
The<unk> is caused in 60% of cases by a mutated gene called CIAS1 that is known to be involved in other syndromes that appear somewhat similar, such as Muckle–Wells syndrome and familial cold urticaria. In many patients, the parents do not have the same mutation, indicating the problem was not inherited, even though it is a genetic<unk> .CIAS1 is involved in controlling the immune system, which is why the mutation leads to out-of-control inflammation. | Neonatal-onset multisystem inflammatory disease | Neonatal toxic shock-like exanthematous disease | Neonatal meningitis | Neonatal sepsis | Shaken baby syndrome | Neonatal hepatitis | Neonatal hypocalcemia | Neonatal diabetes | 00
| 39,483 |
<unk> is indicated only for women with severe diarrhea-predominant irritable bowel syndrome (IBS-D) who have: * chronic IBS symptoms (generally lasting 6 months or longer), * had anatomic or biochemical abnormalities of the gastrointestinal tract excluded, and * not responded adequately to conventional therapy. Severe IBS-D includes: diarrhea and 1 or more of the following: * frequent and severe abdominal pain/discomfort, * frequent bowel urgency or fecal incontinence, * disability or restriction of daily activities due to IBS. Efficacy The phase III trial for approval was published in 2000 as an industry-funded randomised, placebo-controlled trial (PCT). Its authors found 1 mg<unk> , taken orally twice daily for 12 weeks, was associated with a 12% (CI 4.7-19.2) improvement in relief from abdominal pain and discomfort associated with diarrhoea-predominant patients. The prescription of<unk> is currently approved in the U.S. at 0.5 and 1 mg. The FDA Medical Officer's Review, dated November 4, 1999, noted: “Patients considered by investigators to fit the diarrhea-predominant subtype had at baseline… stool consistency values that were neither loose nor watery”. The FDA's Gastrointestinal Drugs Advisory Committee referred to the drug's efficacy as "modest", highlighting that the placebo brought relief on the primary outcome measure to 40–50% of women. | Alosetron | Tropisetron | Granisetron | Cilansetron | Palonosetron | Avacopan | Agomelatine | Bocasan | 00
| 21,156 |
Some causes for<unk> lobe epilepsy can be a lesion and/or injury to the<unk> lobe. If that is not the case, the cause often may be unknown. Other potential causes could be tumors or cortical malformations. Lesions can be due to<unk> cortical dysplasia, which can be difficult to identify and diagnose based on an MRI. Most commonly, the disorder is due to idiopathic<unk> es in childhood, and other rare syndromes affecting the<unk> area is Sturge-Weber syndrome, adult forms of Rasmussen’s syndrome, and more. | Occipital epilepsy | Photosensitive epilepsy | Vertiginous epilepsy | Catamenial epilepsy | Myoclonic epilepsy | Temporal lobe epilepsy | Epilepsy | Childhood absence epilepsy | 00
| 69,695 |
Typically, the incidence of<unk> or<unk> after general anesthesia ranges between 25 and 30%.<unk> and<unk> can be extremely distressing for patients, and so is one of their major concerns.<unk> has been associated with major complications, such as pulmonary aspiration of gastric content, and might endanger surgical outcomes after certain procedures, for example after maxillofacial surgery with wired jaws.<unk> and<unk> can delay discharge, and about 1% of patients scheduled for day surgery require unanticipated overnight admission because of uncontrolled<unk> . | Postoperative nausea and vomiting | Postoperative fever | Post-vagotomy diarrhea | Postoperative cognitive dysfunction | Abdominal compartment syndrome | Short bowel syndrome | Retroperitoneal bleeding | Acute abdomen | 00
| 16,635 |
<unk> of the fingernail: The red line shows the outline of a clubbed nail. Schamroths window test, done to identify<unk> When<unk> is observed, pseudoclubbing should be excluded before making the diagnosis. Associated conditions may be identified by taking a detailed medical history—particular attention is paid to lung, heart, and gastrointestinal conditions—and conducting a thorough clinical examination, which may disclose associated features relevant to the underlying diagnosis. Additional studies such as a chest X-ray and a chest CT-scan may reveal otherwise asymptomatic cardiopulmonary disease. Stages<unk> is present in one of five stages: * No visible<unk> - Fluctuation (increased ballotability) and softening of the nail bed only. No visible changes of nails. * Mild<unk> - Loss of the normal File:Clubbing of fingers.Severe<unk> <unk> 2.Front view<unk> 1.Side views CongenitalHeartCase-133.Cyanotic nail beds | Nail clubbing | Shell nail syndrome | Rose spots | Acrocyanosis | Brachymetatarsia | Parosmia | Copper beaten skull | Varicose veins | 00
| 14,348 |
Hypotonia is a state of low muscle tone (the amount of tension or resistance to stretch in a muscle), often involving reduced muscle strength. Hypotonia is not a specific medical disorder, but a potential manifestation of many different diseases and disorders that affect motor nerve control by the brain or muscle strength. Hypotonia is a lack of resistance to passive movement, whereas muscle weakness results in impaired active movement. Central hypotonia originates from the central nervous system, while peripheral hypotonia is related to problems within the spinal cord, peripheral nerves and/or skeletal muscles. Severe hypotonia in infancy is commonly known as floppy baby syndrome. Recognizing hypotonia, even in early infancy, is usually relatively straightforward, but diagnosing the underlying cause can be difficult and often unsuccessful. The long-term effects of hypotonia on a child's development and later life depend primarily on the severity of the muscle weakness and the nature of the cause. Some disorders have a specific treatment but the principal treatment for most hypotonia of idiopathic or neurologic cause is physical therapy and/or occupational therapy for remediation. Hypotonia is thought to be associated with the disruption of afferent input from stretch receptors and/or lack of the cerebellum’s facilitatory efferent influence on the fusimotor system, the system that innervates intrafusal muscle fibers thereby controlling muscle spindle sensitivity. On examination a diminished resistance to passive movement<unk> be noted and muscles may feel abnormally soft and limp on palpation. Diminished deep tendon reflexes also may be noted. Hypotonia is a condition that can be helped with early intervention. | symptom of Prader–Willi syndrome | symptom of Scheuermann's disease | symptom of Rotor syndrome | symptom of Klinefelter syndrome | symptom of Klippel–Feil syndrome | symptom of Kallmann syndrome | symptom of Laron syndrome | symptom of Angelman syndrome | 00
| 19,218 |
<unk> , also known as 17α-ethynyl-18-methyl-19-nor-δ9,11-testosterone, as well as 17α-ethynyl-18-methylestra-4,9,11-trien-17β-ol-3-one or as 13β-ethyl-18,19-dinor-17α-pregna-4,9,11-trien-20-yn-17β-ol-3-one, is a synthetic estrane steroid and a derivative of testosterone. It is more specifically a derivative of norethisterone (17α-ethynyl-19-nortestosterone) and is a member of the gonane (18-methylestrane) subgroup of the 19-nortestosterone family of progestins.<unk> is the C18 methyl derivative of norgestrienone (17α-ethynyl-19-nor-δ9,11-testosterone) and the δ9,11 analogue of levonorgestrel (17α-ethynyl-18-methyl-19-nortestosterone) and is also known as ethylnorgestrienone due to the fact that it is the C13β ethyl variant of norgestrienone. It is also the C17α ethynyl and C18 methyl derivative of the AAS trenbolone. The androgenic properties of<unk> are more exploited in its derivative tetrahydrogestrinone (THG; 17α-ethyl-18-methyl-δ9,11-19-nortestosterone), a designer steroid which is far more potent as both an AAS and progestogen in comparison. THG was banned by the Food and Drug Administration (FDA) in 2003. | Gestrinone | Gestodene | Mestanolone | Goserelin | Anastrozole | Oxandrolone | Allenestrol | Hexestrol | 00
| 37,440 |
Available data do not show evidence of an increased cardiovascular risk in patients without established, current or past history of ischaemic heart disease, peripheral arterial disease or cerebrovascular disease, or in those without uncontrolled hypertension. In a meta-analysis of 7,500 patients, in those with known uncontrolled or severe cardiovascular disease,<unk> increased the risk of venous thromboembolism, pulmonary embolism and serious cardiovascular disorders, including myocardial infarction as compared with placebo (1.7% versus 1.1%). Its use is restricted in the UK to those without severe cardiovascular disease. The most common side effects include nausea, diarrhea, headache and eczema, but with only 2–4% increase compared with placebo group. Most of those side effects resolved within 3 months. Occasional severe allergic reactions have been reported including drug rash with eosinophilia and systemic symptoms (DRESS syndrome) | Strontium ranelate | Calcium carbonate | Potassium fluoride | Sodium stibogluconate | Ferrous tartrate | Sodium fluoride | Dimethyl methylphosphonate | Lanthanum carbonate | 00
| 44,127 |
Example of Trisomy 21 detected via quantitative PCR short tandem repeat assay Germline<unk> is typically detected through karyotyping, a process in which a sample of cells is fixed and stained to create the typical light and dark chromosomal banding pattern and a picture of the chromosomes is analyzed. Other techniques include fluorescence in situ hybridization (FISH), quantitative PCR of short tandem repeats, quantitative fluorescence PCR (QF-PCR), quantitative PCR dosage analysis, Quantitative Mass Spectrometry of Single Nucleotide Polymorphisms, and comparative genomic hybridization (CGH). These tests can also be performed prenatally to detect<unk> in a pregnancy, through either amniocentesis or chorionic villus sampling. Pregnant women of 35 years or older are offered prenatal testing because the chance of chromosomal<unk> increases as the mother's age increases. Recent advances have allowed for less invasive testing methods based on the presence of fetal genetic material in maternal blood. See Triple test and Cell-free fetal DNA. Types +key color significance lethal normal male phenotype Klinefelter syndrome (abnormal male) polysomy X and/or Y (abnormal male) normal female phenotype Turner's syndrome (abnormal female) polysomy X (abnormal female) + Non-autosomal 0 X XX XXX XXXX XXXXX 0 0 X XX XXX XXXX XXXXX Y Y XY XXY XXXY XXXXY XXXXXY YY YY XYY XXYY XXXYY XXXXYY XXXXXYY YYY YYY XYYY XXYYY XXXYYY XXXXYYY XXXXXYYY YYYY YYYY XYYYY XXYYYY XXXYYYY XXXXYYYY XXXXXYYYY YYYYY YYYYY XYYYYY XXYYYYY XXXYYYYY XXXXYYYYY XXXXXYYYYY +key color significance case where complete non-mosaic trisomy can never survive to term case where complete non-mosaic trisomy can rarely (barring other complications) survive to term case where complete non-mosaic trisomy can frequently (barring other complications) survive to term +Autosomal # monosomy trisomy 1 1p36 deletion syndrome1q21.1 deletion syndrome Trisomy 1 2 2q37 deletion syndrome Trisomy 2 3 Trisomy 3 4 Wolf–Hirschhorn syndrome Trisomy 4 5 Cri du chat5q deletion syndrome Trisomy 5 6 Trisomy 6 7 Williams syndrome Trisomy 7 8 Monosomy 8pMonosomy 8q Trisomy 8 9 Alfi's syndromeKleefstra syndrome Trisomy 9 10 Monosomy 10pMonosomy 10q Trisomy 10 11 Jacobsen syndrome Trisomy 11 12 Trisomy 12 13 Patau syndrome 14 Trisomy 14 15 Angelman syndromePrader–Willi syndrome Trisomy 15 16 Trisomy 16 17 Miller–Dieker syndromeSmith–Magenis syndrome Trisomy 17 18 Distal 18q-Proximal 18q- Edwards syndrome 19 Trisomy 19 20 Trisomy 20 21 Down syndrome 22 DiGeorge syndromePhelan–McDermid syndrome22q11.2 distal deletion syndrome Cat eye syndromeTrisomy 22 | Aneuploidy | Germline mosaicism | Polyploidy | Defocus aberration | Germline mutation | Robertsonian translocation | Chromosomal translocation | Heteroxeny | 00
| 10,540 |
<unk> is an epidemic paralytic disease occurring among hunger-stricken rural populations in Africa where a diet dominated by insufficiently processed cassava results in simultaneous malnutrition and high dietary cyanide intake.<unk> was first described by Giovanni Trolli in 1938 who compiled the observations from eight doctors working in the Kwango area of the Belgian Congo (now Democratic Republic of the Congo). | Konzo | Riken | Sultiame | Gutka | WebTeb | Uinyeo | Koi | Onyalai | 00
| 43,843 |
Pharmacodynamics 7α-Thiomethylspironolactone, the major active form of<unk> . It accounts for about 80% of the potassium-sparing effect of<unk> . Canrenone, the second major active form of<unk> . It accounts for around 10 to 25% of the potassium-sparing effect of<unk> . The pharmacodynamics of<unk> are characterized by high antimineralocorticoid activity, moderate antiandrogenic activity, and weak steroidogenesis inhibition, among other more minor activities.<unk> is a prodrug, so most of its actions are actually mediated by its various active metabolites. The major active forms of<unk> are 7α-thiomethylspironolactone (7α-TMS) and canrenone (7α-desthioacetyl-δ6-spironolactone).<unk> is a potent antimineralocorticoid. That is, it is an antagonist of the mineralocorticoid receptor (MR), the biological target of mineralocorticoids like aldosterone and 11-deoxycorticosterone. By blocking the MR,<unk> inhibits the effects of mineralocorticoids in the body. The antimineralocorticoid activity of<unk> is responsible for its therapeutic efficacy in the treatment of edema, high blood pressure, heart failure, hyperaldosteronism, and ascites due to cirrhosis. It is also responsible for many of the side effects of<unk> , such as urinary frequency, dehydration, hyponatremia, low blood pressure, fatigue, dizziness, metabolic acidosis, decreased kidney function, and its risk of hyperkalemia. Due to the antimineralocorticoid activity of<unk> , levels of aldosterone are significantly increased by the medication, probably reflecting an attempt of the body to maintain homeostasis.<unk> is a moderate antiandrogen. That is, it is an antagonist of the androgen receptor (AR), the biological target of androgens like testosterone and dihydrotestosterone (DHT). By blocking the AR,<unk> inhibits the effects of androgens in the body. The antiandrogenic activity of<unk> is mainly responsible for its therapeutic efficacy in the treatment of androgen-dependent skin and hair conditions like acne, seborrhea, hirsutism, and pattern hair loss and hyperandrogenism in women, precocious puberty in boys with testotoxicosis, and as a component of feminizing hormone therapy for transgender women. It is also primarily responsible for some of its side effects, like breast tenderness, gynecomastia, feminization, and demasculinization in men. Blockade of androgen signaling in the breast disinhibits the actions of estrogens in this tissue. Although useful as an antiandrogen in women, who have low testosterone levels compared to men,<unk> is described as having relatively weak antiandrogenic activity.<unk> is a weak steroidogenesis inhibitor. That is, it inhibits steroidogenic enzymes, or enzymes involved in the production of steroid hormones.<unk> and/or its metabolites have been found in vitro to weakly inhibit a broad array of steroidogenic enzymes including cholesterol side-chain cleavage enzyme, 17α-hydroxylase, 17,20-lyase, 5α-reductase, 3β-hydroxysteroid dehydrogenase, 11β-hydroxylase, 21-hydroxylase, and aldosterone synthase (18-hydroxylase). However, although very high doses of<unk> can considerably decrease steroid hormone levels in animals,<unk> has shown mixed and inconsistent effects on steroid hormone levels in clinical studies, even at high clinical doses. In any case, the levels of most steroid hormones, including testosterone and cortisol, are usually unchanged by<unk> in humans, which may in part be related to compensatory upregulation of their synthesis. The weak steroidogenesis inhibition of<unk> might contribute to its antiandrogenic efficacy to some degree and may explain its side effect of menstrual irregularities in women. However, its androgen synthesis inhibition is probably clinically insignificant.<unk> has been found in some studies to increase levels of estradiol, an estrogen, although many other studies have found no changes in estradiol levels. The mechanism of how<unk> increases estradiol levels is unclear, but it may involve inhibition of the inactivation of estradiol into estrone and enhancement of the peripheral conversion of testosterone into estradiol. It is notable that<unk> has been found in vitro to act as a weak inhibitor of 17β-hydroxysteroid dehydrogenase 2, an enzyme that is involved in the conversion of estradiol into estrone. Increased levels of estradiol with<unk> may be involved in its preservation of bone density and in its side effects such as breast tenderness, breast enlargement, and gynecomastia in women and men. In response to the antimineralocorticoid activity<unk> , and in an attempt to maintain homeostasis, the body increases aldosterone production in the adrenal cortex. Some studies have found that levels of cortisol, a glucocorticoid hormone that is also produced in the adrenal cortex, are increased as well. However, other clinical studies have found no change in cortisol levels with<unk> , and those that have found increases often have observed only small changes. In accordance,<unk> has not been associated with conventional glucocorticoid medication effects or side effects. Other activities of<unk> may include very weak interactions with the estrogen and progesterone receptors and agonism of the pregnane X receptor. These activities could contribute to the menstrual irregularities and breast side effects of<unk> and to its drug interactions, respectively. Pharmacokinetics The pharmacokinetics of<unk> have not been studied well, which is in part because it is an old medication that was developed in the 1950s. Nonetheless, much has been elucidated about the pharmacokinetics of<unk> over the decades. Absorption Levels of<unk> and its major active metabolites after a single oral dose of 100 mg<unk> in humans. The bioavailability of<unk> when taken by mouth is 60 to 90%. The bioavailability of<unk> and its metabolites increases significantly (+22–95% increases in levels) when<unk> is taken with food, although it is uncertain whether this further increases the therapeutic effects of the medication. The increase in bioavailability is thought to be due to promotion of the gastric dissolution and absorption of<unk> , as well as due to a decrease of the first-pass metabolism. The relationship between a single dose of<unk> and plasma levels of canrenone, a major active metabolite of<unk> , has been found to be linear across a dose range of 25 to 200 mg<unk> . Steady-state concentrations of<unk> are achieved within 8 to 10 days of treatment initiation. Little or no systemic absorption has been observed with topical<unk> . Distribution<unk> and its metabolite canrenone are highly plasma protein bound, with percentages of 88.0% and 99.2%, respectively.<unk> is bound equivalently to albumin and α1-acid glycoprotein, while canrenone is bound only to albumin.<unk> and its metabolite 7α-thiospironolactone show very low or negligible affinity for sex hormone-binding globulin (SHBG). In accordance, a study of high-dosage<unk> treatment found no change in steroid binding capacity related to SHBG or to corticosteroid-binding globulin (CBG), suggesting that<unk> does not displace steroid hormones from their carrier proteins. This is in contradiction with widespread statements that<unk> increases free estradiol levels by displacing estradiol from SHBG.<unk> appears to cross the blood–brain barrier. Metabolism<unk> metabolism in humans. Canrenone may be further reduced (into di-, tetra-, and hexahydrogenated metabolites), hydroxylated, and conjugated (e.g., glucuronidated).<unk> is rapidly and extensively metabolized in the liver upon oral administration and has a very short terminal half-life of 1.4 hours. The major metabolites of<unk> are 7α-thiomethylspironolactone (7α-TMS), 6β-hydroxy-7α-thiomethylspironolactone (6β-OH-7α-TMS), and canrenone (7α-desthioacetyl-δ6-spironolactone). These metabolites have much longer elimination half-lives than<unk> of 13.8 hours, 15.0 hours, and 16.5 hours, respectively, and are responsible for the therapeutic effects of the medication. As such,<unk> is a prodrug. The 7α-thiomethylated metabolites of<unk> were not known for many years and it was originally thought that canrenone was the major active metabolite of the medication, but subsequent research identified 7α-TMS as the major metabolite. Other known but more minor metabolites of<unk> include 7α-thiospironolactone (7α-TS), which is an important intermediate to the major metabolites of<unk> , as well as the 7α-methyl ethyl ester of<unk> and the 6β-hydroxy-7α-methyl ethyl ester of<unk> .<unk> is hydrolyzed or deacetylated at the thioester of the C7α position into 7α-TS by carboxylesterases. Following formation of 7α-TS, it is S-oxygenated by flavin-containing monooxygenases to form an electrophilic sulfenic acid metabolite. This metabolite is involved in the CYP450 inhibition of<unk> , and also binds covalently to other proteins. 7α-TS is also S-methylated into 7α-TMS, a transformation catalyzed by thiol S-methyltransferase. Unlike the related medication eplerenone,<unk> is said to not be metabolized by CYP3A4. However, hepatic CYP3A4 is likely responsible for the 6β-hydroxylation of 7α-TMS into 6β-OH-7α-TMS. 7α-TMS may also be hydroxylated at the C3α and C3β positions.<unk> is dethioacetylated into canrenone. Finally, the C17 γ-lactone ring of<unk> is hydrolyzed by the paraoxonase PON3. It was originally thought to be hydrolyzed by PON1, but this was due to contamination with PON3. Elimination The majority of<unk> is eliminated by the kidneys, while minimal amounts are handled by biliary excretion. | Spironolactone | Chlorothiazide | Cyclothiazide | Amiloride | Hydrochlorothiazide | Furosemide | Torasemide | Bumetanide | 00
| 16,904 |
The two most common types of<unk> s are calcium fluoride and lithium fluoride, with one or more impurities to produce trap states for energetic electrons. The former is used to record gamma exposure, the latter for gamma and neutron exposure (indirectly, using the Li-6 (n,alpha) nuclear reaction; for this reason, LiF<unk> s may be enriched in lithium-6 to enhance this effect or enriched in lithium-7 to reduce it). Other types include beryllium oxide, and calcium sulfate doped with thulium. As the radiation interacts with the crystal it causes electrons in the crystal's atoms to jump to higher energy states, where they stay trapped due to intentionally introduced impurities (usually manganese or magnesium) in the crystal, until heated. Heating the crystal causes the electrons to drop back to their ground state, releasing a photon of energy equal to the energy difference between the trap state and the ground state. | Thermoluminescent dosimeter | Gaseous detection device | Dolorimeter | Mercury-in-glass thermometer | Carbon monoxide detector | Whole-body counting | Alcohol thermometer | Keratometer | 00
| 60,506 |
<unk> is listed in Orphanet database as a rare disease. There is not much information available about the epidemiology of microlissencepahly in literature. A PhD thesis has estimated the prevalence of microlissencepahly in southeastern Hungary between July 1992 and June 2006 to be a case every 91,000 live births (0.11:10,000). | Microlissencephaly | Microhydranencephaly | Schizencephaly | Hemihydranencephaly | Lissencephaly | Holoprosencephaly | Hydranencephaly | Megalencephaly | 00
| 70,636 |