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In some areas,<unk> is endemic. While fluorosis is most severe and widespread in the world's two most populous countries – India and China – UNICEF estimates that "fluorosis is endemic in at least 25 countries across the globe. The total number of people affected is not known, but a conservative estimate would number in the tens of millions." In India, 20 states have been identified as endemic areas, with an estimated 60 million people at risk and 6 million people disabled; about 600,000 might develop a neurological disorder as a consequence. | Skeletal fluorosis | Dental fluorosis | Vitamin D toxicity | Hyperparathyroidism | Zinc toxicity | Oncogenic osteomalacia | Calcinosis | Hypophosphatasia | 00
| 10,904 |
Postnatal complications After correcting for several factors such as low gestational parental weight, it is estimated that only around 3% of pregnancies are affected by true<unk> . 20% of stillborn infants exhibit<unk> . Perinatal mortality rates are 4-8 times higher for infants with<unk> , and morbidity is present in 50% of surviving infants. Common causes of mortality in fetuses/infants with<unk> include: severe placental insufficiency and chronic hypoxia, congenital malformations, congenital infections, placental abruption, cord accidents, cord prolapse, placental infarcts, and severe perinatal depression.<unk> is more common in preterm infants than in full term (37–40 weeks gestation) infants, and its frequency decreases with increasing gestational age. Relative to premature infants who do not exhibit<unk> , premature infants with<unk> are more likely to have adverse neonatal outcomes, including respiratory distress syndrome, intraventricular hemorrhage, and necrotizing enterocolitis. This association with prematurity suggests utility of screening for<unk> as a potential risk factor for preterm labor. Feeding intolerance, hypothermia, hypoglycemia, and hyperglycemia are all common in infants in the postnatal period, indicating the need to closely manage these patients' temperature and nutrition. Furthermore, rapid metabolic and physiologic changes in the first few days after birth can yield susceptibility to hypocalcemia, polycythemia, immunologic compromise, and renal dysfunction. Long-term consequences According to the theory of thrifty phenotype,<unk> triggers epigenetic responses in the fetus that are otherwise activated in times of chronic food shortage. If the offspring actually develops in an environment where food is readily accessible, it may be more prone to metabolic disorders, such as obesity and type II diabetes. Infants with<unk> may continue to show signs of abnormal<unk> throughout childhood. Infants with asymmetric<unk> (head-sparing) typically have more robust catch-up postnatal<unk> , as compared with infants with symmetric<unk> , who may remain small throughout life. The majority of catch-up<unk> occurs in the first 6 months of life, but can continue throughout the first two years. Approximately 10% of infants who are small for gestational age due to<unk> will still have short stature in late childhood. Infants with<unk> are also at elevated risk for neurodevelopmental abnormalities, including motor delay and cognitive impairments. Low IQ in adulthood may occur in up to one third of infants born small for gestational age due to<unk> . Infants who fail to display adequate catch-up<unk> in the first few years of life may exhibit worse outcomes. Catch-up<unk> can alter fat distribution in children diagnosed with<unk> as infants and increase risk of metabolic syndrome. Infants with<unk> may be susceptible to long-term dysfunction of several endocrine processes, including<unk> hormone signaling, the hypothalamic-pituitary-adrenal axis, and puberty. Renal dysfunction, disrupted lung development, and impaired bone metabolism are also associated with<unk> . | Intrauterine growth restriction | Uremic fetor | Low Birth Weight | Neonatal hypocalcemia | Small for gestational age | Fetal distress | Large for gestational age | Fetal hydantoin syndrome | 00
| 6,373 |
Some people are allergic to the spermicide used in the<unk> . Women who use<unk> s have an increased risk of yeast infection and urinary tract infection. Improper use, such as leaving the<unk> in too long, can result in toxic shock syndrome. The Today<unk> contains the spermicide nonoxynol-9, which may contain certain risks for those using the<unk> multiple times a day, or for those at risk for HIV. In these cases, nonoxynol-9 can irritate the tissue, which leads to an increased risk of HIV and other sexually transmitted infections. | Contraceptive sponge | Contraceptive patch | Contraceptive implant | Heat-based contraception | Male contraceptive | Spermicide | Vaginal microbicide | Contraceptive vaginal ring | 00
| 14,544 |
The term<unk> is used for a heterogeneous group of diseases that share<unk> skin characteristics. | Pustular psoriasis | Dyshidrosis | Parapsoriasis | Guttate psoriasis | Inverse psoriasis | Xerotic eczema | Retiform parapsoriasis | Lupus vulgaris | 00
| 52,701 |
<unk> is diagnosed by clinical examination of a person with a severe developmental disability and intellectual impairment. The face is often long and myopathic. Overgrown gums become apparent in late childhood. The finger and toenails are characteristically small, with complete or almost complete absence of the nails of the thumb (pollex) and great toe (hallux). | Temple–Baraitser syndrome | Catel–Manzke syndrome | Neu–Laxova syndrome | Nance–Horan syndrome | Parkes Weber syndrome | Bart–Pumphrey syndrome | Valentino's syndrome | Nicolau–Balus syndrome | 00
| 75,118 |
+ Hip fractures per 1000 person-years WHO category Age 50–64 Age > 64 Overall Normal 5.3 9.4 6.6 Osteopenia 11.4 19.6 15.7 Osteoporosis 22.4 46.6 40.6 Although people with osteoporosis have increased mortality due to the<unk> of fracture, the fracture itself is rarely lethal. Hip fractures can lead to decreased mobility and additional risks of numerous<unk> (such as deep venous thrombosis and/or pulmonary embolism, and pneumonia). The six-month mortality rate for those aged 50 and above following hip fracture was found to be around 13.5%, with a substantial proportion (almost 13%) needing total assistance to mobilize after a hip fracture. Vertebral fractures, while having a smaller impact on mortality, can lead to severe chronic pain of neurogenic origin, which can be hard to control, as well as deformity. Though rare, multiple vertebral fractures can lead to such severe hunchback (kyphosis), the resulting pressure on internal organs can impair one's ability to breathe. Apart from risk of death and other<unk> , osteoporotic fractures are associated with a reduced health-related quality of life. The condition is responsible for millions of fractures annually, mostly involving the lumbar vertebrae, hip, and wrist. Fragility fractures of ribs are also common in men. Fractures Hip fractures are responsible for the most serious consequences of osteoporosis. In the United States, more than 250,000 hip fractures annually are attributable to osteoporosis. A 50-year-old white woman is estimated to have a 17.5% lifetime risk of fracture of the proximal femur. The incidence of hip fractures increases each decade from the sixth through the ninth for both women and men for all populations. The highest incidence is found among men and women ages 80 or older. Between 35 and 50% of all women over 50 had at least one vertebral fracture. In the United States, 700,000 vertebral fractures occur annually, but only about a third are recognized. In a series of 9704 women aged 68.8 on average studied for 15 years, 324 had already suffered a vertebral fracture at entry into the study and 18.2% developed a vertebral fracture, but that risk rose to 41.4% in women who had a previous vertebral fracture. In the United States, 250,000 wrist fractures annually are attributable to osteoporosis. Wrist fractures are the third most common type of osteoporotic fractures. The lifetime risk of sustaining a Colles' fracture is about 16% for white women. By the time women reach age 70, about 20% have had at least one wrist fracture. Fragility fractures of the ribs are common in men as young as age 35. These are often overlooked as signs of osteoporosis, as these men are often physically active and suffer the fracture in the course of physical activity, such as falling while water skiing or jet skiing. | complications of Growth hormone deficiency | complications of Kallmann syndrome | medical cause of Precocious puberty | onset of Kallmann syndrome | complications of Klinefelter syndrome | complications of Turner syndrome | medical cause of Hyperdontia | complications of XYY syndrome | 00
| 1,603 |
Differential diagnosis Patch test Cutaneous disorders in musicians include frictional injury ("fiddler's neck"), hyperhidrosis, acne mechanica and vascular compromise. Other agents of irritant and allergic contact dermatitis may be rosewood, Makassar ebony, cocobolo wood, African blackwood, nickel, reed, propolis (bee glue), chromium and paraphenylenediamine. Patch testing can be performed for identification of the cause. | Abietic acid dermatitis | Phytophotodermatitis | Phototoxic tar dermatitis | Ichthyosis acquisita | Urticaria pigmentosa | Lacquer dermatitis | Alopecia mucinosa | Dermatopathia pigmentosa reticularis | 00
| 56,388 |
<unk> is most commonly linked to human papillomavirus (HPV), a usually sexually-transmitted infection. HPV is the most common sexually transmitted infection in the United States while genital herpes (HSV) was the most common sexually transmitted infection globally. | Anal dysplasia | Anal fissure | Perianal cellulitis | Anal fistula | Anal plug | Rectal prolapse | Anal wink | Genital ulcer | 00
| 54,397 |
<unk> , also known as pyridoxine-pyrrolidone carboxylate, is a drug used to treat chronic and acute alcohol intoxication.<unk> accelerates alcohol clearance from the blood.<unk> is an ion pair salt of pyridoxine and pyrrolidone carboxylate (PCA). Pyridoxine (vitamin B6) is a precursor of coenzymes including pyridoxal 5’-phosphate (PLP), which accelerates the metabolic degradation of ethanol and prevents adenosine triphosphate (ATP) inactivation by acetaldehyde. Pyridoxal phosphate dependent enzymes also play a role in the biosynthesis of four important neurotransmitters: serotonin (5-HT), epinephrine, norepinephrine and GABA: see vitamin B6 functions. L-PGA is present in the diet and is produced endogenously by enzymatic conversion of gamma-glutamyl amino acids to L-PGA and free amino acids. In the central nervous system (CNS), L-PGA was found to have a role in composition of neuro-active molecules. Its production has been linked to hepatic gamma-glutamyl transferase activity and levels of reduced glutathione (GSH). It was shown that L-PGA facilitates ATP synthesis by stimulating de novo synthesis of purines. | Metadoxine | Etifoxine | Levomefolic acid | Pyridoxine | Boroline | Retinol | Quinine | Phenothrin | 00
| 65,282 |
<unk> is the internal<unk> at which a blood vessel collapses and closes completely. If blood<unk> falls below<unk> , then the vessels collapse. This happens during the measurement of blood<unk> with a sphygmomanometer. At resting state the arterial<unk> is ~ 20 mmHg.<unk> in arteries is higher than the mean vascular filling<unk> that develops after death (~7 mmHg). Therefore, arteries collapse after death, then fill up with air once the dissection begins. In severe haemorrhage, blood loss leads to a significant reduction in<unk> . This, combined with activity in the sympathetic autonomic nerves supplying smooth muscle, leads to vasoconstriction to the extent that the vessels may collapse. This occurs at the<unk> ,<unk> off blood supply to tissues, which can lead to toxic shock. | Critical closing pressure | Vascular resistance | Renal threshold | Flow-mediated dilation | Effective circulating volume | Rate pressure product | Alveolar–arterial gradient | Arterial input function | 00
| 57,381 |
Poster from 1937 encouraging citizens to "consult your physician" for treatment of the<unk> Treatments of the<unk> primarily involve medications and other therapies for symptomatic relief. Getting plenty of rest, drinking fluids to maintain hydration, and gargling with warm salt water are reasonable conservative measures. Much of the benefit from symptomatic treatment is, however, attributed to the placebo effect. no medications or herbal remedies had been conclusively demonstrated to shorten the duration of infection. Symptomatic Treatments that may help with symptoms include simple pain medication and medications for fevers such as ibuprofen and acetaminophen (paracetamol). It, however, is not clear if acetaminophen helps with symptoms. It is not known if over the counter cough medications are effective for treating an acute cough. Cough medicines are not recommended for use in children due to a lack of evidence supporting effectiveness and the potential for harm. In 2009, Canada restricted the use of over-the-counter cough and<unk> medication in children six years and under due to concerns regarding risks and unproven benefits. The misuse of dextromethorphan (an over-the-counter cough medicine) has led to its ban in a number of countries. Intranasal corticosteroids have not been found to be useful. In adults short term use of nasal decongestants may have a small benefit. Antihistamines may improve symptoms in the first day or two; however, there is no longer-term benefit and they have adverse effects such as drowsiness. Other decongestants such as pseudoephedrine appear effective in adults. Combined oral analgesics, antihistaminics and decongestants are generally effective for older children and adults. Ipratropium nasal spray may reduce the symptoms of a runny nose but has little effect on stuffiness. Ipratropium may also help with cough in adults. The safety and effectiveness of nasal decongestant use in children is unclear. Due to lack of studies, it is not known whether increased fluid intake improves symptoms or shortens respiratory illness. As of 2017 heated and humidified air, such as via RhinoTherm, is of unclear benefit. One study has found chest vapor rub to provide some relief of nocturnal cough, congestion, and sleep difficulty. Some advise to avoid physical exercise if there are symptoms such as fever, widespread muscle aches or fatigue. It is regarded as safe to perform moderate exercise if the symptoms are confined to the head, including runny nose, nasal congestion, sneezing, or a minor sore throat. There is a popular belief that having a hot drink can help with<unk> symptoms, but evidence to support this is very limited. Antibiotics and antivirals Antibiotics have no effect against viral infections, including the<unk> . Due to their side effects, antibiotics cause overall harm but are still frequently prescribed. Some of the reasons that antibiotics are so<unk> ly prescribed include people's expectations for them, physicians' desire to help, and the difficulty in excluding complications that may be amenable to antibiotics. There are no effective antiviral drugs for the<unk> even though some preliminary research has shown benefits. Zinc Zinc supplements may shorten the duration of<unk> s by up to 33% and reduce the severity of symptoms if supplementation begins within 24 hours of the onset of symptoms. Some zinc remedies directly applied to the inside of the nose have led to the loss of the sense of smell. A 2017 review did not recommend the use of zinc for the<unk> for various reasons; whereas a 2017 and 2018 review both recommended the use of zinc, but also advocated further research on the topic. Alternative medicine While there are many alternative medicines and Chinese herbal medicines supposed to treat the<unk> , there is insufficient scientific evidence to support their use. As of 2015, there is weak evidence to support nasal irrigation with saline. There is no firm evidence that Echinacea products or garlic provide any meaningful benefit in treating or preventing<unk> s. Vitamins C and D Vitamin C supplementation does not affect the incidence of the<unk> , but may reduce its duration. There is no conclusive evidence that vitamin D supplementation is efficacious in the prevention or treatment of respiratory tract infections. | Common cold | Whooping cough | Pontiac fever | Allergic rhinitis | Polymer fume fever | Sinusitis | Plague | Bronchitis | 00
| 5,712 |
The most common adverse effects include sleepiness, dizziness, nausea and vomiting. More rarely, coordination problems and changes in behaviour (such as severe depression, aggression, hostility, impatience, rage, depression, suicide ideology, etc) can occur. | Brivaracetam | Piracetam | Phenylpiracetam | Dimiracetam | Tiagabine | Levetiracetam | Retigabine | Mesuximide | 00
| 46,388 |
<unk> <unk> is a technique used in organ transplantation as a means of preserving the organs which are to be transplanted.<unk> has various forms and can be categorised according to the temperature of the perfusate: cold (4 °C) and warm (37 °C).<unk> has been applied to renal transplantation, liver transplantation and lung transplantation. It is an alternative to static cold storage (SCS). | Machine perfusion | Hyperbaric stretcher | Infusion pump | Membrane oxygenator | Perfusion | Muscle energy technique | Articulatory technique | Dye tracing | 00
| 33,309 |
From its beginnings,<unk> <unk> Ambulance employed<unk> and<unk> to distinguish grades within its membership and management<unk> ructure; these were extended across the wider organisation following its merge with the<unk> <unk> Ambulance Association to form<unk> <unk> Ambulance. Based upon the British Army officer and the British Army other<unk> <unk> ructure and<unk> , the original<unk> and<unk> have been subject to several modifications over the history of the organisation. The basic "star" or "pip" has at its centre the eight-point Maltese Cross, the badge of the Order of<unk> <unk> . The crown used is also that of the Order. At the higher general list<unk> , crossed<unk> retchers are used rather than the crossed sword and baton of military use.<unk> are in silver, again symbolic of the Order of<unk> .<unk> . Also, officers who hold<unk> within the organisation at or above R4 wear a cockade in their hat (women) and have a silver bar (men), however at or above R3 wear a cockade and tuft (women) and silver bar and Wort cap (men). Since the mid-1990s the former "Senior NCO" and "Warrant Officer"<unk> have been abolished. These<unk> , whose titles were "Staff Sergeant", "Corps Sergeant Major", and "County (or District or Bailiwick) Sergeant Major" were deemed too militaristic in form although a few previous incumbents remain. Their demise has gone hand in hand with a lowering of emphasis on parading and drill. The county Sergeant Major, if the county has appointed one, wears member<unk> slides and Warrant Officer Class 2 <unk> <unk> Crown in laurel leaves) arm badges on the bottom of each arm. Nurses used to wear Rhodium Metal bars on their Shoulder<unk> raps. A red enamelled bar denoted a<unk> ate Registered Nurse (SRN). A purple enamelled bar denoted a<unk> ate Certified Midwife (SCM) and/or a Nurse on the Special Part of the<unk> ate Register i.e. psychiatric or learning disability). A green enamelled bar denoted a<unk> ate Enrolled Nurse (SEN). Their use was abandoned in the mid-1990s. In 2012, one Warrant Officer Class 1 (wearing Royal Arms badges in silver on both arms) was appointed at National HQ to advise on ceremonial matters across<unk> <unk> Ambulance. In December 2013, as a result of the<unk> review, a simplified<unk><unk> ructure was introduced, being fully implemented by the end of March 2014. The aim of the new<unk><unk> ructure is to ensure that<unk> is applied consistently throughout the organisation and that it is applied only based on an individual's role. A number of<unk> will cease to exist as a result of this change, and the requirements for many of the remaining<unk> will change. In December 2016, it was announced that effective 1 January 2017, no<unk> is to be worn on events, except by persons who are performing an operational management role at that event. Persons who are undertaking an operational management role, but who do not have<unk> will continue to not wear<unk> Persons who do have<unk> but who are not in an operational management role at the event should not display their<unk> | Ranks and insignia of St John Ambulance | Commissioners in Lunacy | Outline of medicine | SA Ambulance Service | Bonded medical place | Isle of Man Ambulance Service | NHIF Ambulance Scandal | Mental health tribunal | 00
| 28,221 |
<unk> is a tricyclic antidepressant (TCA). It acts as a serotonin–norepinephrine reuptake inhibitor (SNRI) (a reuptake inhibitor of serotonin and norepinephrine), with additional antiadrenergic, antihistamine, antiserotonergic, and anticholinergic activities. Pharmacodynamics +<unk> Site Ki (nM) Species Ref 68–95210 () Human 30–5813 () Human >10,0004,600 () Human 5-HT1A 276 Human 5-HT2A 11–27 Human 5-HT2B 5-HT2C 2008.8 HumanRat 5-HT3 Human 5-HT6 136 Rat 5-HT7 α1 24 Human α1B 12 Human α2A 1,100–1,270 Human α2B 28 Human α2C 96 Human D2 360 Human H1 0.09–1.23 Human H2 174 Human H3 39,800 Human H4 15,100 Human 23–80 Human M1 18–38 Human M2 160–230 Human M3 25–52 Human M4 20–82 Human M5 5.6–75 Human 6,500 () Human Values are Ki, unless otherwise specified. The smaller the value, the more strongly the drug binds to the site.<unk> is a reuptake inhibitor of serotonin and norepinephrine, or a serotonin–norepinephrine reuptake inhibitor (SNRI), and has additional antiadrenergic, antihistamine, antiserotonergic, and anticholinergic activities. It is specifically an antagonist of the histamine H1 and H2 receptors, the serotonin 5-HT2A and 5-HT2C receptors, the α1-adrenergic receptor, and the muscarinic acetylcholine receptors (M1–M5). Similarly to other tricyclic antidepressants,<unk> is often prescribed as an effective alternative to SSRI medications.<unk> is also a potent blocker of voltage-gated sodium channels, and this action is thought to be involved in both its lethality in overdose and its effectiveness as an analgesic (including in the treatment of neuropathic pain, and as a local anesthetic). The potencies of<unk> in terms of its receptor antagonism specifically are as follows: * Extremely strong: Histamine H1 receptor * Strong: α1-adrenergic receptor, 5-HT2A and muscarinic acetylcholine receptors * Moderate: 5-HT2C and 5-HT1A receptors * Weak: α2-adrenergic and D2 receptors Based on its values for monoamine reuptake inhibition,<unk> is relatively selective for the inhibition of norepinephrine reuptake, with a much weaker effect on the serotonin transporter. Although there is a significant effect that takes place at one of the specific serotonergic binding sites, the 5-HT2A serotonin receptor subtype. There is negligible influence on dopamine reuptake. The major metabolite of<unk> , nordoxepin (desmethyldoxepin), is pharmacologically active similarly, but relative to<unk> , is much more selective as a norepinephrine reuptake inhibitor. In general, the demethylated variants of tertiary amine TCAs like nordoxepin are much more potent inhibitors of norepinephrine reuptake, less potent inhibitors of serotonin reuptake, and less potent in their antiadrenergic, antihistamine, and anticholinergic activities. Antidepressant doses of<unk> are defined as 25 to 300 mg/day, although are typically above 75 mg/day. Antihistamine doses, including for dermatological uses and as a sedative/hypnotic for insomnia, are considered to be 3 to 25 mg, although higher doses between 25 and 50 mg and in some cases even up to 150 mg have been used to treat insomnia. At low doses, below 25 mg,<unk> is a pure antihistamine and has more of a sedative effect. At antidepressant doses of above 75 mg,<unk> is more stimulating with antiadrenergic, antiserotonergic, and anticholinergic effects, and these activities contribute to its side effects.<unk> is a mixture of (E) and (Z) stereoisomers with an approximate ratio of 85:15. When<unk> was developed, no effort was made to separate or balance the mixture following its synthesis, resulting in the asymmetric ratio. (Z)-Doxepin is more active as an inhibitor of serotonin and norepinephrine reuptake than (E)-doxepin. The selectivity of<unk> for inhibition of norepinephrine reuptake over that of serotonin is likely due to the 85% presence of (E)-doxepin in the mixture. Most other tertiary amine TCAs like amitriptyline and imipramine do not exhibit E-Z isomerism or such mixture asymmetry and are comparatively more balanced inhibitors of serotonin and norepinephrine reuptake. As a hypnotic + TCAs and TeCAs at H1and mACh receptors Drug H1 Ratio Amitriptyline 1.1 18 1:16 Amoxapine 25 1,000 1:40 Clomipramine 31 37 1:1.2 Desipramine 110 196 1:1.8 Dosulepin 4.0 38 1:9.5<unk> 0.24 83 1:346 Imipramine 11 91 1:8.3 Lofepramine 360 67 1:0.2 Maprotiline 2.0 560 1:280 Mianserin 0.40 820 1:2050 Mirtazapine 0.14 670 1:4786 Nortriptyline 10 149 1:15 Protriptyline 25 25 1:1 Trimipramine 0.27 58 1:215 Values are Ki (nM).<unk> is a highly potent antihistamine, with this being its strongest activity. In fact,<unk> has been said to be the most or one of the most potent H1 receptor antagonists available, with one study finding an in vitro Ki of 0.17 nM. It is the most potent and selective H1 receptor antagonist of the TCAs (although the tetracyclic antidepressant (TeCA) mirtazapine is slightly more potent), and other sedating antihistamines, for instance the over-the-counter diphenhydramine (Ki = 16 nM) and<unk> ylamine (Ki = 42 nM), show far lower affinities for this receptor in comparison. The affinity of<unk> for the H1 receptor is far greater than its affinity for other sites, and 10- to 100-fold higher doses are needed for antidepressant effects. In accordance, although it is often described as a "dirty drug" due to its highly promiscuous binding profile,<unk> acts as a highly selective antagonist of the H1 receptor at very low doses (less than 10 mg; typically 3 to 6 mg). At these doses, it notably has no clinically relevant anticholinergic effects such as dry mouth or cognitive/memory impairment, unlike most other sedating antihistamines, and similarly has no effect on other receptors such as adrenergic and serotonin receptors. The H1 receptor antagonism of<unk> is responsible for its hypnotic effects and its effectiveness in the treatment of insomnia at low doses. The incidence of side effects with<unk> and its safety at these doses was similar to that of placebo in clinical trials; the most frequent side effects were headache and somnolence/sedation, both with an incidence of less than 5%. Other side effects sometimes associated with antihistamines, including daytime sedation, increased appetite, and weight gain, all were not observed. Clinical evidence of H1 receptor antagonists and TCAs for the treatment insomnia shows mixed effectiveness and is limited in its quality due to weaknesses like small sample sizes and poor generalizability. However,<unk> is a unique and notable exception; it has been well-studied in the treatment of insomnia and shows consistent benefits with excellent tolerability and safety. Aside from diphenhydramine and<unk> ylamine, which have historical approval as hypnotics,<unk> is the only H1 receptor antagonist that is specifically approved for the treatment of insomnia in the United States. The effect sizes of very low-dose<unk> in the treatment of insomnia range from small to medium. These include subjective and objective measures of sleep maintenance, sleep duration, and sleep efficiency. Conversely, very low-dose<unk> shows relatively weak effects on sleep initiation and does not significantly separate from placebo on this measure. This is in contrast to benzodiazepines and nonbenzodiazepine (Z-drug) hypnotics, which are additionally effective in improving sleep onset latency. However, it is also in contrast to higher doses of<unk> (50 to 300 mg/day), which have been found to significantly reduce latency to sleep onset. A positive dose–response relationship on sleep measures was observed for doses of<unk> between 1 and 6 mg in clinical studies, whereas the incidence of adverse effects remained constant across this dose range in both young and older adults. However, the incidence of adverse effects appeared to increase with longer treatment duration. A dose of<unk> as low as 1 mg/day was found to significantly improve most of the assessed sleep measures, but unlike the 3 and 6 mg/day doses, was not able to improve wake time during sleep. This, along with greater effect sizes with the higher doses, was likely the basis for the approval of the 3 and 6 mg doses of<unk> for insomnia and not the 1 mg dose. At very low doses,<unk> has not shown discontinuation or withdrawal effects nor rebound insomnia. Sustained effectiveness without apparent tolerance was demonstrated in clinical studies of up to 12 weeks duration. This appears to be in contrast to over-the-counter antihistamines like diphenhydramine and<unk> ylamine and all other first-generation antihistamines, which are associated with rapid development of tolerance and dependence (by day 3 or 4 of continuous dosing) and loss of hypnotic effectiveness. It is for this reason that, unlike<unk> , they are not recommended for the chronic management of insomnia and are advised for only short-term treatment (i.e., 1 week). It is not entirely clear why<unk> and first-generation antihistamines are different in this regard, but it has been suggested that it may have to do with the lack of selectivity for the H1 receptor of the latter or may have to do with the use of optimal doses. Unlike very-low-dose<unk> , most first-generation antihistamines also have marked anticholinergic activity as well as associated side effects such as dry mouth, constipation, urinary retention, and confusion. This is particularly true in older people, and antihistamines with concomitant anticholinergic effects are not recommended in adults over the age of 65. Anticholinergic activity notably may interfere with the sleep-promoting effects of H1 receptor blockade. Antagonism of the H1, 5-HT2A, 5-HT2C, and α1-adrenergic receptors is thought to have sleep-promoting effects and to be responsible for the | Doxepin | Chlorpropamide | Pheniramine | Mebanazine | Bromazine | Propranolol | Metkefamide | Bolazine | 00
| 24,663 |
Regarding the primary prevention of HPV-positive<unk> , HPV vaccines show more than 90% efficacy in preventing vaccine-type HPV infections and their correlated anogenital precancerous lesions. A research conducted in 2017 demonstrated that HPV vaccination induces HPV antibodies levels at the oral cavity that correlate with circulating levels. Regarding the primary prevention of HPV-positive<unk> , safe oral sex habits should be advised (see Sex education). Regarding the primary prevention of HPV-negative<unk> , educating people on the risks of chewing betel quid, alcohol use, and tobacco smoking is of the prime importance in the control and prevention of<unk> s. | Oropharyngeal cancer | Laryngeal cancer | Adenoiditis | Epiglottitis | Hypopharyngeal cancer | Nasal polyp | Laryngeal cyst | Nasal septal abscess | 00
| 57,123 |
The virion is enveloped and spherical measuring 120–160 nm in diameter and a core shell of about 65 nm. Glycoproteins and trimers form large surface projections which create the appearance of solar corona. This genus, like other coronaviruses, has a spike protein with a type I fusion machine (S2) and a receptor-binding domain (S1). It assembles into a trimer. Unlike beta- and gammacoronaviruses, this protein is not cleaved into two halves. | Alphacoronavirus | Pandoravirus | Orthohantavirus | Coronavirus | Coronavirus | Arbovirus | Betacoronavirus | Andes orthohantavirus | 00
| 64,689 |
inheritance. thumb Impact of insulin/IGF-1 signaling in<unk> (A) and Western diet (B) on FoxO-mediated gene regulation and associated pathologies. GHR*, growth hormone receptor loss of function mutation in<unk> ; GIP, glucose-dependent insulinotropic polypeptide, a whey protein-induced incretin, which stimulates β-cell proliferation and insulin secretion; PRL, prolactin; PRL secretion is induced by serotoninergic hypothalamic signaling; Trp, tryptophan, and Leu, leucine, essential amino acids enriched in the whey protein α-lactalbumin; Trp via serotonin synthesis stimulates pituitary GH and PRL secretion and Leu stimulates β-cell proliferation and insulin secretion. Under normal circumstances in humans, growth hormone (GH) is released in a pulsatile fashion from cells known as somatotrophs in the anterior pituitary gland. These pulses of GH are regulated by cells in the hypothalamus, via the release of growth hormone-releasing hormone (GHRH) into the hypothalamohypophysial system when stimulated by insulin, ghrelin, glucagon, arginine, deep sleep, exercise, fasting, sex hormone release during puberty, and a host of other factors. GH release is inhibited by somatostatin (GHIH), IGF-1, hyperglycemia, and glucocorticoids. Once released, the GH molecules travel through the bloodstream and eventually bind to GH receptors on the surface of cells composing bodily organs and tissues. One major site of action for GH is in the liver, where it stimulates gluconeogenesis and the release of IGF-1 through the JAK-STAT signaling pathway. IGF-1 promotes growth in a variety of tissues throughout the body, especially bone mineralization, and provides negative feedback on GH release. GH results in increased muscle mass, lipolysis, and protein synthesis. Obesity and increased adipose tissue, especially visceral fat, results in reduced GH secretion. There is a natural age-related decline in the GHRH-stimulated release of GH. Growth Hormone Receptor Mutations Molecular genetic investigations have shown that<unk> is mainly associated with autosomal recessive mutations in the gene for the growth hormone receptor (GHR). These can result in defective hormone binding to the ectodomain or reduced efficiency of dimerization of the receptor after hormone occupancy.<unk> is generally classified as "primary" GH insensitivity, which is distinguished from "secondary" GH insensitivity. Primary (congenital/hereditary) GH insensitivity may result from growth hormone receptor defects, as in the case of<unk> , but can also be caused by defective post-receptor signal transduction (STAT5B), abnormalities of the IGF-1 gene or IGF-1 receptor. Secondary (acquired) GH insensitivity results from antibodies to growth hormone or the growth hormone receptor, as well as poor nutritional status, liver disease or diabetes mellitus. A GHR mutation that results in only partial insensitivity to GH can manifest as a form of idiopathic short stature. STAT5B A related condition involving postreceptor insensitivity to growth hormone has been associated with STAT5B. | Laron syndrome | Hypopituitarism | Jervell and Lange-Nielsen syndrome | STAT5B | Aagenaes syndrome | Cowden syndrome | Dennie–Marfan syndrome | Prader–Willi syndrome | 00
| 42,569 |
Headache is the symptom of pain in the face, head, or neck. It can occur as a migraine, tension-type headache, or cluster headache. There is an increased risk of depression in those with severe headaches. Headaches can occur as a result of many conditions. There are a number of different classification systems for headaches. The most well-recognized is that of the International Headache Society which classifies it into more than 150 types of primary and secondary headaches. Causes of headaches may include dehydration; fatigue; sleep deprivation; stress; the effects of medications (overuse) and recreational drugs, including withdrawal; viral infections; loud noises; head injury; rapid ingestion of a very cold food or beverage; and dental or sinus issues (such as sinusitis). Treatment of a headache depends on the underlying cause, but commonly involves pain medication (especially in case of migraine or cluster headache). A headache is one of the most commonly experienced of all physical discomforts. About half of adults have a headache in a given year. Tension headaches are the most common, affecting about 1.6 billion people (21.8% of the population) followed by migraine headaches which affect about 848 million (11.7%). | symptom of Carbon monoxide poisoning | symptom of Arsenic poisoning | symptom of Aspiration pneumonia | symptom of Sulfhemoglobinemia | symptom of Lead poisoning | symptom of Methemoglobinemia | symptom of Air embolism | symptoms of Aspiration pneumonia | 00
| 4,940 |
Figure 3<unk> -nucleoside reverse-transcriptase<unk> (NNRTIs) inhibit the reverse-transcriptase enzyme (RT) and therefore the replication of new viruses The NNRTIs act by binding<unk> -competitively to the RT enzyme (figure 3). The binding causes conformational change in the three-dimensional structure of the enzyme and creates the NNIBP. Binding of NNRTI to HIV-1 RT makes the p66 thumb domain hyper extended because it induces rotamer conformation changes in amino acid residues Tyr-181 and Tyr-188. This affects the catalytic activity of the enzyme and blocks the HIV-1 replication by inhibiting the polymerase active site of the RT's p66 subunit. The global conformational change additionally destabilizes the enzyme on its nucleic acid template and reduces its ability to bind nucleotides. The transcription of the viral RNA is inhibited and therefore the replication rate of the virus reduces. Although the exact molecular mechanism is still hypothetical this has been demonstrated by multiple studies to be the primary mechanism of action. In addition to this proposed primary mechanism of action it has been shown that the NNRTIs have other mechanisms of action and interfere with various steps in the reverse transcriptase reaction. It has been suggested that the inhibition of reverse transcription by the NNRTIs may be due to effects on the RT Rnase H activity and/or template/primer binding. Some NNRTIs interfere with HIV-1 Gag-Pol polyprotein processing by inhibiting the late stage of HIV-1 replication. It is important to gain profound understanding of the various mechanism of action of the NNRTIs in order to develop next-generation NNRTIs and for understanding the mechanism of drug resistance. | Discovery and development of non-nucleoside reverse-transcriptase inhibitors | Discovery and development of nucleoside and nucleotide reverse-transcriptase inhibitors | Zinc finger nuclease treatment of HIV | Vectors in gene therapy | Innate resistance to HIV | Cancer vaccine targeting CD4+ T cells | Targeted covalent inhibitors | Individualized cancer immunotherapy | 00
| 57,090 |
<unk><unk> thyroid carcinoma is malignant neoplasm of follicular cell origin showing intermediate histopathological patterns between<unk> and undifferentiated thyroid<unk> s. | Poorly differentiated thyroid cancer | Anaplastic thyroid cancer | Thyroid lymphoma | Follicular thyroid cancer | Papillary thyroid cancer | Medullary thyroid cancer | Squamous-cell thyroid carcinoma | Radiation-induced thyroiditis | 00
| 63,326 |
The<unk> can be done as either a slide or a tube test. The antigens necessary (OX2, OX19, and OXK) can be obtained commercially. Slide method 1.<unk> by Slide method * Place 50-100µl of patient serum on the slide * Add a drop of desired antigen ( Proteus OX19 or OX2 or OXK) * Mix the suspension by rotating the slide for 1 minutes * Visible agglutination indicates the positive test . Tube method Using 0.25% phenol saline as a diluent, a series of tubes containing twofold dilutions of patient serum are made with a final volume of 1 mL. A drop of antigen suspension is added to each tube, and the mixture is incubated at 50–55 °C for 4–6 hours. A positive tube would show visible flocculation or granulation, which is accentuated when the tube is gently agitated. The titer corresponds to the most dilute tube in the series that still shows positivity. Generally, a titer of ≥1:320 is considered diagnostic. | Weil–Felix test | Hawkins–Kennedy test | Rinne test | Patrick's test | Elek's test | Bourne test | Buehler test | Draize test | 00
| 30,781 |
The most effective way to diagnose CII deficiency is by measuring the activity of<unk> <unk> in the muscles. | Mitochondrial complex II deficiency | Mitochondrial trifunctional protein deficiency | Carnitine palmitoyltransferase II deficiency | Glutathione synthetase deficiency | Carnitine-acylcarnitine translocase deficiency | Carnitine palmitoyltransferase I deficiency | N-Acetylglutamate synthase deficiency | Acyl-CoA oxidase deficiency | 00
| 73,589 |
Studies have shown its uses to be oral contraception, lessening premenstrual dysphoric disorder (PMDD), and treatment of moderate acne in women over 14 years of age who choose an oral contraceptive for contraception. Five clinical trials were carried out for these labeled uses, “including a one-year contraceptive efficacy study, two 3-cycle studies in women with premenstrual dysphoric disorder (PMDD), and two 6-cycle studies in women with moderate acne.” The drug combination will also increase folate levels due to its extra ingredient,<unk> calcium. This is equivalent to folic<unk> 0.4 mg and will help prevent neural tube defects in case of accidental pregnancy while taking, or shortly after stopping the drug. Dosage and use Each box, as supplied by the manufacturer, contains three blister packs of 28 tablets packaged in individual boxes. Each blister pack of 28 tablets contains 24 pink active pills containing<unk> 3 mg, ethinylestradiol 20 mcg, and levomefolate calcium 0.451 mg and four light orange inactive pills containing of levomefolate calcium 0.451 mg. One tablet is taken by mouth at the same time every day. The failure rate may increase when pills are missed or taken incorrectly. Single missed pills should be taken as soon as remembered. It is important to know that when experiencing stomach upset in the form of diarrhea or vomiting (within 3–4 hours of taking), backup contraception methods should be utilized to account for possible absorption failure. | Drospirenone/ethinylestradiol/levomefolic acid | Ethinylestradiol/drospirenone | Estradiol enantate/algestone acetophenide | Ethinylestradiol/norethisterone | Ethinylestradiol sulfonate/norethisterone acetate | Ethinylestradiol/cyproterone acetate | Conjugated estrogens/norgestrel | Ethinylestradiol/megestrol acetate | 00
| 60,420 |
When combined with intravenous agalsidase alfa or beta, which are recombinant versions of the enzyme α-GalA,<unk> increases tissue concentrations of functional α-GalA compared to agalsidase given alone up to fivefold.Migalastat is not intended to be combined with agalsidase.<unk> does not inhibit or induce cytochrome P450 liver enzymes or transporter proteins and is therefore expected to have a low potential for interactions with other drugs. | Migalastat | Cobicistat | Lazaretto | Miglustat | Truenat | Epiestriol | Lifitegrast | Ketotifen | 00
| 68,844 |
Itch can originate in the peripheral nervous system (dermal or neuropathic) or in the central nervous system (neuropathic, neurogenic, or psychogenic). Dermal/pruritoceptive A chipmunk scratching itself. Itch originating in the skin is known as pruritoceptive, and can be induced by a variety of stimuli, including mechanical, chemical, thermal, and electrical stimulation. The primary afferent neurons responsible for histamine-induced itch are unmyelinated C-fibres. Two major classes of human C-fibre nociceptors exist: mechano-responsive nociceptors and mechano-insensitive nociceptors. Mechano-responsive nociceptors have been shown in studies to respond to mostly pain, and mechano-insensitive receptors respond mostly to itch induced by histamine. However, it does not explain mechanically induced itch or itch produced without a flare reaction that involves no histamine. Therefore, it is possible that pruritoceptive nerve fibres have different classes of fibres, which is unclear in current research. Studies have been done to show that itch receptors are found only on the top two skin layers, the epidermis and the epidermal/dermal transition layers. Shelley and Arthur verified the depth by injecting individual itch powder (Mucuna pruriens) spicules and noting that maximal sensitivity occurred at the basal cell layer or the innermost layer of the epidermis. Surgical removal of those skin layers removed the ability for a patient to perceive itch. Itch is never felt in muscle or joints, which strongly suggests that deep tissue probably does not contain itch signaling apparatuses. Itch is often classified as that which is histamine mediated (histaminergic) and nonhistaminergic. Sensitivity to pruritic stimuli is evenly distributed across the skin and has a clear spot distribution with similar density to that of pain. The different substances that elicit itch upon intracutaneous injection (injection within the skin) elicit only pain when injected subcutaneously (beneath the skin). Itch is readily abolished in skin areas treated with nociceptor excitotoxin capsaicin but remains unchanged in skin areas rendered touch insensitive by pretreatment with anti-inflammatory saponins. Although experimentally induced itch can still be perceived under a complete A-fiber conduction block, it is significantly diminished. Overall, itch sensation is mediated by A-delta and C nociceptors located in the uppermost layer of the skin. Molecular diversity of itch transmitting primary afferents Using single-cell mRNA sequencing, sensory-modality specific primary afferent have been molecularly defined into clusters based on gene expression patterns. Here, 11 sub clusters were detected; NF1-3, transmitting innocuous nociceptive information; NF4-5, which transmit proprioceptive information; NP1-3, transmitting itch information; PEP1-2, nociceptive information and TH, which is involved in pleasant touch, The pruriceptive NP1-3 were shown to express genes related to histaminergic and non-histaminergic signaling, where NF1 expresses genes responding to lysophosphatidic acid (Lpar3 and Lpar5), NP2 chloroquine-responsive genes (Mrgpra3 and Mrgprx1), whereas NP3 expresses neuropeptides Nppb and Sst as well as genes involved in inflammatory itch (Il31ra, Osmr and Crystrl2). The histamine receptor gene Hrh1 was found in NP2 and NP3, suggesting that histaminergic itch is transmitted by both these pruriceptive sub clusters. The spinal itch pathway After the pruriceptive primary afferent has been activated, the signal is transmitted from the skin into the spinal dorsal horn. In this area, a number of interneurons will either be inhibited or activated to promote activation of projection neurons, mediating the puriceptive signal to the brain. The GRP-GRPR interneuron system has been found to be important for mediating both histaminergic and non-histaminergic itch, where the GRP neurons activate GRPR neurons to promote itch Neuropathic Neuropathic itch can originate at any point along the afferent pathway as a result of damage of the nervous system. They could include diseases or disorders in the central nervous system or peripheral nervous system. Examples of neuropathic itch in origin are notalgia paresthetica, brachioradial pruritus, brain tumors, multiple sclerosis, peripheral neuropathy, and nerve irritation. Neurogenic Neurogenic itch, which is itch induced centrally but with no neural damage, is mostly associated with increased accumulation of exogenous opioids and possibly synthetic opioids. Psychogenic Itch is also associated with some<unk> of psychiatric disorders such as tactile hallucinations, delusions of parasitosis, or obsessive-compulsive disorders (as in OCD-related neurotic scratching). Peripheral sensitization Inflammatory mediators—such as bradykinin, serotonin (5-HT) and prostaglandins—released during a painful or pruritic inflammatory condition not only activate pruriceptors but also cause acute sensitization of the nociceptors. In addition, expression of neuro growth factors (NGF) can cause structural changes in nociceptors, such as sprouting. NGF is high in injured or inflamed tissue. Increased NGF is also found in atopic dermatitis, a hereditary and non-contagious skin disease with chronic inflammation. NGF is known to up-regulate neuropeptides, especially substance P. Substance P has been found to have an important role in inducing pain; however, there is no confirmation that substance P directly causes acute sensitization. Instead, substance P may contribute to itch by increasing neuronal sensitization and may affect release of mast cells, which contain many granules rich in histamine, during long-term interaction. Central sensitization Noxious input to the spinal cord is known to produce central sensitization, which consists of allodynia, exaggeration of pain, and punctuate hyperalgesia, extreme sensitivity to pain. Two types of mechanical hyperalgesia can occur: 1) touch that is normally painless in the uninjured surroundings of a cut or tear can trigger painful sensations (touch-evoked hyperalgesia), and 2) a slightly painful pin prick stimulation is perceived as more painful around a focused area of inflammation (punctuate hyperalgesia). Touch-evoked hyperalgesia requires continuous firing of primary afferent nociceptors, and punctuate hyperalgesia does not require continuous firing which means it can persist for hours after a trauma and can be stronger than normally experienced. In addition, it was found that patients with neuropathic pain, histamine ionophoresis resulted in a sensation of burning pain rather than itch, which would be induced in normal healthy patients. This shows that there is spinal hypersensitivity to C-fiber input in chronic pain. | symptoms of Non-Hodgkin lymphoma | symptom of Non-Hodgkin lymphoma | symptom of T-cell lymphoma | symptom of Hodgkin lymphoma | symptom of Lymphoma | symptom of Syphilis | symptom of Autoimmune disease | symptom of Hashimoto's thyroiditis | 00
| 12,496 |
δ-Aminolevulinic<unk> (also dALA, δ-ALA, 5ALA or 5-aminolevulinic<unk> , an endogenous non-proteinogenic amino<unk> , is the first compound in the porphyrin synthesis pathway, the pathway that leads to heme in mammals, as well as chlorophyll in plants. 5ALA is used in photodynamic detection and surgery of cancer. | Aminolevulinic acid | Tetrahydrobiopterin | Fosdenopterin | Hepcidin | Lipochrome | Hematoporphyrin | Beta-2 transferrin | Retinol-binding protein | 00
| 13,938 |
During pregnancy, immunologic suppression occurs which induces tolerance to the presence of the fetus. Without this suppression, the fetus would be rejected causing miscarriage. As a result, following delivery, the immune system rebounds causing levels of thyroids antibodies to rise in susceptible women. Specifically, the immunohistological features of susceptible women are indicated by: *antibodies to thyroglobulin (TgAb) *antibodies to thyroid peroxidase (TPOAb) *increase in TPOAb subclasses IgG1-IgG3 *lymphocyte infiltration and follicle formation within thyroid gland (Hashimoto's thyroiditis) *T-cell changes (increased CD4:CD8 ratio) * TSH-receptor antibodies (TSH-R Abs) | Postpartum thyroiditis | Radiation-induced thyroiditis | Subacute thyroiditis | Autoimmune thyroiditis | Ord's thyroiditis | Subacute lymphocytic thyroiditis | De Quervain's thyroiditis | Riedel's thyroiditis | 00
| 43,513 |
*Metallic Implants unless made up of titanium. *Pacemakers | Magnetic resonance myelography | Spinal fMRI | Myelography | Cervicography | Nerve biopsy | Magnetic resonance neurography | Lumbar provocative discography | Nerve conduction study | 00
| 74,059 |
Unidentified kidney<unk> . Renal<unk><unk> and passage during<unk> flight can potentially pose a severe risk to crew member health and safety and could affect mission outcome. Although renal<unk> s are routinely and successfully treated on Earth, the occurrence of these during<unk> flight can prove to be problematic. | Renal stone formation in space | Renal cortical necrosis | Extravasation of urine | Renal papillary necrosis | Ureteral neoplasm | Catheter-associated urinary tract infection | Blunt kidney trauma | Acute uric acid nephropathy | 00
| 63,406 |
<unk> may refer to: | Clarity | Concept creep | Character orientation | Casualty movement | Acelity | Situational strength | Emotional lateralization | Uniformity of content | 00
| 9,841 |
One advantage of MRI of the brain over computed tomography of the head is better tissue contrast, and it has fewer artifacts than CT when viewing the brainstem. MRI is also superior for pituitary<unk> . It may however be less effective at identifying early cerebritis. In the case of a concussion, an MRI should be avoided unless there are progressive neurological symptoms, focal neurological findings or concern of skull fracture on exam. In the analysis of a concussion, measurements of Fractional Anisotropy, Mean Diffusivity, Cerebral Blood Flow, and Global Connectivity can be taken to observe the pathophysiological mechanisms being made while in recovery. In analysis of the fetal brain, MRI provides more information about gyration than ultrasound. MRI is sensitive for the detection of brain abscess. A number of different<unk> modalities or sequences can be used with<unk> the nervous system: * T1-weighted (T1W) images: Cerebrospinal fluid is dark. T1-weighted images are useful for visualizing normal anatomy. * T2-weighted (T2W) images: CSF is light, but fat (and thus white matter) is darker than with T1. T2-weighted images are useful for visualizing pathology. * Diffusion-weighted images (DWI): DWI uses the diffusion of water molecules to generate contrast in MR images. * Proton density (PD) images: CSF has a relatively high level of protons, making CSF appear bright. Gray matter is brighter than white matter. False color MRI by applying red to T1, green to PD and blue to T2. * Fluid attenuation inversion recovery (FLAIR): useful for evaluation of white matter plaques near the ventricles. It is useful in identifying demyelination. | Magnetic resonance imaging of the brain | Brain biopsy | Hemoencephalography | Cranial ultrasound | Carotid ultrasonography | Stereoelectroencephalography | Pneumoencephalography | Transcranial pulsed ultrasound | 00
| 61,143 |
<unk> are a heterogeneous<unk> of unconventional T<unk> defined by their ability to recognize antigens bound on<unk> <unk> <unk> molecules <unk> a,<unk> b and<unk> c) with their TCR. Natural killer T (NKT)<unk> are a similar population with affinity to<unk> d (the only<unk> 2<unk> molecule). Both<unk> s recognize lipid antigens in contrast to the conventional peptide antigens presented on MHC class<unk> and 2 proteins. Most identified T-cells that bind<unk> <unk> <unk> proteins are αβ T<unk> and some are γδ T<unk> . Both foreign and endogenous lipid antigens activate these<unk> . The TCR usually recognizes the hydrophilic part of the antigen which protrudes outwards from the<unk> protein after the lipid chains are bound in a groove. Small hydrophobic antigens lacking a polar part have also been shown to activate<unk> a-restricted T<unk> , indicating that in this case the TCR may bind<unk> directly following displacement of nonimmunogenic ligands. | Group 1 CD1-restricted T cells | Persistent polyclonal B-cell lymphocytosis | Mutated citrullinated vimentin | Chimeric antigen receptor T cell | IgG4-related skin disease | Cross-reactive carbohydrate determinants | Deficiency of the interleukin-1–receptor antagonist | Antibodies from lymphocyte secretions | 00
| 75,021 |
<unk> " refers to an environmental health issue involving defective<unk> manufactured in China, imported to the United States and used in residential construction between 2001 and 2009 affecting "an estimated 100,000 homes in more than 20 states.". This is an isolated incident that is localised to the USA. In samples of contaminated<unk> , laboratory tests will detect off-gassing of volatile chemicals and sulfurous gases — including carbon disulfide, carbonyl sulfide, and hydrogen sulfide. The emissions worsen as temperature and humidity rise, will give off a sulfuric (rotten egg) odor and will cause copper surfaces to turn black and powdery, a chemical process indicative of a hydrogen sulfide reaction and an early indication of contaminated<unk> . Copper pipes, electrical wiring, and air conditioner coils are affected, as well as silver jewelry. Homeowners have reported health symptoms including respiratory problems such as asthma attacks, chronic coughing and difficulty breathing, as well as chronic headaches and sinus issues. corroded. | Chinese drywall | Pest house | Wellbee | Corn | Whitlow | Straw | Cowlick | Cold turkey | 00
| 54,755 |
A<unk> is a sinus remaining from the allantois during embryogenesis. It is a cyst which occurs in the remnants between the umbilicus and bladder. This is a type of cyst occurring in a persistent portion of the urachus, presenting as an extraperitoneal mass in the umbilical region. It is characterized by abdominal pain, and fever if infected. It may rupture, leading to peritonitis, or it may drain through the umbilicus.<unk> s are usually silent clinically until infection, calculi or adenocarcinoma develop. | Urachal cyst | Galactocele | Dacryocystocele | Urachal fistula | Urachal diverticulum | Lymphocele | Urachal cancer | Chirurgia magna | 00
| 41,485 |
<unk> is a state of complete or near-complete lack of contact between an individual and society. It differs from loneliness, which reflects temporary and involuntary lack of contact with other humans in the world.<unk> can be an issue for individuals of any age, though symptoms may differ by age group.<unk> has<unk> milar characteristics in both temporary instances and for those with a historical lifelong<unk> cycle. All types of<unk> can include staying home for lengthy periods of time, having no communication with family, acquaintances or friends, and/or willfully avoiding any contact with other humans when those opportunities do arise. | Social isolation | Psychological resistance | Psychological resilience | Neglect | Social degeneration | Childhood trauma | Social rejection | Social stress | 00
| 36,644 |
A<unk> , also known as a steroid biosynthesis<unk> , is a type of drug which inhibits one or more of the enzymes that are involved in the process of steroidogenesis, the biosynthesis of endogenous steroids and steroid hormones. They may inhibit the production of cholesterol and other sterols, sex steroids such as androgens, estrogens, and progestogens, corticosteroids such as glucocorticoids and mineralocorticoids, and neurosteroids. They are used in the treatment of a variety of medical conditions that depend on endogenous steroids.<unk> s are analogous in effect and use to antigonadotropins (which specifically inhibit sex steroid production), but work via a different mechanism of action; whereas antigonadotropins suppress gonadal production of sex steroids by effecting negative feedback on and thereby suppressing the hypothalamic-pituitary-gonadal axis,<unk> s directly inhibit the enzymatic biosynthesis of steroids. | Steroidogenesis inhibitor | Neurosteroidogenesis inhibitor | Orexin antagonist | Antiglucocorticoid | 5α-Reductase inhibitor | Aromatase inhibitor | CYP17A1 inhibitor | Growth factor receptor inhibitor | 00
| 68,882 |
Rotational force is key in a concussion. Punches in boxing can deliver more rotational force to the<unk> than the typical impact in American football. Forces The brain is surrounded by cerebrospinal fluid, which protects it from light trauma. More severe impacts, or the forces associated with rapid acceleration, may not be absorbed by this cushion. Concussions, and other<unk> -related<unk> es, occur when external forces acting on the<unk> are transferred to the brain. Such forces can occur when the<unk> is struck by an object or surface (a ‘direct impact’), or when the torso rapidly changes position (i.e. from a body check) and force is transmitted to the<unk> (an ‘indirect impact’). Forces may cause linear, rotational, or angular movement of the brain or a combination of them. In rotational movement, the<unk> turns around its center of gravity and in angular movement, it turns on an axis, not through its center of gravity. The amount of rotational force is thought to be the major component in concussion and its severity. As of 2007, studies with athletes have shown that the amount of force and the location of the impact are not necessarily correlated with the severity of the concussion or its symptoms, and have called into question the threshold for concussion previously thought to exist at around 70–75 g. The parts of the brain most affected by rotational forces are the midbrain and diencephalon. It is thought that the forces from the<unk> disrupt the normal cellular activities in the reticular activating system located in these areas and that this disruption produces the loss of consciousness often seen in concussion. Other areas of the brain that may be affected include the upper part of the brain stem, the fornix, the corpus callosum, the temporal lobe, and the frontal lobe. Angular accelerations of 4600, 5900, or 7900 rad/s2 are estimated to have 25, 50, or 80% risk of mTBI respectively. Pathophysiology In both animals and humans, mTBI can alter the brain's physiology for hours to years, setting into motion a variety of pathological events. As one example, in animal models, after an initial increase in glucose metabolism, there is a subsequent reduced metabolic state which may persist for up to four weeks after<unk> . Though these events are thought to interfere with neuronal and brain function, the metabolic processes that follow concussion are reversible in a large majority of affected brain cells; however, a few cells may die after the<unk> . Included in the cascade of events unleashed in the brain by concussion is impaired neurotransmission, loss of regulation of ions, deregulation of energy use and cellular metabolism, and a reduction in cerebral blood flow. Excitatory neurotransmitters, chemicals such as glutamate that serve to stimulate nerve cells, are released in excessive amounts. The resulting cellular excitation causes neurons to fire excessively. This creates an imbalance of ions such as potassium and calcium across the cell membranes of neurons (a process like excitotoxicity). At the same time, cerebral blood flow is relatively reduced for unknown reasons, though the reduction in blood flow is not as severe as it is in ischemia. Thus cells get less glucose than they normally do, which causes an "energy crisis". Concurrently with these processes, the activity of mitochondria may be reduced, which causes cells to rely on anaerobic metabolism to produce energy, increasing levels of the byproduct lactate. For a period of minutes to days after a concussion, the brain is especially vulnerable to changes in intracranial pressure, blood flow, and anoxia. According to studies performed on animals (which are not always applicable to humans), large numbers of neurons can die during this period in response to slight, normally innocuous changes in blood flow. Concussion involves diffuse (as opposed to focal) brain<unk> , meaning that the dysfunction occurs over a widespread area of the brain rather than in a particular spot. It is thought to be a milder<unk> of diffuse axonal<unk> , because axons may be<unk> d to a minor extent due to stretching. Animal studies in which rodents were concussed have revealed lifelong neuropathological consequences such as ongoing axonal degeneration and neuroinflammation in subcortical white matter tracts. Axonal damage has been found in the brains of concussion sufferers who died from other causes, but inadequate blood flow to the brain due to other<unk> es may have contributed. Findings from a study of the brains of deceased NFL athletes who received concussions suggest that lasting damage is done by such<unk> es. This damage, the severity of which increases with the cumulative number of concussions sustained, can lead to a variety of other health issues. The debate over whether concussion is a functional or structural phenomenon is ongoing. Structural damage has been found in the mildly traumatically<unk> d brains of animals, but it is not clear whether these findings would apply to humans. Such changes in brain structure could be responsible for certain symptoms such as visual disturbances, but other sets of symptoms, especially those of a psychological nature, are more likely to be caused by reversible pathophysiological changes in cellular function that occur after concussion, such as alterations in neurons' biochemistry. These reversible changes could also explain why dysfunction is frequently temporary. A task force of<unk><unk> experts called the Concussion In Sport Group met in 2001 and decided that "concussion may result in neuropathological changes but the acute clinical symptoms largely reflect a functional disturbance rather than structural<unk> ." Using animal studies, the pathology of a concussion seems to start with mechanical shearing and stretching forces disrupting the cell membrane of nerve cells through "mechanoporation". This results in potassium outflow from within the cell into the extracellular space with the subsequent release of excitatory neurotransmitters including glutamate which leads to enhanced potassium extrusion, in turn resulting in sustained depolarization, impaired nerve activity and potential nerve damage. Human studies have failed to identify changes in glutamate concentration immediately post-mTBI, though disruptions have been seen 3 days to 2 weeks post-injury. In an effort to restore ion balance, the sodium-potassium ion pumps increase activity, which results in excessive ATP (adenosine triphosphate) consumption and glucose utilization, quickly depleting glucose stores within the cells. Simultaneously, inefficient oxidative metabolism leads to anaerobic metabolism of glucose and increased lactate accumulation. There is a resultant local acidosis in the brain and increased cell membrane permeability, leading to local swelling. After this increase in glucose metabolism, there is a subsequent lower metabolic state which may persist for up to 4 weeks after<unk> . A completely separate pathway involves a large amount of calcium accumulating in cells, which may impair oxidative metabolism and begin further biochemical pathways that result in cell death. Again, both of these main pathways have been established from animal studies and the extent to which they apply to humans is still somewhat unclear. | types of Head injury | symptom of Stroke | medical cause of Infection | symptom of Birth defect | History of neurology and neurosurgery | symptom of Cardiovascular disease | symptom of Congenital heart defect | symptom of Subarachnoid hemorrhage | 00
| 11,906 |
<unk> (IPO) is a clinical syndrome caused by severe impairment in the ability of the intestines to push food through. It is characterized by the signs and symptoms of<unk> obstruction without any lesion in the<unk> lumen. Clinical features mimic those seen with mechanical<unk> obstructions and can include abdominal pain, nausea, abdominal distension, vomiting, dysphagia and constipation depending upon the part of the gastrointestinal tract involved. It is a difficult condition to diagnose, requiring exclusion of any other mechanical cause of obstruction. Many patients are diagnosed late in the course of disease after additional symptoms are seen. Mortality is also difficult to accurately determine. One retrospective study estimated mortality to be between 10-25% for chronic<unk> (CIPO) and to vary greatly depending on the etiology of the condition. When present for less than six months, it is diagnosed as acute IPO or Ogilvie's Syndrome. Longer than this is considered chronic. Owing to the difficulty of diagnosis, few studies are available which have attempted to estimate its prevalence. The condition can begin at any age. Most studies describing CIPO are in pediatric populations. It can be a primary condition (idiopathic or inherited) or caused by another disease (secondary). It can be a result of myriad of etiologies including infectious, parasitic, autoimmune, genetic, congenital, neurologic, toxic, endocrinological, or anatomical pathology. Treatment targets nutritional support, improving<unk> motility, and minimizing surgical intervention. Bacterial overgrowth of the small intestine can occur in chronic cases - presenting as malabsorption, diarrhea, and nutrient deficiencies - which may require the use of antibiotics. | Intestinal pseudo-obstruction | Ovarian cyst | Distal intestinal obstruction syndrome | Crohn's disease | Vesicointestinal fistula | Bowel obstruction | Gastrojejunocolic fistula | Neoplasm | 00
| 34,774 |
The syndrome may be in part due to persisting physiological adaptations in the central nervous system manifested in the form of continuing but slowly reversible tolerance, disturbances in neurotransmitters and resultant hyperexcitability of neuronal pathways. However, data supports “neuronal and overwhelming cognitive normalization” in regards to chronic amphetamine use and PAWS. Stressful situations arise in early recovery, and the symptoms of<unk><unk> withdrawal syndrome produce further distress. It is important to avoid or to deal with the triggers that make<unk><unk> withdrawal syndrome worse. The types of symptomatology and impairments in severity, frequency, and duration associated with the condition vary depending on the drug of use. | Post-acute-withdrawal syndrome | Benzodiazepine withdrawal syndrome | Alcohol withdrawal syndrome | Nicotine withdrawal | Secondary poisoning | Drug withdrawal | Opioid withdrawal | Antidepressant discontinuation syndrome | 00
| 48,102 |
Mechanism of action as a laxative<unk> is an osmotically acting laxative; that is, an inert substance that passes through the gut without being absorbed into the body. It relieves constipation because it causes water to be retained in the bowel instead of being absorbed into the body. This increases the water content and volume of the stools in the bowel, making them softer and easier to pass, as well as improving gut motility. | Macrogol | Medrogestone | Diatrizoate | Icodextrin | Corn starch | Ellagic acid | Methyl cellulose | Phospho soda | 00
| 47,246 |
<unk> (LSC) is a single-stranded, negative-sense RNA zoonotic Orthohantavirus that is genetically similar to Sin Nombre orthohantavirus which causes Hantavirus pulmonary syndrome (HPS) in humans. HPS causing hantaviruses are found only in the United States and South America. LSC has not been shown to cause HPS in humans. | Limestone Canyon virus | Caño Delgadito orthohantavirus | Prospect Hill orthohantavirus | Slow virus | Seoul orthohantavirus | Chinese virus | Cricket paralysis virus | Sepik virus | 00
| 64,813 |
alt=Redness and scaliness of the entire skin on a 5-month-old female infant The symptoms are very similar to graft-versus-host disease (GVHD). This is because the patients have some T cells with limited levels of recombination with the mutant RAG genes. These T cells are abnormal and have a very specific affinity for self antigens found in the thymus and in the periphery. Therefore, these T cells are auto-reactive and cause the GVHD phenotype. A characteristic symptom is chronic inflammation of the skin, which appears as a red rash (early onset erythroderma). Other symptoms include eosinophilia, failure to thrive, swollen lymph nodes, swollen spleen, diarrhea, enlarged liver, low immunoglobulin levels (except immunoglobulin E, which is elevated), low T cell levels, and no B cells. | Omenn syndrome | Wildervanck syndrome | Malouf syndrome | Hanhart syndrome | Aagenaes syndrome | Gleich's syndrome | Kocher–Debre–Semelaigne syndrome | Pelger–Huët anomaly | 00
| 27,673 |
Monocular PD can be measured during an eye test.<unk> (PD) or interpupillary<unk> (IPD) is the<unk> measured in millimeters between the centers of the pupils of the eyes. This measurement is different from person to person and also depends on whether they are looking at near objects or far away. Monocular PD refers to the<unk> between each eye and the bridge of the nose which may be slightly different for each eye due to anatomical variations. For people who need to wear prescription glasses consideration of monocular PD measurement by an optician helps to ensure that the lenses will be located in the optimum position. Whilst PD is an optometric term used to specify prescription eyewear, IPD is more critical for the design of binocular viewing systems, where both eye pupils need to be positioned within the exit pupils of the viewing system. These viewing systems include binocular microscopes, night vision devices or goggles (NVGs), and head-mounted displays (HMDs). IPD data are used in the design of such systems to specify the range of lateral adjustment of the exit optics or eyepieces. IPD is also used to describe the<unk> between the exit pupils or optical axes of a binocular optical system. The distinction with IPD is the importance of anthropometric databases and the design of binocular viewing devices with an IPD adjustment that will fit a targeted population of users. Because instruments such as binoculars and microscopes can be used by different people, the<unk> between the eye pieces is usually made adjustable to account for IPD. In some applications, when IPD is not correctly set, it can lead to an uncomfortable viewing experience and eye strain. | Pupillary distance | Supplementary eye field | Underwater vision | Cup-to-disc ratio | Pinch | Pupillary light reflex | Corneal reflex | Eye drop | 00
| 33,670 |
The<unk> is an unsubstantiated hypothesis in evolutionary psychology regarding the causes of autism spectrum and schizophrenia spectrum disorders, first presented by Bernard Crespi and Christopher Badcock in 2008. It claims that certain autistic and schizotypal traits are opposites, and that this implies the etiology of the two conditions must be at odds. The<unk> is based around genomic imprinting, an epigenetic process through which genes are expressed differently by way of one parent's contribution having more effect than the other. Specifically, proponents of the<unk> propose that autism spectrum disorders are caused by paternal overimprinting, while schizophrenia spectrum disorders are caused by maternal overimprinting; they point to a number of supposed correlations and anticorrelations seen between the disorders and other traits to support the hypothesis. While the hypothesis has found some attention in popular science, it lacks scientific backing. It has also been attacked as unfalsifiable, exaggerated, and overly broad. Specific issues for the hypothesis include that the predictions it makes about genetic disorders are falsified, that the effects of the two disorders on empathy and mentalizing are contrary to Crespi and Badcock's model, and that many neuroimaging findings fail to support the hypothesis. | Imprinted brain hypothesis | Thrifty gene hypothesis | Drifty gene hypothesis | Germ theory of disease | Two-streams hypothesis | Refrigerator mother theory | Genomic imprinting | Kraepelinian dichotomy | 00
| 61,876 |
<unk> <unk> , also known as the renin (active) assay or random<unk> renin, is a measure of the<unk> of the<unk> enzyme renin, which plays a major role in the body's regulation of blood pressure, thirst, and urine output. Measure of direct renin concentration (DRC) is technically more demanding, and hence<unk> is used instead. DRC assays are still in evolution, and generally a conversion factor of<unk> (ng/mL/h) to DRC (mU/L) is 8.2. A Recently developed and already commonly used automated DRC assay uses the conversion factor is 12.<unk> is sometimes measured, specially in case of certain diseases which present with hypertension or hypotension.<unk> is also raised in certain tumors. A<unk> measurement may be compared to a<unk> aldosterone concentration as an aldosterone-to-renin ratio (ARR). | Plasma renin activity | Aldosterone-to-renin ratio | Fractional excretion of sodium | Captopril suppression test | Ventricular natriuretic peptide | N-terminal prohormone of brain natriuretic peptide | Urine urea nitrogen | Glomerular filtration rate | 00
| 49,109 |
The partial<unk> of carbon dioxide, along with the pH, can be used to differentiate between metabolic acidosis, metabolic alkalosis, respiratory acidosis, and respiratory alkalosis. Hypoventilation exists when the ratio of carbon dioxide production to alveolar ventilation increases above normal values – greater than 45mmHg. If pH is also less than 7.35 this is respiratory acidosis. Hyperventilation exists when the same ratio decreases – less than 35mmHg. If the pH is also greater than 7.45 this is respiratory alkalosis. | Pulmonary gas pressures | Pulmonary wedge pressure | Integrated pulmonary index | Transpulmonary pressure | Lung volumes | Oxygenation index | Fraction of inspired oxygen | Pulse oximetry | 00
| 43,192 |
<unk> s are a cutaneous condition characterized by a collection of blood below the skin, and result as a complication following surgery. | Postoperative hematoma | Postoperative wounds | Pneumoretroperitoneum | Postoperative fever | Wound dehiscence | Hernia | Hematoma | Retroperitoneal bleeding | 00
| 60,260 |
Multiagent chemotherapy is given, and can result in long term success, particularly in childhood but prognosis is generally poor, particularly in higher stage disease. | ALK+ large B-cell lymphoma | Epstein–Barr virus positive diffuse large B-cell lymphoma, not otherwise specified | EML4-ALK positive lung cancer | Nodular lymphocyte predominant Hodgkin lymphoma | Fibrin-associated diffuse large B-cell lymphoma | Pediatric-type follicular lymphoma | RAS-associated autoimmune leukoproliferative disorder | CD30+ cutaneous T-cell lymphoma | 00
| 67,052 |
The symptoms and signs of<unk> were first described in 1827 by the English physician Richard<unk> , after whom the<unk> was named. In his Reports of Medical Cases, he described 25 cases of dropsy (edema) which he attributed to kidney<unk> . Symptoms and signs included: inflammation of serous membranes, hemorrhages, apoplexy, convulsions, blindness and coma. Many of these cases were found to have albumin in their urine (detected by the spoon and candle-heat coagulation), and showed striking morbid changes of the kidneys at autopsy. The triad of dropsy, albumin in the urine and kidney<unk> came to be regarded as characteristic of<unk> . Subsequent work by<unk> and others indicated an association with cardiac hypertrophy, which<unk> attributed to stimulation of the heart. Subsequent work by Frederick Akbar Mahomed showed that a rise in blood pressure could precede the appearance of albumin in the urine, and the rise in blood pressure and increased resistance to flow was believed to explain the cardiac hypertrophy. It is now known that<unk> is caused by a wide and diverse range of kidney<unk> s; thus, the term<unk> is retained strictly for historical application. The<unk> was diagnosed frequently in diabetic patients; at least some of these cases would probably correspond to a modern diagnosis of diabetic nephropathy. | Bright's disease | Darier's disease | Tornwaldt's disease | Dent's disease | Lev's disease | Borna disease | Minor's disease | Blount's disease | 00
| 11,987 |
The prevalence of CLS is uncertain due to the rarity of the disease, but CLS is estimated to affect between 1 in 50,000 and 1 in 100,000 people. Prenatal testing is available to test for CLS of an offspring if a family member has been diagnosed with CLS. | Coffin–Lowry syndrome | Irvine–Gass syndrome | Young–Madders syndrome | Nelson's syndrome | Fowler's syndrome | Potocki–Lupski syndrome | Lujan–Fryns syndrome | Worster-Drought syndrome | 00
| 23,458 |
Cytogenetics * Alterations of chromosome 3p segments occurs in 70 – 90% of<unk> s * Inactivation of von Hippel-Lindau disease (VHL) gene by gene mutation and promoter hypermethylation * Gain of chromosome 5q * Loss of chromosomes 8p, 9p, and 14q Molecular genetics Several frequently mutated genes were discovered in<unk> : VHL, KDM6A/UTX, SETD2, KDM5C/JARID1C and MLL2. PBRM1 is also commonly mutated in<unk> . | Clear cell renal cell carcinoma | Renal medullary carcinoma | Renal anaplastic sarcoma | Papillary renal cell carcinoma | Renal medullary fibroma | Clear cell papillary renal cell carcinoma | Renal oncocytoma | Renal cell carcinoma | 00
| 62,286 |
Two main measures are used in epidemiological studies: incidence and prevalence. Incidence is the number of new cases per unit of person-time at risk (usually number of new cases per thousand person-years); while prevalence is the total number of cases of the<unk> in the population at any given time. Deaths per million persons in 2012 due to dementias including<unk> Regarding incidence, cohort longitudinal studies (studies where a<unk> -free population is followed over the years) provide rates between 10 and 15 per thousand person-years for all dementias and 5–8 for<unk> , which means that half of new dementia cases each year are<unk> .<unk> vancing age is a primary risk factor for the<unk> and incidence rates are not equal for all ages: every 5 years after the age of 65, the risk of acquiring the<unk> approximately doubles, increasing from 3 to as much as 69 per thousand person years. Females with<unk> are more common than males, but this difference is likely due to women's' longer life spans. When<unk> justed for age, both sexes are affected by<unk> 's at equal rates. In the United States, the risk of dying from<unk> in 2010 was 26% higher among the non-Hispanic white population than among the non-Hispanic black population, and the Hispanic population had a 30% lower risk than the non-Hispanic white population. The prevalence of<unk> in populations is dependent upon factors including incidence and survival. Since the incidence of<unk> increases with age, prevalence depends on the mean age of the population for which prevalence is given. In the United States in 2020,<unk> 's dementia prevalence was estimated to be 5.3% for those in the 60–74 age group, with the rate increasing to 13.8% in the 74–84 group and to 34.6% in those greater than 85. Prevalence rates in some less developed regions around the globe are lower. As the incidence and prevalence are steadily increasing, the prevalence itself is projected to triple by 2050. As of 2020, 50 million people globally have<unk> , with this number expected to increase to 152 million by 2050. | Alzheimer's disease | Lewy body dementias | Parkinson's disease dementia | Down syndrome | Vascular dementia | Aging brain | Alcohol-related dementia | Chronic traumatic encephalopathy | 00
| 51,373 |
<unk> <unk> is a kidney cancer that originates in the lining of the proximal convoluted tubule, a part of the very small tubes in the kidney that transport primary urine.<unk> is the most common type of kidney cancer in adults, responsible for approximately 90–95% of cases.<unk> occurrence shows a male predominance over women with a ratio of 1.5:1.<unk> most commonly occurs between 6th and 7th decade of life. Initial treatment is most commonly either partial or complete removal of the affected kidney(s). Where the cancer has not metastasised (spread to other organs) or burrowed deeper into the tissues of the kidney, the five-year survival rate is 65–90%, but this is lowered considerably when the cancer has spread. The body is remarkably good at hiding the symptoms and as a result people with<unk> often have advanced disease by the time it is discovered. The initial symptoms of<unk> often include blood in the urine (occurring in 40% of affected persons at the time they first seek medical attention), flank pain (40%), a mass in the abdomen or flank (25%), weight loss (33%), fever (20%), high blood pressure (20%), night sweats and generally feeling unwell. When<unk> metastasises, it most commonly spreads to the lymph nodes, lungs, liver, adrenal glands, brain or bones. Immunotherapy and targeted therapy have improved the outlook for metastatic<unk> .<unk> is also associated with a number of paraneoplastic syndromes (PNS) which are conditions caused by either the hormones produced by the tumour or by the body's attack on the tumour and are present in about 20% of those with<unk> . These syndromes most commonly affect tissues which have not been invaded by the cancer. The most common PNSs seen in people with<unk> are: high blood calcium levels, high red blood cell count, high platelet count and secondary amyloidosis. | Renal cell carcinoma | Renal medullary carcinoma | Renal oncocytoma | Papillary renal cell carcinoma | Renal anaplastic sarcoma | Renal medullary fibroma | Clear cell renal cell carcinoma | Clear cell papillary renal cell carcinoma | 00
| 12,252 |
It may be relatively safe to restart blood thinners after an<unk> . | Intracranial hemorrhage | Intracerebral hemorrhage | Subarachnoid hemorrhage | Epidural hematoma | Intracranial hypertension syndrome | Brain herniation | Brain ischemia | Hemarthrosis | 00
| 17,960 |
Atherosclerosis is asymptomatic for decades because the arteries enlarge at all plaque locations, thus there is no effect on blood flow. Even most plaque ruptures do not produce symptoms until enough narrowing or closure of an artery, due to clots, occurs. Signs and symptoms only occur after severe narrowing or closure impedes blood flow to different organs enough to induce symptoms. Most of the time, patients realize that they have the<unk> only when they experience other cardiovascular disorders such as stroke or heart attack. These symptoms, however, still vary depending on which artery or organ is affected. Abnormalities associated with atherosclerosis begin in childhood. Fibrous and gelatinous lesions have been observed in the<unk> arteries of children aged 6–10. Fatty streaks have been observed in the<unk> arteries of juveniles aged 11–15, though they appear at a much younger age within the aorta. Clinically, given enlargement of the arteries for decades, symptomatic atherosclerosis is typically associated with men in their 40s and women in their 50s to 60s. Sub-clinically, the<unk> begins to appear in childhood and rarely is already present at birth. Noticeable signs can begin developing at puberty. Though symptoms are rarely exhibited in children, early screening of children for cardiovascular<unk> s could be beneficial to both the child and his/her relatives. While<unk> artery<unk> is more prevalent in men than women, atherosclerosis of the cerebral arteries and strokes equally affect both sexes. Marked narrowing in the<unk> arteries, which are responsible for bringing oxygenated blood to the heart, can produce symptoms such as chest pain of angina and shortness of breath, sweating, nausea, dizziness or light-headedness, breathlessness or palpitations. Abnormal heart rhythms called arrhythmias—the heart beating either too slowly or too quickly—are another consequence of ischemia. Carotid arteries supply blood to the brain and neck. Marked narrowing of the carotid arteries can present with symptoms such as: a feeling of weakness; being unable to think straight; difficulty speaking; dizziness; difficulty in walking or standing up straight; blurred vision; numbness of the face, arms and legs; severe headache; and loss of consciousness. These symptoms are also related to stroke (the death of brain cells). Stroke is caused by marked narrowing or closure of arteries going to the brain; lack of adequate blood supply leads to the death of the cells of the affected tissue. Peripheral arteries, which supply blood to the legs, arms and pelvis, also experience marked narrowing due to plaque rupture and clots. Symptoms of the narrowing are numbness within the arms or legs, as well as pain. Another significant location for plaque formation is the renal arteries, which supply blood to the kidneys. Plaque occurrence and accumulation lead to decreased kidney blood flow and chronic kidney<unk> , which, like in all other areas, is typically asymptomatic until late stages. According to United States data for 2004, in about 66% of men and 47% of women, the first symptom of atherosclerotic cardiovascular<unk> is a heart attack or sudden cardiac death (death within one hour of onset of the symptom). Cardiac stress testing, traditionally the most commonly performed non-invasive testing method for blood flow limitations, in general, detects only lumen narrowing of ≈75% or greater, although some physicians claim that nuclear stress methods can detect as little as 50%. Case studies have included autopsies of U.S. soldiers killed in World War II and the Korean War. A much-cited report involved the autopsies of 300 U.S. soldiers killed in Korea. Although the average age of the men was 22.1 years, 77.3 percent had "gross evidence of<unk> arteriosclerosis". Other studies done of soldiers in the Vietnam War showed similar results, although often worse than the ones from the earlier wars. Theories include high rates of tobacco use and (in the case of the Vietnam soldiers) the advent of processed foods after World War II. | medical cause of Coronary artery disease | medical cause of Myocardial infarction | medical cause of Heart failure | medical cause of Chest pain | medical cause of Ventricular fibrillation | medical cause of Pericarditis | medical cause of Myocarditis | medical cause of Coronary artery aneurysm | 00
| 5,497 |
The characteristic symptoms of<unk> are at least partially caused by bilateral, focal lesions in the brainstem, basal ganglia, cerebellum, and other regions of the brain. The lesions take on different forms, including areas of demyelination, spongiosis, gliosis, necrosis, and capillary proliferation. Demyelination is the loss of the myelin sheath around the axons of neurons, inhibiting their ability to communicate with other neurons. The brain stem is involved in maintaining basic life functions such as breathing, swallowing, and circulation; the basal ganglia and cerebellum control movement and balance. Damage to these areas therefore results in the major symptoms of<unk> —loss of control over functions controlled by these areas. The lactic acidosis sometimes associated with<unk> is caused by the buildup of pyruvate, which is unable to be processed in individuals with certain types of oxidative phosphorylation deficiencies. The pyruvate is either converted into alanine via alanine aminotransferase or converted into lactic acid by lactate dehydrogenase; both of these substances can then build up in the body. | Leigh syndrome | Tay–Sachs disease | Maroteaux–Lamy syndrome | Coffin–Siris syndrome | Ohtahara syndrome | Nathalie syndrome | Laurence–Moon syndrome | Kosaki overgrowth syndrome | 00
| 14,277 |
The expected symptoms of<unk> include fever, pleuritic chest pain, or epigastric abdominal pain that is frequently spasmodic.<unk> associated chest pain is distinguished by attacks of severe pain in the lower chest, often on the right side. In a prior study, the episodes were shown to last five to ten minutes and then subside for thirty minutes. The pain is exacerbated by movement and makes walking and breathing more difficult. Patients have found relief from the pain by lying still for a brief period of time. The slightest movement of the rib cage causes a sharp increase in pain, which makes it difficult to breathe, although it generally passes off before any actual harm occurs. The attacks are unpredictable and strike "out of the blue" with a feeling like an iron grip around the rib cage. The colloquial names for the disease, such as the devil's grip, (see "other names" below) reflect this symptom.<unk> is a clinical diagnosis that uses the spasmodic pain, fever, and relapses to distinguish the illness from other potential causes of pain such as appendicitis or myocardial infarction. Tachycardia and arrhythmias have been found with<unk> by using an electrocardiogram (ECG). Murmurs, rubs, and pericardial effusions have been detected on physical examination. Maculopapular rashes can also be present with<unk> | Bornholm disease | Pulmonary embolism | Freiberg disease | Appendicitis | Haff disease | Pancreatitis | Dent's disease | Cholecystitis | 00
| 5,223 |
-13-{(2R,3S,4S,5S,6S)-3- {(2R,3S,4S,5R,6R)-4-(carbamoyloxy)-3,5-dihydroxy-6- (hydroxymethyl)tetrahydro-2H-pyran-2-yloxy} -4,5-dihydroxy-6-(hydroxymethyl)tetrahydro-2H-pyran-2-yloxy} (1H-imidazol-5-yl)methyl-9-hydroxy-5-(1R)-1-hydroxyethyl-8,10-dimethyl-4,7,12,15-tetraoxo-3,6,11,14-tetraazapentadec-1-yl}-2,4'-bi-1,3-thiazol-4-yl)carbonylamino}propyl)(dimethyl)sulfonium chemical_formula = S=3 molecular_weight = 1415.551 SMILES = CC1=C(N=C(N=C1N)C@H(CC(=O)N)NCC@@H(C(=O)N)N)C(=O)NC@@H(C(C2=CN=CN2)OC@H3C@H(C@H(C@@H(C@@H(O3)CO)O)O)OC@@H4C@H(C@H(C@@H(C@H(O4)CO)O)OC(=O)N)O)C(=O)NC@H(C)C@H(C@H(C)C(=O)NC@@H(C@@H(C)O)C(=O)NCCC5=NC(=CS5)C6=NC(=CS6)C(=O)NCCCS+(C)C)O Jmol = StdInChI_Ref = StdInChI = 1S/C55H83N17O21S3/c1-20-33(69-46(72-44(20)58)25(12-31(57)76)64-13-24(56)45(59)82)50(86)71-35(41(26-14-61-19-65-26)91-54-43(39(80)37(78)29(15-73)90-54)92-53-40(81)42(93-55(60)88)38(79)30(16-74)89-53)51(87)66-22(3)36(77)21(2)47(83)70-34(23(4)75)49(85)63-10-8-32-67-28(18-94-32)52-68-27(17-95-52)48(84)62-9-7-11-96(5)6/h14,17-19,21-25,29-30,34-43,53-54,64,73-75,77-81H,7-13,15-16,56H2,1-6H3,(H13-,57,58,59,60,61,62,63,65,66,69,70,71,72,76,82,83,84,85,86,87,88)/p+1/t21-,22+,23+,24-,25-,29-,30+,34-,35-,36-,37+,38+,39-,40-,41-,42-,43-,53+,54-/m0/s1 StdInChI_comment = StdInChIKey_Ref = StdInChIKey = OYVAGSVQBOHSSS-UAPAGMARSA-O density = density_notes = melting_point = melting_high = melting_notes = boiling_point = boiling_notes = solubility = sol_units = specific_rotation = }}<unk> is a medication used to treat cancer. This includes Hodgkin's lymphoma, non-Hodgkin's lymphoma, testicular cancer, ovarian cancer, and cervical cancer among others. Typically used with other cancer medications, it can be given intravenously, by injection into a muscle or under the skin. It may also be administered inside the chest to help prevent the recurrence of a fluid around the lung due to cancer; however talc is better for this. Common side effects include fever, weight loss, vomiting, and rash. A severe type of anaphylaxis may occur. It may also cause inflammation of the lungs that can result in lung scarring. Chest X-rays every couple of weeks are recommended to check for this.<unk> may cause harm to the baby if used during pregnancy. It is believed to primarily work by preventing the making of DNA.<unk> was discovered in 1962. It is on the World Health Organization's List of Essential Medicines. It is available as a generic medication. It is made by the bacterium Streptomyces verticillus. | Bleomycin | Ifosfamide | Vincristine | Doxorubicin | Epirubicin | Etoposide | Mitoxantrone | Daunorubicin | 00
| 19,587 |
Pharmacodynamics<unk> is an agonist of the GnRH receptor and is used to induce the secretion of the gonadotropins follicle-stimulating hormone and luteinizing hormone from the pituitary gland and to increase sex hormone production by the gonads. Pharmacokinetics<unk> has a distribution half-life of 2 to 10 minutes and a very short terminal half-life of 10 to 40 minutes. It is metabolized by hydrolysis into smaller peptide components. | Gonadorelin | Antigonadotropin | Progestogen | Progestogen | Progonadotropin | Luteinizing hormone | Vinyltestosterone | Gonadotropin | 00
| 25,872 |
<unk> <unk> S) is a rare genetic syndrome caused by one or more recessive genes located on the X chromosome and causing physical anomalies and developmental delays.<unk> was named after the first letters of the surnames of the first patients noted with the disease. First reported by American geneticists John M. Opitz and Elisabeth G. Kaveggia in 1974, its major clinical features include intellectual disability, hyperactivity, hypotonia (low muscle tone), and a characteristic facial appearance including macrocephaly (an abnormally large head). | FG syndrome | Gitelman syndrome | Mungan syndrome | Muir–Torre syndrome | Sly syndrome | Perlman syndrome | MORM syndrome | Angelman syndrome | 00
| 52,705 |
Relative five-year survival of invasive epithelial ovarian cancer by stage Ovarian cancer usually has a relatively poor prognosis. It is disproportionately deadly because it lacks any clear early detection or screening test, meaning most cases are not diagnosed until they have reached advanced stages. Ovarian cancer metastasizes early in its development, often before it has been diagnosed. High-grade tumors metastasize more readily than low-grade tumors. Typically, tumor cells begin to metastasize by growing in the peritoneal cavity. More than 60% of women presenting with ovarian cancer have stage-III or stage-IV cancer, when it has already spread beyond the ovaries. Ovarian cancers shed cells into the naturally occurring fluid within the abdominal cavity. These cells can then implant on other abdominal (peritoneal) structures, including the uterus, urinary bladder, bowel, lining of the bowel wall, and omentum, forming new tumor growths before cancer is even suspected. The five-year survival rate for all stages of ovarian cancer is 46%; the one-year survival rate is 72% and the ten-year survival rate is 35%. For cases where a diagnosis is made early in the disease, when the cancer is still confined to the primary site, the five-year survival rate is 92.7%. About 70% of women with advanced disease respond to initial treatment, most of whom attain complete remission, but half of these women experience a recurrence 1–4 years after treatment. Brain metastasis is more common in stage III/IV cancer but can still occur in cancers staged at I/II. People with brain metastases survive a median of 8.2 months, though surgery, chemotherapy, and whole brain radiation therapy can improve survival. Ovarian cancer survival varies significantly with subtype. Dysgerminomas have a very favorable prognosis. In early stages, they have a five-year survival rate of 96.9%. Around two-thirds of dysgerminomas are diagnosed at stage I. Stage-III dysgerminomas have a five-year survival of 61%; when treated with BEP chemotherapy after incomplete surgical removal, dysgerminomas have a 95% two-year survival rate. Sex-cord-stromal malignancies also have a favorable prognosis; because they are slow-growing, even those with metastatic disease can survive a decade or more. Low malignant potential tumors usually only have a bad prognosis when there are invasive tumor implants found in the peritoneal cavity. Complications of ovarian cancer can include spread of the cancer to other organs, progressive function loss of various organs, ascites, and intestinal obstructions, which can be fatal. Intestinal obstructions in multiple sites are the most common proximate cause of death. Intestinal obstruction in ovarian cancer can either be a true obstruction, where tumor blocks the intestinal lumen, or a pseudo-obstruction, when tumor prevents normal peristalsis. Continuous accumulation of ascites can be treated by placing a drain that can be self-drained. Prognostic factors There are a number of prognostic factors in ovarian cancer. Positive prognostic factors – those indicating better chances of survival – include no residual disease after surgery (stage III/IV), complete macroscopic resection (stage IV), BRCA2 mutations, young age (under 45 years), nonserous<unk> low histologic grade, early stage, co-occurrence with endometrial cancer, and low CA-125 levels. There is conflicting evidence for BRCA1 as a prognostic factor. Conversely, negative prognostic factors – those that indicate a worse chance of survival – include rupture of the ovarian capsule during surgery, older age (over 45 years), mucinous<unk> stage IV, high histologic grade, clear cell<unk> upper abdominal involvement, high CA-125 levels, the presence of tumor cells in the blood, and elevated cyclooxygenase-2. Expression of various mRNAs can also be prognostic for ovarian cancer. High levels of Drosha and Dicer are associated with improved survival, whereas high levels of let-7b, HIF1A, EphA1, and poly(ADP-ribose) polymerase are associated with worse survival. Cancers that are positive for WT1 carry a worse prognosis; estrogen-receptor positive cancers have a better prognosis. Survival rates Overall five-year survival rates for all<unk> of ovarian cancer are presented below by stage and histologic grade: Stage Survival I 90–95% II 70–80% III 20–50% IV 1–5% Histologic grade Survival Low grade 88% Intermediate grade 58% High grade 27% The survival rates given below are for the different<unk> of ovarian cancer, according to American Cancer Society. They come from the National Cancer Institute, SEER, and are based on patients diagnosed from 2004 to 2010. Invasive epithelial ovarian cancer Stage Relative five-yearsurvival rate I 90% IA 94% IB 92% IC 85% II 70% IIA 78% IIB 73% III 39% IIIA 59% IIIB 52% IIIC 39% IV 17% Ovarian stromal tumors Stage Relative five-yearsurvival rate I 95% II 78% III 65% IV 35% Germ cell tumors of the ovary Stage Relative five-yearSurvival Rate I 98% II 94% III 87% IV 69% Fallopian tube carcinoma Stage Relative five-yearsurvival rate I 87% II 86% III 52% IV 40% Low malignant potential tumors Stage Relative five-yearsurvival rate I 99% II 98% III 96% IV 77% Recurrence rates Ovarian cancer frequently recurs after treatment. Overall, in a 5-year period, 20% of stage I and II cancers recur. Most recurrences are in the abdomen. If a recurrence occurs in advanced disease, it typically occurs within 18 months of initial treatment (18 months progression-free survival). Recurrences can be treated, but the disease-free interval tends to shorten and chemoresistance increases with each recurrence. When a dysgerminoma recurs, it is most likely to recur within a year of diagnosis, and other malignant germ cell tumors recur within 2 years 90% of the time. Germ cell tumors other than dysgerminomas have a poor prognosis when they relapse, with a 10% long-term survival rate. Low malignant potential tumors rarely relapse, even when fertility-sparing surgery is the treatment of choice. 15% of LMP tumors relapse after unilateral surgery in the previously unaffected ovary, and they are typically easily treated with surgery. More advanced tumors may take up to 20 years to relapse, if they relapse at all, and are only treated with surgery unless the tumor has changed its histological characteristics or grown very quickly. In these cases, and when there is significant ascites, chemotherapy may also be used. Relapse is usually indicated by rising CA-125 levels and then progresses to symptomatic relapse within 2–6 months. Recurrent sex cord-stromal tumors are typically unresponsive to treatment but not aggressive. It is the most deadly gynecologic cancer. | types of Ovarian cyst | symptom of Cystadenocarcinoma | complications of Ovarian cyst | symptom of Epididymitis | symptom of Ovarian cancer | medical cause of Epididymitis | symptom of Testicular cancer | symptom of Endometriosis | 00
| 12,293 |
<unk> is a condition of abnormally high storage levels of vitamins, which can lead to various symptoms as over excitement, irritability, or even toxicity. Specific medical names of the different conditions are derived from the given vitamin involved: an excess of vitamin A, for example, is called<unk> A.<unk> are primarily caused by fat-soluble vitamins (D and A), as these are stored by the body for longer than the water-soluble vitamins. Generally, toxic levels of vitamins stem from high supplement intake and not always from natural sources but rather the mix of natural, derived vitamins and enhancers (vitamin boosters). Toxicities of fat-soluble vitamins can also be caused by a large intake of highly fortified foods, but natural food in modest levels rarely deliver extreme or dangerous levels of fat-soluble vitamins. The Dietary Reference Intake recommendations from the United States Department of Agriculture define a "tolerable upper intake level" for most vitamins. For those who are entirely healthy and do not suffer long periods of avitaminosis, vitamin overdose can be avoided by not taking more than the normal or recommended amount of multi-vitamin supplement shown on the bottle and not ingesting multiple vitamin-containing supplements concurrently. | Hypervitaminosis | Starvation | Hypophosphatemia | Algaemia | Aluminosis | Hypoproteinemia | Hypoprolactinemia | Salt poisoning | 00
| 18,843 |
A 2018 Cochrane review found that<unk> was an imperfect treatment and other inexpensive drugs less associated with side effects may be an equally effective choice for people with schizophrenia. | Fluphenazine | Nabilone | Perphenazine | Disulfiram | Cinolazepam | Suvorexant | Rimegepant | Fluparoxan | 00
| 7,278 |
Deaths from<unk> per million persons in 2012<unk> is the most common autoimmune disorder of the central nervous system. As of 2010, the number of people with<unk> was 2–2.5 million (approximately 30 per 100,000) globally, with rates varying widely in different regions. It is estimated to have resulted in 18,000 deaths that year. In Africa rates are less than 0.5 per 100,000, while they are 2.8 per 100,000 in South East Asia, 8.3 per 100,000 in the Americas, and 80 per 100,000 in Europe. Rates surpass 200 per 100,000 in certain populations of Northern European descent. The number of new cases that develop per year is about 2.5 per 100,000. Rates of<unk> appear to be increasing; this, however, may be explained simply by better diagnosis. Studies on populational and geographical patterns have been common and have led to a number of theories about the cause.<unk> usually appears in adults in their late twenties or early thirties but it can rarely start in childhood and after 50 years of age. The primary progressive subtype is more common in people in their fifties. Similarly to many autoimmune disorders, the disease is more common in women, and the trend may be increasing. As of 2008, globally it is about two times more common in women than in men. In children, it is even more common in females than males, while in people over fifty, it affects males and females almost equally. | Multiple sclerosis | Lhermitte's sign | Tumefactive multiple sclerosis | Essential tremor | Paraneoplastic cerebellar degeneration | Anti-Hu associated encephalitis | Malignant multiple sclerosis | Thoracic outlet syndrome | 00
| 3,425 |
Cross-section of diseased intestines. Colored lithograph<unk> results from bacterial, or parasitic infections. Viruses do not generally cause the disease. These pathogens typically reach the large intestine after entering orally, through ingestion of contaminated food or water, oral contact with contaminated objects or hands, and so on. Each specific pathogen has its own mechanism or pathogenesis, but in general, the result is damage to the intestinal linings, leading to the inflammatory immune responses. This can cause elevated physical temperature, painful spasms of the intestinal muscles (cramping), swelling due to fluid leaking from capillaries of the intestine (edema) and further tissue damage by the body's immune cells and the chemicals, called cytokines, which are released to fight the infection. The result can be impaired nutrient absorption, excessive water and mineral loss through the stools due to breakdown of the control mechanisms in the intestinal tissue that normally remove water from the stools, and in severe cases, the entry of pathogenic organisms into the bloodstream. Anemia may also arise due to the blood loss through diarrhea. Bacterial infections that cause bloody diarrhea are typically classified as being either invasive or toxogenic. Invasive species cause damage directly by invading into the mucosa. The toxogenic species do not invade, but cause cellular damage by secreting toxins, resulting in bloody diarrhea. This is also in contrast to toxins that cause watery diarrhea, which usually do not cause cellular damage, but rather they take over cellular machinery for a portion of life of the cell. Some microorganisms – for example, bacteria of the genus Shigella – secrete substances known as cytotoxins, which kill and damage intestinal tissue on contact. Shigella is thought to cause bleeding due to invasion rather than toxin, because even non-toxogenic strains can cause<unk> , but E. coli with shiga-like toxins do not invade the intestinal mucosa, and are therefore toxin dependent. Definitions of<unk> can vary by region and by medical specialty. The U. S. Centers for Disease Control and Prevention (CDC) limits its definition to "diarrhea with visible blood". Others define the term more broadly. These differences in definition must be taken into account when defining mechanisms. For example, using the CDC definition requires that intestinal tissue be so severely damaged that blood vessels have ruptured, allowing visible quantities of blood to be lost with defecation. Other definitions require less specific damage. Amoebic<unk> Amoebiasis, also known as amoebic<unk> , is caused by an infection from the amoeba Entamoeba histolytica, which is found mainly in tropical areas. Proper treatment of the underlying infection of amoebic<unk> is important; insufficiently treated amoebiasis can lie dormant for years and subsequently lead to severe, potentially fatal, complications. When amoebae inside the bowel of an infected person are ready to leave the body, they group together and form a shell that surrounds and protects them. This group of amoebae is known as a cyst, which is then passed out of the person's body in the feces and can survive outside the body. If hygiene standards are poor – for example, if the person does not dispose of the feces hygienically – then it can contaminate the surroundings, such as nearby food and water. If another person then eats or drinks food or water that has been contaminated with feces containing the cyst, that person will also become infected with the amoebae. Amoebic<unk> is particularly common in parts of the world where human feces are used as fertilizer. After entering the person's body through the mouth, the cyst travels down into the stomach. The amoebae inside the cyst are protected from the stomach's digestive acid. From the stomach, the cyst travels to the intestines, where it breaks open and releases the amoebae, causing the infection. The amoebae can burrow into the walls of the intestines and cause small abscesses and ulcers to form. The cycle then begins again. Bacillary<unk> <unk> may also be caused by shigellosis, an infection by bacteria of the genus Shigella, and is then known as bacillary<unk> (or Marlow syndrome). The term bacillary<unk> etymologically might seem to refer to any<unk> caused by any bacilliform bacteria, but its meaning is restricted by convention to Shigella<unk> . Other bacteria Some strains of Escherichia coli cause bloody diarrhea. The typical culprits are enterohemorrhagic Escherichia coli, of which O157:H7 is the best known. | Dysentery | Ulcerative colitis | Travelers' diarrhea | Bacillary dysentery | Cholera | Porcine epidemic diarrhoea | Brainerd diarrhea | Jamaican vomiting sickness | 00
| 4,563 |
<unk> (PNFA) is one of three clinical syndromes associated with frontotemporal lobar degeneration. PNFA has an insidious onset of language deficits over time as opposed to other stroke-based<unk> s, which occur acutely following trauma to the brain. The specific degeneration of the frontal and temporal lobes in PNFA creates hallmark language deficits differentiating this disorder from other Alzheimer-type disorders by the initial absence of other cognitive and memory deficits. This disorder commonly has a primary effect on the left hemisphere, causing the symptomatic display of expressive language deficits (production difficulties) and sometimes may disrupt receptive abilities in comprehending grammatically complex language. | Progressive nonfluent aphasia | Global aphasia | Anomic aphasia | Expressive aphasia | Receptive aphasia | Social-emotional agnosia | Visuospatial dysgnosia | Hemispatial neglect | 00
| 27,336 |
Hypoglycemia, also called low blood sugar, is a fall in blood sugar to levels below normal, typically below 70 mg/dL (3.9 mmol/L). Whipple's triad is used to properly identify hypoglycemic episodes. It is defined as blood glucose below 70 mg/dL (3.9 mmol/L), symptoms associated with hypoglycemia, and resolution of symptoms when blood sugar returns to normal. Hypoglycemia may result in headache, tiredness, clumsiness, trouble talking, confusion, fast heart rate, sweating, shakiness, nervousness, hunger, loss of consciousness, seizures, or death. Symptoms typically come on quickly. The most common cause of hypoglycemia is<unk> ions used to treat diabetes such as insulin, sulfonylureas, and biguanides. Risk is greater in diabetics who have eaten less than usual, recently exercised, or consumed alcohol. Other causes of hypoglycemia include severe illness, sepsis, kidney failure, liver disease, hormone deficiency, tumors such as insulinomas or non-B cell tumors, inborn errors of metabolism, several<unk> ions, and alcohol. Low blood sugar may occur in otherwise healthy newborns who have not eaten for a few hours. Hypoglycemia is treated by eating a sugary food or drink, for example glucose tabs or gel, apple juice, soda, or candy. The person must be conscious and able to swallow. The goal is to consume 10-20 grams of a carbohydrate to raise blood glucose levels to a minimum of 70 mg/dL (3.9 mmol/L). If a person is not able to take food by mouth, glucagon by injection or in the nose may help. The treatment of hypoglycemia unrelated to diabetes includes treating the underlying problem. Among people with diabetes, prevention starts with learning the signs and symptoms of hypoglycemia. Diabetes<unk> ions, like insulin, sulfonylureas, and biguanides can also be adjusted or stopped to prevent hypoglycemia. Frequent and routine blood glucose testing is recommended. Some may find continuous glucose montiors with insulin pumps to be helpful in the management of diabetes and prevention of hypoglycemia. | medical cause of Lightheadedness | medical cause of Panic attack | symptom of Subarachnoid hemorrhage | symptom of Intracerebral hemorrhage | medical cause of Stroke | symptom of Vertebral artery dissection | symptom of Posterior reversible encephalopathy syndrome | symptoms of Subarachnoid hemorrhage | 00
| 1,040 |
A<unk> most commonly occurs as a complication of advanced<unk> disease (which is normally painless). A<unk> pocket contains dental plaque, bacteria and subgingival calculus.<unk> pathogens continually find their way into the soft tissues, but normally they are held in check by the immune system. A<unk> represents a change in this balance, related to decreased local or systemic resistance of the host. An inflammatory response occurs when bacteria invade and multiply within the soft tissue of the gingival crevice/periodontal pocket. A pus-filled abscess forms when the immune system responds and attempts to isolate the infection from spreading. Communication with the oral environment is maintained via the opening of the<unk> pocket. However, if the opening of a<unk> pocket becomes obstructed, as may occur if the pocket has become very deep (e.g. with furcation involvement), then plaque and calculus are trapped inside. Food packing may also obstruct a<unk> pocket. Food packing is usually caused by failure to accurately reproduce the contact points when dental restorations are placed on the interproximal surfaces of teeth. Another potential cause occurs when a<unk> pocket is scaled incompletely. Following this procedure, the gingival cuff tightens around the tooth, which may be enough to trap the bacteria left in the pocket. A gingival retraction cord which is accidentally left in situ is an occasional cause of a<unk> . Penetrating injury to the gingiva--for example, with a toothbrush bristle, fishbone, toothpick or<unk> instrument--may inoculate bacteria into the tissues. Trauma to the tissues, such as serious impact on a tooth or excessive pressure exerted on teeth during orthodontic treatment, can be a possible cause as well. Occlusal overload may also be involved in the development of a<unk> , but this is rare and usually occurs in combination with other factors. Bruxism is a common cause of excessive occlusal forces. Systemic immune factors such as diabetes can predispose a person to the formation of<unk> es. Perforation of a root canal during endodontic therapy can also lead to a<unk> . | Periodontal abscess | Dental abscess | Dental plaque | Gingival cyst | Posthitis | Oral mucocele | Salivary gland fistula | Cuffitis | 00
| 57,445 |
Neonates with<unk> s, especially those with SP-B disorder, only have lung transplantation as one possible choice of treatment. Children with lung transplant due to<unk> perform on similar level to those with transplant for due to other reasons. Some less severe cases of ABCA3 dysfunctions manifest in late childhood or adult hood are due to missense mutations that result in semi-sufficient levels of active<unk> , while SP-C clinical presentation varies greatly depending on level of penetration of the mutated alleles. | Surfactant metabolism dysfunction | Congenital pulmonary airway malformation | Hypoplastic right heart syndrome | Humoral immune deficiency | Vocal cord dysfunction | Anomalous pulmonary venous connection | Hypoplastic left heart syndrome | Upper airway resistance syndrome | 00
| 60,140 |
<unk> is not constitutively expressed, but it is expressed at low to medium levels in a variety of tissues. Greatest expression is observed in the stomach and pancreas. It is also thought to be expressed in certain areas of both the developing and adult brain, such as the cerebellum, as well as skeletal muscle tissue, the testis, cardiac muscle, and throughout the digestive system. Little else is known about this gene’s expression, however a 2012 paper published in the World Journal of Gastroenterology suggested that it’s mis-expression could be used as a diagnostic marker locus in the detection of cancer | C1orf127 | AHDC1 | DYNC1H1 | SPATA16 | PANO1 | Mothers against decapentaplegic homolog 4 | WNT4 deficiency | SMN1 | 00
| 71,231 |
<unk> refers to the ability of<unk> s (red blood cells, RBC) to change shape under a given level of applied stress, without hemolysing (rupturing). This is an important property because<unk> s must change their shape extensively under the influence of mechanical forces in fluid flow or while passing through microcirculation. The extent and geometry of this shape change can be affected by the mechanical properties of the<unk> s, the magnitude of the applied forces, and the orientation of<unk> s with the applied forces.<unk> is an intrinsic cellular property of<unk> s determined by geometric and material properties of the cell membrane, although as with many measurable properties the ambient conditions may also be relevant factors in any given measurement. No other cells of mammalian organisms have<unk> comparable with<unk> s; furthermore, non-mammalian<unk> s are not deformable to an extent comparable with mammalian<unk> s. In human RBC there are structural support that aids resilience in RBC which include the cytoskeleton- actin and spectrin that are held together by ankyrin. | Erythrocyte deformability | Platelet adhesiveness | Inflammatory cytokine | Total complement activity | Overall hemostatic potential | Vascular permeability | Blood protein | Mean corpuscular hemoglobin concentration | 00
| 58,137 |
Mechanism of action<unk> selectively and reversibly binds to the catalytic site of COMT in both the periphery and the central nervous system (CNS) with greater affinity than any of the three catecholamines, including levodopa. It thereby prevents the 3-O-methylation of levodopa by COMT in the periphery, which produces 3-O-methyldopa, a major metabolite that competes with levodopa to cross the blood–brain barrier. More of the levodopa that is administered reaches the CNS. Additionally, levodopa that has already reached the CNS, after being converted to dopamine, will not be degraded as quickly when<unk> inhibits COMT activity. Thus,<unk> improves the bioavailability and reduces the clearance of levodopa and subsequently dopamine from the CNS. 3-O-Methylation of levodopa (3-hydroxy-L-tyrosine) via COMT activity The strength of the binding affinity of<unk> , represented by the inhibition constant Ki (2.5 nM), can be thought of as the dissociation constant for enzyme and inhibitor complex kinetics. Maximum catalytic activity denotes the efficacy of<unk> (Vmax = 58.4 pmol/min·mg). Pharmacokinetics<unk> is quickly absorbed from the gut to about 85%. It has an absolute bioavailability of 65%, which is only slightly decreased when taken with food. The substance reaches highest blood plasma concentrations after about two hours. When in the bloodstream, it is almost completely (>99.9%) bound to plasma proteins, primarily albumin. The main inactivation step is glucuronidation; other processes are methylation by COMT, hydroxylation by CYP3A4 and CYP2A6 with subsequent oxidation to a carboxylic acid, and possibly a minor path with reduction to an amine with subsequent acetylation. The half-life of<unk> is two to three hours, the volume of distribution (Vd) being 0.3 L/kg (21 L in an average 70 kg person). 60% of the metabolites are excreted via the urine and 40% via the feces. Only 0.5% of the drug are excreted in unchanged form via the urine.<unk> and its metabolites. The reduction to the amine and subsequent N-acetylation is putative. 99% of<unk> is in monoanionic form in the body because the physiological pH is 7.4.<unk> penetrates the blood–brain barrier much better than two other nitrocatechols, nitecapone and entacapone, because it has higher lipophilicity due to its R-substituent. Partition coefficients quantify the ability of the molecule to cross the blood–brain barrier. LogPIdce= 0.2, –1.4, –0.4 for<unk> , nitecapone and entacopone respectively. Partition coefficients in this case were measured in 1,2-dichloroethane/H2O solution which caused molecules to be in ionized form. There is no current explanation for how these charged molecules permeate the blood–brain barrier. | Tolcapone | Dimethazan | Acolbifene | Lorcaserin | Pretomanid | Quinagolide | Olsalazine | Entropion | 00
| 32,153 |
<unk> is the term used in the United Kingdom for a specialist who delivers facial, ocular and other prostheses which restore form and function to the body. In the United States, this specialty is known as anaplastology. In the UK, the main governing body for the practice of<unk> prosthetics is the Institute of<unk> Prosthetics and<unk> s. | Maxillofacial prosthetist and technologist | Hospital corpsman | Neurohospitalist | Foundation doctor | Obstetric hospitalist | Prosthetist | Dental therapist | Barber surgeon | 00
| 42,412 |
Electron Microscope The diagnosis of an individual with<unk> includes each of the following: * Plasma zinc level (lab) * Light microscopy (skin biopsy) * Electron microscopy (histology) | Acrodermatitis enteropathica | Intertrigo | Garlic allergy | Acrodermatitis chronica atrophicans | Streptococcal intertrigo | Tinea barbae | Dermatitis repens | Eczema vaccinatum | 00
| 35,390 |
The side effects of<unk> are increased when it is taken with central nervous system depressants, such as alcoholic beverages, sleeping medications, other sedatives, or antihistamines, as well as with other antidepressants including SSRIs, SNRIs or monoamine oxidase inhibitors. It may be dangerous to take<unk> in combination with these substances. | Protriptyline | Pargyline | Butriptyline | Bromperidol decanoate | Carbidopa/levodopa | Fluorodopa | Ciladopa | Cupiennin | 00
| 38,604 |
An<unk> is the unique set of antigenic determinants (epitopes) of the variable portion of an antibody. In some cases it can be the actual antigen-binding site, and in some cases it may comprise variable region sequences outside of the antigen-binding site on the antibody itself. Thus each antibody would have multiple<unk> ; and the set of these individual<unk> is termed the<unk> iotype of the antibody.<unk> contrast with allotopes, which are non-varying structures on the Fc receptor. If a separate antibody is produced that has specific binding capabilities to an<unk> of the previously described antibody, it is said to be an "anti-idiotypic antibody". If such is the case, the anti-idiotypic antibodies will be able to bind to the B lymphocyte receptor for the original antigen and inhibit the immune response to that antigen. This type of regulation was proposed by Niels Jerne in 1974. He termed it the "Network Hypothesis". This type of B lymphocyte regulation may be partially responsible for preventing an immune response from getting out of control, which would elicit damage to host tissue or even cause an autoimmune diseased state. Because of the resemblance of anti-idiotypic antibodies to the original antigen, vaccine studies have been performed. These types of vaccines are called "idiotypic vaccines". An anti-idiotypic monoclonal antibody was generated to possess an "internal image of cocaine". The anti-idiotypic antibody bound to the human dopamine transporter with mimicry of the cocaine molecule and completely inhibited cocaine binding. None are produced commercially to date. | Idiotopes | Halocarbon | Iodine | Iodine | Haloalkane | Trace amine | Hematogen | Chlorofluorocarbon | 00
| 35,217 |
<unk> (ZBLS) is a congenital disorder in humans. Presenting conditions include primary hypothyroidism, cleft palate, hypodontia, and ectodermal dysplasia. It is the result of an embryonic defect in the mesodermal-ectodermal midline development. | Zadik–Barak–Levin syndrome | Neu–Laxova syndrome | Wallis–Zieff–Goldblatt syndrome | Sack–Barabas syndrome | Catel–Manzke syndrome | Abdallat–Davis–Farrage syndrome | Snyder–Robinson syndrome | Temple–Baraitser syndrome | 00
| 29,599 |
Epinephrine (adrenaline) Activation of β1 receptors induces positive inotropic, chronotropic output of the cardiac muscle, leading to increased heart rate and blood pressure, secretion of ghrelin from the stomach, and renin release from the kidneys. Activation of β2 receptors induces smooth muscle relaxation in the lungs, gastrointestinal tract, uterus, and various blood vessels. Increased heart rate and heart muscle contraction are associated with the β1 receptors; however, β2 cause vasodilation in the myocardium. β3 receptors are mainly located in adipose tissue. Activation of the β3 receptors induces the metabolism of lipids. | Beta-adrenergic agonist | Alpha-adrenergic agonist | Beta2-adrenergic agonist | Muscarinic antagonist | Dopamine agonist | Norepinephrine–dopamine disinhibitor | Adrenergic release inhibitor | Channel blocker | 00
| 50,844 |
<unk> is a scoring system developed to assess 1-year risk of major bleeding in people taking anticoagulants for atrial fibrillation (AF). It was developed in 2010 with data from 3,978 people in the Euro Heart Survey. Major bleeding is defined as being intracranial bleedings, hospitalization, hemoglobin decrease > 2 g/dL, and/or transfusion. | HAS-BLED | FLOW | MedChi | STAMPEDE | QWERTY Tummy | Ganfyd | ICES | ICECI | 00
| 67,218 |
Cell separation Cells with different densities and compression strengths can theoretically be separated with<unk> force. It has been suggested that<unk> could be used to separate lipid particles from red blood cells. This is a problem during cardiac surgery supported by a heart-lung machine, for which current technologies are insufficient. According to the proposal,<unk> force applied to blood plasma passing through a channel will cause red blood cells to gather in the pressure node in the center and the lipid particles to gather in antinodes at the sides (see Figure 4). At the end of the channel, the separated cells and particles exit through separate outlets. The<unk> method might also be used to separate particles of different sizes. According to the equation of primary<unk> radiation force, larger particles experience larger forces than smaller particles. Shi et al. reported using interdigital transducers (IDTs) to generate a standing surface<unk> wave (SSAW) field with pressure nodes in the middle of a microfluidic channel, separating microparticles with different diameters. When introducing a mixture of particles with different sizes from the edge of the channel, larger particles will migrate toward the middle more quickly and be collected at the center outlet. Smaller particles will not be able to migrate to the center outlet before they are collected from the side outlets. This experimental setup has also been used to separate blood components, bacteria, and hydrogel particles. 3D cell focusing Fluorescence-activated cell sorters (FACS) can sort cells by focusing a fluid stream containing the cells, detecting fluorescence from individual cells, and separating the cells of interest from other cells. They have high throughput but are expensive to purchase and maintain, and are bulky with a complex configuration. They also affect cell physiology with high shear pressure, impact forces and electromagnetic forces, which may result in cellular and genetic damage.<unk> forces are not dangerous to cells, and there has been progress integrating<unk> with optical/electrical modules for simultaneous cell analysis and sorting, in a smaller and less-expensive machine.<unk> have been developed to achieve 3D focusing of cells/particles in microfluidics. A pair of interdigital transducers (IDTs) are deposited on a piezoelectric substrate, and a microfluidic channel is bonded with the substrate and positioned between the two IDTs. Microparticle solutions are infused into the microfluidic channel by a pressure-driven flow. Once an RF signal is applied to both IDTs, two series of surface<unk> waves (SAW) propagate in opposite directions toward the particle suspension solution inside the microchannel. The constructive interference of the two SAWs results in the formation of a SSAW. Leakage waves in the longitudinal mode are generated inside the channel, causing pressure fluctuations that act laterally on the particles. As a result, the suspended particles inside the channel will be forced toward either the pressure nodes or antinodes, depending on the density and compressibility of the particles and the medium. When the channel width covers only one pressure node (or antinode), the particles will be focused in that node. In addition to focusing in a horizontal direction, cells/particles can also be focused in the vertical direction. After SSAW is on, the randomly distributed particles are focused into a single file stream (Fig. 10c) in the vertical direction. By integrating a standing surface<unk> wave (SSAW)-based microdevice capable of 3D particle/cell focusing with laser-induced fluorescence (LIF) detection system,<unk> are developed into a microflow cytometer for high-throughput single cell analysis. The tunability offered by chirped interdigital transducers renders it capable of precisely sorting cells into a number (e.g., five) of outlet channels in a single step. This is a major advantage over most existing sorting methods, which typically only sort cells into two outlet channels. Noninvasive cell trapping and patterning A glass reflector with etched fluidic channels is clamped to the PCB holding the transducer. Cells infused into the chip are trapped in the ultrasonic standing wave formed in the channel. The<unk> forces focus the cells into clusters in the center of the channel as illustrated in the inset. Since the trapping occurs close to the transducer surface, the actual trapping sites are given by the near-field pressure distribution as shown in the 3D image. Cells will be trapped in clusters around the local pressure minima creating different patterns depending on the number of cells trapped. The peaks in the graph correspond to the pressure minima. Manipulation of single cell, particle, or organism Fig. 4: Traces of single cell manipulation Manipulating single cells is important to many biological studies, such as in controlling the cellular microenvironment and isolating specific cells of interest.<unk> have been demonstrated to manipulate each individual cell with micrometer-level resolution. Cells generally have a diameter of 10–20 μm. To meet the resolution requirements of manipulating single cells, short-wavelength<unk> waves should be employed. In this case, a surface<unk> wave (SAW) is preferred to a bulk<unk> wave (BAW), because it allows using shorter-wavelength<unk> waves (normally less than 200 μm). Ding et al. reported a SSAW microdevice that is able to manipulate single cells with prescribed paths. Figure 6 records a demonstration that the movement of single cells can be finely controlled with<unk> . The working principle of the device lies in the controlled movement of pressure nodes in an SSAW field. Ding et al. employed chirped interdigital transducers (IDTs) that are able to generate SSAWs with adjustable positions of pressure nodes by changing the input frequency. They also showed that the millimeter-sized microorganism C. elegan can be manipulated in the same manner. They also examined cell metabolism and proliferation after<unk> treatment, and found no significant differences compared to the control group, indicating the non-invasive nature of<unk> base manipulation. In addition to using chirped IDTs, phaseshift-based single particle/cell manipulation has also been reported. Manipulation of single biomolecules Sitters et al. have shown that<unk> s can be used to manipulate single biomolecules such as DNA and proteins. This method, which the inventors call<unk> force spectroscopy, allows measuring the force response of single molecules. This is achieved by attaching small microspheres to the molecules at one side and attaching them to a surface at the other. By pushing the microspheres away from the surface with a standing<unk> wave the molecules are effectively stretched out. Manipulation of organic nano-materials Polymer-dispersed liquid crystal (PDLC) displays can be switched from opaque to transparent using<unk> . A SAW-driven PDLC light shutter has been demonstrated by integrating a cured PDLC film and a pair of interdigital transducers (IDTs) onto a piezoelectric substrate. Manipulation of inorganic nano-materials<unk> provide a simple approach for tuneable nanowire patterning. In this approach, SSAWs are generated by interdigital transducers, which induced a periodic alternating current (AC) electric field on the piezoelectric substrate and consequently patterned metallic nanowires in suspension. The patterns could be deposited onto the substrate after the liquid evaporated. By controlling the distribution of the SSAW field, metallic nanowires are assembled into different patterns including parallel and perpendicular arrays. The spacing of the nanowire arrays could be tuned by controlling the frequency of the surface<unk> waves. Selective manipulation While most<unk> are able to manipulate a large number of objects collectively, a complementary function is to be able to manipulate a single particle within a cluster without moving adjacent objects. To achieve this goal, the<unk> trap must be localized spacially. A first approach consists in using highly focused<unk> beams. Since many particles of interest are attracted to the nodes of an<unk> field and thus expelled from the focus point, some specific wave structures combining strong focalization but with a minimum of the pressure amplitude at the focal point (surrounded by a ring of intensity to create the trap) are required to trap this type of particle. These specific conditions are met by Bessel beams of topological order larger than zero, also called<unk> al vortices". With this kind of wave structures, the 2D and 3D selective manipulation of particles has been demonstrated with an array of transducers driven by programmable electronics. Alternatively, another approach to localize the<unk> energy relies on the use of nanosecond-scale pulsed fields to generate localized<unk> standing waves. High frequency<unk> and holographic InterDigitated Transducers (IDTs) The individual selective manipulation of micro-objects requires to synthesize complex<unk> fields such as<unk> vortices (see previous section) at sufficiently high frequency to reach the necessary spatial resolution (typically the wavelength must be comparable to the size of the manipulated object to be selective). Many holographic methods have been developed to synthesize complex wavefields including transducer arrays, 3D printed holograms, metamaterials or diffraction gratings. Nevertheless all these methods are limited to relatively low frequencies with an insufficient resolution to address micrometric particles, cells or microorganisms individually. On the other hand, InterDigitated Transducers (IDTs) were known as a reliable technique to synthesize<unk> wavefields up to GHz frequency. | Acoustic tweezers | Magill forceps | Metzenbaum scissors | Tenotomy scissors | Debakey forceps | Mayo scissors | Surgical mask | Surgical elevator | 00
| 65,809 |
<unk> is a solar elastotic disorder consisting of multiple open comedones that occurs in skin damaged by sunlight, especially under and lateral of the eyes. The comedones are widened openings for hair follicles and sebaceous glands filled with material. | Favre–Racouchot syndrome | Gougerot–Blum syndrome | Juberg-Hayward syndrome | Jeavons syndrome | McGillivray syndrome | Van Wyk and Grumbach syndrome | Bowen–Conradi syndrome | Bogart–Bacall syndrome | 00
| 57,749 |
Mitral valve prolapse is a genetically heterogeneous autosomal dominant trait, which can be passed down from one parent to child, who will have a 50% chance to inherit the mutated gene. An association with primary cilia defects has been reported. The mutations were found in the Zinc finger protein DZIP1 gene which regulates ciliogenesis; the same problem was found in mice who also developed MVP with this gene. It was found that primary cilia loss during development results in progressive myxomatous degeneration and profound mitral valve pathology. Myxomatous degeneration of mitral valve is a genetic abnormality mapped to gene Xq28. Other genes associated with MVP are: * 13.q31.3-q32.1 * 16p12.1-p11.2 * Ch16p11.2-p12.1 * 11p15.4 * DCHS1 | complications of Marfan syndrome | medical diagnosis of Marfan syndrome | complications of Ehlers–Danlos syndromes | complications of Noonan syndrome | complications of Long QT syndrome | complications of Treacher Collins syndrome | complications of Hypertrophic cardiomyopathy | picture of Marfan syndrome | 00
| 14,076 |
A variety of conditions can lead to<unk> : menopause is the most common. Primary ovarian insufficiency (premature menopause) due to varying causes, such as radiation therapy, chemotherapy, or a spontaneous manifestation, can also lead to low estrogen and infertility. Hypogonadism (a condition where the gonads – testes for men and ovaries for women – have diminished activity) can decrease estrogen. In primary hypogonadism, elevated serum gonadotropins are detected on at least two occasions several weeks apart, indicating gonadal failure. In secondary hypogonadism (where the cause is hypothalamic or pituitary dysfunction) serum levels of gonadotropins may be low. Other causes include certain medications, gonadotropin insensitivity, inborn errors of steroid metabolism (for example, aromatase deficiency, 17α-hydroxylase deficiency, 17,20-lyase deficiency, 3β-hydroxysteroid dehydrogenase deficiency, and cholesterol side-chain cleavage enzyme or steroidogenic acute regulatory protein deficiency) and functional amenorrhea. Risks Low endogenous estrogen levels can elevate the risk of cardiovascular disease in women who reach early menopause. Estrogen is needed to relax arteries using endothelial-derived nitric oxide resulting in better heart health by decreasing adverse atherogenic effects. Women with POI may have an increased risk of cardiovascular disease due to low estrogen production. | Hypoestrogenism | Hyperestrogenism | Antiestrogen withdrawal response | Corticosteroid-induced lipodystrophy | Hyperandrogenism | Androgen deficiency | Thyroid hormone resistance | Progestin-induced virilization | 00
| 31,675 |
After skin comes in contact with cantharidin, local irritation begins within a few hours. (This is in contrast to Paederus dermatitis, where symptoms first appear 12–36 hours after contact with rove<unk> s.) Painful<unk> s appear, but scarring from these epidermal lesions is rare. | Blister beetle dermatitis | Phototoxic tar dermatitis | Rodent mite dermatitis | African blackwood dermatitis | Lacquer dermatitis | Abietic acid dermatitis | Paederus dermatitis | Shiitake mushroom dermatitis | 00
| 55,635 |
One ad from 1897 claims to restore "perfect manhood. Failure is impossible with our method". Another "will quickly cure you of all nervous or diseases of the generative organs, such as Lost Manhood, Insomnia, Pains in the Back, Seminal Emissions, Nervous Debility, Pimples, Unfitness to Marry, Exhausting Drains, Varicocele and Constipation". The U.S. Federal Trade Commission warns that "phony cures" exist even today. Treatment depends on the underlying cause. In general, exercise, particularly of the aerobic type, is effective for preventing<unk> during midlife. Counseling can be used if the underlying cause is psychological, including how to lower stress or anxiety related to sex. Medications by mouth and vacuum erection devices are first-line treatments, followed by injections of drugs into the penis, as well as penile implants. Vascular reconstructive surgeries are beneficial in certain groups. Treatments, other than surgery, do not fix the underlying physiological problem, but are used as needed before sex. Medications The PDE5 inhibitors sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis) are prescription drugs which are taken by mouth. As of 2018, sildenafil is available in the UK without a prescription. Additionally, a cream combining alprostadil with the permeation enhancer DDAIP has been approved in Canada as a first line treatment for<unk> . Penile injections, on the other hand, can involve one of the following medications: papaverine, phentolamine, and prostaglandin E1, also known as alprostadil. In addition to injections, there is an alprostadil suppository that can be inserted into the urethra. Once inserted, an erection can begin within 10 minutes and last up to an hour. Medications to treat<unk> may cause a side effect called priapism. Prevalence of medical diagnosis In a study published in 2016, based on US health insurance claims data, out of 19,833,939 US males aged ≥18 years, only 1,108,842 (5.6%), were medically diagnosed with<unk> or on a PDE5I prescription (μ age 55.2 years, σ 11.2 years). Prevalence of diagnosis or prescription was the highest for age group 60–69 at 11.5%, lowest for age group 18–29 at 0.4%, and 2.1% for 30–39, 5.7% for 40–49, 10% for 50–59, 11% for 70–79, 4.6% for 80–89, 0.9% for ≥90, respectively. Focused shockwave therapy Focused shockwave therapy involves passing short, high frequency acoustic pulses through the skin and into the penis. These waves break down any plaques within the blood vessels, encourage the formation of new vessels, and stimulate repair and tissue regeneration. Focused shockwave therapy appears to work best for men with vasculogenic<unk> , which is a blood vessel disorder that affects blood flow to tissue in the penis. The treatment is painless and has no known side effects. Treatment with shockwave therapy can lead to a significant improvement of the IIEF (International Index of<unk> Function). Testosterone Testosterone Supplementation - Content 88 g Gel Men with low levels of testosterone can experience<unk> . Taking testosterone may help maintain an erection. Men with type 2 diabetes are twice as likely to have lower levels of testosterone, and are three times more likely to experience<unk> than non-diabetic men. Pumps A vacuum erection device helps draw blood into the penis by applying negative pressure. This type of device is sometimes referred to as penis pump and may be used just prior to sexual intercourse. Several types of FDA approved vacuum therapy devices are available under prescription. When pharmacological methods fail, a purpose-designed external vacuum pump can be used to attain erection, with a separate compression ring fitted to the base of the penis to maintain it. These pumps should be distinguished from other penis pumps (supplied without compression rings) which, rather than being used for temporary treatment of impotence, are claimed to increase penis length if used frequently, or vibrate as an aid to masturbation. More drastically, inflatable or rigid penile implants may be fitted surgically. Surgery Often, as a last resort, if other treatments have failed, the most common procedure is prosthetic implants which involves the insertion of artificial rods into the penis. Some sources show that vascular reconstructive surgeries are viable options for some people. Alternative medicine The Food and Drug Administration (FDA) does not recommend alternative therapies to treat sexual<unk> . Many products are advertised as "herbal viagra" or "natural" sexual enhancement products, but no clinical trials or scientific studies support the effectiveness of these products for the treatment of<unk> , and synthetic chemical compounds similar to sildenafil have been found as adulterants in many of these products. The FDA has warned consumers that any sexual enhancement product that claims to work as well as prescription products is likely to contain such a contaminant. A 2021 review indicated that ginseng had "only trivial effects on<unk> function or satisfaction with intercourse compared to placebo". | Erectile dysfunction | Metabolic syndrome | Urinary incontinence | Sexual dysfunction | Anorgasmia | Dysosmia | Prognathism | Ectopia | 00
| 1,165 |
The<unk> is a bone lesion that arises in settings of excess osteoclast activity, such as hyperparathyroidism. They are a form of osteitis fibrosa cystica. It is not a neoplasm, but rather simply a mass. It most commonly affects the maxilla and mandible, though any bone may be affected.<unk> rs are radiolucent on x-ray. | Brown tumor | Mantleoma | Neuroma | Ameloblastoma | Hemangioblastoma | Pineocytoma | Hamartoma | Medulloblastoma | 00
| 44,192 |
Treatments for CCCA remain investigational. Altering hair care practices has not been proven to assist in hair rejuvenation. High-dose topical steroids, antibiotics, immunomodulators such as tacrolimus (Protopic) and pimecrolimus (Elidel), and anti-androgen/5alpha Reductase inhibitors have been used with unknown efficacy. | Central centrifugal cicatricial alopecia | Triangular alopecia | Auricular hypertrichosis | Hot comb alopecia | Focal facial dermal dysplasia | Intermittent hair–follicle dystrophy | Frictional alopecia | Exudative hyponychial dermatitis | 00
| 52,934 |
Delusions are categorized into four different groups: * Bizarre delusion: Delusions are deemed bizarre if they are clearly implausible and not understandable to same-culture peers and do not derive from ordinary life experiences. An example named by the DSM-5 is a belief that someone replaced all of one's internal organs with someone else's without leaving a scar, depending on the organ in question. * Non-bizarre delusion: A delusion that, though false, is at least technically possible, e.g., the affected person mistakenly believes that they are under constant police surveillance. * Mood-congruent delusion: Any delusion with content consistent with either a depressive or manic state, e.g., a depressed person believes that news anchors on television highly disapprove of them, or a person in a manic state might believe they are a powerful deity. * Mood-neutral delusion: A delusion that does not relate to the sufferer's emotional state; for example, a belief that an extra limb is growing out of the back of one's head is neutral to either depression or mania. Themes In addition to these categories, delusions often manifest according to a consistent theme. Although delusions can have any theme, certain themes are more common. Some of the more common delusion themes are: * Delusion of control: False belief that another person, group of people, or external force controls one's general thoughts, feelings, impulses, or behaviors. * Cotard delusion: False belief that one does not exist or that one has died. Some cases also include the belief that one is immortal or that one has lost their internal organs, blood, or other body parts. * Delusional jealousy: False belief that a spouse or lover is having an affair, with no proof to back up the claim. * Delusion of guilt or sin (or delusion of self-accusation): Ungrounded feeling of remorse or guilt of delusional intensity. * Delusion of mind being read: False belief that other people can know one's thoughts. * Delusion of thought insertion: Belief that another thinks through the mind of the person. * Delusion of reference: False belief that insignificant remarks, events, or objects in one's environment have personal meaning or significance. "Usually the meaning assigned to these events is negative, but the 'messages' can also have a grandiose quality." * Erotomania: False belief that another person is in love with them. * Religious delusion: Belief that the affected person is a god or chosen to act as a god. * Somatic delusion: Delusion whose content pertains to bodily functioning, bodily sensations or physical appearance. Usually the false belief is that the body is somehow diseased, abnormal or changed. A specific example of this delusion is delusional parasitosis: Delusion in which one feels infested with insects, bacteria, mites, spiders, lice, fleas, worms, or other organisms. * Delusion of poverty: Person strongly believes they are financially incapacitated. Although this type of delusion is less common now, it was particularly widespread in the days preceding state support. Grandiose delusions Grandiose delusions or delusions of grandeur are principally a subtype of delusional disorder but could possibly feature as a<unk> of schizophrenia and manic episodes of bipolar disorder. Grandiose delusions are characterized by fantastical beliefs that one is famous, omnipotent or otherwise very powerful. The delusions are generally fantastic, often with a supernatural, science-fictional, or religious bent. In colloquial usage, one who overestimates one's own abilities, talents, stature or situation is sometimes said to have "delusions of grandeur". This is generally due to excessive pride, rather than any actual delusions. Grandiose delusions or delusions of grandeur can also be associated with megalomania. Persecutory delusions Persecutory delusions are the most common type of delusions and involve the theme of being followed, harassed, cheated, poisoned or drugged, conspired against, spied on, attacked, or otherwise obstructed in the pursuit of goals. Persecutory delusions are a condition in which the affected person wrongly believes that they are being persecuted. Specifically, they have been defined as containing two central elements: The individual thinks that: * harm is occurring, or is going to occur * the persecutors have the intention to cause harm According to the DSM-IV-TR, persecutory delusions are the most common form of delusions in schizophrenia, where the person believes they are "being tormented, followed, sabotaged, tricked, spied on, or ridiculed". In the DSM-IV-TR, persecutory delusions are the main feature of the persecutory type of delusional disorder. When the focus is to remedy some injustice by legal action, they are sometimes called "querulous paranoia". | symptoms of Delirium | symptom of Delirium | symptom of Narcolepsy | symptom of Delirium tremens | symptoms of Mental disorder | medical cause of Insomnia | symptom of Conversion disorder | symptom of Bipolar disorder | 00
| 5,981 |
<unk> <unk> is a persistent irritation caused by shaving. It was first described in 1956. | Pseudofolliculitis barbae | Folliculitis nares perforans | Tinea imbricata | Ichthyosis bullosa of Siemens | Neutrophilic eccrine hidradenitis | Steatocystoma simplex | Trichostasis spinulosa | Lichen myxedematosus | 00
| 24,221 |
Gastrinoma is the second most common functional pancreatic neuroendocrine tumor (pNET), with a yearly incidence of approximately 0.5 to 21.5 cases per a million of people worldwide. Gastrinomas are located predominantly in the duodenum (70%) and pancreas (25%). Pancreatic gastrinomas are larger than their duodenal counterparts, may occur in any portion of the pancreas, and comprise 25% of these tumors. Gastrinomas are also the most common functional and malignant pancreatic endocrine tumors. They are characterized by gastric hypersecretion that results in peptic ulcers and diarrhea; this condition is known as<unk><unk> syndrome (ZES). | causes of Zollinger–Ellison syndrome | risks of Peritonitis | risks of Short bowel syndrome | risks of Giardiasis | causes of Peanut allergy | causes of Gerstmann syndrome | causes of Heartburn | risks of Stevens–Johnson syndrome | 00
| 31,150 |
* Physical agents such as heat or radiation can<unk> a<unk> by literally cooking or coagulating their contents. * Impaired nutrient supply, such as lack of oxygen or glucose, or impaired production of adenosine triphosphate (ATP) may deprive the<unk> of essential materials needed to survive. *Metabolic: Hypoxia and Ischemia *Chemical Agents *Microbial Agents:-Virus & Bacteria *Immunologic Agents: Allergy and autoimmune diseases such as Parkinson's and Alzheimer's disease. *Genetic factors: Such as Down's syndrome and sickle<unk> anemia | Cell damage | Cell death | Growth inhibition | Electrolyte imbalance | Viral interference | Bone decalcification | Tissue expansion | Tissue stress | 00
| 37,155 |
<unk> , is an autosomal recessive form of congenital stationary night blindness associated with fundus discoloration and abnormally slow dark adaptation. | Oguchi disease | Chandler's disease | Sequela | Dent's disease | Sever's disease | Freiberg disease | Bornholm disease | Van Buchem disease | 00
| 43,964 |
Schematic diagram of alt=Structural drawing of the myoglobin molecule Damage to skeletal muscle may take various forms. Crush and other physical injuries cause damage to muscle cells directly or interfere with blood supply, while non-physical causes interfere with muscle cell metabolism. When damaged, muscle tissue rapidly fills with fluid from the bloodstream, including sodium ions. The swelling itself may lead to destruction of muscle cells, but those cells that survive are subject to various disruptions that lead to rise in intracellular calcium ions; the accumulation of calcium outside the sarcoplasmic reticulum leads to continuous muscle contraction and depletion of ATP, the main carrier of energy in the cell. ATP depletion can itself lead to uncontrolled calcium influx. The persistent contraction of the muscle cell leads to breakdown of intracellular proteins and disintegration of the cell. Neutrophil granulocytes—the most abundant type of white blood cell—enter the muscle tissue, producing an inflammatory reaction and releasing reactive oxygen species, particularly after crush injury. Crush syndrome may also cause reperfusion injury when blood flow to decompressed muscle is suddenly restored. The swollen, inflamed muscle may directly compress structures in the same fascial compartment, causing compartment syndrome. The swelling may also further compromise blood supply into the area. Finally, destroyed muscle cells release potassium ions, phosphate ions, the heme-containing protein myoglobin, the enzyme creatine kinase and uric acid (a breakdown product of purines from DNA) into the blood. Activation of the coagulation system may precipitate disseminated intravascular coagulation. High potassium levels may lead to potentially fatal disruptions in heart rhythm. Phosphate binds to calcium from the circulation, leading to low calcium levels in the blood.<unk> may cause kidney failure by several mechanisms. The most important is the accumulation of myoglobin in the kidney tubules. Normally, the blood protein haptoglobin binds circulating myoglobin and other heme-containing substances, but in<unk> the quantity of myoglobin exceeds the binding capacity of haptoglobin. Myoglobinuria, the presence of myoglobin in the urine, occurs when the level in plasma exceeds 0.5–1.5 mg/dl; once plasma levels reach 100 mg/dl, the concentration in the urine becomes sufficient for it to be visibly discolored and corresponds with the destruction of about 200 grams of muscle. As the kidneys reabsorb more water from the filtrate, myoglobin interacts with Tamm–Horsfall protein in the nephron to form casts (solid aggregates) that obstruct the normal flow of fluid; the condition is worsened further by high levels of uric acid and acidification of the filtrate, which increase cast formation. Iron released from the heme generates reactive oxygen species, damaging the kidney cells. In addition to the myoglobinuria, two other mechanisms contribute to kidney impairment: low blood pressure leads to constriction of the blood vessels and therefore a relative lack of blood flow to the kidney, and finally uric acid may form crystals in the tubules of the kidneys, causing obstruction. Together, these processes lead to acute tubular necrosis, the destruction of the cells of tubules. Glomerular filtration rate falls and the kidney is unable to perform its normal excretory functions. This causes disruption of electrolyte regulation, leading to a further rise in potassium levels, and interferes with vitamin D processing, further worsening the low calcium levels. | Rhabdomyolysis | Hypermagnesemia | Diabetic ketoacidosis | Tumor lysis syndrome | Sympathicolysis | Proteus-like syndrome | Vasoplegic syndrome | Exertional rhabdomyolysis | 00
| 8,936 |
Multiple colon polyps within the colon of an individual with familial adenomatous polyposis Although there are over 50 identifiable hereditary forms of cancer, less than 0.3% of the population are carriers of a cancer-related genetic mutation and these make up less than 3–10% of all cancer cases. The vast majority of cancers are non-hereditary ("sporadic cancers"). Hereditary cancers are primarily caused by an inherited genetic defect. A cancer syndrome or family cancer syndrome is a genetic disorder in which inherited genetic mutations in one or more genes predisposes the affected individuals to the development of cancers and may also cause the early onset of these cancers. Although cancer syndromes exhibit an increased risk of cancer, the risk varies. For some of these diseases, cancer is not the primary feature and is a rare consequence. Many of the cancer syndrome cases are caused by mutations in tumor suppressor genes that regulate cell growth. Other common mutations alter the function of DNA repair genes, oncogenes and genes involved in the production of blood vessels. Certain inherited mutations in the genes BRCA1 and BRCA2 with a more than 75% risk of breast cancer and ovarian cancer. Some of the inherited genetic disorders that can cause colorectal cancer include familial adenomatous polyposis and hereditary non-polyposis colon cancer; however, these represent less than 5% of colon cancer cases. In many cases, genetic testing can be used to identify mutated genes or chromosomes that are passed through generations. Gene mutations are classified as germline or somatic depending on the cell type where they appear (germline cells include the egg and the sperm and somatic cells are those forming the body). The germline mutations are carried through generations and increase the risk of cancer. Cancer syndromes * Ataxia telangiectasia * Bloom syndrome * BRCA1 & BRCA2 * Fanconi anemia * Familial adenomatous polyposis * Hereditary breast and ovarian cancer * Hereditary non-polyposis colon cancer * Li-Fraumeni syndrome * Nevoid basal cell carcinoma syndrome * Von Hippel-Lindau disease * Werner syndrome * Xeroderma pigmentosum | Causes of cancer | Infectious diseases | Causes of mental disorders | Women's health | Men's health | Drug therapy problems | Infectious causes of cancer | Cancer | 00
| 63,448 |
In biology,<unk> (I&O) is the measure of food and fluids that enter and exit the body. Certain patients with the need are placed on I & O, and if so, their urinary<unk> is measured. With self-toileting patients on I & O, or those who are assisted to a regular toilet or portable commode, a receptacle is placed in the toilet bowl that catches all urine that is put out by the patient. This, in turn, is measured by the nursing staff and recorded prior to its disposal. If the patient is using a bedpan, the nursing staff member who empties the bedpan measures the urine prior to its disposal. Urinals usually contain measuring lines providing easy measurement. Urinals are also useful for measuring urine from other sources. Catheters, which are frequently used when it is necessary to measure a patient's<unk> , often have measuring lines on their bags, but these are not considered to be accurate because the bag is floppy. Urine that is emptied from a catheter must be placed in a level container (such as a urinal) in order to be measured. | Input and output | Dose profile | Scope of practice | Course | Song control system | Procedure code | Diagnosis-related group | QTY Code | 00
| 61,791 |
It is particularly important as a solvent in the production of cellulose plastics such as cellulose acetate. Fuel<unk> has a high cetane number of 85–96 and is used as a starting fluid, in combination with petroleum distillates for gasoline and Diesel engines because of its high volatility and low flash point.<unk> starting fluid is sold and used in countries with cold climates, as it can help with cold starting an engine at sub-zero temperatures. For the same reason it is also used as a component of the fuel mixture for carbureted compression ignition model engines. In this way<unk> is very similar to one of its precursors, ethanol. Chemistry<unk> is a hard Lewis base that reacts with a variety of Lewis acids such as iodine, phenol, and trimethylaluminium, and its base parameters in the ECW model are EB = 1.80 and CB = 1.63.<unk> is a common laboratory aprotic solvent. It has limited solubility in water (6.05 g/100 ml at 25 °C) and dissolves 1.5 g/100 g (1.0 g/100 ml) water at 25 °C. This, coupled with its high volatility, makes it ideal for use as the non-polar solvent in liquid-liquid extraction. When used with an aqueous solution, the<unk> layer is on top as it has a lower density than the water. It is also a common solvent for the Grignard reaction in addition to<unk> reactions involving organometallic reagents. Due to its application in the manufacturing of illicit substances, it is listed in the Table II precursor under the United Nations Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances as well as substances such as acetone, toluene and sulfuric acid. Anesthesia Panel from monument in Boston commemorating Morton's demonstration of<unk> 's anesthetic use. William T. G. Morton participated in a public demonstration of<unk> anesthesia on October 16, 1846 at the<unk> Dome in Boston, Massachusetts. However, Crawford Williamson Long is now known to have demonstrated its use privately as a general anesthetic in surgery to officials in Georgia, as early as March 30, 1842, and Long publicly demonstrated<unk> 's use as a surgical anesthetic on six occasions before the Boston demonstration. British doctors were aware of the anesthetic properties of<unk> as early as 1840 where it was widely prescribed in conjunction with opium.<unk> largely supplanted the use of chloroform as a general anesthetic due to<unk> 's more favorable<unk> apeutic index, that is, a greater difference between an effective dose and a potentially toxic dose.<unk> does not depress the myocardium but rather it stimulates the sympathetic nervous system leading to hypertension and tachycardia. It is safely used in patients with shock as it preserves the baroreceptor reflex. Its minimal effect on myocardial depression and respiratory drive, as well as its low cost and high<unk> apeutic index allows it to see continued use in developing countries.<unk> could also be mixed with<unk> anesthetic agents such as chloroform to make C.E. mixture, or chloroform and alcohol to make A.C.E. mixture. In the 21st century,<unk> is rarely used. The use of flammable<unk> was displaced by nonflammable fluorinated hydrocarbon anesthetics. Halothane was the first such anesthetic developed and<unk> currently used inhaled anesthetics, such as isoflurane, desflurane, and sevoflurane, are halogenated<unk> s.<unk> was found to have undesirable side effects, such as post-anesthetic nausea and vomiting. Modern anesthetic agents reduce these side effects. Prior to 2005 it was on the World Health Organization's List of Essential Medicines for use as an anesthetic. Medicine<unk> was once used in pharmaceutical formulations. A mixture of alcohol and<unk> , one part of<unk> and three parts of ethanol, was known as "Spirit of<unk> ", Hoffman's Anodyne or Hoffman's Drops. In the United States this concoction was removed from the Pharmacopeia at some point prior to June 1917, as a study published by William Procter, Jr. in the American Journal of Pharmacy as early as 1852 showed that<unk> e were differences in formulation to be found between commercial manufacturers, between international pharmacopoeia, and from Hoffman's original recipe. It is also used to treat hiccups through instillation into nasal cavity. Recreation The anesthetic and intoxicating effects of<unk> have made it a recreational drug.<unk> in anesthetic dosage is an inhalant which has a long history of recreational use. One disadvantage is the high flammability, especially in conjunction with oxygen. One advantage is a well-defined margin between<unk> apeutic and toxic doses, which means one would lose consciousness before dangerous levels of dissolved<unk> in blood would be reached. With a strong, dense smell,<unk> causes irritation to respiratory mucosa and is uncomfortable to breathe, and in overdose triggering salivation, vomiting, coughing or spasms. In concentrations of 3–5% in air, an anesthetic effect can slowly be achieved in 15–20 minutes of breathing approximately 15–20 ml of<unk> , depending on body weight and physical condition.<unk> causes a very long excitation stage prior to blacking out. The recreational use of<unk> also took place at organised parties in the 19th century called<unk> frolics, where guests were encouraged to inhale<unk> apeutic amounts of<unk> or nitrous oxide, producing a state of excitation. Long, as well as fellow dentists Horace Wells, William Edward Clarke and William T. G. Morton observed that during these gatherings, people would often experience minor injuries but appear to show no reaction to the injury, nor memory that it had happened, demonstrating<unk> 's anaesthetic effects. In the 19th century and early 20th century<unk> drinking was popular among Polish peasants. It is a traditional and still relatively popular recreational drug among Lemkos. It is usually consumed in a small quantity (kropka, or "dot") poured over milk, sugar water, or orange juice in a shot glass. As a drug, it has been known to cause psychological dependence, sometimes referred to as<unk> omania. | Diethyl ether | Triphenylbromoethylene | Phenylsilatrane | Triphenylchloroethylene | Chloroform | Desmethylchlorotrianisene | Triphenylethylene | 1,1,1,2-Tetrafluoroethane | 00
| 17,250 |
__NOTOC__<unk> (: ), from Russian нарко- (narco-, pertaining to narcotics, illicit drugs) + -логия (-logy, "branch of study") is a subspecialty of psychiatry dealing with the prevention, treatment, diagnosis, social care and recovery of drug-dependent persons. The study and science of phenomena of "narcomania", "toxicomania", alcohol use disorder, and its ætiology, pathogenesis, and clinical aspects. The term for a practitioner of<unk> is<unk> st. In the United States, the comparable terms are "addiction medicine" and "addictionist".<unk> was introduced as a separated medical specialty in the Soviet Union during the early 1960s through the 1970s. The term<unk> " is used especially in the countries of the former Soviet Union, including Russia. | Narcology | Radiomics | Radiochemistry | Hemorheology | Angiology | Radiology | Imaging biomarker | Magnetic Resonance in Medicine | 00
| 71,141 |
Anything compromising the tunnel of the posterior tibial nerve proves significant in the risk of causing<unk> . Neuropathy can occur in the lower limb through many modalities, some of which include obesity and inflammation around the joints. By association, this includes risk factors such as RA, compressed shoes, pregnancy, diabetes and thyroid diseases | Tarsal tunnel syndrome | Heel pad syndrome | Radial tunnel syndrome | Ulnar tunnel syndrome | Carpal tunnel syndrome | Anterior interosseous syndrome | Anterior compartment syndrome | Löfgren syndrome | 00
| 29,271 |
Recent data suggest a prevalence of 20 to 35%. | 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
| 23,372 |