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Whooping cough (pertussis) is a highly contagious respiratory tract infection. In many people, it's marked by a severe hacking cough followed by a high-pitched intake of breath that sounds like "whoop."Before the vaccine was developed, whooping cough was considered a childhood disease. Now whooping cough primarily affects children too young to have completed the full course of vaccinations and teenagers and adults whose immunity has faded.Deaths associated with whooping cough are rare but most commonly occur in infants. That's why it's so important for pregnant women — and other people who will have close contact with an infant — to be vaccinated against whooping cough.

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ON THIS PAGE: You will find out more about body changes and other things that can signal a problem that may need medical care. To see other pages, use the menu.Children with a Wilms tumor may experience the following symptoms or signs. Sometimes, children with a Wilms tumor do not have any of these changes. Or, the cause of a symptom may be another medical condition that is not cancer.Usually, a Wilms tumor is found before it spreads to other parts of the body. A parent or relative may notice a large lump or feel a hard mass in the child’s belly or notice that the belly is much larger than usual. In some cases, a rapid change to a larger diaper size alerts parents to the presence of a tumor. A few children have abdominal pain. However, most of the time the tumor grows without causing pain, and the child feels and appears healthy.


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A wrist fracture is a medical term for a broken wrist. The wrist is made up of eight small bones which connect with the two long forearm bones called the radius and ulna. Although a broken wrist can happen in any of these 10 bones, by far the most common bone to break is the radius. This is called a distal radius fracture by hand surgeons (Figure 1).Some wrist fractures are stable. “Non-displaced” breaks, in which the bones do not move out of place initially, can be stable. Some “displaced” breaks (which need to be put back into the right place, called “reduction” or “setting”) also can be stable enough to treat in a cast or splint. Other fractures are unstable. In unstable fractures, even if the bones are put back into position and a cast is placed, the bone pieces tend to move or shift into a bad position before they solidly heal. This can make the wrist appear crooked.Some fractures are more severe than others. Fractures that break apart the smooth joint surface or fractures that shatter into many pieces (comminuted fractures) may make the bone unstable. These severe types of fractures often require surgery to restore and hold their alignment. An open fracture occurs when a fragment of bone breaks and is forced out through the skin. This can cause an increased risk of infection in the bone.

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X-linked agammaglobulinemia (XLA) is a condition that affects the immune system and occurs almost exclusively in males. People with XLA have very few B cells, which are specialized white blood cells that help protect the body against infection. B cells can mature into the cells that produce special proteins called antibodies or immunoglobulins. Antibodies attach to specific foreign particles and germs, marking them for destruction. Individuals with XLA are more susceptible to infections because their body makes very few antibodies.Children with XLA are usually healthy for the first 1 or 2 months of life because they are protected by antibodies acquired before birth from their mother. After this time, the maternal antibodies are cleared from the body, and the affected child begins to develop recurrent infections. In children with XLA, infections generally take longer to get better and then they come back again, even with antibiotic medications. The most common bacterial infections that occur in people with XLA are lung infections (pneumonia and bronchitis), ear infections (otitis), pink eye (conjunctivitis), and sinus infections (sinusitis). Infections that cause chronic diarrhea are also common. Recurrent infections can lead to organ damage. People with XLA can develop severe, life-threatening bacterial infections; however, affected individuals are not particularly vulnerable to infections caused by viruses. With treatment to replace antibodies, infections can usually be prevented, improving the quality of life for people with XLA.


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Plague is a serious bacterial infection that's transmitted by fleas. Known as the Black Death during medieval times, today plague occurs in fewer than 5,000 people a year worldwide. It can be deadly if not treated promptly with antibiotics.The organism that causes plague, Yersinia pestis, lives in small rodents found most commonly in rural and semirural areas of Africa, Asia and the United States. The organism is transmitted to humans who are bitten by fleas that have fed on infected rodents or by humans handling infected animals.The most common form of plague results in swollen and tender lymph nodes — called buboes — in the groin, armpits or neck. The rarest and deadliest form of plague affects the lungs, and it can be spread from person to person.


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Zika (Zee-ka) virus disease is a mosquito-borne viral infection that primarily occurs in tropical and subtropical areas of the world. Most people infected with Zika virus have no signs and symptoms, while others report mild fever, rash and muscle pain. Other signs and symptoms may include headache, red eyes (conjunctivitis) and a general feeling of discomfort.


Zika virus infections during pregnancy have been linked to miscarriage and can cause microcephaly, a potentially fatal congenital brain condition. Zika virus also may cause other neurological disorders such as Guillain-Barre syndrome.


Researchers are working on a Zika virus vaccine. For now the best prevention is to prevent mosquito bites and reduce mosquito habitats.

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A double uterus is a rare congenital abnormality. In a female fetus, the uterus starts out as two small tubes. As the fetus develops, the tubes normally join to create one larger, hollow organ — the uterus.


Sometimes, however, the tubes don't join completely. Instead, each one develops into a separate structure. A double uterus may have one opening (cervix) into one vagina, or each uterine cavity may have a cervix. In many cases, a thin wall of tissue runs down the length of the vagina, dividing it into two separate openings.


Women who have a double uterus often have successful pregnancies. But the condition can increase the risk of miscarriage or premature birth.

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A drug allergy is the abnormal reaction of your immune system to a medication. Any medication — over-the-counter, prescription or herbal — is capable of inducing a drug allergy. However, a drug allergy is more likely with certain medications.


The most common signs and symptoms of drug allergy are hives, rash or fever. A drug allergy may cause serious reactions, including a life-threatening condition that affects multiple body systems (anaphylaxis).


A drug allergy is not the same as a drug side effect, a known possible reaction listed on a drug label. A drug allergy is also different from drug toxicity caused by an overdose of medication.

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Dumping syndrome is a condition that can develop after surgery to remove all or part of your stomach or after surgery to bypass your stomach to help you lose weight. Also called rapid gastric emptying, dumping syndrome occurs when food, especially sugar, moves from your stomach into your small bowel too quickly.


Most people with dumping syndrome develop signs and symptoms, such as abdominal cramps and diarrhea, 10 to 30 minutes after eating. Other people have symptoms one to three hours after eating, and still others have both early and late symptoms.


Generally, you can help prevent dumping syndrome by changing your diet after surgery. Changes might include eating smaller meals and limiting high-sugar foods. In more-serious cases of dumping syndrome, you may need medications or surgery.

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Dust mite allergy is an allergic reaction to tiny bugs that commonly live in house dust. Signs of dust mite allergy include those common to hay fever, such as sneezing and runny nose. Many people with dust mite allergy also experience signs of asthma, such as wheezing and difficulty breathing.


Dust mites, close relatives of ticks and spiders, are too small to see without a microscope. Dust mites eat skin cells shed by people, and they thrive in warm, humid environments. In most homes, such items as bedding, upholstered furniture and carpeting provide an ideal environment for dust mites.


By taking steps to reduce the number of dust mites in your home, you may get control of dust mite allergy. Medications or other treatments are sometimes necessary to relieve symptoms and manage asthma.

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 Central nervous system (CNS) embryonal tumors form in embryonic cells that remain in the brain after birth. CNS embryonal tumors tend to spread through the cerebrospinal fluid (CSF) to other parts of the brain and spinal cord.

The tumors may be malignant (cancer) or benign (not cancer). Most CNS embryonal tumors in children are malignant. Malignant brain tumors are likely to grow quickly and spread into other parts of the brain. When a tumor grows into or presses on an area of the brain, it may stop that part of the brain from working the way it should. Benign brain tumors grow and press on nearby areas of the brain. They rarely spread to other parts of the brain. Both benign and malignant brain tumors can cause signs or symptoms and need treatment.

Although cancer is rare in children, brain tumors are the third most common type of childhood cancer, after leukemia and lymphoma. This summary is about the treatment of primary brain tumors (tumors that begin in the brain). The treatment of metastatic brain tumors, which begin in other parts of the body and spread to the brain, is not discussed in this summary. For information about the different types of brain and spinal cord tumors, see the PDQ summary on Childhood Brain and Spinal Cord Tumors Treatment Overview.

Brain tumors occur in both children and adults. Treatment for adults may be different from treatment for children. See the PDQ summary on Adult Central Nervous System Tumors Treatment for more information on the treatment of adults.

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Epidermolysis bullosa (ep-ih-dur-MOL-uh-sis buhl-LOE-sah) is a group of rare diseases that cause fragile, blistering skin. The blisters may appear in response to minor injury, even from heat, rubbing, scratching or adhesive tape. In severe cases, the blisters may occur inside the body, such as the lining of the mouth or the stomach.


Most types of epidermolysis bullosa are inherited. The condition usually shows up in infancy or early childhood. Some people don't develop signs and symptoms until adolescence or early adulthood.


Epidermolysis bullosa has no cure, though mild forms may improve with age. Treatment focuses on caring for blisters and preventing new ones.

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Congestive Heart Failure (Heart Failure) – Pipeline Review, H2 2017, provides an overview of the Congestive Heart Failure (Heart Failure) (Cardiovascular) pipeline landscape.

Heart failure is also known as congestive heart failure (CHF). CHF is a condition in which the heart is no longer able to pump out enough oxygen-rich blood. Symptoms include cough, fatigue, weakness, faintness, loss of appetite, swollen (enlarged) liver or abdomen, swollen feet and ankles and weight gain. The predisposing factors include high blood pressure, diabetes, sleep apnea, alcohol use and irregular heartbeats. Treatment includes surgery, vasodilator, beta blockers and diuretics.

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Esthesioneuroblastoma (es-THEE-zee-o-NOO-row-blas-TOE-muh) is a rare type of cancer that begins in the upper portion of the nasal cavity.


The area where esthesioneuroblastoma begins is separated from the brain by a bone that contains tiny holes that allow the nerves that control smell (olfactory nerves) to pass through. Esthesioneuroblastoma is also called olfactory neuroblastoma.


Esthesioneuroblastoma, which can occur at any age in adults, generally begins as a tumor in the nasal cavity and may grow or extend into the sinus, eyes and brain. People with esthesioneuroblastoma can lose their sense of smell, have frequent nosebleeds and experience difficulty breathing through their nostrils as the tumor grows.


Esthesioneuroblastoma can also spread to the lymph nodes in the neck and the parotid glands. In advanced cases, esthesioneuroblastoma can spread to other parts of the brain and other parts of the body, such as the lungs, liver and bones.


Esthesioneuroblastoma treatment usually includes surgery. Often, radiation and chemotherapy are recommended, as well.

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Factitious disorder is a serious mental disorder in which someone deceives others by appearing sick, by purposely getting sick or by self-injury. Factitious disorder also can happen when family members or caregivers falsely present others, such as children, as being ill, injured or impaired.


Factitious disorder symptoms can range from mild (slight exaggeration of symptoms) to severe (previously called Munchausen syndrome). The person may make up symptoms or even tamper with medical tests to convince others that treatment, such as high-risk surgery, is needed.


Factitious disorder is not the same as inventing medical problems for practical benefit, such as getting out of work or winning a lawsuit. Although people with factitious disorder know they are causing their symptoms or illnesses, they may not understand the reasons for their behaviors or recognize themselves as having a problem.


Factitious disorder is challenging to identify and hard to treat. However, medical and psychiatric help are critical for preventing serious injury and even death caused by the self-harm typical of this disorder.

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A febrile seizure is a convulsion in a child that may be caused by a spike in body temperature, often from an infection. Your child's having a febrile seizure can be alarming, and the few minutes it lasts can seem like an eternity.


Febrile seizures represent a unique response of a child's brain to fever, usually the first day of a fever. Fortunately, they're usually harmless and typically don't indicate an ongoing problem. You can help by keeping your child safe during a febrile seizure and by comforting him or her afterward.

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A sexual problem, or sexual dysfunction, refers to a problem during any phase of the sexual response cycle that prevents the individual or couple from experiencing satisfaction from the sexual activity. The sexual response cycle has four phases: excitement, plateau, orgasm, and resolution.


While research suggests that sexual dysfunction is common (43% of women and 31% of men report some degree of difficulty), it is a topic that many people are hesitant or embarrassed to discuss. Fortunately, most cases of sexual dysfunction are treatable, so it is important to share your concerns with your partner and doctor.

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Fibromuscular dysplasia is a condition that causes narrowing (stenosis) and enlargement (aneurysm) of the medium-sized arteries in your body. Reduced blood flow from narrowed arteries to the organs can affect the function of the organs.


Fibromuscular dysplasia appears most commonly in the arteries leading to the kidneys. Fibromuscular dysplasia can also affect the arteries leading to your brain, heart, abdomen, arms and legs.


Fibromuscular dysplasia can cause a number of complications, such as high blood pressure or tears of the artery (arterial dissection), if left untreated. Arterial dissection, or spontaneous coronary artery dissection (SCAD), can limit blood flow to the organ supplied by the injured artery.

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Fibrous dysplasia is an uncommon bone disorder in which scar-like (fibrous) tissue develops in place of normal bone. This irregular tissue can weaken the affected bone and cause it to deform or fracture.


In most cases, fibrous dysplasia occurs at a single site in one bone, but can occur at multiple sites in multiple bones. Single bone involvement usually occurs in adolescents and young adults. People who have more than one affected bone typically develop symptoms before the age of 10.


Although fibrous dysplasia is a genetic disorder, it's caused by a gene mutation that's not passed from parent to child. There's no cure for the disorder. Treatment, which may include surgery, focuses on relieving pain and repairing or stabilizing bones.

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Folliculitis is an inflammatory condition affecting hair follicles. It appears as a small red tender bump occasionally surmounted with dot of pus surrounding a hair. Older lesions that have lost the pus appear as red bumps surrounding the opening of the follicle absent the hair. One to hundreds of follicles can be affected anywhere that hair is present. Actually, acne vulgaris, the facial rash that teenagers develop, is a type of folliculitis.


Depending on the cause and severity of folliculitis, it may require no treatment and resolve spontaneously, or it may require treatment with powerful antibiotics or other drugs.

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Frozen shoulder is the common name for adhesive capsulitis, which is a shoulder condition that limits your range of motion. When the tissues in your shoulder joint become thicker and tighter, scar tissue develops over time. As a result, your shoulder joint doesn’t have enough space to rotate properly. Common symptoms include swelling, pain, and stiffness. You’re more likely to have the condition if you’re between the ages of 40 and 60.

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Gaucher (go-SHAY) disease is the result of a buildup of certain fatty substances in certain organs, particularly your spleen and liver. This causes these organs to enlarge and can affect their function.


The fatty substances also can build up in bone tissue, weakening the bone and increasing the risk of fractures. If the bone marrow is affected, it can interfere with your blood's ability to clot.


An enzyme that breaks down these fatty substances doesn't work properly in people with Gaucher disease. Treatment often includes enzyme replacement therapy.


An inherited disorder, Gaucher disease is most common in Jewish people of Eastern and Central European descent (Ashkenazi). Symptoms can appear at any age.

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Geographic tongue is the name of a condition that gets its name from its map-like appearance on the upper surface and sides of the tongue. It may occur in other areas of your mouth, as well.


You'll be relieved to know that geographic tongue is a harmless, benign condition that isn't linked to any infection or cancer. Two other names for geographic tongue are benign migratory glossitis and erythema migrans.


Affecting about 1% to 3% of people, geographic tongue can show up at any age. However, it tends to affect middle-aged or older adults more often. It appears to be more common in women than in men.

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Germ cell tumors are growths that form from reproductive cells. Tumors may be cancerous or noncancerous. Most germ cell tumors that are cancerous occur as cancer of the testicles (testicular cancer) or cancer of the ovaries (ovarian cancer).


Some germ cell tumors occur in other areas of the body, such as the abdomen, brain and chest, though it's not clear why. Germ cell tumors that occur in places other than the testicles and ovaries (extragonadal germ cell tumors) are very rare.


Germ cell tumors tend to respond to treatment and many can be cured, even when diagnosed at a late stage.

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Glomerulonephritis (gloe-mer-u-low-nuh-FRY-tis) is inflammation of the tiny filters in your kidneys (glomeruli). Glomeruli remove excess fluid, electrolytes and waste from your bloodstream and pass them into your urine. Glomerulonephritis can come on suddenly (acute) or gradually (chronic).


Glomerulonephritis occurs on its own or as part of another disease, such as lupus or diabetes. Severe or prolonged inflammation associated with glomerulonephritis can damage your kidneys. Treatment depends on the type of glomerulonephritis you have.

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A grand mal seizure causes a loss of consciousness and violent muscle contractions. It's the type of seizure most people picture when they think about seizures.


A grand mal seizure — also known as a generalized tonic-clonic seizure — is caused by abnormal electrical activity throughout the brain. Usually, a grand mal seizure is caused by epilepsy. But sometimes, this type of seizure can be triggered by other health problems, such as extremely low blood sugar, a high fever or a stroke.


Many people who have a grand mal seizure never have another one and don't need treatment. But someone who has recurrent seizures may need treatment with daily anti-seizure medications to control and prevent future grand mal seizures.


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Granuloma annulare (gran-u-LOW-muh an-u-LAR-e) is a skin condition that most commonly consists of raised, reddish or skin-colored bumps (lesions) that form ring patterns — usually on your hands and feet.


No one knows exactly what causes granuloma annulare. But it may be triggered by minor skin injuries and certain medications. Some types of granuloma annulare affect adults, and others typically affect children.


In most cases, granuloma annulare isn't itchy or painful, so no treatment is necessary. The lesions usually disappear on their own within two years. If you're bothered by how your skin looks, your doctor can prescribe medications that will speed the disappearance of the lesions.

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Greenstick fractures occur when the force applied to a bone results in bending of the bone such that the structural integrity of the convex surface is overcome. The fact that the integrity of the cortex has been overcome results in fracture of the convex surface. However, the bending force applied does not break the bone completely and the concave surface of the bent bone remains intact.


This can occur following an angulated longitudinal force applied down the bone (e.g. an indirect trauma following a fall on an outstretched arm), or after a force applied perpendicular to the bone (e.g. a direct blow).


This fracture is very different, and much less common, than the torus fracture that results in buckling of the cortex on the concave side of the bend and an intact concave surface.

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The hamstrings are the tendons that attach the large muscles at the back of the thigh to bone. The hamstring muscles are the large muscles that pull on these tendons. It has become common in layman's terminology (and by some medical personnel) to refer to the long muscles at the back of the thigh as the "hamstrings" or "hamstring muscles." Academic anatomists refer to them as the posterior thigh muscles, and more specifically as the semimembranosus, the semitendinosus, and the biceps femoris muscles. These muscles span the thigh, crossing both the hip and the knee. They originate or begin at just below the buttocks, arising from the bone on which we sit (the ischium). They connect by means of their tendons onto the upper parts of the lower leg bones (the tibia and the fibula).


The origin of the word hamstring comes from the old English hamm, meaning thigh. String refers to the characteristic appearance and feel of the tendons just above the back of the knee. Although the tendons are sometimes involved in injuries, this article will refer to the "hamstrings" as the large muscle group at the back of the thigh because the most frequent problems involve this muscle group.

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Heat exhaustion is a condition whose symptoms may include heavy sweating and a rapid pulse, a result of your body overheating. It's one of three heat-related syndromes, with heat cramps being the mildest and heatstroke being the most severe.


Causes of heat exhaustion include exposure to high temperatures, particularly when combined with high humidity, and strenuous physical activity. Without prompt treatment, heat exhaustion can lead to heatstroke, a life-threatening condition. Fortunately, heat exhaustion is preventable.

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A cough is a common reflex action that clears the throat of mucus or foreign irritants. Coughing to clear the throat is typically an infrequent action, although a number of conditions can cause more frequent bouts of coughing.


In general, a cough that lasts for less than three weeks is an acute cough.


A cough that lasts between 3 and 8 weeks, improving by the end of that period, is a subacute cough.


A persistent cough that lasts more than eight weeks is a chronic cough.


Most cough episodes will clear up, or at least significantly improve, within two weeks. If you cough up blood or have a “barking” cough, talk to your doctor. Any cough that hasn’t improved after a few weeks may be serious, and you should see a doctor.

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Hidradenitis suppurativa (hi-drad-uh-NIE-tis sup-yoo-ruh-TIE-vuh) is rare, long-term skin condition that features small, painful lumps under the skin. They typically develop where the skin rubs together, such as the armpits, the groin, between the buttocks and under the breasts. The lumps may break open and smell or cause tunnels under the skin.


Hidradenitis suppurativa tends to start after puberty. It can persist for many years and worsen over time, with serious effects on your daily life and emotional well-being. Early diagnosis and treatment can help manage the symptoms, keep new lumps from forming and prevent complications, such as scar

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A hip fracture is a serious injury, with complications that can be life-threatening. The risk of hip fracture rises with age.


Older people are at a higher risk of hip fracture because bones tend to weaken with age (osteoporosis). Multiple medications, poor vision and balance problems also make older people more likely to trip and fall — one of the most common causes of hip fracture.


A hip fracture almost always requires surgical repair or replacement, followed by months of physical therapy. Taking steps to maintain bone density and avoid falls can help prevent hip fracture.

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Hirsutism (HUR-soot-iz-um) is a condition of unwanted, male-pattern hair growth in women. Hirsutism results in excessive amounts of dark, course hair on body areas where men typically grow hair — face, chest and back.


The amount of body hair you have is largely determined by your genetic makeup. There's a wide range of normal hair distribution, thickness and color due to differences in heredity. However, hirsutism is a medical condition that can arise from excess male hormones called androgens, primarily testosterone. It can also be due to a family trait.

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Hunter syndrome is a very rare, inherited genetic disorder caused by a missing or malfunctioning enzyme. Because the body doesn't have enough of the enzyme to break down certain complex molecules, the molecules build up in harmful amounts.


In Hunter syndrome, the buildup of massive amounts of these harmful substances eventually causes permanent, progressive damage affecting appearance, mental development, organ function and physical abilities.


Hunter syndrome appears in children as young as 18 months. It mainly occurs in boys, although very rarely it has been observed in girls.


There's no cure for Hunter syndrome. Treatment of Hunter syndrome involves management of symptoms and complications.

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Huntington's disease (HD) is a neurological condition. It is an inherited disease that happens due to faulty genes. Toxic proteins collect in the brain and cause damage, leading to neurological symptoms.


As parts of the brain deteriorate, this affects movement, behavior, and cognition. It becomes harder to walk, think, reason, swallow, and talk. Eventually, the person will need full-time care. The complications are usually fatal.


There is currently no cure, but treatment can help with symptoms.

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The term hydrocephalus is derived from the Greek words "hydro" meaning water and "cephalus" meaning head. As the name implies, it is a condition in which the primary characteristic is excessive accumulation of fluid in the brain. Although hydrocephalus was once known as "water on the brain," the "water" is actually cerebrospinal fluid (CSF)--a clear fluid that surrounds the brain and spinal cord. The excessive accumulation of CSF results in an abnormal widening of spaces in the brain called ventricles. This widening creates potentially harmful pressure on the tissues of the brain.


The ventricular system is made up of four ventricles connected by narrow passages.. Normally, CSF flows through the ventricles, exits into cisterns (closed spaces that serve as reservoirs) at the base of the brain, bathes the surfaces of the brain and spinal cord, and then reabsorbs into the bloodstream.


CSF has three important life-sustaining functions: 1) to keep the brain tissue buoyant, acting as a cushion or "shock absorber"; 2) to act as the vehicle for delivering nutrients to the brain and removing waste; and 3) to flow between the cranium and spine and compensate for changes in intracranial blood volume (the amount of blood within the brain).


The balance between production and absorption of CSF is critically important. Because CSF is made continuously, medical conditions that block its normal flow or absorption will result in an over-accumulation of CSF. The resulting pressure of the fluid against brain tissue is what causes hydrocephalus.

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Hypopituitarism is a rare disorder in which your pituitary gland either fails to produce one or more of its hormones or doesn't produce enough of them.


The pituitary gland is a small bean-shaped gland situated at the base of your brain, behind your nose and between your ears. Despite its size, this gland secretes hormones that influence nearly every part of your body.


In hypopituitarism, you have a short supply of one or more of these pituitary hormones. This deficiency can affect any number of your body's routine functions, such as growth, blood pressure and reproduction.


You'll likely need medications for the rest of your life to treat hypopituitarism, but your symptoms can be controlled.


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Ichthyosis (ick-thee-OH-sis) is a group of skin diseases that causes extremely dry, thick, and scaly skin. The skin often looks like it has fish scales.


There are more than 20 different types of ichthyosis. The most common type is ichthyosis vulgaris (vul-GAR-ris). About 95% of people who develop ichthyosis get this type.


The other types are rare and include harlequin ichthyosis, lamellar type, and x-linked ichthyosis.

Of all the types, ichthyosis vulgaris is the mildest. It often begins in childhood.

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Jaundice is particularly common in premature babies - boys more often than girls. It usually appears within the baby's first week of life.


In an otherwise healthy baby born at full term, infant jaundice is rarely a cause for alarm; it tends to go away on its own. However, if treatment is necessary, infants tend to respond to non-invasive therapy.


In rare cases, untreated infant jaundice may lead to brain damage and even death.

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Infant reflux occurs when food backs up (refluxes) from a baby's stomach, causing the baby to spit up. Sometimes called gastroesophageal reflux (GER), the condition is rarely serious and becomes less common as a baby gets older. It's unusual for infant reflux to continue after age 18 months.


Reflux occurs in healthy infants multiple times a day. As long as your baby is healthy, content and growing well, the reflux is not a cause for concern.


Rarely, infant reflux can be a sign of a medical problem, such as an allergy, a blockage in the digestive system or gastroesophageal reflux disease (GERD).

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Infectious diseases kill more people worldwide than any other single cause. Infectious diseases are caused by germs. Germs are tiny living things that are found everywhere - in air, soil and water. You can get infected by touching, eating, drinking or breathing something that contains a germ. Germs can also spread through animal and insect bites, kissing and sexual contact. Vaccines, proper hand washing and medicines can help prevent infections.

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You can also catch flu by touching an infected person, for instance, shaking hands. Adults are contagious 1-2 days before getting symptoms and up to 7 days after becoming ill. This means that you can spread the influenza virus before you even know you are infected.


In this article, we explain the symptoms of flu, how it is treated, how it differs from a cold, and the best ways to prevent flu occurring.

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An inguinal hernia occurs in the abdomen near the groin area. They develop when fatty or intestinal tissues push through a weakness in the abdominal wall near the right or left inguinal canal. Each inguinal canal resides at the base of the abdomen.


Both men and woman have inguinal canals. In men, the testes usually descend through their canal by around a few weeks before birth. In women, each canal is the location of passage for the round ligament of the uterus. If you have a hernia in or near this passageway, it results in a protruding bulge. It may be painful during movement.


Many people don’t seek treatment for this type of hernia because it may be small or not cause any symptoms. Prompt medical treatment can help prevent further protrusion and discomfort.

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Interstitial (in-tur-STISH-ul) lung disease describes a large group of disorders, most of which cause progressive scarring of lung tissue. The scarring associated with interstitial lung disease eventually affects your ability to breathe and get enough oxygen into your bloodstream.


Interstitial lung disease can be caused by long-term exposure to hazardous materials, such as asbestos. Some types of autoimmune diseases, such as rheumatoid arthritis, also can cause interstitial lung disease. In some cases, however, the causes remain unknown.


Once lung scarring occurs, it's generally irreversible. Medications may slow the damage of interstitial lung disease, but many people never regain full use of their lungs. Lung transplant is an option for some people who have interstitial lung disease.

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Digested food particles must travel through 25 feet or more of intestines as part of normal digestion. These digested wastes are constantly in motion. However, intestinal obstruction can put a stop to this. An intestinal obstruction occurs when your small or large intestine is blocked. The blockage can be partial or total, and it prevents passage of fluids and digested food.


If intestinal obstruction happens, food, fluids, gastric acids, and gas build up behind the site of the blockage. If enough pressure builds up, your intestine can rupture, leaking harmful intestinal contents and bacteria into your abdominal cavity. This is a life-threatening complication.


There are many potential causes of intestinal obstruction. Often, this condition can’t be prevented. Early diagnosis and treatment are crucial. An untreated intestinal obstruction can be fatal.

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Intussusception (in-tuh-suh-SEP-shun) is the most common abdominal emergency affecting children under 2 years old. It happens when one portion of the bowel slides into the next, much like the pieces of a telescope.


When this "telescoping" happens, the flow of fluids and food through the bowel can become blocked, the intestine can swell and bleed, and the blood supply to the affected part of the intestine can get cut off. Eventually, this can cause part of the bowel to die.


Intussusception happens in 1 to 4 out of every 1,000 infants and is most common in babies 5 to 9 months old, though older children also can have it. Boys get intussusception more often than girls.

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Invasive lobular carcinoma is a type of breast cancer that begins in the milk-producing glands (lobules) of the breast.


Invasive cancer means the cancer cells have broken out of the lobule where they began and have the potential to spread to the lymph nodes and other areas of the body.


Invasive lobular carcinoma makes up a small portion of all breast cancers. The most common type of breast cancer begins in the breast ducts (invasive ductal carcinoma).


Invasive lobular carcinoma typically doesn't form a lump, which is common in breast cancer. Instead, there is a change in the breast that feels like a thickening or fullness in one part of the breast and is different from the surrounding breast tissue.

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Juvenile-onset fibromyalgia (JFM) is a poorly understood chronic pain condition most commonly affecting adolescent girls. The condition is characterized by widespread musculoskeletal pain and other associated symptoms, including fatigue, nonrestorative sleep, headaches, irritable bowel symptoms, dysautonomia and mood disorders such as anxiety and/or depression. In the past few years, there has been a greater focus on understanding JFM in adolescents. Research studies have provided insight into the clinical characteristics of this condition and its effect on both short-term and long-term psychosocial and physical functioning. The importance of early and effective intervention is being recognized, as research has shown that symptoms of JFM tend to persist and do not resolve over time as was previously believed. Efforts to improve treatments for JFM are underway, and new evidence strongly points to the potential benefits of cognitive–behavioural therapy on improving mood and daily functioning. Research into pharmacotherapy and other nonpharmacological options is in progress. Advancements in the understanding of adult fibromyalgia have paved the way for future studies on diagnosis, assessment and management of JFM. This Review focuses on our current knowledge of the condition, provides an update of the latest research advances, and highlights areas for further study.

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We see through the cornea, which is the clear outer lens or "windshield" of the eye. Normally, the cornea has a dome shape, like a ball. Sometimes, however, the structure of the cornea is just not strong enough to hold this round shape and the cornea bulges outward like a cone. This condition is called keratoconus.

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A bursa is a closed, fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body. Bursae is plural for bursa. The major bursae are located adjacent to the tendons near the large joints, such as the shoulders, elbows, hips, and knees. When a bursa becomes inflamed, the condition is known as bursitis. Most commonly, bursitis is caused by local soft-tissue trauma or strain injury, and there is no infection (aseptic bursitis). On rare occasions, particularly when the immune system is suppressed, the bursa can become infected with bacteria. This condition is called septic bursitis.

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Leukoplakia is a condition in which thick, white patches form on your tongue and the lining of your mouth. Smoking is the most common cause. But other irritants can result in this condition as well.


Mild leukoplakia is usually harmless and often goes away on its own. More serious cases may be linked to oral cancer. These must be treated promptly.

Regular dental care can help prevent recurrences.

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Lichen nitidus is an unusual/ rare non-infectious skin condition most commonly seen in children. It occurs in the form of hundreds and hundreds of tiny grids of bumps over the skin. They are often found in tight groups that appear like a big patch.


The arms and the folds of the skin are most commonly affected, but they can occur anywhere in the body. In fairer skinned people, these bumps are slightly reddish in color, whereas in darker skinned people, the bumps may vary between lighter or darker in color than the normal skin.

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Lichen sclerosus (LIE-kun skluh-ROW-sus) is an uncommon condition that creates patchy, white skin that's thinner than normal. Lichen sclerosus can affect skin anywhere on your body. But it most often involves skin of the vulva, foreskin of the penis or skin around the anus.


Anyone can get lichen sclerosus but postmenopausal women have a high risk.


Sometimes lichen sclerosus improves on its own, and you won't need any treatment. If you do need treatment, your doctor can suggest options to return a more normal appearance to your skin and decrease the tendency for scarring.

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Each strand of hair is made up of the medulla, cortex, and cuticle.[4] The innermost region, the medulla, is not always present and is an open, unstructured region.[5] The highly structural and organized cortex, or middle layer of the hair, is the primary source of mechanical strength and water uptake. The cortex contains melanin, which colors the fiber based on the number, distribution and types of melanin granules. The shape of the follicle determines the shape of the cortex, and the shape of the fiber is related to how straight or curly the hair is. People with straight hair have round hair fibers. Oval and other shaped fibers are generally more wavy or curly. The cuticle is the outer covering. Its complex structure slides as the hair swells and is covered with a single molecular layer of lipid that makes the hair repel water.[4] The diameter of human hair varies from 0.017 to 0.18 millimeters (0.00067 to 0.00709 in).[6] There are two million small, tubular glands and sweat glands that produce watery fluids that cool the body by evaporation. The glands at the opening of the hair produce a fatty secretion that lubricates the hair.[7]


Hair growth begins inside the hair follicle. The only "living" portion of the hair is found in the follicle. The hair that is visible is the hair shaft, which exhibits no biochemical activity and is considered "dead". The base of a hair's root (the "bulb") contains the cells that produce the hair shaft.[8] Other structures of the hair follicle include the oil producing sebaceous gland which lubricates the hair and the arrector pili muscles, which are responsible for causing hairs to stand up. In humans with little body hair, the effect results in goose bumps.

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Answer: Low sperm count implies that the fluids (semen) you ejaculate in the course of an orgasm consist of lesser sperm when compared with normal.


A low sperm count can be referred to as oligospermia. A total lack of sperm is known as Azoospermia. Your own sperm count is regarded as less than normal when you have less than fifteen million sperm per millilitre of semen.


Having a low sperm count reduces the chances that one of your own sperm will certainly fertilize the partner’s egg, leading to pregnancy. Nevertheless, numerous males that have a low sperm count will still be in a position to father a baby.

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Lupus nephritis is inflammation of the kidney that is caused by systemic lupus erythematous (SLE). Also called lupus, SLE is an autoimmune disease. With lupus, the body's immune system targets its own body tissues. Lupus nephritis happens when lupus involves the kidneys.


Up to 60% of lupus patients will develop lupus nephritis. When the kidneys are inflamed, they can't function normally and can leak protein. If not controlled, lupus nephritis can lead to kidney failure.

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Mammary duct ectasia (ek-TAY-zhuh) occurs when a milk duct beneath your nipple widens, the duct walls thicken and the duct fills with fluid. The milk duct may become blocked or clogged with a thick, sticky substance. The condition often causes no symptoms, but some women may have nipple discharge, breast tenderness or inflammation of the clogged duct (periductal mastitis).

Mammary duct ectasia most often occurs in women of perimenopausal age — around 45 to 55 years — but it can happen after menopause, too. The condition sometimes improves without treatment. If symptoms persist, you may need antibiotics or possibly surgery to remove the affected milk duct.Though it's normal to worry about any changes in your breasts, mammary duct ectasia and periductal mastisis aren't risk factors for breast cancer


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MEdulloblastoma is a cancerous tumor—also called cerebellar primitive neuroectodermal tumor (PNET)—that starts in the region of the brain at the base of the skull, called the posterior fossa. These tumors tend to spread to other parts of the brain and to the spinal cord


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Membranous nephropathy (MEM-bruh-nus nuh-FROP-uh-thee) occurs when the small blood vessels in the kidney (glomeruli), which filter wastes from the blood, become damaged and thickened. As a result, proteins leak from the damaged blood vessels into the urine (proteinuria). For many, loss of these proteins eventually causes signs and symptoms known as nephrotic syndrome.In mild cases, membranous nephropathy may get better on its own, without any treatment. As protein leakage increases, so does the risk of long-term kidney damage. In many, the disease ultimately leads to kidney failure. There's no absolute cure for membranous nephropathy, but successful treatment can lead to remission of proteinuria and a good long-term outlook.


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Migraine with aura (also called classic migraine) is a headache that strikes after or along with sensory disturbances called aura. These disturbances can include flashes of light, blind spots and other vision changes or tingling in your hand or face.Treatments for migraine with aura and migraine without aura (also called common migraine) are usually the same. You can try to prevent migraine with aura with the same medications and self-care measures used to prevent migraine.

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Dandruff is a skin condition that affects mainly the scalp. Symptoms include flaking and sometimes mild itchiness.It can result in social or self-esteem problems. A more severe form of the condition, which includes inflammation of the skin, is known as seborrheic dermatitis.


The cause is unclear but believed to involve a number of genetic and environmental factors. The condition may worsen in the winter.It is not due to poor hygiene. The underlying mechanism involves the over growth of skin cells.Diagnosis is based on symptoms.


There is no known cure.The typical treatment is with antifungal cream such as ketoconazole. Dandruff affects about half of adults. Onset is usually at puberty. Males are more often affected than females.Rates decrease after the age of 50.


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Molluscum contagiosum is an infection caused by a poxvirus (molluscum contagiosum virus). The result of the infection is usually a benign, mild skin disease characterized by lesions (growths) that may appear anywhere on the body. Within 6-12 months, Molluscum contagiosum typically resolves without scarring but may take as long as 4 years.The lesions, known as Mollusca, are small, raised, and usually white, pink, or flesh-colored with a dimple or pit in the center. They often have a pearly appearance. They’re usually smooth and firm. In most people, the lesions range from about the size of a pinhead to as large as a pencil eraser (2 to 5 millimeters in diameter). They may become itchy, sore, red, and/or swollen.Mollusca may occur anywhere on the body including the face, neck, arms, legs, abdomen, and genital area, alone or in groups. The lesions are rarely found on the palms of the hands or the soles of the feet.


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Infectious mononucleosis (mono) is often called the kissing disease. The virus that causes mono is transmitted through saliva, so you can get it through kissing, but you can also be exposed through a cough or sneeze, or by sharing a glass or food utensils with someone who has mono. However, mononucleosis isn't as contagious as some infections, such as the common cold.You're most likely to get mononucleosis with all the signs and symptoms if you're an adolescent or young adult. Young children usually have few symptoms, and the infection often goes unrecognized.If you have mononucleosis, it's important to be careful of certain complications such as an enlarged spleen. Rest and adequate fluids are key to recovery.

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Mouth cancer, also known as oral cancer, is where a tumour develops in the lining of the mouth. It may be on the surface of the tongue, the insides of the cheeks, the roof of the mouth (palate), or the lips or gums.Tumours can also develop in the glands that produce saliva, the tonsils at the back of the mouth, and the part of the throat connecting your mouth to your windpipe (pharynx). However, these are less common.

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Multiple myeloma is a cancer that forms in a type of white blood cell called a plasma cell. Plasma cells help you fight infections by making antibodies that recognize and attack germs.Multiple myeloma causes cancer cells to accumulate in the bone marrow, where they crowd out healthy blood cells. Rather than produce helpful antibodies, the cancer cells produce abnormal proteins that can cause complications.Treatment for multiple myeloma isn't always necessary for people who aren't experiencing any signs or symptoms. For people with multiple myeloma who require treatment, a number of treatments are available to help control the disease.

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Multiple sclerosis (MS) is a potentially disabling disease of the brain and spinal cord (central nervous system).In MS, the immune system attacks the protective sheath (myelin) that covers nerve fibers and causes communication problems between your brain and the rest of your body. Eventually, the disease can cause the nerves themselves to deteriorate or become permanently damaged.Signs and symptoms of MS vary widely and depend on the amount of nerve damage and which nerves are affected. Some people with severe MS may lose the ability to walk independently or at all, while others may experience long periods of remission without any new symptoms.There's no cure for multiple sclerosis. However, treatments can help speed recovery from attacks, modify the course of the disease and manage symptoms.

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Myoclonus refers to a sudden, brief, and involuntary muscle jerk. Healthy people can have myoclonus in the form of hiccups and “sleep starts”, which are the sudden jerky sensations that can occur as people fall asleep. Myoclonus can also occur due to underlying neurological disorders such as epilepsy, metabolic conditions, or adverse reactions to medications. Importantly, myoclonus is a symptom, not a diagnosis of a disease.Sudden positive muscle contractions are called positive myoclonus, whereas muscle relaxation is called negative myoclonus. Myoclonus can vary in frequency, and can occur alone or in a sequence. There are several underlying conditions that can give rise to myoclonus symptoms. Doctors aim to isolate and treat the underlying cause of myoclonus symptoms. When the underlying cause cannot be treated or cured, the aim of treatment is to alleviate severe myoclonus

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Neurodermatitis is a skin condition that begins with an itch.The itch can develop anywhere on the surface of the body. Most commonly, though, an itchy patch develops on an arm, leg, or the back of the neck. It also commonly develops in the anal and genital areas. When it appears in the genital area, it often appears on the scrotum or vulva.The itch can be so intense that a person scratches or rubs the itchy patch frequently. The itch can also come and go. For most people, the area feels itchiest when they are relaxing or sleeping. The itch causes people to scratch or rub the area while sleeping — and it can awaken someone from a sound sleep.Quite often, the itch begins during an especially stressful time in someone’s life. Even when the stress subsides, the itch usually continues. Scratching or rubbing can change the appearance of that itchy patch.

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Neuroendocrine tumors are abnormal growths that begin in specialized cells called neuroendocrine cells. Neuroendocrine cells have traits similar to nerve cells and to hormone-producing cells.Neuroendocrine tumors are rare and can occur anywhere in the body. Most neuroendocrine tumors occur in the lungs, appendix, small intestine, rectum and pancreas.Neuroendocrine tumors can be noncancerous (benign) or cancerous (malignant).Diagnosis and treatment of neuroendocrine tumors depend on the type of tumor, its location, whether it produces excess hormones, how aggressive it is and whether it has spread to other parts of the body

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Neurofibromatosis is a genetic disorder that causes tumors to form on nerve tissue. These tumors can develop anywhere in your nervous system, including your brain, spinal cord and nerves. Neurofibromatosis is usually diagnosed in childhood or early adulthood.The tumors are usually noncancerous (benign), but sometimes can become cancerous (malignant). Symptoms are often mild. However, complications of neurofibromatosis can include hearing loss, learning impairment, heart and blood vessel (cardiovascular) problems, loss of vision, and severe pain.Neurofibromatosis treatment aims to maximize healthy growth and development and to manage complications as soon as they arise. When neurofibromatosis causes large tumors or tumors that press on a nerve, surgery can help ease symptoms. Some people may benefit from other therapies, such as stereotactic radiosurgery or medications to control pain.

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Nonulcer stomach pain is a term for recurring signs and symptoms of indigestion that have no obvious cause. Nonulcer stomach pain is also called functional dyspepsia (dis-PEP-see-uh) or nonulcer dyspepsia.Nonulcer stomach pain is common and can be long lasting. The condition can cause signs and symptoms that resemble those of an ulcer, such as pain or discomfort in your upper abdomen, often accompanied by bloating, belching and nausea.

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Norovirus infection can cause the sudden onset of severe vomiting and diarrhea. The virus is highly contagious and commonly spread through food or water that is contaminated during preparation or contaminated surfaces. You can also be infected through close contact with an infected person.Diarrhea, abdominal pain and vomiting typically begin 12 to 48 hours after exposure. Norovirus symptoms last one to three days, and most people recover completely without treatment. However, for some people — especially infants, older adults and people with underlying disease — vomiting and diarrhea can be severely dehydrating and require medical attention.Norovirus infection occurs most frequently in closed and crowded environments such as hospitals, nursing homes, child care centers, schools and cruise ships.

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Occupational asthma is asthma that's caused or worsened by breathing in chemical fumes, gases, dust or other substances on the job. Like other types of asthma, occupational asthma can cause chest tightness, wheezing and shortness of breath.When treated early, occupational asthma may be reversible. Long-term exposure to allergy-causing substances can cause worsening symptoms and lifelong asthma.Treatment for occupational asthma is similar to treatment for other types of asthma, and it generally includes taking medications to reduce symptoms. But the only sure way to eliminate your symptoms and prevent lung damage due to occupational asthma is to avoid whatever's triggering it.

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Ocular rosacea is inflammation that causes redness, burning and itching of the eyes. It often develops in people who have rosacea, a chronic skin condition that affects the face. Sometimes ocular, or eye, rosacea is the first sign that you may later develop the facial type.Ocular rosacea (roe-ZAY-she-uh) primarily affects adults between the ages of 30 and 50. It seems to develop in people who tend to blush and flush easily.Medications and a good eye-care routine can help control the signs and symptoms. But treatment doesn't cure ocular rosacea. It often recurs after an apparent remission.

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Optic neuritis is an inflammation that damages the optic nerve, a bundle of nerve fibers that transmits visual information from your eye to your brain. Pain and temporary vision loss in one eye are common symptoms of optic neuritis.

Optic neuritis is linked to multiple sclerosis (MS), a disease that causes inflammation and damage to nerves in your brain and spinal cord. Signs and symptoms of optic neuritis can be the first indication of multiple sclerosis, or they can occur later in the course of MS. Besides MS, optic neuritis can occur with other infections or immune diseases, such as lupus.

Most people who have a single episode of optic neuritis eventually recover their vision. Treatment with steroid medications may speed up vision recovery after optic neuritis.

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Lichen planus is an itchy skin rash that is caused by an immune response. It can occur anywhere on your skin.oral lichen planusIn cases of oral lichen planus, the mucous membranes inside your mouth are the only area affected. Oral lichen planus presents symptoms different from other cases of lichen planus. Instead of a rash, people may experience swollen tissues, white patches, and open sores.Oral lichen planus isn’t contagious, and it can’t be spread to another person.

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Oral thrush — also called oral candidiasis (kan-dih-DIE-uh-sis) — is a condition in which the fungus Candida albicans accumulates on the lining of your mouth. Candida is a normal organism in your mouth, but sometimes it can overgrow and cause symptoms.Oral thrush causes creamy white lesions, usually on your tongue or inner cheeks. Sometimes oral thrush may spread to the roof of your mouth, your gums or tonsils, or the back of your throat.Although oral thrush can affect anyone, it's more likely to occur in babies and older adults because they have reduced immunity; in other people with suppressed immune systems or certain health conditions; or people who take certain medications. Oral thrush is a minor problem if you're healthy, but if you have a weakened immune system, symptoms may be more severe and difficult to control.


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Both benign (non-cancerous) and cancerous salivary gland tumors may develop anywhere in the salivary glands, but the majority of them are parotid tumors. In fact, as many as 80% of salivary gland tumors begin in the parotid glands. 15% occur in the submandibular glands, and 5% form in the sublingual and minor glands. While most salivary gland tumors occur in the parotid glands, only 20% of them are cancerous. With this in mind, we want to stress that it is important that you come see us if you are find a mass in your parotid gland so we can perform a biopsy. This will allow us to determine whether a growth is cancerous or not, and in turn come up with a treatment plan that may require parotid surgery on the tumor.

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Parvovirus infection is a common and highly contagious childhood ailment — sometimes called slapped-cheek disease because of the distinctive face rash that develops. Parvovirus infection has also been known as fifth disease because, historically, it was one of five common childhood illnesses characterized by a rash.In most children, parvovirus infection is mild and requires little treatment. However, in some adults, the infection can be serious. Parvovirus infection in some pregnant women can lead to serious health problems for the fetus. Parvovirus infection is also more serious for people with some kinds of anemia or who have a compromised immune system.

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Many schools have declared that they are “nut-free,” meaning that the onetime staple of kids’ lunchboxes — a peanut butter and jelly sandwich — is nowhere to be found on school grounds these days. That’s because peanuts can cause a life-threatening reaction in some people. Peanuts are one of the food allergens most commonly associated with anaphylaxis, a sudden and potentially deadly condition that requires immediate attention and treatment.In recent years, awareness about peanut allergy in children has risen, as has the number of peanut allergy cases reported. In May 2010, a study noted that the rate of peanut allergies in children, as reported in a telephone survey, had more than tripled between 1997 and 2008.There are several misconceptions about peanut allergies. A peanut is a legume (belonging to the same family as soybeans, peas and lentils), not a tree nut. And while it was previously believed that an allergy to peanuts was lifelong, research by the National Institutes of Health shows that about 20 percent of individuals with a peanut allergy eventually outgrow it.


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Pectus carinatum, sometimes called pigeon chest, is a non-life-threatening condition. It’s marked by an abnormally outward protruding breastbone caused by rapid cartilage growth forcing the chest cavity outward. Occasionally, symptoms are present from birth or early childhood, but it’s most commonly diagnosed around 11 or 12 years of age.For most children, pectus carinatum is an aesthetic issue only. This condition frequently results in an asymmetrical chest. In more severe cases, symptoms may also include difficulty breathing during physical activities, recurring respiratory infections, and asthma.While its cause is unknown, it appears to be more common in boys, and there seems to be a hereditary component. If needed, treatment for pectus carinatum usually includes wearing a brace for children whose bones are still developing. But it can also include surgery for severe cases.

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Pectus excavatum is a condition in which a person's breastbone is sunken into his or her chest. In severe cases, pectus excavatum can look as if the center of the chest has been scooped out, leaving a deep dent.While the sunken breastbone is often noticeable shortly after birth, the severity of pectus excavatum typically worsens during the adolescent growth spurt.Also called funnel chest, pectus excavatum is more common in boys than in girls. Severe cases of pectus excavatum can eventually interfere with the function of the heart and lungs. But even mild cases of pectus excavatum can make children feel self-conscious about their appearance. Surgery can correct the deformity.

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Pediatric brain tumors are masses or growths of abnormal cells that occur in a child's brain or the tissue and structures that are near it. Many different types of pediatric brain tumors exist — some are noncancerous (benign) and some are cancerous (malignant).Treatment and chance of recovery (prognosis) depend on the type of tumor, its location within the brain, whether it has spread, and your child's age and general health. Because new treatments and technologies are continually being developed, several options may be available at different points in treatment.Treatment for brain tumors in children is typically quite different from treatment for adult brain tumors, so it's very important to enlist the expertise and experience of pediatric specialists in neurology and cancer.

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Pemphigus is a group of rare skin disorders that cause blisters and sores on the skin or mucous membranes, such as in the mouth or on the genitals.The two main types are pemphigus vulgaris and pemphigus foliaceus. Pemphigus vulgaris usually starts in your mouth. It can be painful. Pemphigus foliaceus affects the skin and tends to be more itchy than painful. Pemphigus can occur at any age, but it's most often seen in people who are middle-aged or older.Pemphigus is not to be confused with bullous pemphigoid, another blistering skin condition. Usually a chronic condition, pemphigus is best controlled by early diagnosis and treatment. Treatment may include medications and therapies similar to those used for severe burns

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An “ulcer” is an open sore. The word “peptic” means that the cause of the problem is due to acid. Most of the time when a gastroenterologist is referring to an “ulcer” the doctor means a peptic ulcer.The two most common types of peptic ulcer are called “gastric ulcers” and “duodenal ulcers”. These names refer to the location where the ulcer is found. Gastric ulcers are located in the stomach (see Figure 1). Duodenal ulcers are found at the beginning of the small intestine (also called the small bowel) known as the duodenum. A person may have both gastric and duodenal ulcers at the same time.

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Dark underarms can be defined as the dark coloration of skin in the underarm region compared to the rest of the body. It is a problem many individuals find embarrassing. Ascertaining the reason can help to alleviate the problem effectively. 

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Pericardial effusion (per-e-KAHR-dee-ul uh-FU-zhun) is the accumulation of too much fluid in the double-layered, sac-like structure around the heart (pericardium).The space between the layers normally contains a thin layer of fluid. But if the pericardium is diseased or injured, the resulting inflammation can lead to excess fluid. Fluid can also build up around the heart without inflammation, such as from bleeding after a chest trauma.Pericardial effusion puts pressure on the heart, affecting the heart's function. If untreated, it can lead to heart failure or death

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Perimenopause means "around menopause" and refers to the time during which your body makes the natural transition to menopause, marking the end of the reproductive years. Perimenopause is also called the menopausal transition.Women start perimenopause at different ages. You may notice signs of progression toward menopause, such as menstrual irregularity, sometime in your 40s. But some women notice changes as early as their mid-30s.

The level of estrogen — the main female hormone — in your body rises and falls unevenly during perimenopause. Your menstrual cycles may lengthen or shorten, and you may begin having menstrual cycles in which your ovaries don't release an egg (ovulate). You may also experience menopause-like symptoms, such as hot flashes, sleep problems and vaginal dryness. Treatments are available to help ease these symptoms.Once you've gone through 12 consecutive months without a menstrual period, you've officially reached menopause, and the perimenopause period is over.

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njuries to peripheral nerves are extremely common in many types of upper limb trauma. Injury to peripheral nerves can cause extreme dysfunction in the hand for the patient disrupting their professional and leisure activities. It is therefore vital that adequate treatment is available to repair peripheral nerves to prevent permanent financial loss for the patient as well as the healthcare economy. Galen was the first to describe the concept of the nerve but it was Paulus Aegineta in the 7th century who documented the first nerve repair and wound closure as a military surgeon. Since this time immense research has taken place to understand nerve pathology and physiology. Currently surgical repair involves either reconstruction with direct end-to-end anastomosis or by the insertion of nerve grafts. Despite the long history and major microsurgical research and improvement peripheral nerve repair remains a challenge to surgeons and still has suboptimal outcomes. This review aims to discuss the pathophysiology of nerve injuries including the limitations of surgical repair at a biological level. We will subsequently describe the current techniques, problems and advances in the surgical management of nerve injuries.


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Peripheral nerve tumors are growths in or near the strands of tissue (nerves) that transmit signals from your brain to the rest of your body. These nerves control your muscles so that you can walk, blink, swallow, pick things up and do other activities.Peripheral nerve tumors can occur anywhere in the body. Most of them aren't cancerous (malignant), but they can lead to pain, nerve damage and loss of function in the affected area.Treatment of peripheral nerve tumors usually involves surgery to remove the tumor. Sometimes the tumor can't be removed without damaging nearby healthy tissue and nerves. In these cases, other treatments may be recommended.Several types of peripheral nerve tumors occur. These tumors affect nerves by growing within them (intraneural tumors) or by pressing against them (extraneural tumors).

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Peripheral neuropathy, a result of damage to your peripheral nerves, often causes weakness, numbness and pain, usually in your hands and feet. It can also affect other areas of your body.

Your peripheral nervous system sends information from your brain and spinal cord (central nervous system) to the rest of your body. Peripheral neuropathy can result from traumatic injuries, infections, metabolic problems, inherited causes and exposure to toxins. One of the most common causes is diabetes mellitus.

People with peripheral neuropathy generally describe the pain as stabbing, burning or tingling. In many cases, symptoms improve, especially if caused by a treatable condition. Medications can reduce the pain of peripheral neuropathy.


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Phenylketonuria (commonly known as PKU) is an inherited disorder that increases the levels of a substance called phenylalanine in the blood. Phenylalanine is a building block of proteins (an amino acid) that is obtained through the diet. It is found in all proteins and in some artificial sweeteners. If PKU is not treated, phenylalanine can build up to harmful levels in the body, causing intellectual disability and other serious health problems.The signs and symptoms of PKU vary from mild to severe. The most severe form of this disorder is known as classic PKU. Infants with classic PKU appear normal until they are a few months old. Without treatment, these children develop permanent intellectual disability. Seizures, delayed development, behavioral problems, and psychiatric disorders are also common. Untreated individuals may have a musty or mouse-like odor as a side effect of excess phenylalanine in the body. Children with classic PKU tend to have lighter skin and hair than unaffected family members and are also likely to have skin disorders such as eczema.


Less severe forms of this condition, sometimes called variant PKU and non-PKU hyperphenylalaninemia, have a smaller risk of brain damage. People with very mild cases may not require treatment with a low-phenylalanine diet.Babies born to mothers who have PKU and uncontrolled phenylalanine levels (women who no longer follow a low-phenylalanine diet) have a significant risk of intellectual disability because they are exposed to very high levels of phenylalanine before birth. These infants may also have a low birth weight and grow more slowly than other children. Other characteristic medical problems include heart defects or other heart problems, an abnormally small head size (microcephaly), and behavioral problems. Women with PKU and uncontrolled phenylalanine levels also have an increased risk of pregnancy loss.


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Pink eye (conjunctivitis) is an inflammation or infection of the transparent membrane (conjunctiva) that lines your eyelid and covers the white part of your eyeball. When small blood vessels in the conjunctiva become inflamed, they're more visible. This is what causes the whites of your eyes to appear reddish or pink.

Pink eye is commonly caused by a bacterial or viral infection, an allergic reaction, or — in babies — an incompletely opened tear duct.Though pink eye can be irritating, it rarely affects your vision. Treatments can help ease the discomfort of pink eye. Because pink eye can be contagious, early diagnosis and treatment can help limit its spread.

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Pituitary tumors are abnormal growths that develop in your pituitary gland. Some pituitary tumors result in too many of the hormones that regulate important functions of your body. Some pituitary tumors can cause your pituitary gland to produce lower levels of hormones.Most pituitary tumors are noncancerous (benign) growths (adenomas). Adenomas remain in your pituitary gland or surrounding tissues and don't spread to other parts of your body.There are various options for treating pituitary tumors, including removing the tumor, controlling its growth and managing your hormone levels with medications. Your doctor may recommend observation — or a ''wait and see'' approach.



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A placental abruption is a serious condition in which the placenta partially or completely separates from your uterus before your baby's born.The condition can deprive your baby of oxygen and nutrients, and cause severe bleeding that can be dangerous to you both. A placental abruption also increases the risk that your baby will have growth problems (if the abruption is small and goes unnoticed), be born prematurely, or be stillborn.Placental abruption happens in about one in 150 pregnancies. It's most common in the third trimester but can happen any time after 20 weeks.


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When you breathe, the thin tissues that line your lungs and chest wall, called the pleura, rub together. Typically this isn’t a problem, because the tissue is satiny and generates no friction. However, when this tissue is inflamed or infected, it becomes irritated and swollen, causing significant pain. This condition is known as pleurisy or pleuritis.This condition has a grim fame. It caused the death of a number of historical figures, including Catherine de Medici and Benjamin Franklin.Pleurisy is no longer a common condition. Over the years, antibiotics have been extremely successful in treating and preventing the bacterial infections that historically were the main causes of pleurisy. Nowadays, most cases of pleurisy are the result of a viral infection and deaths from this illness are quite rare.


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Pneumonitis is a general term for inflammation of lung tissue. Chronic inflammation of lung tissue can lead to irreversible scarring (pulmonary fibrosis). Pneumonitis is not a specific disease but a sign of an underlying problem.Acute chemical pneumonitis causes swelling of the lung tissue, movement of fluid into the air spaces in the lung and reduced ability to absorb oxygen and remove carbon dioxide. In severe cases, death may result from hypoxia.Chronic pneumonitis may follow low levels of exposure to the irritant over long periods of time, causing inflammation which may lead to fibrosis, resulting in decreased gas exchange and stiffening of the lung, and ultimately leading to respiratory failure and death.


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A pneumothorax (noo-moe-THOR-aks) is a collapsed lung. A pneumothorax occurs when air leaks into the space between your lung and chest wall. This air pushes on the outside of your lung and makes it collapse. In most cases, only a portion of the lung collapses.A pneumothorax can be caused by a blunt or penetrating chest injury, certain medical procedures, or damage from underlying lung disease. Or it may occur for no obvious reason. Symptoms usually include sudden chest pain and shortness of breath. On some occasions, a collapsed lung can be a life-threatening event.Treatment for a pneumothorax usually involves inserting a flexible tube or needle between the ribs to remove the excess air. However, a small pneumothorax may heal on its own.

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Polymyalgia rheumatica (sometimes referred to as PMR) is a common cause of widespread aching and stiffness that affects adults over the age of 50, especially Caucasians. Because polymyalgia rheumatica does not often cause swollen joints, it may be hard to recognize. It may occur with another health problem, giant cell arteritis.


The average age when symptoms start is 70, so people who have PMR may be in their 80s or even older. The disease affects women somewhat more often than men. It is more frequent in whites than nonwhites, but all races can get PMR.

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Postherpetic neuralgia (also termed PHN) is a condition of recurring or persistent pain in an area of the body that has undergone an outbreak of herpes zoster virus (HZ), also known as the varicella zoster virus, commonly termed shingles. It usually begins after shingles lesions (blisters) begin to crust over and heal but may occur in some patients who do not produce lesions. Some investigators suggest the pain has to be present for three months to be termed PHN.


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Postpartum preeclampsia is a rare condition that can develop soon after birth (usually within the first 48 to 72 hours after delivery) and is marked by high blood pressure and excess protein in the urine. In rare cases, preeclampsia onset can be delayed up to about one month postpartum; it is usually called late postpartum preeclampsia if the onset is more than 48 hours postpartum. "It takes time for the uterus to shed its lining after birth, so this process may be behind the delay that's sometimes seen in late onset preeclampsia after delivery," says James N. Martin, M.D., past president of the American College of Obstetricians and Gynecologists. It's also possible this condition begins during pregnancy but doesn't show signs or symptoms until after the baby has arrived.


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Postpartum thyroiditis is an exacerbation of an underlying autoimmune thyroiditis, aggravated by the immunological rebound that follows the partial immunosuppression of pregnancy (1–3). Women who express human leukocyte antigen haplotypes DR-3, DR-4, and DR-5 have an increased risk for postpartum thyroiditis. In women who develop postpartum thyroiditis, CD4+/CD8+ and CD4 + 2H4+ ratios are elevated throughout pregnancy and the postpartum (4). Histologically, thyroid aspirates reveal either a lymphocytic infiltrate or diffuse destruction, changes similar to those seen in both Hashimoto’s thyroiditis (2, 3, 5) and painless sporadic silent thyroiditis (6). In essence, the immunological rebound that follows the end of pregnancy precipitates the clinical expression of Hashimoto’s disease, which before pregnancy was clinically silent

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After a patient has had a total proctocolectomy (removal by surgery of the large intestine and rectum), a procedure called ileal pouch-anal anastomosis (IPAA) is performed. In an IPAA, the ileum, or lowest part of the small intestine, is connected to the anus to create a structure (pouch) that can store and eliminate stools.


The surgeon creates a J-pouch (which resembles the letter J) to provide for the storage area. Other pouch shapes (S and K) are also possible. The pouch helps improve the patient’s quality of life and reduces the risk of growths that could develop into cancer. However, after this surgery, some patients may get pouchitis.


Pouchitis is an inflammation (swelling) of the pouch that occurs when the pouch becomes irritated and inflamed. The inflammation can cause increased bowel frequency (having to go to the bathroom more often), abdominal cramping or bloating, lower abdominal pain, or sometimes blood in the stool. This condition should be evaluated and managed by an experienced gastroenterologist.

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Precocious puberty is when a child's body begins changing into that of an adult (puberty) too soon. Puberty that begins before age 8 in girls and before age 9 in boys is considered precocious puberty.


Puberty includes rapid growth of bones and muscles, changes in body shape and size, and development of the body's ability to reproduce.


The cause of precocious puberty often can't be found. Rarely, certain conditions, such as infections, hormone disorders, tumors, brain abnormalities or injuries, may cause precocious puberty. Treatment for precocious puberty typically includes medication to delay further development.

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A premature baby is one who is born too early, before 37 weeks. Premature babies may have more health problems and may need to stay in the hospital longer than babies born later. 


They also may have long-term health problems that can affect their whole lives. About 1 in 10 babies is born prematurely each year in the United States. 


The earlier in pregnancy a baby is born, the more likely he is to have health problems. Some premature babies have to spend time in a hospital’s neonatal intensive care unit (also called NICU). This is the part of a hospital that takes care of sick newborns. But thanks to advances in medical care, even babies born very prematurely are more likely to survive today than ever before.

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Premature ejaculation is uncontrolled ejaculation either before or shortly after sexual penetration. It happens with minimal sexual stimulation and before the person wishes. It may result in unsatisfactory sex for both partners. This can increase the anxiety that may add to the problem. It is one of the most common forms of male sexual dysfunction. It has probably affected every man at some point in his life.


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Premature ovarian failure — also known as primary ovarian insufficiency — is a loss of normal function of your ovaries before age 40. If your ovaries fail, they don't produce normal amounts of the hormone estrogen or release eggs regularly. Infertility is a common result.


Premature ovarian failure is sometimes referred to as premature menopause, but the two conditions aren't the same. Women with premature ovarian failure can have irregular or occasional periods for years and might even become pregnant. Women with premature menopause stop having periods and can't become pregnant.


Restoring estrogen levels in women with premature ovarian failure helps prevent some complications, such as osteoporosis, that occur as a result of low estrogen.

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Abusing some prescription drugs can lead to addiction. These include opioids, sedatives, tranquilizers, and stimulants.


Every medicine has some risk of side effects. Doctors take this into account when prescribing medicines. People who abuse these drugs may not understand the risks. The medicines may not be safe for them, especially at higher doses or when taken with other medicines.

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When your child has a primary immunodeficiency disease (PIDD), his body has a harder time fighting germs that make people sick. He may get a lot of infections in his ears, lungs, skin, or other areas that take a long time to go away.

Most cases happen in babies or young children, but sometimes it doesn't show up until adulthood. There are many different types -- more than 200 -- and they affect different parts of the immune system. All make it more likely that he'll get sick from infections.

Everyone with a PIDD has a different experience. If your child has it, in most cases he'll be able to go to school and make friends like other kids. As an adult with a PIDD, he'll be able to work and have an active, normal life.

If your child's PIDD is mild, he may need to take medicines to treat the infections he gets.

Doctors treat some of the more serious types of PIDD with doses of antibodies to fight infections. He'll get these antibodies through an IV in his veins. The treatment takes several hours, and he'll need one every few weeks.

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Pseudobulbar affect (PBA) is a condition that’s characterized by episodes of sudden uncontrollable and inappropriate laughing or crying. Pseudobulbar affect typically occurs in people with certain neurological conditions or injuries, which might affect the way the brain controls emotion.

If you have pseudobulbar affect you'll experience emotions normally, but you'll sometimes express them in an exaggerated or inappropriate way. As a result, the condition can be embarrassing and disruptive to your daily life.

Pseudobulbar affect often goes undiagnosed or is mistaken for mood disorders. Once diagnosed, however, pseudobulbar affect can be managed with medication.

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Pseudogout is a type of inflammation of joints (arthritis) that is caused by deposits of crystals, called calcium pyrophosphate, in and around the joints. Pseudogout literally means "false gout." It derives its name from its similarity to gout.

Pseudogout has many similarities to true gout, which also can cause arthritis. However, the crystal that incites the inflammation of gout is monosodium urate. The crystals that cause pseudogout and gout each have distinct appearances when joint fluid containing them is viewed under a microscope. This makes it possible to precisely identify the cause of the joint inflammation when joint fluid is available.

Pseudogout has been reported to occasionally coexist with gout. This means that the two types of crystals can sometimes be found in the same joint fluid. Researchers have also noted that the cartilage of patients who had both forms of crystals in their joint fluid was often visibly calcified, as seen on X-ray images.

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Pseudomembranous colitis (PMC) is inflammation in your colon that happens when there's too much of certain bacteria in your system. The most common bacterium that causes PMC isClostridium difficile, or C. diff.

PMC is also called antibiotic-associated colitis or C. difficilecolitis. Most of the time, it's a side effect of taking antibiotics.

People in hospitals or nursing homes also can get PMC, especially if they've just had surgery or are receiving treatment for cancer.

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Pseudotumor cerebri is a condition in which the pressure around your brain increases, causing headaches and vision problems. The name means “false brain tumor” because its symptoms are similar to those caused by brain tumors. It’s also known as idiopathic intracranial hypertension. This condition is treatable, but it can return in some cases.

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Pulmonary atresia is a form of heart disease in which the pulmonary valve does not form properly. It is present from birth (congenital heart disease). The pulmonary valve is an opening on the right side of the heart that regulates blood flow from the right ventricle (right side pumping chamber) to the lungs.


In pulmonary atresia, a solid sheet of tissue forms where the valve opening should be, and the valve stays closed. Because of this defect, blood from the right side of the heart cannot go to the lungs to pick up oxygen.

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Edema, in general, means swelling. This typically occurs when fluid from inside blood vessels seeps outside the blood vessel into the surrounding tissues, causing swelling. This can happen either because of too much pressure in the blood vessels or not enough proteins in the bloodstream to hold on to the fluid in the plasma (the part of the blood that does not contain any blood cells).


Pulmonary edema is the term used when edema happens in the lungs. The immediate area outside of the small blood vessels in the lungs is occupied by very tiny air sacs called the alveoli. This is where oxygen from the air is picked up by the blood passing by, and carbon dioxide in the blood is passed into the alveoli to be exhaled out. Alveoli normally have a thin wall that allows for this air exchange, and fluids are usually kept out of the alveoli unless these walls lose their integrity.

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Pulmonary embolism is a blockage in one of the pulmonary arteries in your lungs. In most cases, pulmonary embolism is caused by blood clots that travel to the lungs from the legs or, rarely, other parts of the body (deep vein thrombosis).


Because the clots block blood flow to the lungs, pulmonary embolism can be life-threatening. However, prompt treatment greatly reduces the risk of death. Taking measures to prevent blood clots in your legs will help protect you against pulmonary embolism.


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The pulmonic valve is one of two valves that allow blood to leave the heart via the arteries. It is a one-way valve, meaning that blood cannot flow back into the heart through it. The valve is opened by the increased blood pressure of the ventricular systole (contraction of the muscular tissue), pushing blood out of the heart and into the artery. It closes when the pressure drops inside the heart. It is located in the right ventricle of the heart. The pulmonic valve opens into the pulmonary artery. The frequency of this cycle depends upon the heart rate. Pulmonary stenosis is a condition where the blood flow out of the heart is obstructed at the pulmonic valve. The most common cause of this is congenital heart disease, although rheumatic heart disease and a malignant carcinoid tumor can also initiate the problem. The condition is treated by surgical repair or replacement of the pulmonic valve.

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Pulmonary valve stenosis is a condition in which a deformity on or near your pulmonary valve narrows the pulmonary valve opening and slows the blood flow. The pulmonary valve is located between the lower right heart chamber (right ventricle) and the pulmonary arteries. Adults occasionally have pulmonary valve stenosis as a complication of another illness, but mostly, pulmonary valve stenosis develops before birth as a congenital heart defect.


Pulmonary valve stenosis ranges from mild and without symptoms to severe. Mild pulmonary stenosis doesn't usually worsen over time, but moderate and severe cases may worsen and require surgery. Fortunately, treatment is generally highly successful, and most people with pulmonary valve stenosis can expect to lead normal lives.

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Pyoderma gangrenosum is an uncommon, ulcerative cutaneous condition of uncertain etiology. It is associated with systemic diseases in at least 50% of patients who are affected. [1, 2] The diagnosis is made by excluding other causes of similar-appearing cutaneous ulcerations, including infection, malignancy, vasculitis, collagen vascular diseases, diabetes, and trauma. In a process termed pathergy, new ulcerations may occur after trauma or injury to the skin in 30% of patients who already have pyoderma gangrenosum. (See Presentation, DDx, and Workup.)Patients with pyoderma gangrenosum may have involvement of other organ systems that manifests as sterile neutrophilic infiltrates. Culture-negative pulmonary infiltrates are the most common extracutaneous manifestation. [3] Other organs systems that may be involved include the heart, the central nervous system, the gastrointestinal (GI) tract, the eyes, [4, 5] the liver, the spleen, the bones, and the lymph nodes. (See Presentation and Workup.)n Therapy for pyoderma gangrenosum involves the use of anti-inflammatory agents, including antibiotics, corticosteroids, immunosuppressive agents, and biologic agents. The prognosis is generally good; however, the disease can recur and residual scarring is common. (See Prognosis, Treatment, and Medication.)


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Ramsay Hunt syndrome happens when shingles affects nerves in your face close to either one of your ears. Shingles affecting either ear is a condition caused by a virus called herpes zoster oticus. The general varicella-zoster virus also causes chicken pox, which is most common in children. If you’ve had chicken pox in your life, the virus can reactivate later in your life and cause shingles. Both shingles and chicken pox are most recognizable by a rash that appears in the affected area of the body. Unlike chicken pox, a shingles rash near the facial nerves by your ears can cause other complications, including facial paralysis and ear pain. When this happens, it’s called Ramsay Hunt syndrome. If you get a rash on your face and also start noticing symptoms such as facial muscle weakness, see your doctor as soon as you can. Early treatment can help make sure you don’t experience any complications from Ramsay Hunt syndrome.

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Raynaud's (ray-NOHZ) disease causes some areas of your body — such as your fingers and toes — to feel numb and cold in response to cold temperatures or stress. In Raynaud's disease, smaller arteries that supply blood to your skin narrow, limiting blood circulation to affected areas (vasospasm). Women are more likely than men to have Raynaud's disease, also known as Raynaud or Raynaud's phenomenon or syndrome. It appears to be more common in people who live in colder climates. Treatment of Raynaud's disease depends on its severity and whether you have other health conditions. For most people, Raynaud's disease isn't disabling, but it can affect your quality of life.

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When the occasional headache strikes, most of us take an over-the-counter (OTC) analgesic, such as acetaminophen, ibuprofen, aspirin, or a pain-relief medication containing caffeine. While OTC analgesics can help relieve headache pain they must be taken correctly — or they could actually make your headaches worse. The overuse or misuse of analgesic drugs — exceeding labeling instructions (such as taking the medications three or more days per week) or not following your healthcare provider’s advice — can cause you to "rebound" into another headache. When the pain reliever wears off, you may experience a withdrawal reaction, prompting you to take more medication. This only leads to another headache and the desire to take yet more medication. So the cycle continues until you start to suffer from chronic daily headaches, with more frequent headaches and more severe pain.

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A rectovaginal fistula (RVF) is an epithelial-lined tract between the rectum and vagina. For thousands of years, women simply tolerated the distressing symptoms generated by RVFs. Today, there is no need for such tolerance, because most RVFs can be surgically corrected via a number of approaches. [1] A small percentage, however, cannot be corrected, because of patient comorbidity or disease-related factors; in these cases, patients can be helped only by fecal diversion. [2]  This article discusses only acquired RVFs. Most RVFs are located at or just above the dentate line. Fistulas below the dentate line are not true RVFs but, rather, anovaginal fistulas; the treatment required for these differs from that required for RVFs.

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Ejaculation is the ejection of semen out of the urethra (passageway inside the penis) when a man has an orgasm. Under normal circumstances, ejaculation propels semen forward through a man's urethra and out the tip of his penis. This is because a tiny sphincter (circular muscle) at the entrance to the bladder shuts the opening to the bladder and prevents semen from entering. Retrograde ejaculation is when the semen travels backwards into the bladder.


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Rheumatic fever is one of the complications associated with strep throat. It’s a relatively serious illness that can cause stroke, permanent damage to your heart, and death if it’s left untreated. The condition usually appears in children between the ages of 5 and 15, even though older children and adults have been known to contract the fever as well. It’s still common in places like sub-Saharan Africa, south central Asia, and certain populations in Australia and New Zealand.


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The rotator cuff is a group of muscles and tendons that surround the shoulder joint, keeping the head of your upper arm bone firmly within the shallow socket of the shoulder. A rotator cuff injury can cause a dull ache in the shoulder, which often worsens when you try to sleep on the involved side.Rotator cuff injuries occur most often in people who repeatedly perform overhead motions in their jobs or sports. Examples include painters, carpenters, and people who play baseball or tennis. The risk of rotator cuff injury also increases with age.Many people recover from rotator cuff disease with physical therapy exercises that improve flexibility and strength of the muscles surrounding the shoulder joint.Sometimes, rotator cuff tears may occur as a result of a single injury. In those circumstances, medical care should be provided as soon as possible. Extensive rotator cuff tears may require surgical repair, transfer of alternative tendons or joint replacement


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Rubella is an acute, contagious viral infection. While rubella virus infection usually causes a mild fever and rash illness in children and adults, infection during pregnancy, especially during the first trimester, can result in miscarriage, fetal death, stillbirth, or infants with congenital malformations, known as congenital rubella syndrome (CRS). The rubella virus is transmitted by airborne droplets when infected people sneeze or cough. Humans are the only known host.


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Rumination syndrome, or Merycism, is a rare disorder that affects children and some adults. If your child has this condition, he or she will usually eat meals normally. But after about an hour or two, undigested food comes back up into his or her mouth from the esophagus. Your child will either rechew and reswallow the food, or spit it out. Typically this happens at every meal, day after day. Rumination is a reflex, not a conscious decision.


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The spleen is an organ of the lymphatic system located on the left side of your stomach (abdomen) under the rib cage and diaphragm in a region that is referred to as the left upper quadrant. In humans the spleen is about the size of a fist and its primary roles are filtering the body’s blood and helps to fight infection. It also serves a role in storing and releasing certain types of immune cells that mediate tissue inflammation. [1]Rupturing a spleen describes an emergency situation in which your spleen has developed a disruption in its surface or blood supply. This is serious condition that can occur during a direct blow or trauma and without emergency treatment a ruptured spleen can cause life threatening internal bleeding. [2]


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Salivary gland tumors are rare types of tumors that begin in the salivary glands.


Salivary gland tumors can begin in any of the salivary glands in your mouth, neck or throat. Salivary glands make saliva, which aids in digestion, keeps your mouth moist and supports healthy teeth.


You have three pairs of major salivary glands under and behind your jaw — parotid, sublingual and submandibular. Many other tiny salivary glands are in your lips, inside your cheeks, and throughout your mouth and throat.


Salivary gland tumors most commonly occur in the parotid gland, accounting for nearly 85 percent of all salivary gland tumors. Approximately 25 percent of parotid tumors are cancerous (malignant).


Treatment for salivary gland tumors often involves surgery. Treatments for salivary gland tumors may also include radiation therapy and chemotherapy.

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Sebaceous glands are part of epidermal appendages. Neoplasms of the sebaceous glands may be benign, such as sebaceous hyperplasia or sebaceous gland adenomas. The malignant sebaceous gland carcinoma most commonly arises in the periocular area. Fewer than 120 cases of sebaceous cell carcinoma have been reported at extraocular sites. The most common site of origin is the meibomian glands of the eyelids, leading to the term meibomian gland carcinoma. However, this neoplasm can occur in other sebaceous glands, such as in the caruncle, the glands of Zeis, and in the eyebrow. Sebaceous cell carcinoma is a lethal eyelid malignancy and can masquerade as benign conditions. Error or delay in diagnosis is common, and this tumor carries a significant mortality rate with metastasis.


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A seizure happens because of abnormal electrical activity in the brain. It may go nearly unnoticed. Or, in some severe cases, it may cause unconsciousness and convulsions, when your body shakes uncontrollably. Seizures usually come on suddenly. How long and severe they are can vary. A seizure can happen to you just once, or over and over. If they keep coming back, that's epilepsy, or a seizure disorder. Less than one in 10 people who have a seizure get epilepsy.


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Nonsuicidal self-injury, often simply called self-injury, is the act of deliberately harming the surface of your own body, such as cutting or burning yourself. It's typically not meant as a suicide attempt. Rather, this type of self-injury is an unhealthy way to cope with emotional pain, intense anger and frustration. While self-injury may bring a momentary sense of calm and a release of tension, it's usually followed by guilt and shame and the return of painful emotions. Although life-threatening injuries are usually not intended, with self-injury comes the possibility of more serious and even fatal self-aggressive actions.


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A separated shoulder is an injury to the ligaments that hold your collarbone (clavicle) to your shoulder blade. In a mild separated shoulder, the ligaments might just be stretched. In severe injuries, ligaments might be torn. In most people, a separated shoulder doesn't usually require surgery. Instead, conservative treatment — such as rest, ice and pain relievers — is often enough to relieve the pain. Most people regain full shoulder function within a few weeks after having a separated shoulder.


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The colon is a long tube-like structure approximately 6 feet in length that stores and then eliminates waste material left over after digestion of food in the small intestine takes place. It is thought that pressure within the colon causes bulging pockets of tissue (sacs) that push out from the colonic walls as a person ages. A small bulging sac pushing outward from the colon wall is called a diverticulum. More than one bulging sac is referred to in the plural as diverticula. Diverticula can occur throughout the colon but are most common near the end of the left colon, referred to as the sigmoid colon, in Western countries. In Asia, the diverticula occur mostly on the right side of the colon. The condition of having these diverticula in the colon is called diverticulosis.


Diverticula are common in the Western world but are rare in areas such as Asia and Africa. Diverticula increase with age. They are uncommon before the age of 40, but are seen in more than 74% of people over the age of 80 years in the U.S. A person with diverticulosis usually has few or no symptoms. The most common symptoms associated with diverticulosis are abdominal pain, constipation, and diarrhea. In some of these patients the symptoms may be due to the concomitant presence of irritable bowel syndrome (IBS) or abnormalities in the function of the muscles of the sigmoid colon (in which case it is referred to as diverticular disease); simple diverticula should cause no symptoms. Occasionally, bleeding originates from a diverticulum, and it is referred to as diverticular bleeding.

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The sinus node is a specialized group of cells in the upper chamber of the heart, the right atrium, that creates electrical signals that regulate the pace and rhythm of the heartbeat. Normally, the sinus node produces a regular, steady pattern of signals. With SSS, the pattern is irregular. The normal heart beat should increase with activity and decrease with rest and sleep.  With SSS, this function is disrupted, with a heart beat that is too slow for the patient's level of activity.


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Your sinuses are air-filled spaces inside your forehead, cheekbones, and behind the bridge of your nose. When they get inflamed -- usually because of an allergic reaction or an infection -- they swell, make more mucus, and the channels that drain them can get blocked. The build-up of pressure in your sinuses causes pain that feels like a headache.


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Obstructive sleep apnea is a potentially serious sleep disorder. It causes breathing to repeatedly stop and start during sleep.There are several types of sleep apnea, but the most common is obstructive sleep apnea. This type of apnea occurs when your throat muscles intermittently relax and block your airway during sleep. A noticeable sign of obstructive sleep apnea is snoring. Treatments for obstructive sleep apnea are available. One treatment involves using a device that keep your airway open while you sleep. Another option is a mouthpiece to thrust your jaw forward during sleep. In more severe cases, surgery may be an option too


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Soft tissue sarcomas are a group of cancers that grow in parts of your body like your muscles, deep layers of skin, or in fat. They also can form on blood vessels, nerves, or connective tissues, which support organs and other kinds of tissues.Soft tissue sarcomas account for less than 1% of all cases of cancer. But there are dozens of different types, and they can happen in children and adults.About 12,000 people are diagnosed with one of these cancers every year.

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Solitary fibrous tumors are rare growths of soft tissue cells that can form nearly anywhere in the body.Solitary fibrous tumors most often occur in the lining around the outside of the lungs (pleural solitary fibrous tumors). Solitary fibrous tumors have also been found in the head and neck, breast, kidney, prostate, spinal cord, and other sites.Most solitary fibrous tumors are noncancerous (benign), but in rare cases, solitary fibrous tumors can be cancerous (malignant). Solitary fibrous tumors tend to grow slowly and may not cause signs and symptoms until they become very large.

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A fold of fat that some people have under their chin and that looks like a second chin

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A spinal cord injury is damage to the spinal cord. It’s an extremely serious type of physical trauma that’s likely to have a lasting and significant impact on most aspects of daily life.The spinal cord is a bundle of nerves and other tissue that the vertebrae of the spine contains and protects. The vertebrae are the bones stacked on top of each other that make up the spine. The spine contains many nerves, and extends from the brain’s base down the back, ending close to the buttocks.The spinal cord is responsible for sending messages from the brain to all parts of the body. It also sends messages from the body to the brain. We’re able to perceive pain and move our limbs because of messages sent through the spinal cord.If the spinal cord sustains an injury, some or all of these impulses may not be able to “get through.” The result is a complete or total loss of sensation and mobility below the injury. A spinal cord injury closer to the neck will typically cause paralysis throughout a larger part of the body than one in the lower back area.

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A spinal tumor is a growth that develops within your spinal canal or within the bones of your spine. A spinal cord tumor, also called an intradural tumor, is a spinal tumor that that begins within the spinal cord or the covering of the spinal cord (dura). A tumor that affects the bones of the spine (vertebrae) is called a vertebral tumor.Spinal cord tumors may be classified as one of three different types depending on where they occur relative to the protective membranes of the spinal cord.

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Stress fractures are tiny cracks in a bone. They're caused by repetitive force, often from overuse — such as repeatedly jumping up and down or running long distances. Stress fractures can also arise from normal use of a bone that's weakened by a condition such as osteoporosis.Stress fractures are most common in the weight-bearing bones of the lower leg and foot. Track and field athletes and military recruits who carry heavy packs over long distances are particularly susceptible, but anyone can have a stress fracture. If you start a new exercise program, for example, you might develop stress fractures if you do too much too soon.

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Stuttering affects the fluency of speech. It begins during childhood and, in some cases, lasts throughout life. The disorder is characterized by disruptions in the production of speech sounds, also called "disfluencies." Most people produce brief disfluencies from time to time. For instance, some words are repeated and others are preceded by "um" or "uh." Disfluencies are not necessarily a problem; however, they can impede communication when a person produces too many of them.In most cases, stuttering has an impact on at least some daily activities. The specific activities that a person finds challenging to perform vary across individuals. For some people, communication difficulties only happen during specific activities, for example, talking on the telephone or talking before large groups. For most others, however, communication difficulties occur across a number of activities at home, school, or work. Some people may limit their participation in certain activities. Such "participation restrictions" often occur because the person is concerned about how others might react to disfluent speech. Other people may try to hide their disfluent speech from others by rearranging the words in their sentence (circumlocution), pretending to forget what they wanted to say, or declining to speak. Other people may find that they are excluded from participating in certain activities because of stuttering. Clearly, the impact of stuttering on daily life can be affected by how the person and others react to the disorder.

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The subarachnoid space is the area between the brain and the skull. It is normally filled with cerebrospinal fluid (CSF), which acts as a floating cushion to protect the brain (see Anatomy of the Brain When blood is released into the subarachnoid space, it irritates the lining of the brain, increases pressure on the brain, and damages brain cells. At the same time, the area of brain that previously received oxygen-rich blood from the affected artery is now deprived of blood, resulting in a stroke. SAH is frequently a sign of a ruptured aneurysm


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Sudden Cardiac Arrest (SCA) occurs when the heart stops beating, abruptly and without warning. If this happens, blood stops flowing to the brain and other vital organs. In addition, if the heartbeat is not restored with an electrical shock immediately, death follows within minutes. SCA accounts for more than 350,000 deaths in the U.S. each year.SCA accounts for more than 350,000 deaths in the U.S. each year and is one of the leading causes of death in the United States each year. In fact, SCA claims one life every 90 seconds, taking more lives each year than breast cancer, lung cancer or AIDS. Unfortunately, 95 percent of people who experience SCA die as a result, mainly because treatment within minutes is not accessible.

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Sun allergy is a term often used to describe a number of conditions in which an itchy red rash occurs on skin that's been exposed to sunlight. The most common form of sun allergy is polymorphic light eruption, also known as sun poisoning.Some people have a hereditary type of sun allergy, while others develop signs and symptoms only when triggered by another factor — such as certain types of medications or skin exposure to plants such as limes or wild parsnip.Mild cases of sun allergy may resolve without treatment. More severe cases may require steroid creams or pills. People who have a severe sun allergy may need to take preventative measures and wear sun-protective clothing.

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An arrhythmia is an abnormality in the timing or pattern of the heartbeat. Arrhythmias may cause the heart to beat too rapidly, too slowly, or irregularly. They are common and may cause a wide variety of symptoms, such as a racing, skipping or fluttering sensation (called palpitations) in your chest.Cardiac arrhythmias also may cause light-headedness, fainting, chest pain, shortness of breath, fatigue or no symptoms at all. Many types of arrhythmia are merely nuisances, other types may be serious problems because they cause the patient to develop heart failure, pass out or even die suddenly when the heart beats too slowly or too rapidly to pump blood to the body.Supraventricular tachycardia is a series of rapid heartbeats that begin in or involve the upper chambers (atria) of the heart. SVT can cause the heart to beat very rapidly or erratically. As a result, the heart may beat inefficiently, and the body may receive an inadequate blood supply. There are three major types of SVT including:

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Tachycardia is a common type of heart rhythm disorder (arrhythmia) in which the heart beats faster than normal while at rest.It's normal for your heart rate to rise during exercise or as a physiological response to stress, trauma or illness (sinus tachycardia). But in tachycardia (tak-ih-KAHR-dee-uh), the heart beats faster than normal in the upper or lower chambers of the heart or both while at rest.Your heart rate is controlled by electrical signals sent across heart tissues. Tachycardia occurs when an abnormality in the heart produces rapid electrical signals that quicken the heart rate, which is normally about 60 to 100 beats a minute at rest.In some cases, tachycardia may cause no symptoms or complications. But if left untreated, tachycardia can disrupt normal heart function and lead to serious complications, including:


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Drug addiction is a chronic, often relapsing brain disease that causes compulsive drug seeking and use, despite harmful consequences to the drug addict and those around them. Drug addiction is a brain disease because the abuse of drugs leads to changes in the structure and function of the brain. Although it is true that for most people the initial decision to take drugs is voluntary, over time the changes in the brain caused by repeated drug abuse can impair a person's self-control and ability to make sound decisions, and at the same time create an intense impulse to take drugs.


It is because of these changes in the brain that it is so challenging for a person to stop abusing drugs. Fortunately, there are treatments that help people to counteract addiction's powerful disruptive effects and regain control of their lives. Research shows that combining addiction treatment medications, when appropriate, with behavioral therapy is the best way to ensure success for most patients. Treatment approaches that are tailored to each patient's drug abuse patterns and any concurrent medical, psychiatric, and social problems can help achieve  sustained recovery and a life without drugs.


As with other chronic diseases, such as diabetes, asthma, or heart disease, drug addiction can be managed effectively. Yet, it is not uncommon for a person to relapse and begin abusing drugs again. Relapse does not signal failure; rather, it indicates that treatment should be reinstated or adjusted, or that alternate treatment is needed to help the person regain control and recover.

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Takotsubo cardiomyopathy is a weakening of the left ventricle, the heart's main pumping chamber, usually as the result of severe emotional or physical stress, such as a sudden illness, the loss of a loved one, a serious accident, or a natural disaster such as an earthquake. (For additional examples, see "Stressors associated with takotsubo cardiomyopathy.") That's why the condition is also called stress-induced cardiomyopathy, or broken-heart syndrome. The main symptoms are chest pain and shortness of breath.

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The features of seizures beginning in the temporal lobe can be extremely varied, but certain patterns are common. There may be a mixture of different feelings, emotions, thoughts, and experiences, which may be familiar or completely foreign. In some cases, a series of old memories resurfaces. In others, the person may feel as if everything – including home and family – appears strange. Hallucinations of voices, music, people, smells, or tastes may occur. These features are called “auras” or “warnings.” They may last for just a few seconds or may continue as long as a minute or two.Experiences during temporal lobe seizures vary in intensity and quality. Sometimes the seizures are so mild that the person barely notices. In other cases, the person may be consumed with fright, intellectual fascination, or even pleasure.The experiences and sensations that accompany these seizures are often impossible to describe, even for the most eloquent adult. And of course it is even more difficult to get an accurate picture of what people are feeling.

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The temporomandibular joint (TMJ) is the joint that connects your mandible (lower jaw) to your skull. The joint can be found on both sides of your head in front of your ears. It allows your jaw to open and close, enabling you to speak and eat.This abbreviation is also used to refer to a group of health problems related to your jaw. These disorders can cause tenderness at the joint, facial pain, and difficulty moving the joint. According to the National Institute of Dental and Craniofacial Research, as many as 10 million Americans suffer from TMJ. TMJ is more common among women than men. These disorders are treatable, but there are many different possible causes. This can make diagnosis difficult.Keep reading to learn more about TMJ. You should discuss any concerns with your doctor.

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The cause of the majority of cases is the bell clapper deformity, an anatomic abnormality that is present in some males. This anatomical condition allows the spermatic cord to twist more easily, resulting in compromise of the blood supply to the testicle. This can occur spontaneously or may be associated with trauma. There is no way to detect this deformity. In significant number of men who have this anatomical abnormality will have it in both testicles.

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Tetanus is a serious bacterial infection that affects the nervous system and causes muscles throughout the body to tighten. It’s also called lockjaw because the infection often causes muscle contractions in the jaw and neck. However, it can eventually spread to other parts of the body.Tetanus infection can be life-threatening without treatment. Approximately 10 to 20 percent of tetanus infections are fatal, according to the Centers for Disease Control and Prevention (CDC).Tetanus is a medical emergency that requires immediate treatment in a hospital. Fortunately, tetanus is preventable through the use of a vaccine. However, this vaccine does not last forever. Tetanus booster shots are needed every 10 years to ensure immunity.Because of the easy availability of the vaccine, tetanus is rare in the United States. It’s more common in other countries that don’t yet have strong immunization programs.

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Dry mouth: The condition of not having enough saliva to keep the mouth wet. This is due to inadequate function of the salivary glands. Everyone has dry mouth once in a while when they are nervous, upset or under stress. But if someone has a dry mouth most all of the time, it can be uncomfortable and lead to serious health problems.
Dry mouth can cause difficulties in tasting, chewing, swallowing, and speaking. If it goes untreated, severe dry mouth can also lead to increased levels of tooth decay and infections of the mouth such as thrush. Severe dry mouth is not a normal part of aging. It can be a clue to systemic diseases such as Sjogren syndrome, systemic lupus erythematosus, rheumatoid arthritis, scleroderma, sarcoidosis, amyloidosis, and hypothyroidism. Some medications can also cause dry mouth.

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A thoracic aortic aneurysm is a weakened area in the upper part of the aorta. The aorta is the major blood vessel that feeds blood to the body.A thoracic aortic aneurysm may also be called thoracic aneurysm and aortic dissection (TAAD) because an aneurysm can lead to a tear in the artery wall (dissection) that can cause life-threatening bleeding. Small and slow-growing thoracic aortic aneurysms may not ever rupture, but large, fast-growing aneurysms may rupture.Depending on the size and growth rate of your thoracic aortic aneurysm, treatment may vary from watchful waiting to emergency surgery. Ideally, surgery for a thoracic aortic aneurysm can be planned if necessary.

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The term ‘thoracic outlet syndrome’ describes compression of the neurovascular structures as they exit through the thoracic outlet (cervicothoracobrachial region). The thoracic outlet is marked by the anterior scalene muscle anteriorly, the middle scalene posteriorly, and the first rib inferiorly. This condition has emerged as one of the most controversial topics in musculoskeletal medicine and rehabilitation [2]. This controversy extends to almost every aspect of the pathology including the definition, incidence, pathoanatomical contributions, diagnosis, and treatment.The term ‘TOS’ does not specify the structure being compressed. Investigators namely identify two main categories of TOS: the vascular form (arterial or venous), which raises few diagnostic problems, and the neurological form, which occurs in more than 95-99% of all cases of TOS. Therefore the syndrome should be differentiated by using the terms arterial TOS (ATOS), venous TOS (VTOS) or neurogenic 

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A joint is where bones connect and move.  Arthritis is thinning of the cartilage, which is the smooth covering of the joint.  The body reacts to loss of the joint surface by forming bone spurs (osteophytes) Thumb arthritis is a genetic predisposition: like graying and thinning of the hair, it comes with age and it shows up earlier in some families.  Unlike thinning of the hair, women tend to get thumb arthritis sooner than men do.


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A thunderclap headache is a severe headache that starts suddenly. This type of headache pain doesn’t gradually build in intensity. Instead, it’s an intense and very painful headache as soon as it starts. In fact, it’s frequently described as the worse headache of one’s life.A thunderclap headache may be a sign of a condition that can be life-threatening. It may be connected to some sort of bleeding in your brain. It’s important that you seek medical attention if you think you may be experiencing one. It may also have a benign cause that’s not life-threatening but should still be checked immediately to find out what’s causing it.


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There are two parts to your tongue: the oral tongue and the base of the tongue. Cancer can develop in either part.The oral tongue is the part you see when you poke your tongue out at someone. This is the front two thirds of your tongue. Cancers that develop in this part of the tongue come under a group of cancers called mouth (oral) cancer.The base of the tongue is the back third of the tongue. This part is very near your throat (pharynx). Cancers that develop in this part are called oropharyngeal cancers (pronounced oar-o-farin-gee-al

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Tuberous sclerosis complex (TSC) is a genetic disorder affecting cellular differentiation, proliferation, and migration early in development, resulting in a variety of hamartomatous lesions that may affect virtually every organ system of the body.The best-known cutaneous manifestation of TSC is adenoma sebaceum, which often does not appear until late childhood or early adolescence. This lesion is an angiofibroma (ie, cutaneous hamartoma) and is not related to excessive sebum or acne. Flat, reddish macular lesions develop first, which can be mistaken for freckles early on. See the image below.

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Turner syndrome is a chromosomal condition that affects development in females. The most common feature of Turner syndrome is short stature, which becomes evident by about age 5. An early loss of ovarian function (ovarian hypofunction or premature ovarian failure) is also very common. The ovaries develop normally at first, but egg cells (oocytes) usually die prematurely and most ovarian tissue degenerates before birth. Many affected girls do not undergo puberty unless they receive hormone therapy, and most are unable to conceive (infertile). A small percentage of females with Turner syndrome retain normal ovarian function through young adulthood.About 30 percent of females with Turner syndrome have extra folds of skin on the neck (webbed neck), a low hairline at the back of the neck, puffiness or swelling (lymphedema) of the hands and feet, skeletal abnormalities, or kidney problems. One third to one half of individuals with Turner syndrome are born with a heart defect, such as a narrowing of the large artery leaving the heart (coarctation of the aorta) or abnormalities of the valve that connects the aorta with the heart (the aortic valve). Complications associated with these heart defects can be life-threatening.Most girls and women with Turner syndrome have normal intelligence. Developmental delays, nonverbal learning disabilities, and behavioral problems are possible, although these characteristics vary among affected individuals.


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Tricuspid valve disease affects the valve that connects the upper and lower chambers (atrium and ventricle) on the right side of your heart.Aurora Health Care’s teams are the region’s leaders in diagnosing and treating heart valve diseases. We offer customized treatment using the most advanced, minimally invasive procedures, whether the condition is congenital (a birth defect) or develops later in life.

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Trichotillomania (trik-o-til-o-MAY-nee-uh), also called hair-pulling disorder, is a mental disorder that involves recurrent, irresistible urges to pull out hair from your scalp, eyebrows or other areas of your body, despite trying to stop.Hair pulling from the scalp often leaves patchy bald spots, which causes significant distress and can interfere with social or work functioning. People with trichotillomania may go to great lengths to disguise the loss of hair.For some people, trichotillomania may be mild and generally manageable. For others, the compulsive urge to pull hair is overwhelming. Some treatment options have helped many people reduce their hair pulling or stop entirely.

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Tricuspid atresia is a condition seen in newborns in which they’re born without an important part of the heart called “the tricuspid valve.” This valve plays a part in the heart’s essential function, which is to pump blood between the lungs and body.In some newborns, the tricuspid valve is missing or hasn’t properly developed. Tricuspid atresia is a rare heart disorder that’s congenital, or present at birth. It’s a serious condition, and it can be life-threatening.

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Traumatic brain injury (TBI) is a complex injury with a broad spectrum of symptoms and disabilities. The impact on a person and his or her family can be devastating. The purpose of this site is to educate and empower caregivers and survivors of traumatic brain injuries. This site aims to ease the transition from shock and despair at the time of a brain injury to coping and problem solving. Bookmark this site for the latest medical breakthroughs and brain research, the highest quality treatment for brain damage, the symptoms of brain injuries and the nation's best traumatic brain injury rehabilitation centers and resource information.


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Tourette syndrome (TS) is a neurological disorder characterized by repetitive, stereotyped, involuntary movements and vocalizations called tics. The disorder is named for Dr. Georges Gilles de la Tourette, the pioneering French neurologist who in 1885 first described the condition in an 86-year-old French noblewoman.The early symptoms of TS are typically noticed first in childhood, with the average onset between the ages of 3 and 9 years. TS occurs in people from all ethnic groups; males are affected about three to four times more often than females. It is estimated that 200,000 Americans have the most severe form of TS, and as many as one in 100 exhibit milder and less complex symptoms such as chronic motor or vocal tics. Although TS can be a chronic condition with symptoms lasting a lifetime, most people with the condition experience their worst tic symptoms in their early teens, with improvement occurring in the late teens and continuing into adulthood.


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Uterine fibroids are benign tumors that originate in the uterus (womb). Although they are composed of the same smooth muscle fibers as the uterine wall (myometrium), they are much denser than normal myometrium. Uterine fibroids are usually round.Uterine fibroids are often described based upon their location within the uterus. Subserosal fibroids are located beneath the serosa (the lining membrane on the outside of the uterus). These often appear localized on the outside surface of the uterus or may be attached to the outside surface by a pedicle. Submucosal (submucous) fibroids are located inside the uterine cavity beneath the inner lining of the uterus. Intramural fibroids are located within the muscular wall of the uterus.

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Uterine polyps are soft red outgrowths from the lining of the womb (the endometrium), usually less than 1 cm in diameter, which often flatten to fit the cavity of the uterus.The stalk of the polyp (or pedicle) is usually short, but sometimes it grows long enough for the polyp to project from the cervix (the lower opening of the womb). Polyps are prone to bleeding, and a uterine polyp that develops near the fallopian tubes may obstruct the opening of the tubes, possibly leading to difficulty with becoming pregnant. Uterine polyps can develop in pre- or post-menopausal women. Very rarely, polyps can be cancerous.


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The uterus (the womb, in which a fetus develops) is normally held in place inside the pelvis with various muscles and ligaments. Sometimes, because of childbirth or difficult labor and vaginal delivery, these tissues are weakened. As a woman ages and with age-related decrease in the concentration of the hormone estrogen, her uterus can move downward into the vaginal canal, causing the condition known as a prolapsed uterus.Muscle weakness or relaxation may allow the uterus to sag or come completely out of the body. Prolapsed uterus can be described in the following stages

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Although it is a relatively rare disease, primarily found in the Caucasian population, uveal melanoma is the most common primary intraocular tumor in adults with a mean age-adjusted incidence of 5.1 cases per million per year. Tumors are located either in iris (4%), ciliary body (6%), or choroid (90%). The host susceptibility factors for uveal melanoma include fair skin, light eye color, inability to tan, ocular or oculodermal melanocytosis, cutaneous or iris or choroidal nevus, and BRCA1-associated protein 1 mutation. Currently, the most widely used first-line treatment options for this malignancy are resection, radiation therapy, and enucleation. There are two main types of radiation therapy: plaque brachytherapy (iodine-125, ruthenium-106, or palladium-103, or cobalt-60) and teletherapy (proton beam, helium ion, or stereotactic radiosurgery using cyber knife, gamma knife, or linear accelerator). The alternative to radiation is enucleation. Although these therapies achieve satisfactory local disease control, long-term survival rate for patients with uveal melanoma remains guarded, with risk for liver metastasis. There have been advances in early diagnosis over the past few years, and with the hope survival rates could improve as smaller tumors are treated. As in many other cancer indications, both early detection and early treatment could be critical for a positive long-term survival outcome in uveal melanoma. These observations call attention to an unmet medical need for the early treatment of small melanocytic lesions or small melanomas in the eye to achieve local disease control and vision preservation with the possibility to prevent metastases and improve overall patient survival.

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A urinary tract infection (UTI) is an infection in any part of your urinary system — your kidneys, ureters, bladder and urethra. Most infections involve the lower urinary tract — the bladder and the urethra.Women are at greater risk of developing a UTI than are men. Infection limited to your bladder can be painful and annoying. However, serious consequences can occur if a UTI spreads to your kidneys.Doctors typically treat urinary tract infections with antibiotics. But you can take steps to reduce your chances of getting a UTI in the first place

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An umbilical hernia creates a soft swelling or bulge near the navel (umbilicus). If your baby has an umbilical hernia, you may notice the bulge only when he or she cries, coughs or strains. The bulge may disappear when your baby is calm or lies on his or her back.Umbilical hernias in children are usually painless. Umbilical hernias that appear during adulthood may cause abdominal discomfort.

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Puffiness under the eyes can be bothersome, but it’s usually just a cosmetic concern. While rare, undereye puffiness can be a symptom of some kidney and thyroid conditions. If you occasionally wake up with puffiness under the eyes, consider what you did the day before to look for lifestyle causes such as staying up late or eating too much salt. Consider talking to your doctor about possible treatments for chronic undereye puffiness.

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Unstable angina belongs to the spectrum of clinical presentations referred to collectively as acute coronary syndromes (ACSs), which also includes ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI). [1, 2] Unstable angina is considered to be an ACS in which there is myocardial ischemia without detectable myocardial necrosis (ie, cardiac biomarkers of myocardial necrosis —such as creatine kinase MB isozyme, troponin, myoglobin—are not released into the circulation). See the image below.

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Cancer of the ureter (ureteral cancer) is a type of cancer that begins in the cells that line the inside of the tubes (ureters) that connect your kidneys to your bladder. Ureters are part of the urinary tract, and they carry urine produced by the kidneys to the bladder.Ureteral cancer is uncommon. It occurs most often in older adults and in people who have previously been treated for bladder cancer.Ureteral cancer is closely related to bladder cancer. The cells that line the ureters are the same type of cells that line the inside of the bladder. People diagnosed with ureteral cancer have a greatly increased risk of bladder cancer, so your doctor will recommend tests to look for signs of bladder cancer.Treatment for ureteral cancer typically involves surgery. In certain cases, chemotherapy may be recommended.

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Ureteral obstructions are blockages in your urinary tract, which includes your kidneys, bladder, the tubes that carry urine from your kidneys to your bladder (ureters), and the tube that connects your bladder to the outside of your body (urethra). Blockages can develop for many reasons, including gastrointestinal problems. Ureteral obstructions are more common in men, especially as they get older and their prostate gland enlarges.Obstructions can be cured with surgery, but they need to be treated promptly. If they’re not, they can lead to severe illness, kidney damage and life-threatening infections.

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The idea behind functional training is that each exercise should be more natural and carry over into daily life. Functional training exercises tend to activate more muscles and therefore consume more energy. These multidimensional exercises also tend to improve your natural movement skills and enhance your general mobility.See how many of the below functional training exercises you can incorporate into your workouts for a more practical and fat burning workout.


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Zumba is an exercise fitness program created by Colombian dancer and cyclist/choreographer Alberto "Beto" "Power Pedal" Perez during the 1990s.[1] Zumba is a trademark owned by Zumba Fitness, LLC. The Brazilian pop singer Claudia Leitte has become the international ambassador to Zumba Fitness. Zumba involves dance and aerobic movements performed to energetic music. The choreography incorporates hip-hop, soca, samba, salsa, merengue and mambo. Squats and lunges are also included.[3] Zumba Fitness, the owner of the Zumba program, does not charge licensing fees to gyms or fitness centers.[4] Approximately 15 million people take weekly Zumba classes in over 200,000 locations across 180 countries


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Those who are looking to feel the burn, baby! Looking to strengthen and tone your legs and glutes? Step right up.We combine the awesome toning and strengthening power of Step aerobics, with the fun fitness-party that only Zumba® brings to the dance-floor.Zumba® Step increase cardio and calorie burning, while adding moves that define and sculpt your core and legs.


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This beginner level workout features basic choreography. Gin Miller, the inventor of step aerobics, leads this video. In an article appearing on the IDEA Health and Fitness Association website, Miller says "Everbody Steps" is a top seller. It's a solid, complete introduction to step workouts. You burn fat while learning the step basics from Miller, an IDEA Instructor of the Year with 12 years of step experience. Miller makes the moves understandable and explains common step-aerobic terminology in laymen's terms. The video has six distinct segments that allow you to advance at your own pace and stop when you want. The workout begins with the simplest steps and the easiest patterns and progresses into classic step-aerobic combinations, such as straddles, turns and transitions.


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Look around. There are countless articles in magazines and online about gaining size and strength. Everyone wants to get strong, and everyone wants to add muscle, but most don’t achieve the goal. Why? A number of reasons, including ridiculous exercise selection, poor programming, and—from what I’ve seen as a coach for almost 25 years—bad form.If you’re willing to do the hard work and make the commitment to using perfect form, I’ve got the ultimate plan for you: an eight-week guide to getting stronger than you ever thought you could.It’s a simple plan based on compound movements, high-repetition heavy lifting, and maximum-effort training. Throw in the right assistance work and you’ve got a plan for success.


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At the foundation of fusion yoga is a community of people coming together to practice yoga as a way to be free of pain, to think more clearly, and to have a better relationship with the world.  Fusion yoga is a supporting, exciting, and empowering experience for yoga practitioners of every level. Whether you're new or highly experienced, you'll find a class offering that meets your needs.  Our yoga classes are meant to challenge you mentally and physically.  All classes ask you to look within- to tap into your own innate needs, potential and expression as you cultivate your own experience.


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Gym workouts can help you burn calories and lose fat, gain strength, tone muscle groups and develop an overall sense of well-being. To add a twist to your regular workout routine, get together with one or more others at your gym and play a few gym workout games. Be sure all game participants stay hydrated before, during and after the workout. Consult your physician before beginning an exercise program.


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A nine-to-five job shackled to your cubicle leaves you with hardly any stamina to hit the gym in the evenings. Add to that, lack of motivation and it can only spell doom for your waistline. In such a scenario, can a party workout be that much-needed boost The party workout is redefining the concept of the workout, which brings the dance club into the gym. Fitness clubs host disco-lit classes of boot-camp style routines set to pumping music played by DJs. It's the latest fitness fad hitting New York gyms, and is generally wrapped up with post-workout 'pretend'tinis made from vitamin water! While it sounds like the perfect fix for those who want a club experience minus the calories of cocktails, can it really work for you? We get experts to comment.


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 Inactivity is taking its toll on human beings. As fitness professionals, we are keenly aware that society is fascinated with the human body—with losing fat, specifically—and yet, getting people to exercise is still a major obstacle. Obesity, a significant and growing health problem, has been associated with heart disease, diabetes, hyperlipidemia, hypertension and hyperinsulinemia, among other conditions. The numbers speak louder than words. Overweight is defined as having a body mass index (BMI) of 25 to 29.9, obesity as having a BMI equal to or greater than 30. Fifty-five to 60 percent of adults over the age of 18 have a BMI of at least 25; approximately 22 percent have a BMI of 30 or higher (Jakicic et al. 2001).


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An echocardiogram (echo) is a graphic outline of the heart's movement. During an echo test, ultrasound (high-frequency sound waves) from a hand-held wand placed on your chest provides pictures of the heart's valves and chambers and helps the sonographer evaluate the pumping action of the heart. Echo is often combined with Doppler ultrasound and color Doppler to evaluate blood flow across the heart's valves.

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This test is the same as a treadmill exercise test. This test checks the function of the heart during and after physical activity. In addition, an IV will be started and, at the peak of exercise, the patient will be injected with a mild isotope. The patient will then be escorted to the scanning room adjacent to the stress lab for approximately 30 minutes. From there, the patient will be free to leave and will return 3 hours later for a repeat scan.


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A brainstem auditory evoked response (BAER) test measures how your brain processes the sounds you hear. The BAER test records your brainwaves in response to clicks or other audio tones that are played for you. The test is also called a brainstem auditory evoked potentials (BAEP) or auditory brainstem response (ABR) test.


A BAER test can help to diagnose hearing loss and nervous system disorders, especially in newborns, young children, and others who may not be able to participate in a standard hearing test.


BAER tests are often administered to canines and are the only scientifically reliable way to test a dog’s ability to hear with one or both ears.

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We reviewed the records of 52 amyotrophic lateral sclerosis (ALS) patients examined between 1995 and 2000 who had needle electromyography (EMG) of their respiratory muscles, including the diaphragm, at or near the time of their diagnosis. With respiratory function testing, patients with abnormal diaphragmatic EMG at diagnosis (Group 1, n=23) had significantly lower forced vital capacity (FVC), lower daytime arterial PO(2) and higher PCO(2) measurements (p<0.05) than patients with normal diaphragmatic EMG (Group 2, n=29). Twenty-eight percent of the patients without symptoms or signs of respiratory insufficiency at the time they were examined had an abnormal diaphragm EMG. Mean survival of Groups 1 and 2 were similar. However, sub-analysis of patients within each group, comparing those treated with non-invasive positive pressure ventilation (NIPPV) with those not treated, showed that treated patients in Group 1 (abnormal diaphragm EMG) survived significantly longer (p<0.05) than untreated patients. They also started NIPPV earlier than treated patients in Group 2. We conclude that respiratory muscle EMG was simply and safely performed on ALS patients at or around the time of diagnosis. The procedure can detect sub-clinical respiratory muscle dysfunction. The technique used for EMG of the respiratory muscles, its pitfalls and contraindications are also reviewed.

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This course shows you videos of the commonly studied muscles in the upper extremity, insertional activity and muscle activation and motor unit analysis techniques to help you gain a working understanding of the technical skills you need to perform needle EMG examinations. The video will focus on muscle localization and needle insertion techniques, what results you should expect, how to study the shape, amplitude and duration of motor unit waveforms, pitfalls and common errors you should watch for. Muscles studied include the First Dorsal Interosseous (FDI), the Abductor Pollicis Brevis (APB), the Flexor Carpi Radialis (FCR) the Brachio-Radialis (BR), the Triceps (TRI), the Deltoid (DEL) and the Cervical Paraspinals.

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A nerve conduction study (NCS) involves activating nerves electrically with small safe pulses over several points on the skin, usually on the limbs, and measuring the responses obtained. Usually, the response or signal is measured from the nerve itself or from a muscle supplied by the nerve being activated. This gives information about the state of health of the nerve, muscle and neuromuscular junction (the portion responsible for communication between the nerve and muscle). A commercial device is normally employed to measure the signals.

Electromyography (also known as needle EMG) involves the measuring of electrical activity within muscles by way of a needle electrode. It is rather similar to having an electrical microphone at the tip of the needle. Muscles are electrically active organs, and the signals and patterns of signals can lend additional information regarding the state of the muscle as well as the nerve supplying it.

In Australia, the person responsible for these tests is a neurologist, who frequently has had further training in the subspecialty of clinical neurophysiology.
A doctor may recommend that you undergo this test. There are a wide variety of conditions that are assessed with this technique. Quite frequently, the examination is requested because the patient is experiencing symptoms that suggest some problem with the nerves (numbness, tingling, weakness or pain) or muscles (weakness or pain), even though the physical examination is normal. Indeed, in many cases, there is no abnormality seen and the test can then be reassuring, but it cannot detect all conditions. In general terms, the test is useful for detecting if there is a significant abnormality, but this is also often easier when there is a definite clinical abnormality. In such cases, the test can help clarify what the problem is, although usually, unless the nerve problem is a common entrapment (site of compression), other tests may be required to ascertain the exact nature of the problem.
There are several types of nerves but generally speaking, the two major types are motor and sensory nerves. Motor nerves carry signals from the brain to the muscle to enable contraction and movement, and sensory nerves relay information to the brain. When the nerve is stimulated with metal electrodes (metallic patch/es that can conduct signals), a response can be measured by surface (on the skin) electrodes some distance away in sensory nerves overlying the nerve itself. For the motor nerves, the response is usually detected over the muscle that is activated by that nerve. In this fashion, results can reveal information about the size and speed of the electrically conducted impulse. The size usually reveals the number of nerve fibres present and the speed, the integrity of the myelin (insulating membrane around the nerve ‘axon’ or cable). This is why the word ‘conduction’ is used.
You will be given instructions on how to prepare for the test. You should not use creams or emollients on your hands and feet (the most common sites of your nerve tests) on the day of the test, and preferably since your last shower or bath. Generally speaking, there are no other preparations of note.

Please advise the neurologist performing the test if you have a pacemaker or other similar devices. If you are taking warfarin, heparin or some other medication to thin your blood, and if you are having a needle EMG test, you should advise both your GP and the neurologist. A measurement of how thin your blood is may be important before that test can be performed.
The NCS procedure is usually very safe and is non-invasive. Firstly, you will be told how to position yourself and the skin area will be prepared. Then some electrodes will be attached to your skin and you will be forewarned when to expect the stimulation. Many people are understandably anxious about the intensities of the small safe electrical pulses that are passed via the skin, but usually relax quickly when they know what to expect. It is faily important that you remain relaxed for the recordings to minimise the ‘noise’ (interference) in the recordings from excessive muscular activity.
Here, a small needle is inserted through the skin into a muscle belly. Sterilisation of the skin and a local anaesthetic is not generally required. Usually the consultation and procedure takes about 30-45 minutes in all. More complicated assessments may demand more time.
Following the test, you will be allowed to put on your garments and shoes. It should be noted that the final interpretation of the clinical meaning of the test rests with the clinician who ordered the test. This is because they can put together the whole picture. For this reason, the neurologist performing the test can only give you limited information about the meaning of the results, and may not even be able to provide any information on the next step or any possible treatments because they are unaware of all the other clinical information.


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Proximal conduction studies by F-wave technique, with conventional distal motor and sensory conduction were performed along the ulnar nerves of 20 patients each with cervical spondylotic radiculopathy and/or myelopathy and with classical motor neurone disease (MND). Such F-wave parameters as shortest F-latency, F-conduction velocity, conduction time and F-ratio were calculated. Twenty-five age- and sex-matched healthy volunteers acted as controls. Proximal slowing associated with sensory conduction abnormalities and normal distal motor conduction favored cervical spondylosis (CS). Distal slowing with a normal proximal motor and sensory conduction was associated with motor neurone disease.


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Somatosensory Evoked Potentials (SSEPs) are electrical responses recorded from the nervous system following electrical stimulation of a peripheral nerve.  For example, stimulation of the median nerve at the wrist produces electrical activity that travels along the sensory pathway on its way to the brain. This activity can be recorded with electrodes positioned along that pathway.


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Visual Evoked Potential/ Response (VEP/VER) measures the electrical signal generated at visual cortex in response to visual stimulation. The visual cortex is primarily activated by the central visual field and there is a large presentation of the macula at occipital cortex. VEP depends on integrity of visual pathway including eye, optic nerve, chiasma, optic tract, optic radiation and cerebral cortex. Standard International Society for Clinical Electrophysiology of Vision (ISCEV) protocols[1] assess the anterior visual pathway (eye, optic nerve anterior to the optic chiasma). For dysfunctions of posterior visual pathway extended multi-channel protocols are needed.


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A barium enema is a type of X-ray imaging test that allows doctors to examine your lower intestinal tract. It involves delivering a contrast solution that contains the metallic element barium into your rectum while a technician takes X-ray images of the area. The barium solution will be delivered using an enema — a process in which your doctor pushes a liquid into your rectum through your anus.


The barium solution helps to improve the quality of the X-ray images by highlighting certain areas of tissue. The X-ray used in this procedure is known as fluoroscopy. It allows the radiologist to see your internal organs in motion by tracking the flow of the barium solution through your intestinal tract.


The test doesn’t require painkillers or sedation, but there may be moments of slight discomfort.

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Barium tests are used to help see the outline of the upper parts of the gut (gastrointestinal tract) such as the gullet (oesophagus), stomach and upper gut (small intestines). The gut (gastrointestinal tract) does not show up very well on ordinary X-ray pictures. However, if you drink a white liquid that contains a chemical called barium sulfate, the outline of the upper parts of the gut (oesophagus, stomach and small intestines) shows up clearly on X-ray pictures. This is because X-rays do not pass through barium.

Depending on what part of your gut is being looked at, you may have one or more of the tests listed below. In each test, the barium coats the lining of the gut being tested. Therefore, abnormalities in the lining or structure of the gut can be seen on the X-ray pictures. In each of the following tests, several X-ray pictures are taken using low-dose X-rays. The total amount of radiation for each test is quite small and thought to be safe. The X-ray machine is usually linked to a TV monitor. Still pictures, or a video recording of X-ray pictures taken in quick succession, can be taken if necessary.

In this test you drink some barium liquid. The barium liquid is often fruit-flavoured so it is pleasant to drink. You stand in front of an X-ray machine whilst X-ray pictures are taken as you swallow. This test aims to look for problems in the gullet (oesophagus). These include a narrowing (stricture), hiatus hernias, tumours, reflux from the stomach, disorders of swallowing, etc. You will usually be asked not to eat or drink for a few hours before this test. A barium swallow test takes about 10 minutes.

This is similar to a barium swallow (above). However, it aims to look for problems in the stomach and the first part of the gut (small intestine), known as the duodenum. These problems may include ulcers, small fleshy lumps (polyps), tumours, etc. You drink some barium liquid but you then lie on a couch whilst X-ray pictures are taken over your tummy (abdomen). It may take a little longer to do than a barium swallow.

So that the barium coats all around the lining of the stomach, the doctor doing the test (radiologist) may do one or more of the following:

Ask you to swallow some bicarbonate powder and citric acid before swallowing the barium. These 'fizz up' when they mix in the stomach and make some gas. (You may have to resist the urge to burp.) The gas expands the stomach and duodenum and also pushes the barium to coat the lining of the stomach and duodenum. This makes the X-ray pictures much clearer. It is the shape and contours of the lining of the stomach and duodenum which need to be seen most clearly on the pictures.

Ask you to turn over on to your stomach on the couch. Various X-ray pictures may be taken whilst you are in different positions. You may be given an injection of a drug that makes the muscles in the stomach and gut relax.You will usually be asked not to eat anything for several hours before this test. (Food particles in the gut can make it difficult to interpret the X-rays.) However, you may be allowed sips of water up to two hours before the test.


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A barium meal is a diagnostic test used to detect abnormalities of the esophagus, stomach and small bowel using X-ray imaging. X-rays can only highlight bone and other radio-opaque tissues and would not usually enable visualization of soft tissue. However, infusion of the contrast medium barium sulfate, a radioopaque salt, coats the lining of the digestive tract, allowing accurate X-ray imaging of this part of the abdomen.

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Have your dinners planned for the week within seconds!  As a Scramble member, each week you receive a suggested meal plan with:


Five family-friendly dinners complete with main course and one to two easy, healthy side dishes

Meals feature seasonal fruits and vegetables for great flavors and savings

All meals have full nutritional information by meal and by individual dish

An organized shopping list with items listed by grocery store section


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A barium swallow is an imaging test that uses X-rays to look at your upper gastrointestinal (GI) tract. Your upper GI tract includes the back of your mouth and throat (pharynx) and your esophagus.


You may have just a barium swallow. Or this test may be done as part of an upper GI series. This series looks at your esophagus, stomach, and the first part of the small intestine (duodenum).


X-rays use a small amount of radiation to create images of your bones and internal organs. X-rays are most often used to find bone or joint problems, or to check the heart and lungs. A barium swallow is one type of X-ray.


Fluoroscopy is often used during a barium swallow. Fluoroscopy is a kind of X-ray “movie.”


The test also uses barium. Barium is a substance that makes certain area of the body show up more clearly on an X-ray. The radiologist will be able to see size and shape of the pharynx and esophagus. He or she will also be able see how you swallow. These details might not be seen on a standard X-ray. Barium is used only for imaging tests for the GI tract.

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A carotid Doppler test is generally an outpatient procedure, states Johns Hopkins Medicine. During the test, the patient must lie on his back with his neck bent back slightly. A technician applies a gel to the skin, presses a device called a transducer against the neck, and moves it around the area of the carotid artery. The technician then repeats the process on the other side of the neck. Carotid Doppler tests do not expose patients to radiation, and they usually do not cause any discomfort.


Patients who have carotid artery blockage or narrowing sometimes experience symptoms such as dizziness, confusion, drowsiness or headache that prompt a doctor to perform a carotid Doppler test, states Johns Hopkins Medicine. Other symptoms that may indicate problems with blood flow in the carotid arteries include momentary blindness in one eye or temporary problems speaking or moving. Carotid Doppler is sometimes performed as part of an evaluation prior to major cardiac surgery.

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A Doppler ultrasound is a noninvasive test that can be used to estimate the blood flow through your blood vessels by bouncing high-frequency sound waves (ultrasound) off circulating red blood cells. A regular ultrasound uses sound waves to produce images, but can't show blood flow.


A Doppler ultrasound may help diagnose many conditions, including:


Blood clots

Poorly functioning valves in your leg veins, which can cause blood or other fluids to pool in your legs (venous insufficiency)

Heart valve defects and congenital heart disease

A blocked artery (arterial occlusion)

Decreased blood circulation into your legs (peripheral artery disease)

Bulging arteries (aneurysms)

Narrowing of an artery, such as in your neck (carotid artery stenosis)

A Doppler ultrasound can estimate how fast blood flows by measuring the rate of change in its pitch (frequency). During a Doppler ultrasound, a technician trained in ultrasound imaging (sonographer) presses a small hand-held device (transducer), about the size of a bar of soap, against your skin over the area of your body being examined, moving from one area to another as necessary.


This test may be done as an alternative to more-invasive procedures, such as angiography, which involves injecting dye into the blood vessels so that they show up clearly on X-ray images.


A Doppler ultrasound test may also help your doctor check for injuries to your arteries or to monitor certain treatments to your veins and arteries.

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Alterations of the abdominal aorta are relatively common, particularly in older people. Technological advances in the fields of ultrasonography, computed tomography, angiography, and magnetic resonance imaging have greatly increased the imaging options for the assessment of these lesions. Because it can be done rapidly and is also non-invasive, ultrasonography plays a major role in the exploration of the abdominal aorta, from its emergence from the diaphragm to its bifurcation. It is indicated for the diagnosis and follow-up of various aortic diseases, especially aneurysms. It can be used to define the shape, size, and location of these lesions, the absence or presence of thrombi and their characteristics. It is also useful for monitoring the evolution of the lesion and for postoperative follow-up. However, its value is limited in surgical planning and in emergency situations.

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This study aimed to evaluate the vascular pattern of solid breast lesions using power Doppler ultrasonography (PDUS) and assess whether the presence of intratumoural penetrating vessels can predict breast cancer malignancy.

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Carotid ultrasound uses sound waves to produce pictures of the carotid arteries in the neck which carry blood from the heart to the brain. A Doppler ultrasound study – a technique that evaluates blood flow through a blood vessel – is usually part of this exam. It’s most frequently used to screen patients for blockage or narrowing of the carotid arteries, a condition called stenosis which may increase the risk of stroke.


Little or no special preparation is required for this procedure. Leave jewelry at home and wear loose, comfortable clothing. A loose-fitting, open necked shirt or blouse is ideal.

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The use of Doppler ultrasound to assess both the changing haemodynamics of the neonatal circulation and the perfusion of the brain is reviewed. The brain is particularly susceptible to both ischaemic and haemorrhagic injury in preterm and asphyxiated infants. However, the unique characteristics of the transitional neonatal circulation, and of the cerebral vasculature, pose considerable problems in the interpretation of Doppler signals from intracranial arteries. A volumetric Doppler method which eliminates some of those problems is discussed. The same method allows full assessment of the cardiovascular status of the newborn infant, including estimation of ductal shunting and left ventricular output. Doppler ultrasound, if used with a full understanding of the inherant assumptions and limitations of the particular methodology, is likely to prove invaluable in investigating pathological cerebral and cardiac vascular events in the newborn.

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With the most advanced Echo-cardiography ultrasound and color Doppler system from Philips which uses a X- Matrix Probe (>9000 piezoelectric crystals) and break-through pure wave single crystal technology deliver high wualty images.


This is the only diagnostic centre in city doing ultrasound contrast study. 

Some of the features are unique in the machine and not available elsewhere. The machine gives extreme resolution for excellent 2D and LIVE 3D (4D) images. It has extreme color sensitivity. 3D images in cross sectional view (all three planes). VOCAL ( Volumetric organ calculation), Multislice CT like images. PANORAMIC images to include a wide area in single image. Dynamic MR to give maximum resolution, Broad band frequency compounding, harmonic imaging etc.

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A recent estimate of the number of men in the United States suffering with complete erectile dysfunction is 10 to 20 million. When partial erectile dysfunction is included, the estimate jumps to 30 million.1 Age-specific prevalence is estimated to be 5% at age 40, increasing to 15% to 25% by age 65. In clinical series, the ratio of organic to psychologic male sexual dysfunction also varies with age: 70% of patients under 35 years of age have a psychogenic cause, and 85% of patients over 50 years of age have organic impotence.2 Patient accounts of coital frequency similarly vary with age: 75% of men in their seventh decade report having coitus once monthly, and 37% of patients 60 to 69 years old describe having weekly coitus.

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Doppler ultrasonography of the lower extremity arteries is a valuable technique, although it is less frequently indicated for peripheral arterial disease than for deep vein thrombosis or varicose veins. Ultrasonography can diagnose stenosis through the direct visualization of plaques and through the analysis of the Doppler waveforms in stenotic and poststenotic arteries. To perform Doppler ultrasonography of the lower extremity arteries, the operator should be familiar with the arterial anatomy of the lower extremities, basic scanning techniques, and the parameters used in color and pulsed-wave Doppler ultrasonography.

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A Doppler ultrasound is a test that uses high-frequency sound waves to measure the amount of blood flow through your arteries and veins, usually those that supply blood to your arms and legs.


Vascular flow studies, also known as blood flow studies, can detect abnormal flow within an artery or blood vessel. This can help to diagnose and treat a variety of conditions, including blood clots and poor circulation. A Doppler ultrasound can be used as part of a blood flow study.


A Doppler ultrasound is a risk-free and pain-free procedure that requires little preparation. The test provides your doctor with important information about the flow of blood through your major arteries and veins. It can also reveal blocked or reduced blood flow through narrowed areas in the arteries, which could eventually lead to a stroke.

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A Doppler ultrasound, also called a Color Doppler test is a non-invasive test that can be used to estimate your blood flow through blood vessels. It helps doctors evaluate blood flow through major arteries and veins, such as those of the arms, legs, and neck. It can show blocked or reduced flow of blood through narrow areas in the major arteries of the neck that could cause a stroke. It also can reveal blood clots in leg veins (deep vein thrombosis, or DVT) that could break loose and block blood flow to the lungs (pulmonary embolism). During pregnancy, Doppler ultrasound may be used to look at blood flow in an unborn baby (foetus) to check the health of the foetus. 

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A prospective study comparing colour Doppler ultrasound (US) with the 'gold standard' of intra-arterial digital subtraction angiography in the evaluation of renal transplant artery stenosis was performed. Both the intrarenal vessels and the transplant renal artery were examined by Doppler US. Diagnostic arteriography was performed only if, on Doppler, the peak systolic velocity in the transplant renal artery exceeded 1.5 ms-1. Of 109 patients, the transplant artery could not be visualized using colour Doppler US in three, and these were omitted from statistical analysis. Of the remaining 106 patients, 31 had a peak systolic velocity greater than 1.5 ms-1 in the transplant renal artery and were referred for DSA. Of the multiple renal Doppler indices recorded, the peak systolic velocity in the transplant artery was the best discriminating measurement for the detection of renal artery stenosis. A peak systolic velocity of > or = 2.5 ms-1 in the transplant renal artery had a sensitivity of 100% and a specificity of 95% for the detection of renal artery stenosis ( > 50% diameter reduction). Although a significant difference in Pulsatility Index, Resistive Index, Acceleration Index and Acceleration Time was recorded from the intrarenal vessels in the angiographically normal and stenosed groups with Doppler, these measurements were less useful as discriminating diagnostic tests. In conclusion, the peak systolic velocity in the transplant renal artery is the most sensitive Doppler criterion for renal artery stenosis and is sensitive and specific enough to be used as a screening test. The intrarenal acceleration time and index should not be used in isolation.

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A device called a transducer is passed over the scrotum, directing high-frequency sound waves (ultrasound) at the structures within, including the testicle, epididymis (the tube that transports sperm from the testicle), and blood vessels. The sound waves are reflected back to the transducer and electronically converted into real-time images displayed on a viewing monitor. These images are then saved on film or video and reviewed for abnormalities.

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Color Doppler is an ultrasound-based diagnostic imaging technique used to visualize subcutaneous body structures including tendons, muscles, joints, vessels and internal organs for possible Pathology or Lesions. Colour Doppler is also used for the following applications:-

Carotid Colour Doppler to detect risk of stroke and paralysis by   evaluating the vessels   in the neck that supply blood to the brain.  Peripherial Arterial Colour Doppler.

Peripherial Venous Colour Doppler for detection of Deep Vein Thrombosis (DVT).

Renal Doppler (especially for hypertensive patients and diabetics).

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Color Doppler ultrasound is a medical imaging technique which is used to provide visualization of the bloodflow, using color processing to add color to the image so that a doctor or care provider can clearly see what is happening inside the body. This technique requires the use of an ultrasound machine which is capable of color Doppler ultrasound, and can be performed in a hospital or clinic as an outpatient procedure. Having this imaging study performed is not usually painful, and the patient does not require sedatives. 

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Venous ultrasound uses sound waves to produce images of the veins in the body. It is commonly used to search for blood clots, especially in the veins of the leg – a condition often referred to as deep vein thrombosis. Ultrasound does not use ionizing radiation and has no known harmful effects.


On occasion, you may be asked not to eat or drink anything but water for six to eight hours beforehand. Otherwise, little or no special preparation is required for this procedure. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown.

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A Doppler ultrasound, also called a Color Doppler test is a non-invasive test that can be used to estimate your blood flow through blood vessels. It helps doctors evaluate blood flow through major arteries and veins, such as those of the arms, legs, and neck. It can show blocked or reduced flow of blood through narrow areas in the major arteries of the neck that could cause a stroke. It also can reveal blood clots in leg veins (deep vein thrombosis, or DVT) that could break loose and block blood flow to the lungs (pulmonary embolism). During pregnancy, Doppler ultrasound may be used to look at blood flow in an unborn baby (foetus) to check the health of the foetus.

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The first reported case of the use of computed tomography (CT) to guide biopsy was published in 1975 (1). By 1976, CT was heralded as the single most accurate method for guiding biopsy (2). With the increasing availability of CT and the development of percutaneous techniques, this statement has proved true: CT is now the imaging modality of choice for guiding percutaneous procedures. Over the following 20 years, CT-guided procedures were performed by obtaining a planning image of the region of interest and using cutaneous markers to specify a percutaneous access point. Needle advancement was documented by leaving the scanning room and obtaining one to three contiguous images at the level of the needle plane and repeating the process with each subsequent manipulation of the needle. The advent of CT fluoroscopy in the early 1990s allowed the needle to be visualized in real time, expediting the procedure and markedly reducing its overall length, partly because participants did not leave the scanning room (3). However, the use of real-time CT fluoroscopy potentially increased patient radiation dose and, for the first time, exposed physicians, nurses, and technologists to radiation.


Because CT fluoroscopy–guided procedures have become more common, they account for an important portion of the radiation dose delivered to our patient population. It has been shown that radiation dose may be significantly reduced in diagnostic CT examinations with no loss of diagnostic image quality (4). Likewise, dose should be taken into account when planning interventional procedures, and the radiation dose used should be as low as reasonably achievable to complete the procedure successfully. In this article, we discuss how patient dose is estimated and how knowledge of how a radiation dose is distributed over the course of a procedure is essential in developing low-dose protocols. If certain straightforward steps are followed, it is possible to significantly reduce radiation exposure for both patients and physicians

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Computed tomography, more commonly known as a CT or CAT scan, is a diagnostic medical test that, like traditional x-rays, produces multiple images or pictures of the inside of the body.


The cross-sectional images generated during a CT scan can be reformatted in multiple planes, and can even generate three-dimensional images. These images can be viewed on a computer monitor, printed on film or transferred to a CD or DVD.


CT images of internal organs, bones, soft tissue and blood vessels provide greater detail than traditional x-rays, particularly of soft tissues and blood vessels.


A cardiac CT scan for coronary calcium is a non-invasive way of obtaining information about the presence, location and extent of calcified plaque in the coronary arteries—the vessels that supply oxygen-containing blood to the heart muscle. Calcified plaque results when there is a build-up of fat and other substances under the inner layer of the artery. This material can calcify which signals the presence of atherosclerosis, a disease of the vessel wall, also called coronary artery disease (CAD). People with this disease have an increased risk for heart attacks. In addition, over time, progression of plaque build up (CAD) can narrow the arteries or even close off blood flow to the heart. The result may be chest pain, sometimes called "angina," or a heart attack.


Because calcium is a marker of CAD, the amount of calcium detected on a cardiac CT scan is a helpful prognostic tool. The findings on cardiac CT are expressed as a calcium score. Another name for this test is coronary artery calcium scoring.

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Triphasic spiral liver Computed Tomography (CT) is a standardized procedure for the detection and characterization of a large variety of benign and malignant liver lesions. This helps in the decline of mortality and morbidity rates among patients with liver disease. Spiral computed tomography has gained acceptance as the preferred computed tomography technique for routine liver evaluation because it provides image acquisition at peak enhancement of liver parenchyma during a single breath hold. In addition fast data acquisition allows successive scanning of the entire liver at different intervals after injection of the iodinated contrast material, thus creating the possibility of multiphase liver computed tomography.

Triphasic CT scan is a good non-invasive tool and can be used as first line imaging modality for differentiating benign and malignant focal liver lesions. Benign lesions like haemangioma can be reliably differentiated from malignant liver lesion; therefore unnecessary biopsies can be avoided. It is also particularly useful for hypervascular lesions which can be easily missed on routine CT scanning.



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A doctor or physician may order a CT scan of the leg to make detailed pictures and analyze the internal structure. Computerized tomography (CT) scanning is useful to get a very detailed 3D image of certain parts of legs.


The process begins by taking many different X-ray views at various different angles, which are then combined with the use of computer processing to create cross-sectional images of the bones and soft tissue inside of your body, including tissues inside of solid organ. Ordinary X-ray testing does not show clear images of soft tissue, so doctors often request CT scanning to get a good image of soft tissue including organs, muscles, blood vessels, nerves, and the brain. Sometimes a contrast dye is used as it shows up clearer on the screen.


A quality CT scan of the leg will use multiple x-rays to make cross sectional pictures of the leg.

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A CT scan, commonly referred to as a CAT scan, is a type of X-ray that produces cross-sectional images of a specific part of the body. In the case of a lumbar spine CT scan, your doctor can see a cross-section of your lower back. The scanning machine circles the body and sends images to a computer monitor, where they are reviewed by a technician.


The lumbar portion of the spine is a common area where back problems occur. The lumbar spine is the lowest portion of your spine. It’s made up of five vertebral bones. Below the lumbar spine is the sacrum and below the sacrum is the coccyx (tailbone). Large blood vessels, nerves, tendons, ligaments, and cartilage are also part of the lumbar spine.

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CT scanning-sometimes called CAT scanning-is a noninvasive medical test that helps physicians diagnose and treat medical conditions.


CT scanning combines special x-ray equipment with sophisticated computers to produce multiple images or pictures of the inside of the body. These cross-sectional images of the area being studied can then be examined on a computer monitor, printed or transferred to a CD.


CT scans of internal organs, bones, soft tissue and blood vessels provide greater clarity and reveal more details than regular x-ray exams.


Using specialized equipment and expertise to create and interpret CT scans of the body, radiologists can more easily diagnose problems such as cancers, cardiovascular disease, infectious disease, appendicitis, trauma and musculoskeletal disorders.

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Computed tomography (CT) perfusion of the head uses special x-ray equipment to show which areas of the brain are adequately supplied with blood (perfused) and provides detailed information about blood flow to the brain. CT perfusion is fast, painless, noninvasive and accurate. It’s a useful technique for measuring blood flow to the brain, which may be important for treating stroke, brain blood vessel disease and brain tumors.

Computed tomography (CT) perfusion imaging shows which areas of the brain are adequately supplied or perfused with blood and provides detailed information on delivery of blood or blood flow to the brain.

CT perfusion scanning is a noninvasive medical test that helps physicians diagnose and treat medical conditions.

CT scanning combines special x-ray equipment with sophisticated computers to produce multiple images or pictures of the inside of the body. These cross-sectional images of the area being studied can then be examined on a computer monitor, printed or transferred to a CD.

CT scans of internal organs, bones, soft tissue and blood vessels provide greater clarity and reveal more details than regular x-ray exams.

In many ways CT scanning works very much like other x-ray examinations. Different body parts absorb the x-rays in varying degrees. It is this crucial difference in absorption that allows the body parts to be distinguished from one another on an x-ray film or CT electronic image.

In a conventional x-ray exam, a small amount of radiation is aimed at and passes through the part of the body being examined, recording an image on a special electronic image recording plate. Bones appear white on the x-ray; soft tissue, such as organs like the heart or liver, shows up in shades of gray, and air appears black.With CT scanning, numerous x-ray beams and a set of electronic x-ray detectors rotate around you, measuring the amount of radiation being absorbed throughout your body. Sometimes, the examination table will move during the scan, so that the x-ray beam follows a spiral path. A special computer program processes this large volume of data to create two-dimensional cross-sectional images of your body, which are then displayed on a monitor. CT imaging is sometimes compared to looking into a loaf of bread by cutting the loaf into thin slices. When the image slices are reassembled by computer software, the result is a very detailed multidimensional view of the body's interior.

Refinements in detector technology allow nearly all CT scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, allow thinner slices to be obtained in a shorter period of time, resulting in more detail and additional view capabilities.


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Abdominal and Pelvic CT scan shows the abdominal and pelvic organs of our body (such as the pancreas, liver, kidneys, spleen, and adrenal glands) and the gastrointestinal tract. A doctor usually orders this test to check for a cause of abnormal pain and sometimes to follow-up on an abnormality seen on another test such as an ultrasound.

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A fistulogram is a special x-ray procedure. It uses a form of real-time x-ray called fluoroscopy and a barium-based contrast material to produce images of an abnormal passage within the body called a fistula. It looks at the blood flow in your fistula or graft (dialysis access). This procedure can check to see if it is blocked or if there is any narrowing (stenosis).

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Fluoroscopy is a study of moving body structures. It’s much like an X-ray "movie" and is often done while a contrast dye moves through the part of the body being examined. A continuous X-ray beam is passed through the body part and sent to a video monitor so that the body part and its motion can be seen in detail. Fluoroscopy, as an imaging tool, allows healthcare providers to look at many body systems, including the skeletal, digestive, urinary, cardiovascular, respiratory, and reproductive systems.


Fluoroscopy may be used to evaluate specific areas of the body. These include the bones, bowel, muscles, heart vessels, and joints.

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A micturating cysto-urethrogram (or MCU) is a study using X-rays that shows the bladder and urethra (the tube that carries urine from the bladder and out of the body) while passing urine (see children’s X-ray examination). The test is performed to find out if the urine goes from the bladder back up to the kidneys instead of out through the urethra, known as vesico-ureteric reflux (VUR). This can be the cause of recurrent urinary tract (in the bladder or kidneys) infection and kidney damage. The test also shows how the bladder empties and what the urethra looks like.This test is most commonly performed on children under six months of age, but can be used less commonly as an investigation for older children and adults with multiple recurrent urinary tract infections.


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Diffusion tensor imaging tractography, or DTI tractography, is an MRI (magnetic resonance imaging) technique that measures the rate of water diffusion between cells to understand and create a map of the body’s internal structures; it is most commonly used to provide imaging of the brain. This advanced imaging technique, which provides much more detailed images of the brain than a conventional MRI, may also be used in the diagnosis of stroke, acute ischemia, brain tumors and multiple sclerosis, as well as pre-operative planning.  Using MRI technology, DTI tractography is non-invasive and uses radio waves and a magnetic field to produce images of the brain, tissues and skull. MRI technology provides detailed images showing small changes in body tissue and blood flow, which makes it an extremely reliable tool for the detection of disease, injury, bleeding and swelling.  Loyola offers state-of-the-art imaging and diagnostic techniques in order to provide timely and accurate diagnosis for our patients. Our expert radiologists are recognized nationally for clinical excellence, innovative diagnostic and therapeutic methods and skilled use of the latest technology. Our experienced technologists provide testing in a caring and compassionate environment where we want you to feel comfortable asking any questions you may have about your test or procedure. 


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Magnetic Resonance Imaging is a highly advanced imaging modality. Epilepsy Protocol MRI involves obtaining images of brain slices through MRI scanning in epileptic patients. This scanning enables the doctor in obtaining evidences of abnormalities or injuries in brain. Underlying pathologies inside of brain like infections or tumors cannot be seen externally. Such occurrences can be investigated through an MRI Epilepsy Protocol. As a result, MRI becomes the most accurate mode for planning line of treatment.


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CSF flow studies are performed using a variety of MRI techniques and are able to qualitatively assess and quantify pulsatile CSF flow. The most common technique used is time resolved 2D phase contrast MRI with velocity encoding. Note, when referring to CSF flow in the setting on imaging we are referring to pulsatile to-and-fro flow due to vascular pulsations rather than bulk transport of CSF (the mechanism by which produced CSF is absorbed, via absorption at arachnoid granulations and via the glymphatic pathway). The latter is too slow to be easily assessed clinically. 


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The anatomy of the craniovertebral junction, although complex, may be well visualized by routine MR imaging. This essay discusses the anatomy of the complex articulations of the craniovertebral junction. Representative MR images and gross anatomic photographs are presented to illustrate the intricate ligamentous and articular anatomy. Knowledge of the normal anatomy of the occipitoatlantoaxial region is necessary in order to understand the common disorders that affect this area. The most common disorders are trauma and arthropathies, but also include congenital abnormalities and neoplasm. The resultant abnormal mechanics may lead to neurologic sequelae or pain

 

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 A consistent inability to sustain an erection sufficient for sexual intercourse. Commonly known as impotence. Medically, the term erectile dysfunction is used to properly differentiate this form of impotence from other problems that interfere with sexual intercourse, such as disease, injury, drug side effects, or a disorder that impairs the nerve supply or the blood flow to the penis. Other forms of impotence include lack of sexual desire and problems with ejaculation and orgasm. Erectile dysfunction is treatable in all age groups, and treatment includes using medication (notably Viagra) and penile implants. Abbreviated ED.

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 An MRI scan uses magnets and radio waves to capture images inside your body without making a surgical incision. The scan allows your doctor to see the soft tissue of your body, like muscles and organs, in addition to your bones. An MRI can be performed on any part of your body. A lumbar MRI specifically examines the lumbar section of your spine — the region where back problems commonly originate.The lumbosacral spine is made up of the five lumbar vertebral bones (L1 thru L5), the sacrum (the bony “shield” at the bottom of your spine), and the coccyx (tailbone). The lumbosacral spine also consists of large blood vessels, nerves, tendons, ligaments, and cartilage.


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Pituitary gland plays a central role in body growth, metabolism, and reproductive function. A number of diseases that affect the pituitary-hypothalamic axis can have profound clinical, endocrinological as well as neurological consequences. These conditions can be classified as neoplastic, infectious, inflammatory, posttraumatic, congenital/developmental, and physiological. Various neoplastic conditions include pituitary adenoma/apoplexy, hypothalamic glioma, craniopharyngioma, rathke cleft cyst, germinoma, teratoma, metastasis, leukemic infiltration, lymphoma, and Langerhans cell histiocytosis. Infectious and inflammatory causes include tubercular/lymphocytic hypophysitis, sarcoidosis, and Wegener's granulomatosis. Traumatic causes include postoperative sella or transection of the pituitary stalk. Accurate diagnostic differentiation of these lesions is essential for both safe and effective disease management. Recent advances in neuroimaging helps the radiologists and endocrinologists to study the pituitary region in greater detail. Magnetic resonance imaging (MRI) is the imaging modality of choice for evaluating hypothalamic-pituitary-related endocrine diseases.

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Erectile dysfunction (ED) is the inability to get or keep an erection firm enough to have sexual intercourse. It’s also sometimes referred to as impotence.


Occasional ED isn’t uncommon. Many men experience it during times of stress. Frequent ED can be a sign of health problems that need treatment. It can also be a sign of emotional or relationship difficulties that may need to be addressed by a professional.


Not all male sexual problems are caused by ED. Other types of male sexual dysfunction include:

premature ejaculation

delayed or absent ejaculation

lack of interest in sex

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Magnetic resonance imaging (MRI) of the shoulder uses a powerful magnetic field, radio waves and a computer to produce detailed pictures of the bones, tendons, muscles and blood vessels within the shoulder joint. It is primarily used to assess injuries. Tell your doctor about any health problems, recent surgeries or allergies and whether there’s a possibility you are pregnant. The magnetic field is not harmful, but it may cause some medical devices to malfunction. Most orthopedic implants pose no risk, but you should always tell the technologist if you have any devices or metal in your body. Guidelines about eating and drinking before your exam vary between facilities. Unless you are told otherwise, take your regular medications as usual. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown. If you have claustrophobia or anxiety, you may want to ask your doctor for a mild sedative prior to the exam.


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Temporomandibular joint (TMJ) dysfunction is a common condition that is best evaluated with magnetic resonance (MR) imaging. The first step in MR imaging of the TMJ is to evaluate the articular disk, or meniscus, in terms of its morphologic features and its location relative to the condyle in both closed- and open-mouth positions. Disk location is of prime importance because the presence of a displaced disk is a critical sign of TMJ dysfunction. However, disk displacement is also frequently seen in asymptomatic volunteers, so that other findings may be required to help make the diagnosis. These findings include thickening of an attachment of the lateral pterygoid muscle, rupture of retrodiskal layers, and joint effusion and can serve as indirect early signs of TMJ dysfunction. It is important for the radiologist to detect early MR imaging signs of dysfunction, thereby avoiding the evolution of this condition to its final stage, an advanced and irreversible phase that is characterized by osteoarthritic changes such as condylar flattening or osteophytes. Further studies conducted with the latest MR imaging techniques will allow a better understanding of the sources of TMJ pain and of any discrepancy between imaging findings and patient symptoms.


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The purpose of this study was to correlate disc position and the type of disc displacement, intra-capsular effusion and degenerative changes of the condyle as demonstrated in MRI studies. In this study, 126 temporomandibular joints (TMJs) of 63 patients with TMJ disorders were investigated using clinical examination and MRI. One hundred and twelve TMJs were found to have internal derangement as disc displacement. The angle between the posterior margin of the disc and the vertical line drawn through the centre of the condyle was measured on MRI for each TMJ. The positions of the discs were normal, 0 degrees-10 degrees, in 11.11%; slightly displaced, 11 degrees-30 degrees, in 37.30%; mildly displaced 31 degrees-50 degrees, in 15.08%; moderately displaced, 51 degrees-80 degrees, in 7.14% of the TMJs with anterior displacement with reduction (ADDR). The disc position was severely displaced anteriorly, as over 80 degrees, in all TMJs with anterior disc displacement without reduction (ADD), constituting 27.78% of all cases. We found that the smaller the degree of disc displacement the milder the internal derangement and that the intra-capsular effusion was more frequently associated with TMJ with ADDR. The degenerative condylar changes were more severe with an increased degree of anterior disc displacement.


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Magnetic resonance cholangiopancreatography (MRCP) is a special type of magnetic resonance imaging (MRI) exam that produces detailed images of the hepatobiliary and pancreatic systems, including the liver, gallbladder, bile ducts, pancreas and pancreatic duct. Magnetic resonance imaging (MRI) is a non-invasive medical test that physicians use to diagnose and treat medical conditions.MRI uses a powerful magnetic field, radio frequency pulses and a computer to produce detailed pictures of organs, soft tissues, bone and virtually all other internal body structures. MRI does not use ionizing radiation (x-rays). Detailed MR images allow physicians to evaluate various parts of the body and determine the presence of certain diseases.

Doctors use MRCP to examine diseases of the liver, gallbladder, bile ducts, pancreas and pancreatic duct. These may include tumours, stones, inflammation or infection evaluate patients with pancreatitis to detect the underlying cause. In patients with pancreatitis, an MRCP may be performed using a medication called Secretin to assess for long term scarring and to determine the amount of healthy pancreatic function and secretions help to diagnose unexplained abdominal pain and provide a less invasive alternative to endoscopic retrograde cholangiopancreatography (ERCP). ERCP is a diagnostic procedure that combines endoscopy, which uses an illuminated optical instrument to examine inside the body, with iodinated contrast injection and x-ray images. You may be asked to wear a gown during the exam or you may be allowed to wear your own clothing if it is loose-fitting and has no metal fasteners. Guidelines about eating and drinking before an MRI exam vary. Usually, you will be instructed not to eat or drink anything for several hours before your procedure.Jewellery and other accessories should be left at home if possible, or removed prior to the MRI scan. Because they can interfere with the magnetic field of the MRI unit, metal and electronic items are not allowed in the exam room. In general, metal objects used in orthopaedic surgery pose no risk during MRI. However, a recently placed artificial joint may require the use of another imaging procedure. If there is any question of their presence, an x-ray may be taken to detect and identify any metal objects.


You will usually be alone in the exam room during the MRI procedure. However, the technologist will be able to see, hear and speak with you at all times using a two-way intercom. Many MRI centres allow a friend or parent to stay in the room as long as they are also screened for safety in the magnetic environment.  A radiologist, a physician specifically trained to supervise and interpret radiology examinations, will analyze the images and send a signed report to your primary care or referring physician, who will share the results with you.


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Pulmonary function tests are a broad range of tests that measure how well the lungs take in and exhale air and how efficiently they transfer oxygen into the blood. Spirometry measures how well the lungs exhale. The information gathered during this test is useful in diagnosing certain types of lung disorders, but is most useful when assessing for obstructive lung diseases (especially asthma and chronic obstructive pulmonary disease, COPD). Lung volume measurement detects restrictive lung diseases. In this set of diseases, a person cannot inhale a normal volume of air. Restrictive lung diseases may be caused by inflammation or scarring of the lung tissue (interstitial lung disease) or by abnormalities of the muscles or skeleton of the chest wall. Testing the diffusion capacity (also called the DLCO) permits an estimate of how efficiently the lungs transfer oxygen from the air into the bloodstream.


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A retrograde urethrogram is a routine radiologic procedure (most typically in males) used to image the integrity of the urethra. Hence a retrograde urethrogram is essential for diagnosis of urethral injury, or urethral stricture. The procedure involves the insertion of a Foley catheter into the distal urethra and minimally inflating it. This is followed by instillation of 30mL of water-soluble contrast and a plain radiograph is obtained; leakage of the contrast suggests urethral injury (usually secondary to pelvic trauma) and is an indication for surgical intervention.It is used when there is suspicion of urethral trauma, such as a history of trauma to the area followed by pain, inability to void urine, or the presence of blood at the urethral meatus, a scrotal hematoma, or free-floating prostate on rectal examination. If a urethral injury is suspected, a retrograde urethrogram should be performed before attempting to place a Foley catheter into the bladder. If there is a urethral disruption, a suprapubic catheter should be placed.

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Ultrasound imaging also called as sonography uses a transducer or probe to generate sound waves and produce pictures of the body's internal structures. It is often used to help diagnose unexplained pain, swelling or infection. It is used to see internal body structures such as tendons, muscles, joints, vessels and internal organs. It may also be used to provide imaging guidance to needle biopsies or to see and evaluate conditions related to blood flow. It is also the preferred imaging method for monitoring a pregnant woman and her unborn child. It does not use ionizing radiation, has no known harmful effects, and provides a clear picture of soft tissues that don't show up well on x-ray images.Most of these level II ultrasounds should be done in the second trimester of pregnancy usually between 18 and 22 weeks. It uses sound waves to produce pictures of a baby (embryo or fetus) within a pregnant woman, as well as the mother's uterus and ovaries. It does not use ionizing radiation, has no known harmful effects, and is the preferred method for monitoring pregnant women and their unborn babies. A Doppler ultrasound study – a technique that evaluates blood flow in the umbilical cord, fetus or placenta – may be part of this exam. It is a totally painless and safe procedure. It is useful test to establish the presence of fetus, estimate the age of pregnancy, diagnose congenital abnormalities of the fetus, assess fetal growth and well being etc. Preparation - No special preparation is needed.


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Your doctor has requested an ultrasound-guided biopsy. The goal of a biopsy is to remove a sample of tissue for testing in a laboratory. A biopsy can help diagnose abnormalities such as infection, inflammation or malignancy. During your biopsy, an imaging physician will use an ultrasound scanner to accurately guide a needle to the site of the biopsy. The needle will then be used to remove a tissue sample. At the S. Mark Taper Foundation Imaging Center, a highly trained medical team will oversee your procedure. This team will include an imaging physician, a diagnostic medical sonographer and a registered nurse.


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An ultrasound / SONOGRAPHY is a procedure that uses high-frequency sound waves to scan a the internal organs of the body woman’s abdomen and pelvic cavity, the reproductive system and the fetus of a pregnant woman creating a picture (sonogram) of the baby and placenta. Although the terms ultrasound and sonogram are technically different, they are used interchangeably and reference the same exam. They can show the structure and movement of the body's internal organs, including the abdomen, the fetus of pregnant women as well as blood flowing through blood vessels.

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A biophysical profile (BPP) test measures the health of your baby (fetus) during pregnancy. A BPP test may include a non stress test with electronic fetal heart monitoring and a fetal ultrasound. The BPP measures your baby's heart rate, muscle tone, movement, breathing, and the amount of amniotic fluid around your baby. A BPP is commonly done in the last trimester of pregnancy. If there is a chance that your baby may have problems during your pregnancy (high-risk pregnancy), a BPP may be done by 32 to 34 weeks or earlier. Some women with high-risk pregnancies may have a BPP test every week or twice a week in the third trimester. It is usually done to keep track of your baby’s health. 

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A breast ultrasound uses sound waves to make a picture of the tissues inside the breast. A breast ultrasound can show all areas of the breast, including the area closest to the chest wall, which is hard to study with a mammogram. Breast ultrasound does not use X-rays or other potentially harmful types of radiation. A breast ultrasound is used to see whether a breast lump is filled with fluid (a cyst) or if it is a solid lump. An ultrasound does not replace the need for a mammogram, but it is often used to check abnormal results from a mammogram


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Ultrasound imaging of the breast uses sound waves to produce pictures of the internal structures of the breast. It’s primarily used to help diagnose breast lumps or other abnormalities your doctor may have found during a physical exam, mammogram or breast MRI. Ultrasound is safe, noninvasive and does not use ionizing radiation.This procedure requires little to no special preparation. Leave jewelry at home and wear loose, comfortable clothing. You will be asked to undress from the waist up and to wear a gown during the procedure.

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 Ultrasound imaging of the head uses sound waves to produce pictures of the brain and cerebrospinal fluid. It is most commonly performed on infants, whose skulls have not completely formed. A transcranial Doppler ultrasound evaluates blood flow in the brain’s major arteries. Ultrasound is safe, noninvasive, and does not use ionizing radiation.This procedure requires little to no special preparation. Your doctor will instruct you on how to prepare, including whether adults undergoing the exam should refrain from using nicotine-based products that may cause blood vessels to constrict. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown.

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 B-scan ultrasonography is an important adjuvant for the clinical assessment of various ocular and orbital diseases. With understanding of the indications for ultrasonography and proper examination technique, one can gather a vast amount of information not possible with clinical examination alone. This article is designed to describe the principles, techniques, and indications for echographic examination, as well as to provide a general understanding of echographic characteristics of various ocular pathologies. 

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USG scan for Follicular Monitoring is done to study ovarian follicles that are used to identify ovulation of egg. For couples planning for pregnancy, ovulation period is the important period to try on, for conception to happen. Out of many ways available, the most reliable way to understand the ovulation is Follicular monitoring. It’s an endovaginal scan carried to study the ovaries, uterus and uterus lining. Looking at ovaries, the growth of follicles inside ovaries can be assessed giving a chance to predict the ovulation and also look if the womb is getting ready for pregnancy.

With follicular monitoring, you will get to know the growth of follicles, the approximate rupture period of follicles and hence can predict the ovulation period thereby have an intercourse happen at the right time for conception to take place. The womb if not yet ready for pregnancy can be treated by some supplements prescribed by the doctors.

This scan is carried out in a slightly dark examination room. You will have to undress down from your waist while you get covered by a sheet. Now you will be asked to position yourself lying down on your back on a special bed with your knees bent. Once you position yourself comfortably; the transducer, a sterile lubricated covered electronic device, is gently inserted into your vagina to look at the uterus and ovaries. Depending on how relaxed the patient is, the test takes up to 15 minutes.


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 X-ray beams are passed through the abdomen, producing images of the kidneys, ureters, and bladder on a special type of film. KUB radiography is often used as a first step in diagnosing problems of the urinary system, and is usually done in conjunction with intravenous pyelography.

 

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An ultrasound / SONOGRAPHY is a procedure that uses high-frequency sound waves to scan a the internal organs of the body woman’s abdomen and pelvic cavity, the reproductive system and the fetus of a pregnant woman creating a picture (sonogram) of the baby and placenta. Although the terms ultrasound and sonogram are technically different, they are used interchangeably and reference the same exam. They can show the structure and movement of the body's internal organs, including the abdomen, the fetus of pregnant women as well as blood flowing through blood vessels.

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Thyroid ultrasound uses sound waves to produce pictures of the thyroid gland within the neck. It does not use ionizing radiation and is commonly used to evaluate lumps or nodules found during a routine physical or other imaging exam.This procedure requires little to no special preparation. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown.

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Ultrasound  is safe and paUltrasoundinless, and produces pictures of the inside of the body using sound waves. Ultrasound imaging, also called ultrasound scanning or sonography, involves the use of a small transducer (probe) and ultrasound gel placed directly on the skin. High-frequency sound waves are transmitted from the probe through the gel into the body. The transducer collects the sounds that bounce back and a computer then uses those sound waves to create an image. Ultrasound examinations do not use ionizing radiation (as used in x-rays), thus there is no radiation exposure to the patient. Because ultrasound images are captured in real-time, they can show the structure and movement of the body's internal organs, as well as blood flowing through blood vessels.


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Ultrasound is a high-frequency sound that you cannot hear but it travels through fluid and soft tissues. However, it bounces back, or echoes, when it hits a more solid, dense surface such as a valve or bile in the gallbladder etc. So, when ultrasound 'hits' structures of different densities in our bodies, it echoes differently with each hit. 


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Ultrasound imaging of the scrotum uses sound waves to produce pictures of a man’s testicles and surrounding tissues. It is the primary method used to help evaluate disorders of the testicles, epididymis (a tube immediately next to a testicle that collects sperm) and scrotum. Ultrasound is safe, noninvasive, and does not use ionizing radiation.

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An ultrasound / SONOGRAPHY is a procedure that uses high-frequency sound waves to scan a the internal organs of the body woman’s abdomen and pelvic cavity, the reproductive system and the fetus of a pregnant woman creating a picture (sonogram) of the baby and placenta. Although the terms ultrasound and sonogram are technically different, they are used interchangeably and reference the same exam. They can show the structure and movement of the body's internal organs, including the abdomen, the fetus of pregnant women as well as blood flowing through blood vessels





 

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Thyroid ultrasound uses sound waves to produce pictures of the thyroid gland within the neck. It does not use ionizing radiation and is commonly used to evaluate lumps or nodules found during a routine physical or other imaging exam.This procedure requires little to no special preparation. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown.

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A transrectal ultrasound (TRUS) may also be called prostate sonogram or endorectal ultrasound. It is used to look at the prostate and tissues around it. An ultrasound transducer (also called a probe) sends sound waves through the wall of the rectum and into the prostate and surrounding tissue. A computer analyzes the wave patterns (called echoes) as they bounce off the organs and converts them into an image that doctors view on a video screen.

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An ultrasound test uses high-frequency sound waves to create images of your internal organs. Imaging tests can identify abnormalities and help doctors diagnose conditions. A transvaginal ultrasound, also called an endovaginal ultrasound, is a type of pelvic ultrasound used by doctors to examine female reproductive organs. This includes the uterus, fallopian tubes, ovaries, cervix, and vagina.

“Transvaginal” means “through the vagina.” This is an internal examination. Unlike a regular abdominal or pelvic ultrasound, where the ultrasound wand, or transducer, rests on the outside of the pelvis, this procedure involves your doctor or a technician inserting an ultrasound probe about two or three inches into your vaginal canal.


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An ultrasound / SONOGRAPHY is a procedure that uses high-frequency sound waves to scan a the internal organs of the body woman’s abdomen and pelvic cavity, the reproductive system and the fetus of a pregnant woman creating a picture (sonogram) of the baby and placenta. Although the terms ultrasound and sonogram are technically different, they are used interchangeably and reference the same exam. They can show the structure and movement of the body's internal organs, including the abdomen, the fetus of pregnant women as well as blood flowing through blood vessels.


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Ultrasound imaging also called as sonography uses a transducer or a probe to generate sound waves and produce pictures of the body's internal structures. It is often used to help diagnose unexplained pain, swelling or infection. It is also used to see internal body structures such as tendons, muscles, joints, vessels and internal organs. Ultrasound abdomen is primarily used for evaluating the kidneys, liver, pancreas, gall bladder etc.It may also be used to provide imaging guidance to needle biopsies or to see and evaluate conditions related to blood flow. It does not use ionizing radiation, has no known harmful effects, and provides a clear picture of soft tissues that don't show up well on x-ray images. It is a painless, safe and non invasive procedure.
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17-ketosteroids are substances that form when the body breaks down male steroid sex hormones called androgens and other hormones released by the adrenal glands in males and females, and by the testes in males.

A 24-hour urine sample is needed. You will need to collect your urine over 24 hours. Your health care provider will tell you how to do this. Follow instructions exactly to ensure accurate results.

Your provider will ask you to temporarily stop any medicines that may affect the test results. Be sure to tell your provider about all the medicines you take. These include:

1.Antibiotics

2.Aspirin (if you are on long-term aspirin)

3.Birth control pills

4.Diuretics (water pills)

5.Estrogen..


Increased levels of 17-ketosteroids may be due to:

1.Adrenal gland problems such as tumor, Cushing syndrome

2.Imbalance of sex hormones in females (polycystic ovary syndrome)

3.Ovarian cancer

4.Testicular cancer


Decreased levels of 17-ketosteroids may be due to:

1.Adrenal glands not making enough of their hormones (Addison disease)

2.Kidney damage

3.Pituitary gland not making enough of its hormones (hypopituitarism)

4.Removal of the testicles (castration)

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There are different types of cortisol tests that may be performed, including blood, saliva, and urine tests. The urine test is done over a period of 24 hours.

The cortisol urine test tends to be more comprehensive than the other types of cortisol tests. It measures the total amount of cortisol excreted into the urine over a 24-hour period. Blood tests or saliva tests, however, only measure cortisol levels at a particular time of day. Some people also find blood tests to be stressful, and since the body releases more cortisol during times of stress, the results may not be as precise. In some cases, your doctor may order both a cortisol urine test and another type of cortisol test to obtain more accurate results.


Cushing’s syndrome is a collection of symptoms associated with high cortisol levels. The most common symptoms include:


1.Increased urination

2.Increased thirst

3.Fatty tissue deposits, especially in the midsection and upper back

4.Pink or purple stretch marks on the skin

5.Weight gain

6.Fatigue

7.Muscle weakness

8.Thinning skin that bruises easily

9.Women may have irregular periods and excess facial and chest hair. Children may show delayed physical or cognitive development.


The symptoms of low cortisol levels often emerge slowly. At first, they may only appear during times of extreme stress, but they’ll gradually increase in intensity over several months. Potential symptoms include:


1.Weight loss

2.Fatigue

3.Dizziness

4.Fainting

5.Muscle weakness

6.Abdominal pain

7.Diarrhea

8.Constipation


When cortisol levels abruptly drop to life-threatening levels, an acute adrenal crisis may occur. The symptoms of an acute adrenal crisis include:


1.Darkening of the skin

2.Extreme weakness

3.Vomiting

4.Diarrhea

5.Fainting

6.Chills

7.Loss of appetite

8.Sudden onset of severe pain in the lower back, abdomen, or legs.


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Albumin commonly exists in the blood and is filtered by the kidneys. The presence or absence of albumin determines the functionality of the kidneys. It is said that small quantities of albumin leak into the urine when the kidneys do not function properly. This condition is known as microalbuminuria. A microalbumin test diagnosis urine for the presence of albumin.

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This test finds out how much 5-hydroxyindoleacetic acid (5-HIAA) is in your urine.


Your liver breaks down the hormone serotonin into 5-HIAA. This waste product is normally sent from your body in your urine. Tumors called functioning carcinoids secrete serotonin. Carcinoid tumors are found in the intestinal tract, lungs, appendix, and other body tissues. Because serotonin in the blood is broken down very quickly, the amount of 5-hydroxyindoleacetic acid collected in the urine over a full day more accurately reflects the rate at which serotonin is being made than the blood level at one particular time. 

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Acid- Fast Bacilli (AFB) smear and culture are two separate tests always performed together at the MSPHL, Tuberculosis (TB) Unit. AFB smear refers to the microscopic examination of a fluorochrome stain of a clinical specimen. The AFB culture is the inoculation of a clinical specimen onto culture media Becton-Dickinson Mycobacteria Growth Indicator Tube (B-D MGIT broth) and Lowenstein-Jensen (L-J) media slant, incubation at 37°C for up to six (6) weeks and detection of growth or no growth during this incubation period. Tuberculosis usually attacks the lungs but can also affect other parts of the body. It is spread through the air when people who have the disease cough, sneeze, or spit. The other widely used tests used in the diagnosis & screening of Tuberculosis infection are:AFB, smear examinationCulture, Mycobacterium TuberculosisMantoux test (Tuberculin skin test)Mycobacterium antibody panel (TB-IgG, IgM, IgA)Mycobacterium Tuberculosis by RT-PCRQuantiferon TB Gold.

The Acid Fast Bacilli - Sputum is done for routine health screenings, to identify the acid-fast bacilli in sputum, fluid or tissue specimen and to manage the medication of mycobacterial infections such as tuberculosis. It may also be used when an atypical mycobacterial infection is suspected.

The Acid Fast Bacilli is generally ordered on suspicion of tuberculosis. The most common symptom of tuberculosis is a chronic cough that produces mucus and sometimes contains blood streaks. Other symptoms of tuberculosis include chest pain, weakness, chills, fever and unexplained weight loss.


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White blood cells are an important part of your body’s immune system. They’re vital to protecting you from invading bacteria, viruses, and parasites. Your bone marrow produces all five of the different kinds of white blood cells in the body.


Each white blood cell lives anywhere from several hours to several days in the blood stream. An eosinophil is a type of white blood cell. Eosinophils are stored in tissues throughout the body, surviving for up to several weeks. The bone marrow continually replenishes the body’s white blood cell supply.


The number and type of each white blood cell in your body can give doctors a better understanding of your health. Elevated levels of white blood cells in your blood can be an indicator that you have an illness or infection. Elevated levels often mean your body is sending more and more white blood cells to fight off infections.


An eosinophil count is a blood test that measures the quantity of eosinophils in your body. Abnormal eosinophil levels are often discovered as part of a routine complete blood count (CBC) test.


Ongoing research continues to uncover an expanding list of roles performed by eosinophils. It appears now that nearly every system of the body relies on eosinophils in some way. Two important functions are within your immune system. Eosinophils destroy invading germs like viruses, bacteria, or parasites such as hookworms. They also have a role in the inflammatory response, especially if an allergy is involved.


Inflammation is neither good nor bad. It helps isolate and control the immune response at the site of an infection, but a side effect is tissue damage around it. Allergies are immune responses that often involve chronic inflammation. Eosinophils play a significant role in the inflammation related to allergies, eczema, and asthma.

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The number of neutrophils in the blood is expressed as absolute neutrophil count (ANC) and it measures the percentage of neutrophils in the differential WBC count. The ANC of a healthy individual falls in the range of 2,500 to 6,000 per microliter.

A total blood count gives the levels of the three types of blood cells - white blood cells, red blood cells, and platelets. Neutrophils are present in two forms – polys and bands. Polys are also known as segmented neutrophils and are the most abundant of the WBCs. Bands are also called stabs and are immature polys. Both polys and bands destroy invaders (i.e. microbes) in the body.

The ANC is calculated by multiplying the number of WBCs in blood by the percentage of total neutrophils.  For example, for a WBC count of 7000 per microliter, if neutrophils constitute 40% of the WBCs, the ANC in this case will be 7000 × 0.40 = 2800 per microliter.

An ANC below 1,000 per microliter is called neutropenia. ANCs less than 500 per microliter significantly increase the risk of infection. In cancer patients, frequent blood tests are performed to assess WBC count and ANC to monitor the body’s response to cancer treatment.

Neutrophils constitute nearly 55 to 70% of the total WBC count. Acute infections or trauma are the main triggers for production of neutrophils leading to elevated WBC count also known as neutrophilia or neutrophil leukocytosis.

In cancer patients, ANC is a reflection of the immunologic status of the patient in response to chemotherapy. This therapy suppresses production of WBC and hence neutrophils, thus increasing infection risks. Hence, a low ANC or neutropenia can be an indication of the need for reducing chemotherapy dosage or delaying the next sessions of chemotherapy. ANC also allows prediction of neutropenia-related events including fever after chemo­therapy sessions. It thus offers a clear picture of the patient’s immunologic status.

ANC helps determine the need for antibiotics or other measures along with therapy to decrease complications related to neutro­penia. While for an in-patient, a low ANC may be an indicator of the need to isolate the patient so as to protect him or her from exposure to infectious agents, in case of an out-patient, it can highlight the need to keep away from crowds or people having flu or colds. ANC is thus a powerful monitoring tool in cancer patients who are prone to bone marrow suppression due to radiation, chemotherapy, or bone marrow transplant.



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Most of the time blood is drawn from a vein on the inside of the elbow or the back of the hand. The site is cleaned with an antiseptic. The health care provider wraps an elastic band around your upper arm to make the vein swell with blood.


Next, the provider gently inserts a needle into the vein. The blood collects into an airtight tube attached to the needle. The elastic band is removed from your arm. The needle is then removed and the site is covered to stop bleeding.


In infants or young children, a sharp tool called a lancet may be used to prick the skin. The blood collects in a small glass tube, or onto a slide or test strip. A bandage is put on the spot to stop bleeding.


In the lab, the blood is placed on a microscope slide. A stain is added to the sample. This causes eosinophils to show up as orange-red granules. The technician then counts how many eosinophils are present per 100 cells. The percentage of eosinophils is multiplied by the white blood cell count to give the absolute eosinophil count.

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Approximately 85-90% of patients with myasthenia gravis (MG) express antibodies to the acetylcholine receptor (AChR), which can be divided into binding, blocking, and modulating antibodies. Binding antibody can activate complement and lead to loss of AChR. Blocking antibody may impair AChR binding to the receptor, leading to poor muscle contraction. Modulating antibody causes receptor endocytosis resulting in loss of AChR expression, which correlates most closely with clinical severity of disease. Approximately 10-15% of individuals with confirmed myasthenia gravis have no measurable binding, blocking, or modulating antibodies. This test was developed and its performance characteristics determined by ARUP Laboratories. The U.S. Food and Drug Administration has not approved or cleared this test; however, FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.


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Your pituitary gland is a pea-sized gland located at the base of your brain. It produces many types of hormones, including the adrenocorticotropic hormone (ACTH).


ACTH stimulates the adrenal glands, which sit atop the kidneys, to release two hormones: cortisol and adrenaline (also known as epinephrine). These hormones help you respond to stress in a healthy way and support your immune system. Cortisol is a steroid hormone that affects many different systems in the body, including your:


circulatory system

immune system

nervous system

bone metabolism

metabolism of nutrients such as carbohydrates, fats, and protein

Adrenaline, or epinephrine, is a hormone responsible for maintaining normal nervous system and circulatory function. This hormone, along with another hormone called norepinephrine, are responsible for your protective fight-or-flight response when you face a stressful situation.


Your healthcare provider might have you take an ACTH (cosyntropin) test if they suspect your adrenal glands aren’t functioning properly. This test requires you to receive an injection of cosyntropin, a synthetic portion of ACTH. You will also have two blood samples drawn — one before the injection and one after the injection. These samples measure the level of cortisol in your blood.


This ACTH stimulation test measures how your adrenal glands react to the ACTH in your blood. It does this by measuring your body’s cortisol levels. It’s important not to confuse this test with an ACTH test, which simply measures the ACTH levels in your blood.

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Alpha-fetoprotein (AFP) is a single polypeptide chain glycoprotein with a molecular weight of approximately 70,000 daltons. Synthesis of AFP occurs primarily in the liver and yolk sac of the fetus. It is secreted in fetal serum, reaching a peak at approximately 13 weeks gestation, after which it rapidly declines until about 22 weeks gestation and then gradually declines until term. Transfer of AFP into maternal circulation is accomplished primarily through diffusion across the placenta. Maternal serum AFP levels rise from the normal nonpregnancy level of 0.20 ng/mL to about 250 ng/mL at 32 weeks gestation.


If the fetus has an open neural tube defect, AFP is thought to leak directly into the amniotic fluid causing unexpectedly high concentrations of AFP. Other fetal abnormalities such as omphalocele, gastroschisis, congenital renal disease, and esophageal atresia; and other fetal distress situations such as threatened abortion, prematurity, and fetal demise, may also show AFP elevations. Decreased amniotic fluid AFP values may be seen when gestational age has been overestimated.

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Alpha-fetoprotein (AFP) is a glycoprotein that is produced in early fetal life by the liver and by a variety of tumors including hepatocellular carcinoma, hepatoblastoma, and nonseminomatous germ cell tumors of the ovary and testis (eg, yolk sac and embryonal carcinoma). Most studies report elevated AFP concentrations in approximately 70% of patients with hepatocellular carcinoma. Elevated AFP concentrations are found in 50% to 70% of patients with nonseminomatous testicular tumors.(1)


AFP is elevated during pregnancy. Persistence of AFP in the mother following birth is a rare hereditary condition.(2) Neonates have markedly elevated AFP levels (>100,000 ng/mL) that rapidly fall to below 100 ng/mL by 150 days and gradually return to normal over their first year.(2)


Concentrations of AFP above the reference range also have been found in serum of patients with benign liver disease (eg, viral hepatitis, cirrhosis), gastrointestinal tract tumors and, along with carcinoembryonic antigen in ataxia telangiectasia.

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The skin of the inner forearm is the usual test site for allergy testing using the Skin Prick Test method. One can also take a blood sample for allergy testing and measure Total Immunoglobulin E (IgE) which is the marker antibody for allergy sensitisation. Then there are the Phadiatop inhalant screen, Food Allergy screens and over 450 individual RAST or ImmunoCAP tests available.


We can quantify allergy severity with another cellular marker, this is the Eosinophil cell in the blood stream. Eosinophils are also found in the allergy sufferer’s phlegm, gullet secretions and nasal mucous. Lung function tests are important in asthma diagnosis, and tests include Peak Flow (PF), Forced Expiratory Volume in 1 second (FEV1) and Forced Vital Capacity (FVC). Measurement of Nitric Oxide (NO) in exhaled air is another measure of allergic inflammation and indicates poor control or ineffective treatment

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Alpha-2-macroglobulin is a protease inhibitor and is 1 of the largest plasma proteins. It transports hormones and enzymes, exhibits effector and inhibitor functions in the development of the lymphatic system, and inhibits components of the complement system and hemostasis system.


Increased levels of alpha-2-macroglobulin are found in nephrotic syndrome when other lower molecular weight proteins are lost and alpha-2-macroglobulin is retained because of its large size. In patients with liver cirrhosis and diabetes, the levels are found to be elevated.


Patients with acute pancreatitis exhibit low serum concentrations which correlate with the severity of the disease. In hyperfibrinolytic states, after major surgery, in septicemia and severe hepatic insufficiency, the measured levels of alpha-2-macroglobulin are often low. Acute myocardial infarction patients with low alpha-2-macroglobulin have been reported to have a significantly better prognosis with regard to the >1 year survival time.

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Under normal physiologic conditions, the usual daily dietary intake of aluminum (5-10 mg) is completely eliminated. Excretion is accomplished by avid filtration of aluminum from the blood by the glomeruli of the kidney. Patients in renal failure (RF) lose the ability to clear aluminum and are candidates for aluminum toxicity. Many factors increase the incidence of aluminum toxicity in patients in RF:


-Aluminum-laden dialysis water can expose dialysis patients to aluminum.


-Aluminum-laden albumin can expose patients to an aluminum burden they cannot eliminate.


-The dialysis process is not highly effective at eliminating aluminum.


-Aluminum-based phosphate binder gels are administered orally to minimize phosphate accumulation; a small fraction of this aluminum may be absorbed and accumulated.


If it is not removed by renal filtration, aluminum accumulates in the blood where it binds to proteins such as albumin and is rapidly distributed through the body. Aluminum overload leads to accumulation of aluminum at 2 sites: brain and bone. Brain deposition has been implicated as a cause of dialysis dementia. In bone, aluminum replaces calcium at the mineralization front, disrupting normal osteoid formation.


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Fatigue can be described as the lack of energy and motivation (both physical and mental). This is different than drowsiness, a term that describes the need to sleep. Often a person complains of feeling tired and it is up to the health care professional to distinguish between fatigue and drowsiness, though both can occur at the same time. Aside from drowsiness, other symptoms can be confused with fatigue including shortness of breath with activity and muscle weakness. Again, all these symptoms can occur at the same time. Also, fatigue can be a normal response to physical and mental activity; in most normal individuals it is quickly relieved (usually in hours to about a day, depending on the intensity of the activity) by reducing the activity.

Fatigue is a very common complaint and it is important to remember that it is a symptom and not a disease. Many illnesses can result in the complaint of fatigue and they can be physical, psychological, or a combination of the two.

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Antineutrophil cytoplasmic antibodies (ANCA) can occur in patients with autoimmune vasculitis including Wegener's granulomatosis (WG), microscopic polyangiitis (MPA), or organ-limited variants thereof such as pauci-immune necrotizing glomerulonephritis.(1) Detection of ANCA is a well-established diagnostic test for the evaluation of patients suspected of having autoimmune vasculitis. ANCA react with enzymes in the cytoplasmic granules of human neutrophils including proteinase 3 (PR3), myeloperoxidase (MPO), elastase, and cathepsin G. Antibodies to PR3 occur in patients with WG (both classical WG and WG with limited end-organ involvement) and produce a characteristic pattern of granular cytoplasmic fluorescence on ethanol-fixed neutrophils called the cANCA pattern. Antibodies to MPO occur predominately in patients with MPA and produce a pattern of perinuclear cytoplasmic fluorescence on ethanol-fixed neutrophils called the pANCA pattern.

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Your thyroid is a gland located in your neck. It releases hormones that control your metabolism. It produces a number of different proteins, including thyroglobulin. Your thyroid uses thyroglobulin to make the active thyroid hormones.


If you have an autoimmune condition, it can disrupt your production of thyroglobulin. An autoimmune condition happens when your immune system creates antibodies that attack your body’s own healthy cells. When your immune system attacks the thyroid, it often targets thyroglobulin. This causes it to produce antithyroglobulin antibodies. Your doctor can order an antithyroglobulin antibody test to check the level of these antibodies in your bloodstream. A high level may indicate an autoimmune condition

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Arginine vasopressin (AVP), or antidiuretic hormone (ADH), is a nonapeptide produced by the hypothalamus and released from the posterior pituitary in response to extracellular fluid hyperosmolarity and hypovolemia. AVP promotes concentration of the urine by increasing water reabsorption in the kidney tubules. Inadequate AVP action causes diabetes insipidus (DI), a syndrome characterized by nonglycosuric polyuria, polydipsia, and dehydration. Central DI refers to insufficient AVP release due to diseases of the hypothalamus, pituitary stalk, and pituitary gland. Nephrogenic DI is the result of impaired renal responsiveness to AVP and may be congenital or due to renal disease, hypokalemia, hypercalcemia, systemic disorders (eg, multiple myeloma and amyloidosis), or drugs (eg, lithium or demeclocycline and ethanol).


DI diagnosis is based on the presence of hyperosmolar serum with inappropriately dilute urine. Central and nephrogenic DI can be differentiated by measuring the plasma AVP level and interpreting it in light of the simultaneous plasma osmolality.


The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is manifested by hyponatremia and inappropriately concentrated urine. The diagnosis is confirmed by plasma or urine AVP levels inappropriate for serum osmolality.

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Abdominal ultrasonography, diagnostic paracentesis, and ascitic fluid cultures are recommended by the British Society of Gastroenterology, the European Association for the Study of the Liver (EASL), and the American Association for the Study of Liver Diseases (AASLD), particularly in the setting of supsected infection. [1]


Laparoscopy may be valuable for the diagnosis of otherwise unexplained cases, especially if malignant ascites is suspected. [6]  This may be of particular importance in the diagnosis of malignant mesothelioma.

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Aspergillus precipitin is a laboratory test performed on your blood. It’s ordered when a doctor suspects that you have an infection caused by the fungus Aspergillus.


The test may also be called:


aspergillus fumigatus 1 precipitin level test

aspergillus antibody test

aspergillus immunodiffusion test

test for precipitating antibodies


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Volume regulation and hemodynamic functions change during pregnancy, leading to marked increases in blood volume and cardiac output, peripheral vasodilatation and reduced sensitivity to angiotensin. Atrial natriuretic peptide (ANP) is intimately involved in fluid and sodium homeostasis and exerts marked relaxant activity on vascular smooth muscle pre-contracted with angiotensin. This study was performed to clarify the role of ANP as a regulator of maternal physiology.

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Hepatitis B virus (HBV) is endemic throughout the world. The infection is spread primarily through percutaneous contact with infected blood products (eg, blood transfusion, sharing of needles by intravenous drug addicts). The virus is also found in various human body fluids, and it is known to be spread through oral and genital contacts. HBV can be transmitted from mother to child during delivery through contact with blood and vaginal secretions, but it is not commonly transmitted transplacentally.

 

Hepatitis B surface antigen (HBsAg) is the first serologic marker appearing in the serum at 6 to 16 weeks following exposure to HBV. In acute infection, HBsAg usually disappears in 1 to 2 months after the onset of symptoms. Persistence of HBsAg for more than 6 months in duration indicates development of either a chronic carrier state or chronic HBV infection.

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B-type natriuretic peptide (BNP) is a hormone produced by your heart. N-terminal (NT)-pro hormone BNP (NT-proBNP) is a non-active prohormone that is released from the same molecule that produces BNP. Both BNP and NT-proBNP are released in response to changes in pressure inside the heart. These changes can be related to heart failure and other cardiac problems. Levels goes up when heart failure develops or gets worse, and levels goes down when heart failure is stable. In most cases, BNP and NT-proBNP levels are higher in patients with heart failure than people who have normal heart function.

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Beta-2-microglobulin (beta-2-M) is a small membrane protein (11,800 Dalton) associated with the heavy chains of class I major histocompatibility complex proteins and is, therefore, on the surface of all nucleated cells. The small size allows beta-2-M to pass through the glomerular membrane, but it is almost completely reabsorbed in the proximal tubules.


Serum beta-2-M levels are elevated in diseases associated with increased cell turnover. Levels are also elevated in several benign conditions such as chronic inflammation, liver disease, renal dysfunction, some acute viral infections, and a number of malignancies, especially hematologic malignancies associated with the B-lymphocyte lineage.


In multiple myeloma, beta-2-M is a powerful prognostic factor and values <4 mcg/mL are considered a good prognostic factor.


In renal tubular disease, serum levels are low and urine levels are high. Although urine beta-2-M has been used to assess tubular dysfunction, it is not stable in urine below pH 5.5.


See Laboratory Screening Tests for Suspected Multiple Myeloma in Special Instructions.

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This test looks for bilirubin in your blood or urine.

Bilirubin is a substance made when your body breaks down old red blood cells. This is a normal process. Bilirubin is also part of bile, which your liver makes to help digest the food you eat.


A small amount of bilirubin in your blood is normal. Healthy adults make 250 to 350 milligrams (mg) of bilirubin each day.

Bilirubin that is bound to a certain protein (albumin) in the blood is called unconjugated, or indirect, bilirubin. Conjugated, or direct, bilirubin travels from the liver into the small intestine. A very small amount passes into your kidneys and is excreted in your urine. This bilirubin also gives urine its distinctive yellow color.


This test is usually done to look for liver problems, such as hepatitis, or blockages, such as gallstones.

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Bilirubin is a yellow pigment that’s in everyone’s blood and stool. Sometimes the liver can’t process the bilirubin in the body. This can be due to an excess of bilirubin, an obstruction, or inflammation of the liver. When your body has too much bilirubin, your skin and the whites of your eyes will start to yellow. This condition is called jaundice. A bilirubin test will help determine if you have any of these conditions.


Bilirubin is made in the body when the hemoglobin protein in old red blood cells is broken down. The breakdown of old cells is a normal, healthy process. After circulating in your blood, bilirubin then travels to your liver. In the liver, bilirubin is conjugated, mixed into bile, and then excreted into the bile ducts and stored in your gallbladder. Eventually, the bile is released into the small intestine to help digest fats. It’s ultimately excreted within your stool.


Bilirubin attached by the liver to the glucose-derived acid, glucuronic acid, is called direct, or conjugated, bilirubin. Bilirubin not attached to glucuronic acid is called indirect, or unconjugated, bilirubin. All the bilirubin in your blood together is called total bilirubin.


A comprehensive bilirubin blood test will get an accurate count of all three bilirubin levels in your blood: direct, indirect, and total.


In both adults and children, symptoms related to high bilirubin can involve jaundice, a yellowing of the skin or eyes, fatigue, itchy skin, dark urine, and low appetite.

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A Liver Function Test, also known as LFT, refers to a series of tests carried out to gather information about a patient’s liver conditions. Certain diseases of the liver, which seem mild in their initial stages, can develop to become chronic later on. Hence, proper diagnosis of liver conditions is pretty crucial for the detection and control of these ailments in time.


Liver function tests are performed on blood samples of the patients, and check the levels of various enzymes and proteins present in it. There are enzymes that get released into the blood only when the liver has undergone some damage. While some of the tests are carried out for functionality, a few others may be performed to check the condition of the biliary tract. Cellular integrity tests are also included in the series.


Liver function tests (LFTs), are a group of blood tests that provide details about the liver and identify any inflammation, malfunctioning or damage to the liver. Liver tests may be done together in a panel or tested separately. The list of tests include: Total Protein Albumin Bilirubin (Total & Direct) Gamma-glutamyl transpeptidase (GGT) Alkaline phosphatase (ALP) Serum Glutamic Oxaloacetic Transaminase (SGOT) or AST Serum Glutamate Pyruvate Transaminase (SGPT) or ALT.

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Arterial blood gases (ABGs) are commonly used for estimating the acid-base status, oxygenation and carbon dioxide concentration of unwell patients. However, arterial blood can be difficult to obtain due to weak pulses or patient movement. Due to thicker, muscular and innervated walls, arteries are also more painful to puncture than veins. As such, a venous blood gas (VBG) is an alternative method of estimating pH and other variables.

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Blood typing is a test that determines a person’s blood type. The test is essential if you need a blood transfusion or are planning to donate blood. Not all blood types are compatible, so it’s important to know your blood group. Receiving blood that’s incompatible with your blood type could trigger a dangerous immune response.

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This is a blood test for brucellosis. Brucellosis is an infectious disease usually caused by handling animals or milk products infected with the brucella bacteria. If you have brucellosis, your body will make certain antibodies to fight the brucella bacteria. This test looks for those antibodies in your blood.


The brucella bacteria can infect dogs and livestock, including cows, sheep, camels, goats, and pigs. Recently brucella bacteria have also been found in ocean mammals, including seals.


The disease is rare in the U.S. Fewer than 200 cases are reported here each year. It's more commonly found in Latin America, the Middle East, and the Mediterranean. This is why it's often called Mediterranean or Malta fever. It's also called Undulant fever, Bang's disease, and Gibraltar fever.


If you are exposed to brucella bacteria, you may develop brucellosis. Your symptoms may not show up right away. But if the disease isn't treated after a few months, you may start to feel unusually weak. You may get a fever and chills, headaches, backache, muscle and joint pain, and sweats. You may lose your appetite and appear anorexic. If untreated, the bacteria can sometimes damage the heart, joints, or central nervous system. They can also cause infections that keep coming back. If you are pregnant and have brucellosis, it may cause a miscarriage or infect your unborn child. 

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The test is a simple method to identifying a person’s gender and establish sexual identity in newborns and in adults. Earlier the method was popularly employed in competitive sports to identify males masquerading as females. 


The mouth has to be rinsed and washed before the test. A spatula is used to gently scrape the inside of the person’s cheek. This can be done by a health care provider or by self. A smear of this buccal sample is made on a slide, stained and observed under the microscope.

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A BUN, or blood urea nitrogen test, can provide important information about your kidney function. The main job of your kidneys is to remove waste and extra fluid from your body. If you have kidney disease, this waste material can build up in your blood and may lead to serious health problems, including high blood pressure, anemia, and heart disease.


The test measures the amount of urea nitrogen in your blood. Urea nitrogen is one of the waste products removed from your blood by your kidneys. Higher than normal BUN levels may be a sign that your kidneys aren't working efficiently.


People with early kidney disease may not have any symptoms. A BUN test can help uncover kidney problems at an early stage when treatment can be more effective.


Other names for a BUN test: Urea nitrogen test, serum BUN

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C-peptide is a substance, a short chain of amino acids, that is released into the blood as a byproduct of the formation of insulin by the pancreas. This test measures the amount of C-peptide in a blood or urine sample.


In the pancreas, within specialized cells called beta cells, proinsulin, a biologically inactive molecule, splits apart to form one molecule of C-peptide and one molecule of insulin. Insulin is vital for the transport of glucose into the body's cells and is required on a daily basis. When insulin is required and released from the beta cells into the blood in response to increased levels of glucose, equal amounts of C-peptide are also released. Since C-peptide is produced at the same rate as insulin, it is useful as a marker of insulin production.


In particular, C-peptide testing can be used to help evaluate the production of insulin made by the body (endogenous) and to help differentiate it from insulin that is not produced by the body but is taken in as diabetic medication (exogenous) and so does not generate C-peptide. This test may be done in conjunction with an insulin test.





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The toxicity of cadmium resembles the other heavy metals (arsenic, mercury, and lead) in that it attacks the kidney; renal dysfunction with proteinuria with slow onset (over a period of years) is the typical presentation.


Breathing the fumes of cadmium vapors leads to nasal epithelial deterioration and pulmonary congestion resembling chronic emphysema.


The most common source of chronic exposure comes from spray painting of organic-based paints without use of a protective breathing apparatus; aut

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Calcium is an important mineral that your body uses in many ways. It increases the strength of your bones and teeth and helps your muscles and nerves function.


A serum calcium blood test measures the total calcium in your blood. There are several different forms of calcium in your blood. These include ionized calcium, calcium bound to other minerals called anions, and calcium bound to proteins like albumin. Ionized calcium, also known as free calcium, is the most active form.

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A calcium blood test measures the amount of calcium in your blood. Calcium is one of the most important minerals in your body. You need calcium for healthy bones and teeth. Calcium is also essential for proper functioning of your nerves, muscles, and heart. About 99% of your body's calcium is stored in your bones. The remaining 1% circulates in the blood. If there is too much or too little calcium in the blood, it may be a sign of bone disease, thyroid disease, kidney disease, or other medical conditions.

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Medullary thyroid cancer can be highly aggressive, especially if the diagnosis is done in advanced stages. Early diagnosis is based on RET genetic testing, for familial forms, and on the routine measurement of calcitonin (Ct). Nevertheless, since false-positive results can be obtained with the basal measurement of Ct, a provocative test to evaluate stimulated Ct is often needed. Pentagastrin which has been widely used to stimulate basal Ct, especially in European countries, is now hardly available. Thus, the stimulation with calcium (Ca), used in the 1970s-1980s and then abandoned for around 30 years, has recently elicited more interest. In the past 3 years, studies in patients and normal controls have demonstrated that the stimulation with Ca (2.3-2.5 mg/kg of elemental Ca, corresponding to 25 mg/kg of Ca gluconate) is highly potent and accurate. Novel gender-related cut-offs have been proposed for the Ca test, though the analysis of additional large series is predicted to modify these preliminary data. Finally, Ca seems to be the test of choice to stimulate Ct for the diagnosis and follow-up of medullary thyroid cancer, also because it is widely available, has a low cost and it is associated with a low number and intensity of side effects. In the present review the different methods to stimulate Ct and the cut-offs for the identification of the hyperplastic/neoplastic transformation of the C cells will be reported and discussed.

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Ceruloplasmin, a glycoprotein produced in the liver, carries or transports more than 95 percent of the copper in blood plasma.


Copper plays an important role in the body by aiding crucial bodily processes. These include producing energy, forming connective tissue, and helping your central nervous system function.


A ceruloplasmin test can determine the levels of ceruloplasmin in your body. It’s most often used in the diagnosis of Wilson’s disease, a genetic disorder.

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Chikungunya virus (ChikV) is a single-stranded RNA alphavirus and a member of the Togaviridae family of viruses. The name Chikungunya is derived from the language of the Makonde ethnic groups in southeast Africa and means "that which bends" or "stooped walk." This is in reference to the hunched-over appearance of infected individuals due to the characteristically painful and incapacitating arthralgia caused by the virus. ChikV is endemic throughout Africa, India, and more recently the Caribbean islands. In 2014, the first case of autochthonous or local transmission in the United States occurred in Florida. 


Humans are the primary reservoir for ChikV and Aedes species mosquitos are the primary vectors for transmission. Unlike other mosquito-borne viruses such as West Nile virus (WNV) and Dengue, the majority of individuals who are exposed to ChikV become symptomatic, with the most severe manifestations observed at the extremes of age and in those with suppressed immunity. Once exposed to ChikV virus, individuals develop lasting immunity and protection from reinfection.


The incubation period, prior to development of symptoms, ranges on average from 3 to 7 days. Infected patients typically present with sudden onset high fever, incapacitating joint pain, and often a maculopapular rash lasting anywhere from 3 to 10 days. Notably, symptom relapse can occur in some individuals 2 to 3 months following resolution of initial symptoms. Currently, there are no licensed vaccines and treatment is strictly supportive care.

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